the misadventures of peabody

starting from scratch~

2011-11-12T14:11:00.000-08:00

I had my monthly appointment with my CDE the other day. I told her I felt like a complete mess. Yes, I am a perfectionist about a disease that the word perfection has no ability to even sit in the same room with, but still. I'm trying to keep my a1C under control (it's creeping up) and after my seizure this summer, I need to be extra careful not to let low blood sugar sneak up on me so…well, scarily, again. But it's creeping up partly due to that paranoia and also all these breastfeeding hormones and well...life as a new mum.

I sometimes feel like I'm taking care of two babies, to be thoroughly honest.

It can be hard to eat normal meals when I feel so on the run lately. My boy (aka, Littlebird) is literally on the run now, since he started crawling. I'm just trying to keep him out of the potted norfolk pine we have in our living room. He sticks his chubby little hands in the soil and then proceeds to pull on Norf's branches until he rips off a sample to test. Yum.

So I've found myself tending towards the good old "3 Meals a Day" habit. Not a good one. For anyone, diabetes or not. 4-6 small meals really is the way to go as far as regulating blood sugar and only giving your body a bit to process at one time. But there I am, day after day for the last 3 months, eating 60 grams of carbohydrate in one sitting. Which to most people is not a lot, but that's really hard for your body to metabolize all at once.

At my appointment, we talked about 'starting from scratch'. I'm trying to take it easy on my body again, especially because a woman's body is never the same after having a baby. Especially a type 1 diabetic's, ah! The irony of the situation is that I really, truly need to eat more carbohydrate in order not to lose too much weight since my boy is exclusively breastfeeding still (here we are, nearly 9 months in; more on my take on all of that later) and I'm already my pre-pregnancy weight. Controlling my blood sugar before I had my son was a challenge but it didn't feel as impossible as it does sometimes now. Let's just call it what it is: Hormone Hell. I feel like as I attempt to maintain my weight (it's always been hard for me to keep weight on) and do so by eating more carbohydrate) I end up in this high/low to low/rebound high battle with my BG---as you can imagine: a vicious cycle ensues...

Oh, what a situation to be faced with! But I know this isn't really a situation...it's a condition of my life and I just need to learn to make it work for me as much as possible as hard as that might be. I know some type 1 mamas I've talked to have said it gets easier and I think that's because children get more independent as they get older---a good thing! But for now, I'm literally dealing with what feels like the same thing over and over and over again: Littlebird gets into the Norfolk Pine pot, Littlebird gets into the unable-to-be-moved office computer cords, Littlebird is having a major meltdown right when I'm having low blood sugar. Oy. And as you know, I can't let that go. No discussion.

So I end up dealing with a lot of "diabetes guilt" for so many other reasons than the common ones discussed in the DOC (diabetes online community). The kind of guilt that stems from the fact that I deal with a disease that has very little leeway in certain situations when my son is overwhelmed and needing me---feeling like there is very little leeway for that, haha! As I look down at him sitting on the floor, red-faced and screaming while I chug a juice box, his eyes demanding WHY ARE YOU IGNORING ME?! I find myself looking forward to the day I can explain it to him and he can actually, truly understand. But for now, we struggle in our communications at times; it's all a learning process I know. And yes, yes: I know he doesn't 'hold it against me', but well, it doesn't change my feelings of frustration and anger and guilt surrounding this godawful disease.

So I'll end this post with things I am thankful for because there is always a 'real' reason to look up:

-I am thankful he is so strong and healthy and happy---oh my gosh is my son HAPPY!

-I am thankful for my own health. I have access to everything I need and more and considering my frustration, I'm doing just fine. There's always room for improvement, but hey: that's just life.

-I am thankful for the amazing support system I have in my family and "friend-family". My partner, Matthew, has really done nothing short of amazing in learning my disease-process right along side me, and my close friends are like my family in that they've reached out and been compassionate and understanding without being pitying or condescending. They trust me to know myself, but know I trust them to be there for me in case I need them in a pinch with this beast of a burden!

All in all, it's a wonder, really, isn't it? All of us doing as well as we do, making positive little changes each and every day, whenever we can. Knowledge is power. And we do have a lot of power.

i miss granola~

2011-10-19T13:43:00.001-07:00

I used to eat freely. Before March 2008, that is.

Now, I know some of you reading this are saying, "Here we go again. She's complaining about how she wishes she could just eat."

Bear with me.

Am I technically venting? Well, yes. So please bear with me because maybe I'll make all you non-diabetics hungry and you can go out after reading this and buy yourself some of the snackies I so wish I could freely eat without complication. Things like granola.

Why granola?

Because it's damn tasty, that's why!

Granola is made of:

oats (carbs), fruit (carbs), nuts (protein-fat-carb), [often] honey (carbs). Then of you course you must have milk with it (carbs-protein).

As you can see, granola is a high-carb food. Off the top of my head I can tell you a 1/2 cup (that's right, 1/2 cup!) has 56 grams (!) of carbohydrate (and this can go higher depending on the type of granola) in and of itself. This does not include the tasty milk that mustmustmust go with it.

I am abnormally educated in nutrition. No joke. Every type 1 diabetic (I believe I mentioned this a loooong time ago in one of my posts how we are your [free] source of information on food) who is even slightly attempting good blood sugar control knows so much about food it's almost enough to make you lose your appetite. So really, just ask away.

Everything from what type a food is and why, how it metabolizes in your body when you eat it, and the best part: how it metabolizes in combination with other types of food.

I am simultaneously getting hungry and irritated as I write this, believe it or not. And this is mostly because I'm craving granola.

I would say though that the hardest foods to process are not just 'pure' carbohydrate---like granola. You get quite the spike in blood sugar from a purely high carb food just because it takes a lot of work for your pancreas to spill enough insulin in time to keep up with that amount of carb floating around. The problem therein lies in that combination issue I mentioned above. So do yourself a favor and take it easy on purely sugary foods. This is why it's so important for everyone (not just diabetics) to combine proteins with carbs; it helps slow the carbohydrate release down so that you you burn food more like the "normal" function part of this graph than the "diabetic" function image part. Oh, the struggle.

But as you can see, I'm also not saying what a lot of people like to say to diabetics Oh, you can't eat sugar!

They're trying to talk about straight sugar, like we all crave sitting around downing restaurant sugar packets or something. Um, no. As a side note though, I did see this guy at a coffee shop last week who pouuuuuured (I say pouuuuured because he did not just 'add' some, he pouuuuuured) white sugar and then pouuuuured honey into his coffee for nearly 5 seconds a pouuuuur. Kid you not. Just because his pancreas works doesn't mean it wasn't giving him the finger for that.

So the hardest foods to keep up with as far as diabetes goes (at least as far as I know) are those that are equally high in fat as they are carbs. And of course, they are often the most comforting and tastiest foods:

Icecream

Pizza

Mashed potatoes

Fries

Mousse

Yoghurt

Nutella. Oh, deardeardear Nutella---you are a post in yourself.

Why so difficult? Because when you eat a carby-fatty food (or a fatty-carby food, depending on your view, I guess, haha) the fat literally slows the carb's release and then later, as the carbohydrate finally begins to make its way through for metabolizing, your pancreas has to do one helluva job to keep up with all that carbohydrate suddenly entering your bloodstream. This is why type 1 diabetics have major issues when they take a huge dose of insulin for say, pizza. They crash an hour later (the fat in the cheese is holding the carb back so now you have all this insulin floating around and no glucose to attach to) you treat the awful low, but then 4 hours later (sometimes up to 7!) you have this HUMUNGOUS spike because now there's no more insulin to help the carbs now ready for processing. Nice. And so fun to deal with, right? Low, high, high, high, looooow. So thanks be to god for pump technology; that's what "combo bolusing" and "dual wave" bolus functions are for---they break up your insulin dose into a percentage over a period of time that you decide on so you don't get this boatload of insulin all at once. Kinda like the way everybody else's pancreas functions. Well, the way our pancreas is supposed to be functioning. Hooray! Let's all go eat pizza.

(Hmm, it has just occurred to me that I think I'm writing this post because it's basically a pep talk for me not to raid my snack cabinet of all its granola.)

But it's also a pep talk to all of you out there who are perhaps reading this. Well, obviously you're not 'perhaps' reading this if you're reading this. ;)

Our health is so worth it, though; all this annoying-but-oh-so-important figuring it out. And some foods that are advertised as healthy snacks can be sneaky---like granola. So I've learned to take it easy on my pancreas (Peabody). He did his best and now my insulin pump (Peabody Jr.) does his best, but let's not push it.

So I am now going to go have some granola. Strawberry Almond Hemp, my fave. A small bowl, not like the bowl in that picture up there. That's gotta be like 115 grams of carbohydrate, easy. And while it frustrates and embarrasses me to no end that whenever I want certain things like this I actually need to use a food scale which then makes me appear to be on a diet (I guess I am, kind of) it only helps me to learn how to eyeball foods better in public when I um, do not have my food scale with me. (Can you imagine?! Just call me Type 1 Mary Poppins; I'll be pulling lamps out of my bag before you know it!) Hey, it's better than counting out 23 pretzels, haha. But please note the food scale's not for restricting food so I can restrict my weight. It's the food scale's fault: it's actually restricting me from eating an entire bag of potato chips (the way I'd really like to sometimes!) Honestly, it's helped a lot in doing correct measurements for my carbs so my insulin dose is correct, too.

I've also found this reallyreallyreally great vanilla almond milk to go in my granola and to eat cookies with. It's only 2 grams of carb per cup and quite creamy and is absolutely awesome chilled. Oh, but it's yucky in coffee, though, just a warning. :)

seize the day, literally.

2011-09-01T21:45:00.000-07:00

In July, I had a seizure. Ya, seizure. Let me start off by first just saying yowza.

Now, maybe some of you have had one already. Or maybe you haven't. Maybe you're thinking ohmygoshyoumustbeareallybaddiabetic.

Well, what's a Really Bad Diabetic, anyway?!

Is it someone who doesn't 'do what their told'?

Someone who doesn't check their blood sugar?

Someone who refuses to take insulin if they need it?

And these are just the basics.

What about all of the complicating factors that go into being a person with diabetes---and a person who cares about their disease a lot, at that. I honestly believe that the people who engage and deal with this disease every day and keep it under relative control are those who see how complicating it is to their lives and those around them the most. You find yourself trying so hard to own it, control it, tell it how it's gonna be, that you end up being the person that sometimes feels like they can't take anymore. Of course, as with anything else you've given the finger to---whether from burn-out or just plain apathy--- if you've stopped caring, you're trying not to think about it. This works. For a time.

But I care. I really do. That's what bothers me about the seizure the most. It wasn't a result of my being reckless with insulin or checking my BG or any other diabetic-related matter.

Do I sound sensitive?

Well, I am about this situation, I've realized. Because I work so hard at keeping this disease balanced. Trying to control it, you know? Well, sometimes, diabetes just feels like it's got control over you no matter what you're doing so right.

Having said that first, now let me get into what happened:

I had just finished breakfast and nursing my son (I am a full-time breastfeeding mama to my superhealthy son right now) and our family was headed to the local farmer's market, like we do every Saturday during the growing season. I checked my BG in the car right before we got out and headed over to shop and stroll. I was in the mid-80s with about a unit on board. Not too shabby, so I drank a juice, planning on buying a delectable little snack (like we normally do) when we got there. As we were getting ready to walk over, I asked Matthew, my partner, if I should just wear our son (I'm big into babywearing). He said, "Na, I'll just carry him today". By the way, they both have the same outdoorsy hat and it's so.freaking.cute. I think he just wanted to show Littlebird off, haha.

Good thing.

Looking back now, as we did our initial shopping, I was starting to lose my mind. I was buying things without even thinking about why (3 tiny tomatoes? what the heck was I planning on doing with those exactly?) I usually have a good idea of what I want to buy to make for dinners that week and man, was I off. As we made our way around the bend (almost to the snacky-food area!) I saw an old friend and simply said, "heyhow'sitgoing?" and kept walking past her (she later told me it was as if I didn't recognize her). The last thing I remember is thinking I was tripping and going. "Oh, wow". Scary.

Of course I wasn't exactly present while I was having the seizure, but from what I was told, this is what happened: I started to fall in that "tripping" way like I said, but kind of on a woman (poor woman and my dead weight!) and she kindly attempted to break my fall. But I just fell. When I hit the ground, clearly seizing, not just passing out, people made some space for me. Serendipitously enough, an ER doctor was doing his shopping for the week too and just so happened to be passing by (I'm always amazed at how lucky I've been in life, yeesh!) so he stopped to assist. He said I only seized for about 2 minutes, which is a safe-from-damage number, neurologically speaking. When I came to, the crowd dispersed (good lord, how embarrassing) and because we were next to the stand selling pies, the man behind it starting shouting "hey, you wanna buy my pie?!" Um, no. We don't. want.pie.right.now. Sir.

It really was the perfect place for such an er, incident. The paramedics were already there and just helped me up and they decided to transport me because it was my first seizure ever. Even though they realized I had type 1. To be honest, it's all still blurry from after I woke up all the way to being put into an ER exam room. I'm not sure how well I would've been able to walk to the car, etc---had they decided not to transport. The rest of that day and the next two were all pretty foggy and dream-like, actually.

It took an hour or so for my BG to actually come up and stay up. They gave me good old Tang in the ER and even made me eat half a sandwich and my BG was still in the 70's! So it probably was the safest bet to not just 'sit up, relax, head home'. I was pretty bummed we had to cancel our brunch plans with awesome friends, though. :(

One of the hardest things about it all was the post-muscle-aches. My whole jaw was sore from clenching (every muscle in your body contracts during a seizure. Nice.) and I had a lot of back pain. Even my legs hurt; like I'd been running and out of shape or something. But it eased up in the next day or so. Phew. Thank god for epsom salt baths.

So I know you're wondering, How did this happen?!

Apparently, type 1 diabetic nursing moms are particularly at-risk for seizures. The risk combo of going low from nursing, constant change in how the body processes food, and of course all our fave: female hormone interactions can create what my CDE called so eloquently "a perfect storm of events". Boy, was she right. That day, I'd just eaten breakfast, nursed, used my brain at the farmer's market (which always causes me to burn glucose like crazy) and all the walking, too---yeesh, it's no wonder I just went ahead and passed out.

I just wish someone would've um, you know, WARNED ME.

Even a little bit. About the whole "type 1 diabetic nursing mothers are at high risk for seizures" thing. Ya, that particular warning would've been a real help, I think. I dunno, maybe that's just me. ;)

But, there are so many warnings given to those of us living with this disease. I think good CDEs find themselves not wanting to become that person. You know the one. The person always warning you about being a diabetic. How a 'good' diabetic is, was, and always shall be. Ya, that one. Riiiiight.

So I'm getting back on track. I have a whole new respect for low blood sugar I didn't think possible because I never let a low go (hey, that sounds kinda cool) and have tons of kiddie juice boxes all over the place. However, that blasted day, I only had one and didn't follow it up immediately like I usually do with some carb with protein type snack I keep in my handbag to keep from dropping again too quickly. Oy.

The following week I rode a bit high on my numbers because, frankly, I was terrified out of my mind of it happening again. Like when I'm driving with my little one in the car. :/

Then, my CDE and I started to slowly work our way back to a more normal glucose range safely. I'm still struggling with the lows, but that may now be due to my breastmilk changing. Ya, no one tells you that, either. Breastmilk changes in its nutrient content throughout that first year depending on the baby's needs: sometimes it's higher in fat, sometimes its water content is high for greater hydration purposes, etc.

But I want to make it very clear that I'm happy with my decision to do what is called in the U.S "extended breastfeeding" [insert cackle here because in other cultures it's just called, er, feeding your baby]. It's always been really important to me to provide the wonderful nutrients and immune-regulating properties in breastmilk to my child[ren] for as long as their bodies needed/wanted it (aka, baby-led weaning/solids) and so far, so good. Did you know the immune-regulating properties in breastmilk actually increase after baby's first year? Good enough incentive for me, being a person with an auto-immune disease trying to do the best I can to regulate my kiddo's immune system---um, thanks!

So here I am, doing my best, but sometimes, if this disease was a psycho ex-boyfriend (er, none of mine are psychos, just boring, mostly) I'd like to go after it all knuckle-busting-style and beat the royal crap out of it. But I can't. I just can't. As close as it is to me, every.single.flippin'.day---I can't beat the crap out of it. I can only work my arse off at a friendship that is, at best, 1 and 3/4 sided. And that's on a good day.

But...have I mentioned how so dang worth it all the craptasticness of it is, because my little guy is healthy and happy---and mostly, short of a couple of bruises from falling, so am I?

sometimes we just need a little reminder~

2011-06-02T20:12:00.000-07:00

He is so worth it.

There are days where I'm so overwhelmed dealing with not only the emotional roller coaster of having just had our first child (well, 3 1/2 months ago) but also literally the hormone-hell that is messing with my body in general being a type 1 diabetic.

And then, I need a place to put Littlebird while I do laundry and he looks up at me like... that. My heart melts and I know, no matter what, he makes it all worth it. He motivates me endlessly. He fills my heart up with so much love, it's overflowing.

MAC (his dad) and I really worked for our baby. We had to plan so much because of my Type 1 Diabetes that it started feeling like the romance was being taken out of babymaking! ;) But I'm so glad we did. Our little guy is not only a bundle of joy, he's super healthy and happy (as you can see.) We're both pretty sappy, I guess. Maybe all new parents are. We actually still get tears in our eyes, though, like all googoogaga, you know? ;)

What I'm trying to say is that while my body still adjusts constantly it seems while I'm breastfeeding, I often beat myself up for all the pendulum swinging I can do. Highs to lows, lows to rebound highs. I'm so grateful for having a good pregnancy CDE. She's been my lifesaver! Each week still, it seems I'm needing to get some slight adjustments to my basal rates as my body comes out of pregnancy fog. It's a wonder to even ponder what nondiabetic women's bodies are going through to readjust. No wonder everyone feels crazy for a while. I know I...still do! ;)

Food is (as always, when will it not be?) still a struggle. I'm trying to navigate that fine line between foods that won't make me spike and foods that will sustain me through nursing so that I don't go low. While I've got the nighttime basal rates down (20% reduction after nursing to prevent bottoming out) I'm still trying to figure out the window during the daytime to prevent delayed hypoglycemia but still provide enough of a baseline for daily life. Ugh, what a complicated mess it can be. But we're getting there. Oh wait, where is "there"? Right. We're constantly figuring the ever-changing "there" out.

The thing about type 1 diabetes is that it's one of the realest lessons in learning to go with the flow. It's one of the greatest lessons in learning to be compassionate with yourself. It's one of the worst things to deal with---counting every gram of carbohydrate that enters your body (let alone how it interacts with everything it's combined with) but it's also one of the best ways to learn about good health. Because health is not just a number on the scale. Health is wholeness: it's how you view yourself. Your mind, your body. Your food and where it comes from. How you savor it, if you savor it. Health is wholeness. It's about wholly enjoying life and all that it should truly be about. We talk a lot about learning to love ourselves in this culture, but how many people look like they're the walking manifestation of self-loathing? Why don't we stop to slow down and take it all in...I mean it all in: the good, the bad, the ugly. If we could do this for ourselves, we could certainly do it for others. But instead, we're hard on others and even harder on ourselves.

Maybe that's why when you get diagnosed with a chronic disease it's easy to start the self-loathing cycle.

Well, I promised myself to try to make the 'enemy' part of this disease (re: my immune system up and deciding to attack my poor little pancreas) my friend. I sometimes wish I could say things like, there are no compromises! I shall conquer and WIN! but unfortunately, this battle's not going to be 'won' like that. This battle (like most conflicts in life, if we'd all just wake up and realize this fact, globally) takes negotiation. It takes compromise. It takes discussion. And it takes a helluva lot of work.

It'd be a lot easier to just get up and run away screaming from our disease. But that's just it: it's too easy to burn out. Oh, we all have our burn-outs. But I'm talking about people who completely and utterly give up. They're done. So over it. Their eyes are going. Their kidneys are going. They're just like...Eff it. And when it's really frustrating...who can blame them?

But we've gotta keep going. You have to find that something that makes it worth it.

I know I have.

It's a damn wrecking ball~

2011-04-25T14:23:00.000-07:00

Frankly, this is how I feel regarding this bloody disease lately.

To continue on with the 'building' metaphors, I feel like I built such a strong foundation in my body last year as I prepared for pregnancy. And ya, the building went up, strong as granite, built to protect my sweet Littlebird. He grew and grew and I stayed healthy all throughout.

Then he was born.

I can barely begin to describe the havoc that post-pregnancy hormones wreak upon a type 1 diabetic woman's body.

Sigh. Guys have it so much easier.

Combining all of the pregnancy regulating hormones still processing out of the body, on top of the ones it needs to produce all this milk, let alone the mess type 1 creates in and of itself on a daily basis...I'm a wreck. I feel like a wreck.

Then I got my bloodwork back last week. I was honestly really freaked out about my thyroid panel results. I know that type 1 and autoimmune thyroid disease often go hand in hand (nice) and that women's thyroids often get wonky after pregnancy in general...so I feared the worst. But I kept talking to my body (I'm really into mind-body medicine) and kept saying to myself how I rejected getting another autoimmune disease (go ahead and laugh). Maybe it worked. Or maybe I was just lucky this time around, but my results came back fine.

And my A1c was 5.6%

Good? You readers might be jealous, but I'm honestly not sure how to take it. I know that number is due to a lot of post-breastfeeding lows that I'm still trying to work out. I've found that if I do a temp-basal of 80% for 2 hours after each feeding at night, it prevents the impending low. My CDE wanted me to just snack, but I was like, "um, all I'm thinking about is sleep, not eating at 2 a.m." So that's how I tinkered that temp basal right. But during the day I make sure I snack because otherwise I'll not be replacing the calories I lose through feeding him. I'm already starting to lose weight a bit too fast (I only have a few pounds to go until I'm my pre-pregnancy weight....not exactly a good thing considering I'm such a small gal, ugh!) So I'm trying to monitor this issue closely so I don't become like er, 1995 Kate Moss.

Then last week, I started having more post-partum bleeding. Not heavy, but it upset me because immediately my blood sugars started to go NUTSY. We're talking insulin resistance that caused my numbers to skyrocket. I even hit a 400. So I changed out my site and did a major pump and dump session of breastmilk. Talk about waste. And diabetes guilt. I was so mad. I was so tired. I felt so....disgusted.

Are you getting the picture? I'm up, down, up, down. Like one of those freakin' circus hammer bell games.

The most frustrating thing is that I'm generally a healthy eater. (Point: we went out to eat with a friend Friday night and I ordered Beet Loaf. You read that right: BEET LOAF. Why? Because I happen to like the damn stuff!) and I ended up with BGs in the near-300's. (Yes, it was a balanced meal. And yes, it had protein.)

Then, just as I was thinking about this stupid post and possibly freaking out more about this stupid freakin' disease...my blood sugars stabilized. Interesting that it happened right as that extra postpartum bleeding I'd started having stopped. That's why I hate hormones. Pregnancy was hard, but this....this is sometimes just pure insanity.

Why?

Because I'm caring for another little human being. And the irony of it is that I'm no good at caring for him if I don't take care of myself first. There's no healthy Littlebird if there's no healthy Mamabird to take care of him.

So I'm trying to refocus. To stay calm when things skyrocket or bottom out. To keep positive because I'm actually not doing that bad (read: it's not like every blood sugar's been 300). It just takes time. My superwonderful OB told me at my postpartum check up, "it's kind of a lie to tell women that they're fully postpartum and ready to 'move on' at the 6 week mark. Like it's this magic number where your body's just back to normal. It's more like 3-6 months!" So as my body recovers, I need to remember the process is not just from the physical act of giving birth, but all of the complex, chemical, internal processes that had to occur to make a baby, let alone feed one now. With my own body, (yeah that's amazing, right?!)

I'm just trying to stop judging myself so harshly. I've always been my worst critic. Not a good disease to have with perfectionism, I'll admit. :) The ways I've been easing things now are just by keeping my foods really, really simple (whole foods like yogurt, almonds, wild rice, cheese, dark greens, eggs, apples...and keeping a lot of snacks on board to prevent those breastfeeding lows and also so I can keep my meals small to prevent any spikes.) I've also promised myself a 30 minute walk each day during the week just to clear the babyfog. It's nice because I get to listen to my Ipod while the tinyman sleeps in his stroller. A good time for headspace.

As my CDE said, "we're getting there" and she's right. It's a journey, not a destination. I need to remember that. This is a day-to-day thing. I made it through one of the toughest scenarios with this wrecking ball of a disease (a pregnancy) and managed to build a damn palace out of it (my son) so I think I deserve a little credit after that week of pure hormone hell that I had last week. So my CDE's gonna be saying 'we're getting there' as long as I'm alive with this disease.

And I plan on being alive with it for my little birdy for a very, very long time.

guidance for planning a type 1 diabetic birth (just my 2 cents) ~

2011-04-11T15:17:00.000-07:00

I wanted to write this post because now that littlebird and I are settling in, I know there are still a lot of unanswered questions and/or thoughts regarding my pregnancy and birth. There were certain things (especially towards the end) that were very, very helpful that I think gals can take advantage of and try doing in an attempt to have as healthy and natural a labor and delivery as possible. Of course, as you can read from my birth story below, not everything always goes as planned (ie, I ended up getting an epidural and some pitocin assistance even though I went into active labor on my own). As far as getting my body into natural labor though....hmmm, well, you can leave that up to the "experts" if you like, but I truly believe that many of the things I was doing during my pregnancy and especially those couple of weeks before littlebird's delivery (weeks 37-39) assisted in essentially opening my body up for his arrival (ie, going into natural labor rather than being induced).

[Added later: I just thought of this, but feel it's really important and helpful. If you can, please buy Cheryl Alkon's book "Balancing Pregnancy with Preexisting Diabetes". No, she didn't pay me to say that. :) It's really just the most informative book out there on the subject and you won't regret her guidance.]

Things I think are essential to a healthy Type 1 diabetic pregnancy:

Plan it. Don't ignore the things you need to work on.

Yes, it's that easy. And that hard. Give yourself at least 6 months to do this. Whether you need to get your weight under control, your BG in better control, or your emotional state...just plan it. Go after it with fire and fight if you have to. If you want a healthy kid, the best thing you can do for them and yourself is go into it with your best state of physical and emotional health. If you don't do this and just "wing it" (like my CDE told me some gals do because they're just so frustrated and drained and just want a baby---can I hear a collective W.T.F?!) you will end up being extremely stressed out that first trimester. As if you won't be enough. Don't add fuel to the fire! Not only will you be nervous from knowing this is the window most common for 'regular' miscarriage---a fear every woman has---but also all the fears your diabetes brings up. Increasing diabetes-induced stress is a big no-no, in my humble opinion. Don't do that to yourself. It's not worth it. I was so nervous when I got pregnant but....I knew my body and mind were healthy and doing well. I knew my type 1 was in control when we got pregnant. I knew it wasn't an issue. I was better equipped to handle those common 1st trimester lows. I was also not sitting there royally freaking out during those early 1st trimester ultrasounds wondering if his brain, heart, and spine (those most affected by out of control blood sugar during conception) were ok. Deep down, I knew my kiddo was ok and if not, it was most likely not due to my type 1 and we'd just deal with all that from there.

Pick your OB and pregnancy CDE (and if you can, Perinatologist) before you conceive.

The OB is most important, I think, because they make the final calls on how and when you deliver...and will actually be delivering your baby. Trust me, you need to love them. Not just be "ok" with them. You need to really respect and be comfortable with your OB---and feel they give you the same. These are, most often, the 3 you will see---depending upon your state of health, you may have other specialists assigned to assist you. I just saw these 3 providers. Also, your CDE absolutely needs to know pregnancy and diabetes inside and out. If not, you're going to have a very hard time. While I loved my OB, he also didn't know the ins and outs of how to deal with my type 1. You will, with a good CDE, be talking to them weekly (or moreso) to make adjustments...especially when you hit that insulin-resistant phase during the 2nd trimester and literally might need changes every few days.

*A note on perinatologists: I met several before I got pregnant in my planning phase the year before littlebird was even conceived. Now, if any perinatologists are reading this, please don't be offended. :) Honestly, I felt that many of them took the same approach. They all wanted to automatically induce me at 38 weeks and due to their training, obviously, they are not really around "natural" birth a lot. They're dealing with high-risk pregnancies all day long, after all. So what I'm saying is that you need to keep this in mind if you end up with someone a bit *ahem* high-strung. It's their job to worry a lot and make recommendations based on the reason you've been referred to their clinic, ie, your disease process[es] present. If you're not into natural birth, most of their suggestions and input will be welcome. In my case, I felt mine went overboard a bit; however all in all it went very well. My point: I think choosing your OB (the person who would actually deliver your wee one) is more important than the Peri---the doc making recommendations from your ultrasound and fetal monitor results.

Decide if you want to manage your Type 1 DM via your pump (yourself) or via IV insulin drip.

My recommendation is that you use your pump (if you have one). I never met resistance with this idea at the hospital I ended up choosing. Strangely enough, at the local University hospital when I was interviewing OBs there, they preferred IV insulin. The problem with IV insulin during labor is that, as we already know, insulin's pretty difficult to measure. It's got quite a window of error with syringe measurements. We also know that IVs aren't that accurate as far as giving you a dose (that really needs to be as accurate as insulin needs to be). Think of how it is when you try to give yourself a quarter of a unit via insulin syringe. Difficult, right? So, my point is that if you can get on a pump or use your own pump, do it. You'll be able to make small corrections as needed or even disconnect completely if you're so sensitive at the time---giving birth is like running the marathon of your life. You'll be under a lot of stress though, too, so that's why it's important to be able to give yourself those minute corrections, if need be. Also, just think of how nice it is to not be hooked up to an IV the entire time you're in active labor at the hospital....ugh.

Hire a Doula.

This is a woman who assists and advocates for you during birth. I don't care if you're having the most medically intensive birth you can imagine. It's helpful to both you and your partner to have someone there to qualm fears, tell you you're doing great, offer guidance---other than your partner. They're going through their own "labor and birth" in a way. They need just as much support as you do! If you give your partner a job (MAC's was to check my BG every 30 minutes+ and to also love me up as much as possible [believe me, you need positive reinforcement when in active labor!]) they will be a TON more helpful to you than if they just stand there and have the opportunity to freak out more. They need a job; it makes them feel a helluva a lot better about watching you in a situation they've never seen you in.

Pack your own snacks and juice boxes.

Then, if you have a low, you know the exact carb count on the juice box and snacks and don't over-treat because you just eat or gulp from some random cup the nurses hand you! I don't recommend your favorite low BG treatment, whatever it is, i.e., Skittles. If your nauseous (which you will most likely be) I suggest apple juice: it's neutral in flavor mostly and non-acidic. Don't bring orange-juice---way too acidic and most women will vomit from it. Sorry to be so graphic, but that was some good advice from my own doula---because when the time came to need juice in labor, I was so damn grateful for that plain apple juice!

Drink Raspberry Leaf Tea all throughout your pregnancy.

This herb is one of *the* women's herbs. It's specific to the uterus and while it does not bring on labor, it certainly makes it more efficient as far as contractions go. It also tones the uterus (as it is smooth muscle) and is just soothing in general. It is also astringent, so will assist

postpartum with your bleeding.

If you want to try to go into natural labor, use Evening Primrose Oil capsules.

You will insert 3 of these up by your cervix every night before bed starting at week 37. They'll just dissolve over night as you sleep. They release prostaglandins (which is also in semen; hence why doctors tell you to have sex to 'induce' labor if you can tolerate it) which essentially "ripens" your cervix. EPO (and prostaglandins in general) soften the cervix, which is essential for dilation and effacement. Think of your cervix as being hard during the pregnancy (keeping the baby inside) and needing to soften in order to open to allow the baby to come through. Only makes sense, right? I did this and truly believe it helped me to go into natural labor during week 39. Maybe it won't work for everyone, but from what I've read and researched, it seems to help most women. In the least, it helps with the softening and so if you need to be induced, will help things along so you are not having an induction on a hard, completely unready cervix.

Don't freak out, you're doing great.

Seriously. I can't tell you how many times my OB and my pregnancy CDEs told me this. And you cannot hear it enough. Keeping your eye on the target (a healthy you, a healthy baby) is the goal. Just remember that. You sometimes think you're going through hell and back because of the unpredictability of the situation, but with the right healthcare support team you will succeed! No matter what happens (and you need to be flexible with whatever "birth plan" you have in your head or create on paper because pregnancy is like the 'last frontier'---you simply cannot plan and predict its outcome) remember to be flexible. Your body and baby will thank you. Before you know it, you'll have a wee one of your own to take care of---and as all type 1 moms can tell you: that's a whole other ball game to learn how to play. ;)

a strange sort of tale of thanks~

2011-03-07T12:07:00.000-08:00

I'm sitting here, a day after my 3 year type 1 "diaversary" as we call it in the DOC (diabetes on-line community), pondering my luck. Then it hit me that a lot of it's been my hard work, too. I need to give myself that credit. I often forget to.

When I got diagnosed on March 6th, 2008, I was terrified. I was angry. I felt cheated. I was such a healthy person. The thought actually flew through my mind (selfishly, I know) that a gal like me didn't *deserve* such a disease.

Yup, I said it. Deserved.

No one deserves disease. No one asks for it. And autoimmune diseases certainly have a funny way of entering our lives---unexpectedly. Automatically. Unfair, to say the least. Deserved; never. That's like telling someone with multiple sclerosis or lupus that they somehow brought their body's demise upon themselves. Type 1 diabetes is no different. No one asks for or deserves to have their blessed little pancreas to crap out on them. Ever.

So here I am. "Surviving and thriving" as my friend Mattie, another relatively new type 1 and new mama exclaimed to me yesterday when I posted about my *celebration* day.

We are all lucky to be alive. But more than that, we are blessed to not merely exist with this disease, but also do so well with it. We live in a time when we can not only eat well with it, be active with it---but also have children with it.

And 3 weeks ago, I did just that.

I gave birth to my beautiful little son, my first child, the apple of my eye, with no problems at all. He was unaffected by my type 1 so much so that in a hospital birth setting, they barely brought it up. They let me continue to manage my type 1 all throughout the birth and the biggest deal was checking his blood sugar when he was delivered just to make sure he didn't have neonatal hypoglycemia. But he didn't. He didn't even go near the range for it. He's a healthy, happy boy.

3 years ago I was not thinking about having my first child. I was so focused on graduate studies that I was the type of gal that was all about putting off having kids until, quite literally (I now realize) the last minute. Considering all that I plan on doing with my professional goals, I most certainly would've been about 40 by the time we started our family. Hmmm. Kinda risking not being able to have a family by doing that!

I'm going on and on about all this because...well, type 1 has brought me a lot of surprising and frustrating issues to deal with in my life. But strangely enough, it's also brought me a lot of good surprises. Amazing ones. Gifts, really. An opening up inside myself that I used to think was just one of those "learning to be flexible" things. It's so much more than that; this opening up that I'm talking about. My life has changed in so many ways: from the learning to let go of so many silly worries, to the ability to flip my life-plans around for a while in order to have both a family and the profession I've worked so hard towards, to the heart-wrenching realization that I've been truly lucky to have access to the things I need to take care of myself with this disease...all the way to this ultimate joy: the baby boy sleeping cosily on my chest in his little wrap as I write this.

Type 1, I'd give you back in a heartbeat. But you also brought out in me a new kind of courage. A courage I can't have without you being around. And so, strangely enough, I thank you for the darkness, but most of all...the light.

type 1 diabetic birth story~

2011-02-28T10:24:00.000-08:00

I had a Pharmacology professor in college who described, quite perfectly I think, the difference between pain and suffering:

Pain and suffering are two very different things. A person suffers from cancer, scleroderma, chronic hepatitis. It brings up concerns of pain only for pain's sake. A woman labors with great pain, but little suffering, for the birth of her child. There's an anticipation there; a joy making it worth the pain.

I thought I understood that. I mean, I wrapped my head around it rationally, academically, logically. But I had no idea what it meant until I labored and delivered this amazing little person (I've so lovingly nicknamed here as "littlebird") that I now have the privilege of calling our son, on February 20th.

It all started that week honestly (week 39) when I had one of my (many) 'routine' ultrasounds and fetal monitoring sessions scheduled at the perinatology clinic. Everything was going just fine with littlebird and as they did the growth scan it showed that he was in the 90th percentile for size; ie, nearly 10lbs. Wow. That seemed...off. Even the ultrasound tech felt it was overestimated and admitted that ultrasound can be off when measuring weight in fetuses. She also reminded me that his past growth scans showed him to be quite lanky, not large (both his parents are lanky, and MAC, his dad, is especially tall at 6'4"). She comforted me and said to just show the info to my OB and CDE and let them decide if it was of concern. So that was the plan.

The next day, the perinatologist (a type A, not-so-nice woman throughout my entire pregnancy, I'll admit) called me and said:

Your baby is too big. He's past the max for vaginal birth and so I'm recommending c-section for tomorrow.

Wow. Just freak me out and drag me to the hospital and strap me down while you're at it, lady. I didn't even know I had a "max".

So I called my OB, pretty much in tears and told him what she relayed. He had worked with me to go to 40 weeks as long as all was well with the little one. He had supported me throughout the entire pregnancy to give my body the best chance to go into natural labor. So he understood completely why that conversation upset me so much and got pretty mad. He felt she was putting the patient in the middle of something without having a doctor-to-doctor discussion first. Besides, ultimately, it was his call when I got induced (since he'd be doing it, not her). He read the report and felt the weight was a "vast overestimation" and most likely the baby was merely long, not large. My CDE felt the same, stating also that my diabetes was not to even be a consideration in the matter, since my last A1c had been 6.1% with stable numbers at that, no major pendulum swings skewing the picture.

So my OB told me to relax, we'll stick with the plan unless something called for a change, and to just wait until my scheduled date of induction (my due date, February 24th---pretty much an entire week).

So that's what I did. I went to my appointments at the perinatologist's office the rest of the week where she wouldn't even look me in the eye as I went in for my ultrasound (wow, really mature---this isn't personal!) and baby still looked good on the scans and the fetal monitor. By Thursday, they just told me they'd see me at my usual Monday appointment.

I drove home that day, feeling something different. Was it hope? Something deep inside me told me not to worry. I really knew it was going to be alright. And not just because everything eventually is alright because it well, has to be...even when it's not how we want it, life always gets to its point, you know? There was a warmth, a freshness in the February air, an honesty, an openness. The Sandia Mountains where I live looked lovingly down at me during that drive home. I listened to the music of Beirut, one of my favorite bands, the sounds of their Balkan horns comforting me. The woman I worked with at the refugee resettlement center happened to call me out of the blue and said that she had to call because she gets these "feelings" about certain things and knows how they'll pan out. She said she "just knew" it was all going to be ok. Something in my gut knew to trust her. If you knew her, you'd know why.

My close friend Kalena (we're both massage therapists) called me that night (Thursday) and said she was thinking of me on this nearly-full-moon and that she had some time and thought we should do a session working on all of the acupressure points for labor induction. We met at her office, lit with lovely candles and opera playing in the background. Littlebird moved about happily and I felt contractions throughout the session. I believe with all my heart that her massage jump-started the entire process.

My water broke at 1:30 in the morning on Friday, February 18th---exactly when the moon became full. I'd been told recently there would be a full moon on the 18th and that babies often liked to come on the full moon. I didn't want to put all of my eggs in one basket, but being scheduled for induction on the 24th (exactly my 40 week mark), I laid in the tub at night that week before, talking to littlebird as usual, calling him by his real name, gently weeping and asking him to come on the full moon if he could.

He heard me.

I woke up to wet pajamas, the scent of the ocean strong. I knew it was amniotic fluid slowly leaking from me. I checked my BG; it was 70-something. I had a small juice box. I could feel the excitement in my chest; my BG always drops when my brain in really on, coupled with excitement.

I didn't yet have any contractions, which is not surprising, considering this is my first pregnancy. Things don't move very quickly. I couldn't fall back asleep. Matthew, my partner, was so excited and nervous and half asleep; he started to put all of his things together like we were leaving right then. I told him to relax. So I paid some bills and we both tried to lay back down but kept softly chatting in bed.

I called my doula in the morning, an incredible friend, and told her I had an acupuncture appointment already scheduled for that morning to get things moving along, so we decided I should keep it. Diane, the DOM pulled up just as I was getting out of my car. I told her my water was breaking. She embraced me and said, "This is perfect! This session will really get him moving since your body's opening up as we speak." (Acupuncture works best to 'induce' labor if you are at least starting to dilate, efface, leaking amniotic fluid, or lightly contracting).

We did the session and all of the labor induction points felt deep and painful and different than anything I'd felt in the past doing acupuncture. I imagine those points were really open to being activated!

Later on, I still had no contractions and my BG remained stable all day. My doula came over in the afternoon and we all took a long walk with our dog who could tell something was up, and did lunges in the park. We took our last pictures of me pregnant. All I felt was the amniotic fluid leak.

I know to some people it seems odd (or even dangerous) to wait like I did. But I knew I wasn't in danger of what is called PROM (prolonged rupture of membranes) until past the 24 hour mark (because it increases the risk of infection in the baby), and that we'd certainly be going into the hospital before then. I merely wanted to wait and relax and try to let things get moving on their own at home. I truly believe that the more relaxed you are, the more relaxed your cervix will be and you can birth that baby in the hospital more efficiently (think Ina May Gaskin's 'sphincter law').

MAC told me he'd get me anything I wanted to eat for dinner. So we ordered chicken satay from the lovely little Thai place up the street. By 11pm, nothing was really happening and my doula said we should go into the hospital for the baby's safety at this point.

When we checked in, as expected, my OB was not on call. So we were given the option of birthing with a Nurse-Midwife or the on-staff OB. I chose the midwife, since I was wary of docs other than my OB (sorry) :)

They were very excited about my birth-plan because it stated what was *most* important to me and yet was flexible enough in case things didn't go as planned for a totally natural birth. I want to point out here that they all actually read it; kept checking in as the labor progressed about my input and my options available. You can see the birthplan I used here. I personally think some gals really overdo it on their birthplans. You can't truly "plan" birth. Especially with something like a first birth and type 1 diabetes (in the hospital at that). It seems to become a point of contention for some people. So I simply wrote on it any additional details I needed to add---such as all of my type 1 diabetes issues (using my pump and controlling my diabetes myself during the L&D with MAC's assistance, bringing my own food and treating any lows myself) and also added things like my desire to not be hooked up to anything but my pump, to birth in a position comfortable to me, and for the little one's vernix not to be washed off, no antibiotic eye ointment, no vitamin K shot, no circumcision. At the heart of the matter was me staying in control of my own type 1 DM and not jumping into a medically intensive birth too quickly, and littlebird being cared for with as little intervention as possible, unless necessary, of course.

The night was long. I started in on the contractions and while painful, I was managing them by laboring in the tub and moving around a lot. None of us slept. I couldn't eat at all. I was thankful I had such a high-protein, high-fiber meal for dinner, as it was all that sustained me for the next 24 hours. I was really nauseous and could only suck on ice chips to stay hydrated, despite bringing coconut water and juice and lots of delicious snacks. Haha, that's Murphy's Law for ya: if I didn't pack anything, I would've needed it!

By 8 a.m little was happening and the midwife I was assigned was about to end her shift. She came in and said, "Guess what? Your OB's on-staff today!" I nearly cried with joy! When he walked in he kinda laughed and said, "Well, I guess we can cancel that induction for next Thursday, huh?" He was going to be there all day and all night. I knew he'd be delivering my baby and that made such a difference in my anxiety about anything that might come up.

At this point, they just left us alone. At one point we realized that they weren't even following the "every hour you need to be on the fetal monitor" rule, since I was literally just in the room, laboring naturally. They just kept checking in and asking us how we were doing. So MAC, my doula, and I basically stayed in the room all day and labored *together*. They were amazing. They kept filling and draining the tub with warm water for my laboring. They kept getting ice chips. They kept cleaning up the floor when I had accidents (TMI, I know, but hey--- birthing a baby ain't pretty, folks.)

MAC kept checking my BG and helping me to make corrections. Strangely enough, I struggled not with lows, but keeping it below 140. I was anxious about it because I knew I wasn't eating, but I just couldn't. I was feeling so sensitive that at one point MAC put on chapstick and I exclaimed, "I smell peppermint! What's that peppermint smell?! I think I'm gonna barf!" :) We focused on hydration and just constant monitoring, which the staff was happy to accommodate since they all said they preferred the better control of pumps and made it clear they didn't want to touch mine! :)

Saturday "day" is where everything truly becomes a blur. I entered a different world. A different time span. Time flew by and yet felt eternal. I've never been in so much pain in my life but with so much excitement. The wind was howling like a wolf. The room felt hot, cold, hot, cold. I couldn't be naked enough, but couldn't put on enough clothes. You are a different person when you give birth. You are your internal self turned outward and back again.

I didn't want them checking and rechecking my cervix too often for fear of the increase in chance of infection since my water had broken. I let my OB check once and I was at 9 1/2cm.

Finally, around 5, my body began to collapse. MAC tells me my eyes started rolling into the back of my head. I hadn't slept since those couple of hours Thursday night, basically. The only position I was comfortable in for the contractions was squats and my knees were giving out even though I kept trying. My OB finally asked me if he could check me. I was still at 9 1/2cm. What a blow that was. He said there was a small lip of cervix still there so he tried to lift it over for me. That nearly made me jump off the bed and plaster myself to the ceiling. I screamed Oh my god, I can't! Please stop, Dr. Teicher!" MAC told me he said, "Well, that's good because I'm done. And wow, you're always so polite, I've been called much worse!" :)

He let me labor for about an hour or so longer but when he checked me again, I was still at 9 1/2cm. I started to feel upset. Dr. Teicher gently asked me to consider some help for my pain. He told me he thought I was getting wound up after so long and that was why I couldn't dilate further. I got teary eyed. He said I'd gone on so long and that it was incredible; everyone on the floor was amazed. I don't know if he was just saying that, but I knew he was right in a lot of ways. He seems like he can read your mind sometimes because the next thing he said was, This doesn't mean you've failed, Emily.

When the Nurse-Anesthetist was putting in the epidural, I was at my lowest point. I felt so defeated. All that work and no baby coming. They could see his head a little, but that was it, no more progress. Dr. Teicher told me he thought if I could just sleep for a couple of hours pain free, I would fully dilate, relax and could push him out. So I slept. We all did.

By 8 or 9pm, I was fully dilated and effaced. I started pushing, but my contractions were now not strong or efficient enough and littlebird's heart rate started to decelerate a bit (thanks, epidural, argh!) so my OB turned the Pitocin on to the lowest amount possible. This seemed to do the trick because they guided me in pushing (since I could no longer feel the contractions but thank heaven could still feel "pressure" and certain sensations, unlike some gals I've heard about going completely numb in every way on Epi's).

The room started to feel very dim; almost candle-lit. Quiet and sacred. I was determined to push him out. Caesarean was not on my list of lifetime things to do; especially with my first child, and I knew if all of this failed, I'd be in the OR in just a little while. With just a few contractions, I could feel littlebird coming down the birth canal. Dr. Teicher asked me if I wanted to touch his head as he crowned. I did, and it motivated me knowing he was literally right there. When he got a bit stuck, the OB had some nurses there to help pull him out, although they did need the vacuum on him, which bummed me out. Also, his arm apparently got a bit stuck at the moment he slid out (pretty common, I'm told) and so this caused me to tear quite badly (which, by the way, is healing nicely with Arnica Montana 6x homeopathic and epsom salt baths...) :)

But let me tell you---when I felt littlebird slide out of my body and the collective sigh of relief and excitement, I cried. It just came washing over me that he was out and we were both ok. The entire time, MAC had been checking my BG and it was staying stable in the 120's and 130's. When they checked littlebird's BG, it was about 60. Perfect. So they put him to my breast almost immediately after the birth and he latched beautifully to get some of that wonderful-antibody-nutrient-dense colostrum. Because neonatal hypoglycemia can occur as a delay, IDMs ("infants of diabetic mothers", nice acronym, eh?) are required to have their BG checked for a few hours---at least 3 times. He passed every time and was never even close to needing assistance. This was because my BG stayed stable and also because he latched quickly enough to get that good colostrum.

My OB said, "Are the bets still going on his weight?" People chimed in with their final estimations. The final number: 8lbs, 10 oz.

And he was long and lanky---21 1/2"!

A good size, a normal size; within range of vaginal delivery. And certainly not "almost 10lbs". Yeesh, thank god I always question things. ;)

After the delivery, the sensations in my body changed immediately. First, I went from nauseas to famished. So I ate a granola bar and didn't bolus, fearing the post-birth lows I'd been warned about. Wrong move. I skyrocketed to about 200. All those hormones competing with my insulin, I'd imagine. I got stressed-out towards the end too, knowing I was kind of under a time crunch headed toward c-section, so we all know what stress does to BG---usually increases it. That, and the Epidural and Pitocin change a lot of things I didn't *exactly* plan for as far as how my type 1 would react.

The next day I ended up struggling to keep my BG under control---even as I began to breastfeed. Again, I think it had to do with all those competing hormones, my not eating for over 24 hours, and stress (hello cortisol!) I just drank a ton of water (necessary to counteract the swelling from the epidural anyway) and ate good meals. Things started to decrease and balance out nicely, with no lows, surprisingly. I just kept checking religiously and correcting anything. It's hard to figure out how to change basal and bolus patterns, but I just increased or decreased settings one day at a time. Don't change too much at once or else you'll crash.

All in all, I got what was most important out of my first-birth experience, in a hospital at that, since t1dm makes me ineligible for homebirth (sad face). I always reminded myself throughout the pregnancy that "I worked this hard for a baby, not a birth". That's an important thing to stay focused on, because those of us who value natural birth so highly can easily get sucked into what I call the 'natural-birth-nazi' focus: where the only healthy mamas and babies are born via homebirth with no interventions, and that's just not true. You can use the best of both worlds--western and naturopathic principles because you might very well need them and still have a healthy pregnancy and birth outcome. For some of us, that's the only choice we've got anyway, so one of the best things you can do is find a healthcare team that supports that philosophy with you. So, the most important thing is that both littlebird and I are healthy and happy, and he had no major interventions, like needing to be in the NICU for low BG. He was also only given colostrum and is now breastfeeding beautifully full-time...growing big and strong!

I'll post next on some of the things that I feel made this birth work out well enough and why. For now, I hope my birth story was informative and somewhat helpful to any women out there reading this trying to plan a pregnancy with diabetes. It is possible. Just take it one day at a time---and literally one moment at a time if you need to. Don't let this disease control your personal goals. It isn't an easy one to manage, but it is manageable and you can accomplish anything you want to do with it if you keep it close to you, rather than pushing it away or ignoring it.

so i deserve the Bad Blogger of the Year award~

2011-02-03T21:34:00.001-08:00

I'm finally sitting here, on my couch (actually it's a very uncomfortable futon) to blog.

You read that right.

To blog.

Oh dear god, I feel so bad that it's been not only a couple of months since my last pregnancy post, but that I fell off the wagon just as things were getting interesting. :)

So onto the juicy stuff, right?

As you can see from this picture, I AM HUGE NOW.

And loving it!

(Not really, haha. I'm kind of like those dolls that roll around at the base; I can't remember what they're called?)

This pic is from 36 weeks. I am now at the end of week 37. Whew! Officially full-term!

We made it littlebird! As much as I want and plan for a natural birth, I know that if anything starts to go wrong, needing to get my baby out now, he would be fine. From the ultrasounds, he appears to be a little over 6lbs. There can be inaccuracies in these measurements, so we can't be too sure. However, we do know that littlebird's dad is 6'4", so he might come out on the 'larger' scale (ie, 7 or 8lbs, still completely in normal range) just because he might be quite loooooooong not so much BIG. haha. As my friend and doula said, "considering the lanky genes he's getting from both of you, it should come as no surprise!" (we're both kinda skinny people).

As a minor comfort to any readers who are bumming that I literally failed in my job as a Type 1 Diabetic Pregnancy Blogger, you can catch this little interview I did with Sysy Morales over at the amazingwonderfulstupendousincredible Girl's Guide to Diabetes. You have to scroll down a tiny bit due to the ads, etc, but it's there. And hopefully helpful. I think it covers, in a general way, what you go through when you're pregnant with type 1. I'd like to think this can reassure any women out there who really want to have a healthy pregnancy with this often mind-boggling disease that they can truly accomplish their dream.

As for my state-of-late, all is well. Really, it's kinda crazy. As you can read in that interview I hyperlinked above, it's the 2nd trimester that just blows you away. Everything you thought you knew about insulin resistance, stress, growth hormone, bolusing, and basals changes. Completely. But the important thing to remember is that you are not alone. If you are seeing a perinatologist, they should be in a center or can refer you to someone that offers diabetes education specifically for women who are pregnant. And as far as I know, most people see CDEs in these places who know their stuff well. I can't tell you how often I'm amazed at the suggestions and changes my "pregnancy " CDEs make. It makes a world of difference---life savers, really! Without them, this whole pregnancy would've been a mess (to me, at least). Things change quite fast in that 2nd trimester due to exponential growth of the fetus---a difficult feat to keep up with. By the 3rd trimester, there seem to be more patterns and plateauing in my bolus and basal rate changes needed; it seems more gradual.

But so far, littlebird and I have succeeded! And you can too, if you're reading this wondering what the heck to do. :)

Hmmm, not too much else to say right now except that little update. I'm headed into week 38 next week and will definitely have more to post about my hopes for my birth and what I'm doing to encourage him to come before 40 weeks. Remember, my superwonderful OB is willing to allow me to go to 40 weeks, but not past. Then I get induced. Ugh. But, he was the only doc I interviewed who was even willing to talk about this.

But, so far, so good. More on "why" later. :)

6 things i want you to know about [Type 1] Diabetes~

2010-11-09T08:30:00.000-08:00

Today is national D-Blog Day, in which all of us D-Bloggers (aka, Diabetes Bloggers) are invited by the wonderful Gina Capone over at DiabetesTalkFest to blog about the chosen topic for that year. She's been doing this for 6 years, and I feel honored and excited to be invited to share with you....

just how much diabetes sucks.

Well, and a few other important things....:)

In my case, we're talking about Type 1 Diabetes:

Ya, that's right. TYPE 1 Diabetes. For the love of God, get it straight.

I don't have Type 2 diabetes. I don't have Gestational diabetes. They are all separate, and if you have one, you can't have the other. I won't bore you with too much detail, but here's the gist:

-type 1 diabetes is an Autoimmune disease. Just like Multiple Sclerosis or Lupus, the immune system begins to attack a certain part of the body because...well, that's the million dollar question, isn't it? But the point is, it attacks the insulin-producing beta cells of the pancreas and voila! No.More.Insulin. Without insulin, you die. Doesn't matter if you're a dog, a pig, a horse, or a human....you'll kick the bucket. Why? Because insulin is literally the only "key" that opens all cells up to receive sugar---which is our fuel. Without sugar, we're like a car that runs out of gas. Without gas a car dies, right? Well, don't tell me about some special fuel (herb, drink, exercise, lifestyle modification) that my car can run on instead of...*ahem* You're getting the picture, right? If the door to my car is locked, your "special" car key won't open it. If it's the wrong fuel, the car won't start. Kaput. End of story: I don't make insulin and every person absolutely needs it to survive.

2. I didn't "do anything" to get Type 1 Diabetes.

I didn't eat too much sugar. I didn't go on a weird diet. I didn't hide an out-of-control eating disorder. I wasn't overweight. I could've been a triathlete (and know some people who are) and if my body began to have the Autoimmune reaction to my insulin-producing beta cells in my pancreas...even then, in such an "elite" state of health, I couldn't have stopped it. I was a stick-thin student who ate a healthy diet and biked everywhere when I got diagnosed. And guess what I was after? A stick thin student who ate a healthy diet and biked everywhere. I'm still me. No one asks for a disease. No one deserves a disease. So please stop trying to rationalize it and figure out what I "did wrong". Oh, something went wrong alright, but it wasn't anything I had a say in, trust me.

3. My Type 1 diabetes did not get "really bad", causing me to go on the insulin pump.

Insulin pumps are one of the most magnificent inventions. They mimic the body's output of insulin more closely to that of a non-diabetic's body. I won't get into all the boring details of what pumps do, but let's just say they are very complicated---and that's a good thing. Unlike daily injections of insulin, which are just sometimes [literally] a 'shot in the dark', insulin pumps allow people who don't produce any/enough insulin to set up the way it infuses the blessed little hormone into their bodies more closely to their personal needs. A child's needs are different from an adult's. A pregnant woman's needs are different from a non-pregnant woman's. An athlete's needs are different from a couch-potato's. But at the end of the day, if they all have type 1, they all need insulin. They just need it infused in different ways. This is the beauty of the insulin pump---it makes my quality of life more like yours. :)

4. If I'm eating a treat, don't tell me I can't.

Type 1 diabetes, as we discussed before is all about helping cells to open up to get that fuel (sugar) in. But what's sugar? Sugar is carbohydrate. Read: long chains of carbon [carbo] with hydrogens [hydrate] attached to each one. They're big molecules. The point I'm trying to make is that it wouldn't matter if I only ate salad for the rest of my life, there's still carbohydrate in lettuce. Think of other [higher] carbs you know well, though: bread (including whole grain), pasta (including whole grain), potatoes (not french fries), oatmeal, fruit, milk (lactose, still a sugar!), ...even those spelt-granola-whole-grain-blahblah-muffins you might love. I listed a lot of healthy ones because why? Because they're all still carbs. Since we can't process any carb (sugar) without insulin, it doesn't matter if we eat the healthiest of the healthy carb-options (which, as we all know, is certainly the best way to go!) we all still need insulin to break it down. So what I'm saying is, everyone should eat in moderation. Everyone should get their foods from the most whole, healthy source possible---especially carbs, considering all of the refined-carbs we're all faced with everyday: candy, cookies, fries, breads. So, if I eat a healthy, balanced diet and you see me enjoying a cookie...please don't say something stupid like, "oh, you can't eat that" or I will have to pour the tea I'm enjoying with my cookie over your head. Haha, just kidding. But really, don't be silly. You know better. You yourself knows you should eat a healthy diet and that everything in moderation is about as true of a statement as we can get when it comes to healthy living. Because we now know what's pretty much going on in the body of a Type 1 diabetic, we also now know that while they need carbohydrate to survive like everyone else, they need insulin to cover whichever one they eat. And yes, carbs should be healthy carbs. But at the end of the day, I still need insulin for any carb I eat, so go easy on me and know that it's ok for me to have some treats.

5. If it seems like I check my blood sugar a lot, it doesn't mean I'm "not ok".

Knowing what my blood sugar number is helps me to make decisions about my food, my activities, ...my state of being, so to speak. And, because my state-of-being is being a Type 1 diabetic 24 hours a day/7 days a week for the rest of my life (unless there's a cure, but no one's holding their breath) I need to know what the heck is going on! Let me put it in easy terms: studies show that those who check their blood sugar more often have better control of their diabetes. Because that person knows what the heck is going on with their disease at the moment. What does that mean? Less chances of emergency situations and also long-term complications; better chances of a healthy life, a long life. And that's what we all want, right? :)

6. Diabetes royally sucks, it makes my life complicated and difficult. But...

diabetes has also taught me a lot about myself, about chronic disease, about self-advocation, about health literacy, about empathy, about....EVERYTHING!

Would I give it back? In a heartbeat. But some of these lessons, these experiences...the situations in which I learned how to be stronger and more determined about dreams, goals, hopes, expectations for my life...I wouldn't have without this beast of a burden. So just remember, some days I can be incredibly frustrated and upset about this disease that so randomly chose to come into my life. But other days, I have these moments where I'm like,

You know, I [might've] not felt as much compassion had I not been diagnosed with Type 1.

We live and learn. We grow and change. And as my little profile section says up there, "inflexible people become self-righteous and boring", I believe so strongly in my heart that I can still do anything I put my mind to with this disease. Even though sometimes it seems like my body's been invaded by aliens....;)

let's get personal, dearest littlebird~

2010-10-24T20:45:00.000-07:00

hey little guy,

You'll never know how much we love you. I hope you will. You are so wanted, so planned, so hoped for, so dreamt of...right now you're the size of a mango according to BabyCenter.org. (strange, they always give size comparisons to fruit for the pregnancy progress reports, haha) so I'm not sure how much you can tell about me, your mama, yet. But I hope you can at least tell how much we talk about you, how much we hope for you, and...did I mention, love you?

You see, your little mama's adopted. I've never met another person that looks, sounds, walks, or talks like me. Having you, with the man I chose to be with the rest of my life and especially because I knew he'd be a great dad...well, let's just say I've dreamt of your face for a very long time. I can hardly wait for the next 4 months to pass, when I can hold you up to my own silly face and say, why hello there! my first blood relative!

When I got diagnosed with type 1 in 2008, strangely enough, the very first thought that went through my head as the doctor said it was, does this mean I won't be able to have kids? My mind literally started racing. I knew what type 1 was, but I didn't know anything about having a baby with it, (Steel Magnolias, anyone? Boy, do we need better depictions of people with this disease in film or what?!) There I was, in what was supposed to be my last year of college, taking my hardest load of pre-medicine classes, so many dreams of working as a Family Med doc for the impoverished---and being sick as a dog (no, sicker; more like dying like a dog) and I felt like everything was flashing before my eyes. I even started thinking about things I hadn't thought about in anything but an abstract way; things like kids.

How will I reach my goals?

What about kids?

What the hell am I supposed to do with having type 1 diabetes?!

It was the biggest, are you kidding? moment of my life. But no, they weren't kidding. I'll let you in on a secret: I held it together all day long in that hospital, cracking jokes like I always do when people are freaking out (which I could tell they were) and acting like it was all gonna be ok for MAC, your dad. Well, I was so relieved when everyone left and the docs finally put me in a room for the night, stopped poking and prodding me (even for an hour), relentlessly telling me my sugars were still running high (duh) and not letting me eat, even though I was [literally] starving.

When they put me in that room and shut the light off, I curled into the fetal position and cried my eyes out.

I waited all day for that moment.

My thoughts raced around everything I thought I was losing (no, not dessert). I feared that everything I'd worked for---school, living true to myself, traveling, trying to become a well-rounded person---was all for nothing. You see, I always wanted to be a mom. I wanted to be the best mom I could possibly be and thought, how will I do all of this at once? I was 28 when I got diagnosed, it wasn't like I had another ten years to ponder how to go about it all.

Within a few months, the wonderful docs I had began gently bringing up the issue of having children. Taking my age into account, they asked if we wanted them and how it would be better to have them sooner than later (aka, after all my beta cells stopped helping even the tiniest bit). At first, I was in so much shock, I didn't know how to respond.

Me? Have a kid? Soon?

But that's when it hit me.

We only live once.

This one doc said, "I know this is hard to hear right now, but really, grad school's always there. But the opportunity to have kids...for women, that's not an infinite opportunity."

He was right.

Sure, I could adopt. I love adoption. I'm all for adoption. Hell, I'm adopted.

But again, I'm adopted. I don't know what it's like to have a blood relative around. It was important to me to at least try to have a kid of my own before opting for adoption. Maybe that sounds weird to some people, but not to an adult female adoptee.

So we started the slow process of planning a pregnancy with a disease that is inherently toxic to pregnancy: imbalanced blood sugar.

I fought the pump for a long time. It freaked me out, the idea of being "plugged in". And then, I got so sick of daily injections, I reached a point where I was willing to give it a shot (er, no pun intended). I'm so thankful I did. I started the pump in October 2009, all with the hopes of getting some better balance...for a pregnancy.

I spent the early part of 2010 finding my OB, my perinatologist, my pregnancy CDEs; all while keeping my blood sugar in balance. It was so overwhelming! As soon as we got the green light, we hopped into bed! (TMI: haha!)

And here we are now. Months later, expecting you, healthy so far. I have no regrets, no sadness anymore. In fact, I can honestly say it's all for the best. I'm even more empathetic to those in need, those with chronic disease, people who really struggle with their health, than ever before. Sure, it took me a while to adjust to the idea of flipping my plans. But that's also something type 1 has taught me:

You can do everything. You can work around everything life hands you. You can flip your life's plans around and it's no big deal. You never have to stop--- dreaming, living, loving, learning. You can do it all and still make time to check your [often annoying] blood sugar. You can have your cake---and eat it, too!

That, my little man, is what I hope I give you the most: a sense of adventure and ease and that you should never, ever, ever let the fight go out of you.

week 21: things go wrong, things go right~

2010-10-21T15:06:00.000-07:00

I can be really hard on myself.

Let me repeat that for effect:

I can be really hard on myself.

Throughout this week, I started to see my numbers transition in that way everyone warned me about, but I feel like that's all I've been referring to in my posts:

wow! Things are changing so fast!

wow! Things are so hard to keep up with!

And then I talk with my pregnancy CDEs and realize....this is it. This is me, pregnant.

And you know what?

We're doing ok.

If you're reading this, planning a pregnancy with type 1 diabetes---freaking out like I was a year or so ago, trying to understand this beast of a disease and asking yourself, "Holy crap, this sounds really, really hard, how the heck am I gonna manage this?"

Don't freak out.

I was so worked up at times, so mistrusting of myself. So overwhelmed at what my doctors said, my friends said, the research said.

The bottom line is (and I want you to trust me on this):

You can do this.

What is hitting me is that the best way to make a healthy type 1 baby is to get that A1c in range. Before you get pregnant.

(There's a lot of arguing about what number's best. Some docs say below 6% [hello freakishly scary lows!], some say 6.5% and below...well, Kerri Morrone Sparling over at the incredible Six Until Me blog had an A1c of 7% when she conceived, and her little gal is nothing but perfect. It dropped significantly due to the nature of the first trimester, but still, you get my point).

I sometimes get so worried about Littlebird when I have spikes or lows, and forget what my OB and perinatologist did when I came in for my first visit:

Nothing.

No, really.

They were so relaxed. Just wanted to touch base. Shake hands. Congratulate me on the baby. And then congratulate me on my A1c and say,

Of all the things you could've done right, it was get your A1c in range before conception.

It's all about the average, they said. Sometimes I'm not sure I believe this. Sometimes I think I don't want to believe it. How is it possible that it all comes down to an average? (ie, what if you're running between 200 and 50, of course your averages are gonna come out skewed somewhere in the middle...) Honestly, mine weren't like that. I conceived with an A1c of 6% and it was relatively what the EAG Guidelines suggest: an average of about 126-130. But that doesn't mean I didn't have my share of spikes and lows. They just weren't like that all day, everyday, every number. And now, as I enter my 5th month, this doesn't mean I haven't had my shares of spikes and lows.

But somehow, the experts are right. Overall, Littlebird is floating around in a blood glucose average of around 6% still (we'll see if I'm right next week when I get it checked again) and the ultrasounds are all showing him as growing smack dab in the middle percentile: not too big, not too small. So far nothing weird is going on with the anatomy of his heart, his spine, his brain; all the things diabetes could have a negative impact on had it been out of control before conception.

Who knows who's right at the end of the day about what makes the most "perfect" conditions [insert slightly sarcastic laugh here] for a successful type 1 pregnancy...but we can all guess the basics, to be sure. But you know what? I'll take what I've got so far. ;)

Backblogging week 20: i'm getting high, er, you know what i mean~

2010-10-15T13:05:00.000-07:00

Wow, that picture looks no different from last week's . Sometimes I wonder about these angles....I swear, in real life it's like I'm getting huge! Well, just in one spot, haha.

So this week, hmmmm, a lot like last week, I struggled with getting high again. Haha, it sounds like a confession in tokin' up. Uh, no.

I saw the CDE again and we began having evening phone calls where we'd see if the highs were a fluke (ie, wow, that was high. Let's change your site first and then see if it's hormones or just highs.) Such a fun thing to wait out. Me, sitting there, picturing Littlebird floating around in a bowl of sugar. Homemade, straight from me to you, buddy!

No, really.

We've been correcting and making enough changes that my averages are still stable. But it can really freak a gal out, no matter what your doctor and CDE tell you, i.e.:

Complications [can] arise after the A1C is over 6.5. Even then, this isn't in stone.

Great! What is in stone then?!

The CDE also told me that in the 7 years she's been leading the program at this perinatology center, she has not seen one case of diabetes-related birth complications in someone's baby. Phew. That was really, really, really good to hear. Actually, it totally made my day.

Another strange issue I dealt with this gloriously fun week of 20, was that my insertion sites can literally just fall off. No joke. People mentioned it happening, but I was like, How does your site just "fall off"? It's inserted! However, something's going on with your skin or something because the adhesive literally just...fails, and then poof! your site is out. Just like that. My CDE said it's very common for your sites to only last 2 days. Great. We all know how much fun site changes are. Hey, but I'll take it over multiple daily injections. Those suuuuuucked.

All in all, Littlebird and I are doing well. I finally felt him---it's still very slight. Just like little hello taps. But it's the most amazing thing; it really is. Also, while I stopped wearing the CGM because it made me bonkers (I was catching all my highs and lows long before the device would-- all that beeping made it my enemy); I may give it another try as the 2nd trimester progresses. So far though, checking my BG 12-15 times a day has been just fine to catch anything...the big thing is getting a hold of those post-meal numbers---are they high, are they low? and just taking care of it. I'm also trying to stay as active as possible and find some exercises specific to active labor (my approach) like extended squats and back exercises. Wow, it's so exciting how we really are working towards this one day---only to find that the party's only just begun! Oh my, how I can't wait to meet him!

Backblogging week 19: stability? eh, not so much!

2010-10-12T19:35:00.000-07:00

During the first part of week 19 I struggled so much to keep my numbers in control. With me being the perfectionist that I am (not a perfectionist-friendly disease. Let me take that further: this is the absolute worst disease for a perfectionist to get) I tend to get into this self-blaming cycle where I continue to ask myself "what I'm doing wrong" (even when every damn thing was right). But I have the most wonderful CDEs over at the Center for Prenatal Development. The one is like, "I've been doing this a long time, Emily. You need to remind yourself that this is just pregnancy and diabetes. Fun, huh?"

That's one way to put it!

What's happening is that every few days my stable numbers then start to go bonkers again. Higher or lower, I start to really struggle with any food (salad, you're supposed to be my friend) any situation (walking around a festival: supposed to help, right? Nope) and even scenarios I gave no mind to before (being on the phone for a work meeting for a really long time made me crash just as much as if I was uh, there.)

Every 5 days now my numbers clearly need assistance. And it's all so slight sometimes. But I'm officially in the hardest part of a type 1 pregnancy: the 2nd trimester. This little guy's growing in size. Size means more insulin. More insulin means resistance. More resistance means ohhhhhhhmyyyyyyygooooooood to me. As active as I am, as healthy as I eat, I still need so many adjustments merely due to the hormones---which are all helping Littlebird to grow like he needs to. Gee, imagine if I had a working pancreas. Thanks, Peabody.

So by the end of the week, the perfectionist in me was having another bonkers situation and uploaded my CareLink data to my CDE to look at. She just made the slightest change in my insulin sensitivity and wow, it really helped. To think I'll possibly need adjustments to my pump every 2 days toward the end of this trimester just blows my mind.

The human body's fine balance of fragile and resilient function is nothing to be scoffed at. Imagining what a nondiabetic woman's body is capable of doing completely involuntarily truly amazes me right now---even as I attempt to mimic it as best as I can. Phew. But what also amazes me is how resilient these babies are. I mean, let's be honest. He's not in the "best" of conditions in there. Oh, I know, I know---my A1c going in was prime, my averages are still stable...but technically, he's dealing with a lot; a lot more than he should have to. But he's alright! (I'll tell him this when he's having a hard time in life: You can do it! You made it through that big test way back in 2010, remember? What? You don't? :) And this fact---that so far he is able to withstand a less-than-perfect environment---when even in the best of circumstances women have miscarriages for reasons only Mother Nature will ever know---just humbles and amazes me.

Sometimes I get so frustrated I feel like I'm holding on by a thread. But then I think of our little boy and how hard we're working for him and I just...well, can't wait to introduce myself.

Backblogging week 18: a really bad photo and oh my, am i domestic or what?!

2010-10-11T17:16:00.000-07:00

Wow, behind on blogging again.

Surprise, surprise.

I'll keep this post short, since uh, I'm two weeks behind and there's really only one thing to tell you of amazing significance:

We're having a boy!

Yes, yes, by now many people already know the exciting news because I'm better at using facebook than I am at writing my own damn blog. But that's besides the point. The point is that he's doing really, really well (spot on average, not too big, not too small---hey, let's just say that size does matter with babies who have type 1 mamas!) and the anatomical ultrasound showed nothing significant...except, of course his little "boy parts" (as the perinatologist kept saying...I'm like, you're a freaking perinatologist. You should be comfortable with the terms vagina and penis by now, right?!) Haha, but seriously, it was amazing, and as usual, this little mama got tears in her eyes looking at her little one. My son.

Backblogging week 17: walking and randomness and taking it all in~

2010-09-21T14:11:00.001-07:00

Time is flyin' and this little one is growin' like crazy!!

According to the website I follow, Littlebird's the size of a bell pepper this week. So fun!

This week was pretty busy. Great, but busy. I'm still doing massage therapy, maintaining my work with refugees, and also helping military members access mental health services through the Civilian Medical Resources Network (please support these two wonderful organizations if you're of the mindset!)

I have this wonderful friend who lives south of here and came up on the train to spend the day in the Q with me. She is such an amazing and incredible human being. What was really great, too, was how well my blood sugar cooperated with me that day. We just spent the day walking all over the place, taking the bus all around to do our day of shopping and movies and the like. I'm always amazed at how merely walking everywhere does my BG good. I'm a pretty active gal, but if i could just walk all day, I'd never spike over 120, haha. Of course, life is happening though and we can't get everything we need done by walking all over town.

**As a sidenote, I'm sitting in my favorite cafe in town blogging, and just saw the most beautiful pregnant woman walk in. Wow, she looks so great for like, 8 months!**

After the basal changes of last week, they're still holding pretty well. Any spikes I have are coming down fast with correction. This is hard for me still, though. I blame myself for every little thing that "goes wrong", forgetting that this is the nature of the disease: to keep my body in a state of constant, difficult flux, unless I just do my best at calculations and corrections. Which is all we can do, right? It's not easy, but I look at my averages and realize that we're more than hanging in there.

I still have yet to feel Littlebird. Kinda bums me out. I know I'm only in the 18th week as I sit here and write this, but I can hardly wait. I imagine it to be like a wave, coming over me....Hey mama! I'm here! Just waving from in here to say hi!

Yes, I'm strange. But this last week it's all I can think about, as I get closer and closer to feeling the baby. As my belly expands, it still seems alien...like maybe I'm just getting chubby, haha! So I'm looking forward to my first butterfly kisses inside my tummy from my little one. :)

Tomorrow, I have my 3rd ultrasound. I'll try to post week 18 IN week 18 (haha) instead of doing all this "backblogging". I've read some posts online that say some women find out the sex before the 20 week mark. Wow! Tomorrow I could find out what we're having!!

There's something about calling this little one by name that means a lot to me. But I'll be happy with whoever we get. I love kids, boys and girls a like. 'Cos remember, they all grow up into men and women, and I can think of all the wonderful things I'd like to do and share and talk about and learn about with my adult child, too! :)

Hopefully Littlebird'll cooperate tomorrow and we can do just that. :)

Backblogging week 16: keeping it real, keeping it safe~

2010-09-18T14:43:00.000-07:00

Whew! People aren't kidding when they say how fast pregnancy starts to go at some point. I'm kinda starting to freak out, to be honest. I feel like I have so much to do and am barely starting the "to do" list, haha. I thought I'd use this picture we took in our backyard, since the belly shots get a little weird sometimes. I think of taking 24 more of those shots and wonder if my readers'll think I'm merely a delusional decapitated diabetic. :)

This last week of 16/17 was pretty rough. The placenta is finally starting to truly release its hormones specific to er, insulin resistance (CAN WE SAY FUN, PEOPLE?!) making my control suddenly very difficult. My post-meal numbers suddenly began to skyrocket---even when I got so frustrated one night I merely ate an avocado and tomato salad for dinner...only to end up with a BG of 265. HOLY CRAP, BATMAN.

But as soon as I saw that it was a pattern and not just some fly-by-night bolusing mistake, I thought "Hmmm, Peabody, I think we're in for a basal change." I downloaded my pump data (Medtronic uses "CareLink"; it's not too bad!) and my CDE wrote me back that very day telling me, sure enough, to up my basals. She gave me the numbers and we changed them to an increase of about 10%. Phew. Things are a lot better now; I had some yummy fish tacos last night for dinner and my BG never went above 101. That's more like it.

As most first time type 1 mamas, I'm a royal mess right now. Every little shift, every little change, every BG that surprises me (high or low) causes me to rub my belly, apologize profusely (which, anyone who knows me, knows I do too much of already) and literally get tears in my eyes. Ok, the hormones don't help, but diabetes really throws an added wrench into things. As my CDE said, "we can't compensate preemptively for hormonal fluctuations, so we're forced to wait it out and see what happens, always staying on top of things to make changes as soon as we see a shift." And boy, do we stay on top of it. Like every 3 days, I'm downloading data for her to look at. Yeesh! I'm just glad we even know as much as we do now, as often as we type 1's get frustrated with the state of having the disease in this medical era. Think of the Diabetes Dark Ages, when the disease even freaked doctors out so much, they just said, You can't have children. And the women that tried to...well, it wasn't a pretty 9 months. Some even died trying. We are so lucky to be out of those days. Our babies are really no different now. I'm so grateful for that team over at the Center for Prenatal Development; amazing women there.

When I saw my superwonderful OB this week, he told me to keep focused on the Big Picture. He was like, "your A1c's are excellent [6% or less], your meter averages state the same, you're testing like crazy...your baby couldn't ask for more!" I really needed to hear that this week.

It's a helluva disease to try to be pregnant with, but I'll take the end result over playing it safe and not even trying. :) When I think of how the reward is a baby---a baby!---I just grin like the biggest dork, get teary eyed (how many times am I gonna admit to this in this particular post?!), and think about the next step, like: what exercise do I need today? What is the healthiest thing I can make for dinner? ... and of course, holy crap I still have so much to do! :)

Backblogging week 15: my wicked little CGM~

2010-09-10T13:43:00.000-07:00

Uh-oh, I'm falling behind again on my blogging duties. I promised to be a good blogger during my type 1 pregnancy and ta-da! Here I am, back to my old ways. :)

Wow, from that picture, you could say that I'm really finally starting to show. This is so beyond exciting, being my first kiddo and all, so I could probably blog on and on about all of the ridiculousness that makes up my mushy excitement.

But I won't. :)

My middle of the night lows were still a HUGE problemo for me up until the end of the week when my CDE turned down my night basals even more and I myself realized that I could actually have a half a peanut butter sandwich before bed and not wake up any higher than 80. Not too shabby. We'll see how long it lasts, though. You know how these things change so fast!

Also, I told you how I wasn't getting any sleep because of my CGM's set thresholds screaming their lights out at me all night long: Ohhhhhh, we're dipping, Ohhhhhhh we're low. Ohhhhhhhhh, we're moving up!

Yes, I can hear you buddy. All.night.long.

But then I'd wake up and look at the graph and it pretty much looked like this:

----------------------

(With a tiny bit of variability, here and there.)

So, I hate to admit this, but I'm taking a break from the darn thing. I'll put it on next week. Maybe I can wear it every other week? We'll see how long I last considering that I may actually be missing certain highs now. I do check my blood sugar like a blood-sucking fiend (12+ times a day) so I can't imagine that I'm missing that much. Wonderful Cheryl Alkon, who wrote the fabulous book "Balancing Pregnancy with Preexisting Diabetes" told me she's going nuts with her CGM, too. (She used me as a blurb on the back of her book! Can you believe it?! I'm a blurb! On the back of a book! :) And Elizabeth Edelman over at Diabetes Daily (who had the most amazing natural birth experience with Type 1---Cheryl interviewed her for her book) told me that she got so crazy with her CGM she just took breaks and eventually took the darn thing off in the 3rd trimester. Yeesh! But the key is of course, to just test like a madwoman. Well, a madwomanmama--desperate to keep her wee one healthy. :)

week 14: pregnancy is complicating my diabetes~

2010-09-01T15:53:00.000-07:00

That pun was most definitely intended.

Before I got pregnant, I felt so on top of this disease. Challenging as it was, the pregnancy factor was in the plans, but it sometimes felt far off. Like it was a separate issue. And yet, everything I was doing---all the extra testing and doctor's appointments and research---it was all with the goal of making a healthy baby. My type 1 wasn't a piece of cake, but I certainly felt more intuitive about it on so many levels.

Then Littlebird showed up.

Everything about my disease feels flipped now. I'm still doing well, but sometimes with the freaky lows and rebound highs, I get so worked up about my diabetes I forget I'm actually upset because I'm pregnant with diabetes. I know, weird. How do you sorta forget you're pregnant? When everything about the baby depends upon a 24/7 disease, that's when you strangely forget.

And then you go, "oh my gosh! How's baby?!"

When I saw my superwonderful OB and my superawesome diabetes educator last week, I expressed my frustrations with how nonintuitive making adjustments had been lately. Before, I'd confidently adjust my basals and meal boluses for weird numbers, but with all of the lows, I'd become terrified of the meal bolus. Exercising had become something to be afraid of. We've turned back everything to the point that I'm down to about 9 basal units a day. I go to bed with a good number, and still wake up (literally) all night long with my CGM alarms going off, screaming at me that I'm going low. Even though I went to bed feeling snuggly at a comfy 130. I can't drink enough juice to keep my night numbers up. Lately, I've been pretty tired when I wake up due to treating all those night lows. Oy.

But my providers tell me I'm doing fine, my bloodwork's fine, baby's fine. You're finefinefine. But every time I go low, baby goes low. That makes me sad. And angry. And just plain freaked out. I think of how awful I feel when I go low and I just pat my Littlebird bump and say I'm so sorry, mama's doing her best. Then I sit down and start doubting myself: Am I doing my best? Am I just overwhelmed? Why was I able to "get it" so well before and now feel like I'm "messing up" a lot?

I know they're right. I'm correcting as fast as things go wrong. This is the nature of the disease. I'm not going to have perfect numbers 24/7. I have to remind myself that every day, women with type 1 have perfectly healthy babies. Times have changed. Now we can do this, with the help of a lot of wonderful biomedical technology. But it doesn't mean it's ever going to be easy. Just easier.

Sorry if this post sounds a little down. Really, I'm blessed things have worked out so well so far. But it doesn't change the fact that I'm a mama trying to keep her body healthy so baby's healthy. And it's so worth it! All I can say is that I'm so very grateful for having such a great team of specialists who deal with this everyday. They really do see things clearly, while I'm sitting there wondering what the heck just happened to my well-understood diabetes. They say there's nothing to worry about. They say this is just pregnancy and type 1 diabetes! (Er...fun?) They say women are always surprised and overwhelmed at how fast things change, how often adjustments need to be made. I'll second that!

But I'm also freaking out with joy. Each week, my belly gets a little bit bigger. Each week, MAC and I just giggle at the idea of finally being the parents we've dreamt of being for so long. It's a fine line between accepting the situation for what it is and being willing to keep working on it. Because it's so worth it, I'm more than willing to walk the tightrope.

Backblogging week 13: new CGM and why people should think before they speak~

2010-08-25T08:21:00.000-07:00

Or at least they could start by asking questions. :)

So we made it to our 13th week, Littlebird. Actually, I'm in my 14th week as I type this, so we're really, really starting to move along now, aren't we?! Soooooo excited to meet you!!!! Truly, you are the best gift in my life (besides MAC, your dad.) :)

So anyway, back to what I was er, complaining about. So I'm finally starting to tell people, and gals weren't kidding when they said that people absolutely love to give unsolicited advice. I don't even know if I'd call it advice. Sometimes it just feels like commentary. Everything from diabetes-related (no, you actually don't know what the hell you're talking about, random person) to breastfeeding and diapering. I have thought about all of this for a very long time, thank you very much. I know where to get my questions answered and certainly have no intention of listening to snobby know-it-alls. You'd think people might give a gal at least a little bit of credit. We planned this baby so carefully, took care of my type 1 so carefully, had so many conversations with each other and mentors and those we love...it's not like we have no clue what's going on here, people! Yeesh! Sorry, I just had to get this off my chest. Better now than later, eh? Of course, it's never going to stop. People even do this when your kids are grown! ;)

On the diabetes front, I got my CGM! (You can see it poking a bit into the pic there.) Whew! It's really interesting. It is a lot to deal with, I won't lie. Yet one.more.thing plugged into me. But I'm so very grateful I'm on the Revel now and the CGM transmitter just sends the data to the pump and another menu opens to use the CGMing aspect. I just hate the site. It's really gawky and feels large...but I'm getting used to it. The tegaderm is pretty itchy. But I'll talk about what happened when I didn't wear the tegaderm in my next post. :)

The whole trending aspect takes a little getting used to. Part of it is I've been on it only a few days and am still titrating my numbers to more closely match my fingersticks, but also just learning not to jump the gun and mess with it too much. I know people who freak out about their diabetes way too much...it literally creates a vicious cycle of freaking out about your numbers, only to make them worse, then you freak out some more and surprise! they only get worse. So, like the CGM trainer said, you don't want to just keep staring at the screen all the time. Sometimes we just need to calm the hell down with this disease, do our best and go take a walk. I refuse to let this disease ever own me.

Case in point: we went to the in-laws for my mother-in-law's birthday this past weekend. I always get a little nervous at parties. Because, let's be honest: parties center around food. Good food. Carby food. Untimed, munchy, grazy food. Now, I must say my in-laws are just fabulous about my diabetes. They always let me know what we're eating, when we're eating and if they added a little sugar to a recipe I would've otherwise assumed had none (read: 3-bean salad). My sister-in-law is so cute too, and even makes whole-grain pasta instead of white when she makes this awesome pasta salad with things like black olives, artichokes, sauteed mushrooms and some wonderful dressing she concocts. Yum.

So I was in charge of making the cake (I know, I know: ironic and hysterical). I made a vanilla layer cake with strawberries and whipped cream...kinda looked like this (only I sweeten my baking with agave nectar). Nevermind my dog ate half of each layer cake the morning of the party, forcing me to bake two more [insert wildly hysterical laughter here]. The point is, it all worked out and everyone liked everyone's food. The bigger point is that my blood sugars are always excellent when I just let myself have fun in food-heavy social situations. Instead of stressing about the food, I just do my best...often finding that it's enough. I honestly don't know what it is, but it works like a charm every time. Good times, good sugars. Who knows why, but I think it has to do with something called relaxing and having a good time. ;)

I really want this pregnancy to work out. I want this baby to be so happy and healthy, not under the influence of uncontrolled diabetes and emotional stress surrounding it for the next 6 months. So it's been great so far to see all of my diabetes-related work...work out, and my trying to just let things go whenever I'm worried...about this disease or not. Ya, sometimes I'm still bummed about the how-the-heck-did-I-get-type-1 question, but most of the time, I'm really amazed at how interesting and different my life has become, what I've learned, what makes me laugh, what gets me excited now. And right now, let me tell you, this baby is pretty darn exciting.

Backblogging week 12: the lows got the last word~

2010-08-20T06:42:00.000-07:00

August 13th, 2010

(Look at that baby pooch!) !!!!!!!

This week, whew! I spoke too soon back there in a previous post about "what is everyone talking about with the lows?!"
Oh.my.god.
To eat everything under the sun and still wake up with blood sugars of 50 at 2am and then again at 7 am...yeesh!! What the heck?! Kinda scaweeeey.
My CDE has to keep turning my night basals down. Oh, and she turned my afternoon basals down, too. She also increased my insulin to carb ratio and insulin sensitivity factor. To think all of this is gonna change to accommodate for greater resistance in a few months is mind-boggling to me. Because frankly right now, I'm amazed at the amount of food I can ingest without insulin. Sometimes it literally freaks me out. It's like, ohmygoshijustgotcureishouldremainperpetuallyinthefirsttrimesterinordertokeepdoingthis.
Uh, not.
:)
So on the appointment front this week:
I had my 2nd ultrasound (yes, I know, it's nuts I have to do them so early.) But I did get to check out small fry from the 4-D approach this time. Wow, so weird to see his/her little face! Because I love to laugh, I started laughing of course (with tears in my eyes) and the tech was like, "um, well now. Can't get a really good picture here with all that jiggling around..." But it was so darn exciting! They did the nuchal measurement, which is an indicator for Down's syndrome. So far, baby looks ok. They also looked to see if all of Littlebird's limbs were intact (so far, so good, oh and uh, no wings) and the heartbeat (nice and strong at 160).
On the lab front:
My last A1c came back at 5.8% (I promise that's not me bragging, imagine chasing all those lows!) and all of my other blood tests like Total Protein and 24 hour protein came back fine. I also opted to do the first phase of contingency screening; which is solely blood-based genetic screening for Down's and another chromosomal defect. You can go on for amniotic fluid testing if the blood tests come back iffy, but this increases your risk for miscarriage and is only done (well, it's not required) if you're really high risk (ie, over 40) and worried. I get my results next week. Hopefully, being only 29-going-on-30, my risk is low. But *phew* always a little scary. So far, things have been turning out ok.
As you can see, my wee belly is starting to truly have a tiny bulge. I can't tell you how excited I am to finally *see* this. For me, a skinny gal all my life, gaining a belly---albeit one that makes me temporarily look like I drank too much beer (I kid, I kid)---is pretty darn exciting.
Next week:
I get my CGM (because I'm using the Medtronic Revel now instead of the Ping) next week. Thank god. Because if I'm chasing lows right now, I can't imagine the heinous stress of chasing highs in a couple of months. Wow, I'd be a total.nervous.wreck. Actually, without a CGM at this point, let's make that a capitalized Total Nervous Wreck.
I'll also begin to go through my clothes to decide which ones can fit over this strangely shaped bulge: too small for maternity wear, too big for what I own. Oy! A very interesting situation indeed, and one I am determined not be solved by running gear---as tempting as that is right now, haha. :)

Backblogging week 11: new pumps and yucky bugs~

2010-08-19T08:00:00.001-07:00

August 7th, 2010

Well, well, well. Week 11 was certainly exciting. No, I'm not being sarcastic---what ever made you think I'm like that?! :)

I'm finally getting a real baby pooch. Kinda kangaroo like. It's funny how you expand from the base, up. When you think of pregnancy, you think of how gosh darn big those bellies get and forget they don't just happen! It's been fascinating to me, being a science nerd and all, to watch this process happening in my normally wee body. Wow! I'm pregnant!!!

Ok, enough of that blubby-blub, sorry. :)

As I said very early on, my pregnancy CDE and Perinatologist wanted me to switch to the Medtronic Revel system for comfort's sake (combined CGM and pump, but still two sites...so don't get too excited. It's not an artificial pancreas.) So while there's two sites, it's certainly more comfortable than I would've been had I had to wear both pump and CGM devices. (Hi, my name is Emily! I'm just your regular robotic pregnant diabetic!)

Having said that, I had my pump training on my new Revel. I need to post a pic of my new pump. I got the purple one. I must say, it's pretty hip.

The pump training was pretty easy for me considering I was already on a pump (the Animas Ping). They all do the same things (thank god) and so the verbage and screen scrolling is just a little different. I.e, "insulin on board" on the Ping is "active insulin" on the Medtronic. As I get to know things about this pump, there are definitely pros and cons. I'll do a post on that after this. However, they're both excellent pumps and I don't think you can go too wrong with either one. I may like this one a tiny bit more, though. Except for the fact that it's not water proof like the Ping, which bothers me a lot for some reason. Maybe because a pump is like an extra appendage when you have type 1, and if it can't get wet it's kinda like being told you can't stick your foot in the water. Then again, wearing a pump might make my bathing suit fall down. :)

Towards the end of the week I contracted some very strange 48 hour bug. OH MY GOD. It was so awful. I am not a sickly person. The last time I got sick was when I got diagnosed with type 1 in 2008. So when I got this awful headache Tuesday that blew up into a combined headache with tummy cramps and well, you know, I was not a happy bird. I'm just glad I wasn't vomiting. So I was forced to just lay still. Everytime I tried to move around the house I was met with more stomach cramping. YUCK. So I just ate chicken noodle soup and drank raspberry leaf tea. This helped a lot and I was able to kick whatever yucky bug made its way into my body by Sunday.

*Raspberry Leaf is so wonderful!!

Here's why:

It's an herb that is useful in treating diarrhea as it is very astringent. It tones the digestive tract, essentially cleaning it up. It is also the premiere pregnancy herb, tonifying and strengthening the uterus for the course of the pregnancy, labor and birth.

*You just buy the loose-leaf tea preferably from an ethically-wildcrafted herbalist like Mountain Rose Herbs and put about 2 Tbs into boiling hot water, steeping for a few minutes. I like using a tea-straw to drink my loose-leaf teas, but you can also use a tea-ball. You can drink this wonderfully-easy-tasting tea all throughout the day when you have a bout of diarrhea or stomach problems, and at least twice a day when you're pregnant.

Well, we've made it through week 11, Littlebird. I hope you're doing ok in there. We have our 2nd ultrasound next week. Let's hope we get good news about your heartbeat and growth.

Backblogging week 10: chocolate pudding and the lows~

2010-08-18T07:35:00.001-07:00

July 29th, 2010

As you can see, still not much of a bulgy bulge. Just an Emily-did-you-gain-a-few-pounds?-look. In fact, because week 9's photo is more close-up, I'm wondering now if this photo's more accurate in that it shows...absolutely nothing. Ha! But this bird still finds that little bulge quite exciting. :)

The lows have been really, really (did I mention really?) fun this week. Wow, amazing. Gals weren't kidding when they said it sometimes seems like you've got a bit of mini-D-cure going on in the first trimester just because of all the damn lows.

But they're not fun. oh no, they are not.

At times this week it was like I could eat things I could never eat (pasta! bagels! potato chips [all organic mind you :)] and I still could barely keep my blood sugar up. Constantly chasing. Because I've only had type 1 for a couple of years, I think my hypoglycemic awareness is still good and I really, really (wow, really is really my go-to word for this particular post, eh?) try to catch lows around 70 to keep myself sensitive. However...[voice trails off] that has not been so easy lately. Gosh, one day this week it was like, ew, I feel a little bit odd and BAM! 34 on my meter. Just like that. No warning. No reason. And I don't know about you, but when I'm that low, I just feel sick. Drinking juice is not refreshing, but actually gross. But a girl's gotta do what a girl's gotta do.

Then, I had the joy of doing a 24-hour urine test. This checks for protein spilling into your urine (protein in your urine is a sign that your kidneys are not functioning properly). Well, trying to pick a day where you're going to be at home more than out was hard enough, but just the whole, oh wait, the jug! it's in the fridge! next to the...orange juice! experience was beyond laughable. That night, I of course had to pee twice. Thank god I remembered to put the little pee-catcher-thingy on the seat. Then you have to take it into the lab right away the next day, where you feel like they're inspecting it for drugs or something as they take it from you. Let's just say the whole process is a bit degrading. Hi! I'm uh, here to drop off my...pee.

The only comfort this week was in making chocolate pudding. Super tasty. Didn't save me from the lows, but homemade chocolate pudding certainly saves the day. Hell, it saved my week. With a dollop of homemade whipped cream, it was the well, cream on top.

Backblogging week 9: the waves of nausea are so fun!

2010-08-17T07:31:00.000-07:00

23 July 2010:

This week I finally met my new friend named Nausea.

Before, I was fine.

Then, I was just queasy.

Now, pure nausea. pure.

The worst part (haha, I know, laugh) is that sometimes I wish I'd just get it over with and barf.

But no, oh no. Not me. I get the joys of that awful feeling in your stomach all.day.long. FUN!

So MAC and I thought we'd use the "polarize it" app on the iPhone for our weekly pics. I haven't taken any before this because well, as you can see, there's [still] not much to see. I kinda just look bloated, if you ask me. ;)

But do you see that teeny-tiny pooch sticking out right above my pantline? Ya, that wasn't there before. I've been the same weight since forever...give or take a couple pounds. So let me tell you: this is so darn exciting to see a little pooch of ANY kind on me!

This week according to babycenter.org we have organs kicking into full gear and an almost-complete heart (good job, baby!) I'm also ecstatic to read about tiny eyeballs and earlobes being near-completion. Because as everyone knows, I like to talk. So of course I can't wait to talk to my little one!

As for diabetes. The lows are getting a bit crazy. And yet, I'm struggling to keep my numbers in control after breakfast. The CDE said that it's the pregnancy hormones causing the more difficult-to-control highs after breakfast. I'm now eating hard boiled eggs and corn for breakfast (don't ask: next up, the post on cravings!) :) This combination seems to be working for me right now, though: animal protein seems key along with a more whole-food based carb. Even spelt toast with peanut butter (my go to for the longest time after my diagnosis in 2008) no longer works. That's ok, the idea of peanut butter right now makes me wanna puke. So let's please stop talking about it. ;)

Exciting news though! My CDE and perinatologist really wanted me to be able to use the CGM. Because I'm on the Animas Ping pump, I would've had to get either the Dexcom (which was not covered, but is partnered with Animas) and is a completely separate device worn, or the Medtronic pump's CGM. Wearing a pump, a CGM and its monitor, and then the two sites would've been really fun you can imagine:

Random person I am sure to meet: Hey, look over there! It's a pregnant robot!

Me: Back off, bub! Anything for a healthy baby!

But really, it would not have been a fun experience to be 8 months pregnant wearing all of those....electronics.

However, Medtronic's latest pump is an integrated system called the Revel: yes, you still have to wear the CGM sensor and your regular insertion site, but the sensor on the CGM sends the BG data to the pump!! So I only have to wear one device! I just got approved to switch to the Medtronic Revel system and will go on the pump (I got the purple one! It's so cute! Yes, I'm weirdly excited about the color of my pump technology!) the first week of August. I'll start integrating the CGM in a couple of weeks after that. Kind of annoying since I'll already be in my 2nd trimester, but hey, better late than never. And honestly, as the numbers become harder to control in the highs department, I think I'll be more worried about catching that. My hypoglycemic awareness is still quite good (only having type 1 for about 2 years). It's still freaky though! I check my blood sugar about 12 times a day just to stay on top of everything, high or low.

So far, so good! My last a1C was 5.8% (mostly due to lows, let's be honest) while my others were more steady at 6% when I was planning the pregnancy and when we finally got pregnant.

I can't wait to post these posts! I wish I could, but I'm still so nervous about being in the 1st trimester and all its vulnerability. *Yikes* I just keep focusing on the positive and my deep gratitude just for the entire experience so far...oh my god, I'm a mama!

"Backblogging" week 8: the truth is...!

2010-08-16T08:10:00.000-07:00

July 15th, 2010

Well, I'm 8 weeks pregnant.

I can't tell you how utterly excited and crazed with joy I am!

But, in classic fear of getting too sentimental and attached, I'm not announcing the pregnancy until I know it's safely after the first trimester.

I've wanted to write draft posts since I found out (at about 5 weeks) but to be honest, it all felt so strange and unreal still. It was like, noooooooo this isn't really finally happening! After all that planning and working and planning and working for the past year with Endocrinologists, meeting with OBs, talking with Maternal-Fetal Specialists and Diabetes Educators---we now have a baby on the way. And I hope it stays that way. ;)

It's all exciting, but funny sometimes too, because I haven't felt that wonderful. Oh, it's not like I've been vomiting all day long. Just the generalized queasiness. Ugh. It's awful. It's like that nauseated feeling you have after getting over the flu: you want to eat, but are kinda afraid...you feel just a bit too sensitive still to be sure. Oy. Sometimes it's made better by eating, and other times I just want to run and hide from the looming refrigerator begging me to make dinner for MAC (my honey) and I.

I also found this fun website that tracks your pregnancy (after you've entered your dates to get the due date). It sends you an email each week to read about how baby's growing. So fun! I'd like to start taking belly shots because that'll be just way.too.fun. :)

I haven't been struggling with too many lows, as most women have told me I would...gosh, everyone had me so worked up about getting a CGM for fear of dying. Well, but I can't say it's been easy. My BG's only stable if I eat just so but I haven't had hypoglycemic unawareness. You have to remember though, I've only had type 1 since 2008. I am hoping to get a CGM though. We did a 5 day "silent" reading (I didn't wear the actual device, only the sensor) through my hospital last week (in order to get a long term one approved) and guess what? the stupid sensor failed. 5 hours into it. Ya, I was pretty flippin' mad. I wore that darn thing for 5 days and it wasn't even working 5 hours into it. nice. So we're doing a second trial this week. I'll post about the results.

One frustrating but interesting tidbit is that I was switched to Humalog from Novolog right when I found out I was pregnant because a couple of studies showed it to be ever so slightly safer for pregnant women, as far as fetal development goes. Unfortunately, it threw my sugars so way off I had to switch back. Thank goodness I've met plenty of type 1's who used Novolog with perfectly healthy baby results, or I would've been having a cow (well, no, I'm not having a cow in 9 months!) about what to do. Maybe I spoke too soon about not having lows. I struggled so much to keep my BG in check that terrible week I was on Hellish Humalog, maybe now the "regular" pattern many women report of lows in the first trimester will begin to happen. Let's try and not jinx me here. :)

No specific cravings, although I am completely and utterly grossed out at the idea of a cup of coffee right now, which I used to covet every morning. I literally start gagging at the thought. Oh, and there was one evening MAC watched me work through an entire jar of pickles. So I guess I lied. ;) I was reading in Aviva Romm's fabulous book "The Natural Pregnancy Book" that the craving for vinegary foods "encourages our bodies to release calcium into the bloodstream" (a good thing for a growing baby who needs strong bones!) She tells us that usually when you "improve [your] intake of protein and calcium, no more cravings [for vinegary foods] happen." So interesting!

So this is where I'm at. So far so good. I'm saving these until-after-the-1st-trimester-posts as drafts because of the risk of miscarriage. But I'm feeling blessed and healthy so let's hope this baby---we'll call him/her Littlebird--- can stick around for an extended visit. ;)

the intimacy of food, part 2~

2010-08-11T12:07:00.000-07:00

Wow, I seem to have a pasta theme going on lately with this whole "sometimes I just wish I could eat" topic.

The reason this blog post is broken into two is because the first time around I was just thinking about the most essential ingredient to type 1 frustration: the desire to just eat. Like normal again. To just, you know, get on with it.

But the second part involves something so much more external. It's hard enough having a somewhat, shall we say, strained relationship with food. But what can be even harder is when other people get involved.

Oh, you type 1's all know what I'm talking about:

the good old Diabetes Police.

When I'm in a situation with what we folks from Pittsburgh call "nebby" (aka, "nosy") people, I sometimes feel strangely obligated to eat something overly healthy. Or, to not join in on the shared lava cake for dessert. Now, with understanding people and close friends, I don't feel that way. But every once in a while, when I'm at a party, some loud mouth's gotta say, "Emily, get your hand out of the cookie jar." No joke.

But what can be more difficult is when you have to go to the Endo or the CDE---as nice as mine are, they're only human---and sometimes when they're looking through my logs and spy a day I had a real problem meal, comments like, "My god, what did you eat?!" can come flying.

Ouch. There has got to be a different way to say that, Doc.

What makes this hard is that in the first place, I have to talk about my food. Talk about feeling like you have an "eating disorder." That we have to even do this; show "food logs". So.Darn.Weird. But don't get me wrong, I willingly hand over my logs and am anxious to learn and perfect this sometimes extremely unkind disease. So all in all, things work out. But every once in a while, when I'm hit with the comment, "What happened here?!" there is a rush of guilt.

No, anger.

No, embarrassment.

No, shame. That's it. Like I have the ability to control every outcome of this disease. Like I should be able to predict and determine every meal's perfect 100 ending. Sometimes, diabetes really is like being in the flippin' Olympics. You try ice-skating while serving drinks to the judges and audience, then land a triple axle on one foot.

The bottom line is that again, the intimate relationship we should be able to have with our food as human beings---as snackers, munchers, decadent chefs, sense-blowing souffle indulgers, is not so easy with diabetes. It can be so hard to eat certain meals when you're thinking, "if this goes wrong, my CDE might say, what on earth did you eat?!"

A lot of this might still be due to the fact that I've only had type 1 for a little over 2 years. I'm still learning about certain foods....even the healthy ones, like beans. Beans can be tricky for me (all that fiber combined also as a carb and a protein). However, I wouldn't trade the discussions I have with my CDE and my Endo. I learn so much from pouring over my logs together. And, as my very first Endo said (and I still really believe this is what defines a good Endo; one that is gentle and does not judge):

You own this disease and understand it in a way I never will.

My job's just to help you see the forest from the trees.

the intimacy of food, part 1~

2010-08-02T18:35:00.000-07:00

Sometimes I just wanna eat.

I don't want to think about it. I don't want to count carbs. I don't want to worry about if I should or shouldn't be eating a certain thing.

Sometimes I look around and I see all of these gross people mindlessly stuffing themselves full of french fries and pasta and cake and triple mochaccinos with an extra shot of "carb" and I just wanna be them.

Of course, I'd be sick to my stomach at the end of a day of eating like that, but still. You get my point.

Heck, it's even just the wanting to eat some soup and salad for lunch and hoping the bolus goes ok (too much? too little? too EVERYTHING?)

Now, I know that doctors and diabetes educators tell us we can *technically* eat whatever we want (especially someone like me, who tends to be underweight) but we all know that's not a healthy way to live. And honestly, I like eating healthy. But sometimes I just want some damn french fries. And why do I not eat french fries, you ask?

1) They are a carb count I will never figure out. What is 15 grams of french fry? Do you count them, one by one? Do you just grab a handful?

2) They require a combo bolus (dual wave, to medtronic users) that I simply can't get right. I already have a hard time with this type of bolus, but I really don't wanna mess my cards up doing it on flippin' french fries. Let's just say hours of painful work ensue.

3) I actually don't like french fries that much (honestly). But man, when I want some....

*Please insert the word "pasta" into the above numerical discussion. Now you see why there are just certain foods that make me wanna cry. Especially because I technically *can* grab a handful of french fries in an attempt to measure them, but with pasta? C'mon on. That's just not a dining experience you'd want to share with anybody.

What I'm talking about here is intimacy. With food. My food. But it becomes more than just "my food". Sometimes it feels like it really isn't my food. I look around at a picnic or a restaurant or a dinner party sometimes and it seems like everybody's got their own food but me. Like me and food need to go outside and have a little chat; make an agreement: now you be nice this time. I told you about how what you did last time was so.not.cool

There is so much that goes into eating a meal when you're a type 1 diabetic that you simply cannot plan for...the pre-meal number. The type of food. What you're doing after you eat. The random person who comes up to you to say hi right as you are calculating a bolus, causing you to forget you wanted to do a combo bolus instead of a straight shot. Oops. Life happens.

It takes away the ability to savor your food sometimes. Don't get me wrong, I also think type 1 diabetics are some of the most savor-your-food type people on the planet. But there's always a twinge of anxiety as you check that post-meal number, hoping the calculations and planning and timing and...conversations all.went.right.

So sometimes I just wish I really owned it. Food, I mean. Like we had this intimate relationship. An understanding...the way it should be when your immune system isn't busy attacking your pancreas (what the heck are you doing down there! Get back to your real job, ya lazy...SYSTEM!) Then, you just eat. Mindlessly sometimes. But in my [mostly] healthy world of living and eating, mindlessly simply means I'm focusing on the conversation with my honey. Or my friend. Or my book. Or whatever got stuck in my tooth.

Airheads (but uh, not the candy)

2010-07-17T21:32:00.000-07:00

first off, let me start with a disclaimer:

I am the world's most patient person.

No, really. That is not me being arrogant or bragging.

It's true. To the point of being a fault.

I don't make fun of people, I'm extremely patient (emphasis on extreme [this should explain its faultiness]), and I smile kindly at the most annoying and rude of people. Unless they're being rude to someone who can't help themselves...like the refugees I work with. Then I become like a lioness and will tear you to shreds. That, or like the time I saw some very mean children kicking a pigeon around that somehow had become disoriented and forgot it could, um, fly away. Either way, it was cruel and I rushed up and had some choice philosophical words for those kiddos. Then, I was not kind or patient. Just...honest. :)

*Phew*! What a tangent!

AnyHOO, I wanted to start with that lovely disclaimer because I don't want you to be put off by the title of this post (or the on-coming post, herein) and think me some kind of judgmental, intellectual snob. We all have our moments (as described in my above pigeon story) where we just can't take it. You know what I'm talking about. Ok, so I think I just lied, then. I am certainly not the world's most patient person if I have my moments where I just can't take it anymore. ;)

So tonight, being part of imperialist-consumer America, I wanted to go to the Body Shop in the mall (when do I ever go to damn mall?!) to look at their sale and buy some yummies for the upcoming mother in-law's birthday. She and I have this thing about really great creams and body butters now....so we're always on the look out for each other, haha. (Yes, I actually get along swimmingly swell with my in-laws....)

While we're at the mall, I just had to look in some of the shoe shops, because I do love shoes. When we went in, this girl, ohhhhhhh, this shop girl. Total antithesis of Steve Martin's brilliant character in his novella Shop Girl (yes, Steve Martin the comedian-actor is more than "just an actor": he majored in philosophy and writes real books, too). Wow, I am very tangential tonight! Note to self: never night-blog.

So this so-not-like-Steve-Martin's-Shop-Girl shop girl literally swoops down and clings on and won't let go. She likes the shoes I'm wearing. Thank you, shop girl. She wants to know my shoe size. 7 1/2. She sees I'm looking at Rocket Dogs and states that they are the most comfortable brand. Yes, I know this shop girl. That's why I'm wearing some and also looking at this lovely ballet flat. *Ahem* No, I don't actually think like that. ;)

But then, oh then. Shop Girl spies my insulin pump. Yes, it's green (Animas Ping!) So I can't complain, because I'm pretty loud and proud about Public Education in the World of Non-Diabetic Diabetes Education. But this girl. She began to come close to it. She's staring at it. Gabbing about it. Going on and on in this annoying giggling manner in which I could not get a word in edgewise to um, clarify a few things about the "cool Mp3 player" I seem to be wearing and oh-where-can-she-get-one.

"It's an insulin pump."

"A whaaaa?"

"An insulin pump. I have type 1 diabetes."

"OH! OH, oh oh! I just thought it looked so cool! Like, I love the color and thought it played music or was a cell phone or something. I just thought, like, where can I get one?! OH MY GOD, I had no idea! It just looks so

[get this]....normal."

"Well, I don't think you'd want to have to wear one of these 'Mp3 players'!"

She just flushed. Very red.

But that word normal. So problematic, eh? I am normal. I am healthy. I am happy. I'm just like everybody else and yet still very much unique me: we are all shattered and yet still whole (as Ron Rolheiser, a spiritual writer tells us.) You can't escape it, and yet can find so much comfort in it if you just embrace it as a fact of this beautiful, boombastically blessed life. We get so caught up in feeling awkward about ourselves no matter what's going "wrong" with our bodies that we forget that everyone's got something going on. Some people are just very good at hiding it or acting like nothing painful or difficult has ever happened to them. Difficulty and struggle are not always physical.

So why not use it as an opportunity to learn, to understand? Why always freak out and just start laughing and backing off? Why do we do that so much in the U.S? Is it just me thinking it's only an American thing?

I must give Shop Girl credit, though. She wasn't making fun of me. It was just the way she suddenly shut down and began hysterically laughing to deal with her own sense of..embarrassment? As if my disease and the need to wear an insulin pump was some private matter and she'd crossed the line with me. Yes, granted, some people I know are more private about their type 1. I completely respect that. And I have days and moments in my life, too, where I just don't wanna talk about it with you. Please just let me eat my food without you asking me a million questions. But most days I am open. Most days I'm happy to answer any and all questions people have because frankly, I know it confuses and [somewhat] fascinates people. When they meet someone who is open, they sometimes latch on viewing it as an opportunity to ask all of those questions they never felt they could ask more private people (Seriously, you shoulda heard my acupuncturist the first time she found out I had type 1! "Ohhh, can I see the site? How does this little machine work? How do you take it for a meal?" On and on. And on.)

I guess all I'm trying to say is that (and I think I'm quoting some other way more awesome members of the online type 1 diabetes blogging community here):

This is the new normal.

And I take no shame in that. It's not about showing off, either. It's just that this is my life now and I accept it. I live it to the fullest and have never, ever, ever stopped dreaming or loving life no matter what has come my way. I look forward to each and every day I am given, and find innovative ways to continue to do all of the things I did before I got type 1 at the age of 27. Each day is new and exciting and difficult and awful and ping-pongy and sweet and wonderfully BIG.

Even the days my green pump so does not match my outfit. :)

denise faustman's making headway~

2010-07-07T21:58:00.000-07:00

I just had to post this because while I'm sure it appears that I'm on some "cure diabetes" kick lately [see last post] I promise I'm not. Well, who isn't that has type 1...but that's beside my point.

I just have a tremendous amount of respect for Dr. Faustman. I feel that she is honest, ethical, and not a brown-noser or a business woman. She (at least it seems to many of us in the Type 1 community) is concerned for the science behind autoimmunity; truly wants to understand it's mechanisms. That is why it is so incredible that she is using the time-tested BCG vaccine---we already knew it would pass the Phase 1 portion of the trial. It's amazing though, in this world of Big Pharma always winning, that no one stopped her. And no one did. Oh, they tried. They even tried to do bad science---set up experiments solely for the purpose of proving her own results wrong (when she regenerated beta cells back in 2008). In good science, you work by process of elimination essentially---you don't go about conducting experiments for the sole purpose to "prove" or "disprove". Funny thing is, when the angry scientists against her propositions and results revealed their own, they only found that she was right. Denise Faustman regenerated beta cell function in longterm diabetic mice by using the BCG vaccine. Now she's trying to replicate those results in humans.

The Phase 2 portion of her trial will attempt to do just that.

What so many of us love about her is how unassuming and un-arrogant she is. She blatantly says it might not work. She says it even might only give us a window to prevent hypoglycemia. But as Bernard Farrell said over at his blog a couple of years ago when he had the opportunity to interview Faustman: "Hey, I'd even take never having a low again!" Who wouldn't agree? The point is, she's onto something utilizing the immunological pathways to better understand our disease. This may not be about a cure, but just like pump and CGM therapies have changed the way we approach this disease, so will studying the how's and why's of the immune system's decision-making process to destroy our blessed little beta cells.

I won't be holding my breath, but I just had to post this to say that I'm proud of her. I'm so, so happy for Dr. Faustman because she's never let anyone who put down her work get to her. I really do believe she's in her field of work for the heart of the matter: to better understand what went wrong with our bodies---and how to make it (even a little bit) better quality of life. And yes, deep down we all hope and pray: maybe even a cure.

if there was a cure~

2010-05-24T22:03:00.000-07:00

I was reading a lot of other way more awesome type 1 blogger's posts a week or so ago and there seemed to be going around a wonderful little topic of "what would you do if there was a cure?" for everybody to post about. The funny thing I noticed was a lot of folks had pretty short posts; which I can relate to. There's so much and so little to say. There's so much heartache and hope. There's so much "oh, we've heard this one before, why even ask?" There's been so much disappointment and despair that I tend to be of the school of thought that you just can't live your type 1 life waiting around for a cure.

However, that being said, we've all had moments where we wonder. Some of us like myself, got diagnosed later in life (me at 27) so I have a lot of reality checks where I'm reminded of how much more planning goes into a backpacking trip than before, let alone a simple dinner party at a friend's. And these are moments where I have that fleeting thought of "god, this is just never gonna be 100% second nature for me, is it?"

But then, what would I do if they told me I could stop?

That all of this: $7500 pump on my hip, the tubing, the sites, the isopropyl alcohol, the adhesive remover, the test strips, the cartridges, the back-up needles, the extra q-tips, the juice boxes in every bag, the neosporin, the butter compartment that never holds butter.....could all just go away.

I'd say holy shit you're lying and I'm not giving back this damn glucose meter,

that's what I'd say.

I'd hold onto it all for so long. I'd hold my breath. I'd check my blood sugar as often as I do now: about 8-10 times a day. I'd eat salad and small pieces of toast in fear of my body rejecting whatever "cure" it was that made my immune system stop attacking my pancreas. I'd laugh at every good number maintaining only double digits. I'd cry myself to sleep a few nights in fear of dying in the middle of the night. I'd wait for the symptoms to start all over again: thirst, peeing, hunger, leg cramps, blurry vision. I'd wait in fear of losing 10% of my already tiny body weight again.

But none of that would come back. Not with a cure, right?

Not with a cure.

But then, you know what?

I'd have a dinner party like the ones we always do. Only this time we'd have a big bowl of spaghetti. For dessert we'd have chocolate cake. I'd even put cherries on it. And then we'd dance and dance to the always hopeful and melancholic Billie Holiday until we became the stars in the nightsky themselves. Because we did become them; oh, but we always were.

Oh, I wouldn't overdo it, no. Not with everything I've learned about food and living healthy just from having this disease. I'd not take it for granted. But I'd celebrate, oh god would I celebrate! I'd not just celebrate the cure. I'd celebrate a life well-lived in the face of something so often so unforgiving, something that often laughed in our faces and we had to learn to laugh back, something so distant and bizarre and yet always so damn close. We could never get away. I'd celebrate the enemy-disease turned friend-who-taught-me-so-much.

I'd live the biggest, loudest thank you for the rest of my life.

I really hate it when the diabetes police show up...

2010-04-13T15:01:00.000-07:00

So I'm out somewhere and someone who knows I have type 1 takes it upon themselves to be the diabetes police.

love it.

Today at work, this gal brought some treat bars for the presentation we were giving. I work with refugees part of my week, so it really was a treat for them.

So she opens the container up and basically waves it in my face saying, "I made these for the folks today and they're just so decadent, I know you can't have them."

Not like I asked for one.

So I just look at her and say, "I have type 1. I can technically eat anything but I choose to eat as healthy as I can, as most people should."

"But wouldn't this just like, make your sugar go crazy?"

"Yes, treats should be eaten in moderation---as it should be for everyone. I don't make insulin. If I ate salad for the rest of my life I'd still die if I didn't get insulin."

"Well, I don't know if there'll be enough...."

[Me, thinking: what.the.eff.]

Silence

I'm learning not to become uncomfortable with people's silences in general after they do something like that to me. And not just with diabetes. With how some people treat people in general: as a know-it-all. The more you explain yourself, the more you fight back, the worse they get.

And I've learned not to usually engage in such "diabetes-policing" conversations. You just have to let it go. If they're like that to you, they're probably like that about everything with everybody. You are just an easy-target because what you deal with everyday is so....mundane: food. It's like they're thinking, "what a great opportunity for me to illustrate my deep understanding of this grave matter."

Ya, right.

The best part though, I must say (and I don't usually celebrate people's downfalls) was when she handed them out to the refugees. These people come from all over the world, mind you. What they consider a "good dessert" is often very different from what Americans do. Our palates are trained to crave way-too-sweet things. I'm honestly at the point now that I don't even like things too sweet because I've re-trained my palate to a healthier state in that regard.

So she hands them out and everybody said,

"Ugh. Too sweet!"

I actually felt bad because I could tell she was really excited, and it really is awesome and kind of her to make food for these very poor people. But I had to laugh nonetheless...

blessed by good health~

2010-04-11T20:54:00.001-07:00

I was thinking today how blessed I am by good health.

You read that right.

No really, I know I've not had this beast for more than 2 years now so I'm sure I have an "easier" time while my residual beta cells party on for me, but my health so far has been a blessing. My diagnosis, while traumatic (like everyone's) was not like others': ending up in the ICU after puking all the food they ever ate out. Ok, you coulda done without that mental picture, I know. But some people really do end up so sick they have to stay in the hospital for a couple of weeks, some even go into a temporary coma, their brains so high on glucose. literally.

But me, well, I got terribly sick, but I also got to go home the next day. I view being 27 at the time as also being a blessing, that I could absorb and process what was being told to me not about me. I also have a health background, so there were very few times I was like, "layman's terms, please!!" Which is really not a good thing. All doctors should have enough respect for their patients to know to speak gently and with dignity at their patient's level of understanding.

I'm not exactly sure what this post is about. I sure hope I don't sound like I'm bragging. I guess I'm just trying to count my blessings. I didn't die. I adjusted to the diagnosis well; who knows why. I think I've just had my share of enough personal losses (that wasn't cynical, I promise) and am very good at adapting. But I also think it's a pride thing: this thing is not gonna kill me. Not today. Sure, when I get old, maybe some things'll happen. Maybe diabetes will be the thing that eventually catches up to me. But it can do that when I'm 80 or 90.

Right now I'm excited at how healthy I am. No, I really mean that. Sure, I've learned way more about food than I think is humanly necessary or normal, but it's also what saved me. Every day. We think about food way too much. But we are also these amazing encylopedias on fat, fiber, sugar, stress, socializing, exercise...you name it, a type 1's got the answer (or an idea of one, at least, haha!) We are certainly an opinionated group of folks. With reason!

I'm happy to be where I am today. I sometimes can't believe I'm saying that. But this disease has taught me so much about myself. It has taught me so much about life. About empathy. About listening. It has blessed me with a second chance at seeing life from a completely new angle---one we'd have lost the day the symptoms set in prior to 1921. I'm truly blessed by good health.

oh, what a vacation can do~

2010-04-06T22:20:00.000-07:00

So I didn't post about how my trip actually went. I won't go into the gory details (haha) but let's just say it rocked.

The entire time we were there, I struggled very little to keep my BG in check. AMAZING. There I was, all worried about the slight time change, and then suddenly it hit me that I just need a permanent vacation, haha.

*Ok, wait. There was one night where I stupidly crawled into the tent without juice but after having a snack because I was at about 80 with some insulin still left on board....DUMB. Let me tell you. Woke up in a cold sweat, shaking. But then, I went outside to get that damn juice box I forgot and guess what? Stars. I got a personal viewing of the night sky in a way I hadn't seen in years from living in the city. Maybe my low was meant to be. Or maybe I'm just delirious. :)

No really, it's amazing what a little camping does. I knew it would do that, deep down. It's like a mini D-cure whenever I camp. I did have to keep up with the snacking on some of the hikes (then it hit me that I hadn't been turning my basals down by 50% like I always do for intense exercise....duh.) Chalked it up to not paying attention and having such a blast hiking with my old buddy Martin (rock awesome human being!) and the in-laws, and of course, meeting Matthew's supersweet Grandma. I love grandmothers. But I like people at any age, especially the ages most people hate: toddlers, teenageers, and the elderly.

Matthew's been gently (ok, kicking my ass) lately about reducing my stress levels. He knows I'm freaking out about getting this whole pump-crazy-on-the-female-cycle-let's-not-even-mention-food-and-pregnancy- thing. I've also been dealing with some personal family stress the last year that's not been pleasant. But he's right. All a person can do is calm down and work on what you can and hope for the best in the journey. I'm giving it my all. I'm doing good work in my life: assisting military folks, refugees, and of course, providing massage therapy (i love helping folks, can you tell?) Sometimes, it really is just about letting go of all that bad stuff: the worry, the doubt, the what-ifs, the momentary failures...and just begin again.

So today I offered myself that. After doing my daily yoga routine (really great for your back and hips, I tell you) I went about my normal work of helping the refugees out and some health-intakes for military members in distress. Sometimes, I think part of my elevated BGs are a result of the work I do: helping so many people with very serious, immediate problems. I internalize too much. This is why I think I'd be a horrible social worker. Sigh. Anyway, my point is: in my mind, I was still mulling over all of this carefully-planning-a-family-stuff. I was still harboring worry. But I just tried to breathe and relax and enjoy this little life of mine....and realize that sometimes it's time to shut the hell up! You know? I just went about my normal routine and really worked at letting myself move through it all. That doesn't mean I detached myself, I just really let myself move through my day like light passes through a window.
And my blood sugar was awesome! Of course, it helps when I stay with my healthy-eating patterns, but it's very nice either way, right? To be reminded that yes, each day is a new day; no, I'm not dying of diabetic complications, and most importantly: this is my life and dammit, I'm living it to the fullest I can no matter what.

wayward travels~

2010-03-21T15:26:00.000-07:00

So the guy and I are headed to Arizona this week---only one state away from here. While I'm excited about this trip (we love being outside hiking, camping...) I'm also nervous. Last year we went to Seattle (I was still on injections though, mind you) and while I didn't have absolutely terrible numbers, I do remember having a hard time because it seemed like my basals were off. Heavy on the corrections. Then again, I was on Lantus...when is your basal ever right with Lantus? ;)

All of the literature out there says that going west is easy because you're gaining hours and just cover for it. Apparently going east is the worst. Any advice for how to make traveling a smoother transition when you're on the pump and do have the option to fiddle with your basals a bit?

I'm just a bit sad of late because my first post-pump A1c is coming up and it seems like a dreaded exam. I work so hard to keep my numbers in check with this disease and I just can't get a break on my averages ever since going on the Ping. I mean, I love the pump: it's made my quality of life easier and better, I love being able to turn my basals up and down according to activity or place in my cycle, and the wave patterns, while I'm still figuring them out, make me a happy camper (post-topic pun intended) :)

But my work has more than the I'm-trying-to-stay-healthy-for-my-own-sake purpose now. I'm trying to get my numbers back in check to plan for a baby, for pete's (who's pete, anyway?) sake. And it's stressful. And everyday, the harder I try, the worse I seem to fail. Ok, that's not completely true. But after having a great week, my numbers suddenly blew up in my face. Again. I was so proud of myself! But that's always when the D-bomb explodes: BAM! Have a great day, Emily! I'm here to remind you that you will never have it easy!

I know it'll never be easy. There are easi-er days. But don't we all live for those days? I know I do. You know the ones: your 'type 1 stress' decreases, and just by nature of seeing those non-diabetic numbers pop up on your meter, your mood increases and you feel like twirling. Ok, maybe not twirling. Rock climbing, if that's what you do. :)

I don't mean to sound like a downer. It's just that a trip is supposed to be fun and exhilarating and refreshing...sometimes now, with this disease, it just feels like a whole lotta mess to plan, you know?

Well, enough of that. BLEH!

I'm hoping this time outside will have a positive effect. Lots of sunshine, hiking, visiting friends, seeing my first saguaro cactus....did you know it takes them hundreds of years to get so tall? They work so long and so hard to become what they are: elegant, tall, reaching for the sun above and the moisture below. Often pocked and scratched and scathed, their limbs tell a story.

We weather the storm, folks. We can always weather the storm.

Book Review: "Balancing Pregnancy with Preexisting Diabetes" by Cheryl Alkon (available in April!)~

2010-03-08T10:34:00.000-08:00

There are books.

And then there are bibles.

You know how everyone buys everyone "What to Expect When You're Expecting"...because it's (apparently) the "bible" to read... when you're expecting? Well, Cheryl's book is going to be the bible for women with diabetes trying to plan a pregnancy....only better. Not only because it's for women living with either type of diabetes trying to plan [mostly their first] pregnancy, but because she doesn't skim. Anything. Her book is that book. You know the one. The one Every Woman With Diabetes (especially type 1) has been eager to get her hands on regarding this topic, but without any luck. Sure, there are mini sections included in books about managing diabetes in general, but those were mostly written by men and while they'd offer hints about it (read: It's Gonna Be Hard!) there's never been anything beyond this and oh, my personal favorite: talk with your doctor.

Cheryl Alkon is a type 1 diabetic. She also experienced the trials and tribulations of infertility. She is incredibly open all throughout the book about how difficult it was for her to get pregnant, and purposefully uses the interviews of countless women that experienced the "fun" that pregnancy brings with a disease like diabetes. While she really lays it out on the table for her readers, she is also incredibly encouraging and intelligently weaves the difficulties together with the absolute possibility that you can make this happen. On that note, you can trust that she did her research, knows where you're coming from, and truly wants to be a mentor to all women in this sometimes mind-boggling pursuit.

The book is broken into 4 main parts:

How to plan your pregnancy (preconception issues), the First Trimester, the Second and Third Trimester, Labor&Delivery, and (rather than dropping the ball on us right when we need her) discussions of Postpartum care. She then goes on to offer an Appendix focusing on Infertility and Pregnancy Loss. The Glossary, Resources, and Notes are also very helpful in helping you to go and find specialty books, blogs, groups, etc that center on your needs.

Preconception-

Questions to ask doctors (especially those you think you might have deliver).
Ways to bring your A1c down.
Different insulin therapies and what might be best for you (especially if you think you need to change, ie, from MDIs to a pump).
How to eat while planning.
Dealing with your health insurance, especially so you know what will be covered and what won't be (a very important point not often made, I felt.)
How to deal with an unplanned pregnancy with high blood sugars and risk factors involved (she really does keep it real!)

The First Trimester-

I love that the first thing she tells us is "Enjoy the Moment". She really lays out your biggest fears and frustrations after seeing that positive test result, but goes on to really pump you up for the challenge ahead.

The importance of self-advocacy, knowledge as power, getting support, and how to deal with annoying people who still think diabetics die trying to have children.
What to eat, what not to eat...with heavy input from other women on how they managed cravings/aversions, morning sickness, and the changes beginning to happen with basal and bolus needs. I have to say though, the food issue is woven all throughout the book. Very helpful!
The many tests you will go through initially (great preparation!) and throughout, but also optional tests offered. This is an important section because knowledge truly is power. The more we know going into this, the more you will be able to understand why providers are doing it---let alone how knowing what to expect decreases your stress level.
Alternative birthing options: I nearly fell out of my chair when I saw this section. I have been working to plan as natural a birth as possible, and it was just amazing to see that Cheryl knew there are women out there who would like to know if this is an option. So she researched it, discusses the pros/cons and best candidates, and as always, offers story after story to provide examples.

The Second and Third Trimesters-

She really breaks down how blood sugars [typically] react during each trimester. Through the many examples, she offers readers strategies for dealing with the fluctuations. While you will hopefully have a good team of providers, I found all of the women's examples to be extremely helpful.
Suggestions for testing more often (since this is the time of greatest insulin resistance.)
More eating suggestions (one of our biggest concerns! Cheryl rocks!)
The importance of, but also the how to of exercise modification in these trimesters.
The possibility of going to 40 weeks (or not).
The pros/cons of a birth plan.
The many options for labor and delivery and how your disease plays a role in the decision.
How to prepare for going to the hospital as a diabetic: what to pack, wear, extras to bring.
The benefits of working with a doula and how to find one if you like the idea.
The option of cord blood banking (something I'd honestly not thought about until this book.)

Labor and Delivery-

She prepares you for the best and worst.

Options for insulin infusion: the pros/cons of IV drip vs Pump Delivery (depending upon your situation.)
Managing through a more natural labor&delivery process.
What usually occurs to your blood sugar and suggestions/stories about how to manage highs and lows no matter what type of delivery you have.
What happens if you need a c-section and how your BG will react, food issues, healing, etc.
What to do if baby comes out low and how to emotionally manage a NICU stay, if it is needed.
How your insulin needs change immediately after birth (especially the lows!)
A huge section on breast-feeding, including tips and discussion by other moms.
Formula-feeding and the concerns women often have about it surrounding diabetes.
Dealing with lack of sleep, the possibility of developing Postpartum Depression, returning to exercise and work, and even birth control options.

Appendix: Infertility and Pregnancy Loss-

I think this section was very heartfelt and necessary in a book about pregnancy and diabetes. Because we have so many concerns about having healthy babies, the possibility of not being able to get pregnant or stay pregnant is definitely on our list of concerns with this disease. But Cheryl offers a lot of real encouragement (she went through it herself) and reality-based information about what to do if you are faced with this added complication...especially in how infertility treatments and stress itself interacts with your diabetes. The section on miscarriage, while short, is something I think women should read and remind themselves of if they're on the "family quest" and it hasn't worked out yet. All too often, it is only the negative we are made to focus on, but the author does a lovely job of sharing support through tips and stories from real women who have gone through it.

On a personal note, this book came at just the right time for me. I am 29 and planning my first pregnancy with type 1 diabetes. I was completely freaked out and frustrated there was so little information out there regarding managing the disease while pregnant. When I took her suggested questions to my preconception appointment, the doctor was very impressed and excited about her book. More importantly, I've been excited and impressed! The tips and stories she weaves throughout the book are better than any textbook discussion on diabetes and pregnancy that I've ever seen. Her writing style and voice, while intelligent and articulate, are easy-going, funny, and approachable---truly like a girlfriend who goes out to talk about it with you. But the best, the very best thing about this book is that she makes managing pregnancy with diabetes possible. She actually cheers you on throughout her work; tells you that you can do this and that you know more than you really give yourself credit for. There were honestly times I got tears in my eyes while reading it.

going low: the opportunities abound!

2010-02-23T20:02:00.000-08:00

low:

to stoop down.

a hit below the belt.

to feel hypoglycemic.

also known as an opportunity par excelence in being type 1:

to eat anything in sight without question.

i wonder if this toothpaste'll do the trick...

to eat everything in sight without remorse.

do ya think a latte, 2 peaches, a p.b&j, and a small horse will cover this?

[in your stupor, you actually may not believe this to be quite enough...]

to eat food items that otherwise would get you in a lot of trouble.

-hey, i thought cupcakes were off limits?

-but officer [insert name of diabetes police-person here] i'm low!

to enjoy citrus fruits without abandon.

it's only one orange. that grocery clerk won't notice.

"hey you! step away from the oranges!"

"but i'm... doing a taste test!"

(the best part of this post is that you think i'm joking.)

;)

book review next week: cheryl alkon's "balancing pregnancy with preexisting diabetes"~

2010-02-23T14:11:00.000-08:00

so cheryl alkon's book "balancing pregnancy with preexisting diabetes" is coming out in april. let me be the (not) first person to say that this type of book is long overdue. i had the pleasure of getting to know a bit more about cheryl via facebook and the DOC (she kindly comments on my messy blog). so when she offered some bloggers the opportunity to read her manuscript to do reviews before its release i literally jumped at the chance! this book is going to become the bible for women with diabetes (particularly type 1's) who want to plan a healthy pregnancy. it's like "what to expect when you're expecting with diabetes"! only waaaaaay better.

oh, and she's not paying me to say this. :)

the book (i'm nearly done with it) is amazing. you know how type 1 women are always complaining about how there's no information about diabetes and pregnancy? how,when we do find info, it's from the dark ages and promotes only one way of looking at the pregnancy; that is, assuming that you'll probably suck at control and will most likely need every medical intervention under the sun? oh, and my favorite part: when you do read one of said-bad-books, it actually says...nothing. this often sums up all we get:

keep very tight control. master of the obvious writes the nonfiction piece of the century!
your insulin requirements will drop in the first trimester and reach their highest in the second and third. um, a little more info, please?
you'll need to see a high-risk pregnancy specialist. duh

i could go on and on. but i won't. i know you already know the frustration! just know that cheryl's book covers everything. in detail. and the amount of women she interviewed really assists in making it personal and meaningful. not just some textbook with confusing rules and graphs. she keeps it real. she offers every option. she openly discusses the struggles. she's a type 1 mama who had a heart for her girlfriends!

stay tuned for my extensive book review early next week!

treating low blood sugar naturally and oh ya, i suck at blogging~

2010-01-26T07:51:00.000-08:00

everytime i get on here to do a post i'm reminded at how badly i suck at actually being a good blogger. not good. but then, i hope i redeem myself in what i blog about when i do blog. :)

as most of you know, i'm really into trying to eat healthy, whole, foods-in-as-natural-a-state-as-possible-foods. ok, i think i coulda said that differently.

am i a hippie? a lot of people tell me i am. i admit, i am pretty crunchy at this point in my life! ok, i'm very crunchy. but when some people find out i have type 1 diabetes and am on an insulin pump, all the luddites start screaming and run away.

but i read something in a book on natural medicine and diabetes written by a N.D (naturopathic doctor---yes, they attend medical school) and a M.D. when i first got diagnosed, the book really helped me put my "state of affairs" into perspective. while some things in the book are problematic, the following statement, to this day, holds true to my health philosophy:

Individuals with type 1 diabetes absolutely require conventional treatment with the hormone insulin. We consider this approach consistent with natural medicine---after all, the goal is simply to provide the body with a critical natural hormone.

take that, stinky hippies. ;) just kidding. so basically, what dr.banting and best did for us was hormone replacement therapy---they, to this day, helped us replace a hormone the body should naturally be making, but no longer does. now off my soapbox.

now when you run into somebody who wants to hassle you about your disease and how you didn't eat an anti-parasitic ayurvedic diet or something, just throw that statement in their face and it'll shut 'em riiiiight up. sometimes. ok, most of the time. not that i don't adore ayurvedic food. ;)

the bottom line: i try to do my best at making the entire spectrum of my eating-with-type-1-diabetes-experience as natural as possible. even when it comes to lows. however, a word of caution, when you're low, you're low. don't get stupid and start insisting on things that aren't available if you're out and about. just fix the damn low.

case in point: we were out the other day, i overbolused for lunch, had my little all-natural juicy juice (only 16 grams, yikes!) but calculated from my insulin on board that i needed waaaay more than that, and miraculously, we were headed to whole foods for groceries, yaaaay! so i'm thinking i'll go by a piece of fruit. but then, well then. it was sunday! and on sundays whole foods has lots of free junk food out! [note: i love how most of these natural foods markets are made up of just as many processed, packaged foods as anybody else. what? just cos you don't use partially hydrogenated oil you think you're BETTER?! haha] really, i should've just bought the damn apple.

so we begin to wander around, me in my slightly-low-stupor. and all i'm eyeing is carbohydrates. free carbohydrates. so we see some mini-cookies. we look at the box, realize i'm gonna need to eat like 6. despite my temporary insanity, the dignified person in me realizes that eating 6 of the cookies would be: 1) rude 2) noticeably odd, ie, mommy, that girl's eating all the cookies! 3) quite piggyish.

so i had 3.

on the search for more snacks, i mosied up to a table of pita chips. mmm, when was the last time we ate pita chips? my stomach asked. clearly, too long ago. so i ate about 3. ok, 4.

the problem with this whole scenario is i went waaaay beyond what john walsh in his book "pumping insulin" calls the "tipping point". i'll blog about this wonderful function of pumps later. for now, just know that i "out-ate my low". we all know what that means. but, like i said, when you're in a situation, you do what you gotta do, people!!

but if you can, treating lows with natural fast acting carbs are easier on your body, safer, and more easily calculated. i am so done with glucose tabs. the dyes in them really, really freak me out. and because you need to eat about 4 or 5 when you're low, i swear i can taste the dye. if only i'd had another juicy-juice on me that day....

here's how i [most often] try to treat my lows:

1. skip the cookies. too high in fat. fat prevents the sugar in the whatever-you're-eating from getting into your bloodstream fast enough. this is why a snickers bar will do you no good. neither will "all natural sun drops" (whole foods' store version of peanut m&m's.) because i eat whole grain breads, i even find their "lower glycemic index/load" extends my low longer. we're talking rapid-acting sugars.

2. use juice or dried fruit. there's a reason they're both on your daily no-no list. they're super concentrated in sugar. whole fruit is good for you, but i find the fiber in most fruit (which is what makes [most] fruit low glycemic, makes it just that: low glycemic. doesn't burn fast enough. dried fruit's pretty much had the fiber sucked out of it, and juice is like drinking double-digits of your chosen fruit. nice. i found these mini "juicy-juice" boxes at Target that have 16grams each. usually, this is enough. sometimes, not so much. ;) lots of flavors to choose from. i like the orange juice.

3. try fruit strips. natural foods markets often make these--sometimes called fruit leathers. they cost too much there. sorry to keep promoting Target (don't lie, i know you love it, too) but they make some boxed ones that are organic and about 11grams each. now, that's a little low in carbs for most of our lows, but hey, they're basically squished dried fruit. i think they taste great and are easy to get down, like juice. not like glucose tabs.

4. a tablespoon of honey goes a loooong way. what?! you don't carry around a trusty bottle of honey? just kidding. this one's more for home-lows. this makes me want to break into song: home, home on the range. where the lows can make you deraaaaaanged. ok, i'll stop now. but seriously, honey's a great way to treat a low: even though it's natural, it's super high-glycemic (watch out, you non-diabetics who only sweeten with honey-cos-it's-oh-so-natural.) i think it's basically like maple syrup, in that it's about 16 grams carb per Tbs. wow.

these are my main go-to's...but of course, sometimes there are situations. ;)

breakfast and who woke YOU up on the wrong side of the bed?!

2010-01-08T22:32:00.000-08:00

okokokok,

i know.

i haven't blogged much this year. please don't hurt me. :)

i was...thinking.

too heavily, but you know...

i'll update more (i promise) and let you know all i've been thinking and learning about.so.very.much!

however, for now, i thought i'd reiterate my low glycemic-how-do-we-do-the-things-we-do-with-type 1-kick and start the new year with one of our favorite meals of the day

[insert snicker here]:

breakfast.

ya, i'm calling breakfast a fave.

my fave.

well, before i got diagnosed with the big D (or little d, in my little case) in 2008... i was like, a BRUNCH FREAK. i mean, this gal i know and i seemed to make it our life's purpose to go around all of albuquerque finding the hippest, funnest, yummiest places... for brunch. it's not just about eggs, folks. it's all of the swonderful-smarvelous-simply-splendid things you can do for breakfast.

until i got diagnosed.

ya, it felt like, GOODBYE GOLDSTREET CAFE WAFFLES! GOODBYE FRONTIER BREAKFAST BURRITOS! GOODBYE HUEVOS RANCHEROS! GOODBYE HOMEMADE SCONES!

ok, i sound like i just went off the deep end. and i did...kinda. because i was an adult when i got diagnosed, the whole "golden year" they talk about in the medical field was like, 100 times worse in me: i wanted to rock this beast of burden. i even swore off bread for a while. ok, like a day. but it felt like, forever!

disclaimer: i promise i don't actually say "like" in my daily vocab. it's just happening here because i'm trying to be like, thoroughly honest about my utter FREAKNESS phase i went through until i started figuring out how to actually cook and eat without missing out or...denying myself...or losing too much weight (i'm already too thin) or also, just saying f*%& it i'm gonna be just like those people who actually believe the statement, "you can eat whatever you want...as long as you cover it with insulin."

um, i'm sorry, but like, no. NONONONONONONONONONO. that does not work. i don't care who you are and what you tell me, i know you're lying. and so will everyone else in the DOC. word on the street: don't lose your cred!

anyway, back to breakfast.

i know it's tough. i wanted to go after somebody with one of my whisks and whip their heads into shape who told me to just double the dose because of the insulin resistance experienced by type 1's in the morning.

can i hear a WTF?!

i actually did this sometimes (more like triple) i confess. laziness, pure laziness.

then this summer (due to over full-time health classes) i promised myself i would find a way to balance my day by way of breakfast. 'cos you all know: you screw up breakfast, it takes all damn day to balance it out. it's even worse when you already woke up with Danny Dawn Phenomenon at your side. (it's like, whoa there! i am NOT into these random one night stands! you just think you can show up when you want to?) god, SUCH commitment-phobia!

so i wanted to offer some advice on what i have found that works SWIMMINGLY SWELL for little birdy's pancreas named peabody---who, by the way, did not feel so misadventurous at the end of the summer: that A1c i thought was gonna be in the mid 6's came back as (get this) 5.8%! you read that right. ok, i'll stop bragging.

note to readers: to comfort you, remember i just got my pump in late october and my initial A1c is gonna be like, 6.7% (i'm projecting) OH.DEAR.GOD. take comfort!

my point is i'm trying to show you that getting your food down, your exercise down (even a little--i promise i'm no gym freak) and not starving or overeating will do you wonders:

1. don't skip breakfast and eat it by 9am.

in Traditional Chinese medicine, the Stomach is active between 6 and 9am. with diabetes, we all know rapid-acting insulin's peak is about an hour after you inject and the duration is about 2-3 hours (unless you eat a high fat food.) my logic here (based solely on my personal experiment) is to then go on to to have a snack about 10am. i'm hoping you'll eat breakfast by 8am...

2. don't make breakfast too high-carb.

the logic is of course, morning insulin-resistance---experienced by all people, not just diabetics! the worst thing you can do is eat things like waffles or pancakes....at 8am! trust me, your pancreas (that isn't actually working anymore...hmmm, we need to have a chat about that someday, immune system!) and stomach will thank you.

they're like, "please don't make me work that hard, i just woke up, too." when you wake up, go easy on your body.

ideas that work great for me:

-a nectarine or black plum with a handful of salted almonds (it's a super-yummy combo that your tongue will thank you for!)

-old fashioned rolled oats (if you can't stand the idea of soaking steel cut and cooking in the morning) with a handful of flaxseeds and a squirt of agave nectar (this stuff is sooo sweet to me, go easy on it.) the oats are fibrous, slow-burning and filling, while the flaxseeds give you some much needed omega 3 essential-fatty acids.

-elana amsterdam's amazing recipes for all kinds of muffins are super healthy, low carb and did i mention tasty? i make her recipes all of the time and my BG does beyond great. in fact, i adjust most of her recommended 1/4 cup of agave nectar for each recipe to half that amount and (due to agave's sweetness) have done even better!

-lowfat plain greek yoghurt with a handful of oats and a squirt of agave nectar. the entire meal is low glycemic and filling.

-homemade miso soup. i know you think i'm crazy, but it really is fast, filling, and diabetic friendly. go easy on the paste (because it is salty) and pleasepleaseplease buy it organic (someday i'll explain the dangers of soy), and preferably low-sodium. miso is a version of soy(fermented) that is good for you, by the way, unlike most soy products in the u.s.

3. go easy on the caffeine.

i know i'm a natural-health nut, but seriously: a cup of decaf coffee or green tea will keep you from getting delayed hyperglycemia---which i was experiencing, i don't care that the study was solely on type 2's---and still give you the slightly-caffeinated boost you're begging for. i'm not lying, you will still get the psychosomatic response you need to 'wake up'. just do the weaning process slowly: when you go to buy coffee, fill the bag 3/4 to 1/4 caf to decaf, then the next time 1/2 and 1/2, and so on until you feel you're down to only decaf. nobody said it's a sin to want some java; just try cutting out the caffeine and you'll still feel rejuvenated without the negative effects. try to make this the only cup of coffee that you have a day, though (your adrenals will thank you.) you know, chai tea is a very nice drink throughout the day...wink, wink.

note: the warm drink also stimulates your Spleen to dump--which it should be doing. this is why we have a bowel movement in the morning. well, you should be, and if you're not, your Spleen is not happy, as this is it's time to shine. this is why it's important to eat/drink warmer foods in the morning; it allows the spleen to dump waste-products---Save Your Spleen! um, my new campaign. ;)

4. don't be afraid to snack.

the goal being that your chosen snack will be healthy and not the size of a small elephant---and i'm not necessarily advocating radishes. i'm simply saying if you go easy on the size of your breakfast, you will find that your blood sugar will go easy on you, and then you can have a worthwhile snack, which in turn will cause you not to gorge yourself on lunch and end up with carb coma at 2pm. ahhhhh, good ole carb-coma-high-blood-sugar-to-crash-cycle.

ideas:

-another kind of muffin!

-piece of fruit. i don't care what dr. bernstein says, i do not advocate that people not include fruit in their diets as diabetics. while i understand and appreciate much of what he says, fruit has too many vital vitamins and nutrients naturally occurring to be avoided and then just taken by way of supplements your body will only then poop out. i eat fruit everyday (2-3 servings by way of a smoothie with almond milk or just munching away) and feel that the fructose in it is just enough to give me a boost---and because it is a more complex molecule than glucose, it burns a bit slower in the break down. unless you know you're most likely low in something, get your vitamins and minerals by eating healthy, people!

-a bit of cottage cheese with tomatoes or fruit slices---no joke, it's really good if you like cottage cheese, right? i also think oikos greek yogurt makes these fun little organic cups in vanilla and blueberry (my faves) that are quite low carb.

-celery, apples, or bananas with peanut butter. it's important to have protein with carbs---for anyone not just diabetics. but it's especially important if you have blood sugar problems, which type 1 diabetics do...inherently. you could call us "carbohydrate reactive" as one nutritionist told me. and boy, do we react. :)

this is all i have for now. if this post seems odd or incomplete, get serious. it's wacky birdy we're talking about...of course it'll be odd. no really, please let me know if you have further questions. love&peace to you all, we're all in this boatload of learning together!

how to eat a low glycemic diet, part 3 (final)~

2009-12-06T21:24:00.001-08:00

so what do I eat?

well, i try to do my best, so don't take me for being perfect and the be-all, end-all raw food fanatic or something! i crave cookies just like everybody. (now i just make my own, haha.) a few months ago i went psycho on the nutella and ate an entire jar in a week. seriously, peabody was not happy with me. i am also known to love icecream and cupcakes and to be a connoisseur of dark chocolate.

but the best thing i did for myself was start to eat all.day.long. now i'm never hungry and i never eat 100 grams of carbs in one sitting. i'm telling you, just try eating that whole "6 small meals a day are best for diabetics" philosophy and it'll change your life. your body can figure out way better what to do with synthetic insulin, and your blood sugar will thank you. or you'll thank your blood sugar. ;)

in the morning, i usually eat a small piece of fruit and some nuts, or even dark greens with a few slices of cheese (i know, i know: [insert laugh here]), or a boiled egg with a piece of spelt toast, or one of the almond flour-based muffins i bake for the week (yum!) or greek yoghurt with berries and sweetened with agave nectar. because morning is the time of greatest insulin resistance, go easy on your insulin intake. i'd say eat your lowest carb content meal of the day in the morning. protein and good fats (nuts, greek yogurt, a couple of slices of cheese) in the morning are way more important to wake you up and get you going than french toast with syrup (or even cereal, for that matter.) talk about a gusher. also, cut the caffeine: i know, i know: i am now pure EVIL! but i did some research a while back and found out that caffeine causes delayed hyperglycemia. it was a bit painful, but i slowly weaned myself to total decaf and now have the psychosomatic response i need from it. by the way, the World Health Organization labeled it a 'true drug', as in addiction. :)

about 9 or 10 a.m, i have some nuts or seeds, a small piece of fruit, a piece of peanut butter or almond butter [wholegrain] toast, greek yoghurt again, or a drink like a homemade almond shake or fruit smoothie. again, these are not huge servings. a bit at a time (especially if you are a buff guy, being hungry is understandable: that's why you eat throughout the day and not all your daily calories in one sitting.) :)

lunchtime i have a salad with tuna, egg, beans, or coldcuts, or dark cooked greens (very filling!) with some cold cuts or cheese, or beans (homeade chili) or soup, hummus in a whole grain wrap, avocado salad, quinoa salad...notice all of these are very real foods that burn a lot slower than a glucose tab (ok, better than pasta or a big hoagie.) try to include dark greens for lunch, they'll seriously fill you up. garlic, balsamic vinegar, olive oil, and the spectrum of spices all add wonderful flavors to veggies. i often think this is why people don't eat enough of them: they've just never been prepared with much flavor.

afternoon snacks are the same as midmorning, only lately i've been making it a hot drink, like a big cup of hot chocolate almond milk (or coconut). i also have a lot of wonderful recipes for healthy 'cookies' made from almond flour, coconut flour, spelt, and quinoa. call me a health nut. ;) the key with these is that they are merely nuts ground up; which is not making it 'over-processed' like the poor little pod that wheat once was. you're also getting healthy protein and monounsaturated fats in nut flours, whereas in most other carb-based flours all you're getting is...carbohydrate.

for dinner, i take it easy because i really believe how in chinese medicine, the body is 'slowing down': your stomach's hour is turning off around 6, so you want to try not to eat your carb-heaviest food after that. it doesn't mean you shouldn't eat, it's just best to not make it carb-heavy: hello pasta and pizza! we tend to eat a lot of chicken, pork, fish, kebabs, wild rice, baked veggies, chili, lentil soup, root veggies...and yes, potatoes with their skin.

*on a strange note, i do like larabars. they're 'raw food' snack bars with only a few ingredients in flavors like cherry pie and pb&j and they are stupendous for treating lows or before/after exercise. they never go over about 30 grams of carbs as far as i've seen, either. the only thing i don't like about them is the pretty penny they cost: about $1.29 here in the Q. i wish i could figure out how to make them, i know they're not baked, but how do they get the consistency so.very.right??

does my diet seem...boring? probably to most. but you know, i think getting bored with food is a 'first world' (i hate that phrase) problem. i'm guilty of this idea of boredom just as much as anyone. but we need to rethink our notions of boring, too, and focus on flavor through cooking with herbs and healthy fats like olive oil and nut oils (if you are not allergic), cacao over 70% when baking (for the antioxidants), and using truly unrefined sweeteners like coconut sugar and dark agave nectar---the only two i bake with and sweeten with now. they're lower in carbs per serving and lower in glycemic load, too. as a result of becoming cognizant of how i flavor the basic ingredient of my food, it's become yummier and not so---sugarcoated, if you know what i mean. i can actually taste my food.

on a safety note, i noticed that i often have to take my dose over a bit more extended period of time because of how slow low GI/GL foods can burn. i wouldn't recommend taking your whole dose of insulin at once if you're eating avocado or nuts in the meal. talk about mid-meal hypos! this just goes to show how much slower and steady the rise in BG is, let alone less if the food's got a low glycemic load. and um, yaaay to lower post-meal numbers!

two of my absolute favorite recipe websites:

http://www.elanaspantry.com/

http://www.thenourishinggourmet.com/

big shout out to elana and kimi!

this post is dedicated to dear, patient elizabeth. ;)

*this is officially the longest blog post the planet have ever seen; thank god i broke it into three parts. :)

how to eat a low glycemic diet, part 2~

2009-12-06T21:22:00.001-08:00

what's the deal then, you ask? how the heck am i supposed to figure out what to eat?

listen to michael pollan, a food activist i'm going to blatantly steal from here:

eat real food. mostly plants. not too much.

if you have diabetes and can make that your food mantra, you will live a long, healthy life.

(i do want to point out that he's not promoting vegetarianism, he was just trying to point out what to fill most of your plate with when you eat, and to make it what truly 'fills' you.)

think of all the frankenfoods and over-processed foods we've been taught are normal: cereal, snack bars, crackers, cookies, sports drinks, muffins, pasta, chips...the list is endless. there's a reason you feel tired and hungry after you eat these foods: your body is having to work way too hard to process them. they are fillers. they confuse the human body and make it spill waaay more insulin than it was designed to. it doesn't matter if you have type 1: you are your pancreas now and will only have to take more of the blessed hormone. this is where the term glycemic load comes in and why it's more important than glycemic index: you never want the foods you are eating to be a 'heavy' load on your pancreas' output ability...hello type 2 diabetes! where do you think we get the terms "carb coma" and insulin resistance from? why do unhealthy type 1 diabetics begin to resemble unhealthy type 2's over the years? don't give your body more than it can 'carry.'

the key to low glycemic eating is just real food. i eat a lot of fruits and veggies (very few are high glycemic, here's a list i used to start learning after my diagnosis) and when it comes to grains and legumes, i eat just that: grains and legumes in their most basic form. that means you just do your best to stay away from any real food that's had the life processed out of it: fruit into juice, wheat into white flour, sweeteners so refined they resemble nothing of their former plant self. call it bad-cosmetic-surgery-on-food.

when in doubt, ask yourself:

is it real food? (in as close to its natural state for me to consume?)
is it an 'old' food? (how long have humans been eating it? real food is old food.)
did you make it? (how many ingredients did you use: less is more.)
does it have its own rich color or one that is dyed? (naturally dark pigmented foods are vital nutrient sources.)
has it been sweetened? (does it really need to be?)
did i break it down more than it should be? (i.e., potatoes with skin turned into peeled mashed potatoes)
what 'kind' of sweet is it? (fructose, lactose, dextrose, sucrose: the larger the molecule, the longer it'll take your liver to turn into glucose: this is gentle, this is good.)

how to eat a low glycemic diet, part 1~

2009-12-06T21:17:00.001-08:00

i've had a lot of people in my life ask me about my diet recently. even my nice, new endo. while i've certainly learned a helluva lot more about healthy eating with the disease than without, i will say that eating a low glycemic diet has helped maintain blood sugar balance tremendously. bummer i had to get type 1 to take such a keen interest. ;)

first things first:

what does "low glycemic" mean, anyway? there's a lot of talk out there using the phrase (and somewhat carelessly, i might add) but often little understanding of what it means to eat food this particular way.

it's important to understand the difference between glycemic index and glycemic load, also.

*note: while the picture above only states 'GI' on it, low GL foods also look the same graphically. also, that picture i borrowed sucks. the time is horizontal (as is traditional in algebra, duh) and the blood glucose is vertical. also, the red line is High GI and the blue is Low GI.

the term glycemic index was first coined after scientists figured out the [standard] insulin response to carbs. specifically, it relates to the quality of a carbohydrate and thus how fast the blood sugar will rise. values are placed on foods: the lower the index, the slower the rise. the index ranges from about 20 to 100. obviously, pure glucose is rated 100. there's a reason we all know to have pure sugar when we are low, right?! we need our sugar to come back up fast! so, a good rule of thumb: the more processed a food is, the higher its index. most fruits contain fructose (a more complex sugar than pure glucose, thus it takes longer for your body to break it down: a good thing!) and are low to medium GI foods. this is not only due to their carb content being made of mostly fructose, but also fiber (if you're diabetic and don't like fiber: GET WITH IT! FIBER IS YOUR BEST FRIEND!)

on the other hand we have the more recently coined term, glycemic load. this was figured out after scientists at harvard realized it was not only important to know the standard effect on blood sugar rise, but also the actual amount of carbohydrate in that particular food. glycemic load ranges from 1-20. thus, while a food like beets has a high GI (64/100) it has a measly glycemic load of 3 because its carb count is only 5. same goes for pumpkin, watermelon, carrots...you get the picture.

so, do you think i memorized the GI/GL values for carbs? uh, no.

can i get a loud UH, NO!

don't be ridiculous. as you read my 3-part series on low glycemic eating, you'll get pointers and even the basic list i started learning with from the good (but somewhat problematic lowcarbdiets on about.com.) but more importantly, a way to trust your gut when shopping for food or eating out.

low to moderate GI/GL numbers are key to balanced blood sugar---for anyone, not just people living with diabetes.

you will learn to eyeball food values that'll burn fast or slow or moderate just like you did when you learned to count carbs. in fact, you already know a lot of this, i believe.

this is where a healthy sense of low-carb eating enters: ever try to eat white-pasta-based mac&cheese and wonder why you thought you were going to die?

simple answer: a GI of 64/100 with a glycemic load of 19/20.

god help your little pancreas (even if you're type 1 and it malfunctioned.)

things that make me happy~

2009-11-15T19:36:00.000-08:00

i really need to write about what makes me happy, because frankly, while i'm still very excited about my pump, it's been rough. i don't like focusing on the negative things of life and i really, truly believe this is why my life always works out (and believe me, it hasn't been a hay ride.) i don't really believe in good and bad luck.

i make my own luck.

GASP!

[see random photo taking over the page.]

ahem,

so here is my gratitude list of things that make me jump for joy even while life is handing me some serious humor-sucking blood sugar lemons:

my pump is green. i love green! (even though i have no idea what i'm doing yet!)
i love teaching english to refugees and forging the friendships i have with them (even though we have no idea what the other is saying half the time!)
hiking in new mexico in the fall; there's just no comparison to the colors, textures, air...(you get my point.)
the new music i've been downloading for my workouts (rox my sox!)
i love baking and especially love all of the seasonal food we've been eating: dark greens in our stews, pumpkin in the muffins, and green chile to warm us up! (but not too hot, garcia's cafe!)
i have a stronger desire to play the harmonica lately (thank you, revival tour!)
oh good gracious, matthew gave me a ring for that finger :)
jimmy stewart films make me bubbly (and not just "it's a wonderful life.")
straight-up, loyal friends are a gift i value (and yes, i mean what i say.)
the good healthcare i have received so far from my cde and family doc (and my own brain's ability to process complicated issues while reading, haha.)
getting to do more massage therapy on people actually makes me feel good. :)
i'm getting purple streaks in my hair! (they might be blue or pink sometimes!)

what makes you feel better when you're going through a rough patch? what do you remind yourself of?

how do you make your own luck?

extra-rude endos~

2009-11-10T09:09:00.000-08:00

my last post was all about how upsetting some of the adjustments to the pump have been for me. however, all in all it's been a great thing, this little complicated (but not really) contraption. i have to admit how surprised i was at how user friendly my ping! is.

but then i met my 'new' endo. funny that i like the mechanical device attached to my body more.

this guy was a real piece of work.

classic napoleon complex, on top of his own version of "i have this need to prove that i'm better than everyone."

the resident working under him (pity her) though is super great. she's been very understanding and really makes an effort to tell you how well she thinks you're doing.

get this: she even laughs. at real jokes.

so when this guy walked in the room, all pompous with his chest puffed out, i wanted to stand up and say, " i can see where this is going" even before he opened his mouth. a judgement, i know. but sometimes your gut is nothing but right.

i was really stressed out about the numbers i'd been having. i knew going in that i wanted my basal upped temporarily so i could actually do a real basal test.

i also know my total daily dose, how much was averaging for correction, and how i needed a lower insulin:carb ratio in the morning. but he didn't care about that. he didn't trust anything i said. he wanted to 'figure it out' himself.

so this guy grabs my pump off my pants without asking and starts fooling with it. as he heads to the bolus menu (which is a bit sensitive on the ping, no fear, if you hit too many buttons, it'll just 'bolus' zero, but still...) i start to hear myself saying nooooooooooo! in my head. he kept 'delivering' (zero insulin) but it annoyed me because i could hear the cartridge. i could feel myself sweating.

but the best part: he'd make that shhh sound and put his hand up to stop you when he didn't want you to talk. or, when he asked you a question and heard 'enough' of your response. nice.

then he asked me about carb intake. i said i'm not a carb freak, but that i also don't feel type 1's do very well with high carb bolusing anyway.

he shhh's me, his hand in my face.

"FORGET ALL OF THAT. I DON'T KNOW WHY YOU'RE DOING THAT. IF YOUR SETTINGS ARE RIGHT OR IF YOU'D BEEN BOLUSING CORRECTLY IN THE PAST ON MDI'S YOU WOULD'VE BEEN ABLE TO EAT WHATEVER YOU WANT."

ok, you can stop shouting at me now.

in the end, he regurgitated back to me what i'd tried telling him in the beginning. he stood up, satisfied with himself.

the most upsetting thing about such a visit is your lost sense of dignity and intelligence. this is my disease. i own it. i live with it. to ask me nothing about myself, to care nothing about my responses, my real concerns, my worries is simply...socially retarded if you're a doctor.

as this one wonderful endo once said to me, "it's my job to help you see the forest from the trees." he was also the one who taught me not to have more than 45 grams of carb in one meal. lifesaver.

lately, i've been doing a lot of reading and ruminating on how to speak my mind and heart, stand up for myself with certain kinds of people, and to truly get away from the competitive and possessive nature of many relationships. yesterday, i felt like a failure because he caught me so off guard that i could barely open my mouth. that's a problem with me in general. when and if i finally tell how i truly feel, people either completely ignore me or just attack, never trusting that what i'm saying might uh, actually be how i feel. genius.

while i work on these things, i can at least say this as rule number one:

no one will ever grab my pump off my body like that again.

yes, i cry a lot~

2009-11-08T10:46:00.001-08:00

only in front of my boyfriend and best friend, though. :)

this transition to the pump is overwhelming me. i am doing basal testing but ever since a couple of days ago, i've had mostly high BGs. we're talking even a 370. painful. my control was so tight before on mdi's. of course, i experienced more hypoglycemia due to stacking, so maybe i need to stop whining for a while until this all gets worked out.

i just wish i knew what to do. all i can do is get the basal rates down for now, i know. i need to stay focused on that, because surely it isn't the bolus i did for salad. but i worry that the whole 'the site can affect the absorption' thing people talk about is at fault here. god, i hope not. i only have so much subq fat. i'm a really small gal, so it's not like i can use the little bit of fat in my lower abdomen every.three.days. i have to go upwards a bit and i'm also using the bit by my hips (commonly known as love handles, of which i have none, LOL.) is the absorption really that different?

and man, am i hungry! this testing-requiring-fasting stuff is really hard when you hear your tummy growling. i can rarely go four hours without eating. boo.

i'm seeing my endo tomorrow, maybe we can just up the basal rate immediately due to these clearly out of control highs. i can barely stand it. sigh. the perfectionist in me.

on a positive note, matthew pointed out to me how well i adapt to things. it's only been a year and a half, and despite the (literal) blood, sweat and tears, i always keep on. i'm not afraid of change, that's for sure. at this point in my life especially, nothing shocks me anymore, LOL. much still surprises me; disappointment mixed with a whole lot of joy.

i also have two beautiful classical songs i downloaded that have harps and accordians and pianos and violins. they hint of sadness and hope intertwined as perfectly as i feel right now.

think i'll just keep it on repeat.

on babies and tangerines~

2009-11-04T15:44:00.000-08:00

so i had my preconception counseling appointment with the great and wonderful dr. larry leeman at university of new mexico's family medicine clinic. this guy is great. just scroll to the bottom of that link when you open it to find his impressive "about me" section.

if/when i get pregnant, i wouldn't be delivering at the wonderful midwifery practice. maybe someday they'll have step-down options for some type 1's. but the most important thing to me--that he be a compassionate, understanding, easygoing doc (and a little crunchy)--was all there today. he was really engaging and willing to work with me on so many levels. he was understanding of my anxiety of controlling my own disease, only to fear handing it over to a bunch of people i've never met. he was super excited to take me on as a future patient and just kept asking when are you guys getting pregnant?!

it's amazing to me, that statement.

so often, all we hear as type 1 women are the fear-mongering, overt, threatening gestures meant to warn (or ward off) our desires to get pregnant. it's not too often that people get this bright smile on their face and say, "good on you for being type 1 and trying to get pregnant!" ya right.

now i don't want to be too hard on people. all day, my docs have told me time and time again, how they deal with diabetics who refuse to do anything to even get a teeny tiny bit more in control. so it's understandable that it's hard for them to just adjust their attitude immediately upon meeting someone who really and truly owns their disease; treats it like a bad-neighbor-turned-best-barbq-buddy.

so i'm super excited. we've some time to go before we really start trying, but it takes a while to get everything in order, as anyone who's type 1 and had a bebe will tell you! he thinks (if all goes well with my disease) that we should be able to deliver naturally and he might let me go to 40 weeks. sigh. you know, it all depends on....waiting. in the moment. every moment.

which brings me to my final point: being in the moment. as thich nhat hanh said, "present moment, wonderful moment" with his meditation on the tangerine.

sounds cheesy, but it's basically this story of a person who gives this other person a sweet little tangerine as a gift. and it makes the person who receives it truly stop and think about the small, beautiful little gifts that life offers us, that we offer each other. gifts we so often ignore; gifts we so often scoff at because they seem insignificant.

melting down~

2009-11-03T07:00:00.000-08:00

so i had a melt down the first day i tried to change my site.

haha, go ahead and laugh.

it wasn't the insertion site, it was the fact that i couldn't draw up the insulin without matthew's help because the blue plunger thing on the cartridge is that hard to move without pulling it out. and the bubbles that resulted! oi!

i think that week just devolved for me, though. after my lovely little post below about my first day being great, i went on that night to get rear-ended by somebody at a red light. ya, red, i said! the next day my landlady suddenly had this burst of do-it-all-today energy, and i realized i had no test strips for my new meter.

hrmph. not a big deal, i know, but it kinda bummed me out i couldn't start using my one-touch til next week.

they say "when it rains, it pours" and that person wasn't kidding, eh? but a car accident? seriously, was that a necessary addition?

it's funny how the sky is certainly clearer after a good storm, though.

here's to hope and change.

ze pump is IN~

2009-10-29T14:59:00.001-07:00

this is my picture of me with my little green pump on the very first day.

sorry, i couldn't resist. ;)

and uh ya, the tegaderm is huge!

the cde is ordering some tiny tegaderms for me. she laughed and said, "clearly, we need a smaller tegaderm. you're so tiny!"

but it's all very exciting!

i only had a weeeeee bit of trouble getting the sticky-tape-hand-maneuver-hold-the-cannula-down-while-removing-the-needle part down, but i think it was just because i had two cde's and the pump trainer watching me (!) it was just like when i was a medic doing iv's...honestly, only smaller and kinder and not vein-oriented. and i liked the "tender" insertion set they ordered. it's just like the 'silhouette'.

so i went straight home to have some lunch and you wanna hear something funny? i actually had a moment where i started reaching for a needle and felt something along the lines of...anger? like, sigh, more injections. it was all very subconscious and momentary...so momentary. but the moment was certainly there! (so i guess i've been even more ready for this than i thought.)

then i grinned and reached for my pump.

to be sure i'll have days where i say this thing has got to go but it's so great to think that sometime in the near future i'll understand it, and we can start trying for a bebe next year!! [cross your fingers!]

it's been so frustrating the last couple of months, especially. my diet's pretty low-glycemic, so keeping-up-with-my-lentils had become a tortoise-and-the-hare kind of race. when's it coming? should i take more? should i have taken less? how much do i have left? am i going higher or lower?!

today my post-prandial was about 165. just yesterday i would've sat there pondering if i needed more insulin to fix it. today, i could look at my insulin-on-board still and know that another.whole.unit was still on its way.

the best part?

my a1c came back this morning at an even 6%.

i know i've got a learning curve ahead of that requires a lot of patience, but still:

it can only get better from here. ;)

natural, sugar free pancakes~

2009-10-24T16:08:00.000-07:00

so the other day we went to our local (no kidding, it really is locally-owned: yipeeeeee!) grocery store. i'm always willing to at least skim the nutritional information of [often so-called] sugar free products until i find my usual long list of disappointing ingredients to include but not limited to: maltitol, sucralose, soy protein, etc. more on my issues with these things later. but for now, the good news.

matthew (my partner) found this pancake mix. it's from "maple grove farms" and at first, i was like, yaaaaaaaaaa right! but like i said, i always obligingly look.

not bad at all: wheat gluten, corn starch, unbleached wheat flour, whey protein, leavening, salt, and 'natural flavor' (whatever the hell that means, right?)

so it comes out to about 2 small/medium pancakes a person with only about 8 carbs per pancake (you read that right). it says 'only 6 net carbs' because of the fiber subtraction, but we figured we made the pancakes a bit bigger. also, we like them very thin, so you may want to take that into account if you like thick 'cakes. by the way, no they do not taste like cardboard. matthew, my ever-honest-type 3-diabetic so kindly stated, "ya know, they taste just like whole-wheat pancakes!"

next time we're having the organic apple sausage from applegate farms, and voila! our breakfast will be gourmet stupendous!

but what about syrup, you ask?

well, first i must say i am appalled at the amount of carbohydrate in syrup; yes, even organic, all natural: 56 grams per 1/4 cup [scream!] pancakes are like, the out of the out breakfast option for me. adding even an 1/8 of a cup to already carb-coma-inducing pancakes sounds like pancreatic hell and i just can't justify putting peabody through that mess. think of your children, people! ;)

so we found a different option:

enter maple butter.

i found this stuff at the same grocer, it's from "shady maple farms". the best part is it's organic! and it's only about $3! it'll last forever too, because you barely need any. just be sure to put it on right when the pancake comes off the griddle or else it doesn't spread and melt as yummily.

mmmm, this stuff is amazing! for a big fat tablespoon, you get the same taste for 16 grams of carb. ok, i know it's not runny and fun like syrup, but the taste is swonderful and let me tell you, when you add up all the carbs you're eating: about 48 (2 pancakes, 1 Tbsp butter) instead of say, 100+, trust me: your pancreas will thank you.

the countdown~

2009-10-21T08:18:00.001-07:00

i know i keep going on and on simply about getting my pump...(just getting it!) but i can't help myself. THIS IS NUTS!

i'm actually getting it next thursday!

aaaaaaaaaaaaahhhhhhhhhhhhhhhhhhhhhhhhhhh!!!

i really have mixed emotions. and i know i keep saying that, too.

every time i see a person with one, my nerves are soothed. but the thought of it alone is like, what the hell am i doing?

i picture it as this HUGE THING attaching itself to MY ABDOMEN---maybe even talking and shit, like, "you will never be rid of me! i am going to grow too and take over your...elbows!"

[insert nervous hysterical laughter here.]

then i lighten up and realize my imagination has gone too far. again.

and yet, ironically, just as i am saying this, i've been having issues the last couple of weeks controlling my BG the way i usually can. it's not horrible, just averaging about 130, which is not great to me. i know, i know: COOL IT, birdy. a lot of it i've realized, is seasonal changes.

so i think about the pump as this tool that's going to help smooth out these rough edges i'm having. i know most of it is due to my not being able to do dual waves and extended bolusing. well, i try, but bolusing 3 units over a period of 5 hours is tedious, to say the least.

hey, it's green though and the hipness of that tiny fact comforts me. ;)

ze pump has entered ze building~

2009-10-16T13:48:00.000-07:00

or left the building.

that's animas' factory, i'm saying.

so my CDE wrote me and said they're tentatively looking at October 29th to start my training.

i'm kinda nervous, guys!

i think i just learn and practice in the first session, and then the next time we actually do the first insertion site.

for some reason, i'm starting to get all jittery about this again.

there's a part of me that wants to say,

ok, this has been REAL fun, but i uh, changed my mind.

i know, i know.

and then i think of how annoying it's been to inject myself 10, 000 times a day.

and how impossible it is to eat an avocado with a piece of toast. bad combo.

i need to remind myself that i am not alone. that my hopes are huge for this because it's leading me somewhere better, more comfortable, flexible, and certainly healthier for any future pregnancies...

on a positive note, my work with refugees at catholic charities is going awesome. today we did massage on them; such beautiful people. their essential needs are being met, but it is so nice to also offer them some peace, lavender oil, and compassionate human touch.

by the way~

2009-10-14T21:10:00.000-07:00

i have no idea what went wrong with the font in that post below!

see!

the proof is in the...yoghurt!!

some foods are so not peabody-friendly~

2009-10-14T21:01:00.000-07:00

i literally have a fight with my breakfast every morning.

my stomach screams HUNGRY!

my BG screams TAKE IT EASY, SISTA!

i'm lucky though, i don't struggle with dawn phenomenon. well, not really. as you all know, sometimes baby D loves to kick us in the pants, though.

it's like, HEY, GIMME A BREAK! I JUST WOKE UP!

anywho, my point is that i can't really eat a carb-heavy meal for breakfast because i will seriously pay for it around 10 o'clock with something in the oh, let's say...200's?

this means, all the pancakers, waffle-eaters, french-toast-fiends can kiss my little ass (this is all due to jealousy, of course).

well, i could just eat a waffle for lunch and then go for a hike, right? might not be a bad idea!

ah-hem:

like this morning. i tried yoghurt. again.

non-fat. cherry vanilla. 20 grams of carbs.

20 FLIPPIN' GRAMS OF CARBS, PEOPLE!

like clockwork (well, it is clockwork) two hours later, i check (sometimes earlier!):

221.

2-flippin'-21!!

what the heck is in this yoghurt?! straight glucose?

hello, i'm peabody the pancreas. i do not recognize insulin that wants to assist in the processing of yoghurt products currently at this time. please try again later.

thanks.

so i fix it.

but the problem is (i know, i knoooooow) i've got it down with having a small piece of fruit (peach, nectarine, grapes) and a handful of almonds. toast won't cut it, even oatmeal was too much for me. this is so weird!

2 units. 2 hours. perfect 100.

here's my problemo, chicos:

I AM SO SICK OF FRUIT AND ALMONDS FOR BREAKFAST!!

but then i think:

what about the third world?

those people don't complain about what they eat for breakfast everyday. i've met them. they don't even always get breakfast everyday! (i'm being serious here! so not funny!)

i'm thinking i'll give a boiled egg a try. i like boiled eggs. but i need a little carb to go with it! and fruit and eggs? bleh.

there goes my picky-american-type-1-but-more-than-surviving-and-thriving-mentality again.

akbar, our big reminder~

2009-09-28T09:51:00.000-07:00

meet akbar.

no, that's not his little brother lying next to him.

they're both newborns. ya, you read that right: newborns.
his name translates as The Great in arabic, apparently.

frankly, what happened to akbar is not so great.

in fact, it's every type 1's worst nightmare regarding pregnancy, and every type 1's reminder to keep their sugar in tight control.

unfortunately for akbar's mama, she developed gestational diabetes and didn't really have a choice in the matter. her BG was probably pretty out of control when she became pregnant and a gestational diabetic. akbar has macrosomia; which causes babies born to mothers with major hyperglycemic averages to be, ah-hem, larger than average.

what's the diff, you ask?

please click here if you don't know what gestational diabetes is. women with pre-existing type 1 diabetes with tight control do not develop gestational diabetes when they are pregnant. gestational is a whole other beast.

so how did akbar get so damn huge?

this was no 'freak accident'--- the way the media is trying to spin it; turning it into a sensationalist's dream joke.

more than likely, his mama did not have access to or understand her daily needs for insulin (because the oral meds used to maintain pancreatic efficiency are not safe for pregnancy) during her pregnancy, thus giving her daily high blood glucose. this in turn, causes growth hormone issues centered on insulin---i've even read that it causes the baby's pancreas to spill insulin too early on to cover mom's high plasma glucose. the result: ONE HUGE BABY.

this sucks. akbar's only issue for now is his macrosomia. however, he is now at greater risk for cardiovascular disease and type 2 diabetes, as early as age 15! this just makes me sad.

i want to make it clear that i am not making a judgement on akbar's mom. i'm putting this info out there because while he made the news for being "Akbar the Great" it infuriates me that health media is not using this as yet one more opportunity to discuss the serious risks that uncontrolled blood sugars pose in utero, let alone as a way to prevent women from entering their pregnancies obese---thus placing themselves at a huge risk for even developing gestational diabetes.

this kid's gonna have some major issues. this is not "great" and we shouldn't be making fun of him or his mom.

pumpin' it~

2009-09-21T18:52:00.000-07:00

i forgot to tell you all:

i'm going to get a pump!

i know, i know. i was soooooooo anti-pump. then again, give me a break. i've only had type 1 since 2008. things take a while to get used to! i have to say though, i think it was good that i really "learned" this disease by way of having to go through all the drawing-up/self-injecting/often spaced out into small multiple injections for certain [*ah-hem*] annoying foods. i really do understand more than i think i would have had i rushed into getting the pump too soon after diagnosis. it seems about a year or so later is a good time-frame to start shoppin'. as i said in that earlier post, it wasn't about vanity. it was deeper than that. as my type 1 friend alayna said, "it's ok in the end. but it's certainly weird to get used to wearing your pancreas on your britches!" ha!

so early this year i obsessively kept mulling over the pros and cons and really just kept getting stuck emotionally in the whole OHMYGODICAN'THAVESOMETHINGATTACHEDTOME issue.

ah-hem.

i can't tell you that anything particularly huge came over me, but i can say that this is just my nature. i'm a very gradual girl. i like to read, research, talk to people, think through it myself. look at lots of pictures, LOL. i hate being pushed into things. i'm definitely a think-for-yourself kind of person. god, and i am sooooooo insulin-sensitive. this one-shot-deal that lantus offers is not exercise friendly at all. it is getting really, really old.

it also helped to start researching pregnancy and type 1 heavily and realizing there was no way in hell i was gonna be able to have the control i currently have with injections during a pregnancy with injections. trust me. after reading all of the literature and research, it's crazy to try and manage type 1 with MDIs when we have pump technology with such minute, accurate dosing and wave patterns. i was like, what the hell was i caught up on?!

so i'm 98% positive i'm getting the animas ping. it seems to fit me the best and its little nuances are what are 'selling' me on it. although, i must say, it's been a tough pull between medtronic and animas. they both really seem to be great companies from what i keep hearing from 'pumpers'.

*i'd love to hear from you all about your pumps, how they changed your life, and what you like and don't like.

so i just wanted to put it out there that i'm super excited about it. i really am! it makes me so hopeful for my [possible] future as a healthy type 1 mama.

and guess what? because i'm a loud, silly, unabashedly au naturale type 1 gal:

i'm gonna get the green one.

a hard lesson~

2009-09-20T14:16:00.000-07:00

so i've been essentially going through what is known as "preconception counseling" so my honey and i can be in the best health possible before we uh, try to conceive. so i got my bloodwork done like a good girl which included about 15 tubes, a urinalysis, an ear swab and a fingernail sample. ok, i lied about the last two. but that's what it seemed like they were gonna do next. i was like, why don't you just do a body catheter and take whatever you want! haha.

so it all came back great.

ah-hem.

except my LDL (bad) cholesterol was like a normal human being's.

*sorry, diabetic friends. i couldn't resist. but you know the drill:

we have to be FREAKIN' AMAZING! we're diabetic! we're not normal! nothing about us is normal!

(by the way, this was all intensely discussed with grave concern (ie, you might have to go on a statin drug to get it down , WTF?!) in spite of the fact that my HDL (good) cholesterol was 'abnormally' high and my total cholesterol number was below average, i.e., meaning: MY HDL WAS A COMPENSATOR.

ya. i exercise and eat right (this is how you increase your HDL.) but no i don't scrape EVERY LITTLE SPECK of butter off my bread at the irish pub we like. would you like me to throw the foam off my cappuccino into the garbage, too, doc?

i must say, for such an elegantly chained molecule you see up there, that little guy can start some serious fights!

the American Diabetes Association loves us so much they expect us to keep our LDL cholesterol at or below the 'average' person's : 100 (god forbid mine was 115.) ok, i understand. we're special. we have a higher risk for heart disease. but we're also human and capable of maintaining our health. um, hello, i do that every day. and my A1c's 5.8%! so when you look at someone's lab results, you've gotta look at the person overall before trucking out the Big Pharma reps to pour pills down our throat. especially the wrong person's throat. that fat guy sitting next to me on the bus is at a way higher risk for heart disease than i am (not to mention type 2 diabetes...) i don't care what you say. i'm not gonna have cardiovascular problems just because i have type 1 diabetes. so how 'bout this to mess with your little med-school mind:

i could end up with heart disease if i choose not to take care of my diabetes.

i really hate how they never even try to talk nutrition or health, even with a super-health nut like me. it could go something like this:

emily, can you think of anything you might be eating too much of in the saturated fat group that might've increased your LDL?

my response could've then involved something like,

why yes, despite my tremendous intake of monounsaturated fat, i do enjoy coconut oil, if i do say so myself.

so then i could've admitted the only thing i could think of that might have increased the LDL: my slight addiction to coconut oil the last few months; which i did not know was such a bad saturated fat. i used it in my baking, especially. ok, i was going pretty overboard.

so we could've discussed eliminating it and checking back before pregnancy to see if any changes occurred. instead of always hailing some drug i'd have to go off of anyway (because it's not safe for pregnancy) as the savior to my fifteen-points-to-a-nondiabetic-status-freak-out-session.

so here's the dealio, folks:

OLIVE OIL, SAFFLOWER OIL, CANOLA OIL:

all are monounsaturated fats, excellent for cooking, what i usually use anyway...and try not to bake with coconut oil like i obsessively did. now i'm using safflower and canola for baking because olive oil is a bit too...let's call it too peppy for baking.

oh, and keep it ORGANIC ORGANIC ORGANIC.

note: you should know by now i'm not a doctor and you are absolutely stupid if your own bad cholesterol is dangerously high and you refuse to do anything about it through diet-change, drugs, or both.

so hello, i'm cutting out my beloved coconut oil, alright?! it's not like i have a reserved booth at mcdonald's.

however, i stand by the fact that coconut oil makes a very nice base for all natural sunscreen.

kelly has it DOWN~

2009-09-15T09:55:00.000-07:00

i love kelly kunik's type 1 blog.

pleasepleaseplease read this post by her. it is perfectly lovely and true in every way possible.

even though your pancreas is... misadventurous, know that you're doing your best, you matter, and there are many who love and understand what you deal with everyday in the DOC!

acupuncture~

2009-09-01T10:30:00.000-07:00

i've been really 'off the map' this summer.

i'll just state the facts:

i felt drained.

so lately i'd been really contemplating my emotional state with this disease and also many other futuristically-inclined thoughts...like fertility and children and type 1 diabetes and natural birth.

(ya, don't freak out. you must know by now i'm a healthnut, right?)

so i first started thinking about balance. (i'll get into what i'm learning about birth options/advocacy in other posts.) for now though, i felt like i lacked some of that good balance-stuff.

yesterday i saw an acupuncturist for the first time in a long while and while i found her to be a person unaware of what exactly type 1 is (autoimmune, here we go again) i think all of the meridian points she chose to address really did some good. my sugars are usually in good balance with a good A1c, but we all know that test is just a little bit problematic (standard deviation, anyone?)

but i've barely needed any insulin today. the only reason i think it's related to my appointment yesterday is that i usually need to start increasing my doses a bit as i head towards ovulation, and i'm not. it went down. weird. you can laugh if you want, but i think there's a direct correlation.

i actually saw her for stress and to just 'open' myself as we begin to try to start our family---in the next year. preparation. paranoia. preventive medicine. call it what you like, i just want to be the healthiest i can be when we go down that road.

i've always had a soft spot for chinese medicine ever since i took my first course in massage therapy school. it helped that it was taught by a super-genius-amazing-integrative DOM (doctor of oriental medicine.) she really had a way of explaining things from both the western and eastern perspectives. i still feel the memory of how that class blew me away, even with how much i've learned on my own since taking it. and it's still a profession i consider, even while being completely dependent upon western medicine---which i love and appreciate (thank you, frederick banting!) ah, the reality behind true integrative healthcare; what wonders it works! i'd love to be that person to people someday.

but for now, for the first time, i'm taking care of me. it's even hard for me to say those words. i feel selfish just saying them. but i know that i can't really help others if i'm not in a good place myself, and right now in my life i'm trying to address some of those deep desires (like children) and family (of my own, with no 'conditional love', like the family i was raised in) and making good, whole foods for those i love.

i guess what i'm trying to get at is, if you can do just some small, holistically focused health care for yourself, try it. get a massage--even if only once a month (i've plenty of clients who can only afford it this often) or a good belly-breathing session, or seeing an acupuncturist. it really makes you zone-in, instead of out, so that you can be introspective and slow down and balance out. your thoughts become clearer, and i promise it will even have wholesome physiological effects.

flipping it on its head~

2009-07-25T15:19:00.000-07:00

it's been a rough summer.

the last of my endogenous beta cell function is so officially gone now.

man, dawn phenomenon has been really, really fun. and of course, the cortisol i must be releasing due to taking over full-time summer classes has really helped the insulin resistance.

i know, i need to stop complaining. my everyday averages are still holding at what comes out to about 6.2% for my A1c, but you know how it goes when you see the averages increasing...increasing...increasing.

ugh.

this is not a very positive post!

but you know what?

on a positive note (LOL)

it really hit me this summer how much more aware of my body i am---in a way that most will never be:

diabetes teaches you when to say when.

and i used to live like that was a bad thing! it was always,

GO!

DON'T STOP!

WORK HARDER!

STUDY MORE!

STRESS MORE!

THINK MORE!

so sad!

and ya, it feels pretty pathetic sometimes to admit that this disease came into my life, affecting every thing i put into my mouth, every stresser i experience, every exercise activity i participate in...and more, but the truth is, i've learned to be kinder to myself. to be grateful for how much more i am aware of what goes into my body, what i allow to affect me, and in reality; just how far i can push myself in ways i never knew i could.

we live in a culture that does not know how to walk the fine line between being kind to oneself and pushing oneself. people seem to be one extreme or the other.

i think having diabetes has taught me how to walk this fine line i myself crossed one too many times before i got diagnosed. a sad way to learn, and man, did i learn it this summer!

i know it wasn't a punishment.

rather, i try to look at it as a very strange, serendipitous.... opportunity.

hit me today~

2009-07-16T10:34:00.000-07:00

that sometimes i just need to take my own damn advice.

end of story.

running with needles~

2009-07-09T20:27:00.000-07:00

someone asked me recently if i ever ask "why" and i said, "sure i do. all the time.

but there comes a point when you stop feeling sorry for yourself."

then today i asked why.

i looked at the big beautiful woman of a desert sky and i cried out as loud as my heart could scream,

WHY?! WHY ME?!

and you know what someone said to me today specifically?

"if it was anyone else it wouldn't have meant as much to them."

i felt a pang initially.

but he was right.

some of us type 1's certainly go down the road of anger and depression. i've met them. the resent oozes out of them.

but others are like light. they don't retreat. they smile and spread and share and have found a way to make it work. this doesn't mean they're the extroverted loud-mouthed funny guy everybody can't get enough of. the type 1....representative of all. nope.

they're just them, inspiring everybody around them in their very own way.

and i'm just me.

we all carry our story around. the one that describes the day we got diagnosed and how everything and nothing and everything in between...changed.

so i philosophize everyday the meaning of all of this.

i am a walking dichotomy.

it's so painful sometimes i can't breathe. especially when dealing with the diabetes police, the people who know nothing about type 1 autoimmune-based cause, and of course, you can't forget the ones who think you just ate too many skittles or something...ya, i didn't try hard enough.

but other times i am proud. proud of my ability to buck up. proud of my ability to rise above such an unforgiving process of day-to-day living. proud of who i am; who i've become.

you should know that even though you are one of the 3 million who have type 1 diabetes, you are one in 3 million.

your story matters. your story is your own.

you can still do it all and live the life of your dreams.

i'm attempting to continue that this summer. i try so hard it makes me cry. but dammit, i'm not giving up.

i'm gonna keep running, even with these damn needles.

adapting to change~

2009-06-13T21:48:00.000-07:00

so the seattle trip was a success. not a no-trouble-at-all-success, but a small victory in the sense that traveling (from my understanding) can be cause for anxiety for many type 1's. it became a metaphor for adapting to change!

and ya, it was rough at first. i had to manage some pretty bad morning highs (low 200's every morning i was there until the last day, actually) most likely due to lantus/novolog overlap issues...or, in all honesty, late night eating issues: i cannot eat very late at night and especially not dessert (boo!) unless i want my a.m reading to royally suck. and ya, we had a weird eating schedule (duh, vacation!) and enjoyed many a late-night italian cafe tiramisu, organic icecream with friends, and french dessert fixes to boot. oi!

my 30 day averages still managed to maintain at 117, but i think that's because the rest of the day i managed to just stay on top of it, and ya, try to eat as best as i could: lots of ethnic food was on our yummy-to-eat-list anyway, so that helped, considering the way most people in the rest of the world eat is uh, not the american way of eating...lol. but you know, it's hard. a lot of the fun of vacation is getting to try new desserts and food and just lazying off your regular schedule. so....

i posted this little image i found (courtesy of dreamwork.org) because i found it to be perfect as far as true adaptation goes. my little trip---only a few days, and west (which is the easier of the time changes on the blood glucose because you gain hours rather than losing them) was a good first lesson in how to what i would say initiate (attempt something such as a trip for learning) how to adapt in order to ultimately stabilize again. then, it all comes together so you feel braver, [somewhat] more spontaneous, and shall we say...normal (?!) i was so determined not to let myself get completely out of [glucose] control so i could literally stay feeling good, but also, so that i could actually enjoy the fun that vacationing brings...like lots of exercise and laughing and dancing and socializing. that's all good for the BG!! it hit me that everything in our lives always balances out in the end. my body truly was stabilizing by the 5th day we were there. and we were only there 5 days, so it got me thinking that sometimes all we really do need is time. i thought, "i know this in general in my life, why wasn't i willing to just apply it so easily here, too? i'm always saying to people, 'give it time'!"

time to plan it, initiate it, adapt to it, and stabilize...as we do every day, all day. we can do it! i feel i can take a trip anywhere now and know that all will eventually be well. we know it always is. it may take a little extra time and patience, but it doesn't have to stop you from say, kayaking. things might take a little extra monitoring, but to be sure, in a few days things will always work themselves out. i actually find it kinda funny that i still sometimes fear trusting this basic fact of life when it comes to my blood sugar.

even if i do the harder of the two time changes next time (go east, young woman with type 1 diabetes!) i know i'm now taking baby steps toward....someday going back to africa to continue community health work!!

cozying up to it~

2009-05-26T07:34:00.000-07:00

so much has kept me busy: i graduated with my BA, am moving on towards medicine, have been working like crazy---especially for our little trip to seattle this week (anyone up there wanna give me some fun ideas?) and have just been enjoying gardening, reading and relaxing.

it's amazing how taking my mind off my BG a bit has worked wonders for it! i think some of it is that i've finally 'plateaued' with it. not like i'm never going to struggle again, i just mean it's so weird how my 30 day averages seem to have just come down on their own because i slid off on logging every number, every dose. and i have to say, i haven't had too many bad numbers as a result. honestly though, i 've been lucky throughout this whole first-year-after-diagnosis; i bounced back and in control relatively quickly. but you all know the worrying that comes with dealing with t1 everyday...it can really begin to consume you if you're not careful. sigh. the fine line between tight control and being OCD about it, eh? lol.

guess i'm just saying that it's great to finally relax a bit. it's here to stay, but i'm healthier, more self-aware, more reflective in such a balanced way than i've ever been in my life. so strange! i can hardly describe it at times. it's like a strange blessing that arrived in an old beat up basket. instead of making me into a basket case though, i feel like it's turned into a beautiful little gift; a bit of that 'insider info' we all wish we could have in life sometimes. i think i've got some now and i'm at peace more than i've ever been.

herbalist class~

2009-05-09T07:57:00.000-07:00

i can't even begin to rave enough about my herbalist class. marylou singleton is one of the most dynamic, integrated, amazing women i have ever encountered. she's a complex pioneer, unafraid to mix the best of both worlds (allopathic, biophysical medicine, with traditional natural therapeutics approaches.) she's also got the greatest laugh, super contagious!

i'm learning so much in this course about the body; not only in healing the root cause of an illness, but also tonifying and rebalancing it.

it's made up of a group of ladies who all have different backgrounds and interests, but all of us have that one thing in common: we are fascinated by the healing properties of plants. also, we are learning about relationships with plants. i know some people might find this weird, but i was never taught to view the plant and animal world this way; and let me just say it is very moving and healing in itself. i see scarlet globemallow, mallow neglecta, and wild lettuce everyday on my way to the university and it's like, "hey you! just hanging out waiting to heal us!"

something about merely talking about plant medicine all these years bugged me, and so i've realized with this class that it was the missing relationships! when we took our first herb walk with supermarylou, everytime she showed us a new plant: valerian, clematis, rosehips, sweet sicily....this deep urge came over me to actually greet the plant. finally! nice to meet you! i've heard so much about you! hysterical!

i feel so blessed in my life right now. i'm graduating, i'm really healthy with my type 1, my garden's taken off, all of that joy that used to define me now defines me again, and now i'm developing healing relationships with other species (who are never malicious or twisted or have hidden agendas like some people i'm dealing with this year, ouch.)

now go munch on some lemonbalm!

we are giants~

2009-04-20T18:19:00.000-07:00

isaac newton said,

"if i have seen further, it is by standing on the shoulders of giants".

however, i say this:

you are the giant.

stand on your own, see for yourself. grow yourself into that giant.

it means no one carries you on their shoulders to see; it means your view will be that much more rewarding, because it will be your own.

your own hard fought views, your own hard fought truths. your own hard fought life.

it came to me today, when i read isaac's words:

i am a goddamned giant.

no one will take away my view of this beautiful world; demanding i see it only from theirs, subjecting myself, submitting myself, selling out to make someone feel better about their twisted, sorry self.

life is not a competition;

there are many cracks and crevasses up the mountain;

we each have our own side to climb.

when we finish, we can only sit and share our journey with one another.

on colds and eating clean~

2009-04-05T18:06:00.000-07:00

so i had a pretty bad cold this past week.

my first time 'officially being sick', since uh, GETTING type 1 last year, of course....

not too bad! i mean, other than the feeling of niagra falls being constipated inside my sinus cavity. but my neti pot took care of that.

but i was really nervous about being sick for the first time with type 1, to be sure it's much worse with the stomach flu (my poor type 1 friend, lisa!) because then you've actually got something really serious to worry about: ketoacidosis. however, dehydration and vomiting were not on my list of worries this time 'round, so thank goodness for that, eh?

however, since i've always eaten 'superclean' whenever i've gotten colds, this time was no different. but i definitely noticed something different: i got to see my blood sugars, right? and as this one doc said, "if there's any advice she can give to anybody (diabetic and nondiabetic alike) regarding health: keep the blood sugar in balance.

whew! i had no problems! and it's not because i ate like a rabbit. feed a cold, starve a fever, as they say, no?

well, i did eat a lot, but as i said, i ate really 'clean', as i call it: tons of veggies, broths, herb teas...and no dairy or refined sugar.

as we all well know though, you can't avoid the simple fact that all food, eventually (even a bit of that protein in your chicken) turns into glucose, or at least has an intimate relationship with it. because everything is about fuel; everything you eat is about energy, and that energy is all about glucose.

but wow, i gotta tell ya, really taking that extra precaution, really taking care to avoid the junky-junk... was simply amazing for my blood sugar!

by the way, 'the nourishing gourmet' offers sound advice we could all use regarding health and hydration during a bad cold...not just for kids. superb broths!

of course, it's hard. (it's not like i'm headed to raw-foodie land, friends). and not because i'm some kind of refined-sugar-dairy-frappacino-fried-food-addict. it's just the idea of leeway, right? because i had that cold, i didn't feel a lot of leeway simply because i felt ill. i wanted only herb tea and fresh greens and soups and lean meats. but now...sigh. now i'm back to craving some hazelnut coffee in the morning. now i want some cookies. (even if they are 'organic'---what does that mean, anyway?!)

but that cold really put my overall health into perspective.

and i always think i eat so well. people always tell me how amazed they are at how well i eat.

it makes me laugh, because as my honey's mom said:

"there's no such thing as a 'diabetes diet', there is only a 'healthy diet', and we should all be on it!"

so true! certain fats, sugars, and forms of cooking should really be viewed as treats (or cut out completely, oi!) because the inevitable spike in BG a person experiences, is just not worth the stress caused in trying to 'keep up' when eating foods like that. there are so many other options!

so, i learned something new. not new, something was just... reinforced. we'll see how long my 'lesson' lasts, eh? haha, i'll be honest and tell you i had some chocolate coconut milk ice cream after dinner tonight and it was damn good. (better than regular ice cream, right? by the way, you should try it...super yummy!)

ultimately, what i'm trying to say is that i agree with good ole' michael pollan:

"eat real food. not too much. mostly plants!"

i'm fighting the pump~

2009-03-30T13:21:00.000-07:00

i know, everyone tells me "once you get on the pump, you'll wonder how you ever lived without it."

but to be hooked up like that picture you see there....i'm not there yet.

ya, it's not that bad, but to me, it's that bad:

cyborgish, in a sense. that's how much i shut down when it's suggested by my endo and my cde.

in medtronic and animas' ads they're all like, "on one side you've got your pump infusing insulin, on the other, you've got your continuous glucose monitor checking your blood sugar every minute." hmmm, not so much, i say. sorry, just not feeling the "excitement!!"

but this technology that would be attached to me (helping me no doubt)...i'm still not ready for it.

and believe me, this has nothing to do with vanity.

to be honest, i'm not having any real problems: my last A1c was great, i manage my highs and lows well. but i've gotta tell ya, exercising and eating certain foods and the monitoring that goes with staying on top of that is certainly frustrating. but i'm fighting the pump because like Dee, my sweet diabetes educator said, "when you go on the pump, i think that's when it really hits you that you've got it." on some level, i'm still associating the pump with imprisonment by my disease, and yet all the info out there---including from members of the online diabetes community---say it's what frees you.

but i'm not there yet.

someday, to be sure, i will be. i've always been a gal who adapts well: i take my time, think things through, really ruminate my thoughts and feelings. never been rushed or easily pressured. i just do my thing. because when i make a decision, i am strong and devoted to giving it my best shot. and honestly, that's all that's going on here.

so for now, it's just me and peabody and my needles and insulin vials, without any other friends along for the uh, already crazy ride.

on spring lettuce and herbs and pistachio pudding~

2009-03-19T12:54:00.000-07:00

after my somewhat melancholic type 1 first anniversary---i can't lie, i indeed moped around a bit the early part of the day. it didn't help that the weather was windy and sullen; so i let myself feel it, take it in, chew on it...and then i proceeded to spit the sadness out as the day went on because i realized (i know, i know: i'm forever going on about finding joy and laughter despite disease...and any disease, not just mine!) that well, i'm alive. maybe it's stupid that i like to think about this fact most of us take for granted, but i sure as hell don't. i was raised in a way that made one feel that we should really be more concerned with what happens after life. as far as i'm concerned, this is it, i'm loving it, and no one will ever be able to prove anything different to me because, well, you're not dead yet, either. so let's stop with the bullshit and start skipping.

that was right about when i took my too-sad-to-smile-photo you see here and moved on. i then began to think about my urban spring garden that will be full of container pots: lettuces, arugula (mmm, spicy!) gorgeous japanese eggplants, cherry tomatoes, cukes, and drying herbs in my new little shed in the fall after taking my awesome community herbalist class with ms. mary lou singleton this spring. she was a student of the incredible michael moore (uh no, not the director.) he just passed away, so mary lou is kindly sharing his anarcho-herbalism philosophy of medicinal botanicals with the world...well, albuquerque. i'm so lucky!

then i started craving pistachio pudding.

(ya, this post is officially tangential.)

so i found an amazing homemade recipe for it on this gal's super blog. i adjusted it a bit, of course due to sugar content:

-you can substitute agave nectar -about 1/2c to 1c due to its naturally intense sweetness (which comes out to 48-128 carbs for the total recipe.) divided by the 4 servings, that's 12-32 carbs per serving, depending on how much you add. basically, it's 8 carbs per tablespoon, so just multiply.

-erythritol; cup for cup. (you'll have to order it online; i like the company 'NOW'.) but since my palate is healthily changed to no longer crave/like/need too much sweetness (hand over the turkish coffee!) i always eyeball it lower. remember, erythritol has been shown to have no impact on blood sugar (and i use it all the time so i can tell you: it's the truth!) i think it's pretty sweet, so don't overdo it in my humble birdy opinion.

-instead of milk, you can use unsweetened almond milk. if you use the unsweetened vanilla almond milk, you do not need as much of your choice sweetener!

and there you will have a super snack, homemade so you know exactly what's in it and therefore exactly how much insulin to take. the best part though is that it's really good for you and your friends, too!

oh ya, and i have the most amazing friends (they are what i call "my family tribe".) on my type 1 anniversary they held a surprise party where we all confused the waitress with our talk of 'peabody crapping out' cried and laughed and giggled and ate cheesecake. the best part though of course, was feeling so loved and accepted by such amazing people...

poetry: ahora vivo! (now i live!)

2009-03-03T21:44:00.000-08:00

now i live because this week last year i almost died.

now i live because on march 6th 2008 i finally stopped being stubborn and went to the student health center.

now i live because i was given what my body could no longer make for itself: insulin.

now i live because my life is not promised to me everyday, it is injected if only i choose to make that commitment every single day.

now i live because i am surrounded by deeper friendships, new friendships, and rekindled friendships that have all rejuvenated me.

now i live because my life has deeper meanings than i could have ever imagined; meanings that drive and inspire me to re-evaluate my life and be as strong and yet as flexible as the trees.

now i live because i want to, not because i have to, or because i take waking up every morning for granted.

now i live because for the first time in my life, i'm aware of my age. i am turning 29, and i feel it in my back, my right knee, my left ankle.

but now i live. now i live because i still walk and breathe and talk and laugh and eat and love and cry and take care of myself. type 1 diabetes has not incapacitated me so much that i cannot still work towards studying medicine so that i can help take care of others.

"to whom much is given, much is expected."

open up wide~

2009-02-16T16:59:00.000-08:00

whew! i am seriously starting to get overwhelmed with trying to make a decision about what to do after i graduate in may. i have so many options, which i am trying to view as a positive thing; it would be really snobby of me not to acknowledge the fact that having my bachelor's is opening up a lot of roads for me, regardless of however i might feel about those roads.

sigh, "the road not taken", right?

such as:

-i could do grad school in community health. this is a nice option considering how much i loved doing it in africa; let alone the possibilities regarding disease management model design, educating marginalized communities to empower themselves....however, it will take almost 3 years; therefore pulling me away from my true love (sorry, matthew): clinical medicine. hands on, people!

-matt's mom suggested grad school in social work. this was actually appealing because it really is hands-on in that i could work in a hospital, helping families in emotionally and financially difficult situations to access the proper networks and resources. however, it also would take 3 years (i'm trying to plan for a kid, people!!) be entirely full-time, and again: it's still not treatment based; i really like medicine!!

-the 'nurse to doctorate in family medicine' track. this one seems to appeal to me the most because i could take the fast track to a second bachelor's (in nursing, of course, but wow! the advisor informed me it would only take me a bit over a year! ah-hem, this is all because i took the entire pre-med track, arrrrrgh!) then i could just apply to the schools i like that carry the doctorate for family nurse practitioners after we start a little fam-fam. oi! but here's a problem: how will i continue in my love of natural therapeutics studies? i guess there's always ceu's....

but bend-bend-bendable birdy! i always find a way, since i'm self-taught in most things au naturale medecine, haha.

i have no idea why i just blogged about this, lol. maybe because it's why i've not been an 'interesting blogger' of late. gosh, in this economy, with this disease, with these academic concerns...i know i'm not the only one! i know i could do a multitude of things and be happy; that's just the kind of person i am. i don't complain a lot, i love people, and i love to learn. i do hate being bored, being around overly negative people that have no reason to be, and not feeling like i'm doing something meaningful. that's why i like medicine so much: you get to be really present to people.

but it's been hard this year, i won't lie. i'm so glad i've learned to become a tree the last few years; we really are meant to be like them: strong but swaying. having to truly learn the art of flexibility and compromise...all while finding a way to stay true to professional and personal goals. it was nice to find out before going to med school this fall though, as that would've royally sucked ass to have to be making decisions like, "should i stay or should i go? all the while thinking, 'jesus h.christ, do you even know how hard i worked to get here?!"

now i'm happy to just be re-thinking and re-organizing my life so that i can do everything like having kids, managing my type 1, studying medicine, and still make time for travel, humanitarian work, language studies, dancing, and learning the harmonica!

surge~

2009-02-11T18:11:00.000-08:00

well, i had to increase my lantus (long-acting insulin dose you take once a day) dose. it mimics the human body's basal (base-line release every body does with insulin) quite well. i'm lucky, cos i have a friend who did not respond to lantus at all.

sigh.

here i am, under the full realization that i was truly honeymooning (my pancreas was still releasing its last bit of insulin for me) over the last year. i won't lie, it's hard watching an organ lose function. maybe i'm just emotional right now for other reasons, but i really do get teary-eyed sometimes! it's like, "cut it out!" i haven't enjoyed watching my pancreas slowly 'die'; of course it's not dying, peabody's just.....not functional.

but what does that mean? functional. it's a word we americans use a lot, no? overall, i am functional. i am a functioning member of society. i have functional relationships with some people; and dysfunctional relationships with others.

my immune system does not have a functional relationship with my pancreas.

it really is an emotional time, to have to increase doses, to correct highs and lows, to acknowledge that for instance, the 90 you went into a lecture hall with may leave you at 150 simply because you had to give a nerve-wracking presentation to your colleagues. ah, the things we type 1's get to see happening in ourselves.

whatever the case, i increased my lantus dose last night and woke up to an excellent morning sugar; my first good one in a couple of weeks, really. the day's numbers went well, too. funny, i am eternally grateful for the discovery and use of insulin, but that 1 unit dose increase...man, it's just gets to me because of how deep it hits, how much of a painful reminder it can be that...i am now my pancreas.

sometimes it's the brush with death that brings you back to life~

2009-02-04T21:18:00.000-08:00

just read an article that moved me. i want to share it with you because it moved me ohsomuch.

i think the best part is when they actually get into how people with chronic disease "have a close brush with their own mortality, and sometimes experience a reaction akin to separation anxiety. a separation that in this case, is from life".

the article is very moving in that it tells us how often people 'wake up' up because of their brush with death and begin to do things they never thought they could do, try being the healthiest person they ever imagined.

i mean, eh, we can all do better. but i've mentioned before how type 1 can 'wake a person up' (or whatever your experience is that wakes you up, for that matter) but it's always inspiring to read of someone with brain cancer who figures they can just... keep kickin'.

fat and fiber~

2009-02-04T18:32:00.000-08:00

fiber and good fats, that is!

i was talking with a friend today about how magnificent fiber has been for me. ya, while JAMA came out with a new study showing that (in type II) low glycemic index foods may be better on the blood glucose than high fiber (cereal, that is). i can't help this (sorry): yo, guys at JAMA:

any type 1 coulda told you that, like, duh.

i'm sorry, did that sound arrogant?!

who reading this ever had good luck with cereal? i couldn't eat that crap (even "high fiber") even before i got type 1!!! ahhhhhhhh!!! and where is all this money going for research?!

anywho, back to what i was saying about fat and fiber. this conversation was brought about all because i'd had some peas for the first time in like, forever. and damn, they were good! yaya, i know you Bernstein freaks are like, "but that's a starchy vegetable!" but let me tell you, just because with peas and corn you've got to take your insulin does not mean you're getting a pure sugar. take the numbers i got from my handy nutritional info on the back of those happy little peas:

12 grams carb for 1/4 cup

5 grams fiber and man! 6 grams of protein!

what's all this mean?! it means that you're gonna burn those little peas til the cows come home!

i had such a great experience eating peas the other night, they were filling and yummy (made them with some smoked pepper and fresh garlic) and voila! what a tasty and fibrous side!

of course you want to know:

yes, my sugar did excelente.

by the way, my new diabetes educator (i love you, dee!) gave me the best advice since making my new forced-friend: with high fat and fiber (cheese, avocado, berries, nuts, dark chocolate, ice cream, pure yogurt...can you tell i eat mediterranean?) take your whole insulin dose for it after you eat.

WTF?!

you heard that right: after.

now, i must say that i don't like standardized diabetes advice, so i tell you that heavily insisting you experiment for yourself like i did. but manohmanohmanohman (as my little 2 year old buddy ethan says)

i'm doing great with this new way. my insulin actually gets the chance to catch up with the processing carbohydrate after the fat or fiber's made it's way through my tummy, and i am on the road to an excellent post meal number. [insert kiss to malfunctioned peabody here.] this is way better than what was happening before when i'd even split my dose in half as a little before, a little after: halfway through my meal i'd be getting horribly low because the fat or fiber was holding things up, then keep crashing even after finishing, fix that uh, 42, and ta-da: 220 in an hour! and all because by the time the actual carb made it's way through, there was no longer any insulin available to cover it. fun!

i want a functioning pancreas! hey, i want a non-confused immune system!

ya, i know you love it too.

and it all started because of an avocado!

figuring out this biochemical pathway is my new jesus.

sigh.

i do take a teeny tiny bit of my dose before just to get things going, but what i'm actually trying to cover---the carbohydrate within the berries or icecream or cheese or avocado on the salad or sandwich...i take that dose after.

either way, it's good to slow down some of that carbohydrate, even when it's wholesproutedgrainorganicnosugarunrefined...bread. it's still not a seed on a stem growin' in some field-o-wheat, right?

much ado about nothing~

2009-01-23T22:19:00.000-08:00

type 1 has really taught me a lot about stress. i thought i'd developed some good stress relievers in my life, but whew! to have this strange (somewhat ridiculous) window into my bodily function...man, it'll either help or hinder, eh? i mean, it's like, "wow! this could really educate me!" some of my closest friends are naturally curious about their blood sugar now that they have a full-on practitioner of blood-letting around them all the time. but sure, we check it, i get to steam for a few minutes about their perfect 90 right after they ate a bag of m&m's, and voila! they get to see how awesome it is to have a working pancreas.

but i digress.

no, really, it is an interesting window we type 1's have. however, insulin resistance is no fun. i was all upset the other day because i've been having to do my yoga in my room because, for various strange reasons that i will not get into, i cannot do it like a normal person in my own living room. i kept nearly hitting my feet on bookshelves and the ceiling fan (no, i am not that tall, but you know how you act even when you think you might hit your foot on something.) anyway, i was all upset and telling my friend about my higher sugars and terrible crashes and my stress with this current non-living room yoga- too many people in my house (wink, wink) situation. i think her response really summed it up for me that day:

"you're stressed and now you're resisting your insulin and now you're getting stressed about getting stressed and resisting your insulin even more."

great.

but i daresay, the girl has a point. she basically said to me, "you're stressed about getting stressed!"

i'm-a-tryin' here, people! it is so hard, though, i won't lie. i am as healthy as they come, my docs tell me. i get crap all of the time for "how tight i'm trying to keep it"....but i must tell you, stress is, and always has been my enemy. i used to go-go-go, live on adrenaline (i was a military medic) and love complex classes, books, and being outside. believe it or not, i've actually become quite even-keeled the last few years, so thank god i've learned to manage it.

plus, i despise drama. just freakin' say what you're trying to say to me. heck, even yell or spit. but, the second you expect me to read your mind or put up with moody crap, i'm over and out. just trying to stay conversationally afloat here.

but none of this changes my initial reaction. i still become a temporary mess. so anywho, i guess i'm just trying to get it out there that i'm frustrated this week that all of my stress-reduction habits have not really reduced anything; i've actually only seen an increase---in my averages! now, they're not horrible, but okay, okay. i'm a bit of a perfectionist with this beast, and get mad when it shows anything greater than a thirty day 120 average on my monitor....

shoot me now, you're thinking, eh?

ya, littlebird's got a lot to learn.

miracle pasta~

2009-01-21T07:16:00.000-08:00

ok, not really. when you really want that 'pasta-y' bite but maybe (like me) you can no longer really handle a good bit of pasta without your blood sugar going through the roof.... (rolling drum)

enter the shiratake noodle.

2 grams of carbohydrate (you read that right.)

blood sugar balancing (read on.)

now, when you click this link, don't freak on me and say ohmygoshyou'reintolowcarbdieting?!

nonono, but aren't we all at least into lower/slower burning carbs a little? haha. no, they are not an atkins-approach (ie, low carb/high protein.) they'll go easy on the kidneys because they are pretty veggie based; unlike those stupid "jerusalem artichoke" pastas you see at whole foods markets (notice the first ingredient is...you guessed it! wheat! artichoke pasta my ass!)

anywho my friends, i think these noodles are pretty impressive. i've used them a couple of times now, and am sharing them as a gift to my bestie type 1 gal (big shout out to lovely lady lisa!) they're also pretty cheap, easy to make on the fly, and can be used in a variety of ways: noodle dishes, desserts, salads....

they kind of remind me how tofu can be used, but...taste better to some people who may not like tofu's taste and/or texture.

when i was researching them more for my friend, i just had to post because of this simple fact:

they're full of fiber!

wikipedia kindly informed that the fiber is glucomannan, which is "40% of the dry weight of the konjac plant."

nice.

the real sucker punch: being diagnosed as an adult~

2009-01-19T07:43:00.000-08:00

i randomly found this article on about.com's site regarding adult-onset type 1 diabetes. it's not magnificent, but it's comforting that someone out there felt it important enough to talk about the topic.

i was diagnosed last year (2008) on march 6th. i'm not sure how i'll feel as my anniversary gets closer. i tend to think that people who get diagnosed as adults do feel quite differently about it than people diagnosed as kids. i'm not at all downplaying the emotions any of us feel having type 1, but there's a level of 'this is just the way it is' in people diagnosed as kids that i meet that isn't there as deeply in those diagnosed as adults. hmm, perhaps a better, more honest word is....

denial.

yes, i think that while i jumped on it right away (ie, going from an at-the-time-of-diagnosis A1c of 15 to two months later of 7, only to then drop it below 6%) and just caring enough to understand it was not a disease to be 'played with', i still believed (and sometimes still do) that it's kind of unreal, kind of temporary ("there's a cure just around the corner!") like i'm working towards something, you know?

now, i still take my insulin religiously and feel that my diagnosis has, strangely enough (and you may not believe this) given me a deeper sense of joy for this life that i only thought was possible. it gives you a sense of 'present moment, wonderful moment' (tich nat han); a sense of mortality that utterly transforms you in the best way possible---if you let it.

but that still doesn't change the weird sensation that something is...off. what to do with all of the memories without type 1? super-pragmatics will just tell you to 'get over yourself, you're still you.' but they're not getting the whole oddity of being diagnosed as an adult, are they? it's not that i'm bitter (i just told you i feel joyful!) but it does mean you have a conciousness about the disease that is quite different from 'normal memories'---the kind lumped into the 'just another childhood memory' category---even if it's bad.

perhaps what i am trying to say is that we do indeed have a resilience to even some of the worst experiences a life can have when we are children. in fact, i will tell you that in my community health work in africa, i worked with some people who specialized in child-soldier counseling. their studies were currently showing that the children had the ability to 'bounce back' much better than the adult mercenaries. controversial finding, huh? goes against what we often believe---save the children! at the time they were struggling with the issue of how to [possibly] suggest that some of the child-counseling funding might be transferred for more of the adult needs, as they did not transition and adjust as well; let alone get the same funding to assist with that. because they were adults, it was assumed they had the coping skills to deal with what had happened. it was assumed they understood how to 'get over it.' on some level, it is the naive belief that adults are not...vulnerable.

i am certainly not suggesting that getting diagnosed with type 1 is anywhere near to being a child soldier. i am strictly commenting on the basic psychological adaptation skills that kiddos have compared to adults. but do you see what i am getting at? life changes us enough, and when the only [physical] life you've ever known is drastically transformed into something completely new, it's a real double whammy.

perhaps i am starting to sound depressed. believe me, i'm not. i'm just putting it out there that adults, it seems, tend to think [perhaps too much] about being type 1, about the meaning of being type 1, about how to be type 1 without acting type 1....diabetic. i do prefer what some woman said in an article once:

i don't tell people i'm a type 1 diabetic. i say i am a woman living with type 1 diabetes.

spoken like an adult who has thought through her feelings on the matter.

summing up my thoughts on gaza~

2009-01-13T08:27:00.001-08:00

we're all GAZA
Originally uploaded by ahmed the egyptian"

An excerpt from editor, social justice activist, and truth speaker, Kevin Clarke:

"In justifying the incursion and attempting to rationalize its murderous impact on Gaza citizens, commentators have noted that other civilian populations in the past have been treated brutally because of actions of their government and note Nagasaki, Hiroshima, Tokyo, Berlin, and Dresden as examples, following a "total war" argument that basically runs 'since the Palestinians elected Hamas they share responsibility for Hamas and essentially now are getting what they deserve.' This argument seems pathologically indifferent to the suffering of others. The 135 (more now certainly) children killed so far didn't vote for anybody. I certainly agree it is historical fact that noncombatants often pay a heavy price for the actions of their leaders. I don't agree that this is a historical precedent worth emulating if humankind seriously presumes anything like progress toward more civilization and not more barbarity."

welcome to your new life~

2009-01-12T19:41:00.000-08:00

my life everyday, as i now know it.

i am my pancreas.

i use syringes and meters and finger sticks and sugar alcohols and all of this goes in my hip little indie bag.

call me what you will, an insulin junkie, an involuntary addict of sorts, but i think and live and survive everyday by being my own doctor, mathematician, nutritionist, dietician, gourmet chef, and counselor.

as my endocrinologist put it, "my job is only to help you see the forest from the trees."

and, WTF? life coach? who the hell needs a life coach?

ask a type 1 diabetic how they get through everyday, still laughing, studying, dreaming, hiking, working, running, cooking, despite all of the worrying, and you will realize you are the only 'life coach' you will ever know.

poor peabody's downward spiral started around this time last year, and i made it all the way 'til march 6 (thanks, buddy) until i absolutely could not go on...unless i wanted to end up in a temporary coma, eh?

but you know what? i'm loving my life in ways i cannot fully express yet. oh, it's coming though. it's seeping onto the pages of my green notebooks again, onto my stickered-up laptop you see up there, and my composition books full of messy notes and critiques and essays and thoughts. it's coming back through my camera. i see the world in a whole new light.

i'm. still. flying.

no one can stop you;

take flight!

check out my flickr account!

2009-01-12T07:50:00.000-08:00

am i being exhibitionist? hopefully not.

however, i just got my flickr account more organized: my africa photos are better categorized, and so are the [few] photos i took over the summer.

*ahem* about this summer. i think i fell off artistically, so to speak, because i spent so much more time journaling the hell outta my new type 1 diagnosis, and just trying to enjoy being outside and loving my honey and friends.

www. flickr.com/photos/birdoctober/

enjoy as they come, it's just one more resolution (*winkwink*) to keep my photostreams going!

healthy, savory snacks and treats~

2009-01-10T21:44:00.000-08:00

whew! i haven't posted in a while! sorry folks, life just got sooooo hectic, what with dealing with the acquaintance i have staying while he gets on his feet again.

i wanted to share with you a few of the things that have been keeping me going, as one of my kind of 'understood' resolutions is to [continue] eating the most whole, low glycemic foods as possible; and better than that, find wonderful and nourishing things that anyone can really enjoy.

note: anyone, not just type 1 diabetics can(and should!) enjoy these as they are all low glycemic, high fiber and au naturale. some studies i read recently are actually showing that low glycemic may have more of an important impact than merely looking at high fiber and leaving it at that:

apple flax meal muffins.

worth a measly 8 grams of carbohydrate, these pack quite the fiber punch (5 grams!) i enjoyed these all week, finding i barely needed a morning dose of insulin. i will provide the recipe when i get it perfected, as it is adjusted from one i got from the low carb diet on about.com. the problem is that the author of that site is promoting a lot of splenda and weight loss and often 'weird' carbohydrate alternative-eating, in my humble little type 1 opinion. i understand people have a hard time, i just feel like there are ways to adjust recipes to be simply more slow-burning and naturally sweetened than to take the over-processed, unnatural route. low carb is great, but slow-burning carb makes it even better; hence flax meal and....

coconut flour and berry muffins.

again, i'll provide the recipe later, but wow! so yummy and they've got that heaviness that i think often comes with why you crave such a 'treat'. however, again, they're worth very little in carbohydrate and yet are full of good carbs and fiber and taste good with a dark chocolate drizzle, so can be 'transformed' into a mid-afternoon or evening dessert!

straight and pure coconut milk splashed onto berries.

i love this so much! i've been eating it for breakfast, for snacks, for dessert! seriously, just buy pure coconut milk in the can, chill it if you can (because it'll thicken nicely in my opinion), pop that top and voila! you've the most lovely little treat your heart desires! (that is, if you're into coconut...)

chocolate almond milk cocoa, with cardamom.

this has been a great treat for me. if you buy unsweetened chocolate almond milk and find you just must sweeten it, use erythritol, which i've found has no effect on blood sugar whatsoever (they aren't lyin'!) however, i think it can stand on its own feet at 2 grams of carbohydrate per cup. then, once you've added the cardamom (a wonderfully warm and sensual spice from a pod, often used to treat broken hearts) you have a winter drink sure to make you cosy up with your [hopeful] honey or... a good book (if you're getting over a broken heart.) :)