Slacking on my Diabetes Month Photo-a-Day posts!
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!
Slacking on my Diabetes Month Photo-a-Day posts!
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!
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.
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.
***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.
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.
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.
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!
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.
Big, exciting (for me) news…I have accepted a job offer! WooHoo! I start in a couple of weeks and have been busy wrapping things up at my current job. I’m very excited for the new challenges and increased responsibility.
What I’m not excited for…explaining to my new coworkers over and over and over that I have type 1 diabetes. No, it’s not because I ate too much sugar as a kid. Yes, I can participate in birthday celebrations. No, you do not have to treat me any differently. It’s an insulin pump, not a pager (or camera). Oh, your grandma had diabetes and her foot fell off? That’s nice.
I’m not very shy about my diabetes, there is nothing to be ashamed of. However, I also don’t like to be made a spectacle of or made to feel different. It seems inevitable at new jobs that I have to tell my story, give a cliff’s notes version of what diabetes entails, and answer the same questions again and again. I have been very lucky at my current place of employment as one of my coworkers has Type 2 so we’ve been “D buddies”. He thinks my CGM is the coolest thing ever, by the way.
I think that it is important to let my new coworkers/supervisor know that I have diabetes just in case something happens (that’d be a good first day story, huh?), However there never seems to be a good way to say it unless it comes up in conversation. It’s not like you can just say, “Hi new coworker friend person. Name’s Laura. Type 1 Diabetic. So, tell me what you’re working on?”
How do you deal with a new job and letting people know that you have diabetes?
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.
I’ll get back to Wordless Wednesday next week.
Today I had my much-anticipated endocrinologist appointment. This was the first appointment in which I’d get my a1c since going back on the pump and starting with my Dexcom CGM.
I was called back by the nurse and she took my vitals. I told her that I was super excited about getting my a1c and was hoping it’d be around 7.0. After doing her thing, my a1c still wasn’t ready so she sent me back to the waiting room and told me she’d come out and let me know what it was. A few minutes later she came out with a huge smile on her face and whispered in my ear….
what do you think?
Did I do it?
Did I hit 7.0?
Well, I didn’t hit 7.0. I knocked it out of the freaking park! 6.8!!!!! Sixpointfreakingeight! I haven’t had an a1c that low since…never. I honestly can’t remember having an a1c in the sixes throughout my 14 1/2 years with diabetes. I may have when I was first diagnosed, but not in the last 8-10 years, I know that much.
I almost started crying.
I am so happy that my a1c has shown all of my efforts. And, I was texting with my friend and made the realization. It has been tough, sure, but it’s not like I’ve stopped living my life in order to reach this goal. I’ve made small adjustments and just made my diabetes management a priority. The Dexcom has helped tremendously. I no longer fear going low as I have faith that it will alert me if I need to take action. And when it tells me I’m higher than I’d like to be, I adjust. The constant contact with my CDE and her feedback have also been an enormous help.
So, back to the appointment. My endo walked in and also had a big smile on her face. She asked me if I wanted to hear the good news. I said, “6.8!!!” She was bummed that the nurse told me, haha. She said that she is so proud of me. When I first started with her last June, I was 8.9. My last a1c in April, I was 7.9. I’ve made diabetes my bitch.
I had a long list of questions for her regarding a (hopeful) upcoming pregnancy. Here’s a rundown:
Given my current numbers/a1c, when can I start TTC?
What are my pre/post meal BG goals during pregnancy?
Pre – 60-90
1 hour post – below 140
2 hours post – 100-120
When should I start taking pre-natal vitamins?
Now. (I already did. I win)
Vytorin – when should I stop taking it?
NOW! She was adamant about this. Guess I gotta lay off the steak and other cholesterol-y foods from now on.
What about synthroid?
Keep taking and call her AS SOON AS I have a positive pregnancy test. (She said, “don’t even tell your husband, CALL ME!”) Haha. I guess as soon as I find out I’m pregnant, I need to take extra synthroid that week and adjust my dosage.
How long before we start trying should I stop taking pills?
She said that although “they” say it takes about 3 months, it can happen the first month so she suggested a month or two before, but “Be ready” for a positive result!
Caffeine/artificial sweetener intake during pregnancy? What is safe? When should I give it up/start limiting it?
She is OK with small amounts of caffeine – in her words a cup of coffee with stevia and half and half is OK. She said one additional drink with artificial sweetener is OK. I think I’ll switch to half caf and possibly go to decaf.
How often will I have to go to the DR?
Endo appointments – monthly. Email BGs weekly.
OBGyn – probably about twice/month, more towards the end (obviously)
CDE – communicate via email, appointments as needed.
If BG is high/low, what is the best way to correct? does the 15-15-15 rule still apply? Bolus or increased temp basal?
15-15-15 rule still applies.
She said most women bolus but if they remain high, then they will do a temp basal.
What is my carb intake goal at meals?
She was telling me something about the rule of nines – 2/9 of my carbs will be at each meal (so 6/9 total) and 1/9 at 3 snacks. Although she didn’t give me my daily carb intake. But did say that I will be meeting with a nutritionist.
Daily calorie range? How much weight gain is expected/realistic?
300 additional calories per day. 25-35 pounds is normal, but since I’m fat already (my words), I’ll have to be careful and shouldn’t gain as much.
Any foods I should stay away from other than the usual for pregnant ladies?
She wants me to make an eye doctor appointment within the next few months. We also made some adjustments to my I:C ratios – lunch went from 1:9 to 1:8 and dinner went from 1:8 to 1:6 to prevent some of those mid afternoon and post-dinner spikes.
Soooo, there you have it. As soon as the hubs and I are ready, we can get down to business. Eeeeeeek! I’m so excited/nervous/scared/happy/about to poop my pants!
Here’s your picture for WW – my “Oh shit!” face!
This Shit is Awesome! However, my recent trip was pretty uneventful as far as TSA is concerned. I was a little nervous about flying to New York this week since it’s been a while since I’ve flown with a pump. And now that I’m
more mature in my diabetes care in the “want to have a baby between now and the end of time” mindset, I wasn’t going to do anything to risk damaging my pump or CGM. Because they are, after all, my diabetes care BFFs. Previously when flying with a pump, I’d disconnect and send it through in my purse. The interwebs told me not to do this and to request a pat-down (or “pre-flight massage” as one PWD put it).
Before my trip, I thought about using the TSA Cares program like Meri and her sons used, however by the time I actually really thought about it, it was less than 24 hours before my flight. So rather than requesting a passenger support specialist, I simply called the hotline and asked them what to do. I may or may not have pretended that I’ve never flown with a pump before. The person on the hotline was very nice and she told me to just “Opt Out” and request a pat-down when I got to security.
So I did just that. I told the agent that I had to have a pat-down due to my insulin pump. She told me that I could go through the scanner, but I was firm and told her that I could not because it voided the warranty and since my pump was only a couple of months old, I did not want to risk it. She said “no problem” and had me step aside while she called over another agent to give me my “massage”. I stood there waiting for about 2-3 minutes until I was taken to a separate (although still public) area. The agent brought my things over and asked me if this was OK our would I want a more private screening area. I said it was fine and she began the process. She asked me if I had any sensitive areas and I patted where my CGM sensor is (my thigh) and my pump site on my belly. She began the pat-down, explaining to me what she was doing as she was doing it. Then I had to rub my hands over my pump and CGM receiver and they were swabbed for explosive residue. I was a little nervous waiting for the results of the swab, based on what happened to a fellow D-blogger, but all was good! I was on my way to wait for my very delayed flight!
All-in-all it wasn’t the huge deal that I had built it up a lot in my head. It probably cost me an extra 5 minutes in security, which, no big thing. I think in the future I may try the Passenger Support Specialists, especially way down the line when we have a kid (or two). The TSA agents I had at both RDU and LGA were courteous and respectful. They both did try to convince me that it was OK to go through the machines, but I was nice in my response and they were nice back. The agent in LGA even said “must be hard to deal with” in regards to traveling with diabetes. I just said that it’s not a huge deal, especially when I have nice TSA agents like her. Brown-noser.
The weekend with my friend was great! We had a lot of fun relaxing and catching up – much different from when we would visit each other when we were younger. The goal of those past trips was to eat all the food, drink all the drinks, repeat. Now, we’re like, grownups or something.
Oh, and FYI, my average BG for the weekend was 145, according to my Dexcom! Woohoo!
Reflections of an unpolished pebble ~ a type 1 diabetes blog
A Canadian fitness lover chronicling type 1 diabetes adventures
Real Diabetes. Real Life. Real...Baby? Maybe.
Life with Type 1 Diabetes and Motherhood, the highs and lows
Life as a Type 1 isn't all bad :)
Health Education Across America
A girl's life with diabetes and heavy lifting.
DiabetesAmerica on Wordpress
The Art and Craft of Blogging