Thursday, September 01, 2011

Looking Back, Looking Forward

On this day in 2006, I was diagnosed with diabetes, and I received exogenous insulin for the first time.
In 2007, 2008, 2009, and 2010, on this day, I remembered and commemorated that day. I felt the feelings that I had felt that first day, and I knew how far I had come, and how far I hadn't.

This year is different. This year, I don't remember being diagnosed with diabetes. I don't remember what it felt like to be in DKA. I don't remember what it felt like to have an IV in each arm. I don't remember the thirst. I don't remember the beeps. I don't remember how I felt.

That's not to say that I can't tell you how it felt or what it was like- I can. I know it like a favorite poem that I've performed a hundred times. But I don't know it like it happened to me.

Some of this, I think, is just normal fading of memory. Some of it is not. Between roughly July 2006 and July 2007, I lost the vividness of all of my memories. I lost the entirety of a lot of my memories. I lost the ability to bring up the knowledge that I wanted at will, which destroyed a lot of my function. I lost the ability to orient myself and was continually, perpetually lost. Then I started recovering. I recovered the ability to play chess. I improved a lot in my ability to recall things. I improved in my perception of time. My spelling recovered, and I was able to read books again. I wasn't as tired.

Today, I remember yesterday, vividly. I remember bits and pieces of things from the past fifteen months or so, some things that stand out. Everything else that I remember is just knowledge- I remember it like I read it, like it happened to somebody on TV. But boy, I do know a lot!

On this day in 2010, I started on the Dexcom system. I hope tomorrow to set it up with an amplifier. The Dexcom may or may not have really improved my over all blood sugar control.
In my 1st year on insulin, my A1cs were 16+%, 6.5%, 6.3%, and 6.3%
In my 2nd year on insulin, my A1cs were 6.4%, 7.0%, and 6.3%
In my 3rd year on insulin, my A1cs were 6.6%, 6.9%, 7.2%, and 6.4% (the rise occurred on the Guardian- I also had my gallbladder removed and had thyroiditis in this year).
In my 4th year on insulin, my A1cs were 7.1%, 7.0%, 7.0% and 6.6% (I had acute pancreatitis in this year- also had tendinitis that prevented me from walking).
In my 5th year on insulin, my A1cs were 6.2%, 6.6% and 7.0% (I also had a 6.1% fingerstick A1c towards the beginning of the year- I had less severe abdominal issues in this year).

This summer, my blood sugar stabilized a lot, for no reason I can be certain of, and I expect my next A1c to be below 6.5 for sure, maybe a lot below 6.5.

Some other things I did differently this year, or that I did for the first time in my diabetes management, include a new insulin that is only new to me- Regular, using a Bayer A1c, using 4mm pen needles, using the ketodiastix, using a blood ketone meter (NovaMax).

This was a pretty good year for me in terms of medical issues, compared to the past few years. I continue to have stomach problems, but they are not as bad as in past years. I had some testing done but no diagnosis. My weight this year was below 100 pounds the entire year, but it never measured lower than 96 pounds, so that's pretty stable, although the skinniest I've been since September 2006. I had a number of bizarre blood test results (think prolactin, vitamin D), but nothing that required me to do anything. I had no inpatient hospitalizations.

Going into my sixth year on insulin, I am more worried about fasting. I have been dramatically more ketone prone this year. I am less worried about my kidneys- my renal threshhold seems to have gone up sometime between the fall of 2007, when I tested it as being around 155, and now, when it seems to be around 190. I am more concerned about insulin absorption and scarring. I'd like to improve my injection technique.
I am hoping to break into the 5% club (people with A1cs between 5 an 6 percent) but would be reasonably satisfied with a year that sets no new personal records- no A1cs above 7.2%, no lows below 22, no diabetes related hospitalizations.
I am hoping to use the amplifier to wake up in the nights with my highs and lows, especially because waking up above 300 now means that I also wake up ketotic, in pain, and sometimes vomiting.
I am going to continue experimenting with both Novolog and Regular. By the end of the year, I will probably have decided that I like one or the other better. So far, just taking notes to help with my experimenting is improving my understanding of how the insulins work in my body.
I don't know if I will stay on the Dexcom. I think that I will, because my insurance is now covering it, and I don't expect the new minimed sensors to be available in the US anytime soon, and Abbot is officially removing the Navigator from the market. Also, my fingers swell up if I check my blood sugar much.

Today is also diabetes art day. The past few months I've been playing with the idea of characters inside a Dexcom illustrating glucoasters. One such drawing is on this blog a couple months back. But I haven't developed anything I want to post today. Sorry.

And now it's a bit past midnight... five years ago I was in an ambulance being transported from one hospital to another. Tonight I'm sitting in my own living room. Five years ago I was getting my insulin by an IV drip (regular, I think, at about 2u/ hr). Today, I took three only three shots of insulin- 14 units Regular with breakfast, none with lunch, 10 units Regular with supper, and 9 units Lantus. Five years ago, my lowest blood sugar of the day was about 260 mg/dl, after seven hours on insulin. Today, my highest blood sugar was about 260- a brief I-started-breakfast-before-injecting spike.

This past year was true to life- a mixture of healthy and not so much, conscientious and not so much, happy and not so much, peaceful and not so much. May the next year bring much.

1 comment:

Vera said...

Wow. That one's kinda touching. Keep going! Just realized that I'm reading your blog for over two years now, too (more or less regularly, that is). Keep going that as well!