Monday, March 26, 2007

Hunh.

I just linked to this blog from my facebook account. I don't know if that was stupid or what, but I'm not worrying too much. (I have quite a few "work" friends that may or may not stumble onto this blog. FIRED CUZ OF MAH BLOG. What can I say, I have been nothing but honest. And let me reiterate that I think this job / company is a great place to build a career . . . for someone else. Oh, and I've been writing my blog entries on my lunch break :D No worries!) Okay enough spinelessness.

This weekend was interesting. I woke up on Saturday morning at 11:45. Barely the morning. I felt like SHITE. Awful. Awful. Horrible. But Kendra, you say, you got over ten hours of rest! Isn't that wonderful?

Not when your fasting blood sugar is 177, I say. Keeping in mind that that's probably the lowest it's been in hours since it was nearly noon by the time I got around to testing and I hadn't eaten since 7pm the night before. Mind and body felt like gum. Gummy gum. Husband, chipperly asking if I was well-rested after such a long sleep.

I rather brittlely replied: "Next time I sleep so long, could you help me out and test my blood sugar to make sure I'm not too high? Maybe even give me a correction bolus? If I'm out of range I'm going to oversleep. Sometimes I'm not really that tired, but my body is out of whack." (Lows wake me up, but highs make me sleep the oversweetened sleep of sludgy blood.)

"Uhh, sure, I guess . . . I mean I've seen you test lots of times but I don't think I've ever done it . . . "

Huh, I guess he's right! I've tested his sugar at least three times in our relationship. Once, he was drinking a grape soda and was a cool 120-something. The next time he was something too perfect..a pre-dinner 88. The next time he had just come in from a several-mile summer bike ride into the city, and was an exhausted 68 (! Of course I would've been -868 at that point.) He sees me test anywhere from 2 to 10 times a day. But he's correct, he has never wielded the lancet himself.

I sense a time to be smug, ho-ho! And in my hyperglycemic state I couldn't resist the urge to be snarky. I "let" him test my blood sugar allllll day...AND the whole of the next day, until he was whining to be released from duty! "But honey, I do this ALL THE TIME, what's the big deal!" I couldn't resist, I couldn't. I know, I know. He did have the gall to reply "I'm not diabetic, though." (Implied: It shouldn't be my problem, toots. Oh-ho.) I did take my small delights here and there, though - watching him fumble with holding the meter and squeezing blood out of a finger at the same time. Watching him struggle to get a slippery/sticky test strip out of that infinitesmally small strip bottle opening. "Why don't all of these damn things have automatic dispensers for the strips?!" (insert mad cackling here from myself) Watching him squeeze a freshly-pricked finger, only to have no blood emerge. How puzzling. Watching him wrinkle his nose up at how to dispose of the leftover blood. Such a messy, fussy disease.

Later that day I did apologize, thinking maybe I might have come off too bitchy - blaming him, maybe, for not having the diabetic sixth sense to test me while I snoozed. I know he's worried about me as I slept before, so I thought - why not empower him? I would love some help now and then, if he was willing. He assured me he knew he wasn't being attacked, and that he was glad he now had better finger-prickin' skillz. He also acquired some familiarity with my pump menu (due to premenstrual hormones, there was plenty of correcting to be done this weekend). Next up folks, the partner pump site change! Ha. Now there's trust!

Tuesday, March 20, 2007

Stagnant

I feel like my diabetes management is standing still right now. I don't think I'm doing awful, but I'm not expecting much change from the 6.8 A1C I had a couple of months ago. My next appointment is in May. I'm actually more concerned about my cholesterol reading - I suppose I'm just dreading getting into an argument about whether or not I need to be placed on statins.

Nothing really remarkable, but I'll remark anyway. I'm not eating as well as I could be. If I have bad blood sugars they are almost always related to something I'm shoveling in my mouth that I really didn't need to eat. And I bet it's not making my cholesterol go down. Maybe I'm just slightly depressed or out of it these days because I'm unhappy at work. (And since work is most of your life, I guess I'm unhappy most of the time.) Maybe my whole LIFE is just standing still.

Sometimes my fasting is fine. Sometimes it's not. I can't seem to nail down a pattern. Last night I went to bed with a 91, and woke up at 143. Bleh. The other day I went to bed at 198 with a correction bolus, and woke up at 81. So maybe 198 is better to sleep on, ha. Anyway that's not a typical pattern. I feel bored when I think about it, but I'd rather be interested!

Where I'd really like to be diabetes-wise is getting my A1C as close to 6.0 or under. To be exercising regularly, too. I want to prepare to have a child, but I'm having trouble finding the motivation to finish my damn state taxes let alone keep detailed blood sugar records. Doesn't help that I have two states to file taxes for, either. (Thanks again, job.)

I wish I had the guts to do what everyone else says - if you aren't happy, say see ya! Not that easy when there's health insurance, a wedding to pay for, and everything else on the horizon.

Oh, I did confirm that business traveling and blood sugars aren't friends. I've been on the road since March 6 - first in Dallas and then in Indianapolis. Vacation travel is different because I'm up and walking around, being active . . . and feeling really happy, which usually has a positive effect on blood sugars. Business travel I'm exhausted. I sit around in an inadequate office all day. I eat a lunch with clients. I go back to the office and sit around. Stress. I have a big dinner. Per diem, baby! I go back to the hotel and lay around watching Gilmore Girls reruns and trying not to give into cravings to go to the vending machine and get a huge effing Snickers bar. I can't survive on salads all damn week, and even if I did, it's not a guarantee of level blood sugars.

At least I'm home for a couple of weeks now . . . and something to celebrate: I'm getting new glasses tonight! "I can SEE, it's a MIRACLE!" :)

Friday, March 2, 2007

The Future of Diabetes

This is a question I've read on other blogs: What is going to happen to us? What is our life going to be like?

Assume there isn't a cure coming out in the next 10, 20, 30 years (I know, I know). Assume that you're going to be diabetic until the day you die. What's going to happen to us? "Us" meaning the people diagnosed with diabetes in the current era of diabetes management - daily self monitoring and self adjustment, carb counting, continuous glucose monitoring systems, pumps, and regular endocrinologist appointments. What is our life expectancy? Are we going to lose our eyes and feet even if our A1Cs are under 7?

I started thinking about this yesterday when yet another woman on Diabetic Mommy was the victim of a side-comment from a nurse that ended up being incredibly scary and / or hurtful. Her A1C was 6.9, and on her forms the nurse marked "uncontrolled diabetic" and then said that it made sense to her, looking at the readings downloaded from the woman's blood sugar monitor.

Hold up now. What the hey? I'm the queen of spinoffs, so I'll try and stop myself before I get off on a tangent. . . but isn't an A1C of under 7.0 considered pretty damn good, according to the ADA? Your body makes no insulin. Unless you want to spend your days eating the same meal, at the same time, and pretend like you live in a vacuum with no emotional upsets, exercise, stresses to the body or mind in any way . . . crap, even that won't work. A Type I diabetic is going to have major blood sugar flucuations NO. MATTER. WHAT. She is busting her ass, testing like crazy, and doing everything as best she can. So what is this "uncontrolled" garbage? How about having a box on the form that says "This disease sucks ass; all things considered she is doing very well." Then the other box can say "This disease sucks ass; patient doesn't give a hell and walked in with a jumbo-sized Pixie Stix."

I guess that box on the form hints at the fact that the ADA may very well be full of caca-poopy. How do they know that an A1C of under 7.0 guarantees long life? What if the only way to escape DEATH BY DIABETES is uh, if you aren't diabetic? (And let's not even get into the "the A1C is not a good indicator of overall control" discussion.)

The word on the streets right now is that no one really knows what's gonna happen to us "kids" working to keep our A1Cs under the magical threshold. All the studies on what creates complications are based off of the older diabetes models and patients. The whole culture and feeilng surrounding diabetes is best summed up by those magazines I receive from my insurance company in the mail . . . some cheap, thin rag with a retired gentleman walking his dog on the cover, and the same tired "information" inside. Are you testing your blood sugar regularly? (I could cut glass with these finger calluses.) Do you know the symptoms of hypoglycemia? (Rattle n roll, tootz.) A yummy meal plan for you! (Wow, fat free imitation butter spread AGAIN? Shocker.)

Is 6.9 good enough? Is 6.8 (my last one, in January) good enough? Is 6.2 (my 2nd-to-last one, in September) good enough? Is anything we do good enough, or are the complications inevitable?

I guess I'm also curious at what a typical A1C is for people who are "controlled" - I mean people who test more than 4 times a day, count carbs every time they put something into their mouths, and think they have a pretty good handle on basal rates and bolus ratios. I think my view of this is a little skewed since I'm a regular DM visitor, where the ladies have some of the most stellar blood sugar records around (babies have a way of motivating like nothing else). It's easy to feel "out of control" there when your two hour post prandial reading is - gasp - 140 or your A1C rockets off the charts at 6.5+.

Thursday, March 1, 2007

Emotional Organs

When I think about my pancreas, I feel sad. I want to cry for my pancreas. I have in the past. Maybe I'm melodramatic, but I imagine my pancreas a prisoner inside of my body, struggling and sighing with exhaustion. "Saaaaaave meeeeeee...!"

I wonder what it looks like these days. Was it pink and healthy in 2001, and now it's grey and war-torn? Or has it shriveled, become a ghost of its former self? Is it like those pictures of a smoker's set of lungs, next to the pristine tissue of a non-smoker?

According to a biology professor, my pancreas still makes enzymes like lipase and amylase, even though I am diabetic. (He winced a bit when I asked him. "Don't bother me, kid!") Of course I've never thought to ask an endocrinologist, but I assumed that those enzymes were secreted by different cells. So maybe my pancreas is still alive and kicking (working hard or hardly working?), still pumpin' out those enzymes . . . it's just the beta cells that I should be sad for. The loss of those extremely important little dudes, pumpin' out the amylin and the insulin. I still take an enzyme supplement just in case.

I'm not perfect. I don't always respect my body as much as I should. But I still feel sad about my pancreas.

What about my immune system. Isn't it the killer of my beta cells? An insane murderer? "Your honor, my client was unaware of the consequences of her actions. She was out of her mind, your honor." Forgive it, for it knows not what it does.

No, I can't be angry at my immune system. I feel sad when I think about it, too. I was never one to get sick. The only notable childhood illness I had was the chicken pox, and it wasn't a bad case. These days the old I.S. is still pretty darn reliable. I use and abuse it every day, and it's still tickin'. Since I've been diabetic the only problems I've had were an ongoing infection (pilonidal cyst, a tough cookie to tackle for anyone's immune system), a short-lived pink eye infection in college, a moderately crappy sinus infection, and a cold this past fall that was over in three days. Kudos to my immune system.

I feel sad because I feel like it was something I did. No, I'm not talking about the idiotic "You must've had too much sugar when you were little." I feel like it was my inability to say STOP to the Type-A side of my personality that pushed me to the breaking point in my academic career, and still wants to push me to stay in a high stress job. Why do I do this. Why is this important to me. Who the eff is going to care about this in 100 years. No one, no one. Yes, there are some things I couldn't have known, couldn't have prevented - genetic predisposition, or the fact that I had had an ongoing infection from the time I fell on my tailbone when I attempted to ski for the first time, or the reaction my body would have to the multiple vaccinations I received for entrance into university. You can't tell the medical establishment to go screw itself if you don't know if they're wrong, anyway. But I think I had a choice, and I still have a choice, when it comes to the stress and the self-degradation and the push to be important, to "add value," to Be A Success. I could tell society to go take a flying f**k at the moon so that I can just chill out and spend my time taking care of myself instead of always telling myself I've got...to...do...this...or...be...this...because...I...should...

Oh damn, how do my posts always degenerate into hippyfests? I feel like it's so unrealistic to want to step out of this whole show, like it's never gonna happen. I'm just going to keep doing it to myself. What's next, cancer?