May 30, 2007
DSL Modem bit the dust
Sorry for the offline time, sob, our dsl modem went kaput. It was time... it'd been about 5 years! Anyways, it went out Sunday the 20th, and we just NOW got back online on Tuesday the 29th, yikes!
May 18, 2007
If I could change the past...
I am one of those rare diabetics who really stayed on top of their disease but got the complications anyways. I had bad a1c's in college - too much stress snacking mostly working on late night projects. Yes, I would change that if I could. However, it seems almost every diabetic I talk to had their worst numbers in college (note: this was before insulin pumps were the de facto treatment).
What else would I change?
When I was diagnosed: the tools are a heck of a lot better than they used to be. I was sent home without a blood glucose meter ;)
How I ate: THIS IS MY MOST IMPORTANT PIECE OF ADVICE. I believed that as long as I covered the carbs with insulin, I had free reign. I'd often eat 60-75 g of carbs in one sitting. This was my major problem I believe. My basal rates, as verified by fasting for entire days, were 100% correct. Without eating, I could maintain a number for hours on end, heck probably days on end til my liver dumped glucose ;)
My rock solid basal rates mean that my only introduction of bad numbers was due to eating. My only peaks were post meal. Humalog had a long tail in me, so I'd bolus for my carbs, and then set a temporary basal rate of 0% for 3-4 hrs. This avoided an otherwise inevitable low at the 4 hr mark. While this worked, getting a CGMS (continuous blood glucose monitor) taught me that my post meal peaks were a lot higher than I had previously realized. I had great numbers at 2.5 hrs, my typical post meal test time. I had frightening numbers at 1 hr! Gotta even out those peaks!
Symlin wasn't an option for me because I had gastroparesis. Makes me wonder what my post meal spikes were BEFORE gastroparesis, they must have been sky high.
As I wrangled with my post meal spikes, I found that my max carb intake per meal or snack was 20g. Anything more, and I'd surely peak over 300. Anymore insulin, and I'd crash 2-3 hrs after eating (the whole temp basal of 0% thing allowed me a slightly lower peak than if I had taken less insulin for the bolus and kept my basal at its normal rate). KNOW YOUR POST MEAL PEAKS AND ADJUST YOUR DIET ACCORDINGLY. Before my gastroparesis made my diet utterly unpredictable, I'd take my humalog AT LEAST 30 minutes before eating. Helps even out the peak.
Once gastroparesis hits (or gets more severe), that is no longer an option. I'd get lows that I couldn't treat because I couldn't digest fast enough to treat them! Telling your stomach to empty faster was simply not an option.
Other things:
Other things I'd change are vague. "Get an insulin pump sooner." "Move to testing blood more often sooner." "Not listen to the doctor that told me testing 10X a day was bordering on neurotic." "Move from 2 shots to 3 shots a day sooner." "Move from 3 shots a day to 4 shots a day sooner." "Move from 4 shots a day to 6 shots a day sooner." Hindsight is 20/20 and I did what was 'normal' treatment for that day and age.
While I did have a few bad years in college (and again one year in grad school), I can't help but feel that I lived and breathed diabetes. I never hid it. I never skipped a dose of insulin. If anything, I could have tested more. You can ALWAYS test more.
The reason I shared this is because I hear it so often: "I have an insulin pump, I can eat whatever I want!"
No, you can't.
May 12, 2007
New Beginnings
Random comments on what I've noticed since transplant:
* I'm never thirsty anymore
* I hardly ever use chapstick anymore
* I'm FREEZING all of the time (anemia?)
* I'm tanked after a day of work
* I actually am not terrified of eating out.
I've now been back at work for two weeks. The first week was rough - my back and incision both hurt a lot. I think this was because I was not used to sitting in a chair! The second week was a bit better.
Julian still does most of the work around the house. Wally (as a production) gave me $200 of home delivery of food, so we waited to use that until I went back to work. If we don't eat that, Julian does the cooking (and cleaning). He is also still doing most of the dog walking - I only walked her twice this week.
Although I can now easily sleep 10hrs+/night, since this week was a little better than last, I can only assume things will get better from here.
As for food, I do seem to be eating significantly better than before tx. I do think my gastroparesis has improved considerably! I used to be scared of eating out: would they have a soup I could digest? anything I can digest? Now I eat out, just eating half of what they bring and it's not too frightening. The few times I've tried something more 'agressive' like fried foods, I have gotten sick. So I think it is just a matter of picking 'light' foods nowadays as opposed to pureed foods. THAT is a huge change :)