Saturday, December 27, 2014
Funk
Tuesday marked my most recent endo appointment (only the second with an endo, ever, as I was seeing PC doctors previously). All in all it was a great appointment. I am happy with the care I am receiving from the doctor thus far and the office great. The staff is friendly and calls with reminders of my upcoming appointments and reminders to get labs done the week before. Dr. Ennis listens to any questions I have, gives me an opportunity to say what I need to say, and always follows up on things we had talked about at previous appointments. My blood pressure was a little elevated but not enough to cause any alarm just yet. We followed up on my questions about pumping from the last appointment but it is on the back burner for a while because my insurance just plain sucks when it comes to anything more than the standard care stuff (which also sucks at, but a little bit less). I did ask to switch my scripts from pens to vials because it is a little cheaper if less convenient (a refer to previous sentence re: insurance). In the end we decided to stay the course I'm on but try to test a little more often since I'm not able to CGM until I can get a new transmitter. All of my labs came back looking good and my A1c stayed level at 6.6, down .1 from 3 months ago. That's the part that surprised me the most because of this funk that seem to be and just can't pull myself out of. Emotionally I'm feeling much better but I still can't seem to get a grip on the everyday stuff. I need to test more often. There are times when I know that I'm high and I know why. I know that I should test and treat but I don't. I'll grab a snack or have lunch, consciously think about how many carbs are in it, how much insulin is needed to cover, and that's where it stops. A couple more very easy steps is all that's needed from there. Test, pull out my pen, put on a needle if needed and inject. So simple in theory, yet so hard to bring myself to do it. Sometimes it's just not convenient. I'm at work, wearing a long sleeve shirt that is tucked in and getting to an injection site is a bit of a pain. Hardly a legit excuse but it still gets used. Other times I just can't take another injection. Usually after one or two particularly painful injections previously. I've been doing this for almost 3 years and the needles and injections still get to me sometimes. It's such a mental game that never ends. It seems like it should be so simple to just pull out that pen and inject, and at times it is, but all too often there is this mental block. I go through the whole routine and there is something there that keeps me from finishing the process. I think it starts with baby steps. Getting back into the habit of testing at least 4 times a day. Getting back to having a routine until counting carbs, dialing a dose, and injecting is one seamless motion again. Hopefully while I'm on vacation next month and into the new house I can take some time to address the things that need addressing. Or maybe I'm not missing things as much as I think I am? A 6.6 A1c is good with me but I suspect the funk just wasn't going on long enough beforehand to have a big effect, and then there are those nagging lows that tend to throw off the average. Anyone have any pointers on how to defunkify? On the bright side someone was reading my mind and got me this for Christmas.
Wednesday, December 17, 2014
A near miss
People living with Type 1 diabetes take their lives into their own hands on a daily basis. We are armed with a very powerful tool in managing our disease, and a small misstep can have disastrous consequences. I hear and read a lot about how dangerous insulin can be and how small mistakes can lead to big problems but I never really understood it. I knew that it was definitely possible to take too much insulin and end up in a really scary situation. And I know that low blood sugars are also very dangerous. I've blood sugars register as low as 32 on my meter and felt low symptoms (unfortunately I usually don't feel those symptoms until I'm into the 40's), but I have never felt as though my life was in danger. And then yesterday I made a very stupid mistake. I missed my Lantus dose on Monday night and kept forgetting in Tuesday morning as well. I dropped my daughter off at day care and came back home to get ready for work. I was getting ready and remembered again that I still had not taken my Lantus dose so I went to the kitchen to take it. I keep my Lantus pen next to the coffee maker and usually my Humalog stays in my case that I take with me. I was pre-occupied and grabbed the only pen that was sitting there, dialed up my usual 26 unit dose and injected it. It wasn't until realized that I didn't hear the usual clicking sound my Lantus pen makes when you depress the plunger that I had made a mistake. Yep, I had taken 26 units of Humalog. I stood there for a minute while the potential implications of what I had just done began to sink in. Then I realized that I needed to do something about it before things got really bad. I was home alone, supposed to be at work before too long but no one would take much notice or call if I wasn't there right on time, and no one was expecting me anywhere in particular during that day. No one would be at my house for about 6 more hours. I texted the Pretty Lady in My Life to let her know what was going. She freaked out a little, but at least someone knew that if I didn't respond they needed to send help. Then I checked my blood sugar. I was already high because I forgot to bolus for breakfast so I at least wouldn't have to cover the entire 26 units, only about 18. With some quick math I figured out that I needed to take in about 216 carbs, as fast acting carbs as I could get. I scoured the house, found orange juice in the fridge and poured what was left into a glass. The I looked all over the place to see what was available. I considered glucose tabs but thats a lot of glucose tabs and the thought of chewing and swallowing 50 plus tabs made me feel sick. I settled on Fruit Loops and measured out what I figured to be the amount that I would need to cover the remainder of the insulin. I chugged my orange juice and checked my blood sugar, 42, and started eating my cereal, sans milk. I checked in with my wife and checked my blood sugar every 15 minutes or so to let her know I was still alive. I saw my numbers start to climb back into a safe range. 50, then 56, then 74, and eventually back up to 108 about an hour later. I ended up at 67 around 3:30 before my bloodwork for next weeks endo appointment, so I made sure to keep eating and periodically checking my blood sugar the rest of the day.
In the end everything turned out OK, but the whole experience scared the shit out of me and has reminded me just how easy it is to make small mistakes that can have huge repercussions. And very dangerous ones at that. As people living with diabetes so much of our care is left in our own hands. I'm fortunate to have had good doctors in my short time with diabetes. I received good direction and on how to use insulin properly and through my own research and the help of others know how dangerous insulin can be. But I know through my interactions with other PWD that not everyone is as fortunate. I found out yesterday that even with good training and the knowledge of what to do and what not to do, it's easy to make mistakes. And with a drug like insulin mistakes can be costly. That is why we need a cure. Because insulin is a stop gap measure that keeps us alive, but there are too many doctors out there who just throw a vial of insulin at a patient and send them on there way. There are too many PWD who don't know what insulin on board is, what their insulin to carb ratio should be, or how dangerous it is to be off on your dosage. We need a cure because the thing that we need to keep us alive can too easily be the thing that kills us.
In the end everything turned out OK, but the whole experience scared the shit out of me and has reminded me just how easy it is to make small mistakes that can have huge repercussions. And very dangerous ones at that. As people living with diabetes so much of our care is left in our own hands. I'm fortunate to have had good doctors in my short time with diabetes. I received good direction and on how to use insulin properly and through my own research and the help of others know how dangerous insulin can be. But I know through my interactions with other PWD that not everyone is as fortunate. I found out yesterday that even with good training and the knowledge of what to do and what not to do, it's easy to make mistakes. And with a drug like insulin mistakes can be costly. That is why we need a cure. Because insulin is a stop gap measure that keeps us alive, but there are too many doctors out there who just throw a vial of insulin at a patient and send them on there way. There are too many PWD who don't know what insulin on board is, what their insulin to carb ratio should be, or how dangerous it is to be off on your dosage. We need a cure because the thing that we need to keep us alive can too easily be the thing that kills us.
Monday, December 8, 2014
Frustration abounds
My last post and this one are less about diabetes and more about our hectic life right now, because with everything else going on diabetes has kind of been pushed to the back of my mind lately (which I'm sure will be evident on my A1c in a few weeks). I'm going to preface this post by saying that I don't necessarily believe in fate, things being meant or not meant to be, the universe choosing a path for you, or anything along those lines. Things happen because they happen not because some being willed them to be that way or because they are part of a universal plan. At least as far as I am concerned.
As I mentioned briefly before, I am in the the process of getting a new home. Something that has been much wanted for a couple of years but just not doable financially. Our current house is just over 1000 square feet and with the 4 of us taking up more space everyday it is getting tight. And if someone comes to visit, it gets to the point of insanity. Especially for a person like me with an introverted personality who like to be able to escape for some alone time now and then. The Pretty Lady in My Life takes amazing pictures for a living. As a part of that the company she works for also does business shoots and fingerprinting. She meets a lot of people from the banking and lending world. A few months ago she met a lender who works with a company that we recieve periodic updates from about houses for sale. After talking to him she decided to, on a bit of a whim, see if by any chance we would be able to either sell our house or qualify for a second loan and rent our current house. We got burned a while back looking into something simile when someone assured us we could sell our house and get into a new one only to fall in love with a few houses and find out we had been lied too. Because of this my wife did a lot of research before we even considered the possibility, despite what the lender said. In the end, the lender assured we were in the clear. Our house was barely at a point where we could pay it off with a full price offer at max value and there would still be all the fees associated with that so we decided to rent for a year and re-evaluate. We started to look around and settled on having a house built because it was as cheap as buying an existing home and we would get to make it exactly what we wanted. We crunched a lot of numbers, did a lot of research, and put in a lot of time to make sure we were getting what we wanted but not getting in over our heads. At long last we had picked what we wanted, settled on a location, and went to sign the papers.
With a contract signed, everything we wanted selected, and a floor plan finalized we were excited to see our new home start to go up. We wouldn't actually own it until it was completed and we signed all the closing papers, but, it was finally happening! We were going to get out of the house we had grown to despise and into a new home we were in love with. Our new house is very close to our current one so throughout the process we are able to drive by and pop in to look at the progress. And we do...a lot. The construction crew probably thinks we are stalking them. To say we were excited is an understatement. We had so much invested in this house. So much time researching and reviewing options, ensuring we were good to go. So much emotional investment. In our minds we were already living there. And then disaster struck. On our current home we received down payment assistance from Idaho Housing. On the new house we were told that we would be able to be gifted the funds for down payment, it wouldn't be a problem. Somehow, this wonderful man who had ensured us everything was good to go, had overlooked that our loan was an Idaho Housing loan, even though it is our biggest debt, appears clearly on our credit report, and he deals extensively with the program. Remember that part about my wife being all about researching our options and making sure we really could do this? It was definitely mentioned to the lender that we had that loan. And now, because of that, we wouldn't be able to do our second loan that way. And the lender is really really sorry for the oversight. I'm sure he is. Long story short we looked through option after option to see how we could get this house. We would find one option and think we could make it work, then find out a reason it wouldn't. Can you say emotional roller coaster? In the end it was looking like our only option would be to find some way to come up with $10,000 in reserves and down payment on top of closing costs. Things were looking grim. In a last ditch attempt we had set up a meeting with another lender. She thought she had a solution. We could get an FHA loan and the only question would be how much the reserves would need to be. We were not hopeful but after running our credit we found that we would only need 1 months reserves on both properties, or about $4,000 with the down payment. We could do that! The roller coaster goes back up! I can not explain our excitement. I wish that it had lasted.
We had barely left the office when the lender called us to tell that she thought she could qualify us for two FHA loans but now she can't. And the coaster drops again. The most frustrating part is that my wife had asked that very question when we met with her. Then we learned that my 401k could count as those reserves and I had more than I thought. We were saved! Until I learned that my an does not include an option to borrow against it so it couldn't be counted. Our last option was to try to sell our house fast. That meant getting it into top selling condition, and getting it sold at max value in under 2 months. Not likely. We were dejected. I dreamt at night about living in that house. The thought of all that space to not be living in top of one another was like a dream come true. And to have that all ripped away was like having a delicious meal put in front of you and then told that you can't have any of it. At night I slept fitfully. The few weeks prior had been filled with so many ups and downs, and we were all emotionally spent.
And now some good news. Some amazing relatives have come through and offered to gift the money for the reserves and down payment. So, fingers crossed, we are hoping to be moving into our new home the middle of next month. I am trying to temper my expectations because I can not handle another let down. But as we walked through the nearly completed house today it is so hard not to be excited and be living there in my mind. I can already picture our bed against this wall, our kids things here and there, a tv in that wall. I can see us preparing and eating dinner in our new kitchen. I watched my kids chase each other around and plan out their new rooms. I just hope I'm not setting myself up for another disappointment.
As I mentioned briefly before, I am in the the process of getting a new home. Something that has been much wanted for a couple of years but just not doable financially. Our current house is just over 1000 square feet and with the 4 of us taking up more space everyday it is getting tight. And if someone comes to visit, it gets to the point of insanity. Especially for a person like me with an introverted personality who like to be able to escape for some alone time now and then. The Pretty Lady in My Life takes amazing pictures for a living. As a part of that the company she works for also does business shoots and fingerprinting. She meets a lot of people from the banking and lending world. A few months ago she met a lender who works with a company that we recieve periodic updates from about houses for sale. After talking to him she decided to, on a bit of a whim, see if by any chance we would be able to either sell our house or qualify for a second loan and rent our current house. We got burned a while back looking into something simile when someone assured us we could sell our house and get into a new one only to fall in love with a few houses and find out we had been lied too. Because of this my wife did a lot of research before we even considered the possibility, despite what the lender said. In the end, the lender assured we were in the clear. Our house was barely at a point where we could pay it off with a full price offer at max value and there would still be all the fees associated with that so we decided to rent for a year and re-evaluate. We started to look around and settled on having a house built because it was as cheap as buying an existing home and we would get to make it exactly what we wanted. We crunched a lot of numbers, did a lot of research, and put in a lot of time to make sure we were getting what we wanted but not getting in over our heads. At long last we had picked what we wanted, settled on a location, and went to sign the papers.
With a contract signed, everything we wanted selected, and a floor plan finalized we were excited to see our new home start to go up. We wouldn't actually own it until it was completed and we signed all the closing papers, but, it was finally happening! We were going to get out of the house we had grown to despise and into a new home we were in love with. Our new house is very close to our current one so throughout the process we are able to drive by and pop in to look at the progress. And we do...a lot. The construction crew probably thinks we are stalking them. To say we were excited is an understatement. We had so much invested in this house. So much time researching and reviewing options, ensuring we were good to go. So much emotional investment. In our minds we were already living there. And then disaster struck. On our current home we received down payment assistance from Idaho Housing. On the new house we were told that we would be able to be gifted the funds for down payment, it wouldn't be a problem. Somehow, this wonderful man who had ensured us everything was good to go, had overlooked that our loan was an Idaho Housing loan, even though it is our biggest debt, appears clearly on our credit report, and he deals extensively with the program. Remember that part about my wife being all about researching our options and making sure we really could do this? It was definitely mentioned to the lender that we had that loan. And now, because of that, we wouldn't be able to do our second loan that way. And the lender is really really sorry for the oversight. I'm sure he is. Long story short we looked through option after option to see how we could get this house. We would find one option and think we could make it work, then find out a reason it wouldn't. Can you say emotional roller coaster? In the end it was looking like our only option would be to find some way to come up with $10,000 in reserves and down payment on top of closing costs. Things were looking grim. In a last ditch attempt we had set up a meeting with another lender. She thought she had a solution. We could get an FHA loan and the only question would be how much the reserves would need to be. We were not hopeful but after running our credit we found that we would only need 1 months reserves on both properties, or about $4,000 with the down payment. We could do that! The roller coaster goes back up! I can not explain our excitement. I wish that it had lasted.
We had barely left the office when the lender called us to tell that she thought she could qualify us for two FHA loans but now she can't. And the coaster drops again. The most frustrating part is that my wife had asked that very question when we met with her. Then we learned that my 401k could count as those reserves and I had more than I thought. We were saved! Until I learned that my an does not include an option to borrow against it so it couldn't be counted. Our last option was to try to sell our house fast. That meant getting it into top selling condition, and getting it sold at max value in under 2 months. Not likely. We were dejected. I dreamt at night about living in that house. The thought of all that space to not be living in top of one another was like a dream come true. And to have that all ripped away was like having a delicious meal put in front of you and then told that you can't have any of it. At night I slept fitfully. The few weeks prior had been filled with so many ups and downs, and we were all emotionally spent.
And now some good news. Some amazing relatives have come through and offered to gift the money for the reserves and down payment. So, fingers crossed, we are hoping to be moving into our new home the middle of next month. I am trying to temper my expectations because I can not handle another let down. But as we walked through the nearly completed house today it is so hard not to be excited and be living there in my mind. I can already picture our bed against this wall, our kids things here and there, a tv in that wall. I can see us preparing and eating dinner in our new kitchen. I watched my kids chase each other around and plan out their new rooms. I just hope I'm not setting myself up for another disappointment.
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