The Problem With 80

The problem with 80,they say
Is more, that it stays not that way.
It soon starts to drop
And more eating of glop
Is repeated oft times in a day.

I personally have no problem with an 80, or even upper 70's, but as it creeps down into the lower 70's it gets into my cranky zone & I start feeling low. My Endo can't understand this ("You aren't low. You're just too high most of the time.") implying that I should just suck it up & embrace it for all it's worth,& one day it won't feel so bad.

My Endo does NOT have diabetes. I can't tell my body to love a 71,(which,with the strip margarin of error is probably more like 64) and when I'm dropping, I feel it. And with anything in the 70's, the odds are 100% that I will drop(be it on basal alone) Yeah,my blood sugars are quite a bit more stable these days and my goal is to be near 100,but I don't know if I'll ever be comfortable with upper 60's/lower 70's. I'm glad that I feel my lows(quite well) but numbers like that seem to me to be flirting with fate.(raises hand,been there,got the tshirt)

Yeah, me and the Endo have an oil and water relationship these days..I sometimes think she wants me dead. I don't intend to go from a low though,and as previously mentioned,I think she's from the Land of Textbookidemia & isn't really listening to my point of things(hypos KILL too). I mean, I've only been doing this for 12.5 years(longer then she's been practicing) I think the fact that I don't eat the kitchen sink (treating with the minimal amount of carbs) shows that I have improved in that regard.

Anyone else have an exasperating Endo?(She's good,she's just driving up the wall)


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A Story of a Great Doc

There are bad doctors. There are so-so doctors. There are good doctors. And lastly, there are exceptional doctors,the ones that you will never,ever,ever forget.

This is the story of an exceptional doctor.


It was the best of times,it was the worst of times. It was many years ago,and my health was non-existent with a storm of puzzling,vague,weird symptoms that made my life non-livable 24/7/365. It's hard to get into what that was like,
for it was no kind of a life at all. There were doctors(and more doctors),and tests,and weird abnormalities that did not fit any specific disorder. It was a long,depressing process...and guess what,I was told that I was depressed.(which I was,by that point,but it made me mad to be told it was all "in my head") After the World's Worst Seizure,(and a subsequent workup at Big University) no one told me it was all "in my head" anymore,but answers weren't exactly forthcoming either.And then I went to an ENT(quite possibly,the only specialty I hadn't seen,by that point) I had all these symptoms that were being treated,and no "big picture."

It wasn't hard to like him,this young,charismatic doc with a boundless sense of optimism. He had a plan,& that plan involved figuring out WHY I was as dizzy as a drunken sailor 24 hours a day.After several tests,it was discovered that my eyes/ears didn't track well with my equilibrium & so I underwent "balance training" to try and fix that. What did I have to lose,my brain was on the fritz anyway.Eventually,things got better in that regard(as well as the rest of the health drama) but I think the best thing he gave me was the renewed sense that I was right,& not nuts,no matter what the medical profession did/did not find.A couple years after that,he took out my tonsils and since then,he's been my allergist doc.(all is status quo in that regard too,my allergies haven't been that bad this year) I don't think he ever once chewed me out about anything D-related,(in direct contrast to any other doc I've ever had)which makes him an extremely rare HCP.

Diagnostic Skillz...he's got it.

Bedside manner...he's got it.

Surgical prowess...he's got it.

Cuteness...he's got that too,& let's be honest,anything that goes easy on the eyes is conducive to the healing process. (even for married folk,though that's where it stops)Everybody likes him, he's that kind of a person.

There are good doctors,in every specialty,and when you meet one...you will know it forever.They go above & beyond the Hippocratic Oath,& make the world a better place.They make medicine what it is meant to be. And I think that whatever your definition of a great doc is,there are probably elements of most of the above in it.


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Pictured

Pollen and Puddles




(contents of purse.80% Diabetes Related.No wonder my arm sprang Neuropathic issues on me.(cruel,cruel irony,if diabetes itself doesn't do it carting around all the supplies will)




(fast-forward, please)




(Now Pause!)




(mail treasures...must do book review soon)




The dreaded SoxPox, which is 100% lethal.(attempting to "cure" it...is futile, it gets tossed.)

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iPhone

Beautiful Things

I'm well aware that I flunked out of #Dblogweek, but I'm still going to do this final post as a sort of combination of the last three posts that I missed.Awesome things plus Snapshots plus deep and profound thoughts.

#1 Friday was the final day of nursing school..and the big Nursing Convocation.Passed my final exam with an 88(and how that happened,I dunno,because it was so hard I was only sure about 65% of it),earning me a B for the course(and an A&B for the other courses). It felt quite odd to be done,and smooshed into an auditorium with hundreds of other 1st,2nd,3rd,and 4th Semester students. But it felt good too,for as hard as 2nd Semester is reported to be,with the first semester under our belts we can take on the world now.It almost felt like we should be tossing hats up in the air(along with the graduating class),we made it.(stupid,I know,but it feels like I've been in school forever!) And then(after the various awards,etc.) there was cake,and punch,and a subsequent spiking of bgs to undesirable levels...goodbye,school!

2. Blood sugars can be beautiful. Unfortunately, the effects of Tylenol upon a Dexcom sensor are disastrous,& the effects on consecutive days makes you wonder why you're even bothering. So I'm not going to show you a nice,flat, Dexcom line(because quite frankly, I don't have any) but stable blood sugars are a wonderful thing.(not that I even have that,but I'm trying)

3. My last a1c was down by 0.2.And considering that the "cheat" one I had done(my Endo never knew about) was up by a good 1.1, I consider the fact that I dropped that sucker a good 1.3 in a month's time nothing short of miraculous.Nursing school is the dearth of good control.

4. Summertime,summertime...so much to do,& so little time!Two major trips next month,& I'm sure August will be here before I know it.And September.
(yikes,I'm old) My to-do list is a mile long,& I hope to make a sizable dent in it.

5. All of you awesome people in the diabetes blog'o'sphere (and offline,online). It was great reading (some of) the #dblogweek posts.(what I could get to)

6.











(and the best is yet to come!)

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Just Ten?

Ten things I hate about you, Diabetes - Thursday 5/12: Having a positive attitude is important . . . but let’s face it, diabetes isn’t all sunshine and roses (or glitter and unicorns, for that matter). So today let’s vent by listing ten things about diabetes that we hate. Make them funny, make them sarcastic, make them serious, make them anything you want them to be!!

I don't subscribe to the theory that hating something means that it has dominance over you, that it's "won". And while I try not to be that person who goes around saying "I hate diabetes!" with every breath, I wouldn't also say that I love it..yeah,it has some good points, but the fact is, I do hate it. I guess, for me,hating it makes me want to fight that much more to make sure it doesn't win. So here are ten of the things I hate about this disease...

1. I hate how, after coasting along (per Dexcom) at a nice, stable blood sugar all
evening, within twenty minutes of me falling asleep my liver commences to hard-core partying and dumping out glucose,spiking me to 250+ (which I don't wake up for until 4-6 hours after the fact). Wake up with a parched throat and not knowing what the heck just happened(pump failure? or just good 'ole Dawn Phenomenon?) This is a re-occuring theme, no matter what time I go to bed.(9,11 or 1)

2. I hate the little "wave" the Dexcom does all night,dipping either above or below the High/Low alert and going off every ten minutes...not great, when you just want to sleep. What's it taunting me to do, throw it in the drawer and ignore it?

3. I hate low blood sugars, and how they knock you out of commission (no matter how hard you're trying to act that they didn't).

4. I hate that I just can't exercise, without mathematical calculations on the order of a Phd.(and eating as many calories as Michael Phelp's) I'm pretty sure I'd exercise more, if it weren't for you.

5. I hate that I just can't jump in the car and go somewhere...I have too much "essential" stuff that must be packed.

6. I hate how many young,(and older) innocent lives you've claimed...it saddens me so much.

7. I hate that ignorance about you is so widespread,even among the medical community. How can we fight/prevent/cure something so misunderstood?

8. I hate getting Real Person Sick and watching the diabetes control go completely off the deep end. And I hate ketones. (though I have no problem with drinking vast amounts of Diet Coke, at any hour of the day or night.)

9. I hate the scars (from years of guillotine lancing devices)on my fingertips...I don't think my fingers are as sensitive as they should be,and I worry I won't be as good a nurse, because of it.

10. I hate how much it costs.(pure and simple) So much for trying to save money..even if you wanted to, things are always popping up that make it impossible to do so. I can think of much better ways to be spending it all.


Come back tomorrow, for a cheerier post.

#Dbloopers: The One that Never Was

Diabetes bloopers - Wednesday 5/11: Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realize that things can (and will) go wrong. But sometimes the things that go wrong aren’t stressful - instead sometimes they are downright funny! Go ahead and share your Diabetes Blooper - your “I can’t believe I did that" moment - your big “D-oh” - and let’s all have a good laugh together!!

When I was a teenager, & still going to the pediatric diabetes clinic of Major University Hospital, I looked forward to receiving their periodic "progress reports" post appointment. These Reports would be mini-summaries of everything that had been reviewed at said appointment,and more importantly,would contain The A1c & of course I was dying to know that. It would always take them 3-5 weeks to get The Reports sent out.(hundreds of kids seen each in clinic,you can see why it took so long) There were no instant a1c analyzers in those days, & waiting(for it to show up in the mailbox) was a burden that had to be born.


So anyway, on that spring day in June(2001), when said report finally did arrive(1 month later), I ripped open the envelope in eagerness, wanting to see what my a1c(post pump-start) would be. I flipped to the last page, where "10.2" greeted me (in all it's glory).

"WhaaaaaaaaaTTT?" I muttered crossly, & pitched the paper to the floor. "No way!!!"

(I've had bad a1c's before,but nowhere close to 10+!)

Picked it back up, to see whatever "love notes"(such as,noncompliant teenager refuses to obey instructions) had been written about me.


Read.

Read some more.

Each report was completely anonymous, & written in the 3rd person...much like a medical record. (no names) But when I got to the 2nd page, & read "he" the lightbulb went off for me...this wasn't my report. They'd mixed mine up with someone else's. Thank goodness, because I sure didn't want to be the owner of that a1c.


So I picked up the phone,& called about it.


"Yes, we must have mixed it up. Can you please disregard it(too late,I've read it) and send it back to us...your a1c was 7.4."

"Oh yes,yes, yesssss! I got in The 7.5 Club!" I danced around the room,impervious to what the secretary was thinking about me(at that point in time) I didn't care, I was a D-Star!

The 7.5 club was all the people who had gotten under a 7.5, and their names(while not being inscribed in bronze, were still recorded in the quarterly diabetes magazine...and out of hundreds of patients, there were probably only 100 who made it in there. A select few were in there every time, & they were like the straight A students that annoy the stuffing out of you,they're so perfect) It was my goal in life to get into the 7.5 club...and I'd managed to do so before I had to move on from the pediatric clinic.(I was already too old,& needed to cut the ties before hitting 20) Thanks to pumping,I'd done it.(I would not get that low again in a long,long time)

So this wasn't my particular "D-Blooper," but it was the one that had the happiest ending.(I never loved a mistake MORE then I did at that moment,nothing like going from despair to euphoria in 2.5 seconds)

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A Letter To My 17-Year-Old Self

Letter writing day - Tuesday 5/10: In February the Wego Blog Carnival asked participants to write letters to their condition. You can write a letter to diabetes if you’d like, but we can also take it one step further. How about writing a letter to a fictional (or not so fictional) endocrinologist telling the doctor what you love (or not) about them. How about a letter to a pretend (or again, not so pretend) meter or pump company telling them of the device of your dreams? Maybe you’d like to write a letter to your child with diabetes. Or a letter from your adult self to the d-child you were. Whomever you choose as a recipient, today is the day to tell them what you are feeling.

Dear Self,

I'll cut right to the chase,you feel like your life has just come to a complete and irreversible end.Your eyesight is tanked,your chosen career path is now "off limits", and your new medical regimen feels like the cruelest,strictest imposition ever imposed. (you are a freak,who the heck has "snack time" at the age of 17?)Not to mention,you're still scared out of your mind whenever a "236" flashes across the screen of your monster Accucheck Advantage,envisioning all the complications it will bring.(those feelings will pass,you are not doomed to a certain death with bgs like that...sometimes,such numbers are unavoidable)

Those feelings will get better with time...& you will choose another career path,filled with the shoes of some of the finest individuals to walk this Earth.

Trust your gut,self. Doctors and CDE's will disappoint...they don't know it all.You're going to find out that while the management responsibility is largely yours alone, the burden needs to be shared.Strike that-MUST BE SHARED. Are you listening? Go out & scour the Internet,do what you have to do to get that support.(if nothing local) Because without it,you shall feel like the Worst PWD on Earth.(and very likely will have this confirmed by medical providers) You aren't that,self, no one is.You need to feel that you are not alone. You'll meet incredible role models(and 1 or two ax murderers/esses with diabetes, and you'll feel that you aren't so much the quirk of the town. Millions of PWD live with these challanges,all over the world.

You'll learn that "Diet" is not necessarily a four letter word and you'll learn to hate OJ and Kendall alcohol swabs,forever.

You'll stumble to find how diabetes can possibly fit in a romantic relationship and you'll learn that in the one that was meant to be,it was never an issue anyway.

You'll become an aunt(x 9) ,& you'll say goodbye to the only grandparent you ever knew.

You'll hear many,many lectures and you'll learn to tune them out(the ones inside your head/heart are not that easy to get rid of)

You'll have a few 600+ blood sugars,and you'll stare stupidly at the meter(having forgotten how to drive,you'll mainline 5 units to the gut & wait till you come down to 598 before magically,you can semi-remember enough to get home through the hyperglycemic haze)

You'll pass out,vomit on strangers,& ride in ambulances as both a patient and an EMT.

You'll total two cars and drive an $100,000 fire engine(murdering orange cones left AND right).

You'll participate on Jeopardy & jump off great heights on Fear Factor.(simulating skydiving).

You'll go to Europe and Hawaii & get more of a global perspective.

You'll vote in three Presidential elections & become forever a political junkie.

You'll finally enter nursing school...and feel a bit overdue when the youngest member of the class is ten years your junior.

You'll have other health issues...whether from crappy genetics or Murphy's Law,who knows.(they will put the diabetes in perspective)

You'll learn about the workings of the Health Care System...on both ends.

You'll learn that thinking about mortality,is not an issue to be put on the back burner for the later years.(as you come face to face with it on more then one occasion)

You'll throw your meter at the wall,gorge yourself on carbohydrates,leave your infusion set in for 15 days,& rebel against the powers that be...on more then one occasion. And at the end of the day,you will realize that the problems you perceive that diabetes has caused you are minuscule to the problems of trying to survive,in a 3rd World Country,without the means to treat it. Public mortification does not last forever.(& also,the Universe has it's own problems...& is not revolving around you) And while your at it,self,do something good for someone else every once in awhile.(it will also help lessen the crappyness of said disease) Plus,it's the Golden Rule.

To thine own self be true Self...always and forever.It's a good life,self,now go out & live it.

-An
Older You
(who still wants a cure,like,yesterday)

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#Dblog Week- You Say Potato, I Say Carb Bomb..

Admiring our differences - Monday 5/9: We are all diabetes bloggers, but we come from many different perspectives. Last year, Diabetes Blog Week opened my eyes to all of the different kinds of blogs (and bloggers) out there – Type 1s, Type 2s, LADAs, parents of kids with diabetes, spouses of adults with diabetes and so on. Today let’s talk about how great it is to learn from the perspectives of those unlike us! Have you learned new things from your T2 friends? Are D-Parents your heroes? Do LADA blogs give you insight to another diagnosis story? Do T1s who’ve lived well with diabetes since childhood give you hope? Pick a type of blogger who is different from you and tell us why they inspire you - why you admire them - why it’s great that we are all the same but different!!


Living with diabetes is difficult, on every level. Type 1's, Type 2's, Parents of Kids with diabetes, spouses...neither of these roles is easy. But,in my humble opinion,having diabetes is easier then having a child with diabetes. I read alot of inspirational blogs & I'm in awe of parents who manage 2,3 sets of diabetes(or even their own) while I can barely manage my own. They find the courage from their children(and within themselves).People like Meri and Trev and many, many others..they're just incredible. I mean, just being a parent is hard, much less of a kid with diabetes. They're also part of the few that really GET how hard diabetes really is. And even though I do not get how hard that is,(to be a parent of a CWD) I would say that it humbles me (and amazes me) that kind of selfless love.(one night of 4-5 hours of sleep does me in, much less constantly) Your children will thank you, one day. And even though there's ten million ways of "managing" diabetes (specific to the individual themselves),the way certain foods have a disastrous post-postprandial effect (upon the PWD's blood sugars) is just one example of the bonds that all (or most) of us share.(type 2, type 1, LADA, parent of CWD, spouse, etc.)


Viva la difference!

Countdown

I had a horrible night, a night(or rather,weekend) of nonstop horribly high blood glucoses. Most in the mid 300's,and the rest in the 200's. Changed pump setup,took five million injections...no impact. I know I have ketones,& quite frankly despite living off non-caloric liquids I still feel like if I started to vomit, I wouldn't stop. So,at 7:30 this morning, I switched to yet another vial...waiting to see if an injection of that actually did any good on my 298 blood sugar. It was like magic,an hour later I was 218 so I ate a very light snack,changed out,& bolused for that. Nerves were high anyway...it was the morning of Student Evaluations & we met at the Barnes & Noble (coffee nook)to get it done. I was number 5/7,so there was plenty of time to think the worst. So my clinical instructor told me my presentation grade(51/60,which was better then I thought) & her form on me as a whole(I need to talk more,which was kind of irritating,just because I don't run my mouth 24/7 it's some sort of character flaw?it's just not me,it doesn't mean I don't talk enough.I think I went above & beyond the call of duty in that regard) Told me I was very honest(which I take to be a good thing) & overall, I was a good student. So that went ok...all things considering. Blood Sugar post anxiety-trip was 176,& I promptly went out & stepped on the freshly-painted curb,smearing my tennis shoe in a bright yellow blob.(There were no signs,just some guy telling me after the fact what I'd just done.Lovely) Stomach still feels like a bundle of worms,& throat is still dry as the Sahara but I hope that at least I can get back to some semblance of control.(at least it's under 200)

Now to study for final exams.


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Thoughts from the Fifth and Sixth Week

1. I used to think that the idea of ME,non-conventionist of the D-world,becoming a CDE was absolutely never going to happen.How could I ever tell a patient something that 3/4 of the time I never did myself? And then, I got out into the real world & realized that I have the equivalent of a PhD in all things diabetes. I'm not just saying that,I've been pumped & primed & have been to 10 zillion research events(etc.) since Day 1. And while I may never be that Role Model, I have more then just book knowledge...I don't look at a patient & label them "noncompliant" even if there is something clearly going on. I look at them & see an internal battle to stay in control of something,& I see a medical professional that doesn't have the time or patience to delve into the mysteries of the diabetic psyche or what's really going on here.And I fume when I read the words "noncompliant" or "uncontrolled" when to boot,there's been no documentation of a visit with a mental health professional or a CDE.I guess the vast majority of docs/nurses will just never understand,there is so much more to diabetes then avoiding sugar/taking shots.Even type 2,(and how the Sam's Hill is it NIDDM when the patient does take Lantus at night?yeah,I'd say that insulin is required)most of them get shoddy or no education & it's no wonder ignorance/stupidity runs rampant all over the world. I may never be a CDE,but it is my responsibility to care/advocate for better D-care for my patient(when the occasion warrants it).There's just so much wrong that sometimes it feels like I'm just a speck of sand on the seashore,ignorance is going to be around long after I'm gone.

2. I came out of the D-Closet & confessed that yes,that it was my pump. It didn't kill me to do so.(& my two classmates aren't the D-Police)

3. 3/4 the class flunked the week before's (Monday's) exam,which made me feel better about the 82 I got...and thought was pretty bad. It was hard,but not that hard.(I've been a solid B in all four tests)

4.Last Clinical was last Wed. It was bittersweet, I'm not feeling ready to move on to the madness of the 2nd Semester. I know I have been babied/coddled in this one.
---------
1. Professor "Coordinator of the First Semester Yearlings" will be following us into the 2nd Semester. (to coordinate us there,too) I dunno,but I think it would be better to have all new teachers...& especially where her teaching is concerned. It's through, but it can get so dry and boring that you just want to run screaming from the room after 45 minutes.(much less 3 hours) She'll be teaching Obstetrics.
2. I didn't do well on my client presentation..it was too short by 2 minutes(I couldn't get my YouTube video working), the slide references weren't quoted right, and my nursing DX was all wrong. I dont know if I got the minimum 45/60 required points, but my fears of failing out of the course have been allayed somewhat as I am told that I only have to make 282 total points to pass( I'm at 225 right now). I can get up to 60 for the presentation,& up to 50 with the final exam. So I could totally fail this & still do well on the final, I have wiggle room.Thankful for that,because I don't want to repeat this thing!(the other two courses I got an A and B in but this is the main course,serving mortification & guts on a daily basis. Also,lots of $$'s.
3. In an unprecedented move of unexpected sweetness, one of the other students brought SF applesauce today. Yeah,SF does not equal carb free but it does equal less carbs...and applesauce is applesauce,fairly harmless on the gut. I was actually touched that she was thinking of me (when she made that decision for the whole group)
4. Tomorrow, we go to the Senior Center & see how the healthy older adult lives.(in contrast to the morbidly obese, COPD,nursing home inhabitants)
5.


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Uno de Mayo

I have nothing profound to say..absolutely nothing. An Endo appointment looms (larger then life, 2 pm sharp, tomorrow), diabetes is doing its own rollarcoaster ride from Rootabaga,and I'm up to my eyeballs in school stuff. There are no coherent thoughts left in my head. (or in the universe)

But, in these most trying of times,hope still lives on...for peace-loving people, everywhere. (and tyrants get what they deserve, although this conflict is far from over.)