The D-Log Cabin

Wordless Wednesday: Bottles

2012-02-01T22:47:00.001-04:00

Mommy's and Babies. #rollon70mg/dl

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One Wonderful Day:24 Hours on the L&D Ward

2012-01-29T19:00:00.000-04:00

(the birth...Part 1. Warning: Extremely Graphic Depictions ahead. You've been forewarned)

It was the night. The night my life would change forever. (I just didn't know it yet) After eating dinner out (Chipotle & Coldstone Creamery were the winning combo) with friends, I went to bed and ignored my shrieking POD all night till it died for realz at 3 AM. (before it died, I bolused for several hours of basal so I wouldn't have to get up and change it out until 6-7 AM)

And then, the nausea began. Couldn't get back to sleep. About an hour and a half later, at 4:30 AM on the dot, my amniotic sac burst (but not like a water balloon...there was plenty more to come) and the floodwaters gushed forth, over bed, down to the carpet, etc. leaving no doubt that that's what THAT was. Urine doesn't come forth in those quantities.

I looked over at my husband. "That was amniotic fluid, I gotta call the OB-GYN!"

Which I did. Shortly thereafter, the contractions began. And by the time we'd loaded up the car and got to the L&D ward (5:55 AM), another gush of amniotic fluid spewed out, soaking me from head to toe (right through any so called "protection") It was hardcore, this stuff. The nurse gave me a gown, cleaned things up, put pads down on a table, and hooked me up to the monitors while waiting on the doctor. Meanwhile, amniotic fluid just kept gushing a mile a minute. Very tired looking OB-GYN came in, checked, and said I was 4 CM dilated.

"You are in labor." (no kidding?)

Contractions, regular contractions, sped by on the monitor. And not that I ever doubted it (amniotic fluid gushing forth is a pretty good sign) but it was now official, coming from the mouth of the MD. Progressed 2 CM in 2 days.(after staying at 2 cm for about 1.5 weeks)

"Would you like to take a shower?"

I tried, and the nurse tried to help, but the nausea & the fact that I just about broke my kneck slipping on on the water made it a really, really bad idea. In the meantime, two nurses changed the table again and commented on how much fluid I had in me. (great news, it will just keep gushing out of you till the very end) Weight loss from that had to be a good 5 lbs. It just boggled the mind,over the course of seven hours I'd soak the bed 6 times. (setting some sort of record, I'm sure) By 12, I'd been in a L&D room for a few hours, they'd started an insulin/dextrose/saline/penicillin/and pitocin drips, and contractions were getting extremily painful.

(the ever-so-lovely IV cocktail. Regular Insulin, Dextrose, pitocin, and penicillin. Why on earth they needed to have both dextrose and insulin running simultaniously is beyond me, they tripled my basal rate to 3 units an hour because they were also giving about 15 grams of glucose per hour. But it worked out pretty well.)

L&D nurse #1 turned out to be an OB instructor at my college (I've had her for one lecture). So that was pretty interesting, it's a small world. She monitored me for awhile, checking my bg every couple of hours & admininistering several injections of Apidra (via pen) when my bg was 150-170.) going off a sliding scale. Made me nervous as all get out trusting said "sliding scale" but I didn't have much basal on board at the time, so it worked out ok. She also put in the catheter (I was the guinea pig, it was a new type) and said it was a shame I couldn't see how it was done. I dryly agreed "Yeah, really". That was a new experience, because in lab it looked extremily painful, but I was so numb from the epidural that it didn't feel like anything. The anesthesiologist put the epidural in about 1 pm (by 12:15, I was begging for one), and oh sweet relief, just like that the pain was 100% gone. I'm really not sure how people ever go through labor without one. (I became an instant fan of the epidural) My new OB waddled in, (a good 36.5 weeks along herself) and proclaimed me 5 cm dilated. Increased the pit drip.

That afternoon was spent watching John Wayne reruns & waiting for something to happen..and being extremily grateful that I'd eaten so well the night before. Because the next time I'd get real food would be awhile I was confined to bed, so basically I couldn't go anywhere. Ate sugar-free popsickles, jello, and imbibed on ice water & had my blood sugar checked every couple of hours. At 7 pm, I got a new nurse...who surprise, had TYPE 1 DIABETES as well. On a pump, to boot. When she said that, I knew it was going to be a good "rest of labor" experience, she was going to take my diabetes seriously. By 7:30 the contractions were heating up again and I was 8 cm dilated and extremily uncomfortable, yet again. Anesthesiologist came by and gave me another epidural dose and rigged up a pump for me to press, if I felt like I needed more. Which I partook of,quite frequently. Several hours passed,my fabulous Nurse with Diabetes checking my blood sugar (with my lancing device-NOT the hospital one) every hour & tweaking the IV basal and the dextrose flow rate & that annoying blood pressure monitor going off every half hour. By 11:55, my OB was back in (checked, 9 cm dilated, 100% effaced) so she proclaimed,"Let the pushing begin!" So her, NWD, and my husband all hung out in the hospital room (off and on, the OB did have to go off to check on someone else) for the next 2 hours while I huffed, and puffed, and blew the house down. On every single contraction, which came approximently every 1.5 minutes. The thing about pushing, they actually made me lift my legs and put my hands behind the knees and THAT was just as difficult as the actual pushing part (you try doing that when you've had an epidural and your legs are dead the world). There was lots of encouragement "You're doing great! Keep going." but it really didn't feel like I was making any sort of progress, which was confirmed at 2:30 AM. Still only 9 cm dilated. Maxed out on the safe level of pitocin. OB said she suspected the birth canal was too narrow and although I could try pushing for the next hour, if that didn't work I'd need a C-Section. (because my water had broken,there was a 24 hour time limit on delivery) I opted for the C-Section, because I knew that she was right.(and I wasn't going to do another hour of unsuccessful pushing) And then I had my breakdown (being told you have to have a C-Section when you're horrendously sleep deprived & have been in labor for 23 hours is just not fun),a major, major breakdown which the nurse/OB sympathetically dealt with & reassured me that the odds were very low that I'd have an embolism & stroke out on the OR table(etc.) Fear gave way to the pain taking over again & I seriously wished myself dead as the contractions just kept coming a mile a minute. Was prepped for surgery & I just kind of curled into a ball & wished it all over. Was still pretty mad that I had to have a C-Section, so close to the end.

Was wheeled into the OR,rolled over onto the operating table,sat up as the anesthesiologist delivered another epidural dose,& laid back down. The cheerful chatter of the OR staff served as a momentary distraction before the fun began.

"It's a beautiful day for a birthday, it's Elvis Presley's birthday!" (also Steven Hawking's, FTR)

"Really, that's pretty cool!"

"What was her blood sugar?"

"96." (had been between 70-110 for the past 16 hours)

A horizontal slice, and then...

Many hands, twisting my innards like they were playdoh, had me crying out in agony. Lucky for them, my hands and arms were restrained at my sides, because I absolutely would have gone ferral and attempted to rip somebody's head off. I was out of my brain in agony. (they say a C-Section isn't supposed to be painful, & it just feels like "pressure"...well, they are wrong. It was extremely painful,and they can't give you any real pain meds because it will affect the baby's breathing) Anesthesiologist asked if I'd like a general anesthesia but I said no, I didn't want to be all drugged up when the baby was finally born.

An eternity later...I heard him cry.

And then, I cried.

"He's beautiful!"

(which I figured I'd cry, but this was more of the sense of "I cannot believe I actually birthed a live human being" more then anything else)

Little J.B. made his appearence at 3:33 AM on that Sunday morning.(Jan. 8,2012) weighing 7 lb, 3 oz. and 19.75 inches long. They whisked him off, did Apgars, dried/suctioned/whatever, did a blood sugar (50-normal for a newborn) and stuck him over the blue curtain for our viewing pleasure. And then, I cried again (first thought: I hope they can clean him up some more, he looks sort of greyish-blue) and the anesthesiologist whispered sweet words in my ear("I'm going to give you a stronger pain med, now that he's out"). Which I nodded at, but just the fact that they were stitching me up and not yanking on my uturus anymore had improved the pain considerably. Then, it was off to the Post Anesthesia Care Unit where my awesome nurse with diabetes kept tabs on my blood sugar,bleeding,and everything else. I was thirsty as all get out but they would only let me have ice chips.(which I ate a ton of) They put him on my chest & I bonded with him before we all went off to the 3rd floor Post-Partum Unit and darned if I didn't sob again as NWD gave me a hug and told me he was perfect. (It was one of those nights which will live forever in my memory...the kind where you pour out your gut to a total stranger, but they are not "strangers", they are like the twin you never had) I could not have had better care. And I knew that I'd picked the right hospital,THE ONLY HOSPITAL WHERE I COULD HAVE POSSIBLY HAD SUCH AN EXPERIENCE. (sure as certain wouldn't have gone so well at the other hospital) I was at peace.

And that was the first 24 (plus 2 hours)... at time where I was at peace with myself, my child, and the Universe. It was enough, for then. (the next few days would be an 180 degree shift from that)

Mommyhood: One Week Later

2012-01-15T07:54:00.001-04:00

I love you, Little Guy!!!

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Ice & Chocolate: The Final Week

2012-01-05T15:21:00.001-04:00

Yep, I know I've said this before...but it is getting closer to the delivery.

I am 38 weeks, & the induction is scheduled for Wed, Jan.11. I have been convinced that labor is immenant for weeks now.(just don't listen to me, because I don't know what I'm talking about)

News Flash: Contractions are not labor. Painful contractions, are not labor. 2 cm dilated & 50% effacement is not labor. Real labor has you on the floor, writhing in pain. We were told thus, on Monday evening.(dry run to the hospital,as it were) Of course,baby chilled down & only popped a couple contractions the instant I was hooked up to a monitor.(& were duly
sent home) I had regular,painful contractions for two hours prior to that & it wasn't anywhere close to being "real labor." Really confusing,if you ask me.

So,given that there are 6 days(or less) till they do an induction,it is kind of weird to have an actual date. Carved in stone. People with diabetes frequently go into preterm labor & I still can't wrap my head around the fact that here it is,38 weeks later & no pre-eclampsia,baby is normal size, etc. I've still got too much amniotic fluid on board but that hasn't made me go into preterm labor. I'm really ok with going into labor at any point now,but the only thing that seems to be happening is more frequent contractions. No progress on the dilation front. I've heard that you shouldn't have your water broken until you're 5-6 cm dilated because once the water breaks, the clock starts ticking & they'll want to drag you into the OR for a C-Section should you not progress fast enough. As I'd like to avoid that, I'm taking that advice. But I don't harbor any notions that I won't have to have one...& I'm ok with that. No one is guaranteed a complication-free birth. (I trust the guys/gals with the medical degrees)

Current Cravings: Ice, Chocolate,& Diet Minute Maid. (lemonade) It's kind of a weird late-pregnancy thing, I didn't crave these way back in the 2nd Trimester! I've had lots of opportunity to stuff my face with chocolate, at 37 weeks my insulin requirements took a sudden dip and it's still like that-lots of hypos. Just about the time that I finally get it right, I'll probably go into labor & really have a nosedive. It's common for that to happen,as progesterone production slacks off but it's somewhat disconcerting until they reassure you that it's normal. As with everything else D-related,it doesn't happen to everyone.

I am so,so,so,so ready. (over-ready!)

2011: A Year, Reviewed

2012-01-04T09:26:00.001-04:00

It was a year in which I:

Started Nursing School

Found out I was pregnant

Rafted the mighty Colorado River

Met (& remet) old & new friends at the Friends For Life Conference in Florida

Turned 30

Went to 10 billion doctor appointments

Cried for hours over a 6.5 a1c (my best ever,& the best of the pregnancy!)

Saw my diabetes turn 13...

Dropped out of nursing school,to dream another day

Gained 40 lbs (New Years Resolution=you kind of know what!)

Gained a greater sympathy for disabled/handicapped people's challenges because when you can't do hardly anything for yourself,life is pretty difficult. And I'm one of those people who'd rather fall down trying,then ask for help.

Went to a diabetes meetup (SimonPalooza) in NYC...& felt massively better about my sorry DLife (& everything else,in general). It was refreshing.(& seeing my first Broadway Show was pretty cool too!thanks to Cara R.!)

Here's to 2012,& baby coming SOON.

Wordless Wednesday: The 259th Day

2011-12-28T19:47:00.004-04:00

--------
Yesterday morning, as I rolled out of bed, I was positive that this was the day. I don't think you really want to know precisely why I was so positive (let's just say that it had to do with gross body substances) & that, combined with rocking cramps, had me convinced that this, was it.

Well, it didn't quite work out that way. Husband took me to the OB-GYN (a normal appointment, all ready scheduled) and I'm not in labor...not yet. I am 2 cm dilated (seems to be progressing at the rate of 1 cm/week) but unless 6 cups of amniotic fluid exit the building, I'm not really "in labor". I am also GBS (group B streptococcal?) positive, so labor will involve antibiotics in my IV. And also, the hospital doesn't allow you to wear your own insulin pump, something that doesn't make me too happy because I've been planning on this for months (barring any emergencies). OB-GYN assured me that they have a team of internal medicine guys to "get my diabetes back on track with pump adjustments" after delivery. (yeah, right. NO offense, but my diabetes is never "on track") And then...the issue about blood sugars during actual delivery. He said they like to run them on the high side. (and by that, I'm guessing 100-120,which is kind of laughable to think about those numbers being on the high side! And that's perfectly alright, if that works out to be the case but I'm envisioning having to get ALOT of IV dextrose if they're the ones who actually run the D-show) My Endo doesn't have privileges there, so she doesn't have any say in the matter. I'm not sure that I can refuse to go off my pump (and not be admitted there), I've never been refused the use of my pump for an extended period of time.

And then, it was off to the NST/biophysical profile which went pretty routinely. I never pass the NST, but the biophysical profile always comes out ok. (8/10 is normal) Perinatologist doctor wanted to know what OB/GYN doctor had planned (in terms of delivery)...its kind of like the two offices never communicate. (the answer is:vaginal delivery, unless it hasn't happened by the 39th week, and then they will schedule an induction) I have to get a magnesium infusion (via IV) this week, to prepare for delivery & in the hospital, they'll be checking my electrolytes daily (and the babies electrolytes at birth, to screen for any problems). He also updated all the names/numbers of my Endo,the OBGYN group, the pediatrician that we chose, and my Nephrologist into the hospital computer system in preparation for that day.(suite at the hospital=booked,patient with zillion medical issues coming through)
The antibiotics will fortunately be penicillin (I'm allergic to doxycycline). I don't really know I'm really going to know if I'm in labor if the amniotic sac doesn't burst, because I have contractions (both painful, and not) already,but I'm guessing that if dilation continues at this rate at some point it will switch from "latent"(0-3 cm) to "active"(4+ cm)and things will steamroll from there. I've survived Christmas, so now I'm hoping I have a New Year's baby (you get a ton of free stuff if you've the first baby on Jan.1) & the baby is mature enough, so if he wishes to make his appearance on that date, I'm more then agreeable to that.

Wordless Wednesday: Matching

2011-12-21T16:46:00.001-04:00

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The Last Week

2011-12-18T15:49:00.006-04:00

Nope, it's likely not the "last week of pregnancy..." but, with any luck, my insulin requirements have hit their plateau and that makes me VERY HAPPY. Early next week, it will be considered a "full term" pregnancy...and that makes me happy as well. (in the words of the OB -GYN, the goal is 37 weeks, but if things can go 1-2 weeks longer that is "bonus time")

On schedule for the this week: Weekly appts. with the OBGYN, to start checking for dilation/effacement. And the Group B Strep swab, to determine if antibiotics will be needed during delivery. As well as the (2) mandatory NonStress tests, a final appointment with my Endo (I can't say things are really that great between us, but now is not the time to be looking for a new Endo. I need to iron out a final plan for my bgs/insulin/etc. for birth,and afterwords) It's not the hospital where she has privilages (and realistically, how much time am I going to have to do diabetes overhaul), so I think I really need to have this stuff figured out now. I do agree that my blood sugars should be under 120 the entire time (to minimize the chances of hypoglycemia for the baby) but never having been through this before, will they let me suck on hard candies(or ice) if I'm running low/in the throngs of nausea? I think this hospital prefers you to be on an insulin drip, which I'd prefer NOT to be, unless I need a C-Section. (if I can handle things myself, I'm going to) Basically, I need a natural delivery plan, a C-Section Delivery Plan, and a Post-Baby Delivery plan for my diabetes. We also have to tour the actual hospital ward....I have no idea where it is. (I didn't do my student rotation there) And then I think, I will feel "ready." (the car seat has been installed and all systems are GO) As to when it will actually happen, no one knows (but I rather hope it is prior to 2012) Lightening (whereby the baby drops into the pelvis) hasn't occurred, so my lungs are compressed to the size of golfballs (walking up a flight of stairs, or walking 10 feet both leave me winded). On the positive side, my back does not hurt as much as it did a few weeks ago...but I am grateful that diabetes is going to get me out of having to wait it out an extra 2-3 weeks (should labor not occur). At the most, it will be three more weeks. (and I'm having contractions on my NonStress tests, I don't think it will be that long)

The WEGO Health Awards: 2011

2011-12-14T12:15:00.005-04:00

And while I'm at it (posting, that is) I'd like to thank the kind soul who nominated me for the WEGO HEALTH ACTIVIST (2011) AWARDS...(Best Kept Secret!) You were/are very sweet, and I appreciate the kind words. (I appreciate ALL my readers,all 5 of you!) So I payed it forward, and nominated another health blogger that I enjoy reading...I encourage you to do the same. (you'll probably make their day,even if you/they don't really win anything from this promo)

YOU GUYS ROCK. (DON'T EVER FORGET THAT)

The Week Before Christmas

2011-12-14T10:06:00.001-04:00

Twas the week before Christmas, and all through the state
There were babes being born (both early, and late).

And I had just rolled, on my side, for a snooze
When my nose was soon greeted, by the strong smell of booze

For Santa was here, and cocoa n’ eggnog
Was not his forte’…from the strong whiff of grog.

I groaned, and I waddled, to the window, real slow
I guessed that I couldn’t avoid seeing this show.

And there, was St. Nick, all rosy with glee
He slurped, and he burped, and looked straight at me.

“Hey honey, I’ve brought you a bouncing bundle o’ joy
Today is the day for your baby boy!”

The contractions were strong, & it made me afraid
That this day in the books, a birth would be made.

“All I want for Christmas is just 14 (+) more days
I must decline, and request, that you put in a raise.”

Old Santa was miffed, as he’d wasted his time
On a house in the boonies, on the public dime

He sighed, and he climbed back into his old sleigh
His agenda had most clearly been upset that day

But I heard him exclaim, as he drove out at quite the rate
“Next time, I’ll make sure, to double-check the date!”

Diabetes: The Thirteenth Year

2011-12-10T01:00:00.003-04:00

(Photo: Creative Commons)

Dear Diabetes,
Today, you are a teenager. It seems as though a million years have passed...or at least a generation. (that five year old girl on the other side of your hospital room is now legally an ADULT. Yikers.) Do you remember that day...the pain, the worry, the fear that would soon cast it's long shadow over "all the days of your life?"

I do. But I also remember a remarkable CDE,
who,on that very next day (in fact, some of the first words out of her mouth) told me that I could still have kids. (Was I thinking about having children,heck no,it was about the furthest thing from my mind. I just wanted to live.)

That was then. And this, is now.(I trust I've grown up a bit since then)And in retrospect, I'm glad she said that.(its something every young person needs to hear at diagnosis,& I once talked to someone dx'd in the 1960's who didn't have kids because her doctors forbade it, which is incredibly sad. I think everyone deserves a doctor who will work with them to make their dream happen). It's impossible not to think of the rock n' rolling, hiccupping,rapidly growing life inside of me. I guess I think about babies more then I think about diabetes...which is saying alot.You really do still suck bucketloads, diabetes,and cause more pain then is ever warranted. Seemingly 95% of the other people getting NST's at the perinatologist also have diabetes.(and sugars that warrant "concern". My own sugars in the past week have moved beyond concern to warranted screaming of silent obscenities at the meter & the bolusing of huge corrections, to little avail.Another insulin spike from heck.) But there are things that are stronger then you are,things that in the end make you slick back into the corner,with your tail between your legs...whipped. And though I oscillate between despair & hope on a daily basis,I think that having a baby is the ultimate "sticking it to diabetes" act.I know it can be done.

So today, diabetes, I want you to know that you're not the most important thing on the agenda anymore. And that despite the passage of time,you still don't "know it all"...its a lifelong learning process (what works today, won't tomorrow). It almost seems like a new beginning, this 13th year...the dawning of the 2nd chapter of my life. (PreKid, PostKid) And you and me will have to figure out a working relationship for the next phase as well. (not that I was terribly successful in the first phase...but I want to do better. Pinky Swear It.)

Sincerely,

Me. (13 years later)

Target: Target

2011-12-06T13:10:00.000-04:00

Target is anti-diabetes. Target is a magical place,filled with with many,many things to buy & inhaled insulin pumped through the ventilation system so that inevitably, you will go low.

Target, during the holiday season, is even more magical. Long lines,tantalizing treats to stuff into your mouth to offset any blood sugar discrepancies, etc.etc.etc. Target, seemingly,is the only thing that can drop a 34 week's pregnant, waddling women with diabetes' blood sugar. I think I spent about four hours there,and consumed 67 uncovered carbohydrates (to roll out a "110" by trip's end) It was my own private version of "Extreme Couponing"...

Stats:
Time Spent: 4.5 hours
Number of receipts: 23 (and no, I did not conduct back-to-back transactions...I have too much respect for other shoppers to do that!)
Number of coupons used:20
Total saved with coupons: $183
Total brain cells left: 1
Blood Sugars taken:3
Carbohydrates consumed: 67
Shoppers Who Took pity & let me move ahead in line: 0
Status of back: Regretfully,Target didn't have any of those to buy or I totally
would have.
Status of Christmas List: Done,finished, taken care of.(as well as a few birthday & miscellanous odds and ends) And that's one good thing. I spent alot, but I was going to buy it anyway...so proportionally,it was still a win.

Happy Holidays! (I think they call it "Target" because that's exactly what your blood sugars are, while you're shopping there)Obviously, I love to shop but I can't do any of those marathon type sessions anymore...deal or no deal.My back,feet,and blood sugars all rebel.

Breaking Dawn: Part 1

2011-11-30T17:25:00.006-04:00

I'm glad to see November go...it's been a long month. No more blogging daily for me!

Finally went to see "Breaking Dawn- Part 1" today. My husband doesn't have any interest in seeing it, & ultimately, the best time to go see it is on a weekday (when most of the masses of people are at work, not the mall) It was good, well as good as such things can be (most of the people reading this could probably care less about it). I'm not "in" to Harry Potter, I like Twilight much better. (but I don't fall into the fanatical stage about that either) There were approximently five people in the theater (all female, this is very much the "chick" series) all crying over their popcorn & salting their cokes with their tears. (a true sisterhood, as it were)

Without spoiling anything, between the wedding (beginning of the movie) and the emergency C-Section (end of the movie) it was really action-packed (deviating slightly from the book, to make more of a plot). Things got very, very graphic toward the end of the movie and one person went to the exit and just stood there, with their back to the movie. (for the rest of the movie, a good 20 minutes) I get that it was probably a little too much for them but if it were me, I'd go off and do something else, instead of just standing there. (what good is paying for a movie, if you're not watching it?) That was pretty odd. All I can say is, it wouldn't be the best of movies to watch if you had any sort of food aversions(or were in the first trimester of pregnancy). I've seen a real C-Section (and it wasn't nearly as bloody as the hack job in the movie),but it was still kind of disturbing seeing the effects on the heroine.(I would prefer NOT to end up as bad off as that) Probably not the greatest movie to watch when you're in the 3rd trimester either. At the end, I was getting ready to leave & the person up above my seat told me to stick around, there was one more scene after the credits. (which will lead to the next part)

The next two "parts" don't come out till a year/2 years from now...I've read the book already, so I know what happens but waiting is just too hard!

NaPoBloMo:Diet Coke Fun!

2011-11-29T16:38:00.001-04:00

Answering the age-old question...how many used test strips does it take to fill up a 20 oz DC bottle?

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NST: Take #2

2011-11-28T17:02:00.002-04:00

Captain's Log: Starda(y!) #229

Babies Weight: 4.6 lbs (it's mind boggling how much weight they gain from week 28 on!)

Weeks: Almost 33

Contractions: yes,but much fewer then last week,although my amniotic fluid index has jumped from 25 to 29. I really hope that that is the natural peak,& not the fact that my blood sugars went to pot last week over the irresistible pecan pie/potato/etc.holiday smorgasbord. 33 weeks is supposed to be the "peak"fluid week,& the babies weight is normal. Peri isn't worried.

Movement: not so much on my part,on his,constantly!!

Current complaint list: First Trimester Deja Vu all over again...you name it,I've got it. With the additional challenges of the Third Trimester.

Nursery Status: Ready,once the crib gets reassembled.

Next NST: Thursday...this baby is being well monitored!

NapoBloMo-Day #27

2011-11-27T18:11:00.001-04:00

Happy Birthday to Mr. Handsome!

(no baby handsome,as of yet...and that's ok!)

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Day #26 (NaPoBloMo)

2011-11-26T17:47:00.005-04:00

There was a time when life, as you knew it, was much more simple. When you didn't have to measure,carb-count, guess-ti-mate,SWAG etc. every single carbohydrate that went into your mouth. When food was food,not something that could simultaneously kill/save you.

That was before. Before D came along. Some of us have never really really known a "before", for others, there were many years spent with the "before." The thing about the "before",is,that for many of us, it may never come again (sorry for the downer opinion,yours may vary,& I certainly hope I'm not right). The years dull the memories of some things but for others, the diabetes stuff gets so hardwired into your psyche that you doubt it ever could get itself undone. It's all normal.

Fact: I'm ready to go back to the "just diabetes" phase of existence. I miss sleep, I miss my back muscles not hurting, I miss Chai Tea Lattes (and everything Starbucks),I miss having clothes that would fit, and I miss not having to bolus a unit every time I even look at a carbohydrate, I miss just worrying about the D-Stuff. Vaguely I recall those days where doctor appointments weren't every week,and I'm ready to go back to them. I guess just because something becomes "normal", it still doesn't mean that you particularly love it. I know there are people for whom pregnancy is a 10 month nightmare(bed rest, the whole 9 yards)but I can't even begin to explain what its like, with diabetes. Every day that ends (without disaster) is the best thing that happened that day. I guess when you go to the doc (and everything is a constant stream of negativity) that really doesn't put you in the mindframe of "enjoying your pregnancy." I'm not afraid of caring for a newborn anymore, for even the demands of that is the successful conclusion of the 3rd Trimester. And yeah, I'm nowhere NEAR 39 weeks. My patience has kind of run out (and I would really like to hop in a time machine & fast-forward to the end of December) & I want a healthy,bouncing, bundle o' joy to be here.(NOW) And if it sounds like I'm complaining, I guess I am..there's gotta be some place I can let it all out & it had just as well be here. (which very few folks go) It's my opinion that the people who enjoy their pregnancies don't have complicating medical conditions involved.

Blue Friday: Four

2011-11-25T20:31:00.001-04:00

(life is much more interesting when you don't wear the same color of socks!)

- Posted using BlogPress from my iPhone

NaPoBloMo Day #24

2011-11-24T22:55:00.001-04:00

Happy Thanksgiving! I'm so worn out with traveling, family,& bouncing blood sugars I have absolutely nothing to say..but I hope it's been a good one for you and yours!

Chef de Llehs

2011-11-23T16:43:00.005-04:00

Let the mess-making commence. Rarely do I actually bake,& I know I'm supposed to be all domisticated & stuff by this point (I really do know how...I just don't enjoy it) because the way to a man's heart is through his stomach (so they say) but I find my own baking slightly repulsive (don't ask me why, its a weird hangup I have,everyone else seems to think its just fine), there's more to the story then I'm just too lazy to do it. Nothing like the holidays to make you do it anyway.

(green bean casserole, muffins)

Christmas Baby (Maybe?)

2011-11-22T20:27:00.005-04:00

Fortunately, the eye exam didn't reveal anything dire. It's just a floater (in the words of my eye doctor: "due to getting older." Yes, he knows that I'm 30, and since when did turning 30 put me in the middle-age category?) A black, blob-ish, floater. (being nearsighted, I have a few floaters, but they've never been black/grey, they're the pencil line variety)
Better safe then sorry though (I'm glad I got it checked out). Hopefully it will fade.

No word on when I might expect an induction, the OB-GYN said around 39 weeks. (if it hasn't happened by then) I'm not quite getting how, if anytime after 37 weeks (considered: full-term) is considered just fine, why they would wait till 39 weeks to induce. I guess the womb is a nice,welcoming,nurturing place but 39 weeks just seems too long. I read in my nursing textbooks that diabetic placentas also age faster then non-diabetic placentas (aka, start degrading around 37-38 weeks). And if the baby is too large...that can certainly play a role? (according to the obgyn, that really didn't matter in terms of induction, maybe she meant that would be grounds for a C-Section)

We won't be going anywhere for Christmas, though. (that much is pretty clear) 37 weeks is just after Christmas. (and even 3.5 hours away with family is too far away) Or, it could be a New Year's Baby. Or, it could be a 2012 baby. Time will tell.

NapoBloMo-Day #21

2011-11-21T12:49:00.003-04:00

The only thing that can be said about today, is that it hasn't started well & I think the ending may be even worse.

Today was my first non-stress test. That was a fairly uneventful event, (4 very pregnant people in lounge chairs hooked up to electrodes) until I noticed that the contractions graph was having ACTUAL JUMPS on it,& at this point in the process, I have no business having contractions. The nurse noticed and asked A. if I was feeling them and B. how far along I was. No, I'm not feeling them. (yes, they are actual contractions) What the Sam's Hill?? As far as the heartrate/variability/baby moving went, he is very active.

And then it was time for the ultrasound. I was feeling pretty bummed/on the point of tears over the contractions when the doctor came in and asked how I was (answer "overwhelmed") which he assured me was perfectly understandable on the verge of the beginning of the end. The placental blood flow & everything looked ok, the amniotic fluid index has actually gone down 2 points & the contractions are likely perfectly normal, given the increased amniotic fluid index. As long as the contractions aren't painful there is no need to be overly concerned. See you in a week.

With my nerves freshly shot from that, I got to schedule an emergency appointment with my eye doctor for the large black "floater" that has been swimming around in my right eye for the past 2 days. (the thing shows no signs of going away,initially I thought it was from a headache but nope) I had my eye appointment for the year in October (which showed things to be absolutely perfect, D-wise) but apparently my right eye didn't get the memo. (so here I go again this afternoon)

I think I'm falling apart.

Day #20-Napoblomo

2011-11-20T17:27:00.004-04:00

I eat everything I come in contact with...kid-themed or not!

A Blast from the Past: Day #19

2011-11-19T16:34:00.006-04:00

I found this today...and I'm pretty sure it's the last one on Planet Earth. Long, long ago, Staples & Office Depot would actually give you vouchers for $3 off your next purchase, no minimum required (on the spot, when you turned in ink cartridges). They could be "stacked" (aka, used with 2 more vouchers) and combined with coupons & one's total Out of Pocket costs were very, very low. (and even more weird, the vouchers were all the same so there were no unique codes on the vouchers) It's not like that now, if you turn in ink cartridges it'll be 90+ days before you see the rewards in your "account" and you have to spend $$ at the store to even get the rewards.

But this beauty of these coupons are...that they never expire,so nostalgia aside, I'm going to spend it (one of these days). Maybe not even the manager will know what these were, its been so long since they were in vogue!

Blue Friday #3: The Heir, the Spare, & Why I keep them there

2011-11-18T15:58:00.001-04:00

NaPoBloMo- Day #17

2011-11-17T19:38:00.006-04:00

Darth Meter Strikes Back....

(with the vast majority of today's readings in the 60's, and one at 209) . Stellar diabetes day, all around.

Banking with Baby

2011-11-16T14:36:00.006-04:00

I know it's controversial (and very much in the "experimental" stages)but stem cells already can treat/cure many types of cancers. And I believe that one day,they'll be able to "grow" parts of organs, etc. (from stem cells) Maybe even cure diabetes, or something else.(should they be unfortunate enough to inherit my screwed up genes) So we've made the decision to save our kid's cord blood. (kit goes to the hospital with me)

The Days are Just Packed

2011-11-15T11:16:00.005-04:00

(does this infant carrier come with an infant? sadly, no,that takes 9+ months)

(the saga of the never ending blood sugar logs..)

Sam Talbot is an fiery chef with ecletic taste buds!

I got my flu shot today. I had to go to TWO CVS's to do so, because the first had an issue with my insurance (& I would have had to pay for the whole thing out of pocket) whereas the 2nd store would cover it (if it were under the guise of being a "Minute Clinic" appointment with a nurse practitioner). It wasn't that inconvenient,really, (there are quite a few CVS's in the area) but flu shots feel nothing like an insulin injection & really,please don't say that they do. And so that's done. (I will wake up tomorrow & feel like I've been hit by a bus, but it's better then being hit by the flu)

(please?)

World Diabetes Day: 2011

2011-11-14T13:48:00.006-04:00

Today is World Diabetes Day.

Today, like millions of people all over the world, I didn't get to have the day off from diabetes. (for good behavior) Whether you've lived with it 30 years or 30 days...it is simply there,and it will be there (likely) for some time to come. Today, I awoke (for the 2nd time) with the chalky flavor of glucose tablets still lingering on my taste buds. That is the price for being alive.

Today,there is still no cure. No cure for the millions who have been diagnosed (in the almost 90 years since the discovery of insulin). Babies, kids,teens,adults...we all owe our lives (or if T2...continued health) to the discovery of this one drug. For as much as I'm grateful for insulin,and as much as I realize that future life would not have existed (this baby sponsored by Sanofi-Aventis)..it's still diabetes,& I'd really,really,really like a cure.

Today, the flame of hope still burns...and will burn, until there's a cure.

NaPoBloMo-Day #13

2011-11-13T16:18:00.006-04:00

Today, I'm going to share with you a YouTube Video...from a talented young artist with T1 diabetes!

I love her illustrations. (toward the story line) I can't draw that well..but if I could, I'd love to do something like that on YouTube.

NaPoBloMo- Day #12

2011-11-12T11:47:00.010-04:00

A few weeks ago, we were in California (taking care of the "we won't be seeing you in a million more years" family rounds). Basically, we really didn't do much exciting (I am sick to death of traveling, people) but we did go down to San Diego/Oceanside to wiggle our toes in Pacific Ocean goodness. And it was warm & relaxing on the beach that day. (despite being mid-October)

Pictures below:

I have to say, I love California beaches. Even if you feel like a great beached whale (and not up to the carefree frolicking of bikini-clad models & studly wetsuit surfer dudes) it does improve your mood. Even just for a few hours, it was nice.

And then, we came home to the East Coast blizzard...on the 6.5 hour flight to Philly, my Omnipod PDM died (two hours in), freaking me out. My "backup" syringe (brand new, in the package) proceeded to snap off as I removed it from the package & by that point,I really didn't see how I was going to avoid having to make a scene(4.5 more hours with no insulin (and an already skyrocketing bg) ? yeah, not happening) as I tried to patch the insulin syringe back into function-a-bility but it was impossible. Finally, I systematically searched through my purse and backpack (praying there would be at least one old syringe)...and there was. And it worked. And I took injections with that syringe, once every two hours as our 6.5 hour flight got pushed to a 7.5 hour hour flight as we circled the airport, as babies and toddlers screamed (and puked) filling the plane with lovely sounds (and smells) into the wee hours of the morning.(while their mothers did absolutely nothing,sans hold them. Did not attempt
to soothe,etc. or to tell them to be quiet) I could not WAIT to get off that plane, & meet up with my luggage.(hopefully) However...when we finally did get off the plane, our flight home had been cancelled(because of the East Coast blizzard) so no luggage was forthcoming.(they said it would be on a flight the next day). Well, by that point driving home had more appeal then spending the next 12 hours in the airport so we rented a car, and drove home.

In the rain. (but fortuanatly, not the snow)

Got home, inserted a new pod,and the PDM actually worked again..but the luggage didn't show up till the evening. I would venture to say that that was my most unpleasant flight,ever. (lesson learned: take at least five back-up syringes,because it was some sort of "communication error" and I doubt that it would have worked even if I'd have had a back-up pod)

Blue Friday #2: World Postcard Exchange

2011-11-11T09:29:00.004-04:00

Off to Indiana!!

One and One and One (& Four)

2011-11-10T12:47:00.007-04:00

(4 years anniversary today-& I have to say, that he is all of this & more). I am very fortuanete, good guys do exist out there. (which,when you've been through the dating mill makes you quadruple-ly thankful)

-----
The snap of the perinatologist's glove signified that the exam portion was, for all intents and purposes, over.

"How bad is it?"

(its bad, I know it's bad.The tech isn't saying anything, and if it were better, you'd be reassuring me by now. Just tell me, before I lose my mind.)

"About the same. Last time you were at a 26..now you're at a 27. It's the same."

Happy-happy-joy-joy. (NOT) So what does this mean?

"I think you're going to have to notify the NICU staff (etc.) about the possability of Bartter's Syndrome, so they'll be able to screen for that.(at birth) And you know better then anyone else about what all that means, you'll be doing some educating. (but you're probably used to that by now.) But it doesn't mean the baby has Bartters..your amniotic fluid levels aren't going up, & are not severely elevated, so it may not be that. You don't need an amnio, or any medication to reduce the levels .(at this point)"

"Will I need a C-Section?"

"Not necessarily. If everything else proceeds normally, you shouldn't."

"My blood sugars have been excellent."

"That's good-that can certainly play a role! The baby's weight is normal, & everything else looks good-have you had any contractions?"

"No."

(Confession: I'm not entirely sure what a contraction feels like, but I think that if I were having them, I'd likely know about it. Yeah, I get random abdominal pains occasionally but I think that with a contraction, your abdominal muscles tense up & that hasn't been the case)

"In a couple of weeks, you can begin Non-Stress tests/Biophysical Profiles(basically the NST plus the ultrasound). (1-2x a week?) "

Non-Stress tests= a whole new experience. As a nursing student, I actually got to explain to an anxious, laboring patient what the tracing meant. (all those peaks and dips and random blips) & knowing me, I'll form a conclusion about it long before the doctor enters the room because that's what nursing students do!

But for as much as I feel lost in the shuffle at the OB-GYN...at the high-risk office, I see the same perinatologist every time and I really like him. He is stellar. (about answering all my stupid questions & calming my fears)

Dblog Day: An Ode to the DOC

2011-11-09T15:26:00.006-04:00

Are YOU participating? (it's not that easy this year..I have no time to create a scrapbook page, and I don't feel like delving into said topic.) But I encourage you to not be like me. Really, if I'd have gotten my ducks in a row (1-2 months before this) , I'd probably be doing it. (it's enough to get my postcard project done for WDD!) I will say that online support (before there was a "DOC",) really helped me feel not so alone, in the early years of D. From the CWD chat I found out about insulin pumps (and rapid acting insulins), which changed my D-care for the better. If there weren't anything like that, I'd be floundering around alone & clueless with my diabetes management. (or who knows where I'd be) I'm so grateful for the fine D-folk I've met on the Internet...(and later, in real life) they have shaped my D-life in positive ways & some feel more like family, then friends. (I appreciate each & every one of you!!!!!!)

The Baby Shower

2011-11-08T11:36:00.007-04:00

Want to know what completely rocks?

Surprise baby showers. And yes, it was a complete surprise because we get together with this group of friends ever so often..nothing out of the ordinary about that. Only this time,there was an ambush. (they had it all...food,cake,streamers,and presents!) We are so lucky to have a group of friends to put together something of this caliber for us.(any kind of shower just gives the recipient the warm fuzzies,though I wasn't expecting any since my family lives so far away) Despite the Ravens/Steelers jersey clashes, it was an otherwise amicable evening.

Now to get started writing thank you cards...

From the Newswire

2011-11-07T11:05:00.006-04:00

Joslin Study Finds Clue to Birth Defects in Babies of Mothers with Diabetes

Stimulation of metabolism-sensing enzyme that can regulate crucial gene explains how free radicals generated during maternal hyperglycemia cause malformation of the neural tube

BOSTON – October 17, 2011 — In a paper published today in Diabetologia, a team at Joslin Diabetes Center, headed by Mary R. Loeken, PhD, has identified the enzyme AMP kinase (AMPK) as key to the molecular mechanism that significantly increases the risk of neural tube defects such as spina bifida and some heart defects among babies born to women with diabetes.

Even if women with diabetes—either type 1 or type 2— work vigilantly to control their blood sugar levels around the time of conception, the risk of a defect is still twice that of the general population. This finding could lead to strategies to interfere with the mechanism and reduce the chances of such birth defects occurring.

Previous studies published by Loeken's lab showed that maternal hyperglycemia (high blood sugar) causes oxidative stress in the embryo, and inhibits expression of the Pax3 gene. Pax3 is essential to the formation of the neural tube, which in the embryo is the precursor to the brain and spinal cord. Oxidative stress results when oxidized molecules – called free radicals – are created faster than they can be eliminated.

However, Loeken said, it was not known how the cells that express Pax3 could sense the oxidative stress and why oxidative stress, which occurs throughout the embryo, only damages selective structures such as the neural tube.

In the paper published today, Loeken’s team identifies the key to the process as AMP kinase, which is activated by oxidative stress and was found to signal the cell nucleus to block the expression of Pax3.

“The stimulation of a metabolism-sensing enzyme that can regulate specific genes explains how oxidative stress, which is generated throughout the embryo during maternal hyperglycemia, causes malformation of specific embryo structures,” Loeken said.

“We now know that we must do whatever we can to prevent AMPK from being stimulated,” said Loeken, who is a research investigator in Joslin’s Section on Islet Cell and Regenerative Biology.

Trying to keep the mother’s blood glucose levels under control is currently the only way to do that, she noted. “That’s the best we can do right now,” she said. But armed with the findings of this study, she noted, other researchers may be able to come up with drugs or other strategies to inhibit AMPK activity,

Dr. Loeken added, however, that formulating a strategy could be tricky because it is not known if interfering with AMPK activity -- while a good thing in preventing neural tube birth defects -- might also have negative effects on the embryo.

In their study Loeken and her group, including Yichao Wu, Marta Viana, and Shoba Thirumangalathu, used mice and cell lines to test their hypothesis that AMPK might be stimulated in the embryo and that stimulation of AMPK was responsible for blocking Pax3 expression and causing neural tube defects in response to high glucose.
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“We found in this study that AMPK is stimulated in embryo by both high glucose and oxidative stress,” Loeken said.

The study used interventions including a drug that activates AMPK and another that blocks it. The paper showed that a drug that increased AMPK activity mimics the effects of oxidative stress to inhibit expression of Pax3, thus inducing neural tube defects.

This research was supported by a grant from the National Institutes of Health.

(moral of the story is...just another way diabetes contrives to complicate matters)
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This product looks pretty cool. According to the JDRF "Discoveries" magazine,(fall 2010) preliminary research (at Yale) has been promising,showing increased insulin absorption time/peak levels/increased clearance. This is pretty cool, because with the Artificial Pancreas system that is being developed...faster acting insulins are a MUST. (it can't very well keep your blood sugar in a normal range with such slow-acting insulins) The system that's in place now...its an improvement,but it still has light years to go & I don't think that most people would consider it a "cure" in any sense of the word.(needs much better CGM technology/faster acting insulins) Take it from the person that has to pre-bolus cereal 30-40 minutes in advance...some foods are just glycemic murder. Insulins such as Apidra/Novolog/Humalog start working within 15-20 minutes, but it is very much YMMV. Such technology is years away from being approved (& perhaps decades, if the FDA is involved) but anything that gives that insulin a little extra "boost" start time is a good idea, in my book. (in the meantime,I guess we're stuck with taking hot showers/hot tubs)

The Weekend Green Clean

2011-11-06T13:43:00.008-04:00

Yay-day #6 of NaPoBloMo. But as Colleen pointed out, no one much reads blogs on Saturdays/Sundays...unless its some other blogger in the same boat!

So yesterday, we had our carpets cleaned. This involved eviscerating the contents of the basement onto the outside deck,moving the dining room contents into the kitchen, etc. Project Nursery had to be stacked in the Junk Room (aka, the only room in the house with carpet that wasn't being cleaned)...basically, it was pretty chaotic. (beginning the evening before)

The next morning,(around 10 AM) they showed up and commenced to cleaning the house. As you're probably aware, carpet cleaning chemicals can be pretty nasty (read: lethal) stuff, & you're supposed to be out of the house while they're doing the treatments. Well, with this place (using nontoxic stuff) it wasn't quite that imperitive to be out of the house...you just had to be in a room that wasn't undergoing treatment. (that room would be the kitchen) We have two cats, a baby on the way,& the toxic crap they use to clean carpets is decidedly NON-APPEALING. (say what you may) And the cost, comparitively, was about what it would be with the traditional method.

I ran some errands, getting back about noon. The cleaning team they sent out was composed of two guys...one of whom did the actual work, the other one did the talking. (the instant I walked through the door, he started talking, and didn't "finish" until 2 solid hours later) It was like listening to a Billy Mays infomercial. What did he talk about? A little bit of everything...the evils of large carpet cleaning corporations (in particular, ChemDry, who was apparently resposible for the death of Jett Travolta), the physiology of cat puke/urine/etc. & how to treat such stains to GET THEM OUT FULLY, past horror stories of the houses they had cleaned,(that had gone the traditional cleaning route) the state of the economy, what products we needed to get(that were Au Natrale), how Gerber/Mott's is poisoning us (and the babies)with arsenic-laden apple juice from China(64 parts per million,vs the "safe" 3 per million) , Dr. Oz, how talc based powders will give you leukemia/etc., and on and on and on. In the meantime, it's not like we could go anywhere...the cleaning was still going on. So we sat in the kitchen, ate lunch,and listened to him talk. Two hours, people.

But they did a good job, I'll give them that much. The huge yellow splotch that resides in the future Baby Nursery has at least, significantly shrunk. They seemed to think it was from cat urine (and I was duly scolded never to treat such a stain with an OXY based product, but I didn't know what it was from) . I don't think that stain will ever come out fully, we'd have to "patch" swap it out if we ever sold the house. (it's not very large, 2" x 1", perhaps) I think I have permenatly leached the natural color out of the carpet.And they know what they're talking about...they know how to do their jobs. (as well as educate the masses about carpet care) I'm a firm believer in "going green" when it comes to cleaning your house (if possible). It's much safer for your pets. (and for human beings as well)

The carpets took awhile to dry (about 16 hours), so we had to put on plastic booties to walk around till this morning. (and then, we put everything back as it was) As per the carpet warranty, you actually have to have your carpets cleaned every 2 years (at least)...and if you have cats, you're probably going to be doing it 1-2x a year. (at the least) Our cats are getting older, but one of them still pees (not in the litter box) and the other one pukes, so heck yes the carpet is getting constant action. (I can only imagine what it will be like with a child in the mix)

Hope

2011-11-05T20:39:00.001-03:00

Have you met Hope?

Hope wears a medical alert, the latest Keds tennis shoes...and a smile that will melt your heart.

Hope is in the "All clear" from the eye doctor.

Hope travels thousands of miles to meet up with 40+ DOC'rs. (sight unseen)

Hope is a virus, & I wish everyone could catch it!

Hope beats strong on the fetal Doppler.(& in your own heart as well)

Hope is in the research labs...it's a fine time to be a mouse or a rat!!

Hope is painful,hope can't settle for status quo.

Hope gives up Saturdays to walk,bike,& walk for a cure.

Hope sells sugar-free lemonade(& Girl Scout Cookies) towards that cure.

Hope never dies..but it can disappear for weeks/months/years on end.

Hope & I are not best buds...but we need each other,more then words can say.(we are more then casual aquantinces)

Hope needs its own RX pad.

Hope savors each victory, & forgives past mistakes.

I hope you've met Hope...cure or not,we all need to believe things will get better.

29 Weeks

2011-11-04T11:50:00.006-03:00

Dear Baby,

Wow, 29 weeks? I barely remember those early weeks of bemoaning that it would never, ever,be obvious that you are in there...because in the past 5 weeks, its now become that(to the world). Ah, the joys of the third trimester.(most notably:back muscles turned to silly putty,heartburn,and random strikes of shortness of breath) As for low blood sugars,they aren't really much of a concern these days...I'm not going to say they're non-existent,but the likelihood of a serious one is slightly higher then the likelihood of getting hit by a random meteor. Daily TDD is 50 units and climbing. (it should continue to climb for the next 6-7 weeks)

And...the never ending doctor appointments. Now that it's the third trimester, I go to the OBGYN every two weeks. (starting around week 32,that will be switching to weekly with the OBGYN) As for the perinatologist, up to this point I've gone in every four weeks but depending on the results of next week's ultrasound I may be going in every week from that point onwards. (non-stress test, biophysical profile) The last ultrasound showed normal weight,etc.but the amniotic fluid index was elevated (which could be due to diabetes, and could be due to genetic diseases...such as Bartters Syndrome)I wasn't happy at all to find that out but the perinatologist told me it could be from many different reasons,(sometimes unknown)none of which could be determined at this point & the important thing was to monitor it closely. Sometimes it just goes away on its own,& if the levels greatly increase by the next ultrasound its most likely to be from a genetic cause.(he didn't seem to think that the cause was from diabetes.And I might beg to differ,given that I'm still no diabetes angel cc "results of last a1c" but still,the 'betes control is in the "fair" category) The important thing is to monitor the whole package(any signs of swelling,high blood pressure,contractions,movement etc)and to try not to freak out too much about this one finding. (and I don't have any of that...to date) Baby X is still pretty active in there. (he's always been active,which is comforting, in a world full of uncertainty)

There have been no references to the C word (CSection)...actually,there have been no references to labor, period. (I'm guessing that with diabetes,there's just no way to say "you'll likely be able to due this naturally" when the world can turn on a dime,& the most important thing is deliver the baby,ASAP. I guess that in the next few weeks that Csection word is going to become a reality if my amniotic fluid volume doesn't go down. Which, after you've actually been in an OR and seen all the gory details live is not a comforting thought.

But the most important thing is a healthy baby.

The Hitchhiker's Guide to the Galaxy

2011-11-03T12:33:00.003-03:00

It's impossible to stay mad at someone offering you a diet coke...(or,these days, a diet caffeine less coke!)

The Babies R' US Marathon

2011-11-02T12:16:00.009-03:00

And so,on Monday night (partially to avoid the roaming throngs of sugar-crazed Trick or Treaters, many of whom were adolescents(and not cute at all) my husband & I took a trip to Babies R' Us. (for the first time) It was a kind of "get your feet wet" trip, to see what was out there...but we ended up spending about 2.5 hours in there. The game plan was NOT to make any major purchases until we know what some friends are giving us.(rumor has it, a bassinet & they already did give us a stroller thingie,car seat,& several other odds and ends,which is really nice of them because my family members are still using all their baby stuff) But apparently, there isn't any separate infant carrier that snaps into the car seat...which presents a real problem,because every single one of the 3 aisles(and 200+ options) of infant carriers also had car seats attached. I guess we'll have to look up that particular model online(and see if you can even get the infant carrier separately) In the meantime, we roamed around putting various odds and ends on our registry (in a mostly deserted store...since all the other parents were out doing Halloween stuff with the kiddos(except the first-time parents-to-be) and got a few essentials that it was highly unlikely anyone would buy for us.(like a changing pad,which we'll put on my desk to convert into a changing table,& a baby bath mat to fit into the sink) When you go into Babies R' Us though,you're pretty much going to BLEED money (and find "essential" items that you absolutely cannot live without. (even with the best of intentions) I also intend to get a breast pump,but looking at all of those options put my brain into complete shutdown...all those options/prices/not having a clue what I'd need. I'm sure I wouldn't be the first person to have a mental breakdown in the middle of that store though. (or to spend too much) All in all, I think we controlled ourselves pretty well though. (on the spending) Even my husband,(your own spouse may vary...most of them would probably rather stay home and watch Monday Night Football)who is less-then-enthusiastic about shopping/spending money got into it.(and appeared to have fun)

And now I know how much I absolutely don't know about all of this...yet somehow,all of these "essential must-have" items that kids 40 years ago didn't have (and turned out just fine) that they encourage somehow turn up on the vast majority of parents-to-be lists. Of course, there are the basics...and the things that really,really,make it easier to keep your baby happy(like swings,etc) but deciphering what you really need is kind of difficult when it's your very first kid.(you could walk in there and blow a couple of grand, I'm sure)

November Follies

2011-11-01T11:48:00.005-03:00

Every year, I say I won't do/can't wait for NaPoBloMo to end..and yet every year,I feel suckered into doing it. Last year,I forgo it(due to arm surgery). But November is such an interesting month,chockful of significant diabetes related events,personal anniversaries,birthdays,holidays, etc. (if ever there was a month that I could pull off 30/30, this would be the one)I've yet to recount my experiences with the NYC trip "Simonpalooza" several weeks ago..and I'm sure the world really,really,really wants to hear about the never ending litany of medical appointments that I go to, these days.(as well as nursery pics) As well as last week's "pump failure at 32,000 feet" fiasco.

So, if you choose to stick around, I'm sure it won't be all boring. Because I certainly have plenty of blog fodder. (due to being severely delinquent in said posting duties)

The One that Wasn't

2011-10-19T18:42:00.003-03:00

In retrospect, I knew it would probably happen. School stress, D-stress, pregnancy stress, concurrent Endo appt. (when did that ever turn out well?)

Regardless of that fact, my a1c rang in at 6.5...a marked 0.4 improvement. (not that I expected my Endo to go all gaga over over it, because true to form, she didn't). But what happened next put the icing on the cake.

"Well, you knew what you were getting yourself into (suck it up)." (really lady? that's all you've got to say,& thank you very much,not that I regret said choice,but it's the first time in my life that I've been 27 weeks,hugely insulin resistant,25 excess lbs,and I don't really think anyone "knows" what they're getting into). And then she went on to tell me such additional goodies as how every day in this 9 month stretch mattered,you can never redo it,if you screw up the kid its permanant, blahblahblah at which point I completely lost it.

I burst into tears, which I don't think I've ever done in a doctor's office before. (not even being diagnosed with diabetes did that) There's only so much blame a person can take,and you can pretty much 1/2 that when you're pregnant. (and thank you very much, I have enough blame to last me every single day of my life, it doesn't need to be coming from you.) After that, she toned it down a little bit (remarking drily that my blood glucose, in office, was 296 (OF COURSE IT IS,YOU'VE JUST PUT IT THERE but no additional comments (and at that point, I would have walked out the door and not come back,I was that upset). Why is it that doctors feel the need to tell you what you already know? I'm not here because I've got this crap figured out, I'm here because I NEED HELP & SUPPORT. Which clearly I wasn't getting from her.

So yeah,that appt. was not the greatest. She did try to be slightly more sensitive after that,but the remarks she made left a permanant scar on my already tender psyche. I don't know if I can forgive her, much less go back to her, after that.

I then went forth, spent several hours getting it out of my system, complained on Twitter, took a nap, called a friend, and feel much better now.
Thank goodness for the D-Community,because no one else truly gets it.

The Magnificent Seven (Subtypes)

2011-10-13T10:27:00.012-03:00

Do you remember the last time you did this?

Sitting there in the Hopkins Peds Clinic waiting room,with all the babies (and the little kids)among pictures of yawning Poohs & smiling green dinosaurs, my mind took a turn back, to when (indeed) I was last considered a "pediatric patient."

Diabetes Clinic. Like clockwork, every three months. Getting up the nerve,somewhere around the age of 19 (yes, I was a late bloomer) to make the trip myself. Waiting room conversations with Parents of D. (somehow, I never ran into any other teens with diabetes) Sneaking out the back door (post-appt) & heading straight for the McDonalds across the street, to celebrate the start of the next "A1c Stretch" on a hot fudge sundae. The long, long, long wait for my a1c. Saying goodbye,(at the age of 19 years & 364 days) because I thought 20 was entirely too old to still be seeing a peds Endo. (it really isn't, if they're good, but I was entirely too selfconscious back in the day)

And here I am again, this time with a child in tow (albeit somewhat invisible to the naked eye, but at least I don't have to keep my child occupied, he seems perfectly content to play kickball with my intestines all day). Getting checked in, as a patient. Parents cast me curious looks,staff keeps asking "is this for yourself?" Just like that, it's time to waddle back to the exam room.
(genetics is located in with the pediatric diseases clinic)

"Hello, I'm Carolyn."

We discuss the genetics of Bartters Syndrome, the weird mess of a family tree I have. (they want blood from family members, but yeah, not so sure THAT is going to happen)She tells me people of Swedish & Italian descent are actually carriers 1/200 or 1/100% versus 1/1000 in the general population. (that's not so great,as my husband is 1/8 Swedish but yeah, what can you do) We talk about the research study from Yale, & what they're attempting to find. (testing for the most 7 common subtypes, & perhaps other testing on the types that don't "play by the rules." We review my medical file,& I sign more release forms.(for intial dx'ng records)

The Yale form is long, & geared very much toward the pediatric patient/and their parent, but it still applies. And I sign,my toes curling in anticipation at the thought that sometime soon,3 or so months from now, I'll learn what sub-type of Bartter's I've got. (probably on the day I deliver, when I could really care less)
I'm just surprised that there weren't any conditions that would keep one out of the research,like there generally is.
(start combining diseases, & researchers can't tell what is the effect of what)

And then I give blood, & wait...for something. (too long coming) What something is, I don't know, but it's better then the nothing I've got now. I'm grateful that the genetics counselor at the perinatologists has friends in high places..for somehow,this kind of stuff never just "finds its way" onto the Internet.3/4 of the studies I've been in,I've found out by word of mouth. (by the time it makes it to ClicalTrials.gov, they are desperate to find people,in my opinion, the truly great stuff (like the Artificial Pancreas Studies) go reallyyyy fast)

Questions of the Universe

2011-09-27T11:44:00.003-03:00

And so today, I met with my course advisor...& got the deep, hard, questions rolling.

In a couple of weeks, my OB course will end...and the Medical/Surgical one is slated to begin. Now I know I'm going to sound like a total wuss, but I have my doubts as to whether or not I can hack it. A thousand questions are flooding my mind (is this going to put me in premature labor, could I have really stellar diabetes control & do better by the baby if I just didn't take this,this course is so difficult that NON-pregnant people frequently fail 1-2x, what if I manage to do well but still have some medical complication and have to drop out 3/4 of the way through(I don't want to take a course I'm just going to have to repeat anyway)...questions to which there are no answers,questions that float out there in the stratosphere.

Medical/Surgical is a demanding course, a full time course. (OB is a piece of cake, by comparison)And I'm going to be living fulltime in the doctor's office anyway, as the
third trimester brings with it increased monitoring/tests in the pregnancy. (just because things are going well now, does no mean that will be the case 10 weeks from now)

So, I have several options. I can drop out in several weeks(miss the 2nd class of the semester), start up again in March.(and be one semester behind) I can drop out in several weeks,take next semester off, and be 2 semesters behind. Or,heck,I could take the next two years off & still be eligable for readmission to the program. I don't want to do that,& I don't for see having to do that, but there are no answers out there...for either my advisor, or for me.

And LifeChange 101 is coming our way,& there's a part of me that needs time to get ready for that.(call it my "nesting" instinct)
I want to create the nursery, & get everything in order (and that includes my mountains of junk,let's hope this kid does not inherit my messiness traits) and 2-3 weeks at the end of the semester doesn't seem adequate. (especially not when you have grown so big that you don't want to move) This is what I want,& this is a decision that may never come my way again.(whereas, with nursing school, yes I could do this at age 42) This is the decision that is "best for me" as my advisor would so eloquantly put it, although no one can tell you what to do, the answer in this regard is becoming clearer.
Its admitting that I can't do everything which is a tad hard. People do this, people have emergencies/babies/circumstances routinely that they have to take time off...& get back into the program,graduate,become nurses.(it isn't some bad thing when you can't) I just really wanted to have completed the semester before I did that, it feels like a thorn in my flesh if I can't, like a task unfinished.

Time will tell, I guess. (whether or not I'm nuts enough to take on Med/Surg.)

The $1,200 Baby Care Class

2011-09-21T15:31:00.001-03:00

I don't know nothin' about birthin' no babies! - Gone With The Wind

The third trimester looms,& one thing I know...I still don't know much about birthing no babies. Or that much about caring for one. But I do know,that this nursing rotation has cut down by 80% the actual amount of classes we'll need to take.( Dad101 & BabyCare 101) as I've learned about what labor will be like,what preterm labor will be like,all the drugs that they might give,breast feeding vs.formula, a preemie is going to be different then a 38 weeker,all the maneuvers & monitoring tests that they do,under what indications they ship you off for a
C-Section,how diabetes doesn't just put the infant at a risk for hypoglycemia/being too large but also a risk for placental abruption/bleeding to death right there, etc.Some of it I wish I didn't know. Will it be the sort of pain that makes me want to throw up/die (kind of like the intusseption) or will it be more pressure then pain? It is nice to have a wealth of knowledge at my fingertips,because the OB doesn't have the time to educate you about all this stuff. Most of this stuff is geared toward the Mom(of course), but there seems to be a never-ending amount of childcare classes being offered at the local hospital. (I picked the two that might have relevance to either/both my husband & I) I just need the nitty-gritty hands on stuff,since I already know what labor/etc.will be like.(& my husband needs hands/on too,labor can be summarized with the words "long & painful."

Yes,this $1200 baby care class is well worth it. I feel a little more ready for what is coming our way.

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30 for 30: My Invisible Illness

2011-09-17T20:19:00.003-03:00

(aka 30 things for the 30 year old!)

1. The illness I live with is: Type 1 Diabetes

2. I was diagnosed with it in the year: Dec. 10, 1998.

3. But I had symptoms since: May 1998...I recall getting personally acquanted with every single water fountain/restroom on all 3 floors of the high school. (it was the summer of driver’s Ed)

4.The biggest adjustment I’ve had to make is: Snacks, Eating, and not being my own person anymore.

5. Most people assume: That I’ve got it together by now, & my blood sugars never go over 120 or below 70. (“Do you have it pretty well regulated, dear?”) Yeah, right. (I’d like some of whatever you’ve been smoking) Every day is a constant battle.

6. The hardest part about mornings are: That they exist. (period)

7.My favorite medical TV show is: The Duggars/Greys Anatomy/Private Practice/What Not to Wear/etc....I don’t think I’ve got an absolute favorite, per say.

8.A gadget I couldn’t live without is: You probably think I’d say my insulin pump, or my Dexcom...but I could probably live without those. My iphone is the love of my life, though.

9. The hardest part about nights are: Sleeping on my side...but that’s not diabetes related, that’s pregnancy related. I was a back sleeper for 29 years and suddenly, I had to go cold turkey. (no easy thing) No one ever told me about that little thing known as “Supine Hypotension.”

10.Each day I take (X) pills & 0 vitamins: Well, it depends. I take at least 1 pill, and I’m supposed to take a prenatal(very lax on that one though) & there are the random aches & pains & allergies that I’ll occasionally have to pop some more pills, but yes, one a daily basis, just one. I’m trying to keep the pill brigade to a bare minimum right now. I do pump insulin 24/7, though.

11.Regarding alternative treatments I: if it works for you,& it hasn’t been shown to be toxic/damaging/etc. I think “alternative” treatments may have additional benefits. But you can’t “replace” insulin altogether, & you need to keep your HCP in the loop. I have taken supplements/herbals in the past, but I don’t pretend to speak for the DOC at large.

12.If I had to choose between an invisible illness or visible I would choose: I’m going to go with the invisible illness. If I don’t want to share it, I don’t have to share it.

13.Regarding working and career: I dunno what I want to do exactly...I’m leaning towards something in either pediatrics or research. I’m still very much the naive, impressionable nursing student. I don’t think being a CDE is in my future, I’m not the teaching sort. At this point, I’m just crossing things off my list (of RN jobs I don’t think I could ever do).

14.People would be surprised to know: That “Yes, I can eat that!!!”

15.The hardest thing to accept about my new reality has been:
That the “Golden Years” probably won’t be so golden, unless there’s a major breakthrough/cure. I fear the impending complications.

16.Something I never thought I could do with my illness that I did was:
Every day, I wake up & discover something else that I can do that I never thought possible with diabetes. Fear Factor. Job(s). School. Pregnancy. The list grows as my life goes by, & sometimes I look back & think “I did what?” (in my wild and crazy youth) Diabetes certainly throws monkey wrenches into the above, but it doesn’t have to “stop” any of it.

17. The commercials about my illness: are interesting, I feel a sort of “bond” with some of them in question...but the meter ones make me feel like smashing something.

18.Something I really miss doing since I was diagnosed is: Drinking an extra-large, sugary Slurpee on a hot summer day. I’m sure its entirely possible, but I’ve never been brave enough to try to figure out the bolusing sequence on that one.

19. It was really hard to have to give up: I wanted to enter the military, & well that was obviously out.

20. A new hobby I have taken up since my diagnosis is: Cross-stitch. I enjoy stabbing things (that aren’t body parts) with needles. (a sort of diabetes voodoo)

21.If I could have one day of feeling normal again I would: I’d eat a zillion carbs, & wash it down with a couple of Daquiri’s & veg out in front of the tv for the rest of the day. (of course, “normal” in this case means no D, & the absence of pregnancy)

22. Want to know a secret? One thing people say that gets under my skin is: “Have you had it since you were a baby?” (I know its called juvenile D, but why don’t you just ask me WHEN I got it?)

23.But I love it when people: just listen, and don’t judge!!!

24.My favorite motto, scripture, quote that gets me through tough times is: You can do this!

25.When someone is diagnosed I’d like to tell them: It’s going to be ok, you can do this.

26.Something that has surprised me about living with an illness is: that most of the time, I deal with it fine. You get used to it.

27.The nicest thing someone did for me when I wasn’t feeling well was: Brought me soup/liquids & made sure I was doing ok. (& called the doctor for me)

28.I’m involved with Invisible Illness Week because: It’s going around the DOC!

29. The fact that you read this list makes me feel: Hopeful for humanity. Invisible or not, we all need to be more understanding of others.

30.My illness has taught me: To be prepared for most “disaster” scenarios. Diabetes doesn’t have as much power over you, if you’ve got the antidote to the whatever it throws at you. I try to stay one step ahead of the ballgame, so when that disaster comes, its not "as bad."

The Techno-Dgeek

2011-09-12T12:30:00.001-03:00

My devices have names. I don't feel like this is so unusual, the DOC is thronging with the "my pump-meter is named such & such" (I'm in good company). I have nick-named everything,from my car to my husband. (that's just who I am)

My first pump, a MiniMed 508,was named Code Blue.(it was always having one emergency or the other)

My Deltec Cozmo was Lambo,Jr. (named for an Australian acquaintance of mine)

My Animas was "The Green Hornet."(insulin stung going in)

And then along came the Omnipod, which was dropped into my lap(& after some time, I finally decided that yes,I'd keep). A year has passed,& I still have no clue what to name it. The two separate parts are referred to as "the pod" & "the PDM" & it really hasn't much more personality then that. I wish I could find a name for it,for all my other pumps have had actual names. Even the Dexcom name(s) came easily.("Dex" & "The Cockroach"(transmitter) I really would like the devices to meld into one system so I could just call it "Artie" (short for artificial pancreas),that won't be happening for quite awhile though. Such is life. I certainly would like to participate in future phases of the AP project,but again,that will likely be several more years down the road. It's exciting stuff & I believe in this project more then any other research out there.("curing" diabetes is a stretch,but giving individuals the power to live normal lives with mostly normal bgs isn't)

While the rest of life moves very quickly,the advances in the diabetes field move very,very slowly...& sometimes I wish I could just jump to the future & have it all NOW. I know that sounds selfish,but I've had more then enough years of diabetes & I need a break, I need some of the awesome burden to be lessened (for me & everyone else out there). Decades & decades & decades more with this disease just doesn't sound do-able.( I know others have done it,but there are days where the best I hope for is to finish the day alive)
Technology and diabetes care have become interwined, from the advent of blood glucose meters to the pump/CGM combo.(and for all it may drive you crazy,it's the future,it's (for most people) the best of diabetes care) (not everyone chooses one,for various financial & personal reasons).

But I & technology are joined at the hip...for better,or for worse.It makes my life a whole lot easier,a whole lot less "different" from the rest of humanity.My iPhone contains everything from diabetes management apps to recipes to Twitter/Facebook(essential for my coping mechanisms)...as well as it being the link to the pharmacy,doctors office,etc.(everything a PWD could ask for) And I realize I'm lucky,in a world where many people don't even have the means to buy insulin/test strips (lucky,yet "unlucky"....the great oxymoron of the 21st Century)..I don't dispute that. I do love my technology.(given the chance, I choose to utilize those opportunities)

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Crabbed!

2011-09-06T20:43:00.001-03:00

My first Maryland Crabcake, a culinary adventure worth...well,worth waiting for!
(and deserving of it's own blog post)

I think it was bacon encrusted,because wow,that thing was sooooo good! (I believe the "gotta have one" hype now)

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Up & Up

2011-09-04T18:10:00.005-03:00

I keep hoping that in one regard, I won't be the "typical" type 1 going through pregnancy. I don't mind the weight gain, but taking a boatload of insulin is a bit scary.

The Placental Express has yet to hit with a bang,but my blood sugars are definatly creeping up. Especially overnight. (gone are the days of hanging out at 70-90 overnight) If I do nothing, they remain stable. (versus dropping multiple times per night, in the first trimester) If I treat a low, even 15 carbs will skyrocket me from 60 to 130 by the morning. Which, by this point, doesn't put me in a good mood. There was a time in my life where waking up to 130 on a persistent basis would have thrilled me to death. But now, it doesn't (I NEED under 100). It just makes me annoyed at diabetes, & the fact that it never plays by the rules. (you can't not treat a low) My total daily dose has increased by about 10 units, but some of that is just the fact that stellar control was not my thing pre-pregnancy. Most of this is in the way of basal increases...my ratios are still about the same. (although I just upped breakfast again,with a 1/8) As the day wears on, I get a whole lot more sensitive to insulin (ending at a 1:20 for supper)

So, what I don't quite understand is how much of the insulin increase is related to the placenta and how much of it is related to weight gain. (I'm aware that both just really go to town post 20 weeks) It's very much a YMMV process (as to both),but someone who gains 25 lbs versus 50 definatly has less of an insulin increase. Gaining too much (or too little) weight is not a good thing, you don't really need to "eat for two." (more like 1.1) That being said, I'm most definatly feeling pretty pudgy these days.
(I hope colder weather comes soon, because I've outgrown every single pair of non-sleepwear attired shorts that I own) I've gained about 12 lbs. I just wish I knew just how much of an insulin increase I'm due for, but there seems to be no real way to estimate that either. (other then 2-3x pre-pregnancy daily doses)

As I'm much hungrier, (for everything under the sun) avoiding junk food is impossible. Although I'm aware that such cravings are normal, and "some" is ok, I sometimes eat it 24/7 (especially during class days) and that's not good. I just can't seem to be satisfied on just "healthy" food.

I think that the days of daily basal changes are just around the corner,& that insulin resistance is here to stay.

Diabetes Art Day: Body Art!!

2011-09-01T11:44:00.001-03:00

It is a far,far,better thing that I do then I have ever done before.-A Tale of Two Cities by Charles Dickens

You're worth the 3 AM check,the 12 AM check,& all the checks in between.

You're worth the 200+ kicks daily,mostly in the middle of OB class(a veritable Mexican Jumping Bean). As I learn about Leopold's Maneuvers and fetal monitoring strips,you don't want me to be too caught up in delivering other people's babies that I forget about my own.

You're worth the heartburn,nausea,caffeine/food deprivation,random joint aches,& back pain.

You're worth turning 30 for.(happy Birthday,& don't start falling apart twice as fast now,self)

You're worth the Endo gruel-downs.

You're even worth having diabetes for,although I don't suppose one has anything to do with the other. But diabetes defiantly influenced who I married,it influences so much.As much as I hate the circumstances,there is a silver lining to many a dark & dire cloud.I'm doing my best not to screw this up.

And we're halfway there.

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Sugar,Spice and Snips,Snails

2011-08-25T20:48:00.001-03:00

Today we went in for the 19th week screening ultrasound. Typically,I go alone...but this one is a milestone so this time,it was both me and my husband. I go to a maternal-fetal medicine high risk consult,typically every 3-4 weeks(for an ultrasound,at 8,10,and 14 weeks) and they've also done blood work screening for Trisomy 18/Downs Syndrome.(of which,it was all within normal limits so there's little chance the baby will be born with it. Not impossible,but I believe the more info I have,the better I'd be prepared to begin dealing with that possibility anyway. I need lots of information to keep me sane.)

So,after waiting about an hour,we were called back & the tech started the comprehensive ultrasound scan...looking at the heart,arms,legs,head,etc. (naming what she was looking at) As she was leaving the room,I asked what it was (she certainly wasn't volunteering that information) & in a voice as dry and uninterested as humanly possible said "It's a X" before making her escape. Seriously,we've waited 19 weeks for this moment and that's how you act? (I don't know if she was having an off day or harbored a personal prejudice against moms with diabetes,like they have no business being pregnant) Then the doctor came in,and he was much nicer with explaining everything. Took another look at the fetal heart & proclaimed everything to be right on track.(weightwise,about 8 oz and no abnormalities) And it's kind of nice that they're concerned that I have someone to help with the blood sugar rollarcoaster, as the regular GYN office really doesn't care(or ask)about diabetes stuff at all. But the high-risk group only does the monitoring,not the actual delivering of the babies.(its all very specialized) My Endo handles it,but they've offered the services of their diabetes educator should I ever need it.(emergency or otherwise)

After that,we saw the genetics counselor for an in-depth discussion regarding my medical conditions/chance of passing them on.(more specifically,about my Bartters Syndrome) Because most variants are autosomal recessive,that means that I won the genetics lottery and got it from both parents(while my five siblings got Nada). In the general population,the chance of being a carrier is 1/1,000 so the chance that the baby will have Bartters is 1/1000 but there is 100% chance that they'll be a carrier. That's if it's recessive linked,I could have the (extremely rare) dominant form and in that case,the child will have Bartters Syndrome. (if that were the case,it would be apparent at birth) Insurance,of course,doesn't cover gene testing and I don't see spending $6000 on it,it wouldn't change anything anyway.It would be nice to know at some point in the future though(if I could find a research facility that would test for free). My nephrologist says that since it doesn't change the treatment regimen,there's really no need (I guess the only thing one can do,is be alert & proactive with any changes,at birth).We talked about medical issues on both sides of the family tree,they drew more blood,and scheduled the next screening in 4 weeks.

And it's a boy!!!

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Taking the Plunge...

2011-08-15T16:01:00.003-03:00

and switching to Wordpress. I've decided to not totally abandon this blog,but just use it for "nursing school" related posts. Although I don't think that anything that I've ever said violates HIPAA/patient confidentiality,(I've never put name, age,location,or particulars) it's just better not to have one's diabetes life mixed up with one's professional life on the internet. (especially if your name is very, very, Google-a-bil) Posting anything at all (about my experiences) may be considered too much info, in the eyes of some of the professors. This blog though, I can safely rant away (without too much worry).

Stay tuned.

Profiles (Week 17)

2011-08-11T17:14:00.001-03:00

(warning...belly shot below. Consider yourself forewarned!)

Here,you can see my abdomen at 17 weeks,& yes,this is pretty much what it looked like 17 weeks ago.(mostly just blubber) It's hard to believe that I've packed on a good 11 lbs. (where on earth is it?oh,that's right,it shrinks other vital things in the lower abdomen to the size of a pea) I haven't been overweight in quite a while,but wow that 2nd trimester came in with a roar.(and the lbs as well,the scale is starting to groan everytime I step on it) It's a bizarre feeling,having your stomach measured with a tape measure.(as well)He/She
is already producing insulin from it's tiny itsy bitsy little pancreas(is it wrong to envy one's kid?because sometimes,I wish it could share,& I know that's bad because genetically I may have passed on my bad luck)& setting about to double in size in the 3 weeks.And speaking of weeks,in just 2 weeks we'll get to find out what it is. In the meantime,there are plenty of things to keep occupied(like school,which begins in less then 2 weeks) Gulp...

It is afternoon on December 31,2011. I am doing a POD change,when said water breaks & my husband immeadietly rushes me to the hospital,ahead of the New Year's Eve revelry.After 5 hours of labor,at precisely 10:46 pm,a healthy 7 lb,8 oz baby is born (with no complications)

And that's what will probably not happen (although as long as it's healthy,I don't care what they do to me)

I don't like hospitals. I don't like the way they smell,feel,or degrade a person of the basic rights of human dignity. Unless you're the one in the white coat, you'd really like to be anywhere else on the planet. But when it's your job to care for sick people,well, it's not that bad being in the hospital. Because mentally,you're not entrapped...you don't "have" to be there.You can leave at any time. But a patient can't do that.(unless they want to get sicker/die)

It's something that I have to start thinking about,that yes, I'll be headed back to that place at some point in the next 5 months.And the choices that have to be made...which hospital is it going to be at? There are no shortage of hospitals in this region,and my OBGYN contracts at two of them(the one nearest our house,however,is the one that has diabetes care straight out of 1955). And that's a problem,even if my Endo's office is right down the street.(this hospital doesn't give two beans if your blood sugar is 350,as long as you're still breathing & your pain is well managed) 2008 left a really bad taste in my mouth regarding that hospital.(they pretty much ignored my Endo's orders,because most of the time I was 300's & looped out on painkillers) The other option,is the hospital with all the major equipment to handle anything that might go wrong..NICU,& such. That's definitely the way I'd go if I needed a C-Section,but for now, I have no,no clue which one to pick.I need my diabetes care to be stellar,(more for the effects on the infant,then for me) & I don't know if I'll be in the position to handle that aspect myself. And I sure as heck cannot trust Local Hospital not to kill me(if they'd take over the diabetes care). Personally, I think keeping the pump on is the way to go but things can get pretty dicey afterwards & your insulin needs drop to practically zero while you hypo nonstop & therein lies most of the problem,if you're zoned out on painkillers you aren't going to be able to catch that low & a nurse who checks you 2-4x a day is sure not going to catch it. At the other hospital,they also employ nurses that teach at my college(& the perks of that are many...since you get to know them,when you're a patient you get waited on hand & foot). I kind of also think they might do better with the D-care over there since they are like Baby Hospital Central in the county.(level III NICU) I don't think my Endo has privileges there though,& that is a problem.(I'll need major help in the diabetes dept.) Those are uncharted waters...& I need all the help I can get.

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Code 4 on the Colorado

2011-08-04T15:03:00.001-03:00

It was a typical June day in the lazy little town of Williams, Arizona...& at the unearthly hour of 5 am,there were very few of its inhabitants up yet. Except us,because we were going to go white-water rafting on the mighty Colorado River (ok,white water rafting is a stretch...more like smooth water drifting) and had to meet the tour bus by 6:15 AM. (right outside the Grand Canyon park entrance) As it takes an hour to get there,we had to leave by 5. Met the bus, treated a 69,drove into the Park, picked up more people..and took off for the town of Page, AZ. (some 2.5 hours away) Scrub pine soon gave way to desert & rock formations and it stayed that way. Drove onto the Navaho reservation (huge, spanning several states)
and you could tell it was hot outside.(up by the Park entrance, it was in the 50's & everyone still had their coats on from that). On the reservation, they go by Daylight Savings Time so that put the actual timing of the trip back an hour. (the rest of Arizona does not go by that) They also put on a mandatory "Canyon" movie (which after 2.5 hours got extremily dull, I reckon I know more about every single person who has ever rafted the Colorado then I ever wanted to) but we finally arrived at the agency headquarters, where we got off, stretched legs, perused the gift shop,and sprayed liberal applications of SPF50 from head to toe. It was just 9 AM and 85 degrees. An hour later, another group of river goer's joined us, we all signed release forms, and this Marine-looking type gave us a briefing on what to expect. Boarded buses, took off for the "secured area" which is at the bottom of a dam. To get there, we passed through a two mile tunnel in utter pitch
blackness. (claustrophobic, much? You would be by mile 1.5, our bus seemed to be moving at about 20 mph) came out at the bottom, donned hard hats, (because we were at the bottom of a dam/bridge) and all trotted off towards the river,(provided)lunch boxes in hand.

At the river, we tossed all the hats in a bin & boarded boats. It became very obvious that when they said that it would be hot, they did indeed mean, hot. A blast of 105 degree heat greeted us the instant we stepped off the bus. I wasn't thinking it would be quite that hot... but I was grateful for one thing,that I hadn't brought any back-up vials of insulin with me. (I'm not sure even the Frio would have done any good in that heat) Of course,if my pod would have gone bad I would have been up the Colorado without a paddle(figuratively), and a 4 hour drive to the nearest pharmacy.(not really a good thing,but I was lucky,nothing happened)

There were 17 of us on that boat. Our tour guide was a young Navajo Native American named Ritchie. I was most immeadietly concerned with my blood sugar...it was already trending low & in the insane heat, there's no telling what it would do.But there was lots of sugar on board(both in the form of the lunch boxes,glucose tablets,and the "net" of MinuteMaid Lemonades being drug in the water so I felt safe, in that regard.Checked my blood sugar every hour (during the 4 hour trip),& it held pretty steady. My meter, however, went completely off the deep end & started issuing random Error Codes like crazy.

I had no clue what an error 3, or error 4, meant...it was initially pretty freaky & I envisioned my Omnipod/meter dying right there,it's electronics fried by the Arizona sun.But I could still test(didn't give any sort of "device outside temperature range" messages, and those blood sugars correlated well with what my Dexcom was telling me so I just trusted that whatever was going on,it wasn't screwing with the trusty-ness of those readings. It continued to self generate Error Messages (about 20, over the course of an hour and a half) & then stopped. I bolused once(for lunch),& the function of that also seemed to be working just fine, so I stopped worrying about it.

We made two stops during the boatride...to stretch legs,etc. The French Europeans on board took those oppurtunities to strip off as much clothing as humanly possible & go swimming/skinny dipping in the river.(why they bothered wearing anything is beyond me,since you could see more then you ever wanted/needed to) Fortuantly, they made a bit more of an effort to cover up
on the rest of the journey.

The river was as ice cold as the sun was hot...compliments of the mountain run-off.
After three seconds,you couldn't feel your feet anymore.(45-50 degrees) It certainly helped prevent heatstroke. (those are my frozen toes,FTR)

We had a cooler of water on board,& were encouraged to keep up the H20 intake (as well as wear protective gear,sunscreen) & that got everyone through the 4 hour trip. There was no shade on the Colorado though. (other then when we stopped a couple of times. More then once doubted the wisdom of taking such a trip (despite the guide's reassurances that this "was the best time of year to go"-he may be used to the heat,I was not) but things did work out & it was pretty much fun.

The sun was so hot that I didn't take that many pictures...much less videos (I couldn't see the screen, (hence the upside-downness of any videos,& I am currently tearing my hair out as how to insert those videos...may take a day or two,check back)

It takes between 10-14 days to fully "raft" the Colorado...& its all regulated by private industry, so you just can't go out there and do it on your own. The discoverer/conquoror of the Colorado (one John Wesley Powell) did it in a rowboat, and he only had one arm (they had to tie him to the boat during the really bad rapids...if the boat went down, he would have too. As with the Grand Canyon, alot of people have died (on this great national wonder) & it commands an awesome power.

(Obligatory stop at a reservation store on the way back,& the resulting "Oohhh I really need/want this!" gush (that is,until one viewed the five digit price tag. Probably not as comfortable as a Baby Bjorn,either)

Boarded the bus again,drove the 3 hours back to the car/hotel...and then my blood sugars crashed hard for the next 13 hours.(effects of the heat, perhaps,I certainly didn't do anything that might be considered "physical exercise"-much of that day was spent sitting) The SPF 50 was more then effective in preventing the dreaded "day after" sunburn,although since I reserved my left hand to be SPF free(in order to not mess up blood sugar results) that hand/arm did burn some. The next 24 hours were spent recooperating from the day/hypo night from heck. Despite not being white water rafting,it was still pretty grueling. (I am most definetly not the "diabetic adventurer" type..once in a while is ok,but being away from civilization for an extended period of time is nerve wracking stuff,and the blood sugars were every bit as crazy as I thought they'd be,although mostly after(not during) the trip.

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25 Commands (of a pregnancy with D)

2011-08-01T11:27:00.004-03:00

(I'm not trying to turn this blog into a Mommy blog..but let's face it,kids do have a way of taking over the vast majority of your life. Plus, it's summer, & is not much else to blog about so it is what it is.)

Upon being diagnosed (with most any chronic disorder), comes THE LIST of rules/regulations for that disorder. Meds you can take, meds you can't take, what you can eat/drink/etc. blahblahblah. It's a whole new lifestyle, & "breaking in" does not come easy when you've done it a certain way all your life. Diabetes is a rather extreme example of that (I think it took years for me to "accept it" ) ,& I know that most of my blog readers are familiar with what that entails. On the day that diabetes "becomes yours(till death do you part)" it's an automatic stressor that can lead to a host of other stressors.

And then comes something else, say pregnancy,& an extra layer of stress gets added to the pile. More rules, more regulations, more doctor visits,more everything. I can't say that I'm used to it yet,I'm not sure that I ever will be. (I like my bad habits too much) And that list, the list of "diabetes rules" gets picked up & spun into infinitum (only this time,your opinion doesn't mean jack squat) like the 613 Commandments of the Old Testament/Torah beating you over the head until you're senseless. (I couldn't come up with 613, but here are a few "laws" of pregnancy)

#1 You will go from drinking Diet Coke non-stop to 1-2 a week. (or drink Caffeine-less)

#2 You shall pretty much forget about Starbucks for the next 9 months. (even the decaf has SOME caffeine)

#3 You shall email your endo twice a week with complete blood sugars/FOOD logs. (yeah, fun)

#4 You shall only take Tylenol when the headache/etc. gets so bad that you want to jump off a cliff...all other pain killers are verboten. Be prepared to see the line on your Dexcom go HIGH for the next 6 hours. (and screwy for the rest of the day)

#5 Your deli-meat, blue cheese chomping days are similarly, over.

#6 You shall stand by and watch every other adult sip beer, wine, margaritas, etc. (and not that I drink much,but there's nothing like watching someone else do something to make you wish you could do it yourself)

#7 You shall not eat Danish pastries every morning for breakfast. (even if you have figured out the bolusing sequence, just right)

#8 You shall not stare at random strangers in the doctor's office & wonder if you're the only person who still doesn't look pregnant. (at 16 weeks) The only thing thus far is 7 more lbs.

#9 You shall come to accept that between blood sugar checks and bathroom calls, you will never again sleep longer then a 3 hour stretch.

#10 You shall read Six Until Me (daily) until your eyeballs bleed.

#11 You shall not Google anything on the internet.

#12 You shall take a nap(as often as possible).

#13 You will discover that it is completely possible to have an overnight flatline Dexcom graph (in the 70's) without going low.
Not that it's easy, but it is "easier."

#14 You will go through test strips like a chain smoker goes through cigerettes.

#15 You will discover that chicken (and fish) are not your friends....steer clear of consumption.

#16 You will become a big fan of glacier-cold ice water. (for chasing away those nausea pangs)

#17 You will trim your list of "essential drugs" down to three. Everything else just complicates matters.

#18 You will enjoy the last fleeting moments of regular insulin requirements, for every soon everything will start going up & you'll be blowing through 3.5 bottles a month easy-peasy.

#19 You shall exercise (daily). (seriously, just get out there and do it...even if it is 97 degrees in the shade) It will soon be the start of the 2nd semester, and you'll be lugging more then just books this go-around.

#20 You shall spend many, many hours on the phone with your insurance company, trying to convince them that 6 strips a day just does NOT cut mustard during pregnancy.

#21 You shall change your infusion set (or Pod) faithfully, every 3 days, and under no circumstance put it off (like at 3 AM) just because you'd rather do something stupid, like sleep. (Pods completely expire every 80 hours,& you've got to change it, or go without a basal rate)

#22 You shall avoid diabetes related conversations with certain friends, because it does no good to freak them out too. This is our burden, & one that would probably send normal parents into complete meltdown. Heck, it even sends me into meltdown (on occasion) but I've got a great support system. I guess its normal to worry,& it's normal for that to be compounded by 100 (fueled by every disaster story I've ever heard). Normal people assume everything will be fine,PWD (or at least me) hope everything will be fine but assume the worst until told otherwise.

#23 You will learn to pre-bolus....for everything.

#24 You will realize, that if you didn't have diabetes, there's little chance you'd go the traditional OB route where you never seem the same practitioner in office & get stuck with the backup on the day that you actually do deliver. Discontinuous, much?

#25 You'll discover that any old movie will do....it doesn't have to be particuraly emotional, for you to become emotional.

A Study in Endocrimology

2011-07-27T11:08:00.006-03:00

Little known fact: Endo's are "human beings" too.

Lesser known fact: They have lives outside their medical offices.

Littlest known fact of all: They have friends. Friends to whom "blood sugars" do not come up on a regular basis. Friends with whom they go bowling with,eat cupcakes without asking the said carb count of,and generally have a pretty normal,diabetes-less existence.

When I think of an Endo, it would be hard to imagine being friends with one. (however much of a wonderful person they are) The instant I step into one's office, an aura of guilt surrounds me (I could be the best PWD on earth and I think that would still be the case) & does not let up until I'm well on my way home.(and every once in awhile, a "lightning bolt" accusation just serves to really charge up the atmosphere)

Perhaps its just me. I have to say, that yesterday's appointment went better then most..& also,much more through. Blood Pressure normal,blood sugar about 100 points lower then what it usually is(it is ALWAYS after some meal,so it's always elevated),weight gain 7 (total)lbs...a1c pending. My Endo started out by complimenting me on my much improved control,and I mean really complimenting me.(I really don't recall if that's ever happened before)I am used to negativity right off the bat so I really don't know how to take that switch in tactics.Reviewed the past 5 days of blood sugar logs pretty throughly. I go in every month (rotating between her,and the CDE)for a comprehensive review (so it's only been 2.5 months since I last saw her).

Before I married/moved to this area, all of my diabetes/eye care was done at a University down South..and my former Endocrinologist,after I told her I was moving,recommended my current Endo (my Endo was a resident physician down there,a million years ago).Well,they are still friends and hang out occasionally & though I'm sure my ex-Endo doesn't recall me in the least my Endo is aware of the fact that I used to live down there/have her as an Endo/etc. (I guess the answer to the question "Who do Endo's hang out with?" would be, other endos)That area will always have a place in my heart..& that hospital,where I began my life with diabetes,went through 3 eye surgeries,test drove an artificial pancreas,began insulin pumping,was diagnosed with Bartters Syndrome,learned of life/death/and the value of every minute(be it good or bad),and just generally grew up through is a part of my history,& a part that I kind of share with my Endo.(that makes her less of a white coat,in my opinion)

We discussed how insulin requirements would change...apparently every T1 at least doubles their total insulin requirements(and most triple, or even quadruple). That is not something I am looking forward to,but apparently it's a gradual rise(and given the frequency of tweaks,you won't even be aware of most of it) It is hard to imagine blowing through that much insulin every month,like it was water.

By the end of the appointment,I'd almost managed to forget about my a1c results..my endo left the room to get them.

"6.9."

I was happy/estactic with that(given that I worked my tail off to get there)so the remainder of that conversation was largely tuned out by me. I've never been below 7,and how people can just pop out 5.0's like it's nothing is a mystery to me. I know that she'd like to see it lower,but pregnancy does not suddenly turn diabetes care into a piece of cake.(it's still unpredictable diabetes) I'm going to savor this number,& keep plodding on.(toward better)

Friends for Life:Green Armbanded Moments

2011-07-25T15:27:00.001-03:00

Life is about the moments...the good & the bad.And that's what we're doing right here...we're making moments,we're making memories,to be treasured. (a loose paraphrase,it's been 3 weeks & I don't recall it verbatim) -Tom Karlya,FFL banquet, Orlando 2011

(the color bands of the conference...green was diabetes,orange was not diabetic,and yellow was celiac disease)

Going into this conference, I knew that it would be a bit different. The clock will never go back(to one's carefree,stay-up-to-the-wee hours,childless days) & I wanted to tie up all the loose ends that I never felt I have,in prior years. (I've had my fun,it was time to make this one a bit different) The first step to that,was getting on "Staff"

as a childcare assistant. It's also a job that comes with a few great perks,most notably free conference registration,free banquet tickets,and a free hotel room, which means the only thing Staff pays for is the plane ticket there/from.(& I dunno,maybe the speakers even get that payed for) Definably the best babysitting gig I've ever done. (yes,you lose your mind after 2 days but there are still good moments,& lots of time to unwind from the kid stress.) In the interest of disclosure, I will say that no one there knows(or cares) that I blog...these thoughts are my own & I would say them regardless.

The first "real" day of the conference always starts on a Thursday,but Wednesday is the day of focus groups,the day when the diabetes companies pick our our minds.(as to what we want to see in technology)
The first session of the day was an adult "Meet & Greet" hosted by Kerri & Scott..(group photo below)

I was then supposed to go to the childcare planning meeting,but no one was in said room,(and the leader wasn't responding to email/voicemail) so I said to heck with it & just went to another focus group. I didn't know what else to do (even the hotel "event boards" showed it to be in that room, & I wasn't just going to wait around at a room where nothing was happening.When I got out of that,my voicemail inbox was swarming with frantic calls ("Where ARE you?!?!") and the actual room was as far away from the room they told me.(as humanly possible) As they didn't bother to call until 30 minutes after the "meeting time" (nor did they bother to pick up their phone & tell me the correct place) I don't really think I was at fault there. I went there,intro'd myself to the CDE, and got instructions. I made it a point never to be late again (even if it was their fault).(CWD needs better communication to their staff)

After that,I stopped by the free Retinal Screening...which is offered every year by Dr.Ben Szirth(& team-a group from New Jersey).There was a bit of a wait,but I'm ok with that. I go every year (they don't put drops in,but they do check inter-ocular pressures & take photographs) Last year, it showed that my L lens was beginning to cloud up...and this year,my R lens is following suit. They always recommend follow up with an opthamologist, & given that you're supposed to see one in the first trimester of pregnancy anyway(didn't happen,but it is on the schedule) I don't feel that it's anything that's snowballing out of control,but when it does become necessary for lasaring I hope it doesn't affect any aspect of vision)

Grabbed some lunch (from the food court),wolfed it down, & for
the 1:30 session, I dashed over to LeeAnn's diabetes art workshop. Didn't know anybody (else) there,but the two teens I sat across from were certainly entertaining.(if nothing else) This is my "self-portrait ".

I guess all of the other adult T1's were having fun in the Infamous focus group...I was so rattled by whacked-out schedules by that point that I didn't have any clue what was going on. After that, I attended another focus group...(I don't remember what company sponsored it...)

It was lengthy,but not unreasonably so...and for 35 Disney Dollars you find yourself agreeable to even 1.5 hours of invasive,"Circle of Love", type questioning. It was geared toward kids (with D) & their parents,but guess what,there were adult pumpers there(and an adult pumper with their pumper child) so there was certainly a good representation from most parts of the D-Sphere about how pumps & meters should interact. That was the closest I got to an actual "therapeutic" session...for I couldn't go to any on Thurs-Friday. That done, I went back to the room for an hour's nap before the Exhibit Hall opened at 6. The Exhibit Hall,upon the official "Grand Opening", is immeadietly flooded by 2,500+ eager souls intent on grabbing as much diabetes swag as humanly possible(like an invading army). And while this is going on, the hotel staff sets up a buffet dinner right outside.(so the plunderers can refuel & get right back to plundering) But being starving(& low),I headed straight for the DRI's "Popcorn Machine"& the free samples they were giving out, I couldn't wait for the buffet. Had some dinner,went back to the Exhibit Hall,lugged stuff back to the room,& had a mini-meltdown (in the Florida humidity)when my room key ceased to work anymore.(I sure wasn't going to lug it all back to the convention center)My roommate came through however,(after multiple,panicky calls) & after dumping everything off we went back to the convention center for beverages & to get a new room key.(& I stopped off at Blogger Central,where everyone was sitting by the lake & tweeting(DSMA chat) merrily away. It was like geek central,though on occasion,someone actually did say something out loud. It was also REALLY cool though my phone service seemed to be at least five minutes behind everyone else's,as evidenced by snippets of conversation that I'd finally "get" later on.

(the live,streaming Twitter board in the exhibit hall)
Morning came way too fast...&it was up & at 'em for a quick bite to eat before a day spent babysitting.

My "Mickey Breakfast."

I was at the appointed room by 8:30,although there was some confusion as to which room I really needed to be in.(the "under 2's" were staffed by a professional childcare service,which I found to be pretty odd) Eventually,I was stuck with the 3's & 4's and as the room filled up with crying,screaming children, I tried to find a far corner & make it look like I was doing something essential so I would not actually have to tear a little darling away (& comfort that little darling). A couple kids quickly found the bubbles,& most of my morning consisted of making sure they didn't spill soap all over the carpet/room/universe. Which means,that my hands were also covered in bubble soap & I didn't check my blood sugar all morning,& by the time lunch rolled around (we got 1.5 hours for lunch,the parents would pick up their kids) & I'd washed my hands a "LOW" greeted me,flipping me completely out. I went into the 5 yo room(right next door) & panickly announced that I was low & could I have something? The Diabetes Educators in that room(who hadn't gone to lunch yet)assisted me in the consumption of a vast amount of Carbohydrates(and checking again,to make sure I'd come up). I'm aware that adults with diabetes (much less staff) are supposed to be role models for the kids & not get into these circumstances in the first place,but it happens to everyone...those lows that catch you totally off guard.DE's rock.(and what is the point of a diabetes conference,if not "making new friends"...you'd better believe that they remembered my face for the rest of the conference) Had lunch,got over being shaky,perused the Exhibit hall briefly,went back to the kiddo's for the afternoon. One little boy marched right up, told me he had an insulin pump,& asked if I did too. (the answer to that was yes,but I doubt that he'd know what a Pod was since most of the kids used traditional pumps)It was completely adorable & stole my heart(having diabetes at only 4 must be really hard on the parents-the kid doesn't even grasp what it is yet) but then I discovered that there was not one,but TWO little boys,(TWINS) both with diabetes,both with pumps. Both were very cute,but they were also typical brothers...intent on slugging,hitting,pushing,& completely annihilating the other. It was a relief when "nap time" came around & they sacked out completely. It was even more of a relief when 5 pm rolled around & I could check out for good,it had been a really long day. (reinforcing in my mind that I DO NOT WANT TO HAVE TWINS)
(also that day,Jackson,the CGM'ng dog with diabetes visited..a few of the kids were interested,the rest were not)

Went back to the room, got ready for the banquet, & tried to find some adult bloggers to hang out with. I then bumped into the Roche medical director(who actually remembered me from the previous year...which is odd,because generally,people can't wait to forget me) & in the course of that conversation, lost track of everyone else & spent the next ten minutes looking over the huge banquet hall for some. I finally found some.(Lee Ann,Scott Strange,Karen & Pete, Jess & husband,and I think Jacque?)

Crystal Bowersox performed...(& she's even better in person then she was on American Idol!) it was incredible listening to her,she really can sing.And I will forever think that she should have won it.(she was by far,the better singer,but tween girls(& their mass texts) will forever decide in favor of the young male performer. She answered questions for the kids...about diabetes,& performing on American Idol.

Every year,there is a slideshow of the previous year's conferences....& every year, I get all choked up thinking of the incredible people who come/give of themselves to help kids with diabetes be all they can be. But in the middle of my getting choked up,the infamous diet coke earring picture flashed across the screen & I was more mortified then anything else.(ayeeee!how did that end up there? Never mind, I know how ( Thanks,Scott) it was just somewhat shocking,to say the least. I mean,I'm an adult with D & a solo picture of me has never graced the FFL screen.But I survived the mortification.)

I then rocked out on the CWD dance floor (near Lorraine & family & Michelle & family....)

(Michelle Golliday & I)
The next day, was much like the previous...but by 10 AM I was completely worn out & functioning on autopilot. It wasn't quite as hectic,although I made at least 15 bathroom trips for the kids & 7 of those were for 1 kid who didn't have diabetes.( I was beginning to think that he really did) The main CDE took about half the kids to play in "Sports Central" while the rest stayed in the room. I helped with crafts,games,etc. By 4 pm,everyone was pretty ready for the parents to just come already though. Joe S.came in & all the kids had a free for all jumping on him.(does he still have a back,I wonder?)

By 5, I was beyond worn out & in dire need of a nap(31 kids/12 with diabetes...for two days,inside too small room) which I did, for two solid hours. Didn't want to miss the Adults With Diabetes dinner,so I managed to show up(just an hour late) at 8. The ID checker at the door asked if I was 21,asked again,& had no problem with not seeing an ID. I figured that was because there was an open bar,but didn't bother to check the bracelet he slipped on my wrist. I didn't plan on drinking( no matter how alluring those Blueberry Mojito's looked),later I'd find out that with the armband,you could get 1 free drink.(not quite unlimited alcohol) I guess I should have given it to someone else who could drink,but I didn't know.

Sam Talbot is a former Top Chef contestant.(with type 1 diabetes) And in the same way that Chystal Bowersox can really sing,Sam can really,really cook.(he was giving demos of how to prepare the food on that evening's menu) Problem was,it was a bit too spicy for my pregnant taste buds so the greater portion of that meal was the desserts(mini cheesecake,brownie,fruit tart) and water. Tandom(the event sponsor) had a raffle giveaway(Snuggies,a camera,a couple gift cards to high-end shoe stores in New York) & Sam signed autographs/posed while the adults with type 1(spouses,etc) randomly mingled/shot the breeze. There was one person there(an OB nurse with T1) who went to college where I grew up,works in the state I live in,& could tell you more about the nursing program at my school then I could myself...it's a small,small world. (& a most bizarre one,I was afraid she'd have some sort of sixth sense about me & ask if I was pregnant)

After that, I figured I'd head over for dessert/scientific discussions with the faculty.(more for the discussions,not the food) I'd gotten about a hundred feet,when one of the CDE's saw me & waved me over to join the group of all nurses unwinding from their hectic week with the help of lots of red wine.Certainly they needed it,but I was getting tired again(& there was no caffeine or alcohol on board to help with that) & about an hour later,excused myself...only to run into the blogger group on the outside patio. Stayed till midnight there & then went back to crash.

And that was the week,in a nutshell. Sat. my roommate & I moved to another Disney hotel.(so were not around for the last "farewell" breakfast) FFL will always be exhausting,but it will always be worth it...you meet new friends,reconnect with the old, & feel that diabetes does not suck quite so badly. There's also no "type" discrimination at FFL...although the vast majority of folks have type 1,if you've got diabetes,you're wearing that same green armband as the T2 next to you. I think it's nice not to fight...1 week out of the year.In a sense,I feel like I've "grown up" with CWD (not really,but I have known some of those folks on the chat rooms since I was 18 & as green with diabetes as they come). After 5 conferences, I finally got to "give back" although I think that probably should have taken the form of another age range. I enjoy talking with the parents of the kids with diabetes too...it gives me insight as to what life is like for them.

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100 Days

2011-07-21T16:27:00.001-03:00

On the 99th day of pregnancy,my body gave to me
A raging,snotty,stay-in-bed flu .

Yesterday's Babyscope:

Jul 20, 2011
Staying Healthy
As if you didn't have enough pregnancy symptoms to contend with, you're also more susceptible to colds, flu, and other bugs when you're expecting. That's because nature wisely suppresses your immune system during pregnancy to keep your fetus (a foreigner to your body) from being rejected. The key to staying healthy during pregnancy is to engage in some germ warfare. More than ever, the best defense is a strong offense. Wash your hands often (and carry liquid sanitizer for times when a sink's not handy), don't share drinks or food or toothbrushes, and avoid sick people like the plague. If you think you've caught something, check with your practitioner ASAP, who will treat what you've got with your special needs in mind.

Wow,seriously? Talk about great timing.(telling me after I've already caught the thing,how about 3 weeks ago?)I wash my hands a billion times a day as it is.(so much for that,I suspect someone gave it to me at the airport) The wording of that is also quite interesting ("foreigner to body?" whatever happened to it being the most natural thing in the world?)

100 degrees outside.

100 degrees inside.(me)

100 days of pregnancy.

100 (what my blood sugar should be,& is so NOT,& not from lack of trying,fever raises my basal insulin requirements)

As for symptom relief,the only thing you're really allowed to take is Tylenol.(Sudafed in some cases,but I'm not one of those cases) My "special needs" mainly consist of keeping the blood sugars in line,(emailing Endo 2x/week)& keeping hydrated. Can't use my CGM,because Tylenol messes up the readings so I just have to check a zillion times a day. And is that helping,not really, I need my CGM to alert me before(not after) the fact.

I'm pretty sure that if Michelle Duggar had diabetes...there is no way she'd go through pregnancy 19 times. It's possible,but that doesn't mean that there's anything easy about it.(the real question is,it possible for me to do it.I'm 50/50 on that one.)

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The Ugly Meter(that could)

2011-07-18T13:09:00.001-03:00

Once upon a time, in the land of Meterville(aka Heidi's Closet) there lived a young Freestyle meter.

As meters go, he wasn't very "fancy" or revered,& the young meter felt that he had little to offer the world. He wasn't an Omnipod, One Touch, or Reveal...and couldn't directly beam readings into the pump of choice. He had no fancy backlight.( for the popcorn chewing, diet-coke swagging,testing-in-the-dark patron with diabetes) Yes he was small,& cute,but in the cutthroat world of diabetes technology where does that ever get you? In despair,the young meter wished to be run over by the nearest 2,000+ lb vehicle but as a case of last resort,decided to pay a visit to the oldest (and wisest) resident of Meterville.

Grandfather Accuchek...the very first meter of them all. Grandfather Accuchek possessed more knowledge then any of the other meters,for it was he that had trained that young PWD oh-so-many years ago. The young meter loved to listen to Grandfather's stories(of diabetes care back in the '90's) for it made him feel shiny,young,& special...not just another generic meter.

"What can I do for you today,oh young one?"

"Oh Grandfather, I need a special function,for all of the other meters are so much better then I. I don't have a backlight,manage pump info, or are waterproof. If I had a superpower,like being able to instantly analyze the carb content of any given food that would give me some credence,but I'm just another dumb,useless meter!"

The old meter looked at the younger one & sighed. "You have much to learn,young Meterwan. Listen to your owner, for the day may come that YOU are the meter of the hour."

"Yeah,right. I'm just trash!" moped the young meter. And he went away angry,that the older meter would not help him.

One day,there was quite the commotion in the land of Meterville. A big diabetes Exposition was going on,& all the brightest & best meters were selected to attend,to represent just how far technology had really come. The young meter watched the other meters leave,& cried bitter tears that he wasn't going to.

But then came that night....that terrible,terrible night. At 1 am,young meter was awoken by sweaty,shaky hands grabbing,jabbing,trying to insert a test strip into him by the light of the hallway haze.

49.

Young meter wanted to scream out "Eat Sugar!" but seconds later was knocked onto the floor in the PWD's mad rush to do just that.

56.

Picked up again,he could feel the hypoglycemic heartbeat madly vibrate to his own inner core. The minutes,& hours passed...and the heartbeat slowed, the sweat cooled,and shaking fingers slowly uncurled as the body fell into a sleep of exhaustion.

That day,the young meter learned that it's not so much the fancy features of a device...it's the ability to do the job.(that ultimately matters) In a pinch,you need a meter that delivers.

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Dear Beanie Baby

2011-07-14T12:15:00.001-03:00

It wasn't a day like any other day...for starters, it was Friday, May 13...the last day of the semester/nursing convocation party. Great day to get a little life-changing news. Got up,dragged myself to the lab for a blood draw,& then went home to prepare for the convocation. Bittersweet moment,for I was feeling the emotions of having survived the 1st semester along with the hundreds of other students there. After the ceremony,there was a light reception,& I drove home...stopping at a store for something & my phone beeped with a voicemail. I decided that whatever it said,I needed to be sitting down for the news.

"Hi,this is your doctors office-Congrats! Blahblahblah."

It was true. It was real. It was at that moment,when visions of my latest blood sugar ran like a horror sequence through the soundtrack of my mind,that I knew I needed to pick up the phone & tell the one person in the Universe who needed to know right then & there.

My Endo. And she picked up right away,gave me my next step of marching orders,and congratulated me. But having been down this path before, I waited the weekend before telling my husband(after the repeat blood test showed continued rising levels).

And every day since then, I've awoken every morning expecting the worst. It's a hard burden,those critical weeks of the first Trimester...when every blood sugar,every random stabbing pain,everything you put in your mouth influences another life. (have I been a bit psycho? why yes, I have)

But today, I am 13 weeks...feeling not as miserably sick,& ultrasound shows Beanie Baby to be right on track.(3 inches long,& growing by leaps & bounds)

I think it may be doable after all.
(not quite as nervous now...although it's still not very "real" yet,still no tummy budge)
I can't say that the concept has even become real yet,I guess it's good that it takes 10 months to have one.(but yes, we're really excited, & it's incredibly hard to not tell anyone until 8 weeks later!) It was worse at FFL, I had the uncontrollable desire to blab it to everyone I came in contact with & I couldn't, because I needed today's confirmation that everything was still on track.

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Oh, Baby....

2011-07-04T20:50:00.001-03:00

His name is Mac,& I suppose this means that I have gone totally Apple-holic.(hook,line,& sinker) Bought it off my dad over the weekend.(aka,my b-day/Christmas gift rolled into one...my old PC is pretty ancient/buggy/slow)

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Phases

2011-06-29T14:07:00.001-03:00

I have type 1 diabetes, & my islet cells don't work worth two beans.Or do they?

If you were to measure my c-peptide,it would be non-existent, at 0.0 mmol. I know this,because with diabetes research studies,they are always measuring c-peptides...and as mine goes,it is always non-existent.(some long-term type 1's still do retain a slight production) Researchers theorize that producing insulin may have protective powers against the crazy high-low destructive variability(that is type 1, in a nutshell) So much for any protection for me (should that be true)

But there are times,not related to exercise,illness,temperature,or the phase of the moon...when I could swear that my pancreas is doing something.And when it begins,the lows just go on and on and on(seemingly unending).

Last night was such a night. 95 at supper(a zillion carbs of spaghetti), 65 by the end of supper. Bolused half(because of the low),and waited for the pasta factor to just hit en masse. 45 minutes after supper...70.Ate some candy. 30 minutes after that...72. Ate 16 grams glucose tabs. 30 minutes after that...55.And so on,till about 10 pm,when,sick of eating,I cut off my basal rate for an hour,& threw the big guns(chocolate milk) at it.11 pm-76.Cut off my rate for another hour,had another cup of chocolate milk & prayed that it would work because the next step would have been experimenting with mini-glucagon dosing to try to avoid going to the ER. I was scared that it wouldn't work,but 3 hours later I awoke to a lovely 296 which I bolused half of what I normally would(1.5 units) effectively knocking it down to 106 this morning. I think I probably ate around 300 carbs last night,it was absolutely insane.Rarely does my mind go to the "what if this doesn't work?" scenario,& it makes me realize that I have absolutely no plan(aka "panic-free") way of handling something like this(mainly because it very rarely happens) I have had days where I'd have 7-8 lows a day,because of whatever wackiness was going on,but it was a controlled chaos,& I could keep on top of it. There was nothing controlled about last night...never in my life has a bolus of 2.5 units(plus 1.5 basal) done that. People think that insulin production is a wonderful thing, a dream that they'd give anything to see again but I am not so sure,in the context of T1 diabetes it is just a major pain in the butt. You'd have to figure out just how much less insulin you need(and no answers are forthcoming from said pancreas as to how much it's producing). The world of diabetes is not cut and dried(as to what can/will happen),& more then anything, I just want stability. I'd rather take a relatively consistent amount of insulin & have great control then little insulin & be crashing every five seconds.(of course, I'd much rather just not have D in the first place but that's not one of the options)

I hate diabetes.

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Winning The Battle, Losing The War

2011-06-22T12:26:00.001-03:00

Prioritizing. It's something that I'm none too good at, and by now, the list of things that I've been meaning to blog about is so long that I'll never in a million years catch up so why even try?

And plus, I've been having serious disenchantment with my blog platform. After 5+ years, it just seems so incredibly basic and blah(which was good in the beginning,but now it's overly simplistic). I know next to nothing about developing a website,but there has to be better platforms out there. Change needs to come. As emotionally attached as I am to "The D-Log Cabin", even that may have to go. There are posts in here that I'm sure are none-to-complimentary(too many names) toward certain parties,and I have to think that one day,some online stalker playing "Connect-the-Blogs" could play havoc with that. I try not to put too much private info on my blog but I'm not sure I've been terribly successful in that.

Most of my energy,emotional & physical, seems to be consumed by the diabetes these days...and it seems like I don't have enough energy to blog. It's not that it's hard(to dash off a 20 minute post), it's just that,given the choice, I'd rather collapse into bed. I hope that changes,but that's the reality for right now...winning the D-Battle, seriously losing/behind on every other part of my crazy/ busy life.

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The Runaway

2011-06-10T14:23:00.001-03:00

It's been missing for two full days. I know it isn't in the car(checked) or house (for with the number of lows I've had, I'd have heard the alarm,the battery was fully charged)

Where is it? Where was the last place that I went that it might've fallen out of my pocket? Let's try the doctor's office.

"Excuse me,but did I leave a medical device there on Wed.?"

"Yes,it's here. We were wondering who's it was."

Success, relief. How I didn't realize that sooner is anyone's guess.

I'm not a parent,but I think I know exactly how it must feel to get your kid back safe & sound..a little bit angry ("Bad, BAD Dexcom!") a whole lot scared, and a whole lot relieved. The day I leave a device like that in an airport is the day I NEVER see it again. Everything is getting labeled/phone numbered,against the day that it does happen again.

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The DiabetiThon

2011-06-05T13:57:00.001-03:00

The road stretches straight ahead
Miles and miles, off into the darkness
and yet it seems so oddly familiar
like an endless loop
for I am no hero,& I have been here before
drop-by-drop,counting the gallons lost
hole-by-hole, playing Connect-the-Dots with the scars
Diabetes: 5000 Me:0
seeking to lessen the damage
in this Diabeti-Marathon
I run to live
and my prize is being alive
for in this race,there is more taking then giving
kidneys
heart
eyesight
every other complication under the sun
Am I doing this right?
no one can tell
Although confirming my failures is easily done
and yet I think at least I'm 75/25
and good for many more rounds around the track
but the monotony is stifling
and I am tired to my core
day in,day out
it never ends
Can a human being live this way?
I want to believe in a cure
but the passage of time
jades the most enthusiastic of people
so I settle for survival
and I wait for the sun to come up
the diet coke to kick in
And then I see that I'm not the only one running this race.

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The Problem With 80

2011-05-29T19:19:00.001-03:00

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

2011-05-25T16:58:00.001-03:00

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

2011-05-20T14:15:00.004-03:00

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

2011-05-16T18:52:00.007-03:00

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?

2011-05-12T11:00:00.000-03:00

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

2011-05-11T13:48:00.004-03:00

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

2011-05-10T01:01:00.004-03:00

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..

2011-05-09T14:50:00.004-03:00

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

2011-05-09T12:56:00.001-03:00

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

2011-05-04T20:24:00.001-03:00

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

2011-05-02T18:36:00.004-03:00

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.)

The Night Bill Monroe Came to Town

2011-04-26T12:11:00.006-03:00

Ronald Reagan was our president
A diet coke would run you twenty-five cent
I was just a kid, hair flaxen-brown
On the night Bill Monroe came to town.

The Golden Girls were reigning on tv
(Not that it was something I could see)
Bluegrass was the hit, the biggest sound
On the night Bill Monroe came to town.

Momma scrubbed my face, and packed us in the van
Yeah, we were all going-the whole entire clan
Once all the shoes and socks had all been found
On the night Bill Monroe came to town.

Five hundred people screaming in the gym
The passion in their voices no mere whim
To let it out, in yet another round
On the night Bill Monroe came to town.

On and on went Billy and his band
"Dark Hollow" "Feudin' Banjo's" "Freeborn Man"
We're getting up, we're getting wild, we're getting down
On the night Bill Monroe came to town.

Thronging fans besiged him, to get his autograph
That a little kid could get one, was more then crazy daft
From that mass of people hanging 'round
On the night Bill Monroe came to town.

Cheeks and arms and papers, all were signed and blessed
With the pen of Bill Monroe, his official scrawing crest
It was still a night of being quite profound
I won't forget the night he came to town.

Ten Years Pumping: A Pictorial Odyssey

2011-04-23T17:25:00.009-03:00

On this date in history, my life changed, for the better.

(yes, it sounds cliche-ish, but its all true. I hated the imposed schedule of the 2-shot-a-day regimen. I was about 35 lbs overweight because all I ever did was feed the insulin.Pumping helped me to lose most of that.)

If I had to pick a favorite, well, I wouldn't. (they all have their good points, except perhaps that mid 80's Disetronic) But one thing I know, I don't think I'd ever go back to a Medtronic pump.(they & I had a major falling out,& I don't think much of their products.Your opinion may vary,& I respect that)I want to do a more detailed vlog about the differences.(when I have the time)

But today, is a day for cupcakes & ice cream, to celebrate the freedom that the pump brings.Diabetes is so much easier with a pump.

Thoughts From the 3rd-4th Week

2011-04-21T16:28:00.004-03:00

1.One week,you're on top of the game-the next,you do something unspeakable (or non-HIPAA compatible) & on top of feeling horrible about it,you then get to tell your instructor,the shadowing Masters Degree student,& the RN charge nurse.(the patient is fine) You then get to fill out your very first Incident Report on why the thing you did was a bad idea & burst into tears,well,just because the situation is not awkward enough.Mistakes happen,I know that(it's the sheer amount of authority figures that sent me over the edge). Live & learn.(I haven't been kicked out of the program yet,so that's a positive.)

2. I got to see a cataract operation(video from a guest lecturing ophthalmologist) as well as ten zillion pictures of the Diabetic Eye. It was both fascinating and made me want to throw up,as it seems that the winning combination of diabetes,nearsightedness,cataract surgeries,strabismus surgery,and optic neuritis spells a
near certain dearth for my left eye.(glaucoma,retinal detachment,macular degeneration,pick your poison)I really would like to keep it 'round as long as possible.(renewed vow to get myself to the optho this summer) I think that the clouding on my L.lens has progressed,I don't see as well at night(it seems to have really gone to town in the past 2 years...is it something about that 10 year post-surgeries mark? I think lasaring is in the cards for the near future which is kind of scary to think about. I hope it doesn't A.hurt or B. have any other visual side effects.I've known the day would come that I'd need lasar,it's just hard to remain calm when its an eye(s) you're talking about.

3.150 years ago last week,the Civil War began. iTunes has an incredible app called The Civil War Today which gives you a daily update through the 4 years of war. (it's an iPad app though) It's in newspaper format,& has video clips,journal accounts,quotes,trivia,photographs, etc. & really makes it come alive...it's a pretty cool app.If you love history and have an iPad,I suggest you check it out!

4.Cancelled my Endo appt,rescheduled for May 3.Hopefully my a1c won't be so off-the-charts high by then.

5. Freestyle strips without the Butterfly are becoming next to impossible to try and find. The bad thing is,both kinds have the same UPC so it's impossible for a pharmacy to know what they're getting.It's largely hit & miss trying to obtain any.(at all)
---------------------------
1.In the Event of a Fire Alarm,make darn sure you grab your meter & sugar,because you won't get back in that building for a good 45 minutes. This is not a time to go low.
2. Working in a nursing home is like working in the psych ward..one day everything is "normal", the next, the patient is wheeling all over the cafeteria,& attempting to slug you when you try to prevent disaster from occurring. (while the rest of the population looks on) I guess it's not that bad when the patient is not physically capable of hurting anything,but it was just so,so,so bizarre & the Easter Bunny was not exactly helping me in what I was expected to do in said situation.(me & Easter Bunny in room full of patients,& I couldn't leave because I was monitoring somebody else) HELPPP.(just about ready to be committed to a mental institution myself,I was not supposed to be monitoring the whole entire room) Next time, a little help, Easter Bunny?
3. Forget tiredness, I've progressed to dead. But next week,there is no homework/care plans due(Monday,Test 4) and Wed/Thurs we'll be caring for two patients EACH & then,that's the end to clinicals. Following week,we have our big Patient Presentations & the week after that,evaluations & the cumulative Final Exam and the big Nursing Convocation Dept. "party" and then it's all done! (time flies when you're having fun) I need it to be summer.
4. You may cross "morbidly obese patients" and "chemo/radiation patients" off the list of future career choices.Someone needs to do it,it just won't be me. I can't even find a pulse(anywhere) let alone formulate a good plan. I feel like whatever skills I may have acquired up to this point have not gotten me really far (in terms of a morbidly obese individual)
5.One week & 12 hours till the royal wedding! (I'm sure you're all just dying NOT to know)

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YouTube: A Royal Wedding

2011-04-17T21:31:00.004-03:00

Love this clip...(and yes, I will be waking up at 5 AM (April 29) to watch the real thing!)

Circle of Trust

2011-04-13T20:12:00.003-03:00

Trust. It's a tricky thing,and for a PWD,the question of ultimate trust boils down to a little red box.

In 12 years, I had only asked the question of ultimate trust one time (to a non-family member-family members have given me some,& my husband does know how to give one) It was directed to my then-EMT boyfriend(my blood sugar was under 10 mg/dl, & I was hysterically convinced that I would soon die) and he said no.Who knows why...nerves,perhaps.Or the legality of the situation.It did not matter,I was both annoyed(to the nth degree) and scared & crushed,that question of trust had been thrown back into my face & ultimately,that helped in the breakup.If you cannot trust someone completely,you have no business being together.(and I used to be an EMT & in my section of the universe,heck yes they give them.I know he knew how)

So when I asked my clinical instructor if she would be willing to administer "the shot", it was with a great deal of fear & trepidation. She said yes.(she's an ER nurse,heck yeah she knows what to do in an emergency) I ran through the basics,& what I'd be like(in such a situation). But then a dept wide email circulated RE school policy in such a situation & it was advised just to call 911,not to get involved.

Crushed,that's what I was. I dunno why it feels so important that I have someone on my side,but it felt like that trust I'd just given out for the 2nd time in 12.5 years didn't mean squat,again.Of course my clinical instructor was sympathetic but she couldn't go against dept policy. So back I went to talk to the dept head,& she said in actuality,the instructor could do as they wished-call 911 or give the shot/call 911,the schools liability insurance would cover either way. I wouldn't ever sue but there is liability insurance for everything,these days.

I am relieved..so,so relieved. I thought the school really didn't care if I lived or died,& I don't have the attitude that it's anyone's responsibility to do this..only someone I think would care enough to do so. When my clinical instructor said sure,I thought that to be the case.(she's pretty great) I have worked a retail job & in 7.5 years,never trusted anyone there (even good friends) with that burden.(said person has to be somewhat knowledgeable about medical matters) I think part of the deal here lately has to do with the lability of my blood sugars,& my desire to stay closer to 100 then to the 250's of yesteryears. A blood sugar monitor is also not always handy..like it was at my old job. You can't very well crack the meter open in the middle of a procedure.(plus you have to wash your hands a billion times a day)

I hope to never need it(on the job)but it's so wonderful to have that piece of mind.(Bgs have been all over the map lately & it may come to pass,that I need one) I need to feel safe,& more then anything else,this decision has greatly influenced that. I don't think I'm going to be having this conversation with all my clinical professors but in this rotation,I never needed that reassurance more.(nursing home in the middle of nowhere)

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A Blue Shield Comparison

2011-04-12T14:59:00.005-03:00

It's four months into the year, and I have mixed feelings about our newest insurance plan(Blue Shield/Blue Choice). (previously, we had Blue Cross/Blue Shield)Can't escape them Blues.

Pros:
- no test strip copay when I went and filled my rx at the local pharmacy..I can't remember the last time THAT happened.(age 21, perhaps)
- 100% coverage on the several emergency magnesium infusions(I have a plan in place for that..it's done at an outpatient infusion center) Is it fun, no, but the nurses there can get blood from a stone(they're very skilled) It also takes about half the time then at an Emergency Room. At $2,000 a pop(if not covered),even under the old insurance the copay was just horrendous. I have standing orders there.(fortunately these days my mag levels are doing pretty well but when things go south,I know it)
-diagnostic tests are covered, 100%. Lab tests appear to be covered 100% as well.

Cons:
-no mail order pharmacy, I have to order things directly from the manufacturer.And both pump supplies and Dexcom sensors are a chunk of change significantly higher then what I payed under the last plan.
-Test strips I have to get directly from the pharmacy. I miss getting all my D supplies (strips,insulin,pump supplies) in one fell swoop, at the same time, every 3 months.
- Insulin I haven't attempted to get filled yet,but I fully expect Apidra not be covered(Novolog is apparently the med of choice)or some outrageous copay & I will have to go through a lengthy appeal process. I try to use up my vials to the last drop,& therefore go through them pretty slowly but eventually I will have to face the music & go to war with the insurance company. I just don't have the energy/time to do that right now.
-regular drugs (aka synthroid,etc.) are slightly more expensive then they were with the old plan.
-dr office copays are the same...
-ER copays are $100 a pop,about 2x of the old plan. Now I really don't want to go there.(I need a tattoo that says "Do Not Take to ER" on my forehead)If I were to have a bad low, I think I'd want the IV glucose & then refuse transport.(assuming I were in that state of mind) ER's are money suckers.
-I have to get preauthorization on EVERYTHING,which is a pain in the wazoo. Preauthorization can take days, to months.(cannot begin process right before I'm about to run out of something critical)

Bottom line is...most insurance plans have problems, you're always going to be shelling out for something. I'm just glad to have insurance.(that covers as well as it does) I'm not sure yet if I like it better/worse then the old plan..they both have their advantages. I'll probably have more of a opinion later on in the year, when it becomes obvious just how much has been shelled out in comparison to under the old plan.(for mostly the same stuff)

Thoughts from the Second Week

2011-04-09T13:28:00.001-03:00

1. Sleep? What's that?

2. See above.

3. See above.

4. I need to grow longer fingernails...there is no other way of getting into some medication packets.

5. I caught a medication error this week,& felt really good about it. I guess I wasn't that surprised that in the 4 proceeding months,no one else had.As nursing homes go,this one is ok but of course none of them are going to question the all-knowing pharmacy's RX's.I don't have a very high opinion of nursing homes' care.(in general,if you know of a great one,I will stand corrected) And it is better for the patient that is was caught,but in the grand scheme of the Universe when one has many,many other medical issues I'm not sure how much good it actually ends up doing.

6. Sometimes I need to keep my mouth shut...no one gives two cents about the nursing student's needs. I was under the impression that they did,but administrative policy trumps all.Reality is the bitterest of pills to swallow.
7. Weekends without looming tests are a good thing.And as I've been a test every Monday since Feb(barring the Spring Break) it feels indescribably wonderful NOT to have to study/cram this weekend.I'm still upset about this week anyway.

8. Starbucks is essential for those incredibly early morning risings.

9. There's no way I'll be able to get off an hour early for my would-be Endo appt. next week,you have to be dead.(dying doesn't cut it,according to my clinical instructor) Which is stupid,because all we do that time of day is sit around,talk,& write care plans. I will have to reschedule for July,my Endo will be upset, & I'm already there X 1,000,000.

10. Is it May yet? I need to get out of this semester.

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The Top Ten Ways to Drop Your Blood Glucose(part 1)

2011-04-01T14:39:00.001-03:00

The Top Ten Ways To Drop Your BG-Au Naturale

#1

#2

#3

#4

#5.

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Thoughts from the First Week

2011-03-31T17:57:00.003-03:00

1. Adult bowel incontinence smells 10x worse then an infant's.(goal for this week: do not gag/vomit on patient.I'm sorry, but it does take some getting used to)

2. Paperwork is already the bane of my existence.

3. White shows everything. And I can't use it to "blot" anything, without looking like Frankenstein Nurse.

4. I wish we had lockers.But students are not really wanted, they are just tolerated,and as such, there is a long list of ridiculous rules of things that are not permitted in the facilities...among them, any type of med. Because, as you might have guessed,there was an unfortunate incident involving a resident rifling/OD'ng on a student's meds. So my insulin gets to chill in my car.(it's not freezing,and it's not hot,but still it's highly inconvenient to not have that with me)

5. I have no appetite in the nursing home, but as soon as I get out of it I'm ready to go to the nearest fast food place (or home) and down 1500 calories. I think it's the smells.

6. Looking for information in a chart is like looking for a needle in a haystack.(sorry for the cliche, but it is) I think I could literally spend all day filling out that comprehensive assessment form,it isn't organized,and it's full of conflicting info.

7. I don't know anything.Please don't leave me alone with a patient.(not to worry...the instructor knows this,& first semester we don't breathe on the patient unless said instructor is nearby.)

8. The elderly can be so sweet, and interactive. If I had to live in a nursing home I can't say I would be that way.If I was lucid, I would try and escape every chance I got.

9. Mealtimes and insulin peaks never match up,which is why every time I get a chance to eat I'm in the low 200's.(in another hour, I'd be in the 100's,but lunch is NOW)Not that I'm hungry...but I have to eat something to stop my stomach from growling. Never been close to low but I still get the occasional "are you ok" glance from the instructor.

10. BYO glucose tabs, juice,and food is absolutely imparitive. There are no vending machines/staff (kitchen/cafe) privileges (nor any access to any nearby stores)so you've got to plan for a disaster scenario and bring enough food to treat low blood sugars all day. Otherwise,you're probably in deep water. (I wanted to ask what they do if a resident has severe low blood sugars but since many of them have difficulty swallowing, I'm guessing 911 would be called. Not what I'd want done for me but I'm pretty sure I don't get to go walking around with a huge hulking glucagon kit in my pocket)

Peak & Trough: A Lesson From Nursing School

2011-03-25T18:09:00.001-03:00

Disclaimer: I'm not a doctor, a nurse, or even play one on tv. So don't take any of this as medical fact..YDMV,consult with your own Health Care Guru.

You can go ahead & say it. How does this not look like the action of fast acting insulin(only more of the "peak" part)

And because much of my thinking is colored by diabetes,immeadiatly my mind starts drawing parallels in the D-World.

What you're actually looking at is the action of a medication. There's the time it "starts working" (T1) the time it's peaking (T2,etc) and the time it tapers off.(T3) A "peak" is the time when it's most effective but there is this not so small matter of ensuring that that peak stays inside the minimum effective concentration and the minimum toxic concentration lines as well. And let me tell you something,trying to keep the drug onset,side effects,peak times, minimum toxic concentrations straight (x 20 or so meds per pt) is not exactly easy. Drugs also like to clash with other drugs & are absorbed differently. Anyway,insulin is the easiest example of this because generally there is only one side effect (hypoglycemia) and that's like the minimum toxic concentration. Bad,bad, BAD to have enough insulin in your bloodstream to cause that.(although it's not that difficult to get into that situation)

A "Trough" is a blood level drawn right before the next medication dose. It tells you if you are at the minimum effective dose and if not,that you need to do something about it.(I do troughs with my mag levels too only I don't take the dose until I get the results..it's like a "fasting" result) People with diabetes do alot of troughs only there is always some insulin involved and one can never be quite sure that the dose you are taking is too much/just right/not enough because we can't see how our bgs will respond. But in my observations,blood sugars(postmeal) do not go as high when there is a certain amount of mealtime insulin still floating around, 3-4 hours later.(this also applies to snacks) Maybe because my basal is so low(I have to have insulin above & beyond that,where food is involved). Prebolusing also helps.But with diabetes,the line between keeping a little extra IOB and spiraling down into hypoglycemic horror is a very thin one. (am I an expert on this,nope, but understanding how Apidra works in my body is a step toward more consistent bgs)
And of course there are a hundred other factors involved(exercise,etc) which makes D a constant science experiment. Nursing school is not entirely detrimental to one's health. (it's rekindled the "gotta sync this right" flame)

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Freestyle Failure

2011-03-21T23:23:00.002-03:00

It's been a very (long)& relaxing weekend, but unfortuently, there have been several bumps in it. Most noticeably, I begun using the new butterfly strips with the "Freestyle Freedom" blood glucose meter & am getting readings all over the spectrum.I brought two meters on this road trip,& I can't really tell what's the problem-meter,or strips,because I don't have any control solution) It's really disconcerting when you can't even trust your meter/strips & it's not the sort of situation that you want to strive for "tight"(80-110'sh) control in. I thought if I had my Dexcom on,it would at least give some guidance as to which hundreds I'm actually in(100,200,300,400,etc.)but that's been giving me question marks so at this point, I'll take the lowest meter reading & go with that. Tomorrow,we'll head back home & I do have a One Touch meter(& leftover strips) that I consider to be the "Old Faithful" glucometer...99% of the time it's right. I hopefully have strip solution for the freestyle meter so I can do comparison's & figure out just what is wrong here.

Lesson of Story: never bring something "new" on a trip,without first testing it out first. Technology is a great thing but if it malfunctions it changes diabetes care from control to survival mode.

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Sometimes

2011-03-18T20:22:00.001-03:00

(the following is a deep,dark rant,and if you can't handle unfortunate realities I encourage you to stop reading now.I think most PWD feel like this,at some point.)

Sometimes being the only person with diabetes sucks.

Sometimes I don't bolus for that piece of Triple Decker Death-By-Chocolate caramelized goodness.(on purpose,and I shortly rue the day..not a good idea even you are tired of diabetes)

Sometimes I forget my meter,forget lancing device,forget
strips,forget glucose,forget back up insulin,forget pump supplies,or forget money. And sometimes I forget all of those.

Sometimes I want to give up.(dark thoughts,don't go down that road)

Sometimes a blog comment really makes my day!(ok,most blog comments really make my day)

Sometimes I want to hit the Diabetes Police very,very hard.

Sometimes I can throw 100 carbs at a low & not break 120,other times I can eat 15 & voila, I'm 220.

Sometimes I wonder if a middle of the night low will be how I go.

Sometimes I wonder if there will ever be a cure.

Sometimes spontaneous combustion of tears is the sole symptom of a low blood sugar.(classy,not)

Sometimes I wonder if any of my classmates will be caring for me(in a nursing home) in 30+ years.

Sometimes the combination of Diet Coke & Spearmint gum tastes like rotten socks.

Sometimes having diabetes isn't as bad,when everyone else out there "gets it" too.

Sometimes I wonder why I'm so lucky,despite it all,when others haven't been.

Sometimes I think I'd like to beat the insurance company executives over the head & make them see that supply restrictions is not the way to contain costs,they'll simply pay for the complications later.

Sometimes I'll spot a fellow pumper in the wild.

Sometimes I'll eat twice as much of whatever I'm told not to eat,just to spite whoever said I couldn't.

Sometimes I wake up and have no idea how many carbs were actually consumed during that 3 AM low.

Sometimes I will eat sugar-free candy,and not gag.(if the situation is non-resolvable)

Sometimes I wish I had a personal Endo 24/7 who would take care of the diabetes crap while I just lived my life.

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Luck O'The (Non) Irish

2011-03-17T12:03:00.001-03:00

I did it.

I really just passed my head-to-toe assessment,missing only such minor details as skin turgor, the true position of the Right Lower Lobe/Left Lower Lobe (on the lateral sides) & something else. When that was over,my instructor asked me cheerfully if I felt better about it now.(the answer was no,the anxiety hadn't time to dissipate) & then it was on to the Skills portion. I drew the two easiest skills there were(putting on gown/mask/gloves(& taking off) & drawing up and administering an insulin injection). For one brief moment,my heart stopped as I remembered(too late) that N70/30 is supposed to be rolled prior to draw up but I verbalized it & it was ok.

And then I (so I thought) felt better. About everything.

And then she asked "Can I ask you something?" and I knew precisely where the conversation was going.I can smell invasive personal questioning a mile away.

"Do you wear an insulin pump?" ( yes) "How many years?" (10) etc.etc.
etc.

I guess either the accommodations paperwork found it's way to her or she checked up on it because at no point had I given any indication that I was D,(checked bg,or had a pump in view) unless she really did see me checking my bg in the depths of my purse(& discreetly treat the low) during that first roundtable discussion. (it's not possible to tell someone is D just from how they give an insulin injection) I was going to bring it up the week of clinicals (so she wouldn't have time to forget it) but I guess now was as good as time as any. She was really nice about it,& if I need to test/treat/eat it's fine with her.And if I keel over,well,it's good to know what from.( I assured her that that wasn't likely to happen I don't have many severe lows but it's always a possibility) And it's not like I'm a 2 year old and can't take care of myself but it is incredibly comforting when someone (competent) knows,it takes off some of the burden of trying to handle diabetes & school perfectly.There is wiggle room,in both parallel universes.

And then I felt truly better-and more then ready to chill out for the next week.
(Spring Break starts NOW,woohoo!)

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Apple to Apple(s)

2011-03-11T17:38:00.001-04:00

Thursday,March 10, was another great moment in the history of Apple.It was the day this debuted....

http://ow.ly/i/93DB/original

and I happily gave up my unlimited data plan(well,not happily,but accessibility trumps having so much data that you don't use much anyway.)

Personal Hotspot(created by my iPhone) accommodates 3-5 Wifi enabled electronics on that network. We don't have Wifi at home,& attempts to create one have been unsuccessful(my husband has forgotten/claims to have never created a certain core password & it hasn't really been worth the headache or $$$$'s to get a professional opinion.)Now I can run my iPad (or upload camera, or anything) off it.(instead of having to go to school/someplace with Wifi). It's much easier to blog from an iPad then an iPhone. (5x screen? and I can use my Bluetooth enabled keyboard,which is still in the box from my birthday package!) There is a data cap of 4(GB) which I will probably exceed & have to pay the overage charges,but perhaps not.(I never came anywhere close on just my iPhone usage) When I called to activate it,the phone tech in the iPad dept. had no idea what I was talking about & insisted it couldn't be done.(it's like she hadn't gotten the memo that Hotspot was debuting that day) I gave up,hung up,and rebooted the iPad and voila,it worked.I can also use my iPad to review lectures from the comfort of bed(I don't care what the instructors say,bed is an excellent place to study) which I couldn't do before.

Best Apple update EV-ER.(barring the giving up my gold star unlimited service,but being AT&T,of course they were going to pull something like that. If Verizon ever gets to the point of similar options (& my contract runs out) I would consider switching.)

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The Middle

2011-03-09T19:30:00.002-04:00

In three weeks,there is a plan. That plan involves 80 new white-jacketed,scrubs & gear clad nursing students to be unleashed among 7 healthcare facilities for the long-awaited "clinical" setting.

Frightening, I know. But before we get there,we have 2 classroom tests, 2 "oral competency head to toe assessments" another math test,an online test,and a week of Spring Break to survive. Quite frankly it feels like a lifetime away because if you fail at any step in between you can't go to clinicals and flunk ze course. The oral competencies must be completely memorized (you're doing an actual physical exam in front of the instructor) and the whole situation is a step beyond test anxiety.(multiple choice tests just don't compare) If you go blank,you're good and screwed.

But if you survive,you're awarded with a 1.3 week long "Spring Break" (some of which will be spent studying,still,it will be nice).And when you come back,get involved in real live patient care...it's just a hop and a skip away till May,& you'll get a break for good.(for a few months)One Semester will be done...3 more to go.

I can do this.

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The Not-So- Magical Express

2011-03-04T12:39:00.001-04:00

Somewhere between the intersections of Ketone Valley and DKA Junction, the grand 'ole Diabetes Express made an unscheduled "pit stop" at 3 am last night. It could have been the fluids situation(getting extraordinarily low) or something else. All I know is,it sure felt like all of that. I was hoping the parchment-like thirst wasn't anything critical but the line on my Dexcom revealed a 3 hour spread in the 300+ range & there would be no "ignoring it." Fingerstick revealed a 355 mg/dl.Out came the emergency syringe(I do not mess around with bolusing in such situations). Something had obviously failed big time,but I was too brain dead to fix that something. My blood cells were bathed in glucose,& my "super system" circulatory system felt as sluggish as the Washington Beltway on a Friday afternoon.My kidneys were having their heyday,as my lungs also worked overtime to get rid of the poisonous CO2 accumulating,compliments of the ketones. I felt like a giant prune,& going to sleep never felt so easy but in that moment,there was still a chance to turn The Diabetes Express back to the sunnier (& cheerier) land of Euroglycemia. Chugged two cups of water to chase the ketones,& crawled back in bed.

(down to 201, & non-existent ketones)
Today is another day.(& one that fortuently doesn't require going to school.Youngest brother is getting married today.) Being hit by the Diabetes Express takes a day or so to really recover.(it's amazing how fast you can get into trouble & how long it takes to feel human again)

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Diabetes on Demand (Disclosure)

2011-03-01T16:03:00.007-04:00

"Who here has diabetes?"

Those were not words that I EVER imagined coming from any instructor's lips, let alone the department (semi) head. But flow they did, in response to another student's inquiry on a diabetes-related topic.

"Oh, I do, I do, I do!I got it when I was 16.5, which isn't as sucky as some ages to be diagnosed because you can take full responsibility for your disease,and can wield a needle like a pro, but still,the only good age to get diabetes is age 86(or whenever you're in your final illness) when you don't really care that much because you're nearly dead..."

(Wait a second. What am I about to DO? I'm about to tell a group of people (of which, 50% will probably turn out to be food Nazi's and hound me relentlessly for the next 1.5 years (till graduation) about how I should manage "my" diabetes. They don't need to know. This is a teachable moment,but it is not "my" teachable moment. There are 30+ people in this room & my not saying anything,will not forever influence/ruin their careers.) And so my hand(burning with the urge to go UP) stayed down.

"Some of my student's in past semesters have diabetes,and have better perspectives on that (various diagnosis ages) then I do."

I thought about that, and while it's certainly up to the individual in question whether they want to share that I don't think it's something an instructor should be asking the class. That's an extremely personal question. I have diabetes,and at this point only the disability office knows it because they're the only ones who need to know. It still feels a tad weird though (the amount of candy that flows through this class is like being in kindergarten)like you should say something (about why you're not chowing it down like the best of 'em). Nothing against the candy in question, it's usually my blood sugars that I don't want to chase for the next 6 hours. Regarding different diagnosis ages,things are very different when you're dx'd at 6,16,26, or 60. But at every age, the patient can be involved in SOME way. (6 year olds are very smart & can get concepts before adults do) Being dx'd at 17, my childhood was D-free and candy was candy.(not something to be fought over, or something that would kill me.) I didn't have major food issues because I was diagnosed in the age of carb counting(and we always ate pretty healthy, so no changes there either)Getting diabetes is so much more then "anxiety over insulin injections" such as the examples in class are portrayed. It's more like anxiety over hypo/hyperglycemia/blindness/stroke/heartattack/kidneyfailure/amputations/neuropathy/foodbattles/dating/marriage/childbirth/job/healthinsurance/bloodsugarswings/earlydeath etc.etc.etc. I guess they choose that (as something that the nurse can actually "do" something about.)You can't dive forehead deep into something, you've got to take it by degrees.

On the plus side,I've survived three tests,a math test,a presentation,and a paper (with mostly A's) so I'm not just surviving,I'm doing pretty darn good. Switching to disability accommodations in the testing center was a really good idea.(less stress,lower bgs,and the slightly extra time have really improved my test scores)I should have done this a long time ago.

The Most Awesome Thing

2011-02-23T16:59:00.003-04:00

I've thought about this, and the vast majority of the stuff that I've done with diabetes is just general life stuff. Or, as a direct consequence of chronic disease. And I feel like (life-wise) that I'm JUST getting started (on the grand and glorious degree seeking, family, etc. Things that one could feel pride over,I can't really yet.) Jobs I've disliked(but stuck with for the insurance)...surgeries, hospitalizations, research studies that no sane person would ever subject themselves to, vacations spent at FFL(etc.) No one really wants to hear THAT. (yeah, being alive is a pretty major accomplishment but its often because of D, not separated from it) I have gotten married, stayed married (thus far),moved out on my own (for two years-before getting married), bought three cars,and self-sustained myself without having to file for bankruptcy (so there's that).

But there was one time that I did feel like an advocate for type 1's everywhere...when I went on Fear Factor. (I won't repost it here, but you can access it via the link) That really got my adrenaline going..& although I didn't make it very far,it helped me get over the "type 1's can't do things of that nature" mind-block. Type 1's (or 2's) can do whatever the heck they want,and even WIN. (see also, The Amazing Race winners, one of who has type 1) I would love to be on another game show (of that nature) if the chance presented itself. (I tried out for Jeopardy once,and almost made it past the first draft, was off by about 2 questions.That was a level of stress far beyond jumping off a building.)

“This post is my February entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/introducing-the-dsma-blog-carnival/“

The Blood Sugar Diaries

2011-02-19T17:54:00.001-04:00

"How's your blood sugar?"

"What's your blood sugar?"

"Have you checked your blood sugar today?"

"What's your blood sugar generally range?"

I've gotten alot of that lately,& quite frankly,it's driving me up the wall. Quite frankly,there is never a time where the PWD cannot think about their blood sugars and today, I may be 300, tomorrow,30. The health care providers in question aren't asking you your latest a1c...they are asking you,judging you, on your blood sugar at that very minute. An hour from now it may be a whole different story. Not to mention they don't plan to do anything about it. (except label you "noncompliant" & "out of control" anyway) In nursing school, the label non-compliant is tossed around every three sentences anyway...& most of the time,gets applied to the patient with diabetes. It is an actual nursing diagnosis and you HAVE to use it. Words cannot express how much I loathe that term & how it is a cop out for figuring out what us really going on. At some point, I will write a paper on how that term needs to be abolished.
Anyway....back to the blood sugars.Why is that a topic that gets zero privacy & always gets asked?(I get that they need to "know" it but other sensitive topics,like "how many times have you pooped today?" could be construed in much the same light.And docs don't generally ask THAT.) I am really tired of talking about,discussing and dissecting and digressing and dealing with the topic of blood sugars. Yes,I do it everyday...it's my life.And yes,I do consult my Endo/Diabetes Educator on occasion. But everyone else (in the health care field,& the diabetes police) get on my nerves.(not the online community,they "get it" & I dint mind discussing online) I guess that's why I haven't been to a pump group meeting in forever because even there it tends to get a bit grilling. They all have a1c's in the 5's and 6's and are a tad unbelievable. (not that they aren't nice,but they are just in a totally different world) I need to hang out with REAL PWD. People who forget/leave their pumps at home,who have eaten themselves from 40 to 400 and will admit to having done so. People who don't claim to be perfect.(I also need to to figure out a better answer then "kindasortofnormalrange" which tends to produce blank looks & even more grueling of the blood sugars.) I guess I just hate that it's not considered private at all...& while I'm the one who manages it,the peanut gallery can still have their say about how much better I could be doing. (much like backseat drivers telling you how to drive a car)

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Casualty: 1900's (YouTube)

2011-02-16T09:27:00.006-04:00

My latest tv show addiction. As I don't live in the UK,I just found out about it.(via Amazon Video on Demand) It's kind of like "ER" (early 1900's style) It was a totally different world..gloves were used only during surgery & nurses weren't allowed to get married.(they were married to their jobs)People died routinely of infections,(staff caught them from patients) there were no antibiotics. (they did practice isolation techniques but weren't very effective at containing outbreaks)
Regretfully, it only had two seasons.(and I think that's all it will have) I've finally figured out that the English title sister would be a charge nurse in the US. (see also: My Experience in an English Hospital)I guess some hospitals still go by those titles.(if not all) This show is like crack cocaine,it's got the doctor/nurse romance, the spurting blood,the women's right issues,and pretty much everything a good medical drama should have.And it's primarily from the nursing student (aka "Probationers") point of view so it's really interesting seeing how that differs from nursing student's today.(and yet,so much is the same)I highly recommend watching them all, if you enjoy things of that nature.

Veni, Vidi, Vici

2011-02-10T17:55:00.005-04:00

I studied.

I came, stowed all beeping electronic devices in my car,and walked into the classroom with a roll of glucose tabs in my pocket.

I(along with the rest of the class, row by row) came up and stored every possible physical belonging AT THE FRONT OF THE CLASSROOM NEXT TO THE INSTRUCTOR'S DESK.(it was like being in Kindergarten,the only thing you were allowed to have were 2 pencils(which must be non mechanical) a sheet of paper,and your test/scantron.)

And I took the test.(under meter/blood sugar anxiety)

And I went back out to my car,grabbed my meter,and tested 325 mg/dl, 1 hour and 30 minutes later.

I really,really, really need those accommodations..its one thing worrying about the test(I shouldn't have to worry about my blood sugar too). I'm not that likely to go low-I just need the freedom to be able to check(and adjust) at will. It's very obvious that I need a cranked up basal rate(and possibly an adjusted mealtime Insulin/Carb ratio as well) One test passed(grade wise)and yet it most definatly wasn't a success, diabetes wise.One Stress-a-thon seriously shoots the whole day's numbers to pot.
Still waiting on the paperwork from my Endo's office,(for the accommodations)and it looks like I'll have to take another test in much the same manner.(before it all gets straightened out) I also don't know exactly how the accommodations will play out-perhaps I'll have to take my tests in the testing center.

YouTube: Study Skillz

2011-02-09T13:34:00.005-04:00

Love this video!!(it captures well the amount of knowledge flying around that you're expected to learn/apply/regurgitate on command)

Owner of a Broken Brain

2011-02-04T22:25:00.001-04:00

I'm studying this weekend for a test...my first of many. It mattereth not that it is Super Bowl Sunday, & it mattereth not that I have a horrendous cold/simultaneous monthly occurrence (sorry for the TMI,it is what it is), & it mattereth not that there are also next week's classes to get ready for..somehow I have to stuff 3 weeks of knowledge into my already stuffed-up head. I have to meet with various advisors as well.(next week,it's still really overwhelming)There is no time to be sick-if you miss 2-3 occurrences, you will fall so far behind that they consider you not able to keep up with the program & kick you out. It's scary,& simultaneously annoying. (if I have infected the entire lab group/instructor with my 7 hours of sneezing,sniffling,nose blowing,& coughing, don't blame me. I didn't mean too but you can see why I can't leave) I am still very overwhelmed & I'm pretty sure that feeling will be sticking around awhile.(keep swimming,try not to drown)

And last Saturday's run to the cupcake shop/JDRF summit sadly did not extend it's happiness into this weekend...my husband ate the last one today.Was extremely good while it lasted though.(loved,loved,LOVED the peanut butter frosting one)Cupcakes rock. The JDRF Summit was excellent as well.