The Family Pet, With Diabetes

I recently had a random thought about an old family pet.

We had a dog named Shasta who had canine diabetes. All of the care and attention she needed parallels mine today. I remember my dad giving her insulin shots and even rare instances when she would seizure. A sudden sense of urgency would fill the room and a brown sugar snack would soon rush her way.

It becomes much more complicated treating a family pet who has diabetes. If only Shasta could have signaled when she needed some sugar. I imagine she would scratch at the chip cabinet when in need of a snack. A supply of dog bone shaped glucose tabs would have been perfect! But with such a full, round belly on her, she surely would have taken advantage of her new power of communication! Snacks all day would have been heaven for that old girl.

Shasta was not alone in her canine needs. Other animals need to receive insulin, much the same way Shasta did. Watch Cookie the dog take her insulin shot like a champ through this YouTube clip.  

I had not made the connection of Shasta’s circumstances to my own situation, until now. Diabetes was right in front of me while growing up and I barely even noticed. I presume this is how it works in the human to human world also. Even with the booming rate of diabetes diagnoses we are seeing, if it doesn’t touch your life directly, it is easy to glance over.

Back to the animals…

Cookie and Shasta don’t monopolize the diabetes care seen in pets. Other family pets need treatment in the same way. I ran across this YouTube clip also. One cat owner shares his routine for testing his cat’s blood sugar. He even keeps a kitty log book. Recording blood sugar levels and time of day. All noted to discuss with the veterinarian team, later on. What compassion this owner has for the health of feline Buddy, his family friend.

 

Subsequently, check out Dave and Smokey’s duo-diabetes tale at Kerri’s new feature: Six Until Me’s “Your Story”.

I have a lot of respect for care-givers. Whether professional or familial… it shows a magnitude of compassion to look after the health and safety of others… others with or without opposable thumbs even!

Relying on ReliOn

Too easy of a title, I know… but the glucose tabs ReliOn makes have found their way into my life and I’m lovin’ them so far.

I previously didn’t understand the need for glucose tabs. I mean… come on. Why pop boring old sugar tabs when you can splurg on a little soda or candy? I have found out the answer to my own question.

Reliability and reproducability(a term drilled into my head during chemistry). Each glucose tab holds 4 grams of fast acting glucose. That means, a precise amount of fast acting sugar makes it happy way into the bloodstream—fast. It takes away the need to track down a soda or food and then portion out that food or drink.

I usually need no more than two tabs at a time. Sometimes, just one helps bring up the blood sugar just the right amount. It is nice, also, when I am headed to bed and my number is a little low. I can pop a tab and be confident I will wake up in range. No need to run to the fridge which inevitably leads to overeating and high blood sugar all night.

Glucose tabs… cheap and efficient. Go figure.

Tethered Down: The Low and the 42 Ouncer

I was feeling a little low  before a mildly coercive trip to the Fashion Valley Mall. Julie wanted to do a little shopping and I decided it was better to be out and about with company, than to be home alone… even if it meant bearing through masses of people and enduring the obnoxious sales people aplenty. Regardless of all that, 51 mg/dL would not due. 

A good suggestion of McDonald’s was made. It would serve as a quick glucose pit-stop on the way to our destination. Despite my bottomless loathing of the franchise, I was not in clear enough state of mind to argue or suggest an alternative.

The deal of the week, apparently, was their 42 oz. fountain drink for .69 cents. Yikes. All I needed was a small soda. Something under 20 oz. would have sufficed. But comparing the prices of all sizes, the 42 oz. was still the cheapest. “Ask them if I can just pay for a 42 ouncer and get it in a small cup”, I ask Julie… as she was in the driver’s seat and placing the order. “Nooo”, she says in jest. “Just take the big one”. 

So we are on our way, with 42 ounces of Powerade… and a six piece nugget.

Well, I was hungry too!

I drank some sugar-juice and ate my nuggets. About twenty minutes later, I decided to re-test my blood. 53 mg/dL. Oye, what’s the deal? I should have seen some results by now. 

By that point we were at the mall and I was still sucking on that giant mug of sweet stuff. It was at that moment, I felt a little pissed off. About to enter the mall… to wind throught the maze of consumer goods… and I had to carry around this daunting cup. 

I felt so dependant. I couldn’t leave the cup behind because I needed to bring up my numbers a little more. But I was tired of holding on to it, and the reminder of that curly red-haired, obesity enabling clown could not escape me.   

Minutes later I was able to retest and then pitch the tethering mountain of a cup. Upward and onward, things were looking better.

Yet another reminder on that day, who was in control…

D.

*Revised: I got a little carried away with my numbers! oops. Not a 64 oz. cup, but a 42 Ounce.”64 oz. is tooooo much”.

Double Duty Test Strips

After sitting down and taking a good look at my blood testing habits, I decided it was time for a change in the old routine. I was drawn to this conclusion after obtaining and implementing a copy of Kevin’s data tracker program. It shows a line graph representation of the BG readings for the day, week, weekend, and even averages for these. It also showed me a lot of gaps in my testing through the day.

I decided eight tests a day would be a reasonable goal to shoot for and went forth to make it so.

I knew from my past experience that if I just started increasing the number of times I test, I would run out way before my insurance would allow a refill. So I set out to the pharmacy to request more strips per insurance cycle. They informed me that a faxed request would be sent to my doctor and they would give me a refill size worthy of the 8 a day prescription, when it was approved.

Well… I went back the next day, then the next day, then the next. No response from the doctor’s office. A part of me thought it could be due to the fact that I had not seen this doctor in over eight months, having recently moved to a distant city.  Regardless of the reason, I was officially out of test strips that day, and the pharmacy crew, especially the pharmacist on call, sympathized with my plight. “Out of test strips? That won’t due”, he piped up with. He ended up writing a prescription for me himself, for 200 test strips. Not as many as I had originally hoped for, and no refills either. No worries. This stash, I knew, would get me through the month.

The biggest shock was at the price. At $104.99 for a box of 100 strips, I expected to pay twice that for the double dose I was about to receive. To my surprise, the bill ran up to only $147.05. I had no idea the per unit price would be cheaper if bought in excess amounts! So now, each test strip would cost me $0.73 cents instead of the more gruesome $1.05. That was a bright side to the situation if I ever needed one.Now I await next month’s supply, in hope that all will be resolved.Here’s to eight times a day!

Berry Blood Sugar

Pancakes for breakfast!

Now, normally I would not get excited about pancakes. Truth to tell, I am not much of a breakfast person at all and prefer my mornings to start with the basic cereal/fruit tag team. Cherrios and a banana please! But this day, however, is special. Julie whipped up some ‘cake batter and a very delicious (semi)homemade topping as a treat.

It started the day before at Trader Joe’s, the local grocery with all the essentials… that even extend to the exotic and organic in nature. The necessities list looked like this: 

• 1 bag frozen mixed berries
• 1 bottle maple syrup
• 1 carton eggs
• 1 gal non-fat milk
• 1 pint buttermilk
• 1 bag whole wheat pastry flour
• 1 bag whole purpose flour

The grocery checker inquired what kind of dessert was in the process. I shared with him that no dessert would be happening tonight but… the pancakes may have an early appearance if I’m not patient enough. It was looking like a solid flavor wave of foodstuffs.

Fast forward to next morning…

Ingredients were masterfully put together for the pancakes and began their trips to the burner. One after the other, slowly and surely cooked up and placed in the ember-like heated oven to keep warm. While those happened, the frozen berries were blended, heated and strained. An accompaniment of maple syrup stirred in with the berries and it was ready-to-go homemade Berry Syrup.

A natural insulin bolus insued and the matching amount of ‘cakes and syrup was devoured. Yum!

It was one of those instance when guessing is the best one can do. I really had no idea exactly how many carbs were in each pancake. Or how glucose rich each tablespoon of syrup was. Past experience and a little diabetes know-how led me the direction I needed to go. Sugars turned out good afterwards!

I decided it was time to put the berry syrup to the test, however…

Here’s non-diabetic Julie with a well formed syrup “blood” drop on her finger.

She can test with the best of ‘em!

And the results are: Five, Four, Three, Two, One…

Ooooh. That’s some sugary, berryful, stickable, lickable goodness!

If I Were a Number: I Would Be “65″

That’s right, “65″. It seems like every time I turn around, my blood glucose meter is spitting out a “65″ at me! It is getting to the point where I think “60-64 and 66-69″ don’t even exist, all defiantly rounding to “65″. How can so many morning, post-meal, and otherwise random blood sugar checks lately end up at this attention deprived little number?

I have a theory…and a solution.

• I am stressed out.(that’s the theory)
• My body is pulling in extra glucose to keep me caught up with the stress.(continued theory)
• Down with the bolus and fine-tune the basal.(the solution)

Not that I am particularly worried about my lowly number’s common debut, I can always catch it in time and, honestly, I think it just stops there. Or maybe… by the time I feel low and test, the glucose is always at the same point. Whatever the case, I can function fine short term there, and am taking action against it.

I deduce that the arrival of semester finals, the summer work search, new health insurance hunt, and insane California gas prices (had to throw that in… $3.69 a gal…. grrrr) have me a little more worked up than usual. And all of that time-consuming stress has increased my carb needs and slightly lowered my insulin needs too. Did you know that they say that peforming mathematics increases brain function and also need for energy too, thereby lowering glucose levels? Neat, I know! But also an added culprit in my lows.  

So my morning routine is to crawl out of bed, poke a finger and get a fasting blood result. Then comes the daily dose of Lantus. “Thirty-four units please”, I tell the fridge door as I pull out the lonely vial. I say lonely because, come on… locked away in the butter compartment with only some solidified, churned milkfat as a bunk-buddy… not my idea of good company! And then, some days, after the Lantus, and depending on the fasting result, a friendly Novolog bolus is taken.

I have decided that cutting back on my morning Lantus cocktail is needed. I think “Thirty-two units” sound better anyway. It is the number twenty-three in reverse, a well-known number in my family! We’re talking three birth dates, and an anniversary date in my immediate family alone. I have lowered my basal dose in the past when needed, and it definitely helps.

Lastly, I have cut down a little on the after meal bolus calculation. (Yes you pumpers- I am still doing them in my head… though not for “long”, I hope). And when I say cut down a little, I mean just a small percentage less. I normally go by these figures: One unit of Novolog for every 10 grams of carbohydrate intake. I figure about a 30 percent decrease in that figure does what I need.

ie: If my meal has 60 grams of carbs, I will take 4 units instead of the usual 6. This is just a rough idea though, as trial and error has shown me that certain foods still need their own special dosing… as do special situations.

I feel comfortable making this change as I have done it in the past also. As long as I maintain blood sugar checks throughout the day, it will be all good. And hopefully leave me a little farther north of that “65″ that tries to keep me down. 

Reviewed: Kaplan-Mayer

My desire to start insulin pumping led me to seek out some expanded information on the subject. I felt like I knew the basics… the cannula site goes under the skin, the tubing feeds to the pump and fills up with rapid-acting insulin, and the pump sets the stage to deliver the desired amount. A carb count here… a bolus wizard calculation there, and all is good. Right?

Well, Gabrielle Kaplan-Mayer delves deeper into the expanded world of pumping in her book, “Insulin Pump Therapy Demystified“. For the better part of seven years, Kaplan-Mayer herself has been on insulin pump therapy. She takes her experiences and knowledge, along with many testimonials from other pumpers, diabetes experts and other health professionals and puts them in this book. The goal- to make insulin pumping less confusing and much more relatable to those possible pump candidates out there.

Select sections include: Sex with the pump, cost of pumping, help choosing the right pump, sleeping with the pump on, and even airport security checkpoints…and the pump.  Most sections begin with just a brief overview of the topic at hand and widen into more detail with lists, tips, asides, and relatable info. A lot of the pages are written in question/answer format also. As if written coming from the mind of a to-be pumper, questions are formed in bold print and promptly answered by easy to read and to-the-point succinct paragraphs.

This book is for the pumping novice. It is for those who like their answers in no-nonsense form, free from jargon or lengthy additives. It is for this reason that I found myself wanting more after my paper bound excursion. I was fairly adept to the grand pumping scheme of things. I knew the “nuts and bolts”. And through my expansive blog network on all things diabetes, I had read first hand a lot of tidbits from OC pumpers themselves. What I was hoping to find was more detail on the mechanics of the pump and deeper interpretation of the menus and functions that await inside. What exactly does a square-wave bolus do? A dual-wave? How are basal rates determined and what ease is there to programming them into the pump? These kinds of things are not discussed in the book and must be searched out in other places.

Overall, “Insulin Pump Therapy Demystified” was a short and easy read that helped organize and answer those curious questions about life with a pump. I felt there was room for more elaboration on pump types and a further expanded list of manufacturers.  Also, somehow overlooked, there was a small bolus calculation example towards the end- with an error in the math. Small things like this may have taken away, a small fraction, from the overall satisfaction for me, but I do not regret the time I put into the pages.

I mostly appreciated the authors interviews and real life success stories from high, and low, profile pumpers. It definitely showed how beneficial pumping is to a majority of insulin dependant people with diabetes.  Kaplan-Mayer is a highly positive writer with a knack for making the reader feel at ease about pumping. I am looking forward to my journey of pumping insulin and I will say that the $15.95 Barnes and Noble price tag was worth the added comfort and excitement it brought about my new upcoming venture.

In part: buy this book if you are a true novice to what insulin pumps are and how they affect daily life.

Pop-Top Lantus

Day number twenty-eight was upon me. And how about that- the Lantus vial <loading syringe>….is…tapped…out. Good timing I would say. No wasted insulin and no early trip for a refill. Nice!

I went to the fridge, lifted the butter compartment flap and pulled out the new vial, all boxed up and sanitary. I activated the calender on the computer and counted- one, two, three, four weeks to make note of the twenty-eighth day upon which the new vial would expire. May 30th it is. I pull out a pen and jot it down on the outside of the box. I know if I don’t write it down immediately I will hopelessly lose track of when it should be tossed out. Maybe I can go twenty-nine days or even thirty-plus and be okay, but I don’t want to risk having ineffective long-acting in my system.

I neatly lift open the top tab. Pull out the paperwork of insulin info, and also pull out the vial. Flip the paperwork upside down so it makes a u-shaped “pouch” and push it back into the box. This makes a nice cushion for the vial and keeps things from shaking around more than necessary.

I grasp the new vial in one hand, and with my thumb under the purple cap, flick upwards- as if flipping a coin to decide punting order for the big game. With my intentions being to catch it mid flight, I watch as it flies across the room and smacks the wall. ”Man, I need to practice my execution”, I think.

What I hold in my hand after, is a little bit of an oddity. The punched-out “metal cap thing” was still hanging on by a thread. I assume it was not properly punched out at the factory and was able to luckily escape it’s way into my fridge. No worries, pinch and pull and it is gone.

One of those weird situational happen chances that I wanted to share. And despite the small defect, I still love my little life giving vial all the same.