Summa Time

Most years involve some sort of surgery/body organ failure. (It's just how I roll, apparently) In 2012 it was my thyroid(6 months post C-Section). Nothing in 2011. In 2010, it was ulnar nerve surgery on my left arm,& the year before that I think was the Tonsillectomy. And the year before that I had an intestinal intussesseption & spent the later part of the year A.twice in the hospital and B.getting magnesium 2-3x a week.

So it comes as no surprise to me that something else has popped up. I've had lower right abdominal pain issues for a month...and my doc sent me in for a CT scan with contrast die. The results of that were extremely enlightening(per radiologist: "You have a really,really,tiny pancreas. I mean, it's barely there. Were you born with this?"/no, and now you're saying that my pancreas is literally disappearing and one day I might have to take digestive enzymes as well as insulin? My Endocrinologist has since reassured me that as long as "it" looks normal/not Dierrea'esque it's probably not disappearing(exocrine function intact) & she'll do some more research on that) Primary Care wise, it showed a cyst. So it was a referral off to the OB-GYN who did a ultrasound and confirmed the cyst..watch and go back to pcp if pain does not resolve. Gave it two weeks, & went back to my pcp. My pcp orders an a full abdominal ultrasound which then showed that the cyst had gone (from what they could see..one side was still rather unclear)but I have "sludge" in my gallbladder.
The next step is a HIDA scan.(which tests gallbladder function)(nuclear medicine) These require fasting at at least 4 hours in advance, & laying on a cold hard table for an hour while they take pics. That's scheduled for next Monday, provided nothing happens between now and then.

All things considered,as long as it doesn't mess up my Florida plans I can live with it. I still have all my "useless" organs(ie gallbladder, appendix,spleen) and if getting it out is required, well there could be alot worse scenarios.(just don't tell me that it has to come out eminently because I need this vacation) Being female,having D,being 30-40,and having had a baby pretty much
shoes you in for gallbladder issues.
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A Bucket List

Here's a few of the things I'd love to see happen in this life of mine...


1. Win the lottery. (oh, wait, that will never happen? well, a girl can dream. If I won the lottery, I'd set up a foundation for D-peeps to get needed supplies(test strips,insulin, glucagon, syringes, type 2 meds, etc.) I'd also take a longgggg trip around the world & perhaps buy a yacht to live on for the rest of our days) And I'd help my parents, sibs,family, and friends out. (financially)

2. Go to an Olympics. (opening ceremonies through closing ceremonies) I imagine that is pretty cool.

3. Finish the RN degree, finish the bachelors, finish the Masters.

4. Have another child.

5. Participate in more Artificial Pancreas research studies.

6. Travel. (see also: #1)

7. Perform an impromptu concert on UVA's grand piano (at the medical center).

8. Be in The Doctors/Ellen DeGeneres tv audience.

9. Be on Jeopardy game show. (live)

10. Live to a ripe old age. Although I'm not sure I want to live too long because at some point my husband would not outlive me (13 years age diff) and that is going to be awfully lonely. I want to go together. So, about to the age of 88.

11. Run a marathon. (yeahhhhhhhh...that one won't be happening anytime soon)

12. Get a puppy, and some gold fish. (and perhaps other pets that aren't cat un-friendly) Our cats are getting old though.

13. Move back to Virginia,(retirement?) get a rustic cabin (but not too far from civilization) and stock it to be prepared for any national disaster.

14. Volunteer at a diabetes camp.

15. Learn to quilt/knit/crochet.

16. Learn proficient Spanish.

and the last thing on my bucket list?

See a cure for type 1 diabetes come to pass, preferably applicable to me. I have a whole other bucket list reserved for THAT occurance, mostly involving foods that test out the realness of that cure.
Baby steps, though. (I'd take an artificial pancreas in the absence of that cure)

Random Bits of Double Up Arrows

Technology woes: I has them. On several fronts.

You know how most of the US is finallllllly getting to transition to the new Omnipods? (after being promised this since like, February. I'm not kidding.) Well, I'd estimate that 95% of my podding friends already have theirs. Strange silence for me, still. I have been ordering pods on a month-to-month basis because I didn't want to get stuck with 3 months worth of old pods that don't work with the new system. I get them directly from Insulet. Rumor has it that on the next "reorder" they will send you the new system/pods. I have not ordered in the traditional manner,& have somehow slipped through their (emailing)cracks. However, since they finally have approved me to get the new system(per over the phone), I was game to get a 90 day supply.

Not so fast. This,apparently, has to be approved by my insurance company like everything else. Why they wouldn't approve this when they already approve of the old pod system is beyond me. Then again,they will probably have to pay for the PDM (as well as the partial pod cost) and who knows how that will go down. The Insulet rep suggested I call & bug them,to expedite the process. Insulet isn't exactly helping the process along. It will probably be another week before I get approval/new system in my hands, which means its back to my Ping system for me.(on the last pod) Sigh.

And in other news, my phone is currently bricked...as I was attempting to install/jailbreak to Cydia. Then I tried to reinstall my phone stuff, and couldn't do that because my Mac operating system(Lion?) needed a major (lengthy) update. I know not of what I do, which is why it takes me 3x longer then it would take anyone else. My phone is long out of warranty with Apple(it's an iPhone 4), but I just can't bring myself to get another one/sell this one until something majorly mind-blowing comes out or this phone dies.(in case you were thinking I deserve to get bricked, for jail breaking) I jailbreaked once before,successfully. Jailbreaked phones are just sooooo cool,you get a ton more options/programs that Apple doesn't give you.

Endo appt on Friday. I could very well get my first double-digit a1c since post-dx, things have been that horrid on the bg front. I know I need to go back to the educator and really work on the overnights. However, don't expect any sort of consistency on the shot/pod/tubed pump method because I have to use whatever works or whatever I can get my hands on. I've also had some pain issues (cyst) for the past month,so there is always a reason for these things. It cannot stop there though, it's so easy to say "this is how it is and I'm going to wallow in it." People who live to 100 don't have that attitude. Gotta fix it.

My MIL comes today...so it's off to finish cleaning the house!

 

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My Sugr: A Diabetes App Review

Several weeks ago, I got the chance to try out the My Sugr app (for a comprehensive review, you can read Scott's over at Scott's Diabetes) . Anyway, I'm fairly certain that the entire DOC knows about it at this point but these are just a few of my thoughts. The basic version is free, & that's currently what I'm using. (no one payed me for review of this app, all thoughts are my own)

Coming into this, I wasn't sure what to expect..diabetes apps seem to be a dime a dozen & none of them have really changed how I feel about logging.( HATE IT) I've always found paper logs to be more helpful then current apps.(at least, my Endo's spreadsheet log is. Very comprehensive. Only problem is, it's not exactly little & cute...it's an entire page for just one day. And over time? Forgitaboutit, not easy to discern patterns. But my Endo & CDE both dislike the Omnipod program downloader..so that's usually the path I go down when there is a major bg issue) But hey,why not? It just might not be like all the rest.

The first step was to name my diabetes monster. I christened mine "Sinbad the CGM" because that's the name of my Dexcom, & because I'm singerally short on good device names these days.

Sinbad & I were soon ready for action...I tapped the "+" symbol to make a new entry.

Time/Date

Location

Picture(you can use ths for food, etc...anything you want to remember for later use)

Blood Glucose

Carbohydrates

Bolus (additional area to type specific foods)

Temp basal

Activity(ranging 15 min-12 hours, additional area to type activity description)

Notes

36 icons to "tag" activity..ranging from meal related to illness,work,alcohol, etc. can use multiple tags.

Each of the above activities adds points to your point pile, which you can use to try out the Pro Version for a few days. There are also challenges that you can take, mostly involving exercise, that will get you a day or so of Pro. I think this is a good idea, because I'd want to try something out before I bought it.(the Pro Version, that is) To my knowledge, you have to have pro before you can import/export your data.The challenges give you vouchers for the Pro version.

This is what the home screen looks like. (it's a good summary at a glance screen)

Sidebar Navigator:

Logbook breaks everything down, day-by-day,in a color-coded (for exercise,carbs,insulin,etc) format

Analysis gives bg averages for 24 hrs,7 days,and 14 days.(as well as for each month)

In reports,you can export the info to your kindle app/iBooks/email/print. This is only an Apple app at this point,though they are working on an Android app.

Challenges:

Overall, I like this app. I would like to see bg ranges(adjustable for time of day, not just one flat range). I'd also like to be able to plug my basal rates into the settings & have that remembered, as that generally doesn't change on a day-to-day basis & it's a pain to keep entering that. The Pro version would really motivate me to buy it if it contained secret challenges that would give periodic Amazon gift certificate rewards.(yes, I'd pay extra for that element of surprise) I don't enter all my info,or those graphs would look significantly different(I'm really lazy) but hands down,this app trumps paper logs.(if used in the manner intended)

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A Hitchhikers Guide to the Universe: Friends for Life '13

It's coming.

Friend-for-life-itis: an uncharacteristic phenemena experienced by a person with diabetes, family member, or a health care professional most usually in the weeks leading up to the event. May exhibit behaviours such as excessive list making, packing, checking the weather in Orlando, searching for the same such hash tags on Twitter, and squealing in excitement when anyone whenever someone posts to the Facebook page. Does not entirely dissipate upon completion of the event,but can be managed via upon seeing pictures, reminiscing, etc.

This summer, my mother in law will be coming to visit. For three weeks. I expect it to go well, the last time she was here the J-baby was a newborn. He is now mobile(walking), has a world of likes and dislikes, and says a few words. One of his dislikes hates is flying on planes/strangers/hotel rooms, and so I think that this year, it's best if he stays home with Grandma/Daddy. He'll be a much happier camper & not to mention thats the entire reason Grandma is transversing the entire country. I am slightly worried, because I've never been away from my kid for 24 hours much less a week but I think if I A. Call/video chat B. leave voice recordings, etc. he'll remember me.(but if he starts to cry, it will break my heart & wonder if I'm the worlds most horrible mother for doing this & should I jump on a plane immeadietly. I would take him, but I think Grandma deserves first priority.) For over two years, he's been a part of my life & I can't just turn off my Mommy brain & decompress from that in the space of a few days. (He will be fine. I will be too. Temporary Separation must happen eventually, or he'll be 18 years old & off to college & I will have never dealt with it & be a complete mental wreck.)

Friends for Life in the Disney venue is pretty cool, for a variety of reasons. I've always taken advantage of the Magical Express bus(free transportation), and I use Southwest Airlines to check (2) free bags (I take an extra bag with me to fill with free conference goodies. People have joked that I must have a body in there, it's generally that heavy.) Last year was an exception to the rule, as 3/4 of my suitcase contained baby items & no,no way were we bringing home STUFF with the sheer amount of baby, suitcases, several backpacks, car seat, and stroller to juggle through the airport. I also bring back my plastic Disney mug(they sell these for a fee in many of the Disney Hotels) (free refills on fountain drinks) which saves having to spend any money on drinks. (YEMV. They might make you buy a new mug, but I've been lucky. I recycle from year to year.)And if you know anybody with a car, there are nearby Walmarts,etc. where you can get snack/breakfast items to cut down on the cost of food. (the Conferance runs from Wed.night-Friday night,with Sat./Sun morning breakfasts. Most people stay till Sunday morning...which means you will be buying overpriced Disney food at some point).I don't trust their mini-fridges, I have both baked and frozen my insulin vials in them. (necessitating fellow conference attendees generously giving me some) I always travel with a Frio case, & just leave it in the room. (I try to learn from my mistakes)

Also characterized by the desire to hug everyone in sight. I'm not usually an exceptionally huggy person, but that's what FFL does to you. For 1 week out of the year, diabetes isn't so sucky and you are surrounded by 3,499 people who also get it. Working in some park time also helps the whole "magical week" feeling.

I hope to see you there.

 

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The Friday Appy Hour: Savings

If you own an Apple Device, this post is for you. I do indeed love my IBabies(not as much as the human baby, but still, a lot). And I love to A. Shop and B. Save money...so the following apps make my life just a bit easier in that regard.

#1 Cardstar. This app takes the numbers on your loyalty card(CVS, Office Depot, library, whatever) and converts it to barcode form. The days of forgetting your card or carrying around 50 cards stuffed in your wallet are over...this is the 21st century, people. You simply whip out your phone,they scan the barcode,& you are on your merry way. Its also not dependent on Internet or wifi so you could probably even put it on an I-touch. I love this app.

#2 Retail Me Not. Before you buy anything,check for store coupons in this app. Again,no need to remember real paper coupons & so nice & tidy.(extensive,too)

#3 Shopkick. Gives you "points" for walking into various stores, (Target, Best Buy,Old Navy,etc)& more points for scanning various products & for buying products/gas. (can link to credit/debit card)Points can be redeemed for gift cards,etc.If you're going there anyway, this is worth your while.

#4 Receipts. Snap a pic, save for future account spending record.

#5 Coupons/The Coupons App. Another place to get e-coupons for on-the-go.

#6 Slick Deals. (#1 deal site in the entire universe) Gives you a reference to what you are looking for,when you are out and about.

These are some of the apps that I use..it's a pretty small,basic list.(searching:Coupons in the Apple Store will give you many more) Living Social & Groupon will also give you some good deals occasionally.(I draw the line at hydro colon therapy..no way,no how) My phone gives me so much more then the ability to make calls/play music/post to FB/tweet/picture load to Instagram/bid on Ebay,etc...) it's literally a life manager. (iPhone: Life as CGM:Diabetes Management) Probably other smart phones have a similar money-saving apps..but I enjoy the huge the huge selection that Apple has.

Next week I'll share with you some of my favorite diabetes apps.

 

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Day 6: Diabetes Art (#Dblog Week)

This year Diabetes Art moves up from the Wildcard choices as we all channel our creativity with art in the broadest sense. Do some “traditional” art like drawing, painting, collage or any other craft you enjoy. Or look to the literary arts and perhaps write a d-poem or share and discuss a favorite quote. Groove to some musical arts by sharing a song that inspires you diabetes-wise, reworking some song lyrics with a d-twist, or even writing your own song. Don’t forget dramatic arts too, perhaps you can create a diabetes reality show or play. These are just a starting point today – there are no right or wrong ways to get creative!



Poetry is my preferred method of expressing my D-feelings...so here you go.


If tomorrow never comes
If today is all we have
Diabetes
Deployment
Disasters-man made and natural
All terrible D's

There's a 365
During a qualifying exam
A 110
On a sunny, summer-ish day
A 44
Scarfing down smarties in a Target aisle while your toddler spills chocolate milk all over the floor
Don't stop believing
Eighty ok "in-range, or acceptable" numbers
And 520 that aren't.

It's not about the numbers
Seeking to define us
Seeking to control us
Seeking to destroy us
Showing us who is boss
Not playing well with life.
(grow the heck up, diabetes)

Inverting the equation
We are never defined
By a piece of inaccurate technology.
Up and down
Round and round
Consistently unconsistent
Expect the unexpected.

Maybe tomorrow will be better
Maybe tomorrow will be the same
Maybe tomorrow will be worse
But
The joys of this moment
The sip of this diet coke
The sand beneath my (still present) toes
The laughter of my toddler
Eyes that can see and read and experience the beauty of the written word
Is what I know in this moment
In fact, the best things of life
Diabetes cannot take from me
tonight, tomorrow, not ever.

Day 5: The Other Medical Condition

Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? (Thanks to Jane of Jane K. Dickinson, RN, PhD, CDE and Bob of T Minus Two for this topic suggestion.)


I was going to write an entirely different post then the one I'm writing today. But this morning, I checked my facebook,checking on a friend that I haven't talked to in some time...and the condolences were there, scrolling down her facebook page.

She died one year ago today. I am deeply saddened.
I could delve into the myriad of other chronic diseases, discuss the bad and the not-so-rough ones. I'm not going to do that. I'm going to talk about that disease, that the world needs to know about, and may that have ultimately claimed her life.

Her name was Tess, and we met on an online message board for people with Bartter's Syndrome.Bartter's Syndrome, as you may or may not know, is an inherited kidney condition in which the ion (potassium, magnesium) reabsorbing parts of the kidney do not function correctly and dump out these particles back into the urine. This is a problem, because your body needs to maintain a constant level of these to function correctly, and if blood levels of them drop too low you can have seizures, heart rhythm disturbances, and possibly a heart attack. (as well as all over twitches and muscle weakness)Depending on just how screwed up those parts of the kidneys are, you may need massive IV infusions of magnesium or potassium. (if you cannot take in enough orally) Also, because magnesium and potassium strongly affect sodium and calcium, levels of those may be impacted as well. In rare instances, it may lead to kidney failure. Tess had had Bartter's Syndrome from birth,and was on pretty significant IV doses of various electrolytes. I'd been diagnosed at the age of 23, and had had a fairly stable time of it up until a hospitalization for an intesseception (in 2008), and then required massive doses of IV magnesium(in the beginning, 2-3x a week. I had no life.) She was a wealth of knowledge about the disease, and sent me several hundred vials of magnesium/saline solution, helped me figure out how to use an insulin pump to administer it, helped me find a competent nephrologist.(so I could stop having to get it IV) And then something strange happened, she was diagnosed with type 1 diabetes. (as an adult, in her late 20's) She'd had to deal with her chronic disease all her life...she knew what Bartter's Syndrome was like. I'd had diabetes for 11 years, I knew what that was like. Bartter's Syndrome is extremely rare, something like 1/million people. Type 1 diabetes= not so rare, but still, rare. (if you were going to get diabetes, you'd be more likely to get type 2)
Which made us probably the only two people on earth to have both. And she lived just a state away. I regret never getting to meet her, I'll always regret that. She was so kind and helpful and med-savvy. (I found out from her obituary that she'd been in RN school, before having to drop out.) She asked me questions about the insulin pump about diabetes and insulin pumps and eventually got an insulin pump.

People live with Bartter's Syndrome, successfully. People live and thrive and have careers and babies and travel the world with this disease. For me, its never really been the constant, daily, life-threatening threat (it has been once or twice, but not consistently)...and it may have actually saved my life when I was diagnosed with diabetes.(as metabolic alkalosis balances out metabolic acidosis). It allows me to eat as much salt as I want, and it doesn't interfere with day-to-day life. (all I have to do at this point, is to get an IV infusion once a month) I'd defiantly switch my diabetes for just this disease.But other people aren't so lucky with it. Some people have a rockier course with a disease, while some just sail on through.

RIP, friend.

Day 3: Accomplishments, Large and Small

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small - think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.). (Thanks to Hillary of Rainie and Me for this topic suggestion.)


Pretty proud of this one.





And this one.



(giving whole blood to others a total of 35x over 7 years)


And even my cgm case matching (and formerly insulin pump case matching) ensemble throwing-together skillz have improved over the years.



It's still a work in progress though...there's so much that I want to accomplish (despite the diabetes). If there was a cure tomorrow you wouldn't hear me complaining that I couldn't take it along for the ride, though.

What have you accomplished, with diabetes?

Memories: The Day the World Went White

Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. (Thanks to Jasmine of Silver-Lined for this topic suggestion.)


It was May 1999, (it always seems to be May when such things happen, but I digress) and I'd just been diagnosed with diabetes 5 months prior. I'd worn glasses for nearsightedness for much of my life, and coupled with the diabetes diagnoses my vision was on a rollarcoaster. After diagnoses, however, things improved, went back to normal. One month after diagnoses, I'd had an eye appointment with a pediatric opthamologist who told me that things were back to normal, in that regard. And my a1c improved from 23 to 14 to 9.

And then came May. There were no signs, no indication of what was about to happen. I'd had a little bit of blurry vision (that I chalked up to allergies) and went to sleep one night, blissfully unaware of what was about to happen.

Next morning, my vision was almost completely obscured, it was like trying to stare through a white sheet with little pinprick holes. Naturally, I freaked out...and we got a stat consultation at the pediatric ophthalmologist.

I remember sitting there, scared out of my ever living mind, thinking that this was the end, this was blindness & diabetes had already managed to ruin my life already. And I remember the pediatric ophthalmologist talking about me, not to me, to his roomful of residents as they all took a look-see at my eyes. I remember the words "we can try surgery, which may or may not work, because we're not entirely convinced that this is all that's going on," and how that made me feel. I remember the pediatric ophthalmologist saying he'd only seen this before once (in his entire career)...it was an acute, rapid growth of cataracts within a few days time, and most probably related to the extreme drop in my hemoglobin a1c. And then we went home, to wait for the surgery.

Blindness. I couldn't read my meter. I couldn't draw up my insulin. I couldn't read, watch tv, do so many things you take for granted. I could see (and feel) well enough not to run into the wall and give my self a concussion, but that was just about it. My family went on a camping trip (I had to go) and I was a moody,depressed, introverted, wreck. They went to a Star Wars movie and I couldn't go. And one morning, there was a severe low blood sugar (the number "12" was involved) that made me even more ticked off at it. I was almost completely dependent on others, for my disease management. And that didn't help my desire to foster independence and self-sufficiency with this disease.

Two weeks later, it was time for surgery. I'd never had surgery before. The room was white, and cold, and the orderly had to gently guide me with his arm to prevent me from tripping over the IV pole and falling flat on my face. I felt shame, embarrassed that I couldn't see the bed & that I was half naked & I couldn't see where to climb up on. I felt fear that I'd never see again. And I felt anger, that diabetes had done this to me.

When I woke up, there was a patch over one eye. The world was still white, and I still couldn't see anything. We went home and I had to spend much of that time laying flat to give my eye a chance to heal. The next day, the resident doctor took the patch off & the world literally smacked me in the face with it's clarity. I saw the doctor, I saw the floor, I saw every detail with amazing new wonder. And the tears rolled, unabashed, down my cheeks.(if it would have been proper to jump up and down and hug him, I would have) Two weeks later, they did the other eye and both eyes could see again.

Diabetes took something from me, but it gave me back something much more precious. I don't take my sight for granted anymore...I cherish every day I have with it. I am grateful that medical technology is able to fix that particular complication. And I pray that that is the only serious complication that I will ever have, from this disease. It taught me that even though you can't always prevent this stuff from occurring, you still need to take diabetes management seriously. (odds are much higher that it will happen, if you don't try)

Day 2: We, the Undersigned

Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)

We, the fathers/mothers/sisters/brothers/wives/husbands/aunts/uncles/grandparents/grandchildren/caregivers/friends of the Diabetes Online Community, are writing to you, yes, YOU.(oh clueless, blissfully ignorant, person)Our lives are challenging, and ever revolving around this disease. As such, there are a few things that we feel that need to be changed...and changed NOW.

#1 Let's stop the diabetes discrimination at school, and in the workplace. Let's allow students with diabetes to be able to care for their diabetes needs, without fear of reprisal. Let's fire the jerk instructors of the world that don't want to make those accommodations. Let's make our workplaces and schools SAFE places, where we can all feel good about going to.

#2 Someone needs to conduct a massive re-education of the masses. All diabetes educational materials written prior to 1993 should be burned,and everyone should attend a mandatory diabetes educational seminar. (travelling CDE's?) As well as RIGHT information being taught in schools and universities. Newspapers and other media that publish diabetes inaccuracies should be heavily fined for such offenses.Maybe some day people will understand this disease better, and the ignorant jokes about diabetes will stop.

#3 People with diabetes need access to good physicians, CDE's, proper meds(etc.),and a host of other resources to properly manage their disease. I don't have any answers to how this can take place, but I do know that there are many, many people out there who will never be able to afford good care or maybe ANY care and that breaks my heart. People with diabetes deserve the best care possible.

#4 People with diabetes should be rewarded for trying to take care of themselves. Listen up, insurance companies. I think you should pay for gym memberships, spa days (mental health IS important), and my diet coke RX.(ok, so that last one isn't that important) Incentive is a powerful motivator, and you need to encourage those feelings of wanting to do better. You could save so much money in the long run if you'd cover these things before they esculate to the point of gangrene and amputations and sepsis and million dollar stays in the ICU. PAY FOR THEM. Education. Mental Health. Diabetes supplies. This is not college level math, this is so basic that even I (who is very, very, bad at math) can see it.

Signed,
The Diabetes Online (& offline) Community

To Endo, With Love

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see? (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)

Dear Endo,

I wish you'd say "Good Job." I know my a1c isn't 5.9 (nor will it ever be) and I'm not a lean, mean, marathon-running machine, (I wish that I were) but I get up every morning and try to do my best with this diabetes crap. It isn't always easy, its rarely easy. I wish you knew how encouraging it would be to hear those words coming from your mouth. That hasn't happened yet, not when I delivered a beautiful healthy baby boy,(a "Congrats!" but no "Great job, he's perfect!") and certainly not when I got the best a1c of my entire diabetes existence and you told me I was a bad mother & harming my baby with that a1c and I went home and cried for two solid hours until the DOC pulled me out of the depths of my 7 month pregnant depression. Everyone has bad days, and I've forgiven you for those words. (I cannot, however, forget them. They are seared onto my soul for eternity.) I used to fantasize about getting that under 7 a1c and getting to hear those words from a health care provider, but now I have come to realize that its probably not that big a deal to you and won't ever come to pass. I know I will feel good about any and all a1cs around that number, but it would be nice to feel that my health care provider could also be my cheerleader. I still respect you and your solid clinical skills, I get great care from your office and you (with the exception of pregnancy) don't hound me about my blood sugars. Thank you for that.

But mostly, I just wish you'd acknowledge the effort that I put into this..you have no idea just how uplifted and amazing that would make me feel. Diabetes is a life long journey, and "thus shines a good deed in a weary world." You've got the power to make this journey a little less burdensome.

Signed,

Your Patient

Over a Kansas Rainbow

I love Kansas, I really do. And there's a kind of tenacious toughness to the Midwesterners that's really quite admirable.

But...

I don't love being in the middle of nowhere with no cell service,no phone service,& the nearest "help" one mile away. Heck,even the walkie talkies don't work. At night, the wolves howl their symphonies & you really try not to worry about what the heck you'd do if a wild animal burst into the cabin(stab them with the glucagon needle?) or if the tornado siren went off. To say nothing of having a diabetes emergency(nearest hospital: 25 miles away) or an emergency of some other kind. I was not cut out to be Pioneer Girl.

But....

It is rustically beautiful. Flowing streams, an elaborately decked-out "Lodge", nice views, and a hot tub on the premises...plus a relative(hubby's) who is really just as nice and accommodating as can be. I will just have to woman up & bear the 5 days of no Internet, or well,anything. Hubby's relatives really want to see the J-baby.(I would love to do a Kansas meetup but that all depends on whether Hubby wants to,he isn't overly thrilled about D-meetups)

I will (likely) survive. I can do this. And maybe we will all end up having an excellent time.(toddler tempers pending)

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15 Months

This is my angelic child. He is (now)15.5 months old, bright, funny, cheerful. He loves reading books & splashing in the bathtub. He has a short fuse & his yet primary way of communication(for anything) is yelling at the top of his lungs. And for the most part, he's healthy.(seasonal allergies notwithstanding)

But... He isn't walking yet. He'll pull himself around all over everything in Creation, but has no interest in taking independent steps. (when forced to do so, he does the stop,drop, and laugh at Mommy) Otherwise, if he wants to get something that can't be gotten via holding on, he will crawl.(he can crawl faster then I can walk) And when you go to the Pediatrician's, & they frown & start asking you all these other questions about his development & start planting seeds of doubt as to whether something is seriously wrong...At this age, every normal child is at least walking. She took a look at his hips,his gait, & said it looked normal but if he doesn't begin to walk soon, they will want to get an X-ray & perhaps see a pediatric neurologist although in every other developmental area, he is normal so she doubted that it was some weird neurological deadly disease that could be causing this.(I will not Google. I will NOT Google.)

"Kids just develop differently."

Which I know, but it's not exactly turning the worry off in my brain. You can't just ignore something, hope it's nothing,& find out later that it was a HUGE something.

Enter referrel to Infant & Toddlers Program.(some sort of state funded program for developmental assessment/treatment of developmental issues) Called them, gave them some basic info & the case worker set up an assessment for Tuesday. I'm hoping they can shed some light on whether this is a medical problem or a psychological one, & what can be done to fix it.(or where to go from here,because I'm at a loss)

 

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Choosing This, Not That

This:

Not:

 

This:

 

(mostly not...) That:

This:

Not:

(the child is a perpetual ray of sunshine,so my collection of "angry baby" photos is very slim. This one is probably from a year ago.)

This:

Not:

This:

Not: (the W...)

This:

Not:

This:

Not:

This:

Not:

And always, always,more of this!!!!

 

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Pledge(d)

Long, long ago, when I was a young un' in 4-H...every meeting would begin with the solemn pledge. Which I will probably remember till my dying day, given that I recited it hundreds, if not a thousand, times over those 7 years. It went:

I pledge:

My head to clearer thinking

My heart to greater loyalty

My hands to larger service

My health to better living, for my club, my community, my country, and my world.

Nursing kinda has a pledge like that as well. It's called the Florence Nightengale pledge, as it's kinda like a Hippocratic oath for nurses. You don't get to say it unless you are a graduate/or actual RN. Florence Nightengale,as you probably know, was the founder of modern nursing & the whole shebang...she was quite the remarkable person. In first semester, we learned all about Florence & the history of nursing & all the legal stuff.(aka:how to not get sued)

"First, do no harm."

"Honesty. Veracity. Benevolence. Nonmalifecence." (learn to spell...)

"What would Florence do?" was the theme of that particular course. I grew to rather disliking Florence, for her intrusion into 21st century nursing. Florence,however,is still important. (quirky teachers non-withstanding)

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

I'm pretty sure Florence wouldn't have put up with the legal mumbo-jumbo that passes as being a good nurse today. She was a person who took matters into her own hands,to get the best care for her patients. But it's 2013, & you've got to toe the line if you want to retain a nursing lisence. I went & talked to a prof today(who is really awesome,& probably the straightest shooter in the whole program) & she told me that yep,nurses can't legally make that assessment that a patient is "ok"..it has to be done by a doctor. So if I'm that patient with a low blood sugar in clinical,even if I treat it & appear ok,if I make a mistake & kill a patient or pass out in the hallway legally it's their mess too. And there is the fact that some clinical profs actually do care about you & want you to feel better. But mostly,it's all legal. So,I guess I've got no recourse but to run 200+ if I really want to avoid lows. The instant I A.tell someone I need to treat or B.appear/am low C.eat glucose tabs & someone sees I'm low it's game over in clinical. I hardly think this is preparing me for the real world, I'm acquainted with managing D on the job without killing myself or another party. At least,it was the opinion of the prof that I'd be better off temporarily high & I am tending to agree with her. Classroom is slightly different, it's ok to be low & treat there since there are 20 other students (as long as you don't pass out). Lab is like clinical..low=nono. She cleared up the confusion I had on that matter.(as well as a few others. It's nice when someone tells you exactly why faculty does what they do,even if that reason is completely asinine.) Plus she fed me diet beverages and cookies, & that's always a huge morale booster in my book. It's nice to have someone(in real life) rooting for you.(besides all the people that live in your computer,which I do appreciate ALL of you.Thank you.)

 

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For Want of a CGM

For want of a nail the shoe was lost. (CGM/blood sugar)
For want of a shoe the horse was lost. (blood sugar/class)
For want of a horse the rider was lost. (class/student)
For want of a rider the message was lost. (student/paperwork)
For want of a message the battle was lost. (paperwork/course)
For want of a battle the kingdom was lost. (course/nursing school program)
And all for the want of a horseshoe nail. (CGM)

This is my Dexcom CGM. It is my security blanket, my ray of sunshine in the dark night of diabetes, my cool kids toy, my partner,till death (or cure) do us part. It's sole job in life is to keep me safe.

(of course,it's not a cure so it can't always do that. But it can help. Because right now, I sure as heck don't feel safe. I feel like a certain low/certain legal crappola waiting to happen. And that scares me, because lows can't always be prevented...least of all in a 12 hour shift (crazyness)in the ICU or something.

But the thing about any piece of technology, it has it's limits. And certainly, if you're going to leave your CGM behind one day because you've got a ton to do before you're even at school by 8 am, well,the CGM isn't going to help you there. You should probably put it in your backpack/what have you so you DON'T FORGET IT. And then,later on,when you are wondering "Am I or aren't I?" your CGM will tell you. And knowledge is power...knowledge will help give you the confidence that you so desperately need,that diabetes doesn't have to mean a dropping blood sugar, a freaked out clinical instructor,a trip to the ER,a ton of paperwork,a dropped course.

I'm realizing,once again, that as a student with diabetes, I need this if I ever hope to succeed. It lessens the playing field between myself and the rest of the non-pancreotically impaired class. (who don't have to think about D,on top of everything else)I'm not sure that nursing school will ever be an opportunity to be a gung-ho,let's educate all the staff/students/patients experience that I thought it might be but that's ok, you do what you can. 50 years from now, I hope this is such a NON-issue for a student with D...(assuming D isn't cured by then). Being on the front lines of all this drama wasn't something I'd have ever wanted to get involved in.( I am not a very good pioneer. I prefer for that road to already be paved for me.)

Moral of Story: Don't leave home without your D-Stuff.

(p.s. The Blogsy app ROCKS. New favorite!)

 

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Where the River Runs Deep

Yesterday,I dropped out of nursing school.

It's been one steamroller of a ride,& it's only the third week out of eight. And I guess I should explain that nothing,nothing went right in those days...starting with The Low in Lab & culminating in the Peak De Triumphe anxiety attack on Tuesday over paperwork,for which I gained a Plan For Success in Professional Behavior as well as a Plan For Success in the paperwork that I'd done wrong. I hyperventilated & ended up on the floor,thinking I would fail clinical because I was getting a plan for success (for paperwork)& it took an hour to get me up off the floor. (I got extremely dizzy & thought I was going to black out) Not a really awesome moment in my life,& I can say that's never happened before either. (Blood Sugar:365 by the end of that) That gained me a meeting with the head prof & my clinical instructor as they delivered the Plans For Success & discussed my unacceptable behavior. Before that meeting, (in the time between Tues.afternoon and Wed.afternoon), I'd decided that it was probably best if I dropped out, because there was no absolute way the further deluge of paperwork that missing Wed.clinical plus the 5 (mini)papers & 30 min.presentation due Thurs. morning I could get that all done. And my toddler was sick with an ear infection,the babysitter didn't want him back until he was acting more normal(didn't have a fever,but I digress)& that was more time spent not being able to get work done running to doctors offices & pharmacies. I need like 48 hours in a day. I'd had it with the entire mess of profs & I could see that at this rate, failure was imminent & as I still had the opportunity to drop with a Withdrawal Passing grade(thanks to a decent grade on the first exam), I took it.
So Friday, I finished matters up with withdrawal..you have to do an Exit Interview,discussing what you plan to do different the next time around & factors that led to your demise. I received a not-so-nice little copy of Med Surg I's Plan For Successes (3)and areas of Clinical Probation(3)...that was not a great course for me...& this courses Plans For Successes(2). I guess the only good thing about that is that I know exactly where I stand now & what I have to work on to avoid at all costs. I asked the head prof if I'd get a Plan For Success if I broke one of the rules while I had a low blood sugar, & she said it depended on how low I was. I said low blood sugars at any hypo level could affect behavior & she said that it all depended on the circumstances then. She then went on to talk about the low I had in lab, & whether I was being honest with my doc if I were to have frequent lows,and blah blah blah. (As to my ability to function in clinical) Grand. I'm getting the impression that if I so much as tell anyone I'm having a low, I'll be A.kicked out of clinical and B.suspended from the program. In their eyes,there is no such thing as a mild low. This is discrimination, no doubt about it,but whether its ever going to be an issue is unknown. In this course, I would say heck yes,it would be..but I know profs to which a mild low would not be a huge deal. A major anything has to be reported,& I guess I'm lucky not to have gotten a Plan For Success for my low blood sugar.(& that feels all wrong to say..seriously?like that was all my fault...) My head prof was definitely suggesting that it could happen. I'm now all kinds of confused and angry that that could even be an issue,in today's world of supposed "disability and accommodations." And I still have that matter of being switched to another clinical site,& new prof, because of the D.(did that ever hurt) I reregistered to retake the course in the fall. (Fresh,clean slate..& all of that.Almost.)

Then I went to drop my class at the registration,& was pleasantly surprised that there was no bill remaining. I wish I could have gotten a refund,but at this point,it's considered a Withdrawal,not a Drop. I know that I may be coming back to much the same issues in the fall, & I know that right now, I need a Lawyer, a Therapist, and some other resources as well to help get this mess sorted out for me.

In Ex Evictus, Maeror

Dear Clinical Student,

I'll be short & blunt.. I don't want you in my group. And when the reason for this finally becomes known, I won't be anywhere near you. You'll be in a meeting with the nursing Dept. head and the head of the Med Surg II course when you find out,& the vitriol will suck the breath out of you,but I don't care.
Why don't I want you?

I heard about your low. I don't want to have anything to do with your "unstable medical condition", in fact, I refuse to. The clinical site refuses to to, which means your going somewhere else. Your head instructor and head of the nursing dept. may tell you whatever they want, they can tell you that this site really isn't best for your needs to carry stuff in,they can tell you that it's better this way. I don't care. And when they've finished telling you this,& you walk out in a daze to go & cry in your clinical advisors office..that might be the end of it. I really don't care, I don't HAVE diabetes & I just don't want to deal with you & any low drama. I also don't have any desire to talk to you to really see if this will be an issue. So go,go & do your thing.

Sincerely,

Your Ex-Prof

One flew over the Cuckoo's Nest

It's been one of those weeks...where the diabetes hasn't played nicely with life. It's the first week of Med Surg II(aka Mental Health) & it's been somewhat of a perfect storm.

Monday morning saw 5 inches of fresh snow so some things were delayed to later in the week. There was Orientation (Monday), a simulation (real patient aka paramedic instructor) Tuesday, a math exam & neurobiology lecture on Wednesday, & a Therapeutic Communication & a Central Line Care labs on Thursday. TC went fine but about 20 minutes into the other lab my stomach started rolling & I started to get extremely dizzy & I thought I was going low but I didn't want to start off a chain reaction of "where are you going questions" so I sat there,hoping it would go away. (Because you know,lows just spontaneously disappear when you will them away)Heart racing & jitteriness soon joined the list & I started sweating profusely but I still couldn't move. The instructor stopped speaking, looked at me and asked if I was ok & that was all I needed to burst out crying,have an excuse to get out of there,head to the restroom,swig juice & check my bg.(I hadn't brought my (replacement) Dex with me that day) It was 22 & I felt very much like staying on the floor,however long it took. After probably 30 minutes my instructor (& several other students)came looking for me. Low symptoms were in full force,with a low of this nature I always shake like I'm freezing to death & cry(for absolutely no good reason). So, this instructor's first impression of me was that of a hysterically crying,shaky,confused PWD.(yes,she will be my clinical instructor in the hospital in several weeks) She assured me that it was all ok & made me eat chocolate kisses( I have zero problem doing that) until my bg read 203. The rest of my body took some time to get over the adrenalin surge from heck,& my blood pressure skyrocket to 140/90,pulse 120 as the stress shot it up. Eventually (with the assistance of blankets,fluids,& time) the shakes went away,the BP went down & the bg went up to 260 & we went back to the lab where she finished the lecture for the other students & I finished recovering & went home to take a nap. I really don't remember anything from that lecture, & I didn't try.(post low) I think she was freaked out & now considers me "brittle". I've never had a low of this nature hit in class(or clinical) before, I should have been wearing my Dexcom & had something in my pocket to discreetly treat & it all wouldn't have happened.

Friday morning, I awoke to an email from the head instructor informing me that because of my low in lab, I needed to be seen by a physician and have a form filled out that my D was stable enough to go to clinical. This needed to be done before I go to clinical(in other words,today). Classes began at 9, & I managed to acquire an appt for 3 pm with my primary care office (I still had to miss the last class of the day). So that's all done & the form is ready for Monday. I am a little annoyed that I can't even have a low blood sugar (probably even mild,this wasn't,but still) this is MASSIVE overreaction on their parts.

So that's been my life this week. I also had to get my newly found but non-functional Dex replaced & I have yet to actually send it back,though I got the replacement.(I wasn't wearing the Dex when I had the low, I'd forgotten to bring the reciever) Mental Health rotations will be very challenging, I'm not allowed to bring anything in except the basics(hence why I had to get permission for my D-crap,yep,bringing syringes (etc) into a Rehab facility is a real situation. No coffee,tea,Diet Coke allowed.(for staff or residents) We (my group)are there 3x a week, it's going to be really,really rough days without my caffeine.


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