Wednesday, January 30, 2013

Diabetically Un-educated

Recently I've been wondering if I need to go see a diabetes educator, but then I think to myself, "what can they teach me? I live with diabetes everyday, and unless I find one who has it, too, then I probably don't need one."

Well, today  I did learn something new from a type zero (a person who doesn't have diabetes), and I found myself thinking over and over, "Gosh, I do need to speak to a diabetes educator, after all." The woman works for a major medical company who makes insulin pumps, so she is pretty knowledgeable about them.

I thought I was pretty knowledgeable when it came to the 'betes and being a pump user. Well, I got news for myself: I have tons to learn still. After being on the pump for 10 years (yes, you read this right, I did say 10 years and I'm still learning), I just learned the difference between a dual (or wave??) bolus and a square bolus. Knowing the difference will really, really impact my blood glucose when I go to parties where I eat here and there, as opposed to sitting down for a meal.

During dinner on Christmas day, I had no idea how many cabs I had eaten or would continue to eat. It wasn't a sit down and eat kind of dinner. It was relaxed, everyone grab their plates and eat what and when they wanted. Snacks were everywhere. So, I just kept eating and figured I'd correct later. Can anyone guess my bg after all was said and done? Ya, umm, it was in the 400s. Thus, if I had known what a square bolus was and how to use it, I would have given myself between 3-5 units of insulin, throughout a 3-4 hour period. (I could have used a dual wave combo bolus, but I am re-learning everything regarding pump and diabetes, after I opened up my eyes and realized I was most likely on a downward spiral towards complication after complication by ignoring my diabetes).

So, what is a dual/wave/combo bolus? You split the amount of insulin you want to take for a meal. A couple of weeks ago, I ate Chinese for dinner (now that isn't, nor will it continue to be, a frequent thing and I'll explain why another day). If I remember correctly I ate about 74g of carbs. Due to newly learned information, I knew that Chinese food was full of fat and that would slow down my digestion/absorption of carbohydrates. So I split the total amount of insulin I would be taking. The pump calculated the total of insulin I needed to take: 74/15=4.95 units. I decided to experiment with the combo bolus. I chose to give myself 30% before I ate and 70% in the space of 3 hours (as a result of slower digestion due to fat in the food). Therefore, I took 1.48 units immediately and the pump gave me the rest, 3.47, little bits at a time. It did work out well. I didn't measure my blood sugar before bed because I went to sleep less than 2 hours after dinner, but my blood sugar was 123 (or something in that range) the next day.

Combo Bolus

The square bolus is slightly different. Say I'm about to eat a bowl of cereal (I hate milk, therefore I don't really eat cereal, but this one is hypothetical), but I'm also doing a million and one other things at the same time. Maybe my 5 year old nephew is visiting and keeps asking me to play with him as I eat my cereal. I can set my bolus to dispense insulin slowly throughout 30 minutes, as opposed to taking all the units I need before I eat, which could result in a low blood sugar later.

Square Bolus

Now that I know exactly what these two types of bolusing do for me, I will be sure to use it more in the future (I have never done a square bolus, ever "/).

You live and you learn, and I will call up the diabetes educator that my endocrinologist recommended to me  first thing tomorrow. I thank the Guy up there for looking out for me while I was being negligent with my 'betes. Every night before bed I thank Him for giving me another day on this Earth, especially another day with no complications. I am slowly changing my diet and trying to learn all I can to control the 'betes, not let it control me.

Wednesday, January 23, 2013

Hypo Anxiety

I've been feeling a little anxious for the past week, since my family is leaving for Brazil in 2 days and I'll be alone for a couple of weeks. This type of fear of going hypo unaware and my blood sugar dropping to unconscious levels is the reason I've never considered moving out.
This has happened before. When I was 12, I went to school and ended up not eating lunch. I don't remember the reason I didn't eat lunch, but not eating lunch, plus taking the unreliable long lasting insulin NPH dropped my blood sugar. I know I didn't feel my blood sugar dropping. I remember everything looking hazy and strange, but I didn't think much of it. I usually walked home from school, but that day my mom came home from work early and picked me up. When I got home, I said hi to my neighbor and went inside the house. My dad was home because he had broken his ankle, so I remember saying hi to him and my younger sister. After that, my only memory is of waking up in the hospital and asking my mom where I was and what had happened. My blood sugar  had dropped to 27. She said I was acting as if I were high off drugs. She said she asked me for my glucometer (my blood sugar meter) many times and that I ran around the house, gave her crazy things, like a can of coke, and laughed hysterically at nothing.
From the time I was 17 my family has gone on vacation and I've been home alone more times than I can count, but the problem now is that I've been getting many hypos due to better care of my diabetes (I think that hypo event is one of the reasons I started neglecting my diabetes) and still working to re-adjust my basal rates. I called Dexcom yesterday for a CGM (continuous glucose monitor), thanks to my friend @RichTheDiabetic, who told me I don't need to wait for my endo visit on Jan 25 to contact them. Due to this lack of knowledge, I waited too long to call Dexcom. Had I know this beforehand, I would have called them on the 15th, when my insurance went into effect.
I have people I can stay with, though. My sister lives 25 minutes away (and she cooks very well, while I don't cook at all). The thing is that all my students live within 5-15 minutes from my house, so I would be doing a great deal of traveling if I were to stay with them.
So, for the meantime, I will consider my options carefully. I have an endo appointment on Friday, right before my parents leave, and will discuss this with him.
As for today, I am super excited to attend my very first JDRF meeting for adults and meeting some of my diabetic Twitter friends in person!

Wednesday, January 16, 2013

Finger, Y U No Bleed!!?

Today wasn't one of my best days mood-wise. I was up and down all day (mood, not blood sugar, thank God), with more downs than ups. Then I went on Twitter for a few minutes before one of my students arrived at the library and #bgbingo was on. For those of you who have never heard of #bgbingo (I just learned about it myself not too long ago), it's well, a bingo of sorts. During the weekly Wednesday night Twitter chat by #gbdoc, they call out a blood glucose number. The person who has the closest blood glucose number at the time wins a prize. The number called today around 5pm EST was 6.2 mmo/l - 112 mg/dl.

Well, I had just checked my blood sugar and it was 114 mg/dl - 6.4 mmo/l. I treated a low without going hyper (yay for me, I don't nail those very often!).  So, I tweeted my blood sugar reading and patiently waited to see if someone was closer. Someone could have possibly been 6.2 mmo/l - 112 mg/dl, 6.1 mmo/l - 111 mg/dl, or 6.3 mmo/l - 113 mg/dl. Coincidentally, my student at the time is an 8 year old boy who is very dear to me because I've known him since he was about 1 year old and his mom is one of my closest friends, and he was just diagnosed with type 1 diabetes December 2011.

Then I checked Twitter again, and guess what? I WON!! I won a Verio IQ by OneTouch. Brand New!! I was so excited, and still am. Earlier today I was looking into the Verio IQ on YouTube and it looks so nice and smart! I wanted it. And, well, I won it. That really made my day!! That and my mom educating her friend on diabetes :) . My student and his mom were very excited for me.
The GBdoc Verio IQ is set to mmo/l blood sugar readings, and since I am in the US, I use mg/dl. I really hope they can find one set to mg/dl to send to me. This was the highlight of my day :) .

Now, as for the title of my post. We all have those darned days when our fingertips refuse to bleed. You prick your finger with that little needle and nothing comes out. You've become a vampire, totally bloodless. Yep, I hate those days.

I was talking with my adopted Twitter brother about AST, Alternate Site Testing. I like using my palm. I alternate fingers and palm every day. One finger a day, or palm, to give the rest of the fingertips a rest. My Twitter brother however, could not draw blood from his palm, so he ordered an AST cap. I personally never needed those, I usually throw them out, but other people swear by them. So he tested it and still could not get any blood. Then, he read the instructions and it said to leave the pricker on palm, which he said he thought would help draw blood. And it worked for him! He got a few blood sugar checks out of his palm. Hurrah for AST.

This morning I decided to try something new with my pricker. I set it to a lower depth and pricked my finger. I left the pricker there for a few seconds, rather than prick and remove it immediately, and when I removed it there was a tiny drop of blood already. I didn't have to squeeze hard to get a sample either. It was awesome, painless, and today's finger seems much better than yesterday's or Monday's. I'm guessing that this is the proper way to check your blood sugar. Leave the pricker on site for a few seconds, then remove. Makes for much easier blood drawing, trust me...

I told my t1d student and his mom this discovery and they tried it out right there. Unbeknownst to my student, she set his pricker to a lower depth and he held his pricker there for a few seconds. He got a nice big sample out of that finger prick. His mom and I were elated that it worked.

So, point of this long blog: next time you can't draw any blood, try holding your pricker in place for a few seconds. That may help.

PS: I know that it is not called a "pricker," that it's a Lancing Device, but Lancing Device is just so boring...

Tuesday, January 15, 2013

Positively Diabetes

I woke up today feeling extremely positive about life and diabetes (a large part of my life is about the 'betes anyway). At 7:16 I was wide awake. No desire to curl into a ball and go back to sleep. I was totally and utterly happy! I didn't immediately roll out of bed though. I had to go do my hbA1C blood work, and since I couldn't have my usual cup o'joe, I checked in with my DOC family, then happily went to get yet another needle prick for the day. I wasn't even upset when, after parking my car and feeding the meter, I walked inside LabCorp and realized that I had forgotten the paperwork I needed at home. Who cares if it was extremely cold out? Who cares if someone takes my parking spot? Who cares if I have to take 5 minutes and drive home, pick up the paperwork, drive another 5 minutes to LabCorp and feed another meter? Life felt good. Hey, they even had stickers on the wall at LabCorp!
My new insurance kicked in today! I am finally able to get new pump supplies, get blood sugar test strips for my OneTouch Ping meter for an affordable co-pay, as opposed to it costing an arm and a leg (heeehee, yea yea, bad pun, sorry!), and I could get blood work done for free (well, not free, I do pay for my insurance).

Beautiful, isn't it?
But the joys in my life now are different from three months ago. I want to jump for joy (and sometimes do) when my blood sugar stays in range, or when I carb count correctly. Yes, I wake up happy knowing I can get these things (pump supplies, blood work, test strips, see my endo!), for I took it all for granted while I had easy access to them. And while I had easy access to it all, I managed to neglect my diabetes. I won't say I was in denial. No, I always snuck in diabetes into conversations, but I just plugged in my pump and let it do the work (forehead smack). I'd bolus for very big meals, but some days I wouldn't bolus at all. Sometimes I'd check my blood sugar once a day, and sometimes once a week; I'd skip endo appointments. I know we're all "bad diabetics" from time to time, but I was a HORRIBLE diabetic for years. To be completely honest (these are my confessions, after all), I have no clue what my last a1c was, or when (but I will be sure to find out on next endo appointment).

But one day, October 20, 2012 to be exact, I woke up feeling "positively diabetes." I started checking my blood sugar multiple times that same day. I carb counted throughout the whole day. And it became that easy to be "positively diabetes." And I kept myself going, taking baby steps to get where I want to be (definitely not there, yet). I started exercising here and there and cut down tons on fast food, I even started eating broccoli! Then, I saw a Facebook post by Diabetes Social Medial Advocates about a Twitter chat on World Diabetes Day. One topic per hour, for twelve hours! I figured it wouldn't hurt to check it out.

Thus, I discovered the wonderful world of the Diabetes Online Community. I couldn't believe it! These people were like me. They felt the way I did! They "GOT" it! I was in awe. And just like that my Twitter followers began to grow, and I started following people who really had something in common with me! And I made friends. Yes, I consider you, DOC, my friends. At my darkest hours I can, and do, reach out to my Non-Diabetic friends and family members, but you guys have felt like I do, or are going through the same thing, and it helps so much! Would I have reverted back to neglecting my diabetes if I hadn't found the DOC? I can't say. What I can say is that without the DOC, the battles I fight daily would be much harder to fight.

I want to be forever "positively diabetes."

Monday, January 14, 2013

'Betes Rollercoaster Hangover

After a weekend of the 'betes rollercoaster (tons of lows, then extreme highs), I woke up today at exactly 8:26am and wanted only to curl up into a ball and go back to sleep. But then I remembered how great I felt last week after waking up early, having breakfast, working out, getting my tutoring materials ready for the day, then going to teach my munchkins. Yes I was tired at night, but my days were much more fuIfilling. (Yay for New Year's Resolutions!)
I had tons of energy and felt optimistic for the first time in a long time (more on my d-history, bouts of denial and negligence later).
So I got out of bed, made coffee and had some cookies (still working on healthier diet, but I'm getting there little by little). I checked Twitter, my diabetes support haven, talked to a few people, and reluctantly turned on my iPod, got on the bike and started pedaling. And I'm happy I did. My morning felt better after 30 minutes on that monster of a bike, I felt a bit more energetic and well, my diabetes thanked me... (At least I think it did. Ha!)

Diabetes doesn't take a break. My pancreas will not jumpstart itself on days I feel down. So I must get up. I must exercise. I must do everything in my power to tame the 'betes beast that threatens to overpower me if I give it the chance.