Sunday, July 20, 2014

Burning Out

I don't know when it happened.  I think it was a process of one thing adding on top of another until, all of sudden, I feel buried by everything living with diabetes requires.  It is kind of strange, really.  My overall mood and general outlook has been improving thanks to the help of some medication adjustments.  Mentally I have been feeling better than I have anytime in recent memory.  But on the diabetes front things are going slightly awry.  Looking back I think the beginning was using the last Dexcom sensor from my stockpile accumulated after my deductible was met last year along with the realization that I would not be able to afford to buy more for a while.  Although the alarms could be annoying, the data could be overwhelming, and I would often make myself feel guilty whenever the graph ran into the red, the ability to see where my blood sugar was at a moments notice and react accordingly as well as not having to rely on my horrible memory to get blood sugar readings was invaluable.  A short break from the CGM is always welcome, but long term it leads to me being in the dark about the overall effectiveness of my diabetes management.  I first noticed that things had begun to slip around the 4th of July when we tool a small trip to the town where I grew up to see some family and friends.  Throughout the trip I found myself forgetting to bring my insulin places with me.  In the past I would either return to get it or eat something I knew wouldn't effect my blood sugars too much.  On this trip I usually just brushed it off and even usually forgot to check my blood sugar and take a correction bolus when I got home.  That started me thinking and last Thursday, my third diaversary, I took some time to really think about how I'm doing and evaluate where I am at with my management.  What I ultimately decided was that I have let things slide considerably.  It started with not checking my blood sugars post meal.  That has always been a struggle.  I get busy or I just plain forget.  That, in turn, led to not checking my blood sugar before meals and then to forgetting to check my blood sugars in the morning.  I realized that there have been stretches where I have gone 3 days without a single blood sugar check.  (This post from Kerri Sparling was unbelievably timely.)  In addition, I have found myself just using wild guesses for boluses instead of actually counting carbs.  This can be a dangerous thing, especially given that I usually don't feel my lows until it is at a scary level (like in the 30's).  But the thing I am most disappointed in myself over is putting off my insulin doses.  I am pretty vigilant about my basal injections.  If I forget it at bedtime I always get it the next morning.  However, I have been pretty hit and miss on my bolus injections.  Some of this is from having lots of little snacks here and there and not thinking about taking insulin for it.  Some is because I get pulled away right before I eat or often in the middle of my meal, or both while I'm at work.  And sometimes it is just silly things like not wanting to lift up my shirt and have to tuck it back in at work or just plain not wanting to deal with a painful injection, and those have been more frequent as of late.  I have a common thought when I check and find a high blood sugar; do I want to subject myself to the pain of another injection or wait until I eat again?  More often than not the answer is to wait.

Step one is admitting you have a problem.  I admit it, I'm burned out.  So now I need to find a solution.  I have tried using BG tracking apps, setting alarms, making promises to myself, and none of it has worked.  So my new goal is to find a way to get back on the CGM and eventually a pump.  The first step in that process?  Finally get in to see and Endo.  From there, who knows, but at least I am acknowledging the problem and starting on the path to a solution.  One step at a time.

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