Onward and Upward...2010

Well, it's that time again. The time where you say your goals out loud, and hope that no one remembers them so they don't come back to bite you in the ass.

My 2009 year in semi-review
(It's early to do a year in review, but I want to start looking toward 2010)

2009 was the year of no racing. It was one of the hardest and easiest decisions I've ever made. Hard because it's the first year I haven't raced in any event since 2001 I think. Easiest because my training wasn't up to par. I mean really, really not up to par! Why kill myself to race when I can't race well?

2009 was also a year filled with stress. I had to travel quite a bit for DTC, not to mention the work that went along with it! They were long trips and I missed being home terribly. The last DTC Camp was in Oregon...which had to be the hardest for me to date. We had a very old Airedale, 14 to be exact, that had been going downhill for the past year. Decisions had to be made, and Brent had to put him down while I was gone. I'm sure it was harder for him then me, but nonetheless it was an awful time not to be home with him.
Then there was the move to the new house immediately after I got home from that trip. We had a tremendous amount of help from friends and family that made it easier...but still stressful.
THEN......he realization of not racing with my teammates of Team WILD set in. I set out to do the Austin 70.3 in October with them, but when training was too hard to get in, and money was tight, I had to back out of the race. NOT the team but the race. (AND the training camp they had down in Austin I missed!) The countless emails that were bounced back and forth with details of the race were heartbreaking for me. I admit I skipped most of the team phone calls partly because of that. Since I am the official blog poster for the team, I have read every single blog post, and enjoyed every one of them. Bittersweet to read them, but it was the one thing I could do to participate with the inaugural event. Inspiration is a word that's tossed around a great deal when people speak of Team WILD, and being a fellow teammate it's no different. Thanks to all the women of Team WILD for inspiring me all over again!

Ok...out loud...here are 2010 race goals:

• 3 Olympic distance races

• Steelhead 70.3...hopefully the swim won't get canceled this time

• Team WILD 70.3...wherever that may be

• Detroit Marathon (tentative)

And then there is that dangling carrot......

Can You Feel It.....

......the winds of change are finally here. Time to kick some butt!

New Location, Fresh Start

Another day, another Doctors appt. I actually forgot about this one. Unusual for me, but I received the phone call reminder AND the snail mail reminder. I think this is due to the new office location. (Thank goodness for me they have a new location) It's closer...by maybe 20 min. for me. Which is saying a lot, because in the winter getting to Ann Arbor is grueling! The new complex is HUGE...notice the photo. (It's on the compound of Domino's Farms. Yes, yes, the pizza Domino's. Diabetes and pizza, how's that for irony?) That's what you get when you go to the University of Michigan Intensive Insulin Clinic. State of the art stuff there, and nothing done on a small scale.

No resident doc following him today!! YAY! I'm going on Tuesday's from here on out! BUT, there is a bunch of new staff...and they are obviously still learning. AND, the young lady who drew my blood was nice enough to listen to me and use that butterfly to get my blood sample. Tiny veins require child like tools:) Wait...is there a theme here? Am I child like?
I asked my Doc to not only do the draw for the usual stuff, but I wanted the Vitamin D test also. He humors me...I like that.

The rest is pretty uneventful I suppose. We sat for a bit talking his new baby boy, sleep deprivation, Omnipods, CGM's, basal rates, bolus ratios. I think it was in that order too...how funny. Before I knew it, without hesitation, I whipped out my Omnipod PDM and changed the settings we were talking about. What possessed me?? I've always been so casual about that stuff thinking I'll just do it later. Is this the fresh start to getting my A1c down? Knock me over the head with a hammer already. What the hell took so long? I still think having the CGM will/would help me with this by leaps and bounds, but I'll take this baby step in the right direction. Maybe my insurance company will come around and surprise me. HA! A girl can dream!

Fresh starts for both of us!

Eco-Friendly Diabetic Part 2

I realize most diabetics out there have a snapshot or 2 of this kind, but I'm sharing mine anyway. If I stop and think too much about this photo, I'd depress myself! Not so much for the landfills that others are filling, but because this is a snapshot of about 3 months worth of diabetes...without insulin bottles, tape, lancets, test strips......(FYI..don't put the 357 batteries all together, they get very, very hot. Duh!)
Weep not....I will now move on, and embrace my eco-friendliness!

Here We Go Again

I know I haven't written much about my training lately, but there have been too many good diabetes stories not to share! I've been trying to get back my tight control, and in that process lows happen. Shit happens, lows happen! Here comes another good story.

I was in the grocery store, collecting ingredients to make my Mom's birthday cake. (Yes, this is another grocery store anecdote) Beautiful cake by the way...one of my best to date. I picked up a bag of marshmallows, which will help with the theme of the cake. As I'm walking to the checkout with my yellow cake mix, and marshmallows it hits me like a brick in the face. The confusion, lightheadedness, and the sweating....ohhhh the sweating! I fish through the purse to find my glucose tabs, and of course the container was empty. Of course!! I buy a real soda in the checkout line and head to my car. My plan as always is to drink only half of the soda...which I did. As I sat in my car waiting for all the symptoms to pass and get the "all clear" blood sugar reading from my meter, I proceed to open the bag of marshmallows. "I'm only going to eat the 4 that is the serving size. All people with diabetes can attest to the fact that when having a low all logic goes out the window, and the involuntary urge to put your hand in the bag and keep eating is just that...involuntary. When I finally get to feeling better, I glanced down at the bag and to my shock I ate about 2/3 of the bag!! Crap...here we go again...over-correction.

I put in an emergency call to my friend Michelle. I knew what I had to do, but sometimes having a back-up to agree or disagree with your plan of attack is comforting. At this point I'm laughing...she's laughing. Then I send her the photo of the evidence. Hilarity ensues again! I checked my bg while I had her on the phone to find it only in the 200's. We decide that I had around 100 carbs, but I only bolused for 50 and rode it out. Riding bg's out is the only way to do it sometimes. I checked my bg a couple of hours later and now it was in the low 300's. Not too bad considering. I bolused again and all was good again!

So what happened with the cake?? The original theme for it proved to be too time consuming, so the marshmallows weren't needed. Of course they weren't needed!! Of course! I threw out the remnants of the bag as it made me sick to look at it, and I've chalked it up to another hilarious diabetes event.

p.s. I got in the car the next day and found a stray marshmallow and was sick with laughter all over again.

One of Those Nights

Last night was one of the more interesting nights with diabetes. Here is the long version of the story.

I was overdue for a pod change. Yes, I was pushing it, but there was a ton of insulin left and wanted to get the most of it. This meant going the 8hrs. until it completely conked out on me. I have done this before with no problems, and I knew I would get home in time to change it out. BUT, I was not counting on the low that would happen before I left work...and in typical Nancy fashion, I over-corrected. With my brain a little fussy from the low, I waited it out and then went home and figured after the change I would bolus for the brownie, glucose tabs, and the 8 oz. of real Coke that I frantically ate. (There may be more that I consumed, but I'm trying to forget about the extra calories...and my stupidity!)

By the time I arrived home, all was well, and I changed the pod and checked my bg to find I was in the low 200's. "Already????" I thought. Crap, this is gonna get nasty. I bolused quite a bit for the increase I was anticipating. Then the fatigue set in, and my eyes wouldn't stay open even with toothpicks. I laid down for a quick nap before Brent and I had to head out for dinner with friends. 20 minutes later, and very groggy, I was able to get my head together and clean up. "I'm feeling good now.", I think to myself on the ride to the restaurant.

My plan was to pre-load some insulin for the Mexican food that was to come, so when we got there I checked my bg and was shocked to see it in the high 200's. WOW, that was some over-correction...I must have needed more insulin when I got home. "Oh well", I thought..."it'll come down."

After dinner Brent and I made a couple of stops and headed home. The beeping sound of the Omnipod went off to remind me to check my bg...it's been 2 hrs since you ate, check already! Now this is where it gets interesting.....

You know when you get the blood on the strip, and the wait is longer then it takes you to say.."S**T...it's high"??? Then it beeps back at me..."S**T...you're HIGH"!! Now, I can count on one hand how many times I've actually had the HIGH reading. That's not saying I've never had highs, but the HIGH reading where you're bg is so high that it doesn't give you a number....that's where I'm at. I look at my site, and all looks fine. What the hell? That was some taco salad I had..ok and chips too. So I do a super bolus, and check an hour later only to find it screaming at me HIGH again. "Ok, that's enough of that!"

I pull out the ol' syringes and give myself a super duper rage bolus (with new vial of insulin) via traditional shot and then change out the pod. A little blood backed up in the cannula, but that's nothing too out of the ordinary. I was hoping this would do the trick. Oh, wait...I bolused the new pod too. Now I have something like 8 units of insulin in me, and the wait starts.

By 11PM, I was getting an actual number on my PDM. "Ok", I thought, "this is encouraging!" I desperately wanted to sleep, so I set my alarm to wake me up in a hour to check again. 338...nice, more encouragement! Set the alarm again...265. Is it dropping too fast? 8 units is a lot for me, but I haven't corrected a high like this in a very, very long time. For a fear of going low, I set the alarm again...193. Since this is about 3-3.5 hrs. after the super duper rage boluses, I was happy to sleep peacefully. More like a rock!

Where am I now you ask? I woke up at 198. Of course that's not where I would like it, but I guess my overnight basal is correct since it didn't change at all.:)
Obviously all the highs after the pod change were from lost basal, and no boluses. Or maybe partials of each.

Ahhhh, life without insulin!

Happy For Finger Sticks

Last week I was being that unusually domestic wife and was made Brent breakfast. (Which by the way is the only meal I can cook well....a mean omelette!) And again, as usual, I was trying to do 10,000 things at the same time...get myself ready for work, make my lunch, etc....
Let's cut to the chase...I set a cookie sheet on top of the fry pan to melt the cheese on top of the beautiful omelette that was sizzling underneath. In my haste, I picked up the sheet only to realize that it was scorching hot. Well, OF COURSE it is dummy, it's been sitting on top of there for like 5 min. I threw it immediately on the ground, screamed a few choice expletives, and stuck my fingers under cold water. After those sounds coming from the kitchen, Brent came in wondering what the hell I had done. "You OK?"..."Yes, I'm fine. I'm just an idiot that's all!"

After icing my 4 fingers for 30 min....while trying to get ready for work....I looked closely at them to see nothing in the form of blisters. That kinda surprised me, but I was happy because I have to use my hands for cutting all those domes. I figured I was just lucky, and then looked down again to see nothing...except all those little black dots representing the millions of finger sticks I've done. That's when the light bulb went off!! Callouses I say! Callouses! I just burned a bunch of dead skin.
Happy for those finger sticks! I'm sticking to something I'm good at...out of the kitchen and on to my bike.:)

I'm An Eco-Friendly Diabetic

Diabetes isn't the most environmentally friendly disease to have. We go through strip after strip to test our blood, syringes, reservoirs, lancets, alcohol pads, IV preps, tape..the list could go on and on.

I was lured to Omnipod for my lifestyle, but my lifestyle also includes recycling. I'm not the greatest at it at times, but trying to do better. Since you take a Pod off every 3 days and replace with a new one...what are you suppose to do with the old one??? I started to imagine what my local landfill would look like after just one year of my Omnipod use, and the thought made me sick!

So, out came the hammer. Literally! I tried smashing it up to get to the guts to start saving all the pieces to take to my local recycling center. No luck at all with the hammer. Boy, that would be a good selling point for Omnipod wouldn't it??? So, out came the screwdriver. I wedged it in between the top and the back and with a little effort it slowly pried open. Plastic reservoir, and a circuit board and 4 watch batteries...357 to be exact. I have 3 bins in a drawer to collect all the pieces. I tried to fish out the needle, but wasn't so successful there. I'm satisfied with what I can get out of it, and I sleep better now:)

I'm proud of my drawer, which is quite a snapshot of diabetes. Along with the stale smell of insulin that wafts in the air when I open it, is a constant reminder of what life is like for someone with diabetes. Insulin really stinks...in more ways then one!

Random Thoughts

1. Is it age or diabetes? Which one takes more of your brain cells, because I can't remember squat anymore!
2. Jealousy is complex, unnerving, and at times a good feeling. Jealousy can fuel a passion underneath you like no other...AND it can be detrimental.
3. "No it's not a heart rate monitor or mp3 player!"
4. Who is it at my insurance company that thinks that a CGM is experimental, unproven, and still under investigation?? So...I will send them these results. CGM Trial Results
5. I hate that all my best efforts for a good bg day can go down the tube in an instant.
6. I hate that all my best efforts for a good training day can go down the tube in an instant because of diabetes.
7. I love having best efforts!
8. Placement of a pod proves to be difficult when wearing a swimsuit...not a racing suit, but a girly, on the beach kind of suit. THEN you have the issue of tape marks and bullet holes that are clearly noticeable! I always say that I don't care and won't hide them, but I'm lying....I hate it!
9. Everything that is hard is always worthwhile!

'Nuff said?

Finger Sticks...I've Gone Dry

This will not be a new story to anyone out there that has diabetes, and it wasn't the first time this has ever happened to me. so here it is....
I went on a great, 60 degree weather, great mix on the iPod run last week. My running hasn't been up to par lately, and this day was unfolding into a picture perfect run. Even with the great tunes, I was able to concentrate on the task for that particular training day. This can be a difficult thing when your mind is racing about all the things you need to accomplish, but I succeeded in letting all of that go and enjoy the moment. I came up to one of the usual spots I stop to test. I hit the button to stop my HRM for a moment...God forbid I add in the time for the 30 sec. it takes to test! I'm fishing around in my SPIbelt..(I love that thing!)....and I get out my OT mini, strip, and...what??? No lancet??? What??? Where the hell did it go? This is a meter that I keep in there at all times..never leaves it's home in the SPIbelt. I didn't feel like I was low, but I'm a creature of habit and have to test when I get to that big tree. Maybe I'm a bit obsessive compulsive, but show me a diabetic who isn't! So with my thinking cap on, the first thing that comes to mind is to squeeze the life out of all the fingers I've tested on in the past, which of course is all of them. How many times have you had your fingers squirt out blood at inopportune times...when you aren't testing??? Millions for me. Wouldn't it figure that the one time I need it to happen, it doesn't. I squeezed my fingertips until they were bright red, then blue...no luck. I was exhasperated, but gave it another college try....now there is the blood I've come to love! I just hoped it was enough to fill the strip..and it was. Eureka! A blood sugar of 140.

Early Morning Wake-Up Calls

People with diabetes that use all the new technology out there know all the familiar sounds. Beep, buzz, beep beep beep louder...buzz buzz buzz more frequently....until you can't ignore the sounds and vibrations anymore. My 5AM wake-up call was my Omnipod going off. First the pod, then the PDA...then the pod again...then the PDA...you get the gist right? I'm thinking in I'm in a dream state, and then realize that it has expired and I need a new one. After the first alarm warning, you have about 8hrs. to change it. I was at the 8th hour. Whoops! I counted the hours wrong the night before. When I'm using my Navigator it's worse! That thing beeps louder than my alarm and wakes up the dogs...at least the one that can hear still. Yes, I know that is why it's loud...to alarm the world that Nancy is low again. When it happens at work I get the response of..."you okay?" "Do you need some insulin?" (Yeah, that's always a good one...do you want to see Nancy pass out, fall down the stairs and have an ambulance come and wonder what the hell that pod is on my arm...because they won't know!! Co-workers will tell them an insulin pump, and they will say, what??) Followed by the response.."Do you need some candy?" I love that one:) I'm am trying harder then the dickens to not treat with candy anymore and keep a jar of glucose tabs in my station....but like the candy response. Some people are finally getting it after 10 years of this. Realize that I appreciate all the care and concern they have, but damn...can I just shut off the alarms so the everyone in the salon isn't alerted to my diabetes??

P.S. Before you comment...I know I can shut alarms off:) But I need to hear them still.

Lows in the Grocery Store & Squat Torture

No, I wasn't doing squats in the grocery store..I'm just blogging 2 days into one post. Although that would be one way to multi-task!! The next DVD buzz will be.."Better Buns While Shopping For Buns"...watch out P90X!

Ok..here is my real post:
At least when you have a low in a grocery store you don't have to search your purse high and low for sugar! The downside is that there is way too much to choose from in the environment. I showed a tremendous amount of restraint..with the help of Brent. "Put down the Ho Ho's". I really didn't have them in hand, but he knows where my mind goes. I settled for the Sprite in the checkout line, and this contributed to one of the few successes I had with not over treating a low. It brought it back up to a respectable level, although I did make him drive home. I was a good diabetic that day:) I will take pride in the achievement!!
The Boot Camp..P90Xish class done at my gym took as much strength and willpower as it did to put the Ho Ho down. Great class, and something like that will make you realize very fast that you aren't as in shape in some areas as you thought. Try doing 5 minutes of squats with the only break being in the squat position for 15 sec. while your legs shake. I wouldn't call that rest at all...but a form of rest I suppose. I understand why we were doing that, and have to remember what kind of results it produces...so I won't bitch:) While doing the mountain climbers, I remind myself that I voluntarily showed up at 6AM...so I won't bitch:) The torture left me walking a bit funny, and now will go on to do an endurance swim. With NO kick drills!
This should be a good day.

Logbooks..I Hate Em'

Diabetes and logbooks go hand in hand. I haven't kept a long book in a very long time, because in this day and age downloading stats from blood sugar meters and pumps is so very easy. After yesterdays regular ol' checkup it's apparent people still log...even people who have had diabetes longer then I have.

There are multiple reasons that I love my doctor. The biggest is that he "gets" me. I mean he really, really, gets me. I think that is a huge battle when taking me on as a patient. My A1C has been less then stellar, and has come down this last appointment. I have been trying harder, so it's nice to see those results. May face may have still shown some disappointment, to which Doc starts in on his pep talk. I won't go into it, but he really, REALLY gets me!:)

Doc was playing the good cop...and then bad cop showed it's ugly head! "You said you were going to send me blood sugars last time"...."Uh, yeah, I did didn't I". This is where the Hawthorne effect comes in. "If I send you my log it won't be a true snapshot of what's been going on, because I'll be trying to impress you and do better"....he then gives me that look, like....duh! Ah Ha moment #1. In that moment I realized I haven't been using his knowledge for a long time now. I've been going through the motions, and using him for lab work etc. It gets to a point where you have been living it for so long, you think you can figure it all out on your own. Right! If I could figure it all out, I wouldn't be in this situation. Ah Ha moment #2. I'm now going to take advantage of him!:)

So, I'm back to being a newbie logger. Today is a new day!

The Goal Breakdown

I think my goals will get too long for one post, but I will try to break them down one by one as best as I can so I don't bore all of you!:)

There have been some changes in my goals since I last wrote about them. Some have been accomplished, some have been tweaked, and some are just ongoing struggles! Here is how they looked back in September, and where I'm at with them now:

1. Go for my ACSM certification. Adding to my CI-CPT (Cooper Institute-Certified Personal Trainer) Still in the works, and have added getting my USAC Coaching License, and will be finished soon!
   
2. Get my Spinning Certification. Need to get some experience in group exercise! Finished this one in the winter!! YAY!
   
3. Find a part-time personal training position to gain more experience. This would mean I have time to do it..which I really don't right now, but still a goal.
   
4. Do one race...yes ONE, with Tony! Maybe mtn., maybe a triathlon relay...hmmmm. Hmmmmm still:) Would love to do the Tour de Cure with him down in N.C. Need to win the Lotto!
   
5. Better time management. I have so many things going on now and I need to prioritize! Oh boy, this is a biggie. Actively working on this one as we speak!
   
6. More strength training!!!! Not my favorite thing to do and it always has to be a goal. I started out great, and have fallen off the wagon..again! Hopping back on now.
   
7. Don't sweat the small stuff. *Sigh* Yes, yes, a work in progress.
   
8. Oh yeah....don't forget that I have a husband and family! See number 5!

To be true to my type A personality, I have added some goals:

1. As I will have more time for myself...see #5 above...I will spend it doing more things that I enjoy, and have missed. Yes, that enjoyment may be with my training, but will also be with my husband, and my sewing machine.
2. Try not to beat myself up mentally. I can be SO good at making myself guilty for doing or not doing things.
3. I have been working with Colorado Premier Training as a Resident Coach. I have one athlete with a goal of more. Rick is da man! I will pressure for more time with his brain! He gets the whole diabetes/athlete thing, and is a coach for DTC.
   
4. This is a big one for me...need to concentrate on my own diabetes again. Everything could be better...see #2.
5. Racing: Hopefully Steelhead Half IM again, and 3 Olympic distances, and the Tour de Cure here in Michigan. All depends on the $$$$.
   

Those are the ones that are in the front of my mind, and I beleive are attainable. Some I will always be working on..i.e. all the mental stuff. There is a theme to my goals..look close. It's only when you write them all down that you see that. In a nutshell...life balance. My training has taken a back seat to all the other things I'm involved with, and while I enjoy doing it all to a certain extent, I very much miss the training. My body misses the training. Just being out on my bike, or a long run does wonders for my mind and of course my blood sugars. All of which makes me happier, and I'm sure Brent would agree, easier to live with:)

The ol' saying...All work and no play....

Absence Makes the Heart Grow Fonder

Really?? Does it? I will admit that when I travel this is too true. I recently spent 10 days in Tucson, Arizona with Diabetes Training Camp doing my usual gig of running the logistics for the week. Brent was traveling the days leading up to my departure, and we literally crossed paths in the air! 2 weeks without him was tough. It's very nice to be home and getting back into the routine of our life. I am a creature of habit...just like the dogs:)

Does the absence of training make the heart grow fonder? Absolutely not! It makes you sore and crabby, which makes you unmotivated to do it. Am I speaking for the whole group here? I'm heading to my trainer after this blog post so I can kick my own butt into gear. My race schedule is getting tweaked and will be ready to show the diabetes world what I will be doing for 2009....so I must kick my butt frequently now to be on task in time.

Does the absence of blogging make any difference? Probably not for most of you reading this, but it gives me a chance to write down thoughts and it keeps me honest and true to my goals. So, yes it does make a bit of difference to me.

Are you sensing a running theme here? The absence of hard training, blogging, and the absence of me:) Finding what truly makes me happy again...getting that life balance back. That brings me to goals for the year. Which have changed a bit from my last goal list. That will have to wait for another post!

Bye for now! See you at the races:)