The holiday season is a difficult one for a person with diabetes!  I celebrate Chanukah, and so that means not just one special day (though we know everybody celebrates the holiday season!), but eight days where we perform the same ritual candle lighting , with the same blessings, and the same traditions. Traditional food for Chanukah is not diabetes friendly in any way, shape, or form!  

I am living at home, and my mom has always been really great about limiting the number of times she will make latkes, the fried potato pancakes that are traditional Chanukah fare. So, I usually have latkes on the first night of Chanukah, again somewhere in the middle of Chanukah, and then, at the annual Chanukah party that my family has had every year that I can remember. This year, was no different. The table was filled with not only a huge plate filled with latkes, but a basket of bagels, a tray with both sourdough and rye bread, a cheese platter, bowls of a cranberry, pecan, spinach salad, egg  salad, and tuna salad, sugar cookies, pecan bars, raspberry bars, miniature peach pies,  and more. Most carbohydrate heavy, and what certainly could have been the perfect set-up for high blood glucose levels – the beginning of a miserable evening struggling to get a glucose level down into a safe range. I was really great about dinner during the party. I had one latke, one piece of sourdough bread with cheese on it to make a basic cheese sandwich, a raspberry bar, and a diet coke. Thankfully, we only have Chanukah with its fried, carb-laden food once a year. I also knew that we were going to have the party Monday night, and so I was really good with my carbohydrates earlier in the day. I was good at doing an almost perfect dual-wave bolus, and ended the night with a blood glucose level of 165 mg/dl. Not bad, considering the latkes are such heavy, heavy carbohydrate items.  

I’ve also still been struggling to fight off this respiratory infection. It seems to have travelled from my sinuses to both sinuses and lungs now. My asthma is not happy and I’ve been awake many nights doing nebulizer treatments. I am back on a different antibiotic again, and hoping that this one works so that I can start the new semester after the new year. Doctors and my parents have already very strongly urged that if I am still sick and struggling when it is time to start the new semester in January, I need to take this semester off from school and start back either in summer sessions or next fall, as I still have incompletes that I have to finish from this past semester. I do not want work to pile up on me and have things so that I end up so overwhelmed that I cannot catch up, and I end up getting sick because I’m so stressed out. That is not beneficial to anyone.   My INR level, the blood level that measures how well the Coumadin is working and how thin my blood is from the blood thinners, is still very low again this week. My Coumadin dose was increased again, but I’m back on an antibiotic, so I don’t know what sort of impact that will have on my INR. I will see the specialist in the anticoagulation clinic on Friday to discuss the levels and what they want me to do. It is frustrating to constantly monitor the levels and not see any change, but infection can impact the INR as can antibiotics, other medications, and the foods that you eat. It is a difficult thing to regulate, and will have to continue to be monitored and adjusted for as long as I’m on this particular therapy.  

Since my INR is low and  it takes a change in one dose of Coumadin three or four days to make a difference in lab work or your blood coagulation status, I have to take Lovenox shots twice a day again until the doctors feel that I’m in a safe range. So, in addition to all of the needle sticks from my diabetes, I have to add in two more each day for the Lovenox. Thankfully, right now I’m on a pump and not multiple daily injections or I think that I’d drive myself crazy! When I was on MDI I was on 8 injections a day at one point, so adding the Lovenox would mean 10 injections! I’m thankful for my insulin pump and CGMs. Since I am on the Lovenox and Coumadin, I am bruising a lot each time I insert an infusion set or a CGMs Sof-set. It is difficult to find new places for injections that are not completely bruised with large, very hard lumps under my skin from the lovenox. I also bleed for a long time after I check my blood glucose, which is difficult, as I check my glucose levels anywhere from 6-10 times each day. This is a whole new learning curve. Just like I learned diabetes, I can learn dealing with blood clots and blood thinners. It will just take some time.