Wednesday, July 19, 2006

I feel like SHIT tonight :( :( :( . Not really physically, well, maybe a bit tired, but more so emotionally shitty. I'm just really weepy and in a "poor me" state of mind at the moment. Yes, I'm throwing a pity party for myself... which isn't too unusual for me.

I always think, why are things the way they are for me- why can't things be better? But, saying that, I think I am the one usually responsible for my own problems and misfortune. I believe I really could be my own worst enemy. I get myself in difficult situations and then I have one heck of a time trying to get out of them. I'll give you a "for instance".

This has to do with work. Things aren't exactly great at my job, as you may know. As I've mentioned in the past, I have a difficult time with my bosses, particularly A. I try to avoid her in most situations, b/c I find her rude and unprofessional. Not to mention, that she is not a real warm, friendly, or personable person. The lack of communication has caused lead to a big problem- that being my vacation.

I made plans with my sisters and my sister's friend to take a cruise in mid August a few months ago. Now, instead of letting A & T know right away, I thought I would wait. I can't really explain this logic. But , at the time, I think I thought asking for my vacation & also asking for the time off for my surgery was too much to ask for at one time. So I thought it wouldn't be a big deal for me to ask about taking this time when I returned to work. Well, guess what? I was wrong- it was and IS a BIG deal.

Their reason for it being a problem is that there are just too many people taking off at that time. C., one of my co-workers, is going on maternity leave. S., another co-worker, is on vacation, T., one of my managers, is also taking time off then. And this is going to leave us very short staffed. So after I arrived back from lunch, A. called me into her office and they proceeded to yell at me & ask me what I was thinking? Honestly, I really don't know. I guess I had this unrealistic expectation that they would be more understanding and flexible. Obviously, I expected too much, considering my past history with them. They told me straight off the bat, that they could not approve of my time off.

Well, this puts me in a real jam now, b/c , though they asked me to see if I could get a refund, I cannot. The airline tickets and cruise is already paid for and are non-refundable- so there's no backing out or changing plans. Also, the girls are planning on me being able to go- it impacts their plans too, so, again, I can't just bail out. I went back to tell A. this and couldn't help but get emotional- which I know I should have tried to refrain from.

My Dad always tells me that to get upset in the workplace is unprofessional, and I agree, but I just couldn't hold it together. I think, under pressure, it's hard to control that. Anyway, after my emotional breakdown, A. said that she would talk to T. & see what she could do, so I'm hoping that, somehow, things will come through in the end.

I know it's my fault ;(. I should have planned things better, like I said, but I think that they could work with me on this if they wanted to. First, yes, the phones need to be covered, but there's going to be people there & the phones aren't that busy that they ring off the hook. So I don't think that's a real issue. According to A., the main issue is about my work getting done.

Well, the work will get done- it's not going to go anywhere when I'm away and I don't think I'll have any problem catching up on what I need to get done. When I was away for my surgery for a week and a half & came back, it only took me a day or two to catch up. I'm more than willing to stay late, come in early, & even come in on the weekends to get my work done, if need be. I really don't think a week is going to shoot things to hell...

I am not trying to excuse my mistake, I'm really not. I know I was a complete idiot by not planning things and being more responsible, but I think the fact that A. doesn't really like me (see my past post on what she said about me to 18 year file clerk) is kind of influencing her decision more than anything else. I'll be surprised if she tells me that it's ok...but I'm praying she does. Because if she again says no, I'm not sure what I will do... It will be a BIG problem.

Tuesday, July 18, 2006

I wanted to share that I'm currently wearing and using the DexCom system. For those who don't know, it's a sensor that "reads" my interstitial body fluid and transmits a reading to a receiver. Basically, I can see what my blood sugar is doing, every 5 minutes if I want... Today, my first day on it, I've been checking it A LOT to see how my blood sugar is behaving (or should I say, misbehaving) and it's truly amazing to be able to check my readings at any given moment by just pressing a button. Technology is awesome :).

I probably would have never tried this if it hadn't been for a surprise call from B., who is a CDE/nurse practitioner at a Diabetes practice in my old town. Now, normally I do not use this practice, but they were the ones who offered to help me when I wanted to try CGMS. At that time, the doctor and practice I usually see couldn't offer me use of the system, mainly due to insurance issues. So I was left to me own devices, and on a suggestion from a rep from my health insurance, I found B and the practice she currently works at. And I very much lucked out.

Anyway, B. called me and informed me that they were going to participate in a "field trial" with DexCom and she wanted to see if I had any interest in trying it out. According to B., I would be able to try out this system for a week, for free, and at the end of the week, I would meet up with B. and the DexCom rep and download the readings. Also, I would then be given the opportunity to purchase the system at a discounted price. I thought, what do I have to lose? It could be a great experience & it could be a great experience, so I agreed.

Today, I went in for the training and informational session & got hooked up! I was a little nervous when the rep was going over how to use it, but I guess that's a normal reaction when learning anything new. It feels a bit like information overload. But as the session continued, I was getting more and more comfortable & it seemed pretty straight forward and, relatively easy to use. The rep was very nice and took the time to go over everything and answer questions, which helped a lot. And I knew, once I was up and running, I wouldn't have any trouble with knowing what to do...

At the end of the instructional session, we were taken back to actually be put on the sensor- the fun part. Now, even though I have been injecting myself and using insertion sets and devices for over 4 years, I still am not comfortable with anything regarding needles. And the way the rep described the insertion of the sensor frightened me, quite frankly. So of course I was hesitant to try this out!

I watched as B. helped one of the other trial participants insert hers. To see how this patient reacted didn't help matters- she said "ow" more than a couple times... Looking back, I probably shouldn't have watched, but of course, at the same time, it's hard not to. Before long, it was my turn. I knew that I had to put on a brave face and just do it, but I was really not feeling all the brave and I guess I didn't look it either. The other woman was like, "hon, it's not that bad" , & "it doesn't really hurt". Okay, if that's the case, then why did you say "ow"?

I didn't realize that I looked pretty nervous until B. stated that I was really shaking... which was something else I wasn't fully aware of. I then realized that I was shaking quite a lot. Having to inject something under your skin doesn't stir up a good emotional response from me & then having all eyes on me while I do this, made me even more anxious. Finally, I knew there was no avoiding it, I just went for it. And I was really surprised- it didn't really hurt at all- much less than my insertion sets, in fact. What a HUGE relief :).

From there, things wrapped up and we all went on our way to try this new system out on our own. Despite how excited and amazed I am at seeing and knowing what my blood sugar is at any given moment, I have been a little frustrated. The readings I have received on my meter and the readings collected from this sensor haven't been all that close... Both things have a 20% +/- degree of error so if my reading on my meter is 20 % lower than my actual reading & my sensor reading is 20 % higher, this can make a huge difference! And I've been seeing a lot of differences, to my dismay.

Today, at work, I experienced a situation where my two reading weren't matching... my blood sugars were reading in the high 200s/low 300s on the sensor, but somehow that didn't seem right. For one, I wasn't feeling as if I was high, so I opted to test my sugar with my meter. My meter rang in at 116- which definitely is a large drop from what I was seeing on the receiver. As instructed, I plugged in my meter to my sensor, to see if that would help readjust the readings taken in by the sensor, and soon things were closer in range. However, the difference between the two have continued on as the day has gone by.

I know this has the possibility of driving me crazy, b/c, yes, I do want every reading to match. However, I know that this is, most likely, not going to happen with this system and I shouldn't expect that. It may help to identify highs and lows, but the main purpose of DexCom is to identify trends in my blood sugar or patterns. And, as a whole, that's probably more important.
I'm sure this could very well try my patience, but I think if it shows me things that I don't know about and helps me with adjusting my regimen to improve my control, it will definitely be worth using.

I think it's a very cool system and, yes, I probably would purchase it if money wasn't an issue. But considering my financial status right now, I can't afford the cost of the sensors, replacing the transmitter or receiver, and any other costs involved, unfortunately. It's going to be another test for my patience, because I am going to have to wait until insurance provides coverage, which according to the rep shouldn't be too long from now. So as much as it will pain me to give it up, I'm going to have to think of my bank account and be strong...

Tuesday, July 11, 2006

BetterCell (see updated Links) posted a question on how my blood sugars reacted after my surgery... So seeing that it's actually been a while since I have focused my blog on my Diabetes, I think his question gives me a good reason to not only address his question, but also discuss some other things going on in my current Diabetes management.

Honestly, my Diabetes control wasn't all that great after my surgery... At first, I really didn't notice too much of a change in how my blood sugar is usually. But then, as time went on, I started seeing more and more elevated numbers :o(, to my dismay.

I guess it's sort of understandable- I was off my usual routine, spending most of the day lounging, and got no kind of exercise or activity of any type. I contemplated increasing my basal rates... but, ultimately, opted not to. Instead, I thought I would ride it out. I knew that my week off would end & I would get back in the groove... and, with any luck, my readings would respond accordingly. And I have found this to pretty much be the case- so that is good :)

However, saying that my blood sugar is back to normal isn't saying that my blood sugar is great. Because, honestly, it is NOT. Unfortunately, I am still having some of my old issues. And there's one main issue that I am beginning to think will never go away... that being, my nighttime readings.

Sometimes I wonder if I have some kind of insulin resistance going on in the evening hours. I don't know if that's even possible... All I know is that I eat dinner and my post dinner readings are almost always in the 200 range, no matter what I eat :(. Not only does this leave me frustrated and upset too many times to count, but it's hurting my control.

To give you an example, yesterday, I ate a slice of turkey meatloaf with salad and my post-dinner reading was 243~ wtf! Yes, the dressing had carbs, some of the veggies in the salad may have had a low amount of carbs, and even the meatloaf may have had some carbs (due to the tomato sauce and bread that was listed as ingredients). But, I took about 5 units of Novolog, which I would think would be enough. Evidently not. :(.

So despite my Endo's opinions of perfecting my basal rates before introducing another variable into the mix, I started Symlin (actually started two Sundays ago). I came to a point where I felt like I wasn't getting anywhere with basal test after basal test, that I felt like I had to make an executive decision and take charge of my own disease.

However, saying that, I can't really say that I have seen much of a difference. In fact, I've seen very little difference at all. The first days I took it, I had the same familiar readings after dinner. .. In other words, highs, which, yes, are a little disappointing. So then I thought that maybe I should up the dose a little.

Instead of taking the initial 2.5 units they recommend starting on, I opted to take 5 units instead. Well, the first time I did this, I did see a difference... I think I had a reading of 113 (perfect!) but this also has not been consistent, nor have I been consistent taking it (last nite I forgot!) But, still, it seems like some days it works and sometimes not.

Then tonight I again used it at dinner... I had the meal of turkey meatloaf and salad again, took my 5 units of Symlin, bolused 2 units to correct a pre-dinner high (of 200), and bolused 2.4 units to cover my meal. Two hours later, I was sitting at 154... which is really good for me. But like I said, to take that much insulin for a meal so low in carbs kind of surprises me and makes me think there is another issue going on.

I know 2.4 units doesn't sound like a lot of insulin to cover a meal, but don't forget that when you are on Symlin, you take half of what you would regularly take for the meal w/o it. So that would mean that my meal would typically require about 5 units of insulin,in addition to the 2 I gave to correct... It seems like an awfully large amount of insulin to take when I don't believe that my meal was chock full of carbs to begin with.

The only other thing that might explain things is whether or not my Symlin is even working. I actually opened the bottle a couple of months ago... but my Endo wanted me to hold off on it (in effort to work on my basals), so I closed it up and left it in the fridge. I think it's possible that it's lost some of it's potency and may not be working to it's full potential.

That would sort of make sense to me, b/c that would mean, for instance, tonight my meal wouldn't really require 5 units of insulin, but instead that the 2.4 units was sufficient. It would also explain why I haven't had excellent post meal readings. Plus, it would also explain why I haven't had any negative side effects, such as the hypoglycemic reactions, nausea, or vomiting that some have described.

The only thing it doesn't explain is the weight loss I have seen recently. But now that I am thinking further about it, I think there could be other reasons for that. In the last few months, I have been able to cut down on the insulin I take w/o Symlin, as I have been eating lower carb. Also, I haven't been grazing as much. And, I haven't been having to treat a lot of lows. All of which the weight loss could be attributed to.

Well, whatever it is, I'm not complaining :)... But it would be awesome to see a little bit more and, if Symlin can help in that respect, I'd like to further pursue it (full potency this time!). So I am thinking of trying this vial a few times more and seeing how my blood sugar reacts and if I see more bouncing blood sugar, I will go ahead and get a new vial.

That basically sums up the state of things right now regarding my Diabetes... I did have one other piece of news to share, but I think I will save that for now (as this one has gone on forever already). However, I will try to post about that next time and I will, also, keep you posted with how my adventures with Symlin goes... With any luck, I'll be able to report good things next go around!

Thursday, July 06, 2006

Part 2... Recovery

I ended up staying at my parents house for longer than I originally planned, but this was probably for the best. I think I needed company and, also, it's always good to have people around in case of an emergency or what have you...

Thursday, I wasn't quite out of it, but I wasn't myself either. I spent most of the time lounging and dozing a bit as well. Friday, was similar, but I was even moodier than I am usually. It's no excuse, but I really have little patience... and I am a terrible patient. I don't know how my family dealt with me, particularly my Mom, b/c I was just awful.

However, it worked out that they all had to work my inital thought was that I wouldn't have to worry about any problems. It goes without saying that I was wrong. My Mom and Dad worked full days, but sister, K., only had a half day, being that it was the last day of school (she worked as a teacher's assistant). Of course of all people to have a short day, it would have to be her... which is not what I would hope for. Since my arrival, she had still refused to speak to me and I could tell that she wasn't going to make any part of my recovery easy on me. Sometimes I wonder how she can be so stubborn and cold...even if she was adamantly against my decision.

In fact, she showed little to no consideration that afternoon. That Friday, my older sister, C., my Dad, and my younger sister, K. were all going to a Yankee game. I was pleased to know that I wouldn't have to run into her too much. But before leaving, she decided that she was going to make a lot of commotion and noise getting ready, which was bad timing. I had just went to lie down and had started dozing off. But I was interuppted with her banging drawers, blasting her music, and the hair dryer going. I yelled for her twice to shut the door, only to be completely ignored. Finally, my Dad came upstairs to see what the noise was about... and told her to have a little consideration, since she was being blatantly obnoxious.

At this point, I was quite upset. I knew that she was going to be difficult, but I didn't think she would go out of her way to be so. I eventually did calm down, but I was still so angry. Hours later, my Mom arrived home for work, and I was still furious with K's insensitivity. I was beyond irritable and agitated and I, sadly, took some of that on my poor Mom....which is all she needed after a long day at work.

Saturday and Sunday flew by and by Sunday I was able to drive home. In a way, I was glad to have my own space and not worry about having any noise or difficult people, but at the same time, I didn't know exactly what to do with myself. I spent a lot of time being completely lazy, lounging, reading, or watching tv... and it was nice for awhile, but as the days went on, I was getting bored and anxious to return to my usual routine.

Later in the week, Thursday, a week after my surgery, I returned to my surgeon's office for a post-op visit to follow-up on my healing and also to get the cast off my nose. Prior to that visit, I went online looking for cosmetic surgery before & after photos... probably out of curiosity. However, I think this was a mistake... I saw many photos of patients where you couldn't even really tell they had surgery. This was my fear...that I went through the whole surgery, was going through the healing process, spent a LOT of money, and dealt with hostile, opinionated family member(s), and then wouldn't be able to see a difference.

Ok, I think those photos I saw weren't the best quality or the clearest images, so I'[m sure there were subtle differences, but I think I expected more than that... I knew, however, that I would just have to wait and see my own results. Saying that, that fear was still fresh in my head, but I t tried to stay calm and open minded. Well, I tried anyway.

Anyway, I arrived and soon was taken back by Dr. C to the exam room. He advised me that there still was a lot of swelling, and also advised me to keep that in mind when seeing what was under the cast. He took the cast off with a razor (which kind of hurt) and then went about pressing on my nose to reduce swelling, so he said. Then he gave me two mirrors to view my new nose. Well, I think I worked myself up so much, that I had convinced myself before I saw the images in the mirrors, that there was going to be absolutely no difference. I left composed, but that quickly changed.

My parents wanted me to stop by...which I did, but I think they were kicking themselves seeing the emotional mood I was in. I was extremely upset, disappointed, and teary eyed. They kept telling me that there was definitely a difference and that I would likely see more as time passed and the swelling reduced. But at that point, I wasn't having any of it... they couldn't convince me of this as much as they tried. So I stayed upset and disappointed over the next few days.

However, time has passed and the swelling has gone done dramatically. I can see definite differences, be it subtle, but still differences. Monday I returned to work and, frankly, was a little nervous about facing other people's reactions. But, there wasn't any reaction to speak of, no one said anything. I'm not sure if that means that they can't see any change or what. But then I think, what would they say?

Ultimately, it should my opinion that counts most regarding this. Presently, there still is some swelling and puffiness, but I do see subtle changes... and they are mostly good. Honestly, yes, I'm a little disappointed overall. I guess I was expecting something a little more drastic, but maybe these expectations were a little unrealistic... And when you set expectations like this, it is just setting you up for disappointment.. but that's something I guess I'm getting used to.

~~~As a side note, my sister, K, and I are now on talking terms... I am still hurt and bothered by her reaction., but, saying that, I'm trying to be a bigger person... Staying angry would not get me anywhere and I think it's in my own best interest to try to move on... and I'm trying~~~

Sunday, July 02, 2006

Is it any Wonder? Keane


I, I always thought that I knew
I'd always have the right to
Be living in the kingdom of the good and true
It’s so long, that now I think I was wrong
And you were laughing along
And now I look a fool for thinking you were on, my side

Is it any wonder I'm tired?
Is it any wonder that I feel uptight?
Is it any wonder I don't know what's right?

It's hard to know where I stand
It's hard to know where I am
Well maybe it's a puzzle I don't understand
But sometimes
I get the feeling that I'm
Stranded in the wrong time
Where love is just a lyric in a children rhyme, a sound bite

Is it any wonder that I'm tired?
Is it any wonder that I feel uptight?
Is it any wonder I don't know what's right?
Oh, these days, after all the misery you made
Is it any wonder that I feel afraid?
Is it any wonder that I feel betrayed?

Nothing left inside this old cathedral
Just the sad lonely spires
Adding you make it right

Oh, but you try
Is it any wonder I'm tired?
Is it any wonder that I feel uptight?
Is it any wonder I don't know what's right?
Oh, these days, after all the misery you made
Is it any wonder that I feel afraid?
Is it any wonder that I feel betrayed?