Season Two: Episode Six

MARCH 28, 2021

This week I had an eye appointment for my new glasses. My eyes have gotten a little worse in the last three years. In the past year, I’ve been getting headaches from wearing my glasses so I knew I needed a new prescription. I’m glad I’m getting new ones.

My ophthalmologist said that the pressure in my eye is borderline high. I’m not sure how I can lower the pressure in my eye, but he said that’s the only problem he sees with my eyes right now, so I’m really glad that even though my diabetes still isn’t under control, it isn’t completely messing up my body yet.

On Friday, I had my appointment with my endocrinologist. Not very helpful. He wants to try and put me back on Ozempic. I told him that we were doing better financially but I don’t think we’re that great yet. I mean $800 per pen for only a month’s worth. Not sure how I feel about it but I said I would try. I’m not sure if he’s also giving me the fast-acting insulin too or if I’m even still going to be taking my Lantus with the Ozempic. I have to give his office a call this week to clarify my drug usage.

I’ve been feeling unwell the last couple of days. I haven’t been in to work much but I’m still working from home. I woke up with a sore throat a couple days ago and it went away, then the next morning it was worse and didn’t fully go away. Then this morning at 4:30 I woke up and couldn’t breathe or swallow and I was coughing. And I’m not going to lie to you, I thought I had COVID. I started crying and I couldn’t go back to sleep for a long while. But after sitting up for a while and drinking water, my cough got better and I was able to swallow a bit more.

My husband bought me cold and cough medicine when he came home from work and I took some and felt a lot better. I’m still coughing here and there but I can breathe. I’m still worried it’s COVID. We don’t have free COVID testing until Wednesday and that’s a bit too long to be out of work I think. But we’ll see what happens when I wake up in the morning on Monday, because apparently it happens while I’m asleep.

I’ll give you folks an update next Monday here on the blog or earlier on my Facebook page. I don’t know what’s going on with me, but if tomorrow I feel worse, I’m going to go to Urgent Care to see what the heck is up with my body. Wish me luck folks.

Why I Think Seeing a Dietician is Beneficial for Diabetics

Last year, I wrote a blog post about having your Diabetes Care Team and why it’s so important for you to choose the right people. Choosing the right people that support you and are helpful and sensitive to your current condition is so important. I’m part of a diabetes support group for women on Facebook and it’s always so sad seeing some women being mistreated by their doctors and wondering if what they’re doing is even right because their doctors make them feel dumb and inadequate. Having the right people by your side should NOT make you feel less than the amazing person you are.

Your Diabetes Care Team should consist of a Primary Care Physician (PCP), Endocrinologist, Certified Diabetes Educator, Opthalmologist, Podiatrist, Dentist, and a Registered Dietician. All of them specializing in fields that can help monitor and manage your diabetes.

Since I was diagnosed with Type 2 in February 2017, I have really slowly built my team. Like really slowly. I had my PCP who diagnosed me and started me on oral medication in hopes that by losing weight and eating better would naturally bring me back around,which it didn’t.

In 2018, I went to a diabetes education class with a diabetes educator. I learned a lot at that class and I’m really glad I went, but I don’t know if the lady that headed the class is still working there anymore. Also in 2018, I got my opthalmologist and podiatrist. They’ve been keeping an eye on how my diabetes has been affecting my eyes and feet, which so far has been good.

In 2019, I was referred to an endocrinologist who put me on insulin which I’ve been using ever since. My dose has gone way up to the point that he may have to prescribe me another insulin on top of that.

And finally in 2021, I got a dietician. My PCP was supposed to work it out for me but that never happened so I had to do it on my own. Thankfully I’ve been taking classes and other services from a local nonprofit that provides classes about diabetes, hypertension, and healthy eating among other subjects. They also work with dieticians and other specialists to bring their services to the Native Hawaiian population. I’m very grateful for their services.

Nonprofit organization that serves the Native Hawaiian health care system on Hawaii Island. They provide medical, behavioral health, and community education services.

Here’s why seeing a dietician is so important. Going to classes about healthy eating and diabetes will always go over what you should and shouldn’t eat. You can ask the instructor questions but you can’t have a conversation with them during class because there are others there as well. I suggest seeing a dietician so you can sit with them, one on one, and really get to the nitty gritty.

I saw my dietician for the first time yesterday and we talked about when I usually eat, what I ate in the last 24 hours, what my glucose reading was, what my concerns were, if there were any changes recently in appetite or anything really, and she gave me suggestions on what I could change. Talking to someone one on one is really getting the information to sink in better than during all of the classes I took.

I have to go back in and see her in a month to see if any of the changes I’ve implemented are working. The changes I’ve agreed to make are to eat brown rice instead of white rice, try whole grain bread instead of white bread, get more fiber in my diet is the big goal, try to incorporate more vegetables in to my diet, and continue to walk AT LEAST 15 mins for AT LEAST 3 days (the more the better).

I’m going to have to increase how many times a day I check my blood sugar which might now be about six times a day at least. I think my endocrinologist might also want me to check before and after I eat now too. But I’m willing to do this now more than ever! Why? Because I’m so close to breaking 200lbs! I haven’t been less than 200lbs since 2012. There was a short stint in 2019, but I gained it all back because of stress. I want to break 200lbs once and FOR ALL!

If you haven’t seen a dietician, I really suggest you do. They can come up with a menu of things you should eat more of as well as what kind of physical activity you can do to bring your blood sugar down. The one on one experience will also benefit you as well, I think.

I would love to hear your stories about your journey with diabetes. Feel free to submit your story. You can submit it anonymously if you want. I just really want to know that I’m not going through this alone, that others out there are going through similar experiences like I am.

Season Two: Episode Five

MARCH 15, 2021

I have my Endocrinologist appointment set for next week Friday. I just went and got my lab work done this past Saturday. I forgot how much I hate needles. It hurt like a bugger. I had to make an appointment with our lab to do my blood stuff and the whole night before my arm was so sore and I was freaking out about the needle. The morning of I was scared and my arm was sore.

I’m so glad that even though I freak out about needles, as long as I don’t look at it, I don’t flinch. Do you know how much more sore it would be if I flinched? My goodness that would be painful.

I have to wait a couple of days for my results to be available through my portal and I can see what my A1C is. I’m not looking forward to that at all. I’m sure it’s high, like over 9. I’m so upset at myself. Yes I’ve lost weight but I haven’t been watching what I’m eating and my sugar has been elevated. I was in a rush this morning and I forgot to take my blood sugar before I left the house.

I swear my diabetes management has gotten worse this past year. I need to exercise and eat better so I can get my blood sugar down and maybe I won’t need to take the second insulin, which thanks to the Stimulus check I will be able to afford for a short time. But I can’t keep paying for two insulins and I need to work on myself too.

I’m really scared of needles and I don’t want to take two insulins and inject like three times a day. I don’t like this at all. I’ll let you folks know how my appointment goes in a couple weeks. But I’m sure he’s going to prescribe the second insulin.

The Journey: Episode Twenty Two

SEPTEMBER 6, 2020

So I couldn’t afford to get my Novolog Mix 70/30 this week. No shock there. My insurance preferred that I get the brand name insulin which was obviously more, almost $600 a box of five pens. So the pharmacy asked if I wanted to screw my insurance and go with the generic and I said okay. Hah $300 per box of five pens. Then I asked if they could take my GoodRX card, they said sure. That would have brought my insulin down to $132. Which that was still too high a cost this week with all of our bills we had to pay, including the insurance that won’t pay for my medications.

So instead I went back to KTA and refilled my Lantus for $99. So I’ve been taking that the last two nights again. Not sure when we’ll get the money to pay for the Novolog, if we’ll get that money. Unemployment is supposed to give us backpay for August but we don’t know when that is coming. I’ve resorted to selling life insurance to hopefully help pay the bills.

I say it like it’s a bad thing. It’s not. I genuinely think people should be getting life insurance right now, especially with the pandemic going on and unemployment still being high. I’m really glad I got my life insurance before I was diagnosed with diabetes because I could potentially be uninsurable. My husband is on my policy and he’s the only one currently working a stable job. If I were to lose him, his insurance could help me financially which would be great.

I think of all of my friends and family who aren’t insured and have children. If they caught COVID-19, their children would be at risk. It’s a sad thought. So I’m glad I was able to get one of my friends insured, as well as his wife and kids, because now they can rest easy knowing if anything were to happen, they would be okay financially.

If only that line of business was more stable. But that’s alright. We’re making do. I can’t get my insulin right away but that’s okay, we’ll get by. I’m hoping I can make more sticker sales so I can pay for my business expenses separate from my personal expenses. I just have to keep persevering. Good things will come, I know they will.

So I have to wait until my husband’s pay day and hope he gets paid enough for the bills and my insulin. He worked too much hours to qualify for unemployment this week and my unemployment doesn’t get filed until next Sunday. Pay day is Friday. I have a doctor appointment with my PCP for my regular pills. I might have to pay for those because apparently we no longer qualify for QUEST medical and they picked up on the copay that HMSA left me with so that’s probably another $40 right there.

We have over $200 in bills to pay this week and only $40 in our account. Super great fun right there. Healthcare should seriously be more affordable than this. Isn’t America just great? I’m just upset that I can’t afford my medication. It all just sucks, but I will never give up.

My message to all of you out there: Keep on moving, don’t give up, and especially don’t give up on yourself. You’ve got this and I’m right here with you every step of the way. You have some rooting in your corner, always on your side, all the way out here in Hawaii. Never, ever give up. You can fight this and you can make it out of this alive. I believe in you.

The Journey: Episode Twenty

AUGUST 23, 2020

Well nothing really to report. However, I got my blood test done for my A1C and my number isn’t looking too hot. I was at 7.9 in April and now I’m at 8.2. So it’s gone up a little bit and I’m not too happy about that. All the insulin injections and blood sugar checks and I’m no better. But on the bright side at least it’s not at 11% like it was last year so in a year’s time I’ve managed to drop by 3% so that’s good news.

My doctor appointment with my endocrinologist is this Thursday so I’ll have an update by next episode.

I’ve been drinking the cinnamon tea some more. I talked with my diabetes coach and she said there was no concrete evidence it really helps to lower your blood sugar. I decided to make an experiment of it. But I can only do it for a week. Here’s how it would work:

For three days, I won’t drink cinnamon tea, Wednesday I would drink only the nighttime tea, then the last three days I’ll drink both teas. I’ll eat the same food at the same time every day, take my medications at the same time and check my blood sugar at the same time. That means alarms will have to be set on my phone and I’d have to try and sleep around the same time to be able to wake up around the same time.

I have to wait a couple weeks so I can save up money to buy the food for meal prepping and more prescriptions. Plus, I’m not sure if my doctor is going to give me a new insulin and I’d like to give it at least a week to figure out how it works for me. But when I do start my experiment, I’ll record about it here. I’m kind of excited about it because it’s going to make me feel like a scientist with all the note taking and experimenting.

I’m going to try a couple of days without the tea to see if there is any significant change in my blood sugar readings. So far it’s been looking pretty good although I take my tea either right before or after taking my blood sugar right now so I have to figure out the best time to drink and check. I’ll figure it out eventually.

Oh hey a self love update! I bought a t-shirt and lounge pants with The Child on them and I love them so much. However, the pants were way too long for my short legs so I cut them off at the knees, just below the graphics. Which is good because I can’t inject insulin in my thighs with pants on. I love it like this and I can use the cut off material to either make pillows or face masks, I have options.

The t-shirt is kind of thick and big so I cut the sleeves and collar off and I turned it into a crop top. It comes down to my belly button and it’s very comfy. I’ve decided to use it as my new pajama set, it’s been kind of warm lately anyway. Maybe when it gets colder and I get a little bit more confident I can wear it out in public. I might do it with other shirts that I have. I’m totally in to crop tops right now.

I’ve had issues with loving myself lately with this pandemic and my diabetes so finding something that makes me feel great about myself is a win in these dark times. I greatly encourage you to find that something in your life that makes you love yourself and enjoy it. You don’t have to take it out in to public if you’re not comfortable with that but you deserve to love the way you look and who you are. No matter who you are and what you look like, you deserve to love yourself and the body you’re in.

The Journey: Episode Eighteen

AUGUST 10, 2020

So conditions have been unchanged since the last journey update. I went one night without injecting my insulin and the next morning I woke up and my blood glucose was 210 mg/dL. I’m not sure how it would have been if I had taken my insulin that night because we had dinner kind of late that night, after 7pm, and it was pretty carb heavy. But then there’s today. I ate dinner way before 6pm and it wasn’t very carb heavy. When I took my blood glucose at 9am, kind of late because I woke up late, it was 179! So that’s very frustrating.

I think my insulin injections aren’t working as well as they were when I first started taking them. They’re still working thank goodness, but not nearly enough. It’s only a slight change in my numbers between not taking and taking my insulin. So I’m basically paying $99 every two weeks or so for a drug that’s supposed to be helping me, but isn’t.

And that’s another thing. I have Lantus. It’s 5 pens of about 310units each. I’m at 85units now, I can only get three doses from each pen. I don’t use it all the way to 0 because I don’t want to inject myself twice, it’s bad enough doing one each night, plus there are always bubbles no matter how hard I try. I have a coupon card which helps me get my boxes at a discount, I’m not sure what the discount is, but I only pay $99. However, when I tried to fill my prescription on the last week of July, the Pharmacy said if they were to fill it then, I would have to pay full price, but if I waited until next week, it would be $99. Neither of my insurances companies cover my insulin, which completely fucking sucks, so I had to wait, thankfully I had enough left to be able to wait. But now I go through one box in two weeks and I wonder if they’ll be able to fill it at the discounted price. I think I might have to double inject this time just to make it stretch, which doesn’t sound fun at all.

Liliuokalani Park and Gardens – Hilo,HI

My next prescription of Lantus, I’m moving to another pharmacy where it will be hopefully cheaper for me. If not, then I have no idea what to do and I’m screwed. Unless my doctor can give me another insulin which would be a lot better, if it’s cheaper.

Yea the stress of not having enough money to buy my medication and the stress of my medication not working is very…stressful. I’ve been so stressed out lately that I had a breakdown, in front of my boss. Thankfully she was so kind and understanding. We worked out my schedule so I only work one to two hours a day from home and it’s been working a lot so far. I feel less stressed and I’m getting more work done.

I’m looking in to meditation to try and help get my stress levels down on the regular and take time for myself more often. I’ve got a lot of lovely scented candles that I’ve been lighting and it’s been lifting my spirits.

I hope if you’re facing these same hardships in your diabetic journey, that you’ll take some time for yourself. Your mental health is so important and we always forget to take care of ourselves. Go take a nice warm bath. Drink some tea and read your favorite book. Go take a walk outside in the sunshine today. Take some time to slow down and enjoy your life. Even though you have diabetes, that doesn’t mean you can’t enjoy this life you were given. Smile at yourself in the mirror and take a minute to love being you. I love you. I am here for you. We can get through this together. You’ve got this!

Questions to Ask Your Doctor

So your doctor has officially diagnosed you with diabetes. That’s pretty heavy, but don’t let this be your downfall. Let this diagnosis be the start of your amazing journey. Here are some questions you can ask your doctor to help you on your journey.

  1. What are the results of my blood tests (especially my A1C)? What was my previous A1C and what should my goal number be?
  2. What is my blood sugar target? How often do I need to test my blood sugar levels?
  3. What diet and exercise changes can I make to be healthier?
  4. Are oral medications an option for me?
  5. Could non-insulin injections help me manage my diabetes?
  6. Why are there two types of insulin (basal, or long-acting, and bolus, or rapid-acting)? Are either of them right for me right now?
  7. What is low blood sugar and what can I do to avoid a low blood sugar?
  8. Can you recommend a diabetes education program or a diabetes educator?
  9. Do I need to consult a dietician?
  10. How many times should I check my blood sugar each day?

These questions can help you and your healthcare team come up with a treatment and management plan. Knowing this information can help you come up with a plan for exercise, diet, and diabetes management.


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References

Healthmonitor, Guide to Diabetes, pg. 16.

Metformin in Management

Information

These are what my metformin pills look like at 1000mg.

Metformin is one of the safer, effective and inexpensive drugs used to treat Type 2 diabetes. It is an oral medication that helps to control blood glucose. It comes in multiple forms such as a pill, extended release tablet, and liquid. Usually you’re advised to take it with a meal.

Of course metformin doesn’t work on its own, you have to commit to a lifestyle change. A healthier diet and more exercise will help the user lose weight and lower blood sugar levels. These changes could possibly hold off diabetes in prediabetics for up to 15 years.

Metformin reduces appetite, affects how the body stores fat, and lowers resistance to insulin making your body use your own insulin more efficiently. It can also reduce the risk of dying from heart disease by 30-40%.

Side Effects

Usage of metformin can lead to a vitamin B12 deficiency that could lead to anemia, neuropathy, memory loss, and fatigue.

If you need a CT, MRI, or angiogram that requires the contrast dye you may need to temporarily stop taking your metformin. The contrast dye can cause minor, short term changes to kidney function.

Metformin should not be used if you have severe kidney disease, metabolic acidosis, or diabetic ketoacidosis. Also metformin shouldn’t be used with alcohol.

Pregnancy

During pregnancy, the body can’t create enough insulin to control the blood glucose levels which leads to gestational diabetes. Women with gestational diabetes require insulin injections to help control the blood glucose levels. In women with Type 2 diabetes, that gap grows exponentially with pregnancy. The body is in need of more insulin than can be provided with injections. Studies are being performed to see the long term effects of metformin during pregnancy to see if metformin can be used in tandem with injections during pregnancy to safely keep blood glucose levels in check and see if there are any affects on the baby.


When taking metformin, you’ll see greater results if you also change to have a healthier diet and more active lifestyle. You could potentially hold off full blown diabetes with this medication if you have prediabetes. Watch your health while taking this medication, look out for any side effects and let your doctor know about them as they happen.


Related Content

What is Blood Sugar and A1C?
How to Support Your Diabetic Loved Ones


References

Drugs.com
Diabetes Self-Management, May/June 2019, p. 30-31.


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