Putting my Best (or worst) Foot Forward

I went to the podiatrist today for the first time in my life. I'm 24, and I've been having foot problems for a while now, at least since January. I've tried resting, icing, wrapping, and it helps in the short term, but the day I stop doing these things my pain returns. I went to my primary doctor again earlier this week for the pain. The last time I was in, Dr. Dumbass told me to come back if it kept hurting. It did, so I went back. Thankfully, I got to see my regular doctor instead of the idiot I got last time. Anyway, he wanted to send me to physical therapy for my foot to try strengthening muscles and gain support. I asked him how we can treat something if we don't know what, exactly, the problem is. So he referred me to a podiatrist.

Now, being a diabetic, I get a little nervous when I start thinking about my feet. Every time I'm in the endo's office, I get a clean bill of health on my feet. They look good; strong pulse, no nerve damage, etc. It doesn't stop my worry though. We've all heard about the foot problems associated with diabetes. I was nervous going in. To my surprise, he didn't mention my diabetes once. Woo!

I had my foot X-rayed while standing.

Everything is normal, except for my high arches. I was given some orthotic inserts to bake in the oven and shove into my shoes. Done and done. For now, I hate them, but hopefully they'll help. I hope my problem was something this simple and it resolves soon. 

5 Stages of Low Blood Sugar

We've all had that low experience, the one where something goes awry in your brain and you don't treat it quickly and move on with life. The one where things happen so fast and someone else has to get involved. That is the low that this post is about. I just had one of these lows today in the gym, and I am so thankful that my mother happened to be there today. I didn't quite grasp what was going on as it was happening. It hasn't happened like that for a while. It also happened to be my first training session, so I was letting the trainer push me. That's his job. Apparently I let him push me into ignoring my low signals. So, here I present the 5 stages of low blood sugar.

1. Suspicion. Am I low? Am I shaky because I just did a bunch of squats? Maybe I'm low. Give it a few minutes and we'll reevaluate.

2. Denial/ belligerence. No, I'm not low. I don't want glucose tabs. I don't need glucose tabs. No, I don't want juice. No, I won't drink the juice. Get it away from me. I don't want any damn juice!

3. Acceptance. I'm low. Oh man, I'm so low. I'm just going to sit down, put my head down here. Just give me a minute.

4. Black Hole. I drank the juice. I ate the crackers. What else is there? I need to eat more. Now. Everything in my belly. Now.

5. Rebound high. I shouldn't have had so much juice. Crap, now I have to take more insulin. God, I hope I don't overdo it.

I know everyone experiences lows, but this is often how it plays out for me.

...But the Door Handles are Evil

The boyfriend and I have been apartment hunting for the past few weeks. Our current apartment is nice, but very poorly managed. Plus the door knobs are evil. Evil? Yeah, they're the kind that extend out horizontally and then curl on the end. They grab anything passing by- especially pump tubes. The one day  I wasn't wearing my pump, I managed to get my belt loop caught on the stupid door knob. I wish I were kidding. I told my boyfriend very early into our lease that I was never going to live somewhere with those evil door knobs ever again.

With door knobs in mind, we went out hunting. There were a few places we wanted to check out in our area. The area is nice, and we don't want to leave it. On the first Saturday we were out we toured about 6 different properties, including one willing to rent a 2 bed, 2.5 bath town home for $850/month, and give us two free months' rent! (PS, around this area, that is red-flag waving, send in the cavalry suspicious.) At the last complex we checked out that day, the lady giving us our tour kept commenting that I looked really tired. "Awh, you've been doing this all day. You look exhausted, bless your heart." Yes, I looked so tired she needed to bless my heart. In the car I decided it might be a good idea to test my blood sugar, and it was somewhere south of 50. Oh. That's why I was so tired. Okay.

This past weekend we went out again, expanding our search circle to include a little extra geography. Lather, rinse, repeat. We saw some really beautiful homes and some that made our skin crawl. This day I kept telling myself to look alert, stay sharp, keep going. At the end of this day, my blood sugar was also south of 50. I'm lucky my boyfriend does all the driving, or I'd have been sitting in strange parking lots, chomping on glucose tabs.

We have our list down to two apartments now, and depending on the apartment, we will either move next month or the month after that. Let's hope I can keep my BG up while moving. Last time I dropped into the 30's and had to chug some Mountain Dew. 

...Right in the boob.

I'll stick a needle anywhere once. I'm getting pretty adventurous when it comes to these things. Recently I've stuck my arms consistently and I loved it. Last Sunday, I stuck my boob.

It actually wasn't a huge deal. I have plenty of space on my breasts to place infusion sites. I use the angled sets from Medtronic (Silhouettes). I insert them manually, so I am able to control to speed and angle of insertion. If I'm in new real estate, I can pull out if it doesn't feel right. When I put this one in, I didn't feel a thing. Nope. Not one.

When I was considering this spot, I compiled a few factors that determined exactly where on the breast it was going to go. It had to be somewhere my underwire wouldn't rub it. It had to be somewhere my backpack straps wouldn't interrupt. It had to be somewhere that I could take a non-pornographic photo of, because I share my entire D life with the internet. So, with all of this in mind, I showered and changed my set. After I put it in, I breathed a sigh of relief, and then promptly tweeted about my boob site.

So how was it? Not bad. Like I said, I didn't feel a thing with insertion. As far as absorption, I'd probably rank it with my butt flesh. That being said, I did have a cold this week so I know that messed with my numbers. I'll have to try it again before giving a definitive result on absorption. I didn't feel any of my infusions like I sometimes do with my thighs. It never itched as intensely as my thigh sites, either. It never rubbed on my clothes, and the tubing was always under my shirt, so I didn't catch it on any doorknobs for a few days. That was nice.

*edit* I've tried the boob site a few more times, and every time my absorption was fantastic. It leaves a little dot on my boob for a while, but it's worth it.

On a personal note, I don't think my boyfriend liked my boob site. I told him I'm going to do it again, and he just sighed. "Why there?" Heh.

I'm going to give it another go, on the other boob, before I draw any conclusions. I was not convinced of arm sites until my second try. Who knows, boobs could be my favorite place for sites!

If you're looking for another boob-site blog, C wrote about her experience with using her breasts here. 

Update on 2014 D-Goals

In January, I posted my 2014 diabetes goals on this blog. They were few and not too lofty. How am I doing?

Bring A1C below 8. Going in, my A1C was 8.9. It was checked again in February, and now it's at 8.3. That number includes December, the month of Christmas cookies. I believe I am on my way to doing better, but the next A1C is going to include my 2 weeks with a weird pump where my BG was consistently 200+. We'll see.

I'm getting better at counting my carbs, and being honest about them. I'll look things up on my phone when I'm out eating and not sure. The biggest barrier to accurate carb counting was my unwillingness to put large carb amounts into my pump. I'm not sure why. It would send my BG high, but I still just wanted to not have that many carbs in my pump. So in addition to actually eating fewer carbs, I'm more honest about the ones I do eat.

I'm changing my infusion sets more regularly. I used to not change them until my absorption was crap or my set hurt. Now the calendar in my kitchen is full of Lisa Frank stickers. I get a sticker each time I change my set. It helps me remember when I changed my set, and I'm more likely to change it on time. I think I've only gone more than three days once since January. I'm also trying new sites, like my arms. I thought I would hate using my arms, but once I tried it I fell in love. The absorption is awesome, and it leads to discussions about diabetes with strangers. Bonus!

I've been exercising without my pump. It's an adjustment to actually do anything without it. I check my BG after 30 minutes, and if I'm going too low, I pop a glucose tab or two. They're pretty low-calorie and they get the job done. But then I sprained my foot, and everything went to hell.

Still no CGM. I didn't bring it up at my appointment, but I might next time. I don't know why I'm hesitant to ask, but... yeah. I've got nothing. I know I have a long way to go to bring my BG in line, and I think this could help. I'd catch the highs before they're at WTF levels.

So that's where I am in terms of my D-goals. Hopefully I have a better update in a few months! 

I Should've Kicked You With My Sprained Foot.

I hurt my foot. I am, without a doubt, one of the clumsiest people on the planet. I hurt myself without even trying. My foot's been bothering myself for a while now, so I went to my Primary Care doctor. When I got there, I was told that I'd be seeing a different doctor because mine was out today. Okay, fine, whatever.

After a general check of my weight, blood pressure, and pulse rate, the doctor came in to see me. I've never met this guy in my life, so I didn't know what to expect. I looked him up on my phone while I was waiting. He is a certified family practitioner, with a specialty in family medicine. Okay. He examined my foot, said I'd be fine, gave me a prescription anti-inflammatory, and told me to get an Ace bandage. He was scrolling through my file on the computer and getting ready to send the Rx to the pharmacy. Then he brought up my diabetes, and that's where things got ugly.

"Oh, I see you're a type 1 diabetic. How's your diabetes?" he sounded conversational, so I told him I was managing. Usually doctors leave it at that. Nope. "What's your A1C?" Eight-point- "that's not managing! That is terrible! You're on a pump, there is absolutely no reason you should have an A1C above 7. What? Are you not checking your sugars? Not bolusing? Sneaking candy?" That's when I used my stern voice to tell him I test a minimum of 6 times per day, correct when needed, and bolus for everything. "Well obviously something is not right. Do you actually see an endocrinologist?" Yes. Every three months. Given my circumstances, she is okay with my progress, and- "any endocrinologist worth their salt is not going to be happy with an A1C that high. What is your BG when you wake up? When is it the highest?" Around 100, usually mid-afternoon, but I have a non-constant schedule, so finding patterns is difficult. "Well, if you're high in the afternoons you need to increase your basal rate. Your carb ratios should remain constant through the day, but if you're higher after lunch, you need to increase your basal rate." Okay, whatever. At that point, I was over it, flustered, and taken aback. So I just listened to him talk, nodded, and left as soon as I could.

I'm still finding my voice when it comes to standing up for myself. I can defend other people all day, but I'm still working on advocating for myself. I didn't want to keep going with this doctor about diabetes, mostly because he seemed to have an overly simplified view of it. He was of the opinion that diabetes is a static, formulaic disease. Input the right number of insulin, and there is ZERO reason you shouldn't get the right numbers.

If I run into this again, I don't know what I'll do. Has anyone else dealt with this? 

Wearing Diabetes on Your Sleeve

Recently I've started wearing my pump sites on my arms to give my abdomen a rest. Also, I fell up the concrete stairs yesterday and my whole tummy is basically a giant bruise. Anyway, having an arm site and wearing short sleeves does lead to a lot of sideways looks, and a couple of comments from people who sit next to me in class.

"What... what is that?" in a hushed voice from the girl in my chemistry class.

"Uh, you've got a... something stuck to your arm. Did you know?" from the girl next to me in my psychology class.

"What the hell did you do to your arm? That looks like it hurt!" from the guy on my other side in psych. This one was my personal favorite.

I take the opportunity to give them a little insight on diabetes. "Oh, it's not a big deal. I have diabetes, and it's for my insulin pump. It's how I get medicine" is usually enough. I try to make them not feel bad or embarrassed for not knowing. So far, so good.