Blue and organization!

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

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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!

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

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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!

TSA does not equal…

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!

OK, not really, but better than a broken pump, I suppose!

OK, not really, but better than a broken pump, I suppose!

Rookie Mistake.

The other day I made a rookie diabetes mistake.  I woke up in the morning, checked my pump and realized I had 22 units left to last me until I got home from work.  My daytime basal rates vary from 1.0 to 1.275, so quick, just awake math…8 hours = 10ish units.  And, there’s no way I’ll bolus more than 8 units for lunch, since my average lunchtime bolus is about 5.5 – 6.0 units.  Breakfast is usually about 3-4 units, so, I’ll be just fine until I get home from work!

Mistake number one: A wise diabetic would’ve thrown a vial of insulin in her purse, along with a new cartridge and inset.  I never claimed to be wise.  

Off to work I go, excited for the D-girls gathering that evening and I notice that my morning numbers are running a little higher than normal.  I try to limit my rage boluses to when I’m 200+, instead I rock a temp basal.  So I set my temp basal at +50% for 90 minutes.  Mistake number two.  (Although, D-friends, it’s never a mistake to try to lower your blood sugar, amiright?)

Lunch time rolls around and I have my standard I’m-too-lazy-to-make-lunch Lean Cuisine.  Attempting to be healthy-ish, I had grabbed a banana to have along with it, rather than the Sunchips I have in my desk drawer.  My Ping tells me to bolus 7.55 units so I do because it is way better at math than me.

Literally as my bolus is being administered at warp-Animas-Speed, I remember that I’m low on insulin.  However, the Ping delivers it’s bolus in like, 0.00004 seconds so by the time I realized, it was too late.  Mistake number three – should have checked the amount of insulin I had in my pump before bolusing and deciding to eat that banana!

At this point I had 3 units left.  I thought about setting a temp basal of 60-70% so that even though I’d probably run a little high, it was better than getting no insulin at all.  However, I decided that this wasn’t that dire of a situation.  I work 20 minutes from home and I have a decent amount of sick time.  So, I figured I’d leave when I got down to 1 unit (to spare my coworkers the annoying “You’re out of Insulin!” song) and take a couple of hours of sick time.  I told my supervisor that I miscalculated my insulin in my pump and she, I think, thought death was imminent.  “Ohmygod, LEAVE!” was her reaction.  I told her I still had a couple hour’s worth of insulin in my pump and I’d leave when needed, which was about 2 hours later.

Rookie mistake(s).  Lessons learned – if you are borderline making it through the day, bring your supplies to work.  Better safe than sorry.  Check the amount of remaining units in your pump before deciding to eat the banana/bolus/set an increased temp basal.

And most importantly, don’t attempt to do math before having your coffee.

Not a week goes by….

… without fighting with my insurance company.

Warning: this post is rather venty and may contain some adult language.  Parental Guidance Suggested.

For the past few months I’ve been in one battle after another with my insurance and/or pharmacy benefits company.  Luckily, everything went smoothly with obtaining my insulin pump and CGM.  However, there have been a few headaches that I’ve had to deal with that are really starting to piss me off.  As if we PWDs don’t have enough to deal with, but insurance makes us jump through hoops (of fire, it seems) to get things done.

Test Strips – My blood sugar meter “talks” to my pump.  Yay, Animas!  It’s a One touch meter, not some fancy unique brand that no one has ever heard of.  Well, my strips cost $95/month.  I’ve reached my out-of-pocket max for this benefits year (a perk to making major cyborg-living purchases!) so since they are classified as Durable Medical Equipment, they should be covered 100% for the rest of my benefit year.  Of course they weren’t so I called and was told they aren’t the preferred brand so if I want them covered 100%, I need to switch meters.  Pisses me off.  My pump supplies (remember, my meter “talks” to my pump) are covered, no questions asked.  So, fine.  I’ll switch meters and only use my meter remote when I will need to bolus from it (wearing a dress).  Worth it to save $$ and not a huge deal since I bolus from my Ping 99.7% of the time anyway.  I call to order my new meter (Verio IQ) and they are back ordered/recalled/they don’t like me so they won’t send me one/something.  So, guess who is on her last pack of strips and has to order more at $95 for a month?  THIS GIRL.  I am tempted to call and argue that they should cover this month’s worth of strips since it’s not exactly my fault that I don’t have my new meter yet.  But, I really doubt I’ll win that fight and frankly, I’m tired and don’t even feel like putting forth the effort.
Insulin – Previously, I used Humalog.  Was always covered with no problems.  Well, my doc switched me to  Apidra.  However, when I first got back on pump therapy, my pharmacy didn’t have any Apidra in stock so I used a vial of Humalog that I had to get started.  Worked fabulously.  But, my Endo wanted me to try Apidra so once the vial of Humalog was empty, I switched to it.  I feel like I’m not reacting to it as well as I did with the Humalog, so I asked to be switched back to see if this is the case.  This is all within the last 6 months.  Endo says, no problem, writes me a script for a 90 day supply of Humalog.  I mail it in to my mail order pharmacy and now my pharmacy benefits people are saying it’s not covered.  Something about the “formulary changed”.  Oh, I can get it, I just have to pay out-of-pocket.  So now I have to use a sub-par (for me) insulin because some higher up in some office decided that they weren’t going to cover my insulin.   Granted, it’s not like my control with Apidra is all over the place (if it was I’d be sure to appeal!), but I wanted to see if I’d do better with Humalog, like I think I would.
Dealing with insurance shit makes me rage.  I don’t expect anything to be free, but I’d at least like reasonable options when it comes to my diabetes management.  $1200/year just to test my blood sugar is outrageous.  Telling me what insulin I can and cannot use??  What the French is up with that?!
I don’t often get diabetes burnout.  Sure I’ll have a day here or there where I’m temper-tantruming against the disease.  But, man.  Insurance company burnout?  I have that 24/7.  I just don’t understand why it has to be so hard to make dealing with diabetes or any other chronic illness just a little bit easier with maybe a few more choices so we can make the best decisions for ourselves to manage this disease that we live with every day.
Maybe some day, this will be me.
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Giving diabetes the Stink Eye

I’m annoyed with diabetes today.  Usually I try to let the day-to-day annoyances of the managing the D roll off my back and not get me down.  I try to have an attitude of “it is what it is, deal with it and move on”.  I think if I dwelled on how huge a pain in the ass Diabetes really is, I’d probably be pretty miserable to be around.  Pity party of one.  That being said, I am human and of course I have my days where I just want to throw my hands up and scream at the top of my lungs “This crap really, really sucks!”.

It started last night.  The husband and I were going to have some, ahem, fun-adult-married-couple-time together.  Before going to our chamber of love, I glanced at my Dexcom and saw 92 with a single down arrow.  So I downed half a glass of juice to prevent a low.  Of course, this didn’t work.  A little while later at quite an inopportune time, my Dexcom started yelling at me that I was low.  I felt OK so I ignored it.  A few minutes later the low started to hit me so I had to tell the husband we had to hit the pause button so I could test.  53.  Yay.  More juice for me.  We waited and pillow talked and I didn’t feel like I was coming up so after a bit the plug was pulled on our fun adult time.  The mood was pretty much killed then anyway.  Thanks diabetes, for the unexpected and unwanted threesome.  Grrrr.

Of course after this longer than usual low episode, I over-corrected so my Dexcom was yelling at me all night for being high.  So in my half asleep-ness, I bolused and set up a temp basal and, you guessed it, woke up low this morning.  Needless to say, I was especially slow getting moving this monday morning.

I am also having one of those days where the presence of my gizmos and gadgets is annoying me.

So yeah, I’m cranky pants.  I wish we could just take a day off from diabetes.  I know tomorrow will be a better day, but for today, you get the stink eye from me, D.

Not my dog. Kinda wish he was though.  Image from the google.

Not my dog. Kinda wish he was though.
Image from the google.

Friday Fives – June 28

1.  I really wish the Dexcom showed your 24 hour average blood sugar on the receiver!

2.  I may have to try the side boob as a pump site.  Just to see.

3.  I love the weekly DSMA twitter chats.  So fun!

4.  My MySugr monster’s name is Dia-Butthead.  He’s not supposed to be so cute, is he?

5.  Pre-bolusing is a tricky thing when you realize that your baguette is stale.

Endo Appointment Round Up

Today I had an appointment with my Endo’s Physician’s Assistant.  Honestly, I kinda like him more than my endo (although she’s pretty awesome too!).  He’s young, very thorough, and never seems rushed.  In fact, he spent an hour with me today, which is just unheard of.  Unfortunately I wasn’t due for an A1c test (WAH!) as I had one within the last 3 months.  Kind of a bummer because I wanted to see how my new cyborg life has affected things.  But, I go back in August so I don’t have to wait too long.

We made some adjustments to my evening basal rate so my rates are now:

12 MN – 1.0
8 am – 1.2
2 pm – 1.0
8 pm – 1.6

Insulin to Carb ratios stayed the same:
12 MN – 1:15
7 am – 1:10
11:30 am – 1:9
5:30 pm – 1:9
9:30 pm – 1:15

Insulin sensitivity factor remains at 40 with my goal BG remaining at 120 +/- 10.

So, all in all, decent appointment.  I had emailed my CDE my CGM and Animas reports yesterday and told her about my nephew and that may account for some of the wonky sugars I’ve had over the past week or so.  She asked me when my appointment was and came over today to give me a hug and chat for a few minutes.  So nice.  I am really liking Duke!  My CDE and I have been in pretty close contact since I re-started pumping, I cannot say enough good things about her.  She’s awesome.

I had the PA write me a script for AccuChek test strips and he gave me a present of a shiny new AccuChek Nano.  I’m going to be calling my insurance company to determine exactly what I need to do to get my strips for free now that all of my out-of-pocket expenses have been met.  Hopefully what they told me last month about Accuchek strips being covered 100% is true.  And I have a good supply of one touch strips so should I ever need to use that meter for remote bolusing, I can.

On a personal note, I am muddling through with everything.  Staying busy helps.  My friends and coworkers have been so kind to me and I’m very happy that my sister and her family have such a strong community of friends supporting them.   

A Day in the Life, My #DayofDiabetes

Wow.  I don’t think I could have picked a worse day for my Twitter #DayofDiabetes.  Typically, my blood sugars behave fairly well.  Sure, I’ll have some ups and downs, but last Wednesday was a day full of all ups and all downs.  There was no stability at all.  I am quite embarrassed that this was the day I chose to share on Twitter, however, it just goes to show that Diabetes really will sometimes do what it wants despite our best efforts.

Overnight leading in to my day, I had a blood sugar of 43.  This is pretty low and even though I usually wake up on my own from my lows, it wasn’t until my Dexcom alarmed that I woke up.  I have no idea how long it was alarming for, but I sure am glad for that little device.

In typical overnight-low-blood-sugar fashion, I treated it with everything that could fit into my mouth (cereal, and more cereal, oh, and why not, some more cereal!).  Why is it so hard to stick to the 15-15-15 rule (Consume 15 grams of carbohydrates, wait 15 minutes, and your BG should come up 15) when you’re low, specifically when these lows are overnight and you also have half-asleep grogginess to contend with?  After I started to recover from my low, I even had the sense to give myself a small bolus because I knew that after eating the entire box a large bowl (or two) of corn flakes, I was bound to go high and honestly, I didn’t want to have to listen to my Dexcom beeping all night.  And I didn’t want to wake up with a high blood sugar in the morning.

In the morning, I learned that my plan failed:

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Decided to wait on eating breakfast (except for coffee.  Gotta have my coffee) and gave myself a bolus to bring my sugar down and cover the sugar-free creamer in my coffee.  As I usually level out by noon with these “over correction” highs, I still packed my gym bag in anticipation that I’d be going to boxing that evening.
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After a couple of hours, my blood sugar still hadn’t come down so I gave myself a mini-bolus of 1.05U to try to get it to come down before lunch.  I always get nervous about stacking my insulin like that but it was being so super stubborn!
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Back to our regularly scheduled programming of working, despite feeling icky from the extended high blood sugar.  A couple of hours later, my sugar had slightly come down.  Time to bolus for lunch!
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Lunch wasn’t exactly the best and I broke my “No Lean Cuisines” goal for this week but sometimes you’re just rushing in the morning and don’t have time to make something.  And dealing with the “low, then high” hangover in the mornings doesn’t exactly make you feel energized and ready to take on the day.  Despite my not so hot Diabetes Day, I still was committed to entering my food into My Fitness Pal.  Yay for persistence?
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I had hoped that after lunch, my blood sugar would come down.  Nope.
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😦 But, with diabetes you must have a sense of humor!
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One of the best things about the Diabetes Online Community is the sense of support you get from people who “get it”.
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Thanks for the support, ladies!  I needed it that day.  Badly.
Finally, after a few hours, my blood sugar came down.  Although not far enough and I made the decision to skip (Sky?) the gym.
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At the suggestion of another twitter friend, I did a 200% basal rate for the remainder of the afternoon.  Finally, when I got home from work it appeared that my blood sugar decided it wanted to play nicely.
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Or maybe not.
crashlandingI had dinner (turkey sausage, steamed squash and zucchini, egg noodles – yum!) and my blood sugar returned to normal.
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For a few minutes, at least.
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Hey, at least I got to eat dessert guilt free, right?  I was happy that evening was the weekly Diabetes Social Media Advocacy Twitter Chat.  I’m so happy that I discovered this weekly chat, and although sometimes it is hard to keep up for this newbie Twitter-er, it’s a great weekly event that I’ve enjoyed tremendously!  That night it was an open chat (usually the administrators ask 5 questions that we all answer) and I enjoyed getting to know some of my DOC friends better.  It also distracted me from my icky day.
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Finally, it was time for bed.  I was exhausted after the many ups and downs of my day of diabetes.  *yawn*
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What a day!
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Things I learned from my Day of Diabetes…

  • Diabetes never behaves how you want it to.  I had hoped that my Day of Diabetes would be one of those perfect days where my post meal spikes were below 180 and I stayed right around 110 all day.  Sadly, that didn’t happen.
  • BUT my day did reflect the frustrations that come with Diabetes.  Every day is different.  You can do the same exact thing 2 days in a row and get different results.  The key with dealing with it is to be patient and remember that tomorrow is a new day.
  • The Diabetes Online Community is great.  The support received from other people with diabetes is immeasurable.
  • Temporary basal rates are our friend.  I tend to always have a knee-jerk reaction to highs and bolus, bolus, bolus when I really need to use temporary basal rates so I don’t have those horrible crash landings.
  • If I always tweeted every Diabetes-related action or thought, I’d probably have zero twitter friends.  🙂
  • Every day is a day of diabetes.  And every day is a chance to learn something new about the disease and yourself.

It’s a pager…it’s a cell phone…it’s a…camera?

Last night the Hubs and I were out purchasing me some golf clubs (Because, you know, I golf every weekend.  *Note – I’ve never been golfing, but it looks fun and I had a gift card.)  We were chatting with the sales dude and he notices my pump, which was clipped to the pocket of my jeans, facing out.  He asks, “Is that…ohhh, is that a camera?”.  I’ve heard pager and cell phone, but never a camera!  I just said, “Oh, no, it’s my insulin pump.”  He replies “Ohhhhh, looks like a camera!” Maybe he thought I was a super techy secret shopper? I responded “Nope, just my pancreas.”

The Hubs said I made the guy feel bad, but I was just trying to be my sarcastic self.  How do you respond when people ask you what your pump is or mistake it for something else?