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Wednesday, 17 May 2017

Diabetes Blog Week Day 2 - The Cost of a Chronic Illness




Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?  For those outside the US, is cost a concern?  Are there other factors such as accessibility or education that cause barriers to your diabetes care?  (This topic was inspired by suggestions from Rick and Jen.)


Budgets have definitely been on my mind lately. I just bought a house (I will stop talking about this soon, I swear!), and am now the proud owner of 30 years of debt. Saving for our house deposit was hard and required some cut backs. It didn't leave us a whole lot of wriggle room for frivolous expenses and I had to include my diabetes as a frivolity.

Where I could cut corners in diabetes expenses I did. Whilst not recommended, my sets averaged about 4 to 5 days instead of 3. I reused reservoirs until well after the writing had disappeared.

I cut back on the amount of blood sugar testing I was doing. My average went from around 10 tests a day, to between 3 to 5.
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$170 - a pretty normal chemist bill for a T1D on an insulin pump - This was for NDSS supplies only, no extras

I rationed 8 boxes of CGM over one and a half years (I'm now on my final box from a subscription I started in January 2016). Now that I actually have to pay back a mortgage, CGM is out. Luckily, my my mum helps with that cost, but I can no longer afford a subscription. I have calculated that I will be able to get 3 boxes over the course of 12 months, that I will mostly use for when I go away for work, as I am hypo unaware at night. I will have to start setting alarms for sleep, and just deal with being tired at work.

The consequence has been worsening glycaemic control. In the world of diabetes, money can make looking after yourself a whole lot easier. I went from A1C's in the perfect range, to the 'average to sub-optimal' range. I dream of the day when I will have good control again, but that requires tools I can't really afford right now. Maybe when I'm retired.

Things aren't about to get any cheaper. Private health insurance prices and private doctors fees rise every year. There are talks of a sugar tax - for me that will be yet another increased expense, and probably result in further worsening glycaemic control if I have to try and increase my BGLs to not have to pay for the luxury of treating a hypo. I have severe gastrointestinal intolerances to jellybeans and lollies - and can only have juice or soft drinks to treat my hypos. I can stomach glucose tabs - but these cost an arm and a leg to get into Australia.

Its hard enough as a young person trying to become independent, own a home and even consider raising a family, without adding the expense of a disease like diabetes on top. Most people my age are struggling, and they don't even have an insulin habit to support. If I said a future with diabetes, expense-wise, didn't scare me - I would be lying.


Diabetes Blog Week Day One - Diabetes and The Unexpected

I can't believe it's Diabetes blog week again. Where did that year go? 

Click here for the Diabetes and The Unexpected - Monday 5/15 Link List
Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.  What are your best tips for being prepared when the unexpected happens?  Or, take this topic another way and tell us about some good things diabetes has brought into your, or your loved one’s, life that you never could have expected?  (Thank you, Heather, for inspiring this topic!)

The way that I understand Morty (my diabetes), in the little personality that I have given him, is that his life motto is 'Expect the Unexpected'. Which is actually just a life motto, really. What does go according to plan in life?

I don't know if you can ever truly make diabetes bend to your will and become predictable. Even if I do the same thing everyday, there are still slight differences that can change the course of my day and diabetes. Some days there are only slight varients and my usual diabetes routine works for 90% of the day. Some days I have no idea which way is up and which way is down and diabetes comes along for the ride, and I take it as it comes.

I moved house last week. There were lots of unexpected things to come out of that. I didn't expect to be standing at my front door at 5pm in the afternoon, yelling obscenities and in a flood of tears because I couldn't figure out my new locks for a solid 10 minutes. I didn't think that shoulder barging the door would work to finally get in, but it did - and 20 points to Hufflepuff for not actually breaking the door at all when I did that. I wasn't really counting on inheriting 3 goldfish that the previous owners just kind of left for us to inherit (at least they left the fish food?!). I didn't account for how busy I was at work, and not being home until nearly 10pm each night for various reasons, and how that might affect my eating patterns. I didn't plan to lose all my diabetes supplies in the multitude of boxes in my garage, and not having any spare sets to change out to.

All part of the fun of moving on in life, and just going with the flow and dealing with things as they happen. The locks? We talked about which order we will lock them in so I can get into the house every day. The Goldfish? I'll keep feeding them until they die. Its not hurting me to keep them, so I guess I have Harry, Ron and Hermione now. In getting home late each night, to an unpacked house, I have just had to adapt to eating the best I can on the run. Diabetes supplies? Thankfully, I know other diabetics who have come to my rescue, then made it my mission to find and unpack that box first.

I don't really know if I can prepare for anything unexpected - I just make sure I know the processes for dealing with it. The unexpected high of 30 last week that came when my set stopped working after lifting boxes was dealt with quickly by injection until I could find a new set to change out to. Even if I dont have a spare set, I always have a pen and needle tips. I always have a juice, and I always have my glucometer and strips. Those 4 things mean I can deal with anything that comes my way.


Monday, 8 May 2017

The Diabetics First Home Owners Guide

A step-by-step guide to owning your first home, despite the crippling debt that diabetes forces upon you

  1. Save all the money. Coles brand jellybeans are now your best friends (even if they cause some weird digestion issues), and its time to get comfy with the fact that your pump reservoirs are reusable almost indefinitely. Seriously those babies are still good even after the writing has worn off. 
  2. Being poor means you have a lot of time to not do fun things that make you happy and relieve stress, unless all your friends happen to love sitting on your couch and binge-watching old Buffy episodes as much as you do. Take advantage of this joyless time in your life and find first-home inspiration. View display villages, open homes and auctions.* Don't forget to take plenty of hypo treatment because you will walk far more than you realise, and try to do this in winter, not summer. Temporary basal rates are your best friend at display villages.
  3. You have scrimped and saved and now there's a small but sizable number that has you nervously checking your bank security every day and interrogating your partner on why they used the account to buy chocolate (it turns out its actually your chocolate that you needed to not fall into a pit of despair - Hey, that's years worth of savings and bad Coles Jellybeans right there!). You probably didn't make the 20% recommended deposit but is that even possible these days? A good mortgage broker can still find a way to make it work with some obscure sounding bank that will allow you to purchase the house of your dreams a house that you are vaguely comfortable living in.
  4. Its time to get serious about finding your new home. Expect kitchens to feature prominently in your dreams. Pro Tip: put chocolate bars in your glove box. These will come in handy at around midday when you feel sad about all the houses you have looked at that are not really 'you' and are still somehow out of your price range. Don't talk to other people at the open houses. They are all baby boomers who paid off their first homes in 7 years back when homes were affordable and are purchasing their 12th investment home.
  5. Congratulations! You found a house. Total land size is probably less than 400m2 and at least an hours drive from your place of work, but you can hammer nails in the walls wherever you want and no-one can tell you how clean to keep your venetian blinds. Now to start the extremely tedious process of submitting your offer and waiting for it to be accepted. Expect lots of blood sugar changes. Good diabetes care is waking up alive for the next month until settlement date.
  6. Your offer has been accepted and you played hardball right back to the sellers real estate which was very difficult on your BGLs. Time to relax for 5 seconds, and then start packing. Everything causes a low BGL right now and the closer to settlement date you get, the worse your diet might be. Pizza and the 6 hour later blood sugar spike is a given the night before moving. Everything's packed and you are too physically and mentally exhausted to make a real dinner.
  7. Settlement day will probably look something like this: waiting for settlement to happen = Anxiety, high BGL, feel sick. Moment you hear settlement was a success = sudden drop from BGl of 22 to 3 in 15 minutes flat. Much whooping and air punches. Try not to drive hypo to collect your new house keys, no matter how excited you are. Its a good idea to know where your new property is actually located and at least have enough battery to navigate you there if you don't. ** 
  8. Time to move! Today you will want emergency hypo treatment everywhere. Stash it in your car, your bathroom cabinet, the pockets of everyone helping you move, anywhere and everywhere that you might go. Look forward to your final night of take-out and the chance to get back into regular routine again.
  9. You report to the bank for the next 30 years of your life. Try not to die of anything remotely related to your diabetes in this time, because that leaves your partner in a bad position financially. Its a good time to make an agreement that if you die, your partner should make your death look as non-diabetic as possible, so that your insurance will pay out. Yeah, there's that lovely bit of discrimination we get to go up against.  

*You probably went to all the nice, big display homes with awesome upgrades and inclusions or the open homes in nice neighborhoods. You can't afford these and diabetes. Lower your standards or get rid of your disease. 
**Yes, I did pick up my keys, forget where my new house was and not have enough phone battery to navigate me there. I did follow the signs back to the city so I could pick up my husband who is much, much better at directions, so its ok, I didnt die in the wilderness of my new suburb. 

Saturday, 22 April 2017

Sound

Do you ever have those dreams in the middle of a dead quiet night, that you're falling, and you die? And you think that its real, that maybe you died. You wake up and try to determine if you're in some kind of in-between place, where everything around you seems too calm and still so your sleep addled brain tells you that your gone. Then you hear a dog bark, or a siren, or a terrifying Darth Vader possum hiss and you know they're the sounds of being alive.

My life has another soundtrack that helps to remind me I'm alive. I play it on repeat every day; so constant that I almost know the lyrics. It starts with a mechanical click of springs sliding and locking into place, followed instantly with a dulled thud. Then begins a silent 5 second countdown that might continue on in silence, or end in 2 digital beeps. Silence is good. Beeping is bad. If I beep, even my husband knows what that means - that my day has not started well. Beeps are either followed by angry swearing (and my husband knows he can get a few more minutes of shut eye), or clumsy rustling in my bedside drawer,  the slight hiss of air as a foil seal is punctured and loud gulping and breathing noises as I smash down a juice to treat a low. I don't really hear any of these though. If I am low then my aural senses become dull and disconnected, replaced by a ringing that I can't stop.

The pattern repeats itself, over and over throughout the day. The click of the lancet, the silence or beeps of the glucometer.

My pump plays a different tune to add to my diabetes medley. "Pah-tunk", "pah-tunk". This is the sound I recognise as an interaction between myself and King. Pah-tunk to select bolus. Pah-tunk to unlock. Quiet ticking as a bolus is delivered. I have silenced King, annoyed with his constant chatter. Still he communicates what he needs. The vibrations are audible against my skin, against my mattress, or against thin air. When I am connected to CGM, and in danger, he screams. I cannot ignore the shrill, piercing cry that King makes to alert me to an unresolved low at 2am.

Every 3 days Kings' continuing song is punctuated with a change in rhythm. I add in the clinking of a pencil against a new reservoir to get rid of the air bubbles. The whirring of King's motor as it rewinds. The steady beeping King makes to indicate that insulin is filling a new set line. A pop as the new set is pressed and inserted into my skin. If I am lucky enough, a click of my CGM transmitter sliding onto a new sensor.

These are the sounds that let me know I have life, and am lucky enough to afford to live it.


Thursday, 13 April 2017

Life in the Sensitive Lane

In the diabetes world there is a lot of focus on insulin sensitivity factors.

Insulin sensitivity is how much insulin your body needs to effectively convert your carbs into energy and keep your blood sugar in check. When someone is said to be insulin resistant, their body is needing to use too much insulin to get the job done. When they are sensitive they require less insulin.

It's better to be insulin sensitive. If you google insulin sensitivity there are dozens of articles telling people how to increase their insulin sensitivity and reduce insulin resistance. There are medications that can be used to help patients who are insulin resistant to lower there sensitivity. Exercise is known to increase sensitivity. There are things you can do.

If you're like me, there are no articles or words of advice. I am insulin sensitive. My doctors congratulate me on this, but are always scratching their heads in confusion as to what I can do when I go through episode after episode of unprovoked hypoglycemia.

At present, some of my basal rates sit at Zero. Zero Point Nothing. From 1pm through until 5pm everyday I receive NO insulin through my pump. King sits on my hip merely for decorative purposes (and so I dont forget to reattach later). 

I eat my lunch at 12.30pm and don't give insulin for that either. About 2 days out of every 5 I still find that I can go low mid-afternoon. With no insulin on board. No insulin via basal. Frustratingly, I cannot go into negative insulin. All I can do is eat something which feels unnecessary and only serves to put on any weight I might lose through good exercise routine. Being insulin sensitive means that I find it very difficult to maintain exercise habits, as often I have to consume vast amounts of food to even attempt exercise. 3 days ago I had to eat 200gm of carb to exercise. 90 before, 30 during and 80 following exercise. All on no insulin. My blood sugar was on 4.3 1 hour before exercise rose to 7 after eating..and eating...and fury-drinking some sprite, before dropping back to 3 15 minutes into my walk (oh, so strenuous) and finally settling on 4 after the forced post-exercise meal.

There are no answers for cases like mine. Being LADA, I may still be producing my own residual insulin. It seems unlikely given how quickly my blood sugar can rise if I do get my carb counts wrong at other times of the day, but its possible. 

The suggestion has been to try exercising early in the morning. I start work at 7.30am though, so I am not inclined to get up at 5.30am for a run. I am not a morning person. A nice morning lie-in is not yet another something I am willing to give up for diabetes.

Insulin Sensitivity is over-rated.

Wednesday, 5 April 2017

Rain Dance

 I grew up as a child of the country. I knew geography not by lines on a map but by which rolling green hill. creek or clump of trees signified the end of our family properties in the Tweed Valley. My mum owned 5 acres near Murwillumbah and my dad lived on 25 acres of family land in Piggabeen.

Piggabeen Hall, down the road from our property

Living rurally and away from town centers meant we relied on tanks for a lot of our water needs which meant we had to be conservative with our water use, especially at the Piggabeen property. Cleaning off after a day of playing in mud, scrambling up trees, sitting in old rusted out tanks and traipsing through chin-high grasses was sometimes a challenge. There was a bath in the house, but we were limited to a few small centimeters of water in the bottom of the tub, barely enough to cover our toes. If we remembered early enough, we could have showers which we would do as quickly as possible because the hot water timer was set to 2 minutes of warm water before becoming freezing cold. Showers could only be taken during the day, because the shower and toilet were in an outhouse which had no lighting and was shared by cane toads at night. 

When storm and rain events happened we took full advantage of the pouring water, running around the yard with a bar of soap to enjoy a shower that lasted more than 2 minutes, and getting equally as dirty in the mud as we did clean in the rain.

In a really good storm, there was a dividing ditch that went from the start of the 500m long driveway and past our house. It had been dug to keep cattle and other animals from getting into the farmhouse (except horses, somehow they figured out the small footbridge and were always getting into the yard, or even the house). The ditch ran off into a creek behind the farm house. As kids, it was the best idea to go as far up the driveway as possible, get into the flooded ditch and ride the current until we got to the house, then hop out and do it again. It was not at all hygienic and we'd often be riding through the water next to cow patties, rotting wood and other unknown items. We just knew we had to scrub really hard in the bath afterwards.

The driveway into our property. The tree line at the far back is where Piggabeen Creek ran.

Storms and flooding were usually a fun adventure. The tanks would fill up and we could drink water from cups that we left out to collect the rainwater, which tasted way better than the metallic tasting water that came out of the tanks.

On the flip side, we understood well that too much water could be dangerous. The usually calm creek behind the house would rise and flow heavily and fast, out towards the Tweed River. Riding the ditch could become very dangerous if you didn't get out in time and ended up in the creek.

My mums property was on the outskirts of Murwillumbah and roads could flood quickly, cutting us off for a few days, unable to go to school - which as kids, was awesome. The house itself was never in any danger - it was on high ground. Mum was always prepared, and if she thought we might be cut off for a few days she would fill up all the containers and the bathtub so we would have enough water. She grew her own vegies and fruit and made her own bread so we didn't have to worry about food so much. Helicopter drops were also a good back-up option.

My grandparents still live in Murwillumbah. They live on high enough ground that they were able to stay in their homes over the last week when many others were evacuated.

The importance of being prepared and having a plan is something I learnt on the land. It can't account for all situations but it can help.



Tuesday, 21 March 2017

JapanDia

A month ago my husband and I celebrated 10 years of getting in each others personal space bubbles, mashing our lips into each others faces, and not making decisions about what we want for dinner together. To celebrate, we booked some of those crazy Jetstar return free travel deals to Sapporo in Japan in February.

We left Brisbane with temperatures of 37°, and arrived to temperatures in Hokkaido of -7°. Cold weather and a 40° temperature swing was a very welcome change. Last time we were in Japan it was so hot that my insulin was only lasting a day and a half before expiring. No such issues this time. 

It was such a different travel experience to what I had had before. Sapporo was absolutely covered in snow (It is in contention with a few other places for snowiest city in the world), at points being built  up at least a metre taller than my husband and I. 



Naturally, once again I had to smuggle diabetes and all of its luggage into my carry-on. I must be getting better at controlling my uninvited travel companion though, because I barely heard a peep from my diabetes in the week I was away. Even on that day that we went to Odori Bisse Sweets and I ate 2 desserts before dinner, then dinner, then dessert again (which you can read about on my travel blog at: http://tonyobyointokyo.blogspot.com.au/). 

Of course there were some small blips. Thankfully, unlike in Europe, Japan doesn't believe in trying to sell sugar-free soft-drink alternatives, so not only did I only have to consume a small amount of a soft-drink to treat my hypos, but hypo treatment was blissfully easy to find.

The Japanese have a slight obsession with making food accessible (you cannot walk more than 200m without coming across a mini-mart stocked with delicious goodies). On one particular night, we went to the Sapporo Beer Museum for dinner when just after arriving, as we were standing in the freezing cold, I was alerted to a hypo by my pump. I could see that there was a long line into the beer museum (and therefore to any possible food inside). Immediately my eyes fell on a quiet bus stop across the road. Nearly buried in the snow was my shining beacon of hope. A vending machine. With an endearing exclamation of 'F***ing Japan' and 100Y later, I was guzzling a freezing cold soft drink. The temperature of the bottle made my lips numb and my throat ache as I swallowed the frigid liquid but at least I had hypo treatment.

Later on once we were inside the beer factory we found a beer marketed towards diabetics. Beer is remarkably cheap in Japan, so yea, that beer is 200Y - roughly $2. You can get full alcoholic beer at their mini-marts (like our 7-11's) for about $1AUD. 




The day after visiting the beer factory I discovered an unexpected plus to having diabetes in Japan. The very last picture on this 'reserved seating' sign on our tram was described as being for people with 'internal organ failures'. If my Type 1 isn't an internal organ failure, I'm not sure what is. So at the very least, if I really wanted to, I could get a seat on crowded public transport (although I would never use it, it was interesting to see).


Seat for a Pancreassasin


There were a few learnings in taking diabetes into such a cold climate. Like how hard it is to calibrate when wearing so many layers. Sometimes the CGM had trouble talking to my pump through my 5 + layers. I usually need more insulin in winter in Australia, but because I used so much more energy to walk in my copious amounts, it all sort of evened out and I barely even had to put on reduced basals.

Having CGM with the suspend before low feature was an absolute gosh-send. Usually my pump was hidden well within my clothes, so I just sort of had to rely on the CGM and  pump to make a few executive decisions about my diabetes management for me. Something about punching holes in my fingers in -7° temps didn't make me feel all that enthusiastic about finger-pricking.




_________________________________________________________________________________
Reasons why I'm hypo:

Its the exact opposite right now. After having an AMAZING week BGL wise, I had my first hypo of the week, unclipped my pump, and forgot to clip it back up. 6 hours, dinner and dessert later....all without insulin....my meter is not a happy chappy. Neither am I. #diabetes fail

Tuesday, 28 February 2017

No Pumps On Board

I don't know if I would call myself a regular airport attendee, but between work and spending money that my bank would rather I didn't on holidays, I have developed a well-versed diabetes travel routine. It doesn't give me optimal control all the time, but I do the best I can. Travel days are always going to be something that throws me, because they throw my body out. Different wake and sleep times, less activity, more sitting and the food routine and diet changes wreck havoc on my best-laid plans.

Travel with a medical condition like diabetes can be scary, exhausting, busy and burdening. Plane journeys are uncomfortable enough without the added feelings of a low or high blood sugar or having airport security fussing over your medical condition.

Before any travel (especially international), I always make sure I am well-stocked with supplies and that they are packed in an easy to reach place on my onboard luggage. I never put any diabetes supplies below in checked luggage because I can't guarantee I will get my bag on the other side or that nothing will happen to my bag (such as sudden temperature changes or rough handling). If I'm travelling international I split my supplies between my husband and myself. I take about 30% more supplies than what I need as a precaution. Last time we went to Japan (In 2013) that 30% extra insulin probably saved me a trip to a pharmacy to get more bottles of life because the heat in Japan was causing my insulin to expire every 1.5 days.

I bought some of those packing cubes a while ago, and I found that the smaller ones are perfect to put all my supplies in. It makes it super easy at security and on the plane/travelling around if everything you need is in one spot.

NO PUMPS ON BOARD: Saw this on my recent flight to Sapporo on the flight safety card. The 'not permitted' symbol seems to include an insulin pump. ???

As well as supplies, my number one recommended thing to take with me is my scripts and a letter from my doctor, explaining what each item that I carry is and what it is used for. I also make sure the doctor's note explains why my pump cant go through any screening such as MRI, CT or X-Ray. I have used this letter in Japan every time without fail as Insulin pumps are not common in Japan. In Sapporo, they were insistent that I turn my back-up pump on to make sure it wasn't an explosive device. I had to unscrew the battery compartment to show them that it wasn't possible for me to turn it on, if there was nothing to power it and then they ran the bomb swab over the pump which was fine. In Cairns I whipped out my trusty letter to avoid the full body scanner, which I went through last time by removing my pump, but was not possible this time because of the newly inserted CGM taped securely to my arm.

I don't usually display my pump, and will normally hide it underneath my jumper, to avoid unnecessary questions from security. The few times that I have had it out, it has caused issues. Luckily, my Medtronic pump does not set off the metal detectors, so hiding the pump beneath my clothes is easy.

For domestic flights, I can take juice or other liquids through security, but for International, I try to stock up on glucose tabs in case of a hypo in the security line. I always buy a sugary drink once through security, but in some countries like Indonesia, they actually make you throw out any liquids before you can board the plane, so anything purchased after clearing security is a waste.

At take-off and landing, I disconnect my pump, otherwise changes in air pressure push extra insulin through my cannula and I get very low, very fast.

Most recently, I have been disobeying the rules regarding transmitter devices on planes, and have kept my CGM on during all my flights for the past year (over 20 flights). The plane hasn't crashed, or lost its course, and my pump hasn't exploded. Its made flying so much easier, especially on long-haul flights, where my husband can now just check my pump to see what my BGLs are doing instead of waking me up. I can also see any problems I am having and fix them up far quicker than if I had the CGM turned off and was only doing manual checks once every 2 or 3 hours. Especially when landing, I can see if I need to have some sugar to avoid a baggage claim low.

All of these preparations means that the biggest issue I have with travelling with diabetes, is that I have diabetes. Today, for example, I got on a plane to Sydney at 9am in the morning. Then I got on the return flight home at 3pm in the afternoon. One flight went well for my diabetes, one flight did not. I did the same thing on both flights. The morning flight went well because I had been able to follow a similar routine to my normal day. I ate breakfast, got on the morning flight (when I would normally be sitting at my desk) and BGLs tracked between 4 - 6. The afternoon flight did not go so well because I had missed my 20 minute lunchtime walk, missed morning tea, delayed lunch by 2 hours, and eaten different food to normal for lunch. If only I could have left diabetes at home by itself for the day.

Tuesday, 7 February 2017

Position Vacant

SCENE ONE

ASHLEIGH staggers into an over-bright boardroom in a workplace office. Furnished with a long board table, and many wheel-footed office chairs. Ashleigh flops into a chair at the far-end of the table. She is sucking on a straw plunged through a juice popper. 'B'sits beside Ashleigh. 12 OTHER COLLEAGUES take seats around the room.

ALL (singing): 
Happy Birthday to you, Happy Birthday to you. 
Happy birthday dear colleague, happy birthday to you.

Ashleigh waits until the singing has stopped and lowers her forehead to the table.

COLLEAGUE 1 (to Ashleigh):
Are you alright?

COLLEAGUE 2:
Are you sick? What happened? Are you ok?

COLLEAGUE 3:
Oh yeah, you don't look too good. Are you right?

Colleagues continue firing questions. Ashleigh makes vague grumbling noises, raises her juice and makes shooing motions with her hands.

B:
She's fine. Just leave her alone. She's just having a
low blood sugar.

COLLEAGUE 3:
Do you need us to get you anything?

COLLEAGUE 1:
Ohhhh, I'll get the Glucagon! Can I give you a shot?

B:
She's got her juice. She'll be fine. Just give her a few minutes.

COLLEAGUE 1:
Why can't we use the Glucagon?

ASHLEIGH (with some energy now):
I have a juice. I just need quiet for a few minutes. You can't use 
the Glucagon unless its an emergency; only if I'm unconscious or 
can't have sugar. 

END SCENE




When you have a self-management  heavy disease like diabetes its important that you have a few people around you like S who are on your side in your day to day life. There's a lot to diabetes.

It takes a lot of time, energy and effort to train a Diabetes side kick. You work at educating them over many months, maybe even years. Slowly feeding information through small conversations or simple statements. Whether you mean to or not with these people, you create a relationship with them that involves some amount of diabetes knowledge download.

So I have people. I have friends who I knew before I was diagnosed, who picked it up as we went along. I have family who I expect a lot of. I have diabuddies who I don't need to explain at all to. I have a work colleague. Change that to had, because S will be finishing up her job with my workplace at the end of this week.

I have to start fending for myself again at work. Its helpful having someone who knows your diabetes in situations like the birthday cake hypo debacle. (Which continued on past the initial hypo. I had people asking me days later if I was 'feeling better yet' which really confused me because I didn't remember taking any sick leave or feeling ill. I had to be reminded of 'the other day in the boardroom at morning tea'.)

Its impossible to spread the knowledge among too many people, so if you can have one or two people that know enough about what is an emergency, what a hypo is and when everyone else should leave you alone and stop talking, then you're doing alright.

Goodbye to my work diabetes look-out. I'll never train another quite like you. Thank you for never talking to me when I'm hypo. not stabbing me unnecessarily with the Glucagon, not judging, bothering to listen to my diabetes natter, and all the jaunts down the road to stock up on juice when I ran out.

Monday, 30 January 2017

PoGo

What did I do in 2016 when I was ignoring my diabetic self?

A lot of exercise.

Pokemon Go was where it was at (ok, its still where I'm at, at least until I find the last 3 non-regional monsters I need to complete my PokeDex collection). I did a lot of walking in the latter half of 2016 trying to hatch distance-based pokemon eggs and find new Pokemons.

It helped to have something to concentrate on as I walked. I have always found exercise to be mind-numbingly boring. Or it made me anxious. PoGo took care of both the boring and the anxiety. I was able to forget how nervous exercise made me (thanks for that, diabetes) when I was concentrating on catching little monsters.

I started off small. I have always walked during my lunch hour, so I increased my single block to 2 or 3 blocks (had to try to get as many PokeStops as possible). Then I started off walking 4km in the afternoon after work, then worked on getting my time down as I got better at catching monsters and not tripping over my own feet. When I had gotten my time down, I added more distance and found a 6km route to walk.

I kept going and as my PokeDex got fuller, I got fitter. My 6km route morphed back into a 4km route when I found an exercise park that I could stop off at and complete a few sets of muscle based exercises. I upped my reps. I stopped catching as much Pokemon and my exercise time ballooned out from around 50 minutes a day to around an hour and a half on weekdays, and over 2 hours per day on weekends.

On weekends I vary my exercise a bit more. I might go for a bike ride, or a longer walk for a few hours. Sundays are Springwood Conservation Park Day, where my husband and I go to do laps. There's a very steep set of stairs followed by a 1.5km circuit that I jog 3 times. The stairs are an absolute killer and going up them 3 times is more than enough to give me the lovely 'going to puke my guts up' feeling that you really want when you're trying to run.

I recently started adding jogging to the mix. At first I was breathless after 100m, but I can now run nearly 2km before I need to stop and walk for 30 seconds before starting up jogging again. Every day I push myself to jog further, even if its just a few meters past where I made it to the day before. The only problem with that is, I cant PoGo and jog very well. So I am just turning on the app and then sticking it in my bag while I jog, so that at least I'm walking my Buddy Pokemon and hatching distance-based eggs.

The plan is to eventually be runnning the full 6km while still adding a stop-off to the exercise park. Or maybe getting a 4th lap of the Springwood Stairs in before I get the shaky 'about to vomit everywehere' feels.

Not everyone understood the appeal of PoGo, but for me its managed to keep me interested and pushing myself to get fitter for over 6 months now. Slowly, but at least I'm getting there, and for the first time in my life I'm actually enjoying exercise. So theres a plus. To everyone who complained that there were too many young people out walking their phones, there's a plus.

Monday, 23 January 2017

I think I had Diabetes in 2016

I think I had diabetes in 2016. I know there were nights that I didn't sleep and days where I slept too much because my blood sugar didn't really do what I had planned for it that day. There were finger-pricks and site changes and pump battery changes. There was blood and insulin and sticky-leftover residue from CGM tape. Diabetes was there. I'm sure of it. I can't tell you what my last A1c is, not because I don't want to, but because I don't remember. If it was better or worse than the one before that, I have no idea. But I am vaguely aware that at a few points along the year I let someone siphon some blood out of my arm to produce some readings that I paid no attention to.

I lost my diabetes voice in 2016. It hung in there for a little while at the start. I just got too tired, too busy, too overwhelmed with life to keep hearing it. "Check Your BG" got swamped by the sounds of my rattling washing machine every Saturday morning. "Change Your Basal Rates" was drowned out by copious amounts of Netflix. "Advocate!" couldn't be heard beneath my new nephew's sweet little coos. I didn't take "Be prepared" along to work with me each day, and found myself completely out of test strips, insulin or both more times than I cared to count. (Thankfully there were people close by who helped me pick up the slack during those moments of complete unpreparedness).

In 2016  I let diabetes 'just be there' quietly in the background. I began to accept that sometimes you can't have perfect control...and that that sometimes might span for a year or more. Life was too busy for diabetes.

I think I need my diabetes voice though. My diabetes needs my diabetes voice. It helps.