Friday, October 29, 2004
More fasting news
The fast has actually gone quite well. I've now been through two thirds of it, having completed both breakfast days and both lunch days. Today is a dinner day, but a little more bearable because I can eat dinner, it just has to be late, after 9pm.
So here's the current scoop: I think my basal rate is too low in the morning, though my carb ratio at breakfast may be too high, and the two counteract each other. I don't have my log sheet from the beginning of the week with me, but both days I started out at breakfast time with a good glucose reading, and over the course of the morning, rose up beyond normal, into the low 200's. The rules of the fast say to stop the fast if you're over 180, but since I was not at over 180 until lunchtime, I didn't have to stop. But the next two days, my morning readings were good, as they have been all along. So maybe a basal of 1.2 is too low for the 7am to noon time frame, but if I bump it up, the 1:10 ratio I use in the morning may be too high. I'll be curious to see what Lisa says about this.
The next two days I did the lunch fast, and my numbers were dead-on for both days, perfectly in the normal range from noon to dinner time. I think that 1.2 is good for that time frame, then. We'll see about the evening times tonight and tomorrow night.
I talked to Kelly today, the study drug nurse. She says the doc is still convinced the study drug has nothing to do with the sciatica and accompanying numbness. It makes sense that they are related and that they are being caused by something specific and external, like an inflamation of some kind. Tylenol and Advil definitely help, though I do often forget to take them until the pain is really bad. The pain is worst when I work out, but that is, I think, to be expected, considering the exercises I try to do. There have only been a few I absolutely could not do, most I can do with small modifications. The one thing I absolutely have not been able to do is stretches with my left leg extended in front of me. If I tuck the left leg in (by bringing my left foot up to my right thigh), I can bring my nose to my right knee. But with my left leg in front of me, I can barely stand to bend down to 80 degrees.
The good thing is that I don't think it has gotten any worse. I'm hoping it starts to feel better soon.
So here's the current scoop: I think my basal rate is too low in the morning, though my carb ratio at breakfast may be too high, and the two counteract each other. I don't have my log sheet from the beginning of the week with me, but both days I started out at breakfast time with a good glucose reading, and over the course of the morning, rose up beyond normal, into the low 200's. The rules of the fast say to stop the fast if you're over 180, but since I was not at over 180 until lunchtime, I didn't have to stop. But the next two days, my morning readings were good, as they have been all along. So maybe a basal of 1.2 is too low for the 7am to noon time frame, but if I bump it up, the 1:10 ratio I use in the morning may be too high. I'll be curious to see what Lisa says about this.
The next two days I did the lunch fast, and my numbers were dead-on for both days, perfectly in the normal range from noon to dinner time. I think that 1.2 is good for that time frame, then. We'll see about the evening times tonight and tomorrow night.
I talked to Kelly today, the study drug nurse. She says the doc is still convinced the study drug has nothing to do with the sciatica and accompanying numbness. It makes sense that they are related and that they are being caused by something specific and external, like an inflamation of some kind. Tylenol and Advil definitely help, though I do often forget to take them until the pain is really bad. The pain is worst when I work out, but that is, I think, to be expected, considering the exercises I try to do. There have only been a few I absolutely could not do, most I can do with small modifications. The one thing I absolutely have not been able to do is stretches with my left leg extended in front of me. If I tuck the left leg in (by bringing my left foot up to my right thigh), I can bring my nose to my right knee. But with my left leg in front of me, I can barely stand to bend down to 80 degrees.
The good thing is that I don't think it has gotten any worse. I'm hoping it starts to feel better soon.
Monday, October 25, 2004
Fasting day 1
First day of the fast - I skipped breakfast this morning, and the numbers are a little odd. I'm at a basal rate of 1.6 from 3am to 7am, and I had a 102 at breakfast time, which is just right. But my sugars rose the rest of the morning, coming in at 132 at 9am, 178 at 11am, and 205 at noon. I ate lunch and bolused for the food and for a correction. At 3pm I was a 216. Very odd. We'll see what happens tomorrow, when I'll do the breakfast fast again. Then on Wednesday and Tursday I'll do lunch fast, then dinner fast on Friday and Saturday. Fortunately, I can eat after 9pm, so the dinner fast isn't too bad. It will be tough skipping lunches, though, and I may end up eating a slightly larger breakfast those days. We'll see.
The sciatica is no better - but I cannot say if it is worse or not. The pain comes and goes, and that may be a function of how long ago I took pain medication (I'm sticking with Advil and Tylenol now, as the Aleve seemed to be useless), or it could be activity ... hard to say. I called the nurse who works with the study meds, as I had to report in that I was feeling numbness in my left foot and leg, in addition to the pain. And a little tingling. The doctor had asked me about both of those symptoms in the past. I'm not at the point yet where I'll ask about going off the study med to see if that relieves the sciatica, but if it does not improve, I may do it sooner rather than later. I'd hate to waste the year I've been on it, but it is not worth it if it is causing the pain or the numbness. Anyway, I'll wait to hear back from her before I do anything - her voice mail said she was out until Wednesday anyway.
The sciatica is no better - but I cannot say if it is worse or not. The pain comes and goes, and that may be a function of how long ago I took pain medication (I'm sticking with Advil and Tylenol now, as the Aleve seemed to be useless), or it could be activity ... hard to say. I called the nurse who works with the study meds, as I had to report in that I was feeling numbness in my left foot and leg, in addition to the pain. And a little tingling. The doctor had asked me about both of those symptoms in the past. I'm not at the point yet where I'll ask about going off the study med to see if that relieves the sciatica, but if it does not improve, I may do it sooner rather than later. I'd hate to waste the year I've been on it, but it is not worth it if it is causing the pain or the numbness. Anyway, I'll wait to hear back from her before I do anything - her voice mail said she was out until Wednesday anyway.
Friday, October 22, 2004
Medicinal roulette
Got some catching up to do ... I went to see the Lisa and she is asking me to do the fasting program. I figured I'd start Monday - it is a six-day thing, starting with breakfasts, two in a row, then moving on to lunches and finally dinners. So Monday I will skip breakfast and see what we can see. We adjusted just one other thing, bringing my 3am - 7am basal rate up from 1.5 to 1.6. Everything else is going pretty well. Over the past couple of days, the 1.6 has seemed to work well. Yesterday I had a pretty high dinner blood glucose reading, but that was likely because I misunderestimated my lunch bolus (we had a family picnic thing here at work) and then missed my post-lunch BG check because I was in a meeting. It was back to normal in my post-dinner reading.
I've decided that I prefer the left side of my body for the infusion set over my right. I've only used my abdomen so far, and I'm debating if I want to use a thigh or buttock sometime soon. With jeans, it might be hard to do thigh, but I'll have to look more closely. I wear loose-fit jeans, but even then when you sit they can tighten on your thighs, and I have big thighs anyway. My butt might be ok, but I do worry about sitting. We'll see, maybe I'll check the pumpers site to see what they say.
My sciatica is alternately just annoying and painful. Doing my exercises last night, a leg night, there were several that I simply could not do. Leg raises, which involve no weight at all and are mainly an abs exercise, were nearly impossible. I usually do three sets of 15, I think I only accomplished 5 reps. Angled leg press, where I normally do two sets of 15, pressing 320 pounds, I could only do three or four before I got too scared of losing the weight and crushing myself. Lying leg curls I only did two before I gave up. I just hurt too damn much. I was able to do hack squats, squats, leg extensions, and seated leg curls, though. But that's only half my workout, and that cannot continue.
Today I'm taking Advil for the pain. Jen mentioned to me that Tylenol and Aleve do not help inflamation, and if the pinching of the sciatic nerve is the result of inflamation, neither of those would help the cause - but Advil does help inflamation. I don't know about all of that (I looked on Advil's label and it did not mention inflamation as being an indication), but I figured it was worth a try. One thing is for sure, and that's that I'm disappointed with the Aleve. I'm not sure if it worked at all. I seemed to get more relief from Tylenol.
I've noticed that I have some numbness in my left foot. I realized it because it kept feeling like there was something in my shoe, or that my sock had bunched up in the foot, but there was neither bunching nor any foreign object. So I rubbed my foot and realized there were patches where I could feel much less than others. I'm assuming for now that the numbness is because of the sciatic nerve and not because of "true" neuropathy, mostly because it came on so fast and because it is only in my left foot.
Today we have a teacher's conference to go to. The boys' first report card, essentially. I'm keeping my fingers crossed for him.
I've decided that I prefer the left side of my body for the infusion set over my right. I've only used my abdomen so far, and I'm debating if I want to use a thigh or buttock sometime soon. With jeans, it might be hard to do thigh, but I'll have to look more closely. I wear loose-fit jeans, but even then when you sit they can tighten on your thighs, and I have big thighs anyway. My butt might be ok, but I do worry about sitting. We'll see, maybe I'll check the pumpers site to see what they say.
My sciatica is alternately just annoying and painful. Doing my exercises last night, a leg night, there were several that I simply could not do. Leg raises, which involve no weight at all and are mainly an abs exercise, were nearly impossible. I usually do three sets of 15, I think I only accomplished 5 reps. Angled leg press, where I normally do two sets of 15, pressing 320 pounds, I could only do three or four before I got too scared of losing the weight and crushing myself. Lying leg curls I only did two before I gave up. I just hurt too damn much. I was able to do hack squats, squats, leg extensions, and seated leg curls, though. But that's only half my workout, and that cannot continue.
Today I'm taking Advil for the pain. Jen mentioned to me that Tylenol and Aleve do not help inflamation, and if the pinching of the sciatic nerve is the result of inflamation, neither of those would help the cause - but Advil does help inflamation. I don't know about all of that (I looked on Advil's label and it did not mention inflamation as being an indication), but I figured it was worth a try. One thing is for sure, and that's that I'm disappointed with the Aleve. I'm not sure if it worked at all. I seemed to get more relief from Tylenol.
I've noticed that I have some numbness in my left foot. I realized it because it kept feeling like there was something in my shoe, or that my sock had bunched up in the foot, but there was neither bunching nor any foreign object. So I rubbed my foot and realized there were patches where I could feel much less than others. I'm assuming for now that the numbness is because of the sciatic nerve and not because of "true" neuropathy, mostly because it came on so fast and because it is only in my left foot.
Today we have a teacher's conference to go to. The boys' first report card, essentially. I'm keeping my fingers crossed for him.
Tuesday, October 19, 2004
Medical report
Today I have an appointment with Lisa to go over things. I don't know if she is going to want to put me through the fasting process I've talked about before, where you skip one meal each day, changing the skipped meal as you progress. My numbers have been pretty good and if she wants to skip that step, I'm fine with that. Of course, if she wants to do it, I'm fine with that, too.
I had to change my set at soccer practice yesterday - I'd brought my stuff to work with me, figuring the cartridge would run out at work, but it never did. I decided to change it in the last hour of the day, but several things all came up at once and I ran out of time. So after I rushed to soccer after work, I checked in with the kids and then went back to the car to change it. Not recommended - too cramped, though fine in an emergency. I think I inserted in a spot that was not where I'd prepped, and by that evening the set was coming off. I dabbed on some extra IV prep, though, and it now seems well-sealed.
I did go to see my Primary Care provider yesterday - it has been a long time since I've seen him. He manipulated my leg a bit and listened to my symptoms, and came to the same conclusion I already had: sciatica. The symptoms I'd read about online were dead-on, so unless he had had something really different in mind, it seems like the most reasonable conclusion. Thing is, though, there's not much to be done. He advised analgesics, so I'll keep on the Tylenol. He did advise trying Aleve to see if that worked any better - I bought a big bottle of it yesterday at K-Mart, and it either didn't work real well or my pain was just really bad yesterday. I guess it feels OK now, so maybe it is working ... it is hard to tell. Last night's workout was bad - lots of pain in several exercises.
Now that I know what it is and that my workout won't hurt anything (I was afraid of a back injury for a little while, and I could aggravate that with weight; or a blood clot that I was afraid could be dislodged by a workout), I'm more willing to just push through some of the pain, if only to just get through a scheduled exercise. But bench press hurt (when I laid down), lat pull-downs hurt (when I stretched up against the leg stops), and dumbbell press hurt (when I laid down but worse when I sat up). Cardio is virtually pain-free, which is good, because that's where I burn the calories.
Pretty amazing baseball game last night - my mother called around 9 to ask something and noted that it was in the 9th innning. It was still on when I finished my cardio workout almost two hours later. I like it when the underdog wins, but in the end, I don't care about either Boston or New York.
I had to change my set at soccer practice yesterday - I'd brought my stuff to work with me, figuring the cartridge would run out at work, but it never did. I decided to change it in the last hour of the day, but several things all came up at once and I ran out of time. So after I rushed to soccer after work, I checked in with the kids and then went back to the car to change it. Not recommended - too cramped, though fine in an emergency. I think I inserted in a spot that was not where I'd prepped, and by that evening the set was coming off. I dabbed on some extra IV prep, though, and it now seems well-sealed.
I did go to see my Primary Care provider yesterday - it has been a long time since I've seen him. He manipulated my leg a bit and listened to my symptoms, and came to the same conclusion I already had: sciatica. The symptoms I'd read about online were dead-on, so unless he had had something really different in mind, it seems like the most reasonable conclusion. Thing is, though, there's not much to be done. He advised analgesics, so I'll keep on the Tylenol. He did advise trying Aleve to see if that worked any better - I bought a big bottle of it yesterday at K-Mart, and it either didn't work real well or my pain was just really bad yesterday. I guess it feels OK now, so maybe it is working ... it is hard to tell. Last night's workout was bad - lots of pain in several exercises.
Now that I know what it is and that my workout won't hurt anything (I was afraid of a back injury for a little while, and I could aggravate that with weight; or a blood clot that I was afraid could be dislodged by a workout), I'm more willing to just push through some of the pain, if only to just get through a scheduled exercise. But bench press hurt (when I laid down), lat pull-downs hurt (when I stretched up against the leg stops), and dumbbell press hurt (when I laid down but worse when I sat up). Cardio is virtually pain-free, which is good, because that's where I burn the calories.
Pretty amazing baseball game last night - my mother called around 9 to ask something and noted that it was in the 9th innning. It was still on when I finished my cardio workout almost two hours later. I like it when the underdog wins, but in the end, I don't care about either Boston or New York.
Monday, October 18, 2004
Haunted outing
The weekend, so far as the pump goes, was pretty uneventful. We had lots to do, though. Saturday was the Haunted Harvestfest at the Vermont Boy Scout camp, Camp Sunrise. We took the boys and Brittany down for a full day of activities. The place was packed, far more packed than I thought it would be. The day was not the greatest - it was well overcast and there was the constant threat of rain - but the worst of the weather held off. And it was just warm enough to not be unpleasant. We brought a picnic lunch for ourselves, so it was easy to count carbs. The boys got to mill around with other boys, and we even got them into the Haunted Lodge, though we had to hold them to keep them from completely freaking out. They also got to shoot a BB gun, though they had to wait in line a long time and only got to shoot five times. They may want to try that more later, though we have no guns, not even the BB type, in the house. We'll see.
We ate a lot of chicken this weekend. We had Shake and Bake chicken on Saturday night, salad with chicken on Sunday afternoon, and chicken and biscuits on Sunday evening. Karen's parents came over Sunday night to have dinner with us - we called my parents, but they had something going on both nights.
There was a lot of walking around on Saturday, and my leg bothered me the whole time, though it was not horrible. At times, though, the pain was just excruciating. I mentioned it to a friend of ours on Sunday, and she said "sciatica." This was something I hadn't thought of - I was thinking hernia, or thrombosis, or just plain pulled muscle, but when I looked up sciatica, the symptoms seemed to fit. I made an appointment with my doctor today, and we'll see what he says. If it is that, this is a nerve problem, and I wonder again if the study drug could be partially to blame. We'll see.
No lows or really bad highs to report from the last few days, which is good. I bumped up my basal rate from 3am to 7am from 1.4 to 1.5, and it seemed to help a little bit. My blood glucose was 119 at midnight on Sunday, and 153 at 8 am; today it was 94 at midnight and 175 at 7am. I may need to bump up that basal rate another point or two, but we'll give 1.5 another few days, just to see what happens. I'm scheduled to see Lisa tomorrow, and we'll see what she thinks about that.
We ate a lot of chicken this weekend. We had Shake and Bake chicken on Saturday night, salad with chicken on Sunday afternoon, and chicken and biscuits on Sunday evening. Karen's parents came over Sunday night to have dinner with us - we called my parents, but they had something going on both nights.
There was a lot of walking around on Saturday, and my leg bothered me the whole time, though it was not horrible. At times, though, the pain was just excruciating. I mentioned it to a friend of ours on Sunday, and she said "sciatica." This was something I hadn't thought of - I was thinking hernia, or thrombosis, or just plain pulled muscle, but when I looked up sciatica, the symptoms seemed to fit. I made an appointment with my doctor today, and we'll see what he says. If it is that, this is a nerve problem, and I wonder again if the study drug could be partially to blame. We'll see.
No lows or really bad highs to report from the last few days, which is good. I bumped up my basal rate from 3am to 7am from 1.4 to 1.5, and it seemed to help a little bit. My blood glucose was 119 at midnight on Sunday, and 153 at 8 am; today it was 94 at midnight and 175 at 7am. I may need to bump up that basal rate another point or two, but we'll give 1.5 another few days, just to see what happens. I'm scheduled to see Lisa tomorrow, and we'll see what she thinks about that.
Thursday, October 14, 2004
Low prevented
I got a little concerned yesterday around 4pm - I took my blood glucose reading because I was feeling low, and I was - 61. I'm not sure if I was levelling off or still headed down, but I felt the best thing to do was eat a bit of carb. I went to the cafeteria with a few quarters in hand, to buy a couple mini Peppermint Patties or something, but they were closed, so I headed for the vending machines. I found a small bag of Cheeze-Its for 50 cents that would probably work, but the machine wouldn't give them up. I ended up with a small bag of Doritos. Which are fine, I like Doritos, but I didn't really feel like chips. Anyway, at 18g of carb, it was just right - at dinner I came in at 114, so it was just what I'd needed.
Last night at midnight, I read in at 202, which was not too surprising since we had dinner at Friendly's and my guesses at carb counts are rarely right. I took a compensation bolus and expected everything to be better this morning. But I came in at 263 this morning, which I don't get. I've upped by basal from 3 to 7 to 1.4 units, and aside from two pieces of wheat toast that I bolused for normally last night, I didn't eat any carbs. Well, I did eat something - I was hungry last night, but what I had should have been a negligible carb count. I had a spinach salad with broken-up bacon. The dressing was vinaigrette. Unless spinach is suddenly loaded with carb, it should have been a very low carb snack. I just looked - one 10 ounce package of spinach should only be 10 carbs. So I'm a bit puzzled. As I've said before, if I'm going to be high, I at least want to have eaten something good to have gotten there. Oh well.
As for the pump, it is going fine. I got a thing in the mail to order a cover for the pump and it said I would have to wait 4 to 6 weeks for it. I ordered black. I got it like three days later. I initially thought I wouldn't use it, but when I put it on the belt clip, it makes the pump very inconspicuous, so I'm leaving it on. It adds only a little bit to the weight and it is easy to slip out of the case still. And the cover flips open to reveal the screen and buttons when necessary, so it is a nice addition. One other thing I got with the pump is a little leather-like case that essentially wraps around the pump and has a small belt clip on it. I'm going to dig that out of where ever I stuck it and try using it. There are other accessories that Animas sells that I'd like to try out, too, but I want to wait a little bit more before I order anything.
I'm still dealing with my sore leg - I need to make an appointment with my primary care doc, but sitting here at my desk, it does not hurt, so it is not in the front of my mind. Maybe I'll call tomorrow... tonight I have a Tiger Scout meeting to hold, so I have too much else to do today.
Last night at midnight, I read in at 202, which was not too surprising since we had dinner at Friendly's and my guesses at carb counts are rarely right. I took a compensation bolus and expected everything to be better this morning. But I came in at 263 this morning, which I don't get. I've upped by basal from 3 to 7 to 1.4 units, and aside from two pieces of wheat toast that I bolused for normally last night, I didn't eat any carbs. Well, I did eat something - I was hungry last night, but what I had should have been a negligible carb count. I had a spinach salad with broken-up bacon. The dressing was vinaigrette. Unless spinach is suddenly loaded with carb, it should have been a very low carb snack. I just looked - one 10 ounce package of spinach should only be 10 carbs. So I'm a bit puzzled. As I've said before, if I'm going to be high, I at least want to have eaten something good to have gotten there. Oh well.
As for the pump, it is going fine. I got a thing in the mail to order a cover for the pump and it said I would have to wait 4 to 6 weeks for it. I ordered black. I got it like three days later. I initially thought I wouldn't use it, but when I put it on the belt clip, it makes the pump very inconspicuous, so I'm leaving it on. It adds only a little bit to the weight and it is easy to slip out of the case still. And the cover flips open to reveal the screen and buttons when necessary, so it is a nice addition. One other thing I got with the pump is a little leather-like case that essentially wraps around the pump and has a small belt clip on it. I'm going to dig that out of where ever I stuck it and try using it. There are other accessories that Animas sells that I'd like to try out, too, but I want to wait a little bit more before I order anything.
I'm still dealing with my sore leg - I need to make an appointment with my primary care doc, but sitting here at my desk, it does not hurt, so it is not in the front of my mind. Maybe I'll call tomorrow... tonight I have a Tiger Scout meeting to hold, so I have too much else to do today.
Tuesday, October 12, 2004
Small changes
I spoke to Lisa yesterday, and she's happy with the way things are going. She had me make some small tweaks, though. My 3am blood sugars have all been pretty good (when I was doing them - I've pretty much stopped at this point). But my breakfast numbers were higher than desired, so she had me bump up my basal from 3am to 7am to 1.4 units per hour, up from 1.2, which I use the rest of the day. This morning was the first time I'd used the new rate, and my breakfast BG was 157. Not down very much, but a little bit. Last night, I ate two apples without any compensating bolus, so those may have pushed me up to where I was - we'll see. I love fresh apples, and couldn't resist :)
I felt a little low before I left for work today, so I had a snack-size Kit Kat bar without compensation (easily grabbed from the Halloween bucket), and I was 79 at my 9am reading, so I'm glad I did that.
The other change was that she said I was coming in with lows in the after-lunch time. Both of my hypoglycemic episodes were post-lunch, and my dinner time readings have been consistently lower, so she bumped up my lunchtime ratio from 1:8 to 1:10. Today will be the first time with the new ratio. I got it all programmed into the pump with no trouble, and I just have to reiterate how nice it is to program-and-forget that stuff.
I have an appointment with her next week to look at everything and touch base. Since my last prescription was for a single fill of insulin, I'll have to remember to get an ongoing refill script while I'm there.
The leg pain was really bad last night at the gym, but it may have peaked because it doesn't feel quite so bad this morning. I still have a limp. The stiffness/pain is in my left calf and left sartorius muscle (not the quadricep). The left gluteal is also involved and my left lower back (my lower back hurt when I sneeze or cough heavily - this might just be an extension of my gluteal, though, and not actually my lower back). Yesterday was an arm day, but obviously I use my legs for a lot of the exercizes, and for several of them, the pain was really bad as well as during my cool-down stretching. Today I took Tylenol to help with the pain, and that may be why I feel it less. I'm hoping it is more that whatever this is is going away. My thoughts about what it could be have run the gamut, from blood clots to muscle strain, to blaming the pump infusion sets or the study drug. I am waiting for a call from the study drug nurse, to see if this pain is a listed side effect. I kind of doubt it is, but it is worth asking.
I felt a little low before I left for work today, so I had a snack-size Kit Kat bar without compensation (easily grabbed from the Halloween bucket), and I was 79 at my 9am reading, so I'm glad I did that.
The other change was that she said I was coming in with lows in the after-lunch time. Both of my hypoglycemic episodes were post-lunch, and my dinner time readings have been consistently lower, so she bumped up my lunchtime ratio from 1:8 to 1:10. Today will be the first time with the new ratio. I got it all programmed into the pump with no trouble, and I just have to reiterate how nice it is to program-and-forget that stuff.
I have an appointment with her next week to look at everything and touch base. Since my last prescription was for a single fill of insulin, I'll have to remember to get an ongoing refill script while I'm there.
The leg pain was really bad last night at the gym, but it may have peaked because it doesn't feel quite so bad this morning. I still have a limp. The stiffness/pain is in my left calf and left sartorius muscle (not the quadricep). The left gluteal is also involved and my left lower back (my lower back hurt when I sneeze or cough heavily - this might just be an extension of my gluteal, though, and not actually my lower back). Yesterday was an arm day, but obviously I use my legs for a lot of the exercizes, and for several of them, the pain was really bad as well as during my cool-down stretching. Today I took Tylenol to help with the pain, and that may be why I feel it less. I'm hoping it is more that whatever this is is going away. My thoughts about what it could be have run the gamut, from blood clots to muscle strain, to blaming the pump infusion sets or the study drug. I am waiting for a call from the study drug nurse, to see if this pain is a listed side effect. I kind of doubt it is, but it is worth asking.
Monday, October 11, 2004
Painful weekend
Two bad things happened this weekend. The first, or rather the worst, was a hypoglycemic episode. I had another last week, and from what I know about all this, it is more common with the pump because it easier to give insulin when one cheats on food - at least for me, some of my cheats would have gone uncompensated in terms of insulin injection, but with the pump right on my hip, there is no reason not to give a small bolus. So yesterday, Sunday, we went apple picking. When I go apple picking, I always end up tasting the wares. A lot. I ate about five apples while we picked. Now, pre-pump, I would have likely done nothing about this. If anything, I'd have waited until I was high and compensated then. But instead, as I took my first bite, I bolused five units. Five units for five apples seemed reasonable to me, but combined with the effort of getting the apples, walking the orchard, chasing the kids around, and the like, it was way too much. Or maybe I was low to start with - I don't know.
Regardless, after the orchard, we went to my in-laws house, and Karen had to tell me several times on the way to keep my eyes open - I was dozing off at the wheel. That, in itself, is not unusual. I have a tendancy to doze off at the wheel, though I usually catch myself and perk up after one instance. She had to have awoken me four or five times. Once we got there, I have very little memory of anything else until I was back up to a normal blood glucose level. I apparenly took my blood sugar and got a 37 - it was in my meter and I actually wrote it down, though I have no memory of doing either thing. I apparently ate chocolate chip cookies, a Snickers bar, and drank real Coke (yuck - I've gotten really used to the Diet version). I hate coming out of a hypoglycemic daze, I feel so out of control. Within 30 minutes, I was back up into the low 100's, so I recovered well. We had dinner at their house, too, spaghetti, and I ate heartily, much preferring to be high than low (though I compensated well, since my post-dinner BG was just 159). The rest of the night was fine. I don't like lows - they are a consequence of tighter control, I know. Ijust wish that they didn't sneak up on you the way they do.
The other bad thing was this damn muscle issue I'm having. It gets worse and better and is driving me crazy. It cannot just be a pulled muscle, because I'm able to use my leg without much trouble if I work it enough, but that initial exersion is torture. Yesterday at soccer, I had to walk from my car to the field, and I thought I was going to die it hurt so much. Not excruciating pain, but enough such that when I stepped it hurt, and hurt 300 times as I walked. I was definitely limping. The pain is worst when I get up from a sitting position, or when I swing my leg from out of my car to the road. Left leg only, pain is in the calf and upper thigh, gluteal. Also, when I sneeze, I get a sharp pain in my lower back/very upper gluteal. It is odd, but it all seems connected. Finally, Saturday night I did my set of leg exercizes and nothing was very painful until I got to calf raises and lying leg curls. Those hurt.
So my question to Lisa will be could this be pump related? Could it be an infection that I got at some point that has moved down to my leg muscles? I'm not sympomatic of anything else, and I'm not sure what that means, if anything. It has been going on long enough that I don't think it is just a pulled muscle, aside from the fact that I do not recall pulling anything.
So, anyway, that's all that. Karen has been feeling better, but she is going to her ultrasound today to make sure there is nothing lingering wrong with her gall bladder. I hope it is all clear, but I want to be sure it is, even if she is feeling OK.
Regardless, after the orchard, we went to my in-laws house, and Karen had to tell me several times on the way to keep my eyes open - I was dozing off at the wheel. That, in itself, is not unusual. I have a tendancy to doze off at the wheel, though I usually catch myself and perk up after one instance. She had to have awoken me four or five times. Once we got there, I have very little memory of anything else until I was back up to a normal blood glucose level. I apparenly took my blood sugar and got a 37 - it was in my meter and I actually wrote it down, though I have no memory of doing either thing. I apparently ate chocolate chip cookies, a Snickers bar, and drank real Coke (yuck - I've gotten really used to the Diet version). I hate coming out of a hypoglycemic daze, I feel so out of control. Within 30 minutes, I was back up into the low 100's, so I recovered well. We had dinner at their house, too, spaghetti, and I ate heartily, much preferring to be high than low (though I compensated well, since my post-dinner BG was just 159). The rest of the night was fine. I don't like lows - they are a consequence of tighter control, I know. Ijust wish that they didn't sneak up on you the way they do.
The other bad thing was this damn muscle issue I'm having. It gets worse and better and is driving me crazy. It cannot just be a pulled muscle, because I'm able to use my leg without much trouble if I work it enough, but that initial exersion is torture. Yesterday at soccer, I had to walk from my car to the field, and I thought I was going to die it hurt so much. Not excruciating pain, but enough such that when I stepped it hurt, and hurt 300 times as I walked. I was definitely limping. The pain is worst when I get up from a sitting position, or when I swing my leg from out of my car to the road. Left leg only, pain is in the calf and upper thigh, gluteal. Also, when I sneeze, I get a sharp pain in my lower back/very upper gluteal. It is odd, but it all seems connected. Finally, Saturday night I did my set of leg exercizes and nothing was very painful until I got to calf raises and lying leg curls. Those hurt.
So my question to Lisa will be could this be pump related? Could it be an infection that I got at some point that has moved down to my leg muscles? I'm not sympomatic of anything else, and I'm not sure what that means, if anything. It has been going on long enough that I don't think it is just a pulled muscle, aside from the fact that I do not recall pulling anything.
So, anyway, that's all that. Karen has been feeling better, but she is going to her ultrasound today to make sure there is nothing lingering wrong with her gall bladder. I hope it is all clear, but I want to be sure it is, even if she is feeling OK.
Thursday, October 07, 2004
Levelling off?
I find it funny that since I posted a little bit about working on my basement and putting in molding and the like, the Google ads at the top of this blog have stopped showing ads for diabetes supplies and are suddenly showing ads for crown molding and the like.
Things may have finally levelled off. Jacob and I went out for dinner last night, and though we went to a pizza joint, I was not in the mood for pizza, so had a sausage sub. I must have estimated the carb counts pretty well, because I was 129 at 9pm. So that's good. Yesterday at work, we lost power around 1:30, and by 2:30, after sitting in the dark for an hour, I was ready to go home. I had lots of work to do around the house anyway, and having done it all, my reading was 58 at dinner time. I took a full bolus for the food (which I estimated at 80g of carb), figuring that it would probably be low, but that with a 58 I could afford to underestimate the carb count.
This morning at breakfast, my reading was fine (87), but today at 9am, it was up at 193. That's hard to explain (maybe just thinking about French toast with syrup raises my reading, even if I don't eat them!), so before I officially declare that I'm levelled off, I need to get my lunchtime reading. I took a 2 unit correction with the 193 reading.
I've been having an off pain in my left leg the past few days, and I'm at a loss to explain it. It feels a little like a pulled muscle, but I cannot recall pulling it. Plus the pain is not quite that -- it almost feels like I have a slight muscle infection, if that's even possible. The pain is not constant, feels dull, and is worst when I'm exerting myself just on that leg. It starts at the top of my thigh, in the back, and can extend all the way down to my calf. It also causes me to go into a slightly limpy gait. It is annoying.
Karen has her own medical troubles - the doctor thinks that she may have gall stones. She's trying hard to get into the doc's office and finally slipped in because of some cancelations. She's going in to see one of the docs, presumably to get palpated, and then perhaps to get an ultrasound. It doesn't sound like it is a very serious thing, but it can be a serious thing, so they are wanting to treat her very soon. I'm hoping it isn't too bad, but only time can tell at this point.
Things may have finally levelled off. Jacob and I went out for dinner last night, and though we went to a pizza joint, I was not in the mood for pizza, so had a sausage sub. I must have estimated the carb counts pretty well, because I was 129 at 9pm. So that's good. Yesterday at work, we lost power around 1:30, and by 2:30, after sitting in the dark for an hour, I was ready to go home. I had lots of work to do around the house anyway, and having done it all, my reading was 58 at dinner time. I took a full bolus for the food (which I estimated at 80g of carb), figuring that it would probably be low, but that with a 58 I could afford to underestimate the carb count.
This morning at breakfast, my reading was fine (87), but today at 9am, it was up at 193. That's hard to explain (maybe just thinking about French toast with syrup raises my reading, even if I don't eat them!), so before I officially declare that I'm levelled off, I need to get my lunchtime reading. I took a 2 unit correction with the 193 reading.
I've been having an off pain in my left leg the past few days, and I'm at a loss to explain it. It feels a little like a pulled muscle, but I cannot recall pulling it. Plus the pain is not quite that -- it almost feels like I have a slight muscle infection, if that's even possible. The pain is not constant, feels dull, and is worst when I'm exerting myself just on that leg. It starts at the top of my thigh, in the back, and can extend all the way down to my calf. It also causes me to go into a slightly limpy gait. It is annoying.
Karen has her own medical troubles - the doctor thinks that she may have gall stones. She's trying hard to get into the doc's office and finally slipped in because of some cancelations. She's going in to see one of the docs, presumably to get palpated, and then perhaps to get an ultrasound. It doesn't sound like it is a very serious thing, but it can be a serious thing, so they are wanting to treat her very soon. I'm hoping it isn't too bad, but only time can tell at this point.
Wednesday, October 06, 2004
Hyper and Hypo
I've had a few roller-coaster days this week. On Monday, I had a big-time hypoglycemic reaction. Well, not really really big, but big enough that I put myself out of commission for a little while. On Monday, someone brought fudge into work, and if you know me you know I love fudge. I had a few pieces in the morning, and estimated 14g carbs per piece, and took a bolus for each piece accordingly. At lunch time that day, though, I hit a 296. Now, I don't normally snack in the mornings, so part of the high was probably that fact, but I figured that a good share of it was a miscalculation on the carb grams. So, after lunch I had three more pieces, and estimated 60g. Well, by 3:30pm I was bottoming out at a 48. I was sweaty, could not concentrate, just generally miserable. I never flet totally out of it, but I was useless at work for a couple of hours at least.
I ate some more fudge without bolus to try to bring my BG up quickly. By 3:45, I was up to 70, but I didn't feel any better. By 4:05, I was 108, and by 4:30, I was 229. I still felt crappy, though, so the low had some lingering effects. I was high the rest of that night, coming in at 289 at dinner time and 255 at 9pm. I was back to 70 by midnight, though, so I evened out. At 3am I was 144, and I did not compensate.
By Tuesday morning, I was 171 at breakfast. This was nearly the lowest reading of the day. Sometimes I get into these ruts that I cannot explain nor seem to get out of. I did no extra snacking yesterday, mostly just to see what would happen. After the 171, I was 218 at 9am. I bolused 2.5 to compensate, but was still 172 at 11. I left that alone, and came in at 214 at lunchtime. I had a 253 at 2pm, but could not bolus right away since my cartridge was nearly empty. I had to go home to change it, and I bolused 4.45 as soon as I refilled and changed my set. By dinner, at 7pm, I was back to normal at 81, but shot back up at 10pm to 235 (which made little sense to me since we had a very low-carb dinner of kielbasa and onions and peppers).
By midnight last night, I was 69, and 151 at 3am this morning. I was 126 at breakfast and back up to 249 at 9am. I don't get these numbers sometimes, and the only thing I can think of is that the low threw me into a spiral of some kind (I bolused 3.9 after the 249, and that was two hours ago - I just did another check and I'm at 143 now, so it is leveling out, and hopefully any lingering effects are done lingering).
It is disappointing, after such a great start, to have numbers all over the map like this. I try not to let it get to me, though, because it seems that sometimes, no matter what I do there is no fixing it. I just have to treat highs and deal with it, keeping it in the back of my head that this is just the way it is sometimes.
I ate some more fudge without bolus to try to bring my BG up quickly. By 3:45, I was up to 70, but I didn't feel any better. By 4:05, I was 108, and by 4:30, I was 229. I still felt crappy, though, so the low had some lingering effects. I was high the rest of that night, coming in at 289 at dinner time and 255 at 9pm. I was back to 70 by midnight, though, so I evened out. At 3am I was 144, and I did not compensate.
By Tuesday morning, I was 171 at breakfast. This was nearly the lowest reading of the day. Sometimes I get into these ruts that I cannot explain nor seem to get out of. I did no extra snacking yesterday, mostly just to see what would happen. After the 171, I was 218 at 9am. I bolused 2.5 to compensate, but was still 172 at 11. I left that alone, and came in at 214 at lunchtime. I had a 253 at 2pm, but could not bolus right away since my cartridge was nearly empty. I had to go home to change it, and I bolused 4.45 as soon as I refilled and changed my set. By dinner, at 7pm, I was back to normal at 81, but shot back up at 10pm to 235 (which made little sense to me since we had a very low-carb dinner of kielbasa and onions and peppers).
By midnight last night, I was 69, and 151 at 3am this morning. I was 126 at breakfast and back up to 249 at 9am. I don't get these numbers sometimes, and the only thing I can think of is that the low threw me into a spiral of some kind (I bolused 3.9 after the 249, and that was two hours ago - I just did another check and I'm at 143 now, so it is leveling out, and hopefully any lingering effects are done lingering).
It is disappointing, after such a great start, to have numbers all over the map like this. I try not to let it get to me, though, because it seems that sometimes, no matter what I do there is no fixing it. I just have to treat highs and deal with it, keeping it in the back of my head that this is just the way it is sometimes.
Monday, October 04, 2004
Weekend update
It was a pretty busy weekend. My brother-in-law came over to help with the trim in the basement - it has been almost two years since the basement was finished and has gone without trim around the doors and floors. Firday night, I bought all the trim pieces at Home Depot and Saturday I painted them all. Then Sunday he came over and we got a good half of it all done. We framed all the doors and got most of the fllors done - I'm short on floor molding, mostly because I got three pieces of crown molding instead of floor molding. It was all in the same bin, and I didn't pay attention to the pieces as I pulled them out. So I have to return these three pieces and get some more for the floors. I'm not exactly sure how much - I need to measure. We have done just the door casing in my office - we have to do the floors in there, but there is so much stuff in that room, it will be tough to move it all out. I made some room by moving my old computer into the boys' room (they were excited about that, though it is not all plugged in yet), but I need to make a lot more room. We need to put the casing in the closet door in there, then figure out what kind of closet doors to buy - I'm figuring on standard bi-fold doors.
Anyway, Sunday was busy. It was a good diabetes day, though. I did start out a little high in the morning, 170, which I corrected for but I was still at 167 at 9am. By lunch, though, I was down to 87, the work in the basement, no doubt, having an effect. We had a biggish lunch - we bought a sandwich platter at a local pizza house, and the platter was overflowing with sandwiches. But after lunch, I was down to a 56, so I ate about 15 carbs without any bolus to try to compensate. I was at 118 at dinner time, so it seemed to have worked.
The day before, I started out very high - inexplicably high. I had a 335 at breakfast, and I tested over the next two hours to make sure I was coming down. I'd changed my set the night before, and it was possible that there was a problem. But no, at 9am I was at 297 and at 10am, I was at 74. So mny compensation worked, though I still have no explanation for the high. I had had an omlette the night before, and there are virtually no carbs in that, so I'm at a bit of a loss. I did not do 3am readings this weekend, giving myself a little break, so I don't know when the high started. I was 131 Friday night at midnight. Maybe I sleepwalked and ate chocolate in my sleep! :)
I got the second half of my initial order from Animas last week - the additional insulin cartridges that they had no already sent in the first box. It took a while, and I was starting to wonder, but as long as I got them before I needed them I was OK. I guess when it comes time to reorder, I'll use Animas, especially if they bill insurance. I'll have to look into it, though, as it might be better/cheaper to get it all mail-order or from my local pharmacy. Speaking of local pharmacy, I need to go there today to pick up my strips - I intended to go all weekend, but was always too busy. I've had an order in for several days and I'll be lucky if they have not restocked it all. Maybe today at lunch. Based on what I paid for my insulin last week, I may get the strips at no-cost, having reached my $700 out-of-pocket expense. I'm not sure if I'm there or if I'm close (I'm not even sure there is a way to find out how much my out-of-pocket has been). But I paid a pittance for the three Novolog vials I got last week, and having reached my limit seems like the most likely explanation.
Anyway, Sunday was busy. It was a good diabetes day, though. I did start out a little high in the morning, 170, which I corrected for but I was still at 167 at 9am. By lunch, though, I was down to 87, the work in the basement, no doubt, having an effect. We had a biggish lunch - we bought a sandwich platter at a local pizza house, and the platter was overflowing with sandwiches. But after lunch, I was down to a 56, so I ate about 15 carbs without any bolus to try to compensate. I was at 118 at dinner time, so it seemed to have worked.
The day before, I started out very high - inexplicably high. I had a 335 at breakfast, and I tested over the next two hours to make sure I was coming down. I'd changed my set the night before, and it was possible that there was a problem. But no, at 9am I was at 297 and at 10am, I was at 74. So mny compensation worked, though I still have no explanation for the high. I had had an omlette the night before, and there are virtually no carbs in that, so I'm at a bit of a loss. I did not do 3am readings this weekend, giving myself a little break, so I don't know when the high started. I was 131 Friday night at midnight. Maybe I sleepwalked and ate chocolate in my sleep! :)
I got the second half of my initial order from Animas last week - the additional insulin cartridges that they had no already sent in the first box. It took a while, and I was starting to wonder, but as long as I got them before I needed them I was OK. I guess when it comes time to reorder, I'll use Animas, especially if they bill insurance. I'll have to look into it, though, as it might be better/cheaper to get it all mail-order or from my local pharmacy. Speaking of local pharmacy, I need to go there today to pick up my strips - I intended to go all weekend, but was always too busy. I've had an order in for several days and I'll be lucky if they have not restocked it all. Maybe today at lunch. Based on what I paid for my insulin last week, I may get the strips at no-cost, having reached my $700 out-of-pocket expense. I'm not sure if I'm there or if I'm close (I'm not even sure there is a way to find out how much my out-of-pocket has been). But I paid a pittance for the three Novolog vials I got last week, and having reached my limit seems like the most likely explanation.
Friday, October 01, 2004
Cured!
Yesterday, I talked to Lisa in the afternoon, after I'd called in my latest numbers. The first thing she said was "I think you're cured!"
Of course, I'd like to think that, but it is really more a function of good luck than anything else, I think. She picked good numbers to start with, and I've made pretty good estimations of carb counts, and based on the ratios that have been working for a while, they are still working. That's all good, and it sounds like it could be a cure - but of course, it is far from it.
It is very nice, however, to be able to not have to worry about carrying around insulin. Most of this week has been pretty normal in terms of meals, but there have been some rushed times and a couple of trips to restaurants where it was very easy to just bolus when I sat down to eat and not having had to worry about needles and pens. The nightly shot of Lantus is something I am no where near sad to see gone. The ease with which I can have an extra egg roll or serving of potatoes and do a quick bolus accordingly is great.
Today I was hoping to eat out with Karen, but she was out Christmas shopping with her mother instead. So I went to Friendly's on my own. I'm big on hamburgers, but I wanted ice cream today, and with a chicken dish came a free sundae. So I did that - I estimated the fries were 100 carbs and the chicken was 40, which at a 1:8 ratio ended up with a bolus of 17.5 units. That's a lot, but I did it anyway. The ice cream I bolused separately, another 5 units. I low-balled the carb count on the ice cream, figuring on 40 grams, even though it was probably more (I went to calorieking.com and came up with a more likely total of about 55 grams). I didn't want to go too high because I had a low BG reading yesterday afternoon, and found concentrating to be especially difficult. I didn't want that to happen today. I'd rather be a little high and be able to think straight than a little low and discover that I cannot make sense of 20 lines of code.
The real test is, of course, going to be the long-term. If the pump allows my A1C to come down, then that's a good thing, but I cannot allow the ease and flexibility of the pump to let me go off the deep end on terms of diet. It would now be easy to eat a bag of chips or a candy bar - but though I can counter the carbs with insulin, I still need to work off the calories. I didn't go to the gym last night because of the debate, and it was so nice to just relax at home - I cannot get used to that.
So, OK, I'm quasi-cured. But I cannot forget that I'm still in recovery!
Of course, I'd like to think that, but it is really more a function of good luck than anything else, I think. She picked good numbers to start with, and I've made pretty good estimations of carb counts, and based on the ratios that have been working for a while, they are still working. That's all good, and it sounds like it could be a cure - but of course, it is far from it.
It is very nice, however, to be able to not have to worry about carrying around insulin. Most of this week has been pretty normal in terms of meals, but there have been some rushed times and a couple of trips to restaurants where it was very easy to just bolus when I sat down to eat and not having had to worry about needles and pens. The nightly shot of Lantus is something I am no where near sad to see gone. The ease with which I can have an extra egg roll or serving of potatoes and do a quick bolus accordingly is great.
Today I was hoping to eat out with Karen, but she was out Christmas shopping with her mother instead. So I went to Friendly's on my own. I'm big on hamburgers, but I wanted ice cream today, and with a chicken dish came a free sundae. So I did that - I estimated the fries were 100 carbs and the chicken was 40, which at a 1:8 ratio ended up with a bolus of 17.5 units. That's a lot, but I did it anyway. The ice cream I bolused separately, another 5 units. I low-balled the carb count on the ice cream, figuring on 40 grams, even though it was probably more (I went to calorieking.com and came up with a more likely total of about 55 grams). I didn't want to go too high because I had a low BG reading yesterday afternoon, and found concentrating to be especially difficult. I didn't want that to happen today. I'd rather be a little high and be able to think straight than a little low and discover that I cannot make sense of 20 lines of code.
The real test is, of course, going to be the long-term. If the pump allows my A1C to come down, then that's a good thing, but I cannot allow the ease and flexibility of the pump to let me go off the deep end on terms of diet. It would now be easy to eat a bag of chips or a candy bar - but though I can counter the carbs with insulin, I still need to work off the calories. I didn't go to the gym last night because of the debate, and it was so nice to just relax at home - I cannot get used to that.
So, OK, I'm quasi-cured. But I cannot forget that I'm still in recovery!
