Thursday, July 10, 2014

The boot camp bond

The sun burned brightly in the sky as sweat dripped down my face, falling on the concrete below. My legs burned as I jumped from one side of the block to the other.

"10 more on this side! Keep going!"

The instructor urged us on. It was halfway through the boot camp class, and today we were outside using stepping blocks, jumping up and down, side to side. 

My body was shaking, I was getting light headed. "It's just the heat," I thought, "Your body is just getting tired. Don't give up now." I encouraged myself, trying to push through. But this feeling wasn't exhaustion, it was something different. 

As everyone continued with their workout, I pulled out my glucose meter and tested my finger. 52. Once I stopped, the low hit me full force. I rummaged through my bag looking for my fruit snacks. I couldn't find them, but remembered I have a whole box in my car. I walked silently behind the class towards my car, ignoring the questioning looks. I grabbed a couple packets and poured the contents in my mouth as I headed back to my mat.

The instructor had moved on to the next exercise. I stood there awkwardly, waiting for my blood sugar to come back up so I could join back with the class. I don't usually get self conscious while treating a low, but this time I did. I was sure everyone was wondering why I had suddenly stopped exercising, why I was standing there while everyone continued to jump around. When I tried to join back in, my body felt weak and dizzy. I couldn't do it, I knew I would just have to wait it out. The class is only an hour, and I knew I would be wasting 10-15 minutes waiting to feel better. And while I know this is necessary, I was mad. I was mad that I was missing part of a workout that I wanted to do, that I paid to do. I was mad at how disruptive my diabetes can be. I was mad that I was being forced to eat sugar that I just worked so hard to burn off. And I was mad that my diabetes had singled me out once again.

I sat there as the instructor walked over to ask if I was okay. 

"I have type 1 diabetes and my blood sugar went low. I'm fine but I just have to wait for it to come back up." My voice was full of emotion. I don't know why, but this particular low had made me feel vulnerable. I was afraid that the instructor wouldn't understand. I was fine, I just needed time, but I'm strong and capable. I didn't want her to underestimate me.

But the instructor looked at me and said something that made me confident that she understood.

"My son has type 1 diabetes."

I looked at her and smiled, instantly relieved. As a parent of a T1D, I knew she got it, and I knew I was in good hands.

Friday, June 27, 2014

Oh the Irony

I have this ritual. Almost every time that I go for a long grocery shopping trip, I treat myself to a cold bottle of diet A&W root beer on my way out. I don't drink a ton of pop and root beer has always been one of my favorites. Having performed this ritual enough times, I've come to recognize the diet bottle just from the color of it. I was finishing up a particularly epic grocery shopping trip and grabbed the A&W from the cooler as I got in line to pay, confident that it was the right one.

Parched from my long shopping excursion, I got into my car and immediately cracked open the pop and starting chugging, relishing the cool and refreshing taste. With half the bottle gone, I glanced down at the bottle. Something was off. I didn't see the "Diet" sign anywhere! Shit.

Two thoughts immediately crossed my mind. Well technically first I silently cursed myself. But then my first thought was "What a waste of calories!!" followed by, "Holy crap that's a lot of sugar!" A bottle of regular A&W root beer is a whopping 80 carbs! And here I had just drank close to half.

I took out my insulin pump and immediately started figuring out how much insulin to give. It looked like I drank half, but the top half of the bottle is skinnier than the bottom half, so maybe its not actually 40 carbs. I decided to subtract some to account for bottle shape and gave myself some insulin.

Within 5 minutes Gigi (my CGM) was already buzzing, displaying the two upward arrows showing that my blood sugar was rising quickly. I cursed again. Maybe I should give a little more insulin. I could just picture my blood sugar rocketing to the 300's. I was pissed. What a stupid, careless mistake. Really I was thinking that if I was going to have that many calories and sugar, I would have preferred ice cream or at least a root beer float!

I went about my afternoon and tried to put the incident behind me. That is until about an hour and a half later.

Something wasn't right. Gigi was being quiet, but all of the sudden I did not feel well. I got out my glucose meter and tested my finger. 37. Ummm what?! The low caught me off guard, as I was sure that I had given the appropriate amount of insulin according to the label. I needed sugar, and fast.

The bottle that only an hour earlier I was cursing, was now my salvation.

Ohhh the irony.

Friday, May 23, 2014

A1c Accuracy

"So how have you been?"

A seemingly innocent question asked by my endo as she sat down across from me. I never know quite how to answer this. I've been good. Really I have. My new job is going well, I'm enjoying living on my own in my new apartment, my weekends have been filled with fun events with my friends. I've been trying to get back into working out, I've been getting better at cooking and trying new healthy foods, things are good. But that's not really what she wanted to know.

"I've been good."

"How have your blood sugars been?"

Ah now we get to the real question.

"Have they been high, low, are you having any problems, do you notice any patterns?"

"Shouldn't you know?" I thought, assuming that she had at least looked at my graphs and A1c (which in fact she hadn't since they were still being downloaded).

"They've been high lately, higher than I want, but I haven't really noticed any patterns."

"What about lows?"

"Yea I have them after the highs, probably from over correcting. Lots of roller coasters."

We talked a little and made some adjustments and she got ready to wrap up the appointment.

"I was just wondering, what's my A1c?"

"Oh I hadn't even looked yet. (Ummm what, why not?") It's actually pretty good, 6.9."

"Seriously? Are you sure?? That doesn't make sense." My doctor turned the screen so I could see it on the computer. I looked at her perplexed. "I'm shocked, are you sure that's right?" It's not that I didn't believe that it could happen, after all almost exactly a year ago I was at 6.7, but I know what my blood sugars looked like then and I knew how they have been the past couple months, and something just wasn't adding up. But I was hoping that maybe I was wrong. Maybe I was just remembering the worst of the past few months and in general I was doing pretty well. "I want a re-check," I joked.

"Yea I'm pretty surprised too, that doesn't really make sense based on these graphs."

I'm not going to lie, I kind of wanted my doctor to prove me wrong, to not agree with me. To point to some trend or something that showed that I wasn't as off as I thought.

"We'll have them test it again."

In the 13 years that I've had diabetes and the over 50 A1c checks that I've had, I never really had a reason to doubt the accuracy of the test. But here I was, getting my first recheck. As I sat there waiting for the nurse to come back with the results I debated in my head whether it was better to be right or wrong in this situation. Right in that ordering another test was the correct decision, that the first result wasn't accurate and that I know my numbers and my body. On the other hand, I was hoping that I was wrong. That I was doing better than I was giving myself credit for, that maybe my A1c was 6.9, a number I've been working to get back to.

The nurse walked in and I looked up expectantly.

"It's 7.3."

"Yea that makes more sense."

Slightly disappointed that I wasn't 6.9, I was still okay with that number. It's been where I've been stuck at for the past 9 months so at least I wasn't doing any worse. Okay, 7.3. it's not my best, but it's not my worst. I said the number over and over in my head...and then I let it go. I'm trying to use my numbers to guide me, but not get caught up in them. So instead, I thought about what I need to do different between now and my next appointment in 3 months. Rather than focus on the number itself, I thought about what I can do so that the next time I see that 6.9, I won't doubt its accuracy.

Saturday, May 17, 2014

Diabetes Blog Week- Day 6: The Diabetes Lens

"Back for another year, let’s show everyone what life with diabetes looks like! With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures. Post as many or as few as you’d like. Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves."

In many ways, diabetes has become a lens through which I see everything in life. Thus every picture becomes a diabetes-related picture. So for this post, I chose 4 pictures that at first glance don't seem "d-related," but as you'll see, my diabetes is there in all of them.

Voted Best Tacos in My City

The newspaper of city where I live decided to have a poll to see what the best tacos in the city are. These are from the restaurant that won first place. Having never been before, my friends decided that we had to try them. I have to say, I definitely agree. But looking at this plate, I see more than the delicious food, I see a complicated equation of trying to figure out how many carbohydrates exactly I'm eating here and how much insulin I need to give. 

Spring Is In The Air

On this particular day, my coworker and I decided to take a walk after lunch around the city. Since we've been having unusually cold weather lately, we were excited to see that the flowers were now in bloom and stopped to take a picture. My coworker walked out of the office for our walk carrying nothing besides her phone. I on the other hand knew that I had to be prepared while away from the office. As I pulled my phone out to take this picture, I reached into a bag that also had 2 packets of fruit snacks, my glucose meter, and a little money just in case. The thing is, I can never walk out of the office empty handed because I never know when I might drop low. 

The New Dress

Wedding season is upon us and I've been shopping for some new dresses to wear. With any dress, I look to make sure that I like the style, the cut, the fit, the color, and the material. As I try on each dress I ask myself, will it match the occasion? Is it flattering? Will I get good use out of it? These are the normal considerations. But with every dress or outfit that I try on, I also have to consider my diabetes and specifically, where my pump will go. Does it have pockets? Will my pump show if I strap it around my leg or wear it on my hip? How easily will I be able to access it? My diabetes can influence what I end up buying and wearing.

The Bike Ride

Within the last year, I've gotten pretty into bike riding. My mom and I would go for beautiful, long rides in the summer together. I love the exercise, the scenery, and this quality time that we spend together. I look at this picture and I see the beautiful lake, my awesome jersey with the Detroit cityscape, and my bike. But what you don't see are the 2 packs of fruit snacks and granola bar stashed in the pockets on the back of my jersey. You don't see my CGM and more emergency sugar in the red pack attached to my bike along with my phone, ID, and insurance card in case of a real emergency. Having diabetes means always having to be prepared, especially when you're out exercising.

Friday, May 16, 2014

Diabetes Blog Week- Day 5 Wildcard

Since I don't really have any life hacks, I decided to go for one of the wild card topics and re-post one of my favorites from April 2013 that fits nicely with this topic.

"Write a short story personifying a diabetes tool you use on a daily basis. A meter, syringe, pump, pill, etc. Give it a personality and a name and let it speak through you. What would it be happy about, upset about, mad about?"

I wrote this post after I decided to move my CGM sensor from my abdomen where I usually have it to my arm. It wasn't the smoothest experience, which I reflected in this post.

Dear Dexcom G4 Platinum (or Gigi for short),

I want to extend a personal welcome to you as you take up your new residency at Arm for the next 10-14 days. I know that the move was slightly difficult, especially one handed, so I'm glad to see that you are settling in nicely. This must be a big adjustment for you, being somewhere completely new, but I think you'll enjoy the change of scenery while the restoration occurs at your previous location at Abdomen. I'm hoping that you will continue to stick around.

Gigi, if we're being completely honest with one another, I was a little hesitant to allow you to move to your current location. It's nothing personal, it's just that the last occupant was a bit of a pain. I'm hoping that you and I won't have to deal with similar issues. As you may have noticed, your new location is a bit more public. I'd appreciate it if you could lie low, but I realize that unfortunately, that's not really part of your design. 

I hope that you are comfortable though, Gigi. The area you are inhabiting is a little too cushiony for my liking, but perfect conditions for you. I know how you enjoy having that little extra to pinch. Your location is under continuous renovations; I'm looking for a sleeker, stronger look, but it's a work in progress. 

There is another reason why I'm writing to you though, besides to welcome you. I've actually had a few complaints from some guests about you being extra "grabby" and "clingy". This particular complaint was a bit concerning from Purse Strap: 

"I was minding my own business, attempting to disembark from Shoulder when Gigi aggressively grabbed me and I got hooked around her, causing me to yank her and eliciting a yelp from the Human. I was both startled and deeply dismayed." 

Similar complaints were filed from Shirt, Bra Strap and Sweater. I'm asking that you please stop getting caught up with our guests. If you can refrain from this activity, I believe that you will have a smooth and enjoyable stay at Arm.

Thank you for your understanding. I appreciate your service and trust that we will not have any more problems in the future.


Thursday, May 15, 2014

Diabetes Blog Week Day 4- Mantras

"Yesterday we opened up about how diabetes can bring us down. Today let’s share what gets us through a hard day. Or more specifically, a hard diabetes day. Is there something positive you tell yourself? Are there mantras that you fall back on to get you through? Is there something specific you do when your mood needs a boost?"

I have two mantras, two sayings that get me through the hardest days. I share them both with you, perhaps one will speak to you and help the way it's been able to help me.

1. Tomorrow is a new day.

I get frustrated a lot by my diabetes, and I imagine that I'm not alone. I make mistakes, I see numbers that I don't want to be seeing, I deal with feelings that I don't want to be dealing with. It's easy to get caught up in the numbers and emotions each day. It's easy to look at a CGM graph that looks more like a roller coaster than a flat line and feel defeated. To feel hopeless and helpless. But you can't. Tomorrow is a new day. Tomorrow you can do better. Tomorrow you can try harder. Tomorrow you don't have to make the same mistakes that you made today. Tomorrow's numbers will be better, you'll see. Tomorrow you will feel better. You won't have those icky lows or those gross highs. You'll look at your CGM and smile, not frown and shake your head. Tomorrow is a new day. And if it's not better? Guess what, there's another new day after that.

2. You are not defined by a number. 

That blood sugar number that you see that you don't like, it doesn't define you. It doesn't show what kind of person you are, how much you care about your health and taking care of yourself, how much you care about others. That number doesn't know how much you tried to keep it in range. That A1c number that's higher than you want, it doesn't tell the whole story. It doesn't mean you don't care, that you didn't try, that you don't want to do better. You are not defined by a number. Numbers are there to help you, to keep you on track and tell you what you need to do. They are information, data collected to help you be healthier and live better. They aren't there to label you, to judge you, to condemn you. Good or bad, you are not defined by a number. No number can capture the effort you put into caring for your health: the worry, guilt, frustrations, sadness, preparation, vigilance, triumphs, determination, resilience, and all the blood, sweat and tears.

You are not defined by a number. 

You are so much more.

Wednesday, May 14, 2014

Diabetes Blog Week- Day 3 What Brings Me Down

"May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope?"

For most things in my life, my level of effort has been indicative of the outcome. That is, when I try my best and put a lot of hard work in, I can usually expect favorable results. Of course this is not always true, but it has been true in many cases. For instance, my grades throughout school, events that I put a lot of effort into planning, projects at work, you get the idea. And if the results are not what I had hoped for, it’s usually not unexpected. I usually know that maybe I didn’t study enough, or put enough thought into something, or cut corners. So if I wasn’t completely satisfied with the results, I usually knew what was to blame.

One of the most difficult aspects of living with diabetes for me is the frustration that comes with trying to keep my blood sugars under control. There have been many times where I think that I’ve done everything “right” only to be disappointed. I counted my carbs (yes, I looked them up even), I checked my blood sugar, I gave my insulin before I ate, and I checked my blood sugar 2 hours later. But despite all of this, sometimes I still end up with a high blood sugar or a low blood sugar and I have no idea why.

It’s beyond frustrating to think you’re doing everything you’re suppose to but still don’t get the result that you want. There are a million reasons why that blood sugar could be off. Maybe my infusion set isn’t working, maybe the insulin isn’t good anymore, maybe the food was actually more or less carbs than I thought, maybe the low is a result of exercise I did hours earlier, maybe I’m getting sick, the list can go on and on.

So many times I’ll check my blood sugar and just be perplexed. The number is unexpected and not what I want to be seeing. 345?! Ugh!! Why?! I’ll shake my head, I’ll audibly sigh, I’ll mutter obscenities. As much as I try to dissociate emotions from these numbers, it’s not always possible. High numbers can put me in a bad mood. They make me angry and frustrated and can often feel like a personal failure.

I can always do better. I can be stricter, more vigilant, more attentive. I know that. Most of my high blood sugars I can point to something that I did or did not do that is most likely the cause. But those high or low blood sugar numbers that are unexpected are the ones that really get to me. Those are the one’s that I hate dealing with, but you know what? You just deal. You accept that once in awhile you might not have anything to blame, sometimes you don’t have an answer, things are out of your control. But dwelling on it isn’t going to raise that low blood sugar or lower that high one. So you do what you have to do, and you move on. Because pretty soon, there will be another number, and hopefully that one won’t be unexpected.