Memory Monday: The Shattered Insulin Vial

One Monday per month, I’ll take a trip down memory lane and reflect on how much my diabetes thoughts, feelings, and experiences have unfolded over the years. Today, I remember…

…the insulin vial that my mother and I accidentally broke in the bathroom of a restaurant, many years ago. R.I.P., tiny vial of Humalog.

This goes back to the days of having to scurry off to the restroom soon after ordering our meals to check blood sugars and inject insulin. And it was a pain. We wanted to be considerate of other diners around us in the restaurant, so doing our diabetes things at the table wasn’t an option. That left us with the most logical choice, the bathroom.

On the night of the broken vial, we were having dinner at a local restaurant. Once our dinner orders were placed, we headed off to complete our routine. And it went just as expected: We knew our blood sugar levels and did the mental math necessary for figuring out our insulin intakes. If memory serves correctly, I was still at an age where I wasn’t totally comfortable with injecting myself yet and would ask my parents to help me whenever we were in a public place (I felt better about self-injecting at home, my literal comfort zone). So my mom ushered me into a stall and went about filling her syringe, then mine. Soon after she stuck me with the needle, it happened…the vial fell. I don’t know if it was my hand or her elbow that knocked it off from its perch, but something caused it to tumble down to meet its end.

Capture

 

It was a dramatic moment. If a slo-mo camera had captured the ordeal, I’m sure it would’ve shown my mother and I donning identical, horrified expressions as the vial smashed into smithereens on the tiled bathroom floor.

 

 

 

 

It wasn’t the end of the world; after all, we’d just taken our shots before the incident, and the vial wasn’t completely full. But it was just full enough that we were upset about all the wasted insulin that formed a small puddle on the floor.

I remember my mom gingerly picking up the pieces of the fractured vial and disposing of them, sighing as she went about the task. That whole experience resulted in a few things. 1) We made sure to get a vial protector soon after it happened to help cushion future insulin vials that were accidentally dropped and 2) We got insulin pens a bit further down the road, which proved to be much more durable and portable than vials. In fact, they made it so we could do injections at the dinner table, in the car, and just about anywhere with ease and discretion.

But this incident remains etched in my memory because it instilled always being careful with my diabetes supplies from that moment on. All of my diabetes stuff is expensive and extremely precious because of what it does for me, my mom, and millions of other people on a daily basis – it’s got to be treated carefully, always.

Endo Appointment Anxiety

I’m feeling anxious about my appointment with my endocrinologist tomorrow.

I don’t know why. I like my doctor very much: She’s always encouraging, pleasant, and helpful. The only thing I’d change about our appointments is to slow them down a bit; sometimes, she whips through them so quickly that I forget to ask her the questions floating around in the back of my mind.

Could it be that I’m worried about my A1c test? Possibly. I don’t know whether my A1c has gone up or down in the last three months. I have stretches of time in which my blood sugar behaves the way I want it to, but I also experience clusters of days here and there of complete diabetes chaos. In the last month, for instance, there were a few too many circumstances in which my blood sugar was above 300 mg/dL. Each time, I’d correct the high, only to either experience 1) a sudden drop resulting in a low or 2) several hours of prolonged high blood sugar because it was taking the insulin a long time to take effect.

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I love that there are posters about “understanding” diabetes on the wall – it’s too complex to break down into a few bullet points.

Now that I’m thinking about it, maybe those scattered, wicked-high blood sugars are the reason why I’m anxious about this appointment. I know that my doctor will probably ask me about them, and I’m going to have to admit to her that a combination of emotional eating, lack of carb counting, and general carelessness resulted in those highs. I know that she won’t judge me, but…I can’t help but judge myself for causing the blood sugar swings. The rational part of me is aware that it’s unhealthy to blame myself for occasional slip-ups, but the goodie-two-shoes, Miss “Perfect Diabetes” part of me is shaking her head in shame and disappointment.

If nothing else, this is a prime example of how diabetes can be an absolute (warning: foul language following) mind fuck.

What to do When Diabetes Technology Fails (at the Worst Possible Time)

This past Saturday afternoon, my Dexcom G6 sensor stopped working. It wasn’t sending data to my smartphone app or my transmitter, so I was forced to fly blind…at a party with tons of people I’d never met before, an impressive food spread, and few beverage options other than beer from a keg or spiked punch.

Definitely not a good time for my Dexcom sensor to go kaput, especially considering I was getting on a plane the next day and didn’t have a backup. And I wouldn’t get my hands on a fresh sensor for a couple more days, when I would return home from my adventures in Washington, D.C. and Nashville, Tennessee.

So yeah, it was pretty much the worst timing ever for my heavily-relied-upon diabetes technology to fail.

How did I handle it? It might sound incredibly obvious, but…I just reverted back to life before a CGM, meaning that I tested my blood sugar much more often than I do when the ol’ Dexcom is up and running. At the aforementioned party, I sucked it up and pulled myself away from conversations to check my numbers every so often with my meter. I still participated in barbecue and beer consumption, but I dialed it back because I couldn’t be sure of what direction it would send my blood sugar in, or how quickly it would happen.

As for the rest of my trip, and my travel days, I remained diligent. I’d test and correct as needed approximately every two hours. I set alarms for the middle of the night so I could be certain that I wasn’t too high or too low. I went back to relying on sensation – was I feeling thirsty because my blood sugar was high? Was my shakiness a sign of an oncoming low? It surprised me how easily I slid back into those routines, but I guess that after so many years of practicing them, it makes sense that I was still in tune with my body.

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No data…no problem.

And, perhaps most shocking of all, I remained pretty calm about the whole situation. Normally, it’d send me into a panic and I’d chide myself over and over for not having a backup sensor. But, really, I carry around enough diabetes junk – adding a clunky sensor insertion device into the mix sounds excessive. After all, the sensors are supposed to WORK for the full ten days that they guarantee. It gets exhausting, having to anticipate technology failures when they should never happen, so I shouldn’t be upset with myself for not carrying more than the essentials.

The lesson in this experience, I think, is to be unafraid to depend on my intuition. I literally grew up managing my diabetes with hardly any technological aid, and I can do it again now in a heartbeat as long as I trust myself and the process.

Nor’Easter = No Power? No thanks!

Earlier this winter, I blogged about how winter weather can affect diabetes. I thought I covered just about all of the ways, but Winter Storm Quinn reminded me that I left out a major factor when it hit last week: power outages.

How could I forget? After all the disaster and emergency preparedness articles I’ve read over the years, it should’ve been one of the first things I thought of when I wrote that post. But it didn’t even come to mind until last week’s situation.

On Thursday morning, I woke up to eerie silence. I rolled over and saw that my alarm clock’s light was dimmed, indicating that we had lost power overnight. Groaning, I wandered over to a nearby window and tugged the shade open to reveal a winter wonderland. Or it may be more accurate to say winter horror show. The world outside was coated in freshly fallen snow so heavy and compact that even the strongest trees in our yard found themselves compromised. Branches hung limp and defeated from their trees, and the weaker limbs that had fallen off were strewn haphazardly on the icy ground. But what really got our attention was the power line that lay across our driveway, struck down by the winds and snow.

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A tree that fell victim to the storm, and the power line that collapsed with it.

It helped to explain our lack of power, and it also made it clear that we should get out of our house sooner rather than later – that is, if we wanted to keep warm and work remotely for the day (as opposed to making treks into our offices or taking personal days). So we packed overnight bags speedily, just in case we would need to spend the night away from home, and made our way out into the arctic tundra.

We set off for the refuge of my aunt and uncle’s home, where the wifi was working and the heat kept things cozy. Plus, Monty the black lab and Lucy the yellow lab were present and welcomed us warmly.

As I logged into my work laptop, it suddenly dawned on me that I neglected to pack my diabetes supplies. In fact, it hadn’t even crossed my mind to grab any insulin from our powerless refrigerator to ensure it stayed cool. But it didn’t make sense to make the trip back home for any of it, so I crossed my fingers and hoped for the best.

Our house ended up being without power for about 36 hours. Not too bad in the grand scheme of things, but long enough to make me realize it’s important to come up with a plan for future freak power outages like this. Even though the outage was relatively brief and it was cold out, meaning the odds of my insulin going bad were slim, I know that this won’t always be the case (especially in the summertime). So I’m going to put together a rudimentary emergency kit that I can grab and go on a moment’s notice. I’ll include a checklist with this bag that will serve as a reminder to take as much insulin as needed with me in an emergency situation. I’m also going to try to be better about charging my meter and my Dexcom more frequently – I have a habit of waiting until the battery is dangerously low before I recharge either device.

As the saying goes, I’d rather be safe than sorry.

Favorite Things Friday: FRIO Insulin Cooling Case

One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!

*Insert bad pun about how COOL this product is, like, literally AND figuratively!*

Alright, now that I’ve got that out of my system…let me tell you about my FRIO cooling case.

I heard about cooling cases from the DOC a few years back, and the timing couldn’t have been more perfect when I did. I was about to go on a weeklong vacation to Disney World. In Orlando, Florida. In August. A.K.A., one of the hottest and most humid times of year to be going there. And I was sweatin’ over what I was going to do about carrying my insulin around in the parks.

Before you even think it, no, my option wasn’t just to throw it in my backpack and call it a day. PWD know well that insulin needs to be kept a certain temperature – i.e., cool – in order for it to be viable. It CAN and WILL expire if it’s left out in extreme temperatures for too long. So clearly, I had to figure out how to keep my insulin cool in the Florida heat.

Fortunately, I’d read about the cooling cases on Twitter at some point and decided to order one a few weeks before the trip. When it arrived, I put it to the test right away to see how it fared.

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My magical FRIO cooling case

I followed the instructions that came with the pouch: Immerse the black inner casing in cold water for 10-15 minutes, allowing the beads stuffed within it to turn to gel. After the time elapsed, I removed the case from the water and pat it dry. Then I put two of my Humalog pens (because I was still on injections at this time) into the black case, put that inside the purple pouch, and forgot about the contraption for a few hours so I could see if it would stay cool for that span of time.

And it did! The case worked beautifully. It was just as cool as it was when I had first removed it from the water, meaning my insulin was kept properly refrigerated. The only downside was that my pens felt slightly damp when I removed them from the bag, but they weren’t damaged whatsoever. I knew right then and there that it was just the thing I needed for my vacation.

Fast-forward to present day and the FRIO case continues to serve its purpose as I need it. I couldn’t recommend it more to PWD who travel – even if it’s to a mild-temperatured place. It helps keep insulins cool no matter what, and to me, that makes the case more than worth it. Check out friocoolingcase.com to learn more about their products!