weight

The New World Of Martin

Back On Track

188. That is the number that greeted me Saturday when I stepped on the scale to see just how bad things were. After making significant progress in losing some of my heft, making as much progress as getting down into the mid-170’s by June of this year, at the beginning of July I had a bad diabetes moment, and despite my intentions to throw myself back into exercise and eating low carb, I’ve really lost focus.

My clothes fit a little more tight than they used to, and certainly more tight than I want them to. I look at myself in the mirror and I’m not happy with what I see. I want to look and feel sexy, and make the mistake of asking my reflection for my phone number when I walk by. I need to get new clothes too, as most of my clothes are well worn, some even with holes in them. But I refuse to go buy them when I’m at a weight and size that I’m not happy with. I don’t want to buy the size clothes that I am. I want to buy the size clothes that I want to be.

I’m also tired all the time. I don’t really sleep that much, and when I do it is restless and dream filled. Part of that is because I’m stressed all the time. I feel like I have for more to do than I have time to do it, all the time. It’s not just work, or life at home, or people I need to see, or things I need to do. It’s just the culmination of everything. It’s as if I can never get enough accomplished, and despite my generally optimistic view of the world, lately I feel frustrated because I end every day with a list of things I didn’t get done.

My eating habits are just plain gross since July. When I had my seizure, I really chewed up my tongue and mouth. For two weeks I could only eat soft foods like macaroni and cheese, applesauce, soft cookies, breads, and sometimes soup if it wasn’t too hot. Because I could barely chew or move food around in my mouth with my tongue, it completely broke down my low carb routine that I had been sticking with and was doing so good at keeping up. Now, because my routine changed, I’ve gotten accustomed to foods that I can eat fast, because I don’t have a lot of time to stop and put together a meal that is healthy and good for me. Rather than a breakfast made of something in the 20 grams of carbs or less family, I end up grabbing the blueberry or banana nut muffin that is 58 grams of carbs, just because it is fast, easy, and available. Rather than opt for a healthy salad or protein heavy lunch and taking time to pause and use both hands to enjoy it, I end up with the carb loaded option that I can eat with one hand so I can continue working with the other.

Emotionally, because I feel so far off track, I’m not happy. Sure, I still have a good time with friends, when I can find the time to get to hang out with them at least. A-Flizzle and I still enjoy doing things together. It’s not a social unhappiness, but rather a disappointment in myself for putting back on nearly all of the weight that I was so proud of myself for losing in the first half of this year. I don’t like the way I look, and I don’t like the way I feel.

So, all that said, the first step is looking at the situation objectively and admitting that there is a problem. Now what?

I looked over my 2011 goals, and I still have a lot of work to do, but I’m not severely off track. I got my A1C down, I joined a gym and started taking spin classes to have a group of people to regularly pedal with, I paid off my insulin pump, I’ve gotten to have adventures in Washington D.C., New York, New Orleans, Tampa, Orlando, Jacksonville, and I celebrated 30 years with diabetes and jumped out of an airplane.

I still struggle with wearing my CGM every single day, I haven’t ran a 5K, I haven’t made it to the dentist yet this year, and obviously (given the topic of this blog post) I haven’t made it to my goal weight yet.

I’m making an effort to be transparent. I want others to know that diabetes isn’t easy, but there are other things in life with and without diabetes that are also challenging. I’m going to get back on track. Maybe it’s shallow, but I want to look in the mirror and like what I see, so much that I throw dollar bills at my reflection.

Starting yesterday, I’m back in the gym. My BG’s are better when I’m active and working out, my disposition is more positive, and in time it will all translate to a lower number on the scale and a higher number on the miles I can go on my bike and the things I can accomplish with my body. I have to make time to do this, for me, and I have to stick with it, stay motivated and encouraged, and share my progress. That means my friends on Twitter and Facebook get to endure my constant status updates about my gym adventures, how I’m in spin class, working on my core, flexing in front of the mirrors, and looking like a complete amateur with my weak self trying to bench press and look all hard in front of all the juice heads.

I may not accomplish every one of the goals I’ve set for 2011, but I’m okay with that. If you achieve every single goal you set, you’re not setting them high enough.

I will feel better about myself and my body. I will get back to liking what I see in the mirror, enough so that I sneak my reflection a high five or a wink when nobody else is looking.

Right now I’m telling myself, “Self! You can do this.” And I will too.

The New World Of Martin

Pump Double Vision

Double Vision

So last night after work was fun. I left the office on time and made a beeline to the grocery store. That means I went directly to the store, without passing Go, and without collecting $200, for those of you that aren’t familiar with insect street slang. I wandered around the store looking for Italian bread crumbs, tomato sauce, and rat poison. Yes, I have strange grocery lists. You should see what happens when I go shopping for birthday gifts.

After the grocery store, I stopped by my house to let the dog out and change out of my work clothes, then went over to A-Flizzle’s house so we could make dinner. We were trying an eggplant parmesan recipe that she found. Don’t worry, I couldn’t find rat poison at the store, so there was no foul play involved. Or fowl play, for that matter. Vegetarian, for the win!

When I got there, A-Flizzle had all of the ingredients and baking dishes and bowls and forks and spoons and knives (oh my!) out and ready to start putting the meal together. One problem: I couldn’t read the recipe. As I tried to study the paper, all I could make out were fuzzy words like “mix” and “lightly” and “weight watchers.” Wait a minute…Weight Watchers? Are you trying to tell me I’m…oh, nevermind. It’s just a recipe.

I stopped trying to read and went to my Adidas backpack (aka, man bag) that I carry everywhere with me and fished out my BG meter. Sure enough, 47. Well that explains why I couldn’t read anything. I found my glucose tab keychain and ate glucose tabs, and then went back to the kitchen and struggled through the recipe. The more I tried, however, the more my vision blurred, and eventually I was seeing complete double. I already have glasses! Cut me some slack here diabetes!

30 minutes later and an eggplant parmesan in the oven, I tested again, and BG was 74. Still, I had complete double vision. Defeated, I went and stretched out on the couch and just closed my eyes, determined to give my body a few minutes to catch up and get right.

Pump Double Vision

Just Sunday, A-Flizzle and I were out and about and I had a BG of 37 with absolutely no symptoms at all. She said to me tonight, “How is it that you can have a BG of 37 with no symptoms whatsoever and I’m the one freaking out, but then your blood sugar is 74 and you can’t even see clearly?”

Wait for it…

“Oh, I know why. It’s because you have diabetes.”

She’ll be here all week folks. Don’t forget to tip your waitress.

OMG Scale

Prendojitters

I’ve got the Prendojitters, and maybe even a new entry to the Diabetes Terms of Endearment. You’ve probably contracted the Prendojitters before too, but you just didn’t know what to call this particular collection of symptoms. The Prendojitters are a collection of nerves, angst, and apprehension that you get before an upcoming endocrinologist appointment. Thus, pre-endo-jitters…Prendojitters.

It takes a couple of weeks for the Prendojitters to fully present themselves. They start with a mild case of reflection. You look back at the last few months of your life with diabetes and start to examine and evaluate how well you have been taking care of things. No matter how well your diabetes has been managed, if you’re anything like me, you’re probably overly critical of yourself. Maybe you haven’t done as many BG checks as you should have. Maybe you haven’t been wearing your CGM sensor around the clock like you had planned to do when you went into debt to buy the thing. Maybe you’ve let a few too many desserts invade your sensible diet, derailing your weight loss efforts and sabotaging your summer beach body.

OMG Scale

Once you’ve given all these self-defeating thoughts a breath of existence, your case of Prendojitters progresses to the next level. You can diagnose yourself with stage two of the Prendojitters when you find yourself unceremoniously scrutinizing data. You compare your weight at your last doctor appointment with what that lying bastard of a scale in your bathroom is telling you now. You look at that last A1C and marvel at how good or bad it was, and go to work convincing yourself that this next one is going to be far worse and even less explainable. You look at your daily carb counts and exercise efforts from the logs you’ve been keeping (Right? Riiiiiight.) and settle on the data driven fact that you’ve been having too much of the former and not near enough of the latter.

In a blink, your Prendojitters progress to stage three, the third and final stage before intervention is scheduled to occur. Now you are at full alert to everything that is going into your mouth, every fingerprick and blood drop squeezed, every unit of insulin entering your subcutaneous layer, and every BG altering activity that you might be engaged in. The anxiety of the upcoming visit with your endo has sculpted you into a well-oiled diabetes managing machine.

Unfortunately, it is going to have little to no effect on your weight, A1C, cholesterol, or chances of winning the lottery, because your appointment is tomorrow morning and you’ve just caught on to what you should have been doing all along. So what do you do?

You finally relax a little in the blissfulness of seemingly defeat. You go see the endo, and then realize that things aren’t quite as bad as you worked yourself up to believing. Your endo is on your side, and he gets it: Diabetes is a lot of work to keep up with, and not every progress report is necessarily going to be all sunshine and daffodils with flying unicorns that poop sprinkles and sneeze glitter onto carbohydrate free cupcakes.

And just like that your Prendojitters are cured…until next time.

Package Inspector

Rewards and the Shrinking Waistline

Today was a day of rewards, a chance to recharge my batteries, and a disconnect from the ever present list of things that need to be done.

HAWMC - Day 9

The #HAWMC blog post challenge for today is an unstructured “Health Activist Choice.” I’m good with lack of structure. I like being left to my own devices and given free reign to figure things out on my own. It may not be necessarily what I’m supposed to be figuring out, but a little freedom to wander and wonder appeals to the adventurer in me, and I always end up somewhere interesting.

My day today was a lot like that. I got to sleep in a bit, which was nice (and unusual). Having the option to sleep in is one thing that I can appreciate about having an insulin pump. Back in my multiple daily injections (MDI) days, I can remember absolutely HAVING to get up so that I could take my morning insulin dose. It’s nice having options, and something I try to never take for granted.

I got some fun things in the mail that I had ordered, which I wasn’t expecting until next week sometime. Squirt the Cat especially enjoyed giving the package a proper inspecting, and enjoying the delightful smells that it must have picked up along its travels from wherever it came from to our house.

Package Inspector

"All your boxes are belong to me!"

Inside were new shorts for summer, which included (free of charge) just a touch of disappointment. Having shifted to a low carb eating lifestyle, I’ve lost a touch more than ten pounds so far, and the shorts I ordered were just slightly too big. Amazing the difference a week makes, back when I ordered the correct size. Oh well, shrink & be merry.

As I’m losing weight and eating low carb, I don’t need as much insulin to keep things level. I’ve decreased my basal rates overall by about 5-10% so far to keep from running too low. Also to prevent over or under correcting for meals, I have to be more accurate in my SWAG (Scientific Wild Ass Guess) bolusing, and estimate the amount of carbs as closely as possible. I’m not following Dr. Bernstein‘s diet specifically (and I admit, I haven’t even finished reading his book yet), but eating low carb definitely agrees with my diabetes. At least, it agrees with my not having post-meal BG spikes, which is great since I hate being high. I’m continuing to make slight adjustments to ward off the lows, so that’s still a work in progress. But honestly, what isn’t a work in progress with diabetes?

The rest of the day I spent with friends watching baseball. Even though both of my teams lost, I still had a great time.

Today reminded me that we need a day every once in awhile (more often if you can get it) to do some things we enjoy. If that is sleeping in, shopping for shorts that sort of fit if you tighten the belt enough, or going to baseball games, it’s important to unplug from all the daily stresses (even diabetes) for a few moments.

I’m already looking forward to next Saturday, when my adventure continues…

2010 MS150

Master of Disaster

Exercise, for most folks, is hard to get around to doing. Our days are consumed by so many things that we simply don’t always feel there is enough time to add exercise to the mix. By the time we get up, get dressed, work all day, come home, make dinner, eat, wash dishes, chase the dog, pet the cat, do laundry, get a shower, and try to relax for five minutes, there often seems to be little time left to do much of anything else. That doesn’t even factor in those folks that have kids, and all the shenanigans that I can only imagine (for now) comes with offspring.

In the late Summer of 2005, Hurricane Wilma came roaring across the southern part of Florida and left most of us without power, transportation, and necessities for days, and in some areas even weeks. The local weather coverage had prompted everyone to be prepared for a “mild Tropical Storm,” but they did not anticipate that the storm would gain strength while crossing over the Florida Everglades and pound the opposite side of the state, where I was, as a Category 3 hurricane.

While nothing like the major disasters of Hurricane Katrina and the tsunamis in Indonesia and Japan, Hurricane Wilma still left us in a catastrophic predicament. Like fools, none of us had taken the forecast seriously after being told to expect nothing much more than a mild thunderstorm. Meanwhile, the gated archway at the entrance to my apartment community had succumbed to the winds and had landed in a heap of rubble (blocking our escape by car), roads were closed and impassable, power lines were laying on the ground with no indication as to whether or not they had electricity coursing through their veins, and a mandatory curfew was in place from dusk to dawn for all affected areas of southeastern Florida. Everything was a mess, and a dark mess too after sunset with no lights…anywhere. Because of all the lights, stars are not a sight you get to see in south Florida very often, so it was very surreal looking up and seeing them in all their sparkling glory.

Word eventually got to us that some areas had power and supplies, yet there was no way for me to get to them. I was an easy 200 pounds heavy at the time, out of shape (unless you consider “round” a shape), and hadn’t made exercise a part of my life since grad school. It was then that I realized the perils of my choices that had left me physically incapable of getting from points A to B, so I vowed that I would never get stuck in that same situation again.

That was when I started cycling. I went to a bike shop nearby and overpaid the owner for a bike that I could ride a fair distance, and would withstand the abuse of a 200 pound gargantuan (see also: fat ass). At first I couldn’t ride but maybe three miles before I would be out of breath and energy. But I kept riding, day after day, and I got stronger, and I stretched those three miles to four miles…

…then to six miles…

…then to ten miles…

…then to 13 miles…

…and by the following June I did my first 26 miles in an organized charity bike ride.

1st Bike Ride - 2006

My 1st organized bike ride + hair + heft.

By the end of that Summer in 2006 I felt that I’d earned a better bike, so I got a Trek 1500 as my first road bike, and I have been pedaling ever since. I’ve wrote before about how cycling benefits me both physically and mentally, and long endurance riding comes with its own share of challenges, but I know now that in an emergency I could absolutely get from points A to B, and probably to C and back again if the situation called for it. Last April I completed my third 150-mile bike ride from Miami to Key Largo and back.

2010 MS150

Outside of the Team Stormriders tent in Key Largo, my 3rd MS150 with the team.

In my case, dropping the weight and getting fit was a side effect of my desire to be able to get to where I needed to go. In doing that, I discovered a passion for a sport that has partially defined who I am today. No matter your circumstances, don’t wait for a force of nature to force you to exercise. Get moving now, and be the master of your own disaster!

 

This post is my March entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/march-dsma-blog-carnival.

Emergency Low Kit

5.6 Degrees of Frustration

I like reading about the experiences my friends in the DOC have when they go to their diabetes doctor appointments. Good experiences or bad, it teaches me a lot about what I want and need from my own endo, and things I should be thinking about.

For example, it’s no secret that diabetes and heart disease are BFF’s. Observing the thoughts and conversations that are shared in the DOC about statins, ACE inhibitors, blood pressure, cholesterol, and the effects on the heart of sticking your finger in electrical sockets makes me realize that I  don’t give this component of my life with diabetes near enough attention.

At my endo appointment last Friday, we talked about some of these things. No mention was made about my weight, but I know that I want to be lighter than I am. I’ve lost 7 pounds thus far with the switch to a low-carb lifestyle, and am making satisfactory progress toward my goals, so I have to take things one step at a time on that front.

My blood pressure was normal, so that was good. I’m not one of those folks that shoves an arm in the free cuff & fluff machines at the store, EVER, so if the endo says I’m good and it isn’t an issue right now, I’m taking that and rolling with it. He did order a full lab workup for my next visit, which should add all kinds of interesting new data points to talk about.

The results of the BIG test on Friday, that almighty diabetes report card mother of all tests, the A1C, took the wind out of my sails. I set a goal at the beginning of this year to get my A1C down to 6.2 or better. On Friday, my A1C was 5.6. I have never had an A1C in the 5’s before, so I should be celebrating that, and throwing myself a party. Instead, I feel like a failure.

Diabetes is a candle burning at both ends. You can monitor your BG’s closely, and stay as close to on top of everything as possible, but often when you focus too hard on one problem (too many highs) and fix that, you end up with another problem (too many lows). Diabetes doesn’t give very much room for error, and that frustrates me. Maintaining perfect blood sugar control is like trying to balance on a tight rope, hanging over a cliff, while juggling bowling pins and riding a unicycle. It’s possible, but good grief it requires a lot of attention!

I want to celebrate a 5.6 A1C. I want to upload my pump & BG data to my endo’s computer and see on the screen that I am an all-star diabetic, with nearly flat data charts with very few low or high BG’s. I want to EARN that 5.X A1C, and that is where I feel like I have failed. I did not earn my 5.6 on my terms. I have managed to keep from having very many high BG’s, but in turn I have had way too many lows, some dangerously low, and it leaves me screaming at my diabetes, “I just cannot win with you!” Then I throw a pot and pan at it, tell it to get out of my sight, and pour myself a big glass of Diet Coke and have a good cry while watching an ASPCA commercial. Don’t judge, you know you tear up too every time you see one of those commercials and those poor animals that need loving and adopting.

Friday was a bad day, but it progressively got better the more I digested that 5.6 A1C. It could be so much worse. That 5.6 could have come with severe low side effects, including occurrences of unconsciousness, seizures, ambulance trips to the Emergency Room, car accidents, or the inability to shut up while talking nonsense in front of a crowd of people. It could have resulted in the embarrassment of a low while at work and my coworkers having to help me. It could have included feelings of shame and inadequacy because I needed someone in a way that I can never repay.

My endo and I talked about what I have to treat a low. I have not had a Glucagon pen in…well, maybe not since I lived at home with my parents. That was 13 years ago. It wasn’t until this last year that I even kept a stock of glucose tabs. It’s really a wonder how I survived so many years without them. I did keep glucose gel, so I guess that is worth something, and keeps me from being a total bad diabetic. Now, however, I have an “Emergency Low Kit” so that I have as many weapons in my arsenal as possible to combat diabetes.

Emergency Low Kit

My "Emergency Low Kit" including Glucagon and glucose gel & tabs

I have settled on the fact that it is 100% okay for me to be frustrated with diabetes and an A1C of 5.6 that I don’t feel I earned by being an all-star diabetic. I have settled on the fact that I am going to be working closer with my CDE to adjust my basal rates so that I don’t have so many lows, and still avoid those highs as well. I have settled on the fact that there is no such thing as a perfect diabetic, but striving to be one may very well have played a part in keeping me alive and healthy all these years, and I don’t intend to stop now. I have settled on the fact that there are side effects to diabetes that I absolutely can control, and some that I cannot do a damn thing about.

Diabetes had just better get settled with the fact that I’m not going anywhere, and there is a good possibility that I am more stubborn than it could ever dream of being.

Stuart Smalley

Endo Affirmations

When I set my goals at the beginning of this year, #1 on my list was to get my A1C down to a 6.2 or better. That is a formidable goal, trying to achieve an average blood glucose over time of around 120, depending on what research you consult. At my last endo appointment back in December of last year, my A1C was still reasonable, but it had ticked upwards. I couldn’t let that upward trend continue.

I had gotten my Continuous Glucose Monitor (CGM) and new pump just after my previous appointment in September of last year, and with all the change, I was burnt out. Or maybe just overwhelmed. But really, is there a difference?

I was wearing my CGM intermittently, and was dealing with major information overload with all the beeping and pricking and checking and counting and pumping and beeping and…I was exhausted.

After I wrote my A1C down in my notes, and realized that I had allowed my control to slip in the short three months since my previous appointment, I knew that I had to turn the ship around. I don’t want my A1C to continually creep northward, and me pay for it with problems down the road. I have too much life and dreams ahead of me to get lax with my diabetes management.

So I sat myself down and gave myself a stern talking to. I said to myself, “Self, all is not lost. I want you to look in that mirror, and I want you to repeat after me. I can do better. I have some awesome tools to help me get to where I know I can be. I can wear my CGM all the time, and not take several days off between sensor changes. I can carry around glucose tabs right there in my little pocket to treat a low. I don’t have to be a great diabetic. All I have to do is be the best Martin I can be. Because I’m good enough, I’m smart enough, and doggone it, people like me.”

Stuart Smalley

Daily Affirmations with Stuart Smalley

 

I’m glad we had that talk. Since then, I’ve done really well with wearing my CGM. Every time the sensor battery runs out of juice, it hits the charger, and I’m already putting a new site in and getting everything ready for another round. I’ve gotten to where I really don’t enjoy being without my CGM, and am hoping that I didn’t do too much damage for all the years before now when amazing technology like this didn’t exist.

Lows are still creeping around occasionally, but they are manageable. Nothing a few glucose tabs can’t fix in a pinch. I expect my CDE and endo to want to make some adjustments, and I’m open to that. I’ve started a low-carb journey now, so I don’t expect that I need as much basal rate insulin at certain times of the day as I did with a diet heavier in starches.

Something else that I’m not happy with myself about is that I let myself get lazy, and stopped exercising the way I physically and mentally need to. The scale showed me the truth about that. So far I have lost six pounds, down to 184 lbs. It’s not a lot, but it’s progress, and that is the most important thing right now, to be moving forward. I’m making some big changes to my lifestyle to eat smarter and make better choices. I have my eye on my goal cycling weight, and to slim up and firm up so I look good naked, or at least in a swimsuit. Yes, I’m vain like that.

Back to the A1C, I know that we can’t base our entire diabetes report card on the A1C alone, but it still resonates with all of us where we are in our journey with diabetes when we see that number. I am confident about this upcoming appointment. I am determined. I have a plan. And it’s true, I don’t have to be the best diabetic. I just have to be the best Martin I can be. The rest will find its proper place.