Sunday, September 19, 2010

one year.

tomorrow it will be one year since i was diagnosed.  i'm calling it "eff you diabetes day" and going out with a bunch of my friends to eat delicious pizza and gelato in the west village (read: carb frenzy 2010).  i thought this would be a good opportunity to tell my "story," so here it is...

it all began labor day weekend 2009.  i was home in connecticut for the weekend visiting my family and had brought along one of my good friends, E.  on saturday night my mom, step-dad, E and i all went out to dinner.  in my typical fashion i ate a ridiculous amount of food and still wanted ice cream after, so we stopped on the way home for me to get a cone.  when we got back to my family's house, E and i decided to watch some tv.  out of boredom i decided the cheddar chex mix was calling my name, so i poured myself a bowl to munch on while watching the tube.  i noticed as i was eating that i was incredibly thirsty.  i chugged an entire glass of water and was still dying for more.  it was definitely more intense than any other time, but i chalked it up to the salty chex mix on top of all the other food i had eaten that night.  after we went to bed, i woke up a few hours later to use the bathroom (made sense after all the water i drank so closely to bedtime), but i was still thirsty!  i poured myself another glass of water in my half-asleep stupor and brought it to my nightstand.  this pattern continued on for the rest of the night, with me getting up 2 or 3 more times.  when i woke up in the morning i said to my mother (who is a pediatrician, mind you) "mom, i've been so thirsty since last night...i think i have diabetes!" and laughed, to which she replied "haha, yea right, you probably just ate a lot of salty food."  well, yes, but no more than usual really.  plus the whole waking up in the night thing was pretty odd.  but oh well.  i obviously was joking and did not really think i had diabetes.  in fact, the symptoms of insatiable thirst and frequent urination were just about all i knew of the disease at the time.  oh, and something about a lot of shots? 

i returned to my apartment in new york after the long weekend and resumed my post-graduate life.  i had finished college that may, started a job in july, and was enjoying the carefree life of a twentysomething with a 9-5 job.  i went out a lot and never really got enough sleep, so the fact that i was becoming more and more tired all of the time seemed reasonable enough.  it's all starting to catch up with me, i thought.  so when i was falling asleep in the mornings standing up on the subway, or when the newly introduced second coffee of the day at 3 PM didn't even seem to touch me, i chalked it up to needing more sleep. 

i was also marginally aware of how i was thinner than ever before, even though i was eating a ton of crap all the time and going to the gym very infrequently, when in college i had gone 4-5 times a week.  one night i decided to make chocolate chip cookies to bring to work, and i ended up eating so much of the dough/cookies that i felt sick and didn't eat dinner.  i can only imagine what my blood sugar would have looked like.

the weekend after labor day, i drove 3 hours to foxwoods casino to attend an old friend's bachelorette party.  i slept for 2 hours that night and then drove back to new york.  when i felt like absolute _ _ _ _ the next day, there was no question in my mind as to why.  i was voracious, too.  i ate pancakes for breakfast, stopped at mcdonalds on the road for french fries, and then my roommate was having a bbq, and i ate so many chips that i had to go lay down because i felt ill.  the next day i went into work late because i still felt awful...but we're still a solid week away from diagnosis.

monday night a friend of mine cut my hair in my apartment.  when she was done, i order us pizza, ate an entire small pie, and refilled my poland spring water bottle 8 times during the meal.  pizza is really salty, right?

tuesday i went to the san gennaro festival in little italy where i ate fried calamari, a slice of pizza, an arepa, 3 fried oreos, and probably some other things i forgot.  i was skinny as ever, thirsty as ever, and living in constant fear of getting fat but unable to control my urges to eat everything in sight. 

wednesday night, i was poking around on webmd trying to figure out why this infection i had kept coming back.  "this could be a symptom of pregnancy or diabetes" i read.  what?!  ok, i'm 95% sure i'm not pregnant, but diabetes...i have another symptom of that!  i immediately call my dad's wife (she's basically my age so we're very close) who is a nurse practitioner and say "listen, i need you to reassure me right now that i don't have diabetes."  i tell her everything, and she says "no, no way.  you're too old for type 1 and too thin for type 2.  you're fine."  she says i should probably get blood work just to be safe, but i am reassured.  i have an appointment with a new internist for a physical in 2 weeks, i'll just mention it then.

thursday night E comes over for our weekly viewing of the office.  i can barely keep my eyes open during the show, and when my eyes are open i'm snacking like a madman.  i am so anxious about all the food i'm eating, and i realize i haven't gone to the gym in over a week, so when E leaves i decide to go work out.  it's 10:30 at night.  i get on the elliptical and somehow manage to do it for 20 minutes.  while this is much shorter than my usual workout, it's more than i can even handle.  it's by far the worst workout i've ever had.  gee, i think, i really need to get to bed earlier!

friday was erev rosh hashanah, the evening before the jewish new year (one of the holiest days of the year for jews).  i went to a dinner at my honorary aunt's apartment where i consumed approximately 1 small child's worth of food.  i must have refilled my water cup 20 times.  it was a small cup, i told myself.  i was absolutely exhausted afterward, but that didn't stop me from going out.  i went home, changed, and met two of my good friends at one of their friends' birthday parties downtown at midnight.  when i walked in i half-jokingly told them that i think i have i diabetes because i am so thirsty, they laughed, and i continued on with the night double-fisting a gin and tonic and water.  i only had one g&t (my last one ever, in fact) but i made my friend J go back to the bar for me multiple times to refill the water.  when i left the bar i stopped at a gas station to pick up a water bottle.  the night turned into a crazy one, and i ended up getting 2 hours of sleep yet again.  the next day i felt terrible and even more voracious.  the terrible part made sense, but the 4 pounds of weight loss did not.  wow, i thought.  normally when i eat as much as i did last night i would be gaining 4 pounds.  something is just not right.  i went and bought a giant bagel (i never ate bagels, too high calorie), an orange juice (again, never) and scarfed it all down.  i was wearing a pair of pants that hadn't fit me since i was 16.  i called my mom to complain about something entirely unrelated, and at the end of the conversation said, 'oh, by the way, i'm still thirsty and peeing all the time and i lost 4 pounds.'  "sarah..." my mom replied, suddenly in a tone of serious concern that she rarely has, "that's not good.  you probably should get some blood work." well i don't have a doctor yet.  i have an appointment in a few weeks. bla bla bla.  i made a ton of excuses, but i was now scared.  my mother is a doctor, and i can't tell you the last time any of my health concerns have elicited this kind of response from her.  during the course of our conversation my intensely carb-heavy meal was probably wreaking havoc on me, and i felt completely incapable of doing anything.  "i have to take a nap," i told her "i'll call you later."

i set my alarm so i would wake up in time to go to another rosh hashanah dinner that night.  i felt awful.  when i called my mom back on the way to dinner, she said "i'm worried about you."  the tears started coming.  she agreed to come into the city the following day so we could do a urine test for sugar.  something was really not right and we both knew it.  but there was just no way...

"sarah, did you lose weight?" was the quote of the night from my aunts and uncle at dinner.  i could barely keep my eyes open at the table.  i stopped on the way back from another huge meal at mcdonalds to get french fries.  i never ever go to mcdonalds.  my stomach was starting to feel sour and unsettled (a symptom of dka, i would later learn). i went home to get some sleep (finally) at 11 PM and set my alarm for 7:30 so i could go to synagogue in the morning.

when i awoke on september 20th, 2009,  i could no longer try and convince myself that this was normal.  i felt like i was coming out of a coma, and getting out of bed was almost impossible.  i had lost 4 more pounds.  what is happening to me?  i had made plans to meet my honorary aunt at services, and i couldn't cancel.  i got another giant bagel and heaved myself up the stairs to the subway.  i had to stop and catch my breath.  no, this is not right at all.  when i saw my aunt, she said "too much rosh hashanah partying this weekend?" and i told her what was going on.  "no way," she said "you probably just have a virus or something."  during the services, we sit down and stand up a lot.  i could barely stand without holding the chair in front of me.  i went outside to call my mom, who was on her way, and she had invited my grandmother to meet us.  i was not happy about this, and she said "sarah, it's fine, and after we do the test we can just go out and get lunch or something."  i replied that i was sure something was wrong and that i felt like i was dying.  i didn't think we'd be getting lunch.

when i met my mother and grandmother at the train station, my mom took one look at me and said, "do you want to just go to the ER?"  "yes." i replied.  we took a cab, and since i'm an employee at the hospital the check-in was quite smooth.  we sat for a few minutes before a tech took me in to prick my finger and use the glucose meter to check my blood sugar.  i cringed at the lancet drawing blood from the tip of my finger.  she put the machine down and walked away.  my mother and i sat holding each other, knowing how important this one little test was going to be.  when the machine beeped, it seemed like an eternity before the tech looked at it.  nonchalantly she glanced down.

"it's very high."

and that's when we knew. 

Tuesday, July 6, 2010

Diabetes Takes No Vacations.

last week i went on a trip to mexico with my mom, step-dad, 2 brothers, step-sister, cousin, and family friends (there were 11 of us in total).  we all (with the exception of my cousin) went away together last year and had a blast, so i have been anticipating this vacation for a while now.  however, as it approached, i began to get a little nervous as i realized it would be my first real vacation (and a beach one, at that) with diabetes.  june 20th marked 9 months for me, so the "firsts" are becoming less and less frequent.  this one, though, was pretty daunting.

diabetes or not, the trip was amazing.  it was fun, relaxing, ridiculous and wonderful. we ate delicious food, drank an obscene amount of giant margaritas (see below), swam in beautiful water, and laid in the hot mexican sun for hours on end.  it was over way too quickly and i am already anxiously awaiting our next adventure.

that all being said, there was one area of my life that i was not able to leave in NY and take a break from, and that would be the full-time job of being my own pancreas.

i knew it would be an interesting week when we got off the plane in mexico and got onto a bus to go to our terminal.  i was feeling a bit funny, and thought i should test and make sure i wasn't low.  i stuck my hand in my purse and rummaged around for my meter...but it wasn't there.  i of course had packed extras of every possible thing i could think of, but only brought one meter.  the bus was getting fuller by the minute, the plane almost empty, and i had to think fast.  i ran off the bus, up the stairs to the plane (in a torrential downpour, no less) and down the aisle to where i had been sitting.  "what'd you lose?" the flight attendants laughed as i frantically looked around.  as soon as i said the words "glucose meter" the smiles went away and they ran over to help me.  it wasn't in my seat or in the front pocket where i had it during the flight.  it was in my brother's seat across the aisle (!?) and must have fallen out of my purse when we were getting off.  as relieved as i was to find it, i suddenly felt incredibly vulnerable.  what if i hadn't felt like testing at that exact moment?  i cringe even thinking about it.  and after all that?  110 mg/dL.

we spent the rest of the day settling in and went to bed early, exhausted from a day of traveling.  when i woke up the next morning feeling rested and relaxed, i went to test before breakfast, and my meter flashed a picture of a battery at me and then shut off.  i have had this meter since november.  i have had to change the battery once before this.  once.  and now i'm in f-ing mexico and my battery dies?!  i get it, i should have brought an extra meter, extra batteries, whatever, i already learned my lesson!  luckily i had a very understanding family/crew who all ventured to wal-mart (yes, there are wal-mart's in mexico, thank god!) with me to get a stupid lithium battery.  oy.  vey.

then there was the swimming issue.  looking back, it all worked out completely fine.  getting in and out of the pool/ocean was anxiety provoking for me at first, just because being disconnected feels so strange, but after the first few days i developed a system and my blood sugars were staying in range even when i was off the pump for a while.  even the swim-up bar meals (aka meals eaten with 0 insulin) did not wreak havoc as i thought they might, though it probably helped that i ate very low carb at those meals.  the whole disconnecting/reconnecting business was also an opportunity to educate my family/friends who hadn't spent much time with me post-diabetes/pump, and it was nice to see them showing an interest in the whole 'betes deal.

as the week went on i felt more and more comfortable being on vacation con diabetes (like that little bit of spanish there?).  of course, diabetes decided i was getting a little too comfortable, and threw me this lovely experience: on thursday, the second to last day of our trip, we went to xel-ha, a big freshwater meets ocean water swimming situation where you can snorkel, cliff jump, swim in natural caves, etc.  i put my pancreas (as i took to calling it that day for some reason) and my meter in a zippered plastic bag and kept it on the sidelines as we journeyed through the park.  reattached for lunch, took it off again to swim more, etc. etc.  the day was fun, but long and tiring.  we had to get on the bus at 7 am and make the 2 hour drive to the park, it was about 1000 degrees or so, and by the time we boarded the bus to leave at 5, we were all pretty beat.  i was wearing a dress with pockets, and i was too wet and tired to care if my pump was exposed, so i put it in one of the dress pockets.  you couldn't see the pump itself, but my tubing was coming out of the bottom of my dress and then up which looked kind of funny.  well, turns out it also wasn't so smart.  as i trudged down the aisle of the bus to my seat in the back, i felt a pinch in my butt.  "ow!" i yelled, whipping around and expecting to see one of my family members smirking after pinching me in the rear.  instead, i saw A (the dad in the other family we were with) holding my tubing with my infusion set attached to it.  the tubing had gotten caught on the arm rest of one of the seats and ripped the whole set out of my body.  and we were about to sit on a bus for 2 hours.  cut to me standing in the steamy, gross coach bus bathroom trying to shove the tiny tube back in the tiny hole it came out of, praying that some insulin will go into my body over the next 2 hours and that i won't get a staph infection from this entirely unhygienic scenario.  well, 2 hours later, 88 mg/dL.  all was well in the end.

diabetes itself really behaved for the most part.  i did stick to low carb things which definitely contributed, but regardless, staying in range for most of the week made things a lot less stressful.  i learned that you can never have enough "extra" things, and as long as you do, most situations can be dealt with.  i also learned that, unfortunately, diabetes cannot be left at home when you take a vacation.  damn.

Sunday, June 20, 2010

Success (?)

phase 1 of south beach: completed.  total weight loss: 5 pounds.

i feel good...and i even said before i started that i would be happy with 5 pounds...but now, i'm liking the feeling and i don't want it to stop there.  i leave for vacation in 5 days, so that chances of anything else happening before then are not great, but i'm still happy.  i learned a lot on this diet.  i've done weight watchers, counted calories, and i always thought i could never do a diet that restricted certain foods/food groups.  part of it of course was the motivation of 3 weeks until bikini, but even still, i am surprised and impressed by my will power.

south beach has brought my relationship with carbs to a whole new level.  diabetes forced me to at the very least pay attention to them more closely, but this diet made me realize what i actually genuinely enjoy and what i could care less about.  i missed my morning oatmeal, and having to turn away fruit during peak berry season was pretty painful.  i also could've enjoyed a tasti d'lite or fro yo on one of these hot days.  but other carbs - bread, rice, basically all the grains, i truly did not miss. so i've decided to be very selective about my carbs from now on.  i'm going to stick to the most nutritionally valuable and tasty and avoid the others.  not only is my weight much easier to manage on a low-carb diet, but my blood sugars have been a [diabetic's] dream come true.  when i look at my 7 day average on my meter, what was generally in the 140s/150s is currently 108!  it's hard to imagine any food worth making that number go back up.  i'm sure there will be temptations here and there, but i want to try and ride the wave out as long as possible.  wish me luck!

Wednesday, June 9, 2010

south beach diet & a1c

i hate saying that i'm busy...but i say it all the time...because it's true.  i feel like it's become such a cliched/typical thing to say in modern american culture these days.  everyone is so freaking busy all the time.  personally, i like it...for the most part.  what i don't like is realizing that it's been a week since i received an email and i haven't even thought about a response, or that i haven't written on this blog in almost a month, not for lack of material but lack of time.  i cram so many things into my days because i want to take advantage of every free second that i'm not working/studying/etc.  but then, there is not much time left for anything else.  sigh.  this wasn't mean to be an entry about being busy.  on to more important things!

this past saturday marked t-minus 3 weeks until i go on vacation to cancun with my family and family friends.  last year we all went away together and had the time of our lives, and we've pretty much been looking forward to this upcoming vacation ever since the last one ended.  for me, that is, until a few months ago when some extra poundage crept into my life and has refused to leave.  suddenly the idea of being in a bathing suit in mexico was more of a nightmare than anything else.  when i realized how close the vacation was, i tried to make an effort to lose the weight.  i always eat healthfully, i exercise regularly, i take every opportunity to walk/take the stairs/what have you, and yet those damn pounds just refuse to go.  a few weeks ago i decided drastic measures were necessary, and by drastic measures i mean phase 1 of the south beach diet.

phase 1, for those of you unfamiliar with south beach, is basically a 2 week carb fast.  no grains, starches, fruits, or starchy vegetables.  unlimited protein and non-starchy veggies are the main components of the diet, with low-fat cheese and some other low-fat dairy allowed in moderation.  nuts are limited to one serving a day, and that's basically it.  if you can handle it, it promises results, and fast.

while i was very much interested in the weight loss potentials of this diet, there were many things that scared me.  first of all, can i give up basically all forms of carbs for 2 weeks just purely psychologically?  and secondly, what the eff is this going to do to my blood sugars?  finally, what if i'm that one person who doesn't lose any weight at all?

i am happy to report that as i have just completed day 4, things are going quite well.  each day gets easier in terms of willpower, and i also have a friend/coworker doing it with me which i think is invaluable.  as far as my blood sugars go, they have been beautiful.  i haven't had any lows, nor have i gone above 140 mg/dL since starting the diet.  i really can't argue with that.  and in terms of weight loss, the final effects will be the most telling, but so far i am happy.  i'm very interested to see what the end result will be.  and as a plus, i'm learning a lot of ways to cook/prepare low-carb food that will serve me well in the future.

oh, and i went to the doctor today, and my in-office a1c was 6.3% :) it's nice to see my hard work as a pancreas paying off.

Monday, May 17, 2010

Diabetes Blog Week - Day 7

so i realize i kind of dropped the ball on posting every day last week...i just had an unbelievably crazy few days, and i figured better late than never.  i am skipping day 6 on purpose because it's too late for me to take any pictures right now.

Day 7 - Dream a little dream - life after a cure. To wrap up Diabetes Blog Week, let’s pretend a cure has been found. We are all given a tiny little pill to swallow and *poof* our pancreases are back in working order. No side effects. No more insulin resistance. No more diabetes. Tell us what your life is now like. Or take us through your first day celebrating life without the Big D. Blog about how you imagine you would feel if you no longer were a Person With Diabetes.

i would go to max brenner's chocolate restaurant and eat some sort of obscene 392052 calorie dessert.  all by myself.

i would go for a run outside with no paraphernalia on me/attached to me.

i would go out at night with a clutch purse that barely fits anything in it.

i would drink a frozen margarita with some syrup-y flavor in it. 

my thoughts would be consumed with something else.

Diabetes Blog Week - Day 5

Day 5- Let's get moving. Exercise . . . love it or hate it? Do you have a regular exercise routine? Or do you have trouble finding your exercise motivation? How do you manage your insulin and food to avoid bottoming out during your workout? Today is the day to tell us all about your exercise habits, or lack thereof.

oh, exercise.  sometimes it's exactly what i need to bring down that frustrating high.  sometimes it leaves me shaking and disoriented at 60 mg/dL.  before i was diabetic i was big into working out.  i was at the gym a minimum of 3 days and a max of 6 every week.  after my diagnosis, it was a solid month before my doctor/CDE ok'd any sort of "vigorous" activity, and this was incredibly frustrating once i felt up to working out again.  of course, i now understand full well why they made me wait.  i am now back to my old gym routine, but it definitely takes some serious knowledge/effort to exercise with diabetes. 

when i was on injections, i needed to eat high carb pre-workout, and then fill my water bottle with 1/2 a cup of gatorade to avoid bottoming out during/right after my work out.  this was kind of annoying, especially when i wasn't hungry but too low to start a work out.  being on the pump has made exercise much, much easier.  no more gatorade or eating food i don't want.  even if i get a bit low afterward i just leave my pump off for a while and let my bg come up on its own.  reason # 2394 why i love my pump. 

Diabetes Blog Week - Day 4

Day 4 - To carb or not to carb. Today let’s blog about what we eat. And perhaps what we don’t eat. Some believe a low carb diet is important in diabetes management, while others believe carbs are fine as long as they are counted and bolused for. Which side of the fence do you fall on? What kind of things do you eat for meals and snacks? What foods do you deem bolus-worthy? What other foodie wisdom would you like to share?

before i had diabetes, carbs freaked me out a little.  the last few years of atkins/south beach hype have left the idea of "carbs" with somewhat of a bad aftertaste, and i've always tried to avoid/skimp on breads and starches wherever possible.  however, diabetes takes that to a whole new level.

the truth it is, it is much easier to eat as a diabetic if you keep things low carb, especially when eating out of your home.  when i'm in my kitchen and can weigh all of my food on a food scale, measure it, and plop it on my plate, i can be more confident in my carb measurements/bolusing (which still doesn't always work anyway) but when i'm out and about trying to gauge if there is 1/4 cup or 1/2 a cup of rice, things get difficult.  this is where the "bolusworthy" term really applies.  if i'm going to be bolusing for carbs, they better be damn good ones.  i almost never eat sandwiches because they just don't do it for me, but you better believe that a yogurt and granola parfait will be eaten and bolused for at least once a week.

my breakfast, oatmeal, is obviously overwhelmingly carb'd, but i measure and eat it at home so there's no real guessing involved.  when i'm out, i try to stick to salads, veggies, and seafood to keep the carbs low and the calorie gain low as well. eggs and peanut butter have earned a whole new category in my life as low/no-carb godsends.

of course, sometimes i'll be out to dinner, and the dangerous/sinful/regrettable/whatever the hell chocolate cake will be calling my name, and i will give myself some obscene amount of insulin in order to eat said dessert.  sometimes i will be spot on with this calculation, and sometimes i won't, but i've already come to terms with the possible highs/lows when i decided to eat the cake.  it must be bolusworthy - a word with an ever-changing definition.