Thursday, August 21, 2014

$1.00

Guess what greeted me when I took my fasting blood sugar this morning?

100
 I get unreasonably excited about that elusive perfect 100.  You do know that when you get a #hundy you also get $1.00, right?  I showed my meter to Pete as he left for work, and he pulled out his wallet and handed over my dollar.  I folded it up and put it in the pocket of my meter case, along with other dollars from other 100s.  I have no idea what I’m saving them for, but they make me happy.

Do you play the 100 = $1.00 game?

Wednesday, August 13, 2014

What’s That Wednesday - Just Keep Swimming . . .

MADDdash
Back in 2010, Pete and I ran a few 5K races.  I was slow and I took a lot of walking breaks, but I really did enjoy it.  But then we took a four year break.  (I don’t know why, but we did).

This year we’ve been training again, and our first 5K of the season is on Saturday.  I’m not quite ready, but I’m doing better than I did in 2010.  I can run just over 4K without walking.  My plan is to have fun and do the best I can.  We’ve also signed up for another 5K in September and my goal is to run the whole 5K for that one.  And if I do meet my goal I can apply for my Athletes with Diabetes medal!

Oh, and why did I call this post “Just Keep Swimming”?  After watching Finding Nemo a few months ago, I’ve taken to singing this when I feel like I just can’t run anymore, and it works!!

Tuesday, August 12, 2014

Guest Post: Spring Rains . . . .

Every year during Diabetes Blog Week I get to meet a few members of the DOC I hadn’t had an opportunity to interact with - and I love it!!  This year one of the people I got to meet was Rick Phillips and I’m so glad to have made his acquaintance.  When he offered to write a guest post for me I jumped at the chance!  I think you’ll enjoy getting to know Rick just as much as I have.

Rick
*** First let me say what a joy it is to be a guest blogger for Karen.  I caution I am not up to her high standards but it is nice to swing the bat in the big leagues of blogging every once in a while.  (No worries, Rick, my blog has low standards and isn’t big league, but if it was you’d be up to the task!!  -- K.G.)   I hope you will indulge my ramblings this one time, even though I know nothing about knitting. ***

I used to love spring rains.

I especially loved the gentle water falling that would soak my yard and that sound so pleasant on the roof.  This was especially true as a boy when I would camp out.   There is something dangerous yet tamed about being inside a canvass tent with the gentle rain falling on the fabric.  It was soothing for my spirit to hear those rain drops.

In 1973 and 1974 I had the privilege of backpacking in New Mexico the first year for 12 days and the second for a full month.  (People who know my history probably find that interesting since I was diagnosed with diabetes about 1 month before I left for a 30 day high adventure in New Mexico)  Today we would never allow a kid to do that but my mom and dad sort of had an evolutionary approach to child rearing.  I know what they were thinking, if he dies we have insurance so it’s ok.  LOL  In the mountains in New Mexico it rained every day and that was a special time for me. 

Yes I loved spring rains until I was placed in charge of a city sewer system.   After that every spring rain brought on a slew of hateful calls. As sewers would flood basements I would receive more and more angry calls. My mother (a wonderful person) could never have done all those things she was being accused of by the callers.  Likewise my father and his mother (my beloved grandmother) could not have done those things he was being accused of.  Certainly I was not guilty of the offenses I was being accused of.  Those offenses ranged from causing rain to making people want to move oh if I had that power just once I knew I could use it to good advantage.

The thing is it took less than about 3 months to cure me of loving spring rains.  By the time I was 29 I had come to dislike spring rains which was different than a poem I had written in in high school celebrating the romance of the soft noise of rain beat on the roof.  Instead around age 29 my love affair with spring rains was over.  One might say I had grown up and put a childish indulgence behind me.

The same in a way happened with my diabetes.  Some 40 years ago I was wide eyed and wanted to learn all I could about diabetes.  I really drank it in after I was diagnosed.  Even with my mom being a type 1 diabetic I still had lots to learn.  I practiced the exchange system learned about the wonders of the clinitest and the fabulous promise of the fasting blood sugar.  I learned it even though I had lived it because it was new.  In a way it was a romance of youth, I wanted to beat this disease and besides I only have five years to hold out.

I suppose that was sort of the problem.  I realized soon after release from my week in the hospital that I could not successfully live the way I was instructed.  I am certain the educators meant for me to pick and choose what I could live with, adapt what I could not live with and over time became a ‘better’ diabetic.  Trouble is I threw all that knowledge away.  I decided if I cannot do it all, I am not going to do any of it.  It was obvious to me almost immediately the clinitest was not a good measure of anything except failure.  The fasting blood sugar was a ridiculous test.  Let’s face it one could easily manipulate the fasting blood sugar.  Finally I decided to bank on the 5 year cure.

Therein I think lays the issue with diabetic education.  We tell new diabetics to change their life immediately.  Certainly change is for the better, we can feel better, live longer, and still be productive if we follow the path of total compliance with this new set of rules.  But following those rules is an onerous burden if one has to follow them all at once.  For that reason I believe a different form of diabetic education needs to be practiced for new diabetics.  One that accounts for behavior as well as the practical changes that are required when we are told we have this disease.  In particular this is true for children and parents of children with diabetes. I see way too many fail not because they do not have the tools to do it, rather because it is next to impossible to make a sudden 180 degree shift in lifestyle.

Dieticians, doctors and CDE’s never seem to give practical advice, like how do you explain to a date you need to test your blood sugar?  Or what is that thing with a tube coming out of you.  Or my favorite question, (probably because it was mine), what should I do when everyone goes for pizza at 10 PM after the football game?  I know we can preach the science but we also have to give strength for the practical and accept the failures as part of growth

When the practical is not addressed, more often than not people (kids are my main concern) throw the baby out with the bath water.  They simply reject the concept of meaningful change and put it off until bad things start to happen.  So I ask how do we allow people to enjoy the spring rain, and be as healthy as they can be at that moment?  There has to be better ways than our current take it or leave it diabetic education system.

*** Lawrence ‘rick’ Phillips Ed.D.  Is a 40 year type 1 diabetic who blogs about diabetes, life and films at TUDiabetes.org, you can also find him on twitter @LawrPhil  he is a notorious misspeller of words, and sometimes he tells humorous stories.  He has been married for 37 years Sheryl and has two sons and three grandchildren which he will tell you about ad nauseam if you let him.  You can contact him at rphil2@yahoo.com. ***

Tuesday, August 5, 2014

Exhausted . . . . .

I feel very lucky that the people in my life do their best to understand how tough diabetes can be sometimes and to support me when I need it.  But no matter how hard they try, I feel like they won’t ever really understand how exhausting diabetes can be - both physically and mentally.

Exhausted

Lately it’s been the physical exhaustion that has been hitting hard.  I don’t know if it’s because I’m getting older or what, but lows seem to sap my energy more than ever these days.  Especially those sticky lows that hang on even after being treated, and those very low lows that come in an aggressive whirlwind.  It gets harder and harder to shake them off and continue with my day, when all I want to do is curl up and nap.

Last night brought my exhaustion to a whole new level.  My low alarm woke me in the middle of the night and a finger stick confirmed its claim.  So I treated the low and settled in to go back to sleep . . . . but that was not happening.  My mind raced.  I was tired but just couldn’t fall asleep.  I went downstairs to find K.C. but she was too busy with whatever kittens do in the middle of the night to come cuddle with me.  I got my phone and read my entire Facebook feed, then tried to go back to sleep again but it still wasn’t happening.  I played stupid games on my phone.  I stared at the ceiling and listened to the air conditioner cycle on and off.  I listened to Pete snore.  It took several long  hours before I finally managed to fall back to sleep.  And this morning?  There is just not enough coffee in the world.

Sometimes I wish people on the outside understood just how physically exhausting diabetes can be.   And that my endo could write a prescription for naps!!

Wednesday, July 23, 2014

What’s That Wednesday - Solution or Problem

So I’ve given up calling posts “Wordless Wednesday” because I’m pretty sure I am never, ever Wordless.  Instead I’ve come up with “What’s That Wednesday” since I always show you a picture and then proceed to explain it.

I’ve been thinking a lot lately about what I use to treat my lows.  I’ve gotten pretty sick of juice over the years.  I’ve also gotten tired of glucose tablets, even delicious ones like GlucoLift, so I reserve them for when I’m out and about.  (They’re portable and durable!!)  I’m also trying to break my Pavlovian habit of treating lows with candy, so instead I’m relying on small packets of organic fruit snacks and apple sauce.  But still, sometimes I can’t help but want to treat with candy.  Enter these:

IMG_2317

These are Watermelon Rings I found at Whole Foods.  I’m hoping I’m not misguided in believing they don’t have as much bad stuff in them as regular gummies.  Even so, there is still a big problem with these.  THEY TASTE WAY TOO GOOD.  I know I only need one of these to bring up a low.  And it is nearly impossible for me to eat just one of these.  (By the way, I’m not low now but I may have just bolused for and ate one ring while taking this picture.)

And so, my low solution has become my low problem.  Okay, diabetes, you win this time . . . .

****  Update: After doing  more research, I have determined these are Surf Sweets Watermelon Rings.   They are vegan, organic and free of gluten, dairy and soy.  Some Target stores are test marketing them, so I'm on the lookout!!

Tuesday, July 22, 2014

Going Old School . . . .

****  Happy #dblogcheck day!!  And a big thank you to Hannah and Chris for helping motivate us (okay, okay, ME) to stop slacking on leaving blog comments. ****

MeasuringCupsWhen I was younger, and the Exchange Diet ruled diabetes management, my mom carefully weighed and measured everything I ate.  A small food scale was a permanent and much used fixture in our kitchen, as was the multi-colored set of plastic measuring cups.  To this day I still grimace at memories of meals composed of “2 meats, 3 breads, 1 fat, 1 fruit, 2 vegetables” with no regard to how hungry I was or what I was in the mood to eat that day.  Portions were precisely measured and I ate them whether I wanted to or not.

Thankfully, those days are long gone and instead I count my carbs and dose my insulin for (almost) what ever I’m in the mood to eat.  (I say almost, because I do still try not to overindulge in carbs or else my blood sugar will pay the price.)  When counting my carbs I’ve definitely become more of an “estimator” rather than a “measurer”, simply eyeballing my portion sizes.  It works well for me, maybe because I’m a good eye-baller but more likely because there are so many other factors at play making carb counting somewhat of a gamble anyway.  (Am I going to exercise soon?  Have I exercised recently?  Am I full of hormones this week?  How stressed out am I?  Any of these can assure that even the most accurate carb count ends up a miss.)

But lately, I’ve hopped into my time machine and have begun making regular use of the food scale and measuring cups again.  Why would I subject myself to that?  Calorie tracking.  (YUCK)  I’m working on reversing the steady forward creep my weight has been taking over the past few (or more than a few) years.  I don’t want to do any fad diets and I’m not looking to eliminate anything from my menu - after living years of “diabetics can’t have sugar” I refuse to deny myself anything.  So the solution is careful calorie tracking, allowing myself to eat foods I want but only in portions that keep me within a calorie range for the day.  And while guesstimating carbs works really well for me, guesstimating calories doesn’t work at all.  I find I tend to overestimate portions sizes and underestimate calories.  So the hands of time have rolled back and I’m making regular use of measuring cups and food scales again.  It kind of sucks, but it is working.  I’ve lost almost 7 pounds so far (and I really hope the “blog jinx” won’t kick in now and I’ll gain it all back this week!!).

Are you a measurer or a guesstimator when it comes to food?  What works best for you and why?

Friday, July 18, 2014

3rd Time’s a Charm?

As I sit down to write this post, I realize I haven’t really done a very good job at blogging about my Enlite sensor experience.  I guess the reason is that I seem to only blog about problems.  I just don’t feel inclined to write a post saying “Hey, everything is good and I have nothing to say”.  And, of course, I always feel like the minute I blog about how perfect something is going, it all immediately goes to crap.  Stupid blog jinx.

But, for the most part, my experience with the Enlite sensors has been fantastic.  I think my only complaint is that the sensor wire kinks up quite easily.  (Is it still called a cannula on a sensor?  Or is sensor wire the right term?)  I don’t remember ever having a kinking problem with the Sof-Sensors, so my guess is that the trade-off for the much thinner needle and wire is that it’s more prone to kinking.  If that is the case, I think I would be willing to have some sort of middle-ground - a thickness somewhere between Sof-Sensor and Enlite, so there is more comfort than Sof-Sensor but less kinking than Enlite.  (And with both systems I still wish warm-up time took less than 2 hours and range was better.  And that my CGM data went to the cloud.)  But overall, I’m really happy.  The accuracy, for me, is terrific right from the start and the new tapes hold everything in place perfectly.

Yesterday, however, I had a lot of trouble.  It was sensor change day, so I inserted a new sensor while my morning coffee was brewing.  I like to eat breakfast late, and my coffee bolus is spot on and keeps my blood sugar flat, so that’s the best time for me to start up a new sensor.  Two hours later it was ready to go and I entered my first blood sugar.  Six hours later it was time to calibrate.  The sensor said I was 83.  My fingerstick said I was 93.  A few minutes later?  Beep beep beep, CAL ERROR.  I was surprised to get a CAL ERROR when the sensor and fingerstick values were so close, so  I tried calibrating again.  Beep beep beep, BAD SENSOR.

I thought about turning everything off and restarting it as a new sensor in a few hours, but decided it wasn’t worth it.  I pulled the sensor out and got everything ready to put in a new one.  Loaded up the serter, pressed the button, waited 45 seconds to be sure the adhesive stuck, and began to draw off the serter . . . . when I could see that the sensor needle was only halfway in my skin.  Great.  I carefully pulled everything off and decided to try to load the sensor back into the serter and try again.  But the same thing happened.  SO I pulled that second sensor and got out a third.  It inserted fine, but as I removed the serter the needle came off with it.  The sensor was properly in me, but the needle was stuck in the serter and wouldn’t come out.  That was when I realized I was long overdue for a call to the Medtronic HelpLine.

BadDay
Two dead sensors & a serter with a needle stuck in it.

I’ve always had great experiences with the HelpLine and yesterday was no exception.  Here are the tips I learned.  1)  When I got that first CAL ERROR, I should have cleared it but then waited 45 minutes to an hour before trying to calibrate again.  The error comes up when the interstitial signal doesn’t jive with what the meter says your blood sugar is.  Waiting an hour gives it time for the signal to hopefully recover and for some of the sensor data to clear out.  2)  When the second sensor didn’t go in on the first try, I shouldn’t have tried it again.  Once the serter tries to insert it and fails, it’s pretty much a given that the sensor wire has been damaged and the sensor won’t work.  3)  When the needle is jammed in the serter, hold down the green button and shake the serter in the same motion as if you are ringing a bell.  But in my case, this didn’t actually make the needle come out.

JammedNeedle
Old serter with stuck needle on the left, new serter on the right.

Bottom line, by 9:30 this morning a new serter and two replacement sensors were on my doorstep, along with canisters to send the bad serter and sensors back for analysis.  And that third sensor that I put in yesterday is working just fine.  I don’t know what exactly made so many things go wrong for me yesterday, but I guess I was just having one of those day.

** My Medtronic disclosure can be found here. **

Thursday, July 17, 2014

Still Learning . . . .

It was lunch-time on Friday at Friends for Life.  (Or maybe it was Thursday.  I’m not exactly sure because the days kind of blur together in a rush of activity and fun and exhaustion.  But I’m pretty sure it was Friday, our second official day of FFL sessions.)  As I checked my blood sugar and dosed for my food, one of the hotel’s dining room attendants struck up a conversation.  It was obvious right away that she had a diabetes connection (turned out her nephew has T1), but also that she didn’t quite understand all the details.   (As in “My nephew has a pump, oh you do too, so it does everything for you.”.  I explained that it wasn’t exactly as easy as that.)

We talked about the fact that I’ve had diabetes for almost 35 years.  We talked about how this was my fourth time at Friends for Life.  And then she asked “You’ve had diabetes for so long and have been here so many times, are you really still learning anything new?”.  And the more I thought about it, the more I realized what a great question that was.

Life with diabetes is, for now, a never ending journey.  And I am always still learning.  My first few years at Friends for Life the things I learned were more “technical’'.  I learned in-depth stuff about sensor data and glycemic indexes and how to best manage exercise.  And I’m still always picking up more snippets and tips on stuff like this.  But largely the things I learn these days have shifted from the “nuts and bolts” to the “touchy feely”.  IMG_2253I get the most out of the sessions that deal with the emotional burden of my chronic illness.  I learn the most in sessions where we sit in a circle and let our guard down and pour out our hearts . . . .  to a room full of people who really get it because the same things are in their hearts.  I get the most out of sessions where I’m surprised to suddenly find tears streaming down my cheeks.  I get the most out of the sessions that I can’t really tell you about, because at the start we all make a pact that what is shared goes no farther than the walls of the room we are in.  I get the most out of sessions led by psychologists like the fantastic Jill Weissberg-Benchell.

Over 34 years with Type 1.  Four trips to Friends for Life, not to  mention a big bunch of other diabetes conferences.  Still learning?  Oh yes.  Never underestimate the importance of still learning.