Just Call Me a Super Hero

How’s that for an attention grabbing title?

I feel like a super hero after the night we had. Chad was set up on his pump yesterday! YAY. We went with the Tandem T:slim. It seemed to be operator friendly. He isn’t a techy guy and it’s the one he felt most comfortable with. It’s amazing that he can dose whenever. He doesn’t have to dread the shot. he doesn’t have to “catch it up later”, because he dreads the shot. WE LOVE THAT PART!

However, it was a bit of a rough night. I told him I would get up several times to check his blood sugar, since it was the first night on the pump. He was 125 at bedtime and more than 3 hours after dinner, which is an amazing blood sugar for him. For the first time ever, he didn’t eat a snack or anything. That trust and confidence was so hard! When I woke up at midnight, his blood sugar was 50. I gave him about 40 carbs of chocolate milk. I woke up at 3 to check and his blood sugar was 70. Another 40 carbs! When he woke up at 5, took forever in the bathroom,  was stumbling a bit, I got up and checked him. 36!!!!

I told him it was okay to go into work late. Usually he doesn’t. He gets back on the saddle and makes it into work on time, but I wanted to make sure he was okay first. I quickly googled “How long does Lantus stay in the system?” He was taking it twice a day, half a day’s dose at 8am and the other half at 8pm. His trainer set his pump up so his basal (this is the background insulin that runs continuously all day) didn’t start until after 8pm last night, but we are pretty sure he still had the Lantus from yesterday morning in his system as well, since it can last 18-26 hours! He conferred with his trainer this morning and she agreed that it was likely. Just to be safe she walked him through lowering the basal rate just a bit. (from 2.0 per hour to 1.8 per hour)

As far as the first day on the pump, he is loving it. He really likes not having to take shots. He loves that he can input his blood sugar and carbs and it will figure out his insulin dose. This is a new thing for us and we are fumbling around a bit, but in a week it should be second nature. He has done one infusion set. He will be doing a cartridge change and infusion change tomorrow morning with the trainer.

He has been approved for a CGM (continuous glucose monitor). This will be his next step.

I am hopeful that today will be a better day. He did end up going to work and got there just a little late. He is an excellent family provider and he hates missing time from work. Sometimes diabetes comes first!

ETA: I guess I should explain the super hero comment. I feel like a super hero after saving his life three times last night. :p I’m tired, it makes ME feel better.

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.

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. 

Links and Resources

It’s a short one today, dear readers. Short but important. I want to share the links and resources that I find are valuable in managing my husband’s diabetes. He tests the blood sugars and gives the shots, but I learn the info. It works for us.

Here are two other diabetes related blogs I have come across since starting this blog. To be honest, they found me, and I am so glad they did. I enjoy reading their writings:

Diabetes and Donuts

MumofType1: Surviving parenting 3 boys, one with Type 1 Diabetes

Resources 

These are a few of my favorite go to Resources

Think Like a Pancreas This is my go to book. It has great information. The best part is it’s written FOR diabetics BY a diabetic. (Type 1)

Google Yes. I love to google. It is quick, easy, and painless to Google “how many carbs are in watermelon?” Try it. 🙂

Calorie Count We make a lot of meals from scratch and the carb count isn’t always available. This website makes it simple. I have found a few times when the carb count was off, but balanced with what I know and what I can Google, it’s a wonderful resource and gives a ballpark idea.

Apps: A list of apps for helping to manage your diabetes. These are Android apps, because that’s what we use. I know that Apple has some too. 🙂 My husband uses Accuchek. He has finally ditched the small paper book, which is great because those are getting difficult to find!

What are some of your favorite resources? Do you know of other diabetes related blogs? I’d love to visit! 

Test Strips, Test Strips Everywhere!

My husband goes through a lot of test strips. 4-6 per day on a good day, up to 8-10 on others. He says he throws them away, but I am telling you, I FIND THEM EVERYWHERE! I’ve heard other people say the same thing about their family members, friends, or self with diabetes. Test strips everywhere. When we were on vacation, I found test strips in the driveway. I wonder if he has ever inadvertently left any in a restaurant?

I knew that he had reached new heights in dropping test strips when my 15 year old daughter came in the kitchen and said “I just found one of daddy’s test strips… IN MY BED!”

Now this is a miracle. He never even goes in their room and she is in the top bunk of a bunk bed!

We’ve got test strips…. everywhere!

What is a Carb and Why Does it Matter?

I Googled “What is a carb?”

Google said “Short for carburetor”.

Close. It wasn’t quite what I was looking for.

Carbohydrates, what they are, and how they affect the body are as important to a diabetic as insulin.

Let’s start with what a carbohydrate is. A carbohydrate is defined as: any of a large group of organic compounds occurring in foods and living tissues and including sugars, starch, and cellulose. They contain hydrogen and oxygen in the same ratio as water (2:1) and typically can be broken down to release energy in the animal body.

Um. What?

Foods with carbs are typically pastas, rice, bread, potatoes, sweets, sugars, etc. Carbs! Glorious carbs. I love carbs. 

That sounds simple enough, but it gets tricky when you learn that there are simple carbohydrates and complex carbohydrates. Simple carbs are sweets, white breads, potatoes, sugar, sodas, donuts, etc. Fruits and vegetables also consist of simple sugars, but the body processes them like a complex carb.

Complex carbs are carbs that take the body longer to break down and process. This gives a more steady release of sugars throughout the day and is better than the spike and dip of simple carbs. Complex carbs are whole wheat (rice, pasta, bread). Complex carbs are better for everyone.

Just to complicate things, one carb doesn’t always equal another. 15g of carbs from a bowl of cream of wheat affects my husband differently than 15g of carbs from a potato. If only one equaled another. He has to keep track of how many units of insulin he needs based on carbs and also has to remember that sometimes he needs to take more or less for one food than another.

The body uses carbohydrates for energy. The moment you put it in your mouth and swallow, your body starts processing it. Carbs cause your blood sugar to rise, then your pancreas produces insulin to absorb blood sugar for energy or storage.

Unless you’re diabetic, because your pancreas is broken and not producing insulin. A non-diabetic person’s body automatically calculates how much insulin you need and distributes it.  A diabetic has to do this calculation themselves, taking into account current blood sugar and carbs to be consumed. Then they administer the insulin (synthetic) their body doesn’t produce. Without insulin, your body doesn’t know to level off. A normal blood sugar is under 140. Kycie was admitted to the hospital and diagnosed with T1D. She had a blood sugar of 1,148. This is what diabetes does!

I imagine that for a typical person, the amount of carbs in a food is not particularly important. It seems most people know there are good carbs and bad carbs, even if they like to indulge in the bad. A diabetic needs to be aware of the carbs in any and all foods and drinks that they consume. It’s not as simple as it sounds. Some food doesn’t come in labeled packaging and if it’s a vegetable, you might not think there are carbs in it. Carrots have carbs. My husband loves carrots, so he needs to be careful to either dose for the carbs, or not to over indulge.

I don’t know why anyone would willfully over indulge on a carrot, but hey, that’s me. He sings his own songs. 

Fortunately, these days, information is practically at our finger tips. It is very easy to search “How many carbs are in a carrot?”. 6g for one carrot, in case you were wondering. With this information, a diabetic can calculate their insulin dose, inject and eat. My husband would not dose for one carrot, but if he was eating 3 of them, he would need to do so.  (There’s a calculation and it’s not a one size fits all formula and if you figure out YOUR formula, it can change. Because it wants to. Diabetes is its own boss, it doesn’t need a reason.)

My husband has to be aware, all the time, of all the carbs. If he thinks he doesn’t need to count a carb, he is usually wrong. On Saturdays, we like to grab a coffee. He always gets a sugar free Double Torture. He used to never dose, but then we found out there are 16 carbs in the milk they use. He started injecting two units of insulin prior to drinking it, and hasn’t had wild blood sugars like in the past. “But I only had that sugar free drink!”. Sugar free does not equal carb free and it matters!

Sometime we’ll talk about that time that the waitress served him a regular drink, instead of diet. Fortunately he noticed. We can’t imagine what 38 extra carbs not accounted for, would have done to his blood sugar! By “noticed”, I mean after he drank practically the whole glass, he pushed it across the table and said “I don’t think that’s diet”. I tasted it, confirmed it was not. So he recalculated his dosage, with the extra carbs included.

Carbs. They matter.

Please don’t take anything I say as gospel or fact. Do your own research, talk to your own doctor. If you see a mistake I’ve made, please bring it to my attention. I wrote this based on personal experience, reading, dietitian appointments, and internet searching. I am not a professional, just experienced. I’m going to get to some fun stories some time. I’m starting with the basics. Ha. None of this sounds basic though. Even writing it down makes my head spin and I am not sure how we do it.  

Sources:

http://www.diabetesforecast.org/2011/mar/how-the-body-uses-carbohydrates-proteins-and-fats.html

http://www.everydayhealth.com/diet-nutrition/101/nutrition-basics/good-carbs-bad-carbs.aspx

http://www.hsph.harvard.edu/nutritionsource/carbohydrates/carbohydrates-and-blood-sugar/

http://www.webmd.com/diabetes/how-sugar-affects-diabetes