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MDI and I Don’t Hustle and Bustle July 11, 2014

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City folk and country folk are two totally different characters. The love of noises (or lack thereof), daily expectations and even waking hours seem often to trend in opposite ways. While visiting Chicago awhile back, I wondered if diabetes management choices differ as well. More specifically – insulin pump use.

I used a pump for a couple years before deciding that multiple daily injections (MDI) is currently the better fit for me. Except while traveling. For airplane and flexibility-required journeys, I often switch to the pump. Except I forgot that. (How do I forget to switch insulin delivery systems? I don’t know. It’s kind of a big thing). But man did I miss the pump in the hustle and bustle of a big city.

I missed the option to change a basal rate when a walk through the city, a bus wait or a restaurant wait was longer than expected. Or shorter. Or more strenuous. Or completely changed because an alternate public transportation option became available or the original choice restaurant was more crowded than the one twenty minutes away. Or group plans change because somebody else was dealing with city stuff (aka, the above stuff).

I feel like country (or even suburban) dwellers do not face these diabetes speed bumps on a frequent or as extreme basis. Restaurants do not seem as crowded so I can usually more safely do insulin before I eat. Public transportation? Uh… we’re working on that. The day is just a bit more predictable, and if plans do change last minute it is probably to something I’ve dealt with before (first choice restaurant is full…no problem, I probably have eaten at one of the other 10 options).

City life for me was just a bit more unpredictable in ways that were difficult for me to handle with MDI. Even removing variables like being on vacation and never having been to Chicago before, I think a pump still would have been easier to work with. City dwellers – are you on a pump or is MDI working for you?

My Favorite Things: #Dblog Week, Day 7 June 8, 2014

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Dblog Prompt: As we wrap up another Diabetes Blog Week, let’s share a few of our favorite things from the week. This can be anything from a #DBlogWeek post you loved, a fantastic new-to-you blog you found, a picture someone included in a post that spoke to you, or comment left on your blog that made you smile. Anything you liked is worth sharing!

What is not to be a favorite thing during Dblog week?? I think the only thing I do NOT like about this week is that it’s not a national holiday week, so I have to squeeze in work during all the blog reading and writing! Of the blogs I’ve read so far during this event, I noticed a few more international DOC members this year:

Shannon in Dublin: http://seichelberger.blogspot.ie/
Juliana Brazil: http://insulinaportatil.blogspot.com.br/
Pam in Dubai: http://diabeticinthemiddleeast.blogspot.ae/

While it sucks that we all have to deal with diabetes, I love that the DOC represents members from truly around the world. The core goals that we all have, regarding our health, are often not that different. Reading how people in different environments than I deal with diabetes is another favorite insight that the DOC has helped me find.

 

Saturday Snapshots: #Dblog Week, Day 6 May 17, 2014

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Dblog Prompt: Back for another year, let’s show everyone what life with diabetes looks like! With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures. Post as many or as few as you’d like. Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves.

The below snapshot is one of my favorites. You can see why. But the other part I love about this image is knowing how hard I worked to make that happen. 72 g of carbs means I brought at least that much. A pump setting means I somehow wrangled my insulin pump into a safe position on that trip. It means I also brought a backup pen. Four hour mountain bike ride…that’s a lot of tough riding. I went solo on this trip, but any riding partner would have brought their bike gear, snacks, hydration and that’s it. When they hit a technical spot they think only about the obstacle. I’m thinking about the obstacle, which way to land if I crash so I don’t rip out my infusion set, what by BG is, and what this obstacle is doing do my BG. As diabetics, we are pretty much ALWAYS thinking more than our pancreas-functioning counterparts. And that sucks. But it makes you feel pretty sweet when you can manage an outcome like this:

72g carbs + 4 hour -70% basal + 3 water bottles + 4 hour mountain bike ride =

This only takes 4 hours of mountain biking!

Diabetes Life Hacks: #Dblog Week, Day 5 May 16, 2014

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Dblog Prompt: Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes. Tell us everything from clothing modifications, serving size/carb counting tricks to the tried and true Dexcom-in-a-glass trick or the “secret” to turning on a Medtronic pump’s backlight when not on the home-screen (scroll to the bottom of this post). Please remember to give non-medical advice only!

My current favorite diabetes life hack pertains to a beeping, high alarming CGM. Recently, I’d been over treating highs because I would dose correctly yet my DexCom continued to beep or go straight up arrow or double straight up arrows. This scenario leaves me more irate than what is rational, leading to the overtreatment of highs just because my calculated treatment was not working fast enough. So, I move Dex to a separate room with a closed door where it stays by itself for an hour to two (enough time for my insulin dose to do its thing). If possible, I go for a short walk or do some stretching to try and calm down. After the hour or two I go get Dex and reassess the blood sugar situation.

A few considerations if you give this a try:

  • Put your CGM in a logical place; i.e., don’t lose it. That undoes the whole not frustrated thing.
  • Not a good hack for down arrows or low alarms. In fact, don’t do this.
  • Don’t abandon your CGM for too long. Leaving an unresponsive high unattended isn’t super.
  • I’m not a doctor. Use your CGM as directed by your doctor.

Mantras and More: #Dblog Week, Day 4 May 16, 2014

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Dblog Prompt: Today let’s share what gets us through a hard day. Or more specifically, a hard diabetes day. Is there something positive you tell yourself? Are there mantras that you fall back on to get you through? Is there something specific you do when your mood needs a boost?  Maybe we’ve done that and we can help others do it too?

The one-word difference between a hard day and a hard diabetes day is huge. A hard day IS any diabetes day. A hard diabetes day is like a hard day x 5. Regardless, hard diabetes days are unavoidable. When one hits, I try to remember that I get to try this all again tomorrow. I leave yesterday’s diabetes behind and start again. I restart with a blood sugar I am satisfied with (if that isn’t what you wake up with, treat and do the whole restart thing starting wherever ‘satisfied’ is for you).

One hard diabetes day is not going to change your health outcome, your A1C or your weight. A hard diabetes day is a blunt reminder of how hard you work everyday to avoid days like this. I recognize a hard diabetes day and recognize that I can do my best for the rest of the day, go to bed and try it again the next day.

Alternately, I’ll say fuck it, buy Ben & Jerry’s, rage bolus, find a TV comedy, double check for a low in the middle of the night and let the morning be a chance at redemption. :)

What Brings Me Down: #Dblog Week, Day 3 May 14, 2014

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Dblog Prompt: What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope?

The diabetes online community (DOC).

The DOC is tremendous. The reach we have is huge. I think of changes and differences we have made and, for the most part, feel proud. But my diabetes didn’t really have an affective emotional side before I encountered the DOC. That strategy was working pretty well for me.

Sure, LOW lows, weird highs, carrying glucose every damn place frustrated me every now and then. But that was just part of life. I treated a low, treated a high and didn’t think twice about carrying glucose. I recognized that some of those lows were the cause of something I did previously, and the highs the cause of something I did not do. I didn’t think twice about it, learned from what happened and moved on.

But the DOC. As a whole, we can be pretty big on shit not being our fault (treading on thin ice here, I know). I can’t argue with that concept. Diabetes was not my fault. (And it is not your fault.) Many of my LOW lows and HIGH highs might not be my fault. However, introducing the idea that some of what goes on every day might be excusable, might not be my fault and might even be okay also introduced diabetes behavior that I am not proud of. For me, something not being my fault correlates to an excuse. And how I deal with diabetes goes better when I’ve got no excuses. Nothing to fall back on. Nothing to blame but what I did that day. I think that is the mindset that I need. That’s not the way everyone rolls. I’m not giving up the DOC – it’s too awesome. Instead I need to try being more mental prepared when I engage. Take the helpful pieces, offer my thoughts, suggestions and support, and leave everything else.

Poetry Tuesday: #Dblog Week, Day 2 May 13, 2014

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Dblog Prompt: Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes. 

Disenchanted.
I’m disenchanted with you.
You’ve never been easy and that will always be true.
I don’t get along well with your friends,
and I think they are disenchanted with you too.

Change the World: #Dblog Week, Day 1 May 12, 2014

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Dblog Prompt: Let’s kick off Diabetes Blog Week by talking about the diabetes causes and issues that really get us fired up…Whether or not you “formally” advocate for any cause, share the issues that are important to you.

This post requires a disclaimer. Or acknowledgment. You decide.

Except for the weather, I do not believe anyone has a right to effortly complain about something that they have not tried to fix.

I’ve not tried to fix health insurance at any level.

So, that being said, health insurance is my issue. It is an issue for anyone with a chronic disease. Health insurance (or financial security/ability) that lets everyone choose and use the best treatment option for that one person at that time must be available. It makes zero sense that some people do not get the option to use a pump or a continuous glucose monitor (CGM). I understand that new or unique treatment options are expensive. But so is heart or eye surgery, neuropathy treatment, kidney disease treatment and hospital stays. An insulin pump and CGM are two life-saving and life-changing devices that can help decrease health issues in the future. And if you don’t want a CGM – that’s cool. You should get to choose any number of strips for any meter that you want. Or the insulin you want in the delivery method that works best for you. The world of health insurance is changing, but it has a long way yet to go.

Book Review: Your Diabetes Science Experiment March 6, 2014

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A book title with ‘Science Experiment’ made me worried, as no science class in the past went superbly. But, experiment indicates I’ll be trying out things. Science indicates logic and reason behind these things I could try. Any area of diabetes that even has a chance of logic and reason is something I’ll spend time on.

Seemingly illogical stuff, like going high after intense exercise, has actual explanations. But those explanations often become so complicated, that the explanation only adds to the confusion.

That’s where Ginger comes in (oh, she’s the author). Ginger’s book is solid and full of information. And, refreshingly, I feel like this book focused on ME. A long time Type I diabetic who exercises frequently and with variety, and am struggling to best manage my diabetes but also the benefit from exercise itself. That is not to say that if you were diagnosed yesterday, you would not find this book helpful. You would. Or, if you exercise once a week. Or if you have Type 2 diabetes. That’s the beauty of this book – Ginger writes in a way that respectfully reaches all different groups. Ginger presented examples applicable to me (I’m also vegetarian). A LADA meat lover could say the same thing.

This book discussed topics such as insulin sensitivity, carbs, protein and hydration all related to exercise and diabetes. Plus, exercise itself related to diabetes. Many chapters include real-life examples that Ginger had the guts to put out there. The book includes worksheets and steps to help navigate your own solutions and to help make diabetes work into the life you currently live. Ginger also realizes that these steps are tough, and offers encouragement throughout the book. However, I think the book could have better addressed some of the mental challenges that are likely to come up when you begin to take a hard look at diabetes in your life – burnout, overwhelmingness and intimidation.

Overall this book is real, it is helpful, and will be helpful each time your life pattern takes a shift. My favorite quote from this book sums up the idea that diabetes requires huge amounts of effort. But, it is something you can always work on. It is something you might not get right at the first try, and that is alright:
“You are a work a progress.”

Title: Your Diabetes Science Experiment
Author: Ginger Vieira
Ideal Audience: Insulin dependent or insulin-using diabetics partaking in any kind of regular exercise. Curious folks interested in how exercise, insulin and timing can all work together.
Read when: You have a couple days to think about you and your exercising. Be able to keep your own exercise routine in the back of your head while reading. If the book topic sounds overwhelming, read it right away. That feeling fades by the third page.

Disclaimer: I met Ginger at a conference, and a long story short (plus sweet potato fries), I left with a copy of her book at no cost to me.  As with all entries here, my comments and opinions are my own unless otherwise stated. I am not a medical professional. Contact your medical team regarding any health-related concerns, questions or changes.

When the Star Player Goes Down December 17, 2013

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I didn’t expect the appointment to go well. I recently switched back to multiple daily injections (MDI), and struggled to maintain a solid focus on waiting to eat, carb counting and over treating. I expected about a week of mountain-range style numbers while I adjusted my insulin dosages as compared the pump.

But not two months of drastic up and down numbers. Two months (for me) is more than an adjustment period – that’s frustration, emotion, lack of caring, lack of effort, lack of interest and not enough time to ‘fix’ it all before my next endo appointment.

I knew how to fix what was wrong. I just wasn’t doing it. I knew I would walk into this appointment feeling somewhat guilty, unprepared and defeated. I expected to leave slightly motivated, but not necessarily encouraged for the long haul.

But my endo team cared. Nobody was disappointed in me. Nobody was mad at me. Nobody made me feel guilty or like I had failed. Nobody insinuated that I was dumb or incapable.

My endo team cared. My nurse cared that I was am struggling, and provided a few simple things to work on. My endo was worried about my too-close-for-comfort-night-lows that some people don’t wake up from, or wake up from in the ER. He wasn’t worried about my highs. Other people don’t worry about these things because I don’t often share. But at the endo’s, that is his sole focus – to help me keep me safe and healthy.

I left feeling cared about. I could handle the few things my team suggested. I wasn’t overwhelmed with my failures or the solutions. My endo team IS a team. A team where I am the star player. A team where if the star player is hurt, the team rallies. A team that pushes you to be better, catches you if you fall and helps you back on your feet.

That’s a team I want. And it’s a team I need to remember that I AM on.

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