Tag: Insulin Pump

Four Factors that Impacted my Diabetes in Las Vegas

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Recently, I returned from a trip to Las Vegas with my best friends in the universe. It was awesome to take a vacation with them, especially in a place that’s virtually a playground for adults.

Before I went on the trip, I knew to expect some sort of disruption with my diabetes care and management routine. I did as much as I could to prepare myself for every potential scenario, from packing extra snacks and supplies, to asking the DOC how I should account for a sudden change in time.

While my preparation really did help, I still encountered the unexpected when it came to my diabetes on the trip. Four factors in particular come to mind…

  1. The heat – At first glance, this is a no-brainer. I’ve been to many hot climates on vacation, so it isn’t news to me that intense sun can make blood sugar go low quickly. We were literally in the middle of the desert, so I knew it would be important for me to watch my numbers closely, as well as keep myself hydrated. But I think the fear of going low all the time was a little too strong, which meant that I was running a bit higher than I’d normally like for most of the vacation. My paranoia about drinking plenty of water, though, was not a joke. I pride myself on being good about staying hydrated, but I struggled to keep up with the dry desert heat. I can’t help but wonder: If I’d been better about drinking water, would it have benefited me during some of the stickier high blood sugars? Speculation can only get me so far now; however, all signs are pointing to probably yes.
  2. The strip – The Las Vegas strip is less than five miles in length, but the whole stretch of it, marked by hotels, stores, casinos, and ginormous flashing lights, feels incredibly long. Nevertheless, my friends and I naively believed that we could skip taking taxis and walk all over the place. For the most part, we could, but it was definitely dicey when we walked nearly a mile and a half from the Cosmopolitan to the Rio one evening. It influenced my blood sugar in a positive way – the exercise brought my levels down to a nice and stable place – but that didn’t mean it wasn’t scary to walk practically on the highway at nighttime.
  3. The alcohol – I’m well aware of the fact that different kinds of alcohol can have different affects on blood sugar. To minimize blood sugar swings, I stuck with the less-sugary options as much as I could (i.e., opting to order a rum or whiskey with diet coke), only getting fancier drinks when I was consuming fewer carbs at mealtime. For the most part, this strategy worked well and proved to me that a little extra thought can go a long way when it comes to deciding how to treat yourself. But it also reminded me why I don’t have weekends like this often – it’s exhausting enough to take care of myself on a daily basis without alcohol being a factor. Throw it into the mix and I’m watching my blood sugar so carefully that my CGM’s battery is drained in half the time it normally takes to zap it.
  4. The pizza – The scientific answer to the reason why pizza is tough on blood sugar involves the glycemic index and some fairly complex calculations…boring! All you really need to know is that it takes a long time for pizza to have an affect on blood sugar due to its high fat-to-carb ratio. As a result, it tends to be a “treat” food for me that I only indulge in every once in a while. But when in Vegas…you have as much of it as possible. Pizza was one of the quickest and easiest food options for me and my girlfriends throughout our trip, so we ate it multiple times. I don’t regret a single cheesy, delicious bite…but I am slightly remorseful for not doing a better job bolusing for it. The first time we had pizza, I didn’t give myself enough insulin. The second time, I gave myself too much and went low, though that may have happened because I didn’t finish both slices like I thought it would. The bottom line? I didn’t realize that pizza would be a dietary staple on this vacation, and I’ll probably refrain from eating so much of it on future vacations.
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A slice a day does not quite keep blood sugar at bay. But it’s tasty as hell.

Despite the diabetes curveballs I encountered, I enjoyed my trip to the fabulous Las Vegas. I managed the challenges as best as I could without letting them interfere too much with what I wanted to do. Plus, it helped that my best friends were with me the entire time. I have to give them credit for making the most of my diabetes difficulties, too. For instance, I felt badly about sidelining them in the Bellagio on our last night there due to a low blood sugar that crept up on me after walking (the strip!) and over-bolusing (the pizza!), but they really rolled with the punches and made the most of it. In fact, I’m pretty sure they experienced their favorite people-watching moments while we sat and waited for my sugar to come up (I got a kick out of the weird people coming in and out of the lobby, too, but was slightly more focused on raising my number).

Thank you, Kortney and Roshani, for accompanying me on an incredible girls’ trip and for being my best friends in the world. Maybe Las Vegas 2020 needs to happen – now that we know to expect, perhaps my diabetes will be a more cooperative travel companion the next time around!

How Time Traveling Affected my Blood Sugar

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I traveled through time last week.

No, I didn’t use a magical device or step through a portal. It’s much more boring than that: I flew across the country, east coast to west coast, to spend a few days in Las Vegas.

Okay, there’s no way in hell that I could justifiably describe my Vegas trip as BORING.

But my point here is that flying through a couple different time zones is totally trippy. And, of course, it impacted my blood sugar. Because why wouldn’t diabetes just cooperatively come along for the ride?

I knew I should anticipate some sort of blood sugar swings going to and from my destination, I just wasn’t sure of when and how they’d hit. But I did know that when I landed in Vegas, the first thing I needed to do was adjust the time on my PDM (my insulin pump). Surely, my blood sugar would not react kindly to thinking that it was three hours later than it truly was in my new time zone. My question, though, was when should I do this? On the plane? After we landed? Should I adjust it slowly, in one-hour increments? Or should I dial it back entirely in one go?

Normally, I would’ve asked my endocrinologist what to do – but I forgot to bring it up during my last appointment with her a few weeks ago. So naturally, I asked the next best source: the Diabetes Online Community (DOC).

The answers I received were varied…

…nevertheless, I appreciated the immediate replies. I decided to quit stressing about it so much and focus on getting to the actual destination, vowing to keep an eye on my blood sugar for any suspicious trends while on the flight.

Five and a half long hours later, my travel companions and I arrived at our hotel. While in line for check in, I fixed the time on my pump and glanced at my CGM (which I didn’t bother adjusting, since none of the settings on it or my meter were dependent on time). I was steady at 97 mg/dL…not too shabby at all. And I’m pleased to say that I maintained that decent graph for the next day or so. I was nonplussed by the phenomenon, but I couldn’t complain about it.

The next few days are a different story, due to some “lifestyle choices” I made while in Vegas (c’mon, you know all I mean by that is eating junk food and imbibing alcohol). But that’s a tale for another post, coming soon.

This one’s about time travel, and while I had no issues flying TO Vegas, I did encounter trouble flying home FROM Vegas. My friends and I chose to a red-eye flight, which I don’t regret per se, but I’d never done one before and didn’t realize how much trouble I’d have falling asleep on the plane. It was disorienting enough leaving one place at 9 P.M. to arrive in another at 5 A.M., but add a freezing cold aircraft, turbulence, and an unsettled stomach to the mix, and you’ve got a recipe for disaster. As I tossed and turned in my seat, violently shivering a few times, my blood sugar was very slowly, incrementally, rising. I didn’t realize how much until we landed and drove home, where I had to bolus for an out-of-the-blue 308 mg/dL. I was so bloody tired, yet sleep evaded me further as I anxiously waited for my blood sugar to budge – which it did, but not for several, agonizingly long hours.

It definitely didn’t help matters that I wasn’t eating regularly; at the time of our arrival home, I hadn’t eaten real food in about 36 hours due to nausea that wouldn’t seem to leave me alone. I’d muscled down toast and a couple of granola bars, but not much else. I’d like to think that my entire body was just rebelling against me for spending the weekend eating too much pizza, staying up too late, and drinking a little too much whiskey, because that train of thought at least helps me make sense of my lack of appetite and recurring high blood sugars.

I’ve been back on the east coast for a couple days now, and I’m relieved to report that things have settled down. I’m eating regular meals (and I actually feel hungry for them), and besides a few flukes in my CGM graph, my blood sugars are mostly back to normal. I wish I could say that there was some big takeaway from this all: that I know exactly what to do next time I travel through time zones, or that I know just what to do to prevent it. But that’d be silly, because with diabetes, there are just too many variables. At least I CAN say that I know to take it in stride next time, to roll with the punches. Monitor my blood sugar like a hawk, correct as often as needed, eat normal meals as much as possible, and drink plenty of WATER. In any case, isn’t that what diabetes is all about…

…regardless of time travel and/or sorcery?

 

Diabetes Connections: Gym Edition

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“Are you a diabetic?” Despite the fact that I was wearing earbuds, I heard the question that was undoubtedly being directed toward me.

I glanced to my right and met the gaze of the teenage girl on the treadmill next to me. I smiled, tugging an earbud out, and said, “Yes, I am. My OmniPod gave it away, didn’t it?”

She nodded eagerly. “I have a Medtronic pump, but I know what an OmniPod looks like. When I saw it, I had to say something to you.”

This marked the beginning of what wound up being a thirty minute interaction with Shae, a high school senior with bucketloads of energy and questions for me about life with diabetes. We specifically chatted about college, and I couldn’t resist telling her all about the College Diabetes Network and what a useful tool it was for me during my three and a half years at UMass. The more we spoke, the more it felt like I was looking at a mirror image of myself from seven years ago. She had just finished taking her AP Psych exam and was relieved it was done. Her senior prom was in a few days, and she described how she’d wear her pump while donning her fancy gown. She was excited about college, but a little nervous about the dreaded “Freshman 15” and whether her diabetes would adjust well to college dining halls.

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It’s so funny to think how something as crappy as diabetes can introduce so many amazing people into your life.

I did my best to answer Shae’s rapid-fire questions frankly but reassuringly. As I told her about how much my CGM helped me in college (especially since I was still on multiple daily injection therapy at that time), she exclaimed that I was inspiring her to want to give her CGM another shot (pun unintended – I love spontaneous diabetes humor).

As we parted ways, we both grinned broadly and wished one another well. This is why moments like this – diabetes in the wild – are so great. Diabetes instantly bonds you to a stranger who you might not otherwise ever interact with, and the beauty in that immediate connection is priceless.

What It’s Like to Wear a Medical Device 24/7

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A question I’m often asked is: “Can you feel your CGM or insulin pump on your body?”

The simple answer to that is: usually, no. It’s something that you just get used to. You grow accustomed to seeing a lump underneath your clothing. You adjust to putting clothes on (and taking them off) carefully to avoid accidentally ripping a site out. You acclimate to showering without being completely naked.

And, of course, you get used to the questions from strangers asking about that device stuck to you.

But the more honest answer to that question would be that there are times that I feel it more than others. For example, sometimes I forget where I’m wearing my pump until I hit it against something (I’m a major klutz who constantly runs into doorways and trip over things, almost always managing to catch my pod on whatever it is), resulting in pain at the site and a curse word or two to fly out of my mouth.

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My OmniPod (on my arm) and my Dexcom (on my stomach) are stuck on me 24/7.

I feel it the most, though, when people stare. Whether unconsciously or purposely, people do ogle at it in very not subtle manners. Which makes me feel extremely uncomfortable. It’s worse when they don’t even ask me what it is – I’d rather have a chance to use it as a teaching moment than to have someone walk away not knowing what the device does. This tends to make swimsuit season a little less welcome for me. Nothing will stop me from donning a bathing suit at the beach or by the pool, and I do so as much as possible in the summertime. But it’s just not as fun when I’ve got to cope with lingering looks, especially when I’m an admittedly insecure person in the first place.

So it’s a more complex question to answer than you might realize. Wearing a medical device 24/7 is humbling. It keeps me alive. I’m privileged to have access to it. I’m grateful for the ways it’s improved my life. I’m always wearing it, but it’s not at the forefront of my mind – unless it chooses to make its presence known by alarming, or I’ve got people blatantly checking it out. It’s kind of like diabetes itself. It can make you feel a gamut of emotions, but no matter what, it’s always there. It’s just a part of me, and I can deal with that.

How to Change an OmniPod

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I decided to do something a little different and take video of how to change an OmniPod. Rest assured, though, that it does not take 22 seconds – it’s more like a seven-minute process.

Some things you’ll notice about my process:

  1. I fill my syringe with insulin and set it aside before deactivating my old pod. This simply means that I wear the old pod a little bit longer so there’s less of an interruption in time that I go without insulin.
  2. I use a pen to smack bubbles out of the syringe. Air bubbles will inevitably develop when drawing insulin out of a vial, so I find that gently hitting the sides of the syringe with a pen is the most effective way to get rid of the pesky air pockets.
  3. I prep my site with an alcohol swab, followed by a skin-tac wipe. The alcohol merely cleans the site, whereas the skin-tac makes the pod adhere to my skin better and longer.
  4. The new pod activates best when it is adjacent to my PDM. I always place my new pod to the right of my PDM. This helps the PDM register the new pod.
  5. It doesn’t actually hurt when I rip off an old pod. Not sure if you detected my dramatic facial expressing, but I was just yukking it up for the camera. It truly doesn’t hurt, especially if you just remove it in one swift motion.

So that’s it, the full process boiled down into 22 measly seconds. I admit that I kind of had fun making this video, even though the sight of myself sans make-up is semi-horrifying. But give me a break, I was on my way to a Pilates class! And let’s be real, diabetes isn’t always glamorous.

Insulin Pumps and X-rays

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“You have to remove your insulin pump before we can take your X-rays,” the technician said to me. I stared at him, and responded point-blank, “What? No, I can’t take it off.” I tried to hide the panic in my voice, but it quavered as tears stung my eyes.

“Well, let me check our insulin pump protocol…” his voice trailed off as he left me in the dark room with my right arm held up in the air in an attempt to mitigate the throbbing sensation going up and down my forearm.

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That pod on my arm can’t simply be removed on command.

When I fell and broke my ulna a couple weeks ago, my insulin pump was one of the last things to cross my mind as I was shuffled from doctor to doctor and one medical facility after the other. All I could concentrate on was the injury – how severe was it? Would I be able to work? Could I keep up my exercise regimen? Was I going to need surgery? My diabetes, for once, was far from my thoughts.

But this instantly changed when I went to get an X-ray. When the technician told me that I’d have to remove my pump, I wanted to shout at him, “No! If I do that, my blood sugar will skyrocket! You can’t expect me to do that!” It was hard to keep calm, and my emotions were already running amok due to the chaos of the morning so far. So even as I tried to fight the tears, a couple escaped and ran down my cheeks. When he came back into the room, the X-ray technician’s expression changed. He looked at me empathetically.

“It’ll be okay. Come on, let’s call your endocrinologist. We’ll see what she has to say and get this all figured out.”

Twenty minutes later, after a series of phone calls and a few accidental hang-ups, we received confirmation that I could, indeed, wear my pump for the X-ray. The nurse practitioner who I spoke with at my endo’s office said that it was safe as long as I wore the protective vest. “It’s really only a problem if you’re going in for an MRI or a CAT scan, because those involve magnets,” he told me.

Once I got off the phone, I ran over to the X-ray technician and explained it to him. He smiled at me and said, “Got it. Let’s get these pictures over with – you’ve already had quite a day so far.”

I nodded and thanked him for his patience. He was right, I was overwhelmed from the events of the day – it wasn’t even noon yet – but in hindsight, I’m glad that the technician didn’t try to fight me when I said I couldn’t remove my pump. His willingness to hear me out was huge. It’s not easy to be your own advocate in a high-stress situation like that. But I’m proud of myself for speaking up and getting the answers we needed. Everything worked out in the end – well, except for that pesky broken-bone bit.

Traveling with T1D: Upon Arrival

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Bags packed? Check. Made it to the airport? Check. Boarded the plane? Check. Touchdown? Check. I’ve made it through the actual travel part of my trip. Yay! But after all that, I’ve still got a routine to follow, even though I’ve reached my destination.

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This little cooler comes in handy when en route to a destination, but I always feel much better when I can get my insulin vials into an actual refrigerator.

It’s pretty straightforward, really. I simply need to determine where to keep my diabetes supplies for the duration of my stay. If I’m in a hotel room, I locate the mini fridge and stash my insulin vials  in there. I tend to keep everything else (pods, swabs, etc.) out of plain sight in order to avoid attracting attention from housekeeping. I mean, if I was going in and out of hotel rooms all day long and noticed that one contained a bag filled with needles, I’d probably get a little suspicious. So this means my other supplies live in my suitcase for the week, in an easily accessible pocket.

It’s easier if I’m going to be visiting with friends or family. I still find a fridge to home my insulin, but I worry less about “hiding” my supplies. I’m able to keep them in a spot that’s convenient for me, which helps make site changes throughout my trip a smoother process.

Speaking of site changes, I find them particularly annoying when I’m on vacation. It feels like I have to plan a day – or several days in a row – around the fact that I’ve got an upcoming site change. But planning is a part of T1D management, so I’ve come to accept that I need to be diligent with scheduling activities and meals around it.

Sometimes site changes are no big deal on a trip, other times they’re a whole event (like when my mom and I went to Disney and had to change our pods in the parks – going into a family bathroom to do it was not overly fun). And other, more seldom times, site changes are reminders of why it’s so important to pack extra supplies on a trip.

Case in point: My family and I went on a Caribbean cruise a few years ago. It was an amazing vacation, but also one that presented a few challenges regarding diabetes. I was spending a lot of time in the sun and on beaches, and that took a toll on my pods a couple of times. I had to rip off pods prematurely twice on this trip and replace them with my backups. Thank goodness I had thought to bring a pod for every single day of the vacation (seven days, seven pods) – because I wound up using five of them. So I never feel badly about obsessively packing tons of extra supplies that I might not necessarily use, because I never know when they’ll come in handy.

Travelbetes. It can be kinda complicated; hence, it requires its own word. But it’s worth it in the end, because my choice to travel independently with diabetes shows that it won’t stop me from seeing new places.

Diabetes in the Wild

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Diabetes in the wild refers to a random encounter with another T1D when out and about. My favorite recent occurrence of this happened when I was in Disney World with my mom (also a T1D). We had just entered Animal Kingdom. I was sporting my pod on the back of my upper arm.

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I don’t think Timon noticed my pod, but another T1D in the park sure did!

“Hey, Podder!” I heard someone yell. For a split second, I thought someone was saying, “hey, Potter,” you know, like the Harry Potter kind of Potter.

I looked around and saw a girl a few years younger than me waving her arms in my direction. When we made eye contact, she smiled and pointed at her pod. I gave her a thumbs up and the moment was over as quickly as it happened.

But it puts a smile on my face when I think about it, because it goes to show how awesome these chance meetings are – they serve as little reminders that even when I may feel like the odd duck in a crowd due to my pod, I’m not as alone as I think I am when it comes to diabetes.