I've been away at the beach (and away from any internet access) for a little over a week, but I wrote the following on Monday (August 24):

Well, both Gwen and Samantha are asleep, and I’m kinda stuck in our hotel room with nothing else to do, so I thought I’d write a blog entry.

Unfortunately, since we don’t have any internet access for as long as we’re on vacation, I won’t be able to actually post it until I get back. But whenever you’re reading this, let me get to the main issue I want to talk about…

Over the last couple of days, my blood sugar has been running pretty much at normal levels, which is really good overall. But one relatively common issue with that (as I’ve read elsewhere on these internets) is the effect that lowered sugars can have on vision. Because right now, I can’t see anything much very clearly (thus making the writing of this entry less than easy), and it’s even worse when I wear my glasses.

I’ve got a couple of books I’d like to read while on vacation, and I want to work on two or three game reviews as well. But as long as I can’t see well enough to read, both of those activities (and several others as well) will have to wait. I just hope that my eyes adjust soon, or it’s going
to drive me crazy!!!

Well, my vision has started to clear up quite since then, but it's still a little fuzzy up close. I hope that I continue to adjust.

Three Bits of Good News!

Today was another important day, mainly because I had my first appointment at the Lifestyle Center. Specifically, I met with Julie, who is an incredibly patient, knowledgeable, and kind diabetic nurse educator. I started off by filling out 6 or 7 pages of health, diet, and exercise history, then she checked my weight and blood pressure, and finally, we had the actual consultation. Of course, she looked at my blood sugar readings from the last week, and we talked some about exactly how my body is falling apart to cause type 2 diabetes.

Again, it's a little weird to be on the other side of the table. I mean, I don't know how many times I have done teaching for new diabetics while I was in Critical Care. But now that it's happening to me, I'm finding that there are some major holes in my knowledge base. While I am pretty much on top of the pathophysiology and pharmacological treatment of diabetes, along with being exceedingly skilled at stuff like checking blood sugars and giving subcutaneous injections, what I lack is the real, practical knowledge of how to manage this disease.

While I generally knew the type of diet that I'm supposed to eat, actually building a menu and making consistently good food choices just wasn't connecting in my brain. And that's where Julie just excelled in our time together. She gave me general guidelines for meals and snacks, as far as servings and serving sizes of different food types. But more than that, she also gave real, concrete examples of what meals might look like (quite literally, since she even used some fake, plastic food as visual aids). Before I left, she even had me put together a couple of meals, just to make sure that the information had taken root in my brain.

We also got me signed up for the series of diabetes classes that Gwen and I will be coming to in September and October. I'm really glad that she'll be able to come with me to those, because most of these changes are going to be for the both of us (and Samantha as she's growing up).

But there's a little more good news about today! As I mentioned in my last post, my fasting sugars have been down about 100 points from where they were pre-medication. Tonight, when I checked it a couple of hours after supper, my sugar was down to 116! I was pretty blown away, because I had no idea that my glucose might get back into the normal range so quickly (especially after a meal). I ate a bedtime snack (of peanut butter and vanilla wafers), and I'm interested to see what my sugar will do overnight.

And finally, the last cool thing is that we are leaving for vacation tomorrow! Gwen and I have been packing all evening, and we take off for North Myrtle Beach just after we all wake up and get ready in the morning. Since we stay in one of the oldest freaking hotels in town, however, I doubt that they will have internet access (we're probably lucky that they have in-room telephones). If that's so, I obviously won't be able to post anything before next weekend.

So, armed with my new-found knowledge about meal plans, I'm throwing myself neck-deep into the fire as I will be faced with all kinds of culinary temptations while on vacation. Wish me luck!

A Busy Day

I finally saw my doctor today. I was nervous, more about what his thoughts on treatment would be rather than about my condition itself, but I shouldn't have been. Dr. Lamb is completely fantastic, and after listening to my thoughts on how we should approach this, he agreed. In fact, he said that this treatment was what he would have suggested anyway. So, what did he prescribe?

I'm going to start with Lantus insulin 15U before bedtime, which I'll titrate weekly based on my average fasting blood sugars. I'll also be taking metformin, starting at 500mg per day and increasing every week until I'm taking 1000mg twice a day. While the idea of taking insulin isn't exactly thrilling me right now, I'm really pleased that I have a plan for treatment and that I have confidence in the efficacy of that plan.

He also gave me a referral for the Lifestyle Center that is associated with our hospital. I went by there at lunch and made an appointment for Friday to sign paperwork, do an assessment, talk about some basic tips, and set our initial goals. The staff over there seem really nice, and I'm looking forward to that as well.

Of course, I'm also looking forward to my family's beach trip next week. Samantha (my 16-month old) loves both the water and sand, so I'm sure that we'll all have a great time watching and playing with her. But I am a little concerned about how I'll eat while on vacation. Meals are usually like the focus of the day for us at the beach, and I've got to concentrate on making better choices.

But that's enough for now. I've already taken my first dose of metformin with lunch, and I'll be making my first injection before bed. Here's to the start of a new era!

Still with the Waiting

My appointment with the doctor isn't until tomorrow, but in the meantime, I've been checking my sugar all weekend. It's been running from around the 260 range all the way up to a high of 402, which is sort of what I expected with my A1C as high as it was. I've mainly been getting morning and bedtime readings, but I've also done a few post-prandial checks after different meals. I also figured out that a slice of caramel-icing birthday cake increased it by about 80 points.

It's been a little frustrating to see how high my glucose is and not be able to treat it. I've tried to keep telling myself that it's just to gather information to take with me to my appointment tomorrow, but that doesn't always work. I've been pretty distracted at work and some even at home, and at every meal I get this sense of either frustration and loss (when I deny myself the "bad" stuff) or guilt and fear (when I eat the "bad" stuff anyway). I want to eat right, but I'm already feeling some twinges of rebellion when good-intentioned loved ones offer me "sugar free" foods.

So far, I've already cut out sugary drinks, which isn't a big deal except for my beloved sweet tea (since I do live in the South, you know). And while I haven't eaten very well at every meal, I have been very aware of the foods that are being served and how freaking terrible most of them are for me. It's going to be a huge deal to change my diet. Again, being in the South means meals full of potatoes, biscuits, rolls, cake, fried foods, gravy, and pie. Since I'm not much of a vegetable person, even the "healthy" part of my diet consists of sweeter fruits (like apples, watermelon, and strawberries... sometimes even augmented by a few spoonfuls of sugar).

But enough talk about food. Today, along with actually doing my job, of course, I'm going to be getting my thoughts together about what I want to ask my doctor for in the way of treatment. I'm pretty sure that, based on recent research and talking with the employee health nurse, I'm going to ask for a basal insulin (Lantus) along with metformin. It's pretty aggressive, but with how high my sugar is and how difficult it will be for me to make a lasting lifestyle change (and lose the weight I need to shed), I just want to jump on top of it and get things under control first. Heck, a year or two and a hundred pounds from now, I'll happily stop insulin shots. But until I reach that point, I want to make sure that this sugar isn't affecting my long-term health.

I guess that's enough for today, but I'll get back to you tomorrow with what happens.

So, I Have Diabetes...

Just yesterday, I found out that I have type 2 diabetes. It's a little weird, but I haven't actually been to my doctor yet. I don't know how many other people out there sort of diagnose themselves as I have, but then again, I am a nurse with an above-average understanding of diabetes.

You see, I had some blood drawn yesterday in preparation for my regular (though somewhat delayed) physical that is scheduled on next Tuesday. I work in a hospital, and one of our benefits is to be able to have labs drawn once a year for free, so when the results come back, they come directly to the employee via our Employee Health department. So anyway, my serum glucose was 328, and worse than that, my Hgb-A1c was 11.8. You don't have to be a doctor to know that those numbers equal diabetes. And not any sort of borderline/prediabetic crap; I'm talkin' "do not pass Go, head straight for full-blown Diabetes" territory here.

It wasn't even necessarily a complete surprise to me. About a year-and-a-half ago (at my last physical), my sugar was a little high, and I've got some significant family history of diabetes. But still, to sit there and stare at that number and immediately know the implications was quite a shock. Yeah, any objective observer could probably have looked at me and figured that it was practically inevitable (what with the family history, being overweight, and eating like a crazy lunatic for so long), but there's always a part of you that says, "it can't happen to me".

Well, yesterday, it did.

Thankfully, the Employee Health nurse (Margaret's her name) that was working yesterday has a lot of experience with diabetes, both professionally and personally. So she talked briefly with me pointed me towards some good resources. She also recommended a glucometer (the Accu-Chek Aviva) which I've already gone out and bought.

Gwen, my lovely wife, is completely wonderful and totally supportive. I can tell that she's at a bit of a loss in how to help, but I think that all I really need or want right now is the emotional support. We both know that we've got to make some big changes in our eating and exercise (or current total lack thereof) habits, but I've got to be ready before we can really go there. If I feel that someone is trying to impose changes on me, I'm afraid that I'll resist them; so that kind of stuff needs to come from me and my own motivation.

And as I'm trying to get my head around this thing, I really just need emotional support... and a lot of it.