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That Low, Though.

The low blood sugar hadn’t rooted firmly enough in my brain yet, but I knew something was wrong.  My feet were heavy against the treadmill belt, and I kept rewinding the show I was watching because the dialog wasn’t making much sense to me.

BEEEEP!  BEEEEP!  BEEEEEEEP! hollered my phone (aka surrogate Dexcom receiver) from the cupholder of the treadmill.

57 mg/dL with the pigeon head facing south.

Dexcom G5. Looks like a cute little pigeon who wants a hotdog until you realize, "Fuck – I'm really low." #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

“Oh hey,” I said, all casual, while my brain was throwing itself against the inside of my skull, shouting “That low, though!  Go get something to eaaaaaaaaat!”

Instead, I felt compelled to wait until the treadmill had reached an even number of minutes left (WHY?? This sort of compulsion happens regularly.) before I would head upstairs to grab a snack.

Upstairs, I walked through the living room into the kitchen, passing Chris, who asked, “You okay?” and I responded with a grunted, “Low.”

Reaching the fridge, I opened it up and grabbed the first thing I saw:  an already-opened juice box.  The straw was at the ready, making my fumbling fingers flex with relief.  Slightly dizzy and with the low blood sugar almost fully acknowledged by my mind, I drained what was left of the juice box.

Trouble is, the juice box had apparently been left in the desert to ferment and was then tucked back into the fridge.  The fizzy, nasty grape taste in my mouth woke my brain up completely, only urging me to throw up instead of deal with the hypo.  I ambled over to the sink and stood there, holding the edge of it, the breaking news ticker in my brain reading “DON’T PUKE DON’T PUKE.”

I didn’t puke.  

I chased the fermented juice box with some raisins.  I returned to my work out. I wondered briefly if I was somewhat drunk. This isn’t the first time this has happened, and it sure as hell won’t be the last.

Dexcom Rash: Updated.

Frigging rash.  The issue first presented itself back in August 2012, leaving me scratching my head and itching my sensor sites for the next four years.

At first, I tackled the problem by trying a pile of different barrier tapes, but the only one that brought about any semblance of relief was the Toughpad.  For about a year, I used a Flovent inhaler (sprayed on my skin before applying the CGM sensor), but I was cautioned against it by my first dermatologist, who cited that the skin would become thinner and compromised after prolonged use.  For the last few years, I’ve used the Toughpad exclusively, and it’s held the rash at bay.

Sort of.

It’s never ever perfect.  I’m still itchy as eff sometimes when I’m in the midst of using a sensor (like right now, with my sensor on my right thigh and the skin around the Toughpad is bright red and I want to scratch it off until my nails break but the low alarm that went off two nights ago saved my ass entirely so I’m leaving the sensor on as long as I can stand it).  The rash doesn’t seem to be concentrated underneath the Toughpad as much as before, but now I appear to be allergic to the Opsite Flexifix tape.  Add that to the fact that I get skin irritation even if I put the new sensor next to any place where a sensor has even BEEN for the last month.

A week or two ago, I went to the dermatologist to further investigate my Dexcom rash and to hopefully find different ways to scratch that itch, so to speak.

The new dermatologist circled me like a shark, only maybe a shark in search of medical journal material.  “You’re having an allergic response to the medical device adhesive?”

“Yes.  Since 2012.”

He paused.  “So just don’t use that medical device?”

“Not an option.”  (Totally not an option, especially these days, when I can’t feel my low blood sugar symptoms and I don’t take action on my high blood sugar symptoms unless the CGM is alarming.  This is why I wear a CGM.  And while I’m taking care of two little kids, this is why I will continue to wear my CGM.)

“Okay …” said the dermatologist, looking at my arm and thighs again, assessing the skin damage.  “A Flovent inhaler, too?  You mentioned using that in the past?”

“Yes, but after being warned it would thin out my skin, I stopped.”

“Good call.  Listen, I think we can try two things:  a topical steroid cream, or a non-steroid topical cream.  I would like try the non-steroid one first, because the same skin-thinning issue would happen otherwise.”  He handed me a prescription.

We scheduled a follow up appointment and I was sent on my scratchy way.  The cream, it turns out, comes with a dozen different creepy warnings that have made me very reluctant to try it while breastfeeding my son, but I did put a little bit on my rash and, within the hour, my rash was on fire and the urge to itch was all consuming.  I’m not touching this stuff again until after I’m done breastfeeding, and even then I’ll be very conservative, in case I’m allergic to this shit, too.

I’m not sure what people are doing these days to manage their adhesive irritations, but I’m reaching the end of my available skin real estate.  Any advice out there? It’s been a very long few years of wearing the CGM 24/7 and I’ve just about run out of sites that aren’t already scaly and raw.  I hear rumors about a “sensitive” adhesive being released by the Dexcom team, and about certain elements being removed from the current adhesive makeup, but until those products are shipped to my house and not sending my skin into circus mode, I’m at an itchy loss.

Review: Verio Flex Meter.

For years, my love for the One Touch Verio Sync meter knew no limits.  Despite a slightly MS-DOS interface that only showed me one result at a time and didn’t let me scroll back to other results unless I loaded them to the Reveal application, I loved this meter.  It was small, it was accurate (as compared to my Dexcom CGM, which I feel is my personal gold standard), and it was covered my by insurance.

I really liked how it worked with the Reveal app the most, though.  I have always struggled with maintaining a blood sugar logbook, and being able to bluetooth my results to my phone and have them collect in an at-a-glance and also an in-depth data map took the heat off my data angst.

But not everyone loved the Sync.  And recently, it was scrapped and replaced by the Verio Flex meter.

I resisted the Flex mostly because I hate change (<– curmudgeon font), but a few weeks ago, I finally switched over (after putting my two Verio Syncs into a cryptex).  Here are my initial thoughts:

PROS:

The Verio Flex turns off immediately after you take the test strip out of it.  This is a nice change from the Sync, where it would either have to time out or be pushed off using the button after each blood sugar check.  The auto-off helps conserve battery (more on why that matters in the CONS section).

There’s a small color chart on the bottom of meter screen (on the actual housing of the meter – see picture) where an arrow shows up underneath each BG result to indicate low, high, or in range.  While this isn’t as useful for me because I’m familiar with the ranges recommended for me, this could be a really useful feature for folks newly diagnosed or who aren’t as familiar with in-range and out-of-range.

It comes with a Delica lancing device, which is my favorite, if you can say such a thing about a device meant to pierce skin.

It’s durable and decently priced.  I paid $19.99 for mine at CVS and when it dropped onto the hard kitchen tile that same night, it did not smash to bits.

CONS:

The battery life doesn’t appear to be awesome.  My glucose meters in the past have taken over a year to burn through a battery, but I’ve already replaced the Flex battery after about a month.  I’m sure the bluetooth transmission cycles the battery quickly, but it was irritating to have to switch out the battery so soon.  I like my t:slim pump because it can be plugged in and charged versus needing to keep a stash of AA batteries, and I liked the Sync for the same reason.

No light!  On the Sync, there was a light at the top of the meter that was bright enough to test in the middle of the night without turning on the lamp.  This was an awesome feature, and I have no idea why it was removed from the Flex, but it’s SORELY MISSED.  Never underestimate the value of a little light that keeps you from putting blood on the strip in a mangled way, wasting the strip.

And the syncing feature takes a while.  I feel like the Sync synced faster while the Flex takes more time to flex its bluetooth muscle.  The way the data maps on the app is identical, so that’s fine, but getting that data there is something I have to remember to do, so every second matters.

Overall, the Flex is similar enough to the Sync that I won’t bust the cryptex back open yet, but hopefully the next iteration will be better on battery, upload automagically to my pump, and the light will return!

“How is it going?”

“Oh, I had so much trouble even getting out of the house when my babies were little.  You seem like you have it all together,” said the physical therapist as she massaged the tendons in my arm to alleviate the inflammation (thanks, tennis elbow as a result of playing … baby tennis?)

I would have laughed really hard if she hadn’t been pressing on the ouchiest bits right then.

“Smoke and mirrors.  Also, you haven’t seen my house or my inbox, so hold your praise,” I replied, wincing as her fingertips worked their way between my tendons.

Nothing is “all together” these days.  Everything feels held together by minty floss, so it smells sort of nice but is flimsy and ready to split.  On the surface, there are appear to be people moving around in my house that are reasonably clean and fed, but scratch that surface and you’ll find so much mess.

I’m struggling to find some peace in this mess.  Laundry is a constant battle (one six year old who loves messy craft projects plus a little baby with reflux and spitty-uppiness plus a guy who works out a lot plus a woman who tries to work out and who also is a target of aforementioned spit-up) and there’s at least two laundry baskets with contents that require folding and putting away at any given moment.  Also, if you open the dryer, there’s probably a load of laundry in there, too, waiting to be discovered and cursed at.

And then there’s the medical stuff.  Coordinating care for Birdy and Chris is one thing, but now we have the little Guy and he sees the pediatrician once a month (he’s little, so we check on his weight regularly and also there’s that reflux thing that’s being monitored/treated), so there’s that added mess.  Also, I’m back in physical therapy for de Quervain’s tendonitis (this happened with Birdy, as well – more on that later this week) and also seeing a dermatologist regularly in efforts to beat back the Dexcom rash (more on that ASAP).  I’ve met with a local endo and a new primary care doctor, as well, debating which to keep and where to keep trying. Lots of EOBs and calls to my medical insurer and let’s not forget the ebb and flow of diabetes supplies like insulin, test strips, Dexcom sensors, pump supplies, blood pressure medication, and all the other shit.  The phone feels permanently stuck to my ear and I’m on hold a lot.

Not to mention my lovely email inbox, which is brimming with interesting stuff that I can’t wait to dive into but sometimes comes to a boil in there because it can take me a full hour to answer one email.  (I’ve been doing a little bit of writing, though, and that’s felt good.  Sometimes it’s through the Notes feature on my phone, or in a long text message to myself, but it is happening.  Funny how creative juices flow alongside breastmilk at 4 am.)

Sleep is still at a minimum lately, with my son reverting back to his waking up every three hours for the last few nights, making us both a drooling mess at times during the day.  The lack of sleep is causing brain stalls, and I’ll stand in the middle of the kitchen wondering where the hell my keys are only to find them the hell in my hand.

I’m feeling very mired in motherhood details these days, and while I’m entirely grateful for the chance to parent these two littles, sometimes I’m a little burnt out on the daily tasks.  The list of items I want to tackle every day grows and I find myself only ticking off one or two items at a time instead of charging through the list with a face full of iced coffee and a pitchfork of productivity.  I’m itching to travel again, to get out and be working in full, proving to myself that I’m able to love and raise my children while also loving and raising my career.

“How is it going?” is a question many people ask, and sometimes my response is to show them my silly daughter and my smiling son and beam with pride.  Or my response is an exasperated sigh and a mention of house crap that’s gone undone.

Unfortunately sometimes it feels like the right thing to reply with is the “smoke and mirrors” claim, like I’m not able to say, “Some stuff is a disaster but I am doing really well with lots of other stuff.”  I have to force myself to step back from what I perceive as “the mess” and realize that I am doing a lot, and loving a lot of it, and allowing things like un-emptied driers and missed phone calls to be forgiven.

Sweet boy

A photo posted by Kerri Sparling (@sixuntilme) on

Is it all together here?  Oh hell no.  Have I taken some very long and unintentional breaks from blogging and answering emails and putting on matching socks?  Oh hell yes.  But my focus is different these days.  It’s been more about talking with my daughter about her day at school and working on a craft project with her.  Or holding my son close after he’s done eating and tracing the side of his chubby cheek with my fingertip.  Or taking a morning to go work and leaving all housework and kids in the care of trusted family and friends.

It’s not all together, but it’s not all smoke and mirrors, either.  It’s all hard work.  And love.  And the constant ding of the dryer.

Word Choice.

“Mom, why do you wear that bracelet again?”

She knows why, but every few months, she asks again.  Why do I wear a medical alert bracelet?  Why is that thing as important to leaving the house as having my keys?

“I wear it because it says I have diabetes, just in case someone needs to know.”

“Why would they need to know?”

“In case I wasn’t able to say it myself.  Like if we happened to be in an accident or something, or if I was asleep.”

She thinks about this.

Medical alert bracelet #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

“Is this why we have a house phone?”

“Yes.”  She knows the reason but asks anyway.  We decided to get a landline telephone in the event that there was a storm that knocked the power out, or if we had a babysitter and needed to call the house.  Or if my husband or children ever needed to call 911 on my behalf.  “We have a house phone on the waaaaay off chance that I’d have trouble waking up because of a low blood sugar.  You know, if I was passed out.”

I forget that the words we use matter.  That they are easily confused and conflated.  That she’s just a little kid.

“Passed out?!!”

“Yes, but that’s a very rare thing.  It hasn’t ever happened to me.  It probably won’t ever happen, but it’s smart to be prepared, just in case.”

“PASSED OUT?!!!”

It was then that I remember hearing her and her friend talking about her friend’s grandmother, who had recently passed away.

“OUT, honey.  Not AWAY.  Passed out means I would be having trouble waking my brain and body up and need extra help.  Not dead.  It’s very different,”  I scooped her up and held her close, aiming to hug the panic away from her as I listed all the reasons why passed out was different from passed away and also how it wouldn’t ever happen to me, right?  Right.

The reality of my own thoughts every night before bed stood in contrast to the confidence in my voice talking to Birdy.  The thought is fleeting, but also sharp and cuts through my mettle, reminding me that diabetes looks easy and seems quiet but exists with an undercurrent of worry.

And I’m learning that I’m not the only one who worries.

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