Bittersweet Surrender

These are not the kind of highs I want to deal with...

2011-07-29T12:05:00.004-04:00

Back in April before I had my laparoscopy done (exploratory surgery to see what's going on with my lady parts), I went to two pre-op appointments: one at my OB/GYN's office and the second at the hospital where I was having the procedure done.

At both appointments my general health was assessed. I was poked, prodded, weighed (ugh), and had my blood pressure taken. At both appointments my BP was high. Very, very high.

I got nervous about it and as I sat on the exam table at both appointments, I thought maybe someone would say they couldn't do the surgery, but that never happened. And I thought someone might tell me that I should follow up with my general physician on my BP, but no one did.

I asked about it at my first appointment and the nurse said, "Yes, it's high, but you're probably just nervous about surgery." At the second appointment when it was still high, I told the nurse 2 what nurse 1 had said about being nervous and she said that it was probably true.

My blood pressure was 165/115.

Unfortunately, this wasn't the first time I had experienced high BP, but it had never been THAT high. And the previous incident was a bit of a fluke; by the time I saw my general physician my BP was back to normal.

I had surgery. All went well. I stayed in the hospital overnight to recover and various nurses checked on me throughout the day and night. Every time someone took my BP I could hear an audible "hmmm" from them. A couple of times I asked what the number was, and it was in the range of my pre-op number. And with the pain killers they had me on post-surgery I was relaaaaaaaxed I tell you.

So when I got home from the hospital I told my husband that I needed to make a change. Diabetes and infertility are enough to deal with, I didn't want to add heart disease to that list.

As soon as I was well enough after surgery - which was actually only about 4 or 5 days later - I dusted off my treadmill and started walking.

I began paying attention to sodium content in food. I was shocked to find how much sodium is in most of the foods I was eating. I began to change my diet completely to I guess what you would call a "whole food" diet that you hear a lot of people talking about.

At the beginning of June, almost 2 months after my surgery and the high BP reading, I had an appointment with my endo.

My A1C was a little higher than I would have liked at 7.3%, especially with TTC. But he said he could live with that number and that the risk associated with getting pregnant at an A1C of 7.3% was lower than working to get my A1C under 7.0% and essentially getting older in the process (I am 36).

He took my BP and despite the work I'd been doing, it was still high. 140/100. He recommended that I follow up with my general physician and look into medications that are safe for pregnancy, especially with the risk of preeclampsia.

He had also had my cholesterol checked. My HDL (the "good" stuff) was fine, my triglycerides were fine, but my LDL (the "bad" stuff) was high.

"You're kidding me right?" I exclaimed about the high LDL number.

I told my doc about my new diet and exercise. He said that sometimes you can do all the right stuff but our bodies don't always co-operate. He said that he wasn't too worried about my LDL right now, that my BP is currently of more concern.

So I have an appointment with my general doc next week. I bought my own BP monitor and have been checking every 2 to 3 days. My BP ranges anywhere from 120/75 to 130/85.

And I've continued to exercise and eat right. It doesn't even feel like much of a chore to me anymore.

In the past I've tried various diets and exercise to lose weight (as I've been chronically overweight for almost all of my adult life). But I lose motivation somewhere along the way and fall back into old habits. If I'm being honest with myself, I think I've always been one of those people who comforts themselves with food. A food addict, if you will.

But this time it feels different somehow. I am very concious of what I put into my body, but not because I'm trying to lose weight. Because I'm trying to stay healthy and get my BP under control.

As a result however, I HAVE lost weight that I've struggled to lose for so long. I'm down 28 pounds since April. I have gone from squeezing into size 16 pants, sometimes even size 18, to comfortably fitting into size 12. I have more to go, but I am no doubt on my way.

My blood sugar has reflected the change as well. My basal rates have dropped by almost 20% if I'm doing my math right. And the 14-day average on my glucometer is currently reading 6.7 (121).

Originally my goal was to get my blood pressure down on my own so that I wouldn't need medication. I've always thought that having to go on BP medication would be a failure somehow. That it would mean I didn't take good enough care of myself (which admittedly, I didn't in the past).

But now that I've been doing all this work and see that my BP is still hovering a little on the high side, my goal is to just do the best that I can do. If my doctor prescribes BP medication next Friday, at least I'll know that I did my best to get myself back in order.

TTC

2011-07-28T18:51:00.006-04:00

Hi, I'm back. Again.

I know I tried to resurrect my blog a couple of years ago, but quickly got distracted as I easily do and forgot about it. But I've been doing a lot of diabetes-related and pregnancy-related Internet surfing lately and thought it would be a good time to get back into this blogging thing.

I've actually spent the past couple of days re-reading through Lyrehca's blog Managing The Sweetness Within. I used to read MTSW years ago when I was really into the DOC and found her blog very interesting, although I couldn't relate at the time. Who knew, when I wasn't even really thinking of children then, that 5 years later I would be in the same boat.

Since getting married in the summer of 2008, hubby and I have been trying to conceive (TTC for those unfamiliar with the acronym). At the time I assumed that it would just happen right away and a year after our wedding we would be a happy family of 3. I even thought that by now we would be onto our second child.

Unfortunately this has not been the case. After trying for a year, I finally went to see my primary care physician to initiate an investigation into why we hadn't yet conceived. He did some initial tests on hubby and I and at that point nothing seemed amiss with either one of us. Said doctor then referred us (me) to a OB/GYN.

I spent over a year with the OB/GYN. I had bloodtests, ultrasounds, an HSG exam (which I won't get into details about, but from re-reading Lyrehca's blog again she does an outstanding job of describing what it's like) which did not reveal any blocked tubes although my left tube had a "slow leak" (OB/GYN's words, not mine), and a laparoscopy during which some mild to moderate endometriosis was discovered and removed. In the meantime, he had also prescribed a drug called Clomid to help me "superovulate" (again, his words). We tried Clomid three times to no avail.

At the end of all this and now at the age of 36, OB/GYN said that there was nothing more he could do for us and has since referred us to a fertility clinic. We had our initial appointment with the doctor there and after reviewing our case she suggested going straight to IVF treatment. She said that while she did not see any glaring reason why we have not acheived a natural pregnancy, and we could try other less expensive options, IVF is probably going to be our best chance at success. After a lengthy discussion amongst ourselves, hubby and I agreed that we should give it a go.

So our next appointment at the clinic is a couple of weeks from now and I am kind of excited to begin this next phase of our journey. I have been very involved in forums with other IVF-ers, and I have also started a group on TuDiabetes for those of us experiencing both diabetes AND infertility. The ladies who have joined me there are all fabulous and we have all wondered why someone didn't think of the group sooner.

And although I have been horrible about blogging in the past, as I begin IVF I plan to document my experience since there isn't a lot of information out there for women doing IVF with diabetes. I'm preparing myself for the ups and downs that I will likely encounter on this ride.

Lori gets a new pump

2010-05-19T13:59:00.004-04:00

Yesterday I resurrected my blog to write about the frustration I experienced this weekend at the hands of Medtronic customer service.

Since my Medtronic pump is out of warranty, I was seriously considering switching to an Animas pump. I simply don't like being told one thing by one person, and something by another. Good customer service is high on my list of musts. However, being in Canada Medtronic is the only company here that offers a CGMS system and it's something I've been striving toward for the past year, especially with trying to get pregnant (no it hasn't happened yet, but that's a story for another day).

So... I've decided to stay with Medtronic. I ordered a new 522 this morning (in pink!), and will FINALLY be able to cash in on their minilink transmitter and 8 sensors deal for $299.

I have to say that never have I been more grateful than to live in Ontario. With the province now covering the cost of pump and supplies for adult Type 1 diabetics, it was as simple as having my diabetes team fill in the government form, forwarding it to Medtronic, and BAM - Lori gets a new pump. No worrying about whether or not the insurance company will approve or deny coverage. PHEW!

Frustrated

2010-05-18T08:39:00.004-04:00

I "turned off" my blog for a while because honestly, I just didn't feel like blogging about diabetes anymore. There are a lot of you out there with blogs, which is AWESOME to know that there is such a large diabetes community. But I kind of felt like my voice was getting lost in all the other blogs that are out there (and I see that someone now has a blog called Bittersweet) so, long story short, I gave up. No other way to put it.

But I've resurrected my blog today because I have had the most incredibly frustrating weekend involving diabetes, that I feel like this is the only place to vent about it where people actually get it (I posted my frustration on Facebook, but most of my friends - who do not have diabetes - do not really appreciate what I've been experiencing).

It was my mom's birthday on Saturday, so my sister and I brought her to Toronto for the weekend to see Jersey Boys (great show by the way). We had an incredible dinner before the show. We all overindulged, but since it was my mom's birthday, we still felt like we should have cake (especially since the restaurant included a free piece of sinfully-delicious chocolate cake to those with birthdays). We opted to order pieces of cake "to go" to enjoy later in our hotel room after the show.

When we got back to our hotel, I tested and was slightly high (8.2, or 148 in the US) so I took a correction bolus. We didn't sit down to enjoy our cake until about an hour later... I got ready to give myself a big bolus because it was a fair-sized piece of cake. That's when the trouble started.

I got as far as the screen to enter the number of carbs I was about to eat when all of a sudden the pump wouldn't recognize any of the buttons I pushed. About 5 minutes later it started vibrating and the green backlight came on with a "Button Error" message.

I promptly got on the phone to Medtronic's 24-hour technical support phone line. Note that by this time it was around 11:45 p.m. I waited about 30 minutes before someone finally answered my call. I understood since it was so late, I figured there was probably only like one person working in the call center. At least there was someone to answer my call.

The person was located in the U.S., so after taking all my information he said that he'd have to transfer me back to someone in Canada to arrange for delivery of a replacement pump. No big deal. He put me on hold (to terrible music by the way) and came back a minute later to say that he was having trouble transferring the call so he would get in touch with someone in Canada and they'd call me back in 5 to 10 minutes.

Well, I waited... and waited... and waited. By 2:00 a.m. it was apparent that no one was calling me back, so I decided to go to bed and try them again in the morning.

Side note: While I waited for Medtronic to call me back, I called around to various pharmacies in the area that we were staying, but none were open 24 hours. Although I had syringes with me, I didn't bring my back up Lantus insulin (note to self - ALWAYS carry Lantus when travelling, no matter how short the trip) so I woke up every 1.5 hours to give myself a unit of Novarapid. It actually worked really well, but I was sooooo tired in the morning.

Ok, so 8:30 a.m. Sunday morning I call Medtronic again. Same 30 minute wait before I speak with someone in the U.S. again. I explained what happened the night before and that I was supposed to get a call back from someone in Canada. She apologized and said that she'd stay on the line until she reached someone in Canada, which she did and she transferred me to that person. The guy I spoke with in Canada also apologized and said he didn't understand why I didn't get the call back because he saw the note on my file.

Anyway, he said that I would receive a replacement pump the following day on Monday (which was yesterday). Guess what? No pump. I called Medtronic again at 5:00 yesterday and they said, "Oh, the delivery date is scheduled for tomorrow (Tuesday)." WHAT?!?!?!

So I'm thoroughly frustrated with Medtronic right now. And I am due for a new pump (mine is actually now out of warranty, so they were sending a loaner pump for up to 90 days until I can arrange to purchase a new one). I am strongly considering switching to Animas, but unfortunately Medtronic is the only company in Canada with a CGMS and the discount for the CGMS is only offered with the purchase of a pump.

Any opinions on Animas vs. Medtronic? I've seen a select few of you out there with Animas pumps in the U.S., but I don't think I know of anyone in Canada that has one (seems that Medtronic almost has a monopoly here). If you really wanted a continuous glucose monitoring system, but the only company that carries it displayed poor customer service, would you forgo the CGMS and switch to another company, or stay with them because you REALLY (like REALLY REALLY!!) want a CGMS.

I really appreciate your opinions! Thanks. :)

p.s. If you're wondering, "What about the CAKE!? Did you ever get to eat the CAKE?!" The answer is that I put it in the hotel room's bar fridge that night and brought it home with me the next day... I finally got to enjoy it last night. And it was definitely worth the wait. ;)

The summer blues...

2009-07-22T16:55:00.003-04:00

So, it's summer... well, it's supposed to be. I don't know about your part of the world, but here the summer has been quite non-summer like. Rainy, even cool a lot of the time. It's a bummer.

As a result, I am not as active as I usually am during the summer. And I feel it. My waist band feels a little tighter than normal, and I see my blood sugar gradually creeping up. Yesterday I finally had to give in and adjust my basal rate to compensate.

Sure, I could jump on my elliptical machine to work off those extra calories and get my blood sugar and basal rate back under control, but my heart isn't in it. I want to be outside. Walking, biking, whatever...

Anyone else have the summer blues? Yeesh.

4.0 at 4:00 p.m.

2009-07-14T16:09:00.004-04:00

I just tested my blood sugar for TuDiabetes: 14K People Test Their Blood Sugar At The Same Time.

My result? 4.0 mmol/L at 4:00 p.m... I love it! (Actually, it was at 3:56 p.m. according to my meter but I think the time on my meter is a little off... it was 4:00 according to the clock on my computer.)

It looks like many people are on board and submitting their test results at a fierce pace based on the constant pinging of my e-mail inbox since I left my result, thanks to the feature that alerts you when others post a comment following your own.

I think I may need to turn off MSN Messenger for a while until the comments die down... but keep it up everyone, great job! :)

Ontario Assistive Devices Program (OADP)

2009-07-13T16:11:00.008-04:00

Beginning September 2008, the Ontario government provides funding for the purchase of insulin pumps and insulin pump supplies for adults with Type 1 diabetes.

This bit of information may very well likely have already been posted by someone else from Ontario long ago, but it is something I just found out about two months ago when I had my endocrinologist appointment. My doctor told me about the new coverage through the Ontario Assistive Devices Program (OADP). It was great news for me, because our health insurance through my husband's previous employer is on the brink of cancellation. Like so many others, he was laid off back in November. His employer extended our health insurance coverage for 9 months or until he found new employment, whichever came first. He has finally found new employment, but insurance with them doesn't begin until his probationary period ends in September.

So during my appointment, my endo gave me the form for the program; I filled in my part, and left the form with him to fill in his and submit. I finally received a letter in the mail last week from OADP telling me that coverage is approved and that I will receive my first cheque in the mail sometime in the next 3 to 4 weeks.

So, great news right? The government covers my supplies and we don't have to worry about insurance coverage anymore (at least for pump supplies; we still need coverage for test strips, insulin, etc).

The problem is that I have some receipts that are in insurance limbo right now. I applied for OADP coverage slightly late because I didn't know it existed until two months ago. Without knowing that I was eligible for OADP, I had been purchasing my pump supplies as normal - I bought what I needed each month and saved the invoices, then about every four to six months I submit them all at once to my insurance company for reimbursement.

I'd been wondering why it was taking so long for my last claim to be processed, and today I got my answer. I received a letter from my insurance company stating that because OADP now covers insulin pump supplies, the last claim I had submitted to my insurance company for pump supplies from October 2008 through April 2009 was DENIED.

Six months of supplies at approx. $250 per month is $1,500. $1,500 which I may never see again because I should have applied for OADP coverage sooner.

I'm mad, but I suppose it is my own fault for not keeping myself informed. I knew that OADP coverage for insulin pump therapy had been granted in December 2006 to children age 18 and under with Type 1 diabetes. However, short of checking the Ministry of Health website on a regular basis, I'm not sure how I would have found out about adult coverage any sooner than I did. The government doesn't exactly freely advertise when they are giving away money. I suppose this is a lesson learned the hard way to keep abreast of developments in the diabetes world.

If you live in Ontario and, like me, have also been caught in OADP/insurance limbo, let me know. I'm not sure if we can resolve anything together, but it would be nice to know I'm not the only ignorant one. :)

Still trying

2009-07-10T11:28:00.001-04:00

Okay, I know... it's been a while again.

I'd meant to post a couple of months ago after my endo appointment when my A1C miraculously came back at 6.6 - yay me. Seriously, I thought I was in for some disappointed-in-you frowns from my endo (he has an incredible way of making me feel guilty when my A1C is over 7). But instead he gave me a knowing smile and said, "Go make babies." To which I replied, "We're already trying."

Yes, I've been trying to get pregnant without the 'official' thumbs up from my doc, which I know isn't ideal. But I have been trying to do everything right - eating right, no alcohol, exercising, checking my blood sugar about a thousand times a day. It seems to all be in vain though because so far nothing has happened anyway.

I have an appointment next week with my GP to see if anything could be preventing a pregnancy. My period has been seriously messed up since I went off the pill after our wedding last year. Like, my cycle has been 6-8 weeks long instead of a standard 28-day cycle. I know it takes some time to get back in order after stopping the birth control pill, but this last stretch has me a little freaked out. It has been 12 weeks since my last period. I have taken 5 pee-stick tests and they are all clearly negative. So it's time to find out if anything else is up. I mean, I am almost 35 and trying to get pregnant for the first time.

* * * * *
On another note, it's been like a wonderful diabetes Christmas-in-July this week! I registered both of my Contour glucometers a few weeks ago (my Contour Link and regular, old Contour which is my backup), and today I received my matching pump and glucometer skins AND a fancy-shmancy carrying case for my glucometer. It's, well... LARGE. I'm not sure whether or not I'll use it, but it really is very pretty and matches my pump skins quite nicely.

p.s. It is berry season. My mother-in-law brought me a big bowl of strawberries last night so I made my Berry Muffins this morning. See here if you missed the recipe the first time.

Where I've Been

2008-09-07T09:14:00.002-04:00

Wow, I can't believe it has been a year since I last wrote here. It's been so long that I actually forgot my Blogger password and had to do the password e-mail dance this morning, begging for entry.

So, where have I been? In a nutshell, I graduated in June and about to embark on my new career. This past year was busy, but worth it for a chance to do something that I think I'm going to love.

Oh, and I got married last month. It was a perfect day from beginning to end. It was raining in the morning as we were getting ready, but I was uncharacteristically calm throughout my hair and make-up session and kept saying, "I know it's going to stop." And sure enough it did stop raining about an hour before the ceremony and stayed clear just long enough for outdoor pictures afterward. I wore my pump under my gown and used my remote control to bolus throughout the day and no one was any the wiser; although I have to say that using the washroom was comical, trying to keep the skirt and train of my dress AND the pump out of the way.

And we had an amazing honeymoon in Mexico, despite it being ridiculously hot and humid at this time of year. We spent most of our time by the pool, which was another interesting pump adventure for me being that it was my first time in a bathing suit since I started using my pump two years ago. Also, I think my insulin went funky in the heat on our third day there. I had perfect bg in the morning, then all of a sudden after lunch it spiked to 26 (468) and I couldn't do anything to bring it back down. When I had an inkling that it might be overheated insulin, I changed my set and reservoir and by late evening it settled back down to where it should be. An annoying disturbance, but our vacation was still fantastic overall!

Now, you may be wondering why am I back here posting all of a sudden after such a prolonged absence. Actually, there were many times throughout the past year that I meant to write something, then a pesky school assignment or lesson planning would get in the way, so it was always put on the back burner. But now that we are back from our honeymoon and settling back into "real life", we are planning for the next step in our future... expanding our little family.

I guess I am here to reach out to those in the Diabetes OC who have experienced pregnancy as a diabetic - and I want to be clear, I want to hear both sides, the good AND not-so-good. I have read all the articles about what to do before getting pregnant; have a good A1C and maintain it, yadda yadda yadda... I suppose I just want to hear more "real" stories about how it really went down for some women, not just doctors spouting what should be done.

I know I haven't been around in a while and most of you have likely forgotten who the heck I am, but I know there are some great people out there with sound words of advice, so this is the first place I'm turning to. What do you have to say, Diabetes OC?

Inflation

2007-08-10T15:27:00.000-04:00

I logged into the Medtronic website today to order my monthly supplies.

I clicked through the ordering screens as I normally do without really paying much attention, it's become so routine.

When I finished, the "shopping cart" gave a total of $248.50.

Usually, the total is $238.00.

Huh? Did I select the wrong items?

I glanced above to review my order.

Paradigm 23 x 9mm Quickset 10/Box
Paradigm Reservoir 10/Box

The items are right. Dammit, the prices went up.

I guess even diabetes can't escape from inflation.

p.s. - One good thing is that at least I can order a box of infusion sets next month without a box of reservoirs and not have to pay a delivery charge since infusion sets are now over $200. I'm a couple of boxes ahead in my reservoir supply due to sites falling out and needing to change the set and not necessarily the reservoir of insulin.

I said "yes"...

2007-08-07T16:36:00.000-04:00

This summer has turned out to be much more busy than I ever expected. As a result, I've fallen behind in blogging and reading blogs. I'm doing my best to catch up right now (still chuckling at Allison's birthday story).

I submitted my resignation at work last week in preparation for returning to school on August 28th. It's hard to believe that I will be leaving my job of the past 10 years, however I have to say that I will not miss it one bit. The company I work for has gone screwy and several others have also jumped ship, so I'm glad to go. The only thing I will really miss is having 100% medical coverage.

And, you can probably guess the rest from the below picture:

Berry Muffins

2007-07-17T09:06:00.001-04:00

Last week, BF's mom gave us a large basket of fresh strawberries that she'd picked at a local farm. We started out eating the berries with light whipped cream for dessert after both lunch and dinner every day, but between the two of us, we were barely making a dent in the basket.

So I started searching for muffin recipes.

I don't bake very often, but I know the basics. The first recipe called for one teaspoon of salt. I thought that it sounded like a heck of a lot of salt, and sure enough it tasted more like a bag of potato chips than a berry-liscious baked good.

After much trial and error, and many of my own tweaks to recipes that I found, I think I've discovered a tasty, low-fat, healthy muffin. Note that these are not overly sweet - they're meant to be more of a breakfast muffin.

Anyway, I thought I would share it here for those who like to bake their own goodies.

I calculate that these are about 23 g of carb each (using strawberries), with 2 g of fibre.

2/3 c. all-purpose flour
2/3 c. whole wheat flour
1 c. rolled oats (I used the quick-cooking kind)
1/4 c. brown sugar Splenda (or 1/2 cup real brown sugar, which will add 5 g carb per muffin)
1 tbsp baking powder
1/2 tsp cinnamon
1/4 tsp nutmeg
1 cup milk (I used skim)
1 egg (I used fat-free liquid egg substitute)
3 tbsp vegetable oil
1/2 tsp vanilla
2 cups of your favourite berry

Mix dry ingredients in one bowl (except berries). Mix liquid ingredients in another bowl. Add dry to liquid and mix. Fold in berries. Fill muffin tray (makes 12 muffins). Bake for 20-25 minutes at 425 F.

We are now almost out of strawberries. I think I'm going to try blueberries next!

Doctor My Eyes

2007-07-04T11:39:00.000-04:00

This morning I had my annual eye exam.

Dr. M is one of my favourite people. We've known each other since I was born (she went to school with my oldest sister). When she became an optometrist, I was excited to be one of her first patients. I always look forward to seeing her, it's more like visiting an old friend.

Until today. Today was all business.

Ok, that's not true. We spent about 60% of the visit chatting about our families in between questions of which line of scrambled letters I could see clearest, and which is better - this lens or that lens?

Then she put in those damn eye drops. You know the ones I'm talking about. Within 15 minutes my pupils were large and I looked like I'd indulged in some illegal substances.

She shone various lights at my eyes and scanned for broken blood vessels.

First the left eye. "Gorgeous, darling".

Then the right eye. "Looking lovely, girl..."

Her voice trailed off and I heard her mutter a soft "hmmm..."

I saw the bright yellow line stop and scan back and forth, over and over in the same spot.

She said there is a light hemmorage in my right eye.
She said to try not to worry, that often they clear up on their own.
She said if it was at the outside of my eye, she wouldn't be as concerned, but it is toward the center of my vision.
She scheduled a follow up next month to recheck.
She said that if it hasn't gone away, I'll need to see a specialist.

I'm not sure how I feel about it yet. I don't think I'm scared or worried. I mean, I AM... a little... but I guess I've decided to not let it get to me until next month when I have more information.

I think, more than anything else, I'm a bit peeved since my control has been so much better these past two years. As if my eyes would do this to me now, the nerve!

Anyway, hopefully it will resolve itself. All I can really do is wait and see what happens.

More random bits

2007-06-29T13:53:00.002-04:00

Just some random bits for today:

- The house is sold. That's right, SOLD! In less than 24 hours and with 3 offers from 3 different parties. A bidding war ensued and I actually received more than the asking price. When the real estate agent told me, the most eloquent thing I could think of to say was, "Holy s**t!"

- On a whim, I visited my local diabetes clinic on Wednesday. I have been out of touch with them for over a year since I started traveling to a clinic in the next closest town with a pump therapy program. My town is finally starting its own pump program in the fall and asked me to:
a) attend their open house night to speak with pump candidates and answer their questions, and
b) be a "mentor" for the patients.
I'm excited, this is the kind of stuff I so enjoy.

- I tried a new site this week in order to give my abdomen a break. No, I did not try a thigh site. I tried... are you ready for this?... my, er, backside. Not so far back that I'm sitting on it - more toward the top of my backside and forward toward my hip. Insulin absorption has not been an issue at all, but catching my thumb on the tubing when I pull down my pants has been an incredible nuisance.

- It is a holiday weekend, which means we have Monday off (Canada Day - July 1st). Time to visit the lake for some swimming, cold beer, and maybe a bonfire with a marshmallow or two.

Have a great weekend everyone!

How low can you go?

2007-06-20T16:27:00.001-04:00

As I sit here and type, I am experiencing one of the strangest lows I've had in some time.

My tongue is completely numb, and the feeling (or lack thereof) has spread to the roof of my mouth and into the back of my throat.

My brain feels slightly foggy, but somehow I am able to type here legibly (with several strokes of the <--Backspace key and the help of spell check).

My shoulders feel light, like they are floating. Strangely, my head doesn't feel light. Just thick and foggy.

My hands are shaky. I haven't had shaky hands during a low in a long, long time. Months, at least. More likely in over a year. I'm not sure how I'm even typing right now. I had a hard enough time checking and confirming my blood sugar (2.1/38 by the way).

I am "working" from home today. Checking work e-mail while I complete some final clean-up at the house. Had to take a break just now when the low came over me. I've scrubbed the kitchen floor and mowed the lawn. That would explain the sudden dive in my blood sugar.

I had to scrounge my kitchen for something to eat. Stupid me, I ran out of juice and sugar packets in my purse last night, and forgot to replenish my supply. Most items from my kitchen cupboards and refrigerator have already been packed and moved over to the new house. Somehow, I managed to find a box of Fruit-By-The-Foot stashed in the back corner of a cupboard. BF bought it a few months ago in order to have some fun snacks to offer my nephew while he's here visiting.

They each have 17g of carb. I ate two.

I'm feeling much better now.

Time

2007-06-19T10:59:00.001-04:00

Who knew that selling a house could be so stressful?

My blood sugar has been on a serious roller coaster ride over the past week.

High. Correct. Oops, too much insulin, now it's low. Drink juice or eat some strawberry marshmallows. High again.

Aargh!

Stress, or maybe it's the crappy food I've been eating. Who has time to cook a healthy meal when there are so many other things that need to be done.

The house is going on the market this Thursday. A real estate agent came in on Saturday to assess the property and I was very happy to hear the number she gave me - almost double what I paid for it 6 years ago. Not a bad investment for a single (at the time) girl.

And she predicts that it should sell in about a week.

I hope she's right. I don't want to drag this on any longer than necessary.

I think once everything is said and done, a nice vacation is in order... that is, if I can squeeze it in before I start school at the end of August (and if I can convince BF to take the time off work).

School. Something I haven't even had time to think about.

All of these changes are happening so fast. Time, where are you hiding??

Little Things

2007-06-15T13:39:00.000-04:00

Typically, I'm pretty easy going when it comes to big changes. Starting a new job, moving to a new home. I go with the flow and roll with the punches (well, maybe there are small what-the-hell-am-I-doing? moments along the way).

But the little things... small changes to routines or alterations in products seem to irk me (unless it's a significant improvement). Can't explain it, they just do.

I started using the One Touch Ultra 2 back in April. It came with a much smaller lancet device than previous One Touch models.

It took a bit of getting used to, but being an improvement - I have tiny hands! - I welcomed the new little finger sticker.

Then three days ago, it went all funky on me.

When I was getting ready to do my post-lunch test at work, posed with the lancet pen against my right, index finger, I pressed the button and heard the lancet spring forward, but it didn't even graze my finger. I checked the dial to see if it somehow got changed to a lower setting, but it was at 3 where it always is.

I tried again with the dial set to 4. Same result.

I took the pen away from my finger and loaded and clicked the button a few times. I could hear it spring forward each time, so I was a bit confused as to why it wasn't hitting my finger.

I tried again at 5 and 6. No luck.

I finally pulled the cap off the pen and, biting my lower lip in preparation, stabbed myself with the lancet manually. More than enough blood sprang forward, and a nice, purple bruise followed seconds afterward.

Later when I was at home and prepared to test before dinner, I forgot about the malfunctioning pen. When the lancet didn't pierce my finger, I suddenly remembered the bruise from the forceful jab I gave myself on my index finger. Not wanting to repeat the same incident, I retrieved the pen - which is the same as the Ultra 2 pen - from my Ultra Mini case (as excited as I was to get it, I have decided to keep the Mini as a back up since it doesn't store much data).

I used the pen for that particular test, but I didn't want to permanently separate pen from meter because, as silly as it sounds, they go together. They're the Mini meter and mini pen. Like Ben & Jerry or Häag & (I mean, Häagen-) Dazs.

I went to my stash of old glucometer cases in the closet and dug out the pen from my One Touch Ultra.

The earlier generation of One Touch lancet device felt GI-NORMOUS! And after using the new-old pen for almost three days, it still feels very awkward in my hand.

So I may need to break up Mini meter and mini pen. I hope they don't miss each other too much.

Please forgive my pathetic photo-editing skills.

tu diabetes

2007-06-11T14:04:00.000-04:00

Thought I'd jump on the bandwagon to plug Manny Hernandez's great networking site, Tu Diabetes.

Everyone is there. You should be there too.

Another great way to kill time while I'm supposed to be working.

I need a better profile picture though. Maybe Scott can give me some tips? :)

New surroundings

2007-06-05T11:38:00.002-04:00

I moved into BF's house on the weekend.

Well, I've moved most things... the important day-to-day things, like my clothes, toiletries, and D supplies since we're spending our nights there now. The furniture will have to wait. We are still finishing the last few cosmetic things on my house, but we're on track to get it on the market by next Monday.

Although I have spent many nights at BF's house before, I am still finding my way around my new residence with all of my belongings in it. Where to store things. The easiest order to go from room to room as I get ready for work in the morning. The easiest place to keep my D supplies and change sites...

The house is a raised bungalow. On the main floor, there is the living room, kitchen, bathroom, and two small bedrooms.

The master bedroom is in the basement (as well as a rec room and an office/workout room).

On Sunday evening, after a long day of packing and moving in the rain, I looked forward to taking a long, hot shower. It was also time for a site change, so I took out my old set and enjoyed being site-free for a little while.

As I stood under the flow of tepid water, I felt a headache starting. It was the dull throb of a low setting in. I had been fighting lows for most of the day after lifting heavy boxes and running up and down various flights of stairs.

I stepped out of the shower, toweled off, and wrapped myself in my favourite robe. I picked up my pump from the edge of the sink and put it in the pocket of my robe.

I went out to the kitchen, found my meter on the counter, and tested - sure enough 2.7 (49). I poured myself a glass of lemonade and gulped it down quickly.

I found my large box of D supplies in the living room and grabbed a new infusion set and reservoir. I threw them in the travel toiletry case I keep my Quick-serter and alcohol wipes in so that they would be easier to carry downstairs. I went back to the kitchen, stopped at the refrigerator to grab a new vial of insulin, put it in the case too, grabbed my meter, and headed downstairs to the bedroom where BF was already in bed.

I sat down on my side of the bed and placed the case and my meter on the night table. Actually, more like flopped on the bed and threw my case and meter AT the night table. Right away, BF knew...

"Low babe?"

I nodded. I waited a few minutes for the fog of the low to lift a bit, then picked up the case again to dig out my supplies for the site change.

Infusion set, check.
Reservoir, check.
Quick-serter, check.
Alcohol wipe, check.
Insulin...

Where the hell is the insulin?

Sighing loudly and mumbling "shit" under my breath, I got up from the bed and ran up the stairs back to the kitchen. I could have SWORN I put a vial of insulin in the case. I got a new one from the fridge and went back downstairs.

When I returned to the bedroom, BF asked what had happened and I told him that I forgot my insulin, but was sure I had already brought some downstairs with me the first time. He picked up my case, looked inside, and found the insulin stuck under the cloth barrier dividing the case into two pockets.

I cursed again and with the second bottle of insulin in my hand, ran back upstairs to put it in the fridge (I should have waited or let BF bring it upstairs for me when he immediately offered, but I wasn't thinking clearly and was feeling slightly stubborn - one of my obvious low symptoms).

I returned to the bedroom and, exhausted and frustrated from the low and running up and down the stairs, I threw myself down on the bed, buried my head under a pillow, and felt tears well up in my eyes. BF asked what was wrong.

Sniffling slightly, I replied, "I'm just hating diabetes right now."

He held me for a few minutes until my blood sugar came back into range. I inserted my new site, turned out the light, and went straight to sleep.

Note to self: Do site changes upstairs from now on.

Best Endo Appointment EVER!

2007-05-29T17:05:00.001-04:00

Remember your toughest class in high school? Remember studying for days, weeks even, for the final exam? And although you studied as much as humanly possible, even after writing the exam and answering every question, you felt as though the result could go either way. It could just as easily be a brilliant "A+", or a disastrous "F".

I feel that way every time I go to my 6-month endo appointment.

I've been dreading this appointment for the past month, but thankfully, today was one of those "A" days. My latest A1C results came in at a 6.6% - the lowest it has ever been in the past 2 years. All other numbers were well within range as well. And best of all, my blood pressure was 110/70. Doc and I were both pleased.

I also met with my diabetes nurse/educator (I'm still not sure what her official title is). She gave me one of her samples of the new One Touch UltraMini meter, which is not available in Canada for another couple of weeks. It's a blue one though - no pretty pink or green for me. Oh well, I'm just glad to have it. It is a bit bigger than I expected, but the case is definitely more compact than any other meter I have.

I asked about CGMS and my nurse was glad to hear that I am interested in it, she is very pro CGMS. She showed me the Minilink transmitter for the Paradigm, and it's a lot smaller than I thought it would be. So I am definitely seriously considering purchasing the Minilink and a pump upgrade this summer.

I asked her if she'd heard of any patients getting insurance approval, but she wasn't sure. She recommended that I apply for the Disability Tax Credit. The amount I could potentially receive back on my taxes from this credit would be enough to cover a few months of supplies.

To give you some background, a couple of years ago Revenue Canada (our IRS) allowed diabetes to be included under the definition of life-sustaining therapy (scroll to page 7). Their criteria is proof of at least 14 hours per week spent on therapy. What stinks is that carb counting is not to be included as part of the 14-hour requirement - I don't know about you, but I think it's an extremely important part of insulin therapy. There is a diabetes advocacy group in Canada trying to get carb counting included in the definition.

I did apply for the Disability Tax Credit with my 2005 tax return, but it was denied by the paper pushers at Revenue Canada. That was back when I was still on MDI. My nurse said that I should have appealed it, but said that now that I'm on the pump I should definitely apply again since they consider pump therapy to be more time consuming. If my request is denied, she said to appeal until they approve it. She said dealing with the government is very much like dealing with the insurance companies - the first time around they usually deny requests, hoping to discourage people from pursuing the issue further.

Anyway, regardless of what happens, after I sell my house and have some extra money, I do plan to pursue CGMS.

My appointment ended on a very high note, with my nurse commending my self-care. She called me a "model patient", and said she wished I lived closer to the Diabetes Centre (I travel 1.5 hours each way for my appointments) because she would like me to be a pump mentor for new pumpers. It was a grand compliment, and certainly made my day.

It was nice to hear the "model patient" bit... it's easy not to feel that way on the days when chocolate calls my name.

Edit 05/30/07 @ 8:30 a.m.: I should include the note that a claim for the Disability Tax Credit is in ADDITION to any medical expense claims. It is a flat credit, regardless of how much is spent on medical supplies.

iTest (aka AgaMatrix Keynote)

2007-05-23T08:43:00.000-04:00

I've seen the buzz on a couple of different blogs about the new AgaMatrix Keynote meter (in particular at Amy's Diabetes Mine, and Bernard's Blog).

I was feeling a bit left out and bummed that the website for this seemingly cool new meter didn't mention anything about being offered in Canada.

However, imagine my excitement this morning as I browsed the Sympatico MSN site, I saw an ad on the right side of the page for Canada's version of the AgaMatrix Keynote: the iTest. Honestly, I couldn't believe my eyes! It always seems that technology takes so much longer to arrive north of the border.

For the few Canadians out there in the blogosphere, if you are interested in the iTest, fill in a form on their site for a coupon to get a free meter (i.e. it's free with the purchase of 100 test strips, of course). They will e-mail the coupon with a list of pharmacies in your area currently carrying the meter. Handy information, since it seems that not all pharmacies are on board yet - I haven't decided yet if I will wait to see if my pharmacy is going to carry it, or if I will have my prescription moved to a pharmacy that does. I have a pretty good relationship with my pharmacy, so I think I will see if they would be willing to order it in.

I suppose I will also need to check with my insurance company to see if they cover the strips.

Not sure how soon I will get around to it all, but I will keep you posted on my progress!

Unintentionally Untethered

2007-05-17T13:13:00.001-04:00

This morning I woke up at 4:00 a.m. with the incredible urge to pee.

Okay, that's not an unusual event. My bladder generally wakes me up most nights sometime between 2:00 and 4:00.

But as I made my way through the darkness to the washroom this morning, I realized that I was experiencing the all-too-familiar dry, 'cotton-mouth' sensation. The unquenchable thirst. I thought to myself, "Damnit, my blood sugar must be high. I guess I didn't take enough insulin with the popcorn I ate earlier."

When I arrived at the washroom, I reached for the waist band of my pajama bottoms in order to pull them down and do my "business". Something seemed different though. Something was missing.

"WHAT THE F***?" I shouted in my head. "Where the hell is my pump?"

Turns out that I forgot to re-attach it after putting on my pajamas before bedtime. When I got back to my bedroom, sure enough the pump was perched atop my dresser. I grabbed it, and my test kit from the night table, all the while cursing under my breath. BF stirred slightly and asked what was wrong. I just said, "my blood sugar is high" and left it at that since he was half asleep.

I went back out to the living room so as not to disturb BF further. I primed the line a bit, re-attached my pump, tested at 18.9 (340), and gave myself a correction bolus.

In my 10-month history as a pumper, that was the first time I had ever forgotten my pump.

When I awoke at 7:00 a.m., I tested again and my blood sugar was down to 10.4 (187). I took another small correction, and carried on with my usual morning routine.

I took a hot, long-ish shower (longer than 5 minutes, but less than 10). I got out and wrapped myself in my thick and comfy terrycloth robe. I went out to the living room and sat next to BF on the sofa. We chatted and laughed for about 20 minutes, mostly about nonsense, as we always do.

Just before I got up to continue getting ready for work, he asked me what the commotion was all about in the middle of the night. I told him about forgetting my pump on the dresser and how I felt like a moron for doing so. As I stood up from the sofa, I suddenly realized that my robe felt lighter than usual.

HOLY SHIT, I DID IT AGAIN???

When I get out of the shower, I usually re-attach my pump to its site and put the pump in the pocket of my robe.

You would think that after forgetting my pump earlier, I would be more aware and careful to not do it again. But in less than 12 hours, I forgot my pump TWICE!

Another D moment for the books!

The Reservoir

2007-05-16T19:21:00.000-04:00

Filling the insulin reservoir for my pump has become a bit of a game to me.

I always try to squeeze as much insulin as possible into the 1.76 ml vial of my Paradigm 515. I usually change my site when the reservoir runs out, so it's my way of sustaining my supplies for as long as possible.

I have targets that, in my mind, indicate my successes and failures.

If I have less than 150 units of insulin left after priming the infusion set and getting all the air bubbles out, I feel a bit deflated. Defeated. Akin to a blood sugar reading being out of range. Curses to the heavens!

Between 150 and 155 units is "okay". I can live with it. But it makes me determined to do better the next time. Between 155 and 160 units is even better.

When I manage to cram over 160 units, it is like getting an "A" in twelfth-grade calculus. I knew I worked hard for it, seeing the "A" (i.e., over 160 next to "Units Left") just confirms that it wasn't for nothing.

The very odd time, I manage to pack over 170 units into the reservoir. When this happens, I usually mutter "Yessssss" to myself, and do one of those on-one-knee, hand-pump things in my mind (think Tom Cruise on Oprah).

Silly, no? :)

Random bits

2007-05-15T10:43:00.002-04:00

It was a fun Mother's Day weekend (a late happy one to all you moms out there). Not only was it Mother's Day, but it was also my mom's 65th birthday. We celebrated with a family get-together in the form of a BBQ on Saturday night.

There were 3 different cakes, and yes - I sampled each one. The one with the blue icing was the best. :)

June 1st is only 2 weeks away! Yikes! This weekend will be crunch time to get the house renos DONE for the sale. Thankfully, it's a long weekend in Canada, and BF and I are both taking Friday off as well, so we should be able to finish up all loose ends over 4 full days.

Addition: I forgot to include a funny moment at my mom's party.

My 9-year-old nephew is the cutest.

My older sister was filling me in on her in-laws' side of the family, telling me about her niece who, at the age of 16, has a fake ID and has turned into a real rebel.

Mid-conversation, my sister's nephew (on her husband's side), who came to my mom's party to keep MY nephew (her son) company, interrupted and said, "Yeah, did you know that she doesn't even believe in GOD anymore?"

My nephew's response: "I didn't know she was Buddhist!"

Observation from a non-diabetic

2007-05-08T12:40:00.001-04:00

We spent the weekend doing yard work at my house. June is fast approaching and I need to improve the "curb appeal" of my house in order to get top dollar when I put it up for sale next month.

(I won't get into the series of lows I experienced as a result of hours of shoveling and swinging a hammer, or the aches and pains of muscles I didn't know I had...)

On Saturday, we replaced the old, junky, chain-link fence along the right side of the yard with a new, wooden fence. I was busy digging a hole for the next post, while BF put up the first section of fence. When I thought the hole was almost deep enough, I stopped digging to get the fence post and place it in the hole to see how close I was. As I picked up the post, I caught my middle finger on a small, sliver of wood sticking out. I dropped the post and loudly cursed the stinging feeling coursing through my finger.

BF asked what happened and I showed him the wee sliver sticking out from my finger, expecting his usual sympathy and comforting hugs and/or kisses. He did reach out to hug me, but at the same time had a grin on his face and laugh welling up from his chest. Not amused myself, I asked him why he was laughing.

"I just think it's funny that you can purposely stick your fingers a dozen times a day and not flinch, but you get a sliver and it sounds like your whole finger was cut off."

The comment put my nose out of joint for a few minutes (me: "It just isn't the SAME!..." - he was kidding of course, he totally gets how the two are different), but now that I've had some time to reflect, it IS pretty funny...

Basal rate changes

2007-05-03T13:56:00.000-04:00

On Tuesday, I wrote that I thought my site had "gone bad" and that I wasn't absorbing insulin efficiently.

After reading your comments and realizing it's-better-to-be-safe-than-sorry, I was planning to change my site in the evening. But 2 hours after dinner, my blood sugar had stabilized again, and my sugars stayed stable throughout the night and into the next morning.

I woke up yesterday morning with a fasting sugar of 5.4 (97). Perfect, right? However again, throughout the morning and afternoon, my blood sugars began to climb again, hovering around 12.0 (216) for most of the day. It finally came down again in the evening after going for a nice walk at the waterfront.

Today, similar story. Nice fasting blood sugar first thing in the morning, but I can see it climbing again.

So, it looks like it wasn't a bad site, but a signal for a need to make changes to my basal rates.

I find it so odd how my basal rates can go off track suddenly. This isn't the first time it has happened. I don't recall doing anything different in the past few days that would trigger a change. I have been exercising more in the past 3 weeks, and if anything, that should make my basal rates go down, no?

I guess it's just one of those things I will never fully understand...

Bad sites

2007-05-01T15:00:00.000-04:00

I think that my site has suddenly gone bad.

I changed sites yesterday morning, and had no problems all day. I even woke up this morning with a spectacular fasting blood sugar of 4.7 (85). But within an hour, it climbed to 8.0 (144), and my blood sugar has been increasing steadily throughout the day. I just tested, and right now it is 15.7 (283). I took a correction bolus and I'm crossing my fingers that it comes down.

Anyway, my question is: At what point do you usually decide that you have a bad site and change it?

Honestly, sometimes I'll try to ride one out for as long as possible. Sometimes, it seems that I'm still getting insulin, it just isn't all absorbing. So if the corrections are working, I'll continue correcting as necessary for the life of the site (i.e., until the insulin reservoir runs out). Or I'll increase my temp basal to like 150%.

(Of course, these methods do not work if the cannula has become completely dislodged.)

Infusion sets are too damn expensive to waste. And my insurance is pretty strict about me ordering any more than 10 sets a month.

The decision whether or not to change out a sluggish site is always a struggle for me.

Yay me!

2007-04-25T21:19:00.001-04:00

I'm feeling proud of myself today, and I wouldn't be fair to myself if I didn't write about it and give myself credit.

I had a pretty terrible winter in terms of taking care of myself. Exercise was scattered. Non-existent, even, some weeks. Truthfully, a lot of weeks. I made many bad food choices. Some were good. Probably about 70% good, 30% bad.

But for the past 10 days (after getting the Easter-chocolate binge out of my system), I totally deserve a gold star for my food choices and exercise efforts. Oatmeal for breakfast every day, for that slow carb release that prevents my blood sugar from spiking 2 hours after breakfast, when I typically have the most trouble with highs. Fruits and/or vegetables at every meal. Plenty of lean protein. Brisk walks in the evening (when it isn't raining) with my mp3 player blaring Madonna's Confessions on a Dance Floor (which, for me, has the perfect tempo to keep a good walking pace).

And I can totally see the difference in my sugars. Sure, there's the odd high signaling a site change, or low at the end of my walk sometimes, but overall, no complaints. My 14-day average is 6.4 mmol/L.

My goal is to lose the 10 lbs. I gained after starting on the pump last year before my next endo appointment at the end of May. I've already lost 4... 6 more to go. And I'm crossing my fingers that my blood pressure will have come down by then too.

Anyway, that's all I've got. To sum it up: Yay me! :)

Something I didn't learn during pump training...

2007-04-24T11:14:00.002-04:00

Last night, since it was raining, I went to the mall to browse the stores a bit. This weekend, BF and I are going to a semi-formal dinner and dance, so I thought maybe I'd look for a new dress to wear (not that I really need to buy something new, I have plenty to choose from in my closet, but it's fun to do sometimes).

I haven't worn a dress in over a year. I've worn skirts a few times, but not a one-piece dress.

I started pumping last July.

See where I'm going with this?

As I stood in the dressing room of Le Château with a few of the latest spring fashions, it occured to me: where am I supposed to put my pump? My good friend, who has been pumping for 7 years and originally introduced me to the pump, told me that she wears hers in the cleavage of a dress. That somehow, she's able to position it to, in fact, enhance her cleavage. Huh? I don't even know how that would work. Besides... well, I won't divulge my cup size, but let's just say that I don't need any help in that department.

I always wear my pump clipped to the waist of my pants. I've read of some other creative places people keep their pump, like Kerri's in her sock. But I like wearing mine on my waist. Easy access. And mine sits in a black leather case, so most people don't even notice it (and if they do, I assume that they assume it's just a cell phone).

Anyway, if anyone can explain how the cleavage thing works, I would be ever so grateful (and preferably, in a way that will NOT increase my cleavage). Or offer alternate suggestions for pump/dress combos. Otherwise, it looks like I'll be wearing pants or a skirt on Saturday night.

Swing low, sweet chariot

2007-04-16T15:11:00.000-04:00

Yesterday, by the end of the day I started humming the above song to myself in an attempt to keep my humour intact after a long day of lows...

(Just a reminder to multiply my readings by 18 to get mg/dL - my lows are anything under 4.0 mmol/L).

9:02 a.m. - 4.1 mmol/L
12:39 p.m. - 5.0 mmol/L
2:09 p.m. - 3.3 mmol/L
3:16 p.m. - 3.4 mmol/L
4:21 p.m. - 3.6 mmol/L
5:46 p.m. - 4.3 mmol/L
7:20 p.m. - 2.9 mmol/L
8:10 p.m. - 6.6 mmol/L

I had set a temp basal rate at 60% of my regular rate for the afternoon, but even that didn't help. I don't think I was any more active than I am on most weekends. It was really bizarre.

I've never had to use glucagon before (i.e., never become unconcious from a low). But has anyone used glucagon to help combat a string of lows? The nurse at my diabetes clinic suggested it once. I thought about trying it yesterday, but couldn't remember exactly what she had told me (I'm pretty sure she said to inject about half of the glucagon).

Correction

2007-04-09T15:02:00.000-04:00

BTW, I didn't "buy" the meter in my previous post (it just seems natural to say that) ... it was a manufacturer's freebie of course. :)

New meter

2007-04-09T13:04:00.001-04:00

I bought a new glucometer last week.

I don't know about you, but I always find it hard to switch. As much as I want to try different meters with different features, when I've had one for so long, it's hard to let go of the large bank of results and averages available.

But I forced myself, and I've been using my new meter for 5 days. It's the OneTouch Ultra 2. Nothing spectacular, I probably would have been better off staying with my old UltraSmart since there are so many more features, but the UltraSmart case is too bulky. At least I can still mark before and after dinner tests on the Ultra 2.

And the 5-day average reflected on the meter isn't too bad so far (7.9 mmol/L) considering all the eating I did over the Easter weekend ... turkey dinner at my mom's, ham dinner at BF's mom's, out for breakfast with my cousin, birthday cake for my friend's son, and chocolate the 'easter bunny' left.

I don't dare step on the scale. I don't need to. I can feel the slight snugness of my pants around my waist. *sigh*

Bits and pieces

2007-04-01T08:18:00.001-04:00

Time

It's April 1st, which means Time and I need to have a little talk. I need Time to agree to co-operate over the next two months. The goal is to have my house on the market by June 1st and hopefully sold by the end of June.

We still need to re-do the basement after the flood last month, finish the drywall and floor in the back entrance, and landscape the back yard. BF also has to finish some work at his house before I can start moving my things over - installing and refinishing hardwood floors on the main floor, finish the kitchen, and install and paint baseboards and moldings in the living room, kitchen, and master bedroom. There is much more work that needs to be done on his house, but those are the priority in order to make it a liveable space again.

Roller coaster

My blood sugar has been on a bit of a roller coaster ride the past few days. Not sure if it's the stress of knowing this all has to get done in such a short period of time, or if I maybe had a bad site, or bad insulin. It seems to be better today since changing my infusion set yesterday.

Bruises

Right now, every single one of my fingers is bruised from testing. I have only tried forearm testing once; I became discouraged when I couldn't get my arm to stop bleeding. BFaid that maybe I should try my toes. I'm still not sure whether or not he was serious.

My knight in shining armour

Last night we went for a small walk from my house to his parents so that he could help his dad with some electrical wiring. It is only a 10- to 15-minute walk between our houses, and BF said that he didn't anticipate we would be there very long. I figured we would be back home before I would need to test again, and the walk probably wouldn't be enough to initiate a low, so I decided to leave my purse and glucometer at home.

The wiring did take a bit longer than BF had thought. Just as I was thinking to myself, dammit I should have brought my glucometer, BF asked, "Hey, isn't it time for you to check your blood sugar?" Just as I was about to tell him that I'd left it at home, he pulled my kit from his jacket pocket. He had grabbed it on our way out. "Gotta look out for my girl."

Gearing up...

2007-03-23T16:22:00.001-04:00

...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. :)

My pump

2007-03-19T15:19:00.001-04:00

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.

The Clinic

2007-03-16T11:52:00.001-04:00

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...

Eggrolls and exercise

2007-03-15T10:16:00.001-04:00

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.

Basal:

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

Bolus:

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?

The Damage

2007-03-14T22:50:00.000-04:00

Before...

...and after

I always wanted an indoor pool.

2007-03-14T13:29:00.001-04:00

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!

Welcome

2007-03-13T14:36:00.001-04:00

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 (www.sixuntilme.com) 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...