coffee

Why You So Stubborn, Diabetes?

I think of myself as a typically optimistic person, especially when it comes to my diabetes, because really my life with diabetes is better when I’m able to cast it in a positive light. Even so, that doesn’t mean that I don’t spend a few days in the trough of a wave every once in awhile.

Today was one of those days. I didn’t sleep much over the weekend, so this morning I got up early and fed the dogs and then decided I would try to sleep a little bit longer, considering it was Sunday and all and I didn’t have to go to work or anything. About the time I got comfortable, some masochist with a lawnmower decided that 8:00am was a fine time to mow the grass next door. Seriously, how do you get up so early on a Sunday and think, “I’ll go mow the grass this morning.” Read the paper and have a cup of coffee for Pete’s sake. Have a whole pot if it tickles you. Just don’t go outside and crank up the mower and wake up the neighborhood! </rant>

I like to make a big breakfast at least one morning on the weekend. I’m doing good to get dressed and get to work on the weekdays, so Sunday mornings are my time to pause and enjoy the thrills of a pot (or two) of coffee, eggs, sausage or bacon, and Meet the Press with A-Flizzle. If you ordered that meal at Denny’s, it would be a Grand Slam Nerdy, and could you leave a carafe of coffee on the table please?

I found a little bit of Bisquick left in the fridge, which is weird because most people put that in the pantry, but I decided to use it up and make a couple of pancakes. I limited myself to just one pancake, the one that came out looking like it had been put in somebody’s pocket instead of in the skillet, because I didn’t want my blood sugar to go through the roof or anything crazy. And it didn’t. It just hovered around the stinkin’ penthouse suite all day long, making me real frustrated because it wouldn’t come back down to the lobby where all the normal BG’s hang out.

That was the only starch that I had on the day, and I hovered around 200 mg/dl all day long. Being used to running a BG of around 100 lately, I felt that 200 in full effect. I even resorted to rage bolusing, just throwing a max amount of insulin at it to try and get it to budge. We went to see Hunger Games with some friends, and I barely touched the popcorn. Then we went to dinner afterward, and I couldn’t even eat because I was so nauseous and thirsty from the stubborn high BG. Finally, after I got home and gave up, I started to sink back down to normal again.

I ended up having to take over 100 units of insulin today to combat diabetes. That really, REALLY frustrates me, considering how a normal day for me (with carbs) is closer to 60 or 70. In hindsight, I shouldn’t have eaten that pancake, but there was no way of knowing that it would have been so stubborn all day long. The beauty of the conundrum is that it might not have even been the pancake. It could have been that my insulin lost its potency, or that I’m fighting off a virus of some kind, or that I was wearing green today instead of blue and my diabetes was offended. In other words, who knows?

Some of you may be reading this and thinking, “Wow, he’s got the diabetes real bad.” You may be thinking, “He really isn’t taking care of himself having to dose that much to get his blood sugars to cooperate.” You might even be thinking, “I would have been pissed too if that guy had woken me up with that damn lawnmower!” Or you might just be thinking, “Yup, been there, done that.” I’m convinced that some days diabetes has a mind of its own and does whatever it damn well pleases, regardless of what we try to do to “control” it.

Fighting back the tears, I was telling A-Flizzle about how frustrated it makes me when I feel like I have no control over what my body and diabetes has decided it wants to do. I hate feeling like I’m just strapped in and along for the ride, wherever it may take me. That is why I have the CGM, why I check my blood sugar on average 6-8 times a day, and why I try and count everything that goes in my mouth so that when I do make a mistake, hopefully it isn’t a complete disaster.

This situation is a good reminder to myself that we can do seemingly everything right in our lives with diabetes, from correct carb counting, insulin dosing, BG checking, and everything else, and yet we can still have those days where all of the pieces just refuse to fit together.

Tomorrow is a new day, with a new inset, and a fresh reservoir of insulin in my pump. So bring it beetus! I’ll be your Huckleberry.

Hangry

It’s hard to describe, and even differentiate sometimes, the difference between having a low blood sugar and just running on pure empty from not eating all day.

All week, since Daylight Savings Time kicked in, I have been trying to outrun the clock and get to work on time. I love DST, don’t get me wrong, but it’s really hard to get up in the morning when it’s still dark outside.

Okay, who am I kidding? It’s hard for me to get up in the morning whether it’s dark outside or not.

Yesterday morning was no different. Running late, I brushed my teeth, grabbed my work gear, made certain that I wasn’t walking out of the house with flip flops and pajama pants on, and hit the road.

I realized when I grabbed my messenger bag out of my car that it was lighter than usual. Turns out I had left my lunch (leftover white bean chicken chili from dinner the night before) at home. It happens, right?

This wouldn’t normally be a problem, but I have a habit (a good habit, if you’re viewing things from my employer’s perspective) of getting to work and throwing myself into things and not stopping. I’m notorious for working through lunch, skipping breaks, and looking at the clock to surprisingly discover that it’s mid-afternoon and I haven’t seen the outside of my office all day. The only thing that I will consistently break for is coffee.

After my second cup of coffee…okay, third cup…maybe fourth cup…I realized that I was pretty much plowing through my day of meetings, emails, phone calls, and one-armed library dragon training. Once I was done, and those dragons were tamed well enough to stamp due dates in library books like they were born with that one lonely arm to do just that instead of burn villages and terrorize innocent monks (Trogdor!!!), I called it a day and headed home.

Now, I knew I had been moderately low all day. I’m back to wearing my Continuous Glucose Monitor (CGM) again, after a slight hiatus from all the beeping and bonking and wee-ooo-wee-ooo-wee-ooo alarms waking me up in the middle of the night, and it had warned me off and on all day that I was hovering around 75 mg/dl. Still, I didn’t stop to treat it or deal with it. I just kept working.

When I got home, A-Flizzle and our pal EriCAH were there, so I started preparing dinner. Yay, food!

I kept noticing that I was agitated with everything, but I didn’t have the sense to question why. Cutting the chicken and vegetables, I was seething. Trying to figure out how to make the chicken stock thicker, I was fuming. When I realized that we only had a single serving of rice, I was mulling over what it would be like to throw the refrigerator off a cliff. It was so ridiculous that I was getting on my own nerves. I must have been driving A-Flizzle and EriCAH crazy.

That was when I realized I had reached my limit. I was low. I was hungry. I was angry. I was HANGRY! And I was making dinner and the food was too raw to eat immediately. Oh, the agony! The horribleness! The tragedy!

Eventually dinner finished, and we all got to experience my chicken thai curry science project of a meal, but it was a great example of how normal for some people isn’t normal for those of us with diabetes. There are times that we absolutely MUST stop and eat. Going all day long without eating is dangerous, and in hindsight, I’m probably lucky that I didn’t have a sneaky low that left me sitting in my office in a pile of sweaty, shaky, confused nonsense with a co-worker telling me, “Drink your juice Shelby!”

I’ll probably do it again though. Because I’m stubborn like that.

Some Of What I Learned

Floating around various blogs, some diabetes-related, others just pure nonsense, I’ve noticed that several writers have posts that follow a particular theme at times. I’ve tried Monday Mantras, but I tend to get really busy on Monday’s and forget to do them. Or I can’t find a Sharpie pen to write with. Or my Post-Its to write on. But mostly, I just forget.

Sara over at Moments of Wonderful does this cool thing called Faith Fridays. I’m not a particularly religious person (faith, yes…religion, not so much), but I really dig what she shares because she connects it to her real life. I think that faith must have that connection to real life to have much meaning. Your ability to walk on water may vary from mine…I tend to sink pretty quick.

I know me, probably better than most people do. I know that I have a hard time doing anything on a consistent basis, with the exception of DSMA on Wednesday nights and having coffee every morning. EVERY. MORNING. I have to really be passionate about something to keep it going for a significant length of time (ahem…this blog). I also need to have the vision to see where something is going. If I can’t see the end result myself, or have it explained to me by someone, then it can be difficult to get me to buy into it. I like to dream big, and in detail. Doing something just to keep the ship afloat does me no good if I can’t envision the paradise that the ship is sailing to.

Part of having and developing a vision for the future, any future, is having curiosity and the desire to learn something new. A world where people know everything would be pretty dull. While showering (you just never know where inspiration is going to strike, I tell ya!), I thought up an idea to share some of the things that I learn each month.

Also, if you want to write a post and participate at any time, just throw in the hashtag #SOWIL (stands for Some Of What I Learned) and feel free!

Some Of What I Learned (November 2011)

Daily blogging is hard to do, but doing it for National Health Blog Post Month is totally worth it.
If you have diabetes, you should get gifts on World Diabetes Day.
Disney World is indeed a magical place. More so if you have an A-Flizzle.
If you lose your phone at Epcot (or any park at Disney World) and they tell you that it is with Lost & Found at the Front Gate, that means it’s at Magic Kingdom.
The Muppets are just as lovable, fun, and relevant as they were when I was a kid. And I think they should get a weekly show, like Saturday Night Live, only Muppetier. Mahna mahna.
My dog has an uncanny resemblance to Rowlf.
99% of the diabetes online community prefers kindness over meanness. Also, 47.3% of all statistics are made up on the spot. But I’m certain that 99% is a pretty close estimate.
I miss having CGM data. I don’t miss stabbing myself with the harpoon and the uncomfortableness of wearing the CGM sensor. Can someone please come out with less intrusive CGM technology?
Samsung and Verizon are probably the worst two companies in the world to work together to introduce new technology in a timely manner. Especially when I need a new phone, and theirs is the one that I want.

30 Things About My Chronic Illness

I hate calling diabetes an illness. It implies that I am sick. I feel like sick should be reserved for people that are in dire straights, in need of immediate medical attention. We’re all patients in some way, shape, or form, but not all the time, and certainly not every day. Still, there are chronic conditions that some of us have to operate with, and in honor of Invisible Illness Week (which was actually last week, but humor me anyway), here is a list of things about mine that maybe you didn’t know.

1. The illness I live with is: Type 1 diabetes. Simply put, my body does not produce insulin. Not even a little. Not even at all.

2. I was diagnosed with it in the year: May 11, 1981

3. But I had symptoms since: I was two years old when I was diagnosed. You see, what had happened was I was minding my own business out in my yard, playing with my ball, just doing my thing. Then this girl comes along with her milkshake, and all these other boys showed up in the yard. Next thing I knew, I had diabetes. True story.

4. The biggest adjustment I’ve had to make is: I make adjustments with diabetes every single day. It’s a disease that requires near constant adjusting. I have to make adjustments in the amount of insulin I take based on what I eat, how active I am, what kind of activity I am doing, if I am sick, and sometimes for no reason at all. Every single day is different with diabetes, and the biggest adjustment is accepting that life is not scripted.

5. Most people assume: That if I’m having a low blood sugar, I need insulin. That is exactly what I do NOT need when I’m low! Insulin is a hormone responsible for lowering blood sugar, not raising it. Do not touch my insulin pump…EVER. If I am low and need your assistance, I need you to help me get something in me that is easy to chew and swallow that has glucose or sugar in it to get my blood sugar up fast, such as glucose tabs, juice, or even a regular Coke (not Diet!). If I am unresponsive, or you cannot get me to cooperate, please don’t hesitate to call 911 and ask for help. I’ll thank you later.

6. The hardest part about mornings are: Everything. I hate mornings. Especially before I’ve had my coffee. Sometimes the grumpiness is exaggerated by an early morning low or high blood sugar, making me even more…um, difficult. See #5 above for what you should do if I’m low.

7. My favorite medical TV show is: House. But that is primarily because of Olivia Wilde. (What? There’s more to life than just diabetes!)

8. A gadget I couldn’t live without is: My blood glucose meter. I could live without my pump (if I absolutely had to), as long as I have some way to inject insulin. And I could live without my CGM (Continuous Glucose Monitor) if I had to. All of these pieces add up to optimal diabetes management (for me, YDMV), and I hope I never have to live without any of them. But without my meter, I would have no idea what my blood sugar is, and I would have no way of knowing what action I need to take to manage my diabetes effectively. In essence, without my meter, I would be blind. (Diabetes pun not intended.)

9. The hardest part about nights are: Sleeping. Not only do I feel like sleep is the single most biggest waste of time ever, it is also dangerous for a person with Type 1 diabetes because it is when we are most vulnerable. Sleep is the time when our blood sugar can drop or rise without our being aware, and without the ability to correct it. Too many people, adults and children alike, have been lost to Dead in Bed Syndrome. This is reason enough for why we need a cure…NOW.

10. Each day I take no pills & vitamins. (Just insulin. And awesomesauce.)

11. Regarding alternative treatments I: The treatment for Type 1 diabetes is insulin and monitoring your blood sugar closely, period. The alternatives are health complications and death. I have full faith that science will one day deliver a cure for diabetes. Until then, no amount of exotic fruit or juice from a berry whose name I can’t pronounce is going to get us there. We absolutely must take insulin to keep us alive and well. Still, insulin is not a cure. Neither is cinnamon.

12. If I had to choose between an invisible illness or visible I would choose: Definitely invisible. I appreciate the choice of how visible or invisible I want my diabetes to be. Though I normally don’t, if I choose to hide my diabetes, I can.

13. Regarding working and career: I’m a medical librarian, a diabetes blogger and advocate, I teach, I speak, I travel, and I do anything that anyone else can…and I do it with Type 1 diabetes. I would love to someday have a job working closer with diabetes, on a diabetes hub, maybe with a company that focuses on diabetes, or that will work with me to work with others with diabetes. I absolutely love meeting other people with diabetes, sharing with them, helping them, and seeing that look when a parent realizes that their child with diabetes is going to grow up and be okay, or when that adult with diabetes finally finds someone else to share with who simply gets it.

14. People would be surprised to know: That even after more than 30 years with diabetes, there is still much of it that I can’t explain. For example, how can my CGM tell me that I have a “Low Predicted” and then an hour later I’m high with a BG of 170 mg/dl? Diabetes is pure nonsense sometimes.

15. The hardest thing to accept about my new reality has been: It’s not new, but I still can’t accept that there is anything that I can’t do because I have diabetes. Yes, this gets me in trouble sometimes. No, it doesn’t stop me.

16. Something I never thought I could do with my illness that I did was: I’ve never believed there was anything I couldn’t do with diabetes. Still, I like to push the envelope. Skydiving is fun.

17. The commercials about my illness: When I see a commercial about diabetes, I feel like it is targeting the vast majority of people who have Type 2 diabetes, and usually an older audience. I like Wilford Brimley and all, but that isn’t my generation, so I really wish someone would do something that appeals to those of us with Type 1 or Type 2 diabetes who are under the age of retirement.

18. Something I really miss doing since I was diagnosed is: Life with diabetes is all I’ve ever known, but I miss what I imagine it is like not having to carry so much diabetes stuff around with me. Sometimes I feel like the trash lady from Labyrinth, especially when I travel and end up carrying enough diabetes supplies to last me for two months, even though I’m only going to be gone for two days.

19. It was really hard to have to give up: Although I don’t think my personality is that of someone who would thrive in the military, it does sometimes aggravate me that diabetes took away the option for me to join a branch of the armed forces. Still, I appreciate that I am able to be here, alive and well, so that I can appreciate all of those who have.

20. A new hobby I have taken up since my diagnosis is: Blogging and engaging with the Diabetes Online Community (DOC) has been one of the most rewarding aspects of my life with diabetes so far.

21. If I could have one day of feeling normal again I would: I don’t feel abnormal, except when my blood sugar is too low or high. I wouldn’t be opposed to a day without having to monitor my blood sugar and every single thing that I do and eat. If I could have that, I’d probably just spend all day pigging out in the candy shop at Walt Disney World.

22. My illness has taught me: Patience, and the fact that I don’t have enough of it.

23. Want to know a secret? One thing that people say that gets under my skin is: “How sick are you?” I want to really make them feel awkward and answer that question with something akin to, “Well, at night I dream of riding horses naked in the rain, while hunting dinosaurs with rocket launchers, and then after a good hunt sitting down to a feast of buffalo pterodactyl wings and celery sticks. With ranch dressing.” I’m weird.

24. But I love it when people: Take the time to ask me questions, and clarify what they know or thought they knew about diabetes.

25. My favorite motto, scripture, quote that gets me through tough times is: “You can turn painful situations around with laughter. If you can find humor in anything, even poverty, you can survive it.” — Bill Cosby

26. When someone is diagnosed I’d like to tell them: You can do this. And you will do this. And you will be better because of it. Because you’re good enough, you’re smart enough, and doggone it, people like you.

27. Something that has surprised me about living with an illness is: That most of the time I don’t feel ill from it. Awesomesauce!

28. The nicest thing someone did for me when I wasn’t feeling well was: When you have a low blood sugar with diabetes, it tends to wreck all plans of whatever was happening prior to that moment. I am always and eternally grateful for the folks that put me first when I have a low blood sugar and need a little help. Here is one such story.

29. I’m involved with Invisible Illness Week because: If just one person reads this and learns something new about diabetes, then that is one person who is more empowered than they were three days ago when they started reading this list. (It’s a long meme!)

30. The fact that you read this list makes me feel: Grateful. Whether you have diabetes yourself, or someone you care about has it, I hope you were able to take away something worthwhile.

I think it will be interesting to look back on these answers and see how and if they change with time. Are you curious? Do it!

Playing Jax

Last weekend A-Flizzle and I hit the road to go see a Typical Type 1 and a bevy of Bob’s. Along the way we were fed by 13 Gypsies, a Bob and I went for a solid 24 mile bike ride, we all witnessed a catastrophic Contagion, had some times that were a little low and a little high (BG-wise), and we even managed to snap a few pictures along the way.

It's extremely important to stay hydrated at all times.

There is always my personal favorite way to stay hydrated. What? It had my name all over it.

If you have too much though, things might get out of hand.

Breakfast with two fairytale creatures: A unicorn and an A-Flizzle. What more could a PWD ask for?

Wrestling with The Giant

It has been a couple of weeks since I’ve put together a solid blog post. I’ve been busy. I’ve been traveling. I’ve been exhausted. I’ve been preoccupied. But mostly, I’ve just been out of whack.

Normally, my blood sugars are prone to running low. I can be eating and run low. It’s just the flavor of diabetes that I’ve been blessed with, despite the basal testing and best precautions. The past couple weeks though, I’ve found myself in the 200’s on more than one occasion. At work sometime around mid-morning, 229. Before spin class, 250. A few hours after dinner, 240. Granted, I still have an occasional low, like yesterday’s lovely panic-laced BG of 37, but still. I hate running high.

Since I am accustomed to running numbers in the double digits rather than triple figures, I can feel every single mg/dl of a 200+ blood sugar. It makes me tired, it makes me irritable, it makes me unable to focus, and it makes me wonder what in the Sam Hill is going on?!

To try and figure out where this out of whackedness is coming from, I figure it’s worth taking a step back and looking at the bigger picture. I can’t keep proceeding like this, so I have to find out where my stresses are, and remove them.

So my blood sugars are higher than normal. Why? The first guess is something to do with my diet. I will admit that I’ve had a few more carbs in my meals than I should have lately, but I’ve also started back at the gym for the past three weeks. I need those carbs for fuel. I’ve discovered spin class at the gym, and I can’t keep up the pace for 45 minutes that burns calories, gets my heart pumping, and leaves my entire body covered in sweat if I don’t have the proper fuel. My blood sugar can easily drop 100-200 mg/dl in one single spin class, so it requires a careful balancing act of fuel in and power out. Still, if I’m being honest with myself, I probably don’t need ice cream, pizza, or Chinese take-out to fuel my gym experience. I know I could do a bit better job. But is that it, just my diet that could use a little fine tuning?

Being tired is easy to understand. I don’t sleep enough. But why am I not sleeping? Probably because I have way too much on my mind lately. My mind is all work, responsibilities, money, worry, friends, family, never feeling like I am getting enough accomplished, needing outlets and not being able to find them, not being able to share and say what I really think about things, not getting the support that I need, keeping way too much bottled up inside…too much thinking!

Or maybe too much coffee. Naa…no such thing.

Ironically, I can’t focus because I have too much to focus on. To give one thing my undivided attention, I stress out over everything else that gets ignored and suffers. It’s this constant vicious cycle that keeps repeating over and over, and meanwhile I feel like I’m falling further and further behind.

As you can see, it isn’t just one thing that is the challenge that must be overcome. It is all of it added together that makes it a giant. I don’t know what the exact solution is, but I know I have to keep trying, and hope that I’ll find a way to bring this giant down to size before he looks at me and says, “Hmm…tastes like chicken?” and then eats me alive.

Today I’m going to put a new CGM sensor on my body, and I’m going to pull the rug out from under these high blood sugars at least. I hate them. They make me feel awful. So goodbye to them. I’m bad about taking breaks away from CGM, but I didn’t get it just to look at it. I got it to warn me of when there is a problem, diabetically speaking. Be it warning me that I’m high or low, the CGM has a purpose, and I’m not giving it a fair opportunity to help me when I’m not wearing it. And clearly, I need the help right now.

I’m also going to resign myself to focusing on just one project, at least temporarily. Not 30 projects and things that I need to get done. Just one. And I’m not going to stop until that one is done. Because then I will have 29, instead of 30. And that is progress, no matter what speed it travels at.

Amazeballs

At DTreat in Tampa, Florida over the July 4th holiday weekend, I got to meet some incredibly special people with Type 1 diabetes. It wasn’t their diabetes that made them special, or that they had superpowers, or even that they had three hands and could magically put in an arm site for their Continuous Glucose Monitor (CGM) sensor without having to ask someone else for help. (Okay, maybe that last one is just my wishful thinking.)

What made these young adults special were the fantastic things that they were doing with their lives while living with diabetes. The majority of the folks there were college students, who were preparing for awesome careers in their not-so-distant future. There were young adults there who were transitioning from college, who were getting prepared to or already dealing with diabetes in a full-time job role. I looked around, and I saw lawyers, nurses, teachers, psychologists, dancers, librarians, social workers, and even baristas. (Believe me, if you don’t think a barista is an important job, apparently you’ve never been around me in the morning before I’ve had my coffee.)

Two weeks after DTreat, I got a notification on Facebook that I had been tagged in a photo by my friend Catherine Vancak. Because I’m a complete photo ~~whor~~…um, opportunist…and I like to be in as many of them as I possibly can (just ask Scott Johnson), I traveled over to Catherine’s page to see what Kodak moment I had been captured in this time. That’s when I found the shot of her balls. (Yeah, you try working that line into a blog post and get away with it…that just happened!)

Cake balls! Made by my friend and bolusing ballerina ball baker Catherine Vancak.

While in Tampa, I was asked to speak to the group about how to connect with others who live with diabetes, the Diabetes Online Community (DOC), and ways to take the DTreat experience home. One of the things I talked about pulled from my own personal experience of not having anyone with diabetes to connect with for 28 of my 30 years with Type 1. I stressed to my new, pancreatically challenged friends the importance of not letting the opportunity that they had to connect pass them by. I encouraged them to exchange phone numbers, email addresses, become friends on Facebook, follow each other on Twitter, sign up for TuDiabetes, or Juvenation, or get involved with Students with Diabetes. Whatever way they could to keep in touch.

I wish so much that I had had the opportunity to know more people with diabetes earlier in my lifetime, and that makes me eternally grateful for those that I have become so close with in my life now.

Catherine had made these cake balls, and had tagged each ball with the name of a friend that she had met at DTreat that she had gotten to know and who had made an impact on her life with diabetes. They were her way to connect. To me, it was a clear indication of how important it is to have other people with diabetes in our world, and the positive impact we have on each other.

As Catherine said, “I need to make more balls so I can add more diabetic friends!”

Don’t we all.

——————–

P.S. – Remember I mentioned that there were dancers at DTreat? Catherine is a trained ballerina, with Type 1 diabetes. Proof that with diabetes, motivation comes from what we can do, not from what we can’t do. Dream big. There is nothing you can’t do with diabetes.

Catherine Vancak

Helleaux From New Orleans

I’ve been traveling and working a lot lately, which is to blame for the lack of blog posts in the past couple weeks. A couple weekends ago I spent a few days in New Orleans celebrating A-Flizzle‘s birthday. We had a great time eating good food, exploring quirky and interesting stores and art galleries, and overall just having a great time away from work and responsibilities. We even got to check out a fun swampy sounding backwoods bayou band that featured a mix of blues, jazz, and a quintessential New Orleans sound…and a trombone. I love me some trombone.

New Orleans is a city whose disaster history in recent years is known quite well. In September of 2005, the city of New Orleans suffered a devastating blow by Hurricane Katrina, causing billions of dollars in damage and changing the lives of thousands of people. The city still features glimpses of the storm damage, but it is as rejuvenated and full of that New Orleans spirit as ever, while still retaining it’s signature lack of polish that gives the city so much of it’s soul.

Librarie Book Shop - New Orleans French Quarter

Shotgun House Garden - New Orleans French Quarter

Haunted Hotel - New Orleans French Quarter

Lafayette Cemetery - New Orleans

Traveling with diabetes is always a challenge, as any PWD can attest. Accurate carb counting while on the road is equivalent to winning the lottery or catching an empty cab in the city on a rainy day. Really, it’s mostly luck and best guess. Something that New Orleans is better known for than Katrina is its amazing food, but when you’re trying to stay focused on low carb eating, it isn’t easy being in a city where poor boy sandwiches and fried everything are the staples.

Some of the foods that I enjoyed the most in New Orleans weren’t really food at all. A couple blocks from the shotgun where we were staying was a Community Coffee house, and let me tell you, Community Coffee is so much better in New Orleans than it is anywhere else you can get it. One of the highlights of the trip was a morning when A-Flizzle and I got up early, walked to CC’s to get our coffee, and then headed east to the mighty Mississippi River and sat on a bench and just took a few moments to chat and soak it in. Here is a city that actually sits below the water level, where all that is separating it from a seemingly unending supply of muddy water is a dirt and rock levee, and yet somehow it thrives and survives.

Mississippi River Levee in New Orleans French Quarter

It’s a lot like how I feel about my own diabetes sometimes. I’m always just a break in routine diabetes management away from the proverbial levee breaking and a gush of unpredictable blood sugars flooding in and causing all sorts of chaos. Which is pretty much where I am right now, by the way. My biggest problem is that I’m having a hard time getting pump insets and CGM sensors to stay stuck to my body. On more than one occasion I’ve reached under my shirt to check an inset just to find it floating around in the fabric as free as a bird, spewing insulin all over me like a malfunctioning Band-Aid smelling fire hose.

The thing about diabetes though is that you can’t let it keep you from living life. As annoying as disconnected pump insets and CGM sensors can be, they are manageable and something that I refuse to let keep me chained to the house. I love to travel, and see new places. If that means I have to duct tape my diabetes attachments to me in addition to spending a small fortune and carrying extra supplies everywhere with me, I will.

So in the true New Orleans spirit of things, I say to you, diabetes: “Laissez les bons temps rouler!”

…because ultimately, this is what being in New Orleans was really about:

More Cops and Low Blood Sugars

While trying to figure out a good topic to write a blog post about while enjoying a giant cup of coffee at a nearby Starbucks, I spied with my two eyes a table of three police officers who were on break. I recently read a great blog post by my buddy Scott Johnson titled “Cops and Low Blood Sugars” about a conversation he had recently with a couple of officers about traffic stops involving diabetes and low blood sugars. Feeling curious, I decided to follow Scott’s lead, so I grabbed my blog business cards and headed over to the table o’ police and asked if I might be able to interrupt them for a few minutes. To my surprise, they were very polite and happy to accommodate me, and invited me to sit down and join them.

These particular three officers worked traffic duty with the Tallahassee Police Department. One of them had also worked for a time with the Florida Highway Patrol. The former FHP officer was the most vocal of the group, and seemed to have had the most experience encountering diabetes behind the wheel.

I started with the same question that Scott did, inquiring if they had encountered traffic stops involving diabetes and low blood sugars. The former FHP officer said yes, and proceeded to share a couple of the more extreme cases he had dealt with. One story involved a man who was having a low blood sugar while driving on I-95 near Jacksonville into oncoming traffic. The officer said that he had to force the driver into the guardrail on the side of the highway to stop his car and keep him from injuring someone in a potential head on collision. Another story involved a PWD behind the wheel who was having a diabetic seizure and crashed into a tree.

I proceeded to ask the officers how they distinguish a diabetic medical emergency from driving while intoxicated (DWI). The short answer, they don’t. At least, not initially. A low blood sugar and a DWI can cause such similar behavior that stopping the vehicle and getting the driver away from the wheel in the name of public safety is of the highest priority to the police officers. There was a lot of head nodding at that statement, so they appeared to be in agreement on this point.

The officers said that they can sometimes distinguish a diabetic medical emergency from a DWI based on smell. Two of them described a sweet odor that comes off of a PWD when they are having a severe low, as opposed to the pungent smell of alcohol. I’m guessing what they are describing is the odor from the clothes-soaking sweat that sometimes accompanies a sudden low. Still, I’m not going to bank all of my points on an officer being able to help me based on smell alone. What if that officer has a cold on that one day that I need his sniffer to be fully functioning to save my life? To my relief, they also acknowledged other typical low blood sugar symptoms including confusion, sweating, inability to focus or respond to basic questions, shakiness, and in extreme situations even seizures, vomiting, and loss of consciousness. I gave them a mental check mark for knowing those.

So what happens, after the car is stopped and everybody is safe? If it is a diabetic medical emergency, the officers confirmed that paramedics would be called. After that, they said to fully expect the applicable punishments according to law. Read: citations and possible suspension of driving privileges until review and approval for reinstatement by the medical review board. They informed me that the steps that a PWD would have to go through after such an event would likely be similar to those that someone who suffers from epilepsy would have to go through to get their license or have their license reinstated, including a period of time (unspecified how long, and probably varies by situation or state) showing that their diabetes is in good control. Still, they deferred to the medical review board, as once the traffic case is closed, they are often left out of the loop as to what exactly happens in the long term.

From their no-nonsense point of view (and the one point where we disagreed), having a low blood sugar behind the wheel of a car and driving drunk are both totally preventable and are entirely the choice of the driver. One officer said that it is person’s choice whether or not they want to take responsibility for their diabetes and keep it under control, no different than a person’s choice to drink alcohol before they get behind the wheel of a car.

Obviously, he didn’t have diabetes. Nobody’s perfect. *wink*

We know that the realities of living with diabetes are not necessarily preventable or predictable. Life happens. Still, rather than argue, I encouraged the officer to continue, because I wanted him to understand that I’m asking for a HUGE number of people who live with diabetes each and every day. I want to make his job and our lives both easier in the unfortunate event that we do find ourselves on the side of the road having to deal with each other. What can we do, as PWD’s, to help police officers help us in a time of need?

Wear a medical alert ID on your wrist.

All three police officers acknowledged that recognizing a medical alert bracelet on the wrist or around the neck of a person is part of their training. They even followed up by saying that the wrist is the first place they would look, since they are trained to make sure they can see a driver’s hands at all times.

I also inquired about bumper stickers or window decals that say “Diabetic Driver.” They all said that it might help, but a medical ID on the wrist would be better. In a traffic stop, they are trained to look for other things beyond what a bumper sticker or window decal says, and a medical ID on the driver is more indicative that they are indeed the person in need of attention.

Get your drivers license to indicate that you have diabetes or are insulin dependent.

In Florida, if you indicate that you have Type 1 diabetes you can get a stamp on our license that says “INSULIN DEP” in bright red letters. I actually took my license out and showed it to the officers, and they said that because that is the only red ink on the entire license, it stands out and they will notice it. They also said that sometimes (unfortunately, not 100% of the time) the dispatch officer will also point out to them when they run the license number that this is a person who is insulin dependent and may need assistance. Check with your state to see what your options are. (I’d also be curious to know if there are any options like this for those with Type 2 diabetes.)

Check your blood sugar EVERY time before you get behind the wheel of a car.

The officers (and me) all agreed that managing diabetes is the most important thing we can do before getting behind the wheel of a car. Before you drive anywhere, stop and take 30 seconds to check your blood sugar, and if necessary treat accordingly. Let’s be honest, you probably need to check it anyway.

A Moment Without Diabetes

This past weekend was a working weekend. I spent the vast majority of my time on the computer and frequenting my local Starbucks for liquid motivation. I have a big work project that I’m trying to get finished ahead of schedule, so I had to make sacrifices at the expense of my weekend. If I wasn’t certain that the end project is going to be awesome, that might bother me more.

Coffee houses are very interesting places to do work. You get see all kinds of people come in and order their custom cup of Joe. My personal favorite (from Starbucks) is the skinny caramel latte. In my head it is a dark, sexy cup of deliciousness with just enough cream and candy sweetness to indulge in without too much guilt, equivalent to the joys of silk pajamas. In reality, it’s a latte made with sugar free caramel syrup and fat free milk. They would probably sell more of them if they went with my description, but that’s neither here nor there.

While I was sitting in Starbucks on Sunday, something interesting happened. Earlier in the afternoon I had gone to the gym and did hill climb intervals on the stationary bike, and managed to sweat off my CGM sensor. After the gym I went home and put the transmitter on the charger, got a shower, and immediately put a new CGM sensor in and reconnected.

Two hours later, while sitting at a table in Starbucks with my trusty laptop and mostly minding my own business, my CGM alarm screeched at me and notified me that it was time for a calibration. I grabbed my kit, did a finger prick, and took care of business. Nothing special there.

The special part was that, while doing this, I was having a conversation with a gentleman next to me about the oddness of the electrical outlets at this particular Starbucks being located behind the removable back cushions of the bench we were sitting on. Our conversation had taken place despite diabetes trying to interrupt. Neither he nor I had given diabetes the courtesy of the time of day.

Normally I feel like I have to hit the pause button on my life for these moments with diabetes. Even having had diabetes as long as I have, I notice them, like red flags on a green golf course. I have to hide the red blood drop from a squeamish passerby, or ask the person waiting on me to go somewhere to hold the door for just a few seconds so I can check my blood sugar first, or choke down a couple glucose tabs and wait a few minutes before finishing a conversation.

This was different. Although diabetes was there, this was a moment without diabetes, and it was so subtle that I almost missed it. It was nice, and I appreciate it, even if it was only for that one moment.

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