Click for the One Thing to Improve - Wednesday 5/16 Link List.
Today's prompt: One Thing to Improve. Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!
If "needs improvement" items were monkeys, I'd have a barrel full.
For the last 6 years or so, managing my diabetes has been the first and last thing I think about everyday. That's a change from the 'chasing my tail' method of my younger days.
And it has shown in my great A1cs, improved standard deviation in my blood sugar, and the whole baby thing.
But the thing about diabetes is that it's never good enough.
I test 6-10 times per day - awesome, but, like most veterans, I don't change my lancet. Ever. And when I say that to people without diabetes (as I did today), you can hear a pin drop. Ew, they think. Eh, I reply. I'm still working through the 2nd or 3rd drum on my multiclix I've had since before my wedding. There is a box of lancets in my supply cart from 2001. But that's not an area where I plan to expend any energy.
There are 3 big ones where I'm going to admit to failure though:
Managing insulin during exercise
I eat pretty healthily - homemade, organics, whole grains, lean proteins, almost no sat fat (except for occasional sweets), but I know I SWAG my carb counts terribly. You couldn't even call it SWAGing. It's more like RWAGing ('random wild ass guessing') because the 'scientific' part is all hullabaloo for me.
I am often so so wrong. I'm trying to be better, but I'm annoyed that cooking from scratch - which makes my meals healthier - makes carb counting that much harder. No one slaps a nutritional label on my crockpot for me and tells me how to SWAG my minestrone. Is it 30g? 50g? 65g a bowl? How much is a bowl? 3/4 cup? 1 cup? What if I use lean beef and wheat macaroni? KILL ALL THE THINGS!!!!!!!
*breathes* Okay, what was I saying?
I'm also awful at managing exercise. I don't mean the getting out there and doing it - everyone is awful at that. I mean balancing the trifecta of insulin/food/activity. If you think I'm bad at the Food-to-Insulin See-Saw, you should see me sliding around on the Triangle of Terror.
Last night, we decided as we sat down to dinner (30g rice, $;@?g for the avocado tomato corn salsa on my grilled chicken) that we would indeed do our 2mile walk to the park and back with the kids. Okay. Crap. Okay. Here goes. I can do this.
I was 77 mg/dL before dinner, so I took no bolus insulin for my plate. As we start to head out the door, I'm 93. So far so good. Putting shoes on didn't screw me up then. I reduce my basal insulin by 50% for 90minutes. I grab every edible thing in the pantry and throw it in the basket of the stroller and I suck down a juice box (15g). Miraculously, I stay flat at 90 for the first mile (22minutes). We spent 12min at the park. By the time we are home, I'm at 80 on the CGMS. Best I've ever done. Test blood sugar. 70s. Still functioning on reduced basal, but expecting to continue dropping. So eat 30g. Wait patiently...still dropping...Decide to bake 4 dozen sugar cookies for party today. Handling the sugar on my skin (perhaps sampling some too) raises my blood sugar to 300. Oh f*ckitalltoblazes. I just can't win. I will be my own undoing.
Which brings me to pattern management. I can't make accurate changes to my dosages on my own. Lots of people can. Maybe I don't have the same eye for the details. If I do log my numbers, meals, and activity, I can't make sense of it. I literally hand over my pump and CGMS to my CDE (aka the Evil Genius) and she figures it all out and hands it back to me.
To be honest though, I know I could. I feel like it's a failure of spirit. My numbers are frustrating to me because I feel them. To her and you and my endo, they are just data.
I can't see the forest because I keep smacking my face into tree trunks. She can step back and say, "Look at the lovely Spruces."
I need that. I need to be able to hand it all to somebody and just say, "Here. Fix it."
But she won't always be there. I would like to learn how to fix my basals and ratios myself. I have a brain. I have a book. I have a calculator. I just don't have the will.
I need to solve for "why."