Saturday Morning Sleep in

11am 111

6p 286

1am 129

On weekends, I sleep late and don't check as often. Today we were supposed to go check out the dealership, but if snowed something awful so we went to Donna's for lunch instead. I had a Roast Beef sandwich, which was AWESOME!!! Then we went to the Walter's Art Museum. I didn't check between lunch and dinner because we were in the museum for obvious reasons. At home I expected a high reading. Why?

Fresh deli lunch meats can have preservatives such as spices and sugar and I can never gauge that correctly, especially when I eat a large Italian sub... Mmmmm mmmmm mmmm.

End of the day, I'm doing great.

Dealing with Happy Hour

So let me just list my BG for the day first.

9am 129

1pm 198

4pm 158

9pm 428

1am 131

So here's how my day went. Great start, proof that I'm obviously not having a basal problem. I started Amoxicillin for a nagging cold, which may have been the whole root of my out of control problem. Lunch was soup and some rice and a banana, very calculated.

SO I'm seeing that I really do get a small rise in BG. I don't know if its because I'm not eating breakfast (I'm very doubtful when it comes to dietitian's hand waving), but it does rise in the morning by ~40-60mg/dL.

When dealing with an event that I KNOW I will get high BG at, I always check immediately before and if its a long event, I'll check in the middle. I SHOULD have checked before 9pm, but mom called and I talked her through her first insulin shot as a type 2 diabetic. I know that's pretty ironic. BTW her doctor is way worse than any doctor I've ever seen... seriously.

SO it was the Stout beers (4-5) and chips that sent me soaring, but you can seen that by the time I went ot bed it was doing really well.

Busy with Westerns

Today, I'll be running around with western blot in the lab. I woke at 105mg/dL (9am) and had lunch with a 166mg/dL (1:30pm). I've been told repeatedly by doctors and dietitians that if you don't eat breakfast, your body will release some extra glucose. For clarification....

I DON'T EAT BREAKFAST!
Never have, never will. So I wish the medical profession would just leave me alone.

That being said, I usually don't find this to be very accurate. I've had my lunch sugars go in both directions and stay the same. Its like rolling dice. Usually it goes up by about 20mg/dL. I don't have a very energy requiring job. Mainly walking back and forth between rooms and concentrating on expts, so that generally doesn't account for any change in BG. So I'm happy with these numbers.

Its 5pm now and I'm at 77mg/dL... a bit lower than I'd like to be. I don't know why though. I didn't do anything spectacular.... AHHHHHH!!!! I know.

Whenever I have high carb meals, which I consider to be anything over 75g carb, I tend to lose control either high or low. Typically my sugars go much higher than expected but sometimes lower. Today was a 115g carb lunch.

Another possibility is that with the sun staying out a bit longer, the changing of season to spring could be causing the bolus ration to go from 1:8 to the lower 1:10. I'm not changing the ratio today, but its something to note.

Basal is Fine!

Maybe I'll post my doctor's comments on here at some point... maybe right now actually. Early this January I was concerned about my lack of control and wrote to my doc, Dr Saudek. During the winter months I tend to have difficulty keeping my sugars in control. Usually I had many others problems, including Holiday parties, depression, apathy, or poor medication. But this year, most all of that was eliminated and I STILL had great problems keeping my sugar levels controlled.

"Hello, I'm becoming more and more concerned about my insulin usage.
Briefly, my HA1C is ~8.9 and I have been having problems keeping my BG under control during winter months. When I met with Dr. Saudek onJan11th, he made a couple suggestions. First, I increased the correction ratio from 1:50 to 1:30. Second, I increased my carb ratio from 1:15 to 1:10.
Since then, I still see high BG levels, even when I have increased my carb ration to 1:8. For several mornings, I started at ~180 and without correcting; I am at ~160-170 by lunch time. This lets me know that my basal of 1U/hr is about right. After lunch of a very specific carb amt and a correction I still end the day at 5-6pm with a BG of180-190. This tells me that the correction or carb ratio is off. Other nights I start high at about 190 and take the correction at 1:30.After 2.5h without eating I am at 120. This tells me that my carb ratio is probably wrong. So I increased it to 1:8. I STILL have a BGof ~180 before dinner when I had a lunch BG of 100 at lunch.
Before I increase it further to 1:5.... I worry that this is getting crazy with the insulin dose. Is this normal? According to other people, this is the dose for a 250lbs inactive man. I am a 170lbs fit man. I don't exercise a lot, but I'm far from a vegetable. Aside from Max Bolusing when I eat more than 100g of carb at a meal, what should I be worrying about? Is this normal? I really need some help figuring this out.
Thank you for your time and help. If needed I can send a spreadsheet of BG readings on Monday from my work PC."


He actually got back to me quite fast and said that my spreadsheet would be quite helpful.
"Dennis I don't have chart but Sounds like basal is too low esp over night you should not have fbs [fasting blood sugar] over 120-130 Do send your spread sheet"


OK... so I send him the sheet with a message and he responds, again very quickly, with his response within the message to each question I pose.
"Dr Saudek, I attached the graph of the past couple weeks. NO PATTERNS EVIDENT IN THE GRAPH. MAINLY A LOT OF VARIABILITY. I wanted to assure you that the mornings I woke at 180 were due to me not checking before bed and waking high. THIS IS TOO HIGH A WAKE-UP FBS... SUGGESTS THAT YOU DO NEED A SIGNIFICANT "DAWN RATE" TO BEGIN WITH. NANCY CAN WORK ON THIS WITH YOU, AS MUCH AS 50% INCREASE IN BASAL RATE FROM 4 A.M. TO 8 A.M. Typically my post dinner readings are high, and if I correct, I wake at either normal (~100) or low BG (at ~4am). SO THE GOAL IS TO GIVE THE RIGHT AMOUNT BEFORE DINNER, SO YOU ARE NOT HIGH AT BEDTIME. Thank you for taking the time to look at my records. Several of my lows aren't recorded and I will try to take those measurements before eating.
PLEASE DO BE IN TOUCH WITH NANCYELLEN. CDS”





So its like he's not listening. Its like he doesn't understand what I'm saying. My basal is fine. Again, I went to bed at 166 and woke at 105! If I increased my basal by 50% in the 4-8am, that would be 60mg/dL drop. I'd be at 35mg/dL this morning. Greeeeaaaatttt advice doc. Hypoglycemic coma is a great way to stop BG irregularity.

Look, I'm a scientist with a PhD in biochemistry. I know what’s going on metabolically and I know how to set up an expt. But sometimes I need help with approaching the question or deciphering the data. And sometimes I'm just tired and frustrated and I've been a poor diabetic, so I don’t like the data, but at least I understand it. But in this case, I had been a very very good diabetic and I was suffering. I've had inconsistent results and repeatedly told Dr Saudek that my correction and basal seem just fine. But instead of offering help on how to adjust the basal or answer my primary question... IS THIS OK FOR MY HEALTH TO HAVE SO MUCH INSULIN?... he parroted back "To much variability and increase the basal."

Ridiculous. The man might as well read from a cereal box because his advise is not sound or insightful. I'm at Johns Hopkins where they apparently keep the tenured doctors in clinics no matter how bad their advice can be. In a very roundabout way, Dr Saudek basically said the dreaded, "You need to check your blood sugar and take your insulin," which is insanely irritating, pointless, and futile. That statement never helps.

In short, my basal is fine. I have a BG and 5hours later, without food or a lot of exercise, it’s the same or close to it. If I go to bed at 120mg/dL and haven’t taken insulin within the past 4-5hrs, I wake up at ~120mg/dL. To me, that shows a good basal.

Always question your doctors suggestions. ALWAYS! You have the right to ask and remember, they are human and tend to make mistakes. Asking questions forces them to defend their response and possibly correct themselves before you leave the office. At worst, you leave with a better understanding of your problem and the purposed treatment.

Wed Jan 27, 2010 - New Spot

I was getting tired of a dozen dots on the front of stomach and last night I tried my back ride side.

Last night, 3hr post dinner, I was very high (288) and corrected before bed. This morning I was still high (235). My feeling is that there is less fat on the back side and for whatever else reason, adsorption is not the same. Unfortunately, I just filled it last night, so I don't want to throw out 3mL of insulin.

I'll ride this one out. and monitor throughout today.

By lunchtime (~1pm) it was 166. Not too bad! But I knew later I would be going to a JHPDA Happy Hour. The Happy Hour started around 5pm, and I tried to only drink Michalob Ultra and not eat chips (instead I ate cheese, veggies, and the toppings on the pizza). It was a very successful Happy Hour and lasted for a long while. I got home around 9pm.

BG 9pm... 331. Honestly, considering my day, that's not as ridiculous as I thought it would be. I corrected and ate some Ramyum for dinner. Going to bed soon. At ~11:45pm I'm at 166, so I guess today my bolus is working.

Planted PR in Town Hall

While going through all the phone calls and trying to find answers and numbers online, I've come across two video clips from news channels. Both point out that huge Republican Party, Oil-Conglomerates, and multi-millionaire far right conservatives are funding these "Town Hall Storms" that essentially shout out the competition on Healthcare Reform.



Some groups actually bus people around so they can barracade the Town Hall, chase the Congressmen from and to their cars and yell during the meeting. The GOP's stance... these are just run of the mill average Americans voicing their opinion.

Wisconsin Mom or GOP Plant


Plot to Kill Old People



EDITS:
Great new story. Old people don't want government run healthcare. Old people are on Medicare.... which is government run healthcare. However, they think Medicare is OK. They don't want to change it. They don't want government run healthcare like Obama is suggesting....

WAIT? WHAT? (Halfway down, Rep. Gene Green D-Tex)
http://www.nytimes.com/2009/08/07/opinion/07krugman.html?_r=2&ref=opinion

Finding Healthcare for a Diabetic

I'm a Type I Diabetic (insulin-dependent). For ~14yrs I have given myself insulin injections daily to meet my insulin needs. Throughout these years I have encountered some of the most inane physicians and incredibly few credible doctors. In Wisconsin I met with an great Endocrinologist (Dr. Paul Reber) that told me I was on an archaic regiment. Later - after Dr. Reber had left my clinic - I struggled and had to frequently change my Lantus dosage and timing. Now, after five years of trying to get insurance to help pay for an insulin pump AND to cover a percentage of supplies to USE the pump, I have succeeded. My control is AWESOME! The first 3 months and my HA1C dropped 3.5points.

In truth, the quality Healthcare is what I depend on to keep my quality of life high. I am also well educated in biology of life systems (a Biochemist PhD and now PostDoc at Johns Hopkins Radiation Oncology). I know exactly what is out there and what can really be fundamentally good for my health. Unfortunately, health is another one of the areas where the rich get better "things". Good health has a price and rarely does it depend on 'knowing' whats best. It depends on if you can AFFORD what's best.

That insulin pump... that exact company and model... has been available for a little over 15yrs. I JUST GOT IT. My HA1C has always been high for the past 14yrs(Medtronic Paradigm). My sugars fluctuate daily and throughout the night. With mis-education and out-of-date therapy I was trapped in a circular decline in health and generally being treated as a problem and not a victim. Being able to precisely control injections and the frequency of injections would certainly have helped improve my health and in fact - IT DID IMPROVE MY HEALTH!!! I simply couldn't afford it until now. So my government and country let me rot in my own disease, which I did not cause, because I didn't have the money that others did. Money - unlike my mother's motto - really could buy happiness and it was exactly the kind of happiness I wanted.

So sitting here, I wondered what would happen to me without any insurance at all. Up to this point I complain like a war veteran. Speaking honestly, I have a very cushy stress-free life compared to most. I have job in a nice building, a beautiful wife, a clean and furnished apartment with food and water. And on top of it, I have Healthcare and Dentalcare. I am sitting on a gold toilet and pooping silver... what could I complain about?

Well.... what if I lost my job?
What if my next job didn't have Health Insurance?
What if I die and my job doesn't have Life Insurance?

So I went to find some answers. Just as a precaution. The story with Healthcare in the USA is stereotyped atrocities riddled with horror cases. Is it true or just hype? After watching "Sicko" and listening to the GOP rant about government control, who knew? I wanted to see what an educated, motivated, and technically savvy person could find online and on the phone. I went online first and then to the phones. What I found (our rather didn't find) was actually WORSE than I thought. The maze of confusion and ill-given direction was mystifying and boggling. What's worse was that everyone wanted to know my info (which I refused) and once I said diabetes, they really didn't care... "Oh........... you have diabetes.............. well then...... it really doesn't matter because you'll be declined."

I decided to write this down and to try and find some answers so that others might benefit. For myself, I hope to always have company provided Heath Insurance until I go on Medicare/Medicaide. But the future isn't destined. It just happens.

So follow as I post what I found and what you do if you find yourself without Healthcare. And while you read... consider how you could help relieve the stress by supporting the efforts to have a Public Option available to people who have a tough time finding Health Insurance. So many politicians are against that change because of the vast monies involved. And truly.... maybe we all would do the same! I mean really, the reason I'm pissed is because I can't afford what I need. If I could afford it, maybe I wouldn't care either?

I hope you do care. And I hope you follow, comment, and share your feelings.