Friday, March 23, 2007

Gearing up...

...for a busy weekend.

Mission one is meeting with a group from my class to finish a paper together. Only two more classes to go before the final exam on April 20th.

Mission two is continuing house renovations. This weekend we're focusing on BF's house so that I can start moving my things over there. He's handling the construction-type stuff while I do what I do best: paint.

It's surprising how much exercise painting is though. It almost always kicks me in the butt, resulting in one low after another throughout the day and for hours afterward. Good thing I stocked up on juice this week. :)

Monday, March 19, 2007

My pump

Thanks to those who have stumbled across my journal so far and for all your kind words. It means a lot. I'm slowly adding links to other blogs as I go, from comments that are left and from the links I find on your own pages. If you'd like to see yours listed on the right, let me know. I'd be more than happy to add it.

I don't mean to complain, and I know I've been sounding like a real whiner lately. But over the weekend I developed a sore throat and cough. I'm not sure if it's the chest cold I had 3 weeks ago coming back to haunt me, or if I picked up something new at the clinic last week. Either way, it stinks. My symptoms seem to run the gamut, from sinus headache to sore throat. I went over to Wal-Mart during my lunch break for some relief, but couldn't find a magical all-in-one drug to help me. I picked up some head cold & sinus medication; Robitussin ("for People with Diabetes") to loosen chest congestion; and sucrose-free, antibacteral-action, lemon-flavoured Strepsils for sore throat. Good times.

I also checked my blood pressure at one of those public machines at the Wal-Mart pharmacy. 133 over 72. Still a little high for my taste.

Anyway... I stopped at the lab on my way to work this morning to have the blood work done from the clinic last week - A1C, thyroid, and cholesterol. While I was there, I started talking with a pleasant woman who appeared to be in her early 40s sitting next to me. It turned out that she had type-1 as well and is on a pump. We both commented that neither of us had ever run into anyone in our town with a pump before.

Unfortunately, our town is a bit behind the times. I had to jump through a few hoops to get mine.

I hadn't even heard of an insulin pump until about two years ago, when I met a girl my age with type 1. She had been on a pump for about six years. When I met her, she showed me her pump and explained how it worked. I found it intimidating, but I was fascinated nonetheless. She told me how it had changed her life, and I realized that it was something worth looking into.

When I finally secured a family physician in September 2005, and subsequently an internist (there are no endocrinologists here), I mentioned to the both of them that I was interested in the pump. My internist, despite being the "specialist", didn't know too much about it. He told me to get some literature for him and we'd talk about it at my next appointment. So I did my homework, and after reviewing he agreed to help me pursue pump therapy. He wrote the recommendation to my insurance company for coverage.

I received my Medtronic Paradigm 515 at the end of January 2006, but little did I know what was involved in starting to actually use it. There were no diabetes educators in my town with pump knowledge. I was told that I would need to go to the diabetes clinic in a town about an hour and a half drive from here for training with their nurse/educator, and to meet the endocrinologist associated with the clinic. I would need to complete some classes, including carb counting (which I was already doing, but I guess they needed to make sure that I knew how to do it right), and I needed final approval from the endocrinologist to use my pump.

In March I had my first appointment with the educator, followed by a few nutrition classes and an appointment with the endocrinologist in May. I received his stamp of approval, and scheduled my pump training with the educator. After traveling back and forth 5 or 6 times for monthly appointments, I finally officially began pumping on July 10, 2006.

It was a long process, but definitely worth it. And I was able to educate the diabetes clinic in my town on the process so that they can make future recommendations to other patients interested in pump therapy. I know the clinic here is trying to get a pump support program implemented, but due to staffing changes and cutbacks, it has been difficult for them. So until then, they will need to keep referring patients to the clinic over 100 km away. I still need to travel to the out-of-town clinic for follow up once every 6 months and e-mail my glucose records to the nurse for adjustments since I have no support here.

One of my U.S. collegues is on a pump. He was a great support when I pursued pump therapy, but was surprised at all the legwork I had to do for it. He said that he basically got his 5 years ago, had a couple appointments with his doctor to set his basal rates, and off he went.

If you're on a pump or currently pursuing one, I'd be interested to hear your story. Anyone else go through so much red tape?

I think the biggest lesson I learned during my pursuit was to not get discouraged. It became frustrating at times, having a $6,000 piece of equipment (which I paid 50% for) sitting on my dresser for 6 months, essentially useless. Some days it felt like my pump was doomed to be a paperweight forever, but I'm finally using it and so grateful that I am.

Friday, March 16, 2007

The Clinic

After nearly falling asleep at my desk yesterday afternoon, it occured to me that I'm feeling the way I did before I first started my thyroid medication a year ago. Tired. Cold. Dry skin. Puffy eyes. Realizing this, I called to make an appointment with my doctor.

I was told that he's on vacation for the next 2 weeks, so I can't get in to see him until April 2nd. Great.

Since the appointment is so far away, I thought I'd be proactive and go to the after-hours, walk-in clinic to get a requisition for some blood work ahead of time so that when I have my appointment, my doctor will have received the results and we can go from there.

The walk-in clinic is a busy place. As I mentioned in my first blog post, there is a shortage of doctors in Northern Ontario. A lot of people in this area do not have a family physician, so they rely on the walk-in clinic for all of their issues.

And with cold and flu season in full swing in these parts, it seemed like half of my town was at the clinic last night.

People were lined up out the door and down the hallway just to register at the front desk, so I took my place at the end of the line. There were at least 20 people in front of me .

An hour and a half later, as I finally approached the front of the line with only 2 people ahead of me at this point, I could feel a low sneaking up on me. I wasn't totally sure, so I pulled out my meter to check - 3.6 mmol/L. I scrounged through my purse for a juice box, but realized from the weight of my bag that I didn't have any. I fumbled through one of the side pockets for some sugar packets that I carry as a last resort. Those were gone too, used up earlier this week during another episode. BF wasn't with me, I told him to stay home because I knew it would be a long wait and there was no sense in putting him through it too. Luckily, the clinic is next door to a pharmacy, so I thought I'd wait to register then run over and get an orange juice.

"Please hurry, please hurry..." I thought to myself as the patient at the desk rambled off her long list of various symptoms to the nurse. About 7 minutes later it was finally my turn. I quickly told the nurse why I was there. She told me not to go far because they were preparing to close the clinic from registration since it was so busy. I told her I'd be right back, my blood sugar was low and I needed to get juice. She understood and said no problem, she wouldn't lock the door until I returned. I was back in a couple of minutes and took my place in the waiting room.

Another hour later I finally saw the physician on duty and told him that I'd already made an appointment with my doctor, I just wanted to prepare the blood work ahead of time. He commended me on my proactiveness and asked questions about my symptoms. He agreed that it did sound like my thyroid. I also told him about the headaches I've been having lately, so he suggested checking my blood pressure, just to be sure and rule it out.

I went to the other side of the room where the monitor hung on the wall, sat down on the examination table, dutifully rolled up my left sleeve and held out my arm, familiar with the routine. He wrapped the velcro sleeve around my arm and pumped the bulb of air.

I heard him mutter "160..." and suddenly felt my heart beating hard in my chest. Did I hear him right?

"That's awfully high for you being such a young woman. Let me try the other arm."

He moved the sleeve to my right side. As I felt it squeezing tight on my arm, he said "140 over 90. Yeah, that's pretty high." He wrote it down on a piece of paper and instructed me to bring it to my doctor at my next appointment.

I'm hoping it was a fluke following the stress of the basement flood, etc. I guess all I can do is try to put it out of my mind until my appointment on April 2nd, and try to think of fluffy kittens or something non-stressful until then...

Thursday, March 15, 2007

Eggrolls and exercise

Being both physically and emotionally drained following the chaos of yesterday, I wasn't particularly up to the task of making dinner. So I suggested getting Chinese food, something I almost never do. My boyfriend (BF) asked, "Are you sure?" because he knows I usually try to avoid that kind of thing. I love the stuff, but the high fat content wreaks havoc on my blood sugar, not to mention that I already have enough extra "padding", which I have been failing miserably at shedding...

Anyway, for the first time EVER, I managed to bolus my Chinese feast perfectly! One of my issues with eating away from home is that I have a hard time estimating the number of carbs. I'm much too dependent on my food scale and weigh almost everything. But somehow, I got it right this time. I even successfully administered the dual-wave bolus, keeping my blood sugar stable for hours afterward.

Now I just need to sort out my basal rates, they've been a little off lately. Not much, but over the past couple of weeks my internal alarm has woken me up a few times - that is, the dreaded shakes and sweats. Yesterday I adjusted my pump a bit, but I still woke up just on the verge of a low at 3.9 mmol/L. Although I usually test in the middle of the night if I have to get up to use the washroom, it isn't always at a consistent time. So I guess I'll need to set my alarm and do some midnight/3 a.m. checks. What a drag, especially when I haven't been sleeping well.

Mornings are a bit weird too. I seem to have a sluggish digestive system in the morning. My pump is set to bolus a bit heavier for breakfast, while my basal rate is scaled back because all of a sudden between 10:00 and 11:00, it's like my bolus insulin all kicks in at once.

These are my current pump settings.


00:00 1.00 U/H
03:00 0.85 U/H
06:00 1.05 U/H
08:00 0.45 U/H
12:00 0.60 U/H
16:00 0.65 U/H
20:00 1.10 U/H


Breakfast 1u/6g
Lunch 1u/8g
Dinner 1/10g

It's been a while since I've seen my settings all written out like that. I can see how much it's changed since I haven't been exercising lately (i.e., my basal rates have increased). I really need to get back to it. My energy levels and motivation have both been down all winter. I tell myself, "Okay Lori, when you get home from work today, you're going to get on the elliptical machine," or, "That's it, you're going to set that alarm and get up a half hour earlier and do 30 minutes on the elliptical." But I always seem to find something else that needs to be done when I get home, or those 30 extra minutes of sleep seem so precious.

Where's Richard Simmons when ya need him?

Wednesday, March 14, 2007

The Damage

...and after

I always wanted an indoor pool.

My boyfriend (I'll just call him BF) wakes up at 5 a.m. every day for work. Although the alarm is on my side of the bed, it doesn't usually bother me much and I don't often notice him getting out of bed. But lately for some reason my nights have been restless, so I've been extremely tired throughout the days. Knowing this, he's been doing his best to not disturb me when he leaves (he usually pounces on me to say his goodbyes and I love you's), so I knew there was something wrong when he forcibly shook my shoulders to wake me up this morning.

"Babe, you need to get up. There's a problem in the basement..."

A half an inch of water covered all of our hard work of the past 6 months. We've been living at my house and busy renovating it in order to sell this spring/summer. BF owns his house too, so when we decided to start living together, we determined that it made more sense to sell my house than his (especially with my hope of going back to school in September to change careers).

Anyway, the biggest project was my basement. We knocked out a wall, put up another one in a place that made more sense and opened it up so that there's now a large rec room, and we put down laminate flooring throughout. It really brightened up the space and easily increased the potential selling price.

Now it's all ruined.

We both took the day off work to deal with the mess. First thing this morning, I checked with my insurance company, and unfortunately this particular damage is not covered under my policy. It appears to be an issue with the weeping tile - if it had been due to sewage back up or sump pump failure, it would have been covered 100%.

We had to rip up all the flooring to mop up the water and dry out the concrete floor. And right now BF is in the basement tearing down all the new drywall we had put up just before Christmas to determine where the water is coming in from.

I'm trying not to cry a river - I don't need any more water in my house!

Tuesday, March 13, 2007


I've experimented with keeping an online journal off and on now for a little while, but have never been able to make one stick. I always seem to struggle to find things to write about and my blogs never have much direction. I felt like I was blathering on about nothing and would slowly lose interest in writing even semi-regularly.

I've always thought about starting a blog to talk about my life as a diabetic, but I thought who the heck would want to read about that? Then last week as I was browsing for various diabetes websites, I stumbled across a fabulous blog by Kerri Morrone ( and realized, much to my amazement, that there is already an entire community of diabetes bloggers. Of course then my next thought was, does cyberspace really need another diabetes blog? But you know what? I think it's more about me writing and finding an outlet for my thoughts and feelings than anything else. And if someone else finds it interesting enough to read, that will be a bonus.

I was diagnosed with Type-1 diabetes 14 years ago, about two and a half weeks after my 18th birthday. It was a traumatic day, to say the least - my "bittersweet surrender" to life as I knew it. I was admitted to the local hospital with a blood glucose of 30.0 mmol/L (if you're American, multiply my readings by 18 to get mg/dl - so this one would be 540 mg/dl). Because I was 18, I had to sign all of the hospital and insurance forms myself although I had no idea what was going on. If it had been 3 weeks earlier, I would have been put in the pediatric ward which featured a cool gaming centre and other things to make a child's stay more comfortable. But being 18, I didn't qualify, and since there was a shortage of beds throughout the hospital, I was put in the geriatric ward of all places. Not a fun start to my new disease. And it was 3 days before Christmas when I was diagnosed, so it was kind of a double whammy - in the hospital for the holidays and not allowed to have any goodies. The doctor allowed my release on Christmas morning under the condition that a homecare nurse would need to come to my house at every meal for the next week in order to monitor my injections and blood sugar tests (I did it all myself, they just watched).

My first year as a diabetic, I was a model patient. Although I didn't test as frequently as I do now (believe it or not, my doctor said if I was feeling all right, it wasn't necessary to test more than once every couple of days!), I was on a very regimented meal plan and insulin injections (Humulin R and Humulin N mixed in a syringe twice a day) which I followed to a "T". But the following year I began university and things quickly began to fall off track... I almost never tested, ate whatever I wanted and took the same amount of insulin my doctor had originally prescribed the year before (at that time, I knew nothing of carb counting).

I'm embarassed to say it, but I followed this horrible routine for about 11 years. I did try to get back on track when I moved back to my hometown in 2001, but I had trouble securing a new family doctor. Northern Ontario healthcare is in a sad state, and almost all doctors have full patient rosters so they are unable to accept new patients. Without a doctor to prescribe test strips and insulin, I had to buy my supplies over the counter. This meant that I could not claim the costs through my medical insurance, so my feeling at that point was that insulin was the necessity and testing was a luxury. It took me 4 years to finally convince my older sister's physician to take me on as a patient. That was in September 2005. Since then my life has changed dramatically. I now diligently test 6-10 times a day, and progressed from specific doses of Humulin R and N (meaning specific meal plans, which as everyone knows, is not practical), to using a combination of Lantus and NovoRapid and carb counting. And finally just 8 months ago in July 2006, I started using an insulin pump, which was very exciting, and a story in itself which I will save for another time...