My appointment with Dr. S. started well enough.  Traffic into downtown Baltimore was brutal, but I gave myself plenty of time.  The drive from my office (just on the edge of the city) to the hospital where Dr. S. maintains an office is well, interesting.  It takes me through some of Baltimore’s toughest neighborhoods, which can be a little intimidating. 

Baltimore is a rough city.  Riddled with drugs, crime, corruption, and poverty, the inner city has become something of a battle ground.  Rarely does a day pass when there hasn’t been a murder, nevermind the two or three that seem to be the “norm.”  And it’s getting worse.

As I drove through the streets of Baltimore, at 1pm, I was struck by the number of people just . . . hanging out.  These people were not at work in the middle of the day; they were just sitting on their stoops shooting the breeze.  Doesn’t anyone work?  Seriously, there were hundreds of people just hanging around.  I saw at least two drug deals go down (where are the cops?!?)  Anyway, I am digressing a bit from my original purpose for this post (must focus my short attention span better). 

So, after the enlightening drive in, I arrived 20 minutes early for my appointment.  The first thing that I noticed was the very busy waiting room.  Normally, when I go to Dr. S.’s office, it’s pretty empty.  Yesterday, there were at least six people waiting.  I signed in, paid my co-pay, and took a seat. 

A few minutes later, the medical assistant person (one I’d never seen before) called my name (actually, she called Ms. Burnadette – why is it so difficult to pronounce a name that is so freaking easy?). 

She weighed me (SCARY!!!), took my BP (slightly elevated, but not surprising given the aforementioned drive in), pulse (also slightly elevated), and BG (120 mg/dl).  Then, and this is why I’m still reeling, she began to enter my info into the computer.  At one point, she was clearly frustrated. 

She said, “This is so messed up.  It has two different diagnoses for you.  One is Type 1, and the other is Type 1 Adult Onset.” 

Hoping to help her out, I told her that I am a Type 1 who was diagnosed in my twenties.  She then asked if I take “pills” for my diabetes.  I told her that no, as a Type 1, I need insulin to control my blood sugar. 

She said (and this is where I nearly lost it), “I don’t even know the difference between Type 1 and Type 2!”

WHAT?!? She works in an endocrinologist’s office and she doesn’t know the basics of diabetes!

I calmly attempted to explain the difference, but once she heard “beta cells in the pancreas,” her eyes glazed over and she stopped listening (must find less technical ways of describing diabetes).  I gave up and returned to the waiting area. 

Here’s something I really like about Dr. S.: *he* comes to the waiting room and escorts patients to his office.  Most doctors have their office set up so that you (the patient) are escorted to an exam room by a medical assistant.  Then, you sit in that room until the doctor comes in.  Dr. S. does the talky part of the appointment first, then the exam after that.  It’s really nice.

Here’s the other thing I really like about him: he actually apologizes to patients when he keeps them waiting.  My appointment was at 2:00, but I didn’t see him until 2:40.  Most doctors would just act as though their time is far more valuable than yours. Dr. S. doesn’t do that, and I respect him more for it.

He escorted me back to his office, and we talked about what’s been going on.  Telling him about Lisa was especially hard, but I managed to do it without sobbing, so score one for me!  We also talked about the failed IUIs and other infertility stuff. 

Then, I started babbling about my weight and how unhappy I am.  I told him about my new low-carb resolve (today is day three and I haven’t cheated once!) and asked for his thoughts on Metformin.  His answer surprised me.  He didn’t feel that the potential benefits (Met is weight neutral, meaning that it doesn’t cause weight gain OR weight loss) were worth the potential risks.  When I said that I needed something to help get a handle on my weight, he said that because I’m TTC, I have very limited options.  His exact words were:  “yeah, it sucks.”

I can go back on Symlin during the times when there’s no chance of pregnancy: like now, thank you ovarian cysts, or the time from when I get my period until IUI day.  But it’s not really worth it if I can’t ever adjust to the drug long enough to avoid the horrible nausea.  Besides, I’m not eating enough carbs to take Symlin.

When I left his office, we had made no changes to my treatment plan.  I felt somewhat defeated, but I recognize that there is no magic pill for weight loss.  I’ve got to stick to my new way of eating and get some exercise.  It can work; I just have to stay focused.

So, that’s the (not-so) skinny on my appointment with Dr. S.  I see him again in three months (I can’t believe November is three months away!), and I’m hopeful that I’ll have lost a decent amount of weight by then. 

Or that I’m pregnant – that would rock, too.

So, I decided to participate in Karen’s brilliant idea:  The First Annual Diabetes Blog Week .  All week, I’ll be blogging about the different aspects of my life with diabetes.  When I last checked, there were a TON of bloggers who are also participating, so when you’re done here, check them out.

Today’s topic is: A Day in the Life … With Diabetes

12:01am – 5:29am:  Sleep.

5:30am: Alarm.  Ugh.  I want to go back to sleep.  I decide to let Dexcom decide.  If my BG is in range, I’ll get up; if it’s not, I’ll correct and go back to sleep.  Dex shows a nice flat line with a BG of 87 mg/dl.  I decide that the agreement wasn’t in writing and, therefore, is not binding.  I roll over and go back to sleep.

6:08am:  Brian brings me a cup of coffee because he’s the greatest husband ever.  I slowly come to life.  I check my BG and confirm Dex’s assessment with a PDM reading of 92 mg/dl.  Thankful that my nighttime basals are spot on, I check my iPhone for email and Twitter updates.

6:18am:  I finally get up and stumble into the bathroom.  I brush my teeth, shower (thankful that I no longer have to suspend and disconnect a pump to do so), and get ready for work.  I peek at Dex a few times just to confirm that I’m not rising or dropping unexpectedly.

7:10am:  I do a quick finger test to confirm that it’s safe to drive – 102 mg/dl.  I hop (well, not really– it is still morning, after all) into the car and brave the Baltimore traffic.

7:45am: I arrive at work and unload my various d-tools that I’ll use throughout the day:  PDM, Dex, glucose tabs, iPhone, etc.

7:50am – 9:00am: I work. At staying awake.

9:00am: Prepare a bowl of oatmeal.  BG check is 100 mg/dl, so I inject 60mcg of Symlin and eat. 

9:10am: Finished eating, I bolus for the meal.

9:10 – 11:30am: Work.  Meetings.  More work. Bathroom break.

11:35am:  Dex shows that my breakfast bolus didn’t do its job.  I confirm with a finger stick and take 1.5U to correct.

12:30pm:  Lunch time!  Since I keep a mini fridge at work, I often have lunch stuff available.  Today, I decide to make a turkey and cheese sandwich with mustard.  Dex shows the correction dose finally dropping me to normal range. 

12:35pm:  I do a finger stick to check my BG: 112 mg/dl.  I dial up 60mcg of Symlin and eat my sandwich.  When I’m done, I program an extended bolus and get back to work.

1:10pm:  Feeling weird.  I hear Dex’s low alarm and, after a quick peek, I see that I’m dropping.  FAST.  Looks like the Symlin is working faster than the carbs are being absorbed.  SHIT!  I do a finger stick and look with almost disbelief at the 52 mg/dl staring back at me.  I have no idea what to do.  The Symlin will delay any fast acting glucose I take, so I won’t rebound quickly, AND I’ll be high later.  I decide to wait it out.

1:15pm:  WTF is taking so long?  I’m still hovering at 50 mg/dl.

1:20pm:  Sweating now?  Really? 

1:21pm:  Screw it.  I drink some juice and hope that it helps.

1:30pm:  Finally beginning to rise, I feel well enough to get back to work. 

2:38pm:  Dex HIGH alarm.  Son of a …!!!  Sure enough, finger stick shows 185 mg/dl.  Dex has one arrow straight up, so I know it’s not over.  I correct the 185 and continue working.

3:15pm:  Bathroom break.  Wash hands and test BG – 174 mg/dl.  Damnit!  Correct again.

3:45pm:  Pack up, test BG, and drive home.  Correction dose still not working, but I don’t want to rage bolus only to crash later.

4:15pm:  Home.  Aaaaaah.  I change clothes, go to the bathroom, pet animals, and clean up the kitchen.  I don’t even look at Dex because I’m tired and I just don’t care.

5:00pm:  Waiting for Brian to get home, I begin thinking about dinner.  I check Dex to see if carbs are even an option tonight.  Sure enough, I’m dropping again.  At least this time, it’s a gradual drop and not a jumping-off-a-cliff drop.  More like coasting, really. 

5:30pm:  Brian comes home.  We try to come up with a dinner plan.  “What do you want?”  “I don’t know.  What do YOU want?”  “I don’t know.”  This can go on for hours.

6:02pm:  Dex’s low alarm makes the dinner debate more important.  We decide to go out.  I grab a juice box, and we head out to the restaurant.

6:28pm:  We are seated.  The waitress brings bread (bitch!) and our drink order (iced tea, unsweetened).  After a few minutes, our salads arrive.  I test my BG with a finger stick – still too low for Symlin.  I begin eating the salad, which is soooo good.  I LOVE Carrabba’s Caesar salad. 

6:50pm:  Dinner arrives.  I ordered the Salmon with a pasta side, which I calculate to be about 45g carbs (for ½ of the serving).  I program a 30/70 dual-wave bolus for 2 hours – lots of fat in that lemon butter sauce – and dig in.

7:25pm:  Waitress clears plates and offers us dessert (bitch, again!).  We decline, pay the check, and go home.

7:56pm:  Home.  Again.  Aaaaah.  Dex shows two arrows straight up, so I know that the carbs are hitting me faster than I anticipated.  What to do?  If I attempt to head it off, I WILL go low later.  If not, I’m going to be spiking well above 250 mg/dl before it’s over.  I still don’t know what to do in these situations.  I wait.  I feed the cats and watch some TV with Bri.

9:30pm:  Dex has been bitching at me since we got home.  Since my extended bolus only finished a few minutes ago, I decide to wait a little longer.

10:00pm:  Bed time.  I wash my face, brush and Waterpik my teeth, apply zit cream (don’t even get me started on *that*), and put on PJs.  I grab a juice box from the fridge and put it next to the rest of my diabetes arsenal on my nightstand.  I check my BG with a finger stick – 213 mg/dl.  FUCK!  I take a correction bolus, turn off the lights, and go to sleep.

11:37pm:  Dex alarm – falling faster than 3mg/dl per minute.  Well duh!  I drink the juice box and hope that tomorrow is a better day.  But, I accept the knowledge that today was just another typical day in my diabetes life, and tomorrow is probably going to be similar.

I’ve written about my sister before, and she’s a common commenter on my posts.  Her latest scans and bloodwork did not yield good news.  Her cancer is growing.  FAST.  I’m angry and scared about what this means, and I fear that I’m going to have to step out of my denial bubble soon.  I like my denial bubble – it’s safe there.  I’m traveling to Florida to see her in a month or so, and I’m hopeful that her new treatment won’t leave her feeling sick, weak, or anything else bad.  I know she doesn’t want that.

You all know what’s going on with the fertility stuff.  I got more blood test results today, which indicate that I need more blood tests.  WTF?  My arms are already bruised from the last two blood draws on Tuesday.  Now, I have to go for more (they’re going to have to take a gallon or so for all of these tests!).  I HATE having my blood drawn – mostly because I have to deal with morons. 

The big D is a big B lately.  Almost every day, I’m going low right after I eat lunch, which causes me to treat and then skyrocket a few hours later (damned Symlin).  Today, I’m not eating until I bottom out.  I know that Apidra is a fast insulin, but I seem to have a much longer response time in the morning.  Not to mention my I:C ratio and basals in the morning are so much higher than the rest of the day.  I need an advanced math degree just to figure all of this nonsense out.  I really need a diabetes vacation.

So, that’s why I’ve been scarce lately.  My subconscious is desperately working on sorting all of this out, hence some very weird dreams lately, which have left me completely exhausted when I wake up.

On a happier note, I believe that by now, little BSparl has made her way into the world.  I want to offer Kerri and Chris my most heartfelt congratulations.  I’m very happy for you all.

I have finally reached my goal of 120 mcg of Symlin.  I still can’t believe I was able to do it – I’m such a wuss when it comes to nausea.

Now, lets see what it will do for me …

I wrote that I was afraid to say it out loud, but it looks like the Symlin is working.  I can’t remember the last time I went for 24 hours without a single high or low alarm (which are set for 180 and 70, respectively).  I usually spike up to the mid-200s after meals, even when I bolus early.

But, since using Symlin, I’ve managed to avoid those spikes, I’m taking less insulin, and I’ve lost three pounds.  I’m eating less food because it takes very little to fill me up, and what I do eat is better for me.

I know that there is probably a huge psychological element to this – I think I should be full, so I feel full, etc., but I can’t discount the physical stuff, either.  I can’t ignore the nausea that I feel after every meal – believe me, I’ve tried.  And I can’t deny what my eyes are seeing – fewer BG spikes after meals.

I’m up to 60mcg of Symlin before every meal, and my plan is to go all the way to 120mcg.  I even had Dr. S. call in the Rx for the 60/120 pens.  I figure that if I can’t tolerate 120mcg, at least I can still use the 60mcg setting (and get 2x the meds at the same copay).

So, if anyone out there is desperately trying to lower his or her A1c, experiences high BG spikes after meals, is becoming insulin resistant, or just wants to reduce the TDD of insulin, think about giving Symlin a try.  Yes, the side effect sucks.  I hate nausea more than most people, I think, but it’s worth it.

********UPDATE*********

Not long after writing this post, I was cursed with an inexplicable 237 mg/dl.  WTF?

Through some careful handwashing, limited contact, and vitamins, I’ve managed to avoid the cold.  Until now.  I went to bed last night around 11pm and slept hard.  I woke up (at 5:30am) to a sore throat and an unbelievable fatigue – I didn’t feel well rested at all.  I decided to go back to sleep for a little while, hoping I’d feel better.  I slept straight through to 9am.  Feeling even worse than I did earlier, I decided that work just wasn’t going to happen.   Between the fatigue, the sore throat, and the Symlin-induced nausea, I knew that I would be completely useless at work.  I loathe calling in sick, especially for anything D-related (I like to kid myself into thinking I’m just like everyone else), but sometimes, it’s just unavoidable.

The good news is that I’m up to 60 mcg of Symlin.  I’m even going to try to move up to 120 mcg because I’ve read that I will get the best weight-loss results and BG control this way.

Sorry for the boring Monday post, but I’m feeling useless all around.  I hope you guys are having a better day than I am!

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!

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.

Today, I see Dr. S.  I’m not looking forward to getting my A1c because I know it’s going to be higher than last time.  I just hope it’s under 7% so that the baby progress can continue.  I’m strongly considering going back on Symlin.  I took it once before and had awful nausea, but I didn’t really give it a chance.  I stopped after a few days – mostly because we decided to start “actively trying to conceive,” which meant no Symlin.  Frankly, I wasn’t sorry to see it go. 

But now, I’m really trying to lose weight.  It’s my primary goal and I feel like I’m fighting a losing battle.  I’ve got HUGE genetic factors working against me.  On my father’s side, which is the side I take after, there is not a single person under 200lbs.  I’ve always had to fight my body’s natural inclination to be heavy, but now I need a little extra help. 

The other benefit of Symlin is that it will help to reduce those spikes I get after meals AND reduce my TDD.  So, if I can handle a couple of weeks of nausea, I think it would probably help me.  I’m not looking forward to a form of MDI again, but I’ll deal.

************************************************************************************

Next, I want to talk about Roddy Pippin.  We had some good news in our fight last week.  The Warden of the Jester III prison granted Roddy a few considerations:

1. He would be allowed to attend Sunday worship services – something he’s been denied since December.
2. He would have access to a telephone.
3. He would be allowed to change channels on the television in the infirmary (this one isn’t all that big of a deal since Roddy isn’t a TV watcher).

Unfortunately, these considerations were short-lived.  The prison P.A. said No more – “No more worship service for Pippin!  And no recreation, no law library, etc.”  The P.A. also said “Pippin is NOT allowed to leave the prison solitary confinement for the next 3 years and 8 months!”  This is not a disciplinary case issue.  So, we know that the prison P.A. is in cahoots with the D.A., but the question I have is this:  Does the P.A. have more power than the Warden?  Evidently, she does. 

There was a recent AP article done on Roddy.  While I initially liked the tone of the article, I don’t like what various publications did with it.  One, in particular, was the Dallas Morning News.  They created a headline that was not at all relevant to the article.  They did this to incite anger in their readers, and they succeeded.  I spent some time trying to respond to the nasty comments that followed the article, but most people were content believing a bunch of lies and exaggerations.  I’ve learned that it’s a losing battle with the press.  Unless/until the story breaks out of Texas journalism, it will never be told truthfully.

************************************************************************************

Last, I want to talk about the unbelievable liar my body is making me out to be.  I sat in Dr. T.’s office last week (ironically the day my period was due) and told her how “regular” I am.  Hell, I am more reliable than a calendar.  Until this month.  I am now officially one week late.  I’m not-so-patiently waiting to have all of these tests done, which are dependent on my period.  But my period is MIA.  It’s so frustrating.

Once I finally calmed down enough to actually listen to my doctor (I wasn’t in hysterics or anything, just upset), we talked about Symlin. A big part of my problem with blood sugar is that I’m a yo-yo. I’ll eat a meal, bolus accordingly, and still spike to over 300. Naturally, I correct, but then I’ll drop like a stone a few hours later. He said that Symlin should help even me out and reduce the need for correction doses hours later. Since an added bonus to Symlin is decreased appetite and weight loss, he thought I should give it a try.

As I’ve written before, I struggle with diabulimia. After I left my doctor’s office, there was a big (very big) voice inside my head that screamed “just take the stupid pump off. It’s not working anyway. Besides, you’re never going to be able to have kids, so at least you could be thin.” Why do I do this to myself? Why are we so obsessed with weight that I feel enormous pressure to lose what I’ve gained? Why does my mother think that being thin is more important than being healthy? Why, despite what my doctor has repeatedly said, does my people think that I’m diabetic because of my weight, and that it will simply go away if I’m a size 2? And, why do I care so much what my other people think?

After telling this voice to shut up, I filled the Symlin script and went home. I didn’t use it last night or this morning just in case I had nausea. I’m going to start it with dinner tonight and see how it goes. Wish me luck.