Tag: doc

Happy Birthday, America!

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Today is the Fourth of July! I’ll be spending the day in our nation’s capital. While I’m not entirely sure what the day will bring, I do know that I’m bound to feel a swell of patriotic pride, as I imagine the vibe of Washington, D.C. this time of year oozes red, white, and blue.

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The Stars and Stripes

As much as I love my country, I still think it has a long way to go. I promised myself I would refrain from getting overly political on my blog (for many reasons), but I will say this one thing: Many things about healthcare in America need to change. I found an article on the New York Times recently that opened my eyes to the dire state of the global insulin crisis. Here are some facts from that article:

  • One in four patients with diabetes are cutting back on insulin because of cost.
  • The typical cost of one vial of insulin is $130. One vial of insulin lasts no more than two weeks for a person with diabetes.
  • There is no generic form of insulin. This means that prices skyrocket since there is no competition among generics.

Why is this happening? Why do families find themselves being forced to choose between feeding their families or affording life-saving medication? It’s unacceptable that profits are valued over life in our great nation.

Things need to change. The politicians and policymakers who have the power to make right and just changes need to take a good, hard look at Americans who are crying out for help and struggling to simply live.

This topic is worthy of thousands more words, but I’ll leave it at that for now. Maybe it will open someone else’s eyes, too.

For now, have a beautiful Independence Day doing whatever it is that makes you feel free – and be safe!

Diabetes: A Condition of Consistency

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“Consistency is key” is a well-known adage for a reason: It applies to many things in life, including diabetes.

This has resonated more and more with me over the last few months, as I’ve experienced greater interruptions in my day-to-day routines. The most obvious change has affected my Monday through Friday lunch hour at work. I usually need to go home three out of five days to take care of my puppy – feed him, play with him, and make sure he hasn’t totally destroyed anything in the few hours since I last saw him. I don’t mind this at all, because I love my little Clare-bear, but on days that I have to be with him, my diabetes is definitely affected.

For starters, I have to eat my lunch much later than I normally do on non-Clarence days. Technically, I could eat my lunch when I go home to see him, but I have a very narrow window of time – approximately thirty minutes – to be with him. It doesn’t seem fair for me to go home, pour out his kibble, then spend the majority of our half hour together putting together and eating my own lunch. So I spend my lunch break giving the puppy my full attention, which makes us both pretty happy.

Clarence
My Clare-bear certainly knows how to keep me, and my diabetes, on our toes!

Eating lunch during my allotted break is ruled out, so I have to decide whether to eat it before or after my stop home. I usually end up forcing myself to wait until I get back from feeding Clarence to eat, but this is easier said than done for a few reasons: Sometimes, my blood sugar will crash while I’m with the dog, so I have to eat a snack to correct it because my actual prepacked meal is waiting for me in the office refrigerator. Or I have to scramble from one meeting to home and then back to the office for another meeting and won’t have a chance to sit and eat until 2 o’clock, which means that I have to sit through an afternoon meeting without a full attention span because all I can think about is my grumbling stomach. On those days, I’m pretty hangry by the time I get to eat, and even more so irritated when my blood sugar retaliates at me later on for waiting so long to eat.

That being said, I’ve had to make peace with the fact that my weekday/lunchtime blood sugars will be a bit all over the place. I know that things will be easier when Clarence gets older, but for now, I’m determined to enjoy his puppy-hood without diabetes interfering too much. And if nothing else, it reminds me how important it is to stick to the basics with diabetes: Eat regular, healthy meals and the habit will reflect well on blood sugar and A1c.

Favorite Things Friday: Mini Boxes of Yogurt-Covered Raisins

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One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!

Mini boxes of yogurt-covered raisins is an oddly specific kind of food, but they’ve literally saved my life (and my mom’s) hundreds of times.

I’m almost certain that I introduced these raisins into our low supply kit because I was looking for something that 1) was portable 2) had 10-15 grams of carbs 3) could be quick and easy to consume and 4) wasn’t glucose tablets (I get sick of them). I must’ve been browsing through the aisles of the grocery store when I found a bag containing 10 mini boxes of raisins. Clocking in at exactly 10 grams of carbs per box, they seemed to fit the bill nicely. I brought them on a trip to Disney World soon after buying my first bag, and that sealed the deal for me. They proved to be super convenient throughout the trip and helped prevent me from over-correcting my lows, which was huge for me.

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A box of raisins adjacent to my OmniPod PDM. I can easily fit several boxes of raisins into my purse, along with my other diabetes supplies.

Since that trip, the raisins have become a go-to low treatment for me and my mom, who agrees that they work just as well as glucose tablets. They’re much tastier than glucose tablets, and qualify as a healthier way to treat a low. As tempting as it might be to treat with Skittles or Starbursts, I struggle to control my intake of the candy when dealing with a particularly icky low. The raisins are already perfectly portioned, so that eliminates the can’t-stop-won’t-stop (eat ALL the foods!) feeling that can make dealing with low blood sugars difficult.

The raisins are excellent on the go, too. I can pop a box of them in the car, at my office desk, in the gym, or at church. I’ve even whipped them out at bars, and my friends get a bit of a chuckle when I down them like a shot of alcohol. But honestly, they’re so discreet and go down so easily that most of the time, people don’t even notice that I’m eating them. And if people aren’t noticing yet another part of my otherwise very prominent diabetes care kit, then that suits me just fine!

The T1D Taste Test: My Unofficial Ranking of Drugstore Glucose Supplements

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You may have heard of glucose tablets, but what about glucose gummies? Or liquid glucose, or glucose gel? Have you tried any of these forms of glucose?

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The four forms of glucose (that I’ve tried).

I’ve used them all, and I’ve formed some pretty strong opinions about each of them. I thought it’d be fun to rank them in order of most appetizing to least appetizing, because while they can effectively and efficiently correct low blood sugar, they certainly aren’t created equally:

  1. Best Tasting: Glucose Tablets. I can hardly believe that the most boring variety is the winner here, but it blows the competition out of the water for several reasons. For starters, glucose tablets come in an array of flavors. Orange, raspberry, fruit punch, grape, tropical, and sour apple are among the flavors I’ve tried over the years, and most of them are palatable. Plus, glucose tablets are most akin to actually candy: I’ve described them as giant Smarties to inquiring friends in the past. While actually Smarties are more fun to eat, glucose tablets are their closest counterpart in the diabetes world, making them a number-one choice in low blood sugar situations.
  2. Runner-Up: Glucose Gummies. I’m awarding second place to glucose gummies, mainly because of their novelty. It’s not particularly a standout in other categories like taste and texture. The gummies only come in three flavors: grape, orange, and apple, leaving something to be desired in terms of variety. And all three of those flavors taste a little…off, like there’s a little too much artificial additives going on. Maybe this was done deliberately to distract from the texture of the gummies, which tends to be hard/stale in my experience. It’s nice that the gummies have a layer of sugar on them to convey the likeness of real gummies, but that stuck-to-your-teeth feeling makes it harder to appreciate the gummies for what they are.
  3. Third Place: Glucose Gel. I’ve only ever found glucose gels in the fruit punch flavor at Walgreens – do they actually come in other flavors? Besides being one-note, the gel is a unique texture situation…not quite a liquid, not quite a solid. Gels aren’t a mainstay in my low blood sugar kit because I’m not fond of having to slurp them out of the pouch like a tube of Go-Gurt; in fact, I’d much rather have yogurt from a plastic tube than a gel because the yogurt is much tastier. The gel is just too artificial, with a medicinal aftertaste. And it doesn’t help that the consistency of it reminds me of hand sanitizer.
  4. The Loser: Glucose Liquid. It’s surprising that the glucose liquid wound up in last place, because on the surface, it had a lot going for it. I liked that it came in a small bottle and it seemed like it would be super easy to consume. All I’d need to do is pop the cap off and swig it down. But MAN, the taste was HORRIBLE! I thought I’d like the mixed berry flavor, but it tasted so supremely saccharine and fake that I could scarcely force myself to swallow it. I know, I know, it’s liquid glucose, it’s supposed to be very sweet. But this stuff was just over the top. I definitely will not be buying glucose liquid again any time soon. I’ll stick with my tried-and-true tablets.

Do you agree with my rankings? Did I miss any form of glucose that can be bought in most drugstores, and you think I should give it a try? Let me know in the comments!

Memory Monday: The Diabetes Diet, 100 Years Ago

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One Monday per month, I’ll take a trip down memory lane and reflect on how much diabetes technology, education, and stigma has changed over the years. Remember when…

…insulin had yet to be discovered? Of course you don’t actually remember it, unless you were born in or prior to 1921 (and if you were, wow!!! Thanks for checking out the blog!).

Anyway, prior to the groundbreaking discovery of insulin, people with diabetes lived difficult – rather miserable, actually – lives. I started reading a book called Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle a little while ago. This book has made me realize just how fortunate I am to live during a time when insulin is around (even if it is grossly overpriced).

Many parts of this book have surprised, horrified, and downright depressed me. One of the more shocking things that I’ve learned from it, though, is the diabetes diet that was prescribed to patients in the early 1900s. Patients like Elizabeth Hughes, the T1D daughter of a U.S. politician, were expected to follow a strict meal plan upon admission to the Physiatric Institute in Morristown, New Jersey. Imagine following an eating plan like this every day:

Breakfast – One egg with two and one-quarter tablespoons of string beans boiled three times, and one tablespoon each of cream and coffee.

10 A.M. – Half a small orange for a snack.

12 P.M. – Two and a half tablespoons of cod with two heaping tablespoons of Brussels sprouts boiled three times, as well as five small olives and a half pat of butter…with a cup of tea to wash it all down.

Dinner – One egg and one egg white, 2 tablespoons of spinach (yes, boiled three times), with a half pat of butter.

Oh, scratch that part about following this diet every single day – patients had to fast one day each week. No food was permitted, at all.

Does that not sound vile?

I mean, I love eggs, and I happily eat veggies on a daily basis. But I’m certain I’d get sick of them no matter how they were prepared. And veggies boiled THREE times? I would think that they’d be reduced to mush, which, according to the book, is the point. Boiling them so many times would ensure minimal carbohydrate consumption since the nutrients would basically be cooked out of the vegetable. Plus, with portions so tiny, it’s hard to imagine that anyone ever felt full after consuming a “meal”.

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For context, one egg is about the same size as one tablespoon, meaning that portions on this diet plan were miniscule.

This extremely restrictive diet left patients yearning for pictures of food they saw in magazines, as well as severely undernourished. Following this meal plan practically guaranteed that patients would become emaciated. In fact, by the time 15-year-old Elizabeth Hughes left the Physiatric Institute, she weighed a mere 45 pounds – less than half what a healthy girl that age should weigh.

Even though I haven’t finished the book yet, it already serves as a reminder to be grateful for what I’ve got in this day in age: not just insulin, but amazing technology, wonderful doctors, and radical ongoing research in the diabetes field.

All of today’s advancements make me hopeful for the possibility of the eradication of diabetes, maybe not too far after the 100-year anniversary of the discovery of insulin.

Diabetes Self-Care: Massaging Away my T1D Stress

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Sometimes, you just gotta treat yo’self. (Parks and Recreation, anyone?)

One of my favorite ways to do that is through massage. I can’t think of a more relaxing way to unwind from various sources of stress than massage. Especially when your shoulders and neck are so tense that it feels as though they’re permanently knotted up.

So I went for a one-hour massage a couple of weeks ago to see if I could successfully take a mental break from everything while addressing my muscle tension. And I’m so glad I did that for myself. Plus, it didn’t hurt that my massage therapist was super attentive when it came to my diabetes.

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What makes for a good spa experience? Himalayan rock lamps, calming music, and silent diabetes devices.

I explained to her that I was wearing a tubeless pump on my lower back, and that she should feel free to massage around it. I also mentioned that if she happened to hear anything buzz or beep during our session, she should just disregard it – if my pump or CGM alarmed, I’d take care of whichever device that was going off at the end of the session.

The massage therapist couldn’t have been more reassuring. She let me know that she previously worked as a physical therapist and had experience in the field for more than 10 years. As a result, she’d seen just about everything over the course of her career – an insulin pump and a glucose monitor were nothing.

That short conversation before the start of the session really helped it start off on the right foot. I felt much better knowing that she wouldn’t be freaked out by my devices. My openness to talk about my diabetes also inclined her to ask me if it affected certain parts of my body more than others, and if she should be sensitive to that throughout the session. I appreciated her attentiveness, and she asked follow-up questions throughout the massage to ensure I was getting the best experience possible.

Not only did I leave feeling like a million bucks, but I also left feeling glad that my CGM and pump stayed silent throughout the one-hour massage: allowing me to truly free my mind from diabetes, even if it was just for a short time.

Dad Appreciation Post

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Father’s Day was yesterday, but as I did the day after Mother’s Day, I want to use today’s blog as an opportunity to express my appreciation for dads: Namely, my own father.

Besides being the family patriarch, my dad is a firefighter/EMT. He makes his family feel safe with his emergency preparedness knowledge and skills. He also deals with his diabetic wife and daughter on an almost-daily basis, which warrants, at the very least, a ginormous golden trophy with his name engraved on it in fancy script.

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A dad and his daughter.

That’s because he sees the ugly side of diabetes from time to time. The side that causes blood to spurt out of mom’s abdomen when she removes a pod that struck a vein. The side that causes me to lash out, because my blood sugar won’t seem to come down from a sticky high, no matter what I do. The side that causes mom and I to lose sleep, because we’re treating another middle-of-the-night low blood sugar. The side that forces mom and I to be prepared for any and every possible diabetes scenario that could occur while traveling. The side that causes us to cry, because we just can’t deal with diabetes today.

And he’s there through it all.

He’s there to apply pressure and gauze to the bloody site. He’s there, feeling just as upset as I am, because he just wants my blood sugar levels to come back down, too. He’s there to make sure mom and I have enough glucose tablets or juice to bring our levels back up. He’s there, keeping us calm as we pack for our next trip and taking care of all the travel arrangements. He’s there to comfort us when we need him to, and he hates that we live with diabetes – probably even more than we do.

He’s the kind of guy who says he’d trade his pancreas with us in a heartbeat if it meant we wouldn’t have to live with diabetes anymore.

He’s the kind of guy I’m proud to call my dad.

Thanks, Dad, for helping me handle my diabetes over the years, and supporting every venture (diabetes and otherwise) that I pursue.

Favorite Things Friday: Diabetes Apps

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One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!

Diabetes is a chronic condition that involves several different pieces of technology. Unsurprisingly, quite a few of these technological components are available via mobile apps, and some of them have become instrumental in helping me understand the patterns that my own diabetes follows. Let’s walk through the four that are mainstays on my iPhone home screen.

For starters, there’s the Dexcom CGM apps (there’s one for the G5, another for the G6). When I first downloaded the app for my G5, I marveled at how stinkin’ cool it was to be able to check my blood sugar on my phone. I spend far too much time each day playing with various apps on my phone, anyway, so it was very convenient for me to have this particular app installed.

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A screenshot from the G6 app

Dexcom also makes an app called Clarity, which happens to be something I’ve come to rely on in between appointments with my endocrinologist. That’s because Clarity links directly to my CGM and gathers data from it that creates reports for my analysis. With just a few taps, I can view information such as my time spent in range, average glucose, patterns, and risk for hypoglycemia. Even better, I can generate results for periods of time ranging from 48 hours to 90 days. The app also produces results in clean, easy-to-read charts and graphs, making it extremely easy for me to figure out how I can improve my A1c.

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A view of the Clarity app

A few years ago, I found an app called Glucagon that’s made by Eli Lilly. As you could probably tell by the name of the app, it’s all about Glucagon: namely, how to inject it. It’s an interactive experience that I like to walk myself through every now and then so I’m familiar with how to use Glucagon – because you never know if and when it could come in handy.

A more recent discovery is DiaBits. Besides having a cute name, this app provides another breakdown of blood sugar data. It has a neat feature that estimates your current A1c, as well as other predictors that indicate how rapidly your blood sugar is rising or falling. It doesn’t replace any of my tools that more accurately check my blood sugar levels; it merely is a complementary app that gives me more insight on trends and averages.

One quick visit to the Apple App Store shows me that there are tons more diabetes-related apps out there. Quite frankly, I don’t know which ones to try next! Do you have any favorites or recommendations? Leave them in the comments!

Diabetes and the Blame Game: Why it’s Harmful to Judge People with T1D

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Here’s a little disclaimer: This post is highly personal. I’m going to dive deep here and talk about a few things that bother me when it comes to how others perceive T1D. My opinions are strong, but I’m entitled to them – just like you are.

“I can’t believe his blood sugar got that low. He really needs to have better control over his diabetes.”

“Why wasn’t she carrying a snack with her? That’s so irresponsible, she should know better!”

“They’re unhealthy. The way they manage their diabetes isn’t okay and it’s no wonder they go to the doctor so much.”

These are words that others have spoken about people with diabetes in my presence. While these thoughts and feelings aren’t necessarily about me, it doesn’t mean that I don’t take them personally.

Why do they bother me? Because they’re dripping with judgment.

It’s easy for someone who simply doesn’t understand diabetes to make assumptions based on a couple of observations they make about someone with diabetes. But just because it’s easy to assume things, it doesn’t make it okay.

Just because you see someone have a tough diabetes day, it doesn’t mean that’s what it’s like all the time.

Just because someone forgot to carry a low blood sugar remedy on them, it doesn’t mean that they always forget one.

Just because you know of someone who frequently visits the doctor, it doesn’t mean their diabetes is “out of control.”

Just because you blame someone for not taking “proper care” of themselves, it doesn’t mean that they don’t try their damnedest.

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I can do all the right things for my diabetes over the course of a day, and still have it go wrong. Blaming and shaming me for being a bad diabetic only makes matters worse.

That’s what’s so wrong about making assumptions about how someone manages his/her/their diabetes: It’s impossible for anyone to know the full story about that individual’s diabetes, because they are the one solely in charge of it. They know how it behaves 24/7/365. They know it better than their doctor, spouse, family, friends, and coworkers. And the funny (and by funny, I mean really shitty) thing about diabetes is that sometimes, you can’t predict what it’s going to do next. So you have to be prepared to roll with the punches at a moment’s notice. And you’ve got to be that prepared all the damn time: when you’re awake, asleep, traveling, exercising, working, and just plain living.

Sounds exhausting, doesn’t it?

So that’s why I think the blame game is especially cruel when it’s played to cast judgment on people with diabetes. We have the incredibly difficult task of taking care of something that most other people never have to worry about, and blaming someone for not “doing what they should be doing” is heartless and does nothing to help them.

I challenge anyone reading this to think twice before they jump to conclusions about how a person with diabetes takes care of themselves. Remember that just because you may have witnessed them going through a difficult diabetes experience, it doesn’t mean that it’s like that for them all the time, or that they aren’t doing everything they can to take the best possible care of themselves. The world is occupied by enough critics – do your part to be supportive, not shameful.

Three Things I Learned about Myself after Running a 5K

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I recently ran in my first-ever 5K race. In the weeks leading up to the race, I experienced a variety of emotions – particularly self-doubt – that made me question whether I could really do it. Would my diabetes cooperate the morning of the race? Should I eat a big breakfast before running, or go into the race fasting? How would I handle correcting a low blood sugar while running? What about a high blood sugar? Was I even competent enough to run?

All of my diabetes anxieties aside, I’ve always hated running. HATED it. I played field hockey every fall when I was in high school, and we were required to run a timed mile before the start of each season. I dreaded this mile because I usually wound up finishing the mile last, or close to last – my asthmatic lungs and negative attitude helped ensure that I would give up running halfway through and resort to walking a sluggish, defeated pace.

So like I explained in a recent blog post, making the decision to go through with this 5K wasn’t easy. But I wanted to take on the challenge and prove something to myself.

I did it!
My puppy greeted me after I crossed the finish line.

AND I DID IT!!! I’m pleased to say that I completed the race on a gorgeously sunny Saturday morning along with hundreds of other runners. I was totally proud of myself for accomplishing this goal, especially since I had less than a month to train for it. Plus, I learned a few things about myself after participating in the race:

  1. I should have more faith in my ability to manage my diabetes. I spent so much time dwelling on the “what ifs” (a bad habit of mine) regarding what my diabetes might do during the race that my stomach was doing somersaults as I approached the start line. But as soon as I turned my music up and started running with everyone else, my doubts vanished. And better yet, I was absolutely fine throughout the race. I didn’t eat anything beforehand and went into it with a blood sugar of 142, and I stayed pretty steady for most of the 3.1 miles (I did start to spike soon after crossing the finish line, but I’m certain that was because of the adrenaline). I simply did what I’d been doing during my past month of training, and my experimentation with fasting vs. non-fasting paid off.
My blood sugar stayed steady throughout the race.
I started to spike after crossing the finish line. I blame it on the adrenaline rush.
  1. I’m a lot more determined than I realized. I’ll admit that there were a few points throughout the race when I wanted to give up. I was breathing hard and my legs were starting to ache, but not once did I stop running and slow down to a walk. I pushed myself to keep going, even though I didn’t want to, and my determination helped me achieve my personal best running time.
  2. I’m ready to train for future races. This experience awakened something in me that wants more challenges. I’m still not in love with running, but I think I am a fan of trying things out of my comfort zone. I want to continue to get faster and stronger so I can try tougher races and physical tests. It’s almost like it’s an outlet for me to tell my T1D that it can’t stop me – that I’m stronger than it no matter how hard it tries to knock me down.