Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

What’s wrong with this picture?

For those who have never worn a continuous glucose monitor (CGM), let me explain what you are looking at. This is the screen of Jiminy, my Dexcom CGM.  The numbers on the left are mg/dl blood glucose (BG). Each dot on the graph represents my BG reading at 5 minute intervals.  This screen shows 3 hours worth of data, but you can also display 6, 12 and 24 hours by clicking the ok button.  The symbol in the upper right corner indicates that I am out of range of this receiver, which means that the transmitter (stuck in/on me) is more than 5 feet away. That’s the first problem with this picture – I was sleeping less than 2 feet away from Jiminy, but apparently it wasn’t aware of that.  You might also note that the time is 2:37 am. What in the world, you may be asking, are you doing taking a picture of your CGM screen at 2:37 am?  That’s another problem for another time……Just take it from me that as long as I was awake, I thought I might as well make a note of what I thought was an interesting phenomenon.

So what’s the interesting phenomenon, you ask? Well, maybe you ask. Maybe you don’t really care, in which case, you should probably stop reading now.  What you don’t see is that for several hours before this, my BG had been holding nicely steady at between 80 and 100.  You can see that at one point, near the left end of the graph, all of a sudden the readings take a nosedive and bottom out for about a half hour.  For some reason, I didn’t hear the alarms that must have been going on during that time, which is disturbing.  But what is most curious to me is that my BG just went up after that, all on its own!  I didn’t get up and eat something, I didn’t even wake up until more than 2 hours after it had bottomed out.  So if I am remembering the physiology I learned decades ago, my liver secreted glucagon because it “knew” that my BG was tumbling dangerously low. Glucagon acts to increase blood glucose by breaking down the glycogen in the liver to glucose and shooting it into the blood.   It’s nice to know that one of my internal organs is on the ball at 2:30 am.  My pancreas may be shot, but my liver is on the job!  There’s good news for you. Or at least for me.

I love my Dexcom, mostly.  It is incredibly helpful in my hour by hour management of this disease.  At times I hate it – usually when it beeps or buzzes at me repeatedly until I do something about my low or high BG.  That did happen today and I was ready to throw it out my office window.  But then there are times like 2:30 this  morning, when it shows me some marvelous physiological design that still works in my body, and reminds me that I am “fearfully and wonderfully made”, broken pancreas and all.  So bring it on, diabetes, I’m equipped to do battle!

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Just do it!

The phrase “Just do it!” has been stuck in my mind for the past couple of weeks.  I had a doctor’s appointment recently and got great news of an lower A1C than I had expected, which made me really happy, of course.  But it seems like the Blood Sugar fairy has been hard at work since then, destroying whatever confidence I had in managing my blood glucose.  Specifically, I’ve been spiking quite high after most meals, and then it is tough to get it to come down to normal, often requiring several doses of insulin to rein it in.  I don’t like being high (BGs over 200, and at times, over 250) for hours at a time, which is what has been happening. Several times, this has happened long after dinner, so Jiminy (my Dexcom continuous glucose monitor) wakes me up with an alarm in the middle of the night, informing me that my BG is over 200 and DO SOMETHING ABOUT IT!  When that happens multiple times in one night, it’s pretty frustrating (though it does remind me what it was like to have a new baby, and so gives me empathy for a number of friends).  The only time this hasn’t happened is after breakfast on the days that I swim, but really, I’m not up for a mile in the pool after every meal.

So this new development means that I have to keep on doing what I know I am supposed to do even though I don’t get the results I hope for.  Just do it.  Just keep testing to see where my BG really is to confirm the Dexcom, then just keep dosing until it comes down into range.  Just do it, without investing emotion in that process – no anger, no self-loathing, no equating an in-range BG with self-worth.  Just keep swimming, even when for a time afterwards it feels like you want to lie down and sleep for hours to get rid of that awful low feeling that won’t go away.  Just keep eating wisely, even though the BG readings seem to indicate that you ate an entire box of cookies and a gallon of ice cream, which is what I WISH I had eaten.

Just do it applies to more than just diabetes, of course.  It applies to work.  Just do it, even when you don’t feel like it.  That, fortunately, isn’t a problem for me, since I love my work, both at home and at my job.  It applies to my faith.  Just keep praying. Just keep studying. Just keep obeying.  Just keep loving, God and other people.  Just keep trusting.  The nice thing about being a Christian is that I’m not in this alone. I don’t “just do it” on my own, either in my faith, or in dealing with diabetes. Thank goodness! or rather, Thank God!

So, just do it, whatever “it” is for you.  I’m pulling for you!

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Life goes on

Surprisingly, for the past few days, I have almost forgotten I have diabetes. Almost.  Family transitions and events have overshadowed what I thought was a part of my life that could never take a back seat.  And even more surprisingly, it hasn’t been a disaster to put diabetes in the background. This has made me realize that I have come a long way in a year.  Counting carbs has become easier (though today presented a new challenge –  just how many carbs in a serving of yuca?) and my wonderful Animas Ping helps me dose accurately. I am so thankful it does all the math for me!  And Jiminy (my Dexcom CGM) warns me when I’m going high or low so that I can catch it in time. These past few days though, I have even forgotten about Jiminy and it has been pretty quiet really, with no serious highs or lows to chirp about.  Amazing.  So though my learning curve has seemed really long and slow, there really is a learning curve, and I really am getting better at dealing with this.  It doesn’t seem like a honeymoon anymore, really, more like a settling in for the long haul.

I have to say that this is an encouraging thing.  For a time, I really felt like diabetes ruled my life, setting limits on me and taking up time that I would rather be using for other stuff.  It still takes up a good bit of time, and there are still times when lows or highs knock me off course.  And though I still get discouraged by those extremes that sometimes really flatten me, they happen less often now.  I’m learning new stuff too.  Just a few weeks ago I figured out that those funny looking little pieces that come with my infusion sets are actually  little plugs for the site when I disconnect the pump.  Here in Florida, early one morning when I was trying to test my BG without waking anyone up by turning on lights in the room, I discovered that my meter has a backlight that I never knew about!  I love surprises. (On the other hand, I sure feel dumb that it took me over a year to find it.)

Life moves on even when you have diabetes.  These past 5 days of traveling to Miami to deliver our daughter to her new job and new life have been an emotional time – happiness for her amazing job and the opportunities she has to impact the lives of so many children through music, grief at the thought of only seeing her a few times a year, curiosity about the city she is moving to, confusion trying to navigate this place. Then add in car trouble and meals in all sorts of places and you’ve got a recipe for unpredictable blood sugars.  I was prepared to be all over the map and having to correct things all the time. That’s why it has been such a pleasant surprise to be relatively stable.  Even the car trouble actually had a silver lining, as it gave us an unexpected extra day with Sarah as she rescued us.

I am grateful for small reminders that life goes on, despite my “new normal”. God truly is sovereign and even diabetes cannot thwart His plans for me.  I will continue to settle into this new life, knowing that nothing about it is predictable.  I’m glad to know God is with me every step of the way, showing me the way to live with grace and in His strength. I really can’t imagine dealing with life with type 1.5 any other way.

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