Zen and the Art of Blood Sugar Maintenance

One of the rules of diabetes club is: blood sugar readings don't always make sense.

Like today, both of my blood sugar readings were under 100 mg/dL. I'm certainly not eating no carbs but I'm not pigging out on them either.

The treadmill my wife found from someone who lives a couple streets away was a real find at $20. It's not in the best shape but it works. This means I can walk indoors when the elements are working against me outdoors. I walked a good 40 minutes today, worked up a nice sweat, and was able to proceed straight to the shower.

I even ended the day well below my target calorie range. Not intentionally but that's how it seems to have worked out.

All in all its been a good day for my blood sugar. Maybe today is a reflection of the good work I've been doing to manage it. I'm hoping numbers in this ballpark are the new normal.


The 49ers "Crisis"

Many of us 49ers fans have high expectations for the team. It comes with the rich legacy the team has had, not to mention the last few years where the 49ers were in the NFC Championship game and a Super Bowl. No, the Lombardi trophy was not brought back to the Bay Area in 2012 (first loss in a Super Bowl), but still, there is an expectation among 49ers fans that the team is usually in the playoff hunt.

Of course, that ignores the fact that a lot of the playoff activity was in the 1980s and 1990s. The 2000s, quite frankly, were terrible. I wasn't football aware in the 1970s, and wasn't alive before that, so I can't comment much on that.

This year, 2014, the team is not doing so well. Not by most teams standards, of course, who would probably be really happy with a 7-5 record, but by 49ers standards, it's not so great. The offense is absolutely anemic this year. The 7 wins this year has occurred because the defense has been nothing short of outstanding, despite all the talent currently on injured reserve (Bowman, Willis, etc). Special teams is also not that special right now.

Among 49er fans, there is a lot of finger pointing about who is to blame. The most vocal bunch are ones who are clamoring for the firing of offensive coordinator Greg Roman. Some are starting to blame head coach Jim Harbaugh. There's also folks calling for the replacement of quarterback Colin Kaepernick.

I'm in none of those camps, at least not yet. Unlike a lot of fans, I remember that, even during the dynasty years, the 49ers played some really bad football games. Yes, five Superbowls were won, but 13 playoff games were lost between the years of 1981 and 2002. A few of those losses were ugly, too.

And then there was the 1991 season where, despite a 10-6 record, the 49ers didn't make the playoffs at all. I don't recall anyone demanding that then head coach George Siefert or then offensive coordinator Mike Holmgren be fired, but of course this was before the Internet Outrage Machine existed. Beyond the newspapers and the conversations you had with your friends, this kind of rhetoric was simply hard to come by. That said, Mike Holgrem went onto coach the Green Bay Packers the following year.

I know we are all passionate about this team, we want them to win, and we all think we know the best way to make that happen. The fact is, the 49ers will not necessary hear, or do, anything we say. The team at all levels is very aware of their situation with respect to making the playoffs. They understand what is at stake and they understand they must execute at the highest level from here on out to have a shot at a Lombardi.

And if they don't win? Changes will surely be made for next year in order to improve the 49ers chances for a Lombardi. Even if they do win, changes will be made next year because of the draft, injuries, free agency, or whatever. Either way, things will change next year. Arguing over the minutia of what those changes should be? Not my thing, personally.

Meanwhile, I'm not worried about the "crisis." I'm looking forward to the next game.

So Yeah, That Cough I Have

I've had this little cough for the last month or so. Seems like my throat is occasionally dry. Sometimes it turns into a coughing fit, which is quite unpleasant.

My wife pointed this out to me today and told me it was a common side effect of Lisinopril, the drug I'm taking to lower my old pressure. Sure enough, it is [www.everydayhealth.com]:

Common side effects of lisinopril include:

  • Cough
  • Dizziness
  • Headache
  • Extreme tiredness
  • Nausea
  • Diarrhea
  • Weakness
  • Sneezing
  • Runny nose
  • Low sex drive
  • Rash

Serious side effects can also occur. If you have any of these side effects, call your doctor right away:

  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Hoarseness
  • Trouble breathing or swallowing
  • Signs of infection, such as fever, sore throat, and chills
  • Yellowing of the skin or eyes
  • Lightheadedness or fainting
  • Chest pain

So yeah, I should get that cough checked and my meds changed.

Going All In With 10Centuries?

It seems every few years or so I get tired of whatever blogging or content management system I've been using and I try something else. And, of course, every time I do it, I swear this is the last time I'm doing this.

And yet I do it. Again and again and again. I've actually lost track of everything I've tried, but it included the ever popular Wordpress and I'm even using Jekyll for my main phoneboy.com site because it gave me the most control with the least server overhead.

But it sucks, it all does. And quite frankly, I have better things to do with my time than to try and move things between various content management systems, which have all sucked in various ways.

Ignoring the content management systems themselves for a moment, let's also look at the cost. Sure there are "free" services out there, but do you want someone else's ads all over your content? Do you trust that company will be around in a few years? Do you trust what that company might do with your data?

And while I'm thinking of conventional blog-like content, I'm also thinking of microblogging content. I've put quite a lot of data into Twitter and App.Net over the last several years. Who knows how Twitter will change their Terms of Service or their public API to the point where I'll even want to use the service anymore. And App.Net? It was a nice idea but, sadly, the lights may still be on there, but it's hard to know if anyone's home or not.

And Facebook? I don't even know what to say there, but I've given up trying to manage my privacy settings on Facebook. I just assume everything I post there is public. I also try and post as little content there as possible, as I know it's basically a roach motel.

Basically, I'm tired of it all. I just want to put all my stuff in one place, have it go everywhere everyone else is, and at the end of day, know that I have control over the original copy of said content and actually own it, unlike with the other services, that is not entirely clear.

Have you heard of 10Centuries? Unless you've been on App.Net, you've probably never heard of it. The mission of 10Centuries is simple: "ensuring all of our content is readily available and readable by future generations." And no ads. Ever. Those are principles I can get behind.

Will it last 10 centuries as the name implies? Who knows. I know nothing lasts forever, especially anything that man makes. But I gotta respect someone with the gumption to try.

10Centuries will handle most of my blogging needs for the time being, which are pretty meager. What about the social networks? Version 3 of 10Centuries will hopefully solve some of those pain points once released. Meanwhile, I can import all my Twitter and App.Net stuff so it's searchable on this site.

Hopefully, in a few days, most of the blogs I have on Posthaven will move over to 10Centuries. I have a couple of other, static websites that are not appropriate for 10 Centuries. I opted to move those off of Dreamhost and onto 123systems, which has a reasonably cheap CPanel type hosting setup for websites and email as well as a virtual private system which will host phoneboy.com. Amazon will be my backup solution of choice, mostly because of the pricing on Glacier, but the flexibility of S3 is also a bonus.

So I guess I'm not going all in with 10Centuries, but I'm certainly consolidating and 10Centuries is part of my plan.

Amazing What Blog Posts Get Traction

I'm looking to move some of my blogs over to the 10 Centuries platform and, for kicks, I decided to look through the hit counts on some of my blog posts on my personal blog, currently hosted at Posthaven. A number of posts had a high hit count from when they existed at Posterous, which is where I imported some of the posts from. But a couple really got some traction:

Most of the other page views I see were old, so I don't believe their page view counts.

Lies, Damn Lies, and Blood Glucose Meter Readings

My doctor had originally prescribed me the Accu-Chek Aviva Plus Glucometer to check my blood sugar. It's a good enough device, but with it, it didn't take me long to learn the dark secret of diabetes monitoring.

Namely, that these devices are sold under the Gillette model. Except rather than give away the razors and make money off the blades, it's glucometers and test strips. Same idea, though.

The Accu-Chek Aviva strips cost me $25 for 50. And that's after the insurance pays their share (whatever it is). If I want to get more, say, before a long trip and I'm not "due" for more, well, I have to fight with the insurance company to get them at that price or pay the out-of-pocket cost, which is a hell of a lot more than $25.

Needless to say, I was looking for a cheaper solution. Also, it'd be nice if I could get something that would also send the data right to my iPhone where I'm tracking it.

Enter iHealth Labs. They actually two Glucometers: one">http://ihealthlabs.com/glucometer/wireless-smart-gluco-monitoring-system/">one that is Bluetooth enabled, and one">http://ihealthlabs.com/glucometer/ihealth-align/">one that just plugs into the headphone port on the iPhone (they also work with Android devices too). Since I didn't always want to be tied to my iPhone when checking my blood glucose, I opted for the slightly more expensive wireless model.

That's all fine and good, but what really attracted me to these glucometers: the price of the strips. At $12.50 for a box of 50 (two vials of 25 each), it's half the price of what my Accu-Check Aviva strips cost. Better yet, I don't have to deal with my insurance company if I need more, I can just order them from iHealth Labs and they'll arrive in a few days.

I ordered a new iHealth Wireless Smart Gluco-Monitoring System and a couple boxes of test strips in early November. Given they are based in Mountain View, CA and ship UPS Ground, it only took a few days to ship once the items came in stock which I knew when I ordered. I ordered before my recent trip to South Africa, so the "extra long" shipping time wasn't an issue for me.

When the meter and strips arrived, I of course tested myself using both meters. The iHealth one was giving me very different results. When I looked at the strips a bit more closely, I noticed that the strips I had been shipped were going to expire on 2 January 2015--less than 60 days away.

Another dark secret of blood glucose meters: they're not as accurate as, say, a blood test. They are good for getting a general idea of where your blood sugar is at, which is the reason your doctor tells you to use one. That said, different meters should give you similar results (within a few mg/dL of each other). When they're off by tens of mg/dL as I was seeing, something is probably wrong.

Given where my blood glucose is averaging, which is 117 mg/dL over a 30 day period, consistently higher test results could mean I test ok on the iHealth meter when, in fact, my blood sugar is actually at hypoglycemic levels.

I contacted iHealth Labs customer service via email. I asked for a bottle of the control solution, which is used to verify the meter and strips are working correctly (it has a set amount of glucose in it) and a box of strips with a later expiration date since there was no way I could use the strips I had ordered before they expired. I got a return email saying both should arrive in a few days.

Meanwhile I continued to periodically test with both my Accu-Chek and the iHealth meter. The iHealth results were consistently at least 20 points higher than my Accu-Chek, sometimes much higher.

I finally got the new box of strips in the mail today, but no control solution. My Accu-Chek strips are starting to run out and I really don't want to get another vial of those at $25 a pop, so I decided to test with iHealth using a strip from the new box I just received to see if it's a problem with the strips I had originally received.

On this test, the iHealth result was about 5 mg/dL lower than the Accu-Chek one. I tested with strips from both of the older boxes of iHealth test strips and the results were more than 40 points higher than the Accu-Chek number. This suggests I got a bad batch of test strips.

I just sent another email to iHealth Labs customer service. Hopefully they'll send me another box of strips and, this time, a bottle of the control solution.

Bottom line: if you're going to change blood glucose meters for one reason or another, make sure you test with both meters for a while to ensure the results are similar before completely ditching your old meter. Also, make sure to get the control solution for your meter.

I plan on doing a full review of the iHealth Wireless Smart Gluco-Monitoring System on a future episode of PhoneBoy">http://phoneboy.com/ps/">PhoneBoy Speaks.

Carry That Weight

Earlier this week, I went to the doctor to follow-up on the high blood pressure I had. Thanks to medication and the other changes I've made, it is now very close to the normal range. This is good news.

The other change I've noticed is my weight. Since I started tracking a month or so ago, I've dropped about 15 pounds. Not that I'm trying to lose weight, but I guess with the dietary changes I've had to make, the natural result is: less calories consumed. This along with the increase in activity means I'm losing weight.

My blood sugar, meanwhile, has mostly settled into a normal range after returning from South Africa, with a 7 day average of 116 mg/dL.

Hopefully these trends will continue as we enter the holidays.

Different Strokes for Different Diabetic Folks

As I've been finding others on the Internet that also have Diabetes, I've got a few different observations. They're probably simplistic and obvious, but here goes:

  1. A lot of people have diabetes, including people I know. I keep finding out about more of them every day.
  2. There is no shortage of information about Diabetes on the Internet or from your doctor, some good some bad.
  3. There are a few different "types" of diabetes. It's not just Type 1 and Type 2. Regardless, of the reasons or the treatments used, it's ultimately about getting your blood sugar down to a normal level.
  4. What works for one person won't necessarily work for another. Everyone responds differently to different things (see previous point).
  5. A lot of folks have it way worse than I do. I'm on the Internet whining about numbers that are not that far above normal when some people have numbers that are downright dangerous, for">https://www.facebook.com/phoneboy/posts/10152447037796179">for example one of the comments on my last post on Facebook.
  6. Diabetes is expensive once you find out you have it. I feel bad for those who don't have health insurance because even with insurance, the supplies you need to monitor and maintain your blood sugar gets pricey.
  7. Monitoring, testing, and keeping track of your food intake and activity is the best way to figure out what's working for you and what's not. Right now, my doctor has me testing twice a day. I try to do it: in the morning before I eat, and two hours after some meal during the day. I'll either do it after dinner or, if I have something unusual for lunch, after that. On a few days, I've tested three times in a day.

I'm sure I'll have more to say on this. :)

Morning Has Broken...My Blood Sugar

You'd think when you wake up in the morning, wouldn't have above normal blood sugar readings when, the night before, they were normal. Unfortunately, it can and does happen, especially in people with Diabetes.

It's happened to me--the fasting numbers were higher than I went to bed with. You'd think I was sleepwalking down stairs, going into my pantry, and eating a slice or two of bread. Which actually sounds pretty good right now, but I know what it will do to my blood sugar.

Welcome to the Dawn Effect, caused by the liver dumping glucose into the blood overnight. The hormones that are believed to cause the liver to do this (including cortisol, glucagon, epinephrine) are also believed to give rise to insulin resistance. The end result: your body is unable to process the excess glucose in your blood stream, which of course means elevated blood sugar.

I do not experience this every morning. A diabetes site in the UK suggests this spike occurs 8 to 10 hours after going to sleep, which explains why on the mornings where I did observe this, I slept later than usual.

One of the possible solutions to this problem includes a late-night low-carb snack. Mixed nuts seem to be my go-to snack. We'll have to do some more science and see.

Feeling Groovy

Today, I went to go see the Diabetes Dietitian to learn what I need to eat. Seems kind of silly since I think I've figured out what I need to eat--and avoid--but I am satisfying my doctor's treatment plan. This visit included also had to share what I had been eating over the last week or so, what my blood sugar readings were, have I been exercising, how much how often, and so on.

The prognosis: I could eat some more carbs--healthy ones, obviously--more green vegetables overall, and a little less fat. But so far, so good. I even had normal, non-diabetic blood sugar when I woke up this morning-100 mg/dl. I checked a couple of other times during the day. My numbers were 115 mg/dl mid-afternoon and 126 mg/dl a couple hours after dinner.

Clearly that's only one day, but it's a start. And overall, I feel better than I have in quite a while. I think I'm sleeping better, too. All of this has me feeling pretty groovy right now.