Yeah, for delicious low-carb Thanksgiving recipes...

So, I am finally getting the hang of this low-carb desert cooking...at this moment I have a low-carb pumpkin cheesecake cooking in the oven for Thankgsiving at my sister's....I don't even want to be tempted by her sugar filled pumpkin pie, so I thought it best if I come up with my own diabetes friendly deser...so far the batter taste delicous...even my non-diabetic roommate concurred (she's a pumpkin pie fanatic)...I admidetly starting to concur with a classmate of mine who has DM I, that "Anyone can have good control...all you need is lots of time to obsesse about food." I really don't want this statement to be true, but creative foods do take time....

I am a little worried about the crust though...the first pecan crust had way too much stevia (I followed their proportions on the bottle I swear), and the second batch had 1/4 the amount of stevia, which still amounted to stevia....I ran out of pecans before I could make it right...admidetly when it came time to making the batter I just stuck with packets of Splenda, despite the fact that I know Splenda add a few extra carbs (not nearly as many as sugar....but still)....anyone have any tips on cooking with Stevia, so I don't have to go through 3 batches of ingredients before I get it right?

Also, on a side note....I have officially been taking diabetes meds now for 1-year...so Happy Birthday Diabetes!

Almost Through Block 1...

So I had all these crazy ideas that I would find time to blog every day during medical school, and that blogging about diabetes would help keep me on track throughout medical school...well I am now 15 weeks through the semester and barely making my first post in almost six-months! Phewf...

Med School has brought a whole new set of challenges to managing my diabetes. Yes, my A1c a few weeks ago was 5.7%, my blood pressure was less than 120/80, I had a good HDL: LDL ratio, a nice healthy BMI, but I know the real story. The only tale-tale sign to my doctor was my slightly elevated triglycerides, but I've seen the + 200 spikes a few times a week, and the slowly crawling morning fasting sugars, which have steadily increased from 90 to about 120. Although, they may not last long enough to due to much damage to my A1c, I know they are slowly doing damage to my heart, nerves, eyes and mood. Nick can always tell when my blood sugars wacky. I get grumpy with him, and unfortunately he's been seeing it a lot more the last few weeks.

All the lunch time meetings--pizza (yes a med school frequently chooses Pizza as the lunch time meeting food of choice), burritos, cookies, and sandwiches...I know I should just always plan ahead and pack my lunch...

...Despite how much I know, I still find that stress turns me to an addict...I come home at 11pm from a long day of studying and all I want is chocolate. Every now and again I go on an eating frenzy...a recent study confirmed that studying does indeed cause people to eat more, but still this is no excuse...my brain tells me no, but my salivary glands yes. I think about retinopathy, neuropathy, and I convince myself, "Tomorrow, I start again....but tonight...." Food is always a struggle. I go to clinic and give the diabetic patients a meal plan to follow, and when I get home I sneak one of my roommates ice cream bars...as if no one sees me, it won't effect my blood glucose...I feel lucky that I can afford medications that give me a fair amount of freedom.

I've been trying to get back on the bandwagon. I've been packing 5-minute microwavable Tilapia Fish and Frozen Broccilli, I've loaded my fridge with veggies, and my spice cabinet with an arsenal of flavored stevia products, sugar free, but yummy spices such as pumpkin pie spice mix, baking cocoa powder, a Costco size box of Splenda, lots of great tasting Herbs to spice up all my low-carb meals. I've collected 20-minute or less healthy recipes that employ simple med school friendly ingredients (aka recipes that don't require more than 5 ingredients, but still taste great!)...I've even convinced my roomie to keep the chocolate and cookies hidden in her room. I plan on signing up for a half-marathon in San Diego in January to motivate to get me up before class to jog, and after hitting the climbing gym this weekend with my brother and his wife, I've finally decided that I am going to join the climbing gym up here in Sac, because it absolutely is addicting and super fun!

Recently, one of my roommates classmates was over, a second-year who has Type I...he joked and said, "Yeah, the key to managing diabetes is having lots of time!"

Next, we I have my first appointment with my new endocrinologist. I want to talk to him about injectable Byetta or Amylin...I think they might even out my post-meal spikes and curb some of my stress induced carbohydrate cravings....let's see if the med school insurance will cover it!

So there...I've gotten it all off my chest...blogging really does keep a diabetic honest!

More to come on my life in med school...but for now sleep!

I going to be a doctor! Yippie!!!

So on Thursday as I was heading out to go to a company Padres baseball game, I received a phone call. I jumped when I realized the area code was from the Sacramento area. I must be mistaken...this couldn't be UC Davis, could it? It was!

I tried to stay calm, while the director of admissions asked how my day was going and what I was up to. "Stay calm, stay calm," I kept reciting to myself...

"Oh, I am having a great day," I said, "Just heading off to a baseball game with my work."

"Well, I am about to make your day even better and offer you a place in our medical school," he said.

All I know is that I must have said "Thank You" about twenty-thousand times. Then I proceeded to start to cry...not just get a little teary-eyed...but FULL ON SOBBING with tears streaming down my face. Any bystanders would have seriously thought someone had just told me there was a death in the family. It even caused the Director of Admissions to stop and ask if I was o.k... I was in such a state of shock that I had to ask the director, repeat the directions TWICE on what steps to take next!

Believe me that evening, I threw caution to the wind when it came to my normal diabetic diet (see you knew I'd bring in diabetes somewhere). With pre-dinner Margarita, pasta for dinner, a yummy strawberry creme desert, and a glass from an $85 dollar bottle of port that I had been saving for the occasion, you'd think I would have gone into a diabetic coma...I must have had Nick secretly worried the whole evening! Oh, and did I mention the $35 cigar that Nick brought out...I don't even smoke, but it was fabulous...But the weird thing about all this...just TWO-HOURS post-dinner my blood sugar was only 101! Very strange. I expected that I must have hit 300...I even tested the control to make sure it was correct! Mmm...maybe it was the alcohol...it does have a way of lowering my blood sugar. (o.k. the above paragraph is a good example of "How not to be a good diabetic").

Anyway, almost four days have gone by and I am still in a state of shock! Yippie!!!!!

Report Card Time...

Waiting for A1C results often remind me of waiting for progress reports in high school. Today, I had my follow-up with Dr. Einhorn to find out the results of several of my blood tests and to perform a sonogram on a nodule in my thyroid....

A1C 6.6% - B
Exercise Habits - B
Carbohydrate Control - B-
Initiative and Self-Education - A
Diabetes Self-Care (following up with ophthalmologist, etc.) - A+

Yes, I need some work in some places...

On a good note, it's looking with more and more certainty that I am a Type II diabetic. My C-Peptide was elevated, so I am definitely, pumping insulin throughout my body. I really like that Dr. Einhorn is taking an aggressive approach with me. There are a lot of docs that look at me and think, "A1C below 7...you're good to go." I get really frustrated by this, "Diabetes has a progression and there's not too much you can do to truly normalize your blood sugars" attitude. For both Dr. Einhorn and I this is unacceptable. Good news to me, is that he's a leader in this area and was just lecturing to his students at UCSD about how to optimally control Type II diabetes and preserve beta cell function. Finally, the words I've been longing to hear, "Preserve beta cell function." Someone who actually believes it's possible! He looked me straight in the eye and said, "If I was your age and this was me, this is what I would do for myself."

Einhorn is putting me on a whole new medication regimen, which includes increasing my dosage of metformin and putting me on Janumet, a stiagliptin/metformin combo drug, and also adding pioglitazone to the regime. We're going to recheck it and if I still can't get my fasting blood glucose levels to close to 90 in two months, then I might start on a long acting insulin in the evening. In the meantime, I need to do my part and increase my workouts to 5-6 days a week, incorporate some serous weight training, and meet with a dietitian he recommended...

It's odd because when I have a doctor who really believes in the possibility to normalize my blood sugars, I am more inclined to work harder at it. It really is a team effort. Go team! 5.0% here I come!

Not alone...

So last week, Nick and I attended a formal reception aboard the HCMS Juan Sebastion Elcano--an old Spanish Naval Training Ship that was in town for a few days. Nick introduced me to the captain of his ship who has Type II diabetes. For some reason I had pictured him as this out-of-shape middle age guy, but he was not. I had thrown the stereotypes of a Type II diabetic upon him, even though I myself hate those stereotypes. I still constantly internally struggle with a sense of guilt--that I am at fault because it's Type II. To my surprise, his captain was not only quite fit, but was diagnosed in his early twenties like me. We're a rare breed, so it was nice to find someone with whom to commensurate.

On a non-diabetes note, the rest of the evening went really well. It was quite fun and I got to meet all of Nick's shipmates. To my surprise, Nick invited me to come to Austin with him in June for a family wedding. So all in all, I had a great evening!

Foot Ulcers and Ugly Reminders...

So at work on Friday there was a patient in the ER with a diabetic foot ulcer...it's the kind of horrifying thing I prefer to sometimes stay in denial about, but on Friday it was exactly what I needed to see.

Over the last few weeks I've let my carbohydrate intake whirlwind out of control (and my exercise routine for that matter...). It starts with a glass of wine over dinner, a single french fry there, a nibble of chocolate here, a yummy chocolate desert over a romantic date (yes, romance has a way of causing you to shut off your brain sometimes)...and pretty soon my weekly blood glucose average has jumped from 125 to 140....all in all, really not good since I am trying to get my A1C to below 6%.

So, the ugly thought of having my feet amputated when I am 60-years-old totally freaked me out and threw me back on track again. Uk...even now this picture gives me the shivers and I don't usually have a weak stomach...

Wacky Blood Sugars and Hormones!

So recently I have been experiencing a string of "What the heck" blood sugars. I woke up this morning at 180, so I washed my hands and checked again...178. Even on a bad morning when I've snuck a few sweets the night before the highest I've ever woken up at is around 140....mmm...again after moderate carb lunch of a pear and a half a cup of cottage cheese...185...I just don't get it sometimes!

I haven't been paying close attention to how my female cycle plays into all this, but perhaps it does more than I give it credit for...I hardly ever miss a pill and being on the interview trail has made me a little more forgetful than usual, which ultimetely lead to a last minute weekend "date" to the pharmacy for Plan B after, well um, my backup method failed [yes, Mom I am grown adult and I am at least I'm being responsible]...so I am just going blow all of this off as higher than usual levels of estrogen floating around in my body...

Thankfully, I have my endo appointment this week, so maybe then I can get to the bottom of this...

To Tell or Not to Tale on the Interview Trail...

So things have recently been looking up for me and I finally started on the interview trail for medical school. Two interviews in two weeks and I don't even have to leave the state! As I walked on to the campus of Loma Linda I had the same rush of feelings as when I first exited the cab in Florence, Italy six years ago and took in the city. A flood of emotions came seeping through as I stood over the famous Good Samaritan sculpture at LLU and faced the hospital. I feel like my life is progressing and new and exciting things are awaiting around the corner. Things are finally coming together...interviews are rolling in, I am dating someone who every week just seems more wonderful...I guess it's true that all good things come to those who wait. In addition, I just feel really healthy right now and more centered than I have in a while.

But now my one concern....during my homestay, I was chatting with two of the medical students that lived in the house about my diabetes, why I wanted to go to LLU, and other med school related things. I said that I would never bring it up in an interview, but one of the many reasons that I wanted to attend LLU was because of their strong promotion of a healthy lifestyle. Studying medicine there would make it easier for me to manage my diabetes. The students in 100% unanimity insisted that I mention it in my interview because it would highlight my specific interest in LLU even more. So when I was really connecting with my second interviewer and the time was right I mentioned it to illustrate a point that I was trying to make...The interview seemed like it was going really well and the doc even showed me pictures of her kids towards the end of the interview...let's cross my fingers and hope this doesn't keep me out!

Next week I am interviewing at another great school--UC Davis, but I am more inclined to keep my health private...

Yea! I found a new endo!

So, in the last five months I have seen SIX different doctors regarding my diabetes--two primary care doctors, an endo, the resident the endo was overseeing, a pediatric geneticist, and a pediatric endo. The primary care doc referred me to the endo, the adult endo moved to the East Coast and referred me to the geneticist, who referred me to the pediatric endo...of course the pediatric endo can't keep seeing me at the age of twenty-six, so before he referred me off again, I finally found a doc outside of Kaiser that's covered on my work's PPO. He came highly rated from a nameless ex-boyfriend mother, so I guess I'll give him a shot...

I am starting to get frustrated because all the docs at work and the an urgent care doc I recently saw for some new female issues all have said, "Well, congrats on your A1C of 6.7%." I frustrated by this because (a) this is outside the endocrinology recommendation of 6% or less (b) requires practically starving myself of all carbs to maintain. I am also getting really tired of the, "But your so thin and you look healthy. How can you be a Type II diabetic?" I really hope this new endo has stricter standards. I honestly sometimes believe that because I look healthy on the outside there is a tendency by the medical profession to not take as close of a look as they need to. I REALLY need an anal endo whose just as anal as I am about getting tight control...Let's keep my fingers crossed...

I love you Cheescake Factory!!!

The picture says it all! I was very excited to find this while on a date at the Cheesecake Factory last night (too bad not as excited about the date)! They even served it with Spenda whipped cream and a little side dish of strawberries....yummy! I am a little worried, however, because I just discovered that most of the cake is sugar alcohol, which isn't exactly sugar free...although my BG was less than 115 two-hours post, so maybe it's ok.

6 Carb Original Cheesecake™

with Splenda®

New Year, New Goals...How about a Marathon?

I've been contemplating trying to run a marathon for sometime, and now seems more like the right time than ever...oddly as a former epileptic I was discouraged from running more than a half marathon, but as a new diabetic strenuous exercise seems to be more encouraged. For the last 30 minutes I've been staring at the "register here screen." I just started running again a couple of weeks ago, and I am almost exactly 6-months away from June 1st, the date of the Rock N' Roll Marathon--a reasonable training time. I've looked at "How to train guides" online and am even thinking of placing a subscription for Runner's Magazine. Already, I feel stronger, healthier, and more self-confident as my heart pounds and sweat trickles down the sides of my face.

Maybe tomorrow I will have the courage to finally register...

P.S. I also have my eye on the San Diego International Triathlon as well, which is 4-weeks after the marathon...am I crazy?