Intensive Management vs. Emotional Burnout

This post was prompted by a fellow Diabetes Warrior Parent, who wrote about "When is Too Much, Too Much?" Thanks for the inspiration Reyna from Beta Buddies

That phrase echoes my experience three fold.  I have gone OCD on diabetes in the past. Testing too much, analysing like a crazy mad scientist, CGM, Pumping, weighing, measuring, counting the carbs right down to a half gram. 

Was my Control improved?  Absolutely. Was I happy? Absolutely Not! 

Diabetes was dominating my every waking moment more then it should.  Which brings me to the conclusion that sometimes simple is nice. Now I should add that I definitely advocate for intensive diabetes management, but not at the expense of emotional burnout. And, It really is a fine line.

Now my one Type 1 daughter Rowan, went from MDI, to Pump, now back to MDI.  Why? Primarily for physical reasons, as her pump sites were looking a little on the lumpy side (Hyperlipodystrophy) Also, It too was necessary for mental sanity. We were micro-managing her diabetes and pump.  I was getting texts 3-4 times a week from her school informing me her readings were wonky. Now I am lucky to get one once a  month. We've simplified things dramatically, and as a result, we are feeling some emotional reprieve and her control has improved.

As a parent of 2 children with Type 1 it is very easy to chase numbers, over react, change things, basals, boluses, testings a gazillion times a day, worry or cheer. All this at the will of the results on the CGM or in our case the Meter.

I do know how exhausting this is, and how every reading isn't just a reading, it represents sooo much more then that. It is a Mark, or measure as to how well we(as parents) are managing our innocent vulnerable child's Diabetes. And some of those reading can emotionally crush us.

This insurmountable task of managing as an external pancreas takes a huge toll on us emotionally. So can we simplify things, or at least mentally simplify things? Good Question. And something I encourage all of us Parents and PWD(People with Diabetes) to reflect on. I know my awareness about Quantity vs Quality is evident often. I think it is a Nursing thing, when a person who is told they can live 3 extra months but need to spend half that time sick with no quality of life. What is the point of living if the disease or illness dominiates our life to the point that our quality of life is severely hampered. Not this guy, no freakin way.  I want to prevent longterm complications for all of us but I also want to live Life!

I love the saying KISS, or Keep it simple stupid.  Now before you all swear at me, I am not calling anyone stupid other then myself, cause somehow I make things more complicated then they need to be. My regime for example, always improves when I stick to a simple plan. Eat sensibly,  measurable carbs, test 4-5 times a day, look at the trends weekly and tweak.  It works and no I don't do this all the time, and Yes I often drive myself to the brink of insanity. But lately it is about finding the balance between quantity and quality. Life should be all about diabetes but about Life and Diabetes on the side.

I do know this though, Simple works. I don't mean simpler technology, my pump works better with 4 basal rates as opposed to 8. It is a fabulous device. But I know that I can over complicate things by analyzing things to frequently, over thinking decisions, second guessing my self.

The complexity in diabetes management is taxing on the brain and the trick is to ask - How can I balance all this physical stuff(testing, injecting, pumping) with the Life, so that it doesn't out balance quality of life and lead to burn out?

That's the balancing act for us folks living with diabetes daily.

Trev

Time to Recruit My Team

"There's No I in Team"

My Life is a Whole Lot of Diabetes.  Almost Too Much. 

As my regular readers are aware, I Treat Myself, 2 Children, and Also assist hundreds of patients with their diabetes.

I try my best to assist everyone in the above scenario, but I waver to admit, I am doing a piss poor job with my own diabetes.  I do okay, but I'm frankly in desperate need for an objective opinion on my diabetes. 

As luck would have it, I work with a Nurse, who is also a CDE(certified diabetes educator) who works part-time with my old Endo and her under grad degree prior to nursing was nutrition. Cool, eh?!  So I was complaining about diabetes, and the type one support deficiencies in the system(my opinion of course) and after some discussion she offered to take a look at my trends.

I thought for a brief second, and said "that would be great".  Not only would this take the pressure off me a little, but I would be accountable to give my numbers to a respected colleague weekly to review.

I then thought, I need to take advantage of what I tell others to take advantage of.  Like pump courses, even though I do know a lot, but I have never formally taken the pump training, I just read and digest, and do, so to speak. 

I am also going to ask my family doctor for a re-referral to my Endo.

The neat thing is, my new team will allow me to be helped as a patient, which is a little weird for me, but is likely what I need to feel better, supported, and in better control of my diabetes.

How important is your Diabetes Team or Endo to you or your loved one with diabetes?

Trev

Shocking News - Embarrassed Teen



"Note Pink Shirt Standing to the Left,
She is Not impressed"

 I knew it would happen, but nothing ever really prepares you for what I am about to share.

Last night my oldest daughter Dareian had a Soccer game. During the game she started out with a bang, scored a goal, ran like a cheetah, and totally kicked ass. But I noticed her slowing down closer to half time.

As any concerned Improvising Pancreatic Substitute would do, I ran up to their huddle, and said to the coach, "Can I borrow her?"

She was immediately unimpressed.  She slid away from the group and completely shunned me, her dad, I was hurt, then I whispered to the coach, and awkwardly added, "She has Type 1 Diabetes (like he didn't already know) and we need to test her sugar"  He nodded in agreement.

I then jogged back to my area of refuge, wanting to crawl under a rock. Feeling completely rejected, and confused, to unintentionally embarrass her was different then my purposeful attempts of past.

On reflection, I new the time had come, where she was now transitioning into a self conscious, or overly conscious teen, who unfortunately tend to be hyper aware of their social surroundings. A VERY SAD DAY

10 minutes later, once all attention was back on the game, she jogs over and allows me to test her. She was high, which happens with these adrenaline pumping games.  I gave her some water, and told her she was doing really great out on the field!  She patted me on the shoulder, and ran back to finish the game.

My baby is getting all growed up.

Trev

Dear Diabetic Life

Tomorrow is my 39th  Birthday. Yes, 39 years I have existed on this earth. I have had diabetes now for 30 years, wow, hard to believe.  On my drive to work today, and after dropping my children off, I watched them stroll up to their school. I had a flash of my childhood, or more precisely my childhood prior to being "Diabetic"

I was in my back yard. Kingston Ontario, basking in the warm May sun on my birthday 33 years ago. I was 6 yrs old. I think of this memory often. Not sure why, I think because it was a fond memory. Things were simple, play, gymnastics, swimming, and nothing else.

I remember eagerly awaiting my friends to arrive for my 6th birthday party. I remember hot dogs, cake, treats, laughter, and all that good stuff. I remember biking, and feeling free. I am grateful for my childhood. I am grateful to have been loved and now to be able to love.

I am glad to be healthy still despite my life challenged with diabetes. I am grateful to be still fighting, and meeting the challenge.

I don't feel happy or sad about my birthday tomorrow, just grateful. Funny how that is, as my life progresses, and mortality presents itself, things of importance fall into place.

Family, good health, and enjoying life.


Trev

Diabetic Muffin Man VLOG

Well as Promised, here is my first Baking VLOG and my second installment of the Diabetic Muffin Man.

And the finished Product!

Cheers!

Trev

Electrified Legs or Restless Leg Syndrome

Lately my legs are feeling electrified.  And as a result, I am not able to fall asleep.

Terrible, I know, but it's really starting to drive me crazy!

I go to bed, and literally my legs feel ENERGIZED like I need to get up and run around, even though I am mentally wiped.  Serious conundrum I have. And Apparently so do many others. Like 7 % of the general population.

I of course, self diagnosed my electric leg problem as Restless Leg Syndrome, or perhaps some mild Peripheral Neuropathy, and shared this brilliant epiphany with my Family Doc. He gave me some samples of Caltrate, a Calcium Vit D multivit supplement and told me to trial it.. I now take it daily, and thought it may be assisting, until the last few week.

As a result of my issue I needed more info and did a brief literature review:

Merlino and company define Restless Leg Syndrome as below:

 Restless legs syndrome (RLS) is a sensorimotor disorder characterised by a complaint of an almost irresistible urge to move the legs.

Yup!  That's me, that's me.  Like even sitting in my office today my legs are vibrating. But is it RLS or some other Neuropathy related to my 29 year history of Type 1 DM.

Well the above article adds;

Furthermore, recent studies show that RLS may be associated also to type 2 diabetes mellitus and to multiple sclerosis.

May be linked?  So I continue my search.

Garcia-Borreguero from the Institution Sleep Research Institute, Madrid, Spain adds:

Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2-3% experience moderate or severe symptoms at least twice a week.

and;

RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression.

Man, this better not be another diabetes "Problem" to deal with.

One more study done by Gemignani, Franco and colleagues concluded:

Our data show that RLS is a relevant feature of diabetic neuropathy, as a frequent and potentially treatable manifestation of small fiber involvement in the course of DM and IGT/IFG.

Once again supporting a linking of RLS and DM, Wonderful!!!  Now what can I do about it?

Schapira from the UK links not only Diabetes, but also a genetic component to RLS.  Funny my Dad who doesn't have Diabetes, goes to bed at night and vibrates so much Mom frequently kicks him out of bed.  To quote the study directly:

Four essential diagnostic criteria for restless legs syndrome (RLS) have been identified. Patients experience an urge to move the legs, which typically begins or worsens during periods of rest. The symptoms are at least partially relieved by movement, and are typically worse in the evening and night than in the day. All four criteria are necessary to confirm the diagnosis of RLS. In addition, a family history of RLS, the presence of periodic leg movements in sleep, and a positive response to dopaminergic therapy are useful supportive clinical features to confirm the diagnosis. Whilst many cases of RLS are idiopathic, secondary RLS is often observed in pregnant women, patients who have severe renal dysfunction, or in those with iron deficiency.

I then looked into what can be done about my vibrating legs.  Satija add this about treatment and prognosis.

Treatment of RLS is usually rewarding. Most patients respond robustly to dopamine receptor agonists. Over time, response may lessen, or the patients may develop 'augmentation', whereby they have a worsening of symptoms, usually in the form of an earlier onset. Other treatment options include gabapentin, or similar antiepileptic drugs, and opioids.

So my drug options are laid out above. Not to fussy about the options. Basically Parkinson's, Narcotics, and Anti seizure meds.  I'll pass, for now anyway. Not to mention my Doctor is pretty stingy when it comes to handing out pills.


I did find a web site soley devoted to us people with Electrified Legs, AKA RLS. Check it out at http://www.rls.org/

After reading the site suggestions I have a plan to:

Reduce Caffeine, toughie for me, but okay, the website actually recommends eliminating it, Not!!!
Exercise - already in the plan, just need to do it daily
Hot Bath - Try to fit that one in, I have a hard time just using the bathroom in my house
Practice good sleep hygiene - Bed at the same time, Up at the same time
Limit Alcohol - Not hard for this guy
Review Meds that worsen - Apparently Antihistamines worsen it, Benadryll, Gravol, Anti Allergy meds
Diet - Needs to be balanced, hmmm, define balanced, that is a whole topic to itself
Lab Work - Apparently Iron Deficiency Anemia, and RLS are linked.


Trev

Sources:

Merlino, G. ; Valente, M. ; Serafini, A.; Gigli, G. L. Title Restless legs syndrome: diagnosis, epidemiology, classification and consequences.Neurological Sciences. 28(1) (Suppl 1):S37-S46, January 2007.

Garcia-Borreguero, Diego Institution Sleep Research Institute, Madrid, Spain.Tine to REST: epidemiology and burden. Source European Journal of Neurology. 13 (Supplement 3):15-20, October 2006.Gemignani, Franco; Brindani, Francesca; Vitetta, Francesca; Marbini, Adriana; Calzetti, Stefano Institution Department of Neurosciences, University of Parma, Parma, Italy. Restless legs syndrome in diabetic neuropathy: a frequent manifestation of small fiber neuropathy. Journal of the Peripheral Nervous System. 12(1):50-53, March 2007. 

 Schapira, A. H. V. Institution University Department of Clinical Neurosciences, Royal Free & University College Medical School and Institute of Neurology, UCL, London, UK  RLS patients: who are they?. European Journal of Neurology. 13 (Supplement 2):2-7, October 2006.

Satija, Pankaj; Ondo, William G. Institution Department of Neurology, Baylor College of Medicine, Houston, Texas, USA. Restless Legs Syndrome: Pathophysiology, Diagnosis and Treatment.[Review]
Source CNS Drugs. 22(6):497-518, June 01, 2008.

The Lifespan of a Fly - Seriously!

So as many of you know I "Flip Flop" back and forth between Pump and MDI. 

This past week I have been Pumping.  With nice even sugars to boot.

Until last evening.

Pump infusion sets are like flies they have a very short lifespan.

I head to work yesterday knowing the life expectancy is quickly diminishing as I was supposed to change prior to leaving for work.  I glanced at the site, and made the executive decision to wait until after work or lunch hour.  You'd think I'd learn already.  As I mumble to myself, I'm such a dumb ass.

The site did look OK honest, it did. But looks can be deceiving. My glucose that morning was in range, lunch high normal range, no biggy though, then pre supper was 14 mmol(multiply by 18 = 252) You'd think I'd act at this point, but noooo not I.  I bolus for the high, and head out for some groceries.

Spend the evening watching a contestant on American Idol being evicted off the stage. While I enjoy my snacks etc. 

I go to bed.  I know your thinking, this guys an idiot, he should know better. But sometimes, life just carries on and diabetes is left in the background. In any event.

I wake up with heart burn at 5 AM. I know immediately I'm high. I test and I have now entered the 25 mmol (450) range. I now come to my senses, kinda hard not to now, and yank the site. Take 10 units of rapid, and 13 Levemir, down 2 large glasses of water, let the puppy out to take a leak, and hopefully a poop, and go back to bed.

I woke up feeling like I'd been run over by a truck.  I ask myself WHY do you not do what you tell others to do. 

I equate the day after feeling as a kinda diabetic hang-over, tired, upset tummy, headachey, dehydrated.

AND like any hangover, I say I won't do that again.  Until next time that is. 

I have to remember that Pump Infusion Sets have the Life Expectancy of a Tiny Fly.

Cheers!

Trev

Let me Out of the Hamster Wheel!

It's the end of yet another day as I sit here at my computer and think; where does the time go?

Then I pictured a shrunken me staring out a cage, running on a hamster wheel. But really getting nowhere.

Strange thought I know. Just being honest. 

I just think life is ass backwards sometimes. Like, I drop my children off all day, work nine hours and see them for a fraction of my day after I am mentally exhausted. Not right, but reality.

Diabetes, has simply sped up the hamster wheel, how? Well, in many ways.  

As a parent of two Type 1's I am spending much mental energy, and physical energy testing, problem solving and worrying about their diabetes care, let alone their general well being, which makes the world seem to spin that much faster. Throw in my diabetes management, 2 full time working parents, 3 other kids, 2 dogs, 1 cat, and a rabbit, it's a little crazy. 

Yes, I know, I made my bed and now I must lye in it(or something like that, can't remember the exact saying) I am responsible for my own choices in life, and I can live with that. With one acception, diabetes. We didn't choose this. But we must buck up and deal with it. 

I say ass backwards because, work is first, family second in our society in terms of time committment. It should be the reversed.

Hopefully the hamster wheel slows a little so I can jump off, and chill out on the hamster hammock, or take a hamster dip, hell I'd settle to just stop for more then 30 minutes, to peer out at a nice hamster view.

Funny, I always envisioned life a little less stressful as a kid.  Now I understand why my dad would come home from work, grab the newspaper, and kick his feet up and ignore us on occasion. He was flippin tired.

Well, time to go pick up the off-spring!  Until next time.

Trev 

The Diabetic Muffin Man Chronicles

Hello all you fab DOC peops!!!  I have been thinking. No seriously, I have.  About what you ask?  Well about adding a different weekly element to "Three 2 Treat"

Something we all love!

YES, it's................Sex(y) food.

Okay all silliness aside, food is a pretty important part of our lives! So I would like to share a weekly carb friendly recipe.  I'd eventually like to do a vlog of me cooking, if I can hire a cinematographer in my house full of little people.

I have gone "Baker" crazy in the past month. Like, flour, flax, food processing, mad scientist looking nut bar crazy!! Daily, in the cooking zen mode crazy! Okay I think you get the point.

Why you ask? 

Well, my wife and I have reduced our carb intake(Gasp-I know, fad diets don't work). And trust me I am monitoring my labs every 3 months, and promise to quit if my lousy (LDL) cholesterol sky-rockets. As is one of the potential side effects according to some research studies.

The first one done by Yancy Jr and company concluded the following: 

Compared with a low fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.

According to this one, I should be good. I mean my cholesterol that is. I underlined the cool thing, that is, my good cholesterol or HDL should go up and my sticky evil Triglycerides should drop. But no mention of LDL.

A second study by Nordmann and crew finds this:

Low-carbohydrate, non–energy-restricted diets appear to be at least as effective as low-fat, energy restricted diets in inducing weight loss for up to 1 year.However, potential favorable changes in triglyceride and high density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered.

So I shall monitor those Lipids and proceed with caution.

Now that the boring stuff is covered. Let's bring on the new muffin recipe.

Now I did not invent this. Click the embedded link below to find source.

Low Carb Flax Muffins

6 TBS Melted Butter
1/4 Cup Heavy Cream
3 Large Eggs
1/2 Cup Splenda(Granulated)
1 Tbs Maple flavouring
1 Tbs Vanilla Extract
2 Tsp Ground Cinnamon
1 tsp Ground Nutmeg
3/4 tsp Baking Soda
3/4 tsp Baking Powder
1 cup flax seed meal 
1/4 cup soya flour, I substitute Coconut Flour - Find it makes for a fluffier muffin 

4 ounces chopped walnuts

Preheat Oven to 375F
Mix the wet stuff, then add spenda, mix. Then add all the rest.
Bake for 18-20 minutes.

Makes 18-20 good size muffin, moist, and yummy.
Total Carb = 4 minus 3 grams Fibre so the TOTAL = 1.  Crazy!!! 

Try em and let me know what ya think!!!

Trev

PS:  Don't tell anyone a really like to bake muffins.  ; )

Sources:
William S. Yancy Jr., MD, MHS; Maren K. Olsen, PhD; John R. Guyton, MD; Ronna P. Bakst, RD; and Eric C. Westman, MD, MHS. A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia.A Randomized, Controlled Trial. Ann Intern Med. 2004;140:769-777.


Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel, MD; Ulrich Keller, MD;  Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors Arch Intern Med. 2006;166:285-293

Diabetes - Not for the Weak

 I am in a mood.

Not a bad one, not a happy one, more of a contemplative one.

Just a heads up, I guess. Like a friend warning another before they vent.

DIABETES is many things:

It's SCARY

It's CHALLENGING

It's UNPREDICTABLE

It's CHARACTER BUILDING

It's HEART WRENCHING

And so on and so forth.....

DIABETES is certainly not for the WEAK

What do I mean by "WEAK"  I mean, the minute I feel weak, tired, vulnerable, down trodden, diabetes becomes harder to deal with; it is harder to mentally manage, and if you don't get back up, shake your head, brush yourself off quickly, control slips, and it becomes perpetually more difficult to stay in control.

That being said, we must NEVER GIVE UP.  We need to PERSEVERE. We need to be STRONG.

Emotions are a lot like diabetes really, they are never static but always fluctuating like our blood sugar, I guess the goal is to keep not only our glucose in range but our Emotions as well.

Easier said then done some days.

Here is to staying STRONG with Diabetes!

Trev

On the D-O-C....

I started blogging serendipitously after discovering and reading another blog on the DOC.

I started networking to relate to others, and not feel so alone on the DOC.

To my delight, I have been enriched with a wealth of information that I never knew existed on the DOC.

I found a Network full of people who've experienced first hand what it's like to live with diabetes on the DOC.

The bonus is this:  All this information, experience, wisdom, ideas, are shared on the DOC.

I HAD KNOW IDEA such things existed prior to discovering things on the DOC. 

I learn so much from others. Like how to bake a muffin with only 1.5 grams of CHO, luv em! on the DOC.

Crustless Quiche!!!  4.5 grams of Carb.  Crazy!  and My favorite, home made bread!  5 gams per slice. Also on the DOC

Okay, obviously I luv food.  But this is nominal compared to the spiritual and emotional camaraderie that exists on the DOC.

As I mentioned in a recent post, I read blogs to nourish my diabetic soul on the DOC! 

I laugh when I read Reyna(Beta Buddies), and her candid, comical, often hysterical take on her life as a pancreatic momma caring for her adorable, tough, brave little man named Joe. She totally rocks!!! and can be found...you guessed it....on the DOC.

I Love the experiences and beautiful Pics from a Mom(Sarah)(Ethan and Isaac Show), who looks after her boys, and deals with Two Type1's in da house, her one lil man, and her grown man.  You are amazing, and have had my back numerous times showing me the online ropes. I am forever grateful!

My first ever blog was Kerri from Six Until Me, super blogger, and very vivid story teller, I can still picture her all googly eyed staring at the Eye doctor. 

Athlete and Runner extraordinaire, Celine, I work out more frequently because of your blog, and how you balance D and extreme training.

The boys, Michael Hoskins, and George.  Nice to have the boys represented.

(Links available on my Blog Roll)

I actually feel like I am getting to know you all. Which I would have considered a little creepy six months ago, but what a connection diabetes is for us!  How important it is to relate, feel supported, and validated in our struggles managing the Big D. 

There are many more, Meri, Kelly, Kim, Jackie, Haley, just check my blog roll as I read em all and look forward to each and every post. Man, I don't even read the paper or books as often as it cuts into my blog nourishment time.

And YES all the above folks, are exclusively found on the D-O-C (Diabetes Online Community!)

Cheers.

Trev

Never Let Diabetes Hold You Back!

This is my fifth Contributory Blog to a Project organized by Karen at Bitter Sweet and Friday's Topic is: The Most Awesome thing Done despite having Diabetes.

I have lived a great life and done many amazing things I am proud of.

I think for me, I have never considered diabetes as part of any decision. EVER.  

I've:
-Completed my University Degree
-Married a gorgeous woman created  five beautiful children, yes they are all ours and yes we made em.
-Trained in full contact Muay Thai boxing and received my certificate to instruct others.
-Traveled, and worked in isolated, airplane only access, communities in Northern Canada.
-I now work with others everyday who deal with Diabetes, which is fantastic!

I don't consider myself a Diabetic, I am a person living successfully with Diabetes.

It(The Big D) has never been in my mind when deciding how to conduct my life. Hopefully I can keep it this way. I hope to inspire others to do the same.

Cheers!

Trev

PS:  We are not having anymore off spring in case anyone was thinking this. : )

10 things I hate about my Dead Pancreas

This is my Forth Contributory Blog to a Project organized by Karen at Bitter Sweet and Thursday's Topic is what the title says.

Here goes:

1.  "You're always on my mind"  just like the song.

2.  My D Kids are Now always on my mind too, I could barely handle myself.

3.  The Curve Balls, you know, where the hell did that number come from?

4.  Lows - Especially the night ones. Public ones are no fun too and the one my youngest doesn't feel!

5. Highs - the ones when you really want to eat that delicious morsel of food, BUT FREAKIN CAN'T!!!

6. Worry - Blood Work, Comlpications, will my organ function well next year, we all have our favorite organ

7. Time - I believe I wrote a whole list for this one called Top 10 list - Diabetes Time Wasters

8.  Luggage - It's like having a baby all the time(not that I mind Babies, kinda fond of them actually) but it's the "Don't forget the the diaper diabetic tote bag....just gets tiresome after a while.

9.  Dealing with Health Care System - "Doc I wanna try this"......."Just give me what I want already" or "That should be ready in about 30 minutes" Just guess what I am referring to, yes the pharmacy, really irritating when you look around and there is nobody there, like WTF! It's not like they have to count insulin vials. Like I said before, just slap a label on it and toss it in the flippin bag.  Sorry a lil ranting feels good sometimes.

10. Dealing with Insurance/cost -  Nothing like wanting to test more but thinking crap, can't afford another 85 cent strip. Or going off a treatment just because the cost will result in bankrupcy.  I don't complain too much about this lately as there are hundreds of less fortunate kids and people in impoverished countries who die due to a lack of insulin period.  That puts things in perspective.

Well there you have it!

Cheers.

Trev

Having Diabetes - Doesn't Mean You're Smart

This is my Third Contributory Blog to a Project organized by Karen at Bitter Sweet and Wednesday's Topic is Diabetes Bloopers.

As the title indicates, just because you have a diagnosis of Diabetes it doesn't necessarily mean you know all about diabetes. Let me explain.

When I finished High School, 20 years ago, I decided to take nursing. Now at that point I'd had diabetes for 10 years. So I am plugging along doing my courses, and then in 2nd semester we have to take an Endo unit. Of course Diabetes is a large portion of this class.

I decide, the heck with it, I'll  take advantage of my supreme knowledge related to diabetes and skip the majority of the classes.  Then came the Unit Exam on Diabetes. No problem right?

Wrong!!! Oh sooo wrong.  I remember opening the first page of the exam and  having that feeling of impending doom. My heart sank, I got sweaty, because I came to the sudden realization that I knew jack shit! Hence the title.

I had only attended the initial training session for diabetes education when I was 9 year old with my parents. That apparently was not enough to float me through this exam. 

So I struggled through the exam. And, awaited my fate.  Three days later the results were posted. But before they were posted I had my professor call me in for a meeting. Not to give me trouble, for failing, yes I failed the exam, but because she was genuinely worried about my health, and overall diabetes control.

That was the most embarrassing Diabetic Moment for me. 

Nevertheless, I studied, rewrote the exam and did quite well. I did a placement in a diabetes education centre the following year, which totally rocked, because associating with fellow PWD motivated me to pursue my career full steam ahead,  and the rest is history.

Trev

Forgiving Mr D - A Short Story

"My New Son, Nothing to do
with the post, but really cute!"

This is my Second Contributory Blog to a Project organized by Karen at Bitter Sweet and Tuesday's Topic is a letter to our disease.

I envision this a little differently, I envision myself making an appointment to meet with Mr D(iabetes) in a high rise office building. One that represents or symbolizes the powerful position Mr D has over our life(my kids and I)

So my children and I get all dressed up, I donne my best suit and tie, my kids get their hair done and wear their best dress, and we head off to finally meet Mr D; the entity responsible for changing our life's so drastically.

We arrive 10 before and are greeted by a receptionist. She glances up over her bi-focals, her eyes are bloodshot, and she has an irritated look on her burrowed brow face.  She says in a raspy voice, "Go on in, he is expecting you"

We march in one child grasping each of my hands tightly, we are all filled with such emotion.  I am feeling angry, for what this guy has done to my family.  But I calm myself as we stroll the 100 feet to the single desk at the far end of the room.  The room has a dusty smell, the ceiling is 50 feet high, so every step and movement echoes. The room is cold, hard,  lonely, and dim.

As we approach, we see Mr D sitting behind his huge antique, solid wooden desk. He puts down a paper and slowly raises his gaze to meet mine. He can't make eye contact with my children.  Their hands are completely soaked at this point.

I stare at him for what seemed to be an eternity, and finally I say, "We finally meet" My voice is shaky, but composed. I am trying to hold back my emotion.

He says, "I was afraid you'd finally find me"

I say nothing in return.  My heart is pounding, I am starting to sweat, but I tell myself I have to be courageous for my children.

My kids are as close as possible to me, half hidden behind me, I whisper to them "Shhh, It's okay, everything is going to be all right, he can't do any more to us, he's already given us Diabetes"

I shift my gaze to him, he meets my gaze. I notice he actually looks frightened, ashamed, his eyes are pleading with me to be merciful on him.

I immediately feel pity for him, and say.   "I know you were given this task, and I am not here to cast judgement on you, I just have to tell you how we feel about what you've done to our family"

He immediately looks down at his desk, he looks dishevelled, worn out, and sickly.

I pull out a scrap piece of paper and begin to read.

"We come here today to tell you that even though you have given us this disease, we are going to beat it. At first we were all furious with you, how you gave all three of us a disease and destroyed our beta cells. We asked for many days, how? and why would anyone do such a thing.  What did we do to deserve this. But time passed and we learned how to manage with out insulin. We learned how to think like a diabetic, measure things, inject insulin, test blood sugars, and all all things diabetes related. My journey has been a longer one, and over time, I believe you have actually helped shape my life for the better. I understand my body better then my non-d friends. For that I thank you. Then you gave it to my children, as if to taunt me again, to relive those emotions long dealt with by me.  But once again time passes, things get easier, and more importantly we figure you out more and more each day, each year, and for me each decade."

I pause at this point, and Mr D, is looking at all of us. My children are now out from behind my back. His gaze now is one of complete sadness, and he says.

"I am glad you came today to see me, I don't get too many visitors. I want you to know that I am sorry I gave this to you.  I have been instructed to select those I feel can handle this. Those who are brave, strong, smart, and able to handle it. I know you will live a long successful life."

He paused, and wiped his eyes with a rugged old handkerchief, and added. "Can you find it in your hearts to forgive me?"

My children and I exchanged glances with each other and almost in unison we replied. "We have already forgiven you, we've accepted diabetes as part of our life, we may not enjoy it, but we know we can handle it, we forgive you."

He immediately started to cry.  Unable to say anything. 

When he finally stopped, he wiped his eyes and thanked us for coming.

We didn't say anything, but felt relieved knowing we faced Mr D, and forgave him.  We needed this closure to move on, and live our lives in unison with diabetes.

On the way home my youngest said, "Mr D wasn't so bad, I kinda feel bad for him. I like that he called me Brave, and Courageous. Daddy, am I brave like Mr D said?"

I replied, "You Girls are the bravest little girls I have ever met!"

They had huge smiles the rest of the ride home.



Trev

Type 1's Are From Jupiter, Type 2's Are from Saturn

This is my first Contributory Blog to a Project organized by Karen at Bitter Sweet and Monday's Topic is Admiring our diabetic differences.

Since joining the DOC I have certainly noticed the vast diversity in the folks with D online. We have people with Type 1, 1.5, and 2, not to mention moms, dads, toddlers, kids,  teens, adults, and caregivers.

We have folks from all over the planet, reading, commenting, and contributing to this amazing online world, where we can share, support, and more importantly relate with those who all make significant daily sacrafices, or changes to live successfully with DIABETES. 

I read a book many years ago written by John Grey called Woman are from Venus, Men are from Mars The premise was simple; understand and respect each others unique differences and it will improve your relationship.  The same principle applies to all walks of life. By seeking first to understand, before being understood, we gain great insight, and understanding about each other, and build an open path to communication, understanding and respect.  No, I don't do this all the time, just ask my wife, but I certainly try.

These differences help me to view things from a totally new perspective. I learn sooo much from other perspectives, they say 2 brains are better then one, well we have access to hundreds of brains at our finger tips, that truly is a gift. One that I Cherish daily.

These last few months has been amazing, because of the different perspectives, because I am out of my local box, of Doctor, Nurse, and the same associates.  Not that they are bad, but the more the merrier.

I remember vividly stumbling upon a blog about diabetes, 110 days ago to be exact. It was a completely different DIABETIC scenario cause this Gal just had a baby, she was healthy, had a CGM, Pump, the works.  She blogged in such a positive way, viewed her diabetes world differently then I, made me laugh, and inspired me. Different in so many ways. BUT, relatable in one huge way, Diabetes.  I was instantly hooked. I felt validated, understood, despite our varied background.

That serendipitous read changed my diabetic world forever. Despite our background, age, gender, diabetes type, we were human and both struggling to make sense and live well with the Big D.

Thank-you DOC, and Karen for the great Blog Week Idea!

So even know Type 1 and Type 2 Diabetes are different in so many ways, if we seek to understand each other, we all gain knowledge and support.

Cheers.

Trev

The DOC Buffet - Fuel for My Diabetic Soul

"I think food, and my pouch comes to mind,
staring at me while I eat"

I am here at work chowing down on some food I got from our lunch room.

Every Friday the staff are given a spread of food, which could be called a mini buffet. Which got me to thinking....about this post.

My lunch time is when I generally read other blogs and try to jot down a quick post my self. I look forward to it everyday, Monday to Friday and I try to unplug for the weekend, its impossible to think in my house full of peops.

As I chow down, and read, I always feel better, both physically and mentally. I consider the time I spend reading what others share,  my diabetes fuel, as it gives me encouragement, inspiration, information, and a sense of camaraderie. Truly a buffet for enduring diabetes.

I just wanted to thank-you all for sharing your diabetes lives with the DOC.  I am officially an official customer of the DOC Buffet.

Sincerely,

Trev

Pump Bumps?

"Our Rowan"

Now it's time to talk about my Youngest Super Star Rowan.

You know it is time for a change when your wee one's Triceps(the muscle on the backside of your upper arm - which I suspect most readers already know) start to look like a bodybuilders.  Okay I am exaggerating ever so slightly, but she has been developing some "Bumps from Her Pump" or if you prefer a more technical term she has some early Lipohypertrophy going on.

What the heck is Lipohypertrophy.  It's a fancy way of  saying enlarged  fatty tissue. The issue with this is; if it's ignored it turns into permanent scar tissue.

The only way to get rid of the swelling or enlargement is to completely avoid using the site. Which is easier said then done, especially in a child where fat real-estate is minimal.

But this is what we needed to do.  So off with Mr Wizard, again. On to MDI. Only this time I have done something a bit different. And I do believe I am onto something. And yes I've taken the DOC commenter's advise to heart and I am waiting 3 days to analyse the trends. Thank-you all for the comments!  It is really awesome having so much experience to draw on. Mucho helpful!

Back to Rowan.

We have ended up with a Regime of three different insulins:

AM- NPH 7.5 and Novorapid 2
Lunch - Nothing - Which she is pleased with
Dinner - Novorapid - 2.5
Bed - 0.5 of Levemir.

The first week or so was a lot of testing, but last night she went to bed at 6.8 mmol (124) at 3 AM, god it suck to be up at that aweful hour, she was 6.5 mmol (117) and, drum roll please.........

She was 6.9 mmol. Now as all parents and fellow PWD can attest, it's these successes that make you feel good. Like, I have figured out how to keep her sugars well and also heal up her tiny "Bumpy" arms.

This comment from Rowan also makes it worth while

As she was sitting up on the kitchen counter chatting up a storm watching me prepare breakfast this morning she said "Dad, I'm happy my pumps not on cause when I lean over, it sometimes pinches, and you know, its kinda heavy" 

I also note some decreased swelling in her Tri's. 

What a cutey.

If you're curious about her day readings, they are improved as well. Only draw back is we have to abide by the insulin's schedule. Snack-times, meal times, etc.  But it's worth it.

Trev

The Verdict is In!

I am not being sentenced to an early death.

I Finally made it to the docs and received my blood results I was so worried about as mentioned  in my previous post.

It has been way too long since I have gone to my doctor for an official diabetes checkup.  I usually go for prescription refills, or other issues. But I booked this one just for my diabetes.  I feel a bit hypocritical telling others to followup regularly with their Doctor and diabetes team when I am not doing this myself.

My A1C came back at 8.2%  down .4 from the last one over a month ago.  I'm not surprised, and I know the next one will be a lot better.

My kidneys are doing well as indicated by my Micro Albumin Creatinine Ratio being normal.  So, no dumping mini protein in my pee!  Great news!

My livers doing well, I'm not surprised, as I rarely indulge in the sauce(Alcohol)  Good to check on it though, as I take a low dose Statin(Cholesterol lowering medication) and sometimes the Liver Enzymes can spike up a bit.

Electrolytes also good, also telling me my kidneys are working well. I also take an ARB (BP lowering Medication) that also prevents Mircroalbuminuria, and it can cause your Potassium to go high, which mine didn't. My BP hovers around 115/60. So I am good in that department.

TSH, which checks my Thyroid function, was elevated, meaning I may need to increase my dose of thyroid medication. I know; I totally feel geriatric some days being on multiple medication but most are preventative and my choice.

Another note about my dysfunctional thyroid gland, is it's very common to develop hypothyroid if you have diabetes, and therefore should be routinely checked. Another common disorder us PWD need to be screened for is Celiac Disease. So far I don't have Celiac.

Now my Lipids, or Cholesterol results were fab!
My Total Cholesterol was 3.95 (<6.2)
HDL was 1.22(>0.90)
LDL was 2.5(As low as you can get em! usually a 50% reduction if high risk)
Trigs were 0.51(<1.7)
(Canadian values)

I remember the lipids this way;  Lousy LDL the bad stuff, Happy HDL, the good stuff, and Triglycerides, well they suck too, and are triggered by the sugary starchy food, and alcohol over-consumption.  The targets for PWD are a little tighter.  Normals are noted in the brackets.

Well, Dr C, seemed to think I worry too much. But I know he sees a lot of poorly controlled PWD as I work in Primary Care as well. My standards are a little higher. But I am happy I'm healthy, and remain complication free. Well I still need to see my Eye Doc. But I think it'll be okay.

I also find going to the Doc motivates me to be more accountable.  As a result I have booked to see him in 3 months.

Well, here's to good health!

Trev

Are We Making Things More Complicated?

"Me Looking Confused"

I have to tell you,  sometimes I think we make things more complicated then they need to be.

What am I getting at?

I am not talking about relationships.  I am referring to technology, blood glucose testing, CGM's, and the hundred new meters and pumps that battle it out for a piece of the economic pie.

I have always tried every new meter, and reverted back to the simple design.

Mentally it is taxing, for me anyways.  Let me explain a little further.

I have talked about Flip-Flopping back and forth from Pump to MDI, and insulin to insulin. But in all this Self Experimentation, it all comes down to behaving my self in the diet department.

I can achieve decent control on just about any insulin regime, with the exception of the old fashion two shot a day regime. AS LONG AS; I measure smaller amounts of carbs accurately, don't cave to the temptations of cookies and milk, and cover my fasting states with enough basal insulin.

I see so many folks (myself included) that chase numbers, or make changes to quickly, before waiting for a trend to occur. Thus creating a serious yo-yo effect in the blood glucose readings, or some rather erratic readings in general.

I have driven myself bananas in the past doing the above, only to end up back where I started.

The best A1C I ever achieved, I say achieved cause that's exactly what it is, was 6.2.  It was a result of exercise and diet. Surprisingly before the use of fancy pumps, CGM's and super computer meters. Good old fashioned injections.

Now I am an advocate for doing what ever works, and these devices have increased my and many others quality of life in other ways, like; flexible bolusing, more accurate basal profiles, and less injections, but for me it has never really improved my control.

I find we live in a world where we look for an easy solution, I've been searching for one my whole life with diabetes, but with anything you want to be successful at, it comes down to our choices, actions and work.

Devices, as complicated, neat, and effective as they appear, can work well but;  if we don't measure our carbs, pay attention to trends, plan our exercise,  our diabetes control will inevitably waver.

Just my humble take on things.

Trev