Diabetes and The Other D

A lot has happened in the past two months. I'd like to say that my schedule and stress have evened out, but that is certainly not the case. Moving is hard work! That's all I'll say.

On the upside, Anthony and I have gotten to spend a lot of time with both of our families since moving back, and have been able to reconnect with some old friends we haven't spent much time with for the last several years.

I've also gotten hooked up with a great new Endo, Dr. M, and a CDE. We're working on some basal testing right now in preparation for my next appointment. For those unfamiliar, this involves skipping meals and adding lots of finger pricks to see how my pump's basal insulin settings function without the influence of food and extra insulin.

And today, I had a follow-up discussion with Dr. M about some bloodwork she had drawn a couple of weeks ago. All in all, everything was great. Kidneys, cholesterol, thyroid and all of those other things that can secondarily go bad with Type 1 are doing fine.

Except for one. Now I have a new "D" to worry about - a Vitamin D deficiency. And suddenly, lots of little things make sense. Higher levels of stress and anxiety, feeling more tired than normal, and, I've been sick more times this year than I have probably been for the last several years combined. All of these little things could be affected by low Vitamin D levels.

A web search says that this is very common, and likely very under-diagnosed. To give me a quick boost, I am taking a once-a-week mega-prescription Vitamin D pill for a couple of months, and when that brings me into a normal range, I can rely on over-the-counter supplements. There's not a lot we can do to get more D from diet. Even Vitamin D Milk is not concentrated enough to help much - you'd have to drink several glasses and eat five servings of salmon every day to reach desired quantities of the vitamin. Humans evolved with the ability to synthesize their D from the sun, just like plants. Since we drive cars, sit behind windows (or in windowless offices like me) and wear sunscreen, we just aren't getting what we need from nature. This is not to say that I don't do plenty outdoors. Anthony and I go for evening walks, and we bike and golf on the weekends. However, like my pancreas, my photosynthesis just needs some help.

I took my first dose with dinner this evening, and I hope I will be able to see some benefit from this little miracle vitamin soon.

Newness

Last week, I finally pulled the trigger and went to see a new endocrinologist in Dayton.

It had been about six months since my last appointment with Dr. K in West Virginia, but with all of the changes in insurance, moving and scheduling with a new doctor, this was the soonest I could make it in.

My new endo, Dr. M, is a tiny, soft-spoken, sympathetic woman who knows her stuff. The first thing she did was upload all of my pump data, right there into the exam room, so we could go over my plans. She agreed with most of my assessments, and was very pleased with my numbers considering the general stress involved with moving, selling a home from another state and starting a new job and life in a new city.

We outlined a couple of areas that need improvement, and she had some helpful ideas for handling the challenges provided by my new job. It has me managing nighttime events after a day at the office several times a month, which obviously, confuses my eating/insulin schedules. Dr. M was very understanding that this is a transitional period, and was hesitant to make many changes to the routine that was working for me a few months ago and is still largely okay.

All in all, it went better than I expected. As stressful as these recent changes have been, I was definitely worried about the "getting to know you" appointment.

I go back to see her in a month for a "real" appointment and to see how the numbers are panning out when things have (hopefully) settled down for me personally. She also referred me to a CDE (certified diabetes educator, for those who don't know the lingo) who she likes all of her patients to see. I've never been to a CDE, having just seen an endo or family doctor in the past, so I'm looking forward to having a team look out for me.

And on a positive note since my last post, thanks to my parents' garage serving as our storage unit for now, Anthony's and my apartment no longer looks like this...

When do you tell?

It's time to catch back up to speed here on Sweet Feat. You may remember me writing about moving and job hunting last post, so  you can probably guess what I've been doing...

Our house in West Virginia is empty (still for sale) and our apartment in Ohio is so full that it overflowed to my parents' garage. And, yay, I started my new job this week!

No, it's not a pager.

Which brings up the question all of us Type 1s are familiar with - when do you tell? Being just four days in, the opportunity to disclose hasn't really presented itself yet. And I didn't exactly want to lift up my shirt (see right) during the Monday staff meeting and say, "Hi, I'm Courtney - check this out!"

Being as I have a blog and post to Facebook, this obviously isn't something I'm keeping a secret. Also, with several pending friend requests out to my new coworkers, they'll probably figure it out soon enough.

So, my plan is to just roll with it as it comes up naturally. I had a moment today, when someone asked if there was anything they should know about me, but a client walked in and it was no longer the right time.

Aside from that issue, everything has been going very well with the move and both of our new jobs. We also picked up some new bikes last weekend for the awesome Dayton area bike trails. We went for our first ride on Sunday, and plan to go this weekend too. I have a feeling we'll be doing nothing but biking and golfing all summer!

As Freddie would say, "I want to ride my bicycle, I want to ride my bike..."

Playing Catch-Up

First off, I apologize for not updating in a few weeks. Long story short: I still have no laptop cord, took an awesome beach-house vacation with ten of our closest friends and got out of the habit of writing.

My diabetes was very well behaved on vacation, including long stints without the pump attached because of the heat on the beach. In fact, my numbers were almost too good, resulting in lots of minor lows. But, being out in the hot sun and being pretty active all day will do that. The only downfall was the night when we were playing beach volleyball and got swarmed by mosquitoes. I lost count at thirty bites, and one of our friends probably had double that!

Since vacation, we haven't slowed down. Two weeks ago, we spent a weekend visiting my college roommate, her husband and their adorable almost-one-year-old. Then, this weekend, we attended The Greenbrier Classic Golf Tournament with a couple of great friends. The tourney included a concert. I don't listen to country music, but I have to say that Miranda Lambert and Keith Urban gave great shows!

In addition to all of our travels, Anthony and I have been keeping up our running. We haven't found a 5k to attend yet, and our training has slowed a bit due to the heat.

To help supplement some cardio for our missed days, I stopped by Brickhouse Cardio to try their hour-long $5 Zumba class last night. Wow! What a workout, and what a lot of fun! I did have a really stupid low blood sugar mishap (checked in at 50 halfway through class, after a granola bar) and had to run next door to get a Coke (stupid moment for forgetting to unpack my sugar tabs from this weekend's trip). While I'm not going to sign up for membership yet, I will definitely be going back soon. For just $5, it's great exercise, and, it's air-conditioned!

It's Hard Out Here for a Pump

After weeks of rainy, stormy weather, we had a weekend of sun and hot hot heat. And it seems to be here for the season, finally!

Summer entered with a bang just in time for Memorial Day Weekend, during which Anthony and I did lots of yard work, golfed, partied and generally spent a lot of time outside in the 90+ degree sun. In other words, we were sweating our asses off for the better part of three days!

As a type 1 diabetic on an insulin pump and continuous glucose monitor (cgm), this presents a whole set of problems the average person doesn't consider. This weekend's sweatfest caused me to lose a four-day old cgm sensor, which just seemed to melt off my leg, and caused a pump infusion site's adhesion to lose its sticky, which meant I was leaking insulin. Luckily, I guess, insulin smells weird, so I noticed pretty quickly.

Another consideration is the effects of the heat on the insulin being stored inside the pump and then transferred to me. If I let the pump get too hot or expose it to too much direct sunlight, the insulin can start to go bad by losing its potency. Think of leaving a beer out in the hot sun then re-refrigerating it...eww, right?

So, how does one get around these issues? Usually, if I know I'll be outside and sweating, I'll just unhook my pump and leave it somewhere cool. On beach vacations, I'll leave it shaded in a purse or insulated bag next to me. If I'm not being physically active enough to keep my blood glucose in the normal range, I'll go reconnect for a few minutes and give myself a bit of insulin to get by. As for the cgm and infusion sites melting off due to heat and sweating, there's not much you can do to prevent it. I tend to lose three or four sites every summer to this issue, and since the hubby and I are being decidedly more outdoorsy this year, it's bound to happen more often.

Anthony and I are still going strong on the Couch-to-5k program, now in week four. Week three seemed like a breeze, but bumping up to five-minute runs plus the new 90-degree weather has made this week's jump a little more difficult. We're planning to do a 5k in Huntington at the end of June, intimidatingly called the WV 5k Championship. It says the race is for runners of any skill level. I hope so, but the name alone is scary!

Sponsor a Walk Team because...

Please sponsor my team for the Juvenile Diabetes Research Fund's Walk for a Cure by clicking the tab above, or by visiting here.   

Children are diagnosed everyday with Type 1 Diabetes. Here is what they'll have to live with for the rest of their lives if a cure is not found. These are the "tools of the trade" that help me, and most other Type 1's, live:

This is my insulin pump. It is an alternative to taking my insulin through multiple daily injections. Instead, the pump pushes insulin through a small plastic tube inserted about a half-inch under my skin. It gives me a varying dose every few minutes all day long and when I push the buttons, it sends extra insulin based on what I eat or my activity level. For comparison, it is shown here next to my phone. I usually carry it tucked in my pocket or clipped (like a cell phone belt clip) somewhere on my clothing.

This is where my infusion set, the plastic tube that provides my insulin, is inserted on my side. I pull it out like a band-aid and insert a new site on either my belly, lower back, or outer thigh every three or four days. If you look to side, you'll see a small red circle from a week-old site change.

This is a bottle of insulin. One bottle lasts about three weeks for me, but everyone's usage varies.

This is how I test my blood sugar. After pricking your finger, you touch the drop of blood to the center of the strip, and it sucks a small amount into the meter for testing. A "normal" reading is 70-120.

In addition to finger-pricking, there is another way we can monitor blood sugar. This is a Continuous Glucose Monitor, or CGM.

It is inserted under the skin, and the needle pulls out, leaving behind a very thin wire. You manually input a current blood sugar reading from finger-pricking, and it then calibrates and begins checking your blood sugar on its own every six minutes. The round white part at the top is a wireless transmitter that, in turn, sends the readings right to my insulin pump, which will beep to alert me if my blood sugar falls below 75 or raises above 150. It requires a new calibration, or finger-prick reading, every six hours so it can stay accurate.

Last, but not least, is my medical identification bracelet. Should I ever pass out, be in a car accident, etc., this will let people know the kind of treatment I need. EMTs and other medical professionals are trained to recognize jewelery like this.

Please sponsor my team for the Juvenile Diabetes Research Fund's Walk for a Cure by clicking the tab above, or by visiting here.