Zoe, thank you for such a long reply. I am sorry for taking so long to reply. With my eyes where they are right now, reading and replying takes me quite a bit of time. Please don't let this limit your replies, just know I may be a bit slow to answer. Anyway, on to your questions.
As far as what I am eating, I usually stick around the same familiar foods, and know about what to expect my sugars will do based on what I eat. I have a few evil foods that I tend to avoid. Pizza is one I just can't come out the other side of with a good sugar no matter what I do. I either crash, or wind up high later. The sauce usually gives me heartburn anyway, so I just don't eat it except as the rare treat. There are a few others I can't think of off hand but if named I can say no thanks, not worth my troubles later.
My biggest obstacle to control is my anxiety. It is something I have struggled with for going on 15 years. It is strongest around a fear of low sugars, but when I get anxious about anything, my go to reaction is always where is my sugar at and can I raise it and feel better than I do now, if that makes any sense. In the past, I have tried medication, therapy, and to the extreme of a 4 month inpatient stay in a facility that managed the medical and mental health aspects of it. I was only 16 then, and had no say in the matter. Everything was locked down and managed for me, and I got control but when released, it didn't last.
I really struggle with therapy. I am not a very open person. I am usually quiet and pretty reserved. I have a hard time especially when a therapist kind of gives me the so what should we talk about. I never seem to be able to take that and lead things where they need to go. I haven't ever been to a therapist that I felt comfortable opening up to, its just not what I do. Discussing feelings for me is terribly uncomfortable. I would really like to find someone who understands the Diabetes component to this beyond seeing bad numbers and saying that isn't good. I guess someone who understands the emotions and the feelings that go along with everything and how strongly they can affect us.
So yes, for me, its not so much the mechanics of what needs to be done, but rather the emotions. I have had educators and others tell me that I should be teaching them, not the other way around. I pointed out something that was a result of a medication interaction to a therapist, and she looked it up and handed me her phone and said here, you read this, you will understand what it means better than I will. The grip of the anxiety and probably some bad habits are my biggest problems.
My doctors probably wish not testing was my problem. While not an issue at present, about 10 years ago, I had the anxiety and an OCD component to it, and was testing up to 40 times a day. I was actually being limited on how many strips I went to school with so that I would ration them out to last the day. I log using a website called sugarstats. I am a very visual person, and love how many kinds of charts they produce to show trends. I find if I let my logging slack for a day or so my control suffers a lot because I don't catch problems as they crop up, or at least in time to say tomorrow will be better.
I am very familiar with all of the various formulas and basal vs bolus and what not. These things were all new to me when I began preparing to go on the pump close to 15 years ago. At that time is when I was just becoming old enough to manage everything on my own, so I kind of learned those things as my taking the wheel of my management. I was taught these things and pumping by Gary Scheiner. I am sorry I probably misspelled his name. I consider him an excellent educator, and feel lucky to have had one on one appointments with him. I have also read some of his books since. As a side note I am not on the pump at this time.
As for trending and problem areas, I am trying to get my mornings under control right now. I wake up high every day, and come down from there. I have added a small Lantus dose at night and am increasing it a bit at a time. I can look at the charts and see it slowly helping. This split dose is something I had to do with my Lantus for good control before, and my current endo told me don't split the dose for now, but I can see I need to. I will attempt to make other improvements once I get a better handle on the mornings. I figured the start of the day can set the tone for the whole day so why not start there. It is also my worst reading of the day.
Thanks again for the long reply and for making it through this painfully long reply of my own. Haha!
I look forward to more from you.