Month: August 2018

Solo Travel.

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I’m the kind of person who likes to make my way on foot when I travel. No tour buses or schedules that I need to stick to, telling me when or where I have to be.

I always like to choose somewhere central to stay, so that I’ll have everything within close proximity to me. Although after several visits to Sydney and Melbourne, I have taken a big step out of my comfort zone recently and braved public transport. I say braved, because my biggest fear is getting lost in frightfully massive cities.

In addition to my insulin, blood glucose meter and glucose tabs, my iPad and pocket wifi are essentially my lifeline for navigation. As well as multiple backup power packs, USB cables and my brown Billabong satchel to stash it all. Jacket pockets are also greatly appreciated.

But essentially, the rewards have far outweighed the risk. Meeting up with my diabetes friend Bec in Parramatta earlier this year after first connecting online, finding Cannoli in the ‘Little Italy’ of NSW, or seeing sights such as Glenelg beach in a South Australia, which I’m en route to as we speak.

Having never ventured outside of Australia, I wouldn’t exactly call myself a seasoned traveller. However, travel has definitely helped to liberate me from the daily grind of living with type 1 diabetes. Stepping out of my comfort zone gives me a rush of excitement. Taking in new sights and surroundings helps to remind me that there’s so more to life beyond managing diabetes. A stunning sight has the power to give me a very brief moment away from Diabetes.

Equally, I’m grateful that diabetes blogging has opened my world to new places, people and experiences.

This week is no exception, as I find myself in Adelaide a few days ahead of the rebranded Australiasian Diabetes Congress on Wednesday. DA – that’s Diabetes Australia, and not Dumbledore’s Army – have invited me along to the Congress as one of their consumer reporters. Better known as the ‘Peoples Voice’ team, we will be attending sessions and delivering a consumer voice out of a conference attended largely by industry. I’m super grateful to them for giving me this opportunity once again.

Until then, I’m happily enjoying a few days off in Adelaide.

Stay tuned.

Lack of Back-Up.

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I was in the bathroom at work when I first noticed it. A small, deep purple bruise was forming beneath the clear plastic window of my infusion site.

I was a little surprised, given that it had already weathered 24 hours worth of insulin boluses and a good night’s sleep. But I was also not surprised, given it was placed smack bam in the centre of my stomach where I have the least meat on me.

My mind wandered to the pencil case sitting on my desk, however I soon realised that the spare infusion set sitting in there belonged to my YpsoPump. Not a match for the late Animas Vibe I had replaced it with three weeks ago.

My mind wandered to the demi pen and needles that I carry around with me. However, I soon realised that there was no insulin cartridge in there because I’ve been feeling a little paranoid about insulin going bad until recently.

My mind wandered to the Chemist outside, which would probably loan me some insulin if I presented my NDSS card and promised to return with a script. However, I soon realised that it would be wasteful given all of the insulin I had in my fridge at home.

My mind wandered to the low carb chicken salad that I had packed for lunch. However, I soon realised that there were also amazing croutons in there that I had baked with the chicken juices. Not to mention that my blood sugar might also be a little high if the site was failing.

My mind wandered to the needle that was contained in my YpsoPump infusion set. However, I soon realised that there was no way that I would be able to macgyver it to reapply my failing infusion set into a fresh spot.

My mind wandered to my lunch hour, where I would probably have enough time to drive home and come back. However, I soon realised that even though I lived close enough, I could not be bothered rushing there and back and wolfing my lunch down afterwards.

My mind wandered to my Dad, who I felt super guilty for bothering, but who I also knew wouldn’t ever complain about having to deliver an infusion set to me at work.

It’s been a long time since I’ve had an infusion site fail on me well after placing it. I guess in the back of my mind I’ve been putting off updating my travel kit, telling myself it won’t happen. 

I bring my pencil case carrying all of my diabetes back ups with me almost everywhere I go. I hardly ever need to fall back on it when I’m out and about. And yet the one time I do, I don’t have the right stuff in there!

Do Your Insulin Needs Increase During Winter?

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I could feel my blood boiling.

With every single swipe of my FreeStyle Libre reader against the sensor on my arm, I felt increasingly frustrated.

Despite being pretty confident in what I’d eaten and covered with insulin for dinner, my levels dipped slightly before slowly but steadily ascending once again. A pattern that had become somewhat typical over the past couple of weeks following meals.

Despite correction after correction, my blood sugar levels were yet to budge.

My mind wandered back to the pump break I had taken in late April and May. I thought about how easy blood sugar levels had been to manage with pens and needles. How free my mind had been from frustration.

That pump complacency I felt on the night I disconnected my pump in late April had returned. I didn’t want to be feeling it, but it was there, plaguing my thoughts against my own will.

Then, I just had this sort of ‘epiphany.’

I set a temporary basal rate increase of 10% on my insulin pump, hoping that it would help my correction doses to start working better.

When my insulin still seemed ‘sluggish’ a few hours before bed, I increased it to 20%. After a few more days had passed, I went into my pump settings and permanently adjusted the basal rates upwards by 20%.

I’ve heard it discussed before in the diabetes community. I’ll be the first to admit that I never brought into the whole concept of insulin needs increasing during the Winter. And decreasing during the Summer, for that matter.

I don’t know what causes it. There’s been no significant change in my activity levels. I’m very active during my work day as usual, and don’t go anywhere near the gym or a pair of running shoes when I’m at home. My routine is the same. Admittedly, I probably spend less time outdoors or in the sunlight at the moment. Maybe there’s an increased inclination to drink coffee, eat cannoli and watch Australian Survivor.

More than anything, I think it may be an environmental or physiological factor.

I’m just grateful that my insulin is working again and that I can spend more of my day in range, fighting less of an uphill battle in doing so.

After eight years, I’m still learning new things about my diabetes. I truly believe that the more time and experience I have under my belt, the better equipped I am to live with it.

Dilated.

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I took a seat at the back of the store, thankfully behind a wall which provided me with some privacy from customers shopping. I placed the tissue which I had used to dab my watery eyes into my bag. With 20 minutes to kill, I pulled out my phone. I scrolled through my feeds, watching them get blurrier with every passing minute.

The office door in front of me opened, and I was finally motioned into a dark examination room. I took a seat on the wooden beech chair, placed my chin onto the little chin rest, propelled my head forward and peered through. I watched as an image of a country road in the desert was swapped out for darkness, save for a green light.

Relax. Nice and wide. Looking at the green light.

I blinked, uncontrollably, somewhat startled by the small puff of air that entered my right eye.

One more time. Nice and wide.

I struggled to regain control over my blinking, trying to convince myself that nothing was coming into the way of my eye.

After repeating the exercise on my left eye, we got up and shifted into the Optometrist’s office.

How did you get here today?  

I drove here. I’ve just come from work.

Did you bring your sunnies?

Nope, I replied, thinking about how grey and miserable a day it was outside.

How’s your vision? Not too bright?

Fine.

Following my Optometrist’s instructions, I looked to the left, then up at the ceiling, then to my right, and then to the ground as he shone a blazing white light over each of my dilated eyes.

I sat there, feeling like a bundle of nerves, while telling myself that it was unlikely that much would have changed since my last diabetes eye check 12 months ago.

I’ve visited an Ophthalmologist at the hospital before, prior to learning that my Optometrist can do the same eye screening with far more convenience for me and completely covered through Medicare. My endo is happy with this arrangement, and I know that an Ophthalmologist is my port of call if any eye changes are detected during these appointments.

Okay, we’re done. You can sit back.

Your eyes look nice and healthy. There are no signs of any diabetic changes. We’ll see you again in another 12 months.

I shook his hand and thanked him, pleased that I could check another thing off my ‘to do’ list.

YpsoPump: Eight Weeks Old!

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I was full of enthusiasm when I learned that I would have the opportunity to road test a new diabetes toy in the YpsoPump.

The YpsoPump does have a fair few differences to traditional insulin pumps, but for the majority of my eight week adventure these differences were far outweighed by its sleek and lightweight nature.

With a stockpile of supplies belonging to my late Animas Vibe sitting in the wardrobe, I made the decision to pull my old pump out of retirement two weeks ago. It actually has reminded me of some of the features that I have been missing.

One of my biggest issues with the YpsoPump has been occlusion alarms. Unfortunately, at least 1 or 2 infusion sets in each box that I have used so far have triggered occlusion alarms. There have been no visible signs of site failures such as kinking or bleeding. High blood sugars clearly indicated that insulin was not getting through, however the alarms only seemed to trigger during a decent bolus of at least 3 units.

I’ve been connecting to a new infusion site at mealtimes where I’ll give a decent bolus, hoping that any occlusions will be triggered. I have reported the issue to Ypsomed with little answer, although I was pleased that my level of diabetes knowledge was acknowledged over the phone. I do wonder if this is simply an issue of me being too thin and lacking enough tissue to cushion the cannula beneath my skin.

I do also miss having the option of having infusion sets that sit on an angle beneath my skin. I can really feel the Ypsomed sites ‘digging in’ when I’m lounging on the couch or sleeping. The marks and bumps left on my skin after removing an infusion set also seem bigger, presumably from the sets ‘digging in.’

Being fairly thin, I don’t think the Orbit inserter is the best practice for me to apply a new infusion site. Inserter devices didn’t agree with me on my late Animas Vibe. While my experience was better than the Animas insets, I definitely intend on manually inserting my sets when I next use the pump.

The one thing I would change about this pump is its lack of a built in bolus calculator. While performing bolus calculations on my iPhone is largely okay, I have found myself slacking off here and there. I’d also like to see more customisation in Ypsomed’s bolus calculating app, such as being able to adjust insulin to carb ratios for things like physical activity.

It was also far too inconvenient having to wait for the app to sync with the pump for insulin data to perform a bolus calculation. Bluetooth was also a significant drain on the pump’s battery. I have since switched the bolus calculator to Multiple Daily Injections mode, instead relying on my ability to log all of my bolus calculations to obtain accurate insulin data. With Bluetooth switched off, I’ve also managed to get a more decent 21-24 days from an Energiser AAA battery.

The thing I like most about the YpsoPump is its sleekness, size and lightweight nature. I have definitely missed that in these past two weeks, especially when I’m travelling and have other things to carry around in my pocket as well. I feel confident that I can live with those differences in return for its weight – particularly in the Summer, when pump complacency is a real issue for me.

The YpsoPump has definitely been a learning curve over these past eight weeks, but as with all other aspects of managing diabetes, I’ve learned how to best make it work for me.

Disclosures: Ypsomed Australia provided me with a YpsoPump, infusion sets, reservoirs and an inserter to trial at a launch event in Sydney. There was no expectation that I would blog, or even trial the pump itself. All opinions expressed here are, as always, my own.