Category Archives: Random Glucose

Forty (or more) Winks.

I’ve been feeling tired lately. Like really, really tired.

That’s not uncommon among people living with diabetes… if you consider all the time diabetes tasks require of us, it’s a wonder we get any sleep at all. Add in getting up to use the facilities thanks to a nighttime high, or getting up to ingest carbs thanks to a nighttime low, and you’re talking about even less shuteye.

Is my age a factor? Is it causing me to get less sleep, or not process the sleep I get as well as when I was younger? I suspect one or both of these might be factors.

Real people sick is a thing too. Managing a cold or the flu while already managing an existing chronic condition will wear out anyone.

And let’s not forget other outside influences: the political climate, an economy that we hope will be good but we’ve seen crash before, and work-related stress all play their part too.

In my case, I guess I would have to add in advocacy, and a renewed effort to connect to friends and family more. These are good things, but I can’t sleep when I’m at meetings or other gatherings. What I mean is, when we’re involved in more and more activities, we have less time to just sit, relax, and let our brains and bodies recharge.

For additional context, I’ll refer you to this post at Diabetes Forecast. I especially like the quote “Your brain is a glucose guzzler”.

So what’s a fella to do?

Some of these are no-brainer ideas. Some are just things that work for me. All of them, if implemented properly, should help me get the most out of my downtime:

1. Go to bed! When you’re “on stage”, as the Disney Parks management puts it, all day, it’s hard to come home and suddenly shut your brain off so you can sleep. But I’m also guilty of staying up late, really late, on those rare days when I don’t have something scheduled the next day. I usually get up around the same time every morning, so that means I’m not even getting the most sleep I can get when I can get it. That has to stop. Everything in moderation.

2. Get into better shape. I’ve always been active, but less so in the past couple of years as I’ve gotten busier. Not only do I miss working out more, I need it so I can be stronger on those days when I really need it. It seems counterintuitive to try to add more into my schedule, but in this case, I think there will be a significant return on the investment of my time in being stronger.

3. Find the hidden wastes in my daily routine. Like Frank Bunker Gilbreth Sr. and his wife Lillian, I want to find the “one best way” to go through my days, so I can cut down on the time needed to finish items on my to-do list. I probably won’t find too much wasted motion, but if I look, I’ll likely find something. Even if I don’t find a lot of leeway, when your life is full of schedules to keep, every minute of leeway you gain is significant.

4. Stop complaining about it! Look, this is what I signed up for… this is what I wanted. I want to remain as healthy as possible, but maybe an attitude change could stop me from griping about how I feel every time I wake up in the morning.
 
 
There is probably more I can consider. But I think I’ll start with those four and see where it leads. It’s not about turning myself into a robot who only thinks of sleep, work, and wake. It’s about carving time out of my day to have the freedom to relax, or to have fun, or just to think.

We’re not meant to be robots. We’re meant to be living, breathing, flexible, adaptable human beings. But this human being needs to get more sleep.

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Questions… and gratitude.

So many questions racing through my head today…

At the end of last week, I received the EOB (Explanation of Benefits) from my medical plan for my appendectomy hospital stay in September. Immediately, my eyes moved to the overall cost of my stay in the hospital, the surgery, the intensive care, the drugs.

Total cost: $25,191.74

This included various details, all laid out in my form, including $880 per day for five days’ stay in the hospital, $2,681 to cover services in the intensive care unit my first night, $7,437 in operating room expenses, $2,278 in pharmacy costs, plus nearly $9,000 in various other costs.

As I said at the beginning, there are many questions racing through my mind. I can’t stop thinking about this. How do they come up with specific pricing? Why break out the costs into so many different categories? As always, why are the pharmacy costs nearly ten percent of the bill?

Fortunately for me, I’m enrolled in a fairly generous medical benefit plan through my employer. This plan means that my cost for this stay will be something just short of about ten percent of that bill. Still very high, especially for someone who already spends a few thousand out of pocket for drugs, supplies, and doctor visits throughout the year.

Which brings me to these very important questions: What does someone do if they are not in an employment position as advantageous as mine? In other words, what does someone do without coverage, or without adequate coverage? If it’s early in the year and you’re under a high deductible plan, and you get a big fat statement like this one, how do you pay for it?

Don’t forget, acute appendicitis isn’t something that anyone plans for. Neither is diabetes. Simply reviewing my situation, it’s easy to see why families declare bankruptcy every day due to medical expenses beyond their control.

And now, the U.S. Congress wants to allow states, through the Affordable Care Act, to sell skimpy policies to so-called healthy people. For a moment, let’s put aside the fact that this would mean huge increases in rates for the insurance options available for People With Diabetes.

Instead, since this is a diabetes blog, let’s look at it from the standpoint of initial diagnosis. Let’s say it’s early in the year, maybe February, and someone covered under one of these skimpy plans is diagnosed with Type 1 diabetes, requiring insulin every day, plus the durable medical supplies, test strips, insulin needles or pump paraphernalia, that go with it.

The good news is that the plans being talked about for this kind of individual cover a lot of the cost of “catastrophic” care. The bad news is, the insurance company decides the meaning of the word “catastrophic”.

Even if they cover the cost of a short hospital stay due to DKA or something else just as serious, they’re not going to cover any of the continuing costs of regular daily diabetes maintenance. And, as we all know, daily diabetes maintenance is anything but regular.

So, our previously healthy person is now stuck with what could be overwhelming costs, and over ten months left on a medical plan that won’t pay for hardly any of it.

That’s just a diabetes diagnosis. What about something like a stage 4 cancer diagnosis, a heart bypass, or another condition? What does coverage (or non-coverage) for those look like?

Oh, I have many questions racing through my head today. And an incredible feeling of gratitude that I am one of the lucky few who can afford what just happened to me.

I already have to live with diabetes all day, every day. Why do I have to attach another thing to my body to remind me of that?

So, my new continuous glucose monitor had been sitting in the box it was shipped in since around Thanksgiving.
dexcomgraph
Beginning to wear it now is not a New Year’s Resolution, or an effort to game my diabetes data gathering to avoid the high carb temptation that bombards us during the holiday season. No, it’s not that simple. I’m not going gently into that CGM-inspired good night.

Nor do I have a simple answer for why I’ve waited so long to use a CGM, and why I’ve waited so long to start to wear it since it arrived. In this case, the answers aren’t simple. They’re also not pretty.

I can give you reasons why I’ve resisted so long. Worries about having to carry the receiver in my already overloaded pockets (no, I don’t have an iPhone, and until an iPhone carries a price less than a few hundred dollars more than a comparable phone, I’ll stick with my Android platform– which means I have to carry the receiver too). Concerns about using up already valuable real estate by having both an insulin pump and a CGM inserted into my body at the same time.

Any concerns I might have had about appearances, I lost long ago. When it comes to looks, I care a lot more about my clothes than about my devices. So how it looks doesn’t affect me.

Wearing an insulin pump was an easy process for me. No problems getting started or staying with it, and nearly seven years later, I’m a proud insulin pump user. What’s the issue anyway?

I don’t know, but it’s troubling. I know that something is definitely bothering me about this. I can tell by the way I delayed getting started, until the reasons for my delay were outweighed by the embarrassment that I have access to a device that many crave and cannot get their hands on. I must go forward.

Yet, when I did my first insertion, I was using language that would make a sailor blush. I got even more surly as that first insertion didn’t work, because my brand new transmitter was crap from the start. Now I’ve used two transmitters and two (actually three, after working with technical support to get everything right) sensors with nothing to show for them. Finally, on the fourth try, I got it to start up and calibrate properly. But my issues, I fear, go deeper than a sensor insertion.

I think my problem may be the notion, the confirmation, that a CGM gives you data 24 hours a day, seven days a week. In other words, it’s a constant reminder that I live with diabetes, a fact I try to forget every day.

Yet, there’s no question. I must begin my CGM journey. As The Great Spousal Unit shared, and she was right: sometimes, I don’t want to believe what my numbers are without a glucose check. If I’m going to be such a slave to data (and you have to be one if you live with diabetes), sometimes I need data I can access even quicker than a BG check.

But it’s not easy, and I’m not entirely sure why. The trick right now, I think, is to make the physical effort to get started, and then over time, work on what my brain and my heart are trying to tell me.

I recently read a statistic sharing that adults living with diabetes are at least three times more likely to develop depression than other adults living in America. Depression isn’t exactly what I’m feeling. Still, I already know I have diabetes all day, every day… why do I have to wear something additional so I can be reminded of that? All day, every day?

Ultimately, I need to remember that this is a device that could save my life. And over time, I may actually get used to wearing it. I’ll know I’ve turned the corner when my desire to get the data overwhelms the desire to rip it off of my body for good.

Until then, the emotional price of data gathering seems awfully high.

A dog’s life.

I’ve spent a lot of time at home this week, hanging out with the dog and the cat, and another dog that has been here for an extended sleepover. The dogs, especially, seem to have a certain calmness about them (most of the time, anyway). They don’t seem to be burdened by many of the things I am concerned with.
dogslife
Dogs don’t seem to worry about too much. They sleep when they sleep, they eat when they eat. They’re happy if you’re watching CNBC, or Drunk History, or the ballgame on TV. Their pursuits include fully stretching out on the floor, chasing after balls in the yard, and playing tug of war over a toy. If you’ve had a difficult day, they seem to empathize, but they’re also happy waiting nearby in case you need them.

The dogs that have been my companions this week don’t live with diabetes and all of the crap I live with as a Person With Diabetes. They don’t have to check their blood sugar 7 or 8 or 10 or 12 times every day. They don’t have to guess how many grams of carbohydrates are hiding in my noonday meal, or how many units (or partial units) of insulin are required to counteract the carbs entering my system, and they don’t have to remember to bolus before they eat those carbs.

These dogs get excited about dinner, and walks in the park, and the occasional mailman or jogger that goes by. But the rest of the time, they’re good just hanging out. They don’t have to live with the frustration of high glucose readings and doing the detective work to find out why the readings are high.

They drink water when they’re thirsty. They’re not forced to drink water to help get their blood sugar to come down. They’re not into why my insulin is so freaking expensive. They don’t have to fight with insurance companies to get them to cover devices like continuous glucose monitors and insulin pumps and enough test strips to be able to live the best life I can while standing in for my own pancreas.

Dogs are okay being lifesavers alerting us to highs or lows. Dogs are okay with just being part of the pack, and enjoying the occasional bacon flavored treat. Life isn’t much more complicated than that, because it doesn’t have to be more complicated than that.

I want that. I want a dog’s life.

Checking In.

Hi… how are you? I’m doing well now, thanks.

When I started this blog over four years ago, one of my goals was to keep sort of a history of my life with diabetes. So every now and then, I sit down and chronicle what’s been going on in my world. Partly for me (it’s my blog, after all); and partly for any family (and you’re family) that may come by, now or later, to find out what was really on my mind back in the spring of 2016. So here’s the latest:

You probably know I’ve been traveling a lot. Las Vegas in March, Northern Virginia a couple of weeks ago, California a few days after that. On the way home from Las Vegas, I had a cough, but I attributed it to the dry climate, and thought I would be better once I got home. Then, on my flight home, I wound up next to someone with a mask on (or off and on) through the flight, who was coughing a lot. A couple of days later, I was real people sick, which turned out to be bronchitis, which I never had before. It was treated, but apparently not enough, because a couple of weeks after that, I came down with something else I never had before: pneumonia. Long story short, a couple of weeks of antibiotics, and I’m back to my old self. Thank goodness, ’cause I felt pretty awful there for a few days. Pneumonia takes no prisoners.

Traditionally, my blood sugar runs high when I travel. Chalk it up to a mixture of food I don’t always eat (and thus have trouble bolusing for), and the fact that I’d rather be high than dangerously low when I’m in a hotel room by myself.

But lately, travel has been no trouble at all. Except for one weird breakfast occurrence in Los Angeles where, after breakfast, I found myself low, then ate the carbs I intentionally ignored over breakfast, then suspended my pump, then ate candy, then ate Skittles (thanks Karen). That kind of low doesn’t happen very often. It must have been the animated conversation.

At home, it’s been a revolving door of sorts. It seems like just when I get home, The Great Spousal Unit is headed somewhere herself. So there has been a fair amount of time at home alone for both of us, though we did travel together for the Friends for Life Falls Church event (and I’m super grateful she decided to come with me/let me drag her down there).

Here in Maryland, it’s finally spring. The azaleas are blooming, I have to mow the grass once a week, and plans are being made for throwing mulch down in multiple beds around the yard. I also put up a new window box for Maureen. She was ecstatic.
WindowBox
I got the vegetable garden started over the weekend (which is a week or two late for me– blame travel and the weather), so in a couple of months at most I should be feasting on home grown lettuce just about every night. I can’t wait.

The BGs at home have been playing nice too, mostly. I just have the feeling that my basal rates are really good right now. My dietary bolus needs have changed a bit over time… does that happen to you too? I don’t even touch half a bagel anymore, let alone a full one. Requires gobs of insulin to bring me back down into range, no matter how much I pre-bolus. Seriously, I’m finding that a donut requires less insulin than a bagel these days. Potatoes don’t seem to require much for me now. Bread, on the other hand, is a nuisance. Pepperidge Farm makes a low carb bread that I found a couple of weeks back though, and it actually tastes like bread and requires far less insulin to cover, so when I’m eating a sandwich or toast, it’s at least a decent option.

Other than that, I must admit to going primarily low carb in the last five or six months. Not crazy low carb, but… you know how People With Diabetes say that over the years, orange juice starts to taste like medicine instead of juice? Well, for me, mindless carbs are starting to look like poison to me. I still eat a little of the poison here and there, but I’m also okay with a salad for dinner and something like quinoa rather than rice. My BGs and my weight have responded positively.

Okay, so that’s a lot of my life right now. How’s it going with you? I’d really like to know. Let’s talk!
 

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