Thursday, May 19, 2011

Good Dog, "Bad" Baby

As Sofia gets bigger and bigger, she is getting more and more mobile. As she attempts to pull up on unsteady household objects, or tries to put non-baby-things in her mouth, I will usually try to get her attention using my discipline voice first prior to walking over to remove her from whatever potential harm or object she shouldn't be near. Disa is very familiar with the discipline voice from her puppy days, and her occasional behavioral outbursts. This has created a unique situation in my house. As I try to sternly talk Sofia out of whatever mischievous activity she's in, Disa thinks I'm speaking to her, and will shake with anxiety while she lays on the couch next to me because she can't figure out what she has done wrong. Even when I say "Sofia, don't touch that" Disa still thinks I'm talking to her due to the tone of voice I'm using. Hence when I address Sofia I'll say "No Sofia, Good Disa!". Its very interesting. I hope the dog becomes less sensitive to this tone as Sofia becomes more and more curious. Fingers crossed. Its very tiring to address my human child and then have to praise my furry one all of the time.

So I'm still on the CGM learning curve roller coaster. I had been doing better but in the last week or so I've hit some more rocky road. I've had a few issues with my pump being clogged, which I can always assume is the problem, but I won't really know until I remove it and see if the cannula is clogged, which is a risky move because then I may be under-utilizing a perfectly good 3 day pod. It's been quite frustrating lately. I can't tell if the poorer numbers are due to exercising less ( the weather has been very rainy and I haven't been able to get out on any walks with Sofia AND basketball is over) or if I just need to create a non-period basal. It seems that my numbers are better when I am menstruating, but I'm not really sure. Sorry if this is TMI.

Anyway, I've realized that I really am going to have to become a complete lunatic with my diabetes if and when I'm able to get pregnant. I think that I've tried to avoid the reality of how meticulous I'm going to have to become, but I think I know even now, prior to any pre-pregnancy consultations, the lengths that I will need to go to in order to keep my diabetes in outrageously strict control. This will mean really scheduling my meals, making sure to do insulin way before I eat, measuring out exact food portions (I hate measuring things when it's not for a recipe), exercising on a regular and consistent basis, and God knows what else. I'm sure that when I am able to get pregnant I will be so focused and dedicated that it will all just seem like things on a to-do list, but it's very daunting at this point.

As far as pre-pregnancy consultations, I have my first one in the beginning of June. I'm kind of excited, but also kind of sad. My wife and I work opposite schedules mon-thurs, and of course my appointment is early in the day when she is teaching as they do not have any hours that would accomodate both of our schedules. And of course her co-teacher is already going to be absent that day and she will have to go in to work. So I will be walking into this sit down appointment with just my daughter, who they will probably assume I birthed, and then I'll have to explain the whole sitaution. I debated taking one of our friends who knows the baby plan (as we intend to keep the process secret from 99.5% of our family and friends as we begin trying for baby #2) but then I'd have to explain how "no, this is not my wife, my wife is working, but she is just a good friend" and I feel that situation might seem a little odd. I'll just put on my big girl mommy pants and go without any adult support. I'm sure I'll be fine.

Anyway, baby #1 is just waking up from a nap, and we'll be heading out on a laundry trip in just a few. You can not imagine how badly I wish I had a washer dryer in our apartment building. (its only a 3 fam)

More to come soon, stay tuned.

Thursday, May 12, 2011

1 Month in with the CGM

So I'm pretty sure that I've had the CGM up and running for 4 or 5 weeks at this point. I've really done a lot of learning and a lot of tweaking to my pump settings, and for the most part I've seen some really good improvement (on some days). I still have the bad days where it seems like I'm high for no reason, but thats usually because there is an issue with my Omnipod Insulin Pump (my pod). Like yesterday for instance, I knew I had eaten a lot of carbs, but I had also done enough insulin to correct myself a couple of hours after I had eaten and I just stayed high. Even when I was at work, and had pumped myself full of insulin before I left to go to work AND corrected even more before I left to go home for dinner, I remained high once I got home, and for the rest of the night. When I went to change my pod it seemed as if there had been some kind of blockage in the cannula, but not a complete blockage, which is why my pump did not alert me of the problem. Changed the pod before bed, and woke up in significantly better range. Not where I prefer to be first thing in the morning, but below where I had been.

One thing that I have learned helps to keep me from spiking is doing my bolus a good 15-20 minutes prior to eating. Now I know that a lot of people know that already, but (a) its hard to schedule yourself like that (b) when I want to eat, I want to eat (c) if you have no idea what you're about to cook, that only takes 20 minutes to prepare, its hard to estimate how many carbs you'll be consuming. But long story short is when I make an effort to bolus prior to eating, I'm much happier with the curve my sugar goes on. It's much less severe.

The last couple of days have been pretty good (other than yesterday). I've been able to keep my numbers between the two dotted lines that is my goal range, and it was lovely to go on a brief hiatus from the beeping and buzzing my cgm does when I'm too high or too low. It also helps my mood significantly, and I find that I'm generally much happier when I see that I'm in really good control. It's a good, healthy, happy feeling. I'm really hoping that I can keep up the good work and really get my A1C down before my next endocrinologist appointment. That would be so lovely. Keep your fingers crossed for me... thanks.

Wednesday, May 4, 2011

The Learning Curve...

First of all, I have no idea how other moms manage to write blogs on a somewhat consistent and continual basis. I barely have time to do all of my household chores everyday before I have to get ready for work in the afternoon, never mind sitting down for a few minutes to try to think clearly and write a blog.

So the learning curve. I've had the Dexcom 7 for almost 3 weeks now and it really is interesting. It is certainly a tremendous help to know where my BG is at and in what direction it's going. The one thing that I really wasn't expecting was the sensor's "margin of error". It only has to be within 20% of your actual BG to be considered accurate. So if your BG is particularly high, the "margin of error" just gets larger. I really thought that once I had the Dexcom I wouldn't be checking my sugar with fingersticks often at all, but I find myself sticking to my usual routine of checking all day, up to 10 times per day. I just don't trust the CGM to be that accurate. For me its really important to know exactly where my sugar is when I wake up, before meals, after meals, before bed, and any time I think the CGM is lying to me.

One of the most interesting things I've found with the CGM receiver is just to see the wave of my blood sugar. We all know that your blood sugar will go up and down throughout the day, but it is reallllly interesting to see it plotted out all day continuously. The smaller waves are nicer to see, and the mountains and valleys aren't that fun. I've been struggling lately to keep my blood sugar up in a good range in the evenings around bedtime, which is a big change for me. It's really a new thing for me to need a cup of juice and a bite of peanut butter to try to keep my BG in a safe range when I'm trying to fall asleep. I'm not quite sure why this is happening lately, but I'm not ready to just change my pump settings just yet. I want to see if this issue is going to level itself out or not. We'll see.

I've been changing the settings on my pump to tend to some of the daily issues I've been seeing on the CGM receiver, and one major change that I needed to make was to my overnight settings. I found that I'm spiking around 3am, which I would never have known. According to the CGM I've gone up to 250 on some nights around that time and I was really unaware of the fact that this was happening to my body. Although I think the CGM's readings might be a little exaggerated, I've been able to change my settings to the point where I am waking up slightly under 100 in the mornings. I had been having some trouble keeping my BG in that range for my morning reading and it really does help me start my day in a better mood when my BG is where it should be.

Speaking of moods, prior to being diagnosed in March of 2009, I never really knew much about diabetes and how it affects a person's personality, but I feel like I am a prime example of the possible effects. Prior to my CGM, if I tested and my BG and it was unexpectedly high, typically I was in a pretty foul mood. Angry, unpleasant, cranky, etc. I guess we could call that the effect on a person's personality. If I am low, I get very strange. My wife says that she can tell when I'm low just from the way I act. I'm not sure how she would describe it, but I think I get a little intense, irritable, and disoriented. I'm not quite sure what it's like being around an intense disoriented person, but it must be an interesting experience. I don't have any diabetic friends either, so I've never had the experience of witnessing someone else's low.

Anyway, back to the learning curve. I have found that doing a bolus 15-20 minutes prior to eating really helps to keep me from spiking too severely. I know that a lot of diabetics know this as a fact, but it is really difficult for me to put into practice and make a daily habit. So I've been making more of an effort to try to make sure that I start my bolus insulin a good amount of time before I start to eat.

I just feel like there are so many things on this CGM learning curve I've yet to master, and so many more things on my pre-pregnancy checklist that I really need to get into the habit of doing. But one step at a time I guess... yea one step at a time.