Memory Monday: The Shattered Insulin Vial

One Monday per month, I’ll take a trip down memory lane and reflect on how much my diabetes thoughts, feelings, and experiences have unfolded over the years. Today, I remember…

…the insulin vial that my mother and I accidentally broke in the bathroom of a restaurant, many years ago. R.I.P., tiny vial of Humalog.

This goes back to the days of having to scurry off to the restroom soon after ordering our meals to check blood sugars and inject insulin. And it was a pain. We wanted to be considerate of other diners around us in the restaurant, so doing our diabetes things at the table wasn’t an option. That left us with the most logical choice, the bathroom.

On the night of the broken vial, we were having dinner at a local restaurant. Once our dinner orders were placed, we headed off to complete our routine. And it went just as expected: We knew our blood sugar levels and did the mental math necessary for figuring out our insulin intakes. If memory serves correctly, I was still at an age where I wasn’t totally comfortable with injecting myself yet and would ask my parents to help me whenever we were in a public place (I felt better about self-injecting at home, my literal comfort zone). So my mom ushered me into a stall and went about filling her syringe, then mine. Soon after she stuck me with the needle, it happened…the vial fell. I don’t know if it was my hand or her elbow that knocked it off from its perch, but something caused it to tumble down to meet its end.

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It was a dramatic moment. If a slo-mo camera had captured the ordeal, I’m sure it would’ve shown my mother and I donning identical, horrified expressions as the vial smashed into smithereens on the tiled bathroom floor.

 

 

 

 

It wasn’t the end of the world; after all, we’d just taken our shots before the incident, and the vial wasn’t completely full. But it was just full enough that we were upset about all the wasted insulin that formed a small puddle on the floor.

I remember my mom gingerly picking up the pieces of the fractured vial and disposing of them, sighing as she went about the task. That whole experience resulted in a few things. 1) We made sure to get a vial protector soon after it happened to help cushion future insulin vials that were accidentally dropped and 2) We got insulin pens a bit further down the road, which proved to be much more durable and portable than vials. In fact, they made it so we could do injections at the dinner table, in the car, and just about anywhere with ease and discretion.

But this incident remains etched in my memory because it instilled always being careful with my diabetes supplies from that moment on. All of my diabetes stuff is expensive and extremely precious because of what it does for me, my mom, and millions of other people on a daily basis – it’s got to be treated carefully, always.

Why Backup Supplies are Important to a T1D

“It’s better to have it and not need it, than to need it and not have it.”

Growing up, this mantra was frequently repeated by my mother regarding my diabetes supplies. More often than not, I’d roll my eyes at the saying – not because I was annoyed with her, but because the prospect of carrying extra supplies “just in case” felt very inconvenient. My purse/backpack/overnight bag would already be crammed to maximum capacity, so squeezing in backup needles or insulin was practically impossible. But typically, I’d cave and make it all work somehow, because the fear of not having something essential when I was away from home was strong enough.

I’ve kept up this practice in my adulthood, as overnight travel and increased distance from home have become more common. And I was reminded why it’s a good idea very recently.

I was staying at a friends’ place for the night. They live about 45 minutes away from my house, which isn’t far, but it was far enough for me to want to make sure I had extra supplies. I definitely did not want to have to make that drive twice in one night, and I knew it wouldn’t even be a realistic option, because chances were good that I’d be drinking alcohol – it was game night, after all.

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If you have T1D, always be prepared.

Pizza, beers, and laughs were had, and before we knew it, it was one in the morning. We all headed off to bed, and just as I do every night, I checked my blood sugar before I got totally settled.

I was wicked high – the mid-300s, actually.

I was worried, because I thought I’d been on top of my blood sugar for most of the night. I gave myself an extended bolus for the three slices of pizza I ate, limited my beer intake (too many carbs), and kept a watchful eye on my CGM. While I did know that my blood sugar was climbing, I thought that I was staying on top of it with correction doses. Apparently not.

No matter, I figured. The best I could do was take more insulin, drink some water, and try to relax a bit before bed. I didn’t want to sleep until I knew my numbers were coming down, but I also knew that my willpower to stay awake was fading. So I set an alarm on my phone to wake up in an hour and check my blood sugar again.

When I did, I was 377! I couldn’t believe it. I followed the same process again – bolused, drank water, set an alarm to wake up in another hour – and hoped for the best. But when my alarm blared again at 3 A.M. and I discovered that I was STILL stuck at 377, something told me that there was more to the story here. I lifted up my shirt to check my pod, which should’ve been securely stuck to my belly…except it wasn’t. The end with the cannula was sticking up, revealing that the cannula was not underneath the surface of my skin.

I felt simultaneously pissed off and relieved. I was mad because I’d just changed my pod earlier that day, so it should not have come off so easily. But I was relieved because finally, I had an explanation behind the super-high, super-stagnant blood sugars.

And I was seriously relieved that I’d thought to pack my insulin, a spare pod, and an alcohol swab in my overnight bag.

So there I was, changing my pod at 3 A.M. Far from fun, but it was necessary. I even wound up giving myself an injection with a syringe – yet another diabetes supply that I don’t really need to carry but had stowed away in my kit (just in case) – to ensure that my system had insulin in it to bring my blood sugar back down.

From there, it was a long night (morning!) as I set numerous alarms for the next few hours to wake up, check my blood sugar, and bolus more as needed. I couldn’t rely on my CGM for readings, because guess what? It got torn right off my arm as I tossed and turned in bed. Go figure, right? (I didn’t have a backup sensor because the CGM is one thing that isn’t exactly necessary. It makes life a helluva lot easier, but for a single overnight trip, an extra sensor wasn’t needed.)

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What a long night…

I probably only got three hours of sleep that night, and I was pretty damn defeated looking at a shitty CGM graph the next day. But you know what? The whole incident serves as a stark reminder that it’s important to ALWAYS have backup supplies: You never know when you might depend on them.

Happy Birthday, America!

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!

Memory Monday: The Diabetes Diet, 100 Years Ago

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.

Banana, No Bolus

I ate a banana the other day without needing to correct for it. My blood sugar prior to eating it was 96 mg/dL. I sensed and oncoming low, and trusting this instinct, I decided to skip bolusing (taking insulin) for it. Two hours later, I was 108 mg/dL.

How did I do it?

Did my pancreas suddenly start working again?

Was it a low-carb banana?

Was sorcery involved?

I’ll explain how it happened; no, my pancreas didn’t suddenly decide to start secreting insulin; no, because low-carb bananas aren’t even a thing; and sadly, no, though I do wish I was well-versed in real-life wizardry and/or witchcraft.

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It happened because I was running around like a maniac that entire morning. High activity levels can do a number – that is, lower the numbers – on a diabetic’s blood sugar. Between walking my dog, playing with him some more outside, and running errands, I scarcely had a chance to catch my breath from the time I woke up until noon. It was still mildly surprising, though, since bananas are a notoriously high-carb and fast-acting food. I’d expected to be at least 50 points higher from the initial blood sugar.

I was pleased with this outcome, but I still think that the voodoo magic – ahem, science – behind diabetes is just plain weird sometimes.

 

Spare a Rose this Valentine’s Day

Happy Valentine’s Day, readers. Whether you celebrate the holiday or not, I’d like to make you think about a dozen roses today.

A dozen roses is a classic Valentine’s gift, right? But what if you received 11 roses in your bouquet, instead of 12? What if you knew that a rose was spared because the value of that flower helped support a child living with diabetes in a less-resourced country?

I bet you wouldn’t mind getting one less rose in that case.

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This Valentine’s Day, please consider sparing a rose. Life for a Child is a nonprofit charity that created the Spare a Rose campaign. They’re able to support nearly 20,000 young people living with diabetes by using donations to buy them insulin, syringes, clinical care, diabetes education, and more. Anyone who’s familiar with diabetes realizes that access to care, education, and resources is critical to living a healthy and normal life. No one would want to deny another, especially a child, from having to forgo these resources because of the financial burden associated with them.

Spare a rose and save child this Valentine’s Day.

Sometimes, You Just Need to Enjoy the Sushi.

Or the pizza. Or the burrito. Or the decadent three-layer chocolate cake. Whatever the high-carb indulgence is, I’d rather just relish in it rather than focus on my diabetes.

Does that make me a “bad” diabetic? No. It’s not like I’m skipping an insulin dose or binge-eating food. I’m merely trying to enjoy a rare treat as well as the social experience that comes with it – like having sushi with coworkers.

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A recent sushi dinner reminded me that it’s okay to stop thinking about my diabetes for a little while.

So instead of staring at my double-up arrows on my Dexcom, I’m staring at the artfully arranged sushi platter in front of me.

Instead of ordering the lowest-carb item on the menu, I order what I actually want to eat.

Instead of fretting over how quickly my insulin will kick in, I fret over which sushi roll I should try first.

Instead of letting my diabetes take over my dinner, I’m letting it go and living.

Sometimes, I need to remind myself that it’s okay to stop obsessing over my blood sugar in order to just live and enjoy my life.