Trying to Regain My Footing

So, I've had several overnight highs that have messed up my average, regrettably.  I'm not quite sure why some of them happened, other than possibly bad insulin.  The first night with the high, immediate spike was due to a low that I took sugar for and it skyrocketed.  Ever since then I've felt like I've been a mess and I've lost my momentum.  



Now that I've got some good insulin again I am going to try to kick it back into high gear and get these numbers down.  I really do need to stay on top of my carb-counting and limit the carbs I eat as much as possible.  I may be falling into the high-carb trap again...because where there are tasty snacks, I will eat them!   

Amazing Improvement in 2 Weeks!

I'm amazed...simply blown away.  God has shown me such kindness by placing me with a Nurse Practitioner who truly knows her stuff.  She doesn't just tell me what to do - she listens to me and suggests things based on what I know about how my body responds.

It's been 2 weeks since my appointment with Carrie and right from the start I noticed a difference in my numbers.  After 2 weeks, I'm truly excited about what I'm seeing - it's not just a fluke or a one time deal...it's real, actual improvement!  After years of struggling with a seemingly hopeless roller coaster, a recent attitude change on my part, and a slight insulin tweak, I'm seeing a huge difference in my numbers for the better!  See for yourself! 

Here are the stats:

• From January 10-16 (Week 1), my average blood sugar was 197.  The red line shows my average number for this week.
• From January 17-23 (Week 2), my average blood sugar was 156.  The blue line shows my average number for this week.
• There is a 21% average blood sugar improvement between Week 1 & 2. 
• Week 1 has 33% in target.
• Week 2 has 47% in target!

Thank you all for following my Diabetic Journey, and for walking with me as I continue to take steps to improve my blood sugar numbers.  Achieving a normal A1C has always seemed like an impossible feat, but as I press on toward the goal and rest in Jesus's strength and power I see the impossible become possible.

Overnight Success!

The past two nights I've gone to bed with a good number (140-150) to see how my new basal insulin dose works.  13 units of Levemir seems to be just right!  The yellow boxes highlight my overnight blood sugar trends. 



I feel like I've been doing better with my carb-counting too.  Sure I've had some highs after eating, but the insulin brought it right back down...and even a bit too low yesterday.  Must've bolused too much that time around.  Heehee.  If I can keep up this trend I might have my A1C down even more by my next appointment.  It's a daily fight to stay on top of things and I don't think many people realize this...but little by little I'll get there.

I've printed out a chart to help me stay focused on my goal A1C.  It's good to see how far you've come and how far you have left to go.  Here's what it looks like right now:


May 2014 = 11.1% (272 mg/dl)
August 2014 = 10.1% (243 mg/dl)
January 2015 = 9.5% (226 mg/dl)

Looking Good - Sorta

Lab work came back negative for infection related to the lymph node.  Still taking my other meds - nausea has decreased some but not much.  Still coughing and feeling tight in my chest when I breathe. 

Since my thyroid hormone levels came back high after the appointment, Carrie decided to increase my synthroid dose from 125mcg to 150mcg.  I'll be picking it up from the pharmacy later.

My numbers have really seemed to respond well to my increased basal rate, although I DID have to down a bunch of glucotabs last night to keep from going low.  (And my sensor cut off for about 2 hours during the middle of the night, but then picked up readings again.  Ugh.)  At least it worked!  They've stayed fairly consistent today.

18 straight hours under 200

So I'll definitely say the increased basal insulin is working.  Carrie upped it from 12 to 13 and I had to give myself some glucotabs last night before bed to keep from having a low.  That worked well until about 7:30 this morning.  Woke up and had some more glucotabs, then went back to sleep for a little bit.

Now it's after noon and I've bolused, eaten breakfast, and given myself my basal insulin, and it's coming down again...only slightly.  I took more glucotabs and it's stable.

It's great to have a nice long streak of good numbers under 200.  This is what I want to see more often!

 

Endo Appointment Results

Today's appointment carried mostly good news. 

My A1C has come down, but not by as much as I thought.  At the end of August it was 10.1%, and now it's 9.5%.  I am sad I didn't reach my goal, but maybe in a few months I'll have it down where I want it.

A few things came up in lab work, but nothing bad.  Just my thyroid levels are a bit high, and Carrie wants me to experiment with taking my pill in the morning instead of before bed to see if that helps it work better.   If not, we'll have to increase my dose.

A week and a half ago, I noticed a strange, small, tender bump and I told her about it (lymph node?).  She examined it, then had me get some more blood work done to see if there's any sign of infection (white blood cell count).   She said I could/should also get checked by my primary care Dr in the next few weeks.  

Other than that, just some insulin tweaking and I need to make sure I give insulin right when I eat so I don't go up/spike too high.  She also told me about a discount card I can use to save money on my insulin.  I have a lab work follow up in 6 weeks and I see her again in April. 

Still nauseous today, but no headache.  It's also freezing cold!

Fasting Labs

I went in for fasting labs today - they only drew blood.  I was in and out real quick, but I've gone through a bit of an ordeal for these labs.  I would've gone in yesterday morning, only I woke up with a headache that stuck around all day.  I had a headache this morning too but today was the only other day I could go in so I had to push through it.  Nausea has also made things more difficult for me.  Nothing has really helped relieve my symptoms, and I'm not sure what's causing them.

I'm on edge waiting for Thursday to get here.  I'm hoping Carrie will have good news for me regarding my A1C.  I also have a few questions for her and I'm eager to hear her thoughts.

I've noticed (again) that my sensor doesn't seem to do as well on my right side as it does on my left side.  I've been having a bit of difficulty with it since I put it in a few days ago.  It seems to be having a harder time picking up my numbers.  Here's what my roller coaster looks like:
  


Needless to say, I've been facing some frustration and discouragement.  My number seems to be stuck averaging around 200.  How am I supposed to get it to stay more in the 100 range? 

Dexcom Adventures - Thwarted Again!

The week before Christmas, as we were preparing for our trip to MD to visit hubby's family, I realized that the sensors I was ordering would be shipped to an empty house for the holidays unless I had them shipped to the in-laws'.  Thankfully, the Dexcom rep was more than happy to accommodate my wishes and placed my order with the new one-time address.  We left Saturday morning and arrived safe and sound in time for dinner.  The kitties travelled so well and were very curious about their new surroundings. 

On Tuesday, the sensors arrived on the front step and I rushed downstairs with them to insert my long-missed accessory.  I had just finished putting it in place when a horrible thought occurred to me...my transmitter was still in the drawer next to my side of the bed at home!  After a few minutes of beating myself up for forgetting it, I called my Mom to see if she could run over to our house, grab it, and mail it to me.  She was more than willing and did so the next day, but unfortunately, it was Christmas Eve and the FedEx store was closed.  With a useless sensor in place and my transmitter 8 hours away, I was thwarted...again.  I knew I'd have to wait until I got home to start using my Dexcom again.     



Today, after a long 23-day hiatus, I am happily reconnected to my Dexcom.  I never want to be disconnected again! 

Sensor-less

(Blue line drawn for ease of viewing)

My sensor finally died a week ago.  I was contacted by a Dexcom rep about re-ordering but we still don't have the money to buy more.  She also told me that if my sensor ever fails to call Tech Support and they'll replace it free of charge.  I plan to do that in the future!

According to my Dexcom's Success Report, my average blood sugar has been 198, or 8.5% A1C.  We'll see if I can hold onto that through Christmas and New Years for my next appointment.  If that's truly my A1C, that is the best it's ever been since I was diagnosed!  I'm still having quite a few highs, but nothing like what I used to have.  Oy, was I a mess. 

Sensor on the Fritz

I've now been using my Dexcom G4 Platinum for 95 days.  I cannot begin to express how much easier it has made managing my diabetes.  Being able to see my daily trends is amazing.  I no longer feel like I am aimlessly shooting in the dark when it comes to my numbers because I can see them on the little screen I hold in my hand and fit in my pocket. 

I don't feel like I am "connected" to my Dexcom the way I felt I was connected to a pump.  The wireless transmitter rarely feels like it's there (although I do have to remind my hubby which side it's on so that he doesn't bump it).  I have noticed that my readings are picked up better on my left side for some reason.  And I still input my readings even when my sensor is on the fritz...like it is right now. 



It really stinks that this is the last sensor I have on hand and I have to wait until our next paycheck to order more.  I'm not looking forward to being without my Dexcom. 

I've been trying to stick to a low carb, high fat diet as much as possible, and I've noticed great success with my numbers when I do.  However, the holiday season has made sticking to it a little bit more difficult. 

My body reacts so strongly to sugar.  I have realized that even though lows scare me, I have to have self-control when treating them.  The rule of treatment for lows is take 15 grams, wait 15 minutes, and retest.  If still low, take another 15 grams.  Repeat until number responds/rises. 

My body sometimes takes longer than 15 minutes to react to the initial 15 grams of sugar I give myself, so rather than give another 15 grams every 15 minutes, I need to only give 15 grams once and wait for it to rise...otherwise I skyrocket (and then I have to correct with insulin, ugh!).  Trying to prevent the roller coaster highs is especially hard when you're busy or on the go. 

My average blood glucose has still managed to hover around the 200mg/dl range, translating to an A1C of 8.6%. 

If I can get my average number to stay around the 180mg/dl mark (20 points lower), I will reach my goal of an A1C in the 7% range by year's end.  I only have a month until that time, and my next checkup, fasting labs, and A1C check is on January 8.  Will I be able to reach my goal?  Is my A1C even in the 8% range?  Last time it was checked officially it was in the 10% range (end of August).  I am continually asking God to help me manage my numbers.   

Looking Forward to the Eternal Cure

Ever since I was little and diagnosed with Type 1 Diabetes, I've been told by some people that they wish they could take my Diabetes away. 

I know they meant well, they were trying to comfort me, but you know what?  I don't ever want to be "comforted" by this phrase again. 

Don't tell me you wish you could take away the very thing that saved my life.

Yup, Diabetes saved my life.  I didn't realize it until I turned 18, after I'd thrown myself into a fit of anger and depression.  I turned my back on God because I couldn't understand why He would allow me to have such an awful disease. 

Of course I didn't understand.  I was a naive little girl.  I've grown up now and I've done a lot of learning and growing.  I can see now that Diabetes is the very tool that God used to show me my need for a Savior.  And I don't want it taken away for anything.  I'm glad I have Diabetes.  I'm glad I have Celiac.  I'm glad I have hypothyroidism. 

Having a broken body keeps me humble and meek.  It helps me focus on God as my source of strength.  It reminds me that I am nothing without Him.  I am NOT self-sufficient.  I am NOT self-reliant.  I am NOT the center of the Universe. 

My trials, pains, and frustrations are for my good and His glory.  It's taken me years...YEARS, to learn this.  But I am grateful that these lessons were part of His plan for me.  He made me this way and He did it for my good, for my salvation. 

Every trial has a purpose. Every setback has a reason. Every health issue keeps us humbly reliant on the One who created us. Our lives are about more than overcoming these obstacles; our lives are about glorifying God through them.

 It has taken me 18 years to come to this point...to be able to say that I want to glorify God with every step I take as I work to manage my invisible illnesses. Diabetes, Celiac, and hypothyroidism do not define or identify me; they are merely a part of me. And yet, only for a fleeting moment, for they too shall pass and I will have the eternal cure for all 3 of them.

What will remain will be my True Identity, which is found in nothing less than Jesus' blood and righteousness.

Dexcom Appointment

My appointment with Carrie went really well.  She really liked how I printed out my Dexcom readings.  It gave her a day by day glance at my roller coaster ride with the corresponding insulin doses and carbohydrate intakes. 

She made a few changes:

1. Increased my midnight basal from 10 to 12 units (and told me to watch to see if any lows come about)
2. Took me off my simvastatin drug (yay!)
3. Told me to be careful not to over-correct when low or high (because a few of my high peaks were from doing just that)
4. Told me to take a partial (rather than a full) insulin dose before bed and to eat enough carbs while exercising in order to prevent lows

 They didn't test my A1C this time but Carrie said that since my average BG (blood glucose/sugar) is at 196 and it was around 232 at my last appointment that I've made good progress!
                   
My next appointment isn't until January 8 (1pm) so I won't have an official A1C check until then, but according to my A1C chart an average BG of 196 is 8.5!

Crazy Numbers

I decreased my HIGH alert for the last time.  It now rests at 200.

Today and yesterday I saw some pretty crazy numbers.  I'm not sure what caused them but it felt like everything was going the exact opposite of the previous days with good numbers.  Possibly too many carbs in my diet, or too much exercise?  Stress?  All of the above?  I have been slightly more active so that lends itself to the lows.  I try not to over-correct for them but with how active I've been it's hard to gauge how much sugar I need to raise my blood sugar.



The bedtime highs are the worst because I keep waking up with dry mouth and having to use the bathroom.  I've literally gone from a super low (45) to a super high (361) these past two days.  No real rhyme or reason... *sigh*

Yesterday's numbers - Awesome!

I had a pretty amazing day yesterday.  I stayed under 200 and in my target range (and even a bit low!) until about 9pm!  I stayed pretty strictly low carb and it did wonders!

I think I experienced the lows because I over-calculated the carbs in my "lunch" around 4:30pm.

A correction last night brought them down and they seem to have stabilized now.

Lowering my HIGH alert

Over the weekend I once again lowered my HIGH alert on my Dexcom G4.  It is now at 250.  I have to say, this slow introduction to the HIGH alert has helped me become even more motivated to keep my numbers under control.  I feel like I haven't been rushed but rather I've been gradually helped along in reaching my goal.  It's a nice feeling - to not be pressured or thrown head-long into an annoyingly overwhelming task.  Easing myself into things has always been my way of adjusting.  I'm so grateful that my diabetes team (especially Carrie) understands that this is a good way to start me off on the Dexcom. 

My next appointment is scheduled for October 9...a little over 2 weeks away.  I wonder what Carrie will say about my numbers.

Staying on top of things

The other day I set my HIGH alert to 300.  Next week I'll set it down to 250.  The week after that I'll set it down to 200 and leave it there.  I'm really trying to crack down on these high numbers, a little at a time.  So far, I seem to be pretty successful, and eating a low carb diet is going to help me do that.  I had to stay on top of my carb-counting yesterday while I was at a family reunion, but it ended up being pretty easy since most of the food wasn't gluten-free.

I've noticed that my numbers seem to stay pretty steady overnight if I don't eat or bolus beforehand.  This is good.

I'm currently watching my number drop - I may have counted too many carbs this morning for breakfast.  I'm down into the 70s...time to take action.

Really Good Day!

Today has gone exceedingly well for me.  I stayed between 200 and 86 all day.



I think it had something to do with 2 factors:
1.  I have been testing the GC Control shake from Melaleuca, gifted to me by my best friend, Amanda.  :)  It has been clinically proven to improve your blood sugars and your insulin effectiveness by controlling sugar and carbohydrate cravings.  They are also full of chromium, cinnamon, and other yummy nutrients that help to stabilize your blood sugars.  I really want to get more of these shakes after this package runs out!  They are so good!!  

2.  I've been eating low carbs...I think I've literally had 30g today.  I've been eating lots of meat, veggies, and cheese, plus two GC Control shakes.  Because I haven't been eating that many carbs, my numbers have not been spiking like they normally do.  I've only had to bolus for the two shakes, and I haven't had to take any correction injections.  It's been wonderful and I've felt a lot less stressed, albeit a bit tired from all the running around I've done!

Also, I set my HIGH alert to 350 like Carrie told me to last week.   

Rough Day

Yesterday and today have been pretty rough for me, diabetes-wise.  It was Dexcom Day for me, or the day I'm supposed to change my sensor.  My first sensor was on my right side and seemed to still be holding up pretty well.  I decided to try to make it last a little longer and reset the sensor session.  After a 2 hour wait to recalibrate it, everything seemed to be going fine.  Then, around 8pm, it gave me the alert that it couldn't pick up readings from my sensor.  I waited for about an hour, since it had been able to sort itself out last time.  As bedtime neared, I decided to just go ahead and start over with a new sensor.  I inserted the new sensor on my left side and waited the 2 hour time period for calibration.

Upon calibrating, I noticed that the system wasn't recognizing the correct blood sugar values as it had done the first time.  In fact, it was saying I was low when I was actually in the 160s.  Then, the Dexcom stopped showing me numbers.  I had some tea and bolused for it, and then went to bed around 2am.

I slept off and on, waking up and checking my Dexcom to see what it was doing throughout the night.  It was HIGH all night.

Most of my nights this week have been filled with waking and checking - not very restful!  I'm continually tired and frustrated.

Around 6:40, I woke to my Dexcom telling me my number was still high.  I calculated a correction and gave myself a shot.  As I rolled over to go back to sleep, I had the notion to check my number on my glucometer.  It came back at a shocking 187.  I realized I had just given myself an overdose and ran into the kitchen for more tea and raisins (they have lots of sugar!) to equal the "bolus" I'd just given.  My number stayed safe and I was able to go back to sleep.

Lesson learned.  Always check your meter!  Don't do anything without a fingerstick!  Unfortunately, lack of sleep caused a lapse in judgment this time.

It's just hard because I'm trying to conserve test strips.  I'm not sure when I will be able to get more.  I need to call the pharmacy to see if my endo's new prescription has come in. 

Roller Coaster Readings

Today is Day 6 of Dexcom readings.  I now have physical proof of the roller coaster I am riding with my blood sugar numbers.   Now I can clearly see why my numbers have been so frustrating...!!  (the red dots are my glucometer readings - very accurate!)



My average blood sugar number:  188
My highest blood sugar number:  336
My lowest blood sugar number:  68

I've been experimenting with a slight increase in overnight basal insulin because of a noticed pattern of waking up high.  It seemed to be that my number was rising around 8 am or so.

Three nights ago, I took 11 units of basal insulin, going to bed at 245 (took no correction) and woke up at 4:20 to a low of 72.  6 glucotabs and 2 hours later I was up to 173.

Two nights ago, I took 10 units of basal insulin and went to bed at 170, and woke up the next morning at 8:30 to a big fat 310 after steadily going higher throughout the night.

Last night I took 10.5 units of basal insulin and went to bed at 141.  It seems from there I stayed steady in the 130s for half the night, and then I slowly started to go lower around 4 am.

My alert woke me up this morning at 6:40 to tell me I was 70.  I treated with 2 glucotabs and waited 15 minutes.  At 6:55 I was 68.  I took 2 more glucotabs and waited another 15 minutes.  At 7:15 I was back up to 85 and rising.  I slept off and on until about 10.  It didn't feel all that restful.

And now I'm experiencing my first issue with my sensor.  It is not communicating with the transmitter/receiver.  I am waiting for it to correct itself.  If it goes for another 2 hours without resolving itself, I'll need to call Tech Support.

Stay on Target

I went in for fasting labs on Monday morning.  They were quick and painless...3 tubes full of blood and I was done.   

On Wednesday, I got an email saying that my transmitter had finally been shipped...and what's more, it had already been delivered!  I ran out of the bedroom to find that it was laying on the kitchen floor in the FedEx box, which DP had brought in before he left for work.  I opened it up and praised God for its timely delivery (it had been over-nighted to me before I knew it had even been shipped!).  I would've put it on right then and there but I was delayed by a family emergency.  ;)

Today, I went in for my 3pm appointment.  After the nurse went over the usual questions and medicine doses, Carrie came in to discuss my numbers and lab work.  The first thing she pointed out was my A1C.  It had dropped a whole percentage from 11.1 to 10.1!!  I was so thrilled!  I reached my goal for August!

She then went on to say that both my HDL & LDL cholesterol levels were normal and the rest of my lab work came back normal.  Even my thyroid is where it should be!  I couldn't believe it!  Even though my A1C is still high, I found it to be a very good health report card!

She suggested that I start my Dexcom today and set my low at 70 and not to set my high alert so that I wouldn't get annoyed at it right off the bat for going off all the time.  Every week or two I'll set it 50 points lower until I get it down to about 200.  I'll be coming back in 6 weeks so they can see how my Dexcom is doing.

I told her I'd be pressing on toward my next goal...9%!!  And 7% by the year's end.  She smiled and said, "Then you can start baby-making."  Yup!   

After watching the tutorial video, I now have my Dexcom sensor and transmitter in place.  My receiver is all set up and ready for action.  At 6:45pm, I'll do my first calibration session.  Until then, I've got a yummy dinner to make in celebration of this wonderful news and God's goodness!