Requesting Travel Advice

I'm headed to Ireland for a family vacation next week.  Cannot wait!  Got my new box of supplies from Medtronic so I'll have more than enough packed in my suitcase, carryon and handbag.  And, after a bunch of hoops and red tape- I can now get three vials of Novolog at a time instead of one.  So much easier to deal with.


I have not traveled more than 1-2 hr time difference away since I got my pump in Nov.  This will be my first trip 5+ hrs ahead.  So, I have lots of questions:


1) Just read on medtronics fb page that I am not supposed to wear the pump in the aiport body scanner?  I've gone through it several times before with my pump on.  Is this really true?  Do I have to opt-out and get felt up? I'd rather not.  Can I put my pump in the basket and send it through the x ray thingie?


2)  Dealing with time zone changes- How do you guys adjust your basal rates? Do you just change the time on the pump? Will it automatically skip to the correct basal rate that i have set up for that particular time.  (If my rate changes at 7 am, and I am on the plane on 2 am american time, then set the pump to 7 am Irish time, will the new basal rate start then?)


3) CGMs- do you guys travel with yours? I wore mine when we went on a ski vacation because we were doing alot of snowboarding and physical activity, so I didn't want to go low and not know it.  But, then I misplaced it in the hotel and had a panic attack tearing the room apart looking for it an thinking about how I didn't want (meaning couldn'") to pay $8000 to get another one.  Ideas on if its worth taking the CGM along?


Thanks all for the advice.  I'll try to figure out how to bolus for the beer and chips on my own.  ;)

Taking time

Today I'm taking time to breathe.  To relax.  To catch up on blogging.  To review my BGs from the last few weeks.  To snuggle with hubs.  To get excited about our trip to Ireland next weeek! To celebrate accomplishments, both big and small.


Although I feel like making a list of all the things I am so busy with is cheesy, probably uninteresting to those of you who stumble across my blog, and screams, "I secretly need acknowledgement of how cool/amazing I am with all the things I'm doing?" I'm gonna list anyway.  I'll try not to use bullet points thought :-)


I just finished my two pre-req classes for my grad program in the fall.  6 week crash courses of all things financial accounting and statistical.  Got two A's. WhAAAaat? (read in Shawn Spencer voice from Psych.)  It feels really good to have that item crossed off the to-do list.  All I have left is a recommended class is microeconomics. Yeah, thats all.


We *think* we have found an apartment in Chicago after a loooong search.  Its beautiful (well, I think it is, but I have only seen it through hubs iphone since I've been at school every day) and within walking distance from school and work.  Score on exercise that won't seem like exercise but still counts toward lowering my BGs!


We are going to Ireland next week for a much needed vacation.  I love it there.  I've been very fortunate- this will be my fifth trip there! I studied abroad in Galway during college and can't wait to go back and see how things are, and to take dh on a trip down my memory lane. He'll love it, I'm sure.


Our barn is almost done in VT.  The garage/barn style doors will be installed next Tuesday and that means its one step closer to being complete. I can't wait for my girl-cave (?) to be ready.


My BGs have finally come down after being really high over the last few weeks.  I know the combo of studying, driving 25+ miles to class and back every day, and poor food choices really did a number (hah!) on them so I'm glad that I've been able to make a few postiive changes this week in that regard.

It is so nice to take time out and appreciate all that is good with life.

Doh!

Ever forget to take the little blue protector off the cannula/needle in your infusion inserter?  If you do:

1) It hurts
2) If it coincides with trying a new infusion site for the first time, like your thigh, you might not realize it and think the pain is due to the use of a new site
3) you will wake up with a bg of 358 and a huge painful indent in your leg

After wearing for approximately 12 hours and receiving no insulin whatsoever.  Doh!

Rage Against the Machine

You ruined my beautiful blood sugar you d*mnned CGM!


It was a beautiful day in Vermont.  Temps in the low 80s, perfect blue sky dotted with fluffy white clouds, dappled sunlight shining through the trees...

picture courtesy of Burlington Hostel

I was mowing the lawn; a job I actually don't mind since it appeals to my need for immediate gratification every once in a while.  We have a huge, uneven, hilly lawn so this little chore usually takes me about 4-5 hrs.  We only go up to VT on the weekends, and by then the grass is knee-high and the weeds are out of control. But, I was enjoying being outside, and knew that I would have a good BG reading pre-dinner because of all the mowing, raking, wheelbarrowing and weed-wacking.


After yard duty, hubs and I decided to grill dinner.  We had a delish summery dinner- lamb chops for him, and fresh corn, grilled zucchini, pasta (Dreamfields) salad and grilled pineapple for dessert.  Heaven for a veggie like me!  May sound a  bit high carb, but suprisingly, corn on the cob isn't too bad on my BG  readings.  I bolused 5.3 units for this meal and my pre-meal bg was 66 (a tiny bit low due to all the exercise, but not bad.)


Two hours after dinner I heard the dreaded "your bg's low" tone coming from my pump.  It's really amazing how four little beeps can inspire so much fury!!


 The ensuing disaster is the problem I've been having recently, trying to figure out how to utilize the CGM in the best way with out driving myself or husband crazy.  Any hints/suggestions/advice/commiseration is appreciated!


I looked at the screen.  Beautiful straightish line hovering between 66-82-70.  Ahh perfect combo of exercise, insulin and food.  However, my CGM is set to go off as "getting low" at any BG 70 or under.  I'm hesitant to mess with that setting because I know the CGM isn't 100% accurate and when it says 70 it may actually be 45.  So,  I checked my bg with the meter. Actually 70. Wow.  Very accurate.  Now what do I do? I sit through another half hour or so of beeping every 5 mins and test my bg a few more times 68 was the lowest.  Ok, I thought, I'll eat 5 chocolate covered almonds to raise the bg a few units- anything around 80 or 90 will stop the CGM from going off all night. Test half an hour later: 70.  Ugh, how come I can't raise my bg when I want to, when I don't want to, its always 200+...?  Beeping continues...Blood sugar not rising, but temper is!!  Check the meter and see I have 1.1 units active insulin left.  Ok, maybe that's why bg is not going up.  I decide to eat a Nonni's biscotti 14g of carbs. My ratio at night is 1:10 so I thought- perfect amt of carbs to override the 1.1 units and boost my bg a little? Right?  Am I making sense or do I completely not know how to calculate I:C ratio?


I decide I can go to bed now and I really really want to because I am tired after all that mowing.  I go to bed and fall immediately asleep.  I fall so soundly asleep as a matter of fact, that I don't hear the doo-doo-doo-doos until the meter starts vibrating, lighting up and shrieking like a police siren.  Ahhh!  Test BG again.  140.  CGM still saying low.  Calibrate you damn thing!  I calibrate it and go back to sleep, totally exhausted.  I must have slept for maybe 3 hours when I hear those f'ing doo-doo-doo-doos going off again, but now in the annoying "your bg's high!" tone.  Oh my god. I can't take it.  Why are you messing with me? Bolus.  Sleep. Beep. Bolus.  Wake up in a very bad mood.  Test BG 109. CGM says 170.  CGM, I. hate. you. right. now. 


Hubs nicely asks about my opinion on concrete floors.  (We are looking for a new apartment and that is an option in one apparently.)  "Concrete floors!?!"  I practically yell.  "What are you talking about? You drive me crazy!  This damn things been going off all night and I've had 3 hours of sleep!  Why are you talking about concrete floors?!"  Hubs nicely asks if I am ready for my coffee now. 


Finally, after coffee when I am feeling more reasonable, I apologize to hubs, and to CGM.  I know the CGM is only doing its best and trying to help me, but I am getting sick of these interrupted nights.  Can anyone else relate to this?

School Daze

I am starting grad school in Health Systems Management in the fall (ideal career is nebulously defined as trying to do something to improve diabetes care and I hope I'll be able to get some clarity on that as I start my program.)

The program requires two pre-reqs and strongly recommends a third, so for the last six weeks I have been doing nothing but studying, taking exams and reading.  These classes are accelerated classes during the summer, so they will be over soon (thank god) but it's been a lot, cause did I mention these three classes are microeconomics, accounting and statistics? Oh, yeah.  F-u-N!

I was not a diabetic in college, didn't get the 'betes until I was 25..  (Which is a very good thing, considering my typical college weekend consisted of beer, pizza, waffles, beer, jungle juice, beer, pizza, bread sticks, beer, Gatorade, cereal and Gatorade.)  

I really had no idea what going back to school was going to be like, diabetes-management-wise.  Funnily enough, its easy to go right back to those eating habits I just described...with maybe not quite so much beer.... I've been in class so much that food shopping for fresh healthy food has gone by the wayside, and bagels, pizza, and big macs-with-no-meat are my new besties.  Not ideal, I know.

Last week, I had lunch with a friend near my school. We had sushi, which is definitely on the I list of "I love carbs but they don't love me" foods, but I eat it every once and a while and (thought) I had worked out a decent bolus.  For me, its actually one unit for every piece of sushi.  We ordered three rolls to split and had some edamame.  I bolused 9 units and only ate 7 pieces, so I thought I was good.  On the way to school, I must have immediately been feeling the carb-high-sluggish-brain coming on, because I wanted coffee but for some reason, ordered a cappuccino (way more carbs than I needed/wanted =high bg brain fog?) so 2 more units for that.

Now onto the homework and studying in the library before class.  Two hours of reading and homework later, I realized, I had not retained A (not one) thing. Fast forward to the next day, when I got the grade on the homework I turned in.  Not even half the questions right (Luckily, I've been doing well on all the other assignments.)  Ugh.  Its easy looking back, with a reasonable blood sugar brain, to see that I should have checked my bg sooner, and corrected it.  But when you're in the throes of high-blood-sugar-blood-is-as-thick-as molasses-and-is-clogging-my brain its not even easy to make the decision to test.  So lesson learned.  And, re-learned, as far as my homework goes. 



This is a normal brain...axon and dendride firing signals... you remember biology...making the brain work. (Picture courtesy of http://en.wikipedia.org/wiki/Synapse)

This is a brain after sushi (or other high carb food is consumed) axon and dendrite clearly unable to function normally.

Freaky Tuesday

Yesterday was my birthday.  I had a great day that started with coffee and presents in bed.  Ahhh.  Promoting my happiness.  (side note: I went to dinner a few months ago a new restaurant, and at the end the waiter asked me if there was anything else he could do to "promote my happiness."  I decided that this phrase needed to be included in my life at least once a day from that point forward.)


Then my meter beeped to tell me my reservoir was low.   (Ok, to be truthful it beeped the night before but I didn't feel like to changing it so I checked to see how many hours of insulin I had left.  Omg, 19 hours!  I'm only gonna sleep for about 7, I don't need to change it now! I rationalized...)  And, luckily, I have always drank (drunken? drinked?) black coffee with one splenda so I don't have to worry about bolusing for coffee in the morning.  But...eventually.... I had to get out of my wonderfully warm and comfy presents-covered bed and change my reservoir. 

I don't know why I said this, as I wasn't really in a morbid mood, but I sighed, "Gotta get up and change this thing so I can live another day."

Later, after lunch and cupcakes! on the roof deck I had class from 6-9 pm (brutal!) Its 20+ miles from my house, and knowing greater Boston traffic, I leave 2 hours early just in case.  Traffic was actually light, so I had an hour to kill before class. I decided to take a walk in a huge cemetery that's on the way to class.   It was a nice day, the cemetery is nicely landscaped and  is not at all freaky...

Well, that is, not at all freaky until this:

Two headstones next to each other: one with my  name, one with my husand's name.

Gah!

Who am I Ebeneezer Scrooge 

with the Ghost of Taking-a-risk-by-not-refilling-your-reservoir-when-you-got-the-warning Future? 

And on my birthday? Man!

(Other than this freaky episode, I really did have a wonderful birthday)

The Diabetic Manual

Right now, I am supposed to be studying for my exam tonight.  What am I doing instead?  Procrastinating big time by reading the "Diabetic Manual: Tenth Edition" written by Dr. Elliot Joslin in 1959.

I found this at an antique store in Maine last summer and have been meaning to read it but haven't got around to it until now, when I'm supposed to study :-)  I'm interested to see what kind of advice was given to PWD in 1959.  I'll be sure to post some good tidbits as I get to them.