I last wrote about my appointment with my CDE, and we lowered my total daily insulin (TDI) by about 1 unit a day. I also had to switch brands of rapid acting insulin because of changes in insurance formularies for the new year. That was an extremely scary thing for me! For one thing, I have been either injecting or pumping with Humalog (lispro) since I was diagnosed over 10 years ago!! I had a short trial apparently on Novolog (aspart), because that is what we initially decided to go with, but my doctor found a note in my record from years ago where I had an allergic reaction to not only Lantus (insulin glargine), but to the Novolog as well. So, that left us with Apidra. I suppose since we were going off formulary anyway with the Apidra, I could have made that point and petitioned to stay with the Humalog, but Apidra has a program right now where you can get all vials of Apidra for free through March. So, I’m pumping with Apidra, and I’m doing well from a diabetes perspective.

Last week, I had my usual appointment for a follow up with my doctor in the internal medicine Pain management clinic. I had also seen hematology that morning. I had many large hematomas all over my stomach again, and the clinic sent me straight to the emergency room.  The hope was that if there was active bleeding, we would catch it before I ended up in critical shape like I did a month ago with the hematoma in my leg. I was frustrated, as hematology had seen me that morning, run labs, seen that I was ok, and had a plan, but we went to the emergency room. In the emergency room, because I have a central venous line, a large IV line that leads directly to the heart, the doctors ordered blood cultures because I was on antibiotics, in pain, and running a slight fever. My general labs ended up coming back showing that I was stable, and that I could follow up with my physicians the next day. I had a couple of appointments in clinic already scheduled, so I was already set. We were discharged from the emergency room around 11 pm on Thursday night. Friday I had a CT scan scheduled of my sinuses to see why I keep getting so many sinus infections. It looks like a visit to ENT is in my future, and there are lots of polyps again that have built up. We got home from the scan and I was resting when I received a phone call from an emergency department nurse. My blood cultures came back positive, and I needed to come back in right away. I was going to be admitted, and have repeat cultures drawn. Also, she told me that the CT scan showed that my sinuses were full of infection. So, my dad came home and we were off to the hospital – again. We got to the ER, straight back to an isolated room, and found out that only one of the two blood cultures were positive (blood cultures are always drawn in twos, and always drawn from two venopunctures).  When that happens, unless the blood culture that comes back positive is from a central line, the culture is usually contaminated. So, new cultures as well as full blood panels were drawn, and I was brought upstairs. Cultures take at least 48 hours to grow out and confirm as negative, so the bacteria that was growing is 99% of the time a contaminant.  We changed the antibiotics that I have been taking for my sinuses since I have been on the same two antibiotics since the beginning of January, and I take my last dose tomorrow. Unfortunately, I can’t say that I am feeling perfect, or even great, but I will have at least a few days without antibiotics this week!

Since changing my pump patterns and cutting the unit of insulin off of my TDI, I have been seeing fewer numbers in the 60s and 70s and more numbers in the 80s, 90s and 100s. That is where I feel safer, and my CDE feels more comfortable with me staying. My control is still good here, but I don’t have the danger of going low. I have unfortunately had some rebound highs with some of the fevers and with the antibiotic doses. Fortunately, the antibiotic that I’m taking right now is only once per day, but it is mixed in dextrose solution – pure sugar!! That certainly sends my BG flying!!

Around here, it is taking things one day at a time, sometimes, one hour at a time, and trying to stay super calm in the process. I want to get back to classes, finishing all of my work from last semester, but it takes so much out of me right now to even walk down the hall to the bathroom. Frustrating as it is, I have been here before, and I will move forward, one step at a time, one foot in front of the other. I have the will, and I’m motivated. When there is a will, there is a way, right??

In sisterhood,

Aliza Chana