Merry Christmas!

Hard to believe that it is Christmas Eve already!  I wish all of you a very Merry Christmas, keep safe, relax and enjoy :)  I am looking forward to time with my family and friends, so much to be thankful for.  Here is a picture of my two little guys with Santa.  Cheers!

Resisting Temptation

For those who know me well I have always had a sweet tooth.  I love all things candy, chocolate and have never said no to a cookie.  Given the choice between a bag of chips or a chocolate chip cookie I would grab the cookie and run.  When I was young I dreamed of going to the factory in Charlie and the Chocolate Factory and dunking myself in the river of chocolate (seriously folks!).  As a kid I grew up eating quite healthy and sweet stuff was definitely a treat.  I can say that I never over-indulged (except that one time my brother, sister-in-law and I shamelessly ate an entire ice-cream cake in on sitting) but each day would allow myself something sweet.  Christmas was always my favorite for the yummy goodies.  Shortbread, mince pies, butter tarts, almond rocha, boxes of chocolates and candy canes galore.  A year and a half ago my love affair with sweets came to an abrupt end.

Since being diagnosed with Type 1 diabetes I can honestly say I have hardly touched any of this stuff.  For the first six months I was too scared to eat anything bad at all for fear of further damage.  It is important however that people understand that I can eat what I like with diabetes as long as I count the carbs and dose my insulin accordingly.  For me however it is not worth it.  The more insulin I take the harder it is to maintain a healthy weight and harder for me to control my blood sugars.  A lot of the stuff I used to love to eat, like my beloved chocolate chip cookies, are a no go anyway as a result of celiac disease.  A lot of people ask how I avoid the temptation to just chow down on all the goodness, particularly at this time of the year, and my response would be that I don't think about it and no longer crave it.  I never thought that would be possible but it is!  Once a week or so I will have a square of dark chocolate after a meal  or a spoonful of ice cream but that is about all.

Don't get me wrong though.  Some days I want to be able to just sit back and munch down a giant chocolate chip cookie the size of my head :)

Explaining Diabetes to the Short People

I have two nieces and two nephews, all of whom I love with all my heart.  My two nieces are 12 (Sarah) and 15 (Hannah) and my nephews are 4 (Logan) and 1 (Harris).  When I was diagnosed with Type 1 diabetes my eldest niece Hannah understood what it was and my younger niece Sarah learnt a lot about it and in fact did a project on diabetes at school.  I can talk to them about it and know that they understand.  It is harder however to explain to two little guys about what is wrong with their auntie.  The littlest one Harris is too young to understand or really even notice.  I know that Logan has seen me test my sugars and take insulin but I have never known how to explain to him what Type 1 diabetes is.  Enter the children's show Caillou.

On Monday evening after my workout I had an urgent text from my brother asking if I could come watch Logan.  Little Harris had fallen and split his lip and they needed to take him to emergency (he was okay in the end).  I rushed home, packed my supper that was cooking in the oven and drove straight over.  I sat down with Logan and he asked if we could watch some taped shows of Caillou together.  I put it on and sat down to eat.  Through the corner of his eye he watched me test my blood sugar and bolus insulin through my pump.  He did not say anything but I could see his little mind working overtime.  As I was thinking of how to explain what I was doing and why, a new episode of Caillou came on called "Emma's Extra Snacks".  It was about a little girl called Emma in Caillou's class who had Type 1 diabetes!!  I whispered to Logan that Auntie J (that's me) had the same disease as Emma.  He looked at me with amazement and we watched the show in silence together. 

The episode did a very good job of explaining Type 1 diabetes in a way that the short people can understand.  Emma had an insulin pump and had to eat extra snacks during the day to keep her blood sugar levels up.  The teacher explained that sometimes Emma did not have enough sugar in her blood which meant she needed to eat something and sometimes Emma had too much sugar in her blood which meant she had to take medicine from her insulin pump. When Caillou found out that Emma had diabetes he was very worried about her being sick and he thought that because she had a chronic disease she would be unable to do fun things like play on the playground and run with the other kids.  Emma explained to Caillou that she could do everything he could do, she just had to be sure to check her blood sugar levels many times a day and when they were low she explained that she felt dizzy and weak.  Once Caillou understood that Emma could manage her disease and that it was something she had to live with he relaxed and stopped worrying so much.

After the episode Logan and I chatted about it.  It went something like this:

Logan:  So Auntie sometimes you don't have enough sugar in your blood and sometimes you have too much?

Me:  Yes and depending on which one it is I either have to eat some sugar or take medicine through my insulin pump.

Logan:  And that makes you better forever?

Me:  Well not forever, it is something I have to do everyday and each time I eat.  

Logan:  Are you kind of like a robot now?

Me:  I guess you could say that I have robot parts.  They help to keep me well.

Logan:  Oh, well that makes me happy.

He then inspected my insulin pump and was fascinated with the fact it was attached to my stomach.  He lifted his shirt and looked at his tummy and told me that he does not have one attached to him and neither did his mommy or daddy.  He wanted to know if he would need one one day attached to his tummy.  My eyes filled with tears and I gave him a big hug and told him I hoped he never would need robot parts.

Wordless Wednesday

Kasper with his chicken exhausted after a day at doggie daycare.  Just makes me warm and fuzzy.

Sport Bra - Ultimate Diabetic Assistant

This afternoon while getting ready for my run it dawned on me how useful my sports bra is.  Not only does it hold the girls in place, but it is like a mini suitcase for all my diabetic needs while running!  Amazing what one can pack in there.  Today I had my I-Phone (for music and in case of emergency), insulin pump, tube of 10 glucose tabs, meter and a little baggie with test strips.  Works a charm! 

Two Weeks into Pumping

First of all, today is International Diabetes Day!  I am so very thankful to my fellow Canadian Dr. Banting for founding insulin.  Without this discovery I would not be here along with many others.  I am going to celebrate my hitting the gym tonight wearing blue and working up a good sweat.  To me this symbolizes what insulin enables me to do on a daily basis.

It has been two weeks since I starting pumping and I can sum it up in one short sentence.  I LOVE IT!  I really and truly love my pump and am so happy I made this decision.  Don't get me wrong, it has been frustrating and I will be the first to admit that my numbers have been all over the place (not sure what my current A1C will look like)...but it is improving each day and I have learned so much in the last couple of weeks about how my body utilizes the insulin I give it, when it needs more, when it needs less and how all my different types of exercise and foods affect me.  I had an idea when on needles, but a lot of the time you are just guessing how much insulin you have left in your system and things can go wrong quickly.

Some of the things I have learned.  I have dawn phenomenon in a big way.  I am working with my team to adjust my basal through the night and this is working.  The first day I woke up with a 16.0 I nearly had a bird.  Now my numbers are getting closer to what they should be after fasting all night.  I need significantly more insulin during the night!  My insulin to carb ratio's have also changed and this has helped with my post meal numbers.  I need more insulin at breakfast, a bit less at lunch and then less again for supper.  My team started me on a conservative basal rate during the day and that has increased as well.

Exercising has been most interesting to figure out.  I have found that being able to see how much insulin I have on board (IOB) is invaluable.  This has allowed me to adjust my plan according to what I will be doing.  So far I have had a lot of success in setting a temp basal decrease of 50% an hour before activity and then cancelling it the minute I finish.  This has prevented me, in the most part, from going low during my activity and then prevents the high afterwards.  After really intense activity I have even had to bolus a small amount to counter going high.  I have not run yet (due to some hip issues) and will be interested to see how I react next week when I resume running.  Swimming has gone very well and I was delighted to confirm for myself that it is in fact waterproof!  I was so nervous jumping in the pool for the first time, I was pretty convinced it was going to explode.  But it did not and I was fine :)

Other things I love.  Being able to dose my bolus's to my exact carbs. I have had less lows (although the ones I have had have been intense).  I have lost 5 pounds in two weeks due to not having to eat my way out of lows.  I like that.  I love being able to see my IOB, helps me feel more confident when exercising or when going to bed at night.  I really love not injecting myself all day long, it is wonderful.  The infusions sets pinch when I insert them but it is not bad at all.  I love that my pump has a clock on it and the date, instant watch!  I have had quite a few strangers notice my pump and have asked me about it, particularly at the pool.  I like having the chance to educate and explain.  In fact I am working on a post that explains what an insulin pump does and is.  I realize that not many people know and there are many misconceptions out there, number one being that the pump tests my sugars for me and automatically gives me insulin.  This is not the case at all.  In fact I have found myself testing a lot more. 

All in all I am very pleased and looking forward to learning more and more.

Happy International Diabetes Day to you all :)

My Pump and I Are Attached!

It's official, I am now a Type 1 diabetic on an insulin pump and so far it is fantastic.  I am only three days in and although it is a huge learning curve and has been frustrating at times, I already know that I have made the right decision.

Let me back up a week.  Last Thursday I attended my diabetic clinic as eager as a kid on their first day of school.  I had the big bag of supplies, manuals, workbooks as well as the pump itself in tow ready for my pre-pump class.  There was one other man who would be doing the pump start with me and we hit it off right away.  He has been diabetic for 40 years and had made the decision to start the pump to help him get better control.  The nurse went over some basic diabetic stuff and then we got right into it.  We made some dummy programs on our pumps and played with all the settings.  We practiced loading the cartridge with saline and getting the pump ready to use.  We used dummy stomachs to do our site insertions.  The plan was for us both to leave the clinic by noon pumping saline solution.  Before I knew it we were ready to insert our first sites.  This was the moment I got a bit scared...okay like really scared.  I have always had a fear of needles and although I had been injecting myself for over a year, the needle in the insertion set looked very daunting, long and sharp.  I watched my fellow new pumper insert his with no problem and knew I had to just suck it up.  I got the set ready against my tummy and placed my fingers on the trigger (for those who don't know it inserts itself automatically when you press the sides of the insertion set).  The nurse gave me a big smile, counted to three and...nothing.  I could not do it.  She looked me in the eye and told me to just do it.  So finally after counting to three another four times I took a big deep breath and pushed.  Clunk.  In it went and I hardly felt a thing!  Just a little pinch. The nurse must have thought I was totally bonkers when I let out a big yahoo and kind of punched the air with my fist.  Yeah, I did that.  After inserting the sites we hooked up to our pumps and they shipped us off pumping saline with instructions to do everything with the pump on to get used to the feeling of having it attached.  I left the clinic that day feeling totally elated.  It felt strange to have this little beeper sized thing on my hip but I felt super excited about the whole thing (and inside slightly terrified).

For the next five days I had my insulin pump on me and practiced bolusing saline and using the remote meter (which is totally awesome by the way).  Sleeping with it was easier than I expected, I just clipped it to the back of my undies and slept well.  I went to spin class with it and tried out my Spibelt which worked a charm.  I ran with it, went for a swim where I practiced hooking and unhooking it) and did my strength workouts with no issue with comfort.  I did a site change on the Saturday - it took me a long time but I am sure it will be second nature soon.

On Tuesday morning (Oct. 30/12) I returned to the clinic with a vial of insulin and my supplies.  I was ready to rock n' roll.  A different nurse spent the morning with us and she was fantastic as she is a pumper herself.  We spent the first hour putting all of our settings in with basal rates, insulin to carb ratios and sensitivity factors.  The doctor had started me on a conservative basal rate to work from.  They lent each of us a pump to play with and we practiced bolusing from the remote meter.  We were ready to begin with insulin!  The night before I had only taken half my dose of lantus in order that I would be ready to start.  I changed my site, filled my cartridge, prepped the pump and hooked up. That was it, I was pumping insulin!  I left the clinic with instructions to keep track of all my sugars, carbs eaten and amounts bolused.  They warned me that I would experience some highs as my basal rate was very conservative and could expect to be frustrated.  I was to call the clinic that afternoon and then twice a day for the next three or four days to report all of my data in order that we could get my rates adjusted.  I left the clinic feeling very excited and extremely vulnerable.

My day with the pump felt so weird.  It felt very strange not to i

In order to avoid this post getting to book length, I will post some more stories over the next few days with what has been happening since starting on insulin through the pump.  I feel a bit like a science experiment!  One thing I was shocked at was how emotional going "live" on insulin was.  It brought back the memories of the day I was diagnosed and gave myself my first injection.  It made me realize how far I have come in the last 13 months, how much I have learned and how I have managed so far.  It also made me feel so sad and angry at the same time.  Although I am very excited to have this opportunity to be on the insulin pump, it is just really blows that I have to do this.  It really struck home for me that this disease is here to stay.  The man who took the pump-start with me found it very emotional.  He said that even 40 years in sometimes it just hits him how hard it is, how frustrating and at times how it all feels very unfair.

I look at my pump as an opportunity to learn more about managing this disease and hopefully down the road help others.  I now need a name for my pump as she is going to be literally attached to my hip :)

Wordless Wednesday - New Go Faster Running Shoes

Living Alone with Type 1 Diabetes

I have been asked to take part in a panel this weekend for the Kids 'n' Us Conference (link here).  There will be three of us on the panel and we will be speaking with teenage girls about various topics surrounding living with Type 1 diabetes.  Some of the topics include how to talk to a boyfriend about having diabetes, intimacy, how to tell a prospective employer you have diabetes, looking for jobs that have good health plans, drinking alcohol and living alone, to name a few.  They asked what topics I felt comfortable talking about and while I am comfortable talking about all of them, one that I can talk quite easily about is living alone with Type 1 diabetes.

I have lived alone for the last three years (not counting my two furry friends) and have never worried about being on my own. Things changed when I was diagnosed.  All of a sudden I had a reason to fear being alone, particularly at night.  I was scared of going low in the night and not having someone there to help me or wake me up if I was in trouble.  Pretty much anything negative about being on my own ran through my head.  I have always been a very independent, strong and somewhat stubborn (what? who said that?) women and all of a sudden I felt weak and overwhelmed.  My boyfriend stayed with me for the first little bit while I got used to my new routine.  I still remember the first night I spent alone, I was terrified.  Looking back I do laugh a bit at how paranoid I was.  I set my alarm for every two hours to check my sugars and to make sure all was right.  It was exhausting and I knew that I had to come up with a living alone plan.

Fast forward a year and I have the same routine each evening to ensure that I am safe.  My boyfriend does stay two or three times a week which always put me at ease, but I am well prepared for the evenings I spend alone.  For starters I make sure that I have a phone near me in case I needed to call 911 at anytime.  In my bedside drawer I keep juice boxes, glucose tabs and granola bars.  Each night before bed I check my blood sugar to assess whether I need to have a bedtime snack.  Due to my exercise regime I often find I am lower in the evening so often a banana before bed does the trick.  I no longer set an alarm to wake me in the night, however guaranteed I always wake up to pee at least once so I check then.  I find that having all of this in place makes me feel safe and means I am ready to treat a low at a hands reach during the night.  It has come in handy more than once!  I have only had one occurrence where I went low in the night and had nothing at hand to help.  It scared the bejeezus out of me.  I literally had to crawl downstairs sweating and close to blacking out.  I made it to the kitchen and downed juice and lay on the floor until my sugars came back into range.  Looking back I should have called someone but in that blurred state I was not thinking straight.  Since then I do my best to avoid that situation!

I hope that on Saturday speaking about my experiences of living alone will help reassure these young adults that they don't have to be frightened and can do it!  Just takes a bit more preparation.  I am looking forward to the conference and excited to be involved. I shall report back as to how it went.  I am sure I will learn a lot from these young ladies.

Gastroscopy

Last week I had to go and have a Gastroscopy in order that they could take a biopsy of my upper intestine to see what damage has been done by having celiac.  Now I will be the first to admit that I am not good with hospitals (who is?) and am terrified of needles (really handy for a diabetic) and particularly IV's!  The night before I tried to sleep but was really nervous.  I had to fast for 10 hours and arrived at the hospital hungry and with a bit of higher than normal fasting blood sugar due to my nerves.  On arrival they had me change into one of those god awful hospital gowns and settled me in a bed.  I was happy when they brought over one of their heated blankets and wrapped me up nice and warm.  The nurse took all my vitals and blood sugar and got me ready to have my IV inserted.  I warned her that I was not very good at this and had been known to pass out while having IV's put in.  She was so gentle and talked to me about miscellaneous things.  A quick pinch and it was done.  I felt so relieved.  I could feel the cool saline solution running down into my bloodstream.

The nurse then proceeded to tell me what the doctor would be doing.  I really wish that they would not have to do this as it makes me even more nervous.  She explained that the surgeon would spray my throat with a numbing spray and warned me that it would taste awful.  They would then put a piece of hollow plastic in my mouth to stop me from biting down. I would be given a strong sedative that would not put me to sleep however I would be pretty out it.  They would then feed a long tube with a camera on it down my throat where they would take a look around and take a biopsy.  It would only take about 15 minutes and they would let me sleep for about 45 minutes afterwards before getting me up.  I kept picturing a tiny little video camera going down my throat into my tummy and it made me giggle.

I lay in bed for awhile watching all of the other folks in for day surgery and I was soon taken into the procedure room.  The surgeon sprayed my throat and I gagged a bit.  They were not kidding when they said it would taste awful!  Next they put a big green hollow piece of plastic in my mouth which was held in place by straps around my head.  It felt so weird!  The surgeon then put some sedative in my IV and it stung once it hit my veins.  The nurse asked if I was sleepy and I kept telling her I was not and then all of a sudden everything was kind of blurry and my body felt numb.  It was lovely.  I felt the tube go down my throat which felt very strange indeed.  I think I totally blanked out after that as the next thing I know the nurse was waking me up back in the recovery room.  She said everything went fine and she made me sit up and drink a glass of water.  She told me I would hear from them in the next four weeks or so and that was it.  I felt very fuzzy and when Ryan came to get me I was feeling very smiley and almost drunk.  I got home and had a nap for about three hours and then relaxed most of the day as instructed.  My stomach felt bloated and my throat was a bit sore, but by the next morning I felt normal.  I guess there really was nothing to get so worked up about after all!

My Pump Has Arrived!

When the box arrived at my work from Animas I felt a wave of emotion.  I opened up the box eagerly and peered inside to see an entire new world of medical supplies.  I opened the box with my pump and there she was, nestled in the package all shiny and brand new.  It is hard to describe the excitement I felt (and feel).  I have wanted this since being diagnosed.  It represents so much to me.  The ability to live with a bit more freedom.  I look forward to eating on my own schedule, being able to sleep in on a weekend without so much worry and mostly being able to exercise with a bit more peace of mind and confidence.  I can't wait to start planning my next marathon and then seriously start exploring triathlons.  Lets be honest, I am really looking forward to not having to stab myself with needles 4-8 times a day.  I know that the highs will still happen and certainly the lows, but I just know it is going to make me happier.

Holding my pump in my hand also filled me with fear.  This little machine will be responsible for keeping me alive each and every day.  That is a fact.  I have never really thought of it in that way until now.  I am the operator that must place the commands and trust that it will follow my direction.  I have so much to learn and not a lot of room for error.  I have a million questions and am eager to learn all I can to utilize this to its max.

My little silver pump mostly represents hope.  The hope that I can slow down the complications I already have and the hope that I can prevent others.  The hope that I can be the athlete I want to be and prove to myself that I can do this.  I think it also represents hope for all of us living with diabetes, the hope that a cure may come one day.  If you look at how far the treatment of diabetes has come maybe this is possible.

For now I shall read my manual and learn what I can about my new pump.  She is about to become my best and most trusted friend.  One month until go time!

Meeting another PWD (Person with Diabetes)

First I have to say that we had an amazing holiday! I have a post in progress about the trip and will post it shortly.  We saw so much...I fell in love with California :)  However this post is about meeting someone else with Type 1 diabetes.

We were in the town of Napa in Napa Valley and were picked up by our wine tour bus at 10:30am.  Altogether there were twelve of us.  We made our introductions and then shyly kept to ourselves.  When we were about 1/2 hour away from our first, of four, wineries and tastings I checked my blood sugar.  One thing I can say since being diagnosed is that I never hide it.  I am not embarrassed or ashamed and feel comfortable testing in front of strangers.  I do it as discreetly as possible however as I don't want to make others feel uncomfortable.  Anyway, I quickly tested my blood and noted that it was somewhat high.  I injected a correction and was confident the day would go well.  When I looked up I saw an older couple watching me.  The wife gave me a nod and wink and said to her husband "See, there is someone else".  Right away I was intrigued.  At the first winery we were served what they liked to call a Breakfast Wine (yes, they should market this!) and we started our first winery tour.  I saw the husband check his blood, make a face and then pull out his insulin pump to make a correction.  Well...I could not help myself from here!  I had just seen other bolus though an insulin pump!!  Something I had not see to date.  I cannot explain how giddy I felt. 

After lunch I hooked myself onto the couple whose husband had Type 1 diabetes and asked a bazillion questions about the pump.  My new found friend so graciously show me what the medtronic pump and CGM looked like and how they worked.  I got to see for the first time what a pump looks like, what the insertion site looks like and what a CGM looks like.  I was on cloud nine.  We had a great conversation about the benefits of he pump and also most deeply about the effects it has on our loved ones.  I listened to his wife tell me about issues he has had while being low and she explained how scary it is. It was good to have Ryan there to relate.  I am so very excited now to get onto my own pump!

Packing for my Holiday

I am so excited to leave on holiday tomorrow.  Seriously excited!!  It is going to be a dream trip.  We fly into San Fransisco, drive to South Lake Tahoe to spend a couple of days, drive to Napa Valley to spend a couple of days and then into San Fransisco for four days.  We have a ton of stuff planned and it is going to be a fun filled vacation.  I will post more on our return to regale you of our travels. 

Now packing for a vacation can be time consuming.  Particularly one like this where will be doing anything from hiking to fine dining.  Fancy dress with shoes for one day, shorts and tank top with windbreaker for the next.  I sat down the other evening to make my list to make sure I don't forget anything.  It really struck me how much extra stuff I have to pack now that I have Type 1 diabetes.  From all the reading I have done they advise to bring extra just in case, all of this amounts to quite the haul!  Just to give you an idea of what I will be packing to manage my disease.

Lantus insulin pens x 2
Novo-rapid insulin pen refills x 2
Little ice pack to keep all the insulin cold
200 test strips
Needles x 60
Lancet needles x 20 (no I don't change them every time I check, bad me)
Extra insulin pen
Glucose tabs
Glucagon shot
Letter from my doctor confirming that I must carry all of the above on me
Medical ID for my wallet
Medical ID for my wrist

I think this sums it up.  And this must all go in my carry on. Good thing the only other thing I bring on board is a book and my Iphone. I have only flown once so far with all of this stuff and I was extremely nervous about the whole thing.  I was pleasantly surprised that the staff seemed knowledgeable about Type 1 diabetes and even though they searched through everything they did not blink an eye.  It will be interesting the first time I fly with an insulin pump on!

Well that is about all!  Off to sunny California we go :)  This is how I fee right now:

Weeeee

One Year

One year ago today my life changed forever.   September 7, 2011 is a day I will never forget.  Out of all the "big" days in my life, none of them are as clear as this one was.  I can tell you what I had for breakfast (weetabix with milk and a Starbucks coffee) and  I can tell you what I was wearing (a grey pinstripe summer dress from H&M, size 0).  I can tell you how I felt.  Exhausted, exhausted to the point of collapse, stressed, thirsty and hungry.  And skinny, way to skinny.  Pretty much how I had felt for quite some time.  

I will never forget the words telling me I had a serious chronic disease, Type 1 diabetes.  My reaction was so calm, I could not move or talk.  I was in a dream, a nightmare...instant denial.  I will never forget the first injection...so close to getting the needle in and then me breaking down.  The sudden knowledge that this was it.  Never again would I eat whatever I wanted, exercise whenever I wanted...go to sleep without fear.  I had a disease that was eating away at my body - causing destruction that may never stop no matter what I do to prevent it. Each and every day I read of young, seemingly healthy, model Type 1 diabetics who lose their lives to this disease.  I read these stories and it scares me to my very core.  On that day I was given a life sentence and a hell of a lot of responsibility.  My survival is in my hands, it is up to me...and me only.  And even then, a lot is left to fate.

I am not quite sure that I can express how I feel today into words.  I don't feel that it is a day to celebrate.  It was the worst day of my life.  Sound selfish?  Well it is selfish and that is human nature.  Our ultimate instinct as human beings is to preserve our own life...and I can't help but feel that I am failing. The outside world sees a happy girl with a smile on her face, however no matter how hard I work at it, no matter how much I eat well, exercise regularly, no matter how positive I stay and how I carry on with my day to day life, it is there.  It is part of me now.  It's not leaving and is a serious monkey on my back.  I appear to be a well young women but inside no one really knows what is going on and how damn hard this is.  I try to explain to others, but get frustrated and then go quiet once again.  I have shed more tears in the last year than I have in my entire life.  I don't talk about it much and rarely will show this to the ones I should.

The last year has been the biggest challenge of my life.  Despite the amazing support I have received, and I mean amazing (you all know who you are)  I cannot express in words how it feels to live day to day with this disease.  It is always there, always in the back of my mind, it never gives me a break, never leaves.  Every decision I make during the day has to take diabetes into consideration.  Whether it be the food I eat, the insulin I have to take, the activity I do, the amount of sleep I get, the time of the month it is, the stress I feel...all of it effects my diabetes.  Hell, even if all of this is under control, 9 times out of 10 it throws you a curve ball anyway.

So on this day how do I feel?  A part of me is extremely glad and grateful that I finally got to the bottom of what was wrong with me.  I really don't think that I would be here today if this had not been discovered.  I do feel like a different person, some for the good, some for the bad.  I am much more aware of my body and what it needs.  I have never ate this healthy, ever, it is kind of sickening.  I have never appreciated life more.  I have stopped taking thing for granted.  I look healthier than I have for years (well at least I think so, the stick woman thing did not suit me).  I have a ton of energy and feel like my drive to live and accomplish my goals is back.  These are the positives.

Mostly what I feel is anger.  I thought by now I would have let go of the anger, but I have not.  I am angry that I have had to go through all of this, suffer with so many complications, lose my fitness and generally be dealt another blow in life.  I feel that I have dealt with enough in my life (that would require an entire new blog to explain my life and I am angry I have been dealt another bad card).  With the anger comes frustration to an extreme and unbelievable sadness.  In a totally irrational way I feel like I have failed myself, that I am weak.  Each and every day feels like a battle, so much self judgement.  Every time I check my blood sugars the four second delay sometimes feels like judgement hour.  What have I done wrong? Ate wrong? Calculated wrong?  So many emotions tied to each and every reading.  So many emotions tied to my food decisions and insulin decisions.  So many emotions tied to every high and low.  I get stages of feeling so grumpy and teary and it almost always is because of wonky blood sugars.  I used to be able to get up and run 20km without blinking an eye. Breaks me that now it is just not so easy, never will be.  My frustration is huge.  I eat better than I could ever imagine, exercise diligently and get great sleep.  I have trouble losing weight (which my doctor assures will change as my body adapts) and I cannot go for my beloved long run without ID, glucose, glucose monitor, test strips, medical ID and money just in case.  This makes me feel weak and vulnerable.  I certainly don't want pity and I definitely know that there are others much, much, much worse off.  But this is how I feel.

Perhaps the only bigger thing I feel than anger is determination.  I very much want to tell diabetes to F' itself.  I have always been stubborn (albeit quiet on the outside, but extremely stubborn and determined on the inside which may surprise a lot of you).  I am determined to get the best control that I can, to learn as much as I can, to do the things that many may think I can't...to be me.  Sounds cliche but I will not allow this disease to determine who I am.  I will run another marathon, I will do a half ironman and goddammit one day I will be an Ironman :)

Where do I go from here?  I have to learn to accept that my old way of life is no longer here.  I cannot indulge as I did in food, exercise, stress, lack of sleep etc. without the risk of further complications.  I have to learn to accept that this is the way it is and stop feeling sorry for myself.  I have not only diabetes but celiac as well.  I cannot eat a simple sandwich or eat whatever I want...not if I want to be well. I must take my nutrition extremely seriously and educate myself on how to feel well.  But....I have the insulin pump coming and this will give me a new lease on life! I know it!

So today all I can do is feel proud for how far I have come...and let go of the life I had.  My goal in the next year is to educate people around me and perhaps people who do now know me about what it is like to live with Type 1 diabetes.  It is a very serious chronic disease that the public need to know about.  They need to know that we deserve a cure...we need a cure. 

Today I mourn the old me.  I am still me, but different.  I have come a long way in a year and to be honest I am not sure how I got through it.  There is one person in particular who has been by my side the entire way and he knows who he is. I love you.

An anniversary that does not require champagne...but perhaps deserves a pat on the back.

One More Complication (that I know of)

I have been very hesitant in publishing this post.  Not only do I feel that a lot of my posts are quite depressing, it involves a part of my body that I have always been very self conscious about.  When asked if I would ever have plastic surgery the only thing that I would ever have done is to this part of me.  It is my TEETH!  Ever since my adult teeth came in I have not been overly fond of them.  Every dentist I have seen has always commented on how small my teeth are, like a child's.  The tooth to the right of my big tooth grew in as a peg so I have always had to have a cap over it.  The second tooth to my left big tooth is still a baby tooth and looks terrible.  Rarely will you see a picture of me smiling with my teeth showing.  Silly yes, but very real to me.

So with that background you may understand why the complications I have suffered with my teeth are slightly devastating to me.  In January 2011, seven months before diagnosis, I was outside shovelling the ton of snow that had fallen on my walk the night before.  I had to shovel myself out of the house to get to work.  Well in true Jocelyn fashion, I somehow managed to slip and catch the shovel with my two front teeth (really, I should not be allowed to operate any kind of tool, I am the worlds biggest klutz...well maybe my sister is).  As soon as I took a breath of cold air the pain hit.  I had managed to chop, not chip, both front teeth in half.  I got myself together and made a call to a dentist near work and they agreed to see me right away.  

The dentist fixed my two front teeth beautifully and did an examination of the rest of my mouth.  She was interested to note that some of my gums were receding and felt that it was quite unusual for someone my age. She booked me in to have my gums sealed and sent me on my way.  Just three appointments and my benefits were used up!  

Fast forward twelve months.  I went to see a new dentist here near where I live with a few complaints.  I had noticed that my teeth felt "soft" and that my gums continued to recede.  I also had some mild pain in my teeth.  I have to say that the dentist was wonderful.  He took one look in my mouth and had me sit up.  He knew that I had always attended the dentist regularly and had never had a cavity in my life.  He knew something was up and wanted to know what had been going on.  I explained my entire story and we went through all the meds I was on at the time.  He then proceeded to tell me that I had some serious damage to my teeth.  About eight cavities, serious gum receding, a rotten baby tooth and that the peg tooth under the cap was decaying.  I would have to have fillings, gum repair, two teeth pulled and two crowns put in.  I was shocked.  How could all of this had happened in only twelve months?  He explained that diabetes does take a toll on a persons teeth as fluctuating blood sugars and the use of man made insulin effects them.  However he said that it usually is a very slow process that can be managed with regular check-ups and work.  He felt that going undiagnosed had taken a serious toll on my teeth.  Also I was on a very high dosage of Neurontin for my nerves at that time and he said that Neurontin can actually rot the teeth. Great. In trying to fix one problem another one had been caused.

The dentist laid out my treatment plan to get my teeth back into shape...fifteen appointments were scheduled.  I attended my first appointment, was frozen to the eyeballs and had some work done on my top right gums and teeth.  During my second appointment he finished the work that he had started in the previous appointment and filled one of the eight cavities.  I went to check out and was stopped by the receptionist.  I owed $280!  I had never thought much about how much all of the work was going to cost and was stunned to see that I had already burned through my coverage.  I asked them if they could give me an estimate of how much it would be to get all of the work done.  They advised it would be anywhere from $8,000 to $12,000 of work.  They confirmed that Alberta Health won't cover my dental costs even though the damage was as a result of my disease.  I cancelled my remaining appointments and left in tears.

That day was a bad one.  I was mad, so damn mad.  I really felt at that moment the world was against me.  I had been through hell in a period of six months and felt like I had been punched in the stomach once again.

It won't be long until December comes and my coverage kicks in again.  I will return and see what is desperately needed to be done and then wait it out again.  My teeth bug me on a daily basis, but the pain is not too bad. I am worried about the two teeth that need to be removed and have crowns put on as they bug me the most, but unfortunately those are the most costly. 

Those who know me well know that I smile...a lot.  But I make a point now to never show my teeth.  It is a complication that I did not expect but now that I have done a lot of reading about it, it is quite common for people with Type 1 diabetes to suffer with teeth problems.  Is it fair?  Not at all.  There is not much I can do about it at this point so I try not to stress over it too much.

Well that is it folks.  Probably the most personal blog entry so far as the topic of my teeth is a sensitive one for me.  If any of you know a dentist that likes to do free work be sure to let me know! I can make a mean banana bread and peanut butter cookies!

Wordless Wednesday

Hee hee.

Totally Pumped for my Pump!

Cheesy title I know, but it is exactly how I feel right now.  I am officially going to be pumping insulin by the end of October!  

I knew as soon as I was diagnosed with Type 1 diabetes that I would eventually want to go onto pump therapy.  Not only will it mean not having to stab myself with needles four to six times per day, it means that I will have more freedom and flexibility when it comes to my eating schedule and exercise regime.  On injections it has been very frustrating for me to return to the level of activity that I want to.  I find that after running for about 10km my blood sugars tank.  I know that I can eat carbs to help stop this, but who wants to mow through carbs for a run less than an hour?  Also I have found that I have to eat on schedule otherwise my sugars either crash or fly sky high.  Being on a pump will mean I can eat when it works for me, accurately dose for the carbs I eat and also I will be able to get back to long distance running and hopefully (if I get a bike), triathlons.  I know that being on the insulin pump won't take away the lows and highs, I know it will be just as much work (if not more) than daily injections, but it is going to be so worth it!!

I debated for some time over which pump would suit me best.  It was between Medtronic and Animas.  After doing a lot of research and consulting with each pump company I have decided to go with Animas.  The remote bolus ability and the fact that it is waterproof are what made me decide to go with the One Touch Ping.  I love that the pump will be able to tell me if I have insulin on board already to avoid stacking insulin and that I can adjust the basal rate depending on my planned activity.  I really love the thought of not using needles all of the time!  Sometimes my stomach and legs look like connect the dots with all the little bruises.  I was very impressed that both companies offer payment plans with no interest.  My family generously gifted me the down payment and then I have 30 months of payments to make.  This has taken a lot of stress off my shoulders and given me the ability to go ahead with it all.

I have to admit that I am very nervous.  It is going to be a huge learning curve and it will be strange to have a device attached to me all of the time.  I have about a bazillion questions and am sure that I will drive my diabetic educators, Animas rep and friends that have experience with pumps nuts.  I will get the pump during the first week of October and then attend the Grey Nuns on October 25 for my pre-pump training.  They will then send me home with the pump and saline solution so I can practice all of the features.  I will then return on October 30 and start pumping real insulin.  Only two months and eight days of injections to go :) 

That Hungover Feeling

This morning when I woke up I felt like I had polished off a bottle of wine chased down by some shots, ugh.  The thing is I had not had a drop of alcohol and was suffering with only what I can describe as a diabetic hangover.

The night before I was on the phone with my Dad around 9:30pm.  That day I had ran 10km at lunch and then went to my weight/tabata class after work.  As usual I had bolused conservatively.  I had checked my blood sugar at 9:00pm and it had been a pleasant 6.1.  Perfect.  Or not!  My Dad was chatting away and all of a sudden I noticed my right hand was shaking, then I went very hot and it was like someone opened the taps.  Sweat started to pour off me.  My face, arms, stomach and legs were streaming with sweat.  I knew it was a bad one and did not bother to even check what my sugars were at.  I lunged forward, grabbed my glucose and choked four of them down.  He was still yacking on and did not notice what he was talking about until he asked me a question.  I had trouble registering what he was saying and when I tried to talk it was like I had peanut butter in my mouth.  My brain was having difficult communicating with my mouth and my body was very weak.  I tried to explain I was suffering with a bad low blood sugar and would have to go.  He was pretty concerned but I explained in a slurry voice that I was treating it but needed to lie down before I passed out.

After another two glucose tabs and some juice I was up to 5.8 half an hour later.  I felt like garbage and was completely exhausted, not to mention soaked from all the sweat.  I ate a large banana and got myself into bed to read.  I had trouble falling asleep as my mind worried about the bad low I had just experienced and my fear of being alone when this happens was strong.  Once I was asleep I don't think I moved (except once when my dog Basil fell off the bed, he must have been rolling around in his sleep).  When my alarm went off I seriously felt like I had been partying hard all night.  It took a lot of willpower to get up and ready for work.  I felt like serious crap all morning, but forced myself out for a 10km run at lunch and as predicted I feel great now.  Not sure what happened last night, but it scared me...and frustrates me.  I know that this is going to be an ongoing thing for the rest of my life and that really makes me mad and sad at the same time. 

The good thing is that this kind of hangover does not require more booze or a pile of grease to feel better.  Just time, good food and some exercise :)

The Diabetic Roller-Coaster

Yesterday was comparable to being on a roller-coaster in the dark, diabetes wise that is.    I went to bed the night before with a respectable 8.1 blood sugar.  I like to go to bed between 8.0 and 9.0 as it usually prevents a low in the night and almost always guarantees I wake up between 4.5 and 5.0.  Not yesterday!  

I woke up, checked my sugar and it was 8.8.  Not too bad but unusual for me.  Got to work, bolused for my blueberries with yoghurt as usual.  Checked two hours later and was at 14.6.  As I was running at lunch did a conservative bolus of 1.5 units.  Checked blood sugar an hour later before my run and was at 15.0.  WTF?  I knew I should probably not run, but as I have mentioned before I am super stubborn and I wanted to get this blood sugar down.  My head was hurting somewhat because of the high, but I strapped on my shoes and off I went (totally off topic but it was 34 degrees with the humidex, damn it was hot!!).  Tested after the run and finally it had dropped to 7.8.  I bolused, with a slight correction, for my lunch.  Tested two hours later and I was at 12.0.  Still higher than it should be.  I was heading to the gym after work for a short bike and an hour of weights so I did not want to correct.  Finished my workout and was 5.6 before supper, perfect!  Had a salad and apple for supper and bolused accordingly.  Tested about three hours later before bed and was at 14.9, explains the headache and thirst.  I literally threw my hands in the air and cursed a lot.  I decided to correct with 1.5 units and figured that should at least bring me down to 10. Well the fun continued from there.  I went to bed to read and all of a sudden the pages got blurry and I started to shake.  Tested and was at 2.6 - only an hour before I had been over 14!  Choked back some glucose and a banana and lay shaking and sweating until the low passed.  By this time I was completely exhausted from a day of unpredictable and unexplainable sugar patterns.  

Woke up this morning at a lovely 5.5 and things have been good so far.  Not sure what was different about yesterday!  I think it is just diabetes way of reminding you that it is there and will sometimes do whatever it wants.  Frustrating to say the least.

My New Endo - The Mostly Good, Some Bad and A Bit Of Ugly

As I had mentioned in a previous post, I made the decision to change to a new Endo and diabetic team.  I would say the main reason for this is my desire to go on an insulin pump.  My local specialist does not deal with pump therapy and so I made the decision to move to the Grey Nuns.  I really do want to go on a pump sooner rather than later and know that I will need the support of a good team to do so.  As talked about in my previous post, I met with the diabetic nurse and dietitian already and they were just awesome.  I was scheduled to see my new Endo on the Friday before leaving for my holiday and I was nervous!  Since diabetic management is very self controlled I was nervous about what he would have to say on the job I am doing so far.

From the minute I met him I was relaxed.  He insisted that I call him Greg off the bat and he had obviously read all of my medical notes prior to the appointment.  He started off by telling me I was a very luck lady to still be here.  He said that in all of his years of dealing with diabetics he had never seen someone with such a high A1C on diagnosis.  We talked a lot about what went on before I was diagnosed and all of the symptoms I had that continued to go undiagnosed.  He wanted to know what I had experienced between being diagnosed and the present date.  I told him all about the issues with my nerves and my eyes and he was very educated on the topic of insulin neuritis.  He said that it was extremely rare to suffer to such an extent and was happy to see me come out on the other side intact.  He delved a bit deeper into how my high blood sugars had been dealt with while I was in the hospital.  I told him that they had started me on insulin right away and had brought my sugars down quite quickly.  I explained how terrible it had made me feel and described the symptoms of extreme head pain, confusion, vision issues, swelling, nausea and inability to sleep for the first while.  

Here is where the ugly comes in.  Greg was flabbergasted that they had brought my sugars down at such a rapid rate.  He said that considering how high they were, they should have knocked me down very slowly over the course of quite a few weeks in order that my body could adjust.  He was quite frank with me and said that I was lucky that I had not suffered brain damage or heart damage as a result.  He said that it completely explained why I had suffered with insulin neuritis to such a degree and explained the cataracts in both eyes.  He sincerely apologized that I had to go through what I did.  I was somewhat teary by this point as the thought of what could have happened scares me to my core.  I know that I cannot think about the what ifs, but it is human nature to do so.  Even now when I think about it I am filled with dread.  I feel very lucky indeed to be where I am today.

Now for the little bit of bad.  Greg did the usual vibration test on my feet and found that I did have some sensory damage in both of my big toes.  He said that at this point it should not worsen as long as I continue with my good control and exercise habits.  He will continue to check them each year and I am to let him know if I see any change whatsoever.  I felt a bit saddened, but heck, considering he had told me moments prior that I could have been brain damaged, at this point it did not feel like a very big deal.  The only other bit of bad was the fact that my cholesterol is higher than it should be, which unfortunately often goes hand in hand with Type 1 diabetes.  Since my blood pressure and weight are good and in view of my active lifestyle, he decided that we would hold off on any medication at this point.  We will continue to monitor it.

There was mostly a lot of good.  Greg took a look through my blood sugar log and was very happy with what he saw.  He said that I obviously was taking this very serious and was determined to keep the best control I could.  He said that it is not uncommon for newly diagnosed Type 1's to barely test and to be in denial.  I said that was simply not an option for me, I wanted to be able to live as healthy of a life I could.  We went over my carb to insulin ratios and changed my breakfast ratio to a 1:10 as I often experience spikes after breakfast, which apparently is not uncommon.  We talked about how I manage my lows and highs and he was happy to listen to my frustrations about the entire thing.  He said that I will have these frustrations through life so it is good to talk about it.  He asked me about whether I planned to have children one day and I said that it was a possibility, that I had not ruled it out.  He talked to me about the fact that if I did every wish to conceive it would have to be planned as they need to monitor you quite closely.  I felt happy with that and said that I would keep him informed :)

We then talked extensively about insulin pump therapy.  He wanted to know my reasons for going on the pump and I explained that I felt it would give me more freedom and the ability to return to my long distance running and dreams of triathlons.  I told him about how I struggled with any run over an hour as I would go low and was having troubles knowing how to adjust.  We talked about the fact that once I have injected my basal insulin that is it, you cannot take it away and the option is to eat more carbs before and during exercise and to know how much to reduce my meal time insulin's by etc.  I said that the freedom and flexibility around meal times would be great and altogether I feel it would just make my management that much better.  He was happy with my reasons and he said that he felt I was a great candidate for a pump. He has no hesitation in writing the request for one.  

The only stumbling block in my way is funding.  The Alberta government does not provide funding for the pump and unfortunately my benefits through work do not either.  Luckily my pump supplies would be covered as they would be treated as a prescription, so I would get 80% coverage there.  When the PC government was elected in April, 2012 they made the promise that they would cover the cost of pumps for Albertans, however it is not known when this will happen.  It could be as early as next spring or it could be years down the road.  I have emailed my MLA but have not heard back.  To be honest I don't want to wait.  I desperately want one now.  I was happy to hear that the pump companies are very flexible and often offer payment plans.  I have emailed both Animas and Medtronic to see what they can offer and hope to hear back soon.  If possible I would like to be able to attend the pre-pump classes held in November and be on one by the end of November.  Fingers crossed!!

All in all I walked about from my appointment very happy with my decision to move to this new clinic.  The people make me feel confident in managing this disease.  I try not to think about how worse things could have been, and I mean they already were pretty bad!  I can only move forward from here.

Camping and Diabetes

I just got back yesterday from a wonderful two weeks off, a lot of which was spent camping.  Ryan and I spent three days in Slave Lake with the dogs enjoying the sunshine and a lot of time swimming in the lake.  The dogs thought it was the best time of their life and us humans had fun too.  After a few days at home and an appointment with my new Endo (post to follow), we headed off to British Columbia for nine days of camping.  Spent the first two nights just outside of Revelstoke and spent our time relaxing, staying up too late, mini-hikes and a great canoe trip on the Columbia River.  Our next stop was Vernon and we stayed at a Provincial Park on Lake Okanagan.  I just love this area, it is too beautiful for words.  The weather was hot!!  We spent our days hiking, swimming, suntanning, playing tennis, Ryan went golfing, cooking delicious campfire food, visiting Kelowna, having picnics and of course going to some wineries.  Every morning we were up at a good time and had lots to do.  On the way home we stopped in Radium for two nights and Ryan went golfing while I hit the spa for a massage and salt scrub.  Sleeping in a tent trailer for eight nights takes a toll on the body!

Preparing for a long camping trip can be quite time intensive.  You have to pack clothes for all kinds of weather, food and so on.  Then you add diabetic supplies into the mix.  Since I knew the weather was going to be hot, I made sure I kept my insulin in the cooler as much as possible to keep it from spoiling.  I brought along extra insulin pens and a whole stack of needles and strips, just in case.  I was armed with glucose and granola bars in case of lows and had my waterproof medical ID bracelet with me.  Although it took a bit of extra planning, it really was not a big deal and I managed to keep all my supplies safe.

I have to say that my blood sugars loved being on vacation.  My sugars were perfect the entire time.  I had one high of 14 when I had misjudged the carbs in a meal, but other than that they stayed happily in range.  I experienced a few mild lows, but nothing too serious at all.  I ate healthy so I am sure that helped, but I did indulge in some drinks and suffered no ill effect.  I put it down to being stress free and relatively active most of the time.  Now if only I could find out a way to be on vacation all the time!  We already have out next one booked, San Francisco in September :)

Heat and blood sugars

The last couple of days have been hot here in Alberta.  I mean hot!  Yesterday got up to 29 and today hit 32 (not sure what the humidex has been), tomorrow is going to be 33.  This may not sound super hot for a lot of people, but for us here in Edmonton that is hot.  I have had a cold and at first was sure that was the reason my blood sugars have been running higher than normal.  Not super high, but higher than they usually do.  I have been eating less due to not feeling well, however have found that I have had to adjust my insulin to carb ratio quite significantly.  Usually my ration is 1:10 for breakfast and then 1:15 for the rest of the day.  The last couple of days during this heat wave I have had to adjust it to 1:10 for every meal and even then have had to make some adjustments through the day (which I really do not enjoy as that just means more injections).  After doing some reading on the net, I have found that a lot of Type 1's find that their blood sugars run higher during spells of hot weather.  I take comfort in this as I hate to see high numbers.  As I have said before (and will be the topic of another post), the numbers on that meter really can make you feel great or extremely disappointed in yourself.  I am hesitant to bolus too much of a correction as this has been known to bite me in the ass in the middle of the night.  I will just continue with my adjusted carb ratio, keep cool and not get to down on the numbers.

I love my pharmacy

I have learnt that having a good pharmacy is an integral part of my diabetic care.  My pharmacy is a chain, Shoppers Drug Mart, however the pharmacists and pharmacy assistants have been invaluable to me.  About an hour after I had left my doctor office with the diagnosis of Type 1 diabetes, and before I got the call that I needed to go to emergency, I found myself standing in my pharmacy with a prescription for a years worth of diabetic supplies.  I was in a daze and still in shock.  From the moment they found out I had just been diagnosed up until now they have gone above and beyond to help me.  For the first few months I was in the pharmacy every couple of days.  My doctors were trying me on different medications for my feet and I was also trying to figure out how many supplies to order at once.  One day I would be getting pen needles only to remember that I needed to get more strips.  It did not take long before they all knew my name and each and every one of them has always taken the time to find out how I am doing and they have answered my bazillion questions.  They truly have made the transition to my new lifestyle as smooth as possible.

The last couple of days are a great example of why having a great pharmacy can help ease the stress of managing a chronic disease.  I called in on Thursday to order a supply of Lantus, Novo-rapid and test strips.   I requested more strips than usual as I am off on holidays for the next couple of weeks and want to make sure I have back up supplies while away from home and out of the province.  My heart sunk when they told me that my insurance company had been in touch with them and were contesting the amount of test strips I was using.  They felt that I was testing too much and that I should be limiting myself to 6 times a day.  Before I could reply the pharmacy assistant let me know that it was ridiculous that they felt 6 times per day was enough for a Type 1 to test and she had faxed my doctor that morning requesting that she confirm in writing that it was reasonable for me to be testing 12-14 times per day.  I was so grateful for how proactive they had been.  We went over my testing schedule which they felt was extremely reasonable and were happy to hear that my control was good. When I went to collect my prescriptions this afternoon they confirmed that my doctor had responded and confirmed that I did need to test as much as I was.  Therefore insurance will cover.  I was over the moon as I do not want to cut back on testing, however at $98 for 100 strips I am not sure how long I could have covered this!  I thanked my pharmacist and assistant and they said that they were just happy to help.

So that is why folks having a good pharmacy team is awesome!!!

*If you are interested, a regular day of testing for me goes something like this.  Test first thing in the morning before I get out of bed.  Test before breakfast to dose my insulin and then again two hours after breakfast.  Test before lunch, two hours after and then before supper and two hours after that.  I test before bed as well to ensure that my sugars are good to make it through the night.  As I exercise every day at quite an intense level, I also test before exercise to ensure I am good to go, during the activity to see if I need any carbs and then right after to see how it has affected me.  That takes us to 11 times per day.  I usually wake up once in the night to pee and I often check then as well, which my doctor told me is a good idea.  This is all without taking into account whether I have suffered a low or high blood sugar which also requires testing.  I don't feel I test too much, just a reasonable amount to keep myself safe, active and in control.

Middle of the night lows

Last night I woke up at 3:00am dripping in sweat and my heart was pounding.  I knew right away that I was low and reached for my meter to check.  After fumbling around with my shaky hands I managed to test and was at 2.4 (why do we do this?  Even though I know I am low I still have to check...).  I wolfed down 5 Dex tabs and after I had stopped shaking and was able to get my thoughts together I padded down to the kitchen for a yoghurt to get me through the rest of the night.  I woke up about four hours later and was at 5.2.  Even though my BS was good, I felt like I had been run over by a truck!  Head pounding and slightly nauseous.  As the day has gone on I have felt somewhat better, I think my lunchtime 10km run helped, but I definitely feel off.  First time a low in the night has affected me so much the day after.  As I have been exercising a lot, I have lowered by basal and always make sure I have a good BS before bed, however you just can never guarantee what is going to happen!  I am thankful that my body wakes me up and I have what I need within reaching distance.  I am glad that this does not occur often as man it really makes you feel like a pile of steaming crap!

Have a good long weekend everyone!  I have been working on some posts and look forward to posting more :)

Wordless Wednesday

New "Diabetic Team"

I was a bit nervous going into yesterdays appointment.  After I was diagnosed I was assigned to the endocrinologist that had taken over my care in the last two days I was in the hospital.  He is a nice enough man, but after a couple of visits with him I knew we were not going to be a good fit.  When I asked him about adjusting my insulin for long distance running and other intense exercise he told me that I would be best giving those activities up now that I had diabetes.  I told him that I was not prepared to do that and he basically told me that when someone gets diabetes they often have to give up things to adjust.  Good thing I took this advice with a grain of salt!  There is no way I was about to change my lifestyle and stop pursuing my passions in life.  There were other things he was unable to help me with which I feel are important.  I asked him about how to adjust my lantus for "that time of the month" as I was experiencing extreme highs about a week before it came.  He told me that I would just have to play around to see what works.  For a newly diagnosed diabetic that made no sense to me at all! I was scared to start playing around with my insulin as I really had no idea where to start.  Another major deciding factor for me to move was the fact that he does not support pump therapy and felt that I would do fine on MDI forever.  I know that I want to go on a pump as it will suit my lifestyle better.  The dietitian I had access to was not very helpful either and was unable to help me in figuring out my carb ratio and correction factor. I went to my family doctor and was referred to the Grey Nuns Diabetic clinic.

From the moment I stepped into the clinic I got a great feeling.  The staff were very friendly and in fact most of them are diabetic themselves.  I spent two hours with the nurse and she was amazing.  She took my meter right away and downloaded the previous month of BS readings (other place did not do this).  We went over my numbers and she brought my attention to some of the trends.  In particular that I was going low in the middle of the night regularly.  Once she had background around my exercise regime she advised me right away to lower my basal from 24 units to 22 units and to track that for a week.  If I continued to go low I was to call her to decide whether to drop another unit at a time until we found a balance.  She also noticed the highs I experienced the week before my period and told me for the next month to raise my lantus by a couple of units and track how that effected me.  If need be we could raise it more for the five days or so that was needed.  She gave me her cell and told me I could call her with any questions if that was not working so we could work it out together.  She was very interested in hearing about my running and goals to get back to the marathon distance and in fact she encouraged it.  We did talk a bit about the pump and the advantages I would find.  She arranged for me to attend their next pump intro class to learn more and is going to find out the different payment plans that are offered here in Alberta should the PC government not cover pumps as they promised. 

I was then passed over to the dietitian who was a goldmine of good information.  She had done a lot of study around diabetics with celiac as well and had tons of stuff for me to look through.  We talked about nutrition for before, during and after running and she gave me some things to try once I get back to running longer distances.  In fact I think I am going to take myself out for at least 16km on the weekend and try some stuff out.  She looked over my food diary and numbers and went over my carb ratio and what my correction factor is.  She wants me to track another three days using these formula's and fax it over to her for review and she said she will call me to go over it again.  I am scheduled to see my new Endo in three weeks as well (he was on holiday).

When I left the clinic over three hours later I had a big smile on my face.  I felt like these people "got it" and was even a bit overwhelmed with the support they offer.  I am looking forward to learning more from them and hopefully in the not so distant future getting started on an insulin pump under their care.  What a difference!!  I feel very positive :)

Oh So High

Last week I experienced my first time being real people sick with diabetes.  Well, doesn't that just throw a whole new spin on things!  It started on the Wednesday.  My sugars were high in the morning and I could not figure it out.  By the afternoon I felt pretty crappy.  Starting to ache all over and occasionally getting the chills.  That night I volunteered for a corporate challenge event and by the time I got home I really felt like garbage.  I had not eaten much all day however my sugars were sky high and I was feeling the effects.  

Being the stubborn goat that I am I got up Thursday morning and went to work.  By noon I had no choice but to go home sick and surrender.  Despite bolusing small amounts of insulin throughout the day, my sugars remained high and I felt like utter garbage.  It was hard by this time to distinguish what was coming from being sick and what was from the high sugars.  My head was pounding, I was sweaty, shaky, weak, nauseous, ached all over and felt exhausted.  I had a fever and did my best to keep hydrated.  I was also extremely frustrated with the high sugars, always feel such disappointment in myself.  I slept most of the day away, woke up for a bit, continued to fight the high sugars and headed back to bed.  Although I did sleep I was very restless and having a lot of dreams, some bordering on nightmares.  Sometime early morning I woke up and the room was spinning. I knew I was going to be sick.  Spent the next hour or so being sick and feeling worse by the minute.  Needless to say when my alarm went off for work I called in sick and stayed in bed.  My sugars that morning were 19 and climbing.  Took more insulin and laid around all day trying to fight the flu and the blood sugars.  I tested for ketones and it read that I had moderate keytones.  Shit!  I called the diabetic nurse and she told me to keep monitoring the keytones and if they went to moderate/high to get myself to the hospital.  On her advice I doubled my fluid intake and hoped things would improve.

Finally by Friday evening I started to feel much better and my sugars started to drop into the low teens.  I was able to eat real food and the aches and fever went away.  By Saturday morning I felt pretty much back to my old self and no longer had any ketones.  My sugars stayed on the higher side of the next couple of days, but were much more manageable.  I am very glad that I was not sick for long as it was becoming difficult to manage.  So frustrating to see all those high readings despite the insulin injected.  Yet another thing that diabetes makes so much harder!!

Diabetes Etiquette

I found this link which is an etiquette card for people who don't have diabetes however have someone in their life who does.  I think it is fantastic and wanted to share.  Now I wonder if the people in my life, particularly ones that I work with that don't know me that well, would be offended if I left this on their desks :)

Wordless Wednesday

Changes

I was thinking over the weekend of all the changes I have noticed since being diagnosed.  I did not realize how sick I was, or looked, before I was diagnosed.  Looking back at some photos from my summer holiday last year I was taken aback by how ill I looked.  I was so thin and washed out looking.  My arms and legs, which used to be muscular, were so thin, like twigs.  All of my clothes looked like they were hanging off of me.  My hair was dull and my eyes did not shine.  Not only did I feel exhausted, I looked it as well!  I remember early last year being in the bath and looking at my toes and noticing I had no hair on them anymore.  At the time I thought this was just lucky!  In the nine months since I was diagnosed I have drastically changed.  I have regained the weight I lost (with some extra due to the neurontin - working on that), I have colour in my face and my hair is shiny.  My eyes look healthy again and I have back the curves I lost.  I am slowly toning and regaining my muscles due to exercising again and yes, the hair on my toes came back!

Not only have my looks changed, but the way I feel inside has changed.  I have a ton of energy again and no longer have a need to sleep 12 hours a day.  When I exercise I do it because I want to and enjoy it, not because I feel I should.  I feel motivated at work again and in other aspects of my life.  Doing chores around the house is no longer the huge pain it was, I just get things done.  I feel happy and upbeat!  So many people have commented on how great it is to have the old Jocelyn back.  Once again I feel the fire and desire to love life once again :)

Insulin Neuritis: My Experience

I thought that it would be a good idea to share my experience with Insulin Neuritis as there really is not a lot of information out there with respect to this.  When I began to suffer with this rare condition I searched endlessly for stories of people experiencing the same thing I was, mostly for comfort and reassurance.  I really was surprised at the lack of info out there.  So here is my story.

I was diagnosed Type 1 diabetic on September 7, 2011.  On diagnosis my sugars were hovering around the 38 mark and my A1C was 16% (off the charts according to my Endo).  Looking back I think that I went undiagnosed for at least 18 months, perhaps longer.  Going for so long undiagnosed resulted in the issues I have had with my eyes and teeth (that is another story altogether).  Unfortunately I also have suffered with this rare condition Insulin Neuritis.  

About two weeks after I was diagnosed I began to notice what I can only describe as "buzzing" in my feet. It was not painful but very annoying.  By the time I attended my diabetic education classes in October, 2011 the "buzzing" had progressed to some burning and pins and needles.  I spoke with the nurse about it after class and she said that this can be quite normal and that it should go away within a couple of weeks.  I left feeling assured that it was temporary, I was not too concerned.  Over the next four weeks things got worse, fast!  The burning was soon accompanied by stabbing pains through both feet and up my legs. It felt like someone was shocking me.  I could be sitting and would repeatedly be plagued with these pains.  By the end of October, 2011 I was in a living hell, literally.  I was experiencing the most unbelievable pain 24 hours a day.  Nothing would ease it. By then I had been to my doctor half a dozen times and she had started me on Neurontin (Gabapentin) which was used for nerve pain as well as a cocktail of T3's and Percocet.  She had me taking 2 Percocet every 4 hours and it did nothing to ease the pain.  I was getting on average 4 hours of broken sleep a night and was extremely exhausted and very emotional.  I tried for a while to do some work from home but by mid-November had given in and went on short term disability.  It became difficult to walk and the pain got even worse if travelling in a car, standing for more than a few seconds or wearing socks and shoes.  In fact it was painful for anything to touch my feet, whether it be my sheets or even a breeze of air.  My doctor had referred me to a neurologist right away and I got in to see him at the end of November, 2012.  By this time I was a total wreck.  I was not sleeping and was in agony all of the time.  The pain was the worst in my feet however had travelled up my legs, into my arms and hands and was even in my ribs and breasts. I had noticed some time ago that the hair on my feet had stopped growing and now that my sugars were regulated the hair began to grow back.  I swear that I felt every single one of those things grow.  My diabetic nurse told me about an ointment for nerve pain called Neuralgia and I went out and bought it right away. It was $35 for a small bottle but I was willing to try anything.

The neurologist really was amazing.  He was very thorough and very reassuring.  He confirmed that I had no permanent nerve damage however it was likely I would suffer for the rest of my life with flare-ups of neuropathy.  He advised that the current state I was in was due to having my sugars dropped from a very high level to a normal level in a very short period of time.  He explained that since I had gone undiagnosed for what was a very long time, my blood had become thick with sugar and my nerves had gone into "hibernation".  He said that once my blood sugars had been normalized, the nerves in my body had awoken and were in the process of regenerating themselves.  He said that the process of regeneration is a long process and extremely painful.  If the nerves had suffered damage they would die off quickly and I would be numb, not in pain.  He assured me that things would gradually get better over time and that hopefully within 12 months I should not experience many symptoms at all.  He felt that the Neurontin I was on would help and he upped my dosage significantly. He also gave me a prescription for Amitriptyline which he said would help with the burning pain and also a prescription for sleeping pills.  I left his office feeling somewhat more optimistic.

My boyfriend Ryan and I had registered the previous May to go to Vegas with me running the full marathon and him the half.  I had to cancel the marathon and was so upset. I felt like my life was crumbling around me.  The sleeping pills helped somewhat and I began to get around 6 hours of sleep at night. The medication did start to kick in and I was getting spells of relief.  I found that if I kept my feet ice cold it helped ease the pain.  I did not really leave my house so I kept frozen packs to use on my feet.  At night I would get up six to eight times a night to soak them in cold water or apply the ice.  I spent my days on the couch with my feet up.  I can honestly say that it was the lowest point in my life.  I was still reeling from being diagnosed with diabetes, had two eye surgeries to remove cataracts and was now in the most pain I could imagine.  Ryan and I decided that although I could not run in Vegas we would still go, I needed to get out of the house.  The plane ride was difficult as my feet hurt a lot, but I am glad that we went.  I wore sandals everywhere and spent a lot of time with my feet up.  For the first time in a long time I started to laugh again!  I did have some very frustrating moments, particularly at night, and cried many, many a tear alone in the bathroom. 

Slowly things began improving and I no longer had to apply the ointment every day.  By January, 2012 I was able to go for some walks and had a couple of pain free hours a day.  I had to continue icing my feet regularly and could not wear closed toe shoes.  I returned to work part-time on February 6, 2012 and had my trusty ice packs at work to get me through.  Work was very understanding and accommodating and they even got me a fancy foot stool for under my desks.  As time went on I noticed that I did not have to ice my feet as much and was sleeping better and better. At the end of February, 2012 I returned to full-time work and started to try and run again.  I cried the first time I did a 5km run with relatively no pain.  I began to see a Naturopathic Doctor and they put me on a regimen of different vitamins to help my nerves heal.  I also had 6 acupuncture treatments and can honestly say that they helped.

It is now almost June, 2012 and I am happy to say that things are so much better now.  I have been able to wean off the Neurontin and am down to 600mgs a day from 2,800mg.  I really have not enjoyed being on the Neurontin as it resulted in unwanted weight gain and terrible acne. I still take the Amitriptyline as it keeps the burning at bay.  I do suffer with some burning each day but can deal with it.  On the bad days I keep them as cold as I can. I still wear sandals everywhere I go to keep my feet cool.  I plan on sticking with my vitamin regimen and can honestly say that exercise helps.  The doctors cannot guarantee that I will ever go back to how I was, but compared to where I was not long ago I am a happy camper!  I cannot help but wonder what would have happened if they would have brought my sugars down slowly instead of rapidly.  Would I have suffered with this debilitating condition?  I get angry but have to remind myself that what is done is done, there is nothing I can do to change it.  I feel like I went from being the lowest I have ever been to almost my old self.  And for that I am thankful!!