Dblog Week 2017 Day 5- More than Diabetes

I’ve always liked to exercise, and over the years I’ve found various different ways to stay active: playing tennis, going on bike rides, spinning classes, bootcamp, zumba, online workout videos, the list goes on. The key is to find something that you enjoy doing so that exercise is something you look forward to instead of feeling like you have to force yourself to do it.

A lot of my workouts I used to do on my own or in my apartment, but when I started working from home full time, I realized just how important it is for me to get out of the apartment and be around other people. And since my schedule usually allows for it, I can do my workouts over lunch or in the morning, instead of after work.

I have some friends that were taking barre classes and invited me to try out a class with them. I was pretty skeptical- I’m not good at dance or ballet, I’m not very flexible, and I’m used to fast- paced cardio workouts. A barre class just didn’t seem like it would be a good fit.

Boy was I wrong. The strength-based class was incredibly challenging and was way closer to Pilates than ballet. My legs shook, my muscles completely fatigued, my heart rate went up and I was sweating. With the upbeat music, the encouraging and friendly instructors, and the fact that every class follows the same structure but with different, challenging moves every time, I was hooked!

3462FF48-7909-4511-B2C6-E65CBDB3D197I’ve been taking classes for about 6 months now, last month completing my 100th class, my first major Pure Barre milestone. I’m happy to have found a fitness class that I look forward to going to and a community that I’m proud to be a part of.

And while I’ve had some trouble regulating my blood sugars with some of my other workouts, I’m able to keep my pump on during the class and besides a few lows here and there, my blood sugar stays pretty steady throughout.

So while there are many other aspects of my life besides my diabetes (my love of brunch, traveling, musicals, dog fostering, to name a few) exercise is definitely a big one and I know something that will continue to be a lifelong journey.

 

Dblog Week 2017 Day 4- What Brings Me Down

Diabetes Blog Week

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

Like most things in life, I think it’s pretty difficult to completely separate the emotions from an event. Pretty much everything about dealing with diabetes is emotional, just to varying degrees. And those emotions not only change over time, but also day to day, even hour to hour. When I was first diagnosed, poking my finger to check my blood sugar was the most agonizing process, there were tears and tantrums. Now I don’t even think twice. Some days I don’t even bat an eyelid at a high blood sugar, other days I get really upset and frustrated.

And sometimes, there are so many different emotions involved in a single event. Let’s take a look at an episode that happened last week.

Here’s what happened with all the emotion removed:

My blood sugar dropped to an objectively low number. My body experienced certain physiological symptoms for a finite amount of time. After 15 minutes, my body returned to normal functioning.

Now let’s add the emotion back in:

It was the guy I’ve been dating’s birthday. We were hanging out in his apartment after a nice celebratory night out when I started to feel low. I ate some fruit snacks. But 10 minutes later I wasn’t feeling any better, in fact I was feeling worse. I checked my blood sugar, 33. I stared at the number. “Uh oh. Not good. Not good. This is not good.” The low seemed to suddenly hit me full force. I got off the couch and laid flat on my stomach on the floor. For some reason I find the hard ground comforting during extreme lows. Looking back, I realize this was probably a very strange and maybe slightly alarming action for someone to witness who has never been around someone with a very low blood sugar before.

“What do you need?” The concern was clear in his voice.

“Churro.”

Image result for frita batido churroWe had stopped at a local restaurant that gives you a free churro on your birthday and had saved it for later. Typically I use fruit snacks to treat my lows, but in this low stupor, I clearly had one thing on my mind.

Churro in hand, he got down on the floor next to me, holding it as I took greedy bites. I remember mumbling about how good it tasted, even cold. “Stop talking, keep eating.” Gladly. At some point, I remember saying “I’m not going to pass out, but if I do, call 911.”

As I laid there waiting for the churro to work its magic, the emotions hit. Here we were trying to have a nice celebratory birthday evening and I probably had just scared the shit out of this poor guy. “I’m really sorry.” I was. This wasn’t how I wanted to be spending his birthday, or really any day for that matter. Then the insecurities. What if I scared him off, what if he decides he doesn’t want to deal with this? Or me? Then the frustration of just having such a bad low and feeling truly awful and wanting to feel better already. Then the gratitude of realizing I’m with someone who will get down on the floor next to me and hold me during my lows.

After 15 minutes, the low fog began to fade away and I started to feel better. And the night went on, life goes on.

The version of this story with no emotions is so much simpler and straightforward and yes, sometimes I do wish I could remove the emotions from managing my diabetes. But the emotions also serve a purpose. They remind us what’s important, they spur us to take action, and they can bring us closer to those around us.

 

Read more posts on this topic from other diabetes bloggers here.

DBlog Week 2017 Day 3- The Blame Game

Diabetes Blog Week

I had an interesting experience a couple weeks ago while flying to Las Vegas. I was stuck in a window seat, separated from my friend a few rows up. My CGM vibrated to let me know that it needed to be calibrated so I took out my glucose meter to test my finger. The man sitting next to me started to laugh. Not the reaction I was expecting.

I gave him a perplexed look.

“I was just about to do the same thing.”

Ohhh a fellow T1D! What a coincidence! It’s always nice to run into other type 1 diabetics in the wild. We started chatting, he told me he’s had type 1 for 26 years and no complications. We talked about his choice not to use a pump, how he exercises every day to help manage his blood sugar, and how he watches what he eats. But then the conversation took an interesting turn.

He started telling me about a coworker of his that also had type 1 and didn’t take care of himself and ended up passing away. And then another story about a patient at the office where he works who also was a type 1 with some pretty bad complications that he watched quickly progress and become worse and worse. I hear these stories, but not usually from another T1D. Forgive me, but being stuck on an airplane, I really don’t want to hear sad stories of people with type 1, I know what can happen. What started as a nice coincidence, started to feel more like a warning/lecture. When the flight attendant came around asking if we wanted pretzels, peanuts or cookies, I opted for the peanuts which I wanted, but wondered what my seat mate would have thought about me if I had chosen the cookies.

People manage their diabetes differently. I could tell that this man was very careful about what he eats (he didn’t touch the cookies that came with his airplane lunch combo), what he drinks, his exercise, and probably many other aspects of his diabetes and general lifestyle. And it works for him which is great, he’s healthy and seemingly happy. But when he talked to me, there was this inherent judgement in his voice and stories, he seemed to say, you should be doing this too if you don’t want to end up like the people in the stories. And sure, I know I could be better about certain aspects of my diabetes management and what I eat, but it’s my life and my decisions. I’m sitting here trying to think of what empowering thing I could have said back to him. But really, I shouldn’t even have to sit there and defend my choices and how I live my life with diabetes. Honestly, what I should have done was said “I’m sorry to hear that. If you don’t mind, I’d like to finish watching my movie” put my headphones back in, and enjoyed the rest of my flight.

DBlog Week 2017 Day 2- The Cost of Chronic Illness

Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?

All I can write for this topic is how fortunate and grateful I am that I have insurance that is willing to cover the supplies that I need and that I have a job that let’s me afford the high deductibles that I pay every year. Between the sensors, test strips, insulin, infusion sets and tubing, doctor visits, fruit snacks to treat the lows, diabetes costs thousands of dollars a year, even with good insurance.

It breaks my heart every time I hear that someone doesn’t have a CGM because their insurance won’t cover it and it’s too expensive. Or the horror stories of people not being able to afford the insulin they need to live. The devices and medication that we need to care for ourselves and stay alive should be accessible and affordable for all. End of story.

 

DBlog Week 2017 Day 1- Diabetes and the Unexpected

Diabetes Blog Week

Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.  What are your best tips for being prepared when the unexpected happens?


You’ll never be 100% prepared for what the diabetic life will throw at you, but you can definitely try. Here are 3 tips that have served me well thus far.

Fill every pocket.

Maybe not literally, but no matter where I go, I always have the essentials with me. And depending on how far I’m going, and how long I’ll be gone, I fall into different categories of what I take with me. Let’s use a visual:

circles.png

That’s me in the middle there and everything in that purple circle are things that I always have on me, no matter if I am just stepping outside to throw away the trash. Since my pump is literally connected to me and my CGM is built into the pump, they’re always with me. I have a medical alert tag attached to my watch that I never take off, and I always make sure I have at least one pack of fruit snacks with me at all times in case I have to treat a low.

The second blue circle are things that are with me about 90% of the time in my purse or some other kind of small bag. Even though I might have my purse in another room for example, these items are always close by.

The third circle are items that I’d have with me either in a bigger bag like a backpack, or overnight bag, or stored in my car. They’re items that I probably won’t need on a daily basis, but I want to have with me as emergency back-up, especially if I’m going to be gone for awhile. I wouldn’t take them with me to run errands, but I would have them in a bag if I’m going on a half day kayaking trip for example.

When you’re prepared with the essentials, you’ll be more likely to handle the unexpected.

Use your support system.

Hopefully you have people in your life who love and care about you and are there to help you out in a pinch. I don’t like to rely on other people too much, but it’s good to know I can count on them if I need to. Just the other day, my blood sugar was running extra high and not coming down and I had to excuse myself from a social gathering. My friends immediately asked if I needed a ride home and if there was anything they could do or that I needed. And sometimes I end up taking them up on it. I was once driving a car full of friends to an event when my pump gave me an alert that the battery was going to die in 30 minutes and the pump would shut off. I was 30 minutes from home and 30 minutes to my destination. Luckily a friend who was meeting us offered to bring a few batteries. While I know I could have stopped at a gas station, her generosity saved us time and hassle. When you aren’t prepared for the unexpected, don’t be afraid to let others help you overcome the challenge.

Get creative.

With every pocket filled, you still might not have what you need in a specific situation. That’s when you start problem solving and get creative. I once realized I forgot to pack both my pump clip and leg strap pump holder while wearing a summer dress. Using a rubber band and hair tie, I somehow managed to secure my pump under my dress. Or while on vacation, I realized I didn’t bring extra tape for the sensor that was about to peel off. I found a first aid kit and used the band aids to hold it in place. Sometimes, you just need to think out of the box when the unexpected strikes.

The Attack

Dear customer service woman,

I should probably start with an apology. I’m sorry I got snippy and short with you on the phone, I know that you were just trying to do your job. Unfortunately you caught me at a rather inopportune time, as I was at the airport trying to figure out my seat assignment and was pretty distracted when you called. You also told me it was only going to be a couple minutes, which was not the case, so that one’s on you. So while I do apologize for my behavior, I wanted to let you know where you went wrong on this call. Very, very wrong.

You started by explaining that you are a company that works with my health insurance to connect people with chronic illnesses or traumatic health events with health coaches. You asked me if I have any conditions that would qualify. This struck me as a little odd, you’re the one who called me, you clearly know I qualify and what condition I have. But I went along with it and told you I have type 1 diabetes. You asked me how long I’ve had it. Almost 17 years. You seemed a little surprised.

Here’s where things started to go downhill.

You asked me if I do anything for it. Um excuse me? What kind of question is that? I know you’re probably following a script, but if you knew anything about type 1 diabetes, you know that of course I’m doing something for it otherwise I would DIE. And how am I supposed to answer that? What do you want to know? That I’m on an insulin pump, a continuous glucose monitor, that I see my endocrinologist every 3 months, that I count carbs, that I exercise daily? Your question threw me so I asked for clarification. What do you mean?

“What do you do to attack it?”

Oh hell no. This is where you really lost me. I’m a writer, word choice matters to me. More than that, my masters is in health behavior and health education, specializing in health communication. I know how important it is to be sensitive and use appropriate language for the condition and person to whom you are talking to. What do I do to “attack” my diabetes? Here’s the problem with the word choice, attack. When you attack something, there are mainly two outcomes: victory or defeat, win or lose. An attack is a finite event with a clear result. The only time I’ve ever heard “attack” used in a medical context is with cancer cells to destroy the cells, and even then it’s not always an appropriate analogy. I can’t attack my diabetes, because there is not a clear outcome. There is no cure, no victory besides feeling the best you can each day and minimizing future complications. You should know this! What you should have said is: “What steps are you taking to manage your diabetes?” because living with type 1 diabetes is an ongoing battle, not an attack. And whether you meant that sentence to be understood differently, this was my reaction and interpretation of it, and as your potential future client, my reaction matters.

With that one word, you destroyed your credibility with me. If you don’t understand what it means to live with and manage type 1 diabetes, why would I trust your health coaches?

So I told you I wasn’t interested and hung up. And you lost a potential client. I know this isn’t your fault, especially if you’re following a script. The problem goes higher than you. It goes to the people who didn’t bother to do enough research on the conditions they are coaching, on the people they will be talking to, and proper training to their front line phone callers.

Programs like the one you are offering can be very helpful. I’m a huge advocate of helping people gain the skills and confidence they need to take care of themselves the best they can. Just be cognizant of the language you are using, because words are powerful and I’d hate to see you lose any more potential customers due to poor word choice.

Sincerely,

A disgruntled diabetic

 

Lessons from Levi

My foster dog Levi and I spend a lot of time together. Since I work from home, he’s constantly curled up next to me, usually sleeping while I’m working. They say that owners and their pets sometimes start to resemble one another over time. I’d definitely say that’s been true of Levi and I.

unnamed

There’s a lot we can learn from our pets. In fact, I found a great list on Huffington Post of what dogs can teach us about what matters most. They remind us to live in the moment, to not hold grudges, to be loyal and dependable, and to love unconditionally.

Yesterday though, I found myself imitating Levi in a completely different way.

It was after my bootcamp class. My blood sugar was on the rise, but this was to be expected since this particular fitness class always seems to raise my blood sugar an hour later. Anticipating this rise, I had given a few units of insulin once class ended. I ate dinner, giving another bolus. But it was as if I was delivering water instead of insulin, it wasn’t doing anything to stop my rapidly rising blood sugar! By 9:30 pm I found myself staring at a staggeringly high number, the highest I’ve seen in a very very long time. I changed my infusion set and gave a correction through an injection.

At this point in the night, I was feeling truly miserable. I was thirsty, nauseous, my body and head ached, my brain felt foggy. But it was the end of the night and I had to take Levi out before bed.

LeviDance.gifThat’s when I realized that Levi was doing exactly what I needed to be doing! Tonight, I would channel my inner dog and follow Levi’s example.

Excited to be outside, Levi started pulling me to walk faster. Alright I got it, we’ll pick up the pace! Exercise, including walking, can be beneficial in lowering blood sugar. Great thinking, Levi.

While on our walk, Levi kept stopping to sniff and pee every 10 feet. While stopping so often on a walk is annoying, frequent urination to flush out your system is important when dealing with high blood sugars or even small amounts of ketones. Smart thinking again, Levi.LeviDrink.gif

When Levi finally finished emptying his bladder and marking every pole we passed, we went back inside. Levi made a dash straight for his water dish, lapping up the entire bowl. Drinking lots of water! This can help the kidneys flush out the extra glucose in the blood. Great and important advice, Levi!

I checked my blood sugar again, finally it was coming down! The rapidly dropping arrows confirmed that I was trending in the right direction and I was starting to feel a little bit better.

With the worst behind me, I followed Levi’s lead one last time that night.

Levisleep

By 12:30 am, my blood sugar was back to normal. Thanks for all the lessons, Levi!

 

Saying goodbye

“Are you going to take that out now?” The pump trainer was staring at the purple, sparkly covered dexcom sensor that was still attached to my stomach. My old sensor. She had just helped me insert the new enlite sensor that integrates with my upgraded pump. Clearly in her mind, my old sensor was no longer needed.

“No. I think I’m going to keep it in for another week, see how the two compare.” Yes, it was a challenge. And I met her questioning look with my defiant one.

You see, I didn’t want to give up my old sensor, I loved it. And I trust it. And now I was switching to a sensor that to be honest, I have not heard great things about. I switched because of the benefits and upgrades that the newest pump in June will have. But for now, I was skeptical and reluctant to give up the security and trust I had developed with my dexcom.

I’m trying to think of an appropriate analogy that can help you understand the magnitude of emotions that is involved with this transition and what is at stake. It’s like ordering your favorite meal at your favorite restaurant. You know what to expect and you know it’s going to be delicious. But it’s more than that, maybe you’ve been eating this same food at this restaurant since you were young. It’s not just about the food, it’s also the memories and traditions that are tied together with the food. Now imagine that restaurant closed. You’re devastated, but you decide to try the same meal at a new restaurant with a slightly different recipe. You try to keep an open mind, but how can it possibly live up to your expectations?

IMG_4132So I wore both sensors, and every time I would prick my finger, I would compare the three numbers, silently rooting for my new sensor to be just as good as my dexcom.

And for the most part, the numbers were pretty similar. But every once in a while, something would happen that would make their differences even more pronounced. It would remind me that even though the meals may taste similar, the new one just is missing that special something.

But I reminded myself that the restaurant is closed, I have to make the best of the new situation, and while it’s not my beloved meal, maybe there’s something about this new meal that I too could learn to love.

So I did it. I said my goodbyes and took out my dexcom.

I’m going to be honest, I miss my old meal and restaurant. The new one is fine, but it’s just not the same. But luckily, there’s a brand new restaurant coming in June that promises to be even better than my old favorite. Fingers crossed.

 

 

That time I cried like a baby

I recently got a new insulin pump (in order to have priority for an even newer one). I have a lot to say about this and there will be more to come, but part of upgrading to the newer pump was also switching to a new continuous glucose monitoring system. I have to admit, I am not at all thrilled to be switching. I love my dexcom CGM, but I understand that there are trade-offs and I’m hoping that ultimately, the switch will be worth it.

This new CGM sensor however, gets inserted much differently than my old one. It uses a spring loaded device that you load the sensor into, hold it against your skin, press the button, and the needle gets propelled into your skin.

Here’s the thing. I hate needles, but I deal because overtime what was once difficult and scary, becomes familiar. And there is comfort in familiarity and routine. And I know myself, and having to switch to a new way of doing something terrifies me. It’s the fear of the unknown. Will this hurt? What will it feel like?

Here’s my post from 2013, it’s when I first had to insert my old CGM. I was so scared. This insertion didn’t have a button, I had to manually push this needle down and into my skin. It was new and different and terrifying. But I did it, and overtime, I got used to it.

So fast forward to this week. This new sensor insertion uses a button! For those of you who didn’t read my old post, I love buttons! It means I don’t need to see the needle or have to keep plunging it through my skin even when it hurts. But even though I love buttons, this was still something new.

img_3950

So there I was, the sensor loaded into the inserter, the inserter pressed lightly against my stomach, my fingers poised and ready over the buttons. And I completely froze. I couldn’t do it. I couldn’t press the buttons. What would this feel like? I’m about to forcefully propel this piece of metal straight into my stomach. What if it really hurts? What if I get scared and pull away? What if I bleed? What if it gets stuck? I was petrified and paralyzed. The tears started rolling down my cheek. My hand was practically shaking now. “I don’t know if I can do it.” I texted my sister.  “I don’t know what to do. I’m too scared.”

I took a deep breath and tried again. I held it against my stomach, my fingers on the button, pushing, but not hard enough. But now I was fully crying. I’m a strong, independent adult, and here I was crying at the prospect of inserting this sensor, even though I’ve literally stuck myself with needles thousands of times before.

So what did I do? Called my parents…naturally. They both answered the phone together and through my sobs I explained that I was too scared to insert this sensor and I didn’t know what to do. They both agreed that this spring loaded insertion would probably hurt even less. My mom offered to stay on the phone or for me to drive to their house and she’d sit with me. But I knew I needed to do it today. She told me to take a deep breath in, and focus on letting it out when I pressed the button. A yoga breath, she explained.

“This reminds me of when you were 12 and newly diagnosed, sitting at the picnic table and you were so scared to push the button to prick your finger. But you did it when you were 12 and you can do it now when your 28. You can do this!” My dad was right. I could do this.

I hung up on the phone and took a deep breath like my mom told me. And with shaking fingers, I pressed the buttons, launching the needle into my stomach. And guess what?! It didn’t even hurt! I was so relieved.

Living with type 1 diabetes is not easy, you learn to manage but there are still these occasional moments when you are truly tested. As I shared this story with my friend, he reminded me that these are the moments that you look back on and can say to yourself, “Look what you did! Look how strong you are!” Yes, I cried like a baby, and I called my parents for support, but I did it. And I’m a stronger person because of it.

What does the way you wear your insulin pump say about you?

(Please note, all these descriptions are completely fictional and not based on any evidence besides my own imagination. That being said, enjoy!)

 The Black Box

img_3762You like a little mystery in your life. It’s not that you don’t put yourself out there, but you tend to initially hold back details and information until you feel comfortable in a situation. You like to play your cards close to your chest and it sometimes takes you time to open up. You think before you act and don’t like to rush into decisions. Your friends know they can always trust and depend on you.

 

The Peek-a-Boo

12d02e93-1931-4590-8c00-689deabd8e64

You tend to be a cautiously optimistic person. You’re someone who might spontaneously book a trip to Europe but then research all the places you want to visit and where to stay. You like to try new things, but prefer to have a buddy to do them with. Your friends can count on you for a good time, while also knowing you’ll have their back.

 

 

The Loose Thread

img_3763

You’re someone who’s full of surprises. People may misjudge or underestimate you, but you prove them wrong. Or they think they know you, and you do something unexpected. You’re not afraid to be unique. You’re someone who likes to look for creative solutions or view issues from different perspectives.

 

 

 

 

The Exhibitor

img_3765You’re not afraid to put yourself out there. You’re open to new experiences and aren’t afraid to get uncomfortable. When you talk, people listen and respect what you have to say. You live boldly, and are ready for what life throws your way, the good and the bad. You like to keep busy and enjoy the company of others.

 

 

 

 

The Dangler

0d541d06-94d0-4caf-8ff4-2626ec2161d2You live life on the edge. You know that life is messy and things don’t always work out the way you plan, but you’re willing to take risks and put yourself out there. You’ve made mistakes, but you’ve also learned from them. You’re cool under pressure and like to go with the flow. You’re always looking for your next adventure.