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Looking Back: Visual Reminders.

Nothing helps remind me more about the importance of being familiar with serving sizes and what they look like than being on the road for a few days.  Meals away from the comfort and familiarity of my kitchen make for some guesswork, and these last few days have shown me that I could use a refresher on serving sizes.  Here’s a look back at a post from 2012 about keeping your eye trained as to how “half a cup” really shapes up.

*   *   *

A deck of cards.  A baseball.  A pair of dice and you only look at one of them. (Sorry for the clumsiness; I think it’s weird to write “A die.” as a sentence.  Looks odd.)  A tennis ball.   A hockey puck.

The things that health-related articles use as “visual cues” for portion sizes and serving sizes makes me wish I was more athletic, because then I’d have a really strong feel for the size of these different balls, etc.  (Sidenote:  Hey. Ever write something you want to immediately delete but then you keep it and just wish your brain was less daft?)  But these visual cue things are helpful for me, because if I don’t take note of just how big “one small apple” really is, it’s easy to lose track of how much I’m eating.  I need to constantly refresh my eyes on serving sizes, which in turn helps me better estimate carbs when I’m SWAG (aka Scientific, Wild-Ass Guessing)’ing it.

(Second sidenote:  The hamburger pictured here looks exactly like a fudge-drizzled chocolate cookie, which is making my brain very confused.)

Which is what I spent part of my morning doing today:  busting out the measuring cups in my house and reminding myself what certain foods look like when properly measured out.  I’m not shooting for serving sizes or anything FDA official.  I needed to do this purely for carb assessment reasons.  What does 35 grams worth of Rice Chex measure out to look like?  How much salad dressing is 10 grams of carbs?  Brain, be reminded of what 28 carbs-worth of banana goodness looks like!!

Birdy thought I was a basketcase this morning, measuring things out and then putting them back.  “No eat banana, Mama?”  “No more cereal and milk, Mama?”  “That chicken is very good, right, Mama?” By the time I started eye-balling the lunch meat and measuring it on our kitchen scale, she threw her hands up in disgust and went to find her Thomas trains.  (Tertiary sidenote:  Spencer, the silver, streamlined diesel train, is the same size as 15 grams worth of banana, dagnabit.)

But now my brain is brought back to reality.  Less guesstimating and more true and proper estimating, which should help me fine-tune my boluses a touch.  Reminders like this are helpful in keeping me from sliding down that slippery slope of eating 18 lb apples and bathtubs full of Golden Grahams.

(Last sidenote:  I’m sorry that only 2/3 of this post made sense.)

 

Stress!!!! and Diabetes.

Do your blood sugars respond to food?  Of course.  How about to insulin?  And exercise?  A big “hell yes” to those, too.  Food, insulin, and exercise have tangible influence on my blood sugar levels.  But one influencer that I don’t often take into account is stress … which is a ridiculous variable for me to ignore because stress can make my blood sugars leap over tall basal rates in a single bound.

Oh look – a video!

How does stress change the mapping of your blood sugars?

The Last Straw.

“Mommy … I had a nightmare.”

She shows up in the middle of the night sometimes, evicted from her warm bed down the hall due to a nightmare.  “I had a dream about a blue monster with no arms and popcorn on his feet.”  She’s clutching her blanket, her water, a flashlight, and a stuffed animal; clearly she’s in for the long haul.

I moved over in the bed and she started to climb in.

“Oh and mom?  You’re low,” she said, handing me the vibrating pump.

The fog of feeling sleep lifted immediately and I recognized the symptoms of this hypo.  Sweaty hairline, fumbling fingers, my sight reduced to a tunnel, and my hearing razor-sharp, hearing the shuffle of my daughter’s feet, the steady breathing of my sleeping husband, and – finally – the buzzing buzzery of my CGM alarm.

“Do you need something?” Chris asked from beside me.

“Yeah – can you grab one of those juice boxes from the shelf?”

Birdy was already snuggled in beside me, nestled close against my hypo-damp shoulder.  A few seconds later, Chris returned with a juice box in hand.

Habit, habit, habit – I am a creature of it.  When my blood sugar is low, I go through the motions to treat it, and if anything gaffs up the routine, I’m thrown.  Lows in hotel rooms rock me because the bedside table is five inches farther from me than at home.  When I am home, having the glucose tabs on the table itself instead of in the drawer can be enough to confuse me thoroughly.  (Lows make me the least-sharp knife in the drawer.)  In this case, I grabbed the juice box firmly and reflexively used my other hand to reach for the little plastic sleeve with the straw tucked inside.  Only I grabbed it a little too firmly and juice shot out all over the bed, because my forward-thinking husband had already stuck the straw inside the foil hole.

“Shit …”  My pillow was wet with juice.  And so was my daughter, because I managed to (ocean?)-spray her in the face during this transaction.  “I didn’t know the straw was already in there.”

“Do you need another juice box?”

“No, this should be okay.  Only a little bit flew out.”  I drank the rest of the juice box, per routine.

“MOM. This is not OKAY.  I am all WET.”  (Even at 3 am, my kid can be indignant.)

“Sorry, baby.  You can go back to your own bed, if you want?  That bed doesn’t have juice in it.”

She thought for a minute, then buried her head under the blankets to issue a muffled response.  “No WAY.  The monster had popcorn feet.  NO WAY am I going back to my bed.”

 

 

Do You Lie to Your Doctor?

I have found it challenging, at times, to tell the truth to my endocrinologist.   

“Exercise? Yes. I exercise. Nine times a day, I exercise.”

“I have no idea why I was high last Thursday. Or this morning, for that matter.”

“Counting carbs? Yep, I’m all over it.”

Interested in more than just my lab work, my endocrinologist asks me thoughtful questions about my family, my relationship with my husband, and life outside of the confines of my A1c result. So why, as an adult, have I had issues being honest with my endo about the diabetes problems I need real help solving, particularly in moments where I could have just ‘fessed up and saved my endo the effort of trying to find “a solution.”

In this month’s edition of SUM Musings on diaTribe, I’ve drawn from my own experience and collected some thoughts from others about why patients hide the truth from their doctor, what could improve communication between HCPs and PWDs, and how we can embrace a culture of honesty in pursuit of better health.  (Yeah, it sounds kind of serious, but I had a cat wrapped around my neck the whole time I wrote it, so there’s an element of furry fury to the whole thing.)

Thanks to Martin, Lorraine, Kate, Howard, and Sean for their contributions!  Head over to diaTribe to read the whole thing.

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