Resolving to be Resolute
Taking stock of the things that need to be changed, and figuring out how to change them.
By Kerri Sparling
January 2007 — Sometimes it's just a pair of jeans that sends me over the edge.
"What? These fit a month ago. Why isn't the zipper going up? There must be a thread stuck in there." Quick examination of the zipper reveals no thread. "Hmmm. Maybe they shrunk in the dryer. Or on the floor of my closet, where they've been hiding for the last five weeks."
Or sometimes it's taking a quick assessment of the bottom of my purse.
"Excellent. Time for a healthy snack. I have … let me see … gum. And two smushed glucose tabs. And a Lindt chocolate truffle."
And other times, it just takes one look at the seven-day average on my meter.
"Whoa. My seven-day average is 165 mg/dl? What happened there?"
While I do my best to keep my diabetes – and my overall health – under control, things can spiral away so easily sometimes. It happens so quickly that I barely notice, but regaining control is a tough journey. It takes determination, a support system, and some serious resolution to stay healthy.
Okay, exactly how does one go about doing that?
I've had my share of successes and … not-so-successes. After starting on an insulin pump in January of 2004, I gained about 15 pounds almost immediately. It was as though my body was celebrating my lower A1c's with a few quick pounds as a free gift. While I was so excited about my new diabetes management plan and the prospect of staving off complications by means of these tighter numbers, I wasn't happy with the way my body was shifting. It wasn't until I was comfortable with my pump and how to manipulate basal rates and plot glucose trends that I seriously considered returning to the gym.
I chose to begin my journey at the mother of all gyms - Gold's.
"Why are they all wearing make-up?" I muttered under my breath as my boyfriend helped me sign the membership paperwork.
I took my chances with the first elliptical machine I saw, stuck my headphones on, and tried to focus. With my blood sugar meter at the ready and my bottle of juice standing guard against any tricky lows, I huffed and puffed through that first workout. It was wicked. I was sweaty. My body wasn't ready for that kind of exertion and it told me so with aches and strains the next day.
But I felt oddly exhilarated.
I have to be honest – the first few weeks at the gym were arduous. Not only did my muscles ache, but my blood sugars weren't sure how to respond, either. I experienced some very intense lows while working out those first weeks. It became necessary to test before and during my cardio workouts, in efforts to catch myself before my sugars plummeted. It took me weeks to figure out that I needed to disconnect my insulin pump while working out and to make damn sure I ate something at least 30 minutes before the gym. But I stuck with it, with the help of my supportive boyfriend, and it has since become a part of my daily regimen. (The jeans zip up now, thank you very much.)
So fitness – check.
Controlling my blood sugars has proven to be a bit more challenging.
I have always been crummy at recording my numbers. Back when I was a kid, my mother and I used to sit in the Joslin waiting room and use two different pens to write down all the results we could manage before the appointment. Even now, with the technological advancement of being able to use a USB cord to download results to my computer, I still don't make any logbooks until the night before my appointments. It's pathetic.
I understand the benefit of keeping good records. I can use them to analyze trends and isolate the real "problem times" for my blood sugars. I can use them to assess how well my basals are working and maybe help isolate areas that need a little tweaking. And I can definitely use the wake-up call of seeing my results graphed out neatly and showing me precisely how often I'm out of range. I hate the neat, little chart of highs and lows I see sometimes. Something about that pie chart cuts right through me.
Admittedly, my meter average of late could use some love and attention.
In the interests of full-disclosure, I haven't been as diabetes-focused as I should be. There have been some events lately that have thrown my body for a loop, like the loss of my beloved grandmother and a problem with my eyes, so I have been putting off my A1c test in fear of it's result. However, I've recently made an appointment to have blood drawn, so all bets are off.
It's time to reclaim control of my numbers.
My resolution for 2007 - focus on the Big A1c. My doctor wants me under 7%. I would like that, too. I need to make it happen. Record those results at least on a bi-monthly basis and take a peek at possible trends. Stay away from those delicious chocolate truffles. It can be done.
I can do it!
Resolve to be resolute – check.
(insert Rocky theme here)
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from