Category Archives: Dexcom

Gettin’ Down… Goin’ Low

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My boyfriend (herein after known as M) asks me how I’m feeling when I’m coming back from a LOW bg.  Awhile ago, he asked what it felt like to go LOW.  I described it as best I could but realized it has been such a long time since anyone has even asked me that question that I stumbled over my own babbling description.

Maybe a month ago I had a Saturday of Dexcom beeping lows.  Although partially user error (bolused perfectly for the food I was supposed to eat… operative word being “supposed”), I was also dealing with warm weather and a heck of a lot of walking.  I kept joking that perhaps I was CURED as I spent my day eating chalky glucose tablets almost hourly.  Maybe I didn’t need my pump after all,  I was a summer solstice pancreatic miracle!

M and I went to The GAP.  We both had a bunch of items to take back to the fitting room when we heard Dex beeping yet again. I was in the 70s and dropping (damn you arrow and your knowledge I should be able to feel.  Oh and by “damn you” I mean “thank you for saving me”).  I had already eaten through my glucose tabs, screamed in my mind, “OH MY GOD I’M SUGER NAKED”, and felt panic surge through me like I’d been electrocuted.  M took charge, told me to stay put, and he’d go get juice.  My gut screamed at me to say, “NO, I have to go with you”, but for some reason the self-concious, how-many-more-times-is-diabetes-going-to-interrupt-our-day part of me politely told him to get juice FAST and pointed him in the direction of a drug store.  I tried to play it cool.  I stood looking at the same shirt over and over, attempting to use the least amount of energy possible.  I’m fairly certain The GAP employees pegged me as a shoplifter as I remained motionless, looking at a shirt while holding an arm full of women’s clothing, the other arm full of guy’s gear, and scanning the doorway every 2 seconds.

By bg reached the high 50s and still headed down.  I was alone, mentally kicking myself for eating all my glucose tabs and not replacing them, and angry for ignoring my gut.  I started counting.  I decided when I counted to 60, I would walk over to the check-out counter, ask for the manager and explain that I needed help.  M would definitely be back in 60 seconds and he’d be the hero and that would be that.  60 seconds came and went.  I was in the high 40s. I kept waiting.  There was M, juice in hand, cap already off the bottle.  I drank like I’d been hanging-out waiting for him in the Sahara.  Within 5 minutes I was feeling better and we continued our GAP sale shopping.  M explained that he’d tried to find the “best” juice.  He wanted something that had enough sugar but also was healthy.  He wanted to get the right juice, not all refined sugars.  I celebrated his heroics but alone, in the fitting room, I knew I’d failed.  I’d never explained to my super athletic, gym loving M that when I’m LOW, the term “healthy” is swiftly tossed out the window.  I need pure glucose.  Gulpable glucose.  I need sugar loaded drinks.  Give me a COKE, STAT!

Jump ahead to this past weekend.  It was ungodly, sit-on-the-equator, oh-look-it’s-Satan, Welcome-to-Hell HOT!  M was back in town (oh did I mention I’m in a long distance relationship?  I didn’t?  That’s odd because being 3000 miles apart is so incredibly awesome I can’t believe I haven’t mentioned it.  Oh and in this case the term awesome = torturous). On Sunday morning my bg stayed in the 100-130 range.  I made a terrific breakfast (toot, toot to me) and we ran errands.  We dropped off a ton of my stuff at Goodwill (toot, toot to me for getting organized) and my Dex started beeping.  Dex has been way off recently but it didn’t need it to be correct this time, I FELT LOW.  I felt REALLY LOW.  It is indeed possible to feel the color drain out of your face.  I know because I felt it as it happened.  I grabbed glucose gel out of my purse.  Struggle with the microscopic safety seal.  OMG that stuff is bad!  Gelatinous, warm, thick, super sweet, yuckiness in a tube.  I tried drinking (is drinking even the right word?), that God awful goop.  I felt my hands shaking, my knees and legs looking much like the glucose gel (no, not neon and sugary but rubbery like Jell-O) and then I started to gag.  Not good.  This was not going to do the trick.

M saw my glucometer confirm my Dex warning and he looked at my face.  I looked LOW.  I knew, he knew I looked LOW.  I told him there was a Duane Reade (like the CVS/Rite Aid of NYC) ahead of us and I needed more than this glucose goop.  He grabbed my hand and we started race walking.  We got to the corner and I realized I’d been wrong.  It was yet another block ahead (note, it’s NYC and East to West blocks can be rather long).  M and I were sweating like crazy (gross but true) and he turned to me and said I should stay there in the shade of the scaffolding and he’d be back with juice.  OH NO!  I grabbed his hand tighter and said a very firm “NO”.  As we raced across the street and dodged slowpoke walkers, I explained what I should have said that day at The GAP, I was too LOW to be left alone. That if he left me in the shady spot there was a chance when he’d returned, I’d have X’s over my eyes and my tongue sticking out the side of my mouth.  I also added I’d be robbed (that might have been a bit of an exaggeration). Sadly we both found my cartoon-like imagery very funny which proves I’m sick in the head, not just the pancreas.  At Duane Reade we grabbed grapefruit juice.  Sugary, pink, grapefruit juice.  As I gulped, M started reading the nutrition label and warning me that there’s A LOT of sugar per serving.  YAY!  GIVE ME SUGAR!  We continued walking the aisles, relishing the wondrous air conditioning of Duane Reade as the color returned to my face.  My jittery hands ceased as stability returned and we headed to the diabetes section to pick-up more glucose tablets.  See ya never, glucose gel.  Ewwwww.

So what does it feel like to go LOW? You know on TV shows when the character gets shot and is slipping away and the other character is holding them and crying while repeating to just hold on *sob* help is on it’s way?  A LOW is sort of like that but both of those characters are me.  I tell myself calmly to keep it together while I frantically consume any sugar I can. The first time I explained to M how a LOW sometimes feels like my lips are going numb, almost like they fell asleep and my tongue also feels odd too but a different numbness, that’s exactly how THAT LOW felt.

Yesterday was the type of LOW from my childhood.  A sudden and abrupt paleness my skin doesn’t have even during the darkest winter (yep like an ill Snow White).  The twitching, shaking hands was always the give away as a kid.  Feeling like my legs were so unsteady and almost incapable of supporting me were symptoms I haven’t felt in quite sometime too.  When we headed to lunch (in a cab, thank God), I tried to explain how that LOW was different but yet a LOW I know well.  And the racing heart and sweaty LOW, yeah I know that one too.  There’s also a LOW that my vision gets a bit skewed like I’m about to get a migraine.

So #DOC, how do you describe your LOW?

 

33 out of 39

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Sounds like a passing test score right?  I’ve thought way too much about this blog post (read: over thinking is NOT good).  I considered advice I’d give to a new diabetic, or a letter to my siblings (especially my brother who wasn’t even 2 years old when I was diagnosed) for all the times my “up-keep” took away from theirs.

Me & my brother

I imagined a post about the incredible changes in diabetes technology that have occurred in “my” time and my hopes for the future.  Last week, I kept recalling a memory of my high school English research paper on diabetes and how I left out ONE big fact, a book listed the life span of a Type 1 diabetic to be cut by a 1/3 (I didn’t want my class mates to know that but I cried myself silly).  I envisioned listing all the absurd comments people have made when they realized I’m diabetic (that’s still on the blog list for another day… yeah I’m coming for you Jet Blue flight attendant).  But tomorrow is the big day and it’s getting late and here I am.  So here’s what I got:

My parents took the doctor’s advice when I was diagnosed (6/19/79) as their mantra:

I was a child first, and a diabetic second.

That was it.  Plain and simple.  So I did everything every other kid did.  I played sports.  I played a ton of sports I didn’t even want to play.  I went to sleepovers.  I went to sleepovers for kids I didn’t like.  But I lived.  I got yelled at for getting a C+ in Spanish.  I got grounded for mouthing off to my Mom.  I spent too much time on the phone with my friends.  I had so many summer jobs that I’m pretty sure my parents broke all US child labor laws.  I liked boys who had no idea I even existed.  And I lived.

I looked at colleges (side note: my Dad took me to visit Harvard first… no, I was not even close to Harvard material), and I made sure those colleges were not near my parent’s home.  I had roommates who scared me.  I made friends.  I studied Architecture.  I had a fake ID.  I drank too much.  I didn’t do a good job checking my blood but I always took my shots.  I gained 15 lbs my freshman year of college.  It looked more like 25.  I switched majors.  I had boyfriends.  I never once did drugs.  I made questionable fashion choices (hey it was the 90s, cut me some slack).  And I lived.

I got a job (OK that did NOT happen right away).  I moved to NYC.  I got new doctors. I got more serious about my health.  I embarked on a career. I had a boss who believed in me.  Wait, I had a boss who really believed in me.  My job took me all over the world.  I had my eyes lasered more than once.  I took a heck of a lot of shots.  I traveled more.  I pulled the trigger because I was finally ready, and I got a pump.  Pump training took a ton of time.  My college boyfriend broke my heart.  I couldn’t eat.  I got really skinny. I went to therapy to fast forward the healing of my heart.  Therapy taught me some stuff I hadn’t thought about how I viewed being diabetic. I realized I didn’t like the ex-boyfriend that much.   I lived.

I got back in the saddle.  I dated most of Manhattan (and some of Brooklyn).  My career actually took off.   I saw a lot more of the world.  I had crazy adventures.  I started a JDRF Walk Team (Alecia’s Stem Cells).  I got a lot of people to walk.  I hosted team fundraisers. I had big parties to celebrate diabetes anniversaries (Its NYC.  We eat that stuff up).  I recruited my friends and family for all sorts of MY stuff.  I kept designing lamps.  I started designing jewelry.  I tied my jewelry business to my JDRF fundraising.  My work appeared in amazing places.  I went to amazing places.  I lived.

Our 2010 Alecia’s Stem Cells shirts!

I have the same problems other people have.  I have fears many of my peers have never even considered.  I worry about the future.  I am infuriated that stem cell research lags so far behind in this country.  I frequently curse the FDA.  I have begun to curse the TSA.  I worry I will never have kids.  I worry if I did have kids I won’t be alive to see them grown. I worry I will die in my sleep of hypoglycemic unawareness.  I worry that all this diabetes stuff is too much for my boyfriend.  I worry I will need a new kidney. I worry that if I currently pay more for private health insurance than many people’s annual salary, how will this ever possibly turnout well?  I worry every time I get cut.  My current big worry is that I will someday be a burden to my siblings.  My bigger fear is that my future nieces and nephews will be diabetic too and I don’t want my siblings to have that burden.  I worry I won’t get to see the day of the artificial pancreas being available or I’ll be too sick to get one.  I worry that I will fall through the healthcare cracks.  I worry that I worry too much.

And then I take a minor break from worrying.  I work-out.  I get my heart beating.  I get my heart pounding.  I think of my circulation and telling my heart to step up to the plate because my pesky pancreas can’t anymore.  I think of all the parents I’ve met who cry when I speak to them because they consider me an inspiration.  I think of my sister’s college roommate being diagnosed (T1D)  while in college and how she felt I was the only one she could ask questions.  I think of how I fought to get a pump.  I think of how glad I am to have a Dexcom.  I think of how I was the longest living diabetic in my JDRF mentoring class.  I think of turning 40 next year (OK that freaks me out so I immediately STOP thinking of that and then freak out a little more.  40?  Seriously? I act like I’m 12).  I think of how much I value my life.  I think of all the gifts I’ve been given and how truly blessed I am.  I think of this image below (and I apply it to things far beyond running), oh, and by the way, I live:

Bus riding with B

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Memorial Day Weekend and I did what most New Yorkers do (Ok that’s not true.  I did NOT go to the Hamptons).  I did however enjoy time with friends who happen to have outdoor space (yep, a rooftop get together).  Gorgeous right?

I wore a strapless sundress and just inserted my first (drum roll please) unassisted (more drum rolling) Dexcom site in my arm earlier in the morning (woo hoo *Victory Dance*).

Friends arrived at the rooftop festivities with their 2 1/2 year old, Lady B.  I joke that Lady B is smarter than I am.  The joke is that I’m not joking.  This kid quite possibly (possibly = definitely) has a better vocabulary than I do and is so bright that I am considering hiring her to work in my office and run my finances.  Anyway, when it became too dark to sit on the roof, we went to my friend’s apartment where Lady B and I sat next to each other on the sofa.  We started playing what I would like to call, “Riding A NYC Bus” (lots of colliding into each other).  Quickly it was determined that said friend’s loft steps were the “bus stop” and the sofa was the bus.  When we sat on the steps we were squished (the steps are narrow, or I have a big butt, or something like that, shhh no judgements), and my Dexcom sensor was right in Lady B’s face every time she spoke to me.  I kept her jabbering, not sure how to explain my arm if she asked (I have limited knowledge on 2 year olds. That is also true for 1 and 3 years olds).  Lady B and I ran around the coffee table and back to the bus stop.  I felt a tiny little hand cup right over the Dex sensor and Lady B leaned up and asked what was on my arm.  I stammered and started to explain that my body doesn’t always work correctly and this helps me know how to make it better.  She kept patting the sensor, with the gentlest touch, so cautious.  Her Dad started explaining it is medicine.  She kept smiling, staring at the Dexcom sensor, so I told her it helps me stay healthy and strong so I can play with her.  Apparently that was all she needed to know because she pulled her hand away and told me it was time to get on the bus.

The bus game continued (its Manhattan on a holiday weekend, lots of transfers) and my Dexcom sensor became the hot topic (what else are you going to talk about while waiting for the bus right?).  When Lady B realized a sticker held the Dexcom on my arm her eyes were as wide as saucers and her whole face lit up.  She kept patting my arm and telling me how much she likes “this” (The Dexcom).  I wasn’t sure whether to laugh or cry.  I’ve had my fair share of frowning looks and stares from strangers in the last few weeks.  The weather is warm and I own far more sleeveless items of clothing than I ever realized.  When asked, I explain to strangers that I’m diabetic and and quickly explain “it” tracks my blood sugar levels.  Depending on the person’s reaction I might say something like I’m under house arrest OR I’m in the Witness Relocation Program and add a giggle, but there I was, playing crazy bus ride, with a little girl who wanted to talk stickers and for some reason, kept nodding her head and saying, “I like this”.

D-Blog Week Day 3- One Thing I Could Do Better

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Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at.  Today let’s look at the flip-side.  We probably all have one thing we could try to do better.  Why not make today the day we start working on it.  No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

Oy vey. This morning I came up with at least 6 different answers to this question (had I worked-out longer this AM I am sure I could have easily doubled or tripled that number).  Hmmmm.  Just one thing?  The first one that comes to mind is combining my almost 33 years diabetes knowledge with the information I’ve learned from 4+ months with my beloved Dexcom.  The most obvious one for me is, “HEY if you’re going to eat like the winning hippo in a game of Hungry Hippo, bolus earlier!” 

My first few weeks with my buddy Dex (Dexcom is the name for more formal occasions) taught me that my BG shoots up right after a meal (often) and returns to my target range later.  At first, I felt compelled to correct those post meal highs.  Dex beeping at me that I was too high was like a flashback to my high school Spanish class and Senora Bogan constantly yelling at me to “SILENCIO POR FAVOR!!!”.  Correcting those Dex beeps would lead me to crash later and then eat glucose tablets like they were M &Ms (what can I say, M&Ms are quite tasty).

So after the first few weeks I kinda, sorta started to chill-out about the corrections (I fought myself NOT to do a correction) but knew that wasn’t the answer.  My blood shouldn’t skyrocket in order to comeback to normal range.  I had to face it, I must bolus sooner and as much as I hate admitting it, I need to combo bolus sometimes too.  This boils down to organization and a little more planning on my part.  Ugh.  I’ve admitted it and now I have to do it. Gracias!

Diabetes Blog Week (my first real post)… One Diabetes Thing I Do Well

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Today’s Topic for Diabetes Blog Week:

Tell us about just one diabetes thing you (or your loved one) does spectacularly! 

 A few weeks ago I had what I consider a diabetes test.  No, not a test to see if I am diabetic, that test was in the summer of 1979 (man am I old).  No, this was what I consider a test of my internal Emergency Broadcast System.  The whole story is rather graphic and is better suited for another post (later this week) about insulin pumps, X-rays, TSA, and warranties.  Today, I am supposed to pat myself on the back for the diabetes thing I do well.  My “thing” is that in a serious panic, freak the front-door out moment; I keep a level head, and use my smarts.

I was on a red eye flight and unbeknownst to me had a bent cannula under my skin from a brand spanking new pump site (oh and by “bent” I mean like if you took a regular straw and tried to turn it into a bendy straw).

cannula bent like a non-bendy straw

I have to preface this story by explaining I take anti nausea pills sometimes when I fly and for the first few hours of the flight I believed I was sick, not diabetes sick, which led to some of the impending confusion taking care of the situation.  For the sake of sticking to the topic, I will shorten this to the following facts: hours of puking, taking over one of the bathrooms, and peeing my pants.  When my Dexcom showed my BG was in the low 200s, I wasn’t too concerned since I was getting sick (over and over and over) and definitely didn’t want to deal with going low until my stomach issues were under control. I kept giving myself mini boluses (less than a correction) with my pump, my body continued exploding, and I kept noticing my BG wasn’t decreasing at all.  By the time the Dex said I’d reached 300, I suspected I was possibly having the Perfect Storm scenario.

I changed my pump site in a huge rush to get to the airport (yep, stupid) but I didn’t remove the old site as my just-in-case back-up (yep, smart).  So I switched the pump to the old site, bloused and waited (ok “waiting” is a nice way of saying I drank a diet Coke in the bathroom and started puking it out my nose so violently I got a nose bleed).  My BG sort of stabilized in the 300-320 range.  It wasn’t going down though and at that point it really should have.  I had already peed my pants while puking (and made new very scratchy undies out of toilet paper) so my pride was long gone.  Somehow, in my muddled state, I went through my mental checklist of what to do.  I made it back to my seat and grabbed my glucometer, glucose tablets, a new vial of insulin and a syringe (something I rarely traveled with many years ago when all I thought I ever needed was my back-up old pump).

Back in the bathroom, Pukefest 2012 continued but I was able to check my blood… 427! Ack! Dex said 337.  I opened the new insulin vial and pulled the safety cap off the syringe (as a side note: I used to chew on those caps as a kid as I did my shots. I put the safety cap in my mouth for a second, caught myself in the mirror and couldn’t believe in a time of complete distress I automatically did something I haven’t done since I went on my first pump 12 years ago.  What a weird-O).  Anyway I looked over my belly and figured since I was clearly having insulin absorption issues, I should inject elsewhere so I gave myself a mini shot in my belly far from both pump sites (smart) and then another one in my hip (which was a mess with the plane bouncing but I got it… also smart).

I had puked myself silly by the time I was finally able to sit back in my seat for the remaining 45 minutes.  By the time we landed, my BG was in the 240 range.  I managed to keep hydrating myself (small sips and smart) and grabbed liquids on my way out of the airport (also smart since I ended up in NYC traffic for over an hour).

When I got home and cleaned up (good-bye toilet paper undies), my BG was still hovering in the 200s, so I changed out everything with the pump again.  I then called Animas and had them go through any and all diagnostic testing they could do over the phone.  My next call was to my doctor since I still felt like I’d been hit by a bus and then dragged for awhile and high ketones.  When I told her how I’d used the light on my phone to grab a syringe out of my make-up bag, my doctor told me she was proud of me.  She said how lots of people on pumps don’t have syringes on them at all times.  I had been one of those people.  For some unknown reason, in the past year, I started carrying 2 syringes in my travel bag.  So yeah,  I may not be diabetes perfect, but when push came to shove, I was smart.  No wait.  I Am Smart.

A Start

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In the past few months, I have started reading diabetes blogs with an interest and regularity that I never had before.  There are a few reasons for this but the biggest one is I had an interest in obtaining a CGM since I suspected I was having issues with hypoglycemic unawareness and simply put, i was scared.  Blogs became my real world research.  I was approved by my insurance for a Dexcom in December of 2011. I didn’t know anyone, personally, using this technology and suddenly I found myself mildly dependant on T1D blogs.  Other than an hour long training session, EVERYTHING I learned about my Dex, I learned from the world of diabetes tweets and blogs.

The only times I have considered starting a blog were in relation to my career which is NOT in the field of healthcare or diabetes.  Writing a diabetes blog didn’t occur to me nor did it remotely appeal to me.  But then, something changed.  Not all at once, but little things started happening.  My boyfriend gained more diabetes education, especially about the Dexcom through reading blogs, I trained to be a mentor on behalf of JDRF and realized I am old T1D (dx 1979), I was contacted by someone in my professional life with a Dexcom question…. Someone who knew I was diabetic by something I posted on twitter, not by anything I ever told them directly.  A man stopped me on the beach an hour after my boyfriend put a Dexcom sensor in my arm for the first time.  The man was with his 8 year old son who was on an insulin pump too.  When I told him I was approaching my 33rd anniversary with diabetes, he kept telling me how “cool” that was and then apologizing with tears in his eyes and hugging his son.  He told me how encouraging it was to hear and of course tears then streamed from my eyes too. I thought about what a vast sea of fantastic diabetes blogs I had discovered in a few months and that dissuaded me from pursuing any vague notion of blogging.  Nope, I don’t need to blog.  I didn’t think I had anything new to say on the topic.

April 23, 2012 was the day when diabetes managed to scare me silly (although I didn’t realize it at the time) and a few people told me I should write down what happened (more on that later).  Then the turning point.  I saw a post about Diabetes Blog Week and Karen Graffeo of http://www.bittersweetdiabetes.com wrote, “If you don’t have a blog but have thought about starting one, now is the perfect time”.  So I guess, now is my perfect time.