Today, I am celebrating my 25th birthday. I am at that age where people start dreading getting older because the only thing they have to look forward to is trying to unsuccessfully stop time even up until the night before the big 3-0. I, on the other hand, am not. I see birthdays as a celebration, no matter what the age may be.

For my birthday, I have a goal to not overly worry about my diabetes on this day. Of course, I am not going to go overboard and just completely ignore it (and, yes, tomorrow, I’ll go back to being my regular diabetes worrier and freak out over any bg reading that is out of line), but I am not going to let it take first place today. I will go out and enjoy every minute of my day to the best of my ability. Not only because birthdays are days for family, friends, and cake and ice cream, but because it is a reminder that I have, for one more day, lived to see another year into my life. Diabetes takes a lot out of you, it causes damage if not controlled, and some even lose their lives to it. But, today, God has let me cross that mid-twenty mark. I am alive, and, outside of diabetes, I am well.  I am thankful for every minute, day, and year I have lived. So tonight, when me and my hubby go out for my celebratory dinner (not forgetting to count my carbs carefully), I will order desert, I will order cake and I will eat it too!

The start of this adventure was back in December of 2008 after I started on my OmniPod system. I was getting much better control with this pump because, unlike my prior pump, this one had things like “Insulin on Board”, “Bolus Calculator”, and all that good stuff, not to mention, it was the perfect, closed loop system in my opinion because the PDM had the built in monitor as well. Everything could be kept in a neat, nice little pouch inside of my purse.

Well, as always with getting better, lower numbers, you also get more of the not so good, lower low numbers as well. I could deal with them at the time because there were only a few per week, or I’d only have one really bad day in the week where they just wouldn’t come up. But as with any time you make adjustments to lower the still-high-highs, you are more prone to getting the lows. Well, over time, I am losing the ability to tell when I am dropping low. It’s not quite as bad as some, but where I used to be able to feel a low coming on in the 80-70 range, it’s now down to the 50-40 range, and that, to me, is scary. I have a fear that I will drop too low and not be able to tell anyone what is happening or what to do. I’ve heard many of the horror stories of people passing out, and I have done so myself, and that is something I do not wish to revisit again. So, I decided to apply for a Freestyle Navigator CGM. I chose this one because it would take the same strips as my OmniPod PDM. We filed the paperwork, hassled with my unwilling doctor to get the papers signed, and waited for approval.

The weeks went by and finally I got a call from Abbott that said my insurance had denied my request due to lack of medical necessity. Okay, first off, I would like to know what doctor read my file and said that I, a diabetic of 20+ years, could not show evidence through my testing that I needed a CGM. It’s kind of like when you are a kid and you want to get crayons from the store. You want the best… you want Crayola. But your mom says, “no, these are just as good”, and gets you the dollar store waxy crayons that when you color with them, you get more wax than color on your paper. You are asking the insurance company for the Crayola… The insurance company basically says no and gives you the waxy crayon… They say “No, you can manage your glucose just as well with only doing 8-10 checks a day as opposed to having 288 readings per day, and you should have no problem attaining a great A1C to reflect it.” We were going to file for an appeal, but I never received the papers in the mail. I decided just to give it a rest and try to do my best on my own. Since then, the aim for tighter numbers has given me more lows, still in the 50-40 range, but with less symptoms than before, and also leaving me with killer headaches. Ones that have even recently caused me to lose time work because they would physically make me too sick to work. I looked over my readings on my CoPilot system, and it showed a LOT of lows in the below 50 range happening more frequently than before, most of them unnoticed…

I submitted paperwork back on the 11th of this month to Dexcom to try for their 7Plus CGM since there are reports that they are teaming up with Insulet to somehow integrate the two systems. This morning, the representative informed me that they have already verified my benefits, and were waiting on a fax from my doctors office (a new doctor, due to problems with my old doctor, we switched. That will be covered in another blog. My new one is much better and is in favor of and promotes CGMs as well), then they were submitting everything they had to my insurance company for preauthorization. So the wait begins. I am hopeful… wishful… and am being as patient as I can possibly be right now.

 So, as a diabetic, we know that every three months the wonderful a1c test rolls around to tell our doctors how we have been doing since our last visit three months prior.

I always dreaded my a1c tests. I would do anything to get out of going. Fake sick, be out of town, absolutely could not get out of work that day… all because I knew when I went, I would have a high result. I would even try to cram in the best numbers I could get the month before the visit so my doctor wouldn’t fuss for me not having enough readings ( I would actually go an entire week without testing at times before this month came!!! AAAH!!) and causing the high numbers. And truth be known, I was just in denial of what was really going on. I was diabetic, always had been, I just didn’t want to be. I thought if I just ignored it, it wouldn’t matter and I’d be just fine. After all, I had lived this long, why would anything happen to me if I continued on? Well, I am here to say that I was terribly wrong. You can’t hide from diabetes, it’s a part of you. You can’t ignore it, it will let itself be known one way or another. When I finally opened my eyes, I realized what I was doing to myself. I didn’t know just how terrible I felt everyday until I started doing what I was supposed to do. I also didn’t realize the damage that was being done…

My turning point came after I turned 23 (19 years post-diagnosis). After being married for a few months, conversations started to lead to the subject of pregnancy at some point in the next few years. I knew I had always been told that your a1c has to be perfect before getting pregnant, so I started testing and doing as told. Now, my a1c is not perfect, but it is improving.  The damage that was being done has reversed. The tables of diabetes are being turned. I am now controlling my diabetes, it’s not controlling me. The biggest improvement is that now, I look forward to my doctor visits and a1c tests. I even have a countdown clock on my computer desktop that tells me how many days I have left to go until the next appointment and test. I am excited and have fingers crossed that it will be better than the last one. I may not be on target yet, but if I’m even just a smidge closer or even right where I was last time, I will see it as having done a good job. And if it’s higher, I may throw a little fit at first, but I will pick myself up and start my countdown again. Life is too precious to not take care of yourself and enjoy it.

By the way, as of today, I have 31 one days left on my countdown. Check back in late September for the result!

This week has been rather challenging for me. Other than the normal stresses of work and family, diabetes has decided to really throw me for a loop.

The past few weeks, looking over my CoPilot software that I upload my PDM to, I have had quite a number of “green numbers” (you know, the good ones…. the ones that fall within range). Yes, there have been a few outside of it, but it is a very exciting thing to see when you upload your readings to find yourself looking at a sea of green blocks showing how good you have managed yourself recently.

Well, that streak ended yesterday morning. I did my usual routine of getting up and getting ready for work, checking glucose before breakfast only to be shocked to see “341mg/dl” come on my screen in big bold numbers. I was very upset to say the least. I changed my insulin pod, corrected and decided to wait a few hours before eating breakfast to be sure the ghastly number was on it’s way down. I was finally getting really hungry, so I checked at the two hour marker only to be further disappointed with a 374mg/dl!! I could not believe what I was seeing! My mouth literally fell open! What is going on here? Thought to myself, well, maybe the pod change is just delaying the absorption a little, I’ll wait a little longer…. 398mg/dl was the next reading. By this time, I had enough of the highs and removed the pod and went on pen shots. Took my Lantus for basal and Apidra for correction and went about my business. By the end of the day, after my fingers felt sore from all the pricking and checking every hour or so, I was back to normal (or close enough to it) that I thought, “FINALLY, we’re out of the woods!”….

Not so. This morning, once again, bg was 300mg/dl. “WHAT? NOT THIS AGAIN”, I thought to myself. “Why” was the only question that was crossing my mind. I thought I had fixed it. I went on the pens… carefully took the right amount at each poke of the needle… bg was great before bed. So, I did the same as yesterday, I tried to postpone breakfast to see if it would come down after a correction shot… and it did, some. 237 was my number after waiting an hour. Being very aggravated and hungry at this point, I decided to eat a light snack. 2 hours later, I’m back at 317… 30 minutes later, 310…. not much was changing and I was getting sick. That icky feeling you get when your glucose is high for too long. I had enough. I called the doctors office and got a call back in an hour asking me to come in. He looked at everything, checked me out for sickness, and could not conclude what was going on either, so we bumped up my basal rates and we’re changing my insulin brand to Novolog at my next pod change. He attributes the highs to heat. It is possible, so we’ll see I guess. Bg did finally reach 152, but is going back up. Currently at 178mg/dl. So with the insulin resistance going in high gear these few days, I may be switching back to pens and changing a few other factors (like insulin to carb ratios, correction factors, that kind of thing) until this wave is over.

Looking at my fingers and my arm, I look as if I have been made into a pincushion. All of my fingers have little freckles from all the pokes and my arms have tiny little bruise spots from the shots. It reminds me a lot of how a pincushion looks after a seamstress has used one a few times with all the new holes left from the needles being stuck in it. Of course, they get worn after a while and you can’t tell it, but it’s the new ones you can really see it on. This week, I have used fingers I usually don’t use to test with.. they are my little pincushions… the diabetic’s pincushions.