Not sure what is normal for weight loss at this point. Any ideas on why it has stopped?

[newwomanin2015]

Hello, All,

DS was on 5/27/15. In the beginning, the weight was coming off very well and the surgery really helped with bringing down my blood sugars as have type 1 diabetes. It was wonderful to take much less insulin and to be losing weight. Everything read before the surgery seemed to say that some hit a wall at 6 months after DS and didn't lose any more weight, so wanted to do everything possible on my part to be keep losing since I am in the super morbidly obese category and have a lot to lose.

I was averaging 1.5 pounds a day in the beginning and now, am only averaging .67 pounds a day (58.8 lost/250 excess pounds). It makes sense that it will slow at some point, but am concerned because have not lost anything in three weeks. The last loss was a big one with 6 pounds lost in a week after 3 or 4 weeks of only two pound losses.My goal is to be at 125 pounds lost by the 6 month mark as that puts me at a 30 BMI at the one year mark.

I am eating protein and fat mainly, just like before DS, as my diabetes is managed best through very little carbs. The only carbs eaten are those in eggs,cheese, and the green veggies I eat in small amounts. Recently, have been able to eat salads for the first time and have been able to eat about two cups at a sitting with chicken or steak. From the beginning, I have been surprised that it is rare that food is a problem getting down, and have worried maybe my stomach is bigger than it should be after surgery. I stop eating when satisfied and only have eaten to the point of discomfort a couple of times (it was an accident and didn't realize till feeling the horrible gas pressure).

Pertinent info:

Water intake is about 70 ounces daily.

Bowel movements are very regular, so don't think that is the problem.

Take surgeon's prescribed vitamins without fail 4 times daily (Calcium citrate, 500 iu, plus vitamin D3, 630mg - 2 of these 2x daily; DS multi vitamin - 2 of these daily; Vitamin D3-50, 50,000 iu, once daily; Vitamin A-25, once daily).

Most days, am able to get 65-90 grams of protein without a problem. I have a 3 month check up soon and am wondering if I should request that iron be checked as I have read that can stop weight loss.

Since the surgery, I have been weaker, especially in the legs. For instance, before surgery, I could manage going upstairs to bedroom without hanging onto the railing until the last few steps. Since surgery,I am very weak on the stairs and have to use railing and sometimes opposite wall to help propel myself up the stairs. I thought it would get better eventually, but, it hasn't.

Also, forgot to mention that inexplicably my blood sugars have gone up in the last week or two. So, instead of 75-85, which has been the average, they have been 125-149, and insulin has not been helping with bringing it down like usual.

I don't know what is normal for weight loss, but, at almost the 3rd month mark, it seems like weight should still be coming off well. Anyone seeing something that I am not for what could be the problem?

Thanks to all!

 

[newwomanin2015]

Sorry, equation for weight loss per day should have been: 58.8/87 days. The other one was to determine percentage lost of excess weight, which is 23 %.

 

[southernlady]

Hello, All,

DS was on 5/27/15. In the beginning, the weight was coming off very well and the surgery really helped with bringing down my blood sugars as have type 1 diabetes. It was wonderful to take much less insulin and to be losing weight. Everything read before the surgery seemed to say that some hit a wall at 6 months after DS and didn't lose any more weight, so wanted to do everything possible on my part to be keep losing since I am in the super morbidly obese category and have a lot to lose.

I was averaging 1.5 pounds a day in the beginning and now, am only averaging .67 pounds a day (58.8 lost/250 excess pounds). It makes sense that it will slow at some point, but am concerned because have not lost anything in three weeks. The last loss was a big one with 6 pounds lost in a week after 3 or 4 weeks of only two pound losses.My goal is to be at 125 pounds lost by the 6 month mark as that puts me at a 30 BMI at the one year mark.

I am eating protein and fat mainly, just like before DS, as my diabetes is managed best through very little carbs. The only carbs eaten are those in eggs,cheese, and the green veggies I eat in small amounts. Recently, have been able to eat salads for the first time and have been able to eat about two cups at a sitting with chicken or steak. From the beginning, I have been surprised that it is rare that food is a problem getting down, and have worried maybe my stomach is bigger than it should be after surgery. I stop eating when satisfied and only have eaten to the point of discomfort a couple of times (it was an accident and didn't realize till feeling the horrible gas pressure).

Pertinent info:

Water intake is about 70 ounces daily.

Bowel movements are very regular, so don't think that is the problem.

Take surgeon's prescribed vitamins without fail 4 times daily (Calcium citrate, 500 iu, plus vitamin D3, 630mg - 2 of these 2x daily; DS multi vitamin - 2 of these daily; Vitamin D3-50, 50,000 iu, once daily; Vitamin A-25, once daily).

Most days, am able to get 65-90 grams of protein without a problem. I have a 3 month check up soon and am wondering if I should request that iron be checked as I have read that can stop weight loss.

Since the surgery, I have been weaker, especially in the legs. For instance, before surgery, I could manage going upstairs to bedroom without hanging onto the railing until the last few steps. Since surgery,I am very weak on the stairs and have to use railing and sometimes opposite wall to help propel myself up the stairs. I thought it would get better eventually, but, it hasn't.

Also, forgot to mention that inexplicably my blood sugars have gone up in the last week or two. So, instead of 75-85, which has been the average, they have been 125-149, and insulin has not been helping with bringing it down like usual.

I don't know what is normal for weight loss, but, at almost the 3rd month mark, it seems like weight should still be coming off well. Anyone seeing something that I am not for what could be the problem?

Thanks to all!

1) STAY off the scale. When was the last time you almost 60 lbs in three months? Don't bet yourself up but ALSO do not give yourself unreasonable goals (like the having lost 125 lbs by 6 months). What will you do if you only lose 120? Consider yourself a failure? NOT logical. Whatever you lose in however long it takes will be how YOU lose weight. Some lose steadily, some stair step.

2) The vitamins your surgeon has recommended is just the tip of the iceberg for a DS. See the thread here for what to start with until you get bloodwork post op and can adjust based on your post op labs: http://bariatricfacts.org/threads/vitalady-links.11/

3) At 3 months out, you are still recovering from major surgery. I didn't turn the mark on energy until after three months. Then I was leaving people in the dust.

4) You need a minimum of 90 grams of protein by the three month mark. You will need round 120 grams by month 4. And I notice you didn't mention how much fat or carbs you are ingesting.

5) As a type 1, you will always need insulin. Are you eating small amounts every two hours? And your carbs need to be ones that do not raise your blood sugars. Are you doing multiple daily injections or are you on an insulin pump? I don't know if you have ever read about Dr. Richard Bernstein, a type 1 endo.

What did your pre-op labs look like? If you were low on ferritin, then yes you do need it checked now as I don't see you taking ANY iron at all except the stuff in the multi (which is the wrong type of iron anyway for us).

But the bottom line is DO NOT beat yourself up. The scale is a lousy way to judge your progress.

 

[Larra]

Stalls happen. Most of the time we don't know why. I wish it were otherwise.
Not meeting goals also happens. I had a goal of losing 100 lb in the first 6 months. Close, but no cigar. But you know what, it all worked out just fine eventually.

Be patient with yourself. You have lost a huge amount of weight in a short period of time. Maybe your pcp could refer you to a physical therapist to work on leg strengthening. You may be losing some muscle in those lbs. lost.

 

[star0210]

i think you're doing great....and I appreciate all the detail you provided.
Are you tracking everything you eat? Do you know how much fat you're getting in? sounds like you're doing great on the carb front.
Just keep working it and it will come off.

 

[newwomanin2015]

Thank you for your response and all of this great information! Honestly, I am not beating myself up so much as trying to watch what is happening in order to make changes if necessary if weight loss is not progressing.

1. In the past, back when this body was still able to lose weight through diet and exercise, only could lose about 36 pounds in 3 months, so being able to lose 60 in that time has been wonderful. The problem in my life always was at some point it would stop and start to come back, plus more weight. At various points, have lost 133, 90, 124, etc. through diet and exercise, but, at some point, losing would stop and the weight would come back, plus more. Once, even had no life because was exercising 2 to 3 hours a day 6 days a week to try to stop the gain back. Wish there was a way to travel back to high school self and tell her to just live with being 215 pounds and don't diet as dieting got me to this size. A few years ago, weight would not come off no matter what so I just focused on eating healthy and stopped trying to lose.

Since surgery, I get on the scale once a week so if something changes, I will be aware and hopefully, can try to address it. There is a lot of distrust of my body as it seems to find a way to get it back and am determined to try to stay on top of it. Mostly, don't care about the pounds as much as the percentage of excess weight lost, and am at approx 23 % right now, which is on track. 120 pounds wouldn't bother me as it would be close enough to the 50% mark. Have researched that liver can affect results, and cause some to stop after 6 months. However, pre-op tests said my liver was very healthy (that was a big surprise for me and surgeon). Low iron was mentioned as another possibility of stopped weight loss at 6 months, so want to talk to surgeon about getting that checked now. It's good to know that some folks stair step, so maybe weight loss has changed from steady loss to stair stepping at this time. Biggest fear is that I will be one of the unfortunate ones that stop losing at 6 months or sooner as some do.

2. I will research the vitamins link you were kind enough to provide. Dr. Ayoola's recommended multi vitamin is Dr. Stewart's formula (my surgeon was Dr. Ayoola) and is supposed to be formulated specifically for DS patients. However, each person is different, and am not sure if diabetes affects this as well. I need to get more educated on vitamin needs as have been just following the surgeon's recommendations. Pre-op labs just showed being low on vitamin D, so had to take that prior to surgery.

3. I love Dr. Bernstein and have been following his eating plan for years now. His recommendation on pumps is that you can do it if you want, but, that if you follow his plan, you are, in effect, doing the same thing as the pump.I chose not to do the pump, but, follow his plan and do take multiple injections through the day. All carbs raise blood sugar, but, follow his adjustments for how much insulin to take for both protein (which also raises a type 1's blood sugar, just not as much) and carbs. As per his plan, never eat more than 6 grams of carbs at breakfast, 12 grams at lunch and 12 grams at dinner and only eat acceptable carbs from his plan, which means counting those in eggs, cheese, and green, non-starchy, veggies. Since the surgery, I have less carbs than that most days as the bigger concern is getting the protein and fat in, so may have a 1/3 to 1/2 cup of cooked broccoli (green beans, etc.) with dinner or a few baby kosher pickles with lunch, but, other days may not have a vegetable at all.

It is difficult with work schedule to eat every couple of hours, but, do have a snack of meat or cheese most days at 10:00 AM between breakfast at 7:30 and lunch at 12:30. Also, if schedule allows, have one in the afternoon at 4:00 before dinner at 6:30.

Since surgery,blood sugars finally have been much easier to manage, which has been such a gift! Before, I was constantly fighting lows and highs and it was difficult to maintain an HgA1C between 7.5 and 8. Now, after only 2 months of post-surgery sugars, HgA1C was 6! Insulin is both a necessary good and a necessary evil in my life because as endo put it years ago, I am a type 1 living in a type 2 body. The bigger body requires more insulin as it is not absorbed properly. However, while higher blood sugars make it much harder for the body to lose weight; more insulin also makes it harder for the body to lose. It is like being in the center of a teeter totter and trying to keep it balanced. Until recently, blood sugars have been right where I want them, between 70 to 80, even in the morning, which are usually higher. It is concerning that they are starting to get higher and am seeing more 110 to 125's while eating the same amount of food. This also could be affecting lack of weight loss, and am not sure why this early on in the game blood sugar control is lessening.

Am not sure how else to judge progress other than blood sugar control, which is lessening, and weight loss, which seems to be stalling, and am just trying to play detective to see if there is anything I can do to be proactive in getting both back on track. Thanks again for the great information and also for sharing about not getting your energy back till after the 3 month mark. I will look forward to that and legs getting back to normal!

 

[newwomanin2015]

Ugghh, really need to figure out how to do these reply's correctly! Was trying to reply to Southern Lady, but it doesn't look like it was replied specifically to her. Am a newbie to forums, as well as DS, can you tell!?!?

 

[newwomanin2015]

Stalls happen. Most of the time we don't know why. I wish it were otherwise.
Not meeting goals also happens. I had a goal of losing 100 lb in the first 6 months. Close, but no cigar. But you know what, it all worked out just fine eventually.

Be patient with yourself. You have lost a huge amount of weight in a short period of time. Maybe your pcp could refer you to a physical therapist to work on leg strengthening. You may be losing some muscle in those lbs. lost.

Thank you for your response! Think I will take that advice and ask about a physical therapist because even with being so large have never had weak legs like this. It's great you met your goal and really hope to do the same. Starting at 430, they said it may only be possible to get to 220. 180 would put me at a 30 BMI, which have read is what I should be aiming for. The last weight I felt really good, strong and healthy at was 200, so that is personal goal, and anything after that is a bonus.

Did you stall for 2 to 3 weeks sometimes during your journey? Did you do anything to change it, or, did you eventually just start losing again?

 

[newwomanin2015]

1) STAY off the scale. When was the last time you almost 60 lbs in three months? Don't bet yourself up but ALSO do not give yourself unreasonable goals (like the having lost 125 lbs by 6 months). What will you do if you only lose 120? Consider yourself a failure? NOT logical. Whatever you lose in however long it takes will be how YOU lose weight. Some lose steadily, some stair step.

Thank you for your response and all of this great information! Honestly, I am not beating myself up so much as trying to watch what is happening in order to make changes if necessary if weight loss is not progressing.

1. In the past, back when this body was still able to lose weight through diet and exercise, only could lose about 36 pounds in 3 months, so being able to lose 60 in that time has been wonderful. The problem in my life always was at some point it would stop and start to come back, plus more weight. At various points, have lost 133, 90, 124, etc. through diet and exercise, but, at some point, losing would stop and the weight would come back, plus more. Once, even had no life because was exercising 2 to 3 hours a day 6 days a week to try to stop the gain back. Wish there was a way to travel back to high school self and tell her to just live with being 215 pounds and don't diet as dieting got me to this size. A few years ago, weight would not come off no matter what so I just focused on eating healthy and stopped trying to lose.

Since surgery, I get on the scale once a week so if something changes, I will be aware and hopefully, can try to address it. There is a lot of distrust of my body as it seems to find a way to get it back and am determined to try to stay on top of it. Mostly, don't care about the pounds as much as the percentage of excess weight lost, and am at approx 23 % right now, which is on track. 120 pounds wouldn't bother me as it would be close enough to the 50% mark. Have researched that liver can affect results, and cause some to stop after 6 months. However, pre-op tests said my liver was very healthy (that was a big surprise for me and surgeon). Low iron was mentioned as another possibility of stopped weight loss at 6 months, so want to talk to surgeon about getting that checked now. It's good to know that some folks stair step, so maybe weight loss has changed from steady loss to stair stepping at this time. Biggest fear is that I will be one of the unfortunate ones that stop losing at 6 months or sooner as some do.

2. I will research the vitamins link you were kind enough to provide. Dr. Ayoola's recommended multi vitamin is Dr. Stewart's formula (my surgeon was Dr. Ayoola) and is supposed to be formulated specifically for DS patients. However, each person is different, and am not sure if diabetes affects this as well. I need to get more educated on vitamin needs as have been just following the surgeon's recommendations. Pre-op labs just showed being low on vitamin D, so had to take that prior to surgery.

3. I love Dr. Bernstein and have been following his eating plan for years now. His recommendation on pumps is that you can do it if you want, but, that if you follow his plan, you are, in effect, doing the same thing as the pump.I chose not to do the pump, but, follow his plan and do take multiple injections through the day. All carbs raise blood sugar, but, follow his adjustments for how much insulin to take for both protein (which also raises a type 1's blood sugar, just not as much) and carbs. As per his plan, never eat more than 6 grams of carbs at breakfast, 12 grams at lunch and 12 grams at dinner and only eat acceptable carbs from his plan, which means counting those in eggs, cheese, and green, non-starchy, veggies. Since the surgery, I have less carbs than that most days as the bigger concern is getting the protein and fat in, so may have a 1/3 to 1/2 cup of cooked broccoli (green beans, etc.) with dinner or a few baby kosher pickles with lunch, but, other days may not have a vegetable at all.

It is difficult with work schedule to eat every couple of hours, but, do have a snack of meat or cheese most days at 10:00 AM between breakfast at 7:30 and lunch at 12:30. Also, if schedule allows, have one in the afternoon at 4:00 before dinner at 6:30.

Since surgery,blood sugars finally have been much easier to manage, which has been such a gift! Before, I was constantly fighting lows and highs and it was difficult to maintain an HgA1C between 7.5 and 8. Now, after only 2 months of post-surgery sugars, HgA1C was 6! Insulin is both a necessary good and a necessary evil in my life because as endo put it years ago, I am a type 1 living in a type 2 body. The bigger body requires more insulin as it is not absorbed properly. However, while higher blood sugars make it much harder for the body to lose weight; more insulin also makes it harder for the body to lose. It is like being in the center of a teeter totter and trying to keep it balanced. Until recently, blood sugars have been right where I want them, between 70 to 80, even in the morning, which are usually higher. It is concerning that they are starting to get higher and am seeing more 110 to 125's while eating the same amount of food. This also could be affecting lack of weight loss, and am not sure why this early on in the game blood sugar control is lessening.

Am not sure how else to judge progress other than blood sugar control, which is lessening, and weight loss, which seems to be stalling, and am just trying to play detective to see if there is anything I can do to be proactive in getting both back on track. Thanks again for the great information and also for sharing about not getting your energy back till after the 3 month mark. I will look forward to that and legs getting back to normal!

 

[southernlady]

Ugghh, really need to figure out how to do these reply's correctly! Was trying to reply to Southern Lady, but it doesn't look like it was replied specifically to her. Am a newbie to forums, as well as DS, can you tell!?!?

You don't have to reply directly too me, I knew you were, LOL
As Larra said, stalls happen. The 3 week stall is infamous. But stalls at other times are very common. It's your body's way of adjusting to what it is doing.

The rise in blood sugars, well, that is something different. Are you prone to Dawn Phenomena? I am...still am even now. Maybe your endo will have some ideas.

I was a type 2 but have a type 1 daughter (who also has the type 2 weight gain). Until I had the DS, I was on an insulin pump after trying MDI. And you could not have pried the pump out of my cold DEAD hands...but the DS freed me. While insulin is a given for you, a pump would make it easier. How it was explained to me is the basal of the insulin pump mimics the pancreas action of being there ALL the time and putting out just a tiny bit every few seconds. My daughter has had a pump since she was 14 (she's 30 now) and as long as she covers her carbs and WATCHES what she eats, her blood sugars stay fine and she has avoided the damage that diabetics are prone to developing.

Also age comes into play. I am 61, my PCP is fine with a 6 A1C at my age and my morning blood sugars are usually between 95-110. I've been insulin AND metformin free since right after my surgery. But the lowest A1C I have seen has been a 5.9. And my lowest fasting glucose has tested at 105. When asked if I have diabetes, I still say yes but diet controlled.

 

[newwomanin2015]

i think you're doing great....and I appreciate all the detail you provided.
Are you tracking everything you eat? Do you know how much fat you're getting in? sounds like you're doing great on the carb front.
Just keep working it and it will come off.

I track the protein as already know am not taking in too many carbs as that was being done even before surgery. The fat is harder to track. I don't really worry about it, but, also do not know exactly what am getting, either. If meat is drier, I do as surgeon suggested and eat with mayo or butter. If I have broccoli with dinner, it also is eaten with butter. Since the surgery, have noticed a preference for fattier meats, like bacon, and always want the part of the steak that has the fatty edge on it,and order chopped steak at restaurants. Am not liking chicken or tuna as much as I used to, even with the mayo. Spam got me through the beginning regular food phase and still will have that for breakfast if no crust-less spinach or broccoli quiche has been made that week. Also, I put heavy cream in the two small cups of coffee I drink daily so that should give some fat, too.

Do you have a good counter you can recommend? I would like to start tracking protein on my phone so that I don't have to write it down during the day and that probably will help with keeping track of the fat, too.

 

[southernlady]

Do you have a good counter you can recommend? I would like to start tracking protein on my phone so that I don't have to write it down during the day and that probably will help with keeping track of the fat, too.

Most use My Fitness Pal, that's the one most use. Adjust it to YOUR amount of macros (protein/fat/carbs) and IGNORE the calories. With all the fat we eat, we make it crazy.

 

[newwomanin2015]

You don't have to reply directly too me, I knew you were, LOL
As Larra said, stalls happen. The 3 week stall is infamous. But stalls at other times are very common. It's your body's way of adjusting to what it is doing.

The rise in blood sugars, well, that is something different. Are you prone to Dawn Phenomena? I am...still am even now. Maybe your endo will have some ideas.

I was a type 2 but have a type 1 daughter (who also has the type 2 weight gain). Until I had the DS, I was on an insulin pump after trying MDI. And you could not have pried the pump out of my cold DEAD hands...but the DS freed me. While insulin is a given for you, a pump would make it easier. How it was explained to me is the basal of the insulin pump mimics the pancreas action of being there ALL the time and putting out just a tiny bit every few seconds. My daughter has had a pump since she was 14 (she's 30 now) and as long as she covers her carbs and WATCHES what she eats, her blood sugars stay fine and she has avoided the damage that diabetics are prone to developing.

Also age comes into play. I am 61, my PCP is fine with a 6 A1C at my age and my morning blood sugars are usually between 95-110. I've been insulin AND metformin free since right after my surgery. But the lowest A1C I have seen has been a 5.9. And my lowest fasting glucose has tested at 105. When asked if I have diabetes, I still say yes but diet controlled.

Oh, that is wonderful that you are able to control your diabetes now through diet! Seriously, am very happy for you! Since the surgery, have been able to control mine on about 1/5th of the insulin I was taking (except for the last couple of weeks when it is inexplicably risen).

You have got me reconsidering about the pump since you and your daughter have had such good results with it. The concerns I had with a pump were varied. As a really large woman, was worried about it getting pulled out by being caught on something or getting caught in a fold of fat, or not having a place to put it without it interfering with something else, such as the steering wheel when driving. Also, worried about pulling it out when rolling over when sleeping. I do like all have heard about it from the perspective of the really tight control because that is my goal...the tighter the better, and have had that for the most part since the surgery. The constantly battling the highs and lows, even with following Bernstein's plan and multiple injections was taking more of a toll than I realized because have felt so much better since having the control, not so irritable. Did you have any trouble with yours pulling out?

From what I've read, it uses either the fast acting insulin or regular acting insulin and the long acting insulin. I wonder if there's a way to do both R insulin and Humalog as that is what have been doing for years. The Humalog is the fast acting taken in small amounts for corrections, and the R is the regular acting I take with food. The insurance doesn't recognize this way of doing it that Bernstein recommends for those of us who have slow emptying stomachs, so have to pay for the R myself, but, I don't mind since it is so cheap and can be bought over the counter here. Before, when taking the Humalog for food, it was out of my body too quickly before the food was digested. Also, I adjust insulin for basic protein eaten, too, according to Bernstein's method, will have to see if there is a way to adjust pump according to that, too. Definitely have some questions for endo next time I see her. Maybe being on the pump takes away the need for correction insulin and only the regular and long acting would be necessary?

I did have the Dawn phenomena for a long time, but, haven't had it since changing to his method. Also, had the Somogee effect (hope that is spelled right) for a long time and still struggle with that occasionally, where my sugars drop low in the middle of the night and then, rebound high in the morning. Thank God husband has woken up to find me a sweaty mess at 3 AM and has been able to wake me for gluclose tabs most of the time, and once or twice has had to give the glucagon shot. Since the surgery, have woken with low sugars when alarm has gone off a few times, but, did not have it rebound to a high blood sugar. For some reason, am functioning better when going low these days, woke up with 48 recently and felt fine. Not sure if this is good or bad. I need less insulin in the AM and usually take only long acting before breakfast now since I was going low before lunch, and only need the R with lunch and dinner now.

I am 50 and you're right about age playing a part as well as how long you have had it, and Lord only knows how many other factors there are! My mother-in-law is about my size and has had type 2 for about 7 years, but, her's is so easy to manage. She takes very little medication, eats carbs, including things like donuts and has never had an HgA1C over a 5. A woman I used to work with used to eat bagels or donuts for breakfast every morning and told me hers was never above a 5. Meanwhile, eventually mine got to where even the supposedly better for you carbs like kidney beans, etc. send my blood sugars skyrocketing. Yes, I acknowledge the jealousy! It seems like diabetes can be so variable from one person to the other. I am glad in some ways though, that it forced me to change my diet because getting rid of all carbs except for green veggies really helped with losing the almost constant hunger I used to live with constantly. The surgery made it easier to ignore treats others had at work, like donuts, etc. because wasn't hungry with protein, but, would REALLY want all the stuff others had that I couldn't. So far, a lot of that is not appealing anymore.

By the way, you're explanation of the pump was better than the one my old endo in Illinois gave a few years ago, he had said you had to push a button every time you needed insulin and I didn't see how that was very different from taking the shot. Your explanation, if I'm understanding you right, sounds like at least some of it (long acting, am guessing) is constantly trickling into your body. Then, am guessing again you would need to push the button for the correct dosage of the shorter acting or fast acting.

Thank you for your response and will be talking to endo soon about this.

 

[newwomanin2015]

Most use My Fitness Pal, that's the one most use. Adjust it to YOUR amount of macros (protein/fat/carbs) and IGNORE the calories. With all the fat we eat, we make it crazy.

This cracked me up...the idea of your poor little My Fitness Pal getting frustrated with all the fat! What is she DOING!?! lol! A few of my co-workers have had similar responses and have given up on trying to explain the whole fat not being a problem thing.

 

[southernlady]

The concerns I had with a pump were varied. As a really large woman, was worried about it getting pulled out by being caught on something or getting caught in a fold of fat, or not having a place to put it without it interfering with something else, such as the steering wheel when driving.

My daughter wears hers on her belt like a phone. To my knowledge, she has never pulled it loose. And she has a 3 year old underfoot now who pulls at everything EXCEPT his mommie's pump.

I never caught mine either...part of it was it was always under my clothes. The ONLY time I wasn't wearing the pump was in the shower/pool or when changing the reservoir. The nice thing is even if my endo wasn't available for an emergency, the team at Animas ALWAYS had a nurse available who know about insulin pumps and could help.

I wore mine in a holder that hid around my bra pretty well. I used a white one, it velcroed at each end with a pouch that help the pump itself. I used an Animas pump and got the holder from them. Mine was called a Waist-It. Other companies have similar items. I actually wore it up right AT my bra line and tucked the pump in between. Only if you knew something was there, did you even notice it. Some people use the thigh. I wass never one to poke my thigh. So I used my stomach rotating sides. The ONLY time I used my thigh was the day I got my DS...and yes, I wore it into the OR! My surgeon knew it was there. I actually had three of the Waist-It's, cause like bras, they get sweaty and need washing.

Your explanation, if I'm understanding you right, sounds like at least some of it (long acting, am guessing) is constantly trickling into your body. Then, am guessing again you would need to push the button for the correct dosage of the shorter acting or fast acting.

Okay, pumps use only one insulin. The short acting. It is like a drip system...very small drips of short acting all the time with a bolus added for food depending on your carb count. When I first went on insulin, my basal was about 40 units basal a day broken into .025 units a min. My bolus (for food) was 1 unit for every 10 carbs. When I went into surgery and was NPO for many hours, my endo would have me drop the basal to .010 depending on how long I was without food.

Think of it this way...a normal functioning pancreas is always producing a very tiny amount of insulin for the body. The pump is the closest to that you can get without a pancreatic transplant.

Actually, as a type 2 I was VERY fortunate to be able to even get an insulin pump as they are typically reserved for type 1's by most insurance companies. The fact that while on MDI, I landed in the ER with a blood sugar of 26 is what got me mine. I was on my husband's company insurance as primary back then. Now I am on Medicare and would have had to give up my insulin pump as Medicare ONLY covers it for type 1's. Or find the $1000's of dollars for supplies.

Before, when taking the Humalog for food, it was out of my body too quickly before the food was digested. Also, I adjust insulin for basic protein eaten, too, according to Bernstein's method, will have to see if there is a way to adjust pump according to that, too. Definitely have some questions for endo next time I see her. Maybe being on the pump takes away the need for correction insulin and only the regular and long acting would be necessary?

It doesn't eliminate the need for corrections. But it does make them less likely. As to the humalog you bolus, you literally hit the buttons to deliver that AS you sit down to eat...and you CAN have it be delivered over 15-30 mins if you want it delivered that way.

I did have the Dawn phenomena for a long time, but, haven't had it since changing to his method. Also, had the Somogee effect (hope that is spelled right) for a long time and still struggle with that occasionally, where my sugars drop low in the middle of the night and then, rebound high in the morning.

Do you eat a bedtime snack of protein/fat/carbs? Obviously more protein/fat but need a small amount of carbs, like 5-10. Peanut butter with ONE cracker was always the option discussed on the diabetes lists when middle of the night lows were discussed. It seems to help the rise/fall of blood sugars.

After I had my DS, I remained on my insulin pump one more week. When I woke up in the middle of the night with blood sugars in the 50's, I knew it was time to come off my pump. I was chasing blood sugars the wrong way down the train track! So I unhooked it, took the battery out and put it away. I used shots with the humalog for another 10 days when my blood sugars got over 140. Last insulin was 11 Feb 2011. But I didn't give away my unused/sealed insulin and unused insulin pump supplies until a month later. Gave them to an endo so they could use them for their patients who needed help with supplies due to insurance issues. Btw, I still have my pump as a reminder of where I was.