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!

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Little Less Conversation…

… a little more action!

That’s right.  In the past 3 months, this blog has seen very little attention from me.  In the case that I have been silent on this blog, one of two fundamentally opposed things are taking place.  Option 1: I have fallen off the wagon into an abyss.  In this abyss, there is lots of cake.  And with my mouth so full of cake, I just can’t find my diabetic voice.  Option 2: I am grabbing that feisty diabetic bull by the horns and can’t be bothered to write about it.

Headed into the “holiday months,” I must confess, I was extremely nervous.  Last year, I was doing well up until those pesky pilgrims came out to share their cornucopias and pie, I fell into more of a rut.  That followed through Christmas and into January.  In February, I was bitterly assaulted by a sinus infection that left me on the couch for weeks.  (The plus side of this: watching the entire first season of Once Upon a Time.)  In March, I had my blood work done, and it was horrible.  I was very discouraged, because I knew that my heart had changed so much regarding diabetes, but it was not showing up in the labs.

THIS YEAR MUST BE DIFFERENT.

I must stop Post-Christmas Blood work from coming!  …But how?

Knowing the tendency to “relax” around the holidays, I determined to make the same choices over Christmas as I had been implementing already.

The bloodwork:  in. 

The results: Fantastic!  

My a1c is finally, for the first time in my whole diabetic existence, in a “normal” range.  For those familiar with the test, my number is 6.7.  I had not even dared to hope that it would be below the 7’s, but God’s gracious gift to me was much better than I anticipated.

Thank you, Jesus!

“But God…”

“Bri needs her spontaneity, I need my schedule, and we need each other!” — Ben Frei

I always thought my husband said it best by describing us in this way.  I don’t do too well in boxes.  I like to wander.  I like midnight movies.  I like to feel freedom to make choices on a whim.  Ben likes to plan.  He enjoys knowing each step and what will be next.  We are a good balance to each other in this way–I keep his eye on the horizon and he keeps me grounded.  I’ve always thought that it would be someone like Ben that would do great with diabetes.  Someone who already has a set schedule and a routine way of proceeding through the day, they could just add a few extra steps and voila! diabetes managed.–but not a crazy like me!  In a way, I am more like a hurricane, flying through the house grabbing things, doing my makeup in the car (maybe), leaving the house with at least 3 bags in the morning (usually a cup of coffee too–it’s a balancing act for sure, I should charge admission for this show!) and still HOPING I have all the things I need.

Sometimes Christians like to say, “I can see now why God gave me (insert trial), because it has smoothed out my rough edges.”  I think that this is a true enough statement.  But I don’t believe that it is right to consider this the motivating factor for a trial.  Let me explain:  for a LONG time, I said, “I can see how having diabetes really works against my natural tendency to be unscheduled and under-planned.  God gave me diabetes to help me smooth out these rough edges.”  Which sounds nice enough.  What I was really thinking:  God doesn’t love me the way that I am so He gave me this stupid disease because I’m not scheduled enough!  This caused me to see my diabetes as a punishment for “the way I am.”  I truly did.  How could I, with a perspective like this ever think of diabetes as a gift? You know what, I didn’t.  It made me boil under the surface when people would suggest such a thing!  It even made me resent those who were able to joyfully embrace their difficulty as “a gift.”  “Pha!  That’s not how you really feel,”  I would think.  All the while I would struggle with my own guilt of not seeing my diabetes that way and not understanding why God saw fit to punish me in this way—especially since He is supposed to know what is best for ME!  This was not best for me–for the crazy, unscheduled girl!  It might be good for someone like Ben, but certainly not for me.

It is destructive for me to label my diabetes as God’s little sanding block in competition with my rough edges.   To be clear, it does do that.  Each step in our life is designed by God to make us more like Christ.  “And we all with unveiled face, beholding the glory of the Lord, are being transformed into the same image from one degree of glory to another” (2 Corinthians 3:16).  We are meant to be growing to be more like Christ–and that takes a little elbow grease on the corners, but God’s disappointment with us does not send the sandpaper–what does?

His emphatic LOVE for us! 

It is not God’s disappointment in us that motivates Him to do anything; it is His compassion and love.  Changing our natural tendencies is a “fringe” benefit, not the spark that lights the fire, but a bystander receiving heat from the flames.  My misunderstanding of this truth gave me a warped, crooked view of God and His love.  He is not a heavenly “life coach” looking to help me make improvements.  He is no more in love with me as a hurricane-crazy than He would be if I were as scheduled as the orbiting planets–His love and approval do not hang on me.  His love and approval have already been purchased for me as Christ hung on the cross.  He died for me–not to make me a better person, but to demonstrate His eternal love for me, and for those that accept His death as payment for their sins.

“But God, being rich in mercy, because of the great love with which He loved us,

even when we were dead in our trespasses, made us alive together with Christ–

by grace you have been saved!

So that in the coming ages He might show the immeasurable riches of His grace in kindness toward us in Christ Jesus.

Ephesians 2:4-5; 7

Because of God’s LOVE He saved.  Because of God’s LOVE He “sands.”

One-eyed, One-Horned, Flyin’ Purple People Eater!

…well, that’s what I was expecting anyway!  

The nutritionist actually ended up being a two-eyed, real, live, normal (as normal gets?) person!  She was kinda quarky and clearly much better at Math than I, and I liked her very much.  In my experience, I have not met so many encouraging, helpful diabetic support people.  Is Pennsylvania like a utopia of healthcare professionals?  Is Wisconsin a burying ground of sour-puss endocrinologists?  Maybe, just maybe, fault falls to the hearer–not the various tellers of information–for the previous negative experiences.  That hearer, of course, is this girl right here!  It is refreshing to be at a place in my heart where I can hear.  I know that this is the result of God’s loving, constant pursuit of my heart in this area.  I am truly thankful that He continues His work until it’s done!  (Phil. 1:7).  Thank you, Jesus!

Well, now that I am listening, what did I hear?  Is life as I know it done, or what?  Will I never look a chocolate cake in the face again? —- “Nutritionist” what a horribly super-negatively-charged title to have.

Dun.. dun… dun!

After I kinda laid out for her my history and my self-diagnosis, she proceeded to be very helpful.  YAY!  This is what we came to.  My doctor does not yet have a proper carbohydrate-to-insulin ratio for me.  When I eat food, my body has a special “sweet spot” (pun intended, I guess) when it comes to what I eat and how much insulin it takes to cover any given amount of carbs.   Carbs are like the holy grail to diabetics.  We live and die by this number.  What Lynn (this is how I will refer to my nutritionist for the remainder of the post) said was if  I could make some changes until we get that specific ratio figured out it would be very helpful.  At this point, she lost me a little with a lot of sciency-talk.  The goal is to eliminate as many variables as possible.  I cannot necessarily control stress or other contributing factors to glucose variation, but I can control the amount of carbs that I eat.  (Sometimes, I feel like I CAN’T, but I’m going with her theory on this!)  So, the game plan is this: for the next 2 weeks to a month I am going to eat the same amount of carbohydrates at each meal: 45.  This eliminates that variable.  As I follow this plan, my doctor and Lynn will be able to find my body’s specific ratios.  Then, whether I’m eating 20 carbs or 120 carbs, the ratio will be correct (theoretically).  This is not a forever thing, but it may be an until-the-end-of-the-year thing.  Of course, I’ll probably take a few vacation days during Thanksgiving and Christmas, but for the most part, day-in and day-out, I’m going to be eating 45 carbs at each meal.  (If for some reason you find yourself in possession of some great 45-carb per meal recipes, comment!)

This will not be easy.  It seems simple enough–but, oh boy, this will not be easy.  To break it down for you, my daily eating looks like this: small, if that, breakfast.  Lunch is kinda my dinner meal with Ben.  Dinner is usually those Lipton cup-o-soups, if anything.  Then because I don’t eat or eat little, 9:30 pm is a mad (bad) dash to the pantry to find anything salty and/or sweet.  Not a perfect break down, but sadly, accurate enough.

I told Lynn this and she gave me some pointers.  Since I don’t like to cook dinner for just me, and I don’t always make lunch, (lots of soup here, people!) she suggested making two BIG meals a week that I can re-purpose later in the week.  She said, “Buy a rotisserie chicken; buy rice in the bag that you can throw in the microwave for a minute; buy those steamer bags!”  She added, “Anything you make can be dressed up the next day as a salad, a pizza, or a sandwich!”  Creative leftovers, I can do that.  The biggest concern for her is that I can go days without multiple food groups.  I stick to lots of yogurt and soup.  I went months without buying bread.  I thought the goal was no/low carb, but she said people should have 130 carbs a day at least.  I don’t want to burden you down with all the food nitty-gritty (not nutter-butter) details.  Big picture: I need to try to include 3 food groups at least at each meal and each consistent carb totals.

My goals:

– make a list of 3 breakfasts @ 45 carbs

-make a list of 3 lunches @ 45 carbs.

-make a list of 3 dinners @ 45 carbs.

~~This is a BIG one~~

ACTUALLY EAT THOSE MEALS

We are still waiting to hear back from the Dexcom representative that I accidentally gave the wrong insurance information to.  I’m sure the end of the year is busy for them because people want to purchase equipment before the new years’ deductible rolls over, but that’s exactly what we’re looking to do as well.  Would you pray with us that this could be figured out soon and I could have a Dexcom before January?

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.

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!