Spare A Rose

Life for a Child

Friday, April 18, 2014

Riddle Me This: How Would You Bolus For A Donnoli?

This is a Friday "fun" post based on a very real carb conundrum & a little slice of South Philly heaven known as the Donnoli~
And for those naysayers who think a person with t1 diabetes ( or 1.5 or 2) for that matter can't eat a Donnoli - Think again!
I work hard measuring out my meals, testing my blood sugars and having an electronic pancreas clipped to my hip. 
So when I do indulge in a tasty treat such as a donnoli - Know that I've worked damn hard to make it happen! 

Embedded image permalink
This above heavenly creation is a Donnoli.
photo by John Colosi 
A Donnoli is what happens when a donut and a cannoli have a baby and birth it at Frangelli's Bakery in South Philly - My old stomping grounds. 
Sidebar: South Philly is a mecca for amazing Italian food/bakeries - Always has been. 
Over the past 10 years, Asian and Spanish restaurants have been added to the neighborhood food rotation - Making it one of the best hoods for good eats on the east coast- At least in this blogger's humble opinion. 

ALSO, When I moved out of South Philly, I lost like 5 lbs, immediately.

Back to the story: Frangelli's took their fluffy and flaky cream donut shell (and sans the vanilla cream,) sliced it in half and filled it with the ricotta cheese canolli stuffing,
One of the reasons I'll be going easy re: the treats on Easter Sunday is that I'll be attempting to purchase (if they don't sell out) this tasty treat next week when I go back to South Philly for a visit.

DOC - This is where you play critical and crucial role: I will need your help in determining the carb count of the Donnoli.
According to my research a Dunkin Donuts vanilla cream donut has 42 grams of carbs. 
As far as carbs in a cannoli, that all depends on the size of said cannoli  - doesn't it always?   
We're talking somewhere between 24 and 42 grams of carbs in the cannoli carbs department. Also, I will most likely be cutting the Donnoli in half & consuming the second half at a later time/date. 

SO, based on the above information and your best SWAG  (Scientific Wild Ass Guess,) 
how many carbs would you bolus a Donnoli? 

Wednesday, April 16, 2014

Diabetesalicious Lite: The D List Edition ~

For the record - This list is not in any ranking order- Except for the first one.

First: Please go give our girl Heidi over At “The D-Log Cabin” some love and support because she could really use it!

Second: I have a guest post up over at the Medtronic’s The Loop- Blog and it’s all about what’s in my handbag diabetes wise with some diabetes memories thrown in for good measure! So when you get the chance, stop over and give it a read - And thanks in advance :) 

Third: How does one take an antibiotic 4 times a day for three days?? Do I have to set my alarm clock to start administering in the middle of the night or what?? 

Fourth: We as a community have until May 7th to let the FDA know out thought on glucose meter/test strip accuracy - The current rules were set in 2003 - If we don’t comment and voice our concerns, who knows the next time we will have the FDA’s ears on this subject. Click the following link to walk you through the process!

Fifth: It’s not to late to register for the 2014 #DiabetesSisters Weekend For Women Conference in Washington, D.C. April 25th - 27th. 
Click HERE to learn more about the conference and for info re: registering.

Sixth: Looking to go back to school?? You’re in luck because Hogwarts is now accepting applications. Also: If you do get accepted, do us a favor and work on some spells/ potions to cure Diabetes. OK, thanks! 

Seventh: Easter & Passover - Do you bolus differently for them? I do. I use an extended temp basal rate, but I'm considering trying a duel wave this year - All depends on what’s in my Easter Basket on Sunday morning and on the dessert table Sunday night. 

Eighth: Speaking of temporary and duel wave boluses and yummy stuff, the 1/2 off Easter candy phenomenon officially starts on Easter Sunday. 
I’m going to do my best to steer clear of it - But talk to me next Monday and I’ll let you know how that’s panning out~ 

Thursday, April 10, 2014

Today's Official Hashtag: #dayofdiabetes

Today and long with so many others in the Diabetes Online Community, I'm participating in the second annual #dayofdiabetes & will attempt to storify the outcome later.  
Everyday in our lives involves diabetes - We never get a day off because diabetes never gives a break. But today is different, because not only is there an official hashtag, but it's pretty cool to see how all of our stories unfold re: diabetes through the various forms of Social Media through that one hashtag. 
For me, getting a visual re: how much time that we as individuals and as a community devote to our diabetes care and how we incorporate D into our daily lives - Sometimes seamlessly, sometimes not at all, is always incredibly impressive because WE DO IT EVERY SINGLE DAY, 25X7 & WITHOUT FAIL. #WEROCK
And I love to see how we encourage one another in our D lives and D care through the various forms of Social Media. 
I'll be chronicling my #dayofdiabetes on twitter, Facebook(personal and blog pages) & maybe even Instagram.
You can learn more about the #dayofdiabetes, by clicking HERE & you can follow along on twitter via #dayofdiabetes.
I encourage you to participate, communicate, and or follow along because today, like  everyday, we are in this together! 

My day with diabetes started early~

Tuesday, April 8, 2014

In Life With Diabetes, Small Medical Advances Aren't Small At All - Nor Are They Gadgets~

Gadget: A mechanical contrivance or device; any ingenious article
1. A small mechanical  device or appliance 
2. Any object that is interesting for its ingenuity or novelty rather than for its practical use.
Synonyms: Contraption, whatsis, dohickey, thingamajig
Insulin pump: A pump for delivering insulin in order to achieve tight blood sugar control and lifestyle flexibility while minimizing the effects of low blood sugar (hypoglycemia). The pump is composed of a pump reservoir similar to that of an insulin cartridge, a battery-operated pump, and a computer chip that allows the user to control the exact amount of insulin being delivered. The pump is attached to a thin plastic tube (an infusion set) that has a soft cannula (or needle) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen. The cannula is changed every 2 days. The tubing can be disconnected from the pump while showering or swimming. The pump is used for continuous insulin delivery, 24 hours a day. The amount of insulin is programmed and is administered at a constant rate (basal rate). Often, the amount of insulin needed over the course of 24 hours varies depending on factors like exercise, activity level, and sleep. The insulin pump allows for the user to program many different basal rates to allow for this variation in lifestyle. In addition, the user can program the pump to deliver a "bolus" during meals to cover the excess demands of carbohydrate ingestion. The pump is currently the closest device on the market to an artificial pancreas.”

YEP, nothing novel about an insulin pump - especially if you're the person who's attached to it. And the same can be said for Continuous Glucose Monitors and the accuracy of glucose meters and test strips. 
Dear Elisabeth - 
I read your article in the New York Times, "Even Small Medical Advances Can Mean A Big Jump In Bills.  I’ve marinated on it for a few days and honestly, I’ve struggled with my response.  
I agree that the cost of diabetes and diabetes technologies is high (and has always been in the 36 years that I've lived with t1 diabetes,) and I'm well aware that diabetes is BIG BUSINESS. 
I find the cost of diabetes to be incredibly expensive - even with insurance - And I worry about my financial future. 
I worry about everyone living with diabetes having to deal with the same issues and concerns that I do. The financials keep me up at night. And I believe that things need to change regarding the cost of living with diabetes. 
I hesitate to start the paperwork on a new pump or CGM (Continuous Glucose Monitoring system) with my insurance company because of all the work it requires - And I'm worried about the out of pocket expense.  

BUT, as someone who hasn’t had a day off from her type 1 diabetes in 13,230 days and who knew many of the casualties of the Diabetes Dark Ages by name and personally, I'm here to tell you that my quality of my health and the quality of my life has improved greatly over the years since the advent of diabetes technology. 
And I know that my future good health depends on diabetes technology, highly engineered insulin and anything else that:
  1. Keeps me alive
  2. Reduces the risk or helps to limit future diabetes complications
  3. Gives me a better quality of life with diabetes.
In your article you stated: That captive audience of Type 1 diabetics has spawned lines of high-priced gadgets and disposable accouterments, borrowing business models from technology companies like Apple: Each pump and monitor requires the separate purchase of an array of items that are often brand and model specific. 

I found that statement to be callous and sensationalized and a huge over simplification of the many benefits of diabetes technology - Actually, you glossed over the benefits, BIG TIME.  
But I did and do relate to the frustrations re: to the integration and purchase of diabetes weapons. 

Still, make no mistake - Glucose meters, test-strips, Insulin Pumps, CGMs, fast acting insulin, etc., are weapons when it comes to living with diabetes - crucial ones that help us navigate the ever changing terrain of the diabetes battlefield. Without them, we'd lose the D war. 

Elisabeth - Your article made it seem as if people with diabetes didn't need or benefit from D technology  - And that's not true. 
Here’s the thing: Unlike many chronic illnesses, a large portion (8,757 hours  a year - give or take a few hours) of my type 1 diabetes care is in MY HANDS. 
So yes Elisabeth, people with diabetes absolutely need all the help we can get! 
And people with diabetes need glucose meters that provide us with graphs that chat with both our insulin pumps and our CGMs - Glucose meters and test strips that are accurate in order to properly calculate insulin via pumps, shots or CGMs and we and require fast acting insulin that quickly correct elevated blood sugar and allow us to eat when a meal is ready, instead of 20 to 30 minutes after taking it. 
And those people with vision issues because of diabetes need and require glucose meters with an audible voice. 

Personally, I would NEVER entrust my life, my health or my future health to mere gadgets Sidebar: Please refer to opening paragraph for the definition of the word gadget. 

Life and life with diabetes is far to complicated for novel gadgetry. 
Nobody living with diabetes and regardless of the type would rely on simple gadgets - But it would be great if we could. 
For those of us who remember The Diabetes Dark Ages, the time before insulin pumps; CGMs and glucose meters, life with diabetes had less precision, less flexibility and was more complicated - And led to more diabetes complications. 
We tested urine instead of blood,(disgusting and far from accurate,) had only a few types of insulin to choose from. And as far as the diabetes diet back then, it was anything but flexible. 
God, we would have given anything to have diabetes technology and fast acting insulin available to us! 
Technology like insulin pumps that allow for the customization of insulin delivery and more glucose meters/test strips and Continuous Glucose Monitoring systems and the advent of  analogue insulin .
The creation and availability of analogue insulin changed our lives for the better and allowed better glucose control, i.e.,blood sugars and meal time flexibility
All, key weapons for those of us doing battle with diabetes on a daily; yearly, weekly and decades, basis.

In the 1980’s, when my family and I received our first glucose meter - which cost hundreds of dollars; wasn't covered by insurance and was shared by the whole family shared, my parents, (my dad had t1) sister, (also a t1) and I had to meet with our pharmacist to learn how to operate the meter. 
The meter was the size of a VHS tape, took 3 minutes to calibrate and had a 44 page instruction book. There was nothing portable or convenient about it - And it was far from accurate - But it was more accurate than urine testing - And we were grateful for it.
A few years after we purchased our first meter, I lost 2 of my aunts to type 1 diabetes- they were in their early 50's. 

And I believe that if my older sister Debbie had diabetes technology available to her when she was diagnosed as a child( in the late 60’s,) or even as a teen, she wouldn’t have died from diabetes complications. Complications including; heart attacks, gastroparisis, multiple strokes and kidney failure, 22 years ago at the age of 34. 

I miss my big sister and I think about her every day - And I wish that she would have had the diabetes technology that I have available at my finger tips today - And clipped to my hip since 2002. 
And I will continue to advocate for people living with diabetes - And I'll fight tooth and nail to make sure that we've left the Diabetes Dark Ages forever. 
Kelly Kunik
t1 Person with diabetes for 36 years.

Thursday, April 3, 2014

Lunchy, Lunch & The Funky Bunch! Sorry, Couldn't Resist That Last Part!

Lunch - A lot of times I'm not hungry at lunchtime - It's just the way I am.  Plus, I drink a lot of coffee in the morning (and I bolus for it) and water (I NEVER bolus for water) and both keep me feeling full - And running to pee!   
Being on the insulin pump means I can skip lunch every now thanks to adjusting my basal rates. 
Still, I know it's not good to skip lunch, diabetes or not.  Skipping meals is terrible for your metabolism. No to mention the fact that if I skip lunch, I end up eating a yogurt or a Kind bar in the afternoon - usually both. 
And by dinner time I 'M STARVING.  
I'm working to get my A1C lower and I'm really trying to stay on track when it comes to lunch and actually eat lunch every day. 
For me personally, I always try to my keep lunch on the low carb side, unless I have a crazy schedule that day. If my schedule is crazy, damn right I need a powerful protein carb combo!  
But for the purposes of this blog post - Lets keep it to a low carb lunch theme - Same goes for trying to keep my lunch prep time to a minimum.  
Also, my lunch needs to travel well. Like I love bananas and pears - but they don’t travel well, they smush and bruise and get mushy and gross - So they’re out - Unless I'm working from home
So I’m thinking salads, because salads are great -  I LOVE salads!
But sometimes, salads can make a mess - At least they tend to be messy if I’m eating them. Still, a rainbow of veggies + protein = awesome deliciousness so bring on the salads! 
And extra points for creative containering of said salads! 

Yogurt, as in Greek yogurt with nuts and fruit - I LOVE GREEK YOGURT - That is until I hit  “The Greek Yogurt Wall,” and then I can’t look at the stuff for a week or two. 

Soup. Now, I love soup - Soup is good and I make the most amazing soups and 3 different types of chili,  But sometimes I hit the Soup Wall - Think Greek Yogurt Wall, but with soup instead of yogurt. 

So I'm wondering what do you do for lunch? What lunches do you find keep your blood sugar in check, travel well, are easy to make/take to work and taste good? 

Do you have any and all advice on how to keep my/our lunchtime routine within Blood Sugar Nirvana range while keeping it all types of tasty and funkadelic
If so, BRING IT ON & THANKS for the deliciousness in advance! 

Tuesday, April 1, 2014

Getting A "Leg Up" On Scar Tissue & Trying New Insulin Pump Infusion Sites ~

 I have an affinity for wearing my insulin pump infusion sets on my abdomen and for several reasons. Infusion sites on my belly are easy to access, easy to see, easy to change out  - Just easy in all dimensions - At least for me.
Except of course for scar tissue and the development of deadspots on my belly - As in areas on my abdomen that no longer syphon insulin properly. 
I don't like deadspots, who does? 
So with the being said, I've decided to get a "leg up" re: insulin pump infusion set sites and I've committed to alternate sites for the month of April. 
This rotation started on Saturday March 29th, on my right thigh. Now, I've used leg sites before - it's not a new location for me, but it is a tried and true location. I'm still using my right thigh, but will rotate to the left midweek. 
I'm considering trying out other locations, but I have some questions  -And I figured if I had questions, so did other people. I/we could REALLY, REALLY use your advice regarding the following: 

1. Leg Sites: 
Do you place infusion sites on the backs of your thighs? Also, do you find yourself changing out the sites more on your legs than on your  belly? 
I do, always have. I change my leg sites every 24 to 30 hours, mostly because of the workout that area gets re:clothing - As in pulling pants on and off, up and down, bathroom breaks and  tubing getting caught in underwear.  
2. Arms: Who out there puts insulin infusion sites on your arms and how does the whole subcutaneous syphoning of insulin work for you in that location? 
How long do arm sites usually last and what issues do I need to be aware of with arm sites? Like what happens when I take my shirt off? Will my tubing get all tangled?  
3. Boob: Since I'm being all honest, I'm not really interested in trying that particular area of my anatomy - I'm scared - Like REALLY scared - But let's just say I might be considering it. 
Any thoughts or advice re: infusion boob sites out there? 
Sidebar: C over at "C's Life With D" wrote a great post on this very subject! Click HERE . READ IT. 
4. Calf: Someone posted an infusion site on their daughter's calf recently ( And for the life of me, I can't remember who,) and I was like: WOW, I never thought to try that! Has anyone out there used their calf for an infusion site and if so, how'd it go? 
5. Butt: Believe it or not - I've never tried putting an infusion site in my gluteus maximus
in all my years of pumping for several reasons. My rotator cuff issues and the fact that my culo lacks cushioning.  
 Any and all advice re: arse infusion sites would be greatly appreciated!
6. OTHERS: Are there any other infusion site areas I haven't listed? If that's the case, where are they and how do they work for you? 

Change can be hard in life - And life with diabetes, so thanks in advance for any help in this area - Or should I say areas? Either or, I really appreciate your input, advice and help on this this subject!

Monday, March 31, 2014

Kids: Did I Ever Tell You The One About My Insulin Pump Reminding Some Guy @ A Party Of His Brother's Kidney Stones/Catheterization?

Kids: Sometimes people tell me stuff that I don't always want to know. #fact
But 9 times out of 10 I listen because the sharing comes from a good place, regardless of the TMI details. Also: It makes for a hell of a story.
And I FTR, I really do hope his Filterfree's brother is OK~
Recently, my friend asked me to attend a work party and I was more than happy to oblige - I like meeting new people!
I brought a bottle of Spanish Red and went to the get together and was having a really good time. The people were nice, the food was great and the wine was flowing.
In the middle of the evening I ended up speaking with a quirky older couple and about 10 minutes into the conversation, the husband pointed to my insulin pump  and asked all inquisitive like: What's that? 
So I explained what my insulin pump was and what it did and why I wore it. Which meant I brought up my type 1 diabetes, which of course led me to mentioning the Diabetes Online Community and my blog.
Sidebar: I get super enthusiastic when it comes to the DOC. 
And then the husband - Who I shall refer to as "FilterFree" for the rest of this post, said to me: Subcutaneously, that's interesting. Not to bring up my brother's penis into the conversation because you barely know me, and you've never met him. 
But I'm going to bring it up anyway - And him, strictly for medical purposes. 
My brother is prone to kidney stones - we all are my family- which is why I'm drinking water - not alcohol or caffeine. 
But my brother doesn't drink water, not at all. And he's probably going to have to go on dialysis one day because of all the stones he's had - And the last time he had kidney stones, the doctors had to stick a catheter right up the shaft of his penis - And I don't if you you know this or not …. that hurts like hell!
Me: Indeed it does - I said and looked him straight in the eye.
Filterfree: Yeah, so you having diabetes and wearing an insulin pump reminded me of my brother having to have a catheter in his penis because of his kidney stones. 
Seriously, I couldn't make this shit up if I tried.
Me: We'll, I hope your brother's feeling better.
Filterfree: Thanks, but he needs to drink more water.
Me: YES….That would help. Tell him to hang in there (DAMN IT, why did I say that?!) 
Ya.., you both need to keep hydrated. Speaking of hydrating, I need to grab a refill. 
Then, as if to bring home that ever so important point, I shook my empty glass, smiled and said my goodbyes. 

And that kids, would be the true story of how wearing an electronic pancreas clipped to my hip became the catalyst for a quirky, albeit perfectly sober and #filterfree stranger bringing up his brother's kidney stones and detailed penis catheterization - thanks to said kidney stones & lack of proper water consumption, to yours truly - All because my insulin pump reminded him of all of the above - And within the first 10 minutes of our conversation.

Like I said, I couldn't make this up if I tried - But it makes for a hell of a story/blog post~