Recent Flight

I traveled very early on Wednesday morning to California for my two week vacation. I have been needing some time away from work after all the months of overtime and I know Duchess needed a break as well.  When we are traveling we never know what we are going to encounter. My trip started off smoothly. I noticed while waiting to get on my flight a woman with her pet outside of the carrier it was supposed to be in. I used to travel with my Jack Russel Terrier Jilly on occasion but I always kept my dog in the carrier out of respect for other people. This woman was sitting right across from Duchess ans I had a feeling this is not the last I would see of the dog. Sure enough the woman in mid flight decided that she could take her dog out and hold her but thankfully the flight attendant noticed and took action. The flight attendant told her that she was being disrespectful because of the service dog that was on board. She politely mentioned that she could be distracting a service dog who had a very important job.

Even before we left on our flight we ran into a police dog who was moving around the gates. I have never been prouder of Duchess because the police dog was distracted but Duchess was spot on. She paid no attention to its presence and laid perfectly still at my feet. She also meet another service dog when we arrived in San Jose. This service dog saw Duchess and started to pull on the leash and was trying to move toward Duchess. Duchess again sat down next to me and was so focused on her job she did not even seem to see him. She stayed incredibly focused on task during our trip so far. She even did a night alert last night which is wonderful traveling tends to make a mess of my blood sugars. I was spiking up and down a couple of time during the day which I was not too surprised at. I was so incredibly thankful that I had not problem waking up for my early morning flight. I know the past couple of weeks I had issues with getting up on time to work because of bad lows. I am feeling so relaxed on my second day of vacation. I am really enjoying my trip to Sonoma and San Francisco. The weather has been really nice and the ability to sleep in has been very much enjoyed so far.

Feeling Rather Silly and Forgetful

I am still astonished that I forgot. Yesterday was a really busy day and I was getting ready to leave work my pump sounded off that I had only ten units left in my pump. I did have insulin and new cartridge with me but I knew I had to catch my bus. I figured I could wait till I got home. I got home later than I was planning and had to be some where pretty quickly. So I forgot to refill my cartridge at that point. I figured I would refill it before dinner but dinner came and went. I got busy packing my suit case and finishing up things for my trip that I forgot to get to changing the cartridge. I went to bed last night completely forgetting about the alarm at almost 5pm yesterday. I was sound asleep when I awoke and looked at my Dexcom I was 225 and with an up arrow then I hear my pump sound empty cartridge flashing at me. At that moment I was like what was I thinking I normally really great at changing it out promptly but sadly not yesterday.

I could really tell I was in the two hundred range and I really just wanted to go back to sleep but when I am high I normally have issues trying to sleep. Looking at the Dexcom I missed the first couple of alarms that I was high for almost an hour and a half but thankfully I was able to get my blood sugar heading back down pretty promptly I was reminded yesterday of the importance of not putting off refilling my cartridge because life can get in the way at times. I am usually on top of things but when I am getting ready for a flight I can get pretty concentrated on the task and miss such an important thing. I know this morning I feel completely silly because I missed such a key thing. The good thing is I had a good reminder of the fact that when the cartridge is low warning goes off I need to attend to it as quickly as possible.

Coverage Changes for Prescriptions

I recently got notification from my pharmacy benefit that they will no longer be covering my Novolog insulin. I am really surprised by this considering that Novolog is cheaper than Humalog Insulin. I know my copy is the same but I was really surprised by all the changes I was notified about. They will now only cover One Touch test strips and not cover at all the other brands of test strips as well. They even cut a larger amount of the type 2 Diabetes drugs they cover down to only a few. I know for me when I had pump site issues part of the issue for me was I had been on Humalog for way too long and it was not as affective. So I am really worried about what I am going to do when the Insulin I am doing well on is no longer covered. I find all these changes in my coverages frustrating because they really leave me without choices in the Diabetic products I am able to use.

Thankfully my One Touch Ping does use One Touch test strips and so will the Verio IQ which is covered thankfully. If I was using Medtronic the Bayer test strips would not be covered or the Ominipod the freestyle test strips would not be covered either. So that really limits what options the patients have. I am not sure why the dramatic cuts but the most interesting part of the changes the insurance only covers the most expensive brands. The copay is the same currently regardless of the brand and you would think the insurance company would want the cheaper version of the products covered. I have a feeling they have contracts with certain companies to only cover those products. I am incredibly frustrated this year first by them refusing to cover the 600 test strips a month I need and the having to wait for an approval for the year to get that many test strips and the sad part is that because of my EMS history is the only reason I get the number I am requesting.

I am really hoping they don't have any more big changes because just trying to fill a prescription has become such a chore at this point. Thankfully when I reordered more test strips recently the order came through without issue. I am not a fan of the lets limit the testing as much as possible plan because that increases the odds of complications. I already have some and I am trying to keep things as controlled as possible but with the insurance company not covering much of anything my goal to keep myself healthy will become increasingly difficult.

Trouble On Tuesday

On Tuesday of this week I was late again to work because of a bad low and I was at my wits end. I could not seem to get my blood sugars to stay normal over night and to even sleep much. So I went to a work in appointment that morning. The doctor and I changed over to plan B run them higher and adjust down as necessary. I did do that so far and I actually was high last night because I did have a stubborn low that went for several hours and then decided to shoot up. So thankfully it was not all night but overall I feel better about things after the past couple of days of being able to hear my alarm and get out bed on time for work. I did change my alarms on Dexcom as well to make sure it was because I was blocking the sound out because I was used to it which can happen. I did try the cup but I stopped hearing that but now I am back to where I am more responsive right now which is good. I am thankful to be at least in a place where I am sleeping again and not having lows all night long. I know I struggle with letting things run higher but I am doing it and figuring out what is the best dosage for basal rates. So far the changes have all seemed to be working better and with a little hiccups but I can adjust those as I figure them out.

Overall my blood sugars are having less lows and not really that many higher blood sugars so I just need to keep working on straightening the little things out and I will be in great shape. I have a feeling my vacation will also give me the time to get things all adjusted and just relax my job is way too stressful most of the year and every time I am able to get a break it is a good thing. The only thing that still keeps popping up is rebound highs even when not eating more than 11 carbs which drives me crazy but I have a feeling that soon enough things will be back to normal and I will be on vacation enjoying my time off. It was the strangest thing on Wednesday morning I just could not write about the event maybe I was not ready. I guess some times we need time to process what happens and deal with the events before we can blog about it.

DAD's and What I Have Learned

I know when I started to get Duchess my Diabetic Alert Dog I was so excited but also scared in many ways. The process took quite a while and there was going to be some huge changes in my life which I knew would happen. What I wish I knew when I was looking for a DAD would be numerous things below is a list.

1. How difficult it can be if you decide to take your DAD to an interview because most employers don't want to hire disabled people. I had best of luck having Duchess wait in my friends car while I was in the interview which worked out for me. I could not let them know I had medical Issues.

2. My workplace would not be accepting of my service dog at work. I know in general there are very few service dogs and that makes the process even worse in many ways. Texas is not a very service dog friendly state.

3. I would have issues in College with professors who questioned why I had Duchess until they saw her alert to a low that I had no symptoms of except the professor could see  a change in my eyes. After that things were better. I had to get exceptions to have extended test taking time in case I had a low during a test which did happen. They pulled my medical records and it was never an issue.

4. I spend a great deal of time training and retraining Duchess. I knew there would be work but I had not idea of how much work it would entail.

5. How difficult dealing with the general public can be at times. There has been some incidents of really nasty conversations because they did not believe I was disabled.

6. There is a very delicate balance of work and time off to keep a DAD working. Took me a while to find our balance when I started back to working.

7. That a Diabetic Alert Dog can have bad days like we do. There is days that Duchess does better than others. For the most part she is great but at times she wants to do other things than her job.

8. Having a dog at restaurants or malls etc can be difficult to manage with big crowds and such with worrying about the dogs safety. Duchess has more pairs of boots, vests, leashes etc to help keep her safe and taken care of. So many things need to be taken care of.

9. Grooming standards need to be followed so I brush frequently and bath her frequently so it does take up quite a bit of time but worth the energy spent. Keeping products available if she get wet while going places. A great deal of pre planning.

10. How it felt the first time Duchess missed a low. A DAD will miss some lows but It is so unexpected how you feel. I proceeded to have her smell my hand and arm and she then realized I was low. It can be so easy to forge that yes at the end of the day Duchess is still a dog.

Back on Track

I know nights like last night really make for a long day. I went to bed a little earlier than usual due to being tired and stressed about my blood sugars in general. I wake up around 1:30am  where I was low and I treated it but I was unable to get back to sleep. So I just lay in bed for the remaining hours hoping I can get back to sleep. I know with some bad nights recently and with not waking up at my normal time I was I think making it difficult to sleep. Thankfully I did get a little sleep but not my normal amount which does really help on days like today when I have meetings when I need to be sharp and alert. So I am sure I will be pushing the caffeine today but at least I was not low all night last night and I made more basal changes and probably will until I can reduce the lows completely at night but only having one low was a great improvement.

The weather in Texas has cooled dramatically over the past week or so. Thankfully it is starting to warm back up. Duchess I always try to keep her warm as possible to make it easier for her to concentrate on her job. She was funny yesterday when she pulled her sweater out of my back pack around 3pm and wanted me to put it on. I thought it was interesting that she was telling me in her little way that she was cold. I know working in a 75 year old building that it is quite drafty and can be colder so I always have a blanket on her dog cot for her to lay on or be underneath it. She is quite smart in that she let me know that she was getting cold and wanted to warm up. I know she seemed pretty happy once I put on her dog fleece sweater which she loves to wear when its cold. I know Duchess in general really prefers warmer weather and not cold weather and thankfully we live in Texas where at least most of the time it is warmer. I really appreciate that Duchess is smart enough to let me know that at times when she needs a little extra warmth so I don't have to guess.

Could Not Be Happier

I have to admit I am so loving having my door installed at work. I was worried that it could create more issues but there has been complaints as I expected but overall it really seems to help. I have noticed that Duchess now seems twice as happy at work and since we spend way too much time here as it is. I am always looking for ways to keep Duchess protected because there has been so many issues in my office so far anytime Duchess moves. So with a door being there people will see her less and which should help keep the complaints about dog toys being on the floor. My coworkers don't mind the toys being there and it keeps Duchess busy during really long days. I don't leave them everywhere but she might have antler and rawhide chew out at the same time. Which I am okay with. I have learned so much from this experience so far. I know I really was hoping having a service animal at work would be easier but it has been incredibly difficult and I am not the only person I know to have issues. I work very hard to have Duchess be the best service dog possible but I have a feeling even if she was perfect people would still complain.

I have also learned that I need to protect myself as much as possible in my office. There is actually very few people I trust after all the issues I have had and I tend to keep to myself so people will leave me alone. I know after only a couple of days I could not be more pleased with having the door. I also feel less all eyes on me which is nice and I worry less about people bugging Duchess when we are at work. Even though she has her do not pet patches people will always try and pet. I expect them too but I always try my best to explain why I do not allow people to pet her. Once I explain they usually will leave her alone which is good. Hoping that things will be more smooth sailing when it come to the office issues. I really need a break from all the stress I have experienced because of all the complaints.

Great Reminders

I don't usually get too far off topic but I have been thinking a great deal about other things this week. I know last Saturday Paul Walker an actor passed away. I grew up watching him in movies. My older brother Doug and I used to watch fast and the furious and loved to watch it over and over again. I don't sadly get to hear from him these days. He is busy with his girlfriend and his own daughter Maddyn my niece and his girlfriends daughter. My brothers smile and personality is a lot like Brian the character he played and from the people I know who meet him in person in real life. My brother in so many ways is like Paul was an avid surfer and overall very active person.

My brother has this incredible presence when he walks in the room everyone notices and remembers him. He has a great smile and everyone just loves him. I know the past couple of years I just don't get to hear from him and it feels like I have lost him in many ways. That is really quite true since it has been several years since I was able to see him. I love to go to Hawaii but it is so expensive. My brother rarely ever comes back to the mainland so I almost feel like he is gone. Things really changed drastically after our mother passed away 5 1/2 years ago, I know the relationships between my brother, sister and I have changed so much. The family was so much closer. I know my mom was the reason we all came home. Home has changed so much from the definition of what I used to have of home. My definition is more my friends than my direct family. They are there when things fall apart and when they are smooth sailing.

My own family is very absent when things are not great and really seem to not be very present except for my grandmother. I am so very thankful that I have my blog as outlet for the good the bad and the ugly since our relationships have really changed drastically since my mothers death. I did not realize how much she was the glue for the family. I do miss seeing my brother and sister and especially the relationships we once had. Paul Walkers death really reminded me how much I miss that. I also especially this time of year miss my wonderful mother who gave me so much and I am always grateful. My mothers favorite time of the year was Christmas. I grew up having the most amazing Christmas's where the tree, house and activities all centered around Christmas. I know some things are great reminders to appreciate what you have and the time you do have. I will always wish for more time with my mother but am just thankful for the time I had with her. She was an incredible person who did so much for me and my Diabetes care


.http://www.youtube.com/watch?v=o8UCI7r1Aqw   Paul Walker Memorial Video

Surprised by My Reaction

The whole fiasco about the dog toys and bones that were complained about is officially over as of today. The door was installed and there is already some benefits I am seeing already. The biggest difference is the fact that Duchess seems so much more at ease with having the door in place. There was a complaint from a coworker because they could not cut through my cubicle to get to the copier which I do understand. I told them they can close it or leave it slightly open. I am hoping to give Duchess a chance to experience a more peaceful experience at work than it has been over the past two years. I know my experience with having Duchess at work has been tremendously difficult and so many issues that I never expected.  I know I am blessed to have Duchess in my life but I assumed that it would be easier to have here with me at work. I am disturbed to see all the issues or complaints that have been brought up and all of them have been unfounded.

I know the door will not solve all the complaints but I think management is finding that the complaints are not valid and in fact is not stating  they are not going to address the complaints further because none of them have been true or valid complaints. I know I work with a bunch of complainers but I never dreamed I would be targeted because I have Duchess with me. Duchess is such a wonderful dog and I follow strict service dog protocol for grooming. I bath her weekly and is brushed 3 to 4 times a week. I am not sure how much more I could be doing but I have a feeling there is nothing I could do to change the complaints. Thankfully the door might give me a break from all the complaints hopefully. It really can stress me out tremendously dealing with all the issues I have faced. As much as I hate to admit it I seem unable to always handle really stressful situations like I used to and reducing some work stress will be nice. I honestly already love that I will not be as distracted because the wall is there and I know I will have less interruptions.

Ugh Back to More Lows Overnight

The nights were going so well for a little bit then I am back to the low alert around midnight or if I reduce the insulin I am around 170-180 till around 12:30pm. Then I am dropping again at 4am I have reduced the insulin rates but if I drop it too low then I am moving back up higher fairly quickly. So I have to figure a way to work around these two time periods where my body seems to want to be low every night. I know the night lows have been an issue on and off for quite a while but I do not seem to be able to find the good spot where I am in normal range most nights. I also find that if I can sleep through the night I will have less lows during the days so I need to keep working on getting things adjusted or I might just have to run my blood sugars higher at night but I am also not a fan of running it higher either. I know that will affect my A1c numbers. I know normally I am able to make some adjustments over a week or two and find the right changes and then I seem to be fine.

Sadly this time I think I am going to have to come up with an out of box plan to deal with the craziness I am experiencing. Thankfully everything is manageable but lows can really drag you down after a while. I am not frustrated currently but I am really wanting to find a solution to this issues so I can relax a little more. I know Duchess is tired as well and I would like to keep the lows to a minimum if at all possible. Life would be much simpler with a reduction in these lows. I know traveling at Christmas time I tend to have more lows and I need to get things as smooth as possible. I am always worried about bad lows while traveling as a single woman but thankfully Duchess does keep me safe but recent events have shaken my confidence a bit in some ways. I know Duchess is awesome but I know I can't make that fear go away.

Article on Complications

I was glad to see Kerri Sparling writing about complications. I know I try to discuss mine because I know when I got my first complication there was no information and a great deal of judgements from others. I know the hardest part of having complications was the guilt that maybe if I had tried harder that maybe I would not have a complication or If I had started on a pump sooner things would be different. I know I still catch my self going down that though process and I have to stop myself because the guilt will consume you. Diabetes is hard enough without adding all the judgement by strangers and even my own family. I know my own family will not discuss any complications I have in fact they are the biggest critics of my efforts. I think my family honestly believes that you test take a dose of insulin and test again and its that simple. It has never been that simple. I know the longer I am away from my family the more they seem to forget all the years of the struggle to keep things where they needed to be all the times I had wonderful A1c's.

I never expected my own family to be my harshest critics but they are. I know I get judged by everyone from nurses at the Dr.'s office to others. I have heard constantly if you had managed your diabetes better you would not be where you are today. I have corrected this misinformation every time because I don't need to be judged I just need proper medical care. I have heard comments from my own Retina Specialist how if  you have this one complication you must have all these other one's too. I think part of the problem with complications is that once you have one you have all of them in all the Dr.'s and nurses minds. They also make a great deal of assumptions as who you are as a person because you have a complication. I have never been treated so badly as a patient until I got my first complication. I know a great deal of Dr.'s think I am lying when I tell them what my A1c is and I have to have proof to prove them otherwise. I know my Retina Specialist always seems to not believe that my cholesterol is normal and my blood pressure is normal. I know thankfully my Endocrinologist office views me as a patient who works very hard to maintain good control and manage my Diabetes.

I know I have to live with the fact that everyday for the rest of my life I will wake up with a complication and all the stigmas that go with having a complication. I really wish that more people understand how hard it can be to be a Diabetic and that it is not always as simple as they assume it is. I know I have some really incredible people who have complications and like me it does not stop them or really slow them down. Yes there is more appointments but your life does go on and a little less of the ignorant comments is always appreciated, but sadly they don't teach that in medical school.

http://www.diatribe.org/issues/59/sum-musings?utm_source=diaTribe&utm_campaign=d322f18e90-diaTribe_Issue_59&utm_medium=email&utm

Blessed by Great Friends

I know yesterday the day of good eating and sharing food really has helped me to de-stress quite a bit. I know even though I have a plan of action I just don't handle stress the way I used to be able too. I am thankful that I have some incredible friends who have offered to help me to get to the grocery store. There is also the friends who are trying to get me names of car salesman who they know which would help me feel a little more at ease. I know everything will be okay but I just need to work on keeping my stress level down and finding the positives in this experience. I know my friends who live locally have been so wonderful and I am so thankful that they are in my life. I know my own family who knows about the car issues seem to be not concerned at all and in fact were like you will be fine just go buy another car and things will be great.

I know I am relieved to have a total of four days off from work to relax and get things done. I like to go into the Christmas holidays not overly stressed. I know I am looking forward to my Christmas travels to Sonoma and San Fransisco. I will be able to visit with friends which is really what I need. I know after all the overtime I worked this past year having some time to really enjoy the month of December will be much enjoyed. I know even Duchess loves when we visit Sonoma California. There is always so much we can do and the weather is only slightly colder than we are used too.  Glad some time off and fun is headed my way I know Duchess and I both could use the time.

Happy Thanksgiving

Happy Thanksgiving everyone!!!. I know I am beyond truly blessed no matter what happens to have some of the best friends around. I know one of the biggest blessing over the past three years has been Duchess. She keeps me safe and loves me beyond belief. She has given me back my life the day she came home with me. I was able to continue to work full time and continue to live the life I wanted. I know I never dreamed my life would change so much with Hypoglycemia Unawareness.

Duchess really helps me see things in a different light. She has improved my life in ways I never expected. I am thankful for the DOC and all the wonderful people I have meet over the past couple of years. I have been blessed in many ways and I am thankful.

Thank you for following along for my adventures, and for what I have learned. It has been incredible couple of years. Wishing a safe Holiday for your family.

Several Things

Thankfully most of the changes I made to my basal seemed to work some took me around 160 in the middle of the night which is too high so I am going to make some more tweaks tonight and see if I can improve things further. Thankfully I woke up around 130 this morning which is the much better than the 40 I was averaging recently. I know my stress level has been through the roof and yesterday when I missed I was also assigned quite a few new projects which will only add more stress onto my shoulders. Then my work added a specification to my vacation that I must have everything done before I can leave on vacation. The problem I forsee is that they keep adding projects onto to my workload and I do not have much time to finish this.

I do not handle stress well and I am doing my best to deal with things as it come but it would be so nice to not add a threat that I will not be able to take my vacation if I am not done to where they expect then I would have to delay my departure. I am not able to afford to delay my departure because of all the money coming out of my account for car down payment and the car diagnostics. So I am feeling a little edgy going into the holidays with so much looming over my head. I am normally able to accomplish everything but if they continue to add things on to my deadlines that might create more issues. I am planning to speak to my manager if they continue to add more items. I think it is rather unfair knowing I am planning to leave the state and told you might not be able to leave as planned is rather harsh.

I am a very hard worker and this new rule is insulting normally when I leave everything is done before I go anyways but this is the first time they seems to be throwing more at me instead of letting work on getting things accomplished before leaving. I am hoping to keep the lows at bay but when my work amps up the stress it can makes things very tricky for a Diabetic who is unable to handle stress well.

Low Frustration

My Diabetes recently even with adjustments won today. I missed the bus because I turned off my alarm because my blood sugar was low. I have done this several times recently which is not good. I was not feeling great today so I just took today off but I would have preferred to have made it into work. I set several alarms but must have turned them all off is all that I can figure out. I am trying to avoid this from happening since I don't have my car working. This creates the situation of taking longer to get to work if I am running late which is not good. I need to reduce my stress level would be very helpful I think in helping to get rid of these lows.

I did have a very stressful meeting yesterday and I have a feeling that played a part in my bad low this morning. I already did adjust my basal rates again. Last night I was not low until around 4 am which is pretty common but the rest of the night I was in range which is good. So I have a feeling the tweaks I make today might be enough to get me back on track. The frustration with lows right now is extremely high but I am hanging in there.

Constang Beeping to a Quiet Ending

I am was really happy after very little sleep Saturday night due to low blood sugars. I adjusted my basal rates again but this time luckily it seemed to really help. I was able to sleep till almost 5:15am with no buzzing from the Dexcom. My blood sugar did rise a little bit at midnight as usual but at least it did not seem to go above 140 which is good. I most likely will need to tweak my basal around 12pm but the rest of the night looked to be right in range where I want my blood sugars. It was so nice to sleep the whole night and be able to just sleep. Seems like nights of complete rest are not something I get very often these days so I really do appreciate each night that I am able to sleep soundly.

I know even Duchess seemed very rested because she normally is up if I get up to check my blood sugar in the middle of the night. It would be so nice if the adjustments I made continued to equal more nights of uninterrupted sleep. I have also been able to reduce some of my daytime lows as well this weekend and hopefully that will translate over to my work week. Seems like last week I was low constantly which was driving me crazy and poor Duchess as well. Some times my blood sugars change drastically but others it is a slow change that I catch but tends to push up the number of lows.

My stress level has been through the roof in some ways. My car that was paid of in July is pretty much needs to be replaced. I would rather do anything than look for cars. I hate dealing with car salesman and the whole business of trying to get a good deal but not miss anything. This time I am buying a used Honda most likely. I am just not a fan of spending all that time at a car dealership. I am trying to hold off looking until January because my vacation is December 18t and I won't be back until the beginning of January. So I am really hoping to keep my blood sugars in range through all the stress and still getting all the things I need done. I know the process will not be much fun for Duchess either. I have had my existing care since before I got her so this will be here first time going as well.

A little Angry / Frustrated in General

I am frustrated with the fact that I am back to more lows again but now the minute I treat the low it rebounds to a high even when treating with 11carbs like I normally would. These days are very frustrating for me and I am not sure how to fix this rebound effect when I am not over treating so I am trying to figure out why there is such a large rebound even when I was not low previously but a large rebound with very little food intake.
I am not sure if my body is going haywire or what but I honestly hate moments like this where I have to figure out what is causing the issue and most of the time it is not always a simple answer or very easy for me to figure out. The weather has been wonky here so that could be contributing because I seem to be affected by the weather.

I am feeling very been there done that after all the wonky numbers over the past couple of months. I would love to have a vacation from my Diabetes but I know sadly we don't get one. I am really starting to feel angry about all the constant changes or issues have needed to solve. I think in general at this point I am just tired of it all but I am not giving up. I am committed to making things work but I am just tired of all the energy it is taking to keep things where they need to be. I have so much going on all the time it seems like my Diabetes is constantly screaming endlessly for me to spend more and more time working through issues. I am just flat tired in general and so would love a vacation. Thankfully I will have some time of in December to work through things but I really would love for things to be a little calmer.

Feeling Blah

This November has been so different than last year. I was so excited last year by all the activities of Diabetes awareness month. This year I feeling very blah about it all. I am not upset about anything but my general enthusiasm is missing this year. I am not sure if I am just feeling blah about my diabetes or I am feeling just overwhelmed by it all. I know I am not the only blogger who mentioned feeling this way this year. I know things do vary and I am sure next year I will be back to my more enthusiastic approach to Diabetes Awareness month. I am not sure how I can get myself more excited by it all but I think it is okay to feel blah about it all because I do deal with Diabetes 365 days a year with no breaks.

I know I don't really feel overwhelmed per say but maybe just a little tired of all the scariness my condition brings me on a regular basis. I work so hard but I know it does not always seem to be enough. I guess at the end of the day you can only do so much to prevent lows. I am very tired after my last incident on the bus where people blamed me for it happening and fully believed that I was being irresponsible. I know that is not the case it is really the fact that there is always so much education needed for some of the general public. I am not sure if that is why I feel the way I do this month but who know it might. It can feel extremely overwhelming when you try your best to educate but the person was not really listening can be frustrating.

I know my passion and wanting to help others is why I started my blog and that has not changed but at times that task can feel daunting at times. I do have a great deal of people in my life who understand about lows and so I feel like they get it. I know with Hypoglycemia Unawareness has taken over my life 5 1/2 years ago and it has never been the same since. I am okay with that but I struggle with the fact the most people don't understand.

Research & Diabetes

I know Diabetes has never received the support for illness's like Aids or Cancer. I know more people die every year from Diabetes than Aids and Cancer combined It really makes me sad that a big part of the lack of funding stems from lack of knowledge of the general public. I know that I have had to educate my own family at times because they constantly hear the myths told and retold by the media. I have even seen on Oprah many years back a story on Diabetes and complications which makes us all look bad because they don't have the knowledge to understand. I still will occasionally get asked if I ate too much sugar to cause my Diabetes which I find puzzling because I was diagnosed at 18 months old. My mother did not feel us sugar all day so it is very insulting. I am saddened by the fact that these myths still exist.

I really wonder if more people had accurate knowledge about Diabetes that would help to increase funding for more research. I know they have made a great deal of progress in Diabetes but I really wonder if we had more funding over the years that right now we would have had better technologies or tools to deal with Diabetes than we currently do. Things are improving but I know the companies that produce the products until recently did not seem to ask a Diabetic about their opinions on the products functionality.

I know this being Diabetes Awareness Month and I know we as bloggers and advocates need to fight back more when bad articles are published full of misinformation that it does impact us all in many ways. I know being a Diabetes is frustrating enough without adding more myths to the mix of things. I know we have so much work to do to get things on track to increase funding for more research. I know working for a research University how important and how this research can change lives but I know with Diabetes not getting the funding it deserves it has always left me extremely frustrated.

Noticing a Trend

I have been seeing an increasing number of articles about Diabetic Alert Dogs. The disturbing part for me is that most of these articles do not even discuss Hypoglycemia Unawareness. I do not think you would need a DAD unless you have Hypoglycemia Unawareness. I am concerned with the articles not addressing Hypoglycemia Unawareness that people who can feel lows will be out trying to get a Diabetic Alert dog when it is not necessary. I know I would not have Duchess unless it was necessary for me to have her. My life before was truly much simpler but also twice as dangerous once I was diagnosed with Hypoglycemia Unawareness. I tried everything I could from CGMS to increased testing to try and catch all the lows. Sadly not of these things were working. I was testing so much I was so frustrated that I was still missing lows.

I have also noticed many of the articles do not discuss all of the work that Diabetic Alert Dogs require to keep them working or even very few details about their training. I always worry about bad information being put out their by articles that I have run across recently.  I know these dogs are so incredible but I am really upset at the messages they are sending that everyone needs a Diabetic Alert Dog. I could not disagree more. I know so many people who need Diabetic Alert are not always able to get one especially if people are getting them who really don't need one. I know my Hypoglycemia Unawareness is truly the scariest thing I have faced as a type 1 diabetic. Even with having Duchess it is less scary but still has its moments of scary.

I know I wish no diabetic had to experience Hypoglycemia Unawareness and that we could all get by with using CGMS and frequent testing. Until that day comes I will continue to use a Diabetic Alert dog but only because it is the only option that has worked for me.

Finally Adjusted to the Change

I have been thankful this week for increased sleep finally. I have had my Dexcom staying in range most of the time till around 4:45am and I am still making adjustments so I can fix this as well. Night basal changes tend to take a while for me to get perfected. Thankfully I am cruising through the night from 90-130 range which I am happy with. I hate the nights of constant beeping from my Dexcom and not being able to sleep because of the alerts every 20 minutes. I think I have finally adjusted to daylight saving time and everything seems to be back to normal. I am working out some kinks during the day but overall my blood sugars are not going up and down as much and I feel more confident in my blood sugars and overall control.

I am hoping that things will be calm and mellow for the rest of the year. I thankfully as of now am seizure free for almost 15months. I feel very blessed for everyday that I am seizure free. I am not sure how I was able to avoid seizures for 8 years but my goal is to lengthen the time as much as possible. I know Duchess has played a big part in me being seizure free as well. I know the longer she is with me the sooner she seems to notify me of fast dropping blood sugars. I know when I saw my Dexcom this morning I am getting so close to where my blood sugars are a straight line across which is ideal.

World Diabetes Day!!!

It is hard to believe it is World Diabetes Day of 2013. Remember that this is the last day to record entries into the big blue test. I will post the link below so you can add more entries. They have not meet the goal of 20,000 entries yet and I am hoping we can reach that goal today.

http://bigbluetest.org/?utm_source=FINAL+BBT+-+Manny&utm_campaign=Final+BBT+-+English&utm_medium=email

Please take the time to do another big blue test today all the funds donated will go to nonprofits that helps Diabetics. So it always a win win for all who participate.

Duchess wearing Blue for World Diabetes Day!!
(Halloween picture but fitting)

What I have Learned from Retinopathy.

I have learned so much from my experience with Diabetic Proliferative Retinopathy. There is so many scary aspects of having Retinopathy but most of the items were only scary if I could not find information on the procedures. Retinopathy has reminded me of what is important and how increased control has helped me to have very little issues with my eyes through the process.

1. Keep blood sugars as controlled as possible because it reduces the amount of hemorrhages in the eye.
2. Avoid having high cholesterol, and high blood pressure. If you do have these issues the Dr. recommend to     keep it controlled.
3. Sleep with two pillows at an angle to reduce chance of a hemorrhage blocking vision.
4. Retinopathy is found normally in both eyes even if there has been no hemorrhages.
5. Ask questions about procedures and research.
6. Laser procedures will reduce your night vision so you might end up with glasses to wear at night if vision       loss is great enough.
7. A patient does not have to have surgery there is other options to addressing the issue such as shots and         laser procedures.
8. Don't let a Dr.' push you into surgery if you are not comfortable with them as a physician.
9. Don't be afraid to fire a Dr. if they are too busy to even explain to you about your condition or treat you         respectfully.       

Things I have Learned about Hypoglycemia Unawareness

I still find it hard to believe that I have not had feelings of lows for over 5 years. I have learned so much about Hypoglycemia Unawareness over the past 5 years. Here is a list of things I have learned

1. The feelings of lows will never come back regardless of how hard you try.
2. There is the occassional low you might feel but that is when your blood sugar is quite low like 30.
3. Running your bloods sugars high with no lows will not solve this problem not matter what length of time..
4. Some people running high do get some feeling back but that only lasts so long.
5. Dr.'s I meet seem to know very little about Hypoglycemia Unawareness except run the blood sugars high.
6. I have found that Hypoglycemia Unawareness equals frequent lows even with my best efforts
7. There is not a great deal of information in general on Hypoglycemia Unawareness online.
8. Most of the Information online does not seem to work for most of the people I know with Hypoglycemia
    Unawareness.
9. Keeping lows at bay is very complicated.
10 I get confused much easier than in the past because I don't always know it is dropping quickly.
11.The signs of lows don't completely go away but change to things like confusion, irritation and obsessiveness in my activities at the time of the low.
12. Every person with Hypoglycemia Unawareness all experience different symptoms of lows and have to learn the new one's. It can take a while to find what it a symptom of a low.
13. My blood sugars tend to fluctuate dramatically from day to day and with little patterns at times.

Newly Diagnosed Type 1 Diabetic

I was out shopping on my birthday this weekend and I ran into a family who's son was diagnosed several months back who said they just found out about the diabetic alert dogs. I know they wanted to know all about Duchess but I let them know that when you are first diagnosed you really need to work on getting to know your diabetes first before you throw a diabetic alert dog into the mix. Life with diabetes is stressful enough and when you are trying to learn about diabetes you need to just focus on that instead of rushing to get a dog who needs a great deal of time and training. I know the parents are worried about night time lows but I think everyone needs to try a CGMS before they get a diabetic alert dog.

I know I have never really felt a great deal of my lows since I was a child and I am not sure why. I know she said her son could feel his lows but she is worried about the nights. I did mention to her that not all diabetic alert dogs will alert at night. I know that is probably the number one reason for many they purchase the dogs so I like to inform people that it is not guaranteed to alert at night. I know many people assume getting a dog right away is a good decision but to get the best results from a diabetic alert dog you need to know your diabetes. I know I have achieved my best A1c's of my life since getting Duchess but that would not have been possible without knowing how to make adjustments to my cars, basals and other factors.

I know diabetic alert dogs are great but I think learning how your diabetes responds to things will help you use a diabetic alert dog to help you achieve what is necessary. I know I am lucky that I have my Dexcom, Animas One Touch Ping and Duchess. I know that these tools are worthless until I learn how to use these tools to make improvements in my control and to help reduce my lows. That is why once I got my insulin pump I waited a bit before I would be bringing home my diabetic alert dog home. I know I read books on insulin pumps and how to use insulin. I learned a great deal and with this knowledge I continue to make my life easier.

Putting Dexcom in a Cup Again

I am really happy I decided to take today off from work not because of my low yesterday but because I needed some time off. I am thankfully had a good night last night so I was able to sleep and was not low all night long. I know Duchess seems quite relieved at the quite night as well. I am going to have a long fun birthday weekend and enjoy the fact that I have three days off. I am hoping to get a better handle on things over the next couple of days. I know I have found some little things I had not taken into consideration until yesterday morning. All I know is that recently my diabetes has really become a handful to deal with and I just want to be able to have some time to relax.

I am always trying to avoid all these lows but sadly my body has other things in mind other than cooperating. Thankfully I have some ideas of how I am going to approach things and hope that it helps. I know I was really surprised by yesterday's bad low because I was not really stressed but I know some things such as time change can create issues for me so I am thinking that was playing a part in the bad low as well. I am not sure why it happened but I am always looking for ideas to help. I know I don't remember hearing the Dexcom go off at all. So I am going back to putting my Dexcom in a cup on my night stand.

That seems to help me hear it more clearly and I hoping to catch the lows sooner rather than sleeping right through the alarms. I know I never usually her my pump alarms either so I should not be surprised by this but that usually does not cause many issue except occasionally. I am so glad I am getting to enjoy my birthday weekend with some much needed time off.

UGH I Hate Lows

I had a very bad morning where I did not hear my Dexcom going off all night or my alarm clock this morning. I had two alarms set and I feel bad for my roommate who was most likely wanting to sleep. I know I scared everyone at work because I was not responding to calls or txt messages. Thankfully Duchess eventually was able to get my attention and I finally treated my low. I know the minute I treated my low I shot up to 170 the funny thing is that I only took 11 carbs but I guess my body had other plans. Thankfully I was able to get to work but I was later than I was planning to be. Thankfully I have been at work like nothing happened but I am honestly at a loss. All week long I had been dropping my basals and I had some nights with very few alerts from my Dexcom. So I was not really expecting this but.  I know these times I am thankful that I have Duchess to help me out.

Well the good news is that I am off tomorrow so I have a three day weekend to enjoy. I am hoping to run by the Dr.'s to see if there is anything I need to change right now. I am not sure but I hate these lows.

Overnights are Improving But Feeling Defeated.

My blood sugars overnight thankfully seems to be calming down which is nice. Certain times of the year it seems like every night that my blood sugars want to stay low all night long. I am running a little higher than I like but I am doing some really gradual drops hoping to not over do it with the adjustments. I really love when I can sleep through most of the nights when possible. I know last week I was stressed and I saw first hand how that affected me. I am hoping things begin to slow down at work so I can get my barrings on my blood sugars. I am also working out more and hoping that does not mess with my overnight blood sugars too.

I am working on trying to feel like my old self these days and I think getting out and exercising more will help. I have put on like 5 pounds over the past couple of months and I want to feel better so hopefully I can lose the weight. I am trying to find some new ways to deal with stress for the busiest part of next year to help avoid bad lows or EMS assisted issues. I am not sure what I can do differently but I feel like I need a better plan. This year I avoided seizures and if I can avoid bad overnight lows next year I would feel like things were even more improved.

Having Hypoglycemia Unawareness has honestly been the most difficult and scary aspect for me to face as a Diabetic. I know I am so fortunate to have such a wonderful helper but life in general is never easy and figuring out the basal changes it twice as challenging. I know my Dr. at times seems to need extra time to see what action needs to be taken. I know my bad low from Friday has made me feel like a complete failure because I feel like I should be able to prevent more of the these lows. I know I am doing better than last year but I would love to be like some diabetics who the lows are very rare events.

Great Rewards

On Saturday morning I took Duchess to the dog bakery. I purchased a great deal of things for her after my bad low on the bus which she so deserved. Every time after a bad low or incident I always make it a big party for her persistence and help during these situations. Friday I could not of been prouder because she was so persistent with the people on the bus until they got that something was wrong. She did a wonderful job and was on top of it. I know the man that was on the bus said she kept alerting over and over again before they finally clued in. They said I was very unresponsive which is not completely unusual for me at times. The interesting thing for me is that I had very little active insulin on board but I was dropping pretty quickly which equals me being unresponsive.

I know the routine with going to the dog bakery after those incidents I think helps Duchess feel like I do not view here as a failure. I know during my seizures afterwards she always acted like she let me down so I really make a big deal of everything she did right. I know that her job is very difficult and she handles so much stress and makes it look easy. She handled everything so well and I feel like reinforcing that she did her job that she will continue to be as persistent as necessary. I know a big fear of mine is that after a bad low or seizure she will decide to stop working.

Duchess seemed to be not fazed by Friday which made me feel better and she seemed to keep alerting as she normally would. I am glad she is so very smart and creative in how she gets people's attention when necessary. She is amazing in my eyes and I will always love that she cares so much to keep me safe.

Discussion from Friday Afternoon

After my Friday morning visit with EMS I was not really in the mood to talk about what happened at all. I know sometime it takes me longer than others to get process what happend. I know most of my experience for the most part people are usually just concerned. I know one of the woman that was on the bus that morning was really quite pissed off at me that afternoon when I was catching the bus. She could not understand why I was unable to take care of the low. I simply said lack of glucose to the brain. I know I was really not wanting to discuss things with her when she was pissed off. I have a feeling that she really did not get that I was doing the best I can. I know she even asked me why this incident could not be avoided. I so wish at times people could understand that it is not that easy and I have had issues with lows most of my life.

I honestly had trouble with the fact that she was angry with me. I think she thought I was at fault for what happened. I know it started out like any other morning and everything seemed fine. I am not sure what I could have done differently. I know both of the people who were on the bus when the EMS arrived both were quite pushy in ways I had not dealt with previously. I know after this experience I know I really appreciate how understanding my old roommate was during those scary events. He never was angry with me but seemed to understand that things are not easy.

I am hoping next week things have calmed down and they are not angry. I am sure they were concerned but the lack of understanding seems to have caused quite a bit of issues. I am just not used to dealing with people who are angry about what happened.

Scary Morning Adventure

It has been one of those mornings that I don't usually ever want to experience. I was riding the bus to work but that is where it gets fuzzy. I know things seemed pretty normal for the most part. All I really know is that I had some friends who work at UT and The State of Texas who noticed that I was not responding to Duchess's alerts and let the bus driver know. They pulled over at a bus stop and then EMS arrived. I don't know much of what happened before that point except I kept insisting that I was fine. Which always means I am really not fine.

 All I know is that when EMS tested my blood sugar I was 39 which is low. I know EMS did not like that number but the funny thing in my mind is how calm and unfazed I was by this low number. I think the hard part for me is when I tend to hand lower at times that you get used to those lower numbers and so you forget the seriousness of that number. I know way back a 39 would have had me in a complete panic but these days it seems to really not scare me as much as I think it should. I know I am not invincible but I think having lows more frequently can truly change how you view the lows. I know there is a inherent danger to these lows but I seem to not have a proper response these days.

I am thankful today for my friends who were late to work and helped me get the help I needed. I know it is appreciated and I know how overwhelming it must be for them as well. I know these experiences are scary for them as well. I am really embarrassed as always but overall I am just glad to be safe. I am still at work and doing fine but had my blood sugar shoot up to 240 because of the glucose gel which happens everytime. Hoping to have a calm weekend.

Happy Halloween

Happy Halloween 

Duchess loves to dress up every Halloween and does not mind wearing her costume all day like she will be today. She loves to see all the costumes of the kids that will be coming to our home tonight. She loves to help me give out the candy. I think her second favorite holiday is Halloween. Christmas I know she loves because I get quite a bit of time off and she gets quite a few new toys.

Frustration over Prescription Drug Coverage

I finally was able to get my test strip issue sorted out and I will continue to get 600 test strips a month because I was granted a one year exception. I have to reapply yearly for the exception which is fine. I went to log onto my pharmacy page to re-order some supplies and in big red letters a note stating they will no longer be covering Novolog, Apidra insulin, they also will not longer cover Accu Check test strips, Bayer and Freestyle test strips as well. My issue now is that fact that my body was not responding to Humalog insulin and I had to be changed to Novolog.

That was discovered during my insulin pump site issues last year around this time. I had been on Humalog insulin for years but go to find out sometimes it can be good to change insulin brands. Learned something new that day. I am really upset because I had so many issues with my pump sites and I can't afford to change my pump sites every couple of hours. I am going to talk with my Dr. to see what options I have and if I can switch back to Humalog without issues. I am hoping a year was long enough that my body will be more responsive again with this insulin.

I can tell my insurance is hitting all diabetics hard we are limited to only one covered insulin Humalog and only one test strip brand One Touch. I am find this quite silly because they stated it was to keep costs down but in actuality these are the most expensive brands and the other items I was using were less expensive. I am not sure what I can do in this situation but I am hoping my Dr. has some ideas. I am so reliant on my pump it is really not an option for me to go off the pump right now if the Humalog is not working properly. Thankfully my family lives in Washington State and can drive to Canada to purchase insulin for me if I need to go that route but I find all these recent changes to be very frustrating and not saving money for the company.

The only thing they have not hit yet is my insulin pump supplies and I will be pissed if they only cover a certain brand of pump supplies. Thankfully my Dexcom sensors do not seem to be an issue either but who knows with the direction that my insurance is going in.

Alerts at Night

I am starting to feel like things are starting to settle down a little more after starting to feel better after my stomach bug I had this weekend. I have noticed this year Duchess is back to alerting at night again if we only work a normal day with not overtime. I know I am sad that I will have continued overtime monthly but hopefully not as much as I have had in the past couple of months. I have also noticed the more playful version of Duchess is back again it is like I have a 6 month old crazy hyper dog that I used to see all the time when off duty she is slowing make her appearance again. I love her personality and her quirkiness but when I get really busy  things change. I know she is better than last year's over time but I am still trying how to get her to alert consistently during the night which is getting better the less hours we are at work and the more play time she gets.

Duchess as a service dog needs play regardless of what is going on she thrives off her ability to play and have fun. I do my best during overtime but at times their never seems to be enough time to get her all the play time she needs. I try my best to balance but at times it can be very hard. I know during these times things are more difficult for her as well because I am trying to balance too many things and not enough time. Thankfully Duchess is very forgiving. I just wish I had a more balanced life in general because it really would help make her life and my life better. I am pleased that even with the long hours she always does such a great job but really wish she still alerted at night consistently.

Duchess did surprise me recently by her alert by sitting on me because my blood sugar was low and it really got my attention. She really could of pawed at me or done something a little less in your face but from time to time she wanted to get my attention quickly which makes sense I was at 40.

Flopping Around

I had another busy weekend planned as usual. I was supposed to be working on Saturday morning around 9am. I woke up at 8:50am and don't remember turning the alarm off on Saturday. So I rushed getting ready to get to work. I was really tired and did not think much of it at the time. So I worked for several hours then went shopping and returned home. Shortly after getting home I was pretty low 40 and I stayed there for hours. I kept treating the lows with no real results. Finally around 8pm I got my blood sugar high enough that I could drive safely. I was really tired and did not want to cook dinner. So I went to Chipotle for dinner, I get home and start to eat my dinner but all of a sudden I felt like my stomach was not going to let me eat, So I stopped eating and put my food away in the refrigerator. Then I hear my Dexcom start to wail loudly that I am below 55 again. I try treating my low with skittles and smarties but they made my stomach even more upset,

I am feeling desperate at this point to get something in my system to get my blood sugar up. Then I remember I have juice boxes in the fridge and sure enough that seems to be working. I drank around 5 of them and my blood sugar is finally 70 which was nice. Then my blood sugar starts dropping again dramatically. I have had my insulin pump basal off since I was unable to eat dinner. So I continue to drink juice on and off till around 2am when I was able to reconnect my pump without any lows thankfully. I go to sleep then at 4am my Dexcom is wailing at me I was 400 I guess I had not heard the alerts before this point. I think I had rebounded after being low for hours. I was low from 4pm to 8pm then low from 8:30 to around 12:30pm. I honestly was relieved that two and half hours later my blood sugar was back in range.

It was such a long evening of attempting to keep my blood sugars in line but sadly that did not seem to come easily. I am still having issues with my stomach for the rest of the weekend. I am not sure what is going on but I would like avoid it if at all possible. Thankfully yesterday I was back to my normal blood sugars and was able to get what I needed done. I did have a fast moving high that I was able to stop by two hundred and a couple of low but it did seem tor respond to the smarties and skittles.

Dealing with the Guilt

I was thinking about my last bad low in September today and I realized quite a few things. I have a habit through out all my years as a diabetic to apologize profusely anytime I have a bad low. I am always filled with such embarrassment but also a huge feeling of regret that someone else had to feel the burden of taking care of me during these scary times. Most of the people who have experienced these scary lows with me have always been so nice about it when I am apologizing over and over again.

I know regardless of what caused the low it will never be easy to deal with the feelings that come with it. I know I hate the fact that at times I have needed help over the years but I know it happens. I am always thankful for the help and the caring of the people around me. I guess being a diabetic has so many sides and it is never easy. I am not sure why I always so weighed down by these experiences. I know weeks after bad lows or seizures It always seems to haunt me in many ways. I know my mind tends to focus on the need to know what caused the bad low.

I always feel guilty after the bad lows even though I know that you can't always prevent these types of lows. I know there is normally so many factors that can play a role in these bad lows. I always try my best to find answers when possible. I know I am always trying to avoid these lows.  I know today I was some lows that were not really going away and it always brings back these not so fun feelings. I still feel bad that my roommate had to help me over the past couple of months and I am not sure I will ever not feel guilty afterwards.

Should you let your DAD Alert to Others

. I am still incredibly happy that I have allowed Duchess to alert not only to me but also others. I am still amazed she alerted to people who did not know they had diabetes. She is very good at her job and I feel like sharing her has never ever caused me any issues but in fact only makes her abilities even stronger. I work constantly to keep her as sharp as possible and if there is others around me who are off and I ignore her I find that creates more issues. The issues can be decreased alerts, more aggressive alerts because she feels I am ignoring her. I know Duchess is a dog who thrives on treats so ignoring her when she is alerting seems to have more negative consequences than just allowing her the freedom to do what she was trained for.

I can understand why some people do not allow their DAD's to alert to others because it can cause issues for their dogs. Just like diabetes things may vary from dog to dog so I am okay letting Duchess do what she does best and that is alerting. I know at "The Friends for Life Conference" I went to back in July I allowed her to alert and she became even sharper. I know she alerted to all  my new diabetic friends while we were hanging out and she seemed happy to be earning more treats. She came back home even sharper than before the conference. So I have experienced the positive side of allowing this behavior.

I can say it enough of how proud I am of Duchess when she can handle alerting to more than one Diabetic and makes it look so easy. She loves challenges and faces obstacles better than I do personally. She loved my new friends I made at the conference and alerted before anyone knew they were going high or low. She gave them more time to make better decisions. I love that she does not seem fazed by so many smells at such a large conference. I know going to the conference I was really nervous about the outcome with so many diabetics at the conference but she did quite well. I think all DAD owners have to make the call if allowing them will work for the team.

Ugh Prescription Issues

I went to refill my prescriptions last week after my Endocrinologist appointment. I called the company when I only received 500 test strips for 90 days because now my insurance will only covers testing 6 times a day. I used ten test strips last night alone for a bad night of lows. They said my Dr. put I only test 6 times a day but I test more actually so I am not sure why they would put that. Then I was told my insurance now determined all diabetics only need 6 test strips a day. I don't know very many diabetics who could survive on that few of test strips and maintain good control. I know my Dr. wrote on the prescription that I needed 600 test strips a month. So I had to call my Endocrinologist office this morning asking them to call for a special exception so I might be approved for more than 6 test strips a day.

I am shocked that my insurance wants diabetics to be in control but yet is only willing to allow a number of test strips which does not equal the ability to test frequent enough to have good control. I know this has been very frustrating on how much they charged me for the prescription when it was only a months worth and they are unwilling even with the special approval of the test strips to send the remaining amount that I am missing from my normal test strip amount. So I am really unsure how I am going to come up with the extra test strips except fill a prescription for the  next two months which makes me really mad when I paid for a 90 days supply. My work wants us to use the mail order primarily but when I am having this much issue I would rather pay more at the pharmacy and call it good. The customer service is never good at the mail order and it can make it difficult.

I am hoping to get the test strip issue taken care of because they won't do refills at my office unless the pharmacy contacts them that we are out but that will only create more issues for me because my only prescription is through the mail order.  Hoping to get things back on track with the mail order pharmacy today.

On the testing front. The Big Blue Test is currently going on right now. I hope you all join me. The Big Blue Test is that you test then get active for at least 20-30 minutes and then test again. Then post results on app or on webpage your results. By participating you providing Insulin to other Diabetics who need supplies and education. I participate every year. Hoping you all join me you can do it as many times as you like.

http://www.bigbluetest.org

Thoughts of How Difficult it Must Have Been

I was thinking this weekend about all the times my parents went through those awful drives to the hospital when I was younger. I know there were times when I was throwing up everywhere or my blood sugars would not come back up not matter how they tried. I remember being at my friends birthday party but I would not eat or drink enough to raise my blood sugar so they had to call the EMS. All the times I had bronchitis and needed to stay at the hospital.

 I know now how difficult that must have been for my parents. All the long nights spent at the hospital and trying to take care of my brother and sister as well. My parents honestly made it all look so easy. I know I was blessed to have the most patient caring mother. She did so much and made it look so easy. Even now as an adult I don't think I can make everything seem so easy and handle big obstacles like they are nothing. I am not really sure if deep down she was carrying the weight of the situations with her and I really hope not. I know today my mom would really extremely proud in how well I have handled all the crazy things my diabetes has thrown at me.

I know these times really make me miss her even more. She also managed her own diabetes on top of mine which is no easy task thankfully her blood sugars were much more stable than my crazy one's. I know during the hard times having someone as knowledgeable as her was incredible to have. Thankfully she thought me how to research and find what I need to know. Most of my decisions are still impacted by what she taught me and also how to handle Dr.'s. I know she taught me a great deal and I owe her so much. I know I hope she knew how much I appreciated all the wonderful things she did for me.

 I know the days when I was diagnosed with complications were incredibly scary without her. I know I wish I had more time to tell her how much all her efforts to keep me healthy as a child was appreciated. I know all the parents with children with diabetes we do appreciate all your efforts even if you don't hear it enough. I think it is easy to forget to say thank you enough when your parents make the process look so easy. So to all the mom's and dad's out there you are appreciate and loved for dealing with such a difficult disease.

Getting Back to Normal

I have to say now that things are some what slowing down at work my blood sugars are going back to normal. I have a day where I was cruising all day around 110 which I can't complain about. I am back to seeing patterns again in my blood sugars which is a relief. I know my Dr. was reviewing my numbers yesterday and pointed out that my Dexcom did not detect a pattern during the recent download. She said she understood why the past couple of months have been so difficult for me. I know they now told me anytime I am unable to figure out a solution to download my pump and Dexcom and sent them to her for review. They will call me back with suggestions. They even said I could drop in and they would download which ever was easier. Nice to know if I need help in between appointments they will review what is going on.

I know my Dr. and PA both said my case is never easy and can understand why it has been a struggle for me over the years. I know my appointments are always long because it take a while to review and decide what to do and at times its not always the right settings. I am really glad that for the most part I am able to get things where I need them to be but at times their is no easy answers usually. I am so great full that I have a good medical team that is willing to help me out when I need it. Most of all I really love the fact that my Dr. asks me questions about how my life is going in general and any issues I may be experiencing.

They seem to really understand my need to be under 6.5 to keep more complications at bay where my previous Endocrinologist listed me as uncompliant because I would not run over 7.3. I am all for being safe but I also am for being able to live the highest quality of life I can. If that means running at under 6.5 to get that I am all for that. Thankfully my Endocrinologist gets that and is willing to work with me on keeping me on the right track. The really nice part of the office is also that they are very supportive of me having Duchess and honestly there has only been two Dr.'s who supported me on having Duchess. I

Facing the Reality of The Situation

Before Appointment

I am still not sure why I do this to myself every time my Endocrinologist appointments comes up. No matter how prepared I am I never feel prepared enough. I know my previous bad Endocrinologist appointments where I was called a bad diabetic plays so readily in my mind. Even though I have had almost six great years of A1c's I spent so much time wishing for. I still can't free myself from the night of dreams about blood sugar spikes and bad lows I will have to discuss.

I know I always fear my A1c results because of all the times I feel I failed when I really didn't fail but just had more work to do. I should be fairly relaxed because I know my current Endocrinologist always listens to me and tries to work with me on improving. I know moving beyond bad experiences is never as easy at it seems. I am working on it but it takes time. I am just full of nerves as I wait for my appointment. It always drives me crazy all the worry and the stressing and most of the time everything turns out to be just fine.

I know this appointment I know will be a little more difficult than the past few in some ways because some of the things I normally do are no longer working. I know my Dr. can help but I am very stubborn and hate to ask for help. So I have to admit this time I am completely overwhelmed and have to wave my white flag for help. I feel better because I know I will be addressing the issue  but I feel very defeated in general these days.

After Appointment

Well I went to my appointment and I did mention some of the issues I was having my A1c is not at it's all time lowest which is not really where I wanted my A1c. I know all those terrible lows in the past couple of months have played a part in where I am currently at. I know my A1c is not really reflecting where I am at. My Endocrinologist made some changes to my basal as I knew they would. I normally feel more peppy and like myself but these days I rarely go out or do anything that I love. I am attempting to sleep a great deal more than usual. It took me a while to figure out that I was depressed and I needed to do something about it. Normally I do certain things and it seems to get me back on track without needing medication.

Sadly this time I knew that was not working. I have dealt with depression on and off for years but I also know that I am more moody recently and seem unable to deal with most things. If I had time off from work I honestly do not know what I would except for sleep. None of these things are really me. I am sorry if my depression has crept up in my blog. It really took me a while to figure it out and finally a friend said something to me. No matter how many times my depression becomes an issue I always just consider it part of being a diabetic. I honestly feel like this is very difficult for me to blog about and I want to dance around the subject but sometimes you just have to talk about it.

What I Wish I had Known at The Start

I have learned so much from my Journey with Proliferative Diabetic Retinopathy. I know there is so many things I wish I had known in the beginning. Even though my last couple of appointments have not been great experiences his knowledge of what works is really great and the Dr. shares this information. I have found the more I know the better I am prepared. So I though I would share some things I have learned.

1. My best tip I have received so far is to sleep with two pillows propped up at an angle. The main reason behind this is because most hemorrhages happen overnight so if you are lying flat the blood will flow into the your vision. I have been doing this since Last October and things are much better.

2. The interesting thing about eyes if you have retinopathy you have it in both eyes not just one. I know I have one that has hemorrhages but the other has had not issues and in fact I have great vision. They are always monitoring it to make sure I don't have any issues in that eye.

3. If you have higher blood pressure that can create more issues such as more hemorrhages. ( I have not experiences this but good to know if you do have high blood pressure or other issues). Higher cholesterol, anemia and kidney issues can also cause more issues if not properly controlled.

4.  Almost every online websites says that the laser treatments are not painful but that was not really true for me. I have found them to be painful and the drops they put in for pain just burns. So most of the time I just grin and bear it and take Advil once I am done with my treatments.

Figured Out Some Answers

I went back for a laser treatment with my Retina Specialist on Monday. I really was still upset by my previous visit and was expecting more of the same. I had a different nurse this time from the two I might normally see. Thankfully when this nurse was there he seemed to be more knowledgeable about my case in general. What I realized is that the nurses he has are playing a big part in how my visits go and what is said to me as the patient. When the nurse I see the most is there he questions are more general such as how is your general health and he does not become pushy that some thing has to be wrong. He also seems to know my case quite well and can give me insightful answers to my questions.

The appointment from last week he seemed to not remember my case and seemed thrown off by my questions. I know he was shocked when I asked about when we were going to schedule my surgery for? He did not seem to recall that I was given all the information about the surgery but also the offices typical procedures for scheduling and arranging the surgery. I know he thought I was crazy but yesterday told me that in the future a surgery might be necessary for my right eye. I knew that already but it was interesting the difference in attitude and discussions about my case from the previous visit.

I know am going to try and only schedule the visits when the nurse I like is working in hopes of avoiding rude comments and questions that are not necessary. I am good patient and I work hard at keeping my blood sugars under control so I find it offensive when a Dr. outright tells me I am lying about my A1c's. I am not sure what to do about my visit but I do have a great relationship with my Endocrinologist. I am thinking of discussing the negative visit with them and seeing if they can discuss with him about how not to talk to Diabetic patients. I have to give my Endocrinologist office credit they really work with me and I feel like they really go the extra mile for me. I know how much I really appreciate their help even more after my Retina Specialist experience.

Overstepping The Boundries

I have been frequently disappointed in quite a few of the Dr.'s I have seen over the past two years. That is except for my Endocrinologist who does so many things right and tries to work with me to make my life more manageable. I really appreciate when I meet a physician who takes the time to get things right or at least tries. I was really discouraged after my recent visit. I am overly aggressive with my blood sugars as it is but when a Dr. is constantly telling you that you will get more it is never appreciated. I have had my A1c in a range where I should  not be developing further complications if I stay in the range I currently am. I work very hard to make my life work for me but I do not appreciate Dr.'s who says to the patients that so and so percent develop this complication so you are too. I think my Retina Specialist does not seem to get your diabetes may vary.

He keeps telling me almost all his patients all have this complication as well. I tell him my blood work and test are all in normal range. I am not sure what to tell the Dr. but next time I am going to say something. I have never been a text book case and never will be so comparing me to information in a text book or medical journal will not get you very far. My case has always been complicated and I am sure will stay that way. I really just wish he would not be so rude and pushy about that I have to have another complication.

I feel like my life is already crazy enough without saying to me constantly you will develop x,y and z complication. I think Dr.'s need to be a little more sensitive in how they address these issues. I know my retina specialist does not seem to believe my A1c is what I am telling him. I told him at my appointment that I will sign a form so they can request copy's of my lab results from my Endocrinologist. I am really offended that he thinks I am uncontrolled but at the same time my eyes are doing great which does not add up.

I am really tired of dealing with specialist when they think they are experts in other areas. The Retina Specialist needs to just stick to the eye's and leave the other items to my Endocrinologist. I know a specialist should ask if my blood sugars in control, blood pressure etc but not start trying to diagnose conditions patients do not have.

If there were more options for Retina Specialist I probably would switch but at this point I will educate him and let him know he comments are not appreciated. Hoping that will make for a more pleasant experience. I already hate going the Retina specialist as it is but the comments are too much.

Good News and Irritation

It was an interesting appointment to my Retina Specialist yesterday. During my last appointment we discussed the fact that we would be scheduling a time for the procedure in October. So I figured that is what we would be doing. I go in and they did more full exam including new pictures of my eyes. They really are looking so much better than a year ago. Which is wonderful. So the Dr. decided that we will see how my eye progresses further and decide at a future date if surgery is necessary.

This of course if a big relief in some ways but I also know that means more laser procedures are in my up coming future. Overall my eye is really looking great and I know keeping my blood sugars as controlled as possible will help in my overall eye health. I was disturbed by some off hand comments by the Dr. yesterday in the office. I see my Endocrinologist at least 4 times a year depending on what is going on with my blood sugars normally and some times more. He was asking about my general health and kept insisting I have to have other complications. I told him all the blood work, tests, and such all showed everything was normal. My kidney function is at a normal level and has never shown any signs of issues in the past 33 years. I do not show any signs of  Neuropathy. My blood pressure is normal, my cholesterol is normal  and everything seems great. He kept insisting that because I have retinopathy that I have to have high blood pressure.

I do not have high blood pressure. I know the nurse checked my blood pressure and told me the numbers. He came in the room saying mine was high. I know what normal blood pressure is and it was not high. So I reminded him that my mother was a nurse and the nurse recorded my blood pressure as she told me verbally. So I was pretty furious when he told me I needed to get on blood pressure medication. There is no reason for me to be on blood pressure medication for normal blood pressure. My Endocrinologist is the one who make that decision. I am not liking how my Dr. is trying each time I visit now to suggest I have other complications.

I know others complication can happen but every time I visit insisting that something is off is not right. I already and a little overly crazy about keeping my blood sugars in check. I really don't need a Retina Specialist trying to handle my Diabetes when My Endocrinologist is extremely competent and thorough. I am really hoping he lays off the comments on Monday when I have another appointment to do a little laser treatment. There is a small area they missed last time. I am really getting irritated because of how insistent there must be more wrong. I think some Dr.'s think one complication means text book that you must have others. I know my Diabetes has never been text book and never will be. I know statistics fit some patients but not all. I just wish he would figure it out.

The Time is Nearing

I have my appointment this afternoon with Retina Specialist to schedule my Vitrectomy surgery date. A Vitrectomy is the removal of the Vitreous Humor which is the gel substance between the lenses in the eye.  I am never a fan of surgeries and I have had several already. I know the surgery is supposed to make my eye more stable and decrease the chance of bleeding. For the most part currently my eye has had very few hemorrhages over the past 6 months. I know tight control has also played a part in my eye dealing well with Diabetic Retinopathy. I am hoping for less visits to Retina Specialist once i have my surgery either in October or early November. I want to be done with it before all the holidays which require travel.

I am really surprised how well I have been able to handle the bumpy road since my first hemorrhage in  2012 hard to believe it has been over a year and my vision is quite good and the fact that my left eye has had no issues so far. I am hoping to keep it that way if possible. I know they keep telling me that they see no signs of Retinopathy in my left eye and I want it to stay that way. I am happy I will be able to get this behind me soon but I am sure the recovery will not be fun like most of my previous surgeries.

I think once I know the surgery date it will make it all the much more real for me. I know I will be extremely nervous because your eye is so important. I know every time I have surgery I am full of nerves before I have to go in. I know this upcoming surgery is difficult because some of my family members don't want to know when I am having surgery. So I really appreciate all the supportive people who read my blog because there is not much support from my family these days. I know even if I lived close to my family they would not be present when I was having my surgery. I also don't bother mentioning bad lows to my family either. They tend to criticize me because they think it could of been prevented. Funny thing is that I had quite a few trips to the ER when I was little because of bad lows.

Limitations That Are Necessary

  I am realizing the longer I work in my current workplace the more I need to establish guidelines and restrictions on work hours. I realized recently the night I was at work til almost 10pm that was too long of a day for Duchess. It actually was quite a long day for me as well. I know that night I did not sleep well either because of really bad low blood sugars which keeps Duchess up as well. So looking at these types of situations I need to not only protect my own health but also Duchess as well. Duchess is a very active playful service dog who needs downtime and the opportunity to be a dog every evening for several hours. She works really long days and it can be so easy to forget what issues these hours can create.

Thankfully Duchess is very flexible and reasonable. I think because she is so flexible it can be so easy to forget how much needs to keep he happy. I know after that 14 hour day she was very upset and rightfully so. I know I am working on adjusting my work accommodations to include that I am unable to work 7 days a week. Duchess can work 6 days and that is pushing it but she honestly needs a day off just as much as I do. I know my personal limitations and Duchess has her's as well. I used to be able to handle everything and make it look easy but sadly Hypoglycemia Unawareness does not play fair. So I have to accept that yes there is really certain things I need to avoid.

I know last year when I had my last Seizure in September of last year I was working 7 days a week. I am sure that took its toll and I have learned my lesson about my personal limitations. This year I have learned about Duchess's limitations as well. I knew the day I was working the overtime that I would be their for a couple of hours but did not expect to stay that late. Next year I am putting a limit on the time for both of our sakes. Thankfully Duchess is very vocal in many ways and was able to communicate her frustration to me. I did discuss the current issue with the disability office and they supported my decision to limit the hours if it impacted Duchess and I. I know I am no good for the office if it is going to cause more issues.

Buyer Beware

I saw an article recently that I knew would be coming soon. Families who bought dogs from a man who did not train the dogs and claims they are trained. There is these outrageous contracts that the group can come and take back the dog at any point. When I purchased Duchess I knew the contract I had signed did not allow them to come and take Duchess back. In fact when she retires I get to keep her. I can say it enough if you are looking into getting a dog please do your research. Ask questions, contact the better business bureau, talk to other families, visit the location several times, talk with the trainers extensively. Then keep digging to find any complaints you can find. I have seen so many families scammed by greedy people wanting to take advantage of in particular parents with young children.

There was a group that was being sued and this is another example of the same. Dogs who they were claiming were trained only difference is that one group is saying that 8-10week old puppy was trained which is not true. A service dog requires at least 18 months or more of training. Putting a vest on a puppy does not make it a service dog. In fact this is another great example of  what harms other people who have a well trained service dog who behaves appropriately. I believe one of the families at the Friends for Life Conference I believe had purchased the puppy from this company. This is the same dog that popped in the lobby of the hotel which makes all the great service dog teams look bad. I am sure the family was completely overwhelmed receiving an untrained service dog.

I know the process to get a service dog is a very long tedious process but remember if it sounds too good to be true it probably is. I also know that not all Diabetic alert dogs will alert at night as well. So it is also good to keep expectations with in reason. I know I have learned so much from my process but I really wish no family ever had to experience scams or poorly trained service dogs.

http://fox43.com/2013/10/03/diabetes-service-dog-not-properly-trained-dissatisfied-in-virginia-based-company/