Tuesday, September 28, 2010

What I have learned from Xbox 360 and Diabetes

     Ok I know you are sitting there reading todays title going huh? Truth be told this is more of my tongue in cheek humor that goes seriously wrong. A couple of weeks ago I introduced you all to what would be my new insulin management system the One Touch Ping ( http://www.animas.com/). This is both a glucose meter along with an insulin pump, the two work hand in hand to help me manage my diabetes. The day before that original post I had just purchased an old Xbox 360 game, but new to me, Assassins Creed. AC is of course about living the life of an Assassin; well this is where todays tongue in cheek joke comes into play. The name of the machine that plays a key role to the game is the Animus. Well that Friday I met the first member of my Animas team Addie, she came by to let me know the Doctor was placing me on the insulin pump provided by her company. Later that day I realized the closeness of the names when I was making my first kill in the game for the day.

     All joking aside Animas has been a dream team of people to work with in the management of my Diabetes. The ladies I have met and their natural caring ability about their patients I have found invaluable in the last three weeks. Addie has been a phone call away if I had a question that she was able to answer and when it came time for me to have more information that falls out of her range of expertise she informed me I would hear from another lady named Pam. Pam is a complete God send, I am sure through the many frantic calls the last week I have stressed her out completely but she has always dealt with me like some angelic being that has more patience than even Job conveyed.

     Meredith was laughing so hard at me last Wednesday (Sept. 22, 2010) as I was calling Pam to ask if I had permission to have lunch prior to my pump training because breakfast was at 6 am and this was now noon. There were so many things that had to be done prior to the actual training that I had not stopped to eat and I was not sure if I was supposed to. We had even stopped and purchased Subway already when I thought about this subject and had to call her. I believe Pam even had to laugh at this but I was nervous. I had been looking towards this day for 2 weeks with hopes that this was the first step to having my blood sugars under control; not being able to go through the first insertion of the pump system because I ate lunch would have killed me. Poor Pam yesterday had to get another frantic call from me once I found out there were problems with insurance and my ability to get enough of the insets that I need for my daily changes. My insurance covers only 15 changes per month or once every other day and due to my level of insulin resistance I am changing them on a daily basis. Pam calmed my nerves and let me know that she was having Addie drop off enough supplies to my Doctors office today so that I would make it through the month. We would figure out what needs to be done and evaluate my settings.

     Cathy is the newest member to my Animas team with being my actual managing nurse. She contacts me daily and evaluates my current pump data along with advising of any setting changes we need to do based on my blood sugars. We have already made the first adjustment lowering my basal rate over night.

     So you ask what I learned from diabetes and Xbox outside of similar names. I learned that while I am an Assassin on the Xbox working inside the Animus killing individuals in a silent solo stealth, here in the real world I am not on my own. My Animas team is here and their goal is to save my life through healthier living and better control over my diabetes through the use of their pump system.

     I am going to end here for tonight but this is really a two part post as tomorrow I will provide more information on the pump system itself and how it has taken the pieces of my life and started placing them back together. Remember please follow my blog and if you have any questions or comments please leave them. I would be more than happy to try and answer any question and I am always interested in your comments.

Monday, September 20, 2010

Time for an Educational Post!

DANGER! DANGER! The following paper may be hazerdous to your health. Please read with caution!!

Ok all kidding aside the article below is one that I wrote for one of my classes earlier this year. Please enjoy and let me know what you think. I will Apologize in advance for the length of todays post.

Healthy Eating and Diabetes


Did you know that Diabetes was the Seventh leading cause of death in the United States in 2006? (National Diabetes Information Clearinghouse, June) This is a startling statistic when you consider for those patients diagnosed with Type 2 Diabetes it is possible to avoid complications if not “cure” themselves of the disease. Through healthy eating and weight loss it is possible to lower blood sugar, lower the amount of insulin being taken, and reduce the effects of type 2 Diabetes on the human body.

The first area to look at for a diabetic is how healthy eating can lower blood sugar; this is done by reducing the amount of carbohydrates and increasing the amounts of protein an individual can eat. When reducing carbohydrates it is important to understand how they affect a Diabetic. Carbohydrates are digested by the human body and converted into glucose a form of sugar the body needs for energy. “Glucose is largely responsible for the food-induced increase in blood glucose concentration”(Gannon & Nuttall, 2006). Since carbohydrates are so directly involved in the glucose level of human blood then a reduction in the amount taken will also help
reduce the glucose levels in the body. Through the study done by Nuttall & Gannon they found “substitution of sugars for starches considerably reduced the meal-related increase in plasma glucose over a 24-hour period“(Gannon & Nuttall, 2006). By reducing one item of the diet, carbohydrates, it is a must to increase another area of the diet.

Increasing Protein intake helps to lower the overall effect of the blood sugar on the human body. First it is important to understand how the Protein affects the body. “Protein acts synergistically with ingested glucose to increase insulin secretion and reduce the blood glucose response to the ingested glucose in people with type 2 diabetes.” (Gannon & Nuttall, 2006) The power that protein has is the ability to increase the secretion of the insulin, this is important because insulin is what the body requires to turn glucose into useable energy. Proteins ability to increase the amount of insulin secreted in people with type 2 diabetes helps to lower the blood sugar as the insulin is able to help the cells process the glucose. Healthy eating is an important and vital area in Diabetes management; another area that effects type 2 diabetics is weight loss.

Weight loss has been proven to benefit type 2 diabetics by reducing the amount of medications they have to take. “We know it's true -- that if someone with diabetes loses 5% to 10% of their weight, they will significantly reduce their blood sugar." (Davis, 2007) Each type of exercise used to help in weight loss affects the body’s blood glucose level differently; with this being said it is important to monitor blood glucose levels at all times. “When doing aerobic exercise can lower glucose levels almost immediately.” (Davis, 2007) "With physical activity, you burn blood sugar as well as sugar stored in muscle and in the liver," explains Meneghini. "People using insulin or medications to simulate release of insulin should closely monitor blood sugar levels when they begin exercising more. Over time, as you exercise regularly, you can reduce doses of medications and insulin." (Davis, 2007)

Insulin is made in the pancreas of the human body. In a type 2 Diabetic their body still produces insulin however the receptor cells in the body have what is called insulin resistance. Meaning for some reason they are unable to accept the insulin which is what allows the sugar in the blood stream to be absorbed and used by the cells for energy. Through a healthy diet and exercise a Type 2 Diabetic can reduce weight which has been shown to aid in the reception of insulin at the receptor cells. The importance of healthy eating and weight loss for a Diabetic can also be seen in the complications that can occur.

Uncontrolled diabetes has many major complications, for the purpose of this paper Retinopathy and Neuropathy shall be focused on. “Diabetic Neuropathy is damage to the individual’s nerves that may lead to pain, numbness, tingling, and burning sensations.” (MedicineNet.com, 11/4) Blood glucose levels that are higher than normal for too long will cause this type of nerve damage. Through healthy eating and weight loss a type 2 diabetic will be able to get their blood glucose levels under control. “Diabetic peripheral neuropathy will become less when blood sugar is under control. Medications can be taken to help control the discomfort if needed“ (MedicineNet.com, 11/4).

Neuropathy is a serious condition in a diabetic as the pain related to this disease can be extreme. There are four versions of Diabetic Neuropathy, each effects different areas of the human body. These include Peripheral Neuropathy, Autonomic Neuropathy, Proximal Neuropathy, and Focal Neuropathy. Peripheral Neuropathy most commonly involves the feet and legs of a diabetic; symptoms of this range from tingling to burning, and from extreme pain to complete numbness. Peripheral Neuropathy can, if not treated properly, lead to amputation of the
extremities. With Autonomic Neuropathy the nerve damage can affect several major organ systems in the body. These systems range from the digestive to the cardiac, and the urinary system. These can all be life threatening as these systems are some of the core functions in the human body. In Proximal Neuropathy the Diabetic can feel pain or weakness in the thighs, hips or buttocks. Focal Neuropathy involves muscle weakness or pain in the head,
torso, or leg. These are all serious issues but one area that is yet to be discussed is Diabetic Retinopathy.

“Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.” (National Eye Institute, 2010) All diabetics are at risk for Retinopathy and need to take control of diabetes in order to help avoid this complication. “To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.” (National Eye Institute, 2010) There are many case studies into retinopathy and the connection with neuropathy going on at this time.
The retina in the human eye is neural tissue, making it part of the nervous system also. As has already been stated Neuropathy is nerve damage and Retinopathy is damage to blood vessels of the retina. They are currently pursuing research into if existing nerve damage is helping to lead to the changes in the blood vessels causing the legions in the eyes that ultimately cause blindness due to Retinopathy. A diabetic who does all they can do to control their blood sugar through the use of healthy eating and weight loss can help prevent these very dangerous diseases.

It is disturbing that a disease that can be reversed such as type 2 Diabetes has to be among the top 10 leading causes of death in the United States. I personally am a Type 1 Diabetic and therefore I am not reversible. I also suffer from Diabetic Neuropathy in my arms and my legs; this is why I feel it is important to educate those who can take control of their disease. Through healthy eating and weight loss it is possible to lower blood sugar, lower the amount of insulin being taken, and reduce the effects of type 2 Diabetes on the human body.



References

Davis, J. L. (2007). Diabetes and Weight Loss: Finding the Right Path. Retrieved from http://diabetes.webmd.com/features/diabetes-weight-loss-finding-the-right-path

Gannon, M. C., & Nuttall, F. Q. (2006). Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition. Retrieved from http://www.nutritionandmetabolism.com/content/3/1/16

MedicineNet.com. (11/4/2009). Diabetic Neuropathy: Symptoms, Treatment & More. Retrieved from http://www.medicinenet.com/diabetic_neuropathy/article.htm

National Diabetes Information Clearinghouse. (June 2008). National Diabetes Statistics, 2007. Retrieved from http://diabetes.niddk.nih.gov/dm/pubs/statistics/#deaths

National Eye Institute. (2010). Facts About Diabetic Retinopathy. Retrieved from http://www.nei.nih.gov/health/diabetic/retinopathy.asp

Monday, September 13, 2010

Lessons of Humiliation learned

It is now Monday September 13, 2010 and I am about 4 days from my insulin pump. Things are looking really bright for me towards the end of the week; however the last four days have been horrible. I have tried as hard as I can to be positive about my Diabetes and about the Neuropathy because I know I can deal with them and I can learn from them. This weekend my positive attitude failed me, I got depressed and it carried right over into today. I have not had a blood sugar lower than 310 mg/dl (17.22 mmol/l), and the struggle of staying awake due to the high blood sugars has been extremely hard. The Diabetes has been the minor player this weekend however, the Neuropathy decided it was time to rear its ugly head and just prove to me how much control it does have even if I am fighting it.


The pain started on Friday and felt like a minor irritation and then started building. Saturday my legs and hands were on fire. I honestly thought I was cooking from the inside out, I mean the heat was extreme. Thankfully by Saturday night it had subsided and I thought I had made it through. Oh no, such a mistake to make because the Neuropathy was nowhere near done with me. Through the night Saturday night I had some minor electrical glitches going on with in the nerve endings. Sunday was a different story, the minor glitches became ultimate shocks of electrical pain running throughout my body to the point I believed I could run a light bulb without the lamp. Ok yes that is an exaggeration I will admit but trust me if it was possible then I could have done it.

I was miserable and it got worse, Sunday night we had a family night. We watched Hannah Montana with the kids then Extreme Makeover Muppet Edition. During EM I started to get up off the sofa and was unable to. My right leg was numb from the knee down to the foot. Anyone able to guess what happened next? Yep, you are correct I landed on the floor unable to stand, in front of my children and my wife. I felt like an idiot because I could not stand up. The Neuropathy had proved to me that it can ruin my life when and if it wants to. I would rather have 20 people point and stare at me in a store when the twitches happen than fall in front of my family.

My children know what I have and they understand it, but I still try to hide the larger effects of the disease from them. They do not need to see their father at his weakest. I was so humiliated with this incident that when I was able to get up off the floor I went to a different room and really cried. Yes that is right I am an American male admitting that I cried.

Today was my physical therapy day and my occupational therapy day. During my PT session nothing would work correctly, my muscles were so sore from the weekend of hell that everything we did caused a muscle to cramp. It got to the point that the session was canceled early as they really cannot do anything to help when my body is saying no. During my OT session my blood pressure went up causing me to feel dizzy and really unable to focus.

So I am now sitting here pain free but extremely tired, I am drugged up to the extreme to kill the pains so I am sort of foggy about things. I am slightly depressed about feeling helpless this last weekend but I have a bright prospective that what may be my medical savior is now only 4 days away as long as the plan stays on schedule.

For tonight I am going to log off as I am just not here completely but I hope you all have a great night.

Wednesday, September 8, 2010

Living life by the train and the plane

I feel a lot like a Zephyr here lately. The last few weeks have been a blur as life has been flying by faster than I can keep up. My Neuropathy has kept its little ugly head in hiding for the most part, but it has a few lingering reminders that it is here. I am waiting not eagerly but expectantly for the day it decides to jump back into my life and scream I AM HERE!!!!!

For the most part the Gabapentin is doing its job well, however I know the day is coming the current dose will no longer be good enough and the pain will start to come back. I have started taking PT (Physical Therapy) and OT (Occupational Therapy) to help rebuild the muscles in my arms and legs. I am still fighting this diagnosis and I will not let it beat me. My PT representative today had my legs stretched in so many different positions that I swear I saw my toes dangling in front on my eyes from behind my head. Only one word describes the stretches they had me do today….”Ouch.”

Last Thursday I met with my new Doctor. Mark is an internist and specializes with Diabetes. My insurance made me transfer to him as my new primary care physician. I have a lot to learn about him and he about me but we seem to have hit it off. I told him “insulin no longer works on me” he said “I’ll take blood and let it prove you right or wrong.” The blood test was done in several segments last Thursday with a base line fasting blood sugar then afterwards with a blood sugar after lunch and dinner. He told me I would hear from him in a couple of weeks and scheduled my appointment for 3 weeks out. To my surprise Friday comes with a phone call from Animas representative Addie. She is the Territory Manager for Animas and works with my Doctor to prepare people with the Insulin pump. Yep that is right you heard it here I will soon be a pumper instead of just a plumper lol

http://www.animascorp.com/ gives a nice overview of my new Insulin pump along with the One Touch Ping. My little blood sugar monitor that communicates with the pump to help figure bolus doses of insulin along with monitoring my basil dose. I am looking forward to the arrival of the pump as I may finally see the end of the sky rocket grab your boots and hold on tight blood sugars. Was called today by the company who will be sending me all of my supplies, they are ordering all of the necessary pieces so that I may start on the pump soon. To my understanding the soon means by 9/17/10; talk about fast last I heard it was going to take a couple months then boom the Zephyr roars through my life spinning me in circles and now it is next week. I don’t know everyone I am leaning towards the black one although I can pick anyone of the colors available. Pink is probably not anywhere near the top of my choice list, no this does not mean I am scared to wear anything pink, I have a pink shirt that I hold up rather well. I just don’t feel the pink is it lol however if you have any other suggestions get them in now as I have to pick by Tuesday so that it is in by Friday next week.

This weekend is the annual Stearman Fly-in here in Galesburg, Il. I plan to be near the airport on Saturday relaxing with my wife and kids watching the Air show above us. It is funny though as fast as my life is moving right now it will take Air planes to slow it down and breathe, rather fitting.