meewah*betic

Droppin' Knowledge

2012-01-26T07:00:00.000-05:00

I’m not very open about my diabetes at work. I’m not outspoken about it with people who aren’t close to me. I keep it under the radar. But when faced recently with some serious and potentially dangerous misinformation about diabetes, I opted to step up and set the record straight. I put my diabetes out there for strangers to see. It seems like a small step, but for me, it was a big step in feeling comfortable in identifying myself as someone with diabetes.

At my place of work we have an online health forum where people can get advice from co-workers on various health-related topics. Recently a woman posted concerns about some symptoms her husband had been experiencing and whether they may be diabetes related. As soon as I read them (unexplained weight loss, insatiable appetite, more frequent trips to the bathroom, fatigue, father has Type 1) I thought yeah, diabetes is definitely a possibility. I didn’t think about responding until I saw some of the responses from others and I knew I had to step up and set the record straight.

First, someone dismissed the woman’s concerns about diabetes stating that people develop diabetes because they gain weight not lose weight. This not only perpetuates a stereotype but it is flat out wrong. I went through great lengths to describe how all the symptoms her husband was experiencing can be a result of high blood sugar - including the weight loss. I tried to convey what a vicious cycle it is - insulin gone/diminished causing blood sugar to rise and leaving the body to turn to other sources (body tissues and fat) for its energy needs which causes the weight loss. How the high blood sugar is toxic causing the body to look for ways to get rid of it - frequent urination, constant thirst. How the fatigue arises because the body isn’t getting the energy it needs and is constantly hungry and the eating which continues to drive up blood sugar because of the lack of insulin.

Another response was clearly describing symptoms of severe low blood sugar where people can be mistaken by police and paramedics to be drunk and don’t get the attention they need but used the term ketoacidosis instead. I posted a response describing the differences between diabetic ketoacidosis and hypoglycemia because if this woman’s husband has diabetes, there is no way he is going to go low at this point.

These misconceptions about diabetes can be potentially dangerous to someone who is seeking advice. I can only hope that the information I relayed was useful in convincing this woman to try and get help for husband. Based on what she described - if he does have diabetes - he is on his way to the ER very soon.

If I'm Doing So Good...

2012-01-24T10:12:00.000-05:00

...why does it feel like its not good enough?

I look at my BGs and I see too many zig-zags. I see too many 200s, not enough 100s. Too many readings over 140, 160, 180.

Yet I hear from my nurse coach and dietician how great I'm doing. How steady my numbers are. How I'm doing all the right things and I should keep up the good work. Counting carbs? Check. Exercising? Check. Taking my insulin? Check.

I do everything right.

I do a great job.

Yet my BGs are higher than normal.

Normal blood glucose levels range from 71 - 120 mg/dl.
Normal A1Cs range from 4.6 - 5.3.

In spite of how great other people tell me I'm doing, my numbers are not normal. My average blood sugar this week has been 177 mg/dl. My last A1C was 6.4.

It doesn't feel like I'm doing good because I know that continually elevated blood glucose leads to diabetes related complications:

complications resulting from damage to small blood vessels (things like kidney disease and retinopathy) seem to rise exponentially, rather than linearly, as A1C rises

elevated post meal blood glucose may have direct toxic effects on blood vessels - independent of other heart disease risk factors like high cholesterol or triglycerides - meaning it plays a larger role in developing heart disease

post meal blood glucose values greater than 140mg/dl are associated with increased risk of death from heart disease

So how is it that I'm doing such a great job? When the further my blood sugar values stray from normal the greater my chances are for developing complications?

If I let myself believe that everything is ok, that I'm doing really good, where will I be in 10, 20, or 30 years?

I can't afford to accept that I'm doing a good job.

I Have a Nurse Coach...

2012-01-05T07:00:00.000-05:00

I can get suckered into phone calls from charitable organizations or opinion surveys because I can't bear to hang up on friendly sounding people who are simply doing their jobs. Sometimes I will give a polite "I'm not interested" and hang up. Last night my health insurance company called and they wanted to speak with me.

First thought: "Oh Shit! What is wrong now!" Then I thought, "I can't just say 'not interested' and hang up."

(Image Source)

I spent over an hour on the phone with them. We went over my health history, recent lab results, whether I'm a smoker or drinker, and at the end I made a personal health goal. I couldn't hang up on them because: A) see the first sentence above and B) my life literally depends on them covering my doctor visits and medications. It turns out that I'm qualified for a special program called Condition Care and this call was to get me set up on this new program.

According to their website, "Condition Care is a nationally accredited disease management program for members who are chronically ill. The program is designed to help participants understand their condition and their doctor’s instructions enabling them to self-manage their condition."

(Ah yes, the perks of chronic illness. Lucky me.)

You might say I kinda have an elitist attitude when it comes to my chronic illness. I feel like since I live diabetes 24/7 I know what I need to do and don't need your help. I understand this disease and how to manage it. I know what to do. I don't need you to tell me what I should be doing. Thank you very much.

But I played nice and answered the kind health educator's questions about my health, how I'm managing my condition, whether I know why I'm taking insulin (seriously), whether I'm depressed, when my last urine micro albumin test was, etc etc etc. According to the kind lady this program offers me 24/7 access to registered nurses, dietitians and pharmacists to answer questions and I'll have my own "nurse coach" who will follow-up with me and offer guidance.

I was very skeptical about this program during the whole phone call. At this point with my diabetes I don't think I need this program but I'm willing to see what they have to offer. It sounds like it would be very helpful for people who are newly diagnosed or whose doctors simply write a prescription and send them on their way or for people who lack access to education programs. Who knows, maybe I will get some - as yet unseen - benefits from it.

In the mean time I have an appointment (phone call) with my nurse coach next Tuesday. Stay tuned...

What is Meant to Be

2012-01-04T00:04:00.000-05:00

I go through life hoping, dreaming, and wishing for the future. I make plans. I paint pictures in my head of what I want my life to be. I make decisions and take actions with the promise of bringing my pictures into reality. But the pictures are just rough sketches - notions of a life. I hope and (naively) think that the pictures will someday be true. That everything will work out just the way I envision.

I never painted a picture of a life with a chronic illness. In the fall of 2006 when my diabetes began to manifest and I was blind to the symptoms I had a picture in my head of starting a family with my husband. Today I don't have that picture, I have diabetes. For a long time I wondered how I got this disease and questioned why me. What complex interplay of biology and environment triggered the attack on my pancreas and landed me here?

Was it simply meant to be?

Over these five years I have accepted this disease as part of me and something I cannot change but can learn to live with. Diabetes is a given, a fact of my life. But I'm left wondering what else is or isn't meant to be in my life?

I still have a picture in my head of having children of my own. I've been meticulous in managing my diabetes for that possibility but biology has not pitched in to make my pictures a reality. Having spent the past year coaxing my body into doing what it is supposed to do naturally via artificial means - the poking and prodding of advanced reproductive technologies, the hyper-stimulation, retrieval, culturing, and transfer of embryos - I'm left with empty promises and disappointment. As I slip further into so-called advanced maternal age I wonder why not me?

Is it simply not meant to be?

Fearless

2012-01-03T07:00:00.000-05:00

“Your mental process comes from two sides; one is love, other isfear."
-- Yogi Bhajan

Before diabetes I was never much of a New Year's resolution person. Life was good, I was happy, I didn't feel like I needed to change or do things different. But since that fateful day in 2007 my perspective on life changed. The things that are important to me changed. The way that I want to live changed.

I've come to like the idea of the New Year's resolution. Its the first day of a new year and feels like a fresh start. I take time to review my goals from the previous year. I reflect on what I achieved and what I didn't achieve. I think about why I didn't achieve my goals and what obstacles I faced that prevented me from reaching them. I think about what I want to focus on and hope to achieve in the New Year. I make a list and a plan

Last year I wanted to be grateful everyday. My goal for 2012 is to be Fearless. I read Lemonade Life's New Year post and I really like her idea of having a theme for the year. I like the idea of focusing in a single thing throughout the year.

Fearless.

I chose fearless for my 2012 theme because I know that it is fear that holds me back. Fear is what makes my mind spin with needless worries and what ifs. Fear is what causes the tension I feel in my neck. Fear is what paralyzes me to inaction. Fear keeps me static. Fear prevents me from achieving.

Its not about going skydiving or bungee jumping. For me, being fearless is to stop listening to the stories I tell in my head.

I have an exciting and challenging year ahead of me, full of unknowns.

I want to be fearless as I meet these unknowns.

gracias: 365/365

2012-01-01T19:00:00.000-05:00

(Image Source)

This time last year I was under a cloud. I was angry at all the things I didn't have. I despised my diabetes and the unfairness of it. But I knew deep down inside that my life was not as miserable or depressing as it felt in my head at times. I knew inside that I had a great life and I needed to recognize that.

I started my 365 project this time last year as a way to take stock of my life and focus more on the good things and less on the challenges. Life isn't perfect, its not always sunshine and rainbows - but I've come to appreciate it more. In doing my 365 project over this year I've recognized how important the people in my life are to me, how little I actually need to be happy, how blessed I am to have been afforded the opportunities that I have in my life, and that "things" don't make me happier:

I am so lucky to have my husband. He takes care of me and makes my dreams come true.
The incredible love, support, and generosity of my family. They have given me so much.
My dog Kona is the sweetest canine companion a gal could ever hope for. He's a loving, good natured soul who is always watching me and quick to accept hugs and belly rubs.
Good friends who "get" me.
I have everything that I truly need - a good home, good food, and nice clothes.
I have never had to experience the ills of our world - famines, civil wars, natural disasters, evil dictators, suicide bombers.
I am glad that I have good health insurance and a steady income during these times of economic troubles.
I am fortunate to have the means to choose how I live.
We have sinks and bathtubs and showers in our house that give us clean and hot water - it seems so simple but so many people in the world don't have these small luxuries.
I have been able to experience natural and wild places. Nature is wondrous, inspiring, and perfect.
Its been hard for me to swallow but I've learned to understand how finite life is and it makes me appreciate even more the time that I have now.
I am happy to be living this life in this moment because its a pretty damn good one.

gracias: 364/365

2011-12-31T08:03:00.004-05:00

waking up to sunshine coming through the windows
a really good night's sleep
going out for brekky
enjoying blue skies and sunshine on the last day of 2011
getting dressed up and having a fancy dinner with my hubby
the promises of a new year

why gracias? click here.

gracias: 363/365

2011-12-30T12:59:00.000-05:00

its friday!
short work day!
mild weather = time to take my dog for a short walk
fun night at a hockey game

why gracias? click here.

gracias: 361-362/365

2011-12-29T15:37:00.002-05:00

its ok to just stay home to recharge
got some wardrobe essentials on sale
my car surviving another trip to the repair shop
a clean home

cuddling with my pup
fuzzy robe, sweatpants, fuzzy slippers
my hubby fetching lunch
guac burgers

why gracias? click here.

On the Trail with Diabetes: Keepin' Toasty When it Gets Frosty

2011-12-28T07:00:00.000-05:00

A few weeks ago I set out for another outdoor adventure withmy diabetes – 3 days/2 nights and 23 miles on the Appalachian Trail. In addition to the usual diabetes preparations – being sureto carry enough supplies and thinking about basal rate and bolus adjustments toaccount for the physical activity of hiking several miles a day with a 30lb pack– I would also be contending with cold weather. My main concerngoing into this trip - with expected temperatures ranging from 20F – 40F - was howto keep my diabetes gear functioning.

The tools we use to manage diabetes have parameters underwhich we can expect reliable performance from them. One of these parameters is temperature. Our insulin and our devices work wellin a pretty broad temperature range but once you push the extremes – too hotor too cold – devices like meters can malfunction and insulin can be degraded,losing its potency and its ability to act on blood glucose.

My choice for treating lows during the trip was also a consideration. I’m fond of using glucose gels to treat lows when I’m backpacking. They are light weight and low volume – important things to consider when you have limited space in which to carry everything you’ll need for three days. Going into this trip I wondered whether my glucose gels would freeze rock solid overnight because all food needs to be stored away from the tent during the night to prevent bear encounters. Frozen glucose gels would be problematic should I experience low blood sugar.

I mitigated these problems by carrying my essential supplies (insulin vial, meter, test strips) in a jacket pocket close to my upper body. My husband carried my glucagon in one of his jacket pockets. I wasn’t too concerned about the insulin in my pump getting too cold. I wore it on my waist band under layers of clothes and made sure that the tubing stayed tucked against my skin. At night I kept my diabetes supplies warm by tucking them into my sleeping bag and my husband kept my glucagon in his. Not sure whether my glucose gels would freeze, I opted to take enough gels with me for the trip as well as a full bottle of glucose tabs as back-up.

I’m happy to say that my preparations paid off. I didn’t have any problems with the functioning of my diabetes devices, my insulin didn’t freeze (though our water did) nor did my glucose gels. Here is a little video I put together about my experience:

For more posts on backpacking with diabetes check these out:

gracias: 360/365

2011-12-27T20:55:00.002-05:00

good workout that my body dearly needed this morning
short commute and good parking
my wonderful husband - doing all the laundry on his day off
good conversation, refocusing goals, hopes, dreams

why gracias? click here.

gracias: 357-359/365

2011-12-26T19:17:00.001-05:00

not waking up to an alarm clock
a nice, slow christmas eve brekky with the hubby
quick drive up to my parent's house
feeling grateful for my family and time spent together
feeling good about gifts given and touched by gifts recieved

sleeping in
christmas day brekky with pumpkin pie
dinner with mom, dad, and grandma - a table full of great food and great memories
the way kids can make you smile
another evening with extended family - catching up and lots of hugs

more pumpkin pie
sunshine
a nice, quick drive back home
a great christmas weekend - lots of laughter, lots of love

why gracias? click here.

Happy Holidays

2011-12-24T07:00:00.000-05:00

Wishing you peace, love, and joy!

Count your blessings, hug your

loved ones, eat some cookies, and bolus

as needed!

meewah*betic will be on a short break.

I like to take this time to spend with loved ones,

reflect on the past year and look forward to next year.

No blogging, no BG logging, just living.

gracias: 355-356/365

2011-12-23T15:43:00.002-05:00

my dentist - i may not like it but they take good care of my teeth
comfort - fuzzy slippers, sweatpants, chunky cardigan sweater
a very special gift from my mom and dad
being able to spend christmas with family and loved ones

short work commute
short workday
finishing up a video project
chocolate mint tea
celebrating my husband's birthday with a nice dinner and evening on the town

why gracias? click here.

gracias: 354/365

2011-12-21T20:54:00.001-05:00

a day of steady BGs
fuzzy slippers after a day wearing heels
short commute + leftovers for dinner = a nice long evening to enjoy
rooms lit only by candles and christmas lights
a big warm sweater

why gracias? click here.

gracias: 353/365

2011-12-20T21:02:00.001-05:00

beautiful commuting - people are leaving town for the holidays
overnight crockpot cooking worked beautifully
every time i turn on a faucet clean water and hot water comes out - many parts of the world don't have this luxury
our 4-legged (and 3-legged) companions - amazing to think how over thousands of years we have come to live together and trust each other

why gracias? click here.

The Microscope

2011-12-20T07:00:00.000-05:00

I'm taking a break from logging my blood sugars.

I have 4 years worth of my diabetes spreadsheets saved on my computer. Tracking my meals, BGs, basal rates, boluses, carbs, physical activities, protein, fat.

I keep the spreadsheets so that I can review the data and spot trends and make adjustments to my insulin and/or my habits. They are most helpful when I'm dealing with consistent highs or lows, but most of the time I never go back to them. I enter my numbers, hit save and close.

Things are pretty steady right now. I'm not frustrated. I don't have any reason to change things.

So I'm not going to log my BGs for the rest of the year.

I'm not doing it because my BGs are bad. Or because I want to eat a bunch of holiday goodies and not feel accountable. Its not because I'm lazy or because I don't care.

I'm doing it because I need a mental break right now.

I continue to test. I continue to count carbs and rely on calorie king and food labels to get me through my meals. I bolus, correct, and change infusion sets. I'm still doing all of my diabetes things.

I just need to step back from the micrscope for a bit.

gracias: 352/365

2011-12-19T21:08:00.000-05:00

choosing the right attitude for today - makes mondays feel better
the means and ability to choose the best things for my health - food, medication, devices, lifestyle
easy meals - leftovers tonight, dinner the next two nights in the crockpot and will be ready in the morning to heat and eat when we get home from work
christmas carols

why gracias? click here.

gracias: 350-351/365

2011-12-18T07:57:00.001-05:00

my saturday farmer's market - so happy i have this close by
spending the day out and about with my hubby
night on the town - christmas markets and drinks
christmas shopping is done!

waking up when the sun hits the windows
me, hubby, and kona all squished together in bed
hot showers
long sunday morning
these moments are the only gifts we need

why gracias? click here.

gracias: 349/365

2011-12-16T19:57:00.003-05:00

its friday!
my work day begins when i get there - got in early today, got to go home early
a presentation i have been working on went well - no more stress
christmas cards
quiet evening - dinner, christmas movies, sharing the couch with kona dawg

why gracias? click here.

Eat. Drink. Be Merry.

2011-12-16T07:00:00.000-05:00

'Tis the time of year for office Holiday parties. Cookies, pies, beer, and wine. Indulging in once a year goodies. Nutrition, diet, and healthy eating be damned.

In the past I would fill my plate and glass like everyone else.

But these days I take caution in what I choose to fill my plate. I must estimate and count and bolus and adjust. Some veggies, some cheese, some meat. No cookies or brownies or cake here. No beer. No wine. Simply water.

People question my choices. I question theirs.

I've decided that I will not cheat. I will not be bound by the the selections on the buffet table. I will not buckle under pressure.

Instead, I will treat. I will treat myself to some goodies of my choice, on my terms.

gracias: 348/365

2011-12-15T20:22:00.001-05:00

comfy bed, flannel sheets, warmth
carpooling, better traffic than yesterday
my dog wrestling with his toys
a husband who doesn't mind grilling in the dark, rain, or cold
stress and worries are my own creations and don't have to be

why gracias? click here.

gracias: 346-347/365

2011-12-14T21:05:00.000-05:00

quiet and productive day
things i stress, fret, and worry over usually don't happen
doing what needs to be done
spending an evening at a hockey game with my hubby

an extra 30 minutes in bed
my commute sucks but i have podcasts to learn from and holiday music to cheer me up
a nice break from work chatting with a friend
coming home to a clean house

why gracias? click here.

gracias: 345/365

2011-12-12T20:26:00.000-05:00

solid, much needed, 10 hours of sleep
taking a day off from work
an hour to sip tea and read
my Christmas shopping is almost done

why gracias? click here.

gracias: 341-344/365

2011-12-11T19:22:00.001-05:00

carpooling
going out for lunch
productive meetings
getting in a bit early to my parents house

the guys letting this gal tag along for a 3-day backpacking trip
the warmth of goose down
my hubby who always takes good care of me but also does so much for me when we are out on the trail
fire - what did humans do before this?
a clear night sky and bright moon that lights up the camp site

sipping hot tea by a camp fire
walking in a winter wonderland - thick pine trees covered in snow
testing my physical and emotional limits and making it through a tough day
taking decent care of my diabetes while roughing it in cold weather
spending this time with my dad and my brother

spending three days by choice in the cold makes me grateful for the warmth and comfort that i have in my home
my mom taking care of kona while i'm out gallivanting through the forest
hot showers, indoor plumbing, washing machines
getting to sleep in a warm bed in a warm home

why gracias? click here.

Happy Trails

2011-12-08T07:00:00.000-05:00

meewah*betic will be taking a short break.

I am heading out for a long weekend of backpacking.

I'll catch up with ya'll next week!

gracias: 340/365

2011-12-07T21:44:00.001-05:00

taking 30 minutes just for me
brekky for dinner - yum!
getting some good outdoor gear at half price
a long weekend ahead of me

why gracias? click here.

Cheating?

2011-12-07T07:00:00.000-05:00

cheat: to violate rules or regulations.

I enjoy the Holidays. I like the spirit of the season, the good cheer, the music, the decorations, the giving, and the family time. Its also a time of parties, large meals, and once a year baked goods. Its a time when many people indulge in food and drink.

On more than one occasion since Thanksgiving I've been asked if I was going to "cheat" during the Holidays - implying that I would eat things that are bad for me, things that I shouldn't eat because of my diabetes. I shrugged it off, responding maybe or maybe not.

But what I really thought was, "Why am I cheating? Why isn't everyone else cheating when they eat Christmas cookies, or chocolates, or pies, or breads during the Holidays?" These foods are just as unhealthy for me as they are for everyone else. Just because your pancreas works doesn't mean that a dozen cookies magically meets your nutrition needs but not mine.

The idea that I'm cheating by eating Holiday baked goods stems from misconceptions about what causes diabetes (I got this disease because I ate too much sugar - umm, no.) And misconceptions about how to treat this disease (I can never, ever eat sugar - umm, no).

Part of it also stems from misconceptions about managing diabetes or what is best for me. There are no rules or regulations for managing this disease. There are no laws that state I cannot eat cookies or chocolate or pie. There are guidelines for counting carbs, dosing insulin, and making better food choices. I choose what to eat just like everyone else. I am no more a cheater than anyone else this time of year.

I am already 10 times more focused on what I'm putting into my mouth than most people. I don't need additional scrutiny.

gracias: 338-339/365

2011-12-06T20:37:00.001-05:00

being able to take breaks away from the office to focus on improving myself
taking 30 minutes just for me
leftovers for dinner that taste better the second time around
letting go and realizing that everything doesn't have to get done today

getting through a challenging presentation and not totally blowing it
short work day
talking through things that have been stressing me out, feeling better, and realizing I can manage
not letting fears and worries get in my way

why gracias? click here.

gracias: 336-337/365

2011-12-04T20:25:00.001-05:00

family
home cooked meals
feeling blessed with what i have
having the house decorated for Christmas

not waking up to an alarm clock
wonderful three day weekend with mom and grandma - very nice to spend time together
my sweet doggie
my husband - we are made for each other

why gracias? click here.

gracias: 334-335/365

2011-12-02T20:17:00.001-05:00

a meeting i had stressed about all week turned out to be a breeze
taking a day to listen and learn
dinner on the town with my hubby

not waking up to an alarm clock
a good am workout - completes my streak for the week
sliced apple with almond butter - tastes like dessert
spending a nice day out and about with my mom and grandma
a nice home cooked meal after a long day

why gracias? click here.

gracias: 332-333/365

2011-11-30T20:41:00.001-05:00

a nice home
food on the table, in the fridge and in the freezer
my hubby - the bug killer
the resources to get what i need for my diabetes - anytime, anywhere

a string of steady BGs
guac burgers
my pup is home!!
my mom and grandma are here for the weekend

why gracias? click here.

The Real Thing

2011-11-29T07:00:00.000-05:00

I'm pretty consistent and precise in the way that I eat. Many people would say that I follow a strict diet and they are probably right. I think that I follow a nutritious diet that helps me manage my diabetes by avoiding the kinds of foods that tend to cause my BGs to sky rocket - things like breads, pastas, sweets, potato chips, Doritos, Ho-Hos, Snickers Bars, etc.

I don't stray too often from this way of eating. When I do opt to indulge I usually save it for a special occasion, a birthday, an anniversary, the Holidays. And I can be pretty picky about what I choose to indulge in.

I don't want artificial sweeteners. I don't want sugar free. I don't want substitutions. I don't want an ingredients list that I can't pronounce. I don't want fake.

I've found that so-called sugar free or otherwise "diabetes friendly" sweets affect my blood sugar the same as anything else. They are artificial foods and that is exactly how they taste. Why bother with them?

When I want to indulge in foods, namely sweets, I want the real thing. I want homemade. I want real sugar, real flour, real butter, real milk, real ingredients.

On Thanksgiving day I ate an entire piece of 100% homemade and incredibly tasty apple pie. It was gooey and sweet and cinnamon-ie and I loved every morsel of it and it was totally bolus worthy.

gracias: 331/365

2011-11-28T19:37:00.001-05:00

waking up slowly even though its monday
blessed with light traffic to get to work
pharmacy able to fill my full novolog order - no need for a return trip
my hubby taking care of all the laundry from our thanksgiving trip and winterizing the deck and putting up the x-mas tree - what a guy!
errands done, workout done, dinner done - all before 7

why gracias? click here.

gracias: 328-330/365

2011-11-27T20:38:00.001-05:00

sleeping in
a good post holiday workout
yummy leftovers for brekky, lunch, and dinner
a lazy day – fireplace going, tea, football
finishing up a photo album

a mild november day
yummy breakfast in A2
college football saturday
watching a good win from the stands
post-game dinner with family

my hubby driving us to the airport at 530AM
breezing thru rental car return, airport check-in, and security
AAA roadside assitance
all my car needed to get going was a battery charge
wonderful and relaxing thanksgiving break

why gracias? click here.

Giving Thanks - gracias: 327/365

2011-11-24T20:44:00.000-05:00

Today is Thanksgiving. A time to count blessings and reflect on the good things that we have in our lives. For a long time I found myself in a bad place with my diabetes, angry and depressed. I started my gracias project because I knew deep down inside that my life is way better than that. Joy and happiness is found in the things that matter in life, the things that I have, not what I don't have. Its embracing experiences, finding joy in everyday things, and cherishing every moment with loved ones. A few things that I'm grateful for today:

Insulin that keeps me alive
I am able - I can walk, I can run, I can climb, I can push my limits
My family's warmth, love, and generosity
My friends and neighbors who I can count on to share a good laugh and share their time
My life - here and now, in this moment and this place
The essentials - I don't have to worry about where my next meal will come from, where I will sleep at night, whether I will be warm, or whether I will be safe
The means to be able to choose how to live
The realization that my life is good
My husband who makes my dreams come true. He would do anything for me and I know he would give anything to take this disease away from me.

gracias: 325-326/365

2011-11-24T11:20:00.001-05:00

a break from work
safe and uneventful travels
meeting up with my hubby

not waking up to an alarm clock
enjoying a long walk
spending the holiday with loved ones

why gracias? click here.

Its Just Sugar

2011-11-22T07:00:00.000-05:00

It gives me energy. It feeds my cells so they can perform their essential tasks, keeping my body humming along without conscious effort on my part. My brain uses it so I can think, remember, and make decisions.

In excess it becomes toxic. It destroys the proteins in my body - proteins that help me see, that line my blood vessels, the keep nerve impulses running, that keep my kidneys functioning.

Its the number I get when I prick my finger and squeeze out a drop of blood. Its what many daily decisions are based on - whether or not to eat, what to eat, how much insulin to give, whether exercise is a good idea, should I pull over or keep driving.

It changed the way I live my life. My world revolves around this simple molecule.

Its just sugar.

gracias: 324/365

2011-11-21T19:38:00.001-05:00

nutritious food
new infusion site location with better BGs
blood glucose meters
insulin pumps
i have everything i need to manage my diabetes

why gracias? click here.

gracias: 322-323/365

2011-11-20T19:19:00.001-05:00

not waking up to an alarm clock
sunny fall afternoon
a night out with my mom and sister
the generosity of my parents

flurry of sunday afternoon activity and getting everything done
peace of mind that my pup is in good hands
a sale on a sweater that i've had my eye on
having some time for me

why gracias? click here.

gracias: 321/365

2011-11-18T20:06:00.001-05:00

its friday!
motivation for working out after work
warm house
safety, comfort
good people

why gracias? click here.

gracias: 319-320/365

2011-11-17T19:30:00.001-05:00

muscle soreness - means i did something to improve myself
catching up with a friend
dinner out with the girls
waking up when i get to low
getting some buy-in for something i'm trying to pull together for next year
meetings that end early
hugs
affection
this chocolate-coconut tea - so darn yummy i have to give it another shout out

why gracias? click here.

gracias: 318/365

2011-11-15T19:50:00.001-05:00

Today was one of those very average, uninspiring, gray kind of days where it takes more effort to find the grace and beauty of life. Here goes...

living without sugar - i'm so much better off without it and i don't miss it
relaxing with a cup of tea - hints of chocolate and coconut
my dog beating the odds - pouncing and wrestling with a toy as i type this out
ukulele songs

why gracias? click here.

gracias: 317/365

2011-11-14T19:45:00.001-05:00

choosing to workout this morning - sometimes i have to really talk myself into doing this but i always feel good, energized, and accomplished when i get done
warm day
red and pink sunset
leftovers for dinner - heat and eat and delicious
thankful for stability in difficult times when it feels like the world is turning upside down

why gracias? click here.

This is Diabetes

2011-11-14T07:00:00.000-05:00

November 14 is World Diabetes Day.

I have lived with diabetes for four years. Prior to my diagnosis in 2007 I wasn't aware of diabetes. I knew that it was "out there". That it had "something to do with blood sugar". I knew that it could lead to devastating complications. I thought it was caused by eating too much sugar. I thought that only old people got diabetes. I thought that only fat people got diabetes. I didn't think I could get it.

It took my own diagnosis with this disease for me to understand it. For me to want to understand this disease. Diabetes awareness is so important because most people hold the myths and misconceptions about this disease to be true. I did. When these myths are perpetuated, when others assume that this disease is our fault or that it is easy to manage by simply eating right, it makes it harder to get the education and treatments we need. Its harder to get people to support funding for education and improved treatments.

This is diabetes:

Diabetes is a complicated metabolic disorder caused by a mix of genetic factors and environmental triggers. There are two main types of diabetes - both result in elevated blood sugar. Type 1 diabetes is an autoimmune disease where the cells in the pancreas that produce insulin are destroyed by the body's immune system. In Type 2 diabetes the body's cells become resistant to insulin - they can't use it properly. Its not clear yet what exactly causes diabetes. What is clear is the damage that can be done when diabetes is left untreated - blindness, kidney failure, heart disease, strokes, nervous system damage, limb amputations.

There is no cure for diabetes. Once the damage is done to the pancreas there is no going back. There are things that can make it better - being mindful of food and nutrition choices, exercising, medications - but diabetes will still be there.

Diabetes is a disease that affects 25 million Americans - children and adults. Over 70 million Americans are thought to have pre-diabetes - a condition where blood sugar is slightly higher than normal. This a condition where making lifestyle decisions can prevent developing diabetes. (Statistics and information from the the National Diabetes Information Clearinghouse)

World Diabetes Day is about raising awareness about the facts and realities of this disease. It is also about educating each other in successfully living with and managing this disease.

gracias: 315-316/365

2011-11-13T19:01:00.001-05:00

three day weekend
mild autumn weather, sunshine, blue skies
i have what i need
a walk that lowers my BG
when my hubby helps out in the kitchen
a new purse, half price
mashed sweet potatoes
a home filled with love

why gracias? click here.

gracias: 314/365

2011-11-11T20:40:00.001-05:00

not waking up to an alarm
sleeping in wedged between my hubby and dog
i've never been shot at
i don't live in a war zone
safety, security, comfort

why gracias? click here.

gracias: 313/365

2011-11-10T20:32:00.001-05:00

an endo appointment that wasn't so bad
getting home early and having a nice long evening
working on a photo album of adventurous memories

why gracias? click here.

Why Bother?

2011-11-10T07:00:00.000-05:00

There are some days when I wonder why I work so hard at diabetes. Days when normalcy feels unattainable. Days that diabetes reminds me that I don't have control.

I eat healthy, natural, nutritious food.
I avoid simple carbs and added sugars.
I count my carbs.
I'm active.
I check my blood sugar frequently.
I take my insulin.
I do all the right things.

But if this is the pay-off for doing everything right, why bother?

Days like this when I eat an omelet and an apple for breakfast, a salad for lunch, take a nice hour long afternoon walk and still have BGs in the 200s makes me wonder why I work so hard for this? Fruity pebbles, a five dollar footlong and oreo cookies would be so much easier. At least this result would seem more fitting for those actions.

Doing the right things should make this disease easier, but it doesn't. I work so hard but diabetes doesn't care what I do. Why bother?

Because I have hope.

I hope that someday I'll figure this disease out and it will all click. I hope that someday it will get better. I hope that someday I won't have to put up with all the BS this disease brings. I hope for longevity. I hope that I'll never end up in the hospital as a result of this disease. I hope that this disease won't take my eyes or my kidneys or my heart.

I hope that tomorrow will be different.

Because I have to try. Because these hopes hinge on my actions - trying the right things and tweaking inputs in hopes of better results.

Because I can't let diabetes win.

gracias: 312/365

2011-11-09T20:07:00.000-05:00

warm home, warm bed
the colors on the trees
making progress on something i've been working on for way too long
a clean house

why gracias? click here.

gracias: 311/365

2011-11-08T20:24:00.003-05:00

getting up and getting in a workout before work
a fine autumn day
new beef stew recipe for dinner turned out good
wonderful, caring people in my life
i don't have to worry about essentials - food, clothing, shelter

why gracias? click here.

Its Not Just MY Diabetes

2011-11-08T07:00:00.000-05:00

Most times I think of diabetes as something that just affects me, something that only I have to deal with, stress over, and worry about. I don't often see how my diabetes touches those around me. I don't see their worries and concerns about my diabetes and my well being. I don't grasp their feelings of wanting to help but feeling helpless because this is such an individual disease.

I live away from my family and was diagnosed as an adult. They've never lived with my diabetes and don't see it 24/7 the way I do and the way my husband does. The distance makes me think that my diabetes doesn't affect my loved ones who are far away.

But I'm learning that it does.

A few weeks ago I wrote about my dad signing up for a diabetes walk. I didn't ask him to do this. He felt compelled to get involved as a way to do something about my diabetes. A way to not feel helpless about it.

And because of this physical distance between us, because I didn't think others thought about my diabetes, I was incredibly touched and moved by this gesture and by the friends and family who gave generous donations.

It wasn't until I read his thank you to those who donated that I realized this isn't just my disease. Now I understand that my diabetes does touch others:

Thank you so much for your support of my recent fund raiser walk for the American Diabetes Association. I've been struggling for over a week to find the right words to properly express my thanks.

Like a lot of people I took 'the betes' for granted. It was sort of under the radar. I figured if you had diabetes you just avoided sugary foods and took your insulin. Easy peasy, lemon squeezy; problem solved. Well, as per usual I was wrong and it took a sucker punch to the gut for me to realize that. January of 2007 my oldest daughter Melissa was diagnosed with type 1 diabetes. Since then I've learned that it's a non-stop never ending 24 hour a day grind to manage your diet and keep your blood glucose (BG) in balance. Too high and you can go into diabetic ketoacidosis (DKA) a dangerous condition that results in a trip to the hospital, a coma, or worse. Chronically high BGs lead to the scary 'betes things - blindness, kidney failure, amputations. Too low and you are panicked, incoherent, and your brain doesn't function right. The lower it goes raises the chances of slipping into a coma and not waking up.

Here is a recent post Melissa put on her blog that points out just how quickly the betes can snatch a loved one from your very grasp:
http://meewahbetic.blogspot.com/2011/11/bad-night.html

A year or so ago I decided it was time to stop being the 'oh woe is me' helpless parent of a daughter with diabetes and do something (anything) that was proactive. I'm not a researcher with a PhD in endocrinology so all I can do is help those guys out somehow. I struggled finding a solution till I saw a little piece on Channel 8 news about the ADA Step Out walk for diabetes and decided that was it and signed up. And then you wonderful people came thru with donations and I really can't thank you enough, I truly appreciate what you did.

Thanks again and I hope you'll be there for Melissa if I do something like this again.

gracias: 310/365

2011-11-07T20:26:00.001-05:00

getting a work out in first thing this morning
quick commute despite a late start - a nice Monday morning surprise
leftovers for dinner
a good discussion with my husband over some good wine

why gracias? click here.

gracias: 309/365

2011-11-06T20:06:00.002-05:00

turning back the clocks
taking my time to enjoy breakfast, read the paper, sip tea
taking a nice long walk to enjoy a sunny fall day
lunch out with some friends we haven't seen in awhile
a fridge and freezer chock full of nutritious food and home prepared meals

why gracias? click here.

gracias: 308/365

2011-11-05T19:51:00.001-04:00

sleeping in
50 minutes for ME
rolling hills, gravel roads and places without strip malls, condos, pavements
breakfast for dinner

why gracias? click here.

gracias: 307/365

2011-11-04T21:02:00.001-04:00

its friday!
no power outage this morning
short work day
25 minutes for ME
my dog is 8 and only has three legs but still has moments acting like a puppy

why gracias? click here.

gracias: 305-306/365

2011-11-03T20:45:00.000-04:00

taking 25 minutes for ME
good news from kona's vet - no observable metastases and excellent blood work!
tasty new teas for sipping
dinner out with my fave transplanted Delawarean at my fave burger joint

having the power go out at 6AM on a day i don't have to be at the office and where having my hair in a pony tail will suffice
spending the day in comfy cargo pants and a hoodie
getting to spend two days away from my desk

why gracias? click here.

Now for the Highs

2011-11-03T07:00:00.000-04:00

My diabetes was going good, almost on auto pilot. Test, bolus, test, perfection! Working with a diabetes educator really helped me to smooth things out. But lately things haven't been so good. My BGs are now hovering around 200 and angry bolusing sends my BG crashing too low. I'm back on the roller coaster that I despise.

How can smooth sailing and good, steady BGs unravel so quickly?

Maybe its because....

I keep using a measuring cup to count the carbs for my meals
I eat similar meals day after day and week after to keep my carb counts consistent
I exercise and stay active
I opt to cook regularly instead of eating out so I know exactly what is going into my body
I didn't indulge in one single piece of halloween candy that I bought for trick-or-treaters
I don't eat simple carbs like bread, pasta, cookies, or cakes
I rotate my infusion sites (butt-stomach-thigh)
I test my BG 6-8 times/day

Nope. Its not any of those things.

Diabetes doesn't care what I do. Diabetes does what it wants.

gracias: 304/365

2011-11-01T20:38:00.001-04:00

taking 20 minutes for ME
taking back roads home from work - the trees just make it feel better
my first world problems

why gracias? click here.

Bad Night

2011-11-01T07:00:00.000-04:00

I've been struggling with a string of high BGs lately. Numbers floating around the 190s and 200s more often than I like. I tried being conservative in bringing them down. When that didn't work I went against my pump's judgement and pounded in more aggressive corrections.

I went to bed at 182 on Sunday night. I woke up at midnight at 31.

I had been tossing and turning through stressful dreams when I finally responded to the anxiety and panic. My face, hair, and PJs soaked from sweat, I started popping glucose tabs before I checked my BG. I knew this was a bad one and my meter confirmed it.

I pushed my husband awake. I was incoherent. All I could mutter was "31". I tried to stand but almost fell over and laid back down with my head at the foot of the bed. I felt like I was slipping into unconsciousness. I almost asked for glucagon but the words wouldn't come. I laid there sobbing and mumbling. My mind faltered in the low blood sugar fog when my husband asked if I was ok. I laid there with the open bottle of glucose tabs, popping one after another until I started to feel better.

The fog started to lift when my BG got up to 76. I ate a granola bar and went back to sleep with my damp hair matted to my face.

I went through the motions on Monday like nothing happened. Just another day on the diabetes edge.

gracias: 303/365

2011-10-31T20:25:00.000-04:00

my husband staying up with me during a bad overnight low
taking 25 minutes for ME
silver linings
winter squash - a new favorite veggie

why gracias? click here.

gracias: 302/365

2011-10-30T19:57:00.000-04:00

going out to breakfast with my grandmother
a good weekend with family
my hubby's safe travels
nice sunshiny day

why gracias? click here.

gracias: 300-301/365

2011-10-29T18:59:00.002-04:00

productive day at work
getting into the office early = getting out and home early
safe travels for my hubby and I

safe driving in slick, snowy weather
spending a snowy day in a cozy warm home
cooking dinner with my dad
good college football day - all the right teams won!

why gracias? click here.

gracias: 299/365

2011-10-27T21:51:00.001-04:00

the time i have here and now
my loving husband
my sweet kona dawg
life is what i make it

why gracias? click here.

gracias: 298/365

2011-10-26T20:44:00.000-04:00

people who are willing to do the kinds of things that i have no interest in doing
wasn't too thrilled about a meeting i had today but it ended up being quite productive
a quick workout bringing my BG down
catching up with loved ones

why gracias? click here.

Tools

2011-10-26T07:00:00.000-04:00

The other day the battery died in the digital food scale that I keep in my kitchen. I doubt that alot of people have one of these in the kitchen, especially not the average person. And I doubt that the battery dying would be a big deal.

But for me, this was a crisis.

I use my scale to weigh food so that I can then figure out how many grams of carbs are in it. My insulin dosing for everything I eat is based on this important number.

Despite what they teach in diabetes education, apples do not come in a perfectly proportioned "fruit exchange" of 15g of carbs. In fact, you would be hard pressed to find an apple small enough to only be 15g of carbs in most grocery stores. So, I slice my apple, put the slices on the scale, take note of how much they weigh, do a search for them on calorie king which tells me how many grams of carbs are in my apple. I take that number and enter it into a spreadsheet I keep that helps me tally the total grams of carbs in a meal. This is the number that my insulin bolus is based on.

When the battery died in my kitchen scale I started to think about how much I rely on these tools to manage my diabetes. When my scale doesn't work, I can't do this. When the internet is down, I can't do this. When my computer locks up, I can't get to my excel spreadsheet, I can't do this.

Diabetes is more than insulin and test strips. I have many tools that I rely on to get through every day. It became quite apparent that I have several points of failure in my diabetes tool kit. When one fails I feel lost.
(Editor's note: I keep extra batteries for my scale in a kitchen drawer. Like a good diabetic, I am always prepared and the crisis was averted.)

gracias: 297/365

2011-10-25T21:02:00.000-04:00

being able to enjoy some of this nice mild fall weather
trying some new things for dinner that turned out pretty good
small moments of laughing

why gracias? click here.

gracias: 296/365

2011-10-24T20:49:00.001-04:00

taking 25 minutes to do something for ME
work will be there when i get there - no need to rush things
my car survived the commute home
the way my dog bounds around the house like he's still got four legs

why gracias? click here.

gracias: 294-295/365

2011-10-23T19:59:00.002-04:00

my local farmer's market - love getting my meat and veggies here and supporting small farmers
walking my dog and letting his nose choose the path and the destination
fun night out watching a hockey game

hot water
butterflies
afternoon stroll - enjoying a fine fall day
time for reflecting
my family's love and support

why gracias? click here.

gracias: 292-293/365

2011-10-21T20:47:00.002-04:00

feeling safe and secure
out to dinner with a good friend
a two-day break from desk

its friday!
breakfast for dinner - it just tastes good and is kinda fun
promise of a fun weekend

why gracias? click here.

Someday or Today?

2011-10-20T07:00:00.000-04:00

I used to have lows every single day. For several months that is how I went through life - crashing and recovering every single day. It got to be my norm.

It was my drive to have the perfect BG all the time, no matter what, that resulted in the daily lows. I wanted to keep my BG as close to normal as possible, all day, every day. Only numbers between 80-100 mg/dl were satisfactory. So I over bolused for foods and aggressively treated highs. This approach got my A1C to 6.1 but it was also steering me towards dangerous territory - hypoglycemic unawareness.

Since meeting with my CDE over the summer things are much different, my number of lows are way down. My stash of low blood sugar treats used to dwindle every month but now I'm flush with glucose tabs and mini Lara bars. I never realized how much of a toll the lows were taking on me until I stopped having them. I just feel so much better without the daily sweaty shaky anxiety that the lows would bring. I feel normal.

But at the same time it has been hard for me to accept. Hard to let go of my drive for the perfect BG because I know what the consequences are. Fewer lows mean my BGs tend to be higher and higher BGs mean a higher A1C which means an increased risk of diabetes complications.

Have I traded one diabetes problem for numerous unknown ones?

I make a lot of plans for the future. Someday I'll go back to Maui or when I retire I'll do (fill in the blank). But what will "someday" look like after 20 years with diabetes? And is it wise to wait and see?

I have this disease and am faced with potentially diminished health and longevity by the choices I make on a daily basis. I'm at a point where I feel like someday needs to be today. I've written before about the urgency I feel about this transient life because there are no guarantees of a "someday".

The average day to day just doesn't feel like it is enough anymore. How can I make my days richer, fuller, better?

gracias: 291/365

2011-10-19T21:40:00.000-04:00

going out for lunch
a good friend and a good chat even though it was too short
after work exercise motivation - this doesn't strike very often so i have to take advantage of it when it does

why gracias? click here.

gracias: 290/365

2011-10-18T21:09:00.000-04:00

pumpkins
trees with orange, red, and yellow leaves
mild and sunny afternoon
the means to live comfortably

why gracias? click here.

Failed?

2011-10-18T07:00:00.000-04:00

I had planned to run a 10 mile race on 9 October. I had been training for it. Slowly increasing my mileage and my endurance all summer. But it fell apart in the middle of August. I did a 6.2 mile race and then lost all motivation, desire, and intention to go any further. My last run was 21 August. I just couldn't bring myself to be out there pounding the pavement anymore. It wasn't fun. I didn't run my 10 mile race.

I failed.

During my training when I would finish a run I'd be happy that I did it, that it was over, but I wasn't itching to get back out and do it again. I thought I could be like endurance athletes that I admire, especially those that have diabetes. I thought I could run 10 miles. But I didn't enjoy it. I wasn't having any fun with it. It was hard to get up, to get outside, and to go running. It felt forced

The things that I do enjoy are different.

When I'm scuba diving and I finish a dive, I can't wait to get back in the water to see more. To experience part of our world that many people never ever see. I want to spend 60 minutes underwater. Since I've been back from my Yosemite trip all I want to do is go back out on the trail. I'll jump out of bed at 6AM to be in the water by 630AM for a dive. I'll get up at 430AM to be on the trail by 7AM for a hike.

There is a trail a few minutes walk from my house that leads down to a river. I walked it twice this weekend because the autumn weather was so gorgeous I couldn't bear to not take advantage of it. I was simply walking and loving every minute of it. I could have ran it but it would have felt like a chore - I don't want to spend 60 minutes running.

My minutes, hours, and days are limited. I don't want to do chores. I want to relish life.

gracias: 289/365

2011-10-17T20:30:00.001-04:00

getting up early and exercising - a good start to the day
surprisingly quick commute home
our neighbors who never hesitate to lend a hand
lasagna - always tastes good

why gracias? click here.

gracias: 288/365

2011-10-16T19:25:00.005-04:00

a good night's sleep
another beautiful autumn day - cool air, warm sun
a nice long walk
my kitchen helper - breakfast, lunch, and dinner prepared for the next three days = don't have to cook again until Thursday
the life that i have and the people that i love

why gracias? click here.

gracias: 287/365

2011-10-15T19:49:00.001-04:00

being under budget for groceries today
gorgeous autumn day - blue skies, sunshine, trees changing colors
take some time for a nice long walk
crazy steady BG day after yesterday's high BG shenanigans
an all around pleasant day

why gracias? click here.

gracias: 286/365

2011-10-14T15:48:00.001-04:00

its FRIDAY!
a little bit of sunshine after three days of rain
the way kona dawg bounces to the front door when i pull up to the house
a night on the town with my man

why gracias? click here.

Steppin' Out

2011-10-14T07:00:00.000-04:00

My dad is walking to stop diabetes. He is walking for me, for a cure. I was so incredibly touched when he told me he was going to do this. It means so much to me.

The walk is on 23 October and he is halfway to his goal. Click here to contribute.

Love ya dad!

gracias: 285/365

2011-10-13T19:16:00.002-04:00

exercising first thing in the morning
getting done with work a little early
all cooking and cleaning up done by 630PM
having a long evening all to myself

why gracias? click here.

gracias: 284/365

2011-10-12T20:15:00.002-04:00

clean house
clean sheets
comfy bed
catching up with a gal i haven't seen in awhile
dinner to go cause i don't feel like cookin'

why gracias? click here.

gracias: 282-283/365

2011-10-11T20:19:00.000-04:00

a three day weekend
finally getting motivated to work out after being such a slacker since my vacation
relaxing afternoon enjoying warm weather and a good book

carpooling
a short work week
touched by the generosity and sense of community from other folks with diabetes

why gracias? click here.

gracias: 280-281/365

2011-10-09T19:49:00.001-04:00

soaking up as much of the gorgeous weather while it lasts
exploring a nearby town and finding a great little place for lunch
a home opener win to kick off hockey season

waking up slowly and sleeping in
exploring a new place
being able to spend this beautiful autumn day outdoors with my husband and my pup
being tuckered out from a fun day

why gracias? click here.

gracias: 279/365

2011-10-07T20:07:00.000-04:00

its friday!
a short work day
sunshine and blue skies
stocking up on some jeans and t-shirts that were on sale

why gracias? click here.

gracias: 278/365

2011-10-06T21:17:00.000-04:00

another fine autumn day, lots of sunshine
putting the finishing touches on a video project
leftovers for dinner
enjoying this fine evening walking my dog

why gracias? click here.

gracias: 277/365

2011-10-05T21:10:00.000-04:00

sunshine
a mild autumn day
breakfast for dinner

why gracias? click here.

gracias: 276/365

2011-10-04T19:45:00.004-04:00

sunshine
able-bodied
employed
health insured
each day is a gift to make things better

why gracias? click here.

Guaranteed to Wreck Your BG

2011-10-04T07:00:00.000-04:00

I've blogged about my food choices before. I lean toward lower carb, more natural, less processed fare. But sometimes its hard to find an ideal meal away from home. You are forced to make do with what is on the menu.

Most eating establishments these days at a minimum have some kind of salad when other choices don't fit my strict criteria. But there are still places where the only lettuce to be found is a single romaine leaf used as a garnish for the jalapeno poppers. Places where everything on the menu is either fried or slapped between two giant pieces of white bread.

I found myself at an establishment like this a few weeks ago. A place where the nearest gas station was twenty miles away. It was a college football Saturday and I was there because it was the only place within 30 miles that carried ESPN.

A quick skim of the menu - burgers, chili dogs, grilled cheese, chicken wings, said jalapeno poppers, etc - revealed no salads. I was hungry and needed something to munch on. I opted for the breaded chicken fingers and french fries. One of my pre-diabetes personal faves to munch on, especially at sporting events. But since diabetes it rarely crosses my lips.

Chicken fingers and french fries is one of those meals that I simply have not mastered.

It always jacks my BG. Big time. I'm talking guaranteed 300+ BGs from this stuff. The kind of highs that take all night to come back down.

Maybe its because I rarely eat that kind of stuff that it just hits the right reward receptor in my brain and I can't control myself. Once I have one french fry, I end up eating them all. Or maybe it is the sugar-laden commercial BBQ sauce that has some sort of mind control over me. Its like a feeding frenzy. (Chocolate is known to have similar effect on my me.)

I don't make it a habit of eating food like this but sometimes extraneous circumstances get in the way and I try to do the best I can. I live and learn.

gracias: 275/365

2011-10-03T22:19:00.000-04:00

a kitchen helper
hoodies, fuzzy slippers, and sweat pants
getting things out and feeling better
autumn baseball

why gracias? click here.

gracias: 274/365

2011-10-02T20:18:00.002-04:00

some bacon to have with brekky
a fridge full of nutritious food
hoodies and fuzzy slippers
love
home

why gracias? click here.

gracias: 273/365

2011-10-01T20:30:00.000-04:00

jeans and a hoodie weather
getting errands done in the am so i can enjoy the pm
a relaxing day at home

why gracias? click here.

gracias: 272/365

2011-09-30T21:19:00.001-04:00

my hubby's safe return from his travels
its friday!
a manageable repair bill for my car
pearl jam

why gracias? click here.

gracias: 271/365

2011-09-29T19:39:00.002-04:00

another short commute home
lovely cool, breezy afternoon
friends in high places
good neighbors
my dog running around, playing, and keeping up with the 4-legged neighborhood pups

why gracias? click here.

Backpacking Yosemite - Diabetes Details

2011-09-29T07:00:00.000-04:00

When my husband and I were planning our recent trip to Yosemite National Park which included a 3 day/2 night stint in the wild I had some initial fears and concerns about how to handle my diabetes in the wilderness. I did some short overnight hikes earlier this year to try and get a handle on things so I would have some idea how to manage my diabetes on this trip. I also did some day hikes to get a feel for how different terrain and different situations would affect my BGs. These were good warm-ups for helping me to feel more comfortable being out in the woods and to have faith that I would be able to easily take care of my diabetes.

I have found that backpacking is a safe and enjoyable activity for us folks that have diabetes. The key is to just be prepared. Its the same thing as when you leave the house to go to work.

I want to use this post to touch on a few key things to keep in mind when heading out on a wilderness advenure:

Insulin Needs
Food
Supplies
Bears

Insulin Needs:
Prolonged, moderate activities like walking and hiking tend to lower BGs. This is definitely the case for me. The type of trails and how strenuous they are can be a factor as well. Hiking inclines tend to make my BGs plummet where as flat terrain or going downhill don't produce as pronounced a drop in my BGs. Plus, carrying a pack requires additional physical exertion further driving your BG lower. This trip involved lots of hiking uphill with a 40lb pack so I made some big reductions in my basal rate when I was on the trail - I lowered my basal rate to 20% during the hikes.

We did some day hikes leading up to the overnight camping adventure. Through trial and error during these day hikes I found that it was not necessary to have a bolus with my snacks while out on the trail. (This differs from normal daily life when I need to bolus for pretty much anything I put in my mouth.) The physical work was enough to keep my BGs from sky rocketing.

Another thing to keep in mind is that physical activities can cause delayed drops in blood sugar. This means you are at risk of experiencing hypoglycemia anywhere from 6 to 24 hours after you complete an activity. This time period can span the overnight hours so adjustments to basal rates may be necessary to prevent going too low while trying to sleep.

My overnight basals for hiking is something I don't quite have ironed out yet. For day hikes, lowering my basal to 80% tended to keep my BGs steady and a little high overnight. I found that for the overnight camping I dropped pretty rapidly in the evening and needed a late night snack to keep from crashing completely overnight when my basal was at 80%. Lowering my basal to 60% the second night of camping out had me waking up around 200 but seems like a safer bet to avoid crashing overnight.

For my meal boluses on the days in the wilderness I stuck with my normal bolus settings on my pump but opted not give the recommended corrections if my BG was high before a meal. My thinking was that the day's physical activities would help keep my BGs from going too high; plus I didn't want to risk crashing after every meal. Especially after dinner when we would be turning in for the night shortly after eating.

(Enjoying tea and brekky on Day 3)

Food:
I'm only half kidding when I say half the weight of my pack was food. I needed stuff to treat and manage my BG but also to replenish and refuel. For the overnight wilderness trek I made sure I had 4-6 glucose gels for each day and 4 Lara bars for each day. These were to treat lows as well as snacks when we stopped to rest on the trail. We were going to be on the trail for 3 days and 2 nights so I also had two dinner meals and two breakfast meals with me. I admit I've become picky when it comes to my food. I opted to cook and then dehydrate my own meals to take on the trip rather than make due with prepackaged, processed, additive laden stuff. I prepared two chicken dishes and mashed sweet potatoes to take on the trail. The chicken was not bad, it didn't quite rehydrate perfectly, but was edible. The sweet potatoes on the other hand were AWESOME! They re-hydrated beautifully and totally hit the spot. If you count gels, bars and meals, on average I was consuming about 250-300g of carbs per day in the wilderness. I typically eat around 100g carbs per day.

Supplies:
A key thing to keep in mind when in the wilderness is that everything I could possibly need for that time away from home/modern civilization I will need to carry in my pack. I think I had enough diabetes supplies to get me through a week or more. I had 100 test strips, an almost full vial of insulin, three extra infusion sets (one for each day), meter and a spare meter, back up batteries for my pump and meter, two good 'ol syringes in case my pump stopped working, various alcohol swabs and IV prep wipes, and my glucagon emergency kit.

In addition to my food and diabetes stuff I needed to carry backpacking essentials like water, my sleeping bag, cooking gear, and several articles of clothing. Maybe its because I'm a girl, but like to to at least try and make an attempt to feel clean after a day of hiking and again when I wake up in the morning. So I had some additional toiletries that most hardened wilderness types would probably laugh at (like dry shampoo).

Bears:
Yosemite bears are known for not only stealing backpacks and entering tents but also breaking into cars when a scent catches their fancy. Pictures capturing these kinds of bear encounters are plastered on bulletin boards at the park's campsite to prove the point that it is very important to keep all food away from where you will be sleeping. This meant that all of our "smelly" stuff - not just food but also all toiletries - would be stored about 100ft from our tent. The idea being if a bear does come through our camp at night, they don't have any reason to sniff around our tent while we were sleeping.

This is why its so crucial for me to make sure my BGs don't crash overnight because I won't have anything to treat it with in the tent. If my BG crashes it means getting out of the tent and stumbling through the dark woods to find our stash.

Thankfully we had zero bear encounters on this trip. Not even an inkling that one wandered into our camp on either night that we were in the wilderness.

All in all it was a successful and rewarding wilderness adventure!

gracias: 270/365

2011-09-28T21:10:00.001-04:00

short ride home
a clean house
busy but accomplished evening in the kitchen
i trust my husband

why gracias? click here.

gracias: 269/365

2011-09-27T20:55:00.001-04:00

neighbors who are willing to lend a hand
a cashier who went the extra mile for me
a sweet pup to keep me company
loved ones that keep me in their thoughts

why gracias? click here.

A Diabetes List (Yosemite Style)

2011-09-27T07:00:00.000-04:00

1. Stray test strips spotted in Yosemite National Park: one in front of the post office in Yosemite Valley, one on the trail to Glacier Point, one on the last mile of the John Muir Trail heading to Happy Isles in Yosemite Valley

2. Best way to keep your BG under 100 while eating every hour - walk 4.6 miles up a 3,000ft elevation gain

3. Getting insulin pump props at the top of Clouds Rest

4. Post hike treats in Curry Village - cookies and cream ice cream and a double latte

5. Favorite low BG treatment - Chocolate Mint Glucose Gels

6. Food is fuel

7. Even after a three day wilderness trek a single beer still jacks my BG

8. Hauling 40 pounds on my back - half of which was probably my glucose gels and lara bars (diabetic necessities on the trail)

9. That's not a scratch on my pump face, its a badge of honor from surviving three days in the Yosemite wilderness!

10. Altitude sickness and low BGs do not feel the same.

gracias: 268/365

2011-09-26T20:16:00.001-04:00

comments on my blog that make me feel like i'm having a positive impact
waking up slow, even though its a monday
long commute = extra time to catch up on podcasts
seeing BGs i like on my meter today
video chat - a modern technology that brings us closer

why gracias? click here.

gracias: 267/365

2011-09-26T07:42:00.000-04:00

not waking to an alarm clock
busy day but got stuff accomplished
playing with my dog in the basement cause its rainy out - still has flashes of puppy in him
afternoon tea and my magazines

why gracias? click here.

gracias: 266/365

2011-09-24T21:20:00.002-04:00

apples, apples, and apples and the farmers market
sprucing up the house for fall
new skillet on sale
the sun came out today
the life that i have

why gracias? click here.