#DBlogWeek: One Thing To Improve.

Today's prompt: Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

* * * * *

I've been sitting, staring at a blank screen (okay, who are we kidding - I checked Facebook a few times) for several minutes now, and this prompt is leaving me wondering:

How do I pick just one thing?

I mean, staying in range for more than a few hours? That's something to celebrate when it happens.

Food choices? Not always great.

Do I always remember to keep a coin with me for insulin battery changes? Nope.

And does that insulin pump work perfectly every time? 

Hmm... well what about pump site placement? I must be able to avoid veins by now, right?

Okay, well SURELY after 26 years, I'd having the sense to check my CGM before I brush my...

...OH MY GOD ARE YOU KIDDING ME.

When it comes to diabetes and "areas to improve", most areas overlap. The whole experience is one big experiment; a never-ending cycle of try and try again - then, hey, what about trying again? Which, when I put it like that, sounds very Debbie Downer.

Apparently, my area to improve is "focusing on just one thing at a time".

#DBlogWeek: One Great Thing.

Today's prompt: Living with diabetes (or caring for someone who lives with it) sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”. But today it’s time to give ourselves some much deserved credit. Tell us about just one diabetes thing you (or your loved one) does spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well!

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I'm not sure what this says about me, really, but I seem to have developed a reputation for bolusing for alcohol with some finesse - to the point that a fellow PWD recently texted me well into the night hours, asking for advice on a stubborn high after a couple of glasses of wine. They wanted to bolus, but didn't want to tank later while they slept (alone, and in an unfamiliar hotel room).

Again, should I be proud of this? Because, kids, it takes a lot of trial and error to get here. I emphasize errors. (It also takes finally admitting to yourself that mixed drinks are just a horrible idea all around, unless you can use a Diet mixer.) I don't know the answer to that question, but I do know that a few years back, I would have LOVED to read how someone else did this, because I was clueless and needed to hear someone else's trials and tribulations.

I can only say what works for me, and it is said along with the typical disclaimers: I'm not giving anything even remotely resembling medical advice; don't try this at home; YDMV (your diabetes may vary); I'm not condoning drinking in general, OR drinking with diabetes; consult your doctor first, etc. etc.

Okay, now that THAT's out of the way...

If I drink, it tends to be white wine. Sometimes I'll try a red, and sometimes I'll have a cider beer or a "diet" mixed drink. If you can figure out the full-sugar drinks, more power to you; I just can't walk that tightrope very skillfully. After several years of stubbornness trying, I've pretty well given up. So what's the pattern, you may ask? What's the central piece of knowledge I've gleaned?

Wine will make me go a little higher for the first few hours, and then once I hit hour five, I start tanking.

Here's the deal with me and wine: if I start drinking before the meal (say, half an hour before) and the meal has some degree of fat in it (think Italian food), the two pretty much cancel each other out in terms of delayed spikes and drops, so I do a regular one-time bolus and let it ride.

If I didn't start drinking until after I've eaten some food, I bolus a little bit extra up front. Every time I hit that five hour mark, though, I start dropping. Hardcore. I need food in my stomach at that point, even with no IOB - really.

Am I recommending that you drink? Nope. But if you do, I hope you'll do it safely. I watch my Dexcom receiver like a hawk, and I check my blood sugar as often as I can remember. I can drop very, very quickly once those drinks have had a few hours to do their thing, and past experience has taught me to watch out.

It's also a great idea to let someone that you're out with know about your situation, as it were - and wear a medical ID, wuddya? You do not want things to go badly and have people not know how to help you (or, worse yet, just think you're extremely drunk and let you "sleep it off").

And if anyone can figure out and share how to bolus and stay under 200 (without dropping like it's hot) for sugary drinks - well, I'll buy you one.

 (If you want to know more about how diabetes and alcohol mix - go here.)

#DBlogWeek: Wildcard. (Already?)

Today's prompt is intended to get folks to share the blogs they read that others "may not know about". I'm hoping you'll scroll through my blogroll (see the lower left; you can click to expand) and check out some of those fabulous people!

I'm a bit swamped at the moment, so I'm keeping my fingers crossed in regards to fully participating in Diabetes Blog Week.


Why am I swamped? Well, I applied for a DHF Seeds micro-grant for the You Can Do This Project, and was selected as a finalist! This means that I'm now creating a short video to show the diabetes online community what my idea is, why they should vote to have it funded (the micro-grant is $2,000, spendable only on certain things), and what I'll spend the money on. I've been spending pretty much every free moment in the last two weeks on this video (I think Aaron's starting to forget what I look like), and I'm REALLY EXCITED for you all to see it when voting opens one week from today, on 5/21! In the meantime, here's a sneak peek. I'll leave it to you to guess the storyline. Suspense!

Looking Back: I'm A Jumper.

I noticed this morning that one of my floaters is back, which brings me back to this post from last year around this time. (Which then reminds me that I have an appointment to make.) Anyone else hear "floaters" and imagine little blobs wearing "floaties" and swimming around in your eye juice? Just me? Okay.

* * * * *

"Nope, nope... that doesn't have anything to do with diabetes. It's just a normal thing some people have."

Whew.

For the last several months, I've noticed an occasional floater in my field of vision. It isn't always there, nor is it always in the same spot in my vision.

The only times I see it are at work; specifically, sometimes when I'm looking at my computer screen. But, not always then. It's just this bean-shaped blob that moves around with what I'm looking at.

Frankly, I'd been a bit scared about it.

My opthalmologist had seen a couple of microaneurysms in each eye shortly before I started using a CGM, which would have been in 2009. The technical term is mild non-proliferative retinopathy. In subsequent visits, he's told me that they've been healing/shrinking/running away scared, which is super, but it still scared the crap out of me that something was happening to my eyes. That I wasn't somehow immune to complications, after all.

I know it's a mild complication, but it had felt very major to me.

When I started seeing this floater, my mind understandably went to Worst Case Scenario - that 25 years of diabetes had finally started to take its toll. That my recent not-as-tight-as-before control was to blame. That I was to blame.

But I also told myself - if this was diabetes-related, wouldn't I be seeing it all the time? I guess that's the line of thinking that had me keeping my original yearly exam date, instead of scheduling the appointment for much earlier.

I didn't mind putting off the answer. If it was bad, I didn't want to hear it quite yet. (Yeah, I know.)

So when Dr. D asked me if I'd had any changes in my vision, I told him. I described what had been happening, and when. He took a look.

"Oh, no. No, your eyes look great. Actually, it looks like they're still getting better. That thing isn't diabetes-related. Some people just get those from time to time; you get just the right lighting or look a certain direction, and they show up for a little bit. Nothing to worry about."

Their opthalmologist must use
really strong dilation drops.

I drove home with my anime eyes, wanting to believe those last four words so much. But it's hard to put six months of worry into reverse so quickly.

And as for the title of this post - something must have been written down in my file, because when we got to the part where the thing touches your eye (I'm very technical with my terminology here), he had an assistant come in to hold my cranium against the head holster. Seriously; she applied force so that I couldn't react! (She was very nice and gentle with me, though. No rough-housing.)

I'm a jumper, apparently.

[Almost] Wordless Wednesday: Fun?

I don't know what it is about the Walgreens App, but it makes me want to:

It makes refilling my multitude of prescriptions a bit fun, actually. Way to be, Walgreens.

Highly Uncomfortable.

If we're connected on Twitter or Facebook, you may have seen that I had a bit of a scary HIGH on Friday. I haven't seen a number like that in... well, a really long time. Frankly, it freaked me the heck out.

So what can you do when it all goes wrong, despite doing everything "right"?

Apparently you grab the maple syrup out of your fridge, use groan-worthy puns, and attack a lion. (Sorry, Medtronic!)




(P.S. In case you're wondering who my furry friend is, he's Lenny the Lion - Medtronic's insulin pump mascot for kids, and kids at heart. His stomach, arms, legs and tush are made from polyurethane foam, which is fur-free and ready for kids to try out pump infusion sites on for practice. He's available from Medtronic's online store, and also from Build-A-Bear.)

(P.P.S. Disclosure: I received a free Lenny from Medtronic, as they sent one to all of the diabetes advocates who attended the Forum last month. I'm pretty sure this wasn't the use they had in mind.)

Diabetes Blog Week - Are You In?

Head over to Bittersweet Diabetes to find out all about the 3rd annual Diabetes Blog Week! It begins a week from today, and Karen has made it super easy to participate by giving us a list of topics ahead of time, an easy-to-use form to sign yourself up with, and link lists so you can see where you can read each day's posts. Don't have a blog? Start one on Blogger or Wordpress, or use the built-in blogging function on one of the diabetes communities like TuDiabetes, Juvenation or Diabetes Daily.

What are you waiting for? Go sign up! (And big thanks to Karen for once again organizing this fantastic way to connect with the diabetes community!)

Photo Friday: Travel Tomfoolery.

Top row: "So I guess I didn't lose this after all..."
Bottom row, L to R: Passing time at the airport; the only photo I managed to remember to take
while in NJ; my Blue Fridays acknowledgement.

To further explain the top photo...

Most of the way through eating breakfast in the hotel's restaraunt on Tuesday morning (where I was served the biggest portions of scrambled eggs and bacon that I've ever seen... really, it was like a mountain of bacon), I reached into my purse to check in with Jim, my Dexcom receiver.

Rumble rumble rumble... clink clank clink (that's me shaking the contents around a bit)... rumble rumble...

"Um, what? Where's my Dexcom?"

It wasn't in its usual pocket of my bag. It hadn't skydived to the bottom, or gotten stuck in the lining. It had not fallen out and taken respite in the booth cushions.

It wasn't anywhere.

"Crap."


Before breakfast, I had left my key in the room and taken my bags with me, as I figured I didn't need to go back up there for anything. Remembering that I had set the receiver on the bathroom counter as I rushed to get ready, I could only assume I had left it there. (Poor little guy, sitting all alone in the dark, in a strange hotel room...)

I coerced the front desk to give me a new key and scurried back up to my room, and just in time - the housekeeping cart was just two doors down from mine.

Barging into the room, I flicked on the bathroom light and expected to find my little blue Etch-A-Sketch - except it wasn't there.

What? Where else could it be?

I emptied my purse onto the bed, sure that I somehow missed it - nothing.

Table beside the bed, floor around the bed, desk - nothing.

With few plausible explainations left, I started to unpack my suitcase. And there, nestled between my pajamas and hairbrushes, was Jim. And not only that - he had been taking readings all through breakfast from inside my suitcase! What a guy.

Smaller, Sexier, and Funky Fresh.

It was a harrowing drive home from the airport Tuesday night, as things quickly progressed from "Wow, that'a a lot of lightning" to "And there's the rain they were talking about" to "Crap, is that... hail? Oh HAIL no" to "OH #&*! I CAN'T SEE THE ROAD". It was as if I had to only think about the weather not being as severe as was expected in order for Mother Nature to be all, "Challenge accepted!" and unleash the ice cubes and break open the dam. It was very dramatic.

Wait, where was I going with this? Why was I at the airport? And why did I miss a day of work at my "real job" to fly to New Jersey for 19 hours?

Tuesday marked the U.S. launch of a new type of blood glucose meter: the iBGStar. The big deal with this little guy is that it plugs into an iPhone or Touch, and the corresponding app will track and chart your results (and allow you to email them to, say, your doctor) as well as giving you the option to log carbs and insulin. The meter is very teeny tiny (roughly the size of a flash drive), and can be used independent of your i-device, or in correlation with it.

Did you catch that? It plugs into a freaking iPhone. What is this, the future? Where is my hoverboard?

Sanofi US Diabetes brought a handful of what they dubbed "Key Online Opinion Leaders" (which creates the uncomfortable acronym "KOOL" - cringe) to their headquarters in Bridgewater, NJ to hear all about it, test drive the actual meter, and be able to ask questions directly of the people involved in the product's launch. I somehow ended up on that list, along with a few other familiar (and some, less so - to me) faces.

From L to R: Shawna Gvazdauskas, VP and Device Head US Diabetes;
Brian Dolan; Riva Greenberg; Emily Coles; Laura Kolodjeski,
Sr. Manager, Patient Solutions; Allison Blass; me; Adam Brown;
Kerri Sparling; Kelly Close. Not pictured: Leighann Calentine;
David Kliff.

Photos courtesy of Sanofi

Let me start out here by saying that my learning curve tends to be pretty steep when it comes to stuff like this. I don't consider myself an expert, journalist, industry insider, or any other official-sounding term when it comes to the diabetes world - I'm a story (over)sharer. I never paid much attention to the business side of things until the last couple of years. And even then - I'm sure I've missed a bunch.

That said, I was pretty impressed during the few hours I spent with the Sanofi team. The attitude described by Shawna Gvazdauskas is that Sanofi wants to "delight their customers": notice that she said customers, not "patients". (That kind of thoughtful word choice was apparent throughout the afternoon - "check" instead of "test; the omission of "good" and "bad" from the BG vocabulary; etc.) That's the reality now: most people with diabetes have more choices than ever, and pharma has to compete and exceed the expectations of end-users to keep up. This means that Sanofi is looking more and more to meet people "at their lives, not just at their disease". Give us what fits into our lives, instead of something that we then have to find a way to fit into our lives. Give us something that helps us feel better about doing something that you don't like doing in the first place.

So what might you want to know about this meter?

• The iBGStar received FDA approval in December of last year, so why the long wait? They wanted to make sure they had the product available in multiple channels (which it is now, through places like Walgreens and Apple stores - no kidding) for people once it was released. Once that was in place, they could officially "launch" it in the U.S.
• If you compare the kits in, say, Walgreens vs. Apple stores, you'll notice a price difference: $74.95 at Walgreens (which comes with 10 test strips) and $99.95 at Apple (which comes with 50 strips, since they don't sell the strips seperately).
• You may also wonder, is there a case available that houses the combined device and meter? Yep, there is, and I'm told that it will be available through a loyalty program. It only comes in black at this point. (I clicked around for a while once I registered my meter and couldn't find anything about the case... this might be a "down the road" thing, so don't quote me here.)
• Sanofi has a "Star Savings" program - this is where actually registering your meter on the iBGStar site will come in handy - which you can sign up for on their website. You can either print off the savings card or have it texted to you. (I opted for the latter - shocking to no one, likely.) Provided that you aren't using Medicare or don't live in MA, the card will get you twelve monthly refills for no more than $20 [EDIT: They are $20 refills, providing that your insurance is covering the script. If not, the card only knocks $25 off the retail price for each box. Details can be found here on how that works.] I have no idea about insurance coverage at this point, but I can tell you that our insurance provider (one of the big ones) told me yesterday that it wasn't covered yet. Bummer.
• This meter is marketed to a very niche market, and Sanofi knows that: people with diabetes (or caregivers) who also own an iPhone or Touch. That amounts to approximately 1.6 million people in the U.S. - cool technology, but it's not available to a whole lot of people. And for those using an Android, the official word was that "other smart phones are under investigation, but [they] have nothing more to share at this time". 
• iBGStar's test strips have a "fill window", and the meter apparently won't begin the countdown until that fill window is... well... filled. Less error messages and wasted strips? Yes, please.
• The meter can be used independently of an i-device, and once plugged in again will "catch up" everything that's been missed into the application, once you've opened it.
• There are no claims of superior accuracy with this meter. It's on par with most other meters out there.

I think it's a really slick little meter. Among other things, I asked about the aesthetics of the accessories that come with the meter - the test strip bottle, the lancing device - because you'll notice that while the meter may be sleek and modern, it is flanked by equipment that is decidedly not.

New hotness, right next to old and busted. (It's not really busted.
Just click the link. It will make sense.)

All told, I look forward to test driving this for a while - as well as watching the neat-o graphics that happen inside the application while the meter counts down. (I'm not telling you what they are - no spoilers!) I also look forward to seeing what else Sanofi (and others) have up their sleeves - word on the street is that there are a whole line of "Star" products in the works, as Sanofi delves deeper into the "diabetes devices" ocean.

[EDIT: Apparently, I won't be trying this out for a while - my insurance won't cover the strips yet, and unfortunately a month's worth of strips for me is about equal to a car payment. So - back to the One Touch meters after these 10 strips are gone! Bummer.]

Disclosure: Sanofi US Diabetes paid for my flights, ground transportation and hotel while I was in New Jersey, as well as some of my meals. I received an iBGStar meter at the meeting, which was mine to keep. I was not asked to write about this event.

Also, hat tip to Cherise Shockley for the title of this post. Funky fresh, indeed.

Looking Back: I Have A Few Questions.

I first shared this post in February of 2011, and I'm still finding that all of these questions are still unanswered. I'd now like to add to the list, "When can my Dexcom display be available as an app on my iPhone?".

* * * * *

Why do the most accurate CGM sensor sites also have to be the itchiest?

Why do I only start to drop low after I've brushed my teeth?

Why can't Dexcom covers come in colors like aqua blue, orange, green or purple?

Why, on the nights I most need sleep, does Jim decide to make stuff up about my blood sugar and thusly wake me up every half hour with a BRRR BRRR BRRR BRRR! from the nightstand? (That's my impersonation of him vibrating, by the way.)

How is it possible that I can access the internet from my phone, but I can't access my basal rates from my meter remote?

Why do the Animas cartridge needles make my Humalog bottles leak drops of insulin while I'm filling them? (I've learned recently that I'm not the only one this happens to...)

Why do I sometimes feel like I'm dropping low, when I'm really not?

Why, when I get sick, does it take me three weeks to recover, instead of the three days it appears to take everyone else?

Why can't I keep myself from smirking when the nurse giving me my flu shot says "This might hurt a little"? (And why do I almost always feel the need to tell her that I'm used to it, because I have diabetes?)

And why does the world not yet have an integrated Animas/Dexcom system?!