Small Update

Today I had another paracentesis. I REALLY should have done 5 days, instead of 7. By day 6 I was miserable. My belly was so full it was next to impossible to even take my meds, and I even threw up some of my medications.

Anyway, today they drained 6L, that’s just about 1.5 gallons. 1 liter of fluid (water) weighs about 1 kilogram (2.2 pounds). I was carrying around 13 extra pounds!

I am working on lowering my glucose and increasing my fats. It should be a lot easier now that my belly isn’t stuffed with un-necessary fluids.

Mid-week, Week 2 on Piqray

Glucose seems to be doing relatively well. Today I saw a peak of under 105 and a low of about 70. That’s pretty good compared to a week ago. I’m thinking of asking for another fasting insulin test, just to see if its still high. I’m wonding if (especially if its still high) that’s what’s dropping my ketones. I’m having trouble getting them above 0.6 at 24 hours fasted. I am thinking of doing a 48-hour fast (with eating some pepperoni and cream cheese at 24 hours – since I have to have some food with my meds) to see if I can kick things into gear again. I’d love to drop my peak glucose about 20 points, and the lower end around 10. My “ideal” range used to be under 100, with under 90 being common. I’d sure like to get back to that. I’m not really stressing on the low ketones. Maybe I’ll move taking the supplements from in the morning and at night to morning and afternoon, and see if that makes a difference. They are kinda expensive, so I want to make a bottle last as close to a month as I can.

Next Steps

So, I had an appointment with the NP who works with my doctor today. Things are going forward with the plan we already had in place. That is to say, start the Piqray. Now, the “Big 3” side effects of Piqray are:
1) High blood sugar
2) Rash
3) Diarrhea

The treatments are fairly simple. To treat the high blood sugar (non diabetics have had sugar levels in the 300-400+ range) Metformin is given. Now, Metformin is a generic name for the medication. The brand name is Glucophage, which I like. If you don’t know what it means, it is: gluco (sugar/glucose) and phage (from Greek: eating), or at least from as far as I can determine that’s what it means. Like how autophagy means “self-eating”

To treat rash, Claratin (Loratadine) is given preventatively.
To treat diarrhea, Imodium is recommended, as needed, but not proactively.

I am currently wrapping up a 72 hour fast, as I type this, with about 2 hours or so to go.

Fasting graph, for this 72hr fast (not quite completed)

I’m thinking that my numbers, while great, are not as slow as they have been on long fasts because I was not drinking green tea (unsweetened).

After this, I’m going to keep a close eye on my glucose, via the CGM and fingersticks, as I’m starting my new medication. I’m hoping that I am one of the few that don’t need Metformin. But I plan to track my glucose first, to see what it does, and then take the Metformin only if necessary. Because I have a CGM and do fingerstick tests I can easily keep on top of it, rather than just waiting for a week to do my labs.

On a side note, the pharmacy that supplies the Piqray sent a nice welcome kit. It’s far better than the kit I got with anything else!

Welcome Kit

Stay tuned for updates as to what my glucose does!

Pumpkin Muffins

So, a few weeks ago my kids took a trip to a farm and brought back pumpkins. My son brought home a rather large one. After letting it sit for a long time we finally decided to do something with it. I found this yummy looking recipe for cream cheese pumpkin muffins (see below). We made them and they were very yummy. Normally I only eat one meal a day, but today I decided that I’d have one with my son (the day after baking). I was pleased to see that so far it has had minimal impact on my glucose (these are very low carb, but high in fat).

My glucose went from 76 (before eating) to 81 (an hour later) to 74 (two hours later). That small of a rise is barely a blip, just within normal fluctuations. I’m happy that I was able to share a treat with my son without it doing anything major to my glucose 🙂

Accidental Sugar Consumption

So, I was given some tea that I didn’t realize didn’t have sugar-free flavoring in it, and NO, it did not taste sweet, so there was no reason to think something was off.

I called the store to ask about it, and the drink I had had about 27g of sugar (carbs)!

Yikes!

Unfortunately, my body decided to reject the FreeStyle Libre sensor (I replaced it and then called in the morning about it), so I had to resort to many fingersticks to track my glucose. And yes, I was not feeling great. I was feeling flushed, and a general sense of being warm. Also, my blood flow was fast (tends to happen with me when body is warm or glucose is high).

This is what my glucose looked like. I went from a very nice and respectable 65 to a shocking 147 as a high, only 1 hour and 15 minutes later. Almost 5 hours after eating my glucose was finally down to 84. That took way too long. And my glucose is finally starting to get back into my normal range for the day.

PET Scan day

Had my PET scan today. They didn’t like that my glucose was 65 before the scan. The radiology tech had to call the doc to confirm it was OK to do the scan. Its actually a bit low, by a few points (they want a minimum of 70). They actually wanted me to drink some juice after, which I declined, saying that I don’t do juice or sugar. They were concerned that I would pass out on the way home. They don’t get that I run on ketones (maybe I should make a shirt that says that :smiley: )

The blue line is yesterday (when I broke my fast at supper). The red line is today, I’m kinda surprised at how my glucose shot up after waking. I expected it to come back down, but didn’t think it would dip under 70. I do expect it to be a bit weird today, and maybe tomorrow as I eat again.

Fast #3 – Sept 19 thru Sept 22

So I recently undertook another 72 hour fast.  From what I’ve read fasting can be a good thing for the body, as it gives the body a chance to recycle and get rid of broken and dying cells.

In the graph below the blue line is September 19th, when I had dinner and started my fast.  As you can see, my glucose was up and down a bit, but didn’t go higher than 95mg/dL.  I’m not sure why it went as low as 40, but it could have been something going on with the sensor, based the levels before and after that reading.

Continue reading Fast #3 – Sept 19 thru Sept 22

Camp Wieser 2019 – Part 1 (food and glucose)

So, I’m back from my weekend retreat.
It was a great experience, and very relaxing. My children also had lots of fun.

The food wasn’t the best for someone eating keto, but it was manageable. I’m now back to eating my normal keto foods (as soon as I get some shopping done).

I had lunch on the road on Friday the 13th (I had a bacon-avacado burger at a small diner). Dinner was salad w/ some kalua pork. I’m thinking it wasn’t the best meal, based on how my glucose reacted. Glucose went down and then waaaaaay up (for me).

On Saturday I skipped lunch (it wasn’t looking very keto anyway) and just had supper. I didn’t have any ketoaide with me, or much sugar-free powerade, so I think I was lacking salts. I was trying to stay hydrated, but don’t think I did well with it. Dinner was yummy (they had some sauce free ribs, yay!) that I put my own sugar-free sauce on (and used my own Primal Kitchen salad dressing). My glucose did fairly well with the Saturday supper, the only thing was I ended up puking several hours later. I had been feeling a bit nauseas earlier, but was trying to stay hydrated.

Yesterday I had lunch and dinner on the road. Lunch was late in the afternoon, 3:30ish and supper was about 5 hours later. So that meant that my glucose didn’t have a lot of time to come back down after eating lunch before I ate more food again.

Today I’m back to only eating supper, drinking green tea, and such. I’m not sure why my morning glucose was so high, but it could have to do with being thirsty or not sleeping well (I’m not saying they are causative, but correlative). My glucose seems to trend higher when I don’t sleep as well (I guess its like mini roller-coaster dawn phenomena?).

Fasting Success

Recently I undertook a 72-hour fast.  The results were as I expected, and I was able to monitor my glucose with a flash monitoring system.  This is a bit different from a continuous monitor in that the device doesn’t send data directly.  The sensor has to be scanned to pick up the recorded readings.

This chart shows my glucose over the day, from the 22nd (when I ate dinner) to the 25th (when I ate dinner).  I did not eat on the 23rd or the 24th.

You can see that each day when I was fasting my glucose was lower, overall, than the day before.  Because I am eating ketogenic my body produced ketones to compensate for the low glucose in my system.  This is perfectly safe and normal for someone who is fat-adapted (able to use fat to fuel the body, and produce ketones).  I ate supper around 8:30pm on the 25th, so that is why my glucose started going up then.

This chart shows data from 7pm when I ate dinner on the 22nd (blue line) through when I had dinner on the 25th (green line), and then until I woke up to start my day on the 26th.  This was mostly to show that my glucose went back up after eating.

I do want to say that I did not feel any typical symptoms of hypoglycemia, and I was monitoring my ketones.  I actually felt pretty good, and was able to keep up with my normal activities.