Comments (2)

By shannon, August 27, 2010 9:18 am

I’m still reeling from yesterday. 

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.

Comments (5)

By shannon, August 25, 2010 9:26 am

I like change.  I’m one of those weird people who doesn’t like when things get too stagnant.  Change is good.  Right?

Tomorrow, I see Dr. S.  Yep, it’s time for a visit to the principal’s office.

I have mixed feelings about this.  I am looking forward to and dreading this appointment at the same time.   There will be no lab results; no A1c.  As always, I’ll be weighed (dreaded moment #1), BP checked (this shouldn’t be bad, but who knows?), and BG tested on their dinosaur meter, whose results are ALWAYS vastly different from mine.

We’re going to review my Dexcom reports (dreaded moment #2) and see what, if any, chances need to be made.

We will be making changes.  I have to make some changes.

I know he’s going to ask me about my weight gain (dreaded moment #3).  I have some good reasons for this: my sister’s death, fertility drugs, blah, blah, blah.  They’re all just bullshit excuses.  I’ve gained weight because I’ve been eating like crap and not exercising.  PERIOD.  

But, I feel so deep in this hole that I have no idea how to get out.  I was doing so well on Symlin, but it’s not safe during pregnancy, so I had to stop.  And it pisses me off because so many of the things I’m doing (or not doing) because they’re unsafe for pregnancy are probably for nothing. 

I have a point; I promise.

Starting today and for the foreseeable future, I’m going to be eating only low-carb foods.  No more pasta; no more fries.  I will not eat any of that stuff because it is my own personal kryptonite.  I’m going to stick to protein, fat, and veggies (of the uncooked variety – I loathe cooked vegetables)

I’m also going to ask Dr. S. about Metformin.  This is a big fear because Met is one of the meds I was given during my misdiagnosis fiasco. It did nothing for me except make me sick.  But, I’ve read that the XR version is much easier to tolerate, and at this point, I’m willing to try.  It’s also a pregnancy category B drug, which means that it’s probably safe (nothing is category A).

One of my biggest problems right now is my insulin intake.  I’ve definitely got some resistance happening, and it’s leading to much higher doses of insulin to cover basal and bolus needs, which is leading to more fat storage, which is leading to greater insulin needs, etc. It’s an endless cycle.

There’s got to be an easier way!

I have made no secret of my struggle with diabulimia. And there is this big voice in my head that’s telling me to just stop taking so much insulin.  Just take a small shot here and there to avoid DKA.  My weight would drop so quickly, and I’d feel great.  That’s the thing that makes it so appealing.  When I was restricting insulin, I felt fantastic.  Most of the time, I had no idea how high I really was, but it didn’t matter – I had tons of energy.  Now, I struggle just to get out of bed in the morning.

But, I won’t do it.  I’ve spent the past three years trying to maintain a decent A1c so that I can have a baby.  I’m not going to throw that all away now for a quick fix to my weight issues.  I want to.  But I won’t.

I have a plan, and I’m going to do my best to stick with it:

1. Eat low-carb
2. Take Metformin
3. Exercise

If anyone has any suggestions or words of wisdom, please, please share!

Comments (6)

By shannon, May 14, 2010 9:00 am

I’ve been dreading this post.  I really have nothing good to write about exercise because, frankly, I hate it. 

People always talk about those endorphines you get after exercise, but I think I’m missing whatever gland is supposed to secrete them.  I feel like complete and utter shit after I exercise.  I don’t like to sweat, either. 

So, what can I write about exercise?  Not much.

If someone has some advice (that isn’t going to sound all cheerleaderish), please comment.  I know that I need to exercise, and I just need to find what will work for me.

Comments (5)

By shannon, April 9, 2010 1:44 pm

Two things:

1.  If you write a D-blog, and you read mine, please add me to your blogroll.  If you would like to be added to my blogroll, please leave a comment, and I’ll add you right away.

2.  Last month, I wrote a guest blog for Cherise at Diabetic Iz Me.  I realized that I never re-posted it here, and I think that some of my regular readers might appreciate it, too.  Plus, it’s Friday and my brain has decided to start the weekend early.

So, here it is:

I was never much of a joiner.  Even when I was a little kid, I wasn’t fond of things like Girl Scouts or ballet class.  I was a loner; one who preferred books over people.  When I read a book, I was able to escape my unpleasant life and enter a different world.  It was wonderful.

A little over 10 years ago, I was diagnosed with diabetes.  As is my usual approach, I bought books on the subject and researched it to death.  I learned all about what to eat, when to exercise (not that I follow that one), how insulin works, what causes it, the complications of poorly-controlled diabetes, and the fact that there is no cure.

What I didn’t learn was how to LIVE with diabetes.  Being diagnosed with Type 1 in your twenties is difficult.  It’s even more difficult when you’re initially misdiagnosed as Type 2.  You’re sent home with a prescription for meds and a pamphlet.  The single diabetes education class I took was a joke.  I was the youngest (by a lot) person in the class, and the only one who wasn’t significantly overweight.  I learned all about diabetic exchanges and the food pyramid, and how if I’d just lose some weight, I could eliminate the pills from my life.  When I raised my hand to point out that I was taking insulin, my questions were brushed off as if I didn’t matter.  So, I stopped going to diabetes education classes.

For almost 10 years, I lived this disease alone.  I had little support from my family, and none of my friends had ever known anyone with Type 1 diabetes.  I can remember the night I had to give myself my first insulin shot alone.  I called my sister (and stayed on the phone with her) so that if I passed out (I really had a severe needle phobia), she would come over and help me.  I didn’t pass out; I gave myself hundreds (probably thousands) of shots without ever passing out.

Then, one day, my endo told me that I should do some overnight basal testing.  Being me, I said “absolutely” when he asked me if I knew what that was.  I didn’t know because I’d never had any diabetes education related to my actual kind of diabetes.  Also being me, I came home and googled basal testing.

That’s when my entire life changed.  That one, simple search plummeted me into an entire world of Type 1 diabetes awareness, support, and education.  I read blogs; I joined online groups; I learned more than I ever knew existed.  I had been living with Type 1 diabetes completely alone, and with that single search, I was part of a Community.  And it wasn’t just a “let’s blow sunshine up each others’ butts” kind of Community, it was a real-life, tell-it-like-it-is Community.  I’d finally found a group that I could belong to.

For a few years, I was a silent, but active member of the Community.  I read blogs for hours (if you’ve got a D-blog, chances are good that I’ve read it).  I voraciously absorbed all of the information I read; these real-life experiences were far more valuable to me than the clinical examples described in books.  I began participating in various forums.  I asked questions and answered some; I got lots of fantastic advice and some I wish I’d never read.  But, through it all, I felt like I belonged, and it was wonderful.

Then, one day, there was a rather contentious discussion started by a Type 1 who was insulted because people thought he was a Type 2.  He said that Type 2s were fat and lazy, and that they deserved to get diabetes.  Being an overweight Type 1, I was offended.  Not just because I was overweight, but because there are so many Type 2s who struggle with these assumptions every day.  They’ve been criticized for being overweight for most of their lives.  Even before diabetes, they lived with the pain and ridicule of being fat.  To learn that they caused their diabetes because they’re fat just heaps on more guilt.  The worst part is that IT IS NOT TRUE.  But, when you’re fat, your self esteem is so low that despite all evidence to the contrary, you still believe that it’s all your fault.

The “us vs. them” rhetoric took on a life of its own, and before long, I‘d had enough.  I left the Community entirely.  I deleted my accounts and decided that I was better off.  After all, I’d gotten so involved in diabetes, that it was encompassing my entire life.

For almost a year, I stayed away.  I went through the daily rituals of testing my BG, pumping, etc., but I was just another person living with diabetes again.  I wasn’t learning about this cool new way to program an extended bolus, or that if I ate a certain food, it will actually help lower my BG.  I wasn’t learning anything; I wasn’t contributing anything either.

So, one day, I decided to end my self-imposed exile.  I rejoined that online Community (but vowed to steer clear of any controversial discussions).  I began writing my blog.  I did it for myself; I did it to release some of my diabetes demons.  I never expected people to read it or learn from it, and I certainly never expected the kind of response that I’ve gotten.

Writing is such an amazing release.  When I write about something, it’s almost as if I process it and can finally move past it.  I’m not a big talker; I never have been.  I’m a listener.  And I’m a writer.

That year I spent away was hard, but beneficial because I did learn a few things.  I realized that without the D-Community, I only just live with diabetes.  With the Community, I thrive.  The support and camaraderie we all give and share is something amazing; it’s inspiring and unlike anything I’ve ever experienced in my life.  I wouldn’t trade it for anything.

Comments (14)

By shannon, March 22, 2010 1:16 pm

You all know what’s been going on in our quest to have a child.  Today, I want to give up.  Seriously, I do.

I was told, when I met with the fertility doctor, to have a consultation with a high-risk OB.  I called my regular OB/GYN (Dr. H.) to see who she worked with.  After a lot of run-around, I found the high-risk practice at the same hospital as Dr. H.  Today, I had my consultation.

When I arrived at the office, the front desk person was rude.  Not just a little unfriendly – she was rude.  Not a good start – it immediately put me on edge.  But, I filled out the paperwork, as required.  The receptionist became even ruder (if that’s possible) when she asked me for Brian’s SSN.  I asked her why she needed it (I’m not giving out any SSNs unless there is a damn good reason).  She said that she wanted it for our insurance information.  I explained that the Member ID number is sufficient (truthfully, I probably wouldn’t have been such a hard ass about it if she’s just asked nicely).  Then, she told me that my copay was $30, payable by cash or check only.  This was not something anyone told me, and I only had credit cards (I don’t carry a checkbook around).  When I said that I only had plastic and that I wasn’t aware of the policy, she didn’t say anything.  NOTHING.  She didn’t even look at me.  Oookay.  I took a seat and waited for my turn.

After a while,  I was called to the back where I had the usual vitals done (BP, weight, urine, etc.).  Then, I was led to a small conference room where the nurse asked me the same questions that I’d just answered on the new patient paperwork (medical conditions, meds, allergies, etc.).  I dutifully answered her questions, and when she’d gotten it all, she told me the doctor would be right in.

A few moments later, the nurse returned and asked me who referred me.  When I explained that I wasn’t referred (I’m not pregnant, yet), I was told to get the consult by the fertility group, she said that I should have had records sent over before the appointment.  Getting more upset, I explained that (just as with the copay) no one had told me that I needed to have my records sent over.  She said that the doctor needs the records before she could talk with me.  WTF?  If I’d known that they needed these records for a consult, I would have made sure they had them.  But, no one told me.

The nurse left the room, but I wasn’t alone for long.  The office manager (I think) came into the room next.  She had a release form, which she needed me to fill out.  When I asked her who she was sending it to (one of the fields in the form), she asked me who has my records.  I explained that I have several doctors and, depending on what she needs, the information would come from different sources.  She said that she needs my “medical records.”  That’s it; no further clarification.  She was being pretty rude, too.  My guess was that the receptionist made some sort of comment about me, which led to a judgment on her part. 

That’s when I lost it.  Completely.  I asked her to stop speaking to me as if I were a four-year-old.  I told her that if one, single person had told me that I needed to have medical records sent over, I would have done so.  I told her that I was upset about the fact that without those records, the doctor felt it was pointless to meet with me.  Here I was, a living, breathing person with the ability to recall facts like my last A1c, BP readings, and other pertinent information.  But, without medical records, there was no point? 

Then I started to cry. 

If there is one thing I wish I could change about myself (well, there are tons, but this is a biggie), it would be my tendency to cry when I get angry.  I don’t really cry when I’m sad, but piss me off, and I become a blubbering fool.  This, of course, pisses me off even more because the last thing I want is any kind of sympathy from the person who made me angry in the first place. 

But, before I knew it, the doctor decided to grace me with her presence.  She came into the room, clipboard in hand, and asked me questions.  And miracle of miracles, I was able to give her the information she needed.  But, that’s where the good times ended.

As she went over each of my conditions, diabetes being the biggest obstacle, I began to feel less and less like a potential pregnant woman.  I felt like a complete and utter failure.  Straight off, she didn’t believe that I was a Type 1.  She asked if I had ever been tested for antibodies (yes) and was it positive or negative (positive, duh?).  She told me that what my endo told me about pregnancy BGs isn’t good enough.  She would want my fasting BGs between 60 and 80mg/dl, one hour post-prandials at less than 140mg/dl, and two-hour post prandial at less than 130mg/dl.  This seemed excessive to me and not at all what I’d learned from other pregnant T1s in the DOC.  There’s no way I could achieve that without having severe lows all the time.  She countered with (speaking as if trying to talk me down from a ledge), “we have pregnant diabetics with A1cs of 5% all the time.”  I wanted to say that maybe with T2s or gestational patients this is achievable, but with a T1, it’s just dangerous.  There was so much I wanted to say.  Instead, I cried.

I think the moment when I decided that I didn’t want to go through any of this anymore was when she told me about all of the potential birth defects and complications that can occur as a result of my diabetes, high BP, and “advanced maternal age.”   Why am I putting myself through this?  With every doctor’s appointment, all I feel is guilt, anger, self-loathing, and despair.  I am not enjoying anything about this process, and if this is what I have to look forward to, I’m not very optimistic.

When I think about Elizabeth’s good news, I’m very motivated to pursue adoption instead of putting myself through this again.

Comments (4)

By shannon, March 18, 2010 10:10 am

Last night, I tweeted this photo:

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?

Comments (2)

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!

Comments (7)

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.

Comments (4)

By shannon, March 9, 2010 10:28 am

There are a few things I want to write about today, but they’re not really interconnected.  So, I’m going to just jump from topic to topic.  Try to keep up

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.

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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.

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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.

Comments (8)

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.