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.)

Posted by Kerri Morrone Sparling at 08:22 AM | Permalink | Comments (33) | TrackBacks (0)

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.

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.

Posted by Kerri Morrone Sparling at 10:47 AM | Permalink | Comments (33) | TrackBacks (0)

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. 

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.)

Posted by Kerri Morrone Sparling at 09:12 AM | Permalink | Comments (18) | TrackBacks (0)

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.

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.

Posted by Kerri Morrone Sparling at 02:10 PM | Permalink | Comments (21) | TrackBacks (0)

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! 

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!)

Posted by Kerri Morrone Sparling at 08:42 AM | Permalink | Comments (25) | TrackBacks (0)

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.

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! 

Posted by Kerri Morrone Sparling at 10:41 AM | Permalink | Comments (10) | TrackBacks (0)

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 Roche 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.)

Posted by Kerri Morrone Sparling at 11:34 AM | Permalink | Comments (7) | TrackBacks (0)

For anyone who has been reading my blog since my engagement three years ago, you know that motherhood has been on my radar for a long time.  Longer than marriage.  That quest for a decent A1C, that desire for a "normal" pregnancy, and that hope for a happy and healthy baby.

Part of the reason I wanted to write about my pregnancy here on SUM is because there wasn't a lot of information out there about pre-existing diabetes and pregnancy.  There was a LOT of information on gestational diabetes (obviously), and type 2 diabetes got some good press, but type 1 was sort of swept under the rug.  Thankfully, there were a few diabetes bloggers who had chronicled their journeys, and I wanted to add my voice to that hopeful chorus.   

But also thankfully, Cheryl Alkon had taken the topic to her publisher, and she penned the first book on managing pre-existing diabetes and pregnancy.  And I'm very honored to have been both featured in her book (as a women preparing for pregnancy) and to have her contributing here on SUM:

Doom and gloom. That was the message I got several years ago when I first thought about trying to have a baby while also dealing with my type 1 diabetes. Whether at the doctor's office, going online, or reading the very few books about the subject, trying to get and be pregnant while managing blood sugars, taking insulin, closely counting carbs (and avoiding a lot of low-carb proteins that were good for blood sugars, but bad for babies-to-be) all sounded like a nearly impossible task. One fraught with higher risks of birth defects, overweight babies, worsened diabetes complications, and more.

But I also saw type 1 friends who had healthy babies and sensed what could be possible. This spurred me to research, craft a book proposal, and eventually devote myself to publishing an insider's guide to pregnancy with type 1 or type 2 diabetes. I'm thrilled to say that, five years later, "Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby" was published by Demos Health this spring, and has been enthusiastically welcomed by others who, like me, craved the inside story about how to have a healthy pregnancy and baby while managing diabetes.

I had the pleasure of receiving an advance copy of Cheryl's book just before my baby was born, and even though I was in my third trimester and just weeks away from delivering my daughter, it was so reassuring to read about all the things that could go right.  A diabetic pregnancy is a high-risk one, and the challenges can lead to some tough emotional roller coasters and some scary medical experiences (see also:  stuck in the hospital for a month) - but these pregnancies can also lead to a healthy, happy baby.  (See also:  BSparl)  Touching on everything from pre-conception to managing the months of the pregnancy to post-delivery recovery and how to wrangle in diabetes control once again, this book was exactly what I needed to read while pregnant with my daughter.  I only wish it had gone to press before I had conceived!

If you are a woman with diabetes and you're thinking about becoming pregnant, this book is a good resource for you.  If you are the partner of a WWD (woman with diabetes) and you want the full story on how pregnancy and diabetes can mix, this book is a good resource for you, too.  And if you are the parent of a woman with diabetes and you want to know that your child can have the same chances of a healthy pregnancy as any other woman, this book is a good resource for you as well.  

Cheryl will actually be speaking in Boston in the coming weeks (the first event being THIS WEDNESDAY - sign up!), so if you'd like to hear more from Cheryl in person (and meet my endocrinologist, who consulted on the book with Cheryl), you can attend a discussion this Wednesday.  For more details on upcoming events, check out Cheryl's post on her blog.

Thank you, Cheryl, for giving new moms and moms-to-be with diabetes a sense of peace.  And congratulations on your BIG ANNOUNCEMENT on your blog today!

Posted by Kerri Morrone Sparling at 10:01 AM | Permalink | Comments (16) | TrackBacks (0)

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.)

Posted by Kerri Morrone Sparling at 11:55 AM | Permalink | Comments (9) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 09:55 AM | Permalink | Comments (26) | TrackBacks (0)

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?

Posted by Kerri Morrone Sparling at 09:26 AM | Permalink | Comments (24) | TrackBacks (0)

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."  

Posted by Kerri Morrone Sparling at 11:01 AM | Permalink | Comments (25) | TrackBacks (0)

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.

5 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.  :)

Posted by Kerri Morrone Sparling at 10:43 AM | Permalink | Comments (29) | TrackBacks (0)

Posted by Kerri Morrone Sparling at 08:45 AM | Permalink | Comments (13) | TrackBacks (0)

I'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. 

Posted by Kerri Morrone Sparling at 10:22 AM | Permalink | Comments (65) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 12:07 PM | Permalink | Comments (61) | TrackBacks (0)

Wait ... coverage can't be denied based on pre-existing conditions?  

According to this New York Times editorial, "The biggest difference for Americans who have employer-based insurance is the security of knowing that, starting in 2014, if they lose their job and have to buy their own policy, they cannot be denied coverage or charged high rates because of pre-existing conditions. Before then, the chronically ill could gain temporary coverage from enhanced high-risk pools and chronically ill children are guaranteed coverage."  

I've always wanted to take that leap and run my own business.  I enjoy working in new media and health care, I like working hard, but what kept me from making a bold move was pure and unadulterated fear.  It was the same fear that caused me to immediately grab my diploma after college and start working at a crappy job two days after graduation, simply so I wouldn't lose my medical insurance coverage.  (I was a bank teller.  I have no math skill to speak of.  Tell me how that career choice was safe for anyone.)  As a type 1 diabetic, medical coverage takes precedence over a paycheck, seeing as how I have never had the option of purchasing a private policy.   (Something about that whole "taking insulin" thing makes insurers squeamish.  What, like taking injections ever kept me from becoming a productive member of the work force?  Yet I'm allowed to pay my taxes.) 

Sometimes, it takes a bold move to force a bolder one.  I left my job last October in pursuit of one thing:  a healthy pregnancy.  The fear that once held me back was replaced by the overwhelming desire for a healthy pregnancy, and Chris and I moved forward without hesitation.  But, of course, we had to make sure there wasn't a lapse in my insurance coverage, and with pregnancy being considered another pre-existing condition, I remained insured by COBRA.  Thankfully, once BSparl is born, we have another plan in place.  But the details of my insurance coverage aren't the focus here.  Nor will they be.

The point is now there are options for people with diabetes.  Or at least that's what I'm hoping.  I've been pouring through the newswires and seeing, over and over again, how pre-existing conditions can't be denied.  Reuters reports that  "Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014."  This is in addition to insurers being "barred from excluding children for coverage because of pre-existing conditions."  And I remember when I was a kid and my parents dealt with that very issue after my diabetes diagnosis.) 

Newsweek sheds a little more light on this, stating, "Insurers who offer plans on an insurance exchange will be prohibited from rejecting customers with preexisting conditions or charging them higher rates. But the exchanges won't be mandatory until 2014. In the meantime, people with preexisting conditions will be permitted to enter a 'high-risk pool,' which offers caps on premiums and out-of-pocket spending. Still, there's a catch: only people who have been without coverage for six months are eligible. The rule is designed to stop people from arbitrarily switching from their private insurance plans to the cheaper—but taxpayer subsidized—pools. But it means that people who lose their jobs can remain uninsured for a full six months." 

I don't know enough about the health care reform bill to speak eloquently about the details.  I am only exposed to what the media shows me, and what my research procures, and what pages of the bill I'm actually able to pour through and understand.  And I know that talking politics on the blog (just like talking religion) can be a very tough topic, because PWD have so many varying opinions and stances on these issues.  But I'm a person with diabetes.  And I'm hopeful.  I'm hopeful that this could be the beginning of diabetes not dictating my insurability.  I'm hopeful that people with diabetes will have the option to work in fields that inspire them, not just ones that insure them.  Diabetes has a hold on so much of what we do throughout the day and so many of our choices, and I'm hopeful that the passage of this bill will give back some options.

(Just a quick note:  I posted something on Facebook and the comments are impassioned, but respectful.  So far.  :)  If you are going to leave a comment on this post, you definitely don't have to agree with me or anyone else, just please be respectful.  Or I'll send Siah after you.)  

Posted by Kerri Morrone Sparling at 09:09 AM | Permalink | Comments (33) | TrackBacks (0)

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! 

Posted by Kerri Morrone Sparling at 09:57 AM | Permalink | Comments (32) | TrackBacks (0)

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.

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.  

Posted by Kerri Morrone Sparling at 09:49 AM | Permalink | Comments (7) | TrackBacks (0)

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:

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. :) )

Posted by Kerri Morrone Sparling at 11:10 AM | Permalink | Comments (18) | TrackBacks (0)

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. 

Posted by Kerri Morrone Sparling at 09:29 AM | Permalink | Comments (35) | TrackBacks (0)

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 ...

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.)

Posted by Kerri Morrone Sparling at 10:43 AM | Permalink | Comments (42) | TrackBacks (0)

There are some great new diabetes bloggers out there, one of them being Without Envy, a blog written by the father of a little girl with type 1 diabetes.  Steve has offered to write a guest post for SUM today, and I'm happy to share his words with you.

*   *   *

Pilgrimage

Shortly after our eight year old daughter Lia had been moved to the Pediatric Intensive Care Unit late in the evening of December 23, the same day of her diagnosis for type 1 diabetes, the nurse working nightshift came in to check her vitals and IVs and she asked how my wife and I were doing. We told her that it was a bit much to absorb in one afternoon and because she was a nurse working in a children’s intensive care unit she said that she knew what we were going through and offered a meaningful smile. Then she said softly that we’d be just fine. She had a cousin whose son had developed diabetes some indiscriminate time ago at a similarly young age and since then the boy had taken charge of it and was managing very well. Neither of us knew what it meant to take charge of one’s diabetes but we were both tired and mentally worn out from the trials of just getting through that momentous day so we took what little solace we could from her comment and filed it away under kind, but impractical, healthcare reference.

Besides, we were hurt and dismayed and unsettled. We had no idea how this had even happened and had no interest in hearing testimonials about someone who was weeks, months, years down the road in treating their diabetes. Such well-wishing stories of mastery would become important, but not then, not with our daughter lying two feet away connected to tubes and a heart monitor. Nor were we inclined to receive them and similarly good intentions the next morning when the doctor on duty walked in wearing a holiday cartoon tie and a cheerful grin and wished us a Merry Christmas. I looked at him and hated at once his wit, his casualness and the apparent ease with which he was about to address us. Did he not see what I saw? Did he not know what I knew?

I got over him of course, just as I overcame the shock of her diagnosis and the pain and heartbreak of sticking her with needles, and the fear of letting her out of my sight. There was not much future in holding on to these things, for any of us. So we came home and with the instruction we’d received from the diabetes educators the truth behind what the night nurse had spoken of started to make itself clear. We counted carbs and recounted them. We performed the elementary calculations to determine the necessary insulin dosage then we, holders of two bachelor degrees and one masters  between us, had someone else verify it. We administered the shot through the tears and the anguish and watched as our pivotal day from the one prior struggled to become routine.

And in the days that followed it did and we listened to it and we learned and here we are now, ourselves weeks down the road. The tried and tested. Lay experts. Sharing our own testimonies, like pilgrims set out from their home, rucksacks stuffed with provisions, looking for others to witness and share in their stories and them in ours, hoping to uncover proof that you can take charge of this beast and manage well.

It’s not clear to me yet that you can. Perhaps manage and taking charge are too strong of words, an honest mistake made by someone connected only to the peripheral edges of diabetes. Reality most likely rests somewhere in the middle, a habitable settlement between freedom and tyranny. Wherever it lies, I can honestly say of the company we keep, none has been more supportive or understanding or willing to listen than that which we’ve found right here at our own fingertips. For your patience and your courage and care, we are exceptionally grateful.

Diabetes has changed us, no doubt, and when I hear others talk of their lives in terms of before this disease and after, I worry some because our lives before were good. Not good in terms of its flamboyance or abundance, we had none of that. But good in the sense that we ate right, we exercised, we lived life in moderation, and still...

It was a way of life that had we the choice we would not have aggravated, but like any pilgrimage, in words similar to that of my gracious host, it’s not the beginning or end that defines you, it’s the journey.        

See you on the road,

Steve   

*   *   *

Thanks again, Steve!  And if you would like to contribute a guest post (especially around, oh, let's say the end of April, beginning of May ...), please email me at kerri (at) sixuntilme (dot) com.  

Posted by Kerri Morrone Sparling at 10:21 AM | Permalink | Comments (12) | TrackBacks (0)

Yesterday, the mail arrived.  There were catalogs for clothes (mmmm, can't wait until May!), letters from friends, the crappy bills that keep arriving even though we didn't forward them to our new address, and oh yeah, that one bill from my mail order pharmacy.

For a thousand dollars.

Dated January 30, 2009. 

So, being the rational and patient woman that I always am, I ripped up the envelope it came in, cursing under my breath like my temperamental buddy, Yosemite Sam.  Punctuated each tear of the paper with "fricka-frakin' insurance bill dagnabit ..."

And then I called the mail order pharmacy company.

"Thank you for calling Byram Health Care.  Your call is important to us."

That was enough to start pushing me a little closer to flipping out, even though it was just a recording.  My call is important?  How important is my business with you?  You're billing me over a YEAR after whatever happened, happened.  After entering my account number and social security number and date of birth and favorite color and pressing "pound, star, pound" to confirm that yes, John was indeed my favorite Beatle, I finally got a human being on the phone.

The woman who answered was very nice, and it's not her problem that I was receiving a bill for something from January of LAST YEAR.  So I was as patient as I could be.

"I just received a bill, dated January 30th, 2009, stating that I owe over a thousand dollars for pump supplies.  Can you help me solve this problem?"

She put my information into the system and pulled up my record.  After a quick discussion about the invoice number, she launched into a speech that sounded so well-rehearsed, it scared me.

"This claim was under review as of June 2009, but spans the course of the entire calendar year for 2009.  It has just come out of review and is now being billed to you, as you see there on your invoice.  Your insurance company has denied this claim stating that these diabetes supplies aren't covered under your DME clause and therefore you are responsible for the remaining balance for these insulin pump reservoirs.  In the event that you disagree with this statement, you'll need to contact your insurer and have them contact us to resubmit the claim."

"Oh hell yes, I disagree.  So I need to call the insurance company and pass the buck back to them?"

"Yes.  Have them contact us with their resubmission of the claim."

"Okay, but confirm this for me - this isn't my problem.  This is an issue between you guys and the insurer, right?"

"That is most likely the case, but you'll need to talk to your insurer."

So I called Oxford Health.  And their guy told me that Byram had submitted the claim to Oxford with incorrect billing codes, forcing Oxford to deny the claims for these supplies.

"Even though you guys approved these items for over three years?  And it's not like anything changed?  So it's just the billing code that was different, and that's not even my fault, yet I'm receiving the bill?"

The guy from Oxford confirmed.  "You need to call Byram back and tell them that they need to resubmit the bills to us with this billing code (and he read off some series of numbers to me, that I feverishly wrote down and then promptly doodled cats around - I was fired up, but still easily amused), and then that should start fixing this problem."

"Okay, so let me confirm.  This isn't my fault.  Or my problem.  I'm not on anyone's 'bad list,' and this is an issue with you guys and the mail order pharmacy, right?"

"That's correct, Mrs. Sparling."

"Fantastic.  You've been very nice.  I hope we never have to speak again."

And then I called the customer care center at Byram, one more time.  And this is where I almost got into my car and drove to wherever Byram is located, so I could just find this girl who answered the phone and shove broccoli spears up her stupid nose.

After explaining the basics, and after this new girl brought up my account, I said the following:  "This bill I'm looking at isn't really my problem.  That's been made clear to me by speaking with your associate and then the rep at Oxford.  So can you help me out with this billing issue?  I've been told it's a matter of coding, and not an actual insurance denial?"

And this girl actually said this to me.  "Um, so you want me to resubmit this with a new code?"  Big, big sigh.  "I have to resubmit these to your insurance company?  That's going to take a long time."

I snapped.  BSparl kicked indignantly, egging me on.  "You are upset because you have to resubmit the bill because YOU guys screwed up the billing codes in the first place?  You are giving me attitude - you are really out of line with that, by the way - because you have to do your job, only correctly this time?  Honestly?  I'm looking at a bill for $1000 that is the result of a billing code error, not my error.  And the billing codes are from your side of things.  So this is your error.  I am not paying this bill just so you can avoid doing your job.  Right?  I mean, you have to see where I'm coming from."

Big sigh again.  "I'll have to spend tomorrow resubmitting your claims.  You'll need to call back tomorrow."

"That's it?  So you're on this?  And again, this isn't my problem, right?  I don't need to do anything?"

"No.  You don't need to do aaaaaanything."  Drawing out the A-sound, like I was the one not doing my job.

"Great.  Thank you very much for resubmitting those.  And hopefully tomorrow we'll be all set."  

Co-pays are one thing.  Insurance premiums are another.  But being billed a thousand dollars because someone entered the wrong code and now is griping about fixing the error?  That's a surefire way to piss off a pregnant lady. ;)

Posted by Kerri Morrone Sparling at 09:12 AM | Permalink | Comments (50) | TrackBacks (0)

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 insulin pump, showcasing my new mega-basal rates.  :)

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. 

Posted by Kerri Morrone Sparling at 10:37 AM | Permalink | Comments (48) | TrackBacks (0)

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.

(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?)

Posted by Kerri Morrone Sparling at 09:58 AM | Permalink | Comments (19) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 10:15 AM | Permalink | Comments (19) | TrackBacks (0)

(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.

Posted by Kerri Morrone Sparling at 11:21 AM | Permalink | Comments (17) | TrackBacks (0)

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.

"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. 

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.

Posted by Kerri Morrone Sparling at 08:14 AM | Permalink | Comments (13) | TrackBacks (0)

(I've bombarded you guys with info on Buried and kept a running update on Facebook and Twitter, so I promise this will be the last post about Sundance. I'll go back to diabetes crap in a few minutes.  Or at least I'll blend them.)

We're back from Park City, and the whole Sundance experience was completely and utterly surreal.  I won't go on about the reviews that have come out about the film (i.e. New York Times, LA Times, Variety, Moveline, Slashfilm, Film School Rejects), and I have no plans to talk extensively about the Lionsgate purchase (holy crap).  But we were at the premiere of Buried at the Library Theater on Saturday, January 24th, and it was incredible.

After a private pre-screening dinner (where there was a special "Buried" menu on tap - very cool), we headed off to the theater for the actual screening.  The film premiered at midnight, and it was something else.  Chris's (in my humble, wife-ish opinion) fantastic script was brought to life by Rodrigo's immense directorial talent, and Ryan's performance was emotional and real.  I don't want to ruin the story for anyone who is planning to see the movie (you are ALL planning to see the movie, right?), so suffice to say that the film was incredible.  I applauded wildly, and BSparl did the same from underneath my belly button.  (She's a big fan of her daddy's movie.  Man, that is bizarre to write.  Two and a half more months!  /diatribe)

So many friends and family members came out for the festival (including the majority of Chris's extended family and also my father), so the house was packed.  Chris, director Rodrigo Cortes, and star of the film, Ryan Reynolds were all in attendance, adding some extra excitement to the room.  This was the first time that anyone outside of the production team was seeing the film, so the air was electric.  And since this was our first look at the finished film, we could hardly sit still.  I found myself particularly fidgety during certain moments of the movie - you'll know when you see it.

Writer Chris Sparling, director Rodrigo Cortes, and actor Ryan Reynolds

And it was over.  Ninety four breathless minutes later.  The audience sat back from the edges of their seats - literally - and then there was a Q&A with Ryan, Rodrigo, and Chris, where the audience peppered the trio with questions about the film. (Some video coming soon, once we figure out which suitcase the Flip ended up in.)

Buried screened a total of five times at the festival, and the responses from viewers has been overwhelmingly positive.  I mean, these three guys pulled it off.  A movie, taking place entirely in a coffin with one actor, was interesting.  For over an hour and a half.  That's pretty damn impressive.  ... but I'm not doing a movie review here.  Obviously my bias is impossible to contain. ("Most impressive script EVER!"  "Cutest writer of all TIME!!"  "Framing the movie poster and debating putting it in the baby's NURSERY!") 

I am so proud, as his wife, to have been there to support Chris as he made this huge career leap forward.  But I was proud before, when there wasn't a Sundance movie to talk about or a movie premiere to attend.  He's my best friend, and I'm so, so happy for him.

Now I need to upload a pile of photos and make sense of the suitcases that still need unpacking.  And find out why Siah is curled up around the toaster, purring maniacally.

Posted by Kerri Morrone Sparling at 10:40 AM | Permalink | Comments (22) | TrackBacks (0)

Thanks to the happy combination of Factor V Leiden and being pregnant, I'm rocking a higher chance than average for a blood clot while traveling.  Back in October, when I was just a few months along, a lot of my travel was on the Acela, cruising back and forth between Boston and Philly, in addition to some flights.  So I needed to take these clotting risks into account.

"You're telling me I should pick up some compression stockings, then?"  I asked my obstetrician, after we had discussed my upcoming travel plans.

"Yes ma'am.  And wear them.  Not just for traveling, but as often as you can."

"Will do.  So I'll be potbellied and wearing compression stockings.  Hot!"

My feeble attempts at joking aside, these stockings are important.  Even though I'm working hard to get to the gym several times a week, I'm more definitively working hard on making money, so there's a bit too much time spent at the computer these days.  Heeding the advice of my doctors, I'm careful to keep my legs elevated as much as possible, and I'm sure to pop up and walk around every hour or so, in addition to staying hydrated.  (Note:  Staying hydrated makes getting up every hour easier, especially when BSparl is gnawing on my bladder.)  

And I'm also sporting these socks, purchased for $4.99 at my local CVS.  (Another note:  CVS takes too much of my money on a regular basis, from their clever selection of lip glosses - love me some Bonnie Bell - to their strategic arrangement of Hallmark greeting cards to their convenient pharmacy that's open 24 hours.  I have an intense love/hate relationship with CVS, as evidenced by their constant contact with my debit card.)  The socks aren't uncomfortable, they appear to be working well (no varicose veins yet), and they are black, so thankfully they go with my go-to flats of choice these days.  I'm safe, BSparl is safe, and CVS is safe because they will continue to get my money.

So what's sexier than compression stockings?

Nothing.

Because without these blasted old lady leg warmers, I'd be risking a blood clot and varicose veins, thank you very much.

Posted by Kerri Morrone Sparling at 10:23 AM | Permalink | Comments (13) | TrackBacks (0)

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.

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.

Posted by Kerri Morrone Sparling at 08:21 AM | Permalink | Comments (18) | TrackBacks (0)

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. 

"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.)

Posted by Kerri Morrone Sparling at 08:06 AM | Permalink | Comments (12) | TrackBacks (0)

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!)

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.  

Posted by Kerri Morrone Sparling at 11:04 AM | Permalink | Comments (26) | TrackBacks (0)

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.)

Posted by Kerri Morrone Sparling at 11:49 AM | Permalink | Comments (22) | TrackBacks (0)

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?"

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

Posted by Kerri Morrone Sparling at 10:42 AM | Permalink | Comments (19) | TrackBacks (0)

Posted by Kerri Morrone Sparling at 11:05 AM | Permalink | Comments (3) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 11:29 AM | Permalink

Last week, on Twitter, Elizabeth Arnold posted a link to a photo that made my whole body cringe and I instinctively said, "Oh crap, THAT thing?" (I'm stealing and reposting this photo here, but the original photo credit belongs to Cardinal Health.) 

Behold - The Guillotine:

This photo made me shudder because I remember this lancing device clearly.  It was the first one I ever used, outside of having my finger pricked by the nurses with the lancet alone, and I remember the shunk sound it made as it came careening towards my fingertip.  It wasn't the standard shunk we know now - this sucker would have to be cocked back like a rifle, and once it clicked loudly into place, you had to hit that button on the back to release the spring-loaded lancet.  And it wasn't just spring-loaded - The Guillotine had an agenda.  It would come screaming over the top of the curve and embed itself into your fingertip, and it was all my mother could do to keep my hand pressed against that little plastic circle at the bottom there. 

I hated it.  It scared the crap out of me, and even though more humane lancing devices were introduced soon after my diagnosis, The Guillotine lived in our house much longer than I'd care to admit.  Even the lancets looked like little harpoons. 

Back in 1986, diabetes technology wasn't completely archaic (I was dx'd after disposable syringes were used, and way after pumps were the size of backpacks), but it wasn't comfortable in the slightest for a second grader.  That Guillotine still makes me cringe, even 23 years later, and I'm increasingly thankful for every little advancement we've seen over the last two decades.  

Because I mean, really.  Look at that thing.  OUCH!!

Posted by Kerri Morrone Sparling at 09:06 AM | Permalink | Comments (43) | TrackBacks (0)

Tomorrow is World Diabetes Day.  While my best friend's baby shower is this weekend and I'll be busy preparing for and helping with that event, I know there are lots of events taking place to celebrate the big, blue circle (including the Big Blue Test ... more on that later).

But today is just another day in diabetes management, and it happens to be another endocrinologist appointment for me and the ol' BSparl.  BSparl is getting bigger, as evidenced here:

I am now sporting my first baby bump, and it's becoming more and more pronounced every day.  (Pronounced baaabeee buuuhmp.)  Clothes don't fit, maternity jeans are necessary, and when I zip up my sweatshirt to head down to the gym, the zipper strains a bit over my belly. 

But is it all baby?  Or could it be some weight from treating all these lows?

One of the things I'm talking to my endocrinologist about today is low blood sugar.  Specifically, the crazy-ass low blood sugars I've been experiencing over the last four months.  The other night, I woke up to the BEEEEEEP! of the Dexcom and a pool of sweat in my clavicle.  Blood sugar was 33 mg/dl, and I wasn't even entertained by the Larry Bird reference. 

Instead, aside from the sweat, I was completely symptom free.  And that scares the hell out of me, because there have been several lows in the last few weeks that clocked in under 50 mg/dl without a single symptom.  Last week, it was a 29 mg/dl that just sprang up on me, and even yesterday I had a 41 mg/dl with my only symptom as thirst.

THIRST?  That is my low symptom now?  Come on, diabetes.  That doesn't even make any sense!!

In preparation for my Joslin appointment today, I have two weeks worth of blood sugars all logged and ready to roll, and as I was printing out the logbooks, I noticed that there isn't a single trend.  These lows are cropping up at 3 am, 10 am, 4 in the afternoon, while I shower, while I'm at the grocery store, during conference calls ... you name it.  No reason for these pesky lows (and also no reason why I shouldn't just buy stock in glucose tabs, seeing as how I've wrecked through a bottle in the last week alone).  Plenty of other type 1 diabetic women who have been pregnant have told me about the epic low blood sugars they've experienced, but I had no idea what they meant until the 20's and 30's started pestering me at all hours of the day.

I have high hopes that my endo can help me peel back some of these lows without sacrificing the excellent post-prandials that I've been working my butt off to achieve.  I'm willing to let my A1C creep up a bit in order to bring my machine average back up into the triple digits.  I just need some help in making these lows stop.

(I also have high hopes that I can stop sleeping with a bottle of honey next to my bed, because when I slap my hand against that instead of the alarm clock, it's all sticky.)

Posted by Kerri Morrone Sparling at 11:04 AM | Permalink | Comments (16) | TrackBacks (0)

The second trimester (not semester, as I keep mistakenly saying) is in full swing.  According to the baby books I am reading daily, it's time to start putting on 1/2 a pound to a pound a week - oh what a weird concept!!!  For those of you who have been reading me for a few years, you know I work hard to keep the poundage OFF, so the concept of gleefully adding 20lbs in the next 22 weeks is foreign to me.

The weight gain is a weird adjustment.  I log in to the What to Expect (When You're Expecting) site daily to see the progress of the BSparl and because it helps me keep track of how far along I actually am.  I'm now in the 16th week of my pregnancy and the site says the following:

"It's hard to watch yourself gain weight during pregnancy, even when you know there's a wonderful reason for it. The challenge, though, is to try to embrace your body's new shape and think of every pound you put on as a sign of good health for you and your baby. As long as you eat right during pregnancy (minimize junk and maximize nutrient-dense foods) and get regular exercise, you'll be fine in the long run. Remember, every woman is different and gains (and loses) at her own pace."

Eating right has been a little bit of a challenge because what I'm craving is changing hour to hour, it seems.  Earlier in my pregnancy, I could have devoured an entire fruit stand in a week, craving anything with a high volume of vitamin C in it.  Kiwis, orange juice (yes, with pulp!), blackberries, and raspberries by the fistful.  Healthy choices, right?  But now, with about 7 lbs on board already and closing in on the fourth month of BSparl, my tastes are turning towards less ... diabetes friendly options, shall we say.

Like the other night.

"I want a McDonald's cheeseburger, like you read about."  I said this to Chris from the safety of our home, away from the tempting glow of any golden arches. 

"Really??"  He knows I'm not one for fast food, especially McDonald's. 

"Yup.  It's twisted."

The thing about that craving is that it didn't go away.  No sir ... that one was on board for 72 hours, until Monday, when Chris and I were coming back from an errand and I knew there was a McDonald's around the corner.

"Dude, I'm caving."

He grinned.  (He finds this whole thing amusing, from the potbelly to the bizarre things I want to eat now.)  "It's time."

While he waited in the car, I ran into McDonald's and ordered a cheeseburger from the lady behind the counter.  

"One cheeseburger, please!"  I think I looked euphoric.  I must have.

"One cheeseburger, happy lady?"  

"Yes, ma'am!"

"One cheeseburger for the happy lady!" she said, punching the order into her register and calling back to the guys in the back.

"Cheeseburger coming up!"  A minute later, the cheeseburger I'd been craving slid down the counter and was tossed into a paper bag. 

"Cheeseburger for the happy lady!"

"Thank you!"  (Everyone speaks in exclamation points at this McDonald's, apparently.  And there's nothing wrong with being the "happy lady," in my opinion.)

I went out to the car, my face glowing with pregnancy cheeseburger happiness.  Chris was already laughing at me, but I can't care.  This is part of the process, I guess, all this very odd food stuff.  I bolused 3.5 units for this culinary disaster and ate it in one gulp.  An hour later, 109 mg/dl. 

I swear BSparl was in there, clapping his little hands, the whole time. 

Posted by Kerri Morrone Sparling at 10:08 AM | Permalink | Comments (25) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 11:39 AM | Permalink | Comments (38) | TrackBacks (0)

Posted by Kerri Morrone Sparling at 11:25 AM | Permalink | Comments (31) | TrackBacks (0)

During my endocrinologist appointment last week, I brought up that itchy, scratchy Lovenox rash to my OB/GYN, Dr. T.  And she wasn’t comfortable with how my body reacted.  

“That rash is from two weeks ago?  How does it feel now?”

“Less itchy, that’s for sure.  But it got all hivey and wouldn’t relax, not for about a week.  It itched like mad.”

“I don’t like that.  I don’t want you to continue to take Lovenox, especially if it gave you that reaction.  Who knows how bad the reaction could be the next time?  I want to switch you to something else.”  She started to write on my chart.  “Heparin could be another alternative for you.”

“Okay, what’s the difference?”

She told me that both Lovenox and Heparin are large-molecule drugs that don’t pass into the placenta, so Bsparl is safe, and also that they both serve the same purpose:  to protect me and my baby from blood clots (the risk of which increases with both Factor V and pregnancy).  

But you guys know how I am by now.  I feel weird taking extra drugs, and I’m very conservative about adding more and more Rxs to my daily routine.  Also, consulting with Dr. Google brings me all this scary information about how Heparin is a category C drug, meaning it could have effects on the baby.  I don't know what's what, but I do know that I need to trust my doctor and her years of experience over a Google search.  (Right now, I'm wondering if I can bypass these drugs altogether and just work out in the airplane bathroom for the whole flight.  Kidding.  Sort of.)

Yet I still find myeslf feeling uneasy, and looking to see if any of you have had personal experience with Heparin.  I'm very WTF about this and confused as can be.  Right now, I’m only on insulin, pre-natal vitamins, and blood pressure meds (don’t worry – safe for baby), but according to Dr. T, I’ll be taking something to help protect me from clots for six weeks after BSparl is born.  (Great.)  So now is a good time to figure out what works best for me.

Once again, I’m clueless about what to expect.  I’m sorry to keep pestering you guys with all these questions, but when it comes to anything other than insulin, I’m lost.  When I wrote about Lovenox before, you guys were invaluable and I learned a ton (even brought some of it up to my doctor).  Now I’m asking once more – has anyone ever taken Heparin?  Any weird, itchy side effects?  Any burning at the injection site?  Any … anything?  

(And BSparl says hi.  He just sent a messenger pigeon to me from the womb.  He is baking cookies in there.  Busy little peanut.)

Posted by Kerri Morrone Sparling at 07:50 AM | Permalink | Comments (24) | TrackBacks (0)

Last week, I toddled my pregnant self up to the Joslin Clinic for my endocrinologist appointment and an ultrasound with my OB/Gyn.  And as excited as I was about the ultrasound and the opportunity for Chris and I to see our baby kicking around in there (more on that later), I was just as excited about the H1N1 vaccine.

I know. 

I can't believe I'm saying that, either.  Yes, this is the same Kerri who wrote about feeling "eh" about the flu shot a few weeks ago.  But a few things have come to light in the last couple weeks that have changed my outlook on things.

Like the fact that the Joslin Clinic has been riding me about getting this shot because of my high-risk situation, being both type 1 and pregnant.   

Or the fact that every healthcare professional I spoke with at last week's ePatient conference kept asking me, "You are getting the H1N1, right?" and the look of concern when I said, "I haven't received mine, yet."

Or the very scary fact that pregnant women, regardless of any chronic illness, are singled out as one of the highest risk groups out there.  

I'm not one to leap without looking.  But I'm also not one to put my baby at risk if I can help it, so when Joslin said there was an H1N1 vaccine available to me, I jumped at the chance to get it.  Seems like this vaccine, for some completely ridiculous reason, is not being made readily available to people who need or want it, so if there was one available to me, I was taking it.

It was unnerving, knowing they were injecting me with a virus.  A dead one, of course, but still, with all the information circulating out there about the pros and cons of the H1N1 vircus, it's hard to know what's true and what's just speculation.  Or, unfortunately, what's purely fabrication.  In any event, when I heard about a little girl in my home state who, at the age of 12 had being diagnosed with H1N1 and then died from it just a few days later, it was enough to scare me into rapid and determined action.

But even at the Joslin Clinic, I had to jump through a few hoops in order to be viewed as "eligible."  

"No, I'm sorry.  That vaccine is only for patients who are 24 weeks pregnant and up."

"Really?"  I said, my hands against the counter.  "I was told that being 14 weeks and also having type 1 diabetes made me a shoe-in for this vaccine.  It's like my prize for being the in double risk pool.  So there isn't one for me?"

She checked her chart again.  "Type 1?  14 weeks?  Okay, you can have a seat over there and we'll call you in for your injection in just a few minutes."

It felt so odd, fighting for something I wasn't even sure I wanted in the first place.  But I kept thinking about the pregnant women I'd heard about on the news who had died from H1N1.  And then I thought about all the public transit I'd taken in the last few weeks, and my upcoming travel plans for this week.  Did I want to take the chance?

If it was just me, I may have.  I may have waited or put off the shot or taken my chances.  But I'm responsible for this baby.  And when we heard the heartbeat, loud and strong, and saw him (or her) kicking around in there, I knew that I needed to do whatever it took to take the best care possible of my child.  

So they shot me up with the H1N1 vaccine.  Oddly enough, I felt grateful.

And that night, I promptly felt ill and slept for about 15 hours straight, waking only to test, snack, and drink water.   I wasn't experiencing any full-fledged sickness, but the weather was above me enough that I hid out all weekend long, missing any Halloween festivities and instead camping out at home with hot tea, chicken soup, and Kleenex.

Today?  Feeling much better and on my way to speak at a seminar in New Jersey.  But I keep hearing about others who are seeking out the H1N1 and still haven't been able to gain access to a vaccination.  What does it take to get protection when you need it?  How are there H1N1 clinics in some states but not in others?  Are you someone who is trying to get this vaccine but can't?  Or are you avoiding this shot, and why? 

I've already jumped, so my opinion is moot on this one.  I'm pregnant, my doctors told me this was best, and I (for once) listened.  But this issue is getting bigger and bigger, and with diabetes month just getting started here, I want to know how the diabetes community at large feels about this H1N1 vaccine.  

Posted by Kerri Morrone Sparling at 08:03 AM | Permalink | Comments (43) | TrackBacks (0)

... 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:

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.

Posted by Kerri Morrone Sparling at 11:30 AM | Permalink | Comments (70) | TrackBacks (0)

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:

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.)

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.

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?

Posted by Kerri Morrone Sparling at 10:25 AM | Permalink | Comments (12) | TrackBacks (0)

(That’s just a cool song and I’m in the mood for a little David Bowie.  Humor me.)

I’ve learned a lot in my frequent visits to the Joslin Clinic over the last six months or so, which just goes to show that it doesn’t matter how long you’ve had diabetes – there’s always something new to learn.  As I was preparing for pregnancy, there was a lot of focus on blood sugar control, and frequent monitoring.  That, I knew.

But what I didn’t realize was how often I should have been checking my meter with control solution.  

I have to be honest:  Before Joslin told me to get my act together re: using control solution, I never used it.  Ever.  It would come in the meter kits when I first opened them and it was the first thing I removed.  I ran on the assumption that my meter was the diabetes equivalent of “the customer” – it was always right.

The Joslin CDE disagreed.

“No, you need to be checking the accuracy of your meter with the control solution at least once a week, Kerri.  That’s important to make sure everything is in range.  Think about it – you’re dosing insulin based on these results, and you’re calibrating your Dexcom, too.  Don’t you want to make sure the numbers are accurate?”

Good point.  But how naïve am I to assume that the numbers ARE accurate?  Sometimes I get a result on the meter that I know is way off, and I usually test again to see what the deal is.  But I never thought to bust out the control solution to keep tabs on the accuracy, as well.  

Since I was (and am) trying to be Captain Compliance when it comes to Joslin instructions (thanks to the ever-growing BabySparl), I dug up some bottles of control solution and started double checking my meter.  And yes, I do feel soothed when the control test comes back right on target, because it reinforces my faith in the meter.  And no, I haven’t seen any wonky control results come back yet, but at least I’m looking out for them.  

If you’re already checking your meter with the control solution, bravo!   Just wanted to pass this info on, in case you were like me and tossing the control solution into a shoebox to reside with dust bunnies under the bed.  (Or with Siah bunnies, depending on how much your cat sheds.) 

As I’ve mentioned, I’m learning so much now that I’m in constant contact with my doctors, so I want to pass on all the tips I find to you guys.  Because it’s quite obvious that while I try pretty hard, the rules of the game seem to change overnight.

Posted by Kerri Morrone Sparling at 08:22 AM | Permalink | Comments (34) | TrackBacks (0)

The flight to Las Vegas from Boston is a long one – six hours on the way there and five on the way back.  I talked with my doctors before taking the flight, and being pregnant, I’m dealing with an increased threat of deep vein thrombosis.  The Factor V Leiden gene in my body is also a red flag, so these longs flights caused some concern for my medical team.

“We’re not worried so much as we have some rules for when you’re flying. The first is that you need to get up and move around about once every hour to keep your circulation steady and your legs moving.  And the second thing is that we’d like you to take Lovenox on the days that you’re flying.  That will help combat the Factor V risk.”

Take a shot?  No problem.  At least that’s one thing I can commit to without fear.

So about an hour and a half before my flights took off, I snuck into the airport bathroom and pulled out the pre-filled syringe of Lovenox.  Lovenox is an anti-coagulant drug that helps to prevent blood clots.  I don’t know much about it, other that it’s safe for pregnant women to take and it was one of the conditions set forth by Joslin, so I pretty much do what they say these days.  I’ve never taken anything like it before, so Wednesday evening was my first time.

Fellow diabetics, I just need to say that we have it good with our teeny, ultra-fine needles.  This Lovenox needle was clumsy, long, and thick.  “Inject it right into your abdomen, where you’d normally take an insulin injection,” the doctors recommended, so I did just that.  But it sucked a little bit.  One of the side effects of the injection is bruising and soreness, and they’re not kidding.  Within 15 minutes of taking the injection, a deep red thumbprint popped up on my abdomen, tender to the touch.  

But that seems to be the only side-effect I’ve experienced.  Except for a little bit of paranoia.  And now, a few days after the trip, I have the itchiest, red rash at my injection sites. 

Once a doctor tells me that I could be at risk for something, I do what I can to help mitigate that risk.  For these flights to Las Vegas, I took the Lovenox injections and made sure I was up and about once an hour, but I also did something else.

Every time I went into the airplane bathroom, I did some weird kind of calisthenics.  Thanks to BabySparl, the need to pee is hourly (making me test my blood sugar all the time, wondering, “Is this because of Baby or am I high?), so I’d use the ladies’ room and then face the mirror.  And then do this bizarre mix of high knee raises, running in place, and stretching.  Thankfully, being barely 5’4” gives me enough room to move around in there, but I felt like a tool.

“And stretch!  And stretch!”  I heard Jane Fonda in my head as I faux-exercised in the airplane bathroom.   

I prayed that the stewardesses couldn’t hear me thrashing around in there.  How the hell would I explain that?  “I don’t want a blood clot so I’m doing a little dance here in the bathroom.  That's legal, right?”

It’s all new to me, and I’d appreciate any feedback from someone who’s been there.  (And if you have airplane exercise tips, share those, too.  I’m heading to Florida in two weeks and am wondering how I’m going to embarrass myself on that plane, too!)

Posted by Kerri Morrone Sparling at 10:07 AM | Permalink | Comments (30) | TrackBacks (0)

Dear Baby,

I've been thinking about you for a long time.

My doctors told me it would be a challenge to have you.  They said that diabetes would be a tricky hurdle as I planned for you.  They said you might not happen.  There were so many reasons to be scared and so many reasons to doubt, but I never gave up on you, Baby.  I have always wanted you and have worked so tirelessly to make my body safe for you.

And at the end of August, at the Joslin Pregnancy Clinic appointment several weeks ago, I thought you could possibly be there.  I thought there was a chance, because your dad and I were ready to try for you, so we took that leap.

"It's so early, so the test might not show a positive result, but we should do one anyway.  But remember, it might not be positive because you wouldn't be very far along."  The CDE gave me a warm smile while the nurse went to test the sample.

Your dad went into the waiting room to sit.  We didn't know how long it would take to get the results back.  And while I was waiting, the CDE and I were talking in the hallway about how great it would be if you really were there.

Then the nurse opened the door of the lab and came out with the test in her hand.

"Oh, she's definitely pregnant.  Look!"

And I saw two lines.  And the CDE began to cry.  And then the nurse began to tear up.  I cried, too, because I was so scared and humbled and in love with you already.

"Chris, Chris!"  Even though we were in a waiting room with people who were there for their own appointments, the world sort of stopped for a minute so we could have our moment.

Chris heard the commotion from the waiting room, and came over, his eyes shining.  And Baby, I wish I told him about you with even a scrap of grace.  That I'd whispered, "We're pregnant!" or "We're having a baby!" or even, "Oh my God!" 

"It's on!" is what I said.

Super classy.

We hugged.  And we kissed.  And the family in the waiting room burst into a quiet applause.

There have been many weeks that have passed, and they haven't been the smoothest.  There have been some very scary moments, and I'm still scared to be writing this all down.  There have been so many doctor's appointments since that day.  Thankfully, everything seems to be just fine and on track, and my diabetes is under the best control I've ever achieved.  (Last A1C, taken Friday, was 6.2%!)  You are growing fast, and we've slowly told our friends and family about you.  Everyone is very excited, and I'm working really hard to make sure that we both remain safe.  You're coming next spring  and we couldn't be happier.  Being your mom is the most important job I will ever have, and I'm ready.  

When I looked in the mirror this morning, I saw the rounded baby bump and felt such a surge of happiness.  I don't know if I'll be the best mom, or the most "together" one, or even if I'll be one who has any clue what she's doing.  But I'm so excited for you to arrive, even though I am scared and careful and preparing as best I can. 

You are so wanted.

Baby, I can't wait to meet you.  I've always wanted to be your mommy.  And in just under six months, I'll be able to hold you in my arms instead of just in my heart.

I love you so much.  And now everyone knows.

Love,
Your Mommy

Posted by Kerri Morrone Sparling at 08:27 AM | Permalink | Comments (286) | TrackBacks (0)

Wearing two diabetes devices has its mental hurdles, but sometimes the physical hurdles are the most irritating.  For the last two weeks, my husband and I have been packing up our old apartment and I've been closing out my office at dLife, so there's been a lot of physical lifting and moving of stuff.

Which means there's been a lot of Dexcom and insulin pump site set jostling.  Wearing the Dex and the pump full-time means plenty of little red dots on my thighs and lower back, and the physical movement of moving has made these areas even more irritating and inflamed.  

What's my point?  

My point is that my regular sites are sore.  And I need to switch things up a bit.  Again.  So last night, I opted for an arm site for my infusion set, instead of my standard thigh or hips.  I've worn the site here before, and it was comfortable, but it can be a hassle wrangling the tubing and shirts/bras. 

So this round, I opted to use the longer tubing (43 inches) and I'm snaking that up my arm, down under the back of my bra, and then down to my hips where the pump clips to my pants.  The longer tubing gives me just enough room to accidentally pull on the tubing without jerking the site out.

It is a very different place for me to wear it, though.  So I reminded Chris to remind me.

"Dude, I'm showing you in case I forget.  The site is on my arm, okay?"

"Got it."

Now, as I sit here and write this, I can't feel the wire and it's undetectable underneath my long-sleeved shirt.  Hopefully wearing the site on my arm for a few days will help my other sites heal and give me a little breathing room on the ol' real estate front!

Posted by Kerri Morrone Sparling at 11:01 AM | Permalink | Comments (12) | TrackBacks (0)

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?  

Posted by Kerri Morrone Sparling at 12:21 PM | Permalink | Comments (65) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 12:22 PM | Permalink | Comments (31) | TrackBacks (0)

It's the meme taking the chronic illness bloggers by storm ... and I wanted to cram this one in before Invisible Illness Week came to a close.  Here's my edition of 30 Things About My Invisible Illness You May Not Know.

   1. The illness I live with is: type 1 diabetes
   2. I was diagnosed with it in the year: 1986
   3. But I had symptoms since: the summer before
   4. The biggest adjustment I've had to make is: adjusting to the changing demands of a disease that doesn't sit still for even a second.
   5. Most people assume: that diabetes isn't a serious disease. They couldn't be more wrong.
   6. The hardest part about mornings are: when the start out of range.  Or with a cat on my head. 
   7. My favorite medical TV show is: I actually don't like medical TV shows.  I'd rather watch Family Guy.
   8. A gadget I couldn't live without is: my glucose meter.
   9. The hardest part about nights are: having low blood sugars in the middle of them.
  10. Each day I take 2 pills & vitamins: I take a prenatal vitamin, blood pressure medication.  And then there's that whole "insulin" thing 24/7.
  11. Regarding alternative treatments: I think that insulin is the only course of treatment that works for type 1 diabetes right now.  But I believe that an overall healthy lifestyle is important, regardless of someone's medical history.
  12. If I had to choose between an invisible illness or visible I would choose: These choices suck.  I'd rather not have any illness, thank you very much.
  13. Regarding working and career: I work.  And I have a career. And I'm finally making diabetes work for me, instead of against me, in a financial sense.
  14. People would be surprised to know: that it's not as easy as we make it look.  Sometimes it hurts in every way.
  15. The hardest thing to accept about my new reality has been: that I have no memory of the "old" reality.
  16. Something I never thought I could do with my illness that I did was: get married.  I'm not sure what put the thought in my head as a child, but the doctors scared the pants off my family and I when I was diagnosed.  They had us convinced that I might not be healthy as an adult, and that I may be "hard to love."  Pfffft.
  17. The commercials about my illness: are never about MY illness.  They are always about type 2 diabetes.
  18. Something I really miss doing since I was diagnosed is: I have no idea - um, I'm sure I liked Halloween more before I was diagnosed, in second grade. 
  19. It was really hard to have to give up: hoping for a cure.
  20. A new hobby I have taken up since my diagnosis is: ... these questions are hard because my diabetes has been in the game for almost all of my life.  I don't know what new hobbies I picked up in 1986, but you can bet that there weren't any hobbies I avoided as a result of being diabetic.
  21. If I could have one day of feeling normal again I would: do nothing.  That would be awesome, to just sit around and hang out, without worrying about a single number.
  22. My illness has taught me: to be strong.  And to be realistic.
  23. One thing people say that gets under my skin is:  "That's not a big deal. It's better than __________"  You know what?  It is way better than a lot of things.  But that doesn't make it any less hard some days.
  24. But I love it when people: really try to understand, and see me as a person, not just as a diabetic.
  25. My favorite motto, scripture, quote that gets me through tough times is: "This, too, shall pass."
  26. When someone is diagnosed I'd like to tell them: that they aren't alone.  And they'll be okay.
  27. Something that has surprised me about living with an illness is: that it's not the definition of who I am.  It's just a small part of the bigger ... problem person.  ;)
  28. The nicest thing someone did for me when I wasn't feeling well was: leave me alone. 
  29. I'm involved with Invisible Illness Week because: if we don't raise our voices, we remain invisible.
  30. The fact that you read this list makes me feel: ... like you might post your own list. 

Get involved with Invisible Illnes Week and let people know that just because you can't see it doesn't mean it isn't there.  And have a great weekend!

Posted by Kerri Morrone Sparling at 03:02 PM | Permalink | Comments (8) | TrackBacks (1)

I didn't check my pump before I left for work yesterday morning.  Not a big deal - I live close to work and I have back-up supplies at my office anyway, so there wasn't much I couldn't pinch hit for.  When the day started, I had about 20 units left in my pump to get me through to 5:30 pm.

No problem.  I'm using about 16 throughout the course of a day at the moment, so I wasn't worried about running out.  I went to work and did my thing.

But I forgot about our editorial dinner plans after work, taking place at my coworker's house, located about 40 minutes away.

And I also completely blanked when I went home for lunch because I was so hungry and so distracted by what I was working to finish before deadline at work that I neglected to refill my pump reservoir.

And I also was so elated by a freelance opportunity that came in late afternoon that I ended up racing out of the office, en route to dinner, without grabbing the insulin pen from my desk drawer.   

So I'm in the car.  Driving up to dinner.  With six units of insulin in my pump. 

"We're having apple crumb cake for dessert!" said my coworker's excited email.

I am Kerri's perfect storm of stupid.   

A few things were working in my favor:  the Dexcom had me flatlining, for over three hours, at 98 mg/dl.  I also had enough insulin in my pump reservoir to draw out a unit or two with the syringe I keep in my insulin case.  So there were options.

I didn't panic.  I just thought I'd lay low, eat conservatively, and ride it out until I got home and could change my pump.

Throughout dinner, I kept a close eye on the Dexcom and tested every 30 minutes or so to confirm.  But after a dinner of vegetables, chicken, and delicious rice, I saw the graph starting to spike a little bit.  Not crazy, but edging towards 150 mg/dl for the first time that day.  I avoided the crumb cake.  And knowing I had very little insulin left after dinner (only 0.3 retrievable units), I started to get a little anxious.

So I reached into my kit for that syringe.  

Which wasn't there.  

I am a maelstrom in Kerri's perfect storm of stupid.

In an idiotic move, I waited.  And then, about an hour later, went into the bathroom, removed the insulin cartridge from my pump, and stuck my pinky finger into the end of it to press more insulin into the tubing.  I've done this a few times when desperate, and knowing I had about an hour before I'd get home, even if I left right then, made me willing to take the foolish risk.

Another 30 minutes went by.  My numbers hit 177 mg/dl and stalled there, which made me think it was going to be okay.  I left my coworker's house and drove back home.  Once I got home, I switched out my pump immediately and then relaxed for a little bit.  Numbers were steady-ish, but nothing that made me jumpy.  

"Oh, starting to dip a bit."  The Dexcom said I was 101 and falling, and my meter confirmed with an 81 mgm/dl.  "I'm going to down a swig of juice and a kiwi before bed."

Chris:  "Why are you talking to yourself?"

Me:  "Because ... I don't know.  It's expository for the blog post, I suppose."

Chris:  "Okay."

Right before bed, I was 111 mg/dl, steady Dexcom, and feeling okay. So I went to sleep.

What makes this perfect storm of stupid particularly ... stupid is that my move in the bathroom with the unmeasured bolus was a disaster.  I had no idea how much insulin I'd taken, and I only knew some made it into my skin because of the little pinch I felt.  I could have taken one unit, four units ... or who knows how many.  But I'm obsessively stalking these highs and I was willing to take the risk.  Which wasn't smart at all.

Because at 2:51 am, I woke up completely drenched in sweat, my tongue a deflated balloon in my mouth, and panic buried underneath my exhaustion.  A full glass of juice, a concerned husband, a messy Kerri, and a prowling, yowling Abby.  A blood sugar of 38 mg/dl a few minutes after downing the grape juice. 

A perfect storm of stupid.

Preparation can't be overemphasized.  When your pancreas doesn't make it's own insulin and you're relying upon external sources, and when every food excursion depends on your careful calculation, winging it can cause problems on either side of the scale.  And all the lectures and blog posts and well-intentioned moments can't replace good, old fashioned stupid human behavior.

I am Kerri's hairdryer, running at 3 am because the sweat from the low was so copious and nasty.  I am Kerri's low blood sugar walk of shame.  I am speaking in third person because I'm so beat down tired today.

Diabetes, dude, you are The Suck.    

Posted by Kerri Morrone Sparling at 10:02 AM | Permalink | Comments (26) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 09:01 AM | Permalink | Comments (76) | TrackBacks (0)

Taking a cue from Rachel and Cherise, I wanted to post my diabetes "bad habits."  (Unfortunately, it didn't take long to come up with six.)  But thankfully, after months and months of extreme tweaking, my bad habits aren't nearly as bad as they used to be.

1.  Bolus-Stacking.  (See also:  rage bolusing)  I have a very, very bad habit of stacking boluses when my blood sugar is high.  You know ... test and see that 212 mg/dl, take  two units to correct it back to 100 ... test again 45 minutes later to see 245 mg/dl staring back at you ... freak out and take another unit for good measure ... test one more time an hour later to see no real change ... lace in two more units because you're angry and frustrated and sick of the high ... only to crash five hours later with a 45 mg/dl with your face mushed into a can of Pillsbury frosting.  Not that I've done that. But if I were to do that, it might play out just like that.

2.  Carb Winging It.  Until recently, I've been an estimator.  A SWAGger (scientific wild-ass guesser).  Someone who kind of wings the whole carb-counting thing and hopes that there were only about 15 grapes in that snack bag or that the apple was really "small" instead of "medium."  With the little weeny doses of insulin I take, counting carbs with precision is crucial to making sure my numbers stay stable, so when I'm guessing as to the carb count, the blood sugar results go all over the place. 

3.  Shooting with a Mouthful.  This is a bad habit pointing out by my endocrinologist a few months ago, and one that was wicked hard to break.  And I have no idea how I ended up in this terrible habit to begin with, but it's not good.  I had a terrible tendency to start eating, then decide to bolus.  Even if the carbs were counted perfectly and the insulin dose went in without issue, I wasn't giving the insulin any time to act before introducing the carbs.  Thus, making my numbers go berserk after meals.  No more shooting while I'm eating. Now I need to shoot up before eating.  Makes a big difference. 

4.  Self-Consious During Workouts.  Another bad habit.  When I go to the gym, I used to leave my insulin pump at home and then reconnect when I returned.  It worked out to keep me from going low during workouts, yes, but it was also because I didn't like having the device attached to me while I was wearing form-fitting workout clothes.  Stupid Kerri.  Sure, I was avoiding the lows, but I was also ending up close to 180 mg/dl by the end of my workout.  With pre-pregnancy goals of 150 or lower, this is unacceptable.  So I have to suck it up and wear the pump while I exercise and even sometimes go easier during a workout to avoid lows, instead of sacrificing blood sugar control for an extra mile on the treadmill.

5.  Log Lagging.  I have a good habit of starting logbooks, but a terrible time keeping up with them.  This has been a hard habit to break (habit to break), but I'm close to turning it around.  Logbooks are my diets - I am excellent at the outset, but then I fall apart.  Thankfully, I've got a team at Joslin and a husband at home who are helping keep me accountable, and it's making a world of difference.

6.  Blame Game.  And a sixth (but certainly not the last) bad diabetes habit that I have is my role in the blame game.  I put a lot of pressure on myself to get things "right" and when the diabetes outcome isn't what I'm hoping for, I tend to blame myself.  I have to constantly remind myself that strong efforts and a decent attitude go a long way in this marathon, and I can't beat myself up for every low or high that crops up randomly.  Diabetes isn't fair, and it isn't easy, and it sure as hell isn't my fault, so I just need to roll with the punches as gracefully as I can.

What are your diabetes bad habits?  Or maybe it's better to ask - what are your good diabetes habits?  I'm going to have to concoct another "good" list soon - they're way more fun.  :)

Posted by Kerri Morrone Sparling at 10:15 AM | Permalink | Comments (24) | TrackBacks (0)

I did it. 

I started my mission while we were on vacation in Barcelona, because between the time change and our eating schedule and the fact that sleep was a hot commodity, it was a good time to let go of the caffeine addiction.  No real withdrawal, no extreme headaches, and no unrighteously sassy moments where I can't function "WITHOUT MY CUP OF COFFEE DAMNIT!" 

This is a big step for me, because coffee and I were buddies.  

Bestest pals.

Friends all day long.

But now, I have a new pal.  Someone who can still be part of the collection of stupid iPhotos that the editorial team snaps every few days. (These photos are known as the Friday Face-Off, where we take one photo to emulate, like this one (my version) or this one, and we all recreate it ourselves, then paste them together as a college.  My favorite so far was when we all tried to look like my chubby-cheeked niece.  But I've once again digressed.  Ignore me.) 

My new pal is decaf, and I have embraced the change.  The coffee shop downstairs makes a mean iced decaf coffee, and just a short walk away from my office is a fabulous graham cracker flavored coffee that comes in delicious decaf.  I am finally weaned off the caffeine, but I still get to enjoy the taste and the "coffee runs" that are part of the social routine in my office.

It's nice to feel free.

It's also nice to not drink so much coffee that my fingertips actually jitter to the point where I can't type a sentence without mangling most of the words.

FutureBaby, I hope you appreciate this.  Because it was HAAARD.  But I know it was worth it.

Posted by Kerri Morrone Sparling at 12:23 PM | Permalink | Comments (20) | TrackBacks (0)

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.

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.

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.) 

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? 

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: 

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!!) 

Posted by Kerri Morrone Sparling at 09:31 AM | Permalink | Comments (41) | TrackBacks (0)

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.

Posted by Kerri Morrone Sparling at 10:22 AM | Permalink | Comments (27) | TrackBacks (0)

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 my 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.

Posted by Kerri Morrone Sparling at 10:15 AM | Permalink | Comments (39) | TrackBacks (0)

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:

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:

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!)

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.

Posted by Kerri Morrone Sparling at 10:49 AM | Permalink | Comments (12) | TrackBacks (0)

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. 

Posted by Kerri Morrone Sparling at 10:44 AM | Permalink | Comments (39) | TrackBacks (0)

The catalyst that brought me to BlogHer was a conversation back in October 2008 with Lisa Stone.  Lisa and I met at the BlogHer Outreach event in October and I talked with her about the patient blogging community and how we're truly changing our health outcomes through blogging about our illnesses and connecting with others.

Fast-forward to July 2009, when the PatientBlogging panel debuts at BlogHer, with Jenni Prokopy, Loolwa Kazoom, Casey Mullins, and me on deck as panelists, with Mr. Lady as our moderator.

I will admit to being very nervous before this panel, because it's one thing to write online behind the protection of a computer screen - another thing completely to speak candidly before an audience about our personal health issues.  But sitting there, in front of people who actively sought out the PatientBlogger panel, and elbow-to-elbow with some terrific patient bloggers, I felt like it was almost instantly comfortable once the discussion started.

(It helped that my fellow medbloggers Rachel, Lee Ann, and Kim were right there in the front row.  Familiar faces ease nerves!) 

The PatientBlogging Panel at BlogHer '09.  For some reason, I'm not smiling.  But I was v. happy.

Jenni opened up by talking about the highs and lows of patient blogging, including the notion of being defined by our diseases.  Easy for me to chime in there - "That's actually the tagline of my blog, and I think it's important to remember that diabetes is definitely a part of me, but it's only one part of me.  I'm also married, but that doesn't mean I'm only someone's wife.  There are many, many parts to the whole.  Diabetes is just a part of me."

We talked about what it was like to connect with people who "get it."  About connecting both on and offline with people who share our experiences and sharing best practices while making it clear that we aren't offering medical advice.  

"Big, fat disclaimer, guys."  I kept repeating myself, when asked how we deal with people thinking we're offering medical advice.  "It's not medical advice.  We aren't perfect. Just because we’re patient-bloggers and we’re writing about our illnesses, it doesn’t mean we’re awesome at managing them. I’m writing about diabetes every single day, I’ve been diabetic for 23 years, and I don’t have perfect blood sugar results.”

Loowa talked about her experiences with chronic pain, and how she battled the healthcare system to get the care she rightly deserved.  As a panel, we chimed in with our similar stories of what being a patient in this healthcare system is really like, from Casey fighting for insurance coverage for injections that would preserve the positive outcome of a previous surgery to Jenni talking about how her condition (fibromyalgia) isn't even recognized as legitimate by the medical field at large.   

It was like being in someone's living room, having coffee, only we were miked and people in the audience raised their hands to ask questions.  But it was intimate.  Comfortable.  We, as a group, were protected within that room.  People spoke their minds, and let themselves cry, without fear.

So much that Ree of the Hotfessional boldly took the microphone, introduced herself, at at the gentle urging of Mr. Lady (okay, Mr. Lady offered to make out with her but work with me on this, I'm in the moment), pulled off her wig and exposed her beautiful bald scalp to the room.  "I look like I have cancer, but I don't."  Ree lives with alopecia and despite her assertion that she doesn't experience "symptoms" of her illness, she is a professional woman in a professional environment, dealing with being bald as a woman.

"No one has seen me without this, except my husband and my children."  She was crying, along with almost everyone else in the room who was watching her in awe.  "The way you react mentally to your life with your illness is your own business, but putting it out there, you will get the support you want.  It will do wonderous things for you."   

Sometimes it's hard for us to blog about our diseases.  It can be really emotionally intense to log on to your blogging platform and post, for the whole internet to scrutinize, the real struggles we experience as we live with chronic illness.  Sometimes readers lash out and attack us for our opinions or our care regimen.  Sometimes we are forced to have thicker skin than we'd like.

But sometimes blogging about our conditions is what gets us through the day.  Sometimes it's the email from someone saying, "Hey, me too," or "You helped me feel stronger today."  Sometimes it's the comments from people who really understand what it's like to live with these diseases.  And sometimes it's simply knowing we aren't alone.  And that we never have been alone.

And now, with the support and love of our communities, we never will be alone again.

Patient blogging ... that's some powerful stuff.  This was an inspiring experience, I'm honored to have shared this panel with such inspiring women, and I'm humbled to be part of this incredible community.

Posted by Kerri Morrone Sparling at 10:18 AM | Permalink | Comments (14) | TrackBacks (0)

I have a lot to catch up on, including a post about Lee Ann and I braving the Indiana highways and then the BlogHer conference, but let me just say this first:  I like Charlie Kimball.  I like him as a person, as a fellow diabetes advocate, and as a race car driver because, really, that is just damn cool.  So there's my big disclaimer:  I like Charlie.  (I even have a post ready to write about meeting up with him at Friends for Life a few weeks ago.)

So I do not like to see Charlie, the guy, under such attack for the @racewithinsulin Twitter account.  Plenty of bloggers are up in arms about the Novo/Kimball union and its steps into social media, like John Mack from the Pharma Marketing Blog.  I felt a little protective of my fellow PWD, which prompted me to do a little investigating.  I wanted to know how Novo, the company, feels about this whole Twitter/marketing/Pharma thing.

So I asked them.

She agreed to answer my questions.  And since Novo is the first I can think of to jump in with a pharma-branded Twitter account with a "real face," I wanted to hear the answers.  (Note:  All links to pages within the answers were added by me.)

Kerri:   Charlie is a valued member of the diabetes community, so I can understand why you guys chose to partner with him. But what made you decide to start a Twitter acct?  

Novo:  When we decided to partner with Charlie, we explored a number of different opportunities. He was already "tweeting" personally, however, when he asked about tweeting about our partnership, which includes the insulin he takes everyday, Levemir and NovoLog, we knew had to figure out a way to do it right. We didn't think it was right to ask him to put the prescribing information on his page and monitor every time he tweeted about diabetes. So we created a new account that we could ensure met all regulatory guidelines. Why Twitter? He was already doing it, so we wanted to create something that would easily fit into Charlie's lifestyle.
 
Kerri:  Why are Charlie's personal Tweets and his Levemir Tweets exactly the same?  
 
Novo:  It's important to understand that Charlie does all of the tweeting, both on his personal page and on the Novo Nordisk Race with Insulin page. It's up to him. They aren't always exactly the same, but where convenient and appropriate, he uses the same tweets, as it's probably easier to copy and paste. There are times when the tweets are different.
 
Kerri:  Does Charlie write the Levemir Tweets or is there an editorial vetting proces? Can you explain the thoughts behind the "branded" Tweets?  
 
Novo:  Charlie writes all of the tweets, including the Levemir and NovoLog branded tweets.  We provided him with instruction for how to tweet about the brands and comply with pharmaceutical regulations. So, anytime he tweets the words Levemir or NovoLog, a link to the product prescribing information has to be included.
 
The reason? Take a look at the page from your computer. You see the patient safety information on the left, along with a link to novonordiskcare.com on the right, which contains all of the prescribing and other important information. The challenge is, because the majority of Twitter users read and update their accounts from mobile devices, we knew most people would not see that information if Charlie wrote a tweet. That's why the prescribing information is there. It's required. It's similar to when a company does any stand-alone promotion of a product, that information has to be there.
 
More importantly, it's important to understand that the branded tweets aren't random. Charlie takes Levemir and NovoLog, so when he decides to tweet that he just took his insulin, he really just did. We don't believe a pharmaceutical company has tried to do branded tweets before, much less with a spokesperson who takes the insulin. But we're still learning and trying to figure it out. It's been a fun and definitely interesting time.  
 
Kerri:  Why doesn't the @racewithinsulin Twitter acct follow or reply to anyone? What kind of regulations must be in place for a Twitter acct of this kind?  
 
Novo:  While Charlie is the face of Race with Insulin, it is a corporate account for Novo Nordisk.  At this time, we aren't able to follow anyone, as pharmaceutical usage of social media is very regulated and we want to ensure we do it right. This is just the first phase and as we grow and learn, hopefully we will be able to follow people in the future. We are also open to suggestion.

After speaking to you, we took your advice and set up an e-mail address for the page. (Editor's Note:  I suggested that the account would seem a bit more accessible if they, at the very least, had some contact information.)  You should see an image update in the next week with the new address. But as I know you know, social media moves in real time and we haven't quite caught up to that speed in pharma. We're making baby steps but we're trying to stay in the race.
 
Kerri:  We know you guys are breaking new ground with this Twitter account, so what should we expect as part of your growing pains?  
 
Novo:  We're still learning. We want to do a lot, but we also understand that the pharmaceutical industry is the most heavily regulated in this country. We won't be able to do things as easily as say computer or food companies, but you have our commitment that we do plan to try to engage. Stay tuned.  
 
Kerri:  How has Novo felt about the blog backlash to @racewithinsulin, and how has Novo moved to protect themselves and Charlie?  
 
Novo:  If no one talks about what you do, you probably haven't made much of an impact. That said, it would be nice if the talk was all positive and more importantly, true. We encourage people to ask questions and give us an opportunity answer. We're pretty transparent about our challenges and open to discussion about any ideas to make it better. There were some false assumptions gaining traction, but that's also the nature of this business. You can never please everyone, but you can only hope that social media will adopt some of the principals [sic] of traditional journalism and report the facts, before making assumptions. We're working to move quicker to respond but also encouraging anyone to just ask. As for Charlie, he has been great. He's in a profession where he already has a lot of attention on him and is working with us to help make the page a success.

Kerri:  What do you want the Twitter community to understand about the aims of @racewithinsulin?
 
Novo:  We are very happy to be working with Charlie and wanted to reach as many people as possible. Twitter was an application that Charlie was already using and we wanted to find a way where he could continue to do so and incorporate our relationship.

It's still new and we're just getting started, but we hope to continue to find new, innovative ways to continue to reach everyone with his powerful message that diabetes does NOT slow him down!

*   *   *

I'm glad Novo went out on a limb and dove into the social media space, and I'm also glad that they agreed to answer my questions.  Thanks, Ambre!  What are your thoughts about Pharma in the social networking space?  Don't just say "Hey, they're doing it wrong!"  If you think it's so wrong, what would make it right? 

Posted by Kerri Morrone Sparling at 09:22 AM | Permalink | Comments (6) | TrackBacks (0)

Wait, what's that?  You want to see pictures?  Oh hell yes I have pictures.

This event offered more than interaction with a seemingly open-minded Pharma company.  This event gave me the opportunity to meet and reunite with some of my favorite bloggers in the diabetes space.

Here's the standard shot that the crew at Roche took of all of us.  We look downright jolly.

There are plenty of wonderful people I finally connected with, but without formal photographic evidence.  Like Will from Life After DX, who I've been reading for years and am always inspired by.  And Bernard (spelled Bernard) from The Diabetes Technology Blog, who I should have met years ago but until this past week, had never had a chance to hug in person.  I had the honor of meeting Crystal (aka CalPumper), Christopher Thomas, Chris Bishop, Ginger Viera, and Brandy Barnes for the first time, too.  And there were also the several bloggers who I have had the pleasure of meeting before, like Fran, Amy, Manny, Christel, Scott Strumllo, LeeAnn, SuperG, Scott King, Kelly, Jeff, Gina, Riva, Kelly Close, Allison, and Bennet.

Also, my old friend Sandra Miller was in attendence, representing with Bennet Dunlap (again, I know!) and Jeff Hitchcock as the parents of children with diabetes.  David from Diabetes Daily was also there, on behalf of his wife Elizabeth (who is type 1).  Charlie Cherry and David Mendosa represented for the type 2 crew, and Kitty Castelinni stood as one of the few recipients of a pancreas transplant.

So we all met up. 

And goofed off.

It was a true potluck of diabetes bloggers, representing from all sorts of different demographics.  Unfortunately, there were several bloggers who were missing from this group, and I'm hoping - no, damnit, I'm demanding - that there is an invitation sent to more members of our influential blogging family for any future meet-ups.

These people are my friends.  They're the people who understand what living with diabetes is really like, and they are the external support network I have been hoping for since my diabetes diagnosis in 1986.  So thank you to Roche for giving me the opportunity to say hello to, and hug warmly, the people in this community that I cannot wait to see again.

More of my photos are in Flickr, and there's also a D-Blogger Summit photo pool where you can grab the best of the shots!   

Posted by Kerri Morrone Sparling at 09:53 AM | Permalink | Comments (11) | TrackBacks (0)

You have already read some great wrap-ups of the Roche Diabetes Blogger Summit from some of my fellow bloggers - Amy, Manny, David, Gina, Christopher, Bennet (Note: Mr. YDMV's updates are fictional.  Well, mostly.), and Sandra.  I just wanted to chime in with my thoughts and add my photos to the collection.  :)

We met up in Indianapolis on Wednesday afternoon, after I had flown from LaGuardia to Detroit and then to Indianapolis.  (Yes, I took two flights so that I could avoid taking the itsy bitsy plane that Roche originally had scheduled me on.  The travel people at Roche were very patient and understanding regarding my travel issues, and I really appreciate their compassion.)

But apparently my fear of flying wasn't kept within the travel coordinator circle, as several people from Roche mentioned at the dinner that "Some of us even traveled despite our fear of flying," and heads slowly turned towards me, to which my only xanax-laced response was "I walked."  

Good thing I don't mind being laughed at.  Or with.  More on that later.  

I'm no fool - part of what Roche wanted was to be talked about in the blogs.  Hence why they asked many of the diabetes bloggers to visit their headquarters and brainstorm about social networking and Pharma involvement.  But Roche did this right - they paid for our travel, they paid for our hotel, they made us feel as though we were valued guests, and they listened when we offered our opinions.  We didn't travel on our own dime and feel taken advantage of, but instead appreciated.  That's a good start, in my book. 

It was really a groundbreaking sort of event, with Roche having the balls (go ahead and quote me on that, Rodger the Social Media Warlord) to invite a pack of opinionated bloggers into their house to talk frankly about social media and Pharma - specifically, THEIR Pharma.  We talked about ways that Pharma can appropriately enter the social media space without being received by a mob with torches and pitchforks.

In my opinion, Pharma needs to simply embrace the fact that transparency, honesty, and being open to feedback can make a huge difference in how they are perceived by their patient base.  For Roche to sign on to a social networking site by creating a fake profile or pretending to actually live with diabetes, well that's just plain stupid because we'll sniff them out in a second and destroy them.  However, if Roche, or any other Pharma crew, is willing to put a face to their company and leap into social media by saying, "We aren't living with diabetes, but we want to help improve the lives of people living with diabetes - that's why we are here and that's why we want to be engaged" ... that kind of disclosure and transparency will go a very long way.

I gave the example of Albert Chen, a member of the Agamatrix team who, with grace, honesty, and class, joined the diabetes blogosphere with his blog "What Is Diabetes?"  He said, right in his bio, that he didn't have diabetes, but wanted to better understand the community he was working to serve.  That, Pharma companies who are reading this, is the way to work with the diabetes online community.  Get to know us.  See that we are more than just the sum of our co-pays.  Remind us that Pharma has a face, and more importantly, that you remember we are people, too.  

The Roche team didn't always directly answer the questions, but I can understand that "Why aren't strips cheaper" isn't a question that they can answer without sounding like a business.  However, they need to understand, and always remember, that their business is our life.  So while that chasm remains wide, I think this was an important step in beginning to bridge that gap.

Posted by Kerri Morrone Sparling at 09:14 AM | Permalink | Comments (7) | TrackBacks (0)

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. 

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."  

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.

Posted by Kerri Morrone Sparling at 08:55 AM | Permalink | Comments (10) | TrackBacks (0)

Like I wrote a few weeks ago, "Even though I do not like the disease, there are some diabetes-related simple pleasures that make me smile." 

But on the flip side of that, there are some diabetes-related things that make me grimace.  (Not Grimace, but grimace.)  And when I'm feeling down about the hard parts of managing this disease, I often turn to humor to lift me back up.  (For me, a little gallows humor goes a long way in keeping me from really falling into a depressive state.  It seems like a counterproductive idea, but it really helps me.)

This is where Haidee Soule Merritt's book comes in:  One Lump or Two?  Her book more than resonated for a 20+ year diabetes veteran like myself.  It's taken me a long time to build up this much amusement at a disease that's trying its hardest to take me out, but now I'm in the thick of the smirking-despite-the-chaos.  

As I read through her book, I laughed.  I laughed and nodded my head in agreement, thinking, "Oh hell yes, I hate those geyser fingerpricks."

Who hasn't this happened to?  (Image credit:  Haidee Soule Merritt)

Been there.  Done that. (Image credit:  Haidee Soule Merritt)

Diabetes isn't easy.  Neither is laughing at it.  But laughter, finding something that alleviates some of the anxiety and fear that comes with a chronic illness, can make such a huge difference in health.

If you want to order your own copy of Haidee's book, visit her website (and enjoy the duck sounds on the buttons, because they quacked me up).  As you thumb through your copy of One Lump or Two?, you'll find yourself smirking with understanding, too.    

Posted by Kerri Morrone Sparling at 11:40 AM | Permalink | Comments (11) | TrackBacks (0)

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 gulping 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.  

Posted by Kerri Morrone Sparling at 10:04 AM | Permalink | Comments (21) | TrackBacks (0)

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.

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

Posted by Kerri Morrone Sparling at 09:02 AM | Permalink | Comments (14) | TrackBacks (0)

I'm often asked about why I chose the Dexcom CGM over the Minimed, and I have plenty of posts here on SUM that talk about my experiences with the two devices:

• Trialing the Dexcom.
• Trialing the Minimed.
• Opinions on the Minimed CGM.
• Deciding on Dexcom.

And then fighting for insurance:

• Deciding to Do Battle.
• Appealing Once.
• Appealing Twice.
• Appealing Three Times.
• External Appeal.
• WINNAH!

And after I had won insurance approval, Dexcom and I joined forces:

• Dexcom Disclosure.
• Even though I still talk freely about the Dexcom Pros and Cons.  :) 

Phew!  But part of even starting this process was wanting to go on a CGM to begin with.  I'm often asked about the different continuos glucose devices and pros and cons of each, I get just as many questions as simple as this:  "What made you ready to go on a CGM in the first place?" 

I know that for going from injections to pump therapy, I was frustrated with the lows that were happening three times a week, and how my ex-boyfriend was constantly finding me motionless in the bed at 4 am, covered with sweat.  After 17 years of injections and after two years of an A1C that wouldn't budge, I made the decision to use an insulin pump.

After deciding to wear one medical device, it was easier to try another one.  A few years of pumping made me feel comfortable with the 24/7 attachment of a diabetes device, so when the continuous glucose monitors became more prevalent on the scene, my interest was piqued.  At the time, I was in a serious relationship, thinking about having children in the future, and realizing how my blood sugars still weren't running better, despite my increased education and effort.  It was time to try something a bit different.

With a CGM of any kind, there's a certain security that comes with it.  I feel more confident speaking at events when I can look at the graph on my CGM and see that I'm holding steady.  Same for getting in the car for long drives, or on a plane for a few hours.  After twenty plus years of only having snapshots of what my numbers were like, I now have access to the streaming video, so to speak, of continuous monitoring.

Yes, there's also the "Hey, you're a robot" component to this.  I can't lie.  When I look at my body and I see all these things stuck to me, in addition to the red dots of diabetes devices past, I feel a little overwhelmed.  But it's part of living with this disease. (Most of the time, I'm able to shake off the robot feeling and just let Chris call me Rosie.  Whoops - there's the digression.)  I actually feel okay with wearing two medical devices.  It's sometimes cumbersome and inconvenient, but for me, the pros outweight any cons.  I hear a lot of bad news about diabetes, about how this many years with type 1 can really cause a landslide of issues, about how life can be compromised.  And I don't want that. 

Regardless of what happens in my future, I want to make every effort to be as healthy as I can, both mentally and physically.  And I'm ready to keep trying.  That's why I blog.  That's why I raise awareness.  That's why I pump. 

And that's why I wanted a CGM.

Posted by Kerri Morrone Sparling at 10:44 AM | Permalink | Comments (17) | TrackBacks (0)

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?

Posted by Kerri Morrone Sparling at 08:43 AM | Permalink | Comments (9) | TrackBacks (0)

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.

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

Posted by Kerri Morrone Sparling at 10:24 AM | Permalink | Comments (41) | TrackBacks (0)

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.

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.)

Posted by Kerri Morrone Sparling at 09:20 AM | Permalink | Comments (11) | TrackBacks (0)

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.

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."

Posted by Kerri Morrone Sparling at 11:03 AM | Permalink | Comments (17) | TrackBacks (0)

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:

Posted by Kerri Morrone Sparling at 09:20 AM | Permalink | Comments (55) | TrackBacks (0)

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.  

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. 

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

Posted by Kerri Morrone Sparling at 11:02 AM | Permalink | Comments (20) | TrackBacks (0)