Spare A Rose

Life for a Child

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 dictionary.com
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.”  medterms.com

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. 
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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. 
Sincerely, 
Kelly Kunik
t1 Person with diabetes for 36 years.
Diabetesaliciousness.blogspot.com
@diabetesalish

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. 
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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~
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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!
WAIT… WHAT?
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. 
OF COURSE IT DID. 
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~

Friday, March 28, 2014

Diabetesalicious Lite: Let Your Voices Be Heard & Keep Rocking The Diabetes Advocacy!!

All of us living the diabetes life know that test-strip and glucose meter accuracy are two crucial components of maintaining our health when it comes to living with diabetes. We all want and demand to StripSafely
And here't the kicker - it turns out that the FDA is willing to discuss that very issue with us a community on Monday, March 31st from 1:30 to 2:30 pm, est. 
Bennett Dunlap will host the chat with FDA Expert Courtney Lias. Here's your (OUR) chance to talk, ask questions, listen, observe & have our voices be heard.  But you in order to do all of that and more -  you need to register -  CLICK HERE !
Another key component is access to every person living with diabetes, including those on Medicaid and Medicare to have access to the latest in diabetes medical technology, 
Catherine Price over at ASweetLife.org wrote a great piece on competitive bidding and insulin pumps for people with diabetes on Medicaid and Medicare - FYI: Diabetes Technology is just as critical for PWDS over the age of 65 as for those under: http://asweetlife.org/feature/speak-out-against-competitive-bidding-for-insulin-pumps-urgent-action-required/
To quote Catherine: We in the diabetes community need to speak out to argue that a. insulin pumps should be removed from competitive bidding and b. that if they remain in the  competitive bidding program, CMS must use a different process to determine reimbursement rates, so that cost-saving does not stifle innovation.
AMEN SISTER!
We have until midnight tonight to tell CMS (Medicare/Medicaid law makers ) our thoughts on competitive bidding and insulin pumps (as well as other DME and supplies) for Medicare and Medicaid - Let you're voice be heard by clicking on the following link http://www.regulations.gov/#!documentDetail;D=CMS-2014-0029-0001

The DOC is an amazing community because of the people in it - Thanks for being part of the awesomeness and keep on rocking the diabetes advocacy!

Wednesday, March 26, 2014

A Challenging Blood Sugar Point Spread & Being "Awesome Baby With A Capital A!"

I don't really do a lot of seasonal sports sayings/euphemisms on the blog, except of course when I do~
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Saturday was a day where my blood sugar point spread was driving me nuts! 
I'd fixed Friday's infusion site issues and had textbook blood sugars from lunchtime Friday afternoon until I went to bed on Friday night.  
But on Saturday morning I woke up with blood sugar of 220. INTERESTING.
No worries  - I had to drop my car off at my mechanics for an early oil change and the 1.5 mile walk home would take care of that pesky blood sugar. Except half way into my walk back I was still 220. VERY WEIRD.
I'd been dealing with some blood sugar issues since Wednesday and I was tired of it. 
So I did another correction bolus and picked up the pace and by the time I'd walked home my blood sugar was 180 and down to 134 at lunch an hour later. 
Cut to 2 hours later and me me walking back to pick up my car and my blood sugar dropping to 82 - YAY - Back on track. 
I had a snack, did some laundry, then jumped in the shower and put on dress. I was attending a fundraising dinner a friend was hosting for a great cause 45 minutes away and I needed to get on the road.
And that would be where things get weird again:  Before I left the house my blood sugar was back up to 235 - so I increased the temporary basal rate to 130% and jumped in my car. 
30 minutes later I stopped at the rest stop o the Parkway and tested - I was 228. I was super annoyed and made the executive discussion to crack the Temp Basal to 157% and then did another correction bolus and got back on the road 
25 minutes later I arrived at my destination. I parked, checked myself in the mirror, applied my lipstick and tested my blood sugar yet again - It was 219. 
I cranked my temp basal rate to 167%, did another correction bolus and tried to remain calm - Being angry wouldn't help my numbers but I was PISSED. 
I walked in the house and was immediately greeted by friends - After hugs and hellos my friend Faye asked me if I wanted a glass of wine - I absolutely did - but I knew I needed to wait and told her I wasn't quite ready. 
I stood there for a good 25 minutes talking, laughing and meeting new people, until our gracious host told us to start filing into the dining room and fill our plates. 
As people headed towards the food, I returned to the vestibule,  knelt over my handbag and grabbed my meter, took a deep breath and tested. 5 seconds later the number 168 flashed up on the screen.   
And before I knew it I had somehow channeled my inner Dick Vitale and screamed words "AWESOME BABY" I rocked my fist in the air - And just as my friend John was walking by with a plate full of food
John: What! Did you win your NCAA team just win? 
Me: Ahhhhh, no - But it's definitely about a point spread. #BGNOW is down by 52 points and I couldn't be happier!
John: WHO? Boston? 
Me: Not a who, a what - As in my blood sugar- AKA, #BGNOW. Now that it's going in the right direction I can eat all this amazing food and have a glass of wine and not worry - So yep: "AWESOME, BABY - WITH A CAPITAL A!

I kept the temporary basal rate cranked to 167 and  my numbers stayed in normal range all night and woke up with a blood sugar of 106 Sunday morning
I'm still rocking a temporary basal rate of 145 - because I'm all sorts of stuffed up and my immune system could use the extra pancreas juice. 
  
But I'm not going to worry about the temporary basal rate number, or how many units of insulin I'm taking while on the Temporary Basal Rate - As long as my blood sugar point spread stays "awesome baby - With a capital A!!!

And yep, I believe Dickie V would agree ~ :)