3 Nighttime Lows in a Row

The night of the first low, I was “good” and treated with glucose tablets.

The night of the second low, I shamelessly treated with a leftover Halloween candy blondie (okay, two of them) that I had made earlier that day.

The night of the third low, I was exhausted. And feeling nothing other than a desire to sleep, I treated with both glucose tablets AND sour patch kids, because my body decided it needed that many carbs in order for my blood sugar to level out for the rest of the night.

By that third night, I was so dang tired. I’d had to go downstairs to get the sour patch kids, and by the time I was done eating them, I couldn’t fathom walking all the way back up the stairs to get into my big, comfy bed. So I just crumbled onto the couch, pulling a blanket over me, and snoozed there for a bit. I probably could’ve curled up into a ball on my carpet and slept just as soundly, even if only for awhile, because I was so spent from being woken up in the middle of the night for the third evening in a row to treat a low blood sugar.

I wish that people knew that diabetes is truly a 24/7/365 condition.

I hate having my sleep – which seems harder and harder for me to get enough of as I get older – interrupted by something as stupid as a low blood sugar.

I hate having to eat in the middle of the night and ruining the minty taste leftover from my brushed teeth prior to bedtime.

I hate that sometimes, the low is bad enough that I get woken up one or two or even three more times in the same night because I’ve got no choice but to consume more carbs.

It seems fitting to write about this – how disruptive my diabetes has been to my sleep over the course of three nights, let alone my entire life with diabetes – during National Diabetes Awareness Month. Because I don’t think the rest of the world really understands that diabetes truly does not have an “off” switch. People who live with diabetes don’t have the luxury of sleeping peacefully without having a single worry about diabetes: It can and will disturb the soundest of sleeps, and it’s frustrating, inconvenient, and annoying every time it does.

3 Things I Wish I Knew About Diabetes in College

My blog post earlier this week probably made it very clear to you that I work for a nonprofit called the College Diabetes Network – but in case you didn’t know, now you know.

In my position with the organization, I semi-regularly interact with current college students living with type 1 diabetes. This causes me to reflect every now and then on my college experience and what I would change, knowing what I know now, about how I managed my diabetes when I was in college. I came up with 3 things that I wish I’d known then that would’ve likely made life on campus a lot easier for me – and it seems very appropriate to share these things this week, which is College Diabetes Week. Here’s what I wish I knew…

Me, almost 7 years ago, on the day that I officially became a UMass alum!
  1. I wish I knew then that an insulin pump would greatly benefit me. Hands down, this is the biggest diabetes regret that I have when I think about my time at college. I can’t tell you how many times it was inconvenient for me to whip out my insulin pen in the middle of the dining hall and inject before every meal. My rationale at the time was that there were already too many changes happening in my life (because as we all know, the transition from high school to college is huge), and that I didn’t want to toss learning a new piece of diabetes technology into the mix. Plus, I was stubborn – I figured that my then-current MDI regimen was doing a good enough job for me and my diabetes. If I’d only known that a pump would’ve allowed me so much more freedom…
  2. I wish I knew then that I should’ve asked my parents sooner to let me take over ordering diabetes supplies. All throughout college – and admittedly, for a few years post-graduation – my mom took care of reordering my diabetes supplies for me. She’d keep track of how much insulin I had left in the fridge, and my main responsibility was to let her know when I was running low on test strips or CGM sensors. I really wish I’d asked her (before I turned 26) to let me order supplies on my own, or at least walk me through the process so I had a better familiarity with it by the time I aged off my parents’ insurance plan. I had to learn a lot, and very quickly, when age 26 came around, and I could’ve avoided the steep learning curve if I’d been more proactive about it at a younger age.
  3. I wish I knew then that I could’ve avoided many diabetes mistakes by doing more research and getting more involved with the diabetes online community. Namely, I wish I’d known more about how to “party safely” with T1D. I went into college not having a single clue about how alcohol would affect my diabetes – and that is something that is incredibly dangerous. I learned a couple lessons the hard way in college, and I’m lucky that I didn’t have to pay any serious consequences. Knowing what I know now, I should’ve turned to the diabetes online community for guidance, tips, and tricks from people who could’ve helped me avoid some scary highs and lows I had after a weekend of partying. Imagine what I could’ve learned from Reddit threads, had I known they were available!

While I can’t change anything about the way I took care of my diabetes in my college years, I can say that I’m proud of myself for eventually gaining these insights about it. I may have done better had I known about these things sooner, but what matters is that I did find out about them in due course, which has led to positive changes in my diabetes care in the long run.

How CDN Makes Me Feel 100

This year, National Diabetes Awareness Month is an especially important time to me as it’s the first one that I’m celebrating as an employee of the College Diabetes Network. I’m commemorating the occasion by celebrating College Diabetes Week (which begins today and runs through November 14, World Diabetes Day) with all of our Chapters and by fundraising for CDN. Let me explain (as concisely as I can) why your support matters and how CDN makes me “feel 100”.

I’m a former CDN Chapter leader, past volunteer, and now a current employee. CDN has obviously shaped my career, but it has also had a tremendous impact on my physical and mental well-being as a person with type 1 diabetes.

Without CDN, I never would have realized the power of peer support in managing a chronic illness that is as demanding as T1D. I would have severely struggled to find the confidence and independence in my adulthood that is necessary in order to live and thrive with T1D. I would not be the diabetes advocate that I am today, I definitely would not have a successful blog about T1D, and I never would have made so many incredible friendships and connections that CDN helped make possible.

CDN makes me Feel 100, which is why I want to Raise 100.

Those are just some of the ways that CDN helps me “feel 100” about life with diabetes. “Feeling 100” is a colloquial term that describes feeling your absolute best and at your optimal level of happiness. That’s why it was chosen as the overarching theme of College Diabetes Week this year – we all want to feel 100, especially when managing the many challenges that comes with living with T1D while in college.

CDN has given me so much. Please consider helping me give back to CDN. Help me raise $100 (or more) and that money will go towards CDN Chapter stipends for the year, outreach kits, the ability for us to provide grants and sponsor Chapter activities, and so much more. We appreciate your support as we continue to empower and make positive changes in the lives of young adults with diabetes across the country.

Happy National Diabetes Awareness Month!

It’s that time of year again – National Diabetes Awareness Month!

Did you know that the blue circle is the universal symbol for diabetes? It represents the unity of the global diabetes community in response to the rising number of people affected by diabetes.

I’m not sure if it’s because I work for a diabetes organization now, but sheesh, this month seems to have arrived more suddenly than it ever has. I’d say it’s caught me off guard, but after literally months of preparing for it as part of my job, it’s really just got me marveling over how fast time flies.

It’s also got me reflecting on how I’ve participated in NDAM in the past. Previously, I’ve done daily postings on my Hugging the Cactus Instagram account and replied to various prompts throughout the four weeks here on the blog.

This year, I’m not so sure I have the bandwidth to dive so deeply into the spirit of the month – but that doesn’t mean I’m mentally checking out of it altogether.

Rather, I’m plan on being more intentional in my approach. Instead of replying to daily prompts (that, over the course of the month, start feeling like homework – in other words, an unenjoyable task), I’d like to post when I feel like I actually have something to say. I don’t want to post filler content, I want to post things that are meaningful and capture my feelings about diabetes, NDAM, and the broader diabetes community.

That’s not a knock on the everyday post inspiration that many members of the DOC take part in – I think it’s wonderful that they have fun with it and use it as a very effective way to raise diabetes awareness throughout the month. It’s just that for me, as someone who’s been part of digital NDAM activities for the better part of a decade (!!!) now, it’s time that I mix up my routine a bit and also step back so I don’t spend all of my mental diabetes energy on NDAM in lieu of my actual diabetes care.

Here’s to deliberate diabetes awareness and care this month!

An Endo Update

So I’ve got an update on my whole I-haven’t-seen-my-endocrinologist-in-8-months situation.

It’s not exactly the update I was hoping for, but it’s one that I believe just might push me into making some positive change around my diabetes care.

As it turns out, my endocrinologist is on leave and not taking appointments until February 2022, at the earliest.

What’s even crazier than that February 2022 wait time? The fact that I haven’t been at an in-person endo appointment since 2019.

I found this out after contacting her office and receiving a message back that I could either wait until that time to see her, or I could schedule an appointment with a doctor at a different location that the office would suggest to me.

At first, I wasn’t sure what the right move was. I was almost certain that I couldn’t (and shouldn’t) wait another 4 months to see someone about my diabetes; after all, I’ve been unhappy with my management for most of this year. But even though I have been similarly unhappy about my relationship with my current endo (it’s practically nonexistent), I admit that I felt fear over the prospect of seeing someone new because any other provider would only know me based on the information available to them in my records. In other words, they would only know me based on numbers, not based on who I am and my personal diabetes management style/beliefs.

So I sat on this news for a few days as I pondered whether or not to take this as a sign that it’s time for me to find a new permanent endo, despite the mere thought being incredibly daunting to me.

During my pondering period, I happened to get a call from my endo’s office that wound up making my mind up for me.

They called to let me know about an available appointment with the nurse practitioner who works closely with my endo – an appointment that I could get this week.

I hesitated for a moment (I really hadn’t anticipated getting an appointment before the end of the month) before agreeing to take the open slot. And I’m glad that’s what I decided to do, because 1) at least I can talk to someone about what I think I’m lacking in terms of my current diabetes management; 2) I might end up getting some quality advice that will redeem my endo’s office in my eyes; and 3) even if I don’t see eye to eye with this person, it will be the push I need to start actively pursuing a new endo that will more closely match my diabetes care style.

We’ll see what happens.

The Worst Diabetes-Related Customer Service I’ve Ever Experienced

Roughly six months ago, I wrote a blog post in which I gave diabetes supply company Byram Healthcare a glowing review.

Now, I take back everything I said then (and have since updated the post with a preface).

I truly believe that Byram gave me the worst customer service that I’ve ever experienced as it relates to my diabetes…and maybe that I’ve ever had in life, in general.

I take back every nice thing I had to say about Byram six months ago.

It’s a long, messy story – one that spans half of this year – but I’ll break it down for you.

Basically, I found it in January 2021 that Dexcom would no longer be directly supplying their products to customers. I’d be automatically transferred to Byram Healthcare, a medical equipment distributer. However, I didn’t want to use Byram and called them after I got my first order in the mail a few months later to see if I could 1) return the supplies to them, 2) get a refund for said supplies once they were returned, and 3) cancel my account because I wasn’t going to be using them.

At that time, I was told yes to all three of those things. I got a return label from them so I could mail back the supplies, which I did within days of making that phone call to customer support. That way back in early May.

Imagine my surprise when I started receiving bills from Byram in June that stated I owed them $263 for those same Dexcom supplies that I had mailed back and was told I wouldn’t have to pay for because I never used them – I never even opened the original box!

So of course I contacted Byram. I was told to ignore the bill, that a note would be made on my account (mind you, the account that I’d closed) that I didn’t owe any money. Sounds like it was simple and easy to take care of, right? Oh, so very wrong. I received at least two more bills in the mail from them (which immediately reignited my anger both times). Naturally, I called on both of those occasions and was assured TWO MORE TIMES that I didn’t owe money and that I should ignore those bills because they were being automatically generated by their billing system, which was being falsely triggered because my mailed-back supplies weren’t checked in at the warehouse yet.

Stupidly, I believed them and assumed that the whole nightmare was over when the bills stopped coming in the mail…but everything changed the day that I got the collection notice.

Yup, that’s right – Byram had a collection agency COMING AFTER ME because according to them, I had failed to pay the $263 bill THAT I NEVER OWED IN THE FIRST PLACE. The moment I read that notice, I felt pure rage roiling in my core. I couldn’t believe my eyes. I thought this whole saga ended months ago! Now I’d have to use time I didn’t have – because it was a workday afternoon and I was trying to get real-life stuff done before the weekend – to sort this mess out.

I was beyond upset. Life with diabetes is hard enough, but throw this BS into it and it’s just not fair that getting my regular 90-day supply of a key component of my diabetes toolkit turned into something so stressful and potentially expensive. I was determined to get answers and get reassurance once and for all that they were in the wrong here, not me.

I was able to look up the USPS tracking number for the mailed-back supplies which turned into the proof I needed for both Byram and their collections agency that I had, indeed, done my end of the bargain this past May. When I finally got into contact with their billing department after nearly 30 minutes of being on hold (oh, and after a first attempt to call them during which I “held my place in line” using that option on the service line, only to never get a damn phone call back), I heard the lamest excuse for the whole thing about how they’d recently switched warehouses for this sort of thing, which explained why the billing system wasn’t registering my returned order…

…how do you think I reacted to that news? Like that’s MY fault for their company’s obvious disorganization!?

Needless to say, I didn’t care about excuses, I just wanted assurance that this whole nightmare would go away as soon as possible and they’d do everything possible to accomplish that…which I received in a short amount of time after speaking with the customer service rep.

So yeah, to say that I am displeased and untrusting of Byram Healthcare is a bit of an understatement. I thought it was important to share this story here on Hugging the Cactus not because I want to damage this company’s reputation, but because I want to help anyone else with diabetes who gets Dexcom supplies to avoid going through anything similar. Take my experience as a reminder to advocate for yourself and always hold onto records and receipts from your supply distributors…

…because you never know when you might need them to defend yourself.

Apple-ing Blood Sugars Post-Apple Picking and Pie Baking

I’m gonna forewarn you now – this blog post is gonna have a bushelful amount of puns. If you don’t find that appealing, then it might be fruitful for you to walk away now – I’ll seed you out.

OKAY JUST KIDDING, I actually think I used up all of my good apple puns in that opening paragraph. I can’t think of any evercrisp ones at the moment…

For real, I’m done now (at least for the time being).

So the title of this blog post (and all the ridiculous puns) will indicate to you that I recently went apple picking! And turned some of those apples into yummy pies!

But that’s not all, folks – I did both of those activities, in addition to actually eating slices from those pies, while maintaining excellent blood sugars!!

Pictured above: the brown sugar bourbon apple pie that is the best kind of apple pie I’ve ever had, hands down.

To this day, I still don’t really understand the sorcery that must’ve been at work in order for me to accomplish such a feat. I have a theory when it comes to the apple picking – I was walking all around a large orchard for like an hour, on a quest for the most perfect apples possible – and all that roaming up and down the rows of apple trees kept my blood sugar levels steady, even as I sampled upwards of 10 different types of apples (and I even had to eat an entire apple as I exited the orchard because my blood sugar was, in fact, beginning to dip). So that helps to explain why my blood sugars were so good when I was picking the apples.

But with the baking and eating of the pies…I have no idea how I dodged a high blood sugar. My boyfriend and I made the most decadent apple pies we could think of – one had a peanut butter crumble topping and the other was a brown sugar bourbon apple pie with an ooey gooey caramel sauce. Surely, I thought as we chopped apples, folded ingredients together, and did latticework with our crusts, my blood sugar is gonna suffer when we dig into these pies later tonight.

Much to my utter befuddlement and delight, though, my blood sugar never rose above 150, even after I had two decently portioned slices of pie with caramel sauce generously drizzled over them.

Maybe I nailed the carb counts. Maybe I know my body’s reaction to pies – which I only ever eat at Thanksgiving, normally – better than I thought I did. Who knows, but there’s one thing that’s for sure…

I was happy to my core over my delicious pies and sweet blood sugars!

Way Overdue for An Endo Appointment

By chance, I was looking through some old lab results on my endocrinologist’s online patient portal when I noticed something.

I was (and still am, as of this writing) way overdue for an endo appointment.

The last time I saw my doctor was at a virtual appointment back in February – more than 8 months ago. This gap in time between appointments feel especially significant because most of my life with diabetes, I’ve gone to the endocrinologist 4 times per year. It was only when I started seeing this new endocrinologist (who I’m not a particularly big fan of, BTW) a couple of years ago, and it was at her suggestion that I dropped down to twice yearly appointments.

From the beginning, I haven’t loved that recommendation.

I’ve realized that I am the type of person who kind of relies on regular visits with my endocrinologist in order to keep my diabetes (and myself) in check. This doesn’t mean I actually enjoying going to see my endo – because who honestly likes to go see any doctor – but it does mean that I feel like there’s been a missing component to my diabetes care lately.

I guess I’ve just been too busy (traveling, working, trying to maintain a semblance of a social life) to slow down and really notice the absence in my diabetes care and management.

But what bothers me more is that my endo’s office hasn’t even tried to contact me to schedule an appointment. What gives?! The moment I knew that I was way past due for an appointment, I messaged their office, and I still haven’t received a response back.

So in addition to it being time for my endocrinology appointment, it may also be time for a new endocrinologist, period.

3 Tips for Maintaining Good Blood Sugars on Vacation

As promised in my last blog post, I’m going to share how I kept my blood sugars (mostly) in range while I was on my trip to California a few weeks ago!

I’m not going to lie and say it was easy; in fact, I had a couple of not-so-fun nights where I was stacking insulin like crazy due to some post-dinner highs. But the vast majority of the time, I was really proud of my diabetes management when I was away. It can be tough to take good care of diabetes when in a new place and thrown off schedule, but it can be done, and these are the three biggest tips that I used that were most helpful to me:

Pro tip – Going on long scenic hikes where you can take in views like the one above AFTER eating a huge breakfast is an amazing way to keep blood sugar in range.
  1. Split meals with travel partner(s). I don’t know about you, but when I’m on vacation, any self-control as well as the idea of eating super healthy/clean goes out the window. I want to indulge when I’m in a new place! I want to try new foods and enjoy them rather than stress over how they might impact my blood sugar levels. So I was thrilled when my partner suggested we split any meals that we ate out at restaurants. We figured this was a smart strategy because most restaurants serve ridiculous portions of food anyways, and this also meant that I could order a carb-heavy item from the menu and automatically split the carb count in half because I was sharing the dish. This worked out so well and I got to eat foods that I normally don’t dare to touch, such as a fisherman’s platter (consisting of 3 different kinds of fried seafood) and garlic french fries (these were beyond incredible).
  2. Stay as active as possible. This is kind of a no-brainer – most vacations that I’ve ever gone on have involved lots of walking in order to sightsee and get from point A to point B. But it’s worth mentioning that getting in any other types of activity in addition to walking can reap benefits on blood sugar. For example, I started off one morning with a 25-minute yoga practice soon after I ate a heavy breakfast and my blood sugar levels were stellar for hours. On the night of the wedding that we flew out there for, I balanced sampling every dessert at the reception with hitting the dance floor, which worked wonders for my blood sugars. And generally speaking, I found that sneaking in at least 15 minutes or so of extra exercise after meals was a great way to keep my blood sugars in check, even if it was just walking around the block for a bit.
  3. Keep a consistent eating schedule. Traveling can make it difficult to maintain a regular meal schedule, but with a little extra effort it can be done. Within hours of landing in California, we made a trip to Target to stock up on a bunch of extra snacks and drinks so that we would always have something within reach, whether my blood sugar was going low or one of us just needed an extra energy boost. We also made sure to take advantage of complimentary breakfast provided by the hotel we stayed at for the first couple of nights – the fact that they stopped serving it at 10 A.M. automatically put us on some type of schedule. And on the day of our friends’ wedding, we ordered pizza and timed it so that we’d have it about an hour before we were due to leave for the ceremony…because as anyone who’s ever been to a wedding before knows, guests sometimes have to wait a looooong time before they’re served food. I didn’t want either of us to have an empty stomach for potentially hours on end, so ordering food before the wedding pulled double-duty as a late lunch and as something that would keep our bellies full until we were served dinner at the reception.

But what made it the easiest to take care of my diabetes while on vacation was the support from my partner, who always put me and my blood sugars first and checked in on me frequently (but without being overbearing). That alone goes a long way in making diabetes management a breeze when my normal routine is disrupted, but when combined with all the tips above, it’s practically like taking a vacation from diabetes itself.

The Biggest Diabetes Mistake I Made on My Trip to California

A couple weeks ago, I shared about my fears over flying again for the first time since before the pandemic.

Fast-forward to now and I’m happy to report that basically none of those fears came to fruition over the course of my trip…

…but of course I did experience one snafu that was definitely avoidable.

All smiles in scenic California in this pic, but I definitely wasn’t grinning like this when I made my mistake.

The biggest diabetes mistake I made on my trip to California was neglecting to charge my OmniPod DASH PDM as often as it (apparently) needs to be charged.

I’m not going to make excuses for myself because I should’ve planned better, but I will say that I’ve only been on this system for about six weeks or so now…and I’m still getting used to some of the PDM’s quirks. In particular, I have yet to figure out exactly how often I need to charge my PDM. It runs on a lithium ion battery, which is the same thing that most cell phones use. So one might make the assumption that I’d need to charge the PDM daily, but that’s definitely excessive – I’d guess that I only use about 20% of the PDM’s battery each day, but of course that depends on how frequently I need to bolus or play around with my basal rates. However, using that rationale, I’ve been charging the PDM every 3-4 days, or whenever I notice the battery falling to a 20% or less charge.

My logic failed me, though, when I falsely assumed that my PDM’s battery would last a day trip into San Francisco when it had a 40% charge.

I still have no idea what happened – all throughout my day walking the hilly streets of San Fran, I was careful to turn off my PDM screen whenever I wasn’t actively looking at it, and I was only turning it on to bolus slightly more than usual (I was basically snacking my way through the city the whole afternoon).

I consider myself pretty lucky, though, because I made the discovery that my PDM battery was dead towards the end of our day, right when we were headed on the subway back to our Airbnb: If there was a time for this to happen, it’s definitely better at the end of the day’s activities rather than at the beginning or somewhere totally inconvenient.

At least, this was what I tried to futilely tell myself in an attempt to feel better about my negligence.

Instead of feeling better, I was beating myself up over making what felt like a rookie mistake. I should’ve charged the PDM because, after all, there was no way that I was about to go into a brand new city for the first time with my phone battery at 40%, so why on earth did I think it was okay to do that with my PDM? Moreover, how the heck did this happen in the first place – does the battery really just drain super quickly and/or easily?

I knew there was no point in trying to figure out why it happened at that point in time – it was more important for me to charge the PDM as soon as possible so that my partner and I could experience In-N’-Out for the first time on our way back to the Airbnb as we had planned.

So, because he is brilliant and calm in “emergency” situations (unlike me), he came up with a plan: I’d head over to In-N’-Out, order our food, and wait for him in our rental car while he ran up the street to a nearby CVS to see if they sold any USB cables (you know, the types of charging cables that everyone has because most electronics are charged with those). And his strategy worked out beautifully. Soon after I had our bag of In-N’-Out in hand, he arrived at the car with the charging cable and I was able to plug my PDM into it so I could bolus for dinner right then and there instead of having to delay it. (We could’ve just waited until we were back at our Airbnb, but then I would’ve either had to eat a cold burger [blech] or eaten it fresh and run the risk of my blood sugar jumping up without the necessary insulin in my system. Obviously, we went with the more appealing option.)

All things considered, if that was the biggest diabetes mistake I made in California, then I’d say I did pretty good – more to come soon on my strategies for maintaining decent blood sugars while on vacation.

As for now, I’ll leave you with this – In-N’-Out is kinda overrated.