Tag Archives: 8 things

8 Questions.

You know, sometimes things roll around in your head and you just need to get them out so you can let them go. Like these eight questions:

1. Have you ever used your BG readouts to choose lottery numbers? Just me? Here’s the game:

Let the Powerball or Mega Millions jackpots get really high. Then take your BG number from either your CGM or your glucose meter throughout the day and play those numbers. Of course, you have to use just two digits, so if the number is 123 or 223, you play 23. If the number is 84 (the jackpot numbers only go up to about 60), you switch it so you play the number 48.

I’ve never won the lottery with this scheme, but if I did, wouldn’t that make a terrific story?

2. Does anyone ever think that a president who would fire his Secretary of State via tweet would actually care about anyone living with a chronic condition?

Ever?

3. Would you rather have a CGM sensor that you can stop and restart for weeks, or one that requires exactly zero fingerstick calibrations for only ten days? I think we’re going to find out the answer to that throughout the rest of 2018. At any rate, this is the way of the future, so love it or leave it, this seems to be the way we’re going.

4. After hearing the recent news about Facebook not only selling user profile information, but also the ability to access mobile device data without our consent (and don’t try to shame me for this practice by reminding me that I agreed to the terms of service when I created my account around a decade ago)… are you more reluctant to upload all your device data somewhere?

If I were going to run for president, or the senate, or if I would be up for a cabinet post, maybe. But I think my diabetes device data is pretty low on the official russian operative priority list.

5. What’s your next big focus in diabetes advocacy? Is it insulin affordability? Is it learning more about the FDA drug approval process, or finding out about the tricks pharmacy benefit managers play with formularies? There are still many avenues of diabetes advocacy we can pursue, and one amazing place to find out and take action on them all.

If you live in the USA, go to diabetespac.org and download the DPAC app. Use it to join the chorus of caring patients, caregivers, and other Americans who are taking action on these and even more issues in quick, easy steps that will have you feeling great about advocacy without spending every waking hour wondering how you’re going to squeeze it into your schedule. And one of the best things about DPAC is that they’re totally non-partisan. There’s room for everybody.

Use the easy button. Get the DPAC app.

6. If I donate to a JDRF or ADA ride or walk for someone else, but don’t actually participate in any of them myself, am I a bad supporter of those causes?

I happily donate to others’ JDRF or ADA fundraisers. But I’ve never ridden in a JDRF ride. After doing a few ADA rides and paying all or nearly all of the minimum contribution needed to participate each time, I’ve given up on those too. I’m sure they’re still wonderful happenings, and I still have the energy to do them. But at this point, the price of admission is just too high. Right now, I’m okay with helping four or five people reach their goal of participating, instead of helping only myself. Is that wrong?

7. Is lack of appetite a sign of old age? I’m just not the foodie that I once was. I eat far less today than I’ve ever eaten as an adult. If I could eat anything right now… I don’t think I could choose anything. For the most part, I’m just eating for sustenance. I’m not losing any weight, but I’m certainly eating less.

I’m exercising more too, if that matters. But I’ve always been active anyway.

Finally…

8. What should I do on my birthday? It’s next week. It’s not a milestone birthday, so I’ll probably just go to work and come home and be grateful I can still go to work and come home.

I think winter has lasted far too long around here.
 
 
Great… now that I have that out of my head, I can go play those lottery numbers. What have you been thinking about lately?

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8 Things: Holiday gifts for everyone living with diabetes.

Hey, how are you? I hope you’re in the middle of a rather stupendous holiday season.

I hope that gifts are in order this year. Whether you celebrate Christmas, Hannukah, or another holiday, giving and getting are AWESOME. So let’s look at 8 holiday gifts all People With Diabetes could really use this year:

1. More support. There are new diabetes diagnoses every day. There are new people waking up, like I did six years ago, realizing their diabetes doesn’t exist in a vacuum.

I hope those people find the hope and support that I found when I found this community. And I hope they pay it forward when they do.

2. Laughter. I can’t tell you how long it’s been since I really laughed hard. I’m ready for something really funny to just knock me out of my chair.

Likewise, I think it would be really great if I could make someone else laugh too. I just hope it’s not because I did something really embarrassing at the same time.

3. Retail Competition for Closed Loop Systems. Honestly, the #WeAreNotWaiting movement, and all of the do-it-yourself systems it has spawned, has taken a bit of the wind out of the sails out of the commercial artificial pancreas designers out there.

Eventually, we know these systems (the iLet, Cell Novo, etc.) will be approved, but whenever we start to see rollout of non-DIY closed loop, I hope it’s not just one at a time. Good, reliable technology is what we need, and we need more than one option to choose from.

4. More knowledge sharing. Here at Happy Medium, I try to do my best to keep you as up-to-date as I can on the latest diabetes happenings, especially when it comes to news out of Washington, D.C., and items I gather from attendance at various conferences, research summits, and symposia.

I would like to see more of that from everyone in our community, or at least a sharing of resources for learning about new developments in diabetes. Not just, “Here’s the group I spoke in front of today”– which is still good, and should be shared– but also an occasional post that says, “I read this interesting thing today”, or “This event is happening in your area”. I don’t see much of that anymore.

5. A couple of diabetes memes. I can’t handle something new every week, but it’s fun when we can get out of whatever rut we’re in and post something on a common theme. Hey, I’m not the only one with good ideas!

I love Diabetes Blog Week, and I loved the social media #MakeDiabetesVisible campaign during Diabetes Awareness Month. Again, I don’t need a prompter all the time, but it might be cool to do a #dblog Check-in Day, or Diabetes Art Day, or No-D Day again.

6. A couple of recipes might be nice too. One of my favorite things to do here is share recipes, but I haven’t done a lot of that lately. Have I shared every recipe I know?

Chances are, I haven’t. Chances are, you haven’t either. Maybe it’s time to search our cookbooks (give credit where credit is due) and family recipes and deliver something new for everyone’s palate to enjoy.

7. Less Uncertainty. Let’s face it… we’ve been through the wringer on this Affordable Care Act thing. Ever since this time last year, we’ve all been worried out of our minds about whether ACA will still exist, and whether it will be as helpful and as accessible as it has been up to now.

We’ve always known it was broken. Damn few of us expected a so-called “fix” that would break it entirely. Let’s stop the uncertainty, congress. Let’s take away the roadblocks toward giving Americans the same healthcare rights available in every other decent nation in the world. Do that, congress, and maybe I’ll use the big C when I refer to you again.

8. More Kindness. Any change, meaningful change, change that lasts, begins and ends with kindness. Empathy. Decency. Change that lasts does not include cheating, lying, or calling people, even elected officials, names.

This gift could also go to some of our friends in the diabetes community, who have been less than friendly with people not living with their type of diabetes, or are fans of one cause but not another. We all want the same thing. Bashing each other to get there, or to get more notice, is a recipe for eventual failure. You might get your way initially. But no one is going to be excited about how you got there, and that will be shown in their overwhelming lack of support for you.
 
 
However you celebrate the holidays, I hope they are full of gifts, however you define them. And happiness, however you define it. Here’s to us this holiday season… may we celebrate many, many more!

8 Questions… just because.

It’s been kind of a whirlwind week, in the middle of two or three whirlwind weeks in a row. Lots of things going on, some important news, and a few really sad stories outside of the Diabetes Community.

Since we’re busy and we’ve had a lot of dark clouds hanging over our collective heads lately, I think we all could use a break. So, without further ado, here are eight interesting diabetes questions based on, well, nothing really. Feel free to leave your answers in the comments. Here we go:

1. Insulin pump or MDI (multiple daily injections)? Or neither? We know that some people who live with Type 2 diabetes don’t take insulin at all, and some insulin users are using inhalable insulin. I’m still working with my Animas Vibe pump, even though Animas has decided to go out of business. Whatever you do to help manage your diabetes, if it’s working, you’re doing the right thing. Isn’t it great to have choices? When we’re allowed to have choices?

2. Dexcom or Libre? With U.S. FDA approval of Abbott’s Freestyle Libre continuous glucose monitor, I suspect this will be a question asked more and more in doctor’s offices and at diabetes conferences nationwide. These aren’t the only CGMs available, but they’re the only ones available as standalone devices (not required to be paired with an insulin pump). Again, it’s great to have choices, when we’re allowed to have choices.

3. Have you heard of The Affordable Insulin Project? This is another of DPAC’s efforts on an issue that affects millions of Americans. Check out the website and see how you can help spread the word and help make access to the life-saving drug that many cannot live without more affordable. To find out more, go to AffordableInsulinProject.org.

4. Have you donated insulin or supplies to victims of Hurricane Maria in Puerto Rico? Insulin for Life USA is helping to coordinate efforts to send much-needed insulin and test strips to those impacted by hurricane Maria, and also hurricanes Harvey and Irma. Find out how you can help pay it forward by going to ifl-usa.org.

5. Are you donating blood? All of us were shaken this week by the news that hundreds were gunned down at a concert in Las Vegas. In response, many have donated blood via the American Red Cross. Did you know that many People With Diabetes in the USA can donate blood? Whether it helps victims in Vegas, or those closer to your home, every pint is necessary and so appreciated. I can state unequivocally that donating blood has been one of the most fulfilling experiences of my life. Consider donating too, then go to RedCrossBlood.org.

6. Did you watch the Sammies this year? Maybe you missed them because you were concentrating on the Emmys. The Sammies, or Service to America medals, are known as the Oscars of government service. They’re given each year to federal employees who are recognized as “breaking down barriers, overcoming huge challenges and getting results”. That’s especially true of Courtney Lias and Stayce Beck of the U.S. Food and Drug Administration, who have been instrumental in helping artificial pancreas research move from the “maybe, someday” stage to patient’s hands. I cannot say enough good things about them. Read about their incredible work HERE. Congratulations Stayce and Courtney!

7. Will I see you this weekend? Friends for Life comes to the Washington, D.C. area this weekend in Falls Church, Virginia. If you’re coming, I hope to see you as I advocate at the DPAC table in the exhibit area. Look for a brief recap in this space shortly.

8. Will I see you next weekend? When it rains, it pours, and diabetes events will be pouring over Northern Virginia like monsoon season in Myanmar this October, as the Diabetes UnConference and Diabetes Sisters’ Weekend for Women co-locate in Alexandria October 13-15. I will once again be a facilitator at the UnConference, and I am very much looking forward to getting together for peer-to-peer support, encouragement, and all the feels. I’ll let you know how it goes later in the month.
 
 
Those are my questions of the moment… have any answers, or questions of your own? Let me see yours in the comments below.

Getting Acquainted.

Now that I’m officially several weeks into my life on Dexcom, I just wanted to scribble down some notes for the purpose of keeping a record on how it’s been going so far.
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This is mostly stream of consciousness, but as usual, my stream of consciousness still contains several words. Hopefully, they are ones you’ll want to read. Here are eight observations on the early going with Dexcom.

1. I know that I have FDA approval to bolus based on my Dexcom G5 readings, but I haven’t done it yet. Okay, I may have pushed a one unit correction bolus through once or twice without doing a fingerstick, but that’s all. I’m not blousing for a meal based on my display. I’m confident in my Dexcom– I’m just not confident that it will be perfect 100 percent of the time, every single day. I would hate to over- or under-bolus based on the one time it’s off by a bit. I hate to think of the result of doing that. So, no dice to the bolus-off-Dex so far.

2. I’ve got to remember to order some Skin Tac or Opsite Flexfix or something to hold down my sensor, and soon. The peeling is real, folks.

3. At the Diabetes UnConference, I checked in with a couple of people to get their pointers on doing an upper arm insertion. I also looked at Daniele Hargenrader’s recent video showing her doing this. Then I did it. Then I loved it. It’s mostly out of the way, and the sensor works pretty good there. And the accuracy has been fantastic. Win-win-win.

4. I’m not interested in using my thigh or forearm for sensor placement. I use my thigh a lot for insulin pump infusion sites, and I’m guessing that using my forearm would be painful. This outlook is subject to change, as I should be from time to time. Also, I may be going back to using my midsection for a while anyway. More about that at another time.

5. Based on what I’m seeing up to now, it looks like the basal rate settings on my insulin pump are, frankly, stellar. Whether I’m high or low (you’re welcome Janelle Monae), once the peaks level out, if I don’t touch my pump, the line on my graph is pretty flat. I’m a little shocked, but happy that my endocrinologist and I were able to work this out without the benefit of a CGM to guide us.
dexcom100
6. I have avoided the newbie temptation to check my CGM graph every two minutes. I think that’s because of my Dexcom experience during clinical trials. Of course, not checking the receiver all the time means I’ve made the mistake of putting it on the table and walking out of the room every so often. I never said I was perfect.

7. That said, can I just say how much I really hate the fact that I still have to look at a pager-sized display to get my readings? I’m not buying the “We’re working on an Android solution” anymore. You’re not… just admit it. If I’m wrong about that, I’ll be the happiest guy around who ever had to eat his own words, and I will gladly eat those words in this very space.

8. Like anything, when things go well, you tend to see something in a very positive light. That’s where I am now. At the beginning, I had a failed transmitter which also cost me a few sensors, and that was extremely frustrating. I realize that how I use my CGM, and how I react to various things affecting my use of my CGM, may very well change over time. But I hope things remain positive. Because for the last couple of weeks, it hasn’t been a big problem to deal with, and that’s the only way I’m going to buy into the notion of wearing my Dexcom every single day.

Those are my initial observations. I wonder how I will feel about my CGM in a year? Only time will tell. The goal is to make it to another year and find out.

8 things to help you manage your blood sugar (and your life) over the holidays.

With another holiday season upon us, we have more chances than usual for our blood sugar to get out of whack. There are several reasons for this, and if you will permit me, I’m going to list eight of them here.

Why? Because I’ve made plenty of mistakes in my diabetes management over the holidays. So you can consider these a sort of “don’t make the same mistakes I’ve made” list.
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1. Be careful what, how, and when you drink. Others have written about alcohol and diabetes far better than I ever will. See HERE and HERE and HERE. Of course there are more chances to imbibe in December, and being careful does not always mean you have to say No. It just means it’s important to be aware of how alcohol affects your blood sugar. Hint: it’s not how you might think.

2. What about those parties? There’s no question there are more social situations right now than there are earlier in the year. Some of the questions I ask myself are: Is a party taking the place of a meal? Is it between meals, or later in the evening? It’s important for me to know, because it will help me determine whether I need to set a temporary basal on my pump (either higher or lower).

3. Keep up on the BG checks. If I know I’m going to a party that starts around 6:00 p.m. (around when I usually eat dinner), I can do a check before I leave the house and when I get to the party, so I have a good starting point before I decide to eat something. Of course, if you’re wearing a CGM, you’re going to be looking at that a little more often through the night, and that’s great. If the party includes some finger food but it’s not an actual meal, I’ll probably just bolus a little after I see what’s there to eat and guess what my carb intake might be. The point is to stay on top of my BGs in situations like this because it’s easy for me to have numbers that are not normal, for various reasons.

4. Do not over bolus. As someone who makes this mistake from time to time, let me say it again: Do not over bolus. Your diabetes numbers do not have to be perfect in December, and it’s probably best that you don’t set yourself up for disaster by trying too hard to get to 100 mg/dL. If you’re checking your numbers a lot anyway, you’re obviously doing what you can to mitigate super high numbers. Don’t make it worse by rage blousing and winding up with a hypoglycemic EMT or ER visit at the holidays. I’ve been there. If I can help it, I won’t make this mistake again.

5. That said, Yes, you can eat that. Hey, don’t look to me for validation for eating that cupcake with the red and green sprinkles. But if you do it, don’t complain about a high BG number later. Most of us are adults. We’re capable of making our own decisions, while usually recognizing where the line is, even if we do cross it once in a while. Ignore that crummy “sugar free” [insert dessert name here]. Often, the carb count isn’t any less than the real thing. It just doesn’t taste as good, and sometimes it’s laced with sorbitol, which means if you do eat it, you might be spending more time than usual in the bathroom, rather than with your friends and family.

6. Go with the flow. Like I said in the last paragraph, your numbers are not always going to be perfect. Do you want to concentrate on diabetes perfection, or do you want to enjoy special times with family and friends? We’re meant to celebrate the holidays, not obsess over our next A1c.

7. Have a diabuddy? When spending time in places and among people where your diabetes isn’t well known, it’s especially helpful if someone else in attendance “gets it”. If your spouse, or a friend who knows you and/or your diabetes well can attend with you, you’ll have the added feeling that no matter what happens, someone will be there who understands you and can help you when you need it. Who doesn’t like to have a wingman? Bonus tip: a bracelet or necklace announcing your status as a Person With Diabetes is almost as good.

8. Enjoy, enjoy, enjoy. Be grateful. Be nice. It’s okay to talk diabetes (it’s kind of hard for me not to talk about diabetes), but it’s a festive time too. Ask someone else how they’re doing. Tell someone how happy you are to see them. Wish them all the best this holiday season.
 
 
So remember to check often. Be careful while imbibing. Don’t be too hard on yourself. And have a happy and fun time this December.

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