Posts Tagged ‘diabetes’

My Breakfast Enigma

Something amazing happened yesterday.  Take a look:

(For the American folks, that 5.8 mmol/l is a 104 mg/dl.)

Can anyone guess what I had for breakfast?  I’ll tell you at the end of this post…

This is amazing because every every morning I eat a pretty low carb low GI breakfast, and every every morning I spike within the first two hours and then come down hard.  I’m doing everything I can insulin-wise, including an aggressive bolus (a superbolus, in fact) followed by a major decrease in basal to 0.05 u/hr for the next three hours.  Ideally I’d pre-bolus, but with 2 kids to feed and clothe in the mornings, I’m worried about the impact a delayed (or worse – forgotten!) breakfast would have.  Safety first!

When I was pregnant, I ate balkan yogurt (high protein, high fat) with berries and walnuts for virtually every breakfast, and it worked pretty darn well.  But it also made me pretty darn sick of balkan yogurt and walnuts.  (I’ll eat berries any day, any time!)  So that’s off the table, literally.

Low GI dry cereals are a disaster.  Low GI hot cereals are better, but still far from ideal.

It may be that a further reduction in breakfast carbs is necessary to eliminate that spike and reduce my insulin such that it doesn’t cause a crash, but I’ve been nervous to go below 20g of carbs.  This is partially because I’m breastfeeding and less comfortable with messing around with my nutrient profiles while doing so, but also because I haven’t yet wrapped my mind around how to get over that morning liver dump hump (why does that sound so gross?) with less insulin.  (To be fair, my version of an “aggressive” bolus at breakfast is 2-3 units for 20-30g of carbs, otherwise the mid-morning crash is even bigger.)

Maybe I’m missing something, though.  Maybe I just need to try lower carb.  But what does one eat for an uber-low, or even zero-carb breakfast that will stick with you until lunch but does not contain artificial sweeteners or involve eggs every morning.  I like eggs, but if I eat them every morning, I won’t anymore.  Also not interesting to me is “dinner for breakfast”.  No chicken breasts, thank you.

I’ve even tried a few meal replacement options – drinks and bars.  You know, Martinis and chocolate!  (Kidding.)  To be honest, this is where I’ve had the most luck.  They’re also really quick, which is great!  The downside is that I don’t recognize about 80% of the ingredients in either.  I’ve been able to avoid artificial sweeteners, but it’s hard to say for sure what else I’m not avoiding.

So I’m looking for breakfast options, preferably of the low-carb, low-GI variety.  Something really quick (or make-ahead) and healthy (including low-sodium).  I’d also play around with some zero-carb (or almost zero-carb) ideas…  Anyone?  Suggestions (of either food or food-related resources) are welcome!

So what was the breakfast that gave rise to this lack of a rise?  What perfect food was it that made me almost flatline (in a good way)?

This:

Wordless Wednesday: Temptation

The Waiting Game – Part 2

If you’re a relative newcomer to MeWithD, you may not have read Part 1 of The Waiting Game, as I wrote it quite a while ago.  If you missed it, you can find it here.  If you’re too pressed for time, I’ll summarize:  With retinopathy, I feel like I’m in a perpetual state of waiting for my eyes to get better or worse.

Well at my last Ophtho appointment a few weeks ago, a new layer was added to this game.

I’ve always known that my previous retinal hemorrhages have left a mess in my eye.  I know it because I can see it.  But every time a bleed happens, eventually it clears on its own – at least most of the way.

What I didn’t realize until this most recent appointment is that there is more to this mess than meets the eye.  (Bad pun.)  In fact, lurking just outside of my vision…just on the edges of my periphery…is a nasty, big-assed clot.

Apparently said clot does not pose any significant risk to my long-term health.  It’s quite happy to keep hanging out in my vitreous and has no intention of migrating to more dangerous parts of my body.  It doesn’t indicate retinal scarring.  Nope, in it’s current location, it’s pretty non-threatening.

The problem is, if it decides to move out of my periphery and into my central vision, it will be pretty miserable.  My doc made it sound like I could expect to see pretty much shit-all through that eye if this were to happen.

So now I have the added “suspense” of wondering whether I will wake up to this one morning.  Or will I have to watch it slowly slide into my vision?  I’m not sure which would be worse.

But he assured me that a vitrectomy would clear it up if needed, and that there should be no permanent damage (barring the risks related to a vitrectomy).

Or, he said, if it did make a move and block my vision, we could try waiting for it to clear.

*Sigh*

It Hurts

My oldest daughter (a.k.a. “The Kid”) is three.  She’s at the age where likes to ask questions, watch, help, and do by herself.  My diabetes is no exception.  She likes to help me change the reservoir in my pump – pressing the buttons for me when I tell her to.  She likes to get things for me when I need them.  She wants to know about my infusion sets.  She even wants to watch me insert those awful CGM sensors.

Sometimes when I do the sensors she asks me if it hurts.  I try to be honest with her, but not make a big deal out of it either.  So I usually tell her that sometimes it does hurt, and sometimes I don’t like it, but that if I close my eyes when press the button (on my Serter, that is), it makes me a little less scared.  She seems to accept that and usually watches without much comment.

Yesterday I was changing my infusion set.  I use the Sure-Ts with a needle much tinier than the sensors, and I don’t use a Serter for them, but she still made the connection.  She watched intently while I pulled the new one out of its protective packaging.  I prepped the site and held it in my hand ready to insert.

Suddenly The Kid’s hands fluttered up to her face and she held them in front of her pinched-shut eyes, but only briefly.  Then, seeming to change her mind, she opened her eyes and covered her ears instead.

“Honey?”  I said.  “What are you doing?”

She pulled her hands away to answer me.

“I don’t want to hear you say ‘Ow’.”

And with that, I think my heart cracked.

I was so proud of her empathetic little soul, but at the same time sad that my diabetes would cause her any sort of discomfort.

After assuring her that this needle didn’t hurt at all, she seemed much more content and quickly moved on to other more interesting things, but it left me questioning how much of this disease, and the hurt and frustration surrounding it, I really want to share with my girls.  Maybe in this case being honest with them isn’t in their best interests after all.

Diabetes Art Day 2012 – Self Portrait

This is my first Diabetes Art Day and I’m pretty excited to be participating!  I’m also excited to check out everyone else’s contributions!

For an explanation of Diabetes Art Day, and the creative mind behind it (the lovely Lee Ann Thill), as well as all the submissions (past and present), you can find the D.A.D. website here.

I meant to make my submission long before today, but had been having trouble wrapping my mind around exactly what I wanted to do.  This morning I woke up with another retinal bleed in my left eye – not a big nasty one with the icky opaque blobbies, but an eyeball full of red streaks that was icky nonetheless.  The mess in my eye gave some clarity to my art project.

When people ask me what it’s like to have a retinal bleed, I ask them to think back to an art project they may have done in grade school.  The one where you get a piece of paper, a straw, and a blob of paint, and you blow through the straw and watch the paint wiggle and streak around the page until you have a stringy, goopy, spidery masterpiece.  That’s kind of what an eye bleed looks like.  They can also come in large opaque blotches, or in translucent mists, but this straw-blown paint type is what I’ve grown most accustomed to.

So, looking at myself in the mirror this morning, with my left eye all stringy, I determined exactly what my art project would be.  It’s more of a downer than I initially wanted to submit, but it’s what I needed to create today.  Here it is:

Self Portrait

** Edit:  I realized I didn’t fully explain my media above.  I used a photograph of myself (that I took) and my daughter’s tempera paint…with the straw-blowing method described above. 

New Pump, Take 2

I still have the box that my new pump was delivered in.  That’s because I really haven’t had it for very long, and I haven’t unpacked all the swag that it came with yet.  (I live in a bit of chaos this days – don’t judge.)  The box says it was delivered on Wednesday, August 22nd.  That’s less than a month ago.

So I wasn’t really expecting this last night:

This morning, after dealing with Medtronic (right or wrong, I put it off until morning) I looked back at Scott’s post on Motor Errors from a few months ago.  It made me think that maybe I shouldn’t have been so surprised when this message came up last night.

The woman I spoke with from Medtronic technical support explained to me that a sudden increase in pressure on the piston can cause a Motor Error to display, and often this is just the result of an occlusion or otherwise bad set.  In that respect, it’s similar to the No Delivery error, but is a result of sudden pressure rather than a gradual buildup.  She said that this was most often the reason for the error message, and not an actual problem with the pump itself.  Interestingly, the explanation Scott was given at the time of his Motor Error was slightly different.  I don’t know which is the correct explanation.

Either way, the rep had me run a diagnostic test (the old air-filled-reservoir-with-tubing test).  My pump failed said test.

So I’m getting a new pump tonight.  Or, rather, a new new pump.

Since I bought my first pump in 2007 (this pump is only my second purchased pump), including loaners while malfunctioning pumps were being replaced, the pump arriving via courier tonight will be #8.

This.  Is.  Crazy.

This Sh** Just Got Scary

Something very scary happened to me the other night.  I was woken up by my baby to discover that my bloodsugar was 1.8 mmol/l (32 mg/dl)!

Oh, you thought that was the scary part?  Not so.  Just wait…

Lately I’ve been very tired, due to an unusually restless baby sleeping in a bed about two feet away from me and waking me multiple times every night.  (She was such a good night sleeper, but not lately.  I digress…)  So I’ve been wearing earplugs to sleep.  They let me hear her when she really needs me and tune her out when she doesn’t.  I’ve also been using my short stints of good sleep to sleep extremely soundly.

One drawback to the earplugs and the sound sleep is that I haven’t been noticing my CGM alarms.  My pump is set to vibrate for alarms, and I have it on the waistband of my pajamas up against my belly so I’ll feel it.  (NOT between my boobs!!)  Normally the vibration wakes me.  But lately, between my exhaustion and my earplugs, my husband has been waking me quite often to tell me I’m sleeping through my CGM alarm.

This hasn’t been ideal because it’s meant that my pump has tried to wake me with vibration, then with an alarm, then resorted to waking my husband, who then wakes me.  It gives my bloodsugar time to drop further before I notice a problem – and the CGM already has the (approximately) 15 min. delay, so timeliness leaves something to be desired.  In the past, I actually used to wake up to nypos quite easily, but this has changed with the aforementioned exhaustion.  All in all, timely bloodsugar-related wake-ups are sketchy at best these days.

So when my baby girl woke me up, I realized I was pretty darn low.  My CGM said 2.3 mmol/l  (41 mg/dl), and must have been alarming – which is probably what woke the baby. I wobbled, bleary-eyed, into the bathroom to test and could barely stand up.  When the 1.8 appeared on my meter, I cursed, inhaled seven dextrose tabs (3g carb each) summoned all my energy and dragged myself back to bed .  In a case of bad timing, the baby wanted to eat at this very moment (she’s breastfed).  So I lay in bed and fed her (thank goodness for the side-lying breastfeeding position!), while my husband kept a watchful eye on us.

By the time she was finished, my BG was going up at a reasonable pace (quite quickly, actually), but I tacked on a few crackers with peanut butter for good measure. (Am I the only one who craves peanut butter when I’m low?) It was another 10g of carbs at most.  I was pretty impressed with myself for managing a wicked nypo like that with only 30g of carbs, since I’m just as prone to face-feeding during a nypo as the next PWD.

By breakfast time, I was in the 8s (that’s about 150 mg/dl), which was too high, but really not too bad considering what had happened overnight.  I had my breakfast of high fibre oatmeal/flax/etc. and proceeded to feel hungover.  By mid-morning, though, I was a whopping 17.8 mmol/l (320 mg/dl) – WAY higher than I usually see.

It was at that point (or, rather, after my BG came down to a more reasonable level) that I decided to start logging again to figure out what the hell needed to change in my diabetes management to keep this from ever happening again.

I sat down at my spreadsheet template (because I’m a geek).

I entered in my bloodsugar readings from my meter memory.

I started to enter in my boluses from my pump’s bolus history.

That’s when I saw this:

What the…..??

Something important to know at this point is that I was 8.7 mmol/l (157 mg/dl) when I took this correction bolus during the night.

Something else important to know at this point is that my regular correction for an 8.7 mmol/l should have been about 1 unit.  I would only ever take 7.4 units of insulin at night if I were eating a second supper of about 40g-50g of carbs.

Something else important to know is that I don’t remember taking this bolus.  I do remember fiddling around with my pump – trying to take a smaller bolus or calibrate my sensor or something – but the details are fuzzy.  Thankfully I do have a recollection of doing something or I’d be likely to blame my new pump and would be very afraid to continue wearing it.  But I’m quite sure this was human error.  My error.

Yikes.

I’ve never, in all my 30 years of having diabetes, done something like that before.

Presumably my liver kicked in to bring my bloodsugar up, because I don’t know how 30g of carbs, plus a bowl of oatmeal (with breakfast bolus), would have brought my bloodsugar up to 17.8 otherwise.  So it’s good to know that something was working – since I couldn’t feel the low, feel the vibrating pump, hear the alarming pump, or even think clearly enough to bolus properly.

This mistake has me very freaked out.  Lows like that are so dangerous, and I can only imagine the speed at which I must have been dropping after that whopper of a bolus.  I don’t want to think about what could have happened if the baby didn’t wake me.  Do I owe my life to her already…?

The question is, how do I keep from repeating this mistake?  My pump’s Max Bolus had been set to 12 units, and since this mistake it has been changed to 6 units.  If I ever want a bigger bolus than that, I’ll do it in two parts.  Also, I no longer wear earplugs to sleep.  I’d rather have a restless sleep than continue to sleep through my CGM alarm.  And I’ll be wearing a CGM 24/7 for the foreseeable future – at least until I’m less exhausted and easier to wake.  (Funny how even an unusual breath from my baby can wake me, yet a beeping pump won’t.)

Beyond that, I’m not sure what to do.  Will I do it again…?  I’m crossing my fingers that this was both the first and last time, because that was just way too scary.