It's Ok To Be Different In Life.... And Diabetes~

As a t1 for 35+ years, and on insulin pump therapy for 15 of those years, I added Metformin ER to my daily regiment at my Endo's request last March because of weight gain and insulin resistance.  
And initially it helped re: my weight and utilizing my insulin more efficiently. 
I stopped taking the Met in December, after noticing that my hair was falling out. 
The same thing happened in 2008 when I first tried metformin, but this time around, I was told that Metformin ER was different - and that to stop if I noticed adverse affects.  

I kept working hard and going with the flow, sans the metformin ER and the clumps of hair on the carpet. 

If diabetes has taught me anything, it's that we have to have a good working relationship with our healthcare professionals and we have to keep trying new things. 
Here's what happened at my last Endo appointment. FTR: It's all good~ 

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After I checked in to Dr. J’s office, I was given a copy of my labs. 

My a1c had gone from 7.3 at the end of October to 6.9 as of January 31st.

Kidneys and cholesterol were good, so was my blood pressure, and depending on what scale (my scale vs the Endo's scale,) you went by, I’d lost between 3 and 4 lbs since December. 

When Dr. J walked in the exam room he was excited and dare I say, downright giddy.

We chatted about everything and he kept telling me how proud he was of me - which not made me feel validated, it made me feel like I could do anything! 

Finally, he looked at me, raised eyebrow and said: You are different than other people Kelly.

Me: Yep, I'm weird.

Dr. J: Noooo, being different is a good thing. It's OK to be different in life... and diabetes. 

Most people drop weight on metformin and you did. And then you went off it and lost another 3 to 4 pounds - during the holidays.

Most people have no issues re: metformin and hair loss, but you do - and I’m very sorry about that. Is it growing in? 

Me: I hope so. It’s certainly not falling out in clumps anymore. 

Dr. J: You’re hair looks good today - very good.

Me: THANKS.

Dr. J: Everyone is different when it comes to diabetes and treating their diabetes, and you are a good reminder of that - I need to remember that about you - and everyone else.

OK, so tell me what you did. Did you exercise more?

Me: Well...., I had wrist surgery on December 13th, so not really. I had to be careful and didn’t begin low impact walks again until January.

But I was running around a lot during the holidays.

As far as food, I watched, but I still had Thanksgiving pie and my share of Christmas cookies. 

Dr. J: THAT’S GOOD.

Me: I tried eating more whole foods and less processed. I don’t know - I tried my best and tried to go with the flow.

Dr. J: Clearly that's working for you. 

Me: I need to exercise more, and I can’t wait to get the OK to do push-ups. 

Dr. J: It will happen. Also, it’s clear to me Apidra works well with your system and your insulin pump. 

Me: It definitely made a difference re: spikes. 

Dr. J: Did you experience any lows on the Apidra? 

Me: Yep, the first week I had daily middle of the night lows and it was learning curve, but I figured it out.

Next Dr. J proceeded to go over each one of my labs with me and again, he kept telling me how proud he was. 

Dr. J's always been understanding, has always worked with me when it comes to my diabetes, and all that goes with it, including diabetes burnout. 

The past couple years  have been a struggle and he's worked with me every step of the way. And having a healthcare professional on my side and in my corner has made a huge difference. 

Me: I want to drop more weight. 

Dr. Jay: You’ve lost 16 lbs, you’re going in the right direction. 

Me: It’s taken a while. But what if... 

Dr. J: Don’t worry about the “what-ifs,” keep doing what you’re doing and if we need to tweak, we will. Right now, don’t change a thing. 

Then he gave me some insulin samples,(including Apidra,) and told me to keep in touch with him re: any issues or needed tweaks, and told me to schedule my next appointment for early June. 

And for the first time in a very long while, I left my endo without the weight of diabetes pulling me down. 

I don’t know what’s going to happen in the next four months. 

Maybe I’ll need some tweaks, maybe I won’t. 

I have no idea which which way the scale or my a1c will go.

And that’s OK. Much like my pancreas, I am not perfect. 

But I am tenacious and I have an Endo who listens to what I have to say and works with me.

And we will continue to figure it out, together.  

Me + T1 Diabetes+ Weight Gain+ Insulin Resistance + Metformin ER =

A little over two years ago I started gaining weight - and no matter how much I walked, rode my bike, counted carbs and kept an eye on my plate - I kept gaining weight. 

AND IT SUCKED.

Some of my weight gain was due to me no longer having the metabolism I once had. 
Some of it was due to several rounds of cortisone in the form of shots ( thank you trigger fingers and CT,) and orally( I had a nasty upper and lower respiratory infection in May of 2015,) and the weight that cortisone brings to my person, 
And some of it was due to yours truly developing a resistance to insulin - which I'd had for a while, but which was now dialed up to 11. 

YEP, not only do I not produce insulin, hence the whole, me being a t1 since I was a little girl, but I’ve also become insulin resistant - which I’m told happens after decades of living with type 1 diabetes. YAY ME!

Another signature Kellyism - cortisone tends to sticks to my body for months at a time, requiring me to shoot up a ridiculous amount of insulin for weeks and taking months and months to get back to my regular basal rates.

I’ve figured out the cortisone/insulin dance like Rockstar and I’m not afraid to increase my basals to maintain great blood sugars on cortisone - but I hate that cortisone sticks around in my system for so long. 

But enough was enough and last fall and I started walking between 9 and 15 miles a week - and the damn scale kept going in the wrong direction - and my A1C barely budged. 
And wasn't like I was eating Ben & Jerry's every night - I wasn't. 

Gaining weight and working so damn hard to lose it without success made made me frustrated and depressed. 

On March 15th, 2016, I went to my endo appointment and Dr. J and I had one of our heart to hearts -  I was having hand and wrist surgery in May and I didn’t want to gain any more weight while I was recovering. 

Dr. J mentioned Metformin ER, I mentioned my hair and my fear of losing it. 

Sidebar: The last time I'd given Metformin a try was in 2008 - and I noticed clumps of hair on the carpet. Even though I'm a shedder when it comes to my hair - the clumps on the carpet were beyond normal and I stopped taking Metformin.

And my hair stopped falling out in clumps.

And then I started to cry. 

And Dr. J was great - he told me that we could try some injectables, but that because I was t1, my insurance most likely would not cover them. 

He told me that Metformin ER was different and better than regular metformin - and that price wise, it was cheap. 

Dr. J also felt that it could jump start my metabolism, and it didn’t have to be permanent.  

So we made a deal - I would go on Metformin ER ( Metformin Extended Release - different form the regular metformin I’d tried 8 years earlier,) and if my hair started falling out, I’d stop, ASAP - and Dr. J and I would go to/create plan B. 

I drove home, picked up my RX and started my first round at dinner. 

Sidebar: On March 16th, I received a cortisone shot to pop a ganglion cyst on my palm - I convinced the Dr. to use 1/2 the normal amount of cortisone and twice the amount of saline. The cyst was popped and my blood sugar was only elevated for two weeks.
And on March 20th I tore my quad muscle - and it hurt like hell.  

But back to the Met ER - the first few weeks on Met ER, there were rumbles in my belly for sure - but nothing I couldn’t handle and not nearly as bad as when I'd tried regular Metformin back in 2008. In two weeks the rumblings subsided for the most part.

I also noticed that Metformin ER made me feel fuller, quicker. I’d forgotten about that side effect. 

I travelled for half of April and by May 17th (the day of my hand and wrist surgery,) I’d lost 4.5 lbs. 

By July I was down 9 lbs and I didn’t gain weight while I was in Florida attending Children With Diabetes Friends for Life - and yes, there were some nacho and margarita moments in Florida. 

On July 17th I went back to my Endo - while my A1C had only gone down by a fraction (thank you nasty sinus infection that stayed in my system from late June through mid July,) my labs were great, My weight was down by 9 lbs and my Endo was thrilled. 

Dr. J increased my Metformin ER to 1000 mgs, twice a day and told me he was proud.

The increase caused my stomach to react and the rumblings returned, but were gone quicker the second time around.

In August I bought two new bathing suits - including a red one that made me feel like WonderWoman!  

September rolled in and I was 12 lbs down - and according to my hair dresser (who is also a dear friend, brutally honest, and always has back,) the hair on my head is staying put. 

Sidebar: I take daily biotin and B12 supplements because biotin promotes hair and nail growth and if your b12 is low (which can be one of the side effects of Metormin,) your hair will fall out. 

As of today - I’ve lost 14.5 lbs and my daily insulin intake is down between 9 and 15 units- steadily decreasing in increments since March. 

The most recent insulin decrease happened a few weeks ago, when I started noticing that my daily, 24 hour pump totals were in the mid 30’s. 

5 days in the mid thirties range, followed by a bump up of a couple days in the 40s and then back to the mid thirties. YES, there were a couple middle of the night, kick my ass lows (and one nasty high,) while I readjusted my basal rates. But I did what I had to because that's what people with diabetes do. 

Tomorrow is my Endo appointment - I’m hoping for good labs and a decrease in my a1c . 

And whatever happens, happens - I'm going to keep moving forward.