Monday, April 8, 2013

Morning hypos

There is an important lesson to be learned by some of the diabetics in their first years and I seem to be very slow on accepting this one: low blood sugar is still bad blood sugar.
When you're first diagnosed (usually with pretty impressive blood sugars) you learn to be afraid of high blood sugar pretty fast. It's very easy, actually - your mind has already associated the high numbers with the terrible symptoms that you've had for the last few months - blurry vision, stomach pain, irregular heart beat, difficulty in breathing etc. Those are only some of my worst.
But low blood sugars, on the other hand, seem to be something distant and a little utopic - you have type 1 diabetes, surely it's the high blood sugar that's gonna bug you, right?
I remember how, in the first two days after diagnosis, I was listening to my doctor more intently than Jesus was listened to by his followers (I was in the hospital, there was nothing more interesting to do). She told me that I'm likely to experience hypoglycemia, aside from the usual hypers, but that it will be rare and hopefully uneventful (insert pause for laugh here).
She told me that I'll know when it will hit me and that I'll never forget the first one.
Well, two weeks later, I was dealing with the usual reaction to insulin (blurry vision, swollen legs, dread at the fact that I'm gonna have to inject it for the rest of my life) and I experienced a welcomed and sudden clarity of vision. For the first time after over a week, I could see perfectly clear and I thought that the side effects had finally passed (I was calling my doctor daily, eager to know when I'll get my vision back).
I decided to test, anyway, to see if there's a correlation with the number, and it was 40. And I was actually excited that I was having a low. Finally, I know what that is! I can put it behind me now!
The lows didn't put me behind, though. They kept visiting more or less regularly, we are tight-knit friends.
And lately, as it happens with old friendships, I discover uglier and uglier parts of them.
In the morning I usually wait for 30 minutes between injecting and eating and that helps me not have a peak. Unfortunately, sometimes I eat and I get low right after and there's nothing I can do - I already have carbs in my system, I have to wait for them to reach the blood because eating more food would only get me higher.
Like one of these mornings, when I had a low so debilitating that my vision kept getting black but my brain didn't even register the slow process of going blind. It was only after the sugar hit the system that I started to see better and I realized that I was actually not seeing before that. I was blind for a few moments but only after I regained my vision did I realize that I got blind in the first place.
I didn't even test because I didn't know that I was getting low. I only know it was pretty bad because 2 hours after, another old friend greeted me from my meter - a 270 rebound high.

Friday, March 15, 2013

I'm in an open relationship with Carbs and it's complicated.

Me: Look, we need to talk. You've been acting really weird lately. And by lately I mean all of the last year.

Carbs: What? Are you kidding me? You're the one who's acting weird. It's been over a year since I've seen some of that endogenous insulin I knew and loved. What is it with all this artificial crap you've been throwing at me?

Me: People change! You vowed to be with me for better and for worse! Also, insulin production wasn't gonna be forever. You knew that.

Carbs: I definitely didn't know that! I didn't sign up for this.

Me: I thought you liked me for my intelligence.

Carbs: Well. I only ever liked you for your viable pancreas. I would've said anything to be able to unite with those dashing beta-cells.

Me: Fine! Then maybe we should see other people. I definitely wanna see less of you. Like, 100 grams less of you.

Carbs: Well, yeah, less is more. Maybe you should look into losing some hundreds of grams yourself.

Me: YOU'RE THE ONE WHO'S MAKING ME FAT!

Carbs: Sure, blame it on me. It's your artificial crap that's stuffing me into your cells like crazy.

Me: This has nothing to do with Novolog. Stop picking on him.

Carbs: Fine!

Me: Fine then. Off you go.

Carbs: You're gonne be so sorry. I am very hard to replace.

Me: Yeah, fast energy, cheap meals, yadda-yadda-yadda. I know the drill. I'll survive.

Monday, January 28, 2013

Getting better

In the last week, my numbers have been slowly decreasing, along with the total number of insulin units per day. For the last weeks, I've had insane quantities of insulin injected (about 1 unit per kg and I'm no teenager) and still my numbers were high, high, high.
Well, hormonal changes will do that to you and I'm very happy to be back to normal again.
I didn't see this problem very debated in the DOC, so I'll write a little about how taking the pill affected my blood sugar.
In the first week, the changes in blood sugar weren't very dramatic, but I had to slowly make bigger boluses for the same amounts of food. That led to a weight increase, even if I don't think that I ate more than usual. I know you're supposed to have a greater appetite on pills but this didn't happen to me, I actually couldn't eat very much at the beginning.
I guess that if I would've closely monitored the numbers, I could have seen some steady pattern and I could have, in time, counteracted the effect of the hormones contained in the pill on the blood sugar.  But, as I've said earlier, the total amount of insulin was scary high, I ended up bolusing 1ui for every 5 carbs in the morning. In the evening, about 2h after taking the pill, I would always get a 200+ number, very insulin resistant too.
I was curious to have a HbA1c, to see just how much my average changed but I haven't gotten around to that. Hopefully, I'll have one this week, if not, my own averages show a definite rise.
It has gotten rather scary, at times, to bolus so much insulin but still see the food in front of me as a danger. I can see how, over the years, it's easy to develop an unhealthy relationship with food, as a diabetic.
So I had to give up taking the pill, even though I hate the fact that this would probably render my skin back to the awful state that it had before.
The effects on the blood sugar or the total insulin amount weren't the only ones concerning me. I've taken pills before having diabetes, and they definitely didn't hit as hard as they did this time. I know we're supposed to have weaker immunity with diabetes, but now I've experienced it first hand. The headaches, the stomach sickness, the weakness in the body, the increased appetite (that did, eventually, happen) are harder to bear with diabetes. You get used to this, in time, but it is something to take into consideration nonetheless.
Think about all the side effects before taking a decision, and think about them even after you've made your decision. It's definitely harder to adapt to birth control medication with diabetes, and it also isn't very appreciated by the endocrinologists (my doctor, for example, strongly disagrees with the pill).
This was my experience with the pills, anyway, and in the end I've decided to quit them. Adapting to the side effects has proven harder than expected, and plainly not worth it, for me. I would love to find more testimonies on the subject, it's very important to see more experiences before making this decision.

Tuesday, January 8, 2013

I hereby reclaim my independence



One of the things that bothered me after the diagnosis was my eagerness to please the endo with good numbers, to be the best person with diabetes etc. This has been a recurrent problem of mine, pleasing people even at my own expense. That lead me to believe that a good A1c (which I achieved, in the beginning, by waking up with a number of 60ish and being fine with that because it gave me a better mean and, hence, a better A1c, being that I was 60ish all night long). I felt happy mentally because I got this "good grade". I felt awful, physically because, well, I was basically low all night long and I couldn't sleep properly.
I had nightmares all the time, and if my desire to be a horror-story writer had been active at the time, boy I would've had the right material!
Now I'm dealing with reminiscences of this people-pleaser persona due to the fact that I have a meeting with my doctor tomorrow and my numbers have been awful lately (she would only look at this disastruous recent numbers).
For days I've tried to come up with arguments in my mind, arguing that I might have been a little sick, I was too busy to pay attention, food has declared war to me etc.
Which got me thinking that, again, I'm not worrying about these bad numbers. I'm just worried of how they make me look, like a bad student that didn't do his homework.
I'm not worried about the complications that I might be facing with these high and all over the place numbers, I'm just worried of being labeled as a bad diabetic.
And it hurts to be robbed of independence, to feel the need of explaining your decisions every three months. Sometimes we just get tired!
Sometimes food does declare war on us (Same food at dinner two nights in a row, same carbs, insulin, awaiting time, but a 2h test of 113 in the first night and 237 in the second; and I was eating beans. I didn't even know that beans could do that to me!).
Sometimes we just forget that the only judges of our diabetes behavior can only be ourselves.
So tomorrow I'm gonna march in that office without any excuses or explanations prepared. What I'm gonna do, instead, is work towards better numbers that would make me feel proud or guilty, and not necessarily the endocrinologist.
Note: I had to draw my own picture because Google couldn't find another image with a bad PWD. There's only me out there! And yes, stripes are back in.

Thursday, January 3, 2013

Regrouping for the new year

I don't necessarily believe in the cosmic importance of the New Year's Eve anymore - it's just a date set by humanity for administrative purposes. But I can't help my urge to set resolutions, treat this new year like a new chance, new possibilities to be better, do better etc.
So I found myself thinking about what I want for myself for this new year (only for myself, I'm selfish that way; I understand that you're also supposed to wish things for your family and for the Universe; I just believe in self-control, how can I wish to control my family, much less the Universe? Ofcourse, I wish them only the best, but that's irrelevant; they have to want the wish in order for it to happen; moving on).
Diabetes takes up a lot from my resolutions. A lot. Like, 90 percent.
But it's also what makes most of my life nowadays, being merely a baby with diabetes (1 year on December 28th; present? Gary Scheiner's Think like a pancreas).
Just yesterday I was thinking that I would want to trust my abilities to control my diabetes better, to really trust my insulin to carb ratios and I was thinking that I could drop the 2 hours post meal tests, since I pay for these tests myself.
In the morning, my 2h post-breakfast is stellar, between 90 and 130. But that's just because it's slowly creeping to 140-150 before lunch. So I was thinking that I could drop that test, since it never tells me something new, and save some money. This morning my 2h test was 57.
It really is an ironic disease.
Going back to my resolutions, I still need to think about them, to organise them in neatly little bullets.
Obviously, they'll be the normal ones for people with diabetes: make better food choices, tighter control, more activity, yadda-yadda-yadda.
But they are already forcing me to have better numbers.