Tag Archives: insulin

Why going to the endo is like math class

D E B U T S I N G L ERemember when you used to take tests or quizzes in math class and the teacher would tell you that “you have to show your work or else you’ll only receive half the credit”? First of all, I should be allowed to do math in my head, even though I get it, they wanted to cut the cheating out. Secondly, I hated getting the answer right but the “steps in getting to the answer” wrong. Isn’t there more than one way?

Yesterday, I had a visit with my endocrinologist who I hadn’t seen in a year. This was due to being laid off my job a year ago and finding health insurance again. Going to see a world-renowned endo is pricey! Along with getting to see all my doctors again (yay!), I get my supplies, insulin and everything else I need to get my a1c back down (it was a 7.9). It’s not terrible, but I was doing much better this time last year. I actually thought it was going to be higher!

With that said, I took the time to tell my doctor about the issues I’ve been faced with and really, nothing has changed since the last time I was there– besides the fact that I wasn’t checking myself enough due to a shortage of supply. I feel like most of the time, it doesn’t matter if you have diabetes or not, doctor’s advice is usually the same: Do more exercise, lose more weight, you’re doing fine, at least you’re alive. We’ve all heard it.

This time though, I was scolded about not wearing my CGMS, which I admit slipped to the wayside, again due to shortage of supply. But, not to fear! I’m back on it.

As I was sitting there with the doc, reviewing the printout of history from my pump, what I call my diary because, well, they know EVERYTHING just from looking at a few numbers on paper… and graphs, and charts, and totals, I saw the scatter of numbers throughout the pages. Most notably were the days where I checked only once or not at all.

**[If you know anything about diabetes and this isn’t the first time you’ve heard of this situation, you know how important it is to check yourself. I’ve written about it here. The doctor refers to not checking as the “dangerous road.”]**

This is when the guilt sets in. There are days when you wake up and you just don’t want to deal, so, putting your health at risk, you don’t. It’s not to say that it is the right thing to do, but it happens. For those who don’t have diabetes, let me just say, it gets exhausting. Always thinking about what you’re eating, the amount of sugar, carbs, counting, shots, boluses, double checking how you feel, checking blood sugar, making sure you’re on top of your life! Numbers– all numbers, all the time. So even though it sounded like a good idea to skip on checking out where you were and how you were doing in terms of blood sugar levels, it’s not in the long run and you look like a bad student at the doctor’s office.

At this point, I’m too old to shout out, “But my a1c was a 7.9! That’s still pretty good!” But that’s how I felt. It was a sigh of relief, it was a way to loosen the hook I’d always be on with my diabetes. But you know what? I didn’t show my work.

When the doctor downloads all the information that my purple insulin pump stores in its computer system, he sees what’s going on like when I drop and when I’m too high and all that jazz– my personal life and what my insides are doing. The graphs and charts are only possible with data, but if I’m not checking myself or wearing my CGMS there is no data. The data here is the long division work I did in my head and didn’t show on paper. The a1c result is the answer that I got kinda right. The only reason it isn’t in the “correct” spectrum is because I didn’t show my work, thus slipping up in the end.

Because I didn’t do the work, my doctor couldn’t tell me how to fix it. As much as this is about pricking your finger and sampling some blood, NOT doing actual facts and figures in your head, you’d think it’d be easier, right? Well, besides my need to ration supplies, it’s easy to forget to check. I’m running to work, I’m busy at work, I’m running home, I’m running around, living life, doing things and then, “Oh, shit! I have to check myself!” Does that not happen to you? It happens to me all the time, which is why the CGMS is good for me. It’s stuck there and that’s it. It tells me when to check and I’m good. For the most part. Technology has been known to fail.

So based off of what he knew for sure, he changed my basal rate, changed my carb ratio and sent me on my way for blood tests.

Usually, when I leave the doctor’s office, I’m known to dwell too long on the whole ordeal. I cry most of the time as a release of energy, anxiety and stress that living with diabetes brings about. I’m reminded of everything I have to do to not die a slow and miserable death, and at the same time, I swear that I’m going to change. The difference this time was that I had company and I had to explain things. He told me that I wasn’t perfect, that I’m human and that he was going to support my habits that I intended to build on. I didn’t cry but instead I accepted the fact that I do what I can and sometimes, things don’t just go the way you want them to.

Life is a tumultuous rollercoaster on its own. Sprinkling in some much needed care adds a little anxiety, but more, it adds the motivation needed to feel better and more in control. In the end, I’ve realized that in order to take control of my diabetes, I’m going to have to do the work and hopefully the more corrections I make on my process, the better my results will be.

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Precaution: Diabetes in the Mainstream

A couple of days ago, I caught the episode of “Two Broke Girls” after hearing that there was a “diabetic” on the show. Y’all know how about I feel about that word, and if you don’t, read about it here. Anyway, when I heard that there was a PWD on the show, I had to watch it. The first thing I thought was, “I can’t wait to spot all the errors they’re about to commit!” Especially because, well, that’s what usually happens. We read, see, hear something that’s totally wrong, inconsistent and sometimes unsettling.

TwoBrokeGirlsIn the episode, Max decides to go to pastry school and meets Dick, I think his name was. They make jokes about their instructor and at one point when they get kicked out of the class, they start talking and he shows his fanny pack with syringes and insulin. They make a joke about him being “diabetic” and a pastry chef. He ends up liking Max and goes to the extreme of not taking his insulin so that he goes into… and this is where it gets weird.

While Max is talking to her roommate Caroline, Dick falls over (why? Because apparently he’s going into shock? Or just acting it out) and the head Chef asks if anyone knows how to administer a shot. Max proceeds to just pull out a syringe and shoot him up. After she’s done, he stands up like nothing happened, claiming that he didn’t take his insulin so that Max could be his partner (since she knows how to give shots). What a guy! He must REALLY like her.

OK, what do we know about diabetes? First of all, we know that high blood sugar creeps up on you and as a person with Type 1 diabetes, you’ll feel that and have symptoms. Secondly, bouncing back from a high blood sugar takes at least a half hour because you feel crappy and you need time for the insulin to be absorbed in your body. And lastly, how did she know how much insulin to administer? We should also make note that when your blood sugars are that high, you want to test your blood sugar to figure out just how much insulin to give yourself. The last thing you want to do is “roller-coaster” your body and drop immensely.

Although diabetes is popping up in sitcoms and other general market areas that a wider audience can see, the information pushed out should be correct. Maybe he was pulling everyone’s leg and it was a joke, but it should never be treated as such. Administering insulin is such a serious thing that it came up in a court case in California as recent as August, ruling that schools can administer insulin without a nurse.

I’m glad that people are talking about it and that it’s casual enough to stick it in a sitcom; especially Type 1 diabetes. People should talk about it more, but you also have to know that what you see isn’t always the truth.

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Off With The Pump!

My purple MinimedI know, I know. You must be thinking, how can this girl, the one who made up #WhereThePumpAreYou get off the pump? Right. Well, it’s called lack of funds and no insurance. That’s how.

Not for long, she says! I just got a new full-time job that will give me benefits starting in September. Whew! It’s been a while, Blue Cross and yes, I’ve missed you.

However, I must admit that getting off the pump has taught me a thing or two about diabetes. Especially that little shell-like thing called a continuous glucose monitoring system. Man, the fact that I’m checking myself more is a thorn in my side. And how did I ever go so long without knowing where my blood sugar level was?

Apparently, the average cell phone user checks their smart phone 150 times a day or more. Yeah, well, I beat that with checking my CGMS like 300 times a day. I was addicted to knowing my blood sugar and I’m currently going through withdrawal.

I’m gadget driven and I removed the most important one. Bah,  I say.

insulinAlthough, I must admit, it’s putting a lot of things into perspective for me. For instance, pro: I don’t have anything latched on to me. Right? Well then you have the con: I have to carry needles around and look like a drug addict (even though we are) in public.

Or how about this one. Pro: I can wear dresses without figuring out where to put the damn thing! Con: I’m worried about where my blood sugar will be in the next few hours and if the insulin I gave myself should have been in my arm instead of my thigh or in my abdomen instead of my… you get the picture.

Here’s another one for you. Pro: No attachment or holes made in my body. More like, giving the holes time to heal fully. Con: Checking myself more often means more strips. But get this! The nurse at Stroger Hospital (the county one) told me, “You don’t need to check yourself four times a day! You’ve had diabetes for more than 20 years! You know how you feel. Once a day is fine. Just eat sensibly and take your insulin.”

Umm… what? 

On that note, it took the full force of Zeus himself for me to bite my tongue. The parking meter for my car was also running and I didn’t want to get a ticket so… I just ignored the explanation of how I should check once a day but different times every day. Yeah, no. I need strips.

I find myself guessing sometimes now. Am I shaky or is that a result of my phone vibrating? This might be bad, but don’t worry! I’m ordering my Medtronic supplies as soon as I hit publish on this baby. I’ve also been checking more than once a day, so I’m all good.

I’m telling you though, I’m starting to be really weirded out by the fact that I could deal with myself before the pump and before I re-learned appropriate management of my disorder.

Ultimately, my beef is this. I know how bad this is because I’ve seen better. If there is anything that I’m doing with this week of being off the pump is examining how it is to live the life of so many people out there. Those without insurance, those with sub-par medical health professionals and those who have to live under a system that doesn’t care enough to give them the appropriate amount of strips to test at least three times a day!

So, after thinking about all of this, I wondered to myself, “What can I do?” I grew up with privilege of having parents who took care and educated me. They also had health insurance and provided the best care to my sister and I. I have seen the OK, the good and the best endocrinologists and I know what excellent healthcare looks like. I also know what crazy and no health care looks like and now I can compare.

Don’t judge a person until you’ve walked a mile in their shoes. I’m walking it and I’m learning. Now, the next step is figuring out how to educate, advocate, support and make a change in the system. Who’s with me?

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You don’t know what you have until…

When I talk to people who have Type 2 diabetes, I always wonder what goes through their head. Do they know that they can be rid of it? That it was preventable? Do they not realize that choosing not to take care of their medical condition is basically like suicide? That it’s a selfish act and to think they don’t affect anyone besides themselves is a skewed view of things?

I suppose that the benefit that I have, when it comes to diabetes, is learning about the disorders and realizing that getting rid of Type 2 diabetes should be everyone’s goal. I wish there was an option to get rid of Type 1 except, it wouldn’t be getting rid of, as much as it is making your pancreas work again.

Some say that going to Natural healers is the way to go and was the answer to curing Type 1. I can’t lie, I’m very skeptical about it, but I wouldn’t mind trying it out to see just what it is they give me and what it is they tell me to do. It’s not even something I could fathom right now. Not at all. It’s so abstract that wrapping my head around the idea is hard. Can mixing something into my juice every morning jumpstart my pancreas?

But to hear about people who won’t change their lifestyle, can’t change their habits and don’t bother to help themselves, is really upsetting. There have been plenty of stories about people who get rid of it. They come to understand that all they have to do is eat better and lose weight and they do it. Why? Because it’s possible to reverse the effects of Type 2 diabetes.

I have to worry about blindness, cardiac disease, nerve damage, periodontal disease and premature death even if I take care if myself! How fair is that? People with Type 2 diabetes can lose weight and eat right and not have to worry about all those problems if they keep watching out for themselves.

I inject myself about 5 times a day. I prick my fingers so much and so often that I have calluses on my finger tips and I can’t really feel anything because of it. I’m in the process of getting the insulin pump and I wouldn’t mind having a continuous glucose monitor, either. I wouldn’t have to poke and prick that often.

Actually, it will be something like once in 3 days. That’s exciting to me. Knowing personally that some Type 2 diabetics, some can’t even keep up with a pill nor can they keep up with checking their blood sugar 3 times a day. I have always made my point of view known, saying things like, “Do you know what I have to go through everyday? All you have to do is pop a pill! I wish that’s all I had to do.”

And really, that’s just the beginning. You might get dropped off of your insurance for not taking care of yourself. I always, always, always worry about my insurance coverage in the back of my head. How will I pay for everything? It’s expensive to be sick in this day and age. A Type 2 diabetic can change that. It might be a bit more complicated, but hell, you can fix it.

I’m lucky, I am. For all the reasons I’ve mentioned before, I’m lucky; for my health for my mind, for my support system. And I’m thankful.

 

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It’s a No Go.

I woke up early this morning a tad bit nervous, to say the least. I had to do a lot before noon. A phone meeting, going to the bank, a doctor appointment. No, not a doctor, a nutritionist. A dietician if you will. I literally prepared for this appointment. Had my blood sugars listed and ready, had my machine, had my fear. What was this going to bring? Was this lady going to be like my new endocrinologist or would she be nicer?

My mind started to wander about in different places. I ended up canceling the phone meeting, not going to the bank and taking deep breaths to prepare my mind. What was going to come of this meeting?

I got to the hospital on time. It was the fact that I had to wander through the winding maze of the hospital, find where to check in and all that hot jazz that made me late. They were nice about it. Also, I was in the elevator with the dietician.

As I checked in, I believe the receptionist felt I was nervous. Not too sure though. I sat down and sure enough, the dietician came to get me with her student shadow (like those residents I despise) but I actually liked her. When we first got to talking, she explained to me that getting the pump was not going to solve all of my problems. I knew that right off the bat. She asked me questions about meals, diet and what I knew about carb counting, which is just taking the proper amount of insulin for the grams of carbohydrates consumed.

The one situation that I did have a question about was my carb ratio. I asked about this because when I took the right amount of insulin, sometimes it wouldn’t bring my sugar down after a meal. My carb to insulin ration was 1:15 meaning one unit of insulin for every 15 grams of carbohydrates. They told me to change it to 1:12 and see what would happen with that. Keeping track, even if it’s in your head, is very important. I realize that only I will know what’s going on and how it all works, even if it’s just from memory, remember to always ask questions.

After we settled everything and I explained what I did in certain situations, she thought that I was right on track. I was doing what I was supposed to be doing and doing it right. Rock on! The fact that I used my problem solving skills to balance myself out also played an important role in her decision to agree on an insulin pump for me.

I wasn’t ready for one before since I had just begun learning about how to take care of myself “manually” if you will. When the diabetic nurse came in she said I was exactly the kind of person that should be on a pump since I was doing everything that it entailed anyway. She said it would save me a lot of poking since I take insulin through injection. The bruises and marks sometimes are ghastly (I just really wanted to use that word).

The pump is a small beeper-sized device that is connected to my side with a catheter which is changed every three days. The insulin goes in and I set it up for the amount I’m supposed to get and when. It also remembers the previous amounts and calculates carb intake as well as anything else I program into it. I’m also supposed to be trying out these classes online to see what it’s all about even before I get my hands on an actual pump. Of course, there’s always the question of insurance, which is scary, but for now, I’ll take a deep breath.

When it came down to it, the nurse explained the Medtronic pump to me, with a basic explanation of how it worked with pictures and an example pump. I didn’t have to be put on the CGM again, which was cool. But the visit only inspired me to do more and continue on with my good habits, finding ways to control my diabetes even more.

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