Studying and Tuning

Usually, about once a month, I study my Dexcom trends and make minor adjustments here and there in my insulin needs (with permission from my endocrinologist, of course). This ritual then becomes a weekly thing during pregnancy, and this time is no different. And, later in the pregnancy, I tend to do this every couple of days or so due to all of the increased resistance and stuff.

Since I switched back to my Medtronic pump after issues with the t:slim last week, I wanted to get a good few days of data before making any changes since typically you do have to make some adjustments between insulin pumps. Not all of them deliver in the same manner (though relatively the same, but juuuuuuust enough to possibly need minor changes in insulin dosing). Here’s what I mean:

6 days on tslim 2
6 days on the t:slim I had been using during the first part of my pregnancy…
6 days on the *replacement* tslim... NO changes in rates as they're the same brand of pump so it shouldn't have made a difference...
6 days on the *replacement* tslim… NO changes in rates as they’re the same brand of pump so it shouldn’t have made a difference…
...and the last 6 days since being on MedT with practically the same rates.
…and the last 6 days since being on MedT with practically the same rates.

If you compare the first and the last picture, you can see that there’s not entirely too much difference, and the average BG between the two was only a few mg/dL off from each other. The replacement, however, was whacko.

Either way, I’m doing a lot better on the MedT and will probably stay on it. And since I have made that decision, it’s time to get down to fine tuning things. I’m dropping every night around midnight, and it’s taking longer to treat them, thus I over treat and go high. BUT, the thing is, I’ve not corrected those highs. I’ve been trending back down on my own. So that tells me I have some work to do between supper, bedtime, and overnight basals and other factors.

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I usually look at my trends on the computer and try to identify things. If I think I see something or have a hunch, I’ll print out the Daily Trends report so that I can see the days individually and not as an average, and I’ll write my basal rates below it. This time (for example), I noticed that I dropped an average of 57mg/dL from my highest average to my evened out number when I wake up, which, ironically, is close to my insulin sensitivity factor (55mg/dL currently). So, I took the 1u and divided it by the number of hours it had been dropping  before leveling out, which was 7hours, and it came to 0.14, which I interpret that to be a needed basal rate change of 0.15u per hour less than what I have it set at now.  It all may not be exactly right, as most of what I think I’ve figured out is simply a hunch that I try out and see if it works. If not, I have record of my information pre-changes and I go switch everything back to what I had before.

This the stuff that goes through my head while I’m examining my data. This is why having as much of my data in one place is as crucial as air to me, especially while pregnant. It’s such a pain in the butt to have to look at multiple reports and have to spend more time organizing it than actually analyzing it. So, I’ve also resolved to leave my beloved Verio IQ and use the Contour Next Link meter that works with the pump, so that all of my data from the pump and meter at least are in the same place. That, and since using the CNL meter, my Dexcom data more closely matches it whereas it hardly ever matched my Verio. I’ve done a lot of research over the past couple of days, and it seems that maybe the CNL meter is a bit more accurate than the Verio, and with the Dexcom using the more accurate 505 software, maybe the two are just meant to be… Or I could just be completely off my rocker. 😉

So, I’m off to my endo tomorrow for my monthly checkup and to share my observations and changes with him.

(What I do and write here are in no way medical advice that you should ever take as such. I have worked very closely with my endocrinologist over the years and he has helped me learn how to do these things. If you want to learn how to manage and fine tune, please speak with your health care professional, as I am not one.)

 

Happy 2015!!… with some bullet points.

HAPPY NEW YEAR!… 13 days late….

So, apparently I have a thing now for only blogging twice a month? Well, rather than overwhelm with a very long post, I’ll just use some bullet points to bring out the most important things.

  • Diabetes is being rather weird. Some days, it seems I’m very insulin resistant, others I’m super sensitive. I don’t know if it’s simply diabetes being itself, or if pregnancy has a hand in it, or if my thyroid being wildy off recently plays a roll. Or it could be all three.
  • Speaking of the thyroid thing… my TSH came back above 5 on New Year’s Eve, up from a usual 1.3-1.5’ish. Not sure of the reason other than being pregnant, as this happened when I was pregnant with E, but either way, my Synthroid has been upped yet again, and we’ll recheck in a few months.
  • I’m now 14 weeks, 2 days today. Baby bump is in blooming, and while I’m excited, it’s also freaking me out. The whole going from one to two kids… The further I go, the more freaked I get. I’m sure it’s just a thing I’ll get past soon as my emotions are EVERYWHERE. We’ve also decided to go for an early gender ultrasound, so we’ll (hopefully) know on the last Saturday of this month. I’m excited.
  • School started back this week, and it will be my last semester. I have 3 classes left, two of which I’m taking this 8 weeks. After that, it’s one more 8 week class and I’m dooooooooooooone! Yay!
  • Lately, I’m getting frustrated with my Dexcom being really off. I didn’t have this problem before the new 505 upgrade, but it’s been more and more inaccurate. And, after reading Stacey’s post, I’m beginning to wonder if I may need to change meters. After all, it’s not a secret to me that the Verio isn’t very consistent when tested back-to-back. So I’ve ordered a Contour Next USB meter, which is supposed to work with Diasend (though not the Medtronic Link version of this), so I’ll update as soon as I know something… or at least within two weeks of testing and finding out things for myself.
  • Oh, and the news of Tandem’s t:flex gaining FDA approval this week was also pretty awesome as well. It’s their larger pump, the only one that can hold 480u per cartridge (but knowing what I know about my t:slim, I wonder if you’ll only have 430u available for use per cartridge since I tend to average about 50u loss per changeout). I think it’s great as I do love my t:Slim pump and have had a pretty good relationship with it over the past year or so since getting the whole bad cartridge thing behind me. I still hate the insulin waste, but on a daily basis and for my needs now, it fits perfectly into my “diabetic” life, and I’m happy with it. I can only be that much more excited that others who have needed a much larger capacity pump (some type 2’s, teens with type 1, and some preggo people) will now have an option to help them be able to use a pump without having to change out so frequently.

So, that’s about it. Not much going on, but a lot at the same time. I hope you all are doing well and are enjoying your January.

He’s Learning

The past few mornings, he has woken up tremendously early right along with Erik’s alarm clock due to his week to work 7am shift. So, I will go get him, change him, and try to get him to go back to sleep for another hour with me in my bed. Sometimes it works, other times, not so much.

But, he’s learning that mommy doesn’t just jump out of bed and go. He watches her move with curiosity and patience as she pulls this wallet out next to her, unzips it, and pulls out three things : A box, a pencil-like thing, and something that rattles. She pops open the thing that rattles and takes a piece of something out and sticks it in the box. Then, the pencil thing makes a noise when she pushes the button on top. She sqeezes her finger to make this red stuff come out, and touches it to the thing she pulled out of the rattle… and waits. Then, she pushes some buttons, and puts it all back into the wallet and zips it back up.

Then, she grabs another rattle off of the table beside the bed. She twists the cap off, puts a round blue thing in her mouth, closes the rattle and puts it back. She grabs her bottle, drinks from it, and puts it back.

After this, he knows it’s time to pop up and go.

He’s learning mommy has a routine.

He’s learning mommy has things she has to do as soon as she sits up in bed.

He’s learning mommy’s life with diabetes and hypothyroidism.

Revisting: Thinking of Baby

Last night, I was scrolling through some old posts and once again found this one. My very first post. Seeing as how it’s the eve of my baby boy’s FIRST birthday, I thought it’d be appropriate to repost it, with an updated picture of Kip’s foot. My!, how things have changed in three years!!!! And I wouldn’t trade a bit of it for the world!

Today, my mind decides to play visions of a happy little baby/toddler in mine and my husband’s life. Thinking of how it would be having a “daddy’s little girl” in a cute pink dress sitting in his lap, or walking around trying to reach up to us to hold her. Or maybe a little boy… “Little E” (my husband’s nickname is “Big E” because he’s 6’3″ former college football player) running around with toy Transformers (my husband’s favorite cartoon growing up… still collects the toys from it) or going hunting/fishing/whatever with Uncle Alex and coming home to tell me all about the “BIG BUCK” they saw.

Only problem is, we don’t have that baby neither here or on the way. With my A1c not being on target for pregnancy, and trying everything in our power not to get pregnant, it seems to be that one thing that I want but can’t have. And it’s not like a new house or new car, but just that part of me that wants to be complete… that part of me that my cats can’t take the place of. Although with times as they are with the recession and all, it’s probably not the wisest thing to do right now. And yes, I know, that when the time is right, God will make a way for us to be able to have our little munchkin.

So, until then, I have my goal to work on for my A1c and two loving cats to be my babies.

A big thank you to all of you guys who have helped give me encouragement throughout this wonderful journey. I don’t want to think about how hard it would have been not having your support.

Mobile

So, lately, I have been working with BabyK to up his tummy time. He never has liked being on his tummy, and (completely my fault) I’ve honestly never made him because he would always get frustrated quickly. But after visiting his pediatrician, he stressed the importance not just for building his neck muscles, but back and arm muscles and to build control and all that good stuff. And silly me thought he had to do the time limit all at once, but he told me to try little bit by little bit until he can do the full tummy-time all at once. If he still didn’t like it, to try starting off with tummy-to-tummy… his tummy against ours… then on something else to help prop him like a Boppy or other pillow, then on the floor. (Whew!). So, we have a pillow like a Boppy (the WalMart version – which in my opinion is better anyway because this one has a strap that goes between his legs and velcroes on the side so he won’t wiggle himself down when he’s laying face-up. You can’t do the strap when he’s face-down). We got it right after he had a bad cold when he was about 2 months old because it would prop him up and help him breathe, plus it helped when he would actually breastfeed.

Little by little, we have been making some progress. At first, he hated it and fussed very shortly after placing him on his tummy. I mean, like, within a minute. We’re now up to three 3-minute stretches, sometimes with and sometimes without the pillow.

Tummy time

 He watches the iPad (facetime with friends or a movie) and plays with his rattles.

 This past week, he started rocking back and forth to his side and back, but never could get all the way over. Well, this morning, I left him playing with his toys on the playmat so I could take a shower. He usually gets fussy while I’m in the shower because he can’t see me, so when he got fussy this morning, I thought it was just because of that and I finished my shower as usual. When I got out, I went to check on him, and he had rolled completely over! He must have done it right before he got fussy because by the time I saw him, he had gotten tired and laid his head down. Of course, it was all over when he saw me though – he got fussy until I rolled him back over, and he thanked me with a big grin.

Then it hit me.

My baby is becoming mobile.

Granted, it’s time because he’s 4 1/2 months old. But still. It’s not going to be long before we will have to have a much closer eye on him! Can someone say, baby-proofing is NEEDED now? Whoa. I mean, I was like, all excited and stuff that he rolled over (side-note: seriously… it’s ridiculous how tremendously excited I get over stuff like that with him! /side-note) and was texting Erik about it and then it was like the light-bulb went off and I saw a reel of visions in fast-play mode in my head.. rolling, crawling, pulling up, then walking. OH my!

*sigh*

So much is happening this month with him. He’ll be 5 months old the day after Christmas. (another side-note: My neice will be  10 years old that day too! O.M.Gooses! /side-note 2) 

Then the adventures of BABY FOOD will begin! JOY!!!! 😀

Precious Things

Gifts that are received while you’re pregnant for your baby are always appreciated… Even the ones you don’t need right away. You know the person wants to help out and do what they can for you, whether it be bottles, diapers, wipes, or clothes. But then there are the gifts that are even more special… The ones that have a story behind them. The ones that really touch your heart.

Thursday, Erik came home from work with a gift from a lady he works with. He had left to go to the gym, so I took a peek. When I opened it up, the gift that I saw was very beautiful, and I had a gut feeling there was a special story behind this gift.

See, he has a lot of very nice women he works with that would do anything for him. This one lady knew we were expecting our little boy and wanted to do something nice for us. So, while going through her chemotherapy treatments, she hand-made this beautiful, hand crocheted blanket for us. Someone who didn’t know me from Eve but knew Erik took hours of time during her pain to make something special for us and our little boy.

I will forever cherish this blanket, along with the other special hand-made gifts we have received.

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Re-Thinking Food

Erik and I have started buying food more responsibly. Before, we used to go when we wanted something and would end up spending $40-$50 each trip, a few times per week. Now, we are going once every two weeks to the grocery store and stocking up on sale items (diapers, anyone???) that we may need for the future and grabbing necessary items for the week. Since doing this, I have been able to start packing my breakfasts, lunches, and snacks for the day to take to work, and have been able to save money on drive-thru places and gas to go to them.

packing

But lately, I have been having to re-think the foods we have been stocking up on. I’m trying to incorporate more fresh fruits, whole grains, and just all-around wholesome foods. Granted, if you see us in the store, we will still have a package of something sweet and possibly a pizza in the buggie, but everything else is the good stuff – better cuts of meats, bags and bags of fruits, whole grain rice instead of white rice, you know?

And yes, I’m now 5 months into this pregnancy and you may be wondering why the change now and not when we first found out. Well, since I wasn’t able to eat very much in the beginning of the pregnancy, most all that I ate was the good stuff like fruits, low-carb meals, etc because it was the only thing I could hold down. Now, with hunger coming in full force, I have to control what I’m eating a little better.

Also, if any of you read my post for Diabetes Sisters this weekend, you will see my other little issue that has come up. Gastroparesis. It’s where your body has delayed absorption of food. Granted, my endocrinologist said that this is common in some pregnancies because of the hormones changing things, but I can’t say that it didn’t scare the sh** out of me to actually hear that word. I had some slight symptoms of it before pregnancy, but not enough or not often enough to worry about. Now, it’s on my mind every single day because every day, there will be one problem meal. I can prebolus in the correct amount of time, eat my food, but it just sits there. I will feel full to the brim (almost literally) and completely bloated for 2-3 hours, blood sugar plummeting and staying low in the 40 range until all of a sudden, it’s like the gate opens and everything starts absorbing, then my Dexcom starts going crazy that I’m shooting for the sky and sure enough, I will be. I’ve had this happen for breakfasts, lunches, and dinners now, and it’s not fun at all. So, with his suggestion to eat and use a combo-bolus at every meal, I’m also changing up the foods to try not to have too many high-fat meals and opt for more healthier, fresh, wholesome meals to see if it will help. Granted, I know that high-fiber meals can be just as tricky for those who have GP, but I’m really just adding what should have been in my diet all along. I’m also trying to space out my meals and snacks so that I’m having no more than 30g of carb every 2 hours, instead of maybe 60g at one setting with no snacks. Will it help with the GP? I don’t know, but with insulin resistance and GP now in the mix, I am willing to do anything it takes to keep the best blood sugar control I can have and this is the only way I know to do it.

I have to admit. I feel like I’m going crazy already. I knew things would have to tighten up and I would have to be stricter with a lot of things while I was pregnant, but I don’t think I was fully ready for all of this. Sometimes, it gets the best of me and I have a meltdown. Others, I refuse to let myself because I feel like I’m being selfish. I mean, what’s 9 months of super-tight control if it helps your baby that will be with you for (God willing) years and years and years be healthy as possible when he or she is born? My mind is constantly fighting a battle now, it seems, and it’s starting to wear me out. What keeps me going is the kicks I feel from him, all the pictures I have of BabyK from the ultrasounds, and walking in and sitting in the rocking chair in his room knowing that I’ll be holding him there soon. It keeps my d-sanity in line.

22 weeks

That song by Faith Hill – A Baby Changes Everything? Yep, it is SO true… even before they get here. (And now, I have to hush because that other pregnancy symptom is starting up… the tears! Geewillikers!!)