Day 27: Now What? High Blood Pressure, Increase Fluid Intake, May Decrease Insulin by 2 Units in the AM

September 14 2013

9:58am

FBG 111

12:47pm

PP BG 93

2:52pm

BG 71

5:26m

PP BG 120

8:25pm

119

10:37pm

 PP BG 98

It's annoying when the blood glucoses are doing so well that my blood pressure is so high. It is really little comfort to say it is due to the hip and leg pain especially at my age when it could be other things.

I had been having occasional momentary "feel" of difficult breathing that I chalked up to allergies because after taking my allergy meds and a hit of my inhaler it went away. It occurred after going outside with Bailey into my jungle of a back yard and I also noted that allergens were high, I was well perfused and easily able to do deep yoga breaths so probably it was due to the allergens. 

I also wonder if I have been developing anxiety in my old age, insulin still scares me and I so want off of it. I am taking a mild blood pressure med for a period of time when my blood pressure was between 130-140 systolic (top number) and 80-90 diastolic (bottom number).

I had a very good physiotherapy session yesterday, so I was not surprised at the high amount of pain and without a heating pad I was not managing it very well. My heating pad and won’t be able to replace it until next week. I have microwave heating pads but they don’t last long enough and I have to get up to reheat them and interrupt the therapy and it’s almost like starting over. I am going to get a heated blanket next week as well. The pain after PT is usually worse than the rest of the week – even my bad shoulder ached but I did a new exercise that used that arm.. 

Within the past week and a half I had have some days where I had been feeling tired, weak, on edge, a little dizzy, difficulty concentrating, and my eyesight a little blurry, sort of like when blood sugar is high.  So I thought maybe my blood pressure is low, after all it is always perfect when I go to the docs, even when in pain, and since I had lost all this weight it only follows. So I dug out an old blood pressure kit, thinking it would be low but the sounds started high and faded at 120 to 100. It was a little hard for me to control, the bulb was old and the cuff was a bit hard to get on and part of the bladder was coming out but I knew it wasn't low. The cuff probably needs to be thrown out but I think it worked enough to give me an idea. Naturally I was now more upset, in sorrow that after losing all this weight and getting my blood glucose in control that I am hit in the head with this. I felt defeated.

I took my one and only .5 mg Xanax that I had put up for years, and it worked, I relaxed but did not go to sleep had blood glucose to monitor. When it was time to sleep I put on some lovely classical music very low, took a 1 gm of melatonin and went to sleep. I slept well, waking only once due to pain, medicated with ibuprofen, fell back to sleep and would have slept later if the pain wasn't so insistent. It hurts less when I am up and about. Bailey was also waking me and then there is the insulin and blood glucose routine.

This morning I took one bp pill and rechecked and while the arterial sounds were better I took another. After the fog from the melatonin and Xanax wore off I felt pretty good. I was going to go to check my BP at Walgreens when Anthony got off of work but he got off late and I felt pretty good and tired by that time – it was time for dinner and insulin. I am going to check my bp in the morning at Walgreens and if it is still high will take another bp pill.

I see my new doctor for the second time next Thursday. He was not pleased I was on this particular bp med because it causes edema, and it just so happened my legs were a bit edematous, but it was not because of the bp med it was because of that horrid Gabapentin I was on for a week or so which caused all sorts of crazy anxiety etc. When I went off it I urinated frequently for two days. At any rate the bp med was ordered by the inept physician who delayed good treatment of diabetes so I am open to discussion regarding changing the med as long as it is not something like Lisinopril. Wonder who the genius was who thought it was ok to make a bp medicine that causes coughing as a side effect and expect people to shine on it?

Having a clearer head I realized I also have not been paying attention to my fluid intake. Today I also pushed fluids, besides my morning tea (I skipped my beloved coffee this morning, and will continue if I have to). I realized that besides my morning coffee of about 20 oz, I sip all day on a bottle of water, often with some left over. Not a good thing, esp. since I am losing weight and beginning to increase my activity. So I figure two 24 oz bottles of water in addition to a couple of cups of tea in the morning should be good and certainly doable.

Day 26: What's Stress Got To Do With It? Blood Pressure Elevated, Ended Day with Good BG

 September 13 2013

7:42am

FBG 135 I am almost embarrassed to post my number Had a bit of a rough night. Ugh, almost got through the night but woke up at 4am with severe L hip pain, usually it is my knee and lower leg, but Arthur was making himself known, it was rainy and muggy all night.
Had a good physiotherapy session though!

10:11am

PP BG 106

1:41pm

BG 96

4:19pm

PP BG 127  Blood pressure elevated

7:12pm

BG 112

9:59pm

PP BG

Day 25: Stress Reaction Midday But Finished Well

 September 12 2013

7:52am

FBG 121

10:27am

PP BG 114

2:14pm

BG 92

 

4:40pm

PP BG 141  Think maybe my pain level is affecting my BG

7:44pm

BG 109

8:46pm

PP BG 120

10:54pm

BG 96

Day 24: Bowling w/ Bailey, Stressful Experience and High BGs, Being Cut Off at the Knees and Good Friends Helped

September 11 2013

8:24am

FBG 126

1:19pm

Forgot to check my two hour PP today, not a good thing to do but I feel well. Did not hear the alarm go off, got busy with several things I have neglected in the past coupla few months.

And poor Bailey begged to be played with, I actually felt well enough to lay her favorite game “bowling” where I toss her favorite glow in the dark ball down the hardwood hallway and she scuttles s fast as she can after it. She’s a good baby girl and this afternoon I am going to give her a bath. I filled her pool this morning and by the afternoon the sun should’ve warmed it enough to bath her

I suppose it is a good thing that I am immersing myself back into my life, the joys of my life.

I am going to try a little Tai Chi after lunch then I am going to relax and finish watching the new Star Trek I was too tired to watch yesterday and maybe take a 20 minute nap.

2:00pm

BG 91

3:56pm

PP BG 140

Asked some questions in one of my support groups and included my background information.  Someone I had never seen before, and who I found out later upsets people made me his latest target.

My post served as a presumptuous jumping board for this bully who had the need to show his wonderfulness - and did not even read what I said.  Questions were asked, well demanded of me -of info already in the post. I simply asked for suggestions and tips for speeding up the weight loss and dealing with a potential plateau and a substitute for the nightly lo carb cheese product not for a berating but i got slammed by this young man.

I just needed some clarification on the diets and some suggestions because other wonderful and supportive people in this particular support group have been on this journey with me and I trust them. I feel like I was cut off at the knees. And it makes me angry at myself for being such a wimp. I have not lost confidence in my treatment or my progress but realize how fragile I still am.

I so dislike this disease, it has attacked me from the inside out. It has turned me from a strong independent woman to someone I don't recognize.

But people like Wendy, Thor, Doc, Juli, Dianne, Di , Sandy and Michael are helping me find that woman again.

 6:48pm

BG 172

10:20pm

PP BG 148

11:40pm

BG 106

 Finished out the night in good shape, was able to relax and distressed some, thanks to good friends <3

Day 23: Chocolate? Pain Relief! Fond Memories, eBay and Ended the Day with a Good Low!

September 10, 2013

8:18am

FBG 127

A little high this morning. I kind of expected it. Woke at 3:40am with my thigh and knee throbbing. I expected it because I had such a progressive day at physio yesterday and worked the muscles. Realizing I was going to have to take a dose of Ibuprofen I ate Ricotta and ¾ serving of 86% intense dark chocolate for a total of 15 gm carbs, bringing my carb count to 57gms for a 24 hour period. That is about average for me but I thought I would take advantage of the opportunity to see how the chocolate impacted my BG. I had no idea what impact those sugar carbs would have. Now I do.  About a week ago I indulged with one square of the chocolate (1/4  serving, 4 gms) and it had no impact. So now I know my limits. The thing is I did not truly enjoy it, 86% is not as good as 70%, so I will use the rest to add about 4gm carbs to my fat coffee every now and again.

11:56 am

PP BG 106 a little late got involved in the garden and the time got away from me. Feeling wonderful, full of energy!

2:04pm

BG 91

4:00pm

PP BG 113

I finally gave in and could not take the pain anymore. I tried to watch a movie and could not concentrate. The pain pills I take are weak; I took two at a time today. After having a very accomplished day at PT Monday I ached so much so that the Ibuprofen couldn’t touch it and since my heating pad broke I was down a therapeutic measure. It was worth it. It was good to be without pain, it’s been a long time.

8pm

BG 128 have been a little chilled tonight after muggy wet day, the a/c has chilled the wet air so much it feels like Fall in the house.

Have been busy all day.

Worked on the photo project a bit. I started it a few days before I injured myself, it has turned out to be a bigger project than I anticipated, partly because I am constantly stopping to remember. Those days when my babies were small passed so quickly, my grandson grew up overnight yet I can still hear their baby chatter. Jason when he first began to talk, for some inexplicable reason, called an egg “mambo”, ice cream cone was eye-re-kay-comb, 40 years later and I can still hear his sweet little voice speaking those words. My baby Travis, always wanted a “piss”, meaning “kiss” and his son Anthony loved “bood” (food) and loved to ask friends, when we would visit, if he could look in the “brigerator”(fridge) or feed the “bish” (fish) which often sounded like “bitch” when he was excitedJ Ah me.

10:00pm

PP BG 97. Good. Finally got my target items on eBay, have a couple more to post and then I am done for tonight.

Still feel pretty good. Bailey refused to go out in the yard because it was wet, so I put her leash on and walked her a little in the front yard. The training has worked; she walked great, without the harness! She didn’t pull me and she did her business without dilly dallyingJ

Well off to finish my eBay. Starting the bidding off low, hope it doesn't bite me in the butt.

Good night!

Day 22: Good Blood Sugars, Good Friends, Progressed in Physical Therapy, Curry and a Recipe!

September 9, 2013

6:45am

My FBG was 110. Good because I battled some niggling left hip, knee and shin pain and did not get to sleep until after 3am - and I ate a serving of cottage cheese somewhere around 2am.

I am feeling accomplished as well. In started it out taking Novolog Mix 56 Units am and 54 Units pm - and getting nowhere31 the great, normal, numbers I have been pretty well consistently getting in the past three weeks. My three week "anniversary" was yesterday and I have decreased my insulin dosage by 17 Units. That's 5.6 Units a week.

Three weeks ago I was so hopeless, so confused and so frightened - and so alone. I became someone I did not recognize. I credit my support groups for giving me the hope, focus, encouragement and strength to come this far, thus far

10:09am

PP BG 102

Did well at Physical Therapy today. Was able to ride the bike for 10 minutes with one short rest for cramps in between. This weekend I was fed up and decided the cane was making me worse because it skewed my gait so I walked in the house without it paying attention to how I walked. I still carry the cane to lean on when I need to rest and to help balance but it no longer does the work of my left leg. I had a lot of pain but I managed it, I massaged with the analgesic oil I made, stretched and applied heat and compression.

And took my pain meds and anti-inflammatories.

Also used the adjustable bed to change position.

But did not have the heart to kick Bailey of the bed so I pushed her towards the wall.

She thinks she as to take care of my leg by lying on it - and that hurts. I don’t need to run a marathon but I would like to be able to be free of pain and to walk Bailey at Centennial Park. Anyway I am not being discharged from PT.

Here is a simple Madras Curry powder for cooking with, just mix it up and store it. It has a great collection of herbs known to be supportive for diabetics:

Madras Curry Powder

3 tbsp cumin powder
3 tbsp coriander
2 tbsp ginger
2 tbsp turmeric
1 tbsp Cayenne powder
1/2 tbsp mustard
4 tbsp ground peppercorns
1 tbsp ground nutmeg
1 tsp cloves
2 tbsp cardamom
1tsp fennel
4 tbsp Cinnamon

1:57pm

BG 97

Made the following for lunch, this is the recipe after tweaking it for Low Carb: This a low carb dish for diabetics on insulin, a serving is 9 gms, so for some of you it might be too high. I altered a recipe online and recalculated using an app and my food scales. It was delicious and I have two portions I am freezing for another day. I also added a finely chopped very small jalapeño from my garden and finely chopped a thumbnail size of a superhot habenero, also from my garden, but that is optional:

Coconut-Curry Salmon

5 oz. coconut milk

2 oz. Cream Cheese, cubed, softened

½ tsp. ground cumin

¼ tsp. Crushed red pepper

1 tsp. Madras curry powder, divided (if too much heat use a mild curry)

12 oz salmon fillets, with skins

2 tblsp Juice from 1 lime or lemon

1 tsp. Coconut oil

½ red bell pepper, cut into strips

6 oz plum or beefsteak tomatoes seeded, chopped

½ small onion, cut lengthwise in half, then sliced crosswise

1 Tbsp. Chopped fresh cilantro

Servings: 3

HEAT oven to 375ºF.

BLEND first 4 ingredients and 1/2 tsp. curry powder in blender until smooth. Place fish, skin-sides down, on baking sheet sprayed with cooking spray. Mix lime or lemon juice and remaining curry powder; brush onto fish.

BAKE 8 to 10 min. or until fish flakes easily with fork. Meanwhile heat oil in large skillet on medium heat. Add bell peppers, tomatoes and onions; cook 5 min., stirring frequently. Stir in coconut mixture; cook 5 min. or until heated through, stirring frequently.Stir in Cilantro. Season to taste with salt

SERVE fish with sauce.

Per serving:

Calories 284; Total fat 16g; Carbohydrate 9.1g; Protein 27 g

4:12pm

PP BG 143 Not going to get upset, should come down before dinner.

8:29pm

BG 117

10:54pm

PP BG 109

I can't believe, today was a good day

Day 21: It’s Been a Good Day, Felt Well all Day; Uneventful and Relaxing like Sunday is Supposed to

September 8, 2013

8:25am

FBG 112

9:00am

48 Units, decreased by 2 Units, interesting to see my numbers today.

11:40am

PP BG 131

1:46pm

BG 84 Had a big breakfast was hoping to not have this drop.

5:17am

PP BG 95

6:10pm

BG 106  Felt a little tired = wasn’t sure if my BG was dropping or I just need a nap. I just need a nap, but I have to get some items on eBay. Ate a cheese stick to tide me over until dinner.

8:54pm

BG 120 45 Units Getting dinner and Insulin an hour late.

11:13pm

PP BG 121 I can sleep easily with this numberJ

Day 20: Good Day, Great Numbers, Decreased Insulin another 2 Units and did an Oopsie

September 7, 2013

8:00am

 FBG 100 J Breakfast was an omelet of country eggs stuffed with creamed spinach leftover from the night before and Jamaica Me Crazy coffee. Nice.

10:56am

PP BG 109 Very good! Maybe I am finally getting the hang of it. Fixed a plate of sliced spiced sesame – ginger tomatoes and cheese if I feel I need it: 105 kcal; 6.4gm fat; 4.12gm carbs; 6.29gm protein.

1:06pm

BG 89 Feeling great, prepared a nice lunch of Canadian bacon and cream cheese rolls with a side of mixed berries.

4:10pm

PP BG 113 Very pleased. Mixed up a batch of Madras Curry Spice for Cooking, better than buying it already prepared. Is chock full of spices that support good blood sugar control. Have altered a ‎Mulligatawny Chicken Soup to be moderately Low Carb, 15gm, omitting the rice and fruit. Made enough for for meals, will eat a portion for lunch tomorrow and freeze the rest.  

The Escali Nutrition Scale has proved invaluable for weighing and calculating carbs. Best purchase I have made of late.

I also wore my heating pad out, it is less than a year old so I have to use the pads that have to be micro-waved for heat therapy. Always something.

8:09pm

BG 98 a few minutes after I finished eating and administering 45 Units of insulin; another decrease of 2 Units.

I made an oopsie tonight.

Rushed to get dinner served while juggling a few other things and I lost focus.  I injected the decreased dose of insulin, ate the Mulligatawny soup then realized I did not check my BG before eating. So it had been exactly 9 minutes after I injected the insulin before I checked my Blood Glucose.  Ate some Ricotta to offset any hypo.

8:33pm

BG 103 checked for peace of mind.

10:05pm

PP BG 77. Good numbers, feeling ok but I need to get my BG up a few points as I do not feel confident going to bed with a number so close to hypo. I had not felt fear of hypo today and so have not  carbed  in response. This is a good thing; I am getting used to normal blood glucoses and felt pretty good. Ate some peanut butter and blackberries. I feel fine.

12midnight

BG 87. Still a bit low. I am going to consider decreasing my evening insulin a bit more, perhaps my morning insulin as well I will reassess in the morning Think it s time for the tomato and cheese plate, not hungry but a little wary of my last couple of numbers and will sleep better >100..

And so another day comes to a close~

Day 19: Ups and Downs, Ends On a Good Note But Overwhelmed: Physiotherapist not Supportive & Made Me Feel Hopeless in Front of Other Patients and Staff

September 6, 2013

7:49am

FBG 144 Got off to a bad start by being off schedule. Usually take my morning insulin at 8am but didn't get to it until 9:30. Had a rough night pain from my leg injury kept me awake. Bailey woke me up at 7:49 with bad doggy breath kisses and I reached over and checked my Fasting since it was high but not dangerously so  and I was exhausted I intended to go back to sleep for another 20 minutes.

Best laid plans - it was 9:30 by the time I dragged myself out of bed and this was because my leg was screaming in pain.

9:36am

FBG 145 50U insulin – as I said my leg was screaming in pain, checked my BG again, took my insulin and ate a late breakfast of some plain cottage cheese and drank 2 mugs of coffee tried to get easy, it decreased some but was bothersome for the next few hours.

This morning everything came out ok and appears back to normal. Pretty sure what contributed to the harder than normal stools is that this week I have had to take a full (rather than half) pain pill at night to sleep after physiotherapy. Normally I manage with ibuprofen and take a small dose of the prescription meds two or three times a week if I have stressed the injury more than usual. If it is not one thing it is another.

12noon

PP BG 166   I had no recourse but to take a pain pill; within an hour the pain was finally beginning to subside. Looking back, there is an element of correlation between the level of pain and the elevated blood sugar.

3:00pm

PP BG 94  Pain is nearly gone when I am not up and about, manageable when I am; ate a late lunch of only 5 gm carbs.

6:00pm

PP BG 129

Made a batch of Ayurvedic analgesic oil tonight, a formula that was passed down to me containing buffered acetylsalicylic acid, a little wintergreen and a little Emu oil in a mustard oil base. The original formula contains arnica and camphor as well but I am out of these. I did not have massage grade mustard oil so it might be a little strong - but I am not using it as perfumeJ

 It is suppose to age for several days but I need it ASAP. I usually have some on hand but ran out a few months ago and never did make a new batch. It has always worked well in the past as it is absorbed right into the sore muscles and joints acting directly thereby reducing my need for pain medication.

9:00pm

BG 147 47U insulin. A little high, had a cheese stick, 1gm carb, about 7:30 or so, it is not whole milk but I wonder if it is impacting my BG in some way.  Took my evening insulin and ate a late dinner of 9gm carbs. I am enjoying my new Escali Scale and with a quick input of a three digit number it gives accurate nutritional info, taking the guesswork and calculations out of the mix for greater accuracy in my meal plan. Just took a few seconds. Very pleased I recommend it highly.

Pain is making itself known again. Took a pain pill along with ibuprofen but also massaged in some of my new batch of  Ayurvedic analgesic oil.

11:00am

PP BG 106 Good number. Tomorrow I am back on schedule.

The analgesic oil has worked; for the first time in many days I do not feel pain in my hip. I have been so overwhelmned with so many things I should have put together a batch of the Ayurvedic analgesic oil a couple of months ago.

Now I must resist the urge to carb.

Tomorrow is another day.

1:30am

BG 79, a little low for me, smell ammonia, will eat some ricotta and berries. Just realized I only ate 35 carbs total today – may be not enough with the amount of insulin I take. I’ll reassess in the morning.

Regarding LCHF: I aim for 60 to 75 carbs per day and don't stress too much if I go over as long as  my numbers are ok. Right now I can feasibly eat 75% fat and count calories. I tried .5 gm protein per kilo the formula for those who are essentially sedentary due to the musculoskeletal pain limiting my activity but one piece of Salmon blows that out of the water so I am staying under 1gm protein per Kilo. Although referred to as Low Carb High Fat, my plan is Low Carb Healthy Fat. It is still higher in fat than normal diets and I am eating good fats in foods and healthy oils as they are meant to be, no altered, non, low or 2% fats but I do use half and half in my coffee as opposed to full cream because I like the way it tastes. From the literature I have read I am still getting the good benefits (better blood glucose numbers, exceptionally so) and it seems some of the high fat tenets are so people feel full and satisfied. Not my problem because I had been decreasing my food intake for eight months prior to embarking on Low Carb "Healthy" Fat diet so I get full on smaller portions and remain satisfied. I did not embark on the LCHF diet to lose weight alone, I am already doing that, but to lower insulin doses and improve my blood glucose and this it is doing :)

Addendum:

I have been a bit over-whelmed of late. Not so much by the diabetes management but my physiotherapist really made me feel helpless and hopeless yesterday. It has been a rough week this week, having to heat, massage and medicate to relieve the pains of the day before I fall asleep and having to arise early for morning appointments so I am definitely off my game physically.  I was not prepared or even imagined that I would have such a conversation with an insensitive Physiotherapist who I felt was more interested in how my lack of progress reflected on her skill as a physiotherapist rather than Medicare, after only five visits. She discussed my financial and insurance info in front of an entire room of patients and staff. Besides all heads turned towards us, one of the staff looked at her incredulously as she told me she just could not understand what was going on with me since I am not making progress and nothing she is doing helps and essentially what she said was that since she wasn’t able to solve my problem I was not a success for her even though she blamed it on Medicare after 5 visits. I wrote for Medicare for decades and even took cases before an administrative law judge and mine is not near one of those cases that need such justification. Perhaps if she took a step back and let me work with another therapist who is focusing on rehab of the actual trouble areas I point out and working with my actual abilities rather than where she thinks they are coming from and focusing on how a normal person without my multiple problems would progress I just might make progress. She also would also be able write a valid Medicare note that would get approved. The day the PTA worked with me and taught me stretches and assessed my gait and pointed out the problems and how my use of the cane was contributing did more than she had in her four visits. I was astonished, and I so much pain, that I just could barely reply. Maybe it is because she is has been ready to deliver her baby “any day now” for the past two weeks as she was visibly distressed and short with all her patients, her face a tense grimace even before she realized I was there, in fact it was the first thing I noticed when I walked in.

We’ll see what transpires at my appointment this coming Monday.

Day 18: Progress! Decreased Insulin by 2 Units More, Resisted the urge to over-carb! LCHF and a new Escali Nutrition Scale!

September 5, 2013

7:19am

FBG 121 A good morning and I am happy with this morning’s numbers, could be a bit better but after the past couple of days I need a rest from the anxiety.

Decreased my morning insulin by 2 Units, interested to see what happens later today.

Tried a new recipe from my new cookbook, omelet with bay scallops, with a side of freshly picked tiny plum tomatoes and it was wonderful. I did add a small portion of oat bran with a few berries to hold me through the morning as I have some errands that I need to attend to. Didn’t realize I had 19gm carbs on final calculation as I had a dyslexic moment and thought “16”; may be too much with the dose change.

10:15am

PP BG148 As I thought, a little high, I feel good though and feel confident I’ll make it to lunch without an episode of panicJ

2:57pm

BG 88

A little less than an hour late attending to lunch. I feel so good though so maybe I am getting used to the lower numbers.. I was surprised it was this low, I am a little late checking my insulin, I usually check it a 1pm because it begins to descend then. Of course I over-carbed because I knew I had to sign some papers at the furniture store to finance some furniture and did not want to be caught out dealing with a low. I did not mean to over as much as I had though. I bought some ammunition while shopping so now I am armed with individual 15gm carb packs of cheeze-its and individual 11gm packs of peanut butter. These will go in my arsenal alongside a couple of Clementines and those horrid glucose wafers. My monk bag is getting heavier. I do not carry “purses”, my own little rebellionJ

Had a good meal, leftovers from last night’s supper and I did not over-carb because my BG was 88.

This, my dear readers, is progress. Vive la résistance de manger des glucides!

5:16pm

PP BG 124 Good, veryyyyy good. Good numbers I think

A bit “ferpluxed” by the speed at which my pancreas is responding. Excited as well!

Got my Escali Nutrition Scale from Amazon today! Will take it for a spin at dinnertime.

7:50pm

BG 153 47 Units  Not happy with my blood glucose tonight. Cannot figure what made it go up. Had a nice piece of Salmon with a lovely tomato cream sauce Only 297 kcals and 6gm carbs.

10:11pm

PP BG 107 Good BG may eat some cottage cheese to avoid a low, will check once more at midnight.

12Midnight

BG 130 about an hour after a ½ cup of cottage cheese, 6 gm carbs, and am small ¼ serving of 86% Chocolate, 4 gm carbs

Made it through another adventure. Tomorrow I hope to tackle a problem I see looming in the horizon, constipation. I also hope to relate my experience with the Escali Nutrition Scale; methinks there is magic afoot!

Day 17: The Day After Hypo Episode Freakout. A Note About Anxiety, Panic et PTSD with Hypoglycemia or approaching Hypoglycemia

September 4, 2013

7:26am

FBG 129 this morning, I had the hypo scare yesterday and ate a little, ok a lot, more carbs, but I also decreased my pm insulin by 3U last night and it was lower than the night before! The next few days should be interesting!

10:20am

PP 145 A bit high but this is due to my hypo panic yesterday which occurred about this time. By tomorrow this number should be better.

I am going to start carrying a small jar of peanut butter so after I eat some fast carbs to raise the blood sugar it does not drop again. The protein will help keep it stable. Forgot to put some protein in my bag yesterday so all I had was a Clementine and glucose tablets. Did not take the glucose tablets because I rationalized the hypo wasn’t bad enough. Good thing I was home in 5 minutes. My brain on anxiety. So from now on I m going to be prepared and follow protocol rather than letting my anxiety rule the roost.

Happy because I just received my LCHF cookbook and after looking through it I am very pleased and I do not see anything a domestically challenged individual like me cannot cook. J

Here is Bailey reading “The Low Carb High Fat Cookbook” by Sten Sture Skaldeman:

Anxiety, Panic and PTSD with Hypoglycemia or approaching Hypoglycemia

My lowest Blood Glucose I ‘caught’ so far was 68, but this was enough to frighten me. My nurse practitioner wants me to report anything lower than a 90 and at first I kind of questioned it as 90 is a normal blood sugar but I now see her wisdom. Careful monitoring and reducing insulin doses esp. since I am working so diligently with my diet and schedule we might just be able to avert the scarier lows of 40 and 50 although it just may happen.

Anxiety and Panic are not good things although sometimes one or both are hard to avoid. A caveat of good information regarding the management of diabetes is the knowledge that the meds can be dangerous and that people sometimes die when their blood glucose drops. This is very common with diabetics but not spoken of so people with the diagnosis of diabetes are embarrassed to say something and suffer alone and/or seem non-compliant. This NOT mental illness, this is a very valid fear based on a potential side effect/s of Diabetes and its treatment and it should be discussed with one’s doctor. It is not uncommon to develop PTSD after only one “low blood glucose” experience, even if it is minor, and it is certainly not unheard of to develop PTSD just from the trauma of the diagnosis, esp. if handled poorly. If the doctor brushes it off or prescribes an anti-anxiety med without referring you to a support group, diabetic coach or another member of the team to assist you seek a support group, diabetic coach or specialty diabetic clinic. It is good to have a number to call in case of an emergency of a support person who is willing to talk it out with you

I get anxiety when my blood glucose hits 90 and does not come up after eating fast carbs and a piece of protein within 15 minutes and continues to go down. That has happened twice and it is due to the actions I am taking to reverse DM2, lose weight, and get off of Insulin. So while these are good signs, my knowledge sets of alarms in my brain. Anxiety mimics real Hypo. Shakes, vertigo, shortness of breath, confusion, irritablilty and panic. Some people sweat profusely and pass out. Others experience intense hunger although this may be due to the fact they need to eat anyway and may have missed a crucial meal. Some people become so frightened after a hypoglycemic episode they take test their blood sugar 20 times a day, sometimes even more, even after it gets to what they perceive as a comfortable number.

Forgetting whether one took their medication or took it twice. Happens to us all, esp. in the beginning. The first time I gave myself an injection when I got home from the hospital I had such a panic attack that I thought I inadvertently hit a small capillary vein that was rushing pure insulin to my heart. Irrational but that is also an earmark of anxiety and panic. I took my blood glucose several times: felt as if I was going to faint and was short of breath. I have gone to bed and tried to remember if I took my insulin or not, opting not to because I just didn’t know. I have checked my blood glucose many times thinking that maybe I took another dose.

So many things are going on in a diabetics body a change in blood sugar can cause fatigue and forgetfulness at times, just the emotional weight of the disease and th day to management can be trying at times, esp. if live throws you a couple of curves that may not have bothered you when you were younger or prior to diagnosis.

I took the problem in hand because I knew it was the only way to take control of this little problem:

I have a notebook and also a reminder on my mobile. I put the notebook open to where I note the time and amount of my insulin on the table alongside my mobile phone with the reminder app open. I then fill the syringe to the required units, prepare the area I am going to inject. Then I jot down the time and amount in the notebook and check off the reminder in the app and immediately inject my medicine. It is so worth it and takes just a few seconds for peace of mind. Especially important if you live by yourself or without another adult in your home.

Over-carbing –eating foods that raise the blood sugar so one feels safe. Problem is if one over-carbs fast and with fast acting carbs such as syrupy sugary sweets one might get low after the spike anyway.

The carb sleeping pill – over-carbing to enable a peaceful night’s sleep and feeling secure one will wake up in the morning.

Both the above are a result of diabetic PTSD or an occasional reaction to hypo anxiety. The problem is high blood sugars, poor control and an increased potential for damage to nerves and other organs.

Important Fact:

Dying from Hypoglycemia is rare in Diabetes Mellitus Type 2 without liver disease because the liver acts as a backup and shoots stored glucose into the bloodstream elevating the blood glucose, often above normal into a high range, but not dangerously high to compensate for the low.

Hope this helps someone. If you need some support you might want to check out these wonderful communities:

Type 2 Diabetes - Sugar Attack!

 Diabetic Treatment Alternatives

Reversing Diabetes

As I learn more I’ll try to share, that goes with tips and tricks as well

1:07pm

BG 84 Speaking of low blood glucose, but it is time for lunch and this is my “five hour low”. Although this is not technically low and in normal range, for me it is, based on parameters my nurse clinician and I decided on according to my goals, my medication, rate of weight loss and carb intake. So anything under 90 I am to report. Having had a “mini-crisis” yesterday and having spoke with my nurse practitioner I will pass on reporting this at this time and just adjust my morning insulin, lowering it my 2U and monitoring it. I feel good and as long as it responds to the food I will be eating in a few moments, I so no need for alarm. Lunch contains 13gms carbs, including good protein and healthy fats but I added a Clementine bringing it up to a therapeutic 22gms of carbs.

2:11pm

BG111, checked for my peace of mind, feel pretty good but am fatigued because of not sleeping too well last night due to pain in my problem hip and leg. Just wanted to be certain the fatigue wasn’t from “hypo.” It wasn’t. :)

3:40pm

PPBG 129. Good for the amount of carbs ingested at lunch, I overcompensated a bit. It is better to avert the low in the first place.

8pm

BG 142. 47U pm dose of insulin. Ok, but a bit high, not really too concerned because I take my evening dose of insulin and eat dinner at this time.

10:00pm

PPBG 123 This is good, I am pleased. Will check close to midnight.

11:49pm

BG 116 This is also good. I will eat a small portion, ½ cup, of Greek yogurt to help balance blood glucose to avert a low BG. It’s low carb, about 7gm, to avert high fasting in the morning

FINI

Day 16: Had Hypo Episode, Scary, Panicky: Anxiety and Fears about Low Blood Sugars

Day 16

September 3, 2013

7:00am

Fasting BG 149 this morning. Ugh, was not going to eat any extra carbs last night save what was in the cottage cheese but I thought a coupla few grapes would be ok because i got that fear thing a little. Well the grapes tasted so good, a coupla few morphed into a handful (about 15). There weren't many left so Bailey and I finished them and here I am with a high fasting this morning. I am not buying any grapes for a while, and esp. not the huge carton at Costco. How can something so lean on calories have such an impact on blood glucose. Just Not right. Oh well had a lovely breakfast of 13gms carbs but 11 gms was half a multi grain sandwich thin to hopefully hold me through PT.

9:50am

PP BG 68 Low for this time of day, obviously not enough carbs, but I did have PT, and exercised a little even though I was too sore to get on the bike because of waking up at 3:50am in excruciating hip pain, took an hour to get easy and fall back to sleep. The thing that really concerns me is that it came down from 149 in less than 3 hours and after I had breakfast with a few less carbs than usual. Ate a Clementine and 6 oz of yogurt.

10:17am

BG 88 still a bit low, Doc wants it at least 90. Will check again in a few. Just when I think it is safe to go into the water...

10:31am

BG 106 better but I have to watch it.

10:48am

BG 111

11:13am

BG 113 Still feeling weak and a little shaky I am going to have an early lunch and watch it carefully. I thought I might have a week of balanced numbers at least and with that some peace of mind

12:00n

What in Heck? BG 108. Thanks insulin I am about to blow my orderly diet.  Ate a whopping 636 calories and 39 carbs. Guess it’s time to lower the damned insulin again.

1:00pm  BG 141 Just took my BG again after an hour and after all that food it is ONLY 141. And I feel wiped. This is the usual time for the drop.

2:00pm BG 140 Called my Nurse Practitioner, waiting for her call.

3:07pm Nurse Practitioner called, reassured me everything is going alright and what I am doing is working, so I shall lower the evening dose to 47U and in 4-5 days lower my dose another 2 units. I feel better now, they effects of the low blood glucose seems to have abated. I am just somewhat tired.

5:59pm BG 136 surprised it is so low after “panic-eating” feeling hungry, ate a couple of 50kcal, O carb cheese sticks.

7:50pm BG170 It’s high but I am not surprised. Because of the swift fall in BG I am just going to get back in the saddle, eat a nourishing dinner within my caloric plan, with 11 carbs and let my BG normalize.

8:27pm BG166 47U Ate dinner and a piece of melon upping dinner to a whopping 30 carbs. I shall sleep well tonight as I have fed my PTSD.

10:56pm BG186 high Tomorrow is a new day. Ate a small 99 carb Greek yogurt as it usually helps normalize my BG.

From my Friend Dr Michael Hutch: about anxiety and fears about low blood sugars...listen to this... http://www.diabetespowershow.com/DiabetesPowerShow_75.html

Helped a lot.

Day 15: Labor Day, Rainy Day, Dangerous Disease and I'll Tell You Why But it Has Been a Good Day!

Diabetes Journal Day 15: Labor Day

Monday September 2, 2013

3:45am

Pain where the left femur meets the hip joint woke me but did not feel hypo and did not check my BG, Bailey was asleep in “her chair” in the living room – of course hearing me wake up she was soon right there with me, a bundle of silky puppy love.

The was not as bad as has been but I took a ½ pain pill and Ibuprofen, sat up for a few minutes with the heating pad on the sore area, watched the news and after about 20  minutes went back to sleep with Bailey sleeping at my feet.

My physical therapist and doctor seem to think unless I get an adjustable bed to change my position in the night I undo all the therapy in the day. Naturally the pain and inflammation act up worse when I am asleep. Would be nice to sleep more than a couple of hours at a time! I added a 325mg aspirin to my nighttime ibuprofen which truly helped with reducing the inflammation in my right shoulder, the “good” one and did not have any finger numbing and subsequent pain as I stretch to relieve it in the night and morning. Might be a keeper because it was bothering me so much, esp. the past few nights that I was very tempted to ask my doctor to call in a medrol dose pack. The steroids would have set my diabetic progress back some, and for a week or two.

 So far so good.

I’m excited about the new bed, adjustable but not the sick room kind, and the recliner. The best part is that someone is giving me an almost new Craftmatic base, saving me thousands. The rest I am getting on credit but I got a Labor Day deal.

7:30am

FBG 117 52U I feel great, enjoyed a 16gm carb breakfast. Will begin to lower bedtime carb intake to get my morning numbers closer to a hundred. Really it is due to not just to my anxiety but also so I can get used to the lower numbers and the signs and symptoms of real hypo.

I wonder how many people really realize how dangerous this disease is?

Not just what it does to one’s body but how dangerous the meds can be. Dying from a hypo can be a real possibility, but usually when one’s blood sugar level drops, another hormone from the pancreas called glucagon signals the liver to break down the stored glycogen and release glucose back into your bloodstream. This often causes a high blood glucose reading in the morning.

Still it is a fear.

A dear friend of mine with Type I Diabetes died in his sleep a couple of years ago from hypoglycemia. He often had severe lows and this has left such an impression on me that in the back of my head I fear that one morning my 21 grandson will find me dead in bed.

A major motivator for me to get off of insulin, but I must closely monitor it and control it while working towards that goal.

I need the cooperation of my friends and family. My family is pretty good; they have come a long way. Some my friends don’t understand that a “little sugar” can put me over my limit. And they do not understand the difference between fast and slow absorbing carbs.

For example:

 A tsp. of sugar is 4.2gms of fast carbs and will cause a blood sugar spike, a ½ cup of sugar is 100 gms of fast carbs and exceeds my carbohydrate allowance. Furthermore because it is a fast acting carb it will spike my blood sugar to unacceptable levels.

On the other hand, 6 oz, or ¾ cup of broccoli and cauliflower provides 9 grams of slow absorbing carbs and barely affects my blood sugar esp. if I add fat and protein to the meal.

I don’t expect them to fully understand but I only ask that they please respect my answer when I say “Thank you but I can’t have that.” Sometimes I can work a “tiny taste” of your Aunt Mamie’s Red Velvet cake into my carb count, some days I just simply can’t. It’s just not worth the dangerous act of having to take extra insulin to counteract the effects of the large amount of carbs on my blood sugar and risking potentially life threatening hypoglycemia. I ask that they understand and do not take offense as this truly can be a life and death decision. Or a quality of life decision to avoid the potentially horrid effects of high blood glucose on the body.

I love my friends and want to be around for a long time to enjoy their company!

10:35pm

PP BG 113 That is good! Was going to take Bailey to the park so she can play at my feet when I sit and read, but it was too hot and muggy so she played outside with my grandson and when he went to but the lawn we played “bowling” in the house. I have a long hallway that runs from the back door to the front door and I toss the ball down the hall and she happily runs after it. It’s a funny site and we both enjoy it: I have hardwood floors so she slips and slides trying to get purchase at what looks like warp speed to get her ball. I must say her balance is getting better but she loves the chase!

12:58pm

BG 74 Kind of expected these lows after five hours of my morning insulin dose. I think I am going to add a few more carbs to my breakfast.  I’ll give it a few more days than put it to my support group for their advice.

I feel great, not dizzy, shaky, sleepy or anxious. A little irritable but that may be because my 6’6” grandson decided to look for something behind the couch and accidently knocked over an end table with a lovely bird oil burner and a delicate crystal cluster, both given to me by two dear friends. They both escaped destruction but the crystal cluster lost a couple of tiny crystals, nothing noticeable. We lovingly referred to these kinds of events as “sasquatching” or something being “sasquatched” because my grandson always seemed to be too big for the world around him.

He has grown out of it mostly except when he is in a hurry as he was today.

At the same time he did this I was putting together my pre-planned lunch and feeling a bit pressured to get the food into my system and had to stop to survey for any damage and pickup the items. So it was not so much the accident but me feeling pressured to get my lunch before my blood sugar fell any further.

A note here, I do not think it was “falling,” it may have been going down very slowly because I felt fine.

Lunch was delicious! Tender steak cut in strips, broccoli/cauliflower medley and an avocado quarter; 17gms carbs.

3:56pm

PP BG 120 Good.

 

5:15pm   

BG 126   Sleepy. Thought maybe BG dropped, it’s fine. Been sipping coffee wth cream I made earlier and had a cheese stick earlier to help slow down and offset any carbs from the garden tomato sauce I sparingly taste as it slowly simmers. One of the best pots of sauce I have ever made and I am not sure if I really want to eat it with shredded broccoli in lieu of spaghetti. The supposedly low carb low glycemic pastas cause nearly as much of an impact on me as regular pasta. I have never been much of a pasta eater but when I have eaten pasta in the past I like to enjoy a full generous serving with lots of sauce. Not going to happen.

8:30pm

50U Had a great dinner I was going to pass on the garden tomato sauce but it was way too good so I cooked some broccoli slaw, put some sauce over it, Parmesan cheese and a sprinkling of a mix of peppers and onion. I paired it with a sliced roast chicken breast with skin and wing. I use a smaller vintage plate so it looks like more food than it is. 375 kcals 19gm carbs (and I am still under my carb allowance for the day)

10:30pm

PP BG 111, very good but too low for me to pass on my evening snack. Interesting to see what my fasting will be.

Say good night Bailey~

Day 14: Good day, Friends and Family, Shopped for a Bed and Recliner!

Sunday September 1, 2013

12:30am BG 111 Just checking before I went to bed. .  I also had a few carbs and some protein at 10pm, BG 112: I had a tblsp of peanut butter and a half of a small banana (Bailey had the rest) before going to sleep to avoid the 1am low.

9:50am FBG 111 at 8:08am, same as went I went to bed last night. I am ok with it, it’s safe for me right now, still getting used to the lower numbers. Had 22gms of carbs at breakfast and hopefully that will keep me from getting a 1pm low.

It's an ongoing management of my diabetic life, and I don't have to keep reminding myself of my goal, it is something not easily forgot!

I feel good today!

A diabetic friend is going to send me a computer tracking sheet, currently I keep a written log to track my BG and contributing good or bad factors. Her program tracks carbs, fats, protein, maybe similar to MyNetDiary app.

10:48PP BG 140 This is ok if it keeps my BG from having a 1pm low. I am hoping for a good number, I see in a little over two hoursJ

 1:09pm BG 95, although that is normal, I do not want to go below 90. This is very good and not a lowJ Ate 16gms carbs at lunch.

3:28PP BG 126 Good again, I seem to be balancing out and finding a good carb ratio.

5:16pm BG 117, out shopping for a bed and recliner, feel good, a little tired (no anxiety) due to not being used to going out so much but just wanted to check before I get on the interstate to head home. I am getting more confident but when I feel a little fatigued I want to make sure it is not my BG going hypo. Good number!

6:45pm Resisted the urge to check my BG, tired (no anxiety) but too soon to dinner to take a nap and don’t want to ruin my sleep tonight. Ate a cheese stick to tide me over for the next hour or so until dinner. Learning to listen to my body.

8:24pm BG 113 Good. 50U Had 11gms carbs at dinner

9:11pm BG 125 Was barely able to stay awake. Duh, had a big day but I just had to check. S’ok!

10:24PP BG 119 Good number, sleepy, left leg/hip pain not acting up. Ate  ½ cup cottage cheese and ½ a small banana for a total of 16 carbs. The cottage cheese is probably enough but I want to give my body time to normalize with the change in insulin and avoid that 1 am low. Which is not really a low at 70 but my body is just not used to it yet. My dog Bailey will wake me at 70.

Today was a good day; I am feeling more confident, my positive outlook is returning along with my energy and concentration.