A T1Diary of my Recent Endo Appointment

I’m trying something new here today, folks. As you can see, this blog post features not just words, but video, too. How exciting! The aforementioned video shows the before, during, and after of my most recent endocrinologist appointment. I share a touch more than I normally would in this format, and I cover something that’ll be a big subject in one of my upcoming blog posts.

Originally, I shared this video (in short clips) directly to Instagram, where it would live in my stories for 24 hours before going away. But the thought occurred to me to save and splice the video segments together to create a full video, albeit a poorly manufactured one. I’ve decided to call it my first attempt at video blogging, otherwise known as vlogging.

Fear not, my fellow wordsmiths: I still plan on writing actual blog posts. I’m not sure how regularly I’ll be vlogging. But I can promise that if people kinda dig this, then I’ll make a point to vlog semi-regularly. I can also promise that the videos will be a bit shorter and shot in one take, because 1) I don’t think anyone wants to hear/watch me blabber for more than a couple minutes and 2) it’ll help ensure that I don’t jump around from topic to topic. And for the sake of full disclosure, I’m not lovin’ my once-a-month Favorite Things Friday post as much as I used to…so this may eventually replace it. We’ll see.

So, without further ado, enjoy this little video from me…and remember that it was initially created for Instagram, which encourages users to make very short video/photo clips, and helps explain why this whole package is a bit choppy. And please do let me know, in the comments or on various social media channels (accessible in the upper-right hand menu of the Hugging the Cactus homepage), what your thoughts are on vlogging.

 

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5 Tips for T1Ds Dining Out

Nothing beats home-cooked meals. But it is nice to go out to eat after a long workweek or to celebrate a special occasion. It’s a good way to unwind and socialize.

And like many other things, it’s also a little bit more complicated when you have type 1 diabetes. Not every T1D might feel the same way as I do, but there are times when I feel worried about going out to eat. Specifically, I start asking myself questions like, “Will there be a decent variety of lower-carb choices on the menu? Have I had this kind of cuisine before, and can I accurately predict how it will impact my blood sugar? Can I order what I actually want to eat without worrying about the carb content? Will the portion sizes be too small or too big? How long will it take for my meal to arrive, and does this mean I can safely pre-bolus for it?” Sadly, those are just a few of the questions that come to mind before some restaurant excursions.

5 tips for t1ds dining out

That’s why I like to remind myself of the following five tips. They’re pretty common sense, but then again, they’re also key for me to enjoy a meal out guilt-free and in a way that works best for my diabetes.

  1. Cut down on carbs, as needed. I’ve learned that one of the best ways to make sure my blood sugars cooperate during a dinner out is to try to reduce my carb intake as much as possible. After all, most restaurants don’t have nutritional information readily available for diners to consult. As a result, it’s impossible to know every single ingredient that could be in a given dish, let alone their carbohydrate content. So that’s why I cut corners where I can. If I’m craving a burger, I order it and ask for it without a bun. I substitute fries or other starchy sides for a salad or seasonal vegetables. If I notice that a pizzeria can make a cauliflower crust instead of a normal one, then I ask for it. I find that using this strategy helps me in just about any kind of restaurant. And if I find myself wanting to order something really high carb (which is rare), then I rely on tip #2.
  2. Ask for a doggy bag. Say I ordered pasta at a restaurant. At most places, there could be upwards of 80 or 90 carbs in that one dish, which is just too much for me to consume in one meal. So I make a plan to eat half of it and bring home the rest. It’s a tried-and-true technique that works for anyone who’s trying to watch what they eat, not just people with diabetes. It’s a win-win because I can still order that carb-y dish, but I don’t have to worry about potentially taking too much or too little insulin to cover it. Fewer carbs in one sitting means less room for error.
  3. Load up on veggies. I incorporate as many vegetables as I can into my meals at restaurants. In addition to subbing sides, I also will focus on eating those if they come with an appetizer. For me, it’s all about filling up on the healthy stuff so I don’t leave the restaurant with too much food guilt.
  4. Share with your table mates. Whether I’m with a large group or just part of a pair, I almost always offer to share appetizers or desserts as a subtle form of portion control for myself. Who doesn’t love splitting an order of nachos or a slice of cheesecake? It’s a great way to start off or end a meal out that involves minimal guilt or blood sugar concerns.
  5. Order drinks with care. I’m very careful when it comes to choosing drinks that have zero carbs, or at least very few carbs. More often than not, I stick with water or unsweetened iced tea with lemon to accompany my meals. But when I choose to drink alcohol at a restaurant, I try to order a glass of wine or lower carb cocktails. I tend to have better luck with those, because I can more accurately predict how they’ll affect my blood sugar, if at all. I do like beer and order it from time to time, but I limit myself to no more than two – any more than that and I push my luck by running the risk of experiencing high blood sugars.

But arguably my most important, unofficial sixth rule is to remember to enjoy myself. There’s no sense in stressing too much about what my blood sugar might or might not do (unless there’s extenuating circumstances, then I totally pay it proper attention). I like to bear in mind that no matter how my blood sugars may react to certain foods, I still have to eat. Why not appreciate every aspect of the experience?

My New Low Blood Sugar Symptom

In the last 21 years of diabetes, my low symptoms have been pretty predictable and easily recognizable: shakiness, sweating, dizziness, and sluggishness are all signs that I need some sugar, stat.

But lately, I’ve started to experience one brand-new and totally weird low blood sugar symptom. I’ve decided to dub it “fuzzy tongue”.

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“Fuzzy tongue” or “terrycloth towel tongue” is now one of my low blood sugar symptoms.

I don’t know how else to describe it other than that it feels like my tongue and lips are covered in a terrycloth towel as my blood sugar starts to fall to a certain level, usually 75 mg/dL or lower. Simultaneously, it’s a numb and tingly sensation that feels so disorienting and makes the process of chewing glucose tablets or drinking juice a little more difficult, because it feels weird to eat or drink when my entire mouth feels like it’s covered in cloth.

In fact, the first time it happened, I took to Twitter to ask the rest of the DOC if there was anyone else who had experienced something like that before. And I was comforted by the many responses I got back that assured me that I wasn’t alone in feeling this strange symptom:

“Yes, from certain lows. Sometimes I feel like my [whole] body is buzzing and fuzzy, if not fizzy. Other times, it’s like my body says, “BTDT! Got the glucose tabs! Move on!”

“YES! This is a new symptom for me too (after 17 years of treating lows)..Thought I was allergic to honey the first time.”

“This is a common one for me. Tongue and lips. I hate it”

“Sometimes I get tingly lips or tingly fingers!”

“That’s almost exclusively how I can tell that I’m low”

“YES! If it’s a prolonged low, I get tingly lips and tongue. It’s super weird and really uncomfortable.”

“I get more of the tingling/partial numbness in the lips (‘fuzziness,’ I suppose) that some have described. Usually this occurs with a bad low (under 50 mg/dL).”

Those are just a few of the replies that my initial tweet received. I found these particularly interesting, though, because one person identified it as a new symptom, too, and others implied that it’s always been an indicator of low blood sugar that’s more likely to occur with “bad” lows. In addition to helping me feel a bit more normal about the discovery of my new low symptom, I also found this to be an example of the ways in which the DOC is uniquely unified. To an outsider, this whole Twitter thread probably makes zero sense and comes across as bizarre. But to someone part of the DOC, it’s just another conversation that brings T1Ds trying to get to the bottom of a ‘betes mystery together.

So even though “fuzzy tongue” is uncomfortable, I’m glad to know I’m not the only T1D who’s felt it…and I’m very glad that my body has found another way to alert me to a low blood sugar, especially since it’s a way that makes me want to correct it more quickly than ever before.

My CGM Sensor Ripoff

Oh, the Dexcom G6. You have no idea how much I simultaneously love and hate you. I love you for your painless insertion, increased accuracy, acetaminophen-blocking capabilities, and your sleeker profile. But I effing loathe you for having communication issues with the sensor on days 9 and 10 of wear…that is, if you even last that long on my body. You have serious sticking issues, old pal. Your adhesive tends to be a bit of a ripoff – both literal and figurative.

You see, I was just trying to roll over into a more comfortable position in the middle of the night when you decided right then would be the ideal time to just fall off my arm, prompting me to go from blissfully snoozing to wide awake and angry in less than 10 seconds. Way to go! It pissed me off because it happened with very little effort. I would’ve understood if I had scratched or touched it in any way, but all I had done was flip from sleeping on my left side to my right. Not fair and definitely not the ideal way to wake up.

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The ripoff sensor in question.

I wish I could say it was a one-time occurrence, but no, it happened a couple months ago. Again, it was the middle of the night and again, it was ripped off prematurely. I think that in both cases, I still had at least another three or four days of use before it was due to be changed. And even before these two middle-of-the-night ordeals, I had trouble with a freshly inserted sensor that was peeling all around the edges. What the heck is going on with Dexcom G6 adhesiveness?

Maybe this is a sign that I need to start using something in addition to an alcohol swab each time I change a sensor. Perhaps Skin-Tac or more regular usage of Pump Peelz/Grif Grips will prevent future sensor ripoffs. But still can’t help feeling ripped off, because this never really happened when I was using my G5 sensors.

The small mercy in this situation is Dexcom customer service. Kudos to their team for being understanding and willing to replace my not-so-sticky sensors…but I wish I could say that I had more faith in a G6 sensor’s ability to stay on my body for the full 10 days that it was intended to.

Favorite Things Friday: My Fave Carb Counting App

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

I’ve written about my favorite diabetes-specific apps in the past, but I’ve also got a couple others that aren’t directly related to T1D that are mainstays on my iPhone. But there’s one in particular that 1) on the surface, has nothing to do with diabetes and 2) has been exceedingly helpful at giving me guidance when it comes to carb counting in certain situations. So without further ado, let me share the name and what I like so much about the app itself.

MyFitnessPal is my carb-counting app of choice. As the name implies, it’s an app that revolves around, well, fitness. It’s designed to provide users with a comprehensive log that tracks activity levels, food/water intake, nutrition information, and so much more. Initially, I downloaded it to keep a record of my daily calorie consumption and quickly discovered that it wouldn’t only help me figure out what dietary changes I needed to make, but it would also improve my carb counting.

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An example of MyFitnessPal in action – if I wanted to know the carb count in a cup of veggie soup from Panera, I can find it by simply searching for it within the app. 

How? The app contains a comprehensive food library – sort of like the one that’s built into the OmniPod PDM, except this one is much, MUCH more substantial. It includes foods from fast food restaurants, regular dining establishments, grocery stores, and just about any other place you could order food from. It’s been an absolute godsend in situations in which I’m really struggling to figure out how many carbs are in a dish that I’d like to order/buy. It’s not an end-all, be-all source of information – just like anything else in life, the food library isn’t flawless – but it’s a solid starting point when it comes to foods I’m less familiar with.

In addition to showing me how many carbs I consume in a day, the app has also taught me how logging simple information related to diabetes can go a long way in establishing trends, such as how different foods affect my blood sugar. The act of logging or writing something down can sound like a pain, but really, the few minutes it takes each day is worth the knowledge it ultimately imparts.

Readers, what about you? Do you use carb-counting apps? If so, which ones and why? I’m especially curious in hearing feedback from anyone who uses Figwee – I’ve heard nothing but praise for that one. Drop a comment here, tweet at me, or leave a note on my Instagram page about your favorite carb-counting app!

What is “Controlled” Diabetes?

There are few word pairs I loathe more than “controlled” and “diabetes”.

How the hell can diabetes be “controlled”? It’s not a video game to be played with a controller. There’s no character selection or “start” button. And it most definitely can’t be shut off with the flick of a switch.

On the contrary, it’s my opinion that diabetes is a bit of a wild beast that can’t simply be tamed. It doesn’t care if you follow the same routine every single day – it’ll act up for no damn reason whenever it pleases, much to the dismay of a person dealing with it.

Diabetes will do what it wants, when it wants. It will wake you up in the middle of the night because of a low blood sugar. It can throw your whole day off track because you make your plans around it. Diabetes itself comes with so many variables, between the devices and the effectiveness of medication, that it can oscillate no matter how hard you try to keep it steady. How can something like that possibly be under control? People with diabetes, like me, are given tools that are intended to help manage diabetes, certainly, but we have yet to receive something that allows us to influence it completely.

get lost in stockholm

If I had to take a stab at guessing what people thought “in control” diabetes looked at, it would be more than just the “perfect” flat-lined CGM graph. It would be more than going to bed each night and waking up every morning, having just enjoyed an uninterrupted, sound night of sleep. It would be more than having the freedom to make spur-of-the-moment choices regarding a daily routine or diet.

But for now, I’ve accepted that my diabetes is something I manage rather than control…but I also accept my refusal to let it control me.

Rolling with the Punches (and the High Blood Sugar)

I just wanted a nice dinner out on New Year’s Eve…but diabetes – or rather, my diabetes devices – had another plan in mind.

You see, that’s when my brand-new pod decided to stop working properly, leaving me no choice but to deliver insulin via syringe in the middle of a fancy restaurant.

Hence, my unamused expression in the following photo.

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Shooting up like the diabadass I am.

On the one hand, it was irritating to deal with, especially since my malfunctioning pod delivered high blood sugar to me in lieu of insulin. But on the other hand, what else could I do except roll with the punches? After all, it was New Year’s Eve – the final night of 2018. I was NOT about to allow diabetes to ruin it for me.

So I left my frustration and dismay at my high blood sugars at home, where I first realized there might be something wrong with my pod, and did my best to maintain an upbeat attitude throughout dinner. Yes, I was checking my CGM often, but I also remained engaged in conversation with my dinner companions (thanks for that meal, Mom and Dad). I took comfort in the knowledge that I was prepared with a vial of insulin and syringes should my blood sugar stay high in spite of my aggressive boluses. And when it did indeed climb into the 300s, I calmly set down my fork and knife, fished a syringe and my insulin from my backpack, drew up eight units, and rolled up my sleeve to inject right then and there. It felt kind of weird to “shoot up” in the middle of the dining establishment, but I didn’t have much of a choice. I could’ve gone to the restroom, but I knew that the lighting would be bad – at least I could have assistance from my parents by injecting at the table (again, thanks Mom and Dad, the cell phone lights came in clutch in this situation).

As I pushed down on the syringe’s plunger, I vaguely wondered whether any restaurant patrons were watching and wondering what the actual eff I was doing. I was self-conscious about it for a hot second, but I got over it because I knew I was doing what needed to be done.

I was rolling with the punches, high blood sugar and all, because it was the best thing to do for my body and my mind. Plus, I really got to stick it to my diabetes by refusing to let it spoil my night, and to me, that was much sweeter than the cheesecake my mom and I split for dessert.