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.

Out of Control

Post originally written on October 11, 2008

So my blood sugars have gotten a bit out of control lately. Waking up high several mornings in a row- random high and low sugars. I decided it was time to put the CGM on for a while. On Wednesday of this week my sugars went like this:

6 am: 130 - okay normal

12 pm: 80- wonderful

4 pm: 256- arg

9 pm: 405! what?!

So I had my sensor in that day but it ended at lunch and I didn't feel like starting it up again because it had kept me up in the night for 2 nights in a row beeping every 40 minutes to tell me my sugar was high- 305!

I was hoping to sleep well this night so I was just going to start it back up in the morning. Well, apparently that was a bad idea because when I changed my site around 5pm I guess that's what gave me the dramatic high. So I bloused 9.5 units and then changed my site. When I pulled it out it looked fine- so I'm sure that's just a wasted site- arg. I've been having this problem when I change to a new site that about 2 or 3 hours later I'll be up in the 300's. So I started doing more sites in my tummy instead of in my hips like I always do thinking that those areas of my body might have too much scar tissue or something like that. But, this site was also in my tummy so that shouldn't have been the case- who knows!

I just hate it when I have a high blood sugar and its just 10 times worse when I can't quite figure out what it was that made my sugar go up so stinking high.

The last couple of days have been so much better. The graph on my pump for the last 24 hours has nearly been a straight line. I think I'll probably just wear this sensor until it dies and then evaluate my settings further and move on with those.

7 Years

Post originally written on April 29, 2008

I've had diabetes for seven years! Can you believe it's been that long?! It sure doesn't seem like that long to me. Seven years is a long time.

I remember that when I was diagnosed that I made the decision to make diabetes be a way of forced good health. I knew that I would have to eat healthy, exercise, and do all of the things everyone should do anyway. I felt that my reason to live a healthy life was chosen for me. I went information crazy and tried to learn as much as I could about diabetes. I printed out hundreds of pages off the Internet and read them, highlighted things, put them into a binder. I was really craving to know as much as I could.

Things started off rocky for me, as is the case for a lot of newly diagnosed diabetics. But, I had a good doctor and a GREAT nurse who tried to get my insulin dosages correct. She would call me twice a week to go over blood sugars and insulin dosages.

About a year after being diagnosed, I decided I was ready to try the pump. This was honestly the best decision I made in caring for my diabetes. I was lucky enough to come across the BEST doctor in the entire world, Dr. Robert Day. He and his staff at the Diabetes Clinic at Utah Valley Regional Medical Center have really become a big part of my life. They've taught me so much about caring for myself that I feel forever indebted to them. This team of educators, nurses, dietitians, and doctors really work wonders. I now travel over 40 miles to go to doctor appointments at this office.

About three and a half years of living with diabetes, my blood sugars were finally good enough to try getting pregnant. We were lucky enough to conceive in the first month and nine months later our healthy baby Ryan was born. His blood sugars at birth were minimally affected and he shows no signs of developing the disease.

In my sixth year of diabetes, continuous glucose monitoring systems were being covered by some insurance companies for patients with special circumstances. I was covered 100% through our great health insurance plan about two months into my second pregnancy. Blood sugars were a very small issue during this pregnancy due to the incredible technology of the CGM. Evan was born with no blood sugar issues whatsoever, another healthy baby boy!

Throughout the past seven years, I've been really good at taking my medication, counting my carbohydrates, learning as much as I can about the condition. We've even done a little work for charity too. Diabetes is an all encompassing disease that sometimes gets me really down. Overall, though I think it has been a blessing in my life. I've gained an enormous testimony of the word of wisdom through living with it and I've certainly learned and experienced a lot. I don't mind that I have diabetes (most days) and I love to tell people all about it, mostly because I get tired of hearing very ignorant questions and comments about my condition.

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! :)

Using the Sensor (CGM)

During my second pregnancy, I found the CGM or sensor, as I call it, to be quite helpful in regulating my blood-sugar levels. Here is a post I wrote about using it.

Post originally written October 3, 2007.

Well, I've had the sensor for a week now and have just started my second site for it. So far I think it is working pretty well. The only complaint that I have is that it is keeping me up at night. Almost all night long it's beeping at me and telling me that my sugar is high, or my sugar is low. I guess that is good because then my sugar can be more even during the nighttime as well. However, I was starting to get quite sleep deprived.

Last night the sensor ended and so I took it out. I decided to leave it out for a night and wait until this afternoon to re-connect. I am really glad that I did too because I went to bed at 9:00pm with a BG of 140. I woke up at 6:00am with a BG of 96.

I'll see Dr. Day on Monday so he can have a lot of sensor data to look at. I think this will really help my sugars during this pregnancy. I was really proud of myself for the first three days because my glucose graph was almost a perfectly straight line, I was really excited about that.

Right now I am starting a new sensor and I'm having a lot of calibration errors. I've heard it can take up to 12 hours before it will work well though so I'm trying to be patient with all of the beeping and testing.

Anyway, I just wanted to post something about the sensor so you can all get a feel for how it is working for me.

Great News!

Post originally written on September 20, 2007

I got a phone call at work today that wasn't work related. I think that's happened about twice in my life. Anyway, it was Minimed calling to tell me that my insurance had approved me for the Continuous Glucose Monitoring Sensor (CGM)that goes with my pump!

I am so excited I can hardly stand it.

The sensor itself is relatively inexpensive at about $1000. The kicker is that the senors you have to change out (every 2 to 10 days)cost $30. each. That can get pretty expensive- $90 to $450 per month. The best part of it all is that my insurance covered me 100%! Minimed told me that my balance is zero. They are overnighting the sensor to my doctors office and it will be there tomorrow. I'll have to get trained on how to use it and everything but it should be up and working early next week. Yea!

If you're wondering what it looks like or how it works, click on the hyperlink "sensor" above.

Doctor Visit

I saw my diabetes specialist today. The news was pretty good. My weight has remained the same in the last 4 months and my blood presure was great. My HbA1c was at a 7.1, up from 6.8 at my last visit. He did say though, that I am still in good control and that I'll just need to monitor my sugars a little more closely. He reminded me about writing down glucose levels which is something I used to be very faithful at, but haven't done in over 2 years.

One topic of discussion that came up was the continuous glucose monitor (CGM). This is a device which is fairly new to the public market that monitors glucose levels continuously- hence the name. So, this means it is taking a reading subscutaneously (under the skin) without a finger prick. But, this does not eliminate the need for blood testing because this must still be done about 3 times a day to calibrate the monitor.


The crappiest thing about this though, is that insurance is not covering the monitoring at all yet, so it is very expensive. The monitors range from $300-$1,000 and every three days a $35 site has to be changed. You can see how quickly this could add up. However, it would not necessarily have to be worn all of the time. I guess it would ideally be worn for a 2 week period to study out trends in glucose readings and would not need to be worn again for a few weeks or months. Some people use them to help themselves recognize hypogylcemia (lows) so they might need to wear it on a more regular basis.

Minimed CGM
Dexcom CGM

Anyway, I've also been thinking about upgrading my pump to one with some of the latest features. My pump is currently out of warranty but working fine. As soon as it breaks though, I'd have to buy a new pump. I am not sure what kind of coverage I have on my new insurance, but my last pump cost us $1,000 after insurance. Pretty good for 5 years of 24/7 use. I'd also like to get a glucometer that "talks" to my pump so I'd probably go with the Cosmo or the Minimed.

Mini Med pump and corresponding glucometer
Cosmo pump and attached glucometer

Lots of money in the heath-care industry.