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!
***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.
Five things only a PWD has to think about:
1. When buying a new purse…”does this have enough room for all my D supplies”?
2. When wearing a dress…”Is the cleavage too low for the between boobs pump clip-age?”
3. Before a workout…”Do I need to consume calories in order to burn calories?”
4. When purchasing a bathing suit…”Tankinis. Need to find all the tankinis”. (I don’t know if any other female PWD feel this way, but I feel like one piece suits are a massive PITA when it comes to the pump.)
5. All the time…”When was the last time I ate? Do I need to check my BG? Is that headache because I’m annoyed with work or because my BG is off? I’m thirsty – am I high? Did I remember to throw those glucose tabs in my purse? Should I rage bolus or use a temp basal to get my BG down? Do I really have to do all this again tomorrow?”
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.
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!
The other day my husband was poking around on the interwebs and came across a forum where someone was discussing “Prepping” with Type 1. This prompted him to ask me if I had ever thought about it, which lead me to say I’d be screwed and he has permission to eat me should he ever need to. We used to live in a hurricane prone area, so one would think that I’d be prepared but the great thing about hurricanes is…you usually know they are coming. Of course, since the husband kinda digs me, he decided to come up with a plan should the crap hit the fan due to a fire, blizzard, alien invasion. So, without further ado, here it is…
A Guest Post by Laura’s Husband
The funny title and all joking aside, I wanted to try to make an informative guest post about “prepping” – an often sensationalized topic in this day and age. I wouldn’t say that Laura and I are “preppers” in the sense of the pop culture stigma. However, I was a Boy Scout when I was a kid and as the motto goes – I like to “Be Prepared”.
In case you’ve seen it, please know that I don’t like the TV show “Doomsday Preppers”. I think they highlight more of the eccentric personalities of prepping more than providing any useful real world education. I am however a big fan of TV shows like “Lost, “Revolution” and movies like “Castaway”. So I ask – What have you done to help prepare yourself or your loved ones for any real life emergencies related to the treatment of diabetes? How about a situation like one that may come up on TV or in the movies? Those are obviously the extreme and if you think about everything up to that extreme – you’ll be prepared for anything in between.
Preppers often organize their preparedness into a number of different “bags”. I thought it would be good to create a quick primer on these different types of bags and some of the situations where you might like to have them with you.
Most T1 diabetics are already great at keeping their “Day Bag” stocked out of necessity. Obviously you’d keep your daily insulin, meter & test strips, syringes, alcohol swabs, pens, tips, and glucose tablets here. Laura likes to keep some small snack foods in her purse, such as a granola bar or a rice crispy treat. Maybe some small candies like Smarties. Not ideal ways to treat lows, but there if you need them.
Get Home Bag
I like to think of this bag as the bag that gets you through the 12 hours you get trapped in your car on the interstate during an ice storm. This isn’t something that happens often where we live, but when it does happen every few years it is crippling. This is a bag that is kept in the trunk of your car.
Related to the D, this bag might have a reservoir, an infusion set, more syringes, lancets, more pens and tips, some extra pump batteries, maybe a spare meter and test strips. If you’re not carrying your Glucagon in your Day Bag, one would be here and you would tell everyone that its there. This would also be a good place to have more snacks and maybe a few bottles of Coca-Cola and obviously bottled water. This is an area where some extra care is needed, especially in the dog days of summer where a soda might explode due to the intense heat. I don’t care what Mythbusters said, it is totally possible.
Since folks may not be used to having a bag like this in their car, this bag might also have some things like comfortable shoes, extra layers of clothes, gloves, hat, sunscreen, headlamp / flashlight, knife / multitool, dust mask / handkerchiefs, matches / lighter, extra money (around $100 recommended), etc, etc, etc. Laura currently works about 9 miles from our house. This bag should have the supplies needed to literally walk those 9 miles home if needed.
Bug Out Bag
The one that gets made fun of the most… but be honest – if your house caught fire, do you have a bag ready to go at a moments notice that will help you survive the next 48 to 72 hours related to T1D?
One of the best things you can have in this bag is a copy of all your prescriptions and a thumb USB drive with your health insurance and medical information. Next is some cash and a credit card to begin replacing anything you might need, refilling those prescriptions, etc. In this bag are also more infusion sets, extra sensors for your CGM, an extra charger for your CGM if you have one, more batteries, more Glucose tablets, more syringes and most importantly – Insulin. Unfortunately insulin is the biggest challenge with prepping for someone with T1D. It’s recommended to stay cold, has an expiration date, and once opened needs to be used in a month or so. This bag should have a small cooler or something like an insulated lunch box for your insulin.
The exit plan from your house is completely dependent on the situation at hand, but if time allows there are 3 stops that are made and all can be done in less than a few seconds.
1) Grab the B.O.B. (obviously the bag, not the fun times B.O.B., but hey, I’m not one to judge your priorities)
2) Grab insulin from the fridge and ice packs from freezer.
3) Grab important papers from the safe such as passports / birth certificates.
In a fire, I might be able to make those 3 stops… maybe not. Obviously, get yourself and loved ones out if the situation is dire. But if I didn’t have that bag prepared, there would be many more than 3 stops and probably no chance at making them.
Long Term / Permanency
It’s obviously not likely that something like “Revolution” will ever really develop… but if it did, there would be some significant challenges related to T1D. Test strips run out, there is no way to keep insulin cool, it also runs out, etc. Unfortunately, we don’t have the means to buy a ~1 year supply of T1D treatment supplies to keep a stockpile… but it might make sense to try to stockpile expired insulin or those old test strips and meters from the brands you didn’t like or the insurance company stopped covering. If you find an expired vial, don’t throw it away… clearly mark it and save it. It may not be as potent as fresh stuff, but if you’re at the end of the rope and your life depended on it – wouldn’t it be better to try than nothing?
For many reasons, I used to think about getting Laura a diabetes alert dog. Though now that she has a CGM, I don’t really think about it. Again – it’s extreme from a prepping perspective, but without test strips an alert dog might be a way to help monitor blood sugar. Unfortunately, you then run into the challenge of needing to prep for your dog! This won’t be something we really explore as we don’t have the funds to properly train a service animal and with the price and availability of CGM it simply doesn’t make much sense financially.
We’ll save the discussion of burying a cache of insulin somewhere out in the woods for next time. Just kidding about that last part, but as you can see – being prepared never ends. You don’t need to be a Doomsday Prepper, but any step you can take to make sure you can take care of yourself in an emergency is a positive step to being prepared!
If anyone has suggestions on better T1D preps, please leave a comment below. Insulin is by far the area where more thought and consideration is needed.
Until next time…
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