Hot or Hypo?

I was out of the warehouse on Friday morning, doing the rounds of my work site. I’d done it before. I knew that it would be a more intense level of activity than I was typically used to. I knew that I had gone low the last time that I had done it, some months ago.

I knew what I needed to do to prepare myself, but my mind was elsewhere that morning. It wasn’t until I was outside, that it occured to me I wasn’t prepared. I hadn’t brought any skittles with me. I hadn’t set a temporary basal rate in advance of starting this activity. I hadn’t even checked my blood sugar level since breakfast.

I quickly pulled my insulin pump out of my pocket, setting a temporary basal rate of “OFF” for the next hour. It had been two hours since I had last eaten and given insulin, so I was pretty confident that the insulin I had on board from breakfast wouldn’t be a significant problem. My blood sugar levels had been falling back nicely to 5.5s after breakfast for most of the week, so I was pretty confident I would be fine on that front, too.

I just hoped I had set that temporary basal rate in time.

It was so humid last week. That uncomfortable, sticky, draining, end of the world kind of heat. I was sweating. I was exhaling air loudly, and thinking about how unfit (read: lazy) that I was despite my very physical job.

I had no idea whether it was simply the heat, or whether I was actually hypo.

I glanced down at my wrist, noticing the Medic Alert bracelet that I had neglected to put on that morning – the first morning I hadn’t done so in at least a month. In that moment, all I could think about was the possibility of collapsing in the deserted carpark. Would I lose focus, and suddenly walk across into oncoming traffic? Did anyone around me know that I had diabetes, or what that meant? Would anyone even know what to do if something did happen? Where would I be able to get sugar if I desperately needed it?

It’s rare that I have these kinds of thoughts. Ever. Yet being away from my meter and Skittles, alone and in a potentially dangerous situation of plummeting blood sugars, really sent me to the edge.

In hindsight, I was pretty confident that I was fine. If I were dropping rapidly as I do during intense exercise, I would feel it. If I did really feel the need for Skittles, I’m sure I would have doubled back. If my mind hadn’t been so preoccupied, I would have brought them with me.

When I was finally reunited with my meter an hour later, I couldn’t help but feel a slight sense of accomplishment after the morning’s events.

Being a Support Person to Someone With Diabetes

Last night Ashley led an outstanding and insightful OzDOC chat about being the support person to someone with diabetes. Being a very independent person with diabetes, I feel it’s a topic that I often overlook.

There are days where diabetes definitely has a negative impact on those around me. There are days when I’m really moody and close myself off from the conversation. I want nothing more than to just be alone. It can be frustrating watching my family talk so loudly at the dinner table, without a care in the world. When I’m having a normal person’s bad day, I still have to get through it and manage my diabetes on top of it. That makes a bad day even worse.

I often feel like diabetes is a big accommodation on me. Eating well, getting my insulin doses right, maintaining healthy blood sugar levels, minimising hypos, avoiding complications and blah blah blah. I feel like I’m the only one who will have to deal with future consequences of my condition. I’m fiercely independent when it comes to managing my diabetes. Nobody knows it better than I do. Besides, I wouldn’t want it any other way.

I guess one of the downsides is that somewhere along the way, I overlook the people around me who do care and do have to accommodate diabetes. The people who do hear the 1am alarms from down the hall. The people who do hear the clicks of a lancet, and the footsteps of an early morning hypo dash. The people who are concerned for my well being, but might not feel comfortable asking because I’ve shut them out. The people who have helped me out enormously with the costs of managing a very expensive condition.

If I were a support person to someone with diabetes, I would definitely want to respect that it’s their diabetes and their rules. I would let them know that I’m there to support them, in any capacity of their choosing. As a person with diabetes, I would want to tell my 17 year old self to learn to lean on the people around him. They might not understand, but I know they do genuinely care. Sometimes simply having them there to support me is enough.

I don’t know if I’ve got it all worked out. I definitely don’t apologise or explain my out of character behaviour after a bad day. I often feel like I need to…I definitely need to stop feeling so guilty for drinking juice in the movie theatre when the people I’m with haven’t brought anything from the candy bar. Just tell them you’re low, for heaven’s sake!

I definitely feel that diabetes has made me a healthier and wiser person, which has definitely had a flow on effect to the rest of my family. We do talk about diabetes, food choices and stories that pop up on the News. Mum often cuts out stories from the newspaper and leaves them on my desk for me to read.

I definitely feel like a more confident person who knows what he wants. When I’m talking to others, I find myself speaking in a more “matter of fact” manner, rather than making a point of introducing the fact that I have diabetes to someone new. 

I definitely feel that I know what I want from my support people, and they know how to best support me – even if their role might seem relatively minimal. 

First World Problems

During last week’s OzDOC chat, I was racking my brain to think of ways that I push the boundaries with my diabetes gear. Other than, you know, using a lancet to pop a pimple that’s sitting in an akward position inside my ear…(too much information?)

Then on the weekend, this happened…

I’m now reusing infusion sets. The manual insertion nature of my Animas Comfort sets make them reusable. And my Rockadex Libre patches fitted perfectly around the site, making for a clean looking, one piece adhesive to hold it all down.

So, why exactly am I doing this?

I’m on the verge of opening my last box of Animas Comforts. Besides a few spares floating around in various places, that’s all I have left. After having a few sites that have needed swapping out earlier than anticipated, I just want to make sure that this final box will last me until my new order arrives.

Why don’t I have enough of a back up on hand?

I’m still waiting on an order that I had placed through my local pharmacy in December. When my order still hadn’t arrived at the turn of the New Year, my Pharmacist suggested I order through Diabetes WA, who had 3 boxes in stock. (Diabetes WA still sell NDSS products online without the free postage option that was available prior to the changes).

I was able to get my hands on another two boxes in January through Diabetes WA. However when a subsequent order came back to me last week with the words “on backorder” written on the invoice, I began to worry that there might be shortages.

I’m told that the order from Diabetes WA is on the way in the next week, while the order from my Pharmacy is likely an issue with their wholesaler.

I’m hoping I won’t be doing this for long. The extra adhesive on my skin is annoying, I hate how used it looks every time I glance at it, and I feel cheap. Which is a very first world problem.

I’m lucky that I don’t have to resort to such desperate measures very often. I’m lucky that there’s plenty of spare insulin in my fridge should my pump consumables run out. I’m lucky that I have options when it comes to managing my diabetes.

Which is why I’ll definitely be Sparing a Rose today, and donating the gift of life to a child with diabetes in the form of insulin.

Diabetes sure does force you to get creative…

A Strong “C”

Frank. 60%. C.

Miss, what do I need to do to get a B?

You need to work harder.

English wasn’t exactly my strong suit in high school.

I mean, I always studied English at the highest level. I always passed. My Year 12 English teacher praised my strong “C” at almost every opportunity she had.

Yet at the same time, this always irritated me. It felt like she was placing me in a box. Pigeonholing me. Telling me what I was, and what I always would be.

English is one of those subjects that is so tricky to master. You’re either really good at it, or you’re not. It wasn’t like a maths equation, where your answer is either right or wrong. It came down to my ability to analyse texts, and grasp the hidden symbols and messages. Sometimes it seemed to be more about writing what my teacher wanted to read, instead of what I thought.

I wanted to do better at English. I needed to do better. I worked so hard at it. I used to get so frustrated seeing my friend achieve scores higher than mine, without even studying for his exams. I had to move away from those 50s and into the more safer 60s, because graduating year 12 was dependent on passing English. 

English is the most important subject. My teacher’s words still ring clear in my head today. The pressure was on.

Managing my diabetes today actually feels a lot like Year 12 English. It’s about making sense of things like numbers, food, exercise and any day to day activity that I undertake. I’m constantly analysing, trying to figure out the best response to each of these variables. A pre bolus? A temporary basal rate? A carbohydrate nudge? A delayed bolus? Some time out? A good night’s sleep? It takes a great deal of hard work to figure out what the best response will be for every situation. There’s a lot of frustration, because I don’t always achieve the results I want.

It’s taken me six years to get to what I would consider a strong “C” in managing my diabetes. I walked away from my endo appointment on Wednesday afternoon with a hba1c result that I have pretty much maintained since November. I confidently talked about everything that was going on with my diabetes. I checked off all of the issues I had on my list. We had a few good laughs about not over bolusing for my meals, which is where most of my hypos are coming from.

I’ve worked so damn hard for that strong C, and I certainly don’t overlook it. That strong C isn’t just an achievement of numbers, either. It’s things like remembering to travel prepared. Making observations in my diary. Learning from my mistakes. Not hiding from my diabetes in real life. Sharing my story. Connecting with others. And, being a human being outside of the diabetes! 

I’m damn proud of that strong C. 

I hope that this strong C can be a foundation for getting my diabetes management into the Bs.