Friday, July 26, 2013

Bucket List

"Joseph, we have a roach."

These were the harried words I found myself saying just before bedtime on Friday night. These are the last words I want to be saying just before I willingly leave myself unconscious and therefore completely vulnerable for (hopefully) eight hours.

But there they were, and there it was. In all it's prehistoric glory.

I had seen one outside of our apartment--outside and therefore not something I could take sole responsibility for. That's fine, that's the apartment manager's problem then. This one, however, is likely my fault. It's inside my house, just outside my bedroom, near the bathroom with my diligently cleaned toothbrush.

My valiant husband leaped up from the laptop table, formidable men's slipper in hand, after the intruder. The chase thankfully bypassed the bathroom, but did not stop at the top of the hall--he made it to the living room! We lost him. He managed to skitter off into the abyss underneath the couch where all missing socks and cat toys must also surely go.

I have been feeling guilty for days about not having cleaned up more. Working to correct blood sugars tipping the scales at 389, however, took precedence over the resource sapping task of housework. Now that I've actually SEEN something that might be causally related to my lack of tidiness lately is highly unsettling. I desperately want to go scour the kitchen counter tops and sweep the floor, but the clock's scales, too, are tipping toward inordinately high areas (for me, that is). I can only hope that this particular cockroach is just finishing up his bucket list by visiting my place of residence and will be dead by tomorrow, that my sugars will be in a range ideal for completing housework, and that my cats don't find it in the night and deliver it to my promptly at dawn.

Saturday, February 2, 2013

A First-Person Shooter for the Chronically Ill

So, Day One and Day Two out of the way. On to Day Three of my experiment, but first, an analysis.

Think of all this terrifying looking math like you might a first-person shooter game. I've found thinking of this like a game is the surest coping mechanism. You're the shooter, you have a targeted goal, laws to follow, certain weapons and tools to help you, and some shifty little characters (namely glucose and insulin) that are sometimes friendly, sometimes dangerous. Here are the parameters:

Target blood sugar is 130mg of glucose (milligrams of sugar) per dL (deciliter) of blood (teeny tiny amounts of blood). 

Basal Rates (the steady "drip" of insulin throughout the day measured in percentage of a unit [U]):
          3pm-4am .50U
          4am-3pm- .55U

Insulin:Carb Ratio (how much insulin I get for every gram of carbs I eat):
          12am-1230pm- 1U of insulin per 11g carbs
          1230pm-4pm- 1U of insulin per 9g carbs
          4pm-12am- 1U of insulin 8g carbs

Correction Factor (mg/dL reduction per U)
To get there, I get 1U of insulin for every 36 mg/dL over 130 mg/dL I go.
           12am-12am (doesn't vary) 36 mg/dL:1U

My game here has yielded some interesting results. On Day One, I started out high at 281mg/dL, then had fabulous sugars most of the rest of the day. Around dinner they started to creep up, to 144mg/dL, then 224mg/dL, and then crashing from 157mg/dL to 31mg/dL. And a lot of frenzied rationalization ensued.

Yesterday, Day Two, was almost exactly the opposite in terms of results. My activities stayed the same (which is to say, next to nothing, unless you count reading Vonnegut's biography as strenuous), but the sugars were on some downward spiral. 113mg/dL to 251mg/dL, then 85, 43, 76, 59, 41, 38, and so I could finally get some rest, we ended the night with 113mg/dL.

While I'm tempted to let my frustrations get the best of me and call the whole game off, I have to keep in mind that it takes three days to establish a data set and determine what the trends may be. So whatever the results are for today will be the key to it all, I believe.

Thursday, January 31, 2013

Test-Bolus-Eat-Wait-Repeat

So, before I get started, I would like to get my excuse-making out of the way. With the best of intentions, I had planned to blog once a week or so, but as irony would have it, my diabetes got so out of whack that there hasn't been much time for anything besides day to day activities and total panic.

But, in trying to turn that panic into something productive, I will pick up here with my exciting weekend plans.

At my last visit to the endocrinologist, I came in at an impressive 7.0 Ha1c reading, the best I've ever achieved. This puts my average blood sugar around 150 mg/dL; not low enough to make my husband feel relieved, but enough to bring my anxiety down to a low-grade ridiculous. However, starting on November 27, things went from ok to terrible. I managed to reach a new low, at 28 mg/dL during a sales meeting, in which I found myself slumped over an office chair for almost an hour while my friends and co-workers tried to bring me back to the land of the living. I couldn't be more thankful for that. Ever since then, I've noticed my sugars yo-yo pattern become more and more extreme.

This has become extremely stressful. Anxiety about unstable blood sugars is bad, and anxiety about unstable blood sugars accompanied by obsessive-compulsive disorder reaches a whole new level of hysteria. In an effort to try and regain some control, I reverted back to a lot of the tendencies I've had some success in suppressing: hair splitting and pulling, intrusive thoughts, compulsive organizing. Like any good obsessive-compulsive, I could see the crazy for what it is, and decided to make an early trip to the endocrinologist. Really, there are only so many times you can review closed customer files for phantom updates before I have some awkward explaining to do.

Basically what I was directed to do was a diabetic reset. My pump's settings were put back to a baseline, and I was instructed to stay in as stable an environment as possible and monitor continuously to find the trends and, therefore, the problems. Not the "Erica had a bad day so now her sugar is 248" or the "Erica had a blueberry muffin and couldn't find the exact carb calculation for that particular muffin, so now her sugar is 53" kind of a problem.

So here I am, at home for the next three days, recording all my food, insulin, stress, and activity. I feel very inert, but maybe that's what I need to keep me from being unstable, as fun as that hysteria is.