Pumping: A 2 Week Update

As of today, my fabulous husband has been pumping insulin for two weeks. Today marks two weeks that we have been relearning diabetes. It was hard enough the first time around. I think it’s even more difficult when you know stuff, because the new things you are learning are competing with everything you already know!

There have been a lot of questions asked, material read, and adjustments made in the past two weeks. I’ve also had to explain things over and over… and over again. That’s okay, because I am the reader here. I enjoy it, and he’s finally “getting it”.

We have been through four site and cartridge changes, on our own. Well, mostly Chad does it on his own. I get to help hold the cartridge upright. I also get to clean up the mess it leaves behind. HA HA.

He is using the Tandem T:Slim. One thing I LOVE about this device is the ability to hook it up to the computer and upload all  of his blood sugars, insulin doses, etc. We have been able to make adjustments to his basal rate (the insulin that his constantly trickling) based on the graph reports.

We have had a few frustrating days. One or the other of us has given up, because we haven’t been getting the desired results. There were days that his blood sugar has spiked, dropped, leveled. A few days of that and it is frustrating! Fortunately neither one of us has given up on the exact same day. 🙂

On Friday night, he decided he would test his basal rate. Basal rates are tested with the following process, but don’t take MY word for it, please consult your medical professional!

  • Eat dinner, bolus for carbs and any correction units.
  • 4 hours after dinner and bolus, test blood sugar. If within an acceptable range, do nothing. (if low, eat, if high, dose and do the test another night)
  • Every 2 hours thereafter test blood sugar until 12 hours from last meal.

We ate at 6. Chad tested his blood sugar at 10pm, and then proceeded to test every 2 hours. His blood sugar dropped slightly at midnight, then leveled off to dropping ten units(?) every 2 hours, until 4am when he was low enough that he had to drink some chocolate milk. We tested another night, same results and it seems that he drops the most after the 2AM mark, so we adjusted his insulin to take effect at that time. Two nights in a row, his blood sugar has stayed steady! WHOO HOO! That was worth it. 🙂

Now we are working on the day time insulin trickle (the basal). Once we get the basal figured out for all hours, we will start making sure his correction doses and meal time boluses are correctly set.

I may have felt like pulling out my hair a few times. The last 2 weeks have lasted approximately 3 months. It really seems like he has been on the pump forever. It’s sort of like when the baby was a newborn and I thought she was never going to sleep and then I realized she was only 2 weeks old and hadn’t been sleep depriving me forever.

And a positive change? He has been saying no to the cookies and the donuts. 🙂 Win.

Diabetes is so easy to manage!

I think that anyone who has actually dealt with diabetes can hear the sarcasm dripping from that title. Or they were shocked and wondered what kind of snake oil I was going to sell. No snake oil here!

We are back to the insurance company only wanting to cover 1 test strip per day. “102 every 90 days”. Part of having any semblance of control is knowing where you are at. How can anyone do that on ONE test strip per day? I shouldn’t have done this, but I gave up. I said I would just pay out of pocket for them. I know that this gives the insurance  company what they want, which is more money in their pocket, but come on!

To break it down again, my husband has double insurance coverage. Generally the secondary picks up any co-pays or costs that the primary did not pay for. So, 3 test strips a day, leaves a $50 co-pay for us, which the secondary was picking up. They refused to pick up the $50 co-pay for 4-6 strips per day. It didn’t cost them any more, but they still denied it. Now they are back to saying that they will only cover the 102 every 90  days. We tried to explain that he is type 1, because the 102/90 is what they pay for type 2, while they do 102/30 for type 1, but somehow it’s not getting through. I just need the darn test strips, ok?

We have started the process to get an insulin pump for my husband. This should be helpful in managing his diabetes, if the stress of the process doesn’t kill him first. We met with the doctor, who sent  the information to the pump supply, who contacted insurance. Insurance will not consider paying for the device until he does a blood test that shows the level of c-peptides in his body. A Type 1 diabetic has low or no c-peptides, while a type 2 could have normal peptides. From my research, it seems that they would require a person with normal or high peptides to control their diabetes through diet and exercise. Since my husband is type 1, this is  not going to happen. 45 years of medical records seem to make little difference.

There are two requirements for the test:

  • fasting after midnight
  • blood sugar below 150

The first night, I woke up shortly before midnight and checked his blood sugar. It was 82, so I had him drink some chocolate milk. I woke up again at 3, and it was 62, so he had more chocolate milk. He could not do the test because he was no longer “fasting after midnight”. Last night, I checked him at midnight and he was a little on the high side, so I woke him up and had him take a shot. He was still too high this morning for the test, so we will have another go at it tonight.

It’s really frustrating that I know other diabetics who have taken this test, but they were not required to have a blood sugar under 150. Generally, he is under 180 in the morning, but it is rare that he is under 150. Even if he was under 150, there is no guarantee that it won’t go up between  here and the doctor’s office and waiting to be called in for the lab. Or, it could go the opposite way, he could be under 150, but drop rapidly because he has been fasting since midnight.

We will do this. WE WILL. I am flabbergasted at the amount of frustration that a insurance company is willing to cause a diabetic. He wants a pump to have better control over his diabetes. He wants a pump to have more normal blood sugars. Making my husband meet a list of requirements, although short, makes him feel like a failure when he doesn’t meet them.

We would love your prayers for better results tonight. If he could get this part out of the way, I know he will feel victorious.

Sugar!

Yesterday my husband and I were at Lowe’s, looking at this and that. When we found something we wanted, we moseyed our way up to the cash register. I looked at him and asked if he was okay. He said “Yes”, but I could tell by the look on his face that his blood sugar was low. I asked him if his blood sugar was low and he said “yeah, it might be”.

It was just a quick trip to Lowe’s while the baby was napping and I didn’t know if we had glucose tablets in the truck. The soda fridge was right there, so I grabbed a Mt. Dew, “just in case”.

As we walked to our vehicle, I looked at the nutrition label and gasped. “This has 77 grams of sugar in it!”‘ I told him that if his blood sugar was low, he only needed to drink like a third of it. He tested at 54, and drank just a third. I was actually surprised. He typically chugs a soda if his blood sugar is low, which makes it go sky high. Those of you with diabetes know the drill. Too low, too high, just right is somewhere in between.

When we got home, I got our little scale out and measured out 77 grams of sugar:

20150615_163731

It’s not the world’s greatest picture, but LOOK AT ALL THAT SUGAR! In one 20 oz soda!

How much is 77 grams of sugar? There are 4 grams of sugar in one teaspoon. (77 grams = about 19 teaspoons) Three teaspoons in one tablespoon. (19 teaspoons = about 6 tablespoons) Four Tablespoons in a quarter cup. (6 tablespoons = 1/4 cup + 1/8 cup)

To say I was flabbergasted is an understatement!

I have never been a diehard sugar avoider, but this made me look at some of the foods I eat. Yikes.

The World Health Organization recommends that the maximum amount of added sugar per day for women is 25 grams. For men, 37.5. So if you are a woman, a Mt Dew is three times the daily allowance, and twice the daily allowance for a  man.

Whoah.

At first I was confused, because milk has 12 grams of sugar per 8 ounces and I thought “Wait! That is half the daily allowance!” Thankfully, it is ADDED sugars, although we should not be overindulging on the natural sugars either.

If it wasn’t for my husband’s diabetes, I might not have even noticed how much sugar is in stuff. I tell you, I was a crazy woman, running around, checking the nutrition label on EVERYTHING I put in my mouth. It’s not pretty. Sugar is added to nearly everything. They don’t make it easy for you either, because added sugars and natural sugars are counted together on nutrition labels. So you kind of have to super sleuth it.

How much sugar is in your favorite food? Have you ever realized how much sugar is in everything we eat?

As a side funny, my husband told me that the 77 must have been a misprint, he’s never seen it that high. I used that trusty Google to visit the manufacturer’s site and there, right on the site, 77 grams! I showed it to him, then he brought up that time that I thought the speed limit on our road was 40 and went to prove it and it was only 35. I don’t know what that has to do with sugar, but whatever. 😉

Let’s Grab a Bite to Eat

I prepare, shop for and cook meals approximately a bazillion times a month. There are some days that I just don’t want to do it again.

Or

There are times we are out and about. We didn’t plan very well and someone gets hungry and/or my husband needs to eat because he can feel his blood sugar dropping.

So let’s grab a bite to eat!! A burger, some fries, a soda! Yum.

If only it were that easy for my husband, a type 1 diabetic. It’s easy to grab a bite. It’s more difficult to figure out how many carbs are in a meal so he can dose properly for it. Fortunately with smart phones and web sites, the nutrition info is usually right at our finger tips. I have the mad Googling skillz yo!

I’m going to be completely honest here. My husband and I were blown away, flabbergasted, and shocked at the nutrition info for a lot of meals. One glass of regular soda at Shari’s had 48 carbs. 48! If my husband were to drink that, he would need to take 6 additional units of insulin. (he always orders diet, but recently we went to Shari’s and our totally distracted waitress brought him a regular soda and not diet. And this is how we know how many carbs are in a regular soda)

Typically, a meal from a restaurant has more than DOUBLE the carbs of a meal I prepare at home. And do you want to talk about the calories? My husband’s employer often orders lunch for everybody. We looked up the menu online and an order of a burger and fries had 1800 calories! This is how many calories it is recommended that my husband eats per day. IN ONE MEAL!

I can’t even imagine the people who don’t need to know the nutritional info. Downing 3 or 4 sodas because they are unlimited. UGH!

When my husband orders a meal now, he immediately asks for a to go box and splits his meal in half. He only eats half and saves the rest for his next day’s lunch. Meals at home are typically 30-45 carbs, Meals in a restaurant, or the meals he likes, are typically 90. Splitting his meals in two reduces the amount of insulin he takes, and carbs and calories he consumes.

We are also attempting to be proactive. His employer orders from the same restaurants frequently. We are looking up meals and noting how many carbs are in what he orders. This way he never has to guess at the last minute how many carbs he is about to consume. He has proven time and again that diabetes and guessing just don’t play well together.

In summary, grabbing a bite to eat is just not that easy for a diabetic. And there are more calories and carbs in that bite to eat than you realize. (UGH!)

Do you eat out a lot? Do you know how many calories or carbs are in the meals you eat? 

As a side note, I was so disgusted when the next city over from us started posting the calorie count of items on their menus. I never ordered a milkshake again. 😦