Merry [Pump] Christmas!

merry christmas batman

After eleven stinking months of bitching at strangers on the phone, switching over to Oregon Health Plan (due to losing my job at the shitty, shitty restaurant), and fulfilling all of the compliance requirements in order to be approved for a pump by Kaiser’s weirdo DME committee….

I FINALLY HAVE A NEW PUMP!!!

Allow me to introduce you to Mister Plum, my brand-spanking new Medtronic Revel 523:

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What a handsome little fellow!  

This little monster is CGM-compatible and comes loaded with new, handy features (and complimentary gadgets) that will improve my diabetes management, including:

  • Post-meal BG reminder:  My A1c was recently rose back up to a dreadful 9.0, and my endocrinologist determined that a large part of the problem is my failure to test after meals. I simply forget. This function allows me to set my pump to squawk at me two hours after I eat, so forgetting is out of the question. The sooner I catch highs post-meal, the better I can control my overall sugars until I can determine what I’m doing wrong to get high post-meals in the first place. So stoked.
  • Capture Event function:  This function lets you capture certain moments in time that can be incorporated into your overall trends, such as BGs, exercise, insulin intake, and meals.
  • Missed Meal reminder:  If you have a problem forgetting to bolus with dinner, you can set a span of time to remind yourself to do so.  This is not as helpful for me at the moment because I do not eat at the same time every day.  Also, I generally do not forget to bolus with meals.
  • Bayer Contour Next Link blood glucose meter:  I *love* this thing:
    • The lancet device is less painful and the strips require much less blood than One Touch Ultras.
    • This meter is programmed to automatically ask you to categorize your reading as “Before Meal” and “After Meal” before you even see the reading itself.  This makes it easier to analyze whether you are off on your basal, carb-to-unit ratio, or are possibly in need of a carb-counting refresher.
    • Additionally, this meter has a built-in USB port, and communicates with your pump when plugged into the computer.  And now that CareLink has been upgraded to be more Mac-compatible, I will be able to get a better sense of my overall trends and behaviors.

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BG Reminder!

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The fancy Bayer Contour Next Link BG meter.  My new love. 

Lessons Learned

If you are in pump purgatory as I was, hang in there.  Be patient with the health administrators on the ground who are trying to get this done for you.  I promise you that they want to accommodate you, but because of the administrative hurdles instituted by top-down execs who mercilessly seek to cut costs, it will take time.  Try to humanize yourself to administrators to gain their sympathy (read: cooperation) and remind them why you are an excellent candidate for insulin pump therapy.  As an athlete, I argued that my dynamic and active lifestyle would be jeopardized by the constant eating you have to do while taking long-acting insulin* injections.  You can’t ramp down your insulin intake after you’ve taken a shot, so if you decide on an impromptu bike ride or random mountain climb, you have to eat beforehand or you’ll go low.  This makes weight management difficult, which in turn can affect how much insulin you require in the first place.  It’s a cycle, and remind them of that.  Keep your head up! 

Here’s to great control in the future with my new gadget!

Photo Credit: memecenter.com/keptinkurk

*Nota bene:  I am not full-scale attacking syringe-based insulin therapy.  Many respectable athletes use long-acting insulin.  I just believe that you have to be extremely regimented to make it work.  I am not.

Goal-Setting: My Ideal Body in Pictures and Numbers

In his book “Thinner, Leaner, Stronger,” Michael Matthews recommends setting tangible goals before you even pick up a weight, drop a calorie, or hop on a treadmill. I wholly agree.

I did not do this in the first few weeks because I was extremely motivated to get started and I didn’t want to plan myself out of execution, which is consistent with my rather cerebral tendencies.  But goal-setting is just as important as knowing your baseline, and now that I’ve had a few weeks to really reflect, I’m ready to articulate those goals.

In setting up your goals, Matthews recommends assessing (1) what your ideal body looks like; (2) what your ideal state of health would be like; and (3) why you’re doing this in the first place. Today, I will focus on my ideal body.

A Picture of my Ideal Body

Matthews recommends not just using mere words to describe your ideal body, but pictures. So I found a few. Here is my favorite:
Fit Chick 1What a fox! She embodies a lot of qualities I am looking for: Strong, good lines, lean… but NOT “skinny fat.” I’ve been around this size before, so I’m confident this is an attainable goal (with time and effort). I want a body indicative of a healthy, happy lifestyle, in which I’m not engaging in negativity or self-punishment.

And most importantly, I want my thighs to still touch:

Fit Chick ThighsThe Thigh Gap is not welcome in this house.*

My Ideal Body in Numbers

I finally got my body fat percentage tested at 24-Hour Fitness, by Corey, my new trainer. Sadly, it’s at a whopping 35%. With a body weight of 150 lbs, this translates into 97.5 lbs of muscle, and 52.5 lbs of fat!

I’m carrying a spry tween’s worth of weight on my thighs, hips, ass, arms, and belly. YUCK. No wonder I’ve been feeling like crap.

My ultimate goal is to weigh approximately 135 lbs and have 20% body fat, which means I need to lose 25.5 lbs of fat and gain 10.5 lbs of muscle. I’m not ignorant to the fact that this is a fairly significant “body recomp,” so I set a first milestone to weigh approximately 140 lbs and have 25% body fat. Corey estimated that at a healthy rate of losing 2% of body fat each month, I can reach this goal in five months.

((whimper)) …wish me luck!

*I have A LOT of opinions on this Thigh Gap and Thinspo garbage circulating the internet and infiltrating the minds of young women out there. Stay tuned for more information on this dubious subject, and the all-out war to follow. It’s on, bitches.  

Sunday Stats: Week of March 16, 2014

Sunday, Bloody Sunday…. self-disclosure time!
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There is a lot of anecdotal evidence showing that people who track their fitness see more progress, likely because they know how they measure up against their goals. Now that I am starting to develop a fairly regular health and fitness routine, I’ll be publishing my stats every Sunday to track my progress. They’ll be pretty basic to start – weight and BG stats for now. Next week, I’ll start tracking the inches ((shudder)) and RHR. Also, I’ll be posting about my goals in the near future…

I have a quarterly appointment with my endocrinologist in April, after which I’ll publish many of the same stats I posted in my Baseline Assessment. I would loooovvveee to see my a1c below 7. Fingers crossed.

WEIGHT: 152 ((sigh))

DIABETIC STATS:
     7-day BG average: 181
     14-day BG average: 190
     30-day BG average: 216

     Before Meal 7-day average: 131
     Before Meal 14-day average: 146
     Before Meal 30-day average: 178

     After Meal 7-day average: 241
     After Meal 14-day average: 254
     After Meal 30-day average: 282

     Lowest BG of the week: 40
     Highest BG of the week: 344

THOUGHTS
I’m liking the overall downward trend of my diabetic stats, particularly my pre-meal BGs. I’m down 15 points for my baseline 7-day average of 196. Unfortunately, this was the only stat I took down from my meter to establish my baseline – I’m excited to see what my 14-day and 30-day averages are going to look like next week!

I clearly need some improvement in the After Meal category, as this seems to be the major source of my high BGs. This could be an issue with carb-counting, my carb-to-unit ratio (currently 1 unit of insulin for every 12 grams of carbohydrates), or a little of both. I suspect the most likely culprit is carb counting. It is not even remotely an exact science, and I am in need of a major refresher. Luckily, my endocrinologist referred me to Kaiser Permanente’s nutrition department, and I will be setting up an appointment soon.

Nota bene: A lot of my lows are going unreported. When I was without health care, I had to severely cut back on my blood sugar testing to conserve test strips, so I was taught not to test for lows because I don’t need a meter to know when I’m low (hot neck, cranky, sweaty, disoriented, HANGRY).

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I will be getting in the habit of testing for lows to show that trend to both my readers and my endocrinologist. While we’re on the topic of evil, evil lows, I’ve been having at least one hypo a day for the past four or five days, and I am not a fan of this trend. Lows feel like shit on a stick.

Anything else you guys think I should be tracking on a weekly basis? Chime in and leave a comment!

Photo Credits: ideasmile and http://efficientawesomeness.com/