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.

We Are Making Progress!

I know it’s been a little quiet around here. First my husband went out of town and I found myself with a lot of free time! The night he left, I started painting the bathroom. I’ve been meaning to for a long, long time. We’ve lived in this house for a whole lot of years. It’s been painted once. It was time..

Speaking of my husband being out of town. He survived. Hurray! To ease my mind, he tested his blood sugar at 1:00AM and texted the results to me. This way he wasn’t going 8 hours without testing his blood sugars. They did run a little high during the week, but we attributed that to all the eating out. The first night, his dinner was 90 carbs! 90!!!

So, he’s home and all is well. Yay. 🙂

We went to a new endocrinologist yesterday. I really, really liked her. I have been to the same clinic with my father, but a different doctor and I don’t really care for her. His doctor discredits a lot of what I say and doesn’t listen to me. My husband’s doctor was good about listening to both of us, answering our questions, giving advice, etc. She told us that diabetes is NOT an exact science and that there isn’t a one size fits all approach to it. I told her that we often feel like failures when his blood sugar is too high or too low. I prefer when it’s just right, but she told us that it’s really hard to hit that magic number. She was impressed with his A1C, which is interesting, because his general doctor is constantly telling us he needs to get it down. His endocrinologist said that a lot of times when the A1C is in the ideal ranges, it comes with the risk of low blood sugars. So he was looking good!

She put in a referral to the nutritionist who is also in charge of all things insulin pump related. She feels that he is an ideal candidate for it. Even with all the research I have done, I didn’t realize that he wouldn’t need to take his long acting insulin anymore! I know that pumps can be expensive, but I am hopeful that with double insurance coverage, they will cover a good portion of it.

So now we wait for his referral to go through. I am so excited about the process and next steps. His endocrinologist feels that he could be outfitted with a pump within the next 6 weeks. So exciting!

Diabetes Yo Yo

It was a bit of a rough night. The morning started way too early for my liking, although our two year old seemed okay with it. (UGH!)

When my husband tested his blood sugar last night, it was in the 240’s. We kind of expected it to be high, because we had jasmine rice at dinner. We rarely have rice, but last night I was hankering for this for dinner. I will be having it for lunch today too. It was hard to stop at just one bowl. 🙂 At about 2:30AM, I heard my husband’s c-pap machine turn off. At 5:45, I don’t notice it, but my mind must have known it was the wrong time. I sat up, put my glasses on and asked what was going on. I asked if he had a low blood sugar and he said he thought so. He sounded a little slow, so I got up to check it for him. 57!

In the course of four and a half hours it went from 240 to 57.

This does not reassure me about his upcoming business trip!

After bringing his blood sugar back up to the normal range, covering the sheets from his sweat fest, and laying back down, I couldn’t sleep. First he was snoring. Then that two year old wasn’t interested in going back to sleep. I was going over “Where did we (I) go wrong?” And I couldn’t stop thinking about how to prepare him for his trip, to ease my mind and to help him in the case of a low blood sugar.

I told him that he had to wake up to test each night he is gone, no matter what. I am going to make sure he has some Squeezable apple sauce, pbj’s, and small sodas available. And I am going to pray A LOT.

(What are some other ready to go snacks he could have available?)

Parents of kids with diabetes, how on earth do you survive time away from your kids? I feel like a control freak, or that I am being really annoying about this. We’ve survived time apart before, but still I worry.

By the way, I went to the library yesterday and brought this home:

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Just a little light reading for the kids’ summer break. 🙂

Back to that low blood sugar, what’s the deal with rice anyway?

A Diabetes Break

The thing with diabetes is it never gives you a break. It is constant and you always have to TRY to be one step ahead of it . Some days you will succeed and others you will fail miserably. Every day you have to get right back on the horse, or the bike, or your motorcycle and try, try again, because giving up is not an option. My husband will never ever get a break from diabetes. It will go wherever he goes. It’s a constant companion. No matter where he goes or what he does, he will have to consider diabetes. It’s almost like a girlfriend that turns into  a stalker when you try to make it go away.

My husband will be going on a business trip soon. He will take his diabetes with him. He will take a box full of goodies, hopefully enough for his time away. He will need some carb-y snacks and some low carb snacks. I’ll probably stick some peanut butter, crackers, glucose tablets, etc in there. I will also probably worry the entire time he is gone. Especially at night. He sleeps soundly, but I get up at least once per night. No matter what wakes me up, I make it a habit to check on him. Depending on what his activity level and/ or blood sugar was before or at bedtime, I might check his blood sugar.

These are the things that worry me when he is away for any length of time. It hasn’t happened very often. I can probably count on one hand how many times it has. When he went to Reno 16 years ago, I don’t remember worrying. He was diabetic then, but it hadn’t infiltrated my life as much as it does now. We are constantly checking in with each other on his blood sugars, his insulin doses and how he is feeling. He CAN count carbs, but typically he relies on me to tell him what they are, because I prepare most of his meals. (he’s generally on his own for breakfast and takes leftovers for lunch)

So he won’t get a break…. ever, but I will. He will be gone and I won’t be able to count his carbs or prepare his meals. I won’t have to meal plan with him in mind, while he is gone. The kids and I can graze if we want, we can have ice cream, sandwiches, cereal. I won’t have to make sure that the meal I am providing is well rounded.

It sounds almost delightful, but I am sure that when the time comes, I won’t think so. I will probably worry too much to really enjoy it. He HAS promised to keep in touch morning and night with his blood sugar readings. It sounds awful, like he has to check in with a mom, but he knows that it gives me peace of mind.

And as a side note, have you seen this? http://www.wral.com/news/national_world/national/video/14722595/

Do you think a cure for diabetes is possible? I’ve seen many hopeful “cures” that haven’t panned out, so i am a bit hesitant to get excited about anything that seems possible.

I’ll check back in at a later date and let you know how the time apart went. eeeek.

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:

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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. 😉

Have You Tried Essential Oils?

Ahem. I might step on a few toes today. That is not my intent, but sometimes the suggestions given to my husband are crazy, even if they are well intentioned. Nobody likes to see a friend or a loved one suffer from a disease that *might* be cured or managed. My husband has heard some zingers. These are a few of the suggestions he has heard from others regarding his diabetes and the reason(s) why he is not/ has not/ will not try(ing) them.

1. Have you tried essential oils? No. His doctor doesn’t really recommend essential oils has a viable method of controlling his diabetes.

2. I heard that okra in water will cure diabetes. No. I think if this worked, we would all know about it and there would be an okra shortage. (Source: http://www.diabetesdaily.com/blog/2014/03/why-okra-will-not-cure-your-diabetes/)

3. If you just had more faith, your diabetes would be cured. Do I believe that God COULD cure diabetes? Yes, but so far He hasn’t. My husband said that he was approached at a family wedding by an aunt who thought she could cure him with her faith. This many years later, he’s still diabetic. This has become an inside joke for us though. When his blood sugars are whacked, I tell him to get “in the word”. I’ve heard it’s a cure for all that ails ya. (Don’t hate us, we’re believers. We also think we are funny)

4. Medifast.  I can’t tell you how many times Medifast has been recommended for my husband for weight loss and diabetes control. I have seen Medifast work wonders for some people. I am not discounting that it’s a great product for some people; however when we looked into it we were told that my husband needed to check with his health care provider before starting this program. In fact, straight from here is this: If you have type 1 diabetes, it is essential to discuss Medifast with your health care provider or diabetes specialist before you start any of our plans for weight loss. He has been seeing the same doctor for 15 years. He has a good relationship with him. He asked him about Medifast. His doctor said that he did not think this was a good option for my husband. Rather than leave the people hanging that had recommended this to us, I politely informed them that his doctor did not recommend this route. These were the responses:

  • “What? Really? I have never had a doctor say no before” (There’s a first time for everything?)
  • “He obviously doesn’t understand what it is. Let me give you information to take with you next time. In fact, do you want me to come with you?” (no)
  • “That’s weird. Our doctor said it was okay for my diabetes.” (ok)
  • “Why would he say no? That doesn’t even make sense!” (none of your business)
  • “If his doctor said no, he has a good reason. Honestly, I sell it and wouldn’t recommend it for your husband.” (smile)

5. What about an insulin pump? Yes. Yes. Yes! We have looked into this before, but at the time, the cost was prohibitive. Now my husband has double coverage. I just checked his benefits and BOTH insurances cover the insulin pump! He has had some major medical expenses in the past two years and our out of pocket costs have been minimal. It looks like this will be the case for the pump. He has an appointment with his doctor soon and we will be asking about this again!

Did I step on your toes? I hope not, but when you are a diabetic (I am not) you have heard it all…. for the most part. To keep our patience, we try to remember that people are just trying to help because they care. It’s actually the people who are offended that we are not taking their suggestion that test our patience. We have learned to say “Thank you” rather than give the reason why what they said will not work for him. If you are diabetic, what are some helpful/ unhelpful things you have heard to cure or manage your diabetes? 

ETA: Out of all these things, the only one he has tried is prayer, although he isn’t praying that he’s cured. He’s praying that he manages well. So he can’t say without a doubt that none of these will work to manage his diabetes. 🙂

P.S. in an earlier post I talked about how my husband’s insurance only wanted to cover 100 test strips a month. We talked to a different pharmacist the last time we filled his test strips and she knew the work around/ coding needed for insurance. They just needed to know that he had a condition that required the test strips, because people like to fake diabetes, you know.