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That Clip, Though.

I’ve been using the t:slim pump for the better part of a year now, and over the last few months (here’s a handy disclosure that you should read for context on my relationship with Tandem), I’ve appreciated the new set of options that the t:slim has brought into my diabetes life.

… man, that sounds a little formal.  I’m too pregnant for formality at the moment.  (My feet have officially given up on being feet and refuse any covering other than socks or flip flops, and my son is moving visibly as I type, making sitting close to my desk a challenge. Eff formality.)  The reasons for the t:slim being a badass addition to my diabetes management RIGHT THIS SECOND are that I can take a bolus in a matter of seconds without scrolling through fifty different screens, I can edit my basal or insulin:carb needs with a few beeps, and the 300 unit reservoir is going to come in handy these last few weeks of pregnancy.

One challenge I’ve historically had with the t:slim pump, however, is the clip that is shipped out with it.  For me, the clip was a little bulkier than I preferred and also not as secure as I needed.  I wanted streamlined and secure, and as my pregnant body expands and clothing options like “pockets” and “waistbands” have been shoved into the distance.  I need my pump clip to be able to hang on by a thread.

This one works great, though:

I love this clip. #tslim #diabetes #insulinpump

A photo posted by Kerri Sparling (@sixuntilme) on

A friend suggested this clip to me and gave me one of theirs, but since trying it out, I’ve keep a spare or two on hand because it seriously solves all of my pump clip troubles.  The tape is very secure and I’ve had the same pump clip stay successfully stuck for the last six months.  I have no relationship with the company who makes the clip, and this is not an affiliate link or anything like that, but if you want to try out a pump clip for your t:slim (or any other pump) that is subtle, streamlined, and strong, this Nite Ize Hip Clip is worth a shot.

Hey! An informative post! Who saw that coming? Not me. Bring on the cat gifs.

cat filing his nails

Chipped Battery Cap.

When you wear something every, single day, you notice every, single bit of it.  I’ve been wearing this pump for four years and I know the lines of it by heart.  (I remember the day that I switched from Medtronic to Animas and even those similarly-structured insulin pumps felt entirely different to me in weight, curve, and especially clip.  As I wrote in my Animas Vibe initial review, change can be awkward.)

Two weeks ago, I dropped my insulin pump on the bathroom floor.  It survived the fall, but happened to fall just so and smashed the edge of the battery cap the teeniest bit.  See?  (Ignore the hard knocks look of my pump overall.  I’m tough on this thing.)

Okay, so maybe it’s not obvious (I can barely see it myself, even when it’s pointed out to my eyeballs), but my hip knew instantly.  The jagged catch on the battery cap bit into my skin all day long and drove me bananas.  (The photo is not accurate as far as how the chip lined up with my skin.  The battery cap pictured is not screwed tightly onto the pump.  When it’s on right, the chip faces my body.)

“Do you feel this?”  I asked Chris, running his finger over the edge of the battery cap.  “That teeny chip?  It’s making me crazy.”

“You can feel that?” he asked, surprised.

“I can.  I’m like the Princess and the Pea of insulin pumps.”  (That would make for an excessively long fairy tale title.)

The point of this post?  To illustrate how fully integrated these devices become into our lives, where we notice even the most seemingly insignificant blip.  And to also note how awesome it is when your local pump rep just happens to have a replacement battery cap in the trunk of her car.

Guest Post: A Note to My Newly-Diagnosed Self

Today, thanks to a very generous reader named Cathy Fisher, I’m able to host a guest post about being diagnosed with type 1 diabetes as an adult in the form of a letter from Cathy, to her newly-diagnosed self. 

Cathy was diagnosed November of 2003 at age 18, in her first semester of college. At the time, she was the first diabetic she knew. She has spent the 13 years since her diagnosis writing about diabetes. Cathy is also an entrepreneur and avid traveler living in Lisbon, Portugal, and I’m honored to share her words today.

  *   *   *

Dear Self,

You were diagnosed 13 years ago, during your first semester in college. You had just turned 18. You passed out in the dining hall at breakfast, in DKA. Do you remember waking in the emergency room, doctors hovering above you, blurred images like scenes from a movie? The thirst. The phone call to Dad, all terror. The CD mix from Lauren, “Get Well Soon.” Your first episode of Saturday Night Live from a hospital bed.

You struggle(d). And you’ve learned/are learning. There’s so much I wish you had known from the beginning, and so much to keep in mind still. Here is what I can put into words:

There’s knowledge. You’ll wake in a hospital bed with a new identity to own – “Type 1.” There’ll be so much to learn. How to fill a syringe, the difference between bolus and basal, what the heck a carbohydrate is and how to count it (please learn this one ASAP, it will serve you well). Etc. Etc. Etc. These are all tools. Seek and use them.

Seek wisdom. Book knowledge is only part of the story. Your body will teach you its own truth, a sort of wisdom that doctors can’t teach. Be present for what your body has to say – how different foods make you feel, or how to sense an oncoming low. How to recharge emotionally. Be receptive to your body and mind’s own insights. They can be more important than what you can get from a pamphlet or Google.

Respect your body. Use your body in every way that you can … seek adventure, explore, and do what you love. Go backpacking in Peru, dancing with friends, running by the ocean, for a sunset glass of wine with Pete. Pull an all-nighter, be a student of yoga, try new foods, get lost walking through a city. Catchphrase: with respect. Cathy, it will take you years to learn this, but not all limits need to be pushed. Remember that time you partied on a Friday, ran a half marathon on Saturday and went skydiving on Sunday? That was probably too much. Treat your body with tenderness. Can you find the place where adventure, challenge and harmony meet?

Love yourself. Love your beautiful brilliant diabetic self. You have always been enough. The day you were born with a perfect pancreas. The day your pancreas began to fall apart. That time you “cheated” (could we call it “excursioned”?) over tiramisu in a hostel in Puerto Montt. You are inherently wonderfully made.

Own it. Diabetes contraptions and all. Rock your glucose sensor anywhere that works for you. Clip your pump to your bathing suit bottom, give yourself injections on the subway as needed, and understand that your diabetes paraphernalia can be a sexy thing. And if you ever get weird looks, never underestimate the power of Sass (No, this is not an iPod clipped onto to my hip and INSERTED IN MY SKIN) and teaching opportunities (It’s for diabetes – want to see how this works?).

Make love, not war. Sass can be an ally, but keep your feistiness in check. Don’t take feelings out on diabetes! There are days to hate it, and I hope most days you can accept it. Try to make friends with it sooner rather than later.

Humor helps. Sometimes, all you can do is say “Oh shit,” shrug and move on.

Yes, you can. You have never let anyone tell you that you can’t. You go, girl. Keep it that way. Because yes, you truly can. You can do what you dream of, with or without diabetes. Be a person you are proud of, explore, reach for what’s important to you, set goals and reach them, make mistakes, learn, love and be loved. There is a part of you that is diabetes neutral. Listen when it tells you: yes, you can.

Inspire yourself. Look for inspiration everywhere. Truffaut, Zadie Smith, paper journals, Tokyo, a place called Cherokee, yoga, learning, travel, dawn, morning coffee, the ocean, solitude, people. Diabetes can be heavy, so fill yourself with what inspires and nourishes. And when you do this, can you see the world through a lens of wonder?

Seek community. And lean on it. Friends and family, near and far. The diabetes community, online and in person. Support groups. Your doctor, nutritionist, diabetes educator, psychologist. Putting yourself “out there” can create the most unexpected and meaningful connections.

Perspective. This will be your greatest tool. Your diagnosis was crushing. You felt profound grief for the first time. But you’ll find moments of perspective. When you do, hold onto them, they will humble you. The question will shift from “Why me?” to “Why not me?”. This will feel so good.

Rock on,
Cathy

  *   *   *

Thank you for this amazing, introspective letter, Cathy.  Hopefully you’ll inspire others to pen one of their own … working on mine now.  

What to Work On.

I’ve gotten lazy in my diabetes management.  And I’m not proud of it.  My recent A1C result was still in my goal range but not where it was a few months ago, and I’d love to return to that level of control.  Thing is, I’ve gone soft when it comes to following through on my daily diabetes duties.

Yeah.  I’m at that point in the postpartum recovery thing:  finding ways to up my diabetes game.

I can check two things off my to do list with confidence:  I wear  my Dexcom every, single day and I also have been on top of my doctor’s appointments.  Those two things get big, fat gold stars.

Other stuff needs some grooming, though.  Here’s my wishlist:

  • Check fasting BG immediately after waking up.
  • Calibrate CGM right when it requests calibration.
  • Pre-bolus at least 15 minutes before eating.
  • Exercise 3 – 5 times a week.
  • Sleep more than 5 hours a night.
  • React faster to the high alarm from my Dexcom.
  • Rotate my device sites better.
  • Remember to eat more than coffee before 1 pm.

Hmmm.  That’s a lot.  Plan of attack for each:

  • Check fasting BG immediately after waking up.  We just moved the little Guy out of our bedroom and now he’s sleeping in his crib in his own room, so I have a little more time (3 min versus zero min) in the morning before I have to run and grab him.  I need to return to the habit of keeping my glucose meter on the bathroom counter and using it before I brush my teeth in the morning.
  • Calibrate CGM right when it requests calibration.  Ugh.  This just requires being less of a lazy tool and just checking/calibrating ASAP instead of ignoring the little red blood drop.
  • Pre-bolus at least 15 minutes before eating. This one is admittedly going to be challenging, as my schedule is a little non-scheduley these days.  My son is a busy little creature and also unpredictable, so it’s challenging to find the “right time” to do things like change out my insulin pump, eat breakfast, schedule conference calls.  But as he gets older, he does seem to be settling into something resembling a pattern, so maybe this will get easier.  I’ll try to pre-bolus.
  • Exercise 3 – 5 times a week.  This one is already going in the right direction.  As mentioned, I joined a gym and that gym has childcare, so there’s no excuse.  Except days like over the weekend, when I was away for work, or today, when the little Guy is so sniffling and booger-gross that I don’t want to bring him to the daycare and expose any other kids/adults to his germs.  We did go for a walk around the neighborhood today, clocking in at least a little bit of exercise, so that helps.  The weather warming up will help here, too.  This bullet point is one I’m putting like half a gold star on.
  • Sleep more than 6 hours a night.  OH HA HA HA HA.  The baby thinks 5.30 am is when human beings should wake up.  The early morning hours are gorgeous and I love the quiet of being awake that early, but around 10 pm my body starts to give up on doing body things, although I rarely make it to bed before 11.30 pm.  I need to work on this sleep thing.
  • React faster to the high alarm from my Dexcom.  Again, this one is something I just have to DO.  No excuses and no reason not to.  My high alarm used to be 140 mg/dL (pre-pregnancy and during pregnancy), but I’ve moved it to 180 mg/dL in the last few months.  I should be responding to 180s.  I will work on this.
  • Rotate my device sites better.  Yep, this is also a need.  My thighs have become a permanent home for my Dexcom sensors, but I am okay with the back of my hip or maybe my arm.  I’ll try to get creative.  As far as pump sites, I’ve been working on rotating those better, too.  Maybe it’s time to try a lower arm site?  (Has anyone ever done that and does it hurt??)
  • Remember to eat more than coffee before 1 pm.  Yeah, this is another whoops.  My mornings are generally a bit crazy, and sometimes I’d rather keep my CGM graph steady instead of interrupting it with breakfast.  But this is backfiring because I then get so hungry around lunch time that I eat the fridge, causing a nasty post-lunch bounce.  Moderation here.  Eat regularly throughout the day and I’ll be less likely to unhinge my jaws and devour the contents of the cupboard.

I hope writing this crap down will help up my accountability and will inspire me to keep moving forward.  If I can make one or two of these become habit in the next few weeks, I’ll mark that as a success.  Because backwards is all gross and disgusting feeling and also it looks like there’s a c-section back there and I am NOT going back to that.

“Do You Like It?”

“Excuse me … your, um, arm?  What’s that on your arm?”

Ninety-five percent of the time, I don’t care if people ask about my insulin pump or CGM.  More power to them for being bold enough to embrace the awkwardness and actually ask, instead of assuming.  (And even in the 5% moments of “argh – stop looking, don’t ask,” it usually ends up being a moment of discussion and disclosure I’m grateful for.  I should be more open to discussing diabetes in a public setting.  Hang on a second … let me start a blog real quick.)

“On my arm?  That’s my insulin pump.  I have diabetes.”

I was in line at Starbucks, grabbing an iced coffee (under the gestational lock and key of decaf for just a few more weeks), escaping the blazing summer temperatures for a few minutes before heading back to work.  I was wearing a skirt and a tank top, with my infusion set connected to the back of my right arm.  My body – thanks to third trimester expansion, has run out of subtle places to stash my insulin pump, so it was casually clipped to the strap of my tank top.

Kind of noticeable, but in a “who cares” sort of way.  It’s hot outside.  And I’m wicked pregnant.  And I have no waist anymore.  You can see my insulin pump?  Good for you.  You can probably see my belly button, too.

“No kidding.  Diabetes?  Is it because of the pregnancy?”

“No, I’ve had diabetes way longer than this pregnancy.  I was diagnosed when I was seven.”

The guy paused for a second, his eyes lingering on the infusion set on my arm.  “So you do that thing instead of shots?”

“Yep.”

“Do you like it?”

That question always throws me a little.  Do I like it?  The pump?  I do like the pump.  I like not taking injections.  I like not whipping out syringes at the dinner table and exposing my skin.  I like taking wee ickle bits of insulin to correct minor highs.  I like running temp basals to beat back hypos.  I like people wondering what it might be instead of assuming it’s a medical device.

“I do like it.  It works for me.”  I paused, already envious of the coffee in his hand.  “I like coffee more, though.”

He laughed and finished paying for his coffee.  “Can’t blame you for that.  Good luck with the baby, and try to stay cool in this weather,” he said.

I don’t like diabetes.  That’s for damn sure.  That shit is exhausting and I’m burnt out on the demands it places on my life.  But the pump?  Yes, I do like it.  It’s  a streamlined delivery mechanism for a hormone I wish my body would just cave and start making again.  It handles diabetes so I can go back to trying to put my socks on without tipping over.

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