Tuesday, July 31, 2012

The Big B

Last weekend was a little crazy. I ran a 5k Saturday morning (the spotted monster and I came in at 24:33) and then catered a 13 hour wedding (actually the wedding was only about 10 hours, but hand washing all their dishware took well over 3 hours). I didn't get home until two in the morning. I spent most of Sunday on the couch complaining about how much my feet hurt and watching my blood sugars play out like the profile of a mountain range (high. low. high. low.).

But that is nothing compared to the daunting task that awaits me this weekend: Long's Peak, aka "The Bitch." Seven miles of unrelenting trail with hazards like "the boulder field," "the aunt hill," "the narrows," and "the ledge." 14,225 feet of elevation gain (ok that's not exactly true, but it certainly feels like that much). A billion rock stairs to heave yourself up (seriously, no exaggeration). 3,000 foot cliffs guarding the final ascent. And when you do finally make it to the top, you just have to turn around and do it all again.

This will be my fourth Long's climb (despite me swearing that I will never do it again each and every time I do it). The first time, I wasn't diabetic and it took us 14 hours. The second time, I went with a couple friends who were afraid of heights and I had been diabetic for four months. That one took us 16 hours. The third time, last year, I was a master of my sugars and climbing with two master hikers. It took us 10 hours.

This year? As usual I'll just be happy to make it up and back alive.

Thursday, July 26, 2012

You Put that Where and Other Reasons Not to Vomit

Insulin and vomiting do not go together. That's something T1Ds know all to well. You calculate your insulin dose based on how much food goes in. When some of that food comes back out later, that can be dangerous. We are talking anti-vomitose suppository dangerous (and what could be more frightening than a suppository?!). I will regretfully admit that there have been times in my diabetic life, when I have been placed at the foot of the porcelain god by my own means (it's a mistake you only make once or twice... or five times).

But last night, after a celebratory dinner at Carraba's (we were celebrating the fact that I had a gift card to Carraba's) and trivia night at Ryan's, I found myself meeting the toilet head first late in the night. Luckily, my BS was already riding a little high thanks to the festivities of the night, and the purging had only a positive effect there, bringing me down to a respectable 88 (still, if I had the choice, I would NOT do it again).

But the question remains: Was it the talapia from Carraba's (do Italians know how to do talapia? I've only ever had good talapia in Ecuador)? Or the one bite of pizza I had at Ryan's? Or those brown, skanky limes they put in my drink during trivia? (And no, it was not the drink itself. That particular brand of up-chucking is proceeded by massive vertigo and an unyielding need to end my suffering with a quick shot to the heart).

It may be a question we never answer. But for the time being, I will be throwing away my left overs and refusing all drinks adorned with suspect limes.


On a completely different note, I found a short article about apple cider vinegar and diabetes--something I have wanted to do some experimenting with. Stay tuned.

Monday, July 23, 2012

A Week of Goals

My goals for the week:
  • Come to terms with my new meter (yes, I finally gave in to my insurance--I am now officially a One Touch user)
  • Start training for the Long's Peak climb on 8/4 (this will be the fourth time I have climbed the 14,225 ft beast, but that doesn't make it any easier)
  • Find a good multi-grain bread recipe and figure out how to actually get the damn thing to rise for once
  • Complete the second harvest of my porch garden and make some kick-ass home-grown salsa
  • Get the maintenance guy out here to tell me why my air conditioner is leaking green liquid
  • Decide what sacrifices I need to make in my daily life so that I may actually start working on my third novel (the one I have written ten times over in my head, but have yet to put on paper)

They have grown a bit since that first picture.

Wednesday, July 18, 2012

The Benefits of Boring

For the past couple weeks I have been trying desperately to save money for my September vacation to Costa Rica. And for the past two weeks, my blood sugars have been exceptional.

Coincidence?

Could it be that living simply and within my means can actually have a positive impact on my diabetes?

I am not going out as much, which means I am not eating strange and decadent meals of unknown carb counts at restaurants. I am not buying beer by the pint or being tempted with dessert. I am grocery shopping with a decidedly reserved and simple plan of action and making meals that fall into the "old stand-by" category. And I am spending less time consuming, which means I have more time for things like exercising, biking, and walking the dogs.

So, could it be that a boring, simple life is exactly what it takes to master this disease???

No. Absolutely not.

(Because, what would be the fun in that?)

Monday, July 16, 2012

IVs and Vampires

Flashback Continued...

That night in the emergency room was the first time I had been in the hospital since I was born. It was a strange, chaotic place that bore no similarities to my favorite hospital TV dramas (no hot doctors battling outrageous personal issues while heroically saving my life). My phone died almost immediately after I arrived, which severely limited my ability to communicate with my now panicking family and friends. While I was down in the ER in a tiny closet of a room being strapped up to all matter of machine, my brother and his girlfriend would take turns coming in to talk to me, but it wasn't long before it got late and became painfully clear I wasn't going anywhere.

After they left, it was just me, my Diabetes for Dummies book, and a swarm of doctors and nurses buzzing into my room then out every few minutes. I quickly got used to telling my complicated story.

"You're a diabetic but you don't have insulin?"

"Well, I just got diagnosed this morning, and my doctor didn't give me any..."

By midnight, it was clear I was going to stay the night. Thanks to IV insulin, my blood sugar was starting to fall, but even after two hours I was still hovering around 400. They wheeled me out of the ER and through a long corridor and up to ICU.

I spent the next couple hours reading my diabetes book. There was no way I could get to sleep, and even if I did, I had nurses coming in to take vitals on me every half hour. And beyond that, it was all just a little bit exciting. I had my first IV, my first insulin shot (they were hitting me with insulin from all angles), and my first blood draw. (By the end of my third year with diabetes, I have had over 25 IVs [mostly thanks to a clinical trail I was in], over 15 blood draws and about 4,380 insulin shots.)

By 3:00am my head was pounding as my brain began to expand back to normal size thanks to a never ending supply of IV fluids and I was finally willing to get some sleep. It wasn't easy. Aside from the constant barrage of nurses, I had an unusually young looking lab tech in a wife beater try to steal my blood in the darkest hours of the night (lab tech or vampire? I'm still not certain).

I finally fell asleep around five in the morning. Not much later, as the first rays of sun broke the black of night, I rolled over to find my mom sitting quietly next to my bed. I wasn't sure where she had come from or how on earth she had crept so quietly into my room, but I was certainly glad to see her and to this day, the sight of her sitting there is one of my fondest memories.

Thursday, July 12, 2012

"HI"

Flashback

I was first diagnosed with diabetes by my family doctor while visiting my parents on a weekend home from college. Not having dealt with many cases of T1D, my doctor referred me to the Barbra Davis Center for Childhood Diabetes. She said she would contact some of her colleagues there and set up an appointment for me for the end of the week. And then she gave me a meter and sent me on my way, without a prescription for insulin (not that I would have known how to use insulin even if she had given me one).

I made the two hour drive back up to Fort Collins later that day. I had no idea what else to do. I had been sick for six weeks, what was a couple more days? And besides, I had already missed one day of school. But there was a problem: Now I had a meter. knowledge is power, right? As it turns out, sometimes it's better to stay in the dark.

That night I ate a modest meal (I now knew that carbs were the enemy, but, like most of the population, I had a very warped view of what carbs were and where they were found). My doctor had instructed me to test my sugars before bed and call her if my levels were above 300. After washing my face and brushing my teeth, I pulled the meter out and set it on the bathroom counter. I carefully pulled out a test strip and stuck it into the strange looking device just as I had seen my doctor do earlier. I pricked my finger with the lancet, panicked for a moment when no blood came out, pricked it again with more conviction and pushed the red bubble up to the strip. The little machine beeped and started thinking. After a moment, the meter beeped again and a message appeared on the screen. "HI" was all it read. What? What the hell does that mean? Is it broken? Should that say "81"?

I pulled the strip out and inserted another one and tested again. Again the screen showed "HI." I raced into my room, hands shaking and a cold sweat breaking down my back. I pulled the instruction sheet from the meter box and started flipping through the pages wildly. Finally I found it: "'HI' will appear on the screen when blood glucose levels test to be over 500."

500!?!

Tears started to gush from my eyes as my body sprung into full panic mode. I grabbed the vile of test strips and struggled to remove the cap with shaking fingers. Just as the lid came loose I dropped the whole vile into the sink. I scrambled to collect the test strips before they got wet and began to cry even harder.

By the time I got a test strip loaded and a decent blood bubble ready to test, my bathroom counter was littered with soaking wet test strips and streaks of blood. The third test agreed with the previous two and a moment later I was on the phone, frantically dialing my mother. While she called my doctor to relay the message, I called my friend and told her to stand by because I might need a ride to the hospital.

My mom called back. Yes I needed to go to the emergency room. She had already called my brother (who was attending the same college) and he would be by soon to pick me up. Within ten minutes my driveway was packed with cars as my brother and his girlfriend and my friend and her boyfriend all swooped in to my rescue. Still in my pajamas, I jumped in my brother's car and we were off.

By the time we reached the hospital my disposition had flipped completely. I was calm. Everyone around me panicked, but I was calm. I had one very simple realization hit me on the drive: My blood sugar was dangerously high, but that was unlikely to be anything new. I had been symptomatic for six weeks. I had been gorging myself for six weeks in the face of starvation in the midst of plenty. I had eaten way bigger, carb packed dinners than the one I had had tonight. And I felt fine, well, as fine as I had all month. In fact the only thing that had changed was the meter. I wasn't going to keel over or slip into a coma. I was fine.

In the ER the nurse knelt down before me and tested my blood with her much bigger, much fancier glucose meter. After a few seconds the machine beeped and the screen flashed. 598. But I was fine. I was fine.

Tuesday, July 10, 2012

System Reboot

For a diabetic, fasting can be a four letter word. If you have insulin on board then you'd better be eating consistent meals or you will crash hard. But in my endless experiments I conduct on myself, I have found that there is a place for fasting within my own diabetic world.

I use fasting as a reboot. When insulin needs are skyrocketing and blood sugars are flying high, then low, then higher. And when I have gotten so off routine that a simple turn in the right direction isn't going to get me back to normal fast enough. In that case (i.e. after every vacation I take), fasting works wonders in realigning me on my path to diabetes gold.

Of course, the five day juice fast/detox I so long to be able to do (though I probably lack the will power for anyway) is out of the question. My fasting style--what I call an Easy Fast--is a little different. I eat breakfast--a fiber and protein packed breakfast. And then for the rest of that day, I exist completely on water with lemon and decaf tea (the act of abstaining from all that is flavorful would likely end in my mental demise, so herbal tea is a must to get me through the day). I don't exercise and I don't over exert myself. The next morning, after a full 24 hours without food, I eat breakfast as usual and jump back into my strict, normal routine. (Yes, I was fasting yesterday after my fun-filled trip to Montana over the holiday weekend. And yes, that may have had something to do with the rage.)

I find this kind of fast does two things for me. One, it gives my gut a break. As a person who eats variations of the same meals just about every day, any step off track often leaves me suffering from Angry Intestines. After a few days on this foreign diet, I am usually feeling it in my energy levels as well. And it's not just the food itself, it's the amount I eat of it (what can I say, my mind and body firmly believe that VACATION means it's time to make up for all the months of strict portion control and general military style routine). A fast is the perfect respite for my overworked stomach.

And two, it gives my pancreas a break. I'm not sure how much insulin my body still produces, but I know for a fact that when I abuse my body by upping my portions and doing more sitting than standing, my insulin needs go way up. It's like my pancreas only has so much to give at any given moment and if it can't keep up with demand than it throws its hands up and walks out. But on a fast day, it's my pancreas that gets the vacation. Once breakfast is digested, it has twenty-four hours to kick back and relax. After a fast day, I find my insulin needs drop much quicker than if I just try to get back on my normal routine and wait it out.

Of course--and this should really go without saying because you should question everything anyone tells you, especially about managing YOUR diabetes--this is what works for ME. If you are going to try it there are two things to keep in mind: Check your blood sugar frequently; And if it drops, eat something! As all diabetics know, making compromises to fit your needs at any given time is the only way to stay healthy.

Monday, July 9, 2012

Excuse Me While I Rage

Dear Mr. Insurance Company,

Thank you for being sooooo easy to deal with. I'm glad your phone number doesn't appear anywhere on my member card, after all, why on earth would I ever need to contact you? It's not like I have ever had a question about a bill, or a benefit. Its not like I have ever gone to the pharmacy and had my jaw unhinge and fall to the floor in a bloody heap when the teller read me the total.

But honestly, I'm glad I have to get on the internet and look you up before I am able to give you a call. You know why? Because I loath calling you. I LOATH it. I would rather submerge myself in a vat of ice than to be subjected to the dispassionate, dim witted teller that answers the phone. Can I help you? IT SURE DOESN'T SEEM LIKE IT. But really I don't blame them, after all, it's not easy answering a phone call half a world away and pretending like you actually work for the company you say, and are not in fact just a telephone operator in a damp building in Bhutan with another caller inquiring about motorcycle insurance holding on the other line.

No I blame you Mr. Insurance. I blame YOU for my rage because you are the reason I spent half a day scouring the internet, printing off paperwork, filling out paperwork, faxing the paperwork to my doctor, refaxing the paperwork because my fax machine apparently wasn't working, breaking the fax machine when it continued not to work, driving to my doctors to hand deliver the paperwork, waiting in the waiting room with a menagerie of sick people, and finally handing the paperwork to my doctor so she can scribble out a prescription.

And was that the end of it? Of course not, that would still be too simple for you. Because that i wasn't dotted and that t wasn't crossed, the mail-in pharmacy decides to give me a call. I try to call back but of course they are closed. So I wait. And when I do get a hold of Mr. Aziz who mistakenly answers the phone with the wrong company name and then quickly corrects himself, we finally get things squared away. WRONG. Because two days later I get another call. Well of course you must get my permission to run my credit card if the total is above--HOW MUCH!?! But why Mr. Aziz??? Why is it so much??? Yes of course, I will call my insurance company right away, of course they will know!

Just let me find the number...

So I scream repeatedly at the automated woman who asks me questions but can't understand me when I use certain four letter words in my response, and I eventually am put through to a real human--who may or may not actually be Mr. Aziz once again. Oh, this is a question I should be asking the mail-in pharmacy and not my insurance provider? Of course, why would my insurance have any idea why they are charging me 55% on a prescription that should only cost me 35%? That clearly has nothing to do with you, Mr. Insurance.

Back to the mail-in people it is!

But this time I press a completely new set of buttons and am put on with a whole new branch of people within the phone web of cyberspace. And we talk and talk and I threaten him with cutting words when he tries to tell me to call my insurance about this issue and finally we find the problem.

Oh, these kinds of test strips are non-formulary?

So unless I want to sell a kidney I should change my meter brand?

And get a new meter?

And throw all the other ones in a box somewhere because they weren't good (cheap) enough for you to cover?

And in order to get a different kind of test strip I will need to fill out more paperwork?

And go back to my doctors?

And re-fax it in?

And wait another week for a response?

And I will by that time, of course be out of tests strips completely, so I should go to the walk-in pharmacy?

And pay an arm and a leg, even though the point of this whole mail-in endeavor was to avoid such outrageous charges?

Excuse me, what was your name? Where do you live? Do you usually lock your back door at night???? 

...

So I rage and I rage. But in the end I give in. Because I am at your mercy Mr. Insurance. I LOATH you. But I am at your mercy.

Tuesday, July 3, 2012

Taking a Holiday

4th of July on a Wednesday spells a long, busy week at the boarding kennel. But, seeing as I have spent the last month or so pouring every ounce of myself into that place, I have decided to forgo the madness this year. Instead, Colter, myself, and the dogs will be road tripping up to Montana tomorrow for a looooong weekend get-away.

For my brain, this means a nice relaxing time spent in a beautiful country with my book, my writing, and my pups. We'll be celebrating the Fourth and Colter's mom's birthday with some fun, some laughter, and probably some wine. To put it simply: It will be amazing.

But for my pancreas, it means seven hours on the road trying desperately to avoid all manner of gas station snackery (I pack a plethora of veggies, nuts, and tea so I can engage in the constant grazing my mind so desires on long, boring car rides without so many of the harmful sugar spikes that are already guaranteed by the simple fact that I will be sitting down for more than an hour straight). And of course, after we get there I will have to try and talk myself out of this idea that vacation = gluttony (which = poor dietary choices, which = poor sugar control, which = sky rocketing insulin needs).

But in the end, I still see it all as a small price to pay for a little R&R and mental sanity (because my diabetes control would be much much worse if I went insane, right?)

Monday, July 2, 2012

Today

The sun has been conspiring against me. It has been raging since the last weeks of Spring without signs of ceasing. It has been dancing violently on the parched grass and trees of Colorado forests and lighting them up like kindling. The smoke has joined the conspiracy and has been swimming low across my town for weeks. It has been laughing at me from the other side of closed windows, daring me to come out and play.

Between the sweltering heat that lasts deep into the night and the blanket of suffocating smoke, I have been forced to hang up my running shoes. But today I will prevail. Today I get up at 5:00am. Today I slink out into the first rays of morning sun before the heat sets in and before the wind drives the smoke into town. Today, I run.