Hello Again Insulin Pump

About a week ago, I decided to go back on the insulin pump. We're beginning the process and I'm really excited. It's been three years since I went off pump therapy and returned to injections. But now I think I'm ready to go back.

Nursing school is making me a better diabetic. Mostly because it's instilling the fear of God in me. During clinical yesterday, I had a 55-year-old patient (who looked 75) with a host of problems, including type 2 diabetes. It's terrifying to see firsthand the complications these patients suffer.

Yesterday was really overwhelming. I cried several times throughout the day without a real reason as to why. I've been having trouble coping with seeing such sick, sad people in the hospital. My patient was incredibly obese, he had been in a hospital bed for over a month after back surgery (so he had developed pressure ulcers on his back), he had osteomyelitis (infection of the bone), MRSA and his right lower leg was blackish-purple (maybe caused by diabetes). He was agitated and rude to the PCA. Although, he was nice to me.

When I see patients like this, I feel haunted by the thought of a life being diminished to nothing but lying immobile in a hospital bed, people constantly feeling sorry for you and being afraid of you. I just kept thinking, "What is this man's life, if anything?"

For the bad moments, however, there are also good moments in the hospital. Such as the 91-year-old who serenaded my other clinical partners and claimed, "They told me to watch out; they put all of the pretty girls in red!"

This has been really hard but I know I can handle it.

Anyway, I should be back on the insulin pump in a month or two. I really can't wait.

I want to worry less about diabetes complications. Oh, and I want to take 12 injections a month rather than 120!

P.S. This is my 200th post!

Tetris and Diabetes

I got back from diabetes camp on Saturday. I was the senior counselor for the 12-year-old girls and I fell in love with all ten of the them (yes, there were ten and yes, I was exhausted). I miss everyone so much, already.

The picture above (courtesy of Marci) is from the camp dance--this year, the theme was "Blast from the Past." So fellow counselors, Kat, Jacob, Marci, Duffy, and I decided to dress up as Tetris pieces.

As you can see, I was the green square. And the five of us didn't really fit together at all. But I think it turned out looking sweet (and we were pretty much celebrities at the dance--everyone wanted a picture with us assembled together)...












How are we possibly going to top this next summer?

The Good

I strongly believe that out of bad, there can come good. And I saw it this week...

Friday, my sister Sarah had coffee with my Nurse Practitioner, Shannon. Shannon has been my NP at Children's Hospital since I was diagnosed with type 1 diabetes and, every three months for the past four years, I've seen either her or my endocrinologist (my favorite endocrinologist, Dr. R., however, was recently offered a job as Head of Endocrinology at another children's hospital so he'll be leaving me). My sister was meeting with Shannon this week to discuss Yale--Shannon graduated from Yale's Nurse Practitioner program and became the influence and encouragement for my sister to apply there, as well.

So, I became a diabetic >> I met Shannon >> Sarah met Shannon >> Shannon gave Sarah the courage to apply to Yale >> Sarah grew some balls, applied and was accepted. And come Fall, she's going to go through a great program that will help to make her an awesome NP one day.

"Revenge is fucking sweet"

Watch Jason Statham in "Diabetes" and more funny videos on CollegeHumor

The best video I've ever seen. Thanks, Bear.

It's My Diabetic Anniversary

March 21st was the four year anniversary of my diagnosis! I have lived with juvenile diabetes for four years. It's simultaneously unbelievable and just plain normal.

Tonight I'm celebrating with Brandon, my DFF (Diabetic Friend Forever), and cake!

One day, I hope to be celebrating my four year "un-diabetic" anniversary instead!

"A lack of education is equally as dangerous as a lack of insulin"

It's a long ways off...but I have officially decided to apply to volunteer with AYUDA (American Youth Understanding Diabetes Abroad) in the summer of 2010. I've mentioned the organization before--their mission is to educate and help diabetic children in developing Latin American countries.

This summer, I'm going to start fund raising. I'll need to tackle an overwhelming fee of $4,500. Additionally, since my Spanish-speaking skills are absolute garbage, I'm looking into some non-credit classes during next school year.

I'm really really excited to get started. I'll keep everyone updated!

Perfect blood sugar

This morning, after spending a ridiculous night on the Ohio University campus, my blood sugar was 98! Yay! I rock.

I then proceeded to stuff my face with a large breakfast from the Big Silver Diner. Which shot me up to 269. Damn.

Oh well, I'm still a beast for that 98!

(By the way, 70-120 is considered a good blood sugar.)

Halloween is truly evil

It's Halloween weekend! As excited as I am to celebrate - I've concluded that there is no other holiday or event that sets a diabetic up to fail so miserably. At least, a diabetic college freshman like me. Offerings of beer and candy are rampant! And, even more cruel, tomorrow is the beginning of National Diabetes Month.

So after we drink and eat ourselves into a coma tonight - and our blood sugar can't decide whether to go up from the candy or down from the alcohol - we get to wake up to celebrate healthy diabetes awareness! Woo-hoo.

Oh well, I'm still looking forward to this weekend! I'll try to be good. Happy Halloween!

Halle Berry cured diabetes!

Amazing!

Was she among the thousands of scientists creating an artificial pancreas? Maybe she was one of the researchers manipulating stem cells to form pancreatic beta cells? Or, perhaps, she helped design a drug that utilizes a virus to intentionally infect cells with DNA to carry on insulin production?

Oh, no...her miracle cure is far simpler than any of that: all you have to do is "ween" yourself off of insulin! According to Halle, in this manner, an insulin-dependent diabetic (type 1) can magically transform into a non-insulin-dependent diabetic (type 2).

Holy shit! Why didn't anyone tell me about this before? The doctors said the insulin-producing cells in my pancreas were dead...but, if I follow Halle's expert advice, I can now bring them back to life! And it's as easy as taking less insulin - that useless glucose-absorbing hormone which I don't truly need.

Halle, you may be more attractive than Wilford Brimley, but you're an extremely poor spokeswoman for diabetes - both type 1 or type 2. Please educate yourself.

Bionic Woman

At every three-month endocrinology appointment, my doctor routinely asks if I have considered returning to insulin pump therapy. And I always politely say no.

I remain strongly anti-pump for a couple of reasons:

When I was on the insulin pump two years ago, it just did not work for me. For many people, it helps to improve diabetes control - but I didn't improve at all. Plus, the pump was a bigger hassle than it was worth - door knobs ripping out the tubing, scar tissue build up, allotting an hour of time to numb the injection site, irritating alarms beeping at three AM, disconnecting when showering, etc.

But, by far, my biggest turn off is how terribly conspicuous the insulin pump is. Illustrated by this picture of the continuous glucose monitoring system (the latest "improvement" in pump technology):



The smaller sensor checks your blood sugar every few minutes and relays the information to the pump, which responds accordingly - increasing or decreasing insulin.

It would be cool to, essentially, have an external pancreas that does most of the work for me...but I maintain that I will not go back on the insulin pump while it makes me look and feel like freakin' Bionic Woman.

One day, when the technology is perfected and the device is so discreet that only I can possibly know about it...I would love a sweet bionic pancreas.

Don't Pass Out

It's very rare that I have a day where I truly hate having diabetes. Yeah, it sucks but it's a waste of energy to spend time hating it. However, during my Psychology class yesterday...I really really fucking hated my diabetes.

While my teacher was lecturing, I noticed my hand was shaking a little as I was writing. I hadn't felt it yet but I knew immediately it was a sign my blood sugar was dropping. That's when a mental image of Frosted Flakes popped into my head. Fuck. I suddenly remembered that, in my rush that morning, I had taken five units of insulin but I had forgotten to eat the bowl of cereal. As my worry sunk in, I gradually felt the low blood sugar sinking in, as well. My next thought went to my blood sugar meter...which I had left in my room. Along with my glucose tabs. And my emergency glucagon shot. Double fuck. My wrist was also bare...I had forgotten to wear my medical identification bracelet.

Then I did something incredibly stupid: I just sat there...trying as hard as I could to ignore my low BG. The very last thing I wanted to do was to stand up and call attention to myself in front of 60+ strangers. So I sat silently for over ten minutes, shaking and feeling everything drain out of me (it kind of feels like running 10 miles without having eaten all day). Don't pass out don't pass out, I repeated over and over in my head.

But the panic rising in my chest finally compelled me to ask for help. Reaching my teacher's desk, I asked stupidly, "Is there a vending machine around here?" When she began to explain, however, I blurted out, "I don't have any money." I felt terribly aware of how helpless I was when I admitted at last, "I have a low blood sugar." And with that, tears suddenly began pooling in my eyes. I didn't know this woman I was crying in front of and I didn't know a soul in the entire class...which only intensified my embarrassment and panic.

Pausing the lecture, my teacher led me toward the exit but not before I had to turn to face the entire lecture room, filled with people staring at me curiously. Quickly, my teacher flagged down a Coke and, glancing at my wobbly knees, directed me to sit on a bench in the hallway (Thank God she wasn't one of the people who tries to offer me a stick of chewing gum). For the next ten minutes I gulped down the entire Coke, impatient for the sugar to enter my bloodstream and for my panic to subside. Fortunately, as my blood sugar began returning to normal, my rational thoughts began to return, as well. Why did I sit there for so long? Why didn't I have any sugar with me in the first place? Wow, I'm an idiot.

It just made me so angry that all of my seemingly little mistakes had brought about this awful situation. If only I'd simply remembered to eat my Frosted Flakes. Or to stick my glucose tabs in my backpack. Ugh...I'm not going to let that happen again.

Oh Shit

If my blood sugar meter could speak, that is what it would say. Because, lately, my blood sugars have been pretty terrible. I'm either waking up three times in the middle of the night from a low BG (blood glucose) to chug apple juice or I'm taking a million units of insulin to correct for a high BG.

The good thing, however, is that I'm constantly surrounded by people who are looking out for my safety. Everyone is well aware of my diabetes. At Andy's party on Friday, upon noticing that I'd forgotten to wear my medical identification bracelet, Will took a Sharpie to scrawl "I have diabetes type 1" across my forearm. And at a party on Saturday night, my diabetic friend Brandon tested my blood sugar for me, retrieving my glucose tabs to make sure my BG didn't drop.

Well, aside from the poor blood sugars, I really love college. I'm having such a great time...I love everything so far. However, that might change as my homework load increases...which it most certainly will by the end of the week!

It's not 10.0

I did it! My A1C is 8.7!

Sorry, that's diabetic lingo. A1C is short for "Hemoglobin A1C" and, essentially, it determines how well I've taken care of my diabetes in the last three months. Think of it as a grade on a report card. Every three months at my diabetes check up, the nurse takes my blood which is fed into a computer that determines my A1C in the form of a number (it can range between 4 and 14). A healthy non-diabetic would have an A1C around 5...so 5 is great. To be below 7 is considered good for a diabetic...but once that number begins to creep up...you're in real trouble.

I'd been in trouble for the last year or so because my A1C had steadily been getting worse and worse. At my last appointment in June, my A1C was 10.0 (think of it as an F+). Basically, that A1C reflects dangerously poor control of my blood sugars. I'd never reached a number that high before and it scared the shit out of me because if you allow your A1C to remain that high for a long period of time you're at an increased risk to suffer complications.

Nothing like the threat of losing a kidney or a foot to kick your ass into high gear. After that, I tried harder to keep my blood sugars under control although I definitely didn't always do a perfect job. I know 8.7 isn't an ideal A1C but it's a big improvement. It's a C- if you look at in terms of grades. And still I'm so happy that I'm doing better.

I also found these videos that are kind of cool...



This is a PSA to encourage diabetics to check their A1C...



Here is the same PSA reversed...It's so weird, the guy is saying everything backwards! It's hilarious at the end when he has to trip out of the shot.

I.A.M.D.I.A.B.E.T.I.C

This video is only hilarious if you've heard the original rap "Independent" by Webbie. And if you've ever had diabetes.

Cure...

My new tattoo!

AYUDA

I've been a juvenile diabetic for over three years now. I was about to turn fifteen when I had to spend a week in the hospital learning how to take care of my new disease. Fortunately, my health insurance covered 100% of the hospital bill, which was $40,000 ($10,000 a night). The hospital stay, although incredibly expensive, factored significantly in establishing the system I have for managing my diabetes and maintaining my overall health.

An entire team of endocrinologists, dietitians, diabetes educators, psychologists and nurses educated my parents and me on the facets of managing diabetes, such as counting carbohydrates, injecting insulin, and treating for "lows" and "highs." They also emphasized the importance of tight control of my blood sugars in order to prevent future health complications. And luckily, during routine blood work, my doctor discovered I also had another endocrine disorder, hypothyroidism, for which I was immediately placed on medication.

My health insurance covers the cost of all my daily supplies and medications - short-acting insulin, long-acting insulin, needles, lancets, pens, testing strips, blood sugar meter, Levothyroxine, etc. They also pay for my quarterly appointment with my endocrinologist at which we monitor how well I'm managing my disease and fine tune my treatment plan, if necessary.

And you know what...I take all of this for granted.

Last summer I came across a website for an organization called AYUDA, which stands for American Youth Understanding Diabetes Abroad. The mission of AYUDA is to create programs for diabetics and their families in poor, Latin American countries; places where there is little education on proper diabetes treatment and soaring expenses on necessary medical supplies.

In Latin America, the outlook for a diabetic is much different than in the United States. In most cases, these kids don't get anything near the treatment that I receive. There is no fancy children's hospital with a skilled "Diabetes Team" educating these children and their families on how to properly manage diabetes. There is no doctor's appointment every three months to check on a patient's mental and physical health. And there is certainly no guarantee of being able to pay for medicine and supplies.

AYUDA holds a number of summer camps for diabetic youth in Belize, Bolivia, Bermuda and Ecuador where they try to help and educate children who otherwise might never fully understand or correctly care for their disease. In addition, the organization donates medications and supplies to communities affected by diabetes.

I'm looking into volunteering with AYUDA. Despite the cost (I'd have to raise around $4,000 to pay for the entire trip to one of the camps), this is something I've always had the desire to do. In the future I want to help people who don't have the money for medical expenses or health education that I have. I can't imagine not having my insulin when I need to eat or not having my glucagon when I have a seizure. Or never having learned how to administer a shot in the first place. I'd be dying a lot earlier if that were the case.

In comparison to other diabetics in the world, I've had it incredibly easy. And for that reason I just want to do something, anything for them.

I vant to suck your blood