Friday, April 29, 2011

A lesson learned

My blood sugars have been creeping upwards lately and that really stresses me out.   I do what I can to stop it from happening which means exercise and reducing carbs.  But, both of those things can only be done to a certain level.  I still have to have some energy for the other parts of my life.

On Wednesday, my fasting was 162 which was shocking.  I spent most of the day feeling sad about it.  Then, it hit me that I have been using the same vials of insulin for awhile.  I'm not really sure how long.  I use such a small dose that they last forever.  And I have 2 pens of Lantus and 2 of Novolog going.  One of each for home and one for away.  So I threw out my home pens.  My BGs improved immediately.  On Thursday, my fasting was 94 and today it was 89.  Amazing.  I now will make it a rule to get out new ones on the first of every month.  The package insert says they should last for 28 days.  It will bother the frugal side of me to throw out so much.  But if it saves me from having sad days over nothing, that's a small price to pay.

Dolly was my own therapy dog on Wednesday.  She is growing up and doing very well with her training.

Saturday, April 16, 2011

Islet cell transplant - Day 1000

Today is my 1000th day since my transplant.  I keep track of this number on my blood sugar logs and this feels like an important one.

Everything is going will with my islets in general, but lately I have been having some problems with getting colds.  Since Feb. 1st, I have had one cold after another.  Sometimes upper respiratory, sometimes GI, and this last one has been both.  To make matters worse, my BGs and insulin needs increase during these bouts.  That makes me worry about my islets.

As of now, I am feeling much better.  My BGs are back to normal and my insulin as of yesterday has returned to 8 units/day which is my normal.  I am blaming it on our lousy weather and the fact that I have to be out in it more to take Dolly out.  I have been recruiting more help with this since my last bout of illness and that seems to be helping.  I think I have developed an actual fear of the cold weather.

Dolly is continuing to do well.  Her housebreaking is almost perfect.  She has learned her "sit" and "down" commands and comes when she is called.  We are working on barking for attention and jumping on people.  She also has shown some submissive/fear behavior with other dogs that we are trying to recondition.  She is very eager to learn and is lots of fun to play with.  She is beginning to get the idea of fetching.

I went to a very interesting lecture this week at the community college where I teach.  The topic was stem cells and the speaker was Arnold Caplan who is the founder of Osiris Therapeutics.  He did a wonderful job of explaining how adult  stem cells are harvested from body sites like bone marrow and fat cells and described the various applications of the products. The harvesting process is similar to that of my islets from the pancreas.  The cells are removed and isolated through centrifugation.  The stem cells are next exposed to specific enzymes that direct which type of tissues they will become.  The cells, called mesenchymal cells, are originally located on blood vessels.  Their function is to repair the vessel if it becomes damaged and to neutralize the immune system so that the repair work will not be compromised.

This topic was extremely interesting to me because I know two people who have had stem cell treatments for their diabetes.  Sandra, whose son had a treatment with stem cells from his bone marrow, and Eliza who had her treatment with her own adipose cells.  Both have had positive results.

I told him about my islet cell transplant and he seemed very interested.  I explained to him that if my islets don't last forever, that maybe stem cells might help.  I asked Dr. Caplan if he thought I had enough of my own islets left to repair and he didn't think so.  I asked about the islet cell pouch procedure which could be loaded with stem cells.  He thought that would probably not be available in time for me.  He did say that he believed that my problem was not my islets dying off, but my long term exposure to the immunosuppressants.  He strongly recommended that I ask my doctors about the possibility of a stem cell treatment.  The stem cells have an immunosuppressive effect and could possibly allow me to lessen my current dose of immunosuppressive drugs.  I said that I would ask about it, and I will.  Now that I have had more time to think about it, I realize there would be complications with doing this.  First of all, it would compromise my data for the study.  I am still committed until my 3 year anniversary which is in July.  Second, how would you calibrate the dosage of either the stem cells or the immunosuppressive drugs?  I would be afraid to risk the possibility of leaving my precious islets unprotected.  I am planning on having this discussion with both my endo here and with the doctors in Minn.  It will be very interesting to see what they think, as always.

The beginnings of Spring!
Hopefully, straight to Summer.

Sunday, April 3, 2011

Dolly- our service dog in training

We are fostering a service dog.  We got her almost 3 weeks ago.  Her name is Dolly and she is doing very well.  She is taking up most of my spare time, but she is cute and its fun to be with her.

Its very different raising a service dog.  There are so many rules that we must teach and enforce that we didn't with any of our other dogs.  Right now, the most difficult rule to teach is keeping her off of the furniture.  It would be easier if we didn't already have Callie who is allowed up on things.  That inconsistency is hard, but what is really difficult is that they play and chase around the house.  Callie escapes to the couch and it seem natural for Dolly to follow.  We're working on that one.

There are several commands that we are attempting for this first month.  She has mastered "come", "sit", and "down".  We are trying to incorporate "lets go", "leave it", and "give" into daily routines.  It will be much easier when this awful weather breaks and we can go on some enjoyable walks.  Several of the commands lend themselves well to walks.  The "give" command should inspire some good fetching.  One of the things we can't do with her is tug of war. Since that seems to be what we do with dogs to play, it has been difficult to interact sometimes.  I'm hoping that the fetching will be fun for both her and us.

Literally everyone who we have told about Dolly asks how we will ever be able to give her up in a year from now.  It will be difficult. Very.  But, even from the get go, she feels somewhat like she already belongs to someone else.  She will have a purpose to her life.  The different rules help to reinforce this feeling.  We are already very attached to her and proud of her.  But someone else will love her and also need her.  I think the one who will have the hardest part dealing with her absence will be Callie.  She can't know of the reasons for her departure.  But, it also may happen that Becky decides to move on in the meantime.  Life is uncertainties.

As for me, I have been getting a few colds this winter.  It began in early February with a chest cold.  I had to take amoxicillin for that.  It lasted most of 3 weeks.  Then I had some stomach problems.  That lasted about 2 weeks.  Then, just last week, I developed an upper respiratory infection.  Just some sniffles and coughing and general tiredness.  I'm feeling much better now, so that one was much easier.  I'm not sure what the difference is this year.  This is the most I have been sick in many, many years.  I usually don't get anything.  I have always credited the flu shots for that. This is more what I expected to happen since I was immunosuppressed.  I don't know if I was just lucky before, or unlucky this year.  My blood sugars almost directly parallel my symptoms which I find even more interesting than frustrating now.  It doesn't bother me so much now that I know it will probably come back to normal.