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.
A new online diabetic friend, Sophie, posted that yesterday was her one year diagnosis anniversary. It was a rough day, and it got me thinking about my upcoming appointment with PA J (Dr. K’s physician’s assistant).
I know my a1c is going to go up. Last time it was the lowest it had ever been, at 6.9. However, this was an artificially low number. Over the course of a month or so, I had been increasing my insulin rather than decreasing it. I did this through decreasing the number in my insulin to carb ratio as well as by decreasing the number in my correction factor. For some reason, my brain was thinking, “decrease number = decrease in insulin.” Well, it was a stupid mistake. Decreasing the number in either your insulin to carb to ratio or your correction factor actually increases the amount of insulin you receive.
Long story short, I was experiencing extreme lows nearly everyday. This drove down my a1c number in the long run, but wasn’t healthy or safe. I figured out my error with PA J, and I have had far fewer lows in the last three months. That means that the a1c is probably going back up. My guess is she’ll come in at about 7.3.
When I have upcoming endocrinology appointments, I get to thinking about all of my past failures and how all the chips are going to fall in the future. I should have googled what was in those brownies. And that frozen yogurt. And everything I ate that I estimated for. Will I go blind? Will I have neuropathy? Is it all my fault? Is it all under my control?
The answers are all yes and no to some degree. The only principle that remains true is that I try to manage my health the best I can on any given day. Some days are much more regimented than others, but it is not to say that the less than perfect or terrible days are terrible ever for a lack of trying.
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.