Monthly Archives: June 2018

A Day in the Life.

Earlier in the week, I sat down for an interview with a person doing research on patient perspectives regarding continuous glucose monitors, or CGMs. It wasn’t as dull as that might sound; in fact, it was a great conversation and the time flew by.

Among the questions I was asked were things like “How much do you think about diabetes throughout the day”, and “Describe a typical day managing your diabetes”. I believe many of us bloggers did a “day of diabetes” or some sort a few years ago, and to be honest, I haven’t really written anything like it since.

But, since I was asked, now I’m thinking about it a lot. Here’s how yesterday went for me and my diabetes:

Wake up.
My alarm went off like it does most every morning at 4:30 a.m. Yeah, I hit the snooze and turned over for another 15 minutes, but before I did, I checked my phone to see what Dexcom had to say about my morning glucose level.

I’ve been experiencing some wicked dawn phenomenon lately, sometimes waking up between 60 mg/dL and 80 mg/dL, and 45 minutes later being between 180 mg/dL and 200 mg/dL. Before breakfast. So I checked my phone to make sure I wasn’t already at 150 or above.

I got up, I showered, got dressed, the usual. I went downstairs and fed Max the Cat, took my daily medications and vitamins, and made a cup of coffee. I checked my BG using my glucose monitor to calibrate my CGM, which I have to do every 12 hours. And I pre-bolused for breakfast. There were about 35 grams of carbs in it.

Go to work.
You might think, hey, get in the car and go to work? That’s no big deal! But I only drive about a mile before getting on a commuter train for 20 minutes or so. Then I have a half mile walk to the office.

That means making sure my BG is high enough to sustain me while I make that commute. It also means I need to have fast-acting glucose (in my case, candy) in my pocket just in case I dip low somewhere along the way.

Blood Donation.
It just happened that yesterday was our semi-annual blood drive at work, so I sat down and opened up a vein to do a double red cell donation. I’ve already written about what that’s like. Some People With Diabetes in the USA are eligible to donate blood. I am happy and honored to be one of those people.

Diabetes didn’t really play into this donation, except that I kept checking my phone in the hour before my donation to make sure I wouldn’t have to worry about a low during the bloodletting process.

Work. Advocate.
If I’m not working from home, I sit at a desk all day in the office. I have to make sure I have juice and candy in my desk. I also need to have access to water, and have a chance to get up and walk if my BG gets too high during the day.

Yesterday, I also fired off an e-mail to a colleague in charge of real estate and workplace design for the company. They’re involved in a project right now to transform the way our teams work, and the space we work in. My e-mail mentioned my needs as a Person With Diabetes, and also a reminder that I’m probably not the only one at my company living with a chronic condition that might need attention or special accommodation.

Head home.
About 4:15 p.m., I headed home. Another half mile walk, to the train station, a ride back to the neighborhood, and a quick ride the rest of the way home.

Except my blood sugar dropped dramatically by the time I reached the station. I went through the candy in my pocket, and I was still low. The train was packed, and I stood all the way. I was unsteady, but I’ve done it before, and in that moment, I really didn’t have a choice in the matter. I made it home okay.

I had a little leftover chicken and pasta salad for dinner. I made a quick run for necessities at the grocery store. I sat down to write most of this blog post.

And I participated in the wonderful #DSMA Twitter chat that happens every Wednesday night at 9:00 p.m. Eastern time in the USA.

For all of the extra tasks, the worry, the highs, the lows that I experience in a given day or a given week, the #DSMA chats are just what I need, reminding me that I have support out there, and no matter how hard my day might have been, there are others who have to work just as hard or harder to live their lives with diabetes.

I would add sleep here as a final entry, but c’mon, you took that as a given, right? Yeah, I deal with diabetes a lot every day. When you live with a condition that’s with you 24 hours a day, seven days a week, you tend to think about it almost that much.

That’s why reducing burden is such a big deal with us. If you can’t give us a cure, give us less work and less worry. That’s my day of diabetes. Just one day. Tomorrow, it all starts over again. The next day, the same. Forever.

Diabetes in the summer heat.

I don’t believe I’ve ever written anything like this before. But, since we reached the summer solstice in the Northern Hemisphere last week, I think I’ll take a moment to talk about warm weather and diabetes, which don’t always mix well.

To begin with, did you know that People With Diabetes have a harder time regulating their temperatures in the heat than others do? According to the U.S. Centers for Disease Control and Prevention, stresses on blood vessels and nerves can affect sweat glands, keeping us from cooling effectively.

We also get dehydrated easier. And if you’re an insulin user like me, temperatures north of 90° Fahrenheit change how we use that insulin.

Humidity is a factor too. Another thing I found out is that humidity keeps us from cooling because the sweat we do produce can’t really dry when it’s humid, and the drying is part of what helps us cool off.

Some of the things we should be doing to take care of ourselves at this time of year are summer no-brainers: drink lots of water, don’t go on a bender in the sun, wear loose, comfortable clothing… the usual.

But some other things are really important to remember for our diabetes. Like how insulin is affected by temperatures over 80°F. You don’t want the insulin in your pump skunked because you were working in the yard all day in the hot sun.

That’s why, on hot days, I take breaks more often than I might in the spring or autumn. I go inside. I cool off. I rehydrate. I make sure the insulin in my pump cools off too.

Here’s something else: plan for emergencies. We lost power at home for a little over 24 hours last week, when daytime thermometer readings were well into the 90s. If the outage would have lasted 24 more, I would have needed to go to my emergency plan for storing insulin: a cooler full of ice, my insulin vials in a plastic bag, wrapped in a thick towel. That will keep it cool enough without freezing it.

If you’re traveling or just out for the day, I suggest using a simple lunch cooler, with a gel pack or something similar inside, that will keep your insulin cool. Remember to wrap the insulin in something like a towel… you want to keep it cool, not frozen. If we’re just out for the day, I might freeze a bottle of water overnight and use that as my cooling agent. Once it’s melted, I can have it to drink on the way home.

Don’t forget that heat affects glucose monitors and test strips, and CGMs too. It’s also worth remembering that when you get into your car on a hot day, the extreme temps that exist in the short time before your A/C kicks in can mess up your pump and the insulin in it pretty fast.

That’s my summer diabetes sense two cents. I’m sure you probably have your own tips and tricks for dealing with diabetes in the summer. Feel free to add yours in the comments below.

Happy Summer!

Another 5k.

This past Sunday, I ran in my local neighborhood 5k event. This was probably my 12th or 13th time running this one, and today, I can say, unequivocally:

My back is killing me!

I should mention from the outset that I felt great Sunday morning. I was ready to go. Also, this has never happened before when I’ve run. Maybe my back would feel uncomfortable, sometimes when I ran, but that uncomfortable feeling would go away pretty quick.

Instead, this time my back started hurting toward the end of the first mile. I just powered through, because, again, this has never happened before. A little after mile 2, my back was hurting so much that I walked.

And I alternated walking and running the last mile-plus of the run.

This event helps to raise money for cancer research and treatment for people living with and surviving a cancer diagnosis. Toward the finish, I ran up to a group of 10 to 15 who were either cancer survivors, loved ones of those survivors, or people who trained the survivors to run a 5k.

I didn’t want to finish ahead of them, so I walked a bit so they could get ahead of me. Then I started running again, and before I knew it, I caught up to them again. So I walked a bit longer, then started running again, before catching up to the group one last time. Each time I walked, my back hurt more and more.

By the end, I was running nearly completely bent over. A question mark? No, I looked more like a right angle. Even though I managed a sprint toward the finish, I couldn’t get myself fully upright.

I usually take ten or fifteen minutes to recover after a run like this. Then, I get a little breakfast (this event has the best post-race spread), and we go home.

This time, I took about 40 minutes to recover. It was difficult to sit for long, difficult and so painful to stand, difficult to walk. I could not get comfortable.

In fact, I can’t get comfortable, even now. Things are a little less painful, but days later I’m still feeling pain and still feeling uncomfortable. I’ve given up on the ibuprofen and naproxen sodium. I couldn’t take what it was doing to my stomach, so I’m just gutting it out until I can feel better.

I guess that’s progress in a way, because I can get by without pain relievers now, and I don’t think I could have hoped to do that a couple of days ago. But I’m still hurting.

Believe it or not, my time was pretty good for someone my age… 35:05.8. I don’t really know how I did it.

So I’ve finished this one. I’ve mentioned that I’d like to keep doing this until I turn 60. That’s four more years.

In the final analysis, it doesn’t matter what my time is, or even that I finished. The most important thing is that I did my best, I hung in there, and the adversity I experienced didn’t deter me.

That is SO worth how my back feels right now.

Advocacy Works.

I suppose we’ve all become jaded a bit over the years. When you ask for intelligent changes to policy or rules, you get used to having your concerns ignored, sometimes validated, and mostly not acted upon.

But a recent announcement flies in the face of that argument, and before any more time goes by, I think it’s important to talk about it.

The news, which you may have heard: the U.S. Centers of Medicare and Medicaid Services (CMS) has agreed to allow seniors on Medicare to view CGM data on their smartphones.

As Diabetes Patient Advocacy Coalition noted, this is pretty big news, and it’s thanks to advocacy of this organization and others, as well as individual advocates across the country, that this injustice has been righted.

There are a couple of reasons why I wanted to talk about this.

To begin with, this is how advocacy is supposed to work. In this instance, people saw that seniors on Medicare were being denied the right to use their smartphones as a medical device. Those advocates banded together and took their message to CMS, who were empowered to consider the advocacy message and act on it. And they did.

Second, I wanted to talk about this win because it’s a win. So often, we advocate for causes, and our causes remain causes for years until some movement happens on them (and that’s the most times I’ve written “causes” in one sentence in my life). Once our cause is helped along by a decision or a product launch or something else, we move on to the next cause so quickly that we almost forget the fact that real progress was actually made.

I don’t want that to happen here. Let’s stop and smell the lithium ion of our cell phone batteries and recognize that something pretty great happened here. And you and I had a hand in making it happen.

Let’s take a moment and remember that advocacy works. And let’s remember to thank all those responsible for making it work.

8 Things: Wordplay.

I’m a fan of words. Their spellings, their meanings. Learning to live with diabetes is like learning an entirely new language.

Here’s what I mean by that, using 8 examples:
1. Diabetus
I always hated when people said “diabetus” instead of “diabetes”. It’s the last two syllables… “beat us”. I don’t like the idea of living with a chronic condition that has that kind of language in its very name.

2. Medical Devices
There are more medical devices helping us to succeed with diabetes than ever before. Some people name their Dexcom Dex, or their pump some other name. If you’re someone using an Omnipod, do you call yourself a Podder? Are you Podding? I can tell you that I am definitely not Vibeing…

3. Co-morbidities
I don’t know about you, but I don’t even want one morbidity, let alone two or more. I might settle for 1/2 a morbidity, but that’s all. No more. I can only accept so much. I wonder if this is that bargaining part of bargaining, denial anger, depression, and acceptance we hear about?

4. Target range
To be honest, it would be a lot easier to hit the target if the target didn’t move constantly throughout the day. That’s the way it is with diabetes, every day. This is a term I’d love to find a replacement for.

5. Basal
When I wanted to begin on an insulin pump, I must admit that I didn’t even know what a basal or a bolus was. No endocrinologist I ever saw up to that point described dosing insulin in this way. Once my current endo educated me, I had trouble for a week or two remembering which was the basal and which was the bolus. So I tried to think of basal as the herb… you know, basil. I imagined an herb leaf every time I logged in what my basal rate was for the day. Don’t knock it… it worked.

6. Bolus
I don’t really have much to say about bolusing, except that I get ticked off every time autocorrect changes it to “blousing”.

7. Advocacy
Like many people, I used to think that advocacy was too big and too difficult for someone like me. The truth is that advocacy is easier than you think, it can take place in many forms, and it usually has a positive effect on both the subject and the practitioner of said advocacy. So let your advocacy loose… you’ve got a lot to give.

8. Lancet
Another word I don’t like. Probably because it has elements of onomatopoeia to it. In other words, the word itself sounds too much like what it does, which is lance the skin to get blood for a glucose test. I wouldn’t mind the onomatopoeiac nature of it so much if it were something a little nicer.
And there you have it… eight diabetes words, and eight ways of looking at them. I hope your weekend is fabulous. Talk to you next week!

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