tag:blogger.com,1999:blog-12822851145986638382024-02-20T11:18:42.326-08:00Alternate InteriorMy adventures with diabetesBrian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-1282285114598663838.post-33039531785378624422012-03-30T10:01:00.000-07:002012-03-30T10:01:10.294-07:00Site Selector<p>Yesterday evening, Site Selector appeared on the <a href="http://itunes.apple.com/us/app/site-selector/id512982620?ls=1&mt=8">iOS App Store</a>. If you don't already know, it's a graphical log of where you're wearing you insulin pump and CGM. Since they lose effectiveness at different rates, sites can be reused with different frequencies, and their schedules are generally different, it can be difficult to keep on track of proper rotation. I didn't have trouble until getting the Dexcom, but I needed help and doing it on paper just didn't have the right accuracy.</p><p>So this is my first app. I've been doing web apps for pushing ten years, but this is my first iOS App. I used <a href="http://phonegap.com/">Phonegap</a>, which lets you write native applications with HTML & Javascript. Used <a href="http://www.sencha.com/products/touch/">Sencha Touch 2</a> for the interface. There are other technical details on the project's <a href="https://github.com/altintx/Site-Selector-Webapp">Github page</a>. (That's right. The webapp is open source).</p><p>Of significant importance with medical apps is your privacy. This log lives entirely on your device. It never touches the Internet. (If Apple decides to start replicating your data across devices, or backups, or..., or..., or...; that's different. <strong>I never push your data to the internet. I can't promise that Apple doesn't.</strong>) This also has the downside that all your data lives on the device. I hope it's safe. I've taken steps within the app to keep your data safe. But there's always the potential your phone takes a bath and the data disappears. It's possible an upgrade goes badly, and your data disappears. Perhaps a volcano halfway across the world erupts, and your data is swallowed in a river of lava. I don't think so, but the unexpected can happen. So best not to instantly forget where you've placed sites.</p><p>In the time this app has been under review by Apple, I've worked on bug fixes, and new features. The interface is a little easier to use. It's faster. Both insertion and removal dates are tracked. Times are now tracked. You can look up to 90 days into the past, to see sites from long, long ago.</p><p>One other feature I'm working on, and may be in the next release, or may not, is a CSV export. What that means is the data you enter can be transformed into a spreadsheet. Right now, I'm investigating what's possible, how to make that data available to you (Email? In iTunes? Copy/Paste? Haven't decided yet). I think that will be a useful feature, but want to get it right. And it'll make me feel a whole lot better about your data not living on the cloud: if your phone takes a bath one day, at least you'll have had the opportunity to back it up.</p><p>So that's Site Selector: It's available on almost all iOS devices. At least everything that runs iOS 4. Should even be attractive with the newest iPad, as it ships with insanely high resolution images.</p><p>Last: This is an opensource webapp based around Sencha Touch. Sencha Touch is supported on iOS, Android, Blackberry, and a couple of others. Phonegap has similar compatibility. I'm not especially interested in building or submitting for these other platforms, but if you are, go for it. Shoot me an email (site selector at alternate interior dot com) so we can coordinate but I'm all for this application being more accessible to people.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com2tag:blogger.com,1999:blog-1282285114598663838.post-40035459804255995652012-03-20T08:58:00.000-07:002012-03-20T08:58:38.765-07:00Public Knowledge<p>This is my first-ever contribution to the <a href="http://diabetessocmed.com/dsma-blog-carnival-2/">DMSA Blog Carnival</a>. </p><blockquote>Does your employer/school/friends know you have diabetes? Why or why not?</blockquote><p>Most people I actually know are aware I'm diabetic. Details vary based on closeness, interest, etc, but for the most part, everyone is aware. While I certainly don't introduce myself as "My name's Brian, and I'm diabetic," there are inevitably occasions where my pocket is beeping, or I can't join in lunch, or have to check out of a meeting, or, or, or, and it's easiest to say "Diabetes" than to make up a filmsy excuse.</p><p>Even in the earliest days of my diagnosis, I would admit Diabetes. But while I was on shots, I was nervous about doing that in public. Even checking sugar, I would try to do in private. I have no problem using my pump in public, and I'm now comfortable checking sugar in front of others, but I tend to think if I ever had to go back on shots, I'd still be private about that. It's probably because you're more exposed with shots: it may not be clear what you're doing, but it's clear you're doing something <em>serious</em>.</p><p>But in just knowing, it's easier to put the knowledge out there. I've been fortunate in not having <strong>many</strong> run-ins with food police and even then, the convenience of not having to remember who knows what and who can know and that sort of drama far outweighs the annoyance of know-it-alls. There's also the benefit that, should anything ever happen, people would be better equipped to respond, if only to pass additional context on to first-responders.</p><p>So I put it out there because I'm lazy and it's self-serving.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com2tag:blogger.com,1999:blog-1282285114598663838.post-34900338993037430612012-03-07T07:34:00.000-08:002012-03-07T07:34:44.112-08:00The one with the swollen armLast night, I had a milkshake. <br />
<br />
It was on the tail end of an infusion set. Took a truly absurd amount of insulin, ate, and enjoyed. Once I got home, I changed the set. Put the new one in my right arm.<br />
<br />
Two hours later, I was at 165. Three hours later, I was at 120. I had owned that milkshake.<br />
<br />
But then, suddenly, I got a ↗. Moments later, a ↑. By the time I rage bolused, I was up to 180 something and still raising. The pump wanted me to take about .7U, because I still had some on board. But I know better. So I took 7.0U. Blood sugar continued to rise as it was being absorbed but I topped out around 250. A second smaller bolus followed. Fought for a couple hours and got it down to 170, and went to bed. <br />
<br />
Couple hours later, Dexcom buzzed. I was back up to about 230. Took the appropriate amount (not going to rage bolus if I won't stay up to babysit it) and went back to sleep. Looking at the graph, it got down to about 180 and then started right back up. Next time I woke up was closer to 300. Again, a normal correction, and back to sleep.<br />
<br />
Tangent: Not sure what the point of trying to sleep with bad sugar is. It's the least restful thing I can imagine. 3 Hours of restful sleep is better than a full night of sleep on the glucocoaster.<br />
<br />
When I finally woke up for real, I was around 200. And my arm felt swollen. And I realized, it wasn't the milkshake doing it to me, it was the infusion site. So I replaced it. Of course the old one bled. But the new one didn't stick! Half of it adhered to my belly while the other half flapped in the wind. I pressed and pressed, and there was no taming it. So I took it out. And it bled. Quite a bit. <br />
<br />
The third infusion set in 12 hours went in without incident. My sugar is finally nicely and predictably declining. It just took using extra extra supplies that I'm going to need in another couple months. And enough time to convince myself it wasn't at all feasible that the milkshake was responsible for it all.<br />
<br />
When I had the Medtronic pump, there was only one type of infusion site. It was 23" long, and I could put it in my belly, butt, back or thigh (and I wasn't brave enough to put it in my thigh). Now with the Ping, I have 46" tubing as well, and I'm using body parts like my arms that I just didn't ever use before. If I were to use the Ping exactly the same as the Medtronic, it'd work just as well. But it allows me to try sites I wouldn't have used before and they're just not at all a sure thing. The occasional failed site on a Saturday afternoon is one thing, but a failed site that costs me a night's sleep and 3 infusion sets is much more frustrating.Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com1tag:blogger.com,1999:blog-1282285114598663838.post-44910154196978662732012-01-27T13:18:00.000-08:002012-01-27T13:18:28.707-08:00Carb Limits<p>Since being exposed to so many other Diabetics via the #DOC, I've been surprised by how carb-limited many people are. </p><p>To begin with, I'm slim and slightly underweight. Could stand to gain 10 or 15 pounds. Gaining 5 takes constant work and the first time I waver it melts away. So I don't need to limit for weight reasons.</p><p>I have a self-imposed per-meal limit of 70g of carbs. I'm pretty good at sticking to it. Sometimes I misestimate. Sometimes I intentionally blow past it. But generally, 70 is my limit and 50-60g is common. That makes my per-day carb limit about 210g. In reality, I come in closer to 170g. So that's just north of half the FDA guidelines.</p><p>The only reason for that self-imposed limit is how much harder it becomes to manage blood sugar on larger meals. 70 is hard. 90 is... harder.</p><p>But when talk turns to food, I notice people limiting themselves to 70g... a day. Less than half of my common day and fully a third of my upper limit. Some people eat 20-30 a meal. And I ask, how? I can eat a huge steak dinner, but without a couple servings with bread, I'm simply not full.</p><p>From my understanding, there isn't a maximum safe dose of insulin. So given controlled numbers, there's no downside to taking the insulin to cover the carbs. And if I need that many carbs to satisfy hunger, then I may as well dose for them.</p><p>Largely, then, I wonder two and a half things:</p><ol><li>Is my understanding about insulin wrong? Do I need to use less? Presently I use about 45U on a good day, up to mid-50s when battling highs.</li>
<li>How do you stay satisfied with so few carbs? Do you adapt? Did you never want them? </li>
<li>And last, how do you deal with lows, especially when so carb-limited? If it takes 20g to produce a rebound, and you only get 30g for a meal, then you're looking at salad. Right?</li>
</ol><p>Generally what I'm doing is working. But seeing so many people, with so similar a regiment, that is so different than mine, leads to second-guessing my plan.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com3tag:blogger.com,1999:blog-1282285114598663838.post-5777061200288376422011-11-15T13:13:00.000-08:002011-11-15T13:13:30.229-08:00Pauses<p>When first diagnosed, I was given three hard, numeric references for insulin. Not fluffy relative terms but absolute. rules. I like those. There's no room for interpretation. They just are what they are.</p><p>The first was a carb ratio. I would take 1U for every carb exchange. And one carb exchange = 15 carbs. That ratio quickly proved to be a little off, but it was a hard number I could work with.</p><p>The second was correcting. I would take 1U for every 50 points above 100 I was. That number, too, was fairly quickly changed in the real world but there it was.</p><p>The third I still struggle with. It was an explanation of how long after correcting I should wait to eat. From memory, it was something like:</p><table><thead>
<tr>
<th>BGnow</th>
<th>Dose</th>
<th>Delay</th>
</tr>
</thead>
<tbody>
<tr>
<td>100</td>
<td>0 + Meal</td>
<td>Now</td>
</tr>
<tr>
<td>120</td>
<td>0 + Meal</td>
<td>5 minutes</td>
</tr>
<tr>
<td>150</td>
<td>1 + Meal</td>
<td>10 Minutes</td>
</tr>
<tr>
<td>200</td>
<td>2 + Meal</td>
<td>15 Minutes</td>
</tr>
<tr>
<td>250</td>
<td>3 + Meal</td>
<td>20 Minutes</td>
</tr>
<tr>
<td colspan="3">And so on</td>
</tr>
</tbody>
</table><p>The source of confusion, especially now, is my blood sugar doesn't change <em>that</em> fast. 20 Minutes after correcting with a blood sugar of 250 isn't going to put me anywhere near normal territory!</p><p>Logically, I can reckon that:</p><ol><li>The extra insulin from the meal will lead to a quicker fall than the correction dose by itself.</li>
<li>A meal with fewer carbs will have less of a rebound than a meal with more, so you may be able to fudge and eat a little sooner that way.</li>
<li>And last, you don't want to be #bgnow 100 with 12U active (and active without lag)</li></ol><p>But Novalog, for me, tends to take 15-20 minutes before anything appreciable happens to my blood sugar. And with a hypothetical 250, an hour is unlikely to put me anywhere near 100.</p><p>So instead of dealing with a reasonable 10 minute pause, I tend to follow one of three (including lows) algorithms.</p><dl><dt>For a blood sugar < 140ish</dt><br />
<dd>I dose whatever fractional correction the pump spits out at me and eat.</dd><br />
<dt>For higher blood sugars</dt><br />
<dd>I rage bolus the high, check sugar every 20 minutes or so and once it's fallen by about half eat bolus the difference between active and what I'm meant to take for the food.</dd><br />
<dt>And for low blood sugars</dt><br />
<dd>I tend to take a 30 or 60 minute square wave depending how complex the carbs are and eat now - because <strong>remembering</strong> to bolus at some indeterminate point in the future is not one of my strengths. </dd><br />
</dl><p>Over the years, I've been able to adapt the first two rules from the initial diagnosis rather easily but just haven't ever figured out how to incorporate the delays/lags/etc defined in the third into my regiment. I may have a system but it too often leads to a low or high a couple hours in the future. I'd love to one day figure out a math function to give me an optimal time differential for correcting & eating. </p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com1tag:blogger.com,1999:blog-1282285114598663838.post-90236104955003411972011-11-03T11:54:00.000-07:002011-11-03T11:54:44.562-07:00Approaching 24 hours with the Dexcom<p>The Dexcom was waiting outside the door when I got home last night, a day early. So I opened it up, reviewed the getting start process, plugged the receiver in to charge, and went about dinner and <a href="http://tweetchat.com/room/dsma">#DSMA</a>. After #DSMA, it was time.</p><p>I'd worn a Dexcom for about 10 days a month earlier, in a trial through my <a href="http://www.linkedin.com/pub/donna-tomky/7/a1/ab6">CDE</a>. (Note, sometimes I call her an Endo, sometimes a doctor, sometimes CDE. I don't really know. I don't really care. She does everything I need and is generally awesome.) I read the process of sensor insertion about half a dozen times and started. It must have taken 15 or 20 minutes to get it in OK. Getting the needle in went ok. Removing the insertion mechanism took some work. Getting that collar up as high as can be HURT. The entire sensor lifted up towards the middle and there was some blood clearly visible. But I did manage to remove the mechanism, and settle the sensor down closer to my skin. The pain was much more severe than when my doctor did it. I suspect that's just the learning curve, because she also did it much faster than I was able.</p><p>It was nearly time for bed once calibration was complete. But around 4AM, my wife woke me up because the Dexcom woke her up. (It had been going off for pushing an hour by then.) It was a 48. Confirmed and it really was low, so grabbed some sugar from the nightstand and went back to sleep. When I woke up for real three hours later, the screen looked like ____/----/`````. It said 140-something, but my meter said 104. But over the course of the morning, I had a stubborn but mild high that just didn't want to go away. In retrospect, I wonder if it really was closer to 140. </p><p>And now we're at lunch. I had a slice of pizza and salad. Started a square wave 10 minutes or so before eating, so had a slow descent and was in the high 90s while eating. But an hour later, I was still creaping up, past 150. Small correction and kept climbing. Repeat. Repeat. I managed the arrest it by 175 a half hour agp, so the Dexcom adverted a high. I'm flat or slowly descending at 166.</p><p>I can't know how I'll feel in 6 months, but for now, I love seeing this kind of information. Probably check the silly thing every 10 minutes. My immediate goal with the Dexcom is just to tighten the ranges. My A1c is pretty good (Labwork likes to warn me that with an A1c around 5.8, I'm at risk of developing Diabetes: HAH!) but it's only that good because I have far too many lows. If I can go from 60 being an every day occurrence to, say, once a week, and make the corresponding cuts on the high end, I ought to be able to hold an A1c in the high fives or low sixes, but hold that much more safely. It'll be the Dexcom's credit if that happens.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com0tag:blogger.com,1999:blog-1282285114598663838.post-32297881314511780482011-10-26T19:48:00.000-07:002011-10-26T19:48:07.345-07:00DSMA is the Diabetic Online Community at Large<p>Tonight was <a href="http://tweetchat.com/room/dsma">#dsma</a>. (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.</p><p>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 <a href="http://twitter.com/diabetic_iz_me">@diabetic_iz_me</a> or <a href="http://twitter.com/diabetesalic">@diabetesalic</a> 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 <em>it</em> being a community but given the tools I have, volume-control is the best way to keep Twitter generally useful.</p><p>#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.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com3tag:blogger.com,1999:blog-1282285114598663838.post-9288198232271954362011-10-25T07:41:00.000-07:002011-10-25T07:41:19.849-07:00Feeling discouraged<p>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.</p><p>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.</p><p>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.</p><p>Next, I tried using glutes. Pattern continued, left worked OK, right didn't work.</p><p>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. </p><p>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.</p><p>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!</p><p>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.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com4tag:blogger.com,1999:blog-1282285114598663838.post-77349263934544629812011-10-18T12:14:00.000-07:002011-10-18T12:14:23.779-07:00Gadget Names<p>This probably puts me in the minority of the <abbr title="Diabetic Online Community">DOC</abbr>: I don't name my gadgets.</p><p>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. </p><p>That's all.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com1tag:blogger.com,1999:blog-1282285114598663838.post-72300279465888004812011-10-17T08:23:00.000-07:002011-10-17T08:23:36.319-07:00The Search for Fat<p>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.</p><p>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!</p><p>Luckily, it seems to be working. Been in for about two hours now and my blood sugar's 82.</p><p>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.</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com0tag:blogger.com,1999:blog-1282285114598663838.post-15113273804780496922011-10-14T20:19:00.000-07:002011-10-14T20:20:04.692-07:00Unsolicited Help<p>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.</p>
<p>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.</p>
<p>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 <em>conflicting</em> advice on me.</p>
<p>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 <strong>symptom</strong>, not something correctable! Yet I said nothing.</p>
<p>As I saw it, the options were</p>
<ol>
<li>Explain I'm diabetic and have low blood sugar and I'm off to the cafe to treat.</li>
<li>Keep diabetes to myself, stop playing, but carry on the last couple hundred yards with them</li>
<li>Keep playing, poorly, and then politely lose them</li>
</ol>
<p>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.</p>
<p>And <em>yes</em>, 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.</p>
<p>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?</p>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com1Albuquerque, NM 87113, USA35.151986028827672 -106.6107273101806635.145495028827675 -106.62059781018067 35.158477028827669 -106.60085681018066tag:blogger.com,1999:blog-1282285114598663838.post-57842605541004471812011-10-05T12:35:00.000-07:002011-10-05T12:35:58.098-07:00Today the Dexcom adverted a highToday 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.<br />
<br />
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.<br />
<br />
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.Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com0tag:blogger.com,1999:blog-1282285114598663838.post-28815331188503571322011-09-29T19:27:00.000-07:002011-09-29T19:29:28.264-07:00Invisible Illness WeekThis is weeks late, but <a href="https://twitter.com/#!/jessmeandd">Jess</a> did this and is actually what inspired me to set up this blog. And even if its late I still wanted to do it.<br />
<dl><dt>The illness I live with is:</dt>
<dd>Type 1 Diabetes</dd>
<dt>I was diagnosed with it in the year:</dt>
<dd>2004</dd>
<dt>But I had symptoms since:</dt>
<dd>several months before</dd>
<dt>The biggest adjustment I’ve had to make is:</dt>
<dd>Not trusting my feelings. I can feel fine but know something is off, or something can be off and I just don't believe it. There's a lot of second guessing.</dd>
<dt>Most people assume:</dt>
<dd>I did this to myself by eating sugar.</dd>
<dt>The hardest part about mornings are:</dt>
<dd>Lows. I'm so unbelievably groggy in the morning and with low blood sugar I'm stumped by getting up. Highs aren't fun either, but they lead to a bad mood, or maybe even feeling miserable, but not overall general dysfunction.</dd>
<dt>My favorite medical TV show is:</dt>
<dd>House, though I don't watch it tons anymore.</dd>
<dt>A gadget I couldn’t live without is:</dt>
<dd>If I had to pick, I'd say the pump. Might be reckless but I'd rather guess at corrections than know the number and be unable to do anything about it. (And sure, there are syringes, but this is hypothetical!)</dd>
<dt>The hardest part about nights are:</dt>
<dd>Being tired but not willing to go to sleep because sugar is off in either direction. I sleep bad when it's not right. I can sleep (and appear to be unusual in that sense) but sleep and rest are not inherently linked.</dd>
<dt>Each day I take a few pills & a couple vitamins:</dt>
<dd>Insulin. Don't take pills very reliably.</dd>
<dt>Regarding alternative treatments:</dt>
<dd>Exercise helps but I'm not willing to do a zero-carb diet & maintain the physical exertion necessary to have a chance at it.</dd>
<dt>If I had to choose between an invisible illness or visible I would choose:</dt>
<dd>Invisible. I vent sometimes, but its not because I want sympathy. And I choose to vent. With a visible illness, that's not a choice to the same degree.</dd>
<dt>Regarding working and career:</dt>
<dd>I work in an office and it's never been a big conflict.</dd>
<dt>People would be surprised to know:</dt>
<dd>Diabetes sucks because it requires constant maintenance. But at the end of the day, it's not as limiting as it may appear.</dd>
<dt>The hardest thing to accept about my new reality has been:</dt>
<dd>Initially, it was the crappy selection of diet soft drinks.</dd>
<dt>Something I never thought I could do with my illness that I did was:</dt>
<dd>Grew to adore Diet Coke.</dd>
<dt>The commercials about my illness:</dt>
<dd>I haven't seen many commericals about it but the magazine covers sometimes grate at me. </dd>
<dt>Something I really miss doing since I was diagnosed is:</dt>
<dd>Being reckless. Running off to something without wondering if I can run off to do it.</dd>
<dt>It was really hard to have to give up:</dt>
<dd>High blood sugar. It must have taken months after being diagnosed to not feel terrible at "normal" levels.</dd>
<dt>A new hobby I have taken up since my diagnosis is:</dt>
<dd>Cupcakes!</dd>
<dt>If I could have one day of feeling normal again I would:</dt>
<dd>Pie. Lots and lots of pie.</dd>
<dt>My illness has taught me:</dt>
<dd>To deal with life. Things don't always go your way. Tough. It's not your fault. It's not anyone else's. But you get to clean up the mess.</dd>
<dt>Want to know a secret? One thing people say that gets under my skin is:</dt>
<dd>"How's your sugar?" If it's gonna be a problem I'd volunteer it. Note, this is different than subtly implying I need to <i>check</i> my sugar.</dd>
<dt>But I love it when people:</dt>
<dd>Treat me as a person without diabetes.</dd>
<dt>My favorite motto, scripture, quote that gets me through tough times is:</dt>
<dd>Can't say I have one.</dd>
<dt>When someone is diagnosed I’d like to tell them:</dt>
<dd>Don't worry about all the responsibility people are warning you about. Take as good care of yourself as you can. No reason to fret about things you haven't even encountered yet. And get a pump. Now. I'll wait.</dd>
<dt>Something that has surprised me about living with an illness is:</dt>
<dd>Learning more about nutrition.</dd>
<dt>The nicest thing someone did for me when I wasn’t feeling well was:</dt>
<dd>My wife comforting me, when things just don't go right. It's calming.</dd>
<dt>I’m involved with Invisible Illness Week because:</dt>
<dd>I saw <a href="http://jess-meandd.blogspot.com/2011/09/my-turn.html">Jess's post</a> and though, that'd be fun.</dd> </dl>Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com1tag:blogger.com,1999:blog-1282285114598663838.post-46974108140873929072011-09-29T18:53:00.000-07:002011-09-29T18:53:54.440-07:00Continuous MonitorToday, my endocrinologist set me up on a loaner Dexcom 7.<br />
<br />
I've had a CGMS before; a Medtronic that linked to my pump. That was 2 years ago. Suffered a number of problems with it: it wasn't accurate, it hurt terrible going in, and the adhesive on it would quickly expire. I tried it several times over a two year span but eventually frustration got the better of it.<br />
<br />
So as of now, the D7 has been jacked in for about 9 hours, and feeding data for a couple fewer.<br />
<br />
To start with, insertion pain was much reduced. It's still nothing that I'd say feels good, but it's less painful than my pump and far better than the previous CGMS. As accuracy goes, it's better but still not great. Right around 100-120, it's pretty accurate, but highs and lows seem to be greatly exaggerated. A 140 this afternoon showed as 180. An 80 before dinner was flashing a low that bounced around the low 50s. But so far I haven't seen it report a high as a low, or been wildly off base. Too soon to call adhesive good, but it's better.<br />
<br />
One thing I didn't expect, and admittedly is easily resolvable, is that the belt loops on my pants are quickly being used up. Pump takes one, D7 takes one, and in some cases, my regular meter takes one. Think I'd be more willing to stick the D7 in my pocket if it weren't a loaner.<br />
<br />
For the last half hour, D7 says I'm in the low 70s. I had a moderate-high carb dinner of a meatball sandwich and a cup of fruit. According to the CGM, I never broke 150. Meter say 85: 77 vs 85, pretty good!Brian Boshhttp://www.blogger.com/profile/10776636957211954062noreply@blogger.com0