#my blood sugar has been low enough for the past hour that my basal would be automatically set to 0 if there was insulin in my pump 🙄🙄🙄 | Explore Tumblr Posts and Blogs

type2diabetestreatments-blog · 7 years

Text

"Golden Rules" for Living with Type 1 Diabetes

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/golden-rules-for-living-with-type-1-diabetes/

"Golden Rules" for Living with Type 1 Diabetes

One of the best resources for learning about diabetes and connecting with other PWDs (people with diabetes) locally can be summed up in five letters: TCOYD.

That would be Taking Control of Your Diabetes, the national educational conference series founded by endocrinologist and longtime type 1 Dr. Steven Edelman in San Diego. He's not only a super-knowledgeable clinician and researcher, but a really funny, passionate guy who infuses these day-long seminars with energy and inspiration. Seriously, everything I need to know about diabetes I learned at TCOYD.

For the past dozen years, I've had the privilege of speaking at my local Santa Clara event, that brings in about 1,000 patients for a full day of talks, panels, activities, a product expo and a banquet lunch -- all at the affordable price tag of just $20 per person!

This year, I was honored to be on a very cool opening panel for the Type 1 Track led by another awesome accomplished endo + type 1, Dr. Jeremy Pettus (who shared his smarts on alcohol and diabetes with us here).

Our panel was titled, "Golden Rules for Type 1s: Tips for Living Well with Diabetes," and included Dr. Bruce Buckingham of Stanford, Dr. Christine Ferrara of UCSF, Adam Brown of diaTribe, and Yours Truly from the 'Mine.

I think the audience really appreciated that we weren't trying to act as if we had all the answers, but rather just talking turkey about the realities of the hour-by-hour challenges of T1D. I thought you all might enjoy hearing the answers I prepared for this session, which aren't exactly "golden rules" but my own personal best practices, such as they are...

TCOYD) Do you have an overarching philosophy with your approach to managing your diabetes?

Amy) Do just enough to stay in decent control while STAYING SANE.

Has this philosophy changed over time?

It’s only grown stronger. Not having regular meltdowns over diabetes issues is an ongoing effort.

What would you say is the most important thing that has made a difference in your type 1 life and helped you keep on track? Inner strength/approach? A healthcare provider? Family members? Your job?

The support of my family for sure, and to a large extent exercise -- which makes me feel good physically and psychologically.

I also think it's super important to connect with other PWDs for sanity checks (TCOYD is excellent for that!)

What therapy or equipment has made the biggest difference in your life (CGM, pump, rapid insulin)?

I would say the OmniPod tubeless pump and Dexcom CGM. I love being able to pump with no dangling cannula, and the CGM has been a huge game-changer in just being constantly aware of what's happening in my body. I've also been using Afrezza inhaled insulin for the past year and have found the biggest advantage of that is having less complexity with IOB (insulin on board).

As you know, injected insulin sticks around in your system for four hours, whereas Afrezza is in and out in 1.5 hours. That means way less chance of insulin stacking, going low during exercise, nighttime lows, and more.

How important, or not, has a healthcare provider been in your success?

From my POV, the priority is that your HCP does NOT annoy / judge / misunderstand you / dismiss your concerns. You need to be comfortable and feel respected with that person! I have been fortunate to find such a doctor, although I must admit I don't see her all that often.

When everything goes to shit, what is usually the reason? Travel? Life stress? Change in diet? And what do you do to get back on track?

Travel and lack of sleep are huge for me; they usually go hand-in-hand. For that, I do my best to eat as low-carb as possible and check often, plus correct often.

Laziness / procrastination are also big factors. There are lots of times when my pump is beeping that it's time for a pod change or my CGM is alarming high, and I just don't want to deal with it immediately. I don't want to have to drop what I'm doing. But the results are almost always bad. I chalk this one up to being human.

Finally, my period does wonky things to my BG levels that are hard to predict. For the Ladies reading this: am I right? Hormonal cycles have a strong effect on blood sugar, an issue that's not discussed or explored enough.

How do you deal with exercise? Does it help your BGs or make them worse?

It’s constant trial and error. I have some set Temp Basals that I use regularly for spin class, aerobics, kick boxing, hiking and other workouts, but they’re far from fool-proof. To me, the most important thing is not to have to eat a bunch of empty calories I’m not hungry for -- in other words, to avoid going low at all costs, which often means I end up high after exercise and have to spend several hours at least chasing those highs. Come to think of it, I could use some improvement in this area.

What's your approach to food? Do you eat whatever the hell you want and just bolus for it, or do you avoid certain foods? Do you have any additional dietary restrictions?

I’m also gluten-intolerant, which is a pain in the rear, but it helps keep me very low-carb. I try to eat as low-carb as possible without making myself miserable -- meaning I try to do "just a taste" of the carby foods I desire most (which for me is mainly tortilla chips and granola bars).

Overall, I just eat a lot of protein and veggies, mostly salads. Thank God I actually like kale 🙂

How involved, or not, is your significant other in your diabetes? Do you want them more or less involved? If you could tell them one thing to change, what would that be?

My partner is very supportive, but not at all involved in the daily nitty-gritty. That's usually how I like it.

If I could change one thing, I guess I wish that instead of peering over my shoulder every once in a while to ask something like, "175, wow isn't that kind of high?," he would periodically ask a broader question, like, “Hey, how’s it going with your diabetes?” and then just listen to whatever I feel like sharing -- without necessarily trying to "fix it."

What do you LOVE to eat when you are low?

Raisins! I loved to eat lots of dried fruit before I got diagnosed, and had a hard time giving that up. Now I buy copious amounts of those little red snack boxes of raisins. Did you know the mini-boxes come in chocolate-covered and yogurt-covered varieties now too? Yum!

I stash them in my car, purse, nightstand, kitchen, suitcase, etc.

I stock up so much that one day when I had a bunch of six-packs piled in the backseat of my car, I picked up my daughter and her little friend asked, "Does your mom sell raisins?!"

Tell us a time that you have used type 1 to your advantage?

This is a hard one to admit, but I've definitely used it to get to the front of a buffet line. When I get really hungry, it feels like a low, even if my BG isn't dipping too badly. If you tell people you have type 1 diabetes and need to eat now, they're usually accommodating.

I've also had my doctor write me a letter to avoid jury duty. She actually encouraged me to get out of it if possible, because it really is tough if you get stuck there for weeks on end -- in terms of being able to eat right, exercise, etc. (Before you get judgy, know that many PWDs have gone this route.)

What does "being in control" mean to you? Is it an A1C? No hypos? Time in range?

I would say an A1C of 7.4 or less WITHOUT FREQUENT HYPOS.

My good friend Dr. Richard Jackson of Joslin Diabetes Center always encouraged me to think of "good control" this way -- not as pressure for ever-lower A1Cs, but maintaining a decent level without frequent lows, which shows that you are actually staying "in range" most of the time.

Tell us about your approach to complications. If you have them, how do you deal with them? If you don't, how often do they enter your mind?

I don’t have any yet, knock on wood! But I do think about them often – especially for eyes and feet, which are my “weak spots.” Gotta get those screenings regularly!

Give us a parting piece of advice to others on how to make life with type 1 better?

I’d return to my overarching philosophy: “Do just enough to stay in decent control while STAYING SANE.”

Sanity in this case means allowing yourself slip-ups, and taking time for family, friends and activities you enjoy (and occasional food splurges) WITHOUT FEELINGS OF GUILT.

So Dear Readers, got any "golden rules" of your own to share?

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

#Diabetes Mellitus

0 notes

type2diabetestreatments-blog · 7 years

Text

Ask D'Mine: Moms Versus Dads, and Missed Shots

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/ask-dmine-moms-versus-dads-and-missed-shots/

Ask D'Mine: Moms Versus Dads, and Missed Shots

Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, Wil preps for Mother's Day on Sunday with a question about D-parents and how they get involved in the care of their kid(s) with diabetes. He also tackles a query about missing an insulin dose. Read on...

Got your own questions? Email us at [email protected]

Anonymous, type 3 from Colorado, asks: Who works harder: D-Moms or D-Dads?

Wil@Ask D'Mine answers: You realize there's no way in hell I can answer that without making pretty much everybody mad at me, right? And you also realize I don't have first-hand experience, right? I'm adult-diagnosed, and my kiddo doesn't—at this time—have diabetes. (Of course, I'm not immune from worrying about what crappy genes I've cursed the little guy with, but that's a subject for another day.)

Because of those facts, lots of people out there will be quick to say I'm not qualified to have an opinion. I disagree. I do have diabetes. I do have a mother, and my father was still alive when I was diagnosed. Working in healthcare, I do work with lots of families; and because I've written about diabetes for a decade I do get more calls, emails, and letters from D-families than I can count.

So I self-certify myself as qualified to have an opinion. And not only that, I'm just far enough out of the loop to have a neutral one. No doubt if I were a D-Dad, I'd think D-Dads are the harder working of the pair.

On that note, let's start with the D-Dads. We don't really talk about the fathers of D-Kiddos much in the community, but they're certainly out there. And here's what I've observed about them: D-Dads are utterly amazing. They are smart, loving, dedicated, protective, energetic, nurturing, and career-icidal. So, basically everything D-Moms are. In fact, in my book there's only one thing wrong with them: They seem to be in short supply. Yep. In my observations, the vast majority of the rearing of D-Kiddos seems to fall on the fairer sex.

I don't know if it's a matter of maternal or paternal instincts, the patterns of our culture, or the income disparity between the earning power of the sexes in our economy. I doubt it's the first one. Men are certainly capable of loving their children as much as women are, although, as a male, I'm ashamed to see the number of men who walk out on their families. (Also on a somber side note, I'm shocked at the number of divorces I've seen in the D-Family pool. Maybe the extra stress of a D-Kid is the straw that breaks the camel's back of a relationship that might not have been quite strong enough on its own, but my advice to D-Parents of both sexes to avoid being exes is: don't forget you have a partner. Taking care of the kid can seem to take all the air in the room, but only if you let it. You need to take care of each other, too.)

Sorry, my mind wandered off course again. Where were we?

Oh yes. Culture. Well, historically, men were the breadwinners and women were the homemakers. Although the idea is a bit outdated in these modern times, and not too realistic in this economy—I don't personally know any one person who makes enough in any one job to support a family, but then again I don't know any U.S. Congressmen, either. Still, I suppose some people might fall back into traditional cultural patterns when faced with a "who works, who takes care of the kid?" situation.

And speaking of who works, that takes us straight into money. If the man makes more than the woman, and that's not always true, but national statistics show us this is still the rule, then it would make financial sense for the family to keep the higher salary, and that could lead to a D-Dad working three jobs to try to support the family, plus the huge costs of supporting diabetes while D-Mom stays home with the kiddo. I'm sure some families make that choice, but I'm not sure that alone explains the missing men in our community.

Maybe they aren't missing at all. Maybe, for whatever reason, D-Dads just aren't as active in social media. Research does show that women use social media more than men do—by 62 to 74%. Still, those numbers don't explain the lack of men in this space. Maybe D-Dads really are as common as D-Moms, but they are being the strong silent types about their role.

I hope so. But I kinda doubt it.

So, to your question: Who works harder? Hopefully they won't take away my membership in the Guy Club for saying this, but I gotta go with the evidence I can see, and I see more D-Moms carrying more of the burden of care. There are some really hard-working D-Dads out there, but from what I see, overall, the D-Moms work harder.

But whether you agree with me or not, tomorrow is Mother's Day. Everyone has a mother, and many of us non-hard-working guys are married to women who are mothers. Mothering, with or without diabetes in the picture, is hard work with little recognition.

So, Gentlemen, do something special for the mothers in your life tomorrow. Not flowers, candy, or jewelry this year. Instead, to show you care and understand, I suggest you fill in for them at "work." And let them take a day off.

Glengary, type 2 from Kansas, writes: I take two shots of basal insulin a day. If I miss my dose of insulin at 5 p.m., and it's ten-past 9 p.m., what should I do?

Wil@Ask D'Mine answers: This is one of those "do whatever it is your doctor told you to do" kinda of questions. Of course, the problem is that most doctors never address this issue at all, so I'll have to.

Basal insulins, in theory, last 24 hours. In point of fact, they generally don't, but they last at least three-quarters of a day or more in most folks. This causes a problem when you miss a shot and take it late, because you're at risk of "stacking" the late shot on top of the next shot. Stacking can double the effectiveness of the insulin for several hours, setting you up for a nasty low blood sugar.

Hmmmm.... That's rather boring and technical. How to describe it better?

OK, well, it's crude, but let's pretend your body is a toilet (come on, admit it, we've all had days when we feel that way). Let's say that for whatever reason your anthropomorphic toilet didn't flush quite right. The water in the bowl is waaaaaaaay up at the rim. What's likely to happen the next time you flush it? Right. The damn thing will overflow and flood the bathroom floor.

The same thing happens when you take a late basal shot. The next shot overflows the pot.

In your scenario, your shot—if you take it—will be more than four hours late. I think we can be pretty sure that will overflow your toilet the next day when you take your next shot. Of course, if you don't take anything at all, your blood sugar will go high because you won't have enough insulin in your body. I'm not sure how to plug that into my toilet analogy, but it probably has something to do with the water valve or a plunger. Anyway, you're damned if you do, damned if you don't. So what should you do?

The answer is to split the difference. Literally.

It's not perfect, but a workable solution is to take a percentage of your missed dose. You're gonna do a half-flush, like one of those new dual-valve water-saving toilets (up for liquid waste, down for solid waste). Because you take two doses a day, each shot "controls" 12 hours, even though they last longer. I recommend that you divide your dose by 12 then subtract the number of hours you are overdue.

To illustrate, just making some numbers up, let's just say your missed shot was 50 units (don't freak out type 1s, this is a common T2 shot). Fifty divided by twelve is 4.17. You're 4 hours late, so 4 times 4.17 is about 16 and a half. So reduce your dose by that much. Instead of 50, you'd take 34 units.

Again, it's not perfect, but it reduces both the stacking risk and the damaging effects of doing nothing.

Plus, you won't have to call a plumber.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

0 notes

type2diabetestreatments-blog · 7 years

Text

Ask D'Mine: No Insulin Needed?, Alternative Medicine's Bad Rap

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/ask-dmine-no-insulin-needed-alternative-medicines-bad-rap/

Ask D'Mine: No Insulin Needed?, Alternative Medicine's Bad Rap

Need help navigating life with diabetes? Email us at [email protected]

Yup, you guessed it: it's another edition of our new diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

Alex from Canada, type 1, writes: I was diagnosed roughly 9 months ago. Since then, my insulin requirements have increased every now and then. Last week, I needed 16u of basal insulin in the morning, and from that I work on a sliding scale of rapid on a 15:1 ratio. But in the past two days, I have had so many lows that I didn't take insulin with any meals. Now I've spent the last 48 hours without any basal or rapid insulin. My question is: why?

Wil@Ask D'Mine answers: As I read your email my head starting literally brimming with possibilities. I just love, love, love medical mysteries—this kind of stuff makes my job fun! The top three things that came to my mind were: Custer's Last Stand, prairie dogs, and lazy stock boys.

Bear with me.

Custer first. So, as you're somewhat new to the D-family, this could be a garden-variety case of honeymoon phase. We covered what that's all about in our October edition here; just scroll down to the picture of the syringe and start reading at that point for a refresher on what type 1 diabetes and Col. George Armstrong Custer have in common.

Second, prairie dogs. There's always a remote chance you were a glucose-toxic type 2 misdiagnosed as a type 1. We covered what that's all about in November here; just scroll down to the second question to learn what the pancreas, eagles, high blood sugar, and prairie dogs have in common.

As to the third possibility, it's time to break out a new analogy. Everyone, please meet the lazy stock boy. Lazy stock boy, meet everyone.

We all know what a stock boy is supposed to do, right? His job (or her job, I wasn't dissin' lazy stock girls) is to replenish the stock of goods for sale in retail stores. Done right, the job is much more than just putting boxes of Post-Toasties on the shelf at Safeway, because most grocery items have a limited shelf life. Milk goes sour. Bread gets moldy. Chips get stale. Even beer has a "best used by" date stamped on the can. Or so I'm told.

So a properly trained and motivated stock boy not only re-stocks the shelves, but rotates the stock—placing the newer stock in the back and pulling the older, but still sellable, stock to the front. Oh yes. And the stock boy is also supposed to pull stock off the shelf that's past its expiration date.

That's actually a pretty complicated job for one that pays minimum wage. At night. Which is why it's so easy to get home with your groceries and find you just bought sour milk, moldy bread, stale chips, and un-drinkable beer. Milk, bread, chips, and beer, of course, make up the now-retired My Food Square Nutrition System. (Wink).

And this has, what, exactly, to do with diabetes?

OK. Now all of you. Get up. Go to the bathroom. Look in the mirror. Be honest with yourselves. Are you lazy stock boys and girls?

That's right. All your diabetes meds and diabetes stuff are like milk, bread, chips, and beer. It's only good for so long, and you and you alone are responsible for rotating the stock.

Alex, I see that you take 16u of basal insulin per day. Well, more correctly, you said last week you needed 16 and you had been titrating up. That tells me that a few weeks ago you were probably using even less.

So I gotta ask, when did you start using your current vial of insulin? 'Cause at 16u a day, a vial would last you sixty-two and one-half days. The problem being, of course, that once you pop the top it's only good for thirty days. You might have been injecting sour milk for thirty-two and one-half days.

Now, of course, insulin's useful life can be stretched. It's really not like milk, good one day, vomit-worthy the next. But it can lose its potency pretty quickly. If you were titrating up insulin that was spooling down, and then popped open a fresh one, you might have effectively over-dosed yourself, leading to the chain of lows. Maybe I could be clearer: if you're increasing doses of insulin that is getting weaker every day, then you aren't really titrating to your body's needs; you are titrating to the reduced action of the aging insulin. When you open a fresh one, WHAM! You have a boat-load more insulin than you need, and, to make matters worse, it's a 24-hour-action insulin.

My advice to everyone who uses little enough insulin that a vial or pen won't be empty in thirty days: get a sharpie out and write your own expiration date on the bottle or cartridge.

Then no more lazy stocking!

Jay from Nevada, type 2, asks: Why are medical associations against "alternative" medicine? My current doctor seems to think it's all snake oil.

Wil@Ask D'Mine answers: Fish oil has been absolutely proven by Western Medicine to lower cholesterol. I'm sure it's only a matter of time before the benefits of snake oil will be scientifically demonstrated as well.

But seriously, there's an interesting history behind the attitude of many modern docs towards the universe of alternative medicine. And that history isn't very old because, frankly, modern medicine isn't very old either.

Here's the story: Many of the practitioners of modern medicine would have you believe that Western Medicine traces its roots directly back to Hippocrates in ancient Greece. Nothing could be further from the truth. Our current tradition of Western Medicine, commonly called scientific medicine on the inside, really only goes back about 200 years to the early 1800s. At that time, in fact, scientific medicine was just one of a large pack of competing medicine systems to choose from that also included homeopathy and chiropractic medicine. Hard to believe now, but back then, the medical system we all take for granted today was a barely respectable trade, not well-regarded by much of anyone, and frankly, as likely to kill you as help you.

Then, in 1846, a rag-tag medical rabble formed the forerunner of the American Medical Association. This organization became the enforcer of scientific medicine over the years, using both fair means and foul. Don't get me wrong, the AMA's done plenty of good, and continues to up to this day; but its early mission was to simply put everyone else out of the medicine businesses.

They came damn close to doing it, too.

To their credit, however, they also cleaned their own house while trying to evict everyone else from it. Don't forget that in the mid-1800s anyone could call himself a doctor; there was no accredited system of education or government licensure in place. Dentists had better training than doctors at the time. But by the end of the 1800s the AMA had successfully lead the charge to require a license to practice medicine in every state in the Union. In the early 1900s they took on initiatives that effectively overhauled medical schools, bringing them, literally, out of the dark ages.

But the AMA was also focused on the survival of the fittest, and went to great lengths to stamp out the competition: alternative medicine. Remember that at the time, alternative medicine included just about all the other guys in the field of medicine. You can read more details about the battles between the different "camps" of medicine in Jon Queijo's entertaining book Breakthrough.

To this day, there are many bone-headed died-in-the-wool white coats that're suspicious of everything that doesn't smell like science, a legacy of the AMA's work. In fact, most medical schools today teach the latest incarnation of Western Medicine, called Evidence-Based Medicine, that requires any therapy to be validated by clinical studies before being used in the health care trenches. That said, many modern docs are taking a longer view. A more open view. The sum total of what we do not know overwhelms the sum total of what we do know. A few medical schools are now teaching something called integrated medicine; and I've even seen doctor's referrals for acupuncture. So the times are changing. I don't think that would have happened in 1950. Or 1960. Or 1970. Probably not even in 1980, either.

Doctors, once banned from even associating with chiropractors by the AMA, now will send patients to them. Medical massage is widely recognized. Diet and exercise remains a valid therapy for type 2 diabetes—that's a pretty non-medicine approach, if you think about it.

Scientific medicine has a great many strengths, but it does tend to micro-manage illnesses. It tends to single out symptoms and attack them. It sometimes ignores the person in purist of the illness.

Alternative medicines, on the other hand, while ranging from blatant quackery to highly effective treatments, tends to be better about viewing the person as a whole. And I mean that in the widest possible way: not a whole collection of cells, and organs, and systems; but rather body, mind, and soul. And that's why alternative medicine is rapidly regaining popularity after two centuries out in the cold.

Personally, I don't think alternative medicine has all the answers, but I know that scientific medicine doesn't either. I believe that we can intelligently blend various approaches. But we can't be kooks about it either. If you want to drink cactus juice to lower your blood sugar, be my guest. Just don't stop taking your prescription medications in the meantime.

As to your doc, you're not married to him or her (well, you could be, but I'm assuming you're not); if you think your doctor is closed-minded, go shopping for a new one. Just be sure to check the expiration date to make sure his/her attitudes aren't sour, moldy, or stale. Those damn lazy sock boys are everywhere!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

0 notes

type2diabetestreatments-blog · 7 years

Text

Lessons Learned While Traveling

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/lessons-learned-while-traveling/

Lessons Learned While Traveling

I've lived with type 1 diabetes for the past 18 years and I travel by plane for business or pleasure (or both...) almost monthly. You probably think that by now I'd have traveling with diabetes down pat. But in true diabetes fashion, I'm constantly learning and re-learning D-management tweaks all the time — especially when on the go!

The Insulin Debacle

This past weekend, my husband and I traveled to Phoenix for a family wedding. It was the end of March and it was my second time packing a suitcase that month. Feeling confident and prepared to travel to the Southwest, we were off! While on the plane, my insulin pump alarmed that my reservoir (the drum that holds insulin) was low, and I'd need a refill soon. I checked and had enough basal to get by for a few more hours, so I decided to wait until lunch rather than dig through my carry-on suitcase.

When we arrived in Phoenix, we were starving, so we headed to a local Mexican restaurant with excellent reviews. Settled in with a full basket of chips just calling my name, now was the perfect time to fill up with insulin. But it was still in my suitcase.

"Hey honey, could you run to the car and grab my insulin and a reservoir?" I asked my husband as I took out my meter to test. Minutes later, he returned, handing me the reservoir with one hand while fishing out the bottle of Humalog with the other. Or at least, that's what I thought he was doing.

Next thing I know, the bottle of insulin is rolling out of my husband's hand and onto the table, and then rolling off the table and onto the tile floor of the restaurant, landing with a loud Crack!

Yikes! As I picked up the bottle, I could feel the cool liquid dripping down my hand. The bottle of insulin? Destroyed. Completely totaled. No chance of survival. A gash in the bottom of the bottle was now leaking dozens of units of precious insulin.

Dead on arrival

Lesson Learned: I was actually good in this instance. Even though I haven't broken a bottle of insulin in over 10 years, as a rule, I always bring two bottles of insulin (or more) when traveling. My husband retrieved the other bottle from the car (handled with care!) and I was all set for my crab enchiladas.

The Insulin Pump Debacle

The next day was the wedding. A bright, hot March afternoon, a lovely ceremony and a beautiful bride. We entered the ballroom and sat down for dinner. I tested my blood sugar while chatting with family, and my meter (an UltraLink) transmitted my reading (a respectable 184 mg/dl post-appetizers) to my Medtronic insulin pump. I wasn't quite ready to bolus yet, so I just left things as is. Until I noticed a faint squeal coming from under my dress. You know, where I had my insulin pump clipped. Stuck between my Spanx and my skin sat my insulin pump, and it was not happy.

"Button Error," it yelled. Oh no. Not here. I tried clearing the alarm, but to no avail, so I turned off the pump by taking out the battery. I did this twice. It didn't work.

Party crasher

"My insulin pump is broken," I told my husband. Judging by the look on his face, I'm not sure he realized that was possible. "I have to call Medtronic." I hurried outside. After a brief call with the Medtronic rep, an insulin pump was on its way. It would ship overnight, but it wouldn't arrive until Monday morning (because obviously when pumps break, it will be on a Saturday night).

Since we were leaving the next day and I had a spare insulin pump at home, all I needed was a day's worth of basal. I frantically called Mike Lawson, one of our cartoonists here at the 'Mine, who lives in Phoenix and uses Lantus. I left him a voicemail and then sent out a half-dozen SOS messages on Facebook and Twitter. When my husband came outside to check on me, he gently reminded me that three of his family members at the wedding are doctors. I sure married into the right family! After a quick phone call to a pharmacy less than a mile away, I was set with a bottle of insulin and more syringes than I could possibly use.

Lessons Learned: A few. Namely: for crying out loud, bring a prescription for Lantus with you when you travel! Keeping your emergency prescription(s) in the medical folder of your filing cabinet is not helpful when your pump dies while on vacation. Or maybe that's just me. Although I have not dealt with a pump failure in almost 7 years, they can happen without warning and are completely unpredictable. It's always better to be prepared than scrambling during an important occasion to get what you need to survive.

The TSA Debacle

Our trip to Phoenix was short, and we were at the airport before noon the next day. Free of an insulin pump, I was thinking that for once in my life, security was going to be a piece of cake. The TSA officer motioned me through the regular metal detector, which I was actually disappointed about because this would have been the perfect time to go through the backscatter machine hassle-free! *Sigh* Thinking I was free and clear, I gathered my belongings. Then suddenly another TSA officer holds up my purse and says, "I need to examine this bag." Assuming it was related to the pack of syringes, I paid no mind to this small delay.

She held up my Juicy Juice juice box. "This is 6.75 oz."

Yes, yes it is.

"I'm a diabetic," I explain.

"I need to test it," the TSA officer says.

"But I've gone through security plenty of times with this," I reply. And I have. Dozens of times. Never had an issue so far.

This doesn't seem to faze the officer. "I need to open it to test it." It's a juice box. You can't re-seal a juice box.

Blood boiling, I wave my hand. "Just keep it." I stalk off, holding back tears from the injustice of it all and the aggravation diabetes has caused me this weekend. My husband attempts to console me, but I just need to cool down.

Lesson Learned: You mean other than confirming that the TSA sucks? *Sigh again* As Jeff Hitchcock pointed out when I vented on Facebook, juice boxes are totally legit in passing TSA security. But my protestations weren't going very far with this woman. I could have argued with her more. I could have requested to see her supervisor. Or I could have brought that document from TSA explaining what diabetes supplies are approved to go through security without issue. Guess which one would have been easier? Yep -- the darn piece of paper.

Moral of the Story

There is a never-ending list of ways diabetes complicates life, and issues in traveling are nothing new. I've been lucky to have made it this far without having many issues. I know many, many more people who have had much more painful encounters with TSA over insulin pumps and bottles of insulin, but the combination of all three within 48 hours was just too much.

With the summer travel season kicking into high gear soon, do you have any D-travel lessons that the rest of us could learn from?

My main lesson from this experience? While my vacation was still lovely, what I could really use now is a vacation from diabetes!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

0 notes

type2diabetestreatments-blog · 7 years

Text

D-Blog Week: Celebrating Pump Prowess

New Post has been published on https://type2diabetestreatment.net/diabetes-mellitus/d-blog-week-celebrating-pump-prowess/

D-Blog Week: Celebrating Pump Prowess

Welcome to Day 2 of the third annual Diabetes Blog Week, hosted by Karen Graffeo over at Bitter-Sweet Diabetes.

The topic today: One Great Thing. Karen explains: "Living with diabetes (or caring for someone who lives with it) sure does take a lot of work, and it's easy to be hard on ourselves if we aren't 'perfect.' But today it's time to give ourselves some much-deserved credit. Tell us about just one diabetes thing you (or your loved one) does spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well! "

OK, so this might sound stupid, but for years I was afraid to change the settings on my insulin pump. I mean, sure, I could set an extended bolus or create a new temp basal, but the idea of monkeying with the basic settings just plain scared me; that seemed like something only my doctor and CDE would have the know-how to handle. (So much for "empowered patients" — I know.)

So I just left the basic basal settings as they were, until every once in a while when my endo suggested a little 0.1 bump-up or drop-down here and there. Meanwhile, for a long, long time (I'm not even sure how long), I would wake up between 2 and 4am feeling low. Not passing-out low, but kinda-sweaty, having-weird-dreams low. I'd be uncomfortable enough to have to get up, eat some glucose tabs, and sometimes change my damp nightgown. I could never sleep late, because even when I made it past the witching hour, I'd still hit the '60s and get all shaky by 6am.

In retrospect, it seems pretty obvious that my late night/early am basal settings weren't right. But for some reason, I just kept assuming it was something I was doing wrong (almost every night?)

Until one early, early morning, while dragging myself to the bathroom as usual, a thought crossed my mind:

Is this insulin pump running me, or am I running it?

Well, heck, that was it! That did it!

It kind of hit me over the head that it was darn-well time for me to have a good, hard look at the basal settings on my pump and stop being afraid to experiment a little. After all, it is my body this thing is attached to.

... and I could still seek out an expert opinion for backup, even while taking the DYI approach. So with a little key input from CDE extraordinaire Gary Scheiner, I changed my settings for the hours between midnight and 3am, and from 3am to 7am, waited a few days, and then made a few more tweaks — and whala! What a huge improvement! I sleep better, and my whole entire day is less of a #bgnow roller coaster.

This may not qualify as "spectacular," but it is one great thing that I'm feeling relieved and proud to have finally mastered.

In your face, Diabetes!

See who else is participating in D-Blog Week by clicking here

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

0 notes

type2diabetestreatments-blog · 7 years

Text

Going Low and Losing Time

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/going-low-and-losing-time/

Going Low and Losing Time

Out of nowhere, time can slip away from us when a high or low blood sugar comes at us unexpectedly.

This happened to me the other day, hitting me like a sucker punch in the gut and stealing a couple hours of my afternoon.

Thanks to that Low, those hours are time I'll never get back. Still, I'm so very grateful that I was able to eventually catch this hypo and treat it myself, and it didn't happen overnight when my radar for sensing lows seems to go quiet. We have to be grateful for the small blessings, you know?

Besides the considerable risks, what I hate most about these "hypo excursions" is the sense that precious hours of my life have been robbed from me, gone down some unforeseen rabbit hole.

In this case, a cause isn't tough to pinpoint. I'm assuming it was the fact that I recently began an insulin pump vacation, to take a break through the start of the year, and have gone back to multiple daily injections. While no stranger to the pump hiatus (I've been on two in the past three years), it's always a change that takes my body time to get used to.

My pump use dates back to my final year of college in 2001, and before that I was on two or three injections a day since the time I was diagnosed at age five. But I'm not one who follows the FDA's guidance of rotating my infusion sets as often as one should, so my skin tends to get worn out and I often look like a bruised and battered pin cushion. There's some significant scar tissue.

So I've gotten used to taking the intermittent pump hiatus and "being free" from that contraption for a bit. Don't get me wrong: I love pumping, think it's all kinds of groovy and plan to happily return to that flexibility of dosing. But my body needs time to heal, and the pump vacation mixes things up and allows me to change my routine that doesn't often get the chance for a refresher.

I'd been mulling over this most recent break for a number of months, and finally decided to begin the day after Thanksgiving. But on Day 6 the bottom fell out of my seamless transition and my D-Management caused me to nearly fall of the cliff (not Congress' "fiscal cliff" of course, but the BG Cliff that we PWDs know all too well...)

Diabetes can take you over the cliff in a couple of ways.

With Highs, it takes the form of us feeling that we're stuck in molasses. Tired. Can't get motivated. Just feel under the weather and as if tucking our heads back under the pillow would make it all go away.

With Lows, so often we just find ourselves quickly gorging on fast-acting carbs and then waiting... waiting for higher BGs to arrive, waiting for safety, waiting before getting behind the wheel or carrying on our workday or studies or whatever life activity has been so rudely disrupted by these unwelcome symptoms.

In that Low I mentioned late last week, I lost several hours of work time thanks to a hypo that hit without warning. That day, I'd forgotten to take my basal dose of Lantus first thing in the morning, so I had to catch up by taking the shot three hours later than usual. As a result, the typical kick I get right after lunch was delayed by a few hours, causing that late afternoon Low.

It seems clear to me now, although it wasn't then.

Not wearing my Dexcom continuous glucose monitor (CGM) thanks to my current scar tissue hiatus, there was no early warning this time.

I remember the blurry vision, the cold shivers, my inability to concentrate. But instead of mentally connecting the dots and treating that hypo immediately, I managed to convince myself I was just tired and needed to take a nap.

And that's when I disappeared. Missed a phone conference... Didn't respond to emails or texts from Amy.

Being that I work from home and the only one at my "office"" with me during the day is my dog, this could've turned out badly... Thankfully, it didn't. I managed to wake up, realize what was happening, and pull myself out of it enough to treat.

About two hours had passed by the time I came out from under this Low and inhaled some of the glucose gel that was on hand. My sensibilities flooded back, and I realized how much valuable time had been lost.

Sometimes, these Lows happen and you can't prevent them. Sometimes you don't know why, while sometimes you do. Either way, they aren't welcome and are scary as hell.

I hate using excuses about diabetes when it comes to work or any part of my life, but when these incidents come up, I'm so incredibly thankful for understanding people who "get it" or at least don't give me grief.

And when you feel like you're losing precious hours of your own life due to frustrating factors beyond your control, it's invaluable having that kind of support.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

0 notes