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January 31, 2012

What We Document.: Solving for "Why."

Dexcom graphs that look like gigantic Ms and Ws?  I see those all the time.  But when I sift through the pile of photos I have on my computer (in the folder marked "Diabetes Crap;" I can write real good, Ma), the Dexcom graphs I see are all pretty.  Nice, straight lines or soft bell curves, without the sharp angles.

I know these pictures aren't representative of how my diabetes is controlled, on a day-to-day basis.  There are way more times that I'm muttering "You stupid jerkface pancreas ..." than moments when I want to whip out my camera and take a snapshot for posterity.  But I like having these happier photos outnumber the ones that make me grimace, because when I need a lift, it's nice to have a catalog to draw from.  This is what I chose to document, visually, because it inspires me to earn this photo opportunity again, you know?


I chose to document this, because it made me feel good.

May will mark the end of my seventh year blogging at SUM (and starts the eighth year - jeepers), and when I look back through the archives, I'm weirdly proud to see a diversity in what's documented.  There are some really high moments (high as in "emotionally high," not "OMG, how did that 312 mg/dL sneak in there?" high), like when the Bird was born or when Chris and I got married.  And then there are low moments, like trying to be a strong advocate for PWDs while going through burnout, or when blue candles start peppering our Facebook feeds

And then I look at other people's blogs (holy crap, there are a lot of us!), and see that they're chronicling the good, bad, and decidedly 'eh' of life with diabetes.  The real stuff.  It's crazy how honest we are with the Internet.  I see people writing about things online that they might not be sharing with their doctor.  Or their coworkers.  Or their very closest friends. But it's shared here, and there's a power to sharing our stories.

I'm amazed at what we chose to document, as a community.  From celebrations of a no-hitter to scoring a quality pair of blue shoes, to difficult moments of feeling burnt out and admitting that we're struggling, what we document shows our strength as a community.  We're not afraid to share the stuff that really scares us, or empowers us, and we have one another to mark different milestones with.  What we share, as a global community, could help any one of us improve our health, emotionally and physically. 

Diabetes isn't a perfect math where you can just solve for X.  Usually, we're solving for "why."  And part of that equation is acknowledging, and appreciating, the sum of our community and what we document, every day.

January 30, 2012

When CGMs ATTACK!

I first tried out the Dexcom back in June 2007 (here's that first blog post - forgive the inquisitive cat photos), when it was the Dexcom 3 system (with the crazy shower patches I had to put over the sensor and transmitter because it wasn't waterproof - that was fun, and was like saran wrapping myself every morning before work).  Even though I had reservations about wearing a second medical device and feeling a little gunshy about the potential data overload, I committed to the Dex technology almost right away because it made me feel safe

It wasn't a matter of not trying other CGMs - I did give the Minimed system that was available in 2007 a try, but it wasn't a good fit for me.  (Here's a detailed post about why I wanted a continuous glucose monitor and my experiences with trialing both systems, and also has a lovely .gif of some soap on a box.  So there's that.)  The Dexcom has been a huge safety net for me, especially during the before, during, and after of Bird-Building.

More often than not, this system works for me.  It's spot-the-eff-on and it often triggers me to double-check my meter results when they appear to be roaming around unsupervised.  I rely on the Dex.  It wakes me up when I'm low, it rattles my cage when I'm high, and Birdy thinks it's the best thing since Siah's tail.

Birdy calls the Freestyle strips "meh-cine bra."  Aka "medicine butterfly."

So when it's off, I'm thrown.  Last night, before I went to the gym, my meter gave me an 87 mg/dL and the Dexcom was in the same range.  When I came home from the gym, I was 215 mg/dL, but the Dex was lazily meandering in the lower range, yawning and eating potato chips and watching Are You Being Served.  Not even remotely tuned in to the fact that I was above 200 mg/dL.

"Nope."  I said, yanking the sensor out of my thigh.  

"Ouch," I said, as the new sensor slid into my other thigh.  (Usually they don't hurt, but this one burned a bit on reentry.)

I don't know what causes some Dex sensors to give up so easily.  And I'm not sure what makes me so stubborn.  This troubled little sensor gave me pause earlier in the week with a result much higher than my meter, but because I'm dia-frugal (read: aware of the cost of these sensors, and see also: aforementioned stubbornness), I restarted the sensor instead of pulling it out and putting in a new one.  Whatever the cause of this hiccup, I'm glad I caught this one as it went rogue, and I'm thankful I didn't make any treatment decisions based on the Dex's "recommendations."

New sensor is in.  So far it's in line with my meter.  And today I will test its legitimacy with plenty of coffee.  

[Dexcom disclosure]

January 27, 2012

The Camera Roll.

If I really tune in, there are quiet whispers (and sometimes GIANT SHOUTS) of diabetes everywhere I look.  (And, for once, I don't mean that trail of test strips that seems to follow me around everywhere I go.  Sorry, environment.)

Like in the Children's Museum in Providence, where a giant, rotating piece of art flows between a mermaid, a circus clown, and a unicorn. 

If you look closely, it's like a unicorn with mermaid boobs.

Or the fact that my daughter's pajamas are covered in teeny, colorful cupcakes.  (Also, she pretends to talk on the phone for long pockets of time.  Animated conversations with the ether.  I think she's prepping herself to be a blogger ...)

The conversations go like this:  "Hello?  Jibby jibby meow? Bar oatmeal Elmo moo?  Mama hi?  Dada hi?  Okay, bye Poppy."

Or maybe because this morning I received (earned?) my first speeding ticket in seven years, and when the officer asked me, "Is there any kind of medical emergency I should be aware of?" the only thing I could say was "Stupidity?"   (He also said, "The thing is, I couldn't catch up with you very easily." Not want you want to hear from the cop who is issuing your [deserved] ticket.)

No smile today.  Maybe later.

Actually, the diabetes-related rub here is that my blood sugars were great when I left the house, but after being nailed for speeding, I've since shot up to 217 mg/dL and am holding steady, despite bolusing.  The effects of stress on my blood sugars are direct and sticky.  (Also, just for the record, my shirt is blue.  Blue Fridays FTW?)

After a few weeks of feeling really tuned-in and de-sludging myself, I appreciate that diabetes reminders are everywhere.  Sometimes I need them; helps me stay in control.  But I don't always decide to notice them.  Artwork at a museum can just be artwork.  Pajamas are just pajamas.  And the piss-poor driving decisions made by this mama are just that: piss-poor.  ;)

January 26, 2012

Dining Out.

I love going out on the town for the night
And having a meal by a soft candlelight
(Because I know, at a restaurant, meals are yummy;
For the food isn't prepped, touched, or cooked by me.)
But to dine with type 1 can be quite complex,
Because restaurant food has a whole set of specs
That require some SWAG'ing; carbs seem to inflate
As you wonder what's really down there on your plate.

"Excuse me, but does the salmon have a glaze?
Is it covered in sugary, caramelized haze?"
I ask of the waiter, tuning in as he states
That the glaze can be brought on the side of my plate.
My soda arrives, and I ask, "Is this diet?"
As I bring the glass up to my lips just to try it.
"It is," he responds, and he watches my face
As I try to assess the fizzy soda's taste.

Moments later, I notice that something is wrong.
I'm not sure my thoughts are where they belong.
My brain is all foggy, my hands feel so weak,
I'm having some trouble with words while I speak.
Did I bolus too early?  Did I miscount the carbs?
Is it something I did to make Dex go on guard?
There are glucose tabs right here in my purse,
But I know that I'll feel better if I have juice first.

My husband is almost up, quick as a blink
To go to the bar to grab something to drink.
But it's not a big deal; I chomp tabs while I wait
For the waiter to come back and fill up our plates.
He comes back for our order, but I'm not quite ready.
My Dex shows my numbers as slightly unsteady,
With double-down arrows beaming; so unkind.
"Can I have an orange juice, if you don't mind?"

I see his confusion. The gears start to grind.
I hear the thoughts churning inside of his mind.
"She didn't want glaze, and her soda was diet.
The bread was right here, but she didn't try it.
What's up with this girl? Selective sweet tooth?
Whatever. My job is to bring her the juice."
He walks off to the bar to bring back something sweeter
While I quickly confirm the Dex trend with my meter.

"Here you go," and I down it in one giant gulp,
Not caring for class, or a straw, or the pulp.
"Thank you so very much," I reply with a smile
And try to regain some semblance of my mind.
My husband distracts me with soft, gentle chatter
While the orange juice fixes the thing that's the matter.
And the moments that pass are quick in real life
But it's hard for him, watching a low change his wife.

A few minutes later, things are as they were.
I'm no longer sounding all drunk, with a slur.
The waiter comes back with his menu pad out
And we tell him the entrees we'd like to try out.
Our date night moves forward without any trouble.
(The waiter's confused, but i don't burst his bubble.)
It's not a big deal; it was just a quick thing.
But it's always a riddle, what diabetes will bring.

January 25, 2012

Oh Eff You, Exercise.

Dexy's Midnight Runner?  (Terribie.  Sorry.)The desire to exercise is just as cyclical as diabetes burnout, for me.  There are months when I'm all YES, EXERCISE, LET'S ALL DO THAT NOW! and then there are months when I can't even find the caps button at all.  sure let's exercise if we have to ... snooooooozefest.

During my months of deep diabetes burnout, I didn't go to the gym without literally dragging myself there.  (Literally.  Like tying myself to the bumper of the car and putting a brick on the gas peddle, eeking myself down the road until I had couriered myself into the parking lot.)  I went, but not with excitement or vigor or any kind of desire to do anything other than plod around on the treadmill and hit the 33 minute mark so I could put the mental gold star on my chart.  

Finding the motivation to exercise can be as challenging as the motivation to stay tuned in to diabetes.  I think it's because there isn't an instant payoff - walking out of the gym after one cardio session and I don't feel like I can pick things up and put them down.  Similar to how a week of intense diabetes monitoring doesn't immediately drop my A1C.  It's a slow burn, and not seeing the immediate results of hard work makes sticking with the program a little tricky.  (Versus the consumption of delicious cheeseburgers equaling instant and delicious gratification.  Cruelly unfair.)

Before the baby arrived, Chris and I would go to the gym together.  His dedication to a consistent(ly annoying, sometimes) gym schedule has always impressed me, because I'm very easily distracted by things and would oftentimes wander off to check on ... hey, something shiny!  But when it was just the two of us, heading to the gym was something we did together, and something we did almost every day.

Then pregnancy.  And baby.  And that whole "ugh, I feel a bit strange in this new post-baby body."  And then the "Wait, I want to shed the rest of this weight and be done with it."  But I relied too much on Chris's schedule before, and since going anywhere alone together (oxymoron much?) requires wrangling in a babysitter, I needed to find my own inspiration, my own reasons, my own routine. 

A way of feeling good about exercise, instead of always muttering "Oh, eff you, exercise," in my head.

So, even though it feels scattered and even though my head isn't always "in it," I'm back to regularly exercising.  At least four times a week, I'm either at the gym doing a cardio workout (with a nice, long cool down where I take 20 minutes and read a book, which is the only time I ever have to read) or in our basement, using the ellipmachine and catching up on episodes of Uncle Stephen

It feels relaxing.  It's nice to have an hour to myself, where I sweat and keep an eyeball the Dexcom graph and let my mind go blank for a little while.  And even if the effects aren't immediately obvious in my A1C or my level of fitness, my mental health is already benefitting.  Like I said, small steps.  Focusing on the emotional and psycho-social stuff.  For me, that's the only way to reclaim my health.

That, and it's the only way I'll ever finish reading a book again.  

January 24, 2012

From Abby: First Day on the Job.

Abby is officially working as a Registered Nurse, and in the last few weeks, she's moved to a new state and started her new job.  Lots of change on tap for her.  Today, she's sharing a little bit about her first day on the job and how a little diabetes understanding eased her through her first few hours.

*   *   * 

My first day of orientation at my new job brought a lot of stress. From getting on the shuttle bus and asking a total stranger if I couild sit with her, to sitting through a lecture about the Nurses Union I now belong to while having no idea what they were talking about, to that low blood sugar that hit right before our lunch break.

Luckily, that day I sat next to a nurse who I had had a "pre-orientation" meeting with, so I was a little more comfortable in this room filled with 75+ strangers (and at a table near a super cute male nurse - made the boring day a little less boring).  Through chatting with her, I found out that her husband has type 2 diabetes, so she knows what this whole diabetes thing is all about.  I told her what my Dexcom receiver was (I had it sitting next to my coffee on the table) so that she wouldn't think I was texting throughout the lectures.  (And then we talked about how ridiculous it was that the muffins provided for breakfast were covered in brown sugar on top.)

Then I saw that 54 mg/dL on my Dex about 15 minutes before the scheduled lunch break. As I chomped on two glucose tabs (I was symptom-free at this point) my new nursefriend next to me looked over at me. She looked down at my Dexcom, studied my face for a few nurse-seconds and said:

"Are you okay?"

I nodded, and continued chomping.

Chomp, chomp, chomp.

Then the nursefriend just smiled, and went back to listening about parking passes.

If you have diabetes, you know why this made me feel so comfortable. There was no stress from her side conveyed to me. She didn't freak out and ask someone for juice. At no point did she have a worried look on her face. She just knew. My new nursefriend understood that those three words - "Are you okay?" - were all it took. If I needed help, she gave me the opportunity ask, but she also gave me the opportunity to take care of myself, knowing that someone was looking out for me at the same time.

I'm quite sure that it is extremely difficult to be a person who cares about someone with diabetes, without actually having it yourself. One minute, we want you to fall all over our low blood sugars and and stop time to help us, and the next minute we want you to completely ignore the fact that we even have diabetes. And there is no reason for us to feel this way; we just do and probably always will. But sometimes you type 3s get it spot on. You just know what way to react is best, every time, and for that I am grateful.

New nursefriend's future patients sure are lucky to have her.

*   *   *

Again, Abby, I'll assert that your future patients are lucky to have YOU.  And for others who are disclosing and dealing with diabetes in new situations, how do you prefer people handle your diabetes?

January 23, 2012

Diabetes Burnout.

I've been slogging through some diabetes burnout over the last few months, but I'm starting to feel much better.  Things aren't perfect (Are they ever? Answer: Nope), but I've finally reached that point where I'm completely tuned in, rejecting guilt, and feeling like I'm on my way back to better diabetes control.  It's as much an emotional thing as it is a physiological one, and this video is about crawling out of the (primordial, most likely caramel-flavored) diabetes burnout sludge. 

Small steps are what move me forward best.  What helps you start stepping out of diabetes burnout moments?

January 20, 2012

Paula Deen: Glass Houses.

I have no idea who Paula Deen is. 

Actually, I have a little bit of an idea.  My mother-in-law loves the Cooking Channel and she watches a lot of the cooking shows.  Sometimes she tells us about a delicious recipe she saw, or wants to try.  My MIL is my link to the cooking community (because we all know my talents are limited in that department ... see also my contribution to D-Feast and that thing about froast).  She's the one who told me who Sam Talbot was.  And she filled me in on Paula Deen.

My personal knowledge about the woman is limited, though. 

What I do know is that she was diagnosed with type 2 diabetes about three years ago.  And in the last few days, she's come out as a spokesperson for Novo Nordisk's diabetes drug, Victoza, with her web presence at the branded "Diabetes in a New Light."

But holy crap, the Internet has plenty of opinions about this woman.  The Huffington Post said "Paula is now suffering from the popular perception that money bought her new-found honesty." Anthony Bourdain Tweeted, "Thinking of getting into the leg-breaking business, so I can profitably sell crutches later."  Run a Google search on "Paula Deen and diabetes" and your web browser will collapse from the weight of opinions. 

I don't know the woman.  I have no idea if she is drinking her own KoolAid (or, in this case, eating her own glazed doughnut sandwiches).  But after all the emails I've received and all the posts I've seen in the DOC, it's hard to ignore this discussion.

On one hand, why not talk about her diagnosis after it actually happened?  Why wait for Pharma dollars?  Amy Tenderich shared her opinion: "Building a food empire on unhealthy foods and then being diagnosed with a chronic condition with a known correlation to food and obesity has to be difficult, not to mention embarrassing.  I can understand why someone wouldn’t be anxious to put themselves in that kind of spotlight — although it was inevitable eventually."  Paula Deen said herself:  "I had to really get myself into a place when I made the announcement. I would come with information, and I would be armed to be able to help others." 

Disclosing her diabetes when she felt best-armed to discuss it?  To each their own.  Continuing to market her less-than-healthy recipes?  She can do that, too, you know, even if the media wants to go apeshit on her for doing so.  If doughnuts end up on my plate, it's not because Paula Deen put them there and then crammed them into my mouth.  I think we need to own our own actions, and not be so quick to blame celebrities for being the voices in our heads.

On the other hand, what I also know is that she, like me, is a person living with diabetes.  Paula has type 2 diabetes, while I have type 1 diabetes, but the fact remains that she is part of the diabetes community.  And just like everyone else, she has her right to disclose whatever she'd like, whenever and however she'd like. Not all of us talk about our weight.  Or our A1Cs.  Some of us in this community only disclose anonymously online, never whispering a word about our diabetes to our "real life" friends.  We all share at a level that we alone have the right to dictate.  So Paula Deen and her decision to "come out" as a type 2 diabetic is her call. 

George Simmons said it best, in my opinion:  "Everyone is a hypocrite when they're first trying to change."  For me, as someone who is deeply immersed in the diabetes community and relies on it for psycho-social support (just as crucial as insulin, in my opinion), I want someone to be there for Paula Deen as she adjusts to this new normal.  I'm not a doctor or a journalist ... I'm a person with diabetes, and I want to support my fellow PWDs.  So her past is slick with butter and glaze?  That was then.  She has a chance to change now - and not to impress "us," but to take better care of herself. 

I still don't really know who Paula Deen is, and I can't pretend to be her personal biographer.  But I do know she's a person with diabetes, and like anyone else in this community, she deserves respect.  In my opinion, I don't think that diabetes advocates have to be perfectLiz at The Angry Type 2 Diabetic offered this, and I hope she's right: "How do you even know she might not turn around, and make a show showcasing how you can still eat with flare, and with passion, WHILE managing diabetes?"

I hope that's what comes of this announcement from Paula Deen.  She has a chance to reach millions of people, and I'm hopeful that she'll use her platform to inspire people to take control of their diabetes, despite any and all criticism, judgment, and fear.

January 19, 2012

S#@t Diabetics Say.

The original "Sh!t Girls Say" videos make me laugh, because I unfortunately find myself saying things like "That poor dog needs some water" kind of often. (But they always look thirsty!) Since the SGS videos have busted out, I've seen lots of imitators pop up and do their thing (I'd link to them, but some are sassy and I've already titled this post with a curse word. Keepin' it clean in 2012, damnit.)

What also made me laugh was Marcus Grimm's take on this, from a PWD point of view.  Here is Marcus's video (and here is Marcus's blog, Sweet Victory - read him; he's awesome):

(For me, I'd also have to add, "I need juice," and "I promise not to blog this.") 

January 18, 2012

Blackout.



12 hour blackout.  Here's why:  SOPA Strike

January 17, 2012

First Impressions: VerioIQ.

Meter accuracy is a top diabetes priority for me.  Top.  I don't care if the meter is red or blue or made out of saran wrap and bleu cheese (actually, I would care about that because bleu cheese smells like crumbled up farts ... yes, it does), but if it's accurate and precise, I want in.  In the past, I've experienced a lot of frustrating variability with all kinds of meters, and nothing shakes my confidence more than seeing three different numbers IN A ROW from the same meter.  Chaos, defined, that is.

Thanks to the outreach of a PR company, on behalf of Lifescan, I received a first look at the new VerioIQ glucose meter.  And I am relieved, relieved, relieved.

When I was in California a few months ago, I spoke with the Lifescan team about life with diabetes and the impact of the diabetes community.  I also, in sidebar conversations, voiced my concerns about meter accuracy, precision, and overall "trustability."  During our discussions, the VerioIQ was mentioned, and I couldn't wait to see it for myself.

So when it arrived last week while I was in NYC, I couldn't wait to get home and crack it open. 

Pretty little thing.

First visual impressions:  It looks jazzy.  As Kim mentioned, this thing looks less like a glucose meter and more like an iPod.  At my friend's house last night, I whipped it out to test and she was all, "Hey, is that a new meter?" and I was all "Yup - interesting looking, right?" and she was all "It's way cooler than the other ones" and I was all "Holla."

Aside from a streamlined look and a really nice color screen, this meter has a light.  On the end.  Where the strip goes.  This development has been missing from One Touch meters, in my opinion, and is what made my experience with Freestyle that much better.  But the VerioIQ lights up, so even if you're testing in the middle of the night in the pitch dark with a cat weaving around your arms, you can see what's going on.  Very helpful.

Go towards the light!

I also like the way it charges; this meter has rechargable batteries, and I like that I can plug it into the wall and charge it up, instead of toting batteries around with me.  I'm not sure how long one battery charge lasts, but I'll find out soon.

UPDATE:  From the PR company, responding to some of our comments here:  "You mentioned not knowing how long the battery lasts.  FYI, when fully charged, the meter will perform tests for up to two weeks between charges.  The meter also provides several alerts when the battery is running low – this is to help prevent the situation you mention, being stuck without a charged battery.  However, if someone doesn’t charge the battery and the battery is completely discharged, you will not be able to test. 

If battery power is too low to do a blood glucose test, you can connect the meter (via USB or AC adapter, both included) for a 60 second rapid charge.  After the rapid charge, you will need to disconnect the meter from the wall outlet or computer before testing your blood glucose.  After testing, reconnect your meter and complete the charge."

Charging the One Touch VerioIQ

First strip impressions:  The strips that come with the VerioIQ are completely different.  They look like little golden pitchforks, and they are thinner than my other One Touch strips.  They also suck the blood in from the side instead of the top, which is a different adjustment.  And according to the Canadian Lifescan website, these strips have "SmartScan™ Technology [that] analyzes your blood sample 500 times to correct for common interferences and deliver precision with every result." 

Comparing the older One Touch strips to the VerioIQ ones.

Oh yeah?  I tested these strips against the Ping meter, the Freestyle, and my Dexcom CGM, and so far, so good. The VerioIQ is almost SPOT ON with my Dexcom trends, and repeat testing (three times in a row) hasn't showed me any uncomfortable variability.  The results are no more than 25 points from one another, and I'm hoping this is a trend that continues.

First overall impressions:  I want to like this meter.  I do like it so far, but I'm not one to jump on the "I LOVE THIS!" bandwagon without doing a little more (literal) testing.  Like I said, accuracy and precision are my most coveted bits, and I want this meter to be the gold standard.  I've been a One Touch user for a whole pile of years now, and my insurance also gives priority to this brand of meter.  (I know - making decisions based on insurance sucks, but if it supports a meter I like, I'll roll with it.)  I want this meter to help me make decisions that will help me improve my A1C.  I want this meter to represent true progress in blood glucose management technology.  Sure, it looks cooler and more in line with today's technology, but I want it to WORK. 

So far, I like it.  I hope this trend holds.  If it does, I'll build a special little house for the VerioIQ to live in, and I'll make it lunch every day.

ANOTHER UPDATE:  The PR company also reached out to confirm that the meter is FDA approved and is currently shipping to retailers, to be available to us in 4 - 5 weeks.  Rock and roll!!

[Disclosure time:  I received this meter for free, in addition to 50 test strips.  I was not asked to write about it, but I'm pretty sure they knew I would.  I'm okay with that.  My opinions about this meter, One Touch, and bleu cheese are all my own.  I have an existing relationship with Animas Corporation.  I also have one, small, gray cat that is for sale.  Any takers?]

January 16, 2012

Twenty One.

Birdzonious Maximus, 

(That's your genus and your species, daughter of mine.  Bear with me, and keep your wits about you when you see the coyote run by holding Acme anvil.)

You are in a constant state of war with your vocabulary.  So close, yet so far, on many words, and the journey towards understanding is entertaining.  Green beans have safely been renamed "bean beans" and the letter W is "yubba you," but the one that completely throws me is how you innocently subbed in the eff word for "fork."  You sit patiently in your high chair, pointing out each item in front of you with confidence: "Bowl.  Eggs.  Cup." "Faffle." And then your version of "fork," usually loudly and happily announcing said "fork." It's kind of sweet, in your little high voice, but I'm a bit eager for when you swap it out for the "correct" word.

It's okay.  I laugh when you aren't looking.  

This month, you've had a lot of interesting experiences.  We took our first cross-country trip as a trio of Sparlings, giving rise to some airport dance routines and baggage both in carry-on form and underneath Mommy's eyeballs.  We played in the Pacific Ocean.  And you're back to wearing the colander as a hat.  (Okay, that's not "new," but the fact that you took a hiatus from it is peculiar.) 

I like watching you interact with other kids.  You have a very social personality, and you aren't afraid to weave your way through a group of kids or adults alike.  "Hi!!!" and a vehement wave of your hand (so vigorous that you almost fall over) and a big, toothy smile.  People usually say "Hi!" back to you, but when they don't, you continue to wave until they flash you a smile.  Tirelessly social, you are.  With other kids, you're a little more shy (read: clinging to my legs until you've found your footing), but once you feel comfortable, you run and play and you don't often look back.

... but sometimes I wish you'd look back.  Those moments when you come tearing through the room just to wrap your arms around my legs and say "Awwwww, mama," ... I just lose it.  I want you to be independent and strong and happytown, but I love when you check back in to tell me you love me, and then scamper off again, legs wobbly with velocity.  Sometimes my heart swells with pride.  Sometimes my eyes well with tears.  But either way, I'm watching you grow up, literally right in front of my eyes, and it's amazing.

Your face melts me into a pile of melted Mommy.

You inspire me.  You exhaust me.  You make me look at things in ways that sometimes require crawling on the floor or crawling back to my own childhood.  You make me crazy in the head.  And you make me happy, Birdy.  

Mama loves you. All twenty-one wild months of you.

Love,
Mommy

January 13, 2012

Bullets.

The confusion is instant - the raw and palatable confusion where you know you're in trouble, but you haven't yet grasped just how much.  

"FAILED SENSOR" on the Dexcom screen, and instead of reaching for the jar of glucose tabs, I reach down past my waistband and pull the Dexcom sensor free from my right thigh.  It's stubborn; it wants to stay stuck and takes a firm pull to remove.  The sticky residue left behind by the adhesive tape is in that familiar oval shape, and it grabs my fingers.  I linger there for a minute, feeling the leftover glue securing to my thumb.  I wonder how long this sensor would have stayed stuck if it hadn't FAILED.

The hotel heat vent switches on, which must explain the sweat on my forehead and in the crook of my elbow.  My hands are trembling.  I have diabetes.  It's like a light bulb that goes off on my head, reminding me that I need to eat something.  Sweat collects in a damp veil on my forehead and I wipe at it absently with the sleeve of my shirt.  I slow-motion swat at the bottle of glucose tabs on the bedside table, counting out five ... six ... seven glucose tabs and holding them in my hand like magic beans.

My mouth isn't even mine.  It's just this thing, this portal to shove giant sugar tablets into.  I can't work up the saliva to chew, so the tab sits in my mouth until it starts to dissolve a little, and then my body remembers what to do with it.  "Chew the damn thing."  Tragedy of a low - no saliva.  Nothing to help mince these tabs down into something useful.

While chomping down on the fifth glucose tab, I test my blood sugar and see a 24 mg/dL on the  meter.  My first thought:  "What a screwed up number."  There isn't a second thought.  No room.  My focus is limited to chew, swallow, and stay awake.  I feel the waves of consciousness lapping, and I find myself chewing in rhythm with the ocean in my mind.

Adrenaline kicks in and I'm suddenly aware of everything: the whirring of the hotel heating unit, the sounds of New York City waking up outside the window, the bottle of water on the bedside table, and the fact that my bangs are plastered messily to the side of my face, anchored by sweat and panic.

The second thought finally kicks in.  "You're fine.  You'll be fine.  Seven glucose tabs ... you'll be over 100 soon and get on with things."  It's an internal pep talk, running on a loop in my brain.

I shouldn't have had the wine the night before.  I am angry at the sensor for dying after only four days.  I wish I had set an alarm for 3 am to double-check my blood sugar.  So many things.  But mostly, I'm relieved, relieved, relieved because I felt the whoosh of this bullet as it went by.

January 12, 2012

Snapshots: NYC.

A few thousand words (with alt text):

View from the roof

Viewfinder at the top of the Empire State Building

This photo looks like the end of the world.  Or the beginning of something. Either way, it's amazing how distracting the sky is, seeing as how there are millions of people teeming below. 

Sometimes things are so pretty that you almost don't notice until you see it through a different lens.

January 11, 2012

From Abby: Diabetes and the Cuteness.

The other half of Team Tupperware takes a crack at her own vlog post, talking about how diabetes isn't always necessarily "cute," but the stuff we tote around with us can be.  (Also, there are some wise words about the power of zebra insulin.  You'll see.)

How do you personalize your diabetes ... stuff?

January 10, 2012

Conversations in the Dressing Room.

I pulled my pump out of the pocket of my jeans and clipped it to the neck of my shirt while I tried on pants in the dressing room.  The shirt collar drooped a bit from the weight of the pump.

"Pump, mama?" asked my little bird from her stroller.

"Yes, baby.  That's mama's pump.  I had to stick it in there so I could try on these other pants."  I zipped up the new pants and examined my reflection in the mirror.

"Pants?"

"Yeah.  Do you like these?"

She tilted her head, touching one of her pigtails to her shoulder, then nodded vigorously.  "Mmmm hmmm.  I do!  Pump?"

"Sure, the pump goes right in this new pocket, like this," and I clipped my insulin pump to the pocket of the new pants.

"Nice, mama."  She nodded in approval as I took the pants off to try on a dress.  "Meh-sin?" she asked, pointing to the Dexcom sensor on my leg. 

"Yup!  That's my medicine.  Goes with the blue thing.  You are so smart!"  I pulled the dress over my head hopefully, but Birdy shook her pigtails. 

"Oh no, Mama!"

I looked in the mirror.  "Oh no?  Did you seriously just say 'oh no'??  That's not good.  Maybe this isn't the right color; you make a salient point."  I changed back into my "real clothes" and gathered up our belongings from the dressing room.

"Mama, eat?" 

"Yeah, we should go eat.  We're done trying on pretties.  Do you want a snack?  Mama wants a snack."

She patted my pump with her little hand.  "Pump pretty."

In the littlest moments and the most subtle ways, she learns a little more about her mama's diabetes and teaches me how to see things a bit differently.

That's ... different.

January 09, 2012

Rent the Runway: Diabetes-Style!

Click this photo, and then LIKE this photo on Facebook!My friend Delaine is amazing.  She's a type 1 diabetic, a trapeze artist, a certified diabetes educator, and a fellow Rhode Islander.  And she's also married to the police officer who brought me sugar-free candy on Halloween one year.  (Best.  Halloween.  Ever.) 

Delaine decked herself out properly for New Year's Eve this year, and as part of that, she rented a dress from Rent the Runway.  And now she's part of a little contest from RTR, where the photo with the most Facebook "likes" wins.  ("Wins" what, we aren't sure.  There actually isn't a prize, as far as we know.  This is just for bragging rights.)

But dude ... she's hiding an insulin pump and a continuous glucose monitor underneath those shiny blue sequins. 

Delaine said:  "I removed the clip from my pump and simply tucked it again my skin and inside a pair of lycra workout shorts. It is just inside my right hip in that photo and stayed there without issue through a fantastic evening of dining/dancing and fun as I rung in 2012."

THAT alone is worth bragging about, because she's healthy, she's safe, and she looks like a million bucks!

So if you could please click that photo over there, or THIS LINK, it will bring you over to Facebook, where you can LIKE the photo and help earn Delaine some well-deserved bragging rights.  She's marking her 29th year with type 1 diabetes in 2012, and I think that's worth celebrating the hell out of.

Go get 'em, Delaine!! 

January 08, 2012

Checking Out Telcare.

Over the weekend, I received a demonstration kit for the Telcare meter, marketed as the 'world's first cellular-enable blood glucose meter.'  There's some information out there about Telcare already, including this review from the Wall Street Journal, and I'm happy to take a crack at this new device.

What they mean by "demonstration kit" is that the specific meter sent to me isn't prepared for blood sugar testing at this point.  The unit I received was a pre-production unit, and I was warned not to make any treatment decisions using it.  Actually, it came with two bottles of control solution, which is what I used to test the meter out.  (Strange thing, putting drops of control solution on a strip and actually thinking, "Hey, I like that number!" when the result popped up.  It's like I forgot that the meter wasn't reading my blood.)

At first glance, the Telcare meter looks like an iPhone.  Because everything wants to be an iPhone, doesn't it?  (Except my Blackberry, which wants to be a frisbee sometimes.  Come on, RIM, keeping plugging!)  It's roughly the size of my Blackberry, and while the screen isn't touchscreen, it sure looks like it could be in the future.  

Hey Ma!  Check your email, for crying out loud!

As I had mentioned, this particular meter wasn't quite ready for actual blood testing, so I whipped out the control solution and gave it a go.  (And I liked the color screen.  The whole interface was nice to look at, which is a welcomed change from the MS-DOS-esque screens of so many blood glucose meters.)

Asking for blood ... little vampire meter.

The result popped back after five seconds.  (Note:  With the sound "off," this whole experience was nice.  With the sound turned up, this meter makes phone keypad noises, which drove me berserk after just a few tries.  I would hate to hear that noise every time I tested.)

Once the result came up, there was an extensive selection menu to tag the blood sugar (and you use the scroll buttons on the side of the meter to access and select these options).  As soon as I selected one of the designated options, the results were sent automatically to the MyTelcare database online (mine found an AT&T signal that it attached to, though I'm not exactly sure how.  Purchasing a mobile plan isn't necessary with this device.) 

To the cloud!

The online tracking software is decent (I have had extensive experience on the Animas Diasend software, which I really like), and offers some options for customization.  You can set your own thresholds for "high" and "low," and the visual graph helps reinforce the data trends.  For me, anything that gives a cumulative view of my blood glucose trends is very helpful, because sifting through all the numbers can give me an anxiety attack.  Also, having the data automatically sync online is fantastic, because it makes log booking an instant and easy accomplishment.  That is a huge plus for a scatterbrained PWD like myself. 

I also liked the messaging options on the meter.  There are a series of messages you can chose to have popping up on your screen (and it's a great option to be able to avoid all of these messages, if you want), and these reminders can help adherence with both supply reorders and testing compliance.  Again, having the choice to take it or leave it is a plus.  In the coming days, I'll be able to truly test the battery life of this meter, and how the trends map out using the online software, in addition to checking out the iPad app.

Overall, this meter has a cool look.  (Or at least cooler than most glucose meters, which tend to trend more towards lumpy LEGO than streamlined.)  My main concern, with all glucose meters, is accuracy and precision.  I really love that technology is moving along and becoming savvier, but I am very curious to see how this meter performs when it's testing actual blood.  If this meter is accurate, and if the strips are covered by insurance companies (another huge need), then this little fella could be a contender.

For more photos of the Telcare meter, check out this Flickr set.  For more from the official Telcare website, click here.  And ignore the fact that this post is going up at 2 am.  :)

January 06, 2012

Drink the Juice.

Drink the juice, Shelby!Every person with diabetes experiences low blood sugars differently.  There's that line in Fight Club: "You are not a beautiful and unique snowflake," but in the case of low blood sugars, they are like snowflakes.  Or fingerprints.  You can read the list of hypoglycemic symptoms backwards and forwards, but if you have diabetes or love someone who does, you know there's always that rogue one.

"Dizziness?  Check.  Shakiness?  Check.  Wait ... they don't have 'numb tongue' listed on here ..."

A few days ago, my family and I were in Los Angeles for a photo shoot for a diabetes-related project.  (Details to be shared when I can, but since I can't find the non-disclosure agreement, I'm erring on the side of shhhhh.)  As someone who prefers to be behind the camera, and not in front of it, the whole "make up and hair" experience was a first for me.

"Just sit in this chair and we'll start with your hair," the very nice stylist said, easing me into one of those black, swiveling chairs.  

"And Birdy will be here in the room with me, so I can spy on her?"  That was the plan, anyway.  Since Chris was in meetings while BirdZone and I were doing the diabetes thing, there was someone who offered to help bird-watch while I was being all done up.

"Yes.  She'll either be in here with us or out there with [name]. She's in good hands."

"Okay."  

So they set to work on me, with gigantic rollers and make up sponges and tubes of things that leave me clueless.  And as we're talking and exchanging our diabetes stories, someone asks me if the toddler just outside the room is mine.

"Yes, that's my daughter."  I feel myself smiling, even though the make up lady asked me to keep my face still for a few minutes.

"It's good to see a happy mom and a happy baby. Steel Magnolias is one of my favorite movies, but not when it comes to thinking about my daughter and her future children."

"I know, right?  I love, love that movie ... except for the whole diabetes part." 

Time passed and my hair grew in volume.  And I heard the Dexcom BEEEEEEEP!ing from my purse on the floor.

"Would you mind handing me that blue receiver thing in my purse?" I asked the girl who was arranging her work station for the next person.  And two quick clicks showed me at 54 mg/dL with two arrows down.

The irony was too much.  Did the mere mention of Steel Magnolias make my blood sugar plummet while having rollers set in my hair?  I grabbed a bottle of juice from my purse and drew a few long sips.  The make up girl blotted my forehead with a make up sponge.

"Is it a little warm in here?  You're sweating a little.  Do you need anything?"

I knew Birdy was in capable hands, and I knew the juice would hit my system in a few minutes.  I just wanted to sit tight and let the sugar magic happen.  After a beat, I started to feel a little better.  And once the Dexcom showed that I was on the climb, I relaxed.

Not every person with diabetes experiences low blood sugars the same way.  They manifest in their own, strange little ways.  But sometimes you manually refrain from touching the rollers in your hair because you don't want a Steel Magnolias moment to be the "rogue" symptom.

Besides, you never want to ruin the epic work of a talented Truvy.  ;)

January 05, 2012

PWDs in the Wild.

There's nothing sweeter (pun oh-so-intended) than be able to introduce my daughter to my extended DOC family. 

We love the Simmons...es...es

The amazing Simmons family and me and the Bird.  (Chris served as our photographer, but he was also wearing blue.  Sparlings travel in a color-coordinated pack.)

Random gathering of PWD on the rooftop bar of the London Hotel

And in a random, luck-of-the-Twitter turn of events, I ended up having the pleasure of meeting a few local PWDs (Clarke and Nicole and Brianna), and while we were on the rooftop restaurant, we spied another pump in our midst, belonging to Mike Fisher.  (Actually, Birdy spied it when she and I were doing a hand-in-hand lap around the tables.  "Pump, Mama," she announced casually.  So of course we had to say hi.) 

Thanks for spending some time with the littlest Sparling, you guys!  And for hanging out with me, too.  :)

January 04, 2012

Not Too Shabby.

Not too shabby ... for January.
Not too shabby ... for January.

(Birdy loves the water.  Loves, loves, loves.  And I'm grateful that my pump is waterproof, because it leapt out of my pocket more than once while we were playing in there.)

January 03, 2012

What I Learned Flying Cross-Country with Diabetes and a Baby.

What I Learned Flying Cross-Country with Diabetes and a Baby. 
A bulleted list, by Kerri Sparling. 

  • Traveling with three humans, three bags, and three carry-ons, plus a stroller and a car seat, isn't easy.
  • It's especially not easy when one of those humans (ahem, lazy Bird) refuses to carry her own luggage. 
  • Nothing is more uncoordinated than me, running through the airport in Baltimore, MD and pushing the stroller.
  • Except if I'm running back to the plane I just got off of, trying to reclaim my laptop (which ended up being left on board by my pure and stupid accident), sweating and trying not to curse but whispering a flurry of eff words under my breath so that the kid doesn't hear me.  That's the most ungraceful I'll ever be.
  • (I won't mention the fact that the TSA agent had to convince the guy on the plane, sitting in the seat I had just vacated, that the laptop bag was indeed mine.  That jerkface tried to score my computer and our iPad.  Thankfully, his jerkface ways were thwarted by the kind TSA person.)
  • I will mention the fact that I was less concerned about replacing the technology and more panicked about how we were going to keep the baby entertained for the next six hours.
  • Requesting that the meeting organizers purchase a plane ticket for Birdy was a godsend, because buckling her car seat right into the plane made me feel like she was more secure.  And it also gave her a place to put her wiggly bottom.  
  • Half-full bottles of glucose meter test strips make the best makeshift rattles, second only to jars of glucose tabs.

    The view is worth the chaos.

  • My daughter will not keep her shoes, or her socks, on her feet for more than fifteen seconds once she is buckled into her car seat.  As soon as she's secured, I hear the riiiiip of the velcro and then two socks end up beaning me in the face.  This action is shortly followed by her laughter, and then her happily sticking her feet into her mouth.
  • (Sidenote:  I wish I was more flexible.)
  • Now, when my meter beeps and shows a result, I get an "Ooooh!" from the baby.  She has no idea what she's reacting to, but she knows I am always looking at the meter with a furrowed brow.
  • The Dexcom receiver has been renamed, though.  "Mommy's 'mote."  Ah yes, my remote control.  Thanks, BirdFace.
  • Hour Four of the Six Hour Plane Trip is the hardest.  That's when everyone is in need of a nap (except the pilots - they usually emerge at this point to take a leak) and you've just run out of Happy Baby snack pouches
  • An iPad is an incredible toddler distraction, but my poor kid hasn't quite nailed the concept.  She'll select an app, start it up, greet the character on screen (usually Elmo, who she points at, smiles, and yells at the top of her lungs, "ELMO!"), and then presses the "home" button, sending the app back into dormant status.  She does this all. the. time. Nothing stays on the screen for more than five seconds because she (almost) immediately banishes it with a click of her thumb.
  • Oddly enough, this frustrates the hell out of me and I actually get mad that she won't stop pressing the button.
  • This is where I remind myself that she's not even two years old, and if she wants to press the "home" button and then try to fling the app icons off the screen with her fingers, more power to her.
  • So long as it keeps her quiet.
  • A blood sugar of 38 mg/dl seems to pale in comparison to dropping the last crayon and hearing it roll to the front of the plane.  Until your husband shows up with a can of orange juice and you're all, "Oh, that was a really good idea.  We also need more crayons."
  • Nothing breeds fear in people's eyes more than seeing you board a plane with a baby in your arms.
  • Unless you also have an Italian grinder, which smells of salami and onions and makes the whole front half of the plane smell like armpit.  (Thanks, Guy in Row 7, for stinking up the joint.)
  • But nothing makes people smile quite as much as seeing a very tiny human bust out dance moves in the middle of the airport.  Without music.  Or grace.  Or much rhythm to speak of.  
  • (And yes, we have it on video.  Coming soon.)
Fin.

January 02, 2012

Such Great Heights.

High blood sugars come in three different tiers for me:  No Big Deal (NBD), Tricky Little Sucker (TLS), and What The Eff (WTE). 

No Big Deal (NBD) highs are the ones I see when I first hear the Dexcom BEEEEEEEP!ing.  They are the 180 - 240 mg/dL highs, where I'm cruising out of range, but not so far outside that it takes hours to correct.  The NBD highs are usually mild in their symptoms (kind of thirsty, sort of tired, maybe wouldn't have noticed if the Dex hadn't hollered) are thankfully short in their duration, so long as I'm on the ball about keeping tabs on my blood sugars.

Tricky Little Sucker (TLS) highs are obnoxious pieces of garbage that hang on for hours.  These highs are the ones where you hit anything over 200 mg/dL and just ride there for hours.  HOURS.  Like you can undecorate the Christmas tree and pack up all the holiday nonsense back into the attic and STILL find yourself rolling outside the threshold.  They're the ones that prompt rage bolusing, long bouts of batting practice, and are seemingly resistant to insulin.  No matter how I attempt to tame it (bolus, injection, bolus-and-injection combo deal), the TLS highs are aptly-named.  Tricky.  And sticky.  But despite their tenacity, they don't throw ketones.  And I try not to throw tantrums.

Older photo (from 2008, I think), and I think I only recently bought a new bottle of ketone strips.  Ooops.
The ketone pee sticks.

But the ones I dislike the most are the What The EFF (WTE) highs.  The numbers may vary, but one thing is for certain:  these highs come with ketones.  Trace, small, moderate, large ... whatever the size, a WTE high has that airplane-glue-scented-acetone-taste to it that leaves you slide-tackled with exhaustion and the need to pee every fifteen seconds.  Ketones make everything more complicated, because you have to keep consuming water and carbohydrates, even if your blood sugar is still elevated, to help your body flush the ketones out.  It's a process that must be followed with precision, or you can go into diabetic ketoacidosis and then you're in a world of hurt.

I had my first WTE high in ages this past week, and it knocked me for a complete loop.  I woke up with a blood sugar in the 90s, bolused for breakfast, and thought all was well.  About 45 minutes later, I watched as the Dexcom graph started to do the whole Cliffhangers thing.  And about two hours later, I realized my bolus wasn't even touching breakfast.  High, ketone-laced symptoms were in full effect: lethargy, headache, limbs that felt 15 lbs heavier apiece, that weird pressure feeling behind the eyes, and a thirst that couldn't be properly quenched.

To truncate a long story (the pump site was fine but the insulin turned out to be spoiled - last bit in an older bottle, I guess), it took four hours, two injections, and a whole new pump site to bring my blood sugar down.  And even after it had fallen back into range, I was still flushing ketones for the next few hours (took almost five hours to go from "small" to "negative").   Epic hydration, like the guy from Big Fish.

Nothing feels better than to drink a glass of ice water once the ketones have evacuated.  Drink it, you know ... just because you want to.  It tastes so cool, so crisp, and so blissfully unnecessary.

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