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Friday, March 26, 2010

Managing medical stuff

The last few days haven't been all that great for a number of different reasons. One of these reasons is managing the different problems that CF and diabetes have. I can cope with the regime required for CF, it's something I've done all my life and while it's a pain to do nebulisers and physio and work out your time to fit them all in around what you want to do. I can do that and if I miss a dose or a session of physio I don't feel too bad. What I struggle with is the diabetes.

I need to test my blood glucose levels a minimum of 4times a day (before each meal and before bed) so that I can work out the correct dose of insulin I need to do based on the carbohydrates I eat and what my blood glucose level is so that I stay within the target range of 4-7 before a meal. So after those four stabs with a needle to get the blood I then have to do insulin which is another 4 needles. Then if I choose to have a snack in the day, I will then need to give more insulin which is extra needles. It's alot of needles in a day- at least 8 and then more if I need extra food, which is recommended for those with CF. I get 10g of carbohydrates "free" before I need to do insulin, but not alot of foods suitable for a CF diet have less than 10g of carbohydrates before I then need to do insulin. For example I could eat 1 ginger nut biscuit (7g) or 2 rich tea biscuits (10g), but if I wanted a chocolate bar I would have to do insulin. This then makes you weigh up whether the food is worth it, is that piece of cake you really fancy worth another needle, it takes the fun and enjoyment out of just being able to have a snack and not worry about it. So I get my diabetes under control but then I get moaned at by my CF team because my weight is going down, because I don't eat the snacks because I don't want to keep doing lots of insulin.

The main issue I have is now that I got into a good routine of checking my blood glucose levels properly (I got into a bad habit of not ever really checking them and just hoping for the best), I now feel guilty when I don't check them. Like if I have a meal out and I wasn't expecting so didnt have my blood meter with me, it makes me feel bad that I haven't checked them. This is one of the hardest routine for me to stay in, and when it starts to slip I lose it very quickly. It's not like a missed physio session which I easily pick up again. I get into a mindset where I didnt check it at lunchtime, so I wont check it at teatime because I dont want to look at it incase its running high, so then I wont do it before bedtime either and that very quickly leads to 3or 4 days where I havent done any testing. Thats not a good thing. I know that my control is still good based on how I'm feeling and that if I did just check my bloods at the next meal it would prevent things from getting bad if they were a little high because I could correct it straight away. It's just hard to see an elevated number when all you are doing is trying your best and you can't work out why it is like that.

Sometimes I get high numbers but I know why that is and I'm not worried. It's when you get an elevated reading and you don't know why that it can be very frustrating and down-heartening. To think that your best efforts aren't good enough. Although my worry more at the moment is not of going high but going low.

My insulin dose is correct most of the time, but sometimes it causes me too go to into a hypo (which isnt good) but if I lower my insulin dose then I run high. So I currently run a fine line between good blood glucose and running too low. When I go hypo, I need to get something sugary and fast otherwise I will end up passing out and then this needs to be followed by something like toast or a packet of crisps to stabilise my blood sugars for when I next eat, otherwise I will just then run high (it can be a very vicious cycle). So I now always always always make sure I have some sweets in my bag when I go out, where as before I didnt worry too much about it as I knew I would most likely be ok. Now I just cant be certain.

Life is complicated when you have medical issues and thats before you then try and cope with the day to day life of normal stuff like relationships and just general living and trying to have a good time.

I think this post is probably long enough now.

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