Bad Habits
I’m closing in on my appointment with Not House in a couple of weeks and I’m not looking forward to it. Not because trying to get information out of him rivals pulling teeth or trying to get a child to finish his (or her) vegetables. Not because there is no convenient appointment time considering the commute required to get to his office and back to my job. No, I’m not looking forward to this one because I think that since my last meeting with him I fear that I’ve done more harm than good in my overall management.
I understand that it’s a bit silly to think that I needed permission to take greater control of my Diabetes. My bad. Since then, I think that parts of my management have been on vacation. I’m not necessarily snacking more, or eating more each meal but the control I saw before my meeting is not here now. I’m using at least the same amount of insulin for meals I ate before my meeting, but now even with higher insulin dosages I’m still seeing higher numbers hours after my food has settled.
Part of me misses the higher dose of Lantus because I had a better idea of what was going to happen. Now, 15 units feels like a roll of the dice. Some days it is perfect, other days I wake up at 160 or above 200. I know that looking at a specific window in the timeline of my blood glucose isn’t fair because the rest of the day still factors into a reading at midnight, at 2am and at 8am. I don’t get a do-over when I wake up in the morning. Diabetes doesn’t reset. The problem is that while I’m busy trying to figure out the Lantus portion of my management, the rest of the day is slipping. My unofficial 14 day average according to my meter hasn’t gone up compared to the numbers I recorded over the past 2 months, but I know I have been chasing more highs in January and February compared to the end of 2009.
Every time I have to use a needle to correct a high I feel like I’m wasting resources. I’ve always considered my insulin pen needles to be part of my mealtime ritual. I know their purpose is to deliver insulin when I need it, but I am still fixated on trying to get the insulin/carb balancing act right that I lose sight of how this is supposed to work. (Or at least how I think it’s supposed to work). Highs happen, lows happen – treat accordingly. I know this is how I should be thinking but it’s not my thought process when it matters, when I have to determine the course of action after Bart Allen returns with a 268. Every time I “waste” a needle correcting a high I reconsider switching to a pump. Every click of the pen that dials up another unit of insulin is another second thinking that this would be a lot easier if I just had to press a few buttons instead of going through this process.
I’m really trying to improve my management. I know my language needs to be less extreme when I sit down and interpret something that went right, or wrong. I know that this is a marathon, not a sprint. I know that being more proactive about all of this is ultimately a good thing. But I look at the data available and the results I can immediately interpret and I don’t see progress. I don’t see a falling A1c. I don’t see control.
Maybe all of my effort will be reflected in my next endocrinologist appointment. Maybe I am taking all the right steps. Maybe there is progress beneath the surface. I still wonder what this appointment would be like if I tried to tough out the last 2 months “the old way”. It’s extreme, and dangerous, but I look at those numbers and I see control. I don’t know what it is going to take to break me of these bad habits – both mental and physical. I don’t know which bad habits need to be broken first. If my mind is convinced that I’m doing the right thing then how can I change my behaviors?
This isn’t easy.
Chris: I hear you, I’m prepping for my Endo Appt on March 3, and am going in next week for the lab work… Hope to see a drop from last fall’s number, but am worried. The bad habits are so incredibly tough to break away from. It’s the eternal struggle: Do we stay Higher with stability and no immediate Lows, risking Uncertain Future Complications? Or push for tighter control, where we might risk those Lows and dangerous situations and still not do anything to prevent those possible Future Complications? All we can do is trust that we’re doing what we can, with what we’re given. I take some solace in that. Of course, the D-OC venting space help incredibly, as well. Good luck, bro!
1. When you change your lantus dose and it’ll affect more than the overnights, so you may very well end up chasing daytime highs. Tricky to change one type of insulin and not see it have an impact on dosages/ratios of the other. This isn’t your fault.
2. A pump wouldn’t necessarily stop you from having highs or lows, but yes – it’s the ease of pushing a few buttons, the pump doing the math for you, etc. that can be appealing. You should consider coming to the pumpers (& those interested in pumping) dinner tonight with the CDEs from GW Univ. hospital.
3. It’s going to get worse before it gets better. Change is rocky and rough, but you decided it was necessary (not going to sleep at over 200 – good decision to change in my opinion), so the hardest part about trying new levels, doses, etc. may be building up your own patience. You’ll get there. Just go easy on yourself.
Even pumpers have the same problem. Not that long ago, I lowered my basals to get rid of some nasty lows, and as a result, I had to up my mealtime boluses. Part of what was happening is that I had been using my basal to “cover” my food. Finding the right mix of basal and bolus is hard and takes a lot of trial and error. Here’s hoping you can get some things figured out!
All we can do is try.
And try you Are doing. You are aware of what is going on, what you are doing or not doing.
Have to start somewhere.
Now…..stop being so hard on yourself. Sheesh.
Right there with you man. I have been struggling with management and labs from last week showed it (A1C – 14, Cholesterol 459). One day at a time.
“This isn’t easy.”
NO DOUBT!!!!!
Don’t beat yourself up man. This disease sucks.
I was just diagnosed with reactive hypoglycemia, I had red flags for quite some time that I ignored. My son who will be 16 soon also has this. It’s harder on him I think cause he doesn’t eat much since he had to cut carbs and sugars which means the foods he liked to eat. He doesn’t do meats or vegetables, he gets tired of eating eggs and doing protein drinks to help keep his levels up. The feeling you get when you know you’re levels are low and you gotta eat something right away or you feel like your gonna pass out is at times unbearable for me. I just hate that feeling, like you, it’s hard at times to control things. My son and I check our levels: when they are high, we do what we can to bring them down. Then when we are low, do what we can to bring them back up. It’s a back and forth kind of thing that does get hard to manage. I commend you so much for blogging and telling us what you’re going through. I think you’re brave and strong for doing so. Don’t ever think it’s for nothing, because teenagers like my son need to hear it from someone they can relate to. It helps. Hang in there. You’re strong I can tell. Thxs for sharing your life with this.