I Love New York

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.

Sausage Arms!

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.

Crossfit Foundations

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.

Crossfit

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?

Good Eye, Bad Foot

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!

Greetings from Brooklyn

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!

Languid Spring

Aaaah - spring in the South: the weather is beautiful, the skies are clear, the trees are in bloom, and pollen-induced lethargy has sent in. Even our Scottie is suffering - we took him to the vet today for relief for his goopy eyes and itchy, irritated skin, and he fell asleep sitting up at the exam table. I’m trying to scrape together the motivation to exercise -  something I haven’t had to force myself to do all month. I don’t think I could lift a weight if I tried, so I will reluctantly proceed to the freakishly hyper-energetic world of Turbo Jam for a little Cardio Party. I’d link that for you but the Turbo Jam site is the interweb version of a TV infomercial and therefore is quite high on the annoyance scale.

Oh yeah, the reason for this post (other than procrastination): how cool is this little Recipe Analyzer gadget at Calorie-Count.com ?

Two small victories

I know I sound way too excited about such small, predictable “victories”, but it is always exciting to find some way to make the foods you enjoy fit into your diabetic life.

The first: Overindulged by eating three fajitas at dinner two nights in a row, despite knowing two is my normal limit. Tuesday night it left me at 155 an hour after (ouch), but only at 94 on Wednesday. The difference? Wednesday evening I exercised! Which makes me wonder, how would I weather a typical low-carb dinner post-exercise without any Starlix at all? More thoughts on that later.

The second victory occurred at lunch today at my husband and I’s weekly lunch spot, which we have eaten at several times since I started on my A1C-lowering endeavor but until today just couldn’t seem to find the right combination of food at to not leave me with highs an hour later. Today I hit the jackpot: I took my Starlix 30 full minutes before eating. We ordered our usual cheese dip, but instead of eating out of the basket, I picked out 7 large chips and placed them on a napkin. Once they were gone I didn’t reach into the basket again. For my main course I ordered 1 brisket and one carnita taco, which I opened, ate the contents of, but left the tortillas untouched. I felt great afterwards and just couldn’t wait the hour to check my blood sugar and checked at the 30 minute point instead: 107, followed by 93 at the one hour mark! You all must think I’m crazy for wanting to ditch Starlix when it helps me eat the things I love, but I don’t see any reason why I couldn’t accomplish the same thing with a fast-acting insulin taken at the right time before a meal.

Hello Jello

Normally I avoid packaged, processed and chemically-enhanced “foods”, but yesterday in a rushed search for something to get my blood sugar up from the low 60s before exercising, I discovered a box of Chocolate Sugar-free Jello Pudding in the cabinet and decided to whip up a batch. I knew it didn’t have much nutritional value on its own so I added in a cup of cottage cheese and a scoop of whey powder - heaven! I was actually excited when my blood sugar went too low again after dinner because I got to eat even more. I’m definitely going to have to exercise restraint if I’m going to keep this stuff around, or perhaps make my own instead so I don’t have to fear an ingredient list that includes such gems as aspartame and acesulfame potassium, tetrasodium pyrophosphate, disodium phosphate, mono- and diglycerides (”to prevent foaming” - god forbid!).

Not sure what caused my lows last night other than maybe a little delayed Starlix action. My BG was way too high (174 - suspected culprit: frozen blueberries added to my plain yogurt) after my afternoon snack which was taken with Starlix, but then an hour later it fell to between 47 on one meter and 63 on another at 7. At 8:30, post- Jello/cottage cheese/whey (taken without Starlix) and exercise it was 111, then an hour after dinner (leftover White Chicken Chili, with Starlix) it hit 53! The strange thing about the 53 after dinner was that I didn’t feel at all like I normally do during lows (shaky, confused) - instead I just felt unusually sleepy.

I should also note that I just ate the Jello/cottage/whey concoction again with only a half a Starlix (fearing a repeat of yesterdays lows), and an hour later my blood sugar is 170. Too much carbohydrate (22g by my estimations) too fast I suppose - I’ll try again some day with a whole Starlix, but maybe my new love is at least for now best reserved for lows and post-exercise.

More on Exercise and Highs

This morning my fasting was a happy 76, but after my normal breakfast and two mid-morning snacks of 5 almonds each, my BG was 149. I ate my lunch (leftover Buffalo cheese burger on whole wheat, caramelized onions, spinach, condiments) anyway because this morning the scale showed that I’d lost a couple of pounds which is NOT a desirable outcome and seems to indicate I’m not getting enough calories. I’m wondering if this lack of fuel to burn could also be causing the post-cardio highs.

I’m trying to get a better grasp on the physiology of how the body fuels itself during exercise, and so far if I understand things correctly, the highs could be my liver dumping glucogen into my blood stream for fuel. I’m unclear on whether this is one of your body’s “last resort” fuel sources, or whether that is a normal response to vigorous exercise. It will be interesting to see later this week and weekend if the less intense workouts I plan to do also cause highs. From what I’m reading it sounds like most type 1s just add insulin before vigorous training, but unfortunately I don’t have that option (yet :)), so I plan to try eating some protein or a small meal (with Starlix if necessary) in the late afternoon, perhaps an hour or two before exercise time.

A few helpful links:

• http://www.diabetes-book.com/cgi-bin/yabb2/YaBB.pl?num=1127916086
• http://www.medic8.com/healthguide/articles/exerciseanddiabetes.html
• http://www.diabetes-book.com/cgi-bin/yabb2/YaBB.pl?num=1109249044