Luck O’ the Irish Diabetic

Happy St. Patrick’s Day!!!

Last week, it occurred to me that in more than 3 years of running this blog, I’ve never written anything about St. Paddy’s Day here…so I sought out to rectify that immediately; hence, today’s blog post.

I love St. Patrick’s Day. Always have, always will. I celebrate it each year decking myself out in head-to-toe green. I eat a traditional Irish dinner – always prepared by my mother, until this year when I will attempt to cook the meal myself – that consists of corned beef, cabbage, potatoes, carrots, and Irish soda bread. We eat it while listening to Irish music and more often than not, we’ll have a Guinness or an Irish coffee along with the meal. My family’s attended St. Patrick’s Day parades in various locations in years past, though obviously, we didn’t go to any last year and we won’t this year, either. But we’re still proud of our Irish heritage and we made the most of it in 2020, as I know we’ll do today.

My parents’ dog, Clarence, and I certainly made the most of the day last year. I was dressed up like this for all of my work video conference calls, which made my colleagues laugh at a time when we all needed one.

So you know my plans for St. Patrick’s Day, but what does this have to do with my blog that’s about diabetes?

Let me explain.

The common denominator between this holidays, all the others, and my diabetes is…food.

Foods consumed on holidays are often special and laden with carbohydrates. Rather than deprive myself, I like to indulge on holidays, and worry a little less about my topsy-turvy blood sugar levels.

You might be thinking, “But the food you described isn’t even that carb-heavy!” and you’d be right, for the most part. Corned beef, cabbage, carrots…those are all easy to bolus for seeing as the carbohydrate content is negligible.

It’s the combo of potatoes – which normally, I can bolus for without any troubles – and Irish soda bread – hellooooo, carbs – that really screws me up.

You see, the problem is that Irish soda bread is too delicious. It’s a quick bread that has a buttery exterior and a tender, mouthwatering interior that’s densely packed with raisins. It doesn’t sound like much, but my mother’s recipe is sheer perfection and I can’t resist helping myself to a big ol’ slice (and a couple of mini, just-one-more-taste slices) of the stuff every year.

So more often than not, my St. Patrick’s Days end with high blood sugars (which I suppose is better than ending with a trip to the toilet due to excessive…ahem, celebrating).

The Irish soda bread is worth the high blood sugar alone, but this year, I’m hoping for a little luck when I tuck into this festive feast. I’m tired of simultaneously welcoming holidays and high blood sugars…it’s about time that I make more of an effort to have better levels when I’m eating special meals. I know the extra work will make the day and the food that much more enjoyable and special.

With a little luck o’ the Irish (and some aggressive bolusing), this diabetic will finally have a St. Patrick’s Day filled with lots o’ green, Guinness, and great blood sugar levels.

The Days that Diabetes Bothers Me

The vast majority of the time, I’m relatively unbothered by my diabetes.

I accepted long ago that it’s not going away any time soon. While that acceptance has made it easier to live a full life in spite of diabetes, I definitely still experience the occasional day that diabetes bothers me more compared to other days.

The days that I’m unbothered by diabetes are enriched by the ones when it bothers me.

It’s the days that I’m trying to enjoy time spent with loved ones.

It’s the days that I want to eat whatever I want without any consequences.

Heck, it’s the days that I want to eat, period – I’ve had days in which diabetes has restricted me from eating much of anything at all.

It’s the days that I need a really solid night of sleep the night before, but don’t get it because diabetes interfered.

It’s the days that I’m feeling so burnt out from it all that I just want to be normal.

Obviously, I’ve learned how to power through these days that I’m truly bothered by diabetes. But the ones that I simply can’t find the strength to do so are the hardest, and that’s when diabetes really gets to me.

I think that after 23 years with it, I’m allowed to be bothered by my diabetes every now and then. I don’t have to radiate sunshine and positivity about life with diabetes 24/7.

However, I think it makes the times that I’m unbothered by my diabetes that much richer because that’s when I get to stick it to diabetes.

Take that.

My Thoughts on an Entire Year of Working from Home

One year ago today was my first day working from home due to the pandemic.

I remember my final day in the office like it happened yesterday. There were hushed conversations in conference rooms, cubicles, and the office kitchen in which we all wondered how serious things were – and how serious they might become.

We had no idea what we were in store for.

One by one, as individuals who tended to work earlier in the day left for home, I said hopeful, “see you in a month” farewells, as we were all under the impression that we could come back to the office in a month. I remarked to one colleague, who is a close friend outside of work, that I had a feeling we’d all be grateful to come back and that we’d marvel in being able to be in close proximity to one another again.

I knew then that this was the start of something unlike anything most of the world had faced before, and I even documented the strangeness of it all by taking one last selfie at my cubicle (to be fair, I’d spent my lunch break at the hairdresser’s, so my hair was on point and IMHO warranted a selfie).

And here’s the aforementioned selfie, taken on March 12, 2020 at 5:38 P.M…during my last few minutes in the office.

That would be my final selfie, for certain, in that office. Because just five months later we’d all return to it one last time in small groups to pack up our desks, as our company decided to break the lease and save money on office space.

So I’ve worked from home for a year, and will continue to do so for the foreseeable future. I’ve got so many emotions tied to that: gratitude, sadness, loneliness, anger, resentment, wistfulness…

Let me go over the positives of working from home: I’m so grateful for my job and for how deftly my colleagues and I got used to full-time remote work. Several aspects of life are made easier by working from home, such as managing my diabetes (for example, if I ever experience a pod failure, I have every and any back-up supplies I could need at home as opposed to my desk drawers, which weren’t always stocked up all the way). I save time on a commute which allows me to fit in more tasks at the start and end of my day, and honestly, working from home full-time gave me the ability to get a puppy and feel confident knowing that I would be around to take care of her.

But there are some negatives; mainly, I miss the office camaraderie like crazy. I’m lucky enough to work with a group of people that I truly enjoy being around, so it’s been tough to maintain my connections with them virtually. And truthfully, I get lonely in my condo. Going into the office five days a week not only ensured I had contact with other humans, but it also guaranteed that I’d actually leave my home during the week. I’ve never felt so sheltered in my life, and it’s a weird feeling.

I guess that if I’ve learned anything in the last 365 days, it’s how to be adaptable. Honestly, not to connect it back to diabetes – okay but this is what my blog’s about so that’s to be expected – but it’s a lot like figuring out how to deal with change as it inevitably happens. Over the years, I’ve taught myself what to do when lows and highs happen, and how to manage certain situations if and when they occur in my diabetes life. And that’s what’s happened in this last year: a whole lot of learning how to handle life’s curveballs, in general, along with the ones that diabetes tosses my way.

Hello, Highs: Pooled Insulin Under my Pod Leads to Elevated BG

Have you ever tried troubleshooting a problem so much that you start to feel insane, and then like magic, the solution to it becomes clear and you wonder why you hadn’t tried it earlier?

This was the case with me and the mysterious high blood sugars that plagued me for two and a half days.

Based on this image, can you tell what was causing my blood sugar to be stubbornly high?

Once I started noticing a pattern of high blood sugars that got worse every time I ate food, I started doing everything else except changing my pod. I tried taking insulin for double the amount of carbs that I was actually eating, I ran a 95% temp basal increase for 8 out of 24 hours in the day, I cut carbs altogether and ate only 0 carb foods, I skipped meals altogether, and I even tried marching around the house for 15-minute intervals to try to get my insulin pumping through my system faster.

And nothing worked. I was able to get my blood sugar no lower than 180, but for most of that 60-hour window of time, I spent a good chunk of it in the mid-to-upper 200s.

Finally, on the day that my pod was due for a change, I decided that it must be the culprit behind my high blood sugars. When I removed the old pod, I knew immediately that something was wrong because the smell of insulin was so strong; plus, there was a large, damp spot on the pod’s adhesive, indicating that perhaps my insulin was pooling under my pod instead of entering my body.

It took 5-6 hours after I removed the leaky pod, but I finally did start to come back down to my normal levels, and was totally back on track the next day. It was a frustrating experience to endure, but a stark reminder of something that I’ve known in the back of my mind for years: that when I’m in doubt, I should change my pod.

How Long Do AAA Batteries Last in an OmniPod PDM?

How long do AAA batteries last in an OmniPod PDM?

The answer to this question has subtly haunted me for years.

My PDM is the only device in my diabetes management kit that actually runs on batteries. Everything else, such as my Dexcom receiver and my blood sugar meter, can be recharged, which is highly preferable over batteries. But until I make the transition to the OmniPod DASH system (which uses a rechargeable lithium battery in lieu of AAA batteries), I’m stuck with replacing the AAAs in my PDM whenever they drain.

But it was never overly clear to me…how do I actually know when the batteries are out of juice?

Just by looking at the battery display, you’d think that I’d need to swap out the AAAs A.S.A.P…but I discovered that isn’t the case.

There’s a battery icon on my PDM, of course, that shows roughly how much life my batteries have left in them. When new batteries are put into the PDM, it shows a fully charged battery. Some time after that, the battery icon is half full, and then after more time, it goes down to a tiny sliver to indicate the batteries are running low.

Ever since I became an OmniPod user, I always assumed that the batteries had to be replaced as soon as the display ran down to that itty bit of battery life. I just figured that was the signal. Plus, I didn’t want to run the risk of delivering a bolus or changing my pod only for my PDM to completely die halfway through, leaving me to figure out how much insulin I had left to deliver – or worse, with a pod not fully activated that I’d have to scrap.

For a long time, though, I’ve been wondering if I’ve been changing the batteries prematurely. Maybe they had more life past that little sliver. So I put my theory to the test: Last month, my PDM displayed the low battery icon. Instead of changing the batteries immediately, I decided to wait and see what would happen.

And I can report that my batteries did last much longer after that initial low battery icon appeared. In fact, they lasted an addition 7-8 pod changes (I lost track after the first handful). I was pleasantly surprised to discover that my PDM could make it almost an additional month past that first indication of a low battery! And even better, I learned that the system does give a warning that makes it crystal clear when the batteries should be changed: The battery icon goes from having a tiny bit of life left to a flashing display showing a completely empty battery. I forget what the exact message was on my PDM, but I also got a system notification telling me to change my batteries soon.

I wish I remembered exactly when I changed the batteries last, but if memory serves me correctly, then it was sometime in November. So the AAA batteries in my OmniPod PDM lasted roughly three months.

Not too shabby, and now I know exactly when I can expect to change my PDM batteries.

5 Things That Make My Blood Sugar Crash Quickly

Have you ever noticed that certain activities have a swift and obvious impact on your blood sugar levels?

Well, if you aren’t a person with diabetes, then the answer to that is probably “no”…but I digress! Recently, I realized that there are five things that absolutely, definitely, without-a-doubt make my blood sugar plummet before long. Here’s my list – what’s on yours?

1 – Vacuuming. I live in a fairly small condo – less than 900 square feet total – but when it comes time to vacuuming the floor, it takes me a good chunk of time to do a thorough job. Maybe about 30 minutes total. So it shouldn’t be surprising that by the time I’m done, I’m normally a little sweaty and often in need of a snack because all that moving around has made my blood sugar drop.

Who else “celebrates” vacuuming their entire home by cracking open a fresh…juice box??

2 – Baking. This might be surprising because I’m the type of baker who must lick the spoon and sample the finished product as soon as it’s done, so you might assume that this activity makes my blood sugar go up. Not so. And this is because I am also what I call a “frantic baker”. I shuffle around the kitchen, rifle through cabinets, curse when I can’t find an ingredient and need to rush out to the store to get it…now you must get the idea. I’m always in motion when I’m baking, which pays off in the end. I need to try my baked goods in order to boost blood sugar that went low in the process of creating them. This is one of the many reasons why I love baking!

3 – Playing with my puppy. Little Miss Violet is four months old now and more rambunctious than ever. She loves fetching, running, chasing…and nine times out of ten, I’m fetching, running, and chasing right along with her. Before too long, Violet’s winded and on her way to dreamland while I’m on my way to the kitchen to grab something that will treat my low blood sugar.

4 – Cleaning the bathroom. A self-professed neat freak, I have a very specific process when I’m cleaning the 1.5 bathrooms in my condo. This process probably isn’t the most efficient because it involves a lot of walking up and down the stairs to gather various cleaning supplies, but it does do one thing well: lower my blood sugar, of course.

5 – Walking. This is pretty dang obvious because any sort of physical activity/exercise is bound to make my blood sugar drop, but not in the same way that walking does. I swear that 10-15 minutes of walking at a normal pace is enough to drop my blood sugar by about 100 points – that’s how effective it is for me. Walking is my sneaky little trick when my blood sugar is a tad too high: Instead of taking insulin to correct it, I just have to get a quick walk in and I’m falling fast in no time.

Would You Rather…Diabetes Edition

“Would you rather” is a neat little game because it’s both hypothetical and literal: You’re presented with a scenario or a concept that could either be real or total fantasy, but in both cases, you’ve got to choose the one that you’d prefer to deal with over the other. 

So I figured, why not have some fun and play it with a diabetes spin?

Here’s my game of would you rather….diabetes edition:

High or low blood sugar? I don’t like either, but I have to go with high blood sugar here because the symptoms of a high aren’t as bad or scary for me as my low symptoms.

Insulin pump or injections? If you’d asked me this a decade ago, I would’ve said injections all the way, but I haven’t missed multiple daily injections since I went on my OmniPod about six years ago. So insulin pumps are my winner here.

Glucose tablets or juice boxes? I go through phases and lately, juice boxes are my go-to for lows because they’re so dang quick and perfectly pre-portioned.

CGM or fingerstick checks? As long as the CGM is accurate (accuracy is crucial here), then I’d choose CGM any day of the week.

Lick blood or wipe? The mere prospect of licking a drop of blood away after a finger-stick check gives me the heebie-jeebies. I’ve never done it and will never do it…wiping blood drops on a piece of tissue is the way to go for me (if you’re a blood licker then I’m not shaming you, I just can’t stomach the thought of it).

Abdomen or arm site? This is a tough call because I like both for different reasons, but abdomen sites slightly edge out arm sites – I have great absorption there and they’re more discreet underneath clothing.

Back or leg site? Back sites over leg sites, easily. Leg sites can be so uncomfortable and I always risk ripping them off whenever I’m getting dressed whereas back sites rarely ever get in the way.

Would You Rather... Diabetes Edition
Pretend that this scale is holding glucose tablets and a juice box…which one would tip it for you?

Abdomen or back site? Of course I have to take my two favorite sites and pit them against each other! Back sites win this one again. For me, they’re the most comfortable sites that also have good absorption and don’t interfere with my outfits much, if at all.

Endocrinologist appointment twice a year or quarterly (four times a year)? My whole life, I’ve visited the endo every three months. Only recently have I started going twice a year and I’m simply not used to it. I think quarterly visits keep me more accountable and motivated, so even though I don’t like going to the doctor’s office, I’d choose more visits in the hopes that I’d be more successful in accomplishing my goals.

A1c or time in range? A1c is soooooo 1998 for me. Time in range is where it’s at in terms of measuring how well I’m doing with my diabetes management. The problem with A1c is that it’s narrowly defined as the average glucose readings in a three-month period of time, whereas time in range can be defined in whichever scope of time I find most useful, so that’s the obvious winner here.

What would you rather when presented with this list of choices?

The Best Time for Me and My Diabetes to Exercise

I am a phony morning person.

By that I mean that I pretend that I like getting up early in the mornings, but truth be told…I hate it. Oh how I long for the days that I could sleep in as late as I wanted and shun my very few responsibilities…

Even though I clearly don’t love waking up early, there is one benefit to it that truly lasts all day long. And that is getting my workouts done within the first hour or so of my day.

Listen, I’m not a fitness freak. I don’t have a ripped bod. More often than not, I’m working out so I can eat and drink the things that I like without feeling as terrible about it (only light sarcasm used in that previous sentence). But I do like exercising and try to do so every single day because, well, it’s good for me and definitely helps me to produce better blood sugars.

Exercising is a thousand times harder than it needs to be, though, when my blood sugar crashes halfway through a routine – which happened a lot more than I wanted it to when I was working out in the afternoons or evenings.

Fed up with the lows, I changed up my routine and that’s when I discovered the beauty of fasting morning workouts.

I am definitely not as flexible as this cartoon lady.

I learned that if I work out soon after I wake up in the morning and wait until after I’m done to eat breakfast, then lows almost never happen. It’s like magic. I’m able to get through my exercise routine (which is usually a half hour circuit of some sort) without having to modify my basal rates whatsoever. Since I don’t have any insulin on board (because I haven’t eaten any food yet), I’m only working out with my basal rate running in the background, so there’s a much lower chance that my blood sugar will really fluctuate when I’m exercising. Of course, mornings that I wake up with a low or a high blood sugar are a little more challenging, seeing as I either have to bring it back up to a good level for working out or get some insulin pumping in my system, but I wake up most mornings with my blood sugar in a range that makes me feel comfortable working out in.

All the diabetes business aside, I gotta say…my other favorite part of working out first thing is that it’s over with and done for the day. Ba-da bing, ba-da boom. It’s not looming over my head for the remainder of the day, and that’s a really nice feeling.

A.M. exercise is A-O.K. to my diabetes and me.

The Dexcom Site I’d Never Recommend Trying

I don’t usually regret trying new sites for my Dexcom and OmniPod.

But recently, I discovered the one area that I wish I hadn’t tried…and that is my forearm.

For a couple years now, I’ve seen forearm Dexcom sites all across social media. People lauded the location for how comfortable it is and the accurate readings it produces, so I figured, why not give it a shot? (LOL diabetes humor.)

Plus, I wanted to give my stomach and the backs of my arms a break. I put both pods and sensors in those locations and while I like them a lot, I’m wary of scar tissue building up.

So with little fanfare, I tried putting my Dexcom on my left forearm (my non-dominant arm). And I knew immediately after hitting the orange button to insert the sensor that it was a bad choice because it STUNG. It stung something fierce! I remember wincing the moment it pierced my skin, and fortunately, the pain did go away…but resurged with a vengeance about half the time I made any arm motions. It didn’t matter if I was flexing it up or down or twisting it to reach for something – any movement could trigger varying degrees of pain. Nothing incredibly intolerable, but enough to make this site uncomfortable.

My face says exactly how I feel about this site: It’s not a winner.

And this pain didn’t altogether disappear one day: I still felt stings 24 hours after I put the sensor on. Maybe I hit precisely the wrong spot (I noticed a very small amount of blood discoloring the white adhesive of the sensor), but I asked the diabetes online community and it seems that the general consensus is that this location sucks. The half-dozen or so people who messaged me said that either the pain was too much and they took the sensor off early, or they toughed it out for a full 10 days and never used the site again.

What’s more is that this site wasn’t as out-of-the-way as I wanted it to be. I roll up my sleeves dozens of times each day for different tasks, and each time I went to roll up my left sleeve, I had to go about it gingerly so I didn’t risk bumping into the site and prompting ripples of pain. This was straight-up annoying because my diabetes devices don’t usually inhibit my movements so much.

The one plus-side of trying the new site, and the only thing that motivated me to keep it on for the full 10 days, is that it was just as accurate as any other Dexcom site I’ve tried. My readings matched up pretty closely with how I felt and with what my blood sugar meter reported, so that was a saving grace. And I have to admit that even though I was worried that sleep would be impossible with the sensor in such a tender spot, it really didn’t interfere with my slumbers, which was a relief.

All in all, though, the accuracy wasn’t enough to convince me to want to keep forearm sites in my regular rotation. I’ll stick with abdomen and upper arm sites for now, with the occasional thigh site to further prevent scar tissue.

3 Things I Want the World to Know About Insulin

This post was originally published on Hugging the Cactus on March 13, 2020…coincidentally, the first day of the pandemic that I started to work from home. I decided to repost it today because even though so much has changed in the last 365 days, the fact that so many people know so little about insulin remains the same. I think that if the world knew these 3 things about insulin, then it would go a long way in understanding how it is vital to most types of diabetes care and treatment, and people might finally realize that something must be done about insulin accessibly and affordability.

See that tiny glass vial in the below image? Can you believe that the contents of it are extremely precious?

Can you believe that, at approximately $9,400 per gallon, insulin is ranked as the sixth most expensive liquid in the world?

It’s kind of crazy, right? But besides knowing that insulin is priced outrageously, there’s actually a few other things that I think the world should know about insulin.

Ethan Zohn_ A Survivor Contestant Who Inspires-2
Did you know that insulin is the sixth most expensive liquid in the world?
  1. Not all insulin is created equal. Just like diabetes, insulin exists in various forms. Besides liquid insulin, there’s also inhaled insulin (Afrezza). And some people with diabetes may even take oral medications that are designed to help increase the effectiveness of insulin that they either receive via injection or produce on their own. There’s brand-name insulin produced by several drug manufacturers (the big three being Eli Lilly, Novo Nordisk, and Sanofi) as well as generic versions of the drug…but that doesn’t mean that generic insulin works just the same as brand-name insulin for all people with diabetes. Insulin is complicated and different types work better for different people.
  2. Insulin is incredibly sensitive. Take one look at the vial in the above photo and tell me that the insulin inside it is safe at all times. Nope, it sure isn’t! Besides the packaging being super fragile, people who rely on insulin must also be careful to keep it at the proper temperature at all times. All it takes is dropping the vial once or leaving it in an unstable environment for the insulin to be rendered useless, potentially wasting a few hundred dollars. It’s as volatile as it sounds.’
  3. Taking too much or too little insulin is dangerous and life-threatening. For some people, there can literally be a life-or-death difference between one unit of insulin. Too much can cause blood sugar to plummet and a person can experience severe hypoglycemia that may result in shock. Too little insulin has the opposite effect: A person will experience hyperglycemia that can have ranging consequences, some that are minimal/temporary, others that are very serious. That’s why precision is so important when dosing for insulin; on top of that, nobody wants to waste a single drop of the stuff because it is so expensive. But this is what many people with diabetes need in order to survive.

So when you see the hashtag #Insulin4All or hear someone talking about how overpriced it is, you’ll know some of the basic characteristics about insulin that make it invaluable to people with diabetes. Perhaps you’ll be inspired to join the fight to make insulin affordable and available to all – as it should’ve been to begin with.