Wednesday, May 26, 2010

Can't win for losing.

I've been really diligent about my logging since April. I have logged every. single. day. since I started down this heinous path. Has it been like pulling teeth? Yes. Do I still hate it? Yes. Have I been doing it anyway? Damn skippy (albeit with gritted teeth and clenched jaw).

And aside from the past five days or so (major food-bender derailment after some bad news last week, where it was more of a "Keep from weeping, the D and perfect BGs can be on the backburner for a little while" than it was "Log! Test! Eat right!"), my work had been paying off with BG averages in the neighborhood of 115. Crazy when all that work actually has an effect, right?

Then my CDE emails me today, saying the Kevin logs I've been sending are great and all, but I need to start using their form. Their horrific Word-doc table that doesn't hold formatting

vs. the glory that is Kevin's log with colors! and graphs! and pie charts! and insulin tracking! and! and! and!

I've been so peacock-proud that I've stuck with the logging these past weeks and now I feel deflated.

Tuesday, May 25, 2010

At the heart of it

Yesterday was my first-ever appointment with a cardiologist.

Waaaay back in December, I was told to follow up on an off-handed note in my medical records about a heart murmur. Note the tone of "off-handed" and "waaaaay back," please. Clearly, I had nary a worry about my ol' ticker. I thought the doc was being overly cautious, and didn't really feel like there was a problem that warranted a new specialist, a new test, and all the rigmarole of getting that ball rolling. But, since that was how my diagnosis with the D started out, I figured it's better to be safe than sorry and made the appointment. Or tried to.

My endo recommended Doctor Smeisensmerg. I gave 'smerg's office a call, left a message. Lather, rinse, repeat for three weeks - messages, calls, my endo getting involved, more calls and messages - all to convince the 'smerg that a relatively healthy 32-year-old T1 woman with a thyroid condition, possible murmur, and insane maternal family history of vascular disease might warrant an echocardiogram. At long last, having secured the Golden Ticket appointment for a consult (consult!! not even the test I'd asked for!!), I waited the weeks until said appointment.

The day arrived - in the midst of busy catalog close, of course - and I scurried to the appointment. I walked in, schvitzing from said scurrying, proudly announced my name and appointment time, produced my insurance card with a flourish and....

Receptionist: Oh. He doesn't take Blue Cross.
Me, eyes popping: What?! I checked the site - they said he was a provider.
Receptionist: Oh, he was. He just isn't any more. We sent letters to our patients.
Me: I never got a letter!
Receptionist: Well, you're a new patient. We couldn't have sent you a letter.
Me: I see other doctors at this facility!! I'm in your system!! You could have called me - I confirmed my insurance with you when I made the appointment!!
Receptionist: You were a new patient. [Blink. Blink.]
Me: Well, FINE. I guess I don't need to CANCEL then.

And I stormed out.

My second attempt at getting an appointment went more smoothly, to say the least, and I had another date booked for less than three weeks later. I went in with a combination of eye-rolling exasperation (clearly there's nothing wrong with my heart, so why am I here?) and nerves. At this point in my medical life, it's rare to meet a whole new world of doctors, so it was kind of like a first day at school when you thought you were long done with classes. I had no idea what to expect...and it ended up being a freakily cool appointment.

I got to see my heart on TV. A little sonagram-esque TV, sure, but there it was on a screen. I got to see all my valves flipping and flopping, the blood (colorized for my enjoyment!) squooshing and moving, all the chambers moving to the beat of this crazy muscle that lives in my chest. It was astounding, and rarely am I astounded by biology any more - everything looked so small and fragile! So delicate! All I could think is it's a wonder any of us live at all if we're relying on all these little tiny flaps and vessels to keep us going.

The end diagnosis? One of my little flaps doesn't seal quite like it should when it's done flapping, or I have "trivial mitral regurgitation" - a condition shared by something like 70 percent of adults. In other words, I do indeed have a heart murmur, but it's not anything to worry about at this point. Besides being thrilled to get mostly-good health news, my big takeaway is how cool - and precariously balanced - the human body is. It's no wonder our parts wear out (helloooo right shoulder) or break (helloooo pancreas and thyroid), and it makes me feel a little surprised that my ol' jalopy works as well as it does...and a little more forgiving that it doesn't.

Friday, May 14, 2010

In other news...

I had my first bleeder last night. Popped the set out and "BWWWUUUUUUSHHHHHH" - a giant stream of blood ran out of the hole:

It freaked me right the hell out, but I had the presence of mind to cup my hand under it (cupped! like I was getting water out of a lake or something!) and salvage my pants - only the top of my underwear got all gross before I slapped a paper towel on the river of blood.

Note to self: Never, ever do a set change without something absorbent at the ready.

FAIL: One Touch UltraLink, or Why my forehead vein won't stop pulsing

I've been busting my hump since last summer, working toward tighter and tighter control. I started the pump, I'm rockin' the Dexcom, I'm logging religiously, and I'm testing like nobody's business. And with all of the resulting insane, creepy focus - seriously, it's like my BGs are celebs and I'm a hard-core stalker - I've noticed that my One Touch UltraLink sucks.

I know meter accuracy has been a big issue in the DOC, as it should be. 20 percent +/- accuracy is just ridiculous, and not helpful for correct dosing or closely managing the D. But this is getting out of control. In the past month, I've seen more than 100-point discrepancies between blood sugars done mere seconds apart. My own failsafe of "Hmmm, I don't quite feel like I'm only 130" is not nearly as helpful as Dexcom's bellowing for a new BG when he doesn't think my calibration is right, but the fact is that I'm using failsafes for a piece of machinery from a company that declares "Our DoubleSure Technology automatically checks each sample twice to confirm the result."

Bullcrap. Are you telling me that the two BGs I did this morning at 1:55 - 66 and then 107, which is closer to a 40 percent variation - is the awesome result of FOUR separate failing tests? Nice job by you, Lifescan!

As I've been noticing this more and more (thanks, Dex, love you), I became convinced it must be a lemon meter. And so I called Lifescan this morning. Hoo boy.

Had I tried a solution test on my strips? Yes, yes I did. It's not my strips.

Do you touch the strip when you apply blood? No. I use a bead of blood and allow it to be drawn into the strip. Like I'm supposed to.

Does your last result say "mg/dl"? Are you kidding? Do you think I've JUST noticed that all my BGs are being given in Canadian?!?

Were the strips opened more than six months ago? Is the vial cracked or broken? Uh, no? These are basically a week old. Maybe less than that.

We continued on in this "Are you screwing up the BG test procedure?" vein for quite some time, and then we reached the point where I lost it:

Have you experienced symptoms as a result of this problem? Um. Excuse me? Symptoms?
From the readings. Did you have symptoms because of the problems? I had to retest because the BG was incorrect. If I didn't retest, I would have dosed insulin or treated with juice incorrectly and then would have had symptoms.
So you didn't have symptoms. [Getting a little testy now.] I didn't have symptoms because I've been doing this for 16 years and I know that if I don't feel the same as my meter's telling me, I should retest. But I would have had symptoms if I didn't know your machine was wrong.
I understand. But you didn't have symptoms? If you want to twist it that way, no, I avoided having symptoms.
Great! It sounds like the machine is working the way it's supposed to, as there is an error of margin for results. It could be your insulin. [Officially lose it, and bark a laugh out.] That's not how insulin works! I was taking tests within seconds of each other! The error is completely on the machine!
Well, but the machine is working how it's supposed to. If the solution test gives you results within the range on the bottle of strips, the meter is working correctly. So what you're saying is that, because the solution test was right, the machine is working perfectly?
Exactly! It's just that it's working perfectly crappy, because the results are completely useless. Thanks so much for your time.

And then I hung up, spluttering in frustration and anger. I get that she's some lowly tech support person who clearly has no clue about the way this disease works. I. Don't. Care. It's on Lifescan and Minimed and all the companies who make a gajillion dollars off diabetics to get their sloppy acts together, from customer service reps (she asked if I was on a Dexcom pump! DUDE. I use the UltraLink. Ya know, the one your company makes for Medtronic?!) to their products. I couldn't turn in my work at the office and say "If this was a good day, it's only 20 percent off what you wanted. Maybe 40 or 60 percent! Who knows?" How can they?

Fail, Lifescan. Fail.

Wednesday, May 12, 2010

Song in my head upon waking: "O Valencia"

A killer deadline week at the office means nothing much to write about - or the time in which to write it! - aside from work dreams. My poor brain must feel bad for me, though, as I woke up with The Decemberists' "O Valencia" in my head this morning.

Excellent work, brain!

Monday, May 3, 2010

"Diabetic pasta" redux

Green beans as a sauce delivery vehicle are, as I've mentioned before, my favorite workaround for the MEF that is pasta. But, in complete honesty, they aren't that very attractive. In fact, they're the Shrek of dinners - kind of green and lumpy. Certainly not a meal I'd be able to subject another non-D person to (B - I'm lookin' at you), and I've got my eye on the "I cook all the time for me and other people I love" prize.

So I've got a fancy modified version of "diabetic pasta." Behold:

It's pasta, yes, but with wilted spinach leaves. The spinach is bolus-friendly and makes for a nice color variation in the bowl...and don't we all want to eat more colors? I simply wilt the spinach leaves in a pan with a bit of olive oil and chopped garlic, and add to the pasta once it's done cooking. I use fresh, per my Mom's advice, but I've used frozen successfully in a pinch - just make sure it isn't too wet when you add it to the pasta. In the photos, you can see a regular red pasta sauce. Tasty, but I tried a no-tomato version the other night that was equally good - just toss the cooked pasta and spinach with olive oil, coarse salt, garlic, pepper, and parmesan cheese. Molto bene!