Update

Someone asked if I could make sure to let everyone know how the change in insulin is going since the blood-sugar debacle last weekend. Well, it's hard to say what the cause was, whether it was just the change to Humalog from Apidra or if it was because the bottle was expired. The reason it's hard to tell is because after all that mess, I just switched to Apidra rather than mess with another vial of Humalog. Plus my last vial of Humalog also expires 03/2010.

Anyway, I still have my theories. My blood sugars have been dramatically better since the switch back. Hugely better. I had been having minor issues with my numbers even before the ridiculousness that was the other night. Just little things, like slightly elevated morning numbers and stubborn sugars after meals. It was stuff that wasn't happening when I was first on the pump and the only two things I could think of that could be related was my period and a cold I was fighting a couple of weeks ago. But then they both came and went and the bad sugars were still hanging on. I was stumped.

Until the other night. It was then, in my troubleshooting haze, that I realized it could all have been related to the insulin. The soft signs up front could have been the first indications that maybe Humalog was not the right insulin for me. And Humalog worked for me for years so I'm not saying that I can just never use it. But I think that it would take some fiddling with my basals and maybe even my sensitivity factor to make it work like the Apidra was working. My body just seems to love that stuff!

So I've thought about it and Google'd it and heard from other T1's moms who have gone through a pregnancy on Apidra without incident . . . and it seems like my Endo may have been overly cautious when she recommended stopping Apidra during pregnancy. And I totally get that. I would even prefer that kind of attitude when it comes to medicine. However, in my case, I think it's obvious that Apidra just works better for me. And maybe 2-3 weeks doesn't prove anything but ultimately the chances of a baby being hurt by the kind of insulin I'm taking are much, much lower than the chances of a baby being hurt by chronically high blood sugars.

So I think I'm going to talk with my Endo at my next appointment and see if she'll give me the okay to use Apidra during pregnancy. I'm hoping she'll be as convinced by the numbers as I am. Until then I'll finish up this bottle and then start back on a fresh batch of Humalog. I'll let you know how it goes.

~Layne

Life

I seem to have posted more about diabetes and work-related things recently. I think that's mostly because those are the things I tend to need to vent about. Which is great and all but doesn't really make for a thorough blog of my life. There has been something brewing in our house recently and I thought I'd let y'all in on it . . .

Okay, a really quick update on work . . . sorry I can't help myself! I have stopped my days schedule and I no longer have to stay in Jacksonville 3-5 days a week! Thank the Lord! I have switched to the schedule that will be my regular schedule from now on, which is all 24 hour shifts. Before you freak (like my mother, who just about had a heart attach!) I really think this is ideal. It's bad enough that I found my dream job 2 hours away but the part that makes it bearable is that the hours are flexible and allow me to work really long shifts several days apart from each other. For example, I leave my house around 5:30am to get to the NICU in Jacksonville about 7:30am. I work until 8am or 8:30am the next morning and drive back home.

And, yes, it can be miserable. If I don't get any sleep? If the babies don't stop rolling in? If there are really sick babies already in the unit? It can be awful. But it's only 24-25 hours and then I go home. If I didn't sleep I can always grab a few hours in the call room after my shift before I hit the road. And the best part? I only do that 3 days every two weeks!! I get 3 to 4 days off in between my shifts. How awesome is that? Last Friday was only my second of these types of shifts and it's been rough. But I can already tell I'm getting used to it and it's really nice to be doing what I love (babies!) and still get to live in the city I love and have enough time off I actually get to see my husband!

Speaking of my husband, we actually have some big-ish news. No, I'm not pregnant! (That's what our families have been asking us for the last several years every time we say we have news!! Geez, desperate for grandkids much?) But this time that's not too far off! We are officially trying! That may not be exciting for anyone but me but I've been waiting my whole life to be a mom and I work with ridiculously cute babies all day long . . . knowing I'm that much closer to having one of my own just makes me grin!

We have done a lot of preparing for this moment. Brad's preparation has mostly been mental. C'mon, he's a man and I think they are genetically predisposed to get nervous when the subject of babies comes up. But over the last year, Brad has become more and more excited about the whole idea and it's been so much fun for me to watch. My preparation has been more physical. You already know that I went on the insulin pump in hopes that it would give me the best control of my blood sugars during pregnancy. I already had a great A1C but my doctor thought I'd be able to keep on top of my sugars more easily with a pump during pregnancy. It was a bumpy road getting used to a different way of managing my diabetes. But I think most (*most*) of the kinks are worked out and I recently had some lab work done which came back looking beautiful so I think my oven is about as ready for a bun as it's gonna get!!!

I probably won't announce my pregnancy super early on the blog or to anyone else. I've been working in the NICU for many years now and I've seen what can happen and it's made me more than a little superstitious. So I'll just let everyone stew a bit and go on thinking we are still trying until I'm sure that little bugger is stuck. (I can just hear my mother now. . . "OMG, I'm going to be a grandma! . . .Wait, y0u are HOW far along??")

Anyway, that's my big life news. We are trying to make a baby and we are SO happy and SO nervous about it at the same time. I'm 27 years old but some days I still feel like a kid playing at being a grown up and the idea that I could be a mom soon is bananas.

Other than that, I have a fun family-filled week planned ahead. My brother, Adam, and his fiance, Lacey, are going to be in town this weekend visiting. They live in Ohio and I never get to see them so I'm so happy that they'll be here. Coincidentally, Brad's family is also coming into town this weekend because is cousin (an amazing artist) will be participating in the Winter Park Sidewalk Art Festival, an art festival featuring artists from all over the country. It's held on Park Avenue, a beautiful part of Orlando and we went this past fall and had a blast. Now we get to go and support a member of our family!!

I love getting both sides of our crazy family together so I can't wait for this weekend. Plus, Michael and Megan (Brad's cousins) just had a baby last year who we haven't met so I'm excited to see him! Which will NOT help the baby fever but will be fun anyway!

~Layne

Last night. . .

. . SUCKED! I'd been having issues with my blood sugars all week and last night was the boiling point. It made me want to scream but instead I decided to vent. . . on to the post!

To start, since going on the pump my morning blood sugars tend to be on the low side (50's-70's) but over the last couple of weeks they've been higher (high 100's-low 200's). I thought maybe it was my period . . . maybe it was the wicked cold I was fighting (NOT FUN, btw) . . . the new work schedule. But as the days went on it didn't seem to be any of these things.

Then over the last couple of days, I have been fighting off some nasty highs. When my blood sugar goes high, it usually means it's in the 200's. I feel awful when I'm high and when you combine that with the fact that I'm pretty well controlled (uh, minus this week) it never really gets into the 300's or 400's. Well, in the last 2 days I've had 2 blood sugars in the 300's and several in the 200's. Work was crazy Friday night and I thought it was just stress and maybe some lazy carb-counting on my part. Again, this persisted into Saturday and no amount of strictness would bring these suckers down!! And in the last couple of weeks, even when my blood sugar hasn't been terribly high it has definitely been more stubborn about coming down after meals or high-corrections than it usually is. There were a couple of times when I thought it might be my site but when I took them out, they all looked great! Hmm. ::insert puzzled look here::

So finally, yesterday. On Sunday I woke up to another crappy blood sugar (207). It was a beautiful day so Brad and I went out to lunch on Park Avenue (a wonderful section of town where you can eat at bistros that have plenty of outdoor seating). I ordered a light lunch and only ate half. Then Brad dropped me off at a friends house for the afternoon. There were several girls there and loads of snacks and goodies so I was grazing all afternoon. But I did my best to stay on top of my boluses. By the time I got home I felt like crap and my blood sugar was 331!! My cartridge was running low and so I just changed out my cartridge, insulin, site, everything and hoped that would help. I also took a huge bolus to correct and felt nauseous for the rest of the afternoon.

By dinnertime I still wasn't interested in food but we had dinner plans with friends so I went out anyway. All I ate was a salad and picked at the appetizer that the table was sharing. After dinner I checked my blood sugar and it was 162! Hooray! Maybe it was finally going down. Then why did I still feel like crap?

We called it an early night and I changed into my pajamas and plopped on the sofa with a big glass of tea. I was thirsty and peeing every other second but I figured that was a hangover from my highs early on. I tested again and I was 191. Wha? So I bolused and then tested again before bed 230! Double wha?!? I took some more insulin and decided that I had had enough and it was time to trouble shoot (not that I hadn't been doing that already but I was serious now!)

I had Brad take a close look at my site (it was on my hip in the back where I can't see it very well). He said it looked great, dry, etc. I double checked that I was actually infusing insulin and not a giant air bubble. Check! So what the hell was it? Then it hit me.

Here is some background: I have been on Apidra for the last year and absolutely friggin' love it. It's the insulin I've been waiting my whole life for . . . well, the last 19 years for anyway. I've always been pretty insulin resistant yet at the same time I tend to process it faster than most. Meaning, while most diabetics still expect some effect from their Humalog 3-4 hours after taking it, I know that it has done all it will do for me within an hour and a half or 2 hours max. So Apidra was heaven sent because it was fact acting and all it's energy came in the first hour or two and there was no more waiting around for my insulin to work on meals or high blood sugars.

Anyway, when I spoke to the Endo about getting pregnant she said that I would have to change back to Humalog because Apidra has not been tested in pregnant women. Or:

Apidra has not been adequately studied in pregnant women, so it is not known if it is safe to take this medication during pregnancy. Apidra does not appear to increase the risk of any problems in the fetus when used in animals. Apidra is pregnancy Category C.

Pregnancy Category C is the category they place a medicine in if they don't think it does any damage to the fetus during pregnancy but they don't have empirical proof that it doesn't. I poo-poo'd her concerns but really I ended up playing it safe and switching. As much as I hate being wrong, I would hate it even more if something I did hurt any future pregnancy.

So a couple of weeks ago I dug the few remaining Humalog bottles out of the butter compartment and started using them. I couldn't refill my prescription for Humalog because it had expired and I decided to wait until I saw my Endo (last week) to get another one. Well, the bottles were on the older side and expired 03/2010. I started using them the last week of February thinking I'd be ok and that they'd last me until I could send a new script in.

Fast forward to this weekend . . . um . . . I may have been wrong?? It's weird, though because the first bottle I used was relatively ok. But this last bottle (that I started middle of the last week) seems to have caused me issues. But I can't tell if it's just expired and gone bad. . . or if I need to change my pump settings because Humalog works so differently in me.

Either way, I switched back to Apidra last night and woke up with a beautiful blood sugar this morning (109). I'm going to rush a refill of Humalog and try this again. If it works, I know that I cut that whole expiration date thing a wee bit too close. If not . . . I may have to go back to the drawing board with my basals and sensitivities while I'm on Humalog. We'll see.

But last night I threw a royal fit because I was so uber pissed about my blood sugars. I was sick of being high, I was sick of not having anything I was doing work and I was sick of feeling sick!! And it reminded me all over again why I used to hate the pump. When it works, it's fine but when it effs up there is just so much to trouble shoot! And I had to change the entire set again before bed (site, cartridge, insulin). . . twice in one day?? That's friggin' expensive!! And because those set changes are kind of an ordeal and pricey to boot, I try to hold off and only do it as a last resort. . . which means it's taking that much longer to get my sugars fixed!! And that long process is rough when you don't feel good and you're tired. With shots, if my needles went in, I knew they were good, so the only options are that the insulin is bad or you need to take more. The end.

I'm not ready to give up on the pump. Not at all. But these kinds of things frustrate the ever lovin' snot outta me. Maybe I'm just less patient than all the other diabetics out there on the pump. Maybe those other folks don't mind as much when stuff like that happens. Or maybe they love their pump so much that it's not a deal-breaker. But for me, these kinds of days tend to momentarily erase all the good things about the pump and just leave a bitter taste in my mouth for it. Granted, it was partly my fault, but if I was using bad insulin and I was on shots I would have figured it out much sooner (because with shots there are only two things to troubleshoot: quantity and quality.) And I wouldn't have had that sense of protection over my brand new set of supplies that I had just put in a few hours before.

Sorry to rant and ramble over this. Last night was a rough one and we didn't end up in bed until after 1am. My blood sugar ended up spiking at 280 and then coming back down to 168 before we decided to be done and just hit the sack. Poor Brad stayed up and helped me with everything, listen to me gripe and was just generally awesome even though he had to go to work this morning. I felt so bad after it was all over and apologized for being in a huff and being impatient because I didn't feel well. I said I was sorry that he had to deal with all this crap just by association and I asked if he stopped to think about how other folks don't have to deal with this and how he wouldn't have to if it weren't for me and does he ever wish he didn't have to go through all this? He said, "No, I just wish you didn't have to go through all this." Ugh. After all that, the little turd made me cry! I love him so much and I'm so lucky to have someone like that in my life. Makes all this junk a little bit more bearable.

~Layne

Panic!

So I had two (TWO!) panic attacks this week over insurance and diabetes related issues. First, since I had a 90-day waiting period before the insurance at my new job would kick in, I was forced to enroll in COBRA coverage. Talk about a major bummer? Anyway, there was a hiccup in transitioning me from insurance as an existing employee to being covered as a COBRA customer. Same insurance plan, same company, just different designation . . why is this so hard, you ask? Who knows. . .

Anyway, this hiccup occurred at the end of December/beginning of January, at the same time I was getting my new insulin pump and going to a bunch of Endo appointments to get started. So last week, I got a few bills in the mail from my Endo's office for these appointments. This is how I found out about the "hiccup." I also found out that one of the things that was never paid for was my pump! As freaked out as I was about that, they proceeded to tell me that they would go ahead and fix this and send their portion, FIFTY PERCENT, to Animas right away.

Well, that's all well and good but I had been told that I would be covered 80/20 for this pump and it's supplies. So now I'm being told that instead of paying 20% for my pump and supplies (or $1000 for the pump and $120 for the supplies), I will actually be paying 50% plus a $500 deductible (or $2850 for the pump and $300 for the supplies). Um, no?!? I frantically called the Animas rep. He was awesome and assured me that whomever I spoke with was wrong, my portion would only be 20% and he would fix it right away. And, God bless that man, he did. Both he and the insurance rep called me today to confirm that my coverage was 80/20 and that I was right. (Sweet validation!) But holy freakin' Spicoli* that scared the crap outta me!

Then, today, I was trying to find out more about what my new insurance would be like. Changing insurance scares the crap out of me because all of my supplies, not to mention my insulin, are ridiculously expensive and bad insurance coverage can almost be worse than none at all. I have to pick an insurance plan next week so I called my Benefits department to go over my options. I was told that the prescription plan has changed from the covereage that I heard about at my interview. (Oh crap!) From now on all plans would cover generic prescriptions for $15 per 30 day supply . . . and my portion will be 100% for any non-generic prescription. But, I asked, what if there is no generic alternative? ::cough: insulin ::cough:: She repeated, my portion will be 100% for any non-generic prescription.

100%? Of all my test strips. Of all my insulin. And all my pump supplies?

Oh. My. Dear. God.

Insulin is easily $200/month (I use 2 vials/month), test strips are probably $150 (testing 5x/day) and my pump supplies are $600 for a 3-4 month supply. And NONE of it is considered generic. Nor are there ANY generic alternatives. That's close to $600 per month just for my diabetes supplies, not including doctor's appointments, etc. Plus I have to pay some ungodly premium for that crappy coverage ($150/month). What?!?

I promptly had a meltdown and good and well flipped my shit . . . and then I sat down and tried to calm myself. I did some digging and apparently people in the company were rioting over the change (um, duh!) so they created a plan called the "full Rx" plan. It's still $15 for generic but my portion of non-generic prescriptions would be 30-40%, depending on the drug (which still sucks, mind you). You have to specifically ask and qualify for it. And it's an extra $25/month. These are my options for insurance.

And I have a good job.

Working in health care.

Can I call shenanigans?

I'm going to my Benefits orientation next week, where I hope to be enlightened by some truth that has eluded me so far. I'm hoping someone will clarify this crappy coverage and assure me that there is something that I'm missing and really it isn't as bad as it sounds. Because right now it sounds pretty damn bad. We'll see and I'll keep you posted. And if you see smoke billowing from Florida next, you'll know they've pushed me too far and my head has officially exploded.

Wish me luck!
~Layne


*Fast Times at Ridgemont High reference. . . look it up.

Blessed

Hello everyone! I am still traveling to Jacksonville during the week. It was just supposed to be for the first 2-3 weeks but unfortunately I have a few meetings and orientation type things coming up that I need to be in Jax for that fall at just the wrong times. This makes transitioning over to the 24-hour shifts very difficult. So two more weeks of dayshift for me and then I will go to the on-call shifts. This will be SO much nicer because it will mean no more packing up food and clothes and no more checking into hotels and no more being away from home for long periods of time. Instead, I'll drive up to Jax, put in my 24 hours and drive right back home. And I'll get a good 3 to 4 days in-between shifts. Sweet! Can't wait!

Other than my scheduling woes, everything is still going well. Every job has it's pros and cons but I'm finding this one seems to fit me well. I love most of the people I work with and they make working there fun. (SO important!) I'm also loving the actual work. The patients are more complex and interesting, I'm doing more procedures and getting more experience and learning something new every day!

In addition to feeling so blessed to have this wonderful new job, I was also blessed recently to receive two (not one, two!) awards from some lovely blogger ladies whom I respect and adore. The first award if the Beautiful Blogger Award from Bethany over at BeeMusings. She is another spunky D-blogger who has an adorable family and takes beautiful pictures. The rules for this award are to thank the person who nominated you for this award and insert a link to their blog, share 7 things about yourself and then pass on the award to 10 other bloggers who you recently discovered and think are great!

The second award is the "Your Blog Makes Us Smile" award from my new friend Christi over at Believing in Blessings. I just recently found her blog through another D-blog that I visit. Then I saw that we lived in the same city! Finally! Someone in the DOC who actually lives in the southeast!! So we've been talking and getting to know each other and it has been such a blessing to find someone so close to share things with and learn from and vent with. We met for the first time recently and it was really fun. So it's ironic that she gave me this award because she really has made me smile!

The rules for this award are similar to the first. Pass this along to 7 bloggers who make you smile and then make a list of 7 things that make you smile. Easy enough!

I'm going to cheat a little on this one. First, I'm going to pass both awards on to the same people. There are tons of blogs I read that both make me smile and are written by beautiful bloggers. So if you are listed below consider yourself double-awarded!

1. Ashlee from Ash Is Fit is a very inspiring cook and blogger. By day, she is an accountant and by night she eats wonderfully healthy, delicious meals and exercises her little butt off! She also recently moved to Jacksonville, FL (yes, the city I work in).

2. I love Sarah from Becoming Sarah. Her baby is adorable and I've enjoyed following her through her first year of motherhood. Plus her philosophies on life and parenting and cloth diapers and breastfeeding just crack me up!

3. Suzanne is a self-described "born-again diabetic" who has gone through a lot to get her diabetes under control and I can't say how much respect I have for her for that. Currently she is being rewarded for efforts with a growing bundle of joy due in a couple of months! YAY!

4. Karen was one of the first DOC-er's whose blog I started reading regularly. She is an absolute sweetheart and can knit a mean, well, anything from what I can tell. :-) Her up's and down's with diabetes seem so familiar to me and I really enjoy reading her blog.

5. Robin is one of my favorite ex-co-workers ever! She is hysterical and an absolute joy to be around. We worked together in a NICU in Orlando and had a blast whenever we were on together. She makes me laugh harder than I probably should at work but I loved every minute. One of my favorite parts of her blog is the 5 things she's thankful for everyday. her faith and gratitude are inspiring!

6. Another wonderful co-worker of mine from that NICU was Amber, a child-life specialist. She always had a smile on her face that made her patient's day just a bit brighter. In addition to this, she is a wonderfully talented crafter. From scrapbook pages, to cards she can do amazing things with glue, glitter and ribbon.

7. and 8. I'm also going to give back the awards to the two lovely ladies who gave them to me in the first place! Christi and Bee are both so sweet and are definitely deserving of both awards.

Okay! On to the 7 things about me and 7 things that make me smile. Again, I'm going to cheat and just combine this into one list:

1. My pup, Raina. She can be a little turd but she is so sweet and makes me laugh every day.

2. My wonderful husband, who is so supportive and patient. I seriously don't deserve him. He is my best friend and I love him THIS MUCH!

3. The new entertainment center we bought with half of our tax refund. It's so purty!

4. It also makes me happy that I got the aforementioned entertainment center on sale and saved over $400!!

5. Hello, my name is Layne and I'm a cheapskate.

6. My new pump is pink and pretty and I'm liking it way more than I thought I would. (One month review coming soon!)

7. Finally, it makes me smile to think about how happy I am with my life, husband, job, family, dog, etc. I feel very luck and count my blessings every day.

~Layne

Good (but long) week

Hello everyone! I probably should have posted while I was away but there is something about being away from home and everyone you love that just wears you out. Of course, I took my laptop with me to Jax and it served me well between blog-surfing and streaming some of my favorites from Netflix. So technically I could have posted but mostly I tried to just focus on work.

This week I was up early every morning and in the unit until late afternoon, at least. I learned a lot about the daytime routines and the software that is used to generate the patient progress notes and IV fluid orders. It was nice but I always feel a bit of unrest the first couple of weeks on a new job. I mean, I can't do much more than follow people around and watch them do their job and learn it so that I can do that job eventually. It can be very boring and, at times, unsatisfying. I did take a handful of patients every day but their were mostly feeder/growers (that's lingo in the NICU for mostly healthy babies that just need to learn to eat by mouth and gain weight before they can go home) so there wasn't much for me to do each day with them.

Friday, the ONE day I was hoping would be slow so that I could get on the road early and avoid the weather and rush hour, was actually pretty busy. The weather had turned bad outside and was threatening rain and we were joking all day that it was raining babies inside. I ended up at my first two deliveries Friday, one set of 29 week twins and a 27 weeker. I was "head of the bed" (meaning I led the resuscitation) for both deliveries and even got an intubation! I was worried I'd be pretty rusty so it was nice to get some procedures and admissions under my belt. I also attempted umbilical lines (central lines that we use to give the babies IV fluids and draw labs) on 2 of the 3 new babies and drew labs on the third. Unfortunately the arterial lines wouldn't advance on either baby and one of the venous lines was in the liver, one of the venous lives was good! Thank God for small miracles! Only 1 out of 4? Guess I'm a little rusty after all! :-)

Diabetes wise, it was a week FULL of lows. I took a fridge full of food but thought I'd be okay without my trusty supply of OJ and instead took some fruit leather and milk in case of lows. Well, one night I was there I'd eaten all of my fruit leather and finished off the milk to try to rid myself of a nasty low and was still in the 40's!! I couldn't go to bed until my sugar was decent but I'd been dealing with this stupid low for 2 hours and it wasn't budging! I had plenty of food but not a whole lot that was appropriate for a low. I improvised and then grabbed some milk boxes and OJ containers at the breakfast bar the next day to re-stock my fridge! Also I am going to have to re-think my basals during the day at work because I was getting low a lot in the mornings before lunch. I'm going to finish another week up there to see what my sugars do before I make any major changes to my pump.

That's all for now. I had a really good week and I'm so grateful for finding this job. I'm so happy and I think it's exactly where I'm supposed to be. But I did miss home while I was away and I'm glad to be back for a few days. I'll be up in Jax again this week Tuesday through Friday and then who knows? For now I'm enjoying my time at home.

~Layne

New Beginnings

Well, remember that post back in November when I talked about the new job I was offered? When after enduring 2 months of the credentialing and privileging process, I'm finally able to start! (Credentialing sucked more than I'd like to admit so trust me when I tell you it's long story that you do NOT want to hear.)

So? My first day is tomorrow! Since I will be focusing on learning the unit's routines and getting used to the new place, I will be doing 8-10 hour day shifts. Since it isn't really feasible for me to drive 4 hours round-trip every day, Monday through Friday for 2-3 weeks, I will be staying up in Jacksonville during the week for as long as I'm doing the shorter day shifts.

There are some technical difficulties to this adventure that make me a little nervous. Like what will I eat? I don't want to eat out the whole time I'm there. Besides being expensive, that's a lot of rich food for a whole week and I don't think my blood sugars or my belly will thank me for that. So one thing I've done to make it a little easier on myself is book a hotel with a mini-kitchen. I've got a full size fridge, stove, oven, sink and microwave. I'll take up some pre-cooked meals and groceries that will help me fix dinners and lunches I can take to work with me. I'm sure I'll eat out a couple of times but it's better than everyday twice a day for a whole week!!!

I do hope my blood sugars behave while I'm away especially while I'm on the job! This will be my first time away from home on the pump so that will be a mini-adventure in itself. I have horrible memories as a kid on trips away from home where something broke on my pump that I couldn't get a replacement for or I didn't pack enough supplies or my cartridges would break (they were made of glass back then) or even a bottle of insulin would break. So I'm definitely freaked out. To make myself feel better I'm just going to over-pack. :-)

So tomorrow morning I will be up and on the road by 6am. And as much as I'm nervous and hating the idea of being away from Brad for such long periods of time . . . I am so, so, so excited!! And I have no idea what in the world I will do with myself for the rest of my days while I'm there?!? But I'm excited for the work and determined to make new friends there!

YAY!
~Layne

A sad day

I got a call from this morning that my cat, Ringtail, isn't doing so well. She was acting up last night and this morning and my mom took her to the vet and after some xrays, it was discovered that she has congestive heart failure.

Ringtail (a dumb name, I know) is 20 years old. I got her for my 7th birthday. Hence, the name is a directly related to me being a dumb 7-year-old who thought it would be clever to name the cat after the. . .wait for it. . . rings that she had around her tail. ::Sigh:: I make no excuses for myself. She was always a sweet cat. Part independence and spunk and another part sweetness and cuddler. She was the only cat and she was always a little regal in nature. She was in charge. And the dogs . . they knew it. The older she gets, the more she just wants attention. To lay in a lap and get her ears scratched. Unfortunately, I haven't been around much to do that lately.

I had 4 animals growing up. Squirt was a little terrier mix who was the sweetest, most loyal pet I've ever known. She was my first dog and I got her when I was 5. She was originally named "Lady" but "Lady" and "Lanie" got confusing (especially when my mom was shouting for one of us from across the house) so we decided to change her name. We had been calling her a little squirt ever since we'd gotten her and eventually the nickname stuck. She was dumb as a box of rocks but she loved me so much and I felt the same way about her. She died my first year away at college at 17 years old and I was absolutely heart-broken.

Jasmine was a rottweiler who wouldn't hurt a fly. We got her on my 11th birthday and I got her name from the movie Aladdin, that had just come out 6 months before. My mom had always loved rottweilers and when she heard about a friend who had rottweiler puppies, she couldn't resist. Supposedly, Jasmine was my dog. But we all knew better. Jasmine and I were buddies and we loved each other very much. But she was my mom's dog and everyone knew it. They had a bond from day 1. Some people were afraid of her (at her biggest, she weighed 140 pounds!) but her worst fault is she'd try to lick you to death if you gave her the chance. She absolutely loved people. When she passed, my mom was devastated. We both loved her but it really tore my mom up. She was 11 years old, too young and still so sweet.

Finally, Yup was the dog we didn't figure on. My mom's boyfriend brought him home from a site that he was working at. He was a stray lab-mix puppy at the time and only a few months younger than Jasmine. He was named for the activity that he did constantly throughout his puppyhood. Though, he did grow out of the barking habit eventually. Eventually this boyfriend moved in and brought his dog with him. Yup was a nice dog but he bonded more with Jasmine than anyone else in the house. Those two dogs were best buds. When one left for a while, the other would be miserable until they got back. When the boyfriend left the picture, we ended up keeping Yup because we couldn't bear to split the two up. Yup survived all my other dogs. And I know he hated losing Jasmine as much as the rest of us did. He died last year, out of the blue, at 15 years old.

And now Ringtail is sick. She is 20 years old and that cat outlasted them all. I'm 27 years old and these animals represent part of my childhood. It hurt so much to know that they are old and sick. I love them and have so many memories of each of them. Saying goodbye to them is so hard and I wonder if they know how much I still care about them, even if I'm not there everyday. I have a serious soft spot for these (and all) animals. They were so good to me, there for me and so loyal and and sweet. And now the last one is leaving me. I hate that I couldn't be there more for them and that even though they started out as mine, as I grew up I had to leave them. So I'm leaving now to join my mom at the vet's. It really is a sad day.

~Layne

Pumping

I started pumping on January 12th. (Look! It's pink!) A week and a half ago. So why haven't I blogged about it since then? Well, frankly, I'm still not sure what I think about it. For those who don't know, I have been on an insulin pump before. And it and I didn't get along so well. I started pumping in 1996 and it was one of the first old-school Disetronic pumps. It lasted for about 5 years but in late 2000, early 2001 I had gotten completely sick of (and jaded by) the pump and desperately needed a break from it. I switched back to shots, thinking it would be temporary, but loved the change and felt like I had been freed! I've been on MDI's (multiple daily injections) ever since with A1C's in the mid-low 6's and had no desire to change!

A lot of people who know anything about diabetes were pretty surprised when they realized that I wasn't on the pump. I tell them my A1C and they tend to zip it. But truly, it's the in thing to do, thought of as the top-of-the-line way to manage Type 1 diabetes. The only way, according to some. And, at first, I loved mine as much as everyone else seemed to love theirs. It took my A1C's from being in the high 7's and low 8's to being 6.2 after the first 3 months out!! But over time my A1C's started to slip again. They weren't as bad as they had been but they settled back into the low to mid 7's and didn't budge.

And I knew why. I was a teenager and hated my diabetes. I used my pump as a quick fix. I'd be noshing on something at a party, take out the pump, beep-beep-beep, and think "OK, that'll do it." Not really counting my carbs. Not really paying attention to my boluses. Doing just enough so I'd feel ok and be able to put the pump away and forget about my diabetes again. I'd like to say that I'd matured by the time I was in college. Saw the big picture about my diabetes and wanted to take control again. But if it were just that I could have stayed on the pump. (That maturity came eventually, but it was later when I was in nursing school.)

No, by that time, I was just friggin' sick of the thing. The sites were huge and painful to put in (no inserters back in the day and all the sites went in at a 45-degree angle . . yuck!). And, as a result, I did it as little as possible, leaving sites in until they were practically falling out (5-ish days or so on average, sometimes longer). Usually by the time I'd change it, my old site would be red and puffy and leaky. I even had a nasty infection once. Unfortunately that didn't deter my laziness. On top of that, the whole set change was an obnoxious process that, again, I hated doing. So it seemed like I would put it off and put it off until, of course, I'd get an "empty cartridge" alarm at a most inconvenient time.

And speaking of alarms, OMG! It seemed like every other second that thing would alarm about something or other. "Low Batt." "Low Cartridge." Or the dreaded "Occlusion" alarm. Looking back , I'm sure I got those all the time because my sites were awful but at the time, I only focused on how annoying it was. It seems like there was always a part to the pump that could break, get empty or need replacing at any given time!! Tubing, cartridge, battery, insulin, site, etc, etc . . . . And that's whole lot of crap to carry around all the time "just in case."

Not to mention having that damn thing attached to me all the time! As a girl, I maintain my right to be indecisive about my outfits. Well, it's quite annoying to have something attached to you when you are walking around naked or mostly naked, trying to figure out what to wear. And I remember always having to stand close to the bed, dresser, nightstand, etc so that I had something to hold my pump. And when I say "close" I mean within 23 inches, because that's how long my tubing was (and is). Um, don't know about all the other ladies out there, but sometimes I have to bend over, or flail or kick a knee out to get into something and it doesn't always allow for me to be within 23 inches of a piece of friggin' furniture!! And then of course the pump drops off of whatever is holding it and tugs on the site or maybe even yanks it out! Ugh.

Alright, that's enough kvetching. Can you tell that I was just so very over it? I really liked not being attached to anything, not having alarms and the comfort of knowing that as long as I had at least one syringe and a bottle of insulin, I was good to go. Plus, after those ridiculously huge needles I was using for my sites, the little syringe needles felt like nuthin' going in!

But here I am on the pump again, on the advice of my MD (re: pregnancy planning). The first couple of days I felt like total crap! My sugars ran the gamut from the high 200's to a shaky, weak-knee'd low of 30 in the middle of the night. I hated going from knowing exactly what to do to fix a low or a high or how much to bolus for a meal. . . . to not having one freaking clue. Do I change my basal or my carb ratio? If I change my basal which hours do I change? Sure, I could make a well-educated guess, but who know if it'd work? All this trial and error while my sugars are just standing there laughing at me. And I feel awful when I'm out of range so I spent several days feeling like crap never knowing what my blood sugar was going to do. And the whole being attached to something thing was driving be batty again. I was hoping since it took so many years to get on my nerves the first time, it wouldn't be so bad to start out with. Uh, no.

But, to my utter shock and amazement, I've kinda gotten used to it. It took about 3 or 4 days but my blood sugars started settling down and I'm slowly finding ways around being annoyed by the pump being attached all the time. And, can I just say, how much, much, much more comfortable the sites are now? Holy geez? Back in the day, my sites would itch and sting and drive me nuts, even when they were new! But I can barely even feel these new sites! Big improvement. Also, the first few days I had no clue how to wear my pump when I was in PJs. I mean I don't have PJ's with pockets so where do I put it? My Disetronic used to have a clip built into the back of it but it didn't really hold on to anything, so I never used it. I gave the snap-on Animas clip a try on my 2nd or 2rd night with the pump and it works like a charm!! Plus this thing has way better software, love the meter remote (seriously, love it!) and it's super cute!

There are still things that annoy me about it but it's much more bearable than I thought it would be. Overall I'm getting happier with it by the day. I'm still not sure if I'll stay on it after the pregnancy is over but we'll see. I also have a few more things that I need to adjust to with the pump and a few more hurdles to deal with. I'd love some advice from anyone in the DOC on pumping. I'm sure you guys have figured all this stuff out and I'd love to skip all the trial and error!

Things I'm still trying to get used to:

1. Wearing a dress or a nightgown. I haven't even tried this yet because I have no clue where I'd put the pump. I don't own any of those pump-wear products and don't really love the idea of spending all that money on them. The Animas has a remote control meter so I guess I could put it in my bra since I won't have to go digging it out when I need to bolus. But I'm not so sure how it would hold?? Any advice??
2. What to do when I'm naked?!? I know this is a weird subject but seriously when there is nothing to clip the pump to, what's the easiest thing to do with it? Do you just hold it? (Thing is, I really don't like only having one hand to work with when trying to get dressed . . . ) Disconnect it? Let it drag on the ground?
3. Do you always trust the "insulin-on-board" feature? Sometimes I think that it's giving the IOB way too much credit and not recommending a high enough bolus for my blood sugar. Sometimes I'm right and I need to bolus over and over again to get my sugar to come down and sometimes I'm wrong and it works fine based on the math done by the pump. It's weird for me to let it do all the math for me, though. It's nice in some ways but I'm just so used to guessing my own "IOB" that I don't know that I always agree with the pump. What about you?
4. Where to put sites? Back in the day it was mostly abdomen and occasionally flank. Now I'm rotating between abdomen and flank about 50/50. But I know that it's become more popular to rotate them to arms, legs, etc. And I'd love to try my arm but are there any issues with tubing length or getting tangled in clothes etc when you use the arm/leg sites?
5. Last one! Sleeping. I keep waking up because the pump is all tangled around me or I've rolled over on to it and it's uncomfortable. Any suggestions?
   

I'm sure I'll think of more questions, but I think that's it for now. Thanks for listening to my rant and thanks in advance for any advice!

~Layne

Semi-Charmed Life, Pt 2

Okay . . to continue to post explaining the title of this blog, Semi-Charmed Life. You've already heard about the song Semi-Charmed life and how much I loved it back in the day. Now onto why it works as a description for my life as well . . .

Years ago, I signed up for blogger and at the time "LayneNP" was my username for everything so I just went with it when I was deciding the blog address. But at the beginning of 2008, when I decided I was actually going to try out blogging, I knew I had to figure out a real name. I knew that I wanted it to be something that summed up my life, but how do you say that in a few words? What is my life? Family? Friends? Work? School? Diabetes? It's so many things! All at once!

When trying find a way to word something, I have always gone to song lyrics. They just seem to make the most sense to me with their nonsensical lines and profound words. Since Semi-Charmed Life was one of my favorites it jumped out first. And it seemed to fit my life. Because one thing that stuck out to me was that over my relatively short life so far, I'd had a lot of highs and lows, even more so than most. My life has always been a little bit of something good and then a little bad, something wonderful followed by something devastating. So for those of you who don't know a whole lot about my background, a little history . . . .

**Warning: There is some deep, mushy stuff to follow. Turn back now if that isn't your thing!! **

I grew up with the best mom ever and two grandparents who were more like second parents. But I never knew my (biological) dad. (Side note: I hate saying I didn't grow up with a real dad. . because I did, it's just that he was really my grandfather. Still, he was the best dad ever.) My mom and "dad" had been married but divorced when I was a baby and he was just never around. Anyway, I would find out later that my biological dad had diabetes. (Bastard. The one thing I didn't really want from him he gave me. Isn't that always the way. . .?)

Like I said, I never knew him growing up and just as I was starting to ask questions about who he was and realize that some things about my family weren't quite like other families, we got a phone call. We learned in 1989, when I was 7 years old, that my biological dad had died quite suddenly. He was only 42. He was diabetic (also Type 1) and, from what I was told didn't take very good care of himself in his later years and was starting to suffer from complications. He died of a massive heart attack without warning, again likely a complication of his diabetes.

You might think that since I never knew my dad I wouldn't really be affected by his death. But it was actually the opposite. Losing a parent that I didn't know was actually very devastating to me because it represented a path that I could now never go down. If there were any questions I had about my dad or for my dad they would now forever go unanswered. Who was he? What was he like? Why didn't he want a relationship with me? How did he handle his diabetes? Did we share the same frustrations? Did he think of me? Did he love me? These were all questions that were destined to go unanswered and the finality of all that was really hard for me. Not to mention knowing nothing about a person who (genetically) makes up half of who I am. . . that's just . . . well . . . hard.

This is a picture of my dad with me as a baby. It's one of the very few I have of him and I together. I was very young and if you look closely, you can see I still have my umbilical cord. Not the cutest kid in the world, but still not a reason for him to be such a jackass. ;-)

A year after losing my (biological) dad, my mom was diagnosed with breast cancer. She underwent a double mastectomy and held it together amazingly well from my 8 year old perspective. I was scared, but absolutely sure she'd be fine. And she was. Thank God.

The next year, I was diagnosed with diabetes. Yeah, that sucked. 'Nuf said.

I went into my teen years bitter and angry. In high school, I made amazing friends that made me forget all that and just have fun. The good, clean, happy fun. . . nothing harmful. At that point I was just learning to be happy again. I graduated high school in 2000 and was surprised how upset I was to leave home and go to college. I loved the University of Florida and had some of the greatest times in Gainesville but that initial transition ended up being much more difficult that I had anticipated. Then, in 2001, my grandfather (my real dad) was diagnosed with cancer. It was very aggressive but I had been through this before and I was sure everything would be fine.

Now, I'm a skeptic for the most part and use logic and common sense to find my way through life. I'm not much for going with your gut or feelings or premonitions so please remember that when I say what I'm about to say. It was New Year's Eve at the end of 2001 and I was getting ready to go out and celebrate. My grandfather had been diagnosed with cancer for a few weeks and was about to start chemotherapy. For some reason I was getting ready and thinking about the coming year and a feeling just washed over me. I realized that I wouldn't see another New Year's Eve with my grandfather. I say that I "realized" knowing that it sounds crazy because how could I know anything about the future? The doctors were telling us it would be a hard fight but they never said it was futile.

But somehow I knew. It hit me that night like a MAC truck that I would lose him soon. I had no clue how to handle it and moved forward without telling anyone what I was thinking. I didn't want to go back to school that spring semester. I wanted to stay at home and soak up memories of my grandfather. His smile, his smell, his laugh. I wanted more time. But didn't know how to justify staying home, so off to school I went. I came home often throughout the semester to visit. My grandfather's health quickly deteriorated and thanks to some wonderfully understanding professors who let me take my finals early, I was able to go home and spend his last 4 days with him at home.

This is one of my favorite pictures of him and I. I know it's not the greatest. He's shirtless, I'm looking like hell with my PJ's and rocking some serious bed-head. But that's how we were. Happy, casual, goofing off. And he was always right there to look out for me. Seriously. Best. Dad. Ever.

His loss devastated me. After my biological dad died, I lived in (irrational) fear of losing one of my parents (my mom, my grandmother and my grandfather). And the thing I fear most had just happened and it was so much worse than anything I had ever imagined. How could I live without him? Who would tease me at the dinner table? Who would I call for advice on my car? Who would walk me down the aisle? Who would be a grandfather to my children?

I felt as thought I had lost a part of myself and was now supposed to function like nothing was wrong. I cried and cried and cried. I cried myself asleep. Whenever I was alone, I cried. I cried so much it hurt. I pretended he wasn't gone. Anything to kid myself into thinking that everything would be okay again. I don't know if I was clinically depressed. I never saw anyone or took any meds but I was devastated for a long while. It's still hard to talk about him without breaking down. I wouldn't wish that kind of loss on anyone.

And yet, among all this grief and heartache and death and disease, I really had a great childhood. I had amazing friends that are still my friends to this day. I went to an amazing school (Go Gators!) where I did some soul-searching before deciding what I wanted to do with my life. I got my first "F" in college, which for a straight-A-er like me, might as well have been the end of the world. But as a nurse I also saved lives on a weekly, sometimes daily basis. And through it all I had Brad standing by my side, encouraging me, grounding me, loving me.

So when I thought of "semi-charmed life" it really seemed to fit what I was about. Nothing was ever easy and there were heartaches along the way but there was always happiness too. I love my life and I can't wait to see what's around the next corner!

~Layne