Next Departure: Sensitivity

I think there's a lot to be said for proper training in the work place and certain jobs regarding people with Chronic Illnesses. If there's a possibility that you are going to have a conversation with someone about their chronic illness, then you should probably know how to actually have that conversation.

Whether it be that you work in chronic illness, work at a hospital, doctors surgery, medicare, pharmacy, manufacture goods relating to chronic illness, police officer, bus driver or security guard.

For some of these the training required might be less intensive. A bus driver just needs to know that he can bend the rules of the company if the need arises or how to accommodate someone with a chronic illness or disability. They do make allowances for the disabled on a daily basis, and I have smashed a popper down more times than I can count despite the blaringly obvious 'No food, no drink' rule. Thankfully, I have never had to explain why I've decided to chug one down mid-trip. I can only assume that the drivers have received proper training. Or that they've given up completely and are just driving in a mundane stupor waiting eagerly for the end of their trip.

For some, the training is obviously not intensive enough.

I travel quite a lot for work and family matters. My work sees me running patient education days in every state of Australia throughout the year, and my husbands family are settled at seemingly random areas of the country.

I catch a lot of planes. I've got diabetes down pat when I catch a plane. I've got my entire plane routine down pat, from the way I pack my bag to the clothes delegated as travel only comfy clothes.

My travel only comfy clothes, through no particular care or thought, cover my pump. It's not on display. Somehow last week my shirt had gotten all bundled up and tucked in to my pants and my pump was on display as I walked through airport security.

My bag full of syringes, needles, cannulas, insulin and other diabetes paraphanelia got through just fine. I don't think the guy staring at the screen even looked twice.

I did not get through just fine.

I've never been held up for diabetes before.

I walked through the metal detector. It of course, did not go off and I walked forward to collect my bag.

"Is that an insulin pump?" one of the many security guards inquired.

"Yes" I nodded, feeling relieved that he knew what it was, and thinking there wouldn't be questions about why I hadn't taken it off for screening.

"Right. In here." His manner had changed. I was pointed in the direction of a cordoned off area.

"Sorry, why?"

"Just stand in there." I had no idea why I was all of a sudden being asked to move to a different area, away from my husband and belongings.

"Ok. But can you explain what's going on?"

No answer, just a more pronounced motion for me to walk where he wanted me to walk.

I'm used to the 'random' drug swipes that I 'randomly' get selected for everytime (I think they do have a private signal to select you for this when they spot needles/syringes in your bag because it has happened for every one of the 20+ flights I have been on since being diagnosed). I wasn't being told to go to the random drug test guy. I was being told to go away from him.

So I stood in this little cordoned off area, with this security guy glaring at me. I felt like he was sizing me up. I didn't know why. All I knew was that there were no problems until he saw my insulin pump. Which I had a doctors note for. Sitting in my bag that I wasn't allowed to get.

"Ok. Go back through the metal scanner."

"I still don't understand what's going on"

"Just go back through the scanner."

I didn't want to miss my flight, so I didn't argue. So I walked back through the metal scanner. Again, nothing happened, Nothing ever happens.

The guard held up his hands for me to stop before I collected my bags again.

I could see random drug swab guy staring at me and ignoring everyone else who walked past him.

"Ok. Get your bags and walk forward."

I was immediately directed to random drug swab guy. No surprise there. It was obvious by this stage that I was being treated like a criminal because I have diabetes.

My pump was the only thing he swabbed. Nothing came up and I was reluctantly let go.

Without any explanation about why I was treated like I had done something wrong. Without the process of what they were doing ever being explained to me, despite repeatedly asking them. There were 5 security guards in the area. None of them had the bright idea to explain to someone why they were being singled out for having accidentally displayed their chronic illness.

My husband didn't understand why I was upset, because they were just doing their job. I'm fine with them doing their job, which is to stop drugs and weapons and stuff going through the airport. I wasn't fine with the way they acted when doing their job. Clearly, part of their job needs to include some sensitivity training. Airports make me nervous enough without being led away without explanation and asked to stand separately from everyone else. If they had bothered to explain, it would have been a completely different experience for me.

For someone with diabetes, these experiences can have follow on effects in terms of glycaemic control.

Lesson learnt. I will make sure to hide my pump every time I go through an airport now.



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Today's reason why I'm hypo:

3 days without incidence. Would it be obvious if I told you the last place I hypoed was at the aiport for my return journey? Because I had anxiety going through security given my previous interaction with them.

3282

Yesterday, I talked about the 'T1D Looks Like Me' campaign which you can access here if you would also like to smurfify yourself.

Today, I'd like to show you what a different aspect of T1D looks like.

A year ago, on WDD2014, I started a collection, of sorts. The 'D365' project. It's not quite complete, but I thought I would share a preliminary look with everyone now that the initial collection is finished.

This is what a year with Type 1 Diabetes looks like:

125 Set Changes. 

125 times I pushed a cannula into my leg, stomach or back. That's  1 cannula every 3 days.

Some of them hurt. Alot. Some hurt for the entire 3 days they were in. We don't have any way to x-ray ourselves & find the nerve clusters before we put each cannula in.

3282

3282 Testing Strips. That's how many times I poked a sharp needle into my finger, hard enough to make them bleed. 

3282, is an average of 252 tests per month, 62 tests per week and 9 tests a day. Even when my fingers ache.

208. The number of hypoglycaemic events experienced. The number of times that my blood sugar was not high enough to sustain life long term and required immediate attention. That's 1 low blood sugar every 1.75 days. Sometimes, you can have 4 in one day, and sometimes, none for a week.

There is no way to predict a hypo (or trust me, we wouldn't have them!).

But in Diabetes land, we have this amazing tool to help us manage our diabetes. It's called CGM.

CGM is expensive. But it can stop hypos. Want to know why I was hypo free for 5 days straight? CGM. 

Think 3282 is an awful lot of pricking & poking? CGM gives my fingers a much-needed break.

I'm not holding out for a cure. I don't believe in one and I don't particularly feel like I need one. I can and do live my life just fine with my T1D. What I do want are the tools to HELP ME live with this disease, day in, day out. Like CGM. And in future, the artificial pancreas, or closed loop system, or the smart insulin patches.


‪


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Reasons Why I'm Hypo:

The counter has been reset. I went Christmas shopping.

WDD15

Happy World Diabetes Day everyone!!

Since the start of November, my facebook has been awash with pictures of smiling, happy, blue people. For those who don't know it, November is Smurf Awareness Month. 

Juuuust kidding. There is a reason for the blue take-over.

November is Diabetes Awareness month (and lung health awareness month too....so look that up) and today is WORLD DIABETES DAY!

This year, we T1's have adopted JDRF's campaign: 'T1D looks like Me' - putting a face to what T1D looks like:

There are a great many things that T1D looks like: Test strips, jellybeans, blood and needles. But what I think we're highlighting most is that we are just normal people. Yes, we walk among you, and you don't even know it. Acting like normal people. We eat the same foods as you. Watch the same movies. Go to social events.

Like baby showers (For a diabuddy, but hey). Where you get to eat blue themed food, just to further the spirit of WDD. 

(Yes, that is blue zero-sugar lemonade))

(...and a blue strawberry)

I feel like I filled my quota of blue. What did everyone else do for WDD this year?

_________________________________________________________________________________

Reasons Why I'm Hypo: 

Last Hypo Incident:

5 days since last incident

The Best 10 2 Letter Words You will Ever Hear

'EXPOsing Diabetes', an annual event in Brisbane held by Diabetes Queensland, rolled around on Saturday. I love these events, and recently swapped over from attending them to volunteering at them.

I got the best of both worlds. I got to spend my entire day talking to other people with diabetes. As always, it's a place to feel normal. A place to relax and let my diabetes run free. Well, maybe not too free...

From behind the information table, I briefly wondered, as I stood next to people with fully functioning pancreases, if they ever feel overwhelmed by us at these events. If they stand back a little and wonder how they're going to escape a crowd clamoring over them for information and for the free diabetes goodies on display. Do they feel different?  The odd ones out? Do they think about, and hope, that they'll always be on their side of the table? Do they hear patient stories and sigh in relief that it’s not them?

I don't know why I wondered this. I think because I was on a different side of the table to usual. I was separated from the patients. Usually, I'm swapping stories. But I just listened this time. To a story that was bigger than just my diabetes, one that belongs to many people. It’s the story of people with type 1 diabetes, type 2 diabetes, their families and friends.

We share a great story, simply by living our lives and not letting diabetes stop us. Thankfully, sharing information and enabling self-learning is a part of this story.

It was just before afternoon tea break that I found myself talking to Rob Palmer. A plunge in BGLs had seen me having just scoffed 3 mini muffins in quick succession. He asked how the muffins were and all I could offer up was that as I was cramming them in I had a vague sensation that there was food in my mouth, but I wasn’t aware of having chewed that food or how I managed to swallow it. I really didn’t know what they tasted like, because hypo doesn’t need you to taste things. He pointed at a demolished jellybean packet and said it was from his 2.something earlier.

Later that day I quietly slipped into the back of the Type 1 presentation room to hear Rob address the audience. His scattered story was enrapturing. He was someone whose story the audience ‘got’. He had all the hairy diabetes moments that are part of daily life for us, but he also had the great stories about spending a week on a boat surfing, long days at work and doing it all with a smile on his face.

He rounded it out by passing on the best 10 2 letter words strung together: “If it is to be, it is up to me”. It encapsulated the day perfectly. I love EXPO because it does aim to empower people with diabetes to live their lives to the fullest. Patient education gives us the tools to help us achieve the things we want in our lives.

I don’t have any dreams of being a TV star (I’ll leave that up to Rob, who has a much better personality for it), but I have some good reasons of my own to take control of my diabetes to make sure I can do what I want with life: travel, babies, getting my kellion, throwing old lady tantrums and being buried with all my limbs intact.

He Didn't Let the Quaffle In

I don't really pay much attention to my pump these days. Its just always there and I'm used to that. I usually feel really 'connected' to my pump, but I haven't felt that for a while. I finally figured it out. I haven't named my new pump yet, so I haven't been able to make it feel personal to me yet.

So I had to make it personal. Somewhere, packed away among many boxes in my garage, I have a baby name book. "Why Shouldn't I Call My Son Clint?" was picked up by my husband one day at the Eumundi markets, bought home and packed away for much later use.  I braved the cobwebs in my dark garage, and gingerly opened up boxes upon boxes of books. It took a while, because I spent so long making sure nothing hairy with 8 legs and 8 eyes would scuttle out and up onto my arm. It's a serious and well-formed phobia. The kind of phobia that gets cemented into your soul when you have to pull off a motorway because 8 legs and 8 eyes of the huntsman variety are right next to your face as your driving. After assuring myself that I was not going to get attacked and seriously maimed by anything lurking it was time to choose a name.

I worked my way through the names of the Weasley clan. I'm not sure why I decided that I would call it after the muggle-loving redheads. Maybe I've had too much butterbeer of late. Maybe it's rereading the books and watching the movies for trivia. Maybe it was the paint fumes from my self-made death-eater mask.

Ron -  an obvious choice, but a rather mundane and samey-samey option. My handy name book describes a boring and placid life. Diabetes is anything but boring and placid, so I need a pump name that can keep up with it.
Arthur - "...A funny bastard who has lost his keys. He knew he put them down somewhere but for the life of him he can't remember where." Yeah, this kind of sounds like Arthur Weasley. My pump isn't something I want to chance misplacing.
Percy - Described as a tall fellow, who has risque conversations with women. ...Nope. Just nope. Apparently I need to introduce the author to Harry Potter. One cannot simply use a Harry Potter name with a description that does not fit the character.
Bill - "Sometimes a handshake is all you need to tell you that you like a person.". Agreed. Bill is just flat out likeable. Bill was a strong contender for the name of my pump.
Charlie - Educated. Charlie took too many risks. Diabetes and risks are not good companions.
Fred & George  - I looked up the names, but with no real heart. My diabestie had previously had pumps named Fred & George, and I just thought it would get too confusing.

Nothing really clicked. I chalked it up to being in burnout and feeling too disconnected to aptly name my pump. Then I wondered if I was in burnout because I hadn't named my pump...was the lack of personality that I usually associate with my pump hurting my diabetes management?

I didn't name my pump that day.

I named it 3 days later. When I got a fun, purple package in the mail.

Yep. Someone was listening. Now I need a new life goal because that purple Lenny the Lion case is all mine.

It was the motivation I needed. Funny how something seemingly small can make such difference. I mean, it's just a case. But it was fun, and new, and bubbly and made me feel happy. It gave my pump a face. And a name.

World, meet King.

Weasley is our King.

See him, not letting the hypos in with his smart guard. It fits. It's perfect.






_________________________________________________________________________________
Today's reason why I'm Hypo: I was anxious. For no reason.

どうもありがとう, Mr. Roboto

robot

ˈrəʊbɒt/

noun

1. 1.

   a machine capable of carrying out a complex series of actions automatically, especially one programmable by a computer.

   "half of all American robots are making cars or trucks"

   synonyms:

   automaton, android, machine, golem;
2. 2.

   another term for crawler (in the computing sense)

640G - Part Two - It Thinks


"It Thinks" is the slogan that came out with the 640G. I would believe it of my little Mr. Roboto (Note: not my 640g's name...its actually still unnamed as of yet. I just can't think of anything good enough for it).

When you've had a little while to play around with the pump, its obvious the design was made with the user in mind.


Normal, every day functions are laid out on the opening screen, in easy to see positioning. It means that if you need to quickly bolus or change your basal rate, you never have to navigate away from the home screen. With my previous MiniMed, I accessed the menu fairly frequently, but now I access it only to change my set, or if I have an endo/educator appointment coming up and need to start logging my activities before a pump download.




Bolus take you to a bolus menu, where you can input your BG (if you havent used the meter that sends through your BGs automatically). If you select basal you can set up a temp basal or select from a pre-saved temp basal that you have already created. I set up some temp basals of a pre-determined strength  & time length when I first set up the pump that I could quickly swap to if needed, based on activity that I would do throughout the day. It might be easier for kids because they could be taught to swap to a pre-determined basal rate at sleepovers, etc. without actually having to set it up themselves. You could also set these up as weekday or weekend, etc. and quickly swap between them if needed.



Bolusing remains much the same, but you can now choose what types of bolus you want active. I have never actually used a square wave bolus, and haven't the foggiest what it does, so I only have dual and normal bolus types active.

Suspend delivery is now the very first item in your pump menu. Whats even more exciting is that now, when I bolus, 'stop bolus' is displayed prominently on the screen as the insulin ticks in, and is already selected. So if I need to stop my bolus (which oddly, I do often) mid-delivery, all I have to do is click the middle button and it stops. Easy peasy.

I can also bolus off the meter that goes with my pump. It does not have the wizard built into it, but my current rate is 1 unit to 10gm of carb, so I actually use it to bolus quite a lot so I don't have to grope myself in public at food time. Its much more discreet.

I am actually using the new bayer meter, because I feel like its calibrated better than the previous contour meter. It feels more accurate. It sends to your pump straight away, unless of course yu don't want it to, in which case you can hit the cancel button. Your Diabetes health team will never be any the wiser to the horrible number you just stopped from sending.

It has a strip port light at night time. It works, but not as well as my previous IQ. The light that comes out is very faint and orange, so its not the best for trying to see if you've squeezed enough blood out. Probably the only let-down of the new meter. I think they were going for a soft glow that won't wake anyone else up, but screw everyone else if I've got a reason to check my BGs in the middle of the night.

It does allow you to double-dip, which is great because I often underestimate how much blood has actually come out of my finger, and need to add more, which I can now do and not have to waste a strip in the process.

It also works as the download USB for carelink. Cheering, because I have lost all my carelink USBs now.

My 640G tells me now when I have run out of insulin. I used to always go for about 2 hours or so without insulin on my MiniMed because I would see, and promptly clear, the low reservoir warning, and then it would run out and not tell me. Now it tells me when I have zero units left so I can add more insulin straight away. Alternatively, you can set a 'set change' reminder under the reminders section of the menu so it will remind you.

The 640G was designed (in my opinion) to be more functional for its intended and actual use. It is now waterproof. Whilst I still don't intend to take it swimming, it is better in Brisbane heat. Sweat from Brisbane humidity killed my MiniMed over Christmas last year. I also think it will serve me better when I go on my honeymoon in Europe next year, because I won't have to worry so much if I land in the drink in Venice (which in all likely hood will happen) or get caught in London rain.

The clip now functions as the battery opener. The clip also slides off and on by pressing a small 'button' instead of having to lock it in place with a coin or similar.

I'm pretty excited to take my little Roboto travelling with me. There's not much more I can think of to make it the perfect companion. I've signed up to one of the cheap CGM yearly deals so I will have that helping me as well.

Now just to name it.

________________________________________________________________________
Reasons Why I'm Hypo: I had breakfast half an hour later than normal.

MedicALERT

For the first few months of my diabetic career I didn't have a medic alert ID. I was too embarrassed and too busy trying to work out which sharp pointy object did what to my fingers and stomach. I managed to pick up one for free about 3 months into my diagnosis from my diabetic educator. One of those rubbery band things that they usually give out with charity details on it. It was bright pink, way too large on my wrist, and simply read 'Diabetes'.

After I got my insulin pump I decided to go for an 'upgrade' and bought a whole bunch of colourful bands in bulk from an American website that had them for cheap. My intention was that I could colour co-ordinate them to what I was wearing. It worked for about a week before I just stuck the plain black band on and left it. It's been wrapped around my wrist ever since, the only exception being that I wore a translated medi-alert band in Japan, and on my wedding day.

I know why I wear one. The thought that one day, I might fall unconscious from a hypo, and need someone to know why I was unresponsive. Thankfully, that scenario has not yet eventuated, and hopefully will never eventuate.

That's not to say it sits idly by on my wrist. On Friday I found myself the unexpected and unwilling victim of a seemingly random allergic reaction. I can't eat watermelon, mango or raw tomato, but I've never had a reaction to touching them before and cook regularly with tomato (I can eat it cooked). I had just finished chopping some tomato when I felt a sting and my lips started tingling, like they do when I have accidentally eaten something I shouldn't have. A quick check in the mirror showed that my lips had definitely swollen. I didn't think much of it, because that happens every time, and after about 4 hours the swelling normally subsides.

Not this time. Less than 10 seconds after leaving the bathroom I felt incredibly weak. I had weak legs and pins and needles. I grabbed my kit wondering if I was having an unexpected low (unlikely as I had been sitting on a BGL of 12 less than an hour earlier). I never got to do the BG check. My vision blurred, I felt dizzy, sweaty, shaking, and I couldn't breathe. I managed to grab my phone and punch in for 000 (as I was home alone) but I didn't have enough breathe to tell them anything, and I knew I was seconds away from unconsciousness. Somehow I managed to get down the stairs to the apartment below me, banged on the door, and handed my neighbor the phone.

The end result being that 15 minutes later I had a paramedic kneeling in front of me and telling me I was going to hospital. I remember she looked and sounded a lot like my diabestie. I thought that was a good sign. Before they popped me into the ambulance, the second paramedic did a BGL check. I wondered how she knew, but was thankful because a BG check was far from my mind. Apparently someone had read my Medic Alert ID bracelet. My BG was 3.1, which I am 99% sure was caused by what had just happened.

It was at that point my husband arrived home, and went in search of glucose whilst they bundled me into the ambulance. I found it weird that they checked my BGL, found it low, but didn't offer any glucose and left that up to someone else to organise.

I haven't been hospitalized since my diagnosis, so this was the first time I had to deal with my diabetes in hospital. I felt like I was the only one in the room who actually understood what diabetes was and how to use the equipment involved with it. I had a paramedic BG test me, who threw away a perfectly good, unused test strip because her meter was out of battery when she put the strip in. It amazed me that she didn't have the common sense to stick the same strip into the next meter she pulled out. I can only assume she didn't know how expensive strips are.

When they requested a fourth blood sugar reading within my first hour in emergency, I insisted they let me do it myself and use my own meter & lancing device. I don't know if they were particularly happy with this, but I wasn't quite sure about the improvised torture devices that they were passing off as lancets. So I got my way and did my own Blood sugar levels.

After being ramped in emergency, I got admitted to fast track, which I quickly figured out was a holding area for people who wouldn't be admitted overnight. I was feeling a bit better by this stage, with only chills, muscle cramps & one helluva headache left. A nurse quickly filled in the area's medical staff on why I was there and my diabetic status, explaining that my allergic reaction had triggered a hypoglycaemic event and that I had had fast acting carbs but no long acting carbs and could she please get me some(it was dinnertime, after all). She was met with an incredulous look and reply of: "But that's not why she's here." To which, I'm glad, the nurse basically stamped her feet and laid it out for her plain as can be, that I needed some more carb (by now my BG was creeping back down again and had dropped 4 points in 15 or so minutes).

Everything went somewhat smoothly from there, with the exception of an intern fighting with a registrar about the cause of my allergic reaction symptoms. After reading my patient notes and seeing I had had been brought in with a low BG, the intern decided all my symptoms were caused by my low BG (nope) and wanted to send me home. My husband overheard and went to sort it out, to explain that a BG of 3.1 definitely does not cause those kind of symptoms, and that instead the allergic reaction caused my low BG. The registrar agreed with my husband and I was given some sort of medication, kept in observation for a while longer, and then cleared to go home nearing midnight.

I sank thankfully into bed that night, and slept for a solid 11 hours, waking up only once to take as much Nurofen as I could to try and get rid of the killer headache I still had. I'm not keen on that happening again anytime soon so the plan is now that my husband will chop all the tomatoes, and I will continue to wear my Medi Alert ID.

Hey, Good Lookin'

This post is very overdue. I have felt disconnected to my diabetes as of the past month or so, and have been one slack lady in updating. I have, however, suddenly felt the mood to write, and set up a bunch of automatic post updates over the next few weeks :)

I give to you, my very overdue thoughts on the new 640G:

640G - Part One - It's all about the Looks

On first glance, I was still not sold on the new design. But I'm being superficial here, and I was used to my pretty MiniMed. Then my Educator pulled a pink silicone case from her bag of diabetes tricks, so now it looks 'happier' at the same time as giving more protection against the drops and whacks my pump is subjected to. I'm hoping that they will soon release customised skins like with the MiniMeds, but I'm not sure if the design lends itself towards that. In the meantime I have busied myself with obsessively searching for one of those 'Lenny the Lion' silicone cases, which you can get at the UK Medtronic shop.

ITS A LION. ON YOUR PUMP. As a mature, responsible adult who has a mature, responsible adult job and does mature, responsible adult things with my life; finding and wearing one of these is now my biggest goal. Just incidentally, they have these amazing exercise t-shirts on the UK website that have 4 different pockets for your pump, and I don't know why we don't have these here.

After pulling my silicone case on, I immediately began the size comparisons. The 640G has only been released in 300ml reservoirs here in Aus, and I was used to the smaller 180ml MiniMed. The silicone case also seemed to add some bulk when I put it on. I have seen photos of another 640G user comparing it to his 300ml MiniMed and it is the same size. Obviously, bigger reservoir = bigger pump.

The fact that it only comes in 300ml is a bit of an issue I have with the new pump. I was a big fan of
sticking my pump into the groove at my hip/thigh area under my underwear band when I wore tighter dresses, but the 640G creates just a little bit too much of a bulge to do this anymore without things looking a little suss. So I've had to adjust a little and I just put up with the pump obviously stuck to my chest now. I've only had one query about why my boobs looked so boxy from a lady at a coffee stall. Unfortunately I was in a bad mood, so I just grumbled 'Insulin pump' and walked away. Hopefully she googled it.

Layout of the pump is different. I don't think it makes much difference either way. The 640G is faced upright instead of sideways like the MiniMed. I can understand the need for the upright position on the 640G because of its lovely new screen, but this does create a functional issue (read: issue for lazy people) in that I can't just twist the pump to the side to bolus.

I love the 640G screen. Its bright and colourful and auto-adjusts to light. Read: never squinting in the sun or in the middle of night again.

Everything is also right there on the screen for you to see, including your CGM graph. It is also coloured for a quick-glance check. Green means full or close to full for battery, insulin and CGM time indicators, yellow means about mid and red means its running out of whichever one is in red. The screen is also set up so you can access whatever you need quickly.


One of the weird pluses to the new design is that I no longer get any 'pager' comments, which is good, because I seriously wouldn't be this poor if I was a doctor. I'd be living in rich people town with all the rich people and their many, many tables, and their really weird fashion choices, and not next to a block of housing commission. Not a pager guys, sorry. Instead I now get the "That's a really old MP3 player" statements. Which yeah, it does. It reminds me a lot of my Creative Zen that I had when I was 15.

So mostly pros, some cons with the new design - biggest being that as a previous 180ml reservoir user, I'm just not used to the size. All-in-all, looks don't really make a difference to what the pump does and does not do. I am really loving the screen though.

_________________________________________________________________________________

Reason why I'm Hypo: I was on 21 (shhhh) and gave myself a 2 unit correction.

Happy Gratitude Day!

Today, Facebook tells me, is world gratitude day. Today I feel gratitude for many things in my life.

I am grateful for my husband, my soulmate. The man who makes me smile and loves me unconditionally. The man who puts my needs before his. My husband, who seems to have a weird sixth sense about my diabetes at night, and can tell from the way I'm sleeping if I'm low or high and if I need to be woken up to deal with my BGLs.

I am thankful for my family and friends, who complete my life and who slap on a happy face when they're putting up with me. Especially thankful they accept all of me, weird moods, fussy taste, diabetes and all.

I am super thankful for the food in my pantry, roof over my head, poppers in my handbag, test strips scattered across my carpet and insulin in my fridge. Happy to have the things I need to keep me alive.

I feel so much gratitude to those who work tirelessly to give me access to great diabetes products, like my insulin pump, glucometer and more, that make living with diabetes so much easier. I am thankful for my CGM, that helps to keep me safe.

I am so glad to have my diabestie in my life. Without diabetes, I would not have met so many inspirational and beautiful people.

I am grateful for my health. I know more about my body than most other people my age, and what is good for, and not good for me. I am grateful to be able to see the world around me and watch my favourite TV addictions, and grateful to be able to stretch my legs and walk home at the end of a long work day.

I am thankful for my job. I get to earn a living whilst doing a job that I love, and a job that further inspires gratitude for my life. I am happy I get to help others living with a chronic illness at my work. I do a job that inspires me.

I am most grateful that I am alive. Happy that the disease I have, does not limit what I can do with my life, or stop me expressing who I am.

I am grateful for my diabetes. Just not the high and low blood sugars. I'd appreciate if diabetes kept those particular gifts to itself.

Forays into SmartGuard

The 640G: I finally managed to upgrade my pump and lay my grubby prick-marked fingers on one.

I fully intend to talk ramble about it. And all it's new features. Some people get excited about iphones. I get excited about mechanical pancreases.

But I'm saving that particular blog for later. Right now I'm a little sidetracked by the impressive Hylian Shield function (I'm talking about SmartGuard,for anyone who sadly grew up outside of the Zelda generation).

I didn't really think I'd get too much out of SmartGuard. I was pretty positive that I was just going to turn that function off, along with every other CGM alarm and notification setting. CGM has a unique way of driving me nuts so I usually just switch off any 'help' capabilities and use it as a trends-only tool.

For the sake of testing out a new product I enabled the 'Hey! Listen!' features of the 640G when I connected it up to CGM a few days ago. Smartguard, low & high limits were all set and ready to go.

Essentially, SmartGuard 'thinks' about your BGL trajectory, and if it calculates that you're going to hit hypo, it will suspend insulin delivery before you can hit a low level, and try to head off the hypo before it even happens.

It works. 

The 640G is whisper quiet on vibrate mode, so I didn't even know it had activated the first until I took out my pump to bolus for lunch to discover the exciting 'Suspended before Low' announcement. I was still quite skeptical, so I did a finger-prick to check the accuracy. It was spot-on.

I recently started a new job, and two weeks in, found out that one of the perks of working there was that there was another resident T1D. 

So when I got my exciting little 'Suspend Before Low' message I made a beeline to tell the only other person who could possibly appreciate what the heck I was raving about.

I didn't hypo. My BGL dipped to about 4.3 before leveling off and slowly climbing again. Once I had hit 5 and my BGL was holding steady, the pump made a decision of its own accord to restart my basal insulin flow.

Since then I have given my pump full reign to let the CGM run and do what it was made to do. The effect on my BGL has been amazing. It almost feels like a holiday. I have only had to treat 2 hypos since putting on my CGM last week, both of which were exercise-related, when I had my pump disconnected already meaning Smart Guard was not really able to be activated.

The new transmitter for the 640G seems to have more power, and I think that it somehow helps to calibrate better. Around 95% of the time my BGLs match the CGM to within a difference of 0.5mmol. The accuracy means I am able to give my fingers a well deserved rest. I have been testing only to calibrate or confirm unusual readings.

Not only is the Smart Guard preventing lows, but I haven't had a BGL over 12 since activating the CGM. One of the biggest reasons I would see BGL spikes is because I would be sick of hypos, and running a little higher seemed preferable to running low. Because I trust my Smart Guard to 'catch' me, I find that I'm dosing correctly for food - instead of under counting like normal to avoid lows. Dosing for all my carbs is helping to improve my post-postprandial glucose control. The result is a much straighter graph, with more time in the non-diabetic range.

(For anyone wondering, the orange sections are when SmartGuard activated)

I have also had 4 uninterrupted nights of sleep. In a row. For the past 2 days I have had enough energy to stay up until 11.30pm at night. Prior to this past week, I was so exhausted by hypos, nypos and self-management that I was falling asleep between 8.30 - 9.30pm at night. After scrolling back through my nights readings, I can usually see a drop at around 3am, which the SmartGuard is catching. It kicks in, I never become hypo, and I get to wake up fresh-faced and chipper in the morning. So the message I'm getting is that I need to fix my night-time basals, but in the meantime while I play around and adjust those, I can rest (and actually rest!) knowing that my pump is taking care of me. Extra bonus points for the fact that it doesnt make loud alarm sounds and just does what it needs to quietly.

Verdict? Shut up and take my rupees.

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Disclaimer: Still not being paid by Medtronic or asked by Medtronic to write anything for them. Just a super excited T1D who likes playing with new technology and who cannot process her thoughts without writing them down and sharing them with the interwebs.

Pre-wedding conversations

The parmi in front of me looked delicious. A great last dinner for my last night as a single lady. My husband-to-be, myself, our Maid of honour, her partner and our best man had wandered to the pub across the road from our cabin for a warm meal.

 Without thinking I grabbed my meter, lancing device & strips and proceeded to do a BGL check. Something I do so often that its second nature. A normal part of eating.

As my Verio IQ counted down from 5 I absentmindedly sucked the blood off my fingertip before wiping my finger on my pants.

"Is that a habit?" Our best man asked concernedly.

"Yeah." At first I thought he was just being disgusted by my blood-sucking habits. He raised an eyebrow (Our best man has an unnatural amount of control over his eyebrows and often chooses to communicate through various combinations of raising and lowering them).

I understood what that eyebrow meant.

My maid of honour understood what that eyebrow meant. That's when we arranged that she would be keeper of the testing strips once I was in my dress. My biggest fear leading up to the wedding was that I would accidentally wipe blood on my wedding dress. Wiping blood off my finger onto my pants is habit. Not a habit I could afford to do the next day.

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I went to clean my wedding dress today ready for selling. It survived. 

Fantasy Diabetes Device

Whenever Blog week rolls around, there always seems to be a topic on fantasy diabetes devices. I usually ignore that topic and run off to find a suitable wild card topic. There's never been anything that I needed a diabetes device to do that we don't have already. I mean, an app on your phone where you take a picture of your food and it tells you how much carbs are on your plate would be cool, but I don't really need it. I've got chocolate all figured out already, so really, I'm good here carb-counting my own meals.

But now I've thought of something. Guys - it's going to get a little girly in a second, so if that isn't your cup of tea - kindly click away to another, less feminine, post.

One of the awful truths about being female is that whether you want her to or not, your Aunty Flo wants to drop in every month or so for some female bonding time. You learn to live with it. My problem is that my diabetes loves Aunty Flo. He's always acting out whenever she comes to stay, trying to get her to notice him. But then the diabetes tantrums start once she leaves and he realises he's been left all alone again.

Its only a recent problem. Despite sulking objections from all my HCP's, a few months ago I quit taking the birth control pill after deciding I couldn't live with the side effects anymore. Best decision ever! Unless you talk to my HCPs who weren't too happy with the decision. Sadly for them, I don't care to listen to their opinions on the matter at all and am rudely ignoring their pleas to think about the possible unplanned children. I don't really plan on having any unplanned children, so I don't know what they're worried about really.

Since ditching the pill I have no idea what diabetes wants anymore. I know that I have a pattern that follows my menstrual cycle but by the time I can be bothered to change onto another pattern in my pump I've moved on from the low stage to the high stage.

So basically, what needs to happen is that someone needs to add a new kind of pattern to the pump that follows a set cycle of time before it loops back. Currently I have 3 different patterns set into my pump - 'nomal', 'A' & 'B' - normal for when my BGLs are behaving, A for luteal and B for follicular phases of my cycle. I'm ridiculously lazy and would rather spend a week hypoing a minimum of 5 times a day than simply switch my pump to my A or B pattern. And I won't even consider setting a temp basal every day. Its just more to think about.

My fantasy diabetes device is a pump, that upon set-up, asks if you're a female or male. You can select female and set a basal cycle length - i.e. 28 days. You can then set patterns inside a pattern - so tell it to have one pattern for say 5 days, before automatically switching to the next pattern, which may deliver less or more insulin, and so on and so forth, to follow your cycle.

Does anyone realise how much easier this will make my life? Why is this not a thing yet? Medtronic, are you listening?

Apologies don't regrow Beta cells

"What's that?" The 30 year old waiter pointed to my hip.

Here we go again. 

"Oh. That. It's my insulin pump. I'm Diabetic." 

"I thought it was a pager." A pause, as his brain ran into overdrive to process what I said. "I'm sorry you have that."

"It doesn't bother me." I gave him a quick smile as I turned away. 

A few minutes later I returned to the counter to pay for my meal. He clearly wasn't done thinking about it yet. "I thought you were a doctor."

"No, just diabetic."

"I always thought diabetes only happened to old people." This guy obviously does a lot of thinking. I contemplated buying him a thesaurus just so he could look up alternatives to 'I thought'.

"I have Type 1 Diabetes, it's autoimmune. Maybe you've heard of juvenile or kids diabetes? Its that kind."

He paused, apparently trying to decide if he should say what he was thinking, which turned out to be "Like when their parents feed them too much sugar?"

And he was doing so well in his questions before that.

"No, no. Autoimmune means my body attacked itself. It has nothing to do with sugar. Its just something that happened" Somehow I managed to keep my voice polite. It really did seem like he wanted to know, so I gave him the benefit of the doubt with his statement about too much sugar. He did start to nod his head like he understood.

"Well, I hope they have a cure for you one day. I'm really sorry you have diabetes."



Some days I hate these conversations. You can tell the people who aren't going to listen to or believe you, no matter how many facts you arm yourself with. Today I felt like I was talking to someone who would listen. It was also the first time anyone has ever apologised to me about my diabetes. I didn't really know what to say to that because I'm not sorry that I have diabetes. I'm just sorry that so many misconceptions about diabetes are still mainstream.

NDW (National Diabetes Week) ended just over a week ago and conversations like this are why I will continue to answer questions and field silly comments with as much tact and good nature as possible (out loud, anyway. The ranting monologue in my head may sound a little different). The public currently get their education from the media, which more often than not, print misleading or false information about all types of diabetes. Its open and honest conversations where you don't make people feel silly for asking that help to change wrong pre-defined ideas about diabetes to a correct and better understanding of diabetes.

For myth busting on Type 2 Diabetes, see here. For Type 1 myths, click here.

Kellion Awards

It;s National Diabetes Week here in Oz. I'm very happy that yesterday I got to kick it off in one of the best ways possible.

I had the great privilege of sitting among some of the most inspirational people that the Diabetes world has ever seen. The Kellion Victory Medal recipients. I was invited along by Diabetes QLD to attend with my husband.

I initially thought about asking another diabetic to join me as my plus one, but my husband had recently made a comment that I didn't invite him to enough diabetes things. I was glad it was him that I bought because the experience of watching people receive their Kellion Award who had lived with diabetes for 50, 60 or 70 years was very emotional. I needed a hand to squeeze to stop me from bawling like a baby (although that may have been the high of 22 encouraging the quiet sniffles).

My husband and I were seated at the table of a proud gentleman who had brought along his wife, son, daughter-in-law and grandson. Until the official start of the ceremony we talked among our table, trading tales of old and new technology. Little did I realise that the man who we shared a table with would share one of the most inspirational stories of the day. He talked about the ups and downs of diabetes, of how he hid it from his wife when they 1st started dating, the changes he had seen. He talked about the social advancements in diabetes, and the new stance on discrimination against diabetics in the workforce that he was happy had changed for the better since his time working. And a beautiful tale of motivation. "When my grandson was born" he said, gesturing towards the young man at our table "I made a pact with him, that I had to hang around long enough for him to pour me a scotch on his 21st birthday." At this point he was quite emotional and his voice was cracking, as he stood tall and proud and announced "Well that happens this week."

A 60 year Kellion Award recipient, he was the proudest of the lot, aware of his accomplishments, all made whilst living with a chronic medical condition. The enormity of the effort it had taken him to reach this milestone was not lost on me. By the end of his speech I was almost certain that one of my greatest goals in life would be receiving my own Kellion (in 46 1/2 years time!). Not only is the Kellion a great way to recognise that you've managed to drag diabetes around for 50, 60 or 70 years, but a great way to recognise all of your achievements in life. Perhaps because of the mortality that diabetes represents, we may tend to recognise smaller and more everyday accomplishments as being such important parts of our lives.

I could probably write a small book on attending the Kellion awards and the inspiration I felt. How lucky I am to have been diagnosed in a time when a blood glucose level can be obtained in 5 seconds, instead of by heating urine over a burner for 10 minutes. Especially how lucky I am to have access to technology like insulin pumps. Knowing that other people survived, for 50 or more years, without access for a long time to the advancements we have today.

There was one statement said which summed everything up nicely for me. "Diabetes is about having to do things you don't like, but getting on with it and just doing it anyway". Nothing about diabetes is fun and enjoyable. But I will happily trade the mere seconds it takes to care for myself each time for the many more years I will enjoy if I take that time to look after myself. The longer I have diabetes, the less I think about the strange things I have do to my body to survive. Happily, diabetes takes a back-seat to my life and the brief moments of pain or discomfort are quickly forgotten. The Kellion Medal Recipients were living proof that you can have any life you want, diabetes or no diabetes.





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Reasons Why I'm Hypo: Not Hypo, but I somehow managed to concentrate and soak in the awards ceremony sitting on a BGL of 22. There was no foreseeable reason for the 22 other than the fact that I didn't sleep well (if at all) the night before.

Them Diabetes Food Feels

I like to do quizzes, surveys and make lists. Questionnaires. I like answering things. For some reason I believe my opinion and self-identity matter.

So naturally when I opened up my latest 'Member Matters' email newsletter from DQ and found the link to a research survey on eating behaviours in individuals with Type 1 Diabetes, I happily jumped on board and completed it.

As usual there were the normal trigger warnings that they give out before completing any research survey. I didn't think the warnings would mean anything to me. Basically if I see food that I like, I eat it. I really didn't think this survey would mean, or do, anything for me.

It surprised me. I know that having diabetes doesn't create the best relationship with food. But I thought that somehow I had managed to escape that particular brew of diabetes emotions. The food emotions.

I have them. That little survey dug deep and forced me to really think about my relationship with food. To the outside world, I act like food is no issue. Double chocolate cake with extra chocolate syrup? Yes please, and I'll take that with good glycaemic control to boot (if it has chocolate content of any kind, you know I've got that carb count sorted.)

But apparently there is still some small part of me that says I should be ashamed of food and eating. Because I'm diabetic. Because I know that people are judging me. Because I know that glycaemic control can vary wildly with each morsel I pop into my mouth and the perfectionist part of me wants good glycaemic control, all of the time.

I sneak food. Not like I have a stash hidden under my bed (well I have some in my bedside table drawer but that's for nypos),but in the way that I will pretend I haven't eaten food. Or pretend I didn't eat a particular food. I also don't particularly like eating in front of other people.

And then came the questions on when this behavior was most evident. When do I sneak food? Usually when I'm sick of questions about my diabetes, diabetes itself, or people trying to 'help' me. Food seems to be a 'question trigger' for people to remember to ask you about your BGL, or wonder how many carbs are in that, or various other things. When I'm sick of that, its just easier to eat away from people. Or just pretend I didn't eat.

I pretend I haven't eaten a certain food when someone says something about my diabetes and what I have eaten. The other day I was at a party for a friend. And I was unintentionally 'diabetes shamed'. It was cake time, and as everyone else was handed their pieces, I was handed a smaller piece, because I had diabetes. I chose not to get upset then, because I was in a room full of people who didn't know me or my condition, and I didn't want to draw any attention to myself. Even though I have insulin and therefore could have eaten the cake no problems, the situation made me feel very awkward to be eating the cake at all. I brang some home and my husband asked if Id eaten any there, and I wavered between saying no I hadn't or telling him about what had happened. It was hard to admit how ashamed such a simple misunderstanding had made me feel.

I'm not really sure what I'm supposed to do about my diabetes food habits. I guess that's the perilous side of being survey 'click-happy'. They open the can of worms and dump it all over your floor, but then refuse to offer help in cleaning it up. Good thing I'm pretty handy with a broom.

I Ashleigh, Take you, Diabetes

A month ago I walked down the aisle. Somewhat. I got married, I just didn't really have an aisle. Logistics.

Everyone ever since has asked me how 'married life' has been treating me. Much the same really. My husband still doesn't like to do the dishes. I still don't pay any attention when he starts talking in work lingo. We both still go to work. Come home. Make the house messy. Clean it on weekends when we think it reaaaaally needs a clean. And I still have diabetes.

Apparently it didn't take the hint when our celebrant explained the 'union of a man and woman to the exclusion of all others' part of the ceremony. Although you might forgive my diabetes if it wasn't really paying attention to that part. We actually had that part read separately to ourselves and our two witnesses, given that both my husband and I believe strongly in same-sex marriage equality. Sadly, that particular line is an actual legal requirement for a marriage to be deemed legit here in backwater Australia. 

I did a piece for Diabetes Queensland about a week after I got married as a follow up to a post I did about wedding prep with diabetes. I talked about how diabetes actually left me (mostly) alone for the day. The prep actually worked, it was amazing. 

I got my marriage certificate early this week. The basic gist of getting my marriage certificate meant that I could finally change my name somewhere other than Facebook. So I have been excitedly changing my name on my bank cards, at Queensland Transport (where I handed in my medical certificate for driving with diabetes at the same time. Only one month late), and some weird place with a bunch of bickering bogans out the front. Sorry, Centrelink. Medicare. It only took me four attempts to merge my husband and my Medicare cards. The first time they made me line up  and then sit for ages for no reason. I had to fill out a form apparently. Even after calling to ask that specific question and being told to just turn up with my Marriage Certificate. The second and third times I rocked up to CentreCare the line was out the door by about 50 people. The fourth time I decided to be right outside CentreCare's doors at opening time. It worked pretty well. My husband and I are now an official family unit. I just hope that I didn't miss anywhere, because I'm 85% sure I have lost the marriage certificate already.

Upon coming back from CentreCare the fourth time I discovered a pretty wooden USB sitting in my mail box. Wedding photos. So you'll have to excuse my absence. I've been poring over photos and reminiscing about how my hair and make-up will never ever look that good again. And wondering how I look 10 x fatter now than I did one month ago. I blame it on the cake. 

If anyone was curious, this is what diabetes looks like on your wedding day:

It looks like: The fresh site inserted into your leg. The one you changed simultaneously whilst getting your hair done. When the smell of new insulin overpowered the smell of hairspray. And you found it oddly comforting.

It looks like: A blood sugar check, done just before stepping into your dress. The one your bridesmaid reminded you to do because you were so paranoid about getting blood on your dress. 

It looks like: Pulling your pump painstakingly slowly through your 'suck-it-all-in' underwear so as not to tear out your pump site. And then realising you pulled it up the wrong way and having to feed your pump and tubing back down through your underwear again. 

It also looks like playing 'Find the pump pocket' and having to search all 6 layers of your dress skirt to find the specially altered loop to attach your pump to.

It looks like: Protecting your feet. Even if that means pairing gumboots with your wedding dress.

It looks like: A first look. A time to relax with your husband, before he becomes your husband. It looks like a way to calm those nervous blood sugar lows and highs down.

It looks like: Diabetes? What Diabetes? 

It looks like: It doesn't exist. Especially when your husband makes you cry with the sweetest vows ever written.

It looks like: A tissue in your bra instead of your pump.

It looks like: An amazing view. A reason to look after your eyes.

It looks like: The bouquets you made yourself. When you did a blood sugar test after you pricked your finger on florists stem trying to attach the brooches and other fun trinkets.

It looks like: Hugs from another amazing diabetic!

It looks like: The curious cow who wanted to know why some people came in pretty clothes just to stand around a tree. It looks like trying to avoid stepping in cow patties and trying not to ruin your dress, after being so careful all day not to get sugar or blood on it.

It looks like: The individual cake jars that you had made up as name-place holders. The idea that you came up with that was probably a sub-conscious 'F-U' to diabetes on your wedding day. The super-sweet cake that you ate at 1am on your wedding night as you battled a low of 2.1. 

It looks like: Hours and hours of hard-work. That nobody realises you've done. But you can see that it paid off, so you're happy. And yes, these are THE hand-made table number gold-books that I might have mentioned once, twice or 30 billion times because they took so long to make.

It looks like: Lifelong friendships. You go to your diabesties wedding and they come to yours.

It looks like: Perfect happiness. Love. Your husband telling you that diabetes makes him love you more, not less.

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Today's Reason Why I'm Hypo:

I'm not. I'm kicking Morty's butt today!