Lancet Queen: My Life as a MODY Diabetic

My six-month mail-in A1C results from the Stanford Healthier Living with Diabetes Self-Management Program arrived in the mail today. My HbA1c was a new personal record: 4.8! Of course I’ll want to get this one confirmed at a real lab, but last time the real lab number was only .2 points away from the mail-in result, so I guess I’ll go ahead and celebrate! w00! Thanks go out to Starlix for allowing me to eat, to New York City and Brooklyn for being so darn pedestrian friendly, to my usual low-carb (and more recently, Zone-favorable) diet for the obvious, and to Crossfit for kicking my ass left and right and keeping me coming back for more.

T-minus one day until my next Crossfit class and my arms still look like sausages… hello tendonitis! The pain is all but gone, and I can almost straighten them all the way, but my arms are still so puffy around the elbow that I had to changes sweaters twice this morning to find something with sleeves wide enough to accommodate them. I’ve been icing 2-3 times a day and taking aleve and don’t know what else I can do except NOT do pull ups tomorrow night.

Wednesday was the first of a six-class Foundations series that I signed up for in order to (safely!) learn the basic exercises and nutritional elements of Crossfit. We learned the movements and proper form for the basic Crossfit warmup, which consists of sit-ups, push-ups, pull-ups, squats and Sampson pose. I was able to do all of those exercises OK with the exception of the pull-up. To work towards a full pull-up on my own, I jump into the rings and focus on the descent, allowing my arms to reach full extension before touching my feet to the ground. After a few rounds of the warm-up exercises, we learned Cleans and Jerks, first with PVC then with bars. Afterwards I had a fun time standing around chatting with my new classmates, then went and watched the last few minutes of the group class’ WOD. I felt amazingly energized afterwards and all through the next day.

Unfortunately I think I’ve pulled the tendon in my right and possibly also my left arm. The day of class, no less than four friends told me “don’t hurt yourself!” so I aimed to ease into things, but now it appears I may have over did it on the pull-ups. Actually I probably would have been fine had I not tried to carry my extremely heavy bag of records to a gig last night (my husband had his hands full with our turntables). Thursday and Friday I went through the normal post-Crossfit soreness in muscles I never knew existed phases, but every day was feeling better… but then this morning I woke up unable to extend either arm fully, especially my right. Now my right biceps is swolen and stiff. I was hoping to go to Beginners class tomorrow morning, but I’m going to give myself some time to rest and heal completely before class on Wednesday. I hope this doesn’t become a constant cycle of Crossfit -> debilitating soreness -> injury -> no exercise for a week to heal -> Crossfit again.

Yesterday I accompanied a friend to my very first Crossfit group class in Brooklyn. My husband went a few months ago but I was sitting it out while rest and cortisone treatments via iontophoresis healed the inflammation around my Haglund’s Deformity. I was super-nervous about the class (fears of puking and hypoglycemia made me eat an unreasonable amount of carbs beforehand - oops) but managed to complete the warm-up (which was far more difficult in intensity than my normal workout) then in lieu of the Workout of the Day (35 cleans and jerks), worked on form and technique with the instructor. I’m in a whole new world of pain today, but hope to make this a regular part of my workout routine. I’ve been lamenting my lack of general/cardiovascular fitness lately, especially during my weight lifting routines where I felt like I wasn’t making much progress due to my lack of cardiovascular endurance. Friday at the gym I did an interval routine on the treadmill and felt fantastic afterwards. I think adding more running, buying a bike, and doing Crossfit at least once a week will be just the thing to move me towards better overall fitness. Plus how cool would it be to one day say I’m proficient at gymnastics and Olympic Weightlifting?

Any diabetic pals out there Crossfit junkies?

Thursday’s Lasik procedure went swimmingly. I’m hoping to post an edited-down version of the blow-by-blow I posted on my other personal journal, but it’ll have to wait until my eyes have recovered further and my tolerance for staring at the computer increases. So far I can say this is one of the best decisions I ever made - to be able to go from not being able to see 10 inches in front of your own face to seeing every little detail in this beautiful city with your naked eye is truly miraculous!

Nothing to report on my Achilles Tendonitis - even after 5 days of rest and almost two weeks of only wearing super-padded New Balance running shoes, I still can’t tolerate having any pressure (i.e. any shoe other than the New Balance) on the back of my right foot. Based on the lack of improvement from ice, massage, heat, rest and Aleve, I’m beginning to think it may be Haglund’s Deformity. I made an appointment with a podiatrist in February but tomorrow will be calling around to see if someone can see me earlier.

Happy New Year! Since I last posted, two things have developed in my health life, one good and one bad. The good? Thursday I’m having Lasik eye surgery. The bad? I’ve barely had time to think about the surgery because I’ve been so preoccupied with the excruciating pain when I walk caused by achilles tendonitis in my right foot. Tendonitis sucks for anyone, but is especially bad here where I depend so much on my own two feet for transportation. The GP I saw on Tuesday said that if it didn’t improve after two weeks of ice, Aleve and as much rest as possible, that he would send me to a podiatrist. He mentioned that diabetics have a propensity towards tendon problems. “Even well-controlled diabetes?” I asked, and he replied “Yes”. Bummer.

So far after 5 days of ice and rest, it’s feeling about the same, but if I understand correctly, the Achilles tendon is one of those slow-healing things, so I’m trying to be patient. I did buy a nice, squishy pair of New Balance and can walk somewhat comfortably in those (as opposed to not at all/limping in any other shoe), so my goal is to walk as little as possible and only in the New Balance from now until it heals, which I hope and pray will be in time for my 30th birthday in February. I _will_ dance on my 30th birthday, darn it!

Wish me luck with the lasers on Thursday!

Late last week I got my “real” lab results back from my doctor:

A1C: 5.4
Cholesterol:
hdl: 109
ldl: 79
total: 205

The doctor called my HDL “superlative” and says he’s never seen that high in a patient, ever. Thanks pecans, almonds and fish! I was a little suprised by the A1C but I think it just goes to show how much good all this walking is doing me.

My latest round of labs arrived in the mail today from my Stanford Self-Management program 6-month check-in. Before I spill them, though, I have to confess that I accidentally left the little card that you drop your blood on out to dry for way longer than I was supposed to… about eight hours longer. Therefore I’m not very sure about the accuracy of these numbers, particularly the A1C, which came in at a surprising 5.2, which according to this chart puts my average blood sugars around 108 mg/dl.

On the cholesterol front, my HDL came in at 91 mg/dl, which is fine, but my LDL was a slightly disturbing 132 mg/dl, far above the target 100mg/dl or lower. My total cholesterol was 235 mg/dl, which is well above the target of 200 mg/dl or lower. I’m not freaking yet, though, because Thursday I finally took my fasting butt to a Quest Diagnostics for the large round of tests that my doctor ordered when I saw him well over a month ago. So sometime in the next week or should have a second set of numbers to compare these with and will then either keep on keeping on or make some adjustments.

Speaking of cholesterol, this New York Times article from August, Looking Past Blood Sugars to Survive with Diabetes, is a great read and raises a good question - are cholesterol levels that are OK for non-diabetics really OK for us diabetics?

Greetings from Brooklyn! After two months of working in the Big Apple and living in peaceful, green Brooklyn, I can report that this city is both a wonderful and a terrible place for my diabetes. Wonderful because you can’t even begin to imagine what a positive affect all the walking has on my blood sugars, but horrible for me because the hassle of cooking at home in a tiny apartment vs. the convenience of eating out has resulted in some very poor diet decisions. I hit a low this week by allowing myself to run out of test strips for the first time in months, but am picking up a refill tomorrow and will soon be back on track.

On top of my 3 mile average daily walks to and from the subway station and around the ‘hood, I joined a local gym but have only been making it there 2 times a week, 3 at most. I really miss working out at home. There were so fewer things to come between me and a workout when all I had to do was walk a few feet and pop in a DVD, but I like my downstairs neighbor too much to do Turbo Jam on her ceiling. Now it seems that anything can come between me and the gym - early meetings at work, long days at work, any social activities during the week, illness, etc. My immune system is taking quite a beating too: two colds and 1 food poisoning all in a two months span. I hope this is just my immune system adjusting to living in germ and virus mecca.

Yesterday morning I saw my new internist for the first time and am in love. He gave me an order for a whole slew of tests to take to a Qwest Diagnostic, including an A1C. We both acknowledged that the A1C probably wasn’t going to be very pretty, so the plan is for me to get a second A1C in February then go see him, and if it hasn’t improved he will refer me to an endocrinologist in the same office. For now I’m quite happy with the prospect of seeing him for my diabetes treatment - he was familiar with MODY, seemed up-to-date on his treatment knowledge, and was a very good listener.

So long for now - considering the workload at my (ver stressful) new job, I don’t know how regularly I’ll be able to check in, but I’m thinking about all of my D-friends and hope to catch up on all of your blogs soon!

Well, there you have it - the reason for my present and short-term future lack of posting. My husband, dog and I are getting rid of most everything we own, renting out our house, and moving to Brooklyn in early August. To complicate things, we have a previously planned beach vacation smack in the middle of things, which is either going to be a great blessing or somewhat of a curse.

Despite the inordinate amount of stress, my blood sugars still look surprisingly good, likely because I’m still holding my diet and exercise routine together. Emotionally I’m not as stable as my blood sugars, but I guess you can’t have it all. I make one last visit to my PA in a couple of weeks, then sometime after I get settled, I’ll start the process of looking for MODY-friendly doctors up in NYC.

During our packing/sorting/trashing spree, I did find a couple of interesting pieces of my diabetic history. The first was the extremely high-carb, low fat and low-calorie meal plan that resulted from my very first trip to see a nutritionist, 10 or so years ago. The second was a sheet of paper that I found stashed in an old glucose meter. On it I’d logged my food and blood sugars for a couple of days prior to an endo visit about 4-5 years ago. (This was back in when I only tested before check-ups). I had to laugh at how bad my diet was: a whole everything bagel for breakfast, carrots and potato chips for lunch, etc, and I was waking up in the 120s and consistently in the 170s-200s during the day! My endo had written all over the paper suggestions of different things to eat (nuts, cheeses, veggies, spaghetti squash, etc) - it must have been the first time anyone suggested that I eat high-protein/low-carb.

This may be my last update for a while, so wish us lots of luck!