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.

When you can’t find one that fits, make your own

After checking out one logging sheet and book after the other, I finally came to the conclusion there is nothing out there suitable for what I want.

I need a flexible sheet that I can edit with more or less entries, add new columns to when the time calls for it, make easy to read graphs with, and all without the fuss of having to lug through a ridiculously stuffed sheet or an app with a nightmarish UI that makes my head spin. Simple, clean and flexible is what I want, but often struggle to get.

No more! After spending most of my Saturday morning playing around and making something useful, I present my personalized Food & Glucose Sheet.

The “Food” and “Notes” columns expand and wrap text so you can write as much as you like without messing anything up. As I only take insulin once a day, I feel comfortable using the notes section to log it and my oral meds, but if I switch to bolus I can easily add a new column to track my insulin usage there. (You could too if you want this sheet.) New rows can be added freely, even between existing entries, without disrupting any of the data (as long as the time stamps make sense of course). If you log a hyper (10+ mmol/L) or a hypo (-4mmol/L), the entries will be color coded for easy spotting when reviewing later on.

You can edit your hyper/hypo ranges in the Conditional Formatting for the Glucose columns if your targets differ.

The tables will automatically show your total carb consumption for the day as well as the average of your glucose readings. There is room to log your weight every day as well. The graphs are optional but can be copied and modified next to a new day table. While this sheet is not composed of minimalist data, it can be printed quite nicely if the graphs are copied at the same size for each day. I recommend these settings to save as PDF and to then print the PDF (or email it to your healthcare team, save some trees!):

exporttopdfThe sheet is versatile. Values don’t get messed up if you don’t use a column for the day. Some days I will use this only to track my diet, other days I will track everything.

Some basic knowledge of Excel / Google Sheets is required if you want to make edits. This is not a one size fits all and it’s not really meant to be. Adding rows in the middle of a day is sometimes necessary. Some days you might test 10 times and need to record every step. This sheet will accommodate you plenty if you know how to use the basic functions. Graphs are a good visual tool, but you need to know how to select the ranges (time + glucose) to make it work. The sheet is optimized for mmol/L but you can easily change it to mg/dl through some basic editing.

If you grabbed your own copy and need some help, let me know! If it’s not too much work I will happily help you make some changes. 🙂

Did you find this useful? What’s your favorite way to track your dietary intake and glucose values?

It’s hypo season!

Goodness body, what are you doing?

I was one hour late with dinner yesterday. Just one lousy hour. I made some oven fries with a Dutch snack because that’s what I do on Thursdays. Small portions, nothing crazy. Fifteen minutes after I eat and want to grab a glass of water, my heart started beating fast, I started to feel warm and got sweaty, and generally felt unwell. “It can’t be!” I thought to myself, whipping out my glucometer and going stabby stabby on my fingertip. But it was so. 3.6mmol/L and the knowledge that my dinner, despite being oven cooked, was greasy and would need about 2-3 hours to really have any effect, I shoved a ‘hagelslag’ sandwich down my gullet. (It’s a special kind of chocolate sprinkle for bread, made by the Dutch.)

It took a long time before my symptoms settled down, but knowing I had more than enough carbs in my system to even this out it was a matter of time, not panic. I checked myself regularly and didn’t peak past 9.0, which was a little weird to me as I expected it to be higher.

This morning rolled around, I had a peanutbutter sandwich, got a call from my doctor. She noted down my day curves which were excellent except for some of the post meal peaks. I’m going to increase my gliclazide dosage around dinner time for moments where I test too high or start with a high value to help increase my body’s own insulin production, and we’ll see how that works out in the next 3 weeks. If it helps, great! If not, we’ll start boluses.

Then I went to group and had lunch there. I felt unusually ravenous and had 3-4 crackers with cheese, a slice of whole wheat toast with gouda and salami, and another hageslag sandwich. I tested 2 hours after and was perfectly okay at 9.6. Just a smidgen high, but not high enough to fuss about. I still had to bike home after all.

That’s what I did, stopping by at the grocery store on my way home. I’m having Turkish pizza wraps today, which are about half the carbs of a normal pizza and five times more raw, fresh veggies (or as much as you can force onto it without everything falling out). Yummy! Biked home, stored my bike in my basement storage unit, walked up to the 3rd floor to my apartment, then repeated this journey as I forgot one of my bags in the basement, and I sat down at my desk… with another bloody hypo.

I didn’t even notice I had dropped to 3.1. This is why I’m so worried about biking sometimes. I can’t tell when it’s happening until it’s almost too late and I get dizzy and lose control over my body. I shoved a whole KitKat and a cheese bun down my gullet, and barely got high enough to notice a difference. Almost an hour later it was only up to 4.8, which was 30 minutes ago, so I had another bun. I’m desperate here!

While this will probably be good for my A1C results in October…. I’d rather not go this low all the time. I don’t know what’s causing this. I’m eating well, my exercise is unchanged from the past 3 weeks, so what gives body? What’s this mucking about and screwing with my values, making me eat foods I’ve been working hard on cutting down on?

I’m going to have another late dinner tonight at 8pm because of how much food I’ve had just to fix this damn low, which hardly counts as a nutritious dinner. These are the kind of days that can make you desperate and frustrated with this illness, but you know what? I’m in control, even if that is limited to fixing a drop. I’m managing this. I’m doing fantastic. Thumbs up to me!

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. 🙂

Checking in

How is everyone doing? I’ve been a little busy with life things and I’ve not been good about keeping up with everyone’s blogs!

My sweater is doing fine. I got a little burned out after redoing the sleeve, and it’s resting in my project bag at the moment. To give myself a change of pace I decided to knit up the yarn I was given as part of a contest prize for winning (with my artwork) and QT 3.14159 is almost ready to be shown to the world! He’s a little robot plushie. All his parts have been knitted, now I just have to sew him together. 1 arm and 2 legs left to go.

Monday I went for my quarterly checkup with my diabetes doctor and my A1C went from 6.2 to 7.5. Which is too high and probably because I screwed up my diet throughout the holidays. My daily glucose value was alright though. I talked to her about the constant unexplained spikes and crashes (12mmol/l after a single slice of whole wheat bread with a slice of cheese one day, crashing down to 4mmol/l with the same sandwich the next day after two hours…) and it appears to be typical for someone with LADA. As a reminder, I have the antibodies of type 1 diabetes, but the process is happening slowly in adulthood versus quickly in childhood. I also have insulin resistance and overweight issues common of type 2, which puts me in 1.5 double diabetes. I can go for half a decade to a decade without insulin if I manage my condition with diet and exercise, but my pancreas has ‘hiccups’ with irregular insulin output that can make things very frustrating. There’s not much I can do, we’re going to check my A1C again in April and do a yearly complete checkup to see how my kidneys and everything else is doing.

In the meantime it’s back to focusing on homecooked meals and quitting the snacks.

Speaking of exercise, my friends started using this incredible app for exercising and I joined the horde (pun intended!). It’s called Zombies, Run! and it is a running app that immerses you in a post-zombie-apocalypse world. You run to complete missions, gather supplies and rebuild a town all the while listening to the radio chatter and doing awesome things like rescuing people.

As someone who gets bored FAST of routine exercise, this is a godsend. I turn on my FM radio or music player for music between the sections and either walk normally outside or use my stationary bike indoors. The app is versatile in the cardio you can do. You can use GPS to track your progress by distance, you can use the pedometer to track your steps (for treadmills or if you don’t want to drain battery with GPS) or you can choose a constant speed like when you’re on a stationary bike. Heck, you can bike outside and use GPS and it works!

Now the free version is limited to season 1’s first 4 missions. After that you unlock one mission a week. If you don’t mind repeating missions or making use of the free side-missions, then that works well. If you want to unlock everything so you can do this 5-7 times a week, you can get the subscription at $3 a month or $22 a year. Considering it’s more fun and cheaper than a gym, I’m saving up to get the yearly sub. I tried out 1 month paid and so far I just love it enough to commit. I also suspect paying for it will motivate me to use it more. 🙂

If you like zombies and ant to spice up your cardio, I recommend giving the free version of the app a try!