Met with my pod educator tonight to go over how I'm doing. My numbers have improved dramatically, and it looks like I'm evening out. She went through some more advanced things, like programming an extended bolus and temp basal, which eluded me (apparently some folks find that doing a 30%/70% bolus split for pizza does wonders. That is, you can program it to give you 30% of the amount you take to cover pizza up front and the other 70% over the next 3-4 hours as your sugar starts to *really* spike. God, could you imagine if I could figure out a way to eat pizza again without being sick?). So I'll be playing around with those.
She also gave me a few tips for keeping the pod on during exercise. Some people actually apply extra super glue between the pod and the adhesive (it's actually made to move a little bit with your body, but you can secure it tighter) or to stick it on just below my arm, towards my back and underneath my bra - so my sports bra would, effectively, also serve as my pod bra. Ha.
I've dated some guys who are pretty squeamish and easily weirded out, so I was concerned, at first, about having the pod on my stomach. When I realized you could wear it on the back of your arm, well, hell, there goes the last squeamish thing I had about the pod. Stuck to the back of your arm, it's less likely to get in the way, and less likely to make a partner squeamish or weirded out.
Also, she showed me how the backlight works! Oh, man, you have no idea how fucking sweet this is. All these nighttime sugar checks are a bitch with no backlight. I have to use my cell phone. Back in the day, I'd have to turn on my book light or a bedside light, which isn't bad when you're sleeping alone, but I do hate it when I have a partner and have to bug them.
She cautioned me about my tight target. My target is set at 85-95, and damned it all if the damn thing doesn't fucking keep me there. Today's numbers:
5:33 am: 98
12:13 pm: 81
3:00 pm: 121 (post-lunch correction, look, I'm getting better!)
7:48 pm: 80
With a tight target, though, you do have a better chance of going low, so I need to be aware of it. You're also at risk for developing hypoglycemia unawareness, which I need to watch out for (hasn't been a problem yet, but some people have it right off the bat). I *have* noticed that I feel low more often now when I'm not low at all. I tested twice with this meter and again with my old meter a couple of times when I could have sworn I was low, but was at a respectable 90-something. So it'll be interesting to see how that pans out. I assume that as my body gets used to being constantly at 80-100, that'll happen less often.
I want an A1c under 6. I just do. Under 6 is normal. Under 7 is "target" for a diabetic. But I don't want to be a diabetic. I want to be as normal as possible while living abnormally.
I was dancing around in the hallway today at work for no reason, and realized how great I've been feeling. I can't just bottle this stuff up. I have to work hard for it, everyday, and you know...? It's worth it.
So. Fucking. Worth it.
Wednesday, July 30, 2008
All I Want for Christmas
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Be very careful.
The problem with tight blood glucose control is that the place where glucose is actually important isn't in the blood, but in the extravascular space next to the cells that are taking up that glucose.
The extravascular fluid flows a lot slower than blood, and the glucose and insulin levels in it are lower because the intervening cells take it up.
How you "feel" depends on which extravascular space has how much and what the glucose sensing nerves in those spaces are telling you.
How you "feel" is likely more important than what the "number" you measure is.
Maybe what you need is a custom bra with a third cup to hold the pod ;)
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