I'm picking my priorities, petal by petal.

I'm choosing to wear this Dexcom and adhere another site to my body.  I'm choosing to have the beeps ring out and scrape against the walls of my office, letting everyone know I'm out of range somehow.  Sometimes the site doesn't bother me, sometimes it itches a little bit.  Depending on where it is resting, either on my arm or on my lower back, I sometimes see it in the mirror and am reminded of what I'm trying to accomplish.

I'm choosing to test my blood sugars and log the results regularly these days, even though keeping a log book goes against what appears to be my internal wiring.  I've always been challenged by keeping track of blood sugar numbers, even though just looking at a few days' worth of numbers really does help me isolate patterns.  I'm building a binder, and it's a pain in the arse, but I'm hopeful that tighter numbers will be the result.

I'm choosing to laugh at the things that hurt me.  When the infusion set hits a nerve as it goes in or when my CGM site bangs against the doorjam, I try to embrace my inner Yosemite Sam instead of letting the pain get to me.  Making this choice makes me hop around like a rabid bunny sometimes, and eventually gets me giggling, but it's better than feeling angry.

I'm choosing to go to the gym after work every weeknight.  I do not like the impact this has on my free time, and I don't always like the actual sweating part (oh how I hate to sweat), but I need to keep my heart healthy and my body strong ... and it helps clear my head a little bit, too.  So even though this hour and a half is something I want back at times, I know this choice is worth it.

I've chosen to limit my commitments these days, because over-extending myself leads to stress patterns that make my brain melt.  I'm stoked to do NaBloPoMo, but I've ducked out of doing NaNoWriMo this year.  I'm working at dLife and freelancing, but I'm being careful not to plan to be in fourteen different places at once.  I've decided to stay home in CT some weekends instead of making the long drive back to Rhode Island.  Peace of mind goes a very long way for me, and I'm making the choice to stay a bit more stable. 

Life gets busier and busier every time I blink, and I know it's not just me.  Everyone seems to have a side business they're cultivating, or organizations they're volunteering for, or events they're coordinating.  Life is blasting forward at a breakneck pace and we, as members of this community, have that added bonus of diabetes to manage in conjunction with everything else.  I'm trying hard not to get sucked into the stressful chaos of accomplishing everything, and instead giving a go at managing life petal by petal. 

Posted by Kerri Morrone Sparling at 03:13 PM | Permalink | Comments (8) | TrackBacks (0)

Anyone who hasn't been storing their brain in a shoebox underneath the bed has probably realized that the economy is tanking.  People are being laid off and positions are being eliminated at companies.  Grocery money doesn't seem to buy as much now as it did even six months ago.  Gas prices, despite the fact that they've fallen a bit in the past few weeks, are still just under $4.00 a gallon. 

But these are issues that are affecting all families across the nation.  For us, diabetes care can also be affected by the crumbling economy.  My brain tends to go into panicked little pockets when I think about the economic situation.  For me, a job means more than just money - it's medical insurance.  Even now, in good health and without any outstanding medical bills, my monthly medical expenses add up.  From co-pays on items like blood pressure medication and birth control pills to the non-prescription items like prenatal vitamins and healthy food, it can get expensive. 

I was thinking about money in my budget that I consider well-spent, like my monthly membership to the gym and our grocery bill.  For some, spending $30 a month to workout and spending an inordinate amount of money on foods like fresh produce, organic products, and other fancy crap that they sell at Whole Foods and Trader Joes may seem like money that could be saved.  But when it comes to diabetes management, "control" is more than just the pump I'm using and the insulin I'm taking - it's about all these other variables, too. 

I remember (let's step into the Wayback Machine again, shall we?) test strips that could be cut in half, or into thirds, and at least the gist of a blood sugar level could be grabbed by comparing the color of the strip pad against the guide on the side of the bottle.  Granted, today's strips are more accurate, but are they really costing manufacturers $0.85 apiece to make?  (Because that's about what they charge us, as consumers.)  Diabetes supplies used to be able to go further.  Now they are indeed more accurate, but they don't go very far at all.  And keeping up with the costs of this maintenance, in addition to making attempts at important, preventative care like a CGM, is starting to make me a little nervous.  I'm finding my mind going back to the desire to wear infusion sets past their three-day shelf life and refilling reservoirs, to help extend the life of my supplies.  Ridiculous?  Yes.  But when I'm thinking about other life expenses - car payment, rent, utility bills, gas prices, and the occasional movie or night out - I find myself cutting corners where I can.

What are you guys doing to get the most bang from your diabetes buck?  Are you streeeeeetching out the life of insulin pump supplies?  Are you trying to gain insurance approval for a CGM as a way of conserving test strips?  Do you find yourself debating between paying for gas or renewing your gym membership?  The decisions are tough now, and I fear that they may be getting tougher in the future.  (And have you seen the Twitter election feed?  Regardless of who you're supporting in this election, this constant streaming commentary is pretty fascinating.)

The price of good diabetes control is high, and the cost of not trying to stay healthy is even higher.  How are you managing the cost of care?

Posted by Kerri Morrone Sparling at 11:08 AM | Permalink | Comments (20) | TrackBacks (0)

There's a lot of buzz in the blogosphere today about insurance denials and appeals, starting with an article in the Wall Street Journal about "Pushing Back When Insurers Deny Coverage For Treatment."  Scott Strumello brought this article to my attention this morning via his comprehensive blog post about it, and Bernard sent me there again with his perspective.  And after reading everyone's take, in addition to having experienced three denials for CGM coverage from my insurance company (Oxford Health), I realize that I have gone at this problem the wrong way.

Insurance companies don't care about my future baby.  They don't care about my A1c.  Unfortunately, insurance companies are watching dollars and cents, not good sense.  A passionate letter from a patient doesn't even come close to moving an insurance company to provide coverage or overturn an appeal.  They seem to respond to "the facts" only, and I should have attacked them with facts to begin with.  Instead, I took the personal approach, which left me denied three times.  And it's partially my fault because I expect them to care, even when I know they won't.  My approach was arrogant, thinking they'd respond to actual emotion.

But this time?  No emotion at all.  This appeal was just the facts, ma'am.

I sent the Connecticut Department of Insurance a packet of information this morning, in hopes of having my Dexcom CGM system denial overturned.   I included the following:

• Request for External Appeal form (my insurance information, healthcare provider information, detailed description of disagreement with healthcare plan)
• The denial letter from Oxford Health Plans, stating that their decision is final
  
• Proof that the service in question is a covered benefit (this was in the form of my insurance policy benefit handbook)
• Executed medical release form
• Photocopy of my insurance card
• Documentation supporting my appeal, including a letter from me, my endocrinologist, and Dexcom
• Oh, and a check for $25.  They specify that this is non-refundable. 
  

Under the guidance of the Region Managed Care Director at Dexcom, the supporting documentation I included was very factual and devoid of almost any emotion.  My personal letter, which was written with the help of the Dexcom rep and is so stoic and so dry that it doesn't even sound close to anything I would say is supposedly an example of what "will work."  The letter from my endocrinologist cited my elevated A1c, the ADA A1c standard for pregnancy, the Factor V issue, 22 years of IDDM, and various complications I've experienced (including the cotton wool spot, high blood pressure, etc).

Dexcom also provided a packet, which included the recent NEJM study results and other studies supporting the use of CGM technology to better control diabetes.  The letter from my Dexcom rep included a demonstration of the proven benefits of CGM technology on health outcomes, and also outlined the appeal-denied-appeal-denied cycle that I've been in for the last few months.

So it's in the FedEx box now and waiting to be sent off to the Connecticut Department of Insurance.  Each item is tabbed and in the order requested by the appeal form.  It's on time, comprehensive, and fact-filled.  I hope this appeal gets my CGM approved.

The only frustrating part of this process was that I couldn't really lash out.  I couldn't tell these insurance companies what I was really thinking, which was along the lines of "WHAT THE FUCK IS WRONG WITH YOU?  CAN'T YOU SEE THAT THIS TECHNOLOGY WORKS AND I WANT A HEALTHY PREGNANCY AND WHO ARE YOU TO TELL ME I'M NOT APPROVED?!!"  (Ahem.  Sorry.)  It's infuriating to play by their rules, but I'll do whatever it takes to obtain approval.  It makes me absolutely crazy that this technology exists and it has worked for me and it's still not covered.  Don't insurance companies want people to remain healthy?  Isn't there a cost-benefit to them for acting proactively instead of reactively? What is wrong with this healthcare system?!

I'll wait patiently.  I'll hope that this fact-driven approach gets me somewhere.  And I'm very thankful for the assistance and support I've received from Dexcom, dLife, and my friends and family.

But I had to get my digs in somewhere - the memo line of the check is "ridiculous fee for appeal."  Jerkface insurance company.  They're messing with the wrong girl.

(I hope.) 

Posted by Kerri Morrone Sparling at 12:11 PM | Permalink | Comments (24) | TrackBacks (0)

Control is tough to come by these days - and it seems like the more I fret about it, the more tangled my numbers become.  I'm trying a more relaxed approach (yes, I am as high-strung as I seem, why do you ask?!) to diabetes management.  Like this past weekend:  instead of shlepping myself home to RI and spending more time in the car than with friends and family, I decided to stay home in CT and relax.  I watched movies.  I worked on some writing I was trying to finish.  I made iced tea and cleaned my house.  (And I also tried on my wedding dress for no reason, but that's neither here nor there.)

Overall, I tried to freaking relax.  And it helped - my numbers didn't act out.  Apparently the absence of cortisol helps blood sugar stability - who knew? 

In addition to decompressing a bit, I also tried out a few new site locations last week.  I'm wondering if my thighs are a bit overused and if absorption is suffering as a result of the scartissue.  To give my legs a rest, I made good use of an arm site and a back site.

The arm site I've done before.  I can insert it myself (on my left arm, since I'm right-handed), it is pretty pain-free, and is away from my abdomen, which I prefer.  The mechanics of an arm site are a bit tricky, though.  If I aim the tubing towards my shoulder (see the photo), the tube goes up my shoulder, through the sleeve of my shirt, down the side of my body and then comes to a rest at my waist, where the pump is clipped.  It's a little complicated, because the tubing sometimes pinches where it's snaked underneath the side of my bra and it tickles a smidge, too.  Also, I almost ripped the site off a few times when putting on/taking off a sports bra, but overall, I just need to remember where the hell the site is and I don't screw it up.

Using my lower back as a site for an infusion set scared the crap out of me, but I knew it was possible because I saw Sara stick her CGM trial sensor there at the CWD conference.  It just made me feel squeamish thinking about the needle being inserted into my back ... actually, just writing that is making me feel all eeeew.  But, after psyching myself up and reminding myself that if it hurt, I could just rip it right out, I used the ol' Quick-Serter to stick a set into my lower back, towards the side.

This site didn't sting much going in (totally unused real estate here), but the first bolus was a bitch and a half.  It stung like crazy!  Thankfully, it only took a few boluses to really get the site settled in and by the end of the first day, I didn't feel it at all.  I've worn it to the gym, to the movies, and in clothing with varying waist bands with no problem.  The only difference between this and wearing it on my thigh is that it's higher and the tubing doesn't naturally tuck down my leg, so snagged tubing is a risk.  Overall, I'm digging it, and grateful for the option.

New real estate options for my pump?  Check. Chillin' out, maxing, relaxing all cool?  (Name that sitcom!)  Check.  Have any of you guys tried these sites?  Any options for new places? 

And how was your weekend?  :)

Posted by Kerri Morrone Sparling at 03:24 PM | Permalink | Comments (19) | TrackBacks (0)

Dear Liana Masone, Grievance Associate at Oxford Health,

What can I do to help you understand why my request for a continuous glucose monitor should be approved?   I've received your third and final letter, and according to your team:

"We have thoroughly considered all of the available information submitted in support of your appeal.  Based upon review of that information and the terms of your plan, a medical director with a specialty in General Surgery, continues to uphold the denial of coverage for the Dexcom sensors.  This type of continuous glucose monitoring has not been shown to provide superior health outcomes.  Therefore, an Oxford medical diretor has determined that coverage for the Dexcom sensors is Not Medically Necessary, as the term is defined in your Certificate of Coverage."

You know what's great?  The part of your website that talks about the 2008 Healthy Bonus Offers, claiming the following:  "We recognize there are ways we can help members reduce out-of-pocket health are costs.  We believe in the power of prevention: that is  by taking a little extra time to eat better, exercise and reduce stress, individuals can do a better job of staying on the path of wellness."

Is that so?  By seeking approval for the Dexcom continuous glucose monitoring device, I am trying to stop as many of the fluctuations in my blood sugar control as I can.  I am also trying to safeguard my body against hypoglycemic unawareness, because my body does not recognize the symptoms of low blood sugar with any reliability.  I am also preparing for pregnancy and making these CGM efforts for my baby and my husband.  Proactive approach, no?  You would do well to be more proactive in preventing complications, instead of being reactive and paying for them later.

According to the paperwork you sent me, I have been advised that I have exhausted my internal appeals and may now file an external appeal for CGM coverage.  You have also told me that I need to enclose a check in the amount of $25.00 made out to the Treasurer, State of Connecticut.  This check is the first item on your appeal application checklist, showing me how committed you are to making this appeal process as difficult as possible.  

I have been a type 1 diabetic for almost 22 years.  The paramedics have visited my home due to morning hypoglycemia.  My A1c is currently above 7.5% and not within the range for pre-conception, as advised by my endocrinologist at Joslin.  I do not want to experience diabetes-related complications, and I am trying to stay as healthy as I can. I will continue to fight for approval of a CGM.

In the next week, your team will receive a letter from my endocrinologist, stating her recommendation for CGM coverage.  You will also receive my current blood work results, a copy of my certificate of coverage, and yes, my check for $25.00.

I look forward to your response.  

Best,

Kerri Morrone Sparling

Posted by Kerri Morrone Sparling at 09:20 AM | Permalink | Comments (30) | TrackBacks (0)

We drive.  Friday night, after taking in the new Batman movie, we hopped in the car late at night and drove home to RI.  (Late-night driving means less sleep but also means less traffic, and we'll take the latter, thanks.)  Saturday morning had me at the beach with a few of my college roommates, then dinner out with family on Saturday night, then breakfast with Batman (my friend, not Christian Bale), then a cookout at my mother's house on Sunday afternoon.

It sounds like a lot of driving because it IS a lot.  Chris and I try to connect with as many of our friends and family as possible when we come home on the weekends because we don't have the opportunity to see them for several weeks on end.  Connecticut, though filled with career opportunities for us both, doesn't have much in the way of family.  And lately, family and friends are something I've been missing tremendously.

I've hit a very rough patch, diabetes-management wise.  My A1c came back the highest it's been in five and a half years, and I didn't take the increase with any grace at all.  Even though I can attribute the rise to wedding chaos and honeymoon laziness, I still felt so disappointed.  In addition to an elevated A1c, I've also been diagnosed with a disorder called Factor V Leiden, which can cause blood clots and has forced me to change some of my routine (read: birth control pills are now a no-no).  Despite the fact that this disorder is unlikely to cause problems, it's still a new blip on my health radar and contributed to my feeling of "eh" last week.  I was feeling overwhelmed with health concerns, frustrated with insurance issues for the Dexcom, and pretty damn grumpy.  Crumbs Morrone ... er, Sparling.  Crumbs Sparling.

I needed some time with friends and family this weekend, to help take the edge off a roughish week.  And it worked.  Yesterday afternoon, I was hanging out in my mother's yard, taking pictures of her garden.  My mom is very whimsical and a little silly, and her yard is crammed with flowers and these strange little garden critters that she finds from the Christmas Tree Shop:  small ceramic ducks, little turtles, and garden gnomes.  It sounds like her lawn is littered with trash, but these creatures aren't just flung about haphazardly.  They're carefully placed, hidden between hydrangea bushes and underneath rhododendrons.  You have to look for them to find them.

 

I came across a big, fat, ceramic bluebird yesterday.  It was in her front lawn and guarding an azalea bush.  

"Bluebird of happiness!"  My mother came by, checking out what I was photographing.

"I see that."

"Well?  Doesn't it make you happy?"

I thought for a minute.  I felt revitalized after being socially reconnected with my friend and family.  I felt ready to make the medical changes necessary to accommodate the new condition and to take change of my diabetes management once more.  I felt loved.  Supported.  Happy.

"It does, Mom.  That fat bird totally makes me happy."  She grinned at me. 

Onward, right?  All I can do is get over the bad news and move forward towards something better.  Good health is one day at a time.

Posted by Kerri Morrone Sparling at 12:20 PM | Permalink | Comments (22) | TrackBacks (0)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Posted by Kerri Morrone Sparling at 08:52 AM | Permalink | Comments (28) | TrackBacks (0)

It's been a day of 'brain skippies' for me, where I have every good intention to accomplish something in full, only to be thwarted by my own rambling mind.  I'm remembering only most of what I'm intending to remember. Case in point:

Exhibit A:
"Did you call the church and check on the payment for the officiant?"

"I called the church.  I forgot to ask that part."

(Now that's not a big deal - forgetting to ask one part of a multiple-parted question.  However, my brain is skipping some steps on more autonomic things.)

Exhibit B:
I remove my meter from the case, lance my fingertip, apply blood to the strip, wait for result, remove strip, rezip case, put meter away.

Then I realize, about five minutes later, that I did not look at the result.  So I have to bust out the meter again and scroll back through the memory.

Exhibit C:
I've been sitting here, at my desk, with headphones on for the last 20 minutes.  Yet I forgot to put the music on.  So I'm just hanging out with the earbuds in, like teeny decorative earmuffs.  I do this all the damn time.  I'm starting to wonder what's wrong with me.

Bit silly there, eh?  I can't imagine what the inside of my brain looks like right now.  Monkeys wearing wedding gowns, typing furiously on ancient Smith Coronas?  With the wedding only five days away and the to-do lists not short enough these days, I'm starting to get a little mixed up and tangled in my tasks.

However, we did settle on a first dance song - The Luckiest, by Ben Folds.  It's pretty, it's plain, and it means something to both of us.  My dress is completely pressed and lovely and waiting at my mother's house for me, complete with perfected pump pocket.  And we've just finished up all the bridal party gifts (I'll disclose those after the wedding - don't want to spoil the surprise!).  We're almost ready for this big day.  I can't believe it!!

Posted by Kerri Morrone Sparling at 04:41 PM | Permalink | Comments (18) | TrackBacks (0)

No intro.

1.  Last night I attended the premiere screening of Life For A Child in NYC, a moving documentary profiling children with type 1 diabetes who are living in developing countries.  I'll have a write-up for this next week, but suffice to say that there is so much work that needs to be done, both around the world and here at home.  I ended my evening with a low blood sugar as I left the screening and with mounting frustration on how much worldwide attention diabetes needs, yet doesn't receive.  More on this next week.

2.  The dTOEs that were sent in are AWESOME!  I'll be posting the dTOEs, Second Edition on Monday.  :)  If you have any others you want to add, pop them in the comments section for yesterday's post, or email them to me at kerri [at] sixuntilme [dot] com.   

3.  I spent at least a few minutes siphoning through this list of Smurfs to figure out which one I would be.  I think I'm Jokey Smurf (or Schtroumpf Farceur ... are they French or something?) - I love the idea of his alter-ego, the Masked Pie Smurfer, "a cloaked figure known for sneaking up on other Smurfs and throwing pies at them."  Which Smurf would you be?

4.  Speaking of blasts from the past, one of my favorite books growing up was The Monster at the End of This Book, Starring Lovable, Furry Old Grover.  Come on ... you remember this, don't you?  If not, here's a slide show of all the pages in this book.  I remember being terrified of turning the pages when I was little, entirely unsure of what the monster was going to look like.  I read it to my nephew a few years ago - as we turned the pages, he looked up at me with his big, blue eyes, put his hand on my wrist, and whispered, "Auntie, please don't turn the page, okay?"  The world keeps spitting out all this garbage but at least children's books are still wonderful.

5.  Want to be on dLifeTV?  We're looking for people in good health who have lived with type 2 diabetes for 25 years or more. Send our production team an e-mail and tell us about yourself, including your name, age, contact information, number of years living with type 2 diabetes, plus your thoughts on how you have handled your diabetes, especially what you have done to maintain good control.  Thanks in advance!

6.  It's going to be a long weekend, but not exactly a relaxing one.  Tomorrow night we have the pleasure of attending the wedding of two friends in Brooklyn, then a Cirque du Solelil show on Sunday night, then we're spending Monday in RI to finish up last-minute wedding stuff like finalizing the floral arrangements, the marriage license, our marriage classes, and my final wedding gown fitting.  May is right around the corner, and I couldn't be more excited.  :)

Have a stellar weekend, and look for the dTOEs on Monday!   

Posted by Kerri Morrone Sparling at 04:45 PM | Permalink | Comments (8) | TrackBacks (0)

Well hello - I'm rather grumpy today.

I had a moment of cyborgy-ness yesterday, when I was dressed for bed at the end of the evening, yoga pants and a sports bra, and I realized that my pants were sort of falling down, thanks to all of the gadgets hooked to my waistband.  The pump and the Dexcom, separately, are not heavy items, but together they are a bit weighty.  Even though I welcome the protection from lows and highs that Dex is offering, I felt a bit unattractive and robotic.  And my blood sugars have been troubling for the past few days, causing the Dex to sing at me with that loud, loud, loud BEEEEEEEEP!

(Note to readers:  If this post is making you feel like you want to chime in about how being sexy/attractive is far less important than good diabetes control, now is not the time.  I understand how important diabetes control is, and I work hard to achieve a relatively respectable rein on things.  But for that moment last night, I wanted to feel like a girl, not a robot.  I am entitled to these desires.  I am a real human being, not a spokesperson of any kind.  :: steps off soapbox, though laughing at the literal illustration of the bar of soap on the box over there on the right.  Hee hee. ::)

Dex and I are linked back up again this week, only this time the sensor is on my right thigh.  (My pump infusion set is on my left.  I'm sporting diabetes saddlebags this week.)  I'm hoping that having the sensor in a place that doesn't bend, flex, and deal with waistbands will help keep in place more than four days.  The numbers have been pretty precise all day long, except I've seen my first "???" indicators popping up.  According to the user manual, this means that the sensor may be disrupted by my clothes rubbing against the sensor face.  With the site on my thigh and sporting jeans today, that may be the case.  It seems to help if I keep the Dexcom clipped to my pocket, closer to the sensor itself.  However, numbers are still relatively accurate.  My faith is still strong in this product.

But the annoying bit I'm noticing the most, and which is sending me into a bit of grumpiness, is the beeeeeeping.  The "Above 180 mg/dl BEEEEEEEEP" that permeates my office.  It's not the fault of the product but more of an alarm that announces my body's failures.  It bounces off the wall, ricochets into my ears, and shaves off a bit of my ego.   "BEEEEEEP - Kerri, you're high.  Your diabetes is uncontrolled at the moment - HEY EVERYBODY!  She's high!"

Over the past two weeks, stress levels have once again crept up, and I'm finding myself a bit looped out at times.  The wedding is closer, finances are spoken for before they arrive, work is extremely busy, and personal projects are ramping up, thus grabbing and needing more of my attention. 

Most often, I'm very upbeat, quick-witted, and pretty damn smiley.  But today - meh.  I'm grumpy and frustrated with stress, the snowglobe of ideas in my mind, and that damn BEEEEEEEEEP.  I become disheartened when my efforts at good diabetes control - hell, good LIFE control - are thwarted by these unseen little factors, like stress, or maybe weak insulin, or the pile of wedding things that still need to be wrangled ... it's a bit much today. 

I would love a personal assistant.  Or, better still, a vacation.  Instead, I have a headache.  And BEEEEEEEEEP! 

Posted by Kerri Morrone Sparling at 05:47 PM | Permalink | Comments (19) | TrackBacks (0)

I made the mistake of saying the following to Chris the other morning:

"You know, I haven't had a low in like two weeks!"

The next morning, the alarm went off and my eyes slowly opened, as though there were weights attached to each lash.  Brushing my hand against my forehead to wipe off the sweat, I reached for my meter and loaded in a strip.  For some reason, the lancet wasn't pricking my finger.  Shunk.  Shunk.  Shunk.  Chris stirred beside me. 

"It won't bleed."  Said as though the blood wasn't mine, the finger someone else's.

Finally, a ruby red spot leapt up from my fingertip.  Five seconds later, 48 mg/dl winked at me from the meter.  I drained the small bottle of juice on my bedside table and snuggled back underneath the comforter, waiting for my body to catch up.

I had two more lows that day, one that left me shaking at my desk at work and another that had me stumbling on the treadmill at the gym.  The next day, I hit a sticky high of 409 mg/dl after a site change, the sweaters knitting up in my mouth and lethargy wrapped around every movement.

So when the Dexcom Seven arrived at my office, courtesy of the reps out in California, I didn't think twice about suiting up for another round as the Dexcom Warrior.  I installed my first Seven sensor on Sunday night.

I know what you're thinking:  "You had a rough experience with the MiniLink - why are you doing this again?"  

Why?  Because I found the Dexcom to be a superior CGM product.  Minimed makes my pump and therefore has my appreciation, but their CGM unit is sub-par.  Aside from the flopping sensors and the painful insertions, the darn thing just wasn't right.  I know CGMs aren't supposed to be a substitution for manual blood glucose testing, but I had little confidence in even the trends offered by the MiniLink - and I was very frustrated by the errors that were cropping up.

The Dexcom, however, had a more reliable trending ratio and the actual results correlated tighter with my meter.  I'm not thrilled about using a second device (the receiver being its own entire hub device), but if I'm going to make use of a CGM on occasion, I want things to be as "right" as possible.  Like right now:  Dex says I'm 146 mg/dl.  Meter says I'm 137 mg/dl.  It also says I'm on the rise, which is true - I was 92 mg/dl an hour ago.  

So I'm spending this week with the Dexcom Seven, making it part of my work day, my workouts, and my wedding stress.  With wedding planning coming to a wild and all-consuming crescendo, I'm hoping Dex can help me stay more tightly controlled.  Because, between you and I (and the entire internet), I'm having trouble keeping my numbers steady these days.  Diabetes is rearing its head and I, for one, am not feeling very armed for battle.  Hopefully I can sharpen my Dexcom skills and have it as my secret weapon. 

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

Shannon tells me it's snowing like 8 inches up in her neck of the woods.  My mother reports rain in Providence.  And it's chilly with a side of potential frogs raining down here in Connecticut - what the heck is up with this weather?  Here's the Friday Six for this bizarre-weathered Friday.

As I stated in my earlier post today, Children With Diabetes is now a part of the Johnson & Johnson family of companies.  See it ... look closer - it's diabetes, right there on the map.  Nice.  I'm excited to see how this will affect the diabetes community on the whole.  Big news!

In other diabetes-related news, April 14th is Raise Your Voice: Type 1 Diabetes Awareness Day!  There's a Facebook event if you haven't seen it already (and it's not hard to "attend," seeing as how this is a virtual event.)  Now that the troops are rallied, all we need is a logo ... and here's where you come in.  Bill over at EatSmart has offered one of his nutrition scales as a prize for our logo contest - that's a $75 value!   Here are the rules:

1. Design a logo (the size cap is 200 x 300 pixels). 
2. Include the event name:  "Raise Your Voice!" 
3. Have fun designing it.
   
4. Maybe have a snack while you're designing - apples are tasty.   
5. Email it to me as an attachment to kerri [at] sixuntilme [dot] com with the subject line "LOGO CONTEST" no later than 3 pm on Thursday, April 3rd. 
6. Grin because it's done and submitted.

That's it.  The winner will be decided on Friday morning and Bill (thank you, Bill!) will send you an EatSmart nutrition scale of your very own.

And one last thing on the scale:  After I posted my review of the EatSmart nutrition scale yesterday, Bill over at EatSmart gave me a call and told me that if you guys want to order your own scale, enter "KerriSentMe" into the coupon field during checkout on the EatSmart site and receive 10% off your order.  I thought that was right-kind of him - so if you're thinking about ordering a scale, score your 10% off, damnit!

I know many of you have seen the Gaping Void cartoons (this one is my favorite today), but did you know you can get business cards with these quippy little suckers on them?  I was unaware.  Now I am intrigued.  I like my business cards, but it would be kicking to have something so bizarre.  Food for thought.  And just as a sidenote:  I love these cartoons. 

Tomorrow is my wedding shower.  (Yes, I know I'm not supposed to know, but since I live out of state, I needed to know what day to come home.  So I know it's tomorrow.)  I know I need to be there at noon-thirty.  And I know it will be fun, because with my mother and my terrific bridesmaids at the helm, it's sure to be an awesome time.  Everything is happening very quickly now:  the bridal shower, then bachelorette party, then the last meetings with our vendors, then the rehearsal dinner, then the wedding ... I'm afraid if I blink, I'll find myself on the plane bound for our honeymoon.  I wish I could slow this time down so I could actually enjoy it!  Instead, I will blog it.  (This may be the mark of a blogging addiction.)

And six.  Ahhh, the final moment for me today before the weekend cracks wide open and swallows me.  This morning, at about 3 am, I woke to the sound of scritch scritching, coming from the bedroom floor.  I ignored it at first, thinking that it was just one of the cats lolling around.  But it came again, louder this time:  scritch scritch.  So I leaned up, looked to the floor, and saw Siah completely wrapped up in toilet paper.  She had completely unraveled the roll from the master bathroom, dragged the bulk to the middle of my bedroom, and made a nest in it.  Like an enormous hamster. 

I do not need a dog.  I have a Sausage cat who laughs at me.

Posted by Kerri Morrone Sparling at 12:43 PM | Permalink | Comments (10) | TrackBacks (0)

Last week, I was scraping snow off my car.  The heat was on in the apartment and we were huddled underneath piles of down comforters, often accompanied by a small and irritating gray mess.  This week, I've been carrying my wool coat into work instead of wearing it, and I'm window-shopping for kicky little skirts at Ann Taylor. 

The weather here in New England is about as predictable as my blood sugars some days.  And my moods.

As the wedding draws even closer (it's 75 days away as of today - holy crap), everything has started to seem like it's taking on some fast-forward zoom.  I blink and it's Friday again.  I fall asleep for what feels like an instant at night, only to realize it's been six hours.  It's not stress (I'm trying to leave that behind) and it's not the tasks that need to be completed, but more how quickly time is passing.  In a few weeks, it will be a full year since Chris asked me to marry him.  A week later is my wedding shower.  And barely six weeks after that is my wedding day. 

Life is a patchwork of loosely threaded fabrics with incongruous patterns and unanticipated frays.  I find my mind clutching to the most random thoughts - my imagination is on excessive overload.  I'm collapsing into fits of giggles constantly. I wonder if the people at work think I'm losing it a little bit.  Someone made a comment about how I must keep my cats in cages at home because they are so meddlesome.  I retorted with, "No, I usually peel a banana, remove the banana part, and stuff the cat inside the peel, then reseal it."  My co-worker laughed.  "The ol' cat-in-the-banana trick again."  (Oh how I'd love - LOVE - to see a Photoshop representation of this mental image.  Siah, all tucked into a banana.  I'm laughing all over again.)

They're humoring me, but I don't think they have any idea how oddly wired I've felt lately.  I'm having a hard time writing non-fiction bits at the moment but have been penning so much fiction that it's making my fingers cramp.  My imagination is roaming around unsupervised, waking me up in the middle of the night so I can scribble down the thoughts I'm hosting.  Blogging lately has been a little difficult - maybe because my brain is taking all these unapproved vacations?  Diabetes, for the most part, has been giving me little to worry about, other than the daily maintenance routine, and I like it in the background vs. in the foreground clammoring for attention.  Yes, I'll test.  And eat healthy foods.  And sport the ol' insulin pump.  And exercise.  But I'm feeling highly creative, pretty damn moody, and a bouncing blend of extroverted and introverted.  At any given moment, I could either blurt out a poem or burst into tears.

Are these the chaotic emotions of a woman on the verge of getting married?  Is this part of a woman's monthly emotional ritual?  All three?  None of the above?  Is this normal?

Oh shoot, the banana's meowing again.    

Posted by Kerri Morrone Sparling at 01:20 PM | Permalink | Comments (9) | TrackBacks (0)

Stress management has been on the top of my list for the last few months, and I've finally made it the priority it deserves.  I know that all of this cortisol coursing around in my body isn't good on several levels (contributing to higher blood pressure, hyperglycemia, impaired cognitive function ... wait, what was I saying?) and I can't let this go on any longer without making considerable efforts to change.

So, I'm taking on the Stress Management Six.  My ways of dealing with the chaos that comes along with ... life, it seems.  

1.  Better Manage My Time.  Between work, personal projects, and the wedding, I often feel overwhelmed by the tasks that need to be done and instead of tackling the "to do" list, I end up intimidating and spinning my wheels.  I need to really isolate the things that need to be done and prioritize them appropriately.  Do I really need to update my Twitter status every day?  No.  But do I need to make sure that the wedding invite list is completed by next week?  Yes.  Knowing what truly takes priority and not assigning myself too many tasks can help make better use of my time.

2.  Sleep.  Oh blessed sleep.  I have a tendency to stay up too late, throwing off my whole mindset for the next day.  More sleep is pivotal to achieving a lowered stress level.  So I'm buying new pillows.  And mushing my face into them for at least 7 hours a night for starters, aiming for 8 once I get closer to the wedding.  Part of getting more sleep also means cutting waaaaaay back on the caffeine.  I'm used to be a four-cup-a-dayer, but I'm trying to cut back.  Over the last month, I've worked my way down to two cups, and this week it has only been one cup of tea a day.  I'll eventually switch to decaf tea, I think.  Weaning off the caffeine will help lower stress, help me sleep, and keep my brain from imploding due to the jitters.  (I'm like Tweek from South Park when I have too much coffee.)   

3.  Meditation.  After speaking with my doctor this week and describing the anxiety and stress issues I've been wrangling with for a few months, she strongly suggested a meditation class to help keep me centered and help me let go of the things in my life that are tossing me into the spin cycle.  So I'm currently looking for a meditation class near my office or house.  (Which, here in Western CT - aka Soccer Mom Central - shouldn't be that hard.  It's all the rage to sit on a yoga mat and breath deeply these days.) 

4.  Breathing Exercises.  Even if I'm trying my best to avoid stressors, they will still find me.  (They have some kind of honing device, I think.) I need to find ways to deal in the heat of the moment.  I've found some breathing techniques that I can use while I'm, oh, say sitting in traffic, watching the email inbox total climb into the stratosphere, or for those moments when I mash my hand in the bathroom cabinet by accident. 

5.  Disconnect From The Internet.  I spend entirely way too much time on the computer, especially for someone who is completely social and chatty.  It's unnatural for me!  When I am at work, almost all of my day involves the monstrous computer screen (I do so enjoy the WorkMac, though), but I need to make more of a habit of disconnecting when I go home at night.  Usually, my evening includes the gym, dinner, and then more computer work.  Chris and I are resolving to spend less time online in the evening and more time hanging out.  Work can't suffer and tasks need to be completed, but being online all day and all night doesn't do much for my stress levels.  I need a freaking break. 

6.  Take A Freaking Break.  Lately, I've been mostly work and not enough play.  ENOUGH OF THAT.  I am young, healthy, and part of a wonderful network of friends and family.  I'm resolving to spend more time with my friends and less time mucking around on work-related items.  Last weekend was nice, spending it exploring a new city.  This weekend, Chris and I are tucking ourselves away into a bed and breakfast - no cell phones, no internet, and no tasks.  And next weekend, I have some fun plans with friends on tap.  Life is going by so quickly these days - I need to take some time to actually enjoy it and make some memories. 

So the plan is way less stress, which should have a positive impact on my diabetes and my overall health in general.  And if that doesn't work, I may have to move permanently into a hut on the side of a mountain.  Only it will have running water.  And a wireless connection.  ;)

Have a stress-free weekend and I'll catch you, all mellow and whatnot, on the flip side.  Yo. 

Posted by Kerri Morrone Sparling at 04:46 PM | Permalink | Comments (11) | TrackBacks (0)