That Time I Almost Ran Out of Insulin

The eighth annual Diabetes Blog Week took place last week, and today I’m jumping in late and answering the Wildcard prompt.

Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realise that things can (and will) go wrong.  But sometimes the things that go wrong aren’t stressful – instead sometimes they are downright funny!  Go ahead and share your Diabetes Blooper – your “I can’t believe I did that” moment – your big “D-oh” – and let’s all have a good laugh together!!

One day, a good couple of years ago, I went on a day trip with my family to Rottnest Island. I’ll say I’d had diabetes for a year or two at the time.

In the beginning, I was just full of attitude when it came to my diabetes. I didn’t want to admit that my condition had changed me. I didn’t want to admit that it made me different. I hated the thought of relying on a meter, insulin or jellybeans as a just-in-case. It felt weak. It felt like I was giving into my condition.

So, you can only imagine how this teenager with attitude reacted to his parents nagging. Whenever we were travelling somewhere distant, Mum and Dad would nag me.

Have you got your stuff?

Frank, I’ve got a bag here if you want to put anything in it.

Have you got all your stuff?

You get the idea. Cue lots of eye rolling and humming over their voices.

So, we were waiting to board this ferry on a day trip to Rottnest Island, when I suddenly realised that I didn’t have much insulin left in my pen. It wasn’t empty empty, but there was probably only enough in there to cover a meal. I think I gasped, or made some sort of expression that made Mum and Dad aware of the situation. Aside from a few remarks of I asked you if you had all of your stuff!, I don’t remember them getting super mad.

We did have some time up our sleeve before we had to be on that ferry. Dad suggested that if I found a Pharmacy and explained my situation, I’d probably be able to get some insulin. Of course, yours truly stubbornly said that he’d be fine and make it last the duration of the day.

I remember stopping at Dome for a coffee when we arrived, and not having anything. After some wandering round, we stopped for some fish and chips at lunchtime. I knew that if I just ate the fish and left the chips, I would be able to get away with minimal insulin. Of course, yours truly decided to eat his chips as well and ride the minimal insulin and high blood sugars out until the end of the day.

I can’t recall my pen actually reaching it’s threshold that day. I do remember checking my blood sugar on the ferry ride home and getting something like 16. I do remember thinking about getting home and being able to give a correction, which makes me think that my insulin pen did run out that day. But then again, perhaps I was just too self conscious to inject a correction shot on the ferry. Who knows…

What I do know, is that this was the silliest and most irresponsible thing I have ever done with my diabetes. So many things could have gone wrong that day. The ferry could have broken down, leaving me stranded on Rottnest Island, or somewhere inbetween without insulin. The fish and chips could have sent me into ketones if I didn’t have the insulin to cover them, with limited medical assistance available to me while I was offshore.

But I also laugh at this story. Whenever someone tells me that they’ve left their insulin at home or done something irresponsible, I usually refer to this story. I remind them that they can’t ever be as irresponsible as I was that day. I hope I make them feel a little bit less guilty.

On a sidenote, seeing this prompt among the Diabetes Blog Week topics has had me thinking of this blooper all week long.

To read other responses to this prompt, click here.

One Year Pumping!

I’ve now officially passed the one year mark since I began using an insulin pump! It was a huge leap of faith at the time, but one that I knew I had to make for the sake of lower and more stable blood sugar levels.

The biggest reason I switched was because I never felt I could get my background insulin dose quite right. Some nights, particularly if I ate more than normal, my Lantus dose wouldn’t be enough to keep my levels steady. Other nights, it would be too much and send me low.

Today, that problem is all but gone. The pump delivers a basal rate of insulin that can be customised to the time of day. I have a higher rate running from 1am to mid morning to offset dawn phenomenon, and a flat rate running through the remainder of the day. Night time basals have been the most challenging, with upward tweaks needed every month or two. But thankfully, the remainder of my basal rates have remained unchanged since I first figured them out last year.

Before I started pumping, I was guesstimating a lot of my insulin doses. I guess I wasn’t very motivated to do otherwise. I wasn’t really thinking too hard about what I was putting into my mouth, and there were a lot of emotionally exhausting highs and lows.

I began diligently counting carbohydrates and weighing my food since starting on the pump, and surprisingly I haven’t slacked off since! With a properly tuned basal rate, insulin just worked when I bolused to cover meals, rather than staying frustratingly high. The pump’s bolus calculator was extremely helpful, and of course having the pump attached to me made bolusing a lot more convenient when out and about.

As anticipated, the pump was a huge learning curve. My biggest hurdle in those first few months was site failures. The 90 degree insets that I was using at the time continually failed on me, causing regular bruising and bleeding on the stomach. I’ll always remember one tumultuous night where I ripped out my infusion site to discover the cannula had kinked on the way in. I eventually switched to the comforts which sit on an angle and have a manual insertion. Today, site failures are rarely an issue. 

The insulin pump is hands down more work than injections. Infusion sites need changing every three days, insulin cartridges need to be refilled, pump lines need to be inspected for air bubbles, batteries need changing, and basal rates need adjusting for activity. You really need to be on top of your game with a pump, and that might not be a commitment everyone is able to make.

The insulin pump definitely gave me a renewed drive to better focus on what was some very lousy diabetes management.

From there, the rest of what I’ve achieved is down to my dedication to observing and learning more about my diabetes and the different variables that affect my blood sugar. So in this regard, I feel that I could just as easily have reached this level of management on Multiple Daily Injections as well.

I can’t express just how much of an investment this was – and I’m not sure I would have been able to do this if I were still at uni or had a more demanding job. But overall I now feel more knowledgeable, equipped and experienced to navigate my way through different scenarios. This level of management no longer feels like such a stretch.

While I don’t talk numbers on this blog, I will share that it took me six months to get my hba1c to where I wanted it to be. When I first hit that target in November, I really felt like I had squeezed everything out of myself to get that number. Today, I’ve been able to comfortably maintain that number – and hopefully even better it going forward.

It’s been a huge year for my diabetes, and one that I feel is definitely worth celebrating.

Happy pump-aversary to me!

(And here’s hoping diabetes is a bit easier on me this coming year)

In an Ideal World

In an ideal world, my meter would produce a magical 5.5 while I’m fasting.

In an ideal world, I could select any spot on my stomach for the placement of an infusion site.

In an ideal world, my blood sugars would respond to potatoes in exactly the same fashion as yoghurt.

In an ideal world, I could fall asleep knowing that my blood sugar will stay stable all through the night.

In an ideal world, I could go for a walk and not worry about my blood sugar dropping.

In an ideal world, I wouldn’t have to worry about rage bolusing every time I’m sick or I’m stressed.

In an ideal world, my levels would steadily rise and then fall back into line after I eat.

In an ideal world, my blood sugar wouldn’t be affected by protein or fat.

In an ideal world, I would be able to feel every oncoming hypo.

In an ideal world, my basal insulin needs would be identical through each hour of the day and the night.

In an ideal world, a diabetes healthcare professional would spend a whole day with me if need be.

In an ideal world, I would have been encouraged to consider technology by my diabetes team.

In an ideal world, everyone who wishes to use an insulin pump would have one.

In an ideal world, a Continuous Glucose Monitor would be subsidised for those who want to use one.

In an ideal world, insulin wouldn’t be so fucking expensive.

In an ideal world, insulin wouldn’t keep getting more fucking expensive.

In an ideal world, access to medication and basic healthcare wouldn’t be determined by my location or income.

In an ideal world, diabetes and pharmaceutical companies would have the best interests of people living with diabetes at heart.

In an ideal world, I would be excited about the artificial pancreas systems hitting the market next year.

In an ideal world, nobody would feel isolated or different for having diabetes.

In an ideal world, I would have perfect management of my diabetes.

The Blame Game

It’s day 3 of the eighth (and I just had a dumb moment where I had to google the spelling of the word eighth) annual Diabetes Blog Week. The idea is that bloggers sign up to write about a set topic each day for a week, and readers get a variety of perspectives on each topic. Here is today’s prompt:

Having diabetes often makes a visit to the doctor a dreaded experience, as there is invariably bad news of one kind or another.  And sometimes the way the doctor talks to you can leave you feeling like you’re at fault.  Or maybe you have a fantastic healthcare team, but have experienced blame and judgement from someone else in your life – friend, loved one, complete stranger.  Think about a particularly bad instance, how that person talked to you, the words they used and the conversation you had.  Now, the game part.  Let’s turn this around.  If you could turn that person into a puppet, what would you have them say that would leave you feeling empowered and good about yourself?   Let’s help teach people how to support us, rather than blame us!

I think I’m fairly open about my diabetes. People see me check my blood sugar. People see me exiting, and re-entering the room with a mouthful of skittles. People see me pull out my insulin pump. People see me swipe my arm. I’ll bring up diabetes if it’s relevant to the conversation. I’ve even been caught out on the odd occasion with my shirt up and staring at the infusion set on my stomach!

Yet I find it odd how little they actually ask me about it. I find it surprising that they’re not tempted to ask. Are they scared of stepping on eggshells and offending me? Or is it simply the nature of an invisible illness, that they just don’t notice? I guess it could mean that they don’t automatically see diabetes when they look at me, which is great because there is more to me than just my diabetes.

Yet as much as I don’t like to admit it, diabetes can be isolating to live with at times. Moreso in social situations where others get to be carefree, while I have to worry about carb counts and pockets full of supplies and going low.

I wish I was asked about my diabetes more often. Yeah, I know this is a double edged sword…

Because I also hate having to answer the same old questions, and addressing the same old stereotypes. I can’t stand the looks of pity or sympathy as I talk through some of the things that I have to do. I can’t stand being compared to her husband’s father who suffered at 90 years of age. I hate having assumptions made about me. I hate that I’m only ever asked about my diabetes when I’ve got a plate piled high with desert.

Instead of assuming that sweets are bad for me, how about asking me about what I have to do when I eat them?

Instead of telling me about your elderly relative who had diabetes, how about asking me how I manage or live well with mine?

Instead of giving me looks of pity and sympathy, how about commending me on how proactive and educated I sound?

I want to be asked about diabetes. I’m happy to talk diabetes with you. I just feel like a conversation would be so much more productive without all of the assumptions, reservations, or family comparisons thrown into the mix.

To read other responses to today’s prompt, click here.

Travelling Prepared With Diabetes

Today kicks off the eighth annual Diabetes Blog Week. The idea is that bloggers sign up to write about a set topic each day for a week, and readers can get a variety of different perspectives on the one topic. Here is today’s prompt:

Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.  What are your best tips for being prepared when the unexpected happens? Or, take this topic another way and tell us about some good things diabetes has brought into your, or your loved one’s, life that you never could have expected?

When I was first diagnosed, I had this attitude that diabetes wouldn’t weigh me down. Quite literally. I wanted to prove that diabetes hadn’t changed me. I wanted to prove that I didn’t need to carry a meter, insulin or jellybeans with me as a just-in-case. It felt weak. It felt like giving into my condition.

So if anyone knows a thing or two about how to travel un-prepared with diabetes, it’s me.

I once boarded a ferry to Rottnest Island, only to discover that I had bugger all insulin left in my pen  cartridge. Instead of trying to find a Pharmacy, I decided to wing it and somehow lived to tell the tale.

i remember going hypo on a Friday morning at work, with nothing to eat other than an overripe banana. Yuck.

I discovered a failed infusion site while I was away from home painting a house one Saturday afternoon, and had to drive home in the pouring rain to change it.

When my insulin ran out halfway through a lunchtime dose, I winged it again, probably running high until hometime.

When I suspected spoiled insulin earlier this year, I had to call my Dad to run some up to me work.

When it comes to travelling prepared with diabetes, my biggest dilemma is deciding whether I actually need to carry those supplies with me, or whether I am simply preparing for the zombie apocalypse.

I like to travel prepared. But I also like to travel as lightly as possible. Us guys don’t exactly have the luxury of handbags…

I’ll often stand in front of my desk before heading out, debating over whether I need to bring this with me. I’ll tuck things in my pockets. Then I’ll take things out because I feel weighted down and over prepared.

I’ve tried the whole keeping supplies stashed in different places. You know, desk drawers, lockers, in the car, in my satchel. In theory, it sounds like a great idea. The only problem is you begin depleting those supplies. And you have to remember to keep topping them up. Not ideal, either.

I’ve recently invested in a small, tube shaped pencil case. I keep all the essentials in there. A meter for travel, spare supplies in case of a pump failure, insulin, and hypo food. Those are my essentials. Nothing more, nothing less. I grab that case every time I leave the house. There’s no more dillemas over what to bring, or what not to bring. It’s not big, bulky or akward to carry. It can even stay in the car if it’s going to annoy me while I’m out.

There’s no easy answer to travelling prepared with diabetes.

You learn from experience.

And you do get better at it over time.

To check out other responses to today’s prompt, click here.