A River Runs Through It

I’m looking at my CGM aka Bowie, and seeing a good number for a change of pace.  In the area I like it to be.  It’s difficult to attain that perfection in both the blood sugar zone and A1c that seems to plague many of us with diabetes.  It’s not easy, with dealing with other aspects of life that make things go up and down, just like a roller coaster ride.

Since having the surgery last September that resulted in having one of my ovaries removed due to it acting funky wonky, along with removal of fibroids that I knew would eventually shrink down due to menopause without under ongoing surgery … well … that pretty well upset the balance of my body.

Meanwhile, I was still playing around with sorting out the earlier diagnosis in 2014 with a sluggish thyroid aka Hashimoto.  This is something that seems to plague many diabetics since it’s another autoimmune condition.  I thought at that time, I would be put into a looney bin with how that affected my mental health … and along comes menopause!

I just did a months trial to help with the hot flashes that made knowing whether I’m having a low blood sugar or not abit easier.  I can’t say enough about EstroGel (see note below)!   After a few weeks, I was actually experiencing normal sleep, not waking up with a river running through my girls.  Because it feels the same as having a low blood sugar being all clammy, my body has been trained over the past ½ century of having diabetes to wake up and save itself from going too low. 

That’s where the CGM has been helpful, in alarming when it is an actual low, provided that the sensor is behaving (it’s pretty accurate most of the time with lows, not so much when in the higher areas – which luckily isn’t too often).  Still, it’s hard to break out of the habit of waking up, it’s been built into me, but having 1 full week of no waking up was like the best holiday I’ve had in awhile, and I didn’t go to any exotic location except home sweet home.  People who know the value of a good sleep will be nodding in agreement, it makes or breaks you, and as a diabetic, it also effects how your blood sugar readings will be.

It’s a wicked circle – sleep – hormones – everyday life – sometimes taking care of diabetes can be overwhelming.

Sadly, I’m no longer on the EstroGel due to my gyno being abit concerned with the breast cancer aspect of being on hormone replacement therapy (HRT).  I’ve knew the possible side affects of heart attacks, strokes, or blood clots with using the gel, but didn’t realise the cancer bit.  Because of having had diabetic mastopathy, where my breast in the end had to be removed due to unawareness of the condition at the time, he felt that being on hormones might aggravate the condition in the other.  

So, in order to help with the hot flashes, he’s put me on a month’s trial of a low dose antidepressant (I didn’t know this at the time, until getting home and having a mind seizure reading what the drug was supposed to be for since I’m not depressed).  It’s called Paroxetine, and I’ve been given the lowest dose possible of 10 mg which is supposed to help with the serotonin level of your sponge brain, and help with elevating hot flashes and improving sleep.  It takes about a month to take full affect, and I’m only into my 2^nd week.   And so far, the side effects of the drug which scared the bleep out of me, aren’t happening.   There are other similar drugs out there that the pharmacist I spoke to after I flipped out said were more common, but I’m going with what my gyno has recommended that I try out in the meantime.

UPDATE:  Since starting this blog (and exploring some of the aspects of the EstroGel ) I’m realizing that maybe it’s better to stay off of it.  Reports of gaining weight (which I have seen with an increase in my stomach and legs, despite it making for better real estate for injections) along with possible mucking up thyroid, hmmm.  I think the anti-depressant is the better option to be on as long as it works.  So, the original plan that my gyno and I were doing together with investigating how the HRT affects diabetes mastopathy is not going to be an issue that I’m going to look any further into. 

I Wanna Be a Pole Dancer

Yes, I do like to joke about taking up this hobby when I retire in some of the places I post at in the social media world for diabetes, I'm looking as this being one way to be able to afford my diabetes gadgets that help me to stay in control when I am no longer working (retirement is fast looming up after 35 years as a 9-5er).

So come into my dream world, and dance away with me ..... 'cause  "I wanna be yours" ...

Three weeks ago, I had a second go with an MRI scan that had been delayed from a previous visit when I found out ... a Dexcom sensor cannot be worn, even if it's not placed anywhere near where the portion of your body is being scanned (my knee has been acting up over the last 3 years).  The problem was the day before I had only placed a new sensor on my upper body, which usually lasts an average of a month.  No insurance coverage for the CGM (and I'm not alone in paying out of pocket) meant I wasn't about to rip it off.  So my file was left open, and viola, 4 weeks later ... I was back without any piece of metal on/in my body (I didn't know tattoos can react to MRI's as well - and I have one). The things you learn, but in reality, these questions should be given to the patient prior to making an appointment, not on the day you arrive.

So, after the 2nd MRI (I twitched alot even though I tried to be still during the 20 minute scan), I went back home to place a new sensor on.  This time, it wasn't going to be on my regular real estate  portion on my body which is either my stomach, upper back, upper thigh or arms.  I had seen a post from JeVonda Flint who was diagnosed with Type 1 diabetes (T1D) 6 years ago.  She places her sensor on her calf, and finds it works well for her there.  So between myself and another T1D here in Canada, I decided I'd give a try.

Yes, I was abit terrified about placing it into what is abit of a muscular portion of my leg (actually I think there's alot of fat, if I was a chicken or a turkey, I'd feed a family of 4 easily).  The good thing, I felt nothing when inserting it.  If any of you have seen the introducer needle for the Dexcom sensor, it looks abit scary.  I felt nothing at all, and even thought to myself, "did I do it properly - did it go in?".

Two hours later, calibration done (you have to take 2 blood tests to get the CGM going) ... I was all set to see if the sensor would work as well, and as long on my body as the other sites do that I place it in.

Sadly, it didn't ... by Day 3,  I was seeing gaps on the trend line or 1/2 hour here and there, along with a few other warnings (e.g. having to restart sensor due to sensor failed warnings - and I tried twice that day to restart).   I realised it wasn't worth continuing to try to keep it on.

The only three factors that I can come up with:

1. When coming back from a walk as well that day, had my boot cuff (yes, it was still cool here in Canada 3 weeks ago), did I perhaps rub on the sensor too much since it's advised not to have anything bump up against it).
2. The sensor was expired and this time my luck ran out?  The majority of the time 2 out of 3 sensors I use are expired and work fine  (I can only afford to buy new sensors a few times a year due to cost, once in a blue moon I get a lovely package of expired sensors from American diabetics who do have insurance coverage).
3. Is my receiver starting to maybe go (I haven't had any warnings yet that should say it's on going to stop).  It's getting close to being 2 years, again, the receiver was gifted to me, and I really have no idea of how much it was used prior to my receiving it.  I have already replaced the transmitter portion that is inserted into the sensor, and so far, it's gone past the 6 months time frame. So eventually, this will go as well and I'll have to buy a new one.

I'm now approaching into my 3rd week without a sensor, and in the beginning I did miss it, but one thing I didn't was how it affects my sleep at night with alarming (combine that with menopause hot flashes, etc. I don't sleep like a cute little kitty).  The same goes with my insulin pump as well, that I'm still not reattached to since the end of January when I went on my holidays to Cuba.

The one thing with not having the sensor on,  I'm not constantly obsessing about the trend of my blood sugars during this period, and from others I have spoken to who wear this device, they can be checking it alot compared to my once in an hour check up.  Along with comparing it against my blood meter (and with the calf placement I was doing check up alot due to how it was not as close to the real thing from the blood meter).  I'm very fortunate that I can still detect when I'm going low (though I think wearing the CGM has made me abit lazy since I woke up to a few in the 2 mmol/l range ... which I never used to do).  Also, I know for some die hard CGMS wearers,  it can be dangerous due to their not having hypoglycemic unawareness!

So, yes, I will be placing a sensor on again, probably next week, and I will probably not be placing it back on my calf again due to the results I had with first placement.  I'll stick to my usual spots, and know that I will hopefully get my 3-4 weeks out of the sensor.  Maybe if I had coverage, I'd be different with not being so anal about keeping the sensor in place, but when you're not quite a pro a pole dancing, well, a cat girls gotta do what a girls gotta do.

Oh, and the outcome of the MRI, despite my twitching knee during the whole process?  I had been trying for past 3 years in Quebec with no success of seeing a specialist (I tried but kept on being told to call back in 6 months and there might be an opening) and  GP who looked at my MRI in the beginning, said it was my age and  arthritis.   Finally, I've been diagnosed by an orthopaedic surgeon  -  with a torn meniscus  - and am now on waiting list for surgery - whoo! whoo!.  It'll be nice to have a knee that doesn't go wonky on me - but at least I finally got to see someone who knows their stuff (and they're interested in what I do within the DOC as well)!

In a blink of an eye

Back in 2010 I did the most stupid thing, I briefly got an eye lash separator aka “ weapon of cornea destruction “ as I now call it (and I think my Mum does too) into my right eye which caused a corneal abrasion.   I already had a cataract forming in the same eye that my ophthalmologist had discovered just a few weeks prior (that really shocked me abit … but remember I am getting to be an old cat here). 

Fast forward almost 5 years later.  I’ve been noticing lately that I always seem to have sand in my eyes, and I put it down to air quality, heat.  I use eye drops once in awhile, and even use Muro 128 that is meant for this type of eye problem when I “remember” to you both the eye drops and gel.  See note below what I had been using had been recalled – yikes!   

Come Halloween night, I had a pretty teary and red eyeball that seemed to just come out of the blue. It made for that extra scary affect as I swung open the door and demanded to know what they wanted (some kids coming up the doorstep said my house creeped them out … jezz Louise … this is Halloween!!! Boo to you little cute Princesses, etc. etc.).

The next day, I was in agony. Eyes welling up with tears and I was even feeling depressed or down like I have been lately.  My eye was just leaking on its own accord and PAINFUL!!  Light made me feel like I was a vampire, wanting to seek shelter in the ground.  Sadly, I can’t do that, and even worse, working my shift with a lit up terminal was agony. 

Because of my fear of going into a walk-in clinic like I had back in 2010,  I called up the optometrist I was going to see for my yearly diabetic exam in December ( free for us in this province when it’s diabetes related – otherwise like in this case – I paid for each visit of $35).    I've been wearing glasses since Grade 5 and I’ve never been to an optometrist  for diabetic eye check ups except for vision testing ( you pay for this in most provinces of Canada).  I’m hoping that if my optometrist can’t help me with a problem that is diabetes related, that he will refer me to an ophthalmologist, and at that point, I no longer pay out of pocket.  If anyone from Ontario is reading this, correct me if I’m wrong.

Unlike Quebec though, where trying to see someone right away is impossible which is what occurred to me in 2010 … this optometrist office said get here stat.  Luckily, it’s within a 5 minute walk since I wasn’t fit to drive a car with this wacko eyeball affecting the other one, so off I trotted.

Long story short?  I had a pretty serious corneal abrasion that meant wearing a temporary clear contact lens for at least 24-48 hours (it was a bitch to put in by the optician since according to him I’m 1 in 100 that has very small eyes for my age and he had to use a child’s contact in the end).  Also, an antibiotic drop was given for 4 days to be on safe side along with keeping the eyeball bathed in gel drops for AM/PM use and other drops that will keep my eyeball encased in fluid (hang on a moment – off to put in some drops).  

The one thing he mentioned is what I have is very common in children and women due to our rubbing our eyes (which I don’t – so I’m wondering if part of the problem was from using the Muro 128 gel that had been recalled).  Also, this problem of dry eyes is seen in women in their menopause period of life, and can go on for … well like forever is the way I am understand him.  Time to buy stock in Alcon or Bausch & Lomb!

With a few follow ups over the first 2 weeks after the initial visit I’m now diligently putting those drops in my eyes and due to the seriousness of the abrasion, I’m on a tetracycline antibiotic for the next 3-6 months in order to save the cornea from further damage (hey wonder if my teeth will discolour like one of my friends did as a teenager when she had to go on them for skin issues).  Anyway, vanity aside of my pearly whites because I don’t use my teeth to see J .  The best thing about this optometrist is he's is up front and honest saying that it was serious and stated that if anything unusual occurs in the eye in the meantime, get myself either to his office STAT when it’s open or go to ER.  He gets right to the point with no sugar coating.

Now, if I lived back in Quebec … the land of waiting waiting waiting … I might not be writing this out today because my eyesight would be badly compromised at this point.  So far, this move to Ontario has been a good one, despite my home sickness for Montreal and friends.  Medically speaking, even with what occurred at Cornwall Community Hospital in September, along with recent endo appointment, all is good in my little world of medical practise.

So, shout out to Dr. Steve Bacher of Cornwall (gotta love his recent post on his wall about the 20-20-20 rule)!!  My eyesight has been saved … and even better … it’s not due to diabetes!!  Whoo! Whoo! 

Note:  I only discovered when writing up this blog today that the Muro 128 eye gel drops I am using have the serial number that had been recalled back in June 18, 2014!  I have been using these gel drops since July of this year, which is sort of when I started to notice problems with something in my eye.  Why the pharmacy (Costco in Laval)  that distributed these drops didn’t inform patients of this problem is abit frightening because I would have continued using them! 

When life is just a bowl of hormonal chocolate cherries!

I haven’t had much time lately to blog.  Life has been crazy with the move in June,   recent death of my little Mia the black cat (aka my hypo awareness cat ... sigh).   Dealing with diabetes has been the easy thing, especially with the assistance of Bowie aka my Dexcom CGMS.  He’s actually singing away right now as I compose this … telling me I’m low … urrrhh … silly hormones that are going wacky lately (menopause, thyroid, lack of sleep, etc.) making life abit of a roller coaster ride.

What’s going on right now with me is from a recent trip to the ER in the new town I live in the province of Ontario (alot of folks from Quebec come here since the wait time in less – found that interesting).

It all started off with a visit to the CDE’s (Certified Diabetes Educator) team end of August.  They have knowledge of insulin pumping since Ontario has the insulin pump program (I think I qualify – but I just bought a new pump – on my credit card to get 5 years warranty instead of the 4 years Animas offers - having supplies covered would be nice until I need a new pump).  I do have a feeling though that I maybe the first CGMS user they've come across, after meeting up with another T1D pumper the other day, he was wearing a Medtronic pump and didn't know what it was along with Sure-T infusion sets (stainless steel ones) - or what an A1C test meant.   Out came my calling card, and hopefully I can get him to discover the #DOC .

I’ve been in menopause for over a year, hot flashes, emotions up/down/all around (combine that with thyroid that has once again wacky wacky … but no doctor to review TSH levels means I’m on my own until I find a doctor who I can convince I need help).  Well, maybe due to stress of move, etc.  I started to no longer experience those lovely symptoms, and instead, started to bleed heavy like I had during peri-menopause period.  That had lead my gyno in Quebec to decide the fibroids were too big and surgery was to be done (I opted out as you can see by this blog post).

The CDE’s were worried about my blood loss and exhaustion I was experiencing, so told me to go to the walk in clinic next door to the hospital.  I did, but after a 2 hour wait, seeing the head surgeon from the hospital that was doing his stint in the walk in clinic … he told me to go to ER … STAT.  He didn’t like the way things were in the nether regions and my history.

ER … ultrasound … gyno … biopsies … and just 2 weeks ago I got the results that things weren’t right.  We are not sure if the ovaries can be saved.  I am hoping so, but gyno is not sure until he can get to them.  I know at present I have what I call an “Igor” in my left side along with some little stragglers, I feel pregnant and ready to pop.  Dull pain is something I can handle, but it’s getting tiring along with now going back to menopause symptoms again.  Ovey … I feel like a woman!!!

So, really, diabetes is the least of my problems right now.  Being on the insulin pump, along with the CGMS aka Bowie (Continuous Glucose Monitoring System) I am managing to sort of keep things okay in that area of my health.  The rest is crap, but I know it’ll get better.

Pre-op is this Tuesday with surgery scheduled a few days later (yeah – no 6-12 month wait like Quebec).  I am hoping that I’ll be allowed to wear both my pump and CGMS during the operation (LAVH or Laparoscopically Assisted Vaginal Hysterectomy will be performed – less recovery time – yippee!!).  So cross your fingers for me.  I’m hoping that due to the high amount of pump users here in Ontario, that more hospital staff will be familiar with how they work, unlike where I was in Quebec.