The Elusive Pumps

It finally happened. All the hard-nosed looking, the squinted eye peering, and allllll the unwelcome staring has brought success. And this time, it was right in front of my nose.

While out to lunch at Todai seafood restaurant, I saw a little girl of about 7 yrs. old with an insulin pump. I had yet to that day actually seen a pump in function on someone, whether young or old. She had a dress on with shoulder straps… and clipped to the back towards her neck was this little pump. Spindled down into the clothing went the tube, undoubtedly secured to her stomach somewhere. I am pretty sure that is the preferred absorption location for children and most adults alike.

It was kind of surreal. I wanted to stand up and make everyone notice, after I did, what they were missing. Her large family sat around their table very plainly. She fiddled with silverware on the table and kept occupied, as kids do. And all the while, pump…pump…pump went the insulin. Amazing how common place it must seem in her family. As if an extension of the young one, always there and always accounted for.

I still look forward to seeing someone my age or about with their pump on. Will I walk up to them and open conversation? Should I ask questions to get live and in color insight into my pumping future? Are there any others left besides this child? I imagine so… just proves once again how invisible diabetes can be.

A New Doc

It has been a full year in San Diego and the law has stirred up a fire under me to get a new doctor. It has been that long since I have seen my last doctor, whose job I felt like I could have done on most visits…. but I digress….

So I have put off finding a replacement in my new city until now. But under California law, my old Endo is no longer allowed to refill my prescriptions. There is a one year cut-off if no office visits have been completed during that hiatus. So as my prescriptions edge closer to becoming bankrupt I will now be able to boost my medication bank account through my new doc. I will venture to his office in two weeks and get back on track with my office visit routine.

The past year has gone fairly smooth. I have managed diabetes well without the tri-monthly huddle with my endo. I stayed on top of my insulin needs and completed a mail-in A1c test to see an overview of the past months. I knew where I stood on the diabetes home front and was confident in my decision to lay low from the doctor’s office.

The end of this year, however, brings me new necessity to connect with a local doctor. I hope to start pumping insulin soon. And with the necessary completed paperwork and recommendation from my doctor, as well as approval from my new insurance company, and insulin pump training, crossed fingers, and a virgin sacrifice… that wish should be fulfilled.

In the present moment I am bearing down over the health plan comparison chart supplied by my work. Eenie-meenie-minee-mo, catch an overpriced, complicated, conflict-ready, greedy insurance company by the toe. All I want for Christmas is {No Hassles} with this new diabetes platform I am stepping on. Any bets whether that will happen?

Despite the cumbersome process all this requires, I am excited to see a local professional who I have heard positive things about. He and his P.A. will be my stepping stone to a new Lantus delivery routine(insulin pen), new insulin pump, updated prescription refills, and a record of well being.

Carbs Are King

The e-mail fairy sent me a short, self-sequestered, advertisement today.  Among the myriad of junk mail, I saw a CalorieKing message and popped it open to see what was up. The welcoming note, personally addressed, let me know the new Joslin paired food nutrition web site was up and running. The spotlight focuses on the cold hard facts of the stuff we eat… and among other things, what it takes to burn it off.

A download installs a search toolbar on your internet browser and puts food info at your fingertips. Enter a food/drink query and it shoots you over to the CalorieKing website and a list of matches. Need to know how many calories are in a tablespoon of Nutella? How about the sodium count of the Pepsi One you’ve got? Even the carbs in a serving of TGI Friday’s Spinach, Cheese, and Artichoke Dip. It’s all there!

While calories may be the buzz word of choice, the carb tallies have my focus at hand. You see, I put my name on the list of contacts to inform- once the site was up and running. I was intrigued at the collective database of foodstuffs being put together at the time. If I had a nickel for every time I tried to look up the carb count of my next meal… let’s just say I could build a pair of spare change headphones like in those Bank of America commercials. Now, this database is charging ahead and I have my one-stop resource for carb counts.

Give it a run-through, no download required. Just interrogate the search bar on site. CalorieKing and Joslin Diabetes Center have put together a well organized site.

A Deep Breath

I am able to take some time to breathe now. While my new employment is still moving along successfully, summer school has ended… taking a big weight off my shoulders. And the ”B” I earned in that Calc II class is very satisfying for the condensed 6 weeks of math that it was!

Take that you lengthy Maclaurin Series and you loopy Integrals by Trigonometric Substitution!

I started to realize how demanding both a new job and a quick paced summer school session was when I got a very curt “HI” from my meter. It was a week of firsts. First week at Starbucks, first angst inducing math exam, and my very first glucometer reading over 500. After that knee jerk of a blood test result, a redly backgrounded vision of me throwing that meter into the wall flashed into my head. If I had high blood pressure problems, I’m sure something would have popped!

The high blood sugar trend felt itself appropriate to continue in the weeks to follow. I am convinced my body is using diabetes as a way to punish me. ”If you would only sit on the couch with a movie, I would behave”, my inner diabetes voice tells me. But instead I am waking up at 3:00 am to open for business at my new second home—work. I am eating sporadically, sometimes indulging on discounted Starbucks treats. And able to test my numbers much less frequently than I want.

All that… and throw in uncalculated moments to inject my daily Lantus. Instead of one time daily(suggestively at the same time), it’s more like one time daily(at the closest convenient time)—and it hasn’t been convenient.

I am settling in to the new cycle more and more each day. My days at Starbucks are becoming more  routine and there are less and less skills for me to master. I am becoming more aware of how diabetes unfriendly the menu board is with each shift. Mixing Frappuccinos, Mochas, Macchiatos, and the such, have found me grimacing with each additional pump of syrup, spray of whip cream, or drizzle of chocolate that the recipes call for. It is not for the lack of “friendly” items available, but the requests of the majority of customers, that compels me to concoct these drinks.

More on Starbucks and the menu at another time though.

For the time being, I will put in my hours and collect a paycheck. Edging closer to my receipt of health insurance benefits. And oh ya, keep my numbers in check at the same time!

A Day At the Beach

I decided this nice stretch of beautiful weather needed to be pounced on.

Spring has not fully convinced me that it has sprung yet. Bouts of semi-warm weather intermingle with days of gloomy overhead clouds and nippy breezes. On this particular day, however, spring was stretching it’s arms and showed what it could do. A trip to Coronado Beach was in order. A direct, highway only, route got me to beach front access in twenty minutes.

Coronado is an upscale island and part of San Diego. You can bet, nearly all traffic to the island is produced by construction crews, landscapers, military personnel, and oodles of tourists. It is the place to live when an 800 square foot property line is a steal for $800,000 bucks. Now honestly, I just pulled that number out of my ass… but you get the idea. Big Bucks. 

The sand was warm and the breeze gentle. I stretched out with my towel and plugged in the headphones. Here is my pile of beach belongings.

• Insulin pen that I wouldn’t even need(Not sure why I toted that)
• Pen needles that always accompany the pen
• Loose test strips that I found in my pocket…used of course
• Ever needed stuff like keys/wallet/sandals/glasses(usual goodies)

 

I plugged in and dialed up the Diabetes PowerShow Podcast. This show is my new favorite diabetes geared listen. The cast can be quarky at times and the dialog a little too happy-happy also, but what a great program they have and killer guests to boot! I was feeling at ease and getting my tan on. Good times on the beach.

And no, not all of California’s beauty is nature-made. We have to help out too at times. With diesel engines and large loading grates, a group of Cats scoop up errant seaweed and make way for guests.

One more beach off the list and countless more to go. I aim to hit up as many as I can over my stretch in San Diego and get a real feel for what our coastline is all about.

aaaahh…

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!