Sunday, August 4, 2013

goal setting

Goal setting will probably be a recurring theme for me. It is hard to set "SMART" goals that add up to better A1C's.  So maybe I need to think about things differently from A1C goals. And differently from avoiding complications. How do you focus on each and every moment, action and thought on something as abstract as an A1C.

I feel better if my blood sugar is better. So rather than focusing on success as being a number. How about focusing on keeping myself in range or getting back to range as soon as possible because that is when I feel the best and function the best.

In short, my goal is to feel good. That typically means that I want my blood sugar in range, and sometimes that means I might prioritize something else over a perfect blood sugar, but I won't enjoy other things in life if I am too high or low, so I think this might work. Maybe if I ask myself, "what should I do so I feel good later?" then I will be working toward something more concrete.

My goal is to feel good.

Saturday, May 18, 2013

Diabetes Art Day!

Definitely check out some of the other art!

Click for the Diabetes Art - Saturday 5/18 Link List
This year Diabetes Art moves up from the Wildcard choices as we all channel our creativity with art in the broadest sense. Do some “traditional” art like drawing, painting, collage or any other craft you enjoy. Or look to the literary arts and perhaps write a d-poem or share and discuss a favorite quote. Groove to some musical arts by sharing a song that inspires you diabetes-wise, reworking some song lyrics with a d-twist, or even writing your own song. Don’t forget dramatic arts too, perhaps you can create a diabetes reality show or play. These are just a starting point today – there are no right or wrong ways to get creative!

Diabetes was here.

Diabetes is everywhere. It is a mostly invisible disease. Sometimes that makes it feel a little more lonely. Even with the people I know personally and the DOC. It is nice to have hints that others with diabetes are around and doing what then can to take care of themselves.

Friday, May 17, 2013


Diabetes Blog Week
Click for the Freaky Friday - Friday 5/17 Link List
Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? (Thanks to Jane of Jane K. Dickinson, RN, PhD, CDE and Bob of T Minus Two for this topic suggestion.)

If I could switch chronic diseases...Well, I'd like one that does not involve too much home monitoring and tweaking. I'd also like one that is not associated with a lot of long term complications.  It would be nice to have one that is not very affected by stress and diet. I would trade for hypertension, for hyperlipidemia, IBS, and maybe for celiac. To me these would be one step up, so if I only got one step, Id think about these. I think these all are a little less involving than T1D, but I would not like any of them they are all still a lot of work and involve whole lifestyle approaches which is tough. If I could, I think I would go for hashimoto's hypothyroid because I could take one pill a day and that would be a lot easier than some of these others.

I definitely appreciate the struggles of people with other chronic illnesses, especially Type 2 DM much more since getting involved with the DOC! I am much better informed of the impact that all of these illnesses have on peoples lives. It is not to be underestimated!

Thursday, May 16, 2013


Diabetes Blog WeekClick for the Accomplishments Big and Small -Thursday 5/16 Link List
We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes...

One of the biggest accomplishments I have made in terms of dealing with diabetes is admitting it is a big deal.  I have spent so much of my life convincing people that diabetes is not a big deal and hiding and minimizing all the work that I do that I even convinced myself that it wasn't a big deal. I do not want pity. I do not want people to worry about me, or try to help me if I don't ask. I do not want to be marked by diabetes. But I am. And it is a big deal. And that's OK.  I can still be awesome anyway. It took me a while to be OK with that. I am still working on it. Now, though, I am better at making time to take care of myself, I am better at asking for help and I am a better diabetes advocate.

Wednesday, May 15, 2013

Second year reflection

So second year…
Well I am not a huge fan of the end of year journal when it doesn’t seem like the end of the year yet. However, a lot has passed since the beginning of the year.  I am tired and more worn out and frustrated than last year; but step 1 is 3.3 weeks away so I guess that is to be expected.  I had a harder time this year balancing school and life, but I think the workload has also been higher. If I had to do the year over, I think I would have done some things differently, but not dramatically. I am excited that this is the end of classroom-based learning, probably for the rest of my life. However, I will miss the flexibility and independence that it has allowed. 

My challenge now is to keep motivated until Step 1 of the medical boards. I am over it emotionally, but I know it is important. My mentor helped when he reminded me that I could just study the stuff I want to learn more about, and while it might not be the best for my score, it would be fine. [At this point in my study schedule.] We have spent so long talking about what we have to learn that it was really good to hear him say that. It was a good reminder that I am here because I want to learn medicine and to take care of people, not just to take tests. 

I am looking forward to being able to focus on clinical skills next year, and applying all of the pathology that we have been learning. I have moments of clarity now when I hear a chief complaint and I can grasp a differential diagnosis, without looking it up, and can ask all the right questions, do the right set of physical exam (I think). I am looking forward to that feeling becoming more and more common. It all makes more sense when that happens.

As for my new year goals, I got my A1C blood draw today so we’ll see how that went. I am still married although lately I think it is somewhat by default because we are not spending much time together. I am very lucky for the support and patience of my husband. I will have a few weeks off before third year to spend with him and also with myself. I am hoping to recharge and relax so I can start third year fresh and excited.  Thinking about how to do that is going to be a very different from how I have been and at this very moment seems tiring. Ironic, I know.


Click for the Memories - Wednesday 5/15 Link List
Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. (Thanks to Jasmine of Silver-Lined for this topic suggestion.)

In high school I attended Clara Barton Adventure Camp. It was a spin off camp where we spent two weeks backpacking, rock climbing, kayaking or similar. It was an amazing way to learn how to manage diabetes and how to be safe doing such variable activities, for hours at a time, away from the safety net of ambulances.

One morning we left our camp site for a day of rock climbing.  On the way to the climbing I was getting very very car sick. I tend to get car sick so I had been sitting in the front seat of the van for the whole trip.  Today, for some reason I felt sick anyway. When we got to the parking lot where we were going to hike up to the rocks, I said I felt very sick and I thought I was going to throw up. My counselor tried to calm me, said we were out of the van and I'd start to feel better soon.  A moment later I dashed to the edge of the driveway and projectile vomited into the woods. (Sorry for the visual, it is the part that makes it so memorable.)

"I guess she was serious," my counselor said.  Once I collected myself and we got all our gear together we set off to hike up to the rock climbing site. It was a 20min light hike up. I wasn't feeling any relief from emptying my stomach so I just sipped my water from my camelback trying to convince myself it would pass. I drank 2 of my 3.5 liters of water on that hike.  At the top the guides were setting top ropes and I sat down for a break. Moments later it happened again, slid down the rock ran a couple steps and threw up 2 liters of pure water (weird right, has anyone ever thrown pure clean water).

It was not until that point that one of my brilliant peers suggested I test. I was 300something. Our nurse counselor gave me a ketostick and I had the new experience of peeing on a strip in the woods...(doubt many people get to do that). It was dark purple.  As dark as dark can be. I checked my hip and sure enough, my pump site was out.  It was still stuck to me, but one corner of the adhesive was off and the tube was out and kinked and happily dosing my shorts all my morning insulin.  It had probably pulled off in the early morning so that my fasting blood sugar of 200ish was not alarming.  And my car sick history tricked me into ignoring my body.

Everything worked out fine from that point. I changed my site (because we brought all back up supplies with us.) I injected my correction directly. My friends shared their water with me since I was getting low on it (despite bringing so much along). I sat out the first round of climbing, but by an hour later I was feeling better and a few hours later I was feeling fine. By the end of the day I was loving rock climbing.

This was my first DKA experience since I was diagnosed 4 years before and my first experience since being on the pump with a true site problem. This lack of insulin thing has happened to me since then. But now I know that feeling. The pasty mouth, nausea, weird feeling in my lungs. And I know now how to handle it.  I know that if I immediately try to down water, I will throw it up, but if I inject insulin, wait about 30 minutes and then start flushing, all will return to normal by the end of the day.

I remember this first DKA experience vividly. I think that being in the wilderness for it and learning how to handle it has served me so well over the years. It has taught me to be prepared (can you imagine if I hadn't had back up supplies with me?!) It has taught me not to panic. And it has taught me that even surrounded by 10 other people with diabetes and a nurse who is there explicitly for that reason, diabetes can be sneaky. I might have caught the DKA earlier, but I didn't and neither did anyone else, and it turned out OK.

Tuesday, May 14, 2013

we, the undersigned

Click for the We, The Undersigned - Tuesday 5/14 Link List
Recently various petitions have been circulating the Diabetes Online Community, so todaylet’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)

We, the undersigned want everyone who is treating someone with diabetes, related to someone with diabetes, friends with someone who has diabetes to carb count for one meal and wait 15min for the insulin to kick in before they eat.