Diabetes Blog Week 2013: Spread the Love

4th Annual Diabetes Blg Week 2013

Today’s Prompt: As another Diabetes Blog Week draws to a close, let’s reflect on some of the great bloggers we’ve found this week. Give some love to three blog posts you’ve read and loved during Diabetes Blog Week, and tell us why they’re worth reading. Or share three blogs you’ve found this week that are new to you.

Yesterday I found Ilana Lucas’s Diaturgy. Her post Ode to an Insulin Pump led me to explore the site and smallish collection of well written and interesting posts.

I found Meredith Pack’s blog, With a Side of Insulin, today. There’s no post in particular, I just find the entire blog relatable and fun to read.

I was glad to see a couple of familiar blog names:

  • Texting My Pancreas – Great name and the blog itself is well written with a sense of fun. The day I found this site, I stayed a long while clicking, reading, clicking…
  • Six Until Me’s memories post – Kerri describes a childhood low and how her Mom helped her through it. Her story affected me even more as a parent than as a person with diabetes.

(Thanks to Pearlsa of A Girl’s Reflections for inspiring today’s topic.)

This wraps up my first Diabetes Blog Week. Thanks very much to Karen at Bitter-Sweet for organizing it and for creating connections within the DOC.

 

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Diabetes Blog Week 2013: Adventures Of Isabel

4th Annual Diabetes Blg Week 2013

Today’s Prompt: Essentially, share some art.

For this, I turn to Ogden Nash:

Isabel met an enormous bear,
Isabel, Isabel, didn’t care;
The bear was hungry, the bear was ravenous,
The bear’s big mouth was cruel and cavernous.
The bear said, Isabel, glad to meet you,
How do, Isabel, now I’ll eat you!

Isabel, Isabel, didn’t worry.
Isabel didn’t scream or scurry.
She washed her hands and she straightened her hair up,
Then Isabel quietly ate the bear up.

Once in a night as black as pitch
Isabel met a wicked old witch.
The witch’s face was cross and wrinkled,
The witch’s gums with teeth were sprinkled.
Ho, ho, Isabel! the old witch crowed,
I’ll turn you into an ugly toad!

Isabel, Isabel, didn’t worry,
Isabel didn’t scream or scurry,
She showed no rage and she showed no rancor,
But she turned the witch into milk and drank her.

Isabel met a hideous giant,
Isabel continued self reliant.
The giant was hairy, the giant was horrid,
He had one eye in the middle of his forehead.
Good morning, Isabel, the giant said,
I’ll grind your bones to make my bread.

Isabel, Isabel, didn’t worry,
Isabel didn’t scream or scurry.
She nibbled the zwieback that she always fed off,
And when it was gone, she cut the giant’s head off.

Isabel met a troublesome doctor,
He punched and he poked till he really shocked her.
The doctor’s talk was of coughs and chills
And the doctor’s satchel bulged with pills.
The doctor said unto Isabel,
Swallow this, it will make you well.

Isabel, Isabel, didn’t worry,
Isabel didn’t scream or scurry.
She took those pills from the pill concocter,
And Isabel calmly cured the doctor.

- by Ogden Nash

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Diabetes Blog Week 2013: Dream Diabetes Device

4th Annual Diabetes Blg Week 2013

The Prompt: Tell us what your fantasy diabetes device would be. Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc. The sky is the limit – what would you love to see?

It’s the one I bet many of us want: an integrated CGM/Insulin-pump device.

Along with that, I’d like a food log with voice recognition capabilities. It should also be able to track other diabetes details, like:

  • How much sleep did I get last night?
  • Am I stressed out? Under the weather?
  • Did I exercise today? At what time? For how long?
  • Am I properly hydrated?
  • How many days since last site change?
  • How old is this insulin?

It would be really fantastic if the device could learn some of this information through observation. Maybe there’s an embedded pedometer or fit-bit that tracks movement?

This artificial pancreas is a good start.

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Diabetes Blog Week 2013: Accomplishments, Big and Small

4th Annual Diabetes Blg Week 2013

The Prompt: We don’t always realize it, but each one of us has come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you’ve made in terms of dealing with your diabetes. No accomplishment is too big or too small – think about self-acceptance, something you’ve mastered, making a tough care decision, etc.

I feel like I’m talking too much.
Also, I’d like to have some time today to read what others of you have written this week.
So today I offer a wee bullet list of accomplishments from 2013:

  • I started Icarus & Daedalus
  • I used the dual wave pump setting – twice!
  • I met Jessica and authored a piece for A Sweet Life
  • I started going to the gym before my family gets up in the morning
  • I contacted the Kovler Diabetes Center to join their MODY Registry

(Thank you, Hillary at Rainie and Me, for proposing today’s topic!)

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Diabetes Blog Week 2013: “High-Risk” Pregnancy

4th Annual Diabetes Blg Week 2013

The Prompt: Today we’re going to share our most memorable diabetes day. You can take this anywhere… your or your loved one’s diagnosis, a bad low, a bad high, a big success, any day that you’d like to share.

In 2004 my first child was delivered via c-section. The c-section was planned, as was most everything about the pregnancy:

  • The switch, prior to conception, to Multiple Daily Injections of insulin
  • The counting of carbohydrates and adjusting of doses as hormone levels changed
  • The umpteen appointments with the endocrinologist, obstetrician, and perinatologist
  • The very many ultrasounds
  • And the birth plan that specified the endocrinologist’s favored delivery time: 11 AM

Having a plan felt reassuring. Although I was grateful to be pregnant, I did not love the experience of it, as many women do. Instead, the frequent monitoring served as a constant reminder of the risky environment I provided for the growing fetus. I came to regard my body as a flawed incubator.

I was relieved and excited when the delivery date arrived. September 10, 2004 was a busy day in the labor and delivery wing. (Evidently, I wasn’t the only soon-to-be-mother who hoped to spare her child a September 11th birthday.)
Despite my most proactive efforts, 11 o’clock came and went.

“Excuse me, my c-section was scheduled for 11 and it’s 11:30 now. I have diabetes. My blood sugar’s okay right now, but I haven’t eaten since 9 last night.”

“Excuse me, I can see you’re busy, but I was supposed to have surgery 90 minutes ago. I have diabetes and I haven’t eaten in over 15 hours…”

“Excuse me…”

I continued politely bothering the busy hospitalists. Eventually, 2 hours after the scheduled time, off we went to the operating room. There was some injecting, some hooking up of things, and my OB arrived. I began to feel a little nervous about being cut open so my husband distracted me with baby-names. My OB also began lobbing chatty questions my way.

OB:      So, Emily, do you guys have a pediatrician picked out?
Me:      We do – it’s Spyridon Papadopoulos.
OB:      He’s terrific – you’ll love him. Here’s a challenge – can you spell his last name?

[That I cannot spell the pediatrician’s long, Greek name doesn’t surprise my OB. It surprises me, though, as I’m generally a good speller and have already practiced this name. It’s my first clue that something is amiss.]

OB:     (New topic) When you’re in recovery where should your blood sugar be?
Me:     Well… I think. Uh. It’s like… Recovery? What did you ask? (Is that slurring?)
OB:     After surgery – your blood sugar. Where does your endo want your sugars?
Me:     (Can’t. Quite. Reach. The Words.)

Something’s wrong, I think.
I ask the anesthesiologist if the anesthesia is scrambling my thoughts. Nope.
Something’s wrong, I think.

“Something’s wrong,” I say,I’m low. Please check my blood sugar.”

Anesth:   Ok, where’s your meter?
Me:           My meter? It’s. In a purse. I don’t have it. I’m not supposed to.
……………..I’m in surgery..I’m not even wearing clothes. Please use yours.
Anesth:  I don’t have a meter.

(thunk.)

Me:           But, but – the plan… How do you know if I need insulin? How do know my BS?
Anesth:   We’re not doing any of that.
Me:           But, the plan…! I’m low. I’m very, very low.

[I’m not thinking anymore about the baby, or about being cut open.
All I feel is the panic of an extreme low.
A low that the plan – the one that nobody is following – was designed to prevent.]

I want my OB to remind everyone of our plan, but at this moment she’s tugging the baby out of me and I can’t catch her eye. I’m not her priority and I feel very afraid.

I hear the anesthesiologist say, “There’s no meter; every floor is supposed to have one.”

I’m not a player in this scene anymore. I am tired. I close my eyes so I can focus on listening, which now requires some effort.

I hear someone say, “Get her some orange juice.”
I hear my husband ask, “Can you give her orange juice while she’s in surgery?”
I hear a code announced over the PA system.
I start to wonder about it, but doing so takes too much effort.

I hear drawers opening and closing. They sound like the junk drawers in our kitchen at home. The ones that always have D-cell batteries rolling around inside. I don’t feel afraid anymore. I feel tired and calm and focused and I wonder why a drawer in an operating room contains D-cell batteries. I’m aware of the chaos around me but I feel detached and too tired to care about it.

Somebody finds 500cc of dextrose in a drawer.
10 seconds I feel the change. So much faster than juice.

Someone asks how I feel.
“It’s helping. I’ll feel better soon.”

“You have a beautiful, healthy baby girl.”
I smile from the post-low haze.

It will be hours before I really feel better, but this lovely baby helps a lot.

Greta's birth

Happy, Lucky.

Thanks to Jasmine at Silver-Lined for today’s prompt.

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Diabetes Blog Week 2013: Reinventing How We Celebrate

4th Annual Diabetes Blg Week 2013

The Prompt: Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) – get creative! What are you trying to change and what have you experienced that makes you want this change?

Food is a major focus of celebrations in our culture. Sweet treats especially play such a prominent role that a party without them is almost unimaginable. A birthday without cake? Valentine’s Day without cookies? Halloween without candy???

Yes. I propose that we re-imagine how we celebrate, overturn the norm, and actively shape a new culture of wellness.

Here’s the challenge – pick the micro-culture you’re going to change – your family, school, office, or block. Consider starting with your own birthday. Serve fruit kebabs. Or a watermelon with candles in it. Sure, it will feel awkward at first, but few people will find the change refreshing. Encourage those people to carry the charge the next time and support them when they do. Little by little, people will stop believing that cake has to be part of a birthday celebration.

Commit to gradually shifting what celebrating looks like by making some small changes:

  • Make the focus something other than food. You got a promotion? That’s awesome – let’s go for a walk to celebrate and you can tell me all about it.
  • Be creative. Breakfast meeting? Opt for Clementines over pastries. (yes, the fist time I brought Clementines to a meeting I felt a little funny handing them out. But guess what – they loved it. And now it’s just what we do.)
  • Trump the cupcake. Sure, cupcakes are cute. But so are these (my versions of which  were a big hit with kids and parents at my children’s recent class parties):

Canteloupe Lollipop   Rainblow Fruit Kebabs   Flower-shaped Cucumber Slices
Photos: school-bites.com; weightlossfitnesshealth.tumblr.com; and madiganmade.com.

(And yes, there’s still a place for the odd cupcake.)

Thanks to Briley of inDpendence for today’s prompt.

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Diabetes Blog Week 2013: Share and Don’t Share

4th Annual Diabetes Blg Week 2013

The Prompt: Often our health care team sees us for only about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?

Six months ago my long-time and most trusted endocrinologist suddenly stopped practicing. The prospect of having to replace her was unsettling – after years of working together, she knew my disposition, motivation and relevant goals and shortcomings. All that knowledge translated into effective care. Unfortunately, transitioning to a new endocrinologist meant starting over from scratch.

Last month I met the new team and was struck by how different their model is from the previous one. I’ll still have an appointment every three months, but at those visits I’ll alternate between seeing the endocrinologist (every six months) and either the Nurse Practitioner or the Certified Diabetes Expert/Nutritionist.

While I appreciate the emphasis on specialized care, I wonder how easy it will be to build relationships within this structure. I see patient/medical team relationships as closely related to both quality of care and motivation. So I have some concerns.
With these in mind:

I Hope My New Medical Team Will Understand:
Diabetes is demanding.
Managing blood sugars is a never-ending exercise in planning, calculating, adjusting, and refining. And the resulting numbers don’t  necessarily reflect that effort, which can be enormously frustrating.
Diabetes is also pretty solitary.

Because of that, I hope the new team won’t say things like:
Your blood sugars look awesome. Keep doing what you’re doing!”
A comment like that, from my medical team, will make me feel like diabetes is mine alone to understand and manage. I suppose for a few hours a year, I’d like it to feel less that way.

Instead, how about:

“Your blood sugars look awesome. You’re doing a great job and we know it’s not easy. Stick with it – because all the that work is paying off, right? Here are some ideas that may make things easier and help you get even better results.”


What I Hope My New Medical Team Doesn’t See (Yet)

  • I replace my blood glucose meter about every 5 years (not the recommended 1-2 years).
  • I change my lancing device’s lancet once a year (not with every test, as recommended).
  • I do not store ketone strips properly
    (nor do I replace them when they expire, as they did in 2010).
  • My glucagon pen expired in 2007.

It’s not that I wouldn’t disclose this information; it just feels a little early in our relationship.

(Thanks to Melissa Lee at Sweetly Voiced for today’s prompt.)

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Ron Finley, Gangster Gardener

Ten inspiring minutes. Go on, have a listen:

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Pinterest & MealBoard: Balancing the Pleasure & Task of Cooking

I love to cook… sort of.

I love to spend a long, lazy Sunday afternoon in the kitchen, absorbed by cooking’s sensuous colors, textures, sounds and smells. It’s more than relaxing; it’s restorative.
I crave it.

But weeknight meal making (a.k.a. the reality of cooking) is another story. I find less pleasure in the rushed, staccato of assembling dinner for a family of four with competing schedules and priorities. Productivity experts suggest that the chaos of weeknight cooking can be quelled with weekly meal plans. But despite the well established benefits, I resisted, fearful that the chore of planning meals might further eclipse my enjoyment of cooking.

Enter MealBoard: a productivity app that combines recipe management, meal planning, and grocery-list making.

MealBoard Screenshot

The advantages to this simple, customizable app far outweigh (for me) the time required upfront to input recipes. Once a meal plan is set, MealBoard auto-magically generates a shopping list. The shopping list is grouped by items’ location in the store, and non-recipe items (say, toothpaste) are easily  added. The more I use it, the more useful and efficient the app becomes.

Thanks to MealBoard I wing it less in the kitchen these days, and the making of weeknight meals is more calm. But what of the sensuous pleasures of cooking?

That’s when I turn to Pinterest – where luscious photographs nourish the eyes, and culinary inspiration is a mere finger-flick away.

Passion restored. Phew, that was a close one.

(Please note: Rather than continuing to post recipes here on I&D, I’m going to pin them on Pinterest. If you’re catch me here on Pinterest.)

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Gift from the Diabetes Fairies?

Look what showed up on our porch last night, via UPS:

Countour Next Link

The Contour Next Link Wireless Blood Glucose Monitoring System. A gift from Medtronic (the maker of my insulin pump). Also included was the Contour® CHOICE Card for purchasing the meter’s custom test strips at a reduced cost.

I have mixed feelings about these gifts in part because of an illuminating story I heard in 2009 on This American Life that discusses the origin of prescription savings cards and their role in driving up the cost of insurance premiums. (If you’re curious, listen to This American Life’s Episode #392: Someone Else’s Money.)

Back to the gifted meter – I’m already acquainted with this device because just two weeks ago my endocrinologist suggested I consider getting one. In fact, she gave me the very same discount card. Was she recommending the meter because of its accuracy? No, not necessarily. But with Medtronic having acquired Bayer in 2012, she hoped that the strips might become more affordable. Hmmm. As she handed me the savings card I silently regarded her and wondered if she listened to This American Life.

In truth, I probably should replace my meter. Per their manufacturers, for the sake of accuracy, meters should be replaced every year or two.

The one I currently use (Bayer’s Contour USB) dates back to 2010.

Its back up (Abbott’s FreeStyle Lite) is from 2003.

And the back up for the back up? Abbott’s FreeStyle – 1998. So old I can’t even find it online anymore. [And yet, it's my all-time favorite – both the smallest and the one that requires the tiniest drop of blood.]

Glucometers are essential for diabetes management, but the cost to use them is substantial.

The meters themselves are a one-time cost (and can often be obtained for free). It’s the strips that add up. As my husband likes to say, “That’s how they getcha.”

I currently spend around $36 for 100 test strips. Largely because of the expense, I test my blood sugar only a couple times of a day. The savings card would make my pharmacy co-pay very affordable (at least for the first 12mos). I would pay $15 instead of $36, so for less than half the cost, I could test more frequently and have more data. The temptation is real; diabetes is expensive.

What would you do?

Highlight the three lines below this sentence and you’ll see what I plan to do.

I’m going to give this meter a try and see first how I like it. I’m also going to bring it with me to my next endo appointment and test right after my doctor collects my blood sample. That way, I can compare the accuracy of its results with the ones from the lab. If this meter has the best results, I will use it.

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