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.

Diabetes Alert Day

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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.

 

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!

 

Feeling Totally Derailed

Originally posted on Diabetes Daily.

As I sit to relax after eating a healthy lunch (green peppers stuffed with a mix of brown rice, chicken and veggies) I’m thinking why don’t I eat like this more often. In fact, I’m here thinking what happened in the past few months to make me completely derail from everything a person with type 2 diabetes should do in order to be healthy.

2013 has been hectic. For almost a year I was working two jobs so I could afford health insurance (see the irony?). My schedule was so crappy, I ate whatever was available, which means there were a lot of late night shifts that ended at the BK drive-thru. Decent sleep hours became a joke, so don’t ask me about exercise (which I previously posted about). My routine got completely screwed up, and I won’t get the award for taking my medications on time. Now my jeans feel tighter, you do the math. I feel tired which means my thyroid is angry. So it hasn’t been a good year for my diabetes management.

About a month ago my life changed for the better when I was offered a wonderful position at the college where I work. Now I have a regular week day, first shift, full time job. That certainly gives me time to plan things and take care of myself, but it’s taking me a while to get back on track.

The first thing I did was reassess my health and realize I haven’t seen my doctor since the beginning of May. My last A1C dates from March. I don’t remember when was the last time I tested my blood glucose levels because I ran out of strips, and the doctor will want to see me. But for a month I’ve been afraid to call and make that appointment… I am almost 100% sure my numbers will make her eyes cross.

Because taking my metformin has been rather an irregular thing, now that I’m taking it every day, as many times as required, my stomach is all messed up and I find myself cursing the diabetes demons. And while trying to decide how to soothe my poor stomach, I was thinking if I need a medication change, if it would be better to manage my blood glucose levels with insulin or if there will soon be a magic cure. Truth is, all I need to do is get out of denial and do what has always worked for me.

This is the story of my life. The story of the life of a person with type 2 diabetes. Especially one who doesn’t live on insulin. It’s homework every single day. Every decision affects our numbers. And the guilt paralyzes us.

I made my appointment with the doctor. I know it won’t be pretty, but I ran out of excuses.