Knitting and bolus

Things have been going well in the past couple of weeks. I’m nearing a 3 week mark on the bolus and basal regime for my diabetes and my values are definitely doing better. I’ve got a good control on how to use the insulin, I track it really well and I keep in mind that I have insulin on board when I correct my values. I had to up my basal by 2 units but it seems to be doing its thing well now. I’ll have to figure out a good way to rotate injection sites; right now I just look for any red marks and try to inject a cm or two away from that on whichever side of my belly I’m on. I think I’ll divide my abdomen into 4 regions and rotate them clockwise every 2-3 days. (Is this where I’m thankful for a big belly because it means more space?)

have been dealing with a bad depression low. I isolated myself for a week or two and spent all of my time almost exclusively with one person who always helps me feel better. I’m slowly getting back on track now after that episode, so let’s hope things will look up shortly.

During these two weeks I focused on my ten stitch blanket for a while.

tenstitchblanket

I made more progress on it since taking this pic but it’s coming along super well. I finished all the yarn in this colorway and moved on to more scrap yarn. It’s 2×2 feet right about now, and I hope to knit it up to 6.5×6.5 feet at the end.

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No more punishment

Guilt and self-blaming is a theme running rampant among diabetics who do their best to manage their condition and be healthy. It’s hard to ignore, and something that leads to burnout and lack of motivation more quickly than anything else.

Rule #1: Perfection doesn’t exist, so don’t punish yourself for not being perfect even when you strive for it.

Rule #2: We can’t control everything. Sometimes things don’t work out despite having done everything right, that’s life. What matters is how you deal with it. (Kobayashi Maru anyone?)

Rule #3: What matters is that you’re doing your best. It’s unfair to demand more than 100% from yourself.

I admit, some days it’s difficult not to blame myself for poor food choices or lack of exercise. But in the end I also have to remind myself that diabetes doesn’t take a break, and that it’s humanly impossible to manage it tirelessly 24/7 without breaks. Sometimes you just have to breathe and forgive yourself for not being on top of it all the time. Sometimes you have to accept that your values are what they are, and you can only move forward and continue doing your best to manage them. If you can’t undo something that’s already been done, what good will fussing over it do? I’ve never had a bad situation get better because I told myself I’d gone and fucked up, shame on me, how could I have done that – and it’s never going to happen either.

Yes, it’s rough. Yes, we have to be diligent about it. Yes, sometimes we get frustrated. That’s okay, we’re allowed to feel that. The only thing you can do is be kind to yourself about it. Acknowledge your frustration, look back at what you’ve logged and find out how to do better. Can’t do any better? Then do it differently and see if that gets you anywhere. Sometimes we have to change lanes to get to the right place.

My point is, if you’re working hard on managing your diabetes and you’re trying your best, you’re doing amazing already! You’re not going to improve things by being angry with yourself for stumbling. Anger doesn’t help us make better choices, it just makes us linger in a bad place and feed our insecurities. Acknowledge that you’ve been keeping yourself alive and are doing your best before you even think of scolding yourself. Give yourself a compliment of being where you are, because there are many diabetics out there who don’t care about their health and die early deaths because they don’t want to better themselves. Just wanting to be healthy and putting your best foot forward is worthy of praise.

Be kind to yourself. You deserve it. It doesn’t mean you’re not trying hard enough or rewarding failures.

Considering the switch

For the past week or so I’ve been thinking a lot about LADA and its treatment. I touched base with others who share my diagnosis and one thing I heard a couple of times was “I recommend you get off the gliclazide and to start bolusing”.

The more I think about it, the more I feel like this is something I want to try. Gliclazide is a good drug that helps my pancreas produce more insulin. Taking it with carb heavy meals does help to keep tighter control. It also results in hypo sensitivity during exercise because there is no ‘dosage button’ for my organs. I can’t predict what it will do. On low activity days the gliclazide is not always enough.

I am eating to cover my insulin on exercise heavy days and other LADAs have reported that their control is better off the gliclazide and on bolus. Eating to cover insulin is not what a diabetic should do, and it’s a path that’s keeping my obesity going and growing. Injecting less insulin will remove the hypos during high activity days.

At least that’s what I’m hoping. Two more weeks until my doctor is back from her vacation and we can discuss it.

When we slip

Oh boy. I’ll start out with the good news: my friend sent me his used smartphone so that I can replace my dying one (and also play Pokemon GO!, we’re both first generation players who never stopped playing 🙂 ). He included cards of some of my favorite Pokemon with it! The US won’t allow batteries being sent out through the mail in phones, so he had to send it without. I ordered a new battery which should be here first thing tomorrow.

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The bad news: my blood glucose control has been total and utter shit today. Cravings and random hunger pangs, a bag of chips (or crisps for the non-American folks out there), a bag of Dolly Mix and fast food elevated my values all day above 10. Boo Sanne. Booo!! Right now I’m miraculously low at 6.4 which I don’t understand, except maybe it’s thanks to the extra dose of gliclazide after dinner, and having a both carb rich and greasy dinner. I might spike during sleep again. I have a killer headache and foggy brain right now though. Not sure if it’s from riding the highs all day, or because I’m super tired (maybe from riding the damn highs?).

As I’m a type LADA with a 50/50 treatment plan (oral meds + basal insulin – bolus) a lot of the fancy diabetes tracking apps and sheets are either much too detailed for my regime, or don’t allow me to enter my basal units and meds as they’re too simplistic. I have an app on my phone installed that lets me be a bit more flexible about it, although the features I really want (like pretty PDF and XLS reports for a nive, detailed overview) are locked into a premium version that costs €28 a year or so. Money which I unfortunately don’t have. Boo….

I slipped up today, no use in crying over that. I was weak, I fell, tomorrow I get the fuck back up and eat properly as much as my supplies allow until I get next week’s grocery money on Monday. No dolly mix or chips, I’ll go for a nice bike ride if the weather isn’t going to roast me and I’ll focus on chores. I have peaches for those between meals snacks and a cucumber and I will eat them before they go bad. I have 6g carb crackers that pair well with a slice of Gouda and some salted cucumber slices. I have oatmeal and milk for a nice warm bowl of cinnamon oats. Plenty of options to have filling meals!

I will be meticulous about logging my meals at the very least even if I don’t test my values. I want to preserve my supplies for as much as possible until halfway through October.

Riding highs and lows (but mostly lows)

Early this afternoon, I decided to pay my parents a visit. I needed to do some repairs and maintenance on my bike and I didn’t have the tools for the repairs, but my dad does! Before I left I checked my mailbox, and what do I find?

GX0s8bo

The medical bracelet that I ordered arrived! As I am on my bike every time I have to go somewhere, and I can’t detect hypos well while I’m biking, this was something that I really felt I needed. To my understanding, medical personnel is trained to look for medical bracelets and jewelry in emergency situations. There are medications that insulin does not go together with (even if it’s unlikely I’ll ever need those meds, you never know) and if I am passed out from low blood sugar or get into an accident, a bracelet like this would give the EMTs a heads up to give me the proper treatment. I don’t fit the usual profile of a T1D to most people, so this helps a ton.

I wore it on my bike ride to my parents’ and felt really safe. They really liked the way it looked and the quality of the bracelet too. 🙂 It’s comfortable to wear, not rough, and I forgot I was wearing it half the time.

Some well deserved plugging: this bracelet and many others are sold by Cobra Band on Etsy. (I can’t leave a review until next week, so my blog post will have to do until then. 😉 ) The bracelet is handmade from woven paracord, and the metal plate is custom stamped with whatever text you want within their set limits. The quality is very high and the bracelet feels very sturdy. It’s secured with a strap buckle on the bottom and won’t come off until you want it to. Even with sweaty skin during bike rides, the cord doesn’t irritate my skin!

They have more than an excellent customer service, as they are quick to answer any inquiries and reassured me that they add about an inch of give to make the bracelet feel comfortable even on snug measurements. I’m not disappointed! They estimated production to 1-2 weeks, and my bracelet was shipped out on the 2 week mark. It arrived within 5 business days as promised! All in all, a very transparent process with friendly communication and a high quality product.

The best part is that the price is very affordable. I think I paid €12 or €13 for the bracelet plus shipping to the Netherlands (from the UK). Should I ever need a replacement they will be the first shop I’ll hit up!

If you’re diabetic, allergic, have epilepsy or any other conditions where a bracelet like this will be beneficial, I highly recommend you consider this shop and their bracelets. They make ICE (in case of emergency) bracelets for young children too!

With that addressed, I am proud of myself and mildly frustrated by my body today. My parents live 9km away from where I live, and there are many hills between us. Biking is no joke. I don’t mind, except for the last part where I am basically forced up a very steep hill and then have to ride it all the way back down, THEN BACK UP AGAIN because that’s how things just are around here in the Southern parts of the Netherlands. I don’t relate to my country as ‘flat’, that’s for sure! Those fellows up North and West have it easy with their flat roads.

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This added up to about 18km to and from my parents’ (which my phone didn’t track properly, god I wish I could afford a Fitbit) and took me about 1 hour and 45 minutes total. (The purple in the circle is some walking, the red is biking outdoors.) It wasn’t too hard, the hot sun was really the one thing that made it more difficult than it had to be, but overall I was handling it well.

I did have ridiculous low glucose levels throughout the afternoon though. I left my place at about 9.0, and when I got to my parents’ I was down to 5.9. Not too bad, but my levels consistently continue to drop after that kind of exercise, so I was snacking all afternoon to maintain that level. I didn’t manage to get up past 6.0 anymore despite the whole wheat crackers and biscuits with dried fruit, which was frustrating. My mom and I went on a brief grocery shopping trip and I bought more fruit biscuits and gummy candies mix (we call them Tum Tums, but as I understand it these are antacids in other parts of the world – I’m talking about straight up candy!). I shoveled a small handful down my gullet before I left to go back home, biked my ass off and managed not to drop below 5.2 as I walked into the door.

This is a good example of my low carb and I don’t mix. My body doesn’t want to listen! I had a lot of whole foods during the day, moderately low carb (40-60 grams for breakfast, about 30 for lunch) and the results are too many almost lows that I have to hastily fix with sugar bombs and more complex carbs just so I can stay on top of it. Slow (fiber heavy) carbs are included but they don’t prevent the lows, I’ve noticed.

That said, I did end up burning 800 calories on my bike rides today AND I avoided hypos throughout it all. Can I get a HELL YEAH? I may had to pull some dirty shots with the candy to stay on top, but I did it! 🙂 I’m waiting for my timer to go off to test my post meal values for my day curve, but I don’t expect anything terrible.