Little Steps in my Journey!

I am a list person!  For me, they are energizing, profitable, and heck… just lots of fun!  This list, is not one that will be crossed off, but rather laminated and used for wallpaper in my house!

Ben and I were driving this weekend,  and he helped me come up with a list of things I have been doing lately.  I am sure I will need help to remember them!  I also hope that they will be a to other diabetics out there longing for a lower a1c reading.  Mine went from 8.7 to 6.7 in 6 months!  Big news for this “most-of-my-life-in-the-double-digits” girl!

I made lots of changes in these areas…

My Pump

  • I changed it every 3 days instead of waiting until day 4 or 5.  This means I used more supplies, but the absorption is much better this way.
  • I used new areas for my pump instead of the same stomach locations; again, this also allows for better absorption.
  • I made use of both the “dual” and “square” bolus options.
  • I made adjustments to my evening basal rate.  I did not need a doctor to tell me what I was seeing was a pattern.  I trusted myself and did it!

My CGM

  • I faithfully wore my Continuous Glucose Monitor!  In the past, I would take it off and plan to put it back on in a day or two.  I NEED the constant feedback.  I would only take it off if I had time to changes sites RIGHT THEN.  If not, I did not take it off!
  • I changed the “low” and “high” settings on my CGM so I am notified the minute things start moving in the wrong direction.

My Highs & Lows!

  • I only correct with Skittles, and occasionally a spoon of peanut butter.   Before, I would use a “low” as an excuse to eat anything I had been eyeing up in the kitchen.. now, I only allow myself to use Skittles because I can predict how my body will respond to them.
  • My body has slowly become more used to the 70-90 range.  Before, I would correct if it were headed into the 70s.   I now feel pretty comfortable there, and feel no reason to correct, especially if a meal is right around the corner.

My Diet

  • I have read about health and diet recently.  Literally, thousands of pages… the most helpful have been a book called “Trim Healthy Mama” by Serene Allison and Pearl Barrett and also the “500 Low Carb Recipes” cookbook by Dana Carpender.  I also read a few doosies concerning low-carb living, but I won’t mention those!
  • I had a total epiphany about the correlation between blood sugar and diet.  It’s so simple, I don’t know why I never realized it before: if I don’t eat high carbs, my blood sugar can’t go high.   (Take a moment to laugh if you’re diabetic… because you know that there really is not way to say “can’t” about high blood sugar.)  I can’t prevent it, but I can at least have the science on my side!
  • Armed with this knowledge, I decided to eat generally low-carb, including little low carb switches.  The list merits its own post… so come back for that!
  • I try to limit myself to 30 carbs a day.  Generally spaced out evenly: 10, 10, 10 at breakfast, lunch, and dinner.
  • I do not snack on carbs.  Only at meals.
  • I do not eat carbs after 8.  For me, I have learned that if I eat any carbs late at night, I WILL have high blood sugar at night, regardless of how much insulin I take.
  • No food vacation days.  Before, I would say I probably took a little diabetes diet hiatus about once a week.. it just is not worth feeling sick!
  • I started weighing and measuring my dinner as I make my lunch.
  • I round up with I count carbs.
  • I am also trying to take insulin early if I know that I will be enjoying something higher in carbs than I usually have.
  • I keep almonds or walnuts in my purse for snacking
  • There is more to say on this, but I will stop here for now… :)

My Holiday

  • Celebrations being so prevalent in the past months, I had to rethink how I celebrate.
  • I had my first cookie exchange without eating a single cookie.  Whew.. that was rough!  I almost stayed home.  Glad I didn’t!
  • I can remember the two Christmas cookies I allowed myself to enjoy: a  Scottish Shortbread Cookie and a round little powdered sugar shortbread morsel.  Can you tell I love shortbread.  Please don’t ever bring Sandies to my house.  I will not be able to contain myself.
  • I tried to tell people ahead of time if I thought that I would need something different to eat or if I would not be eating at a gathering.  Sometimes this is appropriate, and sometimes it is unnecessary.
  • I tried to not think of the holidays in terms of food.  I actually went to my Grandma Drendel’s house without eating her thumbprint cookies.  It was hard!  So hard, but I knew that ONE would not be enough.  But you know what?  I still had a wonderful time with my Grandma Drendel & family.  I don’t need special food to celebrate!  I need special people! :)

My Team

  • One word: BEN!  He has been my biggest cheerleader throughout this whole process!  He literally said to me as I was trying to make wise eating choices, “Bri, if we spend all of our savings on groceries so you can figure this out, then that’s what we’re gonna do.  Get what you need!”  He has trusted me and supported me, and he is one of God’s most supreme gifts to me.
  • I have joined many diabetic Facebook pages.  They are SO helpful.  I wish I had found these about… oh, ten years ago.
  • My only true strength is Christ.  Anything right I ever want to do is from Him.  I am elated when I consider Him, grounded when I look to Him, and strengthened when fall before Him.

Not to us, O LORD, not to us, but to your name give glory, for the sake of your steadfast love and your faithfulness. Ps 115:1

This list is long and fractured, but it is some of the things that have been helpful for me recently.  I really needed to write some of them down.  The more I write, the more solidified it becomes in my heart.  I hope to continue to chronicle the journey.  I have been learning so much!  I can’t wait to share it with you!

Advertisements

A Beautiful Mind, Indeed!

Whilst I type tonight, my brow is indeed furrowed.  I find myself on the eve of another appointment.  Tomorrow, it’s to the nutritionist’s house I go.  I was told that paperwork would be coming in the mail for me to fill out for this appointment, so I carefully observed each parcel for the following days.  No mail came.  I called the lady who said that some paperwork was coming and she said, “No, I changed my mind, you would fill it out when you come in.”  So, I stopped watching the mail–and what should arrive the next day?? Paperwork from the nutritionist.  I’m not sure who sent it, but it came.  The unopened envelope sat kinda in the open for a few days; I would glance at it and think, “what sorts of honest, unhealthy reports await to be written in there, I wonder.”  Not that I’m “unhealthy” in a buys-twinkies-and-stuffs-my-face kind of way, but I know I don’t pass the gold-star-from-a-nutritionist test.  (I’m hoping for a bronze-ish star tomorrow, actually)  I know the only way for these people to help me is if I am completely honest with them and with myself about my health, but I also know there are about five versions of myself health-wise.  Let’s see, there’s “just hand over the chocolate” Briana; there’s “Zumba is like my new favorite thing EVER” Briana; “No, I’ll pass on that soda and drink my coconut-flavored-seltzer water” Briana; there’s also “okay, that sleeve of saltines was a bad choice, now I need take insulin and make better choices” Briana —- there’s the making of one of those great movies where the main characters eventually prove themselves to be one person with split personalities in the end here.  Sheesh.  I started filling out the paperwork  and got completely overwhelmed.  WHO AM I?? What are my top 5 snack choices, and does a Caramel Macchiato count?  How often do I work out?  Does being a preschool teacher count?  There was this one time I was going to the gym–and I plan on starting that back up real soon—so how do I answer that question??   Do I need a “refresher” on diabetes management, or do I want them to start over? What are my biggest hindrances?  Honestly, when it comes to what “derails” me, it changes daily.  hourly?  like minutely. They also asked questions like “What are your top 5 questions on diabetes.”  I think that I do have many questions about diabetes, but right now I’m asking all the questions of myself–who am I, why do I do the things I do, is it possible to change, will I ever get this right?  Do I have to go to the doctor’s tomorrow?? I do get anxiety about going, even now my heart is beating fast and I’m a wee bit scared.  I really don’t want to cry, but the truth is, I often do.  I really don’t want to take an honest look at who I am and changes that need to be made —WAIT A MINUTE, YES I DO! — at least, sometimes I do.  I really, really do!  I am so overjoyed to have the opportunity to care for myself.  So many others with terminal illnesses would look on diabetes with envy.  It is NOT something to just “put up with.”  It is a gift to be embraced.  My heart knows that.  God chose it for me and me for it! But on nights like tonight I feel like the wind is out of me–heart rate up and spirits down.  As I picked up and set back down my pen tonight–uncertain how to proceed–echoing in my head was the song, “Lead me to the Rock that is Higher than I.”  I don’t always need the wind “in me,” so to speak–I have the Holy Spirit Who invites me to take each step in His strength.  (Gal. 5:25)  I don’t need to have it all figured out, because He does.  (Jer. 29:11) I don’t even need to dismiss or be ashamed of my struggles, because God longs to my strong in my weakness. (2 Cor. 12:9-10)

I am still apprehensive about tomorrow.  I’m not sure which Briana will show up at that appointment, but I do know my God.

“For God alone my soul waits in silence; from Him comes my salvation.  He only is my Rock and my Salvation, my Fortress; I shall not be greatly shaken.”

Psalm 62:1-2 ESV

Jots and Tittles

I have been frightfully silent for the past week, though many things to say have been whirling around in my head!  I actually went to Starbucks with the intention of writing on the Wednesday after the hurricane.  BIG MISTAKE!  When I got there I remembered that all schools had been cancelled and half the city was without the internet.  It was packed.  After the Barista called, “tall, extra-hot, upside-down caramel macchiato” (my heart fills with joy at the mention of it!) I stood there with two bags and looked kinda sweet but also pathetic in hopes someone would want to rescue me from my seatless plight, but they were all too busy drinking their favorite drinks and typing on their computers to notice! I even entertained the idea of sitting outside on the cold, wet patio furniture, but sense seized me and I headed back to the car.  That is a very long and somewhat dramatic tale, all to say, writing has been on my mind, but not the top of my to-do.

Last week was sensational!  Using the CGM was literally all that it was “cracked up to be!”  Constant feedback is so helpful and encouraging.  It also, undoubtedly, leads to much better control.  I did have to write everything down last week.. everything.  Mood, activity levels, snacks, meals, carb counts, stress levels, (who can tell??) and anything else I thought relevant.  I was dreading it a little, but it just became part of my routine and I didn’t mind it.  I didn’t love it, but I didn’t mind it.  There was satisfaction in knowing that my jots and tittles would help my doctor help me.    I was able to talk to a Dexcom representative that it trying to help us figure out how my insurance would cover a Dexcom CGM for me–I gave her all the information a thought I knew only to find out later that I didn’t actually know it.  From now on, I think I’ll pass those calls along to Ben.  He’s on top of that stuff! (Thanks, Honey!)  Basically, as soon as I get a hold of this lady again, I should have a Dexcom as soon as the US Postal service can accommodate–with no cost to us personally. This is another reason to PRAISE GOD for Ben’s job even though the hours are difficult to handle sometimes.  God has perfectly guided our steps here.  I am thankful for the whole picture even though I can only see a corner of it right now.

“The heart of the man plans his way, but the LORD establishes his steps.”

Proverbs 16:9 ESV

I would not choose even some of the steps in the current stage of my journey.  I want what I want because I want it–I want it to be different–and I want it NOW! But when God gently reminds me that He wants the ultimate best for me–His best–I can rejoice in the stages of life He brings.  He truly is my Good Shepherd!

“The Lord is my Shepherd; I shall not want.

He makes me to lie down in green pastures.

He leads me beside still waters.

He restores my soul.

He leads me in paths of righteousness for his name’s sake.

Even though I walk through the valley of the shadow of death,

I will fear no evil,

for You are with me;

your rod and your staff, they comfort me.

You prepare a table before me in the presence of my enemies;

You anoint my head with oil;

my cup overflows.

Surely goodness and mercy shall follow me

ALL the days of my life,

and I shall dwell in the house of the LORD forever.”

Psalm 23 ESV

I must not let the familiarity of these words breed contempt!  He leads, protects, cares and provides for, and gives goodness and mercy to me.

  Following where He leads is an amazing privilege and honor. 

He is a joy to follow.

**CGM**

Yesterday, I went to visit the doctor’s office again!  Before, I thought that the doctor was talking about getting a whole new insulin pump, and my week-trial would be with a new insulin pump, but it was actually for a new CGM system.  CGM is stands for Continuous Glucose Monitoring — basically, it is a small device that goes partially under the skin with a small piece of technology (for lack of a better word) above.  The small catheter under the skin takes BG (blood glucose) readings every 5 minutes.  Through this, it is more possible to accurately track patterns in BG and prevent problems in either direction.  This technology will be especially helpful for me because it will help my doctor see my body’s specific patterns.  Also, I can see where by BG is headed: if I get a reading of 105 ^ ^ I would react differently than a reading of 105 > or with an arrow downward.  I can catch highs or lows before they happen.  This will be wonderful, if I am able to get it covered by insurance.  Some people may know that I have already tried something similar to this in the past, but discontinued use—it was NOT user friendly, and that is what my doctor was so adamant about!  I have only had it on since 1:00 pm yesterday, but so far I already like it much more than the previous one.

Here is a site that  explains more about the CGM I am using specifically.

http://www.diabetespumpcgm.com/dexcom-g4-platinum-cgm/?gclid=CJmh_PbHobMCFUWo4Aodnh4A7w

Even with the positive prospects of this new technology, I find myself a little overwhelmed with all of it.  I am still testing and keeping track of everything.  I’m not discouraged.  But I woke up at 56 (LOW!) then I covered as I usually would and it spiked to 388 ^ ^ (which means still rising) about 1.5 hours later, which literally was “explainable” going off of my actions (low-carb breakfast) alone.  It’s days like these that would derail me.  I am not, I will not give up!

I need strength today.

“Be strong and courageous.  Do not be frightened, and do not be dismayed, for the LORD your God is with you wherever you go.”

Joshua 1:9 (ESV)

“Blessed be the Lord, who daily bears us up; God is our Salvation.”

Psalm 68:19 (ESV)   

Get in a Row, Little Ducks!

As I have been testing over the past few days (yes 7+ times!) I have noticed a change in the way that I process my blood sugar readings.  I have been working hard to count carbs and know what I eat so I can cover for what I eat—and even still, sometimes the numbers aren’t exactly where they should be.  In the past, that would be so discouraging for me because I would think, “I did everything perfectly, how could this not be perfect??”  But now, when I have seen a high reading I think, “Well that wasn’t the right amount of insulin for that food–let’s make a note so I can change that next time.” (of course there are factors other than food like stress or illness or unknowns to take into account too!)   I see unexplained blood sugar readings as more of a problem for my doctor to help me solve or something that I can learn from instead of a personal judgment.

For many, many long years, I have struggled with thinking that a “good” number reading made me a good person and means that I did everything right that day; whereas a “bad” number made me feel guilty, frustrated, discouraged, and sad.  When honestly, blood sugar readings are fairly predictable with a fair amount of certainty, but there are unexplained, uncontrollable highs and lows.  I am not saying that highs and lows are outside of my control, because to a large degree, they are tethered to the decisions that I make with food and insulin coverage.  What I am saying is, I cannot get caught up in the few readings that are wandering off somewhere in no-man’s land.  In the myriad of times I have started again (or dreaded starting AGAIN) to really seriously control my diabetes, I thought that I needed to have every “plate” spinning perfectly: exercise, meal planning, testing blood sugar, doctor’s visits, eating healthy (and loving it!), sleep schedule (does this mean no sleeping in??  Gasp!) — and if I’m going to do all these things, I might as well do everything else in life right too like sending birthday cards to my relations, entertaining regularly, brushing and flossing 2x’s a day, keeping my nails painted, making meals for the sick, volunteering at church, etc… I mean, if I’m going to figure out diabetes, I probably need to figure out EVERYTHING while I’m at it.   It goes with out saying that I barely made it twenty minutes before I decided it was impossible.  I’m exaggerating slightly about all the things I try to figure out at once, but truly, only slightly.  For some reason, in my mind, everything will run together smoothly and fit, or out of frustration, I will ignore it and complete and under chaos will ensue.  Those seem to be the only choices.  If I’m going to do one thing right, I need to do ALL things right, or what’s the point?–that’s how I think.  That’s how my flesh thinks.  God says that I cannot, no matter how many ducks I get in a row, attain perfection.  In fact, He says the good I can do is like a “polluted garment”  (Isaiah 63:6).  And His love for me is not tied in any way to my performance.  He chose to love me while I was “dead in my sin” (Ephesians 2:5) knowing fully who I am from toe to tousle.  He didn’t choose me because of my goodness or despite my badness–He chose me because He wanted to!

“He predestined [chose] us for the adoption through Jesus Christ, according to the purpose of His will.”

(Ephesians 1:5 ESV)

It doesn’t stop there—God doesn’t just choose me and leave me be. He also promises to finish the good work He has begun in me.  (Philippians 1:6) Meanwhile, I need to remember that He will be the one that accomplishes it–not me and my mile-high recipe-for-discouragement checklists!

Pretty in Pink

Temptation was swift to follow my declaration to diabetes control.   Last night, I found myself in, of all places, Ace Hardware.  It was “ladies night.”  To raise money for Breast Cancer, “the helpful hardware place” was selling hot pink 5-gallon buckets.  There were pink-shirted-hardware-selling clerks, pink balloons, pink Christmas trees, pink punch–it was like walking into a bottle of Peptobismol.   And there, amid the pink carnations and pink grab bags was a huge-mongous, pretty-in-pink cake.  FREE for the taking.. taunting me with it’s sweetness.  Normally, I would say to myself, “It’s LADIES night!  Eat CAKE!”  Or, “maybe if I just take a small piece–it would really be rude NOT to.”  But I turned the other direction.  Yes sir! I ran straight for the fall decorations and did not look back.  I don’t think I can say accurately enough how much a truly LOVE cake.  Like a fat kid, some would say.  But last night, I decided to remain committed in the face of frosting-covered carbs.  As amorous my feelings for cake may be, my love for God and my desire to stay committed are stronger–by His grace!

Today, I am slightly on edge because I have an appointment with an endocrinologist tomorrow at 3:15.  It will be the first appointment I have had since Ben and I moved to PA.  I know that my blood work will not be great, but I am going to ask for a plan to get on the right track.  I’ll let you know what the game plan is tomorrow.  Meanwhile, pray that I ask the right questions and that I make it through without a complete breakdown.

Commit your way unto the Lord; trust in Him, and He will act.”

 (Psalm 37:4 ESV)

RIGHT NOW!

I am notorious for thinking to myself, “Hmmm… when should I really buckle down with my diabetes?”  The answer has been “tomorrow” or “not yet” for about 10 years now. (As of April 2013, it will be 10 years!) I know what you’re thinking… “HOW IS THAT POSSIBLE?  TEN YEARS?  Get with it, Briana!”  You know, it’s not like I have not put up a good fight for a month or two here or there!  I find myself discouraged, tired, sick… grasping for a moldy P & J sandwich in the dark of the night during a relentless attack of low blood sugar. (true story)  Many reasons and factors, stages of life, and “justifiable slip-ups” have occurred, and I have let them kick me down.  I will not make this decision out of guilt.  I will not make this decision because I “think I should.”  I will make this decision because God has already decided it.  He gave me diabetes as a gracious gift.  I do not understand that statement entirely, but I want to.  I know that God has planned “all things [to] work together for [MY] good! (Rom 8:28 ESV)

It is time to put my excuses and drama aside.  Diabetes control (and really, acceptance)  has not happened, but I am committing here, to my cyber audience of friends and family, and hopefully some day fellow diabloggers, to begin TODAY.

RIGHT NOW.