A Tough Topic: Diabetes Complications

I’m broaching a subject I’ve never openly discussed in an online forum in today’s blog post…and that is diabetes complications.

The reason why I’ve never talked about complications is straightforward: They absolutely terrify me.

It’s a topic that’s so foreign and frightening to me that I don’t even know the full extent of diabetes complications. You can Google them, for sure, and discover a long list of scary conditions involving the heart, eyes, extremities, and other internal organs. But I’d rather not do that to myself, let alone the audience of this blog.

I don’t want you to think that I’m naive, though…I know that not talking about something doesn’t mean that it’ll just go away or never happen.

Recently, I became glaringly aware of this fact through the form of (what I presume to be) my own diabetes complication: tendonitis in my left hand.

In the last year or two, I’ve felt sporadic sensitivity in my left hand when I fully extend my wrist, bear any weight on it, or even when I do simple wrist rotations. I never really knew when to expect the pain, but it happened every few months and lasted about a week each time. So when I felt it again around the time I was due for my annual physical with my PCP, I decided to ask him about it.

He explained to me that, based on the type of pain and its duration, it wasn’t carpal tunnel (numbness and tingling are symptoms of that, not pain) like I thought it might be. It also wasn’t arthritis (I didn’t have swelling or reduced range of motion) or neuropathy (I wasn’t experiencing pins and needles), but he did say that those aren’t uncommon in people with diabetes. That’s when he located the exact inflamed tendon – the thick, fibrous cord that attaches muscle to bone – in my left hand/wrist that was giving me trouble.

A Tough Topic_ Diabetes Complications
Me with my new (but occasional) accessory.

Just like all the aforementioned conditions, my tendonitis is probably due to my diabetes. Although my PCP didn’t explicitly state that I definitely have it because I’ve had diabetes for 22 years, he did identify a cause-and-effect relationship between the two. But, fortunately, he also reassured me that my occasional flares of tendonitis are nothing to worry about. As long as I continue to do what I’m doing (which is supporting my hand and wrist with a brace when I experience bouts of pain, as well as rest the area as much as possible during those times), then I’ll be totally fine.

While I’m not exactly thrilled to have to deal with tendonitis, I am very relieved that I know there’s an explanation to help make sense of it all, and that I’ve been doing the right things to handle it. So even though I won’t be going out of my way to research any other diabetes complications any time soon (why on earth would I want to stress myself out unnecessarily), I have come to terms with my tendonitis as a possible complication for me. And rather than seeing it as a completely negative thing, I’ve decided to just keep doing what I’m doing, and continue to take the best possible care I can of myself and my diabetes.

They say prevention is the best medicine for a reason, right?

 

 

One Night with Diabetes

You settle into bed, ready to fall asleep after another long day.

But first, you check your blood sugar, just like you do multiple times every day.

Your glucometer reads 201.

Suddenly,  you’re a little nervous to drift off to dreamland, because you just changed your insulin pod an hour earlier and you’re not quite sure if it’s the reason behind the high blood sugar.

You wonder: Could my blood sugar be high due to a miscalculation with insulin or carbs at dinner? Is it because of my stress levels? Is it because I’m dehydrated, or because I’m starting to get sick, or because my new pod’s site is on scar tissue, or because…?

Before long, you feel incredibly exhausted because you’re cycling through what seems like an endless list of reasons why you might have an elevated blood sugar and it has zapped you mentally.

You feel your eyelids grow heavy, and just before you go to sleep, you give yourself an insulin dose that should bring your blood sugar back down before long.

You experience a broken night of sleep.

One Night with Diabetes
When you read this, put yourself in the shoes of a person with diabetes…and this is just one night with the damn thing.

Since your Dexcom app is programmed to alert you when you’re over your high threshold for an extended period of time, it goes off, practically every hour, from 10 P.M. to 1 A.M.

Every time it happens, you wake up to the sound of your Dexcom alarm blaring in your ear.

You worry about waking up others in the household before you even begin to worry about your blood sugar.

You’re pretty sure it’s not a pod problem, since your blood sugar would probably be higher if that were the culprit, but you’re too damn tired to care about the cause at this time of night.

You bolus, go back to sleep, hear a high alarm, wake up, and repeat until finally your sleep stops getting interrupted by your Dexcom.

You get a few hours of broken rest.

You wake up at 6 A.M. and realize that, after all that, your blood sugar levels are still slightly elevated.

You’re pissed that your Dexcom was off by 40+ points, as confirmed by a fingerstick check.

You take more insulin, and force yourself to get up and out of bed because it’s time to start the day: Your diabetes is waiting for nothing, least of all you.

Just another night of not enough sleep and too much worry, thanks to diabetes.

The Top Three Things my Diabetes Devices Get Mistaken For

When I started using an insulin pump and a Dexcom CGM – and even when I switched to a more modern glucometer – I never really anticipated what other people might have to say about these devices. Yes, I figured that people would notice them, and they’d probably occasionally stare out of curiosity (and sometimes, rudeness).

But I never thought that people would think that they were anything but medical devices. I shouldn’t have so much faith in people.

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Can I see the confusion between my old iPod and my glucometer? Um, sure!

Over the years, I’ve noticed a pattern when it comes to what people think my devices are…here are the top three things that my various gadgets are mistaken for:

  1. My OmniPod PDM is typically confused for a beeper. A freakin’ beeper? Helloooo, we’re not in the 90s anymore! Honestly, I can’t even remember the last time that I saw a legitimate beeper/pager device…so it really cracks me up when people ask if I’m carrying around such an old-school piece of technology.
  2. My pods and Dexcom sensors look like cigarette patches, apparently. The first time someone asked me if my pod was a cigarette patch, I asked them, “Do I look like a smoker?” (Not that smokers are supposed to “look” a certain way.) I was more amused than offended, but also kind of awestruck that somebody would confuse a patch that from my understanding is fairly discreet/sleek in design with a lumpy pod or sensor.
  3. My glucometer seemingly resembles an iPod nano. Once, a person asked me why I was wiping blood on my iPod. I wish I was kidding. I’ll allow that my Verio IQ meter and iPod nano are similar in shape and size, but the similarities end there.

Truth be told, it’s actually pretty funny when people think my devices are something other than medical gadgets. And whenever a comment is made and I have to gently tell whoever it is that they’re incorrect in their assumptions about the device(s), I can almost always guarantee that they will end up feeling foolish for what they said. I almost feel bad, but…not really. For the most part, at least I can say that all’s well that ends well, because these interactions usually lead to a valuable teaching moment that the other person won’t forget.

And clearly, I won’t ever forget these moments, either!

 

More Adventures in Low-Carb Snacking

Snacks are one of the great joys in my life.

I refer to myself as a “grazer” – I’m constantly nibbling on food in between meals and I’m definitely no stranger to nighttime snacking while relaxing/watching television. If there are snacks in a room, I won’t ever be too far away from them.

I’m shameless when it comes to my love for snacks, but I can also admit that it’s not the healthiest habit. That’s because most snacks, at least the ones that appeal to me, contain carbohydrates that require me to take a bolus. Sounds like no big deal, right? It’s not, but for some reason, I usually neglect bolusing for snacks. I know better, but I can justify it to myself by saying, “Oh, it’s just a small handful,” or “Take a 15-minute walk when you’re done to burn off the carbs.” Most of the time, my blood sugar doesn’t go up too alarmingly high, but I’ve definitely experienced a few 250+ readings that shouldn’t have happened or could have been avoided if I had just bolused.

So I’ve made it a mission to track down the yummiest low-carb snacks out there (that aren’t cheese, deli meats, nuts, or celery, to name a few staples of mine that have become boring).

I’m happy to report it’s been a (mostly) tasty experiment.

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These snacks are so good and low-carb. Now if only they could make delicious, zero-carb cheesecake. And chocolate. And pizza. And…

I wrote about my success with pork rinds – the name still makes me cringe, but dammit, they’re good – over the summer. And I’m here today to share three more snacks that I’ve discovered are total wins.

Let’s start with the roasted edamame. These are fantastic. One serving has 9 grams of carbs, but 6 grams of fiber. Since I always subtract fiber count from carb count, this means there are 3 net carbs in one serving of edamame – such a win! I also love that they’re high in protein. Besides boasting enviable nutrition facts, they’re salty and satisfy in the same way as a handful of peanuts – just with significantly less fat and more protein.

Next, there’s the parmesan crisps. I know what you’re thinking: cheese! I just said above that cheese was getting boring for me as a snack, so what are these doing here? Well, they’re different from the old cheese stick or standard slice of American. These crisps are just like chips. But instead of tasting like potatoes, they taste like crunchy discs of cheese. What’s not to like about that? Oh yeah, they also have 0 carbs in an entire bag. Yaaaaaas!

Lastly, there are the seaweed crisps. I hope you didn’t just cringe when you saw “seaweed”. I was skeptic at first, too. How could anything containing that stringy algae that always gets wrapped around your legs when you venture into the ocean possibly be considered tasty? These might be an acquired taste for some, but I was surprised when I discovered right away that I liked these. The seaweed is somehow both salty and sweet at the same time, and combined with the sesame seeds, they’re lightly crispy and quickly become addicting the more you eat. These have 3.5 carbs in a serving of 12 crisps, but there’s fiber in these, too, so the overall carbohydrate content is minimal.

While higher-carb snacks like crackers, trail mix, and the occasional piece of bite-sized candy won’t be leaving my lineup any time soon, it is nice to know that there are some low-to-no-carb options out there that are actually delicious.

 

A Distant Memory: T1D Through the Teen Years

High school is a time in most people’s lives that is not fondly remembered.

I am not most people.

Generally speaking, I really liked high school. Sure, I overloaded my schedule with too many A.P. classes and extracurriculars, but I was a young overachiever in those days (now I’m just a slightly older overachiever).

Academics-wise, I enjoyed taking a variety of classes, from A.P. Psychology and Statistics to Anatomy/Physiology and Cold War Era Film (we got to watch a bunch of awesome movies in that class, everything from Them! to Dr. Strangelove). And I was lucky enough to have teachers over the years that I got along with well – I even keep in touch with some of them to this day.

I had a blast playing field hockey from 8th grade through senior year. I had very minor roles that I nevertheless fully embraced in a handful of plays. And though it was a headache at times, I was happy to be an editor of my senior yearbook.

And it might or might not be surprising to you to discover that I was one of those nerds who actually liked staying after school. My two best friends and I spent many extra hours staying in school later to better prepare ourselves for our upcoming exams, and we had an absolute ball snacking on Sociables crackers and gossiping with a select few of our teachers.

I wasn’t a total angel, though – a Friday habit that my best friend and I developed on senior year was to leave our allotted 30-minute lunch break 10 minutes early so we could sneak out down the street to buy large iced coffees to get us through the final class of the day. I know what you’re thinking: SUCH REBELS!!!

A Distant Memory_ T1D Through the Teen Years (1)
I played field hockey, attended prom, and graduated high school – all while dealing with diabetes. If I can do it, anyone can.

So it goes without saying at this point that I have lovely memories from the high school days. But you know what sticks out to me more than anything about those times?

I can’t remember a single instance in high school where my diabetes got in the way.

Diabetes didn’t, and couldn’t, stop me from doing anything in high school. I just…handled it. I participated in sports teams, clubs, and classes without it ever truly interfering in a way that sticks with me to this day.

Sure, I went everywhere with all of my supplies at all times. And yes, I injected my lunchtime insulin right in the middle of the cafeteria (and I was so damn discreet about it, AND my diabetes was common knowledge, that not one student ever commented on it…at least, not to my face). Diabetes was just a part of me, but it didn’t define me. Honestly, it was often easier to balance my blood sugars and boluses than it was to handle my heavy homework load!

I wonder whether my experience would have been different had I decided to go on a Dexcom and a pump in high school, rather than wait until early adulthood. Would the devices have made it easier to balance homework with extracurricular activities, hangouts with friends, and my weekend shifts at the movie theater? Maybe, but I don’t see the point in speculating on it now. All I know is that I did things the way that worked for me back then, and I was more than fine as a result. In fact, it’s one of the few times in my life that diabetes feels like a distant memory – it didn’t occupy as much of my brain space as it does now; rather, it was just something that was always in the background, not quite my first priority because I was too busy living the life of a normal American teenager.

 

 

Two Different Lists Lead to the Same Conclusion

I like lists. I like them so much because I like to pretend to be an organized person who always has tasks to complete (the former is definitely false, while the latter is pretty much absolutely true). I also like lists because making one feels like an accomplishment in itself, and who doesn’t like feeling accomplished?

Freedom is the atmosphere in which humanity thrives. Breathe it in.
What can I say, I’m a list girl. (But not a hand model; that’s definitely not my perfectly manicured hand in the above photo.)

So I must admit that I felt pretty damn good about myself after making these two diabetes-related lists, because not only do they pull weight as blog post material, but they also help me understand something about me and my diabetes. So here they are:

List of things I should do on a daily basis for my diabetes:

  • Check my blood sugar using my meter 6-8 times per day (upon waking up, before I go to sleep, before I eat a meal, and in-between meals to make sure I’m on track)
  • Change my lancet (LOL)
  • Look up carb counts for every meal using apps and/or nutritional facts
  • Monitor my Dexcom carefully and do fingerstick checks when I disagree with it
  • Take a correction bolus for every blood sugar that’s over 150 mg/dL
  • Eat plenty of fruits and veggies AND drink plenty of water

List of things that I actually do on a daily basis for my diabetes:

  • Check my blood sugar whenever the heck I feel like it; after all, my Dexcom is usually accurate
  • Change my lancet only when I remember, which is like…once or twice a month
  • Eyeball my plates of food and make “educated guesses” on carb counts
  • Monitor my Dexcom OBSESSIVELY – sometimes even every 5 minutes, depending on the situation – and freak out when it doesn’t match my fingerstick checks
  • Take a correction bolus for blood sugars that are 200+ only
  • Eat what I’d like (which, in addition to fruits and veggies, is a wide variety of things) and drink probably not quite enough fluids

When I compare these two lists, I come to the same conclusion: I am lazily in control of my diabetes. I know exactly what my current routines are and just because they aren’t the “right” ones, it doesn’t necessarily mean I’m doing anything “wrong” in terms of my diabetes care and management. Sure, I’m not doing anything the textbook way, and I admit that I’ve gotten a little lazy with things like carb counting and correction bolusing, but so what? The important thing here is that I can recognize the areas where I need and want to improve.

For starters, I’d like to stop depending so much on my Dexcom. I want to learn to check it less – maybe take it out half as often as I do now – so I can strengthen my ability to recognize low and high symptoms. I’m also hoping to use measuring cups and nutritional information more often to make better informed decisions when it comes to how much insulin I give myself at mealtimes. It’ll add a few extra steps to my day, but these are habits that I followed for a long time and that are worth reintroducing to my routine.

As far as everything else goes, I’m not going to sweat them too much…of course, it will be nice if I remember to change my lancet more frequently and be more proactive about correcting high blood sugars, but really, these are matters of minor concern. I think I make my best diabetes progress when I take things one step at a time, so that’s just what I’m going to do.

Precarious Pods and Pure Paranoia

Here’s another previously published blog post from October 5, 2018. What nugget of useful information can you find here? Well, it all has to do with trusting your gut when it comes to an insulin pod that’s dangling precariously off your body and the subsequent paranoia that happens when you’re not sure whether it’ll still work properly…

I’d only been wearing my new pod for about an hour when my arm brushed up in exactly the wrong way against a chair. Riiiiiiiip!

My pod tore right off – not from my arm, but it lifted up from the adhesive that it was glued to and dangled precariously from the still-intact adhesive stuck to my arm.

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Would you have kept the pod on, or changed it?

After cursing loudly, I asked my mother for her opinion. I wanted to know if she could see the cannula, because that was the component that made me most concerned. As long as the cannula was still stuck under my skin and delivering insulin, it shouldn’t matter that my pod was a little loose – right?

She tried to peek under and around my site, but it was virtually impossible to tell whether the cannula was where it should be. I thought about it for a few moments, and decided that it would be wise to just change out the pod. The notion of tossing one that had only been in use for an hour was unappealing to me, but I know myself pretty well, and I know for damn sure that I would’ve been super paranoid about the pod functioning properly for the following 72 hours. I also figured that it couldn’t hurt to try calling Insulet to see if they would replace the kaput pod. The odds were slim, but why not try?

So after I changed my pod, I dialed up Insulet and described the situation to the customer support representative. And…I got a replacement! I was pleasantly surprised by the rep’s empathy towards the situation and how easy it was to get my replacement. She reaffirmed that I did the right thing, noting that if she’d been in my shoes, she would have called it in, too. It goes to show that when in doubt, change the pod – and don’t hesitate to call for a replacement.