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The most recent heat wave may have passed, but summer is still in full swing -- which means heat-related health alerts. While these issues are not directly related to diabetes, diabetes can confound a heat-related health issue, making it harder to recognize and treat. Heat-related symptoms can mimic sugar-related symptoms and vice-versa, so it is in our best interests to know our normal ranges and reactions to the greatest degree possible.

The most basic heat issue is hydration. For some of us, dehydration will cause our blood glucose levels to drop; for others, it will cause those readings to rise. For some of us, the physical stress of dehydration will, at one point or another, trigger an adrenaline response and its associated glycogen release, leading to u-shaped curves (think "Dawn Phenomenon").

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I should start this post by saying there is a history of heart disease and stroke in my family. 

My father, at 43 had a heart attack resulting in a quadruple bypass surgery.  The doctors at the time of the surgery told him that had he not quit smoking eight years earlier, he'd be dead, given the condition of his arteries. 

My maternal grandmother, who struggled with insulin dependent diabetes (we're unsure if it was actually type 2 or LADA) and its complications, for the last 35 years of her life, died at 62 of a massive heart attack.

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My last post was about pretty difficult low bloodsugars.  These continue.  And my hatred for this disease has been just all-consuming of late. 

Over the past several days, my Facebook page has been overloaded with terrible news.  A beautiful 14 year old girl dead from a stroke, an 18 year old dead from a low bloodsugar in her sleep and another young woman is in the hospital in DKA fighting for her life. I hate the heartache diabetes has left for their families.  

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I usually research every prescription I get (minus typical decongestants, cold medicine, antibiotics, etc) before I even think of filling them. I've never been one to trust that the doctor knows everything. Too many years of the doctor knowing just too little of everything. Plus a strong sense of taking care of my body in a more natural way...all leave me wary of conventional medicine.

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I've spent many hours over the past six weeks training in a local hospice program. I learned about the logistics of hospice, toured a hospice house, heard the difference between hearing and listening, and met several amazing fellow volunteers. With this hospice program, I'm certified as a volunteer to sit with hospice patients in their homes or in the hospital.

Over the past weeks, I've had several "hard" moments in the training. There were stories that brought up emotions about both my deceased grandparents and my late great grandfather. There were also moments where I considered myself in relation to death and mortality. Some of those moments, I wasn't exactly sure how to handle what I was feeling.

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Today was my last dermatology appointment for the Accutane. I'm a mixture of excited and sad. I'm excited because the Accutane has been such a hassle. Monthly doctor's appointments and blood draws, debilitating side effects, and just the stress of putting this into my system. So now it's over. Awesome.

Except that my dermatologist isn't exactly happy with my results. Yes, I'm much improved. 90% in fact. But according to him, he likes to end things at 100%. He even suggested staying on it longer or switching brands.

Right now, I'm just not up for that though. My body needs a break. I need a break. To just feel normal again. To not be so tired, so fatigued. To go one day without a headache or muscle ache or joint pain. For my body to just feel closer to whole rather than endlessly worn out.

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If you've kept up with the latest changes for me, then you'll know that I decided to switch birth controls after a lot of research and careful consideration. In October last year, I started Seasonique but had 23 days of breakthrough bleeding...I couldn't take it. So I switched to Ortho Tri Cyclen Lo, a birth control that I'd taken before and hadn't noticed any side effects with.

But this time around, I've gotten plenty of side effects and just don't think it's giving me enough benefits to offset them. I've really had trouble with the changing hormones (it's tricyclic so every week, it goes up until my period) and blood sugars. Stress, physical or emotional, makes my heart beat in my ears which is not only annoying but scary. I'm still getting breakouts the week before my period. Although my periods are lighter and the cramping is less, I'm still getting a lot of pain starting 10 days before my period as well as some mood issues.

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It's my time...to prioritize in my own way.

You may have noticed that diabetes hasn't been my first priority here lately. Not only is school speeding by faster than I can possibly keep up, my other health conditions are facing a lot of changes. Changes that I'm so ready for, but also not prepared for at the moment.

First, I'm starting birth control today after going off the progesterone almost two months ago. I'm hoping that the birth control will help with the premenstrual symptoms that I experience (like cramping, joint pain, headaches, and fatigue), without leaving lasting side effects (like weight gain, stroke, or pulmonary embolism). It took a lot to make the decision to go on it again, but I've made the decision and now I'm excited to see the results.

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I received this news article by email a few weeks ago. I was actually sitting in the middle of the Mediterranean as I read it. I turned to my mom and said "Oh great, something else to worry about."

Diabetes complications are not news to me. My parents and doctors shielded me for many years thankfully. But when I hit the appropriate age, words like DCCT and kidney transplants became part of the diabetes lingo. Slowly, they infiltrated my diabetes lifestyle. The risks, the fears, it all slowly built up over the years.

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