The labels don’t balance

Eat carbohydrates. Take insulin.

I do a pretty good job of maintaining that balance. But that is not what today is about. Today writing prompt is about sharing an area that could use a little improvement.

I am tempted by the fact that the easiest way to know how much insulin to take is when the amount of carbohydrates and the serving size are printed right on the package. As a result, I do not take the effort to eat enough fruits and vegetables and my pant size is clearly showing the result. It’s not about clothing sizes, it’s about not being happy with the way I look.

At diagnosis, I was given a specific meal plan to balance with my awful insulin regime of NPH and Humalog. I ate the exact same thing every day so I remember it now eight years later.

Breakfast: two scrambled eggs with cheese on top, light bread with peanut butter, half a banana

Lunch: peanut butter and no-sugar added jelly sandwich, the other half of the banana, a handful of chips, and two no-sugar added cookies.

Dinner: baked chicken breast, baked potato, zucchini

It was boring (especially after a few months of the same meals) but it was balanced.

Once I started on my first insulin pump I began to gain what I like to think of as “pump weight” – it’s like baby weight but with no adorable child at the end. A few years ago, members of the diabetes online community organized a weight loss/A1c reduction challenge. Having that accountability and support was the perfect thing for my competitive side, and I was able to get back to a place I felt more comfortable.

Slowly but surely I have put that weight on plus a few more pounds.

For example, just this past weekend I was out of town for a wedding. Instead of doing six hours of driving in one day, I stayed over night in a hotel. I suppose I could have brought some food from home, stopped at a grocery store to pick up some fresh food, or eaten in the hotel restaurant, but the convenience store stop was just so much more convenient.

I need to get back to eating more fresh fruits and vegetables and less processed food so I can feel healthier and enjoy the beautiful south Florida summer that has already begun.

Can you tell with my memes the past two days that I really miss Hyperbole and a Half?

Eat ALL the things!

I am scared to even write about this because of what happened last time I talked about this.

One thing that I am good at is…

Fingers crossed…

… should I say it?

I do a good job of not over-treating low blood sugars.

I like things in life that have definite answers. 1+1 should always equal 2.

I love reading the book Pumping Insulin because there are charts, graphs, and tables that I can use to manage the math of pumping.

Even when I am low, and my words don’t make much sense, my brain still can manage enough math to know how much fast acting sugar I need to get back into range without over-treating. I bet I would be some sort of math genius if my blood glucose was always in range!

At home, I almost always have juice boxes in the fridge. I guess they are made for kids, but they are also the perfect size for treating a low blood sugar without draining a whole large bottle of juice. When I am away from home, I always have at least one tub of glucose tablets on me.

This was the topic of conversation at my first meet-up back in June 2007. I never should have mentioned it because this was the e-mail I was forced to send to Scott Johnson and the rest of the group the next day.

Remember how I said that I didn’t usually over-treat my lows? I had one yesterday afternoon (43), and proceeded to have: one glucose tablet (the last in the container), a snack-size bag of peanut butter ritz sandwiches, a DingDong, and the bag of chips I saved from Panera. 30 minutes later I was at 85, but 2-3 hours later I was at 386 – oops!!

And in classic Scott style, this was the reply -

Did you simply panic because you couldn’t get your second glucose tablet? Or did you say “man, all that stuff that Scott eats when he’s low sounds really good…” and throw A1C control to the wind?

So I will publish this post, but if you read about me eating a tray of brownies tomorrow all by myself, you’ll know why.

Wordless Wednesday: Diabetic Recipe

Don’t you hate it when your recipes get diabetes?

(see also people-first language)

Insulin. Action.

Whatever happened to predictability?

(and now you are singing the Full House theme song)

I have a “math brain” and have used it to test EVERY setting related to my diabetes. It helps me feel confident about my carb counts, correction factors, basal rates, and every other bit of math we are required to do in living with diabetes.

Except none of it was working on Sunday. I woke up riding my high alarm and stayed there with a few corrections. Then I started eating and ended up riding the blood glucose roller coaster all day. I stayed up way too late on Saturday night, so I knew I needed to get to bed early on Sunday night to be functional at work yesterday. Of course, that didn’t happen.

About an hour before (my already too late) bedtime, I had a snack with a well-thought out matching bolus (that works every other night). Keeping with the theme of the day, as I headed to bed my blood sugar was low. I just wanted to go to sleep so I purposefully over treated the low. I knew I needed to take insulin so I wouldn’t hear the high alarm once I was finally in REM. What am I supposed to do when I know I need insulin, but I don’t need insulin NOW, and I just want to sleep?

The combo bolus.

It’s not just for high fat foods anymore! It gave my body enough time to come up from the low blood sugar but the insulin went into action in enough time to prevent the rebound high.

My six hours of sleep were uninterrupted by my diabetes. Now I just have to figure out a way to go to bed earlier so I can get more than six hours in!

I didn’t think to take any pictures during my Sunday blood glucose battle, but if I’m talking about insulin action time – guess when I took insulin this day?

A spoonful of sugar… and beyond

The last time I was in the Magic Kingdom was the day before the official beginning of the Friends for Life conference. It was the first time I met Kim, Martin, Jess, Jacquie, Brian, C, and a bunch of other people with with diabetes. In that respect, it was a great day. Diabetes-wise, not as much fun. Heat, humidity, lots of walking, questionable food decisions, and there was more that one type of roller coaster going on that day. I’m not even going to mention the 30 or so minutes that Kim and I spent sitting on a bench trying not to revisit lunch.

Brian was in town this weekend so I made a return trip to the happiest place on earth. Thankfully our day in the park turned out significantly better. Other than a slight low from waiting too long for lunch, I stayed in range all day. I mean, my numbers were so good that I double-checked with the meter just to make sure it wasn’t an error.

I guess you really can do Disney with Diabetes (hat tip: Bennet).

Zing!

First of all, I hope your weather has been as good as mine this winter. Otherwise, please just enjoy this picture.

Secondly, I had the best “dinner” a few nights ago. I was practicing for my award-winning lip sync performance through dinner, so I was desperate for food later that night.

There is a chain called Miller’s Ale House that claims to have world famous zingers. Well, the ~~plate~~ platter below had my zingers on it. I forgot to take the before picture, but I will next time – and there will be a next time.

As you may be able to see from the picture, my Zinger Mountain Melt was a platter of breaded boneless chicken wings, “piled over crispy fries and smothered with melted jack & cheddar cheeses, and bacon bits.” I picked honey mustard flavored chicken wings and asked for a side of honey mustard.

I had a horrible DexCom graph the rest of the night and I woke up ready to drink gallons of water but it was all completely worth it.

Wordless Wednesday – It’s not my fault

*if you are reading this post in a reader on January 18th, please click through to view my updated header image and visit this page.

The facts for a crown

The D-Mom recently posted about her experience dining out at Cracker Barrel and the difficultly she had retrieving nutritional information. It reminded me of a story of something that happened to me at my favorite fast food restaurant shortly after I started using my insulin pump. I actually couldn’t remember if I had blogged about it or not yet, but a search of my archives didn’t turn up anything so here we go!

A bit of a backstory first – When I was released from the hospital a family from my church that had/has a child with diabetes stopped by the house to answer any questions and set our minds somewhat at ease about our new life.

It was a little over a week until my birthday so one of the first questions was whether or not I could still have birthday cake (I could!).

Another important question was whether or not I could have fast food. The mom asked what I typically ordered. When I told her that I ordered the chicken nuggets, she said that was one of the best options because of the balance of protein and carbs. I took that as my go-ahead to continue to enjoy some Burger King.

My first insulin dosing was NPH and Humalog and because of the peaks of NPH I could generally eat most moderate meals without much thought to carb counting. When I started on the pump, I had to get more serious about knowing exactly how much insulin to take.

I was driving home from work (or grad school – you’ll have to forgive me, it was 2004) and stopped at the drive thru of my local Burger King. I ordered the chicken nugget combo for the first time since I had my pump. When I got to the window, I asked for the nutritional information. The employee walked away for a minute and came back to the window with something in his hand. Before I could see what he was holding he said,

I couldn’t find the nutritional information for you, but I did find this…

crown.

At first I was shocked. In what alternate universe is a CROWN comparable to nutritional information. I remember stammering out something about how I needed to know the information because I needed to know how much medication to take.

I think the medication word scared him because he told me that the nutritional information was posted on the wall in the restaurant and that I could come in and look at it. I did end up coming inside and looking at the nutritional information that time. It would be years before I could look up the information on my cell phone. And now I have the carb count of a least one meal memorized at just about every fast food chain for when I am on the go.

****************

A little extra information on nutritional information:

From the FDA – A Labeling Guide for Restaurants and Other Retail Establishments Selling Away-From-Home Foods (basically they don’t have to provide information unless they make a claim. If they say it’s low-fat, they have to know how much fat is in it)

And a federal law passed in 2010 as part of the health care legislation requiring “restaurant chains with 20 or more outlets to disclose calorie counts on their food items and supply information on how many calories a healthy person should eat in a day.” (source). The article is a great read and the regulations sound like good news. But don’t look for your favorite restaurant to have their nutritional information posted tomorrow, “the effective date could conceivably be years away.“

Can I be healthy during the holidays?

I think this week is official start to the holiday season. I know that beginning with Thanksgiving and ending with a New Year’s celebration it is a constant rotation of large meals, work parties, and endless buffets.
I know I have struggled to manage my diabetes effectively throughout the holiday season (and that doesn’t even count the year I forgot to bring the insulin to my brother’s house). Meals typically aren’t served on schedule so it can be hard to pre-bolus for food. Mashed potatoes, stuffing, yams with marshmallows, candy canes, and cookies for Santa don’t really lend themselves to the low carb diet.

I have my insulin pump and my CGM that enables me to somewhat track and trend what my blood sugar is doing, but I know that I will still be chasing some out of range numbers more than usual the next two months.

I would love some help from the diabetes community on how to manage this season.

What do you guys to do keep your diabetes on track during the holiday season?

In a relationship and it’s complicated

Georges recent post about peer pressure has me thinking about the diabetics complicated relationship with food.

In his post, George describes dealing with having food hed rather not eat being pushed on him by a fellow diabetic. He asked us if any of us have ever been in a similar situation. I cant remember that ever happening to me, but I wonder if I’ve been the pusher once or twice.

If food choices were politics, I would probably be described as a moderate. I dont heavily restrict my carbs, but I dont eat nothing but Smarties all day long either. Being diagnosed the year I officially became an adult meant that no one really ever told me what I could and could not eat.

Due to a mistake in the appointment schedule, my one and only appointment with the nutritionist after my diagnosis was done at the same time as a long-time diabetic who was getting a refresher because he was just starting to pump. The nutritionist repeated multiple times that we could eat whatever we wanted as long as we took the insulin to cover for it. I remember asking her incredulously if that meant that I could have a Snickers bar and a piece of cake for breakfast if I wanted to. She said it would be no more unhealthy for me than it would be for any other person. Not quite the nutritional advice I was expecting!

So if I believe I can eat whatever I want, why do I change my eating habits when I am with other diabetics? When I went out to dinner (and karaoke) with Georges family when I was home for a vacation, why did I say no to a refill on my bottomless fries at Red Robin? When I was at dinner with Kerri during a conference a few years ago and she replaced her baked potato with extra veggies, why did I feel compelled to do the same?

Last week I was eating in one of the cafeterias during my lunch break and I saw another diabetic walk in. Our meals come with a main course, side, and a drink. As she walked up to the table, I tried to hide my side under my arm. This girl has never said one word to me about my food choices, so why do I feel the need to hide them from her?

Also last week, I grabbed a bite-sized Butterfinger off the desk of a coworker and heard another coworker ask (say it with me now!) if I was sure I should eat that. That same day, I mentioned on Twitter that I was making my famous banana cake. Cherise mentioned that I should bring it to Orlando in June. Why did I immediately tweet back