Dealing with Diabetes

Not Your Ordinary Bag of Shopping

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It was lunchtime on Friday afternoon. Friday is traditionally my I-can’t-be-bothered day, where I buy all of my food and drink for the day. My morning coffee, my morning tea and my lunch. And I really savour those 10 extra minutes that I have on a Friday morning which I normally spend making a ham and cheese toastie, peeling eggs that I boiled the night before, pulling a can of tuna and a packet of crackers out of the cupboard, or wrapping up two slices of Burgen fruit toast and a chunk of butter. I love my Fridays.

As much as I love to just collapse into a chair at lunch time (I’m on my feet most of the day at work), I try to run my errands so that I can head straight home when I’m finished. Usually that involves topping up my supplies at work – muesli bars, coffee capsules, tea bags, my block of dark chocolate, and everything else I eat at home that I forget to add to the weekly shopping list.

My diabetes educator gave me some sample 4mm needles to try with my insulin pens at my last appointment (I’ve been using 6mm for a long time), and they are amazing. I have more freedom to inject in areas where I have less fat on my stomach. The needles don’t irritate my skin so much, and they don’t sting so much in those “skinny” areas. I had intended on burning through my hoard of 6mm syringes first, but I am absolutely sick and tired of them to be honest. Which brought me to a rare workday diabetes errand on Friday at lunchtime. A trip to the Chemist for some 4mm syringes.

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I walked back into the staff room at work with two plastic bags in my hand – the first which contained my “healthy” lunch, and the second which contained my needles, and some hypo-fixing marshmallows. I slapped both bags onto the table, and went off to grab a cup and some water from the cooler.

I walked back to the table with my cup of water, and placed the bag with the needles underneath my chair. When I sat back down, one of my colleagues sitting at the table started to ask me something. She said a few words, none of which I heard, before she stopped. She kindly retreated, smiled, and said “never mind.”

I knew what she was going to ask. I’m certain she had seen the syringes through my plastic bag. Whether she had any clue why, is anyone’s guess. Would she have any idea what they were for? Unlikely.

Maybe she knew what they were for. Perhaps she knew someone with type 1. I would have happily had the diabetes chat with her, like I naturally have with many of my other colleagues when it comes up. However, I didn’t want to make her feel uncomfortable. And, I knew that she was only being courteous to me.

But as I sat there, and began to eat my cheeseburger and chips, I don’t think that she would have had any clue in the world that I had diabetes. Perhaps that’s a conversation for another day.

Perfect Since Never

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Last week, my diabetes educator gave me a new glucose meter to try out while I think about an insulin pump (I wish there was an easy answer to that question). It’s a meter that also acts as a blood glucose logbook, and calculates my insulin doses for me instead of the usual guesstimates. Unfortunately, the new meter uses a different set of test strips. Which means that if I do decide to “adopt” this meter permanently, I have a hoard of test strips (that I’ve put a lot of effort into collecting) that are completely useless. Or, I deplete my old hoard and go weeks upon weeks before I get to finally use my new meter. Wonderful!

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On the day I began using this new meter, I accidentally ripped open one of the test strips belonging to my old meter from its foil packet. I realised before it was too late, and put the unused strip back into it’s foil packet and tucked it away for next time.

Yesterday afternoon, I decided I’d use my old meter for the “odd” afternoon test. It was around 3 in the afternoon, and I’d just come home from work. I’d had lunch and given my insulin just over an hour ago, but I had a feeling that my blood sugar level might be higher than it should be. I’d probably had a few too many carbs at lunch, thanks to the Muesli bars and Old Gold dark chocolate sitting in my locker at work.

I pulled out that test strip that I’d ripped open from it’s foil packet a week ago. I pricked my finger, applied the blood to the test strip and waited. And this was the result that came back.

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I was in shock. It had been a while since I’d seen a number that low. Normally I test often enough to stop a hypo in it’s tracks, but I’m pretty confident that I can feel one coming on. Add to that the fact that I had just driven home. I couldn’t believe it. I knew that I should have been reaching for the bag of marshmallows on my desk ASAP, but I just could not believe it. 

I was in absolute disbelief.

I ripped open a fresh test strip, and tested again.

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And instantly, everything clicked.

For five years, I’ve been ripping test strips out of their individually wrapped foil packets. Ripping them open at just the right angle, to get the right end of the strip out first to stick into the meter. Without thinking twice about it.

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But it took me until today to realise that those test strips are individually wrapped in foil packets or stored in capped vials for a reason. I guess the outside air, light and temparature can wreak havoc on the results.

I love that after 5 years, I’m still learning something new about diabetes every day.

And, also this quote from Tuesday’s #OzDOC Twitter chat, just because I think it sums up diabetes perfectly.

Happy Thursday!

My Day From The Glance of a Glucose Meter

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At 5.48, you saw me walk into the kitchen.

By 5.48, I had discovered that I was a slightly hypo 3.6. Then I walked into the kitchen.

At 6.25, you saw me eat breakfast.

By 6.25, I had calculated an insulin dose for the slice of Burgen fruit toast and Latte that I intended on having, and a fix for that hypo. Then I ate breakfast.

At 8.54, you saw me return to my work area.

By 8.54, I had checked that my blood sugar level was okay after breakfast. I had corrected that 11.3 with one unit of insulin. Then I returned to my work area.

At 10.23, you saw me come in for morning tea.

By 10.23, I had calculated an insulin dose for the banana and latte with a half sugar that I intended on having. Then, I came in for morning tea.

At 12.59, you saw me come in for lunch.

By 12.59, I had discovered that I was slightly hypo again. I had calculated an insulin dose for the Burgen bread toasted sandwich, muesli bar and 2 squares of dark chocolate that I intended on having. I had factored a fix for that hypo into my insulin dose as well. Then, I came in for lunch.

At 3.28, you saw me come out of my room after getting dressed.

By 3.28, I had discovered that my blood sugar was 5.2 after lunch, with one and a half hours of active insulin still on board. Then, I came out of my room after getting dressed.

At 4.01, you saw me go to sit outside with (another) coffee.

By 4.01, I had checked my blood glucose level once again. I had decided not to bolus for the coffee I intended on having. Then, I went to sit outside with that coffee.

At 5.57, you saw me sitting down at my desk.

By 5.57, I had sworn multiple times at my latest blood sugar reading of 19.8. I had rage corrected with 10 units of insulin. Then I went to sit down at my desk.

At 6.30, you saw me come in for dinner.

By 6.30, I had rage bolussed another 10 units for that plate of high GI risotto we were having. Then, I came in for dinner.

At 8.27, you heard me watching television in my room.

By 8.27, I had begrudgingly forced myself up to check my blood sugar level. Then I went back to watching television in my room.

At 9.29, you could hear that I was still watching television in my room.

By 9.29, I had begrudgingly forced myself up to check my blood sugar level once again. Then, I went back to still watching television in my room.

At 9.58, you heard me switch off the light and go to bed.

By 9.58, I had corrected my bedtime blood sugar reading of 4.3 with two marshmallows. Then, I switched off the light and went to bed.

At 11.59, you assumed that I was asleep.

By 11.59, my alarm had woken me up for my middle-of-the-night blood sugar check. 5.3. Then I was asleep.

Today, I did all of this without you even noticing.

Then tomorrow I’ll wake up only to do it all over again.

Taking Words, and Actions, To Heart

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I’ve always been the kind of person who takes a lot of what others say to heart. And letting those little things get to me is sometimes my biggest downfall.

I woke up yesterday morning feeling pretty good. Things were getting back on track diabetes wise, I’d had a decent night’s sleep and I was ready to take on another day. I got to work, and it was all smiles and laughter with my work Mums as usual. “Dobro utrov, ca cosi?” Which is Macedonian for “good morning, how are you?” It’s one of the little perks that I love about getting to work in the morning.

But after I’d started work yesterday morning, there was one small comment that was enough to turn around my mood, and my day. What was said isn’t as important as the way in which it affected me. I hate how much I took that comment to heart. I hate my behaviour that followed that comment. My moodiness, my negativity, and my stubborn refusal to let that comment go through the morning. While it may have taken somebody else to make that comment, it was me who chose to let that comment ruin my day. And I hate myself for it.

And in a weird way, my attitude towards that situation yesterday kind of parallels my attitude towards diabetes. Every decision that I make has an impact on my diabetes. Every item of food that I eat. Every drink that I put in my mouth. Every place that I choose to visit. Every activity that I choose to do. I carry diabetes along with me, every step of the way. Whether I like it or not.

And it only takes one insulin dose. One finger prick. One really high blood sugar reading. One anger fuelled over correction. One weakening hypo. One handful of jellybeans. One small action is enough to throw my diabetes sideways, and turn my day upside down. It’s enough to make me angry. Teary. Emotional. Moody. It’s enough to make me beat myself up for hours. It’s enough to ride me with guilt for the rest of the day. It’s enough to make me lose my motivation.

I got some wise words of advice from some friends in the staff room later in the day. I know the real truth surrounding that comment, and I shouldn’t let anything else that’s said bother me. Let it in one ear, and out the other.

And I know the truth behind my diabetes management, also. I am living with an unpredictable disease. I am stepping into the shoes of a perfectly functioning pancreas, something which is not easy to do. I find incredible strength to step up to that task, each and every single day. I fulful this role to the best of my ability. It’s something that many others wouldn’t even be able to imagine doing. But I am only human. And I must forgive myself when things don’t go as planned, and take away the added wisdom for next time round.

I must learn not to take words, and actions, too much to heart.

Nightly 1am Blood Glucose Checks

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I’ve always based my decision to check my glucose levels overnight on how confident I am that they will remain stable. There have been good stretches where I have enjoyed several weeks of stable numbers through the night. And some wonderfully uninterrupted nights of sleep. Then there have also been some terrible stretches, where I have had absolutely no confidence in my glucose levels whatsoever. Which pretty much sums up the past couple of weeks for me.

I’ve been stuck in a bit of a rut these past couple of weeks. It probably started with a few days of less than perfect food choices. It would have been followed by a couple of days of less than ideal, and even harder to control, numbers. It has resulted in a lack of energy, and some unhealthy habits on my part. Like some late nights, and some extremely long weekend sleep ins. And the longer I’ve let this go on, the harder it has been for me to pick myself up and begin to climb out of this rut.

There is one thing I have done differently during this rut, however. I have taken ownership for the consequences of my unhealthy behaviour these past couple of weeks. That consequence is getting up at 1am every night to test my glucose levels. I’ve dialled up my Lantus dose to cover the added stress, fat and carbs consumed. But I’ve never really felt certain whether my glucose levels will settle, or spike again after I go to bed (mostly the latter).

There’s no worse feeling than waking up to something like 15. Or even worse, 20. It puts a huge damper on the quality of my day, and the people I interact with. I hate thinking about the fact that my glucose levels have been sitting at those crazy high levels for the better part of 8 hours. I am ridden with guilt when I think about how irresponsible I’ve been, and of all the damage that I’ve done to my body.

During this rut, I’ve managed to catch a lot of those highs at 1am and bring them back down within range by morning. I’m quite proud of that. Having control over those night time numbers has slowly restored some of my diabetes motivation. Gradually I’m getting back into my healthier habits, and my insulin requirements seem to be getting back to normal once again.

By the time I went to bed on Sunday night, I finally felt confident that my glucose levels would not rise through the night. What I did not anticipate, however, was going hypo at 1.30am. But I will still take it as a win. I just need to drop my Lantus dose a tad more, and I should be good to go once again.

Hopefully ready for the start of another good stretch.