Thursday, September 30, 2010

I fought Chinese food...

and the Chinese food won:

Holy Dex mountain, batman!
I think I need to start doing a 40/60 dual wave - the MEF backlash always happens because I tank shortly after eating my meal...and then have to chug some juice and stop my square 3-hour delivery for fear of killing myself. Right around midnight I start to pay for my error. And then, of course, I aggressively correct that sucker upon waking and end up low on the subway.

Tinkering, tinkering, forever tinkering!

Wednesday, September 29, 2010

CGM: The Third Revolution. (And my bestest friend.)

Today's Google reader yielded up a lot of food for thought from the DOC.

The first was Holly's post over at Arnold and Me about her changing basal rates as autumn kicks in. I've been seeing a running theme on Twitter about basal increases the past couple weeks, and so it's already been kicking around my head. I'm not having the same issue (at least not yet), but I find myself completely intrigued by the idea. What could possibly cause such a thing?! Logically - and we all know the D has very little to do with logic - you'd think the cooler weather would be better for insulin efficacy, site adhesion, and all the rest of that. Seems it isn't so, though. Could it be a slight change in diet (more cooked foods, less cold salads and whatnot)? Being a tiny bit more sedentary (warm blankets and the couch instead of being outside)? Or do our bodies actually do a change in hormones for the season/change in light? Like I said, I can't stop wondering. It's like poking at a loose tooth.

The second interesting post, for me at least, was at Diabetesmine: Beyond Fingersticks: Airing CGM’s Dirty Little Secrets. The brief book review was great, but it was the "CGM as the Third Revolution in diabetes management" (after insulin and home glucose monitoring) that really stuck with me.

I know that my Dexcom has completely and totally changed the way I approach my diabetes management. I've been doing this for 16 years, have seen countless CDEs and endocrinologists, read all the literature, filled out endless logbooks, counted carbs, injected/bolused insulin, grappled with the aftereffects of high and low blood sugars, and even found small bleeds in my eyes - and nothing in all of that has made me more hyperaware of what living with this disease looks like minute by minute.

When I'm not hooked up to a sensor, it's easy to ignore my diabetes - if only for 5 minutes. I can watch a TV show, take a shower, sleep, whatever and not give more than a passing I should do a blood sugar soon thought. But now that I use Dex, I have learned a great deal about how much I was "cheating" the rules and have adjusted a lot of the ways I take care of myself.

 Is it weird to want to hug electronic equipment?

For the first time, I'm actually doing my insulin 15-30 minutes before eating so that I can avoid that giant Dex mountain I discovered back in February. For years I've been told to do this, but a thrice-daily "Holy CRAP, look at that postprandial hump!" does wonders to underscore the fact that the doctors were actually right.

I've become more careful about the foods I eat, since I now see how they move my blood sugar, both in speed of rise and change of number. Pizza has always been a MEF, but I'm finding a lot of foods who are secretly in that enemy camp and require devious strategizing to defeat.

I feel safer going about my day knowing that I have the secret insider's scoop about which way my blood sugar is heading.

I'm much more cognizant of how my body is a finely-tuned machine (all those teeny tiny basal changes!), and that's engendered a bit more respect for it than I've had since 1993. This is no small feat. I, like so many in the DOC, have struggled - and will struggle - with food and a sense of deep betrayal. That I feel anything but anger or disappointment or any of the hundreds of bad feelings I've always had about my body and health is an immense shift. I'm not all the way there, but these are baby steps toward a better disposition and I think my regimen changes have a lot to do with it.

CGM has absolutely been my own Third Revolution, after Humalog/Lantus (eat me, NPH!) and the pump. For me, Dexcom is a complete game-changer, welcome eye-opener, and wonderful-if-annoying prod for accountability. I feel naked without it and rely on it to the point of near obsessiveness. Most amazing of all, though, it gives me hope for what advances might be next and the desire to be as healthy as possible for when they arrive.

Friday, September 24, 2010

Welcome, Dexcom the Third

He arrived at noon:

 A third! Do we think this Dexcom needs a monocle or something?

I immediately plugged the him into the wall, shut my door, and put in a new sensor (in my thigh! for the first time!). For the record, kids, if you're using the Dexcom write down your transmitter number someplace. That way, when you have 3 days left on a sensor and you have to replace your receiver, you can just restart the damned thing instead of putting in a new one so you can see what your ID number is. Like I had to do.

Unlike my last go round with Dex Jr. - I'm an old pro at this now! Being on receiver #3 since February will do that to a girl - my new gear came with a new item:

It TOTALLY looks like a pee cup.

I was confused for just a moment, and then I realized they didn't want me to send them urine. They wanted their used sensor back. (Ew.) I had to have B fish that little sucker out of the garbage at home (ew, again), but it shall be sent off to California on Monday.

Let's see if we can get more than a handful of months out of this one, hmm?

Thursday, September 23, 2010

'Betes, bridesmaiding, and the roller coaster of gloom

Last weekend, B and I took off upstate for one of my best friend's weddings. (We've been friends since 8th grade!) Not only was I ridiculously excited to be heading to home territory, I was also going to be in the wedding party AND would get to see B in his brand-new foxy suit. The weekend was bound to be amazing.

And it was! For the most part, everything was pretty smooth sailing:

  • The tailor put a hidey-hole "pocket" in my dress that was completely invisible but allowed for easy access to the pump clipped to my Spanx. (Alas, no true pocket - the matte satin and cut of the dress simply did not allow for pump bulge.) I'd been nervous about trusting my cuff for all the dancing and walking down aisles I had on my agenda, and I think this was the perfect solution. If only I could afford to have her put faux pockets in all my dresses
  • I remembered all my supplies. Well, except for the Dexcom charger. Which sucked, since it would have been nice to have that information during a weekend of different eating habits and restricted access to food and meter.
  • My hair and makeup - while quite over the top for me - didn't make me look like some strange Barbie version of myself. It did, apparently, make me look like a "naughty librarian" though. Oh, the laughing from our table mates when we heard THAT one from another guest...
  • The mushroom tart I had for dinner was AMAZING. (Although there was a bit of a disaster post-ceremony where I accidentally ate something with crab in it and thought I was going to projectile vomit all over the pretty wedding party.)
  • So many of the people I'd met over the past few months, and the new ones I met for the weekend, were great. A lot of folks I thought "I could be friends with this person if I met them at home." Not surprising that someone I love so much has a lot of wonderful people in her life, but it still made me really happy to see.
All those wonderful things, though, and I couldn't help but feel a little sad that it couldn't just be normal. That I had to get a pocket sewn into my dress, that I worried about my pump and the sweat from dancing, that I had to carry the biggest purse around for my meter and other D-necessaries, that I kept checking for VPL (Visible Pump Lump), that I was too shamed by my all-over BGs and eating to send the logs from the weekend to my CDE, that I even HAD to log while I was sitting in the bridal suite waiting for my turn with the makeup artist, that my numbers kept climbing because of all the excitement about the wedding and my stress about tripping while walking down the aisle (full-length gowns are no joke!), that my diabetes - as usual - took precedence over everything and I couldn't just enjoy the event like everyone else.

So I returned to Brooklyn - my poor, tornado-damaged borough - on Saturday with a bit of a heavy heart. My numbers, as is always the case, reflected my doom and gloom, making mountains and valleys on my log graph and making me feel like I got run over by an MTA bus.

And then Monday happened: happy news from my CDE about the logs from the previous week. Immediately, I was in love with the world again. Working 12-hour days? Pshaw. They loved my numbers! Missed deadlines because of coworkers? No matter - think of that email! I've spent the week swishing and twirling, thrilled at the change in circumstances (and the end of my self-flagellation - I mean, c'mon. She LOVED MY NUMBERS)...until this morning happened: Dex Jr. inexplicably kicked the bucket, shrieking and seizing his way to death as I exited the Q train.

Rough week for Karen and the 'betes - the emotional roller coaster is as bad as the simultaneous BG ups and downs that have accompanied it. I know I'll come back up (always do!), but damned if those dips aren't brutal.

Another dearly departed?

I think Dex Jr. just kicked the bucket. And he was such a recent addition to the family! SO. AGGRAVATING.

Tuesday, September 14, 2010

My bookshelf: The Hunger Games

I started Suzanne Collins's The Hunger Games Monday morning. I cracked that little guy open - an oh-so-perfectly squat, sturdy hardcover - on the Q train platform, and was completely hooked by the time I arrived in midtown. I flew through the pages during my return to Brooklyn, impatiently finished my freelance work, and then leapt into bed to find out what happens to Katniss.

It's been a long while since I've had a book that makes me scurry to the train, and I'm heartbroken now that I'm finished with Book One. (Yes, in less than 36 hours. Yes, I went to work.) I just couldn't put that chubby little book down, and I'm ashamed I didn't pick up the series sooner - what's not to love about a book that's a little 1984, a little Shirley Jackson's "The Lottery," a little Stephen King's "The Long Walk"?

To some, I know the fervor with which people love these YA-crossover novels seems a bit...odd. After all, don't we have an overwhelming number of novels available for grownups? Aren't there enough adult stories to be devoured and loved? I'd answer that with a resounding yes, but I'd also say that kind of misses the point. Rarely does an adult novel read like Harry Potter or Twilight - a story intended for adults can be well-paced and exciting, of course, but it doesn't seem to breathlessly gallop across the pages like a YA novel does. I read these crossover novels with my fists clenched, holding my breath and cheering on the protagonists. Adult novels can stir great emotion, but YA novels bring me right back to my teenage years and the uncontrollable, buzzing energy of that age. I don't want to just feel when I read these. I want to shout at the pages, hoot with happiness and howl with rage as the occasion requires.

For a few hundred pages, I remember what it's like to read without a lit criticism class swirling in my head, without 16 years of experience telling me how the real world works, without having a perspective that's already pretty formed and solidly reinforced by life. I remember how it feels to read for the pure joy of reading - not because you should check out more works in translation or "Gosh, I never did read Anna Karenina" or some reviewer in the Times raved about the latest doorstopper tome, but because it's exciting to live someone else's life, to try on a new perspective, to visit a new where or when. Reading these novels makes me appreciate my love of reading, and reminds me why it's there in the first place.

Hot damn, I can't wait to start Book Two.

Friday, September 10, 2010

Ahem: MeMeMeMe!

I'm not practicing for my aria - I'm just prepping for the blog meme Kerri and other D-OC members have rolling around the interwebs. It's been a busy week for yours truly, and this couldn't have come at a better time. So, without further ado: 

What type of diabetes do you have:  Type 1

When were you diagnosed: December 2, 1993. My 17th diaversary is coming up! As it's my favorite number, I'm going to need to come up with some form of celebration....

What's your current blood sugar:  Meter says 126, Dex Jr. says 119

What kind of meter do you use:
  One Touch UltraLink for my pump

What's a "high" number for you: More than 140 mg/dl, now that I'm trying to get the Holy Grail of a sub-6.0 A1c

What's do you consider "low": Less than 65 mg/dl

What's your favorite low blood sugar reaction treater: Apple juice when I'm home, but Lifesavers or Sweetarts if I'm at work 

Describe your dream endo: A doc who
  • listens to me
  • actually answers my questions
  • understands that they might know medicine but I know my body and what it's like to live with this disease
  • who treats me like I'm an active participant in my own management - that I don't just want to be told what to do, but WHY I'm doing it so that I can take care of myself better and better
What's your biggest diabetes achievement: Going on the pump a year ago. I have a sheer terror of automated medical stuff (for the life of me still can't use any devices for lancets - it's all manual), and I had to summon all my bravery to take that step.

What's your biggest diabetes-related fear: For me personally, blindness. I've already got minimal retinopathy, and I get sick thinking about it getting worse. For others: I want to have kids at some point, and I know I'm going to be a wreck while pregnant (what if my BGs boil the baby?!?) and after (when will B lose me? Will I see my kids grow up?).

Who's on your support team: 1) B's my biggest cheerleader, a source of strength, and the only person I know who routinely makes jokes about my loser/failure pancreas. (Please picture me having to defend the thing. "It's not its fault! It was my overachieving immune system!") I couldn't do half of what I do without him on my team.  2) My other biggie is the D-OC. Cheesy, maybe, but it's been revelatory to "meet" so many people who live with diabetes every day. I didn't go to any camps growing up, didn't know any other T1s. It's only been the past year or two that's brought me into this community and it's been an incredible comfort.

Do you think there will be a cure in your lifetime: No. I think there will be more tech advancements, and we'll get more tools to help us live healthier, longer lives. But I don't think there will be a cure - and if there is, it won't be available to us veterans. Still, preventing others from getting this disease that's such an albatross? I'd be down with that.

What is a "cure" to you: My body being able to regulate its own blood sugars without math, injections, food weighing, finger sticking, sweatbetes, glucose tabs, or anything else from me.

The most annoying thing people say to you about your diabetes is:  Oh, GAWD. How can I narrow it down?!?
  • "But you're not fat!"
  • "You have it really bad, huh?"
  • "Are you sure you should eat that?"
  • "You have diabetes? My grandma/aunt/coworker did, and they died/lost their leg/went blind..."
What is the most common misconception about diabetes:
  • For people who have it: That it's no big deal. I know too many people who don't take their meds, don't take care of themselves, ignore their disease because it takes sooooo long for those complications to rear their ugly heads. I wish 32-year-old me could go back to 18-year-old me and say "Dude. Don't fuck up in college. That 13 A1c you're gonna get? Yeah. That's going to damage your eyes." I'm sure a lot of suffering people wish they could go back and shake their younger selves.
  • For people who don't: That it's no big deal. That it's not as deadly as cancer or AIDS, that we all brought it on ourselves, and so it doesn't warrant attention or funding or research. That we should all just stop eating cake and quit our whining.
If you could say one thing to your pancreas, what would it be: I'm sorry my bully immune system murdered you.