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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 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.

Comments (3)

By shannon, February 12, 2010 12:11 pm

When I first went on a carb counting regimen,  after six months of pills that did nothing except make me sick, and another six months of NPH and R, which dropped me like a stone at random, unpredictable times, I used Humalog. 

I liked Humalog.  I was able to keep my TDD low, and I seemed to respond well to its peaks and duration.  At some point, I don’t even know when, I was switched over to Novolog.  It might have been for insurance purposes or maybe it was when I moved to insulin pump therapy.  I honestly can’t remember.

I have a point (I’m just getting there slowly, like everything else I’m doing today).  Since using Novolog, my TDD has slowly been creeping up.  Is it insulin resistance because I’m a lazy putz who doesn’t want to exercise?  Possibly.  But, it could also be that Novolog’s peak time and duration have so totally screwed up my dosing that I’m taking more and more correction boluses for foods that shouldn’t require a correction.  I’ve had to tweak my basals more, too.

So, not liking the fact that I’m taking so much more insulin than I used to, I did some research.  I know, I know, you’re all shocked and amazed.  What I learned is that Novolog has a reputation for being the slowest acting of the three rapid insulins (Novolog, Humalog, and Apidra).  What most people say is that Apidra is the fastest.  Some people have even cut down their TDD with Apidra. 

While I’m not expecting miracles, I do think it’s time to make a change.  So, first thing this morning, I dialed up Dr. S’s office to see about making the switch.  I know he must think I’m a complete pain in the ass at this point (first the switch from MM CGM to Dexcom, then from MM 722 to Omnipod, and now from Novolog to Apidra), but my goal is to achieve better numbers, so that should be commended, right.  I’m still a pain in the ass, though.  I know it, and I’m ok with it.

So, I’ve tried Humalog (and liked it), I’m using Novolog (not happily), and I now I’m switching to Apidra. 

I’m also starting an exercise schedule and eating more healthier (yes, I know that’s not grammatically correct, but I like it, so deal).

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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!

Comments (7)

By shannon, November 11, 2009 8:39 am

I hate vegetables.  I call them Vile Weeds.  There, I said (err, wrote) it.  I cannot stand the texture or the bland taste of almost all veggies.  Especially when they’re cooked.  There’s just something so gross about the mush that most vegetables become when contact is made with a heat source.  Sure, everyone tells me that “when they’re cooked right, they’re really good.”  Yeah, I’m not buying it.

Anyone who’s read this blog knows that I struggle with my weight.  It’s a daily battle between what I love to eat and what I need to eat.  I love cheeseburgers and pizza and french fries and, well, you get the point.  I love junk food.  Junk food loves to make me fat.  My diabetes hates junk food. I’m often rewarded for indulging with a super-high BG that causes me to rage bolus, only to end up three hours later with a low that makes my teeth rattle.  It’s not a good relationship.

So, this week I began a new relationship.  I joined Weight Watchers Online.  It was a big step for me because I remember going to Weight Watchers as a teen and hating it – not the food plans or the strict requirements. No, I hated the meetings.  I hated having to get on a scale every week (while not in the privacy of my own bathroom) and having my weight entered on some little card.  If I didn’t lose enough, I felt like a failure.  It just plain sucked.

Now, as an adult, my issue isn’t the weigh-ins.  It’s the “cheerleader” feel of the meetings that I loathe.  Maybe it’s  just my inner cynical bitch, but I just can’t participate in these types of functions without rolling my eyes.  Yep, inner cynical bitch claims full responsibility. 

This time, I opted for the online version, which I can do myself, in the privacy of my own home.  Since I’m a techie, I LOVE the cool, interactive website that allows me to look up points values, keep a food journal (which comes in handy for meetings with the CDE), and see where I stand with my available points for both the day and the week.  Throw in the mobile app for my iPhone, and I’m so set.  I actually use this app (not something I can say for at least 75% of the apps I’ve downloaded).

Here’s what I’ve learned in the three short days since I started Weight Watchers:

1. I eat A LOT of calories!  Call it denial or avoidance, but I’ve been eating a lot of food.  It’s no wonder that my weight has steadily crept up to its current overall awfulness.
2. My guessing game with bolusing has been pathetic, at best.  It’s not surprising that I kept screwing up my BG – I’ve been bolusing for the portions I *should* be eating, not what I *was* eating.
3. I need to exercise.  If I exercise, I get more points.  More points equals more food.
4. The little Weight Watchers snack bars are fricking awesome.  At one point each, they’re the perfect mid-afternoon snack.
5. Green beans (one of the only veggies that I actually like cooked) have a total points value of ZERO. 
6. I don’t drink nearly enough water.  (Side question: Does Crystal Light count as water? Anyone know?)
7. This system is doable.  Sure I miss my cheeseburgers and pizza and french fries, but there are options.  Last night, I made the best little six point pizza ever (contact me for the recipe)!

For those of you wondering, I have received absolutely no compensation from Weight Watchers to write this blog.  Aside from the credit card I used to pay for my membership, I doubt they even know my name.  However, if anyone from Weight Watchers would like to sponsor this blog, feel free to contact me

I’m still not eating cooked vegetables, though.