Category Archives: Random Glucose

Finally… Spring.

I’ve waited a long time to write that headline.

Winter lasted an exceptionally long time here on the east coast of the United States, and at times (March and April), it seemed like it would never end. And as it happens every three months or so, I’ve begun to take another look at my diabetes and make a few subtle changes.

To begin with, I started to clean up and rearrange all of my diabetes supplies. Winters are really hard for me. Most years, I just try to get through the winter without attending to anything other than the things that absolutely need to be done. I realize that winter officially ended nearly two months ago… but this weekend, I cleaned up my supply cabinets.

When the weather finally breaks, I take on other tasks related to my diabetes too. Yes, I changed my lancet. 🙂
I also looked at my CGM graphs over the past weeks, and then checked my basal rates to see if they needed to be adjusted in any way. My guess is that I’m fine for now, but I’ll be sure to discuss it with my endocrinologist when I see her in a couple of weeks.
 
 
Spring and summer are also the seasons of fresh produce, and there’s no question I eat better from May through September than I do from October through April. Especially when the fresh produce comes from my own garden.

I actually made a salad with some of that red leaf lettuce this past weekend. And it was delicious.

Do you ever feel like the coming of warm weather and additional sunshine gives you extra energy that you didn’t have a month earlier? That’s exactly how I’m feeling today. Here’s hoping your Spring, or, depending where you live, your Autumn, brings a renewed energy and the motivation to continue to live the happiest life you’ve ever known.

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Prickless.

No, this is not a story about removing the president of the United States from office.

Instead, this is about something I did recently.

I went a full day without doing any fingersticks. Twice.

I got the idea when a Dexcom sensor ended, and I still had about four days left in my trial of the Freestyle Libre (Disclosure: Abbott paid for the reader and two sensors. Opinions are my own).

At first, I wasn’t sure about only wearing a CGM that I didn’t have a lot of experience with. But during the trial, it had been pretty reliable. Then I thought, “the Libre doesn’t require fingersticks, even for calibration… what if someone didn’t want to do one?”. So I spent an entire day, a Sunday, not using my meter even once.

Then, once I got through a day using only the Libre, I knew I had to do the same thing with my Dexcom G5. The Dexcom only requires fingersticks for calibration, so in theory at least, after calibration, I could go quite a long time managing my diabetes with only the Dex. Dexcom’s turn came earlier this week.

I don’t know a single person using either of these systems who ever actually does this. I’m sure there are, but I haven’t seen anything about it anywhere. How was my experience?

In a word, I was terrified. When you rely on pricking your finger with a sharp (okay, blunt) object multiple times per day for years on end, drawing blood and using that blood to give you a handle on your diabetes, you get used to it enough to rely on it first. For me, my meter is my truth teller.

Occasionally, my CGM will give me a weird reading I just can’t believe. When it does, it’s important, even comforting, to know that I can grab my meter and trust what it tells me. But the thing is… more often than ever before, even in these moments, the meter and the CGM are very close.

I didn’t have any notable moments during the two days. No big highs, no major lows. I just lived my life, checking my BGs only via my CGM display. Managing insulin dosing and carb intake accordingly. Out of sheer instinct, I took out the meter a couple of times each day, nearly checked, but then put it back in the drawer with a laugh.

Since things worked so well over these two days, you may be wondering if I might want to ditch the meter entirely. The answer is No. As I said, when it comes to blood sugar, I’ve come to rely on my meter as the one bastion of truth above all others.

But… I could see backing off on glucose checks in my future. Maybe I won’t check seven to ten times each day. Maybe four or five, or even three or four might do the job. Maybe it’s time to think of my CGM as more than just an emergency alert system.

What this experience has done is give me the feeling that I can step back and reassess whether I need to give my continuous glucose monitor more of a place at my diabetes table. I would have never guessed that I might do that. I’ll still keep my meter handy. But going forward, I’ll be just as likely to rely on my CGM.

Living with a chronic condition is like : Laundry.

With a rare extra day off and nothing on my schedule, in between watching hockey and football on New Year’s Day, I worked to catch up on laundry.

And there, somewhere in between the Sabres and Rangers, and LSU – Notre Dame, it hit me: doing laundry is a lot like living with diabetes.

It’s not enough to just throw everything into the washer. You have to add soap, and fabric softener. Maybe bleach. Do you have soap, fabric softener? What about bleach? It’s not likely you have an abundance of all three of those in your laundry room at the same time. You might even have to pretreat an item or two before you get started. Every load is different. You can’t count on anything.

You’ll have to eventually shift each load from the washer to the dryer, or possibly hang up the more delicate fabrics. Do you use fabric softener sheets? Do you have fabric softener sheets? Do you need to make a trip to the grocery store?

Now you’re probably thinking you’re through with your laundry. Not likely. Because you’re going to have to fold or hang all of those clean clothes. All of them. The truth is, this is the part I hate the most. It never feels like I’m going to get to the end of what’s in the dryer.

And still, you’re not finished yet. You have to put it all away… unless you just want to select what you’re going to wear from your laundry basket. Personally, I wouldn’t think less of you if you did.

Just like the laundry, living with a chronic condition like diabetes means that I have to keep track of medications and supplies, at least one of which seems to need to be refilled every couple of weeks. I have to treat each circumstance differently. Whether it’s exercise, diet, stress, or something else, no two days are the same.

And here’s where living with a chronic condition is different from laundry, or anything else:

You’re never finished.

If my dirty laundry piles up and I just don’t have the time or the desire to get started on it, if I want, I can try to get away with wearing the same shirt or the same pair of pants twice. But even though I have days where I’d like to just kick back and ignore my diabetes, that’s just not possible.

Every situation, every piece of food I put in my mouth, every workout, every single day brings another factor I have to deal with. I can send my clothes out to the dry cleaner if I want, but I can’t pass off my diabetes to anyone else.

If you want to get a taste of what it’s like to live with a chronic condition, grab your dirty laundry and get going. If you really want to know what it’s like to live with a chronic condition, imagine doing laundry all day, every day, for the rest of your life.

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.

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.

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