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Cruising. Not Along. But to Alaska. October 9, 2013

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Cruising. To Alaska. With the family. Because this is a diabetes blog, I’m skipping over my general cruise commentary and going straight to stuff you might care about.

Cruising Awesomeness:

One of the last questions on the health info boarding form included, Do you need a sharps container for syringes, needles… ?
What? Of course I would love a sharps bin! So…a small sharps bin was delivered to my room before we even left the dock. Delivered!

Purell® everywhere. Perfect for removing sticky substances from fingers before testing.

Handheld shower head thing! Perfect for successful showering without a direct water stream on the Dex and insulin pump sites. (Side note, to get hot hot water, you have to push IN the red button and then turn. Side side note. Try to figure that out before your fourth shower).

Lots of stairs. Our room was on the 1st floor, and we mostly ate on the 9th floor. Eight flights of stairs provide the perfect opportunity to give a meal bolus, skip the elevator and be in perfect BG range for breakfast. Also ideal for keeping your ass in shape while cruising.

Reading Time! I finally had time to finish Ginger’s book (review coming).

Cruising Goof Ups (aka, Where I Screwed Up):
Hydration. This was my first cruise, so maybe I missed something, but staying hydrated took some effort. Glasses and mugs were small, and I only found beverage stations during meal times. Take a water bottle from home and keep it filled from your room sink.

Food. All sorts of food. Food with no nutrition labels, five-course evening dinners, carb-filled breakfasts. Buffets. BUFFETS. With soft-serve ice cream and cookies. However, many of the food options stay the same. For instance, I had French toast and fruit every morning (plus or minus eggs, mini chocolate croissants, you know…). The first morning I bloused generously, but cautiously. Learning lessons from Morning One helped set me up for the remaining mornings. Guestimating carbs didn’t get easy, but I did get a handle on it.

Timing. Getting in insulin just around 20 minutes before a meal, not too late (hello HI) or too early (oh…LOW), was difficult. Some meals are at set times, but many were during a time range. I think you could circumvent some of this issue based on your cruising group and their ability to be accommodating.

Cruising with diabetes is definitely doable. Be prepared that things won’t be all flatline all the time. Or at all. But, with a little planning and a little extra effort, and you’ll come back with a great cruise story and steady BGs.

Or Lack Thereof February 7, 2013

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At first my mind filled with blank thoughts. Nothing beyond a variety of less-than-pleasant emotions. Then specific. Then spiraling. Like a vortex of things, people, relationships, connections, support, all spinning around in an untouchable cloud above my head, all connected. Grasping to gain a hold on anything, only to realize yet again that it’s all just out of reach. With each reason for why I couldn’t reach out to just one part of this vortex came more loss. When one thing that I could succeed at or count on goes away, a domino spiraling affect can immediately put everything else just outside my reach and at the same time leaves me feeling like I need everything I lost.

But control, or lack thereof, needs perspective. When an inexplicable high shows up, or a completely avoidable low that I expected and didn’t do shit about, I often throw away the rest of the day. Set a 100% temp basal with random boluses, eat high carb crap and let the day go by. Sometimes that works perfect and it’s just what I need. But rarely. More commonly I feel gross, dehydrated and no less frustrated at the day’s end.

The irregular bounce of 70 to 327 after exercising does not mean the last few months of work on swings and control to help prevent further neuropathy is worthless. It does not mean that workout was worthless. It means to bolus, drink water, chill out and keep an eye on it next time.

Letting someone into my life that ends as an ongoing clusterfuck shit show does not mean that part of my life was wasted or that all people are no good. I haven’t figured out what that means yet.

The huge bedtime snack because I was hungry that resulted in a 2 am HIGH (even though I was in range at the midnight check) does not mean to eat all the things or eat none of the things. It means think twice or act more responsibly.

Get back the perspective and get it figured out. If figuring out that nothing works is what you learn, so be it. Sometimes there’s a meal, a dessert, a restaurant, that we know ends in a #diafail. But for those moments, you know that the unexpected is what to expect.

And that’s okay. That does not mean that all efforts, past or future, are meaningless.

Day 29: Is It Me or Diabetes? November 29, 2012

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Today’s Topic: Write about unexpected blessings of your health condition? Or how being a patient/caregiver had changed you. ***This post is originally from awhile back, but still applies. (I promise I’ll actually write something for the last #NHBPM day). *** 

I have always been slightly more organized, responsible and mature than most of my friends near my age- and those older. In the moments I become unorganized, irresponsible and immature the diabetes goes out of control; leaving me with the physical and mental gross out-of-control-diabetes feeling.

Situations in the past year have frequently made me wonder- did my diabetes make me this way? Here are a few examples:

*Weekend night out. Who’s the designated sober person? I wonder with no regard to who is driving (also crucial information), but with regard to whom can I count on for blood sugar checks throughout the night? I frequently become the designated sober person, which leaves me slightly less than enthused about frequent nights out. If not for my diabetes, would I be more “fun”?

*Lunch with Coworkers. What time are we going? The food-coverage effort starts the minute I get up and lasts all day. So when a loosely planned lunch outing is postponed by 20 minutes, I become rather impatient and inflexible. Would I be more flexible and easy-going if not for years of diabetes control?

*Sudden Day/Weekend Trip. Huh, we’re leaving right now for the beach? You’re familiar with the questions that follow: For how long? Is there a fridge? How long is the trip? Is there a grocery store? How hot will it be? An unplanned, spontaneous fun trip gets significantly more planned with a diabetic on board. Would I have been more spontaneous if not for the diabetes?

Well, it is for the diabetes. And frankly, I’m grateful for the person it has helped me become. What are your ‘is it me or diabetes’ traits?

Butterfly Strips May 10, 2012

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***I found this post, written awhile back but never published. Better late than never! I have no idea why I was having smores for dinner.***

There are very few things that I haven’t been able to find in order to maintain successful diabetes management here in Costa Rica. Just like in the States, pharmacists are incredible people and have been able to find what I need or some version of what I need- generally. Strips, however make for an interesting story.

One Touch strips do not exist in Costa Rica, or any surrounding country, apparently. My coworkers are excellent drug dealers and often bring down boxes of One Touch strips when they make a States trip. (Note: Not real drug dealers. That I know of). A few times I underestimated my One Touch strip supply, but done so with enough time to purchase a new Costa Rica meter with strips.

The first meter I bought here was only slightly smaller than the first meter I remember using- a One Touch Basic. The strips for this new meter were about double long and double wide than that of my trusty One Touch UltraSmart or UltraMini. This new meter didn’t have a memory or provide an average, but it had strips.

After my move to Tamarindo, Costa Rica, I expected more modernity. Sure enough, now I have a newer, smaller meter purchased as a replacement for not only One Touch strips, but also for the ancient original replacement I bought.

Little meter with cute butterfly strips. It's on top of a post-it!

This meter is tiny, uses little blood, is fast, includes three alarm options and several other features I haven’t figured out yet- including how to turn off the noise. And it has strips, not only 50 strips, but 50 strips each with a cute butterfly.

Allow me to interrupt this story with a quick Costa Rica Spanish lesson. The lesson might contradict your basic Spanish I definitions, but that’s why we have culture.

  • Hoy: today, this afternoon, tomorrow, this week
  • Mañana: tomorrow, the following day or next week
  • Está tarde: this afternoon, next afternoon, or mañana
  • Ahora: now, but later
  • Por seguro: for sure today, or mañana, but at least probably sometime

Back to the strips dilemma. I finished my One Touch strips earlier in the week. I had already determined that getting the ancient meter strips in Tamarindo was a lost cause (hence the cute butterfly meter purchase). Now, when I bought the cute butterfly meter, the strips would be available por seguro. Mid-week, I visited four pharmacies in hope of buying more strips for the butterfly meter.

Pharmacy One: Don’t have them, but the doctor is in next Monday and she will find them for you.

Pharmacy Two: Never heard of your meter, check our main pharmacy.

Pharmacy Three (main pharmacy per Pharmacy Two): Nope…let me call.

Pharmacy Four: Como?? (uhh, what are you talking about?)

Hmm, not good. I revisited Pharmacy Three later in the afternoon. The pharmacist has contacted another branch, and good news, the other branch has the cute strips and is delivering them está tarde. So, está tarde I excitedly head to Pharmacy Three…where the wrong strips are waiting for me. No problem, I still have four days before I’m out of strips. Pharmacy Three calls San Jose, and the strips are being bused up, they will be here mañana por la tarde.

Mañana por la tarde: Turns into Monday. That’s not good. So I return to faithful Pharmacy One to buy a new meter. Interestingly enough, I had brought in the strips from the ancient meter, thinking that perhaps two meters used the same strips. I should have known better. We tried out some Accucheck strips, but to no avail. The solution- buy an Accucheck meter. No problem said the pharmacist, it will be here mañana por la tarde. Well, mañana por la tarde turns into mañana. Mañana turns into ahora. Ahora turns into Monday.

Stripless on a Sunday night with smores for dinner…thank goodness it’s almost Monday.

3 am Bathroom Break August 26, 2011

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The 3 am low. We’ve all had it. If not 3 am, 5 or 10 or 2. The inconvenient low waiting for the smallest excuse to come out. When I was little my mom came and scared this loIce Creamw away with orange juice in a green plastic kids cup. Years later, this low would sleepwalk me down the stairs for scoops of chocolate ice cream. In college, well in college nothing was normal. The 3 am lows scattered themselves throughout the day.

And now? Now my mother lives days away, ice cream is often out of budget and college is behind me. Now 3 am lows are shared with a significant other. Now 3 am lows have been given the title: Our 3 am Bathroom Break. Is there any non-diabetic event that can relate to the appreciation of having someone to share a 3 am low with?

Is it me or diabetes? May 6, 2008

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I have always been slightly more organized, responsible and mature than most of my friends near my age- and those older. In the moments I become unorganized, irresponsible and immature the diabetes goes out of control; leaving me with the physical and mental gross out-of-control-diabetes feeling.

Situations in the past year have frequently made me wonder- did my diabetes make me this way? Here are a few examples:

*Weekend night out. Who’s the designated sober person? I wonder with no regard to who is driving (also crucial information), but with regard to whom can I count on for blood sugar checks throughout the night? I frequently become the designated sober person, which leaves me slightly less than enthused about frequent nights out. If not for my diabetes, would I be more “fun”?

*Lunch with Coworkers. What time are we going? The food-coverage effort starts the minute I get up and lasts all day. So when a loosely planned lunch outing is postponed by 20 minutes, I become rather impatient and inflexible. Would I be more flexible and easy-going if not for years of diabetes control?

*Sudden Day/Weekend Trip. Huh, we’re leaving right now for the beach? You’re familiar with the questions that follow: For how long? Is there a fridge? How long is the trip? Is there a grocery store? How hot will it be? An unplanned, spontaneous fun trip gets significantly more planned with a diabetic on board. Would I have been more spontaneous if not for the diabetes?

Well, it is for the diabetes. And frankly, I’m grateful for the person it has helped me become. What are your ‘is it me or diabetes’ traits?