Archive for June, 2009|Monthly archive page

Aaaand we’re back!

Hi everyone! I’m trying to adjust to normal life again, after a very relaxing week at the beach. I feel very refreshed, and I’ve even managed to achieve a respectable tan along the way (for someone of german/irish heritage, at least). I think my hair got lighter to a greater degree than my skin darkened, but there are worse things than looking like a pink Q-tip, I suppose.
The Big D didn’t throw too many complications into the weekend, although there were some roller-coaster days, likely results of the pump connecting/disconnecting, snacks, and beachy beverages. I had the lowest blood sugar I ever recall having (26mg/dl) and one of the highest in recent memory (411mg/dl) in the same day, so that kind of sucked. I elected not to use the CGM during the week, just so I didn’t have any extra things attached to me at the beach, but in hindsight, there are times I wished I had that additional information. And I only really worked out 1 day, so I’ve got some catching up to do in that department.
I hope everyone had a good week, apart from all the politician infidelity and celebrity deaths and such. I’ve still got a lot of blog/twitter reading to catch up on, but I’m working on it (in addition to coming up with creative ideas of my own). Hopefully you guys will fill me in if I missed anything important.

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Holiday, far away…

beach umbrella
I will be on vacation for the next week, so if I were you, I wouldn’t expect any new posts for a while. Hopefully you guys won’t forget about me during this short hiatus. Feel free to hang out, read, make comments…but no parties. I mean it.

Diabetes, the Pre-War Edition

I went to a funeral for a great aunt last week, and while we were in the church parlor (I believe that’s what the sign on the door said) waiting to go in to the service, I decided to amuse myself by browsing the room. In an old display case, I found a set of World Book Encyclopedias – the 1917 edition. Since nothing in the “Bolivia to Crow” volume caught my attention (really? Crow? Black bird. Loud. End of entry.), I moved on to the next volume and flipped to Diabetes. It’s really amazing what was known (and not known) about this disease 92 years ago. The pictures below are sort of hard to read since I took them with my iPhone in less than ideal lighting conditions, but here are some things I learned:

  • Instead of the normal passage of about 3 pints of urine a day, the diabetic passes from twenty to thirty pints daily” Holy crap. 20 to 30 pints? Did these people ever leave the bathroom?
  • In many cases disease of the pancreas is a feature of diabetes” I find it interesting that at the time, it seems the consensus was that diabetes was due to a liver condition, and that pancreas damage was just a side effect.
  • Diabetics rarely recover, though some live for many years” Sadly, not a whole lot of change here. Sure, the definition of “many years” may have changed, but still no cure.
  • The diabetic must not eat foods containing starch and sugar…He must therefore avoid potatoes, turnips, carrots, cauliflower…” Thankfully this part has changed, and I’m able to enjoy those…turnips?…I so desire.
  • Oh, and I finally learned why we refer to what we have as Diabetes mellitus rather than just Diabetes. ¬†Apparently there’s a condition known as Diabetes insipidus, which is “a nervous ailment of a not very serious character.” I wonder if that’s still considered a real condition? I’ll do some homework on that.

Although the article was short, I found it fascinating. Thinking back over my life with diabetes, I found it remarkable how this article from almost 100 years ago sounded a lot like what I heard when I was diagnosed, just over 17 years ago. The extreme thirst and urination were the first signs that something was wrong, and with the “exchange system”, I was still allotted a sparing amount of starches. Maybe it’s just because I’ve become more familiar with the disease since then and and tried out many different treatment plans, but I feel like there have been some significant advances in treatment since I was diagnosed. However, in the grand scheme of things, it doesn’t seem like there were a ton of developments between the writing of this article and the time that diabetes entered my life. Sure, we learned more about what happens inside the body and the long-term effects of diabetes, but we didn’t figure out what to do about it. I don’t know what the future will hold, but my hope is that when future generations read about diabetes in our lifetime, the summary will be much different. Maybe if we’re lucky, the article will primarily discuss not the disease and its complications, but how it was cured.

Kerri: Blogger, Advocate, BEST PERSON EVER.

I received a wonderful FedEx gift this morning from the great Kerri Morrone Sparling, or as she will henceforth be known in my book, #1. After a discussion about her post on Crumbs cupcakes and my disappointment that we have no such thing here in NC, she was kind enough to surprise me with a box of their best-sellers this morning. It may seem odd that a fellow diabetic blogger would send a bunch of sugar-laden treats, but even though we’ve never met in person, she seems to know me pretty well. Luckily that’s not going to be an issue for much longer, because after sampling one of these delightful cupcakes, I’m moving. Thanks Kerri!!!

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P.S. Any volunteers to send me a vial of Novolog? I seem to have encountered an unanticipated shortage.

The 3rd time’s the charm…

I’m still getting adjusted to the CGM sensor, so I’ve been trying out different locations. Yesterday, I decided the lower back might be a good spot, as it’s out of the way and and not competing with infusion sets for real estate, and I’ve found I don’t get very good absorption back there for whatever reason. The only problem with this spot is that it’s a bit difficult to reach myself, so I enlisted the help of my wife for the insertion process.

I gave a brief training on the design and workings of the sensor and the inserter, and showed her where I wanted the sensor place. I could tell she was nervous, but I assured her I was confident that she could do it. The first “shunk” of the inserter was immediately followed by intense pain. Inspired by the pain and the “oh no!” from my assistant, I inspected my back in the mirror, to discover the needle only went in the skin about 1/4 of an inch. I’m sure Medtronic’s design of the 45 degree needle angle didn’t help, especially coupled with the design of the inserter, but that’s a discussion for another post. Anyway, I cleaned off the introducer needle with an alcohol wipe and loaded up for attempt #2. This time the needle did go in all the way, but was accidentally pulled out when my wife tried to disconnect the sensor from the inserter. She of course apologized, but I assured her that one more hole isn’t going to kill me, and if nothing else, we learned from our previous mistakes. Finally, on the 3rd try, we successfully inserted the sensor, removed the needle, and got everything adhered to my skin. Sure, we were both a little frustrated by the end of the process, but it all worked out in the end.

Thinking about this afterwards, it occurred to me that this is really the first time in our 11 year history as a couple that she has had to inject anything into/under my skin. She has pricked my finger before when I’ve been sick or really low, but never any serious “needlework”. In fact, since my diagnosis at 11 years old, no one else has ever given me an injection (aside from flu/tetanus vaccines and the like). Based on the estimate I came up with a while back, that’s 35,000+ self-inflicted needle holes over the years. I guess I’ve just become so accustomed to sticking things into me that I don’t really give it much thought anymore. She has of course watched me do it countless times, but there’s always a difference in watching someone else do something versus doing it yourself. I guess it’s easy to become complacent about doing something painful several times a day, especially when your life depends on it. I certainly don’t wish the same for anyone else just to make me less of an “oddity”, it’s just hard for me to imagine my life any other way. I’m glad I have someone that’s willing to lend me a hand, even if it’s something she’s not entirely comfortable with. I hope she (or anyone else, for that matter) never has to give me a glucagon shot, but at least now it won’t be the first needle she’s stuck into me. Thanks honey…and don’t worry, we’ll get it right next time.

Incognito Mosquito

I made it 16 years without an insulin pump. After living with one for over a year now, I can see looking back how it could have made things much easier, but as a teenager/young adult, I just couldn’t completely get on board with the idea of having a device attached to me 24/7. I liked being able to look like a “normal” person, even if things weren’t working right on the inside. It’s not that I was ashamed of my diabetes, I just didn’t want to publicize it. Even with the pump, I try my best to conceal it. I always keep the pump in my left front pants pocket, and I cut a little hole in the inside of the pocket through which to snake the tubing. I’m more than happy to talk about my diabetes and answer questions when I take the pump out to check on the CGM or to bolus for a meal, but I don’t like to wear it on the outside as a red (smoke gray?) flag to say “this person has a broken pancreas!!”.

That being the case, I’m pretty excited about my current setup, at least for the next 3 days. I have the CGM sensor on my upper left “gluteal cheek” (note: I learned it is best to try this placement only if you have a trusted person to help with introducer needle extraction. Otherwise it is quite tricky), and my infusion set on on my left thigh. Now, I can wear only shorts and still hide all external signs of diabetes. This is nice because the wife and I are planning to go to the pool this weekend and get our skins prepared for our upcoming beach trip. I’m sure I’ll end up with something along the way, but I don’t need to start out with wierd circular no-tan spots. On the other hand, if it weren’t for those external signs, I never would have seen my neighbor’s Omnipod and found a good D-exercise buddy…so it’s not all bad.

Anyway, the pool/tan talk leads me to my final (and perhaps only) point. With the beach week coming up, I’m worried about how these hours in the sand and sun are going to work with the pump. Am I going to have these adhesive patches and tubes exposed for all to see? Is the heat going to cause the insulin to go bad faster? Will the tiny granules of sand wreak havoc on this $6,000 piece of equipment? I’ve heard about people taking “pump vacations”, I’m just not sure if the hassle of trying to figure out the injection doses is worth preserving the “vanity” factor. What do you guys think? Have you tried pump vacations? Was it worth it? Any tips for how to handle all this equipment in the beach environment?

By the way, I realize this post had absolutely nothing to do with mosquitoes. It was the only word I could think of that rhymed with incognito. I briefly considered “Diabetico”, but I don’t speak Spanish so that was quickly ruled out.

The hopes and fears of all the years…

If it weren’t for the whole “work” thing, today would be a pretty good day. The wife and I went camping this weekend, and I actually feel relaxed for a change. Aside from the CGM sensor failing to detect the high at 4am Sunday morning and the following low later in the morning, things were pretty calm diabetes-wise. I even made it through a 7-ish mile hike without any severe blood sugar fluctuations, which is a rarity in my hiking experience.

More importantly though, today is our 6 year wedding anniversary. I can’t believe it’s been that long, but it has been great. Even though I try to be self-sufficient when it comes to managing my health, my lovely wife is always around to help if I need it, and she tries as best as she can to understand when I get frustrated. We actually talked a good bit this weekend about having kids (since we’re the only “barren” couple in her family now), and specifically, about my fear of my child having to live with this disease. On the way out of town Saturday morning, we were in line at Wendy’s (I know, rustic, huh?) behind a family with a little girl that couldn’t have been more than 3 years old. I noticed the dad was wearing a JDRF Walk for a Cure shirt, but didn’t really think anything of it until he told the little girl that she had to go sit down so mommy could check her blood sugar. It breaks my heart to see someone that young with diabetes…even though I’ve been going through the same routine for 17+ years, I was old enough when I was diagnosed that I could at least somewhat comprehend what it meant. I can’t imagine a child that young having to live her whole life with this, not really knowing life without diabetes. I admire all of you parents of diabetic kids out that that deal with this every day. I’m sure most of you never expected this path in life, but I guess we have to play the cards we are dealt. It is my biggest fear when it comes to raising children…it’s not that I don’t think I can handle it…I just hope for their sake, I don’t have to.

Anyway, today we’re going to celebrate our anniversary and be thankful for what we have, not worry about the “what-ifs”. We’re planning to have a lovely dinner at Ruth’s Chris Steakhouse. I’m sure I’ll completely blow my estimate on the carb count, but tonight, I don’t care.

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I’m sorry, little buddy

I’d like to issue a public apology to my left ring finger. I know it’s unfair, but he gets pricked much more often than any other finger. Unfortunately, I only come to this realization each time after I’ve pricked it.

It’s not really his fault. Maybe it’s just because he lines up so well with the lancing device when the meter case is laying on the table. Sure, the pinky is closer, but let’s face it – that hurts more often than not. Maybe it’s his “bling”. It is, after all, the only finger that gets to wear any decoration, so this could be my subconscious way of settling the score. Perhaps it’s a safe alternative to the middle finger, because you never know when you might need that one for something special. One thing’s for sure, I’m certainly not going to use my thumb. You see, I can’t stand the taste of blood, so once I’m done “loading” the test strip, I lick my non-bloody thumb, and then use that to clean up the finger that has been pricked. Weird, I know…but that’s just how I roll.

Anyway, regardless of the reason, I’m sorry, little dude. I’ll try to spread the love to your brothers (at least when I think about it).

poor little guy

poor little guy

Not off to a good start…

I had a much more lighthearted post that I was working on for today, but I’m just not feeling up to finishing it. Instead, you guys get to hear me bitch about the roller coaster I’ve been on for the last 12 hours. The problems seem to have started when I changed my infusion site after my workout/shower yesterday. Everything felt normal at first, but when I was at 343mg/dl after eating a salad for dinner, I knew something wasn’t right. Not wanting to waste a good infusion set, I took a correction bolus and decided to wait it out. An hour or so later, I was still in the 300s, so I initiated the rage bolus launch sequence. A little while later after still seeing no results, I finally gave in and decided to change the site (this was around 11pm). I set my alarm for a few hours later so I could test and went to sleep. Thankfully I did set the alarm, since I woke up at 2am with a low of 33. I ate a snack (ok, moderately sized meal) and went back to sleep, and when I got up this morning, I was at 140. “Thank goodness, things are finally settled down”, I thought to myself.

So here’s the annoying part: I get to work this morning and test before eating breakfast. The result? 312. WTF? I have had absolutely nothing to eat since 2am, and was only disconnected from the pump for my normal shower time. Correction bolus is hopefully working now, if not, I will be heading back to the house for yet another site change.

On a more positive note, I’m meeting with the Medtronic rep for my CGM training today. I’m just working on how to respond to her instructions.
MM Rep: “Be sure to calibrate the sensor when your bg levels are stable”
Me: “Oooh, slight problem. I don’t have those any more”

I am a complete mess

I can’t seem to get myself together lately. I guess it all started Friday afternoon, when on the way from work, I realized I had left my UltraLink meter in my desk. Even though this is my primary meter, I have backups at home, and it’s going to take a lot for me to turn around and go back to the office on a Friday afternoon. Since my “first backup” Ultra2 meter was also in my desk at work, I made it through the weekend with one of UltraMini meters stashed in my bedside table. This worked fine, although I forgot how much of a pain it is to have to manually plug the bg reading into the pump each time.

Fast-forward to this morning. I arrived at work and opened the drawer to find the trusty UltraLink, right where I left it. So I open the vial of test strips, only to find a whopping 2 strips (not enough to get through my workday). Luckily I had strips in the other backup meter case, even though they were a different code, just one more annoyance for the day. By the way, for some reason, there is no lancet in the backup meter lancing device. I’m not exactly sure what happened to it. I’m really just a few steps away from stabbing myself with a paper clip and tasting my blood to determine how sweet it is.

This chain of events has led me to only one possible conclusion: I need an assistant to help me keep track of my testing supplies. I am now accepting resum√©s for this “meter maid” position. Persons unwilling to be referred to as Lovely Rita need not apply.

P.S. I typed this entire post on my iPhone. I blame that (and a pinch of laziness) for the switching back and forth between tenses.