New Year, New Goals, New Me!

The time has come. I've officially become the owner and recipient of Insulin shots. I'm very surprised to see how easy this will be. One is only at night, once, and 10 units. The other is 15 minutes before I eat, 5 units. Pretty simple, if you ask me. Although the cost was anything but simple. I couldn't believe how much it was! $110 for the pens and needles, and this is only a one month supply!!! I've pretty much determined that there will never be a "cure" for diabetes, because too many health facilities and drug companies make their money off of it. It'll never "go away" because of that. . .

In other news, I'm the proud new owner of a fitbit flex, that I had gotten for Christmas. Can I just say that I ABSOLUTELY love it!!! It tracks movement and sleep patterns, and is helpful in seeing your activity levels. There are group forums that you can chat with others on, add others as friends, etc. For example, here are my activity levels since Christmas:

What this shows you is how many steps I've taken each day, and it calculates that I've walked 8.77 miles in that time. Pretty neat :) The fitbit then syncs with MyFitnessPal, which is an app that I absolutely love, and helps me track calories in (with foods that I log), and calories out (with the FitBit tracker). It does take into account my MBR (You still burn calories even if you are sedentary or sleeping. We estimate your calorie burn based on your age, gender, height, and weight.) So, instead of getting "free" calories burnt, it accounts for, "Hey, you'd probably burn this much just to stay alive, so you're not really doing anything 'extra' right now." I think it's great because it makes me more accountable, and makes me really have to work for it, haha. I've gotten to the point now where if I know I'm under my steps count, I find excuses to get up and start moving. Last night, I went onto the treadmill for 10 minutes just to get in a few extra steps. One of my favorite windows, however, shows you how many calories in and how many you've burned for each day:

 

The lighter green is the amount of calories I've burned and the darker green is the amount of calories I've taken in. . . Basically, it's showing you that I've been burning like crazy, but have to work a little harder today :)

 

There are lots of new changes, but that's okay- this is a new year, a new me :)

 

Finally! One Answer!

I forgot to post about something that was actually a bit of GOOD news tonight! Without going into graphic details, lets just say that I've been having some MAJOR reactions to foods lately. I've been cutting out foods trying to figure out what is going on- an allergy? sensitivity? too acidic? too fatty? I've cut out most breads/pastas and stopped drinking dairy milk or eating a lot of cheese. I finally asked Doc, and he told me I have "Gastroparesis." So, I googled.

What is gastroparesis?

Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.

What causes gastroparesis?

Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinson’s disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men.

What are the symptoms of gastroparesis?

The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food—sometimes several hours after a meal. Other symptoms of gastroparesis include

• gastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach
• pain in the stomach area
• abdominal bloating
• lack of appetite

Symptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fiber—such as raw fruits and vegetables—or drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases.

Well, that kind of sucks. But, here's the worst part:

How is gastroparesis treated?

Treatment of gastroparesis depends on the severity of the person’s symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing condition—the symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible.

Eating, Diet, and Nutrition

Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying.
A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.
When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.

How is gastroparesis treated if a person has diabetes?

An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a person’s blood glucose levels to be erratic and difficult to control.
The primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the person’s insulin regimen.
To better control blood glucose, people with diabetes and gastroparesis may need to

• take insulin more often or change the type of insulin they take
• take insulin after meals, instead of before
• check blood glucose levels frequently after eating and administer insulin when necessary

A health care provider will give specific instructions for taking insulin based on the individual’s needs and the severity of gastroparesis.
In some cases, the dietitian may suggest eating several liquid or puréed meals a day until gastroparesis symptoms improve and blood glucose levels are more stable.

Not all bad, but not all good either. 


But, for once, it's nice to understand WHY something is happening.

When Nightmares Become Reality

I had a follow up appointment with my primary physician tonight. He was glad to hear that I'll be seeing a new Endocrinologist, and didn't have much to say when I told him that I really did not like the nurse practitioner at the first office that I had visited. I showed him a screen shot of my sugar pattern lately, which looks little bit like a breathing chart (with massive spikes and falls). Here's what he saw:

If you're not diabetic, you may not understand, so let me explain. This is a graph of my blood sugar readings. I test upwards of 4 times per day - when I wake up, after breakfast, after lunch, and after dinner or right before bed, depending on how it's going. Some of these readings are on the same day (they're really close together). The magic number that I was shooting for was 120. You can see that the lowest I had ever gotten was 158. The highest was 358, or, in other words, 3 times what it should have been. Yuck!

He looked at me and asked, "So, why aren't you on Insulin?" I laughed and said, "Well, you're the doctor, you tell me."

I kind of knew we were headed here. I'm not happy about it though. I know it's hard to understand, and a lot of people think that I'm overreacting. But, let me explain. I've been cutting back on foods, exercising more, and calorie/carb counting like it's no one's business. I've been taking my meds regularly and testing my sugars regularly. I feel like I'm doing everything I could (okay, maybe not everything, but pretty close) and I feel like I have failed myself. The fact is that I can't fix what's wrong with me. I can't fix my sugar. Maybe I could have done more. I know I could have. Maybe I had too many cheat meals. Maybe I waited too long before taking it serious. I have let down... myself. The hardest realization is when you know that you have done nothing but mess with your own results and have let yourself down.

This all being said, now I'm being placed on insulin. The first will be "Lantus." Here's what I've learned about it tonight:
Lantus gives a steady release of insulin overnight and between meals to help control blood sugar for a full 24 hours.
Prefilled pen, uses a small, thin needle
Push button injection  (similar to Byetta or Victoza, both of which I've taken before).

The second insulin injection that I'll be on is "Humalog." This is a shorter action insulin that I'll take before each meal. This will help combat some of the spiking of my sugar, especially after eating.

It's a new journey, and a long road ahead. I can't say that I'm looking forward to this, but I am looking forward to feeling "normal" again and maybe not so tired and sluggish all the time.

My appointment with the new endo is in January, so that'll be a new journey as well, and we'll see what he has to offer.