Tag: doc

My Diabetes Hates Weddings

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So basically everyone in my life right now is engaged, or on the fast-track to getting engaged.

And that’s awesome! No, seriously, it’s an exciting time for a lot of my family and friends. And I’m happy to be part of it all because I like going to weddings. Who doesn’t love to celebrate love?

Well, I can tell you what doesn’t love to celebrate love…MY DIABETES.

My diabetes effing hates weddings.

My diabetes hates weddings SO much that I’ve yet to go to one where it doesn’t act up in some way.

My New PDM (1)

I was naive enough to think that it would actually be a good diabetes day during the last wedding I attended. And it was, for the most part: I woke up, had a Dunkin Donuts sandwich for breakfast, got dressed and made-up. I showed up for the ceremony with a slightly low blood sugar that was swiftly corrected with a mini box of raisins (oh, if only I knew how many more I’d consume that night…).

I was fine, right through the cocktail hour and the start of dinner. But that’s where the troubles began. You see, there weren’t many passed hors d’oeuvres during the cocktail hour, and I could’ve really used some because I hadn’t eaten anything besides the sandwich and the raisins all day long. By the time dinner started, I was ravenous and basically shoved anything within arm’s reach into my mouth. This included a lot of cheese, meats, and pieces of flatbread.

If I’d actually been thinking about how my blood sugars usually respond to slow-acting carbs in things like flatbread, I might’ve actually wound up okay. But over the course of the next several hours, as wedding guests were whooping it up on the dance floor, my blood sugar was making a slow and steady climb up into the 300s! When I finally realized this, I started taking correction boluses that, apparently, were far too aggressive…because when I finally ended the night in my hotel room around 1:30 A.M., I was in the 70s. And dropping.

My lowest blood sugar was 43 that night. I ate multiple packs of raisins, 5 or 6 glucose tablets, a FiberOne bar, and half a pack of peanut butter crackers. All between the hours of 1:30 and 4 in the morning. It was exhausting. I was tearful and sweating so badly at one point that it looked like I had just come out of the shower. I even wound up sending my sleepy boyfriend down to the lobby at one point to buy me an orange juice, because I was running out of low blood sugar remedies. I drank half of it and was relieved to see my CGM showing, at long last, a diagonal up arrow. I couldn’t believe that I’d just spent the last few hours hovering below my “low” threshold on my CGM, but I didn’t waste any more time thinking about it – I was extraordinarily tired and happy to finally go to sleep.

But now that I’ve had time to think about it, I’ve realized that I need a new strategy for myself and my diabetes when it comes to weddings. I’m going to be my cousin’s maid of honor next month, for goodness’ sake, so I want to do everything I can to ensure “decent” (i.e, blood sugars under 200 but over 80) for the special day.

A key to success, I think, will be regularly scheduled meals and making sure that I avoid an empty stomach at all costs.

Adventures in Low-Carb Snacking

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I’ve logged a lot of miles on the road this summer. From planned trips back to my home state of Massachusetts to weekend getaways to neighboring states, I’ve spent many hours in the car. Conversations with my partner and friends on the phone, as well as podcasts, have helped time pass…but so has snacking on a variety of road-ready foods.

I admit that I often don’t choose the healthiest road trip snacks. I tend to gravitate towards “comfort” foods – anything from peanut M&Ms to cheese-flavored chips. I wish that I craved something better for me, like carrot sticks or celery stalks, but my intense dislike for long hours on the road coupled with the need for convenient foods only (i.e., nothing that needs refrigeration) results in me making less desirable snack choices.

In turn, my junk food cravings are typically disastrous on my blood sugar. I do bolus for the junk, but since I’m forced to sit idle in the car, I face more frequent and intense blood sugar spikes than I would if I were able to get some movement in shortly before or after consuming the food. So not only do I end up eating food that’s bad for me, I also have to deal with the consequences on my blood sugar, and it’s a lose-lose situation.

That’s why I created a little game for myself during my last long car ride. When my boyfriend and I stopped at a gas station to fill up the tank before driving for four hours, I decided to go into the convenience store that was located there and scour the shelves for the lowest-carb snack foods I could find that were also remotely appetizing.

Enter…”pork skins”.

low carb snack
The big selling point of this snack? The fact that it’s 0 carbs per serving!

The name itself is positively revolting, but the actual snack is a savory wonder for a T1D. It’s got 0 carbs in the ENTIRE bag. It also happens to be chock full of protein and is relatively low in calories. What a find! We totally crushed the entire bag in about two hours flat.

Other findings from this particular trip include a lower-carb bag of trail mix that was incredibly satisfying. I was pleased to have found one that wasn’t a mix of 20% nuts and 80% candy/dried fruit, because the latter is what always messes up my blood sugar. I also snagged a bag of beef jerky, because I can always count on that to be a delicious low-carb treat.

And my drink of choice? I found a blue Gatorade Zero, which I’d never had before because it’s not sold in stores I go to when I’m up north. I loved it and was especially appreciative for it after a weekend of not getting enough fluids.

All in all, it was kind of fun to see what kinds of snacks I could find that wouldn’t do damage to my blood sugar. I wound up finding some stuff that’s bound to become staples for future road trips, and was so sated by the combination of them that I didn’t even need to cook dinner when I got to my apartment. Turns out that low/lower-carb snacks pretty much rule!

3 Tips For Anyone Turning 26 with Diabetes (and Switching Health Care Plans)

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Do you have diabetes and will turn 26 in the near future? Will you be forced to switch from your parents’ health insurance to your own plan? If the answer to both of those questions is “yes”, then you’ll definitely want to take a minute to read my tips on how to make the transition as smoothly as possible. And even if you answered “no”, you still might find this to be a worthwhile read because chances are, either you or someone you know will have to go through this process, whether or not you/they have diabetes.

Here are the three most valuable tips I have for anyone who just turned, or is about to turn, 26 years old and is concerned about switching health care plans:

HUGGING THE CACTUS - A T1D BLOG
I figured out these tips the hard way. Save yourself a lot of frustration and time by following them A.S.A.P.

Tip #1: Ask your doctor for copies of all of your prescriptions. Do this well before your actual birthday. That’s what I did, anyways – I had a scheduled appointment with my endocrinologist at the end of April. That’s when I requested a copy of every single prescription she’s ever written for me, including for medications that I don’t really use anymore (e.g., Lantus, the long-acting insulin I used prior to my insulin pump). Then, I made multiple copies of these prescriptions, taking care to separate the originals from the copies. This tip really came from my mother, who told me that having the prescriptions now would save me trouble later. And she was right: When I did send in my Humalog prescription to Express Scripts, I did so with more confidence because I didn’t have to scramble to request it from my doctor.

Tip #2: Start the process of reordering supplies as soon as possible. Even if it means starting to reorder things on your actual birthday…do it. I’d say this is especially important if you’re running low on supplies. It took me nearly two months to start receiving stuff. Part of this was my fault because I procrastinated, and was also at an advantage because my mother took the time to order me plenty of extra supplies before I made the switch. But it was also the fault of the companies I was ordering from, who, for various reasons, didn’t send out my supplies on time or needed a longer period of time to review my orders before shipping them out. I’m lucky that I can say that I was never truly worried that I was going to run out of supplies, but the thought did cross my mind a few times, and it was unpleasant. So save yourself from aggravation and just get the ball rolling as soon as you can.

Tip #3: Keep records of everything. I keep a physical folder that contains receipts, prescriptions, photocopies, notes, and various other documents related to my health. I can’t say for sure what I’ll actually need to keep or throw away in the coming months, but I do know that it’s smart to hold onto this stuff in the beginning. That way, during my company’s next open enrollment period, I’ll be able to make informed decisions regarding things like how much money to put in my flexible spending account (FSA). Plus, any notes that I’ve taken during phone calls have already proved immensely helpful as I’ve needed to track down specific customer service representatives in order to take care of issues that have come up. It can be a little cumbersome to remember to keep all these papers, but I know it’s the right thing to do and that there’s no way that I’ll regret it.

BONUS Tip #4: Advocate for yourself until you get what you need. At first, I felt extremely awkward for calling Dexcom and Insulet every single day for a week. But then I realized that I shouldn’t. They weren’t going to make sure that I had my supplies: I had to depend on myself to do that. I also felt a bit stupid asking just about every customer service representative that I spoke to how everything works, but I eventually got over that, too, because it’s vital to understand this stuff, even when it seems extraordinarily complicated. So I’d tell anyone who’s going through this process, or who is about to go through it, to keep up the hustle. Don’t ever feel shame for asking too many questions or calling too many times; when it comes to all this, the limit doesn’t exist. Ask others for help when you need it (I spoke with all sorts of people in the DOC about my issues, and goodness knows that my mother provided me with all sorts of advice and support throughout this) and, with their assistance and a little determination on your part, you’ll get through this tiresome transition.

When Diabetes Isn’t Responsible for an ER Trip

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If something unexpected happens to me in terms of my health, I can almost always safely blame diabetes for causing whatever it may be. But when I absolutely, definitely cannot blame my diabetes, I can’t help but feel angry at my body for rebelling at me in ways that it shouldn’t. Particularly when those ways end up with me making a trip to the emergency room.

Let me set the scene: It was a Tuesday evening, around 7:45 P.M. My partner and I were watching an episode of Stranger Things (we’re not caught up yet so please, don’t spoil it for me). Suddenly, I felt an itch on my upper left arm. Like anyone would, I scratched it. But then it got more intense. Like, really, seriously itchy. I rolled up my sleeve so I would be able to scratch with greater ease, and was surprised to feel some bumps emerging on the itchy patch of skin.

I peeled off my sweater and stepped into better lighting in the bathroom so I could examine the area better. There was a large patch of red, inflamed skin on my arm that was covered with bumps that looked like hives. I was dumbfounded. Unsure of what triggered the hives, but alarmed by how swollen and irritated my arm looked, I shot a couple text messages to my EMT father and nurse best friend, who both advised me to get my arm looked at stat.

HUGGING THE CACTUS - A T1D BLOG
Stranger things have happened in my life with diabetes (just had to sneak a pun in there)

And that’s how I found myself in a crowded emergency room, tearful and furious at my body, on a random weeknight. Part of me was relieved that my diabetes didn’t seem to have anything to do with this (but see my recent post on Metformin and you’ll understand that I have some theories about that being the cause). But the other part of me was so pissed off that my body just couldn’t be normal for once. I felt that my body was lashing out at me like an unruly child, declaring its anger towards me in the form of an incredibly itchy, ugly rash. I couldn’t help but stew over the whole situation the entire time I waited to see a doctor.

Long story short, a dose of Benadryl cleared up the hives within an hour. The doctor was unable to determine a cause, since I couldn’t think of anything new introduced to my diet or any new scents/lotions/detergents used in my household. And insect bites got ruled out because the doctor was certain that a bite would be more localized and not spread in a giant patch on my arm. I’m still perplexed at how it happened, but I guess I just have to make peace with the fact that it did and be grateful for 1) making a total recovery from it and 2) not experiencing any issues with my blood sugars as a result of it.

When diabetes isn’t responsible for an ER trip, it means that it’s okay to still be upset about it, but also glad for not having to explain the intricacies of diabetes to every doctor and nurse that walks into the room…because I can’t think of a single PWD that would ever feel happy about taking on that happy task.

Diabetes in Pop Culture: Is it Really That Hard to Get it Right?

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I used to be an avid fan of the cultural behemoth, The Walking Dead. Imagine my delight and surprise when type 1 diabetes actually made a cameo in one of the episodes! T1D, in the zombie apocalypse! What could go wrong?

Turns out, a lot. A minor character in the show’s sixth season passes out, only for a main character to flock to her side just in time to give her a shot of insulin. Within moments, she’s totally fine, though – spoiler alert – she gets attacked by zombies and doesn’t survive at the end of the episode.

What’s wrong with this scenario is that if a person with diabetes passes out like that, it’s more than likely that their blood sugar is low, and the last thing that they need is more insulin. I can’t imagine her blood sugar being high seeing as it’s the ZOMBIE FREAKING APOCALYPSE and supplies are scarce. I doubt she’s eating, well, anything, let alone substantial meals. And how the heck does insulin stay fresh during the end of the world, anyways? I don’t necessarily expect a TV drama to explore that in a tight 60-minute time frame, but these are things to consider, as well as details that leave unusually informed viewers like me a little bemused and irritated.

Diabetes in pop culture_

And it’s not just The Walking Dead – it’s a LOT of shows that make mistakes or omissions that can be eyebrow-raising. A few shows that come to mind include The Big Bang Theory, Hannah Montana, and even my beloved soap, General Hospital. The errors have been to varying degrees, but a common theme among countless television shows is perpetuating the stereotype that all types of diabetes are caused by a poor diet; specifically, consuming sweets. It’s always an extremely cheap joke, and one that’s gotten stale in its overuse.

Surprisingly, reality TV doesn’t help dispel any myths, which is a bit ironic. Recent episodes of Southern Charm and one of the Real Housewives franchises spread diabetes misinformation that was just ludicrous to me. In the former, a licensed anesthesiologist implied that his girlfriend shouldn’t eat a pastry because it’ll cause diabetes (insert eye roll here) – last time I checked, an anesthesiologist does not know the intricacies of the endocrine system, so who is he, as a medical professional who ought to know better, to say something like that? And in the latter, one woman was scolding her T2D husband over not taking care of himself. She explained his condition in a confessional…but did a really rotten job of it. If I didn’t know anything about type 2 diabetes, and I “learned” about it from this source, then I would be seriously misled.

I’m not trying to be oversensitive here, but it is hard for me to understand why pop culture struggles to get certain aspects of diabetes right when it appears in various story lines. There’s a wealth of correct information out there that writers could rely on. It’s a shame that they don’t, because whether they mean to or not, all it does is add to the confusion and general misunderstanding of all types of diabetes.

Needless to say, pop culture in this day and age has a long way to go when it comes to the portrayal of diabetes.

 

Why Waiting for Prescription Refills Feels Like a Pending Punishment

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I’ve been waiting.

I’m waiting, impatiently, to learn just how much I’m going to have to pay for a 90 day supply of insulin.

I’ve been waiting for what will inevitably feel like a punishment.

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It’ll feel like a punishment because it will feel harsh and unavoidable. And it’ll be more intense than is fair because my only offense is having a pancreas that doesn’t work the way that it should.

Every time I log into the Express Scripts website, I feel a sense of dread sweep my body. I anxiously click around the portal until I get to the recent order screen (see above image). My eyes immediately flock to the blue box that will eventually display how much money I owe for my insulin.

It’s a process that reminds me of checking my grades when I was in college: After I took an exam, I’d enter my username and password into the student portal to find out whether grades were posted. I’d repeat this process multiple times a day until I found out how I scored. It was a nerve-wracking routine back then, but I wish I could tell my younger self that that was NOTHING compared to looking up the cost of my insulin.

 

Metformin Update #3: Is it My Imagination…or Side Effects?

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Frequent readers of this blog are probably familiar with my journey with Metformin. If you aren’t, or want to brush up on my history with it, read here, here, and here in order to get caught up.

The big white “horse pill” that is known as Metformin has become a relatively solid part of my routine in the last six or so weeks. I’ve skipped doses here and there for varying reasons (i.e., on occasions when I’ve had two or more alcoholic beverages); otherwise, I’ve been taking it and monitoring my blood sugars carefully each day.

But apparently, my blood sugars aren’t the only thing I should be watching diligently.

METFORMIN UPDATE #2

Just like any other drug out there, Metformin comes with side effects…which I totally chose to discount from the beginning, mainly because my endocrinologist thought that the extended release tablets would mitigate the likelihood of side effects. I’m questioning that logic, though, after experiencing indigestion and general stomach discomfort within a few hours after taking my Metformin pill.

It didn’t happen just once. There were at least three consecutive days that I experienced these symptoms. Within an hour or so after eating dinner, I felt uncomfortably full – like I’d eaten a whole Thanksgiving meal instead of a normally portioned dinner. I know that I wasn’t eating a larger quantity of food than usual, and since I typically have a semi-insatiable appetite, I knew that it just had to be related to my Metformin dose.

I decided to do some more research into the side effects of Metformin. And I was pretty surprised by what I saw. Shocked, actually. Because evidently, a massive array of side effects can occur on Metformin. The stomach discomfort I’d experienced was common, but other side effects that caught my attention included restless sleep, muscle pain, cramping, and a rash/hives.

Very interesting. I’ve felt all of those things in the last few weeks. I chalked it up to overdoing it with my exercises, but…it’s not like I was doing anything new or particularly strenuous in my routines. I do a combination of cardio and resistance training, for about an hour most days of the week. I always make sure to stretch before and after working out, and yet I felt a soreness and achiness (mostly in my legs) for a few nights in a row a couple weeks back. There was even one night that I tossed and turned so much that I hardly slept a wink – the restlessness in my legs was that bad. And the rash/hives? I’ll go into more detail in a future post, but on a random Tuesday night, I experienced a breakout so bad that I wound up going to the ER. They cleared up within an hour or so of a Benadryl dose, but it was still a scary experience.

Okay, so I think I can safely blame all of these issues on my Metformin intake. But that still doesn’t quite answer why I was experiencing multiple symptoms so suddenly. My theory is that my body was struggling to adjust to taking Metformin consistently, and as a result, I was feeling the side effects. There’s no way for me to be sure, but I think this warrants another experiment…another break from Metformin. My blood sugars have been good on it, but have they improved so drastically that I can’t imagine life without Metformin?

The answer is a resounding no.

I’ll likely consult with my endocrinologist at some point to tell her my thoughts and theories. But for now, I’m taking a break for an unknown period of time to see if there’s any change in how my body feels. We’ll see how it goes.

Do You Have 2 Minutes to Spare?

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If you’re reading this post, then the answer is YES – of course you have 2 minutes to spare. In that amount of time, you can share your opinions and help my dear friend, Heather, with her research.

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Make your opinions heard by taking this survey.

Please click this link to access the survey. It’s very simple: You’ll see 24 phrases that relate to diabetes in some manner. You’ll rate how often you see these phrases around the Internet using a scale of 1-5. Then, you’ll share which one resonates with you the most and which one you see the most on various diabetes online communities. And…that’s it! You don’t even have to share your name or any of your contact information. It’s quick, easy, and you’ll get to share your opinions in a way that will make a difference. I’d say that’s a great way to spend 2 minutes, wouldn’t you?

It’s Not Called Cryabetes

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C’mon, Molly. Get it together. It’s not called cryabetes. I stared at myself in the bathroom mirror, giving myself an internal pep talk to keep the tears from flowing down my cheeks. I felt a little uneasy on my feet, so holding a steady gaze proved to be challenging after a few moments.

Why was I on the verge of an emotional breakdown? It was all my blood sugar’s fault, of course. For about an hour, I’d been hovering in the upper 60s to lower 70s. There are far worse blood sugar ranges to fall in, but I’d been feeling the classic symptoms of a low for that entire span of time – and it was really testing my fortitude.

My self-talk was fruitless; within seconds, the first few tears escaped from my eyes. It wasn’t long before a couple tears turned into full-fledged bawling. Alarmed by my outburst, my boyfriend tried to calm me down (he was aware of my low blood sugar situation) and attempted to use humor to get the crying to stop. Very quickly, he discovered I was a bit beyond that and that it was best to just let me be sad.

I was sad because I was tired and wanted to go to bed but it didn’t feel safe for me to sleep just yet. Safe to sleep. Can you imagine not feeling safe enough to fall asleep, even in your own bed surrounded by your own blankets in your own room, with your partner nearby?

So the tears came and went because, even though I tried my damnedest, I still felt so out of control in this situation. Not knowing how long it would take my blood sugar to come back up to a level that I felt safe to sleep at, not knowing what exactly caused this predicament in the first place, and not being capable of being mentally stronger than my diabetes all in that moment in time got to the best of me.

Definitely very chronically UN-chill of me, right?

Dualitee Apparel

So sure, diabetes isn’t called cryabetes. But that doesn’t mean my emotional lapse – or any emotional lapses related to diabetes – wasn’t warranted. Crying can be healing, and in this moment in time, it was the only thing, oddly enough, that could make me feel a tiny bit better.

Favorite Things Friday: Vial Safe Insulin Protector

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One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.

Okay, so it’s DEFINITELY been a few months since I last wrote about a favorite thing of mine. I admit that I started running out of things that I deemed worthy enough of sharing with my readers! It felt silly to continue doing it on a monthly basis if I didn’t have anything particularly great to write about, so I stopped, promising myself that I’d pick it up again the next time I got excited about a product.

Enter the Vial Safe insulin protector sleeves that I just ordered.

Favorite Things Friday_ Vial Safe Insulin Protector.png

I’d seen posts about these little insulin vial jackets before on Instagram, and I always had them bookmarked in the back of my mind as something I should order. After all, I’ve felt the agony of a shattered insulin vial before, and let me tell you: It’s awful. I was somewhat young when I broke my first (and hopefully only) vial and basically brushed the whole thing off because I assumed that it would be easy (i.e., free) to get a replacement. But now, at age 26 and in my first few months of being on my own health insurance plan, I know better. Accidentally breaking an insulin vial in this day in age seems like the equivalent to setting a stack of hundred dollar bills on fire – completely pointless, unnecessary, and wasteful.

So I’m betting that my two new Vial Safe sleeves will help protect me from ever experiencing a shattered vial again. I’m especially looking forward to bringing them with me on my next trip, as they’ll surely keep my vials more secure as I have the tendency to shove them wherever I can find space in my luggage.

I bought my Vial Safe insulin protectors on Amazon, but there also available for purchase here. And no, I wasn’t asked (and I’m definitely not being paid) to write about these or any other products I’ve ever mentioned on Hugging the Cactus – I simply believe in spreading the word about a quality item if it has helped make diabetes management easier for me in some way.