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. 

Diabetes Blog Week - Day 3

Day 3 – Your Biggest Supporter. Sure, our diabetes care is ultimately up to us and us alone. But it’s important to have someone around to encourage you, cheer you, and even help you when you need it. Today it’s time to gush and brag about your biggest supporter. Is it your spouse or significant other? Your best friend, sibling, parent or child? Maybe it’s your endo or a great CDE? Or perhaps it’s another member of the D-OC who is always there for you? Go ahead, tell them just how much they mean to you!

when i saw this prompt, i had a bit of a panic.  who could i really say is my 'biggest' supporter?  everyone plays such different, and yet important, roles.  there's my mom, who was in the emergency room with me the very second we found out my life would change forever, who patiently tried to answer all my questions about this disease as i attempted to wrap my mind around this seemingly unreal situation, and who now listens and consoles me whenever i feel the need to whine or complain about highs/lows, pump issues, etc.  she definitely has the more patience for my carping than anyone else in my life.

and then there's my dad, who lives far away but flew up to take me home from the hospital, called me every day for weeks after to ask "how my sugars are," and has been a huge source of support for me whenever i need it.

my dad's wife, kim, my friend and family member. one of the most understanding and kind people i know.  her willingness to listen and her prior understanding of diabetes makes her an invaluable supporter. 

my roommate/best friend ashley - how could i do it without her?  she's been learning about diabetes along with me, and she is one of those who really "gets it."  she's incredibly sensitive to my needs without being patronizing or treating me delicately.

my far away best friend, julia.  my co-workers.  my brothers.  my aunt judi.  cousin caroline.  diabetic buddies jeniece, brianna, etc.  this amazing DOC community.  there truly is not one person who is more important than the next when it comes to supporting me and my life with diabetes.  they all play a roll and help in different ways.  it would be unfair to say otherwise.

Tuesday, May 11, 2010

Diabetes Blog Week - Day 2

Day 2 – Making the low go. Tell us about your favorite way to treat a low. Juice? Glucose tabs? Secret candy stash? What’s your favorite thing to indulge in when you are low? What do you find brings your blood sugar up fast without spiking it too high?

when i get low, i get pissed.

it's a rare occasion that i want to eat or drink something that is pure sugar, and when these occasions do arise, it's usually only because that something is staring me in the face (read: when my candy-obsessed father is shoveling sour patch kids right next to me).  otherwise, any craving for pure sweetness can be quenched with a fake sweet, like sugar free jell-o or crystal lite.

instead of treating with the usual suspects, i go for things that are not CDE-approved to treat lows.  my favorites are nature valley granola bars and tasti d'lite ice cream cones.  both have fat and protein, which means they are not absorbed nearly as quickly as juice or a glucose tab, but i would rather sit and wait for my low to come up while i enjoy my ice cream cone than suck down a juice box that is totally unappealing to me.  

i should note that being a newbie, i've never had any really bad lows.  my lowest on record is 50 mg/dL, and since i feel low at 75 mg/dL, i can only imagine what 30 mg/dL feels like.  if i feel so awful that i wouldn't even be able to enjoy my food if i tried, i will go for fruit snacks or gummies to get up quickly.  if i'm near a tasti d'lite (my favorite thing in the world) and below 65 mg/dL, sometimes i'll get my cone with sprinkles to speed up the process.  but even tonight, when i was 60 mg/dL 1.5 hours after dinner, i had to find the tasti and get a cone, rather than go for the multiple treatment options i have in my purse, and i stayed away from the sprinkles for fear of a high later on.

lows are really awful, and i think we should be able to, at the very least, enjoy what we're forced to consume.  no juice boxes or glucose tabs for me, thank you very much! 

Diabetes Blog Week - Day 1

Day 1 - A day in the life . . . with diabetes. Take us through a quick rundown of an average day and all the ways in which diabetes touches it. Blood tests, site changes, high and low blood sugars, meal planning, anything that comes along. This can be a log of an actual day, or a fictional compilation of pieces from many days.  Thanks, Karen :)


7:15 AM - ugh...really?  i feel like i just went to sleep.  and it's only monday.  oy.  time to get up, and i'm still getting used to grabbing my pump before getting out of bed!  it has definitely hit the floor a few times, but i'm catching on.

8:00 AM - breakfast time!  i ring in at 135 mg/dL.  still can't seem to knock these morning numbers down, even though my CDE did a lot of night/early morning basal adjustments last week.  i would love to see something below 100 - hell, even 110 - when i wake up in the morning!  but at any rate, i plug this meh number into my pump, dial up to 45 grams, and enjoy my daily breakfast: old fashioned oatmeal with strawberries, blueberries, blackberries, banana, slivered almonds, cinnamon, and flaxseed!  yum!

8:30 AM - off to work!  put on my headphones, get on the subway, and go!

10:00 AM - i've been at work for an hour now, and it's already 2 hours post-prandial, time to see what breakfast has done to me...147 mg/dL.  not too shabby! 

11:00 AM - 3 hours post-prandial and i'm only 137 mg/dL...basically haven't changed since 2 hours.  strange, as i usually drop substantially from 2-3 hours.  at any rate, i try not to worry too much about it, and i head my weekly office meeting.

12:00 PM - the meeting ends with a surprise for my boss - a giant chocolate chip cookie cake congratulating him on his promotion, as well as a box of doughy, delicious cookies still hot from the oven.  my meter is in my office, so i assume i'm around 120, and i SWAG the cookies to the best of my abilities.  i eat a piece of the cake and nibble on 2 different kinds of cookies from the box.  55 grams?  sure, why not.

2:00 PM - here's the moment of truth, 2 hours post-cookies: 252 mg/dL.  UGH.  did i really eat more than 55 grams worth?  or is this site just not so great?  not happy to see this number, at all.

3:11 PM - can i eat now?  busy day at work + yucky blood sugars = late, late lunch.  176 mg/dL...at least it's not above 200...and that's without correcting.  i love when my pancreas shows up to do some semblance of its job.  i eat safe foods - all veggie salad and some left over fish from dinner the night before.

5:15 PM - 118 mg/dL.  ahh.  finally, a nice, respectable number.

7:30 PM - leave work late, run some errands in the city.

9:00 PM - walk down the upper east side to the train.  this walk has been known to drop me, especially so many hours after eating, but i feel fine the whole way...a plus side to a "high" day.  

10:52 PM - time for a late dinner.  133 mg/dL?  really?  is this because i've been chomping on the raw broccoli i'm cutting up?  that seems unlikely.  the site?  i'm due to change tomorrow morning anyway, so no use messing with it now.  probably not the best time to eat pasta, but i measure out 2 oz on my food scale, throw a ton of veggies on, and bolus for 60 carbs, which includes my "dessert" of one 4g Dove dark chocolate and a sugar free orange Jell-O with fat free whipped cream on top.  wild, i know.   
12:30 AM - shower.  i worry that this pump disconnection will skew my post-prandial digits.

1:00 AM - andddd....200 mg/dL.  this day is dumb.

1:40 AM - 197 mg/dL.  sigh.  bolus .6 to correct and hope tomorrow's site change brings better numbers with it!

Tuesday, May 4, 2010

"but how do you know?"

questions that we get as diabetics are always interesting.  as a newly diagnosed person, i've been muddling through these questions and answers myself for the last few months, but the learning curve is a steep one, and i now know probably 1000 times more about type 1 diabetes than i did last year.  at first i was learning along with my friends and family, and often times the many medical professionals in my family (and even friends) were the ones answering my questions.  now, however, the tables have turned. 

but of course, it's not those close to me who ask the most ridiculous/funny/stupid questions.  we all get the "but, don't you have to be fat to have that?" or the classic "oh, so, you just have to exercise and eat better then, right?" and even the "maybe it was that fried oreo you ate last year?" kinds of doozies, and i don't know about anyone else but my responses to these have become fairly canned: "that's type 2.  it's a totally different disease with a totally different cause.  what i have has nothing to do with my lifestyle; no one knows why i got it or why anyone gets it.  my immune system is killing my cells that produce insulin, so i have to give myself insulin manually." etc. etc. 

having just gotten a pump, i've been faced with a whole new set of questions as i excitedly show off my robotic pancreas.  my favorite is the title of this entry.

"so, whenever i want to eat, i just hit this [bolus button], tell it what my blood sugar is, and then put in how many carbs i'm going to eat."

"but how do you know how many carbs you're eating?"

this is when i smile and shrug.  "well, i have to figure it out."  it's one of those "oh, wow, diabetes is hard" moments.  it's such a great question, too.  i mean, how do we know?  the truth is that we quite often don't.  we make educated guesses based on our knowledge/past experiences, but with all the other environmental variables it's hard to really know what's what sometimes.   i think this question and it's answer embody a lot of the frustrations and unknowns of diabetes in general.  after all, "knowing" is a huge part of how we manage our diabetes, and yet so often we are left guessing, SWAGing if you will. [that's Scientific Wild-Ass Guessing, for those who aren't familiar].

in one of my neuroscience classes in college, we learned that a study had been done on london cab drivers who had been in the business for 20-30 years.  they found that the area of their brains that deals with spatial mapping was larger than an average person's.  how would this work for diabetics?  where's the carb area of our brains?  someone should study this.

after writing this entry, it was 2 hours post-dinner, so i went to check.  i cooked and measured these lentil tacos myself, so it should be a no-brainer, right?  easy and accurate carb counting.  235 mg/dL says not so much.  diabetes, you suck.

Wednesday, April 28, 2010

diabetic dreamin'

diabetes is now officially invading my dreams. 

last night i dreamed that my infusion site fell out while i was sleeping.  in the dream, i woke up with blood dripping out of me where the site had been (way more blood than would ever actually come from an infusion site, of course).  then i tested, and my bg was 520 mg/dL.  i'm pretty sure real meters only go up to 500 and then say >500 beyond that...but that was my dream.  i remember my dad and his wife were there, and in real life they've never seen my pump.  in the dream this was their first time seeing me with it, and everything was crazy, and i felt very anxious.  they thought the pump was bad and not helping me, and i was trying to convince them that this doesn't usually happen and that the pump is actually wonderful.  sounds like i was having a nice, relaxing sleep, huh?

i don't think this was my first dream that somehow involved diabetes, but it was definitely the first where it played a major role.  i've been thinking recently about how diabetes is forever.  of course i knew this very early on, but i don't think it quite hit home at first.  i've had to adjust my fantasies of the future a bit...my wedding [+ insulin pump in my dress], pregnancy [+ strict, rigid diabetes management], etc.  i had a feeling a day would come where i dreamed in diabetes, and i'm sure this will not be the last time that happens. 

all of this has been on my mind, oddly enough, as i have felt significantly less like a diabetic since getting my pump.  i forget it's there 90% of the time, and eating meals is almost like it was pre-D.  of course, when i get undressed at the end of the night and i forget to grab my pump before it goes crashing to the floor, i am reminded.  perhaps the dreaming is indicative of the fact that diabetes is moving into the background of my life.  it's still always there, but i'm not always thinking about it or paying attention to it, and the day-to-day routine of it's mangement has is becoming seamlessly intertwined with every other part of my routine. 

when i got my pump, my first diabetic buddy ever said to me: "welcome to the world of almost normal!"  truer words had never been spoken. 

Friday, April 16, 2010

sarah + insulin pump

if i had to put it into one word, i would say: glorious.

is it weird having a technological contraption attached to me at all times?  yes.  am i still fairly self-conscious of it?  kind of.  has it made my daily life much less complicated and much easier?  absolutely.

monday morning my pump was filled with insulin.  i had breakfast at the diabetes center and stayed for 2 hours after so they could make sure everything was functioning properly.  i was 268 mg/dL two hours after, but this was probably more related to having no basal insulin in 12 hours (although i still somehow woke up at 135 mg/dL! silly honeymoon phase/pancreas deciding to work sometimes...) i corrected this high, and came down an hour later, so it was clearly not an infusion set/site issue, and i was free to go.

being able to bolus so easily, wherever/whenever i want is amazing.  it's basically like i have a pancreas but i just have to do some of the work for it.  being on injections is doing all of the work.  carrying all the stupid supplies around, having to take out the pen, put the needle on, try and determine how much insulin i needed in 1 unit increments...it was all very intrusive and often anxiety-provoking.  the pump is wonderful.  i take it out, press a few buttons, and i'm good to go.  if i underestimate, it's a simple process to correct.  if i want to work out, i take the pump off, and if i'm low-ish at the end (in the 70s or so)  i just leave the pump off a bit longer and my blood sugar comes up on it's own.  no more shoveling food that i don't even want to eat (or perhaps just a lot less of that).

a few noteworthy events have occurred thus far in getting used to this new limb/organ i have.  the other night, while showing my friend how easy it is to disconnect/reconnect, i stabbed the needle into the tubing, and only realized this when i was high for no apparent reason and not going down hours later.  there was a hole, and insulin was leaking out.  oops!  need to be careful about that.

also, i wore that tight blue dress last night, and it was a success!  i took the clip off, put it in my bra in the back so it was off to the side, and i was told that it was difficult to notice.  it kind of just looked like i'm on a reality tv show, and i'm wearing a microphone.  no harm, no foul.  i was able to forget it was there, and that's really the most important thing.  the pump definitely helps me forget about diabetes.  it's a lot less thinking/work for me to do.  it's also kind of a cool little thing, and it makes for interesting conversation if i feel like having it.  i kind of feel like a robot.  and i'm happy to say that i mean that in the nicest way possible.

Sunday, April 11, 2010

exhausted.

this weekend was freaking exhausting.  actually, the whole week leading up to it was too.  pretty much i have no idea how i'm awake right now.

it all started monday night.  it was my good friend's birthday, and we were out gallivanting around the city.  i got home around 2:30 and went to bed at 3.  sure, this is pretty ridiculous given that i have to be at work at 9, but hey, you only live once, right?  i can handle nights like these every once in a while.

but then, tuesday.  all day i was acting like a crazy person at work, and my coworkers were laughing at me because of it.  i somehow mustered up the energy to go the gym, but while on the elliptical i was beginning to question why i ever thought going to the gym on 4 hours of sleep after a full day of work was a good idea.  also, i had tentative plans to go out with some friends, which was seeming more and more like it was not going to happen.  so, after the gym i went home, took a shower, put on my pjs, and texted my friend to tell her i was in no shape to go out again.  yea...not so much.  i was pretty easily convinced to scratch my plans for a tame night, and promptly got out of my pajamas, made myself look like a real person, and headed out with the intention of getting home by 12 ("i wouldn't be going to bed any earlier anyway, right?")

see, there was a key element missing in this sequence of events: work, gym, shower, go out.....dinner?  nah.  my blood sugar had being running high all day (hormonal stuff + lack of sleep), so i didn't need to eat, and therefore decided to forgo my meal in favor of drinking.  3 vodka/sodas + 1.5 tequila shots later, and i'm feeling like the world's biggest idiot/a freshman in college puking on the streets of new york.  good times.  the next day at work i was even more cracked out and ridiculous, and my blood sugars followed in suit.  ate an english muffin for breakfast that was 32g, gave 3 units even though my normal morning ratio is 1/15, and rang in at 220 mg/dL two hours later,  200 mg/dL three hours later.  thanks, diabetes, for giving me yet another reason to feel like ass.

i was able to reign in my inner rebellious teenager for the rest of the week, and excused my ridiculous weekday behavior with the fact that i had to take my psych GREs this saturday and work on sunday, so no time to go out during the actual weekend.  this meant waking up at 6:45 saturday and 5:15 sunday.  saturday i had one of the most horrendous blood sugars i have seen in months.  i ate my normal oatmeal breakfast that on any given day requires 1-4 units of insulin (it's about 45g), and went to take my test.  i was nervous, i guess, which i know can shoot up my numbers, but i was not at all prepared for the 315 mg/dL that greeted me two hours after breakfast.  i retested and got 305 mg/dL.  um...what?  can you do not do that, diabetes?  it took a lot of strength to return to my test and focus on it, rather than being distracted by that obscene number.  ugh.

oh, and did i mention that i got my pump hooked up on thursday?!  i'm not going to lie, it's kind of annoying the ever loving crap out of me right now.  a lot of that has to do with the fact that it just has saline in it, so currently it's only purpose in life is to irritate me while i am still shooting up the old fashioned way.  i have already dropped it a few times while attempting to go to the bathroom (luckily not in the toilet), tried on and purchased a dress that is not pump friendly:

(i am determined to figure out a way!), and dealt with it just hanging off the back of my pants in a way that is more obvious than i would like.  it doesn't fit in my bra as well as i had hoped.  there will definitely be a lot of exposures, so i'm just trying to prepare myself for that. 

last night was my last does of lantus.  i think once gilbey is filled with insulin tomorrow, i will appreciate it a lot more.  and i just need to get used to it being on me, which is a work in progress for sure. 

so yea, i'm exhausted. [end bitch fest]

Tuesday, April 6, 2010

my friends all think i'm crazy...

...but i had to do it.

we were in mcsorley's - the oldest bar in new york - and there was a table of men next to us.  a few were graying, the others were probably in their 30s.  one of the younger ones in particular caught my eye, just because he was rather good-looking and muscular, and we made eye contact a few times.  i wasn't drinking any alcohol since they only have beer there, and i am not a beer person.  i just sat, sipping my water and chatting with my friends.

all of a sudden, i looked over at the table of guys, and i saw something very familiar on the table in front of the guy i had been eying.  it was a black, zippered case.  then, i watched in awe as he unzipped the case, pulled out an all too familiar bright orange syringe, and stick it in his giant bulging arm.  i almost fell out of my chair.

"dude!" i half-whispered as i hit my friend impatiently, "look what that guy has!" not clear enough. "DUDE THAT GUY IS F-ING DIABETIC" (i swear a lot when i'm excited).

but as soon as the needle was out of his arm, everyone at his table got up and started to leave.  as they lingered for a moment, i was having a major debate inside myself and out loud. 

"oh man...i really want to go over to him..." i said, expecting at least one of my friends to support my urge.  however, none of them seemed to want to condone such bold behavior.  i realized in those quick decision-making moments that this was not something anyone was going to understand but me and my new-found comrade.  until you've had something like diabetes, you cannot understand how absolutely necessary it is to commiserate with people that understand what you're dealing with.

so, i went for it.  with my own little black case in hand, i approached this man as my friends watched on laughing at what they saw as my chutzpah.  as soon as he realized why i was there, he lit up.  he told me how he has been a diabetic for 20 years and how he chooses to stay on injections because he doesn't want something on him all the time that shows people that he has diabetes (hmm...this sounds familiar).  when i told him i've had it for six months, his immediate response was "it's easy!"  which i loved.  whether or not any of us really believe that, his optimism in the face of 20 years with diabetes and doing old-fashioned drawn-up injections all along is really quite inspiring.

we only chatted for a few minutes as his group was already on their way out, and we never even exchanged names, but the whole experience made me so happy.  it was a refreshing reminder that diabetes does not preclude me from a normal life.  while i might logically know this, it is easy to forget sometimes when i'm in a group of non-diabetics, and i feel very different.  until this guy took out his case, he looked like a regular guy just getting a beer with his buddies.  he made me realize that diabetes or not, i am still me, as normal or regular as i was before.

also, his nonchalance about injecting and what not at the table made me think about when i get nervous about checking my sugar or shooting up in public.  maybe this isn't the best route...for all i know, i could be forming a new friendship just by pricking my finger above the table instead of under it. 

Sunday, April 4, 2010

first times

i've been thinking a lot recently about my 'firsts.'  not the big life firsts, but my firsts as a diabetic.

one of the hardest things in the beginning was treading on new territory as a diabetic.  and, since it was the beginning, everything was new territory.  my first day of work with diabetes, first time traveling with diabetes, first time drinking with diabetes, first meal at a restaurant with diabetes, etc. were all quite daunting.  but once i realized that i could do all of these things just as a had before (with a few major/minor adjustments), i felt ok.  and, as time went on, there were fewer and fewer firsts to be had.  life with diabetes has become the norm, and i often forget that i ever wasn't diabetic.

...except for when another first comes around.  as much as it may feel like i've had diabetes forever, i have only had it for 6 months.  there are still a lot of things i haven't yet done with this disease, and in the last few weeks a couple have cropped up.

last weekend was probably the hardest first i've had yet, oddly enough.  it was during a yoga retreat that i went on with my mom.  this is our third year going.  it's a weekend of yoga, yummy (and healthy) food, spa treatments - basically total relaxation.  we both love it, and it's probably the most time we ever get to spend together just the two of us, so it's even more enjoyable for that reason.

this year, though, started out a little differently.  i was nervous.  even though i work out pretty vigorously on a regular basis and have (for the most part) mastered the art of cardio + diabetes, i had not yet done yoga since being a diabetic.  this yoga is not particularly cardio-intensive, but it is still a form of exercise nonetheless.  a regular workout for me is preceded by lots of carbs and no insulin, but i had no idea what to do about yoga.  do i go in high? normal?  if i eat a meal before, do i cover all of it?  part of it?  2/15 of it?  i just did not know.  then i was thinking about the dining room, where we always end up sitting and chatting with random people...how am i going to inject myself discreetly while we're exchanging life stories with people we just met?  am i going to be giving diabetes spiels weekend? all of these thoughts were festering in my head, and they had me everything but relaxed as we made the 1.5 hour drive up to the berkshires.

as we arrived, checked in, and made our way to our room, i remembered our last time there.  i was "normal."  at least my pancreas was.  the words "carb ratio" and "bolus" were completely foreign to me.  i was in my last year of college, looking forward to graduating but unsure of what the future held.  little did i know.

it is in these moments that i have a brief sense of my old life.  i can actually feel it, just for a second.  the life of someone who is not on duty 24/7 to replace her own failed pancreas.  this sensation, coupled with my high levels of anxiety about yoga and eating, left me in tears. 

of course, the weekend was wonderful, even though i had to run out in the middle of our yoga classes and test, and even though i had one 65 mg/dL mid-class that left me shoveling a granola bar.  did any of this really matter?  no.  i still had a great time, and even when i think of it now the blood sugars and insulin calculations are not what i recall the most.  but it was a first, and that made it difficult. 

the hardest part about "firsts" for me is that memory of what life used to be like...the fleeting taste of "before."  i know that i am not done with these firsts.  next year i will go back to school and be a student with diabetes for the first time.  today, against my better judgment, i went tanning to prepare for an upcoming tropical vacation.  while my diabetes had no effect on the tanning experience, i did think "the last time i was here i was not diabetic."  and the tropical vacation, that will be a first too.  i wonder if they will get any easier.

Tuesday, March 30, 2010

our couch post-pump invasion

 
holy diabetes, that is so much crap!  and that's not even all of it!  

that little guy on the left is gilbey (my pump).  the jury is still out, but i think that's it's name. 

pump up the jam

yes, it's true, i am now the proud owner of a minimed insulin pump!

the 10 pound box arrived at my apartment on friday, but since i was away for the weekend i did not get to open it until sunday night.  as i unloaded all of the cargo (reservoirs, infusion sets, linking meter, iv prep, etc.) i thought about how bittersweet the whole pump thing is.  on one hand, i know it's going to make my life much easier, perhaps more like the "normal" i've known for 22 years...but.  but.  the pump is an outward sign that i have diabetes, that i have a chronic disease that is not going to go away.  while being on injections may make my life more difficult and regimented, it also means that no one knows what i have unless i want them to.  while i may be able to hide the pump much of the time, i know that sometimes it will be clipped to the back of my pants, begging questions that i may not feel like answering and causing assumptions to be made where they may not be warranted.  it's not so much that i am concerned what others think, but the idea that i may not always be in control of how much information they get is what bothers me.  i generally have no problem telling people that i'm a diabetic, but it's important that it's on my terms, and the pump sort of takes that away from me.

also, when i held that ridiculously expensive little beeper-like thing in my hands, it hit me that this thing was going to be attached to me for the rest of my life (...ok, maybe not this particular thing, but some form of it) and that was a lot to wrap my mind around.  it's not like getting a new ipod or something, where it's fun but you kind of know it's a fleeting material thing.  this is basically a new part of my body.  and i know i will get used to it.  eventually.

for now, i have to wait until april 8th to get all hooked up on saline and the 12th for real insulin.  until then my living room will remain a storm of pump supplies, and i will be thinking of a name for my newest body part.  suggestions are welcome.

Tuesday, March 23, 2010

huh?

i don't get you, blood sugar.  or rather, glucose meter?  i'm not quite sure who's to blame in this scenario. 

as a lot of bloggers have been posting about meter accuracy recently, it's definitely been on my mind.  mostly i've thought "wow, seeing things like 215, 165, 125 all within a minute is totally insane.  i'm glad nothing like that has happened to me." there have been times where i've been lazy about washing my hands, and after some close contact with a banana i got a 116 mg/dL, which seemed odd given how i felt, so i washed my hands and then got 62 mg/dL, which made sense.

tonight, however, was just plain weird. 

for dinner i had an english muffin with peanut butter, a can of green beans, and a cup of cooked broccoli (i know, that's a weird meal, what can i say).  this is pretty standard fare for me.  in fact, i ate the exact same thing last night, when i was 147 mg/dL two hours post meal and 81 mg/dL three hours post meal.  tonight - 125 mg/dL at two hours and 147 mg/dL at three hours.  what?  why would i go up like that?  i don't understand.  is that just my meter and it's lovely +/- 20% accuracy?  even so, i should be below 125 for sure.  i rechecked, clocking in at 142, and even got out another meter, which said 135.  i. don't. get. it.

this meal was perfectly measured, low carb, and something i eat all the time.  has anyone else experienced things like this?

Sunday, March 21, 2010

shabbos, with a side of betes

for a while now i've been wanting to experience a real shabbos.  from friday night at sundown to saturday night 1 hour after sundown, religious jews observe shabbos, or the sabbath, and they refrain from doing pretty much everything.  they can't use any electricity (though there are some ways around this), write, or basically do any kind of work.  the idea is to use the day as what it was intended for in the torah (the old testament) - a day of rest.


my family is not religious.  we were raised in a reform jewish temple, which is a totally different kind of judaism that does not have the same rule-based approach that orthodox judaism has.  i have never observed the sabbath before, and until the last few years i knew very little about it aside from the fact that orthodox jews don't drive on saturday.


i got the opportunity this year to participate in a real, live shabbos.  a co-worker of mine, whom i love, is an orthodox jew.  when i mentioned to her that i had been interested in doing this, she immediately offered for me to come to her house.  this has been in the works since september, and finally, this past friday night, we got it together.

first of all, it was a wonderful experience.  k, my coworker, has a beautiful and kind family.  her husband was a sweetheart, her two little kids adorable and well-behaved.  the three of us adults stayed up until 1:45 AM friday night talking about pretty much everything.  they were more than happy to answer all the questions i had about shabbat and orthodox judaism in general.  they were even interested in my secular life as a single 22-year-old woman (most 22-year-old orthodox jewish girls are married and often have at least one child).  on saturday, k's husband's brother and his wife came over with their 18-month-old.  they are the same age as me, and she is expecting her second child this summer.  it was a pretty surreal experience to be a part of this world that is quite different from the one i was raised in.  overall, though, i loved it.

of course, this whole event would not be complete without diabetes making everything slightly more interesting.  and by interesting i mean stressful and annoying.  i didn't let it bug me too much; i was careful not to ruminate, but it was definitely testing me.

basically, shabbos is a diabetic nightmare.  it's like 2 thanksgiving meals - one friday night and one saturday during the day.  both meals begin with a blessing over grape juice that everyone drinks (ok not too big of a deal, i can take a microscopic sip) and then a blessing over challah (the yummiest jewish bread in the world) that everyone also eats.  this is where problems begin to arise.  the challah is blessed and then everyone starts chomping down on it.  i have my insulin pen sitting on the table, and as i ingest this delicious high glycemic carbohydrate, the pen stares back at me.  i can FEEL my blood sugar rising, and the actual dinner hasn't even started yet.  i don't want to do my injection yet, because i have no idea what else i'm going to eat.  i know there are a lot more carbs coming my way, but i haven't assessed them yet.  i usually need to taste everything, see what's bolusworthy, and then go from there.  but here we are, eating the challah, and just hanging out.  every course of the meal is dragged out.  it's shabbos, you're relaxing, so the meals last for hours and hours.  you talk, you schmooze, it's great - except when you're me and you're silently freaking out about when/how much insulin to give yourself.  finally i decide to just shoot up 8 units.  i know i'll be eating a lot of carbs, and if i need more i'll take another dose.  i couldn't sit there uncovered any longer.

so i take my insulin, and more food slowly makes it's way onto the table.  gefilte fish (no carbs), minestrone soup (maybe some carbs? hard to say), sea bass (no carbs), vegetable casserole with bread crumbs (carb-y), potato kugel (carb-tastic), fruit cobbler roll (carb frenzy), and finishing with chocolate cake (holy mother of carbs).  i ended up taking 13 units total, and was still in the 250s 2 hours later, and gave a bolus before bed.

lunch the next day was even worse.  k was such a sweetheart - she tried to make a million things that i can eat because i'm a vegetarian, but unfortunately she didn't realize that it's not only sugar that i have to worry about.  pretty much everything had carbs in it.  and i am totally shooting in the dark (no pun intended) with insulin.  i don't know how many carbs are in any of these things.  for lunch we had challah again, salmon, carrot coffee cake, phyllo dough dumplings filled with spinach (made especially for me), stuffed portobello mushrooms, asian coleslaw salad, kugel again, chocolate cake again, and fruit trifle w/ whipped cream-y stuff on top.  just typing that is making my sugar go up.  i gave myself 18 units of insulin. 18.  that's more than i usually take in a day.  and 2 hours later - 220, 3 hours later - 215.  GAHHHH!

granted,  i ate a lot.  wayyy more than i needed to.  part of the problem is that the food comes out, and it stays out.  on the table. in front of my face.  a giant chocolate cake.  and we sit at the table for hours.  the meal began at 1 and we finally left the table around 4:30.  it was great, but stressful.  eventually i had to whip out my gum and chomp away to occupy my mouth and make it try to forget about the ridiculously yummy chocolate cake.  it pretty much worked, but by that point i was already stuffed and not feeling so great.  it doesn't help that i'm trying to lose a few pounds either.  these meals were both dieter and diabetic unfriendly.

but so what, right?  a few times a year we have to just give in and be ok with the highs.  next shabbos, i'm going to have my entire gum arsenal under the table (i usually have 5-10 different kinds of gum on me at all times) and hope for the best.  also, maybe i can ask for the menu beforehand so i can try to estimate carbs better.  or i could just do the same thing i did this time and say whatever.  it's only 25 hours of my life.  may as well enjoy it.

Wednesday, March 17, 2010

subway muffin

a funny thing happened on the way to work today.  well, it was more one of those "i know this will be funny later but right now i'm really f-ing annoyed" situations.  my day started off not so great when i somehow managed to turn my alarm off instead of snoozing it at 7:15, and i ended up waking up again at 8:15(!) when i usually leave at 8:30.  i frantically got ready as quickly as possible, and decided if my bg was safe i would make something to go and eat on the subway (i never do this - the dietitian who saw me in the hospital when i was diagnosed told me to always eat before work so as to not risk going low.  since then it has been ingrained in me to eat breakfast at home, before work, every day).  luckily i was 124 mg/dL, so i threw an english muffin in the toaster oven, slapped on some peanut butter and a piece of banana, and ran out the door. 

now the question became, where/when shall i shoot up?  i'm beyond caring about what people think, in fact, i thought, it might be kind of funny to freak people out by stabbing myself with a needle at 9 AM during our morning commute.  plus, this is new york, we've all seen crazier things.  i decided to do it while waiting for the train, and to be honest i don't even think anyone saw.  i got on the train, grabbed a pole, and fumbled around to get my breakfast out.  this is where things got interesting.  i have this ridiculous thing where i like to separate my meals so that they seem larger - i just couldn't be ok eating this english muffin as a sandwich, even though i was standing up using one hand to hold on to the train pole, i had to pull the thing apart so i could have 2 separate halves.  well, i'm sure you can guess how this turned out.  pretty much immediately half of it was on the floor, peanut butter side down.  first i'm like, shit, there goes half my food.  then i think, crap, i already bolused for that!  what do i do?  i cannot possibly eat this thing.  it has new york subway floor on it.  but now i'm pretty much definitely going to go low in 2 hours if not sooner.  oh this is so not a good start to my day! 

but guess what, it all worked out in the end!  somehow, maybe with all of the morning stress, i did not go low, stayed in range, and made it to work in one, slightly late, piece. i did actually consider eating the floor muffin, though.  how gross is that?  i can't even really blame it on diabetes...i think i just don't like to lose food! :)

Tuesday, March 16, 2010

lucky?

this is also a little old - written february 27th - but it belongs here.

i've been reading the blog of a dad whose 7 year old son has diabetes.  it's so striking to me how this disease reverberates through a family - especially when the person who has it is young.  charlie, the boy from the blog, was 22 months old when he was diagnosed.  TWENTY TWO MONTHS OLD.  i was twenty two years old, and that was difficult enough.  but i am the only one who manages my disease, and manage it i do!  for charlie, he has a whole team - mainly his mother and father, but also siblings, teachers, school nurse, etc.  it's incredible.  i feel so much for this family.  i also feel so lucky that i had 22 years without diabetes.  22 years to eat carbs without consequence (...not entirely true, but without scary, life-threatening consequence).  if there was such a thing as a 'good time' to get diabetes, i would say 22 was it for me.  it waited through my little kid years, which judging from charlie's dad (carey)'s blog would have been pretty difficult for everyone.  it waited through middle school (again, can't even imagine how that would have worked), and through high school, and thankfully through college.  i got diabetes 4 months after i graduated college.  talk about timing.  i had only been doing the real-life, adult routine thing for 2 solid months when diabetes came along.  so if you think about it, diabetes is the divider between my childhood and my adult life.  i will never be an adult without diabetes, and i will never have known it as a kid.

reading carey's blog is both painful and heartwarming.  i am kind of addicted to it right now, just like i was to kerri's when i first found it.  i don't know what i would do if i had a child with this disease.  obviously i know a lot about it, but it's still managing another person, which is inherently different than managing yourself.  i cannot imagine my mother as a parent of diabetic child.  it requires SO much around the clock monitoring.  what the hell would she have done?  i am thankful for her sake that she does not have to bear the burden of my disease.  but sometimes, as sick and twisted as this might be, i wish she did.  i just wish she knew what it was like.  i think she has a better idea of it now than before i was diagnosed.  but even still, i don't live with her, and i think she probably forgets sometimes how drastically different my daily life is.  i shouldn't say that.  it's not drastically different.  it just has this very important unique process that has to occur multiple times a day now, which it did not have before and which she has never had to live with herself.  i remember sitting in the ER with her on september 20th, and i was just asking a billion questions a minute.  what does this mean?  can i have sugar?  i have to give myself shots?  for the rest of my life?  and she was being a trooper, but i also think she was doing her optimism thing, where nothing is really "that bad," except that it is, and she's just sugar coating things (no pun intended) in an attempt to make me not freak out.  but also, i think she genuinely did not know.  how could she?  i sure as hell didn't.  and i sure as hell do now.

Monday, March 15, 2010

first entry.

 i actually wrote this february 27th, but i figure it's an appropriate first entry. 

i'm thinking about starting a diabetes blog.  i don't know if i'm quite there yet, though.  to the point where i'm going to make the assumption that someone might want to read about my life.  but i just keep reading other people's, and i love all of them.  i love the feeling of "oh my god, you do that too?!" and "i know exactly what you're talking about."  i even get that those feelings sometimes when i read the blogs of people i have pretty much nothing else in common with except diabetes.  i'm going to start here, write an entry about diabetes/my life, see how it feels.

...so i'm supposed to be taking enough lantus only to make a "baseline."  i should have to bolus for e-v-e-r-y-t-h-i-n-g. but it's a bit tricky to find that right number.  last night i took 11, woke up this morning at 110 mg/dL.  that's perfect, right?  except that i drank last night...totally throws a wrench into things.  i'm inclined to think if i had not drank, i would be 140 or something.  but also i didn't sleep that much...went to bed at 2:30ish and woke up at 9.  i guess we'll see how the rest of the day goes.

also did a new experiment with breakfast.  i like to be able to enjoy my oatmeal in the morning, and today i didn't want to dawdle too much pre-gym because i'm meeting my gma at the opera at 1, so i decided to do a small breakfast, go to the gym, and then have oatmeal and eggs after.  i basically switched my mini-lunch-on-the-go (english muffin w/ pb) with breakfast.  i put a few slices of banana on it too. yum.  interested to see how this goes blood sugar-wise.  i'm still going to put gatorade in the water bottle, rather be high after than low.

it's funny to think that, when i was first diagnosed, i thought a day would come where this would all be 100% figured out.  i can't help but place some blame on all the doctors/nurses/cdes that i saw, who told me essentially that.  i guess they have to...i guess i needed to hear it at the time.  but what's the truth?  the truth is that there is no 100% figured out with diabetes.  you will never be as brilliant at your calculations as your formerly healthy pancreas was.  also, you cannot predict the future, so you will never be able to anticipate random hormonal/stress/life things that happen and totally fuck your shit up.  oh, you just bolused and ate lunch, and someone's giving you brownies?  hmm...that's unfortunate.  oh, for no apparent reason at all you wake up at 150?  hmm...woops!  although, i don't even know where i went wrong.  you feel guilty.  obviously somewhere in there you made an error.  but i'll be damned if you can figure out where that error is 75% of the time.  ok, maybe 50%.  and i'm still honeymooning.  i have not yet experienced the horrors of a completely fried pancreas, like my other blogger friends.  i still have some back up going on there.  it's by no means functional, but it helps me out, i think.  and how does that work...am i going to wake up one day and be 250 or something?  when does it end?

oh diabetes, who ever knew we would become such close friends.