Category Archives: Diabetes

type 1, insulin pump, blood glucose

Diabetes vs. Cortisone

This has not been a good week for me and Dear Diabetes.

In the last five days I have had 55-60 total units of insulin shooting through my body. Of that, 30 units is continuos basal.

That’s a lot.

To put it into perspective, normally I average 17-21 total daily units of which 12 is basal.

Right now, I am triple dosing.

Yet, my blood sugars are high.

Abnormally, dangerously high, unable to crack below 13 mmol most of those days.

Generally, I am rarely above 10.0 mmol.

The resistance is strong.

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This photo was compiled late Friday afternoon. By end of day, my total daily dose was at 57 units.

The culprit: a cortisone injection in my right hip joint that was administered Thursday morning to counter the effects of a labrel tear.

Apparently it is well known in the medical field that cortisone (and other steroids for that matter) can often wreak havoc on diabetes management. Yet, I was never made aware.

Not from the surgeon who booked the appointment.

Not from the nurse who prepped me for the cortisone.

Not from the doctor who administered the injection.

They all knew I had Type-1 diabetes and that I was on an insulin pump.

When I met with the surgeon, our initial conversation was about surgery, and I flat out asked how surgery would affect my diabetes. He told me, minimally. When it was decided a cortisone shot would be the best course of action, I did not ask about my diabetes. Maybe that was my fault, but given that I had asked about it for the surgery side of things, you would think, if it was an issue, the surgeon would have notified me.

He did not.

Prior to getting the cortisone, when sitting in the radiology waiting room, the nurse had me fill out a form that asked if I had diabetes. I checked yes, and added that I had type-1 diabetes and am on insulin pump therapy. (A similar form had been filled out at the surgeon’s office as well.)

In the exam room, I asked the nurse if I should remove my insulin pump. She said no.

She did not tell me the insulin would essentially be like water going through me following the injection.

When the physician came in and informed me of the procedure and the effect the cortisone may have on my joint, and the small chance of infection, he said not a word of my diabetes. He had every opportunity. I had to move my insulin pump out of the way. When the procedure was done, I got tangled in my insulin pump wiring and he helped untangle me.

No one said a word.

Thursday night my blood sugars had crept up to 13.7 mmol. after dinner. It was a burger dinner, and I thought maybe the ketchup or bun had an effect. By the morning, they were at 16.4 mmol. I thought my infusion was faulty, maybe there was an air bubble in the line, or the canula had bent. I switched it out. Two hours later, they were at 16.9 mmol.

I was beyond frustrated.

I do not do high blood sugars. I rarely have them. I do not know what to do.

I raged bolus. I increased my basal by 100%. I ran the insulin through the line, checking that it was actually going through. I questioned every dose I had administered. I re-reviewed everything I had eaten. I switched out the old insulin, for a new, in-the-fridge bottle.

None of it worked.

Nothing made sense.

By dinner, I was near tears. I had no idea what was going on with me.

I was scared.

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12:30 a.m. Friday: scared.

I was worried about ketones. I was worried about the incessant itching of my legs, so bad I drew blood. I was worried about my perfect hemoglobin A1c.

Big Ring asked if the cortisone could have had an effect.

Light bulb.

My fingers swiftly tapped over the Google keys and sure enough it was there.

Cortisone is a beast for diabetes.

Are you effing kidding me? Why did know one, not one of those doctors, inform me? Why?

I posted on Facebook asking all my T-1 peeps for advice on how to deal. So many suggestions. So many expressions of shock that I was not notified ahead of time.

It’s still not perfect.

My basal has been set at a continuous +200%, which is the maximum basal dose for Animas pumps, for days; if it could go higher, it would. I’ve been testing my blood sugars every two hours, and at nearly every test, I’m doing bolus corrections. Since getting the cortisone, I have dosed, both by pump and syringes, 235 total units. I go hours without eating. I fear food, and the effect it will have on my blood sugars. I’ve cracked the extreme highs for the most part, now sitting between 8.0 and 10.0 mmols, but that’s still with the crazy increase in insulin. I feel sick inside. I feel lethargic, winded. Even talking is an effort.

I don’t know when it will come down.

I don’t know when I will feel better.

But I do know, every step of the way, I was failed by the medical system.

That is not acceptable.

 

The journey begins

It seems appropriate I write this post today. It’s a post long overdue. Some of you already know, some have forgotten, some don’t know at all.

On this day three years ago, I pulled my editor out of his holidays, I told him it was urgent he meet me. My stomach was full of nervous bubbles, it was a day I had been counting down for 10 months prior. It was a day I never believed I would ever have a count down for.

Time did not make it easy.

Three years ago I told my editor I was leaving the world of journalism, the world of my childhood dreams.

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Journalist me: so many adventures!

Today, I am four weeks from starting on a path I have been building up to for the last six years. On May 17 I was officially accepted into the dietetics program at the University of British Columbia.

Eeeeeeeeeeeee!!!

The year leading up to this day there was a lot of nervous tension. This is a highly competitive program: over 100 hundred applicants; 50 of who get interviews; and 30-34 accepted. I spent years working towards acceptance. I interviewed several dietitians, I volunteered in areas I knew would boost my profile, I spent months looking over my application, working on my interviewing skills, anticipating the questions that may be asked. I spent countless evenings studying, perfecting my knowledge, ensuring my grades were above par. (It didn’t always work to my favour: math and chemistry were like bones constantly jabbing my confidence.) I lost friends in the process.

All for the goal.

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Studying me: pretty much anything in the loft was fair game for my studies: whiteboards, walls, spare paper, even my arms!

People kept telling me I was in. They’d be stupid not to take me, they said. My history, my vision of working with Type-1, athletic diabetics, it was solid. But I’d met other candidates and they, too, had solid stories. Deep down, I believed in myself. But on the surface, the what ifs had clouded that belief.

I remember walking out of the interview, which by the way was crazy intense, with a smile on my face. Big Ring was waiting outside and as soon as he saw my face, he knew I had nailed it. And I thought so too. But the thing is, five minutes into the car ride home, that evil little devil on my shoulder started steering my memory into a negative direction. I started thinking about things I didn’t say, or the fact that I was so sure they would ask right off the hop why I wanted to be a dietitian, and that’s how I started to answer, only to realize 30 seconds into answering that oh freaking hell, that’s not what they asked at all.

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The application was in. The interview complete. The only thing left to do was reflect.

 

It took about a week and a half for the worrying pit in my stomach to release.

Thanks to a great friend.

We had been chatting about the interview, and I told him the odds just as I did for all of you above. He broke it down into the most simple terms:

“So, do you really think, honestly, that you could be one of the 16 NOT selected?” he asked.

Hmm. No, no I didn’t.

A huge smile washed over me. Another week and a half and I had my acceptance.

Dear readers, I AM going to be a dietitian!!!!!

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And surely that warrants an ice cream celebration!

 

Forever in my diabetes-thriving heart

Tears.

When I got the email two weeks ago, my heart broke into pieces.

We had been together for 21 years. I had chosen this man, picked him specifically from a lot of others. He was perfect in every way that my 18-year-old self desired. He had an American accent. He had a welcoming smile, a fit body – oh, those legs – a firm, warming handshake, and a delectably nerdy side too.

He had me at bow-tie.

We had grown comfortable over the years, familiar. There was a warmth between us. The awkwardness of new was long gone. Our conversations were easy, filled with laughter, and respect, dare I even say knowing twinkles in our eyes. I yearned to impress him. When not in his presence, I counted down the minutes until I next was. I always dressed the part, making sure my face, hair, clothes were as close to perfection as I could muster.

But now, all that is gone.

Dr. Hottie is moving on.

Yesterday was my last ever appointment with my crush-worthy endocrinologist. It was the last time I would ever feel his strong hands softly caressing, er, I mean, inspecting my neck for thyroid growth, the last time I would feel his warmth so close as he checked my racing heart, the last time I would have his eyes boring into mine, so invested in my words. It was the last time I would see that welcoming, inviting smile of his, so hypnotic you forget you’re talking to a doctor and share everything – everything. It was the last time I would giggle over his choice of bow-tie: a classy navy blue with blood red polka dots. It was the last time I would ever have his silky warm hands wrapped around mine; you better believe I lingered.

Yesterday was the last time I would ever hear Dr. Hottie boast again of my diabetes rockstardom.

The realization of that is where I crumble.

I have not always been a diabetes rockstar. There were several years in my teens and early adulthood where I repeatedly rebelled against this disease. I started seeing Dr. Hottie at 18; the first seven years were not my best years. He saw me at my worst, and yet, he never judged, just encouraged. He was the first specialist to see ME, not my diabetes. If I wanted to go out and drink myself under the table, he didn’t necessarily condone it, but he also didn’t live in a shell. He knew I was going to do it, and he gave me tips on how to do so without completely destroying the diabetes within me. If I wanted to eat the cruddiest food, he didn’t say no, he gave me options for better balance.

He talked with me, not at me. That was huge.

When I finally punched Dear Diabetes in the face and said Look, you don’t control me, I control you, I did it for me. But if we’re being completely truthful, and I think we are, the crush I have had on Dr. Hottie has been a strong guiding force in keeping Dear Diabetes under my thumb. When my hgA1c started on a trajectory towards near perfection, the excitement I saw in his twinkling eyes, and heard in his voice made me want more. I craved his exclamations:

“These are numbers to grow old with!”
“Whatever you’re doing, keep doing it!”
“You’re healthier than many without this disease!”
“You’re a rockstar!”

While I am still mourning the loss of this great specialist in my life, I am proud to say that we ended our relationship on a beautiful note. Yesterday’s hgA1c was 5.3. To put that into context for those without this disease, the hemoglobin A1C for a “healthy” non-diabetic is less than 5.7.

Yep, I am a rockstar!

Goodbye Dr. Hottie, you will forever be in my diabetes-thriving heart.

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     About men, indeed 😉                                                                                     (Photo retrieved from: https://www.flickr.com/photos/44592535@N04/)

The unthinkable

The unthinkable happened.

Seven years ago I had feared the worst. My first marathon, it was pouring rain. The marathon had yet to start, and I was in the porta-potty for the umpteenth time when I heard a loud, stomach-dropping splash in the grossness below. I thought it was my pump. It was not. Thank freaking every god in the world! It was one of my electrolytes bottles.

From that day forward I have been beyond careful. I am, unequivocally, the slowest person when it comes to washrooms. About a month ago I was in a long washroom line with a friend. We were the next up for the two available stalls. She told the girls behind us not to worry, she was quick. I gave them an apologetic look: I’m not.

You see, I don’t hide my insulin pump. It is almost always clipped to my belt loop, or when I’m not wearing a belt, the waistband of my pants or skirts or shorts. That means nearly every time I go to the washroom, I am not only pulling down my pants, but I’m also either unclipping my pump and holding on to it, or trying to ensure the weight of it doesn’t cause my belt to unloop and drop to the seriously unsanitary grounds below.

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The other day, I was not wearing a belt. I was wearing high-waisted jeans. My brain was in a post finals fog; I had only just finished minutes prior. I peed. I grabbed some toilet paper. I heard a clang.

The clip on the back of my insulin pump had wriggled free of my jeans. The infusion was in my stomach. It was the 43 inch tubing attached instead of the 23. Had it been the 23, it might have been saved. But no…

It was in the toilet bowl – the pee-filled toilet bowl.

Oh. My. Freaking. Ewwwww!

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Sure, I’ve heard that urine is “supposedly” sanitary. I learned from one of my lovely campers back when I was a camp counsellor in Maine years ago that pee is the cure for athlete’s foot. Still, that knowledge did not give me comfort. This thing is vital to my life; it should not be covered in pee.

And the worst thing, it actually proved waterproof. That means, no new pump for me.

Ewwww!

Exams and diabetes

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I was freaking out.

I was a couple days off from my first final of the semester, and I was completely wigging. It was an upper-level research course. I had been doing well. I knew the material. By all accounts, I should have been confident. But no, I was in full-blown freak-out mode. I don’t like exams, and no matter how well I know the material, I generally get over-run by anxiety. But this time was different. This time was worse.

Dear Diabetes had gotten in my head.

Not surprising, really. The midterm was a bloody gong show. Normally my blood sugars run high for exams. It’s that whole anxiety thing setting up the fight or flight response, shooting up the adrenaline – and the blood sugars. But for the midterm, Dear Diabetes decided to take me on a different kind of roller coaster. Instead of high blood sugars, they bottomed out 10 minutes prior to the start of the exam. I scarfed down handfuls of dried apricots. It was no use.

High blood sugars, as long as they don’t go above 13 mmol, I can deal with. But low blood sugars, no.

The first 30 minutes of the exam was awash. The words bounced all over the pages for the first 10-15 minutes, and then the next 15 minutes, it was a mumbo of confusion. I couldn’t make out the research abstracts. I didn’t understand what the questions were asking. I knew time was ticking. The anxiety rose. I started to sweat. It was all I could do to stop from hitting my head in all-out frustration.

My moms, and all her hippie friends voices filled my head. I closed my eyes for what felt like an hour but was likely only 2 minutes, doing everything in my power to calm my mind, my heart, my blood sugars.

Finally, the words made sense.

So, the final. I studied the slides. I studied my lecture notes. I asked friends in the class for clarification on some of the smallest details. I studied my diabetes. I looked for trends. I made adjustments. I planned the day’s fuel, and made sure I cut and measured the carbs of the apple for complete bolus accuracy. If Dear Diabetes had plans for me, I was going to be ready, I was going to be beyond prepared – both in material and body.

Dear Diabetes was not going to win this battle. Not this time.

The final was last Tuesday.

Unfortunately, I wasn’t safe from the anxiety; the blood sugars continuously creeped up prior to the exam. I bolused an insulin-correction 10 minutes before going in. As long as they didn’t go too high, though, I’d be safe from nausea.

The highs don’t cripple my brain.

As for the exam, I was 5,000 per cent solid. Results were posted the other night; I scored 91%.

Dear Diabetes: FACE!

Sometimes…

Sometimes I don’t want to stop.

Sometimes I’m in the thick of a really great book, and I don’t want to stop.

Sometimes I’m in the middle of writing a killer sentence, and I don’t want to stop.

Sometimes I’m climbing down the Eiffel Tower in the twilight hours, and I don’t want to stop

Sometimes I’m in the depths of a needed sleep, and I don’t want to stop.

Sometimes I’m at 8.5 km of a strong 10 km run, and I don’t want to stop.

Sometimes I’m hurting with joy, giggling so hard with my boy, and I don’t want to stop.

I can see the words on the screen go blurry.

I can feel the letters in my book as they punch me in the face with every bounce across the page they make.

I can sense the happy flutters in my belly being strangled into sickening worry.

I try to control the shakes.

I try to ignore my heated cheeks.

I squint at the screen.

I cover one eye, hoping it will empower the other.

All for just a few more minutes.

A few minutes without Dear Diabetes.

But then, the full-body sweats come. Reality sets in. I cannot ignore Dear Diabetes. I cannot shove him off to the corner, not even for a few seconds. He is there. He will always be there. He won’t ever let me forget it.

The other day my blood sugars dropped to 3.0; I felt as though they were 2.0.

I didn’t want to stop.

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Hospital: the first

Dear Moms,

I am sorry I was such a sick kid. I am sorry I got whooping cough at three weeks old. I am sorry my appendix nearly burst at three years old. I am sorry about the whole diabetes diagnosis at nine years old that caused a tumult of ER runs and hospital stays. I am sorry I threw my lunches into the bushes and gave your plants my insulin doses and gorged out on chocolate under the covers of my bed, which no doubt added to those aforementioned sick-induced adventures. I am sorry I got jaundice at 11, and a near concussion at 17. I am sorry your mother’s intuition was forced to work over time for so many years just to ensure I made it through the night.

Never in my 38 years did I imagine the anguish I put you through until now.

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NYE: The Sickness part 1

It is an anguish all parents go through, I am sure, but one I had yet to truly experience until recently.

On Christmas Eve Little Ring woke up with a cold. He’s had colds before, but this one was a doozy. He was lethargic; his head seemed to be in a thick fog for most of the day. Still, not a huge deal. Just a cold. On New Years Eve, he started puking. He is not a puker; I think he has puked once, maybe twice, prior. He was scared. He started screaming to scare the “fire in his belly” away. That was hard. It was the flu. Every parent has handled the flu. We could handle the flu. Two days later, his spirits were back up, his appetite was regaining steam. We thought we were in the clear. We took him sledding.

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If only the squeals had stayed joyful

I will forever feel guilt for that decision.

Oh he laughed and squealed with glee. Every ride down was better than the previous. We were out for about an hour. I was getting cold. I suggested we head for hot chocolate. His steps up the hill slowed; his body slouched. It was as though he were lugging an elephant up the hill with him. I had seen this before. It was classic Little Ring style. He was tired. He was dramatic. He wanted mama to carry him the rest of the way.

We got to our hot chocolate haunt. He and Big Ring sat down with their mugs, while I talked to my favourite tea lady at the tea counter. He came over to me and declared he wanted to go home. I thought it was exhaustion. He grabbed his head and started crying.

We got home. He laid on the couch, tossing and turning, writhing in pain. He had a fever. His ear was hurting. We gave him baby Advil. I was on hold with the nurses line for over an hour. By the end of the call, his fever had dissipated and he was chewing dried apricots, which seemed to help.

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With “fire in the belly” lying down was the go-to position

It was just an ear ache; parents deal with ear aches all the time. We were sure it would go away.

Mild fevers came and went for another week, but nothing too extraneous. On Jan. 7, he was nauseous, and feared the red bucket, again screaming to scare the pukes away. The next day he seemed fine. The fevers were on and off, but he generally runs hot. During the day he was eating, energetic, playing, building Lego, fighting superhero crime, cracking perfect Little Ring jokes. But at night, the ear pain continued to present itself.

We gave him baby Advil to make him comfortable. By Monday, we took him to see our bow-tie loving family doc. Dr. Nick looked in his ear, said there was some redness, but nothing overly concerning. He was loathe to prescribe antibiotics, which we were in agreement with, advising that it would likely clear up on its own and to continue prescribing baby Tylenol and Advil for comfort.

I had a long day at school Tuesdaay; I was out of the loft by 6:18 a.m. and didn’t get home until 8:15 p.m. meaning I didn’t see the boy at all. Big Ring texted that Little Ring had swelling around his ear, but wasn’t complaining of pain. He woke up at 10 p.m., crying out, his blanket over his head. His ear hurt. The swelling was significant. Behind his ear, his head was so swollen, his ear was pushing forward as thought it were Spock’s ear. It was red and tender. His lymph nodes were also swollen.

That was it.

Off to the ER we went. The first for the boy.

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Dear kid, PLEASE don’t become a regular like your mama.

Nearly three hours later, we had a diagnosis. The infection was in the early stages of attacking the bone. It was mastoiditis. If left untreated, it could be serious. I didn’t know the implications. All I knew is that the doctor, who I think might very well be Royal Columbian’s version of McSteamy (and he knows it!) caused my child to cry out in pain. I know he had to do it. I know they needed to see his pain level. With my fists clenched in my pockets, the nails of my fingers digging into my hands, the feeling of wanting to jump out of my skin, it took every piece of strength I had not to attack.

My eyes shot daggers.

We were prescribed a heavy dose of antibiotics; so heavy even the pharmacist winced. I didn’t ask McSteamy about the side effects, I didn’t ask if there were any other alternatives, I heard “serious implications” and everything stopped. I just wanted my boy better. It wasn’t until I got home that I started questioning the prescription.

It’s taken my control away. It’s taken Little Ring’s control away. Neither of us like losing control.

For the first 20 years of my life, without realizing, I watched as my moms protected me. I watched her advocate for me, press the doctors  and other such medical professionals for the utmost best care, and challenge them if they didn’t give it to her standards. I watched as her face never cracked. She was calm. She was patient. She rubbed my back, never showing weakness – not in my presence, nor the doctors’. She was strong. She was fierce. She had an Elizabethan fire in her not to be stoked.

Last night, I wanted to cry.

My moms never cried.

Neither did I.

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She will forever be my hero ❤