Consistent Incompetence

Some people, seriously.

One for the Road

Omnipodding Week 3

Is this week three? The beginning of week 3, in any case.

Things have largely settled down and evened out. I'm still trying to figure out the boluses for meals. I used to calculate these entirely differently; the onboard calculator they have seems to usually work so long as you have an accurate carb count. I'm used to dosing certain ways for center food items, and all those previous calcs are kinda fucked.

How can I explain?

Let's say I test before a meal and my blood sugar is 134. According to my little chart, I would take 4 units of insulin to "correct" for that 134 [to get it back to 80] *plus* 1 unit for every 15 carbs I was eating (this 4 unit "base" changes depending on that number. If I test at 80, my base is 2. If I test at 160, it's 6, and on up the scale, up to a 14 unit "base" when your sugar hits 400 and you should prob'ly be phoning a doc).

So if I'm eating, say, eggs and veggies, I'll just take the 4 units of insulin. Afterall, there's no "hard carbs" in those. No bread, sugary items, nothing with more than 15 units of carbs, really.

But if I'm eating eggs and veggies and toast, I'll take 5 units (the base 4 plus 1 for the toast).

Well, the pod doesn't calculate carbs the way I used to. Maybe I've set this up incorrectly. I'm meeting with the local nurse educator tomorrow for a check up about how I'm doing. Thing is, the morning calculator works fine. I know that if I dial in 17 carbs for my berries, then whatever the PDM says to give me is good.

Lunch is trickier, because I don't have an accurate count. I know about what I *used* to take, but every time I try to guess and then plug in the carb amount and test 2-3 hours later to see how I did, I'm always off by 2-3 units. I don't think this is a basal problem. Maybe?

My best numbers of the day (which, strangely enough, used to be my worst) are now my morning numbers. I've consistently woken up with 78-112 all last week. On days I don't exercise, my noon number is usually 100ish as well (I'm trying to figure out how to account for the new exercise routine at work. Because we do intervals, my blood sugar invariably goes up, not down (like it would during cardio), so I'm trying to figure out the best basal rate for the hour; I'm getting closer [I'll test at 134-164 after exercising], but it's not ideal yet).

I've been doing a lot of mid-afternoon tests because of aforementioned inability to get my lunch carb ratio correct. Or whatever is messed up. I even altered the basal for the afternoon so it's a little higher (and then it comes down again around 5pm when I'm less insulin resistant). The mid-afternoon numbers all suck (187, today, three hours after I ate, was the best mid-afternoon I've had).

Thing is, I figure that with a pump you should be more stable more of the time. If you're not, what's the point? So, shouldn't my mid-afternoon number be better than it used to be? 187 is what I'd test at during mid-afternoon *before* the pump.

So I'm working hard at fine tuning it.

I've turned off all the annoying beeps, and the only alarm I get is the one I set for two hours before the pod should expire and the one built into the pod for when the pod actually expires. It does still click when it delivers insulin, which is annoying, but something you just have to live with, apparently.

I'm still not sure if I'm sold on it, but I'm happy and sane and the numbers seem to be leveling out. Now it's just a matter of refining it, which I'll be doing with the educator and my endo next month.

Being diabetic is fun!

I was eating this brown rice and vegetable medley thing tonight that I used to eat all the time in Alaska (it's really good, actually; it has bacon and parmesan cheese and tomatoes and all sorts of great stuff), and thinking, "Man, remember in Alaska when you could eat as much of this as you wanted without really thinking about it?"

Remember when I could eat really, anything I wanted at any time, in whatever amount that caught my fancy, without thinking about it?

It's become such a foreign idea, eating without thinking. At least I don't have to take a shot *after* I think about it now, tho? Just plug some numbers into a PDA-looking thing and click for awhile?

Could be worse. Far worse. Big needles and death worse, but there are time when I think I minimize how much this stuff really eats up you life, your thinking. How much it consumes your day. Little stuff adds up.

People who whine annoy the crap out of me. Hell, I'm alive! It's fucking great! I could be injecting pig insulin into my thigh with a giant needle I had to sharpen myself!

But there's a lot that goes into it. Living, yeah, staying living (and sane living) takes a great deal of effort, and math, and forethought these days. I minimize it as much as I can. It's nearly invisible (which is probably why it's so fucking agonizing to me when it *isn't* as invisible). Because, you know, when we choose places to go out to eat at work, when we have a work gaming day, when Steph and the Old Man invite me over for dinner... it's something that not only I'm aware of, but stuff that other people become aware of, too. I have to have diet pop. I can't be living on Doritoes and Mountain Dew like the guys (I couldn't do that anyway without being 300 lbs, but I can't even do it just for a Saturday, you know?).

And running around, exercise without planning and forethought (impulsive sex can also be a lot less fun), and then there's that 1am sugar check, which I do still have to do with the pod. Every am. At least I don't have to take a shot at 5:30 am, tho?

Three steps forward, two steps back.

It's a lot of work, yeah, but it's my life. It's the price I pay to live. Not a bad price at all, but it eats at you sometimes. I can't pretend it doesn't. Especially when I want to eat bagels and order pizza. I hate that more than 2-3 pieces of pizza makes me sick. Hate it. I hate being broken.

It's not the end of the world, just a different world. And sometimes it can piss you off.

But it can't keep you from doing anything.

And that's the part you have to remember.

Guess Who's Coming to Town?

Scalzi and Toby will be reading at the Books & Co. across the parking lot from my digs next month (I nearly - NEARLY - said, "Fellow writers Scalzi and Toby...." But I'm going to reserve that particular weirdness for after the first of the three books is out next year, at least, thanks).

That should be a fun reading.

Blog Review

You know, I'm not actually a very brutal person, but I seem to play one on the internet:

"Kameron seems to be a very active and independent person. She does what she wants and does not care too much about what people will think of her. She may have relationship issues. Some of her posts talk about how she needs to be more in touch with her feelings and how she needs to be more open with people.

Brutal Women was a very interesting blog and I'm glad I read it. I just hope I never come across Ms. Hurley and get her mad because I will get my ass kicked with her martial arts/boxing skills and then she could potentially shoot me. That would prevent me from further posts."

I almost laughed til I cried.

(from here)

Blogging Break

Not sure when I'll be back, but for the two whole readers who come here regularly, do not despair:

I am probably not dead.

The Day that Blew By

Wow, that was fast.

Today, I learned that a cup of fat-free half and half is 143 calories, whereas a cup of peanut butter is 520 calories.

Which means eating half a bowl of sugar free, fat free pudding is about 143 calories, whereas eating half a batch of flourless peanut butter cookies is only 260.

Dammit man. In any case, those calorie counts are a lot better than I thought they'd be. I think these are nighttime snacks I should stick with.

On a related note:

OMFG sugar free, fat free eggnog!!! OMG!!!! A DIABETIC'S DELIGHT!!!

You have no idea how much I've missed eggnog the last two Christmases.

Zen

On the one hand, feeling neutral is so great. There are no gigantic emotional swings, no depression, no pressing need to do do do go go go, no crazy sugar-swinging hysterics.

On the other hand, it's kind of annoying that I find it difficult to get worked up over much of anything when I go from spiky crazy to normal again.

Dark Knight

Too long. By about half an hour. A typical problem with summer movies.

Also had one too many bad guys (why do they ALWAYS try and pack a *another* one in at the end instead of fleshing out the one they have?).

Extra bad wasn't necessary, as Ledger's joker was terrifying enough.

Not a happy superhero movie.

Just the way I like it.

Things to Look Forward To

Red Sonja (will anyone ever make a kick-ass warrior woman without making a point of saying she has a "vulnerable" side? Did they make a point of saying that Bale was a great, dark, brutal Batman but also had a "vulnerable" side? Is this really a superhero selling point?). But aside from that, yeah, sweet beans.

Terminator 4 with... Christian Bale. Everything else about it looks iffy, but they've got bodies hanging from telephone poles in the teaser trailer, so maybe there will be some kind of substance that doesn't suck? Let me keep my delusions.

Thoughts on the Pod

The Good:

1) I can keep my blood sugar more constant, by testing and correcting easily every... two to three hours.

2) No more shots. No more 5:30 am Lantus shot on weekends, in particular.

3) There is a handy bolus calculator that tells you how much insulin you've injected within the last three hours and automatically calculates how much insulin you need based on the carb amount you enter and some other presets you've given it.

4) I can adjust my basal rate for exercise on the fly, so I don't have to take less insulin at lunch to make sure I can work out before dinner. All I have to do is program a lower basal rate during that hour workout.

5) No shots means no bruises on my thighs, which isn't a huge deal, but which I found vaguely annoying.

The Bad:

1) Note that in order to keep that blood sugar consistency, I have to test and correct... every two or three hours. This is substantially more than the 4-5 times a day testing I was doing before.

2) The online bolus calculator doesn't work for me at all. I've been dialing in an extra unit or two and juggling the presets to see if I can get it to work correctly, but no dice. I don't think it adds in the basal rates correctly. Yes, I programmed all the settings i.e. carb lowering amounts and target blood sugar.

The Ugly:

1) Workouts that involve jumping around? Like tuck jumps and jumping jacks? Totally out, unless I want to tape or bandage the thing in place. It also hurts when you jump around, cause you can feel the needle bumping up and down uncomfortably. I already own a sports bra. I don't want one for my medical hardware, too.

2) It beeps. It beeps 12 hours before you need to replace it and again when you need to replace it. This would not be so bad, only it also beeps when it's finished delivering your bolus insulin, too, so that's more beeping 3-6 times a day.

3) It generally takes upwards of two minutes to inject 6 or 7 units of insulin. Two minutes? What the hell is it so slow for? Since it clicks as it delivers insulin, I can only imagine that it's because it's literally clocking it out at .10 unit increments.

4) It clicks every time it delivers insulin. Every. Damn. Time. I emit clicking sounds like a fucking clock.

5) The PDM is easy to use, but clunky, especially in a device you're using at least 10 - count `em 10 - times a day to check blood sugar and deliver boluses.

6) 1 in 7 pods fail, so you always have to bring a backup and your pens.... so, all that "gear" I figured I could ditch cause I was on the pump? I have to fucking carry it all around *anyway.*

I can see the advantage of a pump for people who hate needles or who have trouble with control, but my A1c runs 5.9-6.5 while using the pens, and I've figured out how to live with them. Sure, the pod makes insulin delivery more discreet, but you still have to stab your finger and bleed on a stick 10 - count `em 10 - times a day.

So again, really, what's the point?

I keep reading about all these folks who say insulin pumps really changed their lives (especially the pod), and I just don't see it. Granted, I've never been squeamish about stabbing myself at the table or telling people I have diabetes. So maybe these are more for squeamish people who have a hard time getting their blood sugar under control and don't like needles?

I admit, the beeping, clicking, knocking around cyborg thing really annoys me. I'm thinking I'll ditch it Monday morning and talk with my endo about it during our appointment in August. This was really the only pump option I was excited about (the idea of having tubing hanging off me isn't all that appealing either), and honestly, I really like the pens. I feel like they've given me a lot of freedom and flexibility, and I don't have to worry about jumping up and down during exercise and hurting myself/dislodging something. The insulin's already in there.

I am not terribly impressed, so far. I mean, when I first got it it was "Oh neat shiny and cool!" and now I'm like, "Was taking a Lantus shot at 5:30 am really so bad that I have to pack around two additional pieces of hardware?"

I just don't think it was.

I don't know. I'll take some time off and revisit it, maybe. So far I'm pretty wishy-washy.

Out and About

Still feeling too anti-social and tired to get out and about tonight. Hoping to at least go see a movie tomorrow.

Now I am faced with the fact that I do not want to cook but do not want to go out and should not be spending money on carry out food.

Pancakes and video games tonight is about all I'm up for.

Much better day than yesterday, tho. Once I switched out the pod things leveled off again and after a few spikes, I'm leveling off again. Give me another night and some exercise, and things should be much better.

But tonight: pancakes and video games.

Home Again, Jiggety Jig

Came home, changed out to a new omnipod (I keep wanting to say ipod heh heh heh), cried for awhile.

Tested at 35. Ate some graham crackers and cried some more.

I hate being broken.

I hate it more than anything in the whole world. I hate being dead already, just limping along with the help of synthetic insulin.

I hate being broken.

Crying some more.

Tomorrow will be better.

That's all living with chronic illness is for me, really: that stubborn conviction that tomorrow will be better.

Getting the sweats and the shakes at the sugar comes back up.

Fucked up cyborg, I am.

Limping along.

Tomorrow will be better.

Sugar Death

You know, just seeing how much insulin I have to take just to stay under 300 because the pump's fucked and basal's not working, I have to say that I'm reducing my, "I could live for at least 3 days without insulin after the apocalypse!" to "I'd be lucky to make it 24 fucking hours."

Glad I took them seriously about those emergency supplies, or I would have had to go home a hell of a lot earlier.

Depressing, to be dying all the time.

Pod Failure

Had my first pod failure this morning when I went to switch out my omnipod. I'd read about this in the omnipod forums - apparently 1 in 7 actually fail out of the box. The good news is that this is supposed to mostly happen immediately, as soon as you put it on. I kept getting communication error messages, so I switched out the pod and successfully activated a new one.

Well, it looks like they "usually" only fail out of the box, because this second one I've had one has kept me at a steady 300 all fucking day long. I have no idea what's going on with it. Checked the cannula, which is in place. It still clicks when it delivers a bolus, the proper basal program is on, it just... wants to keep me at 300.

As recommended, I kept my pens on hand for just such emergencies (I would have had the extra pod, too, but this *was* my backup pod, and I forgot to replace the backup this morning, figuring that the chances of having 2 bad pods weren't high ha haah 1 in 7, do the math).

I suppose it's possible this is also a leveling issue, but I doubt it. I switched out sites and pods, so I'm thinking there's some kind of blockage or bad cannula or something.

I took a 6 unit correction hit with my pens, which should help. I'll just need to manually finagle it until I get home and change out the pod.

Fucking annoying. Seriously, 1 in 7? Don't they have some rigorous quality check for these things?

Man, My Life is Boring

...and it's going to stay that way for at least another year. On the one hand: kind of depressing. On the other hand: this is what you get when you cross wild, roaring 20s with chronic illness and job layoffs:

A year of boring suck.

Ah well, I'm making the most of it. And the upside is, once my boring year of suck is overwith, I'll be ready for my roaring 30s!

By the Numbers, redux

Actual thought tonight, as I prepared for a pre-8:30 bedtime:

"Gee, I don't know why I'm so wiped out and exhausted."

Gee, I wonder.

Numbers this morning were a lot better, but I was running high this afternoon, in part because I think I underestimated the carb count on today's black beans at lunch. So I was running 170-190 pretty much all afternoon, which is less than ideal.

Morning was awesome, though, a nice clean 86-123 until noon, with a 136, which still isn't too bad.

I'm setting my 1am alarm tonight, but not the 3am (yes, I set a 3am alarm last night. What can I say? I'm very cautious with new toys).

I'm already looking forward to Thursday when I get to change the site. They recommend that you keep the omnipod on your stomach/hip/torso area the first week or two, but I really hate having it there. I'd much prefer my arm. Bending over, wearing jeans, situps, etc... it's just not the most convenient place for it. And I can only use one side anyway, because I sleep on my right side.

Anyway, going to bed. Only one sugar check alarm tonight. Huzzah.

What do you want?

I sat up tonight watching the last half of The Notebook. This is one of my favorite romance movies (and not just because I have crushes on both of the leads). I generally hate smarmy, gendered romance movies where some dashing, moneyed guy saves some poor but pretty abused Cinderella from her dead-end life. Excuse me, but I'd like to think that there was more drawing two people together than her desperation to escape a life of abuse and poverty. That's not romance. Call me not old fashioned.

And The Notebook does something else that I also found interesting in Sweet Home Alabama, a trend I wouldn't mind seeing more of.

It's not that the girl needs saving in either of these movies. In fact, she's quite successful and well-off all on her own. And it's not that her current boyfriend is an asshole. In fact, her current boyfriend is pretty perfect. Her life is great. It's just that... it's that... something's missing. And she needs to figure out what it is, or just learn how to live without it.

Most of us make the choice to live without it. It's often easier that way.

There's this big myth that women like assholes and bad boys, people who treat them like crap. This is a a misreading of something else, I think (though there are, certainly, people who are drawn into or just plain stuck in abusive relationships). In fact, what I think some people are looking for - what I realized I was looking for - is somebody who challenges them. Somebody who doesn't put up with their bullshit.

There's a reason I was more broken up about the not-Boyfriend than I have been about any other breakup I've had. And that's because he challenged me. He stood up to me. I can be a scary bitch sometimes, I get that. I've dated people who don't like conflict, and especially don't like to argue with me. So then you just don't talk, or you avoid certain subjects, or stuff breaks down, and then one day one of you wakes up and you realize you've spent all of your time never talking about anything that matters, and you don't actually know each other at all.

Go too far one way and you end up dating an asshole (which I did in highschool). Go too far the other way and you get the NY boyfriend, who refused to get into an argument with me about anything. He found conflict of any kind terrifying, which made that whole jokey sarcasm thing that I do when I really like people kind of... well, it didn't work.

We all need that special someone in our lives who calls us on all our bullshit.

Noah: It's not about following your heart and it's not about keeping your promises. It's about security.
Allie: What's that supposed to mean?
Noah: [yelling] Money. He's got a lot of money!
Allie: You smug bastard. I hate you for saying that.
Noah: You're bored Allie. You're bored and you know it. You wouldn't be here if there wasn't something missing.
Allie: You arrogant son of a bitch.
Noah: Would you just stay with me?
Allie: Stay with you? What for? Look at us, we're already fighting.
Noah: Well that's what we do, we fight... You tell me when I am being an arrogant son of a bitch and I tell you when you are a pain in the ass. Which you are, 99% of the time. I'm not afraid to hurt your feelings. You have like a 2 second rebound rate, then you're back doing the next pain-in-the-ass thing.
Allie: So what?
Noah: So it's not gonna be easy. It's gonna be really hard. We're gonna have to work at this every day, but I want to do that because I want you. I want all of you, for ever, you and me, every day. Will you do something for me, please? Just picture your life for me? 30 years from now, 40 years from now? What's it look like? If it's with him, go. Go! I lost you once, I think I can do it again. If I thought that's what you really wanted. But don't you take the easy way out.
Allie: What easy way? There is no easy way, no matter what I do, somebody gets hurt.
Noah: Would you stop thinking about what everyone wants? Stop thinking about what I want, what he wants, what your parents want. What do YOU want? What do you WANT?
Allie: It's not that simple.
Noah: What... do... you... want? Whaddaya want?

Yeah, it's not gonna be easy, it's gonna be really hard. But there was a time I believed it was worth it, and there will be a time when I believe it's worth it again.

Until then, the beat goes on.

Magic Numbers

It appears that my magic basal number during the day is somewhere between .45 and .55 units per hour. After a shitty morning, my numbers after noon evened out really well.

I've set myself at .55 for the morning and .45 at night, with adjustments for exercise (.25 for evening cardio, .35 for morning exercise, with an option to just suspend insulin for a workout if I need to. I can go as low as .10 per hour).

I knew that the pump process was going to be two weeks of calibration and bitchiness, and I got all of that today. Starting my morning with rolling lows always fucks me up, and I was weepy and bitchy all day, which is rough to do when you have to be cool and professional and on top of shit at work. I got very little done today. I considered it an accomplishment that I finished our spinning workout without passing out (tested at a very respectable 111 after the workout), and attended all meetings and spoke coherently (I only had to test during one meeting, fearing I was spiking low. Turned out I was just really queasy and jumpy; I fear I wasn't as coherent in that meeting as I should have been either).

I should only have to do this crazy testing-every-two-hours thing for another day. After tomorrow, I should have established a reasonable baseline.

I felt so fucking horrible today, though, you know? It's funny what fucked-up sugar does. I wore a loose shirt today to help mask the pod, which I have to wear on my stomach the first couple of days just until the calibration is done, then I can wear it on my leg or upper arm, but here I am, wearing this frumpy shirt, and my skin looks horrible, and has my bottom half always been so big? Why do I look like I mushroom? Why can't I be skinny and cute and unintimidating? Why does my hair look like shit? I look horrible and frumpy and unlovable. I hate the whole world! I just want to die! No one will ever love me! I look like a frumpy Ohio housewife! I am worthless!

And then I look again and just sigh because hey, yo, I'm just crazy. Because I don't look any different than I did the day before, and I love being able to bash things really hard. It's a relief now, you know, that when I feel that way I can just be like, "Hey, I'm crazy!" and move on.

I think I'll wear something a little less frumpy tomorrow, though, which might just help how I feel. As will a less fucking crazy sugar morning.

For now, I'm absolutely fucking exhausted, and not worth much of anything about now.

This is one of those "I hate being sick!" days, but there's that other part of me, the conscious-of-the-crazy part, that thinks it's pretty cool to be alive, and pretty neat that we have such crazy gadgets to help us stay that way.

Rumor has it there's a new pod coming out next year that's 40% smaller than this one (and this one ain't huge at all), and a smaller PDM (remote control) with a cooler screen coming out next year.

Better yet? They're working on the continuous glucose monitor + omnipod thingie that will automatically take your blood sugar all day long (no more finger pricking 10 times a day!); then you can remote in the correction via the PDM. It's already pretty sweet that my meter is integrated with the remote, but to bring the whole thing together will be really great.

That's a couple years away yet, tho. In the meantime, it's manual testing and calibration.

But, you know, let's put this in perspective:

This was the first time in two years that I didn't have to jab myself with a needle at least four times.

That's gotta be a big leap forward.

Things that Annoy Me

Diabetes.

Started the new insulin pump today. You know, I don't really use a lot of insulin. I've been reading these forums where there are people using something like 80 units of insulin a day. 80 units? Srsly?

I've been adjusting my basal rate all day for lows. I'm going to suspend it altogether for my workout at 10:30. And I already had a pretty low set point (.65 units an hour to start. Have changed to .45 already based on the morning's trending. I'm reading that there are people set at 2 and 3 units an hour who are in the 200s). Of course, this could be because I spent 3 hours moving furniture yesterday, so I'm trending lower than I should.

Watching my numbers this morning was fascinating:

Target is 80

5:30 am: 180 +5 .65 basal
7:08 am: 110
7:33 am: 91
7:56 am: 79
8:13 am: 65
(took 2 lifesavers, adjusted basal to .45)
8:40 am: 92
9:09 am: 70
9:20 am: 61
(OK, srsly, I'm having a fucking bagel)

Wheeeeeeeeeeeeeeeeeee!