The Bearded None-der

Diabetes sucks. I don’t need to tell anyone that. There’s all of the usual stuff – the blood-letting, the doctor visits, the expenses. Despite all of that, we’re always told that we can live like “regular” people. We can play sports, eat sweets (as long as we bolus correctly), and have babies. I’ve done all of those things (I’m pretty good at the last 2, the first one…meh).

Thanks to diabetes though, there’s one “regular” thing I can’t do – grow an effing beard. It seems simple enough, right? You just don’t shave for a few days, and it should be there. It’s the epitome of laziness. It’s winter time. It’s what people do. They wear sweaters and grow beards and swap out their iPod playlists for gloomy acoustic indie rock (no? just me?). But unfortunately, my beard has some rather noticeable bald spots. I should clarify that it’s not diabetes directly that causes this, but rather another autoimmune disease that goes by the heartwarming name of Alopecia Areata.

Not me...but something like this.

In this case, the immune system attacks the hair follicles, much in the same way it sought out my pancreatic cells 20 years ago. Why it can’t put that effort into fighting off a common cold, I’ll never know. Of course when you research this condition, you come across that all-too-familar “occurs more often among people with autoimmune disorders such as diabetes”. I get so sick of seeing this. I can handle the diabetes, I just wish it was JUST diabetes.

Is not growing a beard the end of the world? No, of course not. I realize it could be worse. Better bald spots on my face where I shave normally anyway than in the area where I expect to have hair. But how am I ever going to fit in if we move to Seattle? I guess the bright side is that I’ve read that the hair often does eventually regrow, so maybe I can try again in a few years. Perhaps that will inspire my pancreas to do the same!

 

‘Betes in Boston

You know how you ask your friend about their weekend and they tell you about a restaurant they went to, and you’re like “Holy shit that place is still open?!?…I went there years ago and it was okay, but it’s really far out of the way.”? Well that probably happened to you today. Except the friend was Kerri Sparling, and the restaurant was, well, this blog. You see, she was kind enough to mention that we finally met several weeks ago, and linked to my blog so people would know that I’m a real person and not just a sarcastic twitter bot. And then I felt really bad, because Kerri is an awesome blogger (and person, but more on that later), and my blog is in a severe state of disrepair. It’s really hard to believe how long it has been since I posted here. To put it another way, it’s hard to believe everything that has happened since I last posted. I got a new job. We sold our house. We bought a new house. Our daughter turned one. You get the idea. It’s not an excuse, but it’s an explanation. Truthfully, I haven’t been the greatest diabetic in that time either. I haven’t exercised as much as I’d like or should have, and my last A1c was 6.8. Granted that’s not horrible, but it’s the worst I’ve been in several years. I’m really trying to get back on the horse though. Or is it off the wagon? I’m horrible with non-motorized metaphors.

Anyway, back to the “when Harry met Kerri” thing. It’s hard to explain the awesomeness of this community to people that aren’t in it. It’s easy to describe members of the DOC as my ‘internet friends’, but that’s a little too “mom’s basement” for my liking. The internet and social media are what help us get together, but it’s not really what brings us together. As Kerri said, it’s hard to explain, but it makes sense. I’d like to think Kerri and I would be friends if it weren’t for diabetes since as she told me today, I’m a “taller, blonder, more sarcastic her”…but I’m not sure how it would happen. It’s funny that even though diabetes is what initially connected us, we didn’t really talk about it. We talked about things that regular friends talk about, and it was amazing. Kerri is right, we didn’t get a picture…but I’m okay with that. The experience was more fun than I’ve ever had looking at a picture. However, to fill the space in the scrapbooks and time capsules, I’ve put together an artist’s* rendering. As you can see, we’re very classy.

*term used loosely

It’s not you, it’s mio

So I was pretty excited when I went to order new pump supplies a while back, and Medtronic had these new mio infusion sets. 32″ tubing? Awesome. Self-contained inserting device? Neato. Pretty colors? Meh.

What seemed like a good idea in concept does not seem to be working for me in reality. I ordered 1 box of the mio sets just to try them out, and I’ve gotten so annoyed with them that I can’t even seem to get through those 10 set. First there’s the fact that the inserting device just doesn’t work as smoothly as I’d like. I’ve found that I have to apply the IV Prep wipes and let my skin dry to the point that it’s really sticky to prevent the needle from pulling the whole site out when I try to remove it. Nothing worse than inserting the same set twice. And then there’s the issue of what to do with that inserting device when you’re done. There’s really no way to remove the needle part, and I haven’t seen a sharps container* yet that will hold that whole plastic mess.

Another issue I’m not terribly happy with is how the tubing connects to the implanted site. Notwithstanding the fact that it looks sort of like some clear unambitious stingray, it just plain hurts to connect this thing. It seems to require an extraordinary amount of force to get the connection to firmly snap in place, and I’m not crazy about wiggling around things that are stuck inside my body (that’s what she said?). And they only included 2 “plugs” (unlike the Quick-sets, where you get one with each infusion set), which took me about 3 trips to the pool to lose forever to the chlorine-y depths.

So is this blog post just a way for me to bitch about my medical equipment? Sort of. But the bigger picture is this…I’ve been considering a switch to the Animas pump, and looking at their website, their “Inset” family of infusion sets bears a very striking resemblance to the mio. I’m concerned that with Animas the infusion set options are more limited than with Medtronic, and I’m really not sure if I like this design as my primary option. Animas users, any input? Are the Inset sets really the same as the mio? Are there other options that I’m not aware of?

* By “sharps container”, I of course mean “old Clorox bottle”

6 Things You Need to Know

Yes, I know. It’s been a while. We’ll get into that later. But today, it’s D-Blog Day, and if there’s any time to update, this has to be it. Thanks to Gina‘s organization, this year’s topic is “6 things you want people to know about diabetes”. So here goes:

1. I don’t have “bad” diabetes. I don’t have good diabetes either. I just have diabetes. There are lots of things I can do to keep myself healthy, but nothing I do will make it go away. The fact that I use an insulin pump doesn’t mean I have it any worse than I did when I was taking 6-8 shots a day. It’s just a different method of treatment, one which I feel works best for my lifestyle. I think I’m in pretty good control, but that doesn’t mean I don’t still have the risk of long-term complications.
2. Yes, I can eat that. In fact, I can eat pretty much anything I want. Diabetes has come a long way in a short time, but public opinion has not. Long gone are the days where diabetics had to adhere to a strict diet of 1 meat, 2 vegetables, and 2 starches each meal. As long as I know how many carbohydrates are in a food, I can take an adequate dose of insulin to counteract it.
3. Diabetes kills spontaneity. I can’t just hop off the couch and go for a run, or stop for an ice cream cone on a summer day. That’s not to say I can’t do either of the aforementioned things, but there is always planning involved. What is my blood sugar now? Do I have insulin in my body that’s going to cause me to crash 2 miles into the run? Do I have enough insulin in my pump to cover this ice cream? Hold on, I need to look up how many carbs are in that.
4. Diabetes isn’t necessarily hereditary, but it still scares the hell out of me. I love my daughter more than anything. Even though she’s only 2 months old, I know she can handle anything the world throws at her. However, I don’t want her to have to handle this. She has my blonde hair, blue eyes, and affinity for dairy products, but I really hope that she’s able to dodge this curveball.
5. Diabetes brings people together, but they’re still people. The DOC (Diabetes Online Community) is an amazing thing. I’ve met so many amazing friends that share this disease, but we share so much more than that. We’re music fans, runners, triathletes, parents. It’s nice to have a common bond and a group of people that understand the issues you face on a daily basis, but it’s also really nice to know that they’re regular people with regular lives.
6. There is no cure. There are treatments, medicines, and devices, but these are just ways to manage the problem, not ways to make it go away. Please consider donating to fund diabetes research.

Tri and stop me…

I know you probably think this is some Inception-like dream sequence. “Surely Harry can’t be writing a blog post, right?” Sorry to disappoint you guys, but this is not a dream, and this post has absolutely nothing to do with Leonardo DiCaprio.

Anyway, on to the good stuff…yesterday I raced my first ever triathlon. Very few things about the day could be described as “successful”, but I did finish and didn’t have to be picked up by the sag wagon, so I suppose there’s something to be said for that. I’ve been signed up for this race since January (since registration fills up very quickly), but I’ve been seriously training for the past 3 months or so. I think it is important to note that when I signed up for the race, I didn’t really know how to swim. I could tread water and keep myself from drowning, but getting from point A to point B in a hurry was completely out of the question. I’ve been biking and running for years so that wasn’t a problem, but I knew the swimming part was going to take some work. I’ve worked really hard this summer on swimming though, I even enrolled in an endurance swimming class at the YMCA. I’m still the weakest at swimming, but I’m at least at the point where I can do the 750 meters required by the triathlon course (I’ve done much more in practice, but it’s a lot different when there’s no wall to hang on to…

But enough background info…on to the race report. After getting up at 4:45am to get everything ready and get to the race site, 7:00 quickly rolled around and it was time to start lining up for the swim start. My blood sugar had been uncooperative at best all morning, but after a couple of energy gel packs in the transition area, I felt like I was at a comfortable place to start the swim. The start of the swim…that’s about where “comfortable” ended. I’ve done this course at least 4 times over the previous weeks, but somehow right after the second turn bouy, a mysterious current appeared around me in this completely landlocked lake. I swear I swam for 5 minutes and never got anywhere. I turned over on my back at one point to float and catch my breath, and somehow ended up pointed in the complete opposite direction when I flipped back over a few seconds later. I honestly don’t understand it. Anyway, I finally finished the swim, and ran to the transition area to get ready to hop on the bike. Feeling a little week after gracefully flailing in the water for 25 minutes, I thought it would be a good idea to check my blood sugar. I had practiced my transitions earlier in the week, but I failed to practice one thing: removing a single test strip from the vial with wet hands. Of course in my haste to get out on the bike course quickly, I rushed my way into an “ERROR 3 – Meter Not Ready” on the first try, so I had to start over. Believe it or not, wet test strips like to stick together, so in the end my 126 mg/dl cost me about $4. Also during this time, I grabbed my pump out of my bike shoe and started to connect back to my infusion site, at which point I noticed said site was completely dyed red with blood. I’ve been pumping for over 2 years, and this has NEVER happened. Oh well, I thought…I’ll just connect and hope that it works, since I really have no other option right now.

Heading out onto the bike course with this comforting and expensive knowledge, I actually felt pretty good. The bike course travels over many of my favorite training roads, so I was cruising along pretty quickly, knowing just where I needed to conserve my energy for the hills. Right before the first of those aforementioned hills, I was going downhill at about 30 mph when I heard one of the worst sounds in cycling…the “psssssssssssstt” of a flat rear tire (this sound is eclipsed only by the crashing of carbon and aluminum against asphalt, but luckily I dodged that bullet this time). Since I was at the worst possible spot for this to happen, I pedaled my pathetic flat tire up to the next subdivision entrance so I could pull over and change the tube. If I did set any speed records during this race, tire-changing would have to be my gold-medal category. In fact, that might be my proudest moment of the race. I still managed to finish the 17 mile bike leg in 58:42 including the tube change, so I’m pretty proud of that. The rest of the bike leg went by without incident, and before I knew it I was back in the transition area getting ready for the 5k run. The blood sugar check went a little smoother this time around, but the result was quite disappointing: 68 mg/dl. I could tell I was feeling pretty low, but for some reason it really hit me when I saw the number.

I ran up the hill to the run course, but had to stop and walk at the top to chug down another gel pack to hopefully bring up that low…I had also removed my pump at the transition, as the blood from the infusion site had worked its way back through the tubing. But judging by the 68 mg/dl, I didn’t really need it anway, so why carry the extra weight, right? Luckily the start of the run was mostly downhill, so I had a little time to recover. Don’t get me wrong, the run still absolutely sucked, but at that point I knew I was close enough to finish. And finish I did. I didn’t do as well as I had hoped, but a lot of things seemed to be working against me. As Lance Armstrong said after a rough stage at the Tour de France this year, “Some days you’re the hammer, some days you’re the nail.” Yesterday I was the nail.

Strange as it may seem, I still really enjoyed my first triathlon experience. It certainly didn’t go according to plan, but hopefully I got all the bad luck out my way for a few races. There WILL be a next time. Before then though, a few things need to happen:

• Someone needs to develop a test strip device that dispenses one strip at a time. This system should preferably be able to be mounted on a bike to save time in the transition area.
• I need to get a CGM that doesn’t suck ass. I thought the Medtronic system seemed like a good idea at the time, as I could have one device for my insulin pump and CGM receiver. That was before I found out the Medtronic sensor wouldn’t even last 50 meters in the pool before coming off. Really, people? That was the best design you could come up with?
• My bike needs to stop hating me.

Oh, but the one good thing about the day? We managed to convince LT that she was not allowed to exit her mother’s womb until after the race. She held up her end of the bargain and let Daddy finish his race that he had been training for. Now that we’ve got that out of the way, bring on the babies!!!

Diabetes Snapshots

Hello, friends. Thank goodness today’s post is primarily about pictures, because I’m almost out of words for the week! Since no one really want to see pictures of itchy sensor site rashes, or needle-hole ridden ab shots, I thought I’d share a few noteworthy accessory-related photos.

First of all, I always find it astounding how many supplies I go through in a typical month. Since I try not to do math on the weekends (and also because it’s depressing), I’m not going to add up how much all of this stuff costs, but it really is a lot when you look at a whole 30 days’ supply:

Secondly, I thought I’d share a photo of my most often-used accessory – the pump clip. I don’t use it during the day as the pump normally resides in my left front pants pocket, but I couldn’t sleep or work out without this thing. It’s such a simple little piece of plastic, but without it, my insulin pump would just be a $6,000 pendulum hanging from my body.

Speaking of working out, I always wear my trusty RoadID when I’m away from the house on a run or bike ride. I wore the medic alert necklace for years (in fact, I still have the first one my mom bought for me when I was 12), but I’ve found the RoadID bracelet to be much more comfortable, not to mention more informative, as it has emergency contact numbers for my wife and parents if I were to have an accident. You’d be hard-pressed to fit all of that on the back of a Medic Alert necklace. I also added a little pun at the bottom, which I borrowed from the name of Alexis’s blog (hope you don’t mind!). It makes me smile when I look down at it during a workout, and who knows…maybe it will give the EMTs something to talk about on the ambulance ride someday (hopefully they never have the opportunity, though).

Hope you guys have an awesome weekend!

Let’s get moving

Exercise…love it or hate it? Interesting question, especially for today. To explain why, let me give you a rundown of my afternoon:

Around 2pm, my boss tells me if I’m caught up on everything, I should leave and get an early start on the weekend. Awesome, I think. I’ve got enough time to fit in a bike ride before my sister-in-law (who’s spending the night with us) arrives. So I get home, plot out a nice 24 mile loop, and head out on my way. About 8 miles in, I hear the noise that no cyclist ever wants to hear: psssssssssssshhhhh. FANTASTIC. I LOVE flat tires. I pull over to the side of the road, get out my spare tube, CO2 inflator, and get to work. (Did I mention it was 90˚ outside?) Since this isn’t my first roadside tire change, it actually went pretty smoothly, so I get ready to start riding again, and I look at the pump to see how my blood sugar is doing:

This is not what you want to see when you still have 16 miles to go, and have already used 1 of the 2 PowerBal gels that you brought with you. I ripped open the other gel pack, gulped it down, and started pedaling. A few miles later, I check the pump again, this time it’s at 84, still with a down arrow. Knowing that when it comes to lows, the CGM is usually higher than the actual number, I know I’m in trouble. At this point, I decided to call my wife for a ride home, as I can feel myself running out of juice. No answer. I tried a couple of friends in the area…no answer there either. Well crap. Using the old internal GPS, I routed the shortest, most downhill route home and started back. I finally made it home (and since I had suspended the pump, my blood sugar at least leveled off rather than continuing to drop), but still frustrated that once again, diabetes had foiled a perfectly good workout plan.

I like cycling, running, and other forms of exercise, but I often find it really frustrating how difficult it is to do while managing the whole insulin/food/blood sugar issue. I’ve got the normal after-work routine figured out, but any time I change one variable (time of day, duration of exercise, etc.), I never know what’s going to happen. That’s the part I hate. I don’t want to jump ahead to the “after-cure” post topic, but I often fantasize about being able to just go for a run or bike ride, whenever the mood strikes me. Maybe one of these days…

To carb or not to carb?

To me, it’s not really a question. I love carbs. They are delicious. I understand the thinking behind the low-carb diet thing, but it’s not the method I would choose for weight control. I would much rather go for a long run or bike ride to work off a big meal rather than completely deprive myself of a food that I want. Of course I think about carbs, but it’s primarily because it affects my insulin dosage, not because I’m keeping a running tally of the intake. If you ask me, we diabetics have enough numbers to keep track of, I just don’t have the capacity to get down to the complete caloric breakdown of everything that enters my body. That’s not to say I feel everyone should just go nuts and eat whatever they want, after all, you don’t want to end up on Maury Povich. But at long as you’re reasonable with what you eat, you take the insulin to cover it, and you exercise to keep your body healthy, I think that’s enough.

I’m not sure if that addresses today’s blogging prompt, but it’s the best I can do. I considering just playing off of Kerri and writing about the crab’s evil sea-cohort, the carp. But I powered through. Sort of.

You Bastard.

My Biggest Supporter(s)

I have a hard time making decisions. Just ask anyone who’s ever been out to eat with me. First there’s the whole “where do we go?” thing, and once we finally reach a consensus on that, I have to select something from the menu. We’ve all been there. I felt the same way when prompted to choose my biggest diabetes supporter for today’s blog post. Since I couldn’t pick just one, here’s a menu for you to choose from:

• My lovely wife – whether she likes it or not, she’s always there to hear me complain about living with this disease. Like today, when I returned from my run after a low 2.5 miles in. Sure, she doesn’t actually know that it feels like my brain is attached to my skull with rubber bands with about an inch of air around it, but she knows that I feel bad, and she listens to me as I shove food in my dry, sweaty mouth. And she puts up with all of the test strips, infusion set garbage, and such that I leave around the house. And best of all, as Gary mentioned earlier today, she has a purse to carry my meter when we go out together, which is awesome. Because cargo pants just aren’t always appropriate.
• My CDE – We’ll call her K. Partially because that’s her first initial, but also to protect the remainder of her identity. I’ve only been seeing her for a couple of years, but she’s one of the most down-to-earth medical professionals I’ve every worked with. K is the one that got me started on the pump, even though she was surprised at how much I had researched before we even met. I had pretty much decided on which pump I wanted before I even saw them in person. But more than just giving me advice and facts, she actually cares about ME…not just Harry Thompson, type 1 patient. She has reached out on my behalf to multiple diabetes equipment reps about employment opportunities, because she knew I wanted something more out of my career. She has introduced me to several people as “her favorite patient”…I’m sure I’m not the only person she’s said that about, but it means a lot knowing that someone else recognizes all of the work I put into managing this disease. I honestly can’t see how anyone could not put the same amount of effort into something so important, but I guess there are people that just don’t care as much.
• YOU - I know I’m not only person to have said this today, but the DOC is really an amazing group of people. Although I went to diabetes camp when I was younger and met other kids with type 1, there was a good 15 years in my life where I felt like the only person around with this disease. I knew I wasn’t the only one, but I just couldn’t picture real, normal, funny people that were living with it just like me. Like so many others, I have to thank Kerri for opening my eyes to this community, and I’m honored to have met so many awesome people through Twitter, blogs, and other online connections.

I’ll let you guys choose your favorite. I don’t want to be accused of nepotism, but it is worth nothing that since Meredith is “with child”, she really should get double the votes. However, I’m grateful for anyone that read this far, so feel free to vote for yourselves too.

Making the low go

Today’s assignment is to tell you about my favorite way to treat a low blood sugar. Ever since I was a young diabetic, most of my low treatments have involved peanut butter in one way or another. My favorite is probably Honey Maid graham crackers with peanut butter, but Nilla Wafers are a pretty good combo as well. In a pinch, you can use saltines, but in that case, the cracker really just become a vehicle for the PB instead of a complement to it.

The probably usually comes in restraining myself…I’m experienced enough to know that it doesn’t take many cracker sandwiches to bring my BG back into range, but I’ll be damned if those things aren’t tasty. Most peanut butter-infused low treatments are followed by a bolus to correct my gluttony overtreatment.

Well that was easy. Hey, look at that! The CGM line is trending pretty low. I better head to the pantry to ward this low off…

My hero Dr. Carver, presumably enjoying a PB shake.