Sleep. Please Come Back To Me. I Miss You.

Seriously.  This has got to stop.  I’m not sure when it first started, but I haven’t gotten a solid night’s sleep in I-can’t-tell-you-how-long.

I don’t know what’s causing the problems.  Although like just about everyone, I have some anxiety,but it’s not what I’m thinking about in the middle of the night.  Maybe hormone fluctuations have something to do with it, but fortunately, if hormones are a part of this, they are NOT affecting my blood sugar.  And for that, I’m grateful.  Anyway, it’s not clear to me what the problem is between me and sleep.  But lately, it hasn’t been a symbiotic relationship.

I don’t have a problem falling asleep, but staying asleep the duration of an entire night?  Forget about it.  I usually go to sleep around 11:30/midnight, and wake up feeling bright eyed and bushy tailed around 3:30am.  I toss and turn.  Finally fall back asleep after what seems like about an hour or so, and then it happens again around 5am.  And there’s just no way I’m the kind of girl that likes to start her day at 5am.  Nor am I the kind of girl that functions well on a mere 5 hours of sleep.

I’ve tried all sorts of remedies- mostly natural, and even some not natural because lately, I’ve gotten desperate!  Here’s a list, off the top of my head, of the things I’ve tried to help me stay asleep during the night.

*warm baths with epsom salt (baths have always been a ritual of mine, but lately I’ve added in epsom salt and lavender oils)

*avoid screens (tv, computer, phone) as bed time approaches

*no caffeine beyond 2pm

*ear plugs and eye mask

*sniffing/rubbing on my temples some mix of essential oils that was given to me labeled “for sleep”

*this supplement that has melatonin, l-theanine and botanicals

*a magnesium supplement

*Ambien (Yep.  I’ve heard scary stories about Ambien, but again- I’m now desperate enough to try just about anything that might help.) (And yes, I’m going to write a blog post on this, specifically, soon.)

If any of these things have helped, it’s been so subtle, I haven’t noticed.  I still wake up around 3 or 4am feeling wide awake.

I’ve been listening to podcasts, and reading articles about how to get a healthy sleep routine going.  I’m taking any and all recommendations.  The new idea I’m trying this week that I just heard some sleep doctor talking about is: get OUT of bed if I’m not sleeping.  He said we need our brain to associate the bed with SLEEP (or sex), not with tossing and turning.  So, if you wake up, his advice is to go to another room, keep the light low, and do something like read until you feel tired enough to go back into the bedroom and fall asleep.  I’ve tried that for the last few nights, and while I like getting in the extra hours of reading, I’m not sure it’s helping me change my sleep routine. In fact, I fear that it might be ingraining that 3am wakeup call even deeper into my book-loving brain.

Like I said, my sleep issues don’t seem to be directly hurting my blood sugar control or my diabetes in general.  BUT, it’s well researched how vital sleep is to our overall health.  Lately, I’ve had problems with my shoulder (supposedly tendonitus), my hand/wrist (supposedly carpel tunnel) and neck pain in general.  I’ve said out loud, “I feel like I’m falling apart all of the sudden.”  And when I think about my sleep- or lack thereof, it makes sense that this would be the case. SO: It’s important to me that I figure this out.  My goal is to start sleeping a minimum of 7 hours each night. Right now, that sounds very lofty.  But it’s just sleep I’m talking about here.  SLEEP.  Something I love.  Something I want.  Something I need. I CAN DO THIS.

Right?

I’m taking all tips, recommendations and advice if you have any to offer.

#goals

Being Patient with Type 1

I haven’t had any clearly defined complications due to having lived with Type 1 for over 20 years.  And I’m seriously grateful for that.  BUT from time to time, I have little ailments that I wonder… Is this connected to being a Type 1?

My A1c tends to be anywhere from about 5.5% to 6.3%, and as time goes by and technology improves, it tends to be lower as the years go by.  I work hard and obsess over keeping my blood sugars in range, but still, I have spikes and drops in my blood sugars on a daily basis.  So, I’m far from perfect when it comes to blood sugar control.

In the past, I’ve had to have two surgeries for trigger finger.  One, for my left pinky, and the other, for my right thumb (ouch. that one was a bitch.) Before I finally got the surgery, I tried cortizone shots.  But they only helped for a short period of time, and then the trigger finger would return. The surgery, in my opinion anyway, was actually less painful than the shots. And, once you have the surgery, the problem doesn’t return. YAY!  I have read about the correlation between diabetes and trigger finger.  It has to do with inflammation.  Who knows, maybe I would have had this problem regardless, but I suspect Type 1 played a pretty big role in it.

The surgeon I used for my finger trigger insinuated that I would heal quickly from the surgery, but both times, that was not the case.  And again, I wonder, am I a slower to heal because of my Type 1?  Even though my blood sugar control is good?

Lately, I’ve been having problems with my right shoulder. Not from an injury, but just over time, it’s gotten more and more sensitive, and my range of motion has become more limited.  I got an MRI, and learned that I have bursitus and tendonitus.  Again, an inflammation problem.  And again, I wonder… is this related to my Type 1?

And even more lately- just the last 2 weeks- I’ve started having numbing in my left hand.  I’ve been to a doctor about it, a physical therapist about it, and had an MRI.  It could be related to spine problems I’ve had for many years, or it could be carpel tunnel.  (More on that later, in another post- but for now, that’s enough to make my point.) Again, I’m wondering, “Dammit.  Is THIS because of my diabetes?”

So although I’m not usually pissed at diabetes, sometimes I am.  Right now, my numb left hand is so pissed that it wants to punch my diabetes in the face.

But that anger isn’t going to do me any good.  It might even cause more inflammation, which I think this is all related to anyway.  Maybe inflamed emotions lead to more inflamed body parts.

Maybe it’s a good time to just breathe.  And remember that this is just a moment in time and it’s going to pass.  And things might be stiff, and tingly and even numb, but still- everything is working. (“That’s what she said!”)

I’m writing this today to remind myself how fortunate I am.  Fortunate for good insurance.  Fortunate that I have nothing too extreme going on that I am limited from enjoying my normal happy life. Fortunate that I have the money to get the therapies I choose to help me through this.  Fortunate to have friends I can call on (or text) to bitch to. It’s all good.  I know my body is working on healing.  Maybe it takes me a little longer to do that, but I can be patient.

Tips on Avoiding Blood Sugar Fluctuations at Night

There was a post the other day on a Facebook group I belong to that’s for type 1 diabetics. Someone had posed the question, “Do you try to get above a certain number before going to sleep to prevent lows in the middle of the night?”

There was a wide range of answers, but based on most of the people’s answers, this fear of blood sugars dropping off during sleep is a common one.  A lot of people feel comfortable and safe going to sleep with a blood sugar of 150, or even 200 to avoid the possibility of a dangerous low.

This USED to be the way I felt.  I used to have a ritual of eating a “just before bed” snack to get my blood sugar up to about 150 so that it wouldn’t crash during the night.  It often still went low anyway.  And I would wake up sweaty and confused, and have to find my way to some kind of carbohydrate in the kitchen.  And even if I didn’t go low during the night, I was definitely low most mornings when I first woke up.  And whether I was hungry or not, I had to eat something fast, as soon as I rolled out of bed.  And honestly, for me at least, that is NOT the fun or best way to start a day.

But gradually (very gradually!), since I started using a CGM (continuous glucose monitor) and am aware of my middle-of-the-night blood sugars, I’ve adjusted a couple of things and they’ve made all the difference in the world for keeping a stable blood sugar during the night. Now I’m very comfortable going to sleep with my blood sugar around 80-100mg/dL, because it stays pretty consistent during the 8 hours (give or take) of sleeping. And I’d much rather have 8 hours of my blood sugar around 100, than around 200!

TIP #1

First of all, I realized, I was taking far too much long acting insulin.  My blood sugars used to steadily fall throughout the night.  If you’re taking the correct amount of long acting insulin, that really should not be the case. A huge benefit to using a CGM (like Dexcom, for example) is being able to look at the trend line during the night. Your Dexcom (or whatever CGM you use) should have a fairly straight, horizontal line during the night, showing a steady blood sugar all night long. None of my endocrinologists ever told me this, but I learned this from reading Dr. Stephen Ponders book Sugar Surfing, which I highly recommend. I gradually cut back on my Tresiba until I started to see a consistent horizontal line during the hours I sleep.  If my trend line goes up, I’m not taking enough; if my trend line goes down, I’m taking too much.  The slightest adjustment can make a difference… Which is why I did it gradually.

TIP #2

I’ve found that the other big component to steady blood sugars during the night is to make sure I don’t have any short acting insulin on board when I go to bed.  Therefore, I eat my meals fairly early (at least 4 hours before bedtime), so that my fast insulin has time to do it’s job, and then clears out of my system.  I know for me, my short acting insulin seems to peak at about 1.5-2 hours after injection, and is pretty much done within 3-3.5 hours. This varies, but for me, I’ve tracked it for a long time, and I know how it generally works for me. (Notice, “for me” is in italics.  Your body is not my body, and things may be different for you.)

I think these consistent blood sugars during the night is a big reason why my A1C is where I want it to be.  There’s very little guess work during those 8 hours since I’m neither eating, taking insulin or working out, which are the 3 things that effect my blood sugars the most. And the less lows I’m having to treat, the less I have that whole “roller coaster” of highs and lows that nobody likes.

As I’ve mentioned a lot on this website, I’m certainly not a doctor or a nurse.  I only know what works for MYT1Diabetes.  And I’m just sharing that information.  Definitely discuss any changes you want to make with your team of health care providers.  🙂

 

My T1 Diabetes Blog. Reboot.

When I first began this blog about Type 1 Diabetes, although it had the same title, it was a Blogger blog.  I got a good amount of traffic in the beginning, and I felt like what I was writing was helping some people, and creating some great conversation among fellow Type 1 diabetics.  And that was my whole intention.

I thought switching to my own domain, and using the WordPress.org blog would give me better ownership of my content, and seem more legit.  But something got lost along the way during that transition.

boo hoo

I guess I just lost the momentum I had at the beginning. I started getting a lot of bogus comments from robots in the middle of the night. (Apparently, that’s a common problem for WordPress users) I got less feedback from real people than I did at my previous blog address.  I wasn’t sure how to promote my blog and get the readers that had found me the first time around to jump over to this new blog address with me.

I also started to feel like there were only so many posts I could write about insulin and glucometers and my beloved Dexcom. I felt like maybe I had said all I had to say on the topic of diabetes management.

I became frustrated and I decided this blog didn’t really matter to anyone anyway.

Actually, I’ve been re-thinking my pity party.

I’ve had diabetes for most of my adult life.  Something like 22 years.  And I think I have a pretty good handle on how to keep it under control, most of the time.  It’s a lot more complicated than just taking insulin and counting carbs to keep things in balance.  It’s recognizing patterns, it’s dealing with hormones, and emotions, and sleep, and workouts, and!, and!, and the list goes on. All of the things I do for my health- my physical, emotion, mental and even spiritual health- ALL OF IT, has at least some effect on my diabetes.

So I feel rejuvenated to begin again with this blog. I realize now that I can broaden the scope. I won’t just be writing about insulin and blood sugars.  I hope by posting regularly, I can find consistent readers who are also interested in choosing to live a happy and healthy lifestyle with an auto-immune disease like Type 1 Diabetes. Whether it’s in the comment section, or in sharing posts with friends, or in directly emailing me, I appreciate any and all conversation with you!

I’ll be posting on a regular weekly basis. Please subscribe so you won’t miss anything.  Thank you SO MUCH for visiting My Type 1 Diabetes Blog.

Come To the TypeOneNation Summit April 23rd!

This event! If you live anywhere near the D/FW area, you really should come check this out.

JDRF
Greater Dallas and Greater Fort Worth Chapters invite you to TypeOneNation Summit

Sunday, April 23
10:30 am – 5:00 pm
The Marriott Quorum
14901 Dallas Pkwy, Dallas, TX 75254

This event filled day of education, connection and inspiration is for anyone impacted by type 1 diabetes (T1D), including adults, parents, family members, friends, teens and children.

Expert speakers will present on T1D topics including nutrition, exercise, emotional aspects, technology and advanced care.

Industry partners will share the latest in support and technology.

Children and Teens will have a separate track to meet others their age with T1D.

Please join us by registering at http://NorthTXTypeOneNation.eventbrite.com

 

My great friend, Tanya, is the organizer and she always lines up incredible speakers.  I’ve had T1 well over 20 years, but I learn new things each year I attend this. PLUS, I get to be around so many other T1s, and as you know, they’re the sweetest people around!

So do yourself a big favor, and treat yourself!!- learn some things and make a new friend or two at this great event.  And I will see you there!

 

 

The Complications of Type 1 Diabetes

The other day, on another blog I write called Resparkable Vintage, I posted about my contribution for the upcoming JDRF Dream Gala Auction.  That website is really all about my repurposed vintage handmade designs, but in that particular post, since I mentioned the JDRF Gala, as well as the fact that I’m a Type 1, I gave a brief explanation about Type 1, thinking probably most of the readers over there don’t know much, if anything, about it.

Mainly, I just said Type 1 is an auto immune disease, and that our bodies don’tt produce insulin on their own, so therefore we have to inject synthetic insulin multiple times on a daily basis to survive.  I also mentioned that it’s a complicated disease.

And it is.  It’s hard to explain to someone what all of that means- Because what does insulin do exactly?  And that thing I mentioned about having to take synthetic insulin- how do you know how much to take? And when to take it? And what happens if you take the wrong amount?

Because, as anyone who lives with it knows, there’s no obvious or predictable formula for getting dosing amounts correct.  And the way a low blood sugar or a high blood sugar makes one feels varies from person to person, and from day to day.

Here’s a small, seemingly unimportant example of what it’s like to have Type 1 that I experienced today. I can never be spontanious about eating something.  If I’m at an event, as I was earlier today, and they happen to be serving lunch, I can’t just pop food into my mouth on a whim.  If I had wanted to eat at this luncheon, I would have needed to know what exactly I would be eating, at least 30 minutes before eating it, so that I could take what I hope is the right amount of insulin to cover it.  But since I didn’t know in advance, and they put a plate in front of me, I just said, “Oh no thanks, I already ate a late brunch.” It was a lie.  And truth be told, I was getting a little hungry.  But if I don’t take my insulin pretty well in advance of eating, my blood sugar will soar, and I will be on the diabetes roller coaster of high to low blood sugar for a good part of my day.  And it will likely make me feel like crap.

So, I keep it simple.  I say, “No thanks” to unplanned food.  I eat my same (some would say boring) lunch most days because it’s just easier.

I also happen to be a picky eater by nature, so most people who know me (including my husband) just sort of roll their eyes at me, assuming it’s all about my pickiness when I say no to food.  But I don’t even know which came first, my extreme pickiness, or just keeping my diet simple to avoid… well, COMPLICATIONS.

I don’t bother to explain these things.  It’s easier just to tell a little white lie.  “No thanks, my stomach’s a little upset.”  Or, like today, “No thanks.  I ate a late breakfast and didn’t realize there would be food here!”

Type 1.  It’s complicated.

One Touch Veria Meter

Every year or so, I have to switch my glucometer due to what my insurance will cover.  It’s not a huge deal, because meters are just meters- as long as they’re accurate.  I don’t care about the bells and whistles of meters that do special things with data anymore, because, well… I just don’t.  I have my Dexcom, and I feel like the bulk of important information comes from that anyway.  These days, my meter is just what I use to calibrate the Dexcom.  And as long as it’s calibrated, I trust the Dexcom’s numbers just as much or more than a glucometer.

My insurance company now only covers One Touch meters. So, it was time to move on again. My endo had two to chose from: the Verio and one other (I don’t recall the name) that looked a little flimsy, so I went with the Verio. I liked the sleek look of it.

One Touch Verio Glucometer

Instead of batteries, it has a charger.  Initially, I liked this idea.  But I just noticed last night that the charge only holds for 1-2 weeks.  So when I go on a trip that’s anything over a week, I have to remember to take yet another charging cord.  Ugh. So honestly, I think batteries are my preference.  They last for months, and double A batteries are cheap! Oh well.  Not a big deal.

Like pretty much all the meters I’ve tried in the past few years, the Verio is quick and simple.  Just a teeny bit of blood on the teeny strip, and 5 seconds later, you know what your blood sugar is.

I’m currently paying out of pocket until I meet my deductable, so this first 3 months supply of test strips cost me around $560 at my online pharmacy.  Just out of curiosity, my husband checked Amazon Prime’s pricing on the strips and they were actually CHEAPER on Amazon.  But we weren’t sure how regulated they were (when’s they’re expiration? why do the boxes look diffrent?) if I bought them through Amazon and the price difference wasn’t hugely significant. Before I order my next batch of strips, I might look into this a little more.  I guess I shouldn’t just assume that buying from my online pharmacy  (when it’s out of pocket and not a drug that needs a prescription) is always the best, most affordable option. I wonder how much the strips would be if I ordered them from Canada?

 

 

Coke Saves Lives (When You’re a Type 1 Diabetic)

It’s not often that I drink a real Coke. It’s also not often that I accidentally take way too much insulin.  But the two seem to go together well.

fullsizerender-8
the two look nothing alike really. and i keep them in different places. but still… mistakes happen.

Last night, okay- I’ll admit it-, after a glass or two of wine, I dialed up my insulin pen to take my long acting shot of Tresiba for the night.  Except that the second after I injected it, I realized, “Oh crap! This is NOT the Tresiba pen.  This is my Humalog pen!” And then I immediately started searching around for any sugar I had with me so I could counteract what that insulin would soon be doing to my blood sugar.  I had some Mentos (my favorite th-2go-to sugar when I’m having a low blood sugar situation), but most likely not enough to make it through this pickle I had just gotten myself into. I asked my husband to run to the store and get me candy.

It was a little late, and we are on vacation, in the mountains, so he just went to this little market very close to us to see what they had.  Thankfully, they were open, because lots of places around here were already closed for the night.  They didn’t have any candy.  But they did have a 2 liter bottle of Coke.

A Coke. And a smile.

To be honest, I’m so glad it was Coke rather than Mentos this time.  It’s one thing to eat 3 or 4 Mentos when I’m a little low.  But to have to eat gobs of them over the next several hours would have really made me sick I think.  Getting the Coke down wasn’t so bad though. In the beginning, it was actually sort of glorious!

Fortunately, we had a pretty light dinner, so I wasn’t having to drink Coke on a full stomach.  I kept my glucometer near by, as well as my Dexcom. About 30 minutes after my accidental insulin shot, I saw that my blood sugar was starting to tank, so I started drinking the Coke.  This was a medical need!!  And at least, in the beginning, I was sort of in heaven. I even ate a few chips to really get the party going.

I continued to drink a very small glass of Coke about every 15 minutes.  My blood sugar stayed around the 70s-80s range, but it never got below 65 mg/dL.  I was trying to avoid severe highs and lows- those rollercoasters all of us diabetics know all too well- and I actually did!  I knew my Humalog would peak around 1.5-2 hours, and would clear out of my system within 4-5 hours.  We all (that’s me, Fermin, Lucy and Ricky) stayed up until 2am, to make sure I went to bed when my blood sugars had leveled out.

As always, I slept with my Dexcom by my bedside. And I was able to sleep through the night without any high or low alarms going off.  YAY!

Coke. Sometimes, it’s what’s good for you.

th-4

 

The Small World of Type 1 Diabetes

Typically, when I get an unknown call on my cell phone, especially if it’s from out-of-state, I don’t pick it up.  But today, since I’m out of town, and have put out calls to some realtors that I desperately want a call back from, I picked up one of those “random” calls. And I guess, as they say, nothing is random or coincidental at all.

It was a person from GoDaddy just calling to make sure I was happy with the service they provide for this blog.  (I am.) As it turns out, the guy who called me, Jason, told me he is a T1 also!  He’s within a year of my age, and he also has had diabetes since his early 20s.

After he told me that, and I realized we had all that in common, I asked him if he also uses Dexcom’s CGM.  He doesn’t.  But he said he had been reading about it and thinking about it.  Anyone who has visited this blog before probably can tell, without diving in too deep- I’m a big fan of Dexcom and know that I have tighter control now than ever thanks in large part to the information it provides.

I let Jason know that, yep- so far so good with the GoDaddy hosting stuff… but way, way more importantly, I loved having an unexpected connection today with a fellow Type 1 person.

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Dexcom Tells Me More Than My A1C

Last week, as I was driving to my appointment with my endocrinologist, fighting horrible traffic to get there I started to question, really, why was this appointment even necessary. My last appointment was only 3 months ago.

My main reasons for these appointments have always been:

  1. to find out my A1C and
  2. to get prescription refills.

That’s pretty much it. But now, I have a Dexcom, and I look at the Clarity app often enough that I know what my “predicted” A1C is.  Besides that, I think my trend graph is way more important than that A1c number anyway.  An A1C could spit out an impressive number, even if someone didn’t have very tight control on their blood sugars.  As long as the average works out to be something within a good range, the A1C might deceivingly seem “good”even if your control isn’t.

One thing I love about my endocrinologists office is that you get an immediate result of your A1c test.  Last week, mine came back as .5% higher than what the Dexcom Clarity app predicted.  When I told my doctor, he said “we pay more attention to Dexcom results than the lab work.”  I didn’t ask why or for any further explanation, but it’s how I’ve felt about it all along and I’m happy with how things have been going so, I’m just sticking with what my Dexcom is telling me.

img_2529
The Dexcom Clarity App on my iPhone.

It seems like an A1C result isn’t as important as it used to be now that we have more advanced technology.  I can see graphs of what my blood sugar is doing every 5 minutes of the day with my Dexcom CGM.  I can get a predicted A1c for a 7 day, 14 day, 30 day, or 90 day period with the Dexcom Clarity app.  Even better, if I access Clarity from my computer, I can see all sorts of trend graphs to see where where and when my “problem” blood sugars are. I pay a lot more attention to whether or not my blood sugars are staying within my target range than anything else.  The actual A1C or average of those readings is far less important to me than simply staying in my ideal range as often as possible.

I’ve tightened that range little by little.  I think when I first had a Dexcom, I had an alarm set for a high of 180- maybe even 200.  Now I keep my low alarm set for 65 (that hasn’t changed), and my high at 150.  These days, it’s a rarity for me to have a blood sugar that ever gets (or at least stays for long) above 170.  Of course, it still happens from time to time, but thanks to having the alarm set for 150, I can be proactive and avoid those highs I use to battle. Treating a slightly elevated blood sugar is a lot more manageable than treating one that gets way up there.

My endo told me to make my next appointment in 4 to 6 months.  Of course, I chose 6 months.  Unless something new comes up, there’s no reason for me to go any sooner than that. I get more meaningful information about my blood sugars from my Dexcom than an A1c result is ever going to tell me.