Why I love fall

There is so much I love about fall.

IMG_2924I love the colors of the changing leaves.

I love fall fashion- warm sweaters, boots, and scarves.

I love apple picking and eating cider mill donuts.

I love pumpkins. Carving them, decorating with them, eating pumpkin flavored foods and smelling pumpkin spice.

I love the crisp air, walking with the sound of leaves crunching under your feet.

I love college football games and tailgates.

And I love all the increased pocket storage space!

IMG_2932It may not seem like a big deal, but in the summer without jackets, you’re limited to the pocket space that is in your pants or shorts, assuming that they even have pockets! It seems like summer clothing are more often opting for tiny pockets or none at all. Contrast that to fall. Colder weather means sweaters, sweatshirts and jackets, which means so much more room with all the pockets. It makes a difference when you’re going for a run and need somewhere to hold your snacks for low blood sugar and glucose meter and keys. It matters when you go to a collage football game that won’t let you take in a purse so you borrow the pockets of the people you’re with so you can fit all your supplies. It matters when you’re out for a walk and just don’t want to carry your heavy purse and only want the essentials with you.

So heres to pumpkin pies and pockets!

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An update on the 670G pump

It’s been 3 weeks since I started on my new Medtronic 670G insulin pump, 21 days since that life changing day I wrote about. So you’re probably wondering if it’s as great as it seemed to be after those first 2 hours. Honestly, no, it hasn’t been as smooth and hassle free as I had hoped. But after 3 weeks, I can definitely say it’s made an improvement to my life and my blood sugars and I’m so glad I made the switch.

Let’s start at the beginning. About 3 hours after posting how great the pump is, it kicked me out of the auto mode and I got stuck in an endless loop of it asking me for a blood sugar to calibrate, calibrating, asking for another blood sugar, processing, and then saying to wait. This went on for hours. Finally I called the medtronic helpline and spent an hour on the phone with a support person. After the hour, he still couldn’t fix it and I ended up having to take out the sensor which was working fine. It was a frustrating start.

After putting in a new sensor, things seemed to be going better for awhile. I was able to get back in the auto mode feature. My blood sugars have had way less drastic highs and lows, although I still find myself in the 200/250 range and the auto basal doesn’t seem to do much to bring it down. I’ve also had fewer lows especially those that are a result of correcting for the high spikes.

The alarms are a bit annoying, I find that even if I calibrate before bed, it still might need a calibration in the middle of the night, and I get awoken by the buzzing. I find that most often when I do get kicked out of auto mode, it happens during the night. I’ve also gotten stuck in that same loop of repeatedly asking for a blood sugar and not getting back into auto mode for a few hours a few more times. But luckily I haven’t had to take out any other sensors.

I had my 3 month endo appointment yesterday, and even after only having the new pump for 3 weeks, my A1c dropped half a point, so obviously it’s helping. I’m optimistic that the number will be even lower at my next appointment.

Is the pump perfect? No. There are a number of annoying features and issues that happen. But that comes with being an early adopter of a new technology. Am I glad I went through all the waiting and headache to switch? Hell yea! Even with its issues, I can see the positive effect this pump is having. And some of it is still user error. I’m sure my numbers would be even better if I remembered 100% of the time to prebolus my meals and improve other habits.

As someone reminded me, it’s not a magic pill (or pump) that’s going to suddenly make every blood sugar perfect. It’s still a piece of technology that has made advancements, but still requires effort on my end too. With that in mind, I’m eager to see what happens in the next 3 months.

 

 

Relationships, intimacy, and sex…with diabetes

A couple months ago, I was contacted by someone from Diabetes Forecast magazine, part of the American Diabetes Association, asking if I would be willing to answer a few questions about dating, relationships, intimacy, and sex with diabetes for an upcoming article. I gave this request a lot of consideration, since these are sensitive topics that I have tended to steer away from on my blog. Ultimately, these are important, real life issues that people with diabetes wonder about, but are rarely talked about. I decided that I have a perspective that is worth sharing and I hope that it will help others who may have questions or concerns related to these topics.

The article “Sex and Diabetes” in Diabetes Forecast does a really good job of talking to a diverse group of people with both type 1 and type 2 diabetes, and sharing their varied experiences. It combines their stories with important and relevant information from medical professionals. I highly recommend you read it. I have 2 quotes in the article, which were part of a much longer interview. I have decided to post the full interview below.

 

How and when do you reveal that you have diabetes to a partner or potential partner?

My diabetes is a big part of my life, and it’s important that I’m with someone who is understanding and supportive. If they’re not, I’d want to know upfront before things get too serious. I usually tell someone I have diabetes on the first or second date. I’ve always found ways to naturally bring it up in conversation. For example, when discussing hobbies or interests, I talk about my blogging. Since my blog is about living with type 1 diabetes, it has become a perfect opportunity to approach the subject.

How big of a deal did or do you make it?

My diabetes is always there; I’m always thinking about it and managing it. But I’m so much more than my diabetes, it’s just one small part of who I am and part of the package. Although not quite the same, I relate it to someone telling me they’re gluten free or they have a cat (I’m allergic). It’s part of who they are and if you choose to date them, you’re accepting what that person brings to the relationship. For me, it’s a chronic condition. But I’ve also been managing my diabetes for many years now. I’m not looking for a doctor or someone to fine tune the intricate details of managing my diabetes. I’m looking for someone who will be there with me through the ups and downs.

How much of your diabetes do you reveal to them?

I’m very open about my diabetes, especially with blogging about it. I enjoy talking and educating people about type 1 diabetes. So in the beginning of dating or a relationship, it’s mostly the basics: what is type 1 diabetes, how long have I had it, and the what it means to manage it. I’m always willing to answer questions. It shows me the person is engaged and eager to learn, which I appreciate. Over time as I get to know someone and feel more comfortable, I open up more about the emotional and personal aspects of living with type 1 diabetes.

How can you be open and honest, while still keeping personal any health issues that you don’t feel comfortable sharing?

Open communication is important in any relationship. It’s up to you how much you feel comfortable sharing, when, and with whom. And the other person should understand and respect your decision to share or not. I’ve said things like, “I’ll tell you more about that later” or “I don’t really want to talk about that right now.” Ideally, you’re with a person who eventually you do feel comfortable sharing things with, but you should never feel pressured to do so until you feel ready.

Has talking about your diabetes ever upped the emotional intimacy in a relationship?

I think talking about diabetes can have the potential to up the emotional intimacy in a relationship, but it probably depends on the person. You are talking about a personal health issue and if you’re someone who keeps things to themselves, sharing this can be a big deal. For me, talking about my diabetes and what it means for my future, like pregnancy or fears of complications, have led to more intimate and serious conversations. But these are also important conversations that I’m glad I had that brought up non-diabetes related topics as well.

Do you wear a pump?

Yes

Do you take it off during sex?

I don’t have any hard and fast rules. The CGM is very useful, I’ll definitely check my blood sugar on my CGM before disconnecting. If I feel like my blood sugar is in a good place that I can disconnect for a little while, I will. But if not, I’ll keep it connected and just try to keep my pump out of the way. If my blood sugar is dropping or relatively low, I might take a few fruit snacks to avoid the disruption of a low later. But mostly I just go with the flow. Yes, there may be some awkwardness, some cord tangling for example, but when you’re comfortable with the person you’re with, these things aren’t a big deal.

Do you wear a CGM?

Yes

Has the CGM ever come in handy to warn you of lows during sex?

The CGM is a great tool to see how my blood sugar is trending. It’s useful to help anticipate lows before they happen and become disruptive. I usually can feel my lows before my CGM, but the persistent, rather annoying, low alarms definitely do their job of making you stop what you’re doing so you can take care of yourself.

Do you take other precautions during sex? For instance, do you keep a stash of glucose tabs by your bedside?

I’m always prepared for a low blood sugar no matter what I’m doing, but especially if I’m doing something that has the potential to drop my blood sugar. I use fruit snacks to treat a low and basically always have them within reach if necessary. I wouldn’t say I take too many other precautions.

Do you have to plan for sex, or can it be spontaneous?

When you live with diabetes, you learn to always be prepared for anything in any situation. To me, there’s not much of a difference in terms of my diabetes between a spontaneous bike ride or sex. In either situation, you need to be prepared for high or low blood sugars and everything in between.

What are some of the mental aspects of diabetes and sex?

Sometimes I feel a little guilty if we have to stop whatever we’re doing so I can treat a low and then have to wait for my blood sugar to feel normal again. Lows are disruptive, and even more annoying when you have to stop doing something you are enjoying. But I’ve also come to appreciate and enjoy the cuddling that usually happens while I wait for my blood sugar to rise, so even challenges can have a positive aspect too.

Is body image ever a factor?

I used to be more self-conscious about my scars from all my set changes and even the infusion sets and sensor that I wear, but now I don’t really think about them. Body image is complex and something I think people struggle with whether they have diabetes or not. My scars are reminders of how strong I am and how much I overcome each day living with diabetes. The devices I wear keep me alive and healthy and make managing my diabetes easier. I have my own insecurities like everyone else, but they’re not really related to my diabetes.

A life changing day

Today is a life changing day.

No, seriously.

Today, I woke up early, drove 45 minutes to my second training for my new Medtronic 670 G insulin pump, and they turned on the auto basal feature on my pump. What does that mean? It means that this first pump of its kind now has the ability to see what my blood sugar is and every 5 minutes, all on its own, give micro amounts of insulin to make sure my blood sugar stays as close to 120 as possible. It means that if my blood sugar is going up, it will give more insulin, and if its dropping low, it will give less. ALL ON ITS OWN!!! Yes, I still give insulin when I eat or give corrections when necessary, but it is working to manage my blood sugar in the time in between so that I hopefully don’t need to be giving corrections at all.

I’ve been open about my struggles to keep my blood sugars in range, I experience a lot of roller coaster ups and downs, and while my A1c has fluctuated over the years, I’ve never been able to get it to 6.0, a goal that I work every day to achieve. I’ve experienced frustrations, burnout, sadness as well as pride and celebrations over the years, but this new pump feature has the potential to be life changing for someone like me and many others with T1D.

pump2.jpgIt has literally only been about 2 hours since I turned this feature on and I’m sitting looking at one of the straightest, steadiest, in-range blood sugar graphs and I can’t help but get emotional. I have tears falling down my cheek as I type this. I don’t know that I can communicate everything that I’m feeling right now. For some of you, maybe you can relate, and for others, I hope I can come close.

Diabetes is all consuming. You have to be thinking about it all day, every day. You can’t take a break, you can’t say, “I don’t want to deal with you right now” without facing consequences to your health. Diabetes takes so much time and energy, and some days can be so physically and mentally exhausting. It’s exhausting when your blood sugar is running high and you’re not exactly sure why, it’s exhausting when you’re exercising or out with friends and it drops low and you have to stop what you’re doing and treat it and wait to feel better. It’s exhausting just not feeling your best or being able to give your best because you feel low, or high, or just off. It’s exhausting feeling like you do so much, but don’t have the numbers to show for it.

pump1.jpgJust the idea that this pump is literally asking me to give up a lot of control, trust the sensor, and let the pump do some of the work is simultaneously terrifying and liberating. It takes away just a little of the burden of living with diabetes, but even that little bit counts for so much! And I am so grateful and excited that a pump with a feature like this finally, finally exists. The fact that I potentially won’t have as many roller coaster highs and lows is such an incredible thought that is almost too good to be true.

I’ll let you know if I feel the same way 2 weeks into wearing this pump as I do 2 hours in, but for now, I am just so thankful to finally have a piece of technology that can truly help me in a way that I haven’t experienced before. And while it’s not a cure, it’s definitely a step in the right direction.

 

 

The Fighting Kale

There are a lot of words that I could use to describe myself, but gardener is not one of them. In fact, I often joke that I have a black thumb, killing even the hardiest of plants. My boyfriend on the other hand, loves to garden. When I managed to nearly kill a succulent, he nursed it back to health. When he talks about his plants that he grew in containers on his balcony and the vegetables that he harvested, his face lights up. You can tell it’s something that he’s passionate about. So when he suggested that I try to grow some vegetables on my apartment balcony with his guidance, I figured I’d give it a try.

DDDC4FF2-A5D5-439B-82DC-845CF497CFD3We planted 2 kale plants, one beet plant and some chives. I’ll admit, it was pretty amazing to see the transformation of the plants in just a few weeks time. My garden consultant would examine the plants and tell me when to water and how much, helped spray the plants with organic pesticides and just generally kept an eye on how things were going.

It became a ritual each morning to check on the kale plants and report back the progress. Everything seemed to going well until random holes started to appear on the leaves. At first I couldn’t tell what was causing it, but then we found the culprits: baby cabbage worms.

kale3

Get off, worms!

My boyfriend picked them off and we sprayed the leaves again. I thought that was the end of it. We went out of town for a long weekend and returned to devastation. The poor kale plant was almost completely devoured by the now rather large and plump worms.

IMG_6009

At least someone’s enjoying them

It was a sad sight. The worms had won. I’ll admit that I pretty much gave up on my kale plants. It was a good first attempt at gardening, my black thumb prevailing in the end. My boyfriend cut off the mostly eaten leaves, leaving the middle stem, hoping for the best.

And guess what?! Those darn kale plants are fighters! They’re growing giant, strong leaves, with more leaves constantly starting. I look at the plant and I can’t believekale5 it’s the same one that I had practically written-off as a failure. I’m sorry I doubted you, kale. You survived the worm invasion and came out even bigger and stronger than before.

So why am I telling you about my gardening adventures on my blog about diabetes? I’ve been having a really difficult and frustrating time with my pump and CGM the past 3-4 months, which has resulted in poor blood sugars, bad moods, and a lot of frustration and even tears. I haven’t blogged in awhile because I didn’t want my blog to turn into a place of negativity and complaining.

While sitting outside working today, admiring the recovery of my kale plants, I realized that I am in the midst of my own worm invasion. (Metaphorically. Don’t worry, I don’t have worms). Things are hard right now. I feel my mental and emotional resources depleting. It’s sometimes hard to stay optimistic. But I, like my kale plants, am a fighter. And I too hope that in time, I’ll be even stronger and healthier than I am now. I wrongly doubted my kale plants, I won’t make the same mistake with myself.

kale4

 

 

Hurry up and wait

My new medtronic 670G insulin pump is sitting in a box in my living room. It’s finally here.

When I first decided to upgrade to the new pump, it was around January and they told me that I should have it in spring. Well come May, I got a phone call that the process would start, but still no pump. They told me early summer. So I waited. In June I got another call, 3-5 weeks they said. So I waited some more. And finally, mid July, it’s in my possession. But now I have to wait to be trained on it before I can use it, so there is sits in my living room, still waiting to be used.

I should be elated, but instead, I feel like the Grinch on Christmas morning. I don’t know when I became so pessimistic, so skeptical. It’s partly my fault. I got caught up in the hype, after all it’s the “world’s first hybrid closed-loop system.” There were articles calling it the “first artificial pancreas” a “game-changer device.” It must be something great!

But I’ve been so utterly disappointed and frustrated by the 630G that my expectations are now very low for this new pump. And the mixed reviews that are starting to trickle in from people using the 670G doesn’t instill a ton of confidence. But don’t be mistaken, I am still excited and feel very fortunate to be able to use this pump. I just want to be honest with how I’m feeling. And with low expectations, I sincerely hope that my new pump far surpasses them. I hope I’m proven wrong and can come back and write how much I enjoy the new pump and the positive difference it’s making. I really really do.

So back to the waiting. On the plus side, gives me a bit more time to work on my pre-bolusing.

 

Diaversary, henna, and pre-bolusing

Today is my diaversary. Today marks 17 years since my diagnosis. Seventeen years since I went in for my 12 year check-up, symptom free, seemingly healthy, and got the news that would forever change my life. I remember my diagnosis, the flood of information and emotions. I also remember the doctors saying, they’ll probably have a cure in 10-15 years from now. Seventeen years later, there is no cure. But there have been many improvements in the management of type 1 diabetes.

In my 17th year with diabetes, I am eagerly awaiting the most advanced insulin pump to date. It has the ability to self-adjust insulin automatically based on your blood sugar number, a feature that has the potential to be incredibly helpful to keep blood sugars in range. It’s not a cure, but it’s a big step forward towards a completely closed loop system.

But there have definitely been hurdles and setbacks on the way. And while talking to a diabetes educator about this new insulin pump, I found out a crucial piece of information about how the auto basal feature works. She said, in order for that new feature to work, you have to pre-bolus for your meals. That means giving your insulin 10-15 minutes before you eat. Otherwise, your blood sugar could rise too rapidly and the pump will kick you out of that feature. For most people, this probably isn’t a big deal, after all, you’re always supposed to be pre-bolusing your meals ideally. But for me, it’s been 17 years of NOT pre-bolusing.

So I here I am, with a few weeks to break a habit that is 17 years in the making. It’s not that I don’t bolus, I usually end up giving it half way through a meal or after I finish. But I’ve waited so long for this pump, I want to be able to successfully use the new feature. So how do you make yourself remember to do something? Well, I’ve been trying a few things.

  1. I’ve been telling people around me to remind me to prebolus. I want the help, I want people to bug me. I need the reminders. However, I’m finding that most people I’m with also forget so it hasn’t been that helpful.
  2. My mom tried to get me to associate eating with a small meditation or thanks before I eat and then associate that with bolusing. It’s a great idea, except it’s just another thing to remember, so that hasn’t been working either.
  3. Someone suggested setting an alarm. I do use alarms, however, I don’t eat at consistent times always so the alarm wouldn’t be helpful.

hennaI was stumped. Until about a week ago. I was at an art fair with my family and there was a booth with 2 women doing henna tattoos. I love the intricacy of the designs and got one on my arm. Henna tattoos can last anywhere from 1-2 weeks. I loved looking at it on my arm throughout the day. And that’s when it hit me! What about a visual reminder to prebolus? What if I write it with henna on my hand, so then I’ll see it when I’m about to eat and remember to give insulin?

bolus

So that’s exactly what I did. I had my sister write “BOLUS” on the thumb of my dominant hand in henna. You definitely can’t miss it, I’ve even had strangers ask me what bolus means. Is it working? Ehh, kind of! About half the time I remember to prebolus, and the other half, I’ve at least remembered halfway through a meal and not after I’m done. Small steps. And the more I do it, I know it will eventually become a habit.

Seventeen years later and I’m writing words on my hand so I don’t forget. Yes, I wrote 17 not 70, although maybe this will be a trick I take into my old age 😉

 

You put the “um” in “numbers”

“What do the numbers say?”

Numbers are often seen as this objective piece of data. And because they are objective, they cannot lie, right? We might not always like what they tell us, and they don’t always tell the complete story, but they’re often hard to argue with. How’s my blog doing? Well let me check the analytics and number of viewers. How’s my health doing? Well let me check my blood work: my blood pressure, my cholesterol numbers, my A1c. Success criteria is often operationalized in numbers. Who won the race? Let’s check the times. Who won the game? Let’s check the score.

You learn to trust the numbers. And while you can interpret the numbers differently, put them into context, explain the variance or trends with outside information and external variables, the numbers are what they are.

You start to crave the numbers. If some numbers are good, more must be better. I recently switched to a smart scale. I wasn’t just content with knowing my weight, I wanted to know my body fat percentage and my muscle mass percentage too. More numbers could help elucidate what’s really going on in my body and alleviate any uncertainty. If I’m working out more, but I’m gaining weight, I would feel much better knowing the weight was coming from more muscle mass and not body fat.

You rely on the numbers. They show your progress. They show your weaknesses and your strengths. The numbers are your guideposts.

So imagine how you’d feel if those numbers fail you. When all of the sudden, they can’t be trusted. And instead of helping you, they lead you astray.

Lost? Frustrated? Angry? Disappointed?

That’s how I felt as I returned home from my 3 month endo appointment this week. In the past 3 months I’ve had one major change, I switched insulin pumps and continuous glucose monitors. I was having so many issues with the sensor leading up to the appointment. It would suddenly stop working after only 1 to 2 days, it was inaccurate compared to my finger tests, the trending arrows were completely misleading. I told my doctor these problems, but I was still optimistic. After all, I had started eating healthier, been more consistent with my metformin to help with blood sugar spikes, I didn’t feel like my A1c should have been much different from 3 months earlier. But I was wrong. Those inaccurate numbers had contributed to my A1c going up .6 of a point. This may not seem like much, but when you are trying to get below a certain number and are at the lower end, to suddenly be back at the higher end is very discouraging.

numbersAll day I alternated between being livid and just feeling sad. I felt let down by the numbers I rely on every minute of the day to be healthy. By the end of the day, I made the decision to switch back to my old, reliable sensor. Enough is enough. My health shouldn’t be made worse by the devices that are meant to improve it.

Numbers are complicated. So is having diabetes. And that means being critical of the numbers, always. Because what is meant to be helping you could actually be making things worse if you aren’t careful.

 

 

 

Fictional thriller meets T1D

Although it sometimes feels like it, my life does not in fact revolve around my diabetes. Like I’ve always said, it’s part of who I am,  but it does not define me. There’s so much more to me and my life. I feel like often when type 1 diabetes is depicted on TV shows, movies, or in books, diabetes is either there to get a laugh or is central to the plot of the story. It’s rare to find a character who has type 1 diabetes, but there’s more to their story.

That’s why I was so excited to read, The Freedom Broker by K.J. Howe. I was contacted by the author’s team and sent a copy. The book is a fictional thriller about Thea Paris, a kidnap and ransom specialist. Her job sends her and her black-ops team on highly sensitive rescue missions to political hot spots around the world. When her own father, an oil magnate is kidnapped, she throws herself in the most urgent and challenging rescue mission of her life. Exciting right? And Thea has type 1 diabetes! The author’s own grandfather had type 1 diabetes, and watching him manage his diabetes is what inspired her to have her main character have diabetes too.

What I enjoyed most about this book is how Thea’s diabetes was depicted. This badass woman would be about to helicopter into a dangerous location to attempt to rescue a hostage and would first check her blood sugar levels on her smartphone to make sure her numbers were in range. Her diabetes was part of the story, but it wasn’t central to it. And I was really impressed with the accuracy of the portrayal of her diabetes. Hyped up on all the adrenaline from a mission, I found myself thinking, “her blood sugar would for sure go high!”, and sure enough, they acknowledged that it was. And when a downed plane explodes and leaves them stranded in a dessert, both my thought and Thea’s was how she needed to get more insulin since she was only equipped with 2 days worth and a couple protein bars stashed in her pockets. Which brings up another point that this book covered really well, always being prepared.

I was definitely interested to find out who the kidnapper was and what their motive was. But more than that, it was a nice change to read a story about a strong female who doesn’t let her diabetes slow her down. Even if it is a fictional story, that message is still powerful, relatable, and true.

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.