Karen Jensen, RD

Hi everyone!

I have wonderful news. After about a month of studying...I'm a Registered Dietitian! HOORAY! I've wanted this so, so bad for 9 years and it's finally here. I cannot get over it.

I literally screamed and hugged the test center's proctors when I saw this.

Now I am just searching for my perfect job...I suppose that will come with time!

In the mean time, I'm interning with a great diabetes company (YAY), running, hiking, cooking, and enjoying the life of unemployment. =)

Here are some photos I've documented during my 2 months of unemployment adventures.

Hiking Sleeping Giant with my dog, Willow

Hiking at Gillette's Castle with my sister, Christi

Hanging out at the gym with Christi. Isn't she perrrrdy?

Diabetes-wise, I'm doing FANTASTIC. I've cut my total daily dose from ~60 units back in August to ~30 units today. Before I moved back home, I was so used to seeing 200s on my meter screen ALL THE TIME...not anymore! Back in the wonderful 70s-150s. LOVE IT! I'm battling a bunch of lows, but that comes with adding physical activity back into my daily routine....bring on the starburst and glucose tabs. I love the way I feel right now!

One More Step!

Well, I’m officially done with my dietetic internship! It sounds so weird to say this. My 9-year dream of helping other people with diabetes is almost a reality. I remember being in high school and researching accredited nutrition undergrad programs...and I made it through an intense, 11-month, clinical internship in the big city. Just one exam keeps me from using the “RD” after my name! AHHHH! Now that I’m all moved out of NYC and back in CT, I’ve been trying to get back into a routine. My days consist of studying, taking care of the dogs, going to the gym….and battling a bunch of low blood sugars. It’s amazing how shift in routine can completely change your blood sugar. I remember going through this same battle one year ago when I moved to New York.

Accepting my diploma!

86th Class of the NewYork-Presbyterian Hospital Dietetic Internship!

As mentioned in previous posts, I battled some high blood sugars and weight gain earlier this year. I started running (and eating less frozen yogurt) in probably about May. Since then, I’m happy to say I’ve lost 8 pounds! 5 more and I’ll be at my more normal weight! I’m even happier about my awesome blood sugars. I really started cracking down on my lifestyle changes earlier this month and have seen SUCH an improvement. My wake-up numbers are usually below 100 mg/dL and I’m hovering in the 100s pretty much all day. I’m also in the process of getting my Dexcom back! WOOOOHOOO. No more clunky old CGM….I LOVE the look of their sleeker version!!

At the gym with my best friend!

Survived a run around my neighborhood. Stored some emergency candy in my bra.

Not only have I been working on getting back in shape and improving my health, I’m also working on a couple SUPER COOL diabetes fundraisers, including an educational event in NYC! It is such an honor to be helping out… I really hope I can start sharing more about this incredible event.

A Best Friend, A Support System

Today I'm writing about how important it is to have a solid support system in your diabetic life...actually life in general.

When I moved to the city, I made some good friends. I also made a best friend. Not only were they fun to be around and talk to, they became such an important part of my life. From the beginning, I valued our friendship. I guess I really began to realize how special this person truly was the day I figured out they were so interested in my diabetes. This person learned more about diabetes than I ever would have asked anyone to. One day, they just came out and told me what beta cells were...I was so impressed. Soon after, they learned how to test my blood sugar...what a good number was...what a bad number was...how to inject glucagon. They even let me insert a pump site into their stomach just so they knew how it felt.

Up until I met this person, I never really thought about how much I appreciate people taking the time to learn about diabetes. Not only learn about it, but truly understand all the of annoying-ness, pain-in-the-butt, craziness that comes along with it. As soon as I realized this person was doing that, I became even more thankful for having them in my life. I am SO LUCKY.

In the end, this person became my support system. Sure, I have my mom and sister at home, but this person was my NYC support system for life and diabetes. I cannot begin to explain how much this has meant to me. This person needs to know that they are so, so special. I was able to count on them to listen to all of my diabetic problems. They offered me support, advice, and inspiration. They made my life in the city ten times easier and I love them for that. They may not know it yet, but I know they will do great things and help so many other people.

This relationship has taught me how important it is to have an awesome support system. I can't just rely on myself for getting through this. I need people in my life like this and I need to stay connected to the DOC. It makes all the difference.

THANK YOU TO EVERYONE.

Diabetes. It's Like Another Limb..

I apologize for how weird this is about to sound.

So, about 6 months ago, I broke my pump's clip and still haven't gotten around to purchasing a new one. Now, if I have pockets, this poses no issues. If I do not, I have to get creative....if my pants are tight enough, I can usually just put it under my waistband. Sometimes, I just put it in my bra. Anyways, a couple days ago, I had my pump tucked into my waistband. I was going to the bathroom and instead of pulling down my pants, immediately remembered to remove my pump from the waistband...then pull down my pants. That got me thinking. At this point, diabetes is so second nature. It's something I think about constantly, but it's almost subconsciously. Sometimes I can't even remember if I bolused for my last meal....usually I did. :-)

It's crazy to think that I'm on my ninth year of diabetes. My Dianniversary (diabetes anniversary) was on June 22nd. Honestly, I was at a Yankees game and completely forgot about it. At first I felt a sense of sadness that I forgot about it, but I like to think of it as a good thing. Diabetes is something I've learned to live with. "It's like another limb." I think about it constantly, but a great deal of it is subconscious. Over the years, I've managed to go on and live life without must hesitation. Sure, when I was at the Yankees game I had to think about how must insulin to give for my ice cream cone and I had to test at one point...but those were minor thoughts. I was still able to go to and enjoy the baseball game without thinking too much about this stupid disease.

It's crazy to think of how far I've come since diagnosis nine years ago. Bring on year ten!

7.5 Weeks Left

Well, I have about 7.5 weeks left my dietetic internship. This has been the fastest 10 months ever. I feel like I was just starting to get comfortable with the situation and now I have to figure out my next step. I am terrified. Now, I have to take the RD exam...and find a job. There are so many decisions to be made and I am beyond overwhelmed and filled with emotion. Do I stay in New York? Do I go home to Connecticut with my family? Do I move back to New Hampshire? Or should I just pack up and leave the North East all together. GAHHH. I wish this decision could make itself.

Up until this point, I feel like my whole life has been laid out perfectly for me. My diagnosis with type 1 diabetes was both scary and traumatic, but I truly feel like it happened for a reason. It opened my eyes to the wonderful world of medical nutrition therapy and guided my path in life. I have absolutely no regrets in the path I have chosen. Every single day, I feel like I've made a difference in someone's life. Though, not always nutrition-related, it's been such an awesome experience to provide patient's and their loved ones with comfort and support during such difficult times and I have been blessed to have the opportunity to practice my skills in such a prestigious hospital.

Not only has this internship aided in my journey towards becoming a Registered Dietitian, it has helped to grow as an adult. Moving to New York City, I've made some mistakes...but I'm learning from all of them. I have learned that I need to think about and stand up for myself more. I have learned that I need to remember to take care of my body..it's the only one I'll ever have. I have learned the importance in finding a good balance between health, work, relationships, and fun. The list could go on and on.

So as I move forward through the rest of this internship, I am going to try to remember to breathe, think about myself and what I want/need, and do good for this world.

With that, I leave you with some of my favorite inspirational quotes.

"Be the change you want to see in the world." - Gandhi

"Don't be afraid to give up the good and go for the great." -Steve Prefontaine

"Laugh when you can, apologize when you should, and let go of what you can't change." -Unknown

Accomplishments

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small - think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.). (Thanks to Hilary of Rainie and Me for this topic suggestion.)

Becoming independent with my care is probably my greatest accomplishment. I was diagnosed the summer before going into high school. I remember about a month or so after I was diagnosed, my sister and I were invited on a camping trip up in Maine. My mom broke the news that she didn't think I should go since I was so newly diagnosed...I was devastated....but who knows what would have happened without her there. She was still doing all my injections, still checking up on me in the middle of the night to make sure I was still breathing. There was no way I could have gone on that camping trip without her.

Fast forward a few months to October. My friend invited me to her Halloween party...it was a slumber party. I was SO SCARED that my mom was going to have to come and give me my dinner and breakfast injection. Being in high school, all I wanted was some independence. Luckily, I was able to successfully give myself both my dinner and breakfast injections without my mom coming to help me. I honestly think that was my proudest moment. Before that moment, I felt like I was on a leash. Just as I was starting to gain some independence at the end of middle school, it was almost like it was all taken away from me in an instant after the diagnosis. Going to that party without having to call my mom to come give me a shot gave me the confidence I needed to take on more and more responsibilities in my diabetes care.

Now, fast forward to today. I'm 22...out of college...and have total independence. I'm so proud of how far I've come.

Memories

Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. (Thanks to Jasmine of Silver-Lined for this topic suggestion.)

My most memorable diabetes day is probably not the day of my diagnosis...but the day after.

The day after my diagnosis, my mom and I went back to the hospital to meet with a CDE and start our training. The CDE I was working with also happened to be an RD. We started off learning about the basics of diabetes, signs and symptoms of hyer/hypoglycemia, how to treat hyper/hypoglycemia, insulin peak times, how to give injections, and my favorite part....carbohydrate counting. I fell in love with the nutrition portion of her education. She brought out plastic food models, gave me handouts, we practiced making meals with different carbohydrate contents...it was so much fun. The real test was when she had my mom and I go to the cafeteria and pick up some lunch. We had to document what I chose to eat and how many carbohydrates were in that meal. We rocked it.

While we were at lunch, my RD came up with a day-to-day meal plan. I was on MDI at this time, so I had to eat a set amount of carbohydrates at the same times every day. I still remember exactly how it worked out: 7am 40-50 gm, 10am 25-35gm, 12pm 90-100 gm, 2:30pm 15-20gm, 4:30pm 15-20gm, 7pm 65-75gm, 9pm 25-35 gm. This schedule ruled my world for an entire year. As annoying as it was to always stick to this eating schedule, it taught me a great deal. I learned the importance of regular meals and became an expert carb counter. Give me a food in any quantity and I will tell you how many carbs are in it.

This was the day that opened my eyes to the wonderful world of dietetics. When I went home that night, being the nerd I am, I read all my nutrition for diabetes information I could get my hands on. I read every food label I came in contact with...even if I was not planning on eating that food. I LOVE DIETETICS and I honestly don't think I would have discovered this awesome career had I not been diagnosed with diabetes. Diabetes sucks....but it really was a blessing in disguise.

We, The Undersigned

Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)

I would choose to petition insurance companies and their limits on the number of test strips they allot to each patient. This is a problem I have run into on a couple of occasions. Back when I first started college in 2008, I once ran out of test strips. My mom and I tried to call and order new strips, but CVS told us our insurance company had denied our request. We then called the insurance company who told us that I could not reorder anymore test strips at this time because I went over my prescription and had "abused" my strips. I think that is the most ridiculous response ever. How can one abuse their test strips?? I feel like insurance companies sometimes make diabetics walk a fine line between being cautious and staying healthy in hopes of preventing future complications and saving money. It's not fair. I shouldn't have to be worried about testing too many times in one day....I'm probably saving the money by keep my blood sugars in optimum range and preventing costly complications down the road....like amputations and renal disease.

It's unbelievable.

That being said, I'm petitioning larger maximum allotments of test strips per person. I'm tired of worrying about going over my monthly limit. Why should we have to worry about going over our monthly limit? Aren't we supposed to be testing often?

Why we need to test often.....

D-Blog Week: Share and Don't Share.

Day 1 post for diabetes blog week!

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see?

I feel like my doctor and care team seem to understand what my daily life with diabetes is like- I REALLY DO. I give myself such a hard time about my control and constantly need to remind myself that the numbers aren't always going to be perfect. LIFE HAPPENS. Luckily, my care team is always on my side. In fact, at my last appointment, I was explaining my current situation to my APRN. I was throwing out all these ideas of how to achieve better control. One idea in particular was to stop eating fruit at breakfast (an idea I got from gestational diabetic nutrition therapy). MY APRN quickly shot down that idea and reminded me that I'm 22 years old. Go out, have fun, eat good food, take my insulin, and test my blood sugar. LIVE LIFE AND ENJOY IT. I love this woman. Ever since visiting her, I have felt so much better. This is why I feel like my doctor and team understand what my daily life is like. There's no need to explain anything to them.

It's not my medical team that I wish could see what my daily life with diabetes is like...but there are other people in my life that I wish could see how difficult it can be. I don't appreciate being called a "bad diabetic." I take better care of my health than a lot of people out there...just ask my care team. I get upset and cry if my A1c is above 6. All they want to see is one below 7.

I think the reason people sometimes says this to me is because they see the type of food I'm eating. Let's face it... I love food and refuse to deprive myself of one of my greatest pleasures in life. This is why I have an insulin pump. I eat what I want and bolus for it. I just want to be treated like a "normal" person without diabetes. Please don't tell me I'm a "bad diabetic" when you see my heaping bowl of froyo or my cranberry vodka at the bar. I know my body and I know how to work my insulin pump/glucometer. There are a million and one thoughts that go through my head on a daily basis when it come to taking care of myself. Am I low, when was the last time I tested, we're going for a walk??...better eat a little something before we go, do I have my starbursts with me, how much insulin do I have on board, do I have enough insulin left in my pump, how many carbs are in this....the list goes on and on and on. I honestly don't need the comments.

I'm so happy to get that off my chest. Thanks for reading.....and a BIG THANKS to my diabetes team for being so supportive. That includes my doctor, APRN, mom, and close friends. I love you all.

Checkup (finally)!

Last week, I finally had my endocrinologist appointment! It actually went better than I expected. My mom and I made bets on what my A1c would be before going into the appointment. I bet 7.1…so had a little more faith and bet 5.7. Turns out, my A1c was 5.7. Initially, I was pretty excited! The APRN was a bit concerned. We downloaded my meter and I was averaging numbers in the 200s….not exactly a 5.7. We think I’m not detected all my lows, which is bringing down my A1c.

Looks like I’m starting my sensor again! WAHHHHH. In 2010, I got the Dexcom sensor and LOVED it…but I lost the monitor and never got a new one. In 2011, I decided it was time to try out the Medtronic sensor considering I had the Medtronic pump. I ended up using it for a couple of weeks and hating it. To be fair, I don’t think I gave it much of a chance. I’m back on the Medtronic sensor and things are beginning to look up! The sensor really is helping me catch a bunch of lows that I probably wouldn’t have otherwise noticed. It’s scary to realize that I’ve been walking around like this….sleeping through these! The only thing I dislike about the Medtronic sensor is the needle. It’s so intimidating. It took me nearly 2 hours to work up the courage to insert it last week. Luckily, it looks scarier than it feels and I was so surprised with how little pain I felt inserting the needle.

In other news,I think I'm going to participate in the Fourth Annual Diabetes Blog Week! More posts to come! =]

Progress...

Hey everyone! I'm back with an update! In terms of my overall health, I've been doing much, much better. I've gone running and have also attempted some exercising in my box of a room. Now that it's getting darker a bit later, it's been so much easier for me to get out and go for some runs after work! I'm determined to keep up with the cardio at least 3 or 4 days per week. I have also started volunteering with a program called New York Cares. Yesterday, I helped serve lunch at a senior center on my day off. It was great to get out and do something to help others outside of the hospital. I am excited to get involved with more of their projects! In terms of my diabetes control...that's also been better! I think my major issue is I'm using the same area (my back side) too often. As much as I hate it, I've started to use my stomach and have noticed a significant difference in my numbers. This happened to me once about 4 years ago. I saw a nurse who specialized in absorption issues and discovered I was using the same site too often and, again, started to rotate on my stomach as well. Now that I've started using my stomach, I'm mainly seeing numbers 90-140. I just need to tweek my morning insulin:carb ratios (my post-breakfast numbers are about 190-230), but that's always been an issue for me. Overall, I'm very pleased with my control over the past couple of weeks. I'm also excited to say that I'll be attending an insulin pump fair next week! I cannot wait to see the latest and greatest diabetes technology out there. I've been sporting my Medtronic Paradigm for about 3 years now. I'm not sure when I'm due for an upgrade, but I'm hoping soon. I'll definitely be back with an update with how this goes!

Turning Over a New Leaf

Long time no talk! So I've been MIA on this blog for some time now with very sporadic posts. I'm hoping to change this....starting today. I've been busy with my dietetic internship at New York Presbyterian Hospital. I've completed 5 rotations and am almost done with my 6th! This has been the most educational/eye-opening experience. I still cannot believe I'm interning at one of the nation's top hospitals. On a not-so-positive note, my diabetes has not been so well controlled over the course of this internship. Living in the city with no income has proved to be a struggle. I am not eating the way I should be and have no form of physical activity. I've gone from taking 25-30 units of insulin per day to about 60. I'm actually disgusted with myself right now. I woke up this morning after a night out (I drank too much, had a pita from a Halal cart, a McFlurry, a medium fry, and topped it off with a happy meal)and realized I can't keep living this way. Out of disgust for the way I ate last night and my blood sugar when I woke up this morning,I went for a long run (first run since August) and decided I need to take better care of myself. I started this blog during my sophomore year of college after a similar experience and it truly helped me achieve better control of my diabetes. I'm hoping that I can achieve that once again with the help of this blog!

First run! I'm planning on making this a regular activity for me!