The State of the Pancreas

I saw my endocrinologist last week. That wouldn’t be such big news, except for the fact that I hadn’t been to his office is almost 3 years. Between life changes, insurance switchings and everything that comes with it, I was always seeing my PCP because it worked well for me. But with the recent turn of events, my pancreas being so cranky and all, I decided it was time to go back to Dr. B and I’m so freaking glad I did.

I’ve always liked Dr. B. He’s personable, he cares about his patients’ mental well being above everything else, and he never gives me the talk about how things are so horrible, I better watch out. He may get frustrated—oh, so frustrated… but he never shows it. After all, it’s not his job to make me better… he’s just there to guide  and advise, but the biggest tasks are mine. So after almost 3 years, he was glad I went back, but not so glad that my diabetes is giving me a hard time.

The most important questions I had when I saw Dr. B were:

  • “Did my pancreas check out?”
    To which he replied that no, my pancreas is probably just overwhelmed and being stubborn.
  • “When do I start with rapid acting insulin?”
    To which he replied that it’s better to let the Lantus do its work and see if my pancreas responds.

So that’s what I’ve been doing, giving Lantus a chance. I’m up to 20 units a day, and my numbers—at least my fasting numbers—are getting better every day. I’m guessing I’ll find the “magic” number of units this week. However, my post-meal numbers are never under 200, and I hope they start behaving soon… (I’m low-carbing, dang it!). Based on my log, in two weeks Dr. B will decide if I need rapid acting insulin or add another medication to my metformin since Victoza didn’t quite agree with my stomach.

Whatever Dr. B says, this thing is no joke… it’s no joke when your blood sugar is 466 and you realize all hell got loose, and you want a quick fix. There is not a quick fix, not in the general sense (I don’t bolus). And it requires work, and tears, and a few swear words… and it never, ever ends.

I don’t know what I think I know

In the 15 years I have lived with type 2 diabetes, I have not had many meltdowns. I have suffered from diabetes burnout, denial, periods of anger, periods of negligence, and overwhelming moments courtesy of the endocrine rebellion I have been subjected to by my body. But I have not cried or thrown pity parties that often. Not the kind of pity parties where I bawl like a baby because I just don’t know what to do and no one understands me. Well, I had a fantastic meltdown last night when I was supposed to start my Lantus treatment. Why? Because I am afraid of hypoglycemia in the middle of the night and not knowing what to do.

Sure, I have dealt with a few lows here and there; my worst one being a 52 mg/dL that came with some disorientation and face numbness. Other than that, my lows are very rare and not that bad—most of them have been “false” lows when my body is trying to trick me. But a real bad low where I don’t know where I am or what to do? Nope, I don’t remember that, and I am terrified.

Now, we are talking about basal insulin, the one that has a long lasting action and a starting dose of 10 units. Insulin veterans must be laughing at me. But hey… I have never used the stuff before, and my body may get crazy, you never know. I have gotten mixed stories; people telling me they were OK, people telling me that they went really low, etc. I guess we are all different, but I think my fear comes mainly from the fact that I am supposed to do bed time Lantus, I am alone at night because my fiancé works 3rd shift, and I don’t think I can rely on my cats to help me that much.

After expressing my fear to a few people, one of them actually told me something that surprised me. She said I should learn everything I can about hypoglycemia and go from there. Now, wait a minute… I thought I already knew everything I can about hypoglycemia. Are you telling me I have to do the Hypoglycemia 101 course all over again? And if that is the case, does it also mean I have to relearn everything I think I know about diabetes? I guess I will have to go all Socrates… ipse se nihil scire id unum scia… I know that I know nothing. 

But I will be brave tonight, and I will take my Lantus. I am prepared with an alarm clock to test in the middle of the night, a bottle of glucose tabs, and juice boxes. What I need now is to keep on being the same brave human being I have always been and grab this insulin fear by the horns. I am sure my pancreas will thank me.

And then it got really cranky!

I had my regular diabetes check-up this week. The last 7+ months have been a constant battle, trying to figure out why my A1Cs have been so bad. I have been on Victoza for about a year now; it never stopped making me sick, and it obviously did not do the trick. Apparently my beta cells finally decided to take a leave of absence, and what once was a cranky pancreas, is now a full-on angry one. I wonder if I should change the name of the blog… again. J/K

My doctor decided it was time for me to try basal insulin if I was open to it. I told her I have never been afraid of insulin; in fact I think insulin therapy is a wonderful thing (you go, Dr. Banting!). Of course there was the feeling of failure… but no, I did not fail. I had a friend remind me that diabetes is a progressive disease, and this was bound to happen. I guess my pancreas gave me a good 15 years of overtime.

My butter compartment is now occupied by Lantus pens (which made me think of Lee Ann), and I will start this new phase of treatment this weekend. The doctor will decide about meal time insulin as we go. I have been pestering people with all kinds of questions (Thank you, Matt, for all your patience), and I have also been afraid because let’s face it, we are talking about insulin here. But I don’t have to be specific about that.  And all those questions, all those fears, made me realize I had to come back to the only group of people who completely understand what it is like to live with diabetes. Starting insulin for me is like having to relearn everything.

I realized that I was right… the DOC has kept me in check in one way or another, and I need the community from which I have learned so much. At some point I felt withdrawn and probably overwhelmed, so I left. But after seeing my doctor and having so many questions, I realized I needed the support. And I also need that daily reminder that when dealing with a chronic disease, it is better to turn to those who live with it as well. :-)

Diabetes Alert Day

Did you know more than 25 percent of Americans who have type 2 diabetes don’t even know they have it? Are you one of them? Today people from around the country will take a simple test that can change their lives. We’re calling on you to Take It. Share It. Step Out.

There has never been a more urgent time to know your risk. An estimated 79 million, or one in three American adults, have prediabetes.

The Diabetes Risk Test asks you to answer a few quick questions about weight, age, family history and other potential risk factors for prediabetes or type 2 diabetes.

It takes only 60 seconds and it could save your life!

We can’t waste any time. Take the Diabetes Risk Test today and share it with everyone you care about. Chances are someone you love is at risk, and early detection can prevent or delay type 2 diabetes and its devastating complications.

 

Pinch, Poke, Go!

It took me 1 month to stop worrying about the side effects warnings, but I finally started my Victoza. My body didn’t have a lot of fun adjusting to the new medication, but I survived the first week with the 0.6 mg dose. There was some nausea, a lot of dizziness, and the feeling that a Mack truck ran me over. At some point it got so annoying I actually asked for half a day off from work while I crossed my fingers so the crappiness would go away. It subsided eventually, but then I was worried about increasing the dose to 1.2 mg. No issues there!

I have been on Victoza for 3 weeks now. I can’t say I feel wonderful, but all the initial side effects are gone, my blood glucose levels are in range, and I feel like I have a controlled, normal appetite; in fact, some days I just make myself eat something healthy even if I’m not hungry, with the sole purpose of taking my metformin pills at dinner time. I take my Victoza before I go to bed; the needle is a joke, I barely feel it. I am so excited about the pen I even got a special sharps container. I’m silly like that, but maybe it’s a good thing that I’m excited about the new medication because that will help me with compliance which has been my main problem.

And this thing is working! I hadn’t waken up with a BG of less than 150 in a long time, I hadn’t seen anything below 200 after I ate either. Now I’m seeing a bunch of 90’s when fasting, and my post-meal levels don’t go over 160. The only fear I had was the pancreatitis and pancreatic cancer risk, but last week I welcomed the news that the FDA eased the concerns for GLP-1 medicines. So far, so good. Let’s hope my next visit to the doctor shows an improved A1C.

 

On Valentine’s Day

Lack of access to insulin is the most common cause of death for children with diabetes in many countries around the world. In fact, in some parts of the world, the estimated life expectancy of a child who has just developed diabetes could be less than a year.

This Valentine’s Day our community can help change that.

Through the Spare a Rose, Save a Child campaign, we raise awareness and donations for Life for a Child, an International Diabetes Federation program which provides life-saving diabetes supplies, medication, and education that children in developing countries need to stay alive.

Spare a Rose, Save a Child is simple: buy one less rose this Valentine’s Day and donate the value of that flower to children with diabetes. Your loved one at home still gets flowers and you both show some love to children around the world who need it.

One rose, one month of life. A dozen roses, a year of life for a child with diabetes.
We’re hopeful that you will embrace this cause this year.

Spread the word!

Meet my New Best Friend

In a previous post I mentioned that I’ve been struggling with my diabetes management. Back in October my A1C was 8.3, and I thought going back to my regular care routine and making better choices was going to fix that. It didn’t… My latest A1C is a whooping 9.5, a number I have never seen. I felt like a complete loser, and my doctor was nice about it, but she reminded me that diabetes isn’t something to play with. Basically, she said, mine is progressing and we better do something about it.

When I asked if it was too early to start insulin therapy, she said we should try something else first. So she prescribed Victoza, I got my prescription and I’m going to see the nurse tomorrow to learn how to inject myself. Some people think I’m afraid of the needle… Are you serious? Are there any people with diabetes who are afraid of needles? If so, I would like to meet them! So no, I am not afraid of needles. I am, however, not looking forward to the nausea side effect I’ve heard about. Other than that, I’m ready.

I’m trying my best to not look at this as a defeat. Metformin has worked for me for the last 12-13 years, but it’s just not enough anymore. I’m hoping that with a better diet and exercise my glucose levels will improve, and maybe I won’t have to depend on the medication so much.

It is maddening, though… Sometimes it doesn’t matter if you eat well, especially when you’re sick. Last week I had a stomach bug, and every time I checked my blood glucose it was on the 200s, It’s slowly getting better; although I haven’t seen anything under 150 while fasting. So anyone who thinks type 2 diabetes isn’t frustrating, has surely not walked in my shoes.

I don’t know how many people are reading,  but I would like to know about experiences with Victoza. I’ve heard it has really made a difference for quite a few people with type 2 diabetes, and I hope it will make a difference for me.

Bring on that fancy pen!

 

Surviving Christmas with the Diabetes Police

Originally posted on Diabetes Daily:

It’s beginning to look a lot like… CARBS! Yes, it’s that time of the year for over-indulging. All that delicious food, loaded with butter and sugar. So tasty… so comforting… so… STOP! At least that’s what we’re going to hear the most because we live with diabetes. Oh, yes, the Diabetes Police are out to get us. They “know” sugar is bad for us, and they want to keep us away from it. Don’t even look at that nice tray of cookies.

Annoying, right?

So, if this is that special time of the year to eat, drink and be merry, how are we supposed to enjoy the holidays with someone nagging us about what we should and shouldn’t eat? I’ve been there, with someone giving me the stink eye because I went for the sweets. It’s embarrassing, it’s infuriating—especially when you’re chastised in front of everybody—and I know it takes a lot of self-control sometimes not to snap. After all, we’re already living with a condition that limits some of the choices we make, and having someone reminding us of the fact isn’t much fun.

How do we handle it, then? Here are 5 tips:

  1. Education. I think dealing with the Diabetes Police is an opportunity to educate others about how we deal with diabetes and its many complexities. Tell them about how some of us use insulin to help our bodies process carbs; or explain how even people with diabetes can learn to be smart about food choices and exchanges without having to sacrifice  a good moment at the table. Most people just don’t know better.
  2. Planning ahead. We can be honest and upfront, and ask people not to single us out no matter how good their intentions are. Instead of getting reactive, we can be proactive. For example, is there a way to prepare certain foods you know would be healthier? Don’t be afraid to ask if it’s possible to accommodate it.
  3. Realistic behavior. We know how our bodies work, we know how those 90 grams of carbs will make us feel. So the best way to keep the Diabetes Police at bay is probably stay on track with our own management. We have the knowledge, we have the tools, it is our responsibility to take care of ourselves.
  4. Self-love. The most important thing is to keep in mind that we don’t have to be perfect, and we can’t let other people make us feel bad for not being perfect. Remember Eleanor Roosevelt’s famous quote, “No one can make you feel inferior without your consent.” Accept the challenges, roll with the punches, correct whenever you have to, and move on. But most of all, demand respect from others.
  5. Appreciation. In the end, our family and friends think they’re helping us, supporting us, and doing what’s best for us. Understanding what good support looks like for people with diabetes isn’t easy, so we’ve gotta remember that they’re policing and they’re comments are usually coming from a place of love.

I hope you all have a blessed holiday season, happy numbers and lots of memories to cherish!

BG Testing… 1,2,3…

Originally posted on Diabetes Daily.

The first time my endocrinologist told me I was doing so well managing my blood glucose levels, I only needed to test them 2-3 times a week, I laughed… hard… I looked at him with a big “REALLY?” stamped on my forehead. He assured me it was okay, so I thought it was okay.

Guess what? It isn’t okay!

In 2008, I worked for a company that sold diabetes supplies and delivered them in the mail. While I tried to appreciate the experience for what it was, and did my best to keep my compassionate and caring attitude toward the customers, I got burned out pretty quickly. Among the many things that made me unhappy about that job was the absurd insurance companies’ policies when it came to the limit on test strips.

Insurance companies in general oversimplify something that isn’t simple at all. Their perfect equation goes something like this: you use insulin, you test 3 times a day; you don’t use insulin, you test 1 time a day. And good luck with that! Forget the highs and the lows during the day, and just guess what your food can do to your glucose levels before you put it in your mouth. Easy, right? No.

I speak from the perspective of a person with type 2 diabetes who doesn’t use insulin. Most of the time, I’m just praying to the gland gods to behave when I eat. Many times I don’t even pay attention and have the negative thought train about dying any day, anyway, so why bother? And you know why that is? Because I was told it was OK to test only 2-3 times a week… so the rest of the time I’m completely oblivious.

It’s really hard to get into a blood glucose testing routine when you’re advised to do it so randomly. If you choose to stick to that necessary routine and use more test strips, good luck paying for them out of your pocket. I’ve gone without testing for long periods of time, mostly as a personal choice (irresponsible choice, I may add), and let me tell you that not knowing your numbers isn’t a good thing. Especially when you rely on food choices; sometimes even the healthy stuff may play a bad trick.

So, how do you know? By testing your blood sugar more often!

If you’re not testing often because you believe that people with type 2 diabetes shouldn’t test that often, consider talking to your doctor about increasing the amount of test strips in that prescription. Knowledge is power. It’s frustrating not to know where you’re going to land when you jump. And testing often does help you make better choices.

The One With the Giveaway

Most  people believe that being Colombian automatically makes you a coffee lover. If you ask me I’ll probably say yes. Coffee is a staple in my house (well, my mom’s house) and there is always coffee brewing for a “tintico.” I remember there was always a thermos with coffee on my grandma’s table, So yeah… coffee… the elixir of life.

It wasn’t until I moved to Canada that I realize how many ways of serving coffee there are. Some I like, some I hate. Now coffee has become an luxury for some, and what gets to me the most is how complicated it is to order a coffee these days; tall, grande, venti, non-fat, yes-fat, three shots, no shots. Oh, my God, what happened to a regular café con leche?!?!

However, there is one thing I love about different ways to drink coffee. Enter coffee creamers! Yes, I love how you can fancy up that cup with so many wonderful flavors. But I’m partial to the perfect partner, Coffee Mate. Why? I don’t know… maybe it’s because I like Nestlé or I’m just more familiar with it. In any case, Coffee Mate has done a great job bringing the fancy coffee house to our house.

If you ask me what my favorite flavor of Coffee Mate is, I will never give you an answer. It depends on my mood, it depends on what I’m looking for. But one thing is sure, I do love the sugar-free version! To me, it makes my coffee taste and look more like the usual café con leche I grew up with, and there’s the added bonus to not raising my blood sugar levels too much. Of course I was going to mention diabetes in the post!

OK, I wasn’t going to bore you with stories about coffee for nothing… There’s a  giveaway with some neat coffee-related items (believe me, they’re fantastic!). It’s easy… just leave a comment sharing what your favorite flavored coffee is. Yes, it’s that easy. The winner will be picked randomly (I’ll have my cat draw the number!)

Prize packs will include:

· Branded coffee mug
· Sterling silver coffee charm
· AMEX gift card
· Coffee-mate full-value coupons
· Patterned napkin

And you really want one of these! I know you want it… you really do!