Regular Maintenance.

Baltimore County has been busy on my street in the past week.

The county is in the process of replacing water mains in our area, and they’ve been at work for about a week on our block.

Naturally, this made me think about my diabetes (because, why not?).

Occasionally, we need to step back from the everyday grind and consider what about our diabetes needs an upgrade. Or a change. Or a budget adjustment. I’ve got to admit… it’s time for me to do some diabetes maintenance.
I’ve been putting off doctor visits. Not because I hate going to doctors, but because I’ve been busy, and the daily grind of my life these days has made it easy to forget about scheduling an appointment once I get to work or to the gym or out in the yard. Funny how, even at my age, I can still let everything else be an excuse for not getting to the things that I know I need to do for me.

I missed the last appointment with my endocrinologist because I was traveling. I haven’t been to an ophthalmologist in about a year and a half. Finding a good one locally is really tough. And I can’t tell you how long it’s been since I’ve seen a podiatrist. Same reason. To make matters worse, I need to get in to see a gastroenterologist because… well, you know. I’ve been putting that off for a few years.

I also have to consider replacing my wonderful Accu-Chek Nano meter that I’ve been using for something near four years. But I like it so much, and I have four of them, and I just don’t want to get another one. But what am I missing by not finding a newer model?

Last Friday, the county workers must have done some real damage underground, because at the stroke of midnight, I heard pounding outside. It was Baltimore Gas and Electric performing emergency repairs on the natural gas line that runs right where the county was digging. They were working all night and all day Saturday.

I don’t want to get to where my casual attitude toward regular maintenance of my health results in missing something important that I need to address. Besides, the appointments I need to make are piling up.

This isn’t about burnout or anything like that. I’ve just let things go for far too long. It’s time for me to ignore ignoring my well-being and focus on getting the regular maintenance of my health addressed.

Diabetes + Cancer? No problem for this Champion Athlete.

It’s Friday, so how about something to make you feel good?

Today, I have another Champion Athletes With Diabetes story. But Ellen isn’t just a runner living with diabetes. She’s also living with cancer. Her sister Terri sent me an e-mail letting me know about her sister’s remarkable achievements, and I want to share part of them with you now.

“Ellen is a person with type 1 diabetes, who has completed three half marathons since November. That in itself I believe qualifies her. But I am more amazed and proud of her as she has done this while battling lung cancer.”

Last November, Ellen finished the Indianapolis Monumental half marathon:

“Her struggle to finish this run led her to the Dr., where she was told she ran it with walking pneumonia (and T1). A few weeks later, once the pneumonia cleared, they spotted tumors in her lung and diagnosed her with lung cancer.”

“Before Ellen was diagnosed with lung cancer, she had already joined Team JDRF to participate in the Walt Disney World Marathon Weekend. Ellen raised $2,700 + for JDRF and on January 9, after her initial round of chemo and while on radiation therapy, completed her second half marathon as part of Team JDRF.”

“Ellen is now done with all her treatments and doing everything possible to get stronger and also manage her T1 diabetes. She is back to regular exercise and in May, completed the Indianapolis 500 Festival – Mini-Marathon.”

“Her strength and attitude amaze me. I participated in both the Disney and 500 Festival half marathons with her. I witnessed her determination to prove to herself and others that her diseases will not stop her.”

Is that inspirational, or what? Knowing that Ellen did all that while living with diabetes and lung cancer makes it a little easier for me to want to get out of bed and get my exercise on.
We salute you Ellen… your story makes us smile, and we are honored to award you this medal. Keep running, and keep inspiring!
What about you? Are you conquering your athletic goals along with the difficulties of living with diabetes? Is there someone important in your life that meets this description? Then I have a medal for you.

Send me an e-mail at Tell me your name, name of the athlete (it’s okay if it’s you), and your address (gotta know where to send the medal). Most important, tell me what athletic goal was accomplished, and when. Extra points if you tell me how you felt accomplishing the goal. Full disclosure: I reserve the right to use your testimonial here, on Twitter, and on Facebook. I will not use your name if you don’t want me to. As always, I will never share private information.

Join the over 80 Champion Athletes With Diabetes. Send me your story today!

Not exactly MacGyver, but good enough.

Tuesday, I was able to overcome a potentially panic-enducing episode of my own doing. I’m not the most handy guy in the world, so getting over this was a big deal for me, even though it’s probably not to you. Let me explain:

I walked out the door and headed to work without checking the status on my insulin pump. That means I left for work without noticing that I had about 7 units of insulin left in my reservoir. Not nearly enough to last through the day until I got home.

I don’t generally keep extra insulin lying around my desk at work, so I had to come up with something, or inconvenience The Great Spousal Unit and ask her to make a special trip downtown, which is way out of her way. To make matters worse, my Animas pump has one feature that I absolutely detest: when the pump says zero units left, it stops pumping.

The problem is, when the pump says it’s at zero units, there are still about 20 units of insulin left in my reservoir. Now that’s enough to last me through the day at work. What to do?
Well, I don’t recommend that anyone do this on a regular basis. It is far from an exact science. But it beats wasting insulin, or potentially going a few hours without any. Here’s what I did: once my pump went to zero units and gave me a no delivery alarm, I pulled the reservoir out, and every hour, carefully pumped more insulin in using the plunger underneath the reservoir. You know… syringe style. Once the plunger reached a certain point, I had to use a pencil to push it further and continue to pump insulin.

Like I said, this is not an exact way of delivering insulin, and I do not recommend it if you can avoid it. In addition to regular hourly bolus amounts, I checked my glucose levels about every hour and a half to make sure I wasn’t too high or too low. But in this case, this practice solved two problems for me: I did not need extra insulin or to leave work early to get extra insulin, and I did not waste 20 units (or more) of perfectly good Novolog.

My old insulin pump had a 300 unit reservoir. My new pump has only a 200 unit reservoir. This isn’t a huge concern for me. I can manage with either. However, one of the features of my previous pump that I took for granted (and wish I had back) was the fact that I could fill the reservoir, prime the pump, go until the pump said zero units left, and still keep pumping for hours, because it kept pumping until the insulin was gone, not until the display said zero. The “Load Cartridge” feature on my new insulin pump already takes about fifteen units away from a full reservoir, and I take about ten more to prime (it’s long tubing). Then the pump quits when it says zero units, even though there are always 20 units or more left in the reservoir.

All’s well that ends well. When I got home from work, my pre-dinner BG check resulted in a reasonable 115 mg/dL.

I must say, I find it annoying at best, wasteful at worst for my pump manufacturer to stop my pump entirely when I have insulin left in the reservoir. So Animas, if I work on checking my pump status more often, can you work on that delivery of all the insulin in my reservoir? My solution was not exactly MacGyver-esque, but it was useful anyway. Let’s hope I don’t have to employ similar tactics in the future.

The sailing is not always so smooth.

I’m pretty matter-of-fact when it comes to managing my diabetes.

I try to find the best way to handle things I can, and then I just put my head down and do what needs to be done. No fanfare… just do it. There’s no reason for me to complain about what I have to do, though I completely understand when someone does. But I try to avoid that, because I still have to do these things to keep living a decent life.

Much to my dismay, a simple site change Monday night made me realize that sometimes, even I have difficulty with the day-to-day maintenance of diabetes.

For those of you not in the know, a site change is when the infusion site for my insulin pump is nearing the end of its life cycle. According to the U.S. FDA, that’s three days. According to me, it’s as long as the insulin in my reservoir holds out (around five days with a 300 unit reservoir, 3 1/2 to 4 days for a 200 unit reservoir).

Site changes are no big deal, until you realize you’re removing something that’s been attached to you, under your skin, for a few days, and replacing it with another thing that will be attached to another part of your body for a few days. If you’re me, you have to insert the cannula (the plastic tube through which the insulin will flow) using a 9 millimeter needle you have to voluntarily jab into your skin at a violent speed. You know, no big deal. You just have to do this every few days.

What I just described is (usually) not a huge event for me. After six-plus years of pumping, I’m pretty used to it. But for the first time in a long time, Monday was different.

I came home from work with less than 20 units left in my reservoir. My pump had been beeping about the low reservoir for a couple of hours already. At this point, I’ve known for days that I needed to do a site change at this time, and instead of doing the site change, I sat down and ate dinner. I also sat around after dinner. I watched the news, I checked my e-mail, I talked with The Great Spousal Unit. What I did not do was a site change.

Eventually, I had to do it. Now it’s nearing time for bed, and I don’t have enough insulin left to last through the night, and I finally resign myself to the fact that yes, this must be done now.

And I did the site change, but not without some grumbling and swearing and loud complaining because my first two tries at getting the cannula in failed. Looking back on it, I know I must have looked like a spoiled child throwing a temper tantrum. I was not a happy camper.

Just thinking about all this makes me feel guilty, because, hey, at least I have access to tools like this that afford me lots of flexibility in getting the one drug I cannot live without. On top of that, I know that through the lens of the Diabetes Online Community, many times it looks like we’re rock stars when it comes to tackling the tasks necessary to keep our A1cs as low as they can be.

If you look at it from either of those two points of view, you’re likely to say Suck it Up, dude. Deal With It. And you’d be right. I’m not looking for sympathy here. I’m really just trying to describe my experience and get it down in writing. And maybe find some answers.

What I do know right now is: often I am the rock star. And sometimes, like Monday, I’m not. Is it the same for you? Do you ever find yourself sailing along, then confronted with the notion that maybe things aren’t sailing along so smoothly?

#dBlogWeek Wildcard Friday!

Welcome to Diabetes Blog Week! Diabetes Blog Week is just like it sounds… diabetes bloggers all blogging on daily topics for an entire week. Or, in this year’s case, for five days. To find out all about Diabetes Blog Week and to sign up,

As always, thank you to Karen Graffeo, creator and curator of Diabetes Blog Week. It’s been another fantastic week of finding new blogs and getting my own writing mojo back. And it wouldn’t have happened without Karen’s wonderful idea seven years ago.

On our final day of #dBlogWeek, I’m throwing down the wild card… The Let’s Get Physical Wild Card.
Managing diabetes during exercise can be tricky, so share what works for you or your loved one with diabetes and maybe it can help someone else. What to do when you want to work out, but your blood sugar is lower or higher than you want? How do you cope with this? Or how do you manage gym days at school for your child with diabetes? How do you stay motivated to work out? Or how do you encourage your loved on with diabetes to get active? What is your favorite kind of exercise – conventional or non-conventional? (Let’s see how many types of exercise we can find!
Let’s start with that last thing– my favorite kind of exercise. Honestly, I would really love it if I could still be playing baseball. That would be fantastic. I would really like to still be playing slow-pitch softball too. But… not gonna happen. I can’t find a team I can join locally, for either of those.

But I can still participate in (probably) my second favorite activity: riding my bike.
Unfortunately, there haven’t been any sunny days like the one in the photo above available for me to actually ride my bike this spring. Not even one that fit into my schedule where I can get up and go. In fact, because of my knee surgery (and slow recovery) last year, and all the rain we’ve had here in Baltimore this year, I’ve had to rely on my trusty backup:
Hey, it still allows me to get the workout in until the rain lets up. Now, how do I deal with the workout with diabetes along for the ride? I have to remember a few things:

For starters, I have to check my glucose first. I don’t have an absolute number I must be at before I start my ride. It’s really based on how long it’s been since I’ve eaten, what I had to eat, and how long I plan to ride. In the interest of not dragging this post on forever, I’d say I’m looking for a number north of 150 mg/dL (8.3 mmol/L– is that the right non-US number?).

Then, I need to make sure all of my shtuff is close by. You know… meter, juice, glucose tabs if I have them, if not, candy or fruit. Also, and this is crucial: I dial down the insulin delivery on my pump through a temporary basal setting. Depending on my current BG level, anywhere from 25 percent to 50 percent of normal. Effing diabetes.

Of course, there are the non-diabetes things: water, towel, and my phone. The phone? I need it for the Pandora music streaming during the ride. I like 70s music. Almost all of it, but no Osmonds or Bay City Rollers or weak shtuff like that. Sometimes I’ll go for British Invasion music, or Motown.

Now I’m ready to take off. I don’t wear a CGM right now, so I have to be really cognizant of my focus during the workout, especially my cadence. If my pedal cadence won’t stay steady, then I know it’s probably time to check the BGs again. That’s my sign. I’m not one of the gifted PWD athletes out there who can check while riding, so I stop what I’m doing and check. No use wrecking the entire workout if I can resolve things quickly.

If I’m low, I’ll stop my pump completely, or disconnect from my site entirely. I’m going to take a shower after anyway. So I’ll sit and treat the low and check again. If it looks like I’m okay, I’ll start up again. Sometimes, after a low, if I start again, I might not go as long with the workout as I had intended. Effing diabetes.

But here’s the thing: Even if I have to cut it short, I’m still working out. I’m still doing something that makes me happy, even if it’s just for fifteen minutes or so.

I don’t care anymore about how slow I may go, or how long it takes me to reach my goal, or whether I experience bumps along the way, diabetes- or non-diabetes-related. For me, being able to work out is a gift, and I intend to use that gift as much as I can, as long as I can.

Kind of like sex. Which, if I’m being honest, really qualifies as my favorite workout, in case you were wondering. And if you were wondering about that, you should probably be working out right now!

How do you deal with diabetes and getting your workout on?
Find out how others do it by checking out the posts linked HERE.


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