for so long, i have wondered if i am alone in this predicament; so, i thought i would start a thread and ask if anyone understands what i feel, what they have done about it, and how they have achieved their success.
i have an obsession about being in very tight control over my BGs. so much so, that i have become uncomfortable, physically and mentally, trying new foods; particularly anything that doesn’t have a “carb label” attached to it. when i am presented with an opportunity to make an educated guess before i bolus, i go into panic mode. its not that i don’t want to eat more types of foods, because i very much do; its just that i become overwhelmed with being and remaining in control of my BGs and trying to make certain that they remain perfect. but this is a disease of unpredictability and the very best that we can do is manage and use experience and our best judgement to achieve success. places that bring out the worst in me: restaurants, parties, holiday meals, other people’s home meals. the list goes on.
i become so frightened about losing control, that i cannot enjoy myself or the wonderful food that i am actually eating. negative thoughts go around and around in my head throughout the meal. did i give myself enough insulin? did i take too much insulin? did i do a correct dual bolus? did i get the time split right? did i get the length of the square bolus right?
now, heres the thing: i love to eat. and, when i am at home, i can have a generally “perfect” amount of control over what i put in my mouth and how much i should bolus for. so, i have a tendency to stay homebound when it comes to food. but, i want to expand my horizons with great pleasure and less pain. i want to enjoy myself when i am at a party, not obsessing over the carbs and the insulin of the food that i may or may not put in my mouth. i don’t want to take a drink just to relax and chill out. i want to be as present as humanly possible.
i must admit that i feel foolish putting this silliness out there. i have written this thread down 5 to 6 different times, only to cancel it before posting it. but i believe that it is important and could be valuable, even if its only so for one other person dealing with this. so, SOS
@daisymae Really, I feel your pain. Uncertainty is the thing that bothers me the most about diabetes.
But here’s how I deal with it.
First, my Dexcom is my best friend. If I’ve under bolused it becomes readily apparent fairly quickly and I can make an educated correction. I have no compunction about injecting in just about any situation.
Second, I use an app called Fat Secret. I can quickly get an accurate carb count for just about any restaurant around. If it’s not listed, then I look up the dish and make an educated estimate. If I’m off, see the previous paragraph.
My Bg is not as tightly controlled as many around here, but I do throw down A1c’s in the 5.5 to 5.9 range.
An example of this is just yesterday, there were Noah’s bagels at work. I love bagels and haven’t had one for several months. I picked one out and before I toasted it I looked it up, 54g (yikes!), took the correct bolus, waited fifteen minutes before toasting. Then I toasted, slathered on the cream cheese and enjoyed. An hour later my Bg was 160 so I took a correction bolus. Two hours later I was at 106 and steady.
P.S. I can’t use Afrezza either, because of moderate asthma. But I think this whole thing will become easier when FIASP is available.
So, I was a bit high for about two hours. Was it worth it? You bet it was!
I am not certain, but isn’t the point of “tight control” to be able to be healthy, longer? Be healthy, longer, so that you can enjoy your life, and living? I am very OCD myself, but I would only say that there’s a point where the purpose you’re attempting to achieve, is being diminished by the very achievement itself. In other words, your obsessive control on of how you live (what foods you allow yourself to eat) is taking over, which is diminishing the very reason you want tight control in the first place – to enjoy life (enjoy foods and eating).
Not being a diabetic; rather, a father of a toddler T1, I know I can’t relate to all the internal struggles diabetics have with themselves over their health, but I would try your very best to achieve a good A1C (one that cuts down on, or eliminates, the long term medical issues that having a high A1C bring about), then enjoy life. If you don’t…then what’s the purpose of the tight control anyway?
Again, as an OCD person, I know that’s easier said than done, but there are a few things in my life where I just made a decision and stuck it (for the better in each situation.) First, my decision to just “quit” smoking after having smoked for nearly 30 years (started at 7 years of age, stopped at 34 years of age – this year will be 11 years smoke free). Although I tried many times before, this last time my mind was made up that I wanted change. The second thing I did was made a conscious decision to not be like my father (abusive), be my own man, be a good husband/father, but not to allow my childhood to “hold me back” as it has most of my siblings. These two things have nothing to do with your story, but since you’ve opened up I wanted to show that we are a community that doesn’t mind opening up with one another…it helps all of us to be able to lean on one another, get each others input (and knowledge). The underlying point of the two things I listed was just to emphasize how that, although I know being OCD isn’t a choice…we DO have a choice on how much as allow it to control us. Nothing bad is going to happen if you eat that bagle (as long as you bolus for it). Nothing wrong with eating foods that you love (and enjoying eating.) With proper knowledge and processes in place to account for the carbs in the food you eat, carbs are a wonderful thing.
I wish you all the luck, but I just wanted to let you know that nothing about what you wrote is foolish or silly. Everyone has these feelings. That’s what we’re here for - to lean on in times of need…even if that need it to only express feelings…or even VENT sometimes!
thx for your uplifting response. i was on the Dexcom for just over a year and a 1/2. my problem with it has to do with my OCD; i could not stop checking it. every 5 minutes. it ruled my mind. (also, i was too lean at the time, and i didnt have enough sub q fat to inject it into. i would only get about 2-3 days out of each sensor.) those darned direction arrows consumed me with anxiety.
this is the absolute best mind-set. this is the space i want so much to be into. i’m still trying to get there. and, i am not giving up. so far there are 3 meals that were for too long out of my comfort zone that i have “mastered” : grilled cheese sandwich from a favorite diner; beef burger on a brioche bun with ketchup and guacamole and fries; slice & 1/2 pizza from my fav pizza joint. all 3 involve dual boluses and took a lot of anxious perseverence to figure out. felt like a rocket scientist performing a mission to get these right. but, like you said: it was worth it. still, i wish i had this much gumption with regards to other foods and situations. i pray a lot
thank you for your caring empathy and support. [quote=“ClaudnDaye, post:3, topic:990”]
but isn’t the point of “tight control” to be able to be healthy, longer? Be healthy, longer, so that you can enjoy your life, and living? I
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this is what makes OCD so utterly ludicrous: i know the facts, but the mind distorts them. with the OCD, i am fooled into thinking that i would rather be in control and miserable, than let a little loose and enjoy with great pleasure. i know i am certainly on the right path…the road to a certain spiritual freedom, mind, body, & soul. i’m just not there yet.
DM,
Before I give you my comments on this, let me start with a simple question which is related very much to how you can address this.
Which do you think is easier to fix, a high BG or a low BG? Which can you fix faster and easier?
Let’s imagine you are not driving a car, or performing brain-surgery, or flying a rocket to mars. Let’s assume you are sitting safely in your living room.
Pick two numbers that you think are equivalent in terms of crappiness. Is it 50 and 300? 60 or 250? Figure out two numbers for high and low, that you think are about the same.
Would you rather be 60, or 250? Which can you fix easier? Which causes you less trouble, and less worry?
I am really glad because I am physically uncomfortable when I don’t know/understand what my son’s BG is doing. My wife and son don’t have a problem – but I do!
How I deal with it: the first weekend after my son was diagnosed, my wife and I had a long discussion how we wanted or needed to manage this new crisis. We concluded that the most important thing was UNLIMITED. We wanted him unlimited by diabetes.
The outcome is, every time there is something “normal” he wants to do (and that includes trying absolutely anything he wants to eat) we do it. In fact, this results in his doing many more “unusual” things that he would not have done before.
What this means is that I am required to go along with anything. If we had not made that resolution, I would be very uncomfortable with much of every day, or at least weekend. But, because this is the philosophy that drives us, my discomfort ends up being rubbed out by the more important theme of being unlimited. It’s a great psychological help for me. It takes a big burden from my shoulders, because I am forced to be accepting of all the risks that come with it, and, of course, the lack of control as well: I bought into it the first day – so I can’t very well go against it later.
I am not quite sure if I have explained this very well. Let me know if I was understandable!
i would much rather be 60 than 250. at 60, i would eat 2 G Tabs and a small piece of chocolate and know that within a 1/2 hour, my BGs would come back up into range. and, that within an hour, all would be repaired. 250 freaks me out, takes longer to come down from a correction.
yes, you have explained it well and i am pretty certain that i understand your point. its about experimenting, making your best educated guess, and then letting go of the result…AND NOT JUDGING YOURSELF for any errors made. just correct and move on.
so, that being said, i know all of this intellectually, but my pee wee brain doesnt want to cooperate. its almost like an alcoholic who knows that alcohol is no good for him, but he cannot stop drinking…despite all the evidence to prove otherwise. (is that a good comparison?)
I agree. Lows can get fixed faster. And with things like chocolate!
So a possibility for you would be, if you are guessing on a new food or something you are not sure about, guess toward the higher insulin dosage amount rather than the lower dosage amount.
Either you hit it perfectly, or you have to eat a little bit of chocolate later. And for me, eating a little bit of chocolate is not really a bad thing, ya know?!
Of course taking the exact right amount is best. But I’d much rather take “too much” than “too little”. (As long as you are not driving or performing brain surgery)
throwing out that damned Dexcom was one of the best decisions i ever made with regard to my OCD. there was a new freedom b/c i had nothing to check with every 5 minutes. (i didnt really throw it out , i saved it for a rainy day; too expensive to chuck .
of course now i do find myself checking my BGs with my finger sticks. not as much as checking my CGM, but definately more than necessary. (but there is a good thing about not having to look at the Dexcome: i dont have to deal with those anxiety producing direction arrows.)
I’m glad you posted this. I test frequently. I don’t have a CGM, can’t afford it as I have no insurance. I subscribed to OneDrop so I could get unlimited strips. My doctor thinks testing more than 3 times a day is useless and in his words “crazy, and excessive, attention seeking”. No one sees me testing and I don’t broadcast it anywhere, so I am not sure how the heck it is “attention seeking”, only OneDrop knows and I doubt they put out an ad in the news about it. He only wanted me testing prior to meals, said post meal testing was worthless because all people have high BG’s after eating and it doesn’t matter. I want to know pre-meal, post-meal and pre-exercise, post exercise. I also decided that rather than treating a low or a high aggressively, I wanted to know if I was on a trend downward or a trend upward.(I hope that makes some sense.) Since I now have adequate insulin supplies and adequate strips to do what I want, I have gotten my A1C down from 9.3 to 7.2. I am hoping to get it down to 6.0 in the next three months. My doctor and the PA think I am nuts. I can’t say I really care about their opinion when it comes to this. I do, however, think sometimes I am allowing my meter and my “food police editor in my head” to take over my life. Not really sure I can stop that, as certain foods do seem impossible for me to bolus for, such as any grains, bread or fruit. I sure do miss pizza and steel cut oatmeal. edited for typo
I am flabbergasted to read this. It is UNBELIEVABLE that a physician would say that in the 21st century – I still have a hard time writing 21st century, it’s only been 16 years!
As a comparison, my son has a Dexcom, AND we test many times a day, never less than 2-3, often 10, sometimes 20 in a bad day. I feel that what we do is NORMAL if we want to do a decent job at controlling his BG.
This is GREAT.
I am SO angry when I read these statements. There is SUCH A GAP between life’s reality and the understanding of so many in the medical profession about diabetes.[quote=“literaturesnob18, post:14, topic:990”]
I sure do miss pizza and steel cut oatmeal.
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Pizza is tough for us at any time, but we consider it a challenge we cannot turn down, and make a point to do it from time to time!
@literaturesnob18, I am really sorry you have such challenges with your medical team. And I am horrified that you have no insurance. Keeping my fingers crossed for you! You are making such great progress!
i dont think you’re nuts at all. i think you are making realistic and completely appropriate decisions according to your testing strategy. how on earth are you going to be able to see how different foods effect your BGs if you dont test afterwards? i have my pump set so that an alarm goes off 2 1/2 hours post bolusing so that i am reminded at my insulins peak time what effect my bolus decision made on my BGs. i have another post about prepping for swimming and getting the most beneficial prep for my workouts; so much of it relies upon extra testing. i need to know when i can begin my exercise (which brings down my BGs, and when to get out of the pool. if i didnt test, how on earth would i know that i was about to bottom out?)
IMHO, i would change endos ASAP. i wouldnt tolerate a doctor telling me that “I am nuts” just because i want to maintain tight control over my health.
also, congratulations on your lowering your A1cs. thats awsome, and so is your goal
best of luck.
i love that you posted this!!! Yay for you of all of my food fears, i lived for way too long fearing how to bolus for pizza. it has always been one of my favorite foods; and, i am a die-hard new yorker, where the pizza is at its prime. you just cannot live here and not have your favorite pizza joint.
of all of my food fears, i still spent years trying to find the right bolus so that i could eat 1 1/2 slices without negative consequences with my BGs. and, THANK GOD FOR THE PUMP!!!. to bolus for this at the only pizza joint i will go to, i do a dual bolus for 75gms carbs split 40/60 over 2 hours. it works like a charm. (and i just need to walk there and back to get a little bit of exercise in at the same time ) if only i could expand my horizons and try more experimenting on other foods, i would be set. )
My doctor doesn’t have diabetes, but wears an insulin pump, cgm, tests his blood sugar 6 times a day and logs his carbs and hypothetical insulin doses for weeks at a time in order to better understand what his patients go through. He makes his clinical staff do the same.