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February 13, 2013

Down the Stairs.

What, you didn't want to eat the glucose tabs sitting right there, on the bedside table?  WTF IS WRONG WITH YOU?It was a weak alarm, but I still heard it.  I forgot to take the Dexcom receiver out of its case before I went to bed, so the vibrations weren't directly against the wooden nightstand, but the repeated BEEEEEEP!ing was enough to rouse me, after about fifteen minutes. 

"LOW BLOOD SUGAR UNDER 55 MG/DL GET THE HELL OUT OF BED" the screen screamed at me.

"Sure, yeah."  

I clicked my pump (aka 'my watch') to see what time it was - 2:32 am - and I tried to run my hand through my hair to get it out of my face, but my fingers ended up stuck in the mess of sweat-matted, tangled hair.

The lamp switched on after some fumbling, and I stood up gingerly, removing the brace from my foot (thank you, plantar faciitis) so I could walk.  The walls of my bedroom seemed like they were throbbing and pulsing, like I was standing inside of someone's beating heart.

My meter showed me a "34 mg/dL," like it was a prize I won for being so sweaty.

Despite the bottle of glucose tabs on my bedside table (open, and ready, but ignored), despite the sleeping and capable husband in our bed, and despite the fact that I was walking on a compromised and even-more-clumsy-than-usual foot, I decided to go down the stairs to get juice.

Foolish.

And despite the fact that I actually looked at the juice bottle to calculate (ha?) how many carbs would be in a glass, I still drank too much of it.  And then, fueled by adrenaline and bad decisions and the desire to not feel like the kitchen floor was made of shifting sand, I also grabbed a handful of gum drops from the bag in the fridge.Not smart.  Not even a little bit smart, especially because as I was chewing, I was calculating a correction bolus for the overtreat, but then forgot to dial it into my pump.  It was a perfect storm of bad decisions, with a brain slogging through hypoglycemia at the helm.

Such a strange hypoglycemic aftermath: put the juice glass in the dishwasher and then, for whatever reason, decide to finish loading the rest of the dirty dishes in and set the dishwasher to cycle, then go upstairs to blow dry my hair in an attempt to ward off the chills that were already setting in from too long in damp, low-sweaty clothes, then brush my teeth, then check on Birdy to make sure she's okay ... what prompts this routine?  Is this the way my body calms down after being jolted from sleep by panic?  

After about 45 minutes, I felt normal.  I saw 99 mg/dL and an arrow pointing up, so I figured I was safe.  

But the rest of the night was spent listening to the Dexcom BEEEEEEEEP! because my blood sugars were cruising up, up, and away, ready to greet me with a "HIGH!" in the morning. (That, and Siah was nose-to-nose with me this morning, which made me happy and grossed me out, all at once.)

I should have just stayed downstairs and started my day at 2:30 am, because there wasn't going to be any sleep after that moment, anyway.  Besides, there's someone always awake in the DOC, isn't there?  All hours of the day?  

* You don't keep a bag of gumdrops in the fridge?  Just me?  They were on sale at CVS. Happy Valentine's Day?  Go spare a rose instead.  Gumdrops are the devil's work.

February 06, 2013

Context.

Out of context, this early morning Dexcom graph looks like things are all figured out, with barely a bite into the hypoglycemic range.  It makes diabetes look easy.  It makes blood sugars look like they are something you don't even have to think about.

Hey, this looks okay ...

Until you see the whole picture, in context:

... oh, I get it now.  Yesterday you were high all day.  That blows.

Yesterday was miserable, blood sugar-wise, with numbers cruising around in the high 200's and not budging for hours, despite rage-bolusing.  I felt sluggish and exhausted, my brain cells thick with sugar and every word in my mouth swiped by hyperglycemia.  Hours with high blood sugars are The Suck.  It took a full infusion set change (new insulin bottle, new site, new location) and some exercise to bring things back into some semblance of "control." 

The big picture sometimes isn't pretty, but it's real.  And today will be better.  (I'm saying this over and over in my head, with my shiny new infusion set and this morning's Dexcom graph that's more seascape than mountain range, thankfully.)  Today will be better.

September 11, 2012

26 Years with Type 1.

Last night at the gym, I ran as hard as I could, and as fast as I could.  Not the hardest and the fastest of anyone in there, but it was the best I could do.  My legs moved, my arms moved, my ponytail flashed behind me and I felt alive, alive, alive with this strange understanding that "forever" felt tangible and raw.

And with every step, the same sentence ran through my head.  "You can't catch me.  You can't catch me."

I've had type 1 diabetes for twenty-six years today.  Last week, I felt like it might have been a few steps ahead of me.  Yesterday, it was nipping at my heels.  But today, it's so far behind me that even when it hollers, I can't hear it.  Not over the sound of my daughter's laughter or the feeling of my family's love.

Not today, diabetes.

You can't catch me.

(This is all still trueJust add a year or two.)

September 06, 2012

Twice.

"I have family members with diabetes, but they don't take care of themselves," he said.  "They eat whatever they want, and they never test their blood sugar, and they never go to the doctor."

The unspoken thought, capping the end of that sentence, felt like, "So they deserve whatever they get."  

I had a hard time keeping my mouth shut, even though I was at this dinner with people I didn't really know, and who didn't really know me.  They were aware of the fact that I have type 1 diabetes, but it wasn't a big discussion point throughout the day, so I think it was a little snippet of information that fell by the wayside by the time dinner was served.

"But how do you know that?" I blurted out.

He stopped and looked at me.  "What do you mean?"

"How do you know they don't take care of themselves?  Or go to the doctor?  Or test their blood sugar?" 

"Because they don't.  I never see it.  Not even at holidays."  

I didn't want to be That Person. I had zero desire to be the one who raises her voice at dinner table with strangers, preaching on about the misconceptions society has about diabetes, and about all the different kinds of people who live with it, blah blah blah.  I wanted to have dinner, and hang out, and have a good time.

But I don't like the "yeah, but the majority of people with diabetes DON'T take care of themselves" argument, because I take care of myself.  I try, and I do.  And I know so many people who take care of themselves the best they can, and so many who, despite dedicated efforts, still run a rough road.  Perfection isn't achievable, and guilt is inescapable.  Chris encourages me to not take these kinds of discussions personally, because he hates to see my feelings scraped, but it's hard not to take it personally.  I have diabetes.  They're talking about diabetes.  Even when I try, it's hard to keep my viewpoints objective.

"Did you see me test my blood sugar at the table a few minutes ago?"

"You did?"

"Yeah.  I have tested twice, actually, at this table.  While you sat there.  And that orange juice I had before?  Which might not have seemed like the 'right' food for a diabetic?  I was treating a low blood sugar.  You don't always see what we do to take care of ourselves.  But there's a lot that we do. I swear."  I smiled at him, but inside I was begging, pleading for him to see me as a person who, however my life wrings out, didn't "deserve" a damn thing.

There was an awkward silence.

"Twice?  You tested twice?"

"Yeah."

This time, he smiled warmly, erasing all awkwardness.  "Maybe they do stuff I don't see, too." 

I smiled back, wanting to jump across the table and hug him. 

"I hope so."

June 29, 2012

Rage Bolus Redux.

I love seeing Diabetes Terms of Endearment popping up in mainstream diabetes information sources (and it's even better when the terms are capitalized, as if they're proper nouns.  Proper Nouns!) 

Like this Glu question from last week:

"Rarely."  These days.  Last year, the answer would have been "all the freaking time."

A little rage bolus action, anyone?  Maybe SWAG bolusing will be next.  :)

June 04, 2012

Insulin Pump on the Beach.

"Oh, it's like what Cindy has!  That's what Cindy has!"

The lady was about twenty feet away from me, stage-whispering to her husband. 

"Is that the pump?  The insulin pump thing?"  her husband asked, gesturing toward me.  

I lifted the beach blanket by its corners so it would spread out nice and flat.  "It is an insulin pump," I said to them, waving, unaware until that moment how obvious my insulin pump was, clipped to the bottom of my bathing suit, the tubing tucked in kind of haphazardly; it was a diabetes Bat Signal.  "It's nice to meet you!" 

The woman came over, her hands fluttering and her mouth talking and smiling all at once.  She was so excited ...

"... to see a real insulin pump!  My daughter went on one a few years ago, but I've never seen anyone else with one.  And at the beach!!  She's going to love hearing this. Your pump looks different from hers - is it?"

(I loved that she automatically assumed I knew what kind of pump her daughter was on, as if there was a community of people with diabetes who are in constant contact with one another and comparing notes ... wait a second ...)

"Mine is an Animas pump.  Is hers Animas or Medtronic?  Does it have tubing?"

"Yes, it has the wires.  Hers is the Medtronic one.  She really likes it.  How long have you had diabetes?"

"Twenty-five years.  How about your daughter?"

"About twenty years.  She's 31.  She's trying to lose weight and be in better control.  I don't know half of what she does, but I know she's always trying to do better."  The corners of her mouth tugged into a brave smile.  "She doesn't know I worry but I worry all the time."

"My mom does, too."  My mother and Birdy were a few yards away, building a sand castle.  "She worries.  But she knows I'll be okay."

Beach blanket Birdy"Is that little one your daughter?"

"Yes.  She's two."

The woman smiled.  "My daughter would like to have a baby.  That's part of why she went on a pump.  You know."

Birdy came running toward me, her ponytail bouncing and covered in sand.  "Ocean, Mama!!"  The bucket of sand in her hand spilled as she lifted her arms excitedly.  "Sand!  I has sand!"

I gave the woman a big grin as my daughter tornado toddled up the beach, her arms outstretched. 

"I do know."

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 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?

October 17, 2011

To Palooze.

to palooze: v. the act of people with malfunctioning pancrei and their caregivers coming together for cupcakes, support, and fun

In the last few weeks, I've had the pleasure of meeting some old friends for the first time.  (That may sound like a peculiar sentence, but anyone who is part of the diabetes community and has found themselves immersed in a deep discussion about the emotional impact of this disease with an otherwise complete stranger understands the connection between PWD.) 

A few weeks ago, in Boston, I had dinner with Harry Thompson.  (He's @harrythompson on Twitter.)  Our diabetes is about the same age, and our daughters are, too.  Our spouses are supportive and amazing, and our collective appreciation for a good pun is unparalleled.  We spent a few hours exploring Boston and the North End, and we drank cappuccinos made from an old-fashioned coffee robot.  (More on that some other time, because if I try to explain it here, I'm sure to become confused again.)  But it wasn't weird ... it was comfortable, despite the fact that we hadn't met in person until that night.  Harry is awesome, in every freaking way.  (No photo, though, which I'm regretting.  We just forgot!)

And over this past weekend, I trekked into New York City with Briley and Karen to meet up with Simon and a whole pile of other PWD for what's become this strange Simponpalooza phenomenon.  It's hard to explain how and why people with diabetes forge a friendship that's instant and lifelong, despite differences.  It's harder still to explain to people why a man would want to fly halfway around the world to meet a bunch of strangers. 

But when you see photos, and read people's posts, and see videos, and take into account how much love is found in a disease that hurts so much sometimes, it makes more sense. 

I love that he has, like, a LOGO.
The "tour book," which served kind of as a yearbook for Simon's trip to NYC


Kerri, Jeff, and Briley, and Jeff OWNS this shot.  Owns it.


MOST of the group (because Kelly came running in seconds after the shutter clicked)

Kerri and Simon.  Simon says, "Look happy!"
"Simon says ... be happy!"

Actually, it makes perfect sense.

Thanks for coming to spend time with us, Simon.  And thank you to everyone who writes about the friendships found in the diabetes community.  Diabetes isn't exactly known for "giving back," but the community of people who live with it are

(More photos on Flickr here.)

March 09, 2011

Advanced Avoidance Technique.

I received the reminder call.  I discussed my schedule that week with my husband and didn't bring it up.  And the letter from their office still remains stuck to the calendar page.  (Not to mention, the missed appointment cost me $25, to boot.)  But I never made it to Joslin to have my eyes checked again.

And I don't want to go.

If it seems like I've had an eye dilation like every three months, it's because I have.  My eyes were dilated several times during my pregnancy to track the progression of my then-mild and now-moderate non-proliferative retinopathy, and this eyeball issue was the main reason I ended up delivering my bird via c-section.  (The pre-eclampsia didn't help matters much, either.  Yay for ... stuff?)  

I fully realize that what I need to do is pick up the phone, call the eye clinic, and make an appointment for a dilated eye exam.  I know this.  And later this afternoon, I will make that phone call. 

It's just sometimes I find all this crap really tedious.  Not so much the little things, like testing my blood sugar throughout the day, changing out the insulin pump ever few days, and popping that blood pressure pill every night before bed.  That stuff doesn't make me bonkers. 

It's more the Big Stuff.  The eye exams.  The endocrinologist appointments.  The hours spend combing through insurance EOBs and spending even more time discussing this paperwork and battling with insurance claim specialists who think 10 test strips a day is "excessive."  It's making log books and calling the mail order pharmacy.  It's moving the fax machine from the office into the living room (because we neglected to hook up the office phone jack) so that I can fax documents to our insurance company.  It's going online to the insurance website and jumping through all the search hoops to find a doctor within a 30 mile radius who takes both my insurance AND new patients.  Taking a whole day to trek up to Boston to sit with my endocrinologist for an hour; another day to have the dilation drops plunked in and to have to wrangle someone to drive me home afterward.  It's a day away from my baby.  And from the work I enjoy doing.  And a day that someone else has to either watch BSparl or drive me or whatever.  It's a day that makes me resent diabetes just enough.  And it makes me admittedly grumpy because I really don't want to spend the day doing crap I don't enjoy.

Every time I re-find this picture, it reminds me how far we've come with diabetes, but also how much HASN'T changed.
An image from an older post about guilt, but the words I chose are blunt,
and I think if I made this same list today, it would read the same.


(And before you say it, I know I could see someone closer to home, but it's hard to be so close, yet so far from the doctors I know and trust and who are best suited to care for any complications that may arise.  And before you say it, I know it's pointless to have access when I don't actually go to the appointment.  And before you say that you weren't thinking that, let's get some iced coffee and talk about Spring Training, instead.  And before you say you like the Yankees, I'll kindly refer you to my husband and my editorial assistant, who share your bad taste.) 

The time it takes to manage diabetes on a day-to-day basis isn't tremendous.  Constant, yes, but not overwhelming most of the time.  But taking time and sitting in the car and in waiting rooms and hoping they'll call my name first so I can let them stick a needle in my arm and then pay the garage attendant and then drive home for two hours?  (Sometimes with dilated eyes?)  It is so worth it for my health to make these appointments and stick with them.  But sometimes it feels like such a pain in the ass that I'd rather skip the appointment entirely and spend a few hours playing blocks with BSparl. 

And then I realize that in order to play blocks, or to travel for work, or to be able to make the bed and run the laundry and enjoy dinner out with my friends, I need to stay healthy. 

... sigh.  Fine.  I'll make the appointment.

February 16, 2011

I See Pump People.

Navy Seal PWDs are everywhere.  LOOKOUT!A few weeks ago, Chris and BSparl and I went out to dinner.  Dining out with our little bird is a bit of a tangled experience, and we don't spend as much time people watching as we used to because we're very preoccupied with the baby wrangling. 

That night, though, we were sitting and settled and throwing gluten-free puffs (yes, all of us) around the dinner table like confetti when I saw this woman walk in with her family.  She settled her family in at the table, and then reached to remove her coat, revealing a beeper clipped to her pocket.

Only it was one of them fancypants beepers with the tubes and the buttons and the accompanying not-making-insulin pancreas.  Reckon it was an insulin pump.

Immediately, I wanted to swing mine over my head like a lasso and say "OMG lady, me too!!!"  I've had this feeling before, of wanting to sidle up next to someone and say, "I like your pump; want to see my pump?" but to me that sounds more like an awkward attempt to flirt instead of a moment of diabetes bonding.  Living in a very comfortable bubble of diabetes advocacy makes me think that everyone who has a visible "symptom" of diabetes wants to talk about it.  I have to remind myself that some people just plain don't want to talk about it.

But since I still wanted to say something, I targeted Chris instead.  

"Dude, 12 o'clock.  Actually, my 12 o'clock, your six o'clock.  Minimed pump on that lady."  I said to Chris without moving my lips, as if a pump sighting was a covert Navy Seals operation.

"Six o'clock?  Okay, do you guys know one another?  And why are you whispering?" he whispered back.

(I love that because she and I both wear pumps, we must know one another.  I've brought him right into this bubble with me.)

"No, I don't know her.  I have no idea who she is.  But I just saw her pump."  I paused, still whispering.  "And I was like a toddler, wanting to wave my arms around and say 'Pump! Pump!'"

He laughed.  The waitress came over to bring our food, and the two of us were immediately distracted by keeping BSparl's grabby little hands away from the hot plates. We had a nice dinner, and I sort of forgot about the fellow Navy Seal at the other table.

... Until we were leaving the restaurant, when I saw her glance at my hip (where my Animas Ping was tucked away), nudge her husband, and give a little nod. 

In my head, she whispered, "Dude, four o'clock.  Animas Ping.  Hooyah!"

February 04, 2011

Sleeping In.

The other night, I ended up swept into something work-related and didn't smash my face into the pillow until almost 2:30 in the morning.  (If I had been forced to be at work for the breakfast shift at 6 am, it would have been a perfect college throwback.)  So when morning rolled around I started hearing the "Dada, dada, dadaaaaa" coming from the baby monitor as BSparl shuffled her fleece-covered feet in her crib, I was beyond exhausted.

"Mama," I said to the video monitor, trying to will her to say it from our bedroom.  "Say Mama, little bird."  I rolled over and grabbed my meter off the nightstand, fumbling with the lancing device as my hands woke up.

Okay, 68 mg/dl.  The Dexcom confirmed with a flatlined 70 mg/dl, so I at least knew I wasn't tumbling.

The lump in the bed shaped like Chris turned towards me.  "Want me to get up with her?"  

No hesitation.  "Yes.  Yes, I do."  I flopped back down into bed and closed my eyes.  On the monitor, I heard Chris rescuing BSparl from her crib, and I tried to get back to sleep.

Oh wait.  That low blood sugar.  Damn it.  

I foraged underneath the blankets for my pump and clicked through the screens until I hit the "temp basal" option.  I wound the basal down to 0% and set it for one hour, knowing that an hour without my morning basal bump would be just enough to bring me from upper 60's to the upper 90's.  And then I wouldn't have to get up out of bed to get juice.  I could just sleep.  Ahhhh, blessed sleep.  I set the pump to run at 0% basal for an hour, and then snuggled back underneath the comforter.

I JUST WANTED TO GO TO SLEEP!  All nice and snuggly, like this old photo of Siah Sausage

Fur Elise rang out from underneath the blankets, the pump vibrating as well.

"What???"  I fumbled for it, and the screen cheerily told me that the pump wasn't delivering insulin.  Smile!

"I know.  It's on purpose.  Shut up," I mumbled to it, clipping it back on to my pajamas and trying to sleep again.

BEEEEEEEEP! the meter case sang from the bed stand.  

"What, now you?"  I looked at the screen and it, too, reminded me that the pump wasn't delivering any insulin.  

"Argh, stop!"  I smashed against the buttons with my fingers and the meter stopped nagging.  Then the Dexcom starting wailing, because it finally realized my blood sugar was under 70 mg/dl. 

"It's okay, stop making noise.  I'm fine.  Everything is fine would you people please just shut up and let me sleep I am exhausted run on sentence."  I babbled, mushing my face into the pillow as the pump started vibrating again, just in case I didn't know that I was running a 0% basal.

Thirty minutes later, after muting the meter, the Dexcom, the pump, and my temper several times over, I finally gave up and shuffled downstairs.  

"We're okay, baby.  You can go back to bed," Chris said from the kitchen, where he was making breakfast and BSparl was happily chomping on some puffs.  

"Nope.  I had put the pump on a temp basal to head off a low.  It worked - I'm 98 now, but sleep was thwarted by all the reminders from my diabetes crap saying 'OMG you are on a zero percent temp basal!'"  My grumpiness was tangible.  I was rambling borderline incoherently to Chris about diabetes math problems.  The baby was making faces at me from her highchair.  "Baa baa!"

"Hang on, Little Birdy.  Momma needs to make some coffee."

BSparl raised her tiny fists in the air and tossed a few puffs in my general direction.

At least she had the decency not to BEEEEEEEP!

February 01, 2011

Living Alone with Diabetes.

Home alone ... with diabetesAfter college, I moved in with my then-boyfriend and we lived together for about five years.  But when he and I broke up, I lived alone for a little over a year before Chris and I moved in together.  (And by "alone," I mean with Abby the Cat and then Siah Sausage was introduced to the fray.  But neither of them were able to handle a low blood sugar effectively, so they were useless, in a diabetes sense.  ... except that whole "Abby sensing low blood sugars" thing ...) 

Living alone was a big thing for me, because I was always fed the line "You are diabetic; you shouldn't live alone."  And for a long time, I was scared to be by myself.  But after spending those first few weeks alone in my brand new place, alone for the first time ever, I felt empowered.  I know my mother worried - she called every morning - and my grandmother used to drop by "unannounced" (but she was checking to make sure I was in one piece), but I understood why they checked in on me.  Lows were a constant and scary threat.  It was a big adjustment, going from being under the constant care of my college roommates and then my boyfriend to being solely responsible for myself, but I liked it.  I felt like it lifted me up, emotionally, and showed me that I can do anything, with or without the diabetes crap. 

Abby (the Person) talked with a few of her PWD friends about living alone.  Some are in their own apartments for the first time, some are adjusting to college, and some are getting ready for that first leap into living on their own.  Here are a few perspectives on what it's like to live alone with diabetes:

Katie M.
I'm in my junior year in college now, so have been more or less on my own for about three years now. The transition did a number on my A1C because I really don't like being low. Although I know that high numbers can be just as dangerous that's definitely the side I air on because they're much less immediately debilitating - key word immediately. My precautionary tendency is to run high, flawed logic though it is. It's also been very important and helpful for me to be open about my diabetes and to create a support system for myself at school - I mention it to my professors at the beginning of every semester and have friends who I trust and who are interested. This way I have people in my daily life who more or less know what's happening when I talk about diabetes related things and who I can count on to help if need be.

Arianna J.
I've been managing my diabetes on my own for 8eight years now and I'm so used to doing it on my own that I have a really hard time letting other people help. I even get nervous at the doctor's office because I would really like to do my own shots and don't trust other people giving them to me.  Living on my own, I try to keep in touch with other diabetics because it keeps my mind thinking about the best things to be doing (like checking and bolusing), aka the basic things that sometimes are easy to forget in the college life.  I also like to feel like I can complain to others who understand because that keeps me from getting super discouraged every time I'm low or high and just sick of diabetes in general.  Keeping a sense of humor has really worked the best for me.  But now, I have to say that I wish I didn't take so much control because right about now I wish I could go back to the 7 year old phase where someone else does it all for me, but as for now not taking it too seriously seems to be going pretty well.

Samantha S.
There are definitely pros and cons of living on my own. On the one hand, it gets a little lonely, as my D-support team is rather far away (aka my family, aka my parents and camp-friends). Sometimes when I'm really low, I get scared that I'll pass out before I can grab the OJ from the fridge. But living on my own has given so much independence, and so much maturity. My mom no longer comes to my endocrinologist appointments with me, I'm responsible for communicating my questions and concerns. If my pump breaks, I'm the one on the phone to Minimed. Living on my own has made me grow up, like it does for most "aspiring adults". However, living on my own with diabetes has certainly put me on the fast-track.

Bethany K.
Living alone is the best thing I have ever done for myself. However, right before I moved into my new  apartment, I started having second thoughts.  Cold feel. Butterflies. If I move into a new apartment on my own, who is going to take care of me if I have an emergency?  What if I have an extremely low blood sugar and need help, but no one knows it because I live on my own?  What if something horrible happens to me while I live here as a single, young lady who just happens to have type 1 diabetes?  ... So far, so good. It has only been 3 months now, but I've grown so much from this time on my own both personally, spiritually and emotionally.  Also, when it comes to my diabetes, control has only become tighter. Not only do I not need to worry about what my roommate is going to say when she gets home, but I've also found that I have more peace of mind if my blood sugars stay within the range of 90-130-which in the end lead to a 1/2 point drop in my A1C.  So, living alone is pretty great. Are there demons I had to overcome? Definitely. Do I still worry sometimes? For sure, but I have made friends in my complex who know about my diabetes.  I live across the street from a friend from diabetes camp who would be here in 2 seconds flat if I needed her. I am proud to say that I'm doing alright and I recommend living alone to every person at some point in their life. It will change you for the better.

Briley B.
I technically don't live on my own; I have a roommate.  Except that she is clueless about diabetes, even though her own mother also has T2.  Her mother has tried to ignore it for many years though, so I can understand that.  I have to say that when I first realized my roommate was clueless, and after my dia-buddy left again, is when I started my blog.  It helps to write, and then notice what is going on in my diabetes life. I have my glucagon next to my tabs and juice boxes next to my bed.  And I talk to my mother every morning before work (I'm the one to call her).  I try to test before I go to bed and when I wake up.  That way I am at least safe during my unconscious hours.  I've been testing more regularly, but whether that's because of living alone or just growing up, I'm not sure.  I also have everything organized so that if anyone needs to come in and help me, they can easily find it.

Abby Bayer.
The first time I moved out into a dorm room for college, I didn’t really consider diabetes an issue, but more a part of my life that needed to be packed up and brought with me. I bought a tall plastic drawer thing (that most college kids buy) and filled two of the drawers with diabetes supplies.  I also made sure that I had my own mini-fridge to ensure that people knew the stuff inside was off limits. My roommate was totally cool with it, and we just stayed away from each other’s refrigerators.  People often came in and took my snacks (crackers and such), but they also hung out in my room and were my friends, so I kind of took it as a loss (and borrowed things from them without guilt). When I finally got my own house in college and was off the meal plan, I made it a point to try to cook healthy and make sure my house-mates knew I had diabetes and that some of the stuff was simply to be thought of as my medicine, and not as food.  I’m nervous to ever live completely by myself, but I’m sure I’ll come up with some sort of system to make sure I’m safe, and that I can keep my health a priority. It’s also a wonderful conversation starter when people see Arthur or Sesame Street juice boxes in a 20-something female’s kitchen.

Thanks for sharing your perspectives, you guys! 

Are you a PWD who has some insight on living alone, or making the choice to avoid living alone?  Are you a parent who is nervous about their kid going out on their own?  If you have insight to offer, please do!  :)

December 21, 2010

Tangled.

I love my insulin pump (well, as much as you can enjoy anything that's used to manage a chronic disease), and it's a constant part of my daily routine.  It goes with me EVERYWHERE, from the car to the supermarket to the bathroom and to bed at night.  This pump is never more than a few feet away from me, and I keep close tabs on it.

And sometimes it keeps wicked close tabs on me.  See also:  tangled.

Have you ever found yourself wrapped up in a pump tubing hug?

December 20, 2010

What NOT to Say to the Parent of a Kid with Diabetes.

I didn't make this video, but the fact that it quotes questions I've heard people ask the parents of children with diabetes time and time again makes me smirk.  This video is anonymous - I don't have a clue as to who crafted it up.  It's a little bit sassy.  And my goodness did I laugh when I first watched it.  The second time I watched it, I paused it to write down my favorite line.

"There are only two things my daughter cannot eat:  poison, and cookies ... made with poison."

(Note:  If someone can hook me up with this moss that supposedly cures all things that ail ya, let me know.  I'd love some in time for the holidays.)

Found out where this video was born - on Joanne's Death of a Pancreas site. Thanks for the laughs, Joanne!

December 14, 2010

Larry Bird, No One Invited You.

My symptoms of low blood sugar used to run the gamut:  numb mouth, dizziness, sweating, crying at will, shakiness, inability to see completely clearly but a heightened sense of hearing ... fun stuff.  The symptoms of a low blood sugar can really suck.

But you know what sucks even more?  Not having any symptoms at all.

A few days ago, I was making lunch for BSparl and trying to clean up the kitchen (never a good idea at the same time), and my hands felt a little fluttery.  But nothing really worth paying attention to for more than a second.  BSparl devoured her rice cereal and mushed up bananas and then she was down for her nap. 

As I closed her bedroom door, I heard the Dexcom BEEEEEEP!ing from the kitchen counter.  There's a different sound associated with the "low" and "high" alarm, and I was surprised to hear the low alarm sounding.

"I feel fine."  I said, matter-of-factly, but not sure I meant it.  I did feel just slightly ... off.  Abby (the cat) meowed as she circled around my ankles.  But a swipe with my blood sugar meter showed me at 33 mg/dl.

Oh come on, Larry. I love you, man, but not like this.  Not as a blood sugar.  

The problem was that I didn't feel low.  At all.  I didn't have even a whisper of a hint from my body that my blood sugar was rapidly heading towards chaos.  If it hadn't been for the Dexcom, I'm not sure I would have tested.

Instead, I found myself standing in front of the fridge and sucking down grape juice straight from the bottle.  (Note:  Don't drink the juice at my house.  I've licked all the bottles.)  Auto-pilot kicked in and I treated that 33 mg/dl as though I could feel every bit of it.

Oddly, I didn't start to feel low for another five minutes or so, when my blood sugar started to come up a bit.  Such a strange thing, but when I'm coming up from a Larry low (read:  in the 30's), it doesn't throttle me until my blood sugar starts the journey back upwards.  Around the 50 mg/dl mark, I started to hit the sweats, the adrenaline panic, and that weird, white fog of precision that envelopes me when I'm low. 

This lack of symptoms has me very nervous lately.  I know that my numbers have been both pinging and ponging all over creation lately, but it's downright creepy when I'm at a blood sugar so close to chaos and I feel like I could happily climb into my car and start driving, or pick up my daughter and start dancing, or wait just a little while longer before deciding to have a snack.  My body doesn't give me the hints I need anymore, and I'm not sure why. 

Diabetes is messing with my head.

My paranoid (and hyper-sensitive) Dexcom continues to wail even after I'm back up to 70 mg/dl, but I find the noise comforting.  I know I'm back in range, and I don't have that feeling of confusion or fogginess.   

"I feel fine," I said again, only this time I meant it.  

I wish every day could look like this.  But it, um, does not.  Lots of times, I see a big letter M.

November 11, 2010

Parking Lot Lows.

Part of me would love to ride in one of these down a steep hill.  The other part of me wants to live."Brrrrr ... it's a little chilly outside today," I said to BSparl as I tucked her blanket snug around her wiggly little self in the car seat. She waved at me and showed me her sock.

"Yes, that's a nice sock, birdy.  Okay, let's get out of here and get you into the car so we can go home!"

The automatic doors parted and a brisk gust of wind came and skipped down my collar.  With the baby's car seat safely tucked into the belly of the carriage, I ventured out to find my car in the massive parking lot. 

"Ha ha, where did Mommy leave the car?"  I said out loud, walking up and down the parking lot aisles and pressing the alarm on my keys.  Nothing.  No flashing lights, no subtle little "beep" noise from my Honda.  Nothing but a sea of cars and I had no idea which one was mine.

"Am I getting old?"  I asked BSparl.

"Mmmmmm!"  she proclaimed, raising her teething toy into the air.

I walked for several minutes, combing the lot for my car.  And the wind kept whipping, only this time it felt good because it kept whisking the sweat off the nape of my neck.  I felt dizzy.  

"This car has to be here somewhere ..." I passed the the same minivan I had just seen moments ago, the one with the stickers on the back advertising the happy family that held the title.  "I just can't find it.  I can't find anything, baby.  I have no idea where this car is."

BSparl was starting to fall asleep, tucked happily into the blankets in her car seat.  And I could not find the car.  The parking lot was this sea of blue and black and red cars, none of which were mine.  My vision began to sharpen on the peripheral, leaving my main point of focus a little blurrier than usual.  The sounds of the parking lot were magnified in my head, leaving me confused and lost in my mental cotton ball.

I felt the buzzing from my purse, and then heard the unmistakable BEEEEEEEP! of the Dexcom.  Without checking to see what my blood sugar was, I reached into my purse while pushing the carriage and retrieved a jar of glucose tabs.  I chomped down on four of them at a time, the glucose dust taking off into the air.

The ground was starting to shift, like a blurry and constant tremor that only I felt.  I knew this low wasn't good - I needed to find my car and sit in a hurry.  But I had the baby with me.  So I had to make sure she was safe, too.

I saw a young kid who was corralling the shopping carts.  I motioned for him to come over, and he trotted over with a half smile.

"You okay?"  he asked.

"Not really.  I'm having a low blood sugar reaction and I cannot find my car.  I need to get my baby into the car and out of the cold, but I can't find my car.  It's not here.  I can't find it."  I hate when crying is the prominent symptom of a low.  I felt the tears coming.  And then I started to laugh, because I was picturing myself, shopping cart crammed with baby and bags, my coat sleeves covered in glucose dust, crying and roaming aimlessly around the parking lot in search of one little car.  

This poor kid must have thought I was on drugs.

Everything happened in fast forward.  This kid told me to stay where I was and he would find my car.  He took my keys and returned quickly, telling me I was just a few aisles over.  He put the baby's car seat in her car, loaded my bags into my trunk, and asked me if I was okay.  I housed a few more glucose tabs in the meantime.

"Do you need me to call someone for you?"  

"No, I'll be fine in just a few minutes.  I just couldn't find the stupid car and my blood sugar wasn't helping.  I'm so sorry.  Thank you so much for your help."

"Okay.  No problem.  If you need anything, I'll be rounding up carts.  I will be watching you, okay?"  He paused for a second, and then rubbed his hands over his attempt at a beard.  "Not like 'watching you' in a creepy way.  Just like making sure you two are okay."  

I sat in the car and waited for my blood sugar to come up while BSparl napped in the back seat.  After a few minutes, I checked to see 82 mg/dl flashing up from my meter.

"Holy biplane-building cats, Batman," I mumbled to myself.  "I must have been crazy low."

Safe in my car with my baby buckled in, I waited in the parking lot for my blood sugar to continue to rise, thankful for the kindness of strangers.

October 08, 2010

Stubborn Fool.

Last night, I went to the gym later in the day - around 7:30 pm.  Chris was home with BSparl and I couldn't wait to have an hour to myself and to watch Project Runway on the gym televisions.  (Yes, a month of hospital bedrest will indeed make you addicted to weird reality tv shows that make you talk about what an obnoxious sasshole Gretchen is, as though you know her.  /digression)

I'm on the elliptical and plugged in, watching tv while I work out.  About four minutes in, I see this weird spot in the bottom right hand corner of my right eye.  Nothing too dramatic, but just this nagging little floaty thing that makes my eye feel like it has a filmy cotton ball covered the bottom portion of it. 

I continue my workout, and at the seven minute mark, my sneakers feel like cement blocks and that eye thing is still foggy.  And this thought actually goes through my head - "Should I test?" - but because I am a stubborn fool, I don't quite yet.

I reach for the Dexcom receiver, only to realize it's at home on the coffee table.  So I walk for a few more minutes, not realizing I'm listing to one side and hanging on to the hand rail.  (But once my brain starts musing about how I'd maybe wear some of those Project Runway outfits, it dawns on me that I should probably test like right now.)

A bright, shiny 43 mg/dl smiles back up at me from my meter.  The eye thing, the cement feet, and the headache suddenly magnify.  But I am a stubborn fool.  And for some stupid, stupid reason, I decide to keep going.  I bring the treadmill back to a 0% incline and reduce the speed to 2.0 miles per hour.  The sports bottle I brought with me, filled with juice, is drained in a millisecond, and then I just plod along.  Plod, plod, plod.

Internal Motivational Speaker pipes up in my ear.

"Kerri.  Get off the treadmill, you stubborn fool.  You are going to hurt yourself.  Your blood sugar is way too low for you to be physically exerting yourself."

I keep plodding.

"Are you ignoring me on purpose?  Because I can go all night, lady.  You'd better listen up and get yourself off the treadmill and sitting tight until your blood sugar comes up."

I furrow my brow.  "I don't want to.  This is the only time I get to myself all day long and I am determined to banish this abdominal fluff and seriously?  This low is making me so mad at diabetes crap that I want to throw something.  So no, I'm not stopping.  I'll go slow.  I already drank the juice.  And I'll test again in a few minutes.  But I'm not stopping."

I know I should have quit as soon as I saw that low number, but I didn't.  I am stubborn.  I walked slowly and unsteadily for a few more minutes, and then my sneakers felt a bit lighter.  And my eye fog was lifting.  It wasn't until the Project Runway outfits started to look ridiculous again that I felt completely better.  Quick blood sugar check showed me an 81 mg/dl.

"This could have ended badly, you know," said my Internal Motivational Speaker as she filed her nails. 

"I know."She totally looks like this.

"You're a stubborn fool, Ms. Kerri.  You need to listen to me sometimes, even when you don't want to."

"I know that, too."

"Okay.  Next time, you sit out for a few minutes, just to be on the safe side." 

"Fine.  I will."  I glanced up at the tv again.  "Dude, Gretchen looks just like Skeletor."

"She totally does."

October 01, 2010

Joining the Gym.

We moved at the very end of August, and when we left our apartment, we also left behind our gym.  Lovely, right-there-in-the-building gym that was easy to get to because it didn't require getting into the car and trekking across town.  I worked out for the majority of my pregnancy, thanks to this gym, and only stopped when pre-eclampsia started to make my body its home.

Yesterday morning, I weighed myself and saw that I'm back to my pre-pregnancy weight, numbers-wise.

"Whaaaa?"  I said, looking into the mirror and assessing the various areas of squish.  "This is not how I looked before that little biscuit of a BSparl arrived."

Weight, for me, has never been a numbers game.  I've never cared in the least about what winks back at me from the scale, but more how my clothes actually fit.  Over the years, my weight has fluctuated due to muscle mass, stress, season (summer = ice cream), and work schedules, but overall, I've remained the same general size.  

But when BSparl came into town?  (And by town I mean "uterus.")  Chaos.  My body has taken on shapes I have never seen before.  Contents definitely shifted during landing, and I'm looking at a whole new me when I see myself in the mirror.  And honestly, I'm not the biggest fan of what I see. 

Some things, I'm fine with.  Like the scar from the c-section.  It's a sizable sucker, but it's proof positive that my baby came from my body, and I'm reminded of that every time I see her.  Some women call it a badge of honor.  I'll take that.  The stretch marks?  I'm less snuggly with those, but every week they fade a little more and every week I notice them a little less. (And Palmer's cocoa butter helps.)

Other changes in my body can be filed under "changeable," and now that BSparl is five months old, we've moved, and my travel schedule is about to lighten up over the holidays, I'm fixin' (nod to NBF) to get myself back into shape. 

So last night, I joined a gym.  And I worked out for the first time since we moved into our house.  Granted, it wasn't the most aggressive of workouts, but I was there.  I spent 45 minutes on the cardio circuit, and even though my weight didn't shift even a smidge, I felt worlds better when I left.  Like I wasn't just sitting at home, wishing I was making a change.  There I was - making it.

At the end of December, I'll be in Marco Island with my family and my extended CWD family (including my daughter's favorite spit up target, Mr. Scott Johnson), and I want to feel good about how I look when I'm there.  I have three months to reign things in, and I know that - for me - with exercise comes better diabetes control. 

Hear that, Larry?  You thought you shook me off for the last few months?  Pfffft.  I'm comin' for you.

Shhhh!  Larry is always watching.

September 17, 2010

Diabetes Control = Hot Mess.

I want to stop picturing these every time I test my blood sugar.Exhausted doesn't even begin to explain how I'm feeling at the moment.  Over the last few days, we've moved into a new house, worked and lived through some construction efforts in our home, traveled to the Toronto International Film Festival for the Buried Canadian premiere (by propeller plane, but more on that panic attack later), and then hoofed it to NYC for a screening (more on that later, too).  Our house is chaos, our schedules are all over the place, and my health management is under duress.

Even though all of this stuff is exciting and the journey to get here has been incredible, it's a lot to manage all at once.  I love to travel, but I hate the actual process of "getting somewhere."  I don't travel light, I have some physical limitations that make travel difficult (read:  tendinitis so bad that I can't lift a bag without wussing out), and I'm still not a fan of flying.  That, combined with the lack of sleep and a wildly varying schedule (including nights that push the 3 am envelope - hey, college throwback!), is a recipe for disaster with all the diabetes stuff.

Blood sugars have had pockets of success, like last night at the Tribeca screening, where I held rock solid between 100 - 150 mg/dl all evening long.  But there have been some disastrous runs, like the night of the Toronto screening, where I was over 280 mg/dl for four hours, despite boluses.  (I eventually took an injection and pulled the site, but the site seemed fine.  I hate when the cause of highs can't be nailed down.)  I'm testing a lot, but my body isn't responding to things normally.  Foods that I'm usually able to tolerate, numbers-wise, are now throwing me into the stratosphere  or tossing me into the trenches.  I'm living on a steady diet of coffee and lip gloss.  Infusion sets are staying in for four days at a time (instead of the three days I had committed to while pregnant - absorption is so much better when you follow the damn rules) and I think the last time I changed my lancet was when BSparl was born.  

I'm a hot mess.  And not in that cool way.  More in that "Geez, Kerri, you think you're cured or something, the way you've been acting lately" way.  (Note:  Haven't been cured.  Just a very scattered diabetic these days.)

I'm not sure if these hiccups seem more dramatic because they're in contrast to the very tight, very obsessive control I had while pregnant, but in any event, I'm not pleased with my lack of commitment to sparkle motion.  (see also:  hot mess)  But I have to get things back under control.  Events for Chris seem to be coming up every week, and I want to be physically ready to attend with him.  (As in, I don't want to be 39 mg/dl.  Or 399 mg/dl.)  And this is all without mentioning my smiley little daughter, who would do well to have a mom who isn't bouncing all over the blood sugar map.  

The next six weeks will be challenging for me, as both a diabetic and a new mom, because it's sort of non-stop until the holidays.  And even though the events are coming and going, the diabetes isn't.  I can't spend the next six weeks winging it.  I need to find a way to do these things without sacrificing all of my diabetes control.

I can do this.  If I was able to get my terrified arse on a propeller plane, I can wrangle in a blood sugar or two. 

September 10, 2010

24 Years.

Tomorrow is my 24th anniversary with type 1 diabetes. 

There's a lot I can say about the diabetes community, and how far things have come in the last twenty four years.  How what was once a disease that left me feeling alone and obscure now comes with a welcome bag and a community of people who can lift your chin when it sinks to your chest.  I thought about how many people I knew with diabetes on the day of my diagnosis (one) and how many I know today (far more than I can count).  

I am grateful for all of these things.  

Some years I want to celebrate another year marked with diabetes.  Sometimes I feel defiant, like I just poked diabetes in the chest and told it what's what.  Some years I want to keep to myself, feeling a little jumbled at the thought of so many years with this disease.  And some years I'm a combination of all sorts of feelings, just wanting my husband to give me a hug and have a bite of Fudgy the Whale with me.

Last night, I felt different.  This year's anniversary feels different.  Maybe because there's been so much change in the last year.  Maybe because this day could come and go unnoticed, because an anniversary with diabetes doesn't change the diagnosis.  Doesn't make my health any better or worse.  It's just another box I can check, another year that I can say, "Yes.  I've been at this a long time."  Maybe it's because I will wake up tomorrow and it will still be here, despite these promised cures.  Maybe because I've moved into a brand new place but still have boxes marked "diabetes supplies."  As I unpacked, I reached the bottom of a bin of clothes and found a used test strip and I couldn't even tell what kind of meter it went it, it was so old, and that made me so sad for some reason.   

I tried on a few dresses in preparation for our trip to the Toronto Film Festival and felt upset that my post-pregnancy body still felt so unfamiliar, and that the pump seemed the size of a coffeemaker as I tried to hide it in my fancy garb.  Frustration mounted, and I felt like I was swallowing a scream.  I needed a hug. 

I went into my daughter's room, where she was asleep in her crib.  Her arms above her head, in her 'sleep victory' position.  Her breathing was even and steady, and she wrinkled her nose and rubbed her fist against her cheek as the floors yawned in response to my footsteps.  

Diabetes doesn't define me, but my daughter does. 

I scooped her up without thinking and held her close.  She cuddled close to me, resting her head against my neck and I stood there and felt ridiculous because I just wanted to cry, I was so proud of her.  And so in love with her.  And I realized that what had changed was everything.

Twenty four years with type 1 diabetes is a good chunk of time, but I'm not done yet.  It will be with me when we celebrate Chris's film next week, when we walk with our friends and family for a cure at the end of October, and when we have breakfast together tomorrow morning.

Diabetes is always there.  But it's not me.  It will never, ever be the core of me. Not if I have it for a 100 years.

24 years with diabetes

September 09, 2010

Running with Diabetes.

I don't run.  Not well, anyway.  Running isn't my activity of choice because my body doesn't do well at high speeds.  But when I go walking or any other exercise that's outside and brings me far away from my car, I grapple with that whole "what the hell do I do with my diabetes supplies" issue.

For the most part, I usually carry a small bag.  Sometimes I bust out the meter from it's protective black case and throw it into a SpiBelt, adding in a tube of glucose tabs and my keys and cell phone and ... suddenly, I'm a pack mule, careening up the mountainside. 

I am not a "travel light" diabetic.  I'm a messy, throw-it-all-in-a-bag-and-hope-you-don't-lose-the-bag diabetic.  But some PWDs have figured out a terrific way to keep tabs on their diabetes while exercising.  Like my friend Melissa (a fellow Clara Barton Camp alum), who MacGyver'd her meter into her running shoes.  Here's a shot of her kicks, that she's graciously allowed me to share with you guys:

Melissa "Rebel" Kauffman and her diabetes running shoes.
Photo credit to Melissa K.  She also has a series of glucose stashes on her run route, in case of a low.  Clever girl!  (But no, I have no idea where she keeps the actual test strips.  You'll have to ask her.)

I think this is brilliant!  How do you keep your supplies at the ready when you're on the run - literally?  Are you like me, with an awkward bag of everything, or are you as streamlined as the pictured PWD?

September 02, 2010

Diabetes and Moving: Fun.

Every time I look at this bit of clip art, I picture the cats driving it.You know you're a diabetic moving into a new place when:

  • You pack extra glucose meter test strips, baby diapers, and toilet paper into the same box because you know you will need both on the first day.
  • You're watching at the window for the cable guy so you can get yourself back online and immersed in the diabetes blogosphere.
  • You don't care that there's an ice maker in the new fridge, but more than there's a handy compartment that's PERFECT for insulin storage.
  • There's a whole box labeled "Diabetes Supplies."
  • You're grateful that the hardwoods are being installed because it will be easier to find rogue test strips.
  • The washer dryer combo looks like a spaceship command unit and you have no idea how to work it.  (Wait, that's just me?  Domestic goddess I am not.)
  • Even though the fridge is almost entirely empty, there's still a bottle of grape juice at the ready.  (And a pitcher of iced coffee.  Priorities!!)
  • You buy a smaller garbage can for the kitchen to leave room under the sink for a massive, red sharps container.
  • There's a space in the walk-in closet that's dedicated solely to stacking insets, insulin reservoirs, and test strip bottles.  Not to mention lancets, which I've had the same seven boxes for the last four years and I never manage to use them up.  (Something tells me I should change my lancet today.) 
  • And: You test the wall outlets by plugging the Dexcom receiver in to charge.
Diabetes plus moving totally equals fun.  :p

August 26, 2010

My Hat Was Kicked.

I woke up yesterday morning at a blood sugar of 158 mg/dl.  A little on the spikey side, but no worries - after I breastfeed BSparl, I usually drop about 40 points, so I figured I'd use her feeding as my "bolus."  By 8:45 am, I was down to 129 mg/dl.  And then things hit a downward slide that I couldn't control.  

Over the course of the next five hours, I tested several times and saw the numbers tumbling all over the place.  At one point, I had to leave the baby fussing in her crib because I was attending to a 38 mg/dl.  The next blood sugar I saw was 29 mg/dl.  And then 61 mg/dl.  And then 55 mg/dl.  Hours were going by, and carbs were being consumed, but they weren't making a dent on the determined low blood sugar. 

BEEEEEEEEEEEEEP!

Dexcom wailing to let me know I was, once again, under 50 mg/dl.

Shunk.

Another blood sugar test confirmed yet another low.

Hours kept ticking by but I wasn't coming up. It took until 4 pm to see a blood sugar over 100 mg/dl, and then all hell broke loose on the other side.  After over eight hours wrestling with a low blood sugar, my body decided to flip upside down and let all the hourglass sands go to the other side, sending my numbers up into the 400's.  Why on Earth was I low for so long?  And why did I rebound so hard after treating the multiple lows modestly?  

(I keep picturing the carbs, hiding out behind my lungs, waiting to actually enter my blood stream and then all screaming in at once.  "Ahhhhhhhhhhhh!!!" waging war, holding pixie sticks over their heads as they come charging in, full force, for the freaking rebound.)

Which, of course, happened in full force with a gorgeous 405 mg/dl around 9:30 pm.  Yes, I lost track of time between 6 - 9 pm, when apparently the Dexcom graph shows a sharp spike upward.  But still - low all day?  ALL day?  

You know it's been a rough diabetes day when your total dose from 7 am - 6 pm is only 8u, yet your 6 pm - midnight dose is 29u. Diabetes kicked my hat.  Kicked it right-proper.

(We're definitely installing this emergency box.  If nothing else, at least lows will be delicious.)

Yes, this is a reused image.  No, I don't have any guilt.

August 24, 2010

What is the Best Motivator?

I've heard that fear is a pretty good motivator.  Over my two plus decades with diabetes, I've heard the "fear tactic" from many medical professionals.  Actual statements:  "Make sure you test or your eyes will become diseased and you'll go blind." And "If you don't take care of yourself, you'll lose a leg when you're older."  And of course, "If you eat that, you'll end up with complications and then you'll have to live with that."  (see also:  ugh)

Fear has never been a good motivator for me.  When I'm scared, I have a tendency to hole up and hide.  When I think about the future of my diabetes, I know there is a good chance I will have some kind of complication. I have sat in the endocrinologist's office far too many times to tune out the threat of "what might happen."  I know what could be brewing.  Like it or not, I understand the effects of unmanaged diabetes.  I work hard to manage diabetes.  But I'm not so hot with managing the fear.

And if, for even a second, I forgot what diabetes complications may be waiting in the wings, I have many things to remind me.  Like the pamphlets at doctor's offices.  And the commercials on TV.  And videos about how diabetes can cost you a leg.  

That video makes me so frustrated because if I had seen it before the diabetes online community had bloomed, I would have been so distressed.  The images in that video would have haunted me, but not in a way that would impact my diabetes favorably.  That kind of video makes me want to stick my head in the sand and pretend it's not happening, instead of taking charge and control of my own disease and realizing I have the ability to impact my future health TODAY.

Give me hope any day.

I think it's more important to remember that there is a good chance I WON'T have some kind of diabetes-related complication. That some combination of good care and good support and good luck (yes, I think some of it is just plain luck) will usher me into my later years without a scary complication. Fear is not the best motivator for me - hope is far more effective.  I hope to be healthy for a long time.  And it's hope that keeps me testing my blood sugar every morning, working with my doctor to best-manage diabetes, and monitoring this monster closely. I don't want images of amputation flashing in front of my eyes every time I go to grab my meter.  I'd rather think about blowing out the candles on my 75th birthday party, a strong and healthy old bird.

Fear?  No thanks.  Give me hope any day.

July 26, 2010

Your Mom is Low.

Terrible habit, sarcasm.  Especially the "your mom" retort.  Like when my college roommates are out at the bar and someone asks for another beer.  Instantly, "Your mom wants another beer."  Immature retort?  Indeed.  But almost reflexive at this point?  Unfortunately, indeed again. 

(This intro has a point - bear with me.)

This morning, I woke up with my first bad low in a while.  For the last month or so, I haven't seen lows worse than 55 mg/dl, and my sensitivity to the symptoms seems to have increased a bit.  But while the lows of the last few weeks have felt mild, this morning's 49 mg/dl raked me over a little bit.

I woke up feeling groggy and warm, despite the air conditioning and the fact that I'd slept about seven hours straight.  (Yay for Sleeping-Through-the-Night-in-her-New-Crib BSparl!) The corners of my mouth were numb and I felt like my whole brain was encased in cotton balls.  I reached for the black meter case and brought it close to me in bed.  Fully intended to test.  But instead fell back asleep for a few minutes, with my meter snuggled against me.

Once I did wake back up, it had been another eight minutes.  And my symptoms were progressing, giving rise to shaking hands in addition to the cotton ball veil.  But it's strange, where my brain goes when I'm low.  I had a juice box right on the bedside table.  I knew I was low and didn't need to test to confirm, but I was on some kind of OCD autopilot.  I had to test.  Instead of grabbing the juice from beside me, I instead grabbed my meter from the bed, walked out into the kitchen, and set up the machine on the counter top. 

Sorry for the old photo.  (Your mom is an ... old photo?)

BEEP!

Shunk.

49 mg/dl.

"Okay,"  I said out loud, and took some glucose tabs from the cupboard.  (Chompy, chompy ... always a weird effort to get those things chewed up when I'm that low.) 

And then I heard BSparl stirring in the next room.   Not crying, but just stretching her little BSparly legs and easing into the morning routine.  I went in to stand at the side of her crib while I waited for my blood sugar to rise. 

"Hey sweetie girl.  Good morning!"

She kicked her legs and grinned at me.

"Hi!  Hang on just a few minutes, okay?  I'm having a low blood sugar and I need to wait before I get you up.  Just another minute or so.  I'm low.  Your mom is low."

And I thought of my roommates tossing the "your mom" retorts around with reckless abandon. I stood there giggling like a fool for at least a minute, the smile of irony on my face causing my daughter to bust out with an even bigger smile. 

"That's right, baby girl.  Your mom is low."  

Finally - FINALLY - the "your mom" actually makes sense.  (And with that, I've come full circle.)

July 21, 2010

Trends.

So here's a trend:  Today, I woke up to the sound of my baby cooing from her bassinet.  My hands reached over to the Dexcom receiver and I clicked on the button to light up the screen.  I saw a "74" and an arrow trending oh-so-slightly down.  So while Chris changed the baby, I went out to the kitchen to grab a swig of juice before settling in to breastfeed BSparl.  I fed her and then went into the living room to play with her.

Notice any problems here?  Anything ... oh, I don't know ... missing?  Like maybe a blood sugar check when I woke up?  Or at least one after I fed her?

Nope.  Nothing.  No test.  I went all the way from waking up to freaking NOON before busting out my meter.  This is a terrible trend.  And it's happened twice in the last four days.  I'm relying way too much on my Dexcom for guidance, instead of double-checking every hour or two with my meter.  I mean, missing a fasting blood sugar?  I've never, ever done that before.  Even in college, when I was at my diabetes worst, I still tested first thing every morning.

This is not a trend I want sticking.

I miss these little blue guys.  :)Here's another trend:  For the most part, I am BSparl's daytime friend.  During the day, Chris leaves our home office for a distraction and baby-free zone where he can focus on his writing.  So for several hours a day, BSparl is left to her mommy's devices.  (Including, but not limited to, visiting friends for lunch dates, running household errand-type things, and my own attempts to get work done.)   When I'm hanging with the baby, getting to the gym is impossible, and with the weather so hot and humid lately, I don't feel comfortable taking her for a walk in the stroller.  By the time Chris gets home, and we talk for a while, and we have dinner, etc. etc., it's suddenly so late that it's almost time for Colbert to come on.  (NATION!)  And I'm too exhausted to hit the gym.

This is not a trend I want sticking, either.  

A lot of the baby weight has come off (thank you, breastfeeding), but I am in desperate need of some muscle toning.  I need to get some workouts in as part of my schedule in a hurry, because I'm growing tired of feeling flumpy.  Before I got pregnant, I felt good about my body.  Now?  I need a little more effort to get back to fighting shape, or at least faux-fighting shape.  (Like the kind of fighting that includes throwing styrafoam peanuts.  Or something similar.)

The trends of missing blood sugar checks and workouts must end TODAY.  These habits are too damn crappy to let them continue.  I can't let these two trends wreck my goal of good health.  Small changes can make the biggest difference, so as of this moment, I'm realigned myself to test every morning and to get some exercise in at least four days a week.  (I was doing five days a week for years, so four days isn't a bad starting point.)  And it doesn't have to be a gym workout - I'll take anything from a long walk with the stroller and BSparl to an ellipmachine workout to a bike ride. 

Why am I rambling on about this?  Accountability, my friends.  By telling you, I'm setting myself up to be accountable for my actions (or lack of action).  It worked in helping me get my diabetes reigned in for pregnancy, and I hope accountability can help me get my act together to be a healthier mom.

July 13, 2010

Clara Barton Camp.

I love Clara Barton Camp.  I love the way it smells, the way it looks, and the way it makes you feel as soon as you step foot on the grounds.  Driving in to North Oxford, MA last weekend to speak to the staff, I was hit with a wave of excitement at the idea of visiting my old stomping grounds.

And even though the cabins are new (no more rotten old Pixie Place) and they have bathrooms and showers IN THEM (no more waking up a buddy in the middle of the night to take a trek to the lab - which was across the camp - because you had to pee), and even though I was a camper there over fifteen years ago, NOTHING has really changed.  Almost all of the campers and staff have type 1 diabetes, making the few people who didn't have to test their blood sugar first thing in the morning the odd ones out (for once).

When I arrived, the dining hall was literally throbbing with the sounds of campers and staff singing camp songs at the top of their lungs.  "Sounds exactly the same as when I was camper here," I said to Abby, who was giving me a quick tour of the new cabins at CBC.  Admittedly, I felt a little old when she was walking me through the cabins, because I kept remarking at the fact that the structures had both running water and electricity.  

"I feel like one of those old people who constantly tells you about how, when they went to school, they had to walk uphill BOTH WAYS, clutching potatoes in their hands to keep them warm.  But seriously, cabins having bathrooms is amazing.  My mind is blown."

Once we made it up to the dining hall, I had the absolute honor of meeting with the staff and LITs (Leaders in Training) at CBC that had diabetes.  I was invited up to talk about growing up with diabetes what it's like to transition from being a child with diabetes to an "official" grown up with diabetes, and these girls were the best audience I have ever had.  And the audience with the highest percentage of diabetes!  According to the camp director, there are only about 14 people on the grounds who aren't living with diabetes - that's a LOT of insulin being piped in on a daily basis! 

The awesome staff members at Clara Barton Camp.

We all hung out in the dining hall and just chatted.  It felt like a big slumber party, only I wasn't sporting pajamas (and I planned to sleep at home).  They had a lot of questions about managing things like college, dating, and of course, the whole baby thing.  I tried to be as honest as I could be, toeing the line between "one of them" and "an adult."  Like when they asked me about drinking.  "I know I'm supposed to be responsible and tell you that drinking with diabetes can be really dangerous, and can lead to some very serious diabetes-related consequences, which is all true.  But I can't lie and say that I didn't drink in college.  So here's what my experiences were like ..."

It was an incredible night.  These girls are a group for the entire diabetes community to be proud of.  Their energy, their endless smiles, their excitement for everything.  They took pictures (some goofy) and burst into song at the mere mention of the word "song."  (Video of a song about ketones coming at you ... now:)

Clara Barton Camp has this way of making you feel like you're being hugged the entire time you're there.  It sounds cheesy, but it's true.  CBC is like a second home to so many girls with diabetes, and for some, it's the first place they've ever felt like everything was going to be okay.  I asked some of the staff members to tell me what camp means to them.  Their responses were varied, but all hitting on the same general theme:

"Camp helps make me who I am."
"It feels good to be able to text someone in the 'off season' [when camp isn't in session] and vent about a high blood sugar."
"When I'm here, I sometimes feel homesick, but when I'm home, I definitely feel campsick."
"Here, diabetes is cool.  The people who don't have it are 'wannabetics.'"
"When I am here, I feel like a whole person."
"I thought it would be about teaching the kids, but I'm learning so much myself here."
"This place is literally my second home."
"These are friends that I'll have for the rest of my life."
"Camp is my security."
"I'm glad I'm staff this year because I get to give back to something that gives so much to me."

But my favorite was when one staff member raised her hand and said, "It's the happy bubble.  This whole place makes me feel like I'm in a happy bubble."

Clara Barton Camp is definitely one, big happy bubble.  And it was such an honor to revisit a place that played a huge role in shaping how I view my diabetes today.  Huge thanks to Abby, who coordinated the event, and to each and every member of the CBC staff for their warm and inspiring reception - and for the kick-ass t-shirt.  (And props to Savannah for rocking those mismatched galoshes!)

July 06, 2010

Finding Your Voice Online.

Last Wednesday morning, Amy from DiabetesMine and I co-lead a focus group at the Friends for Life conference called "Finding Your Voice Online."  The group consisted of a bunch of d-moms, d-dads, and some kids with diabetes who sat in on the session, not to mention some terrific diabetes bloggers (Heidi, Scott, Chris, and Bernard).  And then there was Amy.  And me.  (And my enormous iced coffee - so necessary.  Apologies to everyone who realized I was way over-caffeinated by the end of the presentation.)

Amy opened with an introduction to her blog and her work in the diabetes community, and I finished with my story of how I ended up immersed in the blogosphere.  (Slides below.)  We shared how we 'got started' with blogging, and what kind of opportunities have come as a result of our efforts.


I've spoken at different conferences before, but the Children With Diabetes conference is different.  Its core audience isn't someone with a Pharma agenda or something to sell - the people who go to the Friends for Life conference are people with diabetes, and the people that love them.  They're the people who are affected every day by diabetes, and if this conference had existed when I was growing up, I would have had a completely different perspective on my diabetes.  The FFL audience cares not only about new research developments, but about the real life of a person with diabetes.  Their kids are more than their disease, and I hope they found some comfort in seeing two adults who were more than their diabetes, too.

As I clicked through my personal slides, I talked about my life and my marriage and my stupid cat.  And then I shared with them what I was most proud of:  my daughter.  "When I was first diagnosed, back in 1986, my doctors told us that my having children would be near impossible.  But I am so proud to say that I proved that you can have a healthy baby, even if you have diabetes."  And her little face, grinning out from the slidedeck, proved to me once again why people with diabetes need more exposure to others living with diabetes.  It feels so empowering to know that you can do anything - have a child, drive a race car, fall in love, climb up Everest! - even if you are living with diabetes.

Bloggers at Friends for Life
Bernard, Amy, Kerri, and Scotty J!!

The parents in the audience had a lot of questions, and many concerns were about online privacy.  We talked about the decision to share or not share our child's name or photo with the online community.  "For me, I decided that a few photos here and there were fine, but I wasn't comfortable subjecting my kid's name to Google just yet.  I want her to make that decision for herself.  But I'm like any other parent, and it's hard not to share my little kid with everyone!"  

One parent talked about her decision to make a JDRF walk fundraiser video, and how she had mixed feelings about the level of exposure.  

"I think that we're all safe in this diabetes community, but I need to remember that there aren't just people with diabetes who are reading my blog."  I said.  "Sure, the patient and medical community might be reading our posts and watching our videos, but there are also some completely random people who might be logging on.  And while we're safe within the 'borders' of the diabetes blogosphere, the Internet as a whole isn't quite as safe."  

Some parents had questions about starting their own blogs and getting involved with the diabetes blogosphere.  Others had questions about how to raise the awareness of their existing online properties.  Amy and I walked them through different resources for developing their online voice.  

I have always been a huge supporter of the Children With Diabetes efforts, in particular the Friends for Life conference, and having the chance to speak at a focus group was more than an honor  - it was like coming home.  Thanks to Jeff and Laura for hosting us, and thanks to all of the discussion participants! 

July 02, 2010

Reaching the Summit.

On Monday afternoon, BSparl, Chris, and I boarded a plane bound for Orlando, Florida.  (It was our first trip with the baby - more on that later, because I'm still processing all the stuff required to travel with an infant.)  My trip was dual-purposed:  to attend the Roche Social Media Summit and then co-lead a focus group on Wednesday morning at Friends for Life. 

Like everyone else, I have a disclosure with this:  Roche paid for my plane tickets to and from Florida, and they also covered my hotel room for Monday and Tuesday night.  But they didn't hold me over a shark tank to gain input from me, and I am also still using my brain on my own, so basically they can only claim travel, food during the conference, and lodging.  They also didn't ask us to blog about the event (even though they knew we would).

But like I said last year, Roche is smart because they know by bringing together a pile of bloggers, Roche will be discussed on a pile of blogs.  And also in step with last year, Roche treated us respectfully and worked hard to make sure we were happy, as a group.  But I can't lie:  I was excited to attend this event because it would put me in "real life" touch with my extended diabetes family.  The invitation coming from Roche makes it a "Roche" event, and I can't hide my bias when it comes to being grateful to them for having the opportunity to socialize with my social media friends.  So that's the full disclosure. 

The event took place as a bookend to the CWD "Friends for Life" conference, which seemed to dictate the timing and location.  I think there was a total of thirty-seven bloggers, representing the type 1 community heavily, but with voices from the type 2 and caregiver crew as well, and we were hanging out in a conference ballroom at the Orlando Marriott all day on Tuesday.  

The Roche representatives were very cool to us, and didn't seem to have an agenda of expectations - just an agenda of events.  They had us engaged in discussions about meter accuracy and they also invited in representatives from the American Diabetes Association and the American Association of Diabetes Educators to talk with us.  I felt a little quiet during these discussions (thanks to the utter lack of sleep the night before, with BSparl not adjusting to the travel schedule and deciding to stay up until about 4 am), but I kept an eye on the RocheWANTED! reps during the chats, because I wanted to see what they were reacting to. (That, and there was this long table set up at the back of the room, where a few of the Roche team members sat, watching us.  So I went over to them and let them know I was watching THEM.  Now the student has become the teacher, grasshopper.  /Confucius rant)

Overall, discussions were interesting.  Meter accuracy has been a hot topic for a while now, with the FDA meetings and an explosion in the blogosphere, and it was a topic of utmost importance for me during the course of my pregnancy.  It amazes me still that meters are "allowed" to be 20% off, and that we almost have to choose accuracy over cost when it comes to test strips.  (More on that later.)  And while the ADA panel of guests answered questions, I still couldn't help but wonder how the ADA spoke for me, as a person with type 1 diabetes.  (More on that later, too.)  

But the Summit itself wasn't about the discussions or the agenda of our host Pharma company.  (Even though, and I'm being completely honest here - I'm impressed that Roche wants to sit in the same room with a bunch of bloggers.  We aren't known for being quiet or demure, that's for damn sure, and we don't have a penchant for butt-kissing.  So they get us and our opinions, raw and unadulterated.  Yet, this is the second year they've invited us to meet with them.  I remain impressed.)  The Summit is about bloggers getting to know one another offline, and whether or not Roche understands that aspect wins out over any Pharma agenda, it doesn't matter.  People power wins over scheduled discussions.

So thanks to the Pharma company that dared to play host to bloggers for the second year in a row.  And thanks to the diabetes blogging community, which plays a huge part in improving my emotional diabetes health. 

(Oh, and thanks to the Photobooth, which let Scott and I pretend to be lions in the first shot and let us see up George's nose in the last one.)

June 12, 2010

Six Week Follow Up.

Yes, I have used this image before.  Yes, I am lazy.  :)For the last year of my life, it's been a monthly visit to the endocrinologist, and then once I was pregnant, the dam broke loose and I basically had a cot set up at the Beth Israel/Joslin pregnancy clinic.  Oh yeah, and then I spent a month at the hospital while waiting for BSparl. 

I have doctor burnout, big time.

So I'm done with doctor's appointments for at least a few weeks.  Mentally, at least.  (Because there is another one scheduled for August - WTF?)  But last week, I had my last appointment, for a while.  I was up at BIDMC for my "six week follow up" appointment (which took place seven weeks after the birth), and I met first with my endocrinologist. 

"How are you feeling?"

"Tired.  That's normal for a new mom, right?"

"Exhausted is more normal," she said, as she opened up my file on the computer.  We ran through my vitals, going over the medications I'm taking, the ones I'm not bothering with anymore, and how my blood sugars have been reacting to new mommyhood.  

"I've had some really good days, but the bad days are like epically bad.  Like 300's and 400's kind of bad," I said, looking at the floor.

"We want to prevent those highs, and the lows that either cause them or follow them, but you aren't the first postpartum patient I've seen who is hitting these kinds of numbers.  It's normal.  You'll even out," she said.

My basal rates seemed to be okay, but we did some tweaking to my afternoon/evening insulin:carb ratios (going from 1:12 to 1:15, which is math beyond my capacity).  Overall, I've had some nasty numbers, but my endocrinologist reassured me that my A1C wouldn't be too awful, because I wasn't letting any of those numbers ride.  (And when she called me on Monday to let me know what my lab work results were, my A1C was sitting comfortably at 7.0%.  Some people might call that too high, but I'm calling it a wicked victory for me.)

After I met with my endo, I was off for my exam with the OB/GYN.  Not to be terribly TMI, but I can't stand the pelvic exams.  They are unholy and cruel and a very strange way to spend an afternoon.  (Not only that, but I can't figure out why I'm not allowed to greet the doctor while I'm dressed.  No, they send her in only after I'm clad in the awkward paper johnny, with my regular clothes balled up on the chair near the examining table.  And it was the first time I had met with that specific OB.  "Nice to meet you, too!  This is my floppy body.") 

Thankfully, I appear to be healing well, both inside and out.  My c-section incision doesn't hurt anymore, and even though my lower abdominal muscles are currently useless and squishy, I am recovering like a "normal person."  (Read:  Not a diabetic who has seen 400's three times in the last eight weeks.  Nasty.)  There is still a little bit of light bleeding (not from the scar, silly), but my doctors told me the bleeding can last as long as nine weeks.  (Yay.)  The scar is shorter, and a light pink color as it attempts to heal.  I can't see the staple holes anymore, and when I spy the scar in the mirror, I don't want to jump out the window due to grossed-out'ed-ness.  That's progress!

So I'm cleared for "normal life," which includes being able to pick up the carseat while the baby is in it, which means I am no longer tied to my house.  THANK GOD, because I swear I was hearing the cats talk about me - in ENGLISH - which means my mind was starting to leak out.  Onward!  To normal life!

(Normal life - ha!  That's redefined with each messy diaper and baby smile.)

May 28, 2010

You Know You're a Diabetic Mommy When ...

You know you're a cat-shaped rattle when ...You know you're a diabetic mommy when ...

  • The bottle of glucose tabs is just as important as the bottle of breast milk in the diaper bag.
  • You have already started wondering how you're going to explain "juice" as "medicine" to the kiddo.
  • When you wake up for 3 am feedings, they double as a 3 am blood sugar check.
  • You start cooing sweetly at your meter when it gives you a result of 100 mg/dl.  ("Oooh, what a good meter you are!  Yes you are!")
  • Your baby ends up with a dot of blood on the back of her pajamas from your middle-of-the-night blood sugar check that didn't stop bleeding right away.
  • When you talk about "the pump," you need to clarify "the insulin one, not the boob one."
  • Sometimes you have to draw numbers to see who gets to feed the baby.  And by "draw," we mean blood samples.
  • Nothing makes you happier than a full baby with a clean diaper and a full pump with a full battery.
  • You need a diaper bag just for diabetes supplies.
  • Your bedside table has just as many burp clothes as used test strips gathered at its base.
And when the Dexcom starts to BEEEEEEEP!, you wonder if it needs a diaper change.

May 26, 2010

Oxygen Mask.

Gotta wear mine before I can help BSparl.In the airplane safety manuals, they instruct you to, in the case of an emergency, put your oxygen mask on first, before assisting others with theirs.  Makes sense.  Can't help someone if you are in need of help, yourself.

Chris and I reference the "oxygen mask" all the time, mostly when I'm low.  During the course of the pregnancy, I had some wicked lows that kept me from attending conference calls, making it to dinner meetings, and even just meeting a friend out for coffee.  "I'm going to be late, but I need a few minutes.  Oxygen mask, you know?"  And Chris would nod, knowing that I was waiting until my blood sugar was stable before I headed out. 

But as I wrote about yesterday, I'm in the middle of The Suck.  Can't wrap my head around what I need to do in order to take care of myself, because I'm too overwhelmed with what my daughter needs.  The baby learning curve is pretty steep, and both Chris and I being schooled on just a few hours of sleep.  My baby is well-cared for, but my diabetes management has seen better days.

... so I guess my baby isn't as well-cared for as she could be.  Because I'm trying to put her oxygen mask on while fumbling with my own.  

Yesterday's post had some good ideas in the comments section, and I'm going to try and implement them going forward.  Like the testing suggestion.  I'm already testing my blood sugar before I feed the baby, so now I need to find other benchmarks in my day to assign testing to.  I'm working off a mental "even numbers" schedule today, making sure that I test at all the even hours.  I'm awake around 6:15 am every morning, so that means I get a 6 am fasting, and then a test every two hours. 

Some other things I simply need to make part of the routine.  So it becomes natural(ish).  Like the Dexcom.  That tool is extremely useful to me ... when I look at it.  For the last 11 days, I had a sensor in and the Dexcom was working great, but I wasn't looking at it.  The receiver would sit on the dining room table while I worked on my laptop and I'd barely pay it any mind.  Then, one night when it was pinging because I was high, I turned off the high alarm so that it wouldn't wake up BSparl.  Being the dingbat that I am, I left the high alarm off.  For four days. WTF?  What's the point of wearing the device when I'm not using it when I need it most?  Today, a new sensor goes on and I'm determined to reset the alarms and to actually use the data.  (Otherwise, what's the point?)

And then there's what Chris and I call "life stuff." Like remembering to call in my reorder for insulin to my mail order pharmacy.  And then remembering to pick it up from the mail drop.  Or remembering to throw a bottle of glucose tabs in my purse or the baby bag, or grabbing a back-up insulin pen, or making sure I have enough test strips in my meter case to get through the day.  Maintenance.  Life stuff. 

But I can't do all this stuff at once.  Baby steps, right?  Today, I'll start with testing more frequently and rearming myself with the Dexcom.  I threw a bottle of glucose tabs both into my purse and the baby bag this morning, and I called in my insulin reorder a few minutes ago.  New bottle of test strips is floating around in my purse.  Small changes that will hopefully make a big difference in how things roll out, diabetes-wise.  Because the better care I'm taking of myself, the better care I'm taking of the little BSparl baby.

Oxygen mask, you know?

May 25, 2010

The Suck.

Bright?  Not me these days.While motherhood is going well and I'm completely in love with my daughter, I'm reminded, daily, that diabetes doesn't care if I've slept or if I have carefully counted carbs or if I've just changed my infusion set.  Diabetes doesn't give a shit about my schedule.

It's The Suck.

Like last week, when at 4:30 am, my "alarm" went off - also known as BSparl starting to fuss and wail from her bassinet in our bedroom.  Not a problem.  I woke up, tested my blood sugar, and saw that I was 176 mg/dl.  That number (albeit spiky) works just fine for feedings, so BSparl and I spent some quality time hanging out, having an early snack, and debating where exactly the sun hides behind the trees before it starts to poke out.

We both went back to bed around 5:45 and slept until the next alarm went off - the Dexcom BEEEEEEEP!ing wildly at me at 8 am.

"Do not wake up the baby, you."  I grumbled while fumbling for the receiver on the bedside table.  "LOW.  Under 55 mg/dl" was the warning it was flashing up at me.  While BEEEEEEEPing.

"Shhhhhh!!"  I unzipped my meter case and deftly stuck a strip into the top of the machine.  I wasn't sweaty, my brain was functioning fine (aside from shushing inanimate objects), and I felt physical capable.  Maybe the Dexcom was just being finicky and throwing lower numbers?

"36 mg/dl"

Well shoot.  Not a whisper of a symptom, either.  I got up from the bed and wandered out to the kitchen, where Chris was making his protein shake.

"Can you keep an ear on the baby?  I'm 36 and just want to grab some juice," I said, opening the fridge door.

"Of course."  Pause.  "What?  You're 36??"

"Yeah.  No symptoms, dude.  Not even one."  I chugged a few sips of grape juice and put the bottle back in the fridge.  "I feel fine.  The Dexcom woke me up."

A blood sugar of 36 mg/dl without a single symptom, other than a wailing Dexcom and a bit of a groggy feeling.  But, in true diabetes form, once my blood sugar started to rise, I felt the symptoms acutely. 

"I feel pretty bad right now."  Shunk.  "Fifty-six.  Why do I feel worse at 56 than I did at 36?"

There's no rhyme or reason to diabetes.  The symptoms of lows and highs change with the seasons, it seems.  And they come without warning, these numbers.  Sometimes it's a hormonal or emotional surge that sends numbers pinging.  Other times, it's a little, teeny technical glitch that sends thing spinning.

Like two nights ago, when I bolused for a snack and felt a damp spot on the side of my shirt.

"What the ..." and I probed with my fingers and felt that telltale wetness around the gauze of my infusion set.  I tugged up the side of my shirt and gave the spot a sniff - yup, that bandaid smell.  Frigging infusion set was leaking some how.  No symptoms, though.  I wasn't thirsty, I wasn't lethargic, and I was actually just about to head off to the gym.  I felt pretty okay.  Problem was, I hadn't tested in about four hours, nor had I peeked at the Dexcom.  So basically, I didn't have a clue what was going on in my body. 

I tested my blood sugar and a 423 mg/dl grinned back at me.   

(Have I mentioned Yosemite Sam yet in this post?  Suffice to say, I rocketed through a list of curse words that would have caused Yosemite Sam to give me a frick-a-frakin' high five.)

New site, quick injection with an orange capped syringe from the fridge, a ketone test (negative), and an hour and a half later, I was down to 195 mg/dl.   But I was pissed.  Because during the course of my pregnancy, I maintained an A1C between 6.0% and 6.5% and I busted my butt to keep myself controlled.  But now, with my body reacting to adjusting levels of hormones and a serious lack of concentration due to a truncated sleep schedule (read:  no sleep 'til Brooklyn, with Brooklyn being college, I think), I'm all over the map. 

I'm frustrated with my control, or lack thereof.  Trying to figure out my post-pregnancy insulin needs and taking care of my little girl have become a full-time endeavor, and I'm not getting it completely done on either front.  I have to buckle down.  These epic lows and highs are not fun, and are wrecking havoc on my healing body. 

Next week, I'm back at Joslin to see my endo.  Diabetes needs to take center stage until I can get things under better control.  It's my priority.  I need to get back to logging, to testing every hour and a half or so during the day, to actually cooking meals instead of just snacking when time allows, to changing my infusion set when it's due, not when it's convenient. 

... after diaper changes, of course.  And breastfeeding.  And BSparl laundry.  And pediatrician appointments.  And 3 am feedings.  And that occasional moment when I lock the bathroom door and look at myself in the mirror with determination and say, "Get it together, Mommy."  

May 10, 2010

A Day in the Life of a New Mom with Diabetes.

For D-Blog Week, Karen challenged the diabetes blogging community with a week's worth of blog prompts. Today is "A Day on the Life," and I've decided to focus on my new life with BSparl.  (Because if I tried to pretend that motherhood isn't affecting my diabetes, I'd be lying my face off.)

DING!!!  Game on.

A day in the life of a mom with diabetes5 am:  Alarms?  We don't need no stinkin' alarms.  Because now we have little baby girl who wakes us up at all hours of the night. 

When BSparl starts to fuss from her bassinet, either Chris or I leans up to check on her to make sure she's okay.  Since Chris usually does the 1 am feeding with a bottle, I try and do the 5 am feeding.  Since I'm breastfeeding, what I need to do first is check my blood sugar.  Anything less than 120 mg/dl and I'm snacking while she's eating.  I start this feeding at 98 mg/dl.

5:15 am:  BSparl is done with one side.  I switch her to the other side to finish eating, and I brush the foil wrapper that the fruit snacks came in to the floor.  

5:45 am:  BSparl is fed, burped, changed, and tucked back in.  I test my blood sugar again - now I'm 74 mg/dl and the Dexcom is showing a bit of a drop.  I wander out to the kitchen for peanut butter and a piece of toast.  (Not froast.) 

7 am:  Up again, only this time because the Dexcom is blaring at me.  49 mg/dl.  WTF?  Breastfeeding has very unpredictable effects on my blood sugars.  Some mornings, it doesn't make me low at all.  And then other mornings, it makes me plummet.

7:30 am:  BSparl and Chris are asleep in the bedroom, so I settle in on the couch with my laptop and a cup of tea.  My goal?  Answer some emails, write a blog post, finish some stuff that always seems to be due and I'm chasing the deadlines of, and use the breast pump to stash some milk for BSparl.  My insulin pump tubing sometimes gets tangled up in the breast pump tubing.  Which makes me think I'm wearing too many freaking pumps.

9 am:  Husband and daughter emerge, both sporting the same furrowed brow of the morning.  BSparl needs to be fed again, so I test my blood sugar to see where I'm at.  145 mg/dl - thank goodness.  Enough with the lows.  Bring on the BSparl!

11 am:  All of a sudden, it's almost noon, and I haven't eaten anything since 7 am.  I also haven't answered a single email.  Or finished the article I needed to finish.  My mornings are usually spent testing my blood sugar, feeding BSparl, changing her diapers (which have baby Sesame Street characters on them, which makes me laugh.  Because what do you call "Baby Big Bird?"  Little Bird?), and doing laundry.  I test my blood sugar - 118 mg/dl - and thank God that it's not pinging all over the damn place today.  Because some days it does. 

High Noon:  Still haven't eaten.  I force myself to stop and devour a Greek yogurt.  Blood sugars are holding steady.  But my pump site is aching a little - when was the last time I changed out the site?

Noon-thirty:  BSparl and I investigate the site.  Well, she hangs out in her bouncy chair on the bathroom floor while I take a look at the infusion set.  Looks fine - edges are peeling a bit - but it's only been four days.  Even though the reservoir isn't anywhere near empty, I opt to change the site because it's achy.  And because if I don't do it now, while I'm thinking about it, it will be another full day before I remember.  With all of my focus on BSparl and adjusting to life as her mommy, sometimes diabetes takes a wicked back seat.

1 pm:  New infusion set is in, baby girl is getting a bottle of breast milk because my own breasts need a break sometimes, and I still haven't answered one single email.  Is this why people take maternity leave?  I need some coffee.

2:15 pm:  Thirsty as all hell.  Test again - oh, that's nice.  233 mg/dl.  Frigging pump site change ... did I forget to take a little 0.3u bolus before pulling the site?  That seems to be the only way for me to avoid post-site change highs.  But of course, I had forgotten to do that.  And now I'm basking in the warm warming glow of a high blood sugar.  FanTAStic.  Still haven't eaten lunch, and now lunch is on a further delay due to the high.  I bolus down the high.

2:45 pm:  Dexcom shows that I'm dropping.  Meter confirms the same - 177 mg/dl.  Thing is, with the baby now out of me, I'm trying to figure out what my body's insulin needs are.  And that's tricky, because with breast feeding, I am never able to do an accurate basal test.  I have an appointment with Joslin in two weeks (for my 6 week follow up after surgery/birth), so I'm trying to log blood sugars to give my endo something to go on.

2:46 pm:  CRAP!  I haven't logged any blood sugars in three days!  With BSparl in my arms, I open up my laptop and try to find the spreadsheet.  I locate it, and then try to scroll through my meter memory and type the blood sugars into the spreadsheet using one hand.  BSparl decides this isn't a good time for her, and she makes a sound not unlike a can of shaving cream being deployed.  (She is a delicate, fragile, pooping flower, this child of mine.)  Diaper change time!

3:30 pm:  Lunch.  Finally.  Blood sugar is 109 mg/dl.  Lunch is a turkey and cheese sandwich, even though I'd much rather go low-carb these days to help lose the pregnancy weight.  But without carbs, I'm low all the time after feeding BSparl, so carbs it is. 

4 pm:  Time to head out to the grocery store and then to the post office.  BSparl hangs at the house with her dad while he works, and I test once more before getting into my car.  167 mg/dl.  How is the post-prandial that high?  I counted those stupid carbs.  My insuiln:carb ratio, I thought, was settled back into 1:12.  I need to test that ratio again, but no time today.  Must run errands.

4:04 pm:  As much as I love my daughter, I felt guilty blasting the Beastie Boys while she was inside of me.  Without her in the car, I can crank up the volume of the music again.  So i do.  As I head to the grocery store.  Damn, my life is a thrill a minute.

5 pm:  Walking out of the store, I realize that my Blackberry has been pinging for three hours and I haven't looked at it yet.  Checking the emails, I see that 75 emails have come in since 7 am.  And I STILL haven't answered a single one.  Whoops.

6:30 pm:  It's time for BSparl's dinner.  And then we read a book together - I like Dr. Seuss, but sometimes we read other books because I can only make my mouth navigate words like "Th'need" so many times before I start to either giggle or accidentally spit on my daughter while reading.  

7:45 pm:  Chris heads down to the gym and I prepare to go when he gets back.  (No, I'm not really "exercising."  Can't for another two weeks, due to the c-section.  But I can go for walks on the treadmill, so that's what I do.)  I test my blood sugar (139 mg/dl) and get all my crap together for the gym:  Dexcom receiver, meter, cell phone, reaction treaters, and that ever-elusive pair of workout pants that actually FIT. 

9 pm:  Back from the gym, blood sugars are steady for once, and BSparl is napping.  FINALLY, I answer some emails and finish up that article.  Oh crap - dinner!  I find something in the kitchen that doesn't require much assembly.

11 pm:  I realize that, since 5 pm, I've either fed BSparl or pumped six times.  How is that even possible?  Sure does account for the unpredictable blood sugars, though.  My body is in a constant state of "feed," making trends nothing short of chaotic.  And I have to be honest - I'm not sure I have the mental bandwidth to wrangle in diabetes and motherhood with any kind of precision these days.  Working off of very little sleep, and trying to understand the new swell of hormone changes in my body, is frustrating as hell.  Diabetes fine-tuning isn't my top priority these days.  I just want to coast as safely as I can at the moment.  (Note to people who may want to lecture me about my own health: Back off for a few weeks before you run cryptic commentary.)

Midnight:  What am I thinking, still awake??  BSparl will be up in two hours for her 2 am snack.  I'd better restock the bedside table with low blood sugar snacks and call it a day.  

Midnight-thirty:  Whoops, forgot to test.  94 mg/dl.  Dexcom confirms it's a steady number.  Off to bed!

Game Over ... until 5 am.  :)

April 16, 2010

Looking Back: Between Dinner and a Movie.

I didn't appreciate everything my parents did for me as I grew up with diabetes, but hindsight being 20/20, I definitely have an appreciation now for their hard work and dedication to not only my health, but keeping the family's routine as "normal" as possible.  And now that I have a child of my own, that appreciation is deeper than I thought possible. 

This post ran here last summer, and I still mean every word.  (Including the bit about the alligators in the carpet.  I know my brother and sister and I weren't the only ones who avoided them!) 

*   *   *

Saturday nights when we were very small were the best. 

We made blanket forts and used every damn cushion in the couch.  Laying pillows on the floor, we'd jump from down-filled island to island, pretending that the carpet was infested with alligators and only by balancing on the pillows would we be safe.

The babysitter always promised to make healthy dinner, but usually we ate popcorn, chicken fingers, and drank diet soda by the bottle, filling the glasses to the very brim and frantically slurping the carbonated foam awayI loved this doll.  I even pretended she had diabetes.  Which is a  bit odd. before it could spill over.

My favorite babysitters were the ones who played with us, not just sat there and talked with their boyfriends on the phone.  Carolyn was my favorite one of all and I named my Cabbage Patch doll after her that year.  She was pretty and smart and the characters she pretended to be were so clever.  She was the perfect example, to me at seven years old, of what a 'hero' really was.

My parents had a standing Saturday night "date night," and they would go out to dinner either alone or with some friends, then maybe to a movie.  Usually they left when it was still light out, while we were still outside playing in the yard or just coming in to have a snack.  My brother and sister and I played and fought and made messes and told stories and generally destroyed the house, like little kids do.

Only now, when my memory is jogged, do I remember the headlights pulling back in the driveway, between when dinner ended and the movie began. 

Dad would wait in the car while Mom ran in quickly to test me and give me my bedtime insulin injection.  Then she'd say goodnight to all of us and run back out to the car to continue "date night."

Only now do I remember those moments and wish I'd named "Carolyn" after my mother, instead.

April 13, 2010

Diabetes During the C-Section: Here's the Plan.

Preparing for the diabetes part of BSparl's birthI've received a lot of emails about the how diabetes will be handled during the actual "birth" of Ms. Bsparl, and while I won't have all the details until it's all over with, I do have a few answers for now.  I talked with my OB (who will be performing the c-section) and my team at Joslin about some of the details.  This might be a detailed, kind of boring post, but I wanted to make sure I'm answering all the questions possible! 

Here's what I know so far:

On Wednesday night, an IV will be "installed" in preparation for the insulin drip.  I'll still have my insulin pump on, though.  As of midnight on Wednesday, I won't be able to eat anything from that point until post-surgery, so the IV will be at the ready in case I go low during the course of the night.  In the event of a low blood sugar, my team will do one of the following:  suspend my insulin pump, administer glucose through the IV, or potentially allow me to drink apple juice, depending on the circumstances. 

The c-section will be first thing in the morning (8 am), so the night before will be spent checking my blood sugar with the glucose meter every 30 - 45 minutes to ensure the tightest, steadiest control possible.  In my circumstances, I plan to keep the Dexcom connected throughout the night, too, to help with that goal.

The morning of the c-section, I'll get up wicked (pissah) early (5:30 am, I think) and I'll rip out my insulin pump and remove the Dexcom sensor.  The nurses will hook me up to the insulin drip and my blood sugar will be monitored - wait, strike that.  Stalked.  :)  I'll be hooked up with the drip, etc by 6:30 am and up to the delivery room.

We'll move into the operating room and my blood sugar will be monitored stalked by the Joslin team while the OB/GYN team prepares to deliver my baby girl.  Chris will be in the waiting room while they administer a spinal epidural (Do not Google this, because it will make you cringe.  I made the mistake once of Googling it.  Never again.  It made me want to give birth orally.) and then they will ensure that my lower half is numb and ready for surgery.  Chris will scrub in and be brought in to the room, where he'll be situated up near my head and the surgery will begin.  My team said that Chris is welcomed to hold my meter and test my blood sugar at our discretion, and the Joslin team will be doing the same using their meter or mine, depending on our preference.  But if I feel nervous about going low, etc, I am able to keep tabs on my own numbers. 

During the course of the surgery, I'll have a regular IV in for fluids, etc, and then the insulin drip will be combined with a glucose drip, the contents of which can be adjusted based on my blood sugar needs.  So if I start to spike, they can increase the insulin titration.  If I start to drop, the glucose can be turned up.  All of this is handled by the Joslin team, so my OB team can concentrate on BSparl's escape.

According to my doctors, the whole c-section will take about an hour, from start to finish.  Bsparl should be in Chris's arms by 8:30, and I should have all my pieces back together again by 9:00 am.  I'll be brought to the recovery room and Chris and BSparl will join me soon thereafter, barring any issues.  The insulin/glucose drip will remain in until I'm able to eat something, at which time the pump will be reconnected (by me), and after an approximate 30 minute overlap, the insulin drip will be removed. 

The Joslin crew told me that my postpartum insulin settings on the pump will be a whisper of what they were during the pregnancy, and about a third of what they were pre-pregnancy.  At this stage, they're assuming that I'll jump down to a midnight to midnight basal rate of 0.3u, an insulin-to-carb ratio of 1:20, and a sensitivity factor of 1:80.  (My pre-pregnancy basals were more around the 0.4 - 0.6u range, an I:C of 1:10, and a sensitivity factor of 1:55.)   And once I'm breastfeeding, all bets are off as to how that activity could affect my blood sugars.  Only time will tell. 

So that's the low-down on how the diabetes, at least, will be handled during delivery.  I don't want to think too much about the surgery itself, because it freaks me out.  But handing over all of my diabetes control also has me a little tweaked.  After over 20 years of doing it myself, it's hard to grasp the concept of "let someone else handle it entirely."  But I know I'm in capable hands with Joslin, and I know that my focus needs to be on the baby. 

She's worth every hurdle that we, as a family, have overcome to make it to this point.

Because at some time during the whole ordeal, her little teeny cry will cut through all the noise, and in that moment, I'll become a mom. 

April 02, 2010

Day Seven in Captivity.

Little on the down side today, thanks to having just marked one week "in" and with still two to go.  What the hell is there to write about, from the mind-numbing confines of my hospital bed?

At the moment, BSparl and I are hooked up to the fetal monitoring system, and I can hear her heartbeat pumping along like a rhythmic Clydesdale and can see the movements of her little 5lb, 5oz body being tracked on the graph.  It looks almost seismic, like a BSparl earthquake.  


They haven't checked the protein levels in my urine in a day or two, but things appear to be holding steady.  Blood pressure is climbing ever-so-slightly, but monitored constantly, and there's room for titration in my Labetalol medication (read:  they can give me more of that crap).  Still rockin' the heparin injections twice a day (hate) and still not sleeping through the night thanks to the monitoring.  (Which I understand the necessity of, but it's not making for "relaxing bed rest."  Bed rest is a misnomer.  This is more like jail where the wardens grin and mean well.)

One of the hurdles I'm having a little trouble with is the diabetes management aspect of things.  The Joslin team comes by once a day to review blood sugars and make suggestions, and they are the experts in all-things diabetes.  However, I am the expert in all things specific to MY diabetes, so I've been working hard to achieve a tolerable blend there.

For example, one of the (very nice, very knowledgeable, mind you) endocrinologists had some commentary about a post-prandial blood sugar of 137 mg/dl that I had two days ago.  In my mind, 137 mg/dl an hour after eating is downright badass, and I'm very happy with it, especially considering that the pre-meal number was 84 mg/dl.  Good control, in my eyes.  

"Well, this is a little high.  We'd like to get this post down."

I don't mean to be rude.  I try to be a good patient, a "patient" patient, and to find that careful blend I had mentioned, the one of my non-medical knowledge and their medical knowledge of diabetes.  But it was 8 in the morning.  And it was the third time I had been woken up by a doctor who wanted to review my goods.  And I didn't agree that 137 mg/dl post-prandial was too high.

"Really?  Too high?  I don't see it that way.  I think that's a number to aim for, especially seeing as how I leveled out to 98 mg/dl at the two hour mark.  That's a respectable peak, don't you think?  Otherwise, I'd be treating a low at the two hour mark."

"Yes, but it should be lower than that."

And I sort of lost my cool.  

"Okay, well how about we all call the FDA and get them to tighten up their requirements for 'what's accurate' to something a little more precise than 20%, and then we can start griping about a 137.  Because for all we know, that 137 mg/dl could actually have been a 110 mg/dl, and then I'm right in the acceptable range, right?"

(I am Kerri's terrible, bedrest-fueled, pregnant rage.)

They agreed that 137 was okay.  And that revisiting my post-prandials after another day of review would be a good idea.  And then the fleet of them shuffled out the door.  I felt bad about blowing off steam, but really - I'm in no way a "perfect diabetic," but these days, I'm running really tight and carefully with my numbers.  Let's remember that the reason I'm having post-prandial peaks is because - oh yeah - I have diabetes?

It's challenging, that feeling of having people take my diabetes management control away from me.  Not that I have all the answers or have it all figured out, but I've been living with this a long time and my own instincts and experience should be as strongly considered as the vast medical knowledge of my new, trusted caregivers here.  I'm no diabetes expert, but I'm pretty well-versed when it comes to "Kerri."  ;)

Eventually, I'll find a way to balance my issues with control while "in captivity," but until then, I may need to vent here a bit.  Because I'm pretty sure they're not reading me. 

... Whoops.

March 02, 2010

Questions About Growing Up with Diabetes.

Rockin' it old school.  Where's my gel pen?No WAY could I ever claim to "counsel" parents of kids with diabetes.  I'm not an expert, I'm not a doctor of any kind, and I don't have the first clue as to what I'm doing 90% of the time.  

So.  That being said, I will admit that I've emailed with lots of parents of kids with diabetes, and I've gotten so much out of that glimpse into what it's like to be the parent of a CWD.  Not counseling, but listening.  And learning.  Talking with these different parents has given me a whole new level of respect for what my mother and father did for me, growing up, and how I view my diabetes as a result of their care.

Over the weekend, I received a few questions from a parent that I couldn't quite wrap my head around.  They were big questions, the kinds that require coffee and one of those old school composition notebooks (and a phone call to my mom) to sort out in my head.  Here's my take on this mom's questions about growing up with diabetes:

How well did your parents do in managing your diabetes until you were able and independent?

I can't say my parents did anything short of remarkable work when it came to my diabetes.  And that goes for every parents of a CWD that I've met in the last few years.  I was diagnosed just before second grade, and my family didn't know anything about type 1 diabetes, let alone that it could ever effect their daughter.  They brought me to the hospital and stayed there with me for 12 days, learning how to inject insulin into oranges using syringes that they would eventually plunge into my own skin. 

My mother, in particular, took her role as "my pancreas" very seriously, and worked tirelessly to control my difficult blood sugars.  She tested me every morning when she first woke up, the sound of the ziiiiip on the black meter case stirring me just enough to poke my hand out from underneath the covers so that she could lance my fingertip.  She carried measuring cups in her purse and had a food scale in our kitchen.  My pancreas wasn't working hard enough, but my mother was.

This isn't to say that we were "perfect" in managing diabetes, or our emotions, or that we had one of those "unicorns and rainbows" types of relationships.  My parents and I battled endlessly about all kinds of stuff, from cleaning my bombsite of a room to my propensity to drive too fast to fighting over the boys I wanted to date to the diabetes I didn't want to control all the time.  Fights were part of the routine, but it wasn't because of diabetes.  It wasn't despite diabetes.  Diabetes was just part of the stuff we fought about. 

(And on the whole "able and independent" part, I'm still not fully either of those things.  I'm able to take care of myself, but I still lean on my parents, and my husband, and my friends for support.   And while I'm fiercely independent, I still need, and want, their help.)

Did you resent them?

No.  I never resented my parents for any of this diabetes stuff.  Not even when I wanted to convince myself that it was hard because they made it hard.  Diabetes is hard because it's diabetes.  Sure, my mom and I had blow outs about when she would say "We have to test our blood sugar," instead of "You have to test," but I grew to understand how much she was truly involved, even though I wasn't aware enough at the time

I've resented diabetes, though, which I know is hard for my parents to hear (and to read on this blog).  I do not like it, I didn't invite it, and I'd sell it to the lowest bidder without thinking twice.  I resent it for making me write To Do lists that a child has no right even worrying about, and I resent it now for making me feel for a kick from BSparl every time I have a blood sugar spike during the course of my pregnancy.  But my parents - my whole family and friends support team, honestly - have tempered that resentment for me by supporting me.  They don't coddle me, or tell me that "Things will be fine" or "Sure, you can go ahead and not care about diabetes."   They understand that this disease is serious.  And unfair.  And only sort of manageable.  But also that it doesn't have to own me.  It never has.  And it never, ever will.

What is one thing you could tell me to do that will make make this easier on [daughter's name]?

Blame the diabetes, not yourself.  Or your child.  Let her know that it's you and her against this monster, and you'll always fight beside her, not against her.  You're in this together, and she'll never be alone.

But Reader, you'll never be alone, either.  You've got all of us.   For the long haul.  :)

I wanted to give my answers to this mom of a little girl with newly diagnosed type 1 diabetes, but I also wanted to offer these questions up to you guys.  To get more than just my perspective, because so many of us have grown up with type 1 diabetes and might answer these questions in completely different, completely honest ways.  If you have insight to offer, please do! 

February 26, 2010

Diabetes 365: Diabetes is Every Day.

There's been a handful of photographers who have tackled the Diabetes 365 project for this year, and I'm proud to be in their company.  It's a very inspiring experience, to see how diabetes is reflected in the lives of the members of D365, and how it is captured through their camera lenses.

An update on Diabetes 365

Some of us are using our DSLR cameras, some of us our point-and-shoots, some documenting with our iPhones or our Blackberries, but every last one of us is showing our lives with diabetes, every day.  I know I've talked about this project before, but watching the photos stack up in the Diabetes 365 Flickr group and seeing how, and what, people with diabetes are choosing to document their lives with this disease is incredible.

You didn't need to join the group in January - it's a rotating door of participants.  If you want to join the Diabetes 365 group, you can jump in anytime and start.  Every day can be Day 1.  

February 25, 2010

Free Shower.

I love "free shower" - which, if you're diabetic and using an insulin pump or a CGM, you know that means "the shower when you're changing sites and you don't have any hubs connected to you."

It's nice to lather up and not worry about catching on an infusion set or a sensor edge.  Thing is, this is what's waiting for me when I'm done getting all cleaned up:

Oh I love me some free shower.
The potlock o' diabetes crap

Yesterday was "free shower" day for me, which is a rarity now that I'm wearing two devices.  The chances of an insulin pump change synching up with a Dexcom sensor change are pretty low, so when I'm swapping both, it's particularly nice.  And this scene on the bathroom counter is what needs to be reapplied after the fact.

That's the potluck of diabetes devices:  the Dexcom sensor, transmitter, and receiver, and then the insulin pump, infusion set, cartridge, and little bits associated with pump site changes (like that all-important insulin).   If you look fast, you can almost fool yourself into thinking it's a photo of make-up stuff, like any lady would have on her bathroom counter.  But the Sparlings don't have a "powder room," - we have a "site change room." 

I'm adjusting, though.  Don't we all?  Back when I first started pumping, I was freaked out about the whole "external symptom" because I'd existed 17 years without one.  Popping in those first infusion sets and clipping on the pump was a very surreal experience, and one that it took me some time to get used to.  ("Do I look like a robot?  Not really, but sort of.  Am I okay with looking a little like a robot?  Do I get special powers?  No?  That's only super heroes?  Okay, well what do robots get?  They're maids on the Jetsons?  WTF?"  The internal monologue was constant back in those days.)  Adding in the Dexcom sensor and receiver sent me back into that "Wait a minute ... I'm now like a SuperRobot!" mode. 

But now, it's been six years with a pump.  And almost two and a half years with the Dexcom.  So while free showers are nice and I like that feeling of not having anything attached, once I put on the new sensor and the fresh infusion set, I still felt fine.  The sites don't look so scary anymore. 

They look ... almost right.

(Note:  But it may be the ever-growing belly that's making things look more proportionate lately.  Ask me in eight weeks. :) )

February 24, 2010

The Good, The Bad, and the Eh.

The good, the bad, and the egg.  I mean, the eh.We'll start with The Bad:

  • Getting my sorry arse to Boston proper yesterday should have been a quick ride.  My first appointment was at 8 am, I was leaving my house with an hour and 15 minutes to spare (I had hopes of grabbing breakfast before my appointment and getting a little work done on the trusty laptop) but traffic on the way into the city dashed all hopes of getting there on time.  It took me two hours and fifteen minutes to make a 35 minute drive.  Needless to say, I was livid by the time I had arrived at Joslin.
  • And while I'm driving, I'm watching my blood sugar climb.  Crap on several levels, because as I edged closer to 170 mg/dl, I started to wonder if my insulin to carb ratio needed to be changed, I fretted about the effects on the baby, and I also realized that two hours in the car at an elevated blood sugar equaled "OMG I have to pee like you read about."
  • Also, felt a dampness in my armpit and became disgusted with myself, realizing I was sweating through my shirt?  Gross, Kerri.  That's just gross.
  • Arrived at my appointment 30 minutes late, they squeezed me in, and after I gave a urine sample, they told me that I was spilling ketones for the first time in my pregnancy.  FanTAStic.

Which leads me into The Eh:

  • Turns out that my blood sugar was climbing because my infusion set wasn't connected to my body.  The pump was on my hip, the site in my arm, but the two weren't joined at the set, leaving every bolus and every basal unit pooling into my armpit.  Thus explaining the stain on my shirt (and the fact that what I thought was sweat was, instead, vital insulin units).  Two hours without insulin explained the high, the headache, and the ketones.  And also made me feel extremely dumb.
  • My eye dilation was deemed "inconclusive" by the retinologist.  She said that my right eye was perfectly fine, but the left did still have two spots close to the macula.  Again, less an issue with the spots themselves and more with their precarious location.  "But I feel comfortable with you attempting a vaginal delivery.  But if you have a long labor, or a difficult labor, you'll need to have a c-section."  My initial response was "Oh, but I'd really like a healthy baby and healthy eyes for myself, so would a section be a better chance at having both?  Or do you just want me to push, possibly harm my left eye, and then possibly still have the c-section?  Does not compute."

But thankfully, there's still The Good:

  • BSparl remains at a steady, healthy weight, and her heartbeat was lovely enough to make my own skip a beat.
  • My doctor called me at nine o'clock last night to tell me that she reviewed my eye exam with the other high risk OB/GYN and they feel confident in recommending a c-section.  Their main concern is the Factor V Leiden issue, which could cause a clotting concern with the delivery wound, but I've already had my medical team advise me that I'd be on Heparin for a few weeks after delivery.  They just want the baby out safely, and for my eyes to remain intact.  I'm on board for that, as I'd like to be able to clearly see this creature we've created. 
  • And now I know how she's arriving, and I can start Googling that and freaking out.  No, I know not to Google and not to completely melt down.  But honestly, the whole "giving birth" thing, no matter the method, has made me nervous for years.  And it's strange to know that in eight weeks, I'll be doing it.

Which brings me to the best part of The Good:  Only 64 days until I can hold her in my arms and tell her I love her.   It's on. 

February 19, 2010

It's All Rainbows and Unicorns.

I love BSparl.  I love her little feet and her pouty lips and that feeling I get when she rolls around inside of me.  I love knowing that my daughter is just a few weeks away from becoming a part of our Sparling family, and I know that every moment of this pregnancy is completely worth every iota of effort and worry.

That being said ...Rainbow not included.

I'm starting to lose my mind a little bit.

I've blogged about the details of the doctor's appointments, and the ultrasound scans, and the way that diabetes has impacted my pregnancy, and vice versa.  But by the end of my posts, I feel better having purged the feelings and worry.  And I want to reassure women who have type 1 diabetes that a pregnancy is possible, and enjoyable, and like they all say - so, so worth it.

But, like I said, I'm starting to crack a bit.  On Tuesday, I'll be at 30 weeks, seven and a half months pregnant with just under nine weeks left to go.  And these last few weeks have been ... well, not exactly rainbows and unicorns.

  • Like last week, when a string of 200's had me bump my basal so high, on the heels of amped up nerves, that I overdid it and ended up with two 50 mg/dl's in the middle of the night.
  • Or on Monday, when a carefully measured breakfast and a carefully calculated bolus, delivered 45 minutes before the meal, sent my blood sugars rocketing up to 248 mg/dl and held there for two hours.  
  • Or the other day, when i realized that pregnancy is actually ten months long, not nine.  Damn lunar months, and why the hell didn't someone give me a head's up about that?
  • Or that yesterday, Joslin gave me the run down on the rest of my appointments that are scheduled.  There are 20 of them.  I don't understand how people manage a high risk pregnancy and keep their jobs. 
  • Or that next week, I'm having the eye dilation that will determine BSparl's method of arrival, and I'm really nervous about it.  I'm nervous about vaginal birth or c-section.  Doesn't matter.  Just "giving birth" has my stomach twisty.
  • Or the fact that I'm craving carbs (nasty carbs, like cheeseburgers and chicken nuggets and pastries) and am having a very hard time not caving to these cravings.  I can't have anything even close to a sleeve of Ritz crackers in the house or they will disappear within a day's time.  I'm ravenous for these rotten carbs, and I've crocheted three scarves in efforts to curb the cravings.
  • Or that every time my numbers are out of range, I want to hold her little hands and tell her I'm sorry.
  • Or yesterday, when a perfect Dexcom flatline overnight was shaken by a cheese stick and a cup of decaf tea, leaving me with a blood sugar of 350 mg/dl and on the cusp of a panic attack.  What does this do to my baby?  Is she okay when I'm spending an hour over 300 mg/dl, without much food at all in my system?  Does she hurt when I am chugging water and stressing out but trying to control my emotions because I want her little womb to be serene and calm, not the spin cycle of diabetes chaos that I am so good at tossing her into lately?

Diabetics have healthy babies all the time.  I know this.  I've read this, others have proven this, and I hope to write those words myself in a few weeks.  But honestly, the mental part of pregnancy is more than I was prepared to deal with.  The guilt of every blood sugar and every miscalculation makes my heart ache, and I have found myself praying more in the last seven months than I ever have the thirty years before. 

I want to paint that "rainbows and unicorns" picture for you guys.  I want to make pregnancy seem like it's the most beautiful thing on the planet and even a person with type 1 diabetes can see the nine (ten?!) months through safely.  But as my delivery date draws closer, I'm not sure.  And I'm scared.  And I feel stupid because I have zero control over my emotions these days, leaving plenty of tears in my wake. (I've become a mega-wuss.)

Ugh, downer of a post.  I really can't wait to have the baby, but I know that part of why I want her out is because I believe she'll be safer once she's in the world and outside of me.  I know that Chris and I can take care of her, as parents, and keep her as safe as any other couple who loves their child.  It's the whole "now" process that has me in knots, wondering if I'm taking good care of her now.  I want the absolute best for my daughter, and I feel so guilty because I know that my body creates a challenge in some ways.

Just a few more weeks.  Every test, every infusion set change, every moment of blood work, every doctor's appointment, every time I pay the co-pay or the parking garage fee, every refilled prescription, every new CGM sensor, every curbed craving ... everything.  Everything is worth it if I can get to the end of this and have her out, safely. 

And then she and I will get matching mommy and daughter tattoos - hers a rainbow, and mine a unicorn.

(Note to people who may think I've completely lost my mind:  Kidding about the tattoos.  But I might buy her a t-shirt.)

February 15, 2010

Disclosure: I've Got One.

Disclosure is the responsibility of the blogger, and we’re under more scrutiny these days than ever before.   But I’ve never had an issue with transparency here – actually, I think I tell you guys way more than you probably want to know.  You knew when I started and stopped working for dLife, you know what publications I’m contributing to regularly, and you know about my relationship with Dexcom.  This blog is about my life with diabetes, and even though I know this is my life that I’ve decided to share, it’s important to me that people know my professional relationships with diabetes companies.  I’d want to know that information if I were reading this blog, too.

So (long winded intro to this post, eh?), I wanted to continue to keep you guys in the loop.  I’ve decided to sign a sponsorship agreement with the Animas Corporation. This whole thing started a few months ago, when I was exploring the idea of a new insulin pump and was excited about the Animas/Dexcom integration (no, I don’t have a CLUE when that’s happening, but I’m mighty hopeful it does go through in 2010).  But I’m still under my current pump warranty, so my hands were tied.  Reps from Animas reached out, one thing lead to another, and now I’m working with Animas, not as an employee, but as part of their outreach program that includes country singer George Canyon, LPGA Golfers Kelli Kuehne and Michelle McGann, and former Miss America Nicole Johnson (to name a few).  The program tries to spread the Animas name by working with people who have diabetes who are doing cool things (pregnancy is cool, right?), can inspire others to consider pump therapy, and want to talk honestly about how diabetes impacts their lives.  Bless their hearts for daring to partner with a – gasp! - blogger.  As part of this program, I’ve switched insulin pumps from my Minimed 722 to an Animas OneTouch Ping and am receiving my pump and pump supplies from the company gratis.  (Don’t worry, my doctor is in the loop and my supplies and pump are still a prescribed item.  This agreement doesn’t replace my medical team – just my method of insulin delivery.)

My new insuiln pump.  With my new, mega-basal rates.  Holy pregnancy!
My new insulin pump, showcasing my new mega-basal rates.  :)

This agreement is similar to the Dexcom one from last year (which is still in effect), in that I’m still going to be business as usual here on SUM.  Like with Dexcom, during the course of drafting this agreement, I spoke at length with many of the folks at Animas and they're well aware that everything I write about won't always be favorable (nothing is perfect, and we’re still talking about needles and diseases here), but what I say about their product will always be honest.  That means that when the pump is behaving itself and working smoothly, I'll say that.  And when I’m frustrated by pump fashion challenges and tangled infusion sets, I’ll say that, too.  This agreement isn’t a filter, but I think it’s important that you, as readers who trust me to be straightforward and honest at all times, know what kind of lens my perspective is seen through.  Just like with anything else.  Like when I tell you that Buried is the greatest film EVER.  (It is.)  Or that my baby is the cutest fetus EVER.  (She does make me smile.)  Or that my cats are the most annoying animals ever.  (I can't stand that gray one.) 

Every blogger is biased, but not every blogger discloses their biases.  I’m trying to do right by you guys, as best I can.

So that’s the latest.  As always, if you have concerns about this, please let me know.  I’m happy to answer any questions (but, just like before, my answer might be “Honestly, I have no idea.”).  And, just like before, if Nikon calls, I’m answering without hesitation. 

February 12, 2010

Diabetic Mommy.

I opened this gift that arrived in the mail, and almost burst into tears because I hope, hope, hope this is the case for my daughter.

Thank you, Lindsay!  For making me feel like I'm going to be a good "diabetic mommy."
(This photo is also part of today's Diabetes 365)

I was thinking about how much planning and effort has gone into this pregnancy, from a diabetes perspective - never mind the regular gearing up that parents-in-training go through.  Chris and I have worked very hard, as a team, to manage my diabetes in efforts to get pregnant, and now that BSparl is in there baking cookies (or whatever it is she does all day), diabetes focus has turned up even higher in our household.

I'm blowing through test strips like a champ, wearing the Dexcom to help me keep track of the constantly-changing numbers, using an insulin pump, trying hard to eat healthy (even though I'm currently weighing the pros and cons of a red velvet cheesecake - recipe link courtesy of my friend Elizabeth Arnold), and making feeble attempts to get a workout in here and there.  Managing diabetes has become, seriously, a full-time job as my pregnancy rockets into the third trimester.

But I wonder what she'll think when she arrives.  And how much things will change.  Will she understand when I need to eat before she does, sometimes?  Will she feel upset if I need a few minutes to get myself together before I'm able to play with her?  Will she think I'm cramping her diaper bag style if I shove my meter in there, alongside her wipes and her binky?  Will she wonder what's wrong with my priorities when I refuse to share my juice box with her on our future playground dates?

Will she understand that even though that t-shirt will only fit her for a few weeks and she may not even remember it, but will she know that her diabetic mommy loves her, and has loved her since the moment she knew she carried her?

(And will she forgive her for all the third-person dialog?  Maybe not.)

I'm heading to Joslin again today, for the first of my four seven-months-pregnant appointments.  Chris and I will see our baby girl through the magic of ultrasounds, and then I'll meet with my endocrinologist to discuss how my body is soaking up insulin like a sponge.  Just a few more months until she's here, in our house, in our arms.

Baby girl, I hope you know how loved you are.

(This is part of a gift from my friend Lindsay, who I've never actually met in person, but I feel like I know, though emails and Facebook and blogging.  Thank you again, Lindsay, for such a thoughtful gift!  BSparl says thanks, too, only I can't really hear here because she's muffled by my enormous uterus.  And potentially the sound of the oven *ding* as her cookies bake.  Who knows?)

February 04, 2010

What Defines Our Community?

What defines our diabetes community? 

At the Smithsonian, there is an exhibit called "Portraiture Now: Communities."  It's described with the following (edited) language:

"How do we define community today? Through new electronic networking, our connections with family, friends and acquaintances are increasingly widespread. And yet, we are still drawn to the idea of small communities and face-to-face interaction. Each of the three painters selected for “Portraiture Now: Communities” has explored this idea through a series of related portraits of friends, townspeople, or families. ... Seen together, the paintings by these three artists suggest the enduring power of personal communities."

I can't remember how I stumbled upon this exhibit, but the idea of it really moved me.  "Community" used to be defined by who lived in your zip code, or who went to your school district, or just what faces passed you in the hallway at work every day.  Back when I was a little peanut, my community was my family (there are a lot of us), my school friends, and my fellow tap dancers from Miss Jeanne's dance class.

Since second grade, I've always been part of the diabetes community.  Back in those days, there weren't many tell-tale tubings sticking out from underneath someone's t-shirt, and kids didn't test as often or as openly in the classroom.  But when another child in my school district was diagnosed, an instant bond formed between he and I, and between my parents and his.  Even if we hadn't met yet.  I had a sparse but crucial community of other Rhode Islander children with diabetes, and when I attended Clara Barton Camp in the summers, my community of "other kids who got it" expanded by leaps and bounds. 

But I grew up, and in those foggy years between 9th grade and my first job out of college, I was alone.  Alone with diabetes, yet still part of the diabetes community.  No one knew I was there, but just hearing someone at school mention "their cousin who has type 1" or "That lady they were waiting on at the restaurant who freaked out when the diet soda was switched - she said she had diabetes," made me feel like I was instantly connected to these imperfect strangers.  

And then I found you guys, drawn in by a desire to not feel alone anymore and wanting to share, out loud, the emotional burden of diabetes that I carried for a very long time by myself.  A whole community of people who were either living with diabetes themselves, or loving someone who lived with it, and who understood exactly what I meant when I said, "It's just ... ugh, you know?"

What defines our diabetes community?  Is it the common thread of syringes and infusion sets and the pile of test strips we leave in our wake?  Is it the shared fear of complications?  The universal celebration of a lowered A1C?  The muttering of "Lows are The Suck," and hearing, "I know what you mean," in return? 


I thought about what a "Portraiture" of the diabetes community would look like.  I pictured all those photographs so many of us have taken over the last few years, the ones that show a bunch of grinning people with their arms around one another.  It's only if you look really closely that you notice the pumps clipped to pants pockets or calloused fingertips.  

"Through new electronic networking, our connections with family, friends and acquaintances are increasingly widespread. And yet, we are still drawn to the idea of small communities and face-to-face interaction." 

Face-to-face interaction is such a huge part of feeling like a community, but it's not the only thing that makes us one.  Whether you want to be part of the diabetes community or whether you are rebelling against the very thought, the fact remains that it's there for you, and will always be there for you.  There's a certain comfort to knowing you aren't isolated or alone.  There are people who understand.  

The definition of our community is found in the people who are part of it.  Each and every one of us:  the bloggers, the lurkers, the medical professionals who care for us, the parents of kids with diabetes, the kids with diabetes who have grown up to become parents themselves, the lovers, boyfriends, girlfriends, spouses, friends of diabetics, the immediate family members and the ones who are slightly removed, the employers, the employees, the strangers who help us get juice when we can't help ourselves, the friends, Romans, and countrymen of the diabetics ARE the diabetes community. 

It's a far-reaching group of people who share more than just a busted pancreas.  

It's a true community of people who understand, despite different backgrounds and preferences and opinions.  We're in this together, and as I'm preparing to bring my daughter into this community as a "child of a person with diabetes," I'm thankful that she can find support as a caregiver in this sea of people who have been instrumental in helping me achieve the strength to bring her into this world.

February 03, 2010

We Can Work It Out.

The Dexcom seems fit enough.  I need to get my yellow legs in gear.(Great song.)

Now that we're back from our trip, it's time to reintroduce myself to the "swing of things."  While we were away, Chris and I were up late, eating fancy food at fancy restaurants (including desserts and carb-fantastic sweet potato french fries and gelato ... things we wouldn't normally eat but we devoured in spades - and in our mouths - all week long during the festival holy run on sentence), going to bed at 3:30 in the morning, battling the frigging hills, and waking up the next day only to do it again.  For nine days running.

It was exhausting. 

But now we are home.  And in the comfort of my own schedule, I can wake up early, eat a breakfast that doesn't include sausage (not the cat), get enough sleep at night, put my feet up as necessary, and get some exercise in.

Oh, the exercise part.  How you plague me.

I used to be awesome at getting to the gym.  Not to toot my own horn - more to toot Chris's, actually - but his dedication to the gym helped me keep my proverbial (and literal) butt in gear.  It was just part of our routine, and it was easy.  And the benefits were tremendous:  good health, pants that fit, and that feeling of "ooh, I'm sort of strongish."

But now?  As the baby belly grows and my sense of balance leaves the building for the next 75 days?  Exercise is hard.  Wicked hard.

Since we've been home, I've been back at the gym with Chris, only the workouts I'm doing now feel completely lazy-ass, compared to the ones I was doing before.  No weights (thank you, retinopathy), no jumping rope (thank you, bouncy belly), and no increased heart rate over 130.  

So I walk.  For like 40 minutes on the treadmill, without an incline and at a speed of only 3.0 miles per hour.  On paper (screen?) that looks wussy, but in reality, it's kicking my behind.  I'm not sure if it's the weight I've put on in the front or the fact that my lungs are squished in there, or maybe just because my whole body is completely different now than it was seven months ago, but just walking on the treadmill is a challenge these days.

I'm going to see how long I can keep exercising.  I've heard that many pregnant women make it to the day before they give birth, and I've also heard that the more active I can remain, the better my recovery will be after having the little baby.  Activity helps keep BSparl healthier, too, which is even more incentive to keep plodding.

Weird thing is, my blood sugars don't drop during exercise anymore.  In fact, they seem to go up a little bit.  Before becoming pregnant, I would disconnect my pump and exercise without insulin, but now I need to leave it attached.  And I sometimes need to bolus during the workout, depending on how the Dexcom is trending.  It's very odd, what my hormones are doing to my blood sugars these days.  I also had to increase part of my wee hours of the morning basal today, after two mornings in a row of waking up at 150 mg/dl.

"Kerri, you're rambling.  You realize that, right?  You're just rambling on about exercise and blood sugars and do you actually have a point with this post?"

Why thank you, Internal Motivational Speaker.  I appreciate you bothering me.  Yes, I'm rambling, but I'm just trying to get all these thoughts out before I lose them.  Which seems to be the case lately.

"Why don't you just tell them that the real reason you're fixated on exercise this week is because when you came home from Sundance, each cat had gained 5 pounds?  Now you have a trio of porkchops racing around the apartment?  Why don't you admit that Siah can't even fit under the couch anymore because she's too darn fat?"

Sigh.  I need to get back into the exercise groove. 

And apparently so do my cats.

February 02, 2010

BSparl: She Likes to Make Me Work.

Park City is an old mining town nestled among the Wasatch Range of the Rocky Mountains, and aside from buzzing with Sundance excitement and brimming with film-goers and celebrities, let me just say that the damn place is not flat.  Not even close to flat.  (See also:  built amongst the mountains)  The majority of the "stuff to do" is on Main Street, and I'm pretty sure that street is a 60 degree angle.

BSparl and her mommy (me), in all their frontal weight gain glory, were not amused.

Something about walking up and down (and usually up and down a few more times) that street had me more winded than if I'd tried to run a mile on the treadmill at a 6.0 incline.  I know that the air is thinner in that part of the country, being so freaking high above sea level, and I also know that having a little baby girl growing inside of me is compromising the room for my lungs to expand.  But I had not anticipated how hard it was going to be just to WALK around in Park City.  We'd take the bus from our condo down by the Yarrow Hotel and get dropped off at the city transit center, and then the huffing and puffing would begin.

We have HOW many more steps to go??

"I'm ... sorry ... for ... not ... keeping up."  I'd pant with each step as I tried to keep up with Chris.

"It's okay, baby.  We'll go slow.  We're not in any rush."

"Awe ... some.  Hang on while I lean against this lightpole for a minute ... and let my lungs ... do stuff."

(Thing was, we were late for two different dinner appointments because I couldn't catch my breath about 15 minutes into the walk.  I've never felt more awkward, or more yeti-like, than I did trying to plod up Main Street.)

Overall, little BSparl was a well-behaved fetus, doing her job of kicking and sleeping and rolling around in there.  I'm officially sporting a major baby belly, complete with visible baby movements even through my shirts.  And thankfully, my basals didn't need any adjusting while we were away.  I don't know if it was the time change or all the walking around or maybe it was just the grace of the diabetes gods, cutting me some freaking slack for the week, but my numbers ran relatively stable while we were away.  (Save for that f'ing 300 that came up as a result of overtreating two 48 mg/dl's in a row, pissing me off royally and causing me to have to skip dinner one night.)  I changed my infusion sets every three days like clockwork - mainly because I'm now using about 50u of insulin a day and that's the shelflife of one pump cartridge and also because sets left in too long are starting to get infected faster than usual - and I tested about 18 times a day.  In addition to Dexcom'ing. 

I may have left a trail of test strips on that there Main Street.

BSparl is proud of her daddy.  When I was trying to coax her into kicking at times, all it would take is a quick "Hi baby!" from Chris to get her scooting around in there.  And during the five screenings of Buried, she danced in celebration for her father's success.  I believe I may be building a "daddy's little girl" in there, and I think they're respectively smitten with one another. 

A sculpture on Main Street in Park City, Utah

Traveling at almost seven months pregnant was definitely a challenge, and I'm not sure I would have done it, were it not such a big freaking deal to go to Sundance.  Heparin before the plane ride was one thing (that shit stings going in, FYI), and not being able to lift my suitcase wasn't exactly heartbreaking, but moving around was a little awkward.  And having to pee every 30 minutes was also cumbersome.  (I know where EVERY bathroom is in Park City.  Thank you, BSparl, for making my bladder your pillow all week long.) 

But I wouldn't have missed this for the world.

January 22, 2010

Looking Back: Rage Bolus, Anyone?

Today, we're traveling to Utah for the Sundance Film Festival.  And yes, I will be photographing and videoing the hell out of the festival, because I am so excited to see how this week plays out for my husband.  But in the meantime, as I board the plane and head off to Park City, I'm looking back to this post from October 2005, where the term "rage bolus" first appeared on SUM

(It made me laugh to read this post, because this was pre-dLife, pre-Chris and I getting married, and pre-so much stuff that's in play right now that I almost forgot that I hated my job back when I lived in RI.  And how much I still want to know how many licks it takes to get to the center of a Tootsie Roll pop.)

*   *   *

October 10, 2005:  Bit of a rantish post here. And there's no reason for this other than to vent frustration.

Last night, after I came home from the U2 show in Boston (more on that later), I was a little bit high. Rang in at 212 mg/dl. Okay, no problem. Bolus it up, go to bed. Woke up this morning at 200 mg/dl. Hmmm, no drop in the blood sugar levels. Not to worry, though, because it's a Free Shower - no infusion set - Day due to the fact that it's time to change the infusion set. Primed and inserted a new set with good ol' Charlene. She purred (beeped?) happily and I set about dressing for work.

RAGE BOLUS!!

Arrived at work. Hungry. Devoured one of those sometimes-delicious-but-most-often-just-gritty Kashi Whole Grain Granola bars. Bolused two units to cover, in accordance with the 1:10 ratio. Worked at my boring job for about an hour before realizing that I had already visited the bathroom twice in that time. Hmmm. Not normal. Tested, revealing 281 mg/dl. Whaaaa... I corrected this morning. I bolused for the crappy snack. And now I'm higher than before? Frustrated Kerri. So I Rage Bolus*. I just crank the shit out the pump, knowing full well that I only need about two units to come back down. I lace in 3.5 units. Sit back, satisfied.

Not done yet. I test again, an hour and half later, clocking in at 286 mg/dl. Fan-freaking-tastic. Good thing all that insulin made me higher. Because that makes f-ing sense. So I Rage Bolus again, sending 2 more units coursing through, Frustrated Kerri not really giving a shit that the "active insulin" tally on my pump is enough to cover dinner at Olive Garden.

So it's noon. I've been high all morning. I just changed my infusion set this morning. And I'm angry. I do not want to pull this set only to find that it's perfectly fine and I've wasted yet another expensive pump supply.

I'm riding this out. It's Me against the D. Who will persevere? How high will Kerri allow herself to rise before she pulls the set and starts over? How much Rage Bolusing will eventually catch up with Herself before Kerri bottoms out at 44 mg/dl? How many licks does it indeed take to reach the center of a Tootsie Roll Tootsie Pop? If you say three, you and that f-ing owl can go screw. It at least takes 125. I'm going to find out as soon as my Rage Bolusing catches up with me and I'm Trick or Treating at people's desks here at work.

*Rage Bolusing: Taking an uncalculated amount of insulin to correct a frustrating high bloodsugar reading. Also see: Panic Eating.

January 17, 2010

BSparl Fights Back.

Last Friday, Chris and I were back up at the hospital for another round of doctor's appointments to spy on Ms. BSparl.  (This might be another long post, because I'm trying to include everything we're doing for this pregnancy, just in case someone else is looking for this info.  So thanks for bearing with me!)

Fetal Echocardiogram No. 2:  We started with a follow-up echocardiogram appointment at Children's Hospital in Boston, because last time we tried to see the structures of our little girl's heart, she was hiding out too low in her little uterine apartment to be properly found. This time, a full month later, she's over a pound and a half, and the size of an eggplant.  So hiding is a little harder.

The babies of type 1 diabetics aren't prone to every kind of complication, but are instead screened for everything under the sun, just to make sure.  The ultrasound technicians were looking for problems with BSparl's heart - ranging from a floppy valve to flow problems between the atria and ventricles, checking out the umbilical cord blood flow, too.  

"She not much of a cooperator, is she?"  the technician asked, pressing the ultrasound wand firmly against the left side of my uterus. 

"I guess not.  Bit of a shy one." 

(I love this kid already!! /sidenote)

"Well she can run, but she can't hide.  We're going to get these pictures today, whether she likes it or not."

The technician visually isolated BSparl's beating heart, looking at every chamber and pulse to make sure she was in one piece.  But as the technician worked to get the ultrasound images she needed, she was pressing pretty damn hard against me ... and against BSparl.

"Almost done.  Just one more image to capture.  You doing okay, Kerri?"

"No problem.  But I think our friend here is ... ooof!  Um, she's not very happy with you."

And when I looked down, I could see the baby kicking and fussing on my right side as the technician pressed the wand against my left.  Big kicks, clearly visible to Chris, who was sitting in a chair on my left.  BSparl was pissed - she didn't enjoy being bothered while she was trying to sleep during the day, apparently.

'Fiesty one, eh?"

I felt a little proud.

"Yes, she is."

(I guess if you poke at my kid, she fights back.  I like that.) 

The fetal echocardiogram came back without any red flags, so thankfully her little heart seems to be okay in there. 

Some orange flowers.  Not diabetes-related, but I thought they'd break up this long, boring post a bit.

OB/GYN: 
After that appointment, we had a quick visit with my OB/GYN who took some measurements of BSparl to see how big she's getting in there.

"Looks like she's about one pound, 12 oz.  She's right on track, so nothing to worry about with her size at this point."

I was relieved.  "I'm glad you're saying that, because I've had some really tough blood sugars these past 2 1/2 weeks.  I was afraid she was beefing up in there."

"No, she's in the 61st percentile, and we aren't going to worry about anything until she's in the 75th.  We're going to watch you to make sure she doesn't get too, too big in there, but at this point, she's doing just fine.  And so are you."

She printed some ultrasound photos for us (which will go into the baby scrapbook I've started but definitely need to catch up on) and then I met with my endocrinologist about my blood sugars.

Endocrinologist:  I am very, very thankful that I have a comfortable relationship with my endocrinologist, because the emotional toll of diabetes has really affected my ability enjoy being pregnant.  I've had some highs that wouldn't go away, and plenty of unexplained blood sugars that have made me feel so frustrated over the last few weeks.  I'm pretty sure my A1C will be up again this month (hopefully still under 6.5%) but I needed help fixing some of it.  And I also needed to be told that what's happening to me is normal.

"I'm high.  Like, crazy high, sometimes first thing in the morning.  And other times, I can't make my post-prandials come down under 160 mg/dl for at least two hours, no matter what I do.  Is this normal?  Is it normal for me to be experiencing such wild insulin increases at this point?  And is it normal for me to be sort of losing my mind at this part in the pregnancy, too?"

She assured me that this is the point in pregnancy when the placenta does, in fact, produce anti-insulin hormones, causing my numbers to elevates and my need for more insulin.  

"Anti-insulin hormones?  That's cruel.  Cruel irony."

She smiled as she worked to adjust my basal rates (now up to almost 20 full units of Humalog per day, in addition to bumping my insulin to carb ratio down to 1:8).  

"You're doing fine.  And you've been adjusting your own basals and going after these highs, so that's the right thing to do.  We just don't want you chasing.  I want to help prevent them in the first place."

I could have hugged her.

"Me, too.  I want to make sure she's safe in there.  I don't want to hurt her in any way, and the recent highs have me freaking out a lot."

"Don't freak out.  Just keep doing what you're doing.  Follow those numbers, stay as controlled as you can, and fax me any blood sugars that have you concerned.  I can review the changes you're making, or I can make changes for you from here.  Either way, we'll get her out just fine."

Building this baby is tough work, and these days, I feel like a full-time diabetic.  This baby, and by default, diabetes management, is my top priority and I am focused on keeping her as safe as I can.  But as my body changes and my insulin needs become less and less predictable, it's getting tougher to stay in good control.  And in solid spirits.

We're almost at the end of the second trimester.  Third trimester starts on February 8th, and after that, it's a fast track towards her arrival.  This is happening really fast.  We actually started registering for baby stuff this past weekend - holy crap.  Emotionally, I'm overwhelmed and excited and scared and trying to figure out how to just slow things down for even a day.

(More on that tomorrow, once I wrap my head around the whole concept.  For now, I need to go make some pancakes.)

January 15, 2010

Taking the Plunge.

My old school insulin carrying case.  In true blue!I'm from a very big family - my mother is one of seven and my dad is one of five, for starters - so I had plenty of relatives who used to babysit for me when I was small.  Overnight visits at my aunts' houses were part of the fun, and I always looked forward to them.  (Because - let's be honest - I liked that they let me put makeup on them and do their hair.  My pretty aunts were like living Barbie Doll heads to me.)

Things changed a bit when diabetes came into the picture.  Sleepovers weren't as easy to manage, because now we had to juggle insulin injections, blood sugar tests, and being on the lookout for high and low blood sugars - especially back in that first year when everything diabetes-related was so new to all of us. I was still a little kid, and now all this medical stuff, too?

When I was first diagnosed, I didn't do my own insulin injections.  At the outset, my parents did my injections for me, but after a few months, my extended family started to learn.  I think about it now, having baby-sat for my nieces and nephews and little cousins, and I can't even picture that learning curve.  I'm so grateful that my family came together to learn to deal with diabetes, instead of leaving my mom and dad as the only ones who were "in the know." 

One of my earliest memories with diabetes is of me waiting on my aunt's couch while my mother tried to explain to my aunt how to administer my insulin injection.  And every time I recall it, it makes me laugh.

"You need to uncap the syringe, check for any air bubbles one last time, and then pinch up where you're going to stick the needle.  Once the needle is in, you press down the plunger and pull the needle out.  No problem!"

My aunt was nervous.  "I pinch the skin and then put the needle in?  How fast do I put the needle in?"

"Pretty quickly," my mom responded.  "Don't think about it.  Just jab it in there, as gently as you can."

"Okay, so pinch, jab, plunge, remove.  Got it."

"Great, so are you ready to give it a try?"

(Mind you, the entire time they're debating this, I'm face-down on the couch with my pants pulled down, waiting for the insulin injection to be given into my seven year old butt cheek.  Another truly classy moment for me.)

My aunt came towards me, brandishing the syringe like a hot poker.  She uncapped it nervously, pinched up the top of my hip, and said (and I remember this clearly), "Ready, Kerri?"

"Yessh I amph."  I said into the couch cushion.

"Okay, here we go!"

She expertly stuck the syringe needle into my skin, and I barely felt the pinch.  And then she pulled the needle quickly out, letting out an "Oooh!  I did it!"

My mother sighed.

"You didn't push the plunger down."

"What?"

"The plunger.  To dispense the insulin?  You didn't push it down.  You just stuck her with a needle and then pulled it out again."  I could hear my mother trying not to laugh.

"Oh shit!" my aunt exclaimed.  

I laughed, despite the fact that they were about to advance on me again with that syringe.

"You shed de esh word."

January 08, 2010

BSparl: She's a Mobile Biscuit.

We're just over 23 1/2 weeks with Ms. BSparl, and she's an active little biscuit in there.  I know I mentioned it in my vlog earlier this week, but this baby is scooting around all over the place inside of me.  Last night, for the first time, Chris and I could actually SEE her kicking from the outside.  Feeling her kick is one thing, but seeing it?  Completely amazing.  When she shuttles and rolls from one side of my uterus to the other, I can see her moving.  My belly swells more on one side, and then I can feel and see the 'bulge' move over to the other side.  (I'm trying to get a video of her doing this, but usually when it happens, I'm too taken by surprised to grab the Flip!)

Baby Girl Sparling, 23 weeks along

On the diabetes front, my insulin resistance is climbing.  Daily.  Like a cat in a tree, howling from the top branch and refusing to come down.  (I need the fire department - stat!)  My basals, once at a conservative 12.4u today per day, are at an even 20u per day and I'm sure they'll need to be upped again sometime next week.  I feel like I'm chasing my tail right now with these blood sugars, but so long as I can continue to effectively stalk them, I'm confident that I'm not boiling BSparl.  This morning, after three days of waking up at 140, 155, and 203 (gah), respectively, my fasting number was 79 mg/dl and the Dexcom reflected a steady overnight, too. I'll take that, and hope it happens again tomorrow. 

But if it doesn't?  CRANK it up again!

A big hurdle I'm encountering is the exercise bit.  Honestly, I haven't had a good workout since before we went to Spain (and returned with Ms. BSparl).  In the first trimester, I was usually too exhausted to get to the gym (went three times a week instead of the five I was getting in before), and then we moved out of our apartment in Connecticut, so that whole transition sucked out my desire to work out almost entirely. 

Now, well into the second trimester, I'm trying to get to the gym but it's just so boring.  My exercise options feel so limited, and I'm not used to the whole "get on the treadmill, walk steadily for 35 minutes, END" routine.  No ab workouts, or I could smoosh BSparl.  No jumping rope, or all these new sticky-outtie parts of my body might leap off of me and my pelvic floor could be weaked.  (Kidding on the body parts leaping off but true on the pelvic floor concerns. I also can't imagine jumping rope being almost 6 months pregnant, nevermind the fact that the kid won't like it.)  And no strenuous weight lifting, thanks to compromised diabetic eyes. Those little five pound weights I have are borderline questionable, considering my retinopathy progression.  Booooooo.

So the treadmill it is, for long and awkward ambling.  (For now.)  And even though it's a whole lot of boring (I've watched that "build a six foot gingerbread house in 8 hours" challenge on the food network like seven times now), it is getting harder and harder to keep moving.  With BSparl expanding every week, my organs are getting a little smushed in there.  An expanding uterus puts pressure on my bladder, my diaphragm, and every other organ I have in there, leaving me short of breath a lot of the time and generally feeling like I'm going to tip over a little bit.  I guess these walking workouts are still exercise, even though they aren't even close to what I was doing before BSparl's creation.  

Every week is different, but I'm definitely not complaining.  Pretty damn grateful, actually.  I'm so happy to look in the mirror and see that my waistline has all but disappeared and has been replaced by this bump o' BSparl.  She's in there, she's doing well, and in just about four months, she'll be here.  

January 04, 2010

Oh, High!

I hope BSparl is going okay in there.Back at the Diabetes 2.0 conference in Florida in November, I was talking to Manny Hernandez about how evenly  my numbers were running due to the pregnancy.

"Dude, it's like a cure.  It's creeping me right out, but I am NOT complaining.  Whatever keeps this baby safest!"

Oh how I wish that was still the case.

The lows chased me all around the house for about five months, helping my A1C drop like a rock and keeping highs out of the rotation for approximately twenty weeks.  A blood sugar of 150 mg/dl felt HIGH (which was a far cry from the 250's I was sadly bonding with this time last year) and my low symptoms weren't kicking in at all (see also:  the 29 mg/dl without a whisper of a hint). 

Tomorrow I'll be in the 23rd week of my pregnancy, and the highs are back.  With a freaking vengeance. 

It started innocently enough - with some spiky numbers in the middle of the night.  Nothing chaotic, but 120's where there were 80's the day before, and they continued to climb a bit every day.  For about four days straight, I was waking up at 4:30 in the morning between 120 - 140 mg/dl, correcting back down to 100 mg/dl, and then the creeping would start again around 10 am.  It was like my body wanted to incubate BSparl at a steady blood sugar of ... 180?  NO WAY. 

After a quick chat with my endocrinologist (who told me, in no uncertain terms:  "Pregnancy is completely different.  Two days is a pattern now.  You know what you're doing - adjust your basals as often as needed."), I starting hiking up my basal rates.  Before I got pregnant, my total daily dosage was around 24u per day, thanks to a low basal rate and a lower-carbohydrate diet.  Now?  Five months and 3 weeks into my pregnancy and 17 lbs heavier?  My TDD is 45u and climbing. 

I am wearing my Dexcom and testing very regularly, but it seems like full-out stalking is necessary for the next four months.  I'm also changing my insulin pump infusion set every three days, like clockwork, to keep absorption issues from adding to the pile of variables.  What's becoming challenging is avoiding basal stacking.  As in, if I'm 140 mg/dl and I bolus it down, I need to be patient and let the insulin do its work.  I can't freak out and take another bolus 35 minutes later just because I'm nervous.  Bolus stacking (and rage bolusing, too) are totally counterproductive when they result in a nasty low blood sugar that leaves me spinning.

So what's the moral of this story?  ... honestly, I have no idea.  All I know is that blood sugar management during pregnancy just went from literal cakewalk (as in, I'd take a step and would require cake to take another step) to a struggle that has me acting like an emotional wreck.  My last A1C came in a little higher than the one the month before (went from 6.1% back up to 6.3%), and I know this is because the lows are tapering.  But I don't want to crest back up towards 7% because I'm unable to wrangle in these stupid highs.  

There's a lot of guilt when it comes to diabetes.  I knew that before.  But what I didn't realize before becoming pregnant is how much I worry about this little baby while she's growing inside of me.  Every time I test and see a number above 130 mg/dl, I feel so sad and frustrated.  My hands immediately go to my belly and I want to feel her kicking, because that at least soothes my heart, knowing she's still okay in there.

Actually, she's rolling around in there as I type this.  My blood sugar is 96 mg/dl and holding, I hope.  I have every confidence that I can do this and that she and I will be okay, but these last few days have been really emotionally tough, and I've found myself praying more now than I ever have before.

(Thank goodness for cute baby girl clip art.)

December 29, 2009

You Know You're a Diabetic When ...

You know you're a diabetic when ...

Diabetes MacAttack!

... a few blood stains on the computer power button are almost expected.

December 15, 2009

BSparl: 20 Weeks.

Dear Baby,

Daddy and I are at the halfway point in our journey to meeting you, and I'll admit - I'm a little surprised at how quickly this is happening.  I feel like I was just in Spain, hoping you were there with us, and then just at Joslin, wondering if they were going to tell us you were indeed hidden inside of me.

Baby, we know you are a little girl, and that every week, different parts of you progress in their development.  Daddy and I read through those books we bought and marvel at what's actually happening inside, when my outside just looks bulgy.  "She can hear us now!"  "She'll start kicking any day."  "Will we catch her sucking her thumb in the next ultrasound?" "Does she realize I don't know the lyrics to ANY songs, not even Christmas ones?"

Baby Girl Sparling, 20 weeks

And I've felt pretty healthy, Baby.  I am about 13 lbs heavier and wearing maternity clothes now (you'll see them when you're born - the crazy pants with the elastic waist bands that everyone was jealous of at Thanksgiving?), but a lot of the "pregnancy woes" aren't part of our lives yet.  Like heartburn.  And stretch marks (yet).  Just some back pain and I feel pretty tired a lot of the time.  Heating pads and naps work wonders these days. 

But Baby, I get very nervous about things that other people don't know about.  The stuff that isn't mentioned on the "What to Expect" websites.  We visit the doctor every two weeks, and I'm being followed very closely by my medical team, but sometimes my mind gets panicked about how capable my body is of taking the best care of you.  I can't lie - I know that diabetic women have healthy babies all the time, but Baby, when my blood sugars ring in at 200 mg/dl after a meal, no matter how carefully I've counted carbs and bolused insulin, I'm terrified that I'm hurting you.  Or this morning, when I woke up at 135 mg/dl at 7 am, I felt a pit in my stomach because I know that it's best for me to be under 100 mg/dl first thing.   I wonder, when the infusion set really stung yesterday morning upon inserting it, do you feel that pain?  Is it normal to worry about every little thing when it comes to your well-being?

Of course it is, moms and dads who have done this before will tell me.  It's completely normal for me to want the very best for you and to hope and pray for your good health and safety.  And it's also completely normal for me to worry about every little thing.  But what I worry most about are the things I am scared to talk about.  The things like blood sugars and hypertension and diabetes-related complications for you and I alike, that other people in my life think I have figured out but I just don't know how to do it right every day.  And the idea of doing it "wrong" makes my breath catch in my throat.  My numbers seem "good enough" and my A1C is lower than it's ever been, but those 200's that are creeping back in at at times terrify me.  So does the 31 mg/dl in the middle of the night.  And so does every single thing that threatens to affect you in any way.  Will I keep you safe enough? 

Diabetes is the shifting sand I'm trying to build my life on, and I can handle my being affected, but I don't want it to touch you.  Not even for a moment.

I love you endlessly, Baby.  I'm so grateful to even be this far, and I appreciate every moment I have with you, and will have with you in the future.  Don't worry, Baby.  I'm not spending every minute of our pregnancy in a panic.  It's just sometimes I feel so scared that I'm not able to provide to you everything that you deserve.  I'm very protective of you already, and I want to be a good mom to you.  When I feel you kicking around inside of me, I know you are exactly what I've always wanted.  You are a new life that your father and I created together, and I hope that I can give to you even an ounce of the joy you've already given to me in the last five months. 

I can't wait to meet you, and hold you, and know that you're okay.

Love,
Your Mommy

December 06, 2009

Looking Back: The Boy at the Health Fair.

Today, I'm revisiting a post from 2006 (writing that makes me realize I've been blogging for a while now!), when I met a little boy at a Rhode Island JDRF event who warmed my heart - which I needed on this snowy, New England morning. ;)

*   *   *

I'd guess about ten years old.  Spikey blonde hair, pale blue eyes, chubby little kid face.

His mother stopped by the table we were manning at the School Health Fair, mussing with the pamphlets strewn about the blue plastic tablecloth.  The tri-fold cardboard display announced "Juvenile Diabetes Research Foundation" in bright blue letters.  Myself and another volunteer from the RI JDRF stood vigil at the table, handing out trinkets and informational packets, answering questions, and enjoying the sights.

"Hey buddy.  Would you like a t-shirt?"  My fellow volunteer leaned in towards the little blonde boy.

"Sure.  Thanks."  Shy blue eyes.

Turning to the mother, my partner asked, "Does anyone in your family have diabetes?"

She waved a green sweatshirt clad sleeve at her son.  "Yeah!  He does!  He has diabetes."

He looked at the floor and contemplated his untied sneaker. 

His mother laughed loudly and clapped him on the back.  "Some days he talks about it and some days he doesn't.  Today he just ain't talking!"  She picked up an issue of Countdown Magazine and flipped through the pages.Lost in the Crowd

"Here's your t-shirt."  Pale blue eyes met my own.  "I have diabetes, too, you know."

"Really?"

"Yeah.  I have an insulin pump."  I pointed to the pump clipped inside the pocket of my khaki skirt.  "I've had diabetes since I was about six."

"I've had it since I was seven."  He smiled and fingered the plastic sleeve around the blue JDRF bracelet.  "It's okay... so you have it, too."  He looked at all the other volunteers at the other booths. 

After a beat:  " You look just like the rest of them."

I stood there after he and his mother walked away, toting plastic bags filled with health fair goodies and JDRF magnets and pamphlets on bloodsugar management.   His blonde head blended in with those of the other kids until I couldn't find him in the crowd anymore.

He looked just like the rest of them.

November 30, 2009

A Piece of Embarrassment Pie.

Diabetes police - :(Over the last few weeks, I have had a few run-ins with the gentlest of diabetes police - people who don't mean to be second-guessing me or asking me why I'm eating that, but still, they can't help but ask.  Sometimes their questions are subtle and we end up having a quiet, private discussion about what type 1 diabetes means to my life, and I welcome these opportunities as ways to help educate and advocate.

But other times, when I'm at the table with a piece of pie in my hand and about to sink my fork into it, knowing full-well that I am at a very good blood sugar and have bolused for the pie carefully, and someone asks, "Why are you eating that?" ... I feel completely defeated.  And embarrassed.  Can't a girl have dessert without being questioned?  And when questioned, why isn't my explanation good enough to justify my actions? 

I'd like to be a person with diabetes who sits down for dinner and eats with everyone without the scrutiny.

There's a difference, in my eyes, between choosing to be a diabetes advocate and being forced to explain myself.  I have no problem explaining to a stranger what the difference between type 1 and type 2 diabetes is, or what this machine on my hip is, or why my purse keeps BEEEEEEP!ing, or why I'm carrying more candy than an Oompa Loompa.  I actually like having these discussions, because I feel like people are only familiar with one kind of diabetes and one linear explanation for "the sugar," and I like knowing that I'm helping to educate them about the different kinds of diabetes, particularly type 1. 

What I don't enjoy is having someone look at me like I'm doing something wrong, just because they are unfamiliar with the ways that my diabetes needs to be managed (or the way I'm choosing to manage it).  I've written about diabetes and guilt before, and my inability to ever be "the perfect diabetic," so this isn't a new gripe.  But what's made me particularly frustrated is how there seems to be this common misconception that "it's only diabetes" and it's okay to pass judgment on my choices.  Diabetes isn't viewed as a serious disease to those outside the bubble of understanding, and complications for a young person with type 1 can thankfully be hard to spot, so maybe diabetes just looks too easy to some people.  Maybe we are just too good at masking how challenging it can be sometimes.

What would my well-meaning diabetes police say if I responded to their comment of "Whoa!  Having pie?  You can't have pie!" with a dissertation:

"Yes, I can have pie.  If I'm willing to go through the necessary motions, you know?  I have type 1 diabetes, and I wear this pump to give myself the insulin hormone that I don't make for myself anymore.  Supplementing all day long!  Unlike type 2 diabetes, which I know you're more familiar with, I don't make any insulin at all, so every meal is a tight balance of blood sugar monitoring, carbohydrate counting, and then dosing my insulin in accordance with the meal I'm about to eat.  Then, after the meal, I'll keep monitoring to make sure that I'm not going too high or too low.  It's about balance, but not about deprivation.  So yes, I can eat this.  And I will eat this.  And so long as I'm able to keep my numbers in check, my body shouldn't rebel after a piece of pie."

The thing is, I've given this explanation before.  Many times.  And I've explained diabetes to so many family members and so many friends (and just as many complete strangers) that it frustrates me endlessly to see that they aren't retaining any of the information.  And not only are they missing what I'm saying, but they're constantly - albeit gently - calling me out for my actions.  It makes me feel like such a crumb, like everyone is watching me while I eat.  (Nothing like that to make you feel paranoid.  Not to mention pregnancy weight gain, adding insult to injury.)  I know they mean well, and I appreciate their concern, but they need to listen to me when I answer them.  And they need to trust me when I give a clear explanation.  I'm not asking them to explain their food choices or exercise decisions or the details of their daily regimen - it's not my business. 

I'm sorry if I seem frustrated, but the scrutiny is making my head and my heart ache.   I don't have a track record of being irresponsible.  I don't exhibit signs of disease ignorance or depression or unawareness.   I'm taking very good care of myself, especially now with the baby growing inside of me and my focus turned to diabetes the majority of my day.  I'm tuned in.  I'm careful.  I'm doing my best.

Yes, I can have the pie.  Next time, I might skip it for reasons all my own.  But whatever my decision, please don't assume you have a right to question it.  Until you are living with type 1 diabetes, you don't understand.  And I'm not expecting you to understand - ask me what you want to ask me.  I'm more than willing to talk to you about this. 

But if you don't have a question, and you only have those comments, I'm just respectfully asking you to be quiet.   Please.  I've had enough.

November 09, 2009

Two Heartbeats on D-Blog Day.

Diabetes Blog Day, 2009.  Holla ... and whatnot.The first time we saw him (or her), it was at the emergency room back in Connecticut.  We were only seven weeks into the pregnancy and barely had caught our breath from finding out when the bleeding happened and I panicked.  We spent five hours in the emergency room, poked and prodded and with an IV line at the ready, only to finally be wheeled into the ultrasound room. 

"Just relax, Mrs. Sparling.  And we'll take a look and see if everything is okay."

And the screen switched on and Chris and I saw our baby's heartbeat, strong and steady and fast, beating inside of me.  Everything changed forever, even though nothing had changed yet.

The bleeding stopped that day, and we moved forward, cautiously, frightened, and so hopeful.  A few weeks later, my mother and I (Chris was in LA on business) were at my Joslin appointment for the first "official" ultrasound, hoping to see the baby growing strong and steadily.

"Oh, there it is.  There's your baby.  Those parts there at the end?  The feet.  Those are the little feet, ready to kick."

And I watched as the teeny, hamster-looking creature inside of me kicked his little feet.  So small.  So ... surreal.  I couldn't wait to see him again.

Two weeks ago, Chris and I were at the Joslin Clinic for the first of a few second trimester ultrasounds, and from what my eight months pregnant best friend had already told me, this ultrasound was very different than the first one.  "It looks like an actual baby at that point," she said, her blue eyes wide.

Chris and I talked with Dr. T, the OB/GYN, for a while about how I've been feeling, my numbers, and overall how the pregnancy is progressing.

"I feel good.  Tired a lot, and doing a bit more traveling than I'm used to these days, but I'm feeling better now that I'm in the second trimester and past that fall-down exhausted bit from the first couple months."

"Good, sounds like you're doing great.  So ... wanna see the baby?"

"Yes!"

I hopped up on the examining table and Chris took a seat by the ultrasound monitor as Dr. T. moved in with the external ultrasound wand.  "A little bit of this warm gel right on your belly and ... okay, there we go!"

On the screen was a baby.  A whole baby, all big-headed and waving arms and kicking legs.  Our baby.  Hands with fingers, legs with knees.  This baby looked like a real baby.

"Oh my God, is that him?  He's so big!"  I couldn't believe this was the same little hamster from just a month or so ago.  He took up the entire space of my uterus, which was a big change from all the room he appeared to have a month ago.  Now he looked like he was out of room in there (and I knew that meant my own expansion was coming fast).

"Yes, that's the baby.  Calling him a 'him,' are you?  We'll find that out next month, right?"

I watched as the baby turned and squirmed, raising his arms up and his body lurching just a little bit every few seconds. 

"Dr. T, does he have the hiccups in there?"

She looked closely and smiled.  "Yes, that looks rhythmic and steady.  Looks like hiccups to me.  Would you like to hear the heartbeat?"

She turned a knob on the ultrasound machine and suddenly the room was filled with a steady whump whump whump sound - the sound of our child's heartbeat.  It was incredible, hearing my own heart thudding in my ears with excitement as my baby fluttered along inside of me.  Chris held my hand as I brought the other one up to my eyes to catch the tears that collected there.

Two heartbeats, both inside of me.  

And today, on D-Blog Day, I wanted to share this story with you guys.  You have been with me from when Chris and I first moved in together, back when the dream of a heartbeat other than my own was something I only hoped to one day hear.  Now, every day that passes brings BSparl closer and closer to meeting his mom and dad.

When I was diagnosed, they said that children would be near impossible for me.  And while I know that nothing is certain until that baby is in my arms, I am already so proud of where we've come, as a Sparling family and as an even larger diabetes community.  We have hope now, hope for lives that are wonderful and meaningful, despite diabetes.  Diabetes is a heavy load to carry, but with the support we get from this community, the burden is so much lighter.

Happy D-Blog Day, you guys.  And thanks for being part of my extended family.

November 06, 2009

Diabetes Archives: An Open Letter to my Pancreas.

I'm in my last batch of travel for this round - thank goodness - but I've been really short on time lately and it's been tough to post.  So I did a quick comb through the SUM archives and I'm revisiting some of my favorite posts from back in the day.  This one, An Open Letter to my Pancreas, originally ran on November 15, 2006.  (Before my wedding, as you can tell by the old "Morrone" there in the return address!) 

Unemployed pancreas.

Dear Pancreas,

I’m not sure what the hell happened to you, but you’ve taken it upon yourself to stop working.  You did have that job for about six years, where you got up early every day and produced my insulin, but apparently that was too much for you.  You were laid off or fired or something.  Don’t blame it on that virus again.  I think you just slept through the alarm and were let go and you just don’t want to admit it.

All you do is sit around, hiding out behind my stomach, reading smut novels and watching reruns of The Facts of Life.  Sure, you push out the occasional juices and you can sound important when you talk about “trypsinogen” and “chymotrypsinogen,” but you and I both know that you don’t do much.  It’s not even like you empty the dishwasher or anything.  The least you could do, after I’ve been testing blood sugar levels and bolusing all day long, is have dinner on the table when I come home.  Is that too much to ask?

Oh no, you’d rather just sit there like a bump on the duodenum, letting me do all the work.  Don’t worry, Pancreas, I’ll make sure I count the carbohydrates in every little scrap of food and bolus accordingly.  No, no, don’t get up.  God forbid you raise an islet these days to let me have a cup of coffee. 

And I don’t care that you’re jealous of The Pump.  I’m sick of listening to you whine about it.  “She gets all the attention.”  “Everyone loves her best.”  “You never made me a special pocket in your skirt.”  Sigh ... Pancreas, if you would just do your job, I could toss The Pump forever.

Remember what it was like when you were working?  How happy we were?  I was playing outside and drinking the Bug Juice Kool-Aide that Grammie made and you were secreting insulin and everything was cool.  We had fun, didn’t we?  Just you and I?  A Girl and her Pancreas?  No pump, no measuring cups, no medic alert bracelet.  Just you and me. 

And now this:  Unemployed.  Lazy.  Would it kill you to even just make some glucagon?  Or maybe cover a meal or two? 

I miss the way things used to be.

That’s it:  you need to find a job.  I’ve had just about enough of this.  Tomorrow morning, we’re going to load your resume onto Monster and see what happens.  I know that the Wonkas are always looking for help.

Signed,
Kerri

October 29, 2009

Diabetes Can be a Five Letter Word.

... and that five letter word is "guilt." 

At the ePatient conference last week, Sue Rago was talking about diabetes and the complications that can arise.  "But the complications of well-managed diabetes?  None." 

And despite the fact that I met and enjoyed hanging out with Sue, this statement cut right through me.  Well-managed diabetes produces no complications?  So diabetes-related complications are just the result of an inattentive "host," or "slacking off?"  It's not the fault of diabetes itself?

The direct relationship between diabetes and guilt has always made me feel ... well, guilty.  I'm not familiar with what it's like to live with any other disease than type 1 diabetes, so I do feel lucky that I have never experienced something like cancer, but since my scope is limited, I know this diabetes/guilt dance all too well.  And diabetes - as a disease state including both type 1, type 2, and gestational - always seems to come with some added bonus of "You did this to yourself."  It sounds harsh, but I hear it all the time.

It makes me feel so frustrated, this assumption that diabetes only does what we tell it do to.  "The pump does it all for you, right?  So diabetes is like, simple to manage?"  Or "Just follow the rules and you'll be fine, right?  Bad stuff only happens to people who are lazy and don't take care of themselves."  I've never, ever heard someone ask a person living with a different disease - "Oh, what did you do to make this happen?" - but I've heard someone ask me about my diabetic retinopathy and respond, "Well, you must not be controlling your diabetes very well."

I work damn hard to manage my diabetes, and before I took the reigns on my disease, my parents worked hard to manage it.  I take my insulin, I test my blood sugar, and I see the doctor as often (maybe more often) than I should.  Efforts are made to best manage my health, but the fact remains that I have a disease.  I don't classify myself as "sick" and I don't view my life as compromised, but the reality is that type 1 diabetes is an autoimmune disease that causes my pancreas to stop its production of insulin.  As a result of this, the blood sugar homeostasis of my body has been forever disrupted.  And while the medical advances of the last few decades have been tremendous, giving rise to things like improved meter accuracy, insulin pumps, faster-acting insulin, and continuous glucose monitoring devices, there still isn't a cure.  My pancreas remains busted, so I will never be in "perfect diabetes control."

Yet so many people think that a pump or a medication is the answer, robbing fault from diabetes for any complications that may arise and instead making complications the result of "something I did."  I will fight that assertion tooth and nail for the rest of my life, because I care too much about my health and work too hard to let the perception of complications be that of fault. 

Back in March, I found this piece of paper wedged into an old diary of mine from middle school:

Diabetes and guilt - nasty combination.

Even then, as a kid, I was taught to feel solely responsible for my diabetes, as though diabetes itself didn't play a role in any of the outcomes.  "If I want to live:" is how that piece of paper starts off.  What a heavy burden for a child with diabetes.  High blood sugars?  My fault.  Spilling protein into my urine?  My fault.  Any threat of complication?  My fault?  Diabetes wasn't the cause - I was, apparently.  (Granted, many times highs and lows were a result of being a rebellious teenager or eating a 'forbidden food,' but were it not for the diabetes in the first place, it wouldn't be an issue.)

I don't agree with this mentality, and I refuse to subscribe to it.  Type 1 diabetes requires daily maintenance and diligence, but even if I follow "all the rules," there can still be complications.  My genetic make-up plays a role.  My family history plays a role.  And of course, my actions play a role.  This isn't a diatribe to give me a free pass to slack off and not care about my health. I need to take care of myself and work hard for my health.  I have always tried to remember my role in this relationship with diabetes, but I can't fool myself into thinking that if I just work hard enough, my body won't ever exhibit diabetes complications.  If my eyes start to bleed, it's not because I didn't care enough.  Things happen, and I need to be able to roll with whatever life dishes out.  I live with diabetes every day - I don't need the guilt.

Because at the end of the day, diabetes complications are the result of diabetes.

October 27, 2009

Diabetes Linky Bits: What I've Been Reading.

Due to some recent traveling, I've been falling way behind on my fellow diabetes bloggers.  But there have been some posts in the last few days that I think are must-reads.  So today, while I finish up my visit in Philadelphia at the ePatient 2009 conference, I wanted to share some of my favorite posts from the diabetes blogosphere:

Diabetes blogs rule.Lee Ann at The Butter Compartment is a longtime type 1-er and a lady who understands the trials of fitting an insulin pump into a fancy dress moment.  Thanks to some Twitter tips and some good, old fashioned ingenuity, Lee Ann managed to McGyver her way into a fashionable moment.  (And personally, I never underestimate the power of duct tape.)

Diabetes blogs rule.Wendy at Candy Hearts stumbled upon a Letter to the Editor from some idiot who saw a little boy take an injection at Burger King.  Apparently, the man who wrote the letter was horrified  by the drug taking at the table and felt the need to write to his local paper.  And while Wendy admits to having no idea what was in that syringe, she wrote a response to The Burger Grump, outlining why certain people may need to take an injection before eating (namely, did the kid have diabetes). 

Kelly at Diabetesaliciousness added her two cents, as well.  What's your take on this Burger Grump?  Do you feel that a PWD should be able to inject in public?  (Personally, I think it's no different than blowing your nose at the table.  If you can keep it clean and sanitary and discreet, it's fine.  People are allowed to manage their diabetes in public, so long as they aren't creating unsanitary conditions for others.)  If you want to chime in with your own letter to the editor, click on this link and visit the Pocatello Idaho State Journal website.

Diabetes blogs rule.And those of us here on the East Coast apparently missed an AWESOME event, at last week's TCOYD in San Diego.  Manny touted it as the best diabetes conference he's ever attended, Cherise gave it a definitive thumbs up, and George agreed.  I've never attended one of the TCOYD conferences, but apparently there's one in my homestate of Rhode Island next September, and BSparl and I will definitely be in attendance.  Will you be there? 

What have you been reading in the diabetes blogosphere?

October 07, 2009

Flu Shots Suck.

I hate flu shots.I'm not a good PWD, because when I'm told to get a flu shot, I do whatever it takes to skirt the issue.

"I already don't feel well."
"I don't like needles."
"I think flu shots give you the flu?"
"They never help me avoid getting sick."
"Your mom should get a flu shot."
"No one likes flu shots and they smell." 

But a few weeks ago, I was at Joslin and they were prepping me for the worst that winter has to offer, namely the Regular Flu and then the ever-looming Swine Flu.  I have to be honest - even though I have a lot of faith in my medical doctors and I believe firmly in their fine training (especially at Joslin), I always second-guess these vaccines. 

But this year, with my health under careful watch by the Joslin Clinic and my eye on the prize of good control and good health, I let them coerce me.

"Do I have to get this shot?"

The nurse wrinkled her nose.  "Yes.  But I can't force you.  But yes."

"You mean you can't make me get it but you can guilt the hell out of me until I get it, citing all kinds of studies and risk groups and the benefits of vaccination?"

"Yeah, that's about the bulk of it."

So I rolled my eyes and then my sleeve, letting her inject the flu shot into my shoulder.  

"Next time you're here, you'll want to get the swine flu vaccine, okay?"

"Seriously?  Isn't it the first round of that?"

"Yes, but people with diabetes are on the high risk list, so it's going to be the same recommendation from your doctor as this one."

My response:  "Grumble, grumble."

Last year, I skipped my flu shot because I felt a little under the weather that day and they advised me to wait.  And I didn't go out of my way to follow-up.  The two years prior, I ended up in the line at work on "flu shot day" and received the vaccine, but reluctantly.  I don't like the idea of injecting myself with a dormant virus in efforts to make antibodies. (If that's how it really works ... don't quote me on that.  I'm sort of making this up as I go along.  See also:  not a doctor.) I don't like going out of my way to expose myself to different illnesses.  It just seems counter-intuative.

Am I the only diabetic who is reluctant to get their flu shot?  

September 29, 2009

Inspired by the Parents.

Parents of kids with diabetes - it's a full time job.Last night I had a chance to sit with some parents here in Norwalk and talk about our collective experiences with diabetes.  These parents were taking care of children with diabetes, ranging from the newly diagnosed three year old to the newly diagnosed 13 year old, and everywhere in between.  High school angst, the issues of disclosure, the pursuit of "perfection," and all those other issues that parents of kids with diabetes, and the kids themselves, are dealing with.

"I was invited here to talk about how to raise a child with diabetes without losing your mind.  But I'm not really qualified to talk about that sort of thing, to be honest.  I'm not the parent of a diabetic child.  I am the diabetic child."

The parents at this group were wonderful, all actively engaged in their child's health, just trying to make sense of what diabetes doles out every day.  We were a small group - about 12 of us in total - so the conversation flowed pretty smoothly and comfortably.  And we hit upon some very intimate issues.

Like menstrual cycles and their impact on blood sugars.  (Remind me again why I'm talking about puberty and my female hormones with strangers?)  Or the dodgy things I did as a kid to lash out at my diabetes or my parents or at life in general.

I admitted to hitting the old school glucose meters with a touch of rubbing alcohol so that the result would come up lower.  I also admitted to knowing that my mother hid ice cream sandwiches in the frozen vegetable boxes, but I ate them despite her efforts. 

"I wasn't the best kid, and definitely not the best kid with diabetes, but I made it through okay.  And my parents and I?  We still talk.  And we still like each other."

They laughed.  

"What advice do you have for parents who are dealing with teenagers?  What's on the 'don't ever say that,' list?"

And the only thing I could think of was the epic "We."  

"It's just that one pronoun.  The 'we.'  We need to test our blood sugar.  We need to take our injection.  We have diabetes.  This always drove me nuts because unless my mother was testing her blood sugar or my father was taking an injection, they weren't diabetic.  They didn't know what the lows and the highs felt like, only what it felt like to watch the highs and lows and to feel those moments externally and emotionally."

The group nodded, understanding.

"But it wasn't until I was older that I realized the 'we' concept did apply.  It wasn't just me.  It was all of us, as a family, living with this disease.  And even though I was the one who had diabetes, my parents were dealing with something, too.  Diabetes has a lot of different sides to it, and it doesn't just affect the person who actually has it.  So it is a 'we' thing.  We live with diabetes, as a family.  And it took me a long time to realize that."

One of the parents piped up.  "How long?"

"Like ... yesterday morning?  Maybe Friday, at the earliest." 

She laughed.  Another parent asked, "When will my kid figure that part out?" 

"I don't know, honestly.  Everyone's experiences vary.  For me, diabetes wa a dragon that we, as a family, fought together.  We didn't fight one another, but it was us against IT.  And now, I'm a married woman with a husband who goes to the doctor with my instead of my mom and dad going, and my mother has no idea how this insulin pump works or how the CGM works or what the hell 'basal insulin' is, but she still has the same protective instincts, and still works hard to take care of me."

"Even just this past Friday, at my Joslin appointment, I saw this CDE I'd never met before.  This lady was critical of every number, every moment of my management, and yelled at me for doing too much while she yelled at me for not doing enough.  I was feeling pretty emotional after 45 minutes of this, so I went to take a break to calm down, leaving the CDE and my mother alone in the room together."

"And I guess while I was gathering my wits in the bathroom, my mother, who had been sitting there quietly and watching the fireworks, leaned towards this CDE and said, 'It's been a long, emotional day.  And you are supposed to support her, not rip her apart.  I think you should tone it down a bit, don't you?'"

"I guess you don't ever age out of being the parent of a kid with diabetes."

Diabetes is a journey, and for some of these parents, they've been on it for many, many years.  For others, they are just beginning to take those first steps.  And for me, with more than two decades with type 1, it was beyond amazing to see them gathered together around the table to find answers, find support, and find inspiration.

September 11, 2009

Twenty Three is a Good Time for Change.

Twenty three years ago, I was diagnosed with type 1 diabetes. And today, I've got nothing but hope in my heart.

During the course of the last three years, Chris and I have taken steps in our relationship to become a family, going from "boyfriend and girlfriend" to "husband and wife," and becoming the Sparlings (or the Sparklings or Spauldings or Sparrings ... pick your favorite mangled version).  And we have hopes to even out the cat:human ratio in our home in the coming year, now that my numbers are in range.

Living here in Connecticut has been a very interesting experience, and I've loved working at dLife.  I absolutely love my coworkers and I know that this kind of team could never, ever be duplicated.  We've gone through a lot together, as a team, and I feel that these fabulous women are not just working alongside me every day, but they are also my friends.  (I mean, they danced at my wedding, for crying out loud!) 

I've also loved living somewhere new and having easy access to a city like New York.  Chris and I have seen so much of the city and have always felt like very thankful tourists.  But there's still more to see.  And more places to explore.

So now, as a family, we've decided it's time to move forward and explore a new place.  We're craving change.  Thanks to some tremendous career advances for my husband and the opportunties that are unfolding for him over the next few months, and thanks to the opportunities that SUM and dLife have opened up for me since I started blogging in 2005, we're on the move once more.  At the end of the month, I'll be leaving my current position at dLife and taking on a consulting role with the company.  I'm also broadening my freelance and consulting career to include other opportunities, and I'm really excited about where the next few months will take me.  Where they'll take my family.

I'm so ready for this.

My handsome husband and I are bidding Connecticut a fond farewell and heading up towards the Boston area to embrace a new chapter in our lives.  We're sad to go, on some levels, but thrilled to move onward and upward.  It's time, and we're excited to see what's next!!!

Thanks for all of your continued support.  It means the world to me.  Now I'm looking forward to seeing if Siah is too fat to shove into her cat carrier.  (It may be time for a bigger one, judging by her potbelly.)

When it's time to change, it's time to rearrANGE.

September 10, 2009

A1C Payoff.

Oh hell yes.I've worked very hard over the last few weeks.  There's no denying that.  

I've logged blood sugar numbers on the Kevin spreadsheet and busted my butt to keep up with the maintenance of those logbooks.

Chris and I have counted carb after carb, making sure that I'm dosing accordingly.

I have changed some of my "bad habits" here and there in efforts to get crap under better control in pursuit of BabySparl.  (I even gave up coffee.  For anyone who knows me, THAT is a huge thing.  Huge-r than logging numbers.)

And yesterday, after spending the entire day under the weather, my phone rang.  Dr. CT was calling with my A1C results.

"Kerri?  This is Dr. CT.  I have your blood work back."

I was napping off my illness just before she called, so I had to shove the cat off my head and rub the sleep from my eyes.  "Okay.  How'd I do?"

"Wonderful.  This is just great - such progress!  You're at 6.3%.  You have done a fine job."

"No kidding?  6.3?  That's the lowest I've had in years.  Ever, maybe."

"Well I wanted to call and tell you personally.  I saw these results and said, 'Oh.  This will be a fun call!'"  

"Thanks, Dr. CT.  Thanks for calling."

And that's that. 

There's so much swirling around me right now and so much change on the horizon that I'm excited, ready, scared, and overwhelmed and all I can think is that tomorrow marks 23 years that I've been living with type 1 diabetes and I'm still learning so much every.  single.  day.

August 27, 2009

Pink is the New Quickset?

Even though I've been pumping for several years, I've only used one kind of infusion set in that whole span of time.  So last night was a diabetes first for me - my first Inset infusion set.  

My first thought was, "Um, big needle?  What's that about?"  But it's just a mega needle for filling the pump reservoir.  The infusion sets are luer lock (which I'm not sure is one word or two or what it means other than some version of "it's like a bottle cap"), which means that using the new sets means using new reservoirs.  I'm not sure how I feel about this, but I think I could adjust.

Mega needle?  No big deal.  It's not going in me. :)

In addition to the funky reservoirs, the Insets come with their own built-in insertion device.  This is a big score for someone like me, who travels a lot and is always having that mid-drive home to RI panic attack of "OMG IS THE QUICKSERTER IN MY BAG?!"  With the tubing coiled around the infusion set there, it's a little complicated (or at least it was for me, this first time) to prime the pump and pull away the adhesive cover.

Pink.  I can't believe I'm using a pink set and am OKAY with that.

But the fact that it cocks back and becomes its own insertion device?  I'm sorry - that's just downright badass to me.  (It also slightly resembles a birthday cake, but that's neither here nor there.) 

Birthday cake, anyone?

One thing I didn't realize until I had attached the site was that it was pink.  Pink, pink, girly pink.  "Chris, it's pink!"  And he took a peek.  "It's cute.  I like it." 

Another change for me to get used to was the fact that this set doesn't connect to the tubing by swiveling in place.  It snaps together like a seatbelt.  It isn't as low-profile as the Quickset hub, but it's pretty close.  But I was weirded out by one thing:

"Where is the pump cap?"

I'm used to that little plastic disc that covers my set when I'm showering or in the ocean or during intimacy.  How does this new infusion set stay "closed" even when I'm disconnected?  Does anyone know?  Or it is just supposed to be open like that? 

All hooked up on the left thigh.

One thing is for certain:  this kind of infusion set does produce less garbage.  Here's the aftermath from a site change with the new infusion set: 

More diabetes carnage.

I like that the set can close all on it's own and be chucked into the sharps container.  And I also kind of like the spaceship look of the infusion "pod."  Actually, I just like trying something new for a change. 

The disease doesn't change.  Diabetes is every day and it's the same kind of crap every day.  But a little technology swap or a different flavor of juice to treat a low or a new kind of workout at the gym to mix up my routine?  Sometimes you just have to appreciate these little bits of change. 

(Also:  You guys are great.  GREAT.  You had so much great feedback on yesterday's post that I really feel like I have the right questions to ask my endo this week.  THANK YOU for all of your informative comments!!) 

August 21, 2009

Staying Accountable.

It's been three weeks since my Joslin appointment and in that time, the accountability train, and thankfully, it hasn't derailed.  Or smashed into me. 

Yet.

But also in that time, I traveled to Spain, had plenty of wonky lows while traveling, didn't have internet access, and battled the time-space continuum, in addition to working plenty of hours at dLife before the trip and upon my return.  Stress levels?  Not at their lowest.  Also, logging opportunities?  Minimal.

But DUDE.  I'm still doing it.  

Thanks to the power of the Kevin Spreadsheet and the fact that I sit on my rear end all day long, staring into the abyss of my work Mac, and also thanks to the jazzy little Ann Taylor flashdrive I picked up at BlogHer, I actually have logbooks that mean something.  And I've actually stayed up on them for the last three weeks. 

Note:  I hate logging.  I always have.  I may always hate it, but the undeniable fact is that logging makes me accountable, too.  Seeing those numbers and the patterns they form forces me to recognize tricky trends and gives me enough perspective to make tweaks.  But I do so despise it.  It's a pain in the arse

The toughest part has been logging day-of.  Before we went to Spain, I was at work and able to keep the spreadsheet open on my desktop and update it as needed, never really breaking from work to fill in the gaps, but just keeping up with things as they happened.  And at night, I'd plug in the flash drive late at night, fill it in, and then start again the following day.  It was a tedious system, but I kept up with it.

Spain, on the other hand, was much harder.  No computer on hand during the day, difficult to track and log food (nevermind counting the stupid carbs) while we were exploring Barcelona, and even though the clock said 6 pm, my body was screaming, "Midnight, woman!!!!!"  If it hadn't been for the Dexcom, I would have completely lost control.  But since that Bad Larry was keeping me between the lines - literally - it helped me stay reasonably even.

Upon our return, it was hard to get back into the swing, but knowing my next Joslin appointment is next Friday helped get my priorities straight.  Right now, I have three neat little spreadsheets on my Flash drive, with 100% of the blood sugar results and about 70% of the insulin doses and food logs intact.  Chris is helping with my food and calculating carbs for me so that there isn't so much SWAG bolusing.  This, my faithful readers, is flipping progress for this girl. 

My 7 day machine average is down to 125 mg/dl.  My 30 day is 130 mg/dl.  This is with fewer highs and fewer lows (aside from a few episodes while traveling), which makes me feel more confident that I'm truly holding steady and not just averaging out.  I feel sickly when my blood sugar is 180 mg/dl, which means I'm becoming more sensitive to highs and also not as used to them.  (A major plus.)  My A1C came back at 7.1% last time - a .5% drop from the time prior - and I'm certain that next week will show even more improvement. 

I'm not messing around.  I can't.  I'm on a mission.  :) 

Another Stupid Note:  I'm not posting these numbers to brag.  Or to elicit criticism.  For me, these numbers are - for the most part - an improvement and I am using both Joslin and SUM as my tools for accountability.  So when you see the graphs and you see my machine average, don't think I'm inviting your commentary on my actual results.  Your diabetes may vary, and mine sure as hell does, too.  Cool?  Cool.

So next week, I'll toddle off to Joslin with four spreadsheets crammed with information and hopefully a cool head.  Chris and I will talk to them about making changes, and I'll leave feeling more in control.  Even if the numbers don't improve as fast as my attitude towards them, I still need to move forward as efficiently as possible.

Good control is RIGHT on the horizon.  I can feel it.

August 19, 2009

The Lows in Spain Stay Mainly on ... Me?

As I mentioned yesterday, the trip to Spain was lovely, but fraught with lows.  I'm not sure what caused what, but between the six hour time change, the excessively late nights and the corresponding late mornings, and spending hours walking around the city of Barcelona - my glucose levels spent a lot of time in the trenches.

Chris and I brought three big jars of glucose tabs (in grape, raspberry, and tropical flavors, of course) and four packages of Mentos candy with us for the trip, assuming this would be enough.  But I couldn't have anticipated the lows that followed us from landmark to landmark.  Aside from the initial high after the plane took off (Oh Kerri, you don't like to fly?  Hmm ... you've never mentioned that before!) and a spike after my mid-week insulin pump set change, my blood sugars were low the majority of the time we were traveling.  Nothing earth-shattering, but more a constant trend of 60 - 80 mg/dl, which sounds good in theory but when it's the result of constantly popping glucose tabs, that's a bit much.

Especially in the airport.

Leaving from JFK to head to Barcelona was fine. Our flight left NYC on time and things went smoothly, schedule-wise.  But coming home?  Completely different story.  

According to our itinerary, we had an hour and fifteen minutes between our flights from Barcelona and from London, so we thought we'd have enough time.  But when the plane left Barcelona 30 minutes late, we knew it was going to be a scramble to make our connection.  In Heathrow.  Which has to be the most confusing, unstructured airport I have ever visited in my life, more like a mall with airplanes thrown in as a bonus, instead of being a well-organized airport first.

Our plane landed in London and we had about 40 minutes to make our connection.  We stood in line to go through security again, and the Dexcom started to wail.  I dug it out of my bag and saw a blood sugar of 102 mg/dl and two double arrows pointing straight down.  (You can guess what that means.)

"Oh darn it gee wilikers, I'm going low," I said to Chris.  (Note:  This is the edited, non-Yosemite Sam version of our exchange.)

"You have glucose tabs?"

"Yup.  Chomping now."

We went through security - down to 23 minutes to catch our flight.  Raced to the board where the flights gates were being announced and searched for our flight.

"Shit, we're all the way across the airport.  We've got to book.  Keep eating, okay?"

So we start moving fast.  The Dexcom is continuing to vibrate, and I'm eating glucose tabs while dragging my suitcase behind me, my purse bouncing off my hip as we run. 

"You okay?"  Chris calls back to me as we're running while on the moving sidewalk.

"Sort of.  Are we close?"  Glucose tab dust covers my hands, leaving imprints on the railing of the sidewalk.

"Sort of." 

Time is tight.  So we start to move as quickly as we can.  We run until we get to the American Airlines gate and Chris goes to the counter to check us in.  I take my meter out of my bag with shaking hands and test, only realizing then that I've been crying.

30 mg/dl.

Oh that's lovely.

And then the panic hits with intensity.

"I'm 30.  I need something fast."  My mouth is dry and the idea of trying to consume glucose tabs with vigor makes myThank goodness for American Airlines kindness. throat close at the thought.

"Juice.  There's a machine.  Sit here, baby.  Sit and eat the tabs and I'll get juice.  You'll be fine ..."  He moves quickly to sit me in a chair, puts the bottle of glucose tabs in my hand, and runs to the Minute Maid vending machine.

Which only takes British pounds.  Not American dollars.  Or Spanish Euro.

"Gosh."  Chris said.  (See above comment re: edited version.)

I'm not sure what happened next.  My brain was in a complete fog and I'm sure I looked frightful to the unknowing outsider, surrounded by suitcases and crying and eating odd little dusty discs and looking as though I was jilted at the airport.  I know Chris ran to the check in desk and explained "medical emergency" and "needs juice from the machine" to the man in the American Airlines uniform.  I know that this stranger gave Chris all the money he had in his pocket as quickly as he could, without asking questions.  I know Chris said "thank you" as he ran back to the machine and I sat on the chair, still trying to choke down glucose tabs.  I know that a bottle of orange juice was in my hands seconds later, and I know that the plane was boarding and we were treating a really miserable low in the airport.

Twelve minutes. 

"Test, baby."

51 mg/dl. 

"You're coming up.  See?  That's already higher."

Still in a fog, but beyond pressed for time, we gathered our bags and started down the gate towards the door of the plane.  We were among the very last people to board.  I wasn't as much of a mess but I was wiped out, my whole body trying to recover. 

"Thank you," Chris said to the American Airlines employee who gave us the money for juice.  "Here, please take the money back."

The guy was behind us in line and smiled gently.  "No, it's fine.  Please.  I'm glad you're okay.  Don't worry."

I took the coins from Chris and pressed them into the employee's hand.

"Thanks very much.  But you might need this change.  You know.  For another diabetic who really needs a helping hand."

He took it.  We boarded.  And headed home.

August 04, 2009

Biking Block Island.

After the loooooooong day in Boston on Friday, I needed to work off some stress.  So Chris and I decided to 'sail away on the Block Island ferry.' (This is the theme song for the ferry, but I couldn't find a YouTube clip or anything.  If someone can find audio proof of this song, please send it to me!  Lyrics are "Sail away on the Block Island Ferry, take a trip back to carefree times.  Sail away, Block Island awaits you.  Just leave your troubles behind."  And thus ends this digression.)

Our ferry ride over was a little choppy, and we were ... green by the time the ferry docked at Payne's Dock, but we shook off our seasickness quickly after breakfast at the Mohegan Cafe.  Then we rented some dented bikes from the shop by Ballard's (I left my bike back in CT ... foolish Kerri) and got on the road.

I must admit:  July was a tough month for me, exercise-wise.  I was traveling way more than I'm used to and only made it to the hotel gyms a handful of times.  My own gym membership at home went virtually unused, save for a few ragtag workouts.  But I thought I was still in relatively decent shape, so I didn't think the bike ride would kick my ass.  I was even grinning before we attempted the hills, all hopeful. 

Oh how stupid I was. 

The first leg of the ride was all uphill.  We followed Spring Street straight up to the Southeast Lighthouse and by the time we reached the top of the bluffs, I was dying.  DYING.  My legs were wobbly and I was panting and my blood sugar was plummeting.   Thankfully, I'm a nerd and I chose the bike with the little basket on the front, and since I didn't have a small dog to stuff in there, I instead had a secure place for glucose tabs.  Which I ate.  Happily.  Next to the Southeast lighthouse. 

Exhibit A:

Tabs by the lighthouse.  Of course.

We hung out for a while at the lighthouse because my numbers just wouldn't budge, so I are a few more glucose tabs near the bluffs. 

Exhibit B:

Tabs on the bluffs, yo.

The Dexcom (also stuffed into the bike basket) finally stopped BEEEEEEEEP!ing and a quick test confirmed a number finally in the triple digits, so we ventured on our way.  Thankfully, the way down was easier on our legs, and we stopped at the Block Island airport to take a break and watch the teeny, tiny planes land.  (Note:  No.  I will never go on one of these planes.  They hold four people.  Including the pilot.  Oh hell no!)

Water Street in the background.

It was fun, though.  Chris and I had a great time - hard not to in one of my favorite places.  Even though my legs were burning and my wrist was a little aggravated from the ride, it was awesome to be out in the sunshine, taking in the sights of a beautiful place like Block Island as we whizzed by on our bikes.  (We also found the same pond three times.  Sad senses of direction, we have.) 

I already have a bike, but it's been sitting in our storage space for the last few years.  I used to ride all the time when I lived in RI because my apartment was across the street from a beautiful eight mile bike path.  Now I think I want to bust that thing out and toddle around town on my ridiculous bicycle with my equally ridiculous helmet (thank you, Nicole), maybe with Siah in a basket on the front. 

Or maybe just my meter would be more realistic. 

Either way, it was awesome to be outside, far from the glowing computer screen, pedaling away my stress on the summer streets of Block Island.

August 03, 2009

A Diabetes To-Do List.

I stood there with my best friend as she rubbed her pregnant belly.  The whole waiting room was filled with these lovely women and their round beachball bellies of varying sizes.

And I felt oddly self-conscious with my lack of roundness.

Last Friday was my first official appointment at the Joslin pregnancy clinic.  It's located at Beth Israel in Boston and is a beautiful hospital, different from the Joslin Clinic across the street that feels like home at this point.  I'm not pregnant, and we aren't trying to become pregnant YET, but this appointment puts things into full swing to bring me to a safe level of pre-pregnancy health. 

Sigh.  This all sounds redundant, even to me.  I've talked the Big Talk before.  "Oooh, look at me!  I'm going to really wrangle in my numbers and have an A1C you can bounce a quarter off!"  And I'm all gung-ho for a week or two, armed with my little log book and my good intentions, but within a few days, Other Things start to creep in.  Like work.  And stress.  And getting to the gym.  And social stuff, like hanging out with my friends and going to RI on weekends.  Eventually my good intentions end up in the spin cycle, and my log book starts to gather dust.  My workload piles up.  And my stress levels skyrocket.

I'm so frustrated because I want to have a career.  And I want to have a baby.  (I'd also love some tight control of my diabetes, too.)  These things would be excellent, but it feels like tightly managing type 1 diabetes is a full time job unto itself.  Slacking off is easy, and frustrating, and not healthy for me or any baby I'd like to have.   

But I also realize this is one of my biggest hurdles when it comes to pregancy planning - the whole "sticking with the pre-program."  This becomes more and more obvious to me when I go back and re-read old blog posts where I'm so excited to get back into better control, only to be derailed by those Other Things.  So during the course of my appointments on Friday with the endocrinologist, the registered dietician, and the certified diabetes educator, I admitted my faults freely.

"I need help being held accountable."  

They didn't quite hear me at first.  "We can do some tweaking, and in a month or two, we can revisit your A1C and see if it's lower and then we can give you the green light for pregnancy."

I knew I needed more than that.  I had to be completely honest. 

"Guys, I really need to be held accountable.  I know this sounds crazy and I seem very compliant, but I have trouble following through.  I'm great out of the gate, but I lose steam after a few weeks and I'm at the point where it isn't good enough anymore.  I'm out of excuses.  And I'd really like to join the ranks of those pretty pregnant ladies out there.  Please help me?"

And they listened.  We spent the rest of the day working out a plan for me.  One that will actually make a difference.  One that will get me there.

I'll be in Boston every three weeks until I'm pregnant.  This is a huge commitment but I need to make diabetes a priority without fail.  I want this.  I want to succeed at this more than anything else.  I'll have my blood sugars logged for those three weeks and we (my husband and my diabetes team and I) will all review them together.  Chris is in charge of my meals, in that he'll be helping me plan my day, food-wise, and he'll be counting carbs and measuring things for me. I'll be eating relatively similar items every day so I can manage the trends and control them.  I'll continue to test all the live long day and wear the pump and the CGM, but I'll actually use these devices to their fullest potential, instead of just going through the motions. 

With these appointments spaced just a few weeks from one another, I hope I can stay tuned in to intense diabetes management for three week stints.  Being sent out for three or four months is too much for me.  Obviously, because I burn out well before my follow-up appointments.  I just plain can't pay rapt attention for that long.  But three weeks?  Can I do that?

I have to do that. 

I will do that. 

It's a long way down from here.

July 08, 2009

Diabetes ... is a Game?

The idea of creating a game about diabetes both intrigues me and creeps me out a little bit.  Diabetes is a game? I guess after an evening of "WHY 200?  WHY?!!" I'm not feeling so light and fluffy about diabetes.  But I see the potential for kids to learn about diabetes and its management through the use of games, so I'm all so for whatever gets good information out there.  And over the last few days, I've come across two particularly interesting games, thanks to reader alerts, aimed at kids who either have diabetes or have friends with diabetes.

The first game is on the Nobel Prize educational games site and it's cleverly called The Diabetic Dog game.  (Wee bit short on imagination once they got to the naming part, I suppose.)  I will admit - I played this game for at least 15 minutes and I appreciated the cuteness of the doggy. 

The Diabetic Dog Game

As a "caretaker," I was instructed to keep my diabetic doggy (named, in my profile, "DoggyPants") happy (by petting him), well-fed (by purchasing food for him), getting him to exercise (by walking him), and keeping his blood sugar in check by giving him insulin injections.  Keeping an eye on the bar at the bottom left of my screen let me know what DoggyPants's blood sugar was, and I could feed and dose him accordingly.

(Sidenote:  Having that bar gauge with his blood sugar in it sure helped me figure out what I was doing, and I wondered if the developers of this Diabetic Dog Game realized how they're helping further the case for continuous glucose monitors.) 

Overall, I liked how this game showed the importance of insulin, food choices, and exercise as the cornerstones for good diabetes management, and it didn't tout insulin as "a cure."  Basically, all you do is chase this little puppy around and feed him or dose him or walk him.  Constant cycle of redundancy, only the results aren't predictable.  Kind of like real life.  :)  

The other game I have been receiving reader alerts on is the Didget from Bayer.  I haven't seen this game in person, but according to the word on the street (read: their website), "The Didget blood glucose meter from Bayer is the only meter that plugs into a Nintendo DS or Nintendo DS Lite gaming system to reward children for consistent testing."  

The DIDGET.  IN ALL CAPS!

So it's an actual meter that snaps into the Nintendo system.  (It appears to be, or be completely identical to, the former "GlucoBoy" from a bit ago.)  Honestly, that is pretty darn cool, and I wish that kind of "fun" was available when I was testing my blood sugar as a kid.  Hell, I'd like to have that kind of positive reinforcement NOW, thank you very much.  

"This unique meter helps encourage consistent testing with reward points that children can use to buy items within the game and unlock new game levels. And, since the DIDGET meter is based on Bayer’s trusted CONTOUR™ system, you know you’re getting a meter that’s reliable." They are also building a community for kids to "hang out in" virtually, comparing notes.  Of course, since it's Bayer, they need to slide in their personal product endorsement, but they have the right idea.  Test often, get rewarded for keeping tabs on your numbers, and maybe Nick Jonas will show up at your house and give you a hug.

That last part?  A lie.  But Bayer is working its way into the hearts of kids with diabetes, and as a former kid with diabetes myself, I would have appreciated that kind of innovation as part of my childhood with this disease.  From what I can tell so far, this meter is being marketed towards diabetics in the UK, but hopefully there will be a United States counterpart.  With mg/dl readings.  Because doing conversions when low?  Not so easy.

So there you have it. We've come a long way from that game with the elephants or the other one about the Escape from Diab, and hopefully more efforts will be made to engage kids - and adults! - with diabetes.  Positive reinforcement is hard to come by in this whole diabetes mess, so every little bit helps.

July 01, 2009

Between Dinner and a Movie.

Saturday nights when we were very small were the best. 

We made blanket forts and used every damn cushion in the couch.  Laying pillows on the floor, we'd jump from down-filled island to island, pretending that the carpet was infested with alligators and only by balancing on the pillows would we be safe.

The babysitter always promised to make healthy dinner, but usually we ate popcorn, chicken fingers, and drank diet soda by the bottle, filling the glasses to the very brim and frantically slurping the carbonated foam awayI loved this doll.  I even pretended she had diabetes.  Which is a bit odd. before it could spill over.

My favorite babysitters were the ones who played with us, not just sat there and talked with their boyfriends on the phone.  Carolyn was my favorite one of all and I named my Cabbage Patch doll after her that year.  She was pretty and smart and the characters she pretended to be were so clever.  She was the perfect example, to me at seven years old, of what a 'hero' really was.

My parents had a standing Saturday night "date night," and they would go out to dinner either alone or with some friends, then maybe to a movie.  Usually they left when it was still light out, while we were still outside playing in the yard or just coming in to have a snack.  My brother and sister and I played and fought and made messes and told stories and generally destroyed the house, like little kids do.

Only now, when my memory is jogged, do I remember the headlights pulling back in the driveway, between when dinner ended and the movie began. 

Dad would wait in the car while Mom ran in quickly to test me and give me my bedtime insulin injection.  Then she'd say goodnight to all of us and run back out to the car to continue "date night."

Only now do I remember those moments and wish I'd named "Carolyn" after my mother, instead.

June 30, 2009

Penguin Truck.

We're planning for a pregnancy, so I've been working tirelessly to stalk my blood sugars.  I'm wearing the Dexcom, testing regularly, and really aggressively chasing highs and lows in pursuit of that nice "between the lines" look on my blood sugar graphs. 

So when I changed my infusion set last night and neglected to take the 1.0 u bolus in anticipation of the high (which seems to be the only way I can keep the highs at bay after a site change), I knew I was in trouble.  Sweaters on my teeth, and my tongue thick with dehydration, confirmed by the 254 mg/dl on my meter.  I cranked up a correction bolus and sent it cruising in, along with some frustration and a few choice curse words. 

A few hours later, I was on the steady but seemingly safe decline, with the Dexcom keeping tabs and my meter serving to confirm.  No worries.  I ate a snack (cottage cheese with some frozen raspberries) before bed and snuggled against the pillow (read: cat) at a blood sugar of 187 mg/dl.  Higher than normal, but I knew it would continue to come down.

Didn't anticpate the 3:30 am wake-up call of BEEEEEEEEEEP!, though. 

I have no idea what my blood sugar was.  The Dexcom showed me only as "low" and I woke up crying, for some reason.  Chris was next to me, fast asleep, but I didn't wake him up.  I don't know why.  A bottle of glucose tabs sat on the bedside table but I didn't reach for them.  I don't know why.  The shape of my body was outlined in sweat on the bedsheet and my hair was sticky, and for some reason combing my hair down before I went to get juice took priority over eating something to correct the low. 

I don't know why.

I don't remember a lot of this low, and that scares me.  I was dizzy.  I was stupid for not waking Chris up and asking for his help.  I remember hearing the Dexcom wailing from the bedroom as I stood at the fridge in the kitchen.  I drank the juice directly from the carton, drinking well past my eight sips and gulpinThese guys can just go right to hell.g until I couldn't catch my breath.  Yet, I remembered to wipe down the floor to clean up what I spilled.  I don't know why.

Hitting that stride, hugging close to the center lane of 100 mg/dl, is really what I'm aiming for.  I've been doing better lately, so every time I'm way off target, I feel the symptoms too late for lows and very intensely for highs.  I know this is a signal that I'm in tighter control, but once I'm stuck in the spin cycle of high-to-low-to-high and back again, it's hard to climb out.  And a lot of time my morning number sets the stage for the rest of my day.  Last night's low blood sugar left me at 199 mg/dl this morning, and I still haven't settled back into range.  I feel frustrated, knowing my A1C is being drawn at the end of July.  But last night's events kicked my ass too thoroughly for me to focus on anything other than muddling through the day.

It's that pesky penguin truck again.  I hope the tire tracks aren't too visible this morning.  

June 26, 2009

The Faces of the Philly Meet Up.

The conference I'm speaking at this week is about social media and how pharma and patient bloggers can work together to benefit the patient community.

My main points are to drive home the fact that even though we might be perceived as "target markets" and "diabetes consumers," we are people first.  We're people before we're patients, before we're anyone's consumer base, before we're diabetics.

People.

And last night, I had the distinct pleasure of hanging out in Philadelphia's Black Sheep Pub with a bunch of people who just happen to have diabetes.   Sitting among all these shining faces (because, holy crap was it hot in there), I wished that Big Pharma was there with us to see the real people behind the diseases about which they create power point presentations.

The D-Bloggers Descend on Philly
 Hey Pharma!  See us!  We're your "target market!"

It was great meeting everyone last night!  Thanks for coming out in that heat, and I'm looking forward to seeing you guys again!!

June 18, 2009

Working On Working Out.

Way overdue on a new vlog post, but I was inspired by George's post yesterday about getting back on track with exercise.  So here's my vlog post about diabetes, working out, and what motivates me to move.

Some of my reasons are a little goofy, but I think whatever gets me to exercise is well worth laughing at myself a little bit.  What gets you to break a sweat?

June 16, 2009

Do I Have the Right?

Over the weekend, Chris and I (and his sister and dad) ended up in a harborside restaurant in South County, RI.  We stood in line and read the chalkboard menu until it was our turn to order from the girl behind the counter.

"What can I get for you?"

"Can I have an iced coffee?  Do you have iced hazelnut?"

"I'm sorry - we don't have hazelnut.  But we have snickerdoodle or french vanilla.  Either of those work for you?"

"Snickerdoodle sounds awesome.  Is that a syrup?  Is it sugar-free?"

She gave me just a quick look.  Not judging, just looking.  "It's definitely sugar-free.  Medium or large?"

"Large," I said, and she turned away to make my coffee and I saw the pink Animas pump clipped to the side of her black pants, the tubing sticking up all crazy. 

And instantly, I want to ask her a million questions. 

With the Dexcom and the Animas being integrated sometime "soon" and with my only pumping experience being with Minimed, I wanted to ask her how she liked the Animas.  I wanted to see how long she'd been diabetic and did she go to Joslin, too?  Did she know any other diabetics?  How long had she been pumping? 

I wanted to tell her that the tubing gets all crazy on my pump, too, sometimes. 

But do I have the right to make her diabetes my business?  Just because I write about it doesn't mean I have the right to grill her about her diabetes.  She wasn't asking me why I wanted to make sure the coffee was sugar-free.  She was just going about her business.  Did I have the right to poke into hers?  Just because she wears an "external symptom" of her diabetes in the form of that pink pump, did I have the right to ask her about it?

There have been a few times when a diabetes discussion was thrust on me without my invitation.  "Hey, what's that thing on your hip?" becomes this moment of advocacy that, while effective, wasn't what I wanted to do that day.  Sometimes I just want to order my coffee without being grilled about why I need to make sure the syrup is sugar-free.  Other times I'm blogging about the teeniest minutiae of life with diabetes.  I oscillate between wanting to be a diabetes advocate and someone who lives a quieter diabetes life.  Sometimes I don't want to talk about it at all.  That day, I didn't want to be an advocate.  (Or a pain in the ass.)  I just wanted to get some coffee and enjoy the day.

Maybe she doesn't want to talk about it, either. 

She made my coffee and added some cream.  I handed her my money. 

And I left without saying anything.

Do I have the right?

It's not always what we have to talk about.  There's way more to us than this. 

June 15, 2009

Old School Diabetes: Diagnosis.

I saw my niece over the weekend.  She just turned seven.  She had a bit of a fever and wasn't feeling very well, so when I saw her snuggled up on the couch under a blanket, she looked every bit the little kid she is.  Poor little peanut, hiding out until she felt better.

I remembered that I was about her age when I was diagnosed.

I found an old school photo from second grade, with me sitting next to my friend Bobby (who I still talk to, which is a very surreal experience, hanging out with someone I've known longer than I've known insulin injections).  I was diagnosed in September, right as second grade started.

Second grade, 1986.
I'm in the blue dress, second row from the bottom, third from the left.
Swinging my feet.  Not much for sitting still, even in second grade.

Over the last few days, I've been reading some emails from the CWD parents as they gear up for the Friends for Life conference in Orlando in a few weeks.  These emails are sent out to a whole mailing list of attendees, and somehow I ended up on the list with all the parents.  (Or maybe the list just happens to be mostly parents and I just happen to be an adult "kid" with diabetes.)  These parents are comparing notes and reaching out to one another, looking forward to other parents who understand what they're going through every day as they care for their kid with diabetes.

And I wish that my mother had this kind of support when she was dealing with my diagnosis over twenty years ago.  My mom had a lackluster team of doctors at the Rhode Island Hospital (where I went for a few months before going to Joslin) and Eleanor (the only other mother of a diabetic kid that we knew of in our town and the woman who just happens to be my local Dexcom rep), leaving her with little to manage the enormous learning curve.

This weekend, I went on a bike ride with my sister-in-law, my father-in-law, and my husband.  I had to remember to test beforehand, bring my meter, stash some glucose sources on several people, and monitor as re rode.  A lot of thought for maybe an hour long bike ride.  And it made me wonder what kind of preparation and worry my mother went through when she sent me out to play for a whole Saturday afternoon.  Lot of work on my mom's part just to keep things normal. 

I forget this sometimes, how many people are really involved in keeping me healthy. 

I need to call my mom. 

(Granted, my diabetes diagnosis hasn't kept me from doing much at all.  And it definitely didn't keep me from being ... um, a bit of a goofball.)

June 12, 2009

Community, Everywhere!

Earlier this week, dLifeTV did some filming for our upcoming new season.  And as part of a segment we're doing on online diabetes support, I had the chance to see Nicole Johnson again and to meet two members of the dLife community - Mark and Shauntaye.

Tune in to dLifeTV to catch these new shows!

We talked about our common experiences as people with diabetes, and how online communities have positively impacted our health.  I thought about all of us, writing our blogs and really sharing so much of our personal medical experiences, and how much this whole journey has helped improve my life with type 1 diabetes.  Our little community here has gotten so big.

I spent the better part of this week confirming travel arrangements for the next few months, and even though I'm not a very good (or calm) traveler, just knowing I'll have the chance to connect with more people who "get it" makes all the flight anxiety worth it.  I'm looking forward to visiting Philadelphia for a conference at the end of the month and hanging out with some fellow d-community members.  I cannot wait to go to Orlando in a few weeks and attend CWD's Friends for Life conference.  I'm excited for the Diabetes Summit in Indianapolis in July, and for the BlogHer event the next day in Chicago.  And I am so honored to be speaking at the BlogWorldExpo in Las Vegas in the fall.  Lots of travel for a cause I'm still so passionate about.

But damn ...  I'm going to need a bigger suitcase.  ;)

Since I started blogging four years ago, I've had the opportunity to meet many fellow diabetics, either through SUM or TuDiabetes or the JDRF or dLife.  We're a supportive and inspiring crew, and I'm really looking forward to meeting more of us "in person."

June 11, 2009

An Open Letter to Brett Michaels.

Idiot.Dear Brett Michaels,

Really?  Really?  I'm going to hope that you were misquoted.  I'm going to hope that maybe the reporter took your comments out of context and made you sound like an idiot, instead of you actually saying the following:

"Brett Michaels:  The only time it [diabetes] will ever affect you in bed is if you have extremely low blood sugar and you go into insulin shock, at which point you won't be standing up, let alone performing sex. However, I will sometimes hold off on the insulin, which will jack my blood sugar level up to the low 200 range. It's like how a prizefighter will want to go into the ring with his blood sugar levels high. It gives you the stamina of a bull. So, yes, sometimes I will endanger my own life to pleasure a woman."

(source:  Huffington Post

You dumb shit.  Brett, going low during sex is a pain.  I know.  I've had to stop for snacks, and I've had to stop entirely.  I've had discomfort and the inability to perform due to high blood sugars, too.  I've had sex while connected to my insulin pump, and I've also had to find ways to feel comfortable with sharing my diabetes with sexual partners.

But you, saying that you purposely run high "like how a prizefighter will go into the ring?"  Gives you "the stamina of a bull," you say?  You don't sound cool - you sound like a toolshed.  I was under the impression that high blood sugars are among the main reasons for sexual complications for diabetic men.  Are you hearing me, Mr. Michaels?  If you run purposely high, your manhood runs the risk of malfunction.  And stamina of a bull?  Pffft.

High blood sugars aren't steroids.  They're toxic and cause lethargy.  They are dangerous for a diabetic.  They make your breath smell like airplane glue, and telling a reporter that running high makes you shag like a rock star is a bit of a misleading statement.  (Are sure you're rocking these women as passionately as you claim?)

Dude, you are in the public eye.  You are among the very few celebrities who are living with type 1 diabetes.  I'm not saying you have to be Johnny Advocate, but don't spread misinformation.  Don't encourage some young guy to skip his injection in pursuit of being good in bed.  You know as well as I do that good diabetes control is what leads to strength and stamina.

You know better.

Or maybe you don't.

Best,
Kerri.

June 10, 2009

Blueberry Awesomeness.

There's stuff that's bolus-worthy.  New York style cheesecake.  Chai tea on a snowy winter day.  Wedding cake made out of red velvet with butter cream frosting.  These indulgences are worth draining my pump reservoir for, and almost worth the spike I try to, but don't always, avoid.

I've been very, very attentive to my diabetes lately.  Logging all these numbers, sporting the Dexcom, trying to manage stress levels, exercising ... whatever it takes to make me as healthy as I can be for the baby I want to have someday. But that wagon is hard to stay on all the time, and I have taken a risk or two in the last month.  Like a trip on the Connecticut Wine Trail with some friends.  And some pasta at Carmine's last weekend with my sister-in-law.  

Oh holy awesome.

And blueberry swirl cupcakes from Crumbs Bakery.

My diabetes control isn't made or broken in one bite of a fluffy, delicious cupcake.  Usually when I'm having a high sugar indulgence, I'm right on top of things, diabetes-wise.  I bolus aggressively to avoid the high and I watch that Dexcom like a hawk for any subsequent lows.  My management problems come more in the form of letting my numbers go untracked and pinging all over the place, letting highs creep up without corrections, then stacking boluses until I hit a nasty low, which I over-treat and rebound into a high ... you know the cycle.  It's not the "one thing" but more my inability to care for more than an hour or two.  The last few weeks of intensive management have been about keeping an eye on everything and not letting the cycle spin out of control. 

And it's hopefully working.  My machine averages are down, I'm seeing many hours straight of flat-lines on the CGM, and knowing my Joslin appointment is at the end of July keeps my mind on task.

Besides, it's not like I ate the whole cupcake.  I split it with Chris and I asked for the estimated carb count before I took a bite. 

But I did take the first, awkward bite. 

Whoops!  Cupcake!

And I did enjoy every other bite of it, too.  Go ahead and judge!  :)

June 09, 2009

Zombie Lows.

Weirdest dream.  Ever.The BEEEEEEEEP! woke me up from a dream about having my arm chewed off by a zombie that looked like Kevin James.  (Zombie dreams are common in my house, apparently.)

I wasn't sweaty and my skin didn't have that flushed, clammy feel, but my whole body was extra-sensitive and jittery.  Like being covered in sand, only every granule was touching a nerve.

For once, I didn't bother testing.  I knew I was low.  The Dexcom was howling from underneath the bedside table (where I must have lobbed it like a softball when it went off the first time.)  The display kept glowing "LOW."  I reached into the drawer of the bedside table and retrieved a tube of cake frosting.  Red.   

It's been a while since I've had a low in the wee hours of the morning.  I've woken up on the lower side a few times in the past several weeks (morning numbers in the 60's and 70's - too low for me), but there haven't been any low messes at 3 am. 

Until last night, of course.

Still unnerved from the Kevin James zombie dream, I consumed some cake frosting and let the sugar settle into my system.  It was absolutely silent -  not a sound coming from the roads outside or the cats milling around in the living room - and my brain kept screaming for more sugar.  

This is where I get stupid every time.  The frosting I ate was enough to cover my reaction.  After I tested, I saw that I was 45 mg/dl.  I'd already eaten about 20 grams of carbs, which would have brought me up nicely to about 100 and left me there.

But I had a brain full of zombie nightmare panic and low blood sugar, so I stumbled out into the kitchen. And proceed to drink about three cups of juice to quell my anxiety, checking in the hallway for zombies after each gulp.  It's so psychological, the way that juice calms the "low feeling" faster than anything else, purely in my mind.  Even if my blood sugar doesn't budge a bit, just drinking something sends my brain the "it's going to be okay" message.  (But I hate over-treating, because then I just end up high. See also: This morning's waking 290 mg/dl blood sugar.)

I wander back to bed, Abby circling my feet like a shark while I walk.  I'm starting to feel better, even though it doesn't dawn on me yet to maybe bolus for all the extra juice I drank.  Running my toothbrush under the water (because I can't stand waking up with that juice taste in my mouth and yes, this post-low dental hygiene thing happens all the time), I look into the mirror.  My hair is a disaster.  My eyes are wild, like a child who has been locked in a closet for days on end, pupils darting from side-to-side, panicked.  The bags under my eyes are distressing and apparently packed for a long trip.

God, I look awful.  Is this what a low looks like from the outside?

I remember the zombie dream and realize how ridiculous it was.  What kind of person dreams that Kevin James is gnawing off her arm?

I smile.  

And am startled to see my red teeth grinning back at me, stained from the frosting.   

June 04, 2009

Stereotypes: We Haz Them.

I'm sorry, can you speak directly into this and let me know what ignorance you're spewing?A member of the Diabetes UK outreach group sent me their video about "setting the record straight," featuring a young girl with type 1 diabetes who is being bullied by her peers.  They taunt her, telling her she brought this on herself and that she is contagious.  She turns to the camera and asserts the facts about type 1.

And I agree with this.  My diabetes isn't contagious.  It isn't because I ate too many candy bars as a kid or because I had a weight problem or because a black cat carrying red balloons crossed my path on a Tuesday evening. But how often do I turn to the camera ... I mean, person, and set them straight with a well-articulated and poised onslaught of accurate information?

I am not a doctor and I can't spin you a tale of the precise physiological aspects of how diabetes works, but I do know that there's a pile of stererotypes. Though blogging, my job at dLife, and just simply sitting on the subway, I come across plenty examples:

  • "Diabetes is from eating too much sugar."
  • If you wear a pump, it means you diabetes is "really bad."
  • "You can't eat sugar."
  • "You can't eat carbs."  
  • (You can't eat anything, it seems.)
  • "Diabetics shouldn't have kids."
  • "Aren't you supposed to exercise when you're low?"
  • "Diabetes is contagious and you can get it through sharing needles."
  • "People with diabetes are unclean."
  • "Diabetics are the reason for increased healthcare costs."
  • Kids with type 1 diabetes can eventually outgrow their disease.
  • "Diabetes is cured by taking insulin shots."
  • "People with type 2 diabetes gave it to themselves."
  • "All diabetics are overweight."
  • "Diabetes isn't a big deal."
  • "Did you used to be fat?"
  • "No one wants to date or marry a person with diabetes."
  • Diabetes can be cured by taking this pill, this chocolate shake (!), this raw food diet, this crap supplement.
  • CGMs and pumps are a closed-loop system and by wearing one, I don't even have to manage my diabetes anymore.
  • "You're grown up now, so your mother doesn't have to worry about your diabetes anymore."

And the list goes on and on and on ... for miles.  I can't even list all the ones I've heard over the last 20+ years because they vary in shapes, sizes, and levels of ignorance.

Chris and I talk about this sometimes, about how much the "average" person doesn't know about diabetes.  About how I get offended at times when people talk about diabetes like it's something not worth worrying about or how people who end up with complications are at fault for their body's failure.

"Not everyone understands, Kerri."

"I know, but I really wish they did.  And I know that's unreasonable because plenty of people have much better things to do than care about a disease.  But I cannot stand when diabetes is made out to be something that I 'asked for' or something I manage so easily with the push of a button on this pump, right?  Do we look to healthy?  Do we not look healthy enough?  I think this is a serious disease and the stereotypes make me nuts sometimes."

After a beat:

"Good thing I'm not bitter, right?" 

We laugh, but the song remains the same.  People don't have a clue sometimes.  Sara is writing about itGeorge is Tweeting about it.  And I've touched up it here at SUM, too.

I want to know what kind of stereotypes you guys hear about.  Do you bother to correct people?  Do you write letters to let companies know that their marketing campaigns are painful to watch?  Do you make efforts to ignore the misinformation or do you work to correct it when and where you can?  Or are you practicing your apathetic "pfffft!" and moving on without giving it much thought? 

June 01, 2009

Focus: The Diabetes Things I Like.

Even though I do not like the disease, there are some diabetes-related simple pleasures that make me smile:

  • I like when I change the battery and the insulin reservoir at the same time.  Having my Medtronic 522 "full" on both sides makes me happy.
  • I like when the carb count on something is exactly 10 grams of carbs because it matches my insulin to carb ration precisely.  One snack, one unit, one oddly happy Kerri.
  • I like the sound of the pump counting up a bolus.  Boop boop beep!
  • I like when the sound of the bolus is caught by Chris and he ends up whistling it back to me, almost without thinking.  It's a little soundtrack snippet of our life.  
  • I like when the cats wait patiently for me to remove the pump tubing from my body before they lunge for it.
  • I like when new boxes of diabetes supplies show up and I can organize them in my little OCD supply closet.
  • I like when the number on my meter is two digits, but higher than 89 mg/dl.  It's a tight range, I'm not usually in it, but it brings me weird joy.
  • I like when the Dexcom beeps and my coworker (who works a wall away from me) IMs me quietly to check, "Low?" because she's ready to get juice if necessary.
  • I like not having to wear a watch. Diabetes simple pleasures.  Damnit.
  • I like when I get to dump all the used test strips that have piled up throughout the day.  Knowing I've tested a bunch makes me feel like I really stayed tuned in.
  • I like the smell of white glucose tabs.
  • I like when the new infusion set doesn't sting at all.
  • I like having someone in my life who is willing to get their hands covered in SkinTac in an attempt to stick a Dexcom sensor to random places on my body.
  • I like that the hope of the parents of kids with diabetes rubs off on me, and makes me feel good for even just a few minutes.
  • I like that diabetes gives two people, who wouldn't otherwise have a thing to say to one another, a whole dinner's worth of conversation.
  • I like having coworkers who understand but don't push.
  • I like when my best friend clinks her beer to mine and says, "Bolus, baby."
  • I like when the cat licks my hand after I test.
  • I like "free shower:"  a shower without a pump site or a CGM sensor attached.
  • I like having a whole network of people who understand - and do not judge - my diabetes life.
I like when I can focus on the silly, simple things when I feel a little overwhelmed by the tough stuff. 

Let There Be Cake!

Even though our anniversary was two weeks ago, we had to wait until this weekend to score our cake.

This shit will set you back about 4,323 units of Humalog.

(Note:  Our original agreement with the cake baker was that instead of saving our wedding cake topper for a year and eating nostalgic, yet crunchy-stale cake, we would have a new cake baked on our anniversary.  Which was fortunate because our actual cake topper ended up in my Aunt Linda's back room for three weeks, stored with our wedding gifts, while we were on our honeymoon.  We returned to a box filled with cake that had sprouted what appeared to be ferns.  Thus, inedible.  And double-thus, we were thankful for the 'new cake' agreement.)

So on Saturday morning, Chris and I went to a cool little tea house in southern RI and stuffed our faces full of red velvet cake with butter cream frosting.

So delicious!

It.  Was.  Awesome.

And as irony would have it, my blood sugar was 130 mg/dl two hours after aforementioned gluttony.

The diabetes gods were smiling upon us.  Thankfully.  Because I've been wondering where the hell they've been lately.  ;)

May 29, 2009

Old School Diabetes: Meters.

A few weeks ago, when I was poking through some old photos, I found my first teaching manual from Joslin.  (The big, red book.)  And tucked inside of that book were some old advertisements for glucose meters.

Like this brick from Accu-Chek:

Old meter from the dark ages of diabetes.

This thing was huge, took two minutes to produce a result, and it was heavy enough to double as a hurricaine doorstop.  It's remarkable how much this technology has changed in the last twenty-two years.  Here's another oldie:

Another oldie.

I love the instructions - they're a freaking mile long!  Blood glucose monitoring has come a very long way since my own diagnosis - from urine testing to blood testing to the Dexcom that reads me every five minutes - but I'm not as impressed as I'd like to be.  I heard a few months back that the accuracy requirements for today's meters are the same as they were back in the late 1970's.  (Is that true?!)  Color options are great and shorter instruction manuals are also nifty, but I'd like this thing to give me results that are SPOT freaking ON. 

Like this morning.

I tested and got 77 mg/dl on my meter.

The Dexcom said I was 39 mg/dl.

I tested again and saw 101 mg/dl.

How can I respond to a number that doesn't sit still for even a second?  How is a diabetic supposed to aim for that moving target?

Most days, diabetes doesn't get into my head and scratch around.  Most of the time, I feel emotionally and mentally equipped to handle the disease management and "life" management.  It's never fun, and never simple, but it's something I feel at peace with.  But this morning, I couldn't even get a sense of what blood sugar number to react to.  And when I peeled off the Dexcom sensor to replace it, a ripe, red dot of infection had brewed up underneath.  My blood sugar, when I arrived at work, was 123 mg/dl but after I ate my snack, it crested up to 234 mg/dl for some ungodly reason.  I don't know which end is up.  And technology isn't doing anything to make type 1 diabetes any easier.

Today, I'm spent.   

May 13, 2009

Guest Listener.

I boarded the train in Connecticut and from the time I found Karen (of Bitter-Sweet fame), I was downing Dex4 liquid things, glucose tabs, and Smarties constantly.  The Dexcom kept BEEEEEEP!ing, my meter kept confirming, and I kept infusing the sugar.  I was under 70 mg/dl for the entire train ride, the cab ride, and then the first ten minutes of the support group meeting in NYC.  By the time the group arrived and we were doing introductions, I was punchy from the sugar rush.

"Hi, I'm Kerri Sparling and I've been low since Karen and I got on the train in Connecticut." 

This is how I decide to introduce myself to the support group in NYC?  Great.  Already off to a decidedly awkward start.  (But I'm nothing if not awkward.)

But these women were patient with my ramblings.  And they truly are something else.  Katie Savin, organizer of the NYC support group for young women with type 1 diabetes, has found some of the most compassionate, open, and well-spoken women in the NYC area to share her space with.  I was invited at their guest speaker, but I was humbled to be more of a guest listener.

They share openly.  Someone asked a question about CGMs and three people leapt up to show their sensors.  A woman shared her emotional journey with complications and guilt and the rest of the group immediately offered words of support and validation.  Another woman is getting married nine days from today and went on her pump barely a month ago, and the group offered tips on hiding her pump in her dress.  Another (with the best hair I've EVER seen) is marrying in November but proactively preparing her body for pregnancy, and I felt her frustrations intimately. 

We talked about what it's like to be newly diagnosed, or a diabetes veteran.  Some on pumps, some on shots, some on CGMs, some on the fence - it was a melting pot of personalities and passions, all lives laced with type 1 diabetes.

It.  Was.  So cool. 

(And I finally had a chance to meet LeeAnn from The Butter Compartment and author Elizabeth Joy. I love putting smiles and inflection to the writers I read, and I was very happy to say "Oh my gosh, hi!" in person.  They are two lovely and extremely talented writers, that's for damn sure.)

The hour and a half meeting ended too soon, and we found ourselves tumbled out onto the sidewalk and chatting out there.  Sidewalk chats lead to sidewalk photo shoots.

And photo shoots lead to "Are you going to put that on the blog?"  

Of course I'm going to put this on the blog, damnit!  :)

(Answer:  Yes.) 

And then we blinked and about ten of us were sitting at the Gramercy Diner and still talking our faces off.  I am constantly amazed by the steady and comfortable flow of conversation between diabetics, and how quickly the conversations stray away from diabetes stuff.  We are not short on things to say, it seems.  (Just short on islet cells.  :: rimshot ::)

Much like the Fairfield County dinners, the group is comprised of people who have nothing in common but diabetes.  But at the same time, that gives them everything in common that they need to sit and talk for hours on a Tuesday evening and become friends.

Thanks for having me, Katie - I was very honored to be your guest.  I hope to see you guys again soon!! 

May 11, 2009

Diabetes Mor(r)on(e).

Is this thing on?I just felt off.  For like an hour.  My head was wrapped in cotton balls and my reaction time was just a half second slower than it should have been.

Internal Motivational Speaker whispered in:  Hey.  You've been a bit of a work nut lately.  How about taking a few minutes and maybe walking around?  

"No, no.  I'm good.  I have to finish this and I have the cruise the week of my anniversary, so I'll have a whole week to collapse and lay on the lido deck."

Hmmm.  So explain the dizzy?  Why are you feeling so dizzy right now?

"I don't know.  Maybe because I've been staring at this computer screen for like five hours straight without much of a reprieve.  Maybe my eyes are fried."

Could be.  Or you could have some kind of brain deformity.  

"What?  Why the hell would you say that?  I'm just a bit burnt out.  And I've had like a LOT of caffeine.  So I'm sure I'm just a little rattled."

Or suffering from some undiscovered, undiagnosed illness that starts with dizziness as a symptom.  Google it.

"No.  I am not consulting Google.  NO.  Back off and let me finish this."

Dr. Google calling.  Come on, Kerri.  You've been dizzy and sort of disoriented for over an hour now.  

"You ... stop it.  I'm not going to let you get me all frantic.  I'm fine.  I just want to finish editing this one article and then I'll take a break for a few minutes.  I promise."

Fine.  Don't say I didn't warn you.

"Warn me?"  I took quick stock of how I was feeling.  I was very irritable, short-tempered, and this weird feeling of swimmy dizziness was dominating my brain.  Granted, I'd been sitting at my desk for at least an hour and a half straight and focusing intently on my column, but maybe I should think for a second and address this nagging feeling of disorientation.  So, despite my better judgment, I Googled "causes of dizziness."

And five minutes later, I was convinced I was dying.

"Oh em gee, I'm dying.  Like today."

I told you.  You can't let something serious like dizziness go undiagnosed.  

"Wait."

And it's also important that you listen to me when I talk to you because I know what I'm talking about.  Finding out what's wrong with you, at least physically, is part of my job and ...

"Wait a second."  I took out my meter. 

Your health takes priority and you need to stay very tuned in to your body and thank goodness you have me because obviously you'd be lost with me and ... 

53 mg/dl.  I reached for some glucose tabs.

Oh.  And then there's that. 

I think it's waaaaaay past time for a vacation. 

May 07, 2009

Wrist and Shout: The Vlog.

I have a lot of things I need to follow-up post on (i.e. product reviews, the guy from Panera, guest posts, etc.), but I found myself recording a ridiculous lunchtime vlog about the cortisone shot, blood sugars, and my ridiculous wrist issue.

Thankfully, my wrist seems to be on the mend, but the shot wrecked some havoc on my numbers.  I'm hoping that this is the beginning of the end of this ridiculous problem.

Also - Siah?  Ridiculous.

April 30, 2009

I'm in the Zone: Cortisone.

So yesterday I went to the orthopedist for this wrist mess.Frigging sting!!

I was all, "I've been wearing the brace and I stopped lifting at the gym and have generally been taking it as light as I can, but no improvement."

And he was all, "Well, we looked at your x-rays from today and your radial and ulna bones are in perfect position, so it does appear to be a tendon issue and not a bone issue."

And I was all, "That's good, right?"

And he was all, "Yeah.  So let's talk about options.  We can move with the brace for another month, or you can do physical therapy, or you can do surgery."

And I was all, "Hmm.  Well the brace isn't helping yet.  And I don't want surgery.  Let's do a cortisone shot and follow up with physical therapy?"

And he was all, "You're an educated patient.  Okay, we'll do a very small shot today and see how that works for you."

So I sat down in a chair in his office and he moved a small table towards me for me to prop my elbow up on.  He left for a minute and then returned with a small bottle, a cotton swap and injection prep wipe, and a massive needle.

And I was all, "Whoa, that's a big needle.  Do you put the whole thing in?  That would come right out the other side of my hand!"

And he was all, "But you do needles every day, don't you?  This should be okay with you."  

And I was all, "Irony, eh?  I hate needles that I'm not controlling.  And that mega-needle?  Scares me."

And my blood in my face was all draining, so I looked white as a sheet.

He was all, "You're going a little pale on me.  Are you okay?"  He swabbed my wrist and shifted my arm around until the proper injection area was exposed.

And I was all, "I'm okay, I'm just not going to watch, okay?"

He nodded.  And the needle was all of a sudden embedded into my wrist and the pressure of the cortisone being injected made me squirm instantly.

I was all, "Ow."

He was all, "Just a few more seconds and I'll be done.  And ... you're done.  You okay?  Do you need to lie down?"

And I was all badass:  "Nah, I'm good.  I'm just going to sit here for a minute while you explain what happens next and I pretend to listen fully despite the pain."  I smiled.  But winced.  Sort of at the same time. 

And he was all, "Elevated numbers for a few days ... increase basals with your endo's help ... keep wearing the brace ... it's going to hurt where I did the shot tomorrow, but you should feel real improvement by about this time next week ... if you don't, we'll want to do that physical therapy and consider maybe another shot depending on how you feel ... you'll be okay ... hey, are you okay?"

And my color was all returning, but slowly.  We finished up, and I tested.  155 mg/dl.  Okay, a little higher than the 114 mg/dl I walked into the doctor's office at, but it must have been a stress bump.  I didn't want to fool with my basals until I was sure that the cortisone would make me high, so I waited a few hours before doing some tweaking

In the course of six hours, I went from 155 to a steady stream of 190 - 240 mg/dl numbers.  I tested for ketones and - low and behold! - the little stick went light purple on me.  Small ketones, prolonged highs, and the pain from the actual shot set in around 8:45 pm.  This morning, I woke up at 213 mg/dl and even after an aggressive bolus, I'm still cruising in that general range.  Basals have since been cranked to 150% and I'm both wearing the Dexcom and testing every hour.

The ketone thing is what's throwing me for a loop.  I hardly ever throw ketones - why now?  I drank a lot of water, ate some carbs, and still had the ketones this morning.  (Poor Chris - I asked him to test himself for ketones because I was convinced the Ketostix weren't working right.  He was all, "Um, I'm negative."  And I was all, "At least I like the color purple.  Blaaaargh.... ")

I hope this was the right decision.  I'm desperate for my wrist to heal.  The doctor said this pain and the highs could go on for 3 - 7 days.   

And I was all, "This sucks."

April 22, 2009

Wrist and Shout: Part II.

I can't take it anymore.  This wrist thing is making me crazy.

Since my "diagnosis" with tendinitis in February, I've done plenty of attempted cutting back on repetitive movement:

I've been trying to use the computer mouse less.  Fat chance, seeing as how my day job is extremely computer intensive, and blogging also uses - wait for it - the computer.

I bought a Bamboo.  Yet I haven't had more than 15 minutes to sit down and learn how to use it.  So it's still in the box.  Sitting there.  A waste of money and good intentions.

I took Advil for several days.  Actually, I took it for almost three weeks, and then I heard about the kidney + Advil conundrum.  But also, I didn't like the fact that once the Advil wore off, I was back to being in pain.  Seemed like a bandaid.  I want to fix this.

I sleep with a wrist brace on.  What's sexier than your wife climbing into bed, wearing a pump, a Dexcom, multiple attached sensors, and a wrist brace?  All I'm missing is the damn headgear.  And I'm wearing the brace for more than just sleep - I wear it when I'm driving, as often as possible at work, and if I ever watch television for more than 10 minutes.  (Rare, but it happens.)  

I stopped weight training.  Before my wedding, I was doing as much resistance training as possible.  I liked the effects it had on my body.  But since February,  I've had to stop weight training completely because I can't lift anything up.  I can't do tricep dips.  I can't jump rope.  I can't even hold weights while doing lunges because of the stress on my wrist.  So I've been doing more cardio than usual and gazing w(r)istfully at the free weights.

I can't carry grocery bags.  My wrist explodes with pain when it grazes my desk or the couch or the kitchen counter.  I can't even throw Siah off my chest when she's trying to sniff me to death at night.  (That cat is getting fat.)  I'm not one to complain about physical discomfort, but this wrist pain is beyond tolerable.   

I feel like a 90 year old woman. 

So I went to the Twittersphere and pinged my question out to them in 140 characters or less:  "Tough workout. Wrist issue (tendinitis) is not healing. Has anyone had this before? How did you fix it? V. frustrating."

Responses ranged from "Advil and rest!" to "Physical therapy and a brace!" to "Cortisone shot!"  Apparently, I'm not the only new media-type to have grappled with this issue before.

I called my doctor this morning and explained the situation.  After she realized that, despite my attempts to ease up on the wrist stress I still wasn't on the mend, she recommended I speak with an orthopedic practice and get an appointment.

"They may want to give you the shot that day, so be prepared, diabetes-wise."

"This could make me go high for a few days, right?"

"It depends.  They won't give you much in the injection, and it's a localized dose, so you may not see more than a premenstrual-style spike.  But you might see more than that.  It depends on a lot of factors.  The orthopedist can help answer those questions more specifically."

(This is EXACTLY why I prefer working with a primary care physician who is comfortable with specialists.  She knows that she can cover my basic needs, but she's quick to refer me to doctors who can handle specialized needs.  I like that she doesn't pretend to know everything.  Doctors who acknowledge that they, too, are human make me feel safer.)Can't dial one of these things, thanks to CRAPPY WRIST THING.

"Cool.  Thanks.  I'm tired of feeling like an old bird."

She laughed.  "Let me know how it goes."

So I have an appointment tomorrow morning with an orthopedist, and I'm sort of hoping they do the shot tomorrow so I start putting this pain behind me.  I can't wait to weight train again.  And lift grocery bags. 

And throw Siah.   

April 21, 2009

Precision LogBooking.

"So what is this one, the 236.  Did you correct this?  Is this after eating?  I can't really tell."

And I peered at the logbook, chock full of results.  Months of results, all neatly organized by date and time.  Only without food or insulin doses written in, so it was less like a diabetes assessment tool and more like the machine that spins the bingo balls. 

"Ah, I have no idea.  Damn, I have no clue, actually.  I'll assume I corrected it." 

There's not too much difference between writing in all the results the night before an endo appointment and printing out the numbers.

With last week's endocrinologist appointment being a little less than thrilling, I'm on a new game plan to get ready for my June follow-up.  Dr. Brown has asked me to keep a detailed logbook of my numbers.  Not necessarily a food journal, but more a list of blood sugars, insulin doses, and carb intake.  

"You don't need to list the kind of fruit you ate, but if you just put that it was 20 grams of carbs, that would be what we need.  That way we can tell what's causing what."

The wee ickle logbook.

So I bought a very small moleskine book to record everything. (I love these books. I have one in my purse at all times and I use it to jot down everything from blog post ideas to words I want to remember to look up to reminders that if I don't pay my cell phone bill, they will come for me.)  It's a wee little thing and it fits in my meter case.  Surely it will be covered in blood and have test strips stuck to it by the end of June, but so far it's been one full day and I'm still on the wagon.  (And that, my Faithful Readers, is saying a TON.)

I get burnt out with the details of diabetes.  The whole logging thing throws me off my creative stream of consciousness.  "You mean I have to write this stuff down and analyze trends?"  I'll wear the pump and the Dexcom and do my due diligence, but when it comes to the diabetes nitty-gritty, I often tumble off the wagon.  

It's a lack of patience.  Maybe a lack of desire to make a blood sugar testing moment last more than the five second countdown.  I don't like when I feel so much of my time slipping into the realm of diabetes management.  And I make plenty of excuses not to focus:  "I'm heading to Tucson."  "I'm going home to RI for the weekend."  "I'm having dinner with NBF."  "I'm too busy at work."  "I'm ... no."  

But I'm a woman on a mission.  If I don't ever buckle down and make my A1C my top priority, it may always hover around seven plus percent.  Even if it's a pain in the ass, and even if it's "hard," I owe it to myself and my future family to give it my best.

Poor Chris.  He thought Twitter ate up time?  Wait until he sees how often I have to logbook.  

April 14, 2009

Joslin: I'm So There.

Thumbs up for, um, blood!I'm driving my little Honda up to Boston today for my endocrinologist appointment.  I spent part of last night printing my blood sugar logs from the end of March and the bulk of April (I have been keeping up with The Log Book, as promised - many blue stars on my chart).  I noticed that while I've been feeling like my control has been relatively good, I've had some zinger highs and a few trenches in the last 90 days. 

For whatever reason, I'm not dreading this appointment.  Oddly enough, I'm looking forward to spending the day in Boston, even if I will be at a hospital for much of the day.  Going to Joslin forces my brain to realign, and it always makes me feel hopeful.  I've been a patient there for over twenty two years, and it feels oddly like home.

They'll take an A1C, and I hope it's finally ringing in at NHB Range.  But my doctor has expressed more interest in having my numbers stable, instead of "good" as a result of averaged highs and lows.  She'd rather see me holding strong at a 140 mg/d as opposed to pinging from 300 mg/dl to 40 mg/dl. 

I'm not sure how I feel about an A1C result being the definitive measure of my diabetes control.  (Apparently Lindsey at Blogabetes has had the same thoughts.)  Is this a state of mind I've decided upon as a result of a result over 7%?  People talk about the estimated average glucose (here is a dizzying article including lots of math and here is an online calculator that keeps the math hidden where it belongs), but is it a true indicator of how I'm running?  And what is this fructosamine test I keep reading about?  What is the best way to tell if my body is healthy?

I'll have these tests today and I'll run through my list of questions (including, but not limited to, what can I do about this relentless tendonitis, is my blood pressure well-controlled enough for pregnancy, and do I really need to cut out ALL the coffee from my diet as I move forward here?)  I feel like I'm in excellent hands at Joslin, and I'm ready for whatever today has to throw at me.

(In the meantime, this had me mesmerized for quite some time yesterday.  I wanted to dive into the middle of that couch and snuggle every last one of those furry messes.)

April 10, 2009

Color Comparision Chart.

As I mentioned yesterday, I stumbled upon some diabetes relics at my dad's house the other day.  Now I'm totally in memory lane mode.  :)  I found this staple of my early diabetes management:

The Red Diabetes Book

The "Red Bible."  This book was given to my parents by the Joslin Clinic when I was diagnosed, and it held the supposed answers to any diabetes questions.  (You can see on the cover there where I was practicing spelling "restaurant" many years ago.)  I thumbed through the book and found plenty of recipes and snack ideas, all using the old food exchange philosophy.  Pages and pages of things I couldn't eat, and small sections of what my lunch options were. Half a cup of spinach, one sugar-free popsicle, rice cakes with peanut butter, those peanut butter nab things ... places to buy food scales and measuring cups ... countless pages focusing on food.  I always hated that assumption that a healthy diabetes life was achieved solely through my dinner plate.

There were three pages on handling diabetes in school settings.  No mention of 504 plans or testing in the classroom or anything about how my fellow students would react.  A short description of the symptoms of low blood sugar and how to treat it, but that was about it.

The pages on blood sugar monitoring and management brought me back to my diagnosis days.  When I first started testing my blood sugar back in 1986, we used a machine that took 120 seconds to produce a result and the strips were color-comparison ones that had to be wiped with a cotton ball and then plugged into the meter.  The color comparison chart seems so remedial compared to the UltraLink on my desk or the Dexcom on my hip.   Here's a screenshot of what we'd compare the color pads to:

Chemstrip color comparison chart

Not much to go on.  (And the numbers were too easy to manipulate.  I remember wiping the color pads on the strip with rubbing alcohol to make the results seem lower.  I wasn't the most responsible kid.)

The thing that kills me is the lack of focus on the emotions of diabetes.  There were only TWO pages on "living with diabetes."  How stress can affect blood sugar management.  How important the impact of a support network is for acceptance and dedication.  I want to rewrite this Red Bible and flesh out more of the parts that count.  Support groups, diabetes blogs, communities ... this is the future of diabetes management.  Meters have improved a little, insulin has improved a smidge, but our methods of support have leapt by such enormous margins that my future health is already brighter.  

My Joslin appointment is next week.  And believe me, I'll be talking about you guys there.

April 07, 2009

Diabetics Running Amuck in New Haven.

I'm a road warrior ... or at least I was this weekend.  And it all started on Friday night, when I met Manny Hernandez for dinner in New Haven, and we were joined by Adam. 

Manny, Adam, and Kerri in New Haven.
 
Plenty of wine, beer, and coffee later (coffee was me - had to drive to Rhode Island after dinner), the three of us were knee-deep in discussions about Dexcoms, diagnosis dates, and our first low blood sugars.  These guys are true kindred spirits and excellent dinner dates. 

One thing that came up was our "before" and "after" with diabetes.  For Adam and Manny, they were both diagnosed in their late 20's, early 30's, respectively.  For me, I was diagnosed when I was in second grade.  Their "diabetes before" included decades of memories and a certain sense of self, not to mention memories without the disease.  My "diabetes before," for better or worse, doesn't include more than a handful of childhood memories without the disease, and my sense of self is coiled around some aspects of diabetes.

"What's better, though?  I mean, there are pros and cons to both and I don't see a definitive 'yay' to either, honestly."  I drank my second cup of coffee and let the caffeine spin around in my brain.

A lot of the people I'm in contact with that have diabetes were diagnosed in their childhood years - Howard at dLife, Christel, most of the Fairfield County dinner ladies - so they are dealing with the same "lifelong" diabetes as me.  But I've also met many late-onset type 1s - the LADA crew, as I fondly call them and then subsequently picture a fire engine - and their life-altering diagnosis must be so jarring, coming into their lives later.  Adjusting to diabetes wasn't much of a challenge for me because it's almost always been there.  I only had a year or two of elementary school before I was diagnosed.  I can't imagine finishing college and then being forced to change everything midstream. 

But I will admit to a bit of a pang of envy as I tried to remember my first low blood sugar while the guys described the recent memory of theirs.

"I'll have to ask my mom," I said.  "She'll remember." 

It's not a debate, believe me.  It's not a question of "Who has it worse?"  Type 1 diabetes, regardless of it's arrival date, is its own cyclone of discovery.  But the discussion made me realize how long I've had this and how old I'm not.  And when people talk about cures, how lives will be changed when a cure for diabetes is found, and even though I don't often think about a cure, I can't help but happily muse about "diabetes after."

I've kept the tags on for 22 years, just in case I need to make a return.  ;)

April 02, 2009

Employee of the Month.

Yesterday at lunch, I was browsing at one of my favorite stores and picking through a pile of spring sweaters.  (Buy one, get one 50% off!  I'm a sucker for a good sale.)  So I find two sweaters that are pretty and springy and have that nice, soft cottony feel that you want to rub against your cheek.

Then that feeling hits.  The one where my jacket felt warm and heavy against the spring chill but suddenly made me feel like it was a fabric tanning booth - too hot, too heavy, and like the sleeves were thick with mud.

"Excuse me?  I know it's a weird question, but do you have any juice or candy in this store?"

The pregnant woman behind the counter gave me an odd look.  "I don't ... hang on ... um, I have half of a mini Milky Way bar?  Is that okay?  You just hungry, sweetie?"

"No."  My tongue was too big for my mouth, making it hard to talk.  "Can I just leave these here for a few minutes?  I'll be right back."

Walking with determined, focused steps, I went outside to where my car was parked and unlocked the door.  Leaning in the passenger side, I grabbed the bottle of glucose tabs from the center console.  

"Damn it, two?  Only two are in here?"  The bottle was almost empty, save for two lonely glucose tabs.  I poured them into my hands and ate them at the same time, the glucose tab dust coming out and snowing all over the passenger seat of my car.

"Gee whiz," I said.  (What's that?  Not kidding you on that one?  Fine.  I dropped an F bomb right there, outside of Ann Taylor.  I have no class.)  I noticed a Panera Bread next door so I slammed my car door and walked over there, listening to the Dexcom blaring from inside my purse.

There was a line for lunch.  Four cashiers were working furiously, but the low was creeping up just as fast and my legs were beginning to buckle.

"I need orange juice.  I'm diabetic and having a low blood sugar.  Can you please help me as quickly as you can?"  I stood there in my work clothes and my coat, with my grown-up purse over my arm and started to cry because I couldn't function properly and I was becoming more and more confused.  Not sobbing, not whining, not outwardly breaking down, but big tears rolled out of my eyes without permission and headed for my jawline.  

The boy behind the counter was taken aback.  "Stay here.  Stand here.  I'll be right back.  Don't move."  He ran and returned with a glass of juice.  I moved toward him like goldfish in a pond going for crumbs of bread. 

He watched as I drank the entire glass without stopping, knowing that people in line were watching me and staring and I couldn't bring myself to care.

"You good?  You seem better already, right?"  CounterBoy answered his own question.  "You're good.  You're fine." 

I fumbled with my wallet.  "How much do I owe you?"

"Miss, it's okay.  I'm happy to pay for that orange juice myself.  Please."

"No, I'm diabetic but I have a job.  And I appreciate your help."  The novocaine of the low was starting to wear off a bit, just by knowing the juice was in my system.   "I'd really like to pay."

"Okay, let's just call it a small, okay?   That's a dollar.  A dollar is fine."  He punched the keys of the register.  "$1.05" came up on the digital screen.

"A dollar five.  Okay."  I handed him a dollar and dug around in my pocket for a nickel.  "Here you go.  Exact change.  We'reHe should be employee of the month, damnit. good."

He put the money in the register and wiped his forehead with his wrist.  "You sure you're okay?  Do you want to sit for a minute?"  A guy waiting in line mumbled something about 'flirting on your own time.'  CounterBoy raised an eyebrow.  "Sir, this is a medical emergency.  I just saved her life.  Your sandwich?  Little less important at the moment, okay?"  

He turned back to me.  "You good?"

"I'm good.  Thank you for your help.  I really appreciate it.  You saved the day, man."

"I did.  I saved the day."  He squared his shoulders.  "I'm going to be employee of the month!"

March 27, 2009

Diabetes Carnage.

I know my daily diabetes stuff produces a lot of waste, like the test strip I use every time I prick my finger and all the packaging that comes along with each disposable insulin pump infusion set. 

But it wasn't until I changed my pump and my Dexcom sensor at once that I realized how much carnage I leave in my management wake.  

Exhibit C (for crap, holy):

So.  Much.  Stuff!

If you scoot over to Flickr, you can see each item flagged in the photo, but the basic gist is that two small bits of technology attached to my body creates a lot of waste.  (The Blackberry is in the photo purely because I forgot to move it.  It isn't related to diabetes management.  Then again, with the number of emails I'm sending from that thing on an hourly basis on the climb, maybe it is.  Digression?  Yup.)

Other PWDs and parents of PWDs (POPWD?) have talked about the insane amount of diabetes-related garbage before, but this one night really showed me how so little goes such a long way - and not in a great way.  And with Earth Day coming up at the end of April, I'm extra-aware of the mess I make sometimes.  Do you guys put your stuff in a sharps container, or do you throw these things out?  I used to be so good about clipping syringe tips and filling those coffee cans and taping them shut with electrical tape, but the last few years have produced medical waste that doesn't look as "druggy" as the orange-capped syringes of my past diabetes life.  ;)

Once, in college, we had a party and threw out a lot of beer cans.  (There were seven of us in one house, okay?)  During the night, animals got into our garbage and we woke up to beer cans and - oh crap - syringes all over the front lawn.  I.  Was.  Mortified and have been paranoid ever since.  How do you guys dispose of your diabetes carnage?  I need some tips, because I'm getting sloppy.

(Also also, SUM may have some downtime this weekend, as I'm moving some web bits around.  So if you stop by over the weekend and hit a 404 or 500 error, please be patient.  I should be back up by Monday morning.  Thanks, and have a good weekend!)

March 24, 2009

French Fried.

Chris has a crush on these things.Last weekend, Chris and I went out on Saturday night for his birthday.  And because he is a Francophile and borderline crème brulée addict, we revisited an excellent French bistro in Brooklyn (that we were introduced to by some wonderful friends). 

We drove in a found a parking spot right across the street from our destination (stroke of freaking good luck, that)- Moutarde in Park Slope, and we were right on time for our 8:30 reservation. 

And we ate.

Oh how we ate.

We started with slices of celery and peppers dipped into an array of spicy mustards.  There was freshly baked french bread with creamy butter.  A shared appetizer of escargot, entrees of duck confit and hanger steak with frites (read: fries) - we were beyond indulgent.  To round out our meal (and our bellies), we had not one, but TWO desserts - crème brulée and two profiteroles with ice cream and covered in warm chocolate sauce.

My blood sugars were screaming at the very notion of these noshes. 

"Nooooo!  Kerri!!!   You'll end up at 400 mg/dl, stupid!"

"Quiet, you.  I'm having a night off from your hollering."  

My husband and I cleaned our plates and topped our meals off with coffee (me) and cappuccino (Chris).   

"So how is your birthday going?"

Francophile Sparling leaned back in his chair, smiling.  "This is great.  I loved this.  I love French food!"

I reached into my purse and consulted the Dexcom, to see if my numbers were started to go berserk.  I saw a flatline - 142 mg/dl and steady.  

"Dude, I think I did this right.  After all that food, I'm barely 140."

"Nice.  Can we get another profiterole?"

I love a good night out with excellent food, excellent company, and excellent blood sugars.  A few hours later, when we were climbing into bed, I checked the Dex again and saw that I was 103 mg/dl with a little arrow pointing straight down, showing that I was falling slowly, but still falling.

Meter confirmed:  97 mg/dl.

"Bah.  I must have over-bolused.  I'm going to grab a swig of juice."

Face-planted into the bed and slowly digesting thousands of French calories, Chris murmured "Mmm hmm."

I took a drink from the grape juice bottle by the bed and settled in beside him, feeling cocky about our indulgent dinner and it's lack of effect on my numbers.

So didn't I feel like a tool when the Dex started singing at 5:30 in the morning, announcing my 271 mg/dl to the entire room?   Sweaters on teeth, that instant "Oh my God I have to pee" feeling, and my tongue weighing about 8 lbs - the whole mess. 

I never, ever remember that the fat hits my blood sugars so much later.  (And we ate a lot of fatty foods!)    Stupid overconfident Kerri.  You done been French fried.

"Kerri, we told you.  We so told you."

"Enough!  I am fixing this now and besides, it was worth it." 

"The high?"

"Nope.  The crème brulée!" 

March 20, 2009

Dexcom Seven Plus: First Impressions.

So far, so good.

Last night, I installed my first Dexcom Seven Plus sensor.  "First" might be a bit of a misnomer, because the sensors that actually go into my body are still the same as the ones I used previous.  I have a new transmitter (the little plastic part that clips into the sensor housing) and a new receiver (the external device), which are the pieces that have been upgraded.  

Dexcom has a good overview of the new system and its features, including a video that walks you through the upgrades.  They can give you all the technical jargony stuff.  :)

For me, I've put this new sensor on my left thigh and after the initial pinch, I was good to go.  The hardware on the Seven Plus works almost exactly like the old system, with a two hour calibration period, same sensor insertion devices, and the same general gist.  What's new is the software inside the receiver.

When I tried out the Minimed system last year, I liked the fact that the MiniLink had rate of change arrows on the CGM.  So when I looked at my pump, I could see my blood sugar graph and could also see if I was plummeting or rising quickly.  I was sorry that Dexcom didn't have this option before - but now they do.  The new Seven Plus has those rate of change arrows, and you can also set an alarm to BEEEEEEEEEP (if you want) when you're rising or falling too quickly. 

Oh so dexy ... I mean, sexy!

And regarding BEEEEEEEP!s, there are more beeping options on this thing, too.  You can set an alarm for a high, low, rise rate, fall rate, and sensor out of range (i.e. when the cat takes off with it in the middle of the night and you don't realize it until you wake up without it).  There are snooze alarms for the high and low levels, so I have mine set to BEEEEEEEP! at a low and then give me 30 minutes to correct and climb, instead of beeping its head off every five minutes for hours.  (Nice.) 

Another feature that's been added is the ability to add "events," like exercise, food, insulin doses, and health info - much like the One Touch Ultra meters.  I've been consistent so far with entering this info (read: it's only been 12 hours with this thing attached, so I'm in a bit of "new device euphoria" and I have no clue if I'll stick with being so tuned in), and if I can keep up, it will make the records from the Dex pretty comprehensive.

Dexcom 2 Software screenshot.  Sorry this caption wasn't that interesting.

The software is pretty good this round, able to download information from past sensors, instead of just the most previous one.  I took some screenshots of the software and gave my notes on Flickr, because honestly, I'm not terribly techy and writing on and on and on and on ... zzzzzzz ... and on about software upgrades could make me yawn my face off.  Overall, the software is good and tracks what I need it to track and if I was able to make my patient profile avatar into a picture of Siah's head, I would.  You know it.

Overall, I like the upgrades.  And the upgrade is universally available to all Dexcom users (EDIT:  It's available immediately to all new customers.  Existing ones can get it in May.  I'm not sure why that is, but if anyone from Dexcom is reading and wants to leave a comment, please do!), but I don't know the details of insurance coverage and cost.  I am glad that Dexcom is willing to push out new options as they become available, instead of waiting for a full device overhaul.  I'm hopeful that the next round of developments will help reduce the size of the sensor and the receiver. 

I'll let you know next week how a few days worth of experience with this system feels, but in the meantime, feel free to check out my Flickr photos of the Dexcom Seven Plus.  If you have questions, I'll do my best to help.  (Keep in mind:  I'm slightly clueless.)

Now I'm heading to work in this snow squall (WTF?) - what is that about?  I thought today was supposed to be the first day of spring??  More later!

[Dexcom disclosure]

March 18, 2009

Knot What I Expected.

I have to admit - I'm pretty satisfied with this longer tubing option.  Maybe I'll be more annoyed in the summer when I'm sporting fitted clothes and no trouser socks, but for those freaking freezing months with bundly sweaters and long pants, I'm content to have an extra 20" of tubing. 

Thing is, I tend to get tangled in it when I take off the pump.  I guess I bunch the tubing together and just shove it in the waistband of my pants or, if I'm rocking the sock, it stays smooth as it travels down from my hip to my ankle.  But when I disconnect to shower or go to the gym, the tubing becomes a knot of chaos.

Exhibit A:

Knot a clever caption, either.

How did this happen?  It was on the bureau for exactly 20 minutes - just for a shower! - and when I went to snap it back into place, the whole damn thing was knitted into this insuiln pretzel.

(Should I mention that it also was wrapped around me, and Prussia the Cat, this morning?  I woke up to find the cat pressed against my side and the pump tubing casually looped around her paws.  Thank goodness she didn't pull a Sausage and bite through the thing.) 

It's weird to look into my diabetes supply closet and mentally map out my tubing options.  Now that the weather is starting to warm up a smidge, I'm thinking about packing up my winter coats and my wool skirts in exchange for my spring sweaters and dresses.  Long tubing works well for using the sock trick with a lower back infusion set, but it could be a pain in the everything when it comes to tucking tubing in a springy warp dress.  I'm planning to switch back to the 23" tubing in a few weeks.

I can't wait until the weather is warm again.  I've had a freaking-nuff of the snowy stuff.

March 16, 2009

The "Ellipmachine."

The Ellipmachine ... by Mennen.When I was preparing for our wedding last year, I spent a lot of time at the gym.  A.  Lot.  As in, too much.  If I wasn't at work at dLife or doing wedding-esque things like cake tastings, dress fittings, and bridal shower fun, I was working out and doing my best to keep the stress from fattening me up.

Fitness was my priority.  

But after the wedding, other stuff started to crop up.  Weekends home in RI.  Travel for work.  Writing projects that required lots of attention.  New focuses at dLife.  Every day was this whirlwind of chaos and while I've been having fun and being very productive, my days at the gym were harder to come by.  Before, I was working out faithfully Monday - Friday after work.  But "life stuff" kept cropping up, and suddenly I found myself at the gym only four days a week.

Then it all became a perfect storm of distraction.  I was working late on dLife initiatives.  I was answering emails from my Blackberry into the wee hours of the night and sleeping less.  My wrist exploded in a fit of tendinitis and low blood sugars returned to my life with a renewed sense of determination.  Piles of snow kept falling and the gym kept closing, and on other days, I worked too late to get to the gym before it closed.

My time at the gym went from frequent and intense to only four days a week and pretty remedial.

Not okay, because my body wants to be fluffy.  It may be a family gene pool thing and it might also be exacerbated by diabetes factors, but if I sit still and let nature take its course, my body wants to be a happy 15 lbs heavier.

I, however, do not agree.

But I was frustrated because between feeling stressed and having lows again, my caloric intake far exceeded my burn off.  Thus, I lost any semblance of abs.  (Shame, too, because I liked them while they were there.)  So, in effort to reclaim my abs before I get pregnant and become a happy beach ball swallower, I did my part to stimulate the economy:  I bought an elliptical machine.

Or, as I keep calling it by mistake, an "ellipmachine."

It was delivered and assembled last Monday morning, and I called Chris (who was on business in California last week) to tell him it had arrived safely.  

"It's here!  The ellipmachine!"

"The what?"  

"I mean the elliptical."

It's a nice machine - very smooth and not clunky as to annoy our downstairs neighbors (I do not want to become Shoes) - and I used it every day last week for an hour.  Now I'm able to go out with my coworkers after work for an hour or two and still manage to slide a workout in.  I am also hoping to use it in the mornings (provided I'm able to get to bed at a reasonable time and eek out a 20 minute workout in the am).  My main hope is to reclaim the level of fitness I worked so hard to achieve before the wedding but lost a bit due to that pesky "life stuff."  

Last week, while Chris was out of town, he called one night and I answered, panting.  

"Hey baby ... what are you doing?"

"Dude, I'm on the ellipmachine."

I could hear him laughing.  "The ellipmachine, eh?"

"Oh you know what I mean."

Here's hoping that the ellipmachine can help me get a workout in even when my schedule wants to thwart my good intentions.  I'm ready to battle.

(Take that, early gym closings!  En garde, late nights at work!  Pffffft, snow days!  Come back, sort-of-abs!) 

March 13, 2009

My Mom Says Hi.

I love my mom.It's no secret that my mom is a huge part of my success as an adult with diabetes.  Her support, even when I rebelled against it with all my might, has made me confident in dealing with whatever diabetes has to throw at me. 

My mom has guest posted here a few times in the past (here are her archived entries), and she's offered to share her perspective again.  Reading her posts makes me think about how much the parents of kids with diabetes work so hard to maintain our "normal." 

From My Mom: 

Hello ... Kerri’s mom here! From time to time, Kerri will ask me to do a guest post.  What prompted me to post at this time is her recent blog regarding her old childhood journals. (Yes, she could write like a champ way back when. It’s always been a gift she has possessed.)

The fact that Kerri went to Clara Barton Camp from the time she was diagnosed until she was too old was a blessing in that I was able to hand over the responsibility of her medical care to a very capable and trusted staff at the camp. I don’t think I ever thought of it as “ok, now we can be normal for two weeks.” Maybe her siblings thought there would now be more sugary, tasty treats available during those two weeks that were not hidden in frozen bean boxes.

Parents are responsible for the well being of their children from birth to when they  are able to live on their own. (Not that it stops us from worrying.)  Throw diabetes into the mix and it can be overwhelming at times. We love our children and would do anything to keep them safe and protected. It is our “job.” I looked at sending Kerri to camp as a benefit to everyone in our family. She could bond with children who deal with the same issues she did on a daily basis. They can complain about how over protective their parents are and that we don’t understand what it’s like. No, we don’t, but as a parent these children don’t understand the fear that is ever present in our minds. Will we handle their diabetes care well enough to ensure that they don’t have serious lows or highs? Have we done enough to protect their future health from diabetes complications. It’s a scary ride we parents are on. I guess until they have children of their own … they can’t know how we feel just like we can’t know what it’s truly like for them.

Kerri used to get upset with me when I would say things like “we have to do a better job at…” She said it wasn’t a “we” disease, it was she who had diabetes. I beg to differ! When you are trying to protect your child from the consequences of diabetes or any disease it does become “our” disease as well. How can we let anything bad happen to them? You become the Lioness protecting her cub! I thought I was the only one that knew how to take care of her and I didn’t insist that others help out. If I could go back in time, I would certainly rethink that one! Everyone needs a support network. In a way, Clara Barton camp was that for me.

I needed that two week camp time to regroup. To take a mental health vacation. While she was at camp, I would often wonder how she was doing. How were her blood sugars running? Was she having fun?  But I can say that I wasn’t worried. She was in good hands. We both felt refreshed when camp was over. Kerri would come home having forged some long lasting friendships. She was more confident and determined. Camp allowed her to share feelings with other kids who understood what it was like to live with diabetes. No worries about acting weird when low…they all had been there and done that!

I lost my job as “Protector of the Kerri” a long time ago. She is very capable of handling her life and health. Will I always worry about her? Yes, like I do with all my children. That’s normal. But she is very fortunate in that she is married to Chris. My mind is at ease ... he is my Clara Barton camp!

Thanks, Mom.  For everything. 

March 11, 2009

Diabetes Back in the Day.

Last night, I found a box of old diaries.  I've been keeping a paper journal since I was seven years old and I have so many hardcover journals with cats and flowers and balloons on them, my handwriting maturing as steadily and awkwardly as my content. 

It's strange, though, to see how little focus I put on diabetes in my previous journaling.  Most of my earlier journals (eight, ten years old at the time) talk about a boy I had a crush on in fourth grade or roller skating on the weekends or battling with my brother and sister.  But there were a few entries in particular that spoke to life with diabetes.  And while I'm not quite ready to recount the long, dramatic entry about my first kiss (gah!), I wanted to share snippets of my diabetes diary from my teenage years (these entries are from when I was 14 and 15):

May 13, 1993:  Beavis and Butthead is over.  It was strange, because they were in school and in home economics.  Their assignment was to carry around a back of sugar as a "baby." But Butthead said he couldn't do it because he was "diatetic."  The teacher reprimanded him by saying, "That's DIABETIC, and yes you can do this."  I'm not exactly sure why, but that comment bothered me.  Alot.  I think it's because I'm so sensitive about being a diabetic.  It makes me wonder how handicapped people feel about 'HandyMan' on In Living Color.  If I feel offended about an off-handed comment, how would someone else feel about a recurring segment?

Was this one of the first moments of diabetes in the mainstream media that I can remember?  I honestly can recall being affected by this, and wishing Butthead had said "diabetes" correctly. 

June 27, 1994:  Today, my mother was talking with [name redacted] about diabetes camp and I couldn't help but overhear.  She said, "As soon as Kerri left, we all relaxed and lead a normal two weeks free of worries and medical stuff."  Am I a burden to my family?  Do they resent my diabetes?  Do I have a "normal" life? 

This isn't to call my mother out for saying this.  I've heard a lot of parents say the same thing about the weeks that their child is away at diabetes camp.  Diabetes requires parents to think on their feet all the time, so the reprieve of having their child away and under constant and capable medical care must have been such a nice break. 

Funny - I've always wanted a break from it, too.

July 6, 1994:  I leave for Clara Barton Camp on Sunday.  I love camp.  We are all incredibly goofy and loved.  It is such a cool feeling to have people who understand it to talk to.  Sometimes I feel alienated at home because I am the only diabetic around.  No one seems to understand the emotions I feel concerning diabetes.  I am frustrated and angry sometimes, and other times I feel bad for myself.  Sometimes I even want sympathy, and that's confusing because I say I don't want to be treated differently at the same time.  It's weird, though, because I want to be able to control every aspect of my health, so when my health emotions get all crazy, I feel like I'm going nuts.  At least at CBC I'm not the only one who feels that way.  If I tried explaining that to my friends, they'd look at me like I was nutso.

Ah, my longing for a diabetes community, even before I knew there would be one online.  :)

And this paper was shoved into my diary from 1991, written on school paper and smelling softly of pencil boxes and recess.  It speaks volumes about how much a 12 year old kid grasps about guilt and diabetes:

A 12 yr old's diabetes to-do list.

It's a lot to carry.  I felt so alone.  And as I read through these diaries late into last night, I was again grateful to know I'm not the only person out there living with this.  The power of this community is tremendous.  I also realized how everything has changed, but at the same time, nothing has changed.

(And some embarrassing diary snapshots coming soon ... once I get the guts!)

March 09, 2009

Diabetes + Stem Cell Research = Hope.

Go Bama!  Go Bama!Chris and I were talking the other day about something completely random, when he turns to me and says, "Oh, wait.  Did you hear that Obama is signing that bill to reverse the ban on stem cell research?"

"I did."  

"So?  Are you excited?"

And I thought about the last two decades.  How the veiled promise of "five more years and then ..." and still nothing. 

"I'm hopeful.  You know me, baby.  I'm almost always hopeful, but until it's actually real ..."

He gave me a grin.  "We just keep you healthy and hoping, right?  Well, this is a huge leap forward."

And today, we leapt as President Obama reversed the ban.

We'll keep hoping.  With the JDRF actively leading (and Tweeting!) the charge, and with diabetes on the national stage, progress could actually be made.  Not just a product redesign or another clever device, not just another type of insulin or another pill - real progress.   

I'd love to go from "type 1" to "type: cured." 

(I've been itching to use the past tense for a long time now.)

March 06, 2009

Kerri's Diabetes Technology FAIL.

I've had about three solid weeks of good blood sugar control, with just one or two lows and not many excessive highs.  I celebrated regularly, because this kind of even keel isn't common for me.  And because I'm in hot pursuit of a lower A1C.

So you can imagine my frustration when I had a 400+ blood sugar with no detectable cause - until I realized the pump tubing hadn't clicked into place properly after my shower.  (Something about the sweaters on my teeth and the fact that I was falling asleep face-first into my laptop didn't tip me off, apparently.   I had to wait until the realization of "Hey, haven't you peed three times in an hour?" hit me in full.)

Kerri + Diabetes Technology = FAIL.

(And also, be on the lookout for "fox paws." You'll see what I mean.)

March 05, 2009

I am Spam. Spam I Am.

F spam.Well this has never happened before.

Click.

Subject line:  diabetes 

Email:  rid myself from insulin lowered glucose from 600 mg/dl to avg of 69 mg/dl to118 mg/dl with an A1C reading from11.8 to 5.8 in 190 days check it out [name and URL redacted] doesn't cost a thing...hard to believe but that's life.... 

Fantastic.  Another spam peddler.  But I'm not looking for a war this morning, so I just filed it into the email folder called "Spamtastic" and proceeded to check my other new messages.

Click.

Subject line:  sorry

Email:  I email you before I read your blog sorry that you have a difficult life with diabetes 1 and am sorry I tried to help by referring a wed site to you as you stated "don't e-mail you with snake oils" it's just that somewhere somplace there is help for us for me it's the referral, Your so positive please stay that way and keep helping others as i shall. Sorry for imposing on you

Wait, what?  An apologetic spammer?  They read the How to Pitch to Bloggers post and the one about snake oil?  And they admitted that they spam people for the referral bonus?  Someone who is sorry that they imposed?  And bothered to email me to follow up?

This is a milestone.  I'm not sure what kind, but it's definitely never happened to me before.  Are we getting through to these people?  Are our raised voices actually being heard?

February 26, 2009

24 Hours with Diabetes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

7:00 am:  Lather, rinse, and repeat. 

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

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

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

February 25, 2009

Diabetes Snake Oil.

Snake oil - he haz it.There is no way I’m going to name the person who contacted me, nor would I even think about linking out to their ridiculous product.  But I received an email over the weekend from a tool who I will call Peddler.

Peddler started their email to me by saying, “Hello Kerri.  You can cure diabetes.”  Then there was a link to a YouTube video.  (With instructions on how to cure me, I assumed.)  I clicked through and watched their video and did the whole “rolled eyes” routine.

I am a relatively well-educated patient.  I am by no means a doctor, but I could pretend to be one for at least 8 minutes (until someone asks me to recommend treatment options or draw blood, and then I pass out and they find out I’m a lowly editor).  False claims of a “cure” don’t sit well with me, so I decided to email Peddler back and see what kind of web he would weave.

“Dear Peddler.  I have type 1 diabetes.  I have been diabetic for over 22 years.  Are you telling me I missed a cure?  Best, Kerri.”

His response:  “Yes, it must be possible.  Although it’s not easy.  Did you watch the video?  You can try [product name] and [other product name] to cure diabetes type 1?  The [product 2] keeps my blood sugar between 5 – 6 (European measure).  When normally it will go like a roller coaster.  It are the most advanced products ever made.  I use them myself.  You can find them here.  [Link]. “

My goodness. 

My response:  “You can cure my type 1 diabetes when no doctors at the Joslin Clinic, no researchers, etc. have that ability?  Can I stop taking insulin when taking your recommended product?  My body doesn’t have active islet cells – you can reverse this?  How much does your product cost and what is your personal involvement?”

Peddler’s response:  “No sure, you can’t stop taking insulin.  But if you take the product it might reverse it over time.  I have absolutely no involvement into this.  I just use it myself.  Have been looking for years to try and find a cure myself.  But you must read the information and watch the video.  But there are a lot of products and research outside of the conventional research.”

Then Peddler loses it a little bit, emailing again:  “[Another guy’s name], the health ranger, healed himself of type 2 diabetes through dieet and supplements.  You can read a lot of information on [website].  Do you know anything about farmaceutical companies and their research?  They only want to make money.  They cannot use natural vitamins and minerals because they cannot pattent them.  It’s a big money industry.  I was a shareholder, been very active on the stock market.  I know a lot about these companies.  It’s just like the oil industry.”

The snake oil industry that wants in on my “dieet” and “pattents” and “farmaceuticals?”  And what the hell is a "health ranger?"

I emailed him back:  “It will reverse my need for insulin?  Type 1 diabetes means my insulin-producing cells were attacked by my own immune system.  This product can reverse my own auto immunity?  I am shocked.  Are you involved with this supplement company, because I have to be honest - I doubt the integrity of your intentions.”

Radio silence.  Maybe he had to call back the Mother Ship for guidance. 

Then Peddler comes back out at me.

"Ok, no I'm really not. I'm 27 years old, working in a pipe factory here in Holland. I really am not involved into this company,  I'm a person just like you."

Then he sent me YouTube clips of different people talking about the supplement, and others of people showing how a certain diet plan "cured" their diabetes.  How if I just authorized some payments from my PayPal account, I'd be right ready for a life without diabetes.  (Come on, Mr. Pipe Layer from Holland.)  After clicking around for a while, I had a good sense of how much snake oil is being peddled to people with diabetes. 

And the thought made my stomach spin.

I can't help it.  This shit makes me crazy!  Don't market your false cures to me.  Nothing I eat is going to cure me.  No amount of raw vegetables or coffee or protein powder or amino acids or special high-fiber, low carb, strapless, backless nutrition bars.  Unless you have a way to keep my immune system from taking out my body's own insulin-producing cells, do not email me.  Stop preying on people with diabetes.

And for crying out loud, use spell check, would you?  

February 19, 2009

Length Matters.

Since I started pumping back in 2004, I've been using the Minimed Paradigm Quick-Sets with 23" tubing and a 6 mm cannula.  (For folks who aren't pumping or who have no idea what I'm talking about, the tubing is the part of the pump that connects the physical pump to the infusion set on my body.  The cannula is the tiny plastic tube that goes into my skin.)

I'm a creature of habit and I'm pretty resistant to change.  But insulin absorption has been crummy on my thighs lately and I've been trying to use my lower back "real estate" more often.  

Thing is, the shorter pump tubing doesn't reach from my back to my sock - no sock trick on those days.  And while I liked the reliable absorption of a new site, I still prefer to keep my pump on the downlow - literally.

So I sucked it up and made a change to my last order of pump supplies: 

A little tubing goes a long way.

Cannula is the same length, but the tubing is 20 " longer.  Now I can wear the pump on my back and still snake the tubing down my leg and into my sock

This tubing is looooooong.  It took over 13 units to prime (versus the 6 1/2 units for the 23 " tube).

The stuff is long enough for the pump to not only hit the floor if it happens to drop from my hand while changing, but even has enough slack for the tubing to coil around like a snake.  It's also long enough to become completely tangled in while changing into my gym clothes after work.  Long enough to take over a full minute to check for air bubbles. 

It's long enough to wrap around my waist and tie into a jaunty bow. Long enough that I can leave my pump on my desk at work and make it home without missing a unit. Long enough that I could knit up a freaking scarf with this tubing and still have enough left over to go fly fishing.

This new tubing gig is just about 2/3 the length of my whole darn body!  I feel like I'm part spider, weaving this weird insulin-filled web.  But this new length option is letting me explore different infusion site real estate while keeping with my fashion preferences

It's all about hitting a blood sugar stride ... and not having my pump fall into the toilet in the process.* 

(*Kerri: 40,800, Pump: Almost 3.)

February 18, 2009

Blood Sucking Meter.

Normal blood sugar test:  Unzip meter, put s strip in it, wait until it gives me the "Hey, apply blood now" signal, and apply a droplet of blood.

This has been the routine for years now.  

So imagine my surprise when I put in a new strip, got the go ahead, and applied a blood sample only to have the meter continue to grin at me.

This meter is so confused it must be related to the cat.

"Apply blood!"

Okay.

Blink, blink.

"Apply blood!"

Um, we tried this already.

"Hey, um ... apply blood!"

"Meter, I already did this.  Count down already, would you?"

Blink.

"You have enough blood on there.  It's good to go.  Give me a result!"

"I like ... your shoes?  Apply blood!"

"Stop.  Being.  Miserable!  Give me the number, you bastard!"

"Hey look over there - is that Rocco?  Apply blood!"

It took three different strips before one actually gave me a result.  This has never, ever happened to me before.  Mind you, on Monday night, I wasn't able to get a result from six different strips from this bottle - kept throwing "Error 5" type-messages and absolutely refused to let me in on the result. 

I switched bottles (with 14 strips left), and all I could picture was tossing actual cash into the garbage can.  Those test strips are expensive!

Can a whole bottle go rogue on you? 

February 13, 2009

Mushy Stuff: Diabetes Edition.

A little love and diabetes never hurt anyone.  :)I love Chris. 

Not that I need to tell you guys - I think it's pretty obvious - but sometimes I lose sight of how much I appreciate him.  I don't tell him how much he means to me as often as I should.  He is a wonderful partner.  There's all the regular relationship stuff- he pumps the gas for my car so I don't have to stand in the cold, he takes out the garbage, he laughs at my stupid jokes, he reads my written messes and helps me make sense of them - but our relationship has an extra, special component that others don't.

He is the significant other of a person with diabetes.  

I don't know what it's like to fill that role.  I am the diabetic, so I only know things from my perspective.  But he makes it look so easy.  A 3 am low blood sugar that has me in tears?  He knows how to quickly give me juice and wipe the sweat from my forehead.  Weeks of working out with no visible results?  He knows what words will soothe me:  "You are healing from the inside out."  Those moments when I feel like I'm crumbling emotionally?   His hugs seem to put my pieces back together again.

And it's not just the serious stuff.  We aren't always talking about complications and fears.  He makes this diabetes stuff feel so normal.  He makes me feel like everyone is wearing multiple devices attached to their body when they climb into bed.  Disconnecting a pump before sex?  Who doesn't do that?  Attaching a new sensor becomes something we do together, with me inserting the needle and Chris wielding the hairdryer like Johan

Chris celebrates the victories with me.  When my wedding dress was perfectly fitted with a pocket to conceal my pump, he knew that was an important moment.  When my period fell perfectly into monthly step after going off the pill, we actually high-fived.  When the Dexcom shows a nice, nine-hour flatline, we do a dance.   And when my A1C dropped a full point, he knew it was a step towards success.

Even though his pancreas works properly, he lives with diabetes, too.  Just as every loving caregiver of a PWD lives with diabetes.  They don't feel the highs and lows as acutely as we do, but they have their own individual variations on these moments that are just as poignant and just as evocative.  Chris understands what this disease means and how it can unfold, but he's as committed to my health and to my life as I am.

Some would say that he loves me, and my diabetes

But I can say that he just loves me.  It's not about diabetes.  It's not like "Kerri" and "diabetes" have to be separate entities, just like "writer" and "uncoordinated" and "messy-hairdo in the morning" and "hot-tempered" remain parts of my whole.  I'm one big mess, and he loves me just as I am

This Saturday will be my first Valentine's Day as his wife

"What I really want is to celebrate a 50th anniversary with you, Chris," I said to him over the weekend.  "Do you think we'll do that?"

He knows what I mean.  Not "Will we be together," but "Will I be okay?" 

"Of course we will."  He knows this.  It's a certainty.  "You'll be 79.  I'll be 81.  And Siah will be 53." 

He's a ridiculous man and I'm lucky to have him.

(And I'll always, always write his name in the peanut butter.) 

February 11, 2009

Wrist and Shout.

It's like the metal arm that Beyonce wears in "Single Ladies," sort of.  Or not.About two weeks ago, I had this little, nagging pain in my right wrist.  Not so much at the bendy part, but on the outside of it, right on the bone.  It was sore to the touch, aggravated by movement, and hurt when I woke up in the morning.  It seemed to get worse every day.

So, because I'm a very bright girl, I didn't do anything about it.  Instead, I went to the gym, continued to work feverishly in efforts to meet some writing deadlines, and even finished a scarf I was working on.  (Crochet.  Yes, I am a Grammie-in-Training, it seems.)

Thanks to all of this injury aggravation, I finally had to get myself to the doctor's office yesterday.  The phone call to the nurse/receptionist, as always, was awkward.

"Hi.  It's Kerri Sparling.  I think I have carpal tunnel or some nonsense."

The nurse laughed.

"Hi, Kerri.  Sure, can you come in this morning at 11:45?  So we can check out your nonsense?"

(They are so patient with me.)

"Thanks, see you at 11:45!"

When I arrived, my wrist was throbbing after a morning's worth of mouse-clicking and typing at work.   After being weighed (five pounds since the wedding - more on that later.) and having my blood pressure checked (120 over 72 - good to go), I waited for Dr. CT to visit me.

"Carpal tunnel?"  She said, walking into the room with a concerned look on her face.  "And hi, Kerri.  Carpal tunnel in diabetes is common, but let's make sure that's what you have going on."

"It hurts here," I said, pointing to the outer right hand side of my ... well, my right hand.  "And when I lift it in a pulling motion, it doesn't hurt.  But a pushing motion and a lifting motion kills."

She took my hand and pressed on the sides, asking me to flex the tendons.  "Here is the worst?"  

"Yes.  Yup, right there."  

"Well, the good news is that it isn't carpal tunnel.  It is tendinitis, though.  I'm sorry because I can tell this is making you very uncomfortable.  What I want to do is start you taking Advil three times a day, wearing a wrist brace while you sleep, and layng off the mouse as much as you can.  We need to let this rest so it can heal properly, okay?"

I'm like an addict.  My Internet-itchy fingers started to quiver.  

"Ah, staying off the mouse will be tough because I work all day on computers and I have a tendency to write a lot when I get home at night."   

She shot me a look.  

"Okay, okay, Dr. CT.  I will be mouse-free as often as possible."  Possibly a lie, but I'll try, anyway.

Tendinitis.   Another side dish that seems to come with diabetes.  Fantastico.  Anyone else have any experience with this one?  I'm looking for fast recovery and yet the ability to remain bloggy.

Edit:  Great idea from George and some folks on Twitter - might need to Bedazzle that shit! Now I just have to order one.  ;)

February 05, 2009

Vlogging While Low.

A funny thing happened to me on the way to the Internet last week.  I wanted to record a vlog post on my lunch break, but my blood sugar took a bit of a dip. 

Moron that I am, I still recorded and talked my face off.  

The point I made at the end of the video is one that I've thought about a lot - diabetes is an invisible disease, especially for those of us who are younger.  Even though we are dealing with diabetes every day, it's not a disease that is visible to people on the outside.  There's a certain blessing to people not knowing we're "sick," but does it make it seem like we don't need our cure?

Oh hell yes we need our cure.

February 03, 2009

Frustrated.

I am absolutely furious.

Last night (after a very nice dinner with Karen and J), I went to bed at a blood sugar of 101 mg/dl.  My Dexcom showed a flat line throughout the night, and I woke up at 89 mg/dl.

Nice.

So I showered and got ready for work.  Dexcom has climbed to 130 mg/dl, but I took .5 u after getting out of the shower (to cover when I was disconnected), so I expected things to be cool.   Commuted to work (10 minutes) and settled in at my desk. 

But I'm already starting to climb.   

Cup of coffee - drained.   I decided not to correct the climb because I had already taken that 0.5 u and besides, I didn't want to completely compromise my new basal settings.  I needed to give this at least a week or two to see how it really worked.

Started answering emails at work.  Checked Twitter.  Sent off a few columns.  

BEEEEEEEEP!  Still climbing.

I tested and saw 189 mg/dl.  Fine, I'll correct this now.  Laced in a few units to correct and to cover my morning snack, and went back to work, headphones in a music blaring.  About an hour went by.

Then I noticed that everything seemed "off."  My eyes felt sticky in my head, like every part of my body was dehydrated.  My mouth was dry, my skin felt too tight, and I was exhausted.  The words were swimming around on the computer screen, and the papers on my desk were a blur of type fonts. 

So I tested.  And motherfucker (sorry):  364 mg/dl.

Taken with my KerriBerry - and it shows the ridiculous climb.

If I had not been at work, I would have thrown something.  Instead, I ripped the headphones out of my ear and grabbed an insulin pen from my emergency kit at work.  I dialed up a correction dose and injected into my stomach.  I wanted relief from this high - I felt like absolute garbage.

While my overnights are completely fine and stable, my mornings have turned into a chaotic tumble of terrible numbers.  I don't know how to fix this, so I am consulting my logbooks, my battered copy of Smart Pumping, and drafting a "HELP!" email to my endocrinologist.  My A1C goal of under 7% will not be achieved while these mornings are mucking up the works. 

But besides all that, I'm pissed.  These highs feel very frustrating and they aren't little, peaky "180s" but instead whopping "360s."  My ability work feels compromised, and I can't chew enough gum to get these sweaters off my teeth fast enough.   I'm drinking water by the liter and skin is so dry and so cracked that my hands started bleeding while I was typing.  I feel "sick."  That makes me mad, because for the most part, I don't feel very sick. I usually feel capable enough to move past whatever is chewing on my nerves.

Today?  I want to crawl back into bed and ride out this high under the covers, hiding from the reality of life with diabetes. 

Except that Siah is most likely face-planted into the bed.  So no hiding for me.

My only option is to relax, try to get some work done, and wait for my blood sugar to come back down.  No need to add more stress to an already-stressful moment.  But when I get home from work tonight, I need to figure out what needs to be done.  This can't go on.  Not for even one more day.  I have a birthday to celebrate this weekend (mine!), and I'm sure as hell not going to do it at 360 mg/dl.  ;)

January 29, 2009

Abby and Dex.

(This is embarrassing.  But true.)

At night, when I go to sleep, I tuck myself in underneath the down comforter and the blankets, I snuggle up against my husband, and I fall asleep, usually with my head about halfway on the pillow.  And Chris and I sleep.  For about twenty minutes.

Until the cats come calling.

Somehow, all 16 lbs of Abby the Fat Cat manages to launch onto my side of the bed.  (I swear the bed lists to one side.)  And instead of curling up at the foot of the bed, like a normal animal, she takes up residence on my pillow. She tries to stick her paws in my ears, she snores, and she completely disregards the fact that the pillow is meant for MY head, not her whole fuzzy body.  (Usually, I end up sleeping on about 1/8 of the pillow.)

Unfortunately for Abby, things have changed in the Sparling household.  Not only is there a Chris and a Kerri in the bed, but there's also a Dexcom.  The Dexcom hangs from a headband that I have wound around the headboard of our bed.  That way, if it buzzes, Chris and I both are certain to hear it.

And two nights ago, the alarm on that sucker sounded at 3 in the morning.  Just as the sun was stirring, the Dexcom BEEEEEEEP!ed and I vaulted up from the bed.  Unfortunately for Abby again, the receiver was sitting on her back, and she also freaked out.

BEEEEEEEEEEEP!

"Meow!!!"  Her claws come out and sink into my head.

"Ahhhhhhhh!" 

BEEEEEEEEEEEP!

Unzip meter.  Shunk.

35 mg/dl.

"Chris.  I need juice."

'Mmmm hmmm."  Juicebox with orange juice in it appears out of nowhere.  

Slurp.

"Meow!"

BEEEEEEEEEEEP!

"You okay?"

"I will be in a minute."

I'm sweaty, shaky, mouth sticky with orange juice and sleep.  It's three in the morning and I want to go back to sleep.  But I know I should wait a few minutes, so while I do, I take picture of what a 3 am low looks like:

You do realize there is very little room for my head here...

 At least she keeps my head warm.

January 28, 2009

If You're Going to Stare ...

I like this image, so I'm using it again.  :)Last night at the gym, I put my bag in the locker and took off my sweatshirt.  Wearing my black yoga pants, sports bra, and a tank top, I went into the bathroom section of the locker room to put my hair in a ponytail.

Two other women were at the sinks, chatting in Spanish and washing their hands.   They were standing to my left and as I raised my arm to put the elastic in my hair, I noticed that both women had stopped talking for a minute and were staring at my arm. Staring like I had moldy peach stuck to my arm, or maybe one of those bizarre happy spiders

Then I remembered that the Dexcom sensor is comfortably resting on the back of my left arm.  Facing them.  

I had a quick surge of "Grrrrr," as in "What are you staring at, woman?  Never seen a CGM sensor before?" ... then I had to check my attitude.  No, they probably haven't ever seen a continuous glucose monitoring sensor before.  Just because it's something I'm used to doesn't mean it's something they are used to.  After yesterday's post purge and your wonderful and inspiring comments, I felt ready to cast off some of this anger and try, instead, to help.

So I decided to smile instead.  

"I'm sorry, I don't mean to notice that you're staring."  Gestured to my arm.  "This thing - it's for my type 1 diabetes.  It's a glucose monitor."

"Oh my goodness, I did not mean to stare," said the woman in the green shirt.  "I was like, 'Is that an iPod thing or something?'  I have never seen that kind of thing before."

Her friend with the glasses leaned in.  "For diabetes?"

"Yeah.  I know it doesn't look completely natural, and I would stare, too, if it wasn't something I was used to." Glasses and Green Shirt smiled back.  "It's cool.  I just didn't want you wondering if I was some kind of cyborg or something."

Green Shirt laughed.  "Cyborg?  No, chica.  It's interesting looking.  I was waiting for, like, the music to come out of it or something.  But I didn't mean to stare.  Lo siento, my friend."

"Not a problem at all.  Have a good workout!"

I left the locker room and went to do my workout.  After I was done, I went back in to grab my sweatshirt and saw Glasses and Green Shirt getting their gear together.  Flashed them a quick smile.  Glasses smiled back.  Green Shirt tapped her left arm and gave me a knowing nod.

Some people can try to bring you down.  But others, even strangers, can raise you up.  

[Dexcom disclosure]

January 27, 2009

Not Perfect, Never Claimed To Be.

Diabetes perfection?  Nope.A few weeks ago, when I was gearing up to hear my A1C results, I admitted freely that the wedding stress of eight month ago really left it's mark on my numbers.

And over that weekend, I received several emails from people that said, "Me, too!  I have trouble lowering my A1C too, but every step towards my goal is a step in the right direction!"  I also received emails just wishing me some luck on controlling these numbers.

Then there was the one that asserted "A person in your public-facing position should have better control of their numbers.  You are a role-model and someone that should set an example to these young children.  An A1C of 7.5% is not good enough."

And then there was a comment from Dr. Bernstein:  "An A1c of 7% corresponds to an average BG of 180 mg/dl.  Not a wise target for someone who wants to become pregnant.  A normal A1c is 4.2-4.6 % -- not what the ADA promotes.  Pregnant non-obese non-diabetics usually have blood sugars below 70mg/dl."

I'm not sure what kind of impression people get of me from reading this blog, but if I've made the mistake of fooling you into thinking I know how to perfectly control my diabetes, that unfortunately is not the case. I'm not a role model, not like that.  I don't have perfect diabetes control and on some days, I'm not sure what to do next.  I am trying to fill in for my islet cells, for an organ that went rogue on me, and it's not a science I've perfected.  I'm working hard, every day, to achieve a level of life and health balance.

So to the folks who think I should have an A1C of 5.0% simply because I blog about diabetes ... for those who are reading and clucking your tongue against the roof of your mouth - "Oh, her baby is going to be upset in there if she has an A1c that high when she conceives." - I invite you to stop clucking around.  (Puns.  Cannot resist.  Sorry.)  SUM is a public blog, and I've made the choice to make my diabetes life a public one, but I'm not a doctor.  My A1C is not 5.0%.  I don't have this "all figured out."  (And I sometimes eat E.L. Fudge cookies when I'm frustrated.)  

But blogging has provided me with a support community I couldn't have imagined.  I can't even begin to tell you what kind of an impact you all have had on me, proving time and time again that I am not alone with this disease.  You guys make me feel connected, secure, and confident that every bump along the way can serve to educate me and make me a tougher (E.L. Fudge?) cookie. I appreciate the support, and I appreciate the criticisms because they are more than valid.  But don't expect me to have this thing completely controlled.

I want to be healthy, and I want to enjoy a healthy pregnancy in my future.  I am working to bring my body to a state of optimal health, but I'm not lying to myself, or to my readers, along the way.  Shit.  Gets.  In.  The.  Way.  I can't pretend to be perfect, but I am honest about my shortcomings, and I am trying to do better for myself and for my family

If you want to leave comments about how you think I should be better controlled, I'll agree with you.  If you want to peck at my armor and find the kinks, you won't have to look very hard.  I put all of this out there knowing the risks and the judgments that come with a public-facing blog.  And I appreciate that people care and offer their opinions and perspectives (both good and bad), and provide that community I was craving when I felt alone. 

But my diabetes, shared with the Internet or not, remains mine. 

Remember that before you pick up a stone.  My house isn't the only glass one.

January 22, 2009

BEEEEEEEEEP!s and Basals.

Damn diabetes juggling act.It's January 22, and I've been sticking with my New Year's resolution of keeping a Log Book.  (Said Log Book is currently in my home, all current and three-hole punched and was almost eaten once by Abby but then I put it in the bookcase so now it's safe.)  And after taking note of all the highs I've had in the morning hours, and the weird drops I'm experiencing just before going to the gym at night, I decided to do a little basal tweaking.

Here's the disclaimer:  Talk to your doctor before tweaking your basals.  Kerri is not a licensed CDE or a medical professional of any kind, and quite frankly, if you follow her advice, you may end up tucked inside of a banana for all eternity.  [See also:  Siah.] 

I don't take a lot of basal insulin throughout the day, but I do use many basal flucutations.  It's not one steady dose for me.  I range from .45 u of Humalog in the afternoon hours to about .75 u in the early morning hours. For a while, this worked out pretty well.  But maybe it's the lack of birth control pill hormones, or the absence of wedding-related stress, or maybe the new mousepad I have at home is shifting the tides ... in any event, I needed to make some adjustments.  I could see the trends happening by watching the Dexcom screen, so I knew this was more than just a fluke thing.  (The Log Book confirmed my suspicions.  Who'd have thought that logging could be useful!)  The Dexcom was hollering at me in the morning - BEEEEEEEEEP!ing to the point where my coworkers noticed.  

"You okay?"

"Yeah.  Frigging beeping.  I have diabetes."

Laughter.  "Oh yeah."

So on Monday morning, after another frustrating BEEEEEEEP! confirmed by a meter check showing me at 267 mg/dl (thank you, glucose goblins), I tinkered around with the patterns in my pump.  I dialed up another .2 u for my mornings, hoping to stave off the highs. 

It worked.

Yesterday morning, I woke up at 6 am with bricks hanging from any firing synapses in my brain.  The Dexcom was BEEEEEEP!ing from the headboard of the bed (where it stays during the night so Chris can see it and hear it, too) and I woke slowly.  Moving without thinking, I unzipped the meter case and went through the motions.  41 mg/dl.  Fantastic.  Seeing the number cut a few bricks loose, and I was able to shuffle off into the kitchen for juice.  (Yes, there were reaction treaters in my bedside table.  No, I didn't use them.  Instead, I found myself in the kitchen with a huge knife, cutting a slice of a brownie from the container in the fridge.  Sharp knife + Kerri when she's low + wee hours of the morning could = disaster, but thankfully no fingers were severed during the course of my low.)

Reaction treated, I went back to bed, crumbs still on my shirt.  I rested my head against the pillow and the Dexcom howled at me once more, showing me the slow bell curve towards a low that had been happening for over an hour.

"No, I heard you.  It's cool now.  Leave me alone."

Chris stirred.  "You're going off.  You're beeping.  Did you hear the beeping?  You're low."  Talking in his sleep, the poor guy.  He's on autopilot, too.

"I treated. It's okay now." 

It's a little research, a little trial-and-error, and a whopping dose of blind faith required for mucking with basals. Hopefully over the next few weeks, I can make slow adjustments to this basal crap and eliminate some of those frustrating highs.  Even though I'm sleepless some nights due to the Dexcom, I'm grateful to be able to see those graphs and lines and make adjustments to my insulin doses accordingly. 

If only it could keep me from juggling knives while I'm low.  I think I need a whole separate alarm for that. 

[Dexcom disclosure

January 21, 2009

Diabetes For The Day: Round Four

This past Monday and Tuesday, another dLife coworker volunteered to be "diabetic for the day."  (We'll call him Johnny CoWorker for the purposes of this post.)  He wore an infusion set (sans needle), a "pump," and tested his blood sugar throughout the day.  But in addition to the physical hardware of diabetes, I spoke with Johnny CoWorker about the emotional aspects of diabetes, citing how vulnerable highs and lows can make us feel, what the feelings/food conundrum is like, and what it's like to manage a chronic condition not just for the day, but for a lifetime. 

He asked a lot of questions.  And he listened.  This is his feedback about his experience with diabetes for the day:

Kerri:  You wore a “pump” and tested your blood sugar throughout your day with diabetes.  How did you feel about these devices?

JC:  The pump was not an issue for me, it was slightly weird getting used to it and when I had to decide what to wear for work. Other than my kids asking me what the wire attached to me was, I didn’t notice it.

I got the hang of testing after a little bit, and was very interested in how working out or what I eat affected my numbers.  A couple of times I got a bleeder and it stung and then one time I had to prick my hand four times to get enough blood to get a reading (rookie!).  I felt in tune with my body and was intrigued to learn my numbers each time.

Diabetic For the Day!

Kerri:  You wore the pump all day and overnight.  Was it comfortable?  How was sleeping with something attached?  Showering?  Was it difficult to dress for?  Did you almost drop it into the toilet at any point? 

JC:  Definitely the decision of what to wear was interesting – a button down shirt tucked in where the wire would be sticking out of my shirt or a sweater where the wire can easily go into my pocket.  I choose the sweater to avoid the tugging of the wire.  Relaxing, sleeping, and showering was much more comfortable than I expected.  When I bent over to tie my shoes, I caught the injection site the wrong way and it pinched, I can only imagine what that would of felt like with a needle injected.
 
Kerri:  How did testing your blood sugar affect the way you thought about food? Did you find the blood sugar testing to be painful? How comfortable were you with the process?


JC:  I ate healthy all day so no big swings high or low, but I was very cognizant of testing before I ate and then two hours after to see what affect the food had on my numbers.

A couple of times it was painful.  Initially when I first started I thought if I had to do this all the time I wouldn’t mind.  But as the day wore on I found it to be more of a burden to do and was struck with the realization that this was a 24 hour experiment for me vs. a lifetime for many others.
 
Kerri:  How did the blood glucose numbers make you feel? Did any of your results make you raise an eyebrow? 

JC:  Luckily no, I exercised and ate well all day so my numbers where in a range of 83 – 121, which I was pleased with.
 
Kerri:  Do you feel as though you have a better idea of what life with diabetes is like?  What else would you want to know?  What are you grateful for not knowing?  

JC:  I think I do, but I don’t know that I can truly appreciate what it would be like for others unless “I had” to do all of this.  I would be interested in learning more about if I had a heavy carb meal (like my favorites – pasta or pizza) and what that might of done to my numbers.  I am grateful that I don’t have to know how food, exercise, or stress effects how I feel on a daily basis.
 
Kerri:  Did this experiment make you appreciate your health any more?  Less?

Continue reading "Diabetes For The Day: Round Four" »

January 20, 2009

New Thigh Thing?

At the JDRF Walk in Connecticut this year, I met with a woman named Joan Benz.  She was tending a table of her homemade wares:  specialty pump pouches and concealment cases.  Joan is the founder of T&J Design.

Joan is the creator of a fantastic little product called "the leg cuff," and it's the Thigh Thing 2.0, as far as I'm concerned.  I absolutely cannot STAND when I'm wearing my pump on some kind of strap around my thigh and it starts to FAIL.  Nothing is more embarrassing than walking down the sidewalk towards my office and feeling that thigh strap start to slip, then slide down towards my knee, then tumble out from under my hemline - making me look like my undergarments are falling off me as I walk. 

The leg cuff is different because it's a thicker piece of fabric and there's a lining that adds some extra grip to the whole thing.  Because it is a wider structure, it isn't as apt to slide down while you walk.  And because Joan makes these herself, specific to your measurements, the fit is precise and snug. You can get the leg cuff in black or white, which makes it pretty darn versatile.  And you know what a fan I am of keeping the pump concealed and quasi-fashionable!

And while this whole leg cuff thing is a wicked cool product, there is something else that Joan makes that really tugged at my heartstrings.  Joan creates these pump concealment pieces, ranging from the leg cuff to a more standard "pump pack."  But she also makes pump packs that are doll-sized, helping a little kid with diabetes to feel more accepted and less alone with their disease.  Each pack comes with a little cardboard, doll-sized pump.  It's just about perfect.

I think having a "diabetic doll" is crucial to that acceptance stage, growing up with diabetes.  I remember I had a Cabbage Patch Kid with blond yarn hair that I named "Carolyn," and she was diabetic.  Just like me.  Carolyn had to test before she ate.  She took "injections," and she accompanied me to many pediatric endocrinologist appointments at Joslin.  Even now, years later, I remember how Carolyn the Cabbage Patch Kid made me feel  like I was normal.  Or at least a new kind of normal.  So, to me, Joan's idea is fantastic.

If you are looking for a good "thigh thing," check out T&J Design and tell Joan I said hello!

Kerri Sparling's insulin pump ... and hands.

(Also, Joan was recently named the Outreach Coordinator for the Fairfield County JDRF Chapter - my local CT chapter - so hopefully she'll have a bigger outlet for her terrific product!  Congrats on your new position, Joan!)

January 16, 2009

Appointment'd Out.

The Friday Six:  January 16, 2009 editionWhat a freaking long week, with a doctor's appointment every day and way too much medical analysis.  This week is a very personal Friday Six, and here it is:

1.  On Monday, I had my A1C drawn.  I've been to this specific lab before, and the same woman has drawn my blood before, so I didn't have a lot of anticipatory nerves.  But when the lab technician said, "Okay, you have lost all of your color - put your head down, Mrs. Sparling," I knew I wasn't as badass as I wished to be.  (And I also winced when I pulled off the cotton ball she had taped to my inner arm ... I'm such a wuss.)  But thankfully, the results were a full point lower than my last A1c, leaving me with a 7.5% and a reachable goal of <7% for April. 

2.  And Tuesday, I had a dentist appointment.  Those of you who have been reading SUM for a few years know that I have an unholy fear of the dentist, but it is warranted.  My teeth are so sensitive and require barrels of novocain to make them numb, so fearing the wielder of pointy metal hooks in my mouth is a rational fear.  However, my new dentist is FANTASTIC and brings me no pain.  I had my teeth cleaned (first time in ... ages, unfortunately), no cavities, and I have already scheduled another cleaning for April.  I'm considering the dentist hurdle cleared for the time being.

3.  Wednesday has me sitting at the dermatologist's office to have a new freckle on my breast examined.  (Whoa, Kerri.  TMI?)  Yes, that is way too much information, but since when did I start censoring myself?  (Since ... today?  Maybe I should start.)  Always in a constant state of medical over analysis, I decided it was best to have it checked out.  So I spent Wednesday morning having a kind, eccentric, little bald doctor look at my breast with a magnifying glass.  Definitely a "first."  This little issue ended up being nothing to worry about, but now I can check "awkward sharing moment with the Internet" off my list for the week. 

4.  Thursday had me with dilated pupils at the retinologist's office.  Of all the appointments this week, this eye one was the least ... awesome.   

"Look up ... okay, now look a little to the left ... Kerri, up again ..."  Dr. Retina kept shining the light in my left eye and making a "hmmmm" sound under his breath.  My face was cupped by the eye examination machine.

"You can't fool me.  I know you found something.  Spit it out."  My eye doctor and I have a very good relationship, and we talk like we're about to go grab a beer together.

"Small little something.  Hemorrhages in there that I want to keep an eye on."

"Pun intended?"  Without moving my face from the chin rest, I reached over and grabbed a Kleenex because I immediately started to cry.  But I was oddly okay with the news.  Maybe I've already had that bubble busted.

"It's okay.  But with you and your husband talking about maybe getting pregnant in the coming year, I want to keep close tabs on your eyes.  You've had diabetes for what, a million years?"

"Twenty-two years."  I smiled.

"Twenty-two years.  And your eyes look beautiful - barely a problem at all.  But I want to keep them that way.  Let's schedule an appointment to do a fluorescein dye exam before you and Chris are pregnant, just so we know exactly what we're dealing with."

"What is that?"

"We'll inject a dye into your arm, then do a dilation on your eyes.  The dye lets me really see what's going on in there with complete precision.  And with you, I do not want to take any chances."

"Okay.  So do I need to worry about this?  I'm worried.   You know I worry."

"You worry?  You do?"  The gentle ribbing was okay with me.  Soothed my anxiety a bit.  "You do what you're doing.  Work to keep your blood sugars controlled.  And think about taking some time off from all that work you do.  Maybe take a vacation?"

Fine.  So now I need to schedule a vacation.  Doctor's orders, you see.  ;)

5.  Now that these appointments are all behind me, I'm moving forward towards the next steps.  I am doing the pre-pregnancy clinic at Joslin in March, and Chris and I are working to get everything in order so that we can make our family-starting decisions based on factors other than diabetes ones.  It's an exciting time, and one I've been looking forward to my whole life.

6.  And in my only news-related bit of the day, this weekend is the end of the MedGadget awards, and thanks to all of your help and support, SUM is in the lead for Best Patient Blog.  I would be honored to win this award on behalf of every last one of us, so please keep spreading the word and voting!  :)  Thanks for everything, and hopefully on Sunday I can report that WE DID IT! 

I'm planning to spend the weekend hanging with my girl friends (finally seeing the Batman after a long absence!) and doing some recreational writing.  I hope you guys have a great weekend, and stay WARM!!

January 12, 2009

Diabetes Rebellion.

The first rule is ... test!When the Dexcom sensor goes kaput, I usually take a day or two off before slapping a new one on.  Sometimes I want to let the site heal a bit and reuse the same location, and other times I just want a quick break before committing to it again for another six days or so.

Most often, these "days off" fall on the weekends.  I usually put a new sensor in on Sunday nights or Monday mornings before work and wear it straight through to Saturday morning. At work, at the gym, and throughout the night, that sucker BEEEEEEEP!s when I'm high or when I'm trending low, and I react accordingly.  I don't test as often on these days - maybe five times a day versus my pre-Dexcom 11-15 times - but I feel like I have a good handle on things, for the most part.

So why is it that, on weekends, my blood sugars fall to pieces?

I can't figure it out. 

And then again, I sort of can.  Over the last month or so, I've become like a diabetes rebel on weekends.  I go to bed at two or three in the morning.  I sleep until 11 am.  I eat French Toast (with sugar-free syrup, but still - holy carbs) on Saturdays and my intake of coffee is as constant as insulin.  I skip the gym and watch tv and generally become a lazy bum.

And, of course, this all goes down when I'm sensor-free.

This particular weekend, I had a glorious 374 mg/dl and a sneaky 38 mg/dl.  We went to the movies on Sunday afternoon to see Valkyrie and I hadn't tested recently before heading into the movie.  During the course of the film, I felt extremely sleepy and felt my eyelids becoming heavy at times.  After we drove home, I tested and saw a grim 374 mg/dl staring back at me.

Fantastic.  "I felt this one, yet I still didn't test.  What the hell is wrong with me?  I'm pissed - it's like I start sliding down that slope and it all goes amuck."

"Did you bolus?"  Chris asked.

"Yeah, I just did.  I just feel stupid."

"You'll come down.  It's okay."

A few hours later, after hanging out at the house, I tested arbitrarily.  I felt completely fine - no headache, no sweaty forehead, no shakiness.  I wasn't pale, my eyes weren't heavy-lidded, and I didn't feel lightheaded at all.  Yet a 38 mg/dl was the result that greeted me this round, and I didn't feel even a glimpse of a symptom.

Tested again and confirmed:  34 mg/dl.  Definitely low.

I drank juice, I sat on the couch, and I waited patiently (or at least patiently for me, which meant I didn't throw anything).  And as I waited for my blood sugar to start coming up, the symptoms came slamming into me.  I was dizzy, to the point where I felt unable to stand up.  Chris came to talk to me and I couldn't string a sentence together, only able to communicate in short bursts.  "Low.  Yes, drank juice.  Waiting.  Love you, too."

From 374 to 38 - a drop of over 330 points.  This doesn't feel good and it isn't healthy for my body, yet it happens sometimes.  Even when I'm paying attention and "following the rules," there's still something I've missed.  I didn't test often enough.  I neglected to account for some of the food I ate.  I took the weekend off from the Dexcom.  I'm battling myself.  It's a diabetes Fight Club.  (The first rule is to not blog about fight club, but I've already blown it.)

I'm feeling frustrated these days and I'm not sure where to go from here.   But at least with this kind of rut, I can flip things towards "change" at any moment.  All ... I ... need ... to ... do ... is hit the switch.

January 07, 2009

FDA Petition For Diabetes.

A little patient perspective goes an awfully long way.

And this time, the diabetes community is rallying to make a lot of patient perspective go as far as it can - straight to the Food and Drug Administration (FDA) to urge them towards creating a Diabetes Advisory Council.

Members of the diabetes community, myself included, are co-sponsoring a petition to achieve this advisory council goal.  Here is the core goal of the petition, as written on the website:

"Due to the very nature of the severity and prevalence of diabetes, the following leaders within the diabetes community, who have signed this petition, implore the FDA for the immediate creation of a Diabetes Advisory Council, whose goal would be to improve options for patients. This council would include practicing endocrinologists, diabetes educators and others communicating directly with patients. Our experience, focus, and keen awareness of the needs of the diabetes community would be an invaluable resource to the FDA as it faces the arduous process of evaluating new diabetes treatments.  Our aim is to improve options for patients.

We urge the new FDA leadership to recognize the urgent need for more safe and effective treatment options for diabetes and to reduce barriers to innovation. More treatment options will benefit patients. The disease is progressive. Delays in the availability of new treatments will only result in tremendous cost to public health and the economy.  Our recommendation can benefit patients without sacrificing their safety."

- Ask FDA to Better Serve Diabetes Patients

This petition isn't about passing unsafe drugs and paving the way for companies to market crappy products to our community.  It's not about turning a blind eye to drug-induced cardiovascular issues.  What this petition does is give people with diabetes, and the people who care for them, a clear voice in these government processes.  As the petition states, our "experience, focus, and keen awareness" of the needs of the diabetes community would be an invaluable resource to the FDA. 

We want safe and effective treatment options.  Diabetes is a disease that affects my life every single day, and I work hard to stay as healthy as possible.  I believe that the perspective of patients like us and those who love us can collectively raise our voices and bring newer, safer diabetes treatment options into our lives sooner rather than later.

I want a cure.

But for now, I'll settle for progress.

If you want to see a Diabetes Advisory Council created, sign the petition and pass it on.  And for more information on the programs the FDA already has in place for patient advocates, check out this link.  Help spread the word on how the diabetes community can make our collective voices heard.

December 29, 2008

Insulin Issues.

What to do about cheesecake??"Now I thought you couldn't eat that?  Or can you just dose for it and it's okay?"

She wasn't being the dreaded "diabetes police," but she was just asking a question.  Type 2 diabetes is a familiar disease for some of Chris's relatives, so I can understand his aunt's confusion about how my type 1 diabetes is handled.  Wasn't I supposed to just avoid sugar?

"I can eat this," I gestured to the slice of cheesecake on my plate, "So long as I check my blood sugar beforehand, take the appropriate amount of insulin from my insulin pump, and I avoid a high blood sugar spike afterwards."

"So you can eat anything you want with that insulin pump?"

And this is where I get a bit confused.  Being a type 1 diabetic since I was a kid, I've always taken insulin.  Always.  I don't know anything about type 2 oral medications and I have no concept of managing diabetes solely through diet and exercise.  It's either been multiple injections or the insulin pump. 

Insulin is cool stuff.  It keeps me steady and solid on days when I'm following "the rules," but for things like holidays (where there is a whole dessert table and all kinds of sugary treats), I do have the option to up the bolus ante.  But a cure?  Nope.  Using insulin requires a lot of work.

The thing is, I think that insulin makes it seem like I can eat anything I want.  While I indulged in that piece of cheesecake after Christmas dinner, it was a risk I took.  I took more insulin, and I've read all these obtuse reports about how taking more insulin is tougher on our bodies. (Is that true - does anyone have a study they can point us to that states how insulin ages us or something?  I'm so curious.)  I risked the immediate spike and the latent spike in my blood sugar after eating the cake.  I wanted to indulge and I weighed the risk of this indulgence.  It's a split-second decision that my brain is programmed to make by this point.  Diabetes is all about coloring in the lines, i.e. keeping blood sugars well-controlled to minimize the impact on my body.

But I wonder what people think sometimes when they watch me eat.  How does it look from their eyes?  They know I have diabetes, and from their less-familiar vantage point, they view it as "serious" because I take insulin.  I use Equal in my coffee and I never drink the eggnog or have regular soda.  I almost always avoid the mashed potatoes and sweet potato casserole, and at family gatherings, there is usually a "sugar-free" dessert.  They hear me talk about blood sugar control and they know I work in diabetes advocacy.  They understand as much as they can, not actually living with the disease themselves.

But what to they think when I reach for a piece of cheesecake?  Do they think I'm "off the wagon?"  Do they think I'm being irresponsible because I'm eating a sweet?  Responsible because I'm testing and shooting accordingly?  Does it confuse them to see me clamor for a glass of grape juice when my blood sugar is low?  Do they wonder why every time they see me, there appear to be new "rules" for managing my type 1 diabetes? 

Diabetes is a constantly shifting platform that we're trying to balance on.  Every day is different, every diabetic is different, and the rules do seem to change every day.  On Christmas, I ate cheesecake and never sported a spike.  Last night, a cup of tea tossed me towards 200 mg/dl.   

"A pump isn't a cure, though, right?  I mean, you still have to prick your finger and tell the pump what to do, don't you?"

She's learning, petal by petal.  And despite all these years, so am I.   

December 22, 2008

Dexcom Pros and Cons.

As with everything diabetes-related (or maybe just life-related), there are pros and cons to this whole continuous glucose monitoring thing.  For those of you who are still thinking about whether you want to make this CGM leap, here are my pros and cons of CGMing to shed some light on the subject.

CGM CONS:

The sensor is bulky.  The sensor isn't tiny (about the size of an iPod shuffle), but it's held securely down by the adhesive gauze, so once it's in place, I can't feel it.  This is a big deal for me, since the Minimed CGM was painful for me.  However, it's visible underneath the sleeve of my shirts when I wear it on my arm and it's slightly uncomfortable to sleep on when it's on my back.

Can be "too much information."  Having blood sugar updates every five minutes is awesome, until you find yourself checking it every five minutes and obsessing over each result.  I needed to be psychologically ready for a CGM, and I need to be able to keep it from ruling my life. 

Receiver is enormous.  The Dexcom receiver is pretty big - bigger than my Blackberry - and it's cumbersome to wear.  I usually keep it on my desk, in my purse, or in my coat pocket when I'm out.  At night, I strap it to the headboard of the bed using a headband.  Not a big deal, but it's hard to miss.  Especially when it ...

Beeeeeeeeeeeps! The beeps are LOUD.  Mega loud.  Loud enough to wake me up during the night if I'm low (thankfully), but during the quieter parts of the workday, it's loud enough to distract my coworkers.  I recognize that the beeping is important, but it's not always convenient.

Adhesive sort of sucks.   This is my biggest compliant about Dexcom sensors.  The things do NOT want to stay stuck for more than five or six days.  I shower twice a day (before work and after the gym) and I wear clothes that rub up against the sensor, no matter where I place it.  Even with SkinTac, the edges of the sensor start to peel up at about the five day mark, and it's loose and ready to fall at the 7 - 8 day mark.  (And sometimes, the SkinTac and the Dexcom adhesive and a not-so-helpful bandaid create a huge and ugly problem:  frigging ouch.  See the photo on Flickr for a full rundown.) 

Ouchy Dexcom

I do not like when a $60 sensor starts to peel away.  This is highly annoying.

Insurance coverage battles. While others have had their requests approved without batting much of an eye, my insurance coverage for the CGM had to be fought for.  I battled my insurance company for over eight months before receiving my approval letter.  The insurance hurdles are a definite con, and might make some people reluctant to fight for their right for a CGM.  (Cheerleader note:  But don't let it stop you!  Go for it!)

Doesn't feel "sexy."  (Yes, I know this "shouldn't matter," but these are my personal pros and cons, so roll with me, okay?)  With the pump infusion set stuck into one part of me and the CGM sensor in another, wearing two devices doesn't exactly feel like I'm ready to model for Victoria's Secret.  There have been plenty of times when a moment has been interrupted by the CGM beeping or the sensor getting stuck on my clothes and whatnot. 

CGM PROS:

Low blood sugar safety net.  This was a huge part of why I wanted to use a CGM in the first place:  hypoglycemia unawareness.  I was exhausted and frightened of the lows at 3 am, so having the added safety net of the CGM has been a huge improvement.  The CGM does its job and protects me from plummeting blood sugars.  When Chris is away on business, he prefers that I wear the CGM to keep an eye on those lows.  It makes me feel safe, and I value that "pro" above all others.

Helps me avoid staying high.  My body reacts to blood sugars that are over 260 mg/dl or so, but those 160's and 180's often go unnoticed.  The Dexcom helps me wrangle in these "minor" highs and tighten up my blood sugar standard deviation overall.  Staving off both the lows and the highs will be particularly helpful during my future pregnancy.

Excellent for exercise.  I go to the gym at least five days a week, and my workouts range from walking/jogging on the treadmill to cardio circuit training.  The CGM has been AWESOME at detecting fluctuations in my numbers while I work out, helping me avoid those crash-and-burn lows at the gym and also the highs that sometimes crop up after a hard workout.  (And it was great on our hikes when we went to Acadia - excellent tool!)

Driving safety.  I spend a lot of time in the car driving back and forth to RI, and the drive time is anywhere from 2 1/2 hours to 4 hours (depending on traffic - I hate CT highways).  Having the Dexcom in the center console next to me while I travel is another big bonus.  With hypoglycemia unawareness and blood sugars that seem to be affected as much by my moods as by what I'm eating, having an extra eye on those numbers is crucial to keep be safe behind the wheel.

Integration-free works for me.  I trialed both the Minimed CGM and the Dexcom and for me, the Dexcom being a seperate device worked best for me.  With the Minimed CGM, I couldn't hear the pump alarming in the night because it was buried underneath the blankets.  Having the Dex receiver separate from the pump is convenient for the nighttime alarms and also if I want to avoid having to deal with the CGM for a little bit.  I can shove it into my purse, bury it in a desk drawer, or even walk away from it for a little while if I want.  I like the freedom from being beeped at sometimes.  It sounds counterproductive, but in the longrun, this is a bonus for me.

Trending and tracking.  Here's the point of CGMs - to track the trends of my blood sugars.  The Dex doesn't replace my meter, but instead works with it.  I test on my meter and see a result of 100 mg/dl, but with the Dex, I know I'm "100 going down," "100 going up," or "100 holding steady."  This makes it easy to go into long meetings at work without fearing a crash, and also lets me go to bed at a blood sugar of 90 mg/dl with confidence.

Pretty darn accurate.  I don't expect this thing to be right all the time.  I already have my head programmed to accept that a CGM doesn't replace finger sticks, so when things don't match up all nice-nice, I don't flip out.  Overall, though, I've found that the CGM rides pretty close to my meter.  Dex works better when I'm running a bit steadier, so it's actually a weird sort of incentive to maintain better control to retain the integrity of the sensor.  Don't ask me to mentally make sense of that - I need to take whatever motivation I can and run with it.  ;)

But it does feel sexy.  And this is the flip side to that "con" coin.  The Dexcom is sexy.  It's stuck to me to gain better control of my diabetes.  Good control helps everything from my weight to my hair to my internal organs to my smile.  Being healthy is sexy as hell.  And being confident enough to wear this machine, despite its cons and because of its pros, makes me feel stronger all the way around.  For me, after weighing all these pros and cons, the CGM is definitely worth it.

Conquering diabetes, damnit.

Readers Beware!!:  These are MY pros and cons.  I chronicle my personal experiences with diabetes here on SUM and I'm not a doctor or a CDE or a medical professional of any kind.  I have decided to use the Dexcom CGM after trialing both the Minimed and the Dexcom, but I know plenty of people who are using the Minimed CGM without issue.  For me, the Dexcom was a more comfortable fit into my life, literally and figuratively.  It's all about personal preferences, and these are mine. 

If you're thinking about trying out a CGM, I recommend trialing as many kinds as you can before making an informed decision.  Your mileage on these devices will vary, so it's important to find out what works best for YOU.  Contact your CDE and see if you can schedule a week trial session with different devices. 

If you want to share your perspectives, feel free!  I love that the online diabetes community has become a real source of information for diabetics everywhere who are looking for real information - we are the true mavens of patient experience!

December 18, 2008

Minimed Trick I Didn't Know About.

I have had this Minimed 522 for over a year now, and just yesterday I discovered an option I hadn't previously known about:  Daily Totals Screen.

My old pump had daily totals.  I would hit the utilities option, scroll down to daily totals, and I'd see a running tally of how much insulin I took in total on the previous two or three weeks.  This was a cool option I clicked on every few days so I could keep track of my total daily dosage (and it also helped me isolate the days when I was running higher, because those TDDs were higher).   

Purely by accident (because I do not read the manuals that come with any technological device - technoJOY!), I realized that my new Minimed 522 not only gives my total daily dosage, but it also gives me averages of my blood sugars.  This is AWESOME because, thanks to the One Touch UltraLink that shoots my results over to the pump and thanks to the CGM sensor lodged in my arm, I have a really good sense of how crap my blood sugars have been for the last week and a half.  

Minimed pump features I had no clue about.

(Oh how I kid.)  Actually and unfortunately, I'm not kidding at all.  Last week was a veritable ping-pong match in my body and there is concrete evidence of this terrible run in both my Dexcom receiver and my pump.  My daily insulin totals have leapt from 22 units of Humalog a day to a whopping 35 units.  (And before you start thinking, "Hey, that's not a lot of insulin," remember:  your diabetes may vary.  It's a lot for me.)  Seeing my blood sugar averages and the number of correction boluses I'm taking during the course of a week shocks my brain into lurching into action.  "Average of 189 mg/dl?  Must ... improve ... control ..."

I think this Minimed bolus/TDD/blood sugar tracking feature is very handy, and a great tool for anyone who wants to see their diabetes in a customizable snapshot.  Like I said, I now know that my numbers truly have sucked for the past week, but I'm hoping that when I take a peek at my 14 day averages next week, I'll see some improvement. 

I wonder what other secrets this pump holds. Maybe if I press a few buttons in unison and hop on one foot while wearing bunny slippers, I can unlock this cryptex to find where Siah's been hiding my wallet ...

EDIT:  Just realized I didn't specify how to find the feature, if you haven't already.  Go to Utilities, then Daily Totals, then Daily Averages. Set the number of days you want, and hit ACT. Viola! 

December 16, 2008

Diabetes Fashion Trends.

Hiding my pump behind the scarfBig sunglasses?  Tucking my pants into a pair of thigh high boots?  Ridiculous white plastic 80's earrings? 

No, no, and NOPE.

But if there's one fashion trend I'm embracing whole-heartedly, it's the scarf thing.  Scarves, pashminas ... whatever you're calling them, I love them.  Every time we're in NYC, I spend way too much time perusing the pashmina color selections offered up by the street vendors. 

Five bucks for one scarf?  Don't mind if I do! 

These handy little numbers come in a whole rainbow of colors - I have everything from midnight blue to pink to purple.  They add a splash of color to an otherwise drab ensemble, and the fabric itself is soft and flowy.  I'm frigging smitten with the things. 

And in addition to being fun and fashionable, these scarves are also my new weapon in diabetes device discretion.  One scarf, draped casually in any way that falls past my hip, can cover the bulge of the insulin pump or the Dexcom receiver.  Since I've been rotating my sites more frequently and making use of the real estate on my lower back, the tubing doesn't always reach far enough to hide the pump in my sock.  In these instances, I clip the pump to my pocket or waistline.  And the lovely scarves are awesome for keeping my devices incognito.

Even though the cold weather is chapping the hell out of my hands and making me shiver as my car warms up in the morning, I'm thankful that this chilly weather offers up plenty of opportunities to be fashionably healthy.  (And they're sort of snuggly, too, these scarves.  Almost forgot that part.)

How do you make your insulin pump or other diabetes device part of your ensemble?

December 15, 2008

Drug-Free Monday.

No more The Pill.Today's post is brought to you by the letters "T," "M," and "I."  And also "Y," for "why the heck am I telling you this?"

Because it may not be just me.  So I'm inclined to both share and draw on the genius of the blogosphere.

My period came when I was 13 years old - textbook "time to become a woman" sort of thing.  And it came for the first time at church.  During Sunday school.  Fantastic.  I knew what was going on (health class + MomTalks = educated Kerri), but the timing was a bit entertaining.

For the first few years, my cycle was more seasonal than monthly.  I only had my period once a season, skipping months at a time, but because I wasn't sexually active, it didn't raise any concerns.  My doctors and my parents decided I was going to take a few years to acclimate to a monthly cycle, and since I was only 16 at the time, it wasn't a raised concern.  I was under the medical microscope at that time anyway, being in my teens, having trouble controlling my blood sugars and/or hormones, and enjoying yeast infections, urinary tract infections, and other high blood sugar added bonuses. 

Once I became sexually active at the age of [hey look, something shiny!], I talked with my doctor about starting on a birth control pill.  Being the paranoid peanut that I am, I talked extensively with my endocrinologist and my gynecologist before deciding on a pill, and kept in close contact when them for the next few years.

But then there were some hiccups in the system that made me rethink the regular pill regimen.  First, I entered my late twenties and realized I had been on hormones for over ten years.  Second, I got engaged, which made me think BABIES and made me want to confirm that my reproductive system was in fine working order.  And thirdly, there was the diagnosis of the Factor V gene, which made regular birth control pills a risky choice and forcing me to try the minipill.

So, with all of these factors (literally and figuratively) in play, I've decided to come off the pill.  Effective last night. 

I've come off the pill once before, in college.  At that time, I was between serious boyfriends and wasn't sexually active.  So, under the advice of my doctor, I stopped taking the pill for eight months.  And during the course of those eight months, I did not get my period even once.  I decided to go back on the pill to re-regulate my cycle and it was only after taking a medication to induce my period did I get one.  Once I was back on the pill, my cycle came predictably and without issue.  But this "gap" concerned me, and I want to make sure I'm okay.

With my marriage behind me, my thirtieth birthday ahead of me, and my desire to start a family becoming more of a "now" than a "later," it's time to make sure my body is ready.  And not just from a diabetes perspective.  From all perspectives.

But - FOR THE RECORD - I am not pregnant.  I am not trying to get pregnant.  And I'm not ready to get pregnant.  When I'm there, I'll definitely share that news proudly!  But for now, I'm going to enjoy being a newlywed for a bit longer.  :)

So ... who out there was on the pill for years and came off it?  I am not sure what to physically expect (Will I cycle right away?  Will my body become sore or more sensitive?  Will I be an emotional wreck?  Will my face fall off?) and I could use some guidance.  Or advice.  Or maybe some coffee would suffice. 

December 12, 2008

Low Blood Sugar Woes. (And Whoas)

Next week will be better.

Because this week has sort of sucked, on the diabetes front.  

On Wednesday afternoon, I stopped home for lunch to make a quick sandwich and grab my laptop. It was a warmer day, so I felt a little sticky as I brushed my teeth in the bathroom.  I was delaying putting on my coat.  My forehead was damp.  And the sounds of cars going by outside and the radio in the living room were tumbling around in my ears like socks in the dryer.  My brain knew I was low.  My body was slower to acknowledge this.  I went to the fridge to get the juice, my legs operating much slower than usual.

And I stood there with the fridge door open for several minutes, just staring into it and trying to remember what I was doing.  I kept looking at the juice, my brain poking at me frantically - "Um, some sugar would be nice.  Why don't you get that?" - but I wasn't moving and instead stood there a few minutes longer, letting the cold wash over me as I found myself sitting on the floor.

I've been diabetic for a long time.  Even I should know better than to let my lows eat my brain like this. (Zombie lows?  Whoops, digression.)  Finally, I fully tuned into the fact that I was low and I drank juice until it ran down my jawline. 

I tested.  45 mg/dl.  Stupid lows.

Low blood sugar:  45 mg/dl.  Damnit.

I can rebound physically from a low that happens in the middle of the night or the wee hours of the morning, but the aftermath of a low during the day sucks the life out of me.  I felt exhausted and shaky for several hours afterward.  These moments make me angry at diabetes, because there is so much out of my control.

Last night, at our holiday party, it happened again.  I was talking with my husband and some coworkers and drinking a diet soda (avoiding the alcohol because ... well, then I may have been inclined to sing karaoke and that would have been a crisis), but then the headache came on.  Again with the damp forehead.  Again with the dizzy feeling and the swimmy sounds in the room.

"Excuse me, I'll be right back," I said to Chris and our friends, walking over to the open bar.

"Orange juice, please?"  I used the bar to prop myself up a bit, hoping no one was noticing how rattled I looked but hoping someone would notice if I needed them to.

"And vodka?"  The bartender put some ice in my glass.

"No thanks.  Just orange juice, please."  He gave me a big glass and I downed it as quickly and discreetly as I could. 

Everyone knows I have diabetes.  It's not discussed and it's not avoided, but it's common knowledge.  Yet I didn't want anyone to see me in that vulnerable state.  The waves of nausea and light headedness were washing over me, but I did what I could to appear "normal."  It doesn't make sense - these people know and like me and I have nothing to be ashamed of, yet I still felt warm with both hypoglycemia and embarrassment.

It passed.  It always passes.  And the night went on without issue.  (And we had fun.)

But these lows.  I can track my blood sugars and attempt to plot the trends. I can wear the CGM and test often.  I can carry fast acting glucose and be all "responsible."  But they still come.  Prevention is a good effort, but it doesn't completely eliminate these nasty lows.   

it's been a crappy week.  I have felt "off" all week long and my the fallout has been visible in my numbers, my mood, and my motivation.  I hope an easy weekend will realign me. 

Next week will be better.    Next week I will be better.

December 11, 2008

Irony: The Thrice Edition.

(No, I'm not sure if that title makes sense either.)

After my last few days of completely screwing up, I tried to do at least one thing to improve my diabetes - I finally created a real emergency kit for work.  

This little gem has everything I need for a diabetes moment on the job:  I have a backup infusion set, some lancets, several boxes of test strips, a Humalog insulin pen, a spare One Touch UltraMini, and even a SkinTac wipe for any CGM sensors or pump sites that go rogue.

Neat and tidy and prepared.  Hang on .. let me adjust my Boy Scout badge.  It's the one for diabetes preparedness. 

But what's missing from this kit?  Fast-acting sugar?  Nope - my office has a handy stash of candy for low blood sugar reactions and sweet teeth (sweet tooths?) alike.  How about the Quick-Serter for the infusion set?  Nah, I live five minutes from my office, so if the site isn't working out, I can pop home and fix it right quick.  Battery for the pump or a just-in-case syringe?  Both are safely tucked into the meter case.  This little box appears to have everything I'd need for a short-term fix ... what could be missing?

Oh, I know!  Irony!

Godiva!  You saved me!

Irony once again:  keeping backup diabetes supplies in a Godiva chocolate box. 

December 10, 2008

Stupid Diabetes Move.

Glucose meter, home aloneMy brain hasn't been attached this week.  I overslept one morning and was late to work.  I left my wallet at home another day.  I completely blanked out on a meeting I had at work.

And yesterday, I left my meter at home by accident. 

You would think that working in a diabetes media company, with another diabetic, would have me existing in a constant state of able-to-be-bailed-out.  But no!  I went foraging for my meter around 9:30 in the morning and couldn't find it.  I dumped out the contents of my work back on the floor (making a clattering sound against the concrete, but my coworkers have since learned that I'm a disaster and they anticipate the random noise), but couldn't find that blasted black zippered case.  

"Where are you?"  I said out loud.  (Coworkers are also used to me talking to myself.  Poor coworkers.)  My meter didn't answer.  Apparently it did not hear me because it was rested quite happily on top of the basket of folded laundry in my bedroom at home.

"Hey, Howard?  Do you have an extra meter hanging around?"  Nothing like paupering for diabetes supplies to the CEO.  While he didn't have an extra meter, he did have a strip I could use in my back up Freestyle meter. 

"Do you need more than one?"  

"Nah.  I'll go home at lunch and find my meter.  No problem - thanks!"

It was a weird feeling of relief to finally test.  Not having the option of knowing my numbers made me feel uneasy.  And it was an even weirder feeling of unpreparedness.  I felt like the diabetes anti-Boy Scout.

And then Real Life took hold.  A meeting that ran late prevented me from going home for lunch, and I had to instead pop out quickly to grab a bite from the deli down the street.  Howard (and his diabetes supply stash) had to leave the office for a meeting for the rest of the afternoon.  Diabetes took a big time backseat to the rest of the day, and all of a sudden, I realized it was 3:00 in the afternoon and I hadn't tested since 9:30 in the morning.

And the Dexcom sensor fell off on Monday evening and I've yet to stick the next one back on.

I felt like I was driving blindly - nervous about eating anything with more than few carbs because I didn't want to chance the spike, reluctant to bolus because I feared not feeling the low.  Yes, I should have gone home to get my meter.  Yes, I should have been more prepared.  Yes, yes, yes, I did the self-nagging and the guilt-tripping.  But NO, I wasn't prepared.  I wasn't even remotely ready.  It was the diabetes equivalent of that dream where you are naked in you 10th grade classroom.

I've talked about this before, but there's a LOT of packing that goes along with diabetes.  A weekend home in RI is never just a bag with clothes and my toothbrush - I bring a whole backup medical kit to account for everything from pump failures to yeast infections (thank you, stash of probiotics!).  And my work desk is more than dLife papers and columns - there's a rotation of meters, infusion sets, and other diabetes supplies kicking around.  I'm always preaching about being prepared, and for the most part, I am. 

Those moments of being caught with my meter down prove why being well-stocked is the best option.  But blah blah, it's not always that easy to get it right every time.  Yesterday sucked, and I felt like a fool, and I was rewarded with a blood sugar of 300 mg/dl when I came home.

I'm off my game this week.  I think it's because I forgot to call Larry on his birthday.

December 08, 2008

Robot Warrior.

Diabetes hardware is FUN!  ;)I love a good bargain.  So when I saw the BCBG Max Azria gray sweater dress on the rack at Marshall's for $30, I had to grab it.  (Consider it my economic stimulation effort.)  The dress is a soft gray with a flattering A line cut and a nice V neck.  Clingy fabric.  Fun.

But.

This dress doesn't hide much.  And it definitely didn't hide anything diabetes-related.

Normally, I'm able to hide my diabetes hardware to the point where I feel comfortable - the sock trick lets me wear the pants I like and not have to worry about pockets, the bra trick works with most dresses, and when it's a big event, pockets can be created

But this gray dress wasn't having it.  The pump set on my outer thigh stuck out.  The tubing snaking up the side of my body and into my bra (where the pump was clipped) was completely obvious.  And the pump itself looked like a cell phone shoved in my shirt.  Not okay.  Nevermind the Dexcom sensor on my right arm that the clingy dress fabric was gathering around. 

"For crying.  Out.  Loud."  I shifted things around to see if I could get the dress to settle smoothly, but every piece of diabetes hardware was on display.  

I don't care if anyone knows I have diabetes.  I don't care at all because it's not this big deal that I want to hide from people.  I am very open about diabetes and I don't mind explaining things to strangers and friends alike.  This is evidenced by my blog, my job, my decision to network with others like me.

What bothers me is when I want to look "normal."  I want to put on a dress and not grapple with wires.  I want to grab a small clutch purse that doesn't howl with a "BEEEEEEEEEP!" when my blood sugar drops or rises.  I want to be able to have a beer at the bar without fumbling to bolus.  I felt frustrated and furious and like a diabetes robot warrior.

"But isn't the pump best for you?  And the CGM?  Isn't that best?"

I know what's best for me.  I completely understand that using a pump with the help of a CGM and all the other technology I have access to is best for me, but in that moment, I wanted it to all be invisible.  I wanted to be living with that version of diabetes that everyone on the outside thinks is so manageable.  "Oh,  you do so well with it!  You seem so well-adjusted!"  But inside I'm screaming. 

Frustration got the better of me and I replaced the pretty dress with jeans and a black shirt.  (This is the abridged version - the full version included me creating some unique curse word combinations and throwing the dress into my bag in a satisfying tangle.)  Shoved the pump into my sock and hide the CGM receiver in my purse.  Tried to forget that the pump on my thigh and on my arm wasn't natural.  Tried to remind myself that this is part of diabetes and part of trying and part of my life.  Tried to remind myself that tomorrow is another day, and it will be another day with diabetes, so rebelling against it won't do me any good.  Acknowledge, accept, and move on.

The dress is balled up in my weekend travel bag, and I think I'll leave it there for a few weeks.  Maybe I'll make another attempt.  It could look different on a different day.  I could feel differently about it.  The emotional ebb and flow of chronic disease management is ongoing.

Some days, diabetes is a better fit than on other days. 

December 03, 2008

Be The Filling.

Toofus, revisited.In many ways, I'm an adult.  I am married.  I have a job.  I am responsible (to a certain extent) and I make the bed without being asked.  This makes me a grown up, I think.

However, I'm scared of the dentist, and the idea of going for something as simple as a routine cleaning makes me tremble like a child.

I have good reason, though.  My family has good looking teeth, but they not the best, structurally.  Our teeth are exceptionally sensitive, and we require more novocaine than your average dental patient.  As a kid, I spent some time in the dentist's chair having cavities filled (so did my brother and sister) and I wore braces for three years in middle school.  As an adult, I've had my share of weird little toofus problems - like grinding down my molars while I sleep and these pesky sensitive spots at the base of a few of my front teeth.

It's these sensitive spots that cause me the most trouble.  About ten years ago, my dentist decided that he needed to cap the base of my sensitive teeth.  "No, I don't want that," I thought.  But becuse I was in Milgram Mode, I caved and let the dentist do his thing.  He shaved off a bit of the very bottoms (near the gumline) of four of my teeth and put a ceramic filling over them.  Sensitivity issues?  Solved.  But the procedure left me sore and bleeding for days. 

And, three years later, one of the ceramic fillings popped off, exposing that vulnerable nervy area.  I had a different dentist, and his repair included not using enough novocaine, accidentally drilling my lip, and earning many bloody cotton balls.

Two and a half years after that, this shoddy workmanship cracked off again.  Another dentist took a literal stab at it, mangling my gums and leaving aching teeth and bruises on the side of my face.   Bastard dentist.

So when this God forsaken filling popped off yet again Monday morning, I was filled with panic.  "Oh, for crying out loud."  The exposed spot wasn't so painful, but past experience told me that repairing it would be a nightmare.  

Without letting my brain reach maximum nervousness, I called a new local dentist and made an appointment.  "Tomorrow morning?  Great, thank you."  Pause.  "Um, is Dr. B nice?  I'm nervous."

The receptionist laughed.  "She's very nice.  We have plenty of nervous patients, and they all like her a lot."

"Awesome.  See you at 8." 

I showed up to the small practice, nerves of all kinds exposed, and Dr. B greeted me at the door.   

"Hi, are you Kerri?"

"Yes.  You knew it was me?"

She consulted my chart.  "They said you were nervous.  You look a little nervous."  She smiled and closed the folder.  "Nothing to worry about.  This is going to be just fine."

Faithful Readers, let me tell you that I sent a thank you note to the dentist this morning because she was awesome.  Aside from being this friendly looking woman with an easy smile, she took great pains to make sure I wasn't in any pain.  She made sure I was novocained to the fullest extent so I wouldn't feel any discomfort at all.  She told me what she was going to do before she did it, and she advised me to close my eyes when the instruments in play weren't the friendliest-looking.  (I told you I was a big ol' baby.)  She also had a DVD player mounted above the chair, and using headphones to listen, I watched two episodes of The Office while she fixed my tooth.  I know this sounds melodramatic but I can't properly explain how scared of the dentist I am, and how much this particular experience didn't suck.

After it was over, she smiled at me.  "I hope that wasn't too bad.  Are you feeling okay?"

"It wathn't bad at aw.  Fank you," I said, trying to look grown up, but it was hard with the drool and one side of my mouth completely uncooperative.  I smiled a lopsided, pathetic smile, but I meant it.  And when I got in the car, I called Chris.

"Chrith!  The dentith wath awefum.  It didn't huht at aww.  I aweady scheduwed a cweaning."

Cwisis avewted. 

December 01, 2008

Dexcom Discard.

Holy December - I can't believe it's the end of the year already!  Holiday chaos reigns supreme, starting with this past weekend's Thanksgiving holiday and stemming straight into New Year's.  Since I've been wearing the Dexcom pretty regularly (approximately five or six days in a row, then a day or two off), I realized how awesome it is to have that little thing attached during holidays like Thanksgiving. 

I slapped on the new sensor last week and it stayed pretty solid until last night, when the adhesive was peeling too much for me to handle.  (It gets itchy once it starts to peel, and that makes me craaaazy.)  

Dexcom sensor before I pulled it off.  All tattered.

This is the sensor after six days of changing clothes, working out, spending hours in the car, wool sweaters, multiple showers, and the general wear and tear that I put my body through in the course of a week.  The sensor is still attached, but the gauze around it isn't in good shape.  So I decided to pull the site and reapply it this afternoon.  Dexcom discard.  I'm freewheeling without the Dexcom at the moment.

The graphic on the Dexcom receiver that indicates ending a sensor run makes me laugh every time.  The little guy tosses off his sensor with reckless abandon into the garbage can.  Then it asks me, "Okay?"  Okay, let's throw the whole thing out.  (Note:  You don't throw the whole thing out.  You remove the EXPENSIVE transmitter first, then throw out the sensor housing.)

Bye bye, Dexcom sensor!

This past sensor was a bit of a needy one - it didn't want me to shower, apparently, because it kept throwing the "???" at me (meaning it's "confused" and needs a few minutes to catch up) every time I was in the shower.  It also wasn't as tolerant as usual when it came to distance, so instead of keeping it on my bedside table or on the back of the headboard, I had to tuck it under my pillow.   Maybe wearing the site on my lower back instead of my arm caused the difference in transmission - I'll have to see if it happens next time.

Watching my numbers closely for the holiday really helped out a lot.  I saw that a glass of white wine on an empty stomach actually made my blood sugar spike almost instantly.  I also saw that lemon meringue pie (de-li-cious) didn't do much after 15 minutes, but the 40 minute mark showed a real intense spike.  Insulin?  Yeah, it takes at least 35 minutes to impact my blood sugars, but knowing that made me more precise in when I bolused.  The result?  Elevated blood sugars during Thanksgiving (avg. about 195 mg/dl) but I didn't hit the wicked highs, and once I was high, I wasn't stuck there for hours.

Thanksgiving has come and gone, but I'm thankful to have another effective tool in dealing with diabetes.  Now it's time to get to the damn gym and work off that pie. 

November 21, 2008

Insulin Pumps In Wedding Dresses!

Six months ago, Chris and I got married.  (Holy crap, six months already?  I can't believe it's been that long!)  When I picked my gown, I spoke with the seamstress about creating a pocket for my insulin pump to hide in all day long.  And on my big day, my pump was safe and secure, and so was I.

Over the past few weeks, I received emails from other women who had just tied the knot.  These two different, wonderful, recently-married women also had their insulin pumps worked into their wedding day, like I did.  And they agreed to let me share their stories - and their gorgeous photos - here on SUM! 

Here is Lindsay:

Lindsay
Lindsay on her wedding day.

"I've been a reader of your blog since this spring when I Googled 'insulin pump' and 'wedding dress' in the same thread.  Your site popped up and I was hooked.
 
I wanted to thank you for showing your readers pictures of the insulin pump pocket that your seamstress made for your wedding dress.  I, too, was wondering how I'd manage a pump in that corset-back dress with a very full skirt (and no way to access a thigh holster!)  Attached is what my seamstress came up with.
 
I was able to have my cake (and champagne) and eat it too, all while maintaining a 121 mg/dl throughout the wedding."

(The best part of this is that her best friend, Jenn, emailed me months ago about how her best friend is diabetic and is getting married.  She and I corresponded for a bit ... then Lindsay emailed me a few months later!  Small online world!)

And this Suzanne: 

Suzanne
Suzanne on her big day - with her big smile!

"I only bolused once during the whole reception.  It was one of those rare 'perfect diabetes days' - hovered between 85-110 mgdL all day!  I didn't have the cake & danced like crazy, so that probably had something to do with it.  :) 

Anyway, it was a grand day, but my husband and I marvel at how great every day since then has been.  We love being married!"

I love their pictures.  I love the look on their faces - gives me goosebumps!  Thank you so much, Linsday and Suzanne (and hi, Jenn!) for letting me share your stories and photos here.  There's no better way to end the week than by celebrating love and showing that diabetes doesn't stop anything - not even a beautiful bride on her big day.

November 20, 2008

Just Another Morning.

Wake up with a start as the alarm begins to blare,
Groggily come to and push aside my mussed-up hair.
Reach out to the nightstand and retrieve the zipper case,
Fumble with a strip and finally get the thing in place.
Lance my finger, squeeze a bit, and for five seconds wait,
Hear the beep, watch the screen, and see the "108."

Disconnect the pump with a quick and easy snap,
Grab that little plastic thing that I call a "pump cap."
Bring the Dexcom with me and connect it to the door
So I can shower, get all clean, and data will still store.

Towel dry - so careful, watching for the set and sensor,
Grab my robe and reconnect to the insulin dispenser.
Blow dry hair, drag a comb, and make attempts to dress,
Aim for outfits that conceal my pump with learned finesse.

Make my lunch and grab some snacks, minding carb-y grams -
Greek yogurt, green beans, protein bars - my morning snack grand slam.
Throw it all into my bag - I just have one more thing to add!
Toss in a tube of glucose tabs for all the lows this week I've had.

Snake the pump tube down my leg, tuck the pump inside
The trouser socks I love to wear - perfect for pump to hide.
Check the Dexcom to see for sure that I'm okay to drive,
Pet the cats, throw on my coat, and I'm out the door in five.

So much is diabetes, but it isn't my whole life.
I'm a daughter with type 1; I'm a diabetic wife.
It's in the fabric of my day, in the subconcious of my mind.
It explains so much of what I do, but I am not defined.

November 18, 2008

No More Larry Bird.

Dexcom - I need  you back!They left me alone for several months, but now the lows have returned, and they brought friends. Last night, before we left the house to go to the gym, I tested at 137 mg/dl. Knowing I'd be doing at least 30 minutes of cardio and some weights, I figured I should eat something. Grabbed a bar from the cupboard and chomped on it.

"Will that do it?"  Chris asked as he mixed up his protein shake.

"Yeah.  It has like 18 grams of carbs.  If I disconnect and eat this, I should be good."

Munch, munch.  Feeling good.  We drive off to the gym and go our separate ways - Chris to the weight room downstairs and me to the women's cardio section.  I hit the treadmill and dial up a 30 minute workout.

Music is loud - a little Muse.  My legs feel strong and my sneakers pound against the treadmill.  Strong, healthy, strong, healthy ... the words jostle around in my brain with each step.

But I start feeling a little funny at the 20 minute mark.  The music is too loud.  My headphones feel tight against my ears and my hands are numb at the very edges.  I scan the far wall of the room and the walls look a little wobbly.  My legs are a little wobbly. 

With the treadmill still running, I jump off quickly to the side and grab my meter from my gym bag.  Jump back on to the treadmill with the meter in hand, slowing down the pace so I can unzip the bag and lance my finger.

33 mg/dl.

"That sucks."  I press "Stop" on the treadmill interface and open my bottle of juice, taking eight long slugs from the plastic bottle.   My legs, which just a few minutes ago were holding me up just fine, feel like they're made of yarn.  Leaning against the railing of the treadmill, I finish the bottle.

This low feels particularly rotten.  Waves of nausea and a feeling of extreme light-headedness are coming up from my knees and cresting over my eyes.  I know I need to get downstairs and find Chris, just in case.  My legs work on autopilot, bringing me downstairs and into the weight room, where Chris is working out.

One look is all he needs.

"How low?"

"Thirty-three."

"Hmm.  Larry Bird."   He guides me by the elbow over to where I can sit down.  "Did you drink juice?"

"Yeah. I'm frustrated.  I only got 20 minutes into my workout.  And I feel like I'm all ..." Words aren't processing properly in my head.  "Mushy.  I feel mushy."

"You just need a few minutes.  You'll be okay.  Right?"

"Right."  The affirmation makes sense.  "Baby, I'm sort of tired of Larry Bird."

He smiled and we waited for the numbers to climb.

I don't know where these lows are coming from, but they are sneaky, intense little suckers that buckle me at the knees and steal the words from my mouth.  I'm waiting on my next order of Dexcom sensors to be shipped, but last night was one of those moments where I missed the Dex.  I would have at least seen the low creeping up on me a little bit.

But the wildest part is how strong I feel when I'm in that range, that 90 mg/dl range.  It's my magic number.  I feel strong, capable, almost borderline athletic.  (For those of you who know me in real life, you know how remarkable that statement really is!)  It's crazy how much just a little fluctuation in these numbers can really change how our bodies respond. 

Dex, I need you back, buddy. 

November 17, 2008

World Diabetes Day in NYC.

Last Friday, on World Diabetes Day, I had the pleasure of spending the day with Fran Carpentier at the Young Voices event in NYC.   Discovery Health showcased the video submissions from people with diabetes and they had a talented panel of guest speakers and ambassadors, including Lee Fine from FiveHumans, the adorable Charlie Kimball of racing fame, and Miss Black USA Kalilah Allen-Harris

I had some great interviews with these folks that I'll be posting over the next few weeks, but in meantime, I wanted to share some photos from the event.

World Diabetes Day in NYC 

Former Mets player Todd Zeile, Fran Carpentier, Kerri Sparling, ESPN report Brian Kenny, and country star Steve Wariner 

Fran, Kerri, and Kalilah. 

Fran, me, and Kalilah Harris

Charlie Kimball and Kerri Sparling 

Charlie Kimball and me.  :) 

A big part of what was discussed at this event was the DAWN Youth Initiative, which is dedicated to improving the level and conditions of psychological support for kids and young adults with diabetes.  The DAWN Youth WebTalk survey was conducted in partnership with Novo Nordisk, the International Diabetes Federation (IDF) and the International Society for Pediatric and Adolescent Diabetes (ISPAD).  I had a chance to speak with Dr. Barbara Anderson, DAWN Youth Advisor (and a former part of my own personal diabetes care team at Joslin!) about diabetes, depression, and how we deal with diabetes.  "It's important to be in touch with other young people with diabetes," she said, and I thought of all of us here in the diabetes blogosphere.  Our interactions with one another are crucial to our diabetes management.  We keep one another sane!

World Diabetes Day was recognized across the world and the outpouring of support was tremendous.  Over 1,000 landmarks were lit in blue.  Those of us in the blogosphere wrote about our diabetes lives, created videos, and even expressed ourselves in song.  But there is still a lot of work to be done (check out the comments on my YouTube video for examples of miseducation and ignorance).  And every day, we all help to raise awareness in our own ways.

How did you celebrate World Diabetes Day?  Feel free to post your link in the comments section.  And with almost two weeks left in Diabetes Awareness Month, how will you close it out?  (Should I dye Siah blue?  Somehow, I think she'd find a way to thwart me.) 

(And, for the record, I wore a bright blue scarf on Friday to show my support.  But it was muggy as hell in the city, so the scarf ended up crumpled up in my purse instead of around my neck.  I tried, I swear!)

(One more post script:  Today is my brother's birthday, so wish him a happy one!) 

November 11, 2008

When You Aren't Looking.

When you aren't looking ...The clock stared back at me.  5:22 am.  I stared at the green, digital numbers for a few minutes.  They stared back.  5:24 am now.

I reached over to the bedside table and pressed the spacebar on my phone - it told me the time was 5:28 am.

"That's not right.  My clock was set against my phone.  How are they different now?"  I thought about this for a few more minutes.  Chris was asleep on my right, his chest rising and falling with his even breaths.  The little gray cat was curled up at the foot of the bed, but her ears were starting to tilt towards me.

Exhausted.  I could just roll over and go back to sleep, but my hands reach out automatically towards the black zipper case on the bedside table.  I unzip the case and my hands fumble to retrieve a strip from the bottle, then clumsily shoved it into the top of my meter.

"Meow."  Abby called from the floor.  A statement, from the cat who always seems to know when I'm tumbling down the well.

"I'm testing."  I said to her.  To the cat.  I'm talking to the cat at 5:29 in the morning while I test my blood sugar.  Even as the result came back at 44 mg/dl, I had to laugh at the ridiculousness.

But something about seeing that number made the symptoms of the low show themselves.  Seeing that 44 made me notice the dampness on my forehead.   I felt like I was about to burst into tears and into a fit of laughter at the same time.  Chris was still asleep - shouldn't I wake him up and tell him I am so low?  

No.  Instead, I threw back the covers and made my legs move me towards the door.  One step, two steps, a few more steps, get to the fridge, open the juice bottle, drink, close the fridge, skate back towards the bed, collapse back into bed, stare at the clock which is blinking 5:32 now.

"Hey.  You okay?"  Chris stirs towards me.

"Yup."  Just lying on my back, waiting for the feeling of sinking through the mattresses to stop.

"Did you have juice?"

"I did.  A lot.  Grape juice."  Details he doesn't need to know, but I just want to hear my voice and confirm I still have some control over what's going on.

Clock is now at 5:34 am.  The sky outside the picture window is just starting to turn the dark blue-gray of the witching hour, and my lips are stained with grape juice.

Low blood sugars haven't been a part of my routine for several months now, and I credit the end of wedding stress, less aggressive bolusing, and the power of Dexcom.  But last night, my last sensor came loose and I haven't received my new sensors yet.  I had a 230 mg/dl before bed and I took a correction bolus.  And for some reason, the bottom dropped out in the wee hours of the morning.

You can be prepared.  You can plan.  You can have a medical team and an emotionally supportive team and a basket full of technology that can help you manage your diabetes, but a high or a low can still come and grab you when you aren't looking.

Tricky little suckers. 

November 10, 2008

Waldorf'ing It.

This past Saturday, Chris and I had the absolute honor of being Fran Carpentier's guests at the JDRF Promise Ball in NYC.  At the Waldorf=Astoria hotel, where I felt waaaay out of my league but thrilled to be there. 

We don't have the opportunity to rock the black tie very often, so it was a fun treat to get all dressed up again.  

Kerri and Chris, black tie and all!

Chris and I at the gala, feeling rather spiffy.

Fran, Kerri (me), and Gina

Fran Carpentier, me, and Gina Capone with our big grins.

Gina, Tom, and Kerri (me)

A D-Blogger sandwich, with Mr. Tom Karlya at the center.

The night was beautiful, with friends and wine and many laughs.  With Mary Tyler Moore speaking to the crowd from years of experience with type 1 diabetes, and with Elaine Stritch backing her up in style, the crowd was impassioned, inspiring, and ready to spend. 

And oh how they spend.  I have never before seen 2.5 million dollars raised in the matter of an hour.  One quick lift of a sign gifted the JDRF with tens of thousands of dollars.  I sat there in awe, trying to keep the tears out of my eyes as people gave so much.

I don't know how many people in that room were living with diabetes themselves, but I know that at my table alone, Fran, Gina, and I tested our blood sugar before eating.  I know that there were others in the room who were also living with this disease, like my friend Jon who I worked with at dLifeTV, and Allison, and several children who would grow up, just like we did, with type 1 diabetes.

The JDRF is a remarkable organization, but there's still so much left to do.  I've been diabetic for 22 years and I have not yet seen a cure.  Fran has been diabetic for 40 years, and has not yet seen a cure.  Isn't it time?  Time to tell people that diabetes doesn't go away, that it can't be ignored, and that it deserves the attention of the nation?

November is Diabetes Awareness Month, and we need to remind our country - our world - that we are still waiting for our cure.  Raise your voices this month and let people know what life with diabetes is all about.

November 09, 2008

SUM Diabetes Blogging.

Today is the fourth D-Blog Day, and I'm proudly raising my voice with you guys, the diabetes community.  Three years ago, I wrote about why my blog is called "Six Until Me."  Two years ago, I wrote about my heroes.  And last year, I wrote about what matters.

This year, I wanted to thank you guys for being such a crucial part of my health.  You are all heroes, and I appreciate every one of you.

November 08, 2008

Do You Disclose?

Do you tell people about your diabetes? How do you handle disclosure when it comes to employers, casual acquaintances, friends, and romantic relationships? Are you the type to slide it in there - "Hi, I'm Kerri. I'm recently married and I work in health media. I have a couple of cats and... hey, what's that over there? Ihavediabetes. Anyway, I also love Italian food." - or do you have in-depth conversations with people about your disease?

Disclosure is one of those tricky parts of diabetes management that doctors and certified diabetes educators don't often bring up, and it's this month's SUM Musings column over at diaTribe.  Check it out, if you have a minute, and enjoy this rainy and chilly fall Saturday!

November 07, 2008

Listen to the diaBeat.

The Friday Six:  November 7, 2008 editionWell that title gets the prize for Worst Pun on the Planet.  It's Friday, I was up way too late last night trying to find a stupid purse, and I woke up this morning with Siah trying to faceplant into my collar bone.  Foolish Sausage ... but at least there's a Friday Six.

1.  ReliOn has issued a recall on some of their insulin syringes.  (Thanks to all of the readers who sent me a head's up on this one.)  According to the press release, ReliOn is "recalling one lot of ReliOn sterile, single-use, disposable, hypodermic syringes with permanently affixed hypodermic needles due to possible mislabeling. The use of these syringes may lead to patients receiving an overdose of as much as 2.5 times the intended dose, which may lead to hypoglycemia, serious health consequences, and even death."  Check the release to see if this development affects you.

2.  Last week, I wrote about the Hannah Montana and diabetes episode that the parents at CWD, and other folks as well, were fighting to have pulled by Disney.  And holy power of the diabetes community - it was pulled off the air!  Parents are pleased, some fans are disgruntled, and Miley Cyrus is now encouraging people to ... Drink Water, Not Sugar?  Not sure where she's going with this, but I'm curious to see.

3.  And because I haven't had a chance to mention it yet, I wanted to thank everyone who came out for the JDRF walk in RI on October 26th.  The day was absolutely gorgeous, and there were about 6,000 people at this year's walk in Roger Williams Park.  My mom, stepfather, brother, nephew, niece, sister- and brother-in-law, Chris's best friend, and my ever-supportive husband walked as part of Team Six Until Me.  I had a chance to meet a few RI readers, chat up some parents, and enjoy a nice lunch out joined by Chris's mother and grandmother.  Diabetes awareness has become a family affair, and I'm so honored and proud to have their support.

4.  This Sunday, November 9, marks the fourth annual D-Blogger Day.  The details are on Gina's Talkfest blog, but the general gist is this:  If you are a diabetes blogger, November 9th is the day we collectively come together and post about diabetes.  Sure, there are other things going on in our lives, and who wants to blog on a Sunday?  But D-Blogger day has been a tradition in this here blogosphere and I've been a proud participant for three years, so be sure to raise your voice on Sunday.

5.  And next Friday is World Diabetes Day - are you ready to mark the occasion?  There are events taking place all over the blogosphere and in the "real world," as well.  Will you dress in blue to show your spirit?  Will you blog about diabetes and educate others?  Are you helping to light a building in blue?  I'll be in NYC marking the day - where will you be?  Do you love questions?  Does it sound like I have upspeak?

6.  Wow, five very diabetes-centric things.  I think I need a little levity.  So I'll consult Le Sausweege.  I went to grab my work bag this morning and it turns out that Siah wanted to visit dLife.  She was sitting patiently in my bag, her little paws pressing the buttons on my cell phone.

Bring Siah to Work Day

Thanks, Sausage.  You aren't annoying at all.

Have a great weekend, and since it's NaBloPoMo all month long (ahhhhh!), I'll see you tomorrow.  And Sunday.  And all next week.  :)

November 06, 2008

Petal By Petal.

I'm picking my priorities, petal by petal.

I'm choosing to wear this Dexcom and adhere another site to my body.  I'm choosing to have the beeps ring out and scrape against the walls of my office, letting everyone know I'm out of range somehow.  Sometimes the site doesn't bother me, sometimes it itches a little bit.  Depending on where it is resting, either on my arm or on my lower back, I sometimes see it in the mirror and am reminded of what I'm trying to accomplish.

I'm choosing to test my blood sugars and log the results regularly these days, even though keeping a log book goes against what appears to be my internal wiring.  I've always been challenged by keeping track of blood sugar numbers, even though just looking at a few days' worth of numbers really does help me isolate patterns.  I'm building a binder, and it's a pain in the arse, but I'm hopeful that tighter numbers will be the result.

I'm choosing to laugh at the things that hurt me.  When the infusion set hits a nerve as it goes in or when my CGM site bangs against the doorjam, I try to embrace my inner Yosemite Sam instead of letting the pain get to me.  Making this choice makes me hop around like a rabid bunny sometimes, and eventually gets me giggling, but it's better than feeling angry.

I'm choosing to go to the gym after work every weeknight.  I do not like the impact this has on my free time, and I don't always like the actual sweating part (oh how I hate to sweat), but I need to keep my heart healthy and my body strong ... and it helps clear my head a little bit, too.  So even though this hour and a half is something I want back at times, I know this choice is worth it.

I've chosen to limit my commitments these days, because over-extending myself leads to stress patterns that make my brain melt.  I'm stoked to do NaBloPoMo, but I've ducked out of doing NaNoWriMo this year.  I'm working at dLife and freelancing, but I'm being careful not to plan to be in fourteen different places at once.  I've decided to stay home in CT some weekends instead of making the long drive back to Rhode Island.  Peace of mind goes a very long way for me, and I'm making the choice to stay a bit more stable. 

Life gets busier and busier every time I blink, and I know it's not just me.  Everyone seems to have a side business they're cultivating, or organizations they're volunteering for, or events they're coordinating.  Life is blasting forward at a breakneck pace and we, as members of this community, have that added bonus of diabetes to manage in conjunction with everything else.  I'm trying hard not to get sucked into the stressful chaos of accomplishing everything, and instead giving a go at managing life petal by petal. 

Diabetes management, petal by petal.

November 05, 2008

More Sweet Irony.

Last Friday, we had a little Halloween party at dLife, complete with costume competition.  And there were treats - oh holy sugar rush, there were brownies and candy bars and cupcakes and other delicious, carb-laden tasty bits.

But somehow, willpower had settled into my brain on the overnight and took up residence there, keeping my hands steady when the sugary treats were passed around.  And while other moments of willpower are hard for me to maintain, this one was easy.  I've felt a little "off the wagon" lately with my eating, so I'm trying to revert back to pre-wedding mentality, with a focus on lower carbohydrate consumption and ramping up my workouts a little bit.

"No thanks, I'm all set," as the candy dish is passed around.
"I'm cool," while the brownies are being cut and served.
"I'll have coffee," when offered a delicious cupcake.

And it wasn't difficult.  I actually felt unaffected by this mysterious willpower.  It was kind of nice to just coast without feeling any pangs of "Man, I wish I wanted to take the leap and eat that ..."

So why, dear diabetes, did you decide to take a mini-hiatus for the afternoon?  My "good behavior" was rewarded by a series of low blood sugars that righteously kicked my ass.  As soon as I got to work, I started taking pictures of my co-workers' costumes and enjoying the festivities.  But after a few minutes, I realized there was a hollow tin to the way everything sounded, and my lightweight Red Riding Hood cape felt like it was about 33 (Larry Bird) lbs of fabric.  

I tested, and sure enough:  34 mg/dl.

Fantastic.  I had to borrow change from a coworker and grab a juice from the kitchen, chugging it in almost one gulp.  Thankfully, my body recovered fast and by the time my friend asked, "Hey, are you okay?", I already was.

Forty-five minutes goes by.  And I'm sitting at my desk, typing away in an email and realizing I've typed the word "diabetus" instead of "diabetes."  I hit the backspace and tried to retype it, but my fingertips skidded off the keyboard clumsily.  The headache behind my ears was a pounding one, and beads of sweat were on my forehead.  Oh for crying out loud - another one?  I reached back and grabbed my bottle of glucose tabs, popping two in my mouth at once as I fumbled with my meter.  

Well lookie here:  48 mg/dl.  How did that happen?!  I haven't eaten anything that required a big, potentially miscalculated bolus, so what gives?  Whatever - treated it and tried to move on.  (But I giggled again at "diabetus," and promptly had Liberty Medical commercials stuck in my head for the next three hours.  Digression?  Don't mind if I do!)

We had our Halloween costume contest, gave out the prizes, and work resumed again.  I was talking with my coworker when I felt the old, familiar symptoms creeping back up on me.  Her voice was too loud, the heating vents were too loud, the buzzing from the computer screen was creeping into my brain and gnawing on my nerves.  I felt testy.  Overly sensitive.  I wanted to tell her I felt low but the words coming out of my mouth weren't ones that had checked in with me, first.  

"I wanted to ... you know, I'm sorry.  I think I'm low again.  I need to test."  Shunk.  55 mg/dl.  I didn't know what to say.  Why won't this low just back off!?  Does it want brownies that badly?  I moved my chair back and reached for the glucose tabs again, my coworker pausing to look at my quizzically.  "Apparently, I'm cured," I said with a shrug.

I do not understand what causes these lows that hang around for hoooooours.  I didn't change my basals.  I didn't do anything bizarre, like run five miles before work or start doing crunches at my desk.  I hadn't eaten anything out of the ordinary, and I was eating snacks at very regular intervals.  But for some reason, this low blood sugar was hanging with me - we were buddies.

Dear diabetes, if you wanted a brownie, you could have just said so.  Seriously. 

Diabetes wanted a brownie.
  

November 03, 2008

Diabetes Crush.

I have to admit it:  I have a diabetes crush.  He is funny, upbeat, realistic, and is easy to identify with.  I've watched all his dLife segments and I think I speak for the entire dLife editorial team when i say, "Jim Turner ... sigh ... he's the best!"

And he came into the office on Friday, just in time to see us all decked out in our Halloween finest.  (Note:  I managed to ditch the red riding hood cape for the picture, but others weren't as quickly uncostumed.  The coworker on my left doesn't usually have this fluffy hairdo, for example.) 

Jim Turner and the dLife Editorial Crew
Swoon. 

Jim Turner has been living with type 1 diabetes for several decades now, but you wouldn't know by looking at him.  He looks healthy, seems happy, and has a wicked sense of humor that makes you giggle at things you didn't even realize were potentially funny.  If laughter is the best medicine, then Jim might be the ultimate endocrinologist. 

And of course he comes in on a day when we're all dressed up like goof balls.  

Thanks for entertaining us for the afternoon, Jim.  We remain your loyal fans!!  

Swoon again. 

October 29, 2008

Hannah Montana Does Diabetes?

Old school TigerBeat.  Ahhh!  Luke Perry!Here I am again, stepping waaaay outside of my comfort zone and admitting that I've seen that ridiculous TV show "Hannah Montana."  My niece M (formerly "Chris's niece M," but now that he and I are married, she's my niece, too!) has made me watch Hannah Montana many times, and it makes her giggle, so I tolerate it.

Now we all know that Hanna Montana is played by Miley Cirus.  Miley Cirus used to date Nick Jonas.  (Gag - I can't believe I'm writing this, but there's a point.  Bear with me being all TigerBeat.)  Nick Jonas was diagnosed with diabetes in November 2005.  And in an episode airing on November 2nd, diabetes makes an appearance on Disney's Hannah Montana show.

I've come full circle.  Finally.  ;)

This upcoming Hannah Montana show was brought to my attention by one of the wonderful CWD parents (full disclosure:  I love the CWD parents.  They remind me of my own mom and dad, and they rock!), and she wanted to know if I could help get the word out about this upcoming episode.  I watched the bootlegged show on YouTube several times, and I can see why the parents are up in arms about this.

Parents are protectors.  That is their job, and the parents of kids with diabetes are the ultimate protectors, acting as external pancreases while maintaining a normal life for their child.  So when a show that kids are rabid for, like Hannah Montana, highlights diabetes, there's this sense of hope.   Like, "Hey, Disney is involved with Nick Jonas.  They are tuned into kids.  They won't screw this up."

But did they?

If you watch the episode, you'll see plenty of references to diabetes, some accurate and some completely eye-rolling.  Calling the character with diabetes "sugar boy"?  Pointless.  (I'm not the most PC person you'll ever meet, and if someone called me "sugar girl," I wouldn't care.  But if it were my kid receiving that moniker, I'd rip heads off.  Yet I've digressed.)

However, the thing that struck me as completely off-base was the constant theme that Oliver couldn't have any sugar.  He spends most of the episode drooling after sweets, fantasizing about cotton candy, and even diving into a trash can to retrieve a tossed out candy bar.   The other kids in the show kept talking about how they need to keep sugar away from Oliver, at all costs.  This is what made me think, "Uh oh."  I get that the show is trying to talk about diabetes in ways that kids can understand, but this theme was dangerous. 

So what if Oliver gets low at school?  And needs sugar?  Is the lesson here that diabetics can't ever have sugar?  Holy food police training video.  This message sets a dangerous precedent, one that could leave a low diabetic child being denied sugar, if all their peers have to base their knowledge on is Hannah Montana.  And yes, I know that education comes in more forms than Hannah Montana, but lots of kid watch this foolish show, and I don't want their impressionable heads filled with misinformation.

I'm not blowing the whistle on this episode, not entirely.  I'm glad that diabetes is making its way into mainstream media, and I'm also glad that the end of this show had Hannah Montana and her friends reassuring Oliver that he was still the same guy and still their friend.   That's pretty damn important.  I just want to see this positive message of acceptance accompanied by accuracy. 

Watch the video (there are three parts) and let me know what you think.  Do you feel like this episode presented factual diabetes information?  Were there parts you liked?  Didn't like?  Wanted changed?  Are you of the mindset that all exposure is good exposure?  That intentions were good with this episode?  Or do you expect more from Disney?  Are you inclined to write a letter?  Plain don't care?  Are you sick of my questions?  Who the hell is Hannah Montana, anyway? 

Phew!  I'm off to read the newest issue of TigerBeat.

October 27, 2008

Do Something!

Mollie Singer is a sweet girl, a talented singer, and a fellow type 1 diabetic.  And like me, Mollie has the benefit of a really terrific support network that helps her better manage her diabetes.  In particular, Mollie has her twin sister, Jackie, who rises above all others to support her.

I'm happy to share that Jackie has been selected as one of the winners of the Do Something awards, and as part of a partnership between Do Something and Doritos, Ms. Jackie herself will be featured on the back of a nacho cheese Doritos bag.  Jackie is highlighting diabetes awareness and their organization, the Diabetic Angels

Mollie and Jackie Singer

Congratulations to Jackie, and thanks to her for her hard work in raising awareness for diabetes!!  And be on the lookout for these snack-tastic heroes in grocery stores today!

Diabetes Radar Blips.

We made it to the church just before the wedding started on Saturday afternoon, and the bride looked beautiful.  It was like a mini-roommate reunion, with all of my roommates in attendence and ready to celebrate.  But as we sat in pew and watched her say "I do," I noticed a run in my stocking. 

"Oh man!  A run.  In my stocking."  (I kept thinking about that lady in Lost In Translation, who encourages Bill Murray to "lip her stocking, Mr. Bob Harris.")

We had some time to kill between the service and the reception, so we stopped by CVS to grab another pair of stockings.  Being the awkward human being that I am, I managed to remove the torn stockings most ungracefully, ripping loose the infusion set that was (at one time) adhered to my left thigh.

"Damn it!"  Blood spurted out from the manged site, which was now fully torn out.  "Shit - I tore out the site."

"Do you have an extra one?"

"Yeah, back here somewhere." 

Thankfully, on our weekends in RI, we live out of our car.  My travel bag was in the backseat, where I had a backup infusion set and the Quick-Serter handy.  I prepped the site with an IV wipe and mutted to myself as I reprimed the pump.

"Thank God we had the travel bag with us, or I'd be screwed." 

"You have syringes with you, though, right?"  Chris asked.

"Yeah, but no Lantus.  I'd be dosing little weeny bits of Humalog every hour or so just to keep up.  Forget sleep - it would be a nightmare.  And even if we got a bottle of Lantus, things would be all mucked up on Sunday and Monday."

I popped the new infusion set in my leg and pulled on a pair of nylons.  New stockings, new infusion set - both "rips" were just blips on my radar. 

But it struck me how much I take this technology for granted sometimes.  I'm used to the pump being attached and everything just plain working.  A tugged out infusion set can throw my whole weekend into a tailspin.  I try and plan for unforeseen issues, but you can't plan for everything.  There's a lot of crap to remember!  Extra infusion sets, enough test strips, glucose tabs for a low, an insulin pen in case of a high ... and back ups of these back ups.  Diabetes pack-muling.

People have asked me why I bring so much stuff everywhere.  Why I'm always toting a bag that makes me shoulders ache after a few hours of carrying it on my shoulder.  Why when someone says, "Oh, do you have a pen?" or "Anyone have some gum?" or "Hey, would anyone happen to have grape flavored glucose tabs?" - I'm their go-to girl.  It's tough to pack light when you're trying to prepare for all the diabetes variables.

"Okay, so you're set now?"

"Set.  Literally."  (Oh, diabetes humor.)  "Want to stop by Second Beach before the reception?"

Second beach in Newport, RI

Diabetes can be a huge pain in the arse.  And sometimes it can just be a blip on the radar.  I'm thankful for the blippers.  :)

October 24, 2008

Le Pals at Les Halles.

I like when worlds collide. 

Christel and I originally met through our diabetes connection, about three years ago.  Conversations quickly stemmed from pumps and blood sugars to laughing our asses off at jokes and talking about our lives.  Nicole is a former co-worker who has had to deal with my ridiculousness at work and outside of work.  Two different parts of my life - work and the internet community.

Yet last night, they were both forced to hang out with me together.  Pals at Les Halles.  ;)  (Crappy pun, but when you mispronounce the name of the restaurant, as I often do, it rhymes at least a little bit.)

We dined at Les Halles (which is where Christel and I went last time she was up north) and the food was fantastic.  Steaks and frites and some wine and creme brulee (holy 273 mg/dl, Kerri) ... good stuff.  It was very cool to sit there with my "diabetes friend" and my "coworker" and realize that these two have stepped far outside of their labels and are true friends. 

Kerri, Christel, and Nicole at Les Halles.

Diabetes talk?  Sure, there was some of that.  Work talk?  Of course, some of that, too.  Plenty of silliness, as well.  Good food, good conversation with good friends. Worlds colliding, in all the right ways.  Thanks for the great night, ladies!

*          *          * 

Unfortunately, I won't be able to attend the DRI sessions on Saturday in NYC as yet another college roommate of mine is gettin' hitched in Newport this weekend, but I hope you guys have a great time!  And on Sunday, Team SUM will be representing at the JDRF Walk in RI, so if you are going to be at that walk, please stop by and say hello!

Have a great weekend!

October 23, 2008

Halloweenin' Diabetes.

Folks who commented on the last vlog post gave me some stuff to talk about, and this round I've tackled diabetes management and Halloween.  I was diagnosed in 1986 and have spent almost all of my Halloweens as a diabetic, so I've been trick-or-treating around the block for decades now.  (Hmmm ... that sounds a bit ... odd.  Yet I've digressed again.)

If you have any tips on managing diabetes during trick-or-treat season, feel free to toss 'em in the comments section! And share what your costume idea is for this Halloween! Chris and I are dressing up as ... well, you'll hear at the end of the video. ;)

October 22, 2008

Diabetes Goodie Bag.

Le Goodie Bag.  Le French.  Fronch?  Fronch fries.Over the past few weeks, I've received some terrific diabetes-related products and information from people out there who are aiming to make a difference.  Ranging from support groups to bracelets, it's time to help spread the word.  (Note:  I received all of these products as samples and have not paid for these items, nor have I been paid to talk about these items.)

This is a green dot.First off, some bracelets from Lauren's Hope came in the mail.  I had a bit of an addiction to beaded medical alert bracelets a few years ago, and this care package seems to have reignited my love for something diabetes-related and delicate.  The beaded samples were beautiful (pictures coming on Flickr later today) and there was also a very cool waterproof/adjustable/washable bracelet that would be great for active little kids ... or active grown ups.  :)  If you are looking for some medical alert jewelry options that are a little different and fun, check out Lauren's Hope.

This is a green dot.I also received a sample from Stephanie Cion at WellAlarm, and she was kind enough to answer a few questions about their unique service (interview will be posted later next week).  The charm itself is sleek and classy looking, and has a sophisticated look, considering it's intended for medical use.  There is a PIN on the back of the charm that, if someone called the number and punched in the code, they'd have access to my medical information. I think this is a unique service and has some potentially life-saving benefits, but I have to admit - the idea that dropping this charm on the ground leaves my information potentially vulnerable.   (Important note:  "regular medical information" can also be engraved on the charm, so it's not just a PIN code.)  WellAlarm has received some good press this morning already, being featured in this morning's HARO newsletter.  I'm curious to see where this product lines goes.

This is a green dot.Bob Hawkins sent me a copy of his terrific book, The Joy Of Diabetes.  I'm a huge fan of anything that helps to raise awareness for diabetes in a way that's easy for people to understand and identify with.  Bob writes about his 45+ years with type 1 diabetes in a way that isn't intimidating.  His little cartoon avatar explores everything from alcohol to exercise to aiming for the joy in life.  I definitely recommend his book, and you can order a copy from his website.

This is a green dot.And I heard from Katie, one of my readers in NYC, that she's starting a support group which is meeting fro the first time on November 18th at the Friendman Diabetes Institute.  According to the flyer, "This group is open to members of the public who are young women living with diabetes. There is no cost for participation. The group will be self-led however there will always be a staff member from Friedman Diabetes Institute available during the meetings. We are creating a place to talk with others about living with diabetes, particularly as young adult women. If you think this group is for you, it probably is. Please get in touch and let us know that you are interested and if you can make it to the first meeting."  For more details, check out this flyer and email Katie at DiabetesNYC [at] gmail [dot] com.

This is a green dot.One other thing, for all your vloggers out there: The JDRF, Discovery Health, and Novo Nordisk are calling for video submissions for their Young Voices: Life With Diabetes program. Videos are being accepted until November 1st, so get cracking!  The videos should be "highlighting your attitudes, wishes, and needs for how the next U.S. president can help defeat this disease."  Okay, easy enough.  The website states:  "For video submissions, Novo Nordisk will donate $10 to the Juvenile Diabetes Research Foundation to help fund research leading to a cure for type 1 diabetes. For teams, group entries, or multiple videos submitted by an individual, a single donation of $10 will be made. Novo Nordisk will make a total donation of up to $25,000."  For more information, visit the Young Voices website and raise your voice!  :)

That's all for the goodie bag today, aside from piles of tissue paper that Siah is already dancing around in.  

Oh, one last thing:  I bet I'm the last person on the whole damn internet to see this video clip, but have you caught the drunken Orsen Wells commercial?  The moment at 0:51 made me laugh so hard that I watched it several times over.  "MmWaaaHaaa ... the Frensh!"

October 20, 2008

Crumbs Sparling. (Different from Crumbs Morrone)

The weekend weather was so excellent that we had to take advantage of it.  On Saturday, we took the quick train ride into NYC with a Chris-driven agenda:  hop on a row boat in Central Park and then devour cupcakes at Crumbs Bakery on Amsterdam.  (He saw the idea written up in InFlight magazine last week, and tore out the page.  We're easily persuaded, as a couple.  The mere mention of cupcakes is enough to send us on a cross country adventure.)

Kerri at the Bethesda Fountain in NYC

We stopped by the Bethesda Fountain (near the Boathouse), which I recognized from photos I've seen online but hadn't ever scoped out in person.  The park was busy, thanks to the beautiful weather, but we managed to grab a few photos.

View from the boat

I did not know you could rent rowboats in Central Park and tool around the Pond.  Chris rowed, rowed, rowed our boat and I did my best not to tip the boat over.  And after all that work rowing (and trying not to fall in), we had worked up quite an appetite.  It was time to bring on the cupcakes!  Trying to guesstimate the carbohydrate content in this sucker was an adventure in and of itself.  

Holy cupcake

"Maybe sixty?"

"Dude, a bagel has eighty-five.  I'm going to guess at least sixty-five."  I cranked up the pump to six and a half units, knowing that the frosting alone was more than my daily carb allowance.  (But it was DELICIOUS.  Easily the tastiest cupcake I've ever had, and almost worth the $4.00 price tag.) 

Dosing for high carb, high sugar dessert treats is always tricky, and I usually over compensate in efforts to avoid the spike.  I bolused and also requested that we walk back to Grand Central (I hate the subway, and I avoid it at every opportunity), which had me chomping on glucose tabs around 56th.

"Thwarted by that cupcake.  I guess I'll have to have another one sometime and see if I can fine tune the bolus."  I'll do my part, even if it means consuming another cupcake or two.  It's for science.

(Crumbs bakery + Kerri Sparling = Crumbs Sparling.  Very different from Crumbs Morrone.)

October 17, 2008

Insomnia.

In need of a cat nap.Back in high school, I used to have wicked insomnia.  I would lay there in bed for hours, unable to fall asleep.  Then I'd get stressed out because I couldn't fall asleep, which kept me awake longer.  Reading a book didn't help.  Watching tv didn't help.  Warm milk is gross, so I didn't even try that.  And some mornings, I would fall asleep during anatomy.

But my insomnia spells were limited to my senior year of high school, and in college, I fell into a more predictable, comfortable pattern of work-class-party-sleep.  I thought this insomnia crap was behind me.

Last night, though, it came back with a vengeance.

Part of what keeps me up at night is the spin-cycle of my mind.  (The Internet doesn't help.)  I'll start thinking about something I'm writing, or something I want to talk to coworkers about the next day, or how I forgot to call NBF back, or how I need to pick up my prescription from CVS, or the emails I keep meaning to answer ... and then I'm cycling and spinning and afraid to look in the mirror for fear of seeing smoke wisping from my ear.  Add in the viewing of a few SNL political clips and checking the Election feed on Twitter, and I'm officially Sleepless in Western CT.

Chris was away on a shoot, so I was by myself in the apartment.  Silent night.  Holy cats splayed out everywhere,, with Siah purring from the pillow next to me, Abby on the floor underneath the window, and Prussia standing guard at the bedroom door.  The sheets were crisp and clean, the bedroom was that perfect "sightly chilly with a chance of sleepy," and it was one in the morning - so I should have fallen right asleep. 

Instead, I relaxed against the pillow and closed my eyes ... only to have them spring open like window shades.  I could not sleep.  One thirty came and went ... two o'clock ... and I was still awake.  My blood sugars were solid (and holding - the Dexcom confirmed a flatline), my stomach was full (yum, lentil soup), yet my brain was wide awake and refusing to let me sleep.

Facing a sleep deficit is something that's always taken a huge toll on my body.  I don't require a ton of sleep - six and a half hours is comfortable for me - but anything less than that has me dragging myself around the next day.  Sleepiness doesn't seem to affect my blood sugars (woke up at 100 mg/dl this morning), but it definitely affects my overall ability to manage diabetes.  Like this morning - I showered, dressed, and was making breakfast before I realized I hadn't reconnected my pump.  I also went all the way out to my car and started it before realizing the Dexcom receiver was on the kitchen counter.  I forgot to bolus for my snack this morning.

Being sleepy = being absentminded.

Being absentminded = dodgy diabetes control for the day.

Does a crummy night's sleep cause your day to get all mixed up?  Does your diabetes suffer?  Is there any way we can Zzzz ... zzzzz ....

October 14, 2008

Fran's Diabetes Parade.

A cup of coffee with a fellow diabetic.  :)There's that instant connection between people who have diabetes, because we really know.  We know what it's like to test blood sugars, count carbs, wrangle in pump tubing, battle numbers, fear complications, and live life with this disease every single day.  We get it, physically and emotionally.

And then there are the people with diabetes who you connect with, regardless of the disease bond.  When I heard Fran Carpentier take the microphone at the Women's Empowerment, Diabetes, and Development event (sponsored by Novo Nordisk, World Diabetes Foundation, the MDG3 Global Call to Action, and the Global Alliance for Women's Health), I knew this lady was on my wavelength.

"I didn't cry when I was diagnosed because my mother was too busy fainting," she said with a loud laugh, filling the room with her warmth and charismatic spirit.  Type 1 for over 39 years and a Senior Editor at Parade.com, Fran looks healthy, sounds healthy, and has a seemingly unbreakable spirit.  And she's passionate about diabetes.  Diagnosed in 1969 and "Patient No. 2" of the landmark DCCT trial, Fran stated confidently, "You not only survive, but you also prevail!"

After the speakers finished their presentations, I made my way over to Fran to introduce myself.  Instant connection - we started comparing diagnosis dates, insulin pumps (we're both Medtronic users these days), questions about CGMs, and talking about those moments that only another diabetic woman can understand. 

"So my pump is here," she reached into her shirt and pulled out her insulin pump.  

I laughed.  "Mine, too.  In the bra is the best place to hide it in a dress!"  

We sat at one of the tables in the conference room and chatted without effort.  Life as a diabetic, life as an editor, growing up in RI versus growing up in NYC, insurance battles (at that time, I was mid-stream in my war with Oxford for the CGM), and diabetes blogs.

"I've been a diabetes blogger since May 2005.  It's a fantastic way to connect with other diabetics, and to help me feel like I'm not the only one out there who is dealing with this."  I grinned at her.  "It's what connected me to dLife in the first place." 

"I know!  I've read your stuff!  I'm starting my own diabetes blog next month at Parade.com."

The conference ended, yet we found ourselves at a diner down the street, sharing stories over many cups of coffee (don't worry - we switched to decaf to prevent off-the-wallishness).  Diabetes brought us together and gave us "war stories" to share, and we spent several hours chatting each other up.  It was like connecting with an old friend, even though we'd never met before.  

I sat across from Fran, a powerful career woman with a laugh that caused heads to turn at the diner and with her pump casually hanging out of the front of her dress, and I saw what I hoped would be my future.  Thank you, Fran, for being someone I can relate to, respect, and hope to be just like.

Editor's Note (read:  more from Kerri):  Fran's blog is live!  Check out Diabetes, Day-By-Day over at Parade.com!

October 10, 2008

Vroooom!

The Friday Six:  October 10, 2008 editionToday has been condensed into just a few little hours of productivity.  But I had a few things I wanted to share.  (Six things, to be precise.)

1.  Is anyone out there going to the BlogHer Reach Out conference in Boston tomorrow?  I will be there, proudly attending my first BlogHer event and helping raise the visibility of patient bloggers.  If you're in Boston for the conference, please email me and let me know - I'd love to say hello in person.

2.  Speaking of blogger ladies, my friend Dr. Val (formerly of Revolution Health) has launched her new site:  Getting Better with Dr. Val.  The site has an accessible tone, a great look, and is definitely going to be one of my regular Internet stops.  Val also offers up some seriously funny medical-themed cartoons, which I'm so happy to see because I feel that humor is a HUGE part of disease management.  A little laughter goes a long way.  Be sure to check out Dr. Val's new site!

3.  Dates and times for another Fairfield County Dinner are being tossed around - any new takers?  Looking to do something in the first or second week of November.  Meet-ups are happening more and more around the blogosphere (check out Scott's Second Annual one!) and it's a great way to put a face and a voice with the blogger's we're reading.  Email me if you are available, and interested!

4.  Just a reminder:  Have you signed your name to the Google Doodle petition?  As of this morning, we have 3,097 signatures.  Let's see if we can crack 4,000 by the end of the day!  So coworkers, friends, family members, random people reading this blog, and cats across the world (use those paws and claws for good), sign it and raise your voice!

5.  In completely unrelated-to-diabetes stuff, this link (found on Twitter - imagine my shock) made me giggle.  Actually, it made me laugh out loud, so loud that I think I startled co-workers.  Nothing like the relationship battles between what appear to be overgrown Dots candies

6.  And in just a few hours, I'll be making the worst financial decision of the year and heading off to RI to pick up my new car.  (THANK GOD - the Jetta and I have not even been speaking for the last month.)  I'm excited and terrified, all at once.  And I know I'm going to be a lunatic about keeping it pristine because, well, it's part of my OCD charm.

Have a good weekend!!! 

October 08, 2008

My Parents.

I saw a mother and her eight year old daughter at the train station this morning.  It was kind of chilly out, so most of the conversations on the platform were visible, with little puffs of cold above the speaker's mouths.  The mom leaned over to her child and touches her finger tip to what looked like a cell phone.  The child drew back her hand and stuck her finger in her mouth.  The mom looked at the machine, furrowed her eyebrow, and  said something to her daughter.  Her daughter reached into her coat, pulled out another machine, then tucked it back into her jacket. 

Untrained eyes wouldn't see this action as anything of note.  Commuters weren't staring.  Everyone was going about their business - a regular Wednesday morning.  But I saw this mother's daily business - keeping her child alive.  I'm watching this from the sidewalk, not able to hear what's being said.  I can only imagine the words, but they sound so familiar.

I read a lot of diabetes blogs (I know - me?!) and some of the blogs written by my fellow diabetics really touch my heart.  Even though we're all working at different jobs, driving different cars, maintaining different values, and living in different families and skins, every last one of us is dealing with the same vulnerability.  We're all trying to pinch hit for our pancreases, and it can be a tough road at times.

Reading the blogs from the parents of children with diabetes ... they touch my heart, too.  But some times they break it.  

I forget that while I'm testing my blood sugar, wearing the pump, and doing my diabetes thing every day, my mother and father are still worrying.  My parents had to step in when I was diagnosed because I was a little kid who has more interest in climbing trees than climbing blood sugars. And I can't imagine what it's like to have a child with diabetes - I've only been a child with diabetes, and now an adult with diabetes.  Sometimes it hurts a bit to prick my finger or do an injection, but I can control and manage that pain.  I can't imagine what it must have been like for my mom to have me crying and hiding behind the dining room curtains while she drew up my shot when I was a kid.  It wasn't like that all the time, but I'd imagine that once was enough to leave a mark on my mother.

They are always our mothers.This mother this morning reminded me of my own mom.  Made me think about the other parents of kids with diabetes, and what they do every day to keep us safe, healthy, and able to be kids.  Just regular kids, even if we have to take a break from playing every now and again to test or shoot or eat.  Some of the blogger moms and dads write about their child's diabetes, and I have to really concentrate to find the bits of diabetes memories from my childhood.  And I prefer it that way - my childhood wasn't "childhood with diabetes" but instead just "childhood."  Our parents, they protect us and keep us safe from feeling scared and unsure.  They absorb those feelings for us and try to make our lives as normal as possible.  And I am so thankful for everything my parents did for me.

The train rumbled to a stop and the mother and daughter climbed on board.  And I went into my office and called my mom.  

October 07, 2008

Doodle For Google.

A Doodle For Diabetes!You know those cool little drawings on the Google homepage?  The moaning man on Edvard Munch's birthday?  Or the one of the turkeys sitting around the dining room table to mark last year's Thanksgiving holiday?  (That one was pleasantly ironic.)  These doodles are done up by the Google crew to raise awareness for specific events and holidays.

And this year, the diabetes community is aiming to have a diabetes doodle for World Diabetes Day on November 14th.  

"How can I help?  I can't even draw a straight line!"

Yes, there is something you can do.  The advocacy crews at Diabetes Daily and TuDiabetes have teamed up to get Google's attention by providing a petition with 20,000 signatures by November 1st.  That means we only have the month of October (which is whizzing by) to get names added to the petition. 

Sign the petition by clicking here.  Add your name, then share it with your coworkers.  Send it to friends.  Family members.  Buddies from Facebook.  Your Twitter pals.  Ask your brother (Hey Darrell) or your sister (Hi Court) or husband (Hi Chris!) or your mom or dad to sign.  Maybe even send it to the nice man at the Honda dealership who is working to get you a new car at a reasonable finance rate.  (Hi, Bill!)  Either way, 20,000 signatures isn't going to be easy, but if there's any community that can pull it off, it's us.

I think it would be pretty damn cool to have our own Google doodle.  Let's make it happen!!

October 03, 2008

Approved!!!

I have been approved!!!!!!!

YAY!!!!!!

They're covering my sensors.  I cannot believe it.  And from what I've been told, I'm one of the first on Connecticut's Oxford Health Plans to be approved for CGM use. 

Also from what I've been told, it takes an external appeal to make it happen.  So if you are fighting for CGM coverage, DO NOT GIVE UP.  Keep fighting!  Appeal every denial.  Make sure you don't miss any appeal deadlines!  It seems like insurance companies deny everything at first and only approve once you battle back.  So keep fighting, and do not give up!  (And use exclamation points!  Ahhh!  I'm so excited!!)

The tools to live well with diabetes should not just be for the people who can afford them.  Fight for your right for coverage.

October 02, 2008

A Unified Front.

United by diabetesTmana wrote a post on TuDiabetes today that hit home and hit hard. An excerpt:

"I am concerned that these different outlooks and interests could, rather than unite us in the common cause of improved quality of life and life expectancy for people with diabetes, cause public conflicts that could rob all of our communities of the resources needed to assist diabetics, both within our online communities and outside of them."

I agree with this whole-heartedly.  While I'm an in-house editor at dLife, a member of several online communities like TuDiabetes, Diabetes Daily, a diabetes blogger here at SUM, and an active supporter of organizations like the JDRF, ADA, CWD, and DRI, these things all come second to why I'm doing this in the first place:  I am a person with diabetes, a diabetic, a type 1, pancreatically-challenged ... whatever you want to call me, I have diabetes, first and foremost.

What I care about is improving my life, and our collective lives, as we live with diabetes.  I want to see support communities do just that - SUPPORT.  The very concept of different online groups pitting against one another is ridiculous.  Aren't we all working towards the same common goal?  To live long, healthy, and well-supported lives with diabetes?  To see technological improvements?  To see a cure, maybe in our lifetimes? 

Everyone has different agendas and different goals - I understand that.  But I also understand that diabetes is not a business to me.  It's my life - our lives.  And anything that can improve that life should be supported and encouraged, despite whether or not I'm a member or if I participate in a fundraising walk. 

And while I understand the business aspect of different companies and organizations, I don't like the idea of division.  I don't like the idea that three different places are working their tails off to cure this disease, but not sharing the data.  I am not sure who crosses what communication lines, but I want to know that the JDRF, DRI, and other research hubs are sharing their theories on curing this disease.  That is happening, right?  We're all working together to cure this, right?  There are so many different diabetes organizations, but where is our unified front? 

In her post, tmana said that she didn't want different communities to assimilate in efforts to "merely to present a united front to the high-priced resources and partners," and I agree with that completely.  This disease is unique to each diabetic and their loved ones, and the various communities and organizations reflect that.  But I want the diabetes communities to mature and embrace one another instead of ostracizing and battling.  It sounds altruistic, but we're not talking about t-shirts here.  This is about a disease, a serious one, that we live with every day.  And while we rally behind all these different organizations, we need to remember - never, ever forget this - that we are really rallying behind one another as a community of diabetics, regardless of whose newsletter we receive or whose network we have a username in.

The "industry" of diabetes continues to grow, especially as more and more people are diagnosed every day.  But we can't lose sight of the most important aspect of these communities and organizations:  Support.   And I value the support I get from you guys here on the blog, outside in your blogs, in-person at dinners and events, and all over the internet and the Real World as a whole.

We are all living with diabetes.  Standing together does far more than walking alone. 

September 29, 2008

Walking The Walk.

Sunday morning, bright and much earlier than I was ready for, I found myself at Cranbury Park in Fairfield County for Connecticut's JDRF Walk to Cure Diabetes.  Despite the rain and the extremely muggy conditions, Team dLife represented and made me proud to be a part of the crew.

The walk, for some reason, wasn't along a track but instead was along a mild hiking trail.  This was fine for people who were able to traverse the rocky terrain, but for some parents piloting strollers, it was tricky indeed. (Note to CT JDRF:  Maybe you should have called it the JDRF Hike for a Cure?)

I had the pleasure of being escorted by my co-worker's daughter, who is four years old but wise well beyond her years.

"Let's go in the wood!  We can camp in the woods.  I saw a movie about bears.  And snakes.  I saw a snakes movie.   Hey, there's a path - let's go that way and we can camp in the woods overnight!"

"No way!  Your mom would be mad if we went camping without telling her.  And why do you have so much energy?  Did you drink a whole pot of coffee this morning?"

"I drank ten pots of coffee." She turned to be and gave me a 1,000 watt grin.

I believed her. 

Team dLife 2008!

Working at dLife, as a person with diabetes myself, is a unique experience because I walk the walk and talk the talk.  But at the JDRF event on Sunday, it was nice to see everyone walking the walk, right alongside me.

Thanks to everyone who came out to the walk, and onward to the RI JDRF walk on October 26th!

September 26, 2008

It's Friday. That Means ...

The Friday Six:  September 26, 2008 edition... The Friday Six.  It's time for a week-end wrap-up, and to share some of the latest bits with you.  I hope you're all having a good week.  I am so ready for the weekend (and the debates tonight)!!!  I'm going to just jump right in with number ONE ...

1.  Last week, I posted a photo on D365 of Tickles the Tapeworm, and just a few days after posting it, a package of Parasite Pals stickers was delivered to my office, courtesy of my Flickr friend, Stinky_Harriet (aka Liz).  THANK YOU, LIZ!!!  You totally made my day, and I shared these stickers with my editorial team.  (We thought they were digustingly awesome.)  If you're following the Diabetes365 crew over on Flickr, you may have seen some of the wonderful photos from Liz.  Click through and check out the photos, and give some love to Sara, who is on the cusp of finishing her 365 days!! 

2.  In CGM news, there's a chat with Aaron Kowalski on Monday, September 29th, in the DiabetesTalkFest chatroom.  Dr. Kowalski will be answering your questions about the JDRF CGM trial that was in the New England Journal of Medicine last week, so check it out if CGMs are on your wishlist.  (It's on mine!)

3.  (Full disclosure:  This next bit has it's fair share of we in New England call "wicked bias.")  My husband has teamed up with some of his old buddies from the fitness world to create a cool and informative health and fitness site called I Look Like Fit.  There's a ton of useful information on the site, including workouts, diet ideas, weight loss tips, and even a social networking page called - wait for it - FitHeads.  So, if you're looking to tone up or trim down, this new site and its social networking sidekick could be a good fit for you.

4.  This Sunday, Fairfield County is playing host to the JDRF Walk For A Cure, and the dLife team will be there.  (I'm hoping it doesn't rain all over our heads during the walk, but we're badass enough to take the risk.  Diabetics don't melt!)  Are there any SUM readers who will be walking on Sunday?  If you're there and you see a cloud of white dLife t-shirts, come by and say hello!  :) 

5.  In cake-related news (this may be my favorite segue ever), the popular site CakeWrecks has its first comment controversy going on, all about a cake shaped like an insulin pen.  Personally, I find this cake to be amusing.  The comments on this post, however, are less entertaining.  Plenty of diabetic-bashing going on in there, from laying down guilt on people with type 2 diabetes to the stereotype that diabetics on the whole can't eat anything but carrot sticks and ... dreams, I guess.  If you want to weigh in on this mess, feel free.  Stop the ignorance, if you can.

6.  And finally, I vlogged.  I vlogged from my stupid car, because time is limited this week but I've felt delinquent as a vlogger (and I've been enjoying the ones from SuperG and Sara and Windy, and Landi even joined the fray!) and I needed to catch up.  If you skip on over to my YouTube channel, you can find my latest attempt at vlogging.  And, like George mentioned in his post today, I'm open to any questions because, quite frankly, sometimes I have no clue what to say.  :)

The weekend should be rainy here in New England, but it's still the weekend, and that makes it awesome.  Have a good one, and I'll catch you on Monday!

September 25, 2008

When At First You Aren't Approved - Appeal, Appeal, Appeal.

There's a lot of buzz in the blogosphere today about insurance denials and appeals, starting with an article in the Wall Street Journal about "Pushing Back When Insurers Deny Coverage For Treatment."  Scott Strumello brought this article to my attention this morning via his comprehensive blog post about it, and Bernard sent me there again with his perspective.  And after reading everyone's take, in addition to having experienced three denials for CGM coverage from my insurance company (Oxford Health), I realize that I have gone at this problem the wrong way.

Insurance companies don't care about my future baby.  They don't care about my A1c.  Unfortunately, insurance companies are watching dollars and cents, not good sense.  A passionate letter from a patient doesn't even come close to moving an insurance company to provide coverage or overturn an appeal.  They seem to respond to "the facts" only, and I should have attacked them with facts to begin with.  Instead, I took the personal approach, which left me denied three times.  And it's partially my fault because I expect them to care, even when I know they won't.  My approach was arrogant, thinking they'd respond to actual emotion.

But this time?  No emotion at all.  This appeal was just the facts, ma'am.

I sent the Connecticut Department of Insurance a packet of information this morning, in hopes of having my Dexcom CGM system denial overturned.   I included the following:

  • Request for External Appeal form (my insurance information, healthcare provider information, detailed description of disagreement with healthcare plan)
  • The denial letter from Oxford Health Plans, stating that their decision is final
  • Proof that the service in question is a covered benefit (this was in the form of my insurance policy benefit handbook)
  • Executed medical release form
  • Photocopy of my insurance card
  • Documentation supporting my appeal, including a letter from me, my endocrinologist, and Dexcom
  • Oh, and a check for $25.  They specify that this is non-refundable. 
Insurance appeal packet - heavy.

Under the guidance of the Region Managed Care Director at Dexcom, the supporting documentation I included was very factual and devoid of almost any emotion.  My personal letter, which was written with the help of the Dexcom rep and is so stoic and so dry that it doesn't even sound close to anything I would say is supposedly an example of what "will work."  The letter from my endocrinologist cited my elevated A1c, the ADA A1c standard for pregnancy, the Factor V issue, 22 years of IDDM, and various complications I've experienced (including the cotton wool spot, high blood pressure, etc).

Dexcom also provided a packet, which included the recent NEJM study results and other studies supporting the use of CGM technology to better control diabetes.  The letter from my Dexcom rep included a demonstration of the proven benefits of CGM technology on health outcomes, and also outlined the appeal-denied-appeal-denied cycle that I've been in for the last few months.

So it's in the FedEx box now and waiting to be sent off to the Connecticut Department of Insurance.  Each item is tabbed and in the order requested by the appeal form.  It's on time, comprehensive, and fact-filled.  I hope this appeal gets my CGM approved.

The only frustrating part of this process was that I couldn't really lash out.  I couldn't tell these insurance companies what I was really thinking, which was along the lines of "WHAT THE FUCK IS WRONG WITH YOU?  CAN'T YOU SEE THAT THIS TECHNOLOGY WORKS AND I WANT A HEALTHY PREGNANCY AND WHO ARE YOU TO TELL ME I'M NOT APPROVED?!!"  (Ahem.  Sorry.)  It's infuriating to play by their rules, but I'll do whatever it takes to obtain approval.  It makes me absolutely crazy that this technology exists and it has worked for me and it's still not covered.  Don't insurance companies want people to remain healthy?  Isn't there a cost-benefit to them for acting proactively instead of reactively? What is wrong with this healthcare system?!

I'll wait patiently.  I'll hope that this fact-driven approach gets me somewhere.  And I'm very thankful for the assistance and support I've received from Dexcom, dLife, and my friends and family.

But I had to get my digs in somewhere - the memo line of the check is "ridiculous fee for appeal."  Jerkface insurance company.  They're messing with the wrong girl.

(I hope.) 

September 23, 2008

Irony.

I cooked last night.  (Contain your shock, please.)  I made chicken and vegetable soup, whipped up some delicious sugar-free pudding, and baked a chocolate cake for my co-worker's birthday.  Nothing caught on fire, nothing turned to sawdust, and consuming aforementioned tasties did not kill anyone.

Damn you, chocolate cake!

However, the cake baking was a little bit of a thorn in my side, because I was soooo tempted to lick the mixer beaters (no, not while they were spinning) and to stick my finger in that thick, chocolate frosting.   

But HA!  I did not succumb to temptation!  I baked that cake, frosted it, and put it in the fridge, all without even a taste.  HA HA!!!  Take that, diabetes! 

After the cake was all done, I sat down on the floor with my laptop to go through my emails.  But the screen was too bright.  The colors were all ... off.  And my hearing was fading in and out, like someone was shaking a blanket out to spread over the bed.  My head was in a complete fog, and Abby was weaving between my elbows, meowing frantically.

So I tested.  

And after all that baking, after avoiding that delicious treat and trying to "stick to the plan" and "be a good little diabetic," I saw "35 mg/dl" winking back at me from my meter.  Eight gulps of juice later, I was laying on the living room floor, telling Chris, "I didn't feel that one coming at all," and "If I lay still enough, I sort of feel like I'm on a record player, spinning."

Damn you, irony!

September 22, 2008

Diabetes ... Period.

Diabetes and birth control ... WTF?About once a month, there's a certain spike to blood sugar patterns that is both predictable and completely chaotic - welcome to this morning's TMI post about diabetes and the menstrual cycle. 

Two months ago, when the gene for the Factor V Leiden mutation was detected in my blood, my endocrinologist and my gynecologist decided to remove me from my birth control pill and switch me to something with less of a clotting risk.  Since I decided to go on the pill when I was a freshman in college, I have always been on the standard estrogen/progesterone pill (I was on the ortho-tricyclen, then tri-sprintec, if you want a good ol' dose of TMI).  When it came to diabetes and this kind of pill, there was plenty of information out there, so I had a good idea of what to expect.

But this new one?  The progesterone only?  It's a bit of a wildcard.  I'm currently taking the Errin pill (28 days of hormones, no "placebo" pills) and these first two months have been pretty damn tricky.  I'm not sure if it's my age, the ticking of my biological clock, or just the changes in my body as I age, but this pill made my emotions run wildly.   And the information I've received on this pill has varied.  The internet (oh Internet!) informs me that the brand name version of this pill comes with a diabetes-specific warning:  "Diabetes patients - Ortho Micronor may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine."

Oh for crying out loud ... another variable?  

I was on the old pill for almost ten years, in total, and I was used to the effects it had on my body.  I was accustomed to the 28 day cycle, the guaranteed four day period, and the pre-period spikes weren't dramatic.  I actually noticed a drop in my insulin needs while I was on the placebo week, and I had a decade to really adjust to the whole process.  This new bit, with a whole new hormone regimen, has thrown my body into the spin cycle.  I can't anticipate the highs because I'm not sure if/when the actual period is coming.  (Part of the trick with progesterone-only pills is that you may not always have a period, which makes my brain melt.) 

Aside from these unpredictable start times, this seems to be the first pill that affects my emotional state closer to the end of the 28 day cycle ... for example, I came across this video of a singing little six year old and promptly burst into tears.  I had a few days of feeling amped up, over-emotional, and anxious, and these emotions had their own little tea party with my blood sugars.

I want stability.  My whole reason for being on birth control at this point is to protect my body from pregnancy, because my A1C is spikey.  So I take the pill to protect body-from-baby/baby-from-body, yet the pill itself could be contributing to an elevated A1C.  It's frustrating because pill options are limited (thank you, Factor V), pregnancy is not encouraged at this A1C, and I'm a young, newly-wedded woman with a healthy libido.  (Kerri!  Your mother reads this blog!  And so does HIS mother!  Ahhhhhh!  Go delete that!  I'll wait.)

Nope.  Can't delete it.  This is real life with diabetes, awkward bits and all.  Anyone out there on a mini-pill and seeing some numbers (and emotional) fluctuations?  I'm trying to learn everything and anything I can, with the end goal being Nice Healthy Baby Range.  Talk to me - I need some advice!

September 19, 2008

Arghhhh, Me Hearties.

The Friday Six:  September 19, 2008 edition

Holy late post, but better late than never, right, me hearties?  (Oh, this pirate crap will be the very death of me.)  Jumping right into this week's Friday Six!

1.  Yes, it's Talk Like a Pirate Day.  In celebration of this silliness, I offer you the Pirate Translator, some pirate jokes, and a Twitter avatar, courtesy of my extremely silly brother:  Kerri the pirate.

2.  The JDRF is still taking applications for the 2009 Children's Congress - but not for long!  The deadline for application is October 6, 2008, so if you and your child are interested in applying and representing the diabetes community before Congress, now is the time to apply.  Visit the JDRF website for more information.

3.  Another D-related event is the First Annual Diabetes Rockstar Cruise, brought to you by the folks at Diabetic Rockstar.  According to Sara, a SUM reader and a member of the Diabetic Rockstar crew, "The most exciting part about the cruise is that Carnival has a program called Cruising for Charity, where we will be receiving a portion of the proceeds for Fight It! our charity arm at Diabetic Rockstar.  Our funding goes to uninsured, in-need and newly diagnosed diabetics who need supplies and additional help."  Unfortunately, I won't be attending this event, but if you're interested in learning more about this cruise, taking place next May, visit the Diabetic Rockstar website

4.  And in my own personal diabetes news, I've been embroiled in the battle with Oxford Health of Connecticut for CGM coverage.  Fun.  (Sarcasm.)  I have a solid insurance representative at Dexcom who is helping me get all the paperwork together for my external appeal - yes, this is the one I have to send them a CHECK for, greedy bastards - and I'm working with my endocrinologist on a letter highlighting pre-pregnancy planning and the need for tighter diabetes control.  This is a paperwork nightmare, and now I understand why lots of people never get to this stage of the appeal, because it's so damn complicated.  BUT I am moving forward and will file this external appeal by the end of next week.  Hopefully this will overturn my previous three denials.  In any event, I'm almost positive they won't refund the $25 filing fee.  Pricks.  ;) 

5.  On the Children With Diabetes site, there's a short video about Friends For Life 2008, and you'll find a smattering of diabetes bloggers in there, including Sara, Heidi, Bennet, and me!  (And I look seeeeerious, since they caught me in the pregnancy seminar and I was all panicked ears.)  Check out the video!

6.  And I'm still woefully behind on vlogging, but I'm hoping to get a clip up here by Monday or Tuesday.  Next week is pretty nuts - I have plans for dinner in the city, I'll be at a seminar at the UN midweek, and I'm gearing up the dLife crew for our JDRF walk next weekend - but I need a little face-time.  I'm sort of short on vlog topics - any ideas from you guys?  For now, all I have is this sort of crummy quality clip from The Swell Season show on Wednesday.  I have another one, of one of their new songs, that I can post this weekend after I pull it from my KerriBerry

For now, I'm off to RI for yet ANOTHER wedding this weekend (btw, Chris and I have been married for four months as of yesterday - holy cow!) and to spend time with the family.  You guys have a great weekend!!!

September 16, 2008

Twenty Nine.

"Are you ..."The bond of diabetes between strangers.

"Yes.  Hi!  Are you ..."

"I am!"

When people who have never met before, yet know one another from the blogosphere, suddenly collide in person, it's always a fun mix of awkward, comfortable, and excited.  And last night I had the wonderful opportunity to have dinner with Karen from Bitter-Sweet Diabetes, R (who I have met several times before), and a woman I will call MW (for "MathWhiz" because she is good with numbers and I am absolutely not).

I've mentioned it before, but the diabetes connection is an instant and easy discussion, helping people who otherwise may have nothing in common to talk freely and comfortably about something that is a huge part of their lives.  Karen, R, MW, and I had trouble ordering our dinner because we were so busy chatting that we barely cracked open the menus.

What was really interesting to me was that MW was 29 years old, like me.  But unlike me, she was diagnosed 6 months ago.  I couldn't stop thinking about that.  R and Karen, also diagnosed as children, have spent most of their lives living with diabetes and for the three of us, life has always included diabetes management.  For MW, diabetes and all its bits and pieces were new to her life.  Life before diabetes for me is something I can barely remember, and it was all I could to do keep myself from quizzing her:  "How do you feel now that you have diabetes?  Do you feel like everything is different?  Do you feel like your life is completely restructured?  Do you remember sometimes that you didn't always have to do this stuff?"  I had to exercise restraint and keep myself from asking all the questions that were floating around in my head.

Diagnosed as a kid, this is just the way things have always been.  Soccer games always started with a glucose check, bedtime always involves a glass of water and a bottle of juice, and now, each skirt hopefully comes with a small, conveniently placed pocket.  For people who were diagnosed as adults, I can't imagine how their lives have changed.  Some people will say that being diagnosed as a kid is easier because you grow up with this disease and it becomes your "normal" without much effort.  Others say that an adult diagnosis is easier because you have decades without the disease, thus maybe lowering changes of complications.  From my perspective, I can't even wrap my head around an adult diagnosis.  I only know what I know.  But I am always eager to learn from others.

We sat at dinner long past when the chairs were put up at the other tables and past when the waitstaff was sitting, watching the football game at the bar.  We compared pumps, weighed out the pros and cons of different CGM systems, and when a quiet beep sounded, we all looked quizzically to see which one of us had "gone off."  The diabetes bond was enough to bring us to the table, but it was the company of kind people and easy conversation that kept us there.

September 15, 2008

The Temptation of Cookies.

But are they bolus-worthy?!"I'll just stand here and keep you company."  He crossed his arms over his chest and kept his eyes on the red bowl I was stirring.

"Chris, you aren't keeping me company.  You're lurking."  The butter and the sugar were starting to mix up in the bowl, giving off that sweet aroma of cookies-to-be.

He smiled.  

"I love cookie dough!"

I'm not much of a cook, but I can definitely bake.  Flourless chocolate cake.  Banana bread that's made with extra bananas so it's all moist and decadent.  I can make chocolate crinkle cookies and Hershey kiss cookies, chocolate chip with oatmeal, peanut butter cookies ... you name it.  And last night, at the begging of my husband, I made chocolate chip cookies with extra chocolate chips.

It's almost Murphy's Law, my cooking talents unable to be used for "good."  I can't cook up a turkey dinner, or make a delicious dinner, but I can create the most sinful desserts without effort.  And the irony of standing there with my insulin pump clipped to my hip as I mixed up a bowl of brown sugar, chocolate chips, white flour, and butter was enough to make me laugh.

I've become decent with the willpower bit, able to say "no thanks" to indulgences if I have my head on straight, but sometimes I completely buckle and make stupid decisions.  I caved to the temptation of cookies last night.  They were fresh from the oven and sitting on the cooling rack, making the whole house smell ... simply: awesome. 

And Chris and I settled in to watch Vantage Point (mini-review: decent enough of a movie, but I could have done with the rewind device every fifteen minutes or so), I grabbed three cookies for Chris.  And then I grabbed three for myself.  My willpower went pfffft.  And the cookies tasted delicious.

Indulgences, for me, make me fear the highs.  I'm not as concerned with the calories or the effects on my weight (maybe I should be), but I try and ward off any post-indulgence highs anyway that I can.  Usually, I bolus aggressively, and sometimes hit the mark perfectly.  Other times I end up chasing a low, making the indulgence go from "reasonable" to downright gluttonous.   Last night I managed to do both.  Those three (delicious) cookies sent me up to 204 mg/dl, then I hit 54 mg/dl about an hour later.  

But was it worth it?  

I hadn't had cookies fresh from the oven in years.  Can't even remember the last time.  And these cookies were moist, hot, freshly baked, delicious, just the right amount of chocolate chips, and delicious.  So yeah, I'd say that little blip in my willpower radar was okay.  One cookie won't kill me.  Neither will three.

But Chris, eating spoonful after spoonful of raw cookie dough?  I think that may be more of a problem.  ;) 

September 12, 2008

Le Friday Six.

(That title's for you, CALPumper!) 

The Friday Six:  September 12, 2008 editionI need a break.  :)  Here's The Friday Six, because if I had to string more than three sentences together, my brain would turn to ice cream cake.

1.  I'm looking forward to the fourth (had to edit - there have been three already and my brain went to mush on this fact) Fairfield County dinner on Monday, September 15th.  So far, there are about seven people coming and I'm excited to meet everyone.  If you live in the Fairfield County area and I missed your email, drop me a line at kerri (at) sixuntilme (dot) com and I can send you the specifics.

2.  Also, the first winners of the TuDiabetes "Word In Your Hand" project are up, and they are remarkable.  (My personal favorite is the "secret" one ... very cool photo.)  If you want to get involved and submit your photo, check out the details on TuDiabetes, and say hi to Manny and Landileigh!

3.  And I'm proud to say that Blogabetes turns one year old this month.  I've had the pleasure of working with Carey, Nicole, Julia, Lindsey, SuperG, Rebecca, Michelle, Kim, Andy, and Scott over the last twelve months, and I am always impressed and inspired by their writing.  If you haven't visited dLife to spin through their posts, you're really missing out. 

4.  In news I'm confused about, I've received several emails from companies asking to make me "part of their blogging team" by adding my posts to their RSS feed.  I don't mean to sound daft, but is that a good thing?  I know plenty of other bloggers have been approached by these kinds of companies and I'm still on the fence about whether or not that's a good thing, since I've also heard that Google penalizes you if you reproduce blog content across the wilds of the Internet.  For my fellow bloggers - how are you guys handling these requests?  Do you let them add your feed?  I am unsure how to handle these requests and I don't know enough about Google to guess if this is a good idea or not.  Help!  I need brain power from the blogosphere. 

5.  dLife has been subjecting me to cute overload this week, starting first with some of dLife's finest teeny dogs and culminating with a crate full of newborn baby chicks.  My co-worker has chicken business (I know) and he brought in a dozen baby chicks for the morning, so we could all coo and chuckle over them.  They are so damn cute.  I stumbled upon my co-worker, diligently answering emails with a baby chick in his pocket.  I love my office.  It's productive, yet eccentric.  I dig that.

6.  And thanks for your uplifting messages yesterday.  You guys, with a little help from Fudgy the Whale, made a bit of a dreary day much brighter for me, and I really appreciate it.  I know I've said it before, but this community is one of the best things to happen to diabetics since ... well, insulin, and you all make this journey a little easier.  So thank you.  And go get an ice cream cake, because damn that makes everything better. 

Unfortunately, no time to vlog this week.  But next week, I will definitely think of something worth waxing on about and will fill your computer speakers with nonsense once again.  Until then, have a great weekend and I'll bother you on Monday.  :)  

September 10, 2008

Diabetes For The Day: Third Edition.

I've said it before, but I must say it again:  my co-workers are a rare breed.  They are funny, brilliant, and they actually care about making a difference in the lives of people with diabetes.  Another co-worker took the Diabetes For The Day challenge, and wrote about what it was like to test all day and wear the newest version of the "faux pump."  (This one was a definite upgrade from the Kool-aid box of yester-post.  We used a Freestyle flash meter as "the pump" and taped an infusion set, sans needle, to the back of it.)  Here's her take on a day with diabetes.

Meter, with infusion set attached, serves as a pump for our experiment.

Kerri:  You wore a “pump” and tested your blood sugar throughout your day with diabetes.  How did you feel about these devices?

Co-Worker:  At first I thought it was kind of fun to know what my blood sugar was, but after maybe the second prick, the novelty wore off. It hurt and seeing my numbers go up and down freaked me out. The pump was a huge pain. At work it wasn’t embarrassing but outside of the office, I felt like everyone saw it and wondered about me.

Kerri:  You wore the pump all day and overnight.  Was it comfortable?  How was sleeping with something attached?  Showering?  Was it difficult to dress for?  Did you almost drop it into the toilet at any point?  ;)  

CW:  It was relatively comfortable, comfortable enough that I would forget about it until I caught the tube on something and felt the yank on my “infusion point”. I was nervous about sleeping with it since I don’t own pajama bottoms with pockets but I was able to tuck it under my pillow. I slept fine but woke up with the pump halfway across the bed. I wore pants with pockets the day I had my pump so I didn’t have to worry about where I would stick it. However, I wear a lot of dresses and I could see that being a big pain. I didn’t drop it in the toilet but only because I was paranoid that I would.

The infusion set, without the needle inserted.
My co-workers put up with a lot from me, and they even wear fake pumps to help them understand.

Kerri:  Did physical evidence of diabetes (i.e. wearing the pump) make you feel self-conscious?

CW:  At work, I felt normal, even proud of what I was doing. However, the second I left, I felt awkward, especially when a friend nearly pulled it out and I had to explain what it was and what I was doing. 

Kerri:  How did testing your blood sugar affect the way you thought about food?

CW:  It made me aware of how many carbs I eat and that it is probably contributing to the fact that my blood sugar was all over the place. It also made me less likely to snack because I wanted to avoid testing.  I remember thinking, "A piece of candy is already in my mouth before I think about testing. Did I just mess up? Man, this is annoying. Diabetes sucks."

Kerri:  Did you find the blood sugar testing to be painful?  How comfortable were you with the process?

CW:  After the first or second time, I started to really wince every time I had to test. The sharp pain only lasts a moment but it made my fingers sensitive and bruised. I felt pretty comfortable with the process because I’ve tested before and I’m not afraid of blood or needles.

Kerri:  How did the blood glucose numbers make you feel? Did any of your results make you raise an eyebrow?


CW:  My blood glucose numbers made me feel anxious. I was like a roller coaster, relatively high and then a few hours later, relatively low. If I hadn’t had Kerri around to reassure me, I would have freaked out.  After a bagel with cream cheese and an iced coffee with Splenda, two hours later I was at 141. I panicked. 141, that’s bad! (Right, except you have a pancreas, give it a second woman). Kerri assured me that I was fine. 

(Editor's note:  Her blood sugars hit highs of 140 mg/dl after a high carb lunch.  So "high" by her standards was a little different than my highs.)

Kerri:  Do you feel as though you have a better idea of what life with diabetes is like?  What else would you want to know?  What are you grateful for not knowing?

CW:  I still don’t think I have a clue what it must be like. I did it for one day. I didn’t change my diet, I didn’t have to take action when my numbers went out of their normal range. I can’t imagine having to test every day. Given that experience, I would rather not know any more.

Kerri:  Did this experiment make you appreciate your health any more?  Less?


CW:  It made me appreciate my health tremendously. That my body functions and regulates things on its own is a blessing most people don’t take notice of.

Kerri:  Do you think other people who are close to diabetes, but aren’t diabetic themselves, should spend a day as a diabetic?


CW:  I think everyone should.

Kerri:  Anything else you want to add?


CW:  Kerri is pretty awesome. (Editor's note:  YAY!)  And diabetes sucks.  (Editor again:  Word.)

September 09, 2008

Lunch Hour Education.

Not in the mood to educateDuring my lunch break yesterday, I dropped by the local Ann Taylor store to poke around in their sale rack.  An older woman, maybe about 55 years old, approached me and asked if I needed a dressing room started.

"No, I'm all set, thanks.  I'm on lunch, so this is just a quick visit."  

"Oh!  You work in the area?  I've seen you in here before."

"Yes, I work at dLife."

She pursed her lips.  "dLife?  What's that?"

"It's a diabetes media company.  We have a website?  And a show on CNBC about diabetes management."  I ran my fingertips down the seam of a black dressy top that I loved.

"Diabetes.  Oh, the sugar!  I have that.  I have diabetes and my doctor told me to try and lose weight."

"That's good!  You're taking the right steps."  I moved away a little bit, perusing another sale rack.  She followed me.

"You know, I see all these fat little kids at the high school when I drop my daughter off.  I see them and I can't help but think that they are all going to get diabetes.  Like me.  They'll end up taking shots and losing their eyesight, you know.  Diabetes is a very serious disease."

I smiled at her.  "Diabetes is a very serious disease.  But diabetes isn't always caused by being overweight.  There are different types of diabetes."

"I know.  The kind I have?  It's because of being overweight.  My ex-husband told me that."  She adjusted her glasses.  "But I want to lose the weight so I don't end up taking shots.  Did you know that some people have to wear a machine all day long that gives them their shot?  My goodness.  Those people must be sick as can be.  No ma'am, I don't want that to be me.  I take my pills.  I'm not going to end up like those people."

I was on my lunch break.  I didn't want to get into a big diabetes discussion while I was shopping.  But I couldn't let this lady ramble on, thinking diabetes was her fault and also thinking that pump wearers are on their death bed.

"Well, diabetes isn't your fault.  It's a disease, not a guilt trip.  But it's good that you're taking your pills and trying to lose weight.  That's a step in the right direction.  I also have diabetes - type 1 - and I wear one of those machines that gives me insulin all day long."  I smiled again, trying to show her that I wasn't dying.

"Oh my.  How long do you have?"

"Excuse me?"

"How many years?"

(Is she seriously asking me this?) 

"Left?  Ma'am, I'm not dying.  This machine doesn't mean I'm dying.  It's just another method of insulin delivery.  So instead of shots, I wear this pump.  It's okay.  I'm in good health.  I've been diabetic almost 22 years.  It's complicated, but it's not my fault.  Diabetes brings enough to the table - we don't need guilt, too."

"Well, I don't want to wear that thing."  She gestured quickly towards my pocket, where my pump was clipped.  "I'll just keep taking my pills.  I don't want my diabetes turning into what you have.  No offense, sweetie.   You look very healthy, and I never expected you to have it, too.  And I never expected yours to be that bad."  She smiled sweetly, making her remarks sound even more ignorant.

I'm all about educating people and raising awareness.  But sometimes I'm not up for the challenge.  I wanted to buy a pretty shirt, go to the bank, and then go back to work.  I didn't have the patience to be tolerant that afternoon.

"That's great, ma'am.  I wish you and your health all the best.  And just so you know, I don't want to wear this pump, either.  But it keeps me healthy.  And I want to be healthy.  Have a good one."

Turned on my heel.  She was still talking, something about "We're having a sale on suits, did you know that ..."

Lady, if I have just one day left or a million years in my future, I don't want to spend another minute of it talking with you.

September 08, 2008

CGM Study Shows This Stuff Works!!!

My insurance company still says NO to my request for approval of a continuous glucose monitoring system.  But - a ha! - a study conducted by the JDRF has given me something to print out and mail along with my third appeal.  Thanks to several dozen emails this morning directing me to the study and special thanks to Cynthia Rice, Director of New Technology Access in Washington, DC, I now have the inside scoop on why insurance companies should listen up and listen good:

Kerri:  This study quantifies the value of a continuous glucose monitoring device for people with type 1 diabetes, in particular, for adults aged 25 and over.  How did individuals over the age of 25 fare using this device?

Cynthia:  The study found patients with type 1 diabetes who used continuous glucose monitoring (CGM) devices to help manage their disease experienced significant improvements in blood sugar control. Overall, adults 25 and over lowered their A1c by .53%; were more likely to lower their A1c by 10%; and were more likely to reach target below 7.0.

Kerri:  In regards to the younger group, the kids under 15, how were their results similar or different?

Cynthia:  Children under age 15 using CGM were more likely to lower their HbA1c by at least 10% and achieve HbA1c levels below 7% compared with non-CGM users.  At the same time, the average decrease in HbA1c was not significantly different in the CGM and non-CGM groups.  Although the study was not specifically designed to assess the effect of frequency of CGM use on A1c, an initial analysis of the data suggests that patients under 15 who used CGM at least six days a week or more lowered their A1cs just as much as adults.  On average, only 50% of children under 15 who used CGM used it six days a week or more.

Kerri:  What is the assumption about the 15 - 24 age group?  Why didn't the use of a CGM make a bigger impact on their A1c values?

Cynthia: 
Fifteen to twenty-four-year-old CGM users as a group did not experience significant improvements in glucose control compared with the control group.  Although it’s clear from a preliminary analysis of the data that teenagers were the least likely group to wear the CGM near daily (30%), the study was not geared to answer this question -- however, many families with teenagers will not be terribly surprised with the result.

Kerri:  At a session at CWD in Orlando this year, Bruce Buckingham discussed how CGMs work best for people who wear them at least six days a week.  Your study appeared to confirm this statement, at least for the 25 and older group.  How does duration of use affect results?

Cynthia:  In the study, CGM use varied with age, averaging at least six days a week over the course of the trial in 83% of the patients 25 years and older, but dropping off to 30% of the 15 to 24 year olds and 50% of the 8 to 14 year olds. Although the study was not specifically designed to assess the effect of frequency of CGM use on HbA1c, an analysis presented this week at a scientific conference suggested that patients within all three age groups, including teens and young adults, who used the device at least six days a week had substantially lower HbA1c levels after six months compared with patients who used CGM less than six days a week.

Kerri:  Many people with diabetes are fighting with their insurance companies to get their CGM systems approved.  How can this study help move patients towards approval?

Cynthia:  By showing that CGM use improves glucose control, this study, published in the prestigious, peer-reviewed New England Journal of Medicine, gives justification for expanded health plan coverage of CGM.  JDRF will be briefing health plans on these results and encouraging people with type 1 diabetes and their loved ones advocate to their own health plans to cover CGM.  You can help secure coverage for CGM by clicking here.

Kerri:  And lastly, how can we, as the diabetes community, get more involved and help move research forward?

Cynthia:  When you click on this link, you can not only help secure coverage for CGM, but sign up to receive emails from JDRF on how you can advocate for federal research funding and get involved in your local community to help move research forward.  

I am Kerri and I approve this CGM.  I wish you would, too!

Thanks for your time, Cynthia!  And for more information on CGM insurance coverage, you can visit the JDRF website, sign the CGM Anti-Denial Petition, and check for more CGM updates here on SUM.

Code Word - "Shoot Up."

Code word:  Shoot up!We know we have a special language - it's been confirmed in several editions of dTOES - and almost all of us in this community recognize the different terms.

But sometimes, those terms drop from the mouths of our friends, and the sound always amazes me.

Like yesterday morning, I was having a marathon phone conversation with Batman, and she mentioned that she told one of her co-workers about me having diabetes.  "I was like, yeah, Kerri is a type 1 and she wears an insulin pump ..." and she kept talking but the phrase "a type 1" stuck in my head.  Batman and I don't talk about diabetes much, but she's one of my closest friends and this language has become part of her vernacular almost by osmosis. 

It's my diabetes and my disease to manage, but my closest friends and family members are so tuned in to it that they don't even notice anymore.  Needles in my purse are par for the course.  Looking at me and casually mentioning, "Ker, your wire is out," happens all the time.  "Whoa, that'll empty out a pump," after seeing a huge dessert delivered to a table.  Smooshed granola bars and stashes of juice boxes have found their way into everyone's glove compartments, and I'm not even sure they realize it.  Numbers like 98 and 112 become amusing - "Hey, that's like a perfect blood sugar!" - and people's mentions of "juvenile diabetes" are quickly corrected as "Yeah, they used to call it that but now it's type 1 diabetes." 

"Oh my gosh, that looks delicious  You think like 40 grams of carbs?"
"Dude, let's go in the water.  Throw your pump in the cooler!"
"We've got everything we need for the hike:  water bottle, sunscreen, and sunscreen." 

They "get it," but the best part is that they don't realize how much they've "gotten it."  Their level of understanding is so intrinsic and instinctive that they barely notice. 

I rely on these people so much.   My meter gives me blood sugar results and my pump delivers life-sustaining insulin, but my emotional health is nurtured and cared for by my outstanding support team.  It blows my mind to think about how many people are really needed to keep me healthy.  My endocrinolgist and my primary care physician monitior my physiological progress and keep me steeped in information.  My ob/gyn keeps tabs on my reproductive system and helps me prepare my body for baby.  My retinologist watches out for those pesky eye issues.

But there's so much more than just the doctors with initials after their names.  There's my mom and dad remind me that regardless of how old I become, I'm still their daughter and still their worry.  My brother and sister, who know how to support without smothering.  My close friends, who make sure my life is as free as theirs, but just in case, they keep juice at the ready.  And my husband, who loves me in sickness and in health, not letting diabetes define our relationship - or us.

"Oh, the food's here.  Time to shoot up."  

That's a phrase only a diabetic, or a person who cares for a diabetic, would understand.

August 29, 2008

I Love The Dirt.

The Friday Six:  August 29, 2008 editionIt's been almost a month since my last Friday Six, so I thought I'd dust off the photoshop file and revive it for this fine Labor Day weekend.  You know why?  Because I'll be in the woods this weekend.  Camping in the wilds of Maine.

Stop laughing. 

So yes, Chris and I are making the long trek to Maine this weekend to spend our holiday in a tree.  I mean in the wood, camping.  And before you collapse into laughter, I have camped before.  Back in high school, my friends and I used to go camping in the summer all the time.  I love hiking, and there's something so serene about being in a place where there's no television blaring, computer whirring, or people connected to any kind of network.  We're camping out in Acadia National Park one night, then staying at a bed and breakfast in Bar Harbor the next.  I'm very excited to disconnect from EVERYTHING for the weekend.  And it's my first camping trip with the pump, so I'm hopeful that I can keep it clean and safe from the freaking bears. 

In the spirit of camping, long car rides, and packing (oh my!), I've realized that a simple walk in the woods requires some serious backpack stocking-up.  We hit the grocery store last night and I bought several protein bars, high-carb power bars, and a few sports bottles of juice.  At home, I took quick stock of the supplies I need to bring "just in case," like insulin and syringes in case my pump craps out in the woods (i.e. stops working, not craps out in the woods ... you know what I mean), extra infusion sets, test strips, and a cooler to store all the cool-temperature supplies in.  Diabetes means hoping for the best and planning for the worst, and for me, that translates into not packing light.  (We did pack marshmallows, a chocolate bar, and graham crackers, of course.  We are going camping, after all, and what's a night around the campfire without s'mores and insulin?!)

In quasi-political news, a certain flash file made me laugh out loud.  Something about the iced coffee and the grinning faces made my day.  And Biden doing the Cabbage Patch in the back seat.  See for yourself and blame my brother for sending me the weirdest things on the internet.

Team Six Until Me is walking again at the Rhode Island JDRF Walk on October 26th!  If you are in the RI area and you'll be at the walk, please come by and say hello!  Just look for the rag-tag crew of silly people, anchored by my grinning head and the grinning heads of my friends and family. 

Last week, Chris and I visited NYC and went to the Top of the Rock.  Yes, it's a big ol' tourist draw and I can't pretend to be anything more than a tourist.  (I'm from Rhode Island - we hardly ever leave the borders of our own damn state! Living in CT is like breaking all the rules.)  Anyway, going to the top of Rockefeller Center was very cool.  The view, as you can imagine, is remarkable.  Of course we took a pile of pictures.  We haven't had much time to get into the city lately, but I'm always impressed with what it has to offer every time I go.

And unfortunately, I haven't had a chance to do a vlog this week, but I'll do one early next week.  And I think I may need to finally respond to the gauntlet laid down by Mr. Bennet himself - for the Whack-A-Meter challenge.  I have plenty of old school meters in my home that don't work and I don't think there are even strips being made for them anymore.  It may be time to take out my aggressions on those symbols of diabetes.  Anybody with me?   It may actually feel good.

Have a good three-day weekend, and I'll see you on Tuesday!  (After I pick the spiders out of my hair.  Oh good Lord.)

August 28, 2008

Everybody Exercises.

There are days when I feel like I'm draaaaaging myself to the gym.  Literally, like scooping my legs off the floor, forcing them into my workout clothes, and dawdling over to the door.  The weeks after the wedding and through the beginning of August were particularly hard, because my numbers were on the level of "sucking royally" and my body was infected with a general feeling of "vlah." 

Thank goodness that Chris is usually ready to roll.  It helps to have someone who is also dedicated to being healthy, because it makes it easier for me to keep from slacking off due to my own laziness or vlah-ishness.  Especially when work gets busy and freelance is hopping - getting my sorry butt to the gym becomes a real challenge.  Chris and his equal quest for good health and a long life serve as more motivation to get moving.

It also helps that the Sausage does her part.  

By trying on my running shoes. 

The cat wears sneakers.  Enough said.

Wrong foot, Siah.  The other one.

There you go, Siah.

There you go, piggy.  That's the correct foot.

Diabetes requires support on all fronts.  Even from the cat. 

August 26, 2008

Corn On The Carb.

Elizabeth Joy Arnold(Editor's note:  Sometimes I like the title of a post so much it makes me smirky.  Man, I love a good pun.) 

Today's post is from my friend Elizabeth Arnold.   Elizabeth is the bestselling author of two novels, with a third due out next summer.  She’s been diabetic for over thirty years, and is the "proud, doting owner of two cats, a husband and an OmniPod, all of whom she considers her best friend forever."  I've had the pleasure of chatting with Elizabeth a few times and she's sharp, funny, and definitely on the level.  She offered to write a guest post for SUM, and I'm honored to have her contribution!

*   *   * 

I woke up the other morning, and my sugar was 287.  And my first thought?  Well my first thought was a word that can’t be printed on a “family” blog, but my second thought?  That I’m an idiot.  I’d eaten corn on the cob the night before (sweet New Jersey corn which has approximately a bazillion carbs), and I could only guess at the correct bolus as one cannot use Calorie King for this corn; it’s THAT sweet.  And I must’ve come up about 20 carbs short.  I know I shouldn’t really eat this corn because I rarely get it right, but you know, it is truly one of the world’s greatest foods.  I do happy dances in July when I see the cornstalks rising on local farms, and when the ears start to grow I fall on my knees in rapture, so giving it up is Just Not An Option.  So I eat and inevitably my sugar’s high, and then of course I beat myself up.   

I also despise myself for those nights my husband’s had to give me glucagon, knowing how freaked out it makes him to see me unresponsive.  (Although for some reason I never feel guilty when I catch a low myself, just think, Yay!  I get to pig out! eat 15 grams, test again and if necessary eat another 15 grams!)

But you’ve all been there, haven’t you?  You test and your number’s not where you want it to be, so you start blaming yourself for not being perfect.  I’d assume it’s twice as bad if you’re the parent of a diabetic, and–since you’re not superhuman–can’t keep your child in perfect control.  And even worse for many type 2’s who probably blame themselves for the disease itself.  The problems we face aren’t the fault of the diabetes, they’re because we’re just not working hard enough.

It can be the same with complications.  I felt guilty about my retinopathy, even though my A1C was in the high 5’s at the time I was diagnosed with it.  I blamed the teenage-Elizabeth for not being more careful, all the afternoons (and yeah, there were a lot of them) when I’d gone out with friends and not taken a shot to cover pizza or fries, NEVER testing in public because, when you’re 14 years old, exposing your blood to the world seems excruciatingly embarrassing.  Even when I was five or six, before the days of blood testing, whenever my urine tests read 4+ I’d be ashamed, and sometimes fudge the numbers so my parents wouldn’t see.

Does this make sense?  Well of course logically, it doesn’t.  We feel guilty because we do have so much control over this disease, but we all know diabetes can be a stubborn and temperamental (insert curse word of choice), trying to prove it’s stronger than all the time and energy we put into controlling it.  There are site issues and infections and stress and hormones, and just days our bodies decide to go wacky for no conceivable reason.

So what’s the answer?  Who knows?  I think it’s our tendency to want to place blame on things we're not happy about, and who can we blame for this other than ourselves?  I guess you could look at diabetes as a separate entity, pin a photo of a broken pancreas on the wall and throw darts at it, or something.  But that doesn’t work for me–I’ve been diabetic for virtually all my life, so it’s an integral part of who I am, which means hating it would be like hating my own right arm.

There probably is no real answer, except to remind yourself that you’re human, and humanness + diabetes = inevitable fallibility.  So I’ve been telling myself that I’m going to just relax when I feel like beating myself (or my meter) upside the head.  If my sugar’s high, I’ll make myself a cup of tea (or rather, take a correction dose, test for ketones and THEN make the tea.)  Put up my feet and go easy on myself until I feel okay.  The “bad” sugars aren’t bad, they’re just information I can use to make things better, and why should I feel ashamed of information?  Ashamed if I don’t test to get that information, yes, but not if I don’t like the results of that test.

So…here we go.  The truth is my sugar wasn’t 287 on the after-corn morning, it was actually 302.  (Eek!  That sounds so much worse, doesn’t it?  Even though it’s only 15 points higher?  Even writing it down was kinda painful.)  But I’m going to remind myself it wasn’t really my fault, just a mistake, and that making mistakes once in awhile is no big deal.

And dammit, I don’t care, I’m having corn again tonight.

*   *   * 

For more from Elizabeth Arnold, including information about her writing, visit her website at www.ElizabethJoyArnold.com

August 25, 2008

Just Say No.

Holy delicious.Saturday afternoon, we were at Diane's birthday party (Happy Birthday, Chris's mom!), and there was a decadent chocolate cake to celebrate.  Sunday played host to my friend Kate's wedding shower, where there was an open bar, cookies, and a delicious butter cream cake.  Yet I didn't taste any of these items.

And I have no clue where this willpower came from.

After a startlingly high A1c result last month and a string of elevated blood sugars, I feel like I'm starting to get things back under control these days.  I'm giving my thighs a rest and trying out new infusion set sites, and the absorption has undoubtedly improved.  I'm also doing my best to keep a closer eye on numbers and be a bit more proactive instead of reactive with corrections (i.e. counting carbs more precisely and giving my insulin time to get in before eating in efforts to avoid a spike), which seems to be working.  My meter average has gone from 160 mg/dl two weeks ago to 143 mg/dl - and I'll take it.

Granted, I'm not all good behavior.  I had an awesome peach martini on Saturday night with my husband.  And I have been indulging in too much tasty iced coffee on those long drives home to Rhode Island. Some stuff is bolus-worthy!  But with such a focus on diabetes management, I'm becoming stingier with indulgences.  I wanted to taste that chocolate cake, but the fabulous smell of chocolate was wiped out by the thought of a big bolus, the potential for a post-prandial spike, and then the low that may result from the correction.  My blood sugar at the time was 89 mg/dl, and I wanted to keep the steady number more than the cake.  Same for the wedding shower treats - it was easier to say no than to handle the potential highs and lows.  (Even though the cookies at the shower looked so exquisite I almost buckled.)  But I keep thinking about a baby someday.  And a lower A1c.  And feeling better.  It made it easier to just say no.

While I was at the shower, my friend's mother (a type 2) remarked while the cookies were being passed around, "You have such great willpower!" 

I laughed.  "Today.  Who knows what tomorrow will bring!" 

Diabetes has become like chess - I'm looking a few moves ahead and basing my decisions on the future rather than the present.  I don't plan on letting diabetes checkmate me ... instead, I'll steal its horse and run off.  For now, I hope I can make the willpower last!

August 22, 2008

Friday Face-Time.

Six Until Me - Vlogging Since ... Three Weeks AgoLow blood sugars are not fun.  Over the past ten weeks or so, I hadn't experienced many lows, but I've hit more than my fair share of highs.  (And not normal highs - instead, those warm, feverish highs that made my eyes ache and suits my teeth up in sweaters.)  But the lows seemed to have returned a bit, in part to a tendency to aggressively correct highs and the lack of carbs in my house this week. 

Like this morning:  I woke up and sat on the side of the bed for a full five minutes before getting up to test. I knew I was low, but it's like I'm unable to let myself drink the juice before testing.  Instinct?  Impulse? The room was thick with a cottony fog and my head was spinning, but I couldn't function clearly enough to grab the bottle of juice from the bedside table.  I grabbed my meter, waited patiently for the 52 mg/dl to pop up on the screen, and only then would I let my hands wander towards the grape juice bottle. 

It's frustrating.  My lows over the years have become progressively stickier, taking longer to come up and with symptoms that linger far beyond their textbook-issued 15 minute window.  This week's vlog entry is about lows and their irritating ways.  (And I tried my best to speak  more slowly, but I think I'm somehow related to the Micro Machines guy.  I just talk too damn fast.) 

Click on the logo to visit my YouTube channel, don't laugh at my crappy flashcards, and let me know what kind of vlog topics you want to see covered in the future! 

August 18, 2008

Diabetes Real Estate.

Control is tough to come by these days - and it seems like the more I fret about it, the more tangled my numbers become.  I'm trying a more relaxed approach (yes, I am as high-strung as I seem, why do you ask?!) to diabetes management.  Like this past weekend:  instead of shlepping myself home to RI and spending more time in the car than with friends and family, I decided to stay home in CT and relax.  I watched movies.  I worked on some writing I was trying to finish.  I made iced tea and cleaned my house.  (And I also tried on my wedding dress for no reason, but that's neither here nor there.)

Overall, I tried to freaking relax.  And it helped - my numbers didn't act out.  Apparently the absence of cortisol helps blood sugar stability - who knew? 

In addition to decompressing a bit, I also tried out a few new site locations last week.  I'm wondering if my thighs are a bit overused and if absorption is suffering as a result of the scartissue.  To give my legs a rest, I made good use of an arm site and a back site.