What Brings You In Today?

a better answer

These are my “goto” medicinal intervention

The Inspiration

Today will be a day in the life post inspired by the last few days. Yesterday was a challenging day as I tried to figure out if I was sick and if yes, how serious. I decided to jump this post to the front of the line. It was easy to write but longer than my goal. The title today is inspired by how a doctor's visit normally begins.

The Setup

On Thursday night I went to bed at a normal time and just expected a nice Friday ahead. I was awakened in the middle of the night amidst a fitful night of sleep. I felt clammy so I turned to my technology devices on my bedside and wrist to figure out what was happening. I keep my phone in the kitchen in the evenings as I have a charging station in a place so I don’t struggle to find my phone. I also know that no matter what we do, our phones can make noises, send alerts and just generally serve as an undesired interruption at times. At around 3 am, I awakened and knew that something was not quite right.

My watch told me something I already knew. My sleep till 3 am was poor quality. I did not need a “SmartWatch” to tell me that. My heart rate was elevated. My blood oxygen level was just a little lower than its “normal” 99%. What amazing things are available to us if we use it. I went downstairs and found my phone, and placed it near my right upper arm until it beeped a couple of times. The glucose meter that I wear is about the size of a half-dollar and is attached to the back of my arm (around the tricep). Since my level of exercise is far from Olympic class, there is more than enough fat in my upper arm to find the fatty tissue the meter operates in.

I turned the phone to face me and noted with alarm that my blood glucose level was 63 mg/dl. That is milligrams per deciliter. My doctor wants my blood glucose level to remain in its control range of 80 to 180 except during the immediate period after I am eating. I shoot for a daily average of around 120 and hope to lower that a bit in the coming year. Diabetes is a disease of unmanaged glucose in our bloodstream. Too much glucose serves as a poison in our bodies and damages vital organs including our liver and kidneys.

The Details

Too little glucose and our body will start shutting down with the organs harvesting it to keep their engines going. Our brains live on glucose and that is why low levels lead to confusion. Low blood sugar is called hypoglycemia. The symptoms are heart palpitations, confusion, shakiness, and anxiety. I am sure at 3 am I had a few of those symptoms!

When I was diagnosed as a Type-2 diabetic, my response was to read extensively and understand the disease and what I could do to ameliorate the symptoms. I am proud of my progress as I exercise more, am more attentive to my sleep cycles, carefully manage my diet, and am now on my latest journey to lose 70+ pounds in all. My peak weight was about 240 pounds and I am now about 185.

My New Year’s health goal is to get to 175 by the end of June and mix in more resistance exercises. If that is not accompanied by better glucose control, I may have to try something else.

I wish my blood glucose was easier for me to manage. I expected better results. My first goal was to lose 25 pounds. Next, I committed to getting to 200 pounds which corresponded to 40 pounds lost. My condition did improve markedly but there was still a long journey to a genuinely normal range. I have lost 50+ pounds so far yet better-managed blood glucose has been elusive for me. I know that each person is different and I cannot expect magic. I just sometimes wish my results were a bit better than they are.

I mentioned in a prior post that I do my New Year’s evaluation the first week of the year. I have shared above my health goals that resulted from that contemplation. The hardest part for me is I have decided to see the impact of no pizza at least until the middle of February. I know that pizza, even in moderation is difficult for my body to handle. 37 days till February 15th! I will undoubtedly have a bit of pizza soon thereafter! I am already thinking about how to make my own cauliflower and cheese crust.

Back to my 3 am debacle. My meter will go into the “red" zone” if my glucose gets below 60. It had been hovering in the 60s and low 70s since about 1230 pm. I reached into my carryall bag and grabbed a couple of jolly ranchers (today’s photo). When I started unwrapping them, that was enough noise to awaken my trusty dog, Denny. He doesn’t wear a watch but associates any noise on the first floor as a time to get up, perform his morning constitutional, and have his first of two-a-day meals. Despite being quiet, he knew that opportunity had arrived. I popped the Jolly Ranchers in my mouth and opened the gate of the laundry room and the morning was now in progress.

I let him out and he was at the sliding door in a flash ready to do his duty. I poured a half serving of breakfast for him and put it in his bowl in the laundry room and freshened his water. He was ready to come in and bolted for the food. When he did not find it in the usual location, he quickly checked near his bedding in the laundry room. I went back upstairs and sat down to make sure my blood sugar would recover to a safer range. After about twenty minutes my blood sugar had climbed sufficiently so I got back into bed around 345 am.

I slept in a bit and when I awakened again, my blood sugar was a little higher than normal for the morning. I assumed it was the Jolly Ranchers and the irregular sleep and just started my day. I prepared my regular breakfast and took my morning medications. This caused my blood glucose to go WAY UP and far beyond where it would normally go even if I had eaten pizza and a bagel (too many carbs).

I normally have a small bowl of quinoa and beans and sometimes have a poached egg. I also drink only tomato juice cocktail that I make (more like a bloody mary mix) and also some berries. If I am hungry I might add one slice of toast. My breakfast is pretty standard and moderate. My glucose level typically responds and quickly rises to about 200 and falls back in about 45 minutes down into a normal range. This is EXACTLY WHAT MY BODY is supposed to do. This morning instead, my usual breakfast caused my blood glucose level to rise above 300 and not quickly drop down but rather level out for a bit before a gradual drop.

I consider my Freestyle Libre sensor, made by Abbott Laboratories the single most amazing piece of health technology imaginable. A diabetic can grow tired of sticking small needles into their fingertips to extract samples of blood, smear it on a test strip and then insert it into a meter to test the glucose in their blood. Because I was a motivated patient and wanted to understand my disease, I would do four sticks per day. I found that 1/4 times, the meter read might fail so on a given day I might do an average of five sticks. The meters recommend alternate sites for sticking so I would rotate between the left and right sides of my four fingertips (16 targets in all) throughout the day. This meant poking the same spot every fourth day or less. I changed to the technological wonder after about nine months of finger sticks.

The Freestyle Libre meter is a wonder of science. I remember my Dad, a Type-2 diabetic who took insulin injections twice per day and his testing with urine strips. I am so thankful that we have more options today. My meter works great and is quite ingenious. Abbott has developed an algorithm that relates the transition of glucose from our bloodstream into our fatty tissue. The meter itself comes with a plunger and lasts 14 days. They estimate that the glucose level it displays tracks 5-10 minutes behind your bloodstream. You simply clean the area you want to apply it (maybe shave hair as necessary) and plunge the meter which then attaches with adhesive to your arm with a filament that penetrates the skin subcutaneously into the fat layer. SIMPLY AMAZING!!! The device, if you look at it closely is a round printed circuit board with an onboard battery sufficient for its two-week duration as well as Bluetooth communication with your phone. It also maintains onboard memory to store 8-12 hours of continuous data on the local device. When you scan it with your phone, your current level as well as all previous rolling history is uploaded to a cloud site, and a continuous trend of your blood glucose level becomes available! Finger sticks only tell you a moment in time. I think the device is a Godsend if you take advantage of all the information and insight it provides.

So why is this device so amazing? We all have that non-specific feeling occasionally that we are “getting sick”. Very hard to ascertain what is going on and I imagine doctors and nurses are frustrated when we cannot be specific. In the age of COVID, it is hard not to jump to that conclusion. My sensor is a “canary in a coal mine”. When I see my levels fluctuate Icoal mine be on alert. Yesterday I started with nasal spray and a temperature near 101 F. The truth is, and I have made the analogy before, I think of my glucose reader as akin to a Star Trek tricorder. I know that our body needs glucose for everything it does. When it is out of whack, there is a problem. Our organs autonomously demand glucose when things are not normal so a way to see it over time is a wonderful analog for our health and well-being. I am not glad that I am a diabetic but I am glad that I have this modern world to thank for an effective way to manage it.

Today’s music is inspired by what I imagine a doctor or nurse is hoping for when they meet you and ask how are you feeling. I would imagine they can do their job a lot better if you have something concrete to share.