Miss T1D Had a Baby!

It has been 10 weeks since I had a beautiful baby boy. As a precaution of my Type 1 Diabetes, I was induced at 38 weeks gestation on the 27^th of April and at 1:30pm Bub came safely into the world via vaginal birth with perfect blood sugar levels and weighing in at a perfectly normal 7lb 11oz. So there you go, it happened, and it all happened without any complications due to my status as a Type 1 Diabetic (or Bubs big head).

Bub was and is healthy, happy and his father and I are over the moon to be his parents. Once he presented with four blood glucose levels (taken over his first 8 hours) that were perfectly normal for a newborn (between 2.7 and 4mmls) the doctors forgot that his gestation was within a mother whose pancreas has trouble doing what it is supposed to do. Instead they focused on the big bruise on his head, thanks to the vacuum that assisted his delivery, which turned his skin a slight hue of yellow indicating jaundice. Bub was fine though, and didn’t even need time under the lights thanks to my determination to continue to get as much breast milk into him every 2 – 3 hours as I could.

I quickly began to realise what a busy schedule it is to be the food source of a vulnerable infant who’s tiny stomach meant he needed to feed very frequently. Throw in a bit of blood glucose monitoring and I am unsure I slept the five nights I spent in hospital (I was prescribed an extra night to the normal 4, for which I am eternally grateful). I also learnt the major affects breast feeding has on your blood glucose levels and became very good at eating while sleeping just to make sure I a) avoided any hypo’s and b) continued to produce as much milk as my body could.

I had specialist coming out of my ears! I had daily visits from Obstetricians, Dietitians, Physiotherapists, Lactation Consultants, Pharmacist, Bubs pediatrician and my endocrinologist, sometimes more than one at a time (I swear there where ten people in my little room at one stage, none of whom were simple visitors). They where all in and out keen to keep an eye on Bub and me. I felt looked after, like I didn’t have to worry about missing something, I just had to focus on my routine: Check levels, feed, burp, pump, eat, check levels (and if there was time), sleep – repeat. Dr O visited me every morning and would give me her predictions on what my blood glucose levels might do in the next 24 hours, and mostly she was spot on, it was like a prescription. I was very grateful, and glad she was my Endo at that time, to know that if there was something odd I just had to wait till morning and check with her about it was comforting.

The past 10 weeks have been great fun and a great challenge. Everything I hoped it would be. To think that not that long ago my doctors would have advise me not to carry children because I had diabetes, makes me want to hug every scientist and doctor who has made an advancement in the medical management of diabetes. Without them I would not now be exactly what I have always ALWAYS wanted to be… a Mother.

Big and Beautiful, Just Like His Mum

This week I have reached 36 weeks pregnant, and seeing as though my induction is only a few weeks away, I thought I had better give an update on how my pregnancy has progressed, and how my baby boy has developed.

Yes, indeed, like a great many babies born to type 1 diabetic mothers, Bub is a biggin. At 32 weeks I had an ultrasound to check on Bubs development and to see how big he was getting, how fast. There are a few things the many Doctors responsible for me and my pregnancy look for when assessing what effects my T1D is having on Bub. They look at Bubs abdominal circumference, the amount of fluid he is floating in, and the blood flow to my placenta.

At my 32 week scan it was revealed that Bub had a big belly (abdominal circumference). Babies are all compared to each other on a graph know as the percentile (not really know as that but that’s what I call it), and their measurements are plotted in to show where they are in comparison to all other “average” babies. So at 32 weeks Bub had a belly in the 94th percentile (bigger than 94% of average babies at 32 weeks gestation). This indicates that my higher than the average bear (or human) blood sugars was having an effect on Bub. After all his pancreas works just fine, so it is as though he has been chomping down on high carbohydrate meals as he grows. That will make a belly big. However a lot of the time T1D mothers find their babies tummies end up big enough to be off the top end of the percentile. So 94% is still within average range… kind of… The good news however is that at my most recent ultrasound, Bubs belly had dropped to the 89th percentile. It isn’t as though he lost weight, he just didn’t gain it as fast as he had been. There is alway a chance that my boy is just, and would have always been, a big bubba.

My Doctors have not been worried about him though, as my amniotic fluid measurements have always been just where they should be. Apparently this means that conditions inside my womb are good, and don’t require as early an exit for Bub.

My blood flow to my placenta has also always been good. However this is what my Doctors and I expected as less than good blood flow is usually associated with T1D mothers who have been T1D for many years and have encountered some blood vessel damage. Babies of these mothers usually end up at the other end of the percentile, small.

The only surprise at my most recent ultrasound at 36 weeks was Bubs head size. It measured in the 98th percentile!! I do not actually know, but I was under the impression that T1D would not have an affect on Bubs head size, so my conclusion is that I was correct in thinking maybe I just have a big Bubba. We will find out when I have my appointment with my Obstetrician in a few days. Though looking at that number… 98th percentile… bigger than 98% of average babies… will this mean a conventional exit is out of the picture for him? Would I prefer it to be? What are my chances of an emergency caesarian from Bubs big head getting stuck if I opt to attempt induction? Should I return the baby beanie I purchased in “0000” newborn size?

Otherwise my pregnancy has been going well, I have impressed Dr O with my blood glucose control (despite feeling like they have been totally out of control), and I have been acing a number of CTG’s (Cardiotacograph, or non-stress tests). I feel very blessed that, for at least this pregnancy, I was able to maintain my honeymoon period, and know that my T1D has had less of an impact into the growth and development of my baby. Let’s see what happens to my blood glucose control after this “little” guy arrives.

A Day without “D”

When talking about the anniversary of my T1D diagnosis, a well-meaning friend suggested I should spend the day eating really well all day, then just eat junk food all night. A nice sentiment, yes, but just completely and utterly wrong about how T1D works. One of the hardest aspects of T1D is there is no way to take a break. No matter what you do beforehand, what you do at any given time affects your diabetes. If I didn’t eat any carbs for a week then had a big bowl of pasta, I would still need to count the carbs, inject insulin and check my sugars before and after. That’s just how my body will (won’t) work.

Even when there is no food involved, diabetics need to be thinking about their base line of insulin (basal), whether it is via the long acting insulin that comes from an injection every 12 or 24 hours, or via the constant slow drip of short acting insulin via an insulin pump. That dosage needs to be just right to keep our blood glucose from creeping up and up, or from causing it to drop too fast because we walked to the bus station today rather than getting dropped off: constant management, constant consideration.

So I started to think about a day, just one, without diabetes. What would I do? Eat? Drink? If I was given the chance to have just one day without diabetes, where my own body would take care of itself and let me take a holiday.

First cab of the rank, I would eat pancakes, ice-cream and maple syrup for breakfast with a big glass of juice, and get to eat them while they are hot! No need to delay for an injection or finger prick. I honestly didn’t think I would miss drinking juice spontaneously, but I do. Then I would find the smallest bag I own, put my keys, phone and wallet in it, and go shopping. Not having to cart my giant bag of supplies around the shopping centre, or having to constantly look out for the inevitable “shopping hypo” that always slows down my retail progress, would be totally freeing.

Next I would drive somewhere far away and sunny, leave my bag in the car and enjoy the beach, without being concerned that my insulin was getting too hot, or that someone would steal my meter case mistaking it for my wallet (“steal my wallet but please leave my meter and insulin!”). I would have lunch (hot chips and crumbed fish) without a care, then go and get an ice-cream straight after (no waiting 2 hours after lunch).  Then snack all afternoon on nuts, chips, lollies, flavoured milk and crispy M&Ms!

 

 

 

I would visit my favourite pasta restaurant for dinner and order a big glass of coke, full of fast acting sugar! Then I would go to a late movie where 10PM would roll around without me noticing or injecting my basal insulin in the dark theatre by phone light. Nor would I need to stop once I had eaten 1/3 of my packet of pop-corn; I would have exactly as much as I felt like or didn’t feel like. Then, half asleep I would wander from the car to my bed, no need to rouse or wake to check my blood glucose or eat a snack to bring my numbers up to a safe level before bed. I could just fall asleep without the fear of not waking up to a midnight hypo, or not waking up at all. Bliss.

But that’s not how T1D works: 24/7, 365 days a year. Always. No matter how much that fact sucks, it is still fun to dream! I bet other T1D’ers would come up with better ideas for a day without D, but this is what I came up with and it makes me smile. Now, excuse me while I go check my blood sugars; I feel a hypo coming on.

New Vs Experienced T1D ft Diabetogenic

I read a fair amount of stories, concerns and questions other T1D’ers have posted over the internet and sometime I find it interesting what worries people, what challenges others have and how other T1D’s feel about certain topics and how this is different to me. It made me wonder if over time I will also start to think about diabetes differently, treat my diabetes in a different way or feel different about it. I have come to realise that since being diagnosed almost 12 months ago these changes have already taken place, so I thought it would be a good idea to compare the answers to a few questions related to living with type 1 diabetes of a T1D novice (such as myself) and a more experienced T1D survivor.

In case you’ve not had the pleasure, let me introduce you to the brutally honest writer over at Diabetogenic, Renza Scibilia. Renza has been living the T1D life for going on 17 years, has used an insulin pump for over 12, and has been a mother for 10 years. In her blog Diabetogenic, Renza openly gives a hilarious, and frank account of her daily life, which happens to include T1D. I would like to thank Renza for contributing her “experienced diabetic” answers to the following questions.

(Note: Nor Renza or I had read each other’s answers before providing our own).

What effects do your blood glucose levels have on your emotions each day?

Renza:

Hmm… that’s an interesting question and a little ‘chicken and egg’ really. I am not sure if my BGLs affect my emotions, or if my emotions affect my BGLs. I think that it is probably both.

When I am feeling stressed or anxious, my BGLs are likely to be higher and far more stubborn. And then if I manage to address whatever it is that is making me feel that way, I end up have a crashing hypo. Fun!

When I’ve had a particularly nasty hypo, I often feel really down and start to worry about how diabetes is going to play out long term.

There is a real and clear link between emotions and BGLs. Unfortunately, it’s unpredictable. The behavioural side of diabetes is one that is really not discussed enough. It’s great to see that there is more discussion about diabetes and mental health, but I believe there needs to be more, including regular and routine monitoring. I know that when I am feeling more emotionally robust and ‘together’, I am able to manage my diabetes far more effectively. And conversely, when I am feeling down, I struggle to care for myself. It’s a catch 22, which is why we need to be looking at ways to help people work through the times when they are experiencing diabetes distress – both short and long term.

Miss T1D:

I haven’t had all that much experience with this one to determine if my blood glucose levels have a definite effect of my emotions. I know that when I am hypo I feel so devoid of energy that I am sure I am short with my husband at times, until my BG comes back up, which rarely takes more than some jelly beans and a piece of toast. I get more cranky if my BG is too low to go to bed when I am already half way asleep (which happens most nights), but that is more frustration at having to wake up and eat something.

Recently I had a not so happy day, I was overwhelmed with a few situations I am dealing with and just felt under the weight of it all, on this day my BG results tended towards high, and I couldn’t put it down to any other reason other than my emotions that day, so I would say in that instance, my emotions had an effect on my BG results.

How do you feel about when you get ‘good’ and ‘bad’ results

Renza:

I really don’t see results as good and bad. I’ve made a huge effort to remove judgement words from my diabetes management and results. My BGLs are ‘high’ or ‘low’ or ‘in target’. It has taken a long time for me to do that with real meaning, but that is how I see things most of the time now. That doesn’t mean I don’t get annoyed and frustrated – of course I do. But there is no judgement or ‘fault’ in place. Instead of getting pissed off with myself, I get pissed at diabetes!

I think that the language we use when talking about diabetes is a real issue. Words have the ability to really sting and using positive language can have a positive effect on how we see ourselves as people with diabetes. It’s difficult though, because even though I feel that (most of the time) I use language that is completely not judgemental, this isn’t necessarily reflected in the big bad world! The media is terrible (very judgemental and stigmatising) and some healthcare professionals use really damaging language.

Miss T1D:

I am still in my honeymoon phase of Diabetes, and I very rarely get a high BG result that I can’t explain – “Oh I had a feeling I didn’t count the carbs right”, “That meal was pretty high in saturated fat” “It must be that time-of-the-month coming up” – so when I do get a result I don’t like, I often feel the need to compensate and get a few ‘perfect’ results in the coming days. I don’t believe I should blame myself, I should blame the diabetes, but I can’t help but get disappointed when I realise I can’t control many aspect of my diabetes.

There is a Facebook group dedicated to people with Diabetes posting pictures when they get the ‘perfect’ 5.5 or 99 (depending on where you live). So at first, I assumed that that 5.5 was hard to achieve and must mean you are doing things right. After getting a number of perfect scores and seeing the many members post their pictures I realised it isn’t about getting the good result because you worked for it, but because you can do it all right, and still miss the mark it’s about celebrating the rare times when outcomes reflect the hard work (or by contrast, getting the perfect score despite having cake for breakfast). This group just highlights to me that feeling bad about getting a ‘bad’ result is pointless, because you can’t always help it.

How do you feel when you see advertising for food with high sugar content (e.g. frozen coke, specialty sweets)?

Renza:

I don’t even think about it. I wouldn’t eat or drink it, but then, I probably wouldn’t have before I was diagnosed (at 24) either. Having said that, there are days – usually in Summer when it is sweltering – that a slurpie is the only thing I feel like. And when that’s the case, I buy one and bolus accordingly.

I am a real foodie – I spend a lot of time preparing, thinking about and eating food. A meal or a coffee or an afternoon tea cake is one of the most lovely ways to bring friends and family together and nothing is nicer than being able to feed people. I go through periods where I bake every day and then deliver the goodies to the neighbours. It is lovely!

What we choose to eat is an incredibly personal decision. If people choose to NOT eat foods that have a high sugar content, that’s fine. Equally, if people do want to, that’s fine too. I very much subscribe to that belief, which is I believe why food ‘movements’ are so awful. They judge people and stigmatise those who don’t follow their ‘rules’.

I am also a big believer that there is no such thing as the ‘diabetic diet’. I am all about moderation. And if I want to eat a doughnut, I will. But probably not for breakfast, lunch and dinner every day. (But…but….but…if YOU want to eat a doughnut every day for breakfast, lunch and dinner, that’s okay!)

Miss T1D:

I am still very new to managing my diabetes, and when I think about eating and drinking food high in sugar, I get a bit nervous. Intellectually I know that I can have a Frozen Coke if I wanted to, I would just need to make sure I bolus right for it, but I am still learning to turn down the feelings of worry when I see such items. One by one, cake by cake I am reaching outside my comfort zone and just eating things that I thought I had to say good bye to when I was first diagnosed. And the more the world doesn’t end, the more I end up balancing sugary treats or realise that I won’t go into a Diabetic coma should I not balance, the more confident I am becoming.

However I still deprive myself of certain things, and feel very much left out when I do so. Especially now I am pregnant and extremely susceptible to food advertising. I see a soft drink such as Coke as my Mt. Everest. I am climbing and one day I will reach that bubbly sugary peak, insulin in hand.

What activities or situations make you nervous that wouldn’t, if you did not have T1D?

Renza:

I really don’t think that T1D makes me feel nervous about any situation. Of course, I consider my diabetes (ALL THE BLOODY TIME!), but that’s the nature of the beast. I went sky diving a couple of weeks ago for my birthday and diabetes was so insignificant in the overall activity. I thought about it, did what I needed, and then jumped out of a plane. But there certainly was never a thought of ‘Oh, maybe I shouldn’t do this – I have diabetes.’ In fact, I don’t think I’ve ever thought that about any situation.

Of course, I am fortunate enough to be living complication-free. This may be a very different scenario for people who have diabetes complications.

The way I think about it is this: Diabetes adds an extra degree of difficult (sometimes SEVERAL extra degrees!) to many situations. A wonderful man I met who had lived with diabetes for 75 years said to me that he doesn’t think of diabetes as an illness; he considers it an inconvenience. I have tried to live by that ever since I had the privilege of meeting him.

Miss T1D:

Anything I haven’t done yet since being diagnosed. I was nervous the first time I ate out at a restaurant, the first time I had to guess how many carbs were in my meal, rather than measuring, the first time I went overseas, had a coffee, slept alone etc. Even after nothing went wrong after doing all those first, I still feel nervous when I have to enter a situation that requires me to be prepared because of my Diabetes. I havn’t yet gone camping, and although I am nervous (how will I keep my insulin cool, what if something happens and I need a hospital?) I am also keen to give it a try (wow just realised I have not been camping in 12 months!).

I know that being diabetic means I have to be prepared, that it makes certain things more difficult, but I am also aware it does not mean I have to exclude myself from situations, or not do things because of it, I just have to consider more and be better prepared (my hand bag is and will always be massive).

Are you more likely to follow the advice of your Endocrinologist, or take it under advisement and trust what you have learnt about your Diabetes?

Renza:

I feel I have a really wonderful and consultative relationship with my endocrinologist. Whenever there is something new to consider or try, it is a decision we make very much together. She knows I will always speak with other people with diabetes to hear about their experiences and thoughts and this is part of my decision making process. She also knows that it is me who is living with diabetes and that whatever management strategy we try has to be sustainable. There is no point in saying something like ‘We need to fix your basals – you need to check your BGLs every two hours, including overnight, for the next six weeks. And write them down in this book; turn them into a spreadsheet and analyse all the results daily, providing me with a written report every couple of days’ because I’ll do it for 24 hours and give up.

Miss T1D:

When I was first diagnosed I was terrified and knew very little about diabetes. I saw my endocrinologist as the person with the key to survival. I took her word as law, and followed everything she said to the letter.

Now I am more confident and understand more not only about diabetes, but about my diabetes. I rely less on Dr. O when I it comes to navigating something I am unsure of. By this I mean, I don’t need to call her up and ask what I should do, but rather I will make a decision about what I will do and then probably consult Dr. O on it at a later appointment.

However there is still so much I have to learn about diabetes management and the best treatments or methods my body responds too, so for this reason still I see my appointments with Dr. O as learning opportunities rather than consulting with each other on best management practices (somewhere I hope to find our relationship down the track).

How worried are you about developing Diabetic complications?

Renza:

Absolutely. Terrified. And this seems to be increasing the longer I have diabetes. But as terrified as I am, I need to keep it in perspective. I know that there is far better treatment these days for complications. I get my eyes screened regularly and if there are any changes they will be picked up early and dealt with.

Talk about diabetes complications is an absolute minefield. We are told that if we ‘look after ourselves’ we won’t get complications. If only it were that easy. Of course we know that we can reduce the risk of complications with a lower, in-range HbA1c, regular complications screening and by keeping in touch with our healthcare team. But that’s no guarantee. I know people who have never had an A1c above 7, have never ‘dropped out of care’ and are meticulous about their diabetes management who still have developed complications.   

There can be this really nasty assumption that if you have retinopathy or neuropathy or nephropathy (all the opathys…) you did something to bring it on yourself. This is a really damaging attitude and incredibly unsupportive.

Miss T1D:

I am pretty dang worried. So far and thanks to my honeymoon period, I have had great control, but from what I have read and heard from other more experienced type 1 diabetics great control isn’t the be all and end all of diabetic complication avoidance. I was lucky my diabetes was found extremely early on before my levels had a chance to go above 12mmol/ml, so I haven’t yet had any hospital stays, or any complications recorded… yet.

I asked my Obstetrician about what he predicts the end of my pregnancy will hold, seeing as I very easily control my sugars and still have a fair bit of pancreatic function. His answer has me thinking. He said that there is still much about Diabetes and the effects it has on the body, especially, the developing body of a foetus, that we don’t know, and that there could be other factors in it that cause complications. I believe this is true for diabetic complications, having perfect control 100% of the time won’t guarantee a life free from them. So I guess I will just have to accept what comes my way and be thankful for medical advances to treat and prevent such conditions.

How does T1D have an effect on the daily running of your family’s life?

Renza:

I try to make the impact of diabetes on my husband and daughter as small as possible, but I know that there are times that it is far more significant than I would like. I hate it when diabetes intrudes in my family time and I hate it when my diabetes becomes something they have to deal with. I really hate that my daughter even knows about diabetes in the detail that she does.

Miss T1D:

There are many people who believe diabetes is a family disease. Not because it can run in families, but because even if only one person has it, it regularly impacts the rest of the family. My husband can count the carbs in my meals as well as I can, and often I trust him to do so. He is always wants to know what my BG is and if I am acting dopy and tired, requests I check to make sure I am not going hypo. It is on his mind almost as much as it is on mine.

As we are about to have a baby I am very anxious about how life will be different for my baby compared to others. I listen to my young mother friends and family talk about how they didn’t even realise they skipped a meal, or how they only get to eat half of a meal because they are sharing it with their toddler, and I know these things just can’t happen for me. I worry my baby will have to stay in his cot crying for a few extra minutes while I treat a hypo; I worry about my toddler having a tantrum because Mummy gets to eat Jelly Beans in the car, but he can’t or even worse, I worry about what effect sleep deprivation will have on my blood sugars. I just hope that Diabetes won’t alter the way I am able to care for my children too much.

Thanks again to Renza for participating in this blog post, if you would like to hear more from Renza you can Subscribe to Diabetogenic.

Happy Diaversary to Me: 1 year with Type 1 Diabetes

Today marks one year since I was diagnosed as a Type 1 diabetic. Wow. Twelve months! 365 days keeping myself alive. On average, I have given myself 1,825 injections and 2,920 finger pricks (150 of which were in the wee hours of the morning), I have taken somewhere between 15 – 20 blood tests, counted the carbs in 2,190 meals/ snacks, according to my meter data have had approximately 115 hypoglycaemic blood glucose results, I wore a pump for two weeks, and have left the house without my meter bag twice. That’s a lot of ouch, and a lot of inconvenience.

To make myself feel better, I should look at the bright side of the past twelve months, or the good things relating to my diagnosis. I have lost a total of 15 kilograms (before pregnancy), have never been over 10.9 mmol/L (196 mg/dl), have (up until the last couple of weeks) had meticulous control, have remained within my honeymoon period, never once been to the emergency room for a diabetes related issue, met new friends who I share a common life experience with, and started one very fulfilling blog. And to top it off, treating my diabetes has finally allowed me to get pregnant!

I owe a lot to my early diagnosis, as I have been able to gain control of my diabetes while still having a fair amount of pancreatic function – kind of like using insulin therapy with training wheels on. However, these past two weeks have been a real challenge for me. Heading into the third trimester of pregnancy means my insulin resistance is starting to pick up (as it does for all expectant mothers, not just diabetic ones), and so I have been finding it difficult to know where my sweet spot sits in regards to my carb-to-insulin ratio. Some days it seems to be double my usual ratio, other days that repeatedly sends me hypo. I will be working closely with Dr O to work out how best to navigate this new stage of pregnancy.

On the whole, I am very positive about my diabetes and its treatment, but I am finding myself feeling rather down about not having as good a level of control as I did. My previous HbA1c was 4.4 and stable (meaning low, but no hypos), which is apparently “unheard of” in the words of Dr O. So basically I have been doing fantastically. My OB and Endo have both said “it’s like you are not even diabetic” about my pregnancy: which, it turns out, is the biggest compliment you can give a Type 1 diabetic. So even though I was well warned about this stage, and I know it is only my pregnancy causing me to have less than perfect blood glucose, I still feel very frustrated. The main factor I find that is bringing me down is that I am concerned the higher blood glucose will have an adverse effect on my baby. I am afraid that he (yes, he is a ‘he’!) will have too much body fat by the time he is born. I just need to keep telling myself that once I have given birth my excellent control will come back, and my baby will be healthy regardless of how he comes into the world (natural, or caesarean).

On the bright side, this increased resistance to insulin will probably mean I finally get to go back on my insulin pump! What an upside! Instead of having to set up and inject at every meal, I will just whip out my pump, press a few buttons and off I go… And I will need only one injection (of the pump cannula) every 2–3 days! See – there is always a silver lining!

So let’s hope that by my next “Diaversary” I will still be in my honeymoon period, be complication-free, Emergency-room-visit free, and very happy with my blood glucose control. For now, I am going to celebrate with a bowl of Ben and Jerry’s Sweet Cream and Cookies Ice-cream, because yes – I can eat that.

Controlling the Things Beyond Your Control

Summer is closing in on us here in Australia, and things are certainly heating up. So far we have had a few days in the high 30s centigrade, with one or two days breaking into the 40s for sure. Seeking the places with air-con is always mission number 1 for most days (especially when baby hormones take away your usual amount of tolerance for uncomfortable situations). Unfortunately, a lot of the time, with high temperatures comes low blood glucose readings (BG) for Type 1 Diabetics.

These past couple of weeks I had been experiencing a sudden increase in the amount of hypoglycaemic episodes that I usually have, and to be honest I didn’t even think about the increasing temperatures – I assumed it was just a new phase of the crazy ride for pregnant T1Ds. I have been getting my below-4mmol/ml BG results late in the afternoons, after I had my lunch and afternoon snack. There really isn’t much I can do about this except for keep a close eye on my BG levels, staying aware of how I feel, and treating the hypos when then happen.

That’s one of the kickers about living with T1D. The truth is that you are rarely in total control of the things that affect your BG levels. You can measure your carbohydrates and match your insulin accordingly, but you just never know if there is an extra concentration of carbs in your food: maybe your apple is a little bit riper than you thought, and so has more sugar in it; maybe that type of pasta contains more flour than most. Even if you do get this right, you can’t control the temperature all the time, or even how active you need to be from hour to hour. Hormones play a HUGE role in levelling out your BG (after all, insulin is a hormone), good luck controlling those!

This is why so many T1Ds suffer from Diabetes Burnout, and end up not properly looking after themselves. We can feel like the efforts we make towards good control are useless and don’t really matter anyway. I like the memes I see on Facebook that say things like, “Be nice to T1Ds, we deal with enough pricks”, or “No, I wasn’t drinking last night, but yes, I am hung over” (referring to a “hypo-hangover”, when someone is up all night attempting to treat a persistent hypo). I like these because they give other people a little bit of insight into the difficulties of controlling T1D. With T1D, putting in more effort won’t always yield better results, and you can imagine how frustrating that could be, especially when you are not feeling well to start with. But to our credit we plod on anyway, keep checking, keep injecting, keep balancing… after all – “you don’t know how strong you are, until being strong is the only option you have” – Unknown.

Type 1 Diabetes and Morning Sickness

Life as a Type 1 Diabetic is challenging. That’s because there are many parts of our days and weeks and years that are made difficult by the Diabetes. Getting a good night’s sleep can be hard, eating out at a restaurant can cause stress… and then there is Christmas. I haven’t been through my first Diabetic Christmas season yet, but I am bracing myself for disappointment over not being able to graze on treats I have always loved – for a whole month!

So I should have been prepared when at five and a half weeks pregnant and my first taste of morning sickness sent me to research methods for coping, I found 101 very useful tips that are completely useless to a Type 1 Diabetic: eat smaller more frequent meals (too bad I have to wait at least two hours in between eating); keep your stomach a little bit full at all times (again, no help there); eat lots of complex carbohydrates (I admit this one wasn’t the hardest to deal with, but when you are trying to eat lower carb and low GI it doesn’t help).

So for six weeks I had a daily struggle with an eating cycle. I would wake up feeling sick, eventually eat, feel a bit better for an hour, spend the next hour feeling terrible (and I mean terrible), check my post-meal blood glucose results, then make a decision about eating again, or simply waiting to throw up, before starting the cycle again.

I have been on B6 and ginger, Maxalon and varying dosages of Zofran. They have helped, but I have been in bed pretty much for a month and a half. At one visit to the doctor to refresh my prescriptions the doctor officially labelled my morning sickness as ‘Hyperemesis Gravidarum’ (Really Bad Morning Sickness) because of my weight loss. Not enough to land me in hospital being pumped with fluids and food, but enough to get me more sympathy and better prescriptions from my doctors.

Luckily I have a really awesome husband, who has for the most part been my full-time carer. I was too sick to stand, so he had taken over all the household duties, including bringing me my food and lemon water (if you suffer from morning sickness I fully recommend trying lemon water!)

How has my diabetes been affected by my Hyperemesis?

Not a great deal – being in my honeymoon phase still means I can get away with a lot more as a T1D. I have had to increase my night time Levemir (slow acting insulin), from 2 to 3 units. I have been having more frequent higher post-meal BG results such as in the 6s and 7s, but I think this may be more to do with the fact that I am having higher carb meals at these times due to my lack of appetite, and aversions to my usual meals. I figured, and Dr. O agrees, that as long as I am eating something, the occasional high carb meal isn’t going to affect me or the baby badly. On the flip side of this, when I have been feeling so ill I cannot eat, my sugars tend to drop, and when this happens I feel even worse (as you can imagine). Often I have had to force myself to eat something when it was against everything my body was telling me to do. For a few weeks, a good 80% of my diet was made up of crackers with avocado and tomato, something I was able to stomach.

Really there wasn’t much relief for me, so I just had to suck it up and deal with my symptoms, and try my best to keep my Diabetes under control (I said my best).

Now that I have reached my second trimester I am gaining better control of my BGLs again and am trying to eat healthier meals (still have many food aversions, which does not help). I am also starting to step down my anti-nausea medication, which some days makes me feel like I am taking a step backwards.

So even though the first trimester of my pregnancy was miserable, I am improving and am able to look forward to the fun side of this time, including watching my bump grow, and shopping for all the essential baby gear, all the while keeping a very close eye on those BG levels.

Happy Diabetes Awareness Week!

Guess What, Everyone!

I have always wanted to be a mother. It has been my greatest ambition. So I am thankful for the better understanding and management we have these days of Type 1 Diabetes, so that couples like my husband and I still have the opportunity to have a family despite my disease. Not that many years ago, doctors advised T1D women not to become pregnant, and we have all seen the movie Steel Magnolias and the repercussions pregnancies have had on T1Ds in the past. However, thankfully this has become a thing of the past. Of course being Type 1 automatically makes your pregnancy high risk, and with that, there comes many different added responsibilities and checks throughout pregnancy, with just one bonus: not having to perform the glucose challenge test (a test that helps diagnose Gestational Diabetes).

Why am I writing about pregnancy? Well, as many of my friends and family have just been informed this Type 1 Diabetic is expecting a baby. I am so elated, so happy, so overwhelmed that I almost didn’t notice the horrible morning sickness I have suffered the past two months (definitely sarcasm!). I’ve been neglecting many aspects of my life: my friends; my church; even had to take a couple of weeks off work – and yes, this blog – all to lie in bed, raising only to vomit whatever food I had managed to get down. But I’ll tell you all about being T1D and having severe morning sickness another time… so look forward to that!

So I am 13 weeks pregnant. We found out when I was about 3-4 weeks, just before I went on a seven night cruise with my mother, two aunts and a sister. Keeping it quiet was difficult, but I did want to keep it quiet. T1Ds have a higher risk of early miscarriage, and I wasn’t sure how I felt about that. At 6 weeks and 1 day I went for an early ultrasound to verify the pregnancy and determine gestational age and low and behold – a heartbeat! An ultrasound this early isn’t offered to most women, but falls under the category of “extra examinations because of high risk”.

As well as regularly seeing my “high risk” Obstetrician and midwives I also need to step up my Endocrinologist visits. In fact, since becoming pregnant I have been to two OB appointments, but have been to see my Endo four times. This is because managing my Diabetes is much more critical now to ensure that while each and every very important part of my baby is forming and developing, I maintain good blood glucose levels. Bad BG control in pregnancy can lead to some pretty scary birth defects. Then, just to make life fun, controlling your BG levels in pregnancy becomes increasingly difficult, thanks to all those raging and changing hormones.

I have found that, because of my honeymoon phase, controlling my BG levels isn’t too hard for me, but I have had to get used to some numbers I haven’t often seen. My post meal BGs used to be in the 4s and low 5s, very well controlled. Now I am reaching into the 6s and depending on the meal, 7s, and even clocked a couple of 9s. It has been difficult to see these numbers that I am not used to, especially now when it is important to keep my control tight, but I need to keep reminding myself that Dr O is happy with my numbers and that they are not adversely affecting my baby. I also need to make better decisions about my diet, which can be very difficult with pregnancy cravings and sickness, but each little bit counts!

So this space will be host to a fair amount of baby talk for the next six months, but I promise to keep it T1D related. And in case you are wondering about the guitars, this was the photo we used to announce our pending baby on Facebook. The relevance is that both my husband and I play guitar and got to know each other when he was my guitar teacher.

Carb Counting – How’s That Going?

Last night I made my husband Tomacaroni for dinner. A family recipe pasta bake dish we all love. It is basically carbs, mixed with carbs, in carb sauce baked in carbs. Due to my diabetes the last time we had this was the night before we went to Dr. O and she diagnosed me. We had it then just in case I was never going to be able to have it again – kind of a last meal situation. Now I wouldn’t say I successfully counted the grams of carbohydrates last night, but seeing as my blood glucose levels after was 7.8 mmol/L I got pretty darn close (no correction dose of insulin needed).

So it has me assessing my carb counting ability. After six months of counting every single gram of carbohydrate that I put into my mouth I would like to step back and give myself an assessment of how I am going. Am I ‘there’ yet? What exactly is ‘there’? What I am going to try to do to improve.

When I first started counting carbs I relied heavily on packaging and the Calorie King app on my phone to tell me how many grams of carbs are in each meal that I eat, so that I could calculate the amount of insulin I would need to give myself for it. Today I am still very reliant on these things; however I have started to develop a mental catalogue of foods I eat on a regular basis. For example I know off the top of my head that bread (Whole Grain, White, Wholemeal) is 50% carbohydrates, so I weigh it and it will be half carbs, I know that pasta is about 70% and jasmine rice is 80%. I know that 200mls of milk is one “exchange” (10 – 15 grams of carbs), as is 1/3 of a cup of mashed potato and that the darker the chocolate the less grams of carbs per piece. I know lots of little numbers and percentages that give me an idea of how I can measure out and portion my food.

What I still need practice in is being able to look at my plate and decide how many gram of carbohydrates a meal contains without measuring it. I am definitely better at this than when I first started, thanks to what I know. If I get a big serve of mashed potato I could try and guess how many “1/3 cups” it would fit into. I am also getting good at guessing the weight of a piece of bread or bread roll.

I am more confident and daring. I am eating ‘scary’ meals to see if I can count the carbs properly. Sometimes I do, sometimes I don’t. Six months ago I honestly believed I would never eat our beloved Tomacaroni again. I just had no idea how I would work out all those carbs, and how much would end up in my serve, and if I could even have enough of it to make a meal before I reached my (self-imposed) carb limit. But last night it took me 5 extra minutes to sit down as it baked in the oven, and add up everything that went into it, and work out the total, then divide by how many serves there would be. That is how far I have come. My skills, my knowledge, my confidence have all improved in six month far more than I thought they would in a life time. So, yeah, I am feeling pretty confident right now.

BUT there is a big “but”. I am still in my honeymoon phase, I can get away with oh so much in regards to my eating and diabetes. Recently I forgot to bolus a meal. I checked my BGLs and worked out how much insulin I needed then plain forgot to actually inject it – but my sugars were (almost) perfect afterwards. Granted it was a low carb meal, but the point is that while I still have pancreatic function, while my beta cells are still in the process of being killed off, I have this huge safety net. So what haunts me is when this time ends. When the training wheels come off and my insulin / glucose functions are all up to me. How will my carb counting fair then?

My aim is to be able to guess the carbs of my food just by looking at my serves; at least enough to be able to have a reasonable BGL after the meal. To achieve this goal, more and more I have been putting aside the scales and measuring cups and trying to guess, I have been looking at everyone’s meals at a restaurant and mentally tallying the carbs on their plate and I am trying to commit regular meals totals to memory. A meat pie from our favourite bakery is 65 grams of carbs so definitely a “sometimes” food.

I don’t think there is any one technique I need to stick to. Each situation is different. Sometimes I am at home and can take the time to measure out, sometimes I will use percentages, sometimes cup measurements and then sometimes I will simply guess. Whichever way makes life easier, and the task quicker. This is called fitting diabetes into my life, not the other way around.

Would They Know What to Do?

When I first started using insulin I made sure I educated as many people, who are often around me, as I could in what to do should I have a severe hypoglycemic episode and required assistance. I showed them my glucagon shot, how to use it and told them to contact emergency services/ give me some sugar.

However yesterday I was waiting a rather long wait for a coffee at the café at my workplace. I hadn’t had breakfast yet and intended to bolus for the chai latte with my porridge. I suddenly started to feel weak and perhaps a little low. I had a quick look around me at who was in the café as well and realised that none of these work colleagues were among the people who I had educated, even worse I was sure none of them were aware I was a diabetic. Good news was my coffee came and I started sipping that bad boy right away, so no issue was had. But it did give rise to that fear, I am sure, all T1Ds get every now and the: What will happen if I pass out and no one knows what to do? Will they just fan my face thinking I had swooned? Would they know to call the ambulance or that me seeming drunk could be an emergent situation?

Luckily I have never been so hypo as I wasn’t able to assist myself in getting what I needed to bring my BSLs back up, though I have had a few instances where it was obvious that my mental capacity had been compromised. But this doesn’t mean it won’t happen in the future. I feel like it wouldn’t even take all the much educating/ awareness among the general public to make life safer, not just for insulin using people, but also people with other ailments such as allergies or epilepsy. Of course our governments could make a compulsory awareness course for high schoolers on the more common/ life threatening conditions ‘How to assist a stranger in need’. I also think it is up to the people who have the condition to speak out and raise awareness, as much as it is the responsibility of the general public to listen.

So the rest of this post is information for my friends and family on how to assist me, with my specific condition, should an emergency arise, and it would mean a lot to me if you had read/ taken this on board. You never know it could save my (or someone else’s) life.

How to identify and assist a diabetic during a hypoglycemic episode:

Hypoglycemia in a diabetic is when the use of artificial insulin has caused the blood sugar to drop too low. This causes the body to be literally starved on energy and can very quickly shut down leading to brain damage and death. A conscious diabetic may also need your assistance during a hypoglycemic episode.

How to help a conscious hypo diabetic:

If you see:

• Extreme confusion
• Apparent drunkenness
• Shaking
• Extreme lethargy

Then do this:

• Give me ‘quick acting sugar’
• Suggest and assist me to check my blood sugar levels
• Repeat the above two steps every 10 minutes until levels have reached above4 mmol/ml (75 ml/l in America)
• Determine when medical assistance may be required

The long instructions:

Inquire if it is possible that I am hypo. Remember that being in a hypo state may reduce my ability to recognise the fact. If I respond with no, acquire and attempt to coax me into eating/ drinking some quick acting sugar. At this stage it won’t matter how much. A high blood sugar level can be treated once I am out of danger of the low. High blood sugar, for the most part, is less of a time sensitive emergency. Most diabetics carry at least a little bit of sugar on them. Sometimes they will also carry glucose tablets or gel. This will also treat the episode. If I am able encourage me to test my blood sugar levels, every 10 minutes until my levels are above 4 mmol/ml (75 ml/l in America). At this point I will be out of danger and well within the ability to treat myself. If you are unable to do any of this, or my condition worsens call an ambulance.

Quick acting sugar: anything that has a very high GI. Examples are: lollies, fruit juice, full-sugar soft drink, even a spoon full of sugar. In a worst case scenario any food will do.

How to help an un-conscious or almost un-conscious hypo diabetic:

If you see:

• Unconsciousness
• Near unconsciousness
• Seizures

Then do this:

• First call ambulance, keep them on the phone
• Determine if the person may be diabetic:
•  –  Search for medical ID jewelry or tattoo
•  –  Search possessions for evidence of diabetes
• Search possessions of glucagon kit and inform ambulance if there is one
• Follow instructions of emergency team over the phone
• Administer the glucagon injection

The long instructions:

If you are there when I (or someone else) have fallen unconscious your first response is to call an ambulance for assistance and keep them on the phone for instructions. If you do not know the person, try to ascertain if they are diabetic by looking at their jewelry, precessions or tattoos for evidence. You will also need to see if they are carrying a glucagon kit. I keep mine in my hand bag usually in a zipped pocket. You will need to inform the ambulance that you have a glucagon kit and ask if/ how to administer it. If I have passed out for another reason, giving me the glucagon is still important just in case it is hypoglycemia. The ambulance people on the phone may tell you not to use the glucagon if it has been over a year since I purchased it. In a worst case scenario you can rub sugar or sugary items on my gums and inner-lips, as this will absorb into my blood stream although it is slow, just be careful not to let it choke me.

How to use a glucagon:

• Remove caps
• Inject the water from the syringe into the vial with the powder tablet
• Shake vial until water has completely dissolved powder tablet and combined
• Re-insert syringe into vial turn upside down and draw up the mixture into the syringe
• Inject glucagon into the back of the arm or thigh (really doesn’t matter where you inject)
• Prepare the person for vomiting (roll onto their side)

 

I didn’t realise how morbid and scary this post was going to sound, but I also feel it is important to know. Hopefully I have safe guarded myself and others a little more.

Six Months Down the T1D Track

It has now been six months since my endocrinologist diagnosed me with Type 1 Diabetes, specifically LADA (Latent Autoimmune Diabetes in Adults). I am now officially considered ‘stable’ even though my sugars have been extremely stable ever since starting insulin therapy. In the past six months I have learnt a number of things I found interesting, about myself, about diabetes and about how diabetes is treated by the world, so I have compiled a list of:

12 things I have learnt since becoming a Diabetic

1. – I can, in fact, deal with multiple injections everyday
As I have said before, I hate needles. They have always given me the heibby-geebies, and I always used to think about people who had T1D and think I would be so horrified if I had to deal with MDI’s (multiple daily injections). Well the thing I dreaded happened to me (go figure) and I am dealing with and have gotten used to it. I am much stronger than I thought.

2. – I never knew what hungry was like until hypoglycemia

Before I had T1D and needed insulin therapy I would refer to feeling weak and hungry as ‘low blood sugar’. I had no idea what I was talking about: the feeling of being low is so amplified, so intense. All you can think about is getting food, and it isn’t just a hunger in your tummy, it’s in your whole body: your head, your limbs, your veins. No wonder people are very distracted when they have a low BGL. There is such a thing as a ‘Hypo Hangover’.

3. – 15 grams of carbohydrates is a very devastatingly small amount of food

And when you have this intense feeling of hunger and need to eat, the prescribed amount of carbohydrates is 15 grams. That’s 7 Jelly Belly jelly beans. That’s it! Then you have to wait for 15 minutes to see your BGLs come up, and let me tell you, even if they do come up, that feeling hangs around for a lot longer than 15 minutes, this is when the anger and frustration kicks in, and definitely why many, many people over treat hypos with too much food and end up going high – just to add insult to injury.

4. – Why food packages have the “per 100 grams” column in the nutritional information section

When I first started out counting carbs, I would serve myself up what the packet’s serving size was. Then I got more confident and would sometimes have 1 and a half servings, or only half. Then when I started in 1 and ¾ territory my dear husband taught me how to find out the percentage of carbs using the math I learnt back in school, and yes this requires me to know how many carbs per 100 grams of food. So now instead of a useless waste of food packaging space I used to think this information was, I find myself heading straight there.

5. – Fingers can heal faster than I thought

One big concern of mine has always been the state my fingers are going to be in when they get pricked all the time to test my BSLs. I have always had dry sensitive skin, so I was expecting cracks on my fingers and big ugly calluses that prevent me from using my iPhone properly. While pretty much every one of my fingers always has at least one prick mark on them at any given moment, I am happy to report they heal faster than expected and some pricks don’t leave a mark at all. I am glad of this.

6. – Non-Diabetics don’t know much about Diabetes

The amount of incidental educating I find myself doing on a daily basis is exhausting. I guess I don’t have to educate everyone every time they get it wrong, “what can’t you eat?” “but you’re so skinny” “you have to check your blood again?” but I can’t help myself. Many diabetics feel the same way I am sure. It is like; if I don’t educate this person they will go on believing that diabetics can’t eat cookies, and that may one day deprive some poor T1D person of cookies!! I hope these people are understanding, or interested, and they don’t start to avoid me because of my lectures.

7. – Diabetics are treated as VIPs within my country’s health system
Since being diagnosed I have noticed that the health system has become easier to navigate. When I call practices or health institutions and mention that I am diabetic I don’t get put on hold, Doctors call me back the same day (hour even), Chemist come and talk to me personally when I put in my scripts and bend over backwards to make sure I have what I need, my Endocrinologist even ordered an X-ray on a past broken bone, simply so I didn’t have to pay for it (you do when a GP orders one, but not when a specialist does).

8. – Type 1 Diabetics get offended when people mistake their disease for Type 2 Diabetes

This I understand, but also believe in education rather than offense. The issues is that Type 2 Diabetes is (wrongly) perceived by the greater population as a disease brought on by people not exercising and eating poorly. While these things can (‘can’ not ‘are’) be a contributing factor, it is being discovered that genetics plays a bigger role in the onset of this disease. However Type 1 is a 100% unpreventable auto-immune disease, which means the body attacks itself, and Type 1 Diabetics often find it hard to come to terms with the fact that this is happening to them, and feel they are being blamed for their disease when people mistake T1D for T2D.

9. – Type 2 Diabetics take offence when Type 1 Diabetics get offended when people mistake their disease for Type 2 Diabetes

Similarly Type 2 Diabetics feel that they are being blamed for their disease as well. This is wrong. Type 2 is associated with a metabolic condition, which simply means your body has reached its thresh hold for certain functions to do with insulin. Genetics determines what this threshold is, so a skinner, healthier person than you could develop T2D because they have a smaller threshold, and managing it is not as easy as eating right and exercising, these things simply help.

10. – Diabetes appears to be easy to cure in mice

In the six months I have been Diabetic there have been numerous cures found for Type 1 Diabetes in mice. Often with the same result: the cure does not work in human trials. Disappointing, but this does not mean pointless. Each research project, every trial brings us closer to a cure. If the scientist, and funding agencies let these setbacks discourage them they might just give up. So instead of finding the setbacks discouraging, I have chosen to find them interesting and uplifting – at least we are trying right?

11. – I can get used to the taste of Diet Coke (Coke Zero)

My husband is well known for his love of Coka-Cola. I admit I have always considered it my soft drink of preference when on offer. So in our house Diet Coke or Coke Zero were taboo words. Now that this is all I can drink I was afraid I was doomed to drink nothing but water and tea for the rest of my life (hypo incidents excluded). However I thought I should at least give Coke Zero a try after all “tastes just like Coke” right? Now when dear husband and I order our drinks and I get a post mixed Coke Zero I sometimes need to get him to taste mine as I am unsure if it is diet or not. I have gotten used to that nasty after taste – leave me be in my blissful ignorance!

12. – Diabetics love their online community

This one I cannot exclaim enough! There are so many blogs, forums, online support groups and Facebook pages, and these are all well-loved. I can see why though. Most Diabetics don’t know all that many other people who are also diabetic. All my Diabuddies are connections at my work I have made since becoming Diabetic. So the DOC (Diabetes Online Community) connects us all, lets us share our experiences and concerns, gives Dr. Google a break makes us feel less alone and overwhelmed. There is a reason the term ‘support network’ exists in the medical industry.

Just imagine what I will learn in six years with diabetes, or even six decades (if no cure is found). So here’s to the next six months of Latent Autoimmune Diabetes in this Adult, and remember Insulin is not a cure!

I Don’t Balk Anymore

Google Type 1 Diabetes and you get a good GOOOOOOOOOOOOOOOOOOOOOGLE down the bottom of your web page to signify all the pages and pages of links those words return, but when I started looking for peoples experiences, anecdotes and stories I came across a list. This list was repeated, many times, in many forms, using many mediums and was slightly different each time. The theme of this list was ‘annoying things people say to type 1 diabetics’. Like a rite of passage for T1D v/bloggers and commentators this list included phrases like:

“Can you eat that?” – Yes, now mind your own un-educated business

“My grandma / cat/ aunty had diabetes, she died” – Are you suggesting I am going to die soon?

“You really have to look after yourself” – Really? I was planning on ignoring my life threatening disease

“I saw a TV show about Orka Water curing diabetes, you should try it” – Stop the research everybody we have cure!

While I have experienced a few of the remarks off the (very long) list, the one that I struggle with the most is:

“You have to inject/ prick yourself all day? I could NOT do that”.

I struggle with it not because it is the most offensive (not by far), or the most un-educated (not even), being ignorant or not thinking over what you say is understandable from people who haven’t had much experience with my disease, however people do hard things (such as injecting yourself) all the time. Mothers drag themselves out of a warm bed at 3am on a cold winter’s morning to feed their child, construction workers use their dry cracked hands to pour cement, dieters reach for the bland salad when they really want to go for the pasta dish.

I have always been extremely sensitive to the cold. When getting in and out of the shower in winter I would work myself up to that cold bite, would spend five minutes standing in the shower before opening the door to reach for my towel because I knew, wet and naked, the cold would hurt. In essence I balked. I remember my elder sister telling me in regards to this behaviour that when she became a mother, she got over the cold. She said when she only had 5 minutes to get in the shower, clean herself and get dressed before her baby would wake and need her, she would just get in, get out and ignore the pain.

Last night when I turned off the water, opened the door and reached for my towel I realised I have been ignoring the pain, ignoring the cold, and I realised – I no longer balk.

When first started pricking my finger and injecting my insulin I would balk, I would work myself up to it and the whole experience would be 100% more traumatic. Now I ignore the pain so much that I don’t even realise it is there. This has spilled over into other experiences in my day, I don’t need to work myself up to stepping out of the shower, I hardly react when I get a paper cut at work, and grabbing a section of my belly with cold hands, is just another day in winter!

So it was appropriate when I was looking at the merchandise for Type 1 Diabetic Memes this saying appeared on one of their shirts:

You Don’t Know How Strong You Are, Until Being Strong is The Only Option You Have.

So now rather than a narky response to non-diabetics such as the examples above, I have a response that will hopefully motivate as well as educate when people tell me they simply could not do what I have to do. My diabetes has already made me a stronger, more resilient person.

Who’da thunk it!

Diabete-Ezy Pump Belt (I am not sponsored – I Promise)

Disclaimer: I have said it before, I like the Diabete-Ezy products and also they are local to me, so this is why I hark on about them all the time. No one is paying or pressuring me to do so.

While I was using my insulin pump I most enjoyed carrying my pump in my Diabete-Ezy Pump Belt. I tried using the clips the pump came with and putting the pump in my pockets. I found the clips too bulky and awkward to use on female clothing and putting it in my pocket often meant the tubing would get tangled up or simply would not stay in my pockets.

The pump belt is a soft stretchy fabric that you step into and ware like a belt: kind of reminiscent of those fabric belts that used to be cool in the early 2000’s. They have five pockets in them so you can choose where you want to store your pump (front right/ left, back right/left, side etc), but I found these came in handy when I wanted to carry other items such as my phone and keys without any pockets in my pants – convenient! Also it was good to be able to stuff my pump in one pocket and the tubing in another, this stopped the tubbing getting tangled up when I put my pump in and out.

The pump sits in the pocket with another layer of the fabric wrapping over it. This made it feel secure in the belt, I was not afraid of it falling out, but it wasn’t fiddly or difficult to pull out, or put away.

The stretchy fabric was comfortable to ware, and it didn’t feel too tight or loose. It wasn’t at risk of falling down, even with my pump, phone and keys stored in it. It was also good to be able to wear the belt while not using it. I took my pump off for my Endo to download my records, and during this time I just pushed the belt a little higher on my waist and was able to forget about it.

Diabete-Ezy has a website here. They ship worldwide and stock a number of good products to make diabetes easier to manage. The founder is the mother of four diabetic children, so she knows what she is doing.

The pumps come in some sensible and also some fun patters, which are worth a look. I have the white, black and Indy check belts, two of which I order off the site and received a lovely treat with my package: which was nice seeing as they arrive the same day my Endo and I decided I should take a break from pump usage which meant I would have to put my new belts away in my diabetes draw.

 

Needle Stick Injury – Technically a Diabetic ‘Hazard’

Another experience I did not anticipate when I started to take my BG levels and inject insulin is getting needle stick injuries. I don’t mean when I prick my finger, or inject my needles on purpose, technically those are procedures, I mean when dealing with the sharp objects associated with managing Diabetes, and accidentally sticking yourself.

In the early weeks this didn’t happen, I was so careful with my lancets and needles, I couldn’t have possibly hurt myself. I think I was so afraid of it happening, kind of like if I pricked myself with a used needle I’ll get contaminated (never mind it was only me who just used it), that it just didn’t happen. I think it is so ingrained into us as kids about exercising extreme causation around used sharps; it takes a while to actually get used to needles in your daily life.

Sharps Containers

But then, I did get used to it all, and I got a bit careless as well and oops… it happened. When putting the cap back onto a needle I missed and stuck my thumb. For a moment I was upset. Then a little bead of blood appeared where I had been pricked and I realised that’s just what I do when I check my BG levels.

Ever since then I have been pricked by my used needles as I try dispose of them countless times, moreover, almost every time I take the cap off my lancet to change it, or attempt to convince my sister that lancets don’t hurt, I end up scratching myself with the darn thing! It has something to do with how the cap comes off. I have also drawn blood when I first inspected the needle that inserts the pump canula into your skin – like, because it was a bigger needle it wouldn’t hurt when you touch it (face – palm!). The more silly issue is the number of times I have inserted a needle into my belly only to realise I haven’t dialed up the dose – it is not easy to try and dial it up while not letting the needle drop out of your skin, it ends up looking more like I tried to tattoo myself in slow motion before I have successfully bolused. Sure, I could take the needle out, dial up and insert it again, but I hold true to the ‘it’s still good’ mentality, obviously much to my own detriment.

Can I just say: just because I make myself bleed every day, and I am ‘used to the pricks’ does not mean I am any less sensitive when I get a boo-boo on my finger; even if I take the opportunity to check my sugars when I spontaneously bleed. However while trying to convince my sister to let me check her BG on my old meter (just for fun), she went and got a sewing needle to draw the blood rather than use the ‘scary’ lancet (a fresh one by the way) that I use 10 – 20 times daily. I believe the first time I used a lancet I was nervous, but I remember being more frustrated as I tried to remember how to use it – even had to consult the instructions: how ridiculous!

Office Sharps Container

So far I have almost filled two large sharps containers at home and have contributed to the sharps disposal at work via my small travel size sharps container that sits on my desk. I say this as I want you to know I am responsible, and do dispose of needles properly; however I have not yet worked out what I will do to with them now. I am told I can take the full containers to a community hall for collection and will investigate this once I have filled my second container (very soon), but am confused why I can’t just pop the container into the bin, as I thought that is why we put them in the special containers in the first place.

Contingency Plan

I have many contingency plans for managing my Diabetes. I keep more needles than I need in my Diabete-Ezy case and more in a pocket in my bag. I keep extra lancets needles, an extra meter and lancet device in my bag. I have low GI snacks, quick acting jelly beans and backups for all these that I carry on me every day. Further to this I keep a third meter and lancet in my desk at work as well as snacks and jelly beans and needles. In my Diabete-Ezy case I also keep contact info for my Endocrinologist, my dosages, my National Diabetes Services Scheme registration info, strips etc. So what am I not accounting for in all this?

Today I was caught out. I ran out of insulin at work. Usually I have to throw my pen-fills away with a little insulin left in them as they have been out of the fridge for over a month and have expired.  However I started using this particular pen fill when I was still using my pump and so its levels were somewhat depleted already. I knew there wasn’t much left in it, however never having actually reaching the end of  a pen-fills capacity before I didn’t know how much would be left once my pen would stop allowing me to inject with it.

So this morning when I tried to bolus 1.5 units of insulin for 30 grams of carbs in my porridge I had at work, I could only dial up 1 unit. It was then I realised I had no contingency plan for my insulin supplies. I didn’t keep any spear insulin at work or in my bag and I didn’t have a prescription on me to get some more… I was up the creek without any paddles. How could I have been so silly? I keep all my prescriptions at home in a folder together. Always have, so I just did the same with my insulin ones.

I don’t live close enough to my work to go home, so to get out of the sticky spot I had to go to the closest GP (ouch, my budget), and get him to give me a script. He asked me 1000 questions about my treatment, checked my blood pressure (all good by the way), and sent me out the door with a script and a bill. Time and money wasted because I didn’t have a contingency plan.

I now have a contingency plan or two. When I filled my prescription I popped the repeat script in my Diabete-Ezy case so I will always have it on me, and I have stashed a vial of my insulin at work (a contingency for my contingency).

There is so much involved in managing Diabetes. I am getting used to it all that it becomes less obtrusive until something goes wrong like it did today. I honestly don’t know how men (and women) diabetics get by without a huge bag over their shoulder. Perhaps I am just over prepared, perhaps I am too obsessive and shouldn’t worry so much, perhaps, but if that is the case, today has reinforced my obsessive behaviour.

After only injecting 1 unit of insulin, where 1.5 was required, and rushing around to the GP and Chemist you’ll be pleased to know I got a perfect 5.5 mmol/l blood glucose result.

And they lived happily ever after…