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.

Diabetes and Technology

This November, I participated in the #HappyDiabeticChallenge on Instagram. This challenge centered around daily prompts to respond to via an Instagram post or story. I’ve decided to spread the challenge to my blog for the last couple days of National Diabetes Awareness Month. As a result, today’s post will be about diabetes and technology.

Diabetes and technology: a pair as iconic as peanut butter and jelly, Lucy and Desi, and Han Solo and Chewbacca. I can’t imagine managing my diabetes without all the technical tools and devices I have in my arsenal.

I’m grateful for all the tools we have at our disposal these days, because I know that this wasn’t always the case. I didn’t have to experience a time without a test kit. I didn’t have to deal with checking my blood sugar only once or twice daily using a complicated urinalysis system. Though I chose to take insulin via manual injections for many years, I had the option to try an insulin pump whenever I was ready. And when the CGM came around, approximately ten years after my diagnosis, I was able to start using this new technology.

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Just a few of the key technological components in my diabetes toolkit.

So I guess that diabetes and technology makes me think of two, somewhat contradictory, concepts: privilege and freedom.

It’s a privilege that I have a wide array of technology available to me. I’m lucky that I’m able to use it, because I know that many people with diabetes in this world cannot afford it or do not have access to it. It makes me upset to think about how diabetes might be harder for these individuals due to a lack of treatment and care options, but in that way, it reinforces how freeing diabetes technology has been for me. I have the freedom to bolus quickly and easily as needed. I’m free from annoying tubing, thanks to my OmniPod pump. I’m free to live a life less interrupted by diabetes, because my technology helps me manage it with greater finesse than if I were doing it 100% on my own.

That being said, I won’t ever take my access to diabetes technology for granted.

I can only hope that, as technology innovations continue to improve the quality of life for people with diabetes, technology accessibility becomes more widespread, as well.

A Diagnosis of LDM

What is LDM? According to my mother, it stands for Lovely Diabetes Mystery. The “lovely”, of course, is sarcastic, whereas the “diabetes” and “mystery” relate to a random, unforeseen diabetes medical incident – which occurred to me on Sunday, October 7th.

I woke up that morning with some abdominal pain. I rolled over soon after waking to check my CGM, and was startled to see that I’d be in the 300s for most of the night as I was sleeping. I quickly bolused for it using my PDM, and shut my eyes, hoping to get some more rest and to wake up again without stomach discomfort.

No such luck. About an hour later, I opened my eyes and looked at my PDM again, and I had barely come down. I tested to confirm, and sure enough, I’d only gone down a few points. I was worried, which was exacerbated by the weird nausea I was having. Could this be a sign of something more serious?

My mother convinced me to do a manual injection with a syringe. We both figured that that would help bring my numbers down faster, and that if I started coming down quickly, then it could mean that the pod I had just applied the day before was not working properly. We agreed that I should probably change it, to err on the side of caution.

However, I didn’t get to change my pod until much later in the day. That’s because of what happened soon after I took my manual injection.

I went to use the bathroom, certain that the churning of my stomach meant that I was about to be sick. I was standing in front of the toilet when I started sweating – profusely. On top of that, my vision went all fuzzy, and I felt totally disoriented. I knew something was wrong, so I called out for help.

My mom raced into the bathroom to find me seated on the floor, dripping in sweat. I placed myself on the floor deliberately because I was worried I might pass out and injure myself. She started cooling me down with a wet facecloth, and searched through the drawers to find a thermometer to check my temperature. She also grabbed her test kit and my lancing device, because naturally, we both assumed that perhaps my blood sugar was dropping rapidly from the insulin injection, and it might be a hypoglycemic event.

But when we checked my blood sugar, I was still in the high 200s. I was pretty scared at this point and just wanted the sweating to stop and for my vision to clear. That’s when my dad came in and made the executive decision to call an ambulance for me.

A police officer, three firefighters, and two EMTs showed up my house. I answered questions in my confused state. My vision restored and the sweating stopped, but I still felt weak and woozy. They put me into the ambulance. I was given an IV bag and medication for the nausea. It was my first time in an ambulance and it was not exciting, just weird. I didn’t like riding backwards or experiencing the twists and turns along the way.

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I was bored in the hospital; so naturally, I created this boomerang of my IV drip.

We arrive to the hospital. I’m whisked away into the ER. I answer a series of questions from various medical students and nurses and doctors. They draw blood for tests. I give them a urine sample for more testing. I keep on explaining the concept of my OmniPod to each one of them. No one seems to have seen it before, besides one med student who has a sister who works for Insulet. Small world!

We monitor my blood sugar closely. My tests come back normal. I eat my first foods for the day around 2 P.M.: sugar-free jello and two hard-boiled eggs. Yum…

I get an injection of insulin at the hospital. We don’t have a vial of Humalog with us – it was the one thing we forgot to grab from the house. But my dad drives home to retrieve it so I can change my pod at the hospital. My mom does it for me. I feel helpless.

The old pod comes off and we notice a definite bend in the cannula. Okay. One thing explained. I wasn’t receiving my full insulin dosages due to the bend, and unfortunately, I have no way of knowing how much insulin I was truly receiving. All I know is that it wasn’t enough, and that’s why I was running high.

I receive a diagnosis: vasovagal syncope, or pre-syncope. It’s explained to me, but I still don’t really get it. So I text my best friend, who is also a nurse. She tells me that it’s very common and can be triggered by a variety of things. The pre-syncope aspect makes more sense to me, seeing as I never truly passed out.

I’m discharged and feel so very tired. It was a long day. The following days are filled with follow-ups and message exchanges between myself, my endocrinologist, and my primary care physician. My healthcare team and I think that we come up with a plausible explanation for the hullabaloo: My body knew something was wrong. It knew that my blood sugar was abnormally high, and it knew to send signals to me that I needed to take care of it. Hence, the abdominal pain. My dehydrated state exacerbated things, and when I started sweating and lost more fluids, it was a lot for my body to experience.

Sheesh. What an ordeal. Like any diabetes-related experience, it taught me a lot, but I certainly don’t want anything like that to happen again. Shout-out to the healthcare professionals, but especially my parents, for taking damn good care of me throughout the whole episode. You’re the bomb diggity.

Favorite Things Friday: My OmniPod

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

This month’s favorite thing is so damn obvious that it’s kind of shocking I haven’t written about it yet on the blog: my OmniPod insulin pump.

I love the friggen’ thing.

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My OmniPod PDM.

I don’t know if it’s because pumping works better for me in general over multiple daily injections (MDIs), or if it’s because the OmniPod is simply the perfect pump for me. Honestly, it’s probably a combination of the two. I love how convenient it is – I can deliver insulin any time, any place, I don’t have to worry about tubing getting caught on random objects, and it lasts me for three full days (of course, only if it’s working properly…I’d estimate that it does about 90% of the time). And I love that my dosages are so much more precise compared to how they used to be when I was doing MDIs. It gives me more control, knowing that I can dose in .05 increments according to my current blood sugar levels and carbohydrate intakes.

However, it is merely another piece of diabetes technology, meaning that it does have some flaws. Sometimes pods fail for the silliest reasons, such as coming into contact with static electricity. And other times pods don’t work for no damn good reason at all, without giving the user proper notice (in the case of bent cannulas, something I recently encountered).

But for the vast majority of the time, I love my OmniPod. I’m still surprised to how quickly I adjusted to the system – the first week or two was tough, but then it was relatively smooth sailing after that period. I think it was easy for me to get used to another wearable device, because I’d already been wearing my Dexcom for a couple years by the time I got my OmniPod.

Will I wear my OmniPod for many years to come? Or will I want to switch things up and give another pump a try? Only time will tell, but for now, I think I’ll stick with what I know best in the world of insulin pumping.

When in Doubt, Change the Pod

I’d only been wearing my new pod for about an hour when my arm brushed up in exactly the wrong way against a chair. Riiiiiiiip!

My pod tore right off – not from my arm, but it lifted up from the adhesive that it was glued to and dangled precariously from the still-intact adhesive stuck to my arm.

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Would you have kept the pod on, or changed it?

After cursing loudly, I asked my mother for her opinion. I wanted to know if she could see the cannula, because that was the component that made me most concerned. As long as the cannula was still stuck under my skin and delivering insulin, it shouldn’t matter that my pod was a little loose – right?

She tried to peek under and around my site, but it was virtually impossible to tell whether the cannula was where it should be. I thought about it for a few moments, and decided that it would be wise to just change out the pod. The notion of tossing one that had only been in use for an hour was unappealing to me, but I know myself pretty well, and I know for damn sure that I would’ve been super paranoid about the pod functioning properly for the following 72 hours. I also figured that it couldn’t hurt to try calling Insulet to see if they would replace the kaput pod. The odds were slim, but why not try?

So after I changed my pod, I dialed up Insulet and described the situation to the customer support representative. And…I got a replacement! I was pleasantly surprised by the rep’s empathy towards the situation and how easy it was to get my replacement. She reaffirmed that I did the right thing, noting that if she’d been in my shoes, she would have called it in, too. It goes to show that when in doubt, change the pod – and don’t hesitate to call for a replacement.

Any Pods to Spare?

Not too long ago, the following message appeared in the inbox of one of my social media platforms:

I’m so sorry to bother with something like this. I down to my last pod. And.. currently I’m having insurance issues.. I was wondering if there were any pods you could spare? I’m trying to search around. Or if you know anyone that does have extras? Or samples? I would hate hate to return to multiple daily injections.. I know u understand that. If not it’s ok. Sorry to bother. I don’t know where else to try apart from everything else I’ve tried

When I read it the first time, my heart immediately sank. The message was fraught with desperation, as evidenced by the typos and fragmented sentences. My gut reaction was to reach out to this person and let them know that everything would be fine, that there had to be an option out there that would help them.

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No pods to spare.

My next reaction, though, was pure skepticism. I’m not proud to admit that, but here are the facts that I was facing:

  1. I did not know this person. I tried to look at their profile to see if I could learn more about them, only to discover that it was private. I couldn’t see any of their information, other than a minute profile picture and numbers regarding their followers/activity.
  2. This person said they might be forced to go back to MDI. Personally speaking, if I ran out of pods and had to go back to shots, I wouldn’t like it – but if it was my only option, then of course I’d do it. I did it for something like 17 years before ever trying a pump. It sounded like this person wouldn’t want to do it, but…
  3. Most importantly, I do not have any pods to spare. I’m not sure why this individual thought that I did. It seemed like they’ve been asking as many people as possible on social media for pods, which makes me believe that they’re exploring the #omnipod or #podder hashtags. Regardless, I rely on regular shipments (every three months) from Insulet in order to maintain the bare minimum of pods that I need. And I can’t exactly give up “spare pods” that I don’t even have.

As horribly as I felt for this person, I had to take into consideration the facts that were in front of me, as well as the unfortunate truth that you can’t trust everything on the Internet. I told them that they should try to reach out to Insulet for assistance, and that I would be hoping for the best for them. I know that my kind words probably brought little comfort, but it was all that I had to offer to this total stranger.

The whole exchange haunts me. That’s why I want to know…

What would you have done if you were in my shoes?

Diabetes in the Wild: Beach Edition

I’d just settled into my beach chair, ready to crack open a book, when I spotted her.

She was walking as quickly as she could through the sand to help her friend carry a cooler, but not fast enough for me to miss the CGM on her upper arm. I sat up in my chair and wondered whether I should say something to her – after all, not all T1Ds are excited to encounter one another in the wild.

She caught up with her friend and grabbed the other end of the cooler. As they passed me, I saw she was wearing an OmniPod on her opposite arm. Not just any OmniPod, though: This one was decorated with some sort of emerald green design. I took that as a sign, a literal green light, that she probably wouldn’t mind if I said something.

“Nice OmniPod!” I called out.

She looked around, trying to locate my voice. My mother, who’d been reading the whole time and was unaware of a fellow T1D in our midst, shot a bemused look in my direction as the woman finally made eye contact with me.

“I have one too,” I said, pointing to my arm.

“Nice! I like your decoration. Do you have a Dex, too?” She asked, smiling at me.

“Yup – I’m wearing mine on my abdomen. I saw you had both and couldn’t resist saying something.”

“Well, we’ve got two OmniPodders over here,” She pointed to where she’d set up camp for the day.

Beaming, I told her that we had two in our group, as well. My mom offered her arm up to show her pod. I think that Mom was half entertained, half embarrassed over the whole exchange, so it made me happy to see her join in at the end.

The woman returned to her spot and we wished her well. Mom and I soaked up the sun for a few hours before deciding to pack up for the day. As we were getting our belongings together, a young woman approached us.

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Proud to wear my pod.

“Excuse me, may I ask what is on your arms? I’ve seen numerous people wearing that sort of thing today and I can’t figure out what it is, for the life of me!”

I was going to answer for the both of us, but my mom beat me to the punch. She explained that it was an insulin pump, though other people may wear different medical devices that look similar to it. The girl, seemingly appreciating the response, remarked that it was cool and that she was surprised to see so many people wearing them on the beach. She wondered out loud if she was missing out on some sort of trend.

“Yeah, all the cool kids have them,” Mom said, and we all laughed.

I don’t know how many people on the beach that day were wearing OmniPods – or any other insulin pump, for that matter – but I do know for certain that my mom is right: All the cool kids have them, and they’re much cooler for wearing them with pride in full view of the world.