Skip to content

Posts tagged ‘diabetes’

Twenty-Eight and Thirteen.

Twenty-eight years ago, I was diagnosed with type 1 diabetes. It’s a moment in time that is so jumbled up with other things – my grandfather had been in a horrible car accident a few months prior to my diagnosis, my older cousin died in a car accident just after my diagnosis – there are memories of people in my family crying and there were so many reasons.  Vague memories of being in Rhode Island Hospital for two weeks, the kid with the spider bite, and practicing injections on an orange serve as markers on the timeline of my diagnosis, but clear memories don’t exist.

Diabetes has always been there.  It doesn’t get easier with time, but it does become more routine and less mentally intrusive.  Either that, or I’ve just become used to the intrusion.

I remember September 11, 2001 very clearly.  I was working in a bank in Newport, RI right near the naval base.  It was my first job after college, and the first plane hit the WTC as I was driving over the Newport Bridge to work.  My coworkers told me about the first plane when I arrived at the bank.  The security guard at the bank told us when the second plane hit.  I remember calling my father because I didn’t know what else to do, and he told me it was going to be okay.  His voice was calm.  Despite his inability to actually influence the events that were unfolding across the country, his words were reassuring and made me feel safe.

I feel very lucky that I didn’t experience personal loss on that day.  My heart goes out to those who did.

The nation is in mourning and I mourn with my country.  Simultaneously, I mark the anniversary of my diabetes diagnosis. I always think about people whose birthdays are on September 11th, or whose wedding anniversaries are September 11th.  I think about the people who lost so much on September 11, 2001. It’s a day where I feel conflicted thinking about diabetes, but it’s impossible not to apply personal bias to life.

I think it’s a day to close the damn computer.  To not read every news article and overwhelmingly sad bit of news being shared.  It feels like a day to be present, to remember to live.

 

So Many Things!

A Friday Six on a Wednesday!  Because why the hell not.

The FitBit obsession.

Renza talks about the messaging of diabetes, and what we can do to get it right.

Here is some damn sneaky research.

Seb is still running. And I’m still supporting the hell out of him, because he’s incredibly dedicated. You can still support him, too.

I am having the hardest time not filling our home with everything Murray, by way of Derek Eads.

“It’s a day to remember those who were lost. For me it’s a reminder that I’m lucky to be alive.”  Amazing post from Carly about a medical emergency on 9/11.

Are you in the Los Angeles area?  Diabetes Sisters is coming to LA on October 24th, and I’ll be part of the event, alongside some of my favorite DOC people (Hi Cherise, Manny, and George!).  Hope to see you there!

That same weekend, up in Anaheim, CA, the Children With Diabetes team will be holding a Focus on Technology conference.  There will be a whole session on setting up your CGM in the Cloud rig – don’t miss it!

Coming Together as a Community – a great piece from diaTribe’s editor-in-chief Kelly Close.

There is no such thing as a “free food.”  Sort of.  New column at Animas.

“today, i felt parts of the monster within myself.  today, i felt parts of the hero within myself.”  Excellent post from Heather Gabel about the activated patient.

THE SEA OF TREES found its way into People Magazine last week.

And these – THESE VIDEOS ARE AMAZING.  Melissa, you are the Weird Al of the DOC.  :)

Changing the Set.

Changing out an insulin pump infusion set is a methodical moment for me. I do things in the same order almost every time, with the same mildly frenetic mindset.

  • Remove old set from my body so I can enjoy the “connected to nothing” feeling for as long as possible.
  • Take out a new infusion set and new reservoir.
  • Ferret out the open bottle of insulin from wherever I’ve stashed it last in the bathroom.  (Usually it’s in the medicine cabinet, but during the hotter months of summer, I tend to keep it in our bedroom, where it’s cooler.)
  • Line the insulin set, reservoir, and bottle up on the counter.
  • Unscrew the reservoir cap and remove the old infusion set and reservoir from the pump.  Throw the tangle of tubing into the garbage, making sure said tangle doesn’t dangle over the edge of the garbage can because otherwise Loopy and Siah will find it and drag it all over the house.
  • Open the packaging for the reservoir and take out all the little parts (except that one frigging thing that I don’t know what it’s for and I usually throw it right into the garbage – see below):

  • Rewind the pump.
  • This is the point where I mentally set some kind of timer, challenging myself to race against the time it takes for the pump to rewind.  While the pump is whirring, I rush to fill up the reservoir and connect it to the tubing.  I do this every, single time.  It’s as satisfyingly ritualistic as shaking the bottle of test strips before I check my blood sugar.
  • Thread the tubing through the battery cap and connect the luer lock, then insert the cartridge into the pump.
  • Load the new cartridge.
  • Prime the cartridge, trying to stop the prime before more than a single drop of insulin escapes from the needle in the infusion set.
  • Hold the tubing up to the light and inspect it for bubbles.
  • After the pump is primed, again the mental timer is set.  This time, the challenge is to unpeel the sticky backing from the infusion set and find a place on my body that’s suitable for insertion before the screen on my pump goes blank from inactivity.
  • Insert the new infusion set, prime the cannula (sort of holding my breath while it primes because I’m never certain that the first introduction of insulin won’t burn under my skin).
  • Tuck the tubing out of sight and clip the pump to my clothes.
  • Fin.  (As in “the end.”  There’s no marine life actively involved in this process.)

This process takes less than two minutes to complete, but if it’s interrupted in any way, I’m thrown so far off course that it takes me five minutes to recover.  The method of this madness is that it’s one, fluid mental movement and any upset to the process makes my brain disengage to seek the comfort of something shiny.

It’s an intricate process involving several steps, precision handling, and the safe housing a powerful drug.  And if I have to change the battery at the same time …

 

Pre-Bolusing for Snacks.

“Do you pre-bolus for your meals?”

“I do.”  (I was happy to answer this question because I actually do pre-bolus.  Pre-bolusing is my A1C’s saving grace.)

“Okay, that’s great.”  She made a few notes in my chart.  “How about for snacks?  Do you pre-bolus for those?”

“I … um, nope.  I am horrible at pre-bolusing for snacks.”

Unfortunately, hat is completely and utterly true.

Meals are easier to pre-bolus for because there’s time involved in making them.  If I know I’m cooking chicken and green beans for dinner, I have 25 – 30 minutes to let that bolus sink in before the meal is even ready.  Going out to eat at restaurants is easy, too, because I usually have an idea of what I’d like to eat, so I’ll bolus for the meal once we are seated at the table.  (Pre-bolusing backfires at times, too, but as long as I’m not in the middle of the woods, I’ll take the risk.)  A meal feels like an event, and therefore easier to accommodate.

Snacks feel like an accident.  An unplanned moment.  I don’t take an apple out of the basket and bite into it in a premeditated fashion, but more like a fluid movement without any thought involved.  (A run-by fruiting by any other name …)  It’s not until I’m done with a snack – apple, yogurt, nuts, protein bar … cupcake? – that I realize I haven’t taken any insulin to cover the carbs.  My post-snackial blood sugars aren’t grateful for the misstep.

This would not be a big deal if I wasn’t such a grazer, but when 50% of my caloric intake throughout the day is on a whim, pre-bolusing for snacks matters.  My A1C is currently in my range (under 7%) but I know if I can remember even half the time to pre-bolus for snacks, I bet my standard deviation will tighten up and blah blah blah other numbers as well.

Little, conscious changes will hopefully become habit.

 

Whoa! Woe.

First this:

Then this:

So whoa!  Much woe.

BOLUS: Beware Of Loose, Unsupervised Snacks.

I graze.  I’m a grazer.  Visually speaking, my food choices are spread out over a gigantic field and I run through, grabbing bites here and there and never properly taking amounts or serving sizes into account.

“How many grapes did I just eat,” is a common, whispered question.  “Did I bolus for that protein bar?” is another one.  “Hey, I only had eggs and not toast – how many carbs did I bolus for, and what needs to be consumed now so I don’t hit the deck?”

I am good at going through the motions of diabetes management, but I have been slacking on minding the minutiae of late.  I don’t sit down to formal meals throughout the day (schedules are nonexistent at the moment), so keeping track of the food I’m eating has been a challenge.  Grazing makes for dodgy carb counting.

I need to mind my B.O.L.U.S:

Must Beware of Loose, Unsupervised Snacks!  When carbs are roaming around unsupervised and unbolused-for (terrible grammar, worse when spellcheck changes it to “unbloused-for”), blood sugars go high and stay there because I’m chasing my insulin-tail or I go low because I’m over-estimating.  Insulin is potent stuff, and SWAG’ing it makes for Ms and Ws on my Dexcom graph.  If I can just pay-the-fuck-attention to what I’m eating, I’ll have fewer frustrating results.  Right? RIGHT??

The more I mind what I’m eating, the more even my blood sugars will be.

Now let’s see how that theory shakes out, as I attempt it for the 10,000th time since diagnosis.

Gluten-Free Pizza Crust for the Epically Lazy.

[Insert whole paragraph about how I hate to cook/am bad at cooking/have no interest in cooking/would rather paint the deck.]

I don’t normally do anything resembling a “food review” because that’s not my bag (baby).  But I’m lazy when it comes to preparing food, so if I stumble across something that makes being a lazy chef even easier, well then hot diggity damn I am going to post about it.

BEHOLD!!  It’s a generic, “Acme Pizza” looking box, but the contents are wonderful.  This is gluten-free pizza crust and it’s legitimately delicious.  Kinnikinnick, your tagline is accurate.

I can’t say the name of it out loud without feeling like I’m casting a spell, but this pizza crust is worth writing about because it crisps up nicely, is thick enough to hold a pile of toppings, and when you bite into it, you don’t wish it was something else.  Birdy and I have experimented with several gluten-free dough options (not because of celiac, but due to preference) and this Kinnikinnick pre-made pizza crust has been the best one we’ve found so far.

“This pizza is good, Mom!”

I agreed.

[This is not an advertisement, or a sponsored post.  This post is the result of going to Whole Foods, spending eight billion dollars, and for once not regretting it.  Again, friends share.  So I'm sharing.  :) ]

Follow

Get every new post delivered to your Inbox

Join other followers