Tuesday, January 24, 2012

Look, Ma! No hands!

D-Moms. For anyone in the know, this term can strike fear into your core, especially members of the DOC {diabetes online community}. D-Moms have street cred, they are the jocks with letterman jackets, and don't you DARE challenge anything they say. They are mama-bears apt to snap an uneducated twit's neck if they suggest their child maybe "shouldn't eat that".

I have always admired these women from the sidelines. Going from a Mom to D-Mom is not something that any mother pines for. Hugging new T1 families in my office often evokes many emotions from me. How did my parents handle this? How did they keep me safe? What if my boys get T1? Will Dr. C and I be able to surf these scary ass waves of diabetes land??

The DOC has opened up many avenues that parents weren't able to access years ago. We now live in a world where we can Google carb counts and ask Facebook how we should DualWave that piece of pizza. We are inundated with blogs filled with helpful...and sometimes not so helpful...information. What someone believes as gospel, another spouts as pure rubbish. I can find 87 different answers to 2 questions in 30 seconds. How do Moms do it? I often wonder what level of basket case I would be worrying about lows, excursions, pump malfunctions...I just know how many little issues I face daily, and then to be in charge of such a Mini-betic??? My kid can barely tell me when he needs to poop, how the HELL is he supposed to carefully articulate the feelings of hypoglycemia??? It's enough to make me batty just considering it.

A deep dark crevice of the DOC lies in parents, even patients, that become martyrs for the disease. That thrive on the drama and turmoil that can so easily consume any one of us on any given day. Blow by blow accounts of "horrible" nurses, "know it all" Endos, "money grubbing" pharmacies, " dumb ass" teachers...some comments and blogs are fueled purely from hatred and depression. At times I've seen DOC members of this caliber become cyber bullies, attacking innocents just looking for more information. These situations must be tread upon lightly, as many times there are much deeper lines that must be examined as a root cause for the behavior. Some parents take their role as sole caretaker of the diabetic too far, and it then defines that person. To the point where conversations can ONLY revolve around their plight. I ache for these people. I want to hug them and say "yes, this DOES suck...you DO matter"...and "PLEASE just be niiiiice!". I've seen some wretched claws let loose in the DOC, and I now avoid many of those known "hang outs" as much as possible.

Being a care taker, whether it be full or part time, is NEVER easy. Your job is NEVER done, and often you do it without pay or recognition. It's from love. I love my husband, and sometimes get angry at him for "making" me take care of his diabetes (only at times), but for the most part I enjoy doing what I can to make his life easier. Do I wish he'd get up and get his own damn juice? Of course, but secretly, I thrive on knowing he's doing better because of my help.

So hats off to ALL diabetes caretakers, not just D-Moms {even though they have bigger balls than any man I will EVER meet}. You are not alone. The DOC is only a click away.....

{The above Keep Calm poster can be found in the Keep Calm Store @ Etsy.com}

Monday, January 23, 2012

Paging Nurse Ratched!!!

Blarrrrrf. That’s the sound of the puking I did this weekend after mixing gluten AND alcohol this weekend. No bueno, ya’ll. I have an inkling that this was also a side effect of mixing the alcohol with the medication given to me by the Rheumatologist. I may never know. All I know is that I was miserable, and had only devoured 2 drinks over 3 hours…so for those of you thinking I was drizzle, WRONG. I even counseled with a pharmacist prior to my GNO to make SURE I wasn’t going to drink and then crap my pants, and I was given the go-ahead to “pace myself”. I thought I was doing a noble job at it, too. Lucky me. I see the Dr this Friday to discuss further medication options.

This brings up an interesting point. I have had MANY questions about the gluten-free diet, and would totally love to chat with a dietitian about the changes I have already made, and the further changes I am open to making. For gluten seems to sneak its way into everything. It’s a sneaky lil bastard. Now. Would I want said dietitian to counsel me on the state of my diabetes. NEGATORY. Carb counting. Check. Fats. Check. Being able to identify fruits & veggies….ehhhh CHECK. Why do we HAVE to meet with a dietitian JUST because we have diabetes? Why can’t a CDE learn you about advanced pump features {typically used with fatty or protein rich foods} just as well as a dietitian? I mean they cross train us educators to do both. Why do you need both? Dietitians do pump starts and teach injections, why can’t nurses teach carb counting & dietary needs???

Growing up, I was part of the Texas Children’s Hospital {TCH} assembly line. Appointments lasted 4-5 hours, we met with a nurse, endo, dietitian, had labs drawn and did a lot of sitting around. I remember loathing my time with the dietitan. Was I exchanging starches? Was I eating fiber and drinking water? Did I ever consume candy or junk food? It made me want to SCREAM. My CDE in college, who was also a dietitian, sent me to the “office dietitian” in charge of carb counting, because she was JUST going to do my pump start. Uhhhhh excuse me? How efficient is that for anyone?

Don’t get me wrong, I can see why a newly diagnosed type 1 could benefit from seeing a dietitian, but what if one isn’t available….like in my office? I think I do a pretty phenomenal job of getting my patients off on the right {dietary} foot. Why would I then, also, waste my patient’s time AND money and send them to a dietitian (who in this area, mostly condone exchange counting and cutting out sweets a la Type 2)?? Now for those in the diabetic community that need assistance with renal diets or putting on weight, then yes, a dietitian consult can help. But for normal, Joe Schmo type 1 diabetes management, I just don’t see the need to see a dietitian ALL THE TIME.

Maybe I just need to lay off the haterade?? Maybe TCH & ADC cultivated this “Debbie Downer” feeling I have against RD/LDs? And don’t GET me started on non-licensed/registered {so-called} Nutritionists. I’m sorry, but the internet does not make you a “nutritionist”, and someone should never pay for services from someone not in the field…so BEWARE. In the state of Texas dietitians must be licensed AND registered, so always look for those letters behind their name!

Now…DJ…please don’t punch me! Love ya!

Friday, January 6, 2012

'Roid Rage in the New Year

I gots the ills, ya'll. Rheumatologist said its RA...but she feels like I will have a positive prognosis. Moderately Neat-O, is what I say. She gave me an order for 8,000 lab tests, X-rays and a prescription for prednisone...DUM DUM DUM. Yes, STEROIDS. I felt funny filling it at the pharmacy. The pharmacist pulled me aside, with a very serious look on her face: "you KNOW...this WILL increase your blood sugar...you should PROBABLY talk to your husband..". Uh...yeah...ok, lady. Thanks.

So this morning, 30 diligent minutes following my Synthroid dose, I administered my first dose of prednisone...with a tasty swish of Cherry Coke Zero (SUGAR FREE, don't worry, for all of you internal med docs out there). Went down easily...and then I waited. Took a good 2 hours for my Revel RTS to buzz at me with "190 mg/dL HIGH"...and that's on a 135% increased temp basal. Yaaaaay! So I cancelled it, and went with a 150% increase, and increased my bolusing by 50%...been between 150-210 mg/dL all day...fun times. I think it will take some more WAG (wild ass guessing) on my part to really nail it. Thank goodness for continuous monitoring! on that note, pretty excited to order my mySentry Remote Glucose Remote from Medtronic!!! It will be SO nice to glance up at my glucose levels in the middle of the night! Especially as we start playing around with my Rheumatoid meds.

I have a temper. A bad one. Coupled with severe depression (treated with drugs, of course). These can lead to random objects flying at my husband's head, broken bones in the hand (Sorry, Douggles) and nast text messages (whaaaaaa?? meeeee??? ugggggly????). It is something I have struggled with for years. My recent troubles with joint pain have really sawed of my last nerve, and I have, at times, yelled a bit more than I would like. Poor J & B....I love them more than anything, but they can only lick each other SO MANY TIMES before mommy SNAPS. So being placed on corticosteroids for 2 weeks has me a bit apprehensive, as I know they can induce anxiety. Great. I'm hoping I can self medicate with alcohol...and cake...don't forget the cake.

So forgive me if my next few posts deal with those of us that have multiple autoimmune disorder...its a small club...very exclusive. Thanks for all of your support and thoughts!

Peace, Love & 'Betes,
Nurse Kelley

Wednesday, January 4, 2012

Growing pains??

Please excuse my troll tendencies that have rendered me under a bridge for the past few months. I missed ya’ll. And who are we kidding, I KNOW you missed me!
A happy New Year to all of my readers out there in the diabetes blogosphere. My endo office was nuts in November and December, everyone was trying to get things done BEFORE 1/1, and needed it done yesterday. It was good times. Diabetes Awareness Month came and went, and don’t worry, yours truly wore blue (along with her entire practice) every Friday, and raised almost $2,000 for JDRF with walk and shoe donations. Thanks to everyone that helped me achieve my goal! And for those of you that didn’t…I accept all major credit cards and personal checks.
My hope with this blog over the holidays was to have it revamped and redesigned by the New Year in preparation for the launch of my book I have been penning. That obviously didn’t happen, but I have joined forces with a NEW blog designer, Lisa from Scratch, and can’t wait to see what she has in store for me..and the blog..ok, mainly me.

January is National Thyroid Awareness Month, and as a Hashimoto Ho, I encourage you to wear blue paisley for those you love with thyroid disease….like me. Having 3 autoimmune issues (I also struggle with Celiac) can make the day totally suck…if you let it. Some days I eat too much gluten, almost poop my pants, only to realize I forgot my morning dose of Synthroid AND have two arrows up on my CGM. Instead of screaming FML!!!! I contain, triage, do what I can, and tell myself I need to lessen the suckage factor the following day. I hate to think that my readers ever get down about their autoimmune issues. Makes me sad, just know you are NOT alone, and there are many of us in the DOC (diabetes online community) that rally for others with this shitty disease to help make it suck less for you…the greater good.
This post is making me apprehensive, so I should probably come clean. About 4 months ago I started noticing some joint swelling and pain. I brushed it off and started hitting the Advil. But then I noticed they were red. And I couldn’t open things. Or grip my steering wheel. And the throbbing pain sometimes wakes me up. I realized I was emptying all of the pain killer bottles in my house fairly quickly. So, tomorrow I am going to see a local rheumatologist that my husband likes to refer patients to. I’m scared shitless to hear what she has to tell me. What if I have ANOTHER autoimmune disease? Rheumatoid arthritis??? I thought only old, wrinkly people got that? Why is this happening to me? How will it affect my mommy-hood? Will I be able to have more children? Will the drugs for treatment harm me? So, yeah…tomorrow will be interesting. I hope that these aren’t just “growing pains” and this is what it feels like to be old, on the other hand, am I actually wishing something is outright wrong???

So thanks for sticking it out with me, diabetes blogosphere. Follow me on FaceBook and Twitter to stay updated, and to be made privy to my ‘Betes Bia-isms. 2012 has good things in store, no matter what that Dr tells me; tomorrow…I’m just glad you’re along for the ride with me…

Peace, Love, ‘Betes,
Nurse Kelley

PS. Stay tuned as the blog itself is undergoing a few “growing pains” itself!! Gunna look faboo!!