Of Puppies and Babies

Last night as my husband and I were chatting before bed and planning out the rest of our week, somehow the topic of babies came up (maybe because we have several friends with new babies, and others are pregnant, etc), as well as the topic of our family getting another dog sometime.

It’s been a year now that Xena has been gone, but I swear sometimes I still think: “I need to make sure to let her out to go potty before we go to bed.” Often, I don’t put down the recliner foot rest without checking for her underneath. I’ll come home after being gone a while, and look for her to greet me at the door. The house just seems empty without a dog, especially since I’d had Xena with me for almost 13 years. I work from home a lot, and wish she was still here to keep me company, to go on walks, to demand that I throw toys for her. She was so full of personality and spunk – the best miniature schnauzer, best dog, best canine friend I’ve ever known and had the luck to have in my life for as long as I did.

My husband said he would be totally on board at any time if I wanted to get another dog. And every now and then, I see rescue dogs come in, or get an email about a schnauzer puppy, and I’m like, “Ooooooo, I could get this one!!!” But then, reality sets in. Work is crazy busy for me right now. I’m in the midst of revamping my entire lifestyle around food and exercise, and working towards having weight loss surgery to help me get my active life back and to help make sure I am healthy and around for many, many years to come. Type 1 diabetes is a 24/7 job in itself, and will be even more so once I have the surgery. I can’t bring a new dog into the family when I’m already being pulled a hundred different ways. It just wouldn’t be fair to the dog, or to my husband and daughter.

Then there’s also the baby thing. Despite mulling over the pros and cons on several occasions, I don’t think I’ve quite resolved in my head and heart that I’m never going to have another baby. In the back dark recesses of my mind I frequently hear, “If you lose a ton of weight within the next year or so, it may help your fertility issues as well, and you MIGHT get pregnant!!” But really, do I WANT to be pregnant or have a baby at 41, 42, 43 years old/ however long that would take??? I just don’t know. And until I know with absolute certainty that we’re never having (or adopting) another baby, I also don’t want to bring in a dog to add onto the already monumental responsibilities of our household.

So, there’s the conundrum. It’s doubtful that I’ll solve it anytime soon. But boy, will I always have some seriously wonderful memories of Xena, the Warrior Schnauzer, and she will always hold a special place in our hearts and our family.

I miss Xena so much....

 

Commitment Issues (also known as, My Big 2014 Commitment to Change)

I have dubbed 2014 to be the “Year of Commitment to Change.” Because, really, I’ve always had some sort of commitment issues. Not with my relationship with my husband or my friends or family, but with myself.

Years ago, I (albeit grudgingly, because I was diagnosed at 21, which should have be the height of “fun” time for me in college) made a commitment to myself to take care of my diabetes. When I was diagnosed, my doctor basically said there are 2 types of people with diabetes: those who live with it, and those who die from it.
I chose to be part of the former, and have taken numerous steps and changed my lifestyle dramatically over the past 19 years to make sure I was going to live, and live healthy, for as long as I possibly could. I’ve worked diligently to learn how to count carbs, take the right amounts of insulin, discover settings on my pump that help me avoid post-prandial spikes, acquired a CGM – the list goes on and on.

I go to my regular 3 month endocrinologist appointments like clockwork. I get my labwork reports. Everything looks pretty darn good, like it has for many years. My HbA1c is 6.1, and has been hanging out in the 6’s ever since I went on the pump in 2003. When I was pregnant, it even dipped into the 5’s.

At my last appointment, my endo and I had one of the most serious conversations we’ve had in years (the last one being in 2008, which was the “I’m trying to get pregnant” one, and I was reduced to tears because I felt it was never going to happen. But it did.) Our new-and-serious conversation revolved around my weight, which has steadily gone up since I was diagnosed with Type 1. I was a healthy weight back then at 21, I was an avid hiker, and loved to exercise. Fast forward almost 20 years…..a sedentary job, maturing into my 30s (and now, 40s), a bout of depression,  the roller coaster of hormones when trying to get pregnant, and then the pregnancy itself have helped me put on so much weight, I am now categorized as “morbidly obese.” Just saying that makes me cry.  I have explored the gamut of diets, exercise, changed how I eat, and definitely lost some weight along the way, but never enough to get down to a weight where my feet don’t constantly hurt, where I can sleep well at night, where I have enough energy to play with my daughter for hours, or where I can take up an exercise regimen without hurting myself in some way and losing track. I’ve been stuck in a rut of metabolic syndrome that has made gaining weight, despite my best diet-and-exercise efforts, far easier than losing weight. It’s discouraging, and my body is so very tired of constantly fighting some kind of pain from carrying around all this extra weight.

The me I want to be, again

A New Year’s picture of me, when I was at a healthy, manageable weight – before type 1 diabetes and metabolic syndrome had set in.
I want to be this again.

My endo says, “You are healthy, except for your weight. The medical issues, pains, etc that you have all revolve around your weight. Have you ever thought of having bariatric surgery? I wouldn’t recommend it for most of my type 1 patients. But you….I think you can do it. And I think you’ll see that as a tool, it will help you get to a place where you can manage your weight once again, and not get sucked back into the metabolic syndrome.”  For some background…my endo is a Type 2 himself. He had gastric sleeve surgery 1 year ago. I’ve seen the change in him – he looks, and tells me most importantly, he *feels* AMAZING now. He told me that he would refer me to his surgeon, he would go to the pre-op and post-op support meetings with me, and we could even do group personal training sessions with his personal trainer. He is on board to help and support me, which helps calm *some* of my fears about having an elective weight loss surgery as a Type 1 diabetic.

So….here comes the commitment part. If I want to do this, it’s going to require a LOT of commitment to changing, well, just about everything. I have to commit to a LOT more doctor visits over the next year. I have to commit to going to support group meetings. I have to commit to learning about how nutrition and digestion will change with the surgery. I have to commit to a non-impact exercise routine (to save me from injuries and so much foot pain) and know I will deal with blood sugar fluctuations as a result.  I have to commit to overhauling my diet and changing the way I consume food and drink. My diabetes management, that I’ve spent so much time perfecting, will drastically change – both before, and certainly after the surgery.

I have already tried to track down other Type 1’s who have had gastric sleeve surgery to ask them how they have managed, and if they have had any major complications or issues.  I have yet to find any. I feel like I’m navigating un-chartered territory here, and it’s scary. But, I’m even more scared of what my life will look like (or, if I will even be alive/healthy) in 20+ years if I can’t get rid of this extra, exhausting-and-debilitating weight. I’m sure there will be people in the DOC who are going to frown upon this choice I’m making…who think I *should* be able to lose 125+ pounds just by diet and exercise alone. Unless you have been THIS weight that I am, and struggled with all my injuries and aches, you have no idea how daunting it is, or how excruciatingly  painful. I need a dramatic change, I need it soon, and this is what I am going to do.

My first steps:

1. I am owning up to this commitment I am making – to take a risk that will change my life and my health for the better.

2. I am sending out feelers everywhere I know to find other Type 1s who have had gastric sleeve surgery. I’ve posted to a few bariatric surgery pages already, and found plenty of Type 2’s who have done it, but not a single Type 1. I’m hoping the DOC can reach out it’s arms and find someone within it’s ranks who has done this as a Type 1 and is willing to chat with me about it.

3. I’ve had my 1st consultation with the surgeon, and have scheduled nutrition counseling and a sleep study. Still to come: psychological evaluations, support group meetings, and various other tests and examinations to make sure my body is a good candidate for gastric sleeve surgery.

Even if I end up on this journey not knowing or being in contact with anyone else who’s done it that’s “like me,” I can at least document what’s going on through my blog, and I hope it will help someone else in the future. Wish me luck & strength, folks, and here’s to a Happy New Year for all of us!!

The Internet. Love. Hate. Religion. Politics. Health. The ACA. Mean People.

My brain is still reeling from being completely overwhelmed with…I don’t even know – astonishment? Confusion? Disgust? So many emotions and thoughts that even the title of this blog post couldn’t cover everything I wanted it to be about. Let me work out the chain of events, and maybe that will help pull it all together.

I’d just gotten through reading and sharing a couple articles about the ACA (Affordable Care Act) on my 15wait15 Facebook page that were written by Karmel Allison on asweetlife.org. I don’t know her personally and haven’t read much of her stuff – just happened to read some today and found it interesting and share-worthy.

I saw a little (but not much, I admit, I got bored) of the President’s Rose Garden speech about the ACA. Then I see posts pop up from people in the DOC about Karmel Allison being the women who nearly fainted while standing behind President Obama as he was talking about the ACA and glitches in the online marketplace website, etc.

Interested now, I cruised on back to the speech, read the article that someone had linked, watched the video, then did what I usually do with all articles I read online – read the comments underneath. I wish I hadn’t.

Just a few snippets here – click on the link above to read more if you dare.

  • The-Monk Oct. 21, 2013 at 12:26pm “That’s called rotating the Latino’s so it looks like there are more in the camera to impress any Latino’s watching.That or her ObamaScare health policy Doctor put her on the wrong meds and she’s about to die.”
  • drattastic Oct 21, 2013 at 12:26pm “Junkie, still in bad share after her latest abortion.”
  • rickc34 Oct. 21, 2013 at 1:18pm “It was all that concentrated evil Obama aka son of satan puts out”

…and those aren’t even some of the worst comments. I can’t bear to give any more of them added attention. My heart just broke. THIS is how people choose to respond to this? Some poor woman looks visibly distressed, needs to leave the podium behind the President, and you assume the worst? You take to the internet to bad-mouth her, tout conspiracy theories, and say horrible things about her, all because she appears to be aligned with the current President of the United States, and you do not like him/his policies? Shame.

I hope that those people realize now that she is a Type 1 diabetic, who is *pregnant* for Pete’s sake, so she could have had a low, been dehydrated, felt woozy, who knows. I’m sure it had nothing to do with BEING ON NATIONAL TELEVISION STANDING BEHIND THE PRESIDENT or anything like that. Gosh, I think my own sugar just dropped a few points from my brain going crazy thinking about that. And pregnant??!! Geesh! Forgot blood sugar and bodily control then.

My thoughts still aren’t quite organized, and I’m still so angry I could spit nails, but here’s what I have to say, take it or leave it:

  • Shame on anyone who relished in her discomfort, called her names, assumed it was staged, used it as a stepping stone for their own political hate-filled agenda.
  • The internet makes it oh-so-easy to have diarrhea of the mouth/fingers. Think before you comment. Pretend that person is standing next to you in THE SAME ROOM. Would you say that comment out loud? The internet has served to encourage a League of Extraordinary Bullies, and I hate it for that, almost as much as I love it for connecting me to the community of people called the DOC. The dichotomy does not escape me.
  • I don’t care what your religion or political leanings are – it’s no excuse for verbally assaulting someone else on the internet (whether you know them or not!), or anywhere else for that matter. I try not to judge, but in my opinion, you purposefully saying/doing hurtful things means YOU are a mean person. And I will not associate myself with mean people.
  • I try very hard not to discuss religion or politics online anymore, not even on my personal social media pages. It is too polarizing, and there are people I love dearly who will say things that make me want to scream, and I bite my tongue instead. I just don’t understand why we can’t all have different beliefs and opinions, and still get along and find common ground? You don’t have to be my best friend, and I don’t have to be yours. We CAN have different beliefs and thoughts on religion, or politics, or child rearing, or anything else of a million different things that make us individuals, *without* it resorting to being mean-spirited and hateful towards one another.
English: Love Heart symbol interlaced

Love Heart symbol interlaced (Photo credit: Wikipedia)

All that to say….I guess it all comes down to having mutual respect for one another in this world. I’m not sure that exists anymore – certainly not on a grand scale, and that makes me very sad.

There are precious few things that will offend me or cause me to blow up in anger – if you hurt me or someone I love, physically or emotionally,  you can expect a fight. If you are out in the world hurting other people/animals physically or emotionally, or doing things that could lead to them being hurt, I will defy you. (I can’t go too far down the rabbit-hole here. I eat meat, I know animals are killed for it, there are many other social issues that impact people, etc, but hopefully you get the gist of what I mean here.)  Otherwise, we can live in relative peace and harmony no matter who you are, what you do, what you believe in. I have done my best over the years to help people and help animals. Note: I am not guiltless – I know I have emotionally hurt people in the past, and I am sorry for that. I was young and stupid at one point, too. But I grew up and learned better. Tried to make better friends, better choices, and learn from my experiences. I like to think that Emily Dickinson was onto something when she wrote:

“IF I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.”

Could you imagine a world where THAT was what people were concerned with instead of punching people in the internet-face with their own hate-filled speech and rhetoric? We are so far away from that kind of “helping” place, it’s pathetic.
I’m so tired of it. I can’t think about this anymore. I need to go give my daughter a hug.

Some posts/comments from others around the DOC about this follow. So many others have expressed what I feel as well, but in far better ways. I think it’s safe to say,  we’re all pretty riled up.

Pregnancy Diet Plan with Type 1 Diabetes

No, I’m not pregnant. Although, I desperately wish I was, that ship may have sailed.

Regardless, I’ve been chatting with a lot of d-friends lately who are looking into the getting-pregnant-business, and they have been asking about pregnancy diet plans.

Below is what my endo’s nutritionist gave me, and it worked like a charm every day that I followed it. And by “charm” I mean: relatively reliable and consistent good blood sugars within a range I could handle at that point in my pregnancy. Blood sugars are ALWAYS a moving target, but pregnancy makes that even more of a challenge. It felt like I was changing basal rates and insulin-to-carb ratios almost every week.
As we all know, your body and diabetes may be different, but this is what I went by, and this worked for me. I am connecting this with Type 1 diabetes because that is what I know, however, I don’t see why it wouldn’t be applicable for a Type 2 or gestational diabetic as well – as always, you should consult with your doctor to discuss what is best for you as an individual.

Everything in ( ) is examples for that meal – you may obviously swap it out for things you like & different stuff each day – these examples are using the Diabetic Exchange lists. I was a little cavalier and didn’t quite stick to it 100% of the time. When you are pregnant and crave a chicken quesadilla, you must have a chicken quesadilla, though it may not mesh exactly into the options for food at dinnertime.

But to this diet’s credit – my HbA1c’s were fabulous throughout the 9-ish months of pregnancy – 5.2, 5.7, and 5.9 respectively. AND my daughter came out with no issues whatsoever (despite my fears throughout the entire 37 weeks that every high or low blood sugar was killing her. If I could do it all over again, I would do my best to NOT be so stressed out, and instead just relish in the ability to BE pregnant.)

Breakfast
– 1 protein (one egg)
– 1 starch (one slice of whole wheat toast)
– 1 milk (1 cup skim milk)
– 1 fat (1 tsp margarine or 1 piece bacon)

Morning Snack
– 1 protein (1 oz. cheese)
– 1 fruit (1 small apple)

Lunch
– 3 proteins (3 oz. lean turkey)
– 2 starches (2 slices whole wheat bread)
– 1 milk (or 1 fruit) (1 cup plain or lite yogurt)
– 1 fat (1 tbsp diet mayonnaise)
– 2 vegetables (1 tomato / 1 cup raw broccoli)

Afternoon Snack
– 1 protein (1 tbsp peanut butter)
– 1 starch (6 crackers)

Dinner
– 3 proteins (3 oz cooked chicken)
– 2 starches (1/2 cup pasta, 1 slice bread)
– 1 fruit (1/3 of cantaloupe)
– 1 fat (1 tsp margarine)
– 2 vegetables (tossed salad with tomato)

Bedtime Snack
– 1 protein (1 slice cheese)
– 1 starch (1/2 English muffin)
– 1 milk (1 cup milk)

Česky: Pizza

Pizza (Photo credit: Wikipedia)

Notes & info links:

  • I had terrible morning (really, all day) sickness throughout my pregnancy, up until the day I gave birth. The ONLY thing that kept me from retching all day was making sure I ate something every 3 hours. It was like clockwork, and I could almost biologically tell you when it had been exactly 3 hours because I would start getting nauseous.
  • Near the end of my 1st trimester, my husband and I went on a cruise. It was amazingly beautiful and relaxing, but my most favorite memory is eating a piece of PIZZA almost every night around 11pm so that my blood sugar would stay stable throughout the night. I AM NOT KIDDING. Pizza!! It was an historic event of perfect blood sugars with relation to that usually-nightmare-blood-sugar-causing food. (This only happened in 1st trimester and beginning of the 2nd. During the crazy-insulin-resistant-3rd trimester….pizza was off the table.)
  • There are tons of resources out there around pregnancy with Type 1 diabetes. Before I really engaged with the breadth of the DOC, I chatted a lot on the boards at  http://www.diabeticmommy.com/
    TuDiabetes also has forums and groups filled with women looking to get pregnant, currently pregnant, or post-pregnancy who can be great sounding boards for questions: http://www.tudiabetes.org/group/diabetesandwomen
  • And for those of us who face infertility (diabetic or not) and issues with just getting pregnant in the first place: http://www.resolve.org/

Period. Insulin Resistance. Period.

Attention men: You may want to stop reading now. We’re about to delve into one of those mysterious women-folk-things that might make you queasy, so don’t feel obligated to read this post in it’s entirety. But if you really want to, by all means, feel free! Maybe you’ll learn something. It’s really not THAT gross, I’m just going to say “period” a lot. You’ve been warned.

OK, back to this period thing. Being a woman of child-bearing age, I have a period every month. Having type 1 diabetes on top of that means, my body goes through weird cycles of hormones that connect both of those things. I’m sure other type 1 women have noticed this, but I finally paid close attention this month, and here’s my personal amazing discovery, always with the disclaimer that Your Diabetes May Vary (and I am in no way a doctor or medical professional):

On the first few days of my period, I CAN EAT CHINESE FOOD and NOT go high as a kite sugar-wise! I was curious as to why, hormonally, this might happen. Then I looked at a chart of the cycle of progesterone and estrogen hormones.

I learned many, many things about my body (some I wish I didn’t know) when we were undergoing fertility treatments trying to have our little girl. The main thing I learned, and saw in action very frequently, was that progesterone made my blood sugars run steadily higher the more of it I was taking. (This also supports why, in your 3rd trimester of pregnancy, you become the most insulin resistant as well – it’s when you have the most progesterone coursing through your body.)

In the little chart above, you can see progesterone levels come crashing down at the end of your monthly cycle, thus, triggering your period. For me this past week, these hormone changes equated to one visit to Red Bowl, with me eating “flower chicken” (no breading on the chicken, and a light sauce low in sugar), veggies, a small portion of fried rice AND half an eggroll, and actually going LOW afterwards. It was so unbelievable, I had to try it again a couple days later. The next time, I got a little more brave, ate some wonderfully evil-and-carb-filled Spicy Chicken, bolused appropriately for it in a dual-wave, and peaked at a high of only 165 about an hour and a half later. It was truly magical.

The one thing I didn’t get the test over the last few days was pizza. Next month, I will! Now, I’m not saying we all should go out and eat vats of Chinese food and pizza when we are all on our periods, but if you’re going to do it, may as well do it when it will affect ye olde blood sugars the least, right?  (Oh, and speaking of monthly reminders – you might want to change out the lancet in your checker 🙂 )

Kindness of Strangers

It was a tough morning. I had to go to my yearly OB/Gyn visit, and see all those lovely pregnant bellies flaunting themselves in front of me. I could almost hear them ridiculing me….. “ha, ha, your belly will never look like THIS again.” I have all but given up on the idea of even trying to get pregnant and have a second baby. I’m 40. I have type 1 diabetes. I’m overweight. I have infertility. I have all manner of aches and pains. I’m tired of the emotional roller coaster. I don’t want to waste away the joy of my one and only daughter’s childhood on the unrequited hope for another baby.

There are a multitude of reasons I believe pregnancy will never happen for me again….and maybe it shouldn’t. I’m even higher risk now than I was when I got pregnant with our daughter, 3 years ago this month. And we only got pregnant with her after thousands and thousands of dollars of fertility treatments, IVF, and years of hope and disappointment. That took a huge emotional and physical toll on me, on my husband, on my family and friends who had to deal with me….and I’m not sure I want to go through that again.

I also see how hard pregnancy is on women my age – with or without diabetes. Just because I got through my one pregnancy OK, my body wasn’t damaged beyond repair, and my little girl came out perfectly healthy through it all…..that doesn’t mean the 2nd time around would be the same, and that scares the bajeezus out of me.

As a treat to myself, I went to Starbuck’s after my appointment. I was starting to edge on the side of low blood sugar, which makes me strangely emotional, and was already a little weepy remembering my conversations with the doctor. (She was all sickly-sweet and upbeat, “you had a miracle once, it could happen again!” referring to the ONE and only time I ever got pregnant on my own and had a miscarriage. Yeah, let’s remember that heartbreak.)

I ordered my Grande Skinny Mocha with 1.5 pumps, and an Asiago-cheddar pretzel. (They are evilly delicious, by  the way.) When I pulled up to pay, my friendly neighborhood barista said, “The gentleman in front of you paid for your order already, and hopes you have a fabulous day.” I think I started openly crying at that point, and replied, “That was so sweet of him. Thank you.” And I went on to pay for the lady’s order behind me. I really needed that pick-me-up, and maybe she did, too. My barista gave me a super warm smile (he kind of reminds me of an Italian Santa Claus, so it was even warmer-feeling) and said he hoped my day was wonderful from here on out.

I pulled away, still weeping, but feeling better and more hopeful than I have in some time. Maybe I will get pregnant again, and it will be OK. Maybe we will adopt, and that will be OK. Maybe my daughter will end up as an only child, and that will be OK, too. That man in front of me had no idea how I was feeling, or what a rotten emotional day I was having, but he showed me a kindness that I must have desperately needed right at that exact moment. My barista shared just a few kinds words with me that were unsolicited and not necessarily part of his job description, but he did it anyway. Today, even moreso than usual, I truly appreciate and admire the kindness of strangers.

Pay It Forward

Thank you, thank you, thank you to the man in front of me in line.