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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Thursday, April 21, 2011
Sunday, April 17, 2011
YouTube: A Royal Wedding
Love this clip...(and yes, I will be waking up at 5 AM (April 29) to watch the real thing!)
Wednesday, April 13, 2011
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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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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Tuesday, April 12, 2011
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)
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)
Saturday, April 09, 2011
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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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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Friday, April 01, 2011
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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#1
#2
#3
#4
#5.
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Thursday, March 31, 2011
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)
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)
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)
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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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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.
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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.
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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!)
- Posted using BlogPress from my iPad
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!)
- Posted using BlogPress from my iPad
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)
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"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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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.
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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.
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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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Thursday, January 13, 2011
Middle of the Food Chain
In the past few days,I've discovered that my aspiring goals lie more towards the middle of the hospital food chain, and less towards the end. I've never doubted that nurses were key to a patient's survival(and wellbeing),but the fact that there is oftentimes a whole host of folks below(and taking orders) from the nurse is well,quite scary. Of course,ultimately the orders are supposed to originate from the doc...but they might see a patient for 10-15 minutes a day (kind of like upper management in a company I used to work for...docs live up in their ivory towers & it's the nurses (aka floor managers)who really get involved in the nitty gritty EVERYTHING of patient care.(nurses really are expected to know a ton of stuff even if most of them know nothing about diabetes.Really,it's mostly not their fault,but it will always bug me that it will always be seen as a "you-deserve-what-you-practice" disease.(among many seasoned RN's) Seriously, what happened to compassion?but that is my unique soapbox,as someone living with the disease. I think at some point I am in for an attitude adjustment...not everyone gives a flying flip about diabetes management & I do not get to play doctor.Or criticize the doctor.(not as a student,at least)(velcro mouth shut) My role is that of a sponge,listen,learn,(wipe up human secretions)& apply under careful supervision.
Students are towards the bottom. (not important to much of anything,& more of a liability then anything else.Unless you're a student MD, then you're probably slightly higher in the hierarchy. And while each and every job in patient care is important,the ratio of patient gratitude/etc.gets exponentially smaller the farther down the food chain you go...not many people thank the janitor.(they should, but don't) There are many other positions in this food chain(therapists, etc.) which I have no idea where they fit in..but this is just my initial impressions. (as a
student)
Students are towards the bottom. (not important to much of anything,& more of a liability then anything else.Unless you're a student MD, then you're probably slightly higher in the hierarchy. And while each and every job in patient care is important,the ratio of patient gratitude/etc.gets exponentially smaller the farther down the food chain you go...not many people thank the janitor.(they should, but don't) There are many other positions in this food chain(therapists, etc.) which I have no idea where they fit in..but this is just my initial impressions. (as a
student)
Monday, January 10, 2011
First Day: Spring '11
I am ready. Books are bought,tuition/etc.accounted for,& accessories/iPad apps installed/purchased,in preparation for the big day.(also,glucose keyring installed on backpack,for the inevitable blood sugar drop in the middle of clinicals) The question is,will the weather cooperate(100% chance of 3-5 inches tomorrow...which probably means they will postpone it till Wed.?)That bums me out(6 months from now I will likely wonder how on earth I could be so enthusiastic about such a hardcore program...but for now, I'm that enthusiastic little kid on Christmas morning.)
I can't wait.
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Wednesday, January 05, 2011
One Wish
Close your eyes. Count to three. Spin around,& repeat after me...
There's no place like home. There's no place like home. There's no place like-
Oops,wrong wish. I'm talking about wishes of the earth-shattering variety. Anything at all.(of the non-supernatural variety) Go.
Got it? (no wishing for 7 more wishes)
Ok,if you wished for a cure for diabetes...well, so did I. That's a pretty popular wish these days.
Now wish for something else. A million dollars,a hot new sports car,anything.
Know what I want? I want a personal meter that reads my magnesium level,that doesn't require a trip to the lab & vial of blood, & another week for the doc to get back to you to get. It's gotta be possible. I mean, if you'd asked a diabetes specialist back in 1968 whether PWD (in the future)would have at-home blood sugar monitoring devices he'd likely have shook his head & wonder what you were under the influence of. But the market (for such devices) just exploded,there was such a need for them that of course it was going to become a reality.
There is not overwhelming need for a "magnesium" meter. Although, if other things(CBC,etc.) could be analyzed simultaneously there might be a demand for it. I'm not a Chemist,engineer,or mathematician so all I can do is dream...but it sure would put the management of my problem more "in my control" & personally,I think docs would be all for that.It's not as complex and difficult to manage as D is(numbers don't do much changing) but what I've got to work with now is compatible to the Dark Ages of D-Care. It's based entirely off how you feel,with the once-in-awhile blood test. I don't feel confident about what I'm doing either...it's hit or miss. Fortuently,the margin of error for missing is quite generous (you don't get into trouble much) but if I could know, & test,& take matters into my own hands(up the dose) that would just be the most awesome thing. My levels would be in-range,& I could treat the slight lows more aggressively.
I could be waiting on that wish awhile...but a girl can dream. Maybe one day something like that will be developed.
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There's no place like home. There's no place like home. There's no place like-
Oops,wrong wish. I'm talking about wishes of the earth-shattering variety. Anything at all.(of the non-supernatural variety) Go.
Got it? (no wishing for 7 more wishes)
Ok,if you wished for a cure for diabetes...well, so did I. That's a pretty popular wish these days.
Now wish for something else. A million dollars,a hot new sports car,anything.
Know what I want? I want a personal meter that reads my magnesium level,that doesn't require a trip to the lab & vial of blood, & another week for the doc to get back to you to get. It's gotta be possible. I mean, if you'd asked a diabetes specialist back in 1968 whether PWD (in the future)would have at-home blood sugar monitoring devices he'd likely have shook his head & wonder what you were under the influence of. But the market (for such devices) just exploded,there was such a need for them that of course it was going to become a reality.
There is not overwhelming need for a "magnesium" meter. Although, if other things(CBC,etc.) could be analyzed simultaneously there might be a demand for it. I'm not a Chemist,engineer,or mathematician so all I can do is dream...but it sure would put the management of my problem more "in my control" & personally,I think docs would be all for that.It's not as complex and difficult to manage as D is(numbers don't do much changing) but what I've got to work with now is compatible to the Dark Ages of D-Care. It's based entirely off how you feel,with the once-in-awhile blood test. I don't feel confident about what I'm doing either...it's hit or miss. Fortuently,the margin of error for missing is quite generous (you don't get into trouble much) but if I could know, & test,& take matters into my own hands(up the dose) that would just be the most awesome thing. My levels would be in-range,& I could treat the slight lows more aggressively.
I could be waiting on that wish awhile...but a girl can dream. Maybe one day something like that will be developed.
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Thursday, December 30, 2010
Ringing Out The Old Year
I don't know about you, but any recent luck o'the averages I may have had has been irrevocably ruined from the Christmas holidays.
Ok I tried to be a good D...truly I did. But the goodies called my name,(over and over) the set changes became fewer,the Dexcom crapped completely out,(of warranty,too) & I just stopped caring what I was,I just wanted to have fun for once.(without inconveniencing anyone with a low). Throw in some hormones and you have the next episode of "Blood Sugars Gone Wild."
All of which equals an average bg in the mid -to-upper 200's.
Yep-not good on the a1c, & unfortuently,the holidays have not yet ended..there's still my side of the family.( New Years Day). I need to get back to regular life, routine really helps.(that and knowing the carb count!) Fortuently,my next a1c isn't till April so there's lots of time to undo that damage. I sure don't want an a1c in the 9's.(after making significant progress on that front)
I'm also starting on a low dose of Levothyroxine (25 mcg) to improve my TSH. My Endo was not wild about the idea,but she agreed to start it.My thyroid antibodies have gone up,my TSH is in the middle of the spectrum(still normal,but not "good") Hence the minuscule dose of (Synthroid). I need my thyroid at optimal levels. It was hard to get my Endo on board with it,she muttered uncomplimentary things under her breath(as to the overkill tactics of certain other specialties) but did agree to start it. It's not going to make me hyperthyroid, it can only help.
Have a Happy & safe New Year,all!
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Ok I tried to be a good D...truly I did. But the goodies called my name,(over and over) the set changes became fewer,the Dexcom crapped completely out,(of warranty,too) & I just stopped caring what I was,I just wanted to have fun for once.(without inconveniencing anyone with a low). Throw in some hormones and you have the next episode of "Blood Sugars Gone Wild."
All of which equals an average bg in the mid -to-upper 200's.
Yep-not good on the a1c, & unfortuently,the holidays have not yet ended..there's still my side of the family.( New Years Day). I need to get back to regular life, routine really helps.(that and knowing the carb count!) Fortuently,my next a1c isn't till April so there's lots of time to undo that damage. I sure don't want an a1c in the 9's.(after making significant progress on that front)
I'm also starting on a low dose of Levothyroxine (25 mcg) to improve my TSH. My Endo was not wild about the idea,but she agreed to start it.My thyroid antibodies have gone up,my TSH is in the middle of the spectrum(still normal,but not "good") Hence the minuscule dose of (Synthroid). I need my thyroid at optimal levels. It was hard to get my Endo on board with it,she muttered uncomplimentary things under her breath(as to the overkill tactics of certain other specialties) but did agree to start it. It's not going to make me hyperthyroid, it can only help.
Have a Happy & safe New Year,all!
- Posted using BlogPress from my iPhone
Thursday, December 23, 2010
Elevator Shift
(this is a story of an elevator encounter of the life-altering kind)
It was his eyes that told the story. They were the sort of eyes that you could go swimming around in,lose yourself in the passage of time...and wake up to find that 20 years had gone by,unbeknownst to all involved. There was a lifetime in those eyes.(magnetizing)
It was the summer of 2003,& I (was very single & uninvolved,ok folks?) had gotten on the hospital elevator,punched my floor number,& was set to tune out the various individuals on board..for I could think of nothing else beyond my impending "Diabetes & Driving" impatient study.(involving a simulated driving game & "controlled" hypoglycemia,I would murder virtual cows right & left.)
"Are you going to the hole?"
I semi-turned, & looked at the person who had asked the question. "The Hole?"
"Yeah-admission?You look like you are." He coughed,& the spasms wracked his thin frame. It had the sounds of cystic fibrosis,of chronic disease,of a life spent in places like this against one's desire & will.
"Ah,yes,the hole. I am indeed."
(I wasn't quite sure I wanted to spill out my medical history in the very public elevator to a guy I didn't know) And did I really have "the look?" I thought PWD were not supposed to look sick. Not like I had any wires or tubes coming from random orifices on my body.(yet)
"Take my advice...don't let the residents near you,they're real bloodsuckers & can't hit a vein to save their lives."
(this advice did not seem to phase the several white coats on board,although,I laughed. Loudly.)
"Duly noted". I was looking in the eyes,& feeling sorry for the suckyness of the situation for people with such chronic diseases & lucky just to have diabetes. We were the same ages...& yet I would likely live 40 years beyond what he would. I didn't know the half of the depths of the disease & dying process. And yet,he was living with his disease in the same way millions must...most of the time,it felt like I was ignoring mine.
The elevator clanged,6th floor.
"Take care." (I felt I needed to say something) "Hope you get out of here soon."
"Yeah,same to you. Stay cool."
IV pole in hand,he took off towards the nursing station on the heart/lung floor. And I continued onto the 8th floor,where the diabetes study awaited.(it was the most grueling,most demanding study that I have ever done,& 48 hours into it my electrolytes would drop(caused by the blood-letting & insulin clamps)resulting in them dropping me from the study early. I had no complaints to that,since they were still giving me full compensation & I just wanted to go home & die quietly,it was the first time my (as yet undisclosed) Bartters Syndrome would cause a problem & it would take months of unsuccessful dosing before I would see a nephrologist,& be diagnosed. At that moment,however,6 additional hours into IV's I just wanted the Endo to let me go home.I hoped I would be ok,and I no longer felt like I was having a heart attack right there,& although still very shaky I could walk out to my car & drive so she let me go.I went home & crashed for the rest of the weekend.)
I couldn't shake the sense that not only old people die in hospitals...22 year olds did too. All. the. time. And yet,they were one heck of well-adjusted individuals...they lived their lives knowing that day was sooner,rather then later. I think most PWD think "it will never happen to me" whereas most other chronic diseases know it will happen to them.(I'm not saying diabetes is a cakewalk but compared to CF it is)
That day,I got another perspective on life with a chronic disease.(& another idea of what I wanted to do with my life,should I ever become an RN(research,peds,or a CF nurse coordinator) This day, I still want to do something along those lines...& next semester, I shall be joining those nursing student ranks.(at last) The world needs more then a few good nurses.I know what being a patient is like...& that will make me a better nurse.
- Posted using BlogPress from my iPhone
It was his eyes that told the story. They were the sort of eyes that you could go swimming around in,lose yourself in the passage of time...and wake up to find that 20 years had gone by,unbeknownst to all involved. There was a lifetime in those eyes.(magnetizing)
It was the summer of 2003,& I (was very single & uninvolved,ok folks?) had gotten on the hospital elevator,punched my floor number,& was set to tune out the various individuals on board..for I could think of nothing else beyond my impending "Diabetes & Driving" impatient study.(involving a simulated driving game & "controlled" hypoglycemia,I would murder virtual cows right & left.)
"Are you going to the hole?"
I semi-turned, & looked at the person who had asked the question. "The Hole?"
"Yeah-admission?You look like you are." He coughed,& the spasms wracked his thin frame. It had the sounds of cystic fibrosis,of chronic disease,of a life spent in places like this against one's desire & will.
"Ah,yes,the hole. I am indeed."
(I wasn't quite sure I wanted to spill out my medical history in the very public elevator to a guy I didn't know) And did I really have "the look?" I thought PWD were not supposed to look sick. Not like I had any wires or tubes coming from random orifices on my body.(yet)
"Take my advice...don't let the residents near you,they're real bloodsuckers & can't hit a vein to save their lives."
(this advice did not seem to phase the several white coats on board,although,I laughed. Loudly.)
"Duly noted". I was looking in the eyes,& feeling sorry for the suckyness of the situation for people with such chronic diseases & lucky just to have diabetes. We were the same ages...& yet I would likely live 40 years beyond what he would. I didn't know the half of the depths of the disease & dying process. And yet,he was living with his disease in the same way millions must...most of the time,it felt like I was ignoring mine.
The elevator clanged,6th floor.
"Take care." (I felt I needed to say something) "Hope you get out of here soon."
"Yeah,same to you. Stay cool."
IV pole in hand,he took off towards the nursing station on the heart/lung floor. And I continued onto the 8th floor,where the diabetes study awaited.(it was the most grueling,most demanding study that I have ever done,& 48 hours into it my electrolytes would drop(caused by the blood-letting & insulin clamps)resulting in them dropping me from the study early. I had no complaints to that,since they were still giving me full compensation & I just wanted to go home & die quietly,it was the first time my (as yet undisclosed) Bartters Syndrome would cause a problem & it would take months of unsuccessful dosing before I would see a nephrologist,& be diagnosed. At that moment,however,6 additional hours into IV's I just wanted the Endo to let me go home.I hoped I would be ok,and I no longer felt like I was having a heart attack right there,& although still very shaky I could walk out to my car & drive so she let me go.I went home & crashed for the rest of the weekend.)
I couldn't shake the sense that not only old people die in hospitals...22 year olds did too. All. the. time. And yet,they were one heck of well-adjusted individuals...they lived their lives knowing that day was sooner,rather then later. I think most PWD think "it will never happen to me" whereas most other chronic diseases know it will happen to them.(I'm not saying diabetes is a cakewalk but compared to CF it is)
That day,I got another perspective on life with a chronic disease.(& another idea of what I wanted to do with my life,should I ever become an RN(research,peds,or a CF nurse coordinator) This day, I still want to do something along those lines...& next semester, I shall be joining those nursing student ranks.(at last) The world needs more then a few good nurses.I know what being a patient is like...& that will make me a better nurse.
- Posted using BlogPress from my iPhone
Friday, December 17, 2010
The Top Seven Holiday Gifts(for the PWD)
#1 For the Dexcom(er) (or Navigator user) in your life... I recommend one of these. You can get small camera & phone cases at any office supply store.(such as Office Depot,Staples) And I've found it to be much more useful then that generic "skin" they provide.(for the Dexcom) Yes,the skins look snazzy,but that feature really doesn't help me locate the Dex any quicker from the depths of my handbag...nor does it have a clip on the back.This does,and it's solid-does not get knocked off five seconds later.And I can find,& unzip it quickly,because it has a unique shape compared to the hundreds of other things that reside in said handbag.
#2 Music Player Cases
(looks like small backpacks)
I'm a fan of jazzed up meter cases...& these are perfect for the job,holding the meter,strips,backup vial,infusion set,syringe,roll of glucose tabs,& the Multiclix lancing device.(IMO,the greatest lancer ever,& no,I'm not being paid by Roche to say so,I am way too uncool for the likes of Roche. The Multiclix is just awesome...& better then the Delica,IMO.
These cases have several zippable compartments & a belt loop and are really quite the on-the-go accessory of the year.And I'm sure they exist in solid colors..for the male PWD in your life.
#3
I found this ornament at CVS..& it immeadietly found a warm fuzzy spot in my heart.(& a place on our tree) Love,love,LOVE anything diet coke themed.
#4
Cup-Cake-y lip gloss. (I prefer the CVS, or Bath and Body Works brands) So very yummy,and completely free (of the need for insulin). Of course, this often has the side effect of making one hungry for REAL cupcakes (and a trip to a real,live,cupcake establishment. More on that in a future post.) A gift card to a cupcake place is also an entirely appropriate present. (if the individual can cover such dietary excursions with insulin...I realize that not everyone who reads this is a type 1/family member of a type 1.Moderation is a must, for anyone.)
#5 If it's jewelry you're looking for,the JDRF and ADA have several new unique choices.(ideas gotten courtesy of Diabetes Living magazine)
- "Katie's Cure" (designed by a 12 year old with type 1)(Proceeds to benifit individuals living with type 2 diabetes,but that's completely beside the point) It's a very pretty design.
- JDRF charm bracelet. It would be cool if you could have the date of dx engraved on this(for $50,that should REALLY be an option)& I'm not sure I'd ever buy this,unless I had more money then I know what to do with..but I like the design.
- Diabetes Awareness bracelet. Hand engraved, in your choice of multiple diabetes sayings.($75)
- If you're looking for something much, much cheaper(and who isn't, these days) head over to the DRI & snag yourself an "I'm Tired of Diabetes" bracelet. It's made of recycled tires(environmentally friendly!) and the cost ($14.50 won't bust the bank.
-Finally, you can get an official Bret Michaels "Live to Rock, Rock to Live!" bandanna or an ID (I decide) tag from the American Diabetes Association.
#6
The Stupid Sock Creature. (now if they would only make the Stupid Hand Creature,they'd be all set) Good for a few laughs(and endless hours of preschooler amusement)
#7 And lastly, you can get a free Bayer Contour USB meter (along with 25 strips) at Walgreens. (until 01/01/2011) Go here, print out a coupon (for $20 off) and they'll adjust it down for you (it's on sale for 9.99). Or, you can find $10 off coupons for both the USB and the Bayer Didget in their pharmacy diabetes magazines.This is not just another "free" meter offer..this is a snazzy meter( with strips), which makes it a pretty generous deal, IMO.
#2 Music Player Cases
(looks like small backpacks)
I'm a fan of jazzed up meter cases...& these are perfect for the job,holding the meter,strips,backup vial,infusion set,syringe,roll of glucose tabs,& the Multiclix lancing device.(IMO,the greatest lancer ever,& no,I'm not being paid by Roche to say so,I am way too uncool for the likes of Roche. The Multiclix is just awesome...& better then the Delica,IMO.
These cases have several zippable compartments & a belt loop and are really quite the on-the-go accessory of the year.And I'm sure they exist in solid colors..for the male PWD in your life.
#3
I found this ornament at CVS..& it immeadietly found a warm fuzzy spot in my heart.(& a place on our tree) Love,love,LOVE anything diet coke themed.
#4
Cup-Cake-y lip gloss. (I prefer the CVS, or Bath and Body Works brands) So very yummy,and completely free (of the need for insulin). Of course, this often has the side effect of making one hungry for REAL cupcakes (and a trip to a real,live,cupcake establishment. More on that in a future post.) A gift card to a cupcake place is also an entirely appropriate present. (if the individual can cover such dietary excursions with insulin...I realize that not everyone who reads this is a type 1/family member of a type 1.Moderation is a must, for anyone.)
#5 If it's jewelry you're looking for,the JDRF and ADA have several new unique choices.(ideas gotten courtesy of Diabetes Living magazine)
- "Katie's Cure" (designed by a 12 year old with type 1)(Proceeds to benifit individuals living with type 2 diabetes,but that's completely beside the point) It's a very pretty design.
- JDRF charm bracelet. It would be cool if you could have the date of dx engraved on this(for $50,that should REALLY be an option)& I'm not sure I'd ever buy this,unless I had more money then I know what to do with..but I like the design.
- Diabetes Awareness bracelet. Hand engraved, in your choice of multiple diabetes sayings.($75)
- If you're looking for something much, much cheaper(and who isn't, these days) head over to the DRI & snag yourself an "I'm Tired of Diabetes" bracelet. It's made of recycled tires(environmentally friendly!) and the cost ($14.50 won't bust the bank.
-Finally, you can get an official Bret Michaels "Live to Rock, Rock to Live!" bandanna or an ID (I decide) tag from the American Diabetes Association.
#6
The Stupid Sock Creature. (now if they would only make the Stupid Hand Creature,they'd be all set) Good for a few laughs(and endless hours of preschooler amusement)
#7 And lastly, you can get a free Bayer Contour USB meter (along with 25 strips) at Walgreens. (until 01/01/2011) Go here, print out a coupon (for $20 off) and they'll adjust it down for you (it's on sale for 9.99). Or, you can find $10 off coupons for both the USB and the Bayer Didget in their pharmacy diabetes magazines.This is not just another "free" meter offer..this is a snazzy meter( with strips), which makes it a pretty generous deal, IMO.
Thursday, December 09, 2010
Twelve Years
Dear Diabetes,
Tomorrow marks 12 happy years of being joined at the hip.And like every morning since then, I've woken up,checked my blood sugar,& taken insulin. Some things blur with the passage of time.I don't remember what an 1100 blood sugar feels like but if I see or smell a Kendall brand alcohol swab my mind takes me back to that moment in a flash. No other brand but Kendall does that.It was a night of strange smells,sights,& sounds...which may well be imprinted permanently in my memory.
Like I do every year, I'm celebrating our Anniversary with great fan-fare. (I hope you don't mind if I bring along my husband) Dinner, and a movie (Voyage of the Dawn Treader)sounds like the perfect way to end the day. One thing about our D-Date,it seems to be a popular day for new movies to come out.
You and I have worked our butts off this year,& have gone from a number that was so bad I couldn't even blog about it to a most-recent 7.1.While that isn't under 7.0,it's a .8 improvement over the last time & was met by enthusiasm from our Endo & deemed acceptable enough for plans involving future offspring on this Earth.(we will keep working on said a1c,obviously) I really wish my a1c had dropped more,but it is what it is.Further testing revealed several whacked out hormones (trouble with the thyroid,yet again) & the jury's not out yet on whether I'll have to start Synthroid/ other drug.As anyone's with D who has gone this route knows, it's not just the simple matter of getting your a1c in line. But with an endocrinologist & a maternal-fetal medicine specialist working on it, I'm sure they'll get those hormones precisely where they should be.(unlike blood sugars..those levels are easier to get into line) There is much to say on this topic,but the relief of not having one's Endo stare in horror at one for even considering the thought is the victory of the moment. I have faith that it can happen.
Bring on 2011!!
- Posted using BlogPress from my iPhone
Tomorrow marks 12 happy years of being joined at the hip.And like every morning since then, I've woken up,checked my blood sugar,& taken insulin. Some things blur with the passage of time.I don't remember what an 1100 blood sugar feels like but if I see or smell a Kendall brand alcohol swab my mind takes me back to that moment in a flash. No other brand but Kendall does that.It was a night of strange smells,sights,& sounds...which may well be imprinted permanently in my memory.
Like I do every year, I'm celebrating our Anniversary with great fan-fare. (I hope you don't mind if I bring along my husband) Dinner, and a movie (Voyage of the Dawn Treader)sounds like the perfect way to end the day. One thing about our D-Date,it seems to be a popular day for new movies to come out.
You and I have worked our butts off this year,& have gone from a number that was so bad I couldn't even blog about it to a most-recent 7.1.While that isn't under 7.0,it's a .8 improvement over the last time & was met by enthusiasm from our Endo & deemed acceptable enough for plans involving future offspring on this Earth.(we will keep working on said a1c,obviously) I really wish my a1c had dropped more,but it is what it is.Further testing revealed several whacked out hormones (trouble with the thyroid,yet again) & the jury's not out yet on whether I'll have to start Synthroid/ other drug.As anyone's with D who has gone this route knows, it's not just the simple matter of getting your a1c in line. But with an endocrinologist & a maternal-fetal medicine specialist working on it, I'm sure they'll get those hormones precisely where they should be.(unlike blood sugars..those levels are easier to get into line) There is much to say on this topic,but the relief of not having one's Endo stare in horror at one for even considering the thought is the victory of the moment. I have faith that it can happen.
Bring on 2011!!
- Posted using BlogPress from my iPhone
Monday, December 06, 2010
December De jour
It's that time of year again...the snow lies thick on the ground(or soon will,if it's anything like last winter), it's bitterly cold and nasty and doesn't lend well to functional toes,fingers, or glucometers. Starbucks & Swiss Miss are absolute must-have's.(yes,I drink Diet Coke year-round but in winter I need something to warm me up) And it seems that life gets even busier, as the "flurries" of day-to-day tasks cascades into a blizzard.(Look for me sometime in January,as I don't expect to be doing much blogging)
On the agenda this month:
*Aforementioned school paperwork, most of which is financial-aid/scholarship oriented. Also a CPR recertification course and yet another physical exam(does the one I JUST had in October (for my surgery) count? Of course not) which shall involve booster shots and blood titers(for every known communicable disease out there). Medical school can't involve any less paperwork.
*Changing health insurance plans.(this being that magical time of the year known as "Open Season," which, for my non-US readers is when one can switch(or get) health insurances without fault for pre-existing conditions.For an individual with a chronic disease,this is one of the few opportunities to get instant coverage. ) My husband leaves this to me, as he rarely gets sick,takes no meds,and has never had a cavity in his life.(in other words, the opposite of me) Our current plan has hit rock bottom-everything costs a ton, & injectables go completely off the formulary beginning next year. Although this is to be expected with all the recent insurance company/Obaminination changes,our particular plan has essentially doubled EVERYTHING-monster deductibles,no diabetes education coverage,etc. and the time has come to jump ship.(before we sink) I'm grateful for the choice of several options,but it will be a monumental choice as I consider what parts are vitally important to me & which parts are less so.
NEED:
- diabetes supply coverage (for pump supplies,insulin,strips, and CGM) via mail order with acceptable copays.
- NO cap on the number of test strips.
- catestrophic coverage cap
-low pharmacy rx copay
-outpatient infusion services covered (this is a biggie,because if I need more magnesium infusions it is very expensive & not otherwise affordable)
-coverage of injectables (such as Symlin)
-good dental plan
-free Diabetes Education Visits
-complete lab & tests coverage
I'm very much looking at this from the diabetes point of view..I want the freedom to see my own endo and follow my own diabetes plan. Access to an educator is a must on my list,(and one that current insurance decided to stop covering completely) since few endo's have the time to work with you on the nitty-gritty, day to day stuff. I guess after all these years I should know how to get myself out of the holes I dig,but they have perspectives that I often times, don't. I live it..the questions and problems never go away,& have numbed my brain so that if the answer were right in front of me, I wouldn't be able to see it. I need the fresh perspective.
I've heard only horror stories about HMO's,and I'm not sure I'd be brave enough to go that route. Freedom in physician choosing is very important to me, and I'd rather concede on a less important point(like the amount of the copay). You have to choose the plan that makes the most sense financially. Life is about more then diabetes..surgeries,tests,random stuff comes up and those possibilities must be considered as well. Decisions, decisions.(and I can't make this one lightly)
* Getting every last RX filled before the deductable/max reset to $0 and everything costs an arm and a leg again in the New Year. (to be done, prior to switching insurances, obviously) We don't have an FSA(flexible spending) account...that's probably something I should seriously consider. Could really save money there.
*Regular Christmas-y stuff..presents to buy, foods to cook,etc. and a week long stint on the Left Coast(come December 22) to survive. I cannot say I'm looking forward to the body scanner/patdown choice.(at the airports)
*Endo appt., continued hand therapy. Things are much improved on the arm front, there's now only a small localized patch of elbow numbness,a slightly weak pinky,and pain only if I lift something heavy. The scar is even starting to fade.
So that's what on the agenda, this won't be my last post of the year,but I won't be doing very many of them. Stay warm and safe, everyone.
On the agenda this month:
*Aforementioned school paperwork, most of which is financial-aid/scholarship oriented. Also a CPR recertification course and yet another physical exam(does the one I JUST had in October (for my surgery) count? Of course not) which shall involve booster shots and blood titers(for every known communicable disease out there). Medical school can't involve any less paperwork.
*Changing health insurance plans.(this being that magical time of the year known as "Open Season," which, for my non-US readers is when one can switch(or get) health insurances without fault for pre-existing conditions.For an individual with a chronic disease,this is one of the few opportunities to get instant coverage. ) My husband leaves this to me, as he rarely gets sick,takes no meds,and has never had a cavity in his life.(in other words, the opposite of me) Our current plan has hit rock bottom-everything costs a ton, & injectables go completely off the formulary beginning next year. Although this is to be expected with all the recent insurance company/Obaminination changes,our particular plan has essentially doubled EVERYTHING-monster deductibles,no diabetes education coverage,etc. and the time has come to jump ship.(before we sink) I'm grateful for the choice of several options,but it will be a monumental choice as I consider what parts are vitally important to me & which parts are less so.
NEED:
- diabetes supply coverage (for pump supplies,insulin,strips, and CGM) via mail order with acceptable copays.
- NO cap on the number of test strips.
- catestrophic coverage cap
-low pharmacy rx copay
-outpatient infusion services covered (this is a biggie,because if I need more magnesium infusions it is very expensive & not otherwise affordable)
-coverage of injectables (such as Symlin)
-good dental plan
-free Diabetes Education Visits
-complete lab & tests coverage
I'm very much looking at this from the diabetes point of view..I want the freedom to see my own endo and follow my own diabetes plan. Access to an educator is a must on my list,(and one that current insurance decided to stop covering completely) since few endo's have the time to work with you on the nitty-gritty, day to day stuff. I guess after all these years I should know how to get myself out of the holes I dig,but they have perspectives that I often times, don't. I live it..the questions and problems never go away,& have numbed my brain so that if the answer were right in front of me, I wouldn't be able to see it. I need the fresh perspective.
I've heard only horror stories about HMO's,and I'm not sure I'd be brave enough to go that route. Freedom in physician choosing is very important to me, and I'd rather concede on a less important point(like the amount of the copay). You have to choose the plan that makes the most sense financially. Life is about more then diabetes..surgeries,tests,random stuff comes up and those possibilities must be considered as well. Decisions, decisions.(and I can't make this one lightly)
* Getting every last RX filled before the deductable/max reset to $0 and everything costs an arm and a leg again in the New Year. (to be done, prior to switching insurances, obviously) We don't have an FSA(flexible spending) account...that's probably something I should seriously consider. Could really save money there.
*Regular Christmas-y stuff..presents to buy, foods to cook,etc. and a week long stint on the Left Coast(come December 22) to survive. I cannot say I'm looking forward to the body scanner/patdown choice.(at the airports)
*Endo appt., continued hand therapy. Things are much improved on the arm front, there's now only a small localized patch of elbow numbness,a slightly weak pinky,and pain only if I lift something heavy. The scar is even starting to fade.
So that's what on the agenda, this won't be my last post of the year,but I won't be doing very many of them. Stay warm and safe, everyone.
Wednesday, December 01, 2010
The Envelope
I got an envelope the other day. It was gorgeously thick & screamed out "Non-Rejection" without me having to open it. But open it I did,with my heart hammering away in my ears & my stomach doing flip-flops in my esophageal tube.
Guess what. I am not "rejected" but I am also not accepted, I'm in that fuzzy grey area known as the WAIT LIST.
So I had to go to Orientation, a 3.5 hour affair which was great for everyone who made it into the Spring 2011 RN program but most disagreeable for the rest of us.You sit there,pretending you belong,but you aren't really "in." You're a wannabe who is hoping someone drops,but you still have to fill out the forms,get the all-inclusive Cootie Report filled out,CPR, and have your financial aid,etc ready to go at the drop of a hat for if someone does drop out & you could get in.
Maybe I'm at the bottom of the "wait list" & maybe I won't get in at all. I hate this not knowing.(it goes purely off GPA) It's the 5th layer of Dante's Inferno,doing all the work & still not getting in & more & more I wish they'd have just rejected me outright.People have till Jan.18 to drop the course...that's a long time to be without an answer.(Everyone who is on the list knows exactly what to plan for) I'm in a state of educational limbo(knowing that I qualify but should I just reapply? or just scrap the whole nursing idea entirely) & it's just really hard & depressing right now.
- Posted using BlogPress from my iPhone
Guess what. I am not "rejected" but I am also not accepted, I'm in that fuzzy grey area known as the WAIT LIST.
So I had to go to Orientation, a 3.5 hour affair which was great for everyone who made it into the Spring 2011 RN program but most disagreeable for the rest of us.You sit there,pretending you belong,but you aren't really "in." You're a wannabe who is hoping someone drops,but you still have to fill out the forms,get the all-inclusive Cootie Report filled out,CPR, and have your financial aid,etc ready to go at the drop of a hat for if someone does drop out & you could get in.
Maybe I'm at the bottom of the "wait list" & maybe I won't get in at all. I hate this not knowing.(it goes purely off GPA) It's the 5th layer of Dante's Inferno,doing all the work & still not getting in & more & more I wish they'd have just rejected me outright.People have till Jan.18 to drop the course...that's a long time to be without an answer.(Everyone who is on the list knows exactly what to plan for) I'm in a state of educational limbo(knowing that I qualify but should I just reapply? or just scrap the whole nursing idea entirely) & it's just really hard & depressing right now.
- Posted using BlogPress from my iPhone
Sunday, November 28, 2010
A Surgery, A Rice-ectomy & The Diabetes Transplant Summit
It went exceptionally well. Although my blood sugar was not well behaved in the least(the instant I rolled out of bed @4:30 am, it began to skyrocket) 165 at 5 am,and 265 2.5 hours later when the nurse took it.
I was the first patient of the day..so as soon as they got me back there, changed,and an IV in, it was a whirlwind of anesthesiologist/nurse/surgeon & it seemed like no time at all that they were all ready. I really wasn't(as evidenced by my blood sugar-gave a several unit correction & cued the anesthesiologist that this sort of excursion was normal for someone who was nervous. I get like that prior to any sort of "nock out" procedure. And I know that sounds stupid,but that's how I am. The dude in the other unit(2nd patient of the day) was not anxious in the least.(I envied his nonchalance) I didn't like the blood sugar,but there's really not much you can do about something(hardcore correction) w/out flirting with hypoglycemia.(they were perfectly ok with it) My sole request,was for a hearty dose of anti-nausea meds,I wasn't worried that worried about the pain.(they did a nerve block & a pain med so I knew it wouldn't wear off for awhile)But I have learned that anytime I go under,there will always be nausea (waiting for me) when I wake up. The anesthesiologist (who caters to cowards) was very accommodating in that last request. Nothing was going to make me any less nervous,but at least the atmosphere was very upbeat.
And just like that,I was waking up from a dreamless dream (some 2 hours later),arm almost completely encased in white plaster at a 90 degree angle. There was no pain, or nausea(much to my surprise) just that fuzzy headed disorientation that takes some time to go away.
Blood Sugar: 276. Happy day in the morning. I corrected(one handed),& discovered just how hard it is to check your blood sugar with one hand.(I use the Multiclix,so I had to cock first,& attempt to hit my pinkie as I pushed down with the thumb) Sat up,getting acclimated to the thought of going home & got hit by a horrible wave of nausea & started dry retching. The nurse got me a smelling salt/nausea killer sort of thing, which smelled really horrible but did indeed knock that nausea into submission. Tried again 15 minutes later to sit up & was fine. The nurse also gave me some alcohol swabs(I never knew that those were nausea busters), RX's,and then the husband drove me home. Nerve block wore off about 5 hours later but I still was not in any great pain. More then anything, it itched.(the crazy,rip your skin to shreds itch) My mom helped out that first day.
The next morning, I dumped my glass of water into the cabinet drawer, flooding my iphone in the process. As soon as that registered,I grabbed it out, attempted to dry it off,& did an emergency Rice-ectomy (container,cover iphone with rice, leave for 24 hours) not knowing if it was truly the end for my phone or not.
That evening,I stuffed my arm in a sling & husband & I went to The Diabetes Transplant Summit. And there's not really much I can add to that(Kathy has said it all) but it was a very interesting experience. One of the participants made a statement that really stuck in my head,and that was "Good control doesn't do you any good if you're dead." Hypoglycemia is a very serious problem..& kills people every year.(how many,I'm not sure,but even if it were just 1 death that is a tragedy)
For these people, hypos were constant, severe, and life threatening. Every single day they dealt with that reality. They had the transplant(s) to fix that particular issue...not very many of them had secondary complications from diabetes. (although that can be another reason for having a transplant) One of them, Gary Kleiman, has been on immunosuppressents more then half his life(he had a kidney transplant in his 20's) For them,having to take immunosuppressents was an acceptable trade-off. None of them has to worry about severe hypoglycemia..even the ones who have to take small doses of supplemental insulin.(over time, the islet's die) And I must agree,if I were in such a situation I would take life w/immunosuppressents over no life at all. I think everyone who goes into those transplants is absolutely informed about the risks they're taking..but the bigger risk is not having the transplant. And I respect their choice,& the courage it takes to do that.
They are working on raising genetically "pure" pigs, for (future) large scale porcine islet harvesting. Of course,this is all stuff for the future...but it's a fascinating concept (pig islets & some sort of localized immunosuppression=possible cure?)
By the end of all that,I really wanted to go home,take painkillers, and not go to any more social events for the next week. It was exhausting,but events like this only come around once in a blue moon...& I'm glad I went.
(the next morning,my iphone powered right up...so it all ended well)
I was the first patient of the day..so as soon as they got me back there, changed,and an IV in, it was a whirlwind of anesthesiologist/nurse/surgeon & it seemed like no time at all that they were all ready. I really wasn't(as evidenced by my blood sugar-gave a several unit correction & cued the anesthesiologist that this sort of excursion was normal for someone who was nervous. I get like that prior to any sort of "nock out" procedure. And I know that sounds stupid,but that's how I am. The dude in the other unit(2nd patient of the day) was not anxious in the least.(I envied his nonchalance) I didn't like the blood sugar,but there's really not much you can do about something(hardcore correction) w/out flirting with hypoglycemia.(they were perfectly ok with it) My sole request,was for a hearty dose of anti-nausea meds,I wasn't worried that worried about the pain.(they did a nerve block & a pain med so I knew it wouldn't wear off for awhile)But I have learned that anytime I go under,there will always be nausea (waiting for me) when I wake up. The anesthesiologist (who caters to cowards) was very accommodating in that last request. Nothing was going to make me any less nervous,but at least the atmosphere was very upbeat.
And just like that,I was waking up from a dreamless dream (some 2 hours later),arm almost completely encased in white plaster at a 90 degree angle. There was no pain, or nausea(much to my surprise) just that fuzzy headed disorientation that takes some time to go away.
Blood Sugar: 276. Happy day in the morning. I corrected(one handed),& discovered just how hard it is to check your blood sugar with one hand.(I use the Multiclix,so I had to cock first,& attempt to hit my pinkie as I pushed down with the thumb) Sat up,getting acclimated to the thought of going home & got hit by a horrible wave of nausea & started dry retching. The nurse got me a smelling salt/nausea killer sort of thing, which smelled really horrible but did indeed knock that nausea into submission. Tried again 15 minutes later to sit up & was fine. The nurse also gave me some alcohol swabs(I never knew that those were nausea busters), RX's,and then the husband drove me home. Nerve block wore off about 5 hours later but I still was not in any great pain. More then anything, it itched.(the crazy,rip your skin to shreds itch) My mom helped out that first day.
The next morning, I dumped my glass of water into the cabinet drawer, flooding my iphone in the process. As soon as that registered,I grabbed it out, attempted to dry it off,& did an emergency Rice-ectomy (container,cover iphone with rice, leave for 24 hours) not knowing if it was truly the end for my phone or not.
That evening,I stuffed my arm in a sling & husband & I went to The Diabetes Transplant Summit. And there's not really much I can add to that(Kathy has said it all) but it was a very interesting experience. One of the participants made a statement that really stuck in my head,and that was "Good control doesn't do you any good if you're dead." Hypoglycemia is a very serious problem..& kills people every year.(how many,I'm not sure,but even if it were just 1 death that is a tragedy)
For these people, hypos were constant, severe, and life threatening. Every single day they dealt with that reality. They had the transplant(s) to fix that particular issue...not very many of them had secondary complications from diabetes. (although that can be another reason for having a transplant) One of them, Gary Kleiman, has been on immunosuppressents more then half his life(he had a kidney transplant in his 20's) For them,having to take immunosuppressents was an acceptable trade-off. None of them has to worry about severe hypoglycemia..even the ones who have to take small doses of supplemental insulin.(over time, the islet's die) And I must agree,if I were in such a situation I would take life w/immunosuppressents over no life at all. I think everyone who goes into those transplants is absolutely informed about the risks they're taking..but the bigger risk is not having the transplant. And I respect their choice,& the courage it takes to do that.
They are working on raising genetically "pure" pigs, for (future) large scale porcine islet harvesting. Of course,this is all stuff for the future...but it's a fascinating concept (pig islets & some sort of localized immunosuppression=possible cure?)
By the end of all that,I really wanted to go home,take painkillers, and not go to any more social events for the next week. It was exhausting,but events like this only come around once in a blue moon...& I'm glad I went.
(the next morning,my iphone powered right up...so it all ended well)
Monday, November 22, 2010
The Little Chevy That Could
This is Nugget.
Nugget is my 3rd vehicle, the last two having met unfortunate ends involving collisions & ex-cops & Northern Virginia intersections.Nugget is a product of the 20th century...they don't make Chevy Cavaliers anymore.(I've had several interesting run-in's with fellow Chevy Cavalier owners,they absolutely loved theirs.Apparently,it's a sub-culture..much like the DOC.And I do love my car,but it is a very basic car & it's racking up the miles..doesn't have as much gumph as it had in 2005.So,when it does quit,I have no problem moving on,and getting something from the 21st century.Technology is not a bad thing.)
And I believe I have matured, (in matters pertaining to vehicular operation)for Nugget is definatly the longest lived vehicle in the lineup. It was a Christmas Eve(make a rapid decision NOW) sort of deal,required by the family members tired of carting me around on a regular basis.
However....
It was a chilly November night,(about 2.5 weeks ago)& I'd had a long day(making the 4 hour trip down to Virginia to complete the research study). Spent several hours at the research study,went to a buffet & stuffed my face with everything I probably shouldn't,bought a gift for our 3rd wedding anniversary(and gotten carded for the first time in my life,which was very annoying.Worse then that-I asked the cashier if she needed to see some ID and she declined. So long, golden 20's) and was headed across the mountain to spend the night at brother #2's house (brother #1's kid had the plague).
Before doing so, I filled up the gas tank(for the 2nd time that day)& hoped the compensation would be quick in coming..for I'd spent a small fortune in gas from all those trips. And yes-it was absolutely worth it(free strips,pods,etc.)but if they didn't have both monetary & supply distribution it may not have been. Research studies can be educational, but they can also be a pain in the butt.(4 times down there=stick a fork in me, I'm done)
It was about half way up said mountain, as Nugget huffed and puffed away like the little engine that could, when it happened.
"YAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAEAHHHHHHHHHHHHHHHHHH!"
Instinctively,my foot let off the accelerator,my eyes closed, and my body tensed
as I waited for 60 mph-flesh-on-metal-contact as a large buck glided strong,gracefully,purposefully, right in front of my vehicle.There was no time to hit the brakes or swerve..it went that quickly. It was like one of those Kodak moments-where the subject has just woken up,and the flash goes off right in their startled eyes.
Several heart-stopping seconds later, when there was no consequent cascade of deer vs car vs airbag vs chest vs flying off road, I opened my eyes. Apparently, large deer had successfully missed my car (and the one slightly behind, in the other lane) and made it to the median strip of the interstate. It took me awhile to truly relax after that,for I thought my car was a goner. I've hit small rodents before (NOT on purpose) but its the first time a deer jumped in front of my car. And I know its a common problem...the sides of the road have alot of dead animals this time of the year.
I'm just grateful nothing happened,for that deer was huge & absolutely would have totaled my car.Nugget lived, to run another day.
Nugget is my 3rd vehicle, the last two having met unfortunate ends involving collisions & ex-cops & Northern Virginia intersections.Nugget is a product of the 20th century...they don't make Chevy Cavaliers anymore.(I've had several interesting run-in's with fellow Chevy Cavalier owners,they absolutely loved theirs.Apparently,it's a sub-culture..much like the DOC.And I do love my car,but it is a very basic car & it's racking up the miles..doesn't have as much gumph as it had in 2005.So,when it does quit,I have no problem moving on,and getting something from the 21st century.Technology is not a bad thing.)
And I believe I have matured, (in matters pertaining to vehicular operation)for Nugget is definatly the longest lived vehicle in the lineup. It was a Christmas Eve(make a rapid decision NOW) sort of deal,required by the family members tired of carting me around on a regular basis.
However....
It was a chilly November night,(about 2.5 weeks ago)& I'd had a long day(making the 4 hour trip down to Virginia to complete the research study). Spent several hours at the research study,went to a buffet & stuffed my face with everything I probably shouldn't,bought a gift for our 3rd wedding anniversary(and gotten carded for the first time in my life,which was very annoying.Worse then that-I asked the cashier if she needed to see some ID and she declined. So long, golden 20's) and was headed across the mountain to spend the night at brother #2's house (brother #1's kid had the plague).
Before doing so, I filled up the gas tank(for the 2nd time that day)& hoped the compensation would be quick in coming..for I'd spent a small fortune in gas from all those trips. And yes-it was absolutely worth it(free strips,pods,etc.)but if they didn't have both monetary & supply distribution it may not have been. Research studies can be educational, but they can also be a pain in the butt.(4 times down there=stick a fork in me, I'm done)
It was about half way up said mountain, as Nugget huffed and puffed away like the little engine that could, when it happened.
"YAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAEAHHHHHHHHHHHHHHHHHH!"
Instinctively,my foot let off the accelerator,my eyes closed, and my body tensed
as I waited for 60 mph-flesh-on-metal-contact as a large buck glided strong,gracefully,purposefully, right in front of my vehicle.There was no time to hit the brakes or swerve..it went that quickly. It was like one of those Kodak moments-where the subject has just woken up,and the flash goes off right in their startled eyes.
Several heart-stopping seconds later, when there was no consequent cascade of deer vs car vs airbag vs chest vs flying off road, I opened my eyes. Apparently, large deer had successfully missed my car (and the one slightly behind, in the other lane) and made it to the median strip of the interstate. It took me awhile to truly relax after that,for I thought my car was a goner. I've hit small rodents before (NOT on purpose) but its the first time a deer jumped in front of my car. And I know its a common problem...the sides of the road have alot of dead animals this time of the year.
I'm just grateful nothing happened,for that deer was huge & absolutely would have totaled my car.Nugget lived, to run another day.
Friday, November 19, 2010
Ten Days
It's unbelievably great to finally NOT have a full arm cast on my arm.Its stiff,sore,numb,and looks like a staple gun went to town from my wrist past the elbow but the surgeon says its progressing well.Therapy starts next week. (it may take months to fully regain function)
(before picture)
Dr.Hand: Any questions?
Me: Can I blog now?
Dr.Hand: As long as you keep it light, don't over do it.
Me: Ok.
Man I've missed blogging.(had to get that out)
(before picture)
Dr.Hand: Any questions?
Me: Can I blog now?
Dr.Hand: As long as you keep it light, don't over do it.
Me: Ok.
Man I've missed blogging.(had to get that out)
Tuesday, November 09, 2010
SIX things (#Dblog Day)
Hey, there.
Don't hit the back button just yet...I'm here to let you in on SIX earth-shattering revolutions about diabetes. Things you may not have known,but things you NEED to know because by 2050 you may be one of the "1 in 3" Americans who has type 2 diabetes. Or perhaps, you may be 1 of the billions elsewhere..diabetes is by no means limited to the North American population. The fact is, it's sweeping the globe,and if we don't get some answers soon both types will continue to wreak damage and destruction in their path. Most of my tidbits will be from a type 1 perspective, but the types have more in common then they have apart. (I feel...type 2 ain't no cakewalk either)
#1 This insulin pump is not an "intelligent" system. Far from it, I have highs,I have lows, I still have to feed my glucose meter blood 7-10 times a day & for the trouble,I get a so-so a1c. Diabetes is difficult 24/7/365. Diabetes sucks, even when it doesn't. A pancreas is a difficult organ to mimic.(In my opinion,the most difficult) And everyone's needs are different..it's all trial & error.
#2 Don't go it alone. The Diabetes Online Community is a support group wherever you are..places like TuDiabetes,Diabetes Daily,and Children with Diabetes Forums. You may feel like you know everything there is to know (and are a rock unto yourself), but take it from the introvert,you NEED support.(in one way or another,be from spouse/family/friends/other)And only other people with diabetes(or parents) truly get what you're really going through. You never realize just how much you needed it until you find it.(and then it's like,where has this been all my D-life!!!?)
#3 Ingested sugar will not kill you. Elevated blood sugars are what leads to complications...if you have type 1 diabetes,you cover that dessert with insulin,and if you have type 2 diabetes,you follow your health care provider's recommendations. I often have the exact opposite problem..I'll overbolus,& end up low, trying to avoid the high. It really bugs me when people don't realize that practically EVERYTHING has carbohydrates in it yet feed me the sweet potatoes when I'd rather have the brownie because it's a "vegetable" & must therefore be safe. Really,really, bugs me.
#4 Diabetes is Expensive. Even if you have insurance,they may not cover much,and if you don't have insurance,you probably don't
have the means to do more then stay alive. 1 bottle of fast acting insulin is now well over $100..pump supplies run hundreds of dollars per month,test strips soar into the upper stratosphere (despite not improving in accuracy),the costs of CGM'ing are over $300/month,(without insurance)
doctor bills,lab fees,other meds, the list goes on. And all of this is still cheaper then not taking care of the diabetes & developing complications. Something needs to be done to make it less expensive.(what, I don't know,I don't favor gov't takeover but how can you curb an epidemic if people can't even afford to treat their disease?)
#5 Insulin is not evil. Insulin is not bad. Insulin is not "a failure." Insulin is perfectly natural,non-D's produce sufficient amounts of it but if you have diabetes,you must inject it. (in one way or another) Insulin will not cause you to go blind, lose your toes,require kidney dialysis-improper management/cumulative effects of diabetes will do that. And I will guarantee you that there are many individuals(who have been on insulin for eons) who are happy,healthy,and have all their toes. Insulin is life,and we all need it.
#6 All types of diabetes need to be taken seriously. Any elevated blood sugar is a blood sugar that is going to cause damage,down the road.Type 2 diabetes is progressive,& often has co-morbiditating factors irritated by higher blood sugars. Whatever type you have,you must do your best to manage/control it.
Don't hit the back button just yet...I'm here to let you in on SIX earth-shattering revolutions about diabetes. Things you may not have known,but things you NEED to know because by 2050 you may be one of the "1 in 3" Americans who has type 2 diabetes. Or perhaps, you may be 1 of the billions elsewhere..diabetes is by no means limited to the North American population. The fact is, it's sweeping the globe,and if we don't get some answers soon both types will continue to wreak damage and destruction in their path. Most of my tidbits will be from a type 1 perspective, but the types have more in common then they have apart. (I feel...type 2 ain't no cakewalk either)
#1 This insulin pump is not an "intelligent" system. Far from it, I have highs,I have lows, I still have to feed my glucose meter blood 7-10 times a day & for the trouble,I get a so-so a1c. Diabetes is difficult 24/7/365. Diabetes sucks, even when it doesn't. A pancreas is a difficult organ to mimic.(In my opinion,the most difficult) And everyone's needs are different..it's all trial & error.
#2 Don't go it alone. The Diabetes Online Community is a support group wherever you are..places like TuDiabetes,Diabetes Daily,and Children with Diabetes Forums. You may feel like you know everything there is to know (and are a rock unto yourself), but take it from the introvert,you NEED support.(in one way or another,be from spouse/family/friends/other)And only other people with diabetes(or parents) truly get what you're really going through. You never realize just how much you needed it until you find it.(and then it's like,where has this been all my D-life!!!?)
#3 Ingested sugar will not kill you. Elevated blood sugars are what leads to complications...if you have type 1 diabetes,you cover that dessert with insulin,and if you have type 2 diabetes,you follow your health care provider's recommendations. I often have the exact opposite problem..I'll overbolus,& end up low, trying to avoid the high. It really bugs me when people don't realize that practically EVERYTHING has carbohydrates in it yet feed me the sweet potatoes when I'd rather have the brownie because it's a "vegetable" & must therefore be safe. Really,really, bugs me.
#4 Diabetes is Expensive. Even if you have insurance,they may not cover much,and if you don't have insurance,you probably don't
have the means to do more then stay alive. 1 bottle of fast acting insulin is now well over $100..pump supplies run hundreds of dollars per month,test strips soar into the upper stratosphere (despite not improving in accuracy),the costs of CGM'ing are over $300/month,(without insurance)
doctor bills,lab fees,other meds, the list goes on. And all of this is still cheaper then not taking care of the diabetes & developing complications. Something needs to be done to make it less expensive.(what, I don't know,I don't favor gov't takeover but how can you curb an epidemic if people can't even afford to treat their disease?)
#5 Insulin is not evil. Insulin is not bad. Insulin is not "a failure." Insulin is perfectly natural,non-D's produce sufficient amounts of it but if you have diabetes,you must inject it. (in one way or another) Insulin will not cause you to go blind, lose your toes,require kidney dialysis-improper management/cumulative effects of diabetes will do that. And I will guarantee you that there are many individuals(who have been on insulin for eons) who are happy,healthy,and have all their toes. Insulin is life,and we all need it.
#6 All types of diabetes need to be taken seriously. Any elevated blood sugar is a blood sugar that is going to cause damage,down the road.Type 2 diabetes is progressive,& often has co-morbiditating factors irritated by higher blood sugars. Whatever type you have,you must do your best to manage/control it.
Thursday, November 04, 2010
"Waiting"
(from the poem archives, dated December 6,2001. I thought it would be appropriate for National Diabetes Month)
"Waiting"
Last night I dreamed there was a cure
And folks were lined up at the door
This cure was real, there were no pills
No side effects, no doctor bills.
One shot, forever free to be
From this dreaded thing they call the D
Islet cells, that won't die off
Each time I get a stupid cough.
The freedom was a sight to see
The joy was real, unbridled, free
We chucked our meters,took a bite
This food would not cost us our sight.
(addendum)
Nine more years have come and gone
Since yesteryear's whisimcal song
We're waiting still, who knows how long
It's all so very,very wrong.
(it's weird how fast time passes when one is waiting on a cure. I'm sure that fifteen years from now,I'll be looking back at 2010 (in much the same light-like,whoa, those were the dark ages of D-care) & there still won't be a cure. Which I'm expecting,but it doesn't mean that I don't want one,bad)
"Waiting"
Last night I dreamed there was a cure
And folks were lined up at the door
This cure was real, there were no pills
No side effects, no doctor bills.
One shot, forever free to be
From this dreaded thing they call the D
Islet cells, that won't die off
Each time I get a stupid cough.
The freedom was a sight to see
The joy was real, unbridled, free
We chucked our meters,took a bite
This food would not cost us our sight.
(addendum)
Nine more years have come and gone
Since yesteryear's whisimcal song
We're waiting still, who knows how long
It's all so very,very wrong.
(it's weird how fast time passes when one is waiting on a cure. I'm sure that fifteen years from now,I'll be looking back at 2010 (in much the same light-like,whoa, those were the dark ages of D-care) & there still won't be a cure. Which I'm expecting,but it doesn't mean that I don't want one,bad)
Monday, November 01, 2010
A Lot to SAE
Sarah, over at Sugabetic has designed an awesome logo that very much represents what National Diabetes Month is all about.
I'm aware that my advocacy efforts will not go very far this year. And I can't do NaPoBloMo (for what would have been the third year running). My education will be limited to direct contact (i.e."Do not touch the pump. Do NOT touch the pump.")with health care providers.
In the works for November: (D-related)
November 3: DSMA. (Twitter chat)
November 5-6: Research study ends.(for now) Return (crappy Dexcom)equipment,fill out forms, participate in focus group. I really,really,really need the break. It's just been one disaster after the next lately,on every front. I really need to unload everything bothering me (equipment failures,communication failures,algorithmic failures) and get back on track. It's one thing when it works,its another,when it doesn't.
November 9: National D-Blog Day.
November 10: THIRD ANNIVERSARY.(actually,the have-surgery-on-your-arm-day) Will move the actual celebration of said day to the 8th,or 9th)
November 11- Diabetes Transplant Summit. I am really,really, really hoping to attend this, but I'm not going to assume that everything is going to be hunky-dory enough to do so. But at least the husband would drive me..if we choose to go.
November 14- The Big Blue Test. I shall move my pinkie finger up and down for 14 minutes,and then test my blood sugar.(in honor of the concept,and not being able to do any more then that)Which will probably make my blood sugar go up,not down,but last year's 35 minute sweat-a-thon had the same effect...so yeah,it's not about the blood sugar,it's about the education.
November 1-November 30 Have the best control possible...an a1c looms mid-December,& it takes hard core committal to bring about real change in an a1c. If you want it,its absolutely about those overnights and post-meals & pre-meals. Deciding to get serious about control (1-2 weeks pre-appointment) does not work. (been there, done that)
I'm aware that my advocacy efforts will not go very far this year. And I can't do NaPoBloMo (for what would have been the third year running). My education will be limited to direct contact (i.e."Do not touch the pump. Do NOT touch the pump.")with health care providers.
In the works for November: (D-related)
November 3: DSMA. (Twitter chat)
November 5-6: Research study ends.(for now) Return (crappy Dexcom)equipment,fill out forms, participate in focus group. I really,really,really need the break. It's just been one disaster after the next lately,on every front. I really need to unload everything bothering me (equipment failures,communication failures,algorithmic failures) and get back on track. It's one thing when it works,its another,when it doesn't.
November 9: National D-Blog Day.
November 10: THIRD ANNIVERSARY.(actually,the have-surgery-on-your-arm-day) Will move the actual celebration of said day to the 8th,or 9th)
November 11- Diabetes Transplant Summit. I am really,really, really hoping to attend this, but I'm not going to assume that everything is going to be hunky-dory enough to do so. But at least the husband would drive me..if we choose to go.
November 14- The Big Blue Test. I shall move my pinkie finger up and down for 14 minutes,and then test my blood sugar.(in honor of the concept,and not being able to do any more then that)Which will probably make my blood sugar go up,not down,but last year's 35 minute sweat-a-thon had the same effect...so yeah,it's not about the blood sugar,it's about the education.
November 1-November 30 Have the best control possible...an a1c looms mid-December,& it takes hard core committal to bring about real change in an a1c. If you want it,its absolutely about those overnights and post-meals & pre-meals. Deciding to get serious about control (1-2 weeks pre-appointment) does not work. (been there, done that)
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