‘Betes and Burns: Playing it Safe

If you told me that I would get a second degree burn on my fingertip from a dish that was in a microwave for a measly 24 seconds, I would’ve laughed in your face.

But then I would’ve apologized immediately to you, because such a thing actually did happen to me a few weeks ago.

The full story isn’t particularly exciting; in fact, it’s as boring as it gets. But for the sake of context…I’d put a tablespoon of butter in a ramekin so I could melt it in the microwave for a recipe that I was making. I knew it would likely take fewer than 30 seconds for it to melt completely, so I stopped the microwave a little early and used my bare hand to take it out. The moment my fingertips met the ramekin, I became acutely aware that the dish had overheated – I couldn’t believe how blazingly hot the exterior was. I dropped the ramekin in the sink almost immediately, but the milliseconds of contact it had with my skin was enough to create a blister on my right middle fingertip that burned painfully for the remainder of the day.

I was quick to put some bacitracin and a bandage on the injury, but reluctant to expose the blister in the ensuing days as I didn’t want to exacerbate the wound (and honestly, it was unsightly, so I was eager to keep it under wraps so I didn’t have to look at it). So I changed my bandage every 24 hours or so, taking care to wash and dry my hands completely before applying a new band-aid.

But roughly one week after the injury occurred, I noticed that the blister was swelling. I peeked at it between bandage changes and saw that it was white and bubbly in appearance – totally gross, but also worrisome as it looked like it might pop should I strike it on any surface in just the wrong way. That’s when I made the executive decision to see my primary care doctor to get a medical professional’s opinion on the matter.

And I’m glad I did. I got confirmation that it was, indeed, a second-degree burn and that I’d done the right thing to keep it covered up. My healthcare provider reminded me that as a person with diabetes, I should do everything I can to avoid infection, so applying antibiotic ointment and keeping an eye on the wound was smart thinking. But I was also advised to remove the bandage when I went to sleep at night so the injury wouldn’t stay super moist for prolonged periods of time (added bonus that I could let it air out overnight while I was asleep so I could again avoid looking at it). More than two weeks post-incident, the burn is healing nicely as the skin grows healthier and I no longer need to wear a bandage over it.

What’s the point of this little anecdote about my kinda ridiculous, definitely painful injury? It’s that it’s always better to play it safe, just as my healthcare provider commended me for doing so. Silly injuries like this happen, but it’s important to roll with them when they do and act accordingly instead of just shrugging them off.

All health matters…well, matter when you have diabetes, and I’ve learned to look out for myself by checking in with my team whenever I’m concerned about something.

It’s More Than a PDM

My PDM (Personal Diabetes Manager) is more than just a medical device. It’s basically an extension of my body at this point.

Much like people treat cell phones as a must-have-on-me-at-all-times sort of item, that’s how I feel about my PDM. I carry it (and my cell phone, TBH) around as a small but mighty stack of technology. When I set it down somewhere and struggle to recall where I left it, I panic and can’t focus on anything else until I’ve found it. I make sure to keep the battery charged, and would argue that I get more concerned if the battery is low on that device than I do with my phone. And I’d sooner give my phone over to a toddler to play around with than consider handing off my PDM, even to a trusted family member or friend.

It’s more than just my PDM, it’s a lifeline.

In a world that remains ever-increasingly reliant on technology, there are times where I certainly wish I didn’t have to depend on my PDM so much. It would be nice to not have to carry it around all the time and fuss over it, making sure it’s charged and working properly. But just when I start to grow resentful of the device, I remember how much easier, overall, it’s made my life. It’s given me freedom that I wouldn’t have discovered if I’d chosen to stick to multiple daily injections. I also believe that, combined with my Dexcom CGM, it’s responsible for my improved blood sugars and time in range into my adulthood.

So even though I didn’t exactly wish for a PDM to be an extension of my very being, I’m glad that it is, because it’s proven to be a valuable piece of equipment in my diabetes care toolkit.

25 Years

This Christmas Eve marks 25 years since I was diagnosed with diabetes.

25 years feels like a significant milestone – and that’s because it is. Diabetes has been my “normal” for that entire length of time; I don’t remember what it’s like to live free from its burden.

I accepted that long ago, but still experience some sadness and bitterness over it from time to time. Can you blame me? There are times when I find myself envious of people with diabetes who were diagnosed later in life and have memories that remain entirely unimpacted by diabetes, but when I find myself getting swept up in morose emotions, I ground myself by remembering that (as trite as it may seem) everything happens for a reason. My diabetes story has taken very deliberate twists and turns, whether or not I was aware of them when they were happening. Each and every challenge, all the emotions, and the many experiences and relationships it has brought into my life were bound to happen, and I’m glad that they did because they’ve made me who I am today.

And today, just a few days shy of officially celebrating my quarter-century diabetes diagnosis, I find myself once again being so happy that it’s happening on a day that I will be around so many of my loved ones. I say it every year, but having my diaversary on a major holiday makes the celebration that much more special to me. The day is always more about spending time with my family than it is about diabetes. Instead of sadness, I feel joy in the reminder that diabetes can’t and won’t overshadow Christmas or any other day for that matter.

So here’s to 25 years of a life enriched and uninhibited by diabetes – and many more to come.

Is it Possible to Decentralize Diabetes?

First of all…what does that question even mean? What does it mean to decentralize diabetes?

In this context, I think of it as deprioritizing diabetes (maybe that’s the better word to use here, but let’s bear with me…let’s stick with decentralize). It’s knocking it down a few pegs rather than keeping it as a permanent fixture at the top of my to-do list.

So I guess this question should be phrased less generally – because of course it’s possible to decentralize diabetes – and more specifically target me, as an individual who is solely responsible for her diabetes care and management…

…is it possible for me to decentralize diabetes from my life?

I’m of two minds when it comes to landing on an answer. On the one hand, I can’t really imagine myself ever being successful at decentralizing diabetes. I’m always thinking about it. Every decision I make, consciously or subconsciously, is made knowing that it will have implications (in some way or another) on my diabetes. Even when I’m asleep, I can’t escape diabetes because if it’s not directly impacting my slumber by waking me up, then it’s the first thing I think of each day because I do a blood sugar check the moment my eyes are open.

On the other hand…

I’ve been using an Omnipod 5 since late August/early September and although I struggled to adapt to it until recently, it’s since come to represent what feels like a diabetes reprieve. For the first time in my life, I’m thinking of diabetes a teensy-weensy bit less, and I do think that my newfound understanding of the automated insulin delivery system is directly responsible for that. It’s been scary to relinquish control that I’ve maintained for so long over every aspect of my diabetes routine – and hand it over to a piece of technology, to boot – but it’s finally beginning to pay off. Which reiterates the question: Is it really, truly possible for me to decentralize diabetes and let myself be a person first, rather than a diabetic first?

After writing this post and musing further on the subject, I’d comfortably say…it very well could be. With some more time and heaps of patience, I do think I can get to a point where my whole world revolves a little less closely ’round my diabetes.

It’s the Most Bolus-Worthy Time of the Year

This post has appeared on Hugging the Cactus a few times now over the years. It’s popping up again today because, well, I had fun writing and singing along to this piece. Plus, in light of a couple of Christmas celebrations over the weekend in which many bolus-worthy goodies were consumed, it only felt appropriate to share this post again today...

It wouldn’t be the Christmas season if I didn’t attempt to rewrite a classic Christmas carol…

I apologize in advance for the cheesiness of this “new” tune, but I was thinking about how there are just so many parties, gatherings, and opportunities to eat absolute junk food this time of year. But even though I’m feeling pretty disgusting by the time January rolls around, I don’t regret it because I love everything about this season…so you might say that I think it’s worth every extra unit of insulin I have to take to cover the food I eat, making it the most “bolus-worthy” time of the year.

So naturally, “It’s the Most Wonderful Time of the Year” was the perfect song to redo for this blog post.

I sprinkled in references about questions that people with diabetes commonly get, as well…because with all the time that’s spent with family and loved ones, they’re bound to come up again just as they do year after year.

Without further ado, here is my rendition of the song…please feel free to read (sing!) along to the tune of the original – it makes it so much more fun, trust me!

It’s the Most Bolus-Worthy Time of the Year

It’s the most bolus-worthy time of the year
With the Dexcom CGMs yelling
And everyone telling you “what’s that I hear?”
It’s the most bolus-worthy time of the year

It’s the ca-carb-iest season of all
With those holiday sweets
And so many treats when friends come to call
It’s the ca-carb-iest season of all

There’ll be parties for pumping
Temp basals a-bumping
And answering the same old,
There’ll be “can you eat that?”
And all that chit-chat
You can’t help that your eyes rolled

It’s the most bolus-worthy time of the year
There’ll be so much indulging
And insulin will be flowing when goodies are near
It’s the most bolus-worthy time of the year

There’ll be blood sugar for checking
Marshmallows for correcting
And sensors and sites to change
There’ll be silly relatives’ questions
And answers in your irate expressions
They should know by now ‘betes isn’t so strange

It’s the most bolus-worthy time of the year
There’ll be so much indulging
And insulin will be flowing when goodies are near
It’s the most bolus-worthy time
It’s the most bolus-worthy time
It’s the most bolus-worthy time
It’s the most bolus-worthy time of the year!

How I Handle my Diabetes During the Holiday Season

It may be the most wonderful time of the year, but my diabetes doesn’t necessarily agree with that sentiment.

In fact, this December 24th (yep, Christmas Eve) marks my 25th year of living with diabetes – crazy thought, right? I’ll have a dia-versary reflection post ready later in the month, but for now, I find myself thoroughly immersed in the overall spirit of the holiday season.

And with that immersion comes a certain level of strategizing. After all, several of the days leading up to and including Christmas are fraught with a variety of celebrations – some more diabetes-friendly than others. For example, a blood-sugar friendly Christmas activity for me is shopping for gifts in stores, as I can spend a handful of hours walking around and keeping my level nice and steady. Conversely, seasonal staples that are decidedly not conducive to my diabetes/blood sugars are the annual cookie swaps (yes, I have more than one that I go to) hosted by family and friends, as well as just about any type of holiday gathering (whether it’s an office party or gift exchange with my two childhood besties).

So in light of the upcoming festivities, I’ve found myself thinking about what’s worked (and what hasn’t) in terms of making the most of the holidays without letting my diabetes interfere – or suffer. Here’s my general game plan for accomplishing that, loosely inspired by Christmas carols…because I couldn’t resist the chance to put a seasonal spin on this how-to post:

  • Have Yourself a Merry Little Pre-Bolus (or pre-bolusing to help ensure more balanced blood sugar levels) – If there’s one tried-and-true technique to keeping my blood sugar levels more stable throughout the many decadent dinners and desserts I consume this time of year, then it’s pre-bolusing. Taking insulin 15-20 minutes before I actually start eating food can be tough to remember, but it pays off big time, particularly when I’m eating foods that I don’t typically have otherwise. So pre-bolusing is perfect for avoiding crazy blood sugar spikes and, in turn, keeps me very merry indeed.
  • Dexcom the Halls (or don’t be afraid to talk to others about diabetes loudly and proudly) – It’s interesting how the holidays bring you closer to both those you know well and those who are total strangers, by way of various gatherings. I know that I’ll be spending at least a couple of holiday parties in the company of people I’ve never met before, and I know I won’t hesitate to talk about my diabetes if it comes up organically or if people are curious about the devices adorning my body. In fact, from experience it can be a pretty good talking point when meeting people for the first time, so I won’t try to hide my diabetes from anyone this holiday season and embrace every opportunity to answer questions about it.
  • It’s Beginning to Look a Lot Like a Pharmacy (or stay prepared with back-up supplies) – Honestly, nobody wants to have to worry about running out of essential medical supplies any time of the year, but least of all during the holidays. So I like to keep back-ups of my back-ups on hand so I don’t have to stress about ordering more supplies or waiting for them to show up in the mail along with all the Christmas presents I’ve ordered.
  • I Saw Molly Eating All the Carbs (or enjoying every treat with minimal diabetes guilt) – This is arguably my most important holiday how-to, and it’s all about remembering to enjoy every little part of this special time of year. It’s such a short window of time that’s filled with so many celebrations (and treats) that it can be easy to get caught up in guilt over indulging in everything or putting diabetes on the backburner for a couple of weeks. But I’ve found that it’s easier to cope with both of those as long as I keep everything in perspective by reminding myself that the holidays fly by so I might as well just enjoy them for what they are rather than putting any sort of negative spin on them. It’s a lot more fun that way!

Security in Snacks

Comfort food…mac and cheese, cheeseburgers, pizza…and snacks?

Sounds like a unconventional addition to my mini laundry list of comfort food examples, but snacks (of just about any variety) go a long way in making me feel a certain degree of comfort. And this is because of – you guessed it – my diabetes.

Sometimes, diabetes can be totally unpredictable. My blood sugar could be steady one moment and crashing the next, and it’s far more stressful in circumstances where I don’t have food readily available or accessible to me.

So it might sound kind of silly, but one of the many fears and anxieties I had about starting a new job was centered around food. Would I be working in an area that was close to a grocery store or cafeteria, like my last job? Since I wouldn’t have a permanent desk in the office, would there be a place for me to store extra food to have on hand in case of emergency? Was it flat-out ridiculous for me to be so worried about access to food?

Turns out the answers to those questions were yes, yes, and definitely yes.

There’s no shortage of snacks at work, much to my relief.

Immediately, I discovered that my new office building has a full cafeteria located on the first floor that serves hot breakfast and lunch. As if that wasn’t great news in its own right, my office suite has not one, not two, but three kitchens that are available to all staff – and get this, they’re fully stocked with an assortment of beverages and foods, everything from yogurts, chips, granola bars, and Ramen noodles, all the way down to ice cream sandwiches in the freezer.

After I got the full tour of the facilities and learned that I had all of these options around me (without even having to leave the building), it dawned on me just how much of a relief this was. I do my best to be prepared as a person living with diabetes, but mistakes happen, and I’m sure there will come a day that I forget to bring an extra low snack to work or need to purchase a meal at the facilities. I was thrilled to find out that it’s no sweat, should I encounter these scenarios. And I’m really appreciative of that because I understand that not everyone has the good fortune to have these benefits provided to them through their occupation. I can’t help but feel grateful for the snack security I’ve found in this new opportunity!

3 Tips for Going Back to an Office with Diabetes

As anyone who lives with diabetes knows, it’s a condition that dislikes disruptions to a daily routine.

This was one of my main concerns when it came to starting my new job last week. The position is hybrid, meaning that I can work from home and in an office as it suits my needs. The prospect of returning to an office again after more than three years of working remotely positively excited me, but I’d be lying if I said that it also terrified me. I was anxious about my first day back in an office environment (in addition to all the jitters associated with starting a new job), and more than anything, I was worried about how my diabetes would be affected by this change.

This is because I’d settled into a fairly standard routine after all this time working from home. I have a workout regimen, eating schedule, and built-in breaks throughout my day that have greatly benefited my day-to-day blood sugar levels, and I knew that returning to an office setting would prevent me from maintaining these habits.

So that’s why I entered what I’m calling “diabetes hyper-prepare mode” the night before my first day in the office so I could try and think about all the ways my day would differ working in this setting versus my own home. And thus, I came up with these three tips that resulted in a very successful diabetes (and work) day:

Tip #1: Get ready as much as possible the night before. The week that I started my new job, I did my best to recall the routines that had worked well for me when I was regularly working in an office. The first thing that came to mind was the amount of preparation I typically did each weeknight so that I could get out the door as soon as possible in the morning. This included laying out my outfit, making breakfast ahead of time, putting together a lunch, and packing my bag. This extra work the night before really paid off the following morning and meant that I hit the road at exactly the time I had planned to; plus, the food prep worked wonders as I didn’t have to waste brain power in the morning trying to think about what I might eat throughout the day. The food was all set and ready to go, and I knew its carbohydrate contents, which resulted in phenomenal blood sugar levels all morning leading up to lunchtime.

Tip #2: Maintain movement. As it turns out, a 40-minute commute combined with lots of sitting in meetings means that my movement patterns in the office are minimal. I did my best to combat this by getting up a few times throughout the day to explore my new building in 10- or 15-minute intervals. Not only did this give my eyes a break from my dual monitors, but it allowed me to stretch and get familiar with the environment. It also helped to curb my post-lunch upward sloping blood sugar, so it was definitely beneficial to my body and mind to make sure I maintained semi-regular movement during the workday.

Tip #3: Have back-up supplies on hand. When I was packing my bag the night before, I made sure to slip a meter, test strips, and fingerstick device, as well as some fruit snacks, into one of the compartments as I didn’t want to run the risk of something going awry with my CGM or needing a low snack and not having it. Of course, I didn’t experience either scenario in the office that first day, but knowing that I had these items close by went a long way in reassuring me that I was prepared to handle any diabetes scenario that might crop up during the workday. And it turned out to be fodder for reminding me that I should also have an extra pod and insulin in my bag at all times, too – next time, I’ll make sure to bring those items with me so I can have even more diabetes bases covered.

These tips might seem pretty obvious, but I was kind of awestruck by just how weird it felt to be back in an office space after a long hiatus away from one. So I think that following these tips truly did help to ground me so I could stay focused on learning my new job and meeting my colleagues, rather than letting my diabetes take center stage for the day.

Lessons Learned from Another NDAM Come and Gone…

As Carrie Bradshaw would say…”and just like that”, another National Diabetes Awareness Month (NDAM) has come and gone.

And yes, I learned a couple of lessons in the past 30 days.

For starters, I learned that my mindset going into NDAM was identical to my mindset at the end of it: Pace yourself. Life with diabetes is a marathon, not a sprint, and it deserves to be treated as such.

I also learned that it’s a whole lot easier to drown out the deafening noise of NDAM online when I choose to be mindful about how much content I consume during the month of November. I kept my focus on everything that pertained to my work at the time, and I decided to remove my personal feelings about social media and NDAM from the equation. That made it so much easier to keep my attention on the specific initiatives I was hoping to accomplish during the month, and I was able to make sure that work stayed separate from anything I shared on my blog.

And finally, this particular NDAM reminded me that you get out of it what you put into it. I could’ve put my heart and soul into diabetes advocacy last month and I’m sure I would’ve gained so much from that experience, but since I had enough self-awareness to realize I just didn’t have the same number of spoons to give this year as I have in years past, I made the conscious decision to cut back. I don’t regret it for a second, especially considering that this extra attention could be placed on my actual lived experience with diabetes and taking extra steps to improve my management. That manifested itself into one of the best endocrinology appointments I’ve had in recent years, and truly, what more could I want out of NDAM? After all, I can’t be the kind of advocate that I’d like to be if I’m not taking proper care of myself…so if the only outcome I have from this NDAM is that I’m finally feeling confident in myself and my use of my diabetes devices, then I have absolutely no regrets about that whatsoever.

4 Tips on Navigating a New Job and New Health Insurance

This blog post was originally published on Hugging the Cactus on August 4, 2021. I’m sharing it again today because I’m starting a new job! I’m thrilled about this new opportunity and as I was planning to make the switch to a new healthcare plan, I found my own advice to be pretty helpful. Read on for all 4 of my tips…

Hi, my name is Molly and I have type 1 diabetes, and although I am extremely grateful for health insurance, I also hate every aspect of it.

When I aged out of my parents’ health insurance plan two years ago, I was completely lost and overwhelmed by choosing my new plan. How much would I have to pay for my supplies? Would everything be covered? Could I keep my doctors? How much money should I put into my FSA? The answers to these questions took me a good chunk of time to figure out, and I only started feeling good about my knowledge of my old job’s health insurance plan in the last year or so.

As a result, the only thing that made me less excited to start my new job was the burden of having to figure out a new health insurance plan. And for good reason, it turns out, because it has been a challenge to say the least. But there are a handful of things I’ve learned along the way that I don’t think I’ll ever forget so that I can have an better experience the next time I need to change health plans. Here are my tips for making the transition from one health insurance plan to another as easy as possible:

1. Take stock of ALL my supplies before starting the new job (and before losing my old job’s health coverage). This was, without a doubt, the best thing I could’ve done for myself before I started my new job. In my last few weeks with my former company, I looked through all of my diabetes supplies and inventoried them. I kept a running list of the most important items (things like insulin, Dexcom sensors/transmitters, and pods) and decided that even if I had plenty of those things, I would still place an order for them before losing my health insurance. This ended up being a fantastic idea because it took me a solid couple of weeks at my new job to figure out which health plan would work best for me, and in that span of time, my supply stash was dwindling. On top of that, it took several more weeks for me to get all my prescriptions straightened away (more on that in tip 3), so I was especially grateful that I had seriously stocked up before leaving my old job.

2. Compare plans extensively. Like I mentioned above, I spent a couple weeks reading through my plan options before I finally settled on one. It took me so long because I wanted to feel 100% comfortable with my new plan, and I knew that I had a 4-week period to complete my research before committing to a new plan. Plus, my new job uses a website that offers a health insurance plan comparison tool (a super cute one, to boot, that explains all things insurance in layman’s terms) that I was happy to take advantage of during the decision-making process.

3. Send as many messages and make as many phone calls as it takes until everything about the new plan is crystal clear. For me, this including calling my local pharmacy and sending toooons of online messages to my doctor’s office, as well as my new health insurance provider. I honestly felt like I was playing a game of telephone – you know, that game that kids play where they have to whisper a message into each other’s ears as a test of listening and communicating effectively – because it seemed that nobody would take accountability for sending my prescriptions to the right place or understanding exactly how I needed help. So in the last few weeks of July (leading into the first few weeks of August, really, ‘cuz I’m still working on this), I made a vow to myself that I’d get to the bottom of everything and get my prescriptions fully straightened away. I’m happy to report I’ve made substantial progress, but I’d be lying if I said it didn’t require a lot of my spare time and energy.

4. Talk to coworkers and ask for their feedback on plans. This might be unique to me because I work for a diabetes organization and my colleagues have an intimate knowledge of health insurance hurdles combined with a chronic illness, but even so, I remember asking coworkers at my previous job about their thoughts on the health insurance offerings and I got some solid feedback from that. So that’s why I decided to ask around at the new job, and of course I was met with helpful replies that made my transition a little smoother.

The biggest lesson I learned throughout this process? I realized I need to give myself a little grace. This stuff isn’t intuitive to anyone (unless you’re some sort of health insurance guru). I shouldn’t beat myself up because the system is more complicated than it needs to be. And bottom line is that I need to focus on the fact that I have choice when it comes to health insurance, period, because I know that there are too many people out there who can’t say the same.

So I guess in a way I am glad for the challenges presented to me by my health coverage.