Diabetes Awareness Month

Welcome to November! You know - that month that everyone likes to skip over to get straight to Christmas/whatever else you celebrate.

I, for one, am glad that it is November. In addition to Thanksgiving, which is a big deal in my family, November hosts Diabetes Awareness Month. November 14th is World Diabetes Day.

During Diabetes Awareness Month, the JDRF and the International Diabetes Federation are asking people to wear blue on Fridays during the month of November, since our symbol is a blue circle.

I'm wearing blue today, and maybe you'll see some others in blue. It seems like you can't get away from all the breast-cancer pink in October, and they've done a spectacular job to raise awareness. Now it's our turn. Do your small part on Blue Fridays and help spread the word!

Another way to participate in Diabetes Awareness Month is to take just 90 seconds to help us Type 1's by electronically signing this petition to the U.S. FDA: http://takeaction.jdrf.org/site/PageNavigator/APAC.html.  By signing, you are asking the FDA to remove any delays on the Artificial Pancreas Project - a device that would have an enormous impact on the management of Type 1 Diabetes. The FDA is set to make a recommendation on December 1, so time is running out to help them see the immediate importance of a device like this.

Happy Diabetes Awareness Month!

Success!

A month ago, I posted about my A1c A1wtf, when I had inexplicably gotten a reading that didn't match up. It was a 7.5, not terrible of course, but not where I want or expect to be. My follow-up appointment was last week.

Since I couldn't get an A1c at the doc's office due to insurance, I bought a Bayer A1c Now test (insurance only covers a blood test every three months; six months if you're a type 2). For the price of an office visit, you can get two tests to do whenever you want between your regular checks.

I assembled the kit, mixed my blood drop with the chemicals...

and...

waited...

five...

long...

minutes...

for...

6.7!

Yay! Almost a full point drop in just four weeks! My pump was reporting a month average of 130, and my sensor was showing 128, so this is just what I was expecting for a three-month average. That means I can expect to be in the low 6's next time.

Dr. K was very excited to see my reports, and even gave me a high-five and a free vial of Novalog for all my hard work!

Some of my non-diabetic readers may be wondering what all the fuss is about regarding the A1c test. The scientific explanation is this: red blood cells in your body live for three months, and during their lifetime, absorb the glucose in your body. There is a chemical reaction between glucose and hemoglobin (red blood cells) that produces glycated hemoglobin. The A1c test measures the percentage of glycated hemoglobin in your blood. Since your cells only live a few months, the reading represents an average percentage for that time frame.

The non-scientific explanation is this: going from 7.5% to 6.7% in just one month is pretty freaking awesome!

A1wtf?!

As you may or may not have noticed, I've been absolutely ignoring this blog for the past month or so. I have no explanation other than a general burnout. We've all been there, I know.

Adding to this feeling, I had my endocrinology check-up last week. I took an at-home A1c test a month ago, just to self-monitor, and was pleased that it showed a 0.3 drop from my last appointment. Needless to say, I went to my appointment last week feeling very confident that I would be solidly in the "under 7" category.

As my fellow T1's know, every endo appointment comes with that hold-your-breath moment when you get your report card A1c number. This appointment felt different. I was confident and upbeat, excited even, to hear my number. As Dr. K flipped through my electronic chart, I just KNEW he would say 6.5. Imagine the sheer disappointment when he reported that it was a full point higher than that at a 7.5. With the at-home test that registered a 7 only four weeks ago, coupled with my last appointment at a 7.3, I just don't get it! I've had my CGM on almost constantly in the past several weeks, and I've seen nothing to verify this higher number. Could it be a fluke?

Dr. K understood my frustration, and practically (and comically) panicked himself when I teared up a little while I explained my at-home test and confusion over this number. We went over my CGM graphs and tightened some settings on the pump. I go back in a month for a retest, which I am again expecting to be better. While Dr. K wouldn't say if he thought the number might be an error, he agreed that it didn't make sense.

Logically, I know that this A1c is just a blip on the radar. Emotionally, though, I am so disappointed and despondent over this number. Until the next appointment, I am stalking my numbers in a borderline OCD fashion, and aiming for the best! Because, really, what else can we do?

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!

A Diabetes Gold Star

Last week, I had my three-month endocrinology appointment, which was technically a five-month appointment thanks to scheduling issues on both ends.

Dr. K was pleased that I had lost some weight and I had great bloodwork returns. Most important, though, we were both excited to see that over the last two appointments, my A1c had dropped by 1.5! Which means I am almost at my goal of under 6.5. All in all, I gave myself a gold star for the appointment. I take my appointments seriously, and I'm a people-pleaser, so I frequently leave Dr. K frustrated and have a pity-party car cry on the way back to work. Walking out with a positive report is always a relief!

As for 5k training, we have been keeping it up this week despite the stormy weather. The muscle strain I mentioned last time is feeling better, and I hope it will be completely healed soon. I've been able to up my distance, anyway. Anthony and I have decided not to do the 5k this weekend because neither of us feels ready yet. It's summer, though, so I'm sure we'll find one in a month or so.

I tried typing this post from my new iPad 2, but couldn't get it to load pics or scroll correctly. The iPad is not Blogger format compatible, I guess. It's a hand-me-down from my mom, who won it in a weight-loss competition at her school (she's an educational aide). She is uncomfortable with the Apple foreignness, so I inherited it. It arrived just in time for my laptop cord to melt through and start throwing sparks. Yeah, fun stuff.

I've been having fun playing with the iPad. It's a pretty cool product. Especially the ridiculous options in the photobooth app...this kaleidoscope photo goes out to all my fellow type 1s, who, I know, love Diet Coke as much as me...

The Peroneus What-us?

As you may have read here before, I'm training for a 5k. All has been progressing well and I am actually starting to make some gains!

But, last week, I started to have some soreness in my lower legs which has progressed into a searing pain and tightness this week. It pops up about 10 minutes in, and sticks around until I stretch it. Which means I'm stopping to stretch every five minutes or so. The pain is not my calf, not shin splints, but on the outside of the leg, between the ankle and knee. There is no discernible swelling or heat, so I'm thinking it's just a strain and not a tendon problem. And while the immediate pain stops shortly after running, it feels fatigued pretty much constantly, in the same way your arms muscles feel after doing a lot of reps.

After some speculation from Anthony that there IS no muscle there to pull, I turned to my next-trusted research source, Google, and I learned that the muscle is called the peroneus longus. It controls eversion (lifting the pinky-toe side of the foot) and plantar flexion (like pushing your gas pedal). And, ouch ouch ouch, pushing the gas pedal on the way home after a run hurts!

Really...leave it to me to strain a muscle no one's ever heard of! My calves, hamstrings, quads, etc. all feel great, but this odd side-stabilizing muscle is killing my training!

I am trying to work through it at a slow pace, but am definitely going to have to put the 5k training program on repeat for a couple of weeks. I'm also icing after runs, which seems to give some relief.

There are some specialized stretches for the longus that I am trying to do a few times a day and extensively before running.  Yoga stretching and rolling onto the outsides of my feet are practically the only way I can feel a good stretch in the muscle, but it does seem to help a bit.

Surprisingly enough, there are a lot of discussion hits for this type of strain. It seems like it will lessen within a couple of weeks with rest and care. While this is a frustrating set-back, hopefully it will clear up soon so I can get back to pushing myself! I still don't enjoy running, but I am enjoying seeing gains and reaching new milestones.

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!