A Tough Topic: Diabetes Complications

I’m broaching a subject I’ve never openly discussed in an online forum in today’s blog post…and that is diabetes complications.

The reason why I’ve never talked about complications is straightforward: They absolutely terrify me.

It’s a topic that’s so foreign and frightening to me that I don’t even know the full extent of diabetes complications. You can Google them, for sure, and discover a long list of scary conditions involving the heart, eyes, extremities, and other internal organs. But I’d rather not do that to myself, let alone the audience of this blog.

I don’t want you to think that I’m naive, though…I know that not talking about something doesn’t mean that it’ll just go away or never happen.

Recently, I became glaringly aware of this fact through the form of (what I presume to be) my own diabetes complication: tendonitis in my left hand.

In the last year or two, I’ve felt sporadic sensitivity in my left hand when I fully extend my wrist, bear any weight on it, or even when I do simple wrist rotations. I never really knew when to expect the pain, but it happened every few months and lasted about a week each time. So when I felt it again around the time I was due for my annual physical with my PCP, I decided to ask him about it.

He explained to me that, based on the type of pain and its duration, it wasn’t carpal tunnel (numbness and tingling are symptoms of that, not pain) like I thought it might be. It also wasn’t arthritis (I didn’t have swelling or reduced range of motion) or neuropathy (I wasn’t experiencing pins and needles), but he did say that those aren’t uncommon in people with diabetes. That’s when he located the exact inflamed tendon – the thick, fibrous cord that attaches muscle to bone – in my left hand/wrist that was giving me trouble.

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Me with my new (but occasional) accessory.

Just like all the aforementioned conditions, my tendonitis is probably due to my diabetes. Although my PCP didn’t explicitly state that I definitely have it because I’ve had diabetes for 22 years, he did identify a cause-and-effect relationship between the two. But, fortunately, he also reassured me that my occasional flares of tendonitis are nothing to worry about. As long as I continue to do what I’m doing (which is supporting my hand and wrist with a brace when I experience bouts of pain, as well as rest the area as much as possible during those times), then I’ll be totally fine.

While I’m not exactly thrilled to have to deal with tendonitis, I am very relieved that I know there’s an explanation to help make sense of it all, and that I’ve been doing the right things to handle it. So even though I won’t be going out of my way to research any other diabetes complications any time soon (why on earth would I want to stress myself out unnecessarily), I have come to terms with my tendonitis as a possible complication for me. And rather than seeing it as a completely negative thing, I’ve decided to just keep doing what I’m doing, and continue to take the best possible care I can of myself and my diabetes.

They say prevention is the best medicine for a reason, right?

 

 

5 Things I’ve Learned about Exercising with Diabetes

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

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.

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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.

Managing Diabetes When Sick

This post initially appeared on Hugging the Cactus on February 26, 2018. Since I’ve already dealt with two bouts of congestion and coughing this cold and flu season, I figured it was appropriate to republish this post to remind myself of my philosophy when I’m run down with illness: Don’t push myself and give my body time to rest as much as it needs in order to get better faster. 

The inevitable finally happened: I caught a cold. It really didn’t surprise me, because 1) it’s cold season and 2) I’ve been running around like a mad woman the past couple weeks and missing out on sleep.

Though it was expected, it certainly wasn’t welcome. I can’t stand being limited with my activity levels, and it’s been tough enough to get by recently due to my broken arm. Alas, I spent about three full days doing nothing but sleeping and binge watching Gilmore Girls as I nursed myself back to health.

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My best friend during my cold? This box of tissues.

During this time, I was extra concerned about my blood sugar levels. They tend to be better when I’m active, so I was worried about how they would fare when I was moving so little.

I admit that I probably did the wrong thing by not eating much during this time. It seemed like I needed to pump myself up with a heftier dose of insulin any time I was eating a meal, likely to compensate for the lack of movement. Even so, I seemed to spike a little too much for my liking after meals. So I really cut back on food. In hindsight, it wasn’t my best move, because even when I did eat it was not healthy (few fruits/veggies, mostly breads and fats).

But I do give myself credit for staying hydrated – a crucial step in getting better. I drank so much water, Powerade, and tea that I felt like I was constantly taking trips to the bathroom. It was worth it, though, because it’s easy to become dehydrated when sick and make a bad situation worse.

Also, I think I made the right move by taking some sick time from work. The day I woke up with a tingly throat, I thought I could soldier on and work a full day, but it became clear the moment I sat down at my desk and couldn’t focus that it would be best to just go home. I took a sick day the following day and was able to work from home the day after that, so I’m grateful that I have a flexible and understanding employer who knows that health is a priority over everything else.

As much as I loathed being mostly confined to my room for 72 hours, it was the smart call. It reminded me how important it is to listen to my body and to not push it when I’m not feeling 100%. There’s no shame in self-care.

Why You Should Get a Flu Shot (If You Haven’t Gotten One Already)

I’m not a medical professional by any stretch of the imagination. But I am a highly opinionated person who happens to have a chronic illness and who feels strongly about vaccinations such as the flu shot.

So with that in mind, let me say that I truly believe it’s of the utmost importance that you get your flu shot this fall.

Whether you have diabetes or someone you know and love has diabetes, you need to help protect yourself (and your loved one) by getting your flu shot. Why? Because it’s common knowledge that people with diabetes simply have weaker immune systems. I’ve made it a practice, along with many other people with diabetes, to keep up-to-date on this vaccination annually because I know how easy it is to get it – and actually, I was excited to get it done this year because my best friend since childhood administered it to me herself. I’ve never had so much fun getting a shot before!

Why You Should Get a Flu Shot (If You Haven't Gotten One Already)

Yes, I know, not everyone is as fortunate as me to have a best friend who will stick you in the arm to help protect you during this year’s flu season. But it doesn’t matter who gives it to you, just get it done.

It doesn’t matter if you’re afraid of needles (besides, they have nasal flu vaccines).

It doesn’t matter if you have a “great immune system” and “never get sick”.

It doesn’t matter if you don’t think you have time to go and get it done, because really, if you have time to read this post then you definitely can hit up your local pharmacy for a quickie shot.

I’ll get off my soapbox for now, because I’m sure you’ve stopped reading this post now in order to figure out when and where you can get yours! 😉

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

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:

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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

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.

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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.