Monday, May 25, 2015

Holiday Weekend

On Friday I left work shortly before 5 PM and checked my Dexcom. It turned on showing... static. Nothing but a black gray and white array of dots. Be still my heart! I tried again and it said: Out of Range for 4:53:06. Waited a minute and tried it again: Out of Range for 19:35:34.

OK, called Dexcom. After being on hold a while, a customer service tech (named Matthew) called back while I was on the bus. While on the phone with him, the Dexcom changed to say Error HWRF Call Tech Support. He told me in that case I should press the restart button with a paper clip. I got home and pressed the restart button and it started up, but asked me to input the time and date, and showed no bg history on the graph. He said that's not what it's supposed to do, and that they'd send me a new Dexcom. He also said the FDA required them to ask my weight, and that if there was water damage (which he didn't suspect) that there'd be a $199 charge.

I was going to use the other Dexcom G4 (which still works) but the sensor failed and so I yanked it and gave up the ghost.

Saturday I tested my bg 6 times and it ranged from 79 to 106; WOW!

Then Sunday my bg meter gave errors for four strips in a row. I thought it was broken, but a few hours later it worked again (I was 186).

I don't know what was up.

Tuesday, May 19, 2015

Big Day

Today I deliver earnest money for a condo! It was January when I first started viewing places (and didn't even know what earnest money was). This is the third condo I've put in an offer on. The first one was counteroffered but for more money than I was willing to pay for it. The second was kind of accepted but the owner died and then the heirs didn't agree about selling it to me and after waiting more than a month I said forget it, you guys still don't know what you're doing, I'm looking elsewhere. I really liked that place though. Anyways, the third place I offered on last week, they counter-offered, I counter-counter-offered, they counter-counter-counter offered, I said OK.

Today the How-Long-Will-One-Vial-of-NPH-Last experiment ends. The NPH isn't dead but the blood sugar's been crazy for four days and yesterday the protamine started sticking to the sides of the vial. I haven't quite made up my mind whether I resume pumping tonight, or go on Lantus. Then I think I'll go back to NPH; it's just so darn cheap.  And the answer to how long it was good for? I think 10 weeks. It was not refrigerated at any part of those 10 weeks, FYI, and my bg average was around 140 for the entire period.

My middle brother, the one I never did interview here, is starting a 24 hour trial period at a group home today. The home is trying out  three candidates for one slot... and I can't imagine they'll pick him. But I have the whole night all to myself!

Sunday, May 17, 2015

Blogs I Met And Liked This Week

I can't find some of the ones I know I read and liked. While looking, I found more. But here are four I like:

1. T1D and Gluten Free No clue what the name of the blogger is, but her daughter has diabetes and celiac. They're carb counting and pumping (neither of which I've been doing in a while).  But reading back through her blog, I see she experimented with a dummy pod, CGM, poking her finger, and eating gluten free to half way experience her daughter's challenges. Kudos!

2. Thomas' Diabetes Blog is written in two languages, by Thomas, a T1 D veteran. And he took apart a pump and put the pictures on his blog!

3. Canadian D-Gal by Scully, a type 1 diabetic experiencing some burnout, and making it funny. She manages her diabetes (I think) in the kind of lazy way that still takes an awful lot of effort (like me!)

4. Joy Benchmarks is by Marie Smith and is focused on finding the good things in life even when life throws you an awful lot of hardballs. Which it  has her; she has myasthenia gravis, had thymus cancer, and has diabetes. And still appreciates the little things. And the big things too.

And the honorary 5... maybe one of you knows which it is. It's by a woman who is 55 and was diagnosed at age 24 and she wrote a great post about running and she collects something village collectibles and she had a foot infection some years ago and she's got an A1c under 6% if I remember right. And her picture is on the upper left corner of the blog. I liked it but I can't seem to find it again.

P.S. Oops, here's the link to the page of other people's favorites.

Saturday, May 16, 2015

A Great Line From A Defunct Blog

I used to have a xanga account with a regular blog, but also with a "pulse" blog.
It was like twitter- a limited number of characters per post. I always started it with a blood sugar. Here's one of the last ones:


176 One of my K students today said another kid said The B Word. I was dubious. "He said 'Butt'" the kid insisted. :->

That pulse thing lasted from March 2007 until October 2011, and makes for an interesting read. Xanga closed the free accounts around 2013.

This reminiscing prompted by the:
http://www.blenza.com/linkies/links.php?owner=dblogweek&postid=30Apr2015e

Friday, May 15, 2015

Wildcard: Crazy Stories

When I think diabetes crazy stories, it occurs to me that most of those I've heard involve somebody being unprepared for a hypo. Eh, forget that. Here's what I think are my top three:

1. For about a year I kept hearing from folks that they knew somebody I should meet, SJ. And one evening I went to an event and saw somebody with an insulin pump so I went and said hi and it was SJ! So when I said that I had had a difficult year since my diabetes diagnosis, SJ said, "Why  would that be difficult?" and meant it non-humorously! I was flabbergasted. We didn't connect.

2. I used to go to a transgender support group and folks there knew that I was diabetic. One evening after the group, a person there told me that he was dating a woman with diabetes and asked me what he should know. I asked him to tell me a little bit about how she managed her diabetes, and also how she felt about her diabetes, from what he could tell. He told me she was on shots, but used to have a pump, and that he wasn't really sure but she was vocally fat-positive so he didn't think she'd be self-conscious about diabetes.  I gave him some advice (learn to use a glucagon) and on the way home I started thinking about it... and realized that by his description of her diabetes, I knew who she was. I met her through this blog.

3. Gushers are always good for crazy. Gushers are those times somebody does a finger poke, squeezes, and instead of getting a drop of blood... it squirts up and makes a dotted line down his shirt. My first one happened when I was showing a friend what a no-big-deal blood sugar checks were, six months after diagnosis.

This  reminiscing brought to you by the:



Thursday, May 14, 2015

If I Could Change One Thing Related to Diabetes...

It'd be the focus of the conversations.

I think people need to think a lot more about how things affect real outcomes (complications, death, daily function) than A1c. There're too many diabetes meds that have no evidence of affecting anything in a good way except the A1c.

I think we need to think a lot more about finances- not our personal finances, but the finances of social security et al. And what we can do to make medical care more equitable.

I think we need to think more about medical pollution. And what we sacrifice in the name of disposables.

I think we need to think about how much diabetes does or DOES NOT matter in terms of global health.

I think we need to think more about the things we take for granted about our own diabetes convictions.

If I could change one thing about all of these conversations... it would be to remove the influence of marketing campaigns. Marketing campaigns for the ADA, JDRF, drug companies, pump companies, insurance companies- all of them. What would we talk about, diabetes wise, if nobody had pushed the idea of a diabetes epidemic, the superiority of any diabetes control method over any other, or pretended that they had The Answer to diabetes?

This piece prompted by the:

Wednesday, May 13, 2015

The Medical Supplies STUFF Situation At My Place

Insulins:
I have 11 empty vials that used to contain Regular. 1 vial with about 80 units left. 1 full unopened vial of Regular. 1 box with an unopened Lantus pen that expires in December, in the fridge. 1 vial of NPH with roughly 150 units remaining.
OOH, I apparently also have a vial of Regular with a vial adaptor on it, containing around 100 units. Probably no good anymore since my guess is I opened that vial a year and a half ago. Also a very expired vial of opened Lantus about half full, and a cartridge about 1/3rd full.

Insulin Delivery:
I have a clear minimed pump, just sitting on my counter. It has a battery and I'll probably use it again somebody because I also have 12 unopened sure T sets, as well as at least one quick set (I thought I had two but I only see one), and 13 reservoirs. I have a Medtronic Quick-serter that has been used roughly five times. Also a silserter, used three times. I have lots of loose batteries and a package of two unopened ones from minimed.
I have one jet injector and two unused vial adaptors.  Also a cleaning block, and a bottle of isopropyl alcohol (green).
I have roughly 160 U-100 31G 0.3 mL half unit syringes still in their bags, unused, as well as a few hanging around and some used ones too.
I have a box of pen needles (Ultra Fine 4mm 32G) with about 80 left.
I hung onto the unused I-Ports for a ridiculously long time, but I think they're gone now.
I have a NovoPenMate.

CGMs:
I have one Guardian, probably dead, and one Sof-Senser, extremely expired. One Mini-link. Two Medtronic chargers and one seashell transmitter.
Two Dexcom 7-pluses, and one 7+ transmitter that I see.
Two Dexcom G4s, one of which I'm wearing. One transmitter, which I'm wearing.
Two sensors in the drawer. Four chargers and lots of cables.
A roll of medical tape.
A couple things of the tape used for enlite sensors.

Blood sugar monitoring equipment:
Three (or more?) multiclix lancing devices, all but one of which are missing their caps (darn caps break every year or two). A box with 14 drums.
An Accu-Chek Aviva, a Bayour Contour, a OneTouch Ultra2, a green OneTouch Ultra Mini. One red and one blue Relion Prime.
One full box of Relion Prime strips, one vial half used.
Five cases.
Four assorted other lancing devices that I see and about thirty unused lancets of the kind you can stick in most devices.

Other:
About 200 alcohol wipes (I really only use them to wipe off the vials about once a week).
A bunch of different types of CGM and pump cases.
4 detergent bottles repurposed as sharps containers (4?! why do I have four in my room? something needs to be done about that...)
A medical bill I haven't paid. Some I have.
Some glucagons. But the most important one is upstairs for my parents. It's the only one that's not expired.
About six monitoring logs that came with meters.
Some instruction manuals I should throw out because you can find them all online anyways.

Non-diabetes:
A bunch of samples of Zyrtec (maybe from 2007?)
Some chewable ibuprofen.
One empty and one mostly full tube of Voltaren.
One empty and one mostly full vial of Depo-Testosterone.
Some 23 G needles that screw on. I don't have the syringes for them and I ought to throw them out.

Well, that embarrassing look through my medical supplies was brought to you by the
Diabetes Blog Week

P.S. I found an old I-Port. Also a Nova Max meter. And I can't believe I forgot to mention my Frio!

Tuesday, May 12, 2015

Things I Don't Say, and Who I Don't Say Them To

1. Some time ago, I was responsible for a diabetic man who had an extremely symptomatic hypoglycemic episode while we were together on a bus. I gave him the food I had, but he was semi-conscious, I called his caregiver. She told me to put him on the phone; when he gave it back, she told me to call 911 (which is the number for emergency services). I called 911, the 911 operator called an ambulance. The bus was stopped and everybody had to get out and wait for another. The paramedics came. They tested his blood sugar. It wasn't even all that low- the kind of number I see a few times a week. The paramedics told me I did the right thing and how dangerous it was, and squirted a sugar gel in his mouth and gave me a lecture on how it wouldn't hold his blood sugar up, etc. The diabetic said I saved his life, etc.

I didn't tell the paramedics I'm diabetic. I didn't tell the bus driver. I didn't tell the bus driver's supervisor, who came by to confirm he hadn't stopped the bus for his own fun and games.

I'm not sure why. But a lot of times when I'm the nurse's aide accompanying a diabetic to an appointment about feet or eyes or whatever, I don't say anything when they lecture us about how you  have to take care of those diabetics...
I dunno. It just doesn't feel comfortable.

2. When people talk about how avoidable complications are, I usually correct them. But not if they're somebody who doesn't have diabetes complications, and does have diabetes, and not if they're a parent of such a person. It's just mean.

3. I like to act like I know everything that's knowable. It's a character flaw. Sometimes I say I have no idea why my blood sugar is doing something, when I have some idea. Sometimes I say I know why my blood sugar's doing something, when I really don't quite know.  I don't like being uncertain about uncertainty.

4. I have been burned regarding putting personal information on the open internet where anybody can see it. But I created this blog because I wanted to document how menstruation impacted my blood sugar and I wasn't comfortable mentioning the fact that I menstruated elsewhere in the diabetes internet world. As a matter of fact, I think I menstruated exactly four more times after creating the blog, and it's ancient history to me now, but I am still very quiet about the things about my life that separate me from normal people other than diabetes, in the diabetes online community, for fear of breaking the tenuous links I make.

5. When I am trying to teach people about diabetes management, I tend to either: not mention it if my bloodsugar is high or low, or to act like it's a no-big-deal thing. I can deal with all kinds of blood sugar; over 500 and under 30 are both reasonably comfortable terrain for me. However, that does not mean that I have anywhere near the level of certainty with them that I sometimes claim. And I'm not a stranger to either sort of number, as occasional as they may be.

P.S. 6. I rarely mention health issues that I'm ignoring. Diabetes- I'm pretty on top of. My teeth? Not so much. Sorry.

So in conclusion: If you call me on something, I will answer you true (unless you're a jerk). But there are things I often don't volunteer.

This post was prompted by the

Friday, May 08, 2015

Insurance

I went to an insurance informational meeting today. My employer currently offers 4 insurance plans. As of June 1, they will be offering four different insurance plans.
I think I am going to have to switch to an HMO plan because if I went with the PPO most similar to my current plan (what they'd put me on if I don't fill out any forms), then I would spent over one year:
Premiums: $943
Doctor visits if I saw the endo three times, podiatrist three times (given I have one year of swollen feet), primary care twice: $1020
Insulin, test strips, syringes (if I stay with NPH + R): about $700
Dexcom: about $800
And if I were to go to the emergency room: $400. If hospitalized: $200/day plus 20%

Whereas with HMO:
Premiums: $65 or $350, depending which one
Doctor visits if I saw the number above, plus another primary care because I would need to get referrals: $690 or $300, depending on the plan
Insulin, test strips, syringes (if I stay with NPH + R): probably about $360
Dexcom: free
Hospital including ER visits: free

Wednesday, May 06, 2015

Blurbs From Pubmed

A group of scientists put gendine on a teflon cannula and showed that it kills common and serious skin infections. They want to make cannulas that can be worn for two weeks instead of three days. Personally? Strikes me as itchy. But then, teflon didn't work for me anyways.
I wonder if it would contribute to microbial resistance too.

The last thing the diabetes mamas would want to hear: fatter mothers have more type 1 babies.  Although the authors of the study conclude that this is a CAUSAL relationship and is responsible for the increase in type 1 diabetes, frankly, there are way too many other possibilities for the relationship of facts. For instance, maybe the relationship is that age increases both risks.Plus, the increase in risk was only around 30%, which is not enough to explain the variance seen in type 1 incidence in the study area (Sweden).
All I can say is, I won't be sharing this blurb with my mother (who was non-overweight before I was born anyways).

Another study shows Sjogren's and type 1 diabetes share some risk factors.  http://www.ncbi.nlm.nih.gov/pubmed/25940005

The Look AHEAD trial, which had some type 2 diabetics exercising a lot and others not, found no difference in heart attacks, strokes, serious angina, or death from heart disease, even after ten years. They did find differences in blood sugar control, physical fitness and in weight loss.  

There appears to be a small increase in type 2 diabetes risk with greater air pollution.