Tuesday, April 26, 2011

my endo appt

The day had finally come...the endo appt. I was dreading. My last appt. didn't go so well. I knew my A1C was on the rise, but my last visit left me upset with an 8.1. Yikes. How did I let it get that bad? This is coming from someone who faced my diagnosis head on and brought it from an initial 12.8 to under 6%. I know I have to let that go and just work harder to bring it back down, but it's hard not to be disappointed in myself.

So today I went in fully expecting it to be the same or worse. I am still surprised by it...a 7.4. Now that is in no way ideal, but it's much better than an 8.1. I told her my numbers still weren't great and I feel like I'm hovering in the high range more often than not, so I didn't understand the drop in my A1C. I explained to her how I stay high after meals and I think my ratio needs changing, so I went from a 1:15 to a 1:12. It was weird to see all that extra insulin on board when I bolused for lunch...I don't know why, but it makes me nervous when I have more than 4 or 5 units on board. I also lowered my sensitivity since my correction doesn't seem to be working very well either.

I sometimes wonder how my stress level affects my blood sugar. My job is somewhat demanding...and there are lots of deadlines. I like being busy and being challenged, but I don't think my body deals well with any kind of stress. I unknowingly tense up! There was even a point when my blood sugar used to drop soon after leaving work, so I knew stress had to be an issue. But how do you measure stress? I guess when your hormones are out of whack, all you can do is play around with basals.

I'm happy about my lower A1C, but I still have a lot of work to do!

Monday, April 25, 2011

Arm sensor fail

After riding out my sensor for about 9-10 days and once it refused to find the sensor any more, I decided it was time for the ARM SITE. I asked my boyfriend last night if he would help me because I couldn't do the whole thing one handed and he agreed. I explained to him what I was doing as I prepped the inserter, and then I handed it to him and tried to explain his part. I'm not very good at explaining how to do things, so it wasn't going so smoothly on my end, but then he decided to just go for it. It stung a little more than usual and then proceeded to bleed. A lot. I had a sneaky suspicion it wouldn't do well with that much blood in the beginning, but I decided to wait it out and see. After 15-20 min., I had him connect the transmitter and then put the tape on. I have to admit, it was kind of fun to see someone else do it. He thought the needle was huge, btw! I actually don't think it looks that scary anymore, but I agree it does look big at first. And intimidating. And like it hurts.

Well, all night, I was VERY aware of the sensor. I could feel it every time I moved my arm and it also kind of hurt. I was looking in the mirror when he did it and I am the one who told him where to insert it, but I'm thinking it wasn't quite in the right spot since it bled so much and hurt. I'm used to having it in the fatty part of my stomach and not even knowing it's there! Before I went to bed, I glanced at it and thought it was even coming out a little, which makes sense since I move and bend my arm a lot more than I do my stomach or thigh. This is the part I don't understand...how does it stay in your arm so well? How are you not aware of it with every movement? The first couple readings were right on with my meter, but in the middle of the night, the sensor was weak and lost. I decided to take it out, and my boyfriend was nice enough to clean off the dried blood. I was a little grossed out, but he seemed to handle it fine! I'm looking at it for the first time just now and saw this lovely little bruise. I told my boyfriend not to feel bad and that it probably wasn't in the best spot. Any suggestions from the DOC on how to do arm sites? Best areas? Bad areas? For now it's back on my stomach...

Thursday, April 21, 2011

switchin up sensor sites

I'm tired of the so-so readings I get with my sensor on my stomach region. Sometimes it's spot-on and other times it's way off. I don't know about you all, but my sensor seems to get itself lost at least once a day, if not more. Not sure how this happens, but it's somewhat annoying. I've been reading some posts with people having success with arm sensor sites, so I tried to do that last weekend. I reached back, found a spot, clicked, inserted and....um...how do I pull this thing away now? Needless to say, I did not succeed and ended up pulling out the entire needle. Ouch!

I decided to go with somewhere more reachable and inserted it into my outer thigh. I thought, briefly, about putting it more towards the butt area, but the thought of it accidentally hitting the toilet or being anywhere near the toilet grossed me out. I can be a germaphobe sometimes, even if it's not totally logical. So I went with the outer thigh area and it's been working pretty well for me, but I'm still itching to try my arm. I told my boyfriend that I wanted to try this and that I might need his help inserting it, but that I would do most of it and it would be easy. No big deal, I said. Part of me wants to see if he'll handle this okay or if he will be uncertain and squeamish. I'm not really sure how he is with seeing needles or the thought of inserting a needle. He doesn't have to do much though...the only thing I can't manage to do is pull the inserter away. I still find that thing a little intimidating! Not the needle part, but holding down the little sensor and pulling away the long inserter that seems to have a good grip. Also, I feel like every time I take the sensor out, it's a little bent, which makes me worry that I'm not doing it right, but I don't know how I'd be doing it wrong.

Any tips for how to do an arm site? Is it even doable on your own?

Wednesday, April 20, 2011

where do you store yours?

When I was on shots/injections/whatever you wanna call 'em, I kept my insulin pens and cartridges in the fridge. When I went on vacation, I made sure the hotel had a mini fridge to store my insulin. At some point, over the years, I decided there was no point in keeping my insulin cold. I didn't think it had any affect on how effective it was, but now I am second guessing this. When my pump malfunctioned last year, I had to go back on shots for a few days. I was so not prepared for that, but I had tons of insulin pens in my parent's fridge, so I figured I'd be okay. Even though it was expired, I figured it would be safe and it was along the same lines of the FDA saying your sensor should be changed every 3 days. The injections seemed to work out fine, although it felt weird to be back on them, and my blood sugar was good during that time, so I can't help but wonder if it was because I had kept it stored in the fridge. This goes back to me trying to figure out why my humalog worked so wonderfully that first week, and then seemed to give up. I'm sure there is more to it (this is where me keeping a log comes in handy), but I still can't help but wonder...does keeping insulin in the fridge vs room temperature make a difference?

I'm trying to keep a log this week, especially since I'm seeing my endo next week. I think I need to make some insulin changes. I ate a bowl of cereal this morning (24 carbs) plus milk (9 carbs) = 33 carbs. I do 15:1 right now, so I bolused, waited maybe 5 minutes or so and then ate. I actually bolused for about 3 extra carbs because I thought I was going to have the full cup of milk, but only had about 3/4. If you're wondering why the carb amount seems low on the milk, it's actually a whole grain "milk" from Trader Joe's. As usual, my sensor showed me spiking up to the 300s and then started to drop around the 2 hour mark. I decided to wait a full 3 hours before testing my blood sugar and it showed me at 246. Not OK! I had only 0.4 units left so I needed a correction of 1.1. If I need a full unit to come down, it seems like my ratio is incorrect, right? Or maybe that's how it is for cereal? So many factors to consider!

Thursday, April 14, 2011

the magic has worn off

I didn't intend to take a little blog break, but it happened. Busy at work, busy (well, busier) social life, and diabetes has been just kind of "meh" lately. My blood sugar hasn't been that ideal...when I changed to humalog, those first few days were excellent! It was almost like my body was like...hey, new insulin, I remember you. I liked you! I'm so glad you're back! I'm going to figure out everything for Val so she doesn't have to work too hard. And then...womp, womp.

I know it sounds strange, but I seriously feel like that humalog worked some magic those first few days, and now my body recognizes it and doesn't think it's so special anymore. Also, I see my endo in a couple weeks and I fear my a1c (which has already gotten to a not so ideal #), isn't going to be any better. If it's worse, well, I may cry. I'm not really in love with my endo though, so it may be time to find a new one. Last time I went into her office, she made me feel slightly bad/guilty for having a number in the 300s. I've never been that high when I go in there, but I had stacked a couple meals and she said it didn't matter...that my blood sugar should never be that high. She also has this weird way of "joking" that I don't really find funny, like when she commented on the fact I had gained 3 lbs since the last time I saw her. Ok, lady, I don't think that's too big of a deal...doesn't your weight FLUCTUATE up to 5 lbs. a day anyway? She wasn't saying it matter-of-fact either, it was more of a "joke" with the feel of a warning behind it...like, hey, you're gaining weight, fatty. I don't know...it's hard to explain.

I went off on a tangent there...all I was going to say was that I think I'm going to ask for apidra when I go in next, and somehow all of that spewed out. :)

Even though my numbers aren't so hot, I have been feeling better overall, and I think that has helped improve my mood. I haven't been too mad or down about diabetes, even with those less-than-ideal numbers. BUT, after reading some other peoples' posts, I realize I have really stopped bringing my A-game. I really need to figure out why my blood sugar isn't so hot anymore...duh, less exercising, more grazing, less paying attention to the reasons for why it's this way. But ya know, I need to look at the nitty gritty details of it all. So, I have to start a food log...I really do. And I have to keep it up.

On a more positive note, I have a bunch of friends coming into town this weekend, which is a coincidence, not a planned thing! My friend's bday was yesterday so we're celebrating this weekend/having a mini reunion with our friends who are visiting. AND the best part is I'm taking a half day tomorrow and taking Monday off. Yay! I really need a mini break from work. Hopefully the weather is nice this weekend, though I don't have high hopes. Weather.com said something about it being in the mid-50s and didn't show the sun coming out until next week. Hmph! AH well, I am used to it, I guess, though I think the Pacific NW has been crummier than usual lately and I can't wait for summer to get here.

Happy almost weekend, everyone!

Monday, April 4, 2011

please don't be a fluke!

Quick post because I am at work and reeeallly busy, but I HAVE TO BLOG ABOUT THIS (mostly for myself).

Yesterday, I talked about humalog vs. novolog. This morning, I had a breakfast that I eat pretty often...gave myself the normal amount of insulin and didn't really wait to eat. That was a couple hours ago and I am getting a teeny bit hungry for a small snack, so I decided to check my blood sugar just to see where it's at 2 hours after breakfast. Here's where I do my happy dance.

91! It has honestly been so long since I've seen a "good" number 2 hours after a meal. I've had so many spikes that I haven't been able to tame and usually my # 2 hours later is closer to 200...this has been going on for SO LONG that I cannot remember when I've had such an amazing number after eating. Yes, I am gushing, and yes it is kind of a weird thing to gush over. Again, it may be due to me being more active this last week, but I can't help but wonder if my body/blood sugar is reacting better to the different insulin.

Anyhoo. Having this happy moment is a nice change from the frustration of seeing a higher # than I'd like. It's a nice change from scowling at my glucose meter and muttering a "wtf" in my head. And I feel like I deserve a happy, "yay me" moment to negate all the terrible, unhappy moments I've been having lately. Time for a snack!

Sunday, April 3, 2011

humalog vs novolog

I've had better blood sugar #s the last two days and I'm wondering if part of the reason is my switch back to humalog. When I first started on shots, I started with humalog and it worked well for me. Soon after I started getting my pump supplies through a medical company, they told me the only kind of insulin they could cover and ship was novolog. I was hesitant to switch, but my endo told me that insulin is pretty much the same...they all serve the same purpose, so I decided to switch to novolog because it was easier to get a 3 months supply and not worry about getting prescriptions and going to the pharmacy.

I don't know if it's a coincidence that I've had a harder time managing my diabetes since I switched to novolog...I am in no way blaming it because I know the bigger issue was me becoming more lax with my diet and not working out like I used to, but I've noticed these last 2 days have been a lot better for me. I haven't waited 15-20 min to eat; it seems to kick in right away whereas with novolog it seemed like I needed to wait a while for it to make a difference. But, I've also worked out 3 times this week, so I'm sure that helps a lot. I'll have to wait a while to see how my numbers are over the next few weeks, but it may be that humalog just works better for me. And if so, I want to kind of kick myself for ever using novolog!

I tried apidra once, but I don't remember how it worked for me. Now I'm curious what other people use and how it works for them. I never really thought about it until my insulin from the medical company finally ran out (as of last year, they no longer ship insulin). I didn't even think about having my endo write a prescription for insulin so that I could stockpile it, but oh well. My shipment lasted a long time, and when I was down to the last bottle, I decided to have my endo write an Rx for humalog.

This post is kind of boring, but I guess that's good sometimes. My numbers have been good, I worked out more this week than I have in months, and I am feeling a lot more positive! Nothing bad to report at the moment. :)