I just read another diabetes book, Reflections on Diabetes: 39 Inspirational Real-Life Stories On Living With Diabetes published by the ADA in 1996. It's short pieces (and a very small book) by diabetics (and people with diabetes) and family members, type 1 and type 2. It is very much a product of the time it was published, with a lot of the stories being about food restriction, and each of those stories having an italics comment from The Editors about how current guidelines recommend a diet tailored to lifestyle, and a sugar is a carb.
My favorite story is about a fisherman with neuropathy in his hands whose son helps him rig his fishing pole with a bobber so that he can see the fish bite 'cause he can't feel them, and this accommodation makes him a better fisher and people without neuropathy copy him. But I don't condone fishing, FYI.
One thing wearing the Dexcom is making me think about again is body image. I don't have much of a sense of what I look like- never have. I'm not sure if this is because of being dysphoric in a gender kind of way, or if it is more autism related.
But anyways, when I was diagnosed with diabetes, and particularly the morning after, I looked at myself and looked and it bothered me that something so important about my body didn't show. Maybe it was my concrete thinking showing, but I kept wondering, WHERE is my diabetes? I kept wondering, could I really be diabetic if I couldn't see the diabetes? (This probably explains why I still wonder if I'm really autistic). After some time, I was relieved to locate it in my fingers, which were and are scarred from blood sugar checks.
Wearing the I-Port, and later on the Guardian, as well as the dummy solo, were cool to me beyond their actual purposes in that they located diabetes on my body. However, the I-Port and Guardian sensors as well as sticking out on my body, hurt. All the time. I never could forget that they were there, and after one would come off, I would continue thinking that I needed to be careful not to jostle that area for some days. They became, quickly, part of how I expected my body to feel.
The Dexcom is different. I still love looking and seeing my diabetes, right there on my arm, as well as on the screen. But I don't feel it. I keep thinking it's on my other arm, that's how much I can't feel it. I run my hands up my arms checking to see where it is. I lie on top of it and don't know until I'm on my side that I lay on the wrong side. Which I guess confirms that I really do have trouble with right and left. Because even though I know I put it on the left side, I don't know until I go feeling for it which side is left.
If anybody is reading this far, I have some questions.
1. I'm not using Windows on this computer. It would probably be a hassle to get to a computer with Windows with which I can access the Dexcom software and/or to install a Windows imitator to run the software. What would I get from an upload? Is this hassle worth the bother?
2. How long will the Dexcom let me go between calibrations without stopping to display readings?
3. Will wearing a sensor on one's stomach interact with stomach pain, pancreatits, gallstones, digestion, and/or gastroparesis?
Sunday, September 05, 2010
Wednesday, September 01, 2010
Dexcom!
On Tuesday I came home expecting to find the Dexcom and instead found a note from Fedex that they'd come and nobody was home. My father and brother say that they didn't hear the bell ring.
Today I went to the Fedex place just after 8, and just after my package left. At noon I heard the door to the foyer open and close, but the bell didn't ring. When I went out to investigate, I found a big box, addressed to me. I opened the door and saw the Fedex truck leaving.
I got the receiver charged, and was pleasantly surprised after a couple of hours to find that all three bars were shaded when I unplugged it. With my mother's assistance, we inserted a sensor into my left arm. We had a lot of difficulty with clicking the transmitter into place, and with removing the latch. That said, the insertion was a gazillion times less painful than I remember Guardian sensor insertions being. And so far, the wearing of the sensor has not been really painful. Not painless, really, but so much less pain that it's comparatively painless.
I calibrated the Dexcom at 5 PM. Around 6 PM, when it showed my blood sugar as having dropped a hundred points, I checked my blood sugar again; my meter read 95 to Dexcom's 96. So I decided to go off the Dexcom for the rest of the evening; I'll check it again soon.
P.S. No sooner had I published this than I saw my first transmitter out of range. BOO! I only missed one reading, and it is back.
Today I went to the Fedex place just after 8, and just after my package left. At noon I heard the door to the foyer open and close, but the bell didn't ring. When I went out to investigate, I found a big box, addressed to me. I opened the door and saw the Fedex truck leaving.
I got the receiver charged, and was pleasantly surprised after a couple of hours to find that all three bars were shaded when I unplugged it. With my mother's assistance, we inserted a sensor into my left arm. We had a lot of difficulty with clicking the transmitter into place, and with removing the latch. That said, the insertion was a gazillion times less painful than I remember Guardian sensor insertions being. And so far, the wearing of the sensor has not been really painful. Not painless, really, but so much less pain that it's comparatively painless.
I calibrated the Dexcom at 5 PM. Around 6 PM, when it showed my blood sugar as having dropped a hundred points, I checked my blood sugar again; my meter read 95 to Dexcom's 96. So I decided to go off the Dexcom for the rest of the evening; I'll check it again soon.
P.S. No sooner had I published this than I saw my first transmitter out of range. BOO! I only missed one reading, and it is back.
Tuesday, August 31, 2010
The Fight To Survive by Caroline Cox
Every now and then I go to the library's online catalogue and I search "diabetes biography". This brings up about 20 books, including biographies of ten people (nine diabetic): Mary Tyler Moore, Frederick Banting, Ron Santo, Deb Butterfield, Zippora Karz, Nicole Johnson, Denise Bradley, Andie Dominick, Lisa Roney, and Elizabeth Hughes.
Now, all nine of these people were diagnosed long before I was, but Elizabeth Hughes was diagnosed long before anybody reading this blog was. Elizabeth Hughes was diagnosed with diabetes in 1919, when she was eleven years old. In 1919, you couldn't get a prescription for insulin. You couldn't get in a research trial and be given insulin. In fact, you plain old couldn't get insulin, unless you made it with your own damn pancreas.
Which is what she did. Using the method of eating until you peed sugar, then not eating until you didn't, she lived on the insulin she made herself, growing smaller and smaller, weaker and weaker, until she went on insulin in 1922.
I checked out The Fight to Survive: A Young Girl, Diabetes, and the Discovery of Insulin by Caroline Cox a week ago and read it through pretty quickly. I wanted to read a book about diabetes that was different. I wanted a book to make me want to celebrate injectable insulin (four years, whoop!). I wanted a book that wasn't about a celebrity or a role model.
This book is about a celebrity though; just not a celebrity of of the twenty first century. Elizabeth Hughes's father ran for president on the Republican ticket and was also a supreme court judge. During the years of her illness, her family was rich enough to hire a personal nurse for her, and they sent her to Toronto to go on insulin. And while this book doesn't really attempt inspiration, particularly not "living with diabetes inspiration", it is an attempt to understand how a preteen and teenage girl starved herself despite not being anorexic. How she managed to enjoy life in some sense at that time.
But I liked it. I liked the way that this book talks about the discoverers of insulin. Their story is told in little snippets parallel to Elizabeth's and while at first it was losing me in biographical detail, soon the details (juicy!) had me taking notes. Did you know that Banting was alcoholic? Did you know that after producing insulin and injecting it in a few patients, they had to stop because they didn't remember how to make more? And I liked Elizabeth herself, despite the fact that her experience did not have much to do with mine, as she didn't really have a lot of diabetes symptoms other than sugar in her urine. This book is really only about those years which she later wanted to forget (I can imagine wanting to put starvation behind you!). I didn't like the bits in which Cox attempts to look at the current diabetes situation, and I believe that her mortality statistics contradict what I read elsewhere. But that's not the book.
This is a book about living with diabetes without insulin. This is a book about heroes who did not behave heroically. I recommend this book because it will challenge your ideas of the history of diabetes.
Now, all nine of these people were diagnosed long before I was, but Elizabeth Hughes was diagnosed long before anybody reading this blog was. Elizabeth Hughes was diagnosed with diabetes in 1919, when she was eleven years old. In 1919, you couldn't get a prescription for insulin. You couldn't get in a research trial and be given insulin. In fact, you plain old couldn't get insulin, unless you made it with your own damn pancreas.
Which is what she did. Using the method of eating until you peed sugar, then not eating until you didn't, she lived on the insulin she made herself, growing smaller and smaller, weaker and weaker, until she went on insulin in 1922.
I checked out The Fight to Survive: A Young Girl, Diabetes, and the Discovery of Insulin by Caroline Cox a week ago and read it through pretty quickly. I wanted to read a book about diabetes that was different. I wanted a book to make me want to celebrate injectable insulin (four years, whoop!). I wanted a book that wasn't about a celebrity or a role model.
This book is about a celebrity though; just not a celebrity of of the twenty first century. Elizabeth Hughes's father ran for president on the Republican ticket and was also a supreme court judge. During the years of her illness, her family was rich enough to hire a personal nurse for her, and they sent her to Toronto to go on insulin. And while this book doesn't really attempt inspiration, particularly not "living with diabetes inspiration", it is an attempt to understand how a preteen and teenage girl starved herself despite not being anorexic. How she managed to enjoy life in some sense at that time.
But I liked it. I liked the way that this book talks about the discoverers of insulin. Their story is told in little snippets parallel to Elizabeth's and while at first it was losing me in biographical detail, soon the details (juicy!) had me taking notes. Did you know that Banting was alcoholic? Did you know that after producing insulin and injecting it in a few patients, they had to stop because they didn't remember how to make more? And I liked Elizabeth herself, despite the fact that her experience did not have much to do with mine, as she didn't really have a lot of diabetes symptoms other than sugar in her urine. This book is really only about those years which she later wanted to forget (I can imagine wanting to put starvation behind you!). I didn't like the bits in which Cox attempts to look at the current diabetes situation, and I believe that her mortality statistics contradict what I read elsewhere. But that's not the book.
This is a book about living with diabetes without insulin. This is a book about heroes who did not behave heroically. I recommend this book because it will challenge your ideas of the history of diabetes.
Sunday, August 29, 2010
On Thursday I visited the endo, and got weighed and had blood drawn and talked and had my feet checked (still having problems feeling vibrations). My weight is 101 lb, which represents no real change over the summer. My vitamin B12 level (which I had drawn because I am a vegan) was in the mid normal range. My vitamin D came down from 97 to 32.6; I suppose we can retest in a few months. The celiac stuff was all normal. The A1c came in at 6.6%. I decided to look at my A1c history. Here it is in a graph: http://nces.ed.gov/nceskids/createagraph/default.aspx?ID=43046429fea34dd08eb29bc32c254686
FedEx says my Dexcom is currently in Memphis. I am impatiently awaiting its arrival!
FedEx says my Dexcom is currently in Memphis. I am impatiently awaiting its arrival!
Wednesday, July 14, 2010
I called Minimed and a replacement receiver is 550, a replacement transmitter is 649. If you are a previous Guardian user, getting a new receiver and transmitter is 1199 dollars. If you then bought a box of four sensors, you'd be at the 1344 cited as the price of start up. But you could buy only 10 pack boxes.
I think I'm going with Dexcom anyways. I want less pain.
I talked it over with my mother. She thinks I should have my thyroid function retested, as I have a history of thyroiditis and thyroid dysfunction can mess up blood sugar. She agreed that, at least if this continues, she's willing to help pay for a CGMS for me.
So I'm thinking about whether I should go in soon to see the endo for a TSH. Maybe. I'm overdue to see my other doctor anyways, so maybe I'll ask her to run a TSH even though it's always been my endo who's done that.
I think I'm going with Dexcom anyways. I want less pain.
I talked it over with my mother. She thinks I should have my thyroid function retested, as I have a history of thyroiditis and thyroid dysfunction can mess up blood sugar. She agreed that, at least if this continues, she's willing to help pay for a CGMS for me.
So I'm thinking about whether I should go in soon to see the endo for a TSH. Maybe. I'm overdue to see my other doctor anyways, so maybe I'll ask her to run a TSH even though it's always been my endo who's done that.
Tuesday, July 13, 2010
Guardian v Dexcom
I have had nutsy blood sugar in the past month, details below. I'm therefore thinking about buying a CGMS out of pocket again. My last experience, in 2008, was with the Guardian. I found it accurate for at least a week per sensor, all sensors I wore in the arm, but continuously painful and itchy. I lost the transmitter and decided not to get another. I still have some sensors, now expired. Anyways.
I'm looking at the Dexcom Seven Plus. I spent a couple hours reading about it today, plus I called customer service. Sales there says I can buy a starter pack and a box of four sensors now for the price of 999 dollars if I pay out of pocket. A box of 4 sensors is 319 dollars unless I agree to buy six or more boxes in a 12 month period, in which case it's 289 dollars per box. The transmitter and receiver each have 12 month warrantees.
So for one year, if I used 28 Dexcom sensors, the total cost would be 2733 dollars.
But if I had to use 36 Dexcom sensors, the cost would be 3311 dollars.
If I went with the Guardian again, then as I remember it startup cost is 1344 dollars and that includes 4 sensors (despite what the internet says). A box of 10 sensors is 350 dollars. The receiver is warranteed for twelve months, but the transmitter only for six months. I forget the replacement cost for the transmitter; either it's 450 or 650 dollars. So if it's 450 and I had to replace it, and I used 34 Minimed sensors, the total cost over one year would be 2844 dollars.
If I needed 44 sensors, the total cost would only grow to 3194 dollars.
Now, I've used the Guardian before so I'm pretty sure I really could stretch 34 sensors over a whole year. I've never used the Dexcom so I don't know how long I could get out of one of their sensors, which is one of the things making me hesitate. Some other thoughts:
The Dexcom only needs to be recharged, and doesn't need batteries. This would probably be a savings of over 100 dollars over the course of a year of full time use.
The Dexcom people charge shipping and handling, which I hear can add up to 15 dollars per shipment. That could add up quick.
I hated dealing with Minimed customer service. Although they replaced the receiver twice, they were horrible with my financial transactions and with talking to insurance.
I hated the feeling of wearing the Minimed sensors and I hope the Dexcom ones would feel less painful.
I loved the data analysis, graphing, and predictive alarm features on the Guardian. I also loved that the screen stayed on. The Dexcom has none of these features. Even worse, the Dexcom has a low alarm that can't be turned off. This would make continuing to use the sensor as it fails probably worse because it reads a little low as it goes bad, and I could accommodate for that if I could turn off the alarms.
Dexcom users can't use tylenol. Probably not a big deal as I don't use tylenol.
The dexcom transmitter doesn't store data and you're not supposed to go swimming with it for more than 30 minutes. I don't go swimming often... but sometimes.
The shape of the dexcom makes buying additional tape to keep it down less likely to be necessary.
I went on a road trip in early June for a week and my Lantus needs went down.
I came home and my Lantus needs rose back to 8 units per day or so.
I left again after two weeks, and on the road I achieved steadyish overnight blood sugar with Lantus doses of 4-6 units.
I got home and my wake up numbers climbed. I took 8 units, 9 units, 10 units.
I woke up in the 200s, 300s, 300s, and more 300s.
I opened a new vial of Lantus.
I still woke up in the 300s. Not only that, but my daytime numbers kept rising out of nowhere, no food on board, 300s and 300s and I took 20 units of Novolog last night when my suppertime number was 316. I ate about 30 cabs (my usual ratio is 1:8, so that means I ate for about four units). I kept checking to see if I'd come down, but all I got down to was 180.
Well, finally I just rage basaled and took 15 units of Lantus last night. I woke up with a blood sugar of 75. But after breakfast I was up at 302. Hoping it would come down, I didn't correct; at 11 AM it was 324. I took 6 units of Novolog. At 12:30 it was down to 296. I left it alone. At 2:30 it was 90. At 2:50 it was 54. I ate 24 carbs of granola bar. At 3:25 it was 52. I ate a muffin and put lots of honey on top, then walked home, a distance of about a mile and a half. At 3:50 I was 132. At 4:50 I was 192 and I took 2 units. At 7:00, I was 232.
I'm looking at the Dexcom Seven Plus. I spent a couple hours reading about it today, plus I called customer service. Sales there says I can buy a starter pack and a box of four sensors now for the price of 999 dollars if I pay out of pocket. A box of 4 sensors is 319 dollars unless I agree to buy six or more boxes in a 12 month period, in which case it's 289 dollars per box. The transmitter and receiver each have 12 month warrantees.
So for one year, if I used 28 Dexcom sensors, the total cost would be 2733 dollars.
But if I had to use 36 Dexcom sensors, the cost would be 3311 dollars.
If I went with the Guardian again, then as I remember it startup cost is 1344 dollars and that includes 4 sensors (despite what the internet says). A box of 10 sensors is 350 dollars. The receiver is warranteed for twelve months, but the transmitter only for six months. I forget the replacement cost for the transmitter; either it's 450 or 650 dollars. So if it's 450 and I had to replace it, and I used 34 Minimed sensors, the total cost over one year would be 2844 dollars.
If I needed 44 sensors, the total cost would only grow to 3194 dollars.
Now, I've used the Guardian before so I'm pretty sure I really could stretch 34 sensors over a whole year. I've never used the Dexcom so I don't know how long I could get out of one of their sensors, which is one of the things making me hesitate. Some other thoughts:
The Dexcom only needs to be recharged, and doesn't need batteries. This would probably be a savings of over 100 dollars over the course of a year of full time use.
The Dexcom people charge shipping and handling, which I hear can add up to 15 dollars per shipment. That could add up quick.
I hated dealing with Minimed customer service. Although they replaced the receiver twice, they were horrible with my financial transactions and with talking to insurance.
I hated the feeling of wearing the Minimed sensors and I hope the Dexcom ones would feel less painful.
I loved the data analysis, graphing, and predictive alarm features on the Guardian. I also loved that the screen stayed on. The Dexcom has none of these features. Even worse, the Dexcom has a low alarm that can't be turned off. This would make continuing to use the sensor as it fails probably worse because it reads a little low as it goes bad, and I could accommodate for that if I could turn off the alarms.
Dexcom users can't use tylenol. Probably not a big deal as I don't use tylenol.
The dexcom transmitter doesn't store data and you're not supposed to go swimming with it for more than 30 minutes. I don't go swimming often... but sometimes.
The shape of the dexcom makes buying additional tape to keep it down less likely to be necessary.
I went on a road trip in early June for a week and my Lantus needs went down.
I came home and my Lantus needs rose back to 8 units per day or so.
I left again after two weeks, and on the road I achieved steadyish overnight blood sugar with Lantus doses of 4-6 units.
I got home and my wake up numbers climbed. I took 8 units, 9 units, 10 units.
I woke up in the 200s, 300s, 300s, and more 300s.
I opened a new vial of Lantus.
I still woke up in the 300s. Not only that, but my daytime numbers kept rising out of nowhere, no food on board, 300s and 300s and I took 20 units of Novolog last night when my suppertime number was 316. I ate about 30 cabs (my usual ratio is 1:8, so that means I ate for about four units). I kept checking to see if I'd come down, but all I got down to was 180.
Well, finally I just rage basaled and took 15 units of Lantus last night. I woke up with a blood sugar of 75. But after breakfast I was up at 302. Hoping it would come down, I didn't correct; at 11 AM it was 324. I took 6 units of Novolog. At 12:30 it was down to 296. I left it alone. At 2:30 it was 90. At 2:50 it was 54. I ate 24 carbs of granola bar. At 3:25 it was 52. I ate a muffin and put lots of honey on top, then walked home, a distance of about a mile and a half. At 3:50 I was 132. At 4:50 I was 192 and I took 2 units. At 7:00, I was 232.
Tuesday, May 25, 2010
Update
In my February visit with the endo, I gave a urine sample for microalbuminuria testing, and asked not to be told the results. I'm really glad I asked that. Because at yesterday's visit, I learned that February's test had been macroalbuminuric. Fortunately, yesterday's urine sample was totally normal, and I didn't have that much time to freak out.
My blood sugar's been an unholy mess lately and my 7 day average at one point was something like 179, which is the highest it had been in three and a half years. But my A1c didn't budge from February, at 7.0%.
My meter had read 145 right before the blood draw; the lab said 138. Good enough.
My vitamin D level skyrocketed above the normal range and I'm supposed to stop taking the vitamin D supplements and come back in another month.
I haven't gained any weight over the last few months, but I haven't lost any either, so that's okay. My appetite is not very good, but I guess there are worse things. My pain levels are way down; I haven't been woken by pain in forever (though I have been woken by hypos and am wondering if nocturnal hypoglycemia could've caused the lower A1c), I haven't had to stop working because of pain... I have no cause for complaint. I do have soreness and tenderness in my abdomen, particularly over my pancreas, and I have a persistent pain in my lower back on the left side. I'm also having squeezing headaches. But I haven't fallen. I took my pulse for a full minute each time about twenty five times over the course of a week and found that my pulse was anywhere from 48 to 81, but usually 55-65. At bedtime it was in the 50s but in the daytime it tended to be in the 60s, and when I was waiting in my therapist's office, it was 81.
So, I think I was even sicker than I realized before the gallstones were removed, and I am on the mend.
Oh, and I did send in paperwork for a CGMS but Dexcom lost it and then I couldn't find the forms I'd filled out (and had my endo fill out) so I decided to just not worry about it for now.
My blood sugar's been an unholy mess lately and my 7 day average at one point was something like 179, which is the highest it had been in three and a half years. But my A1c didn't budge from February, at 7.0%.
My meter had read 145 right before the blood draw; the lab said 138. Good enough.
My vitamin D level skyrocketed above the normal range and I'm supposed to stop taking the vitamin D supplements and come back in another month.
I haven't gained any weight over the last few months, but I haven't lost any either, so that's okay. My appetite is not very good, but I guess there are worse things. My pain levels are way down; I haven't been woken by pain in forever (though I have been woken by hypos and am wondering if nocturnal hypoglycemia could've caused the lower A1c), I haven't had to stop working because of pain... I have no cause for complaint. I do have soreness and tenderness in my abdomen, particularly over my pancreas, and I have a persistent pain in my lower back on the left side. I'm also having squeezing headaches. But I haven't fallen. I took my pulse for a full minute each time about twenty five times over the course of a week and found that my pulse was anywhere from 48 to 81, but usually 55-65. At bedtime it was in the 50s but in the daytime it tended to be in the 60s, and when I was waiting in my therapist's office, it was 81.
So, I think I was even sicker than I realized before the gallstones were removed, and I am on the mend.
Oh, and I did send in paperwork for a CGMS but Dexcom lost it and then I couldn't find the forms I'd filled out (and had my endo fill out) so I decided to just not worry about it for now.
Saturday, April 17, 2010
Sabotaging Urges
After a really rotten blood sugar week filled with 30s and 300s and an average of 169, I had a day like this:
0010 hours 80
0820 hours 104
1020 hours 100
1220 hours 95
1550 hours 72
1720 hours 102
2040 hours 86
2205 hours 125
Can you believe that goodness? Nothing at all high, nothing low enough to be symptomatic. AND I had a huge breakfast with life cereal and potatos, and a lunch with potatoes and pie and supper with sandwiches... not a low carb day- I took 39 units of Novolog and 8 units of Lantus. And I ran around and played catch and stuff. And it was frickin' perfect.
By comparison, here was the 15th:
0005 hours 377
0205 hours 151
0745 hours 45
1125 hours 304
1325 hours 173
1609 hours 86
1730 hours 101
1805 hours 119
2115 hours 221
2330 hours 221
Now, it totally makes sense that on the 15th, I felt like it was partly my fault, and partly a very frustrating body, and that I really wanted to change what was going on. I mean, out of 10 readings, 4 were in my target range of 65-155. But what doesn't make sense to me is that I felt almost as out of control today because... where were those numbers coming from? 8 out of 8 numbers in range?!
When I have one, two, three target range numbers in a row, I feel pretty good. When I have five, six, seven, I start to feel surreal. I start getting an urge to prove that I really do have diabetes, to test the bounds of my body. ARGH! Take your blessings and run, Jonah!
Fortunately, I haven't done anything stupid yet today. I'm plenty wiped out from the week I've just had and I could really use a run of days like today... not that that's at all likely to happen.
One thing I've been figuring out is that my ISF seems to have gone up. It was 35 for a while, then 40. A couple months ago I changed it to 50, but the way I'm crashing after corrections, I'm going to try 60, assuming I go high anytime soon :-) More surprisingly, I think my BCR has also gone up, and that that's part of why I'm seeing so many highs- that it doesn't take as many carbs to do the job. My BCR has been around 4.5 for a long while, maybe as high as five, but it's seemed to me lately that it has gone up- maybe to around 7? I am perplexed. My ICR I changed from 7 to 8 a few months ago and seems to be holding steady.
EDIT: It is now 2330 hours and my blood sugar is 201 (I haven't eaten in at least five hours). I think I'll go with 1.5 units of Novolog.
0010 hours 80
0820 hours 104
1020 hours 100
1220 hours 95
1550 hours 72
1720 hours 102
2040 hours 86
2205 hours 125
Can you believe that goodness? Nothing at all high, nothing low enough to be symptomatic. AND I had a huge breakfast with life cereal and potatos, and a lunch with potatoes and pie and supper with sandwiches... not a low carb day- I took 39 units of Novolog and 8 units of Lantus. And I ran around and played catch and stuff. And it was frickin' perfect.
By comparison, here was the 15th:
0005 hours 377
0205 hours 151
0745 hours 45
1125 hours 304
1325 hours 173
1609 hours 86
1730 hours 101
1805 hours 119
2115 hours 221
2330 hours 221
Now, it totally makes sense that on the 15th, I felt like it was partly my fault, and partly a very frustrating body, and that I really wanted to change what was going on. I mean, out of 10 readings, 4 were in my target range of 65-155. But what doesn't make sense to me is that I felt almost as out of control today because... where were those numbers coming from? 8 out of 8 numbers in range?!
When I have one, two, three target range numbers in a row, I feel pretty good. When I have five, six, seven, I start to feel surreal. I start getting an urge to prove that I really do have diabetes, to test the bounds of my body. ARGH! Take your blessings and run, Jonah!
Fortunately, I haven't done anything stupid yet today. I'm plenty wiped out from the week I've just had and I could really use a run of days like today... not that that's at all likely to happen.
One thing I've been figuring out is that my ISF seems to have gone up. It was 35 for a while, then 40. A couple months ago I changed it to 50, but the way I'm crashing after corrections, I'm going to try 60, assuming I go high anytime soon :-) More surprisingly, I think my BCR has also gone up, and that that's part of why I'm seeing so many highs- that it doesn't take as many carbs to do the job. My BCR has been around 4.5 for a long while, maybe as high as five, but it's seemed to me lately that it has gone up- maybe to around 7? I am perplexed. My ICR I changed from 7 to 8 a few months ago and seems to be holding steady.
EDIT: It is now 2330 hours and my blood sugar is 201 (I haven't eaten in at least five hours). I think I'll go with 1.5 units of Novolog.
Friday, March 19, 2010
Pancreatitis and Type 1 Diabetes
This post was edited significantly after I discussed the facts with my doctor.
On Wednesday I was discharged from the hospital. The diagnoses I accrued while there were: choledocholithiases, cholangitis, and the biggee, gallstone pancreatitis. The spell checker thinks all of those are misspellings. Sorry, spell checker.
I had asked to be tested for pancreatitis three times in the past year, and had been. In fact, only ten days before my hospital admission, my lipase was 11; at admission it was 4040.
An ultrasound showed three stones in my pancreas, and an endoscopic retrograde cholangiopancreatography was performed, removing, according to my discharge papers "2 large stones and several stone fragments".
In type 1 diabetes, the production of amylase and lipase is often mildly to moderately abnormal and may not be an accurate marker of pancreatitis. BEWARE.
Anyways, I am on the mend. I am dealing with much lower insulin needs, probably 'cause I'm not in so much pain and am eating less. Last night I took only 7 units of Lantus, but woke up with a blood sugar of 39 this morning. I think tonight I will take 5.5 units of Lantus instead.
On Wednesday I was discharged from the hospital. The diagnoses I accrued while there were: choledocholithiases, cholangitis, and the biggee, gallstone pancreatitis. The spell checker thinks all of those are misspellings. Sorry, spell checker.
I had asked to be tested for pancreatitis three times in the past year, and had been. In fact, only ten days before my hospital admission, my lipase was 11; at admission it was 4040.
An ultrasound showed three stones in my pancreas, and an endoscopic retrograde cholangiopancreatography was performed, removing, according to my discharge papers "2 large stones and several stone fragments".
In type 1 diabetes, the production of amylase and lipase is often mildly to moderately abnormal and may not be an accurate marker of pancreatitis. BEWARE.
Anyways, I am on the mend. I am dealing with much lower insulin needs, probably 'cause I'm not in so much pain and am eating less. Last night I took only 7 units of Lantus, but woke up with a blood sugar of 39 this morning. I think tonight I will take 5.5 units of Lantus instead.
Sunday, March 07, 2010
Tough News
I got my bloodwork results back on Tuesday, and I've been in shock since then.
My A1c was 7.0%, which was higher than I was hoping for but not a huge big deal.
My vitamin D levels were very low, and I have started on a repletion dose of 8000 IU per day, dissolved in olive oil.
My hemoglobin and hematocrit were moderately and mildly elevated, and I'm hoping that that was caused by dehydration.
But the kick in the stomach was that my liver enzymes, the ALT and the AST, came back dramatically elevated. I went in for more bloodwork on Friday and should have results on Monday. I will also be going in for an abdominal ultrasound this week. If the liver enzymes are high again, and the extra bloodwork and the ultrasound do not reveal an obvious cause, then I'll be seeing a gastroenterologist or hepatologist.
I am taking a low dose of testosterone, and my endo had hoped that this could be the cause, but he doesn't think it's likely; neither does the doctor who prescribes my T. Friday's bloodwork included a check of testosterone levels.
I believe that at this point the most likely diagnosis is autoimmune hepatitis, and I am scared.
I intend to post February diabetes stats soon, but right now they seem sort of moot point.
My A1c was 7.0%, which was higher than I was hoping for but not a huge big deal.
My vitamin D levels were very low, and I have started on a repletion dose of 8000 IU per day, dissolved in olive oil.
My hemoglobin and hematocrit were moderately and mildly elevated, and I'm hoping that that was caused by dehydration.
But the kick in the stomach was that my liver enzymes, the ALT and the AST, came back dramatically elevated. I went in for more bloodwork on Friday and should have results on Monday. I will also be going in for an abdominal ultrasound this week. If the liver enzymes are high again, and the extra bloodwork and the ultrasound do not reveal an obvious cause, then I'll be seeing a gastroenterologist or hepatologist.
I am taking a low dose of testosterone, and my endo had hoped that this could be the cause, but he doesn't think it's likely; neither does the doctor who prescribes my T. Friday's bloodwork included a check of testosterone levels.
I believe that at this point the most likely diagnosis is autoimmune hepatitis, and I am scared.
I intend to post February diabetes stats soon, but right now they seem sort of moot point.
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