low

Star Trek Murder Mystery Dinner Theatre

Make It So…Wait, Low?

We’re right smack dab in the middle of Diabetes Blog Week, and as much as I would love to be able to post every day, my schedule refuses to allow it. Today’s topic, about some diabetes thing that you or your loved one does spectacularly, captured my attention though, and reminded me of a story that happened just this past weekend.

2012 DBlog Week Banner

On Friday, my 31st Diaversary, A-Flizzle and I ventured over to the Monticello Opera House, where I dawned one of these…

Viking Opera Helmet

…and proceeded to serenade the sold out crowd.

Or maybe I just went there for the Star Trek Murder Mystery Dinner Theatre.

Star Trek Murder Mystery Dinner Theatre

In any case, me and Number One (A-Flizzle) were there and made it so. This was my first murder mystery dinner, so I really had no clue what to expect. In diabetes terms, I didn’t pre-bolus, because I didn’t know exactly when we would get food, or even what the food was going to be. The menu said something about sliced Tribble, with a side of pok tar, and a big stein of Romulan ale. Yeah, go ahead…try looking THAT up in Go Meals! (Which is awesome, by the way, if you ever need an app to look up nutritional info. And no, they didn’t pay me or give me anything to say that. But if they wanted to…*cough, cough*)

Do you think the computer in Star Trek would tell you the nutritional info, or would it just beep and buzz at you like our insulin pumps and Continuous Glucose Monitors (CGM’s) do now? Inquiring Klingons want to know.

Back to the story…so we were sitting there in Act 1, and the galactic detective was setting the scene, something about how awful of a detective he was, or maybe he was getting ready to retire, or perhaps he had chased an alien rabbit down a black hole and had been warped to the other side of space and landed on some distant starship. Honestly, I have no clue, because while we were making it so, diabetes and the full-throttle day was making me low.

Near the end of Act 1, I was trying my hardest to focus and keep up with the story, but I was checked out. My attention was somewhere between Jupiter and Pluto. All I could think was, “I’m low…and is that person really wearing a Darth Vader mask under a hood and pretending to be in Star Trek?”

The spectacular of the story is that A-Flizzle noticed. A regular Coke and a couple of glucose tabs later, I was back in space, instead of spaced out. I caught up with the mystery, we enjoyed dinner, had blueberry cobbler for dessert that was to die for, and by the end I had even figured out whodunit.

The biggest mystery though is how A-Flizzle figured out that I was low in a crowded room with attention being diverted in the opposite direction of me. Somehow, she has figured out my low blood sugar tells, those hijinks that give away that something is wrong, sometimes even before my brain is capable of comprehending it…and that’s a pretty spectacular diabetes trick.

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.

I Break For Coffee

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.

I Break For 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.

Cake or Death?

If you have diabetes, regardless of type, it is inevitable that at some point you have encountered some form of THE question…

“Can you eat that?”

Sometimes it takes on the shape of “Should you be eating that?” or “Is that good for your diabetes?” or “I’m eating for two, even though I’m a dude, so why are you eating that when I was counting on eating your share?!”

When I’m asked this question, sometimes I will respond with some well-deserved diabetes education. “Yes, I can eat this. I just have to know how many carbs (carbohydrates) are in it, and what my blood sugar is, so that I can give myself the correct amount of insulin to keep my blood sugar from spiking too high due to not enough insulin, or going too low because I dosed too much.”

That is usually enough to get either understanding or slightly confused looks of acceptance. Math and science, for the win! And truthfully, I’m typically happy to educate. I like it when people learn about real life with diabetes.

If I’m in a mood though, or if I’m having a low BG (low blood sugar) and don’t have the patience for a diabetes learnin’ session, I might just respond with a snotty little question of my own, such as, “Should YOU be eating that?” That’s always a show stopper, as the guilty party takes that last bite of chocolate cake and shamefully makes their way back to the other room while I feel only slightly guilty with my shaky, moody, slightly confused, sweat-drenched self. Cake or death? Whatever, I’ll apologize later…GIVE ME CAKE!

Since I got my CGM (continuous glucose monitor), even more questions have been introduced to my world with diabetes. A-Flizzle is getting good at recognizing the different tones of the CGM alarms, but most people around me and my beeps and bonks aren’t able to decipher if I’m low, high, have a low reservoir, a low battery, or if I just forgot to hit “OK” after my last BG (blood glucose) check. Still, I’m glad when it beeps and they stop to ask, “What does that alarm mean?” It doesn’t matter to me if they were able to define the alarm or not. What matters was that they heard it, and recognized that it was diabetes related, so that if I need something, I have their attention. Diabetes win!

Another diabetes win happened this past weekend when A-Flizzle was supervising, I mean, helping me organize my diabetes supplies. While sifting through test strips, glucose gels, infusion sets, and alcohol swabs, we came across this little gem when I got my paws on a fresh box of CGM sensors.

Cake and CGM Sensors

Do you see it? Look a little closer.

Cake (forget the CGM sensors)

Cake! On a diabetes supply container! For a device that helps monitor glucose levels!

Cake or death, you ask? CAKE! Definitely, cake.

Snow - 12-28-2011

2012 Goals & Resolutions

Last year I put together a post of some of the things that I wanted to accomplish in 2011. My first goal was to get my A1C under 6.2. At my last three endo visits, my A1C was 5.6, 5.7, and 5.6. Goal achieved, sort of, but with that low A1C came a couple of dangerous lows. Those A1C’s don’t make me a “good diabetic” anymore than those dangerous lows make me a “bad diabetic.” It’s just proof that an ideal number goal that signifies that diabetes is in good control is also very close to the edge of a low blood sugar disaster.

I made a resolution last year to wear my CGM more regularly. I did mostly, yet those two aforementioned lows both outran my CGM’s ability to predict the low blood sugar in time for me to fix the problem myself. During the first low, my CGM started beeping while A-Flizzle was feeding me glucose tabs. (See also: This CGM technology stuff has got to improve if we ever hope to see a closed-loop artificial pancreas in reality.) Unfortunately, due to expired sensors, supply refill woes, and now a CGM transmitter that is no longer transmitting, I’ve been without my CGM for 2-3 months, and I can definitely tell because my BG’s are all over the place. Like that sweaty 35 this morning, followed by a headache inducing 237 at dinner tonight. I’m concerned about my next A1C, but I know that it is just data, and I know that I’m struggling, and I’m just going to put my faith in my endo, my CDE, and myself to work together and turn this beat around. Diabetes is hard enough. Why beat myself up about it?

My #2 and #3 goals were really all about exercise, and if I look at them explicitly, I failed them both. I did not run a 5K, nor did I find a group to start cycling with on a regular basis. I did, however, discover the joys of spin class, so I’m chalking those up as a sort of win.

One goal I had that I’m extremely disappointed about not achieving is to get down to a stable 165 lbs. The first half of this year I did phenomenal at losing some weight, eating low carb, getting some exercise in, and really feeling like I was on my way to a more fit me. Then I had that low BG seizure at the beginning of July, where I chewed up my tongue and could only eat really soft, bland, room temperature foods for about 2-3 weeks, and that sunk my battleship. I was traveling at the time, so I resorted to eating total garbage like macaroni and cheese, soft cookies, potatoes, and starchy things that I had done so well at resisting in the first half of 2011. Now, here at the beginning of 2012, I’m right back to where I started, maybe even a little heavier. I have some new weight-related goals in mind though, so rather than throwing myself a pity party, I’m going to try a healthy helping of encouragement instead.

Another resolution I had was to go to the ophthalmologist. I’ve written about this experience, but suffice it to say that I did indeed go, and I got my card the other day reminding me to make a new appointment, and it isn’t something I’m as afraid of as much as I once was. I’m calling that an accomplishment.

Other goals and resolutions involved having adventures, paying off some bills, getting diabetes stuff that I needed (like a new medical ID bracelet), and remembering that even though diabetes is ever present, it isn’t the only thing that is important in life. All of those things I can mostly say I succeeded at, and am not opposed to carrying those ideals forward in the new year.

So without further ado, I present my 2012 goals and resolutions.

Goals
1. A1C <= 6.2. Less would be good.
2. Pay off at least two debts.
3. Have an adventure…regularly. Take pictures. (I really can’t emphasize this one enough. It’s a MUST!)
4. NEW for 2012: Drop some heft. Goal weight, 175 lbs. I will re-evaluate once this goal is achieved.
5. NEW for 2012: Complete an urban disturbance/warrior 5K, where you climb walls, jump fire, wade through mud, etc. I don’t know the exact name of these types of races. I just know I want to do one.
6. NEW for 2012: I will have a pool nearby this year, so I’m going to start swimming again. I miss it bunches. Plus, I need to get my bikini body ready for…*cough*…nevermind. Nothing to see here. Move along people.
7. NEW for 2012: Be successful with at least one big thing for diabetes advocacy. Measure of success to be determined based on specifics of the diabetes advocacy activity. That should leave me plenty of room to cause trouble.

Resolutions
1. Wear CGM consistently.
2. NEW for 2012: Find and go to the dentist, in addition to endo and ophthalmologist.
3. NEW for 2012: Exercise at least 3 days a week, even if work, blogging, and rest have to be sacrificed in order to do so. This will help my strength, energy level, blood sugar stability, and entertainment value while strutting around without clothes on.
4. NEW for 2012: Blog consistently, but only if it meets self-imposed quality standards. Or includes a good laugh. Or both.
5. NEW for 2012: Stop letting other people dictate my emotions. Their Jedi mind tricks are no good here.

Yeah…that’s a good start.

Snow - 12-28-2011

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