Holding Myself Accountable

When things go wrong, excuses usually begin to fly. This is not only true with diabetes, but also with anything in life.  So, this morning when it was time to review my latest blood work, I was going to hold myself accountable for whatever the numbers told us.  I was not going to blame it on the diabetes, but my choices.

I knew going into reviewing the labs that my A1C was going to be higher and that there may be some issues with the lipid panel because of the horrible diet and forgetting what the inside of my gym looks like.

A1C was a little higher than last time, but lower than what I thought.  I honestly felt that my A1C was going to be between 8.0 – 8.5 because I’ve seen the numbers on my meter and they have been bad, probably my worst 3 months in the past 5-6 years.  Which is also why I knew it was time to go back onto the pump and get off of MDI.  The A1C was 7.5.  Not good, but better than I expected.  It was 7.1 six months ago, so I obviously wanted to improve on that, but didn’t.

Everything else in the lab results was good, except for one big issue.  Triglycerides.

I’ve never had an issue with my triglycerides being high because I always had some form of exercise, not intense, but would get at least an average of 15 minutes per day.  My triglycerides were 455.  If you know about triglycerides, then you know that’s pretty damn high.  The doc was concerned about this number obviously, but as I’ve written before, we have a great relationship and she does not scold me, but provides me with the information I need to make better decisions and make improvements.

There was a side of her that wanted to put me on medication, but she knows that by giving me a warning and doing labs again in 90 days, that it will motivate me to improve that number that she feels I won’t need medication.

So, here is to holding myself accountable. No more bolusing 40-50 units for one meal. Yes, you read that right, 40-50 units for just one meal!  No more just sitting on the couch watching horrible reality tv shows (my wife loves that shit!) and more of getting back to the gym, walking around the neighborhood, ANYTHING.

Here’s to lowering triglycerides

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Humulin N Mistaken for Humalog

Yesterday I posted about the excitement that I had about ordering and receiving my first 90 day supply order since having insurance for the first time in 15 months. However, I also had to add an update because after coming home and opening the box, there was 3 vials of Humulin in this box.

Ut-oh!

20130919-171350.jpgI started thinking about why their would be Humulin N in this box and not Humalog, so right away I called the insurance company. They told me that the RX they had on file that the doctor faxed over was for Humulin N, 10 units a day, which meant 3 vials for a 90 day supply. What is this? I’ve never used Humulin N in my life. In fact, I didn’t even know what Humulin N is!

So I asked OptumRX what the process was to return this insulin and to get my $25 back for this 90 day supply because I will never use this insulin and it’s just going to go to waste. Well, since they shipped the insulin that the doctor faxed over, they cannot refund the money and they cannot accept the insulin back as a return. I mentioned that it was a doctor mistake and I’m not even using Humulin so it’s not an actual doctor’s order because I don’t use this stuff, never have.

Their answer, “Sorry, sir, we apologize for the inconvenience, but we cannot refund the $25 or accept the insulin back as a return”

One day back with an insurance company and already the hoops, loops, obstacles, and BS has started. I also mentioned yesterday that I will never complain about insurance or pharmacies again because I have lived without having them, so I am completely grateful for this and the $25 loss is well worth it, as long as the correct insulin is ordered and shipped.

I called the doctors office this morning and explained the situation. The doctor’s assistant is the one who faxed over the RX and there was a bit of confusion….so, let me explain.

During my last visit, we discussed ways to try and cut out these highs in the morning. Here’s an example of one, I woke up this morning at 124 @6:30 a.m. I fell back asleep until 9:30 and my blood sugar was 325. That’s it, no food, no coffee, nothing, just simply waking up increases my blood sugars crazy high. So, my doctor recommended taking 10 units of Humulin N at night before bed to try and stop those lows.

There was the confusion, I guess.

Doctor’s assistant saw the visit notes and saw Humulin and did not see anything about Humalog, because I was on Apidra, but it’s too expensive right now and went with Humalog. Even though I told the receptionist Humalog, and I know she didn’t get it wrong because she’s probably the best doctor’s receptionist I’ve ever had before.

Bottom line is that the issue is fixed….I hope. My credit card was charged another $25, so I’m assuming I should be getting an email later tonight about the order shipping and hopefully will get it tomorrow. If not, it’s back to the doctor for a sample vial of insulin to get me through the weekend.

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Day One of Diabetes Blog Week – Share and Don’t Share

If you haven’t heard of Diabetes Blog Week, then click the link and read all about it.  Today’s prompt is:

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?  (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)

I have blogged before that I am very lucky to have the medical team that I have. My previous endo was type 1 herself and wore a pump and knew the daily struggles that I was going through, so I never had to feel like I was making excuses for things.  She totally understood, but would push me to be better. (more…)

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Driving with Diabetes Study

Last week when I was at my endo for a pump training for a trial of an insulin pump that I am starting this week, my doctor gave me a print out for a Driving with Diabetes test / study.  The information is below.

Do you have Type 1 Diabetes?

Are you 18-70 Years Old?

Do you Drive Regularly?

If YES, you may find www.DiabetesDriving.com useful.

What is Driving With Diabetes?

  • An internet program developed to potentially help ALL drivers with Type 1 Diabetes.
  • Interactive, very engaging, convenient and confidential.

Participation in this NIH study involves:

  • Random assignment to:
    • the Internet program group, or
    • the routine care group
  • Sharing your driving experiences
  • Completing online questionnaires
  • No clinic visits – done entirely in your home
  • Earning up to $270 in Internet gift cards and helping others with Diabetes
Principal Investigator for the Study: Dr. Daniel Cox.
For more information, please visit www.DiabetesDriving.com

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Results from My Endo Appointment

Today was the big endo appointment. I haven’t had one since July because my previous one was cancelled and I couldn’t get in until now. This was a big appointment because there have been a lot of changes in my life. The main ones were my diet and being on Apidra full time which means that I am using less insulin. Over the past week, I have talked about the multiple lows that I am getting every single night and during the day, so I have been making a few adjustments to basal rates and carb ratios trying to find the perfect match.

(more…)

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Endo Appointment Tomorrow

This is a late night post, but I’ve been pretty busy all day trying to catch up on some work.  I’ve also been preparing for my endo appointment tomorrow.  I have not “prepared” for an appointment in probably 7 years.  I usually just grab my meter and go to the doctors office and that’s it.  Not this time.  I’ve been writing some things down because my diabetes has been extra wacky lately. (more…)

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Apidra Samples

Endo Appointment, Bad A1C, and Apidra Costs Too Much

I just got home from my endo appointment about 20 minutes ago, and I wanted to write this blog post while everything was still fresh in my mind.  First, let me mention what some of my thoughts were going into this appointment.  I knew my A1C was going to be high, actually, probably the highest it’s been since being diagnosed.  Why did I think this?  Because my meter results over the last three months say so.  I also knew that I did not wear my Dexcom at all during the last 60 days, so I knew that was going to be a point of discussion.  Finally, I did not reach my goal for my weight loss.  Now, onto what happened. (more…)

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New Year New Diet

2012 brings the opportunity to start fresh and start new things.  Every year I set a few goals, and last years goals I did not do a good job in accomplishing them.  As I stated yesterday, I plan on setting smaller goals throughout the year that lead up to the big 2012 total goal.  Today, I am going to talk about the dieting goals that I have.

During my last visit to the endo, I spoke with the nurse practitioner and the dietician about me losing weight.  They mentioned that I should go on a 2 week vegan diet and that I would lose a healthy amount of weight during that 2 week time frame.  I shot down the idea of a vegan diet right away.  So, since I can’t just jump right not that, I’ve decided to cut MOST meats out of my diet.  The only meat that I am going to eat is chicken.  That means no more burgers, no more hot dogs, no more turkey, no more pork, sausage, bacon…. chicken only.  I am also going to cut out cheese and high fat foods.  No more mayo, no more cheese, no more ranch dressing, etc.

Within this 2 weeks, I am also cutting out fast food.  Once I reach this 2 week goal, I will be going camping, so I know for a fact that I will be eating poorly, so that is going to be my reward for reaching a short term goal.

One goal that Amanda and I made together was to not eat out anymore, well at least not as much.  So I will be cooking more often.  I have a lot of recipes that I have tweaked that are healthy that I can’t wait to make.  I am looking for a good recipe for tuna fish and chicken salad.  I am cutting out mayo, and that was what I used to make it awesome.  Mayo and relish and onions.  Anybody know of a good alternative and a healthier solution?

Let me know.

Thanks.

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My Awesome Endo Office Appointment

I had my endo appointment last Friday and I haven’t had much of a chance to post about it, so here we go.

I knew going into the appointment that I wouldn’t be meeting with my actual endo that day because she was out of the office, but I would be meeting with a nurse that I’ve known from a past career and ventures that I have done.  A quick background and explanation of that.  I used to travel to a lot of local diabetes event when I worked for a horrible company.  One of the events that I regularly attended was a CEU class that was taught by a diabetes educator and an MSRNP.  This MSRNP is now part of my official diabetes team.

Going into this appointment, I already knew how much respect I had for this medical professional.  Then our first conversation about my specific health issues began, and the respect grew even more.

First, we did not have my Dexcom graphs because their office computer was not working properly with the Dexcom software.  And I use a Mac so was not able to get the results ready before the meeting.  I explained what I was seeing in the results and explained that I noticed a large spike in my blood sugar right after I ate.  I told her that I felt it was because I was not taking my insulin enough time before I was eating.  She agreed.  We worked out a schedule and set a goal in trying to take my insulin 10-15 minutes before I actually eat.  She recommended that I set an alarm on my phone about 15-20 minutes before the times that I normally eat.  I said that this might work because I eat breakfast at 8 a.m. every day, lunch at 12-12:30 and dinner at 7.  I’ve set the alarms and so far they have worked :)

The next item we looked at was when she asked me why I was over-riding all of the bolus suggestions from the bolus wizard from the Medtronic pump.  My earlier suspicions were confirmed.  Since I am taking a lot of insulin and I have a 3:1 carb ratio, I’ve been taking more than 25 units at almost every meal.  If I have to take 32 units because of a meal and a correction, my pump maxes out at 25, so it looks like I am over-riding it, but I’m not, I’m just taking the max amount allowed.  Then once that 25 is finished, I have to take the remaining insulin….which never happens because I always forget.  So, there lies a problem.  She said that she never thought about that before and that’s something that Medtronic should fix.  I agree…Medtronic, you should fix that.

Next topic of discussion… where my Dexcom all the time.  Next topic.

Dual wave bolus.  I hardly ever use this, but I have been trying to learn, test and try it more often.  We discussed the 80-20 rule and went over a study from the ADA Scientific Sessions in San Diego about a possible 70-30 rule.  I loved the fact that during my appointment we spoke about studies and I actually remembered hearing something about that during the time the Sessions were going on.

The final part of the appointment was changing my basal rates to get my nighttime / morning sugars to a reasonable level.  My basal rates are ridiculously high, I really need to bring them down.  This is where the conversation moved to talking about my weight and dieting. She mentioned that if I can just cut out some of the meat that I eat, that I could potentially cut down on the amount of body fat that I have.  I am trying this at lunch, but it is damn hard for me.

Once the appointment was over, I started talking to her about the diabetes community and blogging and tweeting and the advocacy and all that fun stuff.  Then she hit me with one of the ideas that she has had, and I told her that I will do what I can to help her.  Her idea is that when she is going to speak to kids with diabetes, or the camps, or whatever group of kids she is working with, they are always in a classroom setting learning about diabetes.  She wants to get the kids active.  Her idea is to create a basketball team, a baseball team, a cheerleading team, some sort of team that can go and compete against others.  Not just any others, but children with diabetes from a different area.  It’s basically like a travel league team, but for diabetics.  I think it’s an awesome idea…. awesome I say.

Get back to me after the New Year and we’ll see how well all of this has been going for me.

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Diabetes in December

Another month has come and gone and now we are in the finally month of the year. Are you serious??!!?? It seems like just yesterday that I was writing a post outlining my goals for 2010. Well I can tell you one thing now, I did not reach those goals. The year is not over so I still have a month to try and accomplish some of them, but I defimitely wont be meeting them all. One of my main goals of the year was losing weight and I have not done a good job at that. I have been spinning at home, but after just two days of doing it, my ass hurts so bad from the seat, so I have to buy something comfortable or else I can’t make it more than 5 minutes on the bike.

I had to get blood work done this morning for my doctors appointment on Friday. This is the big test of the year where I get pretty much everything tested, so that means lots of blood. I know that the results are not going to be good, but all I can do is try and make them better next time. I’ve already cut back on my insulin intake which means that I am eating less.

So here is to another month and the ending of a year. Stay strong in December and carry it through to the new year.

Take care everyone

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