Thursday, November 29, 2007

Holiday Desert Recipe

I got this from a diabetes website I checked out. It sounded real good and I decided to make it as a treat for the Thanksgiving get together last week. It got awesome reviews and it was so fun to make with the boys. I highly recommend it to anyone! It's like an apple shortbread.

Caramel Apple Cookie Bites

Ingredients:

Filling: 1/3 cup chopped unpeeled apple 1/3 cup evaporated milk 1/3 cup sugar 1/3 cup chopped walnuts
Dough: 1/2 cup butter or margarine, softened 1/4 cup confectioners' sugar 1/4 cup packed brown sugar 1 egg 1 teaspoon vanilla extract 1/4 teaspoon salt 2 cups all-purpose flour
Topping: 1 package (14 ounces) caramels 2/3 cup evaporated milk Green toothpicks 1 cup chopped walnuts

Instructions:
1. Preheat oven to 350 degrees F.
2. Mix together apple, milk, sugar, and walnuts in a pot. Cook over medium heat until thick. Let rest.
3. Using electric beaters, mix together butter, confectioners' sugar, and brown sugar. Beat in egg, vanilla, and salt. Slowly add flour in and mix until fully combined.
4. Form mixture into 1-inch spheres. Compress dough with the palm of your hand. Spoon 1/4 teaspoon of apple mixture onto the center of each piece of dough. Fold dough in half and form into balls.
5. Move balls to a greased pan and bake 12 to 15 minutes, dough should be golden. Let cool on wire racks.
6. Pour caramels and milk in a pot and heat over low heat until liquefied. Poke a toothpick into each ball and coat each with caramel mixture. Roll in nuts and let cool. Dip some in chocolate too. Or use bananas as the filling.

Nutritional Information:
Per Serving— Calories: 292 Carbohydrates: 39g Protein: 6g Total Fat: 13g Saturated Fat: 6g Cholesterol: 31mg Fiber: 1g Sodium: 157mg

Friday, November 16, 2007

Diabetes Damnit Mellitus

So I finally got an appointment with an Endocrinologist! His name is Dr Jacobson and I hear he's amazing. It's time to sever ties with my internal medicine dr. They have just been so laid back about my diabetes. How am I supposed to take it seriously and hard core if they don't? Maybe not cut them off altogether. They've taken care of me for 6 years. But I need someone to attack this freaken disease.

I've been fighting with Blue Cross Blue Shield of Georgia for about a month about getting refill strips for my Ascensia Contour Glucose Meter. They won. They won't pay for it because they don't have a contract with Bayer or something. I have to stick with Accu Chek. Good news is Accu Chek sent me a brand new meter, the Aviva. It's much better than the Active that I've been using.

I tried it out after clinicals on Thursday. I figured I'd be kinda low. I ate at 4 am, 12 pm, and here it was 5 pm. My bs was like 96. Very very good. I was happy. I had supper and checked my post-meal bs, which should be around 100-120ish and it was almost 400!! I was so upset. They say that with blood sugars that high you shouldn't really exercise to burn off the extra blood sugar because your system is already stressed to the extreme. But they said if you don't have insulin around, you should just drink alot of water to flush it out. So I laid down, took it easy, and had alot of water. I've got several vials of insulin in the refrigerator but they're expired. Damn.
I've been pretty elevated since then. I guess my blood sugars run really high now. And I found out what I thought was a good a1c (7.2) is actually not good at all. Alot of insulin dependent diabetics find themselves around 5 or 6. I'm upset, but it's time to attack this shit. This endo has a reputation of being pretty tough. Good. I need that. I really see him putting me back on insulin. I hate insulin, but especially with the new pumps out there it sounds like it'll be just what I need. I just want to feel better. I'm tired of being tired. I'm tired of feeling like I just got ran over by a semi. I want the good blood sugars, I want my kidneys to always work good, and I want to live forever. I don't want to die. I want to be there for my kids and husband forever.

I'm serious about this and I pray to God he helps me through this strong as hell!

I'm going for one hell of a walk...

Monday, November 12, 2007

Baby Crave!

Ok, I'm about out of my mind. I SO can't wait to have another baby! I laid down last night to relax and ended up falling asleep. My stomach was hurting and it's like I still felt it in my sleep and incorporated it into my dream. I dreamt that I was laying in bed and my stomach hurt. I reached down to rub it and it was hard and round, like I was 5 months pregnant or something. Then it's like I walked in to the bathroom that's next to our bed to take a pregnancy test and it was positive right away. But I was shocked & scared.

Our plan is to have a baby AFTER I graduate. As bad as I want another baby I'm so scared. I don't know if things are too bad with my diabetes. I had alot of serious complications with my last pregnancy and Colin & I were lucky to come out ok. I know if I get pregnant again I'm likely to repeat those complications.

But this is my plan:
1) Start now with an endocrinologist who will help me take real strict care of the diabetes and get settled on a steady medication and food plan.
2) Get started on a healthy exercise routine. Right now I'm just doing alot of walking, but maybe add more to it. I'd like to get back into dancing.
3) If I need to be back on insulin, so be it. But before I get pregnant I'm going on a pump! I used to inject SO much insulin SO often that I was begging the dr to put me on a pump. That way if I needed more insulin, all I had to do was push a button. Also more convenient being away from home alot. But the dr I had at the time wasn't real familiar with pumps.So I'm hoping that I can get my a1c down (it's at 7.1 now-not cool) and start on a strict medication schedule. In a year I should be in prime shape for a baby! And pray it's a girl.

I've received word from a few people that my doctor will probably discourage me from getting pregnant (and a few said they wouldn't), but I'm motivated to make this work. I just need some words on encouragement!

Baby Crave!

Ok, I'm about out of my mind. I SO can't wait to have another baby! I laid down last night to relax and ended up falling asleep. My stomach was hurting and it's like I still felt it in my sleep and incorporated it into my dream. I dreamt that I was laying in bed and my stomach hurt. I reached down to rub it and it was hard and round, like I was 5 months pregnant or something. Then it's like I walked in to the bathroom that's next to our bed to take a pregnancy test and it was positive right away. But I was shocked & scared. Our plan is to have a baby AFTER I graduate.

As bad as I want another baby I'm so scared. I don't know if things are too bad with my diabetes. I had alot of serious complications with my last pregnancy and Colin & I were lucky to come out ok. I know if I get pregnant again I'm likely to repeat those complications.

But this is my plan:
1) Start now with an endocrinologist who will help me take real strict care of the diabetes and get settled on a steady medication and food plan.

2) Get started on a healthy exercise routine. Right now I'm just doing alot of walking, but maybe add more to it. I'd like to get back into dancing.

3) If I need to be back on insulin, so be it. But before I get pregnant I'm going on a pump! I used to inject SO much insulin SO often that I was begging the dr to put me on a pump. That way if I needed more insulin, all I had to do was push a button. Also more convenient being away from home alot. But the dr I had at the time wasn't real familiar with pumps.

So I'm hoping that I can get my a1c down (it's at 7.1 now-not cool) and start on a strict medication schedule. In a year I should be in prime shape for a baby! And pray it's a girl. I've received word from a few people that my doctor will probably discourage me from getting pregnant (and a few said they wouldn't), but I'm motivated to make this work.

Friday, November 2, 2007

MRSA Oh my!

For most people MRSA sounds like something out of a horror movie that recently invaded our society. For people who work in health care it's old news. Of course, I'm new to everything and I'm so becoming germaphobic!

My patient this week: 42 year old diabetic with end stage renal disease and a massive MRSA infection on contact isolation.

I was real paranoid at first but I had a suspicion I'd get a patient on contact isolation. I just knew it. Just ask Melissa, she'll tell you. I talked her head off about it the whole way to DeKalb LOL
Anyways, I need to shape up alot when it comes to my diabetes. I'm never exposed to anyone who has it so I don't really have a role model to learn from. And my doctors aren't too strict on me. I've really got to find an endocrinologist. I hear they'll kick my ass for my blood sugars. So I'm thinking that seeing this young patient in end stage renal failure will be an eye opening experience.

My first impression of her was ok. She just received a heafty dose of pain medicine a few hours earlier so she was practically comatose. She didn't have an easy morning. She was throwing up everything she ate. She also has a MRSA infection in one of her eyes. So she requires eye drops EVERY hour. And she has 4 of them, not to mention 2 insulins and about 10 oral meds. And it's up to ME to keep track of them and juggle their administration between AM care, vitals, blood sugar monitoring, and 30 pages of paper work. Not to mention having to complete a drug sheet for each med. On 2 hours of sleep.

But something really kicks in when I wear my uniform and assume the role of a "nurse". It's almost motherly. It's weird. I just feel this intense nurturing feeling. Protective even. Almost whatever I see becomes a non-issue to me. My patient was puking in a basin and it didn't matter to me. She has MRSA and it didn't prevent me from caring for her. I jumped right in.
Today she was much better. The doctor is just keeping her on Morphine for severe pain and she tolerates that better. She talked with me more, we even traded "diabetic stories" LOL What scares me though is she has severe kidney problems and receives dialysis 3 days a week and her diabetes is better controlled than mine! That really scares me. What kind of damage is occuring to my body even as I type this blog?! I'll get to my issues with the insurance company in a little bit.

The nurses I deal with have been excellent. They compliment me so much and believe me, they can be some bitter bitter people. So I really feel honored. I reported to the pts nurse at one point today and she's like "I love a nurse that's on her toes" LOL Then later on the pt asked the nurse and I how much nurses make. I was like "Well, I'm not a good one to ask because I don't make anything" LOL

Like my other patients, I really enjoyed taking care of her. She was a really great lady. She's been hospitalized for several weeks now and I told her to get better and when I come back in 2 weeks she "better not be here when I get back!" She really laughed about that. She wants out of there so bad. Just wants to get back to life again. That MRSA that you hear about is some ugly stuff. It's treatable, but it's still ugly. She got it in her eye and lost vision in that eye. And now she can't hear on that side either. Bad stuff.

Ok, the insurance company. I was using Accu-Chek but wasn't too happy with it. Bayer sent me a free Ascensia Contour and some strips. I love it! So I called my drs office to call in a prescription for more. These things are 50 for $49. Expensive, especially when the dr wants you to test 4 times a day. With insurance I can get 100 for $30. Good deal. Anyways, the dr calls in the prescription and I get to Kmart and they won't give them to me. Blue Cross had an underuse precaution on me. Apparently I don't test my blood sugar enough. Ugh. Ok don't complain that I don't test enough and then not let me get my strips.

So I go home, call the drs office, and tell the nurse what Kmart and Blue Cross is saying. She thinks it's insane. The next day the nurse calls me. Blue Cross faxed them a form about "will I use more than 100 a month?", "have I used this brand in the last 30 days", etc etc. Turns out BCBS has a contract with Accu Chek (Roche) and they really push Roche products. They don't have a contract with Bayer. It's not a "prefered brand". How much BS is that?! Just let me freaken treat my freaken diabetes before I end up in kidney failure and you have to pay much more for my freaken dialysis! Ass wipes.

Anyways, 3 days go by and I FINALLY get a call from the drs office. BCBS doesn't mind if I get that brand of strips. ARRRRRRRRRRRGH!