Author: Frank

An E-Mail To My Electoral Candidate

2 Comments

To my Electoral Candidate,

Just a quick response to the e-mail you sent about your campaign for the upcoming State Election. 

I wanted to tell you about something special happening in my life. Something so special, it happens every single minute, of every single hour, of every single day. In fact, it’s so special, that I get to keep it for the rest of my life. 

Exciting, right?

Six years ago, my pancreas did something unprecedented. Something very grassroots. It decided to call it quits, and handed over the reigns to me. A commoner, would you believe it? All of a sudden, I was in charge of trying to mimic a working pancreas. This meant giving insulin to match the foods I eat. Adjusting insulin delivery based on the carbohydrate, fat, protein or glycemic index of my meal. Matching insulin delivery to any physical activity I undertake throughout the day. Keeping my blood sugar level above 4 mmol/L, in order to keep my brain functioning and remain conscious. Keeping my blood sugar below 8 mmol/L for as much of the time as possible, so that I can maximise my chances of living a long and healthy life. 

Sounds like a tough gig with extremely high stakes, right?

I live with a condition called type 1 diabetes. A condition that is often unpredictable, operating with a mind of its own. To stay on top of this, I can often be found pricking my finger. Sometimes, as often as 20 times per day.

Sounds intrusive, right? 

I’ve received care through a public hospital diabetes clinic for many years, but it’s hardly been adequate. Patient numbers continue to grow, while resources continue to be stretched thin. I reached a point where I felt I was no longer getting the personalised support I deserve to help me manage my chronic condition to the best of my ability. This means forking out my hard earned money to receive the support I deserve.

I sometimes wear a device that continuously monitors my blood sugar. A device that keeps me safe from the lows and the highs. A device that gives me a great deal of convenience, allowing me to more quickly respond to the lows and the highs. I’d like to wear it full time. I’d like to try other Continuous Glucose Monitoring devices that are on the market. Yet this device, and others like it, are not currently subsidised in Australia. It costs me a fortune to wear. This is on top of all of the other life challenges facing young adults in Australia, that I am sure you would be well aware of.

You are campaigning for a man who will be a Premier for every West Australian. In my books, a man who truly is a premier for every West Australian, would not let me live through such injustices.

Warmest regards from the bottom of my broken pancreas,

Frank

Sticky Stuff

10 Comments

Is it coming unstuck?

That’s the million dollar question that plagues me through the day. I often find myself prodding my arm, just to make sure that my FreeStyle Libre sensor is still there.

It’s pretty hard to tell whether that sensor is coming unstuck once those edges begin to fray. Sometimes it really is coming unstuck, while other times the edges are frayed but the adhesive game underneath the sensor is still going strong.

The warmer months of the year have definitely tested my sensors. I remember coming home from work after a warm day and the sensor literally fell off as I got dressed. Thankfully, FreeStyle customer service replaced the sensor for me with no hassles.

Without the security of winter thermals and jumpers, I’ve also found that I’ve got to take A LOT of extra caution not to knock that sensor as I go about my day.

I definitely find that getting the best position on my arm makes a huge difference, both in adhesive power and in sensor accuracy. Ideally I want to pick a flat space on my arm, as far up and out of the way as possible. 

This week, I’ve also been rocking my Rockadex Penguin patch. It’s a sticker that simply sits over the Libre sensor on my arm (or any other Continuous Glucose Monitoring device), holding it into place.


Honestly, it’s a lifesaver, especially during the warmer months of the year while I’m more active. As someone who always opts for the plainest or most invisible of colours, this is really saying something!

Yet what’s even better is the story behind it. Rockadex is an Australian business based in my hometown of Perth. It’s run by the mother of a young child with type 1 diabetes. The patches and diabetes accessories are sold solely for the purpose of funding a young girl’s Continuous Glucose Monitoring costs, which is not currently subsidised here in Australia. Anything more is given away. 

I’ve also splashed out on a silicone case for my Libre reader, which often slips out of my shirt pocket when I bend down.


 They’ve also got a bunch of international distributors for those outside of Australia. 

There’s stickers, patches and accessories available to match almost any diabetes device you might use. At the end of the day, anything that adds a bit of extra excitement to the monotony of diabetes is surely a good thing in my book.

Multiple Daily Injections, a Second Time Round

5 Comments


I definitely felt hesitant about going back to Multiple Daily Injections when I was contemplating a pump break.

I didn’t really have too many fond memories of managing diabetes prior to insulin pumping. Lantus was very uneven and inconsistent the last time I used it. I felt I could never get the dose quite right. I remember lots of carb guesstimates, and the wildly fluctuating levels that followed.

But at the same time I knew that I was armed with a lot more knowledge, and motivation compared to when I last did injections. I was actually curious as to whether I could apply these newfound skills into Multiple Daily Injections a second time round.

I gave 9 units of Lantus at around 9pm on the first night of my pump break, which was the sum of the 24 hour basal profile on my pump. I was pretty pleased to see that it did keep me fairly stable when I woke up the next morning.


I was definitely contemplating splitting my Lantus dose, but I wasn’t sure how best to go about it. The general consensus in forums seemed to be that Lantus lasted around 18 hours at best. After running high during the first two afternoons, I decided to experiment with a smaller second dose at 1pm to cover the final third of my day. 3 units seemed to be enough to cover, without sending me low overnight.

After months of diligent carb counting, I knew I definitely wouldn’t be able to survive without a bolus calculator. Although there were plenty of flashy diabetes apps to choose from in the App Store, many of them lacked a bolus calculator. I eventually found RapidCalc for $12.99. Although it didn’t have the flashiest interface, it fitted my needs nicely. I was able to set up my insulin to carb ratios, correction factors, insulin usage profile, and reminders for my Lantus doses.


This break definitely reinforced that to me that you tend to use less insulin on the pump. On the pump, I was using a carb ratio of 1:10g and a correction factor of 1:2.6mmol. On injections, I needed a ratio of 1:6g and a correction factor of 1:1.6mmol. Being off by even half a unit of insulin had a big impact on my blood sugar levels after meals.

What I loved most about injections was the simplicity of it all. There was instant relief from the lows, and far less thinking about where my blood sugar was heading. Small activities around the house had minimal effect on my blood sugar levels. I witnessed steady trend arrows on my Libre during afternoon walks, rather than downward ones. Using Lantus for my basal, rather than rapid acting insulin on the pump, made a BIG difference here. The only time I had to think about lows was when I had mealtime insulin on board.

Gotta say, it was also just awesome to sprawl out on the couch or in bed and not feel that chunk there in my pocket. And I loved having a little less weight in my pockets every time I left the house.

Overall, my blood sugar levels were just as good on injections as they were when I was pumping.

But shots were definitely a LOT of work. Although I carried my pen around with me in my pocket everywhere, I don’t shoot up in front of others. So I really had to make a point of finding a quiet corner to do so when I wanted to eat or correct a high blood sugar level. Speaking of, morning blood sugars were a LOT harder to manage. I didnt have the flexibility of increasing my basal insulin to cover the morning rise after I woke up. I often found myself giving at least 3 corrections after breakfast to bring me back into range. If I had stuck with injections for longer, I would definitely basal test with a few extra units of rapid acting insulin to cover the morning rise.

My pump break definitely reminded of something that Ginger at Diabetes Daily wrote recently. She says that neither pens or pumps were perfect, and that we were choosing between the flaws that bothered us the least. I couldn’t agree more.

For me personally, an insulin pump is a LOT more work than injections. Keeping on top of site changes, dying batteries and insulin cartridges, and having to be on my game in setting basal rates around my activity. It’s more careful thinking about what you’re doing. Not to mention the extra chunk in my pockets pulling my shorts down!

But a pump also offers me more convenience when I’m on the go, more precision in my basal rates and greater flexibility with insulin dosing to cover different kinds of meals.

For the time being, those benefits outweigh the flaws when managing my diabetes.

Taking a Break from My Insulin Pump

9 Comments

I spent two weeks disconnected from my insulin pump last month. It was honestly the best decision I could have made for my diabetes management in the long run. Going back to the simplicity of injections gave me some much needed relief from the stress the pump was inflicting on me, as well as a lot of time to reflect on how I wanted to manage my diabetes going forward. With a much clearer head today, I will add some more to what I wrote about this pump break last month.


As we were heading into warmer weather and the festive season towards the end of last year, I was spending a lot more time being physically active. Watering the garden, Christmas shopping, setting up Christmas lights and activity around the house. Suddenly, a lot of what I had learned and experienced over the past few months from using an insulin pump had changed.

Being plugged into rapid acting insulin all the time felt exhausting. I was going low all the time. Even simple things, like watering the garden, would send my blood sugars spiralling downward. I felt like a single day without a hypo was rare. I often found myself eating my way out of impending hypos, and trying to predict what my blood sugar levels were going to do to me before leaving the house.

I felt really, really lost. I had very little confidence in my basal rates, or insulin to carb ratios. I had no idea whether it was my basal rates, or my insulin to carb ratios that were sending me low. I no longer felt safe leaving the house for half an hour without a meter and tonnes of skittles to fall back on. I’m pretty sure I had made the connection between physical activity and my lows, but I just felt far too overwhelmed at the thought of fine tuning everything once again.

I was nervously pacing up and down on a Friday night in December, deliberating over a site change or a Lantus injection. I was equally scared about going back to using Lantus, given how uneven and inconsistent it had been for me in the past. What finally got me over the line was telling myself that insulin pumping was no longer working for me. I knew that it was the source of all of this frustration, and that I didn’t need to use it if I didn’t want to.

The days that followed were quite honestly the happiest I’d felt in several weeks. The freedom from that annoying chunk of a pump, and the relief from not having to stress about basal insulin sending me low from a short walk. I was honestly so happy at the time, I was convinced that this might be the way forward for me. I was so relieved, I kept telling myself how much better injections were compared to the last few weeks I’d had on the insulin pump.

I went from having days like this.


To having days like this.


I anticipated I’d probably only last a few days without my pump. But injections were going surprisingly well for me. Everytime I stared at my pump, I just knew that I didn’t feel ready to hook back onto it. At the one week mark, I even stashed it in a drawer because I didn’t want to look at it.

My pump break gave me some much needed time to clear my head. I plugged back in for a few days over Christmas, because I knew that I would need the temporary basal rates and extended boluses to help me cruise through all of the food. I was fully prepared to take it off again after Christmas, but quite honestly I haven’t felt any desire to do so since.

I’ve been setting temporary basal rates around physical activity, and they seemed to do the trick from the get go with minimal hiccups. I’ve been setting a -30% temporary basal rate before I get into the car to go to the shops, and switching my insulin delivery to “off” for half an hour if I go for a short walk around the block in the afternoon. I think I’ve had about 2 or 3 hypos in the New Year, which is not only a big relief, but tells me that I must be doing something right. 

If it weren’t for Christmas, I’m not sure whether I would still call myself an insulin pumper today. In those two weeks, I was absolutely fine with the possibility of going back to injections permanently if that was what worked best for me. 

At the moment, things are travelling well with the pump. Things are making sense once again, and I honestly have not felt any desire to be without it since Christmas. 

Could this change again down the track? Who knows? This is diabetes, after all…

What I have learned, however, is that I absolutely will not hesitate to take a pump break if the need arises again.

My diabetes, my rules…

The First Hypo of 2017

7 Comments

I went seven days into the new year without a hypo. And then this happened…

My blood sugar level was 8.8 an hour after dinner on Saturday night. I let things be and went about brushing my teeth, clearing the debris of diabetes waste on my desk, and putting away the clothes and shoes I had worn earlier in the day.

When I checked my blood sugar an hour later, my meter came back 19.8. What? I couldn’t believe I had risen so quickly in such a short space of time. I probably should have tested again, just to be certain.

I entered the reading of 19.8 into my insulin pump so that it could suggest a correction dose for me. I reactively overrode my pump’s suggestion, giving the whole correction dose and ignoring insulin I had on board.

When it was time for bed, I suspected as much. Sure enough, my meter came back with a 2.9. I reached for my insulin pump, which told me I had 3 units of insulin on board to eat my way out of.

I shoved four Chocolate Cream biscuits into my mouth, struggling to recall how many I had eaten by the time I got to (what I think was) number 4. Side note: Christmas biscuit tins are proving to be awesome hypo supplies. Unless they’re tins of shortbread. Shortbread is simply too good to waste on hypos…


I shuffled into the kitchen to weigh one of the biscuits, just to be sure that the serving size was right and I had eaten enough carbs.

As I lay down on my bed, and placed the back of my head on the pillow, the hypo really hit me. The sweat, the shakiness, the feelings of exhaustion, the paralysis. I didn’t want to do anything else other than lie there, willing my eyes not to shut.

Those hypo feelings weren’t subsiding, but almost half an hour had passed and I knew it was time to check my blood sugars again.

My meter came back at 1.8.

I frantically shoved another 2 biscuits in my mouth. My hypo brain decided that those Chocolate Cream biscuits needed to washed down with a glass of Cadbury drinking chocolate. I shuffled my way into the kitchen, driven only by the cravings of chocolate milk. Stirring the powder and the milk together in my glass was absolutely painful. Making sure I scraped every visible bit of powder stuck to the bottom of my glass in my stirring action, and waiting for it to come to that perfectly blended consistency before I could skull it down.

Satisfied, I shuffled back to my bed, once again waiting. The next check came back at 3.6, followed by a 4.7 minutes later. I knew I had overtreated. Not wanting a repeat of the night’s events, I set consecutive alarms for the next three hours until I had brought my levels back into range.