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24 Hours with Diabetes.

This clock is obviously wrong.  Should say 7 am.7:00 am:  The alarm goes off for the first time.  I stumble from bed, find out where my pump has landed during the course of the night, wander off to the alarm clock, bang my hand against it, and then shuffle back to bed to claim another 9 minutes of sleep.

7:09 am:  Alarm goes off again.  Snooze one more time, grab my meter from the bedside table, and hope to test when it goes off again.

7:16 am:  Okay, this is it.  No more snooze, test blood sugar. Whatever the result, it kind of sets the tone for my day.  I’ll correct it, treat it, or celebrate it, depending on the number.  Calibrate the CGM, disconnect the pump, and head off to the shower.

7:20 am:  Connect CGM to my bathrobe on the bathroom door so it’s close enough to pick up a signal while I shower.  Shower quickly so I’m not disconnected from the pump too long.  Carefully dry off to keep CGM sensor and pump site from becoming loose.

7:30 – 8:15 am:  While getting ready for work, put at least underpants on to have something to hook the pump to.  Dress in clothes that make me feel comfortable, fashionable, and able to wrangle in any diabetes technology I’m trying to wear. 

8:20 am:  Grab enough snacks to get me through the day, but make sure the food is d-friendly enough to keep my numbers in line.

8:30 am:  Drive to work.  Check the CGM to ensure I’m not sailing out of range.  For the record, my car has glucose tabs in the glove compartment, in case I go low.

8:45 am:  Time to buckle down.  I’ve got my coffee, my computer, and my meter at the ready.  During the course of my morning at work, I’m testing my blood sugar every hour or so to make sure I’m in range.  Sometimes the blasted dawn phenomenon grabs me and I end up fighting a high for hours.  Other times, a tricky little low sneaks up on me and I have to down some juice and then muddle through the aftermath.  And lots of times, my body behaves and numbers hold steady.  But I still have to check and confirm this, so I’m still actively maintaining diabetes stuff.  And I usually have a snack in the morning at some point. 

Noon-Thirty: 
Lunch time.  I test beforehand, I react to this number, and I try to anticipate what I’ll be eating for lunch.  Most often, I eat carbs at lunch, either in the form of a sandwich or soup or something like that, but food is always consumed at this time.  (I get hungry!)  

1:30 – 5:30 pm: 
Work afternoon.  Looks a lot like the morning, only for me it tends to be a little more even with blood sugars and a little less even with stress levels.  (Something about the afternoons at work tend to bring on the meetings, wacky emails, etc.  Either that, or maybe in the morning I’m too sleep to mind the difference.)  Lots of testing blood sugar and/or scoping out the CGM line during this period.

6:00 pm:  Homeward bound.  But it’s not over, yet.  From here, I have about 30 minutes to change up to head out to the gym, and make sure my blood sugars are high enough to take on an hour of exercise.  (This is one of the only moments in my day when I’m intentionally a bit higher.)  Aiming to be at around 180 mg/dl, I head off to the gym toting my bag crammed with my meter, music, water bottle, CGM receiver, and a fast-acting glucose stash. 

7:00 pm:  (We’re here already?  Man, this day goes by fast.)  Gym is ovah.  Time to test before heading home to see if I need to act on a number, make sure I’m good to disconnect and take a shower. (Yes, two showers.  I hate to stink.)  A shower is followed by dinner.  Dinner is followed by testing.  Testing is hopefully followed by sugar-free pudding with cool whip or something.  ;)

From Dinner to Bedtime:  Evenings are sort of status quo, with lots of options.  Heading out for a movie?  Going into NYC for the night?  Grabbing a drink downtown?  Staying home and working on computer crap?  Perhaps some [hey, something shiny!]  Or grocery shopping, changing out the CGM sensor, cooking (ha!) ...  Whatever the hours of my evening are filled with, I’m still keeping close to my meter and maintaining an eye on my body.

Before Bed:  Go through the whole before bed routine (washing face, flossing, brushing teeth, fighting to keep the cat out from underneath the bathroom sink), and then head into bed.  One of the last things I do every night is test my blood sugar and check my pump reservoir and battery life to ensure I'm good for the night.  After that, I try to fall asleep, with all hell usually breaking loose when the cats run races at the foot of the bed around two in the morning.

Sleep:  Awesome.  Hopefully, there aren't any hypoglycemic episodes throughout the night.  If there are, the Dexcom usually BEEEEEEEEP!s until I wake up.  (No snooze button on that thing, that's for sure.)

7:00 am:  Lather, rinse, and repeat. 

A team of students contacted me and asked me to tick through a day in my life with diabetes.  I tried to do a standard day - one without a wicked low or high - but it's hard.  Variables come raining in from everywhere, and it's nearly impossible to account for all of them.

I've written those kinds of "day in the life" posts about diabetes before, but they never really capture what can and does happen.  I even attempted to do a video, but it didn't cut it, either.  It's hard to show how much instinctive management comes into play, like those moments when we don't realize we're managing diabetes (but we are). 

How would you describe a day in your diabetes life?  Or, when you try, do you get tangled in the same set of variables?  How do we describe something so random and far-reaching?

Comments

Kerri,
I really liked this post. I do not have a pump or CGMS but I can see "lather, rinse, repeat" cycle can get tedious.

Awesome day in the life Kerri. Like you say though, it is terribly hard to capture all of the thoughts that cross our minds relating to diabetes.

Every day is different, even for the parents of kids with D. For example, I haven't heard from Riley's teacher once today. But, other days I may get 3-4 calls. There are always certain things we do, for example the first and last thing of the day is a finger stick, but the stuff in between changes from day to day.

"It's hard to show how much instinctive management comes into play, like those moments when we don't realize we're managing diabetes (but we are)."
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instinctive management = eating right, managing stress, sleeping well, putting band-aids on a paper but so it will heal quickly because its on your favorite testing finger, moisturizing your feet at night, carrying around medical tape for the last day of wearing a site, and checking your purse for a granola bar in the middle of a meeting.

Thank god we don't "look sick"!

I had a doctor recently tell me that I think too much about diabetes, and I should take a break. Seriously. A doctor. She doesn't realize that I can't take a break. If I do, I'll most likely end up feeling like crap.

I often describe blood glucose management in this way. Life is like driving down a road. Life is a Highway, after all. ;) Your blood sugar is like your car. The goal is to stay between the lines. Normal folks get to keep their eyes open. Us diabetics have our eyes closed. And the only way to open our eyes is to test our blood sugar. Now, imagine only testing 4 times per day. That's like opening your eyes only 4 times in 24 hours to see if you're between the lines. Good luck staying between the lines with checking so little! But here's where the CGM and multiple tests come in. With a CGM, it's like I have blurry vision, but I can kind of tell if I'm on the road. And a BG check confirms it.

Now, what happens if I take a break from all that? When you tell me to take a break, you're asking me to drive with my eyes closed all the time. And I know that if I go off the road, it could take me a long time to get back on. Granted, everyone needs a chance to rest. But how do you rest well, knowing that your car might be in a ditch?

That's a day in the life of diabetes.

Side note: There is no such thing as a "typical day in the life". You'd need a week or a month or a year or stories to truly capture it. Or a good blog.

Great post. I agree that the most important part is how hard it is to really capture a day in the life with diabetes, because every day can be so wildly different.

I would want a day with a low or a high because a day without is more random and uncharacteristic. I never tried to record every little thing because there seem to be a zillion little things, like that I turned off the LOW SG alarm 2 minutes ago, and 10 minutes ago I ate 2 hard candies, and a minute before that I checked my BG because I'd already shut off two LOW PRREDICTED alarms 1 minute and 5 minutes before that. ... I think my head is already going to explode, and that's just a 15 minute snapshot.

It's an interesting (and exhausting) prospect though, and props to you for even attempting it.

Diabetes is my pervasive white noise that I filter ALL decisions through.

This is tiring to read! People without diabetes should take note that it's relly hard to keep up with everything.

I wear a CGMS too and I think there's not enough focus in your day on how much of a PITA a CGM is. That thing beeps and vibrates all day long (which doesn't say a lot for my diabetes control but ...) I give you a lot of credit for having the patience to wear a pump and a cgms, and I say the same to anyone else who is wearing two devices. That's committment to diabetes management for frigging sure.

Kerri - totally undestand what you mean about not being able to capture it all. I work for a diabetes pharmaceutical company, and one coworker asked to "be diabetic for a day" so he could better understand the disease we make drugs for - since I wasn't going to waste test trips on him by having him test with me every time I did, I shot him an email every time I tested, dosed, or made any other diabetes management decision - but it only covered the major stuff. I couldn't capture the nuanced items or the little thoughts that run through your head constantly - we make so many subconcious decisions that its almost impossible to translate...and we do it EVERY DAY!

Our( Canadian ) Federal Government has given tax payers with type 1 diabetes an opportunity to apply for a " disability tax credit " . What one has to prove is that it requires a minimum of 14 hours per week to attend to the management , not including carb counting, exercise, purchasing foods, medication .Parents in care of a child with diabetes most likely have no problem being approved, with the help of their Health Team . For adults it requires lots of record keeping and forms have to be signed by GP or Endo . I have been approved previously and know of others in my community . I was NOT approved for 2007 tax year, due to my GP deciding , that it does NOT take me a min . of 14 hours weekly .I have changed GP( another story ) My Specialist , when I told her said : I will sign your papers next time ; you as a pumper and CGMS user are spending a minimum of 14 hours weekly on the mamagement of diabetes. That equates to 2 hours daily every day and indeed I cannot put on paper , that at this very moment my BG( according to the sensor ) is much higher than I like and having thoughts of changing the site keeps coming into my head ...I just did a set change at 09.00 hours today ...the amount of time it takes DAILY to make sound decisions in the management of this chronic disease..26 years of it .

A follow up : it is 8.46 pm ...I decided to give a shot by needle ...have not had all my supper yet ...salad, green beans , some protein ...kind of overcooked and my spuds are cold by now ...number still HI at about 10 ( 180 ) ...this is what living with diabetes is ALL about ...and how can we record this and tell others to understand ...other than our loving mates ???

Yeah the awesome gigantic gym bag stuffed with diabetic supplies and oh yes a change of clothes too in case of an accident which has happened too many times for me to feel comfortable leaving the house without this accessory . also dont forget the breath mints too sugar free of course . LOL !!! great discription of your day . thanks again for a great blog .

Great post, everyone should have one of these on their blogs. Doctors can check em. I'm going to write one up for my daughter (three weeks in, we're finally getting the hang of it). Diagnosed just before 7.

Great post regarding a typical day for a diabetic. Although supplies, food cautions, travel, and sickness can all affect a daily blood sugar.

It can be a difficulty transition as a newly diagnosed diabetic or someone who has this day - everyday

one commenter said her doctor told her not to think about diabetes so much.....huh?? How can you not think about this thing??? Here's a case in point.....squaredancing is my favorite mental escape from the demands of the day. Last Monday I ate appropriately, bolused perfectly, and hit the dance floor. Half way through the first tip (15 minutes of dancing per tip) it started snowing in the room. Voices came from strange places and my legs felt two tons heavy. My partner yelled for another partner. I sat down and tested. I was 40 mg/dl. Bummer. No warning, and no reason. Maybe I should have just kept dancing and 'forgot about diabetes'for a while! LOL
Mousie

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