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Blood Sugar Turbulence.

“The captain has the seatbelt sign on.  Please stay in your seats until the seatbelt sign is turned off.  This is for your safety.”

The flight attendants were also in their seats, having suspended drink service.

Turbulence sucks, but it passes quickly … usually.  Unfortunately, on this flight it seemed like it was going to be a 20 – 30 minute wigglefest for the plane.  And also unfortunately, we were at 38,000 feet and my blood sugars appeared to be making the same climb.

I’ve noticed, especially since my pregnancy last year, that I need to change my infusion set at the three day mark, or my absorption goes full crumb (climbing blood sugars, sticky highs).  I was traveling home from the TCOYD ONE conference in San Diego (awesome event –  more on that conference tomorrow) and my “it’s been three days – change your site!” alarm went off the day before.  I was on borrowed time, infusion-set wise.

I meant to change it at the airport but time was too tight.  And I had no intentions of changing it at my airplane seat, but my blood sugars were high, seemingly stuck there, and I needed to swap out that site ASAP.  Who know how long the air was going to be rough, and I could already see that my blood sugars were in garbage mode. So, tucked against the window and using my scarf as a barrier between me and my seatmates, I was able to quietly change out my site.

Covert site change on the plane. #insulincognito #latergram

A post shared by Kerri Sparling (@sixuntilme) on

And yes, the beeps are usually loud an intrusive but the speaker for the X2 is on the backside of the pump – that series of little holes – so keeping my hand firmly over that part made for a subtle set change.  Shrugged my shoulder out of my shirt and popped the infusion set on the back of my arm and I was good to go without even a side-eyed glance from my seat mates.

Stealth set changes at 38,000 feet without going into the nasty little airplane bathroom? And blood sugars that started coming down within 20 minutes of the set change? Check and check. See ya, blood sugar turbulence.

Dexcom Adhesive, Activated!

Nothing to see here, especially if you’re looking for an adhesive-related Dexcom rash. Because ever since switching to the sensors that expire after 8/17/17, the rash is a thing of the past.

Now I can wear my sensors for the recommended seven days (sometimes stretching it a day or two here and there, if I’m feeling bold), and my skin is fine when I remove the thing.

Great joy! YAY!!!!

However, if I add any Opsite Flexifix tape, that’s suddenly causing an irritation. It’s like the reverse of what was happening for years.  So.  Close.

But it’s awesome to be adhesive itch-free after almost five years of scratchy-scratch.  Life without blistering skin reactions, Toughpads, and welts that last for over a week is so much nicer.

The only downside to the new post-08/15/17 expiration sensors is that the adhesive itself seems to be weaker.  For the first time in years, I had a sensor go loose and yawn off my skin after 10 hours of wear.

A quick call to the Dexcom customer care team was quick to replace this sensor, thankfully.  And I learned something random on the phone call.

“Are you pressing down on the sensor adhesive after application?” the customer service guy asked.

“Yes, I am.”

“Oh good.  That helps activate the sensor adhesive,” he said.

“It activates it?”

“Yes, and that’s what helps it stay stuck.”

Huh.  I’d only heard that once before (earlier in the day, from Abby in the instagram comments section), but apparently it’s true.  In order to DEXCOM ADHESIVE, ACTIVATE!, you need to press down on the adhesive part.  Is that common knowledge or just instinctively done by most Dexcom users?  For me, it was just something I did without thinking, kind of like riding a bike.

tl;dr – The rash is gone. Make sure you press on your sensor adhesive.  Write a blog post about it once in a while to confirm that the rash is still MIA.  And long live sensors that expire after 08/15/17!

Diabetes Pregnancy: Now and Then, Part Two.

Welcome to the continuation of Laddie’s pregnancy story, showing what pregnancy with type 1 diabetes was like back in 1979 and 1982.  Today is a continuation of her story, with details about her sons’ births, the cost of care, and how diabetes did, and didn’t, play a role in bringing her sons into the world.

For more about Laddie’s life with type 1 now, you can visit her blog.  She’s awesome.  🙂

  *   *   *

1979: Baby Boy #1

I was diagnosed with diabetes late in 1976 and became pregnant with Mike less than 2 years later. I was referred to the obstetrician down the hall from my internist’s office. I didn’t know to ask for more intensive care and my personality probably would have insisted that I was not “different” from other pregnant women in their mid- 20’s. There were no home BG meters in those days and I was in good health. So I am not exactly sure what would have been done differently.

What are some of my memories? I had “morning” sickness that got worse as the day went on. No puking—just sickening nausea. I was hugely sensitive to smells and barely survived the weeklong visit of my mother who smoked. Although women who suffer from morning sickness are advised to avoid greasy foods, I totally craved Kentucky Fried Chicken and without fail it made me feel better. I remember the clothes: two jumpers, one hunter green and one navy blue, that I alternated daily with different turtlenecks and the horribly-patterned tunic blouse that I wore with beige corduroy pants. Because we didn’t know the sex of our children before birth, I sewed gender-neutral Winnie the Pooh cafe curtains and yellow-checked bumper pads for the old wooden crib that had been my husband’s. Crib safety standards weren’t a big thing in the 1970’s.

If you want a clue about my birth experience with Mike, just look at his statistics: 11 pounds 11 ounces and 24 inches long. Labor and delivery were hugely painful and towards the end, I received a drug that was magical. Most of the delivery is a blur in my mind but my husband vividly remembers the forceps. We always joke with our grandchildren about the “yankers” used in the Berenstain Bears dentist book to pull out teeth. Well, Mike had the big yankers that pulled him from his warm comfy floating life inside Mom. It took weeks (or months?) for the dent on the side of his head to resolve.

Although I mentioned previously that I only had two glucose tests during my entire hospitalization, Mike had five on the day he was born. I assume that this was to monitor hypoglycemia that is common in babies of moms with “poorly-controlled” diabetes. There were other health concerns that required specialized monitoring, but ultimately Mike was fine. He developed jaundice and required a couple of days under the lights. In today’s world I would have gone home on my third day with daily nursery visiting privileges. Not in 1979. I was asked whether I wanted to stay in the hospital with him and I did for a total of six days. I might argue that for psychological reasons and breast-feeding, it was medically justified …

1979 Statistics:

  • Birth Month/Year:  April, 1979
  • Birth Weight:  11 lbs 11 oz
  • Birth Length:  24 inches
  • Mom Days in Hospital:  6 days
  • Baby Days in Hospital:  6 days
  • Total Fee to Obstetrician:  $450
  • Mom Hospital Bill:  $1,079
  • Baby Hospital Bill:  $1,044

1982: Baby Boy #2

When I became pregnant in 1981, nobody had learned their lessons from my first pregnancy. Once again I visited the obstetrician down the hall from my internist. Once again I visited my doctor every 6 weeks for a blood test and probably drank a lot of water to dilute the sugar in my pee for Diastix tests. It is only because I know the story of Chris’ delivery that I am appalled that I did not see a high-risk obstetrician during this pregnancy. I am appalled that a C-section wasn’t performed. I am appalled about a lot of things. But I didn’t know any better and I guess my doctors didn’t either. Once again I had no home blood glucose monitoring. My insulin regimen was better than in 1978-79 with the addition of Regular insulin. However, as far as I know the doses were fixed and not an equivalent of today’s MDI (multiple daily injections) regimens.

I remember less about this pregnancy than my first. Probably I was too busy taking care of a 2-year old to pay much attention to routine doctor appointments. I do recall that Mike knew where every bathroom was in the southern suburbs of Minneapolis. “Mom, why do you need to go the bathroom again?”

If you look at the birth weights of my children, you might think that I had better diabetes control during my second pregnancy than my first. Fooled you! Chris was born three weeks early and missed the final weeks of sugar-saturated nutrition that is baby-poison.

Three weeks before my due date, I made a new casserole that had spaghetti sauce, hamburger,  and crescent rolls from the tube. This recipe is not on the list of the Top Ten Meals to have before delivering a baby and I have never made it again. Later in the evening my water broke and off to the hospital we went. My baby book notes indicate that I spent the night at the hospital with light contractions and Dad slept at home.

I did not go into labor and the next morning was given Pitocin to induce contractions. Pitocin labors tend to be “rougher” and ‘harder” than natural labors but I don’t remember whether this labor was worse than my first one. 5-6 hours later Chris was born. Once again, I want to ask: why wasn’t a C-section performed???

I don’t have many memories of Chris’ birth. I remembered the incredible pain of my first delivery but had the confidence that it would be over soon and I just needed to breathe and relax. My husband has the nightmarish memories of the birth of a baby who was delivered and stopped breathing. Chris had broken his collarbone during delivery which is not an uncommon occurrence. Unfortunately the broken clavicle bone pierced his trachea and lung. I don’t remember anything else before hearing from my husband later that Chris was in intensive care at Minneapolis Children’s Hospital and was doing OK. Actually I do not think that I even knew that there had been a problem with the delivery and must have been in some drug-induced stupor.

I recovered quickly from the delivery and 3 days later began the daily commute to Children’s Hospital. I was provided with a tabletop breast pump that I recall weighed a ton and was about a foot square. Chris was amply provided with breast milk through a feeding tube. I’m not sure that there had ever been a baby like Chris in the NICU which is usually filled with tiny 1-4 pound premies. At 10 pounds 3 ounces Chris probably weighed more than the combined weight of the other babies in the unit! He spent 15 days in the hospital on a ventilator as his trachea and lung healed and his lungs matured. In those 2 weeks there were two record-setting snowfalls of 18-24 inches and my memories are of cold and endless 11-mile commutes on slippery snowy back roads.

Chris ended up being fine and 35 years later I continue to give thanks for that. His close call didn’t need to happen. Of course I blame my diabetes for putting him at risk, but I also blame my obstetrician who didn’t perform a C-section based on the history of my first delivery.

1982 Statistics:

  • Birth Month/Year:  January, 1982
  • Birth Weight:  10 lbs 3 oz
  • Birth Length:  21.75 inches
  • Mom Days in Hospital:  3 days
  • Baby Days in Hospital:  15 days
  • Total Fee to Obstetrician:  $575
  • Mom Hospital Bill:  $1020
  • Baby Hospital Bills:  $898 + $14,795

Babies at Home:

I don’t have memories of how diabetes impacted my life once I was home with babies. However, just because I don’t recall anything doesn’t mean it wasn’t hard. If there were lows while nursing, they are lost in the brain frizz of watching soap operas and snippets of TV shows in the middle of the night and never knowing how they turned out. My scary memories of lows with young children are all a few years later when I was driving and I can’t stand to think about that. I didn’t know anyone else with diabetes when I was a young mom and I was very private about it anyway. I think I just ate lifesavers and took my shots.

I don’t recall worrying that my children would have diabetes and I don’t think that I ever pressed a Diastix strip into a wet diaper. Diabetes books indicated that the risk was low and without the DOC, I didn’t know any Type 1’s parents with Type 1 children. Also in my family, only my sister and I had diabetes and not my brother. Therefore only girls got T1 and I had boys…. That ignorance used to be bliss, but I now have 4 granddaughters.

I hate diabetes and it tried to rob me of a lot of good things when it came to having children. But it didn’t win. My babies were warriors and I was pretty darn tough also. I rejoice for the great medical care that women with Type 1 diabetes get these days and I admire how incredibly hard these women work throughout their pregnancies. Healthy babies are a prize worth fighting for.

Diabetes Pregnancy: Now and Then.

Managing diabetes and pregnancy in 2010 and then again in 2016 was a lot of hard work, and my story is similar to so many moms in the diabetes community:  a heavy focus on blood sugars, piles of doctor appointments, and dozens of tests for mom and baby.  Today’s management of diabetes and pregnancy is very different than what was available 30-something years ago.  Which is why I’m thrilled that my friend and fellow mom with diabetes, Laddie from Test, Guess, and Go, offered to share her story about what diabetes and pregnancy was like 30 years ago.  

Laddie held on to an incredible amount of information regarding her pregnancies, which is why I’m breaking her guest post into two sections; I didn’t want to leave anything out but I didn’t want anyone’s finger to fall off from scrolling.  🙂  Here’s part one of her incredible journey.

  *   *   *

Like everyone in the DOC, I’ve followed Kerri’s pregnancy diaries with smiles, tears, and warm fuzzies in my heart. I’ve watched her hard work optimizing blood sugars and the intense and state-of-the-art medical care. I’ve delighted in the joy of her posts and the depth of her love for her children. At the same time I’ve always felt a little sad at how much fear and self-judgement was mixed in with the good stuff. I can’t pretend that I don’t have 40 years of diabetes inner demons, but sometimes my rose-colored glasses allow me to forget them. Unfortunately diabetes loves guilt and blame and few of us are exempt from its demands.

I’ve never been able to read the pregnancy narratives of Kerri and other T1 bloggers without a few chuckles at how different my childbearing experiences were. I am a woman with diabetes who had really big babies and no c-sections. That is not necessarily a good thing or anything to brag about, but it is my story. I had two children before the availability of home blood glucose meters and before the landmark Diabetes Control and Complications Trial that proved that good blood glucose control makes a difference in diabetes outcomes. As a mom-to-be in my late 20’s, I received no more intensive medical care than my gluco-normal friends. That was probably fine for my health but the risk to my babies was off the chart.

I must stop here and confess that I can only tell my tale because it has a good ending. Two adult children and 6 grandchildren are testament to my good luck, the grace of God, and good medical care interspersed with less than optimal care. My story could have had a nightmare conclusion and it scares me how close we came to losing our second son.

Recently I approached Kerri with the idea of collaborating on a “Then and Now” discussion of having babies while living with type 1 diabetes. We shared a few statistics back and forth and Kerri quickly discovered in a diabetes circle-of-life way that she and my first son were born the same year. Maybe I should be talking with Kerri’s mom! For sure this explains my once-in-a-while tendency to overstep DOC etiquette and write bossy-Mom comments to her.  [Note from Kerri: my mom would love you, and also I value your mom-ments so much.]

With a seven-year old daughter and a son not yet one, Kerri’s memories of pregnancy are current and accurate. Suitcases of BG logs, Dexcom tracings, medical records, and insurance EOB’s allow her to neurotically detail how many doctors appointments she had during each pregnancy, how many miles she drove to and from Boston, and what her blood glucose numbers were every minute of every day. I have muddled memories and little way of knowing how accurate some of them are. I don’t have medical records from those years but do have itemized medical bills, handwritten spreadsheets, and faded photos. For the most part anything I write here will be a combination of fuzzy recall along with a “Follow the Money” analysis of my paperwork.

I’ll start by paraphrasing and answering a few questions from Kerri’s email.  [Another note from Kerri:  the details of both pregnancies will be included in the second post.]

What kind of preparing did you do diabetes-wise? The answer is a straightforward “Not a darn thing!” I was diagnosed with diabetes when I was 24 years old and have a vague recollection of my GYN telling me not to delay pregnancy because it would be easier sooner rather than later. I wasn’t afraid of pregnancy because I was naive about diabetes and had few books, no community, and no Internet to remedy that. Unlike women like Kerri who were diagnosed as children, I didn’t have years of doctors warning me about the dangers of pregnancy. I had no Shelby-dies-nightmares because Steel Magnolias hadn’t been released yet.

As far as I know, I didn’t do anything special related to diabetes to get ready for pregnancy. I suspect that because of my apparent good health and the short duration of my diabetes, my doctor underestimated the care that I should have received and did not refer me to an endocrinologist or a high-risk obstetrical practice. With no home BG monitoring, I’m not sure what options there would have been to “intensify” my diabetes management. During my first pregnancy I took 1 or 2 injections of Lente insulin a day. Pharmacy records show that Regular insulin was added to my regimen before my second pregnancy, but I’m sure it was a fixed mealtime dose. I was probably advised to follow my Exchange Diet as best I could.

How did your OB/GYN handle your diabetes alongside the pregnancy?
I hate to say that I don’t know a lot about this except that I think urine tests were performed at each visit. Why do I remember this? Because one of my most vivid memories is drinking a ton of water on OB days and then going to the library near the OB’s office for a final pee before showing up at my appointment. This was all so that when I peed on a strip at the OB office, the pad might remain light blue instead of changing to the dreaded dark brown. Although I keep saying that diabetes education was minimal in those days, I obviously knew enough to try to hide what my blood sugars were doing. Too bad the developing babies in my womb weren’t fooled by the drink-a-lot trick.

Did you check your BG more? Cue the laughter track. I did not get my first home BG meter until my youngest son was 3 years old.

Were you using a urinalysis kit? Yes. When I was diagnosed with diabetes in 1976, I used Diastix several times a day to check the sugar spill into my urine. I dutifully logged the result as anything from Neg. to 4+. People diagnosed before me and many diagnosed at the same time used Clinitest with drops of urine, tablets, and test tubes. I never used that. My hand-written spreadsheets indicate that urine strips were not reimbursed by insurance and I remember cutting them in half to save money.

Did you see the doctor more often than your non-D counterparts? My copies of doctor bills indicate that I saw my internist about every 6 weeks for a Glycosolated HGB lab test (early version of A1c). I have no medical records to indicate the test results or my doctor’s advice. I do not think that I saw my obstetrician more frequently than other patients. I have few bills other than the comprehensive fee “OB Care – Total” and a couple of itemized lab tests. Fetal ultrasounds were extremely rare in those days and I did not have them. The tech-iest excitement I had was hearing the baby’s heartbeat with a magnified stethoscope device.

As someone who had two C-sections, I’d love to hear about labor with diabetes. These days few women with Type 1 diabetes carry their babies until 40 weeks. Doctors prefer to deliver early to minimize risks to mother and child. I went into labor with my Mike almost exactly on his due date and was sent home from the hospital I because I was not far enough along in labor. I have absolutely no memories of my blood sugar being a concern and my hospital bills collaborate that.

For the entire 6-day hospitalization including labor & delivery, I was billed for 2 Lab Glucose tests. For my second son three years later I had more intensive care with a total of 3 Lab Glucose tests! I was new enough to diabetes for both deliveries to know that I would have been symptomatic for any low blood sugars and I don’t remember any. My children were born in the heyday of “natural childbirth” and I didn’t have pain drugs until close to delivery. My memories of labor are of pain. My memories of delivery are excruciating pain. To you moms who had C-sections and think that you missed the beauty of labor, don’t stress over it. Enjoy your healthy babies and believe me, it wasn’t all that beautiful.

  *   *   *

Join Laddie tomorrow for her story about the birth of her two sons, the story about “the yankers,” and what pregnancy was like then versus what she’s seen the DOC moms do now.  Thanks for going back in time to revisit your beautiful babies, Laddie!!

Unbreak my panc. (another parody)

(in homeage to the Toni Braxton’s Un-break My Heart, and if Melissa Lee would just let loose with her version of this, that would be awesome.)


Un-Break My Panc

You left me when I was small
Didn’t make insulin at all
Come back and bring back my islets
Come and take these syringes away.
I need panc to work beta now
The nights are so unkind
Bring back those nights when I slept all the way through

Unbreak my panc!
Please make insulin again.
Undo this hurt you caused
When you stopped that big job
And walked out of my life
Undo diabeeeeetes.
(I cried a couple nights.)
Unbreak my panc.
My panc.

Take back that sad word “disease”
And make insulin, would you please?
Don’t leave me here with these fears
Come and bolus like you used to
I can’t recall when you left
Life has still been kind
But panc is so cruel without insulin inside me

Unbreak my panc!
Make insulin again.
Undo this pain in the ass
That you brought to my world
When you took that long nap
I promise you thiiiiiis
I’ll stop all of this whiiiiine
Unbreak my panc.
My panc.

Unbreak my panc.
Oh baby.
Come back and say you’ll bolus.
Unbreak my panc.
Without you I will still go oooon … ooooooon!
I’ll still go on.
(Whoa!)

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