Scott's Diabetes Blog

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Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Tuesday, February 28, 2006


The non-diabetic body is always checking the blood sugar level and making little adjustments.

The most accurate way we have to express "always" would be to say once every second.

So there are 60 seconds in a single minute, and 60 minutes in each hour, and 24 hours in each day. That means that a non-diabetic body is checking and adjusting blood sugars and insulin levels more than 86,400 times every day.

It's no wonder we have such a difficult time trying to manage this on 10-12 tests per day!!

Monday, February 27, 2006

Blood Spots

I hear that doctors that review logbooks actually don't mind seeing little bloodspots on the pages. It lets them know that the person is really testing their blood sugars and logging them.

I was leaking like crazy, and didn't notice it until I smeared it all over the logbook!! Many of my pages have little spots, but nothing like this!!

Now I just loved hearing about your test strip stories. How about any good "leaker" stories?

Saturday, February 25, 2006

Test Strips

A recent post by Penny over at my son has diabetes mentioned test strips, and how they are everywhere. Even somehow following her husband to work! She's right - these things are everywhere!!

It made me think of a couple things that I find a little funny, in a weird diabetes kind of way (we do have a different sense of humor don't we?).

1) I have a "diabetes drawer". Actually, I have a few of them, but this drawer in particular is where I keep my meter that I use when at home. The test strips never quite make it into the trash, but rather pile up by the thousands in the drawer itself. Every now and again I'll clean it out, but it's usually very full of used test strips. This is usually not a very big deal - but one day I accidentally dropped my unused test strip into the pile of used strips. I looked at the pile of strips for a minute, and pretty much wrote off the unused strip as being lost, thinking "how in the hell am I going to figure out which of the thousand strips was the one I just dropped?!"

2) Have you ever been out and about, and seen a discarded test strip somewhere? Did you get a small kick out of just recognizing what it is? Did you send a little silent "shout out" to that anonymous fellow diabetic out there somewhere?

Those are a couple of test strip things that make me grin or chuckle. I'm quite sure you all have some very good stories to share! Consider the comments section officially open! Grand prize for the best story is one used test strip... (your choice - accu-chek, one touch or freestyle).

Friday, February 24, 2006

The Simple Act of Logging

I have been logging pretty consistently lately. I'm using the "Smart Charts" or "My Other CheckBook". The upper portion of the page is a line graph, where you can plot your BG's for each hour, and there are spots for basal rate (or lantus dose), carb bolus and correction bolus.

The bottom half of the page has spots to record food and carb grams for breakfast, lunch, dinner, morning snacks, afternoon snacks & evening snacks. The space is tight, but workable. There is a place for the day of week, the date, your weight and a couple lines for notes/comments. Again, the space for notes & comments is tight, but workable.

I've found it difficult to pay close enough attention to my boluses enough to separate the carb and correction boluses. For the most part, I plug in my BG and/or my carbs, and let the pump figure the dosing for me. If the situation ever dictated, I can go back through the pumps history to nail down details of how much the bolus was. I'm not sure if getting the exact insulin dose is very important or not - or if just counting on my insulin to carb ratio and correction factor is enough. I suppose if I have any suspicions on any scenarios I would certainly examine that more closely.

I do track when I run temp basal rates, such as for basketball, but again I don't track the actual units/hour, but the percentage of my normal basal rate. That is just because that is the way I program my temp rates - in percentage rather than units.

It's been around one month, and I think that the simple act of logging has helped my control. I believe that this is true for many people - but it's really such a PITA (Pain In The Ass) that it gets neglected often.

Maybe it keeps me honest, maybe it keeps my control on my mind, maybe it's the internal conversation of "how the heck am I going to log this?!" that helps me make good decisions - who knows for sure.

I have been consistently logging for about a month. There are pockets of time where I'll miss a couple days (mostly weekends), but for the most part, it is every day.

Of particular value to me is the line graph that's built in. It is helping me to better understand what my food choices do to my bloodsugar, and to spot things that don't seem to make sense (like that dang set change).

Looking through these, many of my morning readings are high. I believe this is due to one of a couple things. For one, I've been very very sloppy at night before I go to bed. So, this results in either highs from overeating and under-counting, or lows that I'm rebounding from. A while back I caught myself rebounding from lows, by doing some 2am tests, but I haven't done any of those lately.

I also think that there is something going on after basketball, due to my temp rate needing some additional fine tuning.

I plan on continuing to log consistently, as I feel it is beneficial for me. Over time it will help me identify problem areas, or confirm suspected problem areas.

Thursday, February 23, 2006

Special Delivery!

I got my delivery of Girl Scout Cookies today!!

And for the record, one sleeve of Thin Mints is 90 grams of carbs and 700 calories.

I've been trying to give them away all day, but I must admit that a fair number have found their way into my mouth...

PIIP - Part "n" - Payoffs vs. Deprivation

Another thing that the therapist and I talked about was looking at the payoffs rather than the deprivation that is commonly associated with changing habits.

For example, take my good nights rest vs. PDA action plan.

What are the payoffs of getting a good nights rest:
1) Not feeling tired through the day (unless my BG is really high)
2) Being able to better focus on tasks and projects
3) Being better able to handle whatever challenges the day presents (diabetic or otherwise)
4) Being better able to make good choices

What are the deprivations involved with not using the PDA at bedtime:
1) This is when I usually catch up on blogs - I'll have to find another time to do that (easy).
2) I'll have to glance at tomorrow's appointments before I put it away (again, easy).
3) Nothing to keep me up when I should be sleeping...
4) Um, ... , is that really all?! Wow.

See - it's simple when looked at from that angle. Funny how perspectives can change so much about a situation. The "pros" easily outweigh the "cons".

This is a pretty easy situation to analyze like this. I know that others will probably be much more complicated. But with almost anything, it seems that the payoffs outweigh the perceived deprivation by a great margin. Those perceived deprivations seem downright silly in many cases when compared to the payoffs...

Wednesday, February 22, 2006

To Be Proud Of

You would all be proud of me.

I tried something new for breakfast the other day.

I had a serving of scrambled "Egg Beaters" (basically egg whites), with one slice of american cheese (the heavily processed variety), in a whole wheat pita bread. Total carbs? About 13 grams.

How was it? It was just Ok - tasted very "eggy" (duh!), which is a taste I'm not crazy on, but think I could get used to. Yes, I know I'm a bit strange...

How did my blood sugar do? Um, pretty good I think. You see, while the day started out with the best of intentions, it kind of ran a bit crazy after breakfast and I didn't pay too much attention to the BG until much later in the day. Shame on me.

I'll try it again on a weekday where I can pay better attention to it.

Tuesday, February 21, 2006

Putting It Into Practice - Part 'n'

Putting It Into Practice - hereby known as PIIP. This, and all future PIIP posts will be known as "Part 'n'", because I don't want to keep track of which number I left off on... Lazy? Maybe. But I like to think of it as "efficient". :-)

I had a great appointment with my therapist last week. I was almost late to the appointment (as usual), so felt very rushed and stressed when I finally sat down in her office. The first thing we usually do is a "check in". Exactly what it sounds like. I told her how I was feeling particularly rushed, and how every day seems like this. I'm rushing to get from place to place, doing what I can do to satisfy the obligations of the day in order to get home, go to bed and wake up to start all over again the next day.

It was a perfect segway into what I talked about in the first PIIP post, how I make it to the appointment, satisfy whatever needs doing to get through the appointment, then leave only to go on to wherever else I'm supposed to be - without giving the appointment another thought.

She logically asked about places in my life that I have some room to slow down a bit. And as I thought about my day, I slowly realized that it really is not very busy. I mean, sure, it's average for a parent, getting my son off to school, getting to work on time, working, whatever appointments I have, then whatever the evening holds, then off to bed - but nothing that I feel should stretch me as much as I had been feeling.

I started to wonder if my days really were as busy as I felt they were. And no, they are not. I'm just usually tired. Which leads to a totally different problem - getting the right amount of sleep each night.

I've looked at this piece of my life before, and it never fails to creep back up. I know that getting a good solid 8 hours of sleep is very important to everything for me. Namely my ability to be resolute in the face of self care challenges that life presents. I also know that I have not been getting the right amount of sleep for a while now. It makes sense that when you are constantly tired that everything makes you feel all stressed out.

So then we started talking about why I wasn't getting a good nights sleep. I usually do get in bed and lay down at a reasonable hour, but then I start goofing around on my pocket pc - which I charge on the nightstand. I will usually catch up on blogs, go through a to-do list, review upcoming appointments, or play some goofy little game. The thing is - this stuff can keep me awake for hours. Next thing you know, I've ended up with a short night of 5 or 6 hours of sleep.

The next thing she said was very powerful. She said "your lifestyle usually supports your habits" - be those habits good or bad - we have worked them into our lifestyle. In this case, the fact that I charge my PDA right there on the nightstand, where I can't resist the temptation to pick it up and mess with it.

This leads into how to Put It Into Practice. We have agreed on one action plan per week, each action plan consisting of three things:

What: charge PDA elsewhere - NOT on the nightstand
When: Immediately - I will start keeping it somewhere else tonight
Confidence (scale of 1-10): 10 - I am confident that I can do this. If this comes in below 7, then I need to re-evaluate the plan and think about why my confidence is lower than desired.

Along with this action plan we established some accountability. I am to call her each Friday to report in on whether I was able to meet my action plan, and if not why not, and also to establish the action plan for the next week.

I am very pleased with this game plan. I know from previous experience that a good night sleep makes a world of difference, and I'm excited as to what I'll be able to tackle for my next action plan.

Monday, February 20, 2006

100 Days (tribute to Johnboy & Keith!)

Here's to Keith over at dead islets. He has just published a post titled "100 Days". The title of his post is no doubt respectfully borrowed from our mutual friend and O.C. blogger Johnboy of Infusion of thought, when he posted about his hitting a major and very inspiring landmark of 100 days straight of getting at least 30 minutes of aerobic exercise!

Johnboy is quite an inspiration to many that enjoy reading his blog, that includes Keith and myself. The dedication that he has shared with us has impacted many of us in a very positive way - talk about a ripple effect!

Both Johnboy and Keith have been very supportive of me, and have shared some wonderful insights in their comments to my posts. I appreciate the heck out of both of them! So when Keith called us to action in his 100 Days post, I felt compelled to respond!

So, starting March 1, 2006 I will commit to getting at least 30 minutes of aerobic exercise each day. I also like the way that Johnboy summed it up in his post:

"Just a quick post today as it marks 100 days since I recommitted myself to concentrating on good health through regular exercise, healthy eating and frequent testing."

Maybe Keith and I can help keep Johnboy going, in addition to reaping the positive impacts on our own health.

Sunday, February 19, 2006

To the 5? To the 10? Exact?

How exact do you get when entering carbs into your calculations?

Looking back on the last few weeks of my pump history, all of my carb values have been rounded numbers, either on the 10 mark, or the 5 mark.

I think this is due to a couple of different things.

1) Carry over from the old fashioned "exchange system" days, where a "carb (or starch) exchange" was 15 grams. So, to me, a slice of bread is always 15 grams. Even though many of the breads these days are more like 18 grams! It's like my brain is stuck in the old system. Or, maybe a slice of bread has always been 18 grams, and the "exchange system" rounded it down to 15 to simplify. I don't know.

2) I have been doing corrections independent of my meals. No special reason, just the way the day rolls out. For example, I test when I wake up. Not two seconds after my feet slide into their hard soled slippers am I reaching for my test kit. So I will correct depending on what that number is. Even if it's a respectable 120 or something, I'll dose to get closer to my target of 100. Then when I eat breakfast 15 - 20 minutes later, there's no sense in calculating in another correction, so I will use my touch bolus button (which counts up in 10g increments) to bolus for that. Or I'll not want to be bothered by pulling my pump out to bolus (how silly is that?!), so I'll guesstimate my way into convincing myself that what I'm eating is an even "10" number (40, 50, 60, etc.).

In many cases I may be miscalculating by a few carbs by using either of the above two scenarios. I had always thought that it didn't matter that much. I had also always thought that I did exact calculations for most of my meals & boluses - but the data shows otherwise!

Looking at my ratios, it can be gathered that being inaccurate by 1 gram of carbs will have an effect of about 4.7 BG points. That's not too much. However, being off by 10 grams changes that number quite a bit! Now we're talking 47 points! That is a very big difference when you're trying to "catch the trap" on the aircraft carrier!

So, my question to you - how anal do you get about your carb grams. Do you enter each and every gram? Do you round to even numbers only when SWAG bolusing? When you round off, is it just a matter of not wanting to do the math, or is it to take some other "shortcut"?

Saturday, February 18, 2006

Excellent Article by Amy Tenderich!

Our very own Amy Tenderich of recently crafted an absolutely excellent article on her column over at The article is titled:

Leadership 101a: Managing Your Care Team

This article goes into whether you appointments with your care team leave you feeling that it was helpful, or rather do you feel deflated and maybe even resentful. I'm often more on the deflated and resentful side of things, but this article goes into an approach that empowers you and can help you get more from the appointments.

One of the most striking paragraphs for me was this:

"The essential goal is to take a proactive, step-by-step approach to managing your diabetes –- rather than being constantly at war with yourself over all the things you “ought to” be doing. Viewing your diabetes as a battle will make you miserable and unmotivated. And you will hate your care team, because they’re part of the enemy front, imposing all this impossible stuff on you. "

A couple of very valid points in this paragraph. For one, I often feel that many of the issues are bigger than they really are. I make them out to be insurmountable giants of a problem, when they really are not. So to take a look at these and break them down into smaller manageable pieces, and attacking them step-by-step would be a much better approach. Rather than feeling like I need to tackle the issue all at once

The second point is that I often feel that I'm constantly at war with myself over all the things I "ought to" be doing. I wouldn't say I hate my care team, but there is most definitely some additional emotional baggage attached to my appointments.

Very good article.

Amy - Great Job!!! I encourage everyone to go and have a look. It's well worth the couple of minutes spent reading it.

Friday, February 17, 2006

Sometimes It Really Is Us Doing Something Wrong...

I have an older Accu-Chek Compact meter that I use at work. This meter uses a "drum" of 17 test strips. There are a few reasons that I don't really like it, but I don't hate it either. It's a good meter to have at work, and I have a TON of strips for it, so I may as well use them up.

One of the things I don't like about it is the noise. The thing is very mechanical, and there is a lot of racket that happens as it spins the cartridge and pushes the next strip out. Another thing is if you bump the "eject" button on the side of it, and the cartridge drops out, it has to "find" where it left off. It takes a long time for it to spin and check, spin and check, spin and check, spin and check, spin and check, spin and check - to FINALLY find where it left off in order to spit the next strip out for you.

The battery door is also a bit loose on mine, so the batteries fall out often. It sucks because it then looses it's date & time. Annoying.

What I considered to be the last straw was that when I would press the button to turn it on, it would only come on one out of ten times! It would really irritate me! I just want to do a test - I don't want to fight with my meter to turn it on!!!

I told my co-worker "this thing is a piece of crap, and I'm going to call and get a new one!!"

So I called the 1-800 support number on the back. I tried for days. The first three or four times I called, I was greeted with a message indicating that my estimated hold time would be greater than 5 minutes, and it suggested some other times of the day that are typically less busy for them.

I finally got through to someone, and she was very nice and professional. She asked the standard questions (name, address, meter serial number, etc). I explained my problem with pressing the power button, and not getting any response.

She calmly explained that this particular meter was built such that if the power button is not pressed directly in the center that it disables the power button for about 10 seconds. This is so that if the button is pressed accidentally, say while in a bag or something, it wont turn on and waste a strip. "Aha!" I exclaimed! I told her that I would pay better attention to where I was pressing the button, and see if that makes any difference. Sure enough, being sure to hit the button in the exact center, it has worked flawlessly since.

I'm not going to go into the design theory here - Well, Ok, maybe a little bit. The button is frickin HUGE! It's the biggest button on the entire device! If you want to make it less likely to accidentally turn the thing on, make the button smaller! Anywho, that's not the point of this post.

The point of this post is that I assumed that I knew this meter well enough to turn in on - it couldn't possibly be something that I was doing that was causing the problem. I automatically assumed it was a mechanical problem with the product, and I was determined to get a replacement.

But, as it turns out, it was something I was doing wrong. I should note, that this important information was not clearly available in a very quick scan of their downloadable user manual or FAQ (which, of course, I did not look at until just now).

So, next time you're on the line with a support person, be patient with them, answer their questions to the best of your ability, and be willing to try any suggestions they may have.

Sometimes it really is us doing something wrong.

Thursday, February 16, 2006

I Hate Set Change Days...

I am very regular about changing my infusion sets. Every three days, usually in the morning - unless some emergency dictates otherwise.

I believe that it is important for me to not leave my infusion set in too long. I feel that it creates more scar tissue when it's left in too long. While I've never had a set in for so long that it created control problems (that I noticed anyway), I have gone longer than recommended in times past. If I remember correctly, my longest infusion set was left in for 5 days. Could be a lot worse.

Now I have been pumping for what I consider to be a long time. I don't know exactly when I started, but I'm thinking that it was somewhere around 8-10 years ago. After all those years, I do know that I have areas of my abdomen that have more scar tissue than others. Those tend to be former "favorite" site spots. Places that I used perhaps more often than I should have, and didn't give enough time to heal between re-use.

I was on shots for a long time before pumping, and I would bet that many shot users can attest to funny pockets or lumps that form when a spot is used too often. For me, I had overuse lumps on my thighs and the back of my left arm (because I'm right handed, so I used it to inject into the left arm). Nothing majorly huge and gross, but they were there. After 8-10 years pumping, they have healed and are back to normal. No, it didn't take all 8-10 years, but I'm just saying that at some point they healed up to where I didn't notice those shot lumps anymore.

So, experiencing the healing of those spots (the body is magnificent isn't it?), I trust that given appropriate rest, any scar tissue in my abdomen will probably heal up pretty good too. Not sure if it's possible to heal it 100% and make it go away, but I think you can get pretty close.

Back on topic - I'm very regular about changing my sets.

What I hate about the days I change my sets, is that I always seem to have trouble with the morning of the set change, and especially the very first meal on that set. I've talked about it a couple times, once back in January of 2005 , and most recently on this post. Kevin made an interesting suggestion, and that was to leave the old site in until the end of the day. Not connected to it, but leaving it in to avoid the little bit of "leakage" that happens when it's removed. Basically allowing time for any insulin infused there to be absorbed. I have heard that before, but haven't experimented with it in many years - so Kevin, thank you for reminding me, and I'm playing around with it again.

This morning is an example of why I get frustrated with this. I woke up and tested at 71. On the upper fringe of being low. I didn't have any symptoms of being low (which I made note of - always on the lookout for hypoglycemic unawareness!). I did my set change (and leaving the old site in) and then had breakfast. I had what I consider to be a very responsible breakfast. I had one slice of white bread (15g), with peanut butter (7g), 2 cups of skim milk (26g) and two servings of Nestle Quick Chocolate Milk (powder, no sugar added) (14g). I bolused for 60g and did not correct for the 71 blood sugar. This was all right around 7:00am.

At 8:45am I checked my blood sugar, and it was on a lunar rocket ship to the moon. 334. WTF?!? Arg. Now I'm lethargically sleepy, moody, pissed off and concerned about a problem with the new infusion set (which, by the way, has never happened in all my years pumping). As hours move on, I keep checking and correcting, and sure enough my BG is coming down (which wouldn't happen if there was a problem with my set).

Now, I can understand if I go and have a huge breakfast (like my Burger King special), throwing on a couple hundred grams of fast acting simple carbs into the fire. But don't beat me up when I'm being good!

Is it possible that I somehow rebound from almost being low this morning? Is it possible that some jerk cut me off on my way to work and pissed me off (though I don't remember)? Is it possible that I thought too hard about some sweet treat, and the mere idea of it spiked my BG? Who knows. Anything is possible.

I would like to try to understand if there is some pattern to this. Are there set changes that go fine, or are they all like this? Is there any other thing that happens consistently? Is it something I'm doing (yes, I do remember to fill the cannula)?

It's a real job to eliminate the variables, and it takes a lot of time and patience. Hopefully in three whole days, when it's time to change again, I'll remember that I'm supposed to pay attention.

Wednesday, February 15, 2006

Because Packaged Food Is Easy To Bolus For

Is it just laziness? Lack of planning - causing runs to the vending machines through the day? Unpolished and unpracticed carb counting by eyeball? Falling victim to the clever marketing schemes that have me addicted to things like Diet Coke & Peanut M&M's? Combination of all of these things? Who knows.

What I do know is that packaged food is usually very easy to bolus for. There is little to no thought involved. You have the package, with the number of servings per package, and amount of carbs per serving. It's still math, unless the servings per package is 1. At least it's usually simple addition, none of that "fancy" division or multiplication. Have I mentioned I don't like math?

The nutritional content of these packaged food is generally very poor, and it's often even more expensive than buying a bigger package of the exact same thing at the grocery store! But I'm buying the convenience of it aren't I? And while that convenience is easy to bolus for, I don't think it's worth the negative trade offs - such as the nutritional content of a pack of pretzels and peanut M&M's for lunch... which are pretty responsible choices given the other things to pick from!

Not to mention the satiety factor, or feeling satisfied with what has been eaten. This rarely ever happens with junk food. In fact, I think that it is designed to make you crave more - I mean, can you really ever eat just one piece of something treaty?

I think that in my case, it boils down to lack of planning, and not prioritizing that planning into my day. If I bring my lunches and snacks, I will eat those, and be satisfied with them. And I will in fact feel good about eating good stuff, rather than junk. But I often let life get in the way, and that planning and prioritizing self care take a back seat.

The thing is, life is really not that busy - I just make it seem that way...

Tuesday, February 14, 2006

The Card Says "Nutrition Counseling Services"...

I think for many of us, we know the truth, but may not be willing to face the truth. I think this is certainly the case for me in looking at my (lack of) "Nutritional Habits".

I talked to my Endo about this, and he handed me a card. It said "Nutrition Counseling Services" and had a name scribbled on the back of it. He said that this dietician is very knowledgeable with diabetes and pumping, and recommended that I make an appointment with her.

I know that the way I eat is probably the core problem with my diabetes struggles. I have known this for a long time. In fact, it's always been like that. As long as I can remember.

While the quantities of the things I choose to eat are certainly a large portion (pun intended) of the problem, it's probably more what I choose to eat.

I don't know if I've gone into this before or not (I probably have - forgive me). I eat carbs almost exclusively. And we're not talking about grams that ride along with other non-carb things - we're talking good old fashioned hard core starches. Meat and potatoes, minus the meat. Grilled ham & cheese minus the ham. Chicken Alfredo minus the chicken & heavy on the pasta. Okay? Okay. I'm embarrassed to a point about sharing this, but I also recognize that it needs to change.
I don't like meats. Does that make me a vegetarian? Well, maybe - except that I don't eat vegetables (some green beans are an exception to that rule). How about fresh fruits, or maybe salads? Nope and nope. Give me breads, pasta (plain jane style), rice, potatoes, etc.

When I go to eat at a place like Perkins, here is what I order. Grilled cheese on sourdough, french fries, side of hash browns, diet coke (can't have too much sugar you know...) times 5 or 6 refills, then a slice of pie to top it off. Don't forget about the entire bottle of ketchup that is poured on top of everything (except the pie...). Burger King you ask? Lunch menu = 2 x Large Fries, Breakfast menu = 2 x medium hash browns and an order of french toast sticks.

Ok, how about a place like Leeann Chin? Chinese food? An entire order of white rice (is that 2 or 3 cups of rice?) and an order of those cream cheese puffs (that would be 6 of them). Not to mention a couple of the fortune cookies.

Well, what about when I'm at home? Surely I can't eat that bad at home. Right? Right.

Well, when I get home from work I will usually help polish off whatever the kids might have had - that is unless it involves meat, veggies or fruit. In that case I'll polish off the carby stuff (mac & cheese, dinner rolls, garlic bread, etc.). Then I'll have some type of sandwich. This will be one of three possible varieties. Cheese & Mayo (or Miracle Whip), Cheese (dipped in ketchup), or (ready for this?) ketchup & mustard (again, dipped in ketchup). Maybe a cup of dry sugary cereal afterwards to satisfy my sweet tooth. Sick, isn't it? Yes, I know.

When I'm being what I think is a step closer to healthy, I'll make the sandwich on whole wheat, have some cottage cheese (for protein) and down a V-8 (that counts as veggies, right?).

Junk food? Yes, I'm all about that. If it's packaged and quick (in other words I don't have to think about the serving size - just eat the whole package), consider it a no brainer. Too bad that those types are typically the worst for you. Anything that ends in "itos" (Frito's, Doritos, Cheetos), etc.

I'll eat candy (and lots of it) that I don't even like, just because it's candy.

Being full has never stopped me from continuing to eat, just because it tastes good.

I look at what I typically eat, and it makes me think I should have a stomach ache. There is little to no nutritional value in what I eat, and I have to wonder how the heck my body keeps going! And what performance boost would I get out of eating better? I say performance in terms of things like sports (basketball), but also in my daily energy levels and moods as well.

This is not from lack of exposure - my mom & dad tried their best to get me to eat all the good stuff. I remember being told I would eat such and such, or sit at the table until bedtime. Well, when bedtime rolled around I got up from the table and went to bed. I remember being a stubborn little rascal when it came to food.

For many of the things I don't like, it's due to the texture or ideas of how it's made that give me the willies. Thinking of some nasty meat processing plant, or that roadkill you drive by, you know, blood & guts. It's terribly silly for a grown man to get grossed out like that!

I do know that there are many things I would like, if I just got the nerve to try some different things!

This is an all encompassing issue though, that I guess I'm glad to say I'd be fighting with regardless of the diabetes. It's just general health here - but the diabetes makes it more important and more noticeable.

I'll be sharing my journey through this introspection of my dietary habits. I'm not trying to move mountains in a day, so it may be a long ride - but I'm sure it will be an interesting one.

As Andrea suggested, I'll make an appointment, and go into it with an open mind. They may have some good ideas, and I can bring up any questions and concerns I have.

Monday, February 13, 2006

Update on Latest Endo Appointment

As expected, my A1C was higher than I'm comfortable with - although not as high as I expected it to be. The result was 9.1, down from 9.2 three months ago. Faithful readers will remember that for my last visit in November, I thought I had been doing really well, and was caught off guard with that 9.2 A1C result. It really messed me up.

I spent the entire three plus months since then fighting to pull out of the tailspin I went into as a result of that surprise.

I actually expected this A1C to be higher than the last one, so I was a bit relieved to see that it was not as bad as I thought.

Everything else was pretty good:

Blood Pressure - 110/64
Kidney - 100% normal
Cholesterol - Total 125, LDL 82 (looking to be below 80) and HDL 32 (looking to be higher than 40)
Feet - no detectable neuropathy

The cholesterol is ever so slightly higher (LDL) and lower (HDL) than desired, so he's upping my Lipitor a bit.

He also referred me to a dietitian. I dread it. I know that diet is my weak spot, and I really do want to change, but how the heck do you change these (poor) eating habits you've had your whole life?! I also have to do some legwork to find out if this particular dietitian is considered "in network" with my insurance.

More to come...

Friday, February 10, 2006

For Wil "PrintCrafter"!

I got a great laugh out of a recent comment from Wil regarding my Aircraft Carrier Post.

He said:


I love this post, but it was chickensh** of you not to post a graph with your BG on it.

Come on, a blank graph???"

He has a good point, I truthfully didn't even think about it, or avoid it on purpose, I just wanted to convey a sense of how narrow our target range is. I chuckled out loud reading this comment - I just love Wil's sense of humor, and I think it "jives" with mine pretty good. So, Wil, this post is dedicated to you!

The first image here is a picture from the computer of the last couple of weeks of BG's. This is not a completely accurate picture for a couple of reasons. I use a Cozmo pump, which has an optional CoZmonitor, which is a freestyle meter that clips onto the back of the pump. I love having everything I need for testing all in a small belt pouch. Very convenient. Any tests that are done with the CoZmonitor are automatically stored in the pumps memory, and can then be used to calculate meal and/or correction boluses.

I do, however, still use other meters for many of my tests. Those typically only get entered into the pump when I need to calculate a correction. There are a couple reasons for this. When I play basketball it is more convenient to use a separate meter than it is to pull my pump out and test. The CoZmonitor units are also especially sensitive to moisture, and I sweat like crazy. So, I keep the CoZmonitor in my locker. I also have many many many unused test strips for some of these other meters, and I figure that I will use them up. So I basically only use my CoZmonitor when I'm out and about. So in this picture, you are only seeing the blood sugars that were in the pump's memory.

The pictures that follow are images from my handwritten logbook. I've started using My Other CheckBook. The manual, empty notebook style was good, plenty of room to make notes and write - but I couldn't analyze it at all. Couldn't see any patterns or trends, nor make any sense out of the data. To be fair, I haven't been using the MOCB log for long, and haven't flipped through to see any trends or anything yet - but having the line graph is nice in seeing how fast things are heading in one way or another.

This is a basketball day. My exercise is indicated by the shading near the top of the page, shaded from top to bottom to indicate that it was intensive exercise (versus a brisk walk, which might be shaded up to 1 or 2). This day had 13 tests between 6:30am and 8:00pm. I consider this to be a better than average day. I attribute that to basketball, decent will power for eating (well, up to bedtime anyway), and starting off with a "not too bad" 179. There's that spike near the end of basketball - could be due to many things (temp rate too low, or too long, or both, high caloric burn resulting in ketones resulting in insulin resistance, too much Gatorade). Haven't got that nailed down yet, but for the most part am very pleased with my ability to do pretty good during basketball.

This is from a non-basketball day. This is also a day of most excellent blood sugars. If I could have every day like this, I'd be in A1C heaven. One thing I notice looking at this, is that I didn't eat anything worth much. It's mostly all crap from the vending machines (Peanut M&M's, Microwave Popcorn, etc.). All stuff that is pretty easy to bolus for, and the portions are controlled and clearly labeled. For the record I got sloppy with my snacking and counting after dinner, and had a 269 for the first test of the next day. This was also a day that I was basically stuck sitting at my desk at work all day - not much activity to deal with, and a pretty stable day all around.

This is yesterday. A basketball day, and a set change day. I started out high in the AM because (once again) I was sloppy with my snacking and counting at night after work (can you see a pattern here?). I took a correction bolus right away, and you can see the BG drops nicely. At 7:30am I did my scheduled set change, and notice what happens - I haven't eaten anything, but after that AM correction bolus is out of my system I start riding the updraft of a set change. I have suspicions that this happens a lot, but I haven't nailed it down yet. At this point, I'm wondering if I'm spilling what the pros call "starvation ketones". Basically it's been a long time since I've eaten, and my body has to get energy from somewhere, so it's been burning fatty acids (a side effect of which is ketones). I tested for ketones and was negative. I started basketball at 11:30am, and my BG comes down a little, but is still unusually high - remember, I haven't had even a gram of carb yet today. I played ball from 11:30am to 1:00pm. This is high intensity full court basketball. I'm working my tail off, but my BG hits a low point of only 158!? There are a lot of things going on now, adrenaline, lots of fatty acid being burned, etc. - but I was still surprised to only hit a low of 158. I usually need to run a temp rate of 25% normal basal rate AND drink Gatorade to keep the BG up. I did not even run a temp rate. I'm out there working like crazy running at 100% basal rate!! I was pretty dehydrated most of the day, which contributes to the strangeness, but also means I wasn't able to check for ketones until many hours later. They were "trace", which means very little amount. I would have expected more I guess. Sometimes diabetes is just weird. Doesn't always follow the rules, which makes it frustrating to try to manage it sometimes.

I am however, confident that my set is working Ok, otherwise I'd be through the roof with heavy ketones much earlier in the day. The fact that I'm 5 or 6 hours post set change and still Ok, helps me attribute the slightly high readings to factors other than a bad infusion set.

There is a meter (one of the Precision line I think) that can test your blood for ketones, which would be nice - but I can't afford the test strips (they are about $7-$8 per strip). Testing urine for ketones is about as useful and accurate as testing urine for sugar used to be. But, again, the tools are dictated more by the finances and insurance than I would like. Being able to test my blood for ketones during basketball would give me a better idea of when I need to adjust my basal rate back up to offset that insulin resistance.

I had my first "meal" of the day (fries at Burger King - yes, I'm a health nut) after basketball, and a big BG spike (c'mon - "lunch" was only like 156g of carbs - what do you expect?). I came down Ok, had a bit of dinner and went to bed at 152, which I considered to be Ok. I woke up this morning at 73, which is a tad low, but overall not too bad.

I can't help but wonder what all I'm missing though, looking at these compared to the graphs that Wil shared from his monitor. There is so much more that is happening behind the scenes, and I would love to get a picture of what all is happening all the time. The technology will be available and affordable for many of us within the next couple of years I believe. It's hard to wait though.

Wednesday, February 08, 2006


Caro 'cross the water over there at has tagged me! I'm honored!

I was tagged before, many moons ago by Wil, but it was a bit different than this round - or ... maybe this is the same round of tag that has mutated a bit since it started... ?? Who knows. Boggling to think that this may indeed be the same tag that started so long ago. I think I'll call "no tagbacks" this time.

This time around we have a number of categories.

Four Jobs I've Had In My Life:
(not in any particular order...)
1) Master Console Operator (sounds important doesn't it?)
2) UNIX System Administrator
3) Owner/Operator of a Rose Shop
4) Loading Trucks at UPS (Takes a special breed to keep that up long. I lasted 33.5 shifts)

Four Movies I Can Watch Over & Over:
1) The Princess Bride (interesting how many of us picked that one!)
2) A Christmas Story (Ralphie & his Red Ryder BB Gun - 24 hour marathon on x-mas eve!)
3) The Usual Suspects
4) Shawshank Redemption

Four Places I Have Lived:
1) Minneapolis
2) Minneapolis
3) Minneapolis
4) ... uh, let me think here... Oh yeah! Minneapolis

Four TV Shows I Love To Watch:
1) Law & Order (SVU & Criminal Intent)
2) Mythbusters (on Discovery)
3) The First 48 (real life cop show on A&E)
4) Spongebob

Four Places I Have Been on Vacation:
1) What is this thing "vacation" you speak of?
2) I've been to Duluth a couple times (northern Minnesota)
3) I went to California when I was a youngster
4) A bunch of work trips to places like Dallas, TX; Denver, CO; Des Moines, IA; Boston, MA and Long Island, NY. They don't really count though, because I was working...

Four of My Favorite Foods:
1) Grilled Cheese Sandwich
2) Grilled Cheese Sandwich
3) Grilled Cheese Sandwich
4) G r i l l e d C h e e s e S a n d w i c h
And nothing "fancy" either. We're talking good old processed american cheese on bread. To crank it up a notch I might use sourdough. Lots of ketchup to dip it in.

Four Websites I Visit Daily:
1) The O.C. (this in and of itself can be an endless journey across the world)
2) Pocket PC Thoughts
3) Engadget
4) The O.C. some more

Four Places I Would Rather Be Right Now:
1) Hanging out with my wife & kids
2) Playing basketball
3) Sitting with my Dad in his screened in porch (well, not in wintertime, but you get the idea)
4) Sitting by the outdoor firepit with my father-in-law during the slight chill of late fall/early spring

I Tag:
mdmpls at "Diabetic Forever"
Jen at "17 going on 50"
and Penny at "my son has diabetes"
Please note - if you don't feel like participating, please don't feel obligated to do so - no pressure at all, and no one will hold it against you. I also want to note that it is completely possible that these fine folks have already been tagged - I can't even pretend to be able to keep track anymore.

And with that, I will hereby officially declare "No Tagbacks"!

Tuesday, February 07, 2006

Evidence of a Lab Draw...

I went in to the lab last Friday to have my labs drawn for my upcoming endo appointment. It went pretty good, nothing like one of my previous visits where nothing went as well as it should have.

I went first thing in the morning. Partially because that is when it was most convenient, but also because these tests required me to fast (which is easiest at night, while I sleep...). Once at the lab, the wait was longer than I hoped for (isn't it always?) but I was back in the draw chair before too long. The poke was a piece of cake, and I was out of there within just a few minutes.

That was about 4 days ago.

The draw itself was not bad, she did not have to "dig around" to get access or anything - overall it was a quick and easy poke. I think what caused the bruising was after she removed the needle and applied the gauze, she accidentally let up on it, releasing the pressure and letting some blood leak out under the skin. Looks nasty, but doesn't hurt at all.

I'd like to hear about your laboratory experiences. No real reason to give us the lowdown on the good old boring stories - we want the bloody & gory stories.

Friday, February 03, 2006

Filament Test/Tuning Fork Test? Feet Post - Viewer Discretion Advised (if feet gross you out)

How often do you guys & gals have your feet examined?

I'm just thinking back, and it's been years for me. I think that most endo's would make it part of the routine for someone like me (approaching 26 years of D in April), and I'm a bit concerned that I'll have to actually ask to have them examined when I go in next.

There are a couple ways that I know of for checking the level of feeling in the feet. One is to use a small filament, very much like a piece of thick fishing line. You are instructed to close your eyes, then they touch your feet in various places with the line, and you are to respond when you feel it. The other is very similar, but it uses something kind of like a tuning fork (not sure what it's really called). The doc will strike this thing on something to start it vibrating, then start touching one end to your feet. You, with your eyes closed again, will respond when you can feel the touch and vibration.

Another common thing is to check you pulse in some specific parts along your ankle and foot, which apparently gives some indication as to your blood flow down there.

I have not had any problems with my feet so far, but have learned to be very careful with them. Even growing up my mom always stressed wearing slippers in the house, and not going barefoot outside. I do check them myself fairly often, and apply lotion at least a few times a week. I wear hard bottom slippers at home, and the times where my feet are exposed are very limited.

One area that I don't feel very confident though, is proper technique in trimming my nails. I've always heard "trim them straight across". But what does that mean exactly? I don't make it a habit to trim my toenails into a razor sharp point, but at the same time I don't like the edges to be sharp cornered either (for when I play footsie with my wife or kick one of my kids in the butt).

I'll ask about that when I'm in next too.

And no, I don't really kick my kids.

Wednesday, February 01, 2006

Putting It Into Practice

I think there are plenty of great ideas out there. Coming from so many different sources - books I read (or listen to), blog entries and comments, medical professionals or just plain intuition and luck.

The challenge comes in putting those ideas into practice in your everyday life.

An example. I see a therapist every couple of months. It is helpful to talk with her, but I mostly do it so that if I have a total meltdown I can call and get scheduled quickly and easily (nothing like trying to find a therapist when you really need one...).

It's really weird when I go to see her, because it's like I take a pocket of time from my day, spend the time in the appointment, but when I'm done, I just go back to my regularly scheduled life, pretty much just letting whatever we talked about roll right out the other ear as I move on with the rest of my day.

Usually I'm very involved with the appointments, and I talk about many of the things I share on the blog. She will listen, ask me some questions, and offer what is usually some very valuable and tangible advice. I even take notes.

Then I leave the appointment and act as if it never happened. Sure, it's in my head for a bit, saying things like "that was a good idea, I need to try that", or "that idea sounds like it might work, but I have to adjust this part or that part". But it never fails that I get wrapped right back into whatever is going on that day, and all those ideas and suggestions fall off some cliff and land in the deep depths of my mind somewhere.

Why is that? If these ideas are so good, why don't I implement them into my life? And we're talking simple stuff - nothing that requires a big life change or anything. Something such as setting small realistic goals (I tend to set huge unrealistic goals), breaking what seem like big tasks down into smaller bite size pieces (I tend to bite off more than I can chew) and not beating myself up over little stuff that doesn't matter (I tend to be a neurotic perfectionist).

It's when I find those notes I took, or have another appointment quickly approaching, that I will think about that stuff, and wonder why I haven't done any of the things we talked about.

So, true to the pattern, I have an appointment in a couple weeks - and I plan to talk to her about this. Maybe we can collectively figure out why I am the way I am.

Anyone else like this, or is it just me?