Glucolift, checklists, and a lot of luck

My Glucolift is packed, I’m ready to go…

I’ve been marking through checklist after checklist for the last two weeks. The nice man who works at CVS doesn’t need to ask for my card number anymore, he just remembers it.

Today I went to the pharmacy twice, yesterday once, and the day before, yep, at least once.

The last time I traveled out of the country was in 2011. At that time I was preparing for a three month long trip. I quit my job, packed up a huge suitcase and my backpacking pack and filled a lunch box sized cooler full of insulin. This time it’s just a three week trip, and yet I feel like my wheels are spinning as I try to get organized with all these medical supplies.

It’s my first trip out of the country since getting the Omnipod insulin pump. I wore it when I flew to San Antonio for a business trip and to San Francisco to visit two great friends, but never on an overseas adventure and never to a place where I’m not sure what obtaining supplies will be like.

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These are some of the diabetes-related supplies I have to carry, and yes, before you say anything, chocolate is a necessity. In the past, I’ve felt so burdened by all of this ‘stuff,’ but in this moment, embarking on this project, I feel so exceptionally lucky.

I am so lucky to be able to afford and obtain these supplies. I am so lucky that this technology is available in the U.S. and that my insurance covers at least a portion of it. And I’m lucky to have so many amazing friends and family supporting me.

When I was diagnosed with T1D 10.5 years ago, a doctor looked at me in my hospital bed and said, “You know, it could always be worse.” At the time, that was not the wisdom I was hoping to hear (actually I was hoping for, “most cases of diabetes clear up in two to three weeks…”). Yet, nearly a decade later I realize how right those words were, although maybe not in the way that doctor intended. I am so very lucky to have been born in this time, with these resources, and this support network, and have such a good starting point for managing diabetes. Not everyone is.

One more thing this time: if you enjoy my blog please go ahead and become an official follower (see the little button bottom right of the screen). It’d be a big help to me and I’d really appreciate it! You can always unfollow or change your email settings if you feel like you’re getting too many notifications from me, but I rarely write more than once a week.

A Question for Omnipod Users

This is a picture of Olympic cross-country skier Kris Freeman that I found on pinterest…so apparently having muscles and wearing the Omnipod is not a problem.

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It’s a challenge in creativity to figure out how to wear a pump and do physical activities like yoga, dancing and other atypical movements. A friend of mine is hesitant to try to the Omnipod because she does aerial arts and is afraid it might come off. I have been having a lot of trouble finding sites that I can wear the pod lately because my favorite sites seem to be building up some scar tissue or something that is interfering with my absorption.

This is a question for anyone reading who wears an Omnipod:

What are your favorite sites and why?

Submit a comment below and thanks for sharing your ideas!

A Matter of Perspective

I went to a yoga class this weekend at the gym/community center where I work as the coordinator of preventive health programs. The yoga teacher knew me as such, a coordinator of a program for people with diabetes, not as a person with diabetes. With Type 1, I was still under cover, even though my omnipod sticks out in my tight yoga pants and threatened to give me away.

After a few moments of opening meditation and one or two poses, she walked over to my mat and said, “Hi Katie, nice to see you here.” I was surprised she knew my name, but we had met before and we pass each other in the hallway: usually she walking zen-like to class and me in a half-run back and forth to the fax machine. She squatted down next to me as she spoke and asked me if there was anything going on with my body she should know about like past injuries, issues, or any concerns at all. I scanned my internal landscape silently, and then sort of shook my head and shrugged ‘Nope.’ Usually at a studio I will mention to the teacher that I have type 1 and they may see me eating glucose tablets or drinking juice in the middle of class, but at the time I felt pretty stable in my bg and had my tablets handy, so I just went with that everything was just fine. She looked at me as I shook my head no and began to shake her head yes. She replied almost before I had spoke, “Yeah, you’re a pretty healthy lady,” as if to acknowledge her asking was just a formality, that she could see my health in a force field around me. And I felt a wave of gratitude for this part of me, the healthy part, which is always there with me even when diabetes is throwing me for a loop. The part that exits simultaneously with the other parts that throw me into exhaustion, dehydration, and frustration. We are not just a sum of the whole, but we are who we are based on the perspectives we allow in. So I am remembering today that labeling me with a chronic disease is just medical pragmatism, not the only reality. Find what works for you.

A Change-Up

So I’m pretty excited about this. A few days ago I wrote about my recent disgust with my own optimistic attitude about diabetes, even though that attitude is what has pulled me through over the past nine years. I’m happy to announce, I can feel it coming back! Largely because diabetes does teach me some strange and interesting things.

For the past few days I haven’t been sleeping well at all. I’ll feel tired, reading my book wrapped up in an afghan in a cozy chair, spits of snow coming down outside. Then I’ll lay down in my cozy bed, warm and tired. And then…

I’ll get this feeling like my bones are hollow and I’m a little bird on a windy branch and I could just blow away, and the feeling is sort of in my heart and mind too, like I’m a reed humming in the wind.

Being low around bedtime often feels to me like I’m vibrating slightly, but lately that feeling has extended to include a low-grade but constant mental agitation. Even when my blood sugar has been elevated, I’ve been edgier. The only and best way I can describe it at this point is a swirling feeling of being unsettled.

A couple of weeks ago I was craving more carbs and food in general at the same time that it felt like my blood sugar was frequently stuck. I wasn’t receptive to insulin like usual. I would hit 250 and stay there on and off for hours. I woke up one morning, mouth dry, feeling like I’d been on a long road trip with no water, and I could tell I hadn’t been getting the insulin I needed from my pod.

So I switched from my usual sight on my upper glute to my belly. I don’t really like having the pod on my belly because I’m more aware of it and it gets in the way of yoga, but immediately my insulin needs and the time it took for insulin to start working went down.

Unfortunately these benefits came at the same time as my sleep troubles. At first I thought I wasn’t sleeping well because the different site was less comfortable to me, but I sensed that there was something beyond that at work.

For two pod changes I kept the pod on my belly. For nearly a week I slept like a guard dog, waking up at every creak and rattle in our albeit pretty noisy house.

Then, suddenly it hit me. That swirling unsettledness was centered around my navel.

Yesterday I changed my pod back to its old favorite spot.

Last night I slept like a champ.

Now the good news is I’m back to better responsiveness to my insulin with the pod in that old spot. I suspect that area did need a break; maybe I had hit some scar tissue or my bun muscles of steel were bending the cannulas. Who knows, maybe I’ll have to eat some more of these truffles from the Chocolate Lounge where I’m writing this.

It’s snowy out today, but not icy, so we spent all morning building snowball players. The title of this post comes from the lady pitcher who’s about to throw a change-up. It’s a pretty weak pun, but she is very strong, so I wanted to put in a picture of her.

So I’m curious to know what other people’s experiences have been with how their blood sugars, emotions, and sleep patterns respond to varying pod or infusion sites. Any feedback or comments are welcome.

Kayakin’ with Diabetes

October 2013

Omnipod on the water, a success. As a paddler I try to be more minimalistic than other times, which can be a challenge with diabetes. But my boat is a Wavesport XXX, an old model from 99’, with no foot space, no cockpit, not much space period. I fill the back with a throw rope, a big yellow sponge, and two pelican cases full of snacks and supplies. In one case I keep a quick dry cloth for blood sugar checks, my ‘river meter,’ a novolog and lantus pen, 3 pen needles, 4 alcohol swabs (never know when somebody’s gonna scrape a knuckle), and some glucose tabs. In the other I keep my glucagon kit, a granola bar, 2 disposable eye drops, and some other snack; today it was beef jerky. I leave my pdm in the car, maybe in a cooler away from the freezer pack itself, because if you’re swimming, you want to worry about your boat, your paddle, and yourself, not your $1000 piece of durable medical equipment!

Then there are my water shoes attached with a carabener, a water bottle, and extra dry layers. That leaves barely enough space for me. Despite being strapped into a tiny container, half boat, half woman, there is something incredibly freeing about being one with the boat. Couple that with finding the river’s line of least resistance and surging down a rapid – blissful and riveting.

Paddling is always a great reset for me, giving me that experience of being absorbed in the present by its very nature. Holding that feeling all day and using my body to accomplish a goal helps me remember what it is like to be fully present, not puzzling or planning. Diabetes sometimes can be a hard balance between planning ahead, reflecting back (often analyzing and criticizing), and going with the flow of the moment (with all of its unexpected holes, strainers, and whirlpools). More and more I’m learning that both are necessary to be healthy, happy, and move forward. For me a successful day on the river means advanced planning for blood sugar management so that I can focus my attention on the river and not on diabetes.

I use checklists. It’s taken me a long time to realize that I just can’t keep everything I need to have organized in my head, much less my home, without real, printed-on-paper checklists. When going out on the river I use the five finger test: boat is your thumb, then each finger is helmet, life jacket, paddle, and skirt. It doesn’t matter the order though because basically if you miss any one of those you’ve got to borrow or go back. Now layer onto that all there is to keep up with diabetes on land: meter, test strips, insulin, extra pods, batteries, glucagon, glucose, alcohol swabs, etc. Maybe you’re paddling the Nantahala, one of Western North Carolina’s icy beauties, so you need to have warm layers, a dry top, extra dry clothes in the car. Perhaps you’re like me and you’re always voraciously hungry, especially after being a little cold and using your muscles all day. That means snacks in the car for your return. My favorite river snacks are beef or turkey jerky sticks, nut butter packets (try ‘Jason’s’ almond butter, peanut butter, and chocolate hazelnut butter in single serving packets), and celery, apple, and carrot for dipping. Today I made a sandwich on ‘Farm and Sparrow’ bread from the local tailgate market spread with sunflower butter, layered with avocado slices, and splashed with balsamic vinegar. I’m an exploratory eater. Nothing to spoil and the river keeps it pretty cold anyway. I like to eat relatively low-carb on the river but have back up carbs in case I go low. I find that the less fast-acting insulin I can take the better to minimize the risk of lows. That being said my basal needs seem to go up from both the cold water and the muscular exertion. My big safety trick is keeping a honey zinger packet in the front pouch of my life jacket. They can get pricey at $1.25 a piece, but the bulk packs are available at a lower cost from multiple sellers on Amazon. I definitely have glucose tabs in my boat but the zingers are packaged in waterproof plastic (nothing worse than a soggy luna bar), easy to eat fast and you don’t even have to chew. That’s helpful if you have to get your blood sugar up and can’t find a place to eddy out. Of course trying to paddle, tear open a packet, and eat honey, is not ideal, but with diabetes you’ve always got to be prepared with the back-up that will let you do what you got to do, if you’re going to do it at all.

One of the last two check-boxes on the list is a great group of friends with some experienced paddlers in it, at least one or two. And let them know you have diabetes. Be that girl who introduces herself with, “I’m Katie (insert your name, don’t steal mine), I love to get outside, meet new people, and I have type 1 diabetes!!” And give your glucagon kit to that seasoned paddler who has a dry bag. Don’t keep it in your boat – because if you flip over and your boat is one place and you are another, well, what good is it going to do you then?

Final check-box: plunge in. Check that sugar thirty minutes before you get on, check it two minutes before you get on. Check over what you need to have with you all day in your boat, check it over again. Flex those muscles, stretch the skirt with all your might over the cockpit, and launch into the rapids. Now you’re a boater as much as your a diabetic. We become whatever identity we embrace.

I am a boater.

I am a diabetic.

I am a planner.

I am an adventurer.

A friend I met on the river who organizes trips for a WNC paddlers meet-up group got me in touch with a friend of hers who is getting into paddling now that she is landlocked and her first love, scuba diving, isn’t easily accessible. Her friend has lived with type 1 for forty two years. Now that’s inspiring! When we were getting to know each other over email she wrote me, “I love the water because it fills up what life drains from me.” Type 1 diabetes can drain out quite a bit. The background stress, the wondering, checking, assessing, judging, criticizing – all of that takes something from the rawness of our experience. Like my new friend, the river rehydrates my soul as well. I have found no faster way to feel the pulse of nature than to be taken in by the current of a wave train and merge with the force of the water.