That “Thing” on my Arm

“Yo, I don’t mean to be rude, but what’s that thing on your arm? Looks pretty cool.”

I turned around to face the stranger who was looking at me and asking me this question. It was well after midnight and we were on the rooftop of a fairly crowded bar. It was a balmy, summery night and I was enjoying the atmosphere with my boyfriend and my best friend. I’d had a few drinks over the course of the night, but judging by the state of everyone else on the rooftop, I was probably more sober than most of them.

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THIS is the sticker I should’ve been wearing that night…keeps things much more simple.

I could’ve answered his question in a scolding manner; it wasn’t a “thing”, it was a device that keeps me alive.

I could’ve totally dismissed him and told him to mind his own beeswax, because really, it is sort of rude to point out something on another person’s body.

I could’ve lied and told him it was something that it’s not to get him to stop bothering me.

I could’ve launched into an educational breakdown of what an insulin pump is and why my OmniPod looks the way it does.

I could’ve done any number of things, but instead I decided to say, “Oh, this is my insulin pump. I’ve got it decorated right now with a picture of a lighthouse because I like adding some style to it.” I smiled at him as a way of reassuring him that I really didn’t care that he was asking me, because I didn’t.

My straightforward answer seemed to please this random man. He told me again that he thought it was cool, and then we chatted a bit about where the lighthouse is and discovered we both have a connection to Massachusetts. Within a few brief moments, the conversation was over as we went our separate ways.

It was a perfectly harmless interaction that could’ve went a number of different ways, but to me, it’s all about context. This guy was just asking out of curiosity, and I truly don’t think he was trying to be rude about it. So I answered his question succinctly but good-naturedly, because I felt that was the only way to go about it in this busy party environment. Plus, let’s be real here…had I delved into a discussion about diabetes and devices, this drunk man probably wouldn’t have digested a single detail of my description. (Ahh, I love alliteration.) And another important point? He was damn right, my pump did look cool because of the lighthouse sticker!

But man, how much simpler it’d’ve been if I’d just been wearing my “THIS IS MY INSULIN PUMP” sticker on my pod that night.

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I Dos and Don’ts: My Tips for Attending a Wedding with T1D

I can always count on diabetes to make life’s most joyous occasions just a bit more challenging…so I shouldn’t have been surprised when my diabetes threw several curve balls at me on my cousin’s wedding weekend.

There was the moment at the rehearsal dinner when I stood up to get something and hit my leg against a chair, literally knocking my pod off my thigh. (But I didn’t even realize it for another 20 minutes.)

There was the moment later that night, after the rehearsal dinner, that I discovered my blood sugar was high and that my mealtime dinner bolus probably was never delivered.

There was the moment the next morning that I realized my breakfast options were limited to a giant, carb-y bagel or a massive, sugary blueberry muffin.

There was the moment when I was with the bridal party – applying makeup, styling hair, and trying to calm the bride down – that it hit me that I had no idea what to do with my backpack (a.k.a., my diabetes bag) during the ceremony, as I had to be standing up there with the other bridesmaids during the vows.

There was the moment I psyched myself out big time by wondering what the hell would happen if I passed out in the middle of the ceremony in front of all of the esteemed guests.

There was the moment I went a little too overboard on drinking Prosecco at the reception…and a few more cocktails at the after party.

There was the moment I woke up the next day with a high blood sugar and hangover from hell.

Needless to say, there were quite a few diabetes “moments” over the course of an otherwise beautiful weekend. As a result of them, I’ve decided to document some wedding dos and don’ts for myself, as this won’t be the first time this year that I’m a bridesmaid in someone’s wedding. Here’s my unofficial roundup.

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Showing off my decked-out pod at the wedding reception.

Do have plenty of back-up supplies. I got lucky this time around because my parents were a phone call and short car ride away from me when my pod fell off. I should’ve been carrying insulin and a spare pod on me, but at least it was within my mother’s reach at the hotel room.

Don’t sweat the small stuff. Things happen, and I’ve got to learn to accept them more quickly so I can better adapt to a situation. It took me awhile to forgive myself for the pod snafu at the rehearsal dinner, and if I hadn’t snapped out of it, then it could’ve ruined the night for me.

Do try to plan meals when possible. I knew that I should avoid a high-carb breakfast on such a busy morning, but I can’t resist a blueberry muffin, especially when it’s one of two breakfast options I had. I wish I’d thought to bring food that had accurate carb counts on it so I could’ve had more predictable blood sugars throughout the day, but I did come back down from the sugar-induced high relatively promptly.

Don’t forget that family and friends are willing to help. My “problem” with my backpack was solved by handing it off to my boyfriend about 30 minutes before the ceremony started. I didn’t miss any photo opps with the bride and bridesmaid during the hand off and I felt better knowing it was in good care.

Do remember that time flies. I had to keep myself in context; after all, I was standing up in front of the guests for less than 30 minutes. I knew there was relatively little insulin in my system and that I was starting to level out somewhere in the 100s by the time the ceremony started. The odds of me passing out were slim, and I needed to give myself that reality check.

Don’t forget to drink plenty of water. Duh, that’s drinking rule #1! I’m embarrassed to admit that I maybe had two glasses of water during the entire reception and after party. It’s not like there wasn’t water available, so I don’t know what I was thinking. But I do know that I was incredibly lucky to hold onto stable blood sugars well into the night, despite my lack of hydration.

Do have a plan for hangovers. Sometimes, they happen, and they’ve got to be dealt with swiftly. After some consultation with my mother, I set a temp basal to fight against my high blood sugar and downed glass after glass of water. By early afternoon, I was feeling much better. And even though I had a bellyache, I didn’t yak, so I suppose that’s a silver lining.

And one extra “do”…do have fun with diabetes devices! I decked out my pod in a Pump Peelz sticker that had an image of the lighthouse we were near on it. Sure, it wasn’t visible to anyone but me (and a few people I couldn’t resist showing), but it still made me feel extra special and coordinated with the wedding venue. Sometimes, its the little things in life.

So besides taking several valuable dos and don’ts away with me from this weekend, I’m also walking away with a wonderful first experience as a bridesmaid to a cousin who’s always felt more like a sister to me. When it comes down to it, my irritation with diabetes doesn’t matter – it’s the love and celebrations I felt all weekend long that do matter.

A Device-Free Shower

For the first time in *literally* years, I took a device-free shower the other day.

AND IT WAS AMAZING.

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Ta-ta for now, little friends.

Let me clarify that by device-free, I mean that I wasn’t wearing a pump or a CGM on my body. Both were due to be changed that evening, so with what can only be described as unadulterated glee, I peeled my Dexcom followed by my pod off my body before practically leaping into the shower.

It probably sounds funny, and perhaps a little dramatic or flat-out fucking weird, but those 15 minutes without a single medical device stuck to me were glorious. I wasn’t worried about accidentally knocking something off. I was free to scrub off the adhesive that had kept the devices stuck to my skin, and I felt oddly empowered – carefree, even – that I could enjoy one of the most mundane daily routines without needing to worry about my diabetes. Sure, for the duration of my shower, I wasn’t receiving my basal rate of insulin, but I really didn’t care because 1) I took a small bolus to compensate for it before I removed my pod and 2) I was more focused on doing this one little thing for myself to reclaim my body from diabetes devices, even if it was for a short window of time.

So you might argue that I had my first truly nekkid shower for the first time in forever. And it made me happy. A brief reprieve from diabetes is always welcome, and I’ll take it in whatever silly form I can get it in.

A Pod Failure Won’t Foil my Fun

I had just zipped up my coat when I heard a faint, high-pitched beeeeeeeeeeep emerging from somewhere in the vicinity.

My mom and I exchanged looks. “Uh, oh,” we said simultaneously.

“It isn’t me,” Mom said, patting her pod.

“It can’t be me, it sounds too far. Are you sure it’s not the refrigerator door that was left open?” I asked, as I unzipped and peeled off my coat.

She didn’t have to answer the question, though, because as I took my coat off, the beeping sound grew louder. I looked down at my abdomen and cursed. Yup, my pod had just failed.

I wasn’t totally surprised that it happened. The dry winter air was triggering excessive static electricity that weekend, and the sweater I chose to wear that day seemed to be charged with it. I couldn’t move my arms without hearing little sparks going off. If I was smart, I would’ve changed my top to one that was less filled with static. But I had somehow managed to convince myself that there was no way my pod could possibly fail due to my clothing choices.

I know better than that.

The real kicker in this situation is that we were obviously headed out somewhere – we were hoping to go to our favorite bar for a quick drink. But with the pod’s failure occurring at basically the most inopportune time, we were left with a three choices:

  1. Stay home. Take out the insulin, wait a half hour, and resign ourselves to the fact that it just wasn’t a good night to go out.
  2. Go out, but take a syringe and a vial of insulin with us. That way, I could give myself a shot, if need be, while we were at the bar. We could head home after the one drink and I could change the pod once we were back.
  3. Go out and take a total risk by leaving all extra diabetes supplies at home, and just wait until after we had our drink to change the pod.
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A cocktail by the candlelight.

I like living on the edge sometimes, but option #3 is just way too dangerous. So we went with option #2. If you’re wondering why we didn’t just opt to wait a half hour (insulin needs 30 minutes to come to room temperature before it can be put into a new pod), it’s merely because we didn’t want to stay out late. And yes, a half hour can make that much of a difference to me and my mom!

So we left the house with an emergency insulin vial and syringe in tow. And it’s amazing how much better it made me feel to know that I had both, just in case.

Fortunately, I didn’t need them. I monitored my blood sugar carefully during our hour-long excursion, drank plenty of water, and deliberately chose a lower-carb, whiskey-based cocktail that wouldn’t spike me. And I was able to enjoy every last sip of it before returning home and changing my pod soon after walking through the front door.

I do have to say, though, that under different circumstances, I’d absolutely make different choices. If we weren’t less than three miles away from the house, and if we’d planned on staying out for more than a single drink, then you bet your bottom dollar that I would’ve changed my pod before going out. But in this situation, I made the decision that felt right for me, and felt comforted by the fact that I had backup supplies in case I needed them.

 

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.

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.

How to Change an OmniPod

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.