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February 10th, 2012
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I've been nursing a lot of highs lately. I'm not talking about the mediocre 200s, but full blown 400s and 300s. Both Saturday and today, I've been stuck well above a comfortable range.

 

Saturday was quite terrible with nausea, headaches, and unquenchable thirst. Even with incredible doses of insulin, I just seemed stuck above 300. I'd eaten a high carb breakfast, but I'd done adequate insulin. And then followed it with even more adequate insulin and then some.

 

Last night's Mexican dinner seems to have pushed me into the 290 to 350 range. It's a dinner that I've had plenty of times, done the right insulin, and not seen these torrential highs. It just doesn't add up.

 

Every now and then, I seem to struggle like this. I have days where all I feel comfortable eating is jell-o and popsicles. It's a constant routine of check, inject, drink water. It's getting really old.

 

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I've really been struggling with the Lantus and exercise mix. When I first started out, I did okay with a few lows here and there (nothing out of the ordinary for me). But as I added in new and different work outs and upped my intensity, I'm struggling to keep my blood sugars stable before, during, and after exercise.

 

With the pump, it was so easy to decrease my basal so I started my workout in the 180-200 range. I struggled with maintaining a higher level during exercise, often going low...but at least I wasn't concerned with those numbers completely wrecking my averages.

 

Now that I'm back on Lantus, I'm re-learning everything that I did five or six years ago (since high school held my hardest workouts). But I'm failing miserably. I can't get the range right before working out, often soaring to the 260's. And during, I'm flatlining in that same range.

 

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Because of my recent tummy troubles, I've decided to put off the Metformin start for at least another week. So instead of starting Metformin today, I've decided to get back into the groove of the need for insulin. Instead of purposefully skipping Lantus doses and fudging my boluses, I'm going to get into the routine of doing these things right.

 

My current Lantus doses are split at midnight (16 units) and noon (18 units). However, I've had a lot of trouble remembering them or getting them on time lately without a schedule. So I think I need to try a one dose Lantus shot for awhile. I've done it before and it just doesn't give me as tight of control as I like, but it's better than no insulin at all.

 

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I was planning on writing a weekly diet update, but I never did get around to it. Now, I'm at the semi-end of the diet so it's kind of pointless. But I’ll throw my thoughts out there anyway.

 

The first two weeks went alright. I had many, many lows but finally I got my basals and work outs adjusted so that I was having a normal amount of lows for my body. The third week, I hit a major bump in the road.

 

If you remember, my blood sugars started doing crazy things. The diet stayed the same roughly and I kept increasing my basals. Nothing changed.

 

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The nurse slapped the small piece of paper down on the table.

 

I glanced at the 8.2 and then looked away, disinterested. I figured as much. Like I said, it’s been a high summer.

 

I spoke to the nutritionist first, then the CDE and then the doctor.

 

Charlie’s height is trending fine, but his weight had dipped in the last three to six months. Despite the A1c of 8.2, Charlie couldn’t have heard better news from the dietician.

 

"Let’s up his food. Make it more like 185 to 200 carbs per day."

 

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Being back to school is the hot topic lately. For me, being back to school is a big change. Not only do I move away from home again every semester, but also my schedule is constantly changing. The stress is different. The food is different. The exercise is different (walking an extra 3 miles a week around campus). My control is different.

 

Over the summer, I really watched what I was eating. I finally got my other health issues sorted out and had the potential to lose the weight I had gained because of them. I was motivated. So I started limiting my portions, choosing "smarter" carbs, and decreasing my overall intake of carbs.

 

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My classes are all over the place this semester. Since I'm down to the final semesters, I don't have much left that I can take outside of my university or online. Plus I'm trying to leave the option to study abroad next semester, which means taking quite a few hardcore classes all at the same time.

 

I haven't done that since my first year here. After that, I managed to take at least one class online so I could better manage my fatigue. This semester, I wasn't so lucky. But you have to do what you have to do, right?

 

So far, I'm feeling okay. Just a little extra stress (headaches, sore muscles) from all the emotional things I'm going through right now. The fatigue hasn't set in...and I'm hoping that I can somehow ward it off this semester. But I am fighting against the balance of class and diabetes.

 

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I don't think I'd want to be an endocrinologist or a diabetes educator treating type 1 diabetics.

 

I'd want to be a doctor with answers.

 

I imagine the job has moments of satisfaction. Guiding those newly diagnosed through those very difficult first years must be rewarding. But eventually the insight the endo provides plateaus. What can you possibly suggest to the diabetic who's been in the game for 5, 10, 20 years? What can you tell them to do that they haven't already tried on their own a million times?

 

How many times must I say, "yes, we bolus prior to the meal" and "yes, we rotate the infusion sites every third day."

 

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My goal was to get my averages down into the 165 to 170 range by the end of the week. I didn't have a plan besides increasing my insulin and attempting a bit more exercise than normal. I refused to log out of sheer need to just not crunch numbers for awhile. And I didn't want to change my eating habits because I try to give my body what it craves.

 

So even without the intense effort that I so often put into my diabetes, I wanted to show what a decent day's numbers are like. A day that I'm celebrating the numbers. A day that I feel like I have more drive to get things done (like finally vacuuming, hanging up clothes, and working a bit).

 

6:30am: It's a very early morning start for me as I'm helping my mom out at work today. I clock in at 114 mg/dl. A perfect start.

 

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After my recent posts, I've gotten a lot of feedback from you guys. I'm very appreciative of it all! Some of it is common sense to me after 16 years with this disease, but you never know which piece you can overlook in the complexity of diabetes. So I decided to sit down with it all and figure out where I need to listen most.

 

I heard differing arguments as to if I'm doing the right things and if I'm just lost with this disease. I've chosen to believe the positive feedback with that. I know that I'm doing the right things. I aim for a low A1c, but I also aim for a safe level of numbers since I know that I'm prone to lows. But lately, maybe I have been aiming a little too low in too little of time.

 

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Brenda Bell
Brenda BellBrenda was diagnosed with high blood pressure, high cholesterol, and Type 2 diabetes in July 2002. After a rocky start, her diabetes has been diet-controlled since January 2004 and she hopes to keep it that way for as long as possible. (Read More)
Michelle Kowalski
Michelle KowalskiMichelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)
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