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Halloween Rules for Kids and Adults with Diabetes.

Halloween DOES rule!!  It’s fun and gives people the opportunity to make costumes, hang out with friends and family, and collect some tasty treats and …

Wait, you thought there would be rules?  Like actual rules to enjoying Halloween?

There aren’t any set rules to doing the whole Halloween-and-diabetes thing.  Back when I was a kid with diabetes (we went trick or treating, uphill both ways), I had the same, normal experiences as my friends, with a few unique moments built in (like that time the cops rolled up on us) and a few more blood sugar checks than average.  Sugar-free candy wasn’t the most appealing option (mostly because it brought about an uncomfortable gastrointestinal concern), so I snacked on the same stuff my friends were eating.

As with most things when I was a little kid, my mom worried for me.  So while she was sniffing my breath for the telltale signs of candy bars, she was also checking my blood sugar and making the necessary corrections, and I continued on, doing the kid thing.  (Thanks, Mom.)  It wasn’t until I was older and going out trick-or-treating with my friends did I start making decisions – good and not-so-good – on my own in terms of diabetes.

The “rules?”  Why should there be rules that make this holiday less fun?  There’s more to Halloween than candy.  Have fun – laugh and play with friends and family and kick piles of leaves and sport excellent costumes.  Be safe – wear glow bracelets to keep you visible in the dark, and test your blood sugar often to make sure you aren’t going low from all the walking/high from all the snacking.  (And maybe go easy on the sugar-free candy, unless you happen to be trick-or-treating in a neighborhood with TP’d houses … if you know what I mean.)

Of all the things to be spooked by on Halloween, don’t let diabetes be one of them.

Halloween rules!!!!!

Ketchup and Mustard.

Blood sugar excursions are one thing (little trips to the grocery store, short flights to Canada … those sorts of excursions are fine) but the long-haul ones are not okay (BOS -> MEL).  I can deal with a sticky high of 180 or 200 mg/dL without getting fired up, and lows are less frequent these days, so I’m not as irritated by them.  Issues seem weekly rather than daily, which is a lovely change of pace.

Except for yesterday.

Holy shit, Yesterday.  You sucked.

The day began with a low alarm in the morning – not a deep one, but a shallow low, easily managed by turning down my basal rate for 45 minutes and popping one glucose tab.  Before breakfast I was 107 mg/dL.  After breakfast, I was 302 mg/dL.  The eff?  I have a breakfast bolus recorded in my pump, but it clearly didn’t make a dent (either that, or the stress of the morning sent me cruising up into orbit).  My goal of bringing my blood sugar down within a few hours was thwarted by a thorough combination of a bloody infusion set (was that why my breakfast bolus didn’t register?), insulin that may have been borked (my pump cartridge was a potluck of dregs from older bottles), the regular stress of work coupled with exacerbated stress of having a high blood sugar … it was gross.

It wasn’t until about 2 pm that I was back down to the 200’s, and that was after pulling the infusion site and taking an injection.  And it wasn’t until about 3 pm that I saw a number under 100 mg/dL.  Which started the second half of my day, spent trying to bring up a low blood sugar that wanted its own bedroom.  I bounced between highs and lows for hours, not able to properly correct at either end of the spectrum due to a magical combination of user error and pancreas error.

When I looked at my Dexcom graph last night, it was way too much ketchup and mustard (aka “highs and lows”) and not nearly enough time spent in range.

“Damn hamburger Dexcom,” I muttered.

A normal day with diabetes doesn’t wring me out, but yesterday did.  Concentrating on work was really difficult, because my high-brain was too sluggish and too thick to let synapses fire.   Writing was impossible.  Sitting at my desk for more than twenty minutes was impossible because I kept having to take breaks to get more water and then to pee.  (I went for a run and a mile and a half into it, made the wise decision to turn around.  A good idea since, by the time I got back to my car, the need to pee was amazingly all-consuming.  Oh hydration!)  My whole body felt like it was submerged in Jell-O, and I tried to swim through it for the majority of the morning.  Instead of making beds/doing laundry/cleaning dishes/writing/answering emails/phone calls, I wanted to climb into bed and sleep off the blood sugar hangover, but that wasn’t an option.  Life doesn’t wait for diabetes.

I made lots of mistakes yesterday – should have pulled the site/taken an injection earlier, should have assumed my blood sugar would rise more after turning down the basal, should have checked an hour after eating instead of two.  So many things I should have done, or done differently.  But my brain isn’t very clever when it’s on the glucose roller coaster.

Oh yeah, and diabetes.

This morning, my fasting blood sugar was 104 mg/dL, a welcomed change after yesterday’s 398 mg/dL, 42 mg/dL, and all the numbers in between.

“Don’t mock me, you little jerkface,” I said to my meter.

If the frigging thing had a tongue to stick out, it would have.

 

Of Cocktails and Community.

“So what you should do is see what people are searching for and then carefully tailor your posts to draw in those searches.  Pick the search engine terms that there isn’t a high competition for, giving you an advantage in Google’s search algorithm.”

The example he used was pretty simple:  “10 Best Cocktails for People with Diabetes”

In a discussion during the European Bloggers Summit in Barcelona (running alongside EASD), a search engine optimization expert gave a presentation about seeding blog posts with keywords in order to cast a greater net for readership.  The SEO strategist was helpful, and had wonderful advice for people who were churning out content to get it read, but my  body had a tangible reaction to this kind of advice.  I felt myself prickling with frustration because is this really what people are writing for?  Page views?

No freaking way.  Not in this community.

So the top ten best cocktails for people with diabetes?  Fucking sure.  Let’s do this, social media-style:

  1. The #DSMA:  Take 140 characters, a hashtag, and equal parts honesty and humor and mix them thoroughly in Twitter.  Tastes best on Wednesday nights at 9 pm EST.
  2. The Blogosphere:  Start with a URL or a Feedreader and slap it into the search bar on your mobile device, tablet, or computer, or Google “diabetes blogs” for a list of ingredients.  Mix reading these blogs throughout your day for a boost in diabetes empowerment and community.
  3. The Flaming YouTube:  Search through YouTube for diabetes, or “diabetes math,” or “breaking up with diabetes,” or “changing the song on my Animas Ping” and you’ll find a slew of video combinations to add to your playlist.  (Title the playlist “Cocktails for Diabetics” and you’ll probably get a lot of search returns, but you’ll also find people who want to be found.)
  4. The Instagrammed:  Take your phone, photograph any ol’ diabetes bit or piece in your house, and mix with Instagram to create a frothy, fun mix of Dexcom graphs, race bibs, brave new infusion set sites, Halloween-candy-casually-pretending-to-be-hypo-treatment, and friends who understand.
  5. Facebook Your Face:  Take your Facebook account and stir gently with groups, hashtags, and posts about diabetes.  It may take a while for this mixture to fully set, but once it does, you’ll have a shot of community you can take in one sitting, or something you can sip on and scroll through for hours.
  6. The Friends for Life Take one part people with diabetes, one part caregivers, one part educators, one part inspirational athletes, one part Disney World, one part green bracelets, and a billion parts love and throw into a salad shooter and spray that stuff everywhere because in-person diabetes meet-ups and conferences will break your heart and mend it within the course of a week.
  7. The Group Text:  No specific ingredients, but a drink best shared with many.  And at 3 am.
  8. The Call Me:  Best served when low, because a phone call to another PWD who understands is the best way to keep from over-treating.
  9. The Honest-Tea:  Equal parts empathy and honesty, this cocktail is a must for people with diabetes who are looking for confirmation that they aren’t alone.  It’s not about enabling, but empowering.  (Goes really well with a side of Communi-Tea.)
  10. The Hug:  Social media is great, but nothing is better than a hug between two people whose much-loved pancreases have taken an extended leave of absence.  There is no set ‘best time’ for this cocktail – serve immediately and enjoy.

The one in the middle looks like pee, to me.

People in the diabetes community don’t communicate with one another for page views or Google search prowess.  Of course, not everyone’s intentions are the same across the board, and there are people who immerse themselves in a community looking for things that aren’t as altruistic, but the majority of interaction in the DOC, from what I can see, is between people who need each other.  That’s why so many of us started doing this, and it’s why so many of us continue.

Because when Google redoes its algorithm and there’s a new system for search engine optimization, when there’s an upheaval in what’s considered the “it” platform for social media, the song remains the same for the DOC.  Diabetes, for many, isn’t just in your body but also resides full-time in your head, and managing emotions and support is as essential as insulin (and with a significantly lower copay).  It’s not about where the discussions are taking place; it’s about the discussions that are taking place.  So “drink” up!

Halloween Prep and Diabetes.

Between the finishing up of Birdy’s Spidergirl costume (a labor-and-tulle intensive endeavor), carving our pumpkin (she wanted a big Batman signal on it this year), and the creation of a cemetery cake (which Birdzone renamed “the grave garden” – a name I like more than the original), we’re getting our Halloween on here in a big way.

A cemetery cake, aka the "grave garden."

Way back in the day, my first Halloween experience after being diagnosed with type 1 diabetes came barely a month in, sending me out trick-or-treating with my family and subsequently having my breath sniffed for evidence of having sneaked a Twix bar (or three).  I remember trading my candy to my brother for a few dollars in efforts to keep me from consuming too much, and a small bag filled with treats was stuck on top of the refrigerator, promised to be used for the next few low blood sugar reactions.

But for me, it’s not as much about the candy as it is about the costumes.  I’ve always been a big fan of dressing up and having fun on Halloween, and being diagnosed with diabetes didn’t make a dent in that part of the fun.

 

So Fresh and So Clean. (Clean.)

I rarely clean my pump.  I hope that doesn’t make me a complete dirtbag (though the more I think about it, the more I should regularly clean this device that is with me 24 hours a day, every single day, and is brought everywhere but in the shower, so it’s likely to be the most filthy thing I own).

How often do you clean your insulin pump?

But honestly, I don’t make a habit of dragging it through the mud or dropping it into a plate of spaghetti, so normally I clean it when it gets grubby from exercise, the beach, etc. or when I take off the battery cap and notice that the edge of the cap looks gross.  (You know, when the cap is threaded with what looks like belly button lint.)

An email exchange with an engineer from Animas got me to thinking about this “how often do you clean your pump” issue, and I wondered if I was the only insulin pumper who didn’t have a cleaning ritual for my pump.  I try to keep the screen clean, and there are a few times I’ve wipe it down with a baby wipe (they’re useful for grubby hands and grubby pumps alike), but I don’t set aside special times to do a once-over on my medical devices.

How often do you clean your pump?

(link to the video clip for the song you surely have stuck in your head now)

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