Kim and I are headed to Costa Rica tomorrow for a week of surfing, fishing, hiking, white water rafting, zip lining and cannoyneering. I can't begin to tell you how excited I am but also have experience for the first time how stressful it can be to plan an international trip with diabetes. If we were going to a less remote locale I'd be able to hit up a CVS or call medtronic if I had any problems with my pump or diabetic supplies. However, since we'll be in pretty remote areas doing some crazy stuff I have to pack my bag like Odysseus headed to Ithaca.
I'm pretty sure the chances of finding a cliff bar in Costa Rica or a glucose tablet are nonexistent so I need to be prepared for lows, highs and everything in between. I have extra test strips packed, two meters, batteries for my pump and meter, two vials of insulin, a full box of infusion sets, and the waterproof case for my pump. This is also requiring me to scour Boston for a new back pack so I can bring this stuff with me on our outdoor adventures - don't think my awesome Timbuk2 laptop messenger bag will cut it while white water rafting!
Look forward to sharing pictures of the adventure with you when I get back - HAPPY NEW YEAR!
Friday, January 2, 2009
Tuesday, December 23, 2008
How Sensitive Are Basal Rates To Diet?
Since I've been home on break my basal rates have bounced around a bit. After a few days of experiencing lows I reduced my basal rates and then encountered some 200 plus days. Two weeks ago when I finally made it back to NY my basal total was 13.5 units of insulin per day. Today my daily total basal is 16.25 units per day, more than double my basal totals at the time of my Ironman.
My diet has not been as healthy or consistent as it was when I was down in Virginia. Staying at my parents house, seeing friends and spending time in Boston all has added to a bit higher carb, higher fat diet than normal. My workouts haven't been as consistent as I would like and my sleep patterns probably haven't been as regulated. However, a 3 unit jump in basal rates in just over a 2 week period seems high.
I suppose it is now time to buckle down, return to nothing but egg whites, turkey sandwiches and chicken sausage until I get this thing back under control. I'm going to try and get my weight back under 190 by the time I return to school to see if the 7 to 10 lbs I gained after the Ironman have increased my insulin requirements. I also really need to find my software for my quick link so I can load my blood sugar information to my computer for analysis - in other words I need to become a good diabetic again.
My diet has not been as healthy or consistent as it was when I was down in Virginia. Staying at my parents house, seeing friends and spending time in Boston all has added to a bit higher carb, higher fat diet than normal. My workouts haven't been as consistent as I would like and my sleep patterns probably haven't been as regulated. However, a 3 unit jump in basal rates in just over a 2 week period seems high.
I suppose it is now time to buckle down, return to nothing but egg whites, turkey sandwiches and chicken sausage until I get this thing back under control. I'm going to try and get my weight back under 190 by the time I return to school to see if the 7 to 10 lbs I gained after the Ironman have increased my insulin requirements. I also really need to find my software for my quick link so I can load my blood sugar information to my computer for analysis - in other words I need to become a good diabetic again.
Monday, December 15, 2008
Is The Honeymoon Over?
My first semester at Darden is finally over so now I have a chance to focus on my internship search, marathon training and diabetes. Last week was hell with 5 consecutive days of 5 hour exams; not a good time by anyone's calculations but thankfully the stress didn't throw my blood sugars out of whack as they were kept pretty steady over those 5 days. However, in general I've been having a much harder time locking in my basal rates.
Over the past three months I've been playing with my basal rates on a near weekly basis; while getting my blood sugars to spike prior to a workout has been much easier. I'm pretty sure the honeymoon is over and the fight in my last islet cell has been won by diabetes. In a way that will make life easier in terms of knowing how my body will react to exercise, food and basal rates. But in another way that kind of sucks since there was a time period when I could eat pizza with just a moderate bolus.
I've been working out consistently for the past two and 1/2 weeks but have not had the reduction in basal rates that I expected. I have encountered more lows over that period than I had when exercise was less consistent due to class work but I still haven't had the blood sugar reactions I expected. Although it does seem like the overall trend in my basal rates is changing; at night I've had to increase my basal rate by a huge amount as I woke up a few nights it a row with blood sugars above 300 at 4 am; but then I would hit consistent lows around 11 am. To get all this corrected I'm going to have to keep detailed notes over the next few weeks to identify the trend and figure out exactly when my basal rate errors are occurring - consistency is the key and I just need to get back to that.
Over the past three months I've been playing with my basal rates on a near weekly basis; while getting my blood sugars to spike prior to a workout has been much easier. I'm pretty sure the honeymoon is over and the fight in my last islet cell has been won by diabetes. In a way that will make life easier in terms of knowing how my body will react to exercise, food and basal rates. But in another way that kind of sucks since there was a time period when I could eat pizza with just a moderate bolus.
I've been working out consistently for the past two and 1/2 weeks but have not had the reduction in basal rates that I expected. I have encountered more lows over that period than I had when exercise was less consistent due to class work but I still haven't had the blood sugar reactions I expected. Although it does seem like the overall trend in my basal rates is changing; at night I've had to increase my basal rate by a huge amount as I woke up a few nights it a row with blood sugars above 300 at 4 am; but then I would hit consistent lows around 11 am. To get all this corrected I'm going to have to keep detailed notes over the next few weeks to identify the trend and figure out exactly when my basal rate errors are occurring - consistency is the key and I just need to get back to that.
Tuesday, December 2, 2008
You Know You're An MBA Dork When....
You are sitting there in your second quarter operations class learning how to use six-sigma models and realize you have been using that methodology nearly everyday since you've been diagnosed with diabetes!
We were learning that under six sigma models you set an upper error limit and a lower error limit. The data points on the graph are filled in by point in time quality spot checks - quality outside this range is deemed in error. There are then a host of equations that spit out some graphs that indicate if your system is out of control and if a change needs to be made to prevent errors.
This is the exact way I manage my blood sugars. When I upload my blood sugar readings to my computer I have an upper limit of 140 and a lower limit of 75. Anything outside that band is considered in error. Overtime I determine if there is a trend for the blood sugars in error and make a change accordingly.
Just like a firm doesn't want to chase their tail to fix errors, we don't want to constantly chase blood sugars. Making a basal rate change too soon will cause the blood sugars to be in error more often. It's essential for us to keep our blood sugars "in control" - who knew I was just using six sigma to do it!
Can you tell I'm a week away from finals!?
We were learning that under six sigma models you set an upper error limit and a lower error limit. The data points on the graph are filled in by point in time quality spot checks - quality outside this range is deemed in error. There are then a host of equations that spit out some graphs that indicate if your system is out of control and if a change needs to be made to prevent errors.
This is the exact way I manage my blood sugars. When I upload my blood sugar readings to my computer I have an upper limit of 140 and a lower limit of 75. Anything outside that band is considered in error. Overtime I determine if there is a trend for the blood sugars in error and make a change accordingly.
Just like a firm doesn't want to chase their tail to fix errors, we don't want to constantly chase blood sugars. Making a basal rate change too soon will cause the blood sugars to be in error more often. It's essential for us to keep our blood sugars "in control" - who knew I was just using six sigma to do it!
Can you tell I'm a week away from finals!?
Tuesday, November 18, 2008
My First MBA A1c
For the first time since my diagnosis I was legitimately freaking out about my A1c. From August to October I had so many changes in my life that I just didn't know how my average blood sugar was going to react. After the Ironman I had blood sugars sky rocket into the 200 and 300 range. When I first arrived at Darden the schedule, free food and stress had my blood sugars close in on 350 from time to time. But thankfully my A1c was just 6.6 from August to October.
6.6 is higher than it has been over the past year - but I'll take it. With all the variables introduced over those 3 months I'm not going to complain about an A1c that slightly creeped up. In looking at my meter this morning my last 341 results over the past 30 days has slid back down to 125; hopefully that next A1c is under 6.4. Regardless I'm proud of my management over my first quarter at Darden.
6.6 is higher than it has been over the past year - but I'll take it. With all the variables introduced over those 3 months I'm not going to complain about an A1c that slightly creeped up. In looking at my meter this morning my last 341 results over the past 30 days has slid back down to 125; hopefully that next A1c is under 6.4. Regardless I'm proud of my management over my first quarter at Darden.
Tuesday, November 11, 2008
Here We Go Again!
Last week I signed up for the Charlottesville Marathon which will be held the same weekend as my 30th birthday in April. With Darden's first quarter under my belt I couldn't help but scratch that athletic itch again. Having gained about 9 lbs since Ironman Lake Placid it was time to lace up the sneakers, place an order with PBN and get my butt back into shape. To make it even better my amazing girlfriend and some of my Darden classmates will be running the race with me.
One of my biggest disappointments from the 2008 season was having to pull out of the Shamrock Marathon. I have yet to run a stand alone Marathon and really want to push myself to run my best in it. With my Abbott Freestyle Navigator in hand (if I ever get it), solid nutrition plan and dedication to training I think a sub 4 hour marathon is very possible. Plus with all my training buddies here at Darden - the training should be fun!
I unfortunately had to tell Triabetes I will not be able to compete at IMAZ with them in 2009. The Darden schedule is just too demanding to train for 20 hours a week and I did not want to race an IM unprepared. I hope that my schedule will allow for about 10 hours a week of marathon training - I'm energized and ready to go!
One of my biggest disappointments from the 2008 season was having to pull out of the Shamrock Marathon. I have yet to run a stand alone Marathon and really want to push myself to run my best in it. With my Abbott Freestyle Navigator in hand (if I ever get it), solid nutrition plan and dedication to training I think a sub 4 hour marathon is very possible. Plus with all my training buddies here at Darden - the training should be fun!
I unfortunately had to tell Triabetes I will not be able to compete at IMAZ with them in 2009. The Darden schedule is just too demanding to train for 20 hours a week and I did not want to race an IM unprepared. I hope that my schedule will allow for about 10 hours a week of marathon training - I'm energized and ready to go!
Thursday, November 6, 2008
Abbot Is Incredible
The good news is, I'm still getting my constant glucose monitor; the bad news is, I have no idea when. At first Abbot had given my supplier the wrong insurance information which delayed the process a week. Today I received a call from my supplier letting me know that all orders to Abbot for the Freestyle Navigator are on back order!!! For a company that is trying to introduce a new and I'm assuming highly profitable technology they may have the worst sales and marketing force in history. If there is one thing that my marketing course at Darden has taught me it is - to know your customer! At each step of the way Abbot has failed on general customer service, I would receive calls from multiple people asking the same information, they would not meet self mandated deadlines to keep me in the loop, they had asked my doctor for the wrong information and they seemingly never wrote down anything I told them. It would be nice if the companies that make the products that allow us to better manage our disease actually knew how to manage their workforce.
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