insulin pump

High Times in Jacksonville

For my birthday, A-Flizzle surprised me with a trip to Jacksonville for a weekend of good food, good times, and great friends. It was such a surprise! I never saw it coming. I was all, “Hey, I’m going to work” and she was like, “No, we’re going on a weekend getaway” and I was like, “Oh wow, I’m so surprised! This is so cool!”

Okay, who are we kidding? I hate surprises, and she knows it. That’s why she’s a keeper. To prevent me from freaking out, A-Flizzle made this awesome timeline of what was going on and where we needed to be. Actually, calling it a timeline doesn’t really do it justice…it was a FUNline. Look at this picture while I do the pencil sharpener…

Birthday Funline 2013

Friday started with a beermaster’s tour of the Budweiser brewery in Jacksonville. Upon arrival, I struck up a conversation with the tour guide who noticed my insulin pump. She couldn’t quite grasp how in the world I could possibly have Type 1 diabetes and drink a beer, at the same time. It’s not an exact science, but I explained to her the basic idea of factoring in blood sugar levels and counting carbs and dosing enough insulin to cover the difference, just like anything else we people with diabetes (PWD’s) eat or drink. Yes, I know there’s some long division and a square root of Pi and other fuzzy math that goes into calculating carbs and insulin when drinking alcohol for some PWD’s, but your diabetes may vary (YDMV). Suffice it to say, it was nice to meet someone in the beer brewing industry who was legitimately interested in how everyone might be able to enjoy what they put so much effort into making.

Birthay 2013 - Beer from the Keg

The tour was fascinating, and getting to sample beer directly from the ice cold tanks was delightful. There is no way to get a fresher beer than that. One lady on the tour, who didn’t even like beer, even became a convert. I’ve got a newfound respect for the Budweiser brand of beers now, and the care that goes into making each and every one. It’s a process of Willy Wonka proportions, and I’d highly recommend the tour if you every have the opportunity. Also, the gift shop is a great place after you’ve had a couple. Just saying. (I left with a Landshark beach umbrella and a hoodie with a built-in beer koozie on the front. So…yeah. In my defense, I did pick those things out BEFORE the tour.)

Birthday 2013 - Amanda and Martin and Beer Kegs

I also found my dream job in the Budweiser brewery…

Birthday 2013 - Dream Job

Afterwards, we met up with Jacquie and the family for dinner: Mediterranean food, for the win! Nothing chases an afternoon at the brewery like chicken shwarma. Shwarma…mmm. Just sounds delicious, doesn’t it?

The next morning, my pal Bob and I were supposed to get up and go for a bike ride. However, it was cold-ish, and the temperature was not appealing to my sense of get out of the warm bed and go pedal at all. After texting back and forth for a bit about it, we decided to do what any normal person who doesn’t feel like braving the cool air to go on a bike ride does on a Saturday morning.

We went and ate bacon.

After that, A-Flizzle and I made our way toward the spa, where she had us lined up for a facial and a 1-hour deep tissue massage, respectively. Now, I’ve gotten a massage before, and my pump was never a big deal for the masseuse. In fact, every massage that I’ve ever gotten, I was able to keep my pump on and just slide it to the side and the masseuse was able to work around the tubing and the infusion set. No big deal, right?

Except, this masseuse was different. Although she was plenty nice enough, and she did a spectacular job of getting some of the knots out of my back and neck and shoulders, she was really weirded out by the idea of having to work around my continuous glucose monitor (CGM) sensor and insulin pump and infusion set. Because I needed that ding dang massage more than I needed diabetes at that moment, I decided to dose a couple of extra units for the hour, and then I took off my CGM sensor and my insulin pump so that I could get some relief. Stop me if you’ve heard this one before.

In hindsight, I should have just let the masseuse be uncomfortable. Once the hour was up, I was a blob of mostly relaxation. A-Flizzle and I took a leisurely pace back to our room, at which time I stupidly decided a birthday cupcake was in order. A cupcake? Really?! Dumbass. Then I proceeded to get a shower, which was delightful, and full of hot water, and a window that I could look out of while scrubbing off eucalyptus oil. I’m like a cat. I can’t resist a good window to look out of. Hours of entertainment. Fortunately, the hot water didn’t last.

Keep in mind, I failed to put my insulin pump back on through this entire episode of Birthday for Dummies with Diabetes.

By the time I got done taking my sweet time with everything, my blood sugar was through the roof. I don’t even remember what it was by the time I put a new infusion set in and reconnected my insulin pump. Probably somewhere around 1,000,000 and rising. I felt like crap. Way to ruin your own birthday there, Wood. Brilliant.

I dosed the snot out of the high in hopes that I could get it at least dropping by the time we had dinner at one of my favorite restaurants in the whole wide world, 13 Gypsies. I was moderately successful, but really had to focus dinner on the lower carb items and lots of water to try and offset the effects of the afternoon.

Birthday 2013 - Martin and Amanda

See those eyes? That’s not glassy eyed from birthday beers. That’s worn out from fighting a high blood sugar all afternoon. I’d have preferred the former.

I guess the moral of this story is to never disconnect your insulin pump and remove the inset unless you have another one handy for immediately after whatever necessitated your getting naked. Because I am the last person in the world to vote against being naked. Also, maybe tell the spa and masseuse that you have type 1 diabetes and use an insulin pump so that they don’t freak the eff out when they see that you’re bionic.

Maybe also do this in an Austin Powers voice, just for style points. Yeah baby!

Friendly Neighborhood Tyrannosaurus Rex

Just Another Day

This past weekend was a good weekend. No deadlines except that one that made a nice whooshing noise as it went by, nowhere to be, just an opportunity to enjoy things at a leisurely pace.

Saturday, A-Flizzle and I got a wild hair and decided it would be fun to go on a six mile urban hike, which is a more adventurous way out saying that we walked through a few neighborhoods and down a few sidewalks. It’s kind of amazing the things you notice when you are on foot that you never see from driving around in a car. We found a house with a dinosaur in the front yard, several Florida rooms off the sides of houses with beds in them that we were hoping to catch someone dozing in, a new sports bar and restaurant being built, and we learned that the pedestrian crosswalks have absolutely no rhyme or reason for when they decide to let you cross the street.

Friendly Neighborhood Tyrannosaurus Rex

Throughout the day, I thought I had done a really good job of counting carbs, factoring in activity, and doing a good job of keeping tabs on things so that I didn’t go low from the activity or high from any of the delicious things that I ate, like the banana and Nutella crepe that I may or may not have had for lunch at about mile 4.5 of our urban hike. And by the way, this is my blog post, and I call it Nutella, not Noo-tella…because there’s a freakin’ “nut” in it. YPONMV. (Your pronunciation of Nutella may vary.)

After a day of near perfect BG’s, around bedtime on Saturday night I realized that I wasn’t feeling too well, so I did a quick check to see where things were. 342. I was pissed. Are you for real?! I counted everything! I know I got the math right, or at least in the ballpark enough to not merit a stupid 342 BG. What the #$@#%#$?!!!!

After I got done pitching a fit, I tried to think what might have jacked my BG up so high. Surprisingly, I don’t think it was the banana and Nutella crepe. There was nutritional info, and I’m pretty sure I was in the ballpark on that one. Since it was sunny and over 90 degrees outside when we were urban hiking all over town, I settled on the idea that the insulin in the tube of my pump probably got a little too warm during the activity and had lost its effectiveness. Insulin is supposed to be kept cool or at room temperature, and let’s face it, late Spring and Summer in Florida is far from being room temperature by any stretch of the definition. Something you have to be aware of if you’re going to sport an insulin pump is that, every once in awhile, heat happens.

I dosed down the 342 BG with a shot of insulin via the old faithful syringe, and then switched out the insulin in my pump. Either I overestimated how much I needed to pull that 342 BG back down to normal, or the activity of the day finally caught up with me, because I woke up around 3:00am at BG 35. After a juice box and a couple spoonfuls of peanut butter (which I may or may not have shared with Hopper dog), I woke up in the morning with a perfect BG of 88.

Diabetes is a total game of numbers. In order to stay alive we have to count everything. And guess. A lot.

We have to know how many carbohydrates are in everything that we put in our mouth, what our blood sugar (BG) level is at the time, and guesstimate how much activity (or lack thereof) is going to affect our metabolism and BG level. Then, on top of that, there are ever present questions about how accurate our BG meters are, we never really know for sure how effective the insulin that we’re injecting is going to be (especially after it has been in an insulin pump for a few days), and our bodies sometimes process that magical life elixir differently than yesterday, when we had the same food, the same activity, and the same BG levels.

My endo says that “doing the same thing over and over again and expecting different results is insanity…unless you have diabetes.” In Martin World, it’s just another day.

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.

Stubborn CGM

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.

Gummy Bears

Twas A Gummy Bear Night

Twas a night before Christmas, when all through the house
Not a CGM was beeping, all sensors were out.
The transmitter was stashed amongst the pump supplies with care
In hopes that my insurance company soon would say, “Clear!”

The gummy bears were nestled all snug in their bag,
Patiently awaiting for diabetes to attack.
The cat under covers, the dog taking a nap,
It was only a matter of time before diabetes would snap.

When just down the hall there arose such a clatter,
I sprang from my bed in a soaking wet lather.
Panicked and stricken, I searched for my glasses,
Hoping to high heavens my feet weren’t molasses.

The moon in the window lighting my way
Leading me to the kitchen where the gummies await.
Like a chorus of Hungry Hippos my teeth were a chatter,
Am I low? Or just cold? Truthfully, it doesn’t matter.

Flicking on the lightswitch in a soaking wet fury,
“Get in my belly you gummies!” I said, a bit slurry.
More delicious than glucose tabs and easier to swallow,
The red ones are best, and what makes the clear ones so hollow?

The clock ticks, the minutes pass, waiting for a fixin’
It doesn’t seem to be working, my brain says as I listen.
I think, “Let’s chase the gummies with a bottle of soda!”
“Diet, that’s not,” a voice says, kind of like Yoda.

As the bottle is emptied I start to stop shaking,
This all will have consequences in the morning upon waking.
Tired and worn out, I drag my carcass to bed,
Where visions of semi-coherent boluses dance in my head.

And then, in a moment, the sun starts to shine.
Morning already?! It was only just five!
As I sit up in bed, and try to shake off the fog,
I realize I feel like a rotting old log.

Time to get dressed, from my head to my foot,
“I think I wore these clothes yesterday,” I think as I look.
A bundle of sweaty clothes, a shower is needed.
What happened last night, and why am I still seated?

I make it down the hallway, shuffling feet in my slippers,
When all of a sudden I spot movement that’s chipper!
When, what to my sleepy-filled eyes should appear,
Those gummies are partying, and one of them has a beer!

I shake, and I tremble, and rub my eyes in disbelief.
A gummy bear palooza, in MY kitchen sink?!
I grab my pump quickly, and notice the last,
A bolus, SWAG-worthy, taken blindly and fast.

I reach for my meter, and check without fear,
Hoping that some sense in those numbers will appear.
Double-digits, that figures, at least now I know
Those gummy bear phantoms were all because I was low.

Gummy Bears

Photo by Pato Garza (CC license)

Time

Progress Takes Time

National Health Blog Post Month, Day 28: Say WHAT?! What’s the most ridiculous thing you’ve heard about health or your condition? Was there any context? What did you think at the time you heard it – and what do you think of it now?NHBPM_2011_Day28

People say the darndest things, especially when it comes to diabetes. Most all of us have heard about how cinnamon can cure diabetes, how Halle Berry managed to wean herself off of insulin, and even how Chuck Norris’s tears contain the cure for diabetes. (Too bad he doesn’t cry. Ever.)

I can handle the ridiculous and imaginative ideas for curing diabetes that people in the publishing business come up with in order to sell copy and get clicks on their websites. I know, as well as they know, that they are often full of crap. Just look at the Reader’s Digest issue from a few months ago. It’s capitalism, and it’s meant to make money. We, as people with diabetes, regardless of type, have to make sure that we are smarter than the fly-by-night snake oil salesmen.

I get extremely upset with doctors who tell parents and children who are newly diagnosed that there will be a cure within five years. Or ten years. Or that it is just around the corner. I was told that when I was diagnosed at age two. That was 30 years ago. I’m not saying that we shouldn’t all have hope, but our efforts would be much better suited if we focused on living well with our diabetes (regardless of type), rather than surviving just long enough until there is a cure. What’s the point in a cure if we don’t make it that long?

If there was a cure for diabetes, it would not require me to buy someone’s book off of a TV infomercial or sign up for an annual subscription to a website. A cure would be grounded in science, and would include known experts in the field of diabetes who live with and work with this disease every single day that would be more than willing to vouch for whatever form and type of diabetes the cure is for.

I also believe that we would see it coming. True researchers dedicate their lives to finding a cure for diabetes. They don’t accidentally mix up samples and say, “Oh, wow, a cure for diabetes. How’d that happen?” So many people are stakeholders for diabetes improvements, and they have their fingers on the pulse of the research that is being done towards better treatments and a cure.

The things that I’m excited about right now are insulin pumps with low blood glucose suspend functionality. Basically, if the continuous glucose monitor (CGM) senses a blood glucose that is below a certain level, then it will automatically suspend the insulin pump for a period of time. I have low blood sugar unawareness, so this would be helpful to me to ward off severe lows, like the 35 that I had while I was at Epcot last week, and maybe even prevent me from having a low BG related seizure.

I’m also excited about CGM sensors that aren’t as invasive as what we have now. My biggest hurdles in wearing my CGM are the components themselves. I love the results, and the data that I get from it, but having to harpoon myself with a fat needle to insert my sensor and then attach a big honkin’ transmitter to it and tape it down so that it doesn’t fall off is really a burden sometimes. I remember the first home BG meters. They were huge, and heavy, and slow. Today they are tiny, and can report BG’s in five seconds, so I know we will get there with CGM technology as well.

As long as research and development is being done, and we are advocating for our needs, progress is inevitable. It just takes time.

Time

This post was written as part of National Health Blog Post Month (NHBPM) – 30 health posts in 30 days: http://bit.ly/vU0g9J

National Health Blog Post Month

Big Success

Geek, Party Of One

National Health Blog Post Month, Day 27: Quote Unquote. Grab a quote from this site (type in any word – see what comes up!) and use that quote to set your writing.NHBPM_2011_Day27

“The twenty-first century will be different. The human species, along with the computational technology it created, will be able to solve age-old problems of need, if not desire, and will be in a position to change the nature of mortality in a postbiological future.” – Ray Kurzweil, The Age of Spiritual Machines

One of my favorite bands, Our Lady Peace, released an album in 2000 titled Spiritual Machines that was inspired by concepts from the book “The Age of Spiritual Machines” by Ray Kurzweil. After hearing the album, I was as intrigued as the guys in the band, and had to dig a little deeper.

There are many quotable passages in the book, and in different scenarios it appeals more than others. I make no bones about the fact that I am a tech geek. I love and live technology. I can spend way too much time keeping up with tech news, advancements, and creative ways that people use technology to solve real world problems. This book was right up my geeky alley.

If you have diabetes, especially Type 1 diabetes, you probably walk around with a myriad of technology at any given time. This does not speak to everyone (or every type of person with diabetes, YDMV), but it isn’t unheard of to hear of someone walking around several devices attached to them or nearby that are helping them to make decisions that keep them alive.

I’m an example. I have a continuous glucose monitor (CGM) that gathers information from a flexible sensor residing just under my skin and a wireless transmitter. My CGM is integrated with my insulin pump, and helps me to maintain better control with my blood glucose (BG) levels by tracking trends so that I can see when my BG is rising or falling.

My insulin pump is connected to me via a similar type of cannula, though this one is linked to my pump via a nearly three foot tube. My insulin pump, powered by battery and programmed to my individual insulin needs, doses very small amounts of insulin around the clock through that tube, with bigger doses occurring when I eat a meal or have a high BG that needs correcting. I also carry around a standard issue fingerprick BG kit that tells me what my BG is at any given time with more accuracy than my CGM alone.

I have other, more multipurpose pieces of technology that I use to help me manage my life with diabetes as well. I have my cell phone (smartphone) and iPad that I use to look up carbohydrate info, keep in touch with the Diabetes Online Community (DOC), and search for other info that I might need on the fly to better manage my diabetes. One of my favorite apps to use when carb counting is the Go Meals app, especially when I go out to eat.

I feel like, in many ways, Kurzweil’s vision of a 21st century where computational technology is used to change the nature of mortality has already come true, though we still have miles to go before we sleep. When I was diagnosed with diabetes over 30 years ago, the information and data that we have today was simply not available. Now, we can figure out how many carbs are in a meal at a restaurant by the time a server can return to the table with our drink order. The swiftness of information is only going to get better, and the quality will continue to improve as well.

I’m excited to see what is next with technology used to live with and manage this disease, and how our world with diabetes will continue to evolve. I believe that one day there will be a cure, but until then, I am thankful that technology keeps improving to keep us alive and well until we get there.

Big Success

This post was written as part of National Health Blog Post Month (NHBPM) – 30 health posts in 30 days: http://bit.ly/vU0g9J

National Health Blog Post Month

Coco and Me - FFL 2011

Here A Mascot, There A Mascot

National Health Blog Post Month, Day 24: My Mascot! Give your condition, community, or self a mascot. Who is it? What do they represent? What is their battle cry?NHBPM_2011_Day24

Dictionary.com defines a mascot as “an animal, person, or thing adopted by a group as its representative symbol and supposed to bring good luck.” I feel like there are a lot of potential candidates for a diabetes mascot.

First, there is this thing that Jacquie and I found at Friends For Life last summer. I’m not even sure what it is. Is it an insulin pump? Is it a BG meter? Is it a calculator? Is it a magic robot with an affinity for sideways exclamation points?

Jacquie Meter and Me - FFL 2011

Then there is Lenny the Lion. Granted, he’s already got a full-time gig as the Medtronic mascot, but he does have the advantage of being well-versed with an insulin pump. And think, with those cat claws, you would never have to replace a lancet ever again!

Lenny and Me - FFL 2011

Coco is a great candidate for a mascot as well. She has Type 1 diabetes. She has lots of friends and lots of adventures. She’s a lot like me! Except her primary contribution to conversations is “Eeek!” But I know people that have a lot more to say than just “Eeek!” and I wish they were as limited in their vocabulary as Coco is, so maybe that isn’t such a bad thing. You know what they say (whoever “they” are)…a little “Eeek!” goes a long way.

Coco and Me - FFL 2011

There is also Phil Southerland, who makes a great representative for the diabetes community. He’s a cyclist and co-founder of professional cycling’s Team Type 1-Sanofi, author of Not Dead Yet, and he’s from where I live, Tallahassee, Florida. He was also recently appointed Director of Healthcare Policy, Planning and Patient Advocacy at the World Health Organization. And he has Type 1 diabetes.

Phil Southerland and Me - FFL 2011

I think any of these candidates would make a fine diabetes mascot. However, I’m glad we don’t have to pick just one. The more characters there are in the world advocating and representing and bringing diabetes to the forefront of people’s attention, the better.

 

This post was written as part of National Health Blog Post Month (NHBPM) – 30 health posts in 30 days: http://bit.ly/vU0g9J

National Health Blog Post Month