Nervous visit
I went to my appointment yesterday and came out feeling nervous. My doctor and I went over my meter print out and I guess I'm having too many lows. Everything else is in line but he's worried, since I'm on such a small amount of insulin, that I could go too low quite easily. He pointed out some lows on the chart and asked if I had experienced any seizures with them. Um, no. You would have heard from me if I had. It's strange to me to think about all these really important things that I just have no idea about, or haven't even had time to think about over the past year. I asked how low you having to be to have a seizure. I'm thinking in the 30s or lower. He said 50. Oh.
In the past year I have been in the 40's two times. I've been in the 50s and 60's a bunch (mostly 60s though). Looking back at this I freaked myself out. I started doubting how well I was actually doing this. Do my roommates really know what to do if I have a low that I can't figure out how to fix on my own? Does my boss know what to do if she walks into my office and I'm having a seizure? What happens when I start noticing the lows less and less? I usually catch them pretty fast now, but the more lows I have the less I notice them.
I guess that was the biggest thing from the appointment, although we also talked about how I can loose some weight. I've been at a steady 150 for the past year, gaining weight back and then some after being diagnosed. I work out 3-4 times a week, cardio and weight training. He said that I'm probably 'feeding' my insulin since I tend to have lows after working out. So he said I should look into a lower carbohydrate diet. South Beach diet to be exact. I can't fathom doing with with a super low carbohydrate diet but I've heard that the South Beach diet is more reasonable and healthy. I don't know much about it. My initial problem is that I really like lots of fruit (oranges! bananas!) and bread/pasta (I'm still eating my homemade bread... It's still so good!). I have started buying the whole grain pasta which I think is good and very filling with a smaller amount. It is just annoying that I have really healthy eating habits (or I think I do) and workout regularly but can't drop this bit of excess weight. ggrrrr.
I had to go back to the lab today to have some blood taken for some tests. They are going to check my 'c-peptide' (no idea if that's spelled right, or what it really means). My doctor said it will help them determine how well my beta cells are still working. To test that I had to have a high blood sugar for some reason. He just recommended eating my regular breakfast and not taking any insulin. That terrified me so I took half the normal amount. By the time I got to the lab I was feeling it. I checked and was at 353. They took the blood and I corrected immediately. I feel strange now but am at 98 so that's good. I'll get the tests back in a week or so.
That's about it for now. I need to get back to work and maybe go for a walk over lunch since it's finally warming up here. I love the midwest. :)
posted by Tekakwitha @ 8:45 AM
8 comments
8 Comments:
Tekakwitha,
Yeah, it is really scary when you realize that you don't have to be extremely low to have a seizure. Joseph was 50 just yesterday (we've been trying to get the highs under control, and it backfired a bit).
Anyhow, I would imagine your doc is checking your c-peptide level to determine how much you may still be honeymooning. Since you went on the pump pretty quickly after diagnosis, it would make sense that some beta cell function was preserved. That may be why you've been having so many lows...
And the need to have a high blood sugar during the test would be so your doc can gauge how much insulin is secreted naturally from your pancreas in response to the high. Unlike insulin that is injected from outside, insulin coming from your pancreas is produced as a large molecule that is then broken into two parts-- insulin and c-peptides. Measuring the c-peptides simply gauges what insulin is coming from your body and not your pump.
Thanks Sandra. Do you (or anyone else) have any recommendations on good books about type 1? There's so much that I don't know anything about (c-peptide...) and now that I have had a year to just get used to the disease I'd like to go into more detail learning about it.
The Joslin Guide to Diabetes is a good resource for all things technical. As is the Joslin website, which is www.joslin.org.
As far as the emotional side of this goes, there is a very evocative book by Lisa Roney, titled "Sweet Invisible Body: Reflections on a Life with Diabetes." This book, without a doubt, confirmed for me that this disease is 50% physiological and 50% psychological. You need to be mentally Game On as consistantly as possible in order to survive. I strongly suggest reading this one. No matter how long you've been diabetic, you will find pieces of yourself in Lisa Roney's paragraphs. And there is significant comfort in that.
- Kerri.
Some of the concerns you are having -- especially going low when exercising and having problem with weight -- are what made me go to the pump.
It would be worth looking into.
I have a question about seizures: what exactly happens when you have one? I've had Type I diabetes for 27 yrs and my blood sugar has been so low (in the 30's) that I crashed my car but don't remember getting into it, putting on my seat belt, starting it, and driving towards the freeway. I've also been so low that I was making goofy noises and tried to bite my mom when she attempted to give me some OJ --I don't remember that either -- and the paramedics had to come. As far as I know, I've never had a seizure, and I don't know any diabetics who have. I was curious what a seizure was like and what happened when you had one. Thanks!
Kerri, I'll be sure to check out Joslin's site as well as that book. Thanks for the recommendations.
Kathleen - Sorry, I may have failed to mention that I am on the pump. They put me on about 1 month after being diagnosed. My problem is that I'm not taking any basal insulin from 8am to 8pm so I can't turn it down during the day at all. And for some strange reason I always drop in the afternoon around 3-5 even though I'm not taking any basal insulin. so I'm forced to eat/drink before jogging at 5:30. Luckily I'm still at a healthy weight (right on the edge though!) so if I can at least maintain my current weight, I'll be alright.
Thanks for all your comments and suggestion!
Patty - Sorry, I've never had a seizure due to lows so I can't really explain it!
Oh dear. I didn't know either that you could have a seizure at 50. I've been in the 30s twice and 50s several times in the six months since I was diagnosed. T, I completely empathize with the fear of becoming unable to take care of a low. I live by myself, so except for the times when I visit my boyfriend in NY I don't have anyone around to give me glucagon if I need it. I'm fortunate to be experiencing WAY fewer lows since I began pumping.
Have you sat down with your roomies and talked through the glucagon procedure with them? It's possible to do this in a fairly lighthearted way, especially if you're open with them about other aspects of your diabetes. If you haven't had the conversation it might give you some peace of mind.
Just FYI, my endo checks my c-peptide in a different way. It's a fasting blood test, so I don't have to eat and then skip insulin. But that may not be as accurate as the test you had; I imagine it isn't.
Books: I like the Joslin site too. I haven't found a thorough, medically reliable nonfiction book devoted to type 1. They all try to take on both types of diabetes. I've found it fruitful to compare the ADA's big guide (forget title, will find if you need it) with Diabetes for Dummies, which is written by an endo and espouses slightly different dietary recommendations. But I take it all with several grains of salt. The Dummies guy, for example, isn't a proponent of pumping, which strikes me as INSANE.
W/r/t the low-carb diets, my reading has indicated that there are two major camps on this issue. The big, medical establishment camp, including the ADA and most researchers, do not feel a low-carb regimen is healthy. Then there's the smaller, antiestablishment camp of numerous individual diabetics + figures such as Dr. Richard Bernstein (he's a type 1 who has several books detailing a VERY rigorous low-carb regimen that bans every food that appreciably raises blook sugar). This camp swears by low carb as the path to the improved health they couldn't find any other way. To me it is very, very hard to discern which camp, if either, is right. But I do share your understanding that South Beach is less severe than some of the other plans. Let us know if you decide to give it a try...
Hi Tekakwitha. I was looking for hypertension remedies related information and came across your blog. Very good reading! I have a hypertension remedies site. It covers everything about diabetes care, complications, treatment and insulin. You'll find it very informative. Check it out when you can :)
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