Living With Diabetes

Have I mentioned lately how much Medco makes me crazy? Here's the latest.

Zyrtec. Along with diabetes and gastric reflux, I'm allergic to dust and also have the typical Texas seasonal allergies. Remember I teach high school. I dropped a dime yesterday morning and discovered 1/4" layer of dust under my desk. Wonder when they last swept there?

So Zyrtec comes up as due to reorder, I reorder, and it sits there not being shipped. I finally get a message saying it needs to be authorized by my doctor, and that they aren't shipping. Then two days later it pops up again, saying it's due to reorder. I reorder -- after I've had a conversation with a pharmacist to see if I should try an over the counter. And guess what -- it's on its way.

Posted by at 8:39 AM | Permalink

Diabetes In Control Newsletter - The Earlier You Get Diabetes, The Worse it Will Get

Especially since I was diagnosed at 42.
People who develop type 2 diabetes when they're younger than 50 years of age are more likely to experience a worsening of their disease than those diagnosed at an older age.

Posted by at 10:07 AM | Permalink | Comments (4)

Optimizing Sleep Duration and Quality Improves Glycemic Control in Diabetes

When I am having difficulty sleeping I also have difficulty with my blood sugar control.
Optimizing sleep duration and quality should be tested as an intervention to improve glycemic control in patients with type 2 diabetes mellitus (DM), according to the results of a cross-sectional study reported in the September 18 issue of the Archives of Internal Medicine.

Posted by at 10:05 AM | Permalink

I've done two more cardio sessions than was scheduled. Managed to get every days workout in, even though it was a long tough week.

Posted by at 9:15 AM | Permalink

At the end of our faculty meeting today, the principal shared with us that one of our collegues had gone in for surgery to remove a blockage and a tumor was discovered.  I think he said that they found that he had both stomach and liver cancer too, but not entirely sure about the liver cancer thing. 

It was a rough way to start the day.  Kinda of makes you wonder if all the finger sticks, knee pain, etc. is worth it all.

The good news is that the vending machine is only taking correct change and it hurt to much to walk back up to the room to get change and go back and get something to eat.

The bad news is that the PSTA put Hersey bars in our boxes, or maybe that WAS a good thing.

The good news is that I've eaten dinner and the TDD for the day so far is around 24.00

Though Macy says she's happy because she's got people who love her and plenty of toys to play with. 

Posted by at 5:38 PM | Permalink

Diabetes Mine: Trouble in Reimbursement City

Diabetes Mine writes about it:

We've been asking the question, "How soon will insurance providers start covering continuous glucose monitoring (CGM) devices?" But it seems the more accurate inquiry would be, "Why won't insurance providers 'reimburse' for CGM devices any time soon?"

And it looks to me that they don't seem real wild about compensating for finger sticks.

So we have to decide if we want to pay.

Posted by at 9:56 AM | Permalink

I wrote about my first day -- and how I had problems with my pump and high blood sugar due to the newest.

The second day went much better, though I didn't sleep very well. Even forgot to check my morning blood sugar, but I was normal after the class. I ended up not showing in Rally because Marcie just didn't have it together.

I've since made a decision. I don't want to spend my weekends getting dressed up, shaving my dog's face, and cutting off her hair along her neck and legs. If she was a super beagle, and it wouldn't take long to finish her, I'd do it. So I have an appointment with the local spay/neuter clinic on Friday.

I'm going to take more time getting Marcie ready for Rally -- maybe next spring.

In the meantime, I'm going to concentrate on my sport. Agility. Where it really doesn't matter if I fall on my face.

And maybe someday, I'll try it again, but not now and not with this dog.

Posted by at 3:23 PM | Permalink

Tundra Medicine Dreams: Grand Rounds, Vol. 2 No. 52

I contributed this round. I addresed the "hope for a cure" issue.

Posted by at 2:04 PM | Permalink

Even though I walked the dog show several times, I came home and got my exercise session, both strength and cardio done.

I tweaked this week and the program for the future to work better with my schedule.

Posted by at 4:08 PM | Permalink

Started out not sleeping well and woke up about 5:00 and discovered the pump was disconnected. Since I had to get up early anyway, I did. Blood sugar was 150 after I finally got out the shower and got everything together. Corrected, ate breakfast.

Showed Macy the first time in conformation, boy was I nervous, was wondering if this morning was going to be the massive coronary event I pray for, heard every heart beat. We got through it. She won the puppy class, and going back in to compete for Winner's wasn't bad.

Blood sugar was 250 when I hit the car, I bolused right for breakfast, did the Symlin thing, etc. Had to have been the nerves, and I even was on my agility program!

We do this again tomorrow, and I think I'll add about 20% to the basal rate (and go with the agility rate), and see if I can have a better blood sugar. I'm going to set it around 6:00 am, and have it only go for half an hour, which is about as long as we did conformation.

Of course, showing Rally will be just as bad, poor Marcie is going to be very upset, but she'll get over it. Probably won't Q, but at least there is only one first time, and hopefully there won't be as many important people around the Rally ring. Part of the problem with conformation, is that I just don't fit in with those people. I'm a agility/obedience type. If you don't do dogs you wouldn't know the difference -- except we don't dress as well, for one thing.

Also, I bought the car. I almost bought the same car I had. But hey, I liked it. I ended up with an Escape. Husband thinks, and I agree we need custom cages, so I'm going to look for them at the shows this weekend -- there actually someone in the area that does them. Actually I brought it up.

The biggest thing, is that the crates I have know had lips on the side. If my crates were straight up and down they would fit better. And I could go with wire, but trust me they make more noise.

And I almost forgot -- I got in ALL of this week's exercise.

Blogging about it helps!

Posted by at 8:10 PM | Permalink | Comments (1)

It finally came today, as prescribed -- but probably I should count the pills... I'll take it on faith though.

I'm not sure which end had the problems -- it's funny but any script my endo writes, turns out fine, sometimes it takes two tries for the primary care, but this one took quite a few tries. But it got done.

Posted by at 6:35 PM | Permalink

Diabetes In Control Newsletter - Chronically High Blood Sugar Linked To Risk Of Cognitive Impairment

A four-year study of elderly women has found that chronically elevated blood sugar is associated with an increased risk of developing either mild cognitive impairment (MCI) or dementia.

Posted by at 8:10 AM | Permalink

Something dawned on me tonight when I was writing an email.  I don't keep this in the front of my mind, but it IS on the back of my mind.

I'm 46.  I try not to think about that very often. 

When my father was 42, he was diagnosed with diabetes.  When he was 46, he was diagnosed with congestive heart failure, told to put his affairs in order, put on oxygen, told not to be exposed to any illness, and sent home to die.

The good news, it took two more years for it to kill him.

Thus, I'm a bit paranoid. 

I think that is a much better attitude than living with the hope that there was be a cure in 5 years.  In fact, I'm sick to death of hearing people repeating that little information.  What does that do for anyone?  I think a lot of them don't take as good care of themselves as they should, expecting that cure.

There is not going to be a cure for my kind of diabetes in 5 years, and even if there were, if I don't take extremely good care of myself, I'm going to be dead in less than those 5 years. 

I also find my own doctor's concillartory message -- there will be inhaled insulin in 5 years.  Yeah, right, meal time insulin and the whole process is a pain in the rear.

So I'm on a pump, I test empteen times a day, and I keep my blood sugar as normal as possible.  Not to live -- but to keep from dying.

There have been good side effects from that -- one of my students asked me why I hadn't given the diabetes speech this year -- well, I haven't had a treatable hypoglycemic event in a year, and the last time was when we played Symlin games.  I often eat a bit of sugar to keep from getting there, but haven't gotten there.

And at lunch, they were trying to get me to eat some homemade ice cream -- they were nice about it -- and not pushy, but I made the choice not to.  Then made the statement, did you realize that my blood sugar hasn't been high even to make me bitchy in years -- and my department chair said "and thank god for that!".  I didn't realize it was that bad, and repeated to the same student who asked about the diabetes speech -- and he AGREED!

Yes, Type 1s are taking care of themselves to keep living -- but remember quite a few of us Type 2s are just trying to keep from dying. 

Posted by at 9:35 PM | Permalink | Comments (2)

And there is at least one Type 2 diabetic who believes that oral medications are for the birds and that insulin is the only way to fly.

Very Old, Very Healthy Diabetic

Posted by at 8:44 PM | Permalink | Comments (1)

It's been interesting.  First of all, right now the dealership I am working with claims they don't have the 2007 Freestyle I want.  Also the guy I was working with forgot he had today off.  Weird.

I tried a PT Cruiser but all three cages will fit, BUT I can't get anything else in it. 

Posted by at 8:32 PM | Permalink

One of the things I track with my insulin spreadsheet is my correction factor.  Also known in the diabetes world as the rule of 1800.  Amazing on how well that works. The rule of 1500 doesn't always work for me, but that's another blog post.

Anyway, I noticed this morning that I was approaching 43.  My pump is programmed for a correction factor of 42.  It's currently an hour and some odd minutes before lunch and I am hungry!  Did a check and I'm just a tad over 100.

Time to break out one of the chocolate candy sticks.  I love them.  Less than 100 calories, about 10 grams of carb, and all the taste of a real chocolate bar.

I also need to remember to buy more.

Means the TDD is still going down.

Plus I think I'm losing weight.  I'm not tracking it, but I am at the lowest I've been in a while.

And hey, I'm not gaining like I was when they first gave me back my classes!

Posted by at 11:17 AM | Permalink

First managed to get the strength portion of today done, but had to reschedule the cardio.  I'm going to have to watch that.

Second, car dealers, don't try to make someone think they made an appointment when they didn't, it 's just annoying.

TDD is still slowly dropping -- mainly because I have been making a smart change, which is to drop my temp basal to 30% two hours before a dog class for the two hours of the class.  Worked for agility and worked for tonight's obedience classes.

We're getting closer to our first conformation show -- I haven't said much about it here or the Macy's blog, but it's Saturday and Sunday morning at 8:00 am (argh!) but at least it will be over fast.

Posted by at 10:16 PM | Permalink

It's been a wild few days. Monday night the fan inside my car squealed.  When I turned it off, did class, and got back in the car it started making a horrible noise.  It wouldn't have been too bad, except that it was an hour to drive home.

As I was driving it dawned on me that I was paying a $500 car payment every month for the past 6 months.  Well, that sucks when you are driving a 6 year old car.  I'd much rather do that for a new one.

Got home and husband was playing internet poker and was acting ugly about talking about it.  We've been married for 20 years and every fight we've had was related to cars.  Or buying cars.       

So I went to school Tuesday morning and called the local car dealer to school (Troy Aikman Ford), and asked if I could drop it over during my planning period.  They said sure.  They diagnosed it, but couldn't repair it then but let me have it back. 

In the meantime, I got from work and Rich had printed out a really nice thing comparing several small trucks.  We decided to go look at an HHR.  It was TOO small.  They also brought out an Equinox which also TOO small.

So I got my truck back today during my planning period again, and I stopped and talked to the internet sales manager and I looked at a Ford Freestyle.  I am pretty convinced that's the car I want.  I may have to wait until Ford has the right incentive though, unless they can find me a 2006.

However, I did get yesterday's workout in.

Posted by at 1:56 PM | Permalink | Comments (1)

I've seen this on several sources -- and Amylin and FDA -- please give us a pen! I hate dealing with the vial and needles.

Daytrading, Eminis, Forex trading, Swing Trading BREAKING NEWS - 361022

Results from this study will form the basis of a supplemental New Drug Application submission to the Food and Drug Administration, currently planned for late 2006

Posted by at 9:58 PM | Permalink

Cardio and strength. Still very short sessions but just about what my knee can take.

I woke up in the middle of the night with it stiff and aching. Of course that was after showing Marcie in Rally twice, doing conformation class with Macy AND working out.

Posted by at 11:09 AM | Permalink

I've gotten in all my exercises sessions scheduled for the past 3 weeks. It is hard, the knee really does bother me.

Posted by at 2:31 PM | Permalink

Very Old, Very Healthy Diabetic

I need to add her to my blogroll.

Posted by at 11:58 AM | Permalink | Comments (1)

If you have the option of going with a flexible spending account DO IT!  It is SO nice.

We have "debit cards", so that makes it even better.

Here's how it works, you sign up in advance -- and I was chicken and afraid that I wouldn't use the whole amount, so went for $1000 the first year.  I went to $2000 last year and got real brave and went to $3000 this year.  I think that's the max.

What it means is that your out-of-pocket expenses are deducted from your paycheck with pre-tax dollars.  That does two things -- automatically saves you money,  but it also allows you pay those expenses with the debit card.

So I have my Medco account set up now, so that it automatically uses the debit card.  When I picked up Requip at the local pharmacy last week, I used the debit card, and again this week at the contact lens doctor.

The neat part, is that you have access to the whole amount from day one.  So if I wanted to go wild and buy a Dexcom system this week, I could.  Or I can be conservative, which is what I am planning.

It didn't quite work this way last year, but hopefully this year, my out-of-pocket expenses will be just about $3000 before I met the deductible and I won't have to pay for any of my supplies, etc. out of after tax dollars.

And my contact lens doctor pointed out to me -- if you don't spend ALL the money at the end of the year, you can always buy an extra pair of glasses -- her business does VERY well because of that. 

Posted by at 9:10 AM | Permalink | Comments (2)

Thank goodness it isn't insulin, though I have been able to get the Requip from the local pharmacy, and the local pharmacy copay.

Medco's website is showing that Requip has been ordered on September 7, and will be shipped next week. 

It even shows the right quantity and the right strength.  WILD!

Posted by at 9:00 AM | Permalink

Managed to do all 15 minutes in one session, but did have to take it slower. Then my knee complained all evening.

TDD has leveled off, which I think is a good thing, but would like to get it lower.

Posted by at 6:29 AM | Permalink

Postprandial numbers are definately better -- adjusting the carb ratio has helped.  We'll see even more by lunch.

I'm running a tad high though, which is normal as I haven't gotten as much sleep this week as I was.  Funny how having a husband around keeps me up later.

Posted by at 12:02 PM | Permalink

Long day. Normal class day, about a 10 minute chess lesson after school. Full contact lens exam -- no diabetic damage! Yeah!

Twitching the left lens slightly.

But even after two dog classes, I still managed to come home and do my strength exercises. Glad no cardio but it is coming tomorrow!

Posted by at 9:33 PM | Permalink

Two mornings in a row, after breakfast, my blood sugar was between 200-210, so I dropped my carb ratio for breakfast only.

Sure wish this would get a little more stable!  But at least I'm good at tweaking boluses.

Posted by at 10:51 AM | Permalink

I just called the sleep doctor, they didn't get the letter I mailed last week, but is has been a holiday weekend.

I asked her just to mail me a 90 day script for Requip, and we'll see what happens fro there.

Posted by at 10:48 AM | Permalink

I've switched from Depo Prevero intermuscular formula to the subQ version so I can self- inject.  I mailed in the script on Friday, and it showed up on the status today.

But that is not where the games begin ... I've been trying to get Requip mail order, and I don't know if the problem is with the doctor's office or with Medco.  I got my first 60 day dose from the local pharmacy, and then went to the website, and requested that Medco contact my doctor and get a script for 90 days.

The nurse swears they did, and that it was supposed to ship.  Instead I got one of their letters saying that they didn't receive fax from the doctor.  So I sent it to the doctor's office in the hopes that they will fill in the form and fax the order in.  So far, it isn't showing in the order status.

Posted by at 11:02 PM | Permalink

Even with my peaks in the low 200's after meals today, I'm still at a lower insulin usage.  Not just from Tuesday two weeks ago, but my average too.

Though I am afraid I might be obsessing some.  I've had problems with that, but I do know if I can get my average TDD down to less than 40, I might start losing weight.

Posted by at 10:59 PM | Permalink

Even with my peaks in the low 200's after meals today, I'm still at a lower insulin usage.  Not just from Tuesday two weeks ago, but my average too.

Though I am afraid I might be obsessing some.  I've had problems with that, but I do know if I can get my average TDD down to less than 40, I might start losing weight.

Posted by at 10:46 PM | Permalink

Diabetes In Control Newsletter - Carpal Tunnel Syndrome or Bell's Palsy Can Indicate Pre-Diabetic State

I have had trouble with carpel tunnel for quite some time before diagnosis, however, I think it's more that carpel tunnel can be linked to sedentary lifestyles.

Posted by at 9:53 PM | Permalink

Diabetes In Control Newsletter - New Study Supports Major Change In Diet Treatment For Diabetes

The changes in getting a Type 2 to go to a low-fat vegan diet are slim to none.

I know I'm not going there.

And no wonder they lost way, there is nothing left to eat on that diet.

Oh, and guess who found this.... PETA! (Physicians for Responsible Medicine is a sub organization of PETA).

Posted by at 9:47 PM | Permalink

Diabetes In Control Newsletter - Insulin Pathway Component Explains Insulin Resistance, Age-Associated Metabolic

This research is pretty interesting, but it will take years before it leads to anything worthwhile.
Insulin Pathway Component Explains Insulin Resistance, Age-Associated Metabolic

Posted by at 9:45 PM | Permalink

Weights only today, thank goodness. I am taking Marcie to a rally fun match on Saturday so I took Macy to puppy conformation class tonight. Will probably do the same next Tuesday night.

Posted by at 8:46 PM | Permalink

I checked my blood sugar 2 hours after and I'm at 101.  That makes me nervous seeing as how lunch is 45 mintues away.  I've just reducted all my corrections to 41.

Posted by at 11:30 AM | Permalink

I'm going to check again right before lunch, but my correction still seems to be working okay, not over kill at 40 units.

Though I am going to keep a close watch on everything -- I know my insulin usage and resistance is higher on Monday than on Tuesday, etc.  I'm sure after the three day weekend it's even a bit higher.

Posted by at 11:15 AM | Permalink

I am noticing though, that the longer the weekend, the more insulin I use.  I finally just bit the bullet yesterday morning and upped my temporary basal for a few hours by 10%.

I also got in an extra cario workout in the afternoon -- and I might do that today, depends on how crazy school is.

However, my average TDD is still going down.  According to the 1800 rule, It's getting time to adjust my corrections but I want to wait and see one in action before I do.

The best news is that my husband is coming home after being gone since a week ago Saturday.  Not sure when he will be in, but he said before school is out.  I got an email a few minutes ago, so it sounds like he was up and getting ready to leave.  Or maybe just play a round of internet poker.

Posted by at 7:03 AM | Permalink

Still on track with light workouts. Which my knee appreciates. I'm doing 3 minutes of cardio at a time, doing my weight workout or knee workout in between.

I also set a temporary basal of 50% less before working out.

Posted by at 12:35 PM | Permalink

Apparently I have been invited to go to China.  See http://www.ambassadorprograms.org/upcomingprograms/education/clarence_ellis.asp

I'm not sure if everyone gets invited to it, or why I was picked.  I looked up the person who invited me, and I do not recall ever being at a conference or workshop with him, but I could have been at the same workshop several years ago in Austin.

I've shown the link to my husand and he doesn't think going to China is a good idea.  (Actually he said getting a 6 week old beagle puppy was a better idea).

My mother also doesn't think it is something I can handle, and I'm inclined to agree.

First, it would take me away from my classroom for week.  I am very disinclined to be away from my students that long, unless there is a very substantial reason for it.

Second, I am diabetic, insulin dependent and on an insulin pump.  Traveling right now is problemic for all diabetics, since we really need to travel with liquids, not just our medications.  Plus I am on a CPAP machine, and while mine travels very well, its emergency battery can be a problem.

Third, it cots $4,195 to go from LA.  While Dallas to LA flights booked this far in advance will probably be cheap.  I really can't afford it.

So I really doubt I will go, but it is an interesting idea.

Oh, and I have never had any desire to go to China.

Posted by at 10:02 PM | Permalink | Comments (1)

Diabetes Mine: Who Needs Patient Studies When You've Got PCs?

This is right up my alley literally. Since I teach computer science, I do keep up with the field.

I certainly don't think that simulated clinical trials will replace real ones, but they will help rule out bad treatments early. Remember the clinical trial that has ruined the health of the healthy volunteers in Great Britian? If a simulated clinical trial could eliminate such problems, you'd see more people participating in the real ones.

Posted by at 12:56 PM | Permalink

I'm doing my last exercise session of the week and have met my goals of exercising every scheduled day.

I did wake up high today, but I'm hoping that between my exercise session and Macy's conformation class I can avoid using any extra insulin to bring it down.

Posted by at 8:31 AM | Permalink

Today was my smoothest blood sugar day, I stayed under 200 each time I tested and over 110. I did make one major change, which was to set my basal at 50% before I ate and exercised. Before I was using exercise to bring my blood sugar down to a decent level, but that wasn't needed most of the week.

I still ate extra food but it's better.

Also, I added an extra cardio session today.

Posted by at 8:29 AM | Permalink

My blood sugar this morning was 107.  And even though I had a reading of 330 after the Meet the Teacher night, my correction was working well, by the time I got home and ready for bed I was at 225 and IOB was saying I had plenty of insulin to handle the rest.

I could any attribute some of the 330 to meeting parents.

The good news, is that my TDD is still low. It wasn't even the highest in the last 7 days, much less the last 14.

Posted by at 6:17 AM | Permalink | Comments (2)