Following the GPS

For the last 3 months I have been taking courses in hopes of being admitted to an accelerated 2nd bachelor's degree program for nursing.  It was my intention to complete nursing school and sit for the certifying exam for diabetes education.  The paths to becoming a certified diabetes educator (CDE) have always been limited and time consuming and I'm convinced that after taking a practice CDE exam, I could already pass the official exam with my current knowledge instead of investing thousands of $$'s and paying off more student loans for years to come.  

My decision to pursue nursing school came from the current standards set by the NCBDE (National Certification Board for Diabetes Educators).  In order to become a CDE, one must be from the following professions:

a) Clinical psychologist, registered nurse, occupational therapist, optometrist, pharmacist, physical therapist, physician (M.D. or D.O.), or podiatrist holding a current, active, unrestricted license from the United States or its territories. 

OR

b) Dietitian holding active registration with the Commission on Dietetic Registration, physician assistant holding active registration with the National Commission on Certification of Physician Assistants, exercise specialist holding active certification as an American College of Sports Medicine Certified Clinical Exercise Specialist®, or exercise physiologist holding active certification as an American College of Sports Medicine Registered Clinical Exercise Physiologist®. 

OR

c) Health care professional with a minimum of a master's degree* in social work from a United States college or university accredited by a nationally recognized regional accrediting body. 

In addition to these stipulations, you must also practice in your field for 2 years and have 1000 hours of documented experience dealing with diabetes management treatment. 

So now you see why my obvious choice was nursing.  However...

Beginning 2014 the rules are changing!  Anyone with a master's degree in a health field with 2000 hours of experience with diabetes management (treating other people, not myself) can apply to take the certifying exam.  

This opens up some doors and I have some decisions to make.  This is where it gets confusing, stressful and plain overwhelming for me.  Besides now having the decision about a 2nd bachelor's or a master's degree, I'm adding in a 3rd dimension of confusion.  I don't believe in following the American Diabetes Association guidelines for treating diabetes.  Unfortunately, during my CDE shadowing over the summer I was informed that the hospitals and all treatments are following them.  I don't want to have to learn and follow what I don't believe in.  As a practitioner though, if you don't follow ADA, insurance doesn't pay for your services and I would most likely struggle finding doctor's to support what I believe in and follow (even though I'm living proof).  That sends us into the 3rd dimension as I stated above...be prepared for a shocker!

 I've been considering scrapping traditional education all together.  

I've been toying with the idea of patching my education together, mixing and matching non-traditional programs like the Nutritional Therapy Association and the CHEK Institute, that better match my idea of promoting healthy living.

Scrapping traditional education does a number of things:

• It would take significantly less time
• It reduces the amount of potential debt I'd ensue
• It would better match my beliefs about health and nutrition
• I would end up working for myself
• I wouldn't become a CDE, rather I'd be focusing on supporting the body naturally (nutrition, lifestyle, exercise, etc.) I would be focusing on the person, not the disease.  I'd help more people live healthier lives than if I stayed focused on diabetes.
• I'd have less stress ultimately and stress and diabetes is a horrible mess! 

I've been praying and pleading with God about showing me the right path.  If only he would mail me a post card reading:  "Dorothy, put on your ruby red slippers and follow the yellow brick road to ________.  This is where you need to be.  -God."  It would be much easier to make a decision and have confidence about it.  If you follow me on facebook, you will have seen my most recent post about success.  If you don't follow me here it is: 

"I'm definitely in the middle of the big scribble. One day I'll find my way. I try to remind myself that just because I have a plan doesn't mean that it will pan out how I envision it in my mind and that it's OK to change my plans, decisions, direction, etc.
Sometimes I get caught up in the "what will everyone think if I change my mind again" but ultimately it doesn't matter does it? I used to think that people would judge me because I've changed my mind numerous times (especially about a career), they'd see me as wishy-washy, indecisive and unsure. However, I see it as me realizing that something is not for me and that's OK! I'd rather try 100 things and fail 99 times and finally on my 100th try have success, than to let fear and judgement dictate my life and stay in the safe box, only trying a few things and never really loving my life or reaching my full potential. So, here's to success, may the road leading there teach lessons, help to strengthen and grow character and may the scribble of life be exciting."

I'm trying to navigate the road to my success.  One thing that I need to make sure I don't forget is to be lead by my GPS-"God Positioning System."  While my journey may have begun one way, it seems my "GPS" is pulling in another direction.  All I can do is enjoy the ride.

~D 
 

Trying a Different Approach

Taking a little "Me" time this afternoon.  I've been struggling with my blood sugar for the past few days and have been repeatedly "riding the diabetic roller coaster."  It's been beyond rough on me, especially since the last few months have been going so well!  I'm afraid that all of my hard work is unraveling before me!
Today alone my blood sugar has been 45mg/dl which is VERY low and all the way up to 219, which makes me feel like a ton of garbage.

Diabetic Coaster-type1diabetesmemes

Typically, my approach to dealing with days like these is to become so frustrated and angry that it ruins me.  I stay angry and stressed over it, which ultimately makes my sugar worse.  So today I am trying a different approach - THANKFULNESS.
While my sugar may be out of whack, I can either let that 1 thing ruin my day or I can rejoice in everything that's going well and give the 1 bad thing to God to deal with.  Today I am choosing to be thankful, and here's what I'm thankful for today:

1. I am thankful for an AWESOME God!
2. I woke up this morning!  God gave me another beautiful day!
3. I had a great weekend and was able to spend time with my parents and family friends who were visiting from Florida.
4. That I'll finally be able to see my hubby for more than 1 hour today!
5. That summer semester is more than 1/2 way over!
6. After sleeping in a house that was 82 degrees last night, that our AC is now working again!!
7. My anatomy & physiology exam went better than expected this morning.
8. My beautiful Gladiolas are blooming outside my kitchen window, which makes me super happy and super thankful for God's creations.
9. I received a phone call requesting a job interview for this coming Friday!
10. I am getting to do 3 of my favorite things; writing, drinking iced coffee and sitting on the porch in my rocking chair while enjoying the afternoon.

There are by far more than 10 things I am thankful for, but for now reflecting on those is plenty.  It just goes to show that there is usually more good than bad in our lives, we just have to put our focus on the positive.  That is hard to do, especially for me when it come to diabetes.  That's why my prayer this afternoon will be for God to help me to only focus on the positive, to let go of the negative and to give it to Him.  

~D

Verses that helped me through today:
James 1:17 NLT
Matthew 11:28  NLT
Psalm 28:7 NLT
1 Peter 5:7  NLT

Chasing Dreams

For those of my readers that don't know, I'm back in school and that is what's responsible for my hiatus from blogging! I'm finally going after my dream of becoming a diabetes educator.  After all, that is what I originally started college for back in 2005 only to come out with a business degree, but that's a whole different story.  
My summer has been consumed with anatomy & physiology plus developmental psych, discussion boards, projects, quizzes, exams and labs.  While it is a bit overwhelming, I keep reminding myself that it will be TOTALLY worth it when I can finally help revolutionize diabetes care.

Trust me, after the shadowing I've done, the whole way doctors, nurses, nutritionists, pharmaceutical companies, etc., go about treating anyone with T1 or T2 diabetes is WRONG and completely INSANE!   There are only a handful of medical professionals willing to go against the grain and truly help those of us fighting this uphill battle called diabetes everyday.  Here's to hoping that one day, I can say that I helped to change that.  

Well, now that the cat's out of the bag, I must get back to studying ;)  Exam's on Monday and these things don't just ace themselves!
~D

 

 


 

Hello May

Time has flown by this year!  Can you believe we're into May already?  I can't.  The other thing I cannot believe is that 4 months ago I ditched my insulin pump for 8 shots and 10 blood sugar readings a day. I don't miss my pump yet, the infusion set changes, the alarms going off, those things can stay away for a bit longer.  
I am so excited for my first spring and summer since I was 12-13 where I can wear dresses without worrying about extra pockets having to be made into the dress or wearing this velcro leg strap thingy that I've had for years (uncomfortable). I was like a kid in a candy store over my birthday weekend when my hubby sent me shopping for dresses!  I was so happy, I felt like a girl again!
I can wear a bathing suit without fear of a wave ripping out my insulin pump site or the lovely tan lines I would get from the infusion sites.  I was kind of like the girls that go tan and put those cute little heart stickers on themselves repeatedly to see what kind of tan was developing, except mine wasn't cute like theirs.  My body would be covered in 2 inch oval white patches where my site had been for 3 days.  Not so hot!
Besides the fashion aspect of not pumping, how have things been going?  Pretty well!  I will know in more detail after May 17th when I visit my endo.  I am praying that my A1c will continue to drop and that my cholesterol will follow that trend as well.  My blood sugars have been much better than when I was pumping.  The only thing that I am still struggling with is my after breakfast highs.  Though, when I was pumping, I still experienced this issue, so I cannot say it's due to the MDI's.  My recent strategy has caused an increase in my insulin (only in the A.M.) of about 40% to fight off the natural resistance that occurs in the morning hours.  For the rest of the day, unless I slip up and eat something I shouldn't, my sugars are great.
I recently ditched my symlin pen (another injection for a hormone my body doesn't make), I was tired of feeling nauseated EVERYDAY!  Who would enjoy that feeling everyday for a few months?  I couldn't take it anymore.
Oh, gosh, I can't believe I didn't mention this earlier.  Another great thing that's happened since switching back to MDI's is my weight loss.  Steady blood sugars, a better nutritional strategy and overall less insulin levels versus pumping has provided a nice change on the scale.  I've lost around 10 pounds!  What woman doesn't enjoy fitting back into her skinny jeans (from high school I might add)!  What a reward that was :)   
Thanks for reading,
~D 

No Cake at This Party

TODAY IS MY BIRTHDAY!  Happy birthday to me, happy birthday to me, happy birthday dear mmeeeee, happy birthday to me!  Was that a bit much?  Oh well, we all get 1 birthday a year and I see it as perfectly acceptable to be self-centered for 1 day a year.

Diabetic Dorothy has a birthday-what to do, what to do?  So how do you celebrate a diabetic’s birthday?  How will I be celebrating mine? Do we celebrate with cake? NO.  How about ice cream?  NO!  Oh, Ok, I got it, “sugar free” foods, right? NO!  In fact, there will be NO SWEETS at all, not even fruit.  My birthday meal will be steak and broccoli; perhaps we’ll stick my birthday candle in the steak (we get creative, one year my bday candles were in a bowl of oatmeal).  Maybe I’ll get froggy later on and make some fake fro-yo from unsweetened Greek yogurt.    

You say, “Oh, Dorothy, you’re no fun at all.  Indulge a little, it’s your birthday!  Everyone deserves a treat!”  I say, it’s not worth the extra insulin, elevated blood sugars and feeling like crap or putting myself out of ketosis.  I work very hard to maintain where I am and I’ve learned that over the years, those “little indulgences,” have a tendency to turn into BIG splurges.  I’m not the kind of person that can have, “just a taste” or “a little bit” of something to be satisfied.  I’d rather be safe than sorry so birthday cake and special treats are not invited to this party!

One thing I’ve come to accept over the past few months of MDI’s is that I was a food focused person.  I thought about food all the time.  It was an obsession.  Partly because I thought I needed way more than I actually did to maintain good blood sugars.  I had frequent lows (on the pump) which always made me scared that I wouldn’t have food at the exact moment my meter read “50,” and that I’d die trying to find the nearest juice box or granola bar.   Basically, fear drove my eating habits, now, not so much.  Continuing on to some helpful tips…

Maybe you have a diabetic (either type 1 or 2) member of your family and perhaps you’d like some non-life threatening ideas to celebrate a birthday.  Here are some:

1)      Make a “cake” out of watermelon, cantaloupe and berries, like in this picture.   I’d rather see someone with diabetes eat real food than crud out of a box or from a bakery that uses transfats, white flour, white sugar, garbage. (If I had the correct URL I’d give credit to whoever really made this, but know it wasn’t me.)

2)      Look up “Ketogenic” recipes for cheesecakes.  I made one for Easter and it was amazing.  I used almond flour and crushed pecans for the crust instead of graham crackers and stevia instead of sugar.  These recipes will be low in carbs which will help not to spike blood sugar.

3)      Take the focus off of the food!  Plan a family outing, like a hike, bowling, biking or kayaking.  Get active!  It’s great for everyone!

4)      Have a party, but make the focus something like “field day,” set up corn hole, volleyball, kickball, tug of war, relay races.  It’s still active and competitive and give out awards, adults and kids can have fun with this one. 

 

5)      Go to a sporting event, football, baseball, basketball, hockey, whatever.  Get totally decked out in your favorite teams stuff and have a blast cheering them on.   

There are tons of things you can do, just think outside of the box!  Don’t focus on the food and instead focus on the celebration and what it represents.  Life is about more than eating, it’s about family and memories. 

Speaking of memories, I’m done blogging now so I can go make some with my family.  Thanks for reading.

~D

I Get Low, Low Blood Sugar That Is!

Recently I’ve had numerous non-diabetic people ask me, “what does low blood sugar feel like?”  “How do you know your sugar is low,” “How long does it last,” etc.  There may be others of you out there that are curious, so I’ll give you my two cents.

If you webmd hypoglycemia, which is the clinical term for low blood sugar they say that the symptoms are: shakiness, hunger, lightheadedness, and sweating.  Let me tell you, there is a lot more to it than these 4 symptoms. 

Front side of my medicalet

 Now, since I’ve been diagnosed I have been incredibly blessed to never have lost consciousness due to low blood sugar, though I’m sure I’ve been very close.  Passing out, coma and death by hypoglycemia are possible and that is why it is very important to stay on top of blood sugar readings and ALWAYS carry a glucagon (emergency kit), glucose tabs and snack.  It is equally important for those of us with diabetes (type 1 or 2) to wear a medicalert bracelet stating type of diabetes, name and medication.  I have always worn one and the few times I’ve had to take it off, I’ve panicked.  The idea of being somewhere and something happening and no one knowing why is scary!  

For me, the most common symptoms are shaking, cold sweats, very rapid heartbeat, heat that radiates so strongly from the inside of my body that I feel like I’m in a volcano and weakness.  When I say weakness, what I mean is that my limbs feel heavy, unsteady and as if I cannot control my muscles like I should be able to.  Typically the heat, cold sweats and strong shakes happen mostly at night.  They will wake me up from a solid sleep and I can usually guess that my sugar will be under 55mg/dl.  When the night time lows hit, I won’t say that I panic but I’m definitely more concerned.  The night time lows tend to be lower than day lows since it takes me longer to wake up and determine what’s going on. 

One of my worst episodes

An example of a bad night low was about 3 years ago.  My husband and I had traveled to visit a soldier from his unit that lives in PA.  Riding in the car and having my typical eating and exercising habits off had caused some turbulence in the blood sugar department as traveling normally does with me.  Before bed I set my meter up on the bed stand as I do every night, along with my cell phone which I use on a regular basis as a flashlight to check at night so I don’t disturb my husband’s sleep.  I was at a normal level when going to bed, but around 2am I woke in a confused, panicked state.  I was shaking so badly that I dropped my glucometer on the floor, I couldn’t find my cellphone on the bed stand in the dark, I didn’t remember where I was and by the time I finally got blood in the strip it registered as “LOW,” oh crap, oh crap, oh crap, serious panic mode.  I tried one more time, “35,” now I am shaking, confused, freaking out, sweating like a pig but cold at the same time and I couldn’t remember my husband’s name!  I stumbled around in the dark bedroom until I kicked the bag I’d packed with food.  I quickly began stuffing my face with muffins that I had made for our trip, almost choking before the noise woke my husband.  I must have looked like death because he even looked scared.  I was purely in survival mode.  

Now I’m crying, I’m scared, I still don’t know his name, I cannot even remember the name of my hometown…I think it starts with an A.  Oh who cares, I need another 37,000 muffins.  This shaking won’t stop, dear Lord I’m hot, I’m cold, I need to change my clothes because I’m soaked, God please don’t let me pass out, I keep dropping muffin everywhere, turn off this stupid insulin pump, my fingers won’t work, how do I turn this thing off?  I’m so confused.  I cannot move from my muffin eating spot on the floor, my legs don’t work, I can’t feel my arms, how are they getting the food to my mouth?  I don’t know, I don’t care.  Where’s the milk?  Do we have milk?  Oh God please make this stop.  These are the thoughts going through my brain meanwhile you’d never know it because my body is in a complete daze.

After about 30-35 minutes with this episode the shaking was gone, the sweating had stopped and now just the cold remains and I am so incredibly tired.  My body usually needs time to recover from these.  It literally wipes out all the energy I have.

Besides this episode, I’ve had dozens of others.  After 8 years of being together, my husband is pretty good at noticing the symptoms like aggravation before I do.  I have a tendency to get pretty feisty when I’m low.  My hubby will say, “You need to go check, you’re grouchy and I bet you’re low.”  Usually he’s right.  He’s also pretty good at noticing any glassy look to my eyes or if I am looking a little dazed and making me test.  Low blood sugar sometimes will sneak up on me and I won’t realize it is happening until I hit 50mg/dl.  That is a little frightening.  There have been times that he and my mom have had to feed me mashed up bananas or stick a juice box in my mouth, typically I could do these things myself even with a low but I tend to get emotional with my bad lows and I’ll be crying, inconsolably crying at that.

Do you guys see why cops may not realize the difference between a drunk and a diabetic?  We’re emotional, we may slur speech, can’t control our limbs like normal, we’re confused, we’re a mess.  So to all my cop friends out there take note to check for diabetes in folks!

Now I’ve covered what it feels like/symptoms, and obviously how I know is by how I feel and then testing.  How long do most episodes last?  Eh, depends on the reading but 15-20 minutes and I’m typically back to normal unless it was a significant drop (below 55mg/dl).  

What I always carry. Juice, tabs & glucagon.

If you need to help someone having a hypoglycemic episode and they are still conscious, a juice box works well, glucose tabs, bananas, most diabetics are taught anything with 15 grams of carbohydrates.  For me every 1 gram of carbohydrate will raise my blood sugar roughly 5mg/dl.  Therefore, if my sugar is 60mg/dl and I eat one glucose tab at 4 grams of carbohydrate my blood sugar should rise to 80mg/dl.  The hard thing is to keep from over doing it when correcting for a low.  They are scary and the symptoms typically last longer than the actual low itself.  As a diabetic when we over correct with food for a low blood sugar we rebound and will end up with a very high blood sugar…it’s a vicious cycle!

I suppose since I’ve covered low's, I’ll cover high’s in the near future.  Hyperglycemia is another lovely beast that accompanies this disease and reminds me that numbers rule my life.  

The long and short of this post, if you find me drinking a juicy juice box, help a girl out ;-)

~D