Living With Diabetes

I got an angry note last night from a reader, which I deleted, but then responded privately. I hope the reader reply to my email again, because I think it's someone who needs some help.

The reader was frustrated because I whined about having a slightly higher elevated blood sugar, and because I saw my endo about it.

I know that I am lucky and that I've made some good choices. Teacher pay is lousy but our benefits are pretty good.

I'm on 6 different medications a day, plus insulin and test strips. I haven't figured out exactly, but I will ball park that at around $150 a month. No that's not bad.

I see several specialists on a regular basis. A sleep doctor about every 3 months now, and the endo, about every 6 months. Right now I am seeing his CDE for diet and weight loss support every month, but may go to every other after November. I used to get allergy shots and saw an allergy doctor on a regular basis, but am taking a break from that.

And don't forget the pump supplies. Those run around $150-200 a month, but the insurance pays 95% of the covered part.

I do use our Flexible Spending account to pay all of the above I can with pre-Tax dollars.

So my diabetes care isn't cheap and does take some personal sacriface. This summer when I was frustrated with my job, I didn't go look for another one, because I knew the benefits wouldn't be as good.

However, I am not whining, just stating facts. And I don't know what I would do if we did lose the insurance.

I know my husband has never been unhappy with the sacriface we've made so I could have the pump.

Posted by at 8:53 PM | Permalink

Hopefully I've managed to upgrade my Movable Type install to 3.1

Yep -- looks like I have it done!

Posted by at 8:41 PM | Permalink

Finally both the big dog and I managed to run an Excellent course successfully. I think one of our issues is that she isn't used to me being able to run.

It was even the hardest type course for us, jumpers with weaves. We had a clean run under time and took first.

Posted by at 9:48 AM | Permalink

Just updated the mobile blogging software.

Posted by at 9:42 AM | Permalink

I really wish I understood it, because I don't want it to end.

For about 4 years, I alternated struggling to exercise every day, and struggling to eat correctly everyday and just couldn't do it. Now, most of the time it isn't a problem.

Yeah, I had trouble with doing any cardio on Monday and today. I'd opened up a blister on the back of my foot this weekend, and while I taped it up and was able to walk on Sunday, I just couldn't get up and do that the last two mornings.

I am confident I can tomorrow morning.

I'm actually having trouble getting enough to eat during the school days, just don't have time. Plus I'm really burning it off, running errands and taking care of stuff.

The biggest contributer though, I think is that I have all my health problems under control. While I'm getting heart burn pain, it isn't waking me up at night like it was. I'm sleeping most of the night, and not having trouble waking up through out the night, and most nights can even go to bed on time.

It's good. Very good.

Posted by at 9:40 PM | Permalink | Comments (3)

Today is one reason. My blood sugar was fairly stable today. It was 180 post pranial (2 hours after meal), and I'm not sure if that was calculations, or what, but it certainly was better than last year at this time.

I will admit that last Monday-Wednesday, I went home and went to bed for at least an hours nap. But that's pretty normal for most teachers. I've spent the summer doing summer teacher things, and they certainly aren't as stressful nor do they take as much energy.

But tonight, I came home late after helping a new teacher, and needed dinner, but gee, it after 5:30 pm! and I had not eaten since 1:00 pm.

But today went well. I wasn't too exhausted to deal with any students, though I admit I've paced myself a bit, and made sure that I wasn't spending the WHOLE class period, all 6, on my feet helping students. I've got good assignments, occupying students most of the class period. Plus most of them can logon by themselves now, though I am getting a few new students each class period.

Also don't feel the need to nap. So all and all, I've doing much better than this time last year. In fact, I'm about to go out and do a few errands.

Posted by at 6:33 PM | Permalink

Olympics Dispatch III: Victorious

My husband doesn't GET why I care about this, but I do. Of course, he isn't a diabetic, he isn't fanatical about having as good as blood sugar as possible, and doesn't understand how hard it is.

It is SO cool that this doctor cares so much.

Sometimes I feel like the little kid in first grade when I'm interacting with my doctors, trying not to be on their nerves and trying hard to have the best blood sugar possible.

Athens Airport, 5:00 AM, Saturday, August 21, 2004 -- Gary won the gold. Unbelievable. He did it. He did it for himself, his family and friends, and for all people with diabetes. He says he'll give his gold medal to the person who finds the cure. I hope he has to give it away soon. But for now he inspires; he inspires me and all of the people in the world who live every day with the disease that is diabetes.

Posted by at 6:30 PM | Permalink

I am still looking for Type 2 diabetes to participate in a research study.

This is the information from the researcher:

Several months ago we had exchanged email concerning this research
project that I am doing with diabetes. We have evaluated 4 groups of
physicians - housestaff, internal medicine faculty, endocrinologists,
and private primary care physicians. They each performed a series of
pairwise comparisons assessing the relative importance of 4 indicators
of diabetes management.

While we hope to make the task a bit more complex in the near future, we
would first like to compare our physician results with a group of
patients. We are looking for type II diabetics who have computer
literacy. If you could assemble a group of 10 or so, we would be very
grateful. We believe that patients may have different priorities than
physicians, and want to test that hypothesis.

Posted by at 6:14 PM | Permalink

Olympics Dispatch II: August 19, 2004

Posted by at 3:48 PM | Permalink

I'm looking for 8 diabetics who are Type 2 and are computer savvy for a study for a doctor.

If you would like to participate, please send me your email address. Send it to kathleenw at gmail . com (spaces inserted on purpose) with the subject line: Diabetic Study and I'll add you to the list.

Posted by at 5:50 PM | Permalink

This is the first time I've seen the pump -- I'm at an insulin pumper user group meeting and the local rep is showing it off.

Basically the features are a calculator and it lets you calculate everything (carb, correction, and even combo bolus) and let's you adjust it on the fly.

I may yet upgrade....

Posted by at 7:17 PM | Permalink | Comments (1)

52 weeks ago, I was hooked up on my pump today.

It has been a very good experience. I've been posting about this in bits and pieces, so I'm going to try to tie some of the accomplishments together.

I've gone from around 100 units of insulin a day to 40 units.
I've gone from an A1c of 7 with lows, to an A1c of 6.2 without lows. I will not deny eating extra food to avoid lows, but I haven't had an emergency, treatable low since on the pump.
I've lost around 10% of my body weight.

But the best thing, is that I feel better. And everyone has noticed.

Posted by at 6:40 AM | Permalink

Part of losing weight is to have a mind set that you are ready to lose weight.

I'll be honest, I have to work at it. I have to physically make myself get up and do the treadmill thing and exercise. I have to write down all my food, I really do it twice, and I have to remember all day that I am losing weight.

It DOES get easier. Your mind and your body adjusts to the new calorie level. That's not to say I don't prefer NOT doing exercise on my off days. I really do.

But feeling better is worth it.

AND be patient!

Posted by at 5:55 PM | Permalink

I decided to move my teacher ID to last year's lanyard, and noticed something really neat between the two pictures. A friend looked and noticed the same thing ...

Thursday is my pump anniversary -- it will be 52 weeks then -- but the calendar anniversary was yesterday. So what has changed?

Last's year ID picture was taken one week before I got my pump. They took this year's last week. If you look at the two pictures, I am definately more tired, my face is fatter as is my neck, and my hair is actually grayer LAST year. You'd really think that they had been reversed. I actually look younger in this year's ID badge.

I know I feel better this week than I did last week at this time. I also know that my blood sugar is definately lower, I've been going between 110 and 190 the last two days.

I definately think the pump was worth it.

Posted by at 6:55 PM | Permalink

So far, the reduced, new basal is working fine. I haven't eaten since 6:30, and the blood sugar is staying in the 120's, which I can definately live with.

Posted by at 11:16 AM | Permalink

If you are a scale fanatic -- and I am one -- get a Tanita scale that measures in .10s. It's made a huge difference, especially since I am only trying to lose about 1/2 a week. This lets me see the fractions.

Posted by at 9:45 PM | Permalink

I had discussed changing my basal rates with my Endo a couple of weeks ago. My basal rates have been close to perfect all summer, but I am typically much more active during the school year.

I really have had trouble maintaining blood sugar since Thursday -- partly because I walked the building so many times, been installing software and moving computers around in my classroom.

I have dropped my carb ratio to 1:13 and most meals it works fine.

I'm really worried about my basal tomorrow, so I deleted my sleeping in basal rate, and put in two new rates with the lower basal rate while I'm at school.

I've gone ahead and switched to that rate. I'd rather be a touch too high than too low, and am planning to watch my blood sugar as carefully as I can.

Posted by at 9:41 PM | Permalink

Seems to me that you wouldn't want to get pregnant after gastric bypass anyway, but who knows.

The New York Times > Health > Case Offers Caution on Stomach-Stapling Surgery

An obese Massachusetts woman and her 8-month-old fetus died of complications 18 months after the woman had stomach-stapling surgery, an apparent first that is leading to warnings about the risks of pregnancy soon after the surgery.

Posted by at 3:12 AM | Permalink

This is one of the most important of my new beliefs and it has taken a lot to figure this one out.

I've gotten in trouble in the past because I've thought that I was obligated to eat other people's food.

For example, I went to a workshop this summer where they provided the food. I honestly should have brought my own that trip, while theirs wasn't bad, it was restaurant portions, and I couldn't tell the makeup of the food.

I would have felt better, been in a better mood, and learned more if I had brought my Diet Gourmet food and knew what was in it.

On the other hand, I was on a two day workshop where the food was perfect for someone like me, so you never know.

Posted by at 8:55 AM | Permalink

I'm going to start putting in some weight loss tips for the morbidly obese.

Yeah, I'm still that, but after having once lost 100 pounds, and now having lost 30, I think I'm an expert.

So I'm going to start documenting the things that have worked for me.

Posted by at 8:54 AM | Permalink

And they have been gone for 3 days.

I've probably lost around 3 pounds this week, I'll know for sure tomorrow. It's been pretty interesting from a diabetic logic point of view.

Monday-Wednesday was technically staff development days, but my department finished their tasks on Tuesday. We're not core curriculum, our subject areas are covered by the state tests and we don't have to meet "No Child Left Behind" requirements -- yet. We just have to agree to assist.

I had trouble keeping my blood sugar at a reasonable level. 4 hours after every meal, my blood sugar was in the 180-200 range.

Thursday, I had to find a teacher whose room is on the opposite side of the building and I had to install software. It took about 6 trips to get it done, but I did it but every since then, my blood sugar was in the 110-130 range after meals.

Last night, went out with the husband, we ate dinner, went mall walking then a movie. We had walked about 1 leg of the mall when I started feeling funny, stopped and blood sugar was at 90. This was less than 30 minutes after eating, and I had been extremely conservative with insulin. So I ate a lifesaver, and then looked for "good carbs". Found a snickerdoodle cookie at a cookie vendor, which believe me is almost pure sugar, and ate it.

30 minutes later the blood sugar was 96, but we were still walking, just real slow.

Ate some popcorn at the therater and again bolus very convervatively and after the movie blood sugar was at 180.

Woke up and I was at 106, so I didn't do badly at all.

I'm going to watch extremely closely, and I am going to up my carb ratio to 1:13 and leave that way.

I am debating if I should change the basals on Monday -- I've been "sanctioned" to do so by my endo.

Posted by at 8:48 AM | Permalink

Bearing the Olympic Torch for Diabetes Awareness

Our patients often teach us more than we could ever teach them. Gary Hall, Jr, an 8-time Olympic medal winner, is one such patient (Figure 1). I was with him when he won 4 of those medals, and I am heading to Athens to see if he can win more. This is the first in a series of reports as I start my journey to the birthplace of the modern Olympics; in this report I will recount my past 6 years as the physician on the team of an elite athlete.

Posted by at 7:16 PM | Permalink

It's actually the one year anniversary of my ordering my pump.

I was diagnosed with probably Type 2 diabetes, in September 2002. I
spent a few very unsuccessful weeks with Metaforum and then went to
shots, after finding that the side effects of the meds didn't go real
well with classroom teaching.

Shots wasn't too bad, but I gained weight, I have a needle phobia, and
you really don't want a lot of syringes around high school kids, in an
urban high school environment.

Plus I had lousy control. I'm "lucky". I'm very sensitive to blood
sugar, and I'm not comfortable unless my blood sugar is between 120
and 160. My vision blurs and I become a b*tch as it raises. I even
get dizzy if I have more than about a 10 point drop in blood sugar --
which presents its own interesting sympthoms.

I had been researching the pump and trying to get my insurance to pay
for it, with no luck.

I realized quickly that I had to do something if I was going to
survive the school year. My blood sugar was exceeding 350 while we
were in staff development. So the first morning I didn't have to be
in meetings, I went to the doctor's office and told him I was going to
the pump, got in the car and ordered my Animas IR1200.

Best move I've ever made. Took a while, but this week, my blood sugar
hasn't exceeded 200. It finally normalized to pre-staff development
level today and I'm predicting a change in basal next week. In fact,
even discussed it already with the endo.

Posted by at 7:06 PM | Permalink

Very odd -- yesterday and the day before had the exact same insulin usage but with completely different food.

Stress level is fairly high but not near as bad as the last two years at this time.

The other weirdness is that my insulin usage numbers show its time to go to a lower basal rate, but I'm still seeing high numbers after meals. I'm attributing a lot of that to stress though.

Posted by at 6:39 AM | Permalink

We reported back to work on Monday, and my coworkers have noticed I've lost weight over the summer.

That's really cool.

When asked, I tell them I've finally learned how to live healthy. And when people who knew back when I lost and regained over 100 pounds, I tell them that I learned from that exerience, that there isn't a diet.

Posted by at 10:11 PM | Permalink

RemedyFind.com

I'm not sure how long this has been around. I've done a few ratings myself, and it might be a good resource for someone who is exploring choices.

I rarely have had choices presented to me with enough time to make a really informed decision.

Posted by at 7:33 PM | Permalink

The New York Times > Health > Cases: A Machine for Sleep? Maybe Later

This is the best article I've read on CPAP and Sleep Apnea.

I can see maybe why the writer choose against the CPAP. I don't think 6 is very strong. My CPAP is set at 12.

Posted by at 8:17 PM | Permalink

I honestly couldn't have choosen a better place to go and a better reason to go. Everything went REAL well.

TSA is definately "weird". They operate with totally different rules at two different airports.

I weigh less today than I did last Sunday. I also weigh less than I did when I left on the trip.

Posted by at 6:58 AM | Permalink

I went ahead and left the workshop when the other flying participant needed to leave. There was really no point in making someone try from Conway to Little Rock twice.

Went I got to the airport, I asked what it would cost to go on the earlier flight. $40.00 approximately to get me home 2 hours sooner so it really wasn't worth it.

AND I'm glad I didn't because that flight was FULL, and the flight I was on had only 6 paying passengers.

TSA at Little Rock was different than Dallas. When I entered the line, just like on Friday, I was told only 2 carry on's. I calmly said "It's a medical bag", she said "oh", and sent me on.

They patted me down in the middle of everything. Didn't swab the pump this time but made me take my shoes off and xray them. I was wearing leather sandels.

Once I got to Love Field, it was very quiet, and luggage was waiting for me. Got back to the car and home again.

Posted by at 6:54 AM | Permalink

I have NEVER been at a better organized teacher workshop.

They scheduled the workshop around the airline schedule. One other person flew in. We were picked up at the airport and brought to our dorm room to leave our luggage behind.

Then we had a short introduction, and then lunch, then an packed afternoon with lots of good information.

All meals have been easy for me to deal with. Carb counting has gone well and my blood sugar has been stable.

The dorm room was fabulous. Someone needs to hire these people to organize workshops, as they are great.

I'm going to leave the workshop early since the other participant has to connect to another flight.

Posted by at 11:16 PM | Permalink

I was patted down ... which was okay. The ladies were very nice and had lots of questions about the pump.

That puts me in teacher mode which after 12 years of teaching, actually relaxes me.

However, the SW person at the beginning of the line was rude and insisted my 3 bags had to be consolidated, even though one was a medical device and is exemt. I checked on that by phone yesterday.

Not a huge problem but annoying. I caan tuck my wallet in my emergency bag and often do.

Having the Treo helps pass time. While it took an hour to get to the airport from the car, I did get here 2 hours early.

Posted by at 6:24 AM | Permalink

I'm a bit anxious. I packed everything yesterday, and I'm glad I did because I forgot personal hygiene items. Got them in the bag today.

I really need to pick up a paperback book somewhere, maybe on the way home from dog class.

I've got my security stuff printed out, and I will probably print out tomorrow's and a boarding pass tomorrow -- or maybe just wait on the boarding pass until I check my luggage.

Flight is at 7:45, and I figure on leaving here at 5:00. I know it is early, BUT I figure the more time I give them and myself to solve problems, the better.

I hear other countries are not allowing syringes at all -- which I'm not taking anyway, but am taking pen needles and lancelets.

I'm not even taking a computer this trip, but am taking two USB mini drives and my Treo. I am going to make sure that I can erase every thing on the one, and bring back stuff if I need to.

Posted by at 5:48 PM | Permalink

He seems to be feeling better. His stress test is set for next Wednesday.

He's taking tomorrow off, which makes me very happy.

Posted by at 5:47 PM | Permalink

DANA Diabecare USA LLC Warning Letter

This is sad, because people's lives are at stake here.

The link takes you to the letter the FDA sent to Dana.

Posted by at 3:44 PM | Permalink

Yahoo! Health

I didn't pick this pump at all, because they had a horrible website.

Posted by at 10:48 PM | Permalink

He saw primary care physician who is moving at a normal rate. Had an EKG and blood tests, they are going to schedule a stress test.

Posted by at 6:13 PM | Permalink

Dia Care -- Abstracts: Nichols et al. 27 (8): 1879

This article shows that some doctor 10-15 years ago should have handed me a blood sugar monitor and had me do something about all this. Doubt I was ready to deal with it yet.

As I told my husband tonight ... at least I have something that I can change and see immediate effects. Nothing quite like getting on the treadmill with a blood sugar of way, 190, and getting off 30 minutes later and seeing it at 120.

Posted by at 12:30 AM | Permalink

Dia Care -- Abstracts: Kovatchev et al. 27 (8): 1922

It seems to work fairly well, and at least better than random arm/finger prickings.

CDE thinks they will be out end of year or beginning of next. FDA

Posted by at 12:17 AM | Permalink

Found this abstract on the Children with Diabetes website.

First, remember that I have been raising and training dogs for over 20 years, and I generally know more about the dog diseases my breeds of choice have than human diseases....

Second, I've been accused of being a statistical voyarer.

Entrez PubMed

What's fascinating is that cats get Type 2 with prevelance based on breed and diet. Dogs get Type 1 based on diet. And pancreatic damage from too much fat is very common. Back when I trained Police K9s, my biggest job was putting dogs on diets.

Posted by at 12:06 AM | Permalink

I'm experimenting with the Compact meter, and I am finding out some interesting things.

First, it isn't compact. It's at least one third more of the mass of the Flash. Meaning that it probably won't fit in my immediate bag. Second, it's SLOW!

Something interesting is that I NEVER get a decent test the first few times ou use a new meter. First of all, you have to lose some muscle memory, and learn new habits. If you test any length of time at all, you have a ritual. Or at least I do.

If you are a meter manufacturer, I highly recommend you do what Accu-check does. Don't throw in 10 lousy strips. Put in at least 50 strips. Accu-check puts 3 drums in their sample box, and my CDE gave me three more drums. That means I have 102 to play with.

Why did they pick 17 tests? It isn't even divisible by anything. I'd have put 15 in, and made it smaller. Or 10. Weird.

After about 3 tests, the results on the two meters started converging. At first they were as much as 50 points apart, and now I am getting tests with 10 points of each other, which is as much as you can ever hope for.

Fun little factoid -- you never get a real number on a blood sugar test, all you are getting is trends. That's even true with the A1C -- actually more true, because that's a so called 3 month average, but it doesn't really work quite that way either.

Just have to learn which trends to follow when it comes to correcting.

So I haven't decided which to go with, but I'm definately going to go with one more round of Freestyle while the copay is still $80, not $120.

Posted by at 11:41 PM | Permalink

He has some sort of congential heart defect and won't share at all what it is or about. He really had problems with it when he had his hip repaired last year. Well, he's been sick all week, has all the sympthoms he's been told to watch for, and is going to the doctor tomorrow.

Posted by at 10:05 PM | Permalink

3 pounds less than last month's CDE visit. 20 pounds over all.

A1c is 6.2

We are adding medication for chlorestral because bew study. they have been watching that tudy and agree with the findings.

Posted by at 10:55 AM | Permalink

The reason I'm up early, if anyone cares, if that I am getting back to my school schedule.

Plus I see my endo and CDE at 9:30. I want to ask them about bolusing for protein. I also want to ask why my carb ratio went down with weight loss and my basal needs hasn't changed, but I have a feeling that's a "huh?" even from them. I do think that the basal will drop about the middle of the week after next -- when school starts, and am planning to watch everything VERY carefully.

I'm also reinforcing the notion very hard, that I am NOT on a diet, that I am on a lifestyle change and that losing weight any faster than I am is liable to cause some emotional eating problems. Been there done that. Besides, with school starting, NOT knowing my teaching load yet -- and this is the closest I've ever been with this much up in the area, I don't need any more stress.

Will post after.

Posted by at 5:49 AM | Permalink

ComputerZen.com - Scott Hanselman's Weblog - Medtronic Minimed 508 Insulin Pump vs. my New Paradigm 512 Insulin Pump and Blood Glucose Meter

Though I disagree on a couple of things .

Personally I prefer the Animas, but there is a funny thing about insulin pumpers -- we're even more adament about our choice of technology than PC vs Mac wars. My theory is that it is because its attached.

I also disagree about handling the insulin stacking thing, and so far, the two CDE's I work with agree, and think the Minimed thing is a bit nuts.

I avoid insulin stacking by taking in account of the insulin on board at the time of the correction, NOT at the next meal. In fact, and I think I posted about this recently, I'm careful to only correct once during a time period. Thus, if I ate at noon, and correct at 2:00, I don't correct again at dinner. I will correct, however, 2 hours after dinner, with two corrections in one day but I haven't had to do that in a long time.

Posted by at 5:33 AM | Permalink

One of the things I have to do today, is get my logs printed out and ready for the endo and the CDE.

I see him for the second time tomorrow.

I've done well since I've seen him. My bolus rates have gone from 8 and 5 (for lunch) to 13. 13 isn't perfect, but 12 is too much. I also didn't lose any weight this week -- I've been following iShapes plan, and I think the calorie level was a bit too high.

I also skipped cardio one day because I'm having heel spur problems again. I'm kicking around the idea of getting a shot for that at the podirist this week. Gee, I'm having trouble spelling foot words...

Posted by at 8:47 AM | Permalink