Archive for the ‘Uncategorized’ category

An endo, a gynecologist, and a patient walk into a bar …

February 28, 2011

Last Wednesday was that time again. Time for tapping my toe and biting my nails in the waiting room before my endo appointment.

And I had reason for concern this time. As I mentioned a while back, this new birth control pill has really thrown me for a loop. I was pretty sure that my A1c would be up from last time as a result of all of the daytime highs, overnight lows, and all-day cravings I’ve been experiencing.

But amazingly, my A1c was still 6.2. Absolutely no change.

Sidebar: How is that even possible? Sometimes I think these A1c’s are a joke. My prediction:  Someday we will find out that the A1c is just about as accurate as the BG readings we get from our meters. /Sidebar

But my endo was alarmed by the increase in my insulin needs after I started this new birth control pill. I think his concern is warranted given that I’ve jumped from somewhere around 35 units a day to an average of 45 units per day. And I’ve gained around seven pounds. In two months. Yikes.

I’d already called my gynecologist to ask for his advice, but the nurse, who did not believe me when I told her that the new pill was increasing my BGs, never called back. And this particular gynecologist was not exactly chomping at the bit to help solve my female troubles. In fact, he tried to encourage me to just keep with the status quo instead of trying to find something better. So my endo suggested a new gynecologist and recommended a “third generation or newer” birth control pill.

I have an appointment with this new gynecologist in a couple of weeks and in the meantime, I’ve gone back to my old pill. I can deal with the highs and the lows, but I can’t deal with the weight gain. And I can imagine my husband has had enough of my mood swings, too 🙂

Sigh. This is just another one of those things that we PWDs deal with that most people are blissfully ignorant of. All of our medications and therapies work together to make a semblance of a balanced system, but when we change just one aspect of the system, everything else starts to fall apart, too. And if you don’t have a good team of experts to support you, things can get out of control fast.

I imagine that this is why my gynecologist did not want to embark down this new pill road. He would rather not deal with the trial and error, the ups and downs, and the rebuilding that will come along with the journey. He would rather just do pap smears and write prescriptions. He does not want to be bothered with a “difficult” patient. Why can’t I just settle for “good enough?”

I’ve asked myself that same question many times. Why can’t I just be content with kidney-damaging highs the week before my period and debilitating lows the week of my period? Why can’t I just deal with the cramps, fatigue, moodiness, and bloating? The headaches and heavy bleeding? The backache and swelling?

And then I realize what a ridiculous idea that is. Why should anyone deal with this type of pain and suffering? I realize that this is not exactly a critical medical need. It’s more of a quality of life issue. But don’t I deserve to live the best life possible? I’ve lived with this mess for a long time because it was just too much work to try to fix it. The doctors were not exactly beating down my door to sign up for this challenge, and I didn’t really want to throw another variable into the mix when we were thinking about have a baby. But it’s been over a decade since I worked with a doctor to resolve my “female” troubles. A lot has changed since then. And I deserve better. I deserve more than two good weeks a month. I’m spending half of my life in discomfort or pain!

So I decided it was time to make a change. The trick now is to find a doctor who is willing to come along for the ride.

The day I met Ted Danson

January 21, 2011

I live a pretty mundane life, really. Diabetes aside, things around here are typically pretty normal. Maybe even boring. So when a head hunter called about a potential new job in a new location, I thought, “Sure, why not?”

The phone interviews went well and before I knew it, we were making arrangements for an in-person interview. The next thing I knew, we were boarding a plane for an overnight trip to Greenwood, MS.

We had done our homework before we left, so we knew that Greenwood was a small town. But we were intrigued by the Mississippi delta culture, and thought the warm climate, good job opportunity, and low cost-of-living might make the move worthwhile.

We were a bit taken aback, though, when we arrived in this speck of a town. I mean it is really small. Really small. And the nearest “city” is over two hours away.

The town is not without it’s charm, though. It has a quaint (really quaint) downtown, some great “home cookin'”-type restaurants, and some of the friendliest people you’ve ever met. And the place is apparently popular with Hollywood, too. They like to film movies there because of the genuine southern charm and the lack of paparazzi. I guess the photographers can’t be bothered to follow the stars all the way to the Mississippi delta.

The company that I was interviewing with put us up in this awesome five-start hotel. The place seems kind of odd sitting in the quaint downtown, but, I have to say, it was one of the nicest hotels I’ve ever stayed at. And I guess the town needs a place to house all of those movie stars when they come to film movies.

After a nice night’s sleep in a wonderful bed, and a nice shower in a spa-like bathroom, I dressed in my “interview suit,” turned my pump to “vibrate” and my husband and I walked down to the breakfast room. Still half asleep, I piled scrambled eggs, fresh fruit, and bacon on my plate. From over my shoulder, I heard “Good morning”. I glanced back to see a white-haired, well-groomed man with a newspaper and a coffee cup. I smiled, said good morning, and returned my focus to my plate.

Back at the table, my husband leaned over to me and whispered, “I think that’s Ted Danson.”

“Really?” I asked, fork mid-air. “The guy I said good morning to?

“Yeah. He’s sitting at that table by the kitchen,” he said motioning with his head.

As nonchalantly as possible, I craned my neck to see the table behind me on the other side of the room. The man was reading his newspaper. Sure enough, it was Ted.

I returned to my breakfast and tried to focus. Ted received something from one of the workers in the kitchen, they exchanged pleasantries and then he left. As we were leaving our table, one of the workers came out of the kitchen to ask, “Is that guy the one from TV? You know the show where he is a doctor?”

It was interesting to me that this guy would think of Ted Danson as Becker, the grouchy doctor. I always think of him as Sam Malone, the bartender on Cheers.

On our way out of the breakfast room, we passed Mary Steenburgen, Ted’s wife, in the hallway. How cool is that?

Later that day, while lunching with the HR Manager, we saw Ted and his wife again in a quaint little bistro cafe (Like I said, this place is small.)

We flew home that afternoon, and I didn’t get an offer for the job. But I’m sure glad I got the opportunity to visit Greenwood, MS.

Making the Low Go: Over the Years

May 12, 2010

So I’m a day late with this post, but they always say better late than never, right? I spent most of the day in bed yesterday fighting some sort of stomach disturbance. I am on the mend, though, and ready to continue with Diabetes Blog Week

Here’s the topic du jour:

Making the low go. Tell us about your favorite way to treat a low. Juice? Glucose tabs? Secret candy stash? What’s your favorite thing to indulge in when you are low? What do you find brings your blood sugar up fast without spiking it too high?

This topic got me thinking about all of the different ways I’ve treated low over the years. And reminded me of one reason why I have such a weird relationship with food.

Back in my early days of being diabetic, some 25 years ago or so, my lows were much more severe than they are now. Thanks to the peaking effect of NPH insulin and the less-accurate BG testing methods we used, I would sometimes end up passed out, then convulsing. This usually happened in the middle of the night, although I did once have a “reaction” in the cafeteria at school. I was in the fourth grade. My friend told me later that I dropped my lunch tray and that some kid stole my milk. So not cool.

In the beginning, we treated these lows with glucose gel that came in a clear bottle that looked a lot like an Elmer’s glue bottle. It had a twist-open lid that was red and white. The “doses” of glucose were marked on the side of the bottle. Later we upgraded to “Insta-Glucose,” an awful-tasting pink gel that comes in one-serving squeezable tubes, kind of like toothpaste containers. Eventually, we added Glucagon to the mix. This shot was part powder, part liquid, had to be stored in the refrigerator, and could not be mixed in advance. The routine was that my mom would force the pink goo into my mouth, while I kicked and fought and spit, and then she would run to the kitchen to pull the Glucagon shot from the refrigerator and mix it while my dad stood by my bed to make sure I didn’t flop out.

Of course, I remember very little of this seeing as I was unconscious. But the evidence was there when I came to: pink goo all over me – in my hair, on my face, on my pajamas, and an aching sensation in whichever extremity my mom could get a hand on to give me the Glucagon shot.

After I was coherent, she would force Coca-Cola on me. She would beg and plead and finally threaten: “If you don’t drink this Coke, I’m going to have to call an ambulance.”

The Glucagon shot left me with an incredible case of nausea, so if I felt that aching sensation in one of my extremities, I knew that the night would not end without a trip to the toilet to empty the contents of my stomach: mostly Coke.

And then there is orange juice. Whenever I had a close call in public, and needed the help of a friendly waitress or shop clerk, or teacher, I usually ended up with orange juice. Because the general public seems to think that the only thing that helps a low blood sugar is orange juice. Of course I was grateful for the help, but I sure would have appreciated a glass of apple juice every now and again.

Needless to say, as a result of these traumatic memories, there are a lot of ways that I choose NOT to treat lows these days. Despite my doctors’ warnings and reprimands, I do not keep Glucagon in my house. I never treat with Coke unless it is an absolute dire emergency, and I do not treat with anything resembling Insta-Glucose, including those squeezable icing packs and those sports “shots” of dextrose gel. I also avoid orange juice like it’s the plague.

I have hung onto a couple of those early low-treaters, though. When I was a kid, I always carried a bike pouch or make-up bag full of granola bars and lifesavers. By the time I needed them, they were usually smashed and stale, but who really cares when you can hardly think straight? When I was on the soccer team in high school, my water bottle had a false bottom in it. It screwed off to reveal a granola bar, a roll of lifesavers and a couple of quarters. You might think that the quarters were for a pay phone (These were pre-cell phone days, after all,) but they were actually for the nearest vending machine.

These days I’ve abandoned the granola bars because of the slow-digesting fat, but I keep rolls of lifesavers everywhere: in my purse, in the glove box in both my car and my husband’s car, in my laptop bag for work, in my desk, and in all of my coat pockets.

When I’m at home, I use those small, toddler-sized boxes of juice (berry and grape are my favorite,) and Dots (five of them is 15 grams of carb.) When I was in the first trimester, I was low ALL of the time. I treated with Jelly Belly jelly beans because they were just about the only thing I could stomach. When I’m out and about and there’s time, I will order a smoothie, because let’s face it, if you have to go through a low, it’s always nice to end it with a little treat.

A Day in the Life of a Diabetic Mom-to-Be

May 10, 2010

In response to Karen’s great Diabetes Blog Week idea, and also in response to Saffy’s question about how I fit in all of the pregnancy-stuff around work, here is my contribution. The topic is “A Day in the life . . . with diabetes.”

5:45 AM: Can’t wait any longer. Have to pee. I’m dancing in front of the toilet while I fight with the vial of ketone strips. Finally.

6:00 AM: My husband stumbles into the bedroom headed for the shower. Seeing as I have been up at all hours of the night for months now, he usually sleeps on the couch. One of us might as well get a little sleep, right? “Are you done in bathroom?” he asks. I mumble “yes” from under my pile of pillows. I can’t believe it’s time to get up already.

6:30 AM: My husband leaves for work. I do a test: 97. I crank up the laptop and upload my BG readings out of my pump, then print them for my doctor.

7:00 AM: Into the shower. A frantic hour of readying myself for the day ensues: shower, hair, teeth, breakfast, packed lunch.

8:15 AM: Another test: 98. I’m late. I throw everything into my laptop bag and rush out the door. Along the way, I discuss this BG reading with my inner self: “It’s only been an hour since breakfast. Will I be low at the two-hour mark? Maybe not … I did have peanut butter with breakfast. I stuff my meter in my coat pocket and pull out of the garage.

9:05 AM: I’m late for my non-stress test. I roll into the parking garage and make a mad dash for the fetal evaluation center. They hook me up to the monitors, and Baby NoName sleeps. We give him a little jiggle, I drink a glass of ice water, and we use the “alarm clock” to try to wake him up. Finally he startles and starts dancing in there. The peaks and valleys are recorded on the red and white graph paper. A half hour later, the nurse is satisfied. She permits me to move on to the next appointment of the day.

9:45 AM: I arrive on the other side of the hospital at my High-risk OB’s office. I am making good time. Sometimes the non-stress test takes an hour. The office manager smiles and calls me by name from behind the sign-in desk.  I sign in, pee in a cup, and weigh myself. It turns out that the Ultrasound Tech is ready for me already. I do a quick test while I’m sitting on the exam table. The Ultrasound Tech has to wait for me and I feel guilty. 156. Damn peanut butter. I ignore the “insulin on board” recommendation of my pump and dial in a .7 unit correction. Let the ultrasound begin.

Baby NoName is doing great, although the tech discovers for the first time that the umbilical cord is a two-vessel cord, not a three-vessel cord as we originally thought. The doctor assures me that it is nothing to be concerned about, but I make a mental note to google the difference later.

I realize that I left my BG readings on the kitchen counter … or somewhere. Pregnancy brain again. I will have to fax them in tomorrow.

10:45 AM: I finally arrive at work. Another test: 93. Much better. On to e-mails and meeting preparations. I sneak in a quick glance at a couple of DOC blogs between projects. I’m starving, so I eat my mid-morning snack.

12:30 PM: Lunch break. BG is 115. I head out to my car for a thirty-minute cat-nap. I am absolutely exhausted.

1:00 PM: Back in the office, I get back to work, and nosh on my packed lunch. Sometimes it’s one of those “healthy” frozen dinners. Today it’s a ham and swiss sandwich and an apple. Due to digestive woes, low blood sugars, and cravings, my pregnancy diet contains a lot more carbs than my non-pregnancy diet. BG is 62, a little low, so I take a little less insulin than the pump suggests.

4:30 PM: The office is starting to clear out. BG is 55. I peel an orange and start to munch on it while I work on one of many never-ending projects. For whatever reason, my BGs have been plummeting in the evenings, so the 4:30 snack has become a normal part of my pregnancy routine.

6:30 PM: One final test before I hit the road: 83. Afraid that my sugar might be dropping, I grab a handful of M&Ms from the office candy dish. I pack up and leave because the “late shift” support rep is locking up, even though I don’t have all of my hours in for the day. This means tomorrow will be an extra long day.

7:30 PM: I am at home, collapsed on the couch. My husband and I are trying to think of something to eat for dinner. All I want to do is sleep, but my BG is low AGAIN. We settle on grilled cheese sandwiches. I am delighted because he is doing the cooking AND the cleaning up. We watch a little TV while we eat and catch up.

9:00 PM: I can hardly hold my eyes open. I get ready for bed, do a test, take my pills, and double-check my stash of juice boxes and gum drops on the nightstand. Satisfied that I have enough sugar to make it through the night, I fall into bed. Because I under-bolused for dinner in fear of another low, I am at 180 now. I take a small correction bolus and settle in under my pile of pillows.

11:00 PM: My husband is on his way to bed. He wakes me up to test. 105. The number barely registers before I roll over and fall back asleep.

2:00 AM: I have to pee. Again. And my hip is killing me. While I’m up, I test. 65. Eyes closed, I slurp down a juice box and then drop it on the floor in the general vicinity of the trash can. Close enough.

4:00 AM: Again with the peeing and the testing. Luckily, my BG is in the “safe range.”

6:00 AM: My husband stumbles into the bedroom … another day begins!

There are a bunch of other D-bloggers participating in Diabetes Blog Week, too. Check out the list on Karen’s blog here.

What Healthcare Reform Means to Me

March 29, 2010

I have been digesting the news about the new healthcare reform law for the last couple of days. Here are the most important takeaways for me:

My pre-existing condition is now covered.
In the past,I could not purchase private insurance on the open market because insurers would simply not cover me. Their explanation was that I had a pre-existing condition, Type 1 Diabetes. With the passage of the new bill, insurers are required to offer me the same coverage as someone without a pre-existing condition.

I don’t think I need to remind this audience that Type 1 Diabetes is an autoimmune disease and that we have no control over who or when it strikes. It is certainly not my fault that I developed this condition and there is nothing we can do to cure or prevent it. But there is something we can do to reduce the complications (and the costs associated with those complications): tight control. Unfortunately, without health insurance, most of us could not afford the test strips, insulin pump supplies, frequent A1C tests, annual kidney tests, podiatrist evaluations, dental cleanings, and annual retinopothy and glaucoma screenings that are required to keep our diabetes in check.

And don’t let the naysayers fool you. For many of us, there was simply no insurance coverage available, at any cost. Only 35 states offered a high risk pool, and mine was not one of them. In addition, most of us were not eligible for Medicaid because we had too many resources. I looked it up … my husband and I would have had to earn $18,900 a year or less to be eligible for Medicaid, and we could have a maximum of $6,000 in “Resources” — things like savings, 401ks, a house, and investments. Sure, we could have used the free clinic in our area … where people routinely waited for hours only to be turned away and where the medications we needed were not available. And those “free drugs” that the pharmaceutical companies offer? You must go through an arduous application process  every month — and the process is different with each pharmaceutical company that sells you a drug. You can be turned away, but if you aren’t turned away, the amount they offer is usually not always enough to your monthly needs.

I cannot be penalized with higher costs because of my pre-existing condition.
We all know someone who has developed some sort of condition while insured on the private market (borderline high blood pressure, sleep apnea, or borderline high cholesterol, for example) for which the insurance company decided not to drop them from the policy altogether, but instead decided to raise their rates until they could no longer afford the coverage. My biggest fear with this bill was that insurers would use this caveat as a workaround to prevent me from purchasing their plans. But the new  law requires the insurance companies to cover me for the same cost as my so-called “healthy” fellow insured.

I have more flexibility and choice in my day-to-day life.
Up until this point, I have been forced to stay employed full-time with a large organization that offered health insurance to its employees. These were the only types of companies that, by law, were required to offer me insurance, even with my pre-existing condition. If I were to lose my job, or choose to work as an independent contractor, I would lose my insurance coverage. Now I have options. I can buy insurance on the private market, and if I can’t afford it, I can receive a subsidy from the government to help me cover the premium.

Is the new law perfect?
Certainly not. We could go on and on about how we would have done things differently. And we might find that, after the law is implemented, some of the ideas we implemented turned out to be really bad ones. But is it a start? Without a doubt. And as someone who has been fighting with the insurance industry for fair treatment and adequate care for nearly thirty years, I’ll take it.

So Lucky

January 19, 2010

Today I read Shannon’s post over at LADA-dee-da, and she mentioned that she and her husband are “taking additional steps in [their] quest for a child.” And I was reminded that so many families have so many problems getting pregnant in the first place.

When my husband and I started this journey, we were pretty sure that we would have similar problems. Let’s face it, my body is certainly less than perfect and given all of the other hormonal problems that I have, it would not be out of the question that my female parts would not cooperate with our desire to start a family.

You can imagine our surprise and joy when this turned out to not be the case. We had surprisingly little problem becoming pregnant, and for this we are so grateful.

And every time I scan through my favorite blogs, and I see a post like this one from Shannon or this one by Lyrehca, I am reminded just how lucky we are.

I spend a lot of time here examining my newest symptom. Sometimes it’s nausea, other times it’s fatigue, or low blood sugars, or my pesky thyroid. At one point it was even the threat of a tubal pregnancy. But I need to stop every now and then and just enjoy this experience. Because there are so many other families out there who haven’t even been lucky enough to make it to this phase in the journey. To experience the nausea, or the fatigue, or the low blood sugars.

So today I am just plain thankful. Thankful for the stretch marks and the ketones and the 2 AM snacks. Thankful for the headaches and the endless doctors appointments and the struggles to find maternity clothes.

We are so lucky.

Zofran, I think I love you

November 10, 2009

Our visit with the OB was relatively positive yesterday. The heartbeat is up from 97 to 119. I still have to go back in a week to make sure everything is growing.

We got another ultrasound picture … a white blob with a blinking black center suspended from a white yolk sac. I’m sure that it doesn’t look like much to the outside world, but it is beautiful to us. We hung the picture on the refrigerator. I am getting less and less nervous with each visit.

One of the highlights of the visit was the prescription for anti-nausea medicine. The doctor prescribed Zofran and I am actually starting to feel human again. Don’t get me wrong, I don’t feel normal, but this stuff is definitely taking the edge off and I am preparing for a day at work (and out of bed) for the first time in almost a week.

Of course, it makes me a little leery that the drug is not actually approved for use during pregnancy, but there is a lot of good anecdotal evidence out there, so I am just hopeful that everything works out. And for the first time in five days, the scent of my own deodorant (powder fresh?) is not making me gag.