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Plan Your Conversation.

“Do you understand everything we’ve talked about?”

Nods.

“Do you have any questions?”

Shoot.  I did, on the ride up here.  I had a whole pile of concerns and questions, but they disappeared awkwardly upon sitting in this chair.  And sometimes, even when I remember what I wanted to ask, I end up somehow caught up in the flurry of discussing medications, reviewing lab work results, physical examinations, and scheduling next appointments.

And admittedly other times my question stays at the back of my throat, either too shy to be asked or makes me feel weirdly vulnerable.

Despite feeling empowered as a patient and having a high level of health literacy, I sometimes sit in the doctor’s office and my mouth forgets to make words.

The team at the Patient Revolution (disclosure:  I’m on the board and also involved with content) has created a Plan Your Conversation exercise to help patients ensure that their concerns are addressed during their visit.

The simplicity of this exercise (created before I joined the team, so I’m not tooting my own horn 🙂 ) is where its power lives:  the action of writing down concerns and expectations makes them easier to articulate.  And hey, if you feel weird saying these things out loud, you can always physically hand the card(s) over to your clinician.  Whatever gets the words out of your face and into the discussion.

You can plan your conversation through the online tool or download a PDF of the cards to print out.  You can also watch this video about The Patient Revolution to get a feel for how storytelling is being brought to the forefront with this effort.  

Sign up for updates on the Revolution efforts here.

Seven Months.

To my Little Guy,

Suddenly, you’re not so little.

Over the last few weeks, you’ve growth-spurted in a way that’s made every plant in this house super jelly.  Pajamas that once fit with room to spare are threatening to hulk out at the feet and your appetite is already edging towards the scary things that moms of teenage boys told me.  (“Prepare to have him eat you out of house and home!!!” they said, running to their second job that pays solely for their son’s lunch consumption.)  Despite still running small for your age, you’re a completely proportionate tiny human tank.

Food is your favorite thing, after your sister and making the “pppbbbblllllltt” noise with your mouth.  Most often you can be found in the high chair eating sweet potatoes,  scrambled eggs, peanut butter and bananas mashed together (that’s your favorite this month), and your hands.  Still no gluten until you’re over a year old, like we did with your sister.

You’d very much like the cats to be your friends, but so far only Loopy will give you the time of day.  She comes up and purrs maniacally, weaving herself in and out of your reach and letting you pet (mash) her on the head.  Siah, on the other hand, is horrified by your existence and keeps serious distance between her fur and your paws.

Unrelated:  Squirrels and chipmunks seem to like you just fine and they grin at you when we go from the front door to the car.

Side eye because he knows it ain't Valentine's Day. #anachronisticbib

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I finished breastfeeding recently and you’re now on formula.  Ending breastfeeding was a difficult choice but one kind of forced, in part, by the eye injury that resurfaced a few weeks ago.  I wasn’t able to feed you because I couldn’t see or manage pain very well during that episode of corneal chaos, so you were receiving pumped breastmilk instead of being able to latch on to me.  Fast forward a few days once I had recovered and putting you on my breast didn’t produce food fast enough for you, so you fussed and freaked out.  Back to bottles of breastmilk (and formula) until pumping wasn’t an option anymore, either.  (Not being able to physically feed you myself slowed production down to nothing.  And yes, I’m writing about breastfeeding you again.  Stop rolling your eyes.)

With the stopping of breastfeeding finally brought an end to the deluge of pregnancy-related hormones that took up intense residence in my body, and that’s been a very positive mental shift.  The postpartum anxiety thing has tapered off quite a bit, in part due to cognitive behavioral therapy once a week and also the lack of hormonal influence.  (We also joined a gym, you and I … more on that in a non-you post.)  I’m feeling like I’m more capable of taking good care of you instead of feeling like I’m holding on to everything by a thread.

And with a more relaxed mindset, I’ve realized you’re it … the last little baby I’ll ever have.  Watching you grow so fast has made me want to slow time down.  Which translates into you and I reading a lot of books together, or going for walks with your stroller.  We snuggle, often.  And I like to look into your eyes and wonder what color they’ll eventually settle on.  Time goes by very quickly and I am trying to spend as much of it as I can with you and your sister.

We’re lucky to have you, little Guy.  So very lucky.  And while I want to enjoy the little friend that you are, I am looking forward to seeing whoever it is you become.

Now go to sleep.

Love,
Mom

Emergency Plan.

Was just 106 mg/dL.  Tumbled fast to 40.

Took minutes.  Felt like seconds.

Dizzy.

Wait – get phone.

Put the baby in his crib.

He’s safe in there.

Already drank juice – plenty of it – now wait wait waaaaaaaait.

…. waaaaaaiting.

Wall edges seem wiggly, like if I poked them they’d shudder like Jell-O.

Baby is safely in the crib, giggling and playing with his feet.  I sit on his floor with my phone in my hand, ready to make a phone call to a neighbor if the waves of confusion start to erode my mental shore.

Briefly wonder what I’d say if I called.  “Hey, this is Kerri.  Can you come over?  I feel like I’m going to pass out.”  I’m sure I’d try to sound casual when casual is not how I feel.  I keep 911 dialed so if I need to just hit the call button, I’m ready.

Emergency plans.  I have them.

My tongue becomes less thick, less clumsy in my mouth.  I flex my fingers, which are attached to my still-shaking hands.  They feel responsive but like their wings are still clipped.

Juice starts to change the course of my blood sugar.  CGM alarms still blaring from my phone, less urgently now.  Walls seem less gelatinous.

Baby burps and then laughs at his own burp.  I laugh, too, the fog of hypoglycemia unwrapping itself from my brain.  I remember that it’s morning.  That it’s a week day.  That I’m due on a
conference call in 20 minutes.

CGM shows me a comforting arrow.

Emergency over.  Status quo returned.

Before I retrieve the baby from his crib, I grab a cloth and clean up the juice that leapt from the glass while my hands were birds.

 

 

Cauliflower Rice.

Not a cook.  Nope, not me.  Which is why this recipe for cauliflower rice was so useful, because it requires little thought, little cooking, and very little insulin.

Cauliflower rice

  • Buy a head of cauliflower.  Become friends with it.  And then rip it into small sections, keeping hold of mostly the florets (the tops of the trees, in Bird terms) and discard the stiffer stems.
  • Rinse the florets.  Dry them.
  • Put them in a bowl and mix with a little bit of olive oil and salt, to taste.  Also add garlic, if you’re gross.  (We’re gross.)
  • Take a food processor, if you’re one of those fancy people who has a food processor, and pulse the florets for 20 – 30 seconds in order to reduce them down to the teeny rice sized bits.  If you’re not the fancy type who has a food processor, take the blender and use that.  And if you’re full analog, grab a giant cheese grater and grate the florets.  (This last option will take a long time and you may be adding finger to your rice, so choose wisely.)
  • Fluff the “rice” with a fork and put into a bowl.
  • Take a picture of the bowl and realize it doesn’t photograph well, but put it on Instagram anyway.
  • Realize the whole process took four minutes and high five yourself for making such a healthy thing in minimal minutes.

Cauliflower rice

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At our house, we used the cauliflower rice as a base for our eggplant parmesan, replacing the pasta.  I won’t lie and say it tastes just like pasta, but I won’t lie and say it caused a wildly high blood sugar, either.  We had eggplant parmesan that required 1.8u of insulin to cover it (mostly for the pasta sauce carbs).

Most recipes online that I saw clocked the cauliflower rice in at 5 grams of carbs per cup, so that’s the ratio I used to calculate my insulin doses.  Which means I did not bolus at all for it, since I only had a half a cup and my I:C is 1:12.

WARNING:  If you put it in your fridge overnight, even if it is in a tightly-sealed tupperware container, your whole fridge will smell like gas.  And not the “runs my car” sort of gas.   Beware.  

Let’s Get it ON!

Happy St. Patrick’s Day!  Whether you’re Irish (I am) or not, today is a day when people will wish you top o’ the morning and will also potentially offer you a beer at 9.30 am (I am not).  Today I’m looking back at a post from ten years ago wherein Mills Lane mediates a melee between a beer and a cocktail.  Read on to find out who wins …

*   *   *
The microphone drops down and Mills Lane plucks it out of the sky.

“In this corner, bringing a bevy of boluses and carbonated carbohydrate content, wearing Gold Shorts and a lime wedge, weighing in at about 12 oz is the mysterious new challenger, La Corona!”

He raises his fists in the air and burps.

“And in this corner, The Titan of Tight Control, the A1c Ally, weighing in at about 9 oz and made up of cheap vodka, cranberry juice, and a splash of Tropicana orange juice – the reigning champion, The Mighty Madras!”

Madras also pumps his fists, holding tight to a thin, red straw and a test strip.

“Gentlemen, this is the title match. Nothing below 50 mg/dl and nothing, nothing above 250 mg/dl – do you hear me? I want a good, clean fight. Now let’s get it on!”

Bell rings.

“And the Corona lurches forward right away, fists flailing! Look at those carbs, folks! The Mighty Madras is backing off a bit – I can hear those ice cubes clanking against the side of him! Corona reels back, swings out and oooooh! A solid hit to the jaw of the Madras! He’s falling back! He’s staggering! Could he be out already? Is this newcomer going to knock the ol’ Tried and True out of the ring?

The Madras is leaning against the ropes … he looks exhausted! Only a few minutes into this fight and the Cold Corona definitely has the upper hand! This could be it! …

… But wait, what’s this I see? Yes, the Mighty Madras is on his feet! He’s taken out a blood glucose meter from his pocket. He’s looking to test Kerri – judges? Are we allowing this? Yes, the judges are allowing a blood test. And Kerri, after having two of the icy cold Coronas, is up to 253 md/gl! Her bolus was grossly under estimated! They’re flashing the results across the marquee – indeed, Kerri is high and the Corona can’t stop staring at the number!

And – ooooh! – the Mighty Madras has snuck in a jab while the Corona isn’t paying attention! He’s now pummeling the Corona! There’s lime juice everywhere, my friends … this is truly a gruesome beating!”

Corona is leaning against the ropes, exhausted from the beating. The Madras reels back his fist, angry that Kerri didn’t measure correctly for her drinks and is now high as a kite. He knows he would have been easier to count. He knows he could have let Kerri enjoy steadier blood sugars and a night out. Why did she pick Corona? Was it the price? Was it the fact that “out having a beer” is what she preferred over a more pretentious mixed drink? Madras didn’t know. He didn’t care. All he knew is that the Corona was horning in on his woman and he wasn’t standing for it.

“And the Madras has brought out a bottle of insulin!! And OH MY GOD he’s cracked it over the Corona’s head! Corona is out! It’s a knock-out, dear viewers! This fight is over! Over!”

Corona falls flat against the mat, out cold. The ring smells of sweat and insulin. Mills Lane grabs the championship belt and thrusts it into Madras’s hand, declaring him “Winnah!” Madras, bleeding profusely from the eye and crying, raises the belt to the air and yells, “Kerri! Kerri!” Kerri comes running from the stands, meter in hand, and stands in front of him as she tests. “153 mg/dl. I’m coming down. I’ll be more careful next time I drink high-carb beers, O Mighty Madras. I promise!”

They embrace. The “Rocky” theme swells in the background. Kerri decides that the next time she wants to have a beer, she needs to measure more carefully and bolus with more precision. She also discovers that she has run this storyline into the ground.

Mills Lane wipes the tears from his eyes. “I love a good fight.”

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