Travelling with My Pharmacy

DBB Huchay Cusco Blog

There will a few posts/Blogs about my travels to and within Peru.

BUT..

I feel this post in particular is a huge one and is pressing upon me to prioritize even though it’s not in order.

We spent Christmas Eve in Agues Calientes. We planned to climb Machu Picchu Christmas Day.

I became very ill with a very high fever and ultimately sinus congestion, sore throat, fatigue among other things.

I am proud of the way the situation turned out as I recovered very quickly compared to most times I experience this. My husband questioned if I should take part in the venture to Machu Picchu but I insisted despite feeling down and out I would not miss such an amazing opportunity. This is a chance in a lifetime!!! And so we did.

With that being said, after we returned to Cusco a few days later we made plans to take part in a two day trek up the Andes mountains, through the Peruvian Tundra. We would then be hosted by a family overnight before descending back down the next day to another town a few hours away from our starting point.

We reach an elevation of 15,100 feet. Understanding that breathing would be a challenge at the best of times, I am overly concerned that with my congestion and swollen throat it would present greater issues.

On our way to the drop off point 1 1/2 hours away by jeep, I ask our guide to stop at a pharmacy to buy cold medication to help keep the symptoms from being too overwhelming throughout the climb.

As I walk into the pharmacy I take note this is the very first lesson I learn.  Never assume I can go away for 2 weeks and be healthy the whole time. I usually pack cold medications, gravol etc for those ‘just in case’ moments.

This is the first time I didn’t take my personal pharmacy with me. Sigh.

Our guide Henry takes me into the pharmacy in Cusco. I tell Henry in English that I need an anti-histamine/anti-inflammatory. I expect something along the lines of Advil Sinus & Cold or Buckley’s.

After the Pharmacist asks Henry a few more questions in Spanish….”Is it altitude sickness?”…”No, I had a very high fever, sore throat and sinus congestion.”…He recommends a product.

I take a ticket to the cash booth/dispensary at the front of the store. She gives me the box of medication. I am so relieved I will have the meds to help with the congestion, I don’t consider that I didn’t tell the pharmacist I have T1 diabetes OR that I took time to read the ingredients.   At this point I don’t make the connection that Dexametasona (in English “Dexamethasone”) is a steroid!!! I mean, come on, I am a Nurse. I should know the 5 R’s!!

AND I can’t buy a steroid over the counter in Canada! For good reason!

I am told to take one pill now (it is 7:30am) and again at supper. I can take it twice a day for a few days.

Within an hour I can feel the relief. I am overjoyed….until…

Fast forward to that evening and into the overnight…AND the next day…my blood sugars begin to climb…and climb…and climb.

I take insulin corrections like drinking water with no change. Not even a flicker in my Continuous Glucose monitor display. My finger pokes confirm all is not right within my diabetes world.

I reflect back on when we arrived in Cusco. Within a day I was setting temporary basal rates on my insulin pump for low blood sugars and now??? I am insulin resistant in the Andes Mountains??

I play scenarios in my mind. Is it the altitude? Is it dehydration? Is it the anaerobic feedback from the intense activity which leads us to experiencing burning leg muscles, shortness of breathe so bad our lungs are burning?

When I work out at the gym and do intense heavy weights my sugars spike. When I do hill training when I run I get the same effect. Is this the same?

At this point I haven’t made the connection yet that the cold meds contain steroids.

I do think that in part, the intensity of the climb did cause an adrenalin surge that did cause my need for more insulin….pair it with an exogenous steroid in my cold meds and here is a recipe for blood sugar disaster.

My key take away?

Bring my own cold meds and pharmacy.

If ever in an emergency that I require medications while in another country, make sure to tell them I have diabetes.

If and when I decide to ascend to 15,100 feet (or higher), take note and act that if it feels anaerobic, increase my insulin rates to accommodate to it.

No doubt it is a tough balance to achieve but I wouldn’t want to throw my hands in the air and not keep playing the game. Next time I want to improve on this experience. I accept my sugars will never be perfect in these situations especially, but, I will do my best.DBB Dexalor

Lofty Goals

Image

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’.

Cravings

Want tips & tricks on eating well & losing weight? Here is Eden’s next Blog about her Journey. Eden is a busy woman!! She lives with Type 1, at the end of her years in University, about to graduate in May and working hard to lose weight & exercise so she is looking good for her height for graduation.

Help me support Eden in her goals as she moves closer to her goals!! Cheers, Tracy

“Hey Everyone!
Sorry my blogs have been so spaced out! Last week of classes so my blogs will be every other day lol Lots going on! So I thought I would share some of my favorite snacks that I tend to have during the evening. Sometimes in the evening is when I feel like eating the contents of my fridge ha ha! Before I started caring about my weight, I would typically not think twice about eating chips, cookies, 2 granola bars (sometimes more) and god knows what else! So it is hard to not want to eat at night, and I know if I don’t I will be hungry and probably have low blood sugars. So these are some of the things I now LOVE
1. One thing I always have is a drink of water, and a HUGE chai tea with one Truvia (or 2 splenda) and my almond milk. Almond milk takes a month or so to really get used to in beverages, but there is NO SUGAR and VERY LOW FAT! I LOVE IT!
2. Another thing I love having is almonds. I usually buy Blue Diamond Lime and Chili almonds, these are salted, but I only allow myself 11 at night if I choose this. If I choose this, I usually have 1 cup (usually 6) strawberries or a small apple with cinnamon baked for 1 minute in the microwave.
3. My Cheat Night Snacks: Ok so everyone has these, and if you were to tell me I would never have another chip or cookie again, I would die! So I figured out different ways to have things I love, but that are healthier for me. So tonight (for example) I had Special K cracker chips (they have sour cream and BBQ flavors) 18 cracker/chips are 80 calories, 1.5 grams of fat and 14 carbs! Compared to regular chips which are ten times the amount of fat and calories!
For cookies, I make my own which take 20 minutes MAX! I usually put in a bowl 1 cup of oatmeal, ½ cup of egg whites, 1 or 2 splenda, and I use half a scoop of chocolate protein powder (I think cocoa would be fine) I mix it all up and bake them in the oven for 10 minutes at 400 (depending on your oven, keep an eye on them!) I also like adding some natural peanut butter on top for some extra flavor. If you mix it up, and it seems dry add some more egg whites and some water 
Hopefully you like some of my ideas! I always have a chai tea because of its health benefits and it makes you feel full ”

As Exciting As the Discovery of Insulin!

Image

As Exciting As the Discovery of Insulin!

In 1983 and for the next 10 years, researchers began to study whether intensifying diabetes management among people living with Type 1 made a difference. Up to this point there had not been long term research to provide data to prove this to institute change.

When I was diagnosed in 1975, I started on one injection of NPH and Toronto in the morning.  A Keto-Diastix before & after school & at bedtime was dipped in a urine sample to determine sugar & ketones. Little did we know that it was not an accurate test of glucose control. Every 3 months my blood work was done & thankfully my A1C as well. We would see the Paediatrician shortly after.

In 1981, an extra injection of NPH & Toronto was added at supper time. Around that same time I received my first glucose meter.

This study has changed the way people with Type 1 diabetes are managed. It was & still is exciting!

Here is what the Diabetes & Complications Control Trial is about.

There were 1,441 people from Canada & the U.S from 29 centres living with Type 1 diabetes more than 1 year but less than 15 years. They could not take part if they had too many or severe low blood sugars, severe complications or limited life expectancy. The ages studied ranged between 13 and 39. Young children were not studied. There were 2 groups; 1 had their diabetes managed intensively, the others managed as before.

The main goal was to keep blood sugars as normal as possible through a criteria of intense methods for diabetes management.

Clinical findings & significance:

1. The risk of eye complications were reduced 76%.
2. The risk of complications of the kidney were reduced by 50%.
3. The risk of nerve complications were reduced by 60%.
4. By keeping blood sugar’s as normal as possible, the onset & progression of eye, kidney & nerve damage caused by diabetes slowed.
5. Even those who had a history of poor control who sustained any type of BG lowering showed a difference in the progression of complications.
6. For those who already had eye complications by participating in intensive management of their diabetes, they saw the progression of the complication slow by 54%.

What is Intensive Management?

1. Testing BG 4 or more times a day.
2. Injecting insulin at least 3 times per day or using an insulin pump.
3. Following a diet & exercise plan.
4. Monthly visits to a health care team which consists of a physician, nurse, dietician & behavioural therapist.

Risks involved with participating in an intensive management therapy? Low blood sugars. It was clear that less stringent goals are appropriate for some patients.

This trial has become the pioneer of studies that changed the management of Type 1 diabetes . Since completion of the study in 1993 there has been further work done to answer more questions & give more data. I will continue to post on these.

To Be Blunt

Video

My friend Jeremy who is a nutritionist & fitness trainer has a genetic pre disposition to Type 2 diabetes. Ultimately, his Doctor gave him the diagnosis of Type 2 diabetes.

Listen to Jeremy’s synopsis of his diagnosis & the lifestyle changes he is now living to overcome his diagnosis. In shock, Jeremy’s Doctor told him he no longer lived with Type 2.  Jeremy told him & he is now sharing with you how he was able to stop it in its tracks.

Enjoy!!

Eden’s Journey – Tips, Tricks & Must Have’s

Image

Eden's Journey - Tips, Tricks & Must Have's

Below is more of Eden’s Journey to exercising and losing weight in a healthy way. Eden lives with Type 1 diabetes. She has a goal to be in tip top shape for her graduation from University in May. Help support and encourage Eden as she shares with us her journey. Today Eden shares tips & tricks that have worked for her & may for you as well. She recommends a “must have” piece of equipment that will encourage & support you when exercising!!

“Okay as I promised, I am going to talk about how I have handled my blood sugars at the gym ha ha. Now I am sure a lot of people struggle with this. You get a low and you don’t want to eat because you want to burn calories and it becomes pointless, or you do not want to go high and have to take insulin to bring it down etc etc etc. It is honestly a battle for some, and it has been for awhile with me. I have noticed in the last 2 weeks since I have been working out so hard, I have struggled with this. I would work out and go down to 3 or lower (obviously not good).

Here are a couple tips that seem to work for me.

1. If you know you are going to work out after a meal, eat a carb during that meal. I find yams are a great thing to eat, and healthy for you. They do not have a huge amount of sugar, and metabolize well. I usually bake mine with a bit of olive oil for 10-15 minutes till they are soft…so good. I also tend to eat a lot of Ezekiel brand products (they have no gluten or flour!). Do not be shocked when you go to a store and see a loaf of raisin bread for $5.99 at Sobeys! The loaf for me alone lasts usually2-3 weeks. I recommend their products; they seem less heavy on my stomach and work well with my sugars.

2. If you are working out during a time where you did not have a meal within the hour, I usually eat a small banana before my work out and a kiwi after. I only do this when I know I will be burning 500 plus calories. Sometimes this is needed for me, but everyone is different.

3. DRINK LOTS OF WATER…Most people seem to think there is a magic pill, there is! It is something that is free and at your disposal all day long. I bought a bottle that’s big enough for my “8 glasses a day.” I found that you instantly feel more refreshed, have more energy and needless to say my skin looks like it has a nice glow to it ha ha. Seriously drink your 8 glasses and I can guarantee with a bit of exercise you could lose at least an inch or two in one week !

I am by no means a doctor! These are tips that seem to work for me, and maybe they can help you. I have had to do a lot of figuring out of this stuff on my own.

Here is a pic of me at the gym last week with my low blood sugar 😛 I thought every post needs a picture!”

Saying No.

Image

Saying No.

How can one word cause so much stress?

Is it the concern of being selfish? Is it the fear that we are not allowing ourselves the opportunity to have new experiences and challenges? Is it the fear of believing there is no one else that can do what you’ve been asked to do? Are we afraid to disappoint? Do we need to prove a point to ourselves or others? Are we afraid of conflict and burning bridges?

In this day and age the pressure we are living under to perform, accept, accomplish, respond to, access and be accountable for is too much, not just as adults but teens and young children are being subjected to this prematurely. Our private lives are jeopardized by the creation of global urbanization and technology with the expectation to keep up at all costs.

Yes is stress. But saying no is too. How do we find balance?

Take a look at how stress can influence our health:

1. Stress hormones raise blood sugars
2. Stress contributes to insulin resistance
3. Stress leads to weight gain
4. Stress can increase blood pressure
5. Stress can suppress the immune system
6. Stress can worsen or create allergies
7. Stress can increase the risk of heart attack and stroke
8. Stress can impair fertility
9. Stress can accelerate the aging process
10. Stress can create psychological imbalances such as anxiety and depression
11. Stress can cause or enhance addictive behaviours such as drugs, alcohol, sex, exercise etc.

Here are some guidelines to assist in determining when it is right to say “No’ and find or keep your balance.

1. When you have a bad feeling and your gut says “this doesn’t feel right”…trust it!!! Be true to yourself!
2. Thinking about saying “Yes” to the request causes you to feel overwhelmed before you have even committed to it.
3. Your principles, ethics and/or beliefs are in jeopardy.
4. The financial expense doesn’t fit your budget.
5. It is not fulfilling the goals and objectives you have set for yourself.

It’s OKAY to say “No”. Words and body language are our most powerful ally. How you respond will empower you and the person who has asked.

“Seek first to understand, then to be understood.” – Stephen Covey