Fail
I had a rather neutral-toned post scheduled for today. To be perfectly honest, I have like 5 blog posts drafted up that you’ll see in the coming week or so. Just a little editing and formatting before it is published promptly at 9:30am. I had a post like that ready to go, but I’m emphasizing past tense for a reason. I hate Diabetes.
I’m still trying to adjust to my reduced Lantus dosage at night. 17 units is significantly less harsh on my overnight habits. In theory, my numbers before I go to sleep do not have to be nearly as high and I should still be able to achieve a nice fasting blood glucose when I wake up. Now I know that a week is hardly the perfect sample size to judge if 17 is the new 21 and I still need to talk to Not House about it after this pen has run its course, but I can already make a few conclusions based on the week of charted numbers.
A. I eat too much for dinner. My pre-dinner and post-dinner numbers are dramatically different. Being higher than my post-meal target is one thing, but the differences I’m seeing are embarrassing.
2. I suck at managing my blood glucose. Somewhere along the way my ability to evaluate serving sizes disappeared. I don’t overeat at every meal, but a few extra chips here, a few extra ounces of milk there. It’s adding up.
III. I still believe in my insulin pens and my ability to keep all of this under control with the tools I have, but it seems that the daily goal of 4-4-6 is not working any more.
I recall my last appointment with Not House, in response to my question about my Lantus dosage he said something to the effect of “I thought we taught you that it’s ok to adjust your insulin as you see fit.”
You know what? YOU DIDN’T.
I have been operating under the ‘insulin first-food second’ thinking process pretty much since diagnosis. Maybe that’s because I was never on a pump, so pressing a button to accommodate that extra slice of pizza was never an option for me. Maybe I zoned out when someone said it’s ok to take a little extra insulin if you are going to eat a little more. But that isn’t how I was “taught”. Every appointment the nurse asks me if I’m on the “sliding scale” for my Humalog and I reply 4-4-6. It irks me that 1. they never look at my chart to see what I previously told them and b. they assume sliding scale. As if they are taunting me, and then nobody even bothers to suggest it in the 10 minutes I have with them.
There is a serious disconnect with all of this. And I don’t know what I’m going to do. But I need to accept that living within this absurdly rigid management scheme is not working. And trying to admit that to myself is not cool.
Fun Fact: I actually contemplated disabling comments on this post because I know what you all are going to say. I love you guys, but I’m not sure if I can handle the head shaking that I know you are doing as you read this. I know that “Your Diabetes May Vary” but I look around and all I see is everyone else in control, or at least more control than me and I hate that I can’t keep up. This isn’t a competition but I feel like I’m failing. Failing you. Certainly failing me.
The best/worst part is that in the grand scheme of things, I know I’m not doing a bad job with all of this. I think I’m fit, my A1c continues to drop with each successive appointment with my Doctor since my awakening at the beginning of the year and I think I’m in a good place in my life. Despite that, Diabetes can break me down so efficiently in the span of a few days and bring me to this.
I need to figure this out. And I will. But right now I don’t have the mental fortitude to deal with this crap.
Stop Diabetes
To my non-Diabetic readers: This is what Diabetes is capable of on a daily basis. This is why so many of us are fighting for awareness among the mainstream public. It’s not nearly as simple as checking your blood, watching what you eat and taking your insulin shots despite what the uninformed might believe. This is why we are spamming twitter with Stop Diabetes, World Diabetes Day, #bgnow, #bgwed, #iblamediabetes and whatever else we can fit into 140 characters.
You might be aware of the impact of Diabetes for this month, maybe only on November 14, maybe only for the duration of this post; But WE are more than aware. WE are fighting it. WE are living it. And hopefully, WE are beating it. Each and every day.
World Diabetes Day
Maybe you should join us.
We are fighters, for sure. You’re Not a failure. It’s a trial and error process. You Will figure out what works best for you. (bear)
Yes, my diabetes is in (arguably) better control — but I have Type 2, so that’s like comparing apples and volleyballs. But the evening eating thing is getting to me, too, and it’s affecting all of my readings. And unlike T1s on a pump, I do not have an option if I overeat: I will run high — now, or later, or both.
I wish I had an answer to dinner other than, it’s the “family” meal (ok, mine is just me and the BF, but…), it’s not always what we would choose in absence of other people’s preferences, and it’s the whole relaxing and munching thing. All of which are IMO excuses rather than answers, and something to flog myself about.
Well, I can tell you I suck royally at keeping my BG in control. I CONSTANTLY look around the OC and feel like a D-failure. You are not alone.
When I finally found a doc that wanted me to be in charge (which no doctor my entire d-life told me) things have gotten better. At least I can try new things but before I just took insulin like a pill and corrected at the next dosage.
You’ll find what works man, I believe that, just like I believe you are not a failure.
I use a pump and CGM, fiddle with my insulin dosage all the time based on activity, extra food, upcoming (lack of) exercise, whatever. My post meal numbers still suck. A lot of time the pre meal ones do too. I doubt I will ever find a magic combination that works for more that a day or two. It’s not “in control”. It’s not “predictable”. It’s diabetes, and it sucks.
I’d be happy to trade my numbers this week for your numbers, as I’m positive yours are much better.
I’m logging so I’ll have numbers for my pump start in three weeks, worst averages ever!
Maybe it’s the weather…???
Excellent post. But remember, we all suck at managing our blood sugars. Eventually you’ll be comfortable with adjusting insulin as you see fit, with deciding on the meal first and doing the math for the insulin later. It’s a learned habit. I suggest you explore it more with Not House and maybe a diabetes educator – using a sliding scale is the most freeing thing (although I blame it for my significant weight gain!). Maybe it was easier for me because the point where I was “given” control of my diabetes by my parents was the point I switched to MDI and a sliding scale, so it was the first thing I really had control of on my own.
Hang in there, buddy. You know you have hundreds of people reading your tweets and blogs who know exactly what you’re going through and are here to support you.
Sarah
Please, please, please don’t feel like a failure. You’re alive and thriving and you have a very cool blog! But I know exactly how you feel. I feel like I’ve failed at this for 32 years … I’m just starting to make peace with myself. If you want to talk to someone who is embarrassed by her numbers and would never dream of posting her a1c, just let me know. I’m all ears and I can definitely relate. Hang in there.
I totally cracked up at the fun fact, “I’m not sure if I can handle the head shaking that I know you are doing as you read this” part. It was like you were talking to me. Simultaneously hilarious and eerie. I was happy to read that you’re considering something a little less rigid though. It’s a process. It’s always a process. No matter how long you’ve been doing it.