Off to the Endo I go

I've uploaded the last month's worth of CGM data from Rose.

I've printed a summary of that data. Complete with pretty colours, pie charts and graphs.

I've breathed a sigh of relief after seeing how lovely my average blood glucose stats were. I then proudly saddle up beside Doug to show him so he could express his delight (or at least make supportive sounds as I clicked through the pages of data).

I have my blood pressure log with detailed notes about each pre and post long-run blood pressure fiasco. I also have my blood pressure meter set out on the counter.

I have my list of questions ready.

It's that time again.

Endo appointment time.

Here's hoping it's a little more helpful than my diabetes centre appointment was a few weeks ago.

I'll let you know next week how the A1C turned out and what her thoughts are on the blood pressure drop accompanied by heart rate spike that keeps happening during long runs.

Stand Up!

I sit a lot at my job.

Like a lot a lot.

Like, on days when I don't have to leave the building for a meeting, I can sit for 8 hours straight. The only reason I don't is that I drink a lot of water which means a lot of trips to refill the bottle and empty the tank. But, even then, I do a lot of sitting.

Which, as I've been reading a lot lately, is the new smoking. Or whatever. I don't think it's actually as bad a smoking but it's certainly bad for you.

I work at a computer so it's not exactly like I can strap my laptop around my neck and type standing up.

And it's not as though I can stand up, bend over my laptop and type and a half-crouch sort of position.

And it's not as if there are stand-up desks out there that I can purchase.

Omigod wait. What?!? There are stand up desks? Built just for laptops? That fit on top of a regular desk? And that can then can be adjusted to be used either sitting or standing.?

Guess who is getting one? It's being delivered next week, complete with a comfy foot mat thing to keep my feet happy while I'm upright. 

It is wrong that I am this excited at the thought of standing up? 

Because I really really am.

Should I?

Sometimes it's easy to weigh the pros and cons of medical choices we have to make.

Should I take insulin?

It's a synthetic hormone that, if taken at the wrong dose, can be lethal.

Well when you weigh that information against the knowledge that not taking insulin has a 100% chance of killing me, I'm all for it.

Bring on the insulin!

And thank you Doctors Banting and Best for giving me the choice.

Other health decisions are a little less cut and dry.

Should I take calcium?

Pros - it will help reduce the risk of bone density loss, something I am at high risk for and have already shown early signs of.

Cons - the are health risks associated with calcium supplements, include cardiovascular disease risks which, as someone with T1, I am also at risk for.

Should I take a low dose statin?

Pros - it will help reduce the risk of cardiovascular disease and stroke, things I am at risk for as a person with T1.

Cons - there are all sorts of side effects that come with taking statins including, I recently discovered, memory loss. For some reason that one I find particularly disturbing...but I can't remember why.

Should I take iron? Should I take digestive enzymes? Should I take vitamin D? Vitamin K? A multi-vitamin? Low-dose aspirin? A pill whose name I can no longer remember that is supposed to help protect my kidneys? Birth control?

All of the above have been prescribed or strongly recommended by a doctor at some point in my diabetes care. Some I have said yes to, many I have said no. All I have agonized over and still second guess as I pop open the daily pill bottles.

Despite all of the no's, I take three pills when I wake up, one with breakfast, one mid-day and one before bed.

I can only hope that they are doing more good than harm.

Operation Combo Bolus

Sunday was a rather bizarre day where everything ended up taking longer than it was supposed to take. We had a nice day but, by 6pm, we had only just arrived home and we were both too hot and tired to care much about cooking. 

We decided to order sushi but, after picking our favourite sushi items from our take out menu, we discovered that our favourite sushi restaurant was closed on Sundays. 

Plan B involved getting back in the car, still sweaty and sunscreen-covered, and driving to another sushi place downtown that was one of those all you can eat kinds. 

"You sure you want to do this?" Doug asked. "Sushi usually messes up your blood sugar". 

"Yes, I do want to do this" I replied "and I have a plan". 

The code name of this plan was Operation Combo Bolus and I was about to take it out for it's first dry run. 

I have been using an insulin pump for 6 years now and have known about the Combo Bolus since the beginning. Yet I have never used it. Not once. 

Why? 

Because it's always been described as a good tool for dealing with high fat high carb meals like pizza and I don't tend to eat too many of those types of meals. The concept makes sense - take insulin over an extended period of time so that it can work in harmony with the food that is digesting over a long period of time, avoiding post-meal highs hours after eating. 

I decided to try it for all you can eat sushi night. 

So we ordered our first few sushi rolls and I dialed in 6 units of insulin and a duration of one hour. 

Every five minutes I could hear the pump gears whirling as I received another small dose of the 6 units of insulin. 

I started my dinner with a blood sugar of about 7. We ended dinner and I was 8.0. We went home, did a few things, sat down to watch an episode of Bloodline and I continued to hover between 8.0-8.5. We went to bed three hours after finishing dinner and my blood sugar was holding steady. 

No extra insulin needed to combat skyrocketing blood sugars. 

No pre-bed snacks do deal with rage bolus-induced lows.

No midnight pump alarms ruining our sleep. 

Operation Combo Bolus was a resounding success. 

Back in the Saddle Again

Last week I took an unplanned blogging holiday.

I was still working my regular job. I was still doing my regular stuff. But, for some reason, I wasn't into blogging. So I didn't blog.

Perhaps it's because the week before had been D-Blog week and, as much as I love it, I'm usually pretty tired of writing by the end of it.

Perhaps it's because Doug and I are busily repainting all of the rooms in our house so evenings and weekends revolve around when we can squeeze in another wall, another handful of doors or some baseboards.

Whatever the reason, it was nice to have a break and just as nice to be back.

Since we last spent time together, I've managed to play in a Mixed Doubles golf tournament (my first golf tournament ever) as well as a Mixed Match Play game. Doug and I did not win the golf tournament (no shocker there) but we did end up with a respectable final score. We also managed to win our first Mixed Match Play game so we are off to play a second round...yet to be booked.

I took a deep breath and signed up to play Thursday golf with some of the more experienced ladies at my golf club. I played my first game with them, followed by wine and dinner, and loved it. I'm all signed up for this coming week and look forward to some very supportive yet challenging golf.

I also ran my last two long runs before my half marathon. A 20k run that turned into a 13.5k disaster thanks to a blood pressure/ear plugging nightmare and a 16k that was the perfect redemption run. I sailed through that one without a hitch.

I got back in the pool again and managed two 2k swims last week. My tendonitis flared a little bit afterwards but not enough to hinder my Sunday golf so I'm hopeful that my poor elbow has turned a corner and is on the path to a full recovery.

I was knocked down for a day with the stomach flu but the diabetes gods didn't seem to notice or perhaps they felt too bad for me to cause any mischief. Twenty-four hours after the first stomach twinge I was back to feeling great with hardly a high or low blood sugar to show for the ordeal. It felt almost too easy.

Other than that, I signed up on a whim for a local Spanish conversation group and will be attending my first meeting next week. I had been looking for a local French group to practice with but couldn't find one. Spanish works just as well since I'm just as rusty in that language as I am in my French.

Well that's my big news.

See y'all tomorrow

D-Blog Week Day 6 - Favourites and Motivations

Today we were encouraged to go back into our blogging past and re-post something that we have written. A favourite sentence or blog post. Well, after years of blogging, I still think that the post I'm reposting today is my favourite. If you missed it the first time, enjoy.

Diabetes - What it's Like on the Inside

It's always the same and yet it's always different.

Sometimes it starts with a dry throat and a gentle headache right between my eyes. The kind that makes me squint a bit and brings out those frown lines that I get when I'm thinking hard about something.

Sometimes it starts with a yawn. And then another one. And then another one. I usually start slouching in my chair a bit or get up to make some tea in an effort to wake up.

Sometimes my elbows start to feel a little less bendy. Like the fluid in my joints is starting to solidify.

Sometimes I get a funny taste in my mouth.

Sometimes the symptoms stop there. Sometimes they get worse and my dry throat becomes a crushing thirst, my gentle headache starts to pound, my yawns flow into each other and my joints all begin to join the stiffening chorus. Sometimes my hands start to ache.

Sometimes I clue in quickly. Other times I don't.

I always clue in eventually and grab my glucometer - knowing I'm going to see 16+ on the screen.

Sometimes my lips and tongue start to tingle just a bit. The way they feel when the freezing is coming out after a trip to the dentist.

Sometimes my heart starts beating a little faster and feels like a fluttering bird in my chest.

Sometimes I start to yawn. And yawn. And yawn. I go make a cup of green tea in an effort to wake up a bit.

Sometimes my limbs start to feel light, like gravity was turned down a notch. I become a little more awkward and clumsy than usual.

Sometimes little things annoy me. Things that didn't annoy me even a minute before and things that don't normally annoy me...ever.

Sometimes I clue in quickly. Sometimes I don't.

When I don't, my lips and tongue start tingling a lot - to the point where I can hardly feel them. My heart beat gets crazier and I start to sweat. It comes on fast and furious at that point and I can easily sweat through a hoodie and a jacket as well as my jeans in minutes. The yawns progress to the point where I can hardly get a sentence out between them. The world starts to spin. I need to sit down.

What I really need to do is grab some juice.

Diabetes is a textbook disease made up of numbers. Dosages. Ratios. Units. Time.

Diabetes is often summarized on a piece a paper with pictures of people drinking water or looking pale and shaky. It comes with warnings that a person is in one of the two ends of the blood sugar spectrum and helpful suggestions about what to do.

Diabetes is all of those things. And it's none of those things.

Diabetes is the horror of waking up drenched in sweat and hardly able to reach the Dex 4s on your bedside table and wondering, through the haze, "what if I hadn't woken up?"

Diabetes is the fear of going back to sleep in case it happens again. And it's the feeling of isolation when you get to the pool the next morning, tired and shaken, and no one has any idea what you've been through and how scared you were...and how important it was to get up early anyway so diabetes doesn't win.

Diabetes is the horror of struggling to control a blood sugar of 25 with dose after dose of insulin and feeling that every minute you spend up in the clouds is another minute that diabetes is doing damage to your body. The only body you have. And diabetes is wondering if this high will be the high that puts me over the edge to the land of no return.

Diabetes is the fear of going low 1500m from shore during a triathlon swim and yet still getting in the water because the fear of letting diabetes dictate your life is greater than the fear of an open-water low.

Diabetes is squinting at the tiny air bubbles in your insulin tube, carefully priming to get them out, and then wondering if anyone will do that for you if your eyesight fails and you are no longer able to do that for yourself one day.

Diabetes is listening to people talk about other people with diabetes and all the horrible things happening to them...and refusing to let that stop you from trying to be healthy even though it's just so easy to give up and hand diabetes the reigns.

Diabetes is about doing the same thing, day after day after day, knowing it's only going to work half the time.

Diabetes is about finding a way to be proud of the fact that you test your blood sugar in public and have tubes coming out of you as you walk around the change room after your swim. Because the alternative is hiding and that's not an alternative you're willing to entertain.

Diabetes is all numbers and ratios and signs and symptoms on the outside.

On the inside, it's a never-ending battle between fear and courage. Between motivation and depression. Between the will to fight and the urge to throw in the towel.

Sometimes I'm the one on the left. Sometimes I'm the one on the right. 

Depends on the day. 

D-Blog Week Day 5 - Foods on Friday

Today is all about food. Specifically the food I ate yesterday. So y'all are getting a glimpse into a day in the life of Céline's stomach.

5:30am
I'm up and ready to run. My blood sugar was 4.6 so I ate two dates. Two fresh, plump, delicious medjool dates.

7:00am
Run done and breakfast is warmed up and ready for eatin'. My favourite breakfast these days is steel cut oats (cooked ahead of time and then put in the fridge in one-serving batches for easy heating). I warm them up with some almond milk (plain, unsweetened and fortified). Once heated, I toss it all into a bowl that already has 1/3 of a cup of All Bran buds ready and waiting. I stir it all together and then top with 1/2  of a banana (sliced), 3/4 cup of plain greek yogurt, 6 walnut halves broken up into bits and, when we have them, some berries on top. Yesterday there were several blackberries and raspberries adding some zip and colour.

12:30pm
Lunch time! I didn't eat anything between breakfast and lunch because a) my blood sugar was well-behaved and b) I was in meetings and it wasn't easy to snack. Lunch was leftover greek chicken salad (chicken, cucumbers, tomatoes, olives, feta cheese, lemon juice and olive oil) topped with an avocado. I followed that up with 1 cup of kefir (delicious) and a small green apple.

3:00pm
Peanut butter chocolate chip Larabar (I was golfing at 4:30pm so this was my pre-golf snack)

6:45pm
9 holes of golf done and I was eating dinner at the golf course with the ladies I golf with on Thursdays. Dinner was the Urban Sombrero salad with flank steak on top. The salad is made up of quinoa, black beans, veggies and cilantro with a chipotle orange dressing. Topped with a few pieces of avocado. Oh, and a 9 oz. glass of red wine.

8:00pm
Home and settled in for another episode of Bloodline on Netflix. A frozen yogurt bar (chocolate fudge flavour) kept me company.

10:00pm
Rose buzzed. I was dropping. Two fig newtons later I was topped up and heading back to sleep.

And that, my friends, is what this T1osaur ate yesterday.

D-Blog Week Day 4 - Changes

Today's topic: changes.

Specifically, changes that we would like to see in the diabetes world or changes that we have been through since we were diagnosed.

Well the first thing that popped into my head when I read the topic was the change in attitude that I have experienced when it comes to insulin pumps.

Like most people, when I was first diagnosed, I started off on multiple daily injections (MDI). I had two different insulin pens (needles). One with long-acting insulin that I took in the morning and again at night. The other with fast-acting insulin that I took every time I ate something with carbs in it or when my blood sugar was high. And heaven help me if I mixed them up.

I did all of the calculations in my head (40 carbs for breakfast, 1 unit of insulin for every 8 grams of carbs = 5 units.  Plus perhaps an extra unit or two because my sugar is high. Or perhaps only 2.5 units because I'm going for a run etc etc).

When I first heard of the insulin pump, I had a visceral reaction to the very idea of it.

No!

My mother and I were having dinner together one night and she asked me why I was so opposed to the insulin pump. She had read about them and said they sounded like a good alternative. I said that I didn't want to have something attached to me all the time. She probed a bit more and, to the surprise and horror of both of us, I started crying. Right there in the restaurant.

See, years ago I had been in a nasty car accident and had to undergo some pretty major surgery that saved my life. I had a temporary colostomy which was successfully reversed a few months later. I thought I was over the ordeal but, when pushed about the pump, I suddenly realized why my reaction to it was so visceral. Having something attached to my body, that was somehow both on the outside and on the inside at the same time, reminded me too much of that really painful, difficult time. It fell into the category of 'colostomy' and I wanted nothing to do with it.

My mother understood and didn't ask again. I went on with my MDI routine.

I had not yet discovered the Diabetes Online Community (DOC). I did not know anyone else with diabetes. I certainly did not know anyone on the pump. Still, it was hard to avoid the information and posters I would see when I went to the Diabetes Centre. It took me a few more years before I would even consider a pump but I slowly opened up to the idea.

When I heard about a pump info session in my community, I took a deep breath and went.

Alone.

I tried on an infusion site. I wore it all day. I lay down on it, I put clothes over it. I bent and twisted and moved around and I realized that it was nothing like I thought it would be.

So I signed up and got a pump.

A pump that does all the insulin to carb calculations for me. And the pump actually remembers when I took my insulin and how many units I took in case I forget. And it tells me how much insulin is left in my system so I don't have to guess. And it lets me fine tune my insulin doses which makes all the sports I do much easier and safer.

It's not perfect and there are days when I curse having to be attached to something. But I don't think I would ever consider going back to MDI.

In fact I am the first person to promote insulin pumps. Anyone I talk to who is considering one gets gushing reviews from me - the girl who once cried in horror at the very thought of wearing one.

D-Blog Week Day 3 - Clean it Out

Today's topic challenges us to look for diabetes-related things that we are holding on to. It might be physical belongings or it might be emotional stuff that we can't seem to let go of. What are these things, why are we hanging on to them and what are we going to do about them?

Yesterday I struggled a bit with the blog topic and today I seem to be doing the same thing. 

In a physical sense, I really don't hang on to too much diabetes stuff. I have my diabetes cupboard where my supplies are stashed and there is usually a pretty good supply stashed. But I use it all and I feel better when there are weeks of back up stuff stashed in there because one just never knows when that pesky zombie apocalypse is going to hit. 

But other than having a good supply of things I use, I really don't have a lot of extra stuff kicking around for no reason. 

Oh wait, that might not be true. 

Actually, when I think about it, I may still have every single glucometer I have ever used tucked away on the bottom shelf of that diabetes cupboard. 

I may also have boxes of lancets for each of these devices that are still 3/4 full because, let's be honest here, you don't go through too many lancets when you only change them one per season. 

Oh dear. Now that I think about it, I may still have all of the start-up information for my Medtronic pump. The pump I used to use before I switched to Animas several years ago. 

And, since we're being honest here, I may also have gotten into the habit of saving the little pump plug thingie that I use when I am unhooking my pump for a shower. I keep one in the bathroom, two in my toiletry bag for when I'm traveling and a few in my swim bag for the pool. And then, for about 5 years, I used to toss every new one I got into a plastic bag in my diabetes cupboard, just in case. And when you consider that I get a new plug thingie every four days when I put in a new site, I have a lot of them. 

I'm proud to stay that, in the last year or so, I have stopped saving them. But I did post this picture a few years ago and it might be worth looking at it again. 

By the way, this is one of those gimmicky wine glasses that holds an entire bottle of wine in it. There are a lot of those plug thingies in there. 

Ok, so maybe I really do need to take a look at my diabetes cupboard and toss a few things out. 

As for emotional baggage that I am dragging around, since we are all being honest here, there is one thing that does make me kinda crazy. 

I am finding it increasingly difficult to respond respectfully to people who say things about diabetes (be it T1 or T2) that are ignorant or hurtful. Most of the time I am able to hold myself back because I know the person and I know that they are not saying these things to be hurtful, they just really don't understand. So instead of snapping at them, I try to patiently educate so that, hopefully, the next time they think something negative about diabetes, they hear my voice in their head saying "don't judge. Just don't. You have no idea and what you just said is very hurtful. If you're curious, ask the person. But for heaven's sake, don't judge." 

But I have to say that, after 12 years of this, there are days when it's really difficult to put on my nice girl pants...because what I really want to do is give them a good smack and say "oh for heaven's sakes, you have no idea what you're talking about, you are spreading negativity and you sound incredibly ignorant. So how about you stop spewing inaccurate information and making things worse for everyone."

Sigh. 

But you and I know that the second response does not make the world a better place. Only the first one does. 

And I'm all about making the world a better place. 

So while I am getting increasingly frustrated by the lack of accurate diabetes knowledge out there, I am also committed to changing that when I can. 

But let me tell you, there are days when I want to toss all of my pump plug thingies out and check to see if that wine glass really does hold an entire bottle. 

D-Blog Week Day 2 - Keep it to Yourself

For this second day of D-Blog week we were challenged to talk about some of the aspects of diabetes that we keep private. Those things that we don't blog about and those things we don't tell our family or our friends about.

This topic was a tough one for me because, to be honest, I had trouble thinking of something to write about.

My immediate thought was that I don't really keep diabetes-related things private. There are plenty of parts of my life that I never blog about but I don't tend to pull any punches when it comes to diabetes. The good the bad and the ugly bits of diabetes all take turns starring in my blog.

Then I told myself to think harder. That there must be something I don't share, some aspect about diabetes that, consciously or not, I don't share. I told myself that I just need to be really honest with myself and I'll find something.

I'm honest about my blood sugars. I write about the tough days, the emotional days, the easy days. I write about the scary moments and I write about the inspiring ones. I talk about the times when I'm angry at the diabetes gods and the times when we are getting along and can go out for drinks together.

Then it hit me.

I don't whine about diabetes.

I resolutely refuse to complain about anything to do with diabetes.

I think it's important to share the challenges but I try very hard to do it in either an entertaining or an informative way. I want others to learn from my adventures and I want people to find comfort in knowing that someone else out there gets it.

But I have no patience for people who complain for the sake of complaining. Complaining rarely makes anyone feel better and usually ends up dragging other people down. Complaining feels destructive rather than constructive.

So, no matter how I am feeling on any given day, about any diabetes-related situation, I won't complain about it, on my blog or to the people I care about.

Even on the toughest diabetes day, when the roller-coaster seems to be running non-stop, there is always something I can do to make it better. So while I might drop the odd f-bomb, I refuse to wallow and I refuse to stop trying.

D-Blog Week Day 1 - I Can...

I have had the honour of speaking in front of various groups about how I live my life with type 1 diabetes.

I usually start off by telling them my diagnosis story so that they know a bit more about who I am and where I am coming from.

Then I tell them the story of the day I decided to become a runner. I talk about the journey from that day to the day that I ran the Run for the Grapes half marathon.

And I tell them the very important lesson that I learned while on that journey.

Life is scary.

Diabetes is scarier.

And I live with diabetes every single day.

I talk about how diabetes is scary in the immediate sense when we have one of those awful lows that comes out of nowhere and scares us for days afterwards. And I talk about how diabetes is scary in the long term sense as we hear and read about those complications we might develop despite our best efforts to try to manage without a functioning pancreas.

I talk about how scary diabetes is and I talk about how brave we are because we deal with that fear every day.

And then I talk about how, since I started to look at life from that perspective, I started saying yes to things that scare me. Yes to cycling. Yes to swimming. Yes to trying a duathlon. Yes to trying a triathlon. Yes to doing motivational speeches in front of a room full of strangers. Yes to golf. Yes to golf tournaments. Yes to curling. Yes to curling bonspiels.

Life is scary.

Diabetes is scarier.

And I live with diabetes every single day.

Diabetes has helped make me so brave that I have said yes to things I would never have said yes to before. My life is richer and fuller now that it would ever have been if I had not been diagnosed with type 1 diabetes 12 1/2 years ago.

So yes, you're damn right I can...

Here Comes D-Blog Week 2015

Next week is D-Blog week.

In fact, it's the 6th annual D-Blog week. 

And it's my 5th annual one. 

I missed the first one because I had not yet heard about the DOC, had not started my blog and really had no idea that anyone on the planet other than me actually had type 1 diabetes. 

Now I know that there are a whole bunch of us out there with more voices joining the choir every year. And as much as I would love it if type 1 diabetes did not exist, it does. And since it does, I sure am glad to be a member of such a lovely, vibrant, passionate group of people. 

D-Blog week, for those of you who don't know or remember, is a week of diabetes-related blogging. 

It goes something like this: 

A list of topics are given to us to write about. One for every day of the week, beginning next Monday. We write a blog about that topic and then we posts a link to our blog on the topics page. Anyone interested can click through the list of links and read blog after blog about the same topic written by different people all over the world. If you're interested in writing for, or reading blogs about, D-Blog week, go visit Karen over at Bitter-Sweet Diabetes. She's the wonderful host of this great event. 

It's a wonderful way to discover new blogs as well as rediscover ones I used to read and lost track of along the way. It's also a great way to challenge myself to write about topics I would not normally write about. 

So come back next Monday for the first instalment of Running on Carbs' D-Blog adventures. 

The Mind is a Funny Thing

Every once in a while I am at a loss of what to blog about. It doesn't happen very often since my life seems to be chock full of diabetes (mis)adventures as well as plenty of running, cycling, swimming or golfing stories to share. Some days though, I don't feel inspired and I stare at my white screen for a few minutes.

Then I will look up at Doug sitting on the other couch and say "what should I write about?".

He usually comes up with something and then I'm off to the races.

Last night I asked "what should I write about?".

Without a moment of hesitation, he said "you could write about hitting three balls into the water that wasn't even there". "You could call it 'the mind is a funny thing'."

So let me tell you a story about a golfing lass who was out golfing with her handsome golfing lad.

When they got to the 7th tee, she watched her lad hit his ball over the water and on to the green. Lovely!

The ladies' tees are closer to the hole and, based on where they are located, the ladies don't need to hit over the water. In fact, the only way for the ladies to go into the water is to hit right. And I mean really really right. Like 90 degrees right. So the golfing lass never even thinks about the water other than to notice how pretty it is and check to see if her friend the blue heron is hanging around.

The golfing lass loves this hole because a) it's a par 3 and par 3 holes always hold the possibility of a hole in one and b) it's not very far and has a nice big green to land on.

As she walked to her tees, the golfing lad said "swing easy baby. Don't go into the water".

"I didn't even think that was possible" she laughed and proceeded to set up her shot.

She hit her first ball into the water.

She burst out laughing and said "that's crazy. I have never done that before". "I'm hitting another ball!".

She hit the second ball into the water.

"Bloody hell" she said, knowing full well that was not proper golf course language.

"I'm doing that again. This is ridiculous."

The third ball flew towards the green, bounced off a boulder and went into the water.

Three balls lost in a water hazard that wasn't even a water hazard until the golfing lad said it was a water hazard.

The mind is a funny thing.

Not Much Help

I went to the Diabetes Centre on Monday, armed with 7 days worth of food logs printed from My Fitness Pal and a few weeks' worth of pre and post workout blood pressure readings.

I had my list of questions.

I was ready!

We started with my food diary. I asked about some of the vitamins and minerals that people with type 1 diabetes are notoriously low in - primarily calcium. I said that, according to My Fitness Pal, I get 100% of the daily recommended dose of calcium most days without taking a supplement.

"My doctor recommended that I take a supplement" I said. "I will if I need to but, if I'm getting 100% of my daily calcium from my diet, is that enough? Or, as someone with type 1 who also has a family history of osteoporosis, do I need more than 100%?"

"Well, if your doctor said to take a supplement, you should listen to your doctor" was the reply.

"Yes, but my doctor never asked about my diet so she has no idea how much or how little calcium I am getting. In your opinion, should I take a calcium supplement on top of the calcium I get in my diet?"

"Well, if you doctor said to take a supplement..." was the reply.

Sigh.

Moving on to blood pressure.

I explained the trend I had noticed where my blood pressure drops during long runs, sometimes dramatically, and that, when that happens, my ears plug up. I also mentioned that, if I make a point of drinking a lot during my run, my blood pressure does not drop and my ears do not plug up. I even showed them some of the before and after readings.

"That's really fascinating" they said.

"Yes it is" I replied. "Do you have any thoughts about this? Am I on the right track? Should I be concerned? Are my low blood pressure readings dangerously low?"

"Well, that is very interesting" was the reply and then they checked my blood pressure (which was 120/80 or something. End of discussion.

Did I mention that I was speaking with a very experienced diabetes nurse and a registered dietician?

Did I mention that, while I knew the nurse from previous visits, I did not know the dietician.  I had to introduce myself to the dietician a few minutes into the appointment because, the second I sat down, I was being asked a bunch of questions without even knowing who I was taking to?

"I'm Céline" I interrupted "what's your name?" She told me and I said "well, I figured we should be properly introduced before I start sharing all the private information in my insulin pump".

Every year I go through this routine. I come armed with information and questions and I leave knowing no more than I did when I went in. It feels like an exercise in getting their form filled out as quickly as possible so that they can meet their requirements and confirm that I quality for pump funding for another year.

"That's because you know more than they do" Doug said when I told him.

"Well, that may be the case but their care is not at all person-centred" I said. "They don't seem to be willing (or able) to provide any medical advice whatsoever and they only give vague answers, if any, to my questions. If I were them I think I would love a patient like me - keen, knowledgeable, willing to work together to find answers."

I just hope that, for people who actually go there for help, that they get it. Because if I really needed help on Monday, I am not confident I would have received it.

I do take comfort in the fact that I am going to see my endocrinologist in a few weeks and can ask her all of my questions. She'll answer them and be absolutely candid when she does.

With her I always leave her office knowing more than when I went in.

When in Doubt, Trust the Feeling

Yesterday I wrote about having faith in diabetes systems, even when they do not always work.

Well, on Saturday, I ended up having to have faith in my ability to feel what my blood sugar is doing rather than relying on technology to keep me safe.

I have been using a Continuous Glucose Monitor now for about 18 months. When I put a new sensor in, the first day readings can be a little wonky and when the sensor starts failing, two or more weeks later, the readings can also be a little bizarre. But from the second day until the second week, it's usually extremely accurate. So much so that I will often  treat highs and lows based on what the readings say

So on Saturday morning, when I headed out for a run with my 3-day old sensor, I had complete faith in the numbers.

I was 6.0 before the run. Since I was only (only!) running 10k, I had one date. That should have been plenty.

At the 5k mark, I did a quick check and discovered that Rose was buzzing to tell me that I was 3.8. I didn't feel 3.8 and I should not have been 3.8 but there it was, flashing on the screen. To be safe, I had a package of fruit chews.

I started running home. A few minutes later, Rose's ear-splitting siren alarm went off. The alarm that goes off when I'm under 3.1. It made no sense. I sure as hell did not feel 3.1 but, because she was telling me I did, I started feeling like I might be 3.1.

I refused to eat another package of fruit chews. I knew that one package should be enough and two packages would send me flying high in no time. So even as she kept alarming to tell me that I was 2.8, then 2.4, then 2.0 and then just plain "low", I kept running.

When I got home, I did a finger prick and discovered that I was 5.6.

I knew it!!

I re-calibrated Rose and, for the next 5-6 hours, she behaved herself.

Then, as we were sitting on the couch after a busy day of yard work, I started feeling low. I checked Rose and she said I was 7.0 and holding steady. And she had been accurate an hour before so she should be fine.

A few minutes later, I couldn't wish that low feeling away. I went to the kitchen and a finger prick told me that I was 3.8. Rose still said I was a lovely 7.0.

I had some maple syrup for the low and I shut down my 3-day old sensor. I waited an hour and then I restarted it. Two hours later, it was ready to go and I calibrated it.

Rose has been fine every since.

A Bit of Faith

Diabetes is just enough of an a$$hole sometimes that it makes it impossible to have faith in the system.

Even when those devilish diabetes gods behave themselves and do the same thing 15 times in a row I I have trouble believing they will do the same thing on the 16th time. Why? Because, in the past, when they have lulled me into a state of compliance and I lowered my guard a tiny bit, that's when they like to throw a curveball (or a hand grenade) my way to shake things up.

Which is why it made it very difficult for me to have faith last Friday when we headed out to the golf course.

It was my first 18-hole game of the season. Eighteen holes means four hours of walking. We cover about 10k at a fairly leisurely but non-stop pace. We walk up hills and down valleys and back up again.

I learned a lot last summer during our rounds of golf and one key lesson I learned was that the only way to survive 18 holes was to play with my basal rates. Trying to do it by eating a few extra carbs was a recipe for disaster and I ended up eating way more than I wanted to.

Last summer I learned to lower my basal rates down to 40-50% for four hours, starting an hour before the game. At some point during the front 9 I would eat a Clif bar without bolusing any insulin for it. Seems pretty simple but it worked fairly well.

So on Friday, I lowered by basal insulin as planned. My blood sugar started dropping around the 4th hole so I ate my Clif bar. By the 6th hole, Rose is vibrating to say that my blood sugar was climbing quickly. By the 7th hole, I was above 10.0 and by the 8th hole, I was over 12 and still climbing.

I bolused 2 units to stop the climb.

By the 9th hole, I had stopped climbing and by the 10th hole, I was beginning to drop.

The insulin I had just taken kicked in and, combined with the 2+ hours of walking, I started dropping...fast.

By the 13th hole I was below four, despite having eaten two packages of fruit chews.

The fruit chews finally kicked in and by the 15th hole I was climbing again. Rose alarmed - two arrows up. By 18, I'm over 10.0 again.

A bit of a roller-coaster ride that left me slightly nauseated and feeling sheepish for not trusting my system.

Sunday, I decided to have faith in the system that I developed last year.

I lowered my basal rate. At the 4th hole I ate my Clif bar. By the 7th hole I was climbing. I reached 12.0 by the 9th hole. Despite desperately wanting to, I refused to bolus.

By the 10th hole I was 11. By the 13th hole I was 10. I slowly drifted downward and, by the time we shook hands at the 18th hole, I was 8.5.

It worked!

Four hours of golf are much more pleasant when I'm walking up and down hills and valleys but my blood sugar is holding steady. One Clif bar and a bit of faith is all it takes.

En Route To Thunder Bay

It's May!

All those April showers, both the rain and the snow variety, are now supposed to translate into Mayflowers.

Or is that May flowers? 

It's all very unclear. 

Before we say goodbye to April, it's time to see how the month went in terms of physical activity and how much closer I am to my January goal of running, walking, swimming and cycling my way to Regina, Saskatchewan. 

Running

I ran exactly 100km in April. Not on purpose, it just worked out that way. I ran 10 times, some runs as short as 4k and some as long as 20. In total I ran for 11.5 hours. 

Swimming and Rowing

I swam only once in April for a total of 2000m (2k). It took me 40 minutes. It hurt so I stopped going. Until my elbow is better, I'm out of the pool again. No rowing machine at all because that was hurting even more than swimming was. 

Cycling

The fact that I have not been swimming (sigh) for a few weeks to let my elbow heal means that I've had plenty of opportunity for cycling workouts. In fact I managed to fit 9 of them into the month of April. One of them was even outside on real roads! 

I covered a total of 137km in 7 hours and 45 minutes. Doesn't seem like a lot considering I cycled 9 times but several of those workouts were Bending Crank Arms where I spent more time doing off the bike squats than I did increasing my mileage. 

Golf

I don't count every step I take every day but I do track how far I walk when I'm golfing. Golf season in back in full swing so I've managed 5 games (all 9 holes so far) and walked 19k in just over 9 hours. 

Total number of workouts = 25

Total time spent working out = 29 hours 

Total distance covered = 258km

By the end of March I had covered 547km and had made it to Sudbury Ontario and a bit beyond.

Add 258km to that and I am now 805km into my 2396km 'journey'.

Which brings me...to the middle of Northern Ontario.

Sault Ste Marie is 781km away so I've made it there and beyond. Thunder Bay is the next stop but it's over 1400km from my front door so that will be another few months I'm guessing.

So let's just say that I'm en route to Thunder Bay.