I Dos and Don’ts: My Tips for Attending a Wedding with T1D

I can always count on diabetes to make life’s most joyous occasions just a bit more challenging…so I shouldn’t have been surprised when my diabetes threw several curve balls at me on my cousin’s wedding weekend.

There was the moment at the rehearsal dinner when I stood up to get something and hit my leg against a chair, literally knocking my pod off my thigh. (But I didn’t even realize it for another 20 minutes.)

There was the moment later that night, after the rehearsal dinner, that I discovered my blood sugar was high and that my mealtime dinner bolus probably was never delivered.

There was the moment the next morning that I realized my breakfast options were limited to a giant, carb-y bagel or a massive, sugary blueberry muffin.

There was the moment when I was with the bridal party – applying makeup, styling hair, and trying to calm the bride down – that it hit me that I had no idea what to do with my backpack (a.k.a., my diabetes bag) during the ceremony, as I had to be standing up there with the other bridesmaids during the vows.

There was the moment I psyched myself out big time by wondering what the hell would happen if I passed out in the middle of the ceremony in front of all of the esteemed guests.

There was the moment I went a little too overboard on drinking Prosecco at the reception…and a few more cocktails at the after party.

There was the moment I woke up the next day with a high blood sugar and hangover from hell.

Needless to say, there were quite a few diabetes “moments” over the course of an otherwise beautiful weekend. As a result of them, I’ve decided to document some wedding dos and don’ts for myself, as this won’t be the first time this year that I’m a bridesmaid in someone’s wedding. Here’s my unofficial roundup.

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Showing off my decked-out pod at the wedding reception.

Do have plenty of back-up supplies. I got lucky this time around because my parents were a phone call and short car ride away from me when my pod fell off. I should’ve been carrying insulin and a spare pod on me, but at least it was within my mother’s reach at the hotel room.

Don’t sweat the small stuff. Things happen, and I’ve got to learn to accept them more quickly so I can better adapt to a situation. It took me awhile to forgive myself for the pod snafu at the rehearsal dinner, and if I hadn’t snapped out of it, then it could’ve ruined the night for me.

Do try to plan meals when possible. I knew that I should avoid a high-carb breakfast on such a busy morning, but I can’t resist a blueberry muffin, especially when it’s one of two breakfast options I had. I wish I’d thought to bring food that had accurate carb counts on it so I could’ve had more predictable blood sugars throughout the day, but I did come back down from the sugar-induced high relatively promptly.

Don’t forget that family and friends are willing to help. My “problem” with my backpack was solved by handing it off to my boyfriend about 30 minutes before the ceremony started. I didn’t miss any photo opps with the bride and bridesmaid during the hand off and I felt better knowing it was in good care.

Do remember that time flies. I had to keep myself in context; after all, I was standing up in front of the guests for less than 30 minutes. I knew there was relatively little insulin in my system and that I was starting to level out somewhere in the 100s by the time the ceremony started. The odds of me passing out were slim, and I needed to give myself that reality check.

Don’t forget to drink plenty of water. Duh, that’s drinking rule #1! I’m embarrassed to admit that I maybe had two glasses of water during the entire reception and after party. It’s not like there wasn’t water available, so I don’t know what I was thinking. But I do know that I was incredibly lucky to hold onto stable blood sugars well into the night, despite my lack of hydration.

Do have a plan for hangovers. Sometimes, they happen, and they’ve got to be dealt with swiftly. After some consultation with my mother, I set a temp basal to fight against my high blood sugar and downed glass after glass of water. By early afternoon, I was feeling much better. And even though I had a bellyache, I didn’t yak, so I suppose that’s a silver lining.

And one extra “do”…do have fun with diabetes devices! I decked out my pod in a Pump Peelz sticker that had an image of the lighthouse we were near on it. Sure, it wasn’t visible to anyone but me (and a few people I couldn’t resist showing), but it still made me feel extra special and coordinated with the wedding venue. Sometimes, its the little things in life.

So besides taking several valuable dos and don’ts away with me from this weekend, I’m also walking away with a wonderful first experience as a bridesmaid to a cousin who’s always felt more like a sister to me. When it comes down to it, my irritation with diabetes doesn’t matter – it’s the love and celebrations I felt all weekend long that do matter.

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Brunching with ‘Betes

Confession: I’m a brunch lovin’ millennial who also really hates brunch.

The reason I hate brunch (besides waiting all morning long to eat my first meal, I get hangry) is that it annihilates my blood sugars.

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It’s not uncommon for me to spend several hours after brunch trying to correct a high blood sugar.

It probably has a lot to do with the aforementioned fact that the timing of a typical brunch is typically not favorable when it comes to my basal rates and insulin-to-carb ratios. On a normal weekday, I’m used to eating breakfast within an hour of waking up. My body and my blood sugars are very much so accustomed to this pattern, so when it’s interrupted, it shouldn’t be any wonder why they don’t respond well.

It’s not that I don’t try. I do everything I can to offset the lateness of a brunch meal by running a temp basal and ordering as low carb as I can. And it seems to work well, up until I get up to leave the table and head home. Often, I find myself correcting two or maybe even three times after brunch, and it’s extremely annoying.

Maybe I could help curb spiking blood sugar by ordering just one mimosa, as opposed to two or even three (or just skip drinking them altogether, but seriously, I’ve had enough mimosas in my life to know how to properly bolus for them). Maybe I could insist to my friends that brunch plans should be earlier and force all of us to wake up early on a weekend morning. Maybe I could skip brunch plans altogether.

But that would be accepting defeat. Just like I refuse to let diabetes ruin any aspect of my life, I won’t let it stop me from enjoying brunch with whomever I please. I’ll figure out how to avoid post-brunch highs, I just know it. It’ll just take a little more time and patience…and several more brunch outings. Yum.

5 Things That I Don’t Mind About Having Diabetes

I thought about how I should title this blog post many, many times. It didn’t feel right to say “5 Things I Like About Having Diabetes” or “5 Things That Make Diabetes Okay”…because I will never like having diabetes, and I will never be okay with it.

But that being said, after living with it for 21 years, there are some “perks” to it that have made it somewhat more bearable. Okay, a LOT more bearable. Besides insulin, diabetes technology, and the like, there are five things that I came up with that make diabetes suck less for me.

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First, and most obviously…diabetes has brought wonderful friendships into my life. I’ve written about these friendships many times before and I’m sure I’ll continue to do so in the future, because they’re invaluable to me. I have some regrets about not realizing the importance of peer support when it comes to diabetes when I was younger, but maybe I figured it out in adulthood because some part of me knew that was when I would need it the most.

Second, diabetes has made me stronger. I won’t downplay the fact that it increases my anxiety and stress levels…but I also can’t deny that the trials and tribulations of life with type 1 diabetes has made me a tougher person.

Third, diabetes has forced me to be an obsessive planner. I do wish that I could live a bit more spontaneously sometimes, but honestly, I’m pretty proud of my ability to think ahead and plan well in advance of things. These planning skills have translated to other aspects of my life, too – I wasn’t on the party planning committee at work just for the heck of it!

Fourth, diabetes has taught me so much about nutrition. I’ve been reading nutrition labels before I could read actual books. I’ve met with nutritionists at various points in my life to learn how to eat a balanced, healthy diet that consists of the right amount of carbohydrates for me. I’ve educated myself on the power of the glycemic index and how it impacts blood sugar. Without diabetes, I’m not so certain that I’d have such a clear understanding of how different foods affect my entire body. I’m grateful to know so much about nutrition, because I think it makes me a healthier person, overall.

And fifth, diabetes has lead me to several interesting (and in some cases, compensated) research opportunities. Yes, you’ve read that correctly – my diabetes has allowed me to be a research study participant in a handful of studies and I’ve gotten paid for my involvement. The amounts have varied over the years – anything from a $5 Amazon gift card to a $200 stipend – but it’s not just getting paid that makes research participation worth it to me. It’s also knowing that I could be making a difference to the larger diabetes community. For instance, offering detailed feedback on a diabetes device or product might help make it better in the future, and if that means I spend an hour on the phone answering questions, then of course I’ll do it.

In times of diabetes hardship, it’s important for me to remember these five things. Diabetes was a shit card in life that I was dealt, but it’s not the worst thing that could happen to me. Reminding myself of these bright spots help to make life with diabetes a little bit better.

Testing for Accuracy, in Addition to Blood Glucose

This post originally appeared on Hugging the Cactus on March 21, 2018. I’m republishing it now because of a recent experience I had with my meter reporting inaccurate and inconsistent blood sugar levels. Has this ever happened to you? Drop a comment and let me know.

Blood glucose meters serve the sole purpose of checking current levels of glucose in the blood. Pretty self-explanatory, right? And it’s equally obvious that it’s crucial for all meters to generate accurate results so PWD can make the right treatment decisions based on those numbers.

Unfortunately, though, accuracy isn’t always what I get.

The other day, I was running low before bedtime. I corrected with an organic rice crispy treat (honestly, it was a million times better than the brand name kind). I waited nearly an hour for my blood sugar to come up. When my CGM wasn’t showing any progress, I tested: I was 47. It’s rare for me to be that low, so I tested again. 52. I believed it, especially since I was experiencing several hypoglycemic symptoms.

B. J. Palmer

I chugged a glass of orange juice and plopped down on the couch to wait for signs of improvement. Before long, I was freezing cold – a sure sign I was coming up, because I had been sweating 20 minutes prior. But I didn’t feel comfortable going to bed yet. I wanted to see if my CGM would show an up arrow. When it finally did, I made my way upstairs to brush my teeth and wash my face. In the middle of my routine, though, I decided to glance at my CGM again – and saw the dreaded ??? screen.

I decided then that the Dexcom should be out of commission, a.k.a. not trusted at all, for the remainder of the evening.

I ripped it out and inserted a fresh one, not really caring that it would wake me up in two hours to be calibrated. I would need to set at least two alarms for the middle of the night, anyways, if I decided to go to bed disconnected from my Dex. So it just made sense.

Once that was done, I tested again. I was pretty tired at this point and really didn’t want to have to eat something else, so I did it as quickly as I could. In my haste, I jostled my meter just so – enough that I saw the test strip, already marked with my blood, move slightly as it brushed against my PDM and was placed next to it.

113 mg/dL flashed upon the screen. Normally, I’d be thrilled! But I furrowed my brow. Something just felt…off about that reading. So I tested again.

206.

What?!

I tested a third time – 203. Okay, something was definitely wrong. Either that 113 was wrong (likely) or my meter had just produced two wildly inaccurate blood sugars in a row (less likely).

This is one of the many times that it’s convenient to live with another PWD. I asked my mom if I could borrow her test kit and see what result it generated. Seconds later…a twin 203 popped up on the screen, reassuring me that the 113 was a fluke on my meter.

Relief with the reality and irritation with the technology washed over me simultaneously as I went to correct the high with a bolus. I was glad I wasn’t heading down again, but irked that my meter had failed me. True, it was a bit of human error there, but aren’t we at a point in technological advancements where this sort of thing just shouldn’t happen? I put my life into the “hands” of my meter, Dexcom, and OmniPod. They should produce results that are undoubtedly accurate.

I guess we aren’t quite there yet.

Type 1 Diabetes…the Uninvited Bachelorette Guest

T1D is an unwelcome presence in my life, but I’ve made peace with it. However, it doesn’t stop me from worrying about how its existence might affect others in a wide variety of situations.

Take a bachelorette party, for instance…I wasn’t sure how my diabetes would respond to a weekend spent in Saratoga Springs with my soon-to-be-married cousin and the gaggle of girls who would accompany her to a few different wineries, a comedy show, and other various shenanigans. I went into the situation hoping for the best, but expecting the worst.

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What does “expecting the worst” mean? Basically, it meant that I was preparing for the apocalypse. The bachelorette weekend was barely 48 hours total, but I was so paranoid about something going wrong with my diabetes that I packed twice the number of pods that I would need, extra insulin, spare syringes, Glucagon, and a low-blood-sugar-snack stash. Although I had a rough idea of what our itinerary looked like for the weekend, I still wasn’t 100% of what we would be eating and when, which as any T1D could tell you, is kind of a major concern when it comes to taking proper care of diabetes – and that concern is intensified when alcohol gets thrown into the mix, as it unquestionably would on our quest to find the best winery in Saratoga.

My worry only grew when things didn’t exactly start as I envisioned them. We hit the road around 4 o’clock in the afternoon that Friday, and picked up the delighted bride in Western Mass a short while after 6 o’clock. I expected that we would stop for food soon after the bride joined our caravan of cars bound for New York…only to be proven totally wrong when I discovered that most people were too excited to stop and eat. “No problem,” I said to myself. “I’m sure that by the time it’s 7:30 or so, people will be hungry.”

No such luck. As I watched my blood sugar slowly drop, my stomach roared with hunger as I thought about the last meal I ate, nearly seven hours ago. I knew I should speak up and ask the group to pull over, but I was scared. I didn’t want to be “that” person who was making such demands, especially since I was merely a passenger in the car and not driving.

But it was almost 8 o’clock and I knew that if I didn’t eat soon, it wouldn’t bode well for the rest of the night. My body tends to rebel if I go to sleep soon after eating a decent amount of food, and my blood sugars usually make me pay for the lateness of the meal. I feebly requested a stop to the girl who was driving, and discovered that she desperately needed to make a trip to the ladies’ room – at last, my chance for food! I called one of the girls in the other car to let them know that we would all be hitting up the next rest stop. “And Molly needs to eat!” The driver yelled into my phone before I could hang up. I felt myself blush, not wanting to be a pain in the ass…but little did I know, the girls wanted me to speak up.

When we all met at the rest stop, everyone asked with genuine concern how I was doing. As I assured them that I was much better now thanks to my Subway sandwich, I was gently scolded by the bride – my cousin – for not saying something sooner. Each girl agreed and I promised them that I would be better about letting them know about potential blood sugar issues for the rest of the weekend.

The funny thing is, though, that I really didn’t have any problems whatsoever. I was very surprised, due to the fact that we were eating late/inconsistent/not-very-healthy meals each day, drinking a few different kinds of alcohol, and spending less time than I anticipated moving out and about…normally, that’s pretty much a recipe for disaster. I can’t help but wonder if I avoided problems because I did everything the “smart” way – ate plenty of food to combat the effects of alcohol, took extra insulin as needed, and stayed hydrated all day, everyday. It certainly is a formula for success, and deserves credit for taming the unwanted bachelorette guest all weekend long.

Now if only I can replicate this for the upcoming wedding weekend…

How Working From Home Affects my Diabetes

Diabetes is a creature of habit. It rarely appreciates disruptions in its expected routine…so when they happen, it likes to make its displeasure known.

This probably explains why I’ve dealt with a number of diabetes curve balls since I started working from home (as opposed to an office) full-time.

I’ve been working remotely, 40 hours per week, for just about a month now. This was a choice I made as I prepared to move from Massachusetts to Virginia. I like most things about my job, from the people I work with to the skills it has helped me develop. But I don’t particularly love that my job forces me to be a self-described “cubicle rat”. When I work in the office, I’m parked at my cubicle for a solid portion of the day. As a semi-fidgety person, this was a tough reality for me to swallow nearly five years ago when I started my job. However, I was able to adapt to the old ball-and-chain that is my desk, and learned to break free from it every once in awhile. Before long, I discovered that getting up every 60-90 minutes to either wander into the kitchen for a drink, walk up the stairs to another floor in the building, or in nice weather, stroll around the building in laps, were all excellent ways to cope with my desire to move as well as keep my blood sugars at bay.

So that’s close to five years of having a very specific routine that my diabetes and I were used to…no wonder it was pissed off when I changed things up.

You are a rare gem.

Working from home affects my diabetes in ways that I expected and others that caught me off guard. First, the things that didn’t surprise me: I knew that I would likely be even more sedentary at home than in an office. I’m not walking across a parking lot, up a set of stairs, and down a long hallway just to set up my desk each day. All I’m doing is walking five feet into the living room in order to power on my laptop. So there’s a lot less daily movement, and I’ve had to work hard to incorporate as much of it as possible because my diabetes responds incredibly well to exercise.

I also knew that my relationship with food would change a bit. Since I was living with my parents before the move, I was lucky enough to have 99% of my food preparations done for me by them (thank you for feeding me, Mom and Dad). Not only would I need to take care of cooking my own food in this new situation, but I would also need to become responsible for making smart choices and stocking the pantries with healthful things…because when you work from home, ALL the food is available to you. And since there aren’t any coworkers nearby me to chat with and take my mind off snack time, it’s much easier for me to just traipse through the kitchen whenever the heck I want and eat a gratuitous number of chips, crackers, cheese, and any other sort of goodies I can find. I don’t like admitting it, but I don’t always bolus for said snacks…making it that much more of a struggle for my blood sugars.

But what I didn’t know about working from home and how it might impact my diabetes is that there’s an emotional side to it that almost certainly comes into play. The first few weeks of my move were absolutely draining. I was homesick and trying to adjust to this strange, new place at the same time, and honestly, I think it was all a little too much for my diabetes to deal with at once. There were three straight days in which I had to fight hard to get my blood sugars to come down from stubborn highs, and there was another string of days in which I felt like I had to eat everything in the kitchen just to keep my numbers up. Between the numbers that my blood sugars represented and my emotions, each day felt like a seesaw and I wasn’t sure what to expect next.

What took me by surprise the most, though, about my new work arrangement was how quickly I acclimated to it. By the end of week two of working remotely, I had a routine – with a few fluctuations here and there – that I’ve since tried to stick with: waking up around 6:30, exercising, showering, getting dressed, eating breakfast, logging onto work, working for 4 hours, eating lunch, taking a break to do household chores/errands, working for another 4 hours, then logging off for the day. So far, I’ve found that following this pattern helps me move around as much as I did when I worked in the office, and it establishes a flow that my blood sugars and diabetes can follow. I’ve also, for the most part, remained mindful of the foods I eat during the working hours, after making mistakes with a bag of pretzels and banana chips in the first couple of weeks.

Even though my diabetes wasn’t happy with remote work in the beginning, I think I’ve arrived at a place in which it’s coming to terms with it…and, I daresay, warming up to the concept.

Hot Yoga: A New Win for my Diabetes

Normally, if you asked me if I would willingly go into a 105 degrees Fahrenheit room for 90 minutes for a workout, I’d say ohh HELL nawwww before you had the chance to finish asking your question.

I’m not someone who has a passion for exercising. I tolerate it. I try to do it daily for two very important reasons: 1) It keeps me in shape and 2) it helps me manage my blood sugars better. Otherwise, there’s very little about exercise that I actually enjoy. I’m not a fan of feeling out-of-breath for long periods of time. I have a love-hate relationship with the post-workout soreness that floods my body after a particularly intense session. And I definitely cannot stand sweating – on just about any given day, I’d rather be freezing cold and wearing layers of clothing than dripping in sweat.

All that said, though, I willingly participated in a fitness class called Bikram yoga…which is also known as hot yoga because you’re in a temperature-controlled room heated exactly to 105 degrees for the duration of the workout. For 90 minutes, you slowly move through 26 poses, and that’s that.

I wasn’t worried about the latter; it was the former that had me sweating (both literally and figuratively). I wondered whether I’d be able to tolerate the heat for a full hour and a half. I also had concerns about my diabetes devices – would I be sweating so much that they would fall off? Would they be able to stay safely in the room with me, or would the heat be too extreme for them? And how would my body and blood sugars respond to the hot yoga, anyways?

I knew the only way to get answers to my questions was to show up for class and find out for myself.

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Me, post-class, dripping in sweat in my car. Next time, I’m bringing a change of clothes.

And that’s exactly what I did. I went to a morning class with my stomach empty and my backpack full of diabetes supplies. My blood sugars tend to respond better to exercise when I don’t have any food in my system or insulin on board, so I made it a point to wait to eat my breakfast after yoga instead of before. But I still wasn’t entirely sure if or how my blood sugar might react to a brand new kind of workout, so I wanted to be armed with several different low snacks. I felt fairly confident about its stability, though, as I headed into the class sitting pretty at 110 mg/dL.

In addition to extra diabetes supplies, I also thought to bring with me some water that I’d filled and frozen the night before the class so I could stay hydrated throughout it with water that was sure to be extra refreshing in the heat.

Even though I had all this stuff with me, I chose to leave most of it in a cubby outside the studio, save for my CGM receiver, a tube of glucose tablets, and my water bottle. I didn’t want to take any chances with my cell phone, PDM, or glucometer and expose them to the heat – I have firsthand experience with an overheated cell phone, and while it does eventually cool back down its own, overheating my devices is not something I’d actively seek to do. I was taking a bit of a risk with the CGM receiver, but since I have the Dexcom app on my cell phone, it’s not like I’d be at a huge disadvantage if something were to happen to my receiver.

So with my gear in hand, I stepped foot into the yoga studio…and immediately started sweating. Yes, that quickly! It was a heavy, stifling, and moist heat – the exact kind that I hate the most. I started to question whether I had the endurance to even sit in this heat for 90 minutes, let alone move seamlessly through yoga poses in it. In the minutes before the class began, I sipped water slowly and told myself that above everything else, I needed to listen to my body throughout the class. I started to feel better as I reassured myself that it would be perfectly acceptable to walk out should I start to feel light-headed, low, queasy, or anything else abnormal.

Fortunately, though, an exit plan wasn’t needed as I made it through the full class! That’s not to say it wasn’t challenging or extremely sweaty – seriously, my body was so covered in sweat that it looked like I’d just come out of a swimming pool – but I proved to myself that I could do it. And the best part was that my blood sugar behaved beautifully: As a reminder, it was 110 mg/dL at 8:30 A.M. Class started at 9 and lasted until 10:30 A.M. I was home by 11 and when I checked my blood sugar there, I was at 118 mg/dL. I couldn’t have asked for better pre-, mid-, and post-workout blood sugar levels.

Was it scary to try this new, moderately intense exercise? Yes. Was I concerned about my diabetes before, during, and after the class? Yes. But was it all worth it? I’d say yes. I overcame my fears and was met by blood sugar success, making hot yoga a diabetes win in my book.