Just a quick update… Got a call from a nurse at the endo’s office.

My A1c is 8.1. While this high, it was not unexpected. It shows regression in my control – last time I was above 8.0 was Dec ’09 (8.2), and I have since worked hard to pull that down, the most recent test being 7.6.

And now to hop back on that bandwagon and remember to bolus! Since that seriously was what got me down to 7.6, and potentially lower had I not had my life completely overturned

(All other tests, kidney & liver especially, were normal. Phew! Will have to wait for the lab result paperwork to come in the mail, and then I can see if my LDL and HDL are still insanely reversed )

So… update…

I met my endocrinologist yesterday for the first time. I’m going to my best to postpone judgment, but I think I’ll soon be on the market for a new one. I really wish I knew people up here who could give me a good recommendation for an endo…. I miss the guy I saw in San Diego. Is it too much to ask for someone who is knowledgeable in insulin pumps, CGM’s, *and* will take the time to sit down, figure everything out with you, and from the get-go work on motivation & habits? Ugh. This new endo is good and knowledgeable, but there was no sitting down and discussing habits, motivators, working on getting better…

Will postpone judgment!

And I have an appointment to see a RD, CDE (dietitian who is a diabetes educator) for next month. This is to actually help with the pump & CGM settings. I’m interested to see what being an RD, CDE is like from the patient end, since this is what I want to do for a living! Let’s see if I can pick up some tips

As for the objectives I’d set for myself –
Yesterday and part of today I had a great day with the BGs. It’s amazing what actually paying attention and being diligent will do. I will say that this is the result of my having met with the endo yesterday morning.

Only issue is that I ate, I think, 5 donut holes after working out. Damn, they were good! But then I didn’t bolus, like an idiot. So here I am fighting the high BG. Blech.

I’ve also been working on temporarily changing my basal rates when needed. For instance, if my BG is high after eating breakfast (damn raisin bran…) I’ll temporarily increase my basal rate to try to fight the craziness. And then when it seems I might go low over night or while working out, I’ll decrease the basal rates in order to try to keep from having to actually correct with food. It actually worked quite nicely sunday night / monday morning! Went from ~70mg/dL to ~150mg/dL in a couple of hours from temporarily stopping the basal rate for an hour. Sweet!

Now to remember to bolus before dinner each night. Between this and my seemingly-incorrect basal rates, getting these correct should really help. Yay for getting some clarity.

Hope that was clear for everyone else

So I know it’s been, um three times the length of time I said it would, but it counts that I’m here, right? And thanks Richard

So my update.

I actually just got home from the GP’s office – had my initial visit with her, to set up scripts, referral to an endocrinologist, referral for this blasted apparently sprained left hip flexor. Yay for sprained hip flexors. Ugh.

She was fortunately very enthusiastic about the endo that she referred me to – I’ll see in about 3 weeks how that goes. I’m really hoping this doctor will be someone who sits and talks *with* me, as opposed to talking *to* me. I need motivation and help, not information. I already know a lot

On the objectives to move me towards the goal of an A1c of 7.0, I have had some success. But only some. Here goes:
* Bolusing 10 minutes before: I have NOT been good about this. Have gotten better – less missed meals, I think. But proper habits definitely need to be made.
* Bolusing some, then following up: I’ve done some of this, and while I don’t know if it actually worked I have actually done it!! This will be an ongoing thing to remember…
* Correct low BG correction: I have made progress on this. I think I need to stop using the most awesome Welch’s fruit snacks packages, though, They are very very tasty, but they tend to cause havoc (unless I’m working out – then they’re amazing). The little snack bags are 18 or 19 grams of carbs, and that’s just too much. Need to be at 15grams or so. Just read how some use jelly beans, since they have 1gram of carbohydrate per bean, so 15 beans is easy to figure out. My other trick is to take 8 sips of juice – not 7, not 9… 8. That way it’s a conscious attempt at control.
* Correct high BG correction: Still having issues with this. This weekend was horrible for me. Part of it was just plain forgetting to bolus (see above objective!). This gets away from me, and before I know, I cruisin’ way high for hours. Sucks. Big time.

And I made mention of exercise last time… ironically enough, this is what I’ve had the most success at! In the last three weeks, I have been able to work out at least once, if not twice, per week. This on top of the normal (for Seattle, not San Diego) amount of walking around that I’ve done. My arms and legs are starting to show some musculature (but only some… to me…)! Hurray!

And this last thing… I mentioned belly dancing before. And what do you know?! A local studio put out a 50% off 6-week class on Groupon about two weeks ago! SO EXCITED to get back in!!! (Side note related to the sprained hip flexor… apparently I *still* have impressive hip flexibility and I’m guessin that’s because of the bellydancing!)

***
So based on all of that, here’s what I intend to do for this week:

- workout at least once (crazy amount of school work – one time will be a success!)
- make a concerted effort of bolus 10 mins before dinner.

That’s it. Slow and easy

***
Again, thank you Richard for kicking me in rear about not having posted lately! I appreciate the friendly reminder

So it’s been a very very long time since I’ve written here. I’ve wanted to blog, but haven’t known what to say.

So here’s my idea on how to get started…

My new year’s GOAL (NOT resolution) is to drop my A1c. (What is A1c, you ask? It measures the amount of glucose crystallized to the blood cells, and since blood cells have a half-life of 3 months, this measures the average blood sugar over 3 months!) My last A1c was 7.6. This is equivalent to an average blood sugar of ~165mg/dL, I think? But, BUT, my first few months here in Seattle have been horrible for my diabetes. I have had to deal with eating more, needing less insulin, more exercise, more stress…. Oh and a huge upset in my habits, as I moved and am completely doing something different! So I expect my next A1c to be brutal – above of 8.0 (avg 180mg/dL).

Where I’d like my A1c to be – I would be very very pleased with myself if I could get into and maintain the necessary habits to get me to an A1c of 7.0 (avg ~154mg/dL) by the end of the year.

But since this is a goal and not a resolution, I must actually write out how I’m going to achieve this idea of mine. So here are my ideas:

* Bolus for food at least 10 mins before eating. 20 minutes is ideal, but 10 minutes is better than nothing.
* When pre-bolusing for unknown amounts of food, at least bolus for SOME, rather than waiting or giving too much. Both cause issues – either high blood sugars from waiting, or being stuffed but needing to eat more because I still have unaccounted-for insulin on board….
* Correct for low-blood sugars how I’m supposed to. Start with 15gm of carbs, wait 10-15 minutes, check BG again, if still low, 15 more grams of carbs. Then wait. Then eat some protein, NOT carbs. Then wait another 30 mins… if stable, can now eat some carbs. Joy.
* Correct for high-blood sugars how I’m supposed to. While this isn’t all that hard (calculate how much insulin I need based on my pre-set ratio), this is complicated by the emotional side… not wanting to deal with it, not wanting to see it, just not wanting it, period.

Ideally, I would say I would add some exercise in this equation, too. And I completely mean to. However, I’ve made that resolution to myself, and it’s never happened. But I am definitely going to get back into bellydancing (YAY!) and am going to try to make it to the slightly-off-campus campus gym for both workouts and classes.

Thanks for listening! I will do my best to update, say, every Saturday on how things are going

So not only did I get two of my eight (8!) Dietetic Internship applications ready to go today, but I learned that I’m going to be a Nutrition Apprentice for an awesome new website! The website is FOODPICKER.org and it’s designed to help people with diabetes, which makes it even better for me!

Almost done with school for the semester! One more test and one more big project (mid-production version of my portfolio), both on wednesday. w00t. Between now and Wed, need to redo my resume (ugh, an objective?!), write a brief biosketch (a what?!), and spruce up a professional goals sheet. And can’t forget three or four one-page reflections on nutrition classes I’ve taken, both this semester and in the past. I’m excited…… < /sarcasm>
Also, finally got a judgment on a car that’s been here in the shop for a year and a half!!! The car has been here since June, and repair completed since August or 2007!! Just won our small claims suit against the owner Now onto the lien sale process. Blargh Not looking forward to the lien sale process, but at least we can move on with this hassle!
Think I’ll try coloring my hair without coloring my walls, too, this time! Long weekend coming up

So on my morning troll of my daily blogs, JD of Get Rich Slowly had a CEO of a small company write out his 10 Essential Steps to Take Before You’re Laid Off.
This caught me as extremely timely because a friend of mine was just let go, and another is looking at job insecurity. In fact, I’m taking steps since reading this, despite my feeling completely secure in my job. This blog came out of reading this entry, and also of hearing multiple Nutrition professionals emphasize just how important it is to start getting my name out there, cached by Google, so that when I start putting my resume out, I have an internet background. A solid, professional, clean background. One missing possible other cached entries, such as possibly being quoted from the pepband newsletter *cough*, or anything similar

Look at me! I’ve joined the blogging world at last!

I’m gonna try to post as often as possible, and give the great stories from my days, between customers and stupid students

w00t!