Of pain and exhaustion

My herniated disc is at it again. I am walking and sitting, but the pain is constantly present. The nerve to my right leg got pinched badly this time around, leaving it in a constant state of ‘bad leg cramps’ that have begun to feel like fire. My toes feel partially numb and my leg gives out every now and then.

This would be manageable, I think I built up a massive pain tolerance over the past 4 years dealing with this crap, if it wasn’t for the accompanying exhaustion that the pain brings. Everything you do suddenly requires so much more effort. The pain keeps your body in overdrive throughout the day and even the night. Some nights I spend 5 minutes figuring out the best way to get out of bed without too much pain (or god forbid, collapsing on my bedroom floor) just to go pee.

No fun. Add to that the dropping of the outdoors temperatures, my period finally having ended, and my glucose values climbing a little because of it. I was doing so well on my first week of insulin, but as I suspected this was partially due to the heat wave and my period partying together like there was no tomorrow. My day curves this week are up by 2 mmol/L on average compared to last week, which kind of sucks. I exceeded 10 mmol/L twice which disappointed me a bit, but I have to admit that overall, my numbers are still in the green. The peaks might be a bit of a concern, but I’m getting in touch with my doctor on Friday, when she’s back in the office, to discuss a couple of details with her. I’m definitely not in any sort of red zone right now though, which is good!

Injections are still relatively painless. (Maybe that’s because of my high pain tolerance?) I’ve noticed that if the needle hurts me when I lightly poke the skin without piercing it, the whole injection will hurt and burn. If I carefully poke around until I find a spot that doesn’t hurt, the whole injection is as good as painless, save for a very, very, very minor burning sensation sometimes. I’m not sure why this is, but maybe my belly’s stretchmarks play a role in this? Either way, if I do have to end up bolusing, I don’t expect it to be a big deal if I can get another pen. I’m surprised at how easy it all really is when the mystery is gone.

I want to pick up my two currently pending knitting projects, but I can’t sit still long enough to get much done. My summer cardigan is dragging on and summer will be over before I finish it. It makes me want to take out the sleeve and start over in a plain stockinette stitch rather than the diagonal openwork I have right now, so that I can turn it into a winter cardi. But I’ve also come so far, and I’m really close to finishing! I still have to rip out the cabled socks I was working on and start over, which I’ve been aching to do on and off. I just can’t get my head right for it.

So instead of doing things I should be doing, I’m watching the first Pokemon season (Indigo League) and playing my Pokemon XYORAS games. I’d be up and about playing Pokemon Go like nobody’s business if I had a phone that supports it, but my Galaxy S3 can’t handle the game. My friend has a spare phone he’s sending out to me soon, so fingers crossed!

While we’re here, I want to share with your the deliciousness of my dinner the past two days. I threw fancy out the window and went back to good old Dutch basics.

My glucose values were perfectly in range after these, which is fantastic. 🙂

Well that was exciting

The hype is real. I’ve been stuck in a bad panic attack loop for over a week now. Many factors contribute: it’s hot as balls, I’m menstruating, my life changed overnight because I started insulin.

All these things combined more or less got me so tense and nervous that my body acted up terribly. Shortness of breath, pain on the chest, dizziness, fear of dying. All very fun.

I think the newness of taking insulin and the rising nervosity towards each shot really set my attacks off too. The closer 8pm got, the more I hated waiting. I just wanted to get it over with! It’s the waiting that I hate so much.

I’m on day 3 of my shots and I have to say they’re incredibly uneventful and boring. (Thank god for my adorable insulin pen case to make it somewhat interesting!) I don’t feel the needle at all, and I make sure to inject one unit at a time as I press the button until I hit 0. I haven’t bruised yet nor do I feel any pain. No burning sensations either. I’m slowly rotating around my bellybutton so I expect no soreness from injection sites as they have time to heal.

My glucose values are killer too! I’m logging a full curve tomorrow and Wednesday, but I have a feeling they will be excellent. So far all my tests have been within my acceptable range even. 🙂 I’m noticing the importance of proper snacks between meals though. I was declining towards a hypo yesterday around 4pm after last eating around 11:30am. It used to not be an issue, but I dropped to 4.6 and got shaky, sweaty and felt bad overall. (Seems my hypo range is a little higher than the usual 3.9) I had one slice of bread with some sweet topping and by dinner time I was absolutely fine.

So I got this injecting thing down and I think I’ll be fine on my current meds for a while. We’ll see! The weather is hot and it is notorious for making my bg low, and so is my menstruation. I might see a change when the weather cools down and I’m 2 weeks down the road.

One thing I DO know is that despite my panic attacks, I do feel much better. I’m more alert and less tired as early as the first morning after my first shot. Two thumbs up!

The first shot is in!

Whoo boy, today was a ridiculously stressful day for me. I woke up feeling anxious as all hell and wanting to not go out because of what I had to do. But I did it!

This morning I set out to my doctor’s office and was shown how to use the insulin pen. At first I got to practice on a little box with a ‘skin’ on top that emulates what it feels like to insert the needle. The pen is filled with water, not real insulin, for practicing purposes. That went well. Then I got to put on a new clean needle and insert it without injecting anything. It was as good as painless to my surprise! We talked a little more and then I was on my way to group. (To be clear, I did not do my injection at that point yet.)

I spent the better part of the afternoon there. After lunch my glucose levels were definitely in the okay range, likely thanks to the ridiculous heat we’re experiencing right now. Being stuck in a heat weave seems to be the only thing keeping my values down, geeshe. (I guess that’s kind of a good thing when your GL is consistently too high though!) I left to go home without snacking (good going, me) and was heading towards a hypo once I’d come home from my cycling adventure.

Had a snack to bump my GL back up, ordered dinner (Greek food whoop!) and I waited for 8pm to draw near. That’s the time I’ve decided to do my daily basal injections. Deep breaths. I was in full on adrenaline rush mode by the time that time hit. My heart raced, my hands felt unsteady, I was dizzy. I mean, it might be the heat, but that feeling in my stomach is definitely a sign of being too nervous.

I prepped the insulin pen like I’d done earlier that day. I remembered the instructions. I set the dose. I squirted 3 units out of the needle to ensure the pen was functioning. I inserted the needle and immediately felt a burn that I didn’t feel this morning. Oh, right, I just squirted some insulin out of this needle so that’s probably why it’s already stinging. Okay, so far so good. Once in it didn’t hurt. I adjusted my grip on the pen four times before very slowly pushing down the button to inject the insulin.

There was some very mild burning and stinging, but nothing I can describe as pain. Kind of like putting some icy hot on my tummy, you know? I held down the button and counted to 10. Toujeo lets you count to 5, but I want to be double sure that I’m doing this right. Then I started pulling out the needle without releasing the button, stopped halfway, released and pulled it out all the way.

That was it. I was shaking so badly from the ridiculous tension I’d built up for myself over what turned out to be a minor inconvenience at best. It wasn’t painful. Yes, I felt it, but it’s nothing compared to the back pain I endure every day. Once my adrenaline had crashed I got incredibly dizzy and short of breath. Great that Toujeo’s allergic reactions are at least 50% consistent with panic attack symptoms! I was Skyping with a friend who helped me feel calmer about it because it was very obviously just my anxiety kicking me in the balls, ugh. I’ve been tense for a week now and having panic attacks, is it any wonder I’m feeling like crap after riding an adrenaline high for two hours?

I checked my glucose levels again, 2 hours after dinner: 5.3 mmol/L. Okay, that’s pretty low but nothing that I can’t explain: my greek food was greasy, I know this delays carb absorption. And I definitely did not have too few carbs. I went to do my thing, melting in the heat inside my apartment; the building retains heat very well and we need some rain to help it cool off. An hour later I test again and I’m going upwards to 6.6 mmol/L. Good! It’s climbing, that’s great.

As it’s a basal injection once a day, I don’t have to worry too much. Toujeo is designed to reduce a hypo after injection. I’m going to have a snack before bed just to be sure, but I’m noting down two curve days for my doctor sometime these coming 7 days. I’m very tired, but proud I overcame my panic attack and did it. I’m proud that I’ve started a journey to a better health and a better life!

Bonus: my doctor also had this ADORABLE pen case for my insulin. My glucometer also looks like a 2000’s MP3 player lol.

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“Why are you eating candy? Aren’t you diabetic?”

I was minding my own business as usual. My sugar is pretty low at 5.3 and I’m not eating dinner for another 1-2 hours, so I pop a lollipop into my mouth (a Tootsie pop no less, I got some ‘Murican candy!) and go take out the trash. As soon as my neighbor spots me with the lollipop, he stops me and asks with great concern: “Why are you eating candy. Aren’t you diabetic?”

I stare at him for a couple of seconds, firstly wondering why he’s not minding his own damn business. Then I wonder why he never retains any information as I explained this to him before, but all the alcohol and pot he consumes killed off large portions of his brain. So I sigh, put down my trash and go over this again.

“As a diabetic my body doesn’t handle insulin the way healthy people do. When I’m active and take my meds properly, sometimes my bloodsugar goes too low. If I don’t eat within the next hour of that happening, I eat some candy to tide me over until I can enjoy regular food.”

He gives me this braindead stare as per usual, nods and says “That’s good then.”

Besides the frustration of having a neighbor who’s as stupid as this, I frequently realize people know a lot of conditions, but they have absolutely zero knowledge on what they mean. I’m a diabetic and I can’t eat candy freely whenever I want to, but there are certainly moments where I can enjoy it – whether you’re a type 1 or a type 2 or a type 1.5, it’s not off limits at all.

My biggest issue is people not wanting to understand type 1.5 exists though. It’s not as uncommon as is often assumed, but a general consensus among diabetics is that type 2’s are often misdiagnosed and are actually type 1.5’s.

So… what IS type 1.5 diabetes?

It’s also known as LADA, or Latent Auto-immune Diabetes in Adults. In layman’s terms it’s a slow form of type 1 that starts in adulthood as opposed to childhood, and insulin dependency may not occur for many years after the diagnosis. The initial symptoms are often similar to type 2 diabetes, but blood work shows that the body fights the insulin producing beta-cells in the pancreas and is very slowly killing them. Still, not every doctor acknowledges 1.5, and not every doctor tests for it. I was very lucky that my doctor told me, “You’re too young for a full blown type 2 diabetes like this, but also too old for type 1. Chances are you’re a type 1.5, so let’s get some blood work done to confirm!” Despite being overweight and it being easy to blame on my lifestyle, my doctor made sure of it because not everything added up, and she’s awesome for that!

Initially oral medication can help. Metformin for example helps to increase insulin sensitivity in the body and lower the glucose output of the liver. Gliclazide helps the existing beta-cells to produce more insulin to make up for the loss of the other beta cells. This combination has worked wonders for me and my bloodsugar is now largely under control. However, when we have to keep increasing the dosages, possibly maxing them out, it is time for me to switch to insulin because the oral medication is no longer able to do what is needed. This could be 6 years from now, or 6 months – it differs greatly per person, but it’s happening. Some doctors choose to treat this with insulin immediately, but it depends on the person. I’m personally in favor of trying meds first, because the longer your pancreas can do this on its own, the better! But it’s important to talk with your doctor about it no matter what.

This is also why many of us believe a whole lot of type 2’s are misdiagnosed, especially if they’re doing everything right. They eat proper diets, they exercise, they lose weight, they take their medication as prescribed and go to their checkups frequently. Then one day they’re told they have to go on insulin because they’re no longer making any insulin themselves, the meds no longer work and something didn’t work out for them. Besides it making them feel like crap as if all their efforts didn’t matter, following the wrong treatment plan can also have negative consequences on one’s health.

There are still people who try to deny the existence of type 1.5 and this is baffling and worrisome. It’s real. I have the blood work to prove that my diabetes is the auto-immune kind, not type 2. But I’m also on meds, not insulin, and it’s working for the time being. Some refer to this as the ‘honeymoon phase’ of type 1, but I don’t believe it’s the same thing at all.

Either way, if you’re a type 2 and you’re doing everything right and it’s still not working, consider asking your doctor for blood work to test for the antibodies. It may drastically alter the course of your condition and treatment plan – for the better!

The Living Pin Cushion

It’s been a while. After being banished to my bed with a renewed herniated disc, I just haven’t had the energy or will power to blog. With the aid of morphine and the excellent care of my wonderful parents I’m making a recovery however. I’m saving up to get surgery on my back, but that may take a while.

I finally got definitive results from my physician on my blood test. I’m “somewhere between type 1 and type 2 diabetic”, which is oodles of fun. I believe this classifies me as a type 1.5, or LADA, or whatever you want to call it. Our first goal is to go with oral medication. I’ve been on metformin for a month or so now without any results, so my doctor also prescribed me gliclazide. We’re increasing the dosages for both medications to the maximum and hopefully this will bring down my glucose levels back within normal range. If it doesn’t, then my only alternative is becoming insulin dependent.

My dad is a type 2 diabetic and purchased a glucometer a while ago. He used it a couple of times, but he gets his regular checkups at the office. I borrowed it from him when I couldn’t make my appointments to check my levels due to my hernia, now he told me I could keep it. (Before anyone pitches in, I know that you’re not supposed to do this; rest assured that I cleaned the tools and that I’m not worried about an infection. This stuff is expensive, no sense in throwing it out. He’s my dad after all!) I ordered new test strips and lancets as his ran out that should come in Tuesday or so.

Testing my own blood is annoying but manageable. Chances are that down the road insulin dependence will happen regardless of the medication, so I’m preparing myself for that. I’m not sure how well I’ll do, but I keep telling myself there are plenty of people who overcame their fears and made this a manageable disease. I can too.

Are you a diabetic or know someone who is? What are your experiences with the process?