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November 30, 2012

The Friday Six: Get Yer Festive On.

So many linky bits, so little time.  Here's a quick Friday Six (plus ... 8?) of links you may want to check out this fine winter Friday:

In this month's diaTribe, Kelly and the Close Concerns team take a look at the state of diabetes care in Germany.

A young girl in Oregon is taking heat for wanting to bring her diabetes alert dog to school.

Does coffee help or hinder glucose processing?  Either way, I'm still drinking it by the bucket-full.

Blue Cupcake is a new line of greeting cards to help mark a health milestone, and today is the last day you can get 14% off any order in honor of Diabetes Month!

Truth.

Here's a video (aka, the one where I blink and nod too much) about patients and interactions with Pharma from the Pharma Digital East conference I attended last month. 

Christmas tree must-have?

What Are D-Moms Made Of?  Meri answers this question in a way that will make you want to high five and hug her, at the same time.

Elf-On-The-Shelf remains a mystery to me, but the off-label uses for him/her are very ... inspiring. 

The perfect marriage of my love of photography and miniatures: tilt-shift photography.  Love!

An action figure of Siah would be pretty badass.

Psychological support as the missing link in diabetes support?  YES.

And lastly:  Kim is hosting a Give All the Things! giveaway over at Texting My Pancreas! Details coming on Monday, but you can learn about the giveaway rules today. 

November 29, 2012

Australian Diabetes Social Media Summit: #OZDSMS

Earlier this month, I was in Melbourne for the first Australian Diabetes Social Media Summit (#ozdsms), hosted by Diabetes Australia Victoria. The fabulous Renza Scibilia (who blogs at here) asked me to come speak with the group about the beginning of my journey as a PWD and as someone who has been sharing their diabetes story online for many years. I was honored to be part of the event.

Renza's goal for the event were very direct: "‘We wanted to find out the key issues that are affecting diabetes consumer (patient) advocates. How are they using social media to push the agenda. As a diabetes organisation, we want to be able to respond and assist using the channels available to us. It’s not about us driving the agenda; it’s about us listening.  The Summit seemed like a great way to get talking to the people doing lots of talking out there on blogs, Twitter, and Facebook."

Jo from FingerPricker summed up her experiences about the summit, and her goals going forward. "Feeling like we have all known each other forever and that, strangely enough, because we all are linked via diabetes I felt as if we were family. There is just this immediate understanding and acceptance that is calming and good for the soul. This enforces the drive within me about the importance of exercising ways to promote good emotional health to balance the demands of living with a chronic condition and that this needs promotion here in Australia."

[Editor's Note: YES! I absolutely love when people talk about the emotional well-being of patients with diabetes, which is a grossly under-served issue in the diabetes community. Go, Jo, go!!]

"Social Media platforms do not mean the end of the traditional face to face support groups or medical advice from the professionals. They can work successfully together so that our emotional well-being doesn’t fall through the gaps while we wait for our next appointment."

What makes Australia unique, in my American opinion, is that they're used to the concept of "long-haul." If they want to visit any place other than their own country (or their neighbor, New Zealand), they need to hop on a plane for hours. And the same goes for anyone who visits them. People from Australia, at least from a travel perspective, know what it's like to work to get somewhere.

Some excellent Aussies ... and a rogue American thrown in.
Happy crew from OZ!

Which is something I think translates into diabetes management pretty fluidly. Type 1 diabetes is a long-haul journey. It's not a pill you take every day and then forget about the disease. And it's not enough to manage solely the day-to-day stuff, either; you need to keep your eye on the balls you're juggling today, and then anticipate the ones you might be juggling months/years/decades from now. Long haul, many balls. (How's that for a ridiculous sound bite?)

As with other international meet-ups I've had the privilege of attending, diabetes doesn't know language barriers. (Or, in this case, amazing accent barriers.) Type 1 diabetes doesn't care where you live or how you talk or what kind of measurements you use to quantify your blood sugar results. If you are a human being living with diabetes, you intrinsically understand others who are living with it in a way that perfect strangers shouldn't be able to ... yet can.

Rachel Lamb, who doesn't blog (yet) but is an active OZ advocate through IDF and co-founder of YWAIT, left the Summit feeling empowered.  "Inspiration. Motivation. Networking. Connection. Confirmation that I'm on the right path. As corny as that sounds, diabetes has my mind on overdrive, always. Being involved in the DOC and events like OzDSMS make me feel like I might actually be sane, I'm not alone, and I'm making a difference. I get a lot of strength from the whole experience."

Being part of this event in OZ was an amazing experience, and a huge thank you to Renza, Kim, Diabetes Australia Victoria, and to my fellow PWD down under. Thanks for having me, and for being part of my diabetes journey!

[And for more from the amazing people in OZ, check out some of these sites:  FingerPricker, Diabetes Australia Vic blog, Bittersweet Diagnosis, Parent's Jury, HypoActive, Lazy Pancreas, 1 Type 1, Simon from the 70's, YWAIT, Diabetogenic, and Insulin Pumps Need Tetris.]

Disclosure: My travel, lodging, and an honorarium were provided by Diabetes Australia Vic. I was not asked to blog about the event, but as always, my opinions remain mine.

November 28, 2012

Looking Back: Special Sib of a D-Kid Day.

There are a lot of people with diabetes, and those caring for people with diabetes (like parents and spouses) who have found community here in the DOC.  But a group that's generally quieter is the sibling crew, the ones who grew up alongside those of us who have diabetes.  Today is Special Sib of a D-Kid Day (started on Alexis's and Sherry's blogs), and today I'm revisiting a post from 2010 to mark the occasion:

I <3 my brother and sister.

I realize I am no longer a diabetes kid, but I used to be one.  And my siblings are still my siblings, no matter how old I get. 

I don't have a clear recollection of life immediately after diagnosis, but I know back in 1986, food choices ruled the roosts of diabetes households.  Once the vials of insulin moved into our refrigerator's butter compartment, gone were the Twinkies and Ring Dings and Yodels (and other snack foods comprised of 1/2 a gram of actual nutrient and then a whole pile of crap).  Our eating patterns changed as a family, and Diet Pepsi and food scales replaced the snack cupboard of days gone by.  My mother hid the ice cream sandwiches in the hollowed out box of broccoli in the freezer.  She had packages of E.L. Fudge cookies hidden between the sweaters stacked in her closet.  She was a food-hoarding squirrel, with delicious treats in every obscure corner.

For me, this was a smart approach that removed a lot of temptation (and also presented some very furtive treasure hunts with tasty rewards), and one that helped to keep me safe and healthy.  But for my brother and sister, both with perfectly capable pancreases (pancrei?), the lifestyle change wasn't necessary.  Didn't they get to have snacks, still? 

What I failed to realize is that my diabetes didn't have to be my brother and sister's diabetes.  There was so much about their lives as the siblings of a child with diabetes that I couldn't even wrap my head around.  I didn't know what it was like to have your sister come home and play host to something no one could see, yet gained so much attention (for better or for worse).  I've talked to some siblings of kids with diabetes and heard about the guilt.  "I felt bad for wishing I was sick, too, because I was jealous of the attention."  Or the worry.  "Was I going to get diabetes, too?"  Or the anger.  "I am sick of her diabetes being the sole focus of our family."  Or just plain fear.  "Will diabetes hurt my sibling?"

Diabetes is a disease that affects the whole family.  It's not just the person who is receiving the injections or pump infusion sets or finger pricks that's carrying the full weight of diabetes.  I don't know if my brother and sister understood what "diabetes" meant when I was first diagnosed, and if any of us understood just how big the words "without a cure" really felt.   But I know that we learned about diabetes as a family, and dealt with it the same way. 

In honor of Special Sibs of D-Kids, I raise a contraband Ring Ding to you in solidarity.  You guys are a very compassionate, understanding, and patient group, and we, as your diabetic brothers and sisters, are very grateful to have you in our lives.

November 27, 2012

Dexcom G4: Second Impressions.

It's been three and a half weeks since my transition to the Dexcom G4 system, and I've finally burned through the first box of sensors. (Because I live in fear of the frigging rash, so I immediately pull a sensor once I hit the seven day mark, and I also had to pull one early because I scraped it off while traveling. Going forward, I expect a box of sensors will last me 28 days.) With the first month behind me, I have a few updates to my initial impressions.

The Receiver.  The receiver is still badass. I really do love the smaller size, especially for things like going to the gym. It fits neatly into my meter bag, and it's not this gigantic, intrusive device that I have to whip out at meal times. It's discreet and looks like any other modern device of the 21st century (dagnabit).

The Transmitter.  The f&*k? This thing is big. It's weird how it's "just a little bit bigger" than the old transmitter, but I notice the difference often, even after a month. I ran into this same problem when I switched from the Minimed to the Animas pump. When you're wearing a device every, single day, you become used to every aspect of it, from the curve of the corners to the way the pump clips sticks up ever so slightly ... you know the shape and the experience of it by heart. Which is why the new transmitter is mucking with my head, because it's a whole new set of angles and curves to adjust to. Even though I know the G4 is progress in the right direction, for this CGM, I do not like the new transmitter for it's size.

The Alarms. I do really, really like the alarms. They're louder. The low and the high one sound completely different from one another. The receiver-in-the-glass trick still works fine. I remain a fan of the G4 alarms.

Accuracy. Being 100% honest, the accuracy for me on the G4 isn't great in the first 24 hours. I rely on my glucose meter and fingersticks for that first day (the four I've experienced, so far, anyway), and I see numbers on the Dex that are sometimes as much as 80 points off from where I'm actually clocking in. However, I hope that changes as I move forward, and maybe the first few sensors had some issues in my body. I'm willing to let the first 24 hours fly because the accuracy going forward is scary. Spot-on. I see my meter and the Dex as almost mirror-images of one another, often only off by a handful of points. I see matchy-matchy numbers several times throughout the week. After the first day, I trust the G4 implicitly. And that's a really useful thing, especially as I add more miles to my workouts and have very unpredictable sleeping schedules. (Note: The photo below is from day one, Hour 8 of a new sensor. Maybe things are changing for the better in those first 24 hours?)

And this was Day One. Maybe the tide is turning?

Randoms. The carry case provided by Dexcom looks more like something fit for Man vs. Wild (Bear Grylls is a fox, which makes this too many animals in one sentence aside.) than for life. I am looking forward to the silicone cases that I'm sure are coming for this receiver. Hopefully they arrive before I drop this thing onto the bathroom floor and it shatters into a thousand expensive pieces. Also, I still think the battery life is excellent, and I've charged it only three times in the last four weeks. (That's big, since I LOVE to click the button and look at the graph.) I've yet to download anything to the software (because I have a Mac) or to Diasend (yes you can ... more on that in a bit), so I don't know how that shakes out yet, but I'm curious to have fifteen minutes to myself to find out.  (See also: Birdy starts "school" this week, wherein I plan to reclaim my inbox.) (And this is the end of my parenthesis excursion.) (Or is it?! Dun dun duuuuuun!)

First impressions are behind me. Second impressions are logged. Hopefully third impressions include "Hey, the accuracy improved in the first 25 hours!" and "Wow, what a lovely case for the Dexcom that keeps it safe from Sparling-inspired destruction!"

[Dexcom disclosure]

November 26, 2012

Collections.

I don't collect things.  Chris and I were talking about this the other day, how we don't have stamp collections or all of the teaspoons from each state or a vast closet filled with winter hats with fuzzy yarn pom-poms at the top.  (Though I secretly - and now openly - wish I had a collection of puppets.) 

But I do have a small and eclectic collection of medical items.  I have a basket full of ancient glucose meters in my bathroom cupboard.  In my jewelry box, there's a drawer dedicated to the sturdy-yet-sterile looking medical alert bracelets and necklaces I wore as I kid. I have a whole cabinet dedicated to unused lancing devices, injection supplies, bits and pieces of diabetes paraphernalia that I've taken home from conferences, and the odd thigh holster for hiding an insulin pump.

And now, lining up along the ledge on my bathroom counter, is this small, but growing, army of insulin bottles.  

"SALUTE US, damn it!"

When I change my infusion set, this moment usually takes place in the bathroom, with my supplies lined up on the counter.  So when an insulin bottle has its last units borrowed, it ends up as part of this guard.  Sometimes I salute them.  (No I don't.)  (Okay, I did once.)

I'm not a collector, but I may be a hoarder.  A diabetes hoarder.

November 23, 2012

Thirty-One.

Dear Birdy Bird,

We have actual conversations now.  They're usually strange and scattered, but they're real, and you are happy to communicate every fledgling thought in your head these days.  And since you're two and a half years old now, it's like watching a circus troupe unpack.

"We should go to the store and buy some eggs so we can boil them and eat the hard-boiled eggies and then we can paint a picture of the eggs in our belly because THAT'S WHERE THEY WILL BEEEEEEEEEE!!"  

(You speak in all caps as often as you can, usually ending your sentences with some kind of ASSERTION!)

I do enjoy listening to you learn the language as you muddle through all the words you hear throughout the day.  Like when I told you, while tickling you, that you were so smart that you were a genius!  This word stopped you cold, as you deliberated.

"But I didn't grant any wishes.  I'm not a genius."

Touché.

While our conversations are sweet and entertaining, your tantrums are NOT.  (All caps on that one, too.)  Your favorite phrase to scream, while fussing in public, is "Don't take me!!!"  Which is great, because it makes me look like I'm abducting my own kid.  "I'm not taking you; I'm your mother."  "No, don't take me don't take me!!!!"  And this is when people start to stare, wondering if they should alert the police.

Even though every parent probably says this about their kid, I marvel at how quickly you're growing up.  You are so independent and stubborn (yes, I realize I'm as much to blame for that as your father is for your pretty brown eyes), and making sense of the world as you go.  You used to be my little baby bird with the chubby legs, and now you're this lanky little thing who wants to learn how to knit.  (Which, to you, means stabbing a skein of yarn with knitting needles until you've morphed the ball into a satisfying and un-fixable knot.) 

And next week, you start "school" (aka "daycare"), which is a direct response to your requests for a brother (and in my desperate attempt to hit deadlines more often):

"I want oatmeal, Mama."  Pause.  "And a bruffa."

"I'll make you some oatmeal, lovey.  And how about we start school, yeah?"

Watching you become this funny little creature has been the most entertaining, unpredictable experience I'll ever know.  And even when you make it seem like I'm abducting you ("Don't take me!!!"), you crack me up, and I love you bunches. 

xo,
Your Mom

November 22, 2012

Happy Thanksgiving!!

This year, we let Birdy paint up our hand turkeys. 

"I paint fingernails on them!"

Happy Thanksgiving from our festive and carefully-manicured turkeys.

Happy thanksgiving to our friends who have become like family to us.

November 21, 2012

Buzz Does Diabetes.

Buzz and I have been Internet friends (is that still a thing, or can you call someone you've never met in person a "friend" yet?) for years now, connected through diabetes, even though his pancreas still functions properly.  Buzz Bishop is a radio personality from Canada and he has been a big supporter of Team Diabetes in Canada, as well as helping raise awareness globally.  I asked him to take part in the T14ADAY challenge (even though we had to construct a workaround since he lives in Canada ... so instead of receiving the texts from JDRF, he received them from me), and today he's sharing his thoughts on the experience.

*   *   *

I try to do all I can through radio and the web to bring awareness to Team Diabetes and the greater cause, but my friend Kerri at Six Until Me asked that I take it a step further this year.

She asked me to sign up for the JDRF’s T1D4ADAY initiative where you go through what it’s like to be a type 1 diabetic for a day. It’s a very simple thing, really. You text the service and they send you texts back throughout the day with incidents that diabetics have to deal with.

On the surface, being a diabetic doesn’t sound like a big deal. We say things like “manage your blood sugar” and “watch your diet” as if they are simple tasks. When you say it like that they are simple, but when you live like a diabetic you realize the greater scope of what those statements mean.

Going for a run? Make sure you bring some glucose tabs with you and calculate what’s going to happen to the carbs in your body on the run. Hit a low in the middle of the night? Call your emergency contact to make sure they can look after you. Missed a few markers throughout the day? Don’t beat yourself up about it, just keep going and try to hit the next one.

We (non-diabetics) go on and off diets all the time. We eat salads and drink water for a week, and then binge on pizza and beer. No big deal. When you’re a diabetic, if you fall off that wagon it is a big deal. Each day you need to bring supplies with you. Every meal needs to be calculated for carbs, and the insulin levels in your body. A healthy pancreas normally does all the balancing automatically, when you’re diabetic you become the pancreas.

Here’s a video I made walking you through my day with type 1 diabetes:

Even though I ‘thought’ I was done when I shot that video, my ‘day’ with type 1 diabetes wasn’t done. In the middle of the night I received 2 more texts. My blood sugar had inexplicably dropped, and an emergency contact had needed to be called.

Kerri tells me this is something that diabetics constantly live in fear of. Even sleep is not a reprieve from the disease, which shouldn’t be too surprising.

I still remember being stunned when I first met Kerri 5 years ago and she told me that she had a diabetes pump sewn into her wedding dress. “Really?” I said. “Yes,” she responded. “Diabetes doesn’t take a day off because you’re getting married.” Diabetes doesn’t take time off when you need to sleep either.

Yes, you and I can binge and fall off the wagon when it comes to our health regimens, but a diabetic can’t. Missing those numbers, or ignoring the warning signs becomes a serious health risk.

November is Diabetes Awareness Month. Are you aware of what nearly 1/3 of Canadians are living with?
*   *   *
Thanks, Buzz, for taking the time to experience type 1 diabetes for the day. 

November 20, 2012

Diabetes Zoetrope: All We Need is a Strobe Light.

At the Australian Centre for the Moving Arts, Chris and I saw this zoetrope thing crafted in the likeness of Ty the Tasmanian Tiger (wiki info here). Fully lit and standing still, this exhibit looked like an overzealous layer cake, and didn't impress me too much.

But then the music starts. And the thing starts to spin, blurring the little figurines together. And then the strobe light switches on, and it becomes something I stood there and watched about fifteen times. So fluid, so seamless, so detailed without seeing any of the real details. 

The work that went into creating this exhibit is tremendous, but you don't see all that effort when you watch it.  It's hard not to marvel at the magic of how all those details become art.

Diabetes, to me, is exactly like this zoetrope.  All of the details of diabetes management, mapped out with precision and painstakingly attended to?  The blood sugar tests and the insulin boluses and the mental math we attempt in our heads whenever a plate of food is served?  Thinking ahead to make sure we have insulin in the fridge when a bottle runs dry?  Knowing that feeling of waking up with glucose tab dust on your pillow case?  Planning and scheduling and worrying and panicking?

It's all a blur.  And when the day starts spinning and life is moving forward, you don't see any of it.  You don't see diabetes and all its details. Sure, you might spy an insulin pump clipped to someone's jeans, or you see evidence that there was another PWD in the wild when you spy their test strip on the floor of the public bathroom, but for the most part, you don't see diabetes when you see people living with it.  You see them.  You see their life. 

The work that went into creating this exhibit is tremendous, but you don't see all that effort when you watch it.  It's hard not to marvel at the magic of how all those details become life.

November 19, 2012

In-Flight Diabetes Management.

My brain is a swirling dryer of thoughts, ideas, and exhaustion, set on HIGH, and that's without even bringing up the amazing OZ Diabetes Social Media Summit.  Bullets are the only way to release the Kraken
  • The flight from Los Angeles, California to Melbourne, Victoria is 15 hours and 50 minutes long.  I don’t enjoy being on a plane for fifteen minutes, never mind fifteen hours, so this was an experience.  And, of course, diabetes was a pesky bird during the course of this flight.  
  • I changed two infusion sets on one flight.  One was because my insulin cartridge ran out about five hours into the flight, sending me into the airplane bathroom with a bottle of insulin, an infusion set, and a pump cartridge.  With the diabetes paraphernalia spread out along the narrow airplane bathroom counter, (and doing my best to keep anything sterile from coming into contact with the petri dish command center known as an airplane bathroom) I felt like a true traveling insulin addict.
  • And then, thanks to a feisty seatbelt and a sleeping seatmate with active hands, the new infusion set was accidentally ripped out, sending me back into the bathroom with a new spaceship.  
  • Dear Qantas flight friends:  I’m sorry for making the bathroom smell like bandaids.  Twice.
  • I accidentally treated a low blood sugar with low-sugar juice.  Three cups of it.  “Why isn’t this frigging juice working?”  Oh, right.  Even the juice outside of the States is healthier.  
  • Which meant that the lingering 65 mg/dL tumbled into a 39 mg/dL, wherein the flight attendant and I got to know one another over a jar of glucose tabs.  “What are those?”  “Glucose tabs.  I use them to treat hypoglycemia.”  “We have a lot of that on our flights.”  And then she tried her first glucose tab.  “Tastes almost like candy, but not enough to make me want to eat heaps of them.”  “Exactly.”
  • I rode bitch from Melbourne to Los Angeles, with Chris on my right (aisle) and a lady we didn’t know on my left (window).  Nothing introduces a stranger to diabetes quite like a 39 mg/dL, some high-flying jelly beans, and a flight attendant grinning through glucose dust.  
  • Somehow, the Dexcom flagged me as “out of range,” despite the fact that I should have been able to go from the front to the rear of the plane without the receiver breaking a sweat.   And despite the fact that it was in my seatback, ten inches from the transmitter on my body.  Go figure.
  • I watched the sun rise via the creepy camera mounted on the tail of the A380 air bus.  That’s a very curious experience.  Didn't contribute to nice, steady blood sugars as it was a constant reminder that I was on a plane. For fifteen hours. Curious indeed.

    Approaching the coast of Australia.

  • Almost as curious as boarding a plane that’s bigger than the state you grew up in.  (Ish.)
  • But definitely not more curious than me, trying to figure out what time it was.  My pump was set to Melbourne time (I change my pump to the timezone I'm traveling toward almost immediately), my phone was set to Los Angeles, and my CGM was set to Boston.  Telling time required doing math, which means I was horrible at it.  “What time is it?” was a question quickly followed by, “What day is it?”  Confusion reigned.  
  • (As a side note, I had the hiccups for two full hours on the flight home.  Not sure why.  I sounded like a sad creature, hiccupping wildly and loudly for way too many minutes.  Good ab workout, but miserable social experience.)

And then we landed.  And it was over … until we grabbed our second flight, bringing us across the country and home to Rhode Island.  Nothing like a trans-Pacific flight to make a cross country one seem piddly. And nothing like being home after a week away to make me appreciate being on solid ground.

November 16, 2012

Guest Post: Air Travel, Diabetes, and Burritos.

TSA madness and a burning desire for a burrito?  Is this what diabetes travel woes are like?  Thanks to Christopher Angell's travel and diabetes guest post today, I'm feeling like a kindred spirit with this particular PWD and fellow travelin' fool.  (Not that he's a fool.  Or that I'm a fool.  You know what?  This time change thing is starting to make my brain splutter.)  Here are some travel tips from Mr. Angell.
*   *   * 
I find it slightly ironic that Kerri asked me to write about diabetes and air travel, since she's the one in Australia, and I'm the one sitting in my office. Still, so far this year, we've run into each other at devents in Orlando, Indianapolis, and Berlin. In fact, assuming my plans don't change (unlikely), I'll have flown 99,652 miles when the ball drops on December 31.

I have broken my air travel advice into four categories: Redundancy, Security, Nourishment, and Shameless Self Reliance.

Redundancy.
In travel, as in diabetes, surprise is the enemy. The more that things go according to plan, the better.  But plans always do change. This is why it's critical to always have a backup plan.

It goes without saying that you should always travel with duplicates of all of your supplies (including treatments for low blood sugar), if possible.  The one thing that I don't always travel with a backup of is my Dexcom CGM, because I don't always have a backup (sometimes I do if I order another after my warranty expires but my current receiver is still working) but I always travel with a backup charger.  It also goes without saying that you should keep the backup in a different location than the original.

Security.
Probably the most controversial (and in many ways personal) aspect of air travel is the TSA security checkpoint. What to scend through the x-ray? Should you request a pat-down?  Metal detectors vs. full-body scanner?

I know Kerri disagrees [Editor's note:  I do.], but I always just go thorough whatever machine they put in front of me.  I want to get away from that area as quickly as possible.  If you take that route, and wear a Dexcom (or other CGM), I suggest wearing your sensor somewhere easily accessible in case you go through a scanner and they want "more information."  This happened to me only 3 times (out of 50+ flights and counting) in 2012.  Twice in Denver and once at Laguardia.  Since I was wearing my sensor in my thigh, it meant that I had to go to a private screening room, as pulling down your pants in the middle of the terminal is still frowned upon.  I take it in stride - I would say 99.99% of the time, if you are polite and cooperative, you'll be treated with courtesy and respect. If not, file a complaint. There was a study released recently about the effects of airport x-ray machines on pumps and CGMs that's worth reading.  I've always sent mine through the machine and never had a problem, but I'd never thought it might be an issue before, so it wouldn't hurt to check your manufacturer's guidance.

I used to keep my insulin pens in a Frio case when I traveled, but I never do anymore, unless I know I'm going somewhere really hot, and will be exposed to that heat for a long time.  The pens provide a bit of protection, and even if it gets heated up, insulin only loses a small percentage of potency.  The space savings are well worth that gamble.  That said, my most amusing security run in happened when I had a freshly-plumped Frio case in my carry on:
Agent: "Sir, is this your bag?"
Me: "Yes"
Agent: "Do you have anything sharp or dangerous in it?"
Me: "A few syringes, but they have caps on them."
Agent: "Ok.  Umm…sir…do you have…do you have a burrito in your bag?"
Three things immediately popped into my head.
1. I was in San Diego.  Shouldn't they know what a burrito looks like?
2. Are we not allowed to bring burritos on planes anymore?
3. I really wanted a burrito.

Sustenance.
This brings me to one of the biggest challenges for me when flying: food.  If you're trying to follow a reasonably low-carb diet, you quickly become one with the grilled chicken caesar.  It's the most ubiquitous bread-less protein source out there, by a good mile, followed by the far-less-satisfying individually-wrapped slices of Tillamook cheese found in United's lounges.  My secret weapon?  Almonds.  I never fly without about a pound of raw almonds.  They're reasonably tasty, do not spoil, are very easy on the bg's, and have a lot of healthy stuff in them.  Should they be used as a meal replacement?  No.  Have I used them as a meal replacement?  More times than I can count.

Shameless Self-Reliance.
When you're on the road/on a plane/out of your normal zone, you're even more at your own mercy than normal. You can't hesitate or be squeamish/embarrassed to test, treat, or correct.    If you think you might be low, don't wait, get ahead of it. If you're high, knock it down, because you'll be sedentary. I am on MDIs and I give myself shots in my seat next to strangers in even the tiniest of aircraft. I figure the least sanitary place I could bolus would be in any travel-related restroom.

As an example of how important it is that you be prepared for whatever the road throws at you, I'll recount what happened on my flight from Indianapolis to DC after the AADE National Gathering.  About 10 minutes before we were scheduled to land in Dulles, I saw the flight attendant move nervously toward the back of the plane.  Then, the classic call over the PA "Is there a doctor on board?".  A few seconds later, someone yelled "Does anyone have any Glucagon?".  I offered glucose tablets, but I knew it must be past that point.  On this small plane of less than 100 people, there were three doctors and countless nurses/CDEs.  Seemingly the ideal flight to have a diabetic emergency.  But NO ONE had any glucagon, and the plane didn't have any either.  They ended up using the glucose drip bag from the plane's first aid kit.  There were ambulances waiting on the runway, and within a few minutes, the woman was carried off the plane, already regaining consciousness and no longer seizing. Still, this is not something you want to count on.

So there it is.  If you practice redundancy, have a plan for security, consider your sustenance, and flaunt a shameless self-reliance, you'll get to where you're going just fine.  I just can't promise the same for your luggage.

*   *   *
For more from Chris, you can check out the Glucolift company blog, or just cut right to the chase and buy a jar of Cherry tabs from Glucolift's Amazon store.  Mmmm ... cherry.

November 15, 2012

Guest Post: Living the Paleo Lifestyle with Type 1 Diabetes.

Lindsay lives with type 1 diabetes and has guest blogged here before about her diagnosis.  But today she's talking about living the Paleo lifestyle while managing diabetes, and I find her journey fascinating.  I'm fortunate enough to call Lindsay (ahem ... I mean Linds!) a friend, and I encourage you to check out her blog or her Twitter feed for more information on how Paleo fits into her diabetes management.  She's pretty freaking awesome.

*   *   *

When I first learned about the Paleo Lifestyle, I was intrigued, as I have become with food and the effects it has on the human body since my late in life diagnosis of type 1 diabetes. I was concerned that I wouldn’t be able to fully live the Paleo Lifestyle having type 1 diabetes. Type 1 requires fast acting sugar at a moment’s notice, careful planning of schedules and exercise, and the ability to be flexible constantly. Glucose tablets, smarties, and Skittles, are not Paleo. More so, kale and carrots don’t exactly raise my blood sugar quick, so I was skeptical.

What is the Paleo Lifestyle? Paleo stands for Paleolithic, also dubbed the "Caveman Diet," or the "Hunter/Gatherer" diet. In short, if it wasn't around when cavemen were, our bodies weren't meant to eat it and can't properly break it down. If you have to process, breakdown, refine the food from its original state, then it isn't Paleo. For me a good rule of thumb to go by is that if it wasn't around 100 years ago, don't eat it. Think about your grandparents or great grandparents, who lived on lard, meat, potatoes, chicken, bacon…they lived to be 70s, 80s and 90s, why? Because they walked out their front door and sourced their meal from the barn, coop, etc. Think about it.

The more research I conducted, books I read, blogs I followed, the more I thought, there really is something to this Paleo thing, because it just plain makes sense. I decided that I’d give it a go, and see how it fit into my life with type 1 diabetes. Disclaimer: I didn’t “go Paleo” to try to be low carb (because of my type 1 diabetes), I went Paleo to take control of my overall health and feel better, not just from a diabetes perspective. Paleo has reversed and cured a lot of individuals from a variety of chronic health issues, which is amazing, however, I never went Paleo thinking I would cure myself of type 1 diabetes and go off insulin, and I know that won’t happen. BUT, I feel better (and different), so many things have changed, disappeared, or have become manageable that I didn’t even realize were an issue. One of the most common misconceptions that I’m sure a lot of individuals with type 1 diabetes can relate to, is this “oh, that’s right, you can’t eat that,” FALSE. I choose NOT to eat that, but thanks for assuming you know me and my disease!

Over a year into living the Paleo Lifestyle, I’ve lost weight (and can easily maintain the loss), my skin is clear, I sleep better, I feel better and the most important benefit for me, I like who I am. It’s been a learning process, still is, but I’m extremely passionate about it. I started a blog to share with others what I learn, and to try to help others feel better too. I’ve tried to find ways to share how being Paleo is easy, flavorful, and rewarding. In all of the benefits I’ve seen, my blood sugar is amazing I’d say 90% of the time. Hard to believe, but I see it with my own eyes, so, yet another reason why Paleo has been wonderful for me. My body behaves entirely differently when I eat real food vs. fake food.


What’s more awesome about being Paleo, is that I don’t have cravings (well, sometimes, but RARE), never feel starved, and eat more than I ever have! Everyone has to find the Paleo that’s right for them. Each person’s Paleo is different, but it’s about learning about your body, how you’re feeling, and eating clean. My definition of eating clean, is knowing what I'm putting in my body through reading and educating myself, what ingredients are (if there are any), properly washing fruits and vegetables, buying organic when possible, and eating grassfed/pastured, hormone, antibiotic free meats. I try to eat as fresh of food as possible, nothing boxed or with an ingredient list. Eating food that our bodies were meant to eat and digest properly fuels us and we receive the most nourishment and benefit from what we're putting in our bodies as a result.

Let me dispel a couple myths for you:
  • I am not starving; people think because the list of foods I don't eat is much longer than the list of foods I do eat, that I'm always hungry. People also assume that I am dieting when I say no thank you to cake or bagels, when in reality; I choose not to put those foods in my body for health reasons, not because I'm dieting, OR because I have type 1 diabetes.
  • I am not deprived; I CHOOSE to live this way, and am happy with my choice, so I don't feel deprived. After removing wheat/grains from my diet altogether, my mental health is much more on point, and I can actually correlate not eating those things with a healthier feeling in my body. Wheat has the same effect as meth in your brain on dopamine receptors, so you're not exactly thinking clearly when you eat grains, which is why they’re so addictive.
  • I eat more than I ever have; I am always munching on fresh fruit, nuts, healthy meats, vegetables, etc. I feel like I'm always eating, and yet I don't gain weight. Realizing that the fewer the ingredients, the more flavorful the actual food is. My tastebuds have evolved with the removal of things like artificial sweeteners, refined sugars, grains, etc.
  • I feel better than I ever have; I sleep more soundly, so I'm more rested. My blood sugar is so consistent; the lack of fluctuation helps my focus and concentration. My skin has cleared tremendously. Living Paleo and exercising regularly, I feel healthy and lean. I've actually had several individuals tell me that I look healthy, and I'd much rather hear that than “you’re skinny.”
  • Living Paleo is easy and affordable; common misconception like with any diet or lifestyle that eating Paleo (or healthy) has to be expensive health foods, and that is not the case at all. There are a lot of posts on my blog about very simple recipes that can be made with very few ingredients that are Paleo. They’re all inexpensive. The next time you are making a recipe, try substituting a few key ingredients with more Paloe-friendly options, and then think about what else you could add for beneficial nutrients and minerals. Most of the time, I make something, then think, “oh that’d be good if I added that, and I have it on hand.”
Paleo, pretty much rocks my world. I love it. I’m passionate about it. I will help anyone that has questions about it, type 1 diabetes or not. I love cooking, but try to make things easy. I love experimenting. I love learning, and sharing what I learn. I started a blog, Living Like Linds, which includes posts about my journey to health among other things.

Here are some Paleo posts that might be helpful:
Here’s to improved health, beyond what I ever imagined ... and diabetes can suck it.

November 14, 2012

World Diabetes Day 2012.

Diabetes is not something I celebrate.  I'm not happy to have it, and if given the opportunity to shove it back from whence it came, I would totally do that.

But the people I've met through diabetes-related events?  The people who share inspiring stories and belly laughs and cups of coffee and tears and who are instant kindred spirits in a world where so many people don't understand what diabetes even is?  

I celebrate the people, not the disease.  Because the people are truly amazing.

Diabetes in OZ!

Happy World Diabetes Day!

November 12, 2012

Guest Post: T1D - Executive Officer: July 2007 - Present.

Diabetes is a full time job.  Even when it's going smoothly and you don't need to drag the printer out back to beat the crap out of it (oh, Office Space), it's still not the easiest disease to stay on top of every day.  And today, by way of guest post, Robert Coombs (of Omnipod dancing man fame) is tackling age-old question (as of today) of "What would diabetes look like on my resume?" 

*   *   *
As someone who hires people from time to time and someone who has obviously been hired, I often think about how one translates their work and life experiences into language that shows employers they are worth being invested in. I became more acutely aware of the importance of such a skill recently when my wife (who is an obscenely talented singer) began her job search here in New York where we recently relocated for my job. As a professional singer for the last dozen plus years, she's gained incredibly skills in networking, event planning, public speaking and rocking people's faces off from the stage. So it's just a matter of committing that to paper, right?

It got me pondering what my "second job" as a diabetic has taught me and what that could tell people about me. In a sense, it is a lifelong career (no retirement here) that requires a level of commitment, problem-solving and expertise that rivals most 9-5 gigs. It doesn't come with the paycheck, benefits, or accolades that follow employment in the traditional sense, though I routinely proclaim to anyone that will listen that "I'm practically a doctor."

So here goes. If I had to explain the skills and tasks that come with being a type 1 diabetic, it would look something like this:

T1D - Executive Officer - July, 2007-Present
  • Served as the primary staff and strategist for a lifelong sustainability project.
  • Recruited, coordinated and directed a team of healthcare professionals with routine contacts regarding project maintenance, innovation and performance.
  • Studied the latest research in endocrinology, nutrition, and skincare in an effort to integrate new discoveries into existing treatment methodology.
  • Identified and achieved measurable outcomes on a quarterly and annual basis with 90% success over 5 years.
  • Adhered to a strict schedule with more than a dozen discrete and complex tasks performed daily including the use of data analysis, algorithmic decision making, and constant multitasking.
  • Nearly 2000 consecutive days without a single absence or vacation.
I don't actually have this on my resume. It's a very personal issue and all too easily could be misconstrued in the formal process of being a job applicant. But it's interesting to think about how diabetes has changed me as a person, a husband, and a worker. The list can go on and on, but in the end, there are few people that can definitively prove they are capable of mastering such a complex system of competing interests and doing it with precision day in and day out.

What have you learned as a diabetic or someone who's helping to manage diabetes that would make your resume look even better?

*   *   *

This man discovered the dancing man in his Omnipod.  I have a lot of respect for that discovery.  Robert Coombs was diagnosed with type 1 diabetes in 2007 at the age of 28. He lives in Brooklyn, NY and he accessorizes his wardrobe daily with a Dexcom 7 CGM and Omnipod insulin pump (powered by a little dancing man).

November 10, 2012

#blood and #lowtreatment #hashtags #ndamphotoaday

Trying to keep up with the #NDAMPhotoADay challenge from 38,000 feet.  I had to do a twofer today, since it's been a hectic travel day (en route to Melbourne, Australia right now to hang out with some of the very fabulous Aussie crew for World Diabetes Day next wek), so these photos are lit by the laptop.  Romantic?  Ish.

Options other than invasive testing?  Not many.

#blood
(and I do have an appreciation for the word "command" highlighted behind this meter shot, because these blood sugar checks do command my attention)

It was really hard to find enough light for these photos, without waking up the whole plane.  I mean, I'm awake.  And hopefully the pilots are, too.

#lowtreatment
(the teeny tubes of GlucoLift fit better in my laptop bag than the bigger jars ... which are tucked into my carry-on luggage)

And are you on Instagram?  I'm following most of the #ndamphotoaday postings over there.  My profile is here, and you can find lots of other PWDs by stalking all the photos of glucose meters and Skittles strewn about haphazardly post-hypo. Party time!

November 09, 2012

D-Blog Day: Media Muggles.

For people without diabetes, PWDs might seem like (bolus?) wizards when compared to their insulin-producing counterparts, aka "the muggles."  (I first read this term on Bethany's blog a few years ago, and I love it.  Still do.)  We pinch-hit for our busted pancreases, and that isn't always the easiest (hey, understatement) task.

There's a general misconception about the umbrella term "diabetes" in society as a whole, and this year's D-Blog Day prompt speaks to clearing up those misconceptions.  (You can read the full prompt on Gina's blog.)  And I'm all for that. 

I've re-posted this D-Blog Day post from 2011 once before, but it still rings true for me today.  The only addition I'll make it that I think it's important for media outlets to listen to/talk to/consult with people actually LIVING with diabetes before they put their article together. 

So here it is, for the media mugglesSix Things I Wish Media Knew About Diabetes.

There is more than one kind of diabetes.  This isn't a knock on my type 2 and gestational diabetes friends, but definitely a knock on society's perceptions at large.  People have one musty, old perception of what diabetes looks like, and it's always someone older, heavier, and lazy.  Wouldn't they be surprised to meet our fit type 2 friends, or the 20 year old gestational diabetic?  Or a "juvenile diabetic" who isn't eight years old?  Diabetes doesn't have "a look."  This disease does not discriminate.

Diabetes affects more than just the person playing host to it. I am the one wearing and insulin pump, a continuous glucose monitor, and actually feeling these blood sugar highs and lows.  But I'm not the only one affected by diabetes.  My parents had to care for me when I was young, acting as my pancreas.  My friends have been affected by my lows and highs while we're hanging out, sometimes forced to jump the bar and accost the bartender for orange juice.  (True story.)  And my husband has taken on this disease as his own as best he can, making it such an integrated part of our life together that I don't feel alone.  Diabetes isn't just mine.  It belongs to everyone who cares about me.

Diabetes isn't just a physiological disease.  It's an emotional one, too. It's not just a question of blood sugar levels and insulin supplementation.  It's about managing the emotions that come as part of life with a chronic illness.  It's about the guilt of complications.  The pressure to control an uncontrollable disease.  The hope that tomorrow will come without incident.  I feel that the emotional aspects of diabetes need to be attended to with the same care and diligence as an A1C level.  Maybe more so, because life needs to be happy, whether it's a short life or a very long one.

Diabetes isn't easy.
  We just make it look that way sometimes.  Some of the perceptions that the general public has is that diabetes is easy to handle.  "You just wear the pump, test your blood sugar, and watch your diet and you'll be fine, right?"  Wrong.  You can do the exact same thing every day and still see varying diabetes outcomes.  It's never all figured out.  Diabetes is a daily dance of numbers and emotions and even though we, as a community, make it look easy sometimes, it sure isn't.   

No diabetes is the same. Even within a community of diabetics, there are still widely varying ways of treating diabetes and even more ways of dealing with the emotional aspects.  There's no winning combination and no "right" way to deal with this disease.  Being on a pump means you use a pump to infuse your insulin - this doesn't necessarily mean you are taking better care of yourself than the person who opts for injections.  Low-carb doesn't work for everyone, and neither do certain medications.  Your diabetes may vary (thanks, Bennet), and what works for you may not work for everyone.   It's important to remember that this disease doesn't have a predictable path, so there are plenty of "right' ways to handle it.

Just because we don't look sick doesn't mean we don't deserve a cure.  That statement sums it up for me.  We might make it look easy, but it isn't.  There's no rhyme or reason to this disease, and even with the best care and the best intentions, complications can sometimes still come calling.  And their effects are devastating.  Diabetes, of all kinds, deserves a cure.  No one asked for any of this.  We deserve better than society thinking that diabetes isn't worth their attention.  We deserve a cure.

November 08, 2012

The Question.

"How old is your daughter?"

"She's two and a half."

"Oh, that's a fun age.  Does she have diabetes?"

"No."

"Will she get it, too?"

And this is where I end up tangled in my words and in my emotions.  Sometimes I rattle off statistics ("The chances of my daughter developing type 1 are only slightly higher than a non-diabetic mom, while if it were my husband who had diabetes, her chances would be more elevated,"), and sometimes I respond, "No," and roll their question around in my head for a while.

Please don't ask me this question.  It hurts more than all the others.  I can answer, "Can you eat that?" and "Do you have the 'bad diabetes?'" until my voice is hoarse from answering because it's about me, and I can handle me.  But when it comes to my Bird, I don't want to discuss her health.  I don't want to talk about anything that could hurt her.  My head isn't in the sand, but I thought my heart was walled up tight, to the point where I didn't have a visceral reaction to something as simple as a question.

(It's not walled up at all, though.) 

I know why they ask.  I have that Thought, too.  When people ask this question, my knees go weak while my back muscles tense up, bringing my shoulders back and squared off.  "The chances of my daughter getting diabetes are only slightly increased over the chances of anyone else's kid."  

What I want to say is, "I love that child with everything I have and even though I know she's okay and even if she ends up with diabetes, she'll still be okay, I don't want to think about her living with a disease.  Any disease."

(And then, in this fantasy that takes place only in my head, I whisper "And your question sucks," psychotic crazytown, like Daniel Day-Lewis' character in Gangs of New York, and I punch them in the face so hard that the BAM! word cloud pops up, all old-school Batman.)

It's Diabetes Awareness Month, and I want people to be aware that I'm already aware of the fact that being a parent means I worry about things I didn't even know existed as potential panic points until two and a half years ago.  And I want them to be aware that my child, despite being the daughter of a person with a chronic illness, is still my daughter, and it's hard to think about any potential hardship in her life.  We don't want to focus and worry about things that could happen.  Ask me her favorite color.  Or ask about her favorite Thomas the Tank Engine train.  Ask me what ice cream flavor makes her giggle.  Ask me what songs make her dance like a lunatic.  Don't ask me about her health.  Don't make her feel like she's a ticking time bomb. 

We just want to enjoy one another.

Just let me enjoy her.

November 07, 2012

Joslin Blogging Project: The Beginning.

This month, I'm honored to be participating in a blogging project, alongside some of my favorite writers in the DOC, to raise awareness for diabetes and funds for the Joslin High Hopes Fund.  As a patient at the Joslin Clinic in Boston, this hospital has helped me stay as healthy as possible, and I'm proud to be supporting them this month.  You can made a donation to the fund by clicking on this link.  Or you can just read the post.  :)

This week’s topic is: The Beginning: Share a story from when you (or the person you blog for/about) were first diagnosed. 


Before starting second grade, I started to wet the bed again.  Nothing too dramatic, but enough that my parents were concerned.  I seemed healthy, otherwise, so their response to this odd bedwetting revival was to buy an alarm that connected to my underpants.

“If you start to pee, these two metal pieces will connect and an alarm will go off.  That way, you won’t wet the bed and you can get up and use the bathroom!”  My mom seemed pleased, hoping this would fix the problem.

“Okay,” I said.  I was embarrassed that I was wetting the bed.  I hadn’t wet the bed in years.  And a pee alarm?  Come on.  Totally weird.  But I was mad I couldn’t control this – I remember that frustration . So I wore the pee alarm for about two weeks, and after waking up almost every night with my underpants going off like a fire engine siren, I was scared straight.  

I spent the rest of the year climbing trees, sleeping over at my friends’ houses, and being a kid.  Never wet the bed again.  But something was still a little bit … off.

A few weeks before I was scheduled to start school, my mother took me in for my before-school physical.  Standard peeing-in-the-cup sort of thing. Never in my life had so many people been so interested in my pee.

“Just wipe with these special wipes – front to back, Kerri – and pee into the cup.  Close it up, bring it out, and we’ll have everything we need!”  The nurse smiled at me while my mother and the pediatrician talked about how excited I was to start school.

I did what they asked, and a few days later, we received a call back from the pediatrician’s office.  My parents repeated words I didn’t understand – “diabetes” and “hospital” – and the whirlwind of change began.  I remember my mom was crying, which was scary.  And I remember my dad crying too, which was even scarier.

I was diagnosed with type 1 diabetes on September 11, 1986.   I spent twelve nights in Rhode Island Hospital, learning to give practice injections of saline to an orange.  

“We use an orange because its skin is most like human skin,” the diabetes educator explained.  Which is when it dawned on me that these needles were intended for my skin.  And at that moment, success was redefined by having the guts to press these needles into my body, every day, for the rest of my life.

I don’t have clear memories of what it was like those first few months.  I know my parents had to learn what this “diabetes” thing was.  My mom learned to give me injections, and she’d press the needle tip against my skin slowly and steadily, trying to go slowly so it wouldn’t bruise, while my father gave me my injections like I was a dart board and his challenge was to hit the bulls eye as quickly and efficiently as possible. 

But this was our new normal.  And it continues to be.

November 06, 2012

Dexcom G4: First Impressions.

I was nervous about receiving the Dexcom G4 because of my issues with the itchy rash, but now that I've found a fix (so far, at least), I was ready to open the package from my partners in San Diego. 

The Receiver.  Very first impressions?  It is SO MUCH SMALLER.  The shape is that of my glucose meter, and I prefer it. Though I never had any issues with The Egg (I sort of have a special, egg-shaped space in my heart for it), I do like a smaller receiver.  It's fly.  (Do people still say that?)  And smaller.  Smaller is better, for me, when I'm trying to carry several other diabetes items at once.  The G4 receiver fits into my meter case, which is very convenient.

It also has a color screen.  At first, I was "eh" about the idea of a color screen, because I didn't see how it would make a difference to me, but for that cursory glance at the screen, it does matter.  Anything "above the line" is yellow, within range is white, and below the line is red.  With a quick glance, I can see how long I've been in, above, or below range.  And having the hypos as red works for me, because it's the most serious issue I face throughout the day.  (Also, it's a nice change from the Seven Plus readout, which looked more like an old school Gameboy, whereas the G4 looks more like an iPod.)

The Transmitter.  The range of the new transmitter is truly remarkable.  I can leave my receiver on the kitchen table and go outside to rake leaves way out in the backyard, and the thing keeps the signal.  I'm still testing how far I can go.  :)  The G4 transmitter is completely different from the Seven Plus in that it's a lot taller, so the profile isn't as streamlined on my body.  Even though the sensor looks almost exactly the same (even though it has some subtle differences, like the gauge of the insertion needle is thinner and therefore more comfortable), the transmitter anchors in with a much higher profile. 


This isn't a huge deal, but it's the most noticeable on-body change for me so far.  I wear my sensors on my thigh, so in regular clothes, it's not a big deal.  But in my gym clothes, which fit snugger against my body, the bulge in my pants is more of an issue.  (And WOW that's a sentence I've never written before but now I can't unthink it or unwrite it so there you go.)

The Alarms.  The alarms are amazing because they are different for low and high alerts.  DIFFERENT.  This has been something Chris and I have been discussing for ages.  Sometimes, when the Seven Plus was alarming, Chris couldn't tell if I was low or high without reaching to the bedside table and clicking the screen alive.  Now he knows what end of the spectrum I'm at just by the alarm.  This is brilliant.  And long overdue, in my opinion.  Also, the alarms can be set to vibrate, soft, normal, attentive (this is where I have mine set, because they're musical), and hypo-repeat.  When I'm low, the notes of the song go from high to low, and the reverse applies for the high blood sugar alarm.  This is such a nice change because I know immediately what kind of issue I'm reacting to, without even needing to click the screen.  (And to that end, it takes an extra second or two for the screen to come alive when I hit the button.  I'm not sure what the delay is about, but it's not as fast as the Seven Plus.)

Battery Life.  Just as a note, I've been wearing the system since Sunday, and I haven't had to charge the receiver yet.  It's not even halfway down in battery life yet.  This is a marked improvement from the Seven Plus, which I had to charge every other day.  Also, it charges through a USB cord, so now I can pack fewer cords when I travel.  Thank goodness, because my suitcase was starting to look like a giant electric spider was trying to escape it, upon unzipping the compartment I store my cords in.

All-Important Accuracy.  So what about accuracy?  The G4 claims to be more accurate, but I can't make that nod yet.  I've only been wearing the new system for a few days, so I don't trust it yet.  We're still in that "getting to know you" phase of our new relationship (even though I've already jumped into bed with it).  I've had some moments I'm really impressed with, like the seven hour block where my meter and the Dexcom were never off by more than 10 points, but I've also had a WTF moment, like when the meter said 188 and 180 mg/dL (double-test), compared to the 64 mg/dL on the Dexcom.  They did catch up to one another about twenty minutes later, but still.  This is what is most important to me, and I'll be writing about the accuracy in more detail after I clock a few more days with the G4.

I want this new system to be exactly what I've been hoping the next generation would be:  fast-becoming a replacement for many of the fingersticks I do throughout the day.  Time will tell.  In the meantime, I remain grateful for technology that serves as a safety net while I'm driving, exercising, sleeping ... living.

[Dexcom disclosure]

November 05, 2012

TD14ADay: Pretending Not To Be.

Last Friday, I took the JDRF's T1D for a Day text challenge for a spin.  I wanted to see how "accurate" the texts were, and if they encapsulated both the blood sugar and the emotional flux of a day with type 1 diabetes. (And don't worry - I'm not recounting every, single text here because I don't want to ruin it for someone who hasn't experienced it yet, but this post does contain ... spoilers, I guess?  If you don't want to know the gist of the TD14ADay bit, you can watch this on loop instead.)

The day opened with a text at 8:45 am, thanking me for signing up for the project (and with the obligatory "Hey, this isn't medical ANYTHING" disclaimer.)  The first "real" text about my diabetes day didn't come in until 9:30 am eastern, warning me to remember to bring all my supplies with me that day.  (Which, for me, didn't match anything even close to my regular day.  Every day starts early, and with my glucose meter in my hand.  I don't leave my bed before testing my blood sugar.  If I waited until 9:30 am to address diabetes stuff, I'd already be behind the 8 ball.)

Preparation = giant purse, for me.

But then we were off and running.  I received a text every hour or two, ranging from managing a post-breakfast high that came out of the blue to finding a finger to prick that isn't already sore and tough to squeeze a drop from.  (And the timing was good for so many of these texts, like the one that came in at 6:19 pm about "going for a run" as I was setting up my diabetes junk on the treadmill.  Art imitating life!)

I liked that there were blood sugar checks and emotional "checks" built into each text.  Diabetes isn't just about testing and reacting (sometimes being proactive) to blood sugar numbers.  It's about acknowledging that some of the outliers don't have explanations, but we still need to address the needs of our bodies and move forward.

I love this.

And then this one I liked very much, as well:

DO NOT CELEBRATE.  At least not with food.  :)

YES!  A blood sugar number clocking in where I want it to?  No, I will not "celebrate" (aka "ruin") it by grabbing a cupcake.  That inclination to celebrate diabetes moments with food (or to reward any positive with food) is a strangely unhealthy one, in my under-caffeinated opinion, and I was happy to see the JDRF making that point here.

And then there was the middle-of-the-night low.  I knew this one was coming (thanks to hints from Facebook), but I still didn't set my phone to silent for the night.  I wanted to see if I would hear it.  Of course, I didn't.  The pinging of the text coming in wasn't enough to wake me from my sleep (even though if Birdy burps from three rooms away, I will wake up with a start).  I did wake up to see that my alternate-text-universe-me had a really tough low in the middle of the night, one that required calling a neighbor to be at the ready.  Having made those awkward phone calls to my mom and my best friend while low ("I'm really low but I'm okay and can you just stay on the phone with me for a few minutes?"), these texts really resonated for me.

Bring it on, Another Day.

When the texts were coming in throughout the day, I remember thinking, "Man, whoever wrote these was trying to give a glimpse into a particularly rough day with diabetes."  A post-breakfast spike, random diabetes math to accommodate an apple snack, the age old question of "indulge or avoid?", juggling exercise, the quiet euphoria of testing and seeing a "perfect" blood sugar number ... but this isn't a particularly rough day. This is every day. 

And as the JDRF sums up in their final text, you can't "TxtStop2End" when you're living with diabetes.  

You can take this text challenge throughout the month of November - click here for more details.  As a person living with type 1 diabetes, I found it to be thankfully accurate, and a really effective eye-to-the-keyhole for someone without diabetes.  I raise my coffee cup to the JDRF this morning - effective advocacy!!

November 04, 2012

Flying Pump.

I keep my headphones plugged into my phone to provide some music during my workout, and the phone stays on the shelf on the treadmill (along with my glucose tabs, CGM, and my insulin pump) ... that is, until I accidentally grab the headphones wire while I'm running and the phone goes flying and I lunge for it and then the pump comes loose and I become a robot octopus with wayward limbs.

Awkward exercise - I'm all over it.

November 03, 2012

#NDAMphotoaday.

I'm making an attempt at the National Diabetes Awareness Month "photo a day" challenge issued to the DOC at large. (Here's a link to the full photo challenge, if you want to jump in!)

So far, this represents #struggle, #prescription, and #fingers. 

Join in!!  Hashtag is #NDAMphotoaday and then whatever the prompt is for the day.  And for more on the origin of 30 day challenge-type online things, check out this Know Your Meme link.

November 02, 2012

Dexcom Rash: Swinging for the Fences.

The Dexcom rash wasn't fixed by Opsite Flexifix tape underneath it as a barrier between the sensor and my skin.  Alcohol wipes after showing/before applying the sensor didn't work, either.  Neither did using a hydrocortisone cream, or Skin Tac, or Cetaphil soap.  Dexcom, regardless of what I threw at the sensor, continued to act rashly.

And this is where a reader came in with a suggestion that saved my skin.  She wrote, "You need to spray steroid asthma inhaler on the site after the alcohol or iv prep and before you insert."  She also attached a photo of a rash she received from a CGM and it looked just like mine.

Oh Internet ... I love you big time.  

It took some research, and several phone calls/visits/consultations with my PCP, dermatologist, and endocrinologist, in addition to phone calls to the Dexcom hotline o' bearded service (shout-out to The Hammer) to lock down a prescription for a steroid inhaler (the conversations about this off-label application were long and intense), and this morning marks the 36 hour mark with a sensor. 

Without a rash.  

"And there goes the ball ... right over the fence ... home run!!!" 

*Crowd goes wild.  Or at least Birdy claps her hands and the cats don't throw up, for once.*

Just as the fabulous reader (my hero) had suggested and after discussing the option at length with my endocrinologist, I showered and dried off, and then sprayed the inhaler spray against my clean, dry skin.  (It surprised me when it came out as a kind of powdery substance and not a mist.)  I sprayed it about three times to cover the anticipated surface area of the sensor adhesive.  After about 30 seconds, when my skin seemed dry, I placed the sensor on like normal and deployed the needle.  The adhesive patch felt a little stiffer and cracklier than normal, but the following morning, it was smooth and pliable against my skin, like it usually is.

But the best part is that after 24 hours, I wasn't itchy.  And this morning, at the 36 hour mark, the adhesive edge wasn't ringed with the red, puffy, reactive skin I've become used to since the end of August.  I'm not sure where this adhesive allergy came from in the first place (and for those who asked, no, I'm not pregnant), and I'm not sure why the inhaler steroid is battling it, but it is.  And honestly, after so many weeks without a proper Dexcom safety net, I don't care why it's working.  I'm just thankful that it is, and that my medical team is on board to try some different things in efforts to keep me safe.

Mystery rash cured, hopefully!

Note:  This is not medical advice.  Please don't try this without consulting with and getting clearance from your medical team.  I'm just sharing anecdotal information about something that worked in my personal diabetes life.  Nothing I ever say should be taken as medical advice because if I was really useful, I'd have an A1C of 5.7% and I'd burp rainbows.

(Second Note, for Monica, who may be reading this post today and who I know hates sports analogies.  "Swinging for the fences" means "attempts at doing difficult or near-impossible things," or at least according to Urban Dictionary.  You're welcome.  Oh, and this is also for you.)

November 01, 2012

Diabetes Month: T1D For a Day.

It's November 1st, which means Diabetes Month starts TODAY.  Which also means that PR initiatives start pouring into my inbox today (often times starting with "Are you aware that diabetes is a serious, life-threatening disease?" to which I respond, "Do tell?").  But I appreciate any efforts to raise awareness for diabetes, both type 1 and type 2 (and LADA and MODY and gestational - the list gets longer with every decade) because I've been living with type 1 diabetes for twenty-six years.  We have some great treatment options, advocacy program, and advancements, but we can do better.

I wish my nails were that nice.  And that my phone was that clean.  Sadly, I'm 0 for 2.To that end, I wanted to support the Be T1D for a Day initiative from the JDRF because I think it's a really clever, really insightful way to give a non-PWD a glimpse into life as a person with diabetes.  Here's the gist, from the JDRF website:

"When you sign up for the T1D for a Day text challenge, you agree to receive as many as 24 text messages over a 24-hour period that simulate the constant blood sugar testing, insulin injections, and dietary decisions that confront people with T1D."

It sounds like it might not be a big deal or too insightful, but it is.  It's a way for someone without diabetes to have an idea of how pervasive type 1 diabetes is during the course of one day.  From testing blood sugars to calculating insulin doses, and negotiating food options, working in some exercise, making sense of numbers that don't match your goals ... and then all the emotional stuff in between these moments?  That's a lot of diabetes tapping into your day.  This exercise, constructed by the JDRF, brings that message home. Or, as they state on their site, "While no virtual campaign can recreate the many needles required or the physical and financial tolls of this serious disease, T1D for a Day seeks to deepen understanding of the many heroic steps our friends and loved ones with T1D take each day."

To sign up for T1D for a Day, text T1D4ADAY to 63566. You will receive a confirmation text that will cycle you through registration.  Or you can click through here to sign up through the web. 

Thanks to everyone who supports PWD every day, by being our friends, loved ones, and family (sometimes all three).  Type 1 diabetes can get a little heavy, and it helps to have so many hands to help lift us up.

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