Wednesday, June 30, 2010

My skirt has pockets

And after a pump-holster day yesterday, I'm quite enjoying the hands-free pump and Dexcom storage.

Tuesday, June 29, 2010

A nice streak for the day!

And that's with my job review from this afternoon! Let's see if it holds steady when I get my midterm back...

Monday, June 28, 2010

What's $30 and was born at Anthropologie?

THIS DRESS. Which is an impossibility, for a number of reasons, but I'm not one to look a gift horse in the mouth. Thanks, universe!

Thursday, June 24, 2010

Bleeeargh, and thank you.

I have eaten so many of these things in the past three days that my tongue feels all strung out, a little hurty, and totally gross every time I pop another one in my mouth. Kind of like when I was a kid and I devoured a whole roll of Sprees every time we went to the movie theater.

That being said, when I'm riding a Dex curl of 70, they're my best friends. Tongue-murdering be damned.

What I'm reading: Olive Kitteridge

Oh, the beauty of working in book publishing! I finally started Elizabeth Strout's Olive Kitteridge, which I picked up a few months ago at the office. I'm not terribly far through it, but I can confidently say I think I'll end up loving it to little, tiny pieces. Beautifully written and heartache-inducing - I got off the subway this morning with a vague ache behind my sternum. A physical reaction to reading is always a sign of a good book....

Wednesday, June 23, 2010

Hang on - it's gonna get a little mathy.

Disclaimer up front: No judgment either way on the numbers, folks. If I didn't have a very, very specific A1c goal - and been putting in a lot of blood, sweat, and tears to reach it - I would not be squawking about my results.

I had my blood drawn for an A1c last Monday. I was fiercely nervous, as this test was going to be the "Am I working hard enough?" gauge for the future - my A1c in March was a 6.4 and since then I'd started intense daily logging, using my kitchen scale (!), and seeing a lot of lows. My meter's 7-, 14-, and 30-day averages were all under 120 - that's an amazing eAG! All of these were signs that, to me, meant even if I didn't achieve the insane sub-6.0 I was aiming for I'd likely get a better than or equal to that 6.4. Yay me!

Or so I thought.

Instead, after many emails to my CDE and endo trying to pin down whether the results were in as Quest said they would be, I got this from my doctor while I was sitting on an architecture boat tour on the Chicago River: "The HbA1c went up a bit to 6.8%, so please start sending records for us to review." My instant reactions:

1) Of course I started crying. The huge wave of surprise and disappointment was a lot to handle all at once. Thankfully, it was sunny and I was wearing giant sunglasses - otherwise, I would have expected awkwardness with the tour guide:  "...and note how the triangle is echoed at this apex, as well. New Yorker lady, are you CRYING?! I know Chicago has the best architecture in the world, but New York's isn't that bad!"

Chicago does look pretty amazing, doesn't it?

2) "Start sending records"?! WTF? I've been sending records to my CDE - my case manager who is supposed to be in daily contact with my endo - since April! How in the hell does my endo not know this? Either she doesn't see them OR she just randomly dashes emails off to patients and forgets who does what. I dislike both of these scenarios.

3) How is this even possible? With all the work I've been doing and the averages on my meter, how could there be such a gigantic discrepancy? I know the DOC talks a lot about tech accuracy (for good freakin' reason, obviously), but this is insane even for One Touch meters. Isn't it?

4) Who the hell says the full "HbA1c" any more?

I managed to have fun during the rest of our trip (thanks to B, of course, as he's the world's best traveling partner), but my brain never really stopped hopping back and forth between #3 and the idea that If all that work only got me a 6.8, what the hell will I have to do to get a sub-6?!

What dinner with a sub-6.0 A1c looks like
And that little brain-hopping act is where I've been since then. At least it was until last night, when I uploaded my Dexcom and apoplectic rage kicked in.

See, I'd been operating under the assumption that it was meter/Karen error. I was only taking BGs at the wrong time and hadn't logged an accurate picture, or the meter was off enough that I wasn't as tightly controlled as I thought. However, for the range of time between my A1cs (March 15 to June 14), freakin' Dex also said my average was in the low 120s. Which agrees with my meter BGs AND includes all the crap mountains and molehills in between said BGs.

I'm left sitting here, sputtering and ranting like some crazy person on the subway, furious and confused and feeling completely helpless. If my machines and logging and work with the CDE have zero correlation to the A1c, what the hell is the point of any of it? How can my management be judged on a number that I can't relate to/sync with day-to-day, rather than all the data I accumulate as the hours roll by? You wouldn't give someone a map of Atlanta to help them out on their trip to San Francisco. You wouldn't tutor a kid in geometry for his algebra class. You wouldn't learn French for your upcoming trip to Italy just because "they're kind of similar." How the hell are we supposed to achieve the kind of self-care we want to ensure our health now and in the future if the tools we have to do so fail to relate to the tests the medical field uses to judge that self-care?

Wednesday, June 9, 2010

24-hours is a world of difference

This is my Dexcom from the past 24 hours:

It is absolutely NOTHING like the 24 hours prior to that graph - an emergency care visit for our poor blind cat at 1:30 in the morning yesterday yielded a pretty consistent BG around 200. Oh, stress! You make my diabetes so much more exciting to deal with....

Friday, June 4, 2010

Waking up is hard to do

Every single morning, I wake up, blearily walk to the kitchen, do a BG, and then bolus.

"ZOMG, Karen, is your fasting BG always high??" you're obviously wondering. But no, you wily D-genius, I'm afraid it's not because it's always high - that, at least, would be some overnight basal I could tweak. The reality is I bolus even when I'm starting out the day in the 70s or 80s. I have to if I want to curtail my morning jump.

Take this morning, for instance, which was completely typical. I got out of bed at 7:30 with a BG of 80. "Excellent work last night!" I think, and confirm the thought with a peek at my smooth 3-hour Dexcom graph. I pop .3 (roughly half of my hourly basal rate), unhook when my bolus done-boop chimes out, and then go take a shower. Once I'm turbaned and bathrobed, I quickly scoot to the kitchen to hook back up - a twenty-minute basalfree period at the very most.

Right about the time my train starts to cross the Manhattan Bridge, "the climb" kicks in. By the time we've hit Canal Street on the other side, my purse is vibrating with Dex high alarms. When I plop at my desk at 9:00, I check the damage - Dex is topping out over 170, but my meter BG says 136. A 56-point leap in 90 minutes with no food or anything? Not horrible, not awesome.

The problem, of course, is that this doesn't make any sense. If I sleep in until 11:00 on a Saturday, the climb doesn't happen. I still do the same routine, but my BGs stay flat. So it's not my basal rates. And it can't be the unhooked-period, since I cover for that with a little fancy mental math and pop half an hour's worth of basal before a shower. It has been driving me crazy, as I've been killing myself to try to figure out what the heck is going on.

Enter Twitter. I lobbed out the question and, lo and behold, I'm not the only one who has this problem. It seems @BadPancreas and I both get a BG bounce just from waking up! The more I think about it, the more that math makes sense:

(1 girl who loves sleep + snooze alarm) x lateness from using said snooze alarm x stress from running around late = 50+ point leap in less than two hours

I think my next step will be trying to get up a bit earlier - ha! -  to test out the hypothesis. In theory, if I can give myself some wiggle room, zap the stress of feeling late (and having to scramble around and run out the door), perhaps I can mitigate the bump a bit. Unless some of you lovely D-geniuses have a better idea you want to share?!

Thursday, June 3, 2010

The Ring is not so rosy

Sunday night was a fraught experience. Having slept in a wee bit too long that morning, there was a bit of tossing and turning when bedtime came around. Sleep finally did arrive, but it brought some pretty horrific nightmares with it.

Over and over, I was riding as a passenger - driver unseen, unknown - in a car that would end up plunging into a body of water. As the water would gush in, filling the floor at my feet, I would start to panic and claw at the doors to escape the sinking car. Inevitably, the windows would implode and a flood of water would burst in...along with that terrifying woman from The Ring. It looked kind of like this:

Except it was a window she was crawling through, riding a crest of murky water, not a TV screen. The car varied, the crash varied, the body of water varied - from station wagons plunging off bridges to little convertibles swerving off country roads into rivers - but it always came back to me, terrified at the rising water, panicking and trying to escape, and then BOOM, exploding glass, torrent of dirty, dark water and that freaking scary lady. I would wake up, try to shake it off, go back to sleep, and I'd be right back in another car.

Now, I've been having a bit of anxiety tummy since last week. You know that feeling that lives right under your breastbone? A kind of buzzing like you swallowed a brick of wasps and you kind of want to puke them up or do something to make that pressure-buzzy feeling go away but you can't? Yeah, I've had that feeling for no discernible reason since last week. As though I'm forgetting something hugely important or royally effing something up because the clock is ticking and I haven't taken care of it...but I can't point to what the something is. I just have a consistent sense of anxiety for what appears to be no reason at all.

I know Sunday's horrors must be related to that (I mean, drowning in a car over and over is kind of the epitome of the worst kind of overwhelm in the universe, amiright?), as are the subsequent dream-riddled nights since then, but I've no earthly clue how to figure out what's eating at me. All I can do is hope I figure it out before I get a repeat visit from Ring lady....