Endo and exercise stuff

I saw my endo the other day and it was such an awesome appointment!!! I've only had one appointment with him before so wasn't sure what to expect for the second one. He spent almost an hour with me looking over readings and discussing things. He wasn't able to spot any patterns (other than that my readings are unstable!) so didn't change any insulin doses. He was most concerned with the lows I'm having lately, so suggested I change my duration of insulin action to four hours from three, which I did. I've still had lows since the appointment so also lowered my basal rates.

He also thinks my A1c of 7.3 is a bit too high, and wants to work on getting it a bit lower. Soooooo refreshing from my old endo who just gave up and said that was "good enough for [me]" (literally his words), and he'd be happy if 50% of my readings were in range. My new endo was also concerned I didn't have a glucagon kit so prescribed one, even though I live alone I will fill the prescription and perhaps give it to a friend or my parents to keep around their place. He also gave me the name of a diabetes nurse he thinks can help with my reactions to infusion sets. He had no problem when I told him I wasn't taking cholesterol medication; said as long as I was informed, it was my decision to make, not his. He also weighed me and I found I lost three pounds during the past three months. It's not much but at least it's something, and the effort I've been putting in is paying off slowly.

It was such a great appointment. I actually left feeling happy and optimistic instead of frustrated and depressed!

In other news, I got a bunch of gift cards for Christmas and used them to buy a Fitbit and a Garmin FR70 heart rate monitor. I had a Timex HR monitor in the past but can't find it since I moved, and wanted something that connected to the computer. So far I LOVE the Fitbit!!! So worth the money!!! It's so motivating to see how active I am and really motivates me to do things like take stairs instead of elevators, etc.

I also like the HR monitor a lot, especially the computer download (partly why I splurged, I really like the download of my swim watch and this uses the same website). I need to talk to my doctor about some things ... Mostly my ankles/toes hurt too much for me to go very fast for very long on the treadmill, even though the rest of my body could do it no problem. (We have a gym in my apartment building, and I'd like to use it every day since it's free and since I love swimming but don't have time to do that every day.) I also can't get my HR above about 120 no matter how hard I work out. I think this is from taking a beta blocker, but I'd like to ask my cardiologist how I should adjust exercise goals for it. I worked with a personal trainer a year or two ago who said I should have a heart rate of 140-150 when I exercise, which I'm pretty sure is impossible now. My cardiologist has said I'm fine to do any exercise I want, no restrictions or anything, but he might know about how I could adjust my target.

Overall I'm feeling super optimistic and good about my health this year! I really want to get better diabetes control and lose weight (and not ending up in the hospital repeatedly for random problems would be good, too) this year. I'm not setting any specific goals because they are hard to meet, but just to put in 100% effort and make any progress would be good!

Great news, Jen I am glad you are feeling optimistic and getting better results from your efforts. It was so grand that you changed doctors. Being aound a pessimistic, scolding endo was not good for your physical health nor your emotional outlook.

Have a Happy New Year!!

God Bless,

A healthy 2013 wished to you .Very promising !! I kept thinking you might see Dr. Wallace in New West ?? ..but she is a she . Do you use proper walking/running shoes ?? The story on shoes is , they work optimal between 500- 800 km ...

PS did you see my comment in your previous last blog ?? Would you consider ??

hi jen, happy new year. im so glad you have found a new doctor youre happy with! congrats on keeping up on exercise-it must be really hard to do sometimes (or all the time, how ´bout)with your crazy numbers!

Wow, what a great endo. That one sounds like a keeper.

ps. I agree with Nel, shoes properly fit can make a big difference. And don't tie the shoes too tight, I found that this led to compressions.

Thanks! I love this new endo and I think if anyone can help me make improvements it'll be this guy.

I do make sure to get good shoes (I have custom orthotics so just get them at the same place that makes those, for running shoes at least), but I will try tying them looser and see if that helps. I think most of my problem is my toes (arthritis) and ankles so I'm not sure anything can be done for that, but maybe exercise alone will help them improve.

Jen - Good news on your new endo. My only exercise is walking and it's essential for my BG control. When I skip walking (2-4 miles) for a day or two, I see my BGs degrade.

I've had toe and heel pain for the last few years. I now see a podiatrist every month and it's been well worth it. His stretching suggestions and orthotics have made a big difference to me. I also have a tendency toward ingrown toenails and he keeps me out of that trouble. It's nice to let someone else cut my toenails each month.

I wish you the best for all your health goals this year.

I think I might ask to see a podiatrist -- I've had a few people recommend them and I've never seen one in my life! Getting custom orthotics and physiotherapy did make a big difference (got them in 2009) but I still experience pain when I walk even short distances sometimes, which makes me feel like I'm 80!

I'm glad you've pounded your numbers in the right direction and am also glad you've found a doc you like who's willing to work to help you! I might steal his idea about the insulin duration as I've noticed that my IOB seems to run out but then my BG keeps going down a lot.

Re shoes, I'm always pro-shoes but recommend a specialty running store rather than podiatrist. Both podiatrists I've seen have recommended New Balance, like it's a mantra. I've had a couple of NB shoes I liked (890s most recently...) but, most of the time, they fail the run with different shoes on each foot test. My dad has very problematic feet, has had problems with plantar fascitis, etc. for years and tried the running store who suggested he get bigger shoes than his feet measured, b/c his feet are so wide. So far, he reports it's made a big difference. MAybe I've blathered about that before but for each kind of shoe (Stability, Neutral, Neutral plus, etc.) there's always different shoes from each manufacturer and I like to try them all before I decide which one is best. If a shoe is clunky in the wrong spot, it'll make a big difference if you can find one that's smoother, even if it's *not* the brand your podiatrist recommends.

Sounds like a great endo appt. I don’t understand why he would change your insulin action from 4 to 3 hours if you are having lows. I would expect that he would change it from 4 to 4.5 or 5 to stop over correcting if he thinks that is the problem. Other than that, sounds great.

I wear Stability New Balance ...I am soo hooked on them , order them through https://www.facebook.com/CoolRunningWalkingAndFitness, take them home and try them on , never had to return any pair , I have wide feet as I think most with Dutch genes have.

Whoops, Lathump you are right, he did change insulin action from three to four, not four to three! Typo on my part!