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Details From My Appointment with an ENT

If you are wondering what an ENT is, don’t worry, I didn’t know what it was until recently as well.  I’ve heard of those kinds of doctors before, but never knew they were called ENT’s (Ear, Nose, and Throat specialist).  You all know of my clogged Eustachian tube problem that I have been having for the last month.  You all also know how freaked out I have been by it, because it just isn’t getting any better at all.  I finally decided to go see a specialist for this situation.  I didn’t want to because I have spent over $500 on medications and doctor’s visits on this whole ear thing already.

The doctor came in and checked out the ear and told me not to be worried or scared because this happens all the time.  When you get a really bad cold, stuff like this happens and he has seen them sometimes takes over 4 months to finally drain and there is no damage to the ear from it.  He explained that there is fluid in the ear, near the ear drum and that is the crackling nose that I hear sometimes when I blow my nose or cough.  He gave me two options, first one was to treat it with medication and two was to do a quick procedure that heals pretty quickly and easily.  The procedure involved putting a small needle sized hole into the ear drum and letting it drain, yea I cringed too!  I said no thanks to that.  He gave me Veramyst to use for 2 weeks and then come back and see him again.

He also advised me not to fly anytime soon, which could potentially be an issue because it is coming around to networking conference season, and I may be flying a lot very soon.  He was assured that my ear did not look that bad and it should be cleared up in no time with the medication and some manual clearing of the ears, as he said, “Just don’t blow your brains out doing it.”  Easy enough for me.  Hopefully this will end it because it is pissing me off now.

There was some good diabetes education going on in the appointment as well.  I first demonstrated my insulin pump to the nurse and then again to the doctor.  He had a few more questions about my diabetes.  He wanted to know if there was family history, or if there was any internal infection, or how the diabetes came about because it sounded very weird to him.  I love education people on diabetes, especially doctors because it just shows that they learned a little about it in their disease 101 class, but they never really learned a lot about it.

Well, still trying to catch back up on work, but I should be all caught up today.  I’m finalizing an outline for next month’s WordPress blog design specials, so if you’re interested, just drop me a line and you’ll get first dibs on timeslots.

Time to Catch Up on Doctor’s Visits $$$

I haven’t been to the doctor in a while.  Not just my endo, which was October of last year, but any other doctor.  This week I am setting up appointments with all the different doctors that I need for yearly check-ups.  The problem is that I don’t even have names of doctors to go and see down here in south Florida.  Even though I have been living here for 5 years, I was always using my doctors from back home in PA until last year when I wasn’t able to travel up there as much because of work related reasons.  I haven’t even had a general health physical / check up in almost 4 years.

I have just set up an appointment to go see an Ear Nose and Throat specialist because my ear is still clogged and it’s been almost a month.  I am still coughing every so often, so it was freaking me out.  I was concerned that I had something more serious then just a simple clogged ear that Mucinex D is going to help with.  Stacey gave me a heads up about getting it checked out because it could potentially be mono and I don’t think that I want to deal with that.  I never had mono, but my girlfriend has had it and she has been sick for a while as well as her mom, so who knows.

The other appointment that I set up is a dentist appointment.  I don’t have any delta insurance, so it is going to be expensive.  I tried to get private dental insurance and I told them I was diabetic and at least they didn’t hang up on me and tell me that they couldn’t help me, they actually gave me a quote, $350 a month for insurance. thanks.  It would make sense if I have to get all kinds of work done to my mouth, then I think I would pay for the insurance.  My first initial visit is going to cost $160, and that is just an evaluation and x-rays.  Then I can come back for a cleaning which is going to be approximately the same price, a little lower.  So that is $300 right there, but I won’t have to go back for at least another 6 months, so it just makes more sense for me to go without the insurance.  Type 1 diabetes and your teeth I know are important because of all the additional risks I have for being diabetic.  I don’t mind spending the money on things like that.

My endo appointment has been scheduled and is at the end of this month.  Before I get to that visit though I have to get blood work done, and I’m sure it is going to be a lot because I haven’t had any done since September of last year.  I know right now that my A1C is going to be bad, I’m guessing around 8-9.  After my initial A1C at diagnosis of 14.7, 6 months later it was down to 9, I haven’t gone abouve 7.5 in 5 years so that is going to be rough for me to handle.  I have made changes to my diet and also added more walking into my life to at least get some exercise because I wasn’t getting any at all.

While at the endo, I will be asking for a referral for a family doctor because I would like to get a physical or check-up once a year to make sure everything is going good.  I have slacked big time in this area of my diabetes management, but I am taking control of things again, my diabetes was starting to control my life a little, but not anymore.

The final visit that I need to make is for my eye doctor.  I just re-ordered more contacts because my prescription expired in about 2 days before I ordered them, so I am right on pace for the once a year eye doctor appointment.

Well, I am really far behind on work, so I need to catch up, so have a great day everybody.

Last Day of NaBloPoMo

Well, this has been the hardest month of my life, but damn does it sure feel good.  It always feels great when you set a goal and you accomplish it. Think about how many times you set goals and never accomplish them.  For me, at least, I know it happens all the time where I don’t meet them.  Especially when it comes to losing weight.  Those are the goals that I set most often and the ones that I most often don’t meet.  I will continue to try and post every single day, but the weekends is when it is the most difficult, but I can schedule posts for then.  Also, I will be going back to work this week, so I won’t have as much time during the day to post and have fun on Twitter all day like I was.

But that is not an excuse because there is still plenty of time that I can get things done.  I wrote a post earlier in the month about how NaBloPoMo was kinda like managing your diabetes.  I still feel that way, and I feel that I accomplished this, I can continue to accomplish managing my diabetes.  If posting once a day is all it takes, than managing my diabetes one day at a time will lower my A1C.  I can set a goal to lower my A1C to a manageable level, then I can win.  My goal is to lower my A1C one tenth (at least) every 3 months.  It does me no good to go from a 7.1 now to a 5.5 in 3 months and back up to 7.2 three months after that.  It will do me good however to go from 7.1, 6.9, 6.7, 6.6, and continue this path every 3 months until I am consistently under 6.0, which is what my ultimate goal for 2010 is.

I have taken about a week off in being on Twitter and Facebook and LinkedIn, sort of what you may call slacking.  I haven’t answered many e-mails in the past few days, so I am taking today to catch up on all of that.  So if you are one of the ones I haven’t answered back to, sorry.  I am also going to work on my Contour USB review.  I went through all 25 strips, but haven’t hooked it up to the computer yet.  It sucks that I am out of strips already, and I still have like 20 boxes of Freestyle Lite, so I’m not going to buy more Contour’s until my Freestyle’s are used up.

Have a great Monday everybody.

Results From Endo Appointment

Today’s post, although later is about the results from my endo appointment today.  I just came home from football practice a little bit ago, so that is why it is such a late post tonight.  But anywho, onto the appointment.  A diabetic’s mandatory meeting.

I was actually on time so that started out well.  I handed my pump and my meter to the receptionist so they could pull the numbers off of the two.  For some reason, my meter decided that it didn’t want to work anymore and wouldn’t give the readings so they were going to give me a new Freestyle Lite meter.  I told them to just keep it because I have plenty of meters at home, leave it for somebody that needs one.  [Plus didn’t know if I’d have to report that to the FTC also 🙂 ]

Next up was the blood pressure.  If you recall from my last endo appointment, my blood pressure was a little high, 140/80.  I was very stressed out that day and was running around like crazy before the appointment.  Today I wasn’t stressed at all, it was a perfectly fine day.  My blood pressure was 122/70, perfect.  So there was nothing to worry about with that.  For some reason they weighed me after the blood pressure.  The scale at their office is always about a 10 pound difference then any other scale I step on.  Their scale last time said 254 when mine at home said about 244.  Today, their scale said 246.  So even though I’m not that heavy, I am obviously losing some weight.

As I explained recently, I have had a month full of highs and was trying to figure out why that was happening.  I discussed it with the doc today and we both agreed on all the possible reasons that I mentioned.  Probably a site issue.  We eliminated those highs so we could see patterns in normal days.  Overall, the sugars were pretty damn good.  Just those few high days did it to me.  Like usual my sugars overnight are killing me, literally!  We increased my basal rate during the late night / early morning hours to 1.8 and kept the rest of them at 2.2 – 2.4 depending on the time of day.  We also increased my carb ratio to 1 unit of insulin for every 4 carbs at night time and kept it at 5 carbs the rest of the day.

I felt very good after leaving today’s visit.  Things are going good and somethings are getting even better.  My goal for next month’s A1C is to have it below 7.  I have busted my butt exercising and eating better to do this, but I can’t stop now I have to continue.  Well, next appointment isn’t until end of November, so I’ll update you again after that appointment.

Endo Appointment Tomorrow, Charlie Kimball Friday

I received a phone call today from my endo’s office to confirm my appointment for Friday and I was confused.  I said, there’s no way that I could have scheduled an appointment for that day because Friday is Charlie Kimball’s race down in Homestead – Miami that I am going to so I can’t have that appointment.  She said, well I don’t think that we have any other openings.  I said, you don’t understand, I can’t miss this race, I am going to meet Charlie and be at the race.  So she said she would look and see where she could fit me in and give me a call back.  5 minutes later I get a phone call and somebody had cancelled for tomorrow, so it looks like now I have an appointment for tomorrow.

First thing that I am going to explain to the doc when I get in there is come straight out and admit that it hasn’t been a good month for me.  In fact, a pretty effin’ bad month.  I had a lot of highs, some major lows and just been all over the map with my sugars.  However, I did manage to find more time for exercise and lost some weight.  I put a little on over the last week, but I had lost enough before that to still be down some weight since the last visit.  The last thing is to explain that I haven’t worn the sensor at all for multiple reasons.  For one, it started to fall out all the time.  Secondly, the ones that I had expired way back in May and never realized it because I just kept thinking, well I still have 2 full boxes.  I will probably still attempt to use them though.

I must also remember to get new prescriptions from her however because I am almost out of insulin.  That also reminds me that I better re-order very soon because there is always an issue, especially when I need a new prescription sent in.  The first time that I had to send in a new prescription, it took me almost 2 weeks to get my insulin delivered, not good customer service in my eyes.

Today’s post a little short because I just got back from the gym and I am tired and I am trying to cook dinner and do laundry and have a lot of work to catch up on tonight.  So you all have a great day and I will have a better post tomorrow.  Hopefully something positive from the endo appointment.

Diabetes and Feet – Not Enough Effort

Well today had a lot better blood sugars then Sunday did that’s for sure.  I didn’t go over 200 at all today, the closet I came was just right now right before dinner and after 2 hours of coaching football, it was 178.  I just had a pulled chicken sandwich and 1/4 cup of baked beans.  I don’t like eating this late because typically it will lead to higher 3 a.m. blood sugars, but I didn’t over eat, I ate very small.  Today is all about my feet.  First, I want to thank my doctor for taking time to check my feet every single visit.  So far they have been pretty good.  I do have a few calouses but I have always had them from sports.

I try to lotion my feet every single night, but I don’t always remember to.  Luckily I have an amazing girlfriend that is willing to do this for me with a special diabetes foot cream.  I use Neoteric primarily, but there are a few others I have tried, but don’t recall their names.  I have also tried the Anastasia foot cream as well, and liked it, but just didn’t want to pay the higher prices for it.  I don’t feel that I pay enough attention to my feet.  How much attention do you pay towards your feet?  I sometimes get the attitude, well I’m only 25, that stuff will only happen when I’m older.  Well I try to smack myself in the face when I say that.

For instance, I just came home from football practice tonight and my feet are soar.  I’m only 25 like I said and still “fresh” out of football so I am very active with the kids and running pass patterns and throwing them passes so I am running around in cleats all night.  Then I come home and my feet kill, my calouses are even bigger and my feet are as dry as can be.  I am about to take a shower shortly, but as soon as I get out, my feet will be extremely dry.

In the industry that I work in, I see a lot of different wound care products and items and sometimes wonder what they are for or how they are used.  Then I see some of the promotional materials or product catalogs for some manufacturers and then I see examples of open wounds, and sores that can come from not taking care of your feet.  This makes me sick to my stomach and do not want to allow myself to get that way.  I know that sometimes it may not be your fault, but if there are things that I can do to prevent it, I want to make sure that I am doing them all.

One of the keys to my health as living a life of a diabetic is that I must keep my feet in great condition and not allow them to crack or get sores on them.

Hope you all have a great day.

Where Would You Be Without Diabetes Education?

So where would you be without diabetes education?  I can tell you where I’d be, and it wouldn’t be here, that’s for sure.  I am willing to bet that majority of you would say the same thing.  To me, diabetes education is the most important part of diabetes in general.  You can’t accept it if you don’t understand it.  You can’t manage it if you don’t know about it.  But there is always something more to learn about diabetes.  As soon as you think you know all there is, something else pops up.

I recently did a post on the old blog starting to get into this subject of diabetes education and that all the programs that are closing down.  Just locally here in south Florida where I live in the last year I have personally seen the JFK Medical Center diabetes center go down, along with the North Broward Hospital diabetes program go down.

I use Google Alerts for the keyword “diabetes education program” and it seems that almost everyday I receive another alert with a local newspaper writing about another program closing down.  I will admit that there are also some that talk about new ones starting up, which is amazing.  But when you read into it, the program is opening with minimal funds and sharing an office with the whole hopsital education system.  Now as someone with diabetes, I know how important it is for diabetes education programs.  I understand that this will lower my chances of any complications that may come in the future.

Now why do hospitals not think this way?  Oh I know, because this doesn’t allow their wallets to get fat.  It is very clear, there is no money in diabetes education, none!  The re-imbursment rates are minimal.  I see all the time in these articles that a reason the hospital will close the center down is because the amount of people coming to certain diabetes education classes or programs are decreasing.  The reasons they may be decreasing are because less people have health insurance, can’t afford to go to the classes, gas prices are getting better now, but during the gas spike of recent times people just couldn’t afford to drive to their local hospital to get the education they need.

So how do we solve this issue?  How do we get the education that we all need to the people that need it most.  One way I am personally trying to resolve this is to raise funds for diabetes education.  Raising funds in these times is a difficult thing to do.  There is a million charities out there and everybody thinks that theirs is the best and their cause is better.  Especially when you have a discussion about the ADA and JDRF, (tomorrow’s post).  Anyway, time to get back on subject.

Please let me know of any projects that you may be working on or that you have heard of or any local events.  I would love to help out and be as active as possible in fighting for the education that we need.  I continue to fight and do what I can to help find a cure, but until that day comes the best I can do is to help people get the same education that I received and still receive today that has helped me stay healthy.

I want everybody to be able to enjoy their lives and share their own stories of living a life of a diabetic.

Have a great night ya’ll

Need to Wear CGM More Often

In a previous post that I had after my doctors visit I discussed that I promised not just my endo but myself that I would wear my CGM more often.  And I started to, but then I haven’t put it back on in a few days.  And why may you ask?  Because I am lazy, and since there are only certain times during the day that I can put it on, I usually decide not to do it.  They say to not put it on during a time that your blood sugars are fluxuating or not stable.  Well that eliminates the morning time and also night time.  So that leaves when I am at work.  Well, it’s not the most comfortable thing to do at work.  So then that leaves me doing it on the weekend, which allows me to have the CGM on from Saturday – Tuesday (unless it falls off during golfing.)

I know all the good things about the CGM.  That it is going to help me conquer my morning lows by knowing more of a minute by minute analysis of what my blood sugars are doing.  There are article out like this one from Science Daily, that states, which we all pretty much know by now anyway, “…patients averaging at least six days per week of CGM use had substantially greater improvements in HbA1c compared with those who used the device less often.”  Hmm, so do I need any more proof or any more of a fire lit under my butt?

I vow to wear my CGM for 7 straight days.  Then 14.  Then 21.  If I start with a goal of 30 days in a row, I have a problem reaching long goals without setting smaller ones in the short term.  This is my promise.

What is the longest that you have worn a CGM in a row?  I don’t mean, did you sneak 4 or 5 days out of a 3 day sensor from Medtronic.  But as in, you inserted a new sensor the same day you took an old one out, etc.

This all makes me think about my mindset.  I am usually so good about doing things the right way.  I have done things the right way my whole entire life.  I worked my butt off to be the best basketball and football player I could possibly be.  Of course there were times that I was lazy, but I would make up for it the next day or next week by working even harder.  Or if you have one of those days and you are a little slower at work, you can catch up on work the next day.  But diabetes is completely different.  If I want to take a day off, or be lazy, I can’t just make that time up or just work harder the next day.  This post could potentially become the change of my life and how I see things and act with my diabetes.  I have had A1c right around 7.0 or below for over 2 years,  but it’s time to stop being complacent with those numbers and continue to work harder.

I am committed to making this life of a diabetic a better one and in turn a longer one!

5 Reasons Why Watching Sports Affects Your Blood Sugar

I wasn’t able to get a post up yesterday because I was having computer issues.  I have a WP app on my IPhone, but there’s no way that I can type that much on that phone.  So it’s Saturday afternoon and I am at the Spanish River Library in Boca Raton with a nice venti bold from Starbucks, with my beautiful girlfriend and getting some work done.  Why am I at the library on a Saturday afternoon when I am no longer in college?  Because football officially begins tonight which means I will have just about zero time left from now until January to do anything at all. Tonight my Virginia Tech Hokies kick off against the Alabama Crimson Tide.  It also means that my diabetes gets tougher.

For those that have been following me for a while probably know that my Hokies and Philadephia Eagles screw with my blood sugars big time.  This year I have a CGM and vow to wear it for every single game so I can monitor how my sugars are going up and down.  At my last Endo visit I was told that I need to track my blood pressure a little more frequently as well since it was 140/80 when I came in and also when I left the visit.  During Eagles games I can feel my heart pounding rapidly on big plays and also at the end of the game.  When they are winning easily it doesn’t really affect me.  More on the Eagles in a further post when their game is coming up.  Right now, it is all about the Hokies.

I am already becoming a little nervous because our star running back is injured and not going to be playing.  Not to mention that we are playing the #5 team in the country.  Grant it, we are #7 in the country, I hate having to play these top teams during the first game of the year every single year.  Let’s get into the diabetes part of it though.  And the reasons for why my sugar goes up.  I have narrowed it down to 5 different reasons why they are all over the place.

# 1 – Passion and Nerves

I am a very passionate and die hard sports fan.  I have been fans of the teams I am fans of pretty much my whole entire life.  I grew up an Eagles fan, became a Hokies fan when I was about 7 or 8, so I feel attached to these teams.  I have also had no luck with my sporting teams winning championships, except the Phillies last year, that I want them to win every single game.  When they lose I become upset and pissed and feel like I am part of the actual team.  Obviously I don’t want to feel pissy but when it is fourth down or there is 2 minutes left in the game and we are down by 6 my blood pressure is shooting through the roof.  My goal this year is to take deep breathes and relax and tell myself that my life is not affected by this game.

# 2 Food Choices

During sports games I am not always able to watch the game at my own home just because of regional TV decisions.  So, at times I must go down to the local sports bar.  While I am there, I may as well make a meal out of it and eat also.  This leads to a game long appetizer of homemade buffalo fried chips from Bru’s Room in Delray Beach, FL.  Second part of the meal is usually a Memphis pulled pork sandwich or some sort of non-healthy meal with some mashed potatoes.  You may have guessed why I named a specific food, because I am extremely superstitious and don’t like to go away from something that I ate when my teams have won while I ate that.  I know, I know, I’m crazy!

# 3- Beer

Beer and football, just makes sense.  Do I really need to go into why the beer intake messes with my blood sugar?  I don’t think that I do, your educator can take care of that.

# 4 Guessing, not Testing

If I go to the sports bar then there is about a 5% chance that I take my meter with me.  During that 5%, there is about a 1% chance that I will test my sugar.  I also am kind of guessing how many carbs are in the food.  Usually what I do is just take a 25 unit max bolus and then eat to cover my insulin.  If I “feel” that I am getting low then I will just eat more of the chips or maybe even order a dessert or something else.  Not a great decision for a diabetic.

# 5 Stress

This one comes during the game which I started to get into during reason #1.  The stress gets even worse after a loss.  I will be stressed out and down in the dumps for a few hours or even the next day until I finally get over it and realize that next week we get another chance to win.  The later into the season the worse the stress gets.

I now know the reasons why sports affect my blood sugars, now it’s time to do something about it and fix these 5 things.  Well I am going to the sports bar tonight even though the game is nationally televised, but I am going to eat healthy.  No beer, no pulled pork.  I will have an un-sweetened iced tea, a cobb salad and maybe a cup of French Onion soup.  Maybe, just maybe I may cheat and get some jalapeno poppers because Amanda also likes them.

Review From Doctor’s Visit Last Friday, To Symlin or To Not Symlin

Friday brought me another doctors visit. Let’s go through the checklist for the visit.

Insurance card, ID, meter, pump, clean socks, clean feet, food log, reasons for why I didn’t wear my cgm all month long.

Ok I have everything I need so now I can go to the visit, let’s check my sugar one more tome before we go. Ut-oh I ran out of strips. Once again I don’t have an extra box at work or in my laptop bag.  Going into the visit, I wanted to accomplish a few things.  They were to get my basal rates at right levels, get my morning sugars lower, figure out a better diet plan, learn more about temp basals and square wave boluses.

To start the visit off, I had weight a few pounds lighter than the last visit, even though that scale is way off.  Next came time for the blood pressure, not so good, it was 140-80.  I don’t know why it was so high.  I have been a little stressed lately with less sleep and some things going on at work.  Once the doctor came in the very first thing we discussed was why I didn’t have a lot of readings from the CGM.  So good thing I prepared for that one.  But I told her straight out that I just didn’t wear it as often as I should.  Then we started to look at the levels from the meter.  At previous visits, I had brought in 3 or 4 different meters and gave them the readings from those because I used different meters at different places.  That was one of the things from last visit I tried to stop and attempted to use the same meter almost every time, and I was pretty successful at doing so.

Now it was time to take a look at the bolus readings from the pump.  There were a lot of 25 unit (max) boluses without even having a blood sugar reading.  She did not like that very much.  The reason for those is when I know I am eating bad, and I don’t test before I eat, I just take 25 units, then will test later and correct from there.  Usually because I know I am eating enough carbs to cover that 25, which at my ratio, 5:1, that is at least 125 carbs in one meal, not too good.  There was even one in there just from last week that was two different 25 unit boluses within an hour of each other, (Olive Garden visit).

The last part of the visit was doc and I discussing the possibility of using Symlin.  The reason being is because she wants me to lose weight and she thinks just by my eating habits that I am not going to be able to do that.  This was brought to my attention with my previous doctor as well, and I had decided to throw the sample away and lose the weight myself.  Pretty much the same result this time.  I told my doctor that I want to attempt to lose the weight myself and by the next month if I don’t lose weight, then I will go on the Symlin.  I really don’t want to do that, but if I have to then I will.

Which leads to me to my question of the day.  How many people out there are currently or have previously used Symlin?  How did it make you feel?  Did it make you lose weight?  Was feeling like crap worth the weight loss?  Please let me know your experiences with Symlin.