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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!

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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.

Diabetes Santa God! Or…I’m Addicted To My CGM. (Part 2) December 4, 2013

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Part Two…Continued from, Part One, when I’d just contacted a local D-member!

  • At work, less than 24 hours preflight: No success with a charger, but local D-member had an older Medtronic CGM she was willing to lend me.

I’ve never used Medtronic anything. I’ve heard mixed comments about the system, including its less than reliable sensors and its harpoon insertion situation. And I’d be carrying an extra pump as the receiver. Was it worth it? I tried to think logically. But as the nerves and what-if scenarios ballooned in my imagination, yes, it would be worth it. Learning a new system in half-hour, less than 12 hours before my flight added to my nerves, but I felt comforted and protected knowing I would have a CGM system during the diabetes disaster that is Thanksgiving. HUGE SHOUT OUT to the local D-member.

And then I pulled into my driveway.

I walked towards my front door. And held my breath.

There.was.a.box. I’d ordered other items this past week, but this box, this possible gateway to complete relief, was perfect Dex transmitter size.

I slowly walked towards this box, my eyes fixated on the return address label, knowing exactly what it needed to read.
Byram Healthcare.
Could it be? Is that even possible?

I carefully lifted the box, fumbled to unlock the front door, and walked inside. Everything else fell to the floor but this box.
Scissors! Where the fuck are my scissors? Ah ha! I carefully cut open the box. I lifted the sides of the box and peered inside.
Nothing but a transmitter could fit in with this packaging. I pulled out the brown packing paper.

There it was.

I felt like the M&M® in the M&M and Santa commercial, “They do exist!”
Some Santa, diabetes god, leprechaun, unicorn was on my side. And I realized how much trust and dependence I have with these devices, the ones that offer me protection, safety and let me live my life how I want. And for that I am thankful – I know others do not have that luxury for which to make complaints.

Diabetes Santa God! Or…I’m Addicted To My CGM. (Part 1) December 3, 2013

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Part One…
I had a sneaking suspicion that my warranty was about up on my CGM system. I had to switch to a 3rd party supplier, who I haven’t quite figured out as opposed to DexCom direct. I called 3rd party company, and wouldn’t you know – my transmitter expired in spring.

No, Ms. 3rd party company, I have no Low Battery screen alerts from Dex. What, my receiver’s warranty is up in two weeks? Great – can I just wait and reorder both things at once? Cool, I’ll do that. Talk to you then.

And then…

LOW BATTERY (go see Brian or Scott for a more colorful display)

Of course. Two days after I called about this very possibility. I immediately ordered the transmitter, which required a new prescription. I wasn’t too worried at this point – most Dex warnings about failure/low things tend to stretch out. An upcoming Thanksgiving trip weighed on the back of my mind, but I figured I could react appropriately after I received confirmation emails about the order.

  • About one week pre Thanksgiving trip: No transmitter, no confirmation emails. But I still wasn’t worried (for future reference, get worried here)(or be smarter and call the company).
  • Three days pre Thanksgiving trip: Transmitter starts consistently losing communication with the receiver, even when less than one foot a part. Still no confirmation emails.
  • Day and a half pre Thanksgiving trip: This transmitter isn’t going to make it. Now I am a little nervous, but I’ve had diabetes for about 20 years without a CGM – I should be able to handle one holiday with travel using my trusty meter and strips.
  • About two hours later: THANKSGIVING! Holy Carb Motherload! Airplanes! So much alcohol! No CGM! Panic ensued. And no confirmation emails.

Now in my panic-mode, I search through my diabetes closet. No random transmitters, but I had one Seven+ sensor, multiple combinations of Seven+ transmitters and receivers…and no Seven+ chargers. I tried to plug things into other things that should probably never plug into one another. No luck. Double-arrow stress increase. In one last-ditch effort, I emailed the only local CGM user I knew.

Stay tuned…

Wordless Wednesday: A Year of Dex November 13, 2013

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Year's worth of DexCom sensor placements.

I use my bathroom mirror to track my DexCom sensor placements. Here’s a year’s worth!

Wordless Wednesday: Bumpy Transition September 18, 2013

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Has MDI always been more colorful??

First 12 hours from pump back to MDI is not going well…

If You Want To September 6, 2013

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“…if you want to,” said my endo. He added on this last phrase, as an afterthought.

My endo plays significant roles in many top Type 1 diabetes studies, including a recent study for the closed loop solution with automatic suspension. Essentially the closed loop system means an insulin pump and a continuous glucose monitor (CGM) talk to one another and can make a treatment decision without user intervention. A key part of this particular study is when the CGM alerts to a low during the night, the pump automatically shuts off for two hours*.

I am not cool with this.

If I turned off my pump for two hours in the middle of the night I’d be sky high by morning. Sure, you can override the turned off pump, but that kind of defeats the purpose of an automatic action. (YDMV – I can see the value of this for kiddos, worried parents and hypo-unaware folks).

I don’t trust my Dexcom CGM 24/7, the best sensor on the market today, enough that I’d be okay with it talking to my pump and making a decision without my input.

This closed loop system uses a different CGM and pump than what I currently use. I picked my system for a reason. Because it works for me and my life right now.

Those are three significant downfalls, for something that I am not convinced will improve my care. And “…if I want to.” is the LAST phrase from my endo after his spiel?

I’ve lived with diabetes for a long time. Since I was old enough to make decisions, I made the decisions about how I handle my care. Yeah, I could be in better ‘control’, but the things that often throw me out of control have nothing to do with my choice of treatment tools.

So Dr. Endo, you are absolutely right – if I want to. It is my decision, not yours. I value your bias yet educated opinion, but only if I want to, will I take action. The tools I use every second of my life – those are tools that I use because I want to. Because I see their value to my health and because I want to find a way to incorporate those tools into my health care.

Don’t you dare make me feel guilty if right now, I don’t want to.

*Note: I am not a doctor. I have not read the study details. Talk to your doctor or do your own research for the scientific facts. The study is titled Threshold-Based Insulin-Pump Interruption for Reduction of Hypoglycemia .

Wordless Wednesday: Oh! A Slide! July 24, 2013

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Just proving the color options in Dex...

First thought when I looked at Dex: Oh! A Slide! And all the colors! How pretty!
Low brain + before 5 AM…

Walk It Off July 11, 2013

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I lost another clipped-to-me, number reading, 24/7 device yesterday.
Not my pump – that’s attached (thankfully).
Not my Dex – this would be a panic-post if that were the case.
A pedometer. A stupid pedometer. I don’t even like pedometers. I don’t care what number shows up on its little screen. But for four months, my employer does.

My employer participates in a program designed to motivate employees to be more active in hopes of increased physical and mental health, and increased productivity. Overall, it’s a cool program. And when I haven’t lost my pedometer, I only get slightly annoyed about tracking yet another number.

But when I reach down to my waistband and realize my pedometer’s missing, I lose it. I already keep track of at least three medical devices each day. My ability to focus, work, drive, exercise depends on those devices. I should be able to keep track of one more. I should be accustomed to a painstaking awareness of where all my devices are at all times.

Losing one, just the most unimportant one, is a reminder of all the other things I carry every day. Shouldn’t I get some sort of extra credit for having to carry and track all sorts of other things during the day, every day? My coworkers get to forget their awareness of what is attached to them after four months. But after this step-count event is over, I still have stuff attached. Stuff with numbers that I need to track everyday. Stuff that can’t be left behind. Stuff that is more important than a pedometer will ever be.

When my attached things stay attached, I feel accomplished in being successful with all the small challenges that become second nature (you know, door knobs, seat belts, pulling down my pants to pee without ripping off a site). But when things go wrong, frustration and bitterness are easily and quickly misplaced. There is no reason a missing pedometer should send me into feeling guilty, irresponsible and defeated. Time to walk it off…

The Look June 26, 2013

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The Look.
The momentary blank glance while I quickly push buttons on my insulin pump or I shift my gaze to my DexCom. It’s the same look. I got it from my grade-school nephew while I glanced at Dex and bolused before I ate dinner. The same look appeared on an acquaintance’s face when I bolused at lunch. But that look, the look of momentary ‘hmm’, of a question, a query, a ponder. It lasts just a split-second before we all move on. I’m done with whatever I was doing before they formulate a verbal thought.

Very rarely in these cases do I say a single thing. I am doing what I must do before I eat, during exercise or whenever. It’s likely that this is the first time you noticed me doing anything different; even though we’ve hung out before.

I prefer that people get to know me first, and to realize that I do all the ridiculous things I do just because that’s who I am. Diabetes might have contributed, but it is not the main point. Stopping to make a big fuss about an insulin injection, pump bolus or blood test makes diabetes more important than whatever I was really doing. And I don’t want that. Yes, I must take extra steps to do the same activity you do. But I take those steps quickly and move on. I think that sets an example for the proper reaction. And in most cases, that split-second look is just that. A nonjudgmental, indecisive, split-second.

But not making a big deal of something does not mean that it is not important. If I don’t take those extra steps, I die. If I miscalculate those steps, I must deal with consequences. And those ideas deserve attention.

Is The Look a missed education opportunity? Or, is not saying anything about The Look an education in itself?

How do you PWD handle The Look? Does it depend on the situation or the person?