Shifting.

I have been managing diabetes for more than fourteen years. Over time, I’ve learned that taking care of diabetes isn’t usually that hard - the actual act of finger pricks and pressing buttons isn’t a challenge - but juggling of numbers is just excruciatingly frustrating. Numbers are not my friends. I haven’t taken math since my junior year in high school and even then my grades were less than stellar. The fact I have diabetes, which requires a life of numbers, is a cruel joke. My saving grace is the bolus wizard calculator in my insulin pump.

Unsurprisingly perhaps, I don’t enjoy making modifications to my insulin pump. I suffer through days of ridiculous blood sugars and obvious patterns before finally giving in. I don’t know why it takes such effort to make these changes. But once I do, once I raise or lower my basal or bolus ratio a notch, suddenly, everything falls back into place and it’s like I’m a whole new diabetic.

Lately, my life seems to come in sweeping changes. First, new school, new classes and new friends. Then, when that was a done, I did a completely 180-degree turn and went to the other side of the country and into a profession I had absolutely no intention of pursuing. With that came a new city, a new apartment, more new friends and new doctors. Now I’m about to make another huge change by moving into an apartment with a girl I’ve known for two weeks.

Big changes have obviously had a huge impact on my life, both physically and emotionally. I’ve noticed that with diabetes, even small changes can have a huge impact. Whether it’s a half a unit more of basal, a half an hour of exercise, or a few less carbohydrates a day, the results show almost immediately in my blood sugar readings. Suddenly the anxiety from my blood sugar readings dissipates and I’m more relaxed throughout the day. Although the changes need to happen more often than I wish, the positive - or in some cases negative - results are encouraging.

So why is it, despite my obvious willingness to take such risks in uprooting my life, that I am so stubborn in making minor changes in something that has such an immediate positive impact on my health? I don’t know the answer, but I know it needs to change.

Another change. So many changes. Makes me dizzy, sometimes, and I wonder if I’ll fall down from all the shifting.

404 Error. Not Found.

Some of you may not have noticed, but at least two people have emailed me this week wondering where my blog ran off to.

Well, as my father would say, it was the nut holding the keyboard.

Last week, I attempted to change the nameservers and move my blog to my host. But that failed miserably (obviously, because I was the one doing it) so I had to put the nameservers back the way they were. Then I had to redo the domain forwarding. But instead of telling Godaddy.com to point lemonade-life.com at lemonlemonade.wordpress.com, I told it to point lemonade-life.com at lemonade-life.com.

Which obviously meant it was pointing at an empty webpage.

Once I figured out that’s what I did, I went back in to fix it. But instead of telling it to go lemonlemonade.wordpress.com, I wrote lemonlemonade.com. That used to be the URL for my blog back when I was still at Blogger. So that did me no good, because lemonlemonade.com doesn’t exist anymore!

Finally, I wrote it down correctly and voila, when you type in www.lemonade-life.com, it points you right here where it should.

I like to take the simplest things and see how complicated I can make them. It’s like a game.

~*~

In other completely unrelated news:

You remember Kassie Palmer? You know, this uber-awesome mom of two boys who loves baseball more than life itself (okay, maybe not, but close, right?). Anyway, she doesn’t blog as much as she used to but she did me a huge favor by agreeing to be interviewed about being a parent with type 1 diabetes for the Juvenile Diabetes Research Foundation website. You can read her interview here. I read a lot of stuff lately about women and pregnancy - which there used to hardly be anything - but now there seems to be a dearth of resources on parenting with diabetes. Glad Kassie can fill us in.

Also, if you have a newly diagnosed college student in your life - or heck even just a regular college student with diabetes - you might want to pass this article on being diagnosed with diabetes while in college. It’s from the perspective of being diagnosed at an older age, while in college and living away from parents. However, I think it has some pretty useful advice for living with diabetes that applies to anyone in college.

“That looks important…”

I was at the Portland International Airport early on Sunday morning. Real early. Six-thirty in the morning early. My usual routine when going to the airport is pretty simple. Check my bags in at the curbside check-in (shorter line). Walk over to security. Unhook my insulin pump and slide it into my bag, while slipping off my shoes and taking out my laptop and resting everything in at least two plastic containers. Walk right on through the security, slip and/or hook everything back together and immediately find the nearest Starbucks.

A frequently asked question I hear is, “What do you do when you fly with diabetes?”

Honestly, my answer is: Not much.

I have flown at least twice a year, every year, since I was diagnosed - sometimes more. Before 9/11, I don’t remember doing anything special with my supplies other than to keep everything in my carry-on luggage because heaven-forbid you’re separated.

After 9/11, things were a little sketchy. We kept everything in their boxes and when I flew to Paris in 2003, we brought along a doctor’s note. When the liquids ban went into effect, it didn’t bother me that much. I didn’t bring juice with me on the plane, so I did one of three things: 1) bring glucose tabs (blech!), 2) buy overpriced juice at one of the hundred Hudson newsstands or 3) trust that the flight attendant will get me juice if I need it on the plane. Usually I went with number 2.

When I first went on the pump, back in 2000, I always wore my pump clipped to my jeans pocket. About half the time, nothing happened. The other half of the time, I set of the alarm, was asked to be patted down even though I insisted, “It’s just the insulin pump, let me take it off!” but was thoroughly denied because, “OMG! That’s a medical device! Nonono…” So then I would spend five minutes being scanned by a nice lady, determining that yes, it was the insulin pump that set off the machine. I could never figure out which airport. In Seattle and Portland, I would set it off. But in San Diego and Dulles, nothing would happen. It seemed random, and very annoying.

After three or four flights, I finally said, “Screw it,” unhooked my pump, tossed it in my bag and let it go through the X-ray machine while I completely uneventfully walked through security.

And I haven’t worn it through security since.

Now, I know quite a few people who have absolutely no trouble at all with going through airport security or people who have develop tricks to prevent the pump from going off. I’ve never had an issue with my diabetes supplies going through the X-ray machine - and I even carried a 4 oz. juice box with me which proves that their caveat of “juice is permitted for diabetics” is in fact legitimate. I personally don’t think it’s worth my time to tempt fate to see whether or not the pump will set off the machine and it’s not like taking off my pump for 5 minutes will kill me. I take it off for much longer when I shower.

However, this past Sunday did not go quite as smoothly as most trips through airport security. I was standing in line, as usual, unhooking my pump, as usual, and setting it inside my carry-on bag, as usual. I took out my laptop and put it in one container, and I put my shoes and my bag in another. It was slightly tilted, not laying flat, but I thought it would probably be fine. I bounced through to the otherside like I was a trained professional, and went about collecting my things. After I slipped my shoes back on, I took my laptop and bag over to one of the chairs to get everything situated.

I reached my hand inside my bag to pull out my insulin pump. But it wasn’t there.

I look inside. Nothing.

I moved things around. Under my meter, behind my book. Nothing.

It was there before security, so it must still be there, right?

I turned around to see a woman, next to the conveyor belt, holding up my insulin pump and handing it over to one of the security guards.

I ran over.

“That’s mine!” I said breathless.

The security guard handed it over to me, and the woman, who had been saying something, said, “That looks important…”

Yes, I thought, very important…

I thought briefly that perhaps putting my insulin pump in my bag wasn’t the safest thing to do. But I have been on a plane dozens of times, with nothing ever happening, and really, the reason it fell out was because my bag wasn’t zipped and the security guard moved the bag so that it would lay flat. That’s all. So next time, I’m zipping up the bag.

Gripes About Glucose Meters.

I would like to register to a complaint.

Twice in the last few days I have had questionable results on my glucose meter. While this isn’t the first time that this has happened, and I know quite a few people in the community have lodged their concerns about the accuracy of glucose monitoring, I would like to add these two anecdotes to the books.

This past Sunday I woke up very, very late (as in, past noon) and eating in the morning isn’t something I typically do on the weekend. Usually I wake up around 11:30 and I’ll just wait a couple of hours until lunchtime and eat then. Sometimes I’ll even go longer and just eat an early dinner if I have a lot of errands to run and my blood sugar is steady. However, on this particular morning, I awoke with an 89 mg/dl (or something like that). It was a little too low to just forgo eating altogether, but I wasn’t that hungry and wasn’t sure what I wanted. I had a bag of chips left over from Panera, so I snacked on that for awhile before heading out to run my errands. I didn’t bolus for this bag of chips, but it was small, coming in at only 19 grams of carbs. I thought perhaps I might go a little higher than ideal, but I also didn’t want to take insulin and then go low while I was driving. I thought I was being smart.

Well, 3:30 p.m. rolls around and I’m starving. As in, I can’t go one more minute without shoving something in my face. I was about to go grocery shopping, and you know what they say about grocery shopping on an empty stomach (anyone seen those Mastercard commercials? Not pretty). So, being the bad diabetic (and WW participant), I went to Burger King. It was was close, it was convenient and it was cheap, especially important when the oil companies are sucking my wallet dry.

I sat down with my food and brought out the trusty Lifescan Ultra (the Keynote was out of strips so I grabbed the other meter before leaving). Whipped out the lancet, pricked my finger and five seconds later…

484 mg/dl

Excuse me??

Okay, now, I know I didn’t bolus for my chips. I realize that may not have been a smart move. But I know carbohydrates pretty well after almost fifteen years of tracking my blood sugar and there is no way in H-E-double-hockey-sticks that 19 grams of carbs would take me from 89 mg/dl to 484 mg/dl. No way.

In complete disbelief, I tested again.

218 mg/dl.

Sigh. Now that’s more like it.

Seriously, now, what the hell was that 484? I clearly was not 484, as I would have been gulping down the Diet Coke like I was in the Mojave Dessert. How does something like this happen? I understand there being some degree of variance in blood sugar meters (I understand it, I don’t like it one bit, but I understand it), but this was a difference of two hundred and sixty-six points!

I’ve even noticed meters that register me higher than I feel when I know I’m low. When I can clearly feel it. Trust me, I am not the least bit hypounaware ( ::knock on wood, toss salt over the shoulder, spin around three times, spit:: ).

You know, these fancy gizmos like continuous glucose monitors and wireless insulin pumps and laser finger pokers are great, but I could really go for a glucose meter that did its job right.

Thank you.

Out of Bounds.

I noticed something a few days after I started using the Wavesense Keynote glucose monitor.

It changes beeps when your blood sugar is high.

I’m not sure if it does this when I’m low, and I don’t know if any other meter does this either. I’ve never noticed it. But there is a distinctly different beep when my blood sugar is high.

The normal beep sounds like most meters… beep-beep-beep. But the high alarm has a lower pitch.

Almost as if it’s going dun-dun-duuuun. Or when a referee blows his whistle really loud when the ball goes out of bounds. The meter is screaming, “You’re out!”

It’s kinda quirky, and slightly annoying, which means I can’t figure out if I like it or not. I think because it has something to do with my blood sugar not being in range that I shouldn’t like it.

I finally downloaded the Zero-Click software too and uploaded my blood sugars to the program. I reprogrammed my mealtimes so that my lunch numbers and dinner numbers actually fall during the hours when I eat lunch and dinner, though the empty gaps seem to suggest I don’t test my blood sugar nearly as often as I do. Mostly I think it’s because I don’t test my blood sugar enough. I also discovered that while my 14-day blood sugar average is 157 mg/dl, my blood sugar is only in range about 47% of the time. Less than half. Which means that I’m out of bounds more than half the time. I’m a lousy player, I guess.

I have some pretty consistent times during the day when my blood sugar is great - mostly afternoons (though a couple of thwarted gym attempts make me think my basal might be too high) and always post-workout (now that I’ve learned to keep my pump on, I don’t get any of those nasty adrenaline spikes which plagued me for years and helped make my gym attendance non-existent). My mornings for awhile were great but now shwooop! up to the stratosphere they go. Can’t figure that one out.

Must be the basals. Always the basals. Or the bolus ratios. Or the moon.

What I Love to Love.

I love driving, because despite how horrible it is for the environment and my wallet, there’s nothing more satisfying than a long drive with good tunes turned up so loud that I can sing along and I don’t even notice how bad I am. I love going to a new place, getting lost and finding out much fun you can have when you have no idea what to expect. I love flying in airplanes. I love the way pillow clouds look like castles and imagining an entire world exists in the sky.

I love the when the clouds are lit on fire by the setting sun. I love the way the Manhattan skyline looks early in the morning, just before the sun rises over the skyscrapers - the dark gray contrasting with the bright yellow. I love people-watching at restaurants, parks and on the subway. I love when people ask me for directions because it makes me feel like I belong.

I love purple. I love the scent of Oregon after it rains and the crackling of campfires. I love Portland. I love diabetes camp. I love waking up to birds chirping outside my window, because that means it’s going to be a nice day. I love Rita’s water ice, especially in mango. I love sitting in Rittenhouse Square in Philadelphia. I love movies that make you think and songs that remind you of someone.

I love blogging and bloggers and RSS Feeds. I love writing. I love doodling. I love giggling. I love meeting new people. I love people who know things that I don’t know. I love asking questions, which I suppose means I love being curious and consequently, I love being a little annoying. I love bookstores. I love Sudoku and word searches. I love sitting on the back porch of Espresso Roma of Eugene, Oregon on a warm May afternoon with a cup of coffee and a good book.

I love when my phone rings. I love Facebook and Twitter and when the little blue envelope icon lights up when I have new email. I love the ping when I have an instant message. I love sussys and hand-written letters and when my grandmother sends me a card with a $5 bill. I love comments on my blog.

I love history. I love antique stores, the smell of old books and when an eighty-year-old couple holds hands.

I love CO Bigelow’s flavored lipgloss. I love going to new restaurants. I love naan and tandoori chicken and curry. I love Trader Joe’s. I love coming home from work and watching reruns of sitcoms. I love sneaking in fast food into a movie theater. I love going to the movies by myself. I love a big bowl of popcorn. I love movie trailers. I love art galleries and amazing photographs and taking photographs that I’m proud of.

I love when the pieces of life fall perfectly into place. I love hugs. I love reunions. I love volunteering and the satisfaction of making the world a better place. I love hearing that I’ve helped someone.

I love life, and you too.

I love that there are so many things in this world worth loving.

Edit!: I spent so much time on this that I completely forgot the challenge part. I challenge you to make your own list or leave a love of yours in the comments. The only catch? You can’t include a single person you know on your list. No “I love the way my husband laughs” or “I love hearing my little girl call for me.” It’ll be tough, I know. But this particular little exercise is about stripping away everyone who defines you and figuring out what you (not his partner; not their mother/daughter/sister/friend) love. (This meme is stolen from Michelle and the City).

Keynote.

Last week I received a new gadget in the mail - a Wavesense Keynote meter from the fine folks at Agamatrix.

The box was huge, which surprised me, but inside I found a “lifetime supply” (I think it’s about three months worth of strips), two meters, the software box and some lancets.

The Keynote is about the same size as my Ultra, though it’s a square instead of the Ultra’s curvier look. But the meter cases are almost exactly the same size, so honestly, the size of the meter matters very little. The Keynote is supposed to have higher accuracy, but I have only compared readings a couple of times and both times they were exactly 10 points off from each other, which is pretty good.

One thing I’ve noticed is that the Keynote runs me a little higher when I’m low than the Ultra does, but I haven’t done any scientific testing because my Ultra was never with me when I went low. I plan on taking a closer look at this in the future because having accuracy during a low - and a high - is important. My blood sugar was in the “normal” range when I did my comparison testing, so it’s still to be determined which one is better when my blood sugars are off kilter.

Another plus: this meter takes way less blood than the Ultra, which I’m thrilled about because my callused fingers are not bleeding as well as they used to. I plan on checking out that laser poker from Pelikan at this summer’s Friends for Life conference.

Reactions to the Navigator Announcement

A conversation between two bloggers:

Christine: holy crap, that navigator was approved

Christine: i thought for sure things were going to start exploding when this happened or something

Allison: I know!

Christine: like the end of the world

Allison: hahahaha

Allison: seriously

Allison: it’s the sign of the apocalypse

Allison: quick

Allison: look outside

Allison: do you see any pigs in the air?

Christine: oh gosh, the sky is falling

Christine: little pieces of the clouds are falling to the ground

Christine: oh wait

Christine: that’s just snow

No Delivery.

If you are currently on the fence about going on an insulin pump, you probably shouldn’t read this post.

It’s not pretty.

After dealing with a pump on the fritz on Sunday and 48 hours of fighting my blood sugars with an inadequate back-up regime of Lantus and Humalog, I finally thought I had salvation in the form on a brand-spanking-new insulin pump delivered to my office this morning.

At lunch, I scurried home to put in a new set and moved my reservoir from my poor broken pump to my snazzy, non-scratched pump. I started to do the priming using a fixed prime - going oh so slowly at 10 units a pop - until I realized I should just rewind the pump and start the priming process from scratch.

I realized this while I was driving and thought, “Well I’ll just do this at work. Priming while driving is probably dangerous.”

When I go to work, I sat down at my desk, hit the rewind button, hit the prime button, listen to the whirling of its rapid forward motion until I hit a BEEP BEEP BEEP.

NO DELIVERY.

Aw, c’mon!

You’re new! You are not allowed to be broken!

Now, in the new pump’s defense, NO DELIVERY alarms are not usually caused by the pump. It’s usually caused by a faulty reservoir or a kinked set. So until I got home, I wouldn’t be able to fix this.

Which left me with this conundrum:

It’s 2pm. My Lantus is almost up (I took Lantus yesterday at 3pm). I leave work at 6pm and I should be home at 6:30 pm. I’m already wearing a new set. I really, really don’t want to deal with Lantus for another day.

What to do? What to do?

Well, I decided to stick with frequent testing and injections of Humalog. My blood sugars have already soared to 354 mg/dl but I just dosed myself with an injection of 8 units, so hopefully that’ll hold me (maybe) until I get home. I don’t want to overdose either, so I’m taking it slow and hopefully by tonight everything will be worked out.

But at the rate I’m going, who knows?

Motor Error.

One of the frustrating things about being a diabetic while both sick and PMSing is that you never really know if your astronomically high blood sugar is from a faulty pump set, bad insulin or the fact that your body is just temporarily psychotic.

I have been fighting the Plague for a week now while simultaneously awaiting my period to start (I know, I know, TMI) and while my blood sugars have been high, they have also been a roller-coaster, sometimes up in the 300s, sometimes steady in the 200s and occasionally and miraculously in the 100s.

When I woke up this morning ringing it at a nauseatingly high 414 mg/dl, I was shocked. I knew that my dinner had been a bit large and quite late and that I had actually run out of insulin in the middle of bolusing, but I was confident that I had made up for the insulin when I got home.

Another thing that shocked me was the fact that typically when my blood sugar is high, I wake up in the middle of the night to go to the bathroom. I had woken around 8 a.m. to go to the bathroom, but that makes sense so I didn’t think twice about it before crawling back into bed.

When I finally did get up at the disgustingly late hour of 2 p.m. (okay, in my defense, it was 1 p.m. to my body and I’ve been sick!), I went and tested and discovered to my horror what my blood sugar was.

Because of the aforementioned “is this the sickness or the diabetes?” conundrum, I went ahead and bolused accordingly considering my pump set was two days old and my insulin was less than twenty-four hours old.

I sat down on my couch and flipped on the television.

BEEEP BEEEP BEEEP

Oh that can’t be good.

I took my pump out of my pocket and stared in horror and disbelief.

MOTOR ERROR.

I was not terribly confident that I could resurrect my pump. I rewound it and primed it, only to get another MOTOR ERROR. I tried taking the battery out, but that only resulted in a FAILED BATTERY TEST. So I went to CVS and picked up more AAA batteries, and once that was complete, I still got a MOTOR ERROR.

The motor sounded like a car stuck in the mud - the wheels were spinning but it wasn’t going anywhere.

I finally gave up and called the Minimed Customer Service and after waiting on hold forever (edit: I actually hung up and waited awhile before calling back, and while I waited, I found out I had moderate ketones - yay!), I finally spoke to a Customer Service Representative. Having gone through my own trouble-shooting, I was confident there wasn’t anything that could be done. I told the rep that my pump broke and I needed a new one.

The rep asked me what happened and I told him that I was getting a motor error. He confirmed my information and told me that the pump would arrive at 10:30 a.m. on Tuesday - because of course my pump had to break on a Sunday (the other two times my pump had broken was at night and when I was on vacation. I have lousy timing).

Luckily, I still had a bottle of Lantus in my fridge from last summer when I was on my pump vacation. Instead of splitting my Lantus dose, I’m taking it just once. With a broken pump I’m stuck on the priming screen so I can’t look up bolus ratios either, but I’m calling the doctor’s office first thing tomorrow morning to double check to make sure I’m remembering everything correctly.

Note to self: write this stuff down somewhere.

However, it is only two days and after a week like mine, if I’m a couple units off my basal rate or my bolus ratios, I doubt I’ll even notice the difference.

Good health can’t come soon enough.