Today I woke up at 5am. Normally when I wake up around this
time I get irritable and annoyed, with the thought that my alarm is not going
to be long at the front of my mind This morning was different, a little like
Christmas morning when waking up early is only ever a good thing! As a child,
anyway… This morning it was with a mixture of excitement and apprehension that
I signed into Skype around 6am to await my ‘First Visit’ with Dr. Scheiner’s
Integrated Diabetes Service. I wasn’t disappointed.
The appointment began with a face to face with Dr. Scheiner
and a nurse, Linda, also a type 1 diabetic. It introductions and questions
about Korea and then it was just me and Linda to talk nuts and bolts of daily
diabetes care. She had my records from the last few weeks in front of her and
kept referring back to them throughout the meeting.
The main things I took away from the meeting were:
- My current target levels are slightly unrealistic. I have been being hard on myself, trying to get my levels within this magic range of 74 – 126. While these are, admittedly, the ranges of perfection, it was nice today to be told that I can relax these limits just slightly: my premeal target should (for now, at least) be between 80-160. After meals, I am looking for a rise of no more than 200. I should also be aiming to have no more than 3 hypoes a week.
- The importance (and method) behind accurate basal testing. Lisa told me that I really need to do some day time bolus tests, especially as my Levemir seems to be holding me fairly stable overnight. To do this, I need to fast over each mealtime on different days. Breakfast-wise, I should have a large snack before bed, then take my morning Levemir dose, but then eat nothing until 11 or so am, testing every so often to check, Over lunch, this would mean an early breakfast before testing intermittently between 11 and late afternoon. Dinner time would be similar: lunch as usual, testing from around 4 and having a late dinner. Doing this will help me to judge whether my basal dose is also steady for the day: the idea being that my blood sugars should vary little with no food or bolus insulin floating around my system.
- As a general day-to-day rule, I should try to leave a 3 hour gap between meals and snacks to avoid topping up the food already in my body, thus not giving my levels time to return to “normal”.
- Where possible exercise (exercise?!) should be done 1 and a half to 2 hours after a meal, and I should reduce my bolus dose for that meal by a third. This is new to me. I always thought that exercise was best done before a meal! But I guess the body needs insulin to feed its muscles and just before a meal insulin levels are too low to do this properly.
There were a couple of tweaks made to my lunch- and
dinner-time ratios too… Now I just need to see how it goes!
By the time I’d reached school I’d received a summary, from
Lisa, of all the things we’d talked about.
I am feeling positive and looking forward to the next
appointment which I have scheduled for a month’s time. In the meantime I have
to send my written records (more detailed! I somewhat trailed off last week…)
to Linda every few days for advice on adjustments between now and the next
appointment.
I am so grateful I browsed Amazon that day… Just looking to
read about other people’s experiences with what I live with every day. If I
hadn’t, I wouldn’t have found Dr. Scheiner’s book and as a result, wouldn’t
have had this morning’s meeting. It feels like I have some support. And, while
I do feel a little frustrated that I am not able to see through the fog myself,
I do have the clarity to realize that subjectivity is a huge impairment to
this.
My final point for today is that writing this blog is finally starting
to help: analysing and recording my blood sugar levels has made me do at least
some of it on my own; I am starting to see patterns I couldn't see and making changes myself. I just need some
extra help to make sense of it all.
No comments:
Post a Comment