Today, I went to see Dr. Lee. It was time for my four month follow-up appointment. I guess things could’ve gone a lot worse, but they could’ve gone better, too. In the last four months, I’ve gained back 16 pounds. That puts me back up to 288. Granted, that still makes a net loss of 23 pounds since November 2, so I guess I shouldn’t berate myself too badly. (Besides, berating myself doesn’t accomplish anything other than to sap my desire to pick up where I left off and try again.) And my glycohemoglobin was up to 7.1, compared to 5.6 in March. This doesn’t surprise me, but it does upset me. However, Jenn did point out that the change probably wasn’t drastic as all that. My last bloodwork had covered the period where I was having numerous drops into the danger areas, so my last results were probably a bit low, anyway. She figures a more reasonable result last time would’ve been somewhere around 6.5. Of course, I think she partly said that just to make me feel better. After all, one of her primary duties is to keep the patients motivated, no matter what the news.

Dr. Lee decided to put my on Byetta, which is apparently a relatively new drug (as I understand it, it’s actually a hormone) they’ve come out with for treating diabetes. Dr. Lee didn’t want to put me back on glyburide or start me on insulin, as he was concerned either of those options would have me bottoming out severely like last time. The downside to Byetta, however, is that it has to be injected (in the thigh or abdomen, no less!). So I’ve had to learn to give myself an injection. Actually, it wasn’t too bad. Jenn showed me how to do it, and she has a pretty good method for convincing patients that it’s not as hard as they think. By the time she’s done, you realize that actually lancing your fingers to test your bloodsugar hurts more than sticking the needle for Byetta (or even insulin, I understand) in does. So that was a pleasant surprise. So hopefully, I’ll start this and get back on track with my diet and exercise, and things will go well.

Today, I had another visit to the endocrinology department. I didn’t see Dr. Lee, though. This was my chance to have follow-up meetings with Jen and Faith. And I have to admit that I had quite a pleasant time with them. Of course, the good news right at the beginning helped that a ton.

I got to the office at about 2:45, checked in, and paid $100 on my outstanding bill. That’s about half of what I owe from my last visit. I would’ve paid the other half too under other circumstances. However, with this being a non-payday week and already having spent a significant amount of money on other bills this past week, I decided I should wait another week or two to pay the full amount. At least I figured roughly 50% would be a “good faith token” that I am paying it and will continue to do so. So having checked in and taken care of the business portion of the visit, I sat down in the waiting room and patiently waited for my appointment. Faith was running a bit late and didn’t get to me until almost 3:15, for which she apologized. I didn’t mind, other than the fact that I was beginning to wonder if something had come up or something, but things turned out fine.

So before leading me into her office to pour over my food diary, Faith has me jump up on the scale to see what I weighed. And there was the pleasant surprise. It seems that since November 2, I have lost 18 pounds. I was a bit shocked. I had known I had lost some weight and I was hoping it was at least five or even ten pounds, but I’d never expected such high results. Needless to say, Faith was quite ecstatic, too. So we rushed into her office and I pulled out my food diary for her to look over. She went through it and was quite impressed with it. She commented that I was missing a few foods on the first page, which I explained was due to the fact that my mother and I had to spend the first few days doing some grocery shopping to help with my change in diet. (My family has never been very good about incorporating an adequate amount of fruits and vegetables in our diets, so it meant doing some serious restocking of foods for us.) She also commented on the few days where I seemed to “skip” meals and was fairly relieved when I explained that this was due to me forgetting to update my food diary in a timely manner and not being able to remember what I just ate. I did assure her that I ate, though, and she was satisfied. She said that I seemed to be doing quite well at making sure I hit all the major dietary needs as well as spreading my food intake throughout the day.

We even talked about my weight loss, and she reiterated her position on that. I actually like it. Her whole philosophy is that while she’s always happy to see her clients lose weight, it’s not her main aim. Her main aim is for them to do the work of eating a properly healthy diet of the proper proportions. In her mind, the weight will then take care of itself in turn. So I’m endeavoring to keep that in mind, because I think it’s a helpful philosophy. So my plan is to continue to keep track of what I’m eating in writing and monitoring my glucose levels. Then I can let the weight take care of itself.

After our conversation, Faith told me she’d like to see me again in a couple months and we determined that we could schedule my appointment on the same day that I go back to see Dr. Lee, which is March 3. After this, she handed me the paper and went to see if Jen was ready for my appointment with her. Jen was ready, so Jen popped in Faith’s office and had me come talk to her. Faith had already filled her in on the whole weight loss thing, and Jen was equally excited about it.

She went over my exercise calendar and saw that I’ve consistently met my goal of taking three twenty minute walks each week. She was quite pleased with this and inquired if I’d given any thought to any changes I might want to make to my physical activity. I told her that I had thought about it and decided that I did not want to increase the number of days I’m walking, due to the fact that it might prove difficult to make it someplace to walk more than three days a week when the snow starts falling. (Speaking of which, it was flurrying on the way home, but that’s probably best left for a different entry.) However, I did mention that I was considering the possibility of increasing the length of each walk to twenty five or even thirty minutes instead of the current twenty minutes. She felt this was an excellent idea.

I also discussed my plans to try and recall as many of the ballet exercises I did in my college dance class and make a twenty minute workout of that. She thought this was another excellent idea, especially as it would add a number of stretching exercises to my physical activity. Overall, that meeting was quite positive, and she commented that I wouldn’t have to come see her again as long as my therapy kept moving in a positive direction (i.e. going off medications rather than needing more). Since I’ve been walking so much, she also gave me a free pedometer from a bunch that she gets as gifts from one of the pharmaceutical companies. I checked it out when I got home and it’s kind of neat. It’s a talking pedometer, which I think is kind of cheesy, but it’s still a neat idea. Tomorrow sometime, I plan on measuring the length of my average step and entering it in. Then I can start seeing roughly how many steps and miles I walk during my exercise routine. Also, Jen suggested that I see how much walking I get in from a typical day when I’m not taking my walk.

Apparently, I also have Jen to thank for my reduced medication. According to her, Dr. Lee missed the numerous glucose readings in the fifties a couple weeks ago. He had sent her a copy of my readings with his recommendation of “no change.” She immediately sent them back to him with all the low values circled and a strong suggestion that he cut my glyburide. So it’s thanks to Jen that I haven’t been bottoming out this week. Well, other than Wednesday. But that was due to an insufficient supper, I think.

This was a highly positive visit for me. It seemed great to see the weight loss and know that I’ve made my goals. And it’s really encouraged me to keep going. I think I’ve about convinced myself to keep up with keeping track of my exercise and food diary, even after I don’t have to show them to anyone. And to celebrate, I ran to Vestal and ate at the Chinese buffet. It was absolutely tasty. I thought I’d had a bit too much, but I guess I didn’t do too badly. When I got home and tested my blood sugar two hours after eating, I was at a 78.

So, I had quite the adventure yesterday. I got up at 10 in the morning, checked my blood sugar, and took my pills. Then I sat down to my computer and played Insaniquarium (I beat the adventure!) while I waited the requisite thirty minutes. Once that time elapsed, I decided to go ahead and have breakfast. I got everything around and ate, then spent the rest of the morning puttering around online. It gave me a chance to get caught up on friends’ diaries and respond to a few emails and posts on message boards.

As it got to be about 12:30, I decided it was time to think about lunch. I decided that I wanted to go out for lunch, as I was having a restless day and just needed to do something to get my mind and body in a calmer state. So I took my shower and grabbed an apple out of the bag. I ate it as I drove to the mall.

I got to the mall at about 2:00. I knew I had to take my walk (it was my last chance to get the third day of exercise in for last week), so I decided to get that out of the way before I ran upstairs to eat. I wasn’t all that hungry since I had the apple, and I was feeling great. So I took my usual circuitous route through the halls of the mall and through a few of the anchor stores. Towards the end, I was getting hungry, but I finished my twenty minutes before getting my back out of the locker at the entrance and heading up to the food court. Once inside Friendly’s, I gave my waitress (Diane) my order and then headed for the bathroom. I was feeling a bit lightheaded, so I decided it was time to get out my glucometer and check my blood sugar again.

Well, I had trouble with it. For whatever reason, the first time I stabbed myself with the lancet, my finger didn’t want to bleed. I got a tiny drop and decided to try it. Unfortunately, there wasn’t enough blood there to fill the test strip and the machine errored out. So I grab another strip, and poke another finger. Now by this time, I’m starting to get concerned because I’ve started sweating profusely. I know I just went for a brisk walk, but I didn’t exert myself that much.

The second time, I got enough blood and the machine flashed up a number. That number was 50. So I immediately spotted Diane, flagged her down, showed her the results (fortunately, she understood what I was showing her) and asked her to get me something sweet NOW. She blinked, ran back into the kitchen and came out with a full glass of Coke for me. (She didn’t even take time to put ice in the glass, bless her heart.) Needless to say, I chugged that down. By this time, the patron sitting at the table across the aisle from me has figured out what’s going on and starts in asking “are you okay”? (Note: While the concern is appreciated on some levels, diabetics are not exactly in the best state of mind when they’re blood sugar is critically low. As such, overbearing acts of concern like CONSTANTLY asking if they’re okay is not a good idea. If you’re in that situation, give the diabetic person something with lots of sugar — fruits are best — and then leave them alone. I managed to be courteous, but not much more than that.)

I get the impression that Diane also went back in the kitchen and told them to move my order to the front of the line, because it wasn’t that long after that incident that my food came out. It may have just been that they were having a slow day, but it just seemed rather fast to me. But I got the soda and real food in me and in fifteen minutes my blood sugar was up to 72. That’s not fantastic, but it’s generally stable for me. And by the time I got home, I was clear up to 166. To tell you the truth, I’m surprised that it wasn’t even higher with all the sugar from the soda. Not that I’m complaining, mind you.

So I learned a very important lesson. Even if I had a late breakfast and a light snack, I will NOT go walking before I eat if I’m having a late lunch. I should’ve known better, really. But I figured I ate breakfast late enough and had that apple so that my blood sugar should be just fine. Apparently, I was wrong. Not that this totally surprises me. I’ve found incidents where my blood sugar level seems to be time-dependent as much as food-dependent. For example, I’ve noticed a tendency to have higher blood sugar in the evening if I eat supper after 5:30 than if I eat it around 5:00. The fact that I take my medicines later and test my blood sugar later when I do that doesn’t matter. Even with everything moved the same amount of time later into the evening, the results come back higher. So apparently, this is another of these oddities.

Two days ago, I said that I probably just took my last walk outdoors for 2004. It turns out that I was wrong. It was such a beautiful and sunny day out, so I decided to take another walk outdoors. It was a bit cool despite the sun (Weather.com says it’s 64*F (or right about 18*C for you metric-heads) in my area), the wind was low and my light jacket was enough to keep me warm. This was especially true after my blood got pumping and the exercise kept my body heat up. But it felt good.

I’m also glad to see that I’m slowly starting to get used to walking again. There for a while, my legs started really bothering me. I was starting to get concerned that something was wrong with them and that I was going to have to run back to the doctor. But it looks like it’s just a lack of regular exercise, and now they’re starting to protest less and less. Of course, I’m still not going quite as fast as I was when I was really focused (I used to go another 200 yards or so in the same amount of time I’m walking right now). I’m a bit bummed about that, but I expect I’ll gain that back as I get working at it again. After all, that was also when I was twenty pounds lighter. I’m still upset I put on that extra weight since July, but I’m determined to take it right back off — and at least another 100 pounds right after it. Though I think I’m going to stretch it out over a year or two if I can. I don’t want to start doing the weight yo-yo game, after all.

Today is a fairly dull day at work. I’m waiting to have a meeting with Nate so that we can go over the new development tools for his project. I’ve configured and used them, and now I have to teach him to do likewise. I suppose I could also work on my specification for Steve’s project, but I’m not in the mood for that. I really hate writing documentation. It’s the one part of my job that I wish I could get out of.

The biggest problem with having a slow day like this — or a day where the only thing I need to do is something I’d like to do — is that it’s the kind of days where my willpower is weak. I find myself tempted to go to the vending machine and get a tasty — but fattening — snack for myself. It’s really quite funny. On days when I’m busier than a one-legged man in an ass-kicking contest, I don’t even consider it. I just go on. Heck, I’ve even skipped supper until much later in the evening if I was sufficiently busy. I’ve heard that some people will eat — particularly junk food — as much out of boredom as out of hunger. I really think I’m one such person. It’s quite a frustrating trait. I wonder if there’s an effective way to break the association between boredom and eating.