Memory Monday: Carb Counting and the Calorie King

One Monday per month, I’ll take a trip down memory lane and reflect on how much my diabetes thoughts, feelings, and experiences have unfolded over the years. Today, I remember…

…discussing carb counting and the role of The Calorie King with a nutritionist.

I’ve met with a nutritionist as part of my diabetes care a few times in my life. During my last visit, maybe six or seven years ago, the nutritionist gifted me with a book entitled The Calorie King. “It’s really going to help you with your carb counting,” she told me.

I remember staring at the book dubiously. It was a compact little thing adorned with bright, bold colors. A bearded man wearing a crown was the cover image, and I couldn’t help but think that it looked totally dorky. I was skeptical: How was a book about calorie counting supposed to help me with my carb counting?

Fresh and Organic
Have you ever heard of The Calorie King or used it yourself for dietary or nutritional purposes?

As it turned out, it could help me a lot.

The Calorie King wasn’t just a list of the calorie content of different foods – it was a comprehensive guide that told me everything about the nutritional content of food. It was like having a manual of nutritional labels, except it was in an easier-to-digest format. And it gave me something that I’d never had access to before: Carbohydrate counts of food that you can get at fast food places, sit-down restaurants, and the like. It gave me a better sense of just how ridiculous some restaurants’ portions can be, as well as how serving size is one of the most critical factors in determining a food’s carb count. My mind marveled at that silly little book’s treasure trove of information, which would be key in helping me determine how much insulin I should take for food in just about any situation.

These days, I use apps on my phone whenever I’m unsure about a given meal or food item. They’re far more convenient than lugging around a copy of The Calorie King. But it turns out my nutritionist kinda knew what she was talking about when she told me that it would open my eyes up to the world of more precise carb counting. And for that, I’m grateful.

 

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8 Things I Hate About High Blood Sugar

High blood sugar, high bg, hypergycemia, sky high…whatever you want to call high blood sugar, it doesn’t change how I feel about it. I hate it. My loathing of high blood sugar is probably not unique among other T1Ds – I’m sure most would agree that it’s the worst – but on a recent and particularly bad day of high blood sugars, I started thinking about why I hate being high so much and it turned into this blog post…which turned into a very cathartic thing for me to write.

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What do you hate about high blood sugar?

What are the eight things that I hate about high blood sugar? Here they are, from least to most detestable:

8. It makes me thirsty.
This reference may be lost on some of my readers, but to those who get it, it’ll be wildly funny (or at least it will be in my mind): *Parched Spongebob Squarepants voice* “Waaaaaaaaater! I neeeeeeeeed it!” When my blood sugar is high, I basically turn into that shriveled-up version of Spongebob that appeared in the episode in which he visits Sandy the squirrel’s treedome for the first time. He doesn’t realize that, being a mammal, Sandy doesn’t depend on water like he does to be able to live/breathe. Hence, he struggles throughout the episode to stay hydrated. I bet that if he were dealing with a high blood sugar at the same time, his desperation for water would become much more dire…because let me tell you, I simply cannot drink enough of it when my blood sugar is above 200. This results in many trips to the bathroom, and as I’m sure you can imagine, it’s pretty annoying.

7. It turns me into a major grump.
Nothing kills a good mood quite as swiftly as high blood sugar…I don’t like admitting it, but I tend to snap at people when my blood sugar’s elevated. So really, it’s a lose-lose situation for everyone.

6. It’s a weight on my shoulders.
If my blood sugar is high, I can’t help but wonder what I did wrong to make it so. Did I miscalculate my carbs? Should I have given myself more insulin? Should I have timed my exercise better? Is my insulin pump work properly? The list of questions and possible answers are practically endless, and it weighs heavily on me when I’m dealing with an inexplicable high.

5. It’s disruptive.
When my blood sugar is high for a prolonged period of time, I can’t focus on anything else but that. I’ll do anything and everything I can to take my mind off it and just let my corrective insulin dose go to work, but I can’t help but worry. This can be especially disruptive when I’m trying to get work done at my desk job, or when I’m trying to enjoy a night out with friends. It can suck the joy out of any situation, and that can be incredibly disheartening.

4. It doesn’t get along with exercise.
High blood sugar is weird, because sometimes it cooperates with exercise, and other times it reacts very badly to it. I find that if I workout at 250 or below, my blood sugar responds wonderfully to the movement and it’ll drop my blood sugar down to a better level much faster than insulin. But if I dare to workout above 250, then things can go terribly wrong and my blood sugar will go up even more. I learned that lesson the hard way in college, when I went to a high-intensity spinning class…I was so nervous about going low in the middle of the class that I overcompensated with a pre-workout snack. So over the course of the class, my blood sugar shot up to 300 due to the strenuous exercise coupled with the extra carbs. Not fun.

3. It makes my CGM wail.
I appreciate the alarms on my CGM, but NOT when they go off over and over and OVER again. It feels like my CGM is judging me for being high and it couldn’t be more obnoxious…and I just want to throw my device across the room to get it to shut up.

2. It prevents me from eating when I’m hungry.
I don’t always want to eat when my blood sugar is high, but occasionally, high blood sugar coincides with mealtimes and I end up staring longingly at food while I wait for my blood sugar to stabilize at a better level. Depending on when the high happens and how badly I wanted to eat some food, I can get very hangry (angry AND hungry), which is never a good state of mind to be in.

1. It’s stubborn.
The worst part about high blood sugar is that sometimes, it feels like it takes FOREVER for it to come back down. During the waiting period, anxiety, irritation, and anger are all emotions that can manifest themselves within me. And it sucks. The mental games that high blood sugar can play with me are straight-up cruel, and since a high can be so damn stubbornly slow to respond to insulin, it makes it that much harder to handle…which is why, I can say with 100% certainty, that I hate high blood sugars with a bloody passion.

Fearful and Falling in Target

What do they pump into the air at Target? Is it Afrezza or something? Because that seems like the only logical explanation for the phenomenon that seems to occur to most other fellow T1Ds when we step into a Target store.

Low blood sugars tend to happen at Target. Also known as “Target lows”, they can occur at any Target, big or small, no matter how long or short the shopping trip.

I experienced one last week. And it was severely exacerbated by the fact that I was visiting one in my new city for the first time by myself.

You are a rare gem.
Damn you, Target, for making my blood sugar go low during basically nine out of ten visits.

As you can see from my CGM screenshot, my blood sugar was definitely not low – not even close to it. I was in the mid-250s by the time I headed to the store, which is absolutely NOT where I like to be. But I didn’t take a correction bolus or even raise my basal insulin temporarily, because I guess I just had that feeling about my Target trip. I didn’t bother checking my CGM again after I parked, figuring that I’d do my best to make it a quick trip with minimal purchases.

Forty minutes (I’d been aiming for 20) after I’d stepped into the store and one semi-full cart (oops) later, I started feeling panicky and gasp-y. I told myself no, no, no, I wasn’t going low, I was just maybe reacting strangely to the scent of all the cleansers in the aisle I was occupying. I could deny it all I want, but in the back of my mind, I knew that I needed to pull my cart over, dig through my backpack, and locate my CGM so I could at least be informed of what my blood sugar was doing.

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Honestly, Target and all other retailers should just make glucose tablets free to any shoppers who are having a low moment.

So I did just that. Upon checking my Dexcom app and seeing that down arrow, I practically started hyperventilating. That’s when the following series of thoughts flew through my mind:

Okay, just get to the checkout…

Ugh, why is there only one open?! Guess you’ll have to self-checkout on low brain. Great…

OMG, Molly, you know you can only scan one item at a time…go faster!

You are NOT going to go down in this Target. Not today!!!

By some miracle, I successfully purchased my items and booked it to my car. Once I loaded everything inside, I suspended my insulin and shoved three glucose tablets into my mouth at once, chewing them so fast and furious that it probably deserved its own movie by the same name…(oh, but that’s taken *tee-hee*).

Normally, I would wait for my blood sugar to come back up before even thinking about driving home…but this wasn’t exactly a normal situation. I was on my one-hour lunch break from work, and I was rapidly approaching the 59-minute mark. The rational part of my brain (the way, way, super-far-back part) knew that I would be okay after about 15 minutes or so, but I was just so stressed about being alone in a strange city and wanted nothing more than to return to the safety of my apartment, pronto.

Of course, I had no idea how to actually get home – I needed my GPS to get to and from Target, and I’m sure I’ll need it to get basically anywhere for the foreseeable future – so I plugged my address into my phone’s GPS app.

And yet I STILL managed to take a wrong turn or three as I anxiously drove back to the apartment.

Less than 15 minutes later, I was parked and my shopping bags and I were inside my apartment. And that’s when I fell apart, feeling stupid for letting the low happen and getting lost on the way home…and feeling extra dumb for crying so hard about it.

Yeah, methinks that I’ll be running a temporary basal reduction the next time I plan a Target trip. I don’t want to be fearful and falling again any time soon.

 

How Moving to a New State Impacted my Diabetes

A few short days ago, I made the move from Massachusetts to Virginia…and just as I predicted, the whole process has been emotionally draining. I’ve cried more times than I can count. I’ve busted my butt trying to get settled as quickly as possible. I’ve been eating poorly as a way to cope with my emotions. And my blood sugars have been all over the place as a result…again, just as I predicted, but still a bit disheartening.

I knew to expect some diabetes turbulence from the get-go. After all, a seven-hour car ride doesn’t exactly bode well for anyone’s blood sugar. But surprisingly, the drive to Virginia was probably when my blood sugar was most stable. I was snacking a little (okay, a lot) on the drive because it gave me something to do other than cry and talk unintelligibly to my boyfriend (my trusty driver) and it was far from healthy snacks…think fast food breakfast sandwich, Reese’s cups, and trail mix. Could’ve been worse, could’ve been a whole lot better. I think that because I was well aware of the high carb content of my snacks of choice, it motivated me to stay on top of my blood sugars and give myself micro-boluses as needed.

So that was all well and good.

Then came the actually moving-in process.

You are a rare gem.

Box after box and bag after bag were transported from the car, up three flights of stairs, and down a long hallway. It’s no wonder that I went a little low from all that back-and-forth, though I did think that riding the elevator as needed would’ve prevented too much of a drop. And if I could go back in time, I’d like to address the day that I took off from work to do the bulk of my unpacking and adjust my temporary basal settings to something like a 50% decrease for six hours or so. That’s because as I sorted through clothing, emptied boxes, and organized all of my possessions, my blood sugar just did not want to stay put at a comfortable level. Over the course of the very long day that I spent unpacking, my blood sugar dropped low enough that I had to stop what I was doing to eat three times. It felt like I was constantly stuffing my face with food, which was frustrating and the last thing I wanted when all I desired was to get settled.

That’s the physical component of moving – a lot of labor; more specifically, lifting, tidying, hanging, folding, unfolding, and if you’re me, cursing.

But there’s an emotional side to it, too, that I would guess affected my blood sugar just as much as the physical aspect did.

I’ll be honest: Tears were shed. Anxiety felt like it would swallow me whole at points. Doubts ran through my mind as I wondered whether I was strong enough to be so far away from family and friends. I was feeling – and am still feeling, TBH – so many different emotional swings that I am fairly certain that I can blame my blood sugar swings on them.

I’ve said it before and I’ll say it again: I know I need to give myself time to adjust. I’ve got to take it day by day, hour by hour, moment by moment. I need to let myself feel the way that I feel and remember to be kind to myself, especially where diabetes is concerned.

It just helps to write it all down.

A Device-Free Shower

For the first time in *literally* years, I took a device-free shower the other day.

AND IT WAS AMAZING.

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Ta-ta for now, little friends.

Let me clarify that by device-free, I mean that I wasn’t wearing a pump or a CGM on my body. Both were due to be changed that evening, so with what can only be described as unadulterated glee, I peeled my Dexcom followed by my pod off my body before practically leaping into the shower.

It probably sounds funny, and perhaps a little dramatic or flat-out fucking weird, but those 15 minutes without a single medical device stuck to me were glorious. I wasn’t worried about accidentally knocking something off. I was free to scrub off the adhesive that had kept the devices stuck to my skin, and I felt oddly empowered – carefree, even – that I could enjoy one of the most mundane daily routines without needing to worry about my diabetes. Sure, for the duration of my shower, I wasn’t receiving my basal rate of insulin, but I really didn’t care because 1) I took a small bolus to compensate for it before I removed my pod and 2) I was more focused on doing this one little thing for myself to reclaim my body from diabetes devices, even if it was for a short window of time.

So you might argue that I had my first truly nekkid shower for the first time in forever. And it made me happy. A brief reprieve from diabetes is always welcome, and I’ll take it in whatever silly form I can get it in.

Diabetes in the Wild, Investment Seminar Edition

I always get kind of excited when I’m out and about and notice another T1D. There are some pretty obvious signs that clue me into their similarly useless pancreases: spotting insulin pump tubing, witnessing a finger stick check, and spying a syringe injection are chief among them. Even though I know what to look for and what it means, though, I still can’t help but feel a little thrill when I know I’m in the presence of another person with diabetes.

I know, I know…that makes me sorta weird/creepy, depending on your perspective. But whatever, it is what it is!

Anyways, I experienced another edition of “diabetes in the wild” when I was stuck, in all places, in an investment seminar. I (willingly) signed up for it as part of ongoing educational training for work and didn’t really know what to expect from it. All I knew going into it was that it was expected to last THREE FRIGGEN’ HOURS.

let's party out loud!
I never thought I’d be writing about diabetes and the investment sector in one single piece, but then again, I never thought I’d do a lot of the things I’ve done so far in life.

That’s a long-ass time to spend talking about stocks, bonds, and ETFs.

To make matters slightly worse, upon seeing the other students enrolled in the class, I figured I had basically nothing in common with them. The other seven people were around my parents’ age and up, with a couple of them looking like they were retirees. It was also a predominantly male group, with the seminar being conducted by a male financial professional…so yeah, didn’t seem like there would be much for me to talk about with everyone else.

No big deal. I settled in for what was bound to be a long evening. Just when the seminar instructor started diving into a very-not-fascinating slide on poor diversification within individual investment portfolios, I heard a high-pitched beep from across the room.

My attention immediately drifted from the front of the room to where I thought the sound had come from. My eyes landed on a man (who looked like the oldest of the bunch) who was reaching into his pocket for something…aha! A glucometer!

One of me, one of me…I started chanting. In my head. Because I’m not THAT weird.

I wondered what kind of meter it was – I couldn’t think of any off the top of my head that beeped. But then I saw the man reach back into his pocket to grab…oh, so that’s where the beeping noise was coming from – his pump. It wasn’t an OmniPod; rather, I saw the trail of tubing peeping out from his jeans.

For the next half hour or so, I noticed the man fiddle with his glucometer and pump a few times. I felt badly for him and hoped that he wasn’t experiencing any blood sugar issues or technical difficulties. Plus, I’m sure he must’ve felt a little self-conscious about his devices being out in the open – the instructor did glance at him a few times, as if he was thinking that the man should stop playing with his electronics and focus on the presentation. Given that was the correct interpretation of the situation, I felt defensive for the man. I wanted to tell the instructor to give him a break, that he was doing what needed to be done for his health.

At the seminar’s conclusion, I had every intention of going up to the man, introducing myself, and having a conversation about diabetes. But then…I stopped myself. I’m trying to get better about remembering that many people with diabetes are not as comfortable as I am when it comes to talking about it to perfect strangers. Maybe it would’ve embarrassed him further or made him angry. So I walked out of the classroom, quietly, albeit with a slight smile on my face…because diabetes isn’t always an illness of isolation. It can be the common denominator between you and someone else you don’t think you could possibly share anything with. And sometimes, you can find it in the most random, unexpected places and suddenly feel a bit less lonely.