1. Adult bowel incontinence smells 10x worse then an infant's.(goal for this week: do not gag/vomit on patient.I'm sorry, but it does take some getting used to)
2. Paperwork is already the bane of my existence.
3. White shows everything. And I can't use it to "blot" anything, without looking like Frankenstein Nurse.
4. I wish we had lockers.But students are not really wanted, they are just tolerated,and as such, there is a long list of ridiculous rules of things that are not permitted in the facilities...among them, any type of med. Because, as you might have guessed,there was an unfortunate incident involving a resident rifling/OD'ng on a student's meds. So my insulin gets to chill in my car.(it's not freezing,and it's not hot,but still it's highly inconvenient to not have that with me)
5. I have no appetite in the nursing home, but as soon as I get out of it I'm ready to go to the nearest fast food place (or home) and down 1500 calories. I think it's the smells.
6. Looking for information in a chart is like looking for a needle in a haystack.(sorry for the cliche, but it is) I think I could literally spend all day filling out that comprehensive assessment form,it isn't organized,and it's full of conflicting info.
7. I don't know anything.Please don't leave me alone with a patient.(not to worry...the instructor knows this,& first semester we don't breathe on the patient unless said instructor is nearby.)
8. The elderly can be so sweet, and interactive. If I had to live in a nursing home I can't say I would be that way.If I was lucid, I would try and escape every chance I got.
9. Mealtimes and insulin peaks never match up,which is why every time I get a chance to eat I'm in the low 200's.(in another hour, I'd be in the 100's,but lunch is NOW)Not that I'm hungry...but I have to eat something to stop my stomach from growling. Never been close to low but I still get the occasional "are you ok" glance from the instructor.
10. BYO glucose tabs, juice,and food is absolutely imparitive. There are no vending machines/staff (kitchen/cafe) privileges (nor any access to any nearby stores)so you've got to plan for a disaster scenario and bring enough food to treat low blood sugars all day. Otherwise,you're probably in deep water. (I wanted to ask what they do if a resident has severe low blood sugars but since many of them have difficulty swallowing, I'm guessing 911 would be called. Not what I'd want done for me but I'm pretty sure I don't get to go walking around with a huge hulking glucagon kit in my pocket)
Thursday, March 31, 2011
Friday, March 25, 2011
Peak & Trough: A Lesson From Nursing School
Disclaimer: I'm not a doctor, a nurse, or even play one on tv. So don't take any of this as medical fact..YDMV,consult with your own Health Care Guru.
You can go ahead & say it. How does this not look like the action of fast acting insulin(only more of the "peak" part)
And because much of my thinking is colored by diabetes,immeadiatly my mind starts drawing parallels in the D-World.
What you're actually looking at is the action of a medication. There's the time it "starts working" (T1) the time it's peaking (T2,etc) and the time it tapers off.(T3) A "peak" is the time when it's most effective but there is this not so small matter of ensuring that that peak stays inside the minimum effective concentration and the minimum toxic concentration lines as well. And let me tell you something,trying to keep the drug onset,side effects,peak times, minimum toxic concentrations straight (x 20 or so meds per pt) is not exactly easy. Drugs also like to clash with other drugs & are absorbed differently. Anyway,insulin is the easiest example of this because generally there is only one side effect (hypoglycemia) and that's like the minimum toxic concentration. Bad,bad, BAD to have enough insulin in your bloodstream to cause that.(although it's not that difficult to get into that situation)
A "Trough" is a blood level drawn right before the next medication dose. It tells you if you are at the minimum effective dose and if not,that you need to do something about it.(I do troughs with my mag levels too only I don't take the dose until I get the results..it's like a "fasting" result) People with diabetes do alot of troughs only there is always some insulin involved and one can never be quite sure that the dose you are taking is too much/just right/not enough because we can't see how our bgs will respond. But in my observations,blood sugars(postmeal) do not go as high when there is a certain amount of mealtime insulin still floating around, 3-4 hours later.(this also applies to snacks) Maybe because my basal is so low(I have to have insulin above & beyond that,where food is involved). Prebolusing also helps.But with diabetes,the line between keeping a little extra IOB and spiraling down into hypoglycemic horror is a very thin one. (am I an expert on this,nope, but understanding how Apidra works in my body is a step toward more consistent bgs)
And of course there are a hundred other factors involved(exercise,etc) which makes D a constant science experiment. Nursing school is not entirely detrimental to one's health. (it's rekindled the "gotta sync this right" flame)
- Posted using BlogPress from my iPhone
You can go ahead & say it. How does this not look like the action of fast acting insulin(only more of the "peak" part)
And because much of my thinking is colored by diabetes,immeadiatly my mind starts drawing parallels in the D-World.
What you're actually looking at is the action of a medication. There's the time it "starts working" (T1) the time it's peaking (T2,etc) and the time it tapers off.(T3) A "peak" is the time when it's most effective but there is this not so small matter of ensuring that that peak stays inside the minimum effective concentration and the minimum toxic concentration lines as well. And let me tell you something,trying to keep the drug onset,side effects,peak times, minimum toxic concentrations straight (x 20 or so meds per pt) is not exactly easy. Drugs also like to clash with other drugs & are absorbed differently. Anyway,insulin is the easiest example of this because generally there is only one side effect (hypoglycemia) and that's like the minimum toxic concentration. Bad,bad, BAD to have enough insulin in your bloodstream to cause that.(although it's not that difficult to get into that situation)
A "Trough" is a blood level drawn right before the next medication dose. It tells you if you are at the minimum effective dose and if not,that you need to do something about it.(I do troughs with my mag levels too only I don't take the dose until I get the results..it's like a "fasting" result) People with diabetes do alot of troughs only there is always some insulin involved and one can never be quite sure that the dose you are taking is too much/just right/not enough because we can't see how our bgs will respond. But in my observations,blood sugars(postmeal) do not go as high when there is a certain amount of mealtime insulin still floating around, 3-4 hours later.(this also applies to snacks) Maybe because my basal is so low(I have to have insulin above & beyond that,where food is involved). Prebolusing also helps.But with diabetes,the line between keeping a little extra IOB and spiraling down into hypoglycemic horror is a very thin one. (am I an expert on this,nope, but understanding how Apidra works in my body is a step toward more consistent bgs)
And of course there are a hundred other factors involved(exercise,etc) which makes D a constant science experiment. Nursing school is not entirely detrimental to one's health. (it's rekindled the "gotta sync this right" flame)
- Posted using BlogPress from my iPhone
Monday, March 21, 2011
Freestyle Failure
It's been a very (long)& relaxing weekend, but unfortuently, there have been several bumps in it. Most noticeably, I begun using the new butterfly strips with the "Freestyle Freedom" blood glucose meter & am getting readings all over the spectrum.I brought two meters on this road trip,& I can't really tell what's the problem-meter,or strips,because I don't have any control solution) It's really disconcerting when you can't even trust your meter/strips & it's not the sort of situation that you want to strive for "tight"(80-110'sh) control in. I thought if I had my Dexcom on,it would at least give some guidance as to which hundreds I'm actually in(100,200,300,400,etc.)but that's been giving me question marks so at this point, I'll take the lowest meter reading & go with that. Tomorrow,we'll head back home & I do have a One Touch meter(& leftover strips) that I consider to be the "Old Faithful" glucometer...99% of the time it's right. I hopefully have strip solution for the freestyle meter so I can do comparison's & figure out just what is wrong here.
Lesson of Story: never bring something "new" on a trip,without first testing it out first. Technology is a great thing but if it malfunctions it changes diabetes care from control to survival mode.
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Lesson of Story: never bring something "new" on a trip,without first testing it out first. Technology is a great thing but if it malfunctions it changes diabetes care from control to survival mode.
- Posted using BlogPress from my iPad
Friday, March 18, 2011
Sometimes
(the following is a deep,dark rant,and if you can't handle unfortunate realities I encourage you to stop reading now.I think most PWD feel like this,at some point.)
Sometimes being the only person with diabetes sucks.
Sometimes I don't bolus for that piece of Triple Decker Death-By-Chocolate caramelized goodness.(on purpose,and I shortly rue the day..not a good idea even you are tired of diabetes)
Sometimes I forget my meter,forget lancing device,forget
strips,forget glucose,forget back up insulin,forget pump supplies,or forget money. And sometimes I forget all of those.
Sometimes I want to give up.(dark thoughts,don't go down that road)
Sometimes a blog comment really makes my day!(ok,most blog comments really make my day)
Sometimes I want to hit the Diabetes Police very,very hard.
Sometimes I can throw 100 carbs at a low & not break 120,other times I can eat 15 & voila, I'm 220.
Sometimes I wonder if a middle of the night low will be how I go.
Sometimes I wonder if there will ever be a cure.
Sometimes spontaneous combustion of tears is the sole symptom of a low blood sugar.(classy,not)
Sometimes I wonder if any of my classmates will be caring for me(in a nursing home) in 30+ years.
Sometimes the combination of Diet Coke & Spearmint gum tastes like rotten socks.
Sometimes having diabetes isn't as bad,when everyone else out there "gets it" too.
Sometimes I wonder why I'm so lucky,despite it all,when others haven't been.
Sometimes I think I'd like to beat the insurance company executives over the head & make them see that supply restrictions is not the way to contain costs,they'll simply pay for the complications later.
Sometimes I'll spot a fellow pumper in the wild.
Sometimes I'll eat twice as much of whatever I'm told not to eat,just to spite whoever said I couldn't.
Sometimes I wake up and have no idea how many carbs were actually consumed during that 3 AM low.
Sometimes I will eat sugar-free candy,and not gag.(if the situation is non-resolvable)
Sometimes I wish I had a personal Endo 24/7 who would take care of the diabetes crap while I just lived my life.
- Posted using BlogPress from my iPhone
Sometimes being the only person with diabetes sucks.
Sometimes I don't bolus for that piece of Triple Decker Death-By-Chocolate caramelized goodness.(on purpose,and I shortly rue the day..not a good idea even you are tired of diabetes)
Sometimes I forget my meter,forget lancing device,forget
strips,forget glucose,forget back up insulin,forget pump supplies,or forget money. And sometimes I forget all of those.
Sometimes I want to give up.(dark thoughts,don't go down that road)
Sometimes a blog comment really makes my day!(ok,most blog comments really make my day)
Sometimes I want to hit the Diabetes Police very,very hard.
Sometimes I can throw 100 carbs at a low & not break 120,other times I can eat 15 & voila, I'm 220.
Sometimes I wonder if a middle of the night low will be how I go.
Sometimes I wonder if there will ever be a cure.
Sometimes spontaneous combustion of tears is the sole symptom of a low blood sugar.(classy,not)
Sometimes I wonder if any of my classmates will be caring for me(in a nursing home) in 30+ years.
Sometimes the combination of Diet Coke & Spearmint gum tastes like rotten socks.
Sometimes having diabetes isn't as bad,when everyone else out there "gets it" too.
Sometimes I wonder why I'm so lucky,despite it all,when others haven't been.
Sometimes I think I'd like to beat the insurance company executives over the head & make them see that supply restrictions is not the way to contain costs,they'll simply pay for the complications later.
Sometimes I'll spot a fellow pumper in the wild.
Sometimes I'll eat twice as much of whatever I'm told not to eat,just to spite whoever said I couldn't.
Sometimes I wake up and have no idea how many carbs were actually consumed during that 3 AM low.
Sometimes I will eat sugar-free candy,and not gag.(if the situation is non-resolvable)
Sometimes I wish I had a personal Endo 24/7 who would take care of the diabetes crap while I just lived my life.
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Thursday, March 17, 2011
Luck O'The (Non) Irish
I did it.
I really just passed my head-to-toe assessment,missing only such minor details as skin turgor, the true position of the Right Lower Lobe/Left Lower Lobe (on the lateral sides) & something else. When that was over,my instructor asked me cheerfully if I felt better about it now.(the answer was no,the anxiety hadn't time to dissipate) & then it was on to the Skills portion. I drew the two easiest skills there were(putting on gown/mask/gloves(& taking off) & drawing up and administering an insulin injection). For one brief moment,my heart stopped as I remembered(too late) that N70/30 is supposed to be rolled prior to draw up but I verbalized it & it was ok.
And then I (so I thought) felt better. About everything.
And then she asked "Can I ask you something?" and I knew precisely where the conversation was going.I can smell invasive personal questioning a mile away.
"Do you wear an insulin pump?" ( yes) "How many years?" (10) etc.etc.
etc.
I guess either the accommodations paperwork found it's way to her or she checked up on it because at no point had I given any indication that I was D,(checked bg,or had a pump in view) unless she really did see me checking my bg in the depths of my purse(& discreetly treat the low) during that first roundtable discussion. (it's not possible to tell someone is D just from how they give an insulin injection) I was going to bring it up the week of clinicals (so she wouldn't have time to forget it) but I guess now was as good as time as any. She was really nice about it,& if I need to test/treat/eat it's fine with her.And if I keel over,well,it's good to know what from.( I assured her that that wasn't likely to happen I don't have many severe lows but it's always a possibility) And it's not like I'm a 2 year old and can't take care of myself but it is incredibly comforting when someone (competent) knows,it takes off some of the burden of trying to handle diabetes & school perfectly.There is wiggle room,in both parallel universes.
And then I felt truly better-and more then ready to chill out for the next week.
(Spring Break starts NOW,woohoo!)
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I really just passed my head-to-toe assessment,missing only such minor details as skin turgor, the true position of the Right Lower Lobe/Left Lower Lobe (on the lateral sides) & something else. When that was over,my instructor asked me cheerfully if I felt better about it now.(the answer was no,the anxiety hadn't time to dissipate) & then it was on to the Skills portion. I drew the two easiest skills there were(putting on gown/mask/gloves(& taking off) & drawing up and administering an insulin injection). For one brief moment,my heart stopped as I remembered(too late) that N70/30 is supposed to be rolled prior to draw up but I verbalized it & it was ok.
And then I (so I thought) felt better. About everything.
And then she asked "Can I ask you something?" and I knew precisely where the conversation was going.I can smell invasive personal questioning a mile away.
"Do you wear an insulin pump?" ( yes) "How many years?" (10) etc.etc.
etc.
I guess either the accommodations paperwork found it's way to her or she checked up on it because at no point had I given any indication that I was D,(checked bg,or had a pump in view) unless she really did see me checking my bg in the depths of my purse(& discreetly treat the low) during that first roundtable discussion. (it's not possible to tell someone is D just from how they give an insulin injection) I was going to bring it up the week of clinicals (so she wouldn't have time to forget it) but I guess now was as good as time as any. She was really nice about it,& if I need to test/treat/eat it's fine with her.And if I keel over,well,it's good to know what from.( I assured her that that wasn't likely to happen I don't have many severe lows but it's always a possibility) And it's not like I'm a 2 year old and can't take care of myself but it is incredibly comforting when someone (competent) knows,it takes off some of the burden of trying to handle diabetes & school perfectly.There is wiggle room,in both parallel universes.
And then I felt truly better-and more then ready to chill out for the next week.
(Spring Break starts NOW,woohoo!)
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Friday, March 11, 2011
Apple to Apple(s)
Thursday,March 10, was another great moment in the history of Apple.It was the day this debuted....
http://ow.ly/i/93DB/original
and I happily gave up my unlimited data plan(well,not happily,but accessibility trumps having so much data that you don't use much anyway.)
Personal Hotspot(created by my iPhone) accommodates 3-5 Wifi enabled electronics on that network. We don't have Wifi at home,& attempts to create one have been unsuccessful(my husband has forgotten/claims to have never created a certain core password & it hasn't really been worth the headache or $$$$'s to get a professional opinion.)Now I can run my iPad (or upload camera, or anything) off it.(instead of having to go to school/someplace with Wifi). It's much easier to blog from an iPad then an iPhone. (5x screen? and I can use my Bluetooth enabled keyboard,which is still in the box from my birthday package!) There is a data cap of 4(GB) which I will probably exceed & have to pay the overage charges,but perhaps not.(I never came anywhere close on just my iPhone usage) When I called to activate it,the phone tech in the iPad dept. had no idea what I was talking about & insisted it couldn't be done.(it's like she hadn't gotten the memo that Hotspot was debuting that day) I gave up,hung up,and rebooted the iPad and voila,it worked.I can also use my iPad to review lectures from the comfort of bed(I don't care what the instructors say,bed is an excellent place to study) which I couldn't do before.
Best Apple update EV-ER.(barring the giving up my gold star unlimited service,but being AT&T,of course they were going to pull something like that. If Verizon ever gets to the point of similar options (& my contract runs out) I would consider switching.)
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http://ow.ly/i/93DB/original
and I happily gave up my unlimited data plan(well,not happily,but accessibility trumps having so much data that you don't use much anyway.)
Personal Hotspot(created by my iPhone) accommodates 3-5 Wifi enabled electronics on that network. We don't have Wifi at home,& attempts to create one have been unsuccessful(my husband has forgotten/claims to have never created a certain core password & it hasn't really been worth the headache or $$$$'s to get a professional opinion.)Now I can run my iPad (or upload camera, or anything) off it.(instead of having to go to school/someplace with Wifi). It's much easier to blog from an iPad then an iPhone. (5x screen? and I can use my Bluetooth enabled keyboard,which is still in the box from my birthday package!) There is a data cap of 4(GB) which I will probably exceed & have to pay the overage charges,but perhaps not.(I never came anywhere close on just my iPhone usage) When I called to activate it,the phone tech in the iPad dept. had no idea what I was talking about & insisted it couldn't be done.(it's like she hadn't gotten the memo that Hotspot was debuting that day) I gave up,hung up,and rebooted the iPad and voila,it worked.I can also use my iPad to review lectures from the comfort of bed(I don't care what the instructors say,bed is an excellent place to study) which I couldn't do before.
Best Apple update EV-ER.(barring the giving up my gold star unlimited service,but being AT&T,of course they were going to pull something like that. If Verizon ever gets to the point of similar options (& my contract runs out) I would consider switching.)
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Wednesday, March 09, 2011
The Middle
In three weeks,there is a plan. That plan involves 80 new white-jacketed,scrubs & gear clad nursing students to be unleashed among 7 healthcare facilities for the long-awaited "clinical" setting.
Frightening, I know. But before we get there,we have 2 classroom tests, 2 "oral competency head to toe assessments" another math test,an online test,and a week of Spring Break to survive. Quite frankly it feels like a lifetime away because if you fail at any step in between you can't go to clinicals and flunk ze course. The oral competencies must be completely memorized (you're doing an actual physical exam in front of the instructor) and the whole situation is a step beyond test anxiety.(multiple choice tests just don't compare) If you go blank,you're good and screwed.
But if you survive,you're awarded with a 1.3 week long "Spring Break" (some of which will be spent studying,still,it will be nice).And when you come back,get involved in real live patient care...it's just a hop and a skip away till May,& you'll get a break for good.(for a few months)One Semester will be done...3 more to go.
I can do this.
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Frightening, I know. But before we get there,we have 2 classroom tests, 2 "oral competency head to toe assessments" another math test,an online test,and a week of Spring Break to survive. Quite frankly it feels like a lifetime away because if you fail at any step in between you can't go to clinicals and flunk ze course. The oral competencies must be completely memorized (you're doing an actual physical exam in front of the instructor) and the whole situation is a step beyond test anxiety.(multiple choice tests just don't compare) If you go blank,you're good and screwed.
But if you survive,you're awarded with a 1.3 week long "Spring Break" (some of which will be spent studying,still,it will be nice).And when you come back,get involved in real live patient care...it's just a hop and a skip away till May,& you'll get a break for good.(for a few months)One Semester will be done...3 more to go.
I can do this.
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Friday, March 04, 2011
The Not-So- Magical Express
Somewhere between the intersections of Ketone Valley and DKA Junction, the grand 'ole Diabetes Express made an unscheduled "pit stop" at 3 am last night. It could have been the fluids situation(getting extraordinarily low) or something else. All I know is,it sure felt like all of that. I was hoping the parchment-like thirst wasn't anything critical but the line on my Dexcom revealed a 3 hour spread in the 300+ range & there would be no "ignoring it." Fingerstick revealed a 355 mg/dl.Out came the emergency syringe(I do not mess around with bolusing in such situations). Something had obviously failed big time,but I was too brain dead to fix that something. My blood cells were bathed in glucose,& my "super system" circulatory system felt as sluggish as the Washington Beltway on a Friday afternoon.My kidneys were having their heyday,as my lungs also worked overtime to get rid of the poisonous CO2 accumulating,compliments of the ketones. I felt like a giant prune,& going to sleep never felt so easy but in that moment,there was still a chance to turn The Diabetes Express back to the sunnier (& cheerier) land of Euroglycemia. Chugged two cups of water to chase the ketones,& crawled back in bed.
(down to 201, & non-existent ketones)
Today is another day.(& one that fortuently doesn't require going to school.Youngest brother is getting married today.) Being hit by the Diabetes Express takes a day or so to really recover.(it's amazing how fast you can get into trouble & how long it takes to feel human again)
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(down to 201, & non-existent ketones)
Today is another day.(& one that fortuently doesn't require going to school.Youngest brother is getting married today.) Being hit by the Diabetes Express takes a day or so to really recover.(it's amazing how fast you can get into trouble & how long it takes to feel human again)
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Tuesday, March 01, 2011
Diabetes on Demand (Disclosure)
"Who here has diabetes?"
Those were not words that I EVER imagined coming from any instructor's lips, let alone the department (semi) head. But flow they did, in response to another student's inquiry on a diabetes-related topic.
"Oh, I do, I do, I do!I got it when I was 16.5, which isn't as sucky as some ages to be diagnosed because you can take full responsibility for your disease,and can wield a needle like a pro, but still,the only good age to get diabetes is age 86(or whenever you're in your final illness) when you don't really care that much because you're nearly dead..."
(Wait a second. What am I about to DO? I'm about to tell a group of people (of which, 50% will probably turn out to be food Nazi's and hound me relentlessly for the next 1.5 years (till graduation) about how I should manage "my" diabetes. They don't need to know. This is a teachable moment,but it is not "my" teachable moment. There are 30+ people in this room & my not saying anything,will not forever influence/ruin their careers.) And so my hand(burning with the urge to go UP) stayed down.
"Some of my student's in past semesters have diabetes,and have better perspectives on that (various diagnosis ages) then I do."
I thought about that, and while it's certainly up to the individual in question whether they want to share that I don't think it's something an instructor should be asking the class. That's an extremely personal question. I have diabetes,and at this point only the disability office knows it because they're the only ones who need to know. It still feels a tad weird though (the amount of candy that flows through this class is like being in kindergarten)like you should say something (about why you're not chowing it down like the best of 'em). Nothing against the candy in question, it's usually my blood sugars that I don't want to chase for the next 6 hours. Regarding different diagnosis ages,things are very different when you're dx'd at 6,16,26, or 60. But at every age, the patient can be involved in SOME way. (6 year olds are very smart & can get concepts before adults do) Being dx'd at 17, my childhood was D-free and candy was candy.(not something to be fought over, or something that would kill me.) I didn't have major food issues because I was diagnosed in the age of carb counting(and we always ate pretty healthy, so no changes there either)Getting diabetes is so much more then "anxiety over insulin injections" such as the examples in class are portrayed. It's more like anxiety over hypo/hyperglycemia/blindness/stroke/heartattack/kidneyfailure/amputations/neuropathy/foodbattles/dating/marriage/childbirth/job/healthinsurance/bloodsugarswings/earlydeath etc.etc.etc. I guess they choose that (as something that the nurse can actually "do" something about.)You can't dive forehead deep into something, you've got to take it by degrees.
On the plus side,I've survived three tests,a math test,a presentation,and a paper (with mostly A's) so I'm not just surviving,I'm doing pretty darn good. Switching to disability accommodations in the testing center was a really good idea.(less stress,lower bgs,and the slightly extra time have really improved my test scores)I should have done this a long time ago.
Those were not words that I EVER imagined coming from any instructor's lips, let alone the department (semi) head. But flow they did, in response to another student's inquiry on a diabetes-related topic.
"Oh, I do, I do, I do!I got it when I was 16.5, which isn't as sucky as some ages to be diagnosed because you can take full responsibility for your disease,and can wield a needle like a pro, but still,the only good age to get diabetes is age 86(or whenever you're in your final illness) when you don't really care that much because you're nearly dead..."
(Wait a second. What am I about to DO? I'm about to tell a group of people (of which, 50% will probably turn out to be food Nazi's and hound me relentlessly for the next 1.5 years (till graduation) about how I should manage "my" diabetes. They don't need to know. This is a teachable moment,but it is not "my" teachable moment. There are 30+ people in this room & my not saying anything,will not forever influence/ruin their careers.) And so my hand(burning with the urge to go UP) stayed down.
"Some of my student's in past semesters have diabetes,and have better perspectives on that (various diagnosis ages) then I do."
I thought about that, and while it's certainly up to the individual in question whether they want to share that I don't think it's something an instructor should be asking the class. That's an extremely personal question. I have diabetes,and at this point only the disability office knows it because they're the only ones who need to know. It still feels a tad weird though (the amount of candy that flows through this class is like being in kindergarten)like you should say something (about why you're not chowing it down like the best of 'em). Nothing against the candy in question, it's usually my blood sugars that I don't want to chase for the next 6 hours. Regarding different diagnosis ages,things are very different when you're dx'd at 6,16,26, or 60. But at every age, the patient can be involved in SOME way. (6 year olds are very smart & can get concepts before adults do) Being dx'd at 17, my childhood was D-free and candy was candy.(not something to be fought over, or something that would kill me.) I didn't have major food issues because I was diagnosed in the age of carb counting(and we always ate pretty healthy, so no changes there either)Getting diabetes is so much more then "anxiety over insulin injections" such as the examples in class are portrayed. It's more like anxiety over hypo/hyperglycemia/blindness/stroke/heartattack/kidneyfailure/amputations/neuropathy/foodbattles/dating/marriage/childbirth/job/healthinsurance/bloodsugarswings/earlydeath etc.etc.etc. I guess they choose that (as something that the nurse can actually "do" something about.)You can't dive forehead deep into something, you've got to take it by degrees.
On the plus side,I've survived three tests,a math test,a presentation,and a paper (with mostly A's) so I'm not just surviving,I'm doing pretty darn good. Switching to disability accommodations in the testing center was a really good idea.(less stress,lower bgs,and the slightly extra time have really improved my test scores)I should have done this a long time ago.
Wednesday, February 23, 2011
The Most Awesome Thing
I've thought about this, and the vast majority of the stuff that I've done with diabetes is just general life stuff. Or, as a direct consequence of chronic disease. And I feel like (life-wise) that I'm JUST getting started (on the grand and glorious degree seeking, family, etc. Things that one could feel pride over,I can't really yet.) Jobs I've disliked(but stuck with for the insurance)...surgeries, hospitalizations, research studies that no sane person would ever subject themselves to, vacations spent at FFL(etc.) No one really wants to hear THAT. (yeah, being alive is a pretty major accomplishment but its often because of D, not separated from it) I have gotten married, stayed married (thus far),moved out on my own (for two years-before getting married), bought three cars,and self-sustained myself without having to file for bankruptcy (so there's that).
But there was one time that I did feel like an advocate for type 1's everywhere...when I went on Fear Factor. (I won't repost it here, but you can access it via the link) That really got my adrenaline going..& although I didn't make it very far,it helped me get over the "type 1's can't do things of that nature" mind-block. Type 1's (or 2's) can do whatever the heck they want,and even WIN. (see also, The Amazing Race winners, one of who has type 1) I would love to be on another game show (of that nature) if the chance presented itself. (I tried out for Jeopardy once,and almost made it past the first draft, was off by about 2 questions.That was a level of stress far beyond jumping off a building.)
“This post is my February entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/introducing-the-dsma-blog-carnival/“
But there was one time that I did feel like an advocate for type 1's everywhere...when I went on Fear Factor. (I won't repost it here, but you can access it via the link) That really got my adrenaline going..& although I didn't make it very far,it helped me get over the "type 1's can't do things of that nature" mind-block. Type 1's (or 2's) can do whatever the heck they want,and even WIN. (see also, The Amazing Race winners, one of who has type 1) I would love to be on another game show (of that nature) if the chance presented itself. (I tried out for Jeopardy once,and almost made it past the first draft, was off by about 2 questions.That was a level of stress far beyond jumping off a building.)
“This post is my February entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/introducing-the-dsma-blog-carnival/“
Saturday, February 19, 2011
The Blood Sugar Diaries
"How's your blood sugar?"
"What's your blood sugar?"
"Have you checked your blood sugar today?"
"What's your blood sugar generally range?"
I've gotten alot of that lately,& quite frankly,it's driving me up the wall. Quite frankly,there is never a time where the PWD cannot think about their blood sugars and today, I may be 300, tomorrow,30. The health care providers in question aren't asking you your latest a1c...they are asking you,judging you, on your blood sugar at that very minute. An hour from now it may be a whole different story. Not to mention they don't plan to do anything about it. (except label you "noncompliant" & "out of control" anyway) In nursing school, the label non-compliant is tossed around every three sentences anyway...& most of the time,gets applied to the patient with diabetes. It is an actual nursing diagnosis and you HAVE to use it. Words cannot express how much I loathe that term & how it is a cop out for figuring out what us really going on. At some point, I will write a paper on how that term needs to be abolished.
Anyway....back to the blood sugars.Why is that a topic that gets zero privacy & always gets asked?(I get that they need to "know" it but other sensitive topics,like "how many times have you pooped today?" could be construed in much the same light.And docs don't generally ask THAT.) I am really tired of talking about,discussing and dissecting and digressing and dealing with the topic of blood sugars. Yes,I do it everyday...it's my life.And yes,I do consult my Endo/Diabetes Educator on occasion. But everyone else (in the health care field,& the diabetes police) get on my nerves.(not the online community,they "get it" & I dint mind discussing online) I guess that's why I haven't been to a pump group meeting in forever because even there it tends to get a bit grilling. They all have a1c's in the 5's and 6's and are a tad unbelievable. (not that they aren't nice,but they are just in a totally different world) I need to hang out with REAL PWD. People who forget/leave their pumps at home,who have eaten themselves from 40 to 400 and will admit to having done so. People who don't claim to be perfect.(I also need to to figure out a better answer then "kindasortofnormalrange" which tends to produce blank looks & even more grueling of the blood sugars.) I guess I just hate that it's not considered private at all...& while I'm the one who manages it,the peanut gallery can still have their say about how much better I could be doing. (much like backseat drivers telling you how to drive a car)
- Posted using BlogPress from my iPhone
"What's your blood sugar?"
"Have you checked your blood sugar today?"
"What's your blood sugar generally range?"
I've gotten alot of that lately,& quite frankly,it's driving me up the wall. Quite frankly,there is never a time where the PWD cannot think about their blood sugars and today, I may be 300, tomorrow,30. The health care providers in question aren't asking you your latest a1c...they are asking you,judging you, on your blood sugar at that very minute. An hour from now it may be a whole different story. Not to mention they don't plan to do anything about it. (except label you "noncompliant" & "out of control" anyway) In nursing school, the label non-compliant is tossed around every three sentences anyway...& most of the time,gets applied to the patient with diabetes. It is an actual nursing diagnosis and you HAVE to use it. Words cannot express how much I loathe that term & how it is a cop out for figuring out what us really going on. At some point, I will write a paper on how that term needs to be abolished.
Anyway....back to the blood sugars.Why is that a topic that gets zero privacy & always gets asked?(I get that they need to "know" it but other sensitive topics,like "how many times have you pooped today?" could be construed in much the same light.And docs don't generally ask THAT.) I am really tired of talking about,discussing and dissecting and digressing and dealing with the topic of blood sugars. Yes,I do it everyday...it's my life.And yes,I do consult my Endo/Diabetes Educator on occasion. But everyone else (in the health care field,& the diabetes police) get on my nerves.(not the online community,they "get it" & I dint mind discussing online) I guess that's why I haven't been to a pump group meeting in forever because even there it tends to get a bit grilling. They all have a1c's in the 5's and 6's and are a tad unbelievable. (not that they aren't nice,but they are just in a totally different world) I need to hang out with REAL PWD. People who forget/leave their pumps at home,who have eaten themselves from 40 to 400 and will admit to having done so. People who don't claim to be perfect.(I also need to to figure out a better answer then "kindasortofnormalrange" which tends to produce blank looks & even more grueling of the blood sugars.) I guess I just hate that it's not considered private at all...& while I'm the one who manages it,the peanut gallery can still have their say about how much better I could be doing. (much like backseat drivers telling you how to drive a car)
- Posted using BlogPress from my iPhone
Wednesday, February 16, 2011
Casualty: 1900's (YouTube)
My latest tv show addiction. As I don't live in the UK,I just found out about it.(via Amazon Video on Demand) It's kind of like "ER" (early 1900's style) It was a totally different world..gloves were used only during surgery & nurses weren't allowed to get married.(they were married to their jobs)People died routinely of infections,(staff caught them from patients) there were no antibiotics. (they did practice isolation techniques but weren't very effective at containing outbreaks)
Regretfully, it only had two seasons.(and I think that's all it will have) I've finally figured out that the English title sister would be a charge nurse in the US. (see also: My Experience in an English Hospital)I guess some hospitals still go by those titles.(if not all) This show is like crack cocaine,it's got the doctor/nurse romance, the spurting blood,the women's right issues,and pretty much everything a good medical drama should have.And it's primarily from the nursing student (aka "Probationers") point of view so it's really interesting seeing how that differs from nursing student's today.(and yet,so much is the same)I highly recommend watching them all, if you enjoy things of that nature.
Thursday, February 10, 2011
Veni, Vidi, Vici
I studied.
I came, stowed all beeping electronic devices in my car,and walked into the classroom with a roll of glucose tabs in my pocket.
I(along with the rest of the class, row by row) came up and stored every possible physical belonging AT THE FRONT OF THE CLASSROOM NEXT TO THE INSTRUCTOR'S DESK.(it was like being in Kindergarten,the only thing you were allowed to have were 2 pencils(which must be non mechanical) a sheet of paper,and your test/scantron.)
And I took the test.(under meter/blood sugar anxiety)
And I went back out to my car,grabbed my meter,and tested 325 mg/dl, 1 hour and 30 minutes later.
I really,really, really need those accommodations..its one thing worrying about the test(I shouldn't have to worry about my blood sugar too). I'm not that likely to go low-I just need the freedom to be able to check(and adjust) at will. It's very obvious that I need a cranked up basal rate(and possibly an adjusted mealtime Insulin/Carb ratio as well) One test passed(grade wise)and yet it most definatly wasn't a success, diabetes wise.One Stress-a-thon seriously shoots the whole day's numbers to pot.
Still waiting on the paperwork from my Endo's office,(for the accommodations)and it looks like I'll have to take another test in much the same manner.(before it all gets straightened out) I also don't know exactly how the accommodations will play out-perhaps I'll have to take my tests in the testing center.
I came, stowed all beeping electronic devices in my car,and walked into the classroom with a roll of glucose tabs in my pocket.
I(along with the rest of the class, row by row) came up and stored every possible physical belonging AT THE FRONT OF THE CLASSROOM NEXT TO THE INSTRUCTOR'S DESK.(it was like being in Kindergarten,the only thing you were allowed to have were 2 pencils(which must be non mechanical) a sheet of paper,and your test/scantron.)
And I took the test.(under meter/blood sugar anxiety)
And I went back out to my car,grabbed my meter,and tested 325 mg/dl, 1 hour and 30 minutes later.
I really,really, really need those accommodations..its one thing worrying about the test(I shouldn't have to worry about my blood sugar too). I'm not that likely to go low-I just need the freedom to be able to check(and adjust) at will. It's very obvious that I need a cranked up basal rate(and possibly an adjusted mealtime Insulin/Carb ratio as well) One test passed(grade wise)and yet it most definatly wasn't a success, diabetes wise.One Stress-a-thon seriously shoots the whole day's numbers to pot.
Still waiting on the paperwork from my Endo's office,(for the accommodations)and it looks like I'll have to take another test in much the same manner.(before it all gets straightened out) I also don't know exactly how the accommodations will play out-perhaps I'll have to take my tests in the testing center.
Wednesday, February 09, 2011
YouTube: Study Skillz
Love this video!!(it captures well the amount of knowledge flying around that you're expected to learn/apply/regurgitate on command)
Friday, February 04, 2011
Owner of a Broken Brain
I'm studying this weekend for a test...my first of many. It mattereth not that it is Super Bowl Sunday, & it mattereth not that I have a horrendous cold/simultaneous monthly occurrence (sorry for the TMI,it is what it is), & it mattereth not that there are also next week's classes to get ready for..somehow I have to stuff 3 weeks of knowledge into my already stuffed-up head. I have to meet with various advisors as well.(next week,it's still really overwhelming)There is no time to be sick-if you miss 2-3 occurrences, you will fall so far behind that they consider you not able to keep up with the program & kick you out. It's scary,& simultaneously annoying. (if I have infected the entire lab group/instructor with my 7 hours of sneezing,sniffling,nose blowing,& coughing, don't blame me. I didn't mean too but you can see why I can't leave) I am still very overwhelmed & I'm pretty sure that feeling will be sticking around awhile.(keep swimming,try not to drown)
And last Saturday's run to the cupcake shop/JDRF summit sadly did not extend it's happiness into this weekend...my husband ate the last one today.Was extremely good while it lasted though.(loved,loved,LOVED the peanut butter frosting one)Cupcakes rock. The JDRF Summit was excellent as well.
And last Saturday's run to the cupcake shop/JDRF summit sadly did not extend it's happiness into this weekend...my husband ate the last one today.Was extremely good while it lasted though.(loved,loved,LOVED the peanut butter frosting one)Cupcakes rock. The JDRF Summit was excellent as well.
Monday, January 31, 2011
Making the "D" List
444 mg/dl.
I know it to be true,long before the blood & the test strip met(in not-so-perfect harmony). My mouth is dry,my eyes heavy,& I'm ready to snap at the slightest provocation. But one task remains,at the end of another school day...a task that is as foreign to me as anything I have ever done.
I must register my diabetes as a disability. Nursing school demands it,there is no way that I cannot.The instant anything on my person vibrates,shrieks,or goes off (or the day I have a massive low & have to eat) is the instant that I am summarily dismissed,penalized,rejected,expelled,etc. I've never had anything of this nature,for I've never had any need for it.But now,there are 4-5 instructors who don't know me from anyone else & don't care & I've got to cover my bases.(against the bad diabetes day...for they happen) Even D won't get me a "go home" card but if it gets me a predictable lunch break,darn right I'm going to take it.
So I pick up the form,(to bring to my Endo)chug a bottle of water,bolus,& track back to my car...the ending of another unpredictable day-in-the-life with the big D. No idea how I got that high,just yesterday it was perfect bgs all day. I really think people with insulin dependent D deserve some sort of break,like exclusive access to the soda machine(diet,of course) to quench that unquenchable thirst.People without D(or a family member with it) have little clue just how lucky they really have it.
I know it to be true,long before the blood & the test strip met(in not-so-perfect harmony). My mouth is dry,my eyes heavy,& I'm ready to snap at the slightest provocation. But one task remains,at the end of another school day...a task that is as foreign to me as anything I have ever done.
I must register my diabetes as a disability. Nursing school demands it,there is no way that I cannot.The instant anything on my person vibrates,shrieks,or goes off (or the day I have a massive low & have to eat) is the instant that I am summarily dismissed,penalized,rejected,expelled,etc. I've never had anything of this nature,for I've never had any need for it.But now,there are 4-5 instructors who don't know me from anyone else & don't care & I've got to cover my bases.(against the bad diabetes day...for they happen) Even D won't get me a "go home" card but if it gets me a predictable lunch break,darn right I'm going to take it.
So I pick up the form,(to bring to my Endo)chug a bottle of water,bolus,& track back to my car...the ending of another unpredictable day-in-the-life with the big D. No idea how I got that high,just yesterday it was perfect bgs all day. I really think people with insulin dependent D deserve some sort of break,like exclusive access to the soda machine(diet,of course) to quench that unquenchable thirst.People without D(or a family member with it) have little clue just how lucky they really have it.
Thursday, January 27, 2011
Then and Now
Discovered this meme over at Canadian D-Gal, and it looked fun, so I thought I'd try it.
10 years ago I was:
-in my 2nd semester of community college,and preparing to beginning pumping on Ye Ole Minimed 508.But because my insurance company took 3 months to approve the pump,and it took another 2 months to get a training date I would not actually begin pumping until April.
-working a retail job, and ok with it.
-living at home.
- wishing I could win the lottery.
Five Years ago I was:
-still working that (same) retail job, and hating it.
-finally moving out of home, to my very own place.(small, rented house)
-now pumping with a Deltec Cozmo
-dating a wonderful guy who would later become my husband
- still in community college
-doing my best NOT to go bankrupt
1 Year ago I was:
-finishing the very last nursing school prerequisite! (it only took me 9.5 years, how about that...)
- Enjoying (or not) my first trip to NYC
-working hard to lower my a1c
Yesterday I:
-had a doctor's appointment
-barely ate anything at all until 4 pm because I was busy rushing from one end of the county to the other end so I could get to my class lab on time.
-had a nightmare involving my endo screaming at me for no good reason.
- sacked completely out (post-supper) and did not look at the books at all.(wise, no, since I have mandatory homework but I'd ceased to care)
Today, I:
-woke up to a 125, went back asleep and skyrocketed 120 additional points in two hours(doing nothing).
-ordered cupcakes for a party on Saturday.
-checked the school closings & was elated to find that 5 measly inches DOES cancel school for the day. (although, I have to make it up tomorrow)
-made lists of all the things that I really should be doing.(and haven't done yet)
5 things I'd do with 1 million (or rather, billion) dollars
- buy my parents a house
- set up a foundation for uninsured folks to get the medications (in particular,
diabetes meds) that they need
- go on a year long "tour the globe" trip
- give to charities
- buy my own personal CVS scanner machine
5 favorite TV shows:
- Grey's Anatomy
- Private Practice
- Royal Pains
- House
- The Middle
5 biggest joys
- being alive (and in relatively good health)
- being married
- being in nursing school!
- having health insurance,which gives me the means to do all of above
- a cold diet coke
10 years ago I was:
-in my 2nd semester of community college,and preparing to beginning pumping on Ye Ole Minimed 508.But because my insurance company took 3 months to approve the pump,and it took another 2 months to get a training date I would not actually begin pumping until April.
-working a retail job, and ok with it.
-living at home.
- wishing I could win the lottery.
Five Years ago I was:
-still working that (same) retail job, and hating it.
-finally moving out of home, to my very own place.(small, rented house)
-now pumping with a Deltec Cozmo
-dating a wonderful guy who would later become my husband
- still in community college
-doing my best NOT to go bankrupt
1 Year ago I was:
-finishing the very last nursing school prerequisite! (it only took me 9.5 years, how about that...)
- Enjoying (or not) my first trip to NYC
-working hard to lower my a1c
Yesterday I:
-had a doctor's appointment
-barely ate anything at all until 4 pm because I was busy rushing from one end of the county to the other end so I could get to my class lab on time.
-had a nightmare involving my endo screaming at me for no good reason.
- sacked completely out (post-supper) and did not look at the books at all.(wise, no, since I have mandatory homework but I'd ceased to care)
Today, I:
-woke up to a 125, went back asleep and skyrocketed 120 additional points in two hours(doing nothing).
-ordered cupcakes for a party on Saturday.
-checked the school closings & was elated to find that 5 measly inches DOES cancel school for the day. (although, I have to make it up tomorrow)
-made lists of all the things that I really should be doing.(and haven't done yet)
5 things I'd do with 1 million (or rather, billion) dollars
- buy my parents a house
- set up a foundation for uninsured folks to get the medications (in particular,
diabetes meds) that they need
- go on a year long "tour the globe" trip
- give to charities
- buy my own personal CVS scanner machine
5 favorite TV shows:
- Grey's Anatomy
- Private Practice
- Royal Pains
- House
- The Middle
5 biggest joys
- being alive (and in relatively good health)
- being married
- being in nursing school!
- having health insurance,which gives me the means to do all of above
- a cold diet coke
Monday, January 24, 2011
Low to Go
Lately, I've been having two of my most unfavorite types of lows.( yes,there are types) The worst kind (of course) is the glucagon requiring ones. (bad,bad, BAD to have) And there is no "good" low but the ones which occur in the comfort of ones own home & respond rapidly to the ingestion of glucose aren't too bad.
None of that for me. It's either the brain shakes/freeze in the middle of class or the "non-low-low." It's really mortifying trying to get it together(public lows are horrible) & act like nothing is wrong,when no one else knows you yet(or that you have diabetes). That will change someday..but I'm not the sort of person to blab it out until I need to.(or,are friends with someone) The nursing instructors are extraordinarily competent, intelligent human beings who I think would actually know what to do if I keeled over but right now, I don't want it to get to that stage yet.(having to tell) I will have to(in a few weeks) when I go to clinicals,as you're required to disclose anything that might make you appear loopy. I do need to get (& wear)a new medical ID,for my old one is nowhere to be found.(in the meantime)
The other type of low is the one that feels much worse then it actually is. Case in point: yesterday's 10 pm 68 mg/dl,with NO units of IOB. I ate like I would knock it to 300 & beyond(44 fast carbs), fell asleep, woke up at 2:30 with a 69, ate another 35 carbs & was 133 four hours later. You feel bad because you are dropping quickly, not so much from the actual bg. Or being 108,not low,but dropping extremely rapidly(ton of IOB) & needing to treat it as a low. I treat something how it feels,rather then what it is,when in doubt.All the exercise(tramping all over campus) I've been getting is no doubt triggering these lows.(& until I get some sort of a pattern,all I can do is pack a jar of tabs/3 juice boxes in my backpack,to nip anything before it turns major) Lows will drain every last ounce of remaining energy(& then some) from you.(school plus lows=no desire to go to the gym,ever again) I am exhausted.
- Posted using BlogPress from my iPhone
None of that for me. It's either the brain shakes/freeze in the middle of class or the "non-low-low." It's really mortifying trying to get it together(public lows are horrible) & act like nothing is wrong,when no one else knows you yet(or that you have diabetes). That will change someday..but I'm not the sort of person to blab it out until I need to.(or,are friends with someone) The nursing instructors are extraordinarily competent, intelligent human beings who I think would actually know what to do if I keeled over but right now, I don't want it to get to that stage yet.(having to tell) I will have to(in a few weeks) when I go to clinicals,as you're required to disclose anything that might make you appear loopy. I do need to get (& wear)a new medical ID,for my old one is nowhere to be found.(in the meantime)
The other type of low is the one that feels much worse then it actually is. Case in point: yesterday's 10 pm 68 mg/dl,with NO units of IOB. I ate like I would knock it to 300 & beyond(44 fast carbs), fell asleep, woke up at 2:30 with a 69, ate another 35 carbs & was 133 four hours later. You feel bad because you are dropping quickly, not so much from the actual bg. Or being 108,not low,but dropping extremely rapidly(ton of IOB) & needing to treat it as a low. I treat something how it feels,rather then what it is,when in doubt.All the exercise(tramping all over campus) I've been getting is no doubt triggering these lows.(& until I get some sort of a pattern,all I can do is pack a jar of tabs/3 juice boxes in my backpack,to nip anything before it turns major) Lows will drain every last ounce of remaining energy(& then some) from you.(school plus lows=no desire to go to the gym,ever again) I am exhausted.
- Posted using BlogPress from my iPhone
Tuesday, January 18, 2011
The Dexcom Song
(this is a semi-true story, and is to be sung to the tune of "The Bricklayers Song". All of this didn't happen, but life gets pretty bizarre on the night watch.And last night, was particularly bizarre.)
Dear Maam, I write this song to tell you of a fight
Tween' me and my odd Dexcom, it twern't a pretty sight
Me body is one massive bruise, my glucose 403
And I think that school (in any form) is not for me today.
It was a normal Monday night, basal checks galore
Alarm clock on the ready, juice and tabs on drawer
My Endo said it must be done, and so it was to be
I prepared to follow out The Royal Endocrine Decree.
Now, all went well initially, I was just 123
I felt quite smug, and told myself, it'd go just perfectly
A job half done, I smuggled down, prepared to sleep, to dream
But all was not as steady as would otherwise seem.
At 12 am the Dex went off, I shot up in my bed
Confused, dazed,alarmed...and thoughts raced through my head
The house's aflame, or else I'm low where is that meter when
Your legs are made of jello and the world is in a spin.
My Dexcom shrieked, it was telling me once more
But in me brain I had to know that I was low for sure
I slipped from bed, crawled toward the light, and bumped into a chair
Things were (at that point and time) a little less then fair.
My meter finally in my hands, I got a 52
But tabs, coke, cake and candy would simply not do
I must have juice, and juice alone, no matter what the price
The former lures of chocolate now failed to entice.
Now the juicy-juice spilled over, and dribbled down my face
As I sat there, sweating, shaky, a hypoglycemic daze
It hit the rug, and stained quite blue, and as I finally rose
Left trails to the bed where I would fitfully repose.
Well, I lay there groaning on the bed, and thought that that was that
But then a blur streaked through the door, our gray and fuzzy cat
He jarred the tabs, and down they fell, pelting me full force
As I lay there( cringing) I had PWD's remorse. (apparently, you CAN be too prepared)
I snatched up sturdy Dexcom, and threw it at the wall
But it met instead with fuzzy cat, who then began to howl
My husband woke, and chaos reined, just who is to be blamed
But I'm going with the Dexcom, and that will be maintained.
Dear Maam, I write this song to tell you of a fight
Tween' me and my odd Dexcom, it twern't a pretty sight
Me body is one massive bruise, my glucose 403
And I think that school (in any form) is not for me today.
It was a normal Monday night, basal checks galore
Alarm clock on the ready, juice and tabs on drawer
My Endo said it must be done, and so it was to be
I prepared to follow out The Royal Endocrine Decree.
Now, all went well initially, I was just 123
I felt quite smug, and told myself, it'd go just perfectly
A job half done, I smuggled down, prepared to sleep, to dream
But all was not as steady as would otherwise seem.
At 12 am the Dex went off, I shot up in my bed
Confused, dazed,alarmed...and thoughts raced through my head
The house's aflame, or else I'm low where is that meter when
Your legs are made of jello and the world is in a spin.
My Dexcom shrieked, it was telling me once more
But in me brain I had to know that I was low for sure
I slipped from bed, crawled toward the light, and bumped into a chair
Things were (at that point and time) a little less then fair.
My meter finally in my hands, I got a 52
But tabs, coke, cake and candy would simply not do
I must have juice, and juice alone, no matter what the price
The former lures of chocolate now failed to entice.
Now the juicy-juice spilled over, and dribbled down my face
As I sat there, sweating, shaky, a hypoglycemic daze
It hit the rug, and stained quite blue, and as I finally rose
Left trails to the bed where I would fitfully repose.
Well, I lay there groaning on the bed, and thought that that was that
But then a blur streaked through the door, our gray and fuzzy cat
He jarred the tabs, and down they fell, pelting me full force
As I lay there( cringing) I had PWD's remorse. (apparently, you CAN be too prepared)
I snatched up sturdy Dexcom, and threw it at the wall
But it met instead with fuzzy cat, who then began to howl
My husband woke, and chaos reined, just who is to be blamed
But I'm going with the Dexcom, and that will be maintained.
Monday, January 17, 2011
FDA: Build-A-Pancreas
Jan.17,2011
Dearest FDA,
I've been thinking,lately,of how despised you must be (not just among the D-Community,but among the entire medical community) Everyone wants a cure, yesterday. Your job is to protect us from those drugs & devices out there that (properly or improperly used) have the ability to injur,maim, and kill. I get that,I really do.( & I'm glad that you exist)
But I have diabetes...and sometimes,it feels like everything is "five years away." A Cure. Inhaled Insulin. Smart Insulin. An Artificial Pancreas. And on the subject of the later,the minds at JDRF & the clinical test sites know much more then I do about how it will play out. But they are dependent on us,those of us who live with diabetes..without us,it goes nowhere. At the end of the latest research study,my "Big Picture" got a little bigger.
Right now,it's in phase 2.(still very stuck in the clinical setting) They say phase 3(moving to outpatient,probably a hotel) is still a couple years away. In the meantime, research continues as to how to best incorporate various features for each & every user, a "build-a-pancreas" as you were.( not everyone needs,or wants,the same features)
And so, this led to an hour long discussion (via phone) as to what features would be most important to me. It was not the standard "I need the darn thing to shut off at 80 mg/dl so that it doesn't OD & kill me" type of conversation( because,not everyone needs that) it was more of the nitty-gritty,get your hands dirty kind.
Because an artificial pancreas is to be MORE then a glorified CGM.(& mine,is not too glorious at the moment) So you need to know if you're high or low...a CGM will alarm,& tell you that. The real issue here is the accuracy of said CGM & you can't really trust your life to it, it's lagging behind actual blood glucose by 15-20 minutes. Blood
Glucose calibration is still necessary, as are "safety parameters".(below or above certain bgs,an alarm would sound) That would be largely user defined...hence the need for initial data collection before setting those parameters. Still, I would really like for it to do SOMETHING automatically(initially), for I'm doing everything anyway & it couldn't be any more disastrous then what I've got now. (right now,even an integrated pump-CGM would make me deliriously happy) The action of the fastest acting insulin is still not fast enough to prevent a postmeal spike.(outside controls & ability to override system is a must) Technology is just not to the "slap it on and forget about it" stage...it's a work in progress.
All I ask,is for you to give it a chance.There is so much potential in it,& it blows the socks off what we have now. The moments that I didn't have to worry about my blood sugar are the moments I will treasure forever.( I,and everyone else would like more of those moments)
Cordially,
Heidi
(type 1 for 12 years and counting)
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