Back when I started blogging in Sept 2005 it was out of a sense of desperation. Was there anyone else out there who knew what I was going through? All the reading I had done on type 1 talked about blood glucose levels that behaved correctly as long as you counted carbs properly, exercised, and found your "patterns".
What a relief it was to discover the non-textbook reality: people whose BG refused to fall into predictable patterns, people to remind me that 2+2 almost never equals 4 in the world of diabetes, people who said the same things I wanted to say, only much more eloquently.
A big part of the reason I don't blog as often is that I am no longer so frustrated with this disease. And that is because of the comments, support, and writing of all of the other d-bloggers out there. Thank you all, and happy D-blog day!
Sunday, November 09, 2008
Sunday, October 26, 2008
Hanging out at the D.R.I
Yesterday I had what was probably one of my all-time most frustrating D-days, but with the greatest people to hang out with. I got up at 4:30 (after 2 below-40 lows overnight) and was already rebounding high as I took the train down to NYC and the Diabetes Research Institute’s “Diabetes 2.0” conference. I did a small correction on the train (no breakfast yet, and I didn’t want to worry about being low while trying to find the conference).
I got to the conference just as the first speaker was about to begin, grabbed some breakfast, elbowed my way to a seat between Allison and Kelly… and proceeded to spend the next 22 hours fighting against The High that Would Not Die. You’ve heard the expression “glass ceiling”? Well, this was a glass floor. I passed quickly through the “maybe-I-underestimated” and “just-bolus-again-might-have-been-an-air-bubble” stages, while my BG hit the 300s and would not go down. I could see the nice little dotted-line high threshold on my Dexcom, and soon rage bolus followed rage bolus as I kept trying to tap, stomp, and finally jackhammer my way back through the glass floor into somewhat normal BG readings. I mean, if you can’t risk a low by stacking insulin sitting at a table with a bunch of Type 1s, when can you do it?
But the amazing thing about the day was, I was not alone. Really, really, not alone. While I was fuming and running through the whole troubleshooting checklist (can’t be the site, I was low all night; basal is at 180%, 5 units on board, why the hell am I still 280) Kelly next to me was doing the same thing. While the mom in one session was talking about being worried that her son would be over-bolusing for highs while away at college, I was attempting, unsuccessfully I need not add, to over-bolus myself back down. When Bernard complained he had been above his Dexcom’s high threshold all day, I knew exactly how he felt – we even had the same threshold set! And when Dr. Rappaport asked how we react when we see a 300 on the meter, I had just seen a 304 on mine. And Kelly’s quick response of “W.T.F?” was exactly how I felt. Kelly, you are my new hero!
Other people have written about how great it is to get together with other Type 1s, other people who really “get it”. I can’t agree more. If I had been home, I would have been in the throwing things and swearing stage. Instead, we were laughing, hugging… and still swearing. Let’s face it, diabetes is pretty damn frustrating sometimes. And that’s why it was so great to spend a day with the people who “get it” – with the bloggers I am always surreptitiously reading from work: Amy, Bernard, Scott, Allison, Gina, LeeAnn, Kelly, Karen – and anybody else I forgot. Thanks guys, for turning a crappy BG day into such a great time!
Oh, and that high?
After a day with no fewer than nine correction boluses, doubled basal rates, and a 3am site change by the light of my dex did nothing it finally faded away - of its own accord - around 9 the following morning. W. T. F.?!?
I got to the conference just as the first speaker was about to begin, grabbed some breakfast, elbowed my way to a seat between Allison and Kelly… and proceeded to spend the next 22 hours fighting against The High that Would Not Die. You’ve heard the expression “glass ceiling”? Well, this was a glass floor. I passed quickly through the “maybe-I-underestimated” and “just-bolus-again-might-have-been-an-air-bubble” stages, while my BG hit the 300s and would not go down. I could see the nice little dotted-line high threshold on my Dexcom, and soon rage bolus followed rage bolus as I kept trying to tap, stomp, and finally jackhammer my way back through the glass floor into somewhat normal BG readings. I mean, if you can’t risk a low by stacking insulin sitting at a table with a bunch of Type 1s, when can you do it?
But the amazing thing about the day was, I was not alone. Really, really, not alone. While I was fuming and running through the whole troubleshooting checklist (can’t be the site, I was low all night; basal is at 180%, 5 units on board, why the hell am I still 280) Kelly next to me was doing the same thing. While the mom in one session was talking about being worried that her son would be over-bolusing for highs while away at college, I was attempting, unsuccessfully I need not add, to over-bolus myself back down. When Bernard complained he had been above his Dexcom’s high threshold all day, I knew exactly how he felt – we even had the same threshold set! And when Dr. Rappaport asked how we react when we see a 300 on the meter, I had just seen a 304 on mine. And Kelly’s quick response of “W.T.F?” was exactly how I felt. Kelly, you are my new hero!
Other people have written about how great it is to get together with other Type 1s, other people who really “get it”. I can’t agree more. If I had been home, I would have been in the throwing things and swearing stage. Instead, we were laughing, hugging… and still swearing. Let’s face it, diabetes is pretty damn frustrating sometimes. And that’s why it was so great to spend a day with the people who “get it” – with the bloggers I am always surreptitiously reading from work: Amy, Bernard, Scott, Allison, Gina, LeeAnn, Kelly, Karen – and anybody else I forgot. Thanks guys, for turning a crappy BG day into such a great time!
Oh, and that high?
After a day with no fewer than nine correction boluses, doubled basal rates, and a 3am site change by the light of my dex did nothing it finally faded away - of its own accord - around 9 the following morning. W. T. F.?!?
Monday, April 14, 2008
Oh, for crying out loud!
Even though there is another blog post I’ve been meaning to write for weeks.. um, months … now, in honor of Raise Your Voice Day, I figured this one would be more appropriate. I’m not going to do a “type one 101” session, as you can find many good examples here at Kerri’s blog. And, in previous posts I’ve covered my diagnosis, a 24 hour log of life with diabetes, and a short humorous summary of the impact of this disease. So for today, I will instead write about being a Type 1 in a world trying to cut Type 2 costs – fun with health care chronic illness “support”. My snide comments on the Q&A will be in italics, their questions in bold.
My new health care plan at work has this wonderful (this word should be dripping with sarcasm by the way) perk for people with chronic illness: your own personalized version of the “diabetes police”. Just what every diabetic needs – a “friend” to call you up and chat about your diet (don’t have one) your weight (doing fine, thank you) and remind you to test your blood sugar (I’m pretty compulsive about this - as my Number Three Son has observed “Just like the dog leaves black hair everywhere, Mommy sheds those little test strips”).
A few years ago I had inadvertently been signed up for one of these and hated it. The first call wasn’t too bad. Do you know what a hemoglobin a1C test is? Yes, I had one last week. Every three months, in fact. Do you know it’s important to keep your a1C below 6.0? Actually, given the huge fluctuations in my BG, like dropping 150 points in an hour for no reason, trying to get my a1c below 6.0 would probably kill me. I already have to treat two 50s a day to keep myself in the sevens. How often do you test your blood sugar? Ten times a day. [dead silence on the phone]. Then: “Oh. Keep up the good work then.”
From there on in, the calls got more annoying. Next was the 6pm call on Halloween. Yeah, sure, maybe it’s a tough day for diabetics, but it’s not like I’m sitting here contemplating eating the whole bag of Almond Joys. I’ve got three kids to get into costumes, a dog having a nervous breakdown (she’s scared of flapping robes but loves barking at the door) and I live in a development where my doorbell is guaranteed to ring no less than 150 times tonight. I do not want to discuss the exchange diet with someone who tells me if I don’t control my weight I could wind up on insulin.
After the second call, I started just saying “If you really cared about improving my health you would pay for my continuous monitoring system.” When the next year’s health care flavor showed up, I made sure they did not sign me up. I don’t return the messages left by various perky sounding people, offering to tell me of an exciting new benefit free with my healthcare plan. I considered issuing the callers a test to see if they even know there is a chance they could be talking to a person with type one. You know, “can you explain the significance of a positive GAD64 antibody test?”….but then I decided that took too much energy.
Last week at work, we were told that if we completed an online health survey, we would get a few bucks taken off the cost of next year’s health care plan. OK, so it wasn’t much money, but I figure they are at least trying to do something good, so I should play along. Even though I knew what I would be in for.
To start off, I resolved to be as honest as possible with the thing. Honesty is the best policy, right? I did fine with the gender, age, height, weight, non-smoker, non-drug-abuser, teeth-brusher, exerciser, seatbelt-wearer, single-partner, occasional-drinker questions.
The general state of my health? Well, excellent is out. Good, I guess. With one glaring exception. I smile a bit, remembering my favorite great-aunt saying "For the shape I’m in, I’m healthy."
Have I missed more than one day of work in the past month due to illness? Well, considering I had strep throat and a 102 fever the week before, spent two days home asleep… Yes. Yes I have.
Have I ever been told by a doctor that I had diabetes or pre-diabetes? Um. Yeah. How long ago? Within the past 5 years.
Have I seen a doctor since that time? What are you smoking? Yes. (duh!)
Has my doctor ever told me my blood sugar was high? Is a bear Catholic? Does the pope shit in the woods?
Have I tested my blood sugar in the past three weeks? Yes. They only ask yes or no, so I can’t put “over 200 times”.
What was it? Excuse me? My choices are “80-110”, “120-140”, “150-180”, or “above 200”. No “All of the above”? No “below 40”? No “above 400” (thank you, strep throat!) I decide in the interest of honesty here to go with my most recent reading. “120-140”.
OK, I am now booted out of the information collection stage and into the “diabetes for idiots” stage. I’ll try and reproduce the gist of the canned messages here, cleverly tailored with personal data from the collection stage inserted in so I know they really care…
Diabetes can be controlled through diet and exercise. Hooray! I’m throwing out my pump! You indicated that you exercise 5 times a week. You should exercise at least 3 times a week for 30 minutes. I should cut down? Exercise doesn’t have to be tough. Try starting with a brisk walk for 15 minutes and work your way up.
Maintaining a healthy weight is important also. Your BMI is 21. An ideal BMI is 19-24, so yours is in range. Dieting is an effective way to control your weight. Don’t get discouraged if you don’t see results immediately. Remember that controlling portion size is important to losing weight.
Your fasting blood sugar was 120-140, which is above the ideal range of 80-100. It’s also not a fasting BG, you morons, it was dead-on after lunch! You never asked for a fasting reading. Elevated fasting blood sugar can lead to crippling complications. Yes, I know that. This may be a good time to speak with your doctor about changing your medication to something that may more effectively control your diabetes. Yeah, fine. I’ll tell him I want to stop insulin and switch to something more effective. Should give him a good laugh.
Controlling your blood sugar is easy with proper diet, exercise, and regular doctor visits. Obviously written by a person without diabetes, any acquaintances with diabetes, or any knowledge of diabetes – of any type. Contact your doctor for more information and help and directions on how to manage this illness. Oh, yeah, maybe I should call every time my BG is out of range… Remember, it’s all up to you. And that is the exact kind of blame-the-victim bullshit that makes ANY TYPE of diabetes so hard to live with. It is NOT just up to me. But now I’m going to be haunted by those perky phone idiots who call during supper to ask what I weigh. I just know it.
The final page of the survey asked if we had ever been the victim of a medical error. And for once instead of a multiple choice we could actually write in 250 chars to explain. So of course I put in that my medical error was being misdiagnosed as a type 2 diabetic when I was type 1 and would die without insulin. I’m hoping if my answers get spit out to their telephone police, maybe they’ll actually glance at that and decide not to call.
If not, I’m compiling my own list of questions. Maybe I’ll ask my personal policeman what they weigh and how often they exercise. If they test their blood sugar at least eight times a day. If they have tested their basal rates recently. How many abstracts they have read on PubMed. If they have noticed different insulin sensitivity at different times of the day. If they re-evaluate their insulin to carb ratios periodically..........
My new health care plan at work has this wonderful (this word should be dripping with sarcasm by the way) perk for people with chronic illness: your own personalized version of the “diabetes police”. Just what every diabetic needs – a “friend” to call you up and chat about your diet (don’t have one) your weight (doing fine, thank you) and remind you to test your blood sugar (I’m pretty compulsive about this - as my Number Three Son has observed “Just like the dog leaves black hair everywhere, Mommy sheds those little test strips”).
A few years ago I had inadvertently been signed up for one of these and hated it. The first call wasn’t too bad. Do you know what a hemoglobin a1C test is? Yes, I had one last week. Every three months, in fact. Do you know it’s important to keep your a1C below 6.0? Actually, given the huge fluctuations in my BG, like dropping 150 points in an hour for no reason, trying to get my a1c below 6.0 would probably kill me. I already have to treat two 50s a day to keep myself in the sevens. How often do you test your blood sugar? Ten times a day. [dead silence on the phone]. Then: “Oh. Keep up the good work then.”
From there on in, the calls got more annoying. Next was the 6pm call on Halloween. Yeah, sure, maybe it’s a tough day for diabetics, but it’s not like I’m sitting here contemplating eating the whole bag of Almond Joys. I’ve got three kids to get into costumes, a dog having a nervous breakdown (she’s scared of flapping robes but loves barking at the door) and I live in a development where my doorbell is guaranteed to ring no less than 150 times tonight. I do not want to discuss the exchange diet with someone who tells me if I don’t control my weight I could wind up on insulin.
After the second call, I started just saying “If you really cared about improving my health you would pay for my continuous monitoring system.” When the next year’s health care flavor showed up, I made sure they did not sign me up. I don’t return the messages left by various perky sounding people, offering to tell me of an exciting new benefit free with my healthcare plan. I considered issuing the callers a test to see if they even know there is a chance they could be talking to a person with type one. You know, “can you explain the significance of a positive GAD64 antibody test?”….but then I decided that took too much energy.
Last week at work, we were told that if we completed an online health survey, we would get a few bucks taken off the cost of next year’s health care plan. OK, so it wasn’t much money, but I figure they are at least trying to do something good, so I should play along. Even though I knew what I would be in for.
To start off, I resolved to be as honest as possible with the thing. Honesty is the best policy, right? I did fine with the gender, age, height, weight, non-smoker, non-drug-abuser, teeth-brusher, exerciser, seatbelt-wearer, single-partner, occasional-drinker questions.
The general state of my health? Well, excellent is out. Good, I guess. With one glaring exception. I smile a bit, remembering my favorite great-aunt saying "For the shape I’m in, I’m healthy."
Have I missed more than one day of work in the past month due to illness? Well, considering I had strep throat and a 102 fever the week before, spent two days home asleep… Yes. Yes I have.
Have I ever been told by a doctor that I had diabetes or pre-diabetes? Um. Yeah. How long ago? Within the past 5 years.
Have I seen a doctor since that time? What are you smoking? Yes. (duh!)
Has my doctor ever told me my blood sugar was high? Is a bear Catholic? Does the pope shit in the woods?
Have I tested my blood sugar in the past three weeks? Yes. They only ask yes or no, so I can’t put “over 200 times”.
What was it? Excuse me? My choices are “80-110”, “120-140”, “150-180”, or “above 200”. No “All of the above”? No “below 40”? No “above 400” (thank you, strep throat!) I decide in the interest of honesty here to go with my most recent reading. “120-140”.
OK, I am now booted out of the information collection stage and into the “diabetes for idiots” stage. I’ll try and reproduce the gist of the canned messages here, cleverly tailored with personal data from the collection stage inserted in so I know they really care…
Diabetes can be controlled through diet and exercise. Hooray! I’m throwing out my pump! You indicated that you exercise 5 times a week. You should exercise at least 3 times a week for 30 minutes. I should cut down? Exercise doesn’t have to be tough. Try starting with a brisk walk for 15 minutes and work your way up.
Maintaining a healthy weight is important also. Your BMI is 21. An ideal BMI is 19-24, so yours is in range. Dieting is an effective way to control your weight. Don’t get discouraged if you don’t see results immediately. Remember that controlling portion size is important to losing weight.
Your fasting blood sugar was 120-140, which is above the ideal range of 80-100. It’s also not a fasting BG, you morons, it was dead-on after lunch! You never asked for a fasting reading. Elevated fasting blood sugar can lead to crippling complications. Yes, I know that. This may be a good time to speak with your doctor about changing your medication to something that may more effectively control your diabetes. Yeah, fine. I’ll tell him I want to stop insulin and switch to something more effective. Should give him a good laugh.
Controlling your blood sugar is easy with proper diet, exercise, and regular doctor visits. Obviously written by a person without diabetes, any acquaintances with diabetes, or any knowledge of diabetes – of any type. Contact your doctor for more information and help and directions on how to manage this illness. Oh, yeah, maybe I should call every time my BG is out of range… Remember, it’s all up to you. And that is the exact kind of blame-the-victim bullshit that makes ANY TYPE of diabetes so hard to live with. It is NOT just up to me. But now I’m going to be haunted by those perky phone idiots who call during supper to ask what I weigh. I just know it.
The final page of the survey asked if we had ever been the victim of a medical error. And for once instead of a multiple choice we could actually write in 250 chars to explain. So of course I put in that my medical error was being misdiagnosed as a type 2 diabetic when I was type 1 and would die without insulin. I’m hoping if my answers get spit out to their telephone police, maybe they’ll actually glance at that and decide not to call.
If not, I’m compiling my own list of questions. Maybe I’ll ask my personal policeman what they weigh and how often they exercise. If they test their blood sugar at least eight times a day. If they have tested their basal rates recently. How many abstracts they have read on PubMed. If they have noticed different insulin sensitivity at different times of the day. If they re-evaluate their insulin to carb ratios periodically..........
Friday, January 18, 2008
The low-over
My numbers have been wacky lately. I mean seriously wacky, not just diabetes-wacky. For the longest time, lunch has been my most stable meal. I eat my usual lunch, do a 3-mile walk, and my BG does one of two things: either climbs to 260 or so and drifts gently down to 110 by 3pm, or dips first, meaning an occasional juice on my walk, then climbs to about 180 before back down by 4. I can live with that. That’s about as close as I get to being predictable.
But lately, things have been weird. I always knew if I skipped my walk, I need to add another 0-1.8 units (your guess as good as mine). Lately, even doing that, with or without the walk I hit 300 and stay there. Plus, missing lunch (which I don’t do too often) meant my BG goes up to 350 by 1pm. So, I decided it was time to do some midday basal testing.
Skipping breakfast has never been a big deal, except that as Mr Thyroid finally dies off I find it really tough to miss that a.m. coffee – actually cappuccino (make it myself 4oz milk, 2 oz espresso with our little electric cappuccio maker – best $40 I ever spent). So I decide I will just have my cappuccino at 6:30, then around 10:30 I should be in range to start a lunchtime basal check. I still pack a lunch figuring I’ll eat it around 3pm.
Wake up at 80, look real good overnight, like between 70-120. I’ve been level overnight for two months. Have my drink, bolus the usual amount and head off to work. Waiting for the traffic light two intersections from my office, my Dex’s high alarm goes off, saying I’ve passed 180. This happens almost every morning at the exact same spot, regardless of how long between having breakfast and actually going out the door.
Ten-thirty rolls around, and I check my BG in preparation to starting the basal test. 390. O-kaay, no lunchtime basal checking for me. Plus, thanks to my body’s completely backwards wiring, I am ravenously hungry anyway. Eat my lunch, bolus and correct. BG stays steady a bit, then drops, then back up….basically for the entire rest of the day I’m between 200-250.
At ten pm I’m around 190 and drifting down very gently. I decide not to do any corrections and just fix things tomorrow morning. But, I’m not sleepy yet so I spent forty minutes or so working on my “The Times’ Fiendish Sudoku” book I picked up in London.
After a while, making no progress on my current puzzle, I decide to turn off the light and go to sleep. But, let me just check first and see how out of range I really am. Thirty-one. WTF? Did I do a correction and forget about it? And where the hell are my juice boxes – my bedroom stash is empty.
I go downstairs, pour myself a glass of milk, and chug it. And interrupt my husband’s piano practice to tell him I’m low. I should be using something quicker, but I don’t have my little green juicy-juice boxes and stubbornly wont consider those darn sidewalk chalk glucose tablets. After about 5 minutes, I have a second glass of milk. And one of my homemade molasses cookies. So I don’t go low again. Then, because they’re tasty, I have another. And another.
OK, I’ve just gobbled down like 50 g of carbs. Now I’m tired. My husband comes up and reads to me, to make sure I’m going up before going back to sleep. It takes an hour for me to break 60. At this point I assure my husband that I’m most likely headed for 400 but that I really just want to sleep now and I’ll fix it tomorrow.
The alarm goes off. I hit the snooze, grab the meter, and test. 74. WTF x 2??? I pull Dex from under the pillow. According to him, I never went above 100 all night. Unhook pump, shower, get ready for work, sit down for breakfast, retest. 78. Hmm. Have a real breakfast – toast and cappucino. Low alarm goes off. Hang out for half an hour until fingerstick shows my bg hitting 78 again, then go in to work.
At work, I feel like I am completely wrapped in blankets. Muscles ache, brain hurts, and I bumble through the day, feeling as though I’ve switched brains with the dog. At least, maybe the dog could make more sense of the code I’m supposed to be working on today.
At lunchtime I’m 94. I eat, bolus lightly, and take a walk, hoping to clear my head. Nope. All I can think about is going back to bed, lying down, and sleeping.
Somehow I make it through the day – with a juice box at 3:30 as I dip down to 64 – and head home. Bed. Bed. Bed.
I call Number One Son over, explain to him what needs to get done for dinner, and go upstairs. Bed. Bed. Bed. I check my BG – 96 – and fall asleep instantly.
45 minutes later, my husband wakes me up for dinner. I feel about one thousand percent better. I can keep my eyes open. I go down to eat, do a fingerstick. 46. Hoo, boy.
By the time dinner is over (juice, wait for BG to come up, dinner + extra 35g carbs so I don’t dip again) I am back wrapped in my metaphorical blanket, too dull to think of anything. I stand up. “I’m going back to bed.” It’s barely eight. BG 220.
Dex beeps at 1am. I’m 46 and drink juice (bedside stash has been restocked). Back to sleep, wake up at 90, go to work. Once again, high all afternoon and evening. I do no corrections, only bolus for the carb contents of meals. 224 at 11pm. Ignore it and go to sleep – last bolus 5:15.
I wake in the middle of the night, drenched with sweat and shivvering like mad. Check Dex; he says “LOW”. It’s 3:30, and I’ve been LOW for an hour. Flip to the 3 hour screen and see that BG went into free fall about 1am. I must have slapped the “below 90” and “below 55” alarms in my sleep. Wonderful. I feel much, much worse than the 31 two days ago. I know I should wake my husband, but all I can think of is that he’ll turn on the light, and I don’t want the light on. Poke straw into juice box in the dark, slurp, toss, roll over, sleep.
When the alarm goes off this morning I’m 46. Great. Another juice. Wait. Shower. Get ready. No way am I driving in to work this morning. I feel like I’ve been beaten with sticks, then taken a few turns in one of those witch dunker things, into ice water. I’m achy and tired and miserable and not able to think.
I try to log in from home, but after about 90 minutes of bumbling around in the code, doing things like spending fifteen minutes trying to figure out where I can find the script that updates the version info file, giving up and emailing a co-worker to ask where to look for it, then getting the sudden brainstorm that maybe the code is inside the file named “update_version_info.bat”. That sort of thing. A menace to myself and any poor sucker stuck working on the same code base. And my brain is running through the same loop, over and over : “I’m tired. I’m cold. I want to lay down. I don’t like these lights. I’m tired…”
I check out Dex's nine hour graph and see a perfect "W" 220 - LOW - 55 (after 3am juice) - LOW - 220.
I give up, email my boss that I’m sick, and go upstairs, proceeding to lie in bed for two hours with my brain going “I’m bored. I’m cold. This bed isn’t comfortable. Too much light….”
At least it’s Friday.
But lately, things have been weird. I always knew if I skipped my walk, I need to add another 0-1.8 units (your guess as good as mine). Lately, even doing that, with or without the walk I hit 300 and stay there. Plus, missing lunch (which I don’t do too often) meant my BG goes up to 350 by 1pm. So, I decided it was time to do some midday basal testing.
Skipping breakfast has never been a big deal, except that as Mr Thyroid finally dies off I find it really tough to miss that a.m. coffee – actually cappuccino (make it myself 4oz milk, 2 oz espresso with our little electric cappuccio maker – best $40 I ever spent). So I decide I will just have my cappuccino at 6:30, then around 10:30 I should be in range to start a lunchtime basal check. I still pack a lunch figuring I’ll eat it around 3pm.
Wake up at 80, look real good overnight, like between 70-120. I’ve been level overnight for two months. Have my drink, bolus the usual amount and head off to work. Waiting for the traffic light two intersections from my office, my Dex’s high alarm goes off, saying I’ve passed 180. This happens almost every morning at the exact same spot, regardless of how long between having breakfast and actually going out the door.
Ten-thirty rolls around, and I check my BG in preparation to starting the basal test. 390. O-kaay, no lunchtime basal checking for me. Plus, thanks to my body’s completely backwards wiring, I am ravenously hungry anyway. Eat my lunch, bolus and correct. BG stays steady a bit, then drops, then back up….basically for the entire rest of the day I’m between 200-250.
At ten pm I’m around 190 and drifting down very gently. I decide not to do any corrections and just fix things tomorrow morning. But, I’m not sleepy yet so I spent forty minutes or so working on my “The Times’ Fiendish Sudoku” book I picked up in London.
After a while, making no progress on my current puzzle, I decide to turn off the light and go to sleep. But, let me just check first and see how out of range I really am. Thirty-one. WTF? Did I do a correction and forget about it? And where the hell are my juice boxes – my bedroom stash is empty.
I go downstairs, pour myself a glass of milk, and chug it. And interrupt my husband’s piano practice to tell him I’m low. I should be using something quicker, but I don’t have my little green juicy-juice boxes and stubbornly wont consider those darn sidewalk chalk glucose tablets. After about 5 minutes, I have a second glass of milk. And one of my homemade molasses cookies. So I don’t go low again. Then, because they’re tasty, I have another. And another.
OK, I’ve just gobbled down like 50 g of carbs. Now I’m tired. My husband comes up and reads to me, to make sure I’m going up before going back to sleep. It takes an hour for me to break 60. At this point I assure my husband that I’m most likely headed for 400 but that I really just want to sleep now and I’ll fix it tomorrow.
The alarm goes off. I hit the snooze, grab the meter, and test. 74. WTF x 2??? I pull Dex from under the pillow. According to him, I never went above 100 all night. Unhook pump, shower, get ready for work, sit down for breakfast, retest. 78. Hmm. Have a real breakfast – toast and cappucino. Low alarm goes off. Hang out for half an hour until fingerstick shows my bg hitting 78 again, then go in to work.
At work, I feel like I am completely wrapped in blankets. Muscles ache, brain hurts, and I bumble through the day, feeling as though I’ve switched brains with the dog. At least, maybe the dog could make more sense of the code I’m supposed to be working on today.
At lunchtime I’m 94. I eat, bolus lightly, and take a walk, hoping to clear my head. Nope. All I can think about is going back to bed, lying down, and sleeping.
Somehow I make it through the day – with a juice box at 3:30 as I dip down to 64 – and head home. Bed. Bed. Bed.
I call Number One Son over, explain to him what needs to get done for dinner, and go upstairs. Bed. Bed. Bed. I check my BG – 96 – and fall asleep instantly.
45 minutes later, my husband wakes me up for dinner. I feel about one thousand percent better. I can keep my eyes open. I go down to eat, do a fingerstick. 46. Hoo, boy.
By the time dinner is over (juice, wait for BG to come up, dinner + extra 35g carbs so I don’t dip again) I am back wrapped in my metaphorical blanket, too dull to think of anything. I stand up. “I’m going back to bed.” It’s barely eight. BG 220.
Dex beeps at 1am. I’m 46 and drink juice (bedside stash has been restocked). Back to sleep, wake up at 90, go to work. Once again, high all afternoon and evening. I do no corrections, only bolus for the carb contents of meals. 224 at 11pm. Ignore it and go to sleep – last bolus 5:15.
I wake in the middle of the night, drenched with sweat and shivvering like mad. Check Dex; he says “LOW”. It’s 3:30, and I’ve been LOW for an hour. Flip to the 3 hour screen and see that BG went into free fall about 1am. I must have slapped the “below 90” and “below 55” alarms in my sleep. Wonderful. I feel much, much worse than the 31 two days ago. I know I should wake my husband, but all I can think of is that he’ll turn on the light, and I don’t want the light on. Poke straw into juice box in the dark, slurp, toss, roll over, sleep.
When the alarm goes off this morning I’m 46. Great. Another juice. Wait. Shower. Get ready. No way am I driving in to work this morning. I feel like I’ve been beaten with sticks, then taken a few turns in one of those witch dunker things, into ice water. I’m achy and tired and miserable and not able to think.
I try to log in from home, but after about 90 minutes of bumbling around in the code, doing things like spending fifteen minutes trying to figure out where I can find the script that updates the version info file, giving up and emailing a co-worker to ask where to look for it, then getting the sudden brainstorm that maybe the code is inside the file named “update_version_info.bat”. That sort of thing. A menace to myself and any poor sucker stuck working on the same code base. And my brain is running through the same loop, over and over : “I’m tired. I’m cold. I want to lay down. I don’t like these lights. I’m tired…”
I check out Dex's nine hour graph and see a perfect "W" 220 - LOW - 55 (after 3am juice) - LOW - 220.
I give up, email my boss that I’m sick, and go upstairs, proceeding to lie in bed for two hours with my brain going “I’m bored. I’m cold. This bed isn’t comfortable. Too much light….”
At least it’s Friday.
Wednesday, November 21, 2007
Seven Random Things
Sandra tapped me to join in.
To participate, one must:
- Link to the person’s blog who tagged you.
- Post these rules on your blog.
- List seven random and/or weird facts about yourself
- Tag seven random people at the end of your post and include links to their blogs.
- Let each person know that they have been tagged by posting a comment on their blog.
- I am what my husband calls a “binge gardener”. I will often spend entire weekends outside setting up new flower beds, planting trees and whatnot – then ignore the whole thing for months. I figure any plant that can’t deal with this kind of neglect doesn’t deserve a spot in my yard.
- For our honeymoon, we spent ten months doing some low-budget backpacking through the Mediterranean: Italy, Tunisia, Greece, Austria, Germany, France, Spain and Portugal on a fellowship my husband won. I always claim I married him for the ten-month honeymoon. He always claims he married me for the extra four grand he got as a married student.
- I once took a completely bizarre language course that taught seven languages simultaneously. To this day, I can still say “Hello, Fish-face!” in German, Italian, French, Spanish, Portuguese, Japanese and Arabic. This was after the honeymoon, when we were homesick for travelling and could not afford to go anyplace…
- When I was little, my next-older brother’s nickname for me was “Grace”. This was because I was a complete klutz, and would fall down the entire flight of our non-carpeted stairs once a week or so. Surprisingly, I never once hurt myself doing that, though I would regularly turn my ankles just walking to school.
- I really enjoy faux-finish painting. I started with the castle room, and just recently did this in our basement band room:
- I am apparently a natural at ping-pong. Who knew?
- I own a 1925 player piano that we just had restored. It’s the only way I’ll ever be able to play an instrument (see #4 above), and I’m sometimes found doing Singing Frog imitations while pumping away.
I don't know who hasn't been tagged, so if you read this and aren't tagged yet, consider this your tagging!
Val
Friday, September 21, 2007
Hugs
So on Saturday I'm in the kitchen, trying to clean up the mess of us being a virtual single-parent family for a week, when Number One Son walks in.
"Mommy! Are you still radioactive?"
"No," I say, and he runs over and gives me a big hug. Now Number One Son just turned 13, and hugs really aren't his thing, so I hug back happily, glad for a bit of spontaneous cuddling.
Then he backs up, grabs his neck, and gasps, "Ahh! My thyroid!"
Wise@$$.
"Mommy! Are you still radioactive?"
"No," I say, and he runs over and gives me a big hug. Now Number One Son just turned 13, and hugs really aren't his thing, so I hug back happily, glad for a bit of spontaneous cuddling.
Then he backs up, grabs his neck, and gasps, "Ahh! My thyroid!"
Wise@$$.
Thursday, September 13, 2007
Because
Because the first attempt to kill off my thyroid with radioactive iodine didn’t work.
Because it was an abyssimal failure as a playroom (As in I didn’t make the mess in here, Mom! times three).
Because that honking huge bed from my in-laws needed the proper room to set it off.
Because I’ve always wanted a window seat to read in.
Because we need more than one spare bed when out of town friends and family visit.
Because my BG never seems to do as well as when I’m coating myself in sawdust, dirt, or spackle.
Because my dad didn’t mind me borrowing all his power tools for months at a time.
Because if a hyperactive thyroid is giving me all this extra energy, I may as well put it to good use.
Because if I’m spending my second week of the year shut away in a room, I might as well enjoy being there.
Because when you don’t normally do caffeine, starting the weekends with an espresso makes you really productive.
Because if I do develop superpowers this time, I’m going to need a really cool secret hideout.
Because as a guest room it was just a place to collect clutter.
Because my husband got the basement for his playroom.
Because neat wall painting always escapes me, but I can make messy look pretty darn good.
Because if I’ve got a spare bedroom, I can do what I like with it.
Because our cat looks really good curled up on a window seat. (Don’t worry, he is not allowed in while I’m radioactive).
Because I’ve been a castle freak my whole life.
Because all three boys think it’s the coolest sleepover room ever.
Because it will probably always be a work in progress, but I wanted a fun work in progress.
Because that cute boy from high school English class, to whom I’ve been married for the past nineteen years, has many great qualities but is not an actual prince. (Though I hear real princes are pretty high maintenance, anyways).
Because Number One Son and his friends really like it as a place for playing Dungeons and Dragons.
Because last time I was locked in here, I got to play around with my sewing machine for a week.
Because I’ve collected really weird souvenirs over the years and needed a place to display them.
Because my elliptical really does look like a medieval implement of torture.
Because we always have more books than shelves to hold them.
Because barring a winning lottery ticket, I’ll never afford to live in a real castle.
Because if I made the whole house look like this, people would think I’m really weird, but one room practically makes me a medieval Martha Stewart.
Because if I’m spending a week locked away in a tower, it should look like I’m locked away in a tower.
Because it was an abyssimal failure as a playroom (As in I didn’t make the mess in here, Mom! times three).
Because that honking huge bed from my in-laws needed the proper room to set it off.
Because I’ve always wanted a window seat to read in.
Because we need more than one spare bed when out of town friends and family visit.
Because my BG never seems to do as well as when I’m coating myself in sawdust, dirt, or spackle.
Because my dad didn’t mind me borrowing all his power tools for months at a time.
Because if a hyperactive thyroid is giving me all this extra energy, I may as well put it to good use.
Because if I’m spending my second week of the year shut away in a room, I might as well enjoy being there.
Because when you don’t normally do caffeine, starting the weekends with an espresso makes you really productive.
Because if I do develop superpowers this time, I’m going to need a really cool secret hideout.
Because as a guest room it was just a place to collect clutter.
Because my husband got the basement for his playroom.
Because neat wall painting always escapes me, but I can make messy look pretty darn good.
Because if I’ve got a spare bedroom, I can do what I like with it.
Because our cat looks really good curled up on a window seat. (Don’t worry, he is not allowed in while I’m radioactive).
Because I’ve been a castle freak my whole life.
Because all three boys think it’s the coolest sleepover room ever.
Because it will probably always be a work in progress, but I wanted a fun work in progress.
Because that cute boy from high school English class, to whom I’ve been married for the past nineteen years, has many great qualities but is not an actual prince. (Though I hear real princes are pretty high maintenance, anyways).
Because Number One Son and his friends really like it as a place for playing Dungeons and Dragons.
Because last time I was locked in here, I got to play around with my sewing machine for a week.
Because I’ve collected really weird souvenirs over the years and needed a place to display them.
Because my elliptical really does look like a medieval implement of torture.
Because we always have more books than shelves to hold them.
Because barring a winning lottery ticket, I’ll never afford to live in a real castle.
Because if I made the whole house look like this, people would think I’m really weird, but one room practically makes me a medieval Martha Stewart.
Because if I’m spending a week locked away in a tower, it should look like I’m locked away in a tower.
Wednesday, September 12, 2007
So What's Not to Like?
I said I would post more about using the new Guardian instead of my Dexcom Seven. Here it is.
I would say the “honeymoon” with this device is over. I had originally thought that by setting the low threshhold to 100, I could bypass the Guardian’s rather crappy performance on lows. So I have. And most of the time that is OK, I get a low warning that I am 100 or 95, and test and see that I am really in the 70s, so I treat if it’s dropping and forget about it. But that doesn’t always work. Today, for example, I was working and my “Low Predicted” alarm went off. It said I was 120 with one arrow down. I tested and got a 60. Quite the difference there.
Still, though, it caught it. So that’s not the most annoying thing.
The most annoying thing is when a sensor just flakes out and your readings either launch skyward or drop like a rock. Sure, my Dex has done this a handful of times in the 15 months I have had either the STS or the Seven. But I have been using the guardian a little over two weeks and it has happened 3 times.
The first time I was at work. It was the middle of the morning and I had been drifting down after breakfast when I suddenly got a predicted high warning at 170. I tested and was 125. A few minutes later Guardian said I was 190. Then 225, then 300 in the next half hour. I tested again. 122. I entered this value on the Guardian, which by now had me in 400+ range, and promptly got a CAL ERROR and a request for a new reading. Now, when Guardian thinks you have a CAL ERROR and asks for another reading, it doesn’t really mean it. If you give it that second reading you’re begging for a second cal error and a bad sensor. So instead you wait for your BG to level out if it was weird, and don’t give it a new reading for an hour or so.
So I waited. And waited. Ate lunch, went for a walk, tested two hours after lunch and was 170. OK, let’s tell Guardian. Cal Error. Bad Sensor. Since I’m in a study, I can’t just restart, I do need to change the sensor. Which is at home in the fridge. Big PITA.
The second time, I was in bed. It was not quite one in the morning, and I got a predicted low warning. I tested and was 130, right where I want to be at night. A few minutes later a high warning. Then a predicted high warning, then a bunch more high warnings and assorted beeps. I was never over 160 on the meter and pretty level. Again I tried a sync up, and got a cal error. Now it was also beeping for a “Meter BG Now” that I wasn’t going to give it. Needless to say, after that first alarm, I never fully got back to sleep. At 5:15 I finally got out of bed, flung the damn receiver into the closet and shut the door. I could still hear its muffled complaints in my 30 minutes of sleep before morning. I had to call in sick to work that day because I just couldn’t function.
At 9am I let Guardian out of his prison and let him Find Lost Sensor. He happily chugged along for the rest of the time with no problems.
Then a few days ago it happened again. Only this time Guardian thought I was low. I was 156. After an hour or so of bogus below-40 readings, that I refused to dignify by trying to sync up again, I locked Guardian in his closet and went downstairs. Several hours later he was paroled and again behaved himself.
So now I’m thinking that clunky software and carrying a goddam potato clipped to my belt might be a small price to pay for actually getting to use the darn sensor when I want to. If I’m at work when Guardian flakes out, how do I get him out of range for long enough to smack some sense into him? Ask a friend to keep an annoying beeping or vibrating device in their office for a few hours? Put him inside some kind of Faraday cage to block out the signals? Leave him in the ladies room with a “please don’t steal me” post-it note? Or just give up and go back to Dex, who flakes out every few months not every few days.
I’m done with this study in a week and a half. I find now that I’m looking forward to my old clunky but reliable Dex.
I would say the “honeymoon” with this device is over. I had originally thought that by setting the low threshhold to 100, I could bypass the Guardian’s rather crappy performance on lows. So I have. And most of the time that is OK, I get a low warning that I am 100 or 95, and test and see that I am really in the 70s, so I treat if it’s dropping and forget about it. But that doesn’t always work. Today, for example, I was working and my “Low Predicted” alarm went off. It said I was 120 with one arrow down. I tested and got a 60. Quite the difference there.
Still, though, it caught it. So that’s not the most annoying thing.
The most annoying thing is when a sensor just flakes out and your readings either launch skyward or drop like a rock. Sure, my Dex has done this a handful of times in the 15 months I have had either the STS or the Seven. But I have been using the guardian a little over two weeks and it has happened 3 times.
The first time I was at work. It was the middle of the morning and I had been drifting down after breakfast when I suddenly got a predicted high warning at 170. I tested and was 125. A few minutes later Guardian said I was 190. Then 225, then 300 in the next half hour. I tested again. 122. I entered this value on the Guardian, which by now had me in 400+ range, and promptly got a CAL ERROR and a request for a new reading. Now, when Guardian thinks you have a CAL ERROR and asks for another reading, it doesn’t really mean it. If you give it that second reading you’re begging for a second cal error and a bad sensor. So instead you wait for your BG to level out if it was weird, and don’t give it a new reading for an hour or so.
So I waited. And waited. Ate lunch, went for a walk, tested two hours after lunch and was 170. OK, let’s tell Guardian. Cal Error. Bad Sensor. Since I’m in a study, I can’t just restart, I do need to change the sensor. Which is at home in the fridge. Big PITA.
The second time, I was in bed. It was not quite one in the morning, and I got a predicted low warning. I tested and was 130, right where I want to be at night. A few minutes later a high warning. Then a predicted high warning, then a bunch more high warnings and assorted beeps. I was never over 160 on the meter and pretty level. Again I tried a sync up, and got a cal error. Now it was also beeping for a “Meter BG Now” that I wasn’t going to give it. Needless to say, after that first alarm, I never fully got back to sleep. At 5:15 I finally got out of bed, flung the damn receiver into the closet and shut the door. I could still hear its muffled complaints in my 30 minutes of sleep before morning. I had to call in sick to work that day because I just couldn’t function.
At 9am I let Guardian out of his prison and let him Find Lost Sensor. He happily chugged along for the rest of the time with no problems.
Then a few days ago it happened again. Only this time Guardian thought I was low. I was 156. After an hour or so of bogus below-40 readings, that I refused to dignify by trying to sync up again, I locked Guardian in his closet and went downstairs. Several hours later he was paroled and again behaved himself.
So now I’m thinking that clunky software and carrying a goddam potato clipped to my belt might be a small price to pay for actually getting to use the darn sensor when I want to. If I’m at work when Guardian flakes out, how do I get him out of range for long enough to smack some sense into him? Ask a friend to keep an annoying beeping or vibrating device in their office for a few hours? Put him inside some kind of Faraday cage to block out the signals? Leave him in the ladies room with a “please don’t steal me” post-it note? Or just give up and go back to Dex, who flakes out every few months not every few days.
I’m done with this study in a week and a half. I find now that I’m looking forward to my old clunky but reliable Dex.
Thursday, September 06, 2007
A new CGMS study
Note - I wrote this post overa week ago and hadn't gotten around to downloading the pictures to go with it...
Yes, just a few weeks after upgrading to the Dexcom Seven, I am participating in yet another CGMS study, this one using the Minimed Guardian system. Unfortunately my Dex was in a Day 11 fade-out when I got the new system, so I don’t have a good comparision, but I may try to put a new Dex 7 sensor in at the same time I put in my last sensor for the study.
In the meantime, here’s some comparison pix (please excuse the quality I’m not at my best first thing in the morning):
The sensors (side view, I know they look a bit beat up – sorry) Yes, the Minimed really is that much thicker)
With transmitters
Transmitters again
Receivers
Now, having been completely exasperated with the MM product in the first study I did, I’m going to revisit some of my original concerns.
Accuracy at BG readings under 100: I still feel the Dex is more accurate here; but I currently set my low threshhold on the Guardian to 100, meaning that it sets off the “predicted low” alarm when I’m around 85 in real life. So, it’s something I can work around.
Features – by this I mean how much can you customize the alarms. The Guardian wins hands down, having not only a “crossing threshhold” alarm, but alarms for impending highs or lows, and for rapid rise or fall rates, as well as a “snooze” feature (meaning beep again in 20 minutes if I’m still low, or 2 hours if I’m still high), and a regular alarm clock feature. Everything is configurable. Dex only allows you to set the low and high alarm threshholds.
Software – OK, I don’t actually get to use the software until the download at the end of the month, but I was able to look it over at the doctors office, and it is much better than the Seven’s reporting software.
Added bulk – I had been resigned to the Dexcom’s big bulky oval, but didn’t realize what I was missing until I have the Guardian’s reciever, which is basically a minimed pump with the pump guts taken out. Very easy to slip into a pocket, while the Dex reciever is too large to do much except clip on a belt.
So now, having lived with Dex for over a year, I’m starting to think about more than just the accuracy. I mean, I can easily work around the Guardian’s flaw by setting my “low” level to 100. But how to you work around lame software, limited configurability, and the bulky receiver? Next year when my pump goes out of warrantee it might be worth it to go for the all-in-one system. I’m tempted.
In the meantime, here’s some comparison pix (please excuse the quality I’m not at my best first thing in the morning):
The sensors (side view, I know they look a bit beat up – sorry) Yes, the Minimed really is that much thicker)
With transmitters
Transmitters again
Receivers
Now, having been completely exasperated with the MM product in the first study I did, I’m going to revisit some of my original concerns.
Accuracy at BG readings under 100: I still feel the Dex is more accurate here; but I currently set my low threshhold on the Guardian to 100, meaning that it sets off the “predicted low” alarm when I’m around 85 in real life. So, it’s something I can work around.
Features – by this I mean how much can you customize the alarms. The Guardian wins hands down, having not only a “crossing threshhold” alarm, but alarms for impending highs or lows, and for rapid rise or fall rates, as well as a “snooze” feature (meaning beep again in 20 minutes if I’m still low, or 2 hours if I’m still high), and a regular alarm clock feature. Everything is configurable. Dex only allows you to set the low and high alarm threshholds.
Software – OK, I don’t actually get to use the software until the download at the end of the month, but I was able to look it over at the doctors office, and it is much better than the Seven’s reporting software.
Added bulk – I had been resigned to the Dexcom’s big bulky oval, but didn’t realize what I was missing until I have the Guardian’s reciever, which is basically a minimed pump with the pump guts taken out. Very easy to slip into a pocket, while the Dex reciever is too large to do much except clip on a belt.
So now, having lived with Dex for over a year, I’m starting to think about more than just the accuracy. I mean, I can easily work around the Guardian’s flaw by setting my “low” level to 100. But how to you work around lame software, limited configurability, and the bulky receiver? Next year when my pump goes out of warrantee it might be worth it to go for the all-in-one system. I’m tempted.
Dexcom, are you listening?
Next post - I remember what irritated me so much about MM in the first place....
Monday, July 30, 2007
Duelling Dexcoms
Copying Bernard, I'm posting a picture of my duelling Dexcoms. This shows some data from this morning, after spending all of Sunday doing yard work. The new Dexcom Seven is on top.
This shows me a couple of things:
- They really do track quite well - at one point I got low alarms 30 seconds apart on the two recievers.
- The new Dexcom Seven is a little more cautious about jumping up at the first few readings after drinking my juice. Actually I had just tested at 102, so both were quite reasonable. When I finally stopped treating them as alternating snooze alarms and actually looked at the screens this morning, one said 61, the other said 62, and my meter said 61. Can't get better than that!
- Obviously, I need to quit my job and become a landscaper. I never see nice in range lines like that after a day of programming. And you don't want to know what I was eating Sunday night, but it did include bolus-free eclair, cookies, and lemon Italian ice - and my yard looks great.
There has been a huge gap in my posting. Life intervened - busy at work, big vacation (took the family to Edinburgh, York and London for 2 weeks), visitors and family parties. I still may be getting another shot at superpowers depending on my bloodwork mid-August. If so, maybe I'll have some time to post ; )
Tuesday, April 17, 2007
You would think I’d at least get superpowers
I mean, that’s how it happens in the comics. Radioactive spiders, gamma ray exposure, you name it. So there was always the hope that the pill full of radioactive iodine I swallowed for a hyperactive thyroid could have imparted some kind of special ability.
Hey, it could happen.
Just think of the possibilities here. The ability to regrow beta cells, or corral and destroy the errant T-cells that have already taken down two organs. Being able to wave your hand over a plate (I admit, I do this) and know instantly the precise carb count of everything on it (OK, so that part seldom works).
Or better yet, being able to see different paths 4 hours in the future to know the precise insulin dose you should give yourself to avoid that nasty 327 after lunch.
How about being able to keep you blood sugar level, no matter what you eat? Or turn a chocolate chip cookie into a “free food” just by looking at it? Without changing the taste or texture of course.
There were just so many things that could have happened.
I guess I just wasn’t specific enough about which organ I wanted to regrow.
Because, in the nine weeks since the radiation treatment, my thyroid output has more than doubled. In fact, if it doesn’t die off soon, we’re going to have to try it again.
This time I’ll be hoping it’s the pancreas that regenerates.
Hey, it could happen.
Just think of the possibilities here. The ability to regrow beta cells, or corral and destroy the errant T-cells that have already taken down two organs. Being able to wave your hand over a plate (I admit, I do this) and know instantly the precise carb count of everything on it (OK, so that part seldom works).
Or better yet, being able to see different paths 4 hours in the future to know the precise insulin dose you should give yourself to avoid that nasty 327 after lunch.
How about being able to keep you blood sugar level, no matter what you eat? Or turn a chocolate chip cookie into a “free food” just by looking at it? Without changing the taste or texture of course.
There were just so many things that could have happened.
I guess I just wasn’t specific enough about which organ I wanted to regrow.
Because, in the nine weeks since the radiation treatment, my thyroid output has more than doubled. In fact, if it doesn’t die off soon, we’re going to have to try it again.
This time I’ll be hoping it’s the pancreas that regenerates.
Monday, January 29, 2007
Late Night Conversations
A play in six acts
Cast of Characters –
- Val – an increasingly sleep-deprived, mother of three, type 1 diabetic
- Pump – an Animas IR1200+ insulin pump, who usually sleeps in the pocket of Val’s tee shirt
- Dex – a DexCom STS continuous blood sugar monitor, whose job it is to make sure Val’s blood sugar doesn’t go too low or too high overnight. He is set to alarm at values below 80 or over 200. He usually sleeps under Val’s pillow.
- Clock – your basic digital alarm clock, set for 5:30 am on weekdays, 7 on weekends. Lives on Val’s bookcase headboard next to a large pile of Juicy Juice 100% apple juice boxes (15 grams carbohydrate each) and a scattering of used test strips.
- Meter – a one-touch Ultra Smart blood sugar meter, whose job it is to provide real data if Dex is getting flaky. He sleeps on the headboard between Clock and the juice boxes.
- Various and sundry other characters, whose short-lived appearances should be self evident.
Act I
Thursday night – or very early Friday. We can assume that Val went to bed around 11pm, after first checking that both Meter and Dex agreed that her blood sugar was about 140.
1:30 am
Dex You’re low.
Val Hmm? [reaches under the pillow, jabs Dex, who shuts up. Goes back to sleep.]
2:15 am
Dex You’re low.
Val Hmm? [reaches under pillow, jabs Dex again. Then thinking better of it, grabs Meter off the shelf. Pops cap, inserts test strip, pricks finger without turning on the light. Then pulls Dex from under the pillow and hits a button so he lights up.]
Dex You’re low. 68, you know. [Val uses light on Dex to guide her finger to the appropriate spot on the test strip. Meter begins his countdown]
Meter 5 – 4 – 3 – 2 –
[Dex goes dark]
Meter 1!
[Val pokes Dex again, twists him so light falls on Meter]
Meter 46.
[Val stuffs Meter back on his shelf, tucks Dex under his pillow and grabs a juice box from the shelf. Pulls off straw, unwraps it, and finds the little foil dot in the dark. Sucks down juice, tosses box off side of bed. Sleeps.]
2:21 am
Dex You’re low.
Val I know that, let me sleep. [Jabs Dex and rolls over]
2:32 am
Dex You’re low. Really, really low. Like 40.
Val I know that, I just drank the juice. Leave me alone.
2:40 am
Dex You’re low. [Val hits him]
3:28 am
Dex You’re low.
Val I can’t be low.
Dex You’re low.
Val What time is it, anyway?
Clock 3:28 am. [Val grabs Meter, repeats testing procedure.]
Meter 5-4-3-2-[pause as Dex goes dark]-1. You are 54.
Dex (smugly) told you so.
Val Shit! [Stuffs Dex and Meter under pillow, grabs another juice box, then has to pull Dex from under the pillow to light up because she can’t find the spot to put in the straw.] How the hell did that happen, anyway?
Dex Last juice box brought you up to 134, then you coasted back down again. Drink your juice.
Val’s husband (sleepily) You all right?
Val Yeah. Just low. I’ve got juice.
Val’s husband You sure?
Dex We’re fine. [Val’s husband rolls over and returns to blissful sleep. Val finishes juice, tosses box to the floor, sleeps]
3:36 am
Dex You’re low.
Val Will you shut up! I just drank the frigging juice. [Jabs Dex and goes back to sleep]
5:30 am
Clock Time to get up. [Val reaches under pillow, jabs Dex]
Dex Hey!
Clock Time to get – [Val reaches up to shelf, slaps Clock]
5:39 am
Clock Time to get up. [Val groans and sits up. Turns off Clock and reaches under pillow]
Val How’d we do last night?
Dex You are 124. Nice and steady after that second juice.
Val Is that right? [tests]
Meter You are 124.
Dex See?
Act II
Friday night/Saturday morning. Scene – the same. Val was about 86 at bedtime, so she had a glass of milk and a cookie before going to bed at 11.
11:57 pm
Dex You’re high.
Val I know that, I just had a snack.
Dex But you’re high.
Val Yes. Shut up. I’ll be fine in a half hour or so. We don’t want a repeat of last night. [pokes Dex]
3:12 am
Dex You’re high.
Val I’m not low, leave me alone. [pokes Dex].
3:20 am
Dex I said you’re high. High, not low.
Val What was that? [Pulls Dex from under the pillow and hits a button].
Dex 278
Val Oh, man! [Gets Meter from his shelf]
Meter 5 – 4 – 3 – 2 [pause for light] – 1. You are 174.
Val 174’s not bad. And I drop in the morning anyway. [Pulls a wire from Meter’s case and plugs it into Meter and Dex. They converse]
Dex Maybe you aren’t that high after all.
Val Go away, Dex.
4:46 am
Dex You’re high again.
Val Wha…. [Val grabs Dex from under the pillow and hits a button]
Dex You’ve been steadily climbing for the past hour. 172 to 265. [Val hits button again] You did it twice in the last three hours. [Val hits button a third time] All night long. You’re high.
Val Are you sure? [She frowns at the nine-hour graph, blearily realizing that she is seeing The Dreaded Scallops, a pattern she has recognized before. She reaches down and finds where Dex’s transmitter is clipped to the sensor on her leg and presses on it. A click is heard.] Aha!
Dex I’m only as good as my information, you know. So what is your blood sugar? [Val pulls Meter off his shelf, puts test strip in slot, pricks finger]
Val’s cat [jumping on bed] You’re up! You’re up! Feed me. [Val pushes cat off bed. Cat jumps back up] You’re going to feed me, aren’t you? Even if you aren’t I just love you. I’ve told you that, right? And my buddy Meter. Can I have the little bottle of strips? Please? It shakes and it rolls -
Meter Get him off me! [Val picks up cat, drops him off side of bed. Now has cat fur stuck to blood drop, so has to prick a different finger.]
Meter Any day now.
Dex Don’t bother her, it’s been a rough night. [Second finger refuses to bleed, Val pricks a third]
Meter 5 – 4 – 3 – 2 – [pause] – 1. You are 143. [Val finds wire for Meter, plugs him and Dex together.]
Dex. Oh. 143. My bad. [Val returns Dex to his pillow and stuffs Meter, wire still dangling, on the shelf. Sleeps]
7 am
Clock Time to get up. [Val slaps him] What?
Act III
Saturday night – early Sunday. Scene – same. As with Wednesday, Val had a snack – a glass of milk - at bedtime because her blood sugar was 74.
2:03 am
Dex You’re high! [Val hits him]
3:16 am
Dex You’re high! [Val pulls him out from under pillow, hits a button] You’ve been high all night. Go ahead, ask Meter, he’ll back me up.
Val There is no way one glass of milk can bring me from 74 to 300. Leave me alone.
Dex But you’re high. Ask Meter, if you don’t belive me.
Meter Leave me out of this. You don’t want her getting mad. Remember what happened to Pump.
Pump What?
Dex Not you. The last Pump. Three weeks ago.
Meter Dropped on the bathroom floor. Cracked the screen straight across. It was awful.
Pump Ooooh!
Meter So watch your step.
Dex (worried) She wouldn’t do that to me, would she? I’m out of warrantee, and out-of-pocket besides. [No one answers] Oh, all right. She is high, though.
7 am
Clock Time to get up.
Val [reaching under pillow] Dex?
Dex You’re high. Like 400 plus. I can’t count that high.
Val Shit. [takes meter from shelf, tests]
Meter 5 – 4 – 3 – 2 – 1. You are 374.
Val What the hell?
Dex I tried to tell you, but you just wouldn’t listen.
Val What do I do now? [She wiggles the little button on her stomach marking Pump’s infusion set, thinking he’s disconnected. But it seems fine]
Pump Well, for starters, let’s try three and a half units of insulin. You changed the site yesterday, so it should still be good.
Val All right.
Pump And you could try listening to Dex. [Dex preens]
Act IV
Sunday. It is bedtime. Val has just tested.
Meter You are 157.
Val OK. Good. No snack tonight. Now, I have work tomorrow. You’re going to let me sleep, right, Dex?
Dex I’m just doing my job. Talk to the pancreas. And the thyroid, too, he’s hyper.
Val I mean it, I really, really need some sleep. No interruptions.
Meter (whispers) Bathroom tiles! [Dex gulps]
3:09 am (now Monday)
Pump Uh, Val? [Val reaches under pillow, slaps Dex]
Dex (sleepily) What?
Pump Val? [This time Val hits the shelf.]
Clock Ouch. Hey, what’s the big deal?
Pump Val? [She pulls pump out of his pocket and looks at him incredulously] Umm.. I just thought you should know. I’ve only got 20 units of insulin left in my reservoir, so you’re going to have to fill me by about suppertime tomorrow.
Dex Asshole.
Val What time is it anyway?
Clock 3:10. [Val puts Pump back in his pocket and looks at Dex.]
Dex You are 145. Perfect. And I’d like to point out, I didn’t wake you up. [Val puts Dex back under the pillow and sleeps]
5:30 am
Clock Time to get up. [Val hits him]
Act V
Monday night/Tuesday morning. Scene – same. Val has gone to bed at 10:15, exhausted.
11:31 pm
Dex You’re low.
Val Leave me alone. [Hits him].
12:04 am (now Tuesday)
Dex You’re low. [Val hits him again]
12:13 am
Val’s bladder I gotta go!
Dex See! I told you you were low. [Val pulls Dex from beneath the pillow, tucks him in the pocket with Meter, and heads for the bathroom]
Val’s cat You’re up! You’re up! Feed me. [Val pushes cat out of bathroom and shuts door]
Dex You’re low, you know. You really should check with Meter when you get back to bed. I think you’re 58. [Val finishes, opens bathroom door]
Val’s cat You’re back! Now you’re going to feed me. [Val pushes cat into bathroom and shuts door]
Val’s dog What’s going on up there? Are you feeding the cat? Because if he gets fed, I get fed. [Val ignores dog and goes back to bed, this time switching on the reading light]
Meter What’s up? Oh, a check. 5 – 4 – 3 – 2 – 1. You are 53.
Dex Told you. Have a juice box. [Val drinks juice, turns off light, goes back to sleep]
12:27 am
Dex You’re low! [Val hits him]
12:46 am
Dex No, I mean really low! [Val hits him again]
1:04 am
Val’s bladder I gotta go again! [Val gets up, walks to bathroom]
Val’s cat I’m saved! You’re here to feed me, right? [Val blinks at Dex]
Dex You are 55. Talk to Meter.
Val I can’t be low again, after the juice.
Dex Didn’t work. You just went lower.
Val Oh, crap. [Back in bed, Val reaches for Meter]
Meter Again? Somebody have a loose transmitter?
Dex Up yours! [Meter counts down]
Meter You are 39.
Val Shit. [Grabs another juice box]
Dex I tried to warn you, you know. If you’d just listen –
Meter Yeah, it’s the little boy who cried high. [Val ignores the bickering and sleeps]
3:29 am
Dex You’re low!
Val OK, I believe you. [Drinks another juice].
Val’s bladder You really are, you know. Or maybe it was all that juice.
Val I know, I know. [puts Dex in pocket, goes to bathroom, shuts cat in closet]
5:23 am
Dex You’re low!
Val You have got to be joking.
Dex No. 61. Honest!
Val What time is it?
Clock You have seven minutes.
Meter You are 64. Drink some juice.
Val Arrgh!
Val’s cat Um? Somebody? It’s dark in here…
Act V1
Tuesday night to early Wednesday. Scene – same. Val was 112 at bedtime and too tired to care that she should have had a snack.
5:30 am
Clock Time to get up! [Val reaches under pillow, hits Dex]
Dex Hey!
Clock No, it’s me. [Val stares at him]. It’s 5:30. You know, wake-up time?
Val Dex, how’d we do?
Dex Flat at 120, all night long.
Val You mean, we slept the whole night? It’s over?
Dex Don’t get used to it.
Saturday, December 16, 2006
Quick, bring me an orange!
My in-laws took the boys overnight last night, and we decided to go out to dinner. It was a spur-of-the-moment thing; we didn’t have much in the way of leftovers and were both frazzled from the long week at work.
I wasn’t worried; I had changed my site the day before, had a ton of insulin in my pump, had my meter and juice and all in my purse. Decided, in the light of recent news, to go eat something with chili peppers in it as a sort of salute to capsaicin.
I had been running in the low 200s all afternoon despite corrections, but wasn’t too concerned. This was just my thyroid getting jealous since the pancreas was getting all the attention. I’ve noticed before I work backwards to most “typical” Type 1’s – this apparently includes being hyper- not hypo- thyroid. So when things act up, it just randomly spits out some extra hormones and keeps my around 250 for 4 or 5 hours. My 4 hours was just about up, the latest correction would work, and I’d be back to normal by the time our food arrived.
Alas, wrong again. Still 250 when we sat down. Ordered a Pilsner Urquels on tap and nibbled a bit of bread, bolused 4 units and doubled my basal for 4 hours. Dinner arrives: 300. Eat the Cajun fish and a few tablespoons of spicy risotto. Despite the menu, this is an Irish pub; my beer comes in a pint, about 4 times as much as I normally have at one sitting, and I’m pleasantly buzzed. Maybe my site’s clogged. No problem, we’ll just finish eating and head home and I’ll take care of it there. Bolus another 5 units.
I check my Dexcom. 390. Yeah, like it climbed that fast in ten minutes. Restaurant is pretty tight quarters; I’ll just nip into the ladies’ room and swap out my site with the spare from my purse. Once in the ladies’ I test again. 390. Damn! OK, lets swap out that…site…Damn again. I’d transferred the spare infusion set to my evening bag for last weekend’s Xmas party, and hadn’t put it back. OK, another 6 units, and I’ll just ask for a doggie bag for that lobster risotto.
We head home. I run upstairs to check. 372. OK, forget the stupid site, let’s just inject 5 units and then change. Rip out the old set and inspect it carefully. No kinks or bends, nothing to show why it didn’t work. Which means I may actually have like 15 units of insulin on board. Probably not though. I check Dexcom; it shows me dropping. Sharply.
Oh, shit.
“Honey, you remember how to use the glucagon, don’t you? Just in case?” We’d done a practice with an expired set last year and he’d been nervous just injecting an orange – but since then I’d made him do my site change or Symlin a few times so he’d be used to sticking me (I’m snickering here) just in case he ever had to.
I dig out the glucagon kit from the bedside table. It expired in June. But wait, I know I picked up a new one; must be downstairs. We take out both kits, set the good one aside and take the expired kit and a Clementine from the fruitbowl. Practice time again.
“All right, you need to figure out what to do. I’m not going to be telling you if you really need to use it.” He flips over the kit and begins studying the label on the bottom. “The instructions are inside.”
He opens it up, takes out the folded glucagon-for-dummies sheet and starts reading.
“Um, honey? I don’t think you need to shake the bottle until you add the liquid – it’s just a tablet in there now.”
He growls just a bit and returns to reading the sheet. Needle in the bottle, squirt and shake, draw it up into the syringe.
OK, that takes a few tries, he keeps sticking the needle too far in and sucking up air. My tipsy self is finding this incredibly humorous.
Finally, the moment of truth. He pins the orange firmly against the counter with one hand, needle in the other.
“Throw it in like a dart, don’t hang on to the plunger. Great. Now just wait ten seconds or so, you don’t want to let it dribble out if you pull out too soon…” Yeah, I know I said I wouldn’t help him. I also promise not to back seat drive.
He waits, then pulls out the syringe. The orange erupts like a mini geyser, like a garden fountain with its single perfect arc three inches into the air. Our own personal “Citrusken Pis”, taking a leak on the kitchen counter.
I lose it. We laugh so hard we can barely stand up. We can’t even look at the real kit without giggling.
“Okay, honey, if my BG keeps dropping, just dial 911 tonight, all right?”
But we don’t need to. It levels out at a great 150, stays that way most of the night.
I wasn’t worried; I had changed my site the day before, had a ton of insulin in my pump, had my meter and juice and all in my purse. Decided, in the light of recent news, to go eat something with chili peppers in it as a sort of salute to capsaicin.
I had been running in the low 200s all afternoon despite corrections, but wasn’t too concerned. This was just my thyroid getting jealous since the pancreas was getting all the attention. I’ve noticed before I work backwards to most “typical” Type 1’s – this apparently includes being hyper- not hypo- thyroid. So when things act up, it just randomly spits out some extra hormones and keeps my around 250 for 4 or 5 hours. My 4 hours was just about up, the latest correction would work, and I’d be back to normal by the time our food arrived.
Alas, wrong again. Still 250 when we sat down. Ordered a Pilsner Urquels on tap and nibbled a bit of bread, bolused 4 units and doubled my basal for 4 hours. Dinner arrives: 300. Eat the Cajun fish and a few tablespoons of spicy risotto. Despite the menu, this is an Irish pub; my beer comes in a pint, about 4 times as much as I normally have at one sitting, and I’m pleasantly buzzed. Maybe my site’s clogged. No problem, we’ll just finish eating and head home and I’ll take care of it there. Bolus another 5 units.
I check my Dexcom. 390. Yeah, like it climbed that fast in ten minutes. Restaurant is pretty tight quarters; I’ll just nip into the ladies’ room and swap out my site with the spare from my purse. Once in the ladies’ I test again. 390. Damn! OK, lets swap out that…site…Damn again. I’d transferred the spare infusion set to my evening bag for last weekend’s Xmas party, and hadn’t put it back. OK, another 6 units, and I’ll just ask for a doggie bag for that lobster risotto.
We head home. I run upstairs to check. 372. OK, forget the stupid site, let’s just inject 5 units and then change. Rip out the old set and inspect it carefully. No kinks or bends, nothing to show why it didn’t work. Which means I may actually have like 15 units of insulin on board. Probably not though. I check Dexcom; it shows me dropping. Sharply.
Oh, shit.
“Honey, you remember how to use the glucagon, don’t you? Just in case?” We’d done a practice with an expired set last year and he’d been nervous just injecting an orange – but since then I’d made him do my site change or Symlin a few times so he’d be used to sticking me (I’m snickering here) just in case he ever had to.
I dig out the glucagon kit from the bedside table. It expired in June. But wait, I know I picked up a new one; must be downstairs. We take out both kits, set the good one aside and take the expired kit and a Clementine from the fruitbowl. Practice time again.
“All right, you need to figure out what to do. I’m not going to be telling you if you really need to use it.” He flips over the kit and begins studying the label on the bottom. “The instructions are inside.”
He opens it up, takes out the folded glucagon-for-dummies sheet and starts reading.
“Um, honey? I don’t think you need to shake the bottle until you add the liquid – it’s just a tablet in there now.”
He growls just a bit and returns to reading the sheet. Needle in the bottle, squirt and shake, draw it up into the syringe.
OK, that takes a few tries, he keeps sticking the needle too far in and sucking up air. My tipsy self is finding this incredibly humorous.
Finally, the moment of truth. He pins the orange firmly against the counter with one hand, needle in the other.
“Throw it in like a dart, don’t hang on to the plunger. Great. Now just wait ten seconds or so, you don’t want to let it dribble out if you pull out too soon…” Yeah, I know I said I wouldn’t help him. I also promise not to back seat drive.
He waits, then pulls out the syringe. The orange erupts like a mini geyser, like a garden fountain with its single perfect arc three inches into the air. Our own personal “Citrusken Pis”, taking a leak on the kitchen counter.
I lose it. We laugh so hard we can barely stand up. We can’t even look at the real kit without giggling.
“Okay, honey, if my BG keeps dropping, just dial 911 tonight, all right?”
But we don’t need to. It levels out at a great 150, stays that way most of the night.
Thursday, November 09, 2006
On driving a junker
(This really is a D-related post, so be patient..)
I grew up in a family that bought only cheap used cars. So I’ve seen my share of real clunkers: the rewired toggle-switch ignition, the horn under the dash, the rusted out gas tank that could never be filled more than half full (well, it could be filled more, it would just run out until it was half full), the speedometer that always read 0 mph. When I was in grade school my dad even had a car that, if he stopped at a traffic light, he often had to open the driver’s door, duck under the side of the car, and hit something with a wrench before he could start moving again (don’t ask me what he did, I think it was something involving the clutch).
So when we were first married, our first car was a true junker given to us for free by my older brother. To be fair, he really thought we would just use it for a weekly trip to the grocery store, not 3 ½ hours of daily commuting in Boston (Callahan Tunnel or Tobin Bridge in a rusted out 1979 Chevy Monza is not for the faint of heart) and for trips back and forth between Boston and Albany at least once a month. That car lasted almost two years, helped out that every time we came home, another brother would rebuild the carburator or something to keep it running. I used to be proud of the fact that I “paid” less for my car than for subway fare; that, by God, it was ugly and clunky but had four wheels and ran (most of the time); and that when you were trying to merge on Storrow Drive you could just look over at the Alfa Romeo next to you and laugh - a car full of holes is a great intimidation factor - and they would always move out of the way.
But there was a downside to the seventiesmobile, as we affectionately called it. We had to get the AAA-plus package, the one with the 100-mile free towing (and actually used a 96.2 mile tow once when we broke down in the middle of the pike); we had to carry at least 2 gallons of water for the leaky radiator at all times; we had to drive with the heat on full blast and the windows open in the middle of July; we had to fill one tire with air every two weeks, and we had to budget a lot for repairs for the times we broke down when we weren’t near family. I could call the local tow company and say “Jim, it’s Val.” and they would ask “are you at home or at work?” not “who are you?”. We had to plan trips around how flaky the car was being, what the temperature was, and how far to the nearest rest stop. And on mornings it wouldn’t start, we had to call in to work, because none of the rental places in town would rent to someone under 25.
Finally the repairs were more than a car payment would be (and the seventiesmobile died with a boing, as the snapped alternator belt richocheted through the radiator leaving nothing but a pile of metal shavings behind). We decided to break with my family tradition and get a real car. It was a life-changing experience. Not only did we not need to run the heater in the summer, it had A/C! We no longer had to say “We’ll be there sometime between 2 and 7” or check that our supply of antifreeze and fix-a-flat was okay before we went anywhere. We could just get in the car and start it up and go.
After a week of having a “grownup” car there was no way we could ever go back. A whole layer of stress I wasn’t even aware of evaporated once I realized that I no longer had to keep track of where the nearest pullover was or how long a walk back to the emergency telephone.
Fast forward fifteen years or so to my diagnosis with Type 1. I feel I’ve got a pretty good handle on things, I’m doing okay with carb counting, and there isn’t a heck of a lot that I want to do that diabetes really gets in the way of. But, it’s like driving a junker. It’s always that background level of stress, that constant vigilance, that keeping track of stuff that nobody else needs to. I want automatic transmission, cruise control, and a stereo system. I want my grownup car.
I grew up in a family that bought only cheap used cars. So I’ve seen my share of real clunkers: the rewired toggle-switch ignition, the horn under the dash, the rusted out gas tank that could never be filled more than half full (well, it could be filled more, it would just run out until it was half full), the speedometer that always read 0 mph. When I was in grade school my dad even had a car that, if he stopped at a traffic light, he often had to open the driver’s door, duck under the side of the car, and hit something with a wrench before he could start moving again (don’t ask me what he did, I think it was something involving the clutch).
So when we were first married, our first car was a true junker given to us for free by my older brother. To be fair, he really thought we would just use it for a weekly trip to the grocery store, not 3 ½ hours of daily commuting in Boston (Callahan Tunnel or Tobin Bridge in a rusted out 1979 Chevy Monza is not for the faint of heart) and for trips back and forth between Boston and Albany at least once a month. That car lasted almost two years, helped out that every time we came home, another brother would rebuild the carburator or something to keep it running. I used to be proud of the fact that I “paid” less for my car than for subway fare; that, by God, it was ugly and clunky but had four wheels and ran (most of the time); and that when you were trying to merge on Storrow Drive you could just look over at the Alfa Romeo next to you and laugh - a car full of holes is a great intimidation factor - and they would always move out of the way.
But there was a downside to the seventiesmobile, as we affectionately called it. We had to get the AAA-plus package, the one with the 100-mile free towing (and actually used a 96.2 mile tow once when we broke down in the middle of the pike); we had to carry at least 2 gallons of water for the leaky radiator at all times; we had to drive with the heat on full blast and the windows open in the middle of July; we had to fill one tire with air every two weeks, and we had to budget a lot for repairs for the times we broke down when we weren’t near family. I could call the local tow company and say “Jim, it’s Val.” and they would ask “are you at home or at work?” not “who are you?”. We had to plan trips around how flaky the car was being, what the temperature was, and how far to the nearest rest stop. And on mornings it wouldn’t start, we had to call in to work, because none of the rental places in town would rent to someone under 25.
Finally the repairs were more than a car payment would be (and the seventiesmobile died with a boing, as the snapped alternator belt richocheted through the radiator leaving nothing but a pile of metal shavings behind). We decided to break with my family tradition and get a real car. It was a life-changing experience. Not only did we not need to run the heater in the summer, it had A/C! We no longer had to say “We’ll be there sometime between 2 and 7” or check that our supply of antifreeze and fix-a-flat was okay before we went anywhere. We could just get in the car and start it up and go.
After a week of having a “grownup” car there was no way we could ever go back. A whole layer of stress I wasn’t even aware of evaporated once I realized that I no longer had to keep track of where the nearest pullover was or how long a walk back to the emergency telephone.
Fast forward fifteen years or so to my diagnosis with Type 1. I feel I’ve got a pretty good handle on things, I’m doing okay with carb counting, and there isn’t a heck of a lot that I want to do that diabetes really gets in the way of. But, it’s like driving a junker. It’s always that background level of stress, that constant vigilance, that keeping track of stuff that nobody else needs to. I want automatic transmission, cruise control, and a stereo system. I want my grownup car.
Sunday, July 16, 2006
DexCom versus The Other Guys: Twelve Thoughts
I am in a fairly unique position with regards to the new continuous glucose monitors. I partcipated in a study with an integrated pump and monitor (you know the one) where I got to use it for six months, and then went out and bought a DexCom, which I have been using for two weeks now. So I thought I’d give you the lowdown on them. Remember, this is only my opinion, your mileage may vary, etc, etc, etc.
So, here’s my notes on who beats who for various categories:
1. Size of transmitter: DexCom wins. You get a little rectangular plastic doohickey on a large white pad that’s the size of the other transmitter. Plus, DexCom has no wires, while The Other Guys (hereafter TOG) have a little 3-inch wire tether between the sensor and transmitter, which I wound up having to over with a second piece of IV-3000 so the wire didn’t catch. That brings me to the next item:
2. Sensor and water: this is a toss-up. DexCom says not to cover your sensor, except for short periods of time like a shower. I’m not going to pay $ for the big cover-up every time I shower, so I just shower with the transmitter/sensor still uncovered on my leg. Sometimes it’s a bit off for an hour or so after, other times it stays dead-on. However, when I have covered the sensor, about half the time my improvised multi-IV-3000 patch leaks, and I walk out of the shower with the sensor in a little bag of water taped to my leg, and it’s off for much longer. With TOG I never had to worry about the sensor, happy under it’s IV-3000 blanket. However, read number 4 below:
3. Accuracy in the 200-400 range: Hey, am I supposed to admit I still go this high with a continous monitor? Well, I do, and I would say both seem pretty good in this range.
4. Accuracy in the 30-100 range: DexCom wins, big time. If I look over my six months of records with TOG, it claims I’ve been below 70 maybe a handful of times. Not True. My favorite was a gardening low where I felt low even tho sensor said I was 160. Tested in at 30. I hit 30 while on vacation last week, and DexCom read 36. Much, much better. The times when the DexCom sensor is off are when it’s still drying out from one of my bad shower patch jobs. In fact, that’s when it acts like TOG – maybe theirs is affected by the humidity under that patch and they just haven’t figured it out yet?
5. Size of receiver: TOG definitely win on this. DexCom’s receiver is way too big, and awkward to stuff in your pocket. I like the size of the screen on the DexCom, but maybe in version 2.0 they could move the buttons to the top and slim it down a bit. I mean, TOG has all the same kind of stuff in there, plus a full insulin pump in almost half of the space.
6. Flexibility: TOG lets you program in a lot more choices: alarm volume, etc – DexCom pretty much lets you set the high and low alarm numbers (it also has a built-in non changeable low alarm at 45). TOG would let you specify when to re-alarm if you are still low x minutes after the first alarm. Plus, DexCom’s picture driven menu is just a pain in the butt to use. Either use that extra CPU space to do something useful, or let me have the option of a single menu with “start sensor/stop sensor/set alarms/set date”. I don’t need the cute little animated transmitter. Really.
7. Accessories: TOG wins here too. Because it’s a pump, it has the standard belt clip plus all those companies making pump cases, etc. DexCom comes with a psuedo-leather, black plastic case with an annoying cell phone clip on it. You know, the ones that stick out like a little flat-topped mushroom on the top and hook into a too-small clip that keeps falling off your pants? Plus, it clicks whenever you bump it: CLICK…CLICK…CLICK. Yuck.
8. Packaging: I have to say, I know it doesn’t matter in the long run, but my DexCom came in a plastic case, that looked like I bought it off the shelf at Target. Much nicer than the standard cardboard-box-with-label. I felt more like a consumer of geeky electronics than a medical patient.
9. Battery usage: For both, the transmitter battery is understandably sealed. TOG’s pump-and-reciever works on a AAA battery, while the DexCom needs to be recharged every 3-4 days. It would be convienient to keep the charger at work, because that’s where I sit still the longest, but then I might forget it on the weekend. The don’t recommend charging it in bed, because the range may be a bit less while it’s charging, but that’s what I have been doing anyway. Come on, guys, drop a double-A into it, please.
10. Receiver range: Seems about the same on both. Both occasionally flake out in bed. I can live with that, I suppose, but I don’t like it. Maybe Navigator will fix this.
11. Sensor insertion: Once they’re in, I never felt either sensor, though TOG's transmitter would sometimes catch on somthing and feel like a pinch. DexCom has a thinner sensor wire, but TOG has a reusable inserter that is spring-loaded. With DexCom, I can’t help feeling that part of the $35 cost is the big plastic inserter I have to throw out with every use. Plus, I really can’t bring myself to do thumb-on-the-plunger insertion with something that big – I wind up holding it in place with one hand, and slapping the plunger down a la whack-a-mole with the other.
12. Software: I’m not sure if the software I used for the study is available to those who buy TOG, nevertheless they win because DexCom doesn’t have any yet. I know, it’s in the works and I’m waiting for it, but I really miss being able to print out my single-day summaries.
Well, I’ll probably have more to say later but that’s it for now. For me #4 is the only real point. That’s what I want the thing for, the rest is just fluff. I’m sure as these products mature, they’ll move a lot closer together – especially if insurance would start paying for them, a lot more people would use them.
So, here’s my notes on who beats who for various categories:
1. Size of transmitter: DexCom wins. You get a little rectangular plastic doohickey on a large white pad that’s the size of the other transmitter. Plus, DexCom has no wires, while The Other Guys (hereafter TOG) have a little 3-inch wire tether between the sensor and transmitter, which I wound up having to over with a second piece of IV-3000 so the wire didn’t catch. That brings me to the next item:
2. Sensor and water: this is a toss-up. DexCom says not to cover your sensor, except for short periods of time like a shower. I’m not going to pay $ for the big cover-up every time I shower, so I just shower with the transmitter/sensor still uncovered on my leg. Sometimes it’s a bit off for an hour or so after, other times it stays dead-on. However, when I have covered the sensor, about half the time my improvised multi-IV-3000 patch leaks, and I walk out of the shower with the sensor in a little bag of water taped to my leg, and it’s off for much longer. With TOG I never had to worry about the sensor, happy under it’s IV-3000 blanket. However, read number 4 below:
3. Accuracy in the 200-400 range: Hey, am I supposed to admit I still go this high with a continous monitor? Well, I do, and I would say both seem pretty good in this range.
4. Accuracy in the 30-100 range: DexCom wins, big time. If I look over my six months of records with TOG, it claims I’ve been below 70 maybe a handful of times. Not True. My favorite was a gardening low where I felt low even tho sensor said I was 160. Tested in at 30. I hit 30 while on vacation last week, and DexCom read 36. Much, much better. The times when the DexCom sensor is off are when it’s still drying out from one of my bad shower patch jobs. In fact, that’s when it acts like TOG – maybe theirs is affected by the humidity under that patch and they just haven’t figured it out yet?
5. Size of receiver: TOG definitely win on this. DexCom’s receiver is way too big, and awkward to stuff in your pocket. I like the size of the screen on the DexCom, but maybe in version 2.0 they could move the buttons to the top and slim it down a bit. I mean, TOG has all the same kind of stuff in there, plus a full insulin pump in almost half of the space.
6. Flexibility: TOG lets you program in a lot more choices: alarm volume, etc – DexCom pretty much lets you set the high and low alarm numbers (it also has a built-in non changeable low alarm at 45). TOG would let you specify when to re-alarm if you are still low x minutes after the first alarm. Plus, DexCom’s picture driven menu is just a pain in the butt to use. Either use that extra CPU space to do something useful, or let me have the option of a single menu with “start sensor/stop sensor/set alarms/set date”. I don’t need the cute little animated transmitter. Really.
7. Accessories: TOG wins here too. Because it’s a pump, it has the standard belt clip plus all those companies making pump cases, etc. DexCom comes with a psuedo-leather, black plastic case with an annoying cell phone clip on it. You know, the ones that stick out like a little flat-topped mushroom on the top and hook into a too-small clip that keeps falling off your pants? Plus, it clicks whenever you bump it: CLICK…CLICK…CLICK. Yuck.
8. Packaging: I have to say, I know it doesn’t matter in the long run, but my DexCom came in a plastic case, that looked like I bought it off the shelf at Target. Much nicer than the standard cardboard-box-with-label. I felt more like a consumer of geeky electronics than a medical patient.
9. Battery usage: For both, the transmitter battery is understandably sealed. TOG’s pump-and-reciever works on a AAA battery, while the DexCom needs to be recharged every 3-4 days. It would be convienient to keep the charger at work, because that’s where I sit still the longest, but then I might forget it on the weekend. The don’t recommend charging it in bed, because the range may be a bit less while it’s charging, but that’s what I have been doing anyway. Come on, guys, drop a double-A into it, please.
10. Receiver range: Seems about the same on both. Both occasionally flake out in bed. I can live with that, I suppose, but I don’t like it. Maybe Navigator will fix this.
11. Sensor insertion: Once they’re in, I never felt either sensor, though TOG's transmitter would sometimes catch on somthing and feel like a pinch. DexCom has a thinner sensor wire, but TOG has a reusable inserter that is spring-loaded. With DexCom, I can’t help feeling that part of the $35 cost is the big plastic inserter I have to throw out with every use. Plus, I really can’t bring myself to do thumb-on-the-plunger insertion with something that big – I wind up holding it in place with one hand, and slapping the plunger down a la whack-a-mole with the other.
12. Software: I’m not sure if the software I used for the study is available to those who buy TOG, nevertheless they win because DexCom doesn’t have any yet. I know, it’s in the works and I’m waiting for it, but I really miss being able to print out my single-day summaries.
Well, I’ll probably have more to say later but that’s it for now. For me #4 is the only real point. That’s what I want the thing for, the rest is just fluff. I’m sure as these products mature, they’ll move a lot closer together – especially if insurance would start paying for them, a lot more people would use them.
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