Thursday, October 25, 2012

Results, Anxiety, & The Future

In my last post, I wrote about how frustrated I was with the excruciatingly slow progress I'd seen in my blood sugars since changing my pump settings. More so than the actual results, the lack of control over my numbers is what has bothered me the most.

I had my quarterly appointment with the endocrinologist on Monday, along with my official A1c lab test. Since the at-home tests I'd done in previous months showed 6.8% (in August) and 6.9% (earlier this month), I was fully expecting it to be in that range. I explained everything that had been happening in the past few months to my doctor, but he said as long as it was under 7.0%, it was fine.

When I anxiously opened my results yesterday, however, I was pleasantly surprised to find that it was actually 6.4% (which translates to an estimated average of 132)--and my cholesterol and triglycerides were finally in the normal range, too. Yay!

Like I've mentioned before, I've always been harder on myself than anyone else (my endocrinologist included) is, but I'm usually pretty good at predicting what my A1c will be. This is one time I'm very glad to be wrong!

Even though we're not planning to have another child anytime soon (at least not until Baby Girl is a year old, another three months from now), the thought of the future is always in the back of my mind. The next baby deserves the same start on life as our first had, with all the attention I can possibly give to my health for his/her benefit. Since I have an IUD, we obviously have to consciously plan our next one anyway, but for us my diabetes definitely factors into that as well.

Another thing that has been weighing on me heavily lately is exercise...or rather, my lack of it. I've written several times in the past about working out, most recently in January when I asked my OB about exercising postpartum. Clearly I had on rose-colored glasses back then, because I definitely underestimated how difficult it would be to work in a workout with a full-time job and a baby (and house) to take care of.

My exercise "routine" thus far has been spotty at best. I get on my Gazelle or go for a walk when I have the time, but other than that it is nothing more than a passing thought on my way to do something else that has to be done. I know I need to make it a priority (especially as the future becomes more of a reality rather than a distant possibility), but it's just so hard.

Since my Chiari stuff started back in June, I've been having anxiety attacks on and off in the evenings. I would lay awake in bed trying to go to sleep, but I just couldn't shake the panic I got with that "about to pass out" feeling (though I never actually did check out). It got so bad that I'd get up and sit in the living room in the middle of the night trying to decide whether or not to go the ER because I was afraid I was actually having a heart attack. I'd eventually convince myself it was "just" anxiety, but that doesn't make the feeling any less real.

Earlier this month, my husband went out of town for business. The first week he was gone, I finally decided I couldn't take it anymore and made an appointment to get some anxiety medication. The decision to do so was extremely difficult for me because I knew it would mean I would have to stop breastfeeding (SNRIs have not been studied like SSRIs have in regards to breastfeeding), and even though Baby Girl was 8-1/2 months old at the time and down to one morning feeding, I had planned to continue nursing until she was a year old. After some discussion with the doctors and a call to my husband, I decided that our baby having a calmer, happier mom was more beneficial. And, like my husband said, she would be getting teeth soon anyway...little did we know, her first one would pop up less than a week later!

I've been on the medication now for two weeks and I can tell it's making a difference. I still had that anxious feeling quite a bit for a while, but it was definitely more manageable than before. Overall, I'm a lot less "on edge" and more positive about things, so life has been better in general. I'm hoping that now that I'm back on track mentally and emotionally, I can focus on getting there physically too. Maybe I can even lose those last 10 lbs! =)

Friday, October 5, 2012


It's been about a month since I last posted about changing all of my pump settings, and although things have gotten better, it hasn't been as noticeable (or quick) of a change as I'd like it to be. To be honest, I've been very frustrated with my lack of progress. Everyone who knows me or reads my posts is well aware of the fact that I'm a perfectionist to the when my blood sugar #s are not where I'd like them to be, it irritates me.

The worst part about it all is that I know I can do better. Throughout my entire pregnancy, even though I had plenty of lows and highs, I was still able to keep my average in the normal range and my A1c stayed under 6.0%. Recently, however, I've had such a hard time getting my average back down to used to be closer to 115. I know a lot of it probably has to do with changing hormones (hello, postpartum period) and stress (ditto), but it's been hard for me not being able to control things as well as I used to.

I'm torn between being afraid of crashing and annoyed by highs, and for the past couple of months, the fear has won out. Now that I'm sure of what's behind my dizzy "low" feeling and that is slowly getting better, I've been slightly more comfortable with running lower again. It seems like such a long, frustrating road, but I'm hoping that my progress (however slow it may be) will continue and things will get better.

I re-worked my basal/bolus rates once again just like I did about a month ago, and again increased my TDD of insulin in hopes that it'll bring my average down a little more. As frustrated as I am by feeling so "out of control", I feel like that's all I can do so that maybe--just maybe--it will help. Either way, at least I'll be doing something, which always makes me feel better about the situation.

Through all of this, I've tried to remind myself that a few months of so-so control compared to a year and a half or two years of pretty great control isn't so bad...that in the grander scheme of things, it shouldn't make much of a difference. Nevertheless, as Type A as I am, it still feels comparable to one of those irritating little rocks in your shoe that you can't get to. Last week, I bought one of those at-home A1c tests that you mail off and can then get results either through the mail or online. I received an email this morning that my results were in, so I logged on and was admittedly more than a little disappointed to see it was at 6.9%. I know that the ADA recommends that someone with diabetes keep their A1c under 7.0%, but being the perfectionist that I am and knowing what I'm capable of, I like to keep mine in the normal person's normal range (4.0-6.0%). Even when I was first diagnosed, mine was never higher than 6.5%!

Now I know that 6.9% is still in the 6's, and it's still below 7.0%, and my endocrinologist will probably not care as much as I do about it. Usually, I'm much harder on myself than he is, but that doesn't mean I'm comfortable "slacking off." I want to be as healthy as possible for as long as possible...I love my baby girl too much to risk anything else!