Monday, July 10, 2006

It's working - and it's not.

A quick update regarding the Symlin Experience.

I have lost 8 lbs in just over a week. Too fast a weight loss, I think - and one strictly related to the fact that this stuff totally decreases appetite. I am lucky if I can eat the two meals a day at which I take the Symlin. I fit in fewer than 1,000 calories - and I'm not hungry at all. So, the losing weight part is working, for sure. But, it's got me thinking; do I really want to be on another medication indefinitely? I don't know. I need to talk this through with nurse at my next visit (next Monday, which happens to be my 33rd Birthday.)

My insulin sensitivity has been increased all-around. I have gone from taking between 30 and 45 units per day to taking between 20 and 30 units - more often than not, the intake is in the low 20s, where it was typically in the high low 40s before Symlin. OK news, I think. At mealtimes with Symlin, my insulin to carb ratio is at 1 to 45 or 1 to 60, at mealtimes without Symlin (which, because of the aforementioned decrease in appetite, are rare) my insulin to carb ration is at 1 to 40. My basals have decreased at all times of the day.

But, the adjustment continues. I have had more sugars over 200 and more under 50 than I'd like to be having and I've had to call the doctor at least once everyday. And, because I'm letting the doctor take the wheel - following instructions and only giving my opinion if I feel like he's got it totally wrong - I'm feeling a bit helpless sometimes. It seems like we've got the morning under pretty good control... (Ie, yesterday: 118 before breakfast, 121 one hour after, 130 two hours after, 128 three hours after - today: 128 before breakfast, 121 one hour after, 116 two hours after...) than the afternoon has to come; I've been shooting up into the 160s-250s after lunch and not coming down -- only to swoop into the 50s before dinner, swoop up again after dinner and than plummet in the later evening hours... Yikes.

So, it's working - and it's not working. I'm still feeling slightly overwhelmed.

On a side note - I didn't write anything about last weekend, because I pretty much took the weekend off. With the wedding and the driving and the memorial service... I just couldn't deal with another variable... I have started a post, to fill you all in on how the offtime went (not great) - but it's slow in coming and work is busy...

More to come.


Scott K. Johnson said...

Overwhelmed for sure - but isn't that a bit expected when you make a major therapy change? Maybe it is something you need to adjust to over time, and feeling overwhelmed might be normal at this stage. Especially given that you have given so much control in the clinic? Just a thought.

Those numbers for the morning are just awesome.

The weight loss does sound fast, but maybe that's normal too? What does the clinic think about that?

Thanks for the update - I was curious as to how things were going for you.

KSC said...

How do you feel about letting the Dr make adjustments? Does he/she "get" your particulars, all the little things that interrupt a regular routine?

Nicole P said...

Thanks, Scott. I think you're right, the overwhelmed feeling is a direct result of handing over most of the reins and making such a huge adjustment in my diabetes life. I think the weight loss is probably normal, but that's on my list of questions to ask once we calm things down with my bloodsugars...

And that's a great question, KSC. I have said and they have acknowledged that sometimes life gets in the way of diabetes.

For example, yesterday, I spent the entire day with my cat at an emergency vet center as her tail got shut in a window. Between her screaming when she got shut in it - as if she were being attacked, to the vet telling me she may lose her tail, to them having to dope her up just to examine her - I didn't eat all day, which meant I gave no Symlin, and between that and the stress of the whole thing, my sugars ran fairly high all day. (A post on all of the above later - my cat still has her tail, thank heavens.) Since I had no access to a phone, I couldn't call as directed with out of range sugars.

They seem to understand that sometimes things happen and that sometimes diabetes takes a backseat to living. I also am one who'll admit when I've done something that I know they won't approve of. Ie; feeling low in a meeting at work, can't leave -- set a temp basal of 0.0 on the pump and wait it out... They clearly don't approve, but they're never judgemental when I tell them about it and they factor it in when they're giving advice.

I'm scheduled to start a fast today to test my evening bolus rates. No dinner and no food after 6pm -- which shouldn't be a problem given my total lack of appetite. We'll also test my morning and midday rates at points in the near future. I'm really glad we're doing this, because I have a strong feeling the rates he's set are not right. I've given my feedback and he's asked me to try his way - so, I'm doing it, but I'm almost certain that my instincts about the rates will be proved correct by the fasting tests...

KSC said...

I hope it all works, and that your fast give you good data. I also hope your cat recovers! Poor dear.

Nicole aka Fred said...

Symlin sounds like a really big regimine change and it is really impressive how you have stuck with everything. I think I would have said screw it by now and not just because of the frustration but also becuase it sounds a little scary to have such a difficult time keeping things smooth, Kudos on sticking with it and being so willing to try to improve your health!

Sandra Miller said...


I've been so lost in Joseph's numbers lately that I'm afraid I am very late to this entry.

After reading your comment on my blog, and this post, seems like we're dealing with some of the same stuff.

Not fun.

I think you're so right that "handing over the reins" to the doc makes this process far more overwhelming. Just adds to the overall feeling of being out of control.


It does sound like you're on the right track, though. And very much holding your own.

Take care, and hey-- Happy Birthday!

Hope you had a good one.

(Just celebrated mine on the 8th :-)