And I hate the stuff
The New York Times > Health > Wakefulness Finds a Powerful Ally
I find it elevates my blood sugar and makes me feel like a zombie.
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The New York Times > Health > Wakefulness Finds a Powerful Ally
I find it elevates my blood sugar and makes me feel like a zombie.
I see him tomorrow and I've been dreading it.
First, I have found out that Sleep Med has not been paid by Blue Cross Blue Shield because the doctor has not provided proof of medical necessity.
So that's MY first issue on the books.
The good news, is that my scale shows about a 5 pound weight loss since I was there last. I'm QUITE sure that won't be enough for him, but screw it. It's my health, it's my body, and I'm doing things MY way.
I lost weight fast AND it didn't stay off. I am losing weight slow now, and I want this to be the last time I am at this weight.
He wants me to go for bariatric surgery, but if he can't provide the medical necessity for CPAP equipment, how can I even imagine he'll help through that process? And I don't want to go there. I am watching someone go through the recovery right now, and I'm sorry, I think I feel better and I think I look better. At least I have my hair! Maybe that sounds vain, but to me, good hair is a sign of good health. When I'm not sleeping well, my hair is an absolute mess.
But the good news, is that I see my CDE the next morning.
Cutting Back on Medications Has Adverse Effect on Health Status
There are lower cost alternatives to some of the meds I'm taking, but so far, they just aren't as effective.
For example, I could go from fast acting insulin to regular. Instead of a 2 hour delay, there would be a 4 hour delay. AND I've used that insulin, and it is really hard to manage things with it.
I had to do a fasting blood test this morning for the diabetes doctor and since I was already fasting, decided to make it into a basal test.
I keep hoping that my basal rates will decrease, and while today wasn't completely normal, it seemed as good a time as any.
I did have a big dip but my glocuse level popped back up 30 minutes later. The rest of the time -- and I ended up being to do the basal from 7:30 - 11:50, my glucose level was stable enough that I don't need to mess with anything.
I'm going to discuss it with the CDE, but I think we just need to leave things alone until after school starts.
The quick note was left because I had received a few emails asking if I had gotten back.
The trip itself was a success. Nothing happened I couldn't handle, and I did manage to get all of the supplies with me. The two things I forgot -- dog food and shoes -- were easily replaced. Actually I didn't bother to do anything about the shoes.
I was able to maintain my weight while I was gone. Still with the same very slow but steady weight loss.
I did have some eating issues on Sunday, I think that was the stress from not doing well at the show, the stress of the drive, it was raining most of the drive and severe rain for a short period of time. Since I've gotten eating problems down to about once every week and half, I think I am doing well on that. I would like to get that to even lower, but if I work on it too hard, it aggravates it.
So the trip was a success, even though the agility trial itself wasn't.
Right now, those courses are just too long for me to do well on. But I am not giving up yet.
I did get back safely. Just too tired to post or deal with anything besides unloading.
And have to hit the ground running this morning.
Well, we didn't do well today. I feel good about the first course, but she didn't do ANYTHING right, not even the things she is good at. She even left off the stay at the start!
The JWW run was better, but I blew that one. I didn't know the course well enough as I expected to be blown off again, but she was with me.
Traveling itself is going well. I would have done fine with out the food, I think, but it was nice having a good dinner waiting for me. And having breakfast here was nice too.
I'm going to plan better on food next time. Lunch was something that needed to be heated, so I left it behind. I ended up eating consession food instead.
I didn't think to bring the book I was reading, so I picked up one I've already read. I didn't MEAN to, but that's okay. It's easier that way, and I don't remember how it ended.
Oh, and I dropped my blood sugar monitor in the dog's bowl. I'm having a real problem with the case provided by Therasense for my monitor. The monitor slides right out of the case when I get strips out of the test strip container. How it managed to land in the water bowl, I have no idea.
It's not a real problem -- I have a spare. I immediately took it apart, and shook out all the water I could. I have it drying out now. I did this with a cell phone and it survived so we'll see.
I need to remember to use test solution to check it.
But at least she is well. She's had a pulled muscle at class right before Memorial Day and then an ear infection and a hot spot right where her collar sits.
So now I am on my first trip away from home with an insulin pump. I am in Monroe, LA with one beagle, and we're entered in an agility trial here. I have a NICE hotel room, Holiday Inn, and it's a suite room. I found years ago that helps the sleeping problem.
I did notice that my blood sugar was a bit elevated driving. It makes sense, since you aren't moving around much and people driving around you do goofy things on the road. I also had some edges of thunderstorms and some road construction to deal with.
Not eating sugar as I went wasn't hard. A bad habit my father taught me -- eat sugar to stay awake. FYI: It makes diabetics sleepy. This is NOT a good thing.
I ended up eating fried chicken and salad on the road instead of Diet Gourmet when I got to the hotel, but the calorie level worked out fine. Maybe a touch over.
I only woke up once, and my blood sugar was a tad high. It was low when I went to sleep -- 125 and the last time -- Wednesday -- it was that low, I woke up three times and had to treat it. Instead I ate a Snickers minature without insulin. Thus I was a little high when I woke up too. I treated the high with a half insulin correction since right now I'm on my dawn syndrome basal.
I did leave the dog food and my running shoes behind -- it was starting to storm and I wanted to get out of town before it did. Luckily I only managed to get hit by the leading edge. Stopped and got dog food in south Dallas, and will deal with the shoes sometime today.
Free food isn't really free. I would have done MUCH better if I had brought my own food.
I still lost weight though. We'll see if I maintain that over the weekend. I just had to feel a bit deprived in the evening. I probably could have eaten half -- but it's a mind set thing. Once you figure out how much insulin, and administer YOU have to eat whatever you decided.
My basal rate is probably a bit high for a normal day for me. We will see over the weekend.
I am making my first trip and going to be away from home for the first time since the pump.
My "day" pack already has enough supplies in it for a week, so that should be fine. I've packed clothing, taking my electric cooler -- LOVE this thing, and will be packing CPAP and meds in a bit.
I'm going to take an extra vial of insulin -- just in case.
Big dog and I are going to an agility trial in Monroe LA. I may do some other out of town agility trials if this goes well.
I've done everything I can to make it convenient -- suite hotel, fridge and microwave in the room, free breakfast buffet, taking the food, and high speed internet access -- all the comforts of home. Probably won't do much of that on later trips.
The LAST trip I made, I did the same type of thing. No dog, first time on insulin injections, and did the "suite" hotel thing.
So wish us luck. I'd like to get an Excellent leg. We've been an obstacle short for a time.
I was going to push back my sleep doctor's appointment because I just knew I would gain weight this week. Face it, sitting all day in the same chair for 4 1/2 days does not burn calories. HOWEVER, I'm wrong. Something has happened because this morning I weigh 5 pounds less than I did on Sunday.
I'm not counting it as "real" weight, since it hasn't shown up on Sunday morning, but it is encouraging.
It worries me. I haven't been pleased with either Caremark or Medco. Insulin handling with both are stressful, though Caremark was a bit more considerate.
DB's Medical Rants » Patient’s rights and managed care
And of course, this is one that I'm going to be on the side of -- if the doctor orders, the insurance company should pay.
I feel 100% better because of my pump. The cheaper alternatives just weren't doing it for me.
Insurance should cover it.
There is a deal going on now -- the insurance company denied a claim on a CPA machine because my doctor didn't show medical necessity. Who requests a CPAP machine for someone who doesn't need one?
Okay, the true issue is that my CPAP machine was over 5 years old and we all agreed it needed to be replaced since the newer technologies have compliance information and apnea information.
The rest of the issue is that the insurance companies tend to deny new masks unless the doctor's have proof that the patient is compliant. Bit of a catch 20/20 here. At least we're talking $600 and not $6000.
I'm surviving.
I did the BEST thing I could do today, I took "big dog" to agility, just her and I to an advanced class. She is feeling well enough to compete this weekend, even if she does have a punk beagle haircut.
This will give me the choice to skip her class tomorrow evening if I am tired. Though I probably won't.
It was very nice for her to have her mom to herself, and have a "fresh" handler. She's had to deal with a tired handler, and one with low blood sugar at that -- I'm still fighting the lows.
I woke up feeling funny three times last night, but my blood sugar was low when I went to bed. No danger of that right now, 186!
1 and 1/2 days to go, and then I'm off to the dog agility thing.
If you don't care to go back to the archives, a short recap ....
My doctor and I decided that I should go on the pump because I was gaining weight on MDI and had what I felt was inadequate control with shots.
It was the right decision, but the idiot HMO said, NO, you have to throw all the diabetes meds in the world at her in combination before we'll approve it.
I'd had my full of diabetes drugs after the first one, and besides, insulin really is better and the pump is the most efficient way to deliver it.
And by the way, I've been steadily losing weight again.
Family Medicine Notes: Psychiatry Archives
Any time I get frustrated with my doctor or insurance I'm going to go back and read this.
So far, none of our lunches have been under 1000 calories, and I shudder to think what the snacks have been (I skipped the snacks).
Don't get me wrong, it's GOOD food. Yesterday was a box from Jason's Deli. Good food, but when I entered it in iShape, it totaled over 1000. I've been averaging about 600 a meal lately, so that's been different.
Today was Taco Cabana. Again, good, but adding it all up, 1200 calories! Slow carbs too
I'm still "clean eating", but it isn't going to be easy this evening. I've also managed to workout. Though tomorrow I have to force myself to get on the treadmill, or I won't make it. Same goes with either Thursday and Friday. I've been doing the workouts in the afternoon but I've got dog agility both evenings. Decided to "spoil" Marcie and let her have a dog agility night to herself for a change.
Survived yesterday. I am convinced though that I turned down my temp basal instead of up, but have not proof. I have asked Animas yet again, to provide that information.
By surviving, my weight is less than it was yesterday morning, and my blood sugar was at 108. Kind of wish I'd switched to the exercise basal, and I really had time to walk even though I didn't but I am having heel spur problems.
I can always walk afterwards anyway. And I probably need an off day after the 55 minute walk yesterday.
--
On the friend's job -- well, she took the SS early retirement. Which I am very much against, it never should have been available anyway. I've never really understood the whole thing, but she ends up with $827 more a month, and supposedly can get her job back. Supposedly they have to post it. Okay, right now, I'm not believing much of what she says since she spent so much time and energy lying to me, and what was the point? It really wasn't nice to freak me out like I was yesterday.
But it doesn't change. The things I like about my job are staying the same. The things that bother me, change and always do. I like the neighborhood kids. I would even consider living in that neighborhood, if it wasn't in Dallas, and didn't have Dallas services and politics. We live in a suburb with a less than 5 minute response time on emergency services, and a city council who runs things and doesn't drive people nuts.
Funny, but when I really analyze what is going on, it gives me more time in the classroom and more time to concentrate on what matters. Teaching 5 preps -- the norm for me -- is hard. One class never gets my attention. 6 was worse, two didn't. I'll be down to 3 preps, and I will be able to spend lots of energy on PreAP which is where I should concentrate. A good PreAP program will make a really strong AP program which is what people want.
I get paid pretty well for a teacher. I consistently take home $45000 a year, and may top that this year. I get lots of time off, after this workshop, I'll actually have summer -- I still have 2 days of staff development in July, but I understand most of that is on line.
They are paying for a master's degree and I'll have the majority of that work done soon. The classes I'm taking are pretty easy, more paperwork than anything. Most of that is online too.
So why change?
And I'm going to walk in and turn up the basal to 20% (not down) and test all day. And get through another workshop day.
I've been meaning to blog about my bolus rates. It's been pretty interesting. When I first started I saw fluctutions, my total daily dose swung widely, and I thought I might even end up at a 1:12 ratio but each day the average usage got closer and closer.
Right now I'm consisent around 45 units a day with fasting blood sugar at under 110. My post pranial is in the mid 130s.
moblogged with Treo
Actually it pertains to me. The people that I have trained agility with have noticed that Marcie (big beagle), often "stops" me from running when I am not feeling well. Often when I was having GERD related asthma, she would actually stop and urinate to get me to stop.
Last Thursday night my blood sugar was a tad low and she wouldn't work.
And tonight, my blood sugar was also low while I was on the treadmill and she insisted that she HAD to go out now.
Seeing as how I came close to dropping a pickle jar on her last year when I was low (yes, I dropped the jar, missed the dog), you can see why she might learn to stop me when low.
The New York Times > Health > Vital Signs: Behavior: An Epileptic Child's Best Friend
AMNews: June 28, 2004. Bariatric surgery patients need care for a lifetime ... American Medical News
Another reason(s) to resist bariatric
surgery.
My sleep doctor is really pushing it on me.
PalmOne reports profitable quarter | CNET News.com
PalmOne reports profitable fourth quarter.
This is good since I sort of survive on my Palm.
Mobile blogging isn't quite working.
Neither was my blood sugar. Sitting still all day made it go high. I finally got it in the right range, and then had trouble keeping it high enough.
I'm hoping to try working out in the morning, and a 20% temp basal and see have that works.
Someone who hasn't seen me since right before the diabetes diagnosis commented that I appeared healthier and more animated now than I had appeared before
I think this is a good thing.
as predicted, sitting still isn't good for blood sugar so I upped my temp basal by 5% -- of course I won't see a difference for 2 hours and we have to eat in that time period.
Well so far this has been fun. I found out the a friend's position is "open" and it's one I would like to apply for.
Several problems:
She'll be a bit difficult to be around if I do.
Insurance is supposed to be better
I'm three years from incentive pay and I'm in the middle of a master's degree.
She puts in a lot more energy than I do.
I think the pay is less.
So I don't know
I hate them. 4 1/2 days of sitting still and the presenter pours a years worth of data into your head. its hard on the blood sugar too.
they provide lunch and it will be interesting to see what we get. breakfast was jason's deli. carb fest! I had have a muffin.
... moBloged so pardon the lack of caps
One of the reasons I got my pump was Sunday mornings....
Sunday is my alone and quiet time -- I do do my laundry, but I do everything at the speed I want to do it in...
I "sleep out" which means to me, sleeping until I want to get up. Sometimes I sleep until noon, sometimes I'm up before 8:00. I piddle, I do what I want to do on my time. I even ignore my dogs.
Back in the MDI days, that's when I would hit low the most often. Terrifying times, fortunately I had a nurse line I could call to get help.
But today ... I didn't get up until almost 8:00, I didn't eat until almost 9:00, I took about two hours to get my work out in, and I haven't even finished the first load laundry yet.
But my blood sugar has been constant all day until lunch. Between 104 and 115. Not bad.
I think I have a basal and bolus rate that is working. Though next week will be interesting since I'll be going to a teacher workshop -- TEST TEST TEST. I usually have to do a 10%-20% temporary increase because we're sitting all day.
Anyway, I'm losing weight gradually, I'm keeping a fairly consistent insulin rate -- between 40-50, mostly around 45, and my blood sugar is at under 115 fasting, rarely over 150 -- and then usually 2 hours after a unknown meal. If I eat a meal that I have a reliable count on, I'm in the 130 range 2 hours after a meal, something I can live with. If I'm in the 120 range, I usually hit low if I don't eat something then. I'm trying to eat every 4 hours, not every two. My GERD is better than and so is my weight loss.
It's been almost two weeks since the last bad eating day. This one was better. I woke up with "normal" blood sugar for me, so I did correct it correctly. I only needed 50 units of insulin, rather than 73 units the last time -- and didn't get the blood sugar down where it was supposed to be with the 72 units.
My biggest problem was in the afternoon. I'm not sure why, but I was craving sugar bad, and ate more lifesavers than I usually do.
I also ate two fairly high in carb items in the evening -- at least one more than I planned for in my calorie count.
I'm having some carb lockup in the afternoon, I did yesterday before the lifesaves, and today after a "planned" meal.
I am suspecting my basal rate, but I'm not sure what is going on.
This year is the first year I opted to go for a flexible spending account. It works out really well. The money for it is deducted pre-tax dollars, and put in an account. When I have a medical expense (actually I usually do 4 at a time), I fill out a form, send it in, and get the money back.
Actually, it works out even easier. I scan the receipts, and file them on my hard drive. I fill out the form online, print it, sign it, and scan it. Then I take that form, the 4 receipts and fax them to the administrating company. Less than a week later, I get a check back, which I put straight into my charge account.
Oh, that's the other key -- I charge everything -- especially mail order prescriptions, since I do that all online too. That's one reason I always put the reimbursement checks on the charge card.
Here's the cool part -- they go ahead and give you the money, even if you haven't deposited yet. Right now, I only have $30 in the account, but they are still giving me the money. They pay up to the projected amount.
"Next year" starting in August, the state will be putting some money is a savings account. I have to pay out of the flexible account before I can go to the savings account, but one neat thing about that one, is that it has a debit card. I wish this one had that option, and maybe it will. That would make life a bit easier all around.
Still have decent control with the 11:1 carb ratio. My insulin usage is down to less than 45 units a day on a fairly consistent basis. I'm still going as low as 120, 4 hours after I ate, and the 7 day average is showing that I should be at 12:1. I do think I'll wait until I see 12:1 on the two week average, OR I start seeing 110's 4 hours after.
I'm also showing some significant weight loss. I'm sure that its all related.
I'm even having a bit of trouble making sure I eat enough food. iShape wants me on somewhere between 2200 and 2600 -- it varies your calorie level each day.
By the way, I stalled out for a while when I was consistently eating 600 calories less than I burned and was really having trouble on non-cardio days. Which I switched to the calorie level (but not meal plan) on iShape, I saw a change in weight loss. In other words, I losing. Still slowly, but still a steady loss.
Another hint -- use a scale that measures digitally and at .10's It makes you feel better when you see the .10's as the change is more apparently.
Head game, but head games work.
I ordered insulin last week, and it was shipped Monday night. I was worried because in April the gel packs were room temperature.
Well these didn't arrive until this morning and was still cold. However, I think this was first off the truck and in April it was last off.
I stress out every time I mail order insulin.
I was afraid of this ... Yesterday my Freestyle Flash meter failed. Switching batteries worked temporarily....
But I called and was on hold for over 15 minutes -- I know, because my Treo told me. Didn't get a satisfactorily answer but did get the meter working.
But today it was dead. I called Therasense again, and was on hold for 15 minutes AGAIN, I know, I recorded the time I called. The rep was not friendly, was not very helpful and resisted replacing the meter. Wouldn't believe me at all, because yesterday's rep did NOT record the battery problem.
I was afraid of this. I am afraid I'll be switching to One Touch Ultra because
a) Animas has parterned with them and is planning having their pump talk with their meter.
b) The copay will be $60 instead of $112 starting in August.
My CDE really doesn't want me to switch or I would have already. She claims the Hb1AC is correlarates to the reports better than any other meter.
Real Gains but Practical Limitations to Glycaemic Control With
I was on MDI (Multiple Daily Injections) for almost a year. This study sites the reasons I went to the pump.
I couldn't get my HbA1c better than 8, I lost control when my schedule changed -- which happens fairly frequently. If I went to a workshop, had a long weekend, etc. I lost control.
Also, I kept gaining weight no matter what I did.
Going to the pump solved all those problems.
The new bolus ratio seems to work okay. In fact, it might still be too high, but I'm giving it a few days. Especially in case I have another -- "got to have everything a diabetic shouldn't eat in one day" day. Still amazes it that it took 3 days to recover from that. Good learning experience though.
I've been able to do two short basal tests. One this morning which lets me know that the correction we set up for dawntime phenomemom
One the other evening that let me know that the new basal rate (.05 less every hour during the day), is okay. I still don't have enough courage to completely change that time period without talking with the CDE. I see her in two weeks.
I think it was because I hurt from sitting in one place, but I really wanted to know my TDD (Total Daily Dosage). 38.135 which puts me at 11:1 for the 14 day average and puts my correct at 38, which I think is more reasonable than the 7 day average (11:1 / 41).
So I test a lot tomorrow.
And it makes me feel like there is a light at the end of the tunnel ...
... probably a train though.
Daily Palm, views & rants updated multiple times a day
I just sent them a User Thought, even though the case company doesn't have a Treo case yet, and I need another Palm like I need another hole in my head....
But it's a fun little article about addictions.
wnbc.com - Education - Conn. Teacher Fired After Student Pricks Finger On Used Needle
I've never made a secret that I inject and use needles. I make sure my students know in advance that they need to avoid my desk and my personal items. I keep a sharp container in my desk and dispose of everything in it.
But he's right, he was sloppy and used poor judgement.
(If the article is gone -- basically teacher with diabetes and Hepatitis C dropped an insulin needle on the floor and a student picked it up and pricked herself).
Inhaled Insulin Formulations Continue to Show Promise
The doctor that diagnosed me "promised" the inhaled insulin. I have been on asthma drugs, and I am not thrilled with that mode of delivery. It seems to waste quite a bit of medicine.
I also have a feeling they force the patient to comply, rather than dosing the insulin on needs -- that's the beauty of the insulin pump.
Before the "Saturday binge" of Saturday a week ago, I was just experimenting with carb ratio of 11:1 (means I take the number of carbs in food and divide by 11) and it was working for most meals.
I went back to 10:1 because my insulin usage was up, and the 11:1 wasn't working and I was chasing highs.
Now I'm chasing lows... (I write this stuff so if I screw it up, I can go back and look at it, even print it out and show the CDE or Dr.)
All weekend, two hours after I ate, I was in range of 120-130. If I am that "low" -- the goal is 140, I tend to go low within two hours. I really don't want to eat every two hours, it aggravates the GERD (the more often you eat with GERD, the more often you experience heart burn). In fact, in a perfect world, like tonight, I eat about 5:00 and don't eat again until morning, and I sleep better. I ate enough slow carbs and protein to keep me going tonight, so far. Though I'm keeping a close eye.
SO, I think I'm going to try the 11:1 ratio again, though I hate that math (10:1 is the easiest, you just move the decimal point). If I do a 7 day average, the 500 rule works out, it's just that nasty 70 unit day that is causing problems.
Besides, I'll just be chasing highs rather than lows, and it takes less calories to chase a high -- but more insulin.
I really hate making two adjustments at once, but that's the way it goes -- when you reduce insulin usage, you reduce it all the way around, basal AND bolus.
Fun stuff isn't it?
And I decided to look this stuff up in Pumping Insulin. Interesting facts: According to Pumping Insulin, I should be taking 72.5 units a day, based on my weight. So at an average of 44 units over the past 7 days, I'm doing REALLY REALLY good. My exercising is paying off.
The book says decrease or increase by 5% and recalcuate everything, but I honestly am afraid that's too much too fast.
And according to the book, I've done two things that cause my TDD to go down: changed my activity level (more weights, more time on the treadmill), and changed my weight -- lost weight.
Anyway my goal is to make gradual changes without screwing up control. I really hate chasing highs.
Tight Glucose Control May Provide Long-term Benefits in Diabetics
And it is interesting, because of the long term results and the opinions of the researchers.
The New York Times > Health > Personal Health: On the Road, Avoiding Pitfalls at the Pit Stops
I actually keep a copy of Wendy's, McDonald's, and several other restaurants in the car.
First, I need the carb counts (though they are in my Palm Pilot). But what I really use them for is to compare calories.
By the way -- I count carbs, and try to keep them low AND count calories, and don't worry too much about protein and fat. I also always choose the lower calorie of two items -- sometimes the low-fat is actually higher in calorie than the regular. Sometimes it's the other way. So you have to watch.
By the way, Wendy's has more gotcha's on the menu than McDonald's. I've eaten more calories than I planned at Wendy's than McDonald's.
Also, watch the Wendy's chicken sandwiches, since they "reformulated" them, they changed in carb count and calorie count.
I ended up running a bit of a basal test on the new basal rate, since I was able to go all evening without eating.
It's good.
And this morning ate breakfast, and the new bolus rate looked good. At least so far, I'm not chasing a high
As a patient, I know that there is a raging debate among endos as to whether or not tight control is a good thing or bad thing.
Some of that is up to the individual patient, few patients are as sensitive to insulin and or blood sugar as I am. Most diabetics and most doctors (my own included), tend to think I'm nuts. My doctor at least humors me.
However, I have trouble with my vision when my blood sugar is over 160 ... this is a problem. I'm dizzy at 90-110, especially if I have come down from a higher number. This is a problem too. And those are just the beginning sympthoms.
But who knows if the tigher control I tend to prefer is better for me in the long run? I do run the risk of hypoglycemia. Look at the last week. If I lose my awareness, I could get into real trouble.
At least now I can point back to some research and maybe more is coming. It's only in the past few years we could even achieve tight control.
The New York Times > Health > Scientists Unlock One More of Sleep's Secrets
This thing also makes me wonder if my allergies aggravate or are part of my sleep problems.
I've updated my photo album, adding the Spring 2004 - Best Friends
This is the most interesting photograph. Maggie doesn't like the camera and decided that she didn't want her picture taken, so the photographer and I decided we'd see if we could get them to interact and maybe she would forget the camera.
I was baiting Maggie over the teeter, and I forgot that Marcie would of course, follow.
I should have grabbed the board, but didn't think to do that, I don't even know if I realized they were both on the board until it tipped anyway. Baiting them all the way down to the bottom assured their safety -- the teeter automatically tips back into the original position.
FYI, having both dogs didn't really work, whenever the photogather thought harder than I was thinking about food, Maggie was off.
Obviously Marcie LOVES the camera.
Glad I changed that basal rate -- woke up at 3:00 am with a blood sugar of 108 and again at 5:00 am with a blood sugar of 103.
I've decided to go ahead and add the 1/2 hour decrease (by .05 units) in basal tonight, as it looks like I am right where I want to be.
Still seeing some weight loss too.
Since I've woken up with fairly low blood sugar three mornings in a row, I've decided to drop my midnight to 4:00 am basal rate by 0.05 unit. I'm reduced my basal by a whole .20 units :-) Actually every little bit helps reduce the total.
I've also been slowly, from midnight back, decreasing my biggest and longest basal rate during the day. I've been dropping by .05 unit every half hour, and am now dropping from 9:00 pm on.
It works out pretty well, the basal rates are now
12:00 - 4:00 0.85
4:00 - 8:00 1.10 -- this will be the next place I change
and I half it on cardio in the morning days
8:00 - 9:00 1.00 -- this is the rate I've been decreasing by half
9:00 - 12:00 0.95
So things are going well.
Here's the really good news, my daily total insulin usage has dropped to 38 - 45 units a day with an occasional excursion to 78. That's a whole lot better than it was before I started working out regularly.
And I know I've lost at least 20 pounds since I discovered my scale wasn't working.
This is why I like my pump, and why I work so hard, and I do document what is going on.
DB's Medical Rants » Long term benefits of tight control in diabetes
I'm actually quite pleased how things have been going. I'm not only maintaining control, but losing weight.
The New York Times > Health > Diabetics Count Carbs, but Can't Give Them Up
Good article explaining carbs in the diabetic diet.
Brings up some interesting issues.
So often when I go to a restaurant these days, they list "net carbs". Well, they are interesting, but all of my calculations are based on real carbs. It's not perfect, but we all use the same calculations based on real carbs. Sure wish they would list both or quit playing games. I usually add a unit or two if I can't get real carbs out of them.
Kind of carb is an issue too. Eating something that is pure sugar, like the gummy bear snack this afternoon produces a huge spike, usually both a high and a low.
What you try to do, is match your food to the insulin peak. If your food releases sugar into the blood stream to fast, you get a sugar high -- literally, and then end up going low. Especially if you correct for it.
Mixing protein and sugar is always good, tossing a bit of fat in slows things down too.
It isn't easy, but I know of a Type 2 diabetic who has cut her insulin usage dramatically and has lost lots of weight. I met her on iShape and she's an insulin pumper too.
Here's what is working for me:
Regular cardio and resistance training.
I have a treadmill and weights here at the house. I belonged to a gym, but I will say I've been more regular since I set up at home.
I also have iShape as a support system. I track my workouts, track my food, and my other progress. I also have people to work with. Right now, we're doing a two week challenge with partners (that's a first).
I really think you need a good regular schedule -- which iShape provides, and a tracking system -- which iShape also provides.
I will say that it is a long hard progress. I've got about 4 weeks without any weight changes. At the same time though, I was tracking everything else -- during that period I saw a change in insulin usage.
See that, kept me sane.
All of a sudden I've seen a drop in weight (about 3 pounds), though I admit to making a change in my definition of "clean eating". That's a challenge term. I was making sure I was 600 calories under what the program said I burned, but right now, I'm using their calorie level. Some days it's 500, some days it 700 under what I burned.
And I'm not feeling deprived. Yesterday I had a Subway sandwich with a small bag of chips. I've had gummy bears, and other "treats" through the week.
Oh, and I really think you need to be on a pump. Or at least really really understand what you are doing if you are on insulin. Thursday, and Friday morning, I was fighting low for about 12 hours. If I had been on my own regimen, I would have had to have added even MORE calories than I did with the pump, defeating the whole purpose.
You need to be able to cut your insulin usage to match your decreased needs, or you ARE going to have a hypoglymic episode.
I woke up clammy and feeling funny, and with a blood sugar of 89. I did sleep in a bit and did use my "non-exercise basal".
I'm going to start changing my evening basal again, since I'm "back" to where I was.
And yesterday insulin use was actually under 40 units.
I'm really documenting this because I don't want a repeat. I screwed up on Saturday and I've been paying since yesterday!
Sometimes yesterday, probably after I changed my set, though it was working fine, I believe, my blood sugar started going back to what it was before Saturday's screwup. This morning clinched it, blood sugar fasting was in the 110-120 range even though I haven't hit the treadmill yet and I'm on morning exercise basal.
I did notice that this site was more irritated than those in the past which follows my theory that only a certain amount of insulin can go through a site.
More positive things on resistance training. Personally I find that resistance training reduces my insulin needs.
DB's Medical Rants » Resistance training for diabetic neuropathy
I am still using 50 units of insulin -- and I'm still having higher blood sugars than I like. However, things are dropping -- except for weight.
There is definately a coorelation between how much insulin I use and whether I gain or lose weight. However, I'm not going to sacrifice control for weight.
Fasting blood sugar at 116. Better, still not as good as it was, but better!
I got really aggravated this morning because at 9:30, my blood sugar was 198.
NOW, I kinda of forgot I didn't have cardio scheduled today, and was still on that basal schedule. So that's part of the reason it was high I think.
So I decided to give the full correction instead of giving myself 50%. This would have worked if I had brought and eaten my lunch, or if I had eaten a snack, but I'm trying to lose weight. So I didn't.
The good news, is that I am really insulin aware. I felt the drop from 198 to 112 and I even felt the drop down to 108
Now here's the weird part, I started having problems with cognitive functions -- we were writing a test. So I remembered that there were tootsie rolls in the next room, but I forgot I keep about two bags of lifesavers in my emergencie supplies. I did remember after I got the tootsie rolls. I also took a glucose tablet because they dissolve faster. It didn't take long to get the sugar back in my head and working again, but it's interesting how quickly cognitive functioning is impared, and how quickly you recover. Takes just a little bit of sugar to tip it either way. I ended up with a glucose, lifesaver and a tootsie roll -- real fast, fast, and regular release sugar. A fix, and a prevention. An hour later I was fine and running at 112.
My blood sugar is still ranging higher than I like and it's been two days since my bad eating day!
I've ranged between 130-200 all day.
Well, hopefully I learned from THAT one!
children with DIABETES - ADA 2004 Scientific Sessions
Some VERY interesting information is coming out of these sessions, as always.
I had a bad food day on Saturday, and I'm not really sure why. I had 60 minutes of cardio scheduled by iShape and decided as a reward I'd do some pizza. Ate my pizza, bolused it, fine, etc.
Now this might be part of the reason, but I got eaten by mesquitos on Thursday evening doing dog agility so needed to run by a drug store and get something for the itching. It was BAD.
So while I was there, decided to see if they had sugar free Lifesavers -- they do, and I haven't decided if it was worth it. Also spotted Lifesaver fruit slices which I love. Pure sugar.
I figured I'd do one serving and be fine, but wasn't. Ended up with the whole bag. Bolused correctly, etc.
Then that evening ended up by the grocery store and spotted potato chips, and ended up eating a whole bag.
Between the three items and the rest of the day, did 78 units of insulin and yet the blood sugar was still high the next day.
I'm still seeing the effects. My blood sugar is still slightly elevated, and I'm back firmly to a 10:1 carb ratio. I also stopped adjusting my basal rate -- leaving it where it was on Friday. I won't start adjusting it again until I start seeing lower blood sugars again.
I've decided that one way to fight reoccurences of Saturday is to make sure I have small amounts of those types of foods on a regular basis. I think I just went too long "good".
The only good news, is that it's been about 1 1/2 week since the last "bad" day. However, it wasn't as bad. Only around 55 units, not 78!
Very good article on life style changes.
The New York Times > Health > Faces of an Epidemic: Type 1: The Morning I Will Never Remember
So weird, why didn't any of the doctors check her blood sugar? She even asked that at the end of the article.
One of those funny things -- the less insulin you use, the less you need.
According to the "rule of 500" I have for a week required a 11 unit of carb to unit of insulin. That is certainly shown by the numbers. I'm consistently low, and I don't want to go so low, I have hypoglycimia. So I'm changing my setting in EzManager for that calculation.
I am also still very slowly dropping my basal rates.
And if this works I'll be using even less insulin. However, I'm not losing weight very fast, but I am working out extremely consistently.
Tales of Hoffman: Get Well Soon (but first, read this message from the sponsor)
I agree-- this is creepy. I know I don't want e-cards telling me how to deal with my diabetes.
My blood sugar is still doing well. I decided that today would be my break day from cardio because I was having quite a bit of foot and leg pain -- I'm doing 60 minutes or 25 minute sessions according to iShape, so I switched over to the non-exercise basal.
Woke up at 4:30 -- I really wish I knew why I do that, took blood sugar and it was at 124. Went back to bed after messing on the computer for a half hour or so and woke up at 8:00 am to a 104 blood sugar. Ate, did weights, etc. and now 1 1/2 half later, I'm at 144. Right where I want to be all day so far.
I'm still gradually reducing my basal by .05 units a half hour a day, so it isn't significant, but still keeping my insulin usage in the 40-50 unit range. In fact, the insulin rules say I should be at 11 carb to insulin ratio, but I'm staying at 10 for a bit longer and watching my blood sugar closely. I'm not quite ready to drop to that -- besides 10 carb to insulin is SUCH an easy division!
I decreased my bolus rates last week. I'm down to 10 units of carb to 1 of insulin. It's working exceptionally well, I haven't seen a blood sugar post pranial (4 hours after a meal), over 135 since I made the change when I had an accurate carb count.
I've missed on a few guesses, and been a little high.
I've even changed my lunch bolus as I've been seeing blood sugar in the 120's and hitting low in the late afternoon. I did one other thing for "insurance" though and switched to low carb lunches for a while. I'm following Dr. Bernstein's idea, that the less variability the easier it is to control.
I've decided to drop my basal rate, on a very gradual basis.
My basal rates were set as:
12:00 am to 4:00 am -- 0.90
4:00 am to 8:00 am -- 1.10
8:00 am to 12:00 am -- 1.00
And a second program for exercising:
12:00 am to 4:00 am -- 0.90
4:00 am to 8:00 am -- 0.55 << for exercise in the morning
8:00 am to 12:00 am -- 1.00
By the way, the second basal rate has been working very well and was my idea. I have it set right now, and plan to get up before 8:00 am and work out. I haven't had an exercise low in the morning since I put this in place, and was having plenty before that.
Anyway, back to the plan... so what I did last night, was to set a basal rate at 11:30 pm for 0.95 When I woke up this morning, my blood sugar was close to what I've been seeing in the morning -- in the 110-115 range.
Tonight I've change the rate to kick in at 11:00 pm and plan to back the time up by a half hour every day until I start seeing a change in the morning.
Anyway, it at least SEEMS logical.
Physical Activity Does More Than Burn Calories & Improve Diabetes Control
Interesting article
Physical activity lowers body weight, cuts cardiovascular risk and blood pressure, improves lipid profiles, has positive effects on the immune system and can reduce the risk of cancers. It strengthens the heart, helps the lungs function better, enables the blood to carry more oxygen, makes muscles stronger and improves motion in the joints. Why isn’t it considered a treatment?
My morning blood sugar is still good -- in fact, today was UNDER my target.
My average use is still not very stable -- but then again, I'm adjusted both the basal and bolus lately. The calculations show I can go down to 11 units, but I want to stay at 10 units for a few days and see if things stablize.
I'm a bit discouraged on the weight loss... I'm losing but at around 1/2 pound a week. I think mentally it would feel better if I was losing a bit more -- but I don't want to put my body in starvation mode either.
Anyway, I'm off to the home gym...
Sad to see, but I do agree with Dr. Koslosky. There is very little to do to improve the Treo 600.
I've been able to make 4 or 5 phone calls, pull email and surf the internet all on one charge.
In fact, I haven't run out of battery yet.
And while I have liked PDA's, I really LOVE my TREO. I just wish the web browser would handle cookies correctly so I could log onto the Mailblocks site and my online course site.