Silly Thought

Today I showed my father how to draw up glucagon. My mother says if I need a glucagon injection, I should call her. Wish I thought I'd have that luxury.

Another Accu-Chek Aviva Failure

Remember in August I got mad because my accu-chek meter gave some pretty inaccurate numbers, how I called the company and got a new accu-chek aviva and a new accu-chek compact?
Well, I've been using the accu-chek aviva and been pretty happy with it. Until... a month ago, it started giving me a low battery warning. Okay, whatever. I changed the battery. It kept giving me the warning. Whatever. On Friday, it refused to operate, beeping ERR and a picture of a battery. OK. I tried three new batteries, none of which worked. Used the sample strips sent to me with the accu-chek compact. Tried the aviva again, hopefully. ERR. Found one of my other accu-chek avivas, one that hadn't been real accurate, and I'm using it again.

Life Masters

I got my first call from a real life health educator in the Life Masters program. She didn't seem to really know the stuff that I got quizzed on last time, but whatever. She strongly suggested I see dentist, said that she thinks it's probably still worth it to get a flu shot. Said she couldn't answer my questions about the workings of my glucometers or about the wackiness of Lantus.

Wondering about Scarring

I'd like to see a research study on scar tissue caused by injections. Do you get more or less scar tissue pumping? Does blood sugar control affect the rate at which your body scars? To what extent does scarring accompany absorption problems? What percent of diabetics have absorption problems after 15 years of insulin? To what extent does scarring affect A1c? To what extent does rotation minimize scarring?
In the last 24 hours, I injected myself 11 times. Yump, eleven times. Granted, that's about double my mean, and about treble my median, but days like this are still not that rare. Sometimes I wonder, when I do a shot before and after meals (which is what I do with most large meals), is the potential scar tissue worth the control?
I don't have any diabetic scars. I have been injecting insulin for just under eighteen months. 18 months x 30 days per month x 5 shots per day = 2700 shots. I think that that's probably a slight overestimate of the number of insulin shots I've had. I think about the fact that diabetics at one point tended to take only two shots per day or so, and still got scar tissue within ten to fifteen years. If we figure 2 shots per day for ten years, that was only 7300 shots to get to scarring. I'll be at 7300 shots in another three years.
Some days I find myself pretty desperate for a site that doesn't already hurt. What will it be like when instead of bruises I have scars?

Bad Diabetes Day

Today was possibly my worst blood sugar day since diagnosis day.
I woke up with a blood sugar of 343, which is the third time I've woken up over 300 in the last seventeen months. I checked for urine ketones, which I think were negative (my vision wasn't so great).
I took some Novolog, some Lantus, skipped breakfast. Two and a half hours later, I realized I needed to get my butt out the door because I had a midterm to take very shortly. I took my blood sugar on the train, it was 54. I treated that with three packets of Domino's sugar. No, I don't know how many carbs that is.

My midterm was in a math class that I'm finding incredibly easy. My classmates, however, are not. In the quizzes we've had so far, the class average has been just over 50%, while I've made perfect scores. So, not a challenge. The test was in two parts, the first closed book and the second open notes (I didn't bother taking or using notes). The open book part I finished in about ten minutes, was the first to hand it in. I sat down and read a book while waiting for part II. I did not take out my meter, pricker, or sugar. I got part two and breezed through question one. Reading question two however, brought about the realization that my thinking was a little loopy; the question looked extremely difficult and I thought I might be hypo. I skipped question two and completed the rest of the test, then came back to two. Realized that the reason it looked difficult was probably a misprint. So I tried to walk over to the professor's desk. My gait was unsteady; I couldn't really gauge my distance from the ground. I'm sure I looked drunk. I asked him about the question and it was a misprint. So I finished that question, easy peasy, and turned in the test, first in the class to finish. My hands were shaking pretty badly. I went out of the room, sat down abruptly, fished in my pack for my meter, and tested. 33. Drank some sugar.

Later in the day I was very very hungry; I've eaten a ton today. I ate a lot last night too; I had gone to bed with a blood sugar of 203, but because I had active insulin and undigested food, I set my alarm for middle of the night and decided to sleep. The alarm didn't wake me, and I went high in the sky. My blood sugar today varied by an order of magnitude!

The rest of the day's reading were fairly uneventful. I talked in the class following to a classmate whose boyfriend's dad was recently hospitalized for hypoglycemia. I think I'm gonna bring in a glucagon and show her how it works and maybe even give it to her next week.

Fundus Camera?

Soon after I was diagnosed with diabetes, I went to an ophthamologist to have my eyes examined for diabetic problems. The nurse tried to insert eye drops into my eyes; when I kept jerking, she angrily called me a baby, taunted me, and told me that if I was acting like that, I obviously didn't care if I went blind and I could just leave.

Well, I eventually did get dilated but I didn't want to go back there ever again. The doctor's office recently called saying I was past due for another screening, but I'm not going. I don't want eye drops. And I don't want to deal with mean nurses either.

The studies I've read suggest that it's safe only going for an eye exam every other year as long as your previous exam showed you to be in fine eye health, and especially with my pretty decent blood sugar control, I figure I'm safe skipping this year's appointment. But sooner or later, I'll be wanting to have my eyes examined again, and just yesterday my parents and I talked about the difficulty of me not wanting my eyes dilated but wanting my eyes screened.

Well, today I watched a video on the use of the fundus camera in screening for diabetic neuropathy. Guess what? With the camera, you don't have to dilate the eyes in order to see any diabetic eye damage!

So now the question is, how do I find out which opthamologists or optometrists in the Chicago area use fudus cameras for looking at diabetic eyes?

Hypoglycemia and Spirituality

Last night at 0057 hours I tested at 97, went to bed, almost immediately felt hypo, protested to myself that I'd just tested and felt fine, that it was my insomnia making me restless. I sat up and did some Sudoku, noticed I was having to concentrate harder than usual. Retested at 119 hours with a 31. In 22 minutes, my blood sugar had fallen by more than twice what my blood sugar ended up as. Gah!

I ate a little bit, felt woozy. I sleep wearing just swimming trunks and I looked at myself and said, if I were to pass out and be discovered my 'rents in the morning, I'd want to be wearing more clothes. So I got dressed.
Still feeling woozy, noticed an apple. Made a long long dramatic blessing on the apple, like this Thank you G-d for fruit that grows on trees! To apples! And and carrrrrrbohyydratesssssss... Thank you for keeping me alive! (long pause) Thank you for hypos!
Then I ate the apple and thought about the way sometimes going hypo can make me feel alive in a way that little else does, and about how sometimes it's just really cool to be alive that way, and how, when I was early into diagnosis, I felt lucky to be going on the journey of diabetes, if only because I was gonna experience all this stuff I'd never thought about before, and how my sense of wonder and gratitude for and around diabetes had slowly dissappeared.
How stupid I was to let go of that wonder! How foolish to buy into the idea of tragedy, when living in the wonder and appreciation for the differences and goodness in all experiences is much more pleasant.

At 153, with my blood sugar up to 72 and the Sudoku mostly done, I went back to bed. I woke up at 800 hours with a blood sugar of 102; perfecto. I took two fewer units of Lantus this morning anyhow.

It was Symogii

So yesterday I tried 30 units of Lantus (it's a high dose, and the most I can measure in my syringes). Throughout the day, my blood sugar was highish, but the evening brought hypo after hypo. After treating a hypo at one AM, I fell asleep.
Woke up at 5:30 feeling really really thirsty and kinda dehydrated in other ways. Thought, dammit, the Lantus must really be expiring. Decided that I'd check my urine sugar, and that if that was positive, then I'd check my blood sugar.
The strip turned purple almost the instant the urine hit it. Stifling the urge to swear (my roommate, after all, was sleeping), I got myself a drink of water, headed back to my room, turned the light on and tested. Guess what my reading was?
51.
I guess I'm really lucky that the strip turned color! I ate a twizzler. Lay down and listened to the garbage truck and then my roommie's alarm going off and then fell asleep. Woke up at 11 with a blood sugar of 101.

By the way, I realize that nighttime lows are sometimes a problem, and often if I suspect Symogii I try lowering my Lantus dose to see what happens. But when Lantus expires, it usually has a shorter duration of action, and I guess I had been really suspicious because of what happened with the shipping.

Tempermental Lantus And Diabetic Pixel Art

Last night: went to bed with a 101. Couldn't fall asleep. One hour later, 100. Woke up around eight with a blood sugar of 256.
Previous night: went to bed with insulin on board, blood sugar 167. Couldn't fall asleep. One hour later, 147. Didn't touch it. Woke up eight hours later at 245.
Two nights part: had been treating hypos, went to bed with a 62. Couldn't fall asleep. Forty minutes later, blood sugar 94, left it alone, woke up 293! Couldn't believe it; I didn't treat the hypo that aggresively! Rechecked, 287.

So, I think maybe the Lantus that took two weeks to get here in the mail is expiring extra fast. Today I'm taking 30 units of Lantus, I'm going to do a 4 AM blood sugar check, and if I go up up overnight, then...
I think I'm going to start taking 5 units of August's vial of Lantus every night whenever I happen to go to bed. That stuff acts more quickly than normal Lantus, slower than Novolog. I only have about 50 units of it left. We'll see what happens. If I end up having to take two doses of Lantus daily for three months, I'm going to need to either ask for a prescription for more syringes, or else reuse syringes. My current scrip is for two syringes daily.

On tudiabetes, I started the Diabetic Jews group, and didn't add a profile picture. Deciding it needed one to spruce it up, I did this pixel art: It's 50x50 pixels, although it could obviously get smaller (cut off the edges). It's supposed to be a star of David made out of syringes.

Non-Injected Insulins

Exubera stayed on the market for about a year. It was a financial flop, but worked fine as a short acting insulin. Another inhalable insulin in development has been called off just now. Currently, multiple research studies are ongoing working on brining oral insulins to market.

Many in the blogospher and elsewhere scoffed when Exubera hit the market. They said that shots don't hurt that much, that a bong is too conspicuous, and that Exubera added nothing new. I admit it, I didn't run out and buy Exubera either. But I was excited. I was pretty sad about Exubera leaving the market. Why? Because shots do hurt. Certainly, the insulin shots don't hurt much compared to some of the other injections I take. But I've got bruises right now on my stomache, my breasts (I inject 'em), my legs, and my ass. I don't think I've got any on my arms at the moment, but that will probably change in less than a week. I get a new injection bruise almost every day. The I-Port red marks each lasted over a month.

That we lost the option of switching away from bruises- well, that stings.