You’re All Awesome

Here’s the thing. I really hate — okay, that’s a bit strong — I really don’t like posts that fish for blogger recommendations because invariably it becomes a bit like a popularity contest of who is most loved. And even though I was mentioned by a couple awesome bloggers, it’s always leaves a bitter taste in my mouth because I see a lot of repeated names and I can’t help but think about all the other bloggers who weren’t sparkly and bright enough to get mentioned as an “awesome new find.”

So in order to not be completely hypocritical, I’m not going to answer the question.

Instead, I’m going to say a big thank you to everyone who read my blog this week (whether you commented or not) because creating those connections (whether I know about them or not) is what diabetes blogging is all about to me. I’m here, whether I know you personally or not.

Although I do happen to really like getting to know new bloggers and I had a blast subscribing to everyone who participated in D-Blog Week. I may not have commented on every post (although I tried to comment on at least one post per blogger!), but I plan on continuing to read and try to catch up over the next week or two. If you looked at my RSS feed reader right now, you’d probably think I subscribed to the entire blogosphere… and you might be right!

When I first started blogging ten years ago, there were about eight diabetes blogs. And I think half of us are still blogging (me, Kerri, Scott Johnson and Amy). Over the years, I have seen dozens — nay, hundreds! — of diabetes blogs come and go, so it can be really tricky to keep up with who is new. That’s why I love D-Blog Week so much because it gives me a chance to catch up with the latest and greatest of the D-bloggers who are currently plugging away at not only managing their diabetes, but spending the time to share about it too.

Anyway, my point is that if you read my blog but you’ve never heard from me on your blog, please leave me a comment introducing yourself! I would love to add you to my feed reader but there’s a chance I just haven’t stumbled upon you yet. I find most of my D-blogs through comments, both here and on other blogs, and I know a lot of other bloggers are the same way. So that’s my advice for continuing to grow your blog after D-Blog Week! Hope to see you around!

 

An Unexpected Career

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If you have been blogging for a while, what is your favorite sentence or blog post that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?  (Thank you Laddie of Test Guess and Go for suggesting this topic.)

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Have I been blogging for awhile? Have I been BLOGGING for a WHILE?!

While this little blog is only a mere two years old (I launched it during Diabetes Blog Week 2013 and it celebrated its second birthday on Tuesday), I have been writing about diabetes for almost 15 years.

I have written hundreds of blog posts and dozens of articles about this stupid disease. I wish I could remember something as specific as a particular sentence, but there are just too many. However, last year a reader rather liked this sentence: ““The grass isn’t always greener on the other side. Sometimes it’s just another shade of crap.” I don’t know if it’s my favorite, but I think it’s pretty apt for a lot of different situations! That being said, I do have a couple of memorable publications that I can reflect on.

I will say that one of the blog posts that got the most attention (by way of comments) was my post on DiabetesMine called “Losing Faith in a Cure.” I wrote it after midnight in my living room, rather stream of consciousness actually, and then immediately sent it to Amy to see if she wanted to use it. Some of the comments ended up deviating into the “Big Pharma doesn’t want a cure” conspiracy but I do not believe that. I don’t believe in a Big Pharma conspiracy, at least not to the extent that most people think. But that doesn’t mean I think there will be a cure any time soon. I still don’t.

Another favorite thing I’ve written is an article on diabetes blogs for Diabetes Self-Management magazine. It was one of the first things I wrote for a diabetes publication, and it was one of the first times I got to write about my friends. The website says I wrote in March 2013,  but it was published in their magazine a lot earlier than that. I believe it came out in late 2007 or early 2008.

In January, I wrote up a little post reflecting on my favorite posts from the past year (so, 2014). If you want to look at some more recent favorites, you can check that out.

I started blogging because it was a natural extension of things I was already doing. I had already been writing about diabetes on a website that I created, but I wanted to take it to a more personal level. While I love reporting about diabetes and educating people about what’s going on in the world, I also like having the ability to share my own little discoveries. Even though we are all sharing this experience of living with diabetes, our own journeys and our own perceptions are unique. I have learned so much over the years from knowing other people with diabetes, and hopefully you’ve learned a little something from knowing me.

Memory Lane

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Today let’s talk about changes, in one of two ways.  Either tell us what you’d most like to see change about diabetes, in any way.  This can be management tools, devices, medications, people’s perceptions, your own feelings – anything at all that you feel could use changing.  OR reflect back on some changes you or your loved one has seen or been through since being diagnosed with diabetes.  Were they expected or did they surprise you?

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keep-calm-because-everything-changes-1The theme of changes has me going on a trip down memory lane. I’ve had type 1 diabetes for 21 years, and there are some people in the diabetes community who have known me almost that entire time. I went to diabetes camp the summer after I was diagnosed, and I still know people from that first summer (in fact, I interviewed one of them — Clare Rosenfeld Evans — in the latest issue of Diabetes Forecast!).

Twenty one years is a long time. There are not many things that I have been doing longer than that. Although anytime I’m around people who have had diabetes for forty, fifty, sixty (etc. etc.) years, I always find myself sheepishly chastising myself with “You know nothing, Allison!” ala Game of Thrones.

Anyway, a lot has changed since I was a wee little lass, getting diagnosed with diabetes. Since most of you didn’t know me then, I was diagnosed on January 27, 1994. Yes, I know the exact date because we have celebra — well, marked the occasion — every year since then. So it’s an easy date to remember. When I was diagnosed, I was on Regular and NPH insulin, but Regular only last for  a year (maybe two?) before Humalog became the new It Drug. I swear, Humalog is to Regular what Smart Insulin is to… everything. I mean, you’d think they’d cured diabetes. It was supposed to be this saving grace for all mankind.

LIARS!

Not that I’m bitter or anything.

Anyway, a few years after that, in the summer of 2000, I was approaching FIVE injections a day. My doctor gave me the ultimatum of a lunchtime shot at school (Nooooooooo!) or the insulin pump. He was a huge advocate of insulin pumps and thought it would be great if I went on one, even though I was completely against it. I had a couple friends from camp who were on the pump but I didn’t want anything attached me.

“I don’t want to be reminded that I have diabetes!”

Right, because diabetes is just so easy to forget.

I finally gave in because taking a shot at school somehow equated in my 15-year-old brain as the ABSOLUTE WORST EVER. I’m still not sure why or how I came to that conclusion but there you go.

First I went on a Medtronic 508. It pretty much did nothing except give you the basal rate and allow you to take a bolus, but it didn’t tell you how much to take, it didn’t connect to a glucose meter and it certainly didn’t have CGM capabilities because that wasn’t even a thing yet. Yeah, that’s right, you little newbie whippersnappers. We didn’t even have a bolus wizard calculator!

Back in my day, we had to bolus in the snow, uphill, both ways! 

That lasted for a couple of years, and then the Medtronic 522/722 came out and that had the bolus wizard calculator, the saving grace of everyone who can barely add single digits together. The Paradigm came out awhile after that which had the CGM capability, and that’s when I finally started using a continuous glucose monitor. Because why not, right?

Well, I’ll tell you why not! It was a piece of crap. A stupid, horrible piece of technology that lulled you into a false sense of security and then smacked you with reality when you least expected it (usually at 3 in the morning). So that didn’t last very long. In fact, I didn’t even use the CGM for the most part. I didn’t use a CGM — a Dexcom — until much later, when I went on the Omnipod.

Going on the Omnipod actually happened after I decided to go Lantus. Well, deciding to go on Lantus makes it sound planned. What really happened is that my Medtronic Paradigm pump kicked the bucket while I was at a wedding in Phoenix in April 2012. Luckily, my brother-in-law is a doctor, and despite also being the father of the bride (!), he kindly called the local Walgreens a mile away so that I could, you know, not die.

Lantus for a couple days while I waited for a new pump turned into a week off. And then it turned into “Well, when the bottle is empty, I already opened it.” Which then became “until my next A1C.” Then I finally just up and admitted that I thought pumps were stupid and I WAS NEVER GOING BACK.

Okay, that’s a lie. But I was pretty happy not being on a pump. My pump sabbatical lasted until I remembered all the reasons I don’t like shots (they hurt, they’re inflexible, you have to remember to bring your stuff with you all the time). Of course, trying to decide between shots and a pump was sort of like choosing between death by poison and death by firing squad. End result is the same, they’re both pretty painful and… do I really gotta?

So I took some time to investigate my options with pumps and I settled on Omnipod in August 2013. It seemed the closest to shots because you didn’t have to attach a pump anywhere. What is ironic is that for the longest time I really didn’t like the Omnipod. I thought it was really big and couldn’t figure out why you would want to wear that on your skin. It seemed like it would so heavy and uncomfortable. I also thought the sales reps at the diabetes conferences were super rude and aggressive. But lo and behold, it actually worked out the best for me. I’m marking two years on Omnipod in August!

On top of the traditional methods of managing type 1 diabetes — read: insulin — I also tried a few other therapies. The first was Symlin, which I tried for about a month during my junior year in college. But I realized I hated that it was another shot, I hated that I couldn’t figure out how to properly adjust my insulin at meals, and I hated having low blood sugars that lasted forty-five minutes. The next treatment I tried was metformin, and that was in 2010. That last for a few months. It helped me take less basal insulin, but it also meant swallowing a horse pill which I was not a fan of. So that didn’t last long either. Then in June 2014, I went on Victoza. I’m still on it, although I’ve had some digestive issues because of how it slows down digestion so I have to be careful with how much I take. I’m not sure how common the side effect is, but I get enough of a benefit on it to keep taking it.

So let’s review:

  • 21 years of diabetes
  • Five endocrinologists (first ped endo, second ped endo, college endo, NYC endo, Minnesota endo)
  • Three Medtronic insulin pumps and one Omnipod insulin pump
  • Plus 16 months on Lantus
  • About forty glucose meters (I’m kidding… maybe)
  • Three adjunct therapies and counting…

That’s a lot of change, right? Maybe, maybe not. Obviously people who have had diabetes even longer have seen even more change, and most of these changes aren’t huge leaps and bounds in progress. Part of that has to do with the fact that diabetes research and technology approvals just aren’t what they could be. Yes, there’s safety but Europe approves a lot more devices and medications a lot faster than we do in the United States and that’s really frustrating. I want to think of the U.S. as being innovative and cutting-edge, but that just isn’t true in the grand scheme of things. Twenty-one years and only four insulin pump upgrade/changes? That seems pretty pathetic. I’ve had like 10 different cell phones in half that time!

Hopefully the next 21 years will see a lot more progress, and a lot faster. In fact, progressing all the way to a cure would be mighty fine.

 

My Diabetes Closet

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Yesterday we kept stuff in, so today let’s clear stuff out.  What is in your diabetic closet that needs to be cleaned out?  This can be an actual physical belonging, or it can be something you’re mentally or emotionally hanging on to.  Why are you keeping it and why do you need to get rid of it?  (Thank you Rick of RA Diabetes for this topic suggestion.)

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I’m just going to admit it: I’m a pretty messy person. If we didn’t regularly have people over to our house, this place would be a great candidate for Hoarders: Buried Alive.

But lately, my diabetes closet has been getting the shaft when it comes to a regular cleaning. Well, it honestly shouldn’t be a diabetes closet. It should be a diabetes shelf. That’s really all the room I need for my diabetes supplies. And yet this morning, if you opened the door to our hall closet (which is where my diabetes supplies are kept, obviously), you’d see that there was a lot more diabetes supplies than linens.

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And most of this stuff is just garbage from previous set changes that I never take with me and don’t think to throw away in the bathroom garbage can that is literally five feet away. I just set the stuff back on the shelf and go on my merry way!

Anyway, I finally got my act together and straightened up all the supplies so now the closet looks semi-respectable (the linens still need work…).

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I’ve noticed several bloggers talking about old glucose meters and other supplies that they keep around. For a long time, that was me. I’ve received a lot of complimentary meters over the years because of my work in the DOC and I might use them a couple times and then toss them in the diabetes closet. I held onto them forever, moving them from apartment to apartment. But finally, when we were getting ready to move from New York to Minnesota, I decided enough was enough. I was not going to haul diabetes junk 2,000 miles just because! So I threw it away. Yep, all of it. In the garbage. Probably not the most beneficial or environmentally friendly decision, of course, but our move was pretty spur-of-the-moment and you gotta do what you gotta do. And let me tell you, it is such a nice feeling not having that stuff hanging around anymore.

So I suppose I’m not really a candidate for Hoarders. I’m just really messy…

The Highs and Lows

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Many of us share lots of aspects of our diabetes lives online for the world to see.  What are some of the aspects of diabetes that you choose to keep private from the internet?  Or from your family and friends?  Why is it important to keep it to yourself?  (This is not an attempt to get you out of your comfort zone.  There is no need to elaborate or tell personal stories related to these aspects.  Simply let us know what kinds of stories we will never hear you tell, and why you won’t tell them.) (Thank you Scott E of Rolling in the D for this topic.)

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I had no idea what to write about for this response. There were a few things that were floating around in my brain, but nothing really seemed right. Then this morning, as I was suffering from a 341 mg/dl blood sugar that was a result from severely and stupidly miscounting the nachos we had for dinner last night, I finally figured it out.

I don’t like to write about my blood sugars.

Now, I need to clarify that I have written about my blood sugars. Sometimes I include them in my race recaps, and sometimes I do write about episodes of high or low blood sugars, such as when I started Victoza. But for the most part, I don’t like to tell stories just about being low or being high. There are a few reasons for this.

First, it’s kind of embarrassing. Especially with the highs. I mean, I know that I shouldn’t think this, but I think part of me is afraid that everyone is judging me for doing things “wrong.” For example, I jump to the conclusion that all of you are now either judging me for not being able to figure out the carbs for nachos, or you’re judging me for eating the nachos period. So there’s that.

Second, I don’t find my blood sugar excursions very interesting. Most of the time when I’m low or high, I just deal with it. Lows? Juice box. Highs? I bolus. I don’t find my blood sugar stories to be very interesting, unless for some reason I’ve been able to glean some kind of lesson from it. For example, sharing my blood sugars from starting Victoza or learning about insulin absorption after my epic low blood sugars last summer.There are times when my blood sugars teach me something about how to be a better diabetic (or a better blood sugar whisperer — haha) and those are the times that I want to share with the Diabetes Online Community. That’s when you’ll see me writing about my blood sugars. That doesn’t mean my blood sugars are perfect, it just means that I don’t find them very blog-worthy.

When I write on The Blood Sugar Whisperer, I want to write about things that will help people become better blood sugar whisperers. I never want this blog to be a “I ate spaghetti three times last week” kind of blog. I want this blog to be something that you might learn something from. So even if that means that means my quantity is a little bit less than other blogs, hopefully they are always quality posts. That’s the kind of thing I want to write about. Thanks for reading.

Ragnabetes

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In the UK, there was a diabetes blog theme of “I can…”  that participants found wonderfully empowering.  So lets kick things off this year by looking at the positive side of our lives with diabetes.  What have you or your loved one accomplished, despite having diabetes, that you weren’t sure you could?  Or what have you done that you’ve been particularly proud of?  Or what good thing has diabetes brought into your life?  (Thank you to the anonymous person who submitted this topic suggestion.)

 

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PrintThis August, I’ll be running in the Ragnar Great River.

What’s a Ragnar?

It’s a two day 200-mile relay race that goes from Winona, Minnesota through eastern Wisconsin and then back over the St. Croix River and then ends here in Minneapolis.

Don’t worry, I’m running it with 11 other people and we run 3 legs of varying lengths, somewhere between three and eight miles. While I haven’t been assigned my official legs yet, I’ll be running somewhere between 13 and 17 miles total, so just a little bit longer than a half marathon.

As if that wasn’t exciting enough, I’m running it with Team JDRF and we are the first official JDRF team to run a Ragnar! The team is mix of people with diabetes as well as friends and family members who just want to get involved for a good cause. I’m super pumped about it!

Of course, I wasn’t always so excited about running a relay race. In fact, I wasn’t always excited about running period. Or exercise for that matter.

One thing that I often hear from people who are thinking about exercise is their struggle with blood sugars. Having to eat to prevent low blood sugars. Overdoing it on basal reductions and having high blood sugars. Plus dealing with crazy blood sugar drops hours after you’ve finished exercising. Most of the time it seems like it would be so much easier if we just didn’t exercise!

I was definitely one of those kinds of people when I was growing up. Not only did I find exercise totally uncomfortable, but I didn’t understand the impact that it had on my bloods sugars. It seemed safer just to avoid it entirely. But I also knew that it was good for me, not just because of the diabetes but because of the other physical benefits that comes from regular exercise. We’ve all read the stories about how sitting is the new smoking!

I also started to admire people who were physically active. My friends who ran regularly or played sports always seemed so excited and passionate about what they were doing. I was envious of their enthusiasm. I wanted to love something like that too.

I started and stopped various kinds of exercise — including running — many, many times. And time and again I had the same issues with my blood sugars, which would compel me to quit.

I’ve had it. I’m not dealing with this. My blood sugars are probably better if I don’t exercise, I’d think.

But I also realized that I liked making what modest progress I did when I would start running. Going father. Going faster. It was amazing to see what my body was capable of achieving, even though I’m certainly not amazing! Eventually I kept going. And going. And going.

What I learned from that is that you don’t get better at doing something by not doing it. You have to do what you’re struggling with in order to move through it. You have to put in the work. It’s hard, but I learned that I could do it. I can do it. I’m doing it. I’m going to keep doing it. In fact, I don’t just have the Ragnar to look forward to…

In July, I’ll be running my second half marathon, and in October, I will be running the Twin Cities Marathon — my very first marathon! Woohoo!

Even though it has taken a lot of work, I stick with running because I know that it helps my physically. It also helps me emotionally to know that I am accomplishing something that “normal people” can do. Yes, I’m frustrated and sad sometimes that it takes so much extra work. But I also get so excited when I finish a run with perfect blood sugars, knowing that I not just can run (which is hard enough as it is!) but I can also balance the diabetes aspect of things. I love knowing I can do it and that I’m not letting diabetes tell me whether or not I can do something! It always feels so incredibly empowering and kick-ass, if I do say so myself.

And to finish up the first blog post of this year’s Diabetes Blog Week, I’m going to plug the fundraising that I’m doing for Team JDRF and the Ragnar Great River (which is 95 days away! Eek!). Because I’ve lived with type 1 diabetes for 21 years, my goal is to raise $2100! You can head over to my personal fundraising page if you’re interested in supporting my efforts.

The Rule of Half

This past Saturday, I ran my second Get in Gear 10K (that’s 6.2 miles) in Minneapolis. Unlike last year, my blood sugars at the beginning of the race were much better, but I’ve had a recurring problem over the past few weeks where my blood sugar plummets about three or four miles into my run. In the past, I’ve gone for my runs after a meal, using a half bolus to keep my blood sugar afloat. But not even that has been working lately! It’s been very frustrating as I’m trying to train for a number of races this summer.

I had an endo appointment last week, although this time I met with the physician’s assistant because I had to reschedule my appointment and my endo wasn’t available for a number of weeks. Anyway, the PA was nice enough (although I prefer my endo) but I did talk to her about my consistent lows, just to see if she had any ideas. I’d thought about emailing my CDE (Jenny Smith at Integrated Diabetes Services) but since I already had this appointment I figured I’d see what she had to say. This PA suggested that I also cut my basal which I have always, always been super nervous about because 1) I never really believed that cutting basal started up quickly enough for a run and 2) I don’t like dealing with high blood sugars from cutting insulin hours down the road.

But I decided that it couldn’t hurt to try since my usual course of action wasn’t really panning out.

When I woke up on Saturday morning at 7:30, I was 223 mg/dl. I decided to take half a correction, because I didn’t want my blood sugar to continue to rise. Good performance in athletics requires the same balance as everyday life — you don’t want to be too high or too low. For breakfast, I had a simple piece of toast with jam (needs to digest quickly) and some coffee, and I took half a bolus. Now typically this is where it would all stop for me, but this time I decided to cut my basal in half for 2 hours — from 8am (one hour before the race started) to 10am, which is about 20-30 minutes before I expected to finish running.

Erik dropped me off at the starting line and I did another BG check — 221 mg/dl. I was stable and steady. Awesome! Now you might be wondering about the Dexcom. I’m sort of taking a Dexcom break right now, but more importantly, I have never really found the Dexcom to be terribly useful for exercise. I know, it sucks, and I’ve complained to everyone and anyone at Dexcom who will listen to me. I’ve had it tell me I was dropping when I wasn’t, and I’ve had it tell me I was staying steady when I was rising dramatically. It’s irritating as hell, so I tend to just run based on feeling and fueling at appropriate intervals. So far, it seems to work pretty well for me.

During the run, I took one GU at the water stop, which was located at the halfway mark. I was struggling physically because I started out too fast, but I was confident that my fatigue was from over exerting myself and not because I had a low blood sugar.

When I finished the 10K, I headed over to the car and tested my blood sugar — 180 mg/dl. Perfect! Not too high, not too low. Well, I suppose it would have been better to be just a bit lower than that, but I thought that was a pretty decent number to finish at.

Overall, I think the rule of half (half correction, half bolus, half basal) worked out pretty well for me and I think I’m going to continue a similar routine moving forward. Of course, it may not always end up with the same results, but it’s a place to start!