Part 2: New Doctor, lots of Tests

So my new Doc, Dr. Lee, decided to have me get a full panel of blood work.  I was to be fasting and have all of the blood in my body drained out for testing.  Not really, but this list was LONG!  I was actually really glad though, because I've been wondering about some things and feeling like others weren't properly treated.

Anywho, I got a taxi after 40 minutes of waiting in the rain and headed down to the medical center for labs.  Little did I know, the results were gonna be scarier than that dang needle.

The same day that I had my labs done, I went to my doctors office to have a CGM inserted for my blind trial.  Again, he wanted a blind trial so that I wouldn't be interacting with the CGM but rather to collect the data and make adjustments to my insulin regimen.

One week later, I went back to the doc to upload the CGM data, review that, and talk about my labs.

The week that I was wearing my CGM, my doc wanted me to be recording all of my blood sugars, meals, and insulin doses.  Introducing the mySugr app.  Very cool, highly recommend it!  It was a great little app on the iOs and I found it was easy to use and maybe even a little entertaining.  I logged everything really well for seven days and haven't used it since. What can I say?  I gave up on logging a LONG time ago!  Plus I log all of my calories on MyFitnessPal so that's just way too much time on logging!

I digress.  So, I went back to see Dr. Lee.  First we went over all of my labs.

Testosterone & Estrogen tests were normal: no PCOS (whew!)
Lipids (Cholesterol): bad (CRAP!)
Hashimotos (thyroid): still uncontrolled even though I take thyroid meds (SIGH)
Uric Acid (proteins in urine detecting kidney function): high (SHIT!)
Celiac (allergy to wheat): Positive (double SHIT!)

Then we went over my CGM and it was fine.

So, basically, my blood sugars are under control and I don't have PCOS but other than that I'm a complete mess.

This was REALLY HARD news for me to swallow.  Really.  Hard.

I'd seen a doctor about my thyroid and possibly having Celiac previously but I was never actually tested for Celaic.  I played around with gluten free for about a month and then I decided to move across the globe and basically forgot about all of it.

This time though, it's time to face the facts and realize what I already thought I knew.  Celiac. Positive.  And no more wheat for me! That SUCKS!

As for the Cholesterol, I'm just gonna go ahead and say that I had already had a high cholesterol come back and this one wasn't really a surprise.  In the states though, my beloved Dr. Day told me I could wait until I was 35 before starting on any medications.  Not this Doc.  He wants me on a low dose of Statins.  It took me almost a week to take that first pill.  So far no bad side effects so I think I"m good there.  And if it protects my heart, then I'll do what I gotta do.

Hashimotos.  or hypothyroid.  So I've got that.  I have been taking thyroid meds for quite some time and I knew they weren't enough.  I saw some whack job at the beginning of last summer and he wasn't doing it for me so I quit him and ignored it.  Until now.  I'm on double my dose from before and finally able to wake up in the morning!  Hooray for that!

As for the Uric Acid, I got to do the ever so enjoyable 24 hour urine collection.  I never heard back from them so I'm assuming that test was fine.  Geez!  I don't want to find out that my kidneys aren't working well.  Guess I gotta stay vigilant and do everything I know to keep this dreaded diabetes under control.

Celaic.  Damn. I can't believe I have Celaic.

Switching over to gluten free has been difficult.  I think that's compounded with the fact that I live in a freakin expensive country and it's hard to pay for regular groceries let alone switch it all up and eat a different way.  I had some really good go-tos back in the states when I tried this before.  Some of those things just aren't available here and I've resorted to eating eggs all the time.  Not really, but... really!  I am so bored and need some good gluten free meal ideas.  Particularly lunch.

I guess after a few months of focusing on the big move, and home-schooling my oldest due to some unforeseen circumstances, it is time to focus on me and my health again.  It's hard when you're a mom and have another life outside of taking care of diabetes 24/7.  But it's wake up calls like this that kick your butt into gear.

I didn't reach out to many in the DOC about all this, but it's time I put this story out there.

Update on my progress to follow.

New Country, New Doctor (part 1)

I've totally neglected this blog.  And at this point I'm sure no one is reading it.  I'm not sure if I should just delete it or... try to keep it up better.  I think the stories I tell (about Diabetes) are important and valuable for some to read and I really love it when someone has a question about something specific and I realize that I've written a nice long post on the topic.  The only problem I have with consistently blogging about diabetes is that I HAVE ANOTHER LIFE.  I mean, Diabetes is my life, but it's NOT my life and I don't want to spend ALL of my time talking about it, or writing about it.  So.  Yeah.  That's why I don't blog here much.


HOWEVER, there have been a few things recently that I should really put out there.

So most of you know that I recently moved to the other side of the world and now live in Asia; one degree above the equator, in the tropics, on a tiny little island, city, country called Singapore (no, not Japan or China or the Philippines).  Anyway, there are a lot of things about diabetes which were affected by my diabetes, or maybe it's the other way around.

First of all, I had to find a new doctor.  I asked some really great resources for help on referring me to a doctor here in Singapore.  Several people suggested this one doctor in particular so I figured he would be a good one.

I basically waited until the last minute to book an appointment.  I'm not sure why I was dragging my feet.  Maybe because I had plenty of other things to adjust to what with living in a new country or whatever, maybe it's because I REALLY like my old doctor and didn't want to face the fact that I am going to be seeing someone new for the next two or three years.  Dr. Day, if you retire before I get back, so help me!

Getting ready to go see my doctor.  I was so nervous! 

He was.  or... is, or whatever.

The first appointment I had with him went REALLY well.  I was very pleased with the experience and found him to be VERY thorough in getting to know me, my diabetes, and my health history.  He took my HbA1c and looked at my blood glucose data. He decided that he'd like more data and asked me to do a week on a blind CGM so that he could use the information to adjust my basal and bolus rates.  He also ordered a FULL panel of blood work.

I wasn't really pleased with my a1c but given the disruptions to my life the previous three months, I decided to give myself a break about it and aim for better next time.

Stay tuned for part two.

adjusting to a new schedule

Keeping good control over diabetes means making frequent adjustments.  A friend of mine, and diabetes podcaster recently asked the question; "How often do you make changes to your basal rates?"  This questions means making adjustments to the amount of insulin your body receives throughout the day.  Basal rates are the amount of insulin your body requires at different times in a 24 hour period.  Each time I visit my Endochronologist, like I did about 2 weeks ago, we look at my blood sugars, analyze my A1c, and examine my basal rates.  Usually, we make some little adjustments.  My doctor has taught me that there needs to be a minimum of a 10% change in basal rate for an effect to take place.  I see my doctor every 3 months.  Occasionally we don't make any changes, most of the time however, we do.  I rarely make adjustments to my carbohydrate ratio (the amount of insulin I take for the amount of carbohydrates I consume) but in the beginning I made those changes more frequently.  I also made carb ratio changes when I was pregnant because EVERYTHING changes and gets really wacky when you're pregnant and diabetic.

Anyway, recently, my weekend schedule has changed.  I wouldn't say that it has changed dramatically but it has changed enough for me to notice a pattern of change- for the worse.  So, I've got to decide what I'm going to do to make some changes and adjust to this new change.

Each year, our church schedule changes.  We attend church for a three hour block of time.  Each "ward" or congregation, is assigned a different start time so that the buildings may be shared by more than one ward.  This year, its our turn to attend the 12:30-3:30 block.  AND I HATE IT!  I absolutely detest this schedule.  It's not good for me, and it's not good for anyone else in my family.  Last year we were lucky enough to attend the 9-12 block.  Yeah, it's nice to sleep in on Sundays but I'd much rather be finished with church by noon.  Also, when do you eat?  Either you sleep in and eat a big, late breakfast; or you wake up early and eat two small meals before attending church.  This is what has been really whacking out my blood sugars.  In the 5 weeks we've attended church in 2012, I've had ONE Sunday where my sugars were under control.  The other weeks, I've had one issue or another.  I've been high, I've been low, I've been quickly rising and falling fast.  Ugh.  I cannot figure out this schedule.

Yesterday, it finally clicked that something had been off for five straight weeks, each and every Sunday.  Yesterday I took the day to sleep in.  I slept until 9:00 am like a total slob (for a mom) and didn't eat breakfast until 9:50am.  At that time, my blood sugar had dropped to 59.  I didn't even feel it.  I almost always feel lows. Not this one.  So I ate.  And I ate.  And I probably did eat too much.  And I didn't take any insulin.  So, 2 hours later, my sugar was like 280.  Then I got to take my naked and free shower (where you aren't wearing a pump site or sensor) and put in a new site after my shower.  I bolused and figured I'd come right on down.  Only no.  1 hour after my bolus I checked my sugar and it was 316.  I felt super dizzy.  And super thirsty.  And it just happened to be the first week of the month which means that everyone is fasting.  So I'm taking down at the water fountain when all the adults around me are fasting from food and drink, including water, for 24 hours.  Ugh.  But you do what you have to to take care of yourself, right?
Eventually my sugar came down and I spent the rest of the day fighting lows.  Which leads me to tomorrow's post.

So, let me get to the point here, I know I've got to make a change.  And I hope it will be an easy one.  I just need to wake up earlier.  No more enjoying the ONE BENEFIT of this stupid late schedule, I've got to get up at my regular time and eat breakfast at my regular time.  As for lunch, I don't know.  I think I'll just go for a little carbohydrate and protein combo snack before church and maybe another portion when I get home and then have dinner at the regular time.  That should do it.

I'll let you know how it goes.

How it's changed my life

My 8th year diabetic diagnosis anniversary is April 29, 2001. I've been thinking lately of how that diagnosis has changed my life. I think maybe I'll just write it out in list form so that it isn't a mumbled jumble of thoughts. These are in no particular order.

Diabetes has changed my life in that, it has:

- made me have to go to the doctor a lot more

I see the doctor every three months. I have to have my A1C taken every three months when I visit the diabetes doctor. I have to have "routine" (as in routine for diabetic) blood work at least every other year. I have to have a foot exam at least every year. I have to get a flu shot every year.
During my pregnancies, I had to visit the diabetes doctor more frequently, every three weeks on average. I had to see the ObGyn more often than regular women. I also had to see a specialist at least once or twice per trimester. During the 4 weeks of pregnancy I had to have non-stress tests performed on the boys twice per week. Going to the doctor was like a part-time job. Much time spent in doctors offices.
I also now have to see the eye doctor once per year.

-made my vision worse
Two weeks before I was diagnosed with diabetes, I couldn't see. It was the strangest thing in the world. I swear to you I lost my vision over night. One day I woke up and had a difficult time seeing anything. It was so bad that I went to Zuka Juice and could not even read a single word on the menu. I remember moving to the front row in each of my college classes, thinking, why in the world can I not see the board?
As soon as I was diagnosed and put on insulin, my vision dramatically improved. However, I have worn glasses for nearsightedness ever since.

- made me more aware of the ingredients in my food

I control my diabetes basically by doing two things. 1. I take insulin via infusion set with an insulin pump. 2. I count my carbohydrates.
I've had to learn a lot about nutrition since becoming diabetic. I've learned a little more about what's in foods such as proteins, carbs, fiber, fats, calories, etc. But mainly, I just know how to count carbs. Some foods are harder for me, but I could look at just about any item of food or meal and tell you how many carbs it contains.

- made me an expert on diabetes

I was diagnosed at the age of 20. My doctors at the time figured that I was an adult and could figure it out on my own. They helped me a lot in trying to get my insulin regimens stabilized but mostly I had to learn about it on my own. I went information-crazy and read every thing I could about diabetes. I love to talk about it. I blog about it occasionally. I hate it when people are ignorant about the disease. I often think that I'd love to be a diabetes educator.

- made me more sensitive to pain

The weirdest thing, and maybe you don't believe me... but I've become less tolerant of pain. I've heard people use the term "pain threshold" before. Mine has significantly decreased since being diagnosed. Any ideas why?

- made it a little more difficult for me to heal

For some reason I don't heal as well now that I have diabetes. I guess it has something to do with the lessened blood flow/ circulation issue that diabetics have. When I get a minor cut or abrasion on my skin, it doesn't heal well. 7 days ago I had some blood work taken. I still have a mark on my arm. 3 weeks ago I scraped my arm on the garage door, I have a pretty bad scar there now.

- made me more aware of my body

Not always, but for the most part, I'm very aware of how I feel. I can tell if my sugar is too low right away, almost always. I can often tell if my sugars are high. I will sometimes just know when I shouldn't take any insulin, or if I should just give myself an extra unit. Someone told me when I was first diagnosed, I think it was that first doctor, that I would be the one who knew myself better than others. I've certainly come to find that as truth.

- made me somewhat more susceptible to illness
Diabetics are often more ill than others. I have the immune system of a true teacher. I can be around millions of germs each day and go weeks without coming down with an illness. There are a few things that I've had more trouble with though. My digestive system doesn't work as well as it should. I often have tummy aches. I also get bladder infections more easily. No fun.

- made me very grateful for the scientists in the world
Scientists are getting closer and closer to finding a cure for Diabetes. The advances in technology and medicine they've made have made my life with Diabetes so much easier than it would have or could have been.

- made me a little healthier
I think that if I didn't have Diabetes, I wouldn't be as healthy as I am today. I have a really big sweet-tooth and although I CAN eat sweets and be diabetic, I'm at least more conscious of what I eat. I could stand to lose 15 pounds and exercise a whole lot more than I do, but nonetheless.
- allowed me to make many friends

Everywhere I go, I meet someone with diabetes. A lot of people have type 2, but inevitably, I'll meet someone who has type 1. It's always nice to be able to talk to someone who knows EXACTLY what you're going through. When you have something like diabetes, its easy to become fast friends.

Anyway, that's all for today I suppose. Diabetes isn't always a bad thing. Although diagnosis can be quite overwhelming, it has taught me a lot and has probably made me a little better of a person.

My Latest A1c

Post originally written on November 19, 2007

Today I had my tri-weekly (every third week) visit with Dr. Day at the Diabetes Management center. He is my favorite doctor ever. His personality and mine couldn't be more different (this man is my polar opposite) but for some reason, that works for me as a diabetes doc. Anyway, I had my HbA1C taken today and it was .................(drum roll)................ 5.2!!!

This is as good, if not better than a non-diabetic person's. So, I've talked about an A1c before, but for those of you who aren't familiar with this diabetes lingo- it is basically a two-month average of blood sugar (Web MD link). Anything under 7% is considered normal. So, I'm pretty proud of myself.

Overall though, a good A1c means I'll be healthier in the long-run, have less long-term complications that come with diabetes, and have a healthy baby during this pregnancy. I'm pretty excited. I even did better than one of the nurses in the office who gave me a hard time a while ago. I had to rub it in his face today! :)