The SDE: Spontaneous Diabetes Explosion

Explosion“Ok and with your steak tonight miss did you want a baked potato or french fries?”

“Um, neither, thank you. I’m good.”

“Are you sure, they come with the entrée for free?”

“No thank you I don’t want any. I have Type 1 diabetes and I just don’t eat potatoes that often. It’s not that I can’t eat them ever it’s just that they’re really hard to manage for me so I just generally don’t have them and it doesn’t bother me because I don’t even like potatoes that much and…” oh my god please stop talking Lexie this poor waiter doesn’t need to know all of this!

Ever found yourself over-explaining diabetes to a complete stranger for no reason? I found myself doing just that last Wednesday while at dinner by myself in a little town in Eastern Washington state. I was staying the night there for work, and had wandered to a local chain restaurant, laptop in hand, ready to crank our some work and enjoy a nice, low-carb steak and salad dinner. But apparently, one little question about potatoes was all I needed to turn in to an over-enthusiastic, over-sharing little bundle of TMI. And although I consider myself very open and willing to talk about having diabetes, this was a little much, even for me.

Why do these spontaneous diabetes explosions happen sometimes? Why do we sometimes feel the need to justify and explain our disease to some people – even if they couldn’t care less?  And even for those who do care – do they really need ALL the details? Probably not.

I think the answer lies in the fact that for us folks with diabetes, our brain is so often crammed to limit with diabetes stuff, that it’s all we can do to keep it from spilling over some moments. What that waiter doesn’t know is that as I’m scanning the menu, I’m also clicking in the trend line on my CGM, thinking about my IOB, wondering if that 20 minutes on the elliptical is hitting me now, and curious if the their “world-famous steak glaze” is packed with sugar. It’s almost as if him coming up to take my order shocks me out of my little diabetes number-crunching bubble that I’m living in. It’s actually a wonder that more outbursts don’t occur, given the amount of time diabetes is running laps through my mind every day.

Some of these explosions occur more subtly. It’s those moments when a friend asks how you’ve been and you realize you spend 20 minutes talking about how absolutely bonkers your BGs have been for a few weeks. It’s the moment when your sister asks you if your pump is waterproof and you wax eloquent on diabetes innovations for the better part of an hour. I think what this shows about us is that we do have a tremendous need to talk about this disease. Because when we keep it all inside in that little bubble, it’s bound to burst at some point. Diabetes takes up way too much of our mental capacity to not overflow at some point.

If you’re lucky, these explosions land on family members who patiently listen, nod their head, ask questions, and support you. And if you happen to do it to the poor waiter in small-town Washington who was just freaking wondering if you wanted potatoes, well, just accept his polite and awkward smile and move on – no major damage from that explosion except maybe you gave him a funny story to tell his coworkers at the end of the night. And that’s ok!

Fancy (low) pants.

For the past few years, my stepmom has given me candy in my stocking for Christmas – and not because she’s trying to tempt me. She gives me Jelly Beans in small packets and boxes that are great to stash for lows in the car or my gym bag. I’m always happy to have these on hand because hey, they taste way better than glucose tablets and they work fast. So when she gave me a bunch of assorted Jelly Bellys in my stocking this Christmas, I took the haul and tossed it in the center console of my car without much of a second glance.

And then I got low yesterday, and reached for a packet. I quickly realized that these were no ordinary Jelly Bellys…no my friends these were special Jelly Bellys. Fit for royalty in fact, as evidenced by the illustration on the packet. And when they say “sparkly” they do not disspoint. Nope. Those are ACTUALLY SPAKRLY JELLY BEANS. The enchanted kind, as it were. Who knew?

photo

Most fabulous, fancy  low snack ever? I think so!

Burn less, Basals up

TotalsHow can I NOT start the new year with a post about exercise? I wish this was a post about how much exercise I’ve been doing and what cool new race I’ve signed up for as a resolution, but it’s not. No friends, this is way less exciting. I have an injured Achilles tendon and I’m pretty much here to tell you that this is one big bummer of an injury (sorry, I was probably supposed to start the year off with something positive….later this week maybe? Can I just bitch for one post? Ok thanks….)

I ran a half marathon in August of this year, and it went great. Towards the end of my training though, I noticed pretty consistent and troubling pain in my left Achilles. It would be the worst first thing in the morning upon getting out of bed. I would run on it anyways, and the pain would subside about five minutes into the run, then return full force shortly after finishing. It got bad enough that I would hobble a bit in the evenings after a morning run and walking on it all day. Not good.

I did some research online: really not good. Achilles tendon tears can be career-ending for runners. They occur more frequently as we get older (great, thanks for the reminder), and they occur when ramping up mileage or speed too quickly (I trained pretty fast overall for the half). But I actually didn’t need the internet at al – I need not look further than across the breakfast table to know I had to work on this injury. My husband actually blew out his Achilles several years ago. He said although it wasn’t a crazy painful injury, the rehab was torture. He was forced to stay off it completely for weeks, completely limiting his mobility. The road to rehab was long and boring, and he has said more than once that it was one of the most challenging times in his life. Yeah….let’s not push it with this one.

I took a firm, no-running whatsoever stance way back in November, with the intent to give it two weeks and see if it improves. Now, I’m nearly six weeks deep of no running and it hasn’t improved much. Next week I’m going to see a doctor about it finally, but I’m concerned about it.

Without running, my activity level has changed quite a bit. I still have to get the dog out several mornings a week, so I’ve been walking her for an hour in the mornings. And if you thought getting up at 5:30 to run for 30 minutes in the Portland winter sounded unappealing, trying getting up twice as early so you can walk twice the distance and not be nearly as warmed up as a run would get you. Super. Lame.

I’ve been going to strength training classes as well, but there’s nothing that torches calories or is as mobile as running. My work trips have forced me to get on the dreaded elliptical in hotel gyms, and truly, I would rather watch paint dry than do the elliptical, I find it so so boring.

The biggest challenge with all of this, aside from me missing running is that it has quickly cranked up my insulin needs. You can see it as clear as day between my endo appointment on September 1 and the one on December 5th. My total daily units in September were in the high 20s. December has shown a 10 unit increase to the high 30s. Ug. We all know more insulin means more weight gain, which can lead to insulin resistance. I’ve gone up a few pounds despite my best efforts to eat well, partially because I have to maintain this low A1c. And lemme tell ya, the holidays is not the season I want to be restricting anything.

I am hoping a trip to the doctor will at least give me a clear path of how to move forward. My fear is that I won’t be able to return to my beloved running, but I’m trying to think positive. Until then, I’ll be the crazy dog lady on walks at 4:45 in the morning….see ya out there.

Happy New Year!

I’m taking a much needed break as soon as the clock strikes midnight on the 31st. Right up until then, I’m trying to close out the year at work. So I will leave 2014 with a simple thank you to my readers and the Diabetes Online Community. You are the reason that I know I am never alone with diabetes. Thank you for being my support and my sounding board for another amazing year.

To a healthy, happy 2015, full of low A1cs, and high amounts of joy.

 

Happy New Year 2015

 

 

 

 

 

 

Merry Christmas!

Wishing you and yours a wonderful, magical, healthy Christmas full of joy and flat-lined CGMs. From our Little Elf (who has still not forgiven us for this photo) to you and yours!

 

Cal Dog

 

Diabetic Diet secret – FOUND!

This was spotted at the zoo the other day by my sister. I’m so glad they’ve found an easy way to control the monkey’s diabetes! I’m going to try this whole “don’t feed me anything” routine. Sounds like it will work wonders for my BG control….

 

The Zoo

Holidaze.

Someone. Please. Carb. Count. For. Me.

BRAIN CANNOT COMPUTE! Also I’m really hoping I packed extra Humalog right about now….it certainly is the Holidays!

The Cookie Party

 

 

 

32. And 22.

Bday cake with candlesToday I turn 32 years old. And next week, my diabetes will clock 22 years. I’m now in a category of “more than two decades with diabetes.” And also “in my early 30s.” I can’t have a birthday or a Christmas without thinking about my diagnosis and my duration with this disease,  because I was diagnosed on Christmas Eve in 1992. My birthday, Christmas, and diabetes are all intertwined. Because they all fall in December, it always feels very official when another year passes, because it’s the end of the year and a time for reflection.

This year, I landed a job at a company I’ve had a career crush on for years. It has easily been the hardest job that I’ve ever had. The hours are insane, the workload can be crushing at times, and the pressure is high.  But every single day, I think about how lucky I am to be here in this exact moment in my life. I get to help other people with diabetes live better every single day, and that is the part of my job that sings to my soul. How blessed I am to have found a career where that’s possible in the day to day work I do? I find it especially poignant at this time, almost one year into my tenure with the company. Because this time last year, I was still without a job, worrying about my future, and wondering if I’d made a huge mistake moving to Portland and away from my job network in San Diego. My, what a difference a year makes.

This year was a pivotal one for my diabetes management too. After struggling for a full year to bring down the high A1c that our trip to Asia created, I settled into my comfort zone of the low sixes, only to be told that wasn’t good enough if I wanted the best possible chances for a healthy pregnancy down the road. I had been in the fives once before, and that had to have a been a bit of a fluke – an average of way to many lows. But this time, I took on the challenge and cranked up d-management. I bolused corrections for 145s and restrained myself to one glucose tablet for 72s. I cut carbs and increased my exercise.  This kind of dedication is not easy and I don’t know that I’d recommend it, outside of this particular situation of wanting to have a child in the near future (still not pregnant folks, by the way….I intend to celebrate my birthday tonight-with wine!)

But when I hit that 5.9 A1c – and not because of a fluke but because of my very own hard work and dedication – that felt as good as it gets. And even though 22 years with diabetes has cracked the door open for the dreaded complications, with mild retinopathy now sitting on my health chart, I feel empowered to lean into that door harder than ever to shut down that specter of further complications as long as I can. When we accomplish something we were scared of or thought we couldn’t do with diabetes, that ramps up our Diabetes Confidence and helps us prepare for the next battle. Getting to 5.9 has shown me that what I thought was impossible is actually within my reach.

Today, while I reflect on the amazing, crazy, challenging, sometimes exhausting and sometimes utterly exhilarating year I’ve had, my accomplishments and challenges with diabetes will be there. But they will simply be one part of a wonderful year – not the centerpiece. There are too many other things to be grateful for.

That Christmas Magic.

Bolus – worthy is the term we usually reserve for sweets and treats that are a pain to dose for, but oh-so-worth it once in a while. And on Sunday, I had one of my best buds over for our now-annual cookie baking fiasco. We’re both decent cooks (she’s actually phenomenal – her enchiladas could make a grown man cry. I’ve literally seen it happen) but somehow, when we get to baking, things go all kinds of wrong.Cookie tree Gingerbread men fall apart, recipes don’t make sense, and more often than not, the best of the baked bunch ends up being the scraps of the experiments we tried but miserably failed. I’m not above frosting a Gingerbread man’s leg and calling it dessert. That happened. Cookies, I’m sure, fall onto many people’s bolus-worthy lists. But it’s more than that.

CookiesBolus-worthy is that moment when a new Christmas tradition is born. Bolus-worthy is when you’re laughing so hard with your friend that neither of you can breathe or even remember what was so funny in the first place. Bolus-worthy is making a somewhat-decent cookie tree in honor of your late Great Aunt, who used to make a beautiful one each year. Bolus-worthy is being ok with the 194mg/dL you end up with after ingesting half a pound of cookie dough while making said tree, and actually feeling like, “hey, I managed to keep it under 200mg/dL even with all these cookies – WINNING!” Bolus-worthy is not missing a single experience in life.

Bolus-worthy is not letting diabetes stop the magic of Christmas. And we’re so lucky that we CAN decide if things are bolus-worthy to us or not in this day and age. It wasn’t that long ago that all of these foods were viewed as off-limits according to traditional “Diabetic Diets.” My how times have changed – I can watch the rise and fall of my BG on my CGM, and bolus with the touch of a few buttons to iron out the damage. Although not every food is easy for me to eat and manage, I have the confidence that I can handle it if needed.

And there’s nothing more bolus-worthy than time with the folks you love.

Oh, that’s what that’s called.

I explained to my endo on Friday that I feel like I’m doing everything I can to keep my BGs nice and smooth and maintain this crazy low A1c (actually that remains to be seen – getting it drawn on Wednesday!), but I told her that exasperatingly, I was still getting these odd spikes in the middle of the night, despite bolusing well for dinner and going to bed with a good BG and tweaking my basals. It wasn’t happening every night, but enough to drive me a little (ok…a lot) nuts. It just didn’t make sense, there wasn’t much of a pattern to it, but when it happened it ruined the night of sleep and usually the next day.

She asked me if I had ever heard the term gas-lighting. I had not.

She explained to me the term comes from a story from Ye Olden Days when we used gas lamps to light our homes. A man would turn down the lamps ever so slightly at night and when his wife would ask if the lights were dimmer he’d say “Why no, not at all!” leading her to believe that she was going crazy when in fact, she was being messed with.

This, she explained, is gas-lighting, and it’s something diabetes does incredibly well. It messes with you just enough so that you have to wonder if it’s the diabetes…or maybe it’s just all in your head. It’s those times when you feel like there can be no possible rational explanation for whatever nonsense diabetes has put on your plate that day….and it turns out that you’re right and there is no explanation. It’s just diabetes utterly, royally, unapologetically effing with you. I love this new term because it so perfectly describes what happens with diabetes and why the mental side of managing this disease is the crazy-making part, not the injections/bleeding/finger pokes. That stuff would be downright easy if only it worked every time, for every situation. But it doesn’t and the subtleties of this disease are where you can make yourself nuts. I’ve been getting gas-lit by diabetes for over two decades now, and it doesn’t make it any less obnoxious. I’m so glad I have a new term for the nuttiness though!

And apparently, it’s a totally acceptable medical term. Because it made it right into my chart notes, all official like. Love it.

Gas lit