Tag: A1C

To Pump or Not to Pump

To Pump or Not to Pump

Pump and CGM

I don’t meet, in person, very many people living with Type 1 diabetes. In fact, there is only one other that I see regularly. There are others in the area. You just have to participate more. On the rare occurrence that I do, it seems that many of us suffered the same dilemma.  Should I get the pump?  Should I get a CGM? Is there enough room on your toothpick-shaped body to have two devices?

Apparently, many of us ask these same questions.  I was very resistant for years. I always thought that I would need better control of my diabetes before I thought about adding expensive devices to the equation. I was worried about not being able to swim or shower because I was always plugged in. He was worried that he didn’t enough fat on his body to accommodate two devices. I now use both a pump and a CGM and wear them 24/7. They have dramatically changed my life with diabetes. I have much better control of my blood sugar. No where near as good as mine was. And I don’t resist eating because I don’t feel like taking a shot or dealing with my disease.  I no longer have the strange lows or highs that I cannot explain my basal insulin isn’t adjusted just right.

My endocrinologist, who I think is excellent, did not seem keen on me getting a pump.  He didn’t tell me not or that I shouldn’t; it just appeared that it wasn’t something he felt I needed. He did seem very keen on the CGM though. Probably because your A1C was consistently pushing 10. A few years ago, I found Keri Sparling’s blog, Six Until Me, and felt that I had found a kindred spirit of sorts.  I had found someone else that knew exactly what life with diabetes was like.  She had just had her baby and my wife had recently delivered Squishy as well.  As I have never had a c-section or attempted breast-feeding, I could not relate to everything  in her blog, but many things that were affecting her were also affecting me. The one thing in my life, that seemed to be missing from hers, was the annoying need to constantly stab myself with a needle. The hard bumps that kept forming in my abdomen and hips because I could not find new places with enough fat to give myself another injection. The irritation of accidentally leaving my insulin at home or not bring enough with me for the day. Not that those situations do not affect a person using the pump, but those were affecting me constantly.

I finally got my CGM in February 2012. It only took a moment for me to see the benefits of it. My A1C immediately started dropping. Just having an alarm to tell me when I was in trouble or being able to see what my eating habits were doing to my blood sugar took my A1C from a 9.1 to 6.7 in a few months. No, my blood sugar is not perfect and I still have my ups and downs, but I would not go back to the way things were. In fact, my endocrinologist asked me at my last visit, which device do I think contributed the most to my improved A1C. I told him flat-out, the CGM. The pump is nice and I wouldn’t give it up either, but the CGM is the reason my A1C is better.

But, if you have been keeping up, I have a pump as well. Which must mean there is something I like about it. I don’t know about every pump, I know about my pump.  So if you are thinking about pumping insulin into your body, some research into what the different pumps offer and what the pros and cons of each are is an important step. One he skipped. I chose the OneTouch Ping from Animas. And it is true, I did not do my research.  What I saw was something from my favorite diabetes blogger talking about her Ping and being able to swim without worrying.  I cannot find it now, or I would have linked to it. Mostly because he can’t remember if it was a video, a blog post, or advertisement on the Animas website. I love playing in the water.  My girls love playing in the water. We always live near a pool because they love the water. So I needed the one that allowed Kerri to go in the ocean without worrying. Don’t get me wrong; I love my Ping. And for those of you with the same list of concerns that I had, here are the responses I wish someone would have given me, as they apply to me and my Ping:

I will have to keep a close eye on the clock when playing in the water because I won’t be able to take my pump with me.

Not true. Many of the pumps are waterproof.  I spend hours in the water with the girls and don’t even think about my diabetes unless I feel light-headed or start to smell that funny your-blood-sugar-is-outrageously-high smell.

I won’t be able to take long showers any more.

So, as it turns out, the pump isn’t constantly delivering insulin to your body.  You tell it when you eat to give your bolus just like you would do with your regulated stabbings.  The difference is, no stabbing. What it does do, is give you a little bit every hour to keep your regulated when you are not eating.  And if you are taking a long shower and miss that one basal, which for me is 0.625 units of insulin, who cares.  Seriously, it isn’t a big deal. I don’t even think my body notices if it only misses one.

I’m too skinny. I’ll have nowhere to put it.

You actually have more options than you think. Areas that are difficult to reach are now options because you only have to reach it once. The love handles work great for me. Love handles? Those are not nearly big enough to be handles.

How will I have naked fun when I must have something to clip the pump onto?

This is exactly the same response as the one for the shower. Which could also be naked fun. In fact, this may even be better.  You are replacing the small amount of insulin you are missing with physical exercise.

Don’t be afraid of the devices. They are awesome and have made a world of difference in my life.  If you really cannot get around your fears, start with the CGM. Once you realize how awesome it is, you will be rushing to get plugged into a pump.

7.7 A1C for My Diaversary

7.7 A1C for My Diaversary

This may get long winded, so bear with me.

Today I had an appointment with my endocrinologist. I was a little worried about my A1C because the holidays are evil. Wow. I mean it. I cannot have carbohydrates without taking insulin; yet every gift basket, box of candy, and tin of cookies that gets sent to the office has food that requires insulin. Snaking is my weakness. The idea of taking insulin for one little, bitty, teeny, weeny cookie is absurd. One? That’s just it; it never is just one. It is one every time I pass the table. That adds up. This is my life every holiday. But, despite my lack of control and my worry, my A1C was 7.7. And the crowd goes wild-ish. My last A1C was 8.0 and the one before that was 8.4 and before that I was playing with the nines for more than four years. That’s still not between 4 and 6. It’s an improvement. It may be a minor victory, but it is still a victory.

Tonight is also the night were a bunch of people dealing with diabetes get together for a TweetChat.  I found this out last week. Though it was difficult to keep up, I learn a lot, and it is nice to talk with others who are going through the same sort of things I am. Using http://tweetchat.com/room/dsma a bunch of us get together on Wednesday evenings at 9PM EST, have some conversation, and answer some fun questions. Or in my case, learn new acronyms. My two acronyms for the day are CDE and MDI.  CDE is Certified Diabetes Educator and MDI is Multiple Daily Injections. I think the next page on The Frizbian is going to be a lexicon for PWDs. Dork.

Christmas tree with gifts

Also this week, is my diaversary (diabetes aniversary). That’s right; tomorrow will officially be six years of diabetes fun and adventures.  That is six years of stabbing myself day-in and day-out in order to process sugar the way the body is supposed to “naturally”. Hopefully that artificial pancreas is on its way.

I received my Veterans Affairs medical benefits card in the mail this week.  Hopefully, I will be able to use that to get some discounts on the prescriptions and may be a pump or CGM. I want the toys. I am tired of having MDI. Having MDI? Being MDI?  I don’t know. I just learned the acronym today. We’ll work on grammer later.

Finally, for now anyway, my sister decided that this year, since she doesn’t have a job, she is going to play Santa Claus and sent us a box full of goodies. She should have saved her money, rented a sled, and came over for Christmas instead. But it does make our Christmas tree look more Christmasy. I can’t believe the spell check let you get away with that.

Things to try on vacation

Things to try on vacation

I went on vacation.  That’s right, I left my office and ignored my email (mostly) for almost 2 weeks.  It was wonderful.  I plan to do it again sometime.

Right before I left, I had my quarterly checkup with the endocrinologist.  He says my A1C is now down to 8.0.  Could be better.  Has been worse.  He also suggested that I may want to increase my Lantus dosage to help bring my A1C down.  I raised that up to 27 units and my blood sugars have been a fluctuating just has horribly as normal, but in a better range.

I have also realized that PWD (an abbreviation I have often used to mean password) can also be used to say person with diabetes.  Some people with diabetes prefer this to the term diabetic.  For some, this is a big deal.  For me, it is not.  Personally, I don’t care, but you will find that I will start using PWD whenever I would have said diabetic as people like me do care and I care for people like me.  He has to care.  This is a blog.

If you are a PWD, there is something you should know about going to Europe from the U.S.  If you take a daily dose of a long lasting insulin, like Lantus, at the same time every day; that 5 hour time difference that we call the Atlantic Ocean is going to have an affect on your blood sugar for the first couple of days.  You end up taking two shots in a less than 24 hour period and your body plays a little catch up. I didn’t notice any change.  You haven’t noticed any change since 2005.  Alternatively, if you are a PWD traveling from the U.S. to Europe and you take a daily dose of long lasting insulin at the same time every day; that 5 hour time difference that we call the Atlantic Ocean is going to have an affect on your blood sugar for the first couple of days.  You end up waiting over 24 hours between two shots.  You could always account for the time difference and just adjust the time you take your insulin while on vacation.  And you could always start producing insulin.

I had a little trouble with low and high blood sugar while on vacation.  High because it is difficult to carry all my diabetes stuff in my speedo and low because I wasn’t getting up and eating breakfast at my regularly scheduled time.  That and I needed to back off a bit on my rapid insulin as I was taking more of my daily insulin.

Other than having diabetes, vacation was awesome.  We went to Italy to see Beth’s family.  Granted we didn’t see as much of Beth’s family as we would have liked, but we had a good time anyway.  We spent most of the vacation in Duna Verde near the beach.  Really we spent most of the vacation on the beach or in the ocean.  It was awesome.  I got a tan and apparently, I am now sexy.  Even more surprising was that I was not sexy prior to the suntan.  I’m not surprised.

Tata discovered an important lesson on vacation about digging in sand.  In case you were not aware, digging in sand is often difficult due to the fact that sand has a tendency to fill the hole back in rather quickly with even the slightest tremor.  This is especially important when you dig a hole under some playground equipment and then stick your head in the hole.  If you move your head, the sand will quickly refill the hole trapping you under the equipment with sand in your mouth.  Sand in your mouth makes it very difficult to scream for help and breathe.  That little incident is getting added to multiple lists including:

  • things Tata will never hear the end of
  • ways to give Papa a heart attack
  • Papa’s lastest nightmare additions
  • ways to scare your father to death
  • interesting methods for suicide
  • things that can cause your father to have a panic attack
  • how to make your father dig for your life
  • things not to teach your baby sister
  • thank God Mamma wasn’t there or she would have killed you herself

Tata seemed to be very accident prone for the entire vacation.  She also had a run-in with a water slide that she lost.  There was a short slide that one was supposed to sit down on. Tata decided to lay down to get some better speed and when entering a curve in the slide, her lower body curved and her upper body did a different maneuver more like a slingshot.  Her face struck the slide, especially that part of the face that sticks out, and she ended up with a very painful nose bleed.  Based on the amount of blood, most of the people in the pool thought she had been attacked by a shark and everyone was trying to escape with their lives. Thankfully he isn’t prone to exaggeration.

All-in-all it was a great vacation.  We have a couple of stories that we will tell for years to come and a couple that I have already forgotten.  I can’t wait to do it again next year.

A1C: Status Quo

A1C: Status Quo

I know it has been a while.  We will ignore the fact that I don’t get much time to blog.  Even now, I have an appointment in 27 minutes.  I just don’t have the free time to blog like I want.

Last week, I had another appointment with Dr. Langley.  First, let me tell you how much I like my doctor.  He has to be the greatest endocrinologist of all time.  He doesn’t make me feel like I am failing.  Even though he should.  He talks to me like I am a person.  Even though he shouldn’t.  His personality is perfect for a doctor.  He is almost parent like, and I actually feel bad, like one does when they forget their siblings birthday.  He never makes feel guilty.  He gives strong advice, shows understanding without feeling sorry for me, and always has a lighthearted attitude.

Anyway, I had another appointment.  My A1C was still 8.4.  Wow.  That is almost a good number.  Not worse, but not better either.  I must say I was a little surprised, because I was extremely disappointment in how I have been managing my diabetes.  You’ve been managing your diabetes?  I start the day off right with breakfast and insulin. It’s a hormone; not a condiment.  Lunch is something I think about.  Then, I am so hungry by the time I get home that I eat everything I possibly can.  Next, I eat dinner and might take some insulin.  Might?  When was the last time that happened?  Then, I take insulin to try and compensate for how badly I messed up.  I was truly expecting my A1C to be back in the 9s and was embarrassed to be sitting in Dr. Langley’s office.  As it turns out, my A1C is still 8.4.  I’m maintaining the status quo.

It has become very difficult to keep my blood sugar under control.  After I get home from work, Mamma leaves for school, and I am home alone with Squishy and Tata.  Tata and I can entertain ourselves without issue.  Squishy creates issues.  If Mamma isn’t home, Squishy isn’t happy.  I mean that.  I don’t know what it is.  I think Squishy is sexist.  Every night it is the same thing.  We start with trying to get supper made for all three of us.  Then Squishy begins fussing while I am trying to feed her, Tata complains that she has eaten too much and only has room left for candy, and my food gets cold.  Next, Squishy falls asleep in my arms as I walk around the room.  I, then, begin to move slowly in an attempt to put her down without walking her.  Ever tried to move past a motion sensor without getting caught.  Same exact thing.  Tata continues eating and Squishy sleeps.  Finally, Tata will finish eating and then scream for some reason and wake Squishy.  Squishy screams.  Tata brushes her teeth, puts her pajamas on, and goes to bed.  Squishy screams.  I begin walking around the house while holding Squishy because she screams less when I walk.  I do NOT sit down or sit her down.  The level of anger a 7 month old can produce is not known until you set Squishy down when she is missing Mamma.  Hours later, Mamma comes home and Squishy eats while I check my blood sugar and think to myself, “I’ll start taking better care of myself tomorrow”.

I can’t wait until tomorrow.  Not tomorrow as in the day after today, but tomorrow as in the day I remember to check my blood sugar and take my insulin when I am supposed to.  There are lots of things on my to-do list for tomorrow.  Until tomorrow, at least I am maintaining the status quo.

Eight and Four Tenths

Eight and Four Tenths

Yesterday was my appointment with the endocrinologists.  I was hopeful that I would finally have broken the curse of the 9 point A1C.  The doctor came back with the results.  I was all pins and needles in anticipation.  Imagine the scene.  My endocrinologists is an older gentleman.  He walks back into the room and says, “I have to remember what your last A1C was in order to compare.”
“9.1,” I said eagerly.
“Well, then you have made some improvement. You have 8.4.”
“YES!” I shout. Not, I said with emphasis. I shouted. A diabetic shouting with joy about an A1C that is 8.4 is just a tad unusual to begin with.  Now, imagine his reaction.  He could have explained that 8.4 was still not good.  He could have congratulated me on my small improvement. There are lots of things he could have done, but nothing quit as great as what he did do.
“YEESS!” he shouted.
“YES!” we shouted, raising our arms in the air like the winners of a race crossing the finish line.  My endocrinologist is awesome.

We also talked about getting a Continuous Glucose Monitor (CGM).  I have a number to call today to speak with a diabetes educator and get some time plugged in.  I’m still not sure if I’m ready to have things dangling from my body, but I know I’m sure I want to get my A1C down to normal.  The CGM could really help.  So I’ll start with that.  If that goes well, maybe I can get below 7 next time.

Being Good at Diabetes

Being Good at Diabetes

Tomorrow is my endocrinologist appointment.  The last few weeks have been so hectic that I have had barely enough time to think.  I certainly did not take care of diabetes appropriately.  Not that a couple of weeks will save my A1C as it is over a “prolonged period time” and not just the last few weeks.  One can hope though.  I’m just hoping that my A1C is lower than 9.1 at the moment.

Who has time for diabetes anyway?  I started this blog because I like to write, and I thought that I could help others and remind myself of what I needed to do.  I haven’t posted since the 27th and my sugar has been sweeter I would generally like.  Monday through Thursday I start at 6:00 AM and don’t quit until well after 10:30 PM.  Friday through Sunday is make up for the family business I missed during the week.  Mostly checking our budget to see how badly we have messed it up or making the menu for the week so that we can get a shopping list together.  This week I had the added joy of trying to consolidate my student loans.  After tallying up the totals, I realized that my accumulative student loan monthly payment was going to be over 1,400 dollars a month.  Going to be?  It was due October 1st.  I can’t really afford that so consolidation attempt it is.

And back to my initial point, who has time for diabetes?  Tomorrow is going to be difficult to focus.  The ADHD excuse?  Now?  I am so worried about this A1C.  It is so frustrating.  In order to keep myself healthy, I have to slow down and focus more on myself.  I feel like I can’t slow down, because I have so much work to do and I have to get it finished.  Yet, if I don’t slow down, I could win some diabetic complications…  If you haven’t already.  And not be able to complete my work at all.  Who would that help?  How do I force myself to change?  I wake up in the morning, thinking, “Today I will be a better version of me.”  Only to go to bed at night and realized that I failed again.  And who I am failing?  Just myself?  No.  Not really.  If I were to have major nerve damage or paralysis, my family would be forced to take care of me.  My co-workers would be forced to pick up my slack.  I know I don’t do anyone any good sick, but if I don’t keep up, I feel like a failure.  I want to be a good father, a good husband, a good friend, a good worker, but in order to be successful at any of those things in the long run, I have to be a good diabetic first.

I’m not the only one.  I know I’m not.  And it is not only diabetes, but for me, diabetes is the thorn in my side.  Tomorrow, I plan on asking about starting on the pump and a CGM.  I’m not sure I can afford either or that my insurance will cover either. I figured if I can at least get my hands on a CGM then an alarm letting me know that my sugar is up or down is better than me remembering hours later.

Anyway, cross your fingers for me.  Tomorrow is my A1C and maybe my plan for making things better in the futu