The Night Bill Monroe Came to Town

Ronald Reagan was our president
A diet coke would run you twenty-five cent
I was just a kid, hair flaxen-brown
On the night Bill Monroe came to town.

The Golden Girls were reigning on tv
(Not that it was something I could see)
Bluegrass was the hit, the biggest sound
On the night Bill Monroe came to town.

Momma scrubbed my face, and packed us in the van
Yeah, we were all going-the whole entire clan
Once all the shoes and socks had all been found
On the night Bill Monroe came to town.

Five hundred people screaming in the gym
The passion in their voices no mere whim
To let it out, in yet another round
On the night Bill Monroe came to town.

On and on went Billy and his band
"Dark Hollow" "Feudin' Banjo's" "Freeborn Man"
We're getting up, we're getting wild, we're getting down
On the night Bill Monroe came to town.

Thronging fans besiged him, to get his autograph
That a little kid could get one, was more then crazy daft
From that mass of people hanging 'round
On the night Bill Monroe came to town.

Cheeks and arms and papers, all were signed and blessed
With the pen of Bill Monroe, his official scrawing crest
It was still a night of being quite profound
I won't forget the night he came to town.

Ten Years Pumping: A Pictorial Odyssey

On this date in history, my life changed, for the better.

(yes, it sounds cliche-ish, but its all true. I hated the imposed schedule of the 2-shot-a-day regimen. I was about 35 lbs overweight because all I ever did was feed the insulin.Pumping helped me to lose most of that.)













If I had to pick a favorite, well, I wouldn't. (they all have their good points, except perhaps that mid 80's Disetronic) But one thing I know, I don't think I'd ever go back to a Medtronic pump.(they & I had a major falling out,& I don't think much of their products.Your opinion may vary,& I respect that)I want to do a more detailed vlog about the differences.(when I have the time)

But today, is a day for cupcakes & ice cream, to celebrate the freedom that the pump brings.Diabetes is so much easier with a pump.

Thoughts From the 3rd-4th Week

1.One week,you're on top of the game-the next,you do something unspeakable (or non-HIPAA compatible) & on top of feeling horrible about it,you then get to tell your instructor,the shadowing Masters Degree student,& the RN charge nurse.(the patient is fine) You then get to fill out your very first Incident Report on why the thing you did was a bad idea & burst into tears,well,just because the situation is not awkward enough.Mistakes happen,I know that(it's the sheer amount of authority figures that sent me over the edge). Live & learn.(I haven't been kicked out of the program yet,so that's a positive.)

2. I got to see a cataract operation(video from a guest lecturing ophthalmologist) as well as ten zillion pictures of the Diabetic Eye. It was both fascinating and made me want to throw up,as it seems that the winning combination of diabetes,nearsightedness,cataract surgeries,strabismus surgery,and optic neuritis spells a
near certain dearth for my left eye.(glaucoma,retinal detachment,macular degeneration,pick your poison)I really would like to keep it 'round as long as possible.(renewed vow to get myself to the optho this summer) I think that the clouding on my L.lens has progressed,I don't see as well at night(it seems to have really gone to town in the past 2 years...is it something about that 10 year post-surgeries mark? I think lasaring is in the cards for the near future which is kind of scary to think about. I hope it doesn't A.hurt or B. have any other visual side effects.I've known the day would come that I'd need lasar,it's just hard to remain calm when its an eye(s) you're talking about.

3.150 years ago last week,the Civil War began. iTunes has an incredible app called The Civil War Today which gives you a daily update through the 4 years of war. (it's an iPad app though) It's in newspaper format,& has video clips,journal accounts,quotes,trivia,photographs, etc. & really makes it come alive...it's a pretty cool app.If you love history and have an iPad,I suggest you check it out!

4.Cancelled my Endo appt,rescheduled for May 3.Hopefully my a1c won't be so off-the-charts high by then.

5. Freestyle strips without the Butterfly are becoming next to impossible to try and find. The bad thing is,both kinds have the same UPC so it's impossible for a pharmacy to know what they're getting.It's largely hit & miss trying to obtain any.(at all)
---------------------------
1.In the Event of a Fire Alarm,make darn sure you grab your meter & sugar,because you won't get back in that building for a good 45 minutes. This is not a time to go low.
2. Working in a nursing home is like working in the psych ward..one day everything is "normal", the next, the patient is wheeling all over the cafeteria,& attempting to slug you when you try to prevent disaster from occurring. (while the rest of the population looks on) I guess it's not that bad when the patient is not physically capable of hurting anything,but it was just so,so,so bizarre & the Easter Bunny was not exactly helping me in what I was expected to do in said situation.(me & Easter Bunny in room full of patients,& I couldn't leave because I was monitoring somebody else) HELPPP.(just about ready to be committed to a mental institution myself,I was not supposed to be monitoring the whole entire room) Next time, a little help, Easter Bunny?
3. Forget tiredness, I've progressed to dead. But next week,there is no homework/care plans due(Monday,Test 4) and Wed/Thurs we'll be caring for two patients EACH & then,that's the end to clinicals. Following week,we have our big Patient Presentations & the week after that,evaluations & the cumulative Final Exam and the big Nursing Convocation Dept. "party" and then it's all done! (time flies when you're having fun) I need it to be summer.
4. You may cross "morbidly obese patients" and "chemo/radiation patients" off the list of future career choices.Someone needs to do it,it just won't be me. I can't even find a pulse(anywhere) let alone formulate a good plan. I feel like whatever skills I may have acquired up to this point have not gotten me really far (in terms of a morbidly obese individual)
5.One week & 12 hours till the royal wedding! (I'm sure you're all just dying NOT to know)

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YouTube: A Royal Wedding

Love this clip...(and yes, I will be waking up at 5 AM (April 29) to watch the real thing!)

Circle of Trust

Trust. It's a tricky thing,and for a PWD,the question of ultimate trust boils down to a little red box.



In 12 years, I had only asked the question of ultimate trust one time (to a non-family member-family members have given me some,& my husband does know how to give one) It was directed to my then-EMT boyfriend(my blood sugar was under 10 mg/dl, & I was hysterically convinced that I would soon die) and he said no.Who knows why...nerves,perhaps.Or the legality of the situation.It did not matter,I was both annoyed(to the nth degree) and scared & crushed,that question of trust had been thrown back into my face & ultimately,that helped in the breakup.If you cannot trust someone completely,you have no business being together.(and I used to be an EMT & in my section of the universe,heck yes they give them.I know he knew how)

So when I asked my clinical instructor if she would be willing to administer "the shot", it was with a great deal of fear & trepidation. She said yes.(she's an ER nurse,heck yeah she knows what to do in an emergency) I ran through the basics,& what I'd be like(in such a situation). But then a dept wide email circulated RE school policy in such a situation & it was advised just to call 911,not to get involved.

Crushed,that's what I was. I dunno why it feels so important that I have someone on my side,but it felt like that trust I'd just given out for the 2nd time in 12.5 years didn't mean squat,again.Of course my clinical instructor was sympathetic but she couldn't go against dept policy. So back I went to talk to the dept head,& she said in actuality,the instructor could do as they wished-call 911 or give the shot/call 911,the schools liability insurance would cover either way. I wouldn't ever sue but there is liability insurance for everything,these days.

I am relieved..so,so relieved. I thought the school really didn't care if I lived or died,& I don't have the attitude that it's anyone's responsibility to do this..only someone I think would care enough to do so. When my clinical instructor said sure,I thought that to be the case.(she's pretty great) I have worked a retail job & in 7.5 years,never trusted anyone there (even good friends) with that burden.(said person has to be somewhat knowledgeable about medical matters) I think part of the deal here lately has to do with the lability of my blood sugars,& my desire to stay closer to 100 then to the 250's of yesteryears. A blood sugar monitor is also not always handy..like it was at my old job. You can't very well crack the meter open in the middle of a procedure.(plus you have to wash your hands a billion times a day)

I hope to never need it(on the job)but it's so wonderful to have that piece of mind.(Bgs have been all over the map lately & it may come to pass,that I need one) I need to feel safe,& more then anything else,this decision has greatly influenced that. I don't think I'm going to be having this conversation with all my clinical professors but in this rotation,I never needed that reassurance more.(nursing home in the middle of nowhere)

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A Blue Shield Comparison

It's four months into the year, and I have mixed feelings about our newest insurance plan(Blue Shield/Blue Choice). (previously, we had Blue Cross/Blue Shield)Can't escape them Blues.

Pros:
- no test strip copay when I went and filled my rx at the local pharmacy..I can't remember the last time THAT happened.(age 21, perhaps)
- 100% coverage on the several emergency magnesium infusions(I have a plan in place for that..it's done at an outpatient infusion center) Is it fun, no, but the nurses there can get blood from a stone(they're very skilled) It also takes about half the time then at an Emergency Room. At $2,000 a pop(if not covered),even under the old insurance the copay was just horrendous. I have standing orders there.(fortunately these days my mag levels are doing pretty well but when things go south,I know it)
-diagnostic tests are covered, 100%. Lab tests appear to be covered 100% as well.

Cons:
-no mail order pharmacy, I have to order things directly from the manufacturer.And both pump supplies and Dexcom sensors are a chunk of change significantly higher then what I payed under the last plan.
-Test strips I have to get directly from the pharmacy. I miss getting all my D supplies (strips,insulin,pump supplies) in one fell swoop, at the same time, every 3 months.
- Insulin I haven't attempted to get filled yet,but I fully expect Apidra not be covered(Novolog is apparently the med of choice)or some outrageous copay & I will have to go through a lengthy appeal process. I try to use up my vials to the last drop,& therefore go through them pretty slowly but eventually I will have to face the music & go to war with the insurance company. I just don't have the energy/time to do that right now.
-regular drugs (aka synthroid,etc.) are slightly more expensive then they were with the old plan.
-dr office copays are the same...
-ER copays are $100 a pop,about 2x of the old plan. Now I really don't want to go there.(I need a tattoo that says "Do Not Take to ER" on my forehead)If I were to have a bad low, I think I'd want the IV glucose & then refuse transport.(assuming I were in that state of mind) ER's are money suckers.
-I have to get preauthorization on EVERYTHING,which is a pain in the wazoo. Preauthorization can take days, to months.(cannot begin process right before I'm about to run out of something critical)

Bottom line is...most insurance plans have problems, you're always going to be shelling out for something. I'm just glad to have insurance.(that covers as well as it does) I'm not sure yet if I like it better/worse then the old plan..they both have their advantages. I'll probably have more of a opinion later on in the year, when it becomes obvious just how much has been shelled out in comparison to under the old plan.(for mostly the same stuff)

Thoughts from the Second Week

1. Sleep? What's that?

2. See above.

3. See above.

4. I need to grow longer fingernails...there is no other way of getting into some medication packets.

5. I caught a medication error this week,& felt really good about it. I guess I wasn't that surprised that in the 4 proceeding months,no one else had.As nursing homes go,this one is ok but of course none of them are going to question the all-knowing pharmacy's RX's.I don't have a very high opinion of nursing homes' care.(in general,if you know of a great one,I will stand corrected) And it is better for the patient that is was caught,but in the grand scheme of the Universe when one has many,many other medical issues I'm not sure how much good it actually ends up doing.

6. Sometimes I need to keep my mouth shut...no one gives two cents about the nursing student's needs. I was under the impression that they did,but administrative policy trumps all.Reality is the bitterest of pills to swallow.
7. Weekends without looming tests are a good thing.And as I've been a test every Monday since Feb(barring the Spring Break) it feels indescribably wonderful NOT to have to study/cram this weekend.I'm still upset about this week anyway.

8. Starbucks is essential for those incredibly early morning risings.

9. There's no way I'll be able to get off an hour early for my would-be Endo appt. next week,you have to be dead.(dying doesn't cut it,according to my clinical instructor) Which is stupid,because all we do that time of day is sit around,talk,& write care plans. I will have to reschedule for July,my Endo will be upset, & I'm already there X 1,000,000.

10. Is it May yet? I need to get out of this semester.

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The Top Ten Ways to Drop Your Blood Glucose(part 1)

The Top Ten Ways To Drop Your BG-Au Naturale



#1


#2



#3





#4


#5.



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Thoughts from the First Week

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)

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)

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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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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.

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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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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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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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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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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.

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/“

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)

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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.