JonahDiabetic

2010

2010-01-01T14:32:00.003-06:00

I started the new year with a disappointing blood sugar of 234. How 'bout you?

2009-11-25T08:59:00.002-06:00

I called the patient information network this morning to access the lab results from my blood draw and doctor visit Monday.

My A1c is exactly what I guessed, 7.1%. Last time I was spot on accurate too, but last time it was 6.4%. I think my endo was joking when he said in the message that maybe we should stop drawing it since I guess my A1c so precisely.

My TSH came back 1.54, normal normal normal. Also, only .02 different from last time, so maybe I've stabilized. I can hope, hey? My thyroid is still tender.

My endo didn't say exactly how my other labwork came in, just that it was normal. Except for my blood sugar, which was 207. My accu-chek had read 206 just a few minutes earlier. Which reminds me that I've been meaning to make a list of things about the accu-chek aviva:

1. It's accurate.
2. It takes .6 microliters of blood (half the amount of the newer accu-chek).
3. There are four ways to turn the meter on that I've figured out so far. You can hit the forward button a few times, you can hit the back button a few times, you can hit the rather redundant on button, or you can insert a test strip.
4. It comes with the multiclix, which comes with easy to change, not horribly painful lancets.
5. It has skins.
6. And it comes with great customer service from accu-chek.

NovoPen Cartridge Hardiness

2009-11-01T08:53:00.002-06:00

I was foolish enough to leave my diabetes kit unattended for a few minutes while in my synagogue's childcare area, and a kid got ahold of my NovoPen Jr and dialed up and pressed until the insulin bubbled through the sides of the opening with no needle on. You know, at the top where the orange part meets the silver? Maybe this isn't a great description. I got it from him, and unscrewed it to relieve the pressure on the cartridge. Wasn't sure if I should keep using it. Decided to take insulin out of it by syringe, did that for a couple of shots, and then decided to see if it would work with a pen needle- and it does!

:-/

I've turned 21 since I last wrote. Didn't do anything special. Did decide to give out candy to my 7th graders if they could draw an obtuse triangle... less than a third could, and my diabetic student wasn't one of them. I had thought she knew that I'm diabetic too, but it turned out she didn't.
I had had a bad tremor in class that my students had commented on in the class before lunch, and she'd seen it. When she'd asked (while I shook) to go to the office to check her blood sugar, I said yes and joked that I should be the one checking my blood sugar. Ten minutes later at lunch as she walked by, I held up my meter to show her my blood sugar. "I didn't know you had diabetes too!" she said. "Now you do," I answered. My blood sugar was 66, which she said was "really low". I guess that tells me about how low she goes (or doesn't).

I've been having a variety of health problems that don't seem to be blood sugar related, including a sometimes tremor with normal and low blood sugars, but not really with high blood sugars. I'm wondering what that could be. I don't feel like I did in the spring, but am still wondering if it could be thyroid related.

I got my H1N1 vaccination (injected) on October 23rd and went and scheduled my next endo visit for November 23rd.

Diabetes In School

2009-10-11T20:42:00.002-06:00

If I had progressed through school at a normal rate for people in Illinois, then I would have been diagnosed with diabetes going into my senior year of high school. But I started first grade at age 5, and then started college after three years of high school, meaning that I was at the beginning of my sophomore year in college by the time I was diagnosed with diabetes at the age of 17. So, lucky me, I never had to deal with diabetes as a student in a school setting where anybody might expect to be able to forbid me to carry around medication, etc.

So although I've talked to a lot of others about diabetes in school, I don't have first hand, as a student experience with having diabetes in school.

I started student teaching five weeks ago, and got a list of my students (I've got about 140 of them) who have 504s (medical plans) and IEPs (special ed). There were 2 504ed students. Neither diabetic. My teachers told me that the last student with diabetes in the school had been six or so years previous.
Four weeks later, I'm giving my first test to the students, and one of them raises her hand and asks to go to the office. I ask what for. She says to check her blood sugar. I say, "You have diabetes too?! Go!"

Now I have a million zillion questions. I had candy I was about to try giving as rewards to the students who answer questions, and I'd gotten in peanut free and everything for my student with a peanut allergy, but of course I didn't get carb free candy. And while this particular student is not a quick student, there's no way I'm giving a reward that I can't give to every student. I would like to figure out if I can still give out candy. Should I simply make her an exception to the "candy given by teachers must be eaten in that class period" rule? Should I contact the parents and ask?
And just knowing that there's a diabetic in front of me, I want to be able to ask her a zillion questions, diabetic to diabetic. What insulins do you use? How long ago were you diagnosed? What do your hypos feel like? How often does diabetes make it difficult for you to concentrate in school? Is your diabetes managed more by yourself, your mother, or your doctor?
But I'm a teacher, and she's a student. Not my homeroom student either. There is no way to ask her just casually. So so far, I ask nothing. I notice now that she is first in the lunchroom, and that she eats school lunches; I test my blood sugar in the lunchroom, but she sees the nurse. We have a full time nurse.

I teach in a school with seventh and eighth grades only. I teach all seventh graders, five periods of them. I have the classes at different times each day. So this student has me fifth period on Mondays, fourth period Tuesdays, third period Wednesdays, second period Thursdays, and first period Fridays.

----------------------------------------------------------------

And on another note, teaching with diabetes. I don't set the school rules, which say that students can't eat in class. I try not to eat in class. It's hard, trying to find the time to check my blood sugar. No time to use the bathroom. Fingers getting covered in marker and chalk.
At lunchtime, I take my lunch and my insulin and needles down to the lunchroom, where I eat with the students. I check my blood sugar, and about half of the time inject. I inject my calves since that requires the least amount of undressing. Most of the students don't pay any attention, as far as I can tell. A few have made comments, all of them fairly positive. One of them told me about "this guy, he has type 1, he's famous and he's my boyfriend" and was surprised that I knew she meant Nick Jonas. I have not mentioned diabetes in class, only when students at lunch have asked me what I was doing or what that little case is.

My blood sugar was running high a lot, but I finally got it down (mostly) this week. That meant more hypos while teaching, yuck yuck. I just raised the Lantus 20% and then backed it down a half unit at a time. Looking at my records for September, it looks to me like student teaching was challenging my blood sugar in each of the following ways:
depriving me of sleep, and making me less willing to wake up and check during the night
depriving me of time to check blood sugar
putting stress on me
reducing the amount of exercise I get
reducing the amount I eat (I eat when I'm hungry, and apparently I wasn't hungry in September)

Yom Kippur Log (written after Yom Kippur)

2009-09-28T20:36:00.002-06:00

September 27, 2009

1704 hours -bg 153 Injected 20 units for the before fast feast. Started stuffing my face.

1814 hours- bg 103 20 minutes until the fast. Decided to eat another 30 carbs of fig newtons. Was absolutely full, vomitted a bit. Stayed home from services.

2011 hours- bg 213 Ignored it, read.

2035 hours- took 10 units Lantus. Ketones negative.

2116 hours- bg 246 Two units Novolog. Hoped it wasn't too much.

2249 hours- bg 217 Went to bed.

September 28

0628 hours- bg 252 Took two units of Novolog, went back to sleep.

0909 hours- bg 147 Ketones negative. Walked to the synagogue (about a mile and a half)

1030 hours- bg 121 no action

1205 hours- bg 156 no action

1426 hours- bg 163 morning services ended, I decided to stay in the synagogue rather than risk lowering my blood sugar by walking someplace

1655 hours- bg 149 evening services started

1942 hours- bg 128 evening services ended

2000 hours- took 6 units Novolog, broke my fast with 2 cups chili plus half cup granola, a little (I mean a little) melon, three slices cucumber, one slice tomato, one cup water

2119 hours- bg 331 took another 6 units Novolog, 14 units Lantus.

So, all in all, it went well. I should have been more aggressive with the post fast feast.

A No Good Rotten Cold

2009-09-26T23:38:00.004-06:00

I started showing symptoms of a cold at exactly 1:40 PM on Monday. It was unusual mostly in its suddenness. I got a runny nose, sore throat, sore eyes. On Tuesday I woke up feeling horrible in the middle of the night covered in sweat (bg 142). I went back to sleep after an hour, woke up again at 6 AM feeling better by a bit, even more coated in sweat (it is not hot in my place). I made it through the day with nothing worse than a persistant runny nose and a sore feeling in my throat.
On Wednesday, my students heard it. Mr. B, are you coming down with something? Mr. B, I have a question. Are you sick? I know you feel, Mr. B, my baby sister is sick, too.
On Thursday, I started losing my voice, throughout the day, my voice fading in and out. I developed a hot feeling all over my body, and felt very sore when anything touched me.
On Friday, more of the same.
Saturday (today, really), I stayed home and did nothing much all day. I've only had two or three times when my voice didn't come out and I don't feel too bad.

Thing is, the insulin resistance is driving me insane.
I had 0 readings above 300 from August 2- September 14 inclusive. I had an explainable reading of 300 on September 15. But then, what happens with a cold? Two readings in the last week above 300. And insulin resistance unpredictable.

Here's a story. Today, I finish lunch (and its insulin) by half past noon. At 3:20 PM I check my blood sugar: 221. Nothing too unusual about that, I'm sorry to say. I would usually correct that with an injection of 2.5 units Novolog (at an ISF between 40 and 45), but I decide that I'll inject 9 units of Novolog, wait an hour, and then eat for the extra 6.5 units. Brilliant, right?
So an hour comes and goes, I check my blood sugar again. 246! No drop at all, in fact a rise!
So instead of having a lovely 45 carb meal, I go have some tea (peppermint papaya, no carbs or caffeine) with some celery and lettuce (that was my mother's idea). After another two hours, when the Novolog has done it's job, I am down to 132. Not a bad number- but it took 9 units to get there?!
So I had some more to eat at that point, took what should have been enough insulin too. A couple hours later I'm at 123, looks good. Took a bit more Lantus than usual. Shabbes ends, I go on the computer.

Three more hours later (right before writing this post, in fact), I check my blood sugar just because and SURPRISE! 340. Now what? I haven't seen a number that high since August 1. I'm not at all sure what my insulin sensitivity is. What to do? I took 9 units. I'll check again after an hour, I suppose.

And the worst part of this story? Yom Kippur is on Monday! It's hard enough fasting on Yom Kippur with my body's usual shenanigans- now I have to add a cold into the mix?! Oy vey!
What Lantus dose will I take next? Will I be able to fast on that holiest day of the year? Stay tuned to find out...

New Meters

2009-09-23T20:30:00.003-06:00

On Friday, I changed the code chip in my meter, and had a hard time putting the new chip in because the plastic was loose where the chip goes in and was blocking the place where the chip goes in. So, although my meter was well out of warrantee, I called Accu-Chek. When the woman on the phone (named Eilene) found out that my back up Accu-Chek Aviva meter, also out of warrantee, also didn't totally work (the forward button is broke), she said she'd send me two new meters.

The new meters came today. I took out my usual meter, and both of the new ones. I drew a large drop of blood from my right big toe. I applied it to my usual meter on a test strip. Then I took the code chip out, put in one of the new meters, put a strip in that meter, and put blood from the same drop there. I repeated that for the third meter.
And a minor miracle occurred, for lo and behold! My meters were not 50 points aparts, not 10 points apart, no! Not even by one mg/dl did they differ. So I decided to capture the moment. Look!

Ketosis

2009-09-15T21:09:00.002-06:00

This morning I woke up with a blood sugar of 300. It was the highest reading I'd had in, oh, 44 days :rolleyes: However, I'm no stranger to blood sugar readings that high, and I did the correction and went about with my morning routine. Just as a matter of habit, I checked urine ketones- something I always do with readings over 300. I was SHOCKED to see that my urine ketones were small, because that is the first time I've had ketones since the month of dx that weren't within a few hours of throwing up. I rechecked and they were small again. In the past, I have even forgotten bedtime Lantus, woken up with a blood sugar in the upper 400s- no ketones.

So now I'm wondering if this is a sign of things to come: am I going to be more ketone prone than I have been in the past?

And as a post script to my previous post, I took off the demo pod today, almost exactly 72 hours after putting it on. The site under where the pod had been was red and in some places purple, and there was some lumpiness under the site. This is with no cannula, nothing. The wearing of the demo pump was tolerable, but the fact that my stomache is looking this irritated after nothing but the adhesive and the weight of the solo, suggests that pumping with the solo would probably not be a great option for me.

Dummy Solo

2009-09-12T23:58:00.002-06:00

I ordered a dummy pump from Solo a few weeks ago and it came in the mail today. I put it on my stomach, because I've been curious about what it would be like to wear soemthing there, on account of it not being smooth at all. Would the adhesive stick to a surface so hilly? Would the adhesive hurt? Etc. So far, better than expected. Of course, there's no needle or canula with the dummy, so it's not the same as it would be, and it's not entirely comfortable, but better than expected. I'm a little disappointed that the dummy can't be taken apart, because I wonder if that would be painful if I was actually wearing a Solo pump, but that's okay.

Insurance Question

2009-09-06T00:07:00.002-06:00

So, I'm going to be all certified and ready to get a job in December, and will be starting to look for jobs in October. The thing I am looking forward to the most is getting an insurance plan that will cover a CGMS.

So here is the question: How do I find out, before choosing an insurance, whether or not it would cover a CGMS for me? My googlesearch so far has not been useful.

If you are in Illinois and have been either approved or denied for a CGMS by your insurance, particularly if you are in my age range, please let me know which insurance and what decision.
I am on BCBS-IL-PPO and they are covering for persons 25 and up who check blood sugar 8x+ per day, and who are willing to wear a blinded CGMS for three days first. I think you also have to have hypos below 50 but that is not a problem here. My problem is, I am 20. I will be 21 by the time I switch insurance plans, but this still means I need an insurance that isn't following the stupid JDRF study as the basis for its decisions.

BCBS-IL-HMO covers CGMS for everybody as far as I've heard.

Any other Illinois experiences? Knowledge of a dependable online resource? Way to look at insurance websites or call them up or anything like that?

YES!

2009-08-29T19:58:00.002-06:00

I called the patient information network a few minutes ago, got my message.

"Jonah, your test is back [sic]. Your guesses were surprisingly accurate. Your hemoglobin A1c is 6.4%, like you guessed it would be. Your TSH is 0.88, which is normal- the normal range is .4-4. So, that's very good! Call me if you have any questions."

I love that he says "That's very good!" most of the time when telling me my A1c. When I was in his office on Friday, there was a drug rep in there, and I tested my blood sugar (88). The rep asked me if I was testing my A1c, and I said no, I was testing my blood sugar. He looked confused, so I told him an A1c is a sort of a measure of average blood sugar, where as I was testing my blood sugar of the right now. Then I went and sat next to the rep and showed him the components of my meter and the memory. He was fascinated, and said so (hopefully this was not sarcasm that my autistic brain missed). However, when I scrolled back he said that my blood sugar had quite a lot of variability, so I said I was doing exceptionally well for a person of my age (20 years) with my islet cell function (not enough for a cpeptide to measure anything). I told him I thought my numbers translated to an A1c of 6.4, and he thought for a moment, and said, "That's pretty high, right?" and I said well, it's high for a nondiabetic, but it's very good for a 20 year old type 1 diabetic." Eventually, I said, "You must not be a diabetes drug rep, right? What kind of stuff are you selling?" and he told me that he was there with blood pressure medicines. Which, so far, I don't have any reason to be very interested in.

So anyways, I am quite happy about the drop in HbA1c. I would love to see it drop even lower, but this appears to be my floor; my A1c readings not counting those within a week of diagnosis have been: 6.3, 6.3,6.3,6.4, 6.4, 6.5, 6.6, 6.9, 7.0, 7.2.
So while I've shown myself to be quite capable of getting higher A1cs, it also looks like what I get when I pour myself into it and my body cooperates is 6.3-6.5. And in light of that fact, 6.4 is a very nice number.

Today's Endo Visit

2009-08-28T17:36:00.002-06:00

Was not so good, not so bad.

My weight was down a teensy bit from three weeks ago at my other doctor's office. That's not good news, but not horrible news.
I received a seasonal flu vaccine in my left shoulder, and a pneumonia vaccination in the right shoulder, and had blood drawn for an A1c and TSH (expect a post on that topic on Monday or Tuesday).
I had my feet checked for neuropathy and didn't do too great but not horribly. I wanted them checked partly because I check blood sugar on my toes and would stop if there was evidence of neuropathy After he did the check, the endo said, "Well, that's not such strong evidence of neuropathy, but you probably should stop checking the toes." So.... I think that I do have neuropathy in my feet. I felt the filament just fine, and I could tell if he was bending my toes up or down, but when he touched a vibrating thingy to my big toes in turn and asked me to tell him when the vibration stopped- I couldn't tell. I think that means I have neuropathy, but on second thought I'm not sure. Maybe I should have the conductivity test done... but why bother? The doctor wants me to stop with testing on my feet due to risk of infection. I asked him if my immune system is really compromised with my level of blood sugar control. He said no, BUT since my blood sugar control isn't guaranteed to stay stable and can get worse fast (and did get a lot worse this past spring for a couple months), it's just overall best not to risk it. Feet are too vulnerable, he said. However, I am not fully convinced.
We also discussed switching me from Lantus to Levemir. He said that studies show that Levemir is more consistantly bioavailable than Lantus, meaning less daily variation in how the drug works. I told him I would think about it... and I am. Have any of you switched from Levemir to Lantus or vice versa?

Both my most favorite and least favorite part of the visit is the blood draw. It's my least favorite because it hurts, but it's my most favorite because we sort of chit chat. I know autistic people aren't supposed to like small talk, but I do. I love how you can discover odd and unexpected things about people. I asked my endo what prompted him to go into endocrinology and he said it was working at the University of Michigan when Jerome Conn decided from the evidence that hyperaldosteronism existed and set about proving it. This was back in the days when they couldn't image these things, which is what they now do, and nobody was sure that there would really be such a thing. When the very first patient was sent into the OR on Conn's suspicion that he had an aldosterone producing tumor on his adrenals, the hospital caferia was abuzz, waiting to see if the guy really did have a tumor- and he did!

I just looked up Jerome Conn and his syndrome, and it was discovered in 1955! I didn't realize my endo was that old. That means my endo has been practicing medicine for over fifty years. My father was born in 1955.

Endo Visit Coming Up On Friday

2009-08-25T09:06:00.002-06:00

On Friday I go to see the endo. Haven't seen him since June, haven't spoken to him since July. I guess that's not so long. I've been trying to think about what to say to him. Some things are obvious:
I need to ask about what he thinks about me getting the flu shots, particularly for the H1N1 thing.
I need to report my awful terrible stomache pains.
I'll have my blood drawn for an A1c and for TSH, both of which I'm very curious about. The A1c I can guess at- somewhere between 6.4 and 6.8, is my guess. The last A1c was 7.2, but my my blood sugar average for the last two months has stayed below 140, so I'm pretty sure that the A1c will be done. The 30 day average when the A1c was 7.2 was something like 155. I suspect that the TSH will be back down below the normal range, but I don't know. Maybe it will be normal. In the last week I've had that sort of shaky feeling that I often get before I'm visibly shaky, and I've had it most of the time. I'm also thinking I'm looking skinnier than I did two weeks ago, so my guess for weight is something like 102 lb (last weigh in was 104, and before that was 99).
I need to ask about what insurances have him as preferred because I'll be job hunting in just another month or two.
Some things I do every now and then:
I'm going to ask for him to run the monofilament on my feet, because I check my blood sugar on my toes and I'm only planning to do that for as long as there's no overt neuropathy in my feet.
I'm thinking about asking for a celiac panel, although I think not this time.
We'll probably check my urine for microalbuminuria.

If anybody can think of anything else I need to bring up, tell me now.

Heat and Diabetes

2009-08-18T11:26:00.002-06:00

I had a bunch of really unusually good blood sugar days this week and when I talked to a friend with diabetes- so had she. I've been wondering about the affects of weather on diabetes. I searched on pubmed, and discovered a few things:
That keeping lab animals at room temperature gives them insulin resistance vs if there's temperature variation.
A bunch of articles on vitamin D deficiency and brown fat and developing diabetes.
An article about the 2006 California heat wave noting a 3% increase in hospitalizations due to diabetes during the heat wave.
Two articles about people with pumps going into DKA due to heat related damage of the insulin in the pumps.

In sum, it seems that moderately hot and cold weather decreases the amount of insulin people need, and that beyond that there isn't much research.

If you have multiple D householders, do you notice that their blood sugars tend to go high or low on the same days?
Does anybody know of any articles about daily weather- as opposed to seasonal- affecting blood sugar? Please comment.

2009-08-16T15:32:00.002-06:00

I spoke to the representative of LifeMasters last week. They have a system that calls me and then whichever nurse is available gets to talk to me, which does not produce much continuity or consistancy in the quality of conversation I get. They leave notes for each other about me.
Although I told them from the outset, about two years ago, that I am a transsexual, this was not put into my notes until recently, and I just recently had a conversation in which it became apparent that somebody had read the note.

First, she started with the observation that she didn't know why it was down that they would call me every other week, when I was a type 1 diabetic and probably better informed about diabetes than most of the nurses. I said it was because I'd had surgery in the past year.
OOOOOH?????? SURGERY???????
Yes, my gallbladder had to come out.
Oh, your gallbladder.

Later she says:
Well, it says here that you're a female to male transsexual. Have you had any surgeries for that?
Ah, no. Just testosterone.

And later, she said she had to go but she would love to hear about how going on testosterone affected my diabetes.
So, hey, this is a topic I'm willing to share. I start talking about insulin sensitivity and testosterone levels and all of that.
But she says...
No, what I was interested in is, how is it different dealing with diabetes as a man.
Oh. Uh. Well, I had a few menstrual periods on insulin and a couple announced themselves by dropping my blood sugar into the 30s. That doesn't happen anymore.
This reply seems to satisfy her much more, and we say goodbyes.

Sometimes my medical life would be so much easier if I just lied.

In real life, I developed polycythemia as a result of being on too much testosterone, and my dose was cut pretty dramatically and as a result of that, I started spotting back in May, which lasted about two weeks, and I started again Wednesday night. The spotting doesn't seem to be correlated with any blood sugar changes, but I am having my dose raised at the end of this week as a result of bloodwork showing signs of ovulation (!) which is a little nerve racking because that will very likely change my insulin sensitivity dramatically in one direction or another.

Let's Get an End of August Gathering Planned

2009-08-06T22:26:00.002-06:00

I'm hoping I can get a Chicago area meetup of diabetics and their folks. I posted this on the children with diabetes forums about an hour ago. I'm looking at either Sunday August 30 or Monday August 31 at Foster Beach. If you can commit to any time on either day at Foster or another nearby beach, let me know. I will set a time and place and publicize once I get two definite yesses for any particular time and place in addition to my own yes.
I am hoping to get some teens/adults with diabetes as well as a couple of families of kids with diabetes.

I hit three years on insulin in less than a month, how time flies. Got my eyes looked at today with a dilated exam by an optomotrist (you read that right- I did not see an actual MD) and the coolest thing happened- when he shined the light in my eyes, I could see all of the veins in my eyes. It was so awesome. On the right eye it all looked good to me and I said that and he said it all looked good to him to. On the left eye it looked to me like maybe there was something there but he said it looked okay (I didn't tell him it looked funky to me). He said he was particularly looked at the periphery since that's where retinopathy tends to start. My general myopathy got better in the good eye and worse in the bad eye- that's not really diabetes related. Anyways, feeling pretty good about that.

Answer

2009-08-05T22:25:00.003-06:00

Bernard got it. I forgot that the ice would account for a sizable volume, and that I did not in fact get 16 ounces. My guess is that I got less than half of 16 ounces of pineapple juice; I went hypo within the hour and despite treating the hypo, stayed hypo for over an hour and a half. Oops, hopefully won't make that mistake again. The next day I ordered tomato juice and injected for only half of the volume to better results.

Rookie Restaurant Mistake

2009-08-03T15:08:00.002-06:00

I'm taking a course in wetland conservation and we had a field trip today to learn about wetland delineation. The school paid for the class to eat lunch in a classy restaurant.
So we go in, sit down, I go the bathroom and wash my hands, dry them, and check my blood sugar. 61. Okay, good thing it's lunchtime.
So I go sit back down, the waiter asks if we'd like a drink, tells us they've got water and colas. I ask about juice: he says they've got pineapple, cranberry, and lemonade. I ask for pineapple, and soon I get it; a tall glass of ice and pineapple juice with a straw. I ask for nutrition information and drink the whole glass.
The waiter comes back with a can of pineapple juice; the side says 8 oz is a serving and that there are 35 g of carbohydrates per serving. The waiter tells me I got 16 oz.
I wait until my dish, hummus and vegetables, arives, before I inject. I inject for 60 carbs.

Can you find the rookie mistake? Did I go high or low? Answer in next post.

Loser, loser, loser.

2009-08-02T09:28:00.002-06:00

I'm always losing stuff.

On Wednesday night and Thursday was a Jewish fast day, the 9th of Av, and I managed to fast the whole day. I just cut the basal from 12.5 to 8.5 Lantus that night. I woke up 228, took a unit of insulin, was down to 130 by lunch, rose to 150 by midafternoon, dropped to 72 by 5 PM, and hovered there - with another reading of 72 and a reading of 68- until I broke the fast at 9 PM. Then I couldn't find my NovoPen Jr. I looked and looked to no avail, so I took out a cartridge and used a syringe to dose for supper. This, I think, makes the fourth one lost in under 3 years.

Still taking my Novolog out of cartridges with a rapidly dwindling syringe supply, Friday night I couldn't locate my Lantus. It's usually in the fridge. I looked and looked and then gave up for the night; decided to take some expired Lantus to hold me through the night. I took 4 units, and woke up around 2 AM. My blood sugar was 441 and my urine ketones were negative. I took 7 units of Novolog and went back to sleep.
In the morning my blood sugar was 252 and my ketones still negative. I decided to open a new vial of Lantus and just not worry about wasting the opened vial. So now I'm back to morning Lantus shots. Hope this works out.

I will be buying a new NovoPen Jr. or two ASAP.

2009-07-24T14:36:00.002-06:00

I got sent the glucagon I've been waiting for, finally- but I got sent three glucagon kits instead of the one I was supposed to get. Since I was billed the same as if I was sent one (insurance paid the full price for the other two) and since they say nonreturnable on them, I think I will just let it be. Store them in different places and I'll have plenty!

My blood sugar's been pretty bouncy but still not bad at all. It turned out the Lantus had not gone bad. I wish my body was more consistant. I'm having a problem getting the Lantus dose right. It seems like I wake up either high or low most of the time- I woke up 203 and dehydrated this morning and 48 and psychotic the previous morning and I had not dropped the dose much at all. And no, it isn't Symogii.

2 for 12

2009-07-12T18:14:00.004-06:00

Mike Lawson posts 12 pictures on the 12th of each month and I always think that's really cool.I was planning to do the same but am having trouble uploading pictures. So here are a mere two pictuers instead.

All Better Now, And Hoping It Stays That Way

2009-07-03T16:20:00.002-06:00

Thyroid level tests all came in normal range, with the TSH, T3, T4 all being just above the bottom of normal. My endo says to call him if I get symptomatic of hypothyroidism, because he thinks that might be where I'm headed to.
The erythrocyte sedimentation rate came in at 3, which is low- not a symptom of inflammation, though it doesn't rule out the possibility. The lowness of it may be a continuing symptom of the polycythemia I had, I don't know.
The c reactive protein was too low to measure, also a sign that there wasn't inflammation.

My diabetes numbers continue to be nice and low, but my Novolog needs are falling dramatically again and I'm had a bad hypo on Wednesday like nobody's business. Ahhh- I'll take that over the highs. If this keeps up for another two months, I bet I'll see an A1c in the lower 6s or even (dare I hope?) upper 5s. My 7 day average is now 120! The 14 day is 138, and the 30 day is 150. I haven't seen a 7 day average of 120 since last fall. Heck, I haven't seen a 138 average since winter. I'm holding my breath, hoping this lasts.

Waiting, Waiting, Waiting

2009-07-01T10:37:00.002-06:00

I saw the endo on Friday. He drew blood for thyroid hormone levels and erythrocyte sedimentation rate. He asked me if I'd like my A1c drawn and I said no. I hadn't been decided, but when I looked at the needle and the vial, I just didn't want the blood drawn when I knew it would have been an awful A1c. My 30 day average at that point was close to 170. Starting last week on Sunday, I've been running excellent blood sugars. My 7 day average is 123, my 14 day is 145, and my 30 day is 151. I'm loving it. The doctor said that my results would be in on Monday but hasn't gotten back to me. I don't like this pattern at all.

I'm at a sort of a camp for autistic people right now. My roommate's been curious about blood sugar and I've tested him three times, which I suppose affects my average, except his three tests were 145, 134, and 104, which I think averages to higher than my 7 day average anyhow. He's not diabetic. He says if he was, he wouldn't take shots, just could not do it, but he seems fascinated by the needles. I dunno what to make of that.

2009-06-18T16:44:00.003-06:00

My iodine uptake is low. My thyroid antibodies have been retested and are negative still. My TSH is low. My T3 and T4 are normal. My thyroid is painful and tender. So. My endocrinologist has suggested that I may have subacute thyroiditis, although he says that that is not the only possibility. This will cure itself sooner or later, and in the meantime I just have to hold on and wait for the ride to end. My endo would like me to come in once per month for monitoring. That way, if I plunge from hyperthyroid to hypothyroid (a definite possibility) we can treat that as fast as possible, and if I go more severely hyperthyroid, we'll know and respond to that. Also, he mentioned that beta blockers may be an option if my cardiac symptoms become more pronounced.
All in all, I think this is confusing but mostly pretty good news.

Yesterday I had the unusual occurrance that I saw THREE other T1s. One person on the bus I saw with a minimed 722 pump; I went and sat next to her. She's had diabetes for 52 years. I was impressed. Then I met up with Carrie, who I know because of this blog, so that wasn't a random coincidence. And then towards the end of my day I was about to eat supper and I had taken out my Novopen Jr, and somebody said to me, "Hey, is that an insulin pen?" and I said Yeah, how'd you know? And she pulled out her humalog pen. A most unusual day.

The Uptake Scan That Wasn't

2009-06-04T21:32:00.001-06:00

Tuesday night I lowered my insulin dose, checked when the early bus was leaving. Wednesday I caught the bus at 6:16 in the morning and headed to the hospital. Checked in around 7:15, filled out paperwork. A nurse took me into her office at around 7:40. We went over my papers and she asked me some questions about my health. Then she told me that I'd be swallowing a capsule. Stop right there.

I can't swallow pills. I can't swallow capsules either. For the medications I've had to take that were in those forms, we've either emptied the capsule and let me take it that way, or I've chewed it, or we've ordered an alternate form. Some of these things have been horrendously bitter and I've attempted to learn to swallow them- to no avail.

I informed the nurse that I can't swallow a capsule. She picked up the phone that was on her desk and called. "Marcy, I've got a young man here with orders for a 123 scan and he has grave doubts about his ability to swallow the capsule." Within minutes a meeting is convened: the nurse who I've been talking to, the head nurse, the pharmacist and me. We run through the options:

1) Could I attempt to chew this thing? No, that would render the test extremely inaccurate.
2) Is there a liquid form? No. The capsule can be melted, but nobody in the building has ever done that before, and they're not confident that they can do it right. There is a guy in the department who can, but he's on leave for the week.
3) Can we do the I131 scan instead? That's a liquid. No, because there's a suspicion of cancer and the 131's not nearly as accurate in that area.

So we rescheduled for a week later when the guy who melts the capsules will be back. They were really apologetic and offered me any time slot I might want and I stupidly picked a 10 AM time; I need to call and move it to earlier because they want me NPO from midnight until 2 hours after taking the thing, and I want to be able to eat lunch. Missing breakfast messes with my blood sugar plenty.