I woke up Sunday night after being asleep for about 30 minutes. I didn't feel right, so I checked my BG. As I expected, it was low - 52. You might think, oh that's easy to fix, just eat some carbs and you're all good, and the general recommendation is to eat 15g of carb if you are low, then wait 15 minutes and test your BG again...
Well, it's not quite that simple, and after chatting about this on the phone with my mom, I realized that it's a good thing I'm a math major!
My Insulin: Carb ratio is about 1u:33pts right now, and my Insulin: BG ratio is between 1u:60g and 1u:80g. Thus, eating 10g of carb would raise my blood sugar about 20 points. My desired BG when I go to bed (and at most other times of the day) is 100, So if I had eaten 24g of carb, my BG would be right where it should be. Right? Not quite. I checked my pump to find out that I had .37 units of "Insulin on Board" which means that it is insulin from my last bolus that could still be used by my body. I also knew that I had some Insulin on board before I went to bed, so I set a temporary Basal rate at -90% for 1.5 hr. I checked my pump to find out that this had been active for .4 hr (note: my Basal rate is .5 unit/hr). So, sum it all up and figure out how many carbs should be eaten!
...No cheating!
Let's start with the basics - 24g of carb would work, considering nothing else. .37 units of Insulin on Board translates to about 12g of carb extra to be eaten. But, a -90% basal for .4 hr equals a .18 unit deficit of insulin (-6g carb), and 1.1 more hours at that rate equals another .495 (-16g carb) unit deficit.
So, that comes out to a grand total of 24 + 12 - 6 = 30g of carb to be eaten right at that moment, then I could have canceled the temp basal and been fine. Or, I could have eaten 30 - 16 = 14g of carb, kept the temp basal going, and it would have (hopefully) worked out eventually.
What did I do then? I thought about all this math for a couple minutes, figured the temp basal for .4hr would allow me to eat about 10g less carb than I needed to, and figured that the 1.1hr temp remaining would negate the .37u on board. So, I ate as many glucose tablets as I had near me, which happened to be 6. At 4g of carb per tablet, that comes out to a grand total of 24g of carb. Math is so much fun with a low blood sugar!
...My BG when I woke up was 160. Go Diabetes.
Thursday, November 10, 2011
Tuesday, November 1, 2011
1 Year Anniversary!
Wow, it's been a while since I last posted here! I'm sorry that I haven't shared anything in so long. Obviously, last hockey season has ended... and the current season has begun! So, what happened between hockey seasons, you might ask. Well, during spring break, on March 15, 2011, I started using the pump.
It has improved my bg control and quality of life unbelievably! First of all, I don't have to worry about using a new needle or excusing myself from the table every time I have food - just eat, program the pump to bolus, and that's it (after checking my blood sugar, of course). Possibly my favorite function of the pump is the ability to adjust the basal rate on the fly. Before the pump, I would take one shot of long acting insulin every day, and if I overestimated how much was needed, I just had to suck it up and stuff my face for pretty much the whole day (this happened a couple times after Friday night games, and I would be in real trouble during Saturday's game). This function is also useful after a night out. A low blood sugar can be caused by taking too much insulin, and a low blood sugar can be caused by drinking too much (insulin is not used to process the carbs in alcohol, so blood sugar drops when your body digests the carbs from alcohol... or something like that). So you could imagine that alcohol + normal basal insulin = low bg. When you cut out or reduce the basal insulin, the chances/severity of a low are decreased. So now I can drink to my heart's content with absolutely no worries (just kidding, Mom). Another great feature of the Ping is that it is waterproof. Over spring break, I divided my time pretty evenly between the pool and the beach, so this feature definitely came in handy. Lastly (this is not the last feature of the pump, but it is in regard to this blog post), the Ping's bg monitor doubles as a remote bolus controller. This is a great feature if I don't want to take the pump out in public or if I am driving (say, back to school from practice when my blood sugar is a little high). The downsides I have experienced with the pump are the fact that you have to carry it everywhere you go, since it's attached to you, and the infusion sites sometimes start to peel off after getting (extremely) wet or sweaty. The pros definitely outweigh the cons for me!
That is a pretty short summary of my D-life last spring, now what about summer?
This summer I had the privilege of living in San Francisco, CA for an internship with Thomson Reuters. This opportunity was afforded to me by the Lawrence Scholars in Business (LSB) program. I was lucky enough to win a scholarship which provided funding for internship/job related expenses including housing, travel costs, living expenses, etc. The LSB Program also has introduced me to many Lawrence alumni who have successful business careers, one of whom was integral in helping me acquire this internship. I worked on a face-to-face sales team in the Markets division focused on Investment Management firms. The experience was amazing! After a little road bump regarding my housing situation, I ended up living with a friend and fellow LSB scholarship winner, who also was interning at TR in SF. We lived near the intersection of Polk and Union streets, in the Russian Hill neighborhood. I had a pretty regimented schedule over the summer. I would wake up around 6:15 every morning, be into work around 7:15, and get home around 5:30, then work out, eat/watch TV or a movie or read, and go to bed. I mention my schedule because it seemed to be a blessing in disguise for diabetes control, which I'll get to later. The internship was a great opportunity to meet and work with extremely talented people, see how capital markets work, research investment management firms, discover what financial services they need in order to make a profit, and learn about high performance sales strategy.
About mid-way through the summer, I realized that the internship was not just about working. It was also about getting a better perception of the world, experiencing a new area of the country, and enjoying the unique opportunities that San Francisco has to offer.
While living in the shadow of the Golden Gate Bridge (or was that shadow actually just the fog?), I:
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| The Animas OneTouch Ping, in all its glory on my kitchen table |
That is a pretty short summary of my D-life last spring, now what about summer?
This summer I had the privilege of living in San Francisco, CA for an internship with Thomson Reuters. This opportunity was afforded to me by the Lawrence Scholars in Business (LSB) program. I was lucky enough to win a scholarship which provided funding for internship/job related expenses including housing, travel costs, living expenses, etc. The LSB Program also has introduced me to many Lawrence alumni who have successful business careers, one of whom was integral in helping me acquire this internship. I worked on a face-to-face sales team in the Markets division focused on Investment Management firms. The experience was amazing! After a little road bump regarding my housing situation, I ended up living with a friend and fellow LSB scholarship winner, who also was interning at TR in SF. We lived near the intersection of Polk and Union streets, in the Russian Hill neighborhood. I had a pretty regimented schedule over the summer. I would wake up around 6:15 every morning, be into work around 7:15, and get home around 5:30, then work out, eat/watch TV or a movie or read, and go to bed. I mention my schedule because it seemed to be a blessing in disguise for diabetes control, which I'll get to later. The internship was a great opportunity to meet and work with extremely talented people, see how capital markets work, research investment management firms, discover what financial services they need in order to make a profit, and learn about high performance sales strategy.
About mid-way through the summer, I realized that the internship was not just about working. It was also about getting a better perception of the world, experiencing a new area of the country, and enjoying the unique opportunities that San Francisco has to offer.
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| A view of the Golden Gate Bridge my first day in the city, taken from a rooftop on Union Street (see more photos from San Francisco below) |
While living in the shadow of the Golden Gate Bridge (or was that shadow actually just the fog?), I:
- Played in a charity soccer tournament for disadvantaged youth... then joined the league that sponsored the tournament
- Met distant relatives, one of whom is a winemaker... then went on a private tour of his new state-of-the-art winery in Napa Valley
- Planned to go to Big Sur for a day trip... then at the last minute decided to go to Yosemite.
- Flew to Los Angeles on a "business" trip... then surfed in Huntington Beach.
- Attended multiple street festivals... one of them on my first day in the city.
- Met new friends from the East Bay... then spent at least one day of almost every weekend outside the city from then on.
- Saw a Giants game... then sold ice cream at AT&T Park the following week.
- Met some LU hockey alumni... then played pick-up hockey with them at 7am on Sunday mornings.
- Saw a live concert in a park... for free.
- Made many friends at Thomson Reuters and outside TR... and made even more memories.
The summer was a blast, and I can't believe it came to an end so quickly. I'm very thankful for the opportunity to live in San Francisco, work at Thomson Reuters, and make the friendships I made.
After returning home to Galveston for a week, I came back to Appleton to begin Senior year. The fall has been a blur so far. Classes, job applications, and hockey have pretty much dominated my life. We have been officially practicing as a team for 2.5 weeks, and I don't think that I could be any happier! Our first game is in 3 days... I can't wait
I guess the summer summary is short on D details, so I'll give you this one - my A1C during the first week of September was 5.7, which is almost what a normal (non-diabetic) person's would be. I was ecstatic when I found out! Unfortunately, I had way too many lows this summer. I have been trying to keep my bg a bit higher this fall since I am playing more hockey, so the next A1C won't be nearly this low.
By the way, today is the one year anniversary of diagnosis for me. One year off the zero-carb diet. One year full of needles, finger pricks, glucose tablets, skin adhesive, counting carbs, bent canulas, bg mood swings, eating in the middle of the night, keeping on weight, not waking up to pee, not drinking water 24/7... one year happier and healthier
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| Alcatraz |
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| The Golden Gate Bridge... and the fog |
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| The soccer field |
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| Favorite weekend brunch place - The Crepe House (on Polk and Washington) |
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| In-n-Out! |
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| Half Dome at Yosemite |
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| Giants vs. Astros... Go Astros! |
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| Coit Tower |
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| The Haight |
Sunday, February 13, 2011
Symptoms (?)
So I haven't added anything new in way too long. I'd like to pause the story for now and talk about the types of things I felt leading up to diagnosis (Nov. 1, 2010). I'm not exactly sure if these are all symptoms (I know some are), or if they can be attributed to something else.. but here it goes:
Muscle Cramps - I started getting upper leg cramps after a road game against Lake Forest on Nov. 13, 2009. On the bus back to Appleton, I almost fell over walking to another seat because my legs got so tight right above my knee. I played a lot that game, so it wasn't super surprising that I was cramping a little. I was told to hydrate a lot and stretch, which sort of helped.
The next thing I knew, I would get terrible cramps in my calves at least once a night. I started to supplement with calcium/magnesium because they are supposed to help muscles relax. These nightly cramps continued to wake me up for the remainder of the season.
Extreme Thirst - Not much to say here, I drink tons of water when I'm at home in Texas and when I'm playing hockey, so it seemed natural to NEED water all the time (I even craved water when I woke up with the leg cramps)
Joint trouble - I first noticed that I was having a lot of trouble with the left side of my groin during winter term of 2010. I realized that something wasn't right because when I was sitting in the computer chairs in one of the economics class rooms, I could tweak my leg so that my left pelvic joint (?) popped. My whole leg usually felt better after it popped, but I had never experienced this before in my life, so I was pretty sure there was something unusual going on.
Increased Appetite - In the winter of 2010, I would consistently eat full meals then go back to my room and immediately start snacking. My appetite was literally insatiable. My roommate and I used to joke that I would 'eat myself into diabetes' like Jay Cutler did. Of course, Jay Cutler didn't eat himself into D and neither did I, but it was pretty funny at the time.
Urinating frequently - I don't think I slept for an entire night without going to the bathroom for the first ten and a half months of 2010.
Weight loss - I've mentioned this in previous posts - I lost 15-20 lbs during the first couple months of 2010 and was hovering around 170 until November.
Foot problems - At the beginning of the hockey season in September, I developed plantar fasciitis. I got new skates around then, so I thought it might have been those, but I'm not entirely sure... by the way, I don't have it anymore
Muscle Cramps - I started getting upper leg cramps after a road game against Lake Forest on Nov. 13, 2009. On the bus back to Appleton, I almost fell over walking to another seat because my legs got so tight right above my knee. I played a lot that game, so it wasn't super surprising that I was cramping a little. I was told to hydrate a lot and stretch, which sort of helped.
The next thing I knew, I would get terrible cramps in my calves at least once a night. I started to supplement with calcium/magnesium because they are supposed to help muscles relax. These nightly cramps continued to wake me up for the remainder of the season.
Extreme Thirst - Not much to say here, I drink tons of water when I'm at home in Texas and when I'm playing hockey, so it seemed natural to NEED water all the time (I even craved water when I woke up with the leg cramps)
Joint trouble - I first noticed that I was having a lot of trouble with the left side of my groin during winter term of 2010. I realized that something wasn't right because when I was sitting in the computer chairs in one of the economics class rooms, I could tweak my leg so that my left pelvic joint (?) popped. My whole leg usually felt better after it popped, but I had never experienced this before in my life, so I was pretty sure there was something unusual going on.
Increased Appetite - In the winter of 2010, I would consistently eat full meals then go back to my room and immediately start snacking. My appetite was literally insatiable. My roommate and I used to joke that I would 'eat myself into diabetes' like Jay Cutler did. Of course, Jay Cutler didn't eat himself into D and neither did I, but it was pretty funny at the time.
Urinating frequently - I don't think I slept for an entire night without going to the bathroom for the first ten and a half months of 2010.
Weight loss - I've mentioned this in previous posts - I lost 15-20 lbs during the first couple months of 2010 and was hovering around 170 until November.
Foot problems - At the beginning of the hockey season in September, I developed plantar fasciitis. I got new skates around then, so I thought it might have been those, but I'm not entirely sure... by the way, I don't have it anymore
Friday, February 11, 2011
Mega Summary of December
Ok, let's pick up where we left off - It is mid-November and I have decided to take insulin before/during hockey if my bg isn't quite right. Since it seems to ALWAYS go up when I play, I made a sliding scale for injecting before I hit the ice. A sliding scale sets a certain amount of insulin to take depending on what my blood sugar level is. Basically this scale was identical to the one I used at meal times, but +1 unit for each range. So, if my blood sugar was perfect, I would take one unit of insulin to combat the inevitable rise that would come with hockey.
This worked out pretty well for a while.. or so I thought. I was pretty consistently in the 90s when I played. I thought it was awesome because I was playing pretty well and was not getting low. Well, that's not entirely true. I got low a few times during practices. I think I was in the 50s once or twice. Maybe it was 60s, but either way, I was walking a fine line and I am very thankful that I had glucose tabs on the bench. This is the way things were for the rest of the first half, which ended about 5 weeks after diagnosis.
I feel like I could write a full post about every different subject that comes up when I write these, and maybe I will... but not if I keep updating at this pace! Anyway, what prompted that thought is the fact that I had to fly home to Texas for the first time with diabetes. I was going home for almost a month, so I had a lot of supplies with me - 300 test strips, 50 needles, 100+ pen needles, 100 lancets, 2-3 insulin pens, and 1-2 vials of insulin. I asked my doctor to write me a note saying that I required all of this junk in case anyone asked. I was worried that someone would stop me and think I was dealing drugs or planning to stab tons of people with needles. I was also worried that I'd go low or do something stupid waiting in the security line. Nothing. No second looks at my bags or anything. It was just as smooth as every other time I have flown!
A day or two after I got home, I went on a cruise with a friend and two of his friends (now I can say I went on a cruise with three of my friends). I'll have to write a full post about the cruise because it was one of the best weeks of my life, and it came at the perfect time. I was kind of frustrated with diabetes and I was worried about how much it would limit me for the rest of my life. The cruise allowed me to experiment with doses, guess carb contents, participate in plenty of different activities, drink, workout, dance, stay up late, etc. Sort of just push the limits. The cruise experience confirmed that diabetes would not limit me at all. I can do anything I want to do, anytime I want to do it, in any capacity... As long as I manage my blood sugar.
After the cruise, I spent about 2 weeks at home. I used this time to get back into good shape for hockey (not that I was turbo out of shape, but I had been limited by high blood sugars for a long time, so I wanted to push my body more than I had been able to for the past few months/year). I worked out with my dad every day. He had never really done leg lifts in his life, and I think legs are the most important body part to work out (in terms of hockey.. lower back is pretty important too). So he was pushing himself as I was pushing myself, and it was nice to be able to work out together and have some time to bond each day. I also experimented with different foods, made my mom look up the carb contents of hundreds of different dishes, hung out with my brother (when he was awake!), and caught up with friends. I was able to fine-tune my insulin and carb intake, and determined what was optimal in different situations (ie. post workout, late-night, different foods, skipped meals, having drinks, etc).
I also made a visit to New Orleans over the break with the same friends from the cruise plus Daniel. I experienced a lot of typical N.O. things, like hand grenades (a bourbon street super drink - see picture below), muffalettas, and beignets.
There's not really any reason to mention this, but after an intense night where I saved the day - I'll tell you the story if you ask me in person, or you can ask any of the four other guys - I received one of the best compliments ever, and one that inspires me every time diabetes starts to get me down. Jay sent me a text message the day after this long night (I didn't sleep) that said, "They say diabetes is a bad thing, but you make it look like something I want to have." This reminds me that even with diabetes, I can do anything, everything, and sometimes more than anyone else can do. Thanks for the encouragement, Jay!
This worked out pretty well for a while.. or so I thought. I was pretty consistently in the 90s when I played. I thought it was awesome because I was playing pretty well and was not getting low. Well, that's not entirely true. I got low a few times during practices. I think I was in the 50s once or twice. Maybe it was 60s, but either way, I was walking a fine line and I am very thankful that I had glucose tabs on the bench. This is the way things were for the rest of the first half, which ended about 5 weeks after diagnosis.
I feel like I could write a full post about every different subject that comes up when I write these, and maybe I will... but not if I keep updating at this pace! Anyway, what prompted that thought is the fact that I had to fly home to Texas for the first time with diabetes. I was going home for almost a month, so I had a lot of supplies with me - 300 test strips, 50 needles, 100+ pen needles, 100 lancets, 2-3 insulin pens, and 1-2 vials of insulin. I asked my doctor to write me a note saying that I required all of this junk in case anyone asked. I was worried that someone would stop me and think I was dealing drugs or planning to stab tons of people with needles. I was also worried that I'd go low or do something stupid waiting in the security line. Nothing. No second looks at my bags or anything. It was just as smooth as every other time I have flown!
A day or two after I got home, I went on a cruise with a friend and two of his friends (now I can say I went on a cruise with three of my friends). I'll have to write a full post about the cruise because it was one of the best weeks of my life, and it came at the perfect time. I was kind of frustrated with diabetes and I was worried about how much it would limit me for the rest of my life. The cruise allowed me to experiment with doses, guess carb contents, participate in plenty of different activities, drink, workout, dance, stay up late, etc. Sort of just push the limits. The cruise experience confirmed that diabetes would not limit me at all. I can do anything I want to do, anytime I want to do it, in any capacity... As long as I manage my blood sugar.
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| Jay, Adam, Me, and Love (pronounced 'loovah') about to embark on our cruise. Note, we dressed like this as a joke! |
I also made a visit to New Orleans over the break with the same friends from the cruise plus Daniel. I experienced a lot of typical N.O. things, like hand grenades (a bourbon street super drink - see picture below), muffalettas, and beignets.
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| Jay, Me, Love, and Daniel drinking hand grenades on Bourbon St. |
Sunday, January 23, 2011
The First 2 Weeks
For the first week or two after being diagnosed, things were pretty surreal. It was tough to figure out when and where to test my blood sugars and inject myself, since I still was not very comfortable doing either in front of people. From Monday (D-day) to Thursday, I only took short acting insulin before meals, and I only took a correction dose - nothing to account for how much food I ate. (I also took and still take long acting insulin once a day to account for all the internal functions that can raise blood sugar throughout the day) For those few days my bg was running mostly in the 200-300s. I felt better, but the change was not very drastic. During hockey I was feeling a ton better. I felt like I could skate forever, and my whole mindset changed. Before that week I felt like everything was going against me, and now I was finally making some real progress. I met with a diabetes educator on Thursday who gave me a lot more (true) information about diabetes, carb counting, insulin, injections, blood sugars, lows, highs, etc. At this meeting, we decided that I should begin to take a dose of short acting insulin to account for food as well as blood sugar level before eating.
So Friday, November 5, I started the new regimen and immediately saw results. My bg levels were in the 100s for the entire day. My hockey coach (and I agreed with this decision...) was not confident that my bg was quite under control yet. So I was scratched for the first time in my collegiate career for our first home game of the season. I experienced another 'low' of 88 during the game (it might have been 80, I remember that there was at least one 8 in there and that it wasn't actually a low for a normal person). When the low came on, I realized that it was probably good that I wasn't playing on day one of adjusting insulin for carb intake. We won the game, but it was much different to be in the stands and watch the team play. It wasn't where I wanted to be, and I told myself that night that I wanted to do everything in my power to be on the ice for every game from then on. I also learned how 5-10 of our teammates feel during every game because we can only dress 20 players and have almost 30 on the roster. Every time I glide around or feel myself getting lazy when I'm playing, I think of how it feels to be in the stands and about how much those guys would give to be on the ice representing our school. As if I needed any extra motivation, this experience gave me that much more.
On Saturday I got a phone call, "How are you feeling?" "I'm good." "Ok, you're in..." YES! So many thoughts raced through my head... How much food should I bring? Do I need juice? How many carbs are in gatorade? How is a bus ride going to affect me? What about nerves? (The Diabetes educator told me that) I should be between 150-250 before skating.. What if I'm not? It's not ok to take insulin before playing, right? Then I thought, screw it, I'll prepare normally and see how it goes...
I did everything normally. I was in the low 100s before our off ice warmup so I ate a banana. I was also slightly low before the on ice warmup, so I drank a capri sun. Before the first period? Exactly 150! I was so excited that I couldn't stand it. Perfect for my first game back! I felt pretty good for the entire game. And I scored! What a comeback! I felt that my energy got low towards the end, but my blood sugar was not - actually it was slightly high - it got up above 260 by the end of the game.. I guess I ate too much to correct those readings around 100 before hand - oops. After the game I bolused for our post-game pizza on the bus. For some reason, though, I got pretty low (legitimately low this time) even though I had actually eaten more carbs than I planned for. Why could this be? (Now I know that after hockey, bg tends to fall pretty quickly and insulin sensitivity is high. Also, pizza is digested more slowly than a lot of other carb sources, so the insulin may hit before the carbs do.)
Following the directions of every person who had given me advice that week, I did not participate in the celebratory festivities with my teammates. That sucked, because it is always fun to go out after a sweep, but hey, I had diabetes now, so drinking was totally off limits... Oh well, there are bigger tragedies in life than not being able to drink.
The next week was a lot of the same. Actually, the hockey part was the same - Have a good bg upon waking, eat a little before practice, and have a high bg afterward. Hmm, hockey makes my bg go up. I thought everyone said that exercise would make it fall? That's weird. What was different this week is that my mother was in town. Coincidentally she had planned a trip to visit and watch our games that weekend. I was so happy to have her there and be able to talk about what was going on. Surprisingly though, I didn't find much to talk about. I had done tons of research on the internet, and had learned a lot from the people I had met the previous week. I also had spoken to her and my father over the phone a couple times since being diagnosed, and everything was going pretty well. So we talked mostly about normal stuff. How's home? work? school? yada yada.. Of course, at meal times I would ask, "hey, how many grams of carbs are in (insert carb-containing food here)?" and she usually wouldn't know the answer. Whoa, this is my mom, she has fed me for almost a quarter century, and she doesn't know about this (common food item)? I have to figure all this out by myself? Thank God for smart phones, because at least I can do a quick search on Calorie King for baked potatoes while sitting at the table!
We had another home-away series that weekend. During the game on Friday, I was struggling much more than I had the week before. My bg was in the upper 200s and even in the 300s (I check between periods). I told an assistant coach that it was high, and I ended up sitting for most of the third period. The next day, after going to breakfast with my mom, I was in my car when I got another phone call from my coach. "Hey, it seems like you don't quite have things under control yet, and I'd like to give some other guys a chance. You won't be in the lineup tonight." I think this was the first time I cried in a couple years. Just broke down. I had been working so hard to manage everything in stride, had been successful until the day before, AND my mom had flown across the country to watch me play. "Well this sucks." After a few minutes, I called my coach and asked if I could warmup with the team and see how my bg was after warmups, and we could decide based on that. I prepared the same way. After the bus ride I was a little high, so against every recommendation I had received, I took some insulin! What an outlaw! Are the D police going to find me and deliver a super-turbo low so that I never ever do something this STUPID again?? Nope. I figured I might go low during the team stretch, but I didn't. I also figured maybe I would go low during warmups, but I felt great. When I checked before the first period, I was right around 140. This is awesome! I spoke to my coach, who told me, "Hey I'm going with someone else tonight, just like I told you before." Well, my impression was that he would decide after hearing what my bg was, but it was obvious that his intention was never to do that. So I sat in the stands and watched my team (win another game!) with my mom and the other scratches (two of whom lived in the town in which we were playing, so it's unfortunate that they did not dress either). I decided not to eat anything and check my bg after every period to make sure that the insulin was the right idea. It was great for the whole game. Thus, I decided that since hockey usually made my bg rise, I would combat it with insulin. I was not going to let that high blood sugar situation happen again.
So Friday, November 5, I started the new regimen and immediately saw results. My bg levels were in the 100s for the entire day. My hockey coach (and I agreed with this decision...) was not confident that my bg was quite under control yet. So I was scratched for the first time in my collegiate career for our first home game of the season. I experienced another 'low' of 88 during the game (it might have been 80, I remember that there was at least one 8 in there and that it wasn't actually a low for a normal person). When the low came on, I realized that it was probably good that I wasn't playing on day one of adjusting insulin for carb intake. We won the game, but it was much different to be in the stands and watch the team play. It wasn't where I wanted to be, and I told myself that night that I wanted to do everything in my power to be on the ice for every game from then on. I also learned how 5-10 of our teammates feel during every game because we can only dress 20 players and have almost 30 on the roster. Every time I glide around or feel myself getting lazy when I'm playing, I think of how it feels to be in the stands and about how much those guys would give to be on the ice representing our school. As if I needed any extra motivation, this experience gave me that much more.
On Saturday I got a phone call, "How are you feeling?" "I'm good." "Ok, you're in..." YES! So many thoughts raced through my head... How much food should I bring? Do I need juice? How many carbs are in gatorade? How is a bus ride going to affect me? What about nerves? (The Diabetes educator told me that) I should be between 150-250 before skating.. What if I'm not? It's not ok to take insulin before playing, right? Then I thought, screw it, I'll prepare normally and see how it goes...
I did everything normally. I was in the low 100s before our off ice warmup so I ate a banana. I was also slightly low before the on ice warmup, so I drank a capri sun. Before the first period? Exactly 150! I was so excited that I couldn't stand it. Perfect for my first game back! I felt pretty good for the entire game. And I scored! What a comeback! I felt that my energy got low towards the end, but my blood sugar was not - actually it was slightly high - it got up above 260 by the end of the game.. I guess I ate too much to correct those readings around 100 before hand - oops. After the game I bolused for our post-game pizza on the bus. For some reason, though, I got pretty low (legitimately low this time) even though I had actually eaten more carbs than I planned for. Why could this be? (Now I know that after hockey, bg tends to fall pretty quickly and insulin sensitivity is high. Also, pizza is digested more slowly than a lot of other carb sources, so the insulin may hit before the carbs do.)
Following the directions of every person who had given me advice that week, I did not participate in the celebratory festivities with my teammates. That sucked, because it is always fun to go out after a sweep, but hey, I had diabetes now, so drinking was totally off limits... Oh well, there are bigger tragedies in life than not being able to drink.
The next week was a lot of the same. Actually, the hockey part was the same - Have a good bg upon waking, eat a little before practice, and have a high bg afterward. Hmm, hockey makes my bg go up. I thought everyone said that exercise would make it fall? That's weird. What was different this week is that my mother was in town. Coincidentally she had planned a trip to visit and watch our games that weekend. I was so happy to have her there and be able to talk about what was going on. Surprisingly though, I didn't find much to talk about. I had done tons of research on the internet, and had learned a lot from the people I had met the previous week. I also had spoken to her and my father over the phone a couple times since being diagnosed, and everything was going pretty well. So we talked mostly about normal stuff. How's home? work? school? yada yada.. Of course, at meal times I would ask, "hey, how many grams of carbs are in (insert carb-containing food here)?" and she usually wouldn't know the answer. Whoa, this is my mom, she has fed me for almost a quarter century, and she doesn't know about this (common food item)? I have to figure all this out by myself? Thank God for smart phones, because at least I can do a quick search on Calorie King for baked potatoes while sitting at the table!
We had another home-away series that weekend. During the game on Friday, I was struggling much more than I had the week before. My bg was in the upper 200s and even in the 300s (I check between periods). I told an assistant coach that it was high, and I ended up sitting for most of the third period. The next day, after going to breakfast with my mom, I was in my car when I got another phone call from my coach. "Hey, it seems like you don't quite have things under control yet, and I'd like to give some other guys a chance. You won't be in the lineup tonight." I think this was the first time I cried in a couple years. Just broke down. I had been working so hard to manage everything in stride, had been successful until the day before, AND my mom had flown across the country to watch me play. "Well this sucks." After a few minutes, I called my coach and asked if I could warmup with the team and see how my bg was after warmups, and we could decide based on that. I prepared the same way. After the bus ride I was a little high, so against every recommendation I had received, I took some insulin! What an outlaw! Are the D police going to find me and deliver a super-turbo low so that I never ever do something this STUPID again?? Nope. I figured I might go low during the team stretch, but I didn't. I also figured maybe I would go low during warmups, but I felt great. When I checked before the first period, I was right around 140. This is awesome! I spoke to my coach, who told me, "Hey I'm going with someone else tonight, just like I told you before." Well, my impression was that he would decide after hearing what my bg was, but it was obvious that his intention was never to do that. So I sat in the stands and watched my team (win another game!) with my mom and the other scratches (two of whom lived in the town in which we were playing, so it's unfortunate that they did not dress either). I decided not to eat anything and check my bg after every period to make sure that the insulin was the right idea. It was great for the whole game. Thus, I decided that since hockey usually made my bg rise, I would combat it with insulin. I was not going to let that high blood sugar situation happen again.
Sunday, January 16, 2011
Background story
I was diagnosed with type 1 diabetes on November 1, 2010. A few weeks later I found out that November is in fact Diabetes Awareness Month...
In January - February of 2010 I lost 15 pounds. Now, I had started to drink coffee (lots of coffee, encouraged by my roommate Colin) in the fall of 2009, and hockey season ran from October to March. So, I attributed the weight loss to a combination of the intense exercise for hockey, caffeine, and stress. I also woke up almost every night at least once or twice to use the bathroom beginning in mid-January. I play sports and stay hydrated, so this too seemed natural to me.
During the summer, no matter what I ate or when, I couldn't gain weight. I've been around 185 pounds for the last 4 or 5 years, and suddenly I had somehow managed to get below 170 for the first time since high school. I thought, 'Wow, I must have a great metabolism... and without all that bulk I'll be faster than ever on the ice!' At the beginning of the summer I would wake up around 6:30 or 7 to go for a 1-1.5 mile run before work, then bike and lift weights after work. Running 3 days a week, lifting for 2 hours 4 times a week, and playing hockey once a week was not helping me gain any weight, and I felt that I was somehow losing even more weight! So about halfway through the summer, I decided to cut out the morning run. Around that time I determined that there was definitely something wrong physiologically and I knew exactly what it was - too much coffee! So, on a family vacation near the beginning of August, I cut out caffeine completely. That was a tough couple weeks! No caffeine and an irregular workout schedule left me feeling extremely groggy and irritable for almost the entire vacation.
When school started back up in September, I was committed to gaining back some weight. I wasn't feeling any better on the ice at the lower weight, and had always been pretty successful around 185, so I ate as much as I could at every meal and loaded up on the carbs between meals. I gained about 5-7 pounds, but for some reason I felt even worse on the ice. After a stride or two, my legs felt like they were made of concrete, and I couldn't hold my own in the corners or in front of the net. I spoke to my family about how much I was struggling and about my lack of a full night's sleep in almost a year. They had plenty of suggestions - don't drink water before bed, maybe you have mono, there could be a parasite in your intestines cannibalizing your protein... I knew it wasn't mono because I had tons of energy throughout the day and had none of the other symptoms. But, just to be safe, my father suggested a blood test.
I went to the school nurse one morning, had some blood drawn for 3 or 4 different tests and gave a urine sample. That afternoon she said that there was concern because the level of sugar in my urine was far above normal. I thought, 'well I had a recovery drink after hockey practice, so that could easily cause my urine to have too much sugar in it.' The nurse suggested returning on Monday to take a fasting blood test... great, I have to go to hockey practice without eating anything beforehand (not telling my coach, because I don't want him to think I have a medical problem if I don't) and then give blood - just how I want to start my week! The nurse said she would contact me by the afternoon to let me know the results.
I had a huge breakfast and lunch per usual, then got a phone call right before my 12:30 class.
-Hi is this Ben?
-Yes.
-Ben I have some bad news, it looks like you have diabeetus.
-(1. What the hell is diabeetUS? 2. Fuck.) Um, ok.
-We'd like you to come to the office right away to meet with a nurse who will tell you more about it.
-Ok, well I have class right now so can I come in after? (What the hell is wrong with me, I'd rather go to an INTRO spanish class than get healthy right now???)
-Sure, you can come in any time.
After my class I called my family and let them know what was going on. We all knew it was a possibility because of the symptoms, but none of us actually thought I had diabetes. I work out almost every day and try to avoid unhealthy foods. How could I have diabetes?
The next call was to my hockey coach, who I wanted to tell in person because we both knew that I wasn't playing to my potential. Unfortunately he couldn't meet in person, so I had to tell him over the phone. Basically I told him what I had just found out and that I might have to miss our team workout that evening, and he said that he would do anything to help.
At the doc's office I met with a nurse whose son had diabetes his whole life. She taught me how to check my blood sugar (527 mg/dl), how to give myself a shot (10 units of Humalog), what a hemoglobin A1C test is (12.8% - meaning my mean blood sugar for the previous 3 months was 373 mg/dl), and the difference between long and short acting insulin. She also had plenty more advice for me:
'The only time my son ever got into trouble was when he drank in college. If you drink too much, you can confuse a low blood sugar with drunkenness and have to go to the hospital." (Wonderful, I can't drink anymore! -not true)
'When you eat, be sure not to eat only a simple carb, if you have cereal or a banana, eat some peanut butter with it because the fat will make you digest it more slowly' (Great I can't eat any of my favorite foods anymore -not true)
'Don't take insulin before hockey or a workout because your blood sugar will go way too low' (not true)
'Try to eat at the same time every day to keep your blood sugar stable throughout the day' (not true)
I could go on and on about the things I learned in the first few days that were not true at all, but this nurse (Liana) was extremely nice and informative and was a great person to introduce me to life with diabetes.
That evening before dinner I started to feel sweaty, shaky, and dizzy. I checked my blood glucose (bg) before eating, and it was 95 (this is above normal for most people if they haven't eaten for a few hours - evidence that my body had been used to a super high bg for a long time). When I saw my teammates at dinner they wondered why I had missed the workout and I just told them that I had an appointment. I still woke up to use the bathroom that night, but I noticed that my sleep was much more sound than usual. The 5am wakeup for practice still wasn't easy. I ate my 1/2 banana and peanut butter and went to practice. Hockey was strange the first few times I played. I felt stronger and faster, but I was pushing my muscles much harder than I had in a long time, which left me pretty fatigued. I was extremely happy that I was finally making progress after struggling for so long.
We had a team meeting (more like meating) and video session that evening. I told the coach that I wanted to tell everyone at the meeting, so when we arrived, he said 'all right, I have a couple items to address before we get started...'
'FIRST, I have an extra dollar from a fine that was assessed last week and I'd like to know what we should do with it. Should we use it for the next fine or does the person want their money back?'
(Um, why is this the first item on the agenda? And why does it matter?)
'Next, DiMo has something he wants to say'
'Hey guys, as everyone knows I haven't been myself on the ice lately. I feel like I'm giving everything I've got and am getting no results. I've talked to a lot of you about how much I have been struggling lately, and...' (I'm sure some guys are thinking, Is he going to quit right now?? - No way, Jose) '... I just found out yesterday that I have diabetes. So please bear with me as I learn to manage it - I'll keep working my ass off, and you guys keep beating the shit out of me.'
'Thanks, DiMo. Ok, well now we have that problem figured out. Next item...'
In January - February of 2010 I lost 15 pounds. Now, I had started to drink coffee (lots of coffee, encouraged by my roommate Colin) in the fall of 2009, and hockey season ran from October to March. So, I attributed the weight loss to a combination of the intense exercise for hockey, caffeine, and stress. I also woke up almost every night at least once or twice to use the bathroom beginning in mid-January. I play sports and stay hydrated, so this too seemed natural to me.
During the summer, no matter what I ate or when, I couldn't gain weight. I've been around 185 pounds for the last 4 or 5 years, and suddenly I had somehow managed to get below 170 for the first time since high school. I thought, 'Wow, I must have a great metabolism... and without all that bulk I'll be faster than ever on the ice!' At the beginning of the summer I would wake up around 6:30 or 7 to go for a 1-1.5 mile run before work, then bike and lift weights after work. Running 3 days a week, lifting for 2 hours 4 times a week, and playing hockey once a week was not helping me gain any weight, and I felt that I was somehow losing even more weight! So about halfway through the summer, I decided to cut out the morning run. Around that time I determined that there was definitely something wrong physiologically and I knew exactly what it was - too much coffee! So, on a family vacation near the beginning of August, I cut out caffeine completely. That was a tough couple weeks! No caffeine and an irregular workout schedule left me feeling extremely groggy and irritable for almost the entire vacation.
When school started back up in September, I was committed to gaining back some weight. I wasn't feeling any better on the ice at the lower weight, and had always been pretty successful around 185, so I ate as much as I could at every meal and loaded up on the carbs between meals. I gained about 5-7 pounds, but for some reason I felt even worse on the ice. After a stride or two, my legs felt like they were made of concrete, and I couldn't hold my own in the corners or in front of the net. I spoke to my family about how much I was struggling and about my lack of a full night's sleep in almost a year. They had plenty of suggestions - don't drink water before bed, maybe you have mono, there could be a parasite in your intestines cannibalizing your protein... I knew it wasn't mono because I had tons of energy throughout the day and had none of the other symptoms. But, just to be safe, my father suggested a blood test.
I went to the school nurse one morning, had some blood drawn for 3 or 4 different tests and gave a urine sample. That afternoon she said that there was concern because the level of sugar in my urine was far above normal. I thought, 'well I had a recovery drink after hockey practice, so that could easily cause my urine to have too much sugar in it.' The nurse suggested returning on Monday to take a fasting blood test... great, I have to go to hockey practice without eating anything beforehand (not telling my coach, because I don't want him to think I have a medical problem if I don't) and then give blood - just how I want to start my week! The nurse said she would contact me by the afternoon to let me know the results.
I had a huge breakfast and lunch per usual, then got a phone call right before my 12:30 class.
-Hi is this Ben?
-Yes.
-Ben I have some bad news, it looks like you have diabeetus.
-(1. What the hell is diabeetUS? 2. Fuck.) Um, ok.
-We'd like you to come to the office right away to meet with a nurse who will tell you more about it.
-Ok, well I have class right now so can I come in after? (What the hell is wrong with me, I'd rather go to an INTRO spanish class than get healthy right now???)
-Sure, you can come in any time.
After my class I called my family and let them know what was going on. We all knew it was a possibility because of the symptoms, but none of us actually thought I had diabetes. I work out almost every day and try to avoid unhealthy foods. How could I have diabetes?
The next call was to my hockey coach, who I wanted to tell in person because we both knew that I wasn't playing to my potential. Unfortunately he couldn't meet in person, so I had to tell him over the phone. Basically I told him what I had just found out and that I might have to miss our team workout that evening, and he said that he would do anything to help.
At the doc's office I met with a nurse whose son had diabetes his whole life. She taught me how to check my blood sugar (527 mg/dl), how to give myself a shot (10 units of Humalog), what a hemoglobin A1C test is (12.8% - meaning my mean blood sugar for the previous 3 months was 373 mg/dl), and the difference between long and short acting insulin. She also had plenty more advice for me:
'The only time my son ever got into trouble was when he drank in college. If you drink too much, you can confuse a low blood sugar with drunkenness and have to go to the hospital." (Wonderful, I can't drink anymore! -not true)
'When you eat, be sure not to eat only a simple carb, if you have cereal or a banana, eat some peanut butter with it because the fat will make you digest it more slowly' (Great I can't eat any of my favorite foods anymore -not true)
'Don't take insulin before hockey or a workout because your blood sugar will go way too low' (not true)
'Try to eat at the same time every day to keep your blood sugar stable throughout the day' (not true)
I could go on and on about the things I learned in the first few days that were not true at all, but this nurse (Liana) was extremely nice and informative and was a great person to introduce me to life with diabetes.
That evening before dinner I started to feel sweaty, shaky, and dizzy. I checked my blood glucose (bg) before eating, and it was 95 (this is above normal for most people if they haven't eaten for a few hours - evidence that my body had been used to a super high bg for a long time). When I saw my teammates at dinner they wondered why I had missed the workout and I just told them that I had an appointment. I still woke up to use the bathroom that night, but I noticed that my sleep was much more sound than usual. The 5am wakeup for practice still wasn't easy. I ate my 1/2 banana and peanut butter and went to practice. Hockey was strange the first few times I played. I felt stronger and faster, but I was pushing my muscles much harder than I had in a long time, which left me pretty fatigued. I was extremely happy that I was finally making progress after struggling for so long.
We had a team meeting (more like meating) and video session that evening. I told the coach that I wanted to tell everyone at the meeting, so when we arrived, he said 'all right, I have a couple items to address before we get started...'
'FIRST, I have an extra dollar from a fine that was assessed last week and I'd like to know what we should do with it. Should we use it for the next fine or does the person want their money back?'
(Um, why is this the first item on the agenda? And why does it matter?)
'Next, DiMo has something he wants to say'
'Hey guys, as everyone knows I haven't been myself on the ice lately. I feel like I'm giving everything I've got and am getting no results. I've talked to a lot of you about how much I have been struggling lately, and...' (I'm sure some guys are thinking, Is he going to quit right now?? - No way, Jose) '... I just found out yesterday that I have diabetes. So please bear with me as I learn to manage it - I'll keep working my ass off, and you guys keep beating the shit out of me.'
'Thanks, DiMo. Ok, well now we have that problem figured out. Next item...'
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