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Posts tagged ‘diabetes management’

Untethered, After a Fashion.

Around 8.30 am, I took an injection of Levemir.

At about 9 am, I switched my basal profile to “OTHER” and disconnected my insulin pump.  The OTHER profile has me at 0.025U basal rate per hour (as close to zero as I can get on my pump) but still holds all my other settings.  I kept the pump in my purse and the infusion set attached to my body, with one of those pump caps (there are two that come with every box of Insets) to keep the site closed.

At 9.03 am, I put on a skirt with a loose waistband that had previously been tugged down by the weight of my insulin pump BUT NOT ON THIS DAY.

Throughout the day, my basal needs are served by the Levemir injection, but I reconnect the insulin pump to deliver my boluses (allowing me to take my meal boluses and correction doses with precision and also without piercing my skin another time because the infusion set is still in place).

Around 9 or 10 at night, my Levemir injection is pretty much toast (over the years, I’ve seen that Levemir leaves my system after 12 hours, so I usually split my dose completely on pump vacations), so I reconnect my insulin pump and spend the overnight connected, receiving the basal bump at 5 am that is delivered to combat the dawn phenomenon my body experiences.

And then, depending on what I’m doing the next day, I’ll decide to keep my pump on or off during the day.  The Levemir pen in my toothbrush holder serves as a reminder to take a morning dose, if that’s my jam.

I like having a choice.  Can’t un-choose diabetes, so having a choice as to how I deliver my insulin is a plus.

It sounds complicated, but it works for where I’m at right now, because I am aiming to make good on the whole “fit diabetes into life, not work life around diabetes.”  And as petty and superficial as it may sound, it made me bananas (read: super angry, not yellow and slippery) when I went to get dressed for the sticky, summer heat and didn’t have a good place to shove my pump.  On the waistband pulled my skirt down.  Between the cups of my bra made for weird lumps and also unnecessary warmth.

This kind of frustration is the shit that can send me into a week-long DBM (Diabetes Bad Mood) and I am trying to mitigate as much of that as possible.  So off came the pump.  On came the highly structured plan to untether in the most graceful way possible.

Keeping an eye on my CGM showed when things were working and when things need tweaking, and I felt at peace with my diabetes instead of Rage Against the Islets.  Which, while a solid band name, doesn’t do much for my emotional health.

Reboot.

Diabetes and I are not getting along these days.  Not even a little bit.

Funny how that shit happens.  You’re rolling along [insert lilting “do de doooo” tune here] and then BAM Dexcom graphs start to get weird and BAM other health concerns start issuing commands that dominate the conversation and BAM all of a sudden, my blood sugars are absolute garbage and I need to reboot my whole system.

So okay, fine.  I’ll reboot my system.  Only it’s having trouble rebooting because of a few hard-to-change-at-the-moment things.  Like a demanding travel schedule for work.  And some meds that are gaffing up my blood sugar numbers all on their own.  And my unparalleled ability to instantly be distracted.  These aren’t excuses, but they are reasons, and these reasons are keeping me from rebooting entirely.  Instead, I’m temporarily stuck in that spinning pinwheel of rainbow doom that my old laptop was stuck in, going around and around in an attempt to reboot but ends up being a “press the power button until the whole thing powers down” moment.

(Yes, I also cannot stop staring at that thing while it spins.  It pulls me in.  Siren song of Mac doom.)

I’m aware of a lot of my shortcomings, though, and I recognize that a full reboot isn’t going to help.  I am not a “change everything all at once” sort of diabetes repair woman.  I’m more of a “change one thing, then change something else” type, leaving me with a breadcrumb trail of good decisions that eventually brings me back to better blood sugar control.  It’s a mixed metaphor that has yet to involve Hansel (he’s so hot right now, so I should get on that), but in time, I can wiggle these glucose numbers back into a better groove.

This time, I know it’s my response time to data that needs the most attention.  I have to be checking my glucose more regularly (and not simply in the morning, before bed, and whenever the CGM needs to be calibrated) and responding to the data I collect ASAP.  (Calling it “data” helps keep me from feeling like those numbers are little pockets of judgement and self-worth assessments.)  High?  Correct it.  Low?  Don’t over-treat it.  In range?  Do a happy dance in the kitchen because hot damn.  But the bottom line is PAY ATTENTION.

Complaining about this crap helps, but working to fix the parts I’m complaining about helps more.  This was my whine.  Now it’s time to work.

 

Organized Diabetes, Now With More Tips!

Just before the close of November, Susan Weiner was kind enough to guest post about tips and tricks on getting diabetes organized – and keeping it that way – throughout the hectic holiday season.*  In the comments section of that post, there were some awesome tricks, tips, and suggestions on keeping diabetes from tipping over your Christmas tree, spilling eggnog on the couch cushions you’ve already flipped over once, and tracking snow through the house.

I wanted to share a few of them here, because they’re handy as eff:

My best tip is to bring a dish that you not only enjoy but that you know will treat your blood sugar nicely.”  – Rachel

“I try to enter as much info into my pump as possible so that I have a full logbook when I download the info. For example I tell my pump when I have a low–even if I don’t need a bolus. That way it shows up in my records without having to write anything down.” – Katie S.

“Holiday time is also the end of the year and time to order prescriptions, pump supplies, test strips, etc., especially if your deductible and out of pocket max have been met for the year.”  – Lisa

“I’m going to dust off the CGM and use that graph to remind/add incentive to stay in moderation.”  – Heather

“My best tip is to keep extra supplies at different locations. Grandmas house, daddy’s bag and mama’s bag. That way you can stay spontaneous and never leave your supplies behind!!” – Leigh Fickling

“When I’m making a plate at a party, I try to load up on the low carb/no carb options, and then really portion control the rest. I also try to bolus early and eat my low carb/no carb options first — that way when I get to the carb-y stuff, my insulin is already starting to work.  Most importantly, I make doubly sure to pack extra supplies when I’m at holiday parties and gatherings. There’s nothing worse than a bad pump set (and no backups) when you carpooled with four other people and just scarfed down two brownies. I’m not a fan of being the center of attention for diabetes stuff!”  – Carlyn

“If you’re on a pump, dual wave and square wave boluses are your best friends for high carb, high fat, large holiday meals and parties. Especially if you don’t follow a lot of the above tips about portion control and healthier grazing.” – John

“When I know I will be eating at a holiday party I will drink a glass of water before I eat. This way it fills me and then I chew gum. With my jaw moving it tricks my brain I guess and think I am eating. I will say I do eat just a couple of cookies to satisfy myself. Hey no one is perfect. With diabetes type 2 I just try and eat all in moderation and test with my meter.”  – Larry

“I have named all my robot parts (meters, pump, CGM). Not only does it help me keep things straight, but also helps my family understand what item I’m talking about, or asking for. It is so much easier to say, ‘Hey, could you bring me Charlie, please?’ instead of “My meter, in the black case, on the kitchen counter.. yes the thing I test my blood sugar with.. could you bring it to me please?’” – Jenn

“Most important tip: Enjoy the holiday season. Don’t let diabetes ruin it with overly complicated checking, rechecking and reorganizing everything. Of course big meals need to be bolused appropriately – but if you guess the carbs wrong you’ll notice next test and can correct them down.  Go ahead and actually eat a bit more than is sensible, enjoy an additional glass of wine or champagne and make sure the holidays are holidays. As long as it’s only a few days a year (and it is only a few days in the grand scheme of things), this won’t hurt you much.”  – Floh


Good advice indeed.  And now, with a week’s worth of blog posts about organizing and hacking diabetes, now is probably a smart time to upload my glucose meter.   😉

* Her publisher also offered to giveaway five copies of her book – the winners were Eileen B, Ellen, Steph, Annie, and Kelli (you will be contacted by one of the Spry Publishers team members, if you haven’t been already).

Hope vs. Fear: The Video Edition.

A million years ago (in Internet time, I think that translates to about eleven months ago), I had the opportunity to work with the team at Novo Nordisk and a few hyper-local Rhode Island/Massachusetts diabetes advocates to create a series of videos.  Our focus was on how hope can be a more powerful motivator than fear, in terms of staying dedicated to the daily duties of diabetes.

We were slated to create one video, but the discussions ended up creating three different videos on that same theme.  And here they are, featuring Katy from Big Foot Child Have Diabetes, Ryan from Diabetic Cyclist, and The Briley from InDpendence:



HUGE thanks to Katy, Ryan, and Briley for their patience and participation, and to Novo Nordisk for their support.

 

Going Solo.

Seven weeks is a long time.

It’s a lot of garbage days (I hate, hate taking out the garbage, especially since we have a crew of vindictive raccoons who have made it their agenda to bust into the garbage cans of everyone on our street, spreading trash all over the place and laughing maniacally whilst wearing hats).  Seven weeks is a lot of grocery store visits and pharmacy trips.  It’s a ton of bills.  Seven weeks is so long that your brain turns to inoperable mush.

Chris came home yesterday, after being away for seven weeks on a film shoot.  I don’t discuss much about his job here because it’s his news to share, but for the last two months, it has been hard not to discuss his absence, since it was affecting everything about my life.  Normally, our respective business trips are short.  For me, being away for a full week is a tremendously long time, and that is an anomaly.  For Chris, his travel jaunts are less frequent but usually longer, sometimes dipping into the eight – ten day away range.  This is something we’ve learned to handle, as a family.

But seven weeks?  Eff that.

Seven weeks is a long time to spend thinking about single parents and to build up even more respect for them, as the experience redefined “challenging” for me.  And I only experienced simulated single-parenting, my husband away but with a timeline for return.  It was while he was gone that I revisited the post-pregnancy feeling of not knowing whose needs to tend to first:  mine, or my daughter’s?

Unless I was away for work, I went to sleep every night with Birdy sharing a bed with me.  (Which was fine, except for the nights when she had a nightmare and would wake us both up, hollering about “the lemons are watching me!!” or the mornings when I’d wake up with the help of her tiny hands prying open my eyelids.  “Good morning, Mawm!”)  Every morning kicked off with a Birdy focus, unlike regular mornings, where the first thing I do is test my blood sugar and then go retrieve the kid, knowing I have Chris as back-up.  Good diabetes habits that I have forced (and then enjoyed) for the last year or so went a bit pfffft as Birdy became the focus and I was flying solo.

“But your health needs to come first, so that you can best care for your daughter.”

Shut up;  I tried.  Everything was a circus.  For five of the weeks of Chris’s trip, I was finishing up final edits on a book I’m writing (submitted to the publisher two weeks ago – more on that later!), which meant that once Birdzone was in the sleepzone, I was up until all hours, combing through pages to tweak content.  And the last two weeks of Chris’s trip included two trips for work, leaving my daughter under the capable (and so appreciated) watch of my mother.  “A good night’s sleep” was a laughable goal.  “Exercise” became either chasing my daughter while she rode her bike at a breakneck speed or brief stints on the ellipmachine in the basement (because going to the gym/for a run while she was awake wasn’t an option, and most times I was so spent that I couldn’t eek out much in terms of exercise).  Emails went unanswered.  Deadlines were pushed.  Pigtails were installed at uneven angles.  Bananas ripened and rotted due to neglect.

(But we always had gluten-free banana bread baking, because that has become a favorite past-time of the Bird’s.  So there was that.)

Diabetes became like a second kid, only one I don’t want to snuggle with.  It needs to be walked.  Fed.  Checked on and monitored.  It’s a needy little sucker.  When it whined and needed tending to, I had to explain to my daughter why we needed to wait a few minutes.

“Do you have whoa bwoodsugar?  Your Dexcom is howering [hollering].” Birdy asked me when I was popping glucose tabs into my mouth, car keys in my hand.

The term “whoa bwoodsugar” took on a whole new meaning when I was solely responsible for my daughter.  Being a parenting soloist for seven weeks made diabetes management pretty freaking tricky.  I’m thankful Chris is home now, because for the duration of his absence, my target blood sugar went from 150 mg/dL instead of 100 mg/dL, in efforts to avoid hypoglycemia while I was the only adult in the house.  My meter average followed suit, which was a frustrating increase after so many months in a comfortable zone, but I knew it was a temporary fix.  My job was/remains to take good care of my kid, and that’s hard for me to accomplish when I’m low as all hell.  It was an enlightening (read:  WTF) experience, and one that, for all of its challenges, I’m glad I proved to myself that I could handle, thanks in large part to friends and family, and the blessings of a flexible job.

But, for a dozen different reasons, I’m so glad Chris is back.  Because, at the end of the day, he’s the one who gave those hats to the raccoons in the first place, so he should be the one doing battle with them.

 

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