FINALLY on bolus and basal insulin!

Good morning followers! I hope you’ve had fantastic holidays. 🙂 My life’s been super hectic, but in a really good way. My last post was in September, not because I didn’t want to blog anymore, but because all my energy went into my mental health and life circumstances. Now things seem to smoothing out a bit and my desire to write is kicking back in, woop!

Last Monday, I went back to my specialist. I’ve talked before about going off the oral medication (gliclazide) and starting an insulin bolus regime instead, but was met with quite some resistance when I finally reached out back in October.

At that time, the specialist (who happened to be an intern) was very focused on prescribing me Victoza, a medication used primarily for type 2 diabetics. Now while it sounded like a great medication, I had one problem with it; I’m a type 1 diabetic, not type 2, and my pancreas is already struggling like hell to give me enough insulin while LADA takes its course. Victoza is designed to trigger insulin release from the beta-cells when your food reaches a certain point in the digestive tract, which helps to even out your levels and leads to weight loss in most people who use it. Great! But only if your body can actually produce enough insulin of its own.

The running theme I got was “you’ll lose weight on this medication, but you’ll probably gain with insulin”. So I asked, why do people gain weight with insulin? Is it because they inject too much and need to eat to cover their insulin? Is it because they just don’t bother adapting their diet so they consume more calories than they use? Is it because they were eating everything and losing weight due to a lack of insulin production, and then on insulin their bodies can finally use all the fuel they’re putting into their mouths leading to weight gain? Is it because they don’t exercise much or at all while eating generously?

He said all of these are possible, and when I expressed interest in switching to insulin instead because I’m confident in my ability to control these factors, he backpedaled and wanted me to consider Victoza anyway. It just so happened that because I was already on basal insulin, insurance nationwide wouldn’t cover it. There are strict regulations and requirements a patient has to meet before they’re put on that med, and basal insulin use disqualified me. Initially he suggested I go off the basal and just take the other med instead, but I absolutely refused because my gut instinct told me that was a terrible idea. Then he informed me that regulations were about to change in the new year for this and suggested that we meet again in January to see what the situation was and take it from there.

I felt frustrated but relented. I didn’t have a lot of info on Victoza at the time, so I couldn’t really formulate whether or not I wanted it. After some research I was 100% confident it was not for me, and went to my appointment last Monday with that in mind.

He started the appointment with an explanation on the state of regulations; the change was approved, but not yet implemented, and he didn’t know when they would so I’d have to wait. Although I went in with “I don’t want Victoza” at the front of my mind, I hooked in on that and said I was absolutely not willing to wait any longer. I’ve been dealing with very hard to control values for almost half a year and I can’t afford to waste more time waiting for regulations to go through. He said that he could put me on Novorapid, but that it closed the chapter on Victoza.

Fine by me! I agreed immediately, and he prescribed the insulin to me and took me off the gliclazide. I walked out of that appointment feeling a lot of things. I texted my best friend immediately that I finally got the insulin because I was excited and happy, but I also felt bad for people who get thrown into situations like that and don’t have the ability to stand up for themselves or do the research I did. I’m not sure where my treatment would be at right now if I’d just gone along with this. I feel it would have been horrible for me, and I can only imagine that there are people out there suffering from bad decisions made by doctors who don’t listen to their patients in similar situations.

Either way, I picked up my insulin the same day and got started immediately. The specialist told me to take 4 units for every meal, but I find that I am very sensitive to insulin so 2 units is enough for most smaller meals. 4 works best for dinner. As my meals typically don’t exceed 40gr carbs that is actually plenty. I’m still trying to find my actual insulin:carbs ratio so I’ve been testing and experimenting vigorously to see what my body does with carbs so I’m still spiking after meals, but I’m getting the hang of correction dosages pretty well. It took me a day to wrap my head around “insulin doesn’t stack if you take what you need to cover the carbs you eat, even if you eat twice in 2 hours – total insulin for total carbs is what matters here”. I did learn very fast that you don’t correct shortly after eating when you injected enough insulin for the carbs even if you’re spiking at 13. My problem was the timing of the insulin, not so much the amount, so when I biked home I crashed from 13 to 4, nearly into a hypo.

insulin

This is why I love experimenting and pushing boundaries though; nothing makes me learn things quicker than to just go ‘let’s see what this does’. (I’m playing it safe, don’t worry. I always have glucose on hand for crashes and am very aware of what I’m doing and need to look out for.) It’s still too early for me to go low carb as I still need to get this figured out, but hopefully I can progress to 3 out of 7 days in the week of low carbing to get started.

I seem to roll around between 1:15 – 1:30 for my ratio, which is not uncommon for LADA diabetics I’ve heard. But my average values tend to be pretty alright so far, and I’m looking forward to getting this harness on my diabetes and making sure it behaves while I work on my health!

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Impulse control (or lack thereof)

I’m back to 120kgs. The good news: I’m not gaining weight beyond this point. The bad news: I’m not losing any either.

Thanks to feeling sickly, I’ve been slacking on my daily routine. I’m sleeping in until past noon, I’m not eating breakfast, lunch and dinner at appropriate times, sometimes I am not hungry enough to eat a full meal. Then a couple of hours later I get so ravenous that my desire to put food into my mouth overrides all my common sense and I just keep shoveling until I can’t anymore.

That’s doing a number on my blood sugar levels too, naturally. :/ There’s no real excuse for it, I should step up my game and be better about it. I think it all comes back to routine; food is much easier to control when you control the rest of your day. The moment the rest of your day is in shambles, structure wise, there’s no rhyme or reason to meals anymore either. So my main point of focus, right now, is to get my routine back under control, and then tackle my eating habits.

I’m feeling a bit better but still very sluggish. Hopefully when my court date is over tomorrow, things will smooth out a bit more.

On another note, I’m fighting really hard not to cast on anything new until these socks are done. I want to cast on my sweater next, but the nice old lady who got knitted knockers from me before is still waiting for a new pair, so those have priority this coming week. My mental mantra comes down to “First socks, then boobs, then sweaters”!

Your shoe won’t fit my foot.

I weighed in at 118.3 kgs the other day. It’s a new milestone! I haven’t been this light in years. Since the beginning of this year, I’ve lost 7 kilograms. It may not seem like much, but here’s the thing: I’m going and I’m not stopping, so it doesn’t matter how slow it goes. My weight fluctuates a lot, but there’s a steady downward trend and that’s the most important thing. 🙂 The best pat is I’m not on an actual weight loss diet. There are no obligations, no reprimanding myself for ‘cheating’, no stress over not having lost that pound I set as my goal this week etc. It’s what killed all my previous attempts at losing weight, I’m sure. At some point the weight loss takes over your life and becomes a burden that you cannot carry forever. At some point counting calories is going to take the fun out of enjoying your meals. When you start thinking that frying your food is the worst thing that you can do because it means you MUST do three times as much exercise, you have a problem with your relationship with food. So you stop dieting, you feel like a failure for not being able to stick with it, and you pack on twice as much weight as you lost.

Dieting works for some people, but it just doesn’t for me. It took me so long to realize that small changes in my daily life can be incorporated without obsessing over my weight, and even longer to feel that is absolutely okay. It’s why I gave up on weight loss communities — everyone just tries to one-up one another and makes you feel like shit when there’s yet another thing in your life you can’t seem to get done. People always telling you what you should and shouldn’t do without realizing that everyone is different and their methods may not work for you. Inspire, don’t dictate!

So, yes. I’m doing well! My birth control implant is also working well, my period came but it’s so light I only need to wear pantyliners. My periods used to be crippling with heavy bleeding, cramps that wouldn’t allow me to sit up and extreme fatigue. If I can have periods like this for 3 years, I won’t even mind having periods. Though there’s hope that they’ll go away entirely, too.

I’m still going strong with my bento boxes. Even when I don’t go out, I prepare them. It helps me to prepare nutritious meals and my increased protein intake also makes it easier to have smaller portions for dinner. Ergo, I’m full longer. A bento’s traditional formula is pretty brilliant in that aspect.

What have you been achieving as of late? What’s your latest food craze?

Bring Zen into my life

I’m finally catching my breath again after a couple of weeks of utter madness. I’ve spent many days without power because electricians were fixing a very dangerous electrical situation in my apartment complex, which meant no computer, no opening of my fridge or freezer, no music, no tv and no chores until the work days were over. There is only so much reading I can do on my tablet before I need to recharge it or get bored, so I spent copious amounts of my time at my friends’ or my parents’ being bored to death. I got behind on some of the work I had to do for my friend, but as soon as the electricians left and the power was back on, I had to stuff a day’s worth of things into a few hours before I had to go back to bed because these guys show up bright and early at 8am the next day.

My legal battle is going well. My landlord has dug his own grave and makes feeble attempts to climb out, only to be smacked down my by lawyer every single time. I have the law backing me up without doubt and he’s screwed. I’m grateful all correspondence now goes between my landlord, the real estate agent he hired to take over maintenance and my lawyer though. Not having the responsibility of dealing with letters is a relief!

Therapy is going well. The vacation season is upon us, which means I see my therapists less until the beginning of September, but to be frank I’m feeling good enough to be confident I can bridge that gap without too many issues. I’m doing better at setting my own boundaries and picking up things after I dropped them. I have to start on logging my days again too for my psychologist because all this electrician business interfered and made it hard to get back in, but I’m going to do it.

My weight is dropping very slowly but steadily. I’m down to a solid 119.2kgs and I haven’t gone over 120kgs in a week, so it’s safe to say the weight is off and will stay off. I might go over 120 again when my period hits, but it shouldn’t be by too much.

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On the downside, my blood sugar is all over the damn place. I’m having a blood draw on Tuesday morning to check my cholesterol and we’ll be doing my A1C at the same time. It could be stress, the temperature fluctuations or my pancreas is finally kicking the bucket and we need to up my medication or even switch to insulin. It’s hard to tell when you’re a type 1.5 and it can be frustrating when people who deal with diabetics tell you it’s 100% ‘just the heat’. No, it doesn’t have to be, it could be more serious because I’m not a solid type 1 or 2. I know they mean well but good god at least listen to what the person who has the condition tells you.

I’m looking forward to the end of August. Two of my friends will be flying in and staying with me for a while and I intend on having a really good time with them! My boyfriend got out of the Navy and moved to a different state. He’s applying for college and hopefully can pursue an education in computer science like he’s wanted!

“What’s your secret?”

I weighed in this morning at 121.2kgs. This is the lowest I’ve been this year and it’s awesome! I’m noticing a drastic improvement in my health in numerous areas: my blood sugar is more evened out without awful spikes or dips, my fitness condition has improved (I walked up and down the stairs to my apartment, with groceries, five times in a row and was only mildly out of breath!), and I’m overall more active. Even my emotional and mental problems seem more manageable than before, although part of it can probably be contributed to having a proper professional support system in place that is willing to work with me instead of pushing me through to the next person.

My neighbors in particular are commenting on this frequently. “You look so much prettier than you did last year!” “You look really sexy now that you lost weight!” “You’re looking so good this year!”

I choose to take these as compliments rather than insults lest I snap and shove their heads into their filthy pool and drown them. I choose to understand they’re not very intelligent but very shallow people who can’t see past someone’s looks and they don’t know any better. I was pretty and I was awesome when I was heavier too, thank you very much. A couple of days ago, my neighbor’s sister asked me “What’s your secret?” and looked at me with those horribly drug riddled judging eyes, as if I was going to give her the magic button she wanted to get rid of her excess weight.

“There is no secret. I just watch what I eat and focus on my blood sugar levels and try to exercise more.”

“Oh…”

I suppose in hindsight I think there is some sort of magic button to press, but the downside is that it’s not easy to do so. The upside is that it’s something everyone can do.

Just be honest with yourself. If you do this, you’ll find that your only obstacle to a healthier life is your own dishonesty. It’s the only reason you’re not losing weight, it’s the only reason you’re not becoming healthier and it’s the only reason whatever condition you have isn’t manageable to you.

When I peaked at my top weight, I was lying to myself a lot. I don’t eat that much, it must be medical. I tried to lose weight so often and couldn’t so it must be out of my reach. I don’t have the money to buy healthy foods so I better not try. Exercise isn’t good for me because of my health issues. I won’t get sick from being a bit too heavy anyway.

All lies and twisted truths that I had convinced myself of to be my reality because actually making changes is really, really hard when you’re dishonest. It wasn’t until I started counting calories and couldn’t deny seeing right there in front of me what I knew deep down to be true, that I was confronted with my dishonesty. I eat too much. I can lose weight but I just didn’t really try that hard and gave up too quickly. If I do my best I can at least eat partially healthy and cut down on bad foods with the little money I have. I can do exercises if I pace myself properly and don’t overdo it. I did get sick from being too heavy.

Bam. My whole life turned around just because of this. Don’t get me wrong, it was tough as shit to admit my faults to myself, but once I did it everything else got easier. Eating healthy when you’re in denial about your diet affecting your health negatively is much more difficult than making the right choices when you take your health seriously and approach it with honesty. You don’t have to give up everything you love, but you do have to make compromises and stick to them. Exercising when you put effort into finding something that works for you is pretty easy to do despite the discomfort it gives you, as long as you admit to yourself that sitting down and doing nothing is worse than getting up and walking up and down your apartment 20 times. If you put effort into planning for your shopping, you can replace half of your bad, fattening junk food meals with healthy ones without fucking up your budget. You may not be able to get there 100%, but hell, you turned around 50% of your diet. That’s 50% more health right there!

Some illnesses are unpreventable (such as type 1 diabetes and PCOS) and they come with disheartening consequences. But here too, admitting you’re sick and that’s just how it is instead of feeling sorry for yourself or even denying it’s serious makes all the difference. You’re not a lost cause just because you’re sick and your life doesn’t have to suck because you need to cut out foods that make your condition worse. You can choose to just accept that’s how it is, and you can choose to find alternatives that taste good. It won’t be easy, but it is possible.

When people spoke of unhealthy people being too lazy, I got offended and tried to deny it. But if that’s how you respond to such statements, that by itself is an indication that deep down inside yourself you know it to be true. If someone tells me now I’m fat because I don’t even try, it makes me feel… exactly nothing. I’m no longer lying to myself. I know what I eat, I know what I can do and what I actually do. I know that, sure, maybe I COULD go that extra mile and be the best of the best, but I’m healthier now than I’ve ever been. There’s nothing deep down inside of me cringing because someone’s words revealed a painful truth I tried to deny. I just know their statement doesn’t apply to me and therefore it doesn’t offend me. So if you take offense in what I wrote, just take a step back and look inside yourself. There’s probably a good reason as to why you’re offended.

Every time I try to think of the magic fix to be healthier, I always come back around to honesty. I got fat because I lied to myself about what I put in my mouth. I got fat because I lied to myself about the exercise I did and didn’t do. I got sicker than I had to be because I denied that something was wrong when initial tests came back pre-diabetic. I continued to be on a bad diet because I lied to myself about the possibilities of changing what I bought from the store. When I became honest, I became healthier. That’s the only magic button there is.