Skip to content

Posts from the ‘Blood Sugars’ Category

Looking Back: How Often Should I Change My Lancet? (A “Grost.)

source: Type 1 Diabetes Memes

I’m on the road today, visiting with the Patient Revolution team, so I’m looking back at a post from the past.  But it’s not just any post … it’s a grost.  (A gross post.)  How often do you change your lancet?  I will admit that I don’t do it as often as I should, but I’ve been really trying to do it more regularly.  In efforts to keep my fingertips from hating me.

  *   *  *

(Taking a cue from Glu today because when this post rolled through my feed, I was like, “Hmmm.  A lot now, but before?  NEVER!!”)

Every single time there’s a new meme about changing the lancet in a finger pricker device (nope, that is not the technical term), I laugh because they are all true in that “whoops” sort of way.

Upstairs in the bathroom closet, I have boxes and boxes of lancets for all kinds of different poker devices (again, not the technical term).  All different sizes and shapes and gauges … years and years worth of lancets for half a dozen different devices.  (Except The Guillotine.  That thing was retired decades ago, thank goodness.)  And the reason I have so many lancets stashed?  I went years without regularly changing my lancet.

Gross.  I know.  And I’ve seen that photo of what a needle looks like before use, after one use, and after six uses and yes, it grosses me right the hell out.  But for a long, long time, I changed my lancet once a month.  Maybe once a week, depending.  And I only changed it if it didn’t procure a good blood droplet or if it went into my fingertip and got “stuck.”  (You know what I mean … when you press the button and the lancet deploys, only it lodges itself into your fingertip and has a weird suction feeling when it pulls out?  Horribly horrible.)  Lancet swapping-out was a shameful non-priority for a long time.

Two things made me start changing my lancet regularly:

ONE.  A friend told me about how she’d heard a story about a person with diabetes whose fingertips were downright gangrenous because they didn’t change their lancet.  “Ew, really?”  “Really.”  And even though I stand firmly on the “hope vs. fear” motivation concept, this story about mostly-dead fingertips made me want to throw up.  Then I started searching the Internet for information on needle reuse and the photos made me want to apologize profusely to all my digits.  I had no idea how nasty and serrated the needle edges became after just one use.  I thought about all the times I had injected syringes through my jeans in high school.  I thought about how a box of lancets could last me two years.  I thought about how gross I was.  Gross, gross, groooooosssssss.

TWO.  And then I explored lancing device options.  I had heard really good things about the Accu-Chek Multiclix (mostly from Sara, because she frigging loves hers), and the device was snazzy because it comes with a drum of lancets that automagically swap out, but the size of the thing was too big for the case I kept my meter in.  Switching to the One Touch Delica was the winner, for me, because the lancet gauge is so thin that I’m forced to change it regularly because otherwise, I don’t bleed.  (It becomes that dance of pull back the device, press the button, nothing happens, repeat 10x, change lancet and curse.)  Like it or not, I have to change my lancet regularly or the device becomes useless.

Now I change my lancet once a day.  Every day.  And every time I kill a box of lancets, I feel accomplished because in the last four years, I’ve gone through at least two dozen boxes.

In the 20+ years prior?  Probably the same number of lancet boxes.

Useless Juice.

We don’t drink juice “for fun” in our house; it’s only for low blood sugars, considered almost as medicinal as the insulin hiding out in the butter compartment of our fridge.

So when I came home with these juice boxes unintentionally, I was pissed.

35% less sugar?  That’s exactly what I don’t want!

Useless juice.  I’m bringing it back and swapping it out for the fixes-a-40mg/dL-at-4am kind of juice.  The high octane juice.  Proper juice.

Hips Don’t Lie.

“You’re early for your appointment!”  The receptionist looked at me hopefully.  “Less nervous this time?”

(My track record as a nervous dental patient follows me everywhere.)

“Yep.  I’m early.  And I have a babysitter this morning for my kid.  I have to follow through now!”

Over the last seven years or so, I’ve finally hit stride with my dentist visits.  Very sensitive teeth and an obsession with flossing and brushing at home made me feel invincible, skipping cleanings because they were painful and only showing up for emergency dental appointments (like this).  But I’ve been trying to practice what I preach about preventative care, so showing up every six months for cleanings and scheduling repairs immediately is my new jam.

It helps that the dentists I’ve seen over the last few years have been very receptive to requests for more novocaine during repairs or sensitivity-reducing pastes during cleanings. When the procedures aren’t painful, I’ll follow through on all of them.  Which is what brought me to the dentist yesterday:  a very old filling on my back-most molar had come loose, in need of a redo.  As soon as it popped off, I made an appointment, wrangled coverage for my little Guy, and marched into the dentist armed with good blood sugars and my copay up front.

“Can I just duck into your ladies room before going in to see Dr. Fang? [Not his real name, of course.  But holy shit, I wish it was.]”

“Sure thing.  We’ll be calling you in about 15 minutes.”

In the bathroom, I went to de-pants (?), forgetting about the fresh, new pump site on the back of my right hip.  It was exactly where my waistband hit.  Which is why I deftly ripped it off when removing my pants.  Hips don’t lie.  They also don’t like infusion sets.

NEVER FEAR!  BACK UP PEN IS HERE!

Riding a wave of arrogance because I was ready for my dentist appointment and also because I knew I had an insulin pen in my meter case, I checked my CGM graph to see if I needed a little boost before my filling.  (Dentist appointments make me feel nervous, which causes my blood sugar to rise, so I expected to see an upward arrow.)  Sure enough, I was 160 mg/dL with double arrows up.

A unit will fix this right quick.

I pulled the pen cap off and saw a pen needle already screwed in.  Hmmmm.  I knew I’d used this pen when traveling in April.  Had that needle been on there for over a month?  I turned the dial on my Humalog pen to find it spongy and sticky.

Shit.  The last time I had a pen with a sticky dial, it was the result of an old needle cap that had contributed to built up pressure in the pen cartridge.  When it happened previously, I called the pharma company hotline and they advised me to check the rubber stopper on the cartridge.  I did that this time and saw that it was bulging.  I tried to push a unit into the air but nothing came out.  The pen was clogged.  No other pen.  No backup infusion set.

Awesome.  Insulin right there for the taking but no way to access it.  And my blood sugar was climbing aggressively.

“I need to run to my car for a second; is that okay?” I asked the receptionist.

She nodded, eyeing me skeptically.  “You’re coming back in, aren’t you?  Or are you making a run for it?”

“Nope.  I will be back in,” I promised.

The center console of my car is a treasure trove of crap:  lip gloss, spare diapers and wipes, glucose tabs, mints, packets of Truvia, a GPS from 2009 that wouldn’t be able to get me out of my garden never mind to a specific location, and the odd lancet or needle tip.  I was hoping to find one of those needle tips hiding in there, all sharp and new and ready to de-bulge the insulin pen pressure.

And there it was, crammed in the back corner of the console trench, unsure of how old it was but with the paper tab still over the base, so I knew it was unused.

Back in the dentist’s bathroom, I stashed my now-disconnected pump in my purse and was able to steal a unit and a half from my insulin pen (after a test bolus that exploded out of the pen and into the air – I’m sure I heard it yell, “Weeeeeee!!”), heading the high off at the pass.

Thankful for my packrat tendencies, I was called in for my appointment and after 45 minutes of drilling and scraping and refilling and novocaine and polite “Are you okay’s” from the dentist and mangled “mmm hmmm’s” from me, my tooth was filled and my blood sugar wasn’t garbage.

The moral of this toothy tale?  Bring backups of all your diabetes crap when you leave the house.  You never know when you’ll need to forage in the center console for drug paraphernalia.

DBlogWeek 2017: Diabetes and The Unexpected.

Diabetes Blog Week prompt for Monday: Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.  What are your best tips for being prepared when the unexpected happens?  Or, take this topic another way and tell us about some good things diabetes has brought into your, or your loved one’s, life that you never could have expected?

Diabetes Blog Week YAYYYYYY!

Unexpectedly, my iPhone decided to update itself on Saturday night.

I must have “agreed” to terms of service and scheduled the update, but I didn’t think the process through, because if my phone is updating the operating system, that means the processes on my phone are sort of stalled.

Including my Dexcom data transmission.  Which means I didn’t have any CGM data streaming overnight.  The low blood sugar came out of nowhere, a product of stupid poor planning and over-correcting a high in the wee hours of the morning.

Mother’s Day morning broke open with my body outlined in damp sweat, my color ashy, hands shaking, but my mind still sharp, considering my blood sugar was 35 mg/dL.

Super low glucose result - crappy way to start the dayOnly once or twice before, in thirty years of diabetes, have I ever felt close to passing out, but the precursor feelings seem to be waves of unconsciousness that lap at the edge of my mind coupled with a calm, reasoned mind, as if I knew I was about to go under and I needed to mentally take the biggest breath I could.

I had the sense to call Chris (he was downstairs with the baby) and ask him for juice.  I was afraid to sit up, thinking that might be enough to tip me into the abyss.

I asked him to put the baby in the crib in case I needed physical help.  I spoke to him through a mouthful of glucose tab dust, asking if he knew how to use the glucagon on the bedside table.  He said yes.  I asked if he could please hand me a towel so I could mop the sweat off my forehead.  The whole discussion was so calm, so structured, so oddly practical in contrast to the panic of being intensely low, the voice in the back of my mind screaming “AAAHHHHHHHHH!”

Makes me think I could solve quadratic equations while putting out a car fire while sitting in said car.  And the car is moving.  Fast.

Actually, that’s sort of what we do when severely hypo.

Unconsciousness due to a low blood sugar is the unexpected I think about the least, but prepare for the most.  I mean, I think about it, but not obsessively.  I just prepare all over the place, just-in-casing myself with juice boxes and raisins stashed in my frequently visited spots.  I try to always have fast-acting sugars on hand no matter where I am.  I share my CGM data while traveling. I keep that glucagon shot on the bedside table.

We’d talked about glucagon a few weeks early, after I’d refilled my prescription.  We almost used it when I was throwing up from the flu and my blood sugar was stuck at 45 mg/dL, not able to keep down the juice or tabs I was consuming.  It’s part of planning for the scary moments while simultaneously pretending, “Oh, that could never happen.”

Eventually, my blood sugar came up.  Exhausted from treading the hypo-waters for so long, I almost immediately fell back asleep on the damp pillowcase.  When I woke up again, I looked over at the glucagon kit, thankful for the fact that it was still sealed and hoping it continues to collect dust.

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.

Follow

Get every new post delivered to your Inbox

Join other followers