Friday, February 29, 2008

You are what you eat . . .

. . . and your unborn child is also what you eat. In my son's case, he is mostly composed of the following:
  • Subway (6 inches on wheat of turkey or Italian BMT, tuna once a week)
  • Baked Lays (sour cream & onion or BBQ)
  • crackers with peanut butter, or crackers with cheese
  • Quaker Oats granola bars (my favorite thing to treat lows)
  • Juicy Juice (Comes in handy 15g boxes; grape or fruit punch flavor. What I drank at least 2 of each day in my first trimester to keep above 50 mg/dl at any random moment.)
  • chocolate chip cookies (honesty, best policy)
  • cheddar cheese and mustard sandwiches on Nature's Own low-carb wheat bread (yeah, sounds gross; tastes like the nectar of the gods)
  • golden delicious apples
  • Mediterranean chicken salads from Au Bon Pain
  • Dannon light yogurt
  • oatmeal
Does it sound like a typical diabetic diet? Ha. My 14 day average is 102. I'm happy (AND STILL HUNGRY!)

Thursday, February 21, 2008

Aunt Minnie and me.

I've read a couple of posts recently on two of my favorite diabetes-related blogs (Kerri's and Scott's) that made me want to bring up a topic that upset me pretty badly recently. Ready for the whine? GET YER CHEESE OUT!

The "etiquette" of testing your blood sugar.

Okay, I have to be up front and say that that sentence alone makes me want to snort in disgust. Ridiculosity abounds! My gut reaction as a Type I is that testing blood sugar doesn't fall into the realm of napkin-on-your-lap excuse-me-please societal rules. It's just something diabetics have to do or we die. End of story. most of us folks with diabetes know, the rest of the (diabetes-free) world may not identify with or understand that at all. Even if they SAY they understand it, they don't.

So I read about Kerri and Scott's trials and tribulations when it comes to actually getting the used strips in the trash can. I'm not pretending like I don't have the same problem - just emptied out my purse this morning and there were about 10 of the little boogers hanging out at the bottom. I find them on the floor of my bedroom, on the kitchen floor, in my shoes . . . the point is, a diabetic is going to leave some detritus around at some point no matter how vigilant or clean we try to be. Usually our diabetic trash involves blood. Yeah, the blood is often a minuscule amount, but it's still blood. The idea of coming into contact with blood, even SEEING blood, squicks out many a non-diabetic (and many a diabetic as well). So how to deal with the etiquette problem of testing your blood sugar/taking a shot/changing your pump site in public, or in mixed company of any sort, when it's sure to cause at least mild disgust for one or two witnesses?

This very subject came up on a thread last week at the popular Etiquette Hell forums. Most of the posters chiming in agreed that testing blood sugar or taking a shot at the dinner table was just not in good form, at all. ANY blood in public is unacceptable (but I guess that guy coughing into his sleeve over there is okay, he can't help it and he's doing his best to contain his mucus). I mean, guys, can't you go to the bathroom and do that gross stuff? Jeez. My Aunt Minnie faints if she sees blood. How come you aren't taking my Aunt Minnie into consideration when you start splashing blood around at the dinner table?

The diabetics on the thread said hey, we've gotta do this, we're pretty discrete about it, we try to be clean, we're not always able to test in private. Some apologized for not taking Aunt Minnie into consideration in the past; some said they tested in the car before going into the restaurant or tested in the bathroom stall to avoid making others feel uncomfortable.

I have to admit that although I respect that some/most people have a serious problem with blood, I was flabbergasted by the attitude shown by the non-diabetics and the apologetic diabetics (ha, rhyme!) We don't care if you have to do it: we don't want to see it. It's gross. It's rude. Your best efforts are not good enough, if I have to see it.

Here's what testing involves, in my world:
  • About ten tests a day. Before I eat, and after I eat. Whenever I feel "off," too.
  • A lancet device, with a hidden needle to prick my skin.
  • A small drop of blood, that I touch to a test strip immediately after it surfaces. (In other words, I'm not starting a catheter up or squirting blood across a wall a la cheap horror flick.)
  • Disposing of any excess blood on a piece of tissue in my testing case, or, yes, in my mouth. YEAH, I'M A LICKER.
  • Tossing the used strip into the trash, or keeping it in my case until I can get to the trash.
  • Whole process takes about 10 seconds. I can do it my lap. 99% of the time, no one is the wiser.
Sometimes I'm testing under ideal conditions. I'm at home, or at my desk at work, and I can do the test privately and get on with my business. My blood sugar is good and my hands are steady. Other times, not so ideal. I'm in the toilet paper aisle in Target and I realize there is a problem. I'm shaking as I guide my finger to the strip with a Herculean effort while I stand behind my cart. Walking to the bathroom at that point, across the store, would be kinda fricken dumb. Am I supposed to consider the feelings of others when my blood sugar is 35? Or should I focus on not passing out or having a seizure? Where does etiquette come into play here?

While I admit licking blood off of my fingers is pretty gross, I take umbrage with the opinion that taking a shot in the car before a meal is preferable to taking it at the table. There is no guarantee when eating out that food is going to arrive in time to cover that insulin I oh so politely dosed ahead of time. That just doesn't work in the real world - in my diabetic world, that is incredibly foolhardy. I also take offense that because I could possibly leave a red blood cell on the table, I should be testing in a toilet stall in a public restroom and introducing gosh-knows-how-many pathogens into my bloodstream. In both of these situations, I'd be putting myself into real, physical danger because of the possibility of offending someone else.

The risk of not testing, or of testing in a grossly inappropriate place, seems to me of much greater concern than the comfort or disgust level of the non-diabetics around me. And the practicality of dosing insulin or testing when I am absolutely alone or in a private place 100% of the time is close to nil.

Am I rude? Do I care too much about what other people think? Is a diabetic's used test strip on par with radioactive waste that the general public should be totally sicked out by? What do you guys think?

Thursday, February 14, 2008

What's the point?

It's a boy! :) After a week chock full o' doctors appointments (endo on Monday, pediatric cardiologist on Wednesday, perinatologist this morning) the baby is looking fine and dandy. We've decided to name him Jason and the nursery is coming together nicely. I'm so excited . . . but at the same time I'm going through a strangely boring period of the pregnancy. I guess I'm not big enough to be super uncomfortable yet.

My blood sugars were less than great last week, but my endo cleared things up for me. I went in with a week's worth of charts and a list of suggested changes, all of which she agreed with - but I let her do the math. Now my I:C ratios have me staring in shock when the bolus wizard calculates a dose, but I was prepared for this by years of community participation at Diabetic Mommy. I'm down to 1:5 at breakfast and 1:7 the rest of the day - holy cow! She said to expect the insulin resistance to ramp up and up from this point on. In the meantime it feels REALLY strange to take 10 units of insulin for breakfast, when I usually take 2 . . . but I can't argue with the numbers this week. They've been awesome. My most recent A1C was 5.4, up from the 4.8 but still great in my opinion.

We had a fetal echo cardiogram performed to check for any defects in Jason's heart. The tech and the cardiologist both asked me why I was there with a quizzical look on their faces - and although my response of "I have Type I diabetes" seemed explanation enough, the doc still seemed a little nonplussed as to what the fuss was about. She said, "His heart looks perfect," and sent me on my way.

Today was a routine check-up at the high risk OB's. I'm going twice a month now (and at 32 weeks will go twice a week, ouch) . . . I had the gall to ask the doc what the purpose of the visit was, and she seemed a little put out and didn't answer me right away. "You are just checking up on things then, I guess?" I offered, and she said yes. Ooooohkay. So I take a two hour chunk out of my day to tell her things I could tell her over the phone in 2 minutes (how are my sugars, what is your A1C) - and she gave the baby only a cursory glance on the ultrasound screen. "Look, there is his heart beating." Yeah lady, I know, I stared at his heart beating for 35 minutes yesterday. I could've told her he was still alive as he was kicking me at that very moment, and she didn't take the time to see if there was anything else to note besides his heart.

So, I'm trying to take away what is important and what isn't from my first experience as a pregnant Type I. I think the AFP and nuchal translucency tests are worthwhile. I think the echo cardiogram was worth it, kinda, although after getting an all clear at my Level II ultrasound it did seem redundant. I'm not sure that I will be running to a high risk practice with my second child, though - I feel like my doctors are honestly bored with me and don't spend very much time with me at all, even though this is my first pregnancy. They look, they see nothing to alarm them, and they shoo me out of the door. Next time I may try to go with a single OB - and let him/her refer me to a peri as needed.

I'm very relieved that thus far my diabetes hasn't had an impact on Jason, but I am a little disenchanted with the high risk fuss. I'm pouring out a lot of money in copays on people that ask me why I'm there (shouldn't they know?), or expect a lot out of me (do this do that wait an hour to be seen by me just to have me ask what's your A1C), but don't give a heck of a lot back (okay well, we're done here, bye).