Tuesday, August 29, 2006

To love, honor and obey

The other day when The Mr. asked why I stopped wearing perfume I had a very logical answer. When I started nursing the baby, I said, I didn’t want any interference. I want her to smell me, not perfume.

“Well, I like it when you smell pretty,” he said.

“I smell clean, isn’t that good enough,” I asked sarcastically.

He smiled.

A few days later when he asked why I didn’t wear skirts anymore, I didn’t have such a logical answer. I had a good excuse, but not a logical answer.

“You see, when I wear a skirt, my thighs could light a fire just walking down the hall,” I explained.

"Wear pantyhose," he countered.

"Blech! Why wear pantyhose when I don't have to?"

“I like it when you..."

"Look like a girl?" I interrupted.

"Yeah,” he said. “Not like frilly pinky stuff, just an occasional dress or skirt.”

“Oh. Ok.”

So today, in honor of my beloved and adorable husband, I am wearing body splash and a skirt. (Thank God it’s not hot and humid today!) I love you sweetie. And I love looking like a girl for you.

Friday, August 25, 2006

The day of surgery

5:58 a.m. Shit. Today of all days my alarm doesn’t go off. Thank my angels that No. 2 came to bed with me about an hour ago and I’ve been in and out ever since.

6:05 a.m. BS is 97. Geez. I really thought and hoped I’d be higher than that. I only took half my Lantus last night and had a big glass of whole, chocolate milk before bed. OK, we’ll just have to deal with it. Five hours until surgery…this is going to be rough. Open an 8 oz. Sprite and down the hatch.

6:50 a.m. BS is 150. That’s good, but I really thought that soda would have taken me over 200. This definitely won’t hold me over until 11 a.m.

8:02 a.m. BS is 90. Well, shit. I’m dropping. I’ll never last until we get to the outpatient center. One, two, three, four big sips of white grape juice. Ahhh. Just one more sip for kicks.

8:31 a.m. BS is 143. Good, the juice worked. Hopefully it will carry me through. Knowing me and fruit, I’m hoping to continue to climb. We leave to take No. 3 to the sitter and No. 2 to school. Take one more sip of juice just for good measure.

8:59 a.m. BS is 173 and we’re on the road to the outpatient center.

9:24 a.m. BS is 133. Still good, but I dropped 40 points in 30 minutes, which isn’t so good. **big sigh**

9:57 a.m. BS is 108. We’re at the outpatient center a full 45 minutes earlier than they told us to be here, but I’m glad. I’m checked in and they know I’m diabetic.

10:25 a.m. BS is 89. OK, time to act. The soda and the juice are making me crash, which is exactly what I feared, Exactly what I knew would happen. I go to the registration desk and talk to the lady who checked me in.

“My sugar’s not low, but I’m going low,” I told her. “I’m 89 now and I was 108 half an hour ago.” She says OK and I walk away. She gets right on the phone and I hear her telling someone my name and my sugar situation. Roughly two minutes later, a nurse calls me back.

Sherrie Perry starts an IV and checks my sugar with blood she got when she started the IV.
“73,” she says, and we look at each other knowingly, both thinking “good catch.”

“They should have had you come in on a day when they do surgery in the mornings,” Sherrie Perry said.

“Oh, I asked for a Thursday because my husband is off on Thursdays,” I said.

Now that you mention it, though, that seems like it would have been a great idea since I am sugar impaired. Since the physicians’ assistant knows I’m diabetic, knew how long I’d have to go without eating and was the one who scheduled the surgery, seems like he would have been the best candidate to have said something like “Gee, I know you asked for a Thursday, but we do early morning surgeries on Tuesdays. Do you think you could come in then?” I don’t even know if they do early morning surgeries, so I could just be getting bent out of shape for nothing.

10:40 a.m. Another nurse comes in with about the biggest syringe I’ve ever seen…a 25 gram syringe filled with 50% dextrose. Sounds like fun, I thought.

“You should just have your hubby come in and kiss you. That would sweeten you up,” she joked.
She slowly squeezes in just half of the solution. It makes my elbow hurt and the nurse covers up my arm with a warm blanket, which immediately makes it feel better.

11:08 a.m. BS is 144. Nice. That worked well. Hopefully that will carry me through. Sigh and relax.

Meanwhile, The Mr. and I talk about our lunch options. Steak N Shake, Ruby Tuesday, Applebee’s and Bob Evans are all top contenders.

11:30 a.m. The Mr. says my face looks flush.

11:33 a.m. BS is 102

11:53 a.m. EKG done. Second IV in.
“Give me my meter so I can check my sugar one more time before I go in,” I tell The Mr.

11:54 a.m. BS is 88. Push the little red button to call Sherrie Perry.
“I’m 88,” I tell her. “Thirty minutes ago I was 102.”

She walks off and I hear her rattling off my numbers to someone. Massive-syringe-nurse comes back. 12 more grams of dextrose. It makes my elbow hurt worse than the first time. The first dose lasted about an hour; this one should get me through the surgery, we all think aloud.

I get some nice sleepy drugs and next thing I know I’m seeing ceiling tiles and saying “I’m waking up.” “Good,” the anesthesiologist tells me, “because we’re done.”

“I want to see it,” I begged.

They shove a specimen container close to my face and I see a blob stuck to the side of the container. Someone hands me my glasses and I get a better look at it. About the size of a pea and about the color of baby flesh—very light pink.

“Can I take a picture? A picture, I want to take a picture. There’s a little digital camera in my bag…”

But they wisk it off before I can have my Kodak moment, and before I know it, I’m talking to Debbie.

12:30 p.m. They wheel me into recovery. Debbie is there taking my vitals.
“Will someone check my sugar, please?” I ask her. I think I asked twice. It was a mild sedative, but I was still super loopy. “I’m just fascinated by modern medicine,” I say to Debbie. “Why did you want to be a nurse?”

12:35 BS is 131. Wonderful. Debbie gets me some peanut butter crackers and a Diet Pepsi. My left hand is incredibly floppy and tingly. My hand and arm up to my elbow are covered in yellow goop that makes my skin feel tight.

“So, I’m thinking no sit down restaurants,” I joke to The Mr. and holding up my arm just a bit.

1:30ish p.m. We finally drive away.
“Food. Now.” I instruct.
“What do you want?” The Mr. asks.
“Something close.”

After a junior Whopper and onion rings, I’m still hungry. (Well, you didn’t eat breakfast, The Mr. says.) On our way out of town, I get a large chocolate cone from DQ.

3:30 p.m. We’re home. I pump and dump and we go after the kids.

6 p.m. Dinner. Hardly any carbs. I had planned to have biscuits (No. 2 chose breakfast for dinner since it was her first day of school), but they didn’t get made.

6:30 p.m. I’m wickedly tired and go rest on the couch.

7:30ish p.m. I do another pump and dump. The baby's not happy about the formula bottle I fixed her (won't take the bottle from Daddy either), but does take some juice from a bottle.

9:13 p.m. I’m ready for bed. Better check my BS. It’s 122.

10 p.m. Take 15 units of Lantus (normally take 20).

6 a.m. Friday morning, fasting is 89.

Wednesday, August 23, 2006

Taking diabetes management into my own hands

I didn’t realize that I had done this until after I had actually done it. I have been managing my diabetes on my own since I was diagnosed essentially. But what I did today I think is the definition of being a patient-advocate. This is sort of minor, but I think it exemplifies how we simply have to be aware that doctors know best, but don't always know me best.

As you’ll see from my last post, I’m having surgery tomorrow. I was nervous enough about managing my sugar level when they initially told me that the surgery likely wouldn’t be until late morning. The physicians’ assistant didn’t seem to know much about diabetes. Example, when I told him that my fasting the morning of my original appointment was 85, he seemed to think that was “low.” I don’t remember his exact words, but he said something to effect of not wanting me to be “that low.” I don’t want to bad mouth the doc on the eve of the event, but 85 is pretty darn good in my book. Seems like it’s almost right smack dab in the middle of exactly where I should be. But anyway, I digress.

So someone from the doctor’s office called today to ask a bunch a questions (which I had already answered, by the way, but why not be thorough) like if I had a family history of cancer or stroke or diabetes and all that stuff that I’ll likely get asked again tomorrow. (But, again, thoroughness is good.) She told me where to park and asked if someone was coming with me and told me about not eating after midnight. And, oh, by the way, the surgery is at noon. Ok, Ok, sounds good, see you tomorrow.

Waaaaaiiiiittttt just a stinkin’ minute. If I don’t eat after midnight, which will actually be not after 10 p.m. because that’s when I go to bed, and the surgery isn’t until noon, that’s more than 12 hours since I’ll have eaten. Even NOT being on insulin I just don’t think that’s such a swell idea. I can’t just not eat.

So I called the doctor’s office back and spoke to one of the physicians’ assistants. She told me that it’s marked on my chart that I can’t eat because “you wouldn’t want to throw up during surgery.” Well, no, I wouldn’t, but I’m not going to be under general anesethesia, I countered, I’ll just have a local and probably some versed. Surely I could eat a piece of toast around 6 a.m. I mean, that’s a full six hours before the surgery. No, she insisted, nothing to eat. But since I can have clear liquids until 6 a.m., I should have 6 oz. to 8 oz. of regular soda or juice before then, she told me.

I’m really, really nervous about going low, I told her. And with soda or juice, I'm nervous about an eventual crash. Well, if you’re feeling “a little weird” you can always come in early and we can put you on an IV. Well, sure, because I could just hop right over…your office is 45 minutes from where I live. **big sigh**

So, the plan is that I’ll probably not have such a sensible dinner (which wasn't the original plan), take half my Lantus tonight, skip the Metformin in the morning, have my Sprite at 6 a.m. (Yuck!), get ready, drop No. 2 off at her first day of preschool (Mom, is it a school day, yet??), and high tail it to the doctor’s office where we’ll likely be about 45 minutes earlier than they told me to be. Hopefully, this will help us get started sooner than noon, which they told me might be likely if I show up early.

The Mr. wants to know if I’m taking him out to lunch afterwards. Ah, yeah, and I’ve already got Steak N Shake on my brain. I'll probably eat one of everything. Can't tell you the last time I went more than a couple of hours without eating.

Friday, August 18, 2006

Random Friday Things

Random thing number one: I’m having minor, out-patient surgery on my hand next Thursday. This might sound totally bizaare, but I’m actually looking forward to it. OK, so I’m not literally looking forward to surgery, but I am looking forward to being rid of this ganglion cyst that’s on my thumb. I discovered it a few months ago. I don’t even remember when or how. My nurse practitioner made the diagnosis and said that if it’s not getting bigger and doesn’t bother me that I don’t have to do anything about it. So that’s what I resigned myself to—not doing anything about it. I mean, really, who looks forward to surgery? Maybe just the dentist from Little Shop of Horrors. Well, now this cyst is constantly in the way. Typically it’s when I grip something, such as a jar or a can, or when I’m driving that it bothers me. It’s not painful, but it’s definitely noticeable and definitely uncomfortable. I really tried to ignore it, but I can’t seem to. Seems weird to me to make a fuss over such a small thing, and, honestly, after I scheduled the surgery I started having second thoughts mainly because I felt like it was such a small thing and I shouldn’t make such a big deal out of it. But then, I remembered how much it bothers me and decided to just get rid of it. Funny side note: I won’t be able to get it wet for a few days because I’ll have stitches, so I told The Mr. this morning that we’ll have to shower together. Teeheehee.

Post-script number one to random thing number one: Trying ever so diligently to keep my blood sugar in optimal working order in preparation for said surgery. Which, by the way, likely won’t be until late morning. Preparing also for wacky blood sugar and severe hunger next Thursday. I want a king-size serving of a chocolate-icing-covered fudgy brownie so bad right now. *sigh*

Post-script number two to random thing number one: Day of surgery is also No. 2’s first day of preschool. I will miss picking her up, but will get to drop her off. Considered postponing the surgery for a week, but then we’re messing with magazine deadlines and that’s an ugly thing to mess with.

Post-script number three to random thing number one: Local anesthesia will likely affect breastmilk. Asking pediatrician today (here’s to hoping I don’t forget) if I need to pump and dump or if the local won’t really affect the milk. Buying formula for the first time in about seven months.

Random thing number two: Jealousy is an evil, evil beast. I have found lately that I’m not as included as I suppose I would like on certain things that go on at work. I’m nosey by nature and I know that I’m not being excluded on purpose necessarily. I guess I’m just disappointed that I’m not as chummy as some others are. On the flip side, though, a former employer once made my life a living hell and I swore that I would never again get involved with office gossip nor office politics. So I suppose not being included is exactly what I get for not wanting to be involved. Still hurts.

Random thing number three: I am just barely under two hours post lunch (around an hour and 45 minutes). I tested slightly early because I’m taking No. 3 to the doctor to have her ears checked out. I was 52. 52! That’s the lowest I’ve ever tested. I am starting to think that I’m developing a slight case of hypo unawareness. I even asked my friendly Diabetic Mommies this week because I tested once at 57 and didn’t even feel low. I mean, I felt like I was getting low, but not like I was already low. So how do I feel right now at 52, you ask? Perfectly normal, thank you. No shakes. None of my normal tell-tale low symptoms. (I just scarfed down a granola bar, in case you’re wondering.) I do have a weird sun spot, though. Sort of like what I have when I’m getting a migraine. Wondering if there’s such a thing as a false low. I mean, I know the meter can misread a high based on not washing hands or something of that nature. I was 98 post breakfast and had a decent snack. Had basically no carbs for lunch, though: pork chop and a big salad. This is what I get for trying to stay in optimal control for Thursday’s surgery.

Post script to random thing number three: The low hit me in the car on the way to the doctor. That’s when I figured it would. *sigh* The baby has an ear infection. Hopefully, this will fix her sleeping problem. Also, the pediatrician said I won’t have to dump the milk, but to double check with the anesthesiologist.

Random thing number four: I thought I had more random things. hmph.

Wednesday, August 09, 2006

Love letters

Courtesy of my six-year-old son. Sometimes folded. Always on my pillow at bedtime.

Friday, August 04, 2006

Signs of Food Addiction

According to recovery experts, you may be at risk if you answer yes to any of these questions.

1. Have you ever wanted to stop eating and found you just couldn't? Yes.
2. Do you think about food or your weight constantly? Yes.
3. Do you find yourself attempting one diet or food plan after another, with no lasting success? No.
4. Do you binge and then "get rid of the binge" through vomiting, exercise, laxatives or other forms of purging? No.
5. Do you eat differently in private than you do in front of other people? No.
6. Has a doctor or family member ever approached you with concern about your eating habits or weight? No.
7. Do you eat large quantities of food at one time (binge)? Yes.
8. Is your weight problem due to your "nibbling" all day long? Yes.
9. Do you eat to escape from your feelings? Yes.
10. Do you eat when you're not hungry? Yes.
11. Have you ever discarded food, only to retrieve and eat it later? No.
12. Do you eat in secret? Yes.
13. Do you fast or severely restrict your food intake? No.
14. Have you ever stolen other people's food? No.
15. Have you ever hidden food to make sure you have "enough"? Yes.
16. Do you feel driven to exercise excessively to control your weight? No.
17. Do you obsessively calculate the calories you've burned against the calories you've eaten? No.
18. Do you frequently feel guilty or ashamed about what you've eaten? Yes.
19. Are you waiting for your life to begin "when you lose the weight"? No.
20. Do you feel hopeless about your relationship with food? Yes.

Tuesday, August 01, 2006

Facing the music, or the longest post ever

My CDE used to tell me I was the poster child for diabetes management. Well, not in so many words, but she did say something to the effect of wishing her other clients were as dedicated to the cause as I was.

This was, of course, when I was pregnant, when I had a specific goal in front of me: no big babyness, no birth defects, no excess amniotic fluid. I seem to be like that with most things. Specific deadline=dedication. Must be why I seem to excel in journalism. And also why I haven’t sat down to write The Great American Novel yet. . . no deadline.

After the baby was born I tried very, very hard to stay on track, but there is about a six to eight week gap in my paper log books because I simply quit testing, quit tracking. I more or less quit diabetes. And since then, no matter how I’ve tried to stay on task for more than a day or two, I revert back to bad habits (read: Taco Bell and king size Twix last week for dinner).

When I saw my endo for the first time, the baby was about four months old. He had good things to say to me and about my management—“What you’re doing isn’t broken,” he said. I was terrified, though, of what my A1C was going to be. It was 5.9. But since I hadn’t had it tested in over a year, I really didn’t know where I was coming from. (I asked my perinatologist somewhere in my third trimester if I ought to have it checked and he said the pregnancy would skew the results so it would be a worthless number.)

I was tempted to cancel my next appointment with my endo based on how poorly I had been managing my disease. I had recently learned that he is considered an expert in our area. When he entered the room I felt oddly like I was in the presence of greatness. And more oddly, I felt inferior—I stumbled over my words, made excuses for my behavior. It was like being in the principal’s office after putting stink bombs in the bathroom. You know it’s wrong, but you do it anyway because it feels good in the moment.

We talked about my eating habits and my meds and my post-meal numbers. And we talked about carbs. Check out our conversation in progress:

“I generally have about 40 to 60 carbs for lunch and dinner, about 30 to 40 for breakfast, and about 15 to 30 for snacks,” I relayed.

“Well, you really don’t need a snack do you?”

“Are you absolutely insane, man? No snack?! Haven’t you read my blog?”

Ok, so I didn’t say the last part, but, frankly, I’d rather take more insulin than give up any food.

After discussing Byetta (which I will likely start when No. 3 has finished nursing) and deciding to start me on Metformin, he sent me to the lab. **big sigh** Needless to say, I knew my A1C would definitely be higher than 5.9. But certainly, I thought, not higher than the 7 I was when I was diagnosed.

Surely, I thought, even the minimal management I was eeking out over the last three months was better than the no management I had pre-diagnosis. The dry, unemotional voice of my endo’s nurse telling me “7.3” proved me wrong. What I hadn’t considered was that my disease had progressed. Something I realized I would have to deal with forever.

I hadn’t really factored the increased insulin resistance into the equation either. I’m actually taking more Lantus now than I was at the end of my pregnancy. When Dr. C wrote the prescription for Metformin he told me to decrease my Lantus from 20 units to 15 units on the first day I took it. Well, after taking the first ½ pill and still getting a 168 after dinner, I kept my night time Lantus at 20 units. And the following night? I increased my Lantus to 23 units after clocking in at a lovely 330 after dinner. I think I’ve narrowed that one down—no more potatoes or milk for me. ((loud weeping sounds at the thought of no milk!))

For-ev-er. Like the kid in The Sandlot. It used to be such a far off thing, and I guess to a certain degree it still is. I mean, really, I remember when 30 seemed old. But the realities of this beast hanging around and being generally unpredictable are starting to set in. I’ve thought about this recently and decided that I likely had somewhat of an extended honeymoon period during my pregnancy. I was extremely diligent and in incredibly tight control (man, I really wish I would have had my A1C tested during my pregnancy) that I think I was still in a fog after the baby was born. I really think I thought that if I just kept on keeping on then things would be fine and dandy and that I would never have to increase the amount of medicine I was taking and never have to deal with any of the funky stuff The Big D hands out on a daily basis. I literally have had to learn things over again. I’m dealing now with all the emotions that I should have dealt with around the time I got pregnant (just two months after being diagnosed).

Dec. 5, 2005, was my first D deadline. That’s where I had to get to have a healthy baby. To have a healthy me? Every day has to be its own deadline.