After the Ride

I am slowly recovering from the grueling bike ride on Thursday. I am not nearly as sore as I thought I would be (actually my sit-bones are just as sore as I thought they would be). The new trail (the Cheyenne Rim trail at Soapstone Natural Area) proved to be a little harder than I had anticipated. It took us about two hours to get to the turn around point (and only one hour to get back to the parking lot--I do love down hill so much better). But the pay off was well worth it. After 7.6 miles of tedious elevation gain, the landscape opened up to a beautiful red dirt valley. We stopped and ate lunch on a rock outcropping and took in the magnificent scene. We were the only people for miles. There is something so healing about that kind of silence.

Before we started the bike ride, I drank a homemade protein shake (about 17g protein, 20g carb). That, along with a conservative amount of insulin at brunch, held me over pretty well. I checked my sugars around the 6 mile mark, after a painful hill climb left me feeling drained. 67 and likely dropping. I took four glucose tabs and hopped back on my bike. I could sense that the halfway point and subsequent lunch break were near. It turned out I was being a little too hopeful in that aspect. by the time we did stop for lunch, I knew I had some room to work as far as blood sugars were concerned. I ate freely with little regard to carb counting (just one of the many benefits of serious activity). The way back was mostly downhill and by the time we got back to the car my blood sugar was holding strong at 93.

We ended the day with a home cooked meal and some celebratory drinks on the patio. (Did I mention that my parents kick ass?)

Activity is the Best Thing

Down to 2u of long acting insulin! Things are definitely looking good. Thanks to a very fun integrated iPod adaptor my boyfriend got me, I have been pushing my morning runs farther and farther each day. I have my eyes set on three and a half miles for Friday. That is, if I can walk after my 15 mile mountain bike trek tomorrow. My parents are coming up for a belated birthday celebration and we have big plans: brunch at Snooze, bike ride, and homemade Moroccan shish kabobs for dinner. With any luck, I will be able to ditch the Lantus entirely for a few days and embrace a life that involves three needle pricks a day instead of four.

To all the T1Ds out there who were told they had to limit their activities because of this disease, it is just not true. I was lucky enough to be ignorant to that myth and to have an outpatient nurse with an eight year old diabetic son. She knew, just as I do, that diabetes does not have to keep you pinned down. Eat before you exercise, check your sugars frequently, and always pack glucose tabs and extra snacks. You can take on the world.

Porch Gardens and Yoga Class

Overall, I had a very successful weekend. Saturday started early as I rose with the sun to go to work. Now normally, working on a Saturday would make me a little glum. But my job (which involves a lot of being on my feet, chasing dogs around, and making decision after decision--did you know, thinking over and making a choice actually uses up to 20% of your blood sugar?) has an incredible capacity for sucking the glucose right out of my blood. And right now, I am on a mission to get my sugars back on track.

Sunday, I enjoyed a peaceful morning on the porch with a cup of tea. After an extravagant breakfast of mushroom, spinach, kale, and green onion eggs, with toast and strawberries, I forced myself to the gym for vinyasa (yoga on speed--especially if the instructor has had a bad week and wants to take it out on the innocent). About ten minutes into class I had a sudden and unfortunate realization: I only had one piece of toast this morning. Now to any normal person, this would be a good thing--way to not overeat, cut those calories out where you can! But for a carb counting diabetic, this spells disaster. I had taken enough insulin for two pieces of toast and five strawberries. In the middle of chaturanga dandasana I felt a pulse of cool blood rush through my system. The realization flooded through my body and into my subconscious before being perceived by my conscience mind. I stared at my hand. When my sugars crash my fingers flush and swell just slightly. (I can't even glance at my hand without my boyfriend asking if everything is okay.) Angrily, I jumped up from downward dog, bypassed the maze of yoga mats and went out to my car to fish some glucose tabs out of my purse.

I stubbornly finished the hour long class with teetering glucose levels (much to the chagrin of my healthcare team), and rushed home to find a more substantial snack (a piece of toast, because I was so angry about having shorted myself the pleasure of it at breakfast). I finished the day by planting my porch garden and praying to the gods of the deceptive Colorado spring to be kind to my vegetables and not strike them down with a late season frost.

Though the weekend held less time for relaxing than I would have liked, all the hard work has brought my long acting insulin needs down to 5u. With a long week of hard work ahead of me, I'm hoping those numbers will only continue to fall.

The Road to an Herbal Treatment

My insulin requirements are slowly coming down from the debauchery of last weekend. After a week on a strict diet, my fast acting dose is back to 1u per 30g carb and my long acting is finally coming down from 8u per day. Before the trip I was down to 4u a day thanks largely (as far as I can tell) to the Nopal Cactus supplements. I hope to be back to that number by the end of next week (assuming I can continue to refuse all temptation--lets be realistic here--most temptation).

This little hiccup reminds me of why I started pursuing alternative treatments for diabetes in the first place. Four months ago, after a holiday season full of poor choices (and a whole lot of fun to match) my blood sugars were less than admirable, my A1C was climbing, and my insulin intake was up up up! I got back on my normal diet routine and hit the gym with more vigor but still could not get things to return to the way they had been at the end of Summer. For the first time since my diagnosis, I couldn’t eat a snack (10-20g of carb) without taking insulin. I had to face reality, my honeymoon period was ending. Whatever function my beta cells had left was spent. My immune system had won the pancreatic war. My insulin needs were going to rise and rise until 100% of my insulin came from a funny looking pen filled with clear liquid. I had no choice but to accept it.

That certainly doesn’t sound like me.

It was around that same time that a friend of mine started working the supplements section at Whole Foods. One day she told me about a customer coming in and buying loads and loads of cinnamon. She claimed to be a Type 1 and claimed to be off insulin shots completely. I was skeptical of course (and still am--I have met more than one diabetic in my life who didn’t even know which kind of diabetes they had--don‘t even get me started on diabetes education in this country). But I looked into it and sure enough cinnamon has a compound in it called MHCP that mimics insulin and opens your cells to glucose.

So we did some research on the effective dose, the type of cinnamon (powder or extract) and I bought myself a couple bottles. I had no delusions about cinnamon curing a disease that’s been plaguing people since ancient Greece (although many ancient cultures claimed to have found effective herbal treatments). All I wanted was to get back to where I had been before the final pancreatic decline. And wouldn’t you know, things began to get a little easier to control.

A door was opened. I was on a mission to find more alternative treatments. With my friends help, I came across more potential glucose tamers. Gymnema Sylvestre. Bitter Melon. Octea. Ginseng. Fenugreek. Chromium Polynicotinate (I actually have to give props to my grandma on this one, she had me on this supplement the second I was diagnosed). And of course Nopal Cactus.

At the beginning of January I was using 12u of slow acting insulin a day and 1u per 15g carb of fast at each meal. I put myself on a strict diet clad with super foods and started taking 2 tsps cinnamon a day (I have almost tripled that dose now), 500mg Bitter Melon, 400mg Gymnema, and 3 drops Octea. By the end of two weeks I was down to 4u of long term and 1u per 60g carbs.

So there is something to this herbalist witch craft after all.

The experiments continue. I have no dreams of being off insulin completely (ok I do, all the time). But if I can find a supplement regiment that is affordable and allows me to hand over fewer of my paychecks to Big Pharmaceutical, then I will be happy. And of course, I will do everything I can to share my findings with others (who are willing to use their own bodies as laboratories).

Starvation in the Midst of Plenty

Starvation in the Midst of Plenty

Syran Wrap covers my eyes

they’ve decomposed before their time

focus. fail.

focus. fail.

bones cut skin like butter

wasting weight wears away

I’m skin and bones

And hunger

ravenous and extreme

I dream to eat all I see

And do

but not an ounce or gram or inch

do I gain

I remain a fading frame

and I thirst

I want I crave I need

to drink entire seas

And do

but it runs straight through

drains as quickly as it came

I shrivel and dry

skin cracks it lacks it dies

I’m weak

muscles hang on tired frame

of which my body

does consume

I feel my death

its coming on and soon

my eyes grow tired

focus. fail.

I’m weak

still I eat and eat

but not an inch do I gain

and soon,

not an inch will remain

I came across this poem this morning. It was something I wrote for a a class just months after my diagnosis, when the symptoms of uncontrolled high blood sugars were still very much at the front of my mind. 

Focus. Fail. My eyesight had blurred substantially over the course of a single week. One day I could read street signs from blocks away. Literally the next, I couldn't read them while sitting at the stop light they hung from. I forced myself to the eye doctor who persuaded me into believing that I was wrong--this hadn't occurred suddenly, it had been coming on for months. Yes of course doctor, you do know what I see better than I do.

Wasting weight wears away. I lost six pounds over the course of one week. I went from 114 to 101 before I decided (my mom actually decided) that something was wrong.

I dream to eat all I see. And did I! My body, starved of glucose, craved food--sugary, syrupy, sweet food most of all. My stomach was a bottomless pit. I would clear my plate in seconds and then set my eyes on the plates of those unfortunate enough to be sitting next to me. At my friend's birthday dinner at Old Chicago, I ate an entire calzone, half a plate of pasta, and half a sandwich (and I wouldn't have stopped there if there had been food left on the table). My friend and I joke that I once ate her entire kitchen. It would be more amusing if it wasn't true (box of oreos, packets of instant oatmeal, half a liter of soda, chips...). I didn't gain a pound. The glucose cycled endlessly through my bloodstream for days, then slipped out through my kidneys. My body fed instead on the protein in my muscles.

And I thirst. I couldn't sit through a 90 minute movie at the theater without getting up five times to run to the drinking fountain. I got up multiple times a night and guzzled water. I once had an anxiety attack while driving home to my parents' because I hadn't brought a water bottle. I thought I was going to shrivel up on the seat. My lips were so cracked that I had open, stinging cuts in the corners of my mouth. My throat was permanently parched. My tongue was a salted slug.

It runs straight through. Trips to the bathroom were frequent but an afterthought, really. I was in there sucking water out of the faucet anyway. It seemed an obvious consequence.

I'm weak. I didn't want to get out of bed in the morning. I would lie there with a swollen bladder and cotton mouth, but I would not want to get up. I forced myself to the rock gym multiple times a week (after all, I was consuming thousands of calories per meal--my girlish frame couldn't hold on forever). I could barley make it up a 5.7 route, even after weeks of practice. I was fatigued. On weekends I would sleep all day (getting up every hour to drink and pee of course).

After my diagnosis and subsequent hospital stint, things rapidly fell back into place. I gained seven pounds from IV fluids alone. My cracked lips healed. My eyes almost instantly sprung back to 20/20 (still, the persuasive eye doctor refused to give me a refund for the glasses). I felt alive again. The only thing that never got better was the insatiable appetite. My guess is that I wore out all the hormones meant to keep my eating habits in check. Without strict portion control and a focused willpower, I can still easily over eat to the point of pain (and blood sugar explosions). Over the last three years I have developed a system to help keep myself in check. I've turned my obsession with food into an obsession with health through food. Superfoods, supplements, health shakes. I feed my hunger through food education, cooking fresh meals, and the satisfaction of knowing that what I put in my body may not fill me up, but at least it will make me feel good. (Of course, even after years of practice, this can go out the window with a little tequila, a long work week, and reason to celebrate).

A symptom list from Diabetes for Dummies (Wiley Publishing, Inc. 2008)

Live and Learn

This weekend provided an all too brief respite from the stresses of real life, and unfortunately, way too much stress on my pancreas. But sometimes the overindulgences are worth it. Sometimes you just have to let yourself live a little (at least that’s what my fun-loving, care-free self tries to tell my type-A, perfectionist self--usually to no avail). We (including both dogs--which was fun, but definitely took away from the serenity of the trip) drove the car up to Chico Hot Springs in Montana (a short drive from Yellowstone's north entrance). Along with its natural beauty and tranquil environment, Chico also boasts an amazing restaurant. I arrived fully prepared to battle against the seductive tendencies of this world famous kitchen, but lost all will to fight as soon as I heard someone say “breakfast buffet.” I was lured in by the steaming eggs, homemade granola, and an array of salted meats (a treat I rarely indulge in). That night, my fate was sealed when a heaping bowl of wild mushroom risotto materialized on the dinner table before me. Thanks partly to the intoxicating aromas of the dish and partly to the intoxicating alcohol of the two vodka and sodas I had downed at the bar before dinner, I was unable to conjure any self control until it was too late. The hefty serving of food was all but polished off by the time I forced myself to release the grip on my fork.

Early morning walks with the dogs and some swimming in the hot springs helped curve the skyrocketing blood sugars, as did the Nopal supplements (though it seems obvious to me now that I should have packed more than my usual dose as I was eating quite a bit more than my usual amount of food), but in the end, my insulin needs still doubled. It happens every time I travel and really shouldn’t surprise me, but I am still feeling a bit disappointed. It occurred to me yesterday as we made the long drive home, that I could double my Lantus the first day of my trips and save myself a lot of trouble (and possibly save my pancreas a little time). It is a little embarrassing to admit this thought has never crossed my mind before. But what can you do? You live, you indulge, you learn (eventually).

The beautiful Chico Hot Springs Lodge nestled in the hills of Paradise Valley, Montana.

The Curse of Routine

I love to travel. I think there is nothing more important to building knowledge than to get out into the world and gain experience in different dimensions than what you are used. My pancreas, on the other hand, hates new anything. Success in blood sugar management, at least for me, relies heavily on routine. Each meal, I choose from a mental list of old standbys. For breakfast its usually oatmeal with coconut milk and a some berries--always 60g of carbs. Lunches vary, but again, they always add up to 60g. Dinner is usually soup or salad. Sometimes grilled veggies, but the amount of carbs is always between 0g and 40g (depending on my insulin to carb ratio at the time). I eat one snack between breakfast and lunch (one serving of nuts), and one between lunch and dinner (an apple or orange). I thrive on routine. It keeps everything simple. It also keeps everything fairly boring. That's what vacations are for (and sometimes weekends).

Traveling, whether in a car or a plane, is not kind to diabetes. I'm not sure if it's the long periods of sitting, the stress of travel, the eating of unfamiliar food, or just the simple act of change, but something about it shoots my blood sugars way up. Last December I went to Hawaii. Armed with the knowledge that travels creates 200+ glucose levels, I decided to avoid carbs that first day. I survived on nuts and salad. When we arrived in Kauai, I was a bit irritable (I do love my food) but my blood sugars were in great shape. I believed, for a brief moment, that I had conquered the traveling curse. And then I woke up the next morning to a BS of 180. There goes that theory. I kept a tight hold of my blood sugars for the rest of the trip. Still, my insulin requirements had doubled by the flight home.

Tomorrow, I am road tripping to Chico Hot Springs in Montana for my birthday. Eight plus hours in the car spells disaster (especially since I have a tendency to snack when I'm bored). But I have a little more hope for this trip than I have had for others in the past. My blood sugars have been holding in the fantastic zone for the last two weeks thanks largely (I believe) to the Nopal Cactus supplement. My long-acting dose is down to 4u a day! I haven't been that low since I played guinea pig for a drug trial at the Barbra Davis Center over a year ago (a post for another time). With any luck, the Nopal will be enough to keep my insulin needs from sky rocketing during the trip. That may be asking a lot of a simple desert cactus (after all, it is my birthday, which entitles me to a little gluttony). I guess only time will tell.

Nopal Supplement Update:

Day 8 (4/16) cont'd:

• 6:00pm- 85

Day 9 (4/17):

• 5:00am- 60
• 5:00pm- 73
• 11:00pm- 48 (sleeping low--never fun)

Day 10 (4/18):

• 5:00am- 77
• 11:00- 56
• 5:00pm- 74

Day 11 (4/19):

• 5:00 am- 121

(For those of you keeping track, yes I have gotten a little skimpy on the testing. That's what happens when the cost of test strips goes up 400%. And I had such high hopes for this new insurance plan.)


Insulin Requirements:

• Short acting- 1u/30g for all meals (yay!)
• Long acting- 4u per day (also yay!)