Monday, February 20, 2012

Lows in the night

I went to bed last night shortly after midnight. I'd been eating for a couple of hours trying to get my blood sugar up, and I thought I'd finally done it.
I woke up briefly around 7 am, noted that my blood sugar was slightly low, didn't do anything about it, and woke up again at 9 am when my mother checked on me. At that point I needed to go to work, so I skipped breakfast. Lunch made me high, probably because it was my first meal of the day, and I didn't correct it because I had taken insulin and because I knew I was going for a walk after work (a friend is training for a 5K and I walked with him and then by myself). I took 12 units when I was about half a mile from home and still around 190. Came down a bit before I ate, ate too much at one sitting, and am now going down again. I had raised my Lantus dose back to 7 units Friday night and kept it there Saturday and Sunday nights, but I just took 6 tonight.

Anyways, I wanted to show this Dexcom graph mostly because it shows me going LOW and coming up without treating it, and I do not have much of any insulin resistance today; the high from lunch did not keep climbing. This is pretty typical for what happens after I am low in the night.

Thursday, February 16, 2012

Hodgepodge post

I keep thinking about the methotrexate shortage and drug shortages in general and cost control of drugs. And how Iran has the cheapest insulin. And about scandals regarding drug manufacture. I think the US government should get in the drug manufacturing business in order to cut prices, improve purity, and create access for Americans. Or if not the US govt, then a nonprofit.

When I didn't have a CGM, and I decreased my Lantus dose and had more overnight drop, I assumed that on the first night I'd had lows. Well, I didn't have lows the last few nights on 7 units of Lantus, although I didn't trust the down trend. So I dropped the dose to 6 units last nght and thought I'd be stable or rise overnight. Nah... dropped and woke up hypo, with an overnight drop of roughly 70 mg/dl. 6 is a pretty low Lantus dose for me- before last night, the previous time I'd taken 6 units was the night of Yom Kippur, and the time before that was on my retreat in August- I tend to run low when traveling.

The first ten copies of the zine were all distributed with five requests pending, so I made another ten copies. I made a different cover because I didn't do the margins well the first time. Next issue, when I'm writing the pages, I'm going to use a yellow marker to create (small) margins. I went to buy 2 cent stamps so that I wouldn't have to put eight 1 cent stamps on a zine going overseas, and while I was at it I bought a sheet of the Go Green! stamps 'cause I like them. But then I gave them to my mother as a gift.

I made some scatter plots by hand on paper, comparing my daily standard deviation and averages, and time spent in the 75-165 range and daily average. The latter graph had a much more visually apparent trend; I sometimes have low standard deviations with high averages. But lower days are more likely to have been controlled, and also a large standard deviation is less likely when going down from the average much makes me hypo.

Dexcom is giving an extra free sensor to anybody who places their first online order in the next month or so. I gave it a try, and so far it is frustrating me. It took about a day to link my account to the information I provided online, and then after I put in a request for sensors, I got a statement that it'd get back to me regarding coverage and now it says something like cost $920 (two boxes), and that my part of that $920 would be $233. $233 sounds high to me, although I guess I'd pay it. But I'd really like to know where that comes from, since the online statement doesn't say anything about what my insurance is paying or anything like that. Do I have a deductible and then I pay 10%, like last year? Or am I going to be asked for $233 for each shipment this year?

Thursday, February 02, 2012

Sonia Sotomayor: The True American Dream

by Antonia Felix

I checked this book out last Thursday and finished it today. It is a biography of Sonia Sotomayor written by a contemporary of Sonia Sotomayor who has never spoken to Sotomayor. The book is based off of interviews with Sonia Sotomayors family and friends and people who used to go to the same school she did even if they weren't family or friends. It also draws from speeches, artilces briefs, and opinions by Sotomayor and articles about Sotomayor by other people. Oddly enough, Felix seems to have taken at face value everything said about Sotomayor as long as it wasn't negative, which makes for a somewhat conflicting story.
The story roughly told is: what Puerto Rico was like in the time of her mother's childhood, her mother's general life story, where Sonia Sotomayor went to school, what she did there, her more prominent escapades, her career, what people have to say about it, particularly if they praise her.
This book has nothing bad to say about Sonia Sotomayor at all. She's perfect! That gets a little bit annoying. But it's a sort of interesting story anyways. Because Sonia Sotomayor has had an interesting life. She was born to Puerto Rican parents in New York city in 1954, and she has one younger brother (he grew up to be a doctor). Her mother was a former WAC and nurse, her father a dye maker. She lived in the projects when people were proud to live in the projects. She was diagnosed with diabetes at the age of eight, after a long period of being withdrawn and quiet, and insulin made her seem to come magically back to life. Her father died the following year, leaving her mother to raise two kids alone. Sonia went to a prestigous Catholic high school while working to help support her family while her mother went to school to get an RN degree. She went to an Ivy League college; her test scores were not as high as those of her classmates but they had instituted affirmative action policies. She struggled but scored well in her classes. She then went to an Ivy League law school, where she "worked hard and partied hard." She also picked up a chain smoking habit. She went from law school to being a prosecutor (assistant Distrist Attorney in New York) then went into practice defending copyrighted bags and stuff like that, then became a judge, then another kind of judge, then supreme court justice. While she was judge, she got to end the baseball strike.

As to her diabetes: while the book suggests that her lack of diabetes complications was because she did everything right, and while it gives evidence that she did take her shots regularly and had very low A1cs consistantly, I think the evidence is stronger to suggest that she doesn't have type 1a diabetes. Why? Well, she didn't, in fact, take spectacular measures to control her diabetes- she took conscientious but ordinary measures to control her diabetes, such as always taking her shots, but still did things like drinking in the way that college students often do, eating no particularly controlled diet, and going long periods without exercise. She was diagnosed in a time period where she couldn't have been testing her blood sugar. Despite this, she never had an episode of severe hypoglycemia or even any episode of hypoglycemia that her coworkers could remember in which she had symptoms. She never had a hospitalization for diabetes, except possibly at diagnosis. She was diagnosed after a lengthy period that was so long that people saw her being quiet and withdrawn as just being normal for her, and she was not very sick when she was diagnosed. She'll be hitting fifty years with diabetes this year, and she has no complications at all. It's not proof that she doesn't have the regular type 1a diabetes, but it's suggestive.
Diabetes is mentioned in the book as one of the reasons she gave for wanting to get a lot of experience in different areas of law quickly- to get as much as possible done in case she died young.

Anyways. I think Sandra Sotomayor is an interesting character and if she ever publishes an autobiography, I'll be interested in reading that, but I think this book is a little too hard to trust.

Wednesday, February 01, 2012

My insurance company sent me an email today asking me to "show [my] red on facebook". That was in the title; I was curious enough to open the email. Turns out February is Heart Awareness Month. The email does not say exactly what it is I am supposed to be aware of when it comes to hearts. I think we are all aware that we have hearts- right? It's that thing that sort of burns when I do a sustained fast walk. Our awareness of hearts shows in the way we talk. Nobody talks about having kidney; they have heart. You don't take it to your liver, you take it to heart. And it's only second to the brain in terms of organs we feel that we need: you might be declared dead if your heart doesn't work, and whereas your kidneys and liver are said to "fail", if your heart doesn't work, you've been betrayed by a "heart attack"*. While it's not uncommon for people to be unable to locate any other internal organ (save the brain and maybe the larynx and stomach), most people know where their hearts are, and when their hearts hurt, they don't think maybe it's their lungs.
So frankly, I think we're all pretty aware of hearts. And I think turning your facebook red (or whatever it is my insurance is suggesting) is pretty pointless if all it's supposed to do is "support heart awareness".

So, so... what should you be aware of?
I dunno, honestly. I could give you statistics about who heart disease, but frankly I don't think it's useful to know how many people die of heart disease. I'll give you one statistic, but only 'cause it surprises people- more women than men die of heart disease (in 2009's CDC report, 397,874 American females vs 382,750 American males, out of a total of just under two and a half million deaths) . They just tend to die of it at older ages, is why it's more associated with men. But yeah, I have no idea how that statistic would help anybody.

So here's my challenge to you, my opinionated readers. Find me any data about hearts that is definitive, some data that actually means something. Raise my awareness. Leave me a comment and I'll make a post about it.

*I was five years old the first time I remember hearing the term "heart attack". As in, "Yitz just survived his third heart attack." I got a very confusing picture of what happened and I imagined that a heart attack was something along the lines of being attacked by a motorcycle gang- I was pretty sure about the motorcycles. It took years for me to stop associating heart attacks and motorcycles.