Up HIll Battle

I’ve noticed lately that I’m dealing with a new set of emotions/feelings towards T1. I’m not even really sure what I would call it, maybe indifference? I really don’t know. So let me explain….

In the last couple of days insulin resistance is making it’s lovely appearance and showing its ugly head. I thankfully haven’t really been feeling sick or bad because of the high BGs, just the constant peeing almost every half hour it seems like and guzzling what feels like gallons of water. I do get really upset about these numbers and the fact that a 150  would be a beautiful number to see. Then, that anger fades to indifference and I figure I can’t do much other than the constant checking on Lexie’s screen (my Dexcom CGM) or doing a finger stick and checking on my meter to confirm the 200 something number is correct and then do a correction bolus if I don’t have too much insulin on board.

With all of this being said, I feel like it’s a constant battle raging on inside me lately trying to get to safer numbers. I guess that’s the best way to put it. I think that’s why I feel like when it comes down to it I just don’t have much fight left in me lately for anything other than trying to keep my BGs in a safer zone, nothing else seems to matter and it all seems so petty. Even other diabetes/health related things.

 A couple examples…..

I know I should really be putting up a fight on this one, and when it happened I was UBBER pissed, you can ask my husband. I still am but at the same time I’m shrugging it off. This stunt the insurance company pulled is a totally load of BS and I know I should have been on the phone with my insurance company right off the bat after the long weekend, but I haven’t and at this point, I don’t know that I will. Since my insurance changed I had to get a new script for test strips. I emailed the mail order form to my CDE, she had the doctor take care of it and I had just been waiting. They sent it in on the 8^th, I called on the 22 to check and confirm that everything was fine, no issues, that they would cover the strips and that all was good that it was only taking so long because I’m a new customer and it’s a new prescription. I was told that there were no notes in their system, it was just being processed and that everything was fine and yes it was only taking a while because it was a new prescription. Blah blah blah…. It would ship out on the 28^th. Saturday the 24^th the mail came and so did my strips, but not the ones my doctor sent in the script for, not the ones that I use!!! On the RX stickers on the boxes it clearly says to use in place of Contour Next! OMG! I guess the money hungry, having no idea about the actual individual’s health or care a bit idiots over there think that I just want to use a fancy digital meter, they don’t stop to think that there is a legitimate reason that my doc prescribes these, which is because that meter talks to my pump! Ugh! Not only that, no courtesy call to say or even ask if I have the One Touch Verio the meter that goes with the strips they sent. (I did happen to get a free one at a JDRF function but they don’t know that! That’s beside the point!!! I don’t like that meter, I like the one that I already use.) What if I didn’t have that meter, what if I didn’t and then I was down to my last couple of strips?!  So I did call on Saturday, but of course it was the weekend and no one was in to take my call. As time has worn on I’ve just mentally shrugged my shoulders and said what the heck?! They suck, it’s not fair that they won’t cover the ones that I’ve been using. It’s not fair that I already have to live with this chronic illness on a daily basis that is wearing me down not only physically but emotionally and mentally, between insurance companies, doctors offices/staff, and medical companies hardly any of them ever try to make life easier for a diabetic. Since the change with insurance companies in March it's been nothing but a head ache and I'm so done with it! I don’t have the fight in me to do anything about it, so I let it go.

 Instance number 2…

 I have a no animals in my car rule. I know, hate me all you want but I’m not an animal person. I’ve never allowed the dog in my car, we always take my husband’s car if we take her with us some place. Hubby doesn’t like it, and it turns into an argument every time. He thinks I’m evil for it. Not really. Anyway, we were going out to a friend’s farm for the holiday weekend and instead of trying to find someone to stay with her we brought the dog with us. Brad insisted that we take my car and that it would be fine to have the dog in it. I griped a little and then became indifferent. I know in the long run now I have hurt myself because in the future I’ll have to allow the dog in my car, but right now, I just shrug.

There have been a few other instances along with these, but I won't get into all of them. Times when I would usually put up a fight for what I believe in or what I want/think I need, but I just grumble a bit, and then give up. I have nothing in me to push me to fight for what I really want or deserve in situations right now. I'm praying that I don't eventually end up exploding, especially on my husband. If that were to happen I have to admit it would probably be something totally stupid and little that I would flip out about.

On a positive note, the hell pills, Letrozole, along with the insulin resistance that they are causing, the increased dosage this month did cause me to ovulate!!! Yippee!

Insulin Pump VS. MDI (Multiple Daily Injections)

Insulin Pump vs MDI (multiple daily injections)

 

Since going on a pump vacation last week I’ve come up with a list of pros and cons between being on the pump vs doing MDI via insulin pens. I’m emphasizing that I’ve only ever used insulin pens in the almost 6 years since my diagnosis because I can’t compare to having to deal with vials and syringes.  

Cons-

Pump-

Always having a battery operated pancreas attached with the exception of showering or swimming.

MDI-

Bruises and dots in my tummy from the 5 times a day giving injections. I’ve forgotten how that can happen especially when getting back into the habit of how to do injections again.

Pump-

While swimming always having to check hourly on BGs and reattach and program pump to give the amount of insulin I would be getting during that time I’m disconnected from it.

MDI-

Forgetting about the heat and leaving insulin pens in a place of extreme heat causing it to gel/become less potent and BGs to in turn rise and not be able to come down for hours on end. (In my case it was an extremely hot car for about 2 or so hours and it took 12 hours for the light bulb to kick on before I realized why I couldn’t get lower than 290’s.)

Pump-

Tubing that gets tangled on door handles or other odd ball things you would never think of and pull infusion site from their snug place on your physical being.

MDI-

Remembering to give injections every 12 hours of slow/long acting insulin.

Pump-

Trying to wear dresses/skirts/fitted clothing/work out clothing/anything without pockets. There are only so many places to try and hide the pump when wearing any of these things and none of those places are convenient or discreet places to get to or do so.

MDI-

Having to always carry or have my insulin pen nearby in case I want a snack or meal.

Pump-

Even more supplies to store: infusion sets, reservoirs, batteries.

MDI-

Having to use long acting insulin which is therefore already in my system so when being very physically active I end up dropping and having to consume unwanted calories and eat more fast acting glucose of some kind.

Pump-

Extensive cost of pump itself and all the supplies including insulin to go along with it.

MDI-

Not being able to use temporary basal rates for high fat content or slower acting carbs; work outs/extensive physical activity.

 

Pros-

Pump-

There really is more freedom to snacking and eating because the pump is just there and does some of the thinking for me and there is no searching around for an insulin pen. Just program and enjoy. Same goes for correcting high BGs.

MDI-

Freedom to wear whatever I want and not feel frumpy or frustrated that there is no place to put a bulky battery operated pancreas with long tubing.

Pump-

I don’t have to dig around my purse searching for my insulin and then when in public people don’t see me shooting up.

MDI-

No remembering to reattach to something after showering or swimming.

Pump-

Middle of the night high corrections are so much easier.

MDI-

Sleeping without an attachment is so nice!

 

MDI-
No having to stash a pump in a cool dry protected place while at the beach. No worrying about sand or water or anything else damaging a very expensive medical device.  

 

I know my Pros list isn’t as long, but I think you get the picture of the Pros under my Cons list as well. I’m not really sure that one outweighs the other in my opinion. They are the choices I have in order to stay alive, I’m thankful that I have had the opportunity to be on the pump for the past 15 months. As hard as it was adjusting to it in the beginning I have learned to like it, to an extent. If I stay on it or go back to MDI when the warranty is up in 4 more years, we will see. That all depends on where we are at with having kids and of course financially. I have to admit that I almost cried when I reattached to my pump after vacation. It was bittersweet.

A Work Out's Never Just A Work Out

For a diabetic,  a type 1, a work out is never simply as easy as just working out.  A run is never just a run and a walk is never just a walk.

I have to have a fast acting sugar source with me so I stashed fruit snacks under my laces before my walk/run.

Must check bgs to see if they are matching my CGM and if I need to eat a snack first.  Also use a temp basal on my pump so I'm not getting my normal dose of insulin.

2.2 miles brought my bg down nicely.  I did check my meter to confirm that Lexie my cgm was giving me the correct info and she was.  Don't judge me for my slow pace and distance!  I've never been a runner and yesterday I incorporated quite a bit of running into my walk and today I was hurting. But I thoroughly enjoyed my time outside and the beautiful weather.  Thank God it's spring!

Hot Hot Heat!!!

Our first few days of vacation we didn't need to worry about the heat.  It was cooler than we expected and we spent the days at an elevated level hiking in the mountains where it was cooler and windy. I already wrote about my lows from those days in my last post.  Due to those days I didn't think about the heat in the car yesterday where I kept my insulin in my purse while hiking Valley Of Fire National park in the morning or the fact that I could be hitting the beginning stages of insulin resistance the last couple of days of vacation. I'm thinking it's a combination of both that I delt with last night into today.  We headed back to where we were staying about 1:00 or so in the afternoon. I was dealing with lows off and on from then until about 6pm. During that time I also developed an awful head ache from the heat and sun and car sickness from the 1 1/2 drive.  I went to bed at 2:30 in the afternoon because of these symptoms. My last awful low was about 5pm and then I started to climb.  After that I spent the next 12 hours between 220 and 395 and would not come down.  I was amazed how I was able to stay in bed from 2:30pm yesterday to 8:00 this morning with maybe getting up for a little over an hour to eat dinner last night. Of course high bgs can do that for me.  It's was finally at about 6 this morning that it occurred to me that my insulin was probably not at its optimal use.  Then after still changing it then it's only been the last couple hours that I've finally dropped below 150. Live and learn right?  Each day is another day to experience a lesson with my body,  sometimes scary,  sometimes I feel like I am the strongest person I know and I reward myself with a sweet treat.  Others days I feel totally defeated and like I must be missing something and the guilt piles on.  But I'm thankful for the opportunity for this vacation,  it's given me the umph I've needed to face every day life again and I've gotten to conquer some pretty big cliffs literally that have encouraged me to press on and conquer my daily challenges.  I also really want to look into our next vacation being a hiking/mountain vacation.  It's reminded me how beautiful life really is and that as scary add it can be,  that the Lord is in control and that He's got this.  No matter the out come, it'll be okay.  Now if only I can remember that on a daily basis.  :)

Vacation Lessons

This vacation was not the laid back relaxing vacation that I've always taken. I'm not complaining whatsoever,  its been amazing. We hiked Snow Canyon National Park in UT on Sunday.  Monday we hiked the mountains in Zion National Park UT and Tuesday we walked Hoover Dam and then the Las Vegas Strip.

So far going pumpsles and back to injections for this week here is what I've learned.

Need For Sugar
It hasn't mattered that I haven't been taking the amount of insulin that I would usually need with a meal,  I still end up eating 2-5 packs of fruit snacks during our hikes after lunch. By dinner I'm low enough to need another snack before eating dinner and even then I have still dropped each night after dinner. Thursday we plan to go to either the Grand Canyon or Bryce Canyon so since I've gotten a little too low at times and almost been caught without enough sugar of some kind I'm not letting that happen again.  I will be prepared.

There Is A Difference Between Novolog And Humalog
Before going on my pump I used Novolog insulin pens.  Then when I went on pump I changed to Humalog because it was cheaper.  I don't know if I would have noticed a difference without my Dexcom but going back to my Novolog pens I'm seeing a noticeable difference in that my highs don't last as long and I seem to come down smoother on Novolog than on Humalog that I use in my pump.  I'm sure that all this extra activity has helped with the highs but I can tell that there is a difference in insulin types.

Patience With The15/15 Rule
I don't know that I've really learned a lesson here.  Last night after dinner sitting pool side with a glass of wine Lexie my Dexcom CGM starting warning me I was low. I had been feeling something for a while but thought it was the wine.  Thank God for Lexie!!! I looked at her screen, she said I was at 59 I think so I did a finger stick to confirm and I was 34 according to my meter! I grabbed a huge glass of juice because I know red wine tends to drop my bg. I didn't feel this 34 the way I felt a 52 at the grocery store our first day here.  That 52 actually felt scarier.  About a half hour after the juice I was 100, but around 12am I was back to dropping again and between the famished feeling of the 56 low and the fear of going to bed and Lexie not catching a low in time I way over did it this time. After 1 pack of fruit snacks,  a glass of juice and a granola bar,  (I already admitted I over did it! ) I went to sleep and woke up a couple of hours later to Lexie alarming me that I was 188 with two straight up arrows.  I did a correction of insulin,  went to sleep again to wake up at 4am hanging around 292. More insulin,  sleep and waking up at 7am to 225 still.  More insulin,  trying to fall back to sleep but unable to because I had the nasty high bg mouth feeling,  sinus congestion and soar throat.  Those are the typical symptoms I get with hours of a high bgs. Well,  at least I hadn't gone terrifying low in the middle of the night right? 

After a night like last night I'm glad to have a relaxing day by the pool today.

Meter Errors, Mishaps, Taking Breaks and Facing My World

It’s been a little bit since I’ve written, but not much new. Hormones still messing with blood sugars, now Dr. O is increasing my dosage for the “Hell pills”, if they don’t seem to make me ovulate in May then I’m to go in for an ultrasound again to see what the dealeeo is.

In other news….

I had a meeting today at work with some clients and we ordered in  lunch, this ended up with a couple of issues for me and “D”. First, I took my insulin too soon, I thought we had wrapped things up and were going to be ready to eat, but they kept talking and asking questions before they were ready. Once we did finally decide to eat, while going through the orders we found that there were two lunches the Panera forgot. I’m the one that had placed the order online so I called about the order to let them know about the missing lunches. I was on the phone for a few and I could feel I was getting low, which I had known for a while. One of the guys stepped out of the conference room to check and see how things were going with getting the missing lunches and since I was on hold I asked him to grab me one of the cookies that was in there. These are GINORMOUS chocolate chip cookies and I scarfed the entire thing! After getting things squared away with having the lunches delivered I got out my sheet I had printed off with the nutritional info and found that the cookie had 58 grams of carbs!!! Good grief that was more than my meal should have been!!! My half of a Caesar salad and grilled cheese sandwich was only 45 carbs so I had to add additional bolus to make up for the other 13 carbs I had just consumed. That still didn’t help because I went from being 65 and then when I finally did eat my lunch I guess I didn’t give insulin soon enough because then I hung out in the 240 range all afternoon. Fun times I’m telling you.

 Oh, and I forgot this. Really wish I would have taken a picture but before I stepped into my meeting I checked my BG to make sure everything was all good and I got an error on my meter that I’ve never seen before. Something along the lines that the reading was below 20mg/dl and to check with health care professional right away. My Dexcom CGM was showing I was at 149 so I checked on my One Touch meter which I keep as back up and it showed I was at 93. Stupid, three different readings all totally different and not even slightly close to each other. I retried on my original meter and it read 93 just like my back up. When I first saw the error message I scared a co-worker because I made a loud surprised noise and said something about according to this I should be close to dead. Yeah, I know I’m real sensitive about what I say out loud when it comes to this stuff.

 

Now...Since I know for a fact that I’m not pregnant and will not be getting pregnant next week while on vacation……… Drum roll please!!! I’m taking a pump vacation!!! I’ve decided! I need one! With everything going on lately although I cannot take a vacation from diabetes I am taking a break from my battery operated pancreas! I need to not have something attached to me with tubing for a while. I’m still debating on my Dexcom, I’m partially afraid I’ll stress myself more having just that and not my pump by seeing my numbers constantly if I’m running higher than usual. I of course will test a lot, but I need to take a step back and enjoy things. I’m just getting too uptight with all this management and trying for perfect baby making numbers. I have quite a few insulin pens left from before my pumping days and the pens don’t expire until I think July of 2015 so why not get a little use out of them?

 I just saw recently that next week is diabetes blog week and as much as I enjoyed participating last year I’m undecided if I will participate this year. I’d like to and I’m not sure that if being on vacation at the same time if I will have more time to blog or less. I’ll be bummed to miss it, but at the same time since I’ve kinda needed to take a step back from things I’m feeling the same about blogging and reading blogs and pretty much anything diabetes related. I’ve not read in quite some time the three books I have, “Think Like A Pancreas”, “Balancing Pregnancy With Pre-Existing Diabetes” or “Balancing Diabetes”. I am in the middle of all three, have yet to even come close to finishing them.  All of which I know are fantastic books but I’d rather clean, garden, be outside or watch a mind numbing TV show or movie than read more about something that I already can’t ignore but really wish I could. I know that all three of these books have wonderful info that would totally help me, but I just don’t feel like picking them up to read lately. Hopefully this vacay will be just what I need to get me back on track and when I come back I’ll be refreshed and ready to jump back into everyday life head on and ready to face my world with everything in it!