Monday, October 24, 2016

Me + T1 Diabetes+ Weight Gain+ Insulin Resistance + Metformin ER =

A little over two years ago I started gaining weight - and no matter how much I walked, rode my bike, counted carbs and kept an eye on my plate - I kept gaining weight. 
Some of my weight gain was due to me no longer having the metabolism I once had. 
Some of it was due to several rounds of cortisone in the form of shots ( thank you trigger fingers and CT,) and orally( I had a nasty upper and lower respiratory infection in May of 2015,) and the weight that cortisone brings to my person, 
And some of it was due to yours truly developing a resistance to insulin - which I'd had for a while, but which was now dialed up to 11. 

YEP, not only do I not produce insulin, hence the whole, me being a t1 since I was a little girl, but I’ve also become insulin resistant - which I’m told happens after decades of living with type 1 diabetes. YAY ME!

Another signature Kellyism - cortisone tends to sticks to my body for months at a time, requiring me to shoot up a ridiculous amount of insulin for weeks and taking months and months to get back to my regular basal rates.

I’ve figured out the cortisone/insulin dance like Rockstar and I’m not afraid to increase my basals to maintain great blood sugars on cortisone - but I hate that cortisone sticks around in my system for so long. 

But enough was enough and last fall and I started walking between 9 and 15 miles a week - and the damn scale kept going in the wrong direction - and my A1C barely budged. 
And wasn't like I was eating Ben & Jerry's every night - I wasn't. 

Gaining weight and working so damn hard to lose it without success made made me frustrated and depressed. 
On March 15th, 2016, I went to my endo appointment and Dr. J and I had one of our heart to hearts -  I was having hand and wrist surgery in May and I didn’t want to gain any more weight while I was recovering. 
Dr. J mentioned Metformin ER, I mentioned my hair and my fear of losing it. 
Sidebar: The last time I'd given Metformin a try was in 2008 - and I noticed clumps of hair on the carpet. Even though I'm a shedder when it comes to my hair - the clumps on the carpet were beyond normal and I stopped taking Metformin.
And my hair stopped falling out in clumps.

And then I started to cry. 

And Dr. J was great - he told me that we could try some injectables, but that because I was t1, my insurance most likely would not cover them. 
He told me that Metformin ER was different and better than regular metformin - and that price wise, it was cheap. 
Dr. J also felt that it could jump start my metabolism, and it didn’t have to be permanent.  
So we made a deal - I would go on Metformin ER ( Metformin Extended Release - different form the regular metformin I’d tried 8 years earlier,) and if my hair started falling out, I’d stop, ASAP - and Dr. J and I would go to/create plan B. 

I drove home, picked up my RX and started my first round at dinner. 
Sidebar: On March 16th, I received a cortisone shot to pop a ganglion cyst on my palm - I convinced the Dr. to use 1/2 the normal amount of cortisone and twice the amount of saline. The cyst was popped and my blood sugar was only elevated for two weeks.
And on March 20th I tore my quad muscle - and it hurt like hell.  

But back to the Met ER - the first few weeks on Met ER, there were rumbles in my belly for sure - but nothing I couldn’t handle and not nearly as bad as when I'd tried regular Metformin back in 2008. In two weeks the rumblings subsided for the most part.
I also noticed that Metformin ER made me feel fuller, quicker. I’d forgotten about that side effect. 
I travelled for half of April and by May 17th (the day of my hand and wrist surgery,) I’d lost 4.5 lbs. 
By July I was down 9 lbs and I didn’t gain weight while I was in Florida attending Children With Diabetes Friends for Life - and yes, there were some nacho and margarita moments in Florida. 

On July 17th I went back to my Endo - while my A1C had only gone down by a fraction (thank you nasty sinus infection that stayed in my system from late June through mid July,) my labs were great, My weight was down by 9 lbs and my Endo was thrilled. 

Dr. J increased my Metformin ER to 1000 mgs, twice a day and told me he was proud.

The increase caused my stomach to react and the rumblings returned, but were gone quicker the second time around.
In August I bought two new bathing suits - including a red one that made me feel like WonderWoman!  

September rolled in and I was 12 lbs down - and according to my hair dresser (who is also a dear friend, brutally honest, and always has back,) the hair on my head is staying put. 
Sidebar: I take daily biotin and B12 supplements because biotin promotes hair and nail growth and if your b12 is low (which can be one of the side effects of Metormin,) your hair will fall out. 
As of today - I’ve lost 14.5 lbs and my daily insulin intake is down between 9 and 15 units- steadily decreasing in increments since March. 
The most recent insulin decrease happened a few weeks ago, when I started noticing that my daily, 24 hour pump totals were in the mid 30’s. 
5 days in the mid thirties range, followed by a bump up of a couple days in the 40s and then back to the mid thirties. YES, there were a couple middle of the night, kick my ass lows (and one nasty high,) while I readjusted my basal rates. But I did what I had to because that's what people with diabetes do. 

Tomorrow is my Endo appointment - I’m hoping for good labs and a decrease in my a1c . 

And whatever happens, happens - I'm going to keep moving forward. 

Monday, October 17, 2016

Diabetes Tell: Tired, But Can't Sleep.

After two weeks of for the most part - beautiful blood sugars - with some lows spattered in just for diabetes shits and giggles, I knew that diabetes would hit the fan sooner rather than later - I just wish it hadn’t hit the fan in the wee small hours of Monday morning.
So am I the only one who can’t sleep when their blood sugar is starting to rise? 
OK, let me rephrase that: Am I the only one who goes to bed sleepy, but can't actually go to sleep because my blood sugar is unexpectedly/unknowingly rising? 
I’m sans CGM so it’s a good thing and I’m not complaining - OK, I am complaining, but  only because I’m in need of sleep and there’s only so much caffeine and water I can drink without my bladder exploding. 

I think it’s a little strange (and by strange I mean WEIRD - but in a good way,) that unexpected rising blood sugars in the middle of night - for the most part, don't allow me to reach full REM sleep - and FORCE me to check my blood sugar. 
 WEIRD, because normally high blood sugars make me tired and all I want to do is sleep - except when I’m actually trying to sleep. 
GOOD, because I’m so damn thankful that I have this as one of my “diabetes tells.” 
Here’s what went down and hoping you can relate: 
Last night’s dinner began with a beautiful bg of 91 and low in carb deliciohsness to boot. Things sailed smoothly - I checked two hours  after dinner and I was 160 - PERFECTO... until right before bed when my bg was 206. Not a big deal - I corrected and was ready to hit the sack by 11p.m.. 
Cut to 12:50 a.m. and yours truly tossing and turning. I finally grabbed my meter off the nightstand and checked - I was 220 and my less than 12 hour old site hurt. 
I didn’t feel like changing it out, but I did - and I gave another correction. 
Cut to 2:40 am and me still tossing and turning. 
You guessed it, I checked my bg AGAIN - and it was 269. 
I gave my self another correction of 1.8 - which was interrupted half way through by my insulin pump’s occlusion alarm.
YES, I STARTED TO PANIC, but I was too tired to actually FREAK.
And I silently reminded myself that I would have most likely slept through the occlusion if I hadn't been unable to sleep - YAY ME. 
I did the whole prime/rewind thing and the alarm went off, AGAIN. 
Tried a new battery and prime followed by rewinding a second time - same thing. 
My reservoir had been filled Sunday morning - it couldn’t be my insulin - maybe it was the tubing? I changed out the pump’s tubing and and it worked like a charm.
Then I finished the previously interrupted correction bolus - my head was a bit hazy on the math - I literally had to do the calculations with a pencil before I bolused. 
Then I waited until until my bg was going in the right direction before closing my eyes at 3:30. 

My alarm went off at 7 a.m., I hit the snooze button twice - thank GOD my coffee maker has a timer! 

This morning started off with a bang, followed by a 7a.m., bg of 155. 
After the early morning high blood sugar/occlusion escapades, I was more than cool with that number.
Monday was certainly a Monday from the get go - but things got done, blood sugars have stayed in range since 3:30 a.m., and I haven't once asked: IS IT FRIDAY YET? 
But I have asked for more coffee~ 

Thursday, October 13, 2016

My "Diabetes Back In The Day," Article Is Live On T1EveryDayMagic.Com !

A few months ago, the folks at T1EverydayMagic reached out to me about writing a “Diabetes Back In The Day,” article for their website. 
I was excited and proud that they asked, I’ve lived with diabetes for almost 4 decades (gulp,) and the way we treat diabetes has changed tremendously -and for the better! 
For instance and sidebar: Back in the day, we didn’t have a Lilly/Disney character called Coco the Monkey who lived with T1 diabetes! 

Going down memory lane re: my life with D, reinforced how far we’ve come in terms of diabetes tools and management. 
Diabetes is hard work - everyone single one of us living the diabetes life knows that. 
Technology is key to managing out diabetes, the D diet has become so much more user friendly over the years, and as you and I know - support makes a huge difference - THANK YOU DOC!

 Today being Thursday, as in #tbt, my article is the #tbt post on T1EveryDayMagic's Facebook page.  
Here’s the direct link to my article on the T1EverydayMagic website.
Please give a read and hope you can relate, feel free to share the post with others if you're so inclined, and thank you in advance from the bottom of my busted pancreas!

Also, be sure to check the 70s kitchen pic of my sister Debbie and I, featured in the article. I love that picture of her so much. 

 And take note of the super deluxe ponytails yours truly is rocking!

Tuesday, October 4, 2016

When Diabetes Burnout Enters My World

I originally wrote this post for back in 2014 and it's one of my favorites. Diabetes Burnout happens to the best of us because we live with it 365, 24X7 and it's hard offing work.
I haven’t had a day off from type 1 diabetes in over 14,000 days. Not once in all that time have I received time off from diabetes for good behavior, vacations, family weddings, funerals, etc.  
I’ve accepted that I will never have a day off from my diabetes unless they find a cure, and I do my best to live a great life – and have a great life with diabetes.
But like every single person living with diabetes and regardless of the type, there are moments (sometimes extending into weeks,) where I deal with Diabetes Burnout.
Living with diabetes itself is a never-ending full time job:
The continual blood sugar testing, battling insurance companies to cover the insulin that you require to live. Counting of carbs of absolutely everything you put in your mouth and the anxiety of doctors’ appointments & the lab results that accompany them. Insulin pump tubing getting tangled in doorknobs and ripping out my infusion site, just when I’m ready to go out the door.
The diabetes guilt that creeps up and then into my heart, just when I think I’m passed it. There’s the worry that’s always in the back of my head, and every PWD (person with diabetes,) head regarding both the present and the future.
My diabetes burnout comes in waves and not always necessarily when you’d expect. Sometimes it strikes when I’m packing for a trip and my diabetes supplies take up more room then I think it has a right to. And in those moments I wish I could chuck my Diabetes and my diabetes supplies out the window - BUT I CAN'T. So I acknowledge the frustration and forge ahead with a vengeance.
Other times my diabetes burnout appears right on queue and has lingering effects. Like when it’s 2 a.m. and I have to be up in four hours and & my blood sugar refuses to go down, even after 4 correction boluses and 2 site changes.
The same can absolutely be said about my blood sugar refusing to stay up – even after lowering the temporary basal rate on my insulin pump twice and downing 4 juice boxes in three hours and a fist full of glucose tabs.
In those moments of diabetes exhaustion, anger and fear, tears sting my eyes and I physically and mentally feel like Atlas – And it’s hard to shake off the diabetes muck of it all.
And there are days when I cry for those I’ve loved and lost to diabetes. People like my sister, my father, my two aunts, one of my best friends from Diabetes camp who passed away last year, and DOC family members who lost their battle with D. I think about them every day – And most times the memory of them makes me smile and gives me strength. And there are days when I cry for them and feel their loss so very profoundly.
Sometimes diabetes burnout occurs just because it can. On those days, I do what I have to when it comes to living with my diabetes, but I take extra care not to define myself by the number that flashes on my meter, and use it as my Diabetes GPS system - telling me where my body is and what direction it needs to go . 
And I’m incredibly lucky that I have an amazing diabetes support system when it comes to dealing with diabetes burnout.
I have my Diabetes Pit Crew. 
My amazing Endocrinologist and Certified Diabetes Educator who understand diabetes burnout and who treat it as a very real symptom of diabetes. 
A counselor who I can reach out and schedule some one-on-one time with, when I find that diabetes burnout is creeping into the picture of my life. I have family members and friends who are there for me whenever I need them.
And I have a strong and supportive community of people living with diabetes.
The Diabetes Online Community lifts me up during bouts of diabetes burnout because they not only understand diabetes burnout; they’ve experienced it, they "get it."  The DOC show's me that I am not alone in my life with diabetes and are always there for me when I feel as if I am. And thanks to my multi-faceted/tiered support system, I get glad again - and I am a lucky duck, indeed.

Monday, September 26, 2016

Diabetes Brain - 2016 Fall Edition~

Diabetes always has a way of creeping into other areas of my life like a weird word association game. Sometimes funny, sometimes not at all. Sometimes it makes no sense, other times, Diabetes Brain makes perfect sense. Also, I'm weird. 

1. Went to check the daily totals on my insulin pump this morning, instead I reached for my iPhone and punched in my security code, then sat there looking at the screen for 10 seconds before I realized I’d picked up the wrong device. TRUE STORY.

2. Whenever I look at food posts on Instagram and Pinterest, I immediately wonder the carb count, then I start calculating the carbs. 
Then I start to wonder about the fiber count and then I go down the diabetes, food pretty pictures, and fictional verses non fictional carb, rabbit hole.

3.Speaking of food. I recently realized I haven’t bought orange juice in years. 
Yep, totally D related and having to do with hitting the Orange Juice Wall when it comes to treating lows.

4. When I check into hotel rooms I automatically put my diabetes low stash on the nightstand. 

5. Sometimes when I’m in the middle of a conversation and fiddling with my insulin pump near a table or a counter, I check my pump, place it on said table or counter, and then go back to the conversation. 
And 9 times out of 10, when the conversation is over or I need to grab something from another room, I walk away and bungipumping ensues. 

6. Random but true: I kid you not, I cannot remember the last time I drank beer. 
Beer requires too much math so I stick to wine or vodka with club.

7. Lately I’ve started to throw out my used test strip as soon as I’m done with it. WEIRD. 

8. Sherlocking diabetes on the TV. 
Watched a rerun of Rizzoli & Isles a few weeks ago, even though I’d seen it before.
 It was an interesting episode because the murder victim had diabetes. 
D was not the COD, but the murder had an intimate knowledge of D
And even though I’d watched it before, I still felt let down when it became clear that the writers of R&I tried, but didn’t quite succeed re: diabetes reality as a plot line. 
Still, it was a good attempt. The episode didn't spread D myths or falsehoods, but they were off re: the actualities of living with diabetes. 
Seriously, what 30 something D adult female carries a log book and takes copious notes re: food and blood sugars every time she pricks her finger?  OR am I projecting? 
Also and spoiler alert: If someone secretly replaced the insulin in my pump with something other than insulin, I would have known something was up because I would have felt like shit because of high blood sugars and all that goes with them. 
Also, if doesn't smell like band-aids or scotch - it ain't insulin.
I would have tossed out the insulin in my pump - and I would have been correcting with injections after I switched out my reservoir. 
UNLESS....  what if hypothetically, R&I's victim ( a PWD, even though she's completely made up fictional character in a fictional television show, I'm still compelled to get into her PWD head,) was worried about throwing out the insulin/insulin imposter because insulin is so f*v$ing expensive? 
And now I'm down the diabetes as a plot-line, rabbit hole!

9. Speaking of insulin, the price of insulin and diabetes related supplies and costs keeps me up at night. This is nothing new nor is it even slightly amusing. 
It’s scary and it’s real and I know I’m not the only one who feels this way. 

10. Re: Smart insulins , (aka insulin with a brain) is on the horizon for those us who require insulin to live - and that's great - I'm all for having access, using and utilizing smarter, faster, insulin. 
But I struggle to pay for the "dumb insulins" that available to us now, so how the hell will I be able to afford the smart ones? 

Thursday, September 22, 2016

#TBT: Diabetes Life And Calling All Midvale Alum ~

Originally posted the following on 2.14.08, back when the blog was all sorts of new. 
As of late my life has been a series of occurrences right out of The Far Side cartoons and captions in real life, so I thought I'd revisit this post - Hope you dig.

OK - favorite"Far Side" pic ever!

The above carton reminds of me of this life of mine. 

While I'm an excellent dancer when the music is on, I'm a bit clumsy in real life...on occasion. Sometimes the blatantly obvious, is not so very for those of us who are Midvale alum.

For instance.....I've actually put my my pump battery in backwards and then wondered why "the damn thing wouldn't work!"

I've walked into, and almost through a screen door - with coffee in hand. No damage to the screen, but I ended up wearing my coffee.

I've put my test strip in the machine upside down and then wondered where the area was to place my drop of blood.

Once, in High School when I was deep in conversation with my 3 best buds, I actually walked smack into Stop sign because I was enthralled over my friends latest escapades, I looked at them instead of looking ahead. I don't know which hurt more, my head or my pride.

I used to give my insulin
 shots through my clothes to save time - andto secretly impress my friends. Of course, only when I was wearing white or some other light color, would a drop of blood decide to appear. Ironically it never once happened when I was wearing black, purple, or blue.

We all know about pump tubing and doorknobs. It's a global issue, nuff said.

I won't even tell you how I broke my arm a few years ago. Let's just say it involved preventing
 a cordless phone from falling down a flight of 16 steps - by blocking its descent at the top of the stairs,
I inadvertently caused myself to fall and ended up at the bottom.

We all push when we should pull at times, but we learn and move forward just the same.
It's very similar to dealing with our Diabetes. Just when we think we know it all about this disease, it throws us curve ball or two, forcing us to learn yet another set of rules regarding the Big D.
And we do, because we can....And because we must.

Monday, September 19, 2016

Fingers Crossed

I lift up my shirt and poke a round my abdomen with my finger - making sure the spot I eventually choose for my site change will be free of lumps, bumps, marks, redness and any weird tender to the touch. 
Real estate is slim on my belly and I must choose wisely. 
I find a spot that looks and feels right, grab the skin and slide the needle of the cannula in. 
This morning’s 11a.m. site change went in easy and as it did, I let out a sigh of relief. 

Sidebar: Sometimes I don’t realize how much and or often I hold my breath when it comes to diabetes related things, until I actually stop holding my breath. 

I filled filled the cannula and silently said, “fingers crossed,” - and then I tweeted that thought because I know I’m not the only one.  
Now all I can do was wait to see if it took. 
After 3 days of a damn near perfect site - this new site could work, suck at sucking up insulin, or be some strange hybrid of working and not all rolled into one. - what I like to refer to as a zombie infusion site. 

I’ve been considering (and by considering I mean that I keep telling myself that I really should and then completely ignoring what I said,) attempting an infusion site in my arm - the thought of tangled tubing makes me wince at the thought - but diabetes requires us to be brave and try new things because we must - and an arm infusion site is on the docket in the next few weeks, (first week in October,) like it or not. 

Current #Bgnow as of two seconds ago 180 - not terrible after a breakfast of lots of fresh pineapple,(pineapple tends to make me go higher in the mornings but I couldn’t resist,) eggs and 2 cups of coffee, and a site change mid morning. 
And so far so good, for now.~