“You’re a Challenge…”

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My endocrinologist highly discouraged trying to get pregnant until at least another A1C round. Then reminded me that the only reason my A1C corrected itself like that was because I ran hypoglycemic for 2 months straight. (With some epic rebounds.)

Since this isn’t a progressive way to maintain control, I met with my CDE again for another pump download. During the analysis of the last two weeks of records (all I really had because it’s a new pump), she sighed after starring at my 6:00 pm lows and said “well, you’re a challenge…”

Well, there you have it. Another CDE is stumped by my glucose control. I added that this is why so many other doctors gave up and just said “Meh, I guess you are okay.” Generally, that had to do with my sugars running higher, but same difference.

That said, no, there isn’t really a rhyme or reason why there are lows plaguing my evenings. Basals have been adjusted, as have carb ratios. I run low regardless of activity or lack thereof. A fatty lunch or a plate of vegetables. The a new problem cropped up – overnight lows.

So I’m stuck with another round of basal tests; this time overnight. And I need to monitor my evenings after another round of adjustments.

I’m really hoping this is all worth it.

Wordless Wednesday: Waste Not?

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The final piece of my deductible spending arrived today. Yup, that’s 1000 test strips right there. Since I seem to be going through a vial every 2 days, this may last me three months. Maybe. But honestly, these would have fit in a small Amazon box.

This is what it came in:

IMG_0578Cat not included.

ONE box was in one of those plastic bags. ONE! The others were grouped in threes. I thought maybe they were pre packaged and someone is just grabbing stuff on a shelf. Nope. Why would you package ONE box in that giant plastic bag?

Stupid.

Cookies for Breakfast

Yes, you read that right. I made cookies on Sunday that are supposed to be my breakfast for the remainder of the week. However, the carb count is still to be determined, so it’s throwing my breakfast sugars under the bus.

Mmm... nutrition

Mmm… nutrition

Here is the recipe.

As you can see, no refined sugar nor flour. It’s basically an oatmeal cookie made with fruit and peanut butter. The protein count is supposedly off the chart. So I made them thinking this would be a great alternative to my missing English muffins.

The problem is the whole “homemade” aspect of it. Sure, I like knowing that what I’m putting into my system is healthy, organic, fresh, and not processed. With the exception of the extract and the protein powder, I feel pretty confident eating this. And the original blogger even gave us the nutrition facts. How nice! That’s something you don’t ever really find for insulin pumping purposes.

Except they aren’t quite accurate or don’t factor in the tiny bit of chocolate chips that I added in. Guess I should have read closer.

The original nutrition facts say 11.8 carbs for a cookie. This assumes that there are 16 in a batch and you didn’t add chocolate chips.

I made 9. Yikes. That’s quite a difference in size to batch ratio. And full of melted chocolate. Yum! (Well that explains my crappy glucose control.)

Some other edits besides making these ginormous cookies.

  • I used crushed almonds as my “nuts.” I didn’t have anything else. I probably should have used almond butter instead of peanut butter. Lesson learned.
  • I used regular oats rather than quick. They are a little bigger than those pictured in the original blog.
  • I didn’t have butter extract. I have no idea what that is or where to find it. She said it was optional, so…

Taste wise… I’ll be honest. I don’t know if I’d like them without chocolate chips. They are pretty bland otherwise. But reheated in the morning with my cup of coffee and a hard boiled egg is nice and quick.

Starving for Enlightenment

These basal tests are really starting to get to me. On first glance, it feels like a carefully planned eating disorder. You skip meals, poke yourself repeatedly for blood, and then binge because you’d skipped a meal, thus throwing the rest of your day off because you are correcting your indulgence. Because diabetes management relies on discovering patterns and adjusting accordingly, each test requires at least 3 attempts per time of day. (Unless the basal rates are perfect the first go-around.)

There are four tests you can and should take: overnight, breakfast, lunch, and dinner. If the test fails by having the blood sugar go too high (over 250) or too low (under 70), you repeat the test the next day or whenever convenient to see if a pattern arises. Adjustments will be made and tests are to be repeated to try the new basal rate or to get more conclusive results.

Yesterday was my second dinner time test since before Christmas. On my first attempts, I decided to try gluten free meals for both tests I took. Bad idea. Apparently gluten free meals don’t hold the same carb breakdown as non-GF meals, so my insulin dosage at lunch sent my sugars plummeting around 3:00 pm. I was advised to eat “real” food at lunch and try the test again. (Or just food I would typically eat, rather than stuff I was experimenting with.)

On these last two tests, I tried two variations: first day was quinoa and some Indian spinach curry and cheese, second day was a plain ol’ PB sandwich on wheat. I survived my 2:00 pm and 4:00 pm checks, which means my lunch dosage is as it should be. On both days, however, precisely at 6:15 pm, my blood sugar dropped to 63 and 65 mg/dl, respectively.

A pattern! (And the test is over… I can have dinner after all.)

Not only did this tell me something was wrong with the basal rate at this time, but it also explained all of the strange issues I was having in November and December. During those months, I’d get off work at 5:00ish, go grab a Subway sandwich, and eat dinner before my 6:30 pm dance lesson. Shortly after eating my sandwich or during the lesson itself, I would plummet down to hypoglycemiaville. (Which made spinning and learning choreography that much more complicated.)

My CDE and I were trying to adjust my dinner bolus rates to account for my activity levels in the evening. Hmm. Maybe we fixed the wrong thing.

Now that we have a pattern, we’ll probably adjust. Which will then lead to another round of testing to see if the adjustments succeed.

Sigh.

These tests aren’t for people with active calendars. During these tests, you are supposed to keep activity, stress, high fat foods, (life), to a minimum because, as all PWDs know, anything can have an effect on blood glucose control. Never mind that you aren’t eating anything for about 8 hours straight. (Or trying to.) Since I have a lot of evening plans, explaining that I need to skip dinner three nights in a row is impossible (which is why I didn’t test during the holidays). Not doing any exercise for three nights in a row is also impossible. If you are female, you can pretty much forget testing one week out of the month.

I am still struggling with my morning rates, so there are a couple of skipped breakfasts in my future. Possibly even an overnight test because I’m not quite sure if that’s effecting my mornings. (Which equates to getting up at midnight, 2 am, and 4 am.) All in the name of science, I suppose.

As much as I hate starving myself repeatedly and the wrenches that get thrown into plans when I can’t pass, the results are quite enlightening. I just wish there was an easier way to see if you were administering the correct doses.

On Treadmills and Fancy Dress

From Wikipedia

I posted to my friends on Facebook today that I wondered if Viennese Waltz could be done on a treadmill because that’s kind of the sensation I was feeling today at work. Others describe this as “spinning your wheels” or “running nowhere fast.” I felt I needed something more dramatic, so I added in the challenge of a really fast, rotating dance, where you sometimes just have to shut up and hold on for 3 minutes. It was determined that this could be done as long as I had a “double wide” treadmill or maybe at an airport with empty people movers. I joked to my teacher that I had come up with a fantastic new showcase idea.

With the stress at work rising, I’m finding little time to actually take care of myself. The only reason I remembered to eat lunch today was because I started a dinner-time basal test and my phone’s alarms are set for every two hours starting at 12:20 pm. (I failed the test by dropping to 63 mg/dl at around 6:00 pm.) And unless those alarms go off, I just don’t really pay attention to how fast time is going by and how quickly my sugars are rising or falling. Control? What control? Thus, my blood sugars also feel like v. waltzing on a treadmill and they get ignored until someone falls off the end.

Rise and Fall

Rise and fall is a characteristic of Smooth and Standard Waltz, a ballroom dance set to music in 3/4 time. Here is a recognizable example of waltz from pop culture:

(And hell, Pasha is just fun to drool over… even in a full suit.)

Rise and fall has also been a characteristic of my blood sugars as of late. Granted, I’m barely tipping over the 200 mark on upswings, which is kind of nice for a change, but my new pump settings seem to be working overtime. I tried lowering my target range because that’s what the pregnancy police expect. (An ideal range between 80 and 105.) This range will add a correction based on your sensitivity if your current blood sugar is above that before a meal, in the middle of the night, or when the wind blows differently, etc.

I’ve also been experimenting with a much different diet. Protein shakes, quinoa, fresh meals, higher protein, carbs from fruit, etc.

So for the past two mornings, I’ve woke up around 150ish. I administer a correction. I eat my quinoa bars from two days ago. And hour later, I’m at the 120 mark and most likely falling. Fabulous. I try to stop my impending low with some milk or something similar. By hour two, I’m in the 50s. Eat and raise blood sugar. Two hours later I’ve rebounded. Correct. Eat lunch. Repeat vicious cycle.

Apparently I miss my multi grain english muffins with almond butter a LOT.

So I tweaked my settings again, making my target range 85-110 and upping my sensitivity to 45 points, rather than 40.

I have no idea. Can I get my old pump back? At least it was predictable.

Detoxing is… colorful

salad

The designer in me couldn’t let my lunchtime salad be¬†asymmetrical. (Except, those avocados off to the side are fired…)

Here is what you have:

  • 1/2 cup fat free cottage cheese (I use Trader Joe’s. Every other brand makes me gag.)
  • Some grape tomatoes
  • Some cucumber slices
  • Half an avocado (I LURVE avocado.)
  • Cracked black pepper

Less than 5-ish carb grams! Tons o’ protein.

But I had a banana to make my insulin pump feel like it was still useful. (And a snickerdoodle that my co-worker brought in from home, shhhh.)

I barely got through the salad because it’s pretty filling for just some veggies and cheese. (The banana probably helped.)

Quinoa Experimentation

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Quinoa Bake attempt – “fancy oatmeal”

I’ve been busy trying to start my year off right with new food ideas. Particularly at breakfast time.

I had some luck with this recipe (though it molded super fast. Yay zero preservatives!) I managed to have one slice for breakfast with a hard boiled egg and my postprandial records seemed to stay semi normal (i.e. didn’t spike above 200.)

Quinoa at other meals has also been beneficial as a side. Much more so than my typical rice standard. (Which has a really high GI, apparently.)

Tonight I tried making another breakfast recipe so I wouldn’t have to worry about scrambling to find something healthy to start my day with. And I have to take my boss to the airport tomorrow so I don’t have an hour to putz around as usual.

So here is the Cinnamon Quinoa Bake. My version is nearly sugar free, gluten free, and dairy free. (But not vegan.)

A couple things that I changed:

  • I used unsweetened vanilla almond milk instead of soy milk.
  • I used sugar free maple syrup instead of plain. (Because I’m still a PWD; “fake” food be damned.)
  • Yes – that is 2.5 cups of cooked quinoa. (Or 1 cup pre-prepped.) The baking doesn’t cook the quinoa. I made that mistake once before.

The taste? Well… as I was prepping this, I noticed the recipe only had about a 3 star rating. Honestly, it tastes like Quaker Instant Maple and Brown Sugar Oatmeal and it kind of has a jell-o consistency. And with a lot more protein (that’s 4 eggs there). The hubs didn’t really care for it. I’m debating, but I’ll see what happens after I store and reheat in the morning.

She’s Here!

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And we’re back to the wired life. Well, the mini vacation was needed, that’s for sure. Even though it was short, I’m actually pretty happy to only have to stick myself once every three days rather than five times a day.

She’s still pink… And has been giving me attitude. Apparently factory default settings really are nothing. (I really don’t remember needing to set a fixed prime amount. Oh? Now you just want to stop working? Cool.)

The control was unreal though. I thought for sure I’d ruin my average in three days.

Anyway, so now I’m dealing with an awkward bruise from that gusher I had on NYE. My bruise has taken the shape of two nearly intersecting lines. Apparently the capillaries are upset at me. But, naturally, I start looking up “infections from infusion sets” and “blood poisoning.” (Which, if you Google along with anything diabetes related, you get a bunch of stuff about Bret Michaels.) I have neither deathly condition, but still scheduled an appointment. Not sure if ill go or not. It’s been a busy half week at work.

Wireless Vacation

Today’s thought – from Kate Spade NY’s Tumblr

Whhhheeeeeeeeeeeeeeee!!

Ladies and gents… big news. I wore a dress today. With leggings. In 35 degree weather. To work. Yes. No clips, bands, square bulks on my side… just me in a dress I haven’t worn in 2 years because I hate dealing with pump fashion sense.

I’ve been riding the Lantus high for about 2 days now. But thankfully, that’s not where my blood sugars have been residing. In fact, they’ve been kind of on the low side, so I’m probably way over-doing the Lantus.

But – have a morning snack and not give any insulin for but still have an amazing blood sugar by lunch? Don’t mind if I do.

Wear PJ pants without pockets? Of course!

An infusion set free shower? Yes please!

Seriously, why did I give this up?

Oh, wait… yeah. The whole awkward, whipping out syringes at random and sticking yourself multiple times for grazing the pantry before dinner thing. And the fact that my post prandials are probably shit right now. (But hey, I eventually come down because of all the Lantus.)

Okay – my pump should be here tomorrow. I hope it’s not pink. Maybe I should have specified.