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Day Ten

Today provided somewhat of a breakthrough. After being on Levemir for 10 days now, the insulin finally seems to have started working to lower my blood glucose levels. I got a reading of 90 on my blood glucose monitor early in the day, much to my surprise. Granted, I hadn’t had anything to eat in a couple of hours prior to the test, but I’ll take what I can get at this point. It is the lowest blood glucose reading I have had in nearly two months now.

Unfortunately, the breakthrough progress proved to be short-lived. Throughout the rest of the day, my glucose readings went back up to the low 300′s. I can honestly say that I am feeling quite a bit better though, and finally have the energy to tackle some jobs around the house that I had been meaning to get to for awhile. It was nothing too strenuous, but enough to break a sweat. Strangely, the more work I did, the higher my readings kept going. I ended up working around the house for several hours. Exercise doesn’t seem to have much of an immediate effect on my blood sugar levels though.

At the end of the day, I can tell that I am starting to suffer from dehydration once again, and increase my water intake. This was the first day I can remember in weeks that I was able to go as long as a couple of hours without having to urinate. I’m not sure if it is due to the insulin being more effective or my water intake being insufficient though. So, it could be good news or it could be bad news. We’ll see. Overall, I’m happy that I made at least some progress though.

Day Eleven

I awoke fairly early today. At least compared to the times I usually wake up on Sundays. I started-in on some work on the house at about 8 a.m. My main chore today was cleaning the kitchen and fixing my bathroom sink. It definitely was not hard labor, but much more than I had been able to do a week ago.

My blood glucose readings did not return to the low level that I was able to reach yesterday. Throughout the day, my blood glucose monitor readings varied from a low of 176 to a high of 311. It is definitely an improvement, but not enough of an improvement to say that my blood glucose levels are anywhere near under control.

I struggled most of the day to keep hydrated. It seems like I have had to start urinating more often than I had yesterday. Everything with my treatment seems to be a case of one step forward, two steps back as of late. It is frustrating, to say the least. I am in better shape than I was a week ago, but a long, long way from having my diabetes under control. I have maintained a very disciplined diet over the weekend, gotten a good amount of exercise and taken all of my medications on time. Still, it doesn’t seem to be enough.

My wife prepared a fantastic turkey dinner tonight and I probably ate more than I should have for dinner. It was by no means an outrageous amount of food, but over the past several weeks it seems that I am satisfied with eating much smaller portions than I ever had been in the past. I only finished-off a single plate of food. No seconds. Three hours after dinner, it still felt as if I hadn’t digested all of my food though. I am beginning to notice that my need to urinate is now triggered more by the intake of food (likely, carbohydrates) than it is by liquids. My diet has been very healthy, but I definitely have not been counting carbs with each meal or following any particular type of diabetes diet. It seems like very few foods I eat fall into the category of being easy to calculate when it comes to carbohydrate intake. I imagine that tends to be the case with most people though, unless they are eating specially prepared meals.

I will have to question my Doctor further about what the proper amount of carbohydrate intake is. As it is, I am eating a diet so strict that I would not have even imagined it possible just a few, short weeks ago. With my current blood glucose readings, I am beyond the point of having any margin for error though. It would be nice to get back to the point where I could at least eat some “bad” foods on occasion without having to worry about going into a diabetic coma. The insulin dosage I taking right now is obviously not going to be sufficient. The day ends with my blood glucose level higher than I want it to be, but at least I am nowhere near hitting the 400′s on the blood glucose monitor though.

Day Twelve

I am going to cut-back on updating this blog to an as-needed basis, since little seems to happen worth mentioning as of late, plus I’d like to spend the holidays away from writing. I will start posting by date from now on, instead. This last numbered post is being written on December 23rd, 2009.

I had yet another Doctor’s appointment this morning. My blood glucose readings have stayed about the same over the last couple of days. They are still way out of control. My Doctor tells me to increase the amount of Levemir I am taking to 30 units, twice per day. That’s up from 24 units, twice a day. She also starts me on 35 mg a day of a drug called Actos. This drug is supposed to somehow help “retrain” my body to use it’s own insulin.

The warnings my Doctor gave me about the side-effects of Actos were a bit scary. They apparently include “heart failure”. I’m told that considering the fact that my high blood sugar levels can also cause heart failure, that the risk is an acceptable one. I’m not sure if that is supposed to make me feel better about taking it, or not. I’m told that this side-effect only happens in a small, small amount of cases though. The other side-effect I am told to look for is swelling of the legs and feet. I already have that on occasion, so I’m not that alarmed about it. Besides, the sudden heart failure thing makes just about any other side-effect seem rather trivial by comparison.

According to my Doctor, the Actos could take up to two weeks to start working. The extra insulin I will be taking seems such a modest increase that I could hardly expect it to do much on its own. I am told that if my blood glucose readings drop too much (hypoglycemia) that I should back-off on using the Actos, rather than lowering the amount of insulin I am taking each day. It looks like I am going to need to start monitoring my blood glucose levels even more closely than I had before.

I am told to come back in two and a half weeks for another follow-up. I hope that things will be under control by then. My out of control diabetes has been with me way too long now. I really need this to work. If the Actos does not help, I’ve been told that the next course of treatment would be taking fast-acting insulin injections after every meal. These would be in addition to the Levemir that I am already taking now. By my count, that would mean taking up to a dozen injections each and every day. Not something to look forward to, for sure.

At the end of the day, my blood glucose readings are in the mid 200′s. I got quite a bit of exercise in today around the house and my diet has been o.k., other than a few sugar-free gingerbread cookies that my wife made for me. It isn’t really Christmas without them though.

January 4, 2010

It is a new year, but not much seems to have changed since my last post nearly two weeks ago. My blood glucose levels have continued to stay high, despite the increased dosage of Levemir and the addition of Actos. The best blood glucose reading I’ve had so far this year has been 187. The worst my blood sugar has risen to was 397. From a statistical view, it may be a slight improvement, but I need much, much more of an improvement before my diabetes is anywhere under control.

I managed to make it through Christmas and New Year’s without completely deviating from my strict diet, but I definitely had a couple of moment of falling off the wagon though. My particular weakness always seems to be ice cream and pizza. On the whole, I’d say that my diet has been pretty good though.

That being said, I was rather alarmed to discover this morning that I have put on a whopping 16 pounds of weight over the past 2-3 weeks. I have been eating sparsely, for the most part, and have tried to get a moderate amount of exercise each day. Unfortunately, I am very visibly losing muscle mass and adding fat to my midsection though. I had been losing weight, up until just a couple of weeks ago. Is it the Actos? The increasing dosage of slow-acting insulin I am taking each day? I will have to ask my Doctor. This is definitely not a positive development though.

Although I have been exercising regularly lately, the intensity at which I am exercising is quite low. I don’t have much energy these days. It doesn’t take very much to over-exert myself either, which quickly becomes a scary issue. I’ve had serious shortness of breath as well as some minor chest pains during these incidents. Slow and steady seems to be the best I can do at the moment.

I am noticing that my blood glucose levels seem considerably higher, the closer I get to the time where I need to take another injection of Levemir. I am taking the insulin injections twice each day at Noon and Midnight now. By the time that either of those rolls-around, my feet and legs have usually started to swell and I am feeling rather miserable.

My only hope is that the Actos just hasn’t kicked-in yet and that things will soon rapidly improve. It seems doubtful, but I still have to hope. Having Type I diabetes has been one of the worst experiences of my life. My outlook on life has taken a bit of a turn towards despair. I hope that something positive will happen… Soon.

January 5, 2010

It has been a week of disappointment so far, to say the very least. After working on cleaning my house for 3-4 hours, I figured that this would be an excellent time to test my blood glucose level. Not only had I been getting a lot of exercise for an extended period of time, but my last meal two hours earlier had been a protein shake with NO carbohydrates, other than about a cup of 2% lowfat milk that was mixed in. About four hours before I had eaten a small serving of leftover whole wheat pasta with tomato sauce and cheese. I had actually taken my insulin injection, Actos and other medications a bit late today, at around 2:30 p.m. So, you would think that by 9:45 p.m. that my blood glucose level would be doing pretty good. Right? Wrong. My blood glucose reading was 365.

I’ve ruled out dehydration as the culprit for my blood glucose level being so high today, since I have been drinking a sugar-free, low-sodium, zero calorie, zero carbohydrate rehydration drink through most of the day. About the only improvement I have seen is that I am having to urinate less frequently. Instead of every 30 minutes, I am down to once every couple of hours. Still, that’s small consolation when you figure how bad a beating my circulatory system, liver and pancreas are taking at the moment.

I can definitely see a difference when I do my regular blood sugar testing as of late. My blood seems much more watery when I take a sample using the lancet. A few weeks ago, I had a difficult time drawing enough blood to even get a sample. Now, I sometimes have a difficult time getting the blood flow to stop. I’m sure that’s because I am paying much greater attention to my fluid intake and am drinking water and other liquids throughout the day. Again, it’s a small consolation when you take into account the damage my high blood glucose levels are doing to my body though.

Diabetes is a bewildering disease, to be sure. There seems to be no consistency to my diabetes whatsoever. Things I do that should make things better often only lead to my condition getting worse. It’s becoming more and more difficult to constain myself to such a measly and taste deprived diet day after day, when it seems to do nothing to help.

January 6, 2010

I’m writing this fairly early in the day. About 3:00 a.m., to be exact. I will follow-up later in the day, if I remember to.

Why am I up writing so late? It seems that all of the exercise I got tonight actually ended-up paying-off, after all. After doing an extensive amount of house cleaning, 7 to 8 hours of it, my blood glucose finally seems to have responded. After finishing-up for the evening, I sat down and began to feel very shaky and light-headed. My hands were trembling as well. These are the same symptoms I get when I am hypoglycemic. I seriously doubted that this was the case, but I decided to pull out my blood glucose monitor and check anyway. Lo and behold, my symptoms were genuine. The monitor read 67! I was suffering from hypoglycemia, or low blood sugar.

I was barely steady enough to make it to the kitchen, where I opened up a cold can of pineapple chunks. It was the only fruit, or any food with sugar in it, I could even remember having around. After five minutes, I was still very shaky though. So, I asked my wife is she had anything with sugar in it. Fortunately, she had some chocolate left over from Christmas. Unlike the pineapple, the chocolate seemed to work within a few seconds. I was feeling completely back to normal within 2-3 minutes.

Having my blood sugar swing from 365 to 67 within 2-3 hours seems rather absurd, no matter how much exercise I had gotten. The chocolate not only cured my hypoglycemia, but it tasted so good that I had a slight feeling of euphoria after eating it. My brain must have been absolutely flooded with endorphins at that point. It had been so long since I had eaten any “real” chocolate that I had almost forgotten how amazing it tastes. Chocolate and pizza are my two favorite foods. I miss them both a lot. For once, chocolate was actually helping my body rather than hurting it. The pain of going through hypoglycemia was actually worth it in order to taste chocolate once again. I will not likely check my blood glucose readings until tomorrow. The chocolate also made me sleepy. I seriously doubt that I will have a problem getting to sleep tonight.

March 8, 2010

It has been quite some time since I last posted any updates here. Things have changed quite a bit in recent weeks. First, I started using, then discontinued, using the diabetes medication Actos. It seemed to cause my blood sugar levels to dip too low, for whatever reason.

Besides the Levemir, my Doctor also put me on a short-acting insulin, which I was having to take after each and every meal. This particular insulin product was called Novolog, which is made by the same company that produced Levemir. After trying this combination for several weeks, my blood glucose levels finally started going back down. I ended up having to back off on the injections after each meal, and am now down to using a fairly low dose of Levemir once a day. I am hoping to eventually be off of the insulin injections altogether. Only time will tell if that will end up happening.

I am hoping that the crazy, high blood glucose readings I had before was just something temporary. I am no longer getting readings in the 400-500′s. Keeping my blood glucose levels down to something reasonable does require my getting a significant amount of exercise each day though, and avoiding large meals and sweets. I can actually “get away” with eating sweets without it severely impacting my blood sugar levels if I only eat them after I have been exercising for a considerable period of time. I am nowhere near being in the shape I want to be physically, so most of my exercise is done off and on for extended periods, rather than doing any intense workouts. I still have occasional chest pains when I overdo things. It’s simply not possible to get out of the hole I have dug myself into overnight in regards to my previous lack of exercise though.

My biggest problem with exercise has been finding the free time for it. My work schedule has been extremely busy as of late, so I am just having to get exercise when and where I can. On days that I do not exercise, my blood glucose levels are still intolerably high. On days that I do exercise, my blood glucose levels seem to hover in the mid 100′s though. That’s a far cry from how high it used to be, especially considering how much I have cut back on insulin.

My next Doctor’s appointment is in approximately two weeks. I will post another entry as soon as I get my next A1C results.

More Soon… Stay Tuned!