My path to healthier habits is slow, but steady. My examples of progress may not look like much to you, but to me, I’m moving mountains.
Actually keeping to that “apple a day” mantra means I’m having at least one fruit serving a day, and I’m eating more than oranges. Again, this might not seem like a lot to you, but it’s a big deal for me.
Not entirely featured among this carefully constructed array of test strips that were delivered today are my Lisinopril and Synthroid pills which I have been neglecting for…longer than I care to admit. But the only way to establish healthy, or healthier habits is to start somewhere. (Even if it’s starting over.)
Also not featured are my cats. Being the weekend, I should remedy that one.
Last week I had the privilege of attending Dr. Larry Chu’s (of Medicine X) Engage and Empower Me course, serving as the moderator of the Tweetchat portion of the class. The topic was the “Neuroscience of Engagement”, featuring guest lecturer David Eagleman. I encourage you to watch the entire presentation if you have time, but I want to focus on the specific action items David mentions when talking about ways to improve our own engagement with our health.
- Minimize Temptation
- Risk Money
- Recruit Social Pressure
- Leverage Emotion
- Establish Habits
Proper diabetes management unfortunately has the potential to frequently brush up against diabetes burnout if I’m not careful. The harder I try to keep things “normal”, the more frustrated I become when I don’t see results. That frustration leads to more aggressive efforts to control my diabetes, which in turn leads to less control and more frustration. Eventually I have to take a step back and refocus my efforts, but not without taking a “break” from my typical on-the-nose diabetes care that I need to implement on a regular basis if I want to be as healthy as possible.
David’s presentation discusses some ways to help with taking control of our health and, in my case, ways to minimize the potential for diabetes burnout. These tips start around the 30 minute mark of the video above, if you’re curious. Of course this is all easier said than done, but the core concepts are enough to get me thinking about better ways to approach my own diabetes management.
This has been happening way too often.
I’m not sure if it’s tunnel vision to my move, looking forward to the holiday break, or a general apathy toward my diabetes, but my self care has taken a tumble lately. For whatever reason, I am forgetting my mealtime bolus on a regular basis.
Actually, “forgetting” isn’t the right word for what this is. I simply don’t make time for it. I’m viewing eating as a roadblock on my path to whatever it is I need to do next rather than an opportunity to relax and enjoy a (potentially) good meal. Instead I test my blood sugar, think about the proper insulin dosage, eat, and then carry on with whatever I was doing.
Only after my Dexcom high alarm goes off…a second time after I’ve ignored the initial buzzing do I take my Humalog. Of course by now my meal has had a significant head start in the race to elevated blood sugar levels, so I have to take a larger-than-normal amount of insulin to try to get back to target numbers. The increased bolus means I’m likely to go low in the coming hours after my plateau, likely resulting in an overcorrection from the other side of things, sending me back above 250 mg/dL.
This has been my routine for at least a month now.
I shared this picture with the caption saying “Everyone can have a bad day, even Medicine X ePatient Scholars”.
I don’t necessarily think there is or was a mystique or aura about being one of the featured ePatients at Medicine X, I just think we all go lucky among a plethora of applicants. Even so, I don’t want anyone thinking I’m a “perfect patient” or something like that.
I have bad days. I have good days. And I have really bad days.
I dreamt of a world where I went to the gym every morning during the week, targeting different muscle groups for a well-rounded approach to physical fitness. Every evening I spent an episode of Breaking Bad on the elliptical machine or searching for zen with a yoga session. In this world, I kept better track of my physical activity and ate responsibly.
I checked my blood glucose at least 6 times a day. I took my insulin Lantus at 11pm and 11am every day. I took my Humalog at least 15 minutes before eating. I took my Synthroid and Lisinopril every day.
I dreamt of a world where I was in complete control.
Then I woke up and realized that world doesn’t exist.
But I can try to make that dream a reality.
You can see when my Lantus kicked in. And when I finally corrected for those pesky low alarms
Sometimes you do everything like normal, and diabetes responds in kind. I wish those days happened more frequently.
I will say up front that this story has a happy ending. I received my re-up of test strips, insulin pen needles, and insulin when I got home from work and immediately tested my blood glucose after relying on my Dexcom, and only my Dexcom for the entire day. For what it’s worth, my Dexcom was only 3 mg/dL off from my meter when I tested it after a day flying blind.
My concerns are still the same with all of this. My Dexcom is only as accurate as my meter is only as accurate is the technology is capable of calculating. Hardcore diabetes advocates know the FDA’s mandated accuracy for meters is nothing close to acceptable for the people that are directly impacted by these liberal data ranges. The result is a flimsy, but necessary, measure of trust that this technology will live up to the standards and can withstand the tremendous burden placed upon its metaphorical shoulders: keeping me alive.
Count the corrections
Clearly, I’m doing something wrong.
Relying on 1. my Dexcom receiver to accurately monitor my blood glucose, 2. my ability to acknowledge low alarms when they happen, and C. my ability to properly treat lows if they occur is a dangerous combination.