Chloe in Motion: Peaks and Valleys

Sunday, February 10, 2008

Peaks and Valleys

I started a constant glucose sensor yesterday. The sensor gives a constant readout of my interstitial fluid glucose concentration (quite similar to blood glucose) in fancy graph format.
I couldn't help but notice the striking similarity between my glucose graphs and the graphs from our cycle touring book, which shows the elevation gain of the terrain we are travelling.

Although they are proably inversely related...the bigger the hill, the lower the sugar...a peak on either graph is a pain in the butt.

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"So...what are your plans?"

Everyone always wants to know this of a recent graduate and never hesitates to ask.

"What are your plans?" is just one of many variations of the question...other ways of saying it include:
"Where are you working now?" or "How is the job search going?" or "Applied to any boards yet?"

I know what they want the answer to be, what they are dying to hear.
"So glad you asked. In fact, I have just secured a full time position with my local school board, I have a salary (highest pay scale of course!), a quality drug plan, we have just bought a condo and I am making regular payments into my RRSP".
It would be so much easier to justify my existance if this were the case.

But that just ain't the truth. That's not me.

I want to work outside doing what I love, be active everyday, love what I do, teach outdoor experiential education, guide trips and expeditions, get more people outside, work with people with Type 1 diabetes...and who knows what else, but I am confident I will find it outside.

Then those people get really nervous.
"What about your diabetes? How will you pay for your medications, supplies, insulin, test strips? You need a drug plan. You need security."
And this, I agree is true. This chronic disease has really thrown a wrench in the plans, really mucked things up.
But those are the cards I have been dealt.
I could look at my hand and fold. Or, I could see that as my Ace.
I have taken it as a challenge. It's time to get creative.

So my answer to the question: I am taking a 'year ON' and if that year is not enough, than I will take another, and another until I find my passions, what gets me excited about being alive, where I want to live, what I want to do for a living, how I can live the healthiest life possible with diabetes, how to make that happen and who I want to be around when all this falls into place.
In short, I am embarking on a journey to find me.

The Low Down

I know a lot about Type 1 diabetes, but I sometimes forget that not everyone reading this blog has the same background knowledge.
A few things about Type 1 Diabetes:
Type 1 is an autoimmune disease and has nothing to do with the amount of sugar we ate as a kid or how much we sat around on the couch.
Our bodies attacked themselves (for reasons unknown) and killed the insulin producing 'beta' cells in the pancreas.
Beacause of this, our bodies do not produce the hormone insulin, we have to give it ourselves in the form of multiple daily injections.
For me, this means wearing an Insulin Pump- a pager-like device with a tube that ends in an infusion site.
The infusion site is basically a wee little flexible tube that is inserted with an introducer needle. After the needle pulls out, the tube is left under the skin, covered with a sticky patch of tape. I normally wear my sites on my tummy and around my sides, low back and upper bum.
My pump is constantly infusing insulin 24 hours a day, at various differnt rates throughout the day (which have been carefully determined by my stellar medical team at TRIDEC, Women's College Hospital in Toronto). This is called my basal rate.
I can change this rate depending on what I am doing, and often need to reduce this rate of infusion when I am active.
Then there is the bolus. The amount of insulin I give myself to cover the food that I eat. I know that for every 15g of carbohydrate I eat, I need to tell my pump to give me 1 unit of insluin.
So when I eat, I count.
How do I know what things are worth?
I have a roladex of food values and carbohydrate contents of hundreds of foods in the back of my brain. And if it's not in there, I read the label, and if there is no label...I guess.

If this all goes according to plan and I get all the math right, then my blood sugar should be normal.

I know what my blood sugar is by testing with my glucometer - a small drop of blood on a strip that goes into a small machine. On average, I do 5-8 tests a day.
There is a scale for blood sugar levels.
Normal is between 4-7mmol (if I test and I am in this range, I silently cheer and jump for joy)
Low is below 4mmol (if I test and am in this range, I have one of two reactions - darn it! I don't feel like eating right now, arrrrg! OR YES! Free license to eat something sugary and delicious, bring it on!
High is anything above 7 (or 10 I like to think) up to around 30, where the scale stops. (if I test and am in this range, I usually think, darn it, what happened? Time to pump it up and get things back in range OR get moving, walk, run, jump around, run the stairs).

But its not all math...things like stress, excitement, exercise, illness, travel etc etc etc all play a role.