Friday, July 27, 2007

A Couple of Things

I've got a lot going on lately, and no set schedule. It's the first time since maybe my freshman year of college that I've had two weeks off work in a row. Even during college I worked through Christmas breaks and summer breaks. I'm not sure how to be certain that I get everything done that I need to do before I get completely overwhelmed with my new teaching job.

Here's what's been on my mind this week (besides my quickly-growing TO DO list):

  1. My last day of work was a week ago. I don't officially start with the school until new teacher orientation on August 6. This means that I haven't had a regular schedule in a week, and my bloodsugars are CRAZY! It shouldn't be like this - I use an insulin pump not injections so I should be able to have any kind of schedule I want. But I've been eating at different times (and having birthday cake - my husband's birthday was this week) and exercising at different times. It's not like I've been just laying around the house either. We've been painting rooms and painting furniture. Uuugghhh.
  2. I also have next week off between jobs, but I'll be busy with all kinds of appointments - my family Dr (because trying to get my endo to write a prescription for anything not directly related to diabetes is like pulling teeth), my check-up at the dentist, my annual eye exam, donating blood at the Red Cross, and my first appointment for a study I'm participating in. I get to drag my husband along for his own appointments at the dentist and the eye doctor.
  3. After I called my insurance company TWICE to ask if they'd cover the CGMS with my new insulin pump, and they told me yes both times (though I did have my doubts each time that they even knew what I was talking about), it was DENIED :-( I received the letter telling me how I can get the decision reviewed, but I'm not sure my endo will help me.
  4. I don't like my endo, but there's nothing I can do about it. The office is too busy. They have too many patients to actually worry about me and my concerns. It takes 4 weeks to get the results of my labwork each time I go in. This is the only office full of them (I think there are 4 at this office) for HOURS in almost any direction. So my only other option is to drive 3.5 hours to the closest University Hospital.
  5. I'm going to participate in a study for Type 1 diabetics. I'll be required to check my bloodsugar at least 4 times a day (I already test more than that), I'll be using a hand-held computer to record symptoms of low bloodsugar (cool - a new toy!), and they give me a new meter and supply me with test strips for a year. The only catch is that I have to go in for 9 appointments over the next year so they can download all my info from the meter and hand-held computer and draw blood to test my A1c.

Monday, July 16, 2007

Sushi for Breakfast?

Let me start out by saying that I live in a very small town, but I have lived in and often visit nearby cities. I'm finally getting used to small-town life again (I grew up in a small town, but moved to a city after college), but there are still things that I miss from cities: nice movie theaters, variety in the grocery store, shopping centers, festivals, events, culture, and RESTAURANTS!

Most Saturdays, I drive about an hour to run with friends who live in a nearby city. We met several years ago when we all participated in Team in Training, and have been friends ever since. I don't mind driving that far because it's early AM so there's not much traffic, and it gives me an excuse to get things at stores that we don't have in my town.

I ran 10 miles with Anna on Saturday, and as we were finishing up I asked if she'd been to the new Ukrops yet. She said she hadn't but that she was thinking about going after we finished running. Since I'd been wanting to check it out too, we decided to go after we cooled off and stretched.

I don't think I've ever been in a nicer grocery store! They had all kinds of all-natural, organic things (produce, cleaning supplies, soaps, shampoo, lotion, vitamins, etc.). They had so many things that I'll ever be able to get in my small town. And there was enough ready-to-eat food to consider the place a restaurant as well as a grocery store! I saw pizza, sandwiches, typical deli stuff, soups, salad bar, dessert bar, cheeses, sushi, and the list goes on and on.

I suggested to Anna that we get something to eat and take it upstairs on their deck. And since it's been so long since I've had sushi, I couldn't resist even though it was only 9:30 AM. I bought some spring rolls and california rolls, and surprisingly, Anna thought those were great choices and got the same thing! I don't know many (any?) other people who would eat sushi that early on a Saturday morning!

So we took our food up to the patio on the 2nd level and chose a table overlooking the traffic circle coming into the parking lot. Talk about entertaining! I grew up in a town with a traffic circle, so I know how to go through one. And Anna knew all about them too, so we laughed and laughed at the people who had obviously never seen one before. Several people ignored it completely and made the left turn into the parking lot instead of going around the circle. One person drive down the wrong side of the median and then went the wrong way through the circle. And one person actually got it right and merged in behind the car that was going around the circle.

I had such a great time Saturday morning, with an incredible 10 mile run, excellent food, awesome company, and amusing drivers. We might just have to make this a Saturday morning tradition!

Monday, July 9, 2007

Somethings Up...besides my bloodsugars

I've used my stomach for my infusion site for as long as I've had my pump. I remember trying my thigh and my backside a long time ago, but I always ended up pulling those sites out. Since I've read about so many people using sites other than the stomach, I decided to try again. Last Thursday, I stuck it in my left hip and yesterday, I stuck it in my right hip. Since Thursday, I've had high readings after breakfast - over 200! And I've been having some lows in the evenings that seem to require a lot of food to keep up.

For example, at 9:30 PM yesterday, my bloodsugar was 71. That's not really low, but it's low enough that I had to eat something before bed, especially since I'd been swimming in the lake all afternoon. I drank a can of Coke and ate 2 slices of whole wheat toast with peanut butter. I didn't take any insulin with all of this. At 2:30 AM, by bloodsugar was 142 so I still didn't take any insulin. But when I got up this morning at 6:30, it was up to 212 so I took a unit of insulin. Just now, 2 hours after breakfast, it's 205 even though I ate the same type of breakfast and the took same bolus that I usually do. I could understand my bloodsugars being this wacky if I'd eased up on my running in the last week, but even my running has been the same amount as usual.

So I don't know what to think. Maybe having the site in my hip changes my bloodsugar patterns. Maybe I'm coming down with a cold or some kind of infection and just don't know it yet. Maybe I got too much sun yesterday even though I'm not sunburned (although this could explain today, it doesn't help with the end of last week and the weekend). Maybe I'm stressed about my career change - I only have 2 more weeks in this job before I take 2 weeks off and start my teaching career. Maybe it's the stress of knowing that I'm changing jobs and even though my insurance will still be the same, I'll be without it for a month (don't worry - I'm on my husband's policy so I won't be completely without insurance) and I haven't gotten my new insulin pump yet.

Whatever is going on, I hope I figure it out soon so I can stop having high bloodsugars mid- to late-morning and stop having to eat so much to keep them up in the evenings.

Monday, July 2, 2007

11.5 Wonderful Miles... and new shoes too!

I ran 11.5 wonderful miles on Saturday morning. I'd planned to run 10 miles, but the route we took ended up being 11.5. It felt great to get out and run that far! And it felt even better to not have any bloodsugar issues at all! I was completely out of gels and Clif Bloks, so I had to carry glucose tabs instead, in case my bloodsugar got too low. Since I really don't care for the tabs in the first place, and I know the chalkiness is even harder to choke down when I'm running, I decided to take Gatorade in my water bottles in the hopes of avoiding low bloodsugar altogether. Instead of mixing 50% Gatorade and 50% water, I used 2/3 Gatorade and only 1/3 water. I also remembered to set my temp basal rate down to 50%, starting an hour before my run. Apparently this is a great combination for me, because my bloodsugar did not get low at all during my run. I started my day at 65 when I got up at 5 AM. It was a little high, at 212, just before I started the run. After I finished, I was surprised to see a reading of 110 after all that Gatorade. I'll have to remember this and try it again next week!

I went to Fleet Feet's annual tent sale after my long run to see if I could get some new shoes at a great price. I was a little worried that they would be too crowded to discuss my sizing/ sore toenail issues, but that was not the case. There was definitely a crowd, but they had plenty of staff available to answer everyone's questions. I ended up getting 3 pair of running shoes, all up 1/2 size from what I've been wearing: New Balance 1060, Asics Gel Nimbus, and Nike Air Pegasus. I also bought a new Moving Comfort bra and another pair of Balega "hidden comfort" socks. I must have looked like a crazy person with the grin on my face from getting so much running stuff all at once!

Tuesday, June 26, 2007

Running & Yoga

I started a yoga class at the Y on June 4. The class goes from 6:30 to 7:30, so instead of going home after work and not being able to convince myself to go back out for yoga class, I go to the Y right after work. I usually run a couple miles on the treadmill before class, at a fairly constant pace while listening to music on my mp3 player.

The first couple of weeks, I had major low bloodsugar issues during my run. The first time wasn't too awful since I had some Clif Bloks in my locker. The second time, my sugar was lower (down to 48) and I didn't have any Bloks or gels left in my locker. I panicked and ended up having a whole can of Coke and a whole 5th Avenue bar from the vending machines. I don't recommend eating junk like this before yoga class - I was pretty uncomfortable for most of the hour.

This week I decided to try a different approach because I planned a more intense running workout. I wanted to use a Cardio Coach workout instead of just listening to music on my mp3 player. I ate a cupcake with frosting before I left work, then took my insulin pump off while I ran on the treadmill. Success! When I checked my bloodsugar between running and yoga it was 80. I ate a couple of glucose tabs (because my bloodsugar tends to drop after exercise), put my pump back on, and turned my basal rate down to 50%. By the time I got home, my bloodsugar was 176 - a little high, but much better than the drastic lows I've been having on yoga night. When Jason checked my bloodsugar around 2 AM, it was a perfect 112.

My strategy may or may not work again next week, but at least I got it right this time!

Wednesday, June 20, 2007

running & toenails

The nail on the toe next to my big toe (on both feet) gets sore, black, and kinda loose whenever I do a long training run or a race. So far, I've been very lucky because I've never lost a toenail completely like many runners do. And I want to keep it that way! I don't want to think about what my endo would say if I showed up for my next appointment missing a toenail! I wish there was some information out there about anything I should do differently if I lose a toenail since I have diabetes. I know I'm supposed to take really good care of my feet, but running is not something I'm willing to give up, or even cut back on.


From what I've read and heard, the cause of black toenails is usually shoes that are too small or too big. My running shoes are already a size larger than my regular shoes, but I might have to try going up another 1/2 size and see if that makes a difference, because I know my shoes are not too big. I think it's time for a new pair of running shoes anyway, and I got enough money for my birthday to get a pair. Hopefully I'll even have enough money to get a few new pair of socks too!

Wednesday, June 13, 2007

2001 Rock 'n Roll 1/2 Marathon: Lessons Learned

I started running sometime in 1997. I was a sophomore in college and was supposed to share an apartment with my then-boyfriend and a friend of ours. Just before classes started, the boyfriend decided to do a co-op assignment (alternating semesters of college and work) and the friend decided he didn't really want to go to college so I ended up in a 3 bedroom apartment by myself. I got a puppy to keep me company in the apartment, and before long, the walks I was taking her on weren't calming her down very much. That's when I started running, mainly to wear my dog out so I could study without her dropping frisbees and tennis balls on my notes.

Fast Forward: I ran my 3rd ever 5K on Thanksgiving morning in 2000, with my Mom. We really enjoyed the race that morning, and decided to sign up for a training program to run the Charlottesville Ten Miler in April 2001. We followed the training plan and successfully ran the Ten Miler, so we thought we'd try a 1/2 marathon next and the Rock 'n Roll 1/2 Marathon in Virginia Beach sounded like fun. This would be it's inaugural year. I think we trained OK for the 1/2 marathon, but not really as much as we probably should have.

One of my very best friends went with us for the weekend, and the 3 of us went shopping the day before the race because the weather wasn't great. It was nice to get out to the mall and get my mind off the race anyway, because I was getting nervous. Mom and I were SO NERVOUS Sunday morning while we were standing around waiting for the race to start!

I decided not to wear my insulin pump for the race since I'd taken it off for most of my training runs. I did not take any other/extra insulin to make up for not wearing the pump because just didn't think about it. I think I was OK for the first 9 or 10 miles, then things got kinda rough. By that time it was getting hot out there, and we were running on the boardwalk the last 3 miles so there was no shade.

At mile 9 or 10, we were all offered Powerbar gel and, seeing how exhausted I was, I took one. Double Caffeine Tangerine. Sounded good to me and was looking forward to the energy boost from the caffeine. I'd never used an energy gel before, and didn't even think about how much sugar was in them.

Even though I started feeling worse and worse after I ate the gel, I managed to finish the race. The longest run we'd done in training was only 9 or 10 miles, so it was a huge accomplishment for me. I was so proud of myself for finishing!

I thought I'd grab a bottle of water, meet up with my best friend, then watch for my Mom to finish. I found my friend first and told her that I was going to get some water and that I'd meet her back right there. I went and got the water and, before I could drink any of it, started throwing up. This didn't concern me because I knew that I'd felt sick to my stomach after running a hard 5K. But I couldn't stop. It was embarrassing. And I still couldn't stop.

I finally decided to check in with the Med Tent. I told them I was diabetic, that my Mom was running the race, and that she had my insulin pump in her waist pack. They checked my bloodsugar and decided that I needed to be put in the ambulance and taken to the hospital. I asked if we could wait for my Mom to finish because I didn't want her to worry about me, but they said I had to go now. They promised me that they would watch for her to finish and let her know where I was.

At the hospital, I waited and waited for my Mom to show up. When she got there, she told me about the adventure of trying to get to the hospital: She looked everywhere for me when she finished the race. She found my friend, who told her I'd gone to get water and never come back. She finally made her way to the Med Tent, where they informed her that I'd been taken to the hospital. She asked them how she could get there, because our car was still at the hotel, several miles from the finish line. Nobody had an answer for her. She found a police officer and begged him to drive her to the hospital, which thankfully he did. I'd hate to find out what she would have done if nobody would take her to the hospital!

I'm sure it was just because this was the first year of such a large race, but Virginia Beach General Hospital was not prepared for the flood of runners that day. The hospital rooms filled up quickly, so I was on a hospital bed in the hallway with lots of other runners. Most of us had IVs to help rehydrate us. They gave me some insulin along with my IV, so my bloodsugar started coming down and I was eventually able to stop throwing up.

I don't like being in the hospital at all. I think I can rest & recover better in the privacy and quietness of my own home (or in this case, hotel room). Besides, my Mom is an RN, so if anything terrible happens she'll know what to do. So I put on my best "I'm all better" face, and convinced the ER nurse & doctor to let me go, even though they wanted to admit me. Mom knew I was lying my butt off, but she kept my secret.

My friend made her way back to our hotel, got the car, and came to the hospital to pick Mom and I up. The two of them were starving, so we stopped at Burger King on the way back to the hotel, but I certainly didn't feel like eating much. I slept most of the afternoon and evening. My friend was able to meet up with another friend of mine to go to the post-race concert. Whenever I finally woke up, I was starving! Mom ordered a pizza for me, so I ate and then went back to sleep. Woke up the next morning and felt great!

These are the lessons I learned that weekend:

1. Even if I'm not planning to use any insulin, I need to keep my pump on me at all times!
2. When experienced runners say "don't try anything new on race day," they know what they're talking about!
3. Drink plenty of water when running on hot days!
4. Be sure to put in enough miles during training!
5. Pizza is truly a comfort food :-)

Monday, June 11, 2007

Flying Pig 1/2 Marathon - May 6, 2007

The weekend started off wrong – my bloodsugars were very high all day Friday (which didn't surprise me since I was in the car for 7-8 hours), and even higher through the night. I barely slept Friday night, because I was drinking so much water and getting up every 2 hours to use the bathroom, check my bloodsugar, and take more insulin. I finally figured out why my bloodsugars were so high on Saturday morning, when my insulin pump completely stopped working. I ended up having to go to CVS to get some NPH insulin (I had used Lente before I went on my pump, but apparently that is not a common insulin anymore because none of the pharmacies I called had any) and some extra syringes. My bloodsugars were higher than usual all weekend and I was stressed out beyond belief with trying to figure out how much insulin to take and what to do about my pump (the warranty ran out last year, so they gave me a hard time about replacing it). I wasn't even sure I should run the ½ marathon on Sunday morning, but eventually decided that I'd at least try it.

I wasn't excited the morning of the race like I usually am – I was dreading it. I had to carry my bloodsugar meter, insulin, and syringes in my waist pack/ water bottle holder instead of gel & Clif Bloks, and fill my bottle with water instead of Gatorade. I decided to take the race very slowly, even though I knew I had trained well enough to finish in close to 2 hours. I even stopped and waited in the porta potty line with my friend around mile 4.

While we were stopped, I checked my bloodsugar; it was 104, so I ate 2 Clif Bloks. Another friend passed by while we were in line, so we decided to catch her. Once we caught up with her, I ran ahead to get water, then couldn't find them again. I decided that I wasn't going to let diabetes stop me from finishing as fast as I could. I knew by this time that I couldn't make up enough time to get the 2:04 that I should have been able to do, so I aimed to finish in 2:10.

The first 10 miles or so of the Flying Pig ½ Marathon are uphill and the last 3.1 or so are downhill. I ran reasonably hard from the time I lost my friends until I passed mile marker #10, then I went all out. I wasn't going to let diabetes stop me! My official chip time was 2:08:44, and that's 10 minutes faster than my best time ever (last year at the Country Music ½ Marathon). I'm trying desperately to be happy to have a new best time, but I just keep thinking about how much better I could have done if I'd had my insulin pump, because I would have been much more confident from the beginning of the race.

Nothing New on Saturday's Run

I planned to run 8 miles on Saturday morning with my running partners, and that's exactly what we did. I rode through my neighborhood Friday night and measured some new routes in my car to come up with what I thought should be an 8 mile route. It turned out to be 9.5 miles in my car, so we modified it a little Saturday morning, ended up short, and had to run out & back on another street to get to 8 miles.

It was pretty hot Saturday morning, and we didn't start until 7:30 AM. I'm glad the route I picked had lots of trees to provide shade! Even with the shade though, it was hot enough to make my bloodsugar drop. I don't know what it is about the heat, but it gets me by surprise every time. We were running up a slight hill, but not much of one, and I felt like I was struggling more than I should have been. I blamed it on the heat and tried to keep going. Eventually I figured out that it wasn't exactly the heat, but that the heat was causing my bloodsugar to drop more than usual on a run. So I walked long enough to suck down a Lemon-Sublime GU (yuck! I didn't like this flavor) and drink some water. A couple minutes later, I was feeling good again. I stopped my insulin pump and finished the run without any more problems. I wonder how many times the whole heat-causes-low bloodsugar thing will have to happen before I'm able to remember this and do something about it before it happens?

Friday, June 8, 2007

20 Years

June 8, 1987. Twenty years ago, just 6 days before my 10th birthday. My mom took me to the pediatrician for my annual checkup. Something wasn't normal. We had to go to the lab at the hospital first thing the next morning, before I even had breakfast. They drew some blood, then sent us out to Perkins to have a big breakfast. I've always loved breakfast, especially pancakes, but not when I felt forced to eat. Mom kept pouring more syrup on my pancakes, and trying to get me to keep eating even though I was full. Eventually she decided I'd eaten enough and we went back to the lab at the hospital, where they drew more blood. Apparently my bloodsugar had gone up quite a bit between the two samples - they said I had diabetes. I had no idea what this meant, but judging by the way Mom was crying, I was sure I was about to die.

Later that day, as Mom was trying to explain what diabetes was and what I was going to have to do to take care of myself (Mom is an RN, so she know a little bit about diabetes already), my dad gets an idea. I don't know why he thought it was a good idea, but he did it anyway. He told me that one of his fishing buddies' sons has diabetes and he thinks that this boy left a syringe in the boat. He goes out to the garage to look for it. When he comes back in and shows me the syringe, I went crazy. I cried, screamed, punched the couch cushions, and I think my whole body shook.

I had a dance recital coming up that weekend, and my birthday was on Sunday, so Mom convinced the Doctor to let me not go into the hospital for diabetes training until the day after my birthday. I remember being backstage at the recital, with my friends. Someone offered me some goldfish and I ate a handful. Then I remembered what Mom had told me about eating anything sugary, and I was convinced that if I liked them, goldfish must be sugary. As soon as the recital was over, I told Mom that I'd eaten them and I hoped I wasn't going to die from it. She somehow convinced me that I would live, and told me I did the right thing by telling her what I'd eaten.

To celebrate my birthday, I wanted to go out to dinner at my favorite restaurant at that time - Hoss's Steak House. I always ordered a steak off the kid's menu and got the Soup & Salad bar. Since it was my birthday, they would sing and bring me a birthday cake. Well the wait staff sang to me and brought out the cake, but Mom was not about to let me eat any of it. I think my grandparents convinced her to let me have at least a tiny piece of cake. That was probably the smallest slice of cake ever cut! I was devastated.

Other than the goldfish at the recital and my birthday dinner at Hoss's , I don't remember a lot about the week between my diagnosis and my hospital stay. Mom says that at one point she took me to the hospital where she worked (different from the hospital where I would go for my training) and checked my bloodsugar there. She said it was normal and that she called my Doctor to tell him he was wrong, that there was no way I had diabetes.

I was admitted to the hospital on June 15, 1987 as a perfectly healthy 10 year old. I spent a lot of time giving shots to an orange (until the saline I was injecting leaked from other holes in the orange!) and learning about what I should and shouldn't eat. Eventually I had to start giving myself injections. Just once a day to begin with, since I was still in the "honeymoon phase" of diabetes, where my pancreas was still producing some insulin. I was only taking 2 units of NPH back then!

Here's the good and the bad from my hospital stay:

The Good:
My best friend sent me a card every single day.

My aunt's 4th grade class made cards and sent them to me. I eventually got to meet the kids who had made the cards for me because we moved and I ended up in their class for 5th grade!

Several family members brought me toys and gifts.

My grandfather gave me a 10-speed bike. He'd just been diagnosed with type 2 diabetes, and he gave me the bike because "we can't eat the same stuff as everybody else".



The Bad:
I didn't get any sleep the entire week that I was in the hospital because nurses were constantly coming in to check my temp, bloodsugar, and whatever else.

I was a picky eater back then, so I wasn't thrilled with the hospital food.

I was bored. I was a perfectly healthy 10-year old stuck in the hospital. Thankfully, I don't think they do diabetes education like this anymore!

My room looked out to a playground across the street from the hospital. See above - I wanted to go out there!


So here I am, 20 years later. I have not had to stay overnight in the hospital since that week. I do not have any complications. I still get frustrated with diabetes, and yell, scream, cry, etc. but I get over it. And I'm still hoping and praying for a cure.