Main

May 29, 2012

From Abby: Summa, Summa, Summatime.

Memorial Day is behind us, so that means summertime has officially begun.  Bring on the white pants, white shoes, Will Smith song references, and ... diabetes devices?  YES!  Abby talks about being an adult, sporting diabetes devices, and dressing for summa.  I mean, summer.

*   *   *

Here it is, the groove, slightly transformed ... just a bit of a break from the normHere in Vermont, it's beginning to look a lot like summertime. Temperatures are hovering in the 70s, occasional 80s, with the occasional crazy 20 minute afternoon thunderstorm thrown in. I love summer in the Northeast. I like that the temperature is perfect between 5 - 7pm, and now that I'm working grown-up hours, I can sit in air conditioning during the hot,hot mid-day sun, but then get to go outside and enjoy the weather after work. (I love sleeping with my windows open to the sounds of crickets and random people driving into the condo parking lot.)

For the past four summers, I have been at Clara Barton Camp. Basically from June to the end of August, I was surrounded by diabetes. This also meant that my summer wardrobe does not have to be pump-friendly or "professional." Most of my summer attire, since 2008, has consisted of gym shorts and t-shirts. (This is an ultra-friendly pump hiding combo. Clip it on the shorts waist band. Clip it on your sports bra. Clip it on your shirt collar, clip it on your sneakers, wear it in a child-size pump pack outside of your shirt or as a head band - all completely valid pump storage options at diabetes camp.)

But I'm not at diabetes camp this summer.  I'm a grown up now, with a grown up job. Which is making my summer wardrobe in need of an upgrade.

Today I wore shorts outside to read on a bench in the sun. My pump site was showing on my thigh. I didn't even think twice about it, until I stood up and realized my neighbor was on his porch and probably saw the little pink sticker stuck to my leg (he's a doctor, so for some reason this eased my mind a bit).

A lot of us blog about diabetes and fashion. The amount of tricks we have to hide our d-gear (especially girls) is endless. I'm fine with hiding it, and I'm also fine with showing it off, but I'm generally a hider when it comes to my pump. You will rarely find a picture of me and be able to spot my pump unless I'm surrounded by d-people, and even then it'll be a glimpse of tubing here or there. I'm not ashamed; I just feel more comfortable with it tucked close.

So this summer will be exciting. I will wear dresses, shorts, capris, tank tops (not all at the same time, and not at work of course - health care dress codes and all that) and if my pump shows, so be it. I probably won't be wearing my tally-gear outside of my clothing in public ever, but I also won't be afraid to wear a sleeveless dress with an arm pump site.

*   *   *

Rock the arm site, Abby.  Sometimes you just need to rotate the real estate options, you know?

March 30, 2009

Trading War Stories.

It weird, because we originally connected through my diabetes blog and her diabetes podcast, and we spent a lot of time comparing war stories about our collective decades with diabetes. 

Diabetes was our introduction, but isn't the glue that holds our friendship together.

We grabbed dinner at Antico Forno in Boston's North End on Friday night with Christi and John, and I was again reminded of how good friends aren't necessarily the ones you talk with every day.  They can also be the ones who you go months without seeing but can fall right back in step with in minutes.

Kerri and Christel, reunited!

(We miss you guys already!!)

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!)

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 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 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. 

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.

August 11, 2008

Beach Blanket ... Pumping.

Growing up in southern Rhode Island means having access to some of the most beautiful beaches in the country.   The sound of the ocean waves, and of the seagulls flying overhead.  The smell of clam chowder (chowdah), fritters, and onion rings from the beach stand.  The ancient woman who sold popcorn from the kiosk in Watch Hill.  The hot sand and the hot sun.  I love it all.

My best friend and I hit the beach in RI this past Saturday, drinking iced coffees, swimming around in the August ocean, and gossiping our heads off.  I'm very pro-pump when it comes to doing my diabetes thaang, so I do what I need to do in order to make it part of every day.  Wearing it at work or out to dinner doesn't present many issues, but the beach is tricky indeed.  Here are a few tips I use to keep the pump from interfering at the beach:    

Pumping can be a day at the beach.  Holla.

Top Five Beach Pumping Tips:

1.  Bring a bottle of water.  If you're like me and you love to swim around like an awkward little dolphin, you'll find that the infusion set can get covered in salt and sticky sand.  Sometimes I have trouble reconnecting my pump due to the slty build-up.  Using a water bottle to rinse off the site helps remove the stick and get me reattached without any trouble.

2.  Bring an extra towel.  If you are like me and you stay attached to your pump while you lay on the blanket, make sure you keep it covered.  An extra towel or t-shirt is handy to wrap up the pump in, keeping it cooler and away from the heat of the sun.  

3.  Have back-up insulin.  Whether it's the salt caked up on your site that's keeping you from reconnecting or if there's a malfunction with you pump, it's important to keep an insulin pen in your beach stash.  I have one of those Frio things that works great to keep the pen cool and collected. 

4.  Sunscreen it  up.  If you're an Irish girl who burns with the best of them, sunscreen is your friend.  This past weekend, I blew it a little and didn't wear enough sunscreen, and now my body is slightly crispy.  Pushing a new pump site into sunburnt skin is not very comfortable.  Also, wearing enough SPF keeps me from getting wild infusion set tan lines. 

5.  Be confident!  People are going to stare at the pump.  This is a fact - they can't help it!  It's probably not something they see every day, and it's hard to hide in a bathing suit.  Just remember that we're wearing this device to manage diabetes, and it's nothing to be ashamed of.  Let 'em stare.  ;)

What do you do with your pump in the hot, hot heat?  Any tricks you want to share?  (And any good recipes for chowdah?  I think I'm ready to try and make some at home!) 

July 16, 2008

Body Image.

What fits.Beauty benchmarks seem to be measured in what size pants you fit into and what designer hand bag you have draped over your rail-thin arm. 

This is the biggest bunch of crap I have ever heard.  In my life.

There's a lot of body image problems in our society.  Women are shown almost-unattainable media images and are encouraged - expected? - to achieve that look.  As a girl with diabetes and part of a family of curvier people, whittling my body down to that socially mandated size isn't easy ... and wasn't accomplished.  Life with diabetes puts a huge emphasis on food, making me unable to eat just a raisin for lunch.  Instead, I ate in accordance with the then-peaking of my insulin and tried to keep my weight, and my diabetes, under control.  This was difficult at times.

I was never a "thin" adult.  I've always had more of an athletic build than that of a runway model.  As a kid, I was scrawny, but once puberty hit, my body took on womanly curves and held fast to them.  I never felt shapely or feminine - instead, I felt fat. In college, I lived with six other girls (six until me?) and they were all teeny little things.  They had thin arms and thin legs and they shared clothes with one another, but I couldn't get in on that scene because I was about two sizes bigger than all of them.  If they were wearing size 4 pants, I was in an 8.  I always felt a bit bigger, a bit more awkward, and very shy about my body. Despite whether or not I looked as overweight as I felt, my mind was entrenched in thoughts that were self-conscious.  I was very unfair to myself, just like many other women are.  It sucks to feel bad about yourself.

Diabetes challenges my health, but it sometimes offers up a healthy perspective.  It took me several years to really come to terms with the fact that my body needs to have different priorities.  Going to the gym has become less about slimming down my stomach and more about improving my cardiovascular health, lowering my A1C, and reducing body fat so that I can make better use of my injected insulin.  It couldn't be about fitting into a smaller dress size because it needed to be about being healthier every day.

I'm not going to be teeny.  I will not be the girl who appears to be challenged by every breeze that blows through.  My body will be strong and curvy and ornamented by various medical devices, like a diabetic Christmas tree.  It's taken me a long time to achieve a level of confidence in how I look and how I feel about myself.  But I see myself now and realize that I don't look much different than I did in high school or in college.   I just feel different.  I feel like the numbers that matter aren't the ones on the scale or sewn into the tag on my skirt, but instead the ones stored in my meter. 

I feel happy, and that looks better on me than any stitch of clothing I own.

July 02, 2008

Dexcom Tips.

Dexcom and an old Trot Nixon shirt.  Almost classic.Last Thursday, my local Dexcom teaching nurse came to visit me here at dLife.  I think she's fantastic, but I'm also tremendously biased.  Little back story:

When I was first diagnosed, I was a little peanut of a kid.  My parents had no experience with diabetes or how to handle type 1 being a part of their child's life, so they looked for help within our town.  As fate would have it, one of my father's cousins (one of those once-removed cousins added to the family by marriage sorts of things) had a son with diabetes.  Jim was diagnosed when he was 18 months old, his mother, Eleanor,  was a registered dietitian and had spent time as both a diabetes professional and the mother of a kid with diabetes.  Perfect guide for my parents, right?  Right.  For years, my mother and I traveled to Joslin with Eleanor and Jim for our back-to-back endocrinologist appointments.  And when my parents would go on vacation, I would stay with Eleanor and her family because she knew how to take care of me.

So imagine my surprise when I find out that the CT/RI Dexcom teaching nurse is Eleanor!  Holy small world.  And holy long story, sorry about that.

Anyway, Eleanor came to visit me last week and brought me two spare Dexcom sensors.  We covered a lot of the technical bits about Dexcom'ing, as well as some tricks o' the trade.  My session with Eleanor helps me answer some of the reader questions I've received over the past few weeks.  Like these:

Q:  Can the sensor get wet?  I used the Dex3 and had to wear the shower patches.  They were terrible!


Yes, the Dexcom 7 sensor can be worn in the shower and the pool and any other soggy environment.  You don't need to wear those wild shower patches that eat your dermis anymore.  But here's something I didn't know:  When you are ready to put a new sensor on, you should clean the underside of the transmitter with an alcohol swab or similar.  I thought you weren't supposed to get this transmitter wet at all, but it turns out that a good swabbing can remove any soap residue, body lotion, or other random smudgy bits that may worm their way underneath.  This cleaning process helps retain the integrity of the transmitter.  

Q:  I've seen you wearing the sensor on your arm.  Aren't you supposed to wear it on your abdomen?

Ahem - according to the official Dexcom guidebook, "Choose a site on a fatty area of your abdomen (belly) to place your Sensor.  You can choose a site above or below your beltline. The best insertion areas are usually flat, 'pinchable,' and relatively free from where rubbing can occur (i.e., pant line, seatbelts)."  However, and off the record, the sensor can be worn anywhere there is a good amount of fatty tissue so you can grab the ol' interstitial fluid easily.  For me, I have a lot of placement options.  I've been wearing the sensor on my arm because that keeps it away from my waistline (I hate wearing any of these devices on my abdomen) and doesn't encounter much friction throughout the day.

Q:  You always talk about how you want your diabetes to be "seamless" and you've talked about how you hide your insulin pump so that it's not part of your wardrobe. So, my question is, how come you don't wear your sensor on your stomach or thigh?


This reader caught my recent dLife column, where I talked about some people staring at the Dexcom sensor on my arm.  This is a very good question. I wear the Dexcom sensor on my arm because it stays put there best.  The sensor is less apt to become peeled back and doesn't catch on my waistband.  It is also less likely to become loose and therefore irritating.  I don't feel comfortable wearing any diabetes devices on my stomach, and my legs are too muscular for the sensor.  Also, the sensor needs to be away from any insulin pump infusion set and from big pockets of scartissue.  So ... my arm is the best out-of-the-way location for Dex and still have it working correctly.  I'm trying to find the compromise between "external symptom" and "using available technology."  People stare sometimes, which makes me bristle a bit, but I would probably stare, too.  It's a different look for your average twenty-something.  ;)

Q:  Can you get more than seven days from one sensor?  Or are you just sticking $60 on your arm, getting a week from it, and then ripping that $60 off?  I can't imagine!

I haven't had the opportunity to restart a Dex7 sensor because the past few have melted off me before the seven day point.  On this last sensor, Eleanor applied some SkinTac on the sensor gauze and it has held steady through daily showers, daily workouts, and this blasted heat.  I have heard that you can "re-queue" a sensor by "pretending" that you've installed a new one.  I will give this a go next round.

Any other CGM-type questions?  Send 'em to kerri (at) sixuntilme (dot) com. 

EDIT:  Again, comments are being problematic.  Hopefully they're fixed now.  I need a new webhost, damnit.  Thanks for letting me know, Rachel! 

June 24, 2008

My Own Shoes.

These are the shoes I am wearing today.  :)In the past, I have written about Shoes and her ridiculously unneighborly habits.  But I have my own shoes issues I need to fess up to:  I love shoes that are not diabetes-friendly.  (Oh come on, like you don't have a vice?)

Ever since I was a kid, doctors have been preaching on about the importance of good cardiovascular health and how even the smallest blister on my foot could bloom into a raging infection that bears will eventually smell from the woods and come devour my toes ... okay maybe not bears, but that blister would cause more damage to my diabetic body than it would to the toes of my brother or sister.

Unfortunately, I am slow to heed this warning.  As a kid, I wore (gasp) flip flops all summer long.  I tap-danced for over a decade in high-heeled, patent leather nightmares.  And as an adult, I've donned everything from strappy sandals to back-breaking heels, occasionally causing a rub or a blister on my feet. 

It's one of those things I have a hard time grasping.  I realize that my body may be slower to heal than your average Kerri's, but I have a hard time worrying about diabetic foot complications at this stage in the game.  When I go to Joslin, my endocrinologist does the foot-tickly thing with the tuning fork and checks my feet for cuts or abrasions.  So far, I've passed with flying colors.  I exercise regularly to keep my cardiovascular system as top notch as I can.  I regularly inspect my feet for any unsightly bits.  And I swear that I always wear clean, moisture wicking socks when I work out.

But I like fancy shoes.  I like heels and sandals and fun colors and open-toe styles and the occasional wedge.  I'm embarrassed to admit that I don't heed "the warnings." Even today, knowing full well that these shoes would be a bitch to break in, I'm sporting them at work (at a diabetes company, for crying out loud!) and waiting for the sting. 

It's a hard habit to break.  Maybe it will take just that one pinchy ouch to bring me back to my senses, or maybe I'll continue to have both Wolverine-esque healing powers and fun shoes.  But I can't be the only one who is breaking this cardinal rule of diabetes management ... can I?

June 03, 2008

Diabetes On My Wedding Day.

Yesterday I wrote about my wedding, focusing on the parts that meant the most to me:  the man I love, our families and friends, the church service, saying "I do," and dancing ourselves silly at the reception.

But diabetes was a part of my wedding day.  We did our best to keep it quiet and unnoticed, though, using several tricky methods.  I'm like a diabetes wedding magician ... sort of.

First things first:  the dress.  Wearing an insulin pump is the easiest and least intrusive way for me to take my insulin, and I wasn't about to go off the pump just for the sake of fashion.  My solution?  Design a pocket to hold my insulin pump, hidden in my wedding dress.  I spoke with the seamstress at Ye Olde Bridal Shoppe and she and I designed something that left the pump accessible, yet hidden.

Insulin pump hidden in the wedding dress

Even if you were looking for it, the pump pocket was almost impossible to find.  Hidden along the seam of my wedding gown, it was held shut with a small piece of velcro.

Reaching into the pocket.

The hole cut in the seam was just big enough to fit my hand into, so I could reach for the pump.

Pulling the pump from my pocket

The hole was big enough for the pump to be pulled through. 

Wedding day bolusing

And once it was free, I could make whatever adjustments I needed and then slip the pump back into its pocket.

Insulin pump hidden in pocket.

The pocket itself was underneath the main fabric of the dress, attached to the petticoat.  It was sized to be about half an inch bigger than my insulin pump, leaving room for my hands to reach in and access the pump.  We stuck a safety pin to the top of the pocket so that when I reached in, I could feel around quickly for the pin and know exactly where the top of the pocket was located.  This made pump retrieval and replacement very easy.

Concealed!

The tubing itself went from the top of the pump, through a hole cut into the petticoat, and attached to the infusion site on my right thigh.  I had to plan ahead of time where my infusion set would be located so the pocket could be properly situated.

And during the entire course of my wedding, no one had any clue that I was wearing my insulin pump in my wedding dress.  Even my friends who know about it couldn't find it unless I pointed it out.  I felt empowered and like a secret agent ... only the bridal version.  

So insulin pump:  check.  And I had a few other tricks up my sleeve.  Like the flowers carried by my maid of honor:

Flowers with low blood sugar backup treater

After speaking with the florist, she devised a small pocket in the ribbon of NBF's bouquet.  This pocket could hold a life saver (as pictured) or even a tube of cake gel.  As I stood at the altar, I felt safe knowing that NBF had a quick dose of sugar at the ready, if I needed it. 

Diabetes, on the whole, didn't affect my day enough to matter.  I danced, ate cake, and experienced a wild array of emotions.  But there were a few moments when it required some attention.  Like after the ceremony at the church, when I tested and realized my blood sugar had cruised up from 156 mg/dl pre-ceremony to a whopping 380 mg/dl afterwards.  (Nerves - they hit me right in the A1c.)  Before the ceremony, I was running on the high end, cresting up around 160 - 180 mg/dl and holding steady.  And during the reception, I was too excited to eat much, so I let my numbers run higher there, too, to compensate for all the dancing. 

I did have a pretty aggressive low blood sugar just before our first dance, but thanks to my fast-as-lightning maid of honor, a glass of orange juice from the bar held me steady as we were announced on the dance floor as Mr. and Mrs. Christopher and Kerri Sparling. 

"I'm a little low," I admitted to Chris as the opening bars to "The Luckiest" played from the speakers.  He held me close and gave me a smile.

"You'll be fine.  Just focus on me.  As far as I can tell, there's no one else in this room but you." 

You may have had your moments, Diabetes, but my wedding day was mine. 

March 12, 2008

Infusion Sets.

I've made it pretty clear that I'm an advocate for using my thigh to host my insulin pump infusion sets.  I like having it placed lower on my body, keeping it a bit incognito, even from me.  It doesn't rub against the waistband of my pants, it doesn't press against Chris when I hug him, and it doesn't get in the way when I'm at the gym.  Overall, the thigh placement keeps my blood sugars stable and my pump tucked away most easily. 

I'm a fan. 

But there are times when it's a little tricky, too.  Take this weekend:  I spent the majority of the day lolling around the house and traipsing around town in jeans, vs. the dress pants or skirts I wear at work.  The jeans aren't baggy or loose, so the denim fabric is pressed pretty snugly against my legs.  Over the course of the last few months, I've noticed that wearing jeans while wearing a thigh site leaves my infusion sets a little battered.  The white edging gets frayed and stained with blue fibers.  Eventually, if I wear jeans for a few days in a row, the site gauze starts to peel back a little, threatening to dislocate the site entirely.  

Insulin pump infusion set, post-jeans.
The infusion set, hanging out on my right thigh. 

Aside from the times I've almost ripped the site out while getting dressed, this jeans thing is the biggest problem.  To help keep the site from bailing before its time, I will stick a few pieces of medical tape around the edge of the gauze.  The tape ends up frayed and blue, but the site remains intact.

I've been thinking about doing some site rotations again - maybe trying out the arm site again or perhaps making an attempt at the (gasp) rear end location.  I'm such a creature of habit, though, a little shy to try something away from my regular routine.  Are you guys using some creative locations for your infusion sets?  (Aside from the breasts - I cannot bring myself to try that one.) 

(Also, THANK YOU for all of the great music selections yesterday.  I have been at Amazon all morning long, picking out CDs and previewing stuff on Seeqpod.  I feel like I've been completely revitalized.)

February 21, 2008

Where Do I Hide My Insulin Pump?

I had dinner this week with a woman who has been type 1 diabetic for over two decades, like me.  She lives in my proverbial neck of the woods, so we met up in Fairfield and hung out for a while.  (Read:  Almost three hours.)  How is it possible to find something to talk about with a complete stranger for three hours?  Oh yeah - the diabetes connection!

One of the things we talked about was pumping, and how we handle wearing our pumps.  R has been pumping for three years, me for four, so we're relatively new to pumping insulin but veterans to diabetes.  R has a 15 month old son whose cute little feet occasionally kick against her pump when it's clipped to her hip, and she also expressed the same "where the heck do you put it?" question when it came to dressing for work.

"Mine?  Right now?  It's in my sock."

"No kidding?  Right in your sock?"

Being the shy and timid human being that I am, I hitched up my pants leg and showed her.

"Here.  It's attached at my thigh, the tubing goes down the side of my leg, and my pump rests against my shin bone.  The only thing that's a bit of a hassle is reaching down to bolus, but I was over that within a few days of wearing it here."

"Wow.  I may have to try that!"

I'm very fastidious about integrating my pump into my wardrobe.  I've written about this several times before and am sometimes met with the "You shouldn't be ashamed of your diabetes - you should wear your pumpinBLOGnito with pride!" response.  Please know:  I wear my pump with plenty of damn pride.  I'm proud to be taking these steps towards controlling my diabetes and I'm proud of the access I have to such progressive medical technology.  But be warned:  I'm also proud of being sort of incognito about it.  "You have diabetes?" they ask, not sure.  And I like that uncertainty.  I like being healthy to the point where people are surprised when I reveal my diabetes.  And also like seeing my reflection and noting no evidence of diabetes unless I know where to look.

Pumping - yes, very proud.  And subtle about it - also very proud.  This topic comes up so often when I'm talking with other young professionals that I'm always happy to share my techniques, and to learn any tricks from them. 

So when I heard this voicemail message on my phone this morning, I laughed out loud. 

"Kerri, hey it's R from dinner the other night.  I'm calling because I wanted to tell you that I've been doing the sock thing and I'm so, so excited.  You've revolutionized where I put my pump.  So far, it's wonderful!"

I was barely able to contain my grin.  Here's to the power of sharing ideas! 

Visitors since November 7, 2005