Check

I haven’t written in forever. So here’s an update.

I trained, and trained, and trained for the half marathon. The longest I ran before race day was 8.5 miles. I got sick with two separate week-long illnesses (one cold and one flu) during training. I hoped that the excitement and flow of race day would get me though. And it did! That and having Emily and Matt my cousins, and my bff Suzi at my side. Emily and I ran the entire thing together. I would have finished by myself, but I wouldn’t have done it before they officially closed the course. At the 7 or 8 mile mark, Suzi sped-the-heck up and went for gold. Matt stayed with one of our group-mates, Ayla, while she slowed down. Emily and I toughed it out together, walking the hills and running the straights with our identical buzz cuts.

I could tell tell Emily started to struggle at mile 10. The only thing that hurt for me was my arms, where the insides were chafing against my sports bra. No side ache, no knee or foot pain, so I couldn’t really complain. I did my best to coach Emily to mile 12 with my brand of running ‘coping methods.’ I had us run to certain signs, count our strides, and provided ample words of encouragement. We walked approximately 1-2 total miles between miles 9 and 12. I really wanted to run the last mile. I didn’t know if I could get Emily there myself, so I asked Matt to talk us through the last 1.1 miles. He did a great job. He extremely encouraging without pushing us to the limit.

Matt, Emily, and I crossed the finish line together. It was a great feeling. My time was 2:47. Here are all of my other stats. Also proof that I finished. It made me a little sad to see that out of 1154 runners, I finished 1121. That’s ahead of a whole 33 runners. It doesn’t count the people that didn’t finish at all (which I estimate at 30-50 people), or the people who finished after the 3:00 hour mark (which was maybe another 10-25). But it’s still a little embarrassing.

Here is the progression of half-marathon goals from January to race day:
1. Finish it by any means possible.
2. Run more than half of it.
3. Finish in under 3 hours and 30 minutes.
4. Finish in under 3 hours (when I found out that the official course was closed at the 3 hour mark).

I achieved goal #4 which means I achieved all of the other goals. This was all after waking up on Friday morning with a sore throat. I consumed my body weight in Emergen-C (which didn’t do anything at all) and hopped myself up on DayQuil, pseudoephedrine, and Vitamin I (a.k.a. ibuprofen) on the morning of race day. I felt fine/normal during the race, but rapidly declined in health afterwards.

I was extremely sore and felt a general sense of malaise for the rest of Saturday and all of Sunday. On Monday I knew something was wrong when, in the evening, I got a major case of the chills. My temperature topped out at 103 degrees on Monday night. I had the flu. I’m glad it didn’t keep me from running the race, but it was the 4th time I’ve been sick this school year (which is how anyone who works at schools counts the number of times they get sick).

I can’t say I ever want to run a half marathon again, but if the cousins would be down, I’d do the same race again next year. We had a Grade A group of cheer-er-on-ers. Mama Linda, Papa Paul, auntie Laura, uncle Frank (also race day photographer) sister Beth, cousins Maggie and NIck, friend Jenny, and wiener dogs Pippa and Nico cheered us on at 4 (or 5?) different points on the course. It was awesome.

I’ve had no knee or back pain, which is common among the runners in my family, but am experiencing some plantar fasciitis type symptoms in my right outer-heel. I feel a bruise-like pain toward the outside of my inner heel in the mornings. It goes away after 5-10 minutes of walking around, but is back the next morning like clockwork. I am also experiencing some bruise-like pain on the top of that same foot, which probably has something to do with the tendons. I’m resting it–hard. I haven’t run or engaged in any strenuous activity since the race on April 17th. I’m going to give it 6 full weeks before I think about taking up running again.

Diabetes wise–here is low down.
I woke up on race day at 179, which was good. I ate greek yogurt with berries and granola. I only bolused for the carbs–not to correct the 179. I completely suspended my insulin for the entire duration of the race (3 hours). 10 minutes after finishing, my blood sugar was 116.

I resumed my regular basal program about 30 minutes after the race’s end, thinking my sugar would continue to drop. I went home and took a 2 hour nap. When I woke up I was at about 389. I corrected, ate lunch and bolused for the carbs. I went back to sleep, and when I woke up the second time, I was at 410. I gave an actual injection of insulin and started consuming lots of water. It eventually came down into the 250s, and by the time I went to bed was back down in the 100s. I think the stress hormones and all the other chemicals in my body had something to do with the major rebound afterward. Next time (if there is one), I will be watching far more closely after the race. I had more fear that I would go low, but I knew there was a good chance I’d end up high.

I’m still alive and kicking, and looking forward to achieving the next goal I set for myself.
Whatever that may be.

Ages

Sticking to my new years resolution and training hard for the Earth Day Half Marathon in St. Cloud, MN. It’s not imaginary anymore. I have the pleasure of running it with my cousins Christy and Emily. Hopefully Matt joins us, too (but he never signs up for races longer than 2 weeks in advance).

I have been using the Temporary Basal option on the OmniPod during my runs. I started by decreasing my basal (background insulin) by 50% for 2 hours. I ended up low about 3 hours after each session, so I change it to 50% for 3 hours (which is the maximum time period for a temporary basal). The longer I ran, the lower I went 3 hours post workout. Through trial and error, I have my current running temp basal at a 90% (yes that’s ninety percent) decrease for 3 hours. I start it about 20 minutes before I actually start running.

I have also had to decrease my insulin across the board. The regular running has increased my sensitivity for both my insulin to carb ratio (was 1 unit to every 14 grams of carbs, now at 1 unit for every 18 grams of carbs), as well as my correction factor (was 1 unit to lower me 34 points, now is 1 unit to lower me 40 points).

Right now I’m waiting for a call from the nurse line to see if my throat culture grew a streptococcal jungle.

Ketones

I hadn’t thought a lot about ketones until a week ago when they hit with a vengeance. Ketones are a yucky thing produced when blood sugars are high for a prolonged period of time. They are the bodies reaction to the high blood sugar. You can have different levels of ketones in your system, depending on how high the blood sugar has been and how your body decides to react to it. The ketone test describes the amounts as: none, trace, small, medium, and large.

Whenever my blood sugar has run high, I have simply corrected until it came down. Correction doses are doses of insulin only to bring the blood sugar down (not as a part of eating something with carbohydrates in it). In the past, my blood sugar has usually come down pretty predictably. I’ve only tested for ketones once or twice before in my 7-year tenure as type I diabetic. And those two tests were just to see what happened. Both tests came out ‘none.’

On the Sunday before Memorial day, I was running between 300-450 all day. I was at home and munching on treats all afternoon, so I assumed I wasn’t giving myself enough insulin to cover what I was eating. Each time I’d test, a high number would appear on the screen. I felt okay, so I just kept eating and correcting assuming it would eventually make it’s way back into my desired range (between 80-120).

I tested before bed that evening and it came back as 350. I corrected one last time before bed, which freaked me out a little as I was risking going low while sleeping, but I figured if I didn’t give myself a correction dose, I’d wake up with a blood sugar of 1 billion. In the middle of the night I woke up feeling like a train had hit me. I was very nauseated. I tested again at 1:00am and was at 370. The (pretty large) correction dose had done nothing. In fact, my sugar was higher than it was before the dose. I started flipping out.

I am a part of some diabetic groups on Facebook. A favorite is called I Hate Diabetes (Type 1). A rather aptly named group, most people come with questions, concerns, and to complain heavily about the disease. I’ve read various posts about people experiencing ketones and ketoacidosis. Mostly stories of them having to go for a stint in the hospital. Thus, when my blood sugars weren’t coming down, I knew I had ketones.

I tested my ketone levels and they came back as “moderate.” It was the darkest color I had ever seen on the test, and started dreading a visit to the hospital. I looked up treatment for moderate ketones. Half the websites said: GO TO THE HOSPITAL. The other half said: drink lots of water, keep giving large correction doses, and keep testing blood sugar and ketones until they both come down. Water flushes ketones out of the system. Such a simple, but powerful treatment to a yucky thing.

So I made my first post to I Hate Diabetes and described my situation. The consensus among members and fellow T1Ds was similar to my Google results: half said GO TO THE HOSPITAL. The other half said treat it yourself for a couple hours and if it’s still terrible THEN GO TO THE HOSPITAL.

Over the course of 2 hours, I drank about 7 glasses of water, tested my blood sugar 10 times, and tested for ketones 5 times. I gave myself approximately 40 units of insulin to correct the high blood sugars. That’s a TON of insulin. For a Thanksgiving meal, I have given myself 25 from a pen at most. My insulin pump won’t let me give a single dose of more than 20 (you’ve got to split it up into 2 separate doses to bypass it). Basically, it’s a ton of insulin. Even 10 units of insulin given to a non-diabetic could kill them.

I started feeling better once I was at 120 with trace ketones. At 3:30am, I flopped down in bed–exhausted from the ordeal. After only one minute, my mouth started watering and I knew I was going to throw up. I leaped out of bed and dashed to the bathroom where I had the most violent and glorious vomits of my life. They broke blood vessels all around my eyes; the ‘gin blossoms’ lasting three days. After ralphing, I finally felt just right. So I passed out a second time–making it until morning.

And then I woke up low.

Everything’s Up

I had an appointment with my interim diabetes practitioner on Friday afternoon. Dr. K is on mama-leave with her kids, so I’m seeing PA. L, who is an endocrinology physician’s assistant. I had my labs done and everything is up including the a1c. It’s now at 7.4. As much as I’d like to blame it on the Freestyle test strip recall, it’s also due to guessing on carb counts at lunch everyday and eating too many treats at work. We made small changes to my basal rates, bolus rates, and correction factor, but two mornings in a row, I’ve gone low at the all day correction factor of 22. Between 6am and 9am it should probably be closer to 25. It all feels like one big test of trial and error, but at least the snow is melting.

I also donated a pack of unused Levemir pens to the clinic, along with 100 or so used pen needles. Just kidding. They had not been used. They were sealed and all. Since I use a pump, I don’t have a need for the long acting insulin. It’s been sitting patiently in my refrigerator since two Octobers ago. The expiration date is August 2014, so I figured I should let some living being get use out of it before it goes to waste.

I contacted a twin cities dog rescue, and they told me they would be happy to take it. Dogs use the same long acting insulin as humans, albeit in smaller amounts. I noticed there was a diabetic doxie on their site named Junior Mint, and emailed them letting them know that I would be happy to donate the insulin to be used for any dog that needed it, and that if a family adopted a diabetic dog that I would be more than fine with them taking the insulin to ease the initial cost of the adoption.

After consulting my ever wise and patient sister, Beth, I decided I should offer it to the nurse educators at my endocrinology clinic for human use. They have an ’emergency supplies’ area for patients who are in between insurances, aren’t/weren’t covered for health insurance, or don’t have enough money for their prescriptions even if they were covered. The clinic happily accepted it, and I feel good today knowing that the insulin I donated will keep someone from having to urinate 46 times a day, blurred vision, headaches, and a general feeling of malaise.

New Omnipod System

I just set up my new Omnipod system. Different PDM and smaller pods. It looks very much the same, save for the pod size. Overall the set up and application of the new pods was just as fast as the old ones.

There is one annoying difference in the PDM. Each time it’s turned on to do anything, it makes the user confirm that they’re the…user. Mine reads, “PDM ID – Andrea Dry Bones. Press Confirm if correct.” The tricky thing is that the ‘confirm’ button is never in the same place so it can’t become an automatic keystroke. It cycles between three different soft keys. It’s probably an additional feature to prevent people from ‘butt-bolusing.’ I believe I just coined a new term. It sounds absolutely disgusting.

Ice Cream & Sandwiches

My blood sugars have been terrible the last 3 months. Highs and lows, peaks and valleys. It could be a number of things, but it’s probably a lot of things combined. Here is the list:

  1. Basal rates not right
  2. Crossfit
  3. Inaccurate carb counting
  4. Change in schedule
  5. Stress

Last night I teared up about it and decided to take a hot shower to help me calm down. After the shower, in the process of putting on my shirt, my pod ripped off my arm. At that point I just broke down. I put my face in my bath towel and cried. But it didn’t really help anything. I still ended up going low two times in the night even after I lowered my night time basal rates significantly.

Today I’m flying to Chicago with my sister. The TSA swabbed my hands and pod for explosives. They did not find any. I had to laugh.

3rd Pod

I just put on my 3rd pod. Everything went fine. I put this one on my back, but on the opposite side of the last two. The cannula insertion definitely hurts more than single pen injections. I’ll deal with it, though.

The only issue I’m having is when I dose (bolus) for say 40g of carbs, but then 10 minutes later decide to have another 40g. The pump doesn’t want to give me the full dose since I still have insulin on board. I remember the nurse educator from Insulet telling me how to get around this. I think I have to manually enter the right dosage for the extra 40g. This has happened 3 times in the last three days, and I’ve ended up super high because of it.

I also need to fight the urge to mess with my own basal settings, although my dawn effect needed to be addressed, so I set my higher daily basal to start at 3am–right about when my liver starts pumping out glucose. I’ve been waking up super high because of this dawn effect.