25 and Counting

Making the Low Go… May 13, 2010

Filed under: BG numbers,Uncategorized — Emilie @ 11:53 pm

I’m a few days behind, but want to try to keep up with Diabetes Blog Week.  Day Two’s topic is “Making the Low Go”.  I have vivid memories of the first orange juice I used to drink when I was low.  Specifically, I remember the night when my mom went into labor with my brother and sister.  My father sat me down in the waiting room, put two of these Donald Duck OJ’s in front of me and said “Drink this if you feel shaky.”  I spent the next few hours entertaining an elderly couple by doing cartwheels…

 

After Donald Duck OJ, I think I moved on to other things like BD Glucose Tablets and that horrible gel that I cannot remember the name of. I feel like it came in a foil-like tube. The standard was always OJ at home.

Fast forward to present day and I think somewhere around the introduction of carb counting (a.k.a. you can eat what you want as long as you bolus appropriately for it) all reason went out the door. Things also seemed to get worse when I got married and my husband introduced all sorts of things in our house that I avoided buying at the grocery stores because my will power is zilch.  So surrounded by seasonal goodies (chocolate easter egg things, girl scout cookies, etc.) things get dicey for me.  It seems I have no problem getting my numbers up, it’s just keeping them from sky rocketing the opposite direction. 

Case in point.  A few nights ago I wake up feeling not right.  I decided if I felt low then I best start treating asap, so attempting to be responsible I grabbed the costco sized glucose tabs container on my nightstand (favorite flavor is tropical fruit!).  I down 4, sit back and try to wait for things to go back to normal.  I still feel lowish about 10 min later so I test and am 58.  At that point, I panic and head to the kitchen.  Things never go well if I head to the kitchen in the middle of the night.  Still trying to be responsible, I drink a juice box.  Five minutes later the red velvet cupcakes I had made with my daughter are staring at me.  I am still in panic mode, so I eat one.  I bolus for the cupcake, but still wake up at 265.

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persistent highs… November 4, 2009

Filed under: BG numbers — Emilie @ 2:25 am

The past week my CGMS has been alarming non-stop.  I haven’t slept more than 3 hours at a time.  For the past three days, I wake up feeling like I haven’t slept.  I am in the throws of a THREE DAY long persistent high. 

For example, two days ago – I woke up to a lovely 273.  After bolusing 4 units, I’m only down to 180 two hours later.  I see double down arrows on my CGMS and figure maybe I could get by with eating some breakfast.  I find a BG friendly granola bar, punch in the carbs into the handy-dandy bolus wizard, and hope for the best.  Only to be foiled by another screech putting me on notice I’ve spiked over 200 AGAIN. 

Today I started to feel a scratchy feeling in my throat, and an achey malaise.  I suppose this may just be my body telling me I am about to be sick.  I gave in yesterday and started cranking up my basals.  Yesterday, I was down to running in the 140’s all the time.  Another increase and I’m back down to the 100’s for most of today.   So, crisis averted for now, but how long would you have waited until you fixed the problem?  I tend to sit on these things for a while to be sure the pattern that has emerged really is a pattern.  Sometimes life likes to throw me a diabetes curve ball and change the pattern just when I think I’ve figured it out.  

And then, once I get enough nerve to make the basal change…it’ll reverse itself and it’s a mad dash to undo all of my work I agonized over.  Why do we have to ride these roller coasters all of the time?

 

Bad report card… July 10, 2008

Filed under: A1c results,BG numbers — Emilie @ 2:31 am

Last week, I blogged about CGMS needing to be covered by insurance companies to prevent things from happening like the car accident I had this past spring.  I have been seeing my endo more frequently sice then.  Right after the accident, my endo recommended me keeping my numbers higher so that I could regain the feeling of being low when I was higher.  He wanted my pre-meal numbers between 120 – 140 and post meal numbers higher than that. 

This was a huge blow to my ego.  I have worked so hard on my control for so long.  My A1c’s have been in the 6’s since 2003.  And in the 5’s when I was pregnant.  I knew it would be hard to see the higher numbers.  I didn’t want to do it, but my endo said there wasn’t an option.  The alternative was having another episode and possible suffering permanent neurological damage as a result. 

So I have spent the past few months running slightly higher.  And the result at my endo appointment yesterday?  An A1c of 7.4.  I was so shocked, I have not had one this high in a long time.  It is really hard to swallow even though I know that I am just doing what I am told.  That number really defines how I feel about my success as a diabetic.  Good a1c, I’ve done a good job.  Bad a1c, I have been slacking and need to work harder.  It is a report card to me. 

On a better note, running higher has eliminated the bad lows I was having before.  I don’t download my data enough from my pump, but looking at the reports that I printed for my appointment, it looks like I haven’t had a bg lower than 60 in a few weeks.  And, truth be told, a few times last week I felt low, and saw a 61 on my meter.  Before I was not feeling them until at least 45.  Before this, I would not even test most times because if I felt low, I knew I was really low.  So my endo was pleased with this development.  He said that a 7.4 was not a huge sacrifice for eliminating the bad lows.  So I do have to feel good about that.

 

REQUEST FOR CGMS: (hopefully won’t be) DENIED BY INSURANCE July 2, 2008

Filed under: BG numbers,CGM's — Emilie @ 2:38 am
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Today, thanks to Gina at Tu Diabetes, is CGMS Denial Day.  While I am still awaiting word from my insurance company as to whether or not my Mini-Link CGM sensors will be covered, I wanted to join others in making sure insurance companies understand that CGM coverage is medically necessary.

I’ve had several bad hypoglycemic episodes, and I’ve noticed that they’ve become more frequent since I tightened up my control after I got married and starting thinking about pregnancy.  While my A1c’s dropped to the low 6’s, the cushion I had between being low and not low diminished.  Being in the 60’s pre-meal was a good thing, especially when pregnant, it gave me more room to bounce from 2 hours post-meal.  This way I ensured my 2 hour readings never went over 125 while I was pregnant. 

With these lower numbers, I’ve become unaware of my lows until they hit in the 40’s.  The first bad low happened when I was 9 weeks pregnant.  I had apparently just hit a point where my insulin needs were dropping, and my changes did not keep up.  My husband and I woke up on Sunday morning.  I was apparently telling him about a necklace I had gotten the day before.  When he changed the topic, I kept talking about the necklace, and was not able to answer his questions.  He got concerned, asked if I was low, and when I didn’t answer, he pulled out my meter and tested me.  37 flashed back at him.  He fed me some orange juice, tested 5 minutes later and I was stil in the 30’s.  He called 911.  I came to as the paramedics were pumping dextrose into my forearm.  I was embarrassed, and very scared of what harm I may have caused our baby.   

AFter Naomi was born, I had another incident where I woke up unresponsive.  Josh tested me, I was low, and he could not feed me juice, so called 911 again.  I came to on my own before the paramedics arrived.  Every night, Josh asks me if I have tested.  I know he is scared that I will wake up unconscious, as my lows don’t seem to wake me anymore. 

If these incidents are not reason alone for coverage of a CGMS, my continued hypoglycemia unawareness struck again this past spring as I was driving home from work.  One Friday, I ate lunch at 11:30, gave what I thought was an appropriate amount of insulin to cover the carbs I ate, and got into my car at 2:00.  My pre-meal blood sugar was 124.  I did not test before I got into my car, and regret this still today.  The last thing I remember was driving past the White House.  When I came to about 10 miles away from where I remember last, I was being pulled out of my car by the Fire Department.  They kept yelling at me – is your bloodsugar low?  I could only look down at my clothes, trying to remember who I was and what I was doing here.  I hope that I had just been having a bad nightmare, that this was just a really bad dream that I needed to wake up from immediately.

I hit 5 cars and caused thousands of dollars worth of damage.  I am thankful that my daughter was not in the car with me at the time of the accident, and that I did not hurt anyone else’s children.  I have to live with the regret of not checking my blood sugard before driving, but I would not be able to live with myself had I caused anyone harm. 

The day after my accident, after I got home from the hospital, I called my Minimed Rep and told him I needed the CGM asap.  I opted to pay out of pocket, because billing my insurance would add a few days to me receiving it.  I have been working to keep my blood sugars higher over the past 3 months, in order to hopefully regain some awareness of lows when I am higher.  But my CGM makes me feel better about not feeling a suddent dip when I am driving.  My husband knows that I will wake up conscious the next day. 

Anyone who says this device is not medically necessary does not understand the world of fear that I live in on a daily basis.  If there is technology out there that can alert you to lows before they become life-threatening, why would you deny this to somebody?  And why would you wait to allow someone to have this technology until AFTER an incident has already happened?  Aren’t our lives worthy enough of having the most protection possible?  I know the technology is new, and I do know for a fact that my CGM spits out bad numbers from time to time but, good lord, it is better than NOTHING. 

Please do not deny my claim for coverage for a device that can help me be the best mother I want to be.  Please do not deny my claim for coverage so my husband does not have to worry about me every night when we go to sleep.  Please do not deny my claim so I can stop living in fear every time I get in my car.

      

 

Life as a graph… June 25, 2008

Filed under: BG numbers,CGM's — Emilie @ 2:00 am
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Don’t get me wrong, this sensor is really great.  When I am creeping up, it alarms to tell me I have eaten too much, or given too little insulin.  When I am low, it alarms to tell me I am heading into dangerous territory.  I can sleep better knowing I will wake up conscious, or without a headeache from a prolonged high overnight. 

BUT, as nifty as this piece of technology is, it is not fun to downloan your bg stats, and see this:

Not pretty.  It makes me cringe…no wonder I feel like ass most days.  This pretty much sums up all of the roller coaster ups and downs I go through on a daily basis.  It is days like this that makes me feel like those target range numbers I program into my pump are a pipe dream.