DSMA is the Diabetic Online Community at Large

Tonight was #dsma. (It's every Wednesday @ 9PM EST if you're interested.) And so I got to talk with a number of other diabetics who are outside of my normal #doc feed.

While I don't have an exact number, I'd bet I follow fewer than 50 diabetics on Twitter. There are tons more. There are the celebrities of the community like @diabetic_iz_me or @diabetesalic that I don't follow. Absolutely nothing against them, but I use Twitter for bantering with real-life friends, political posturing and technical issues as well. They and many other core group of DOC members are so followed that the number of tweets in the timeline grows exponentially because not only do I see them, I see the bantering between them and everyone else too. It's part of it being a community but given the tools I have, volume-control is the best way to keep Twitter generally useful.

#dsma is a way around that problem. For once a week, I can forsake all matters non-diabetic and see the spectrum of peoples and their thoughts. One hope from this blog is I can follow more in a less instant manner. Still won't see every thought, but it enables seeing more than I would on Twitter alone. And until I can handle the volume on day-to-day Twitter, #dsma is the outlet to the community at large.

Feeling discouraged

It was early 2007 when I got a pump, the Medtronic Paradigm 522. The first month or two could have gone smoother but that was learning and growing pains. Stuff like dealing with the tubing. Or unlearning to pinch my belly before putting the injection in. Since then, I've dealt with a water-damaged pump, two other mysterious incidents where the pump would consume batteries in a matter of hours (for days at a time) but in general, it's all gone smoothly.

But these last few months have been harder. I've started to notice small scars or marks from the infusion sites that last weeks instead of days. As I've been more active this summer than I typically am, it's been a struggle to find fatty parts of my belly to use. And so, four years after starting pumping, I've been exploring alternative sites.

First was hardly exotic at all. I just went all the way to the edges. The infusion site was at my 3 and 9 o'clocks. The first time was on my left and it worked fine. But then on my right side, it could have gone better. Then I followed around to my back. There's little fat there, just two small spots above my hips. And again, left side worked, but on the right side, I struggled with high blood sugars and the infusion site came out with a bent tip.

Next, I tried using glutes. Pattern continued, left worked OK, right didn't work.

I've never been brave enough to try thighs. It's hard to imagine them working any better plus I'd need to shave. And I've heard of people using their arms but that makes me even more squeamish than trying legs.

So last night, being out of viable sites on my stomach, I tried the left side of my butt again. It went it, it didn't hurt, and I was relieved. My last 2 stomach sites have felt like beatings, so for it to go in relatively peacefully was a relief. Couple hours later, I went to bed with a blood sugar of 90.

I've slept better, waking up around 3AM but getting back to sleep. But at 6AM I felt like death. Checked blood sugar and was up to 414. Can't remember the last time I was that high. 350, but 400? Not in a while. I didn't even try correcting, went right to replacing the infusion site. And found the cannula sitting atop my skin. No wonder it didn't hurt!

The Dexcom should be coming in the next week or so, and hopefully that'll keep me from getting into that bad a place again. But I'm so discouraged about pumping right now. It's convenient and has worked well, but it's been so hard these last couple months to find usable sites and the rash of skewed cannulas isn't helping either.

Gadget Names

This probably puts me in the minority of the DOC: I don't name my gadgets.

I've got a Medtronic pump, a FreeStyle meter and soon, a Dexcom 7 CGMS. And I call them "the pump," "my meter," and "the dexcom." Some people seem to give them funny names, people names, etc, but mine are just descriptors of what they are.

That's all.

The Search for Fat

It was time to put in a new infusion site this morning. I searched, groggily, for fresh torso that I could sink it into but found I was somewhat lacking in usable fat. Every really juicy part of my stomach still has those red marks from sites past. I couldn't find a spot on my back that was assuredly cushioned enough. My butt has been too unpredictable and I've never explored thigh sites or other parts of my body.

So I did find a clean spot on my stomach, and it had a bit of fat, so I went ahead to use that. Did all I could to loosen up before releasing the needle, pushed the button, and POW: It hit me like a metallic fist of fury. It was one of those insertions that makes you want to puke in response. Luckily, it passed quickly and settled into something closer to the typical dull pain that the first few hours of a new site means. But, OW!

Luckily, it seems to be working. Been in for about two hours now and my blood sugar's 82.

People often look at me like I'm crazy when wishing to be fatter. I don't want a beer belly or anything like that, but it's incidents like today's that makes me wish I had a little bit.

Unsolicited Help

This afternoon, after work, I stopped to play golf on the way home. I've been playing for several years and have fun with it, but am not by any stretch good. That said, that late in the day the course is pretty slow and I started playing alone.

On the third hole, another solo player waved me forward and we finished the hole together. But as we started hole 4. he could help but offer advice on how to improve my game. A big part of what I like in playing alone is that not happening. But things being what they were, I tried to be friendly and try his advice. And truth be told, his advice wasn't bad.

A few more holes transpire, and another individual joins our little group (a large group ahead was causing us to stack up behind them). Luckily, he too wanted to impart his conflicting advice on me.

On the last hole, my swing went to hell. That's a good indicator my blood sugar has gone south. But the guys I was playing with didn't know that, so they just wanted to further help my swing. Yes, I'm swinging too hard, or moving my back, or any number of other defects you can so helpfully point out, but they're a symptom, not something correctable! Yet I said nothing.

As I saw it, the options were

1. Explain I'm diabetic and have low blood sugar and I'm off to the cafe to treat.
2. Keep diabetes to myself, stop playing, but carry on the last couple hundred yards with them
3. Keep playing, poorly, and then politely lose them

I choose #3. I don't want to advocate while low, and I don't want to spend 15 minutes insisting everything's OK while they finish. I resented having to choose at all.

And yes, I had reduced basals hours earlier, and had sugar for the game, but I'd run out a couple holes earlier. Just need to remember to bring more.

I like the support system the DOC offers. It's a support system I've opted-into. But this well-intention-ed unsolicited help? I can do without it. Not for diabetes, and not anywhere else in life. One day, I'll have to learn to more forcefully reject people's good intentions. I don't really want to be an island, but how about a really long peninsula?

Today the Dexcom adverted a high

Today was Applebee's Wednesday, that fabled day the developer group goes to Applebee's for lunch. And I got a bacon cheeseburger; one of the about three dishes I get there. I too often spend a few hours in the early afternoon around 200 after.

Getting back from lunch, blood sugar was about 130 and slowly increasing. But 40 minutes later, or so, it was accelerating towards 150. So I corrected. That slowed, but did not stop, the assault on my blood sugar. An hour later, it was accelerating towards 170, and I threw more Insulin on the fire. That stopped it and turned it around. I'm presently falling, quicker than I'd like, but a couple glucose tabs in 20 minutes and I'll be right as rain.

170 two hours after eating is nothing wonderful. But without the Dexcom, I'd be more like 210 or 220 right now, and those numbers are much harder to correct than a 170.