coffee

A-Flizzle and Martin - NOLA - May 2011 (FI)

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

Librarie Book Shop - New Orleans French Quarter

Shotgun House Garden - New Orleans French Quarter

Shotgun House Garden - New Orleans French Quarter

Haunted Hotel - New Orleans French Quarter

Haunted Hotel - New Orleans French Quarter

Lafayette Cemetery - New Orleans

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

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:

A-Flizzle and Martin - NOLA - May 2011

TPD Patch & Badge

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.

TPD Patch & Badge

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.

Skinny Caramel Latte

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.

Skinny Caramel Latte

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.