DASHed Hopes No More

I have some exciting news…I’m switching to the OmniPod DASH!

While I won’t start using my DASH until after my old OmniPods are used up (first generation OmniPods aren’t compatible with the DASH PDM), I’m still really excited about switching things up. Nearly a year ago, I expressed my desire to switch to the DASH in addition to my frustration that it would be more expensive for me to make the change.

But with a new job comes new health insurance and a whole new set of “rules” that I’ve been figuring out in the last couple of months.

And let me tell ya…it hasn’t been easy. But more on my struggles to get my basic diabetes prescriptions filled under my new health insurance to come in a blog post very soon…

Violet is excited about my new DASH PDM, too!

Anyways, back to the DASH. When I called Insulet to report a failed pod not too long ago, the representative I was speaking with was asking me if I’d heard about or was interested in the DASH system. Normally, I would’ve brushed her off and explained that I was only interested in getting a replacement for my failed pod that day, but I happened to have some spare time on my hands and decided to ask her if she could see if/how my new insurance would cover the DASH.

She kindly did some research and reported back to me that yes, it was indeed, and that all I’d have to do is get my doctor’s office to prescribe some DASH pods to me and in the meantime, Insulet could send my DASH PDM to me so that I had it on hand when I was ready to start using it. What really sold me, though, was the price – I’d be paying less for a 90-day supply of DASH pods than what I was paying for regular OmniPods under my old health insurance plan.

It was a no-brainer, really.

Even though I’m not DASHing away to start up my DASH (again, gotta make use of those old pods first), I’m still looking forward to getting acquainted with a new piece of diabetes technology that will feel familiar to me because of my years on the OmniPod system. I can’t wait to share more when I finally get DASHin’!

How I React to People’s Diabetes “Horror Stories”

I attended a family reunion earlier this month and got into a conversation with a relative who’s well into her 90s. She was asking me what I do for a living and I kept my explanation fairly high-level: “I work with college students who have diabetes”.

(Which, side note, I help handle the communications side of things for CDN and so far, I don’t often interact with the students…but I figured this was still a semi-correct answer that spared me from getting into the social media aspect with someone who’s probably never even heard of Instagram.)

Her response to my job description was…interesting. She started telling me the story of a “young bird” she once knew who had diabetes, needed dialysis, and then got her foot amputated. And then died.

This is a classic diabetes “horror story” that people often seem to tell when they discover that the person they’re speaking with has diabetes. It’s a story that’s told as a knee-jerk reaction: Either the person expresses their sorrow for the fact that the other person has diabetes, or they tell the tale of someone they knew who had diabetes and suffered immensely from it.

It’s a strange phenomenon, for sure, but one that happens across the board to people with diabetes.

You might be wondering…how do I react in situations like this? Is there a right or a wrong way to handle them?

Diabetes horror stories are not among my favorite kind of tales.

I chose to navigate this particular interaction by nodding sympathetically. While I truly was sorry to hear about this “young bird” and her fate, I was also very uncomfortable by the story. I’ve never felt “okay” about discussing diabetes complications because they scare the living daylights out of me, and I also was completely caught off-guard that a simple question about my job was enough to trigger the telling of this vignette. So for me, this wasn’t exactly a teaching moment in which I could correct this distant relative of mine and explain why it can be harmful to tell these horror stories; in fact, this whole incident made me realize that I don’t think I’ve ever truly reacted to a diabetes horror story when it was told to me.

And I think I’ve finally figured out the reason why…I just don’t want to engage with a person who’s going to react to my diabetes by telling me about the terrible outcome experienced by someone with diabetes who they may or may not directly know. What’s the point? What else am I supposed to say besides I’m sorry? I can’t really think of a graceful way to turn the conversation around, so for me, it’s always felt easiest to just nod, smile, say something compassionate, and then end the conversation by walking away or changing the subject completely. It’s not right or wrong, per se, but at least I know that I’m doing right by myself and my comfort levels.

This tried-and-true tactic of mine just goes to show that not every diabetes anecdote can be turned into a teachable moment – at least, not in my opinion or experience.

Diabetes in the Wild: Go-Kart Edition

Diabetes in the wild moments happen when they’re least expected.

I mean…I never go out anywhere in public assuming that I’ll run into another person with diabetes, or a person who will recognize my Dexcom sensors or OmniPods as diabetes devices. It just happens organically and it’s always a unique encounter. But given that my other most recent diabetes in the wild experience left me feeling awkward and uncomfortable, I wasn’t exactly looking forward to having another one any time soon.

But on my vacation, I did indeed have one that I’m pleased to share was much more pleasant than the last.

Yes, this is a graphic of an insulin pump taking a trip around a racetrack.

I was waiting in line for go-karts – as one does on vacation – when the woman in front of me spotted my Dexcom and asked me if I was type 1, to which I replied that I am.

This launched a short conversation about diabetes technology in general. She expressed knowledge of the OmniPod and I told her that I was wearing one, and she nodded eagerly and said how much easier it makes her life in the summertime, when she’s frequently swimming and doesn’t have to worry about disconnecting her tubing before going for a dip (a comment which I wholeheartedly agreed with). We exchanged a few more words about our diabetes devices, and before she turned her attention back to her group, she thanked me for taking the time to chat with her.

I couldn’t help but smile after the whole interaction. After all, it was kind of nice knowing that another person who just “gets” diabetes was standing inches away from me and looking forward to a carefree go-kart race, too.

Do You Know How Long OmniPods Last?

This post was originally published on Hugging the Cactus on June 3, 2020. I’m sharing it again today because I have seriously benefited from learning the “true” length of time that a single OmniPod lasts on my body. Read on to learn more…

When people notice my OmniPod insulin pump, the first question that I’m asked is “what IS that?”

After I explain that it’s my insulin pump, and it’s called a pod, the second question I’m asked is some variation of “how long does it last?”

The canned answer that I provide is something about having to change it every three days, because that’s how the OmniPod is advertised.

But I’ve used this pump for years now and never bothered to really test this three-day limit. I’ve known for a long time that my pod works a handful of hours after the expiration alarm starts chiming, but I wasn’t sure about exactly how many hours I had before a pod expired for good.

So, the other day, I decided to find out.

Have you ever made your pod last longer than 80 hours? If so…are you a wizard???

My pod expired at 10:22 A.M. Since I prefer to change my pods in the evening, I figured it was the perfect time for this little experiment, assuming that the pod really would last me for the majority of the day.

And, well, it did! At 10:22 on the dot, the pod beeped at me to notify me that it was expired. And in the six hours after that, it would alarm every hour (on the 22nd minute) to remind me, time and time again, that it was expired. In the seventh hour – beginning at 5:22 P.M. – my PDM started chirping at me on and off every 15 minutes or so. First it was because I was running out of insulin, but then it was to really get the point across that my pod was expired!

I was determined to use every last drop of insulin in the pod, though, so I bolused for my dinner around 5:45 and I was pleased to discover that I got my full dose of insulin without any issues. As I was cleaning up after dinner, that’s when the signature OmniPod BEEEEEEEEEEEEEEEEEP went off as one blaring, unceasing alarm. I checked the time: 6:22 P.M.

So there was my answer. An OmniPod can last precisely 80 hours after you initially activate it for the first time (or in other words, 8 hours after you receive the first expiration message)…as long as it still has insulin in it. It’s definitely something good to know for sure now, because in the future, it might come in handy and help me avoid wasting precious insulin.

My A1c Results are in and…

Before I left for my vacation, I had my (long overdue) annual physical with my primary care doctor. Like he does every year, he ordered bloodwork for me which meant that I had a whole host of health data to review on my online patient portal, including my current A1c.

When I saw that value up more than half a point from my last reading, my heart sank.

Now, I’m not going to say specifically what the reading was, because I’m a strong believer in keeping that sort of information to myself (and if you’re the type of person who shares their A1c, that’s okay, too – it’s just not for me). But I will say that it definitely isn’t the worst A1c reading that I’ve ever had, though it upset me because I think it’s the highest I’ve been since my college years.

Once it fully sunk in that this was my current A1c reading, like it or not, I started thinking about the why. Why have I gone up? I could think of a few factors…

  • I haven’t been eating super healthy; rather, I probably eat too many sweets that cause my blood sugar to fluctuate more than it ideally should.
  • The pandemic has changed a few things about my daily lifestyle – I don’t get out of the house as much I used to because I work from home, which means I’m in very close proximity to my kitchen and that gives me too many opportunities throughout the day to snack.
  • I get lazy and don’t bolus for “small” snacks (i.e., snacks with 10 carbs or less).
  • On the subject of laziness, I’ve been really bad about “eyeballing” my plates and portions lately when it would obviously behoove me to measure out my food and study my nutrition labels.

So those are the things I could think of that are the likely culprits behind my dissatisfactory A1c. As I sat and stewed over them and chided myself for my carelessness, though, I also tried to gently remind myself that A1c is only one measure of blood sugar “control”: I told myself that I need to bear in mind that my overall time in range is something that I should study and try to learn from, rather than dwell on this narrow snapshot of my 90-day blood sugar averages.

This is as close as I’ll get to sharing my personal A1c/time in range metrics… 😉

Using my Dexcom Clarity app, I learned that my time in range was suffering. I prefer to spend 80% of my time in range, and lately, I’ve fallen short of that goal. So after studying the amount of time that I spend “high” or “very high” (high blood sugars are always more troublesome for me than lows), I started to get a clearer picture of what was going wrong for me and what I might need to do to fix it.

This whole exercise, as bummed as I was to have to go through it, is going to serve as a great reminder to me that whenever I get disappointing news about my diabetes management, the best way to cope with it is to study the facts that I quite literally have available to me at the tips of my fingers. I know why my A1c is where it is, and I also know now the areas in which I need to improve. And that’s something to be grateful about and use as a motivator so that I can improve both my A1c and my time in range.

I know I can do it – I’ve done it before and can’t wait to feel that triumph over my diabetes.

How I Learned the Importance of Carb Counting

This blog post was originally published on Hugging the Cactus on April 6, 2018. I’m reposting it today because most people know that carb counting is important to a person with diabetes, but they might not understand exactly why. This post features an example that demonstrates all too well the negative implications associated with neglecting to carb count. Read on to learn how I figured out the importance of carb counting…the hard way…

One recent evening, I was rummaging through the kitchen pantry and noticed a bag of “veggie stix” stashed away, waiting to get opened. The sight of the bag instantly brought back memories of a time I was blatantly irresponsible with my carb counting and insulin dosing…

I learned the hard way that neglecting to count carbs can lead to scary high blood sugars…

…It was my junior year of college. I had plans to meet with a friend for dinner at seven o’clock. While that’s a standard suppertime for many people, it was kind of late for me. So that explains why I decided to treat myself to a snack a couple hours before it was time to go, just to hold me until I had my meal. My snack of choice? A bag of veggie stix just like these were sitting in the kitchen of my on-campus apartment. I thought I’d help myself to a few, believing (naively) that I had enough self control to know when to stop shoveling them down my gullet. That’s right, instead of doing the right thing and counting out a bunch before stowing the bag away, I was blindly consuming handful after handful without dosing for a single stick.

I can’t even use the defense that these veggie stix are strangely addicting – they really are, they taste a little like those potato sticks that used to come in cans – because I knew what I was doing wasn’t good for me. I just didn’t care. I had munched my way through half of the bag when it dawned on me that it would probably be smart to stop myself from eating more. I rolled up the bag, returned to my room, and did some homework until it was time to meet with my gal pal.

Little did I know that my blood sugar was rising to potentially dangerous levels.

I didn’t find out how high I was – over 400 mg/dL – until I reached the sandwich shop and had a plate full of chicken pesto carb-y goodness waiting to be consumed. My face must’ve shown my shock, because my friend asked me if I was alright. I quickly explained to her my mistake, and took an extra large bolus to cover my food and correct my blood sugar. Once that was done, I somehow managed to stop panicking long enough to enjoy the dinner with my friend, even though I couldn’t eat a bite of mine until an hour or so after injecting my insulin.

Although it sucked to go through this, I’m kind of glad that it happened because I learned a major lesson from it: ALWAYS count my carbs. It doesn’t matter if I WANT to be lazy or pretend that my diabetes doesn’t exist, I HAVE to hold myself accountable. It may be mentally draining and a bit of a nuisance, but it’s my own health here. It’s up to me, and me alone, to manage it.

And by the way, I did just help myself to the above bag of veggie stix. I had exactly 24 pieces, which equals exactly 5.4 grams of carbohydrates – a much smaller amount than what I ate that one night five years ago.

From Patient to Medical Student: My Journey with Diabetes Treatment – A Post by Konstantina Taki

This post was written by Konstantina Taki and it was originally published on the T1International blog on June 8, 2021. I’m sharing it here today because the journey from patient to medical student as person with diabetes has always personally fascinated me. Despite my interest in medicine, I’ve never actively pursued it as a career (and probably never will), but I appreciated learning about Konstantina’s experience. Thank you, Konstantina, for sharing your perspective!

Having lived with type 1 diabetes for more than 12 years, I have experienced different aspects of the condition. First of all, as a patient, I approach diabetes from a personal view. I can also understand how the condition affects parents of children with diabetes. It’s something new, demanding and difficult to handle. The last five years, as a medical student in Greece, I have seen diabetes from yet another more practical and scientific perspective.

The world of medicine is a marvellous, enormous one. It is a multifaceted science. When I started studying medicine back in 2016, I had a completely romantic approach. I was convinced that the core of medicine is the purpose of making people’s lives better. I believed that healthcare systems were patient-centered and every decision or strategy was made in order to ensure that people’s lives were safe and to improve their health. It was a challenge for me to realise that even in such a human-centered domain, there are motives and decisions which aren’t really altruistic. Instead they are often led by powerful companies.

“Inequality in treatment of people with diabetes should come to an end.” – Konstantina Taki

Over the course of time, I had to face the fact that pharmaceutical companies influence healthcare systems in such a way that healthcare professionals almost have no control. For example, a lot of medical research is funded by the pharmaceutical industry, or ‘Big Pharma’. So how can we ensure that the outcome of research is unbiased? The vast majority of medical seminars and conferences are also sponsored by Big Pharma. This means that organisations who want to support medicine without pharmaceutical industry support struggle in terms of fundraising. Healthcare systems, and the people leading them, tend to lose their purpose of saving people’s lives and improving the health of patients. Instead, they take advantage of people’s health to make profits.

Type 1 diabetes is a non-preventable chronic illness, and its successful management depends on insulin. Without insulin, a person with diabetes is in danger. Insulin belongs to the category of essential medications. I believe pharmaceutical companies take advantage and exploit this situation. Unfortunately, many patients, including those with diabetes, deal with the effects of Big Pharma’s politics and strategies. Having read articles, and later discovering T1International, I saw the process of how the profits of pharmaceuticals cause the loss of human lives. In 2021, people with diabetes still die of their inability to access the only drug that keeps them alive: insulin.

Your money or your life. This is a dilemma that seems to have deep roots in medical society. I am lucky, and I feel safe due to the fact that in Greece this phenomenon doesn’t occur as much as abroad. However, I did experience this dilemma personally in my Endocrinology appointment. In the examination room, there was my doctor, a nurse and a sales manager from a pharmaceutical company with diabetes products. The whole appointment was led by the sales manager. She was focusing on the weak points of my blood sugar throughout the session. Her aim was to convince me to start using a continuous glucose monitor (CGM), which at the time wasn’t distributed for free in Greece. Once I understood that she was trying to get me to use and pay for the product, I tried to focus on my diabetes management without discussing the CGM. The doctor was indifferent. She didn’t seem to be bothered by the sales manager. I ended up arguing with them and then I left the room.

Access to healthcare is an unquestioned human right for every person, which includes the need for medication and technology. Given the fact that the production and distribution of medication diabetes technology can provide extreme amounts of profits to companies, people with low or even no income are therefore excluded from healthcare systems. So who is being served by healthcare systems? Patients or profits? And how could all those profit-maximizing strategies come to an end or at least decrease?

Being able to approach diabetes as a patient but also as a medical student, and hopefully as a medical doctor in a few years, I have mixed feelings. I undoubtedly want to see a change. From a humanitarian view, I strongly believe that no human life is inferior when it comes to health and medicine. People should be treated equally, without discrimination or undue pressure. If there is one thing that medicine has taught me is how vulnerable we are when our health is at risk. In addition, I acknowledge that my awareness for this phenomenon is a result of the realisation of the catastrophic effects my life would have if I had no access to insulin. Companies should not hold patients hostage – but it happens every day.

The reason I appreciate T1International so deeply is its scope to change this condition through raising awareness and advocacy. Inequality in treatment of people with diabetes should come to an end. Health care systems globally must turn into patient centered systems. It is a difficult and slow process but nothing is unachievable. #insulin4all isn’t just a trend. It is a need, a vision, and hopefully one day it will become a reality.

Vacation Time

This time last year, I was headed to the beach for a week and wrote a post expressing my excitement over the change of scenery…and the fact that the CWD FFL conference was taking place, albeit virtually, during the same span of time.

I was beyond stoked to get away for a week, my enthusiasm no doubt fueled by having spent the last few months in isolation (with my parents) due to the pandemic. But I was also incredibly anxious seeing as I didn’t know how drastically this vacation would differ from the ones we’ve taken in years past because of COVID concerns. I wrote:

I have no idea if my family and I will be able to even go to the same strip of sand and ocean without having to worry about things like too many people and not enough masks. We probably won’t be able to eat at many restaurants like we typically do on vacation; instead, we’ll likely cook a significantly higher percentage of our food at home. And we definitely won’t be able to peruse the shops like we have done every year since going to this particular beach town – we’ll have to be a little more creative when it comes to staying entertained.

Granted, I also wrote in that blog post that I was grateful to have the FFL conference to “attend” as a distraction that was both one that I wanted but also one that might be necessary so I wasn’t completely without fun things to do over vacation.

The beach I’m heading to may not look exactly like this but that doesn’t make me any less excited for vacation.

What a relief it is to think about how much things have changed between now and then. Thank goodness for vaccines!

This is my long, roundabout way of saying that I’m on vacation all of next week and I’m so excited to have all that time to unplug and unwind. As much as I liked attending the FFL conference virtually last year, it didn’t foster that sense of community and joy as much as it does when I’m attending it in-person. I’m thrilled for the individuals who are able to go in-person this year, though – I know they’ll get so much out of it and have a truly fun time.

But for now, it’s time for me to hit the recharge button. I’ll still have a couple of new blog posts up and ready next week so be sure to come back then to check them out!

My Close Encounter with the Keto Diet

Remember that time that Oprah Winfrey did a Weight Watchers commercial and proclaimed loudly and proudly before the cameras that she loves bread? (If you don’t know what I’m talking about, here’s the link to the ad with a little doctoring done to it – it is worth a watch.)

Well, I can relate to Ms. Winfrey – except my obsession with carbs extends beyond bread. I love cake, candy, chocolate, pizza, pasta, sushi…and just about every other carbohydrate-laden food that exists. So while I think it’s awesome that many of my peers with T1D choose to follow low or close to no-carb diets, that’s not the kind of thing that works for a girl like me: I’m happy managing my diabetes in tandem with a moderate carb intake. But that’s not to say that I don’t eat lower carb sometimes or that I don’t have an interest in the principles of the keto diet, just because it’s so restrictive.

At least, that’s what I used to think about it.

Would my love of carbs prevent me from trying out aspects of the keto diet?

When my boyfriend decided to go on the keto diet back in May (he’s had experience with it before), I was simultaneously impressed with his dedication to it, but also a little worried. We have dinner together a few times each week and since I wanted to show him that I support him 100%, I knew that I’d have to change up my cooking so it adhered better with the dietary guidelines of keto.

So for the last two months, I’ve had a lot of exposure to the keto diet, and this is what I’ve learned about it:

  • It’s not as restrictive as I thought it would be. I figured that eating strictly keto meant that the only food groups we could eat were meats/proteins, fibrous vegetables, and cheese. That wasn’t 100% true. While we stuck to proteins and vegetables for most dinners, we also had plenty of snacks that kept things fun and interesting. I developed a mild addiction to cheese crisps and chicharrons (otherwise known as pork rinds). I also had a lot of fun trying different keto dessert options out there, including cookies, ice creams, and peanut butter cups (the latter being my absolute favorite).
  • Snacks can get expensive. One of the keto peanut butter cups that we ate cost $10 for a bag of 7. That’s an insane price. When you factor in the cost of other more expensive grocery items, like beef jerky or nuts, things add up quickly, which is definitely a downside to the keto diet.
  • My blood sugars tended to respond well when I ate keto…for the most part, anyways. Eating keto dinners was mostly great for my blood sugar and it stayed relatively steady more often than not. On the occasions it didn’t, it was because I was trying to bolus for the amount of protein or the negligible amount of carbs in the veggies I was consuming at dinner, and I would go low as a result. There’s an art to bolusing on the keto diet, for sure, but since I was half-assing it (really quarter-assing it) and not following it all the time, I never got a grip on how to account for minimal carbs.
  • Keto can inspire creativity in the kitchen. The best thing I made, ate, and loved throughout my experience with the keto diet was cauliflower crust pizza. I found the best recipe for it that was so easy to make and yielded delicious results. I always assumed that cauliflower pizza crust would be too difficult to make or not satisfying in the same way that pizza is, but that isn’t accurate at all. I grew to appreciate the challenge that keto presented me to come up with new things to eat that were tasty and filling, which I didn’t expect but liked.

Swimsuit Season is Here and My Diabetes Gadgets and I are Not Ready

A “yay”: Summer is here!!! Hooray for warm weather, beach trips, and backyard BBQs! (Not to mention VACCINES!)

A “nay”: My pods and my CGM sensors are about to bare themselves for the world to see and we are NOT READY for it.

My confidence in my appearance is rarely, if ever, high. But I like to fake it ’til I make it and act like I’m rocking my summer wardrobe instead of stressing about how my legs or arms look in the staples of the season that are designed to show more skin.

Usually, I have a lot more success in feeling good about how my medical devices appear on my body. Whether they’re hidden under my clothes or out for the world to see, I typically don’t care because these gadgets are keeping me alive!!! And that’s a lot more important than any negative body image connotations they may create.

A picture from a time during which I was very okay with PDA (public displays of my arms).

But something about this year feels different to me. I am so not looking forward to the extra stares that my diabetes technology attracts. I’m not sure if it has to do with being sheltered in the last year and a half because of the pandemic, but whatever the cause may be, this is something I’m grappling with as the temps creep up and the temptation to hit the beach grows stronger.

I know I’m not the only one dealing with this. In fact, I was in Maine for a couple of days with my parents and I was wearing my pod on my leg, whereas my mom had hers on her arm. And we had multiple people approach us about our pods! They weren’t necessarily rude in their approaches – curiosity drove them to speak with us and that’s innocent enough – but it’s still weird to know that people are looking closely enough at our bodies to see our devices and feel comfortable enough to ask us about them. Plus, I felt extra self-conscious about it because in typical Molly fashion, I had a sunburn all around my pod thigh site…when applying sunscreen, I almost always miss the area directly around my pods because I’m afraid of the sunscreen making my adhesive weaker or interfering with the pod’s functionality. So not only did I have this big chunk of plastic sitting on my leg, it was also red all around the site, drawing even more attention to it. It was a relief when I was able to put shorts on over my swimsuit and cover up both the burn and the pod.

So while I’m not loving how wary I’ve felt lately about baring my diabetes devices, I’m also coming to terms that it’s just a sort of phase that I’m going through right now. And that’s okay. I’m also trying to remind myself that I don’t have to feel obligated to go into detailed explanations when people ask me about my pod or CGM. It’s a natural tendency that I have to use it as a teaching moment and be a good diabetes advocate, but sometimes I just don’t have the energy for it. I’m keeping my fingers crossed that as the summer season goes on, my comfortability with my diabetes devices increases and I worry less about the looks they tend to draw.