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Why I Pack Heavy.

“And then Marcus gave me a Valentine and it had SPIDERMAN STICKERS on it and I love Spiderman stickers so that was the best Valentine I got except the one from Maddie that had a pencil and that was ALSO THE BEST ONE,” yelled Birdzone from the backseat as I was buckling myself into the driver’s seat.

“Yeah?  So Valentine’s Day at school was awesome?” I asked her, reaching over my left shoulder to grab the belt.

And then I felt that familiar, gentle * pop * of the infusion set coming loose from the back of my arm.

Rarely do I have the chance to use my emergency supplies (which is a plus because that means I rarely have emergencies), but I always carry them.  Even though I wear an insulin pump, I keep a back-up pen of Humalog floating around in my purse.  Sure, it will eventually expire and I’ll have to swap it out for a new one, but in a pinch, it’s enough.

And even though it’s a bulky little spaceship to keep on hand, I always have a back-up Inset for just-in-case moments, like when I accidentally rip out my infusion set in the parking lot of Birdy’s school.

This is why I don’t ever pack light; when you’re a klutzy PWD, a small purse just isn’t an option.

 

That Escalated Quickly.

After downloading and uploading and reloading all my device data to Diasend, I’ve seen the Big Picture, and it kind of blows.

For a good, long clip, things have been completely fine.  In range most of the time, not too many gross lows, and highs were classified as an extended 180 mg/dL, with symptoms to boot.  Well done!  Diabetes on point!  Celebrate by shoveling snow!

But a hiccup here and there have given way to a slippery slope of fuckery.  My two week average a month ago was fine.  My two week average yesterday was gross and not at all where I want it (and know I can have it).

I’m glad I’ve looked at my data, because I’m not sure I would have noticed just how dodgy things had become.  (And a quiet but still curmudgeonish thank you to the need for a flurry of paperwork in order to get my new insulin pump through insurance approval, forcing me to provide blood sugar logs and other data points in order to convince my insurance company that yes, I do have type 1 diabetes.)

I didn’t realize how much higher my two week average had become until I looked at it and recognized the need for change.  Two weeks for me makes a big difference, because it’s in that time frame where I make crappy tendencies into crappy habits.  Ignoring high alarms is okay for a day, but not for a week.  Forgetting to pre-bolus can roll by a few times but more than that equals out to crummy postprandials.  Carby food choices that are lackadaisically carb-counted brings on the blood sugar roller coaster.

Eff that noise.

Time to deescalate this.  Quickly.  Before it becomes as piled on as the three foot mound of snow on the back deck.

I’m Not a Doctor, But I Can Help.

“Mom, what is that rose?” she asked as colored at the kitchen table.

“It is part of a thing I’m working on that helps kids with diabetes who need insulin.”

“You give them insulin?”

“Kind of.  These kids live in countries that are far from here, but they have diabetes like I do.  And their fridge doesn’t have insulin in it, so we’re helping to give them insulin.”

“What happens if they don’t get insulin?”

“They can get sick.  And feel really bad.  So insulin helps keep them from getting sick.”

It’s hard to explain to my daughter why our fridge has insulin in it and why I don’t worry about where my next injection is coming from.  It’s hard to explain why insulin is so small, so silent, but so important in keeping her mother alive.

“I want to help.  I’m not a doctor but I can help,” she said.  “We can take one of your bottles of insulin in the fridge and put it in a FedEx and send it over to those kids.”

We send a little bit of money that helps do that.  Five dollars.  It helps.”

“So they can have insulin, too?”

“Exactly.”

“And so they can not be sick?”

“Exactly again.”

“That sounds like a good idea, mom.”

Exactly.  

Knowledge Gaps.

I wish I knew more about a lot of things.  Like dinosaurs.  (Mostly because Birdzone keeps asking me about them and what their names are and what kind of foods they liked to eat, and I’m not as brushed up on my dinosaur details as I was back in second grade.)

But there are things I truly wish I knew more about, in a diabetes sense, and I’m eager to learn.  One theme that’s come circling back around every few weeks is that of advocacy and influencing policy decision makers in Washington, DC.

This “lets all go to Washington!” advocacy, admittedly, makes me feel like an idiot because my knowledge gaps in this arena are obvious to me.  I know how to tell my diabetes story, but I don’t know how to made that story resonate for decision makers.  What makes issues matter to people?  What’s the best way to reach folks in policy?  How can one voice make a difference, and – more importantly – how can a collective of voices make the biggest difference?

We, as a community of people touched by diabetes, have the opportunity to learn from one another.  And I’m excited to do that, because I need to learn.  I want to be more effective as an advocate and for me, part of that process means closing some of my personal knowledge gaps.  (Here’s where programs like Masterlab are already so effective, and could be even more so.)

What do you want to learn (more) about?  Once we start minding the gaps, we can start filling them in with good information.

I want to learn more about effectively influencing health policy in a way that takes the best possible care of people with diabetes.  I want to learn more about how to make the most out of the healthcare I have access to.  I want to help empower myself to live well with diabetes, and to assist in empowering others.

Sparing roses helps.  It’s simple and makes sense to me.  But what else is there that can be done?

I seek education, dedication, and determination to help me find out.

(And yes, I’m sticking it into a blog post as a way to keeping myself accountable.)

Overheard.

Overheard from my daughter’s playroom, where two stuffed animals were having an intense conversation in high-pitched voices (and one soft toy was pretending to be me):

“Hi, I’m Kerri and we’re going to talk about type 1 diabetes.”  She paused.  “Or maybe type 2 diabetes. But either way, we have to talk about it.”

She makes a good point.  Either way, we have to talk about it.

 

 

Animas Vibe: A Few Weeks Later.

Again, disclosure:  I work with Animas and have a sponsorship contract.  Here are more details on my disclosures. And this is the Mr. Plow theme song.  Mr. Plow would be great, about now, since the snow keeps dumping down outside.

It’s been several weeks since I’ve switched to the Animas Vibe insulin pump (with integrated CGM technology – doesn’t that sound like a rehearsed phrase?  How about “insulin thing with CGM thing built in and have you seen my coffee, pleaseandthankyou.”), and I thought I’d take a crack at some second impressions, since the first impressions were only compiled after a few days.

Talking ‘Bout CGM:  I am still into the concept and application of having one device that does the work of two.  While the Vibe still requires that I wear an insulin pump infusion set and a CGM sensor as two separate insertions, it removes the need for an external CGM receiver.  I wrote about this last time, but to reiterate:  I am okay with not using the separate receiver.  I’ve traveled a lot in the last few weeks and the first few trips, I brought along my CGM receiver so I could plug it into the SHARE port.

For the record, I still haven’t upgraded to the 505 software.  Judge all you want.  :)   Which may explain my identical CGM graphs.  (And, also for the record, I’m really, really excited to see the new Dexcom receiver.  That may change how I feel about clouding, as it would be much simpler.)

But then Chris and I came to realize that we aren’t good at this whole “data sharing” thing.  As much as it sounds like a good plan in theory, we aren’t good at the application of it.  I think this becomes a patient-specific preference sort of thing, and for this PWD, I’m not a data-sharer.  But as I mentioned with that previous dead horse that I keep flogging, I like options.  Love them, actually.  And anything that gives data options – LIFE options – to people touched by diabetes, I am all for it.

(That sentence was a grammatical nightmare.  Ignore the sloppy parts and move on, yes?)

DiasendYesterday, for the first time in a long time, I downloaded (uploaded? loaded.) my data to Diasend.

The data collection portion is cumbersome.  I hate dongles and charging cords and all the extra beeps and wires required to make sense of diabetes data.  (Which is why I’m such a fan of the Verio Sync idea, which uses bluetooth technology to automagically suck the results off my meter and spit them into my iPhone, but there are issues with that system, too, because it’s only iOS compatible.  Pluses in one way, minuses in another.  But see aforementioned “I love options” sentiment, because it still applies.)  But I did download my pump data, which also downloaded my CGM data.  And, because I was feeling ambitious, I uploaded my glucose meter, too.

So this was my first time looking at Diasend with information about my insulin doses, glucose meter results, and CGM results on the same screen.  (No, I am not sharing my results.  My numbers have been absolute shit lately and I’m not going to pepper my blog with confirmation that I have diabetes.  I’ll let the c-peptide test that’s required by my insurance in order to cover my insulin pump serve as that confirmation.  Yes, that’s a thing.  Yes, more on that later.)

Diasend is good for granular information, but the information on the “compilation” tab was ace for me.  Seeing my blood sugar averages based on time of day was powerful.  (I have midnight to 11 am nailed and awesome.  Everything not in that time frame needs a solid snuggle these days.)   As a Mac user who hasn’t explored the new Dexcom/Mac Portrait (I’m woefully behind on everything that doesn’t involve Birdy these days), seeing my Dexcom data on my laptop is amazing.  I’ll be exploring Portrait in the next few days but in the meantime, I’m happy that information can be siphoned over to Diasend.  And it puts the constant flow of data into digestible context.

Pump Stuff.  Since I was a Ping user before, using the Vibe feels familiar and easy.  I’m still glad this sucker is waterproof and the button clicking process is familiar to me.  All of that feels the same.  One thing I have noticed is that the more my CGM needs attention, the faster the battery in my pump needs replacing.  This is annoying, but makes sense despite the annoyance.  For the first time ever, I’ve invested in lithium batteries for my pump and it seems to hold much better than the alkaline ones I have been using for the last … forever.  But overall, the pump feels familiar and comfortable, and since I hate change, that familiarity is a plus for me.

Alarms, for whatever reason, remain easier to hear and feel when they are coming from the pump.  This was a huge concern of mine because I thought the pump alarms would be muffled by clothes and bedding, making them hard to catch.  But I actually respond to low and high alarms more readily on the Vibe.  I am not sure why.  Maybe because it’s attached to my hip and I feel the vibration?

What remains to be seen is how the changing state of Dexcom progress will affect my feelings about this pump.  Right now, it’s the only one integrated with the CGM I already use, so that’s a huge plus.  But I am concerned about the fact that the software in the Vibe is already behind on the current Dexcom system.  I know the FDA process creates hurdles that are hard to clear, but since the Vibe has already cleared the Big One, can I expect that updates and upgrades will come fast and furious?  As a PWD using the Animas product, I hope this is the case.

And lastly, I’m hoping to have this pump covered by my insurance company.  I’m still trying to get a c-peptide test done (travel, snow, and issues with fasting) to fulfill the requirements issued by Blue Cross Blue Shield, so that journey remains ongoing.

Thankfully, I’m still pretty effing sure I have diabetes.   So yay?  Yay.

Spinach and Mushroom Fritatta.

I can’t cook.  Except when I can.

Turns out following a recipe is a helpful way to make a graceful transition between “fridge full of ingredients” and “actual, edible outcome.”  And a recipe that’s reasonably low in carbs, high in eggs (I frigging love eggs), and tastes good works for me.  Stolen from AllRecipes, I tweaked my version of this mushroom and spinach fritatta a little bit based on what was in the house and what I wanted in my face:

Ingredients:

  • 3/4 cup of fresh, chopped spinach
  • 4 eggs
  • 1 cup ricotta cheese
  • 2/3 cup freshly grated Parmesan cheese
  • 3/4 cup of chopped mushrooms
  • 1/2 cup of finely chopped scallions
  • 1/4 teaspoon dried Italian seasonings
  • salt and pepper to taste

Directions:

Preheat the oven to 375 degrees.

In a large bowl (preferably one that the cats haven’t been eating from), whisk the eggs and ricotta cheese together until smooth.  Then mix in the seasonings, then the spinach, and then the mushrooms.  The whole bowl sholud become a weird, pudding-ish mixture of breakfast bits.

Coat a 9-inch pie plate with a little bit of olive oil to keep the fritatta from sticking and then pour in the egg and spinach mixture.

Bake in the oven for 30 minutes, or until the edges are browned and the top is solid.  For me, it took 32 minutes to cook in full, and I let it sit for half an hour before we cut it and served it.  (I think if we cut it up any earlier, it wouldn’t have settled and had been a little soggy.)

Carb-wise (and according to the AllRecipes version), this dish serves up about 6 grams of carbs per slice.

The verdict at the brunch we hosted was that this spinach and mushroom fritatta was a hit.  “It’s delicious,” said one of our friends.  And that’s when I refused to tell them I made it, because I didn’t want my reputation to cause them to second guess their taste buds.

 

 

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