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By shannon, March 11, 2010 11:15 am

As you all know, I decided to try Symlin again.  While its primary purpose is to help reduce those pesky blood sugar spikes I get after meals, the secondary (and perhaps *my* primary) purpose is to help with weight loss.  The unfortunate side effect is nausea. 

Symlin works by replacing the natural Amylin that, in non-Type 1 diabetics, is secreted by the beta cells of the pancreas.  It works by delaying stomach emptying, which helps you digest slower.  It’s also that little voice in your head that tells you when you’re full.  Since I am beta cell challenged, my body doesn’t make Amylin, which is why I often feel hungry even after a satisfying meal (= weight gain).  It’s also why my BG can easily spike to 300+ after I eat, which = more insulin, which = weight gain, which = insulin resistance, which = weight gain, which = well . . . you get the point. 

As it happened, George (a.k.a. Ninjabetic) also decided to start Symlin again.  He and I had very similar beginnings with Symlin, and we were both reluctant to try it again.  So, it’s really nice to be doing this with someone else who knows what it’s like. 

As you know, I started on Tuesday night at just 15mcg (the absolute minimum for a Type 1).  Yesterday morning, I skipped breakfast, so no Symlin.  Truthfully, I was feeling a little nauseated, and I wasn’t sure if it was from the Symlin or just general morning crappiness.  I was super-busy at work, which meant that lunch was upon me pretty quickly.  Knowing that I had a meeting at 1pm, and feeling the desperate need to get a home pregnancy test because my period is still MIA, I quickly ran to the drugstore for the test and Chick-fil-A for a salad. 

Back at the office, I peed on the stick.  Negative, which was no big surprise, considering . . .  Even still, I was disappointed and relieved at the same time.  After all, I’m taking meds that are not pregnancy safe (Lisinopril and now Symlin).  Still, it sucks to see that one lonely line on a pregnancy test time after time. 

Anyway, back at my desk, I dialed up 15mcg of Symlin and ate my lunch.  I programmed a 60-minute square wave bolus on the pod and watched Dex like a hawk.  Sadly, my BG began to spike within 30 minutes, and it went high (like mid-200s high).  Then the nausea hit.  I felt like complete shit.  It was weird because it was more severe than the night before.  As George, Scott, and I were discussing last night on Twitter, it feels like you’ve got food stuck at the very bottom of your throat.  I don’t know how else to explain it.  Whatever.  I wasn’t going to let this nausea screw with the potential benefits of using Symlin.

So, last night before dinner, I decided to up the ante.  I dialed up 30mcg on the pen and bravely took the shot (it stung, too!).  I ate my dinner (about ½ of my typical portion size) and waited for the nausea.

It didn’t come.  As soon as I finished eating, I got up and started cleaning.  Keeping busy really seemed to help.  My BG remained steady and under 150 mg/dl before dropping slightly.  I tested before going to bed and was 145 mg/dl.  Hearing Dr. S.’s voice in my head (he wants me under 100 mg/dl in the morning), I did a small correction bolus and went to sleep.

Sometime around 11pm, I heard a low BG alarm.  I grabbed Dex from my nightstand and saw that I had dipped just below 70 mg/dl.  However, a finger stick showed me at 75 mg/dl, so I didn’t treat and went back to sleep.

At 1:30am, Brian’s stupid on-call phone for work rang.  I woke up instantly.  A quick peek at Dex showed me still hovering in the low 60s.  A finger stick confirmed, so I decided to drink a very small glass of milk.  This was definitely the right thing to do.  I woke up this morning at 99 mg/dl (hey, it’s under 100, right?), and Dex showed a nice flat line all night.  I felt pretty good, although tired because of the phone call. 

I got to work, dialed a 30mcg dose of Symlin for my modest breakfast (45g of carbs).  I programmed a 30-minute square wave bolus this time to prevent any spikes. 

That was an hour and a half ago.  My current BG is 157 mg/dl, but it looks like I’m rising fast.  I’m going to keep trying different ways to get the most out of Symlin.  I am anxious to get up to the 60mcg dose, which has more weight-loss benefits.  But, as it is, I’m eating much less than I was, so that’s good.  I’ve read that some Type 1s are able to tolerate the 120mcg dose, which offers the highest weight loss benefits.  I’m going to shoot for that, but I’m prepared to stick with 60mcg if necessary.

Overall, this experience with Symlin has been significantly more positive than my last attempt.  It’s something I’m determined to stick with, so I’m not going to let a little nausea derail me.  I’m committed to losing this weight, dammit!

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By shannon, March 10, 2010 9:41 am

As I expected, my A1c went up.  I just didn’t expect it to go up *that* much.  For almost two years, my A1c has been below 7%.  It’s a lot of work, but totally worth it.

I admit that I rebelled a bit.  I also got lazy.  I was just so tired of the tight control and limitations.  I went a little nuts.  I have the weight gain and lousy A1c to show for it. 

All other tests were good.  BP was “excellent” according to Dr. S.  He also said that I’d *lost* two pounds since my last appointment.  This just doesn’t seem right, but I wasn’t about to argue.  He gave me a list of group meetings and events (read: support groups) for Type 1s and encourage me to attend.  I don’t know if I will – I admit that it would be nice to meet some other Type 1s in person, though. 

As I mentioned yesterday, I wanted to talk to Dr. S. about Symlin.  After looking at my A1c, Dex graphs, and logbook, his initial feeling was to further increase my basals.  Since I had decided that I was not going to let that happen, I needed to find an alternative.  See, *I* think my basals are too high as it is.  The highs I’m experiencing aren’t the result of too-low basal settings; it’s because I’ve been eating like shit for months and, more often than not, SWAG bolusing.  So, I’m high because I didn’t count carbs correctly.  Sure, I correct, but once I’m high, it’s so hard to get back down. 

Which, once again, led me to the Symlin talk.  I’d tried it once before and gave up after a few days.  I was told that it is not indicated for pregnant women, and since we were actively trying at that point (and blissfully unaware of our fertility issues), I decided that it was best to stop.  To be honest, I was not heartbroken to lose the awful nausea that accompanied it.  But, the thing is, I never really gave it a chance. 

In preparation for my appointment, I did a bunch of research.  I learned that the nausea goes away pretty quickly and that the key is to stick with it.  I learned that some people have lost huge amounts of weight thanks to it.  I learned that most decrease their boluses by at least half.  All of these facts solidified my resolve to give it another shot.

So, just before dinner last night, I dialed up the minimum 15mcg and gave myself the shot.  I ate my meal slowly (I did notice that I got fuller faster) and waited.  I carefully calculated the carbs in what I ate (49 grams total), and programmed a 60-minute extended bolus.  And I waited. 

Sure, I felt a little nauseated, but nothing too extreme (I definitely didn’t feel like I was going to puke or anything).  I wasn’t hungry either, which was nice.  I often feel hungry even after eating a decent meal.  Dex showed almost no movement in my BG for over an hour.  Since I was super exhausted yesterday, I went to bed early. 

At 11:53pm, Dex beeped.  The dreaded low alarm.  I looked at the screen: 68 mg/dl.  Not too bad, but I did a finger stick to confirm:  66 mg/dl.  Since Dex indicated a downward trend, I decided to drink a juice box.  Then, I did something really stupid.  I programmed a temp basal of 50%.  I was spooked; I admit it.  I didn’t want to have a horrible low that would be difficult to treat because of the Symlin (I’d read that this happens).  I wanted to play it safe. 

Just as any sane person would expect, a few hours later, my BG started to climb.  Nothing drastic – I was sitting at 150ish.  Then my usual Dawn Phenomenon kicked in (I have a basal rate that is more than two times greater during the hours of 5am-8am).  A temp basal of 50% was not going to make a dent in that train wreck.  After my shower, I was sitting at 180 mg/dl and climbing. 

Since the pod was due for a change, I swapped it out and canceled that stupid temp basal.  Now, as I write this at 9:16am, I am at 189 mg/dl.  This is despite two decent correction boluses.  I know the crash is coming, and I’m ready for it.  I’m just pissed off at myself for giving in to the fear.  It’s the fear of lows that gives me a 7.5% A1c.  It’s unacceptable.

Ugh, diabetes, I hate you.

**UPDATE**

As I wrote this post, I got a call from the fertility doc’s office.  They wanted to tell me that they’d received a copy of my A1c (which the nurse described as “elevated”), and that for conception, they want it to be under 6%.  As if I didn’t already feel shitty enough.

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By shannon, March 2, 2010 1:06 pm

Today is my birthday.  I don’t really feel older, but I am acutely aware that I am.  Today, I am 36 years old.  When my mother was 36, she had two (almost) grown daughters.  That’s some perspective I didn’t need this morning, but there it is.

I share my birthday with Dr. Suess, Jon Bon Jovi, Mikhail Gorbechev, Chris Martin, Daniel Craig, Karen Carpenter, and Reggie Bush. 

So, Brian and I spent most of the morning meeting with our new fertility doctor.  I admit to being a little (or a lot) overwhelmed by all of the information, but I’m optimistic.  I’ve got a full battery of tests ahead of me depending on when I get my next period (yes, guys, I’m talking menstruation – deal with it).  The good news is that I’m not really considered “past my peak” until I turn 37, so I’ve got one year left to get it done!

I have to find a high-risk OB, which is a little confusing because when I called my regular OB/GYN’s office (to find out which high-risk OB she prefers to work with), I was told that she handles high-risk patients herself.  However, I was also told that I would be “sent over to the diabetes center” at the hospital.  This sent some red flags waving, so I tried to clearly communicate that I am a Type 1 diabetic who sees an endo on a regular basis. Here’s the response I got:

“Oh, well, if you’ve already seen an endo, you probably won’t have to do the diabetes education class.”

Um, you think? 

I can’t stand it when people don’t listen.  Anyway, Dr. S. and I have talked extensively about how we’ll handle pregnancy, and I’m very comfortable with that.  I don’t want to throw another doctor into the mix when I’ll likely be seeing at least four of them on a regular basis.

Of course, I’d do just about anything to have a baby, so in the end, I’ll sit through whatever bullshit education for gestational diabetics they want me to.    

On a different note, last night, I spoke with Roddy’s good friend Bob.  Things are looking extremely grim at this point.  I’m becoming more scared with each day that goes by.  Roddy is suffering torture like I can’t even begin to imagine.  Please continue to keep him in your thoughts and prayers.

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By shannon, February 26, 2010 10:42 am

It was not a scenario we had considered.  After our last appointment with Brian’s doctor, we had resigned ourselves to the fact that biological kids were never going to happen for us.

Well, I guess when they say “never say never” they’re right.  No, I’m not pregnant, but if all goes well, I could be. 

Our follow-up appointment yesterday was to get the results of the genetic testing that had been performed on Brian to help determine the cause of his lack of sperm.  We also got the results of some additional hormone levels.  We were all surprised, including Dr. F. 

At our appointment last month, Dr. F. strongly suspected that Bri had a genetic abnormality that had rendered him sterile.  He gave us the information, which we interpreted to be fact.  After all, there aren’t *that* many causes for male infertility.  But, lo and behold, Bri’s genetic panel looked great.  No abnormalities and no genetic cause for infertility.

So, while this doesn’t change the fact that Bri’s shooting blanks at the moment, it does open up some possibilities for trying different things to stimulate his boys to get working.  We’re going to be spending a small fortune on fertility drugs each month, and Brian is going to know what it feels like to be a pin cushion.  There are some surgical options, as well, but Bri’s not amenable to them (it would require cutting his testicles in half – I’m completely serious).  Even if he did agree to it, the procedure has to be done in conjunction with IVF and we’re not financially ready for that.  Maybe as a last resort . . .

So, while Brian’s getting his shots, I’ll be getting a full check-up by a fertility doctor of my very own.  I’m a little nervous about what to expect, but if it means we could actually have a child of our own, I’ll do it. 

This month has been an absolute roller-coaster of emotions.  Neither of us really knows what to think at this point, but we’re cautiously optimistic. 

In other amazing news, my sister, who is battling Stage IV breast cancer, has been on a new chemo regimen.  Lisa had bone and liver mets, which were growing rapidly.  She’s tolerated the new chemo incredibly well; she lost her hair, but she’s managed to avoid the severe nausea and fatigue associated with chemo.  So, she had a PET scan last week and the results indicated that her bone mets are GONE, and her liver is almost cancer free, as well.  Her bloodwork confirmed the scan’s results.  Her tumor markers are all almost normal.  Lisa’s doctor actually used the words “near complete remission.” 

I’m so stunned by two consecutive days of good news.  Seriously, you could totally knock me over with a feather.

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By shannon, February 23, 2010 8:14 am

So, in a couple of weeks, I have my quarterly appointment with Dr. S.  For the first time in a while, I’m dreading this appointment.  I should be focusing on things like getting my blood drawn, having an excuse to get a pedicure, and figuring out what to wear.  Instead, I’m bombarded by images of what our appointment is going to look like.

I figure it will start with the not-so-good news that my A1c has gone up since last time.  I know this is going to happen.  Then, we’ll take a look at my Dexcom reports, which will clearly show how horribly I’m slacking.  Dr. S. will ask me what’s going on.  He won’t be critical, he’ll just want to know if there’s some reason for my shitty numbers and weight gain.  He’ll talk about basals and boluses, but that’s not the problem.  The problem is that I’ve been in such a funk that I really haven’t cared as much about diabetes.  My numbers aren’t crazy; they’re just not as good as they have been.

This is when I’ll probably lose it.  I’ll have to tell him that I really don’t feel the need or desire to work so hard since there’s zero chance of me getting pregnant accidentally.  I’ll say sure, put me on whatever meds you want (Symlin, Lisinopril, etc.) because it really doesn’t matter which pregnancy category they are.  And, I’ll cry.  I know I will.  I’ll probably make him very uncomfortable – he’s an endocrinologist not a psychiatrist, after all.  He’s also got two beautiful children.  So, I’ll sit there blubbering about the unfair hand Brian and I have been dealt. 

He’ll probably attempt to get the appointment back on track by moving on to the physical exam.  I’ll sit there like a good patient, breathing in and out on cue.  He’ll declare me “healthy,” and that will be that.  We’ll go back to his office where he’ll write prescriptions, talk about what I can do to improve, and schedule our next appointment. 

So, life goes on.  On the outside, nothing has changed.  I continue to breathe in and out on cue.

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By shannon, February 1, 2010 1:53 pm

Last week, my world changed forever.  As Brian and I left the doctor’s office, completely numb, we talked about mundane things like where to go for dinner and the DC Auto Show.  Neither of us really acknowledging the finality of the visit; both content to wait for the results of additional testing.  But knowing, deep down, that any further hope was gone.

Together, we will never have a biological child.  That’s it; game over. 

We tried to talk about things like donors and adoption, but it was all so forced and transparently optimistic. 

I’ve often asked “why me?” when it comes to diabetes. I’ve wondered what I did to deserve this kind of life.  It’s gotten me down sometimes, but I always managed to dust myself off and continue doing what has to be done.  

There is nothing to be done, now.  We got dealt this shitty hand, and there’s absolutely nothing we can do about it.  I feel helpless, hopeless, and simply devastated.

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By shannon, January 12, 2010 1:20 pm

Totally not related, but a really cute shot of Hoosier.

On Saturday, I got my period.  Again.  Deep down, I knew that I wasn’t pregnant, but I still secretly hoped that I was.  It was probably for the best because I wasn’t a good diabetic during those two weeks.  I had far too many highs (thanks to holiday eating), I took Advil, and I drank coffee.  I totally knew I wasn’t pregnant.

But, after reading Kerri’s blog yesterday, I wondered (not for the first time) if I am really meant to carry a child.  Maybe I’m not getting pregnant because I shouldn’t have a baby.  When I look at Kerri and read about her struggles, it scares the crap out of me.  I’m terrified that I would be doing more harm than good by having a baby.  I’m not as disciplined as I need to be.  I seem to want to take the “I’ll buckle down when it actually happens” kind of attitude.  But, will I?  Really?  I like to think that I will, but I have so much self-doubt at this point that I just can’t be sure.

Does everyone have these kinds of feelings?  Is it normal?  Is it just a diabetic thing?  Seriously, if you’re reading this and you can identify with it, please comment.

The good thing is that I couldn’t be more confident about being a parent.  Brian and I are SO on the same page when it comes to parenting styles.  We joke about how our kids are probably going to hate us, but we don’t want to be our kids’ friends.  We want to be their parents.  We want to teach them to be strong, confident, and independent.  They will learn the value of a dollar and do chores to earn it.  We will encourage their hopes and dreams, but also keep them grounded enough to appreciate the little things in life.  

The bottom line is this:  we both WANT children so badly that the absence of a child is physically painful.  With nearly everyone around us pregnant, we can’t escape the longing.  If the adoption process wasn’t such a terrifying prospect, I think we probably would have already started pursuing it.  We both want a child that is biologically ours, but we’d love an adopted child just as much.  

So, as I struggle through another month of uncertainty and doubt (and guilt), I try to remember the good things.  I’m free; and I’ve got a good job (not something everyone has today), a beautiful home, a fantastic new (to me) car, and the most wonderful husband in the world.  I’m truly lucky, and I love the life I’ve built.  I’m just missing that one, final piece to my puzzle.

On the bright side, this means that when I fly to Florida this Friday, I can (and will) take as much Xanax as I need.

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By shannon, December 8, 2009 9:06 am

Last Friday, I wrote a quick tweet and facebook status message about my intent to give up caffeine.  It’s something I’ve wanted to do for a long time, both for better health, and in preparation for pregnancy.  

When I told Brian my plan, he asked me why I wanted to do this now. There was nothing discouraging in his query, just curiosity.  I thought long and hard about my many reasons, but it really comes down to one:

I know that the 1^st trimester of pregnancy is hard.  I can expect morning sickness, exhaustion, headaches, and other not-so-fun symptoms.  Why would I want to add caffeine withdrawal to that list?  

I’m a realist, and I know there’s a possibility that I’ll never conceive, but just in case I do, I want to avoid as much unpleasantness as I can.

So, on Saturday morning, while Brian gulped his normal three cups of java, I slowly sipped my new strawberry blooming tea.  It’s not only yummy, it’s also pretty (oh, how I love pretty things!).  I steeped the same tea four or five times, and each time, it tasted as good as the first.  

Now, it’s Tuesday, and I’d give my right arm for a cup of coffee.  I’m resisting, but it’s really, really hard.  I can smell it throughout the office, I can taste it when Brian kisses me goodbye, I can almost feel the caffeine running through my co-workers veins.  Almost.

I’ll be strong and get through this withdrawal.  I’ve got my tea.

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By shannon, November 23, 2009 10:45 am

As I roll forward into my third week of Weight Watchers, I thought I’d take a few minutes to tell you all about my progress.  So far, I’ve lost six pounds.  In two weeks! 

I’ll be honest, I didn’t have high expectations for this when I started.  I wanted to like the idea, but I’m just not a “healthy” eater.  However, I’ve learned a few things since that first day:

1. I’m hungry a lot, but I can live with that. 
2. 96% lean ground beef makes a very tasty burger, especially with a lightly toasted whole wheat bun.
3. Weight Watchers (Smart Ones) has some super yummy dessert choices.
4. My insulin sensitivity increases with each lost pound – basal changes coming again soon.
5. I feel better.
6. It’s a completely livable system.  I haven’t cheated once, but I also haven’t felt the need to.  If I know I’m going to be eating badly or a lot of food, I just save up the points.

Overall, this system has opened my eyes to how much food I used to be eating.  I love that I can still eat anything; it’s the moderation factor that I just didn’t grasp before.  After eating, I almost never feel full, but I always feel satisfied.  By BG control has been so much better, too.  Although I’ve been battling some pretty serious and annoying lows, lowering my A1c even further in preparation for pregnancy is totally worth it.  With tighter control, lows are inevitable (are you listening, Mom?).  It’s just part of being a type 1.

So, I’m going to continue on WW journey until I’ve achieved what I view to be a healthy weight for me.  I’ll never be a skinny girl; I’ve got hips and boobs and they’re not going anywhere.  But, I can and will get to a place where I feel best.  Then, (hopefully), I’ll get pregnant and fat and happy!

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By shannon, October 29, 2009 3:32 pm

Today, right now, I personally know eight women who are pregnant. EIGHT!  Four are close friends, and four are more like acquaintances. All seemed to have no trouble conceiving.  All are incredibly lucky.

Attending baby showers is incredibly difficult these days.  I’m so happy for the moms-to-be, but inside, I’m sobbing uncontrollably.  I don’t understand why Brian and I were “chosen” to have fertility problems.  Is that why we found each other?  Because we both have our own issues that make having a baby especially difficult?  Because we can share the pain and disappointment of another month gone?  Or, were we just never meant to be parents?

This is, without question, the most painful time I’ve experienced in my entire life.  I’m 35 years old and I don’t think I’ll ever be a mom. 

So, to all you future moms (and the current ones), know how lucky you really are and be thankful.