Tattoos & Diabetes

Crisis: Danger - Opportunity

I know that this is going to completely shatter whatever "mental image" you may have of me. Yes folks, that is a tattoo, and yes, that is really my arm.

I'm big on symbols. Certain images convey to me a million messages with one quick glance. This particular symbol has been a part of my mental arsenal for a long time - in fact an early post on this blog, back in December of 2004 (wow!) covered some of the feelings this symbol evokes for me. I am an optimist, probably to a fault - even through my rough periods, I know that there is some purpose to it.

I had it done a few months ago, but had been thinking about it for a long time. Earlier in the summer, Amy Tenderich of Diabetes Mine authored a piece over at dlife called "Tattoos and Piercings: Does Body Art Jibe with the Big D?".

The timing of her article was uncanny. I had been to the tattoo parlor myself not even a week or two earlier. I was so excited that I had to e-mail her right away! I had intended on posting something about it here, but wanted to let it heal up some more.

Amy posted a follow up to that article today, and I thought now might be a good time for it.

My experience was a good one. It was uncomfortable to get done, but I attribute that to having it done on a sensitive place. It was sore for a couple of days, but proceeded to heal normally over the next 2 to 3 weeks. It was probably a complete month before it was 100% healed. I'm not sure if that is longer than typical, but I'm wouldn't be surprised if it takes me longer to heal up after 26+ years of the big D.

So, there it is. I'm on the record as a long term type 1 diabetic with a successful tattooing experience. I wish I could have found more of this when I was researching the subject.

I enjoy my tattoo, and the symbol is powerful to me.

I Don't Deserve This High

I did everything that I am supposed to do, according to what I've been told.

I followed all of the "rules".

I counted all of the carbs.

I checked my blood sugar.

I did all of the math.

(68g carbs / 7.5g per unit = meal bolus) + (current BG (163)- target BG / 35 mg/dl per unit) = total insulin to cover my meal and bring my slightly elevated current BG down to my target BG.

My "meal" was two vend bags of wheat thin crackers from the machine. Maybe not the best choice nutritionally, but it's not like I had a snickers bar and pop tarts for dinner. And it wasn't really a meal, per se, but rather an afternoon snack.

One hour and forty five minutes after eating I check my BG.

Insert the strip, poke the finger, squeeze the finger, apply the blood, BEEP, watch the little animated symbol, BEEP, a mumbled "mother fuck" escapes my lips, 303 mg/dl.

I probably tested a little bit too early, a fair amount of insulin on board yet, I did have a heck of a time battling lows during basketball (that's fun - I'll tell you about it someday), I may have had some exercise ketones floating around, but when I checked there were none showing. Lots of possible reasons to be running a bit high, but 303 mg/dl is uncalled for in my opinion.

Is my infusion set working? Did I reconnect it properly after showering when I was done with basketball? I surely would have noticed an eleven and a half unit bolus if I wasn't hooked up correctly, right (puddle of insulin, wet clothes, the smell of it)? So what gives? Was my food choice really that bad? Maybe, but it seems like a lot of "punishment" for wheat thins.

Is it necessary to be trying to "figure it out" for an entire lifetime? Is there a point where one can stop troubleshooting things? A point where things run smooth? Enough already!

There are still so many unknowns to diabetes, and living the life with it is a never-ending source of blogging material.

Trying to Force It...

I know that it has been a while since I last posted. And I do feel some obligation to get something new out there - self imposed, I know, but I still feel it.

I sat down tonight to try to put something together, and it's just not flowing. I have not felt like writing for a while, and my attempt to force something together was turning out just plain bad.

Until the feeling returns, which I hope is soon, I thought I'd at least let everyone know what is going on.

I'd rather take a little break than to post some crap that really isn't worth reading. I trust that it won't be long, as the feelings to write can strike me faster than a low blood sugar.

When that happens, I promise to capture the moment as best I can.

Update & Random Stuff

Hello everyone!

I really appreciate all of your support to my last post. I can't tell you how meaningful it is to me. I think the OC is the best thing I've found since my insulin pump. You all are the best. I wish I could find words that better expressed how much you all mean to me. Thank you.

My brain meds finally arrived last night. Thank the Lord above. While my irritability, emotional instability, and general mood have been feeling better, I have not been sleeping well at all. What is it about depression that makes you not able to sleep at night, and makes you want to sleep the day away instead? I also fight with restless legs at night - but only when my meds are out of whack. Does this happen to anyone else? It's so disruptive and it really drives me crazy. But since I know that I'm back on my meds, it's not worth going to any doc about just that alone. It will take a couple weeks I think for the meds to kick in, but hopefully the restless legs at night will go away sooner than that (please).

To hopefully prevent my running out of meds again, I'm using a suggestion that Bernard made, and am entering those "eligible to reorder" dates into my calendar. It was a big mistake that I made, not remembering to re-order in time, and I feel that I paid dearly for it. Whatever I can do to prevent that from happening again, I'm all for it.

I'm using this down time to do a lot of reading. I don't have a very good understanding of general nutrition and healthy eating practices, and I'm working to build that up a little bit. I feel it's a real weak area in my self care, and it impacts the entire package, not just my diabetes management. Improving this area of my life will benefit not only my diabetes, but my overall health. Sounds like a good deal to me.

I have been reading a couple books by Dr. Diana Schwarzbein, and I think I like what she has to say. It's all about balance - and I like the idea of balance. For the most part it is not any crazy diet, just balance. Sticking with natural stuff where possible (very hard in today's world). Have any of you read work by her? What are your thoughts on it?

I know that I eat a very unbalanced diet, heavy on the carbs, no meat at all, and before you ask if I'm a vegetarian, I don't eat many veggies (yet) either. So, learning more about what's out there, things to try, I'm bound to find some things that I like. It's all about building my food repertoire.

I had been, up until the last few weeks, trying one new food thing every week. Finding a few things here and there that I like, others that I can tolerate, and many things that will not make it's way between my lips ever again. But - I did find new things! Each new thing I find adds many options to my diet. If I can keep on trying new things, and keep building that menu up, I'll be in better dietary shape all the time.

And you want to know why I picked these books out of the sea of stuff that's out there on health & weight loss? The bullet items on the cover caught my attention, then I flipped the book over to check out the price. $12.95 - and I thought that was really cheap. Maybe I'm just used to buying computery books at $50 a pop, but that low price made me feel that she was not out to rob people blind with some expensive fad thing. Who knows if it's justified or not. Either way, it's at least worth a read. What's the worst thing that will happen? I might waste some time reading the books. Big. Flippin. Deal.

In other news, I participated in a big kayaking event a couple of weeks ago. It was a fundraising event, raising money to clean up the Mississippi River (which starts here in Minnesota). I have been interested in kayaking on the Mississippi for a long time, but it intimidated the heck out of me (you know, big river, moving water...). This fundraising event had 200 - 300 other boaters (canoes & kayaks), and a whole slew of safety and support boats. So, what better time to become more familiar with the river?


This picture (don't laugh at my hat - the sun was cooking me...) was at the finish line - which was at, of all places, a big gravel pit. Let me tell you, I have never been happier to see a gravel pit in my life!!

The trip was two days long, and covered a total distance of 44 MILES! We covered 22 miles each day - all of it right through the Minneapolis & St. Paul area. The trip was well organized with rest stops every few hours along the way. Sponsors donated great food and there was a lot of support from gracious volunteers all along the way. Let me tell you though, the end of the first day, I was beat. The trip was all downstream (going with the current), but there was such a strong headwind on the first day that if you stopped paddling to take a drink or take a picture, you started going upstream - backwards!! And the only way to get to the end was to paddle paddle paddle! Day 2 was great - wind at our backs, great weather. A wonderful experience all around.

I ran a very aggressive temp rate on both days, and didn't have any low BG's (a good thing when your paddling down a river). I did misjudge some of the meals/snacks at least twice, and shot up to the mid 300's. That sucked, but I was able to take a little mini-bolus and get back down very quickly (isn't it crazy how exercise super charges your insulin? It can get you in a bunch of trouble if it catches you off guard!).

I'd like to end this post with a couple of really great quotes from fellow OC bloggers that caught my attention shortly after my last post.

The first is from Kevin, over at parenthetic (diabetic):

"As I get closer and closer to my goal I'm definitely getting a much more healthy outlook on my life with diabetes and what my future with it will be like, and that's better than any doughnut I've ever had."

The second is from Zazzy's site, over at Zazen in the moonlight:

"Be nice to diabetics, we deal with enough pricks already"

And if you're not laughing at that, have someone check your pulse.

At least a smirk, c'mon now...

Maybe it's the Moon?

Is it just me, or is there a lot of emotion floating around the OC lately?

I thought it was just me, but then I sat down tonight to catch up on some posts, and I was just struck by the seemingly all encompassing "blah" that many of us are going through right now.

I had my endo appointment on Friday. It did not go well. I think I'm over reacting, but maybe not.

See, I'm particularly vulnerable and overly emotional right now, due to my mismanagement of my prescription for Lexapro - the anti-depressant that I take. Typically these anti-depressants are not to be stopped "cold turkey". Well, guess what - I ran out. I've got more on the way, but I completely missed that critical "catch point" where you are supposed to actually order it in time for it to arrive before you run out.

Managing prescriptions is another PITA (Pain In The Ass) thing. Why can't your meds run out all at the same time? Because that would make your job way too easy. It's another full time job managing all the damn prescriptions (not to mention actually paying for it all).

By the time I hit my endo appointment, I had been off the meds for 7 or 8 days, expecting a delivery any day - figuring "no big deal, they'll be here soon". Well, days 9 & 10 pass and I place a call to figure out what's happening. I've got it all straightened out, and expect a delivery any day now.

So the doc spills the lab results. A1C - 9.1.

(stunned, quizzical silence)

"But that's actually UP from my last time right?"

"Yes, a little, last time was 8.9, but you know what you need to work on, so just keep at it. Don't worry about this too much - just keep working on it - you're doing good - you know your problem areas and are focusing on them. Don't let this upset you too much".

(more stunned silence as he rattles off more lab results)

"Um, wait - did you just say my HDL has gone down?"

"Yes, it's at 26, down a bit from (low thirty something number). I'm not going to take any action on this yet, let's give it some time and see where it goes. "

"That's the one that is improved with exercise right?"

"Yes"

"But I'm playing full court basketball for two hours, three times a week...I just don't understand...?? I don't see how anyone could be getting any more exercise than I'm already doing?"

"Again, don't worry too much about it yet - let's see where it's at next time and go from there"

He walks me out to the receptionist area to set up my follow up in three months - offering more encouragement and telling me not to be too upset - we'll work it out with time.

I leave the office, with my head hanging so low that I can't see anything past a foot and a half in front of my feet. I just simply can't believe it. How can it be? More exercise? I can't do more exercise. With the amount of exercise I'm doing, my HDL numbers should be through the roof - how could they have gone down? I just don't get it. And my A1C - what the fuck is up with that.

Am I fooling myself? Thinking I'm doing much better than I actually am? Or is my BG really averaging 240. Impossible. ImFuckingPossible.

I'm out in my beat up old truck, going through wild swings of wanting to smash my head into the steering wheel, and tears welling up in my eyes. From being all super pissed off to being defeated. Just literally crushed by a 10 minute visit with my endo. Deflated. Defeated. The numbers just don't make sense. Not sure if I'm more upset about my shitty A1C, which says that I'm destined for devastating complications if I don't get my shit together, or my low HDL cholesterol level indicating that I should give up my family and job just so I can exercise more than I already do. Why do I take these numbers, and translate them into some personal failure?

What is going on?

How can this be?

It doesn't make sense.

My numbers say that I'm not working on it - but I am working on it. I'm working hard. And it's a lot of work. All that work and I'm broadsided with these numbers that indicate failure? But I'm doing all of the right things? And I'm tired. Tired of working so hard to be rewarded with what...

I spent the next few hours just an emotional train wreck. Having been off my "brain meds" for a while, my mental ability to withstand these things, the ability to logically analyze and plan for action, had gone completely out the window. So, train wreck it is.

We are often faced with things that are what they are. You can't change the truth. I can't change the fact that my lab results are what they are.

What I can do is look at my situation - try to figure out what it is that is not working right for me. Try to figure out what I need to do differently to get myself back on track.

In reality I know what it is - and it's something I don't want to change. I know I need to, but I don't want to. But - I do want to - or I think I need to want to (huh?). My diet. My eating habits. My carb cravings. My unbalanced meals. My long times between meals. Some days with way too many (unbalanced) calories, the next day virtually fasting all day to make up for the day before.

Is it any question why my body is revolting? How can it survive through all of the punishment I put it through? How can I play basketball when there is nothing for it to burn for fuel? How can I even put together two rational sentences when I'm causing such destruction inside myself?

Eating a nothing but a bagel for breakfast, playing (hard) basketball for two hours, having nothing but popcorn for at least 5 to 6 hours afterwards, then having a carb loaded dinner right before bedtime. What the hell am I doing?

When you really want to do something, you find a way around the obstacles you are faced with.

And I know that I will feel and perform so much better with a balanced and nutritional lifestyle.

In some ways I feel that I'm close - that if I can just get this piece of my self care put together that I'll have the package mostly there.

So what's the delay? Why don't I start? If it's that clear, why not just do it?

I don't know.

And I feel really fucked up about not knowing why I continue this obviously self destructive behaviour. I'm not a highly educated person, but I do think I have common sense (but maybe not eh?). I also feel pretty strong about my level of knowledge around diabetes. Is it a matter of will power? Where is mine?

So why don't I just fix it?

As this stuff has started to sink in, I think that there are a few things that I need to deal with.

1) I tend to be an "all or nothing" kind of person.
2) I don't feel I have a good level of knowledge around nutrition and balance.
3) I believe I have some deep seated mental issues around eating, and am not at all in tune with my bodies signals.
4) Denial.
5) Spinning my wheels. Working hard in areas that are not paying off.

The lines around these issues are all very gray, and they all blend together creating a recipe of self destruction.

Mix issues 1 & 2, and I get frustrated when I don't know what to do - so I toss it all out the window and indulge in some huge "all carb" type meal. "If I can't do it perfectly right I'm not going to do it at all". What sense does that make? And how impossible is it for me to expect perfection all the time? What a way to set myself up for disappointment when I can't do it!?

Mix issues 3 & 4 and I just want to crawl in a hole and wait for it all to "go away".

Issue 5 is about spinning my wheels. Working so hard and not getting anywhere. There has got to be a better way.

Mix them all together and you end up with many imbalances that throw you very much out of your natural state.

So, where do I go from here?

Well, first off, I'm sure I'll be feeling better equipped after my "brain meds" show up and have had a chance to do their thing. Second, work to realize that I can't fix these lifelong habits and behaviours overnight. Work on making small improvements. Recognize that things take time, and to not be frustrated so quickly. Be patient. Third, Improve my knowledge around general nutrition. Maybe get some books or something. Fourth, look at ramping up the frequency of my therapist appointments. Fifth, identify where my hard work will reap positive rewards, and re-focus my energy there.

I am tired of it all though - I mean, does it have to be work all the time? Just tired. Tired of dealing, tired of fighting, tired of calculating, tired of counting, tired of limits, tired of tired. Tired of mustering up the strength to battle on.

But what am I going to do? Just quit and let diabetes destroy my life? No - that's not me either. I am strong, even through these periods of "down".

Check back with me once my meds arrive. To be so reliant on those damn brain drugs is disturbing to me, but it's quite clear that I can't do without them. I'm a mess.

Do recent highs impact A1C draws?

I'm looking for some opinions here.

If you have something more concrete than an opinion, that's even better.

I have a story to share, but I don't have time to post about it right now. But due to the events in that story, I had the first reading of "Hi" on my meter last night (that means over 500 I think, or is it 600?) Either way, I was super high. I'll tell you all about it another time. I was able to catch it middle of the night, and correct, and woke up this morning at 167 mg/dl. Feeling a little tired, but overall, not too bad.

Then I went and had breakfast - and totally forgot to bolus for it. Doh!! So, I caught that one a couple hours later, feeling yucky, with a test result of 350 mg/dl. What the hell was I thinking about that I forgot to bolus?! That's the first time in many, many months that I've forgotten. If it were more common for me, I would utilize the "Missed Meal Bolus Alerts" that can be configured on my Cozmo. I don't use them, because it just doesn't happen very often.

I have my endo appointment a week from tomorrow, and I need to get my labs drawn so he has the results in time for the appointment. I have tomorrow and Monday off from work, and had planned on getting the labs drawn and out of the way tomorrow.

But - will my recent episodes of really high readings somehow skew the results for the A1C test? Would it "buy" me anything by going on Monday rather than tomorrow?

What are your thoughts on this? Cast your vote! Thanks!