Playing the Game

“If you’ve had a good time playing the game, you’re a winner even if you lose.” – Malcolm Forbes

Such a beautiful Saturday!

Such a beautiful Saturday!

It’s Saturday afternoon.  The house is clean, errands done. The sky is blue, the sun is warm and inviting.  It’s time to give my body and mind some love and go for a bike ride.

This is not a leisurely bike ride.  My intention is to make my heart pump fast and hard. I am looking for an adrenaline rush.  I want my muscles to burn while I push my peddles and ache afterwards in thanks for making them work hard.

I hate to bring fanny packs or extra baggage to carry my emergency supplies in case of a low blood sugar.  Instead I have a favourite pair of Lulu Lemon capris that work perfect. Two pockets on the outside of each leg.  One pocket for lifesavers, house key and money. One pocket for my iPhone for music and to record my time, distance and route on MapMyWalk or Run or Bike.  In the pocket in the back of the waist is room for my Burt’s Bees lip chap.  I NEVER go anywhere without my trusted Burt’s Bees!

These items I describe are not the only ones I carry with me.  I am attached to my Continuous Glucose Monitor transmitter and sensor on my outer, left thigh.   Clipped to the right strap of my tank top is my insulin pump.  I keep it there when I work out so I can check my CGM graph to keep my sugars in check.  I check this on my ride based on how I feel.

Today’s work out starts out on a positive note.  My blood sugar is 7 mmol/L (126 mg/dl). Based on this, I decide to eat 1/3 cup of Prana Organic Maple Almonds.  I don’t want my sugar to spike up quickly with a rapid acting carb but I don’t want my sugar to drop fast mid workout.  I figure the almonds are the perfect match for today.

It was a good ride!

It was a good ride!

As I walk in the door of our home, I look at my pump again.  It is a beautiful thing!  I end with a BG of 6.2 mmol/L (94 mg/dl) with one arrow going down which is not bad but I’m a little worried I will go low.

AND this is where it turns into another huge learning curve.  Even after living with Type 1 diabetes celebrating 40 years this Fall.  I am always playing the game.  I am forever learning.  Because the rules are never the same.  They are always changing.  There is no formula.  I need to stay on top and adapt to these changes.

Looking at the screen of the CGM on my pump, I have to make a decision.  Do I take a chance and ride it out?  Risk having a low blood sugar?  OR do I set a temporary rate on my pump to slow down the flow of insulin?  AND/OR do I take less insulin for my post work out snack?

An uncomfortable way to learn.  I hate high sugars.  Especially when I make the wrong choice and cause it.

An uncomfortable way to learn. I hate high sugars. Especially when I make the wrong choice and cause it.

This is what I decide to do:

1.  I set a temporary rate for 50% for one hour.  So, for one hour I will ask my pump to give me 1/2 the amount of insulin I need to sustain me in a fasting state.

2.  I measure out 1 cup of lactose free chocolate milk my post work out snack at 22 grams of carbs and decide to only take insulin for 12 grams.

AND that is when my evening from hell begins.

I spend a better part of 4 hours trying to get my sugar from a stable 13.5 mmol/L (243 mg/dl) back down to target.  My head is fuzzy.  I feel angry at myself.  AND the extra sugar in my brain is not helping.

I evaluate what I could do better next time.  What rules in this game am I going to change for next time?

1.  I always need a post exercise snack.  I don’t think milk is the answer.  I think it is too high in the Glycemic Index.  It spiked my sugar almost like juice does.  I will choose something that is solid food with a combo of complex carbs and protein.

2.  I will take the full amount of insulin for the snack.

3.  I will not panic with one arrow going down and I will confirm the sugar on my pump/CGM with my blood glucose meter.

4.  I will wait to set a temporary rate on my pump until bedtime instead of immediately after exercise.  I do believe that part of the spike involved a glycogen response from my liver as I rode hard and my stomach told me I performed in an anaerobic state for the last part of my ride.  My stomach felt heavy and I lost my stamina as my muscles failed.

“Many times what we perceive as an error or failure is actually a gift. And eventually we find that lessons learned from that discouraging experience prove to be of great worth.”
Richelle E. Goodrich, Smile Anyway: Quotes, Verse, & Grumblings for Every Day of the Year

Lofty Goals

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Lofty Goals

Are the goals you set this New Year too lofty?

Do you find you can be like a race horse waiting for the gate to open? You give it your all but you haven’t trained or prepared enough OR don’t have the build or stamina to be a race horse…yet?

My Mom used to say to me “you can only hit the telephone lines if you reach for the sky.”

I’m sure as you read this you say…”What the heck? Isn’t this supposed to be a website for motivation & empowerment?”

It is…this is the point of my post;

I want to help you create positive, realistic goals that are achievable long term.

There is nothing more defeating then setting goals that you are not prepared for which are so lofty yet you are SO excited about. All of the sudden you begin to make excuses, you let the goals drift into what was and you look back and realize you have let them dwindle into a memory, harshly criticizing yourself for failing. A terrible cycle to be in.

An important point to support you in succeeding is to be realistic & committed. The other point is to know that setting small goals that work toward your desired accomplishment is OK!! Congratulate yourself when you reach each small goal. Mark those as your successes.

Bottom line…be realistic.

If your A1C is 10%, don’t expect it to drop to 7% in 3 months. Pick 1% every 3 months & in 9 months you will have reached your goal.

If you decide to test 4 times a day but test randomly throughout the week, start with 1 time for 1 week & 2 times the next week & so on. Establish the habit of testing pick test times that coincide with your life, your schedule.

If you want to lose weight set your goal at 1-2 pounds per week. Weigh yourself once a week, not everyday. Eliminate self-defeating variables that are beyond your control. Did you decide to set your goal to exercise for 1 hour everyday? Will that work with your crazy schedule or your fitness level?

Do you want to run a marathon this year but have never run? Start with running the distance of a telephone pole or run for 1 minute walk for 1 minute for 15 or 20 minutes. If it’s too much, it’s okay to say ‘that’s enough’ and try again tomorrow or re-set your goal to what you can achieve.

What small, realistic goals will you set that will help you get to the final achievement?

Put one foot in front of the other & focus on where that foot is going. Before you know it you have crossed the ‘finish line’.

Chili Con Carne

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Chili Con Carne

It’s getting to be that time of the year! Coming home from work or inside after a day outside in the cold to the smell of comfort food. What says comfort food better then Chili? A healthy, wholesome meal in one pot. Here is the tried & true recipe I’ve used for the past 10 years. Lot’s of flavour & spices! I double the recipe & freeze in meal size containers. Always tastier after it’s been reheated. Enjoy!

Ingredients:

1 1/3 lb ground meat (chicken, turkey or beef)
1 large onion, chopped
1 large green pepper, chopped
4 stalks celery, chopped
3-4 cloves garlic, finely chopped
28 oz (796 mL) canned pureed tomatoes
14 oz (398 mL) brown beans in tomato sauce
14 oz (398 mL) tomato sauce
2 (19 oz) red kidney beans, drained
1 (19 oz) romano beans, drained
1 tsp dried oregano
1 1/2 tbsp chili powder
1 1/4 tsp cumin
1 tsp salt
1/4 tsp black pepper
1/8 tsp cayenne
1/8 tsp ground thyme
pinch white pepper
1 tsp Louisiana style hot red pepper sauce
1/2 pkg taco seasoning (I use “Simply Organic” as it doesn’t contain MSG)
Olive oil, as much as necessary

Directions:

In a large heavy pot, brown ground beef in a little oil.
Add onions, celery, green pepper.
Saute over medium heat for 5-10 minutes.
When vegetables are cooked, but a little crisp, stir in tomatoes, brown beans, tomato sauce, red kidney beans, romano beans & mix well.
Add garlic & all other spices & mix well.
Cook on low for at least 1 1/2 hours.

Serves 6-8.

If too ‘hot’ add up to 1 tbsp brown sugar.

Meat Sauce

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Meat Sauce

Here is my favourite recipe for spaghetti sauce. I substitute pasta noodles for spaghetti squash for my plate. The rest of the gang prefers pasta noodles. I always double this & freeze, it makes a lot!!

Ingredients:

2-3 tbsp olive oil
2 onions, chopped
1 head garlic, minced
2 lbs of ground meat (chicken, turkey, beef)
1 tbsp + 1/2 tsp salt
2 1/2 tsp freshly ground black pepper
2 tsp paprika
2 (28oz) cans tomato sauce
2 (28oz) cans tomato puree
2 tbsp dried basil
2 bay leaves, cracked
1/2 tsp cayenne pepper
6 tbsp finely chopped fresh parsley
1/2 tsp dried oregano
1 cup of red wine

Directions:

Heat a large stockpot on medium heat.
Add the olive oil & onions. Saute until the onions are translucent, about 7-10 minutes.
Add the garlic & saute 1-2 minutes longer.
Add the ground beef & sauté until brown.
Season the meat with about 1/2 tsp salt, 1/2 tsp pepper & the paprika.
Add all 5 cans of tomatoes.
Add 1 tbsp salt, 2 tsp pepper, the basil, bay leaves, cayenne, parsley, oregano & red wine.
Stir until all ingredients until well combined.
Bring to a low boil then lower heat & simmer 1-4 hours. The sauce will be ready in 1 hour but tastes better the longer you simmer it.

Makes about 4 quarts.

Connecting the Dots

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Connecting the Dots

I notice the biggest challenge in diabetes management is testing blood sugars.

It is a nuisance, no doubt. We all claim we can tell what our sugars are by how we feel & for the most part I believe that. But similar to hunger not always being hunger but a symptom of something else, symptoms we typically feel with a low or high can be a result of another event in our body.

Remember when we were kids & we would pick our favourite colour crayon & connect the dots or complete a # to # pic? It was so cool to see what our efforts of connecting the dots or numbers created….the big picture. So it is with blood sugars.

Making Diabetes Sexy

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Making Diabetes Sexy

Pictured is my “Keeping Diabetes Sexy” bag. If you saw it in my purse you would think it was a make-up bag. It’s pink, it’s pretty, it’s girly, it’s sexy. It has character & looks glamorous. But, that is not the sexiest part of this bag, what is? The contents contained within.

Inside is a back up infusion set, tubing, cartridge, Tegaderm, AAA battery, pen tip, lancet, 1/2 unit pen with rapid acting insulin, test strips, Dex 4 gel, SweetTarts (in it’s own sexy container), ketone meter, ketone strips, BG meter & gum. GUM?!? Yep. What’s the one thing that is so not sexy when you have a high sugar??? Bad breathe!!

So why are these items that are products to support my diabetes in a time of high or low blood sugars sexy? Let me convince you they are by telling you what is not…

1. In 1995 I worked full time at a daycare. Driving home from work I realized that I was going low. All I had with me was a really ripe banana. Cayla & Kurtis were in the car with me. I managed to eat the banana & arrived at a convenience store only to discover I had no money on me. At that time there was no debit, no cell phone. I decided I could make the 15 minute drive home to get the juice I so badly needed. I don’t remember driving home. I could’ve killed my children, someone else or left my children without their Mom.

2. Just this past November we attended a Christmas dinner. We stayed overnight. About 2am I woke feeling very, very sick to my stomach. I tossed & turned until I realized I should run to the bathroom. I didn’t make it. From that time until about 8am I continued to vomit violently. My muscles ached, I couldn’t shake it. My BG’s were between 12-15 mmol/L. I determined they were high because of the stress of vomiting. I thought for sure I had food poisoning as the salmon I ate dinner was a bit ‘funny’. I continued to correct & at one point did see my BG drop to 8 mmol/L. Finally at 8am when I was struggling to breath, my chest felt so heavy, every breathe I took burning like acid, I turned to my fiancé & asked him to take me to the hospital, something was really wrong. It was at that moment I picked up my pump to correct a high one more time & realized I could feel the wet insulin coming through the tubing at the connection of the cartridge. It was only then I realized I was in DKA. Thankfully I had an extra site change, tubing & cartridge with me. I changed it up & took a sufficient bolus to avoid hospitalization. I reversed the DKA fairly quickly on my own. I had no ketone meter & no ketone strips to test & avoid this. So not sexy…my fiancé cleaning up after me every time I threw up not knowing what else to do.

What’s else makes our diabetes look unattractive?

1. Having a low & asking someone for something… anything… because we didn’t have our sexy bag.

2. Running out of test strips & ‘guessing’ BG’s only to find out they were out of target & resulted in being sensitive to someone that was unnecessary…or thinking you’re low when you’re high, treating & ending up being really high…because we didn’t have our sexy bag.

3. Being stressed because the infusion set tore out & now acutely making a Plan B to get insulin by injection or an infusion site….because we didn’t have our sexy bag.

4. Having the insulin pump run out of insulin & no access to any for several hours…by the time you get to some you are very high, feel sick & really, really crappy…ugh!! Not sexy!

5. Having the lancet device in your ‘poker’ bend (believe me it’s happened!!) & have no way to check for a full day because there isn’t a sexy bag with a back up…refer back to #2.

6. Having your infusion sweat off to the point of you having to hold in place for hours because the ‘sticky’ stuff is no longer working or accidentally ripping a stainless infusion set out when taking off your shirt to put on a gown for an x-ray. Sexy is having a Tegaderm & infusion site to to stick it down or replace it.

All these events don’t sound so attractive do they?…quite frankly, if you stood back & watched someone have these things happen AND they had pulled out their “Keeping Diabetes Sexy” bag you would’ve thought to yourself…wow, that person has it together, even living with a 24-7-365 disease…that’s attractive!! AND…what is so good looking & sexy about a plain old blue or black case that stores your pens, meter & pump stuff?? Dress them up, make them yours!!

SO….go shopping!! Have fun picking out a bag that says who you are. Fill it up! It’s time for you to own “_____________(insert your name) Keeping Diabetes Sexy” bag….it’s time to make your diabetes sexy!!

Obvious

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Obvious

The tabby cat in the picture is Oscar. Yes, he is wearing a cast. He broke his leg in our basement shortly after we moved in to our new home last June. How? We have no clue. Young Oscar just wanted to be cuddled & cared for by our 12 year old Midge. How did Midge sense that Oscar needed some down time & snuggling to heal? Who knows. BUT…it is obvious to anyone looking at the picture that there is a cat with a cast. Something is wrong with him. Shortly after this photo op the cast fell off. For the cost of re-casting & the misery we caused him by doing so we decided to let him heal without it. He limped & hobbled around for several weeks, obvious he still had something painfully wrong with his leg. It was difficult to watch. Today you can not tell he broke his leg just a year ago. Does it hurt him still? Does it ache? Maybe. But as cats do, unless it is serious they can’t, won’t or don’t have the ability to communicate that. They act like all is normal. They keep to themselves & prove they can rebound from the impossible.

I hear time & time again the frustrations of people living with diabetes. Where is the cast, the seizure, the wheelchair, the appearance that tells those around them they have a chronic condition that somedays can make them feel like they’ve been hit by a bus? Aside from having a hypoglycemic seizure what are the obvious signs that one living with diabetes has had a series of highs or lows that have left them feeling like they want to be cuddled & cared for until they feel better? Words can only express the experiences one has. How can bystanders relate?

The frustration for many is to call into work or not go to school because they had 2 low BG’s in the night, woke up really high in the morning & just want to nap a few more hours to get the sugar back on track & clear the cobwebs out of their head. This is near impossible if one wants to continue to be a productive member of society….which is the expectation…because diabetes is not obvious. To the contrary, many living with diabetes attempt to hide it from others, compounding the exhaustion of managing it & recovering from the times of variability that come with it.

There are pros & cons living with a ‘not so obvious’ disease.

We hear about the cons all too much. Let’s focus on the good. Consider anyone living with diabetes that are in the spotlight & those that achieve many feats but have not gained the recognition. Examples which I encourage you to Google & research…Team Novo Nordisk (a team of cyclists competing in various events), Chris Jarvis (Olympic Rower & founder of iChallenge), Sebastien Sasseville (1st Canadian with T1 diabetes to summit Mount Everest, completed the Ultra Marathon Sahara race & 5 IronMan races to date), Chloe Steep (Founder of Connected In Motion), Steve Richert (Founder of Living Vertical), Kerri Morone Sparling (Six Until Me), Shawn Shepheard (Sugar Free Shawn), George Canyon (Country Music Artist), pilots, doctors, nurses, pro sport & not so pro athletes, trades, heavy equipment operators…these are just a few. There are so many it would seem like you are reading the Census in the book of Numbers in the Bible….but far more exciting!!

By living with a ‘not so obvious’ disease, people with diabetes accept that because we appear as ‘normal’ we want to supersede normal, we want to communicate that despite living with a not so obvious chronic condition we can & will accomplish whatever is put before us. We want to prove we are different in a good yet obvious way. Sometimes to the point of achieving near superhuman achievements.

Is that a good thing? I have heard time and time again from many..”I am thankful for my diabetes because I am healthier living with diabetes then if I didn’t.”

Many living with diabetes see themselves as healthier as those who don’t because they become more aware & pro-active in their health. Initially one with diabetes becomes healthier & begin to set goals beyond what they knew existed by no choice of their own but ultimately by the drive, strength & tenacity that become product as a result of the benefits they experience by living that way.

There is an obvious that surfaces by living with diabetes. That is the incredible accomplishments & outcomes that result in living with the not so obvious.