Arm Site Review

I’ve been wanting to try using the backs of my arms for a CGM site for quite some time now.  My High Risk OB told me that once I get pregnant (I’m not yet!) I shouldn’t wear my sensor on my thighs for some reason or other.  I forget what the reason was as it was an information-overload type of appointment, but anyway, I remembered she said that!  So when I got a mild rash from my last site, I decided it’d be time to give my thighs a break and try the back of my arms.  Sadly, I don’t have Cameron Diaz guns, so there is a lot of fleshy area to choose from.

I wanted to have my husband insert it (hehe, see what I did there?) but he seemed a little apprehensive, so I took matters into my own hands.  (You could go so dirty with that last sentence, but I’m going to assume that the kind readers of my blog will be keeping their minds out of the gutter.)  So, using a mirror, I put a sensor in the back of my left arm.  It wasn’t easy, but it was do-able.  I’ve been wearing this sensor for almost 2 weeks and had my husband reinforce it with some OpSite FlexiFix for me a few days in.  So far, it’s been sticking like a champ.  Probably better than it sticks to my thighs.

A few things I don’t like about the arm site – I seem to meet so many more door frames.  I swear, I’m constantly bumping it. Visibly, it is definitely more noticeable than thigh sites.  Also, I’ve noticed that overnight it doesn’t seem as accurate.  Maybe because I am a side sleeper and my sensor doesn’t have clear access to my receiver?  Regardless, I’ve woken up a few times with it pretty far off.  This morning I tested at 168 and my Dexcom said 102.  On Thanksgiving morning, it said I was 144 and I was 222.  I haven’t yanked it due to this inaccuracy just yet, as it only seems to happen over night.

Also, it’s really nice to not have to remember to be careful of my sensor every time I go to the bathroom.  I think the arm is definitely the way to go as far as out-of-way-ness, (as long as I miss those door frames!), but accuracy-wise, my thighs seem to work a little bit better.  But, it is great to know that my arms may be a good Dexcom spot for a future pregnancy!

 

Blue and organization!

Slacking on my Diabetes Month Photo-a-Day posts!

I may not always wear blue on Fridays (I really try though!) but I always make sure I sport my “Cure Type 1 Diabetes” bracelet! Thanks JDRF!

My pump supplies cubbie. Don’t worry, I just placed an order today!

My test strips/extra Rxs/Random D stuff drawer. Anyone want to have a BG testing party?

Sadly, I don’t have a fun spot for my Dexcom supplies.  They just stay in their box in the bottom of my closet.  I feel I need a cute (blue) basket for them!

“That is so cool.”

In a meeting the other day, a coworker noticed my CGM receiver (which I still rock in the Dexcom provided 1990s business-person themed leather snappy case thing).

“What is that?  A MP3 player?”

“Oh, it’s my continuous glucose monitor.  It tells me what my blood sugar is.  See?  Right now I’m 98 and steady.”  (I wanted him to high-five me for my awesome reading, but alas, he did not.)

“But….how?”

“See this lump on my leg?  It’s a sensor that’s reading my blood sugar level.”

“So, does it alert you if you go out of range?  Is that what those lines are?”

(Dude. He must be brilliant.)

“Yup!  It beeps and vibrates and acts like a jerk if I go too high or too low.”

“That.is.so.cool.”

And to think, a couple of months ago I was all sorts of nervous about starting a new job and explaining diabetes and stuff.  Now I’m clearly the coolest kid on the block!

 

Five for Josh

Last Sunday I participated in the Durham Bull City Race Fest in honor of my nephew, Josh, who passed away in June.  My sister, Josh’s Mommy, organized a team of over 80 people to participate in this event – from the one mile fun run to the half marathon!  She is amazing and has raised over $6000 for SIDS research!  It was a great weekend, full of love.

I decided to participate in the 5 mile distance.  Myself and a few others on “Team Josh” were going to walk and I admit, I trained for this event for about 10 minutes.  I think I’ve gone running (shuffling) maaaaybe 3 times since we’ve moved here a year and a half ago?  Boxing is my favorite exercise, but I’ve been a complete bum in that department as well.  Oooops.

Of course since I didn’t train, diabetes decided to be a butthead.  I woke up around 200 and had a bagel for breakfast.  I bolused about 70% of what I’d bolus normally.  I wanted to come down a smidge but I still wanted to stay around 170-200 because I knew this was going to be physically challenging and personally, I like to run a tad high when I exercise to prevent drastic drops.

Before the race started I looked at my CGM and saw the dreaded double down arrows. 

Oy.  I ate two glucose tabs and figured I’d hopefully level out.  I’d be very pleased if I stayed around 160 for the whole 5 miles.

Of course, diabetes rarely plays nice when you want it to.  Throughout the whole race I had at least a southeast arrow.  I was popping glucose tabs every 2 miles or so (along with texting my husband such ladylike things as “My BG is being an asshole”, I am the epitome of class, friends), took Gatorade when it was offered, set my pump to only give me 10% of my insulin, and still finished the race at 78.  I suppose this could be considered a victory because I never really dropped, was just slowly going down.  However, it caused me to panic and I couldn’t really enjoy myself and take in the race.

BUT, I did it, there wasn’t a catastrophe, and it was nice to be a part of Team Josh.  I think about him often and miss him so much.

However, the next time I decide to do 5 miles, I’ll do one of two things: I will either actually train for it so I can remember how my BG reacts and can properly prepare, or I will eat a giant cupcake right before the race.

I made these delicious chocolate cupcakes with peanut butter icing for the Team Josh potluck. Don’t judge my awesome icing skills.

Artificial Pancreas? Say what now?!

***Note, I’m not a tech guru.  I panic when I have to update my iPhone and can’t find my apps on the correct screen.  My husband manages the DVR because I don’t understand why we can’t record 200 shows at once and having to pick only two overwhelms me.  And, as always, I’m not a doctor so this isn’t medical advice and all that stuff.***

In case you haven’t heard the news, Medtronic has developed an artificial pancreas.  AND, even better, the FDA has approved it!  HUZZAH!  So this means that I can slap on a pump and CGM sensor, leave it there, and not have to think about diabetes for a few days until it’s time to change my site?  Right?  Like, that’s it?!?!  The days of finger pricks, bolusing, temp basaling are over?  Freakin’ awesome, man.

Scrreeeeeeech.  Wait a hot second.  According to this article by The Wall Street Journal, “the U.S. Food and Drug Administration has approved a pump designed to automatically stop insulin delivery in diabetes patients when blood-sugar levels are too low, the first “artificial pancreas” to be approved in the U.S.”.  Heh?  I mean, that’s cool and all, but is that an artificial pancreas?

“Medtronic’s MiniMed 530G, which includes a sensor, sends out an alert if (blood sugar) levels are too low, and if the individual is sleeping, unconscious or unable to react, the pump will shut off for two hours.”  Oooook.  But what does it do if my blood sugar is creeping up?  Does it automatically bolus insulin or set a temp basal?  What about if I eat a bowl of pasta?  Will it sense my blood sugar rising and do what needs to be done to keep me in that 100-130 zone?

To me, this sounds like a pump with a shut-off feature.  Definitely an added security measure that I am sure many people will be happy to have for themselves, their spouses, their children.  Hell, I dropped to 40 the other night and didn’t hear my CGM beeping at me.  (Thank you to the husband for waking me up so I could treat and clip coupons!)  A shutoff feature would’ve been great in this situation!

Another thing that concerns me is that according to the interwebs and other rumor mills, the Medtronic CGM isn’t quite as accurate as the Dexcom.  I wonder how many false shutoffs occur?  And if they do and your body is getting zero insulin for two hours while you’re blissfully unaware in dreamland…well, that’s not really a good thing.

Also, I don’t know about anyone else, but when I have those pesky middle-of-the-night lows, I’m not quite fully awake.  I stumble to the kitchen, pretend I’m only consuming 15g carbs, wait (half-asleep) for 15 minutes, test again, and stumble back to bed.  I can guarantee that I’d forget to turn my pump back on and would not be getting insulin to cover all those carbs (Because we all know, it’s more than 15g) I just consumed.  Of course from the sound of it, this device is geared more towards when the wearer is incapable of treating their low, but still.  I’m forgetful.

So while I think that this new device is a step in the right direction towards the artificial pancreas, I think it’s more of a baby step than the giant leap it’s being made out to be.  Artificial, to me, means I don’t have to think about it.  I want a device that I just wear on my hip and it does all the work for me – it knows when I’m exercising and to give me less insulin, when I’m stressed to give me more insulin, or when I’m indulging in a plate of nachos and may need an extended bolus.  Sure, I’ll change out my insulin/glucagon and change the site every few days, check my sugar for calibration purposes, but, other than that, I want something that is mindless.  To me, artificial pancreas does not = pump with a shutoff feature.

The beauty of choice.

I recently read a post on the diabetes sub-Reddit from someone claiming that their doctor said MDI was the best way to manage diabetes.  This lead to a fury of posts from people claiming “No, no, no, the pump is the best” or “I agree with you!  MDI is the way to go!”.  This got me thinking…

There is no BEST course of action for managing diabetes.  What may work for me (currently cyborging with a pump and CGM) may not work for you.  Heck, what works for me right now hasn’t worked for me in the past (remember that time I took almost a year-long pump vacation?  Yeah.) and may not work for me in the future (sometimes been a cyborg gets old).

The great thing is that we have options.  We, as PWD, have the beauty of choice (of course within the realm of our finances, insurance plans, etc.).  I may be going to a wedding or on a vacation and a pump may not work with my vacation plans or my outfit (cue my inner Cher from Clueless “Ummm, a pump doesn’t really go with this outfit, Daddy”). So, I can rock MDI for a bit.  I may get sick of the constant information about my blood sugar, so out comes the CGM.  I may be planning a pregnancy so I may want the tightest control possible right now and for me, that comes in the form of a CGM and a pager/camera.  In a world surrounded by blood sugar testing, carb counting, and insulin dosing, it’s nice to have just a little bit of freedom.

It’s important to remember that what works for you may not work for someone else.  And it’s hard to not say “Hey, have you tried what I’m doing?  Because it rocks.”  I know I’m guilty of this and I hope that when I suggest things to people who may be struggling with their management or are looking to shake things up, they know I’m not judging them for their choices in diabetes care.  I’m just offering friendly tips about what is currently working/not working for me and different things they can try.  Because change is good.  And choice is great.

 

Wordless Wednesday -9.18.13

Monday was a tough BG day.  I felt like no matter what I did, I could not get above 100.

Invisible Illness Awareness Week 2013

Did you know that this week is Invisible Illness Week? I didn’t either until this blog post came across my reader. Thanks Rose!  I used to love filling out the old email surveys way back in the day, so why not? Here’s an easy chance to learn a little more about me and my diabetes. Don’t worry, there won’t be a quiz at the end.

30 Things About My Invisible Illness You May Not Know

1. The illness I live with is: Type 1 Diabetes

2. I was diagnosed with it in the year: 1998, 4 days after my 18th birthday!

3. But I had symptoms since: Not long before diagnosis. Maybe a month before? I lost weight (Yay!) and was peeing a lot (Non-yay when there wasn’t a bathroom on my floor in the dorms!) but I didn’t think anything of it.

4. The biggest adjustment I’ve had to make is: Testing my blood sugar, injecting insulin/wearing a pump, and carrying all the crap ever around – wherever I go.

5. Most people assume: That diabetes is just having to test my BG and taking insulin before meals. I don’t think people realize how serious it is and how I am constantly aware of what my BG is/how my body feels/how my actions affect my numbers.
Or, that my foot is going to fall off.

6. The hardest part about mornings are: Giving up cereal. My BG hates it. No matter how I try to bolus. I miss you Cocoa Puffs.

7. My favorite medical TV show is: Grey’s Anatomy. I’m one of the 4 people who still watch it.

8. A gadget I couldn’t live without is: My Dexcom CGM. Seriously my most favorite Diabetes device ever! I credit it for helping me get my a1c down to 6.8 and I always say I’ll give up my pump before I give up my Dexcom. It has given me a sense of security and much more awareness of my diabetes.

9. The hardest part about nights are: Deciding if I need a snack before bed. Seriously. Food is hard.

10. Each day I take __ pills & vitamins: 2 Pills – Sythroid and Vitamin. I’m usually on Vytorin but my doc took me off of it in preparation for baby making. Also, continuous insulin via the pump.

11. Regarding alternative treatments I: Think they have their place. Although, with T1D there really aren’t any alternatives to insulin. But I think there is nothing wrong with seeking out a natural treatment for more common ailments like the common cold if that’s what you choose.

12. If I had to choose between an invisible illness or visible I would choose: Invisible. I don’t like my diabetes being made a huge deal of and I imagine if I had a visible illness I would feel uncomfortable much more often.

13. Regarding working and career: I’ve been working in some capacity of another since before my diagnosis. I don’t think that Diabetes has affected my ability to get and keep a job. I’ve really only missed maybe 3 or 4 days of work because of wonky blood sugars. In 14 years, that’s not too bad. I do feel guilty sometimes for having to miss time for doctor’s appointments, but I supposed that is what PTO is for!

14. People would be surprised to know: We really don’t want to hear stories about how your best friend’s cat has diabetes, or that your uncle “died from diabetes” or that your former boss’s mother’s sister lost her foot because she was diabetic. Really. Not helpful.

15. The hardest thing to accept about my new reality has been: My reality isn’t really “new” but back in college, the toughest thing to accept was that this is permanent. At least for the next 5-7 years until there’s a cure, right?

16. Something I never thought I could do with my illness that I did was: I got nothing. Ask me again in a year or so and hopefully my answer will be “Have a baby.”

17. The commercials about my illness: Annoy me.

18. Something I really miss doing since I was diagnosed is: Eating without thought. I miss not having to test, figure out my insulin, not having to wonder how this meal/snack will make me feel in the next 15 minutes, hour, 3 hours, etc.

19. It was really hard to have to give up: One piece bathing suits and low cut dresses. Female pumpers will understand.  Oh, and cereal.  And money.  Diabetes is expensive, yo.

20. A new hobby I have taken up since my diagnosis is: Blogging. This is a really new hobby!

21. If I could have one day of feeling normal again I would: Eat all the pasta without a worry in the world.

22. My illness has taught me: A lot of stuff.

23. Want to know a secret? One thing people say that gets under my skin is: See number 14.

24. But I love it when people: Ask questions and actually listen when I explain what I live with, my pump and CGM, etc.

25. My favorite motto, scripture, quote that gets me through tough times is: Tomorrow will be a better day.

26. When someone is diagnosed I’d like to tell them: Diabetes is a pain in the ass, there’s no sense sugar coating it (Pun intended). But it is manageable and even though it seems like you are being inundated with information right now, in just a short amount of time, all of this will become second nature. You can do this. And if you feel like you can’t there are tons of people both online and in real life who are happy to support you, answer your questions, or listen if you need to vent.

27. Something that has surprised me about living with an illness is: That even though there are people around for support, it can be very isolating. That’s why I am so grateful for the DOC and IRL D-friends I have. They “get it”.

28. The nicest thing someone did for me when I wasn’t feeling well was: My college roommate took me to the hospital and sat with me for hours in the ER on what was a pretty useless ER visit (Something I could/should have handled on my own, another blog for another day). Also, my husband does nice things all the time – getting my meter for me, checking my CGM receiver when he thinks I’m not looking, grabbing me some juice, starting dinner when he’s not hungry yet so I can eat/won’t go low, etc. I’ll keep him.

29. I’m involved with Invisible Illness Week because: My blog isn’t so invisible, so why not?

30. The fact that you read this list makes me feel: Happy and hopeful that you weren’t terribly bored.

 

Have a great weekend, everyone!

Up and down and all around.

Man, I am dizzy from the diabetes roller coaster I rode all weekend.  Good, steady D-Days were a thing I could only dream about.  This resulted in frustration, belly aches, annoyance, and a little more frustration.

The only culprit I can think of is that I had pizza and beer on Friday night.  Even after commenting on Katy’s Combo Bolus Victory that if I make it 8 hours without a spike after eating high fat foods, I’m usually in the clear, I woke up Saturday morning with a BG in the 250s.  My dexcom, it appears, was a liar.  And made me eat my words. 

I yanked it Saturday morning since it was off by over 100 (and was almost 3 weeks old, so…) and as you can see above, I was up and down all day.

The roller coaster continued on Sunday:

Up and down with a few good hours in the early morning while I was sleeping (and hadn’t eaten!).  Just looking at food caused a BG spike this weekend.

Finally the last day of the holiday weekend was pretty normal and much prettier:

Phew.  What a weekend.  I don’t know if it was the pizza or diabetes just being a jerk as diabetes often is but it seemed like a constant game of cat and mouse.  My pump was smoking from all the rage bolus and temp basal action.  I’m starting to think that maybe eating the naughty foods just isn’t worth it any more.  (Does this mean I’m an adult?)

And I am annoyed that according to my Dexcom, my average BG has gone up by 1 over the weekend.  Lame.

I confess…

I’ve been cheating on the DOC with Reddit.  Does anyone else read the Diabetes sub-reddit?  I really enjoy it.  Check it out!

After my awesome A1c results last week I, of course, had to share with my Reddit friends.  One person asked me to list 10 changes I’ve made to make such an improvement in my A1c (I went from 7.9 in April to 6.8 now, however a year ago, I was 8.7!)  Of course the first thing I thought when this person asked was: “Blog Post!”  I love to make lists.  If you ask the hubs, I make them for him pretty frequently – 10 Reasons why I miss him while he’s away (there’s no one around to kill spiders!), 10 reasons why I am excited for the weekend (Sitting on my butt is better than working, duh!), etc.  The lists.  I make them.

So, without further ado, here are 10 changes I made to improve my A1c:

1. I switched to sugar-free flavored creamer. When I first got my CGM I noticed that I was spiking big time after breakfast, even if I was bolusing to cover the carbs. Not willing to give up coffee, I switched to SF creamer and that has helped a lot.

2. I also gave up cereal. I eat a bagel and cream cheese for breakfast most mornings. I should have more protein but so far I’m doing OK, blood sugar-wise.

3. Getting the CGM period. It’s been amazing to know what my BG is doing at any given moment. I’ve been very attentive to it and adjusting my insulin when needed to keep me in range.

4. Baby-stepping my high alert on the CGM down. It started at 200 and I’ve gradually gotten it down to 160.  I think if I started with a high alert of 160 right out of the gate, I would have gotten frustrated with all the beeping.  If Bob can do it, so can I.

5. Communicating with my CDE a lot! I’m lucky in that she is very receptive to emails. I send her my reports every couple of weeks and she makes small tweaks. She’s noticed patterns I never would have noticed before.  She has quickly become my diabetes care BFF.

6. Getting back on the pump, in general.  For me, it’s much easier to correct those pesky high numbers with a couple mini boluses or temp basal.  A little more difficult and time-consuming to do on MDI.

7. Pre-bolusing for meals. It takes me about 30 minutes to get ready in the morning and halfway through I bolus for breakfast. Since I eat the same thing every day, it makes it easy.  I also pre-bolus for lunch and dinner too and I think it really helps prevent those after meal spikes.

8. Using combo boluses when I eat high fat meals.  I will master you, pizza.  I will.

9. Trying (although not always successful) to cut back on processed foods.

10. Really paying attention to the 15-15-15 rule when I’m low. Although this doesn’t always work (especially over night!).

It honestly hasn’t been a huge lifestyle adjustment or anything. I’ve just made diabetes a priority.  I know that I feel better physically and emotionally when I’m in better control of my blood sugars.