A Day in the Life of Daytona

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This was originally posted to my blog, SweetGeek.

After being hit by the diabetes truck 6 years ago, I am seeing my first endocrinologist tomorrow. I am terrified. I am excited. I am hopeful. I am ashamed.

A few years ago I had a pretty good handle on my diabetes. The coolest kids on the diabetes forums all assured me that diabetes isn’t progressive. If I maintained normal blood sugar levels, aiming beyond what doctors and the ADA settle for, then I could control my diabetes indefinitely.

Unfortunately, I am not as awesome as my online persona may have lead you to believe. Over the past three years my fasting has crept up, up, UP. Before I started insulin this January, I would regularly wake up at 185, and never see a number under 145 for the rest of the day, no matter what I ate. Eight months later, after first admitting that “I need just a little help”, I am now admitting that I need a metric butt-load of help. Here’s an average day in the life, and mind, of Daytona:

  • Wake up at 145. Inject 13u of fast-acting Novolog to stop the steady climb and keep it down around 100. Inject 25u of my basal insulin, Levemir. Log all the things on my phone.
  • Walk at my treadmill desk and read email, sometimes with a wee bit of coffee, until I am concede that yes, I am in fact awake.
  • If I’m feeling masochistic, obsessively test my blood sugar during this time, injecting more insulin in the vain hope that I could get my blood sugar under 100 to my target of 80. I’ve mostly given up on this and don’t look again until lunch.
  • Test before lunch, usually around 125. Combine my correction (5u) and pre-bolus (2u) into a single injection about 30 minutes before lunch.
  • Fart around and pretend to work until I can eat.
  • Scarf down my salmon, broccoli and soul bread (9g of carbs total) while working.
  • 2 hours after eating, get a 115 and let it ride.
  • An hour later remember that I forgot to record the last 2 tests and my injection on my phone, dig up my meter and redo the math for my bolus and reproduce what I most likely did.
  • Go back to work and do my best to not think about eating a snack.
  • Give up and eat a snack, then feel bad about not bolusing for it. But I’m not really sure the best way to bolus for a 7g fatty snack and I am not really confident 5g of those carbs are real. Should I pre-bolus, or do it afterwards? I can’t wait that long and an hour ago thought that I could make it through the afternoon without a snack and now I’m grumpy and want it NOW! Also I don’t want to see that I’ve yet again failed to hit my target and then have to decide if I should correct too. In the end, it’s two hours of fighting in my head and then 1 minute of guilt-ridden nomming on a single square of 100% unsweetened chocolate with a tsp of unsweetened peanut butter plopped on top. Seems like a good use of my time.
  • Stop working and test my blood sugar again, oops 136. Do another combined correction (6u) and pre-bolus (8u) 30 minutes before dinner. I’m tired of everything at this point, and for some reason I hurt all over, so I order my go-to meal of 5 plain chicken wings, a small french fry with some delicious melted american cheese (46g of carbs). The cheese is for the wings. Slimey yet satisfying!
  • Pickup my dinner and eat the cheesy wings first. Look longingly at my cooling fries, managing to hold off on eating them until I’ve finished the wings, about 15 minutes later.
  • Test 1 hour after I started eating the fries, and pat myself on the back for the 133.
  • Check again at 2 hours, turds, 163. Wonder why sometimes this meal works and other times it doesn’t. Feel bad about not shopping and making home-cooked meals, then feel bad about being too tired to do that, then wonder if the new endo is going to actually read my logs. Maybe she is a low-carber who will helpfully point out that if I just didn’t eat carbs, I could go off insulin and all my problems would go away? Console myself with the knowledge that most doctors are high-carb, and instead I will be scolded for eating so much protein/fat and not enough quinoa or kale. Have a good cry because no matter what I do, the doctor will rightfully see through my BS and know that I am pathetic excuse for a human being, with no self-respect or willpower who brought this on herself and doesn’t deserve her time or treatment…
  • Put on my big-boy pants, calculate my IOB (7u), then take another 4u because I just don’t trust that the 7u is going to really bring me down another 70pts.
  • Check again an hour later, 136. Leave well enough alone, inject 25u of Levemir and go to bed.

That’s a pretty good day actually, only 7 tests, no highs over 200, and just 6 injections.

So yeah, I need help, probably therapy. And god help me, I wish I had some Xanax right about now. But as I tell myself every night before falling asleep, “Tomorrow everything is going to be different”.

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We’ve all felt this pain and had those days. Some days it does what it’s supposed to do and other days it fights you tooth and claw, no matter what you try. Diabetes is a constantly moving target (duh).

Imagine being a doctor and having to spend your entire day/week/working life chasing moving targets. No wonder some of them turn cynical.

And on top of it all, nobody but nobody understands what you’re dealing with. Except us here. Hugs.

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Your post illustrates the internal dialog most of us conduct. The debates followed by the resolute, “I won’t do x!” Followed by, of course, x.

Diabetes is mostly fought out of sight of others – the invisible disease. People have no idea how much we think and ruminate about diabetes. Some might even offer advice, if they were aware of our endless deliberations. “Get over it,” or “just move on.” They don’t get the beast we attempt to slay every day. Even if we’re successful, we confront the resurrected dragon tomorrow.

By the way, endocrinologists are just people, too. I hope you discover a good one!

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I think that it can be really hard to have diabetes and not feel that our individual actions are not absolutely perfect. That our decisions and our actions not only brought on our diabetes but are at the root of our inability to perfectly control our blood sugars. Your diabetes is not your fault, you didn’t choose to be overweight or a coach potato. You didn’t choose to catch an autoimmune condition. And you didn’t choose to take action to deliberately have high blood sugars. You need to not blame yourself. If you do everything perfectly and you still have a poor blood sugar you need to pat yourself on you back and remember that you have the curse of diabetes it doesn’t make you a bad person. You did the absolute right thing in the face of a condition which kicks you in the face every day despite your heroic efforts to do everything to control you condition. In my view, if you did everything right, then you are a hero, despite any blood sugar outcome.

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Bullseye. An utterly perfect description, and perhaps the biggest single factor in the disconnect between what diabetes really is, and what everyone else thinks it is.

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Thanks, it’s good to know that I’m not the only one having these little chats with myself. :smiley:

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LOL, no, definitely not. It’s part of the disease. Don’t feel singled out :wink:

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I met with the new endo today, for over an hour!

I spent most of the time trying real hard to steer the conversation where I wanted (getting a CGM) and away from my cholesterol, blood pressure, replacing insulin with T2 drugs, etc. I did accept the Victoza sample, though I’m not sure if I’ll try it. Need to look into it more.

She didn’t look at my food log at all or insulin dosing, just downloaded the data from my meter and noted that most of it is “in range”. Though we greatly disagree on what “in range” means! At least I escaped the anticipated scolding about my carb range. :wink:

Thinking on it further, I don’t plan on arguing with her more about targets. I asked her if she cared if I shot for lower numbers as long as I didn’t go hypo, she said that’s fine. So I don’t really care if she’s okay with me being 180 2hrs PP (and told me to never check at 1hr, it doesn’t matter how high I go before 2 hours). I got the CGM, and will meet her targets, by hitting my lower ones. :smiling_imp:

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