Surviving a Holiday – T1D Style

Thus begins the season of extra stress, extra meals, and wondering how I managed to plunge through 150 units of insulin in 2 days flat.

It’s the HOLIDAYS!

And if you are celebrating Hannukhah, you get double the celebration today and tomorrow.

With all of the home-made goodness, piles of appetizers, and a litany of desserts, carb counting becomes damn near impossible a challenge. And it’s not just the variety of food that’s available with my family – it’s the amount. Seriously – Thanksgiving is an ordeal. We invite 30 people, but we cook for 50 and for whatever reason, everyone feels inclined to also bring a dessert. It really doesn’t make sense. But – I press on anyway. Usually avoiding my mom’s latest Pinterest find.

So what to do? Well, let’s start with the basics. This really cool infographic got tossed around on Twitter by Glucolift (and was created by Tandem Diabetes Care.) Give it a whirl.

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Not a bad place to start. But it’s missing the appetizers, wine, beer, cupcake turkeys, y’know… what really messes with your carb counts and makes you wonder why you suddenly have 15 active units in your system by the time dinner rolls around.

Here’s my plan – For appetizers, I try to stick to the veggie platter and dip. I’m trying this recipe instead of buying regular ol’ Ranch. Since it has avocados, I’m hoping it’ll fill me up faster so I don’t sit in front of the appetizer table and fill up before dinner actually starts. I just have to watch the carrot intake and I’m good.

For dinner? I’m actually not a huge fan of Turkey by itself. On a sandwich with cheese? Fine. Alone? Nope. But you kind of have to eat it on Thanksgiving. Then I load up the plate with salad, because salad expands and takes up a ton of room on a plate, thus leaving zero room for not so D-friendly items. (Like cheesy casseroles, mashed potatoes and whatnot.) I also don’t like Stuffing, gravy, and certain vegetables. (And definitely not the canned cranberry sauce.) See? Being a picky eater has its benefits! I just avoided a crap ton of carbs right there!

Dessert time! I’m usually too full to stick try and stuff more food down my throat. But if I have room, a sampler plate is generally the way to go. Or I share with my husband. Small tastes of everything are a lot easier to manage than trying to eat all the pie, cupcakes, cookies, candy… yes it’s ALL there!

Or I’m nursing a glass of wine for dessert. Either or. (Alcohol intake and your D may vary.)

So – there you go. A mini survival kit for your holiday experience. Have a wonderful Thanksgiving and thank YOU for following along!

Let the Sky Fall

It's stuck in my head, so it's the title of the blog.

It’s stuck in my head, so it’s the title of the blog.

Blah. So busy. Haven’t even had time to read up on my CGM and I could really use its wisdom right now. Particularly at dinner; my current sticking point.

It is the same deal. I lower my ratio to 1:6 and I’m 300+ 3 hours later. I bump up my ratio to 1:5 and I flatline two hours later. I can’t remember if I’ve tried a 1:5.5 yet, but I was going to just for funsies tomorrow since I wasn’t heading out to dance until later. (Silly knee injury keeping me out of technique class.)

All in all, maybe I haven’t really given the lower ratio a fighting chance. The last couple times I’ve tried the 1:6, I’ve experimented with desserts, sushi, and other fine dining, thus resulting in the ridiculous spikes at 8 pm. Last Friday, I tried it again, only to indulge in vegetarian pizza and have my infusion set canula bend to a 45 degree angle some time during the evening. (Double whammy.) So I really can’t count those as my control tests… well, because they aren’t the norm.

But I really hate those 300s and the feeling of hopelessness when you see everyone chowing down and dancing up a storm and I’m left feeling like ass. (And really thirsty.) Do you keep correcting? Do you wait it out? Because what if those corrections all come crashing down on you at once. Kind of like it did tonight.

No amount of Girl Scout cookies could make my blood sugars get back to normal this evening, so I started my dance lesson as any PWD experiencing hypoglycemia would: completely incomprehensible and unable to turn. (Wait, isn’t that all the time? <shhh!>)

This odd turn of events turned into a fantastic opportunity for my instructor to clean up some choreography for our routine because it allowed me to sit there and shake quietly back into Normalland, mostly catching everything that was being explained. (Kerry and Co. refer to something similar – the D’Ambien experience: One of those middle of the night lows where you can’t remember what you ate or drank, or how much, as well as any conversations you had. Except I’m not asleep during my lessons. But same feeling. Yeah?)

Either my instructor was feeling particularly empathetic or saw the space cadet look on my face and queried: “So from what I’ve been observing, reading, and so forth, the real problem is patience? You give all this insulin to correct only to have it come falling down on you later… It’s like a college student experiencing drinking for the first time and wonders why he isn’t drunk immediately after taking the first shot, so he has another and another…”

Right??? My CDE will be very excited to hear that SOMEONE is listening. It just doesn’t happen to be me.

So what do I do now? Do I give the 1:6 another try, but with a less risky meal? Do I experiment with different ratios for different types of foods because sushi might require a 1:4, but a steak and veggie dinner might only need a 1:6? Because that’s totally convenient…

But I have T1D… who said this was convenient? <laughs>

When it rains, it pours.

Stopping Bad Habits

I failed my basal test early last night. Why? Because about 2.5 hours after I ate, I dropped into the 60s, which leads me to believe that my dinner bolus ratio is still too high.

Or is it?

I have a horrible habit of overriding my pump. I feel that if my blood sugar isn’t under 200 2-3 hours after a meal, I must have seriously miscalculated my previous meal’s insulin intake. So I rage bolus (feverishly administering mathematically-inaccurate amounts of insulin just to make blood sugar readings do something) until I get down to a normal level. Never mind that there may be 2, or 3, or 5 units still working through my system that haven’t done anything yet.Don’t care. I just don’t want to be 289 anymore please, thanks.

Herein lies the problem. Rage bolusing blindly often just stacks insulin against you, resulting in an epic tumble down to no-man’s land and leaves you crawling to your fridge for another glass of orange juice. My doctors and CDE have told me, repeatedly, to stop this practice because it just sets me up for all the lows that I’m diligently trying to avoid. However, when you test every hour for four hours straight with an average of 170, you start to think something isn’t doing it’s job. (Yes – pump air bubbles – I’m blaming you… because who else can I blame?) I have been “conservatively” over correcting in places, rather than just administering an entire correction at will. A unit here… a unit there. If it’s still not enough, another a half hour later.

By the time dinner rolls around, I’m hanging out between 120-140 mg/dl with about 4 units of insulin on board. What possibly could go wrong?????

Oh hey… maybe I should try NOT micromanaging my sugars for an afternoon to see what my dinner blood sugar will actually be around 5:00 pm. Hmm.

Today was an exception. I was treated to a luncheon/learn session by a local PR association, which was catered by one of my favorite restaurants. (And was held in a nightclub I used to frequent when I was 24… weird…) I had a salad of mixed greens and <*goat cheese!!!*>, a half turkey sandwich… and an epically huge brownie. I started the meal at 112 and felt myself falling. Lunch popped me up to nearly 300 and kept me there. all. afternoon. I still haven’t really come down to stay down yet. (But that may have been the veggie pizza I had for dinner…)

BUT – before I headed to dance class at 7:15, just barely an hour after I ate that pizza, I was 116. Maybe all of that insulin I was correcting with finally kicked in. (Only to have the fat in the pizza negate all my progress.)

I should take my own advice. Maybe I’ll have an accurate test here soon. But that involves not having a social life or a need for sleep for three evenings.

Measured Lunch

I saw a note on Pinterest recently about bento box style lunches you can bring to work.

A recent shopping trip yielded two options for bento box compartmentalization. Especially handy since I’m trying really hard to break the habit of packaged or frozen lunches. These also make it really easy to measure out my food and take it with. So that is exactly one 1/4 cup of trail mix there. Much easier than bringing the whole bag with you and eating it al day.

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