Living With Diabetes

Tonight was "Meet the Teacher" night.  Husband is on vacation so no one was home to take care of dogs.  I decided to "treat" myself with my favorite comfort food, El Chico's Chicken Fajita Chimiganga.  And beans and chips.

I did an extended bolus -- half my insulin immediately and half over 2 hours.  At 2 hours after I was at 179, not bad.  BUT at 4 hours after, I was at 330.  Yikes!

So it's force fluids and at least it will be easy to get to sleep.  I've done a can of cafeine free diet coke and a large bowl of egg drop soup. 

The rest of the day was pretty good, though I did go lower than I like before lunch and after I moved furniture.

Posted by at 9:27 PM | Permalink

The changes I made yesterday did help, but I'm still having problems.

I headed towards low during my exercise session, and had to eat more on the way to dog class. However, I turned my basal down to 50% for the two hours of dog class, and finished at 175, and then did a correction.

I'm starting the day off at 107, which is a good thing. Yesterday I started off at 137 and with a correction.

I'm still seeing a trend of reducing my TDD, but I am not losing weight. In fact, I may be gaining, which is frustrating.

Posted by at 6:49 AM | Permalink | Comments (1)

There is a certain group of people who persist in using my posts against detection dog training for their own advertising purposes. I thought very little of detection dogs when I saw them on Dlife, and their attempts to spam my blog have caused my opinion to drop to negative.

Rest assured, I will not let anyone use my blog to advertise services or goods. In fact, I've turned the commenting off of those entries and off of this entry because of the spamming.

About the only good thing I can say about them, as that the use of detection dogs is not as painful as the Glucowatch. However, they are taking a lot larger sum of money.

I've had associations with assistance dogs in the past, and in the case of legimate detection dogs, the assistant dog did cost the user any money. All expenses were paid through donations. That is true of Seeing Eyes, Canine Companions, and Texas Hearing Dogs. Anyone who is selling an assistant dog is not legimate.

Posted by at 6:48 AM | Permalink

Did both cardio and strength, though a nice light workout.

The blood sugar has been all over the place today, partly because I forgot a bolus.

Posted by at 5:23 PM | Permalink | Comments (1)

It's a pretty easy spreadsheet, but if you want a copy of it email me at kathleenw at gmail.com or just leave a comment on the blog asking for it.

Posted by at 12:15 PM | Permalink | Comments (1)

Of course, it's a short drive.

Seriously. Overall, my control hasn't been bad. But I've been hitting a low every evening. I've been tracking my TDD closely and it has dropped. Those of you who pump understand that if your TDD drops, you have to adjust everything.

I keep a spreadsheet of the 14 day average, which also calculates boluses based on the rule of 500 and corrections based on the rule of 1800. I try to use those numberes as references, but adjust both boluses and corrections conservatively.

However, I got so tired of being low, especially in the evening, this morning, I just broke down and moved all my corrections up to 40, hoping that will solve the problem -- which is what my spreadsheet says they should be. I also adjusted my non-regular boluses to 11 -- again, what my spreadsheets says they should be, just in case. I am still being conversative about my meal time boluses, only adjusting them according to my meter readings.

Here's what I do. If I start seeing consistantly post pranial readings of under 130, I'll up the carb ratio. If I see post pranial reading over 150 consistantly, I drop the carb ratio. And I always change just be one.

I do the same thing on corrections, but they can be hard to see if I correct too close to a meal. I'm hoping it will all balance out in a few days. Like I said, it's driving me nuts.

I don't know if I'm losing weight, I kind of doubt it, since I"m having to eat to avoid treatable lows.

Posted by at 6:36 AM | Permalink | Comments (2)

I really like the fact that iShape is taking me back into a program, very slowly. Today was weights only and that was a good thing.

Posted by at 6:54 PM | Permalink

Journal Scan -- Type 2 Diabetes

Effect of Lowering LDL Cholesterol Substantially Below Currently Recommended Levels in Patients With Coronary Heart Disease and Diabetes: The Treating to New Targets (TNT) Study

My endo has me on Vitorian and is working hard to bring all my values down. I kind of blew it the last few months but I think I'm doing better now. Part of it is just keeping the blood sugar control tight too.

Posted by at 6:44 AM | Permalink

Diabetes In Control Newsletter - How to initiate basal-prandial insulin therapy in Type 2 patients

Long PDF article, well reading, easy read. Although I am on pump therapy, I found the whole article fascinating.
How to initiate basal-prandial insulin therapy in Type 2 patients

Posted by at 6:50 AM | Permalink | Comments (1)

Just finished the first trial of the fall season. Blood sugar was wonderful. Never over 188 the whole time but I also did not eat. Left with blood sugar of 127.

Our runs:
To: bestfriendsagility@yahoogroups.com, rweaver@augustmail.com, reginaekrause@att.net, dbfarrell@msn.com
Subj: TKC Brags

Maggie had a decent first Excellent Standard run with her usual problems. Weaves, table, and had problems with one tunnel.

Marcie had a nice standard run. I was ready to pull her. She did everything but go through the last tunnel. I pulled her out by going too far ahead for her.

I messed up two jumps for Marcie. She ran very well. Looks like she recovered friom the pancreatitis.

Maggie had problems with the weaves, then I missed up a jump and then later she lost focus.

I am real pleased with all four runs.

We only got into the one day.

Posted by at 1:09 PM | Permalink

Just finished the first trial of the fall season. Blood sugar was wonderful. Never over 188 the whole time but I also did not eat. Left with blood sugar of 127.

Our runs:
To: bestfriendsagility@yahoogroups.com, rweaver@augustmail.com, reginaekrause@att.net, dbfarrell@msn.com
Subj: TKC Brags

Maggie had a decent first Excellent Standard run with her usual problems. Weaves, table, and had problems with one tunnel.

Marcie had a nice standard run. I was ready to pull her. She did everything but go through the last tunnel. I pulled her out by going too far ahead for her.

I messed up two jumps for Marcie. She ran very well. Looks like she recovered friom the pancreatitis.

Maggie had problems with the weaves, then I missed up a jump and then later she lost focus.

I am real pleased with all four runs.

We only got into the one day.

Posted by at 1:05 PM | Permalink

Got up and got it done early. Though my knee is really bothering me.

Posted by at 9:00 AM | Permalink

Yesterday was another off day, thank goodness, it was a long day. I did get today's workout in, which was a strength only day.

Posted by at 7:22 PM | Permalink

Got Day 2 in (yesterday was my off day -- I have two dog agility classes that night.

Posted by at 8:57 PM | Permalink

Diabetes In Control Newsletter - Study Compares Gastric Bypass and Gastric Banding Surgeries

This is what I was told by a surgion.

Study Compares Gastric Bypass and Gastric Banding Surgeries

Posted by at 7:40 PM | Permalink

I'm just finished my iShape program for today and my goal is to get back to the program.

I had to quit because I injured my knee a few weeks ago, and besides the fact that it hurt to walk, I didn't have time for exercise AND physical therapy.

Posted by at 10:52 AM | Permalink

Actually the good news, is that I have all my scripts I've ordered this month, except the syringes.  I am trying very hard not to spend any more medical money until the 1st though, because that's when my Flexible Spending Account starts again.

The latest game involves Requip, which I do believe is helping me to sleep.  Apparently (and I don't blame them), they don't want to fill the prescription with 2 1 mg tablets, but I am hoping they and the doctor's office will finally see eye to eye and fill it.  I would not mind 1 2mg tablets at all.  I'm going to get with the doctor's nurse on it Monday.

Posted by at 10:20 AM | Permalink

I've learned a lot about Symlin.

Medco has started shipping my Symlin and Novolog (insulin) without telling me.

Yesterday I got a hot batch of Symlin. The gel packs were cold but at one end of the package and the Symlin was hot.

I put it all in the fridge but decided to try it to see if it was still good. it wasn't. Clearly after two doses.

I did leave the rest of the shipment in the fridge.

I left that bottle out in the shipping contents and called Medco at 6:00 am.

They told me that it would be good as long as it was rechilled so I took a second vial out and used it.

Apparently they are right as it is working fine now.

I even called the 1800 number for Symlin and they said that they can tell if a vial is good if you give them the worst possible temperature, the lot, and the expiration date. they did say it was good.

FYI: I told the Medco pharmacist that if they packed with the Symlin in the middle with the gel packs at each end it would have been cool and he sais he couldn't comment but would pass my comment on.

Guess what? That is exactly how my Novolog was packed and it was cold.

Go figure.

Posted by at 5:16 PM | Permalink

Diabetes In Control Newsletter - Postprandial Glucose Fluctuations Impair Cognitive Functioning

Awareness and better control of postprandial glucose can help to prevent declining cognitive function.

Posted by at 9:03 PM | Permalink

Diabetes In Control Newsletter - A Tale of Two Insulin Pumps

Diabetes has been an interest of mine throughout pharmacy school. I am now in my final year of school, and I recently experienced a small glimpse into the life of a person with insulin-dependent diabetes. I do not have diabetes, but during my last clerkship rotation, I lived for four weeks as if I did. I tested my blood glucose and injected imitation insulin (actually saline). I was also given the opportunity to wear two insulin pump devices, both unique in their own way.

Posted by at 9:02 PM | Permalink

Candid Diabetes: Tips For Saving Money With Diabetes

However, I don't recommend buying test strips from Ebay. You have no idea where they came from.

Posted by at 8:31 AM | Permalink | Comments (2)

Managed to go through the day slightly high -- 180 post prandia most of the time, and I'd like to be 40 above rather than 40 below, let me tell you!

Class sizes are great, kids were extremely well behaved, not at all like last year's algebra kids OR the summer school kids.

I do quite a bit of data entry when they first come in, keeps everything organixed, and every class waited patiently. 

Posted by at 6:18 PM | Permalink

I'm trying out Windows Live Writer.  Looks like a nice interface.

Posted by at 9:59 PM | Permalink

I've had some major victories -- I'm usually sick whenever we have workshops, and the week before school starts is usually one of my bad times.

My blood sugar was fine on Monday and Tuesday, actually great, but I made a bit of a miscalculation on Wednesday and have been having lows almost every day ever since.

Part of the problem is that I've been very conservative on fixing boluses as I don't want to end up rebounding or being high.

Here's the deal, we had a convocation at the American Airlines Center here in Dallas. I figured on sitting still for half a day, but didn't take in account that I would have to walk between 3-6 blocks to the Airline Center (probably closer to 6).

When I got to AAC, I had to get help. Which was actually a good idea as it got me out of a mob of people.

After a tube of glucose and sitting in the cool, I was fine.

And I did do something smart -- I had my lunch all packed and ready to go in the car. That was smart, as when I got back to the car I was at 90. I just got into the line to get out of the parking lot and ate my lunch as I waited.

The bad news is that my corrections are working too well, and I've had at least one crash a day after a correction. The good news, that I have been avoiding rebound highs by actually bolusing for most of the correction.

I'm looking forward to next week, but reminding myself to check often!

Posted by at 1:42 PM | Permalink

I woke up to the news that travelers cannot take ANY carryon items, especially those containing liquid and thought -- oh, my god, what if were coming back from Pittsburg today.

And while these new terrorists haven't actually broke any planes down, they have completely disrumpted air travel. Not just for the diabetics, but everyone.

Hopefully this too will pass -- though Richard Reid's act of terrorism is still affecting us all today. Making us wear shoes without metal, or making us take our shoes off at airports.

And Amy, I've thought of you this morning too -- coming back from Germany will be interesting to say the least.

Posted by at 6:20 AM | Permalink

Notes from Dr. RW: Diabetes type 1.5

Fabulous article explaining the different types of diabetes. In addition, links to MODY and LADA descriptions.

Posted by at 11:43 PM | Permalink

Never brag about "getting" something. It will bite you. Here's the deal -- I was just bragging to my endo, that finally after 4 years, I had finally figured out workshops, but then two hours after lunch I was at 200.

At the same time, that's not NEAR as bad as I was in the old days of workshops. I would have been at 200 at 9:00 am then.

And I never went over 200.

So I think I have workshops, I just didn't bolus enough for lunch.

And I'm "officially" an old teacher. One of my former students is in our school. Teaching French.

Posted by at 6:10 PM | Permalink

I'm doing last minute doctor's visits before starts.

Gynocology - which resulted in the self inject victory.

Endo - numbers are slipping upwards along with the weight.

Cardologist - insurance won't pay for the test. Personnally I don't care but wish they had not freaked me out.

I still need to talk with someone. Hopefully the cardiologist and I have a mammogram at 1:00.

Posted by at 11:15 AM | Permalink

But not for another 12 weeks.

I finally got my gynocologist to let me self inject depot by switching to Depo Sub-Q.

I've been on Depo Prevera for over 15 years. I went on it before I went into teaching. I've never had any complications except for the lack of period and PMS (and I don't see that as an adverse side effect).

Both the doctor and I are concerned about bleeding and he wants me to let him know if that is an issue.

Since it is non-formulary and there is a generic version (but intra-muscular), it is actually going to be cheaper to get it at the retail pharmacy than it will from mail-order, we think -- we being from my looking at the Medco site and my talking to a customer service representative.

So I have a script and it's on my list of things to do in 4 weeks.

Posted by at 6:25 PM | Permalink

Though I do have one issue about a career change -- I'm pretty expensive these days -- I know I will be making more than $52,000, and might be over $55,000, I haven't quite figured out the district tables.

So few non-profits could afford someone like me at this point. However, when I retire that might be an option. I wonder if a practice like my doctor's could afford someone like me -- I might take a moment to ask the doctor.

But I'm with Wordsmith when it comes to the CDE program. I've looked at doing that, and I've looked at what it would take, and at my age and income level, it just doesn't make sense.

But I also see a place for non-CDE's. First of all, in a large endo practice, someone like me would not need to draw blood, but would need to be able to interpret the results for patients. I'm quite sure I can handle that. I could certainly teach someone how to inject -- which was very difficult for the three CDEs I had since none of them was a diabetic. They didn't even do the orange thing for me (which is kind of goofy anyway).

I could certain design curriculum -- thats what all my post graduate work has been about. I would be able to design both face-to-face education and on-line. And I think I'd be better at it than a non-diabetic because I know the pressure points.

I'm not sure I'd be good with small children. I haven't been around many, but I would be absolutely fabulous with teaching teens on how to take responsbility for their own care. I've actually done a bit of that, every one including the nurse sends them to me when they need advice with dealing with their parents. Don't worry -- my advice doesn't involve how often to inject,etc. but on how to show your parents you are taking responsibility for yourself. Teacher get that all the time, but maybe me more than most, from non-diabetics.

I really think I'd be best with adult Type 2s as they can tell from looking at me I'm struggling with the environment factors.

So yes, a non-CDE diabetes educator is a good idea, and could solve a lot of problems including the nursing shortage.

Posted by at 6:17 PM | Permalink | Comments (1)

LifeAfterDx--The Guardian Chronicles: We interrupt our regularly scheduled program...

Every CDE and every doctor I've dealt with says I should become a CDE. However, that means going back to school and taking a huge cut in pay. I've done that once for education.

I have a much better track record when it comes to the education end of things -- that's my training, and I too live with the diabetes thing. Probably can reach Type 2s better than a lot of Type 1s since I understand before diabetes better.

More when I have more time.
I think we D-folk should band together to create two new certifications to "compete" with the CDE. The DDE and the FMDE. These would stand for Diabetic Diabetes Educator and Family Member Diabetes Educator.

Posted by at 6:44 AM | Permalink | Comments (2)