MDI

Package Inspector

Rewards and the Shrinking Waistline

Today was a day of rewards, a chance to recharge my batteries, and a disconnect from the ever present list of things that need to be done.

HAWMC - Day 9

The #HAWMC blog post challenge for today is an unstructured “Health Activist Choice.” I’m good with lack of structure. I like being left to my own devices and given free reign to figure things out on my own. It may not be necessarily what I’m supposed to be figuring out, but a little freedom to wander and wonder appeals to the adventurer in me, and I always end up somewhere interesting.

My day today was a lot like that. I got to sleep in a bit, which was nice (and unusual). Having the option to sleep in is one thing that I can appreciate about having an insulin pump. Back in my multiple daily injections (MDI) days, I can remember absolutely HAVING to get up so that I could take my morning insulin dose. It’s nice having options, and something I try to never take for granted.

I got some fun things in the mail that I had ordered, which I wasn’t expecting until next week sometime. Squirt the Cat especially enjoyed giving the package a proper inspecting, and enjoying the delightful smells that it must have picked up along its travels from wherever it came from to our house.

Package Inspector

"All your boxes are belong to me!"

Inside were new shorts for summer, which included (free of charge) just a touch of disappointment. Having shifted to a low carb eating lifestyle, I’ve lost a touch more than ten pounds so far, and the shorts I ordered were just slightly too big. Amazing the difference a week makes, back when I ordered the correct size. Oh well, shrink & be merry.

As I’m losing weight and eating low carb, I don’t need as much insulin to keep things level. I’ve decreased my basal rates overall by about 5-10% so far to keep from running too low. Also to prevent over or under correcting for meals, I have to be more accurate in my SWAG (Scientific Wild Ass Guess) bolusing, and estimate the amount of carbs as closely as possible. I’m not following Dr. Bernstein‘s diet specifically (and I admit, I haven’t even finished reading his book yet), but eating low carb definitely agrees with my diabetes. At least, it agrees with my not having post-meal BG spikes, which is great since I hate being high. I’m continuing to make slight adjustments to ward off the lows, so that’s still a work in progress. But honestly, what isn’t a work in progress with diabetes?

The rest of the day I spent with friends watching baseball. Even though both of my teams lost, I still had a great time.

Today reminded me that we need a day every once in awhile (more often if you can get it) to do some things we enjoy. If that is sleeping in, shopping for shorts that sort of fit if you tighten the belt enough, or going to baseball games, it’s important to unplug from all the daily stresses (even diabetes) for a few moments.

I’m already looking forward to next Saturday, when my adventure continues…

Magic Strips

A Tale of Two Pumps

Once upon a time, in the land of Diabetes, there was a person named Martin. This stunningly handsome and striking specimen of a man had endured the variety of ways to treat and manage the kingdom of Diabetes his entire life. Having been abandoned in Diabetes at the wee age of two years old, he had lived through the olden days of determining blood sugar by careful aiming his sword at magic strips that could tell him the range of his blood sugar level.

Magic Strips

Back in those days, Diabetes was managed quite differently than it is in our modern day. Similar to the race between the tortoise and the hare, two different kinds of insulin were used in relay to get our budding hero through the day: One a fast-acting rabbit-like insulin aimed at beating the gangs of sugars and carbohydrates at the beginning of the day, and the other a turtle-paced insulin made to finish out the battles as the day grew long. This type of managing Diabetes seemed to work reasonably well for a good number of years, until the evil dictator Adolescence descended upon the land and threatened to throw the whole world into chaos.

Adolescence would attack with severe low blood sugars, often resulting in visits to the dreaded land of Hospital, where to this day inflation runs wild and it takes nearly a lifetime to escape. As Adolescence continued its terrible reign of…um, terror…our fearless hero Martin teamed up with his trusty wizard, Endo, and called upon the forces of Multiple, Daily, and Injections. Armed with the power of MDI, Martin was able to defeat the evil Adolescence back to the twisted realm of Puberty, and for many more years peace once again ruled the kingdom.

But alas, peace was not meant for a lifetime. As the years wore on, Adolescence’s cousin, Adulthood, came to power in the realm of Puberty and declared revenge on Martin. Adulthood struck suddenly and deliberately, causing seizures, confusion, and shaking from fear. Adulthood would attack at even the most innocent of times, during exercise, vacations, trips to the market, and even during sleep. Adulthood screamed from the mountaintops, “Hear me Martin, your MDI is no match for my wrath!”

Tired, nearly defeated, and not knowing what to do, Martin turned to his trusted wizard and said, “Endo, I just can’t do this anymore. I try so hard, and feel like I’m doing everything right, yet Adulthood still manages to outsmart me in this land of Diabetes.”

Endo knew Martin’s heart was pure and true, and that his will could never truly be beaten. With a mighty wave of his staff, the Rx Pen, Endo conjured a beast like no other. Formed from the power of lightning, the miracle of insulin, and the technology of the future, Endo presented Martin with a new tool for fighting Adulthood in Diabetes…the Animas 1250 insulin pump!

Animas 1250

With the Animas 1250, Martin was not only able to bring peace back to the kingdom, but he was also able to partake in the joy of eating at odd times, sleeping until midday on the weekends, exercising without having to eat more calories than burned, and even indulging in the occasional late night ice cream.

Yet, Adulthood would not go quietly into the pages of Diabetes history. Watching and learning how the power of the Animas 1250 was wielded, Adulthood planned its attacks carefully and maliciously. Adulthood would test the weaknesses of the Animas 1250 by introducing a slow and steady low blood sugar, fooling Martin into believing that nothing was wrong.

Finally, after Martin had spent a long day toiling in the fields, Adulthood struck in an attempt to finally capitalize on its long-awaited revenge. With a severe low of 33, Adulthood knew that its time had come to capture the throne.

Yet our fearless, well-groomed, and attractive hero was prepared. As Adulthood celebrated its victory and marveled at its use of a Larry Low, Martin fought back the surprise attack with the spirit of the swamp, Gatorade! Adulthood cowered in defeat, outmatched by the sugars and electrolytes in the magical potion.

Although Adulthood was defeated once again, Martin realized that the Animas 1250 was no longer the superior weapon in the Diabetes fight. Martin once again turned to Endo for a solution. Endo, who had locked himself away in the Diabetes research labs for years in anticipation of this day, with a mighty wave of the Rx Pen, revealed a new pump from the technological land of Medtronic…the MiniMed Revel!

MiniMed Revel

To this day Martin and the MiniMed Revel rule the land of Diabetes with a plastic grip. Partnered with the built-in omniscient Continuous Glucose Monitor, the influences of Adulthood on the kingdom of Diabetes have been mostly kept at bay, with only an occasional uprising. However, no one in the land of Diabetes can forget the low blood sugars that almost kept them from these prosperous times. Anticipating the next time Adulthood tries to rise up, the people of Diabetes vow to always remain a community, to support each other, to be Friends For Life, and to never give up in the fight for a cure, when Diabetes and Adulthood can finally live free from one another.

10-10-10 - photo by Woodley Wonderworks on Flickr

New Rule: 10-10-10

101010 - photo by Woodley Wonderworks on Flickr

10-10-10: 10 THINGS for you to take 10 MINUTES to share with 10 PEOPLE about your diabetes.

#1
That you have diabetes.
If you aren’t comfortable sharing it with a group, share it with just one person at a time. A friend, coworker, or roommate is a great start. You may need them one day, and awareness is in both of your best interests should that need arise.

#2
What type diabetes you have.
Each different type of diabetes requires a different set of rules and things to be aware of. An easy talking point is to share what type diabetes you have, and how it compares to others. It’s also always fun to baffle people with your expert knowledge that yes, you can indeed get “juvenile diabetes” (Type 1) as an adult. Mind blowing! Because it takes so much of our attention to manage our own diabetes, check the ADA web site if you need help educating yourself on the various types of diabetes.

#3
Your story.
Every one of us has a collection of diabetes stories. People can most identify with what you went through when you were diagnosed. Some of us, like me, were far too young to remember, but maybe your parents or loved ones passed these stories down to you. If not, share how your life has changed pre- and post-diagnosis. I have found that most people are very impressed by how much us diabetics know about our bodies. Toot your own horn!

#4
How you manage your diabetes.
Some of us use an insulin pump, continuous glucose monitoring (CGM), multiple daily injections (MDI), and hopefully all of us with diet and exercise. Share the tools and tricks of the diabetes management trade that work for you. You don’t have to go into the nitty gritty details, but sharing that you know what you’re talking about and how to manage your diabetes goes a long way into the comfort levels of all involved in being able to talk about it openly. I like to show off my insulin pump and BG meter when I am sharing, and curiosity usually gets the cats to talking. This is also when I like to point out that I can eat the same foods as everyone else, as long as I know my BG and count carbs. This goes a long way in warding off the Diabetes Police.

#5
The difference between a low and high blood sugar for YOU.
Although this can dance on the edge of being clinical, it’s something that most non-diabetics don’t know. Try to put into words what it feels like when you have a high or low BG. For example, when I am high, it feels like my blood has turned to molasses, and doing anything is like trying to do it while submerged in Jell-O. Most people can appreciate that description, unless they’ve never had Jell-O. And if that is the case, you get to make a new friend tomorrow by bringing them a Jell-O cup. I suggest Sugar Free Lime or Strawberry Banana.

#6
Symptoms of a low blood sugar.
As scary as a low BG can be, this is quite possibly the hardest part of the “I have diabetes…” conversation, because it is 100% serious REAL LIFE when it happens. Describe a low blood sugar in your own words, and include those symptoms that are most common to you and your diabetes. We’re not all the same. If, like me, you’re prone to nonsensical motor mouth as a symptom of a low BG, share that. Then, if you’re talking too much and annoying your friend, at least they have an out by suggesting that you go check you’re blood sugar so you’ll shut up. Winner, winner.

#7
How to treat a low blood sugar.
Share the important details, such as where you keep your glucose or Glucagon hidden, and that insulin does NOT make your blood sugar go up. I don’t know why so many people think that insulin makes blood sugar go up, but they do. Educate them. Let people know what works best for you to treat a low BG. If juice is your go to low BG fix-it-all, then tell them that, and where they can find it. Your life may depend on it, and it will reduce panic if you need an extra bit of help.

#8
Your medic alert identification.
Point out where it is, whether it is a bracelet, necklace, wallet card, or other form of medic alert. I have had diabetes nearly my entire life, and am as guilty as anyone of not wearing my medic alert ID like I should. So, dig it out of your underwear drawer (or jewelry box, if you’re a girl) and put the thing on. If you don’t have one, go buy one. No excuses. I’ll even guilt you into it: Don’t put the people around you in the position of having to answer a paramedic’s medical questions about you in the event of an emergency. Emergency personnel are trained to look for medical alert ID’s, so get after it.

#9
What you can do despite diabetes.
I think it is so important to let people know that diabetes is NOT a death sentence. It is so very far from a life ending condition, and as long as we manage it successfully, we can do anything that anyone else can. Thanks to modern technology and medicine, we can play sports, have a family, and even be a celebrity. We are only limited by our own imagination. Diabetes only holds us back as much as we allow it to, which coincidentally means that us people with diabetes (PWDs) are notoriously stubborn. I think that’s a side effect we can live with.

#10
Where they can learn more about diabetes.
As much as we know about our own diabetes, none of us knows everything about diabetes. Some great places to refer others to learn more about diabetes are the Juvenile Diabetes Research Foundation, American Diabetes Association, and the Joslin Diabetes Center.

This Attraction is Closed

Time for a Change

I remember the days of “timestamped injections” where I would take a specific dose of insulin at a specific time of day with no special considerations for what I might have been eating or doing at the time. I also remember very clearly my thoughts when I switched from that old method of diabetes management to MDI (multiple daily injections). I had been having some crazy low episodes in my early 20’s that facilitated the necessity for a change. I would get confused while driving or trying to do something, other times just wandering around completely out of it. I was found passed out on the kitchen floor one morning completely unconscious, and the one that really put me over the top was when I had a seizure from a low BG while on a roller coaster…A ROLLER COASTER!

I considered a pump at the time from MiniMed, but my own fears made me choose MDI because I was not yet ready to rely on a machine to keep me alive any sooner than I absolutely had to. Maybe I am a control freak when it comes to my diabetes, but I didn’t feel an insulin pump was as reliable as I needed it to be for my own comfort. Plus, I had no insurance, which plays a big factor in people’s ability to get a pump even today.

MDI worked for a time, and staved off some of the low episodes. But not all of them. After all, diabetes is an unpredictable beast, and even the best control can be thwarted for seemingly no reason at all. One example is when I went on a 12-mile bike ride by myself one evening, and before I could get back home I was pushing my bike down the street fighting off a low BG seizure. After getting home, getting help, and recovering from that episode, I knew that it was time for another change.

My endo at the time helped me get my first and current pump, the Animas 1250. Since having the pump, I have still had some lows, but so far not near as dramatic as before. My Animas 1250 has allowed me so much more freedom in my life with diabetes, and ability to control it, than I’ve ever had before.

Recently however, I’ve been dropping into dangerously low levels again (see my recent post Bike Ride & Motivation). Being in my early 30’s, and arguably too independent for my own good, I know that it is up to me to take care of myself. No one is going to do it for me. That is why I am very excited about my upcoming transition to the Medtronic Revel insulin pump with Continuous Glucose Monitoring (CGM). Once again it is time for a change, and I am ready to use technology to its full potential to help me not only manage my diabetes, but to keep me healthy, aware, and alive until it is time for the next change.

One day I hope that we willl be able to abandon these pumps and needles altogether. In the meantime, I will use technology and whatever diabetes treatments I can get my paws on to make sure I am around to see the day when we finally shut down the glucoaster thrill ride once and for all.

This Attraction is Closed