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June 30, 2005

Good article on the Treo

Good article about the Treo.

The Awkward Smart Phone Grows Up - New York Times

Right now, I am really missing my 600. I kinda of like the 650, but it doesn't hold as much data as the 600 and I've had to delete several programs I liked.

One thing I do like about the 650, is the side button, I have it set up to do EzManager (my diabetes software).

When the 600 finally died, I thought about going back to two devices, but the unlimited internet is just too good. I can't do with out. It keeps me sane at dog shows. It will probably keep me sane in the new classroom.

Articles about Symlin

The June issue of Diabetes Health has a very comprehensive article on Symlin and the August issue of Diabetes Forecast has a sort article. They actually have more information on the next drug, right after it.

Third Day - First Dose

Just upped my dose to 20 units and ate lunch. Feel a little full and a little odd, but not really nausea.

One good side effect, my GERD seems to be a bit better. I've been having problems even though on medication.

Checked my blood sugar two hours after, and its at 135, slightly under my goal.

Still no nausea, actually feel a bit bloated and full.

Accu-Check Aviva

It is bigger than the Flash (my current standard) according to a table in Diabetes Health, and it says nothing about a backlight, which by the way, I used last night.

I like the idea of the lancing device so will probably snag one and try it out when I can. FYI, I do NOT pay for meters. I refuse to, when I am testing 10 times a day.

children with DIABETES - Roche Shows New Accu-Chek Aviva System At ADA

Roche Shows New Accu-Chek Aviva System At ADA

Upping the dose

Just heard from my CDE and she agrees to up the dose and said to feel free to drop it back down if I can't tolerate it.

So I'm on 20 units now.

Benefits so far:
It is definately making eating easier to control. I don't feel hunger as often, and feel full more. I have been able to drop my calorie intake without feeling deprive.

I'm definately losing weight, though I've also upped my cardio this week.

Insulin usage is down.

Cons so far
Injections -- one of the reasons I went to the pump. The pump manufactures need to find a way to deal with this.

Supplies -- I have to carry syringes and another vial in my daily pack. I was carrying syringes before. I do try to keep the carrying weight down.

One more thing to keep up with.

Math -- I have to remember to half the carbs when I do symlin.

June 29, 2005

Second day, third dose

For lots of good reasons, I stopped and had a fast food meal on the way to dog agility -- I needed more calories, I was a bit low, I'd eaten healthy all day.

I did another dose of Symlin, and did fine with it. Still a bit high after meals, but I'm not on the full dose yet.

I'm certainly not having hunger problems I have had before.

Depression and Diabetes

Good advice here.

Cyber-Pancreas: Depression and Diabetes

This is half the reason I am seeing a CDE right now. I'm been to a couple of mental health care peaople, and they didn't specialize in diabetes.

Well, one was diabetic himself, but not taking care of himself as well as I take care of me, and he was supposed to be helping me with some of my eating issues. Hard to take someone seriously who is gaining weight himself.

Next time I decide to see someone like that I'm going to be VERY specific on what I want.

Second day, second dose

This dose is fine. Absolutely no problems. Blood sugars are a tad higher right now, but I expect they will be better when I up the dose.

I just emailed my CDE to ask if I can go up to 20 units tomorrow.

Lunch - Second Day

This was probably the worst reaction I had. Today's lunch is a tuna apple salad on a pita and has a lot of bulk to it. About halfway through I started feeling full and a bit off.

Not real bad though.

Woke up early

Not sure if this is symlin related or not.

Was feeling a bit odd. Sure enough, I'd pull my set off. Not a huge problem, because it is set change day anyway. Blood sugar was at 112 which isn't too bad for me.

Still had 40 units in the cartridge but decided to waste it, since only 20 units would be left after priming AND that cartridge, insulin, etc. had been in nasty dirt (I'd lain in the dog agility arena dirt twice).

I'm not sure if I had a low and pulled the set off -- I have pulled off sets in the night before, and every time my blood sugar has been in the low to regular range so I think I pull sets off in my sleep when low.

Heading back to bed.

June 28, 2005

Fourth Dose

I did another dose this evening. Still no nausea. I actually feel better after meals -- I've always been a bit loggy, after lunch the worse.

I didn't get hungry in the afternoon -- I usually snack then, but boy did I this evening.

Symlin

Good information on dosing symlin and how to use it with diabetic syringes.

I'm lucky, I've got a bunch of boxes of 30 unit syringes from my injection days.

Diabetes In Control - SYMLIN� (pramlintide acetate) Injection

Third Dose

Took my third dose almost 2 hours ago. Still no nausa. I'm tolerating it very well. It does sting on injection.

My insulin usage is WAY down.

Also, it does seem to help suppress hunger.

Treo 650

I was forced to upgrade to a Treo650 today. I knew it was coming, the old one was looking ragged, sounding bad on calls etc. I had checked on it a few weeks ago. I really wanted to keep the 600 until they had another device upgrade, because the accessories aren't very compatable.

I am thinking about sending the old Treo to Palm and pay for it to get refurbished. That way I would have a backup.

"Duh" on Second Dose

I just checked and 10 units IS what I am supposed to be taking.

I wonder about me sometimes.

Second dose

I already screwed up -- I took only 10 units with my lunch dose instead of 10.

Still no nausa though.

Blood sugar two hours after was 208 -- not unexpected since I'm dosed low.

Symlin

Went to see the CDE today and since I've adjusted to Apidra we decided to add Symlin.

It's supposed to help with weight loss, and bring insulin usage down.

I picked up two vials from the pharmacy in their building.

I waited until after the CDE appointment to eat, in case we needed any labs, so I grabbed a combo at Wendy's after and took my first dose.

Type 2's start at 10 units with each meal. Also reduce insulin dosage by half. Which is what I did. I'm at 163 now, an hour later, and will keep very close tabs on blood sugar through the next few days.

The literature and CDE said to expect nausa, but so far, so good.

I'll be using the blog to keep tabs on things.

June 27, 2005

Pros and Cons of Pumping

An excellent list! I agree 100%

Scott's Diabetes Journal: Pros & Cons fo Pumping

Pros & Cons fo Pumping

Home

Got in last night around 9:00 pm. Was tired. First thing I did was shed my clothing and got into the pool. Well, I was visiting with my husband while I did that. Then soaked in the hot tub.

My husband was real surprised I stayed all four days, and kept saying that. It's the longest I've been away from this house, including the trip to Nice, but only by one day, and certainly the longest I've been away by myself.

The ride back was good. I got frustrated in Shreveport because

a) People kept pulling out in front of me and stopping. When you are traveling on a highway, you do not pass someone, pull out in front of them, and then slow down.

b) Was trying to go to a restroom, then through a drive through since it was 97 degrees and not a great neighborhood. The two places I tried had people waiting on someone mopping. I ended up going to a Quizo's which was very nice instead, because it was tied to a gas station/convenience store, had shade and I could leave the back of the truck open.

My blood sugar stayed pretty stable through out the trip. The times I bolused conversatively, corrected well with the correction I'm using.

I weigh less, by a little bit than I left, which is a good thing!

June 26, 2005

Very Good News

This article is about the town I live in. I suspect response time to our house if less than the 4 minute and 41 seconds, I can almost, but not quite see the fire station.

Best yet, we have an alarm system with a panic button.

Since the cardio-vascular thing runs in my family, I pay attention to this.

DallasNews.com | News for Dallas, Texas | Northwest News

Farmers Branch cardiac-save rate among U.S.'s top

Why I don't go to bed lower than 150?

A commenter asked why don't I go to bed under 150?

If you are on insulin, there is something called "Dead in Bed" Syndrome that you have to worry about -- also you need to worry about hypoglycia -- which may be what causes "Dead in Bed".

Diabetics on insulin have been found "Dead in Bed" -- cause of death has not always been determined.

Therefore, most CDE's require their patients to eat a snack with 1 serving each of carb, protein, and fat. That is to keep the diabetic from becoming hypoglycmic. It is possible to sleep through a hypo.
Most parents of Type 1 diabetes test their children through the night as a result.

Since I has gastic reflux disease also, I often skip a snack, especially one with fat and protein. However, the few times I've been below 150 I have had some hypos, and I do need to start experimenting with that more. I suspect I could go a bit lower.


June 25, 2005

Accomplished one of my goals!

Marcie Q'd again today, with a 1st place! I have to go back and check, but 2 Qs and 1st places in a row is NOT BAD!

I'm going to move her back to preferred now, as she is more comfortable with that time.

Maggie had a clean run, but way over time. I ended up laying down in the dirt to get her to down. Oh well.... There were people there surprised I could get back up to finish the run that quick. Including the judge.

June 24, 2005

Spoiled Myself Today

Of the concession choices, the best sounding was Pizza Hut Pan Pizza. It didn't go too bad, but I have to practice on the extended bolus thing. I was at 201 two hours after, using the suggested EzManager carb count. I had split the bolus, but probably not right. The good news, is that I was at 125 two hours after the correction.

I did a baked potato tonight, with steak and salad. Most carbs I've eaten in the evening all week, especially since they had rolls and peanuts. Though I was good with the peanuts. Unfortunately the salad was loaded, but the potato wasn't. I didn't know about the salad, I order the potato that way. But it was good. I was at 225 two hours after, so obvious was too conservative, but it's back down to 157. I am just not comfortable going to bed any lower than 150 yet. Especially in a hotel room in another city.

Maggie had a WEIRD panic attack in the room after which reinforces that I never never leave that dog outside of a crate when I'm not around. Which unfortunately I do on a regular basis at home. I am going to have to stop.

Tomorrow, I am definately going to take a break and get a salad for lunch since there hasn't seemed to be a prohibition from outside food -- many of the dog show venues will not allow that. I think it's a health department thing or a City Ordinance to support the concession companys.

Family is planning to come visit early Sunday. I'm trying hard not to think about it though.

Diabetes Care

Amy, you did a really good job on this interview, but I do want to do back to the source at some point. Has he published his suggestions on the internet?

In case anyone is wondering, one of my hobbies is "Behavior Analysis". Yep, dog agility is all about behavior analysis. I've even taken some basic graduate courses. Use it every day in my classroom and even tell my students how to use it.

So, from a behavior analysis standpoint, a lot of what he is saying makes sense, and is good concrete advice. It's the type of advice I give others:

His points in bold

Find Out Where You Are
Very important. You can't figure out where to do if you don't know where you are now!

Decide What to Focus On
That's Behavior Analysis 101 -- you can't change more than one behavior at a time. Actually we do that in dog training, but NOT in one training session. I always tell everyone pick one thing to do well, and do it real well. Once that thing is mastered pick the next one.

Also pick things that are measurable and that you can see progress in. I would also, in the beginning stages, pick something that you can see change. For example, I might not pick blood pressure to begin, because it will take a while for to see those changes. I might pick, testing and logging every morning, as that is something I can measure and see change immediately. Rewards come more immediately (an important part of behavior analysis). Blood pressure or even A1C are for people who have mastered the easy stuff.

Think of Your Diabetes as a Small Business, and Your Care Team as Your Consultants
Not a BA thing, but it is something we talk about on the insulin pumpers list. One thing I try to keep in mind is that the doctor is my employee, and if he doesn't do what I am paying him to do, it's time to fire him/her (In informal BA terms, it's called "Shooting the Dog")

Make Sure You See the Results
Again, a BA thing. If you to know if you are making progress.

By the way, if behavior analysis is of interest to you, the best source is Karen Pryor's "The New Art of Teaching and Training", subtitled as "Don't Shoot the Dog!" (If you get the Second edition, I'm quoted).

"Shooting the Dog" is an abbreviated term for the most final of training solutions. Her example is a barking dog in a neighbor's backyard and gives differing ways of solving the problem. The most extreme solution is of course, shooting the dog.

At the hotel...

You can see the girls are tired.

Picture033_24Jun05.jpg

Monroe

Today was a better beagle day. We are 1 for 4, which is 25% better than yesterday!

Marcie Qed and took a first in the class I am most wanting her to do well in. That was Open JWW. We need to Q one more time and we'll finish that title.

Right now, her name is Bettner's Byte of Magic NAJ, OA, OAP, AJP and I would like to get rid of the Novice title -- that's the NAJ for those of you aren't into agility.

In Excellent Standard, we had a refusal at the table and she ran around last jump. The table is a weird thing with her. I am not sure what is happening with it. We would have been over time too. We're not quite ready for regular Standard.

Maggie and I did better today than we did yesterday. In Jumpers with Weaves, she had one refusal, and had a score of 83. You need an 85 to qualify, so we got caught on time. Novice standard was my fault, I came off the A-frame and turned in Marcie's direction instead of her courses direction, which pulled her off into the wrong jump. She cursed me out and we had it together until the chute. I lost her after the chute to a hole in the wall. Then I moved to fast for her, and pulled her off the dog walk.

Maggie's name is just Maggie? No titles yet, but she has Qed once for each type -- Standard and Jumpers.

I had a Pizza Hut Personal Pan Pepperoni Pizza today. I think the split bolus was off -- was 201, 2 hours after eating it. But was down to 126 after correcting it, 4 hours later.

I did pull off a set last night. Dumb, got tangled up in night gown, pump and sheets. Pays to bring plenty.

Slept okay, only waking up twice. Both nights, somewhere around 1 - 2 am, and again around 5:00 am.

Traveling

Sleep is going fine, food is going fine and blood sugar is going fine.
Unfortunately my feet really hurt. And the dogs still aren't cooperating. Marcie has a hot spot behind her ear, and it isn't getting better. I can't decide if it's worse. Maggie is being Maggie, which can be frustrating.

So here's the plan. I'm going to try to run Marcie. Her first run is at 9:30. If her run goes well, we'll stay. If she is still running half heartedly, we're going to go home and find a vet.

I did make changes to avoid yesterday's frustrations. I am taking today as an off day for exercise. That may relieve my feet. I only feed the dog's 1/4 of what they usually get. That may help their energy level.

So wish us luck!

June 23, 2005

This has NOT been a good beagle day, but everything else is going well.

Feet are killing me right now, especially the left. It has been a long day.

Marcie has an ear infection, but oddly, her ears are clean, but she has a hot spot behind her ear, a certain sign. I'm putting ear junk in her ear, but so far, she is just miserable.

So she tried, but just couldn't do it.

Maggie on the other hand, just wasn't interested in doing things my way.

I'm sure I'm part of the problem, I didn't sleep well, but not as badly as I usually do in a hotel. I went to sleep fairly easily -- with the help of a Sonata. I woke up twice and was able to go back to sleep after doing the bathroom thing.

Morning didn't go well either. I learned a valuable lesson. Get up, get workout gear on, take the dogs and and then PUT THEM IN THE CAR! They did not want to be left in the room and pitched a fit. So I couldn't do a good workout. I finally did put them in the car but was feeling bad about it.

Food has been decent. I had a biscuit with gravy for breakfast, yeah, high carb, but I did do time on the treadmill and at least it was protein and fat laden carb.

I had jimbalya (sp) for lunch -- the choices were hot dog, pizza, or that. I might do pizza tomorrow though, we'll see.

Blood sugar was between 120-150 all morning -- and I had all the runs but one in that time frame. Maggie's run was in the late afternoon.

Had a couple of cookies at the hotel when I got back since I was going to try to finish my workout (I got 20 minutes done!), and hadn't turn down my temporary basal in time.

I'm going to a grill this evening with some Monroe people.

June 22, 2005

First day

This is going to be an interesting 4 days because most of the time I eat prepackaged food. I use a service called Diet Gourmet in Dallas, and they list nuition information on every meal. This trip I decided not to take it, especially since we pick up on Friday.

I went out to a local restaurant, with a "local", and a couple of Dallas agility friends. It was a very Louisiana style place with lots of fried food. In fact, Hush puppies were on the table.

I had 3, and I had baked catfish with a cheese sauce which was out of this world. Probably as much fat as if I had fried, but at least I avoided the breading And I had no-carb veggies for the side and a salad. I ended up taking 4 units of insulin for the meal and was at 170 2 hours after the meal, which is fairly typical of evening meals, in fact a bit low -- with the carb counts, I had ended up at 220.

My TDD is going to be under 40, which has been typical of the past 5 or 6 days, so that again, shows I'm doing well.

iShape has upped my cardio -- they do something called periodization, and I'm up to 65 minutes of cardio most days. I can do it, but then I wear the boot the rest of the day.

In the morning, I'm going to try to get up, take the girls out to pee, leave them in the room in cages with breakfast and cheesy toys, and go to the fitness center and do my 65 minutes. They do have 3 different cardio machines, a treadmill, a bike (yeck) and an elliptical trainer -- I love them but they give me heel spurs.

Marcie and I are in the ring at about 9:30, and Maggie will be shortly after. Then we wait a while for Marcie's next run and then all day for Maggie's. It will be long.

I'm hoping that the concession will at least have hot dogs tomorrow.

In Monroe

If you are traveling and need a place to stay, so far Jameson Inns is good (or is that are good?).

I will have to see what their breakfast is like, it sounded pretty high in carbs, and mostly fast carbs but the high speed internet access is working well.

Have been running a bit lower than I like and also a bit sleepy, which worked out well, I ended up stopping about every 45 minutes. It's difficult to travel with dogs -- and that is the point -- this time of year, because you can't leave them in the car.

So it's, stop somewhere, run in and do what you have to do and get back out as quick as possible. Also, being diabetic, I need frequent bathroom breaks, so the 45 minutes was pretty reasonable.


Almost packed and ready to go

I've got to get my morning stuff out of the car and some shoes and I'm ready to go. Have dentist appointment first.

Took the open box of cartridges, open box of sets, and box of IV-Prep -- and added some Uni-solve, so I should be good to go on pumping supplies. Plus refilled my "emergency" carry around set. Infusion sets and cartridges can't just be picked up anywhere, and who knows if there is a pumping CDE in Monroe, LA. Hopefully I only have to do one set change, but I have been known to rip out a set while trialing. Several times during runs.

I LOVE having the new CPAP machine, as packing that is always stressful and I have to do it the morning of. Plus when I get back, I have to re set it up. No more, now that I have the old machine and spares. I set up the old machine yesterday afternoon and packed all the new stuff. The old machine is different -- it just blows where the other one matches my breathing somewhat. It's a different sensation. I also used a slightly different model of mask, but I think I slept okay. Anyway, all that is packed in and the car.

I'm also looking forward to the three sets of crates, and I'll drop one set off when I get to Monroe. Since it's a four day trial, it makes sense to have a set of crates at the show site, a set of crates in the car and a set of crates in the motel. Now I can do what I normally do, which is leash the girls to move them instead of having to pack and unpack crates constantly.

I've got a bottle of Aprida that I just opened, and am taking a bottle of Novalog just in case. I wish I could store them in two seperate places, but because of the heat, that won't work out. They are in a bag I will remember to keep with me and not leave somewhere hot. Also have a Novolog pin and plenty of pin needles (I keep a bag of them in the car, along with lancelets, just in case).

Turned in one assignment that is due this weekend. I've got another one done that is due Monday, and hanging on to that. And I backed up all my CECS files to a CD-RW just in case the network server goes down. Plus it is a hassle to upload and download. I should just have to do discussion posting for both classes.

June 21, 2005

New pictures of the dogs

I have pictures from the USDAA trial we went to a few weeks ago at Dog Pictures

June 20, 2005

Losing weight and the pump

I have been conducting my own scientific study with a participant of one, and probably using very questionable research methods. But I have "figured" some things out when it comes to losing weight and the pump that work for me.

This is primarily for me, so I can go back and look at it. However, it would be interesting to find out if other people have had similar results.

Here's what I have figured out (in the second person but it does apply to me).

You can eat whatever you want and control your blood sugar while on the pump. You also gain weight when you do that, and it doesn't take much to push the envelope on controlling your blood sugar. You have to constantly track your corrections and blood sugar because eventually your TDD (Total Daily Dosage) of insulin will go, causing your carb ratios and/or basal rates to go up.

If you drop carbs you will drop insulin usage. Dropping carbs can often stabilize blood sugar, at least it does for me.

If you exercise, you will drop insulin usage. Strength seems to drop basal rates for me over a long term. I have stopped strength training occasionally and see my basal rates rise.

Cardio exercise only affects blood sugar temporarily. However, doing it every day, drops blood sugar and insulin usage every day.

Too much fat and too much protein does affect blood sugar levels and does affect weight loss. Just not as much.

When I am able to drop insulin usage down to a certain amount, I tend to lose weight. If my insulin usage is higher than a certain amount, I tend to gain weight. Weight gain tends to be faster than weight loss.

When I do drop insulin dosage, I tend to be able to decrease carb to insulin ratios. It tends to take several weeks to stabilize the insulin dosage, and I tend to go low then. It's important to test more often, sometimes hourly to prevent the low.

By the way, you can't play these games as easily with injections. In particular, you can't fix the basal rate as easily -- nor can you fix lows as easily. When I get the starts of a low (I try hard not to go low enough to be truly low), I turn on the temporary basal AND do two lifesavers. With shots, you have to wait until the next day, decrease the dosage and then correct all day.

Tarsal Tunnel & Other Update

I went without the boot most of the day on Sunday, and the pain was back but not as bad this morning, so except for treadmill time, I have worn the boot today.

It's not bad to walk in as long as I wear a shoe with a decent sole height. Sandel works well.

This is definately overuse and weight related. When I double the treadmill mileage it started and running agility made it worse.

Thus, Saturday I weighed skipping the treadmill and giving it a rest. Giving it a rest won but I think I'll make it up tomorrow. Tomorrow is a scheduled off day but I think getting some weight off will help more than resting will.

FYI: Blood sugars have been low for the most part but weird. It might be a mild effect from the depo provera shot on Friday, but I've been either normal or slightly high all weekend. Today was even weird, as it was higher after lunch than usual, though I'd done my cardio in the morning, but after dinner was low. It just means I have to keep watching.

Master's classes are going well. I got my first grade back on one class, and haven't seen any grades yet on the other, but I think I'm doing well since it consists mostly of discussing reading.

June 19, 2005

Traveling

I'm taking the girls to a 4 day agility trial in Monroe. We went for 2 days last year. This is the first time I've traveled since I tried to go to Monoco and the first time alone, probably since the trip last year.

Today, I made sure that my laptop worked and had the right software. I haven't touched it since school was out. I also installed Firefox on it. If it weren't for the fact I'm taking two online classes, I would be very tempted to leave it at all. The hotel is supposed to have wireless access in the room. I brought network cables and phone cables just in case.

DLife

DLife continued with their improved format which is MUCH better than the old.

They covered issues I'm not concerned with. I never drank much before I was diagnosed and have never done recreational drugs.

The depression aspect was also good. I struggled against that myself since diagnosed, but as of now, haven't felt the need for clinical help.

This research helps after my Depo decision

The Well-Timed Period: Bone Density and Depo-Provera

Bone Density and Depo-Provera

Not sure of a time frame, but interesting

Patients get 999 chip implants - Sunday Times - Times Online

Patients get 999 chip implants

June 18, 2005

I'm not sure how I feel about this

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

June 17, 2005

Maggie

Maggie is a mess ... but she isn't NEAR as much a mess as she was.

She's a rescue (wish you could hear me say it the way I say it), think pathetic... She came with two trunks of baggage, and I have to say, I'm down to half a trunk. It's taken a huge amount of work.
She was free to a good home, found on a chain with no house. Then accidently had a little of beagle puppies. We have no idea how old she is, but we got her the Friday before September 11th.

I often introduce her as the bad beagle, especially when we are lining up for an agility run, so people understand that she doesn't behave.

When I first got her, when you came into the house, she would bellow until you left. I accidently found out, that if people went to the downstairs bathroom and flushed the toilet, she would settle down. For about a year, I had to have people do that. She now bellows a few times, then settles down. Bellowing is not a bad thing -- it keeps burglars way. They hate small, loud dog.

She used to rush up to every dog bigger than her and bellow in their faces. She would also snap at any dog smaller than her (or the same size). I can't stand dogs that don't behave around other dogs. It's one of my pet peeves.

She will still bellow at other dogs but she doesn't snap very often any more. Snapping and biting really isn't a problem because her teeth don't meet. She bit me several times when I first got her. It's a wonder she can eat, she's both undershoot and wry. Her canines go in two different directions.

When I first got her, she was afraid of police cars. A big problem, since we live on a large busy straight, and on any given weekend the cops will pull over 5 or 6 days in front of house. Until last February, she was deathly afraid of cameras. She now bellows at them when I forget to give her a treat for taking her picture.

She is still deathly afraid of thunderstorms. Right now, I'm using Zanac to help that. I can at least sleep peacefully when she is on it and there is a thunderstorm.

She does try very hard. However, when I start with a new behavior, she yells at me in 4 letter beagle words. She even does that in agility class, and sometimes during runs. Usually when she is confused. She is getting better though. Sometimes when I get frusterated that the yelling my husband has to remind me -- he will tell me that she really is trying hard. And she does!

I think in the last few months she's finally learning that this is her forever home. I also think she trusts more. The best part, is that she is running full courses and doing what I want, most of the time. I can't rely on her saving my rear when I make a mistake yet, like Marcie does, but I think it will come.

I've always felt sorry for her, but lately I'm starting to really like her.

Why the Animas?

Amy has also asked me why I picked the Animas. Now, remember when I got my first pump, it was an IR1000.

First reason: It is truly waterproof and the PDA interface. I actually used eZManager for over 6 weeks before I got my pump.

I will admit to already having a Palm Pilot addition before my pump.

Here's what cinched the deal ... the Cosmo people never returned my phone calls and Minimed had just flunked the waterproof test. Plus Minimed sells their pump by selling technology that is at least 10 years in the future. If not more.

I will admit I had never seen a Minimed or Cozmo in person until after I got my Animas. After wearing a IR1000 I would NEVER get either. Frankly, they are both b**t ugly. Also, you put round on round and the smaller round falls off all the time.

The IR1250 (and IR1200) is smaller and cuter. The smaller reservoir doesn't bother me. If I ran out of insulin, I just put another cartridge in.


Ladies Only -- Hiding Pumps

Amy over at Diabetes Mine asked about hiding a pump. No one notices mine. In fact, people who know I wear one, often ask me if I have it on.

First it takes a small pump, this won't work with the Minimed or the Cozmo. The Animas footprint is perfect for this.

Second, it takes a somewhat talented seamstress. I'm not, but I do business with a custom bra shop. Most large towns have them. Look for someone who specializes in breast cancer patients. That's how I found mine.

Now the pocket that is in my bra is designed for the IR1000. Next time, I'll get it made smaller for the IR1250.

So here's the first picture, that's the inside of my bra. As you can see, it's on the top part of the cup, towards the strap. It's made of the same material as the inside of my bra, which cuts down on the sweat. Trust me, if you put a bare Animas pump in your bra, it will get slick with sweat.

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This one shows the pump in the pocket.

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Hopefully you can see how low the profile is.

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Marcie

I thought I'd talk about my dogs and that I would start with the one I've had the longest. I do have their pictures posted at Dog Photos.

I've been in dogs and especially beagles for many years. When Peppermint Patty was diagnosed with cancer at 9 years, I know it was time to start looking for the next beagle, but I wasn't serious. At the time, I had a GSD (German Shepherd Dog), named Aysha that I was doing Police K9 work. She was a handful, so I wasn't real serious.

An internet friend saw the photographs of litter of beagles in Vermont and sent the pictures on to me because one of the pups was the spitting image of Patty. At the time, I was just realizing that Aysha needed a job and that she was bored living with me. Yes, I bought Marcie over the internet, but it isn't as bad as it sounds. Ellen and I had been IMing for quite a while, and emailing on a frequent basis even longer. She knew Deenie, plus since Patty was the Number 1 Obedience Beagle in the country at the time, I had a reputation.

I got with the breeder Deenie via IM, email and telephone and we all decided that it would work. I had a short list of things I wanted out of a pup, and some things I wanted a breeder to do, if I couldn't do it myself. Deenie agreed to doing all of that, and had some other really good ideas. For example, I mailed them a t-shirt I'd wore overnight, and Marcie slept with the tshirt for several nights before she was shipped.

So Marcie was purchased sight unseen and shipped to Dallas. She was thrilled to death to get out of the cage after 12 hours, and to smell the person she'd been sleeping with. Okay -- it was REALLY getting out of the cage.

She always been a real adament dog. Very pushy on how she thinks the world should be and somewhat vocal when she doesn't get her way. When she was a puppy, she'd even bite when she didn't get her way. It actually works out pretty well, as most of the time her way is my way. About the only time it doesn't work out is ear time, nail time, and oh, after agility -- leash time. Oh, and you can't pick her up.
Not for all the beagle chow in China.

I had Deenie click and treat her every time she feed the dogs, and also had Deenie play ball with her daily. Most people don't know this, but many of the lines of hunting beagles are natural retrievers with extremely soft mouths and the younger you encourage that the better. They will actually retrieve a killed rabbit to hand. Marcie's obviously of that line. So is Miss Maggie, but she's another post.

I've done lots of clicker training with Marcie. She's got some really cool tricks, I need to get some movies done of some and post them on the photos site. She's backup, retrieve, spin in both directions (has different cues), high fives and nose touches, crawls forwards and back with different cues. I can teach her to target to just about anything, that's one of our favorite parlor tricks.

She is a fabulous agility dog. Unfortunately she paces to me, so sometimes comes across as slow, but can turn on a dime. She often saves my butt when I give a slow command. The other thing I think that makes her run over time a lot, is that she really overjumps. She can easily clear 20" and once cleared a 26" triple -- at agility trials she measures at 14 3/4 and jumps 16" in almost every venue. She tends to take off very early, clear by a lot, and land very far out. They tend to move faster on the flat.

Her weaves suck, she tends to go into the weaves too fast, pulling her out of the poles, and she often can't get a rhythm. That's all my fault. She's also got a table problem. She doesn't like getting on them, and likes downing less.

She LOVES tunnels, but also likes obstacles. I can never really tell which obstacle she's favoring in a discrimination -- for the non-agility person, you'll often see a tunnel under a contact obstacle, with both facing the dog.

She's a really cool dog. She doesn't like it when I am in pain, or having trouble breathing and will shut down, not just when we are doing agility. She's very affection but on her terms. With strangers, I can tell she's really just sucking up for treats. Or scratches. She has a problem with ear infections and lves ear scratches.

She's extremely photogenic and got some modeling work when she was a puppy. She was featured in the "Essential Beagle". I think she's got around 10 pages. She LOVES having her picture taken. I think she just likes the extra attention.

Oh, and she loves other dogs. She played with a 100 pound Malinois when she was 8 weeks old until she was about 2 years old. Other dogs don't scare her, and she likes to mess with dogs in crates. Her favorite thing to do at trials is to get in crated dogs faces.

Her other favorite thing to do is what I call f* with border collies and other focused dogs. She pulls this all the time with a friends dog. He'll be laying at course side watching class, very intent, and she'll walk up and do all the "I want to play things" Finally she'll start patting him in the face with her paw. She's totally fascinated with the fact they are ignoring her.

Depo PreVera

Doctor and I decided to leave well enough along. Depo has been my friend for about 15 years, and one of the biggest reasons I'm on it is to prevent having periods. I used to have horribly painful periods, to the point I would almost always have to go home sick. A lot of time accompanied by vomiting and other gastro intestinal problem.

We're both afraid of the 30% reduction in dosage, and as he said, if it isn't broke don't fix it.

Tarsal Tunnel -- I got the spelling wrong

I'm dealing with Tarsal Tunnel. The boot does seem to help. I wore it right up until Maggie's class and it didn't really start bothering me until Marcie's. At that point, I'd been on my feet and moving, for about 1 hour and 45 minutes.

Tarsal Tunnel Syndrome - Overview, Symptoms, Causes & Treatment - podiatrychannel

Tarsal tunnel syndrome is caused by the entrapment of the tibial nerve.

Depo-SubQ and Medco

Okay, now this is just weird.

If I get Depo-SubQ mail order, it costs $65.84 each fill, but if I get it at the local pharmacy, after the first 2, it's $55.00. On the first two fills it is $40.00. That's weird. Now I need to look up Depo again.

I'm glad I checked. They must have changed the prices because it's $25 for the first two, and then $35.00 at retail and $45 by Mail.

I'm going retail.

I wish I had checked this before I ordered the last one.

This is cool!

I want to talk to my ob/gyn about this form of Depo, so I used the blogger function to email the address to myself. I downloaded the email to my Treo, and now I have the links to show him when I get to the office. I'll just pull them down while I am waiting.

The Well-Timed Period: Depo subQ: Birth Control & Endometriosis

Depo subQ: Birth Control & Endometriosis

Tomorrow gynocologist

I probably spelled that wrong. It's my yearly well woman visit.

I need to remember two things, I still have some function problems. I like the way my doctor put it once, basically the hanger is too small for the plane. (No big is not always better).

Also, we don't have as many days off next year, I've sat down and entered all our days off, and getting the depo shot in September is a problem to begin with. I am wondering if we can go to the new Depo SubQ and let me self inject more. He doesn't like the idea, but I've been on the stuff for 10 years, and I give myself shots all the time.

Part of the problem is his office hours. He closes a bit early.

If he is worried about allergic reaction, he could write a script for that, just in case.

June 16, 2005

I second this advice!

Professional Patient: Be Kind to Yourself after an Appointment

I actually go one step further -- during the school year, I schedule one or two appointments together -- usually ending with my CDE in the afternoon, because no matter how bad things have been, she's always on MY side.

Then I take the whole day off and take myself out to lunch. Nothing is a better treat for a teacher than real lunch with adults in the room and someone serving you. In other words, don't go to a buffet!

Tarpel Tunnel Syndrome

Went to the podarist today. Good move, I'm having problems with my Tarpel Tunnel.

He gave me 3 choices:

Antiinflammatories
Cortisone shot
Boot.

I picked the boot, which was also his suggestion. I can wear this thing all the time, including sleeping unless I'm doing treadmill or dog agility running, and hopefully nip this in the bud, without affecting my blood sugar too much -- all will elevate, including the boot as it forces some inactivity, but is the least invasive.

Am to see him again in a month.

How I was told.

At dLife Today: War Stories the Dlife blog asks how we were told. I have posted this story before.

I was surprised when I was told. My family history indicates that I will be diabetic and my medical team and I have been watching for diabetes for years.

I had been told I was borderline the year before diagnosis, but that my lipid levels were worse, so the doctor wanted to watch the blood sugar levels first, and deal with the possible diabetes later. At the time, my faster blood sugar was around 125.

A year passed and we were still seeing faster blood sugar levels between 125 and 150. Nothing higher. So after the year was up, the doctor decided to send me for a glucose tolerance test.

Well, by the end of glucose tolerance test, I wasn't. (that is tolerating the glucose).

I went through a weekend I was sicker than a dog (and I use that expression wisely, being a dog person). I got to school and realized that I couldn't cope with the day by about 9:00 am. So I called for a emergency sub and called the doctors office and told them I was coming in. At the same time, they were calling all my numbers to tell me to get into the office now.

I'm honestly not sure if I told the doctor the diagnosis, or if he told me.

I really think I was lucky. I got drastically sick quickly from the glucose tolerance test so I had incentive to do something to get well.

I was feeling perfectly okay Friday morning, and by Friday noon, I was a snarling, nasty person, blurred vision, headaches, horrible thirst, you name it. To this day, I feel badly for the people who did my mammogram in the afternoon, as they didn't deserve me at all.


Supplies

Life is funny -- I was just going to post on a "mistake" another pumper made, when I just did something incredibly stupid -- I lost the rubber cap on the top of my insulin pump. Probably because I had my mind on other things.

I'm fairly certain I threw it in the trash. The good news, because I am anal, I am not completely screwed. When I sent back my recalled pump, I kept the rubber cap. I ordered an extra battery cap (and kept the recalled one, so I have two), but I was waiting until my next supply order to get another rubber cap.

I'm fairly certain I threw it in the trash and I am looking for it now, in between posting.

And yes, that is exactly what I did -- I had it in my hand with some trash and threw it all way.

Here's the start of the original post:

I was reading another one of our pumper blogs the other day and felt really bad for her. I am not going to link to the post as I am afraid I'm going to come across critical.

One of the biggest problems with pumping insulin is obtaining supplies -- meaning cartridges and infusion sets. This is not a item you can pick up at your local pharmacy. In a pinch, I could probably get some supplies from my endos, but that would only happen during office hours. Maybe even from my pump trainer, but I would also never presume to both her outside of "office hours", even though she works out of her home.

This means you have to plan ahead. And planning ahead saved my rear today.

Because I had saved the plastic cap from my old pump, I could calmly go get it, put it on the pump, and then take a long time to search. You see there was a possibility it was laying on my desk. There was also a possibility it landed on the floor -- which opens the possibility that a beagle ate it -- though they usually don't, but you never know. If I had a puppy, it surely would have been eaten if it had hit the floor.

SO NOW THE POINT.

I keep at least one spare of everything I need. I even have a spare CPAP machine these days. I keep at least 1 month's worth of any medication I need on hand, and I get nervous if I go less than 2 weeks.

At the end of the 90 day period, I have at least one extra box of infusion sets and one extra box of cartridges. Back before I was covered on insurance, I bought those extras on ebay. (By the way, watch eBay and expiration dates, always ask, sellers aren't always aware of expiration dates).

Same things goes with test strips.

I'm REALLY bad about meters. I keep an extra in my car -- the old Freestyle, and keep an extra in my bag. If you go WAY back in time, I actually go to an agility trial without my meter. DUMB, DUMB, I dropped it on the street and a neighbor returned it.

Being anal isn't always back.

Good article about Diabetes and Dental problems

Yeah, diabetes affects everything and this is not something I don't think about very often, so I am sure it is helpful for others.

MSN Health & Fitness - Dental care and diabetes: The importance of a healthy mouth

Dental care and diabetes: The importance of a healthy mouth

June 15, 2005

Behavior Changes and Motivation

Bloglines | My Blogs

(Anyone with brilliant ideas on how to motivate people to take better care of themselves can contact Dr. Polonsky's institute here. Make sure to cc me at amy@diabetesmine.com as well!)

Hmmm, maybe I should contact him. I've studied behavior analysis for years on both a theoritical basis and a concrete basis for years.

Between training beagles for dog agility and teaching high school students technology, and between working on myself as a diabetes patient, I'm got a lot of practical work done.

One of the biggest problems with motivating diabetes patients, is that it hard to come up with tangible rewards. Also the "noncompliant" behaviors tend to be self rewarding. It's always hard to eliminate self rewarding behavior.

June 14, 2005

Sidekick

It's a cute little device, probably best for emergencies, because I doubt you can download from it.

http://www.prestigesmartsystem.com/products-sidekick.asp

GERD

I doubt GERD is a complication, since I've had problems with it long before the diabetes, though I wonder if diabetes is a factor keeping it out of control.

Diabetes In Control - Gastroesophageal Reflux Disease in Diabetics, an under Diagnosed Complication.

Gastroesophageal Reflux Disease in Diabetics, an under Diagnosed Complication.

June 13, 2005

A much read for every patient

RangelMD.com

The 10 Commandments of medication usage

I'm on 6 daily medications a day and I have sat down, read all the side effects, and have had intelligent conversations with my doctors on the medications.

For example, the reason I'm on Zyrtec, is because Allegra makes my blood pressure go high.

The reason I'm on insulin is because I don't like the side effects from the Type 2 medications, nor do I like what they do to your lifestyle.

I believe it's important for patients to know what is going on with their medications.

New Fundraiser

This is a real neat story ... and I wish that DLife would have featured him along with the pilot last night, and kept the focus on diabetes in the workplace.

I kept expecting them to talk about this story, as it has been in the diabetic news for several months.

Back From Iraq: A Soldier's Story - American Diabetes Association

Staff Sergeant Mark Thompson convinced the Army that having type 1 diabetes shouldn't keep him from serving in Iraq.

See, I'm right...

Tight control IS a good thing. Besides, I feel better.

CNN.com - Study: Tight?glucose control cuts diabetics' heart risk - Jun 13, 2005

After a follow-up of 6 1/2 years, it emerged than these patients also have a 57 percent reduction in the rate of heart attacks and strokes, said Dr. David Nathan of the Massachusetts General Hospital in Boston.

ADA Scientific Sessions

If you are interested in the ADA Scientific Sessions, this blog is doing an excellent and timely recap of the actual sessions.

Richard's San Diego Diary

Follow the happenings at the 65th Annual Scientific Sessions in San Diego through the eyes of Dr. Richard Kahn, Chief Scientific and Medical Officer of the American Diabetes Association.

Extremely Disappointing

I find it very disappointing that there is no progress being made on continous monitors. See snapshots of blood sugar readings is NOT helpful.

Also that means we won't be seeing a closed loop system anytime soon. A close loop system, for those who aren't in the know, is an insulin pump that operates automatically. For that to happen we have to have a continous glucose monitor and it will have to have been out of the market long enough to be known to be reliable.

Diabetes Mine: Product Roundup: Continuous Monitors (in the Holding Pen), Convenience Enhancers

Product Roundup: Continuous Monitors (in the Holding Pen), Convenience Enhancers

DLife

Yesterday's DLife episode was a LOT better. Pulling the cohost off with the guest and letting the two focus on each other was a vast improvement on 4 people firing questions without listening to each other.

I still think they are trying to give out too much information too fast. I think the segment on breakfast could have been a full show. They still hit and glance off the topic rather than go in depth. There was also much more to say about dealing with diabetes in the workplace. The ADA guide never said when it was okay to share with diabetes, just when you didn't have to.

All in all, MUCH better.

June 12, 2005

Heel spurs are back but fabulous dog agility weekend

My heel spurs are back. I know it's because I increased my treadmill time. I'm taking an off day today, and going to ice my food down most of the day and hoping it will go away.

I know my dog agility runs didn't help, though we were on grass. It was a fabulous dog agility weekend. I ran both dogs and the trial was scheduled for Friday and Saturday only.

This was an USDAA trial, which has been extremely frustrating for me. Marcie either makes one mistake which wouldn't count in AKC, or is over time, which is shorter than AKC time. (For the non-dog agility person, there are several dog agility venues with different rules and different ideas, for us AKC is the easiest).

On Friday night, Marcie started out the evening with a 1st in Gamblers. USDAA has games, in Gamblers, you get as many points in the opening, a buzzer sounds (or a whistler), and you have a fixed amount of time to get a "gamble". It's basically a set of obstacles where you have to stay behind a line and the dog has to get it right by verbal commands. Marcie Qed, getting enough points in the opening AND getting the gamble.

Marcie was also clean in Standard, but .6 seconds over time. ARGH! She took a second.

Maggie got distracted, and went off course once, and came in second. That was Maggie's best course at that point, she's only competed about 4 trials.

Saturday was even better. Marcie and I played Snooker. It works like the pool game, I think. There are 3 red jumps, and a small course. You take a red jump, take part of the course, red, another part, etc. Then when you finish that part, you take the course. Marcie took a 1st place in that compeition and Q'ed.

Standard runs were both clean with both dogs, but both were over time. They both had trouble with the weaves and Marcie had trouble with the table.

Marcie had a final jumpers run, which was real fun for both as there are no weaves or table to mess us up. She ran clean and in time, taking another 1st and Qing.

So our total was:
Marcie had 3 Q's, and got 3 1st places, and 2 2nd places.
Maggie had 2 second places.

It definately means that I'm running better, even with the heel pain.

Some goo d news here

Some of the news is good, but the misdiagnosis thing needs to be fixed.

Diabetes Care Improved Over Last Decade - Yahoo! News

The federal Centers for Disease Control and Prevention said the rate of people with diabetes who need hospitalization or develop kidney failure has dropped about a third since the mid-1990s.

June 11, 2005

This study irks me

You are not going to be able to get anywhere if the patient doesn't know something about diabetes.

However, too many doctors throw a pill at diabetes and don't have much of a commitment. I know lots of diabetics, some even Type 1, who don't take care of themselves sufficiently.

However, I'm not sure why I'm different, except for the fact, I don't like feeling sick all the time. And when my blood sugar is out of control, I feel sick.

Patient Education Won't Alter Diabetes Outcomes - Yahoo! News

Simply educating diabetics about their condition doesn't seem to improve their blood sugar control or reduce their likelihood for risk factors such as obesity, researchers report.

June 9, 2005

Nuclear Stress Test

I'm "done".

The technician, who has apparently done these for a long time indicated that the test was within normal parameters, but that there was some shadowing that was consistent with breast tissue. I should hear from the doctor or the nurse practioner for the final okay.

They finished up with another series of xrays. Then sent me to the nurse practioner who went over my medical history. She suggested I add Pepcid when I was having GERD symthoms (chest pains when exerting). I'm not really worried about it, but if the GERD doesn't get better soon, I'm going to get more aggressive about it, because I think it is affecting my sleep.

My part of the charge on this was a lot more expensive that I thought it would be. I think I've met my deductable though, I'll check with the insurance once it gets processed.

The other was the timing -- though I understand now, that it wasn't the first appointments of the day, but I should have it NEXT year.

Nuclear Stress Test

Here's my first problem.

I made this appointment months ago and asked for the first appointment of the day. Got here 10 minutes early and volunteered that my insurance card is different but the only change is the number.

It is now 15 minutes past my appointment time and no one has spoken to me since I talked with the receptionist.

About 20 minutes after the appointment time I am taken back, given instructions and the tech makes a big production out of finding a vein. The production is much more dramatic than the procedure. Interesting device, let's them put the tracing dye in painlessly.

After the dye was in and started circulating they put me in an xray machine that took lots of pictures.

Next they put electodes on for the stress test. They had me lay down and put in the stuff to put me under stress. It hit pretty quick but was actually easier than last years stress test. That lasted four minutes. they put some more fluid in, then pulled that port and then took most of the eletrodes off.

Now I'm waiting for the xrays again.

I'm sure it was psychological more than anything but I really wanted to check my blood sugar. It was 114 which is great. It was 128 this morning and I had a sausage and reduced carb yogurt smoothie for breakfast.


---
From my Treo

June 8, 2005

My Master's Degree

A commenter asked what I was getting my degree in.

It's CECS -- Computer Education and Cognitive Studies. It's an interesting program. I started it two summers ago, kinda of accidently. I decided to add an additional certification, technology applications, although I was grandfathered to teach webmastering.
Upon completing the certification, I learned I was eligible to join a district program that would give me this master's degree. The district has been paying my tuition and we usually take one class a semester as a group, with the same professor.

For those of you who are still scratching your heads, here's what the degree is all about: It's an educatio