Tag: doc

Do We Take Medical Technology for Granted?

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Before I dive into this post, I want to make it abundantly clear that I don’t know the answer to this question. I’m not judging how anyone reacted during the recent Dexcom G6 outage, nor am I stating that there was a “right” or a “wrong” way to handle the situation. I merely think it’s important to ask ourselves questions like this when things don’t go according to plan with diabetes care/management.

Alright, now that I’ve got THAT out of the way…

Capture
Many variations of this graphic have floated around the Internet in the days since the outage. I am not mocking anyone by posting it here; rather, I am using it as an example of ways in which we cope with diabetes difficulties. This example, to me, is an attempt at using humor to deal.

For the last several days, the DOC has been in a bit of a panic. And when I say “bit” I mean “a helluva lot”. That’s because the day after Thanksgiving, Dexcom Follow stopped working. This means that parents/caretakers who rely on the technology to monitor their child’s/loved one’s blood sugar levels were left in the dark. It sparked confusion, outrage, and downright fear, all of which only seemed to intensify over the weekend and into this week when the problem was only partially solved for most users.

Rather than coming together to support one another, the DOC swiftly divided into two camps: The first consisted of individuals who sought to gently remind others that this technology is still pretty new. It hasn’t even been around for two decades. That meant that for many years before then, people with diabetes were doing things the “old school” way, and getting by just fine. Doesn’t this mean that we should all be able to make it through unexpected technology blackouts, knowing that we have our blood sugar meters to fall back on?

The second camp was in a greater fury over the issue. This camp relied on the Dexcom G6 system because those within it simply didn’t know a life without the continuous glucose monitoring technology. For them, the outage was a bit like asking them to Google something without access to the Internet – it’s pretty much impossible, unless you’ve got an Encyclopedia handy. Oh, and it’s MUCH higher stakes, because people who don’t recognize symptoms of low or high blood sugar need this technology to work in order to stay on top of fluctuating blood sugar levels. Let’s not even get into how much is PAID for this expensive piece of medical equipment…one would argue that the high cost of supplies means that the technology should work at all times, no matter what.

If you’re like me, you can see that both of these groups have perfectly valid points. I’ve had diabetes long enough that I didn’t even use – and didn’t see the point in using – continuous glucose monitoring or insulin pumps until a few years ago. I took care of my diabetes the old fashioned way growing up: doing fingerstick checks multiple times per day, treating low blood sugars with 15 carbs then waiting 15 minutes, checking blood sugar levels about an hour after injecting insulin to make sure highs were coming down the way they should. This way of handling diabetes worked for me for a long, long time…throughout elementary, middle, and high school, right up to college.

Then I got a continuous glucose monitor (I believe it was the Dexcom G4) just before starting my freshman year of college. And I haven’t really been without a CGM device since then. It’s changed my life and helped me navigate adulthood with diabetes. Whenever I do experience periods of the technology not working the way it should, it’s infuriating because I feel like it’s not worth throwing away buckets of cash on it in those periods of inconsistency and inaccuracy.

But here’s what I’m wondering, as a result of this Great Dexcom G6 Outage of 2019…do we take this technology for granted?

Do we truly appreciate the times that it works the way it should?

Do we expect too much from something that, technologically speaking, still has a long way to go in terms of working perfectly?

Do we rely too heavily on continuous glucose monitors to provide us peace of mind when, in reality, they simply provide us with real-time updates of our blood sugar levels (i.e., it’s a stream of data)?

I don’t have answers to these questions. I can reflect on my own answers to them; furthermore, I can ponder how and why the DOC gets so divisive in these times where we should try to come together, listen to (and learn from) differing perspectives, and figure out what we can do to best support one another during trying times.

 

Setting and Sharing Diabetes Goals

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It’s November 29th which means it’s day 29 of the Happy Diabetic Challenge! Today’s prompt is about diabetes goals. I decided to use this as an opportunity to share and set my diabetes goals as National Diabetes Awareness Month draws to a close…

Goal-setting sounds like an ambitious activity. It implies that goals will be met, and we all know that sometimes that just doesn’t happen.

Why? Occasionally, we set goals that are simply unattainable. As an example, let’s pretend that you have a goal to lose weight. Well, if you tell yourself that you can shed 20 pounds by next week, then you’re setting yourself up for failure – ‘cuz it’s unhealthy to lose that weight so quickly, not to mention practically impossible.

But setting a goal to lose those 20 pounds over the course of, let’s say, two months…that’s FAR more realistic. You give yourself a workable time frame in which you can accomplish the goal and you can take small steps each day to work towards it, rather than doing anything extreme or overly difficult in order to meet the goal.

Setting and sharing diabetes goals
It’s always very satisfying when you can say that you’ve met a goal you’ve set.

That’s why they say it’s important to set SMART goals. The acronym stands for Specific, Measurable, Achievable, Realistic, and Timely. Goals that are set with this criteria in mind are far more likely to become a reality, so with that in mind…I’m going to share and set a few diabetes goals for myself, right now, that I hope to accomplish in the coming months (think of it as an early diabetes-themed list of New Years’ resolutions.)

  • Goal #1 – I’d like to go back to checking my blood sugar with my actual meter at least 4 times per day. I’ve come to rely on my not-always-totally-reliable Dexcom a little too much. And since I have a well-stocked stash of test strips, I figure that it makes sense to use them before and after each meal, as well as when I’m not sure about my Dexcom’s readings.
  • Goal #2 – Change my lancet weekly, instead of monthly…ish. This is the other underused diabetes supply in my possession. As long as I decide on a particular day and time to do this quick little task, then I think it’ll be easy to follow through week after week.
  • Goal #3 – Stop snacking on “free” foods. I need to get it through my semi-thick skull that there’s no such thing as free foods when it comes to diabetes! I used to be able to eat a short stack of crackers, a handful of popcorn, or a bite-size piece of chocolate at any hour of the day and notice a very minimal bump in my blood sugar levels. This sure isn’t the case these days, and I want to set myself up for success by making sure that when snack cravings strike, I have plenty of water or gum on hand to help distract from faux-hunger pangs.

These goals may seem very minor to you, but for me, they’re all examples of some things that I truly think I need to address when it comes to my diabetes care and management. And the fact that they are “easy” makes them that much more attainable: It won’t take much for me to incorporate them into my routine, but over time, I’m bound to notice a difference (especially when it comes to that last goal).

Also, I think it’s wise to avoid setting overly ambitious goal – at least for the time being – because I’m not seeing an endocrinologist again for another month. When I do have that appointment, I’ll have a much clearer picture of what my diabetes goals should be as we approach 2020, and I can go about formulating a plan as to how to pursue them.

And on that note, this blog post wraps up the Happy Diabetic Challenge posts on my blog for National Diabetes Awareness Month 2019. I hope you enjoyed them, learned from them, or at least got to thinking more about your own diabetes as a result of reading them. I’m proud of myself for sticking with the challenge for the month, but boy, was it an exhausting 30 days of nonstop diabetes advocacy! I’m looking forward to December: It’ll be a nice change of pace to slow down and appreciate time spent with loved ones throughout the holiday season. I’ll still be blogging regularly throughout the month, just a little less intensely.

Hoping you had a wonderful Thanksgiving no matter how you chose to spend it, and wishing you continued success with your diabetes as the holiday season gets into full swing.

5 Things I’ve Learned about Exercising with Diabetes

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It’s November 26th which means it’s day 26 of the Happy Diabetic Challenge! Today’s prompt is about diabetes and exercise. There’s so much I could say on the subject, so I decided to settle for a bit of a round-up post that explains what I’ve learned about exercising with diabetes over the years…

I exercise on a daily basis.

This statement is not a faux-humble brag, nor is it an exaggeration. Unless I’m sick, I work out in some form or fashion every single day. My workouts will vary in their intensity, but one thing is consistent: My diabetes plays a major role in how long, when, and what type of exercise I choose to do.

Since I grew up playing sports, I’ve had just about my entire lifetime with diabetes to figure out how to make it peacefully coexist – or, at least, merely coexist – with whatever exercise routine I’m completing. As a result, I’ve learned quite a few lessons along the way, and I’ve come to recognize several patterns that my diabetes follows when I exercise:

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My diabetes is practically BFFs with exercise.

1. My diabetes is happiest if I work out first thing in the morning. I never thought I’d be the type of person who works out before eating breakfast, but trial and error has taught me that this is the way to go in order to better manage my blood sugars during a workout. Fasting exercise has worked wonders on my blood sugars: I never have to worry about dealing with an insulin-on-board-inducing low blood sugar, nor do I have to be concerned about what the food I ate prior to my workout will do to my blood sugars while I’m exercising.

2. Different types of exercise affect me (and my blood sugars) in different ways. Many people probably relate to me when I say that weightlifting and high-intensity interval training (HIIT) often yield stable blood sugars during workouts but then trigger the need for more insulin hours later, whereas cardio (such as dancing, running, or circuit training) usually causes sudden drops in blood sugar levels. Of course, it depends on the timing, duration, and intensity of the workout, but it’s interesting to see how different types will require me to react in different ways in terms of my diabetes care.

3. Sometimes I need to suspend my insulin, sometimes I don’t. Again, whether or not I suspend my insulin – or even run a temp basal – depends heavily on when and how I exercise. If I’m doing my morning routine (which happens 75% of the time), then I don’t really do anything with my basal rates: I just keep them running normally. But if I’m taking a midday walk or decide to exercise in the evening, I often have to do something about my basal rate to avoid crashes or spikes. Insulin suspensions or temp basals are wait-and-see situations in those cases.

4. The hardest part about exercise and diabetes is that I can do the exact same routine every day and get different results. If I worked out at precisely the same time, for the same amount of time, and with the same sequence of movements every single day, then…my diabetes wouldn’t give a damn. Every day of life with diabetes is different because of the variables that inevitably cross my path. Things like mood, that time o’ the month, stress, diet, illness, and more can cause major changes in my blood sugar levels. It’s my job to react accordingly to those changes, but that doesn’t mean I always hit the mark on the first try. So with that in mind, it can sometimes be hard to accurately predict how my blood sugar will fare after every single exercise routine. Just thinking about it can be more exhausting than the workout itself.

5. My diabetes is my biggest motivator/fuels my desire to exercise. At the end of the day, I work out because of my diabetes, not because I’m trying to sculpt washboard abs (though I wouldn’t complain if that actually happened). My diabetes loves exercise: It results in an increase in insulin sensitivity and it helps tame my blood sugar levels overall. How could I not be motivated to work out every day with outcomes so tangible?

It’s Not Just About the Money: The Cost of Living with Diabetes

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It’s November 25th which means it’s day 25 of the Happy Diabetic Challenge! Today’s prompt is about the cost of diabetes. Naturally, I started thinking about just how much diabetes costs me, not just in terms of money but also emotionally and physically…

We all know that diabetes is an expensive chronic illness.

Diabetes is associated with doctors appointments, pricey medical equipment, and maybe even the occasional trip to the hospital…all of those things aren’t cheap. My insulin alone would cost me $4,962.32 per year if I was uninsured (and if I do the math, this means that I would’ve spent over $100,000 in the past 22 years on JUST INSULIN). Those are not small sums of cash!

Diabetes hits those of us who are affected by it hard financially, but there are also significant emotional and physical costs associated with it.

It's Not Just About the Money_ The Cost of Living with Diabetes..png
Diabetes is so greedy, and not just in terms of how much money it costs to care for it.

Emotional – Diabetes takes a toll on my mindset (un)fairly often…and it can happen so rapidly that I barely have time to process the emotions. For example, I can go from being happy-go-lucky to angry because my Dexcom alarm went off and it’s telling me that my blood sugar is high. The anger will hit me hard and I’ll spend too much time stewing over my blood sugar and the best way to correct it.

Plus, I’d be remiss not to mention diabetes burnout. It’s the feeling of total defeat, of no longer having the desire to take proper care of diabetes. It happens to the best of us, and it’s not fun to experience. But it makes sense to feel this way from time to time, because diabetes is so demanding and relentless. People with diabetes never get a break from it, so it’s no wonder that it takes a toll on emotional well-being.

Physical – Diabetes is a physically present in many ways on my body. The OmniPod insulin pump that I wear, as well as my Dexcom CGM sensor, leave the most obvious lumps and bumps underneath my clothing that often prompt unwelcome stares from strangers. And although these devices have improved my quality of life with diabetes, they’ve also undeniably altered my body image. I never had much self-confidence when it comes to that, anyways, and my devices certainly don’t improve how I feel about my own body. I know plenty of people with diabetes who can relate to that sentiment.

There are also the scars that diabetes leaves behind. My fingers are dotted by dozens of permanent black scars left from lancets pricking them multiple times per day for the last 21+ years. I sport purple circles under my eyes pretty frequently from a lack of sleep that is, more often than not, my diabetes’ fault. And sometimes, I have unsightly red marks when I remove old pods that practically look like zits and can take days to go away because the pods’ cannulas pierced sensitive spots. These are all unattractive, physical reminders of diabetes that I can’t do a damn thing about, and it’s frustrating to have even less control over how my body appears because of this stupid chronic illness.

Diabetes is a friggen’ greedy disease.

It depletes my wallet and emotional state, and it manifests itself on my body in ugly, visible markings.

It tries so hard to rob me of everything I’ve got.

But luckily, my determination to fight back harder against it is stronger than my diabetes will ever be.

Who Inspires Me from the DOC

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It’s November 22nd which means that it’s Day 22 of the Happy Diabetic Challenge! Today is called #FollowFriday and we’re encouraged to share who inspires us from the diabetes community. Rather than capture the dozens upon dozens of names in a blog post (because truly, there’s practically an endless list of people who inspire me in the DOC), I’m going to write about what I think makes someone in the DOC inspiring…

I’ve lost track of how many years I’ve been involved with the diabetes online community (DOC).

It’s somewhere between five and eight. Regardless of what the true number is, I can tell you this: I’ve “met” and interacted with countless people who’ve shared their stories with me. Each story is unique and marked by different struggles and victories, but the common theme is diabetes.

But what else do these storytellers share that make them so inspiring to me?

Happy Independence Day!
Chances are that if you’re reading this post…you’ve inspired me in some way. Thank you.

Here are three qualities of people with diabetes who inspire me:

  1. Vulnerability. I’ve come to value this more than just about any other trait when it comes to talking about diabetes in an online space. Nothing makes a person more relatable (or more human) than when they speak uninhibited and honestly. In a social media world where everyone is so concerned with capturing and filtering the “perfect” photo with the “flawless” caption to go with it, I find that it’s the stories that are raw and obviously imperfect that pack more of a punch. It’s important to stay grounded, and those who aren’t afraid to share their tribulations as much as they share their successes are truly inspiring to me.

2. Kindness. The Internet can be harsh and judgmental. (Okay, that’s a total understatement). It’s brutal out here in cyberspace, and unfortunately, the DOC isn’t immune to all brands of savagery. In the past, I’ve seen disputes erupt because of hateful comments made about all aspects of life with diabetes. So when I notice thoughtful, supportive, and downright nice comments between perfect strangers in an online space, it restores a bit of my faith in humanity. Those who take the time to send a tweet to another PWD in need or who use their presence online to do some good don’t go unnoticed by me, and I applaud each and every single person who does their best to reduce the negativity in the diabetes online community.

3. Willingness to listen and learn from differing perspectives. Those of us who live with diabetes can be wildly, passionately opinionated. Pumps! No, MDI! Carbs! No, keto diet! Your diabetes is just like mine! No, it’s not! – Those are just a few examples. While some may be quick to judge others for dealing with diabetes in a way that is different or just plain “wrong” to them, I’m far more impressed by those who remain open to having conversations and learning from those who disagree. After all, what matters most is that a person finds what works best for them. It shouldn’t matter that it’s different from what I or anyone else might do. So I really admire those who are able to put aside differences and focus on learning and growing from others.

Thank you to each and every single person out there in the diabetes online community who possesses one or all of these qualities. This means you’ve inspired me in some way, and I am incredibly grateful for you and your willingness to share part of yourself with strangers online. Keep doing what you’re doing and I can guarantee that you’ll continue to inspire many more people.

My Take on Diabetes and Support

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It’s November 20th which means that it’s Day 20 of the Happy Diabetic Challenge! Today’s prompt is “biggest supporter”. Since it’s impossible for me to identify a single person as the biggest source of support with my diabetes, I decided to write about how my thoughts on diabetes and support have changed over the years.

Emotional support is a lovely thing. It feels good to have people in your life who you feel have your back. And it’s twice as nice to have when you’re dealing with a chronic illness like diabetes.

I talk extensively about diabetes and support in the most recent episode of the podcast, Ask Me About My Type 1. (Here’s the link in case you haven’t listened to it yet.) Rather than rehash everything I said in that episode, I’m going to use this post as an opportunity to reflect how my wants and needs in terms of support for my diabetes have changed over the years.

It’s interesting (at least, it is to me) to think about how and why my desire for support has changed as I’ve grown older. My childhood was very normal despite diabetes. It was always there and it was always a thing I had to deal with, but I definitely didn’t feel compelled to talk about it as much as I do now, let alone lean on others in difficult times. Why is that?

I think it has a lot to do with getting to know myself better as I’ve aged.

HUGGING THE CACTUS - A T1D BLOG
In this post, I get all self-reflective-y on diabetes and support.

After all, they say that with age comes wisdom. And though I don’t exactly consider myself a wise old sage or anything of the sort, I do think that I’ve acquired some enlightenment about myself and the way that I process things in my adulthood.

Specifically, I realized in the last few years that diabetes has instilled in me a strong desire to feel in control of every aspect of my life…not just diabetes. When something doesn’t go according to whatever carefully thought-out plan I’ve cooked up, I get upset. And I tend to either bottle up my dismay, which is never a good thing to do, or I totally take it out on the whichever poor soul happens to be within my vicinity, which isn’t fair. Neither of those reactions is a healthy method of dealing with things, but at least I’m aware of that and I’m actively trying to improve how I cope.

I think that this example shows how important diabetes support has become to me because I’m able to lean on others in those times that all of my diabetes plans don’t work out the way I envisioned them. I’ve figured out, over time, that it’s just about the only thing that really works for me. Talking to other people with diabetes (and without diabetes) about struggles that I’ve faced makes me feel less alone. It used to be scary for me to be so vulnerable with others, but I’ve found that it’s worth it because it helps me heal, move on, and forgive/accept myself for feeling whatever I’m feeling.

Support from others is truly powerful…but above that, learning to rely on others – learning how to best support myself, really – is more than that. It’s magical and absolutely enhances the quality of my life with diabetes.

Where I’m From and What my Diabetes Community is Like There

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It’s November 18th which means that it’s Day 18 of the Happy Diabetic Challenge! The prompt for today was fairly simple – state where you’re from – so I decided to delve a little deeper and explain what my diabetes community is like at home…

Home is where the heart is, and it just so happens that I’ve got quite a diabetes community there, too.

I spend most of my time in Virginia these days, but I’m originally from Massachusetts. Growing up in that state shaped me as the human being that I am today, and it’s also where I had a total change in perspective when it comes to diabetes, community, and support.

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A map of Massachusetts, with a few diabetes accessories sprinkled in there.

I’ve said it many times here, but throughout my youth, I had my mom and my aunt as my type 1 influences in my life – that was it, and that was all that I needed and wanted.

Or so I thought.

When my feelings on diabetes support changed in college, I quickly discovered the value in fostering a sense of community wherever I go. So I made it a mission upon graduating to make sure that I maintained diabetes connections at home. It felt especially important as I was about to undergo another major life transition: joining the workforce full-time.

And I’m glad I fulfilled that goal. Through the power of social media, I attended a handful of diabetes meetups in the last few years that provided that sense of belonging that I yearned for and introduced me to many local T1Ds.

So as you may be able to imagine, it’s been tough for me to still receive invites to events and gatherings that I can no longer readily attend since I’m in a different state most of the time.

This is why I finally decided to do something about it. Feeling inspired by the spirit of National Diabetes Awareness Month, I found a group that meets up semi-regularly in my new location. I was nervous about it, but I made an introductory post on their page. I explained that I work from home; as such, it’s hard meet new people. And not only would I like to connect with other T1Ds, but I’m also interested in volunteering in the area.

My “bold” move paid off. Within hours, several people had commented on my post and made it known that I could reach out to them whenever to arrange a lunch or explore the city. I haven’t taken anyone up on it yet (with the Thanksgiving holiday being so close and all), but it’s really nice to know that the offers are there when I’m ready to take them up on it.

Even though the concept of “home” has been a little shaky in the last year, I know this much: Wherever I wind up, I’ll find and nurture a diabetes community there because people who just get it make even the strangest of places feel a whole lot more welcoming…and like home.