Buying yourself Christmas presents is SO not overrated!

This year I am proud to announce that I bought myself a Christmas present: the new Dexcom G4 Platinum Continuous Glucose Monitor.

Ta Da!

This newer model of the Dexcom system I am currently using has a lot of really great upgrades and technology that I cannot wait to start using. Just like the current Dexcom meter I use, this one is made up of two components: (1) the wireless sensor that is attached to my abdomen and (2) the hand-held device seen in the picture above.

As far as I can tell the sensor attached to my abdomen hasn't changed much. I change it once per week and then it wirelessly transmits blood sugar readings every 5 minutes to the hand-held device. The hand-held device, however is definitely different, in a lot of great ways! Below you can already tell the difference between the the one I have been using (top) and the new one (bottom).

The new one is a lot smaller, almost looks like an iPod, and it came in this cool pink color, which makes me feel so much more comfortable to carry around. The screen, I am told, is also in color and comes with upgraded features such as customizable high and low blood sugar alerts and a range of 30 feet from the sensor on my stomach. (The old one had a 5 foot range). Now I can roam a little more freely without taking the hand-held device with me everywhere I go.

I can't say enough about the technology of continuous glucose monitors and the benefits for blood sugar control. Since starting to use the original Dexcom in March of 2011, my overall blood sugar control has never been better and I am even more confident in managing diabetes. Despite still having days when this disease is a real downer, I can't help but be thankful for the resources I do have to make living with diabetes a whole lot easier.

They call me Iron Woman

The other week I was doing my very best to help a good friend of mine out with some assessments for her students. I had finally found about an hour in my day to waltz over to the Kindergarten class to begin to take children out one by one to to do individual phonics assessments. This task included asking each child to participate in a series of "fun" activities ranging from counting how many syllables are in a word to affirming yes or no if two words did or did not rhyme. I really tried my very best to be excited for these children and play up how oh-so-exciting these tasks were ... but completely understood when one little friend started to get a little distracted.

I was sitting at the table with one of the children whose hand started to wander a little closer every second in my direction. Bit by bit I saw his hand stretching further across the table and as I looked up at his eyes I could see that his gaze was fixated on my Dexcom continuous glucose meter. Curiously I watched him for a second and right before he was about to grab my meter I said, "Please don't touch that." He looked up at me with widened dark brown eyes knowing he had been caught!

"But what is that?" he replied. Wanting to stay on task with the phonics assessment I matter-of-factly stated, "It's my medicine," knowing full well that this was barely an explanation. I was ready to move on but this little boy's curiosity wasn't about to end. "Does the side open and you keep your medicine in there?" as he pointed to the rubber encased Dexcom meter.  And right then, I knew we weren't going to be able to move on until I gave him a sufficient answer.

"Actually, I press this little button right here and it shows me a number. There is also a machine attached to my stomach that this part 'talks' to," I stated, ready for a barrage of more questions and possibly even a "Can I see?" But to this explanation my little friend nonchalantly summed up my situation better than I could to any other Kindergartner, "Oh, so you're like half human, half robot. Cool!"

I mean, despite how hilarious this sounds I had to give this 5 year old some credit.  And with the Kinder class' current affinity for superheros, this totally made sense. My little friend just smiled up at me, obviously so proud of his discovery, and all I could do was smile back, smirk just a little, slowly nod, and say, "Yes ... yes I am." And within a split second that answer would suffice for my little friend and we were on to the next phonics task.

I'm not going to lie, I feel pretty cool right now and halfway tempted to dress up as Iron Woman for Halloween next year. 

Zodiac Signs are SO true!

As I flip through the Pinterest app on my iPhone every now and again I see quotes about being born under the zodiac sign of a Scorpio. I can't say that I read my horoscope every day, but whenever I get a free moment to read about traits of a Scorpio, I am thoroughly intrigued. Tonight I came across an article called, "11 Traits of a Scorpio Woman," among many other articles written about the passionate astronomical sign, and couldn't help but laugh and realize at the same time how incredibly true these traits thoroughly described my personality but also even parts of my relationship with diabetes.

Among some of the traits described, these ones really stood out to me ...

1. "Loyalty is in her blood." -- When I truly trust someone I am loyal to a fault. It has been a long hard road for both my family and me to trust each other about blood sugars and diabetes care, but I truly feel like we are there. I've also found an amazing medical staff whom I trust with my life and put my care in their hands. I trust that they will steer me in the right direction, feed me with information that will benefit my diabetes management, and trust me for being on track with my own day to day responsibilities. Without the trust and loyalty I have for these professionals, my diabetes management would not be where it is today.
2. "Independent" -- This has been obvious from day one. I have never felt like I needed someone to watch over me or take care of me, and that no matter what I've always had the strength to pull through, even in the hardest of times. Because of this strength and courage, I've had the ability to take care of myself, when I wouldn't let anyone else in. If you haven't noticed, I absolutely hate being told what to do, but hopefully when I really think things through it turns out to be the right decision.
3. "Determined and Indomitable" -- When I put my mind to something, nothing gets in the way. In everything in life, and even diabetes, when I make goals, I am determined to achieve them. A year ago I was told that to carry a healthy baby, my A1c test would have be below 7.0%. Three months later I had it at 6.3%. It took both minor and major changes to my diabetes care and mental health to get there, but I am happier than ever to have the strength to stay on track.
4. "Marvelous Memory" -- My husband would probably refute this, but with diabetes care this isn't something that can be forgotten. Staying on track with timing of insulin dosages and eating is an absolute must and my conscious brain is always calculating past, present, and future blood sugars, meals, and anything else that could effect blood sugars. I may not be able to remember what I wore to work yesterday or if my husband told me about his Tee Time on Saturday, but I can assure you that my blood sugars for the last 24 hours have been temporarily tattooed into my brain.
5. "Ambitious" -- In this day an age where Type 1 Diabetes care and management is on the cutting edge of technological advances and I am thankful for taking a leap of faith with the available technology for diabetics. Within the year that I started using both the continuous glucose monitor and wireless insulin pump, my A1c level went from over 7% to 6.3%. A typical non-diabetic usually has an A1c of less than 6% and last month I made a goal to get my A1c under that within the next year. This is truly a feat that is rare in the Type 1 diabetic community and ambitious to a "T." But like I said before, I am a goal setter and I like to set that bar high ... 5.9% and below, here I come! 

And here is just one of the many quotes about Scorpios that I read this evening that I couldn't help but share:

A Scorpio woman has her own mysterious personality. She is confident and deep down inside she is quite proud of herself. She hates to think she is borne a woman and so limiting her with a certain social acceptable rules. She is a real woman and despite her innocent and childish looks, she has a spirit of free soul. Many men will make mistake if they think she is a good follower, they are wrong.

A case of the Mondays

Today was one of THOSE mornings, when nothing, absolutely NOTHING could go right. We all have them. And for me, it always happens at the most in-opportune time. First off, it was Monday. Enough said. I was scheduled to travel to Los Angeles to provide trainings for two centers on early childhood curriculum. I of course lingered in bed, as always, because who wants to get out from under perfectly warm blankets? While showering, brushing my teeth, and eating my morning bowl of cheerios and milk my mind was trained on what outfit to wear and making sure I had all of my training materials. I absolutely could not show up 2 hours away, in Los Angeles, missing a single thing.

So I finally get out to my car and wouldn't you know, my new very smart car computer is beeping at me to check the tire pressure. COME ON!! Really?! After one frantic call to my husband, ("Do I really need to take care of this now?") and about 15 minutes of my patience wearing thin (I just couldn't stand the thought of watching this blinking light on my dashboard for the next two hours), I pulled into a gas station to take care of the tire situation. And yes, I pumped air into not one, but TWO tires wearing 3 inch heels and a super-cute black and white dress at 7 o'clock in the morning, all by myself. Go me!

As I made my way back on the freeway, music turned up high, I was finally ready to settle in to what I hoped to be a traffic-free drive to the USC campus in Los Angeles. BEEP ... BEEP .... BEEP. What now? I knew exactly what it was and almost had to laugh, if it wasn't for the panic that runs though my blood when my Dexcom meter is pretty much yelling at me, "Your blood sugar is low." I reach into my purse and sure enough my continuous glucose meter is all but flagging me down and being almost as obnoxious as my tire pressure warning. But unlike the tire alarm, this one isn't something I can ignore, even if I had the patience of a Saint.

Luckily my blood sugar wasn't too low, or anything 3 sugar tablets couldn't quickly fix. I mindfully watched the road and thanked my lucky stars for my Type-A personality that remembered to triple-check my diabetic supplies while making sure I had all of my training materials for the long-day ahead. When it rains, it pours right? As if I didn't have enough to think about this morning, it seems like the blood sugars always have to stop in to remind me, "Hey, we're still here and yes, you still have to be thinking about us!" Thank goodness for my Dexom alerts though, because times like today make it truly hard to stay in-tune with what my body is telling me 100% of the time.

On a good note, my trainings went well and I got a great compliment from my boss's boss. :-) I had just about forgotten all about my hectic morning when I finally had a chance to go to the bathroom at lunch only to look in the mirror and realize the worst of it all ... I had completely forgotten to put make up on this morning. :-/

HAPPY MONDAY EVERYONE! And thank you to all of our Veterans out there, past and present, who have served our great country. 

My Diabetes "Dream Team"

While attending a conference today for Type 1 diabetics, the keynote speaker continually addressed the idea that blood sugar logs are first and foremost for yourself, and secondly for your health care provider. I've mentioned before that during my teenage years with diabetes, when a doctor would ask for a written log of a week or two's worth of blood sugars, my instinct was to lie and fabricate blood sugars that clearly were not accurate. I think there are several factors that have since changed my outlook on sharing this information with my "dream team" of health care providers, including a more mature outlook on long-term diabetes care, a greater understanding of the disease, an increased sense of self-confidence, and a support system of doctors, family, and friends that I care about and trust.

As most of us are probably familiar with the term, "It takes a village .... " this phrase truly epitomizes what I have come to value as THE most important factor in controlling a disease that is so commonly associated with an array of health risks that I know will most likely never affect me. I'd like you to meet my "Dream Team":

Chris Sadler, Physicians Assistant - When I moved from the Bay Area to San Diego, I was determined to maintain contact with an Endocrinologist from up North because for the first time he truly understood my personal struggles. Once I realized this wasn't a reality I could continue for very long, I was referred to Dr. Einhorn's office in San Diego. It was here that I started to see Chris on a regular basis and he continued to be the understanding, supportive, and educated doctor I needed. He is incredibly involved in the diabetes community, always has great advice, and continues to keep me updated (without pressuring me too much) on cutting edge diabetes technology. Today we had a chance to catch up at the TOYCD conference.

Dr. Thomas Moore, Perinatalogist - Now don't get too excited everyone, but when the time is right, of course my husband and I would like to start a family. Having type 1 diabetes certainly does not make this feat impossible and working with Dr. Moore and his wonderful side-kick and diabetes educator, June Fowler, makes the idea of managing type 1 diabetes and pregnancy a lot less concerning. With their help and positive attitude I have achieved better blood sugar management, that eventually will lead to smooth pregnancies. It was so great catching up with them today at the TOYCD conference!

Those who work to make our lives a better place ... I would really like to include a dedication to members of our society who really do work to create solutions for those of us who struggle with the day to day management of diabetes. Today I had a chance to meet Bobby Deen (Food Network star's son, Paula Deen) who works to create recipes for diabetics. During a personal conversation we bonded over having mothers in the food business and the reality that a well-balanced diet and healthy lifestyle should truly be a reality for everyone, not just those with diabetes.

And last but not least, my husband and family. My husband never asked for the added stress and worry that comes with having a spouse with diabetes. His never-ending patience and thirst for knowledge are only two of the many attributes I fell in love with. His support knows no limits when it comes to me, and especially my health. I have also really enjoyed bonding with my family and finally becoming comfortable with sharing information with them as well. It took me over 10 years to be able to openly discuss my struggles and triumphs, and I am thankful for the interest they take and the love and support they give.

My husband, Pearce, and me.

My amazing family (Anthony, Mom, Me, Megan, Dad)

Nana - You have never given up on me. I appreciate you more than you know.

Today I no longer feel the urge to lie. I also do not feel the urge to tattoo the phrase "I have diabetes" on my forehead, but that's not to say that I have also not come to appreciate the journey I have taken to get where I am today. Additionally, I know there is even more to this journey that I have yet to discover. I am certainly not perfect and continue to have my moments of frustration and anger ... as well as extreme high and low blood sugars. Almost every single one of these people has seen me either cry, break down, or turn into a monstrosity of anger and stubbornness. While I am not proud of some of these moments, I sure do appreciate that no one has given up on me. And for that, I am thankful.

Old School

Seeing a vial of medication and needles brings back memories from long before my diagnosis. I remember sitting in the pediatrician's office at age 10 and deciding between me and my sister who was going to get their shots first. I watched the nurse draw the clear liquid from the bottle and waited for the sting. I loved and hated to watch the events unfold of these injections each time. And of course I cried like a baby.

When I was diagnosed and sitting in the hospital bed with a tray of diabetic materials around me (needles, alcohol swabs, test strips, insulin, etc.) I did what I knew how to do: be a good student. I carefully watched the nurse educators describe each object. I was excited in a way to learn more about the purpose of these things. And I so badly wanted to be good at the task that lay before me. I took to my assignments quickly and in a matter of minutes knew how to test my blood sugar, draw insulin from a vial, and carry out an injection. The motions were easy. The emotions are another story ... 

For 13 years I relied on a bottle of insulin, alcohol swabs, and needles. The clear liquid must remain at or below room temperature at all times, but never frozen. The needles are one-time use and must be disposed of according to medical standards. And the alcohol swabs leave your skin feeling dry and irritated. And all of it simply became a part of my daily routine.

It's been 10 months since I've given myself an injection now. I've kept a few needles for "just in case" and the bottles of insulin stay in the fridge and are only used every few days to refill the pods for my insulin pump. Long gone are the days of 4-8 injections per day and feeling the sting of those tiny needles making their way under my skin.

Re-Building Trust

Let me set the scene for what really should have been one of the greatest nights of my life ... On a very romantic whim I decided to surprise my husband Friday night with a evening out downtown. Hotel room, drinks, and food ... just the two of us. We both have had a hell of a summer with demanding jobs which have led to stress and not a lot of "us" time. We started off with a complimentary bottle of champagne from the hotel and then made our way around town, stopping at our favorite places for drinks and appetizers here and there. It was a blast and it just felt so good to be with JUST him, the man I truly love and adore.

I've always been pretty cautious about drinking. I definitely stay away from the sugary mixed drinks, very rarely drink hard alcohol, and only sometimes will I have a beer. I stick to wine because not only do I just love it but I have also come to "understand" what it does to my blood sugars. And when I say "understand" with the quotation marks, drinking can still be hit or miss because you never really know what and how much wine makers are adding to their wines. Nevertheless, a girl's gotta have a vice or two ... and wine is definitely one of mine :-)

Around midnight, once we were back at our hotel I definitely was feeling the effects of the 4 glasses of wine I'd had over the last 3 hours. The combination of feeling the effects of the alcohol with a Dexcom meter that was not giving me proper readings was the perfect storm for not being able to detect THE lowest blood sugar I've ever seen. I just remember having this feeling like something wasn't right and I told my husband, I need to check my blood sugar. I easily found my meter, inserted the test strip, pricked my finger, and 5 seconds later the screen flashed a larger than life 20.

20?!?!?!?!

If you google "blood sugar of 20" you get the following information:

That is a reading that is so low you would likely be unconscious and need emergency hospital treatment. If alert and able to swallow without choking, use a glucose tablet or sugar candy immediately and call 911 if you are diabetic and on oral hypoglycemic medications or insulin.

If you have no symptoms of sweating, shaking, agitation, dizziness or fainting which are common symptoms of hypoglycemia (low blood sugar) and if you are self-testing, it could only mean that your testing meter needs a battery or your strips are expired. Check those things and recheck your blood sugar, if still low seek urgent medical advice.
 
My mind immediately started racing (clearly my brain was still functioning) ... How was I still conscious? How was I alert? How could I even string two thoughts together? I'll tell you what my initial thought was, "That's not right!" So I checked it again ... and this time the monitor just read "LOW," in all caps. That's the reading you get that is supposed to scare you. That's the reading that means, "We're not even going to tell you how low you are, just get sugar NOW!" 

My husband was standing right there and we both reacted so quickly it's hard to even remember the events that followed. Thank goodness I was more than equipped to handle a low blood sugar and I sucked down a sugary gel that was in purse faster than you can imagine. I lay down on the bed, covered in sweat from the adrenaline and effects of a low blood sugar, chewed and swallowed a few more sugar pills just to be on the safe side, and held my husband's hand until I felt better.

I can't entirely blame the wine for this, although I continue to realize that alcohol is just a tricky thing to have to deal with. I was also so caught up in the evening, that I probably wasn't paying as close of attention that I normally do. And it also goes to show that even though the Dexcom technology is great, it's definitely not perfect. I've been through such a range of emotions since the other night from guilt for taking my focus away from my blood sugars, apologetic for taking away from the romantic evening I had planned with my husband, ashamed that my blood sugar even got that low, and mostly fearful that it will happen again. The last 36 hours have been filled with some anxiety and I've been on high alert. After a low like that it's going to take some time to re-build the trust I have in the Dexcom readings and most of all the trust that insulin is here to help and not hurt me.

Battle of the Blood Sugars

War is defined as, "A state of armed conflict between different nations or states or different groups within a nation or state." War is what happens in my body. War is the constant struggle between my body's inability to produce insulin and the constant efforts to sustain my blood sugars. Every day, this war rages on within.

Every time I eat, small battles erupt from within my body, sustained fighting between two enemies that can't seem to figure out that they are fighting for the same side. The food I eat pulls my blood sugars up, using glucose as their weapon, threatening to go higher and higher. The insulin I inject counters the attack, promising to pull my blood sugars down.

Too much food and not enough insulin, a victory for the food, leaves my body feeling like a ravaged battlefield, with heavy limbs, body aches, and in need of relief. Too much insulin and not enough food, a victory for the insulin, leaves me feeling disoriented, dizzy, and confused, like a surprise attack no one saw coming.

And I am the peacekeeper, or so it feels, not letting one side of this war rage over the other. Every day, every meal, and every battle ends differently. For the most part, thankfully, I am able to sustain my role as the diplomat, diligently preserving the peace in the troublesome areas known as the depths of my physical being.

Sometimes I feel as if this war will never end. Actually, I am pretty sure this war will never end, as long as the cure for diabetes has not been found. As in real life though, War is ugly. War is tiring. And War is sad. War can also give us purpose. For without this War, I would not have life. I sustain this War and these daily battles for the purpose to survive, for without both sides of these battles I could not continue to thrive, live, and be happy. It's a small and large price to pay for the many blessings that I continue to have in life.

Putting ME on Hold

If you have talked to me in the last few months and asked, "What's new?" I've probably answered with something along the lines of "Work is busy." And to be completely honest, that phrase is definitely an understatement. While my boss has been on maternity leave for the last 12 weeks, it has been my job to not only maintain my own job responsibilities, but hers as well, AND we started a whole new program at our school under my guidance. 9-12 hour work days, weekend visits to the office, and being up all hours of the night because I can't get my brain to shut off, have left me exhausted, grumpy, and putting a lot of personal stuff on hold ... including ordering more diabetic supplies.

I had noticed about a week ago that I was just about to use my last Dexcom sensor refill. I made a mental note to call the company and order a new shipment immediately, which usually doesn't take too long since the company is based about 10 miles from where I live. Well the week came and went without me stepping away from work for 2 minutes to make a call to Dexcom, and yesterday, of course, my very last sensor failed after I had been wearing it for about 10 days (3 days longer than recommended).

My heart sank and since it was a Saturday I knew there was nothing I could do until Monday morning.  I obviously wouldn't be able to depend on my Dexcom meter for a few days, something I haven't done since starting to use it over a year and a half ago. For a few seconds I thought might even panic, since I can't remember a time where I wasn't able to reach into my purse, press a button, and see my blood sugar right away. I felt like I was going "old school" with having to only rely on finger pricks.

Well, I didn't panic and I think the reason for that is because I am more confident than ever that my blood sugars are controlled. I hadn't seen any worry-some high blood sugars in weeks, and only 1 "scary" low which I was able to detect without having to even look at my Dexcom. Don't get me wrong, I am so anxious to get the sensor refills, but I'm so much more at peace with not wearing it than I ever imagined I might be.

I am left feeling really very guilty though. My inner dialogue chastised myself with, "I told you so's" and "Why didn't you just order the refills last week?!" This was no one's fault but my own. I feel bad that I have let my work life get in the way of taking care of what really matters, my health (and if you ask my husband, some of our personal life too. :-( Sorry sweetie ...). Thank goodness with the support of the Dexcom and OmniPod pump my blood sugars have been in great control, despite my recent work schedule, BUT juggling it all isn't and hasn't been easy.

My boss comes back to work tomorrow ... and now it's time to get back to what really matters: ME!

Mama said there'd be days like this ...

Today started out like any other Monday, but it only took about 2 hours into my day to realize that it wouldn't be just any other Monday .... or any other day for that matter. To preface this post, I have to say that the Omni Pod insulin pump is a GREAT device, but as I realized today, technology is technology and stuff happens.

About 10 minutes into my work day a singular, consistent, high-pitched beeeeeeeeeeeeeeeep started emanating from my arm. I roll my eyes as I know exactly what it is. Others around me start turning their heads in all directions to figure out what the beep is and where it's coming from. No one suspects me, because why would someone's body parts just be beeping like that? Is a smoke detector going off??? Should we be evacuating the building?

No, it's my arm. I play it off and casually mention to someone giving me a funny look, "It's my insulin pump," as I hastily start making my way to my office. I see the person give me a confused look as if to say, "yeahhhhhh, right .... about that ..." because they have no idea I'm sure what that means.

I get into my office, dig through my purse, and find the Omni Pod wireless handheld device I use to "talk" to the pods. I press the home screen button to finally turn off the wretched high pitched noise that has continued to ring into my ear and anticipate the message the I am about to read on the screen: Your pod has been deactivated. Discard the pod and activate a new pod immediately.

AWESOME! ...

This doesn't happen too regularly but once in awhile it does and usually it's no big deal .... when I'm prepared. I remembered bringing some extra pods, batteries, and alcohol swabs to work and I prayed that insulin was part of that back-up kit as I was searching through my things. Unfortunately, today was not my day because the insulin I needed to refill a new pod was at home ... 30 minutes away.

15 minutes into starting my work week I grabbed my purse, mumbled something to my Assistant Director about needing to go home to get insulin, got into my car, and started the over 1 hour round-trip adventure for the one thing that keeps me alive every day: a bottle of insulin sitting in the fridge at home. (And yes, I am well aware that most of you are reading this thinking to yourselves, "Why don't you have the insulin with at all times?")

The fact of the matter is that this can happen any time. Today must have been some sort of "test" for me though because 2 hours after going home to activate a new pod and getting back to work, the new pod I had just activated deactivated as well! The high-pitched tone starting ringing in my ear at 11:45 and I literally thought to myself, "This has to be a joke!" Twice in the same day?!


Luckily I didn't have to go home for a second time since I had thought to just bring the bottle of insulin back to work with me. Thank goodness! Moral of the story here .... well, the obvious: always be prepared! Because despite the odds that 2 pods would fail within just a few hours of each other, today obviously showed me that anything can happen. I love the technology that is continuing to make diabetes management easier, but like most things in life, it's not always dependable. The only thing I can depend on is my ability to be prepared. Lesson learned ... for now. ;-)

Reaching Out

In an eighth grade literature class we were prompted to write about a life changing event. We had gone over the 5 paragraph essay writing method and the prompt was very open ended. Besides, by the age of 13, it's safe to say that not many people where I grew up probably had too many "life changing" events.

My pencil began to write and before I knew it, 5 paragraphs sprawled my paper and I was ready to type my finished product on the computer. Writing felt so natural. I wasn't afraid. I felt comfortable not thinking about who was going to read the paper, especially because I only considered it a school assignment and because I wasn't ready to share the emotional turmoil I felt about my recent diagnosis with anyone out loud ... or maybe I was?!

After I typed the assignment though I felt a sudden urge to read the paper to my Mom. I began with the introduction that talked about my symptoms and getting sick before I was diagnosed. The "meat", or middle 3 paragraphs, explained diabetes, or what I thought I knew about diabetes at the time, and what I had to do every day to control my blood sugars. And my final paragraph finally said the words that subconsciously I must have wanted people to know .... I no longer felt like I had anything to live for.

I was sitting on the floor of my bedroom and my Mom stood in my doorway, wide eyed. I can't say I could ever guess what went through her mind as those words exited my mouth, and she slowly said to me, "Do you really feel that way?" My eyes began to tear and probably for the second time after my diagnosis I was crying. I didn't know what to think, except that all of this was really hard to handle.

I never really thought about or truly contemplated what those words meant as I wrote that essay, and never would I classify my thoughts as "suicidal," but just more scared than anything. I didn't understand a lot about what diabetes meant, both scientifically and emotionally, back then. It was hard to process, along with trying to just figure out my place in this world as a kid growing into a young adult.

I can see how it would be so easy for any of us to feel frightened with no way out because we are scared. I was reminded of that just this past weekend. But ultimately I am just so glad to have persevered through the tough times to see what has awaited me on the other end. I believe that I have truly found what makes all of "this" worth it, something we are all capable of.

"Doctor" Chris

These days I really look forward to my doctor appointments. My "doctor" is actually a Nurse Practitioner who has been seeing and treating diabetic patients for years with his colleague, Dr. Einhorn, at Scripps La Jolla. Chris Sadler, or just Chris as I like to refer to him, has been a breath of fresh air and a real resource for up to date diabetes technology.

He knows my husband and I well and I truly feel as if he is invested in my treatment, without being condescending or judgemental. It's not like 10 years ago when I felt like doctors treated me as a child, which I was one, but being an adult with diabetes has been a completely different experience. Chris makes me feel good for the hard work I put in and every time I thank him for the motivating role he plays in my treatment as well.

I had my most recent 3 month check-in with Chris last Friday and got some great news! My A1c is 6.2%, which is awesome. This percentage is an overall indicator of what my blood sugars have been doing over the last 90 days, and mine have been stellar.

Another thing about Chris is that he is really into diabetes technology and on Friday he showed me a new "gadget." It's a glucose meter that looks like a small thumb drive that hooks into your iPhone. You can check your blood sugar with it, input your carb and insulin information, and make notes on exercise, stress, alcohol intake, etc. The app on your iPhone associated with this device makes graphs that not only help you see the big picture of your management and things that may or may not be working well, but also has the ability to email your data to others as a neat and organized graph. This function is especially great to share with any health care provider to pinpoint exactly how to even better manage the detailed intricacies of daily diabetes living.

Click here to read more about the iBG STAR glucose monitor ... now sold at the Apple Store!

A BIG Thank You to all of the doctors who push me to be better and are supportive at all times. Having a good doctor who you trust and respect is a big part of my management and makes all the difference.

Making It Look Easy

Probably one of my favorite parts of diabetes, if I had to have a favorite, would be educating others about the disease and talking about my experiences. For those of you who have known me since my diagnosis in 1998, this probably comes as a shock, because to be honest I'm still surprised by it. It's taken me a long time to be this comfortable, and ultimately I am glad to have reached this place.

I am caught reflecting though on what has made the difference though. When I was a teenager and even in my early twenties, I found it hard to talk about diabetes. I felt like people were intruding on my business any time someone even asked me what my blood sugar is. I feel bad for being so hurtful, because I know that those people were just interested or truly cared about my well being or worried. The reasons I would feel so angry when anyone wanted to talk about it though ultimately come down to shame. I hated talking about diabetes almost as much as I hated taking care of my diabetes, two things I did very poorly for a few years following my diagnosis.

I felt guilty that I couldn't "perform" like I was supposed to or told to. When my blood sugar was over 200, I hated to see the look of worry in their eyes. I was ashamed for not being able to do something that I think others see as "easy." Besides, isn't having diabetes just about checking your blood sugar and not eating sugar?? Not at all ...

Yesterday after a doctor appointment I was talking to a co-worker of mine about the check up. She was asking questions about things she had heard happened to people with diabetes and I started to explain why some of those things do happen. At the end, her response went a little something like this: "Well you must have it so easy then because you take care of yourself." At the time I agreed but by the end of the day I had a very different perspective.

I think that truly managing Type 1 diabetes is the hardest job I will ever encounter in my life. Sure, I am "making my life easier" because ultimately 10, 20, and hopefully 50 years from now I won't have to deal with the possible side effects of high blood sugars, but right now a salary for the work I put into taking care of my healthy lifestyle I think should make me millions. If only ... right?

But seriously though, diabetes is a full time commitment of checking blood sugars, monitoring blood sugars, dosing insulin, carefully considering every food choice, taking into consideration when is and isn't a good time to exercise, worrying about blood sugars during stress, scheduling doctor's appointments, managing finances to afford all of this, and working just as hard to try and find a minute to stop thinking about blood sugars to focus on the millions of other thoughts I have during the day from my professional to personal life. It's hard to explain to others how literally everything I do affects my diabetes and there are very rare moments in my life where my brain is not calculating how my every move is going to affect something related to diabetes.

So last night I made the comment to my husband that I think I make what I do look easy. Others around me are confident to throw around comments like, "You have it so easy," because they don't live it and to some extent I still am private about a lot of things, like not making it a big deal when my blood sugar is 38 or 300. I am of the opinion that I am not going to ramble on about diabetes or draw attention to fluctuating blood sugars to be that annoying diabetic that needs all the attention. In turn, I feel like my nonchalant attitude gives off the vibe like diabetes is no big thing, when in reality it's the biggest most hardest thing in my life every single day.

Managing diabetes is hard. It's 24 hours a day. It's consuming. And it's my life. I'm happy to do it because the reward of being healthy enough to spend every day with my loving husband and great family and friends for the next 100 years is MORE than worth it. :-)

Loss

Throughout the last several years of having diabetes I have experienced a LARGE range of emotions, from frustration to elation and sadness to success. Some of these emotions have remained a constant in my life with diabetes while others have come in ebbs and flows. It would be truly a feat to describe each emotion that I could relate to my experiences with diabetes, but recently one has been really hitting home for me.

A few weeks ago my husband and I experienced a loss that isn't something any couple could be prepared for. During the days and now weeks of healing, this sense of a loss has really stirred up one particular emotion that I have struggled with since the day I was diagnosed with Type 1 diabetes. I was brought back to December 31, 1998, sitting in the doctor's office and hearing a man I had never met before try to describe how my life would be forever changed. I could never go back yet I could barely understand what the future held. I could be advised as to medically what was happening, but emotionally, news like this is not something most people ever imagine to prepare for.

I was truly stunned how the last few weeks of my life have truly mimicked the first several years of my diagnosis. Back then, medically I was struggling to understand what it even meant to lose the ability to create insulin and process sugars. I also struggled with feeling alone, broken, and ashamed. I was told there was nothing I could have done to cause this. And I was in shock. I could barely understand what was going on, because like I said, these conversations are not something we prepare for in life.

So many times I have cried, begged, pleaded and tried to make a deal with God, asking him or someone for a divine intervention, "Please make this all go away!" I want to go back to the day before this conversation even happened. Unfortunately in life, we are probably all blind-sided with news that at the time seems like too much to handle, that is unbearable, and that seems too twisted to even comprehend. It's heartbreaking, and it's life.

Most of my posts end in hope, and this one does too. Because in all of our unbearable circumstances, we each deserve to HOPE and have faith in the future... whatever that may hold for each and every one of us.

Negotiating

It's with no hesitancy that I am willing to let you all know that I do not like being told what to do. I am happy to take direction or recommendations, but unfortunately my husband even has found out the hard way, that without meaning to sound like he is telling me what to do, I will be the first to snap back, "Don't tell me what to do!" Poor thing .... he is such a trooper to deal with not only the diabetes part of my life, but everything that comes with marrying an independent, driven, and emotional woman. And vice versa, he is strong enough to let me know when enough is enough. We challenge each other, and I love that.

It has taken me a long time to respect when a doctor is making a recommendation about my insulin levels for it to not feel like a command, but instead a conversation or negotiation if you will. I was sitting in the doctor's office a few days ago going over blood sugars and insulin doses with the doctor and my all time favorite nurse, June. As we were all looking over them Dr. Moore suggested to change some of my doses as June started to type them into the chart. I immediately took out my insulin pump to start changing the doses right away, at which point I was completely caught off guard when Dr. Moore "scolded" me ...

I looked at him with such a surprised look on my face as he said to me, "Now wait a minute, these are my recommendations. Next we negotiate and you tell me if you are comfortable." So while I have just mentioned how I hate being told what to do, I am also very trusting, and I have trusted doctors with my life for several years now. They know what do to with insulin levels, they tell me whats good or not so good to eat, and they tell me when to come back for more appointments. Yet at that moment this doctor was finally telling me that it's okay to do what I have been doing all along ... negotiate, and do so without feeling guilty about it.

Most of the time I take the doctor's recommendations, but once and awhile I will walk out of the office thinking that something they said was silly and I wasn't going to do what they said or tweak their "treatment" recommendations. I did so in private without letting them know it wasn't really something I felt comfortable with though. Yet now, this doctor was telling me it was okay! After all, I'm the one with the diabetes! Yes, he seems as old as stone, and has probably been doing this forever, but he doesn't live the highs and lows like I do. He gets it though. And I so much appreciate that.

Taking care of medical issues can always be a negotiation. After all, along with our families, we need to be our biggest advocates. To me, a doctor's advise is always comforting and trustworthy, but living with diabetes 24 hours a day, 7 days a week, has to make me some kind of professional too. It's a balance that each of us must find, and I am grateful as ever to have found that with the team of health care providers that I have the amazing opportunity to be supported by. I know my right-fully so overprotective husband feels the same way too :-).

Story of my life!

It seems like just yesterday, but last October a very good friend of mine told me she was pregnant. And now here we are, 8 months later and she will be the mother to a baby boy in just a few short weeks. I see her every day and it has been such a pleasure to be sharing this journey with her, and all the ups and downs of pregnancy, especially the food cravings and food do's and don'ts of being pregnant. Thankfully for her, she never had to deal with morning sickness or very many other annoying pregnancy symptoms, except for some pretty crazy heartburn. The other day she made a comment about having to really think about every piece of food she put into her body, because she knew what would or wouldn't give her heartburn and also what would or wouldn't be good for the baby. And my IMMEDIATE response was, "Story of my life!"

Not that I have heartburn or a baby growing in my body right now ... But I could completely sympathize with having to scrutinize every piece of food or drink that went into my mouth. Everything we ingest gets processed in our bodies and insulin is surely a factor in the digestion process of, I would say, about 98% of what goes into our stomachs. Put simply, insulin is responsible for making sure the sugars/carbs we eat are appropriately distributed into our cells and blood stream. Not having insulin poses GREAT problems.

I remember sitting in the pediatrician's office on the day I was diagnosed and the doctor on call was telling my mom and I about diabetes and what it meant to have to take insulin for sugars. My Mom asked the doctor if I could eventually go on a diet where I wouldn't need to take insulin, and simply put, the doctor said that would never be an option. Almost everything we eat has carbohydrates, from bread to soda to meats and veggies. Of course there are foods that are much lower in carbs, and those are my favorites, but there will never come a day where I could just eat and not take insulin. 

Therefore, anything that goes into my body is scrutinized completely. There hasn't been and there will never be a day where a donut in the break room looks so good that I would just grab one and take a bite or two and think nothing of it. Walking around Costco with all the free food samples kind of sucks. Just taking a handful of chips and guacamole at a Memorial Day BBQ isn't even possible, without insulin involved. ANYTHING that goes into my body requires an action on my part, which really makes me think more than twice about what I choose to eat.

The negative to this, is it really sucks to take up so much time to over analyze what I am eating.  I would love to sit down at a restaurant, order a burger, and devour it when it's served warm with some great fries immediately. Instead when the burger arrives, I do my best to count the carbs in my head, check my blood sugar, wait for the insulin to be injected from my pump, and then ideally wait 15-20 minutes to eat for the insulin to start working.

The positive though is that analyzing all of this food REALLY makes me think about what I am eating, and a lot of the time I end up making healthier choices. Surely I enjoy a cheeseburger here and there, but mostly during my thought process of what I am about to eat, 9 times out of 10 I will choose an overall healthier option because of the fact that I am constantly scrutinizing every ingredient. Not only do I count carbohydrates now, but since I have gotten so into nutrition, I am taking into consideration several other factors as well. I'm not any special diet. I'm just on a plan to eat healthy, natural things. And for me, it totally works and I feel great.

6.0%

I only have a few minutes but it's time to brag. The other week I had an appointment with my AMAZING doctor, Chris Sadler. One week before each of these appointments I ritually give blood for testing. I imagine several tests are run to make sure everything is looking good, but really the most important number from those tests is the A1c.

The A1c tests an average blood sugar over the last 3 months. The test is calculated as a percentage that correlates to an average blood sugar. Over the last 13 years I have seen the results from my A1c test yo-yo up and down, and while I was a teenager it was mostly up. I would have to say that I vaguely remember getting results anywhere from 10-13% .. which if you know diabetes at all, this is REALLY high and puts people at risk for future complications. Here is a link to how an A1c test correlates to average blood sugars:

A1c and Blood Glucose Equivalents

When I reached my early twenties I finally had the mind-set (and a new doctor in the Bay Area) that really helped me start to get on track. Over the last 6 years my A1c numbers have fallen drastically, to the point where going to the doctor is now more fun than ever, as my husband and I try to guess what the number will be this time.

I especially knew that this last appointment would go well, since I've been on the insulin pump and using the Dexcom meter. These two pieces of technology have made SUCH a difference in keeping my blood sugars more consistent and I knew this would really make a difference in my A1c test this month.

Sooo ... drum roll please! My most recent (AND BEST EVER!) A1c was 6.0%!!!!! I feel proud that this was such an amazing feat and I know it's just going to keep getting better and better. I am a healthy and happy diabetic and couldn't be more on top of the world right now.

The pressure to lie

Back when I was "bad" with diabetes (the teenage years) my mom was really great about making sure I at least saw the endocrinologist every 3-4 months. Each time they would ask me to bring in a written record of my blood sugars for the previous few weeks. I was supposed to record my blood sugars on a chart, the doctor would look at them, and then make recommendations for changes to my insulin regiment. I also had to do blood tests before the appointments which would identify my average blood sugars over the last 3 months. And all of this data is REALLY important in figuring out how to uniquely manage each person's diabetes care since every person's insulin needs are fairly different.

I was so emotional about going to these appointments. I knew I was "bad" at diabetes. The doctor definitely had to know I was bad at diabetes. I'm sure my parents knew it too ... But I pretended I was good because of the enormous pressure I felt to be good at it.

I couldn't tell you how many times I even checked my blood sugar as a teenager but I know it wasn't consistent. Instead I would make up blood sugar numbers for my doctor. The night before an appointment I would sit in my room with the little chart and fill it in with guesses. I thought I was so sly too. I thought I had everyone fooled! I would hand the charts over to my doctor the next day, he would smile, and say "Thank you," and at the time I thought he totally bought it. Looking back now, the numbers I wrote down could have never matched my blood tests and he HAD to have known I was lying.

I had already felt so sad that this was my life and I felt so different from everyone I knew, and everyone I cared so much about. I hear a lot of people talk about how hard it is to be a diabetic teenager because at that age you just want to fit in with your peers. But even worse, it was hard to be diabetic with my family. Especially with the close family I have, being around them without any of them being able to relate to me, was difficult.

I felt pressure every day to be "good." When I didn't know how to be good, I lied about it. I didn't want the look of disappointment on my parents faces when my blood sugar was 300. I didn't want to worry anyone in my family. I couldn't stand feeling like I did something wrong and it was my fault that blood sugars weren't perfect. And without any known previous genetic links in my family to diabetes, I didn't have anyone to blame but myself for this disease.

Today I have SO much to brag about with my terrific blood sugars and very rarely do I see a blood sugar over 200. But, when a higher number does show up on my meter though I am taken back to those days of guilt. The "what did I do wrong?" questions cross my mind instantly and I am embarrassed. It happens though. Sometimes with cause, but sometimes without a reasonable explanation. There really isn't a "perfect" in this world of diabetes because just like how people come in all shapes and sizes, diabetics come in all sorts of blood sugar numbers. Some of us have highs and some of us have lows, and that's just the name of the game.

**Here's a picture of my Dexcom today. It's been a great day of consistent blood sugars. :-)**

Jumping Through Hoops

I really take a lot of pride in my motivation to stay healthy. Despite any bitter feelings about being diabetic, I try my very best to do everything I can to make sure that I am keeping my blood sugars as controlled as I can. Despite these efforts, I feel like I am constantly running an obstacle course and jumping through hoops. If it's not one thing it's another, and in my mind, my world is filled of floating pink hula hoops waiting for me to jump through just to make it to the next minute, hour, day, or month.

I got a letter from my insurance company last week that read a little something like this, "We just wanted to inform you that the glucose test strips you currently use will no longer be covered. If you would like to continue to use the same test strips, you must get special permission from you doctor, or you will have to pay full price for your prescription."

Dear Insurance Company People,
Thank you for putting another big pink hula hoop in my path!
Sincerely,
Me

Ok, I understand that insurance companies have their reasons but do they realize that "getting special permission" requires a doctor visit or a 15 minute phone call on my behalf? Do they realize that it wastes the doctor's time to even have to put in this request? Do they realize that the test strips I currently use are my ONLY option? And do they realize that I already pay an arm and a leg for prescriptions, and not covering my prescriptions will cause at least 100 more pink hoops to appear?? I mean, in the grand scheme of things, test strips are a minor part of my diabetes care, yet just as essential as any other prescription or tool I use to help monitor my blood sugars.

I just starting thinking about how there are people out there, much like myself, who just want to take care of themselves and be healthy. Unfortunately, I am feeling like doing this requires a person to jump through a whole lot of big, pink, round, hoops. Managing prescriptions. Dealing with insurance companies. Making and keeping doctors visits. The financial burden. The daily monitoring. I mean, why does the desire to be healthy "cost" so much?

"I could NEVER do that!"

It seems like every week someone new wants to know about my "devices"and today a colleague of mine had lots of questions during lunch. She was asking me about when I was diagnosed, how it even happens that people get diabetes, how my machines work, and so on and so on. I actually tend to really like these conversations because it gives me a chance to educate others on something that not a lot of people know about. I take that back, I like these conversations until I get the following statements:

"My grandpa has diabetes" or "Everyone in my family has diabetes"

... and in today's case, "They test me all the time for diabetes and I'm so worried I'm going to get it."

... and then to top it off, "I could never do that!"

 I can usually manage the conversations about how Type 1 and Type 2 diabetes are different. And generally I am pretty forgiving when people don't know a lot about what I have to go through on a day to day basis. I can even tell when people don't quite understand WHY I have to do what I do, but ultimately I appreciate their taking the time to try and understand by asking questions and doing their best to be empathetic. To me it can all be so simple, although, again, I understand that an explanation of blood sugars, insulin, and carbs can sound like a foreign language to some people.

Today though it really struck a chord when this particular person flat out exclaimed, "I could never do that!" while I was answering her questions about my daily regime. Despite my original annoyances against some of her previous statements, I was really trying my best not to let my feelings get in the way of a totally teachable moment. I did however have several thoughts about this particular statement ...

Diabetes is not a choice. I did not choose this for my life nor would I wish for anyone to HAVE to choose this for their life, because let's be honest, living with diabetes is a challenge, to say the least. I didn't have the choice of "Should I do this?" I was forced to do this. The only other option: Not to do "this" and end up with a slew of medical problems and ultimately death if I CHOSE not to do anything. When faced with the news of a diagnosis that will ultimately follow me the rest of my life, to me there was no other option than to hook up machines to my body and do my best to keep my blood sugars decent. And I gaurentee that while probably every person faced with this diagnosis is going to deal with some type of stress, negative emotion, frustration, etc, a lot of us would choose life over "never doing this."

This conversation has really got me thinking about things I have said "I could never do this" to. Wearing an insulin pump was probably one of them, and look at me now. I'm attached to TWO wireless machines that I couldn't imagine my life without. Giving birth .... freaks me out! Will I ever do it? Hopefully some day.... The list of fears could probably go on and on, but surprising myself by doing those things has been enlightening to say the least.

It takes a strong person to really manage Type 1 diabetes. Diabetes takes it's toll physically and emotionally. I work every. single. day. 24 hours a day to manage my blood sugars. If you had asked me 5-10 years ago if I could get my blood sugars down to an average of 100 every day, my answer probably would have been, "I could never do that!" Well, guess what ... I AM doing it! The moral of the story here is, we're stronger than we think. I didn't choose this, but I chose a life of health and happiness ... and a life of "I can do this!"

Sorry, but I'm not really that impressed ...

This morning I woke up like any normal Monday morning and after showering and getting ready for work I found my husband sitting on the couch catching up on his daily (sports) news on the lap top. I started making my normal breakfast when he said to me, "Sweetie, you have to come read this news article." I feel bad, but the answer in my head went a little something like this: What sports article does he want me to see now? Did Tiger Woods get caught again?? 

At any rate, I apologized to him in my head when I found out he had actually been perusing CNN (which he does every day as well), and found this article about Type 1 diabetes and the ariticial pancreas:

CNN link to articifial pancreas article

The article talks about an artificial pancreas that sits on the outside of the body. Currently this device has two tubes that are implanted under the skin, one that tests blood sugars and another that injects insulin (to lower blood sugars) and glucagon (to raise dangerously low blood sugars). In theory, this new invention eliminates the need to do a finger prick to test blood sugars and also allows a diabetic to eat a large amount of carbs per meal (we're talking 70-100 carbs in one sitting), to name a few "benefits." The laptop size machine that is hooked up to the patient does all of the "thinking" and calibrating on it's own, without the need for a person to do much of anything. Currently this option is only in testing phases and the FDA will not allow anyone hooked up to this device to leave the hospital with it on. The article also says this could be a viable option for the public in approximately 4 years, although my guess would be more like 10-15.

So I can guess what you all are thinking, and I don't blame you if it goes something like this: THAT'S SO GREAT! or This is exciting! or Wow, a cure! and Aren't you excited Danielle? Well, I hate to burst your bubble but honestly I am not all that impressed with this option. If you look at the pictures and and watch the video, the tubing and machinery and monitoring involved with this whole process just seems REALLY extensive. I know the whole thing will probably be the size of a cell phone by the time this could actually be a feasible option for the public, but I really don't see how it's any different than what I am doing now?! Do I have a machine that tests my blood sugar every 5 minutes? Yes. Does this machine also tell me if my blood sugar is going up or down? Yes. Do I have a machine that injects insulin into my body without me having to do anything? Yes. Do both of these machines also wirelessly 'talk" to sensors injected under my skin at all times that test blood sugar and inject insulin? Yes.

The article talks about how "lucky" this 12 year old girl was to be able to test the artificial pancreas for a few days, without having to "worry" about her diabetes. Actually, the phrase they used was that she got to take a "vacation" from her diabetes.  Well if the artifical pancreas she tried for a few days was a "vacation" from her diabetes, then what I am doing now must be like living on a beach in the Carribean indefinitely. I'm a lucky girl.


... as a side note, I will say that the increasing amount of medical technology in this field is absolutely amazing and I appreciate all of the efforts that go into finding a cure for diabetes. There are several of us who would not be as healthy as we are without these outstanding accomplishments.

Omni Pod Check In

So I've had the Omni Pod (insulin pump) for over a month now and I told myself when I first got it that I would give it some time and then really make up my mind about how I felt about it all. Well, the jury has reached their decision and .... I. LOVE. IT. Of course there are pros and cons, but in my case the pros totally outweigh anything negative that I have to say about it.

There are lots of things I love about the Omni Pod pump. I love the flexibility it gives me to eat whenever and wherever. If I am out in public I no longer have to worry about getting out a needle and pulling out a piece of skin from my stomach, arm, or leg to inject. Talk about minimizing exposure in public! Now all I do is press a button on my Omni Pod and just like that insulin is being injected into my body and no one else has to know or see the process happening.

I also love that I can change my basal rates throughout the day. Typically, a non-diabetic produces insulin 24 hours a day to keep blood sugars stable and then more is produced when you eat. Depending on the time of day and your activity level, any person is likely to need a different basal rate of insulin throughout the day. Before the Omni Pod I gave myself 1 injection a day of an insulin called Lantus that would work for 24 hours, slowing releasing insulin into my body at a consistent rate. Now, the Omni Pod does the same but as it turns out at certain points of the day I need more or less of this basal insulin, and the insulin pump allows me to do that. In turn I have experienced so many less high and low blood sugars.

My favorite part of the Omni Pod though has been sharing my experiences with family and friends. I had been really worried about attaching this "thing" to my body and having to explain it, but it has actually turned out to be a neat experience to share with so many people. My two favorite reactions have been from my Dad and from a child at the Child Development Center I work with.

When my dad was here a few weekends ago I offered to show him how I change the pod and we even dissected an old pod to see the components inside. We were both intrigued by the engineering of the pod and it sparked a lot of dialogue between the two of us. I appreciated so much his interest in this part of my life. It's nice to know that something that can be such a pain in my life can bring me closer to people I love.

And then just yesterday I was in a 3-year old classroom helping a teacher give a little boy some asthma medicine. He was very apprehensive about using the inhaler in front of his friends and I decided to show him my "medicine" and took off the sleeve of my jacket to show him the pod attached to my arm. I told him how I needed medicine every day and how it helped me feel better, even though no one else I knew had to use medicine like this. He didn't really say much but the look in his eyes and the smile in his face said it all ... and he took his asthma meds like a champ after that.

While this disease has so many physical components to it, it's really the emotional side that needs tending to on a regular basis as well. Today is a good day and I am feeling so confident in the decision my husband and I made to try the Omni Pod.

Sugar Coated Dreams

Ever since I was a child I had a hard time getting to sleep at night. I remember my mom taking me to the pediatrician once when I was about 9 or 10 years old and asking them what I could do to help me get to sleep quicker. I would lay in bed at night, sometimes for hours, staring at the ceiling, or doing leg and arm exercises to hopefully tire my body. During college staying up late never seemed to be an issue because let's be honest, no good party started until 10:00pm at the earliest anyways :-)

While my issues with getting to sleep at night have pretty much diminished, I have run into a newer issue: staying asleep. To be honest, I can't remember a night where I haven't woken up at least once or twice (if not more) during the night in the last year. Of course there is the occasional bad dream (and I tend to dream A LOT) that abruptly wakes me, but many of the reasons I am up so much in the middle of the night are related to the diabetes.

Before I had the Continuous Glucose Monitor or the Insulin Pump, the only reasons I would be up in the middle of the night would be that I felt a low or high blood sugar. I would wake up feeling a little different, finally convince myself to get out of bed, turn on the light, and check my blood sugar. With low blood sugars I would have to find something to eat and wait the 15-20 minutes for my blood sugars to even out before I could get back to sleep. With a high blood sugar I would have to find some insulin, give myself an injection, and then I would have no issue getting back to bed because high blood sugars generally tend to make me sleepy anyways. At any rate, these episodes were often disruptive.

Within the last year though I have added the Continuous Glucose Monitor (CGM) and Insulin Pump to my life, that besides their numerous advantages, can sometimes cause even more disruptions to my sleep. The transmitter (little cell-phone like machine that tells me my blood sugars) for the CGM has to be within 5 feet of my body in order to get a reading. At night I usually put it on my nightstand or under my pillow. I have set it to beep at me if it goes higher or lower than certain blood sugar numbers. Sometimes the CGM will end up beeping at me, and in which case I will get up and correct a high or low blood sugar if needed. These disruptions seem to be happening less and less with the tighter control I have no with the insulin pump. Yay!

What I do notice myself doing though, that is almost comical now, is waking up naturally throughout the night at almost the same times during the night just to check the number on my CGM. My husband and I get in bed anywhere between 10:00 and 11:00 at night and I have a tendency to open my eyes around 12:30, 3:00, and 5:00 (give or take a half hour or so) each night just to adjust my body position and check my CGM. I appreciate the easiness of knowing my blood sugar right away but man oh man, what's a girl got to do around here to get a full night's sleep?? All joking aside, it's really not all that bothersome and probably just something I have naturally gotten used to. And something my husband has had to get used to as well. As a matter of fact, when he hears me stir in the middle of the night he's set on auto-pilot to ask "Are you okay?" and "How is your blood sugar?" Just another thing we all adjust to maintain the success of the diabetes.

2 hour countdown

My Dad was in town this weekend, with my Uncle, cousin, and good family friend. Every year we have a little tradition of attending the Dirtbike Supercross in San Diego. Despite my Dad's best efforts to get me to ride a dirtbike when I was 12, it didn't really become something I wanted to do very often, but I can safely say that the males in my family are very much into it. Nonetheless, attending the Supercross with my Dad is a fun experience we share together each year.

Going to things like this, in addition to having a husband who grew up eating out for meals a lot, I am constantly faced with the fear of having to guess how many carbohydrates are in a polish dog or nachos or beer, for example, that I am about to consume. The guessing can get REALLY tricky sometimes, leaving me with approximately 2 hours of anxiety following these guessing games.

Before each meal, I follow the routine of checking my blood sugar, counting the number of carbs I am going to consume, entering the information into my insulin pump, and then the insulin gets delivered into my body. Let the countdown begin ... For me, insulin works for about 2 hours in my body, meaning that 2 hours after an injection I can check my blood sugar again to find out if I've injected too much, too little, or just enough insulin for any given meal. If my blood sugar is low after those two hours it means I injected too much. If my blood sugar is high, it means I injected too little. You get the point ....

Well, after 13 years I can pretty much guess what my blood sugars are going to be and what they will do during those 2 hours for the foods I commonly eat. I try to stick to a pretty regular diet because of this. But the anxiety really kicks in when I am left to guess how many carbs are in a meal I don't usually eat. Going to restaurants can be a nightmare sometimes.

Last night at the supercross I ordered a polish dog and agreed to have some of my husband's nachos. Recently I had a hot dog at costco and thanks so my handy-dandy iphone app (Calorie King) I knew there were 35 carbs in the hot dog bun there. The polish dog last night looked a little bigger, so I guessed 40 carbs for that one and 20 carbs for the nachos (about 2 carbs per chip, meaning I knew I could only have 10 chips). Boy does this get exhausting!

Blood sugar check. Counting carbs done. Enter the information into my insulin pump ... begin delivering bolus (that's the term for a one-time insulin injection). I eat and then I wait. 2 hours of holding my Dex, watching which way my blood sugars will turn. Will they go up? How fast will my blood sugar rise? Did I give too much insulin? Is my blood sugar going to plummet? Oh gosh, where are my sugar pills? Do I know where the closest medic station is in case I pass out? Pearce will surely know what to do. Oh, gosh this will be so embarassing if something happens to me right now in front of all of these people. Okay, Danielle, calm down ... And so I go back and forth trying my best to simultaneously watch the races and keep an eye on my blood sugars. As this is how it normally goes most of the time when I am left to guess if I gave myself the right amount of insulin.

Luckily last night everything worked out. I had probably guessed a little too much insulin, as my blood sugar was slightly low about 1 1/2 hours after I ate. I chewed on 2 sugar tablets and I was good to go the rest of the night and headed to bed around 11:00pm with a blood sugar of 114. Crisis averted ... this time. :-)

Danielle's Diabetes Dictionary

Below are terms I commonly refer to, described in words that make sense to me :-) I hope this clarifies some things for y'all.

Blood Sugar: A number that tells me how much sugar is in my blood. A desired number falls between 80 and 120. It's not always perfect ... so please don't judge when it's high. Keeping it there is HARD WORK!And synthetic insulin isn't exactly like the real thing.

Insulin: A hormone produced by the pancreas that allows sugars to get from the blood stream into your cells so that they can have energy. Since my body no longer makes this hormone, I use synthetic insulin to do the job.

Carbohydrates: The enemy! haha Just kidding. Any carbohydrates that enter a body turn into sugar and end up in the blood stream. Without insulin, the amount of sugar in the blood stream would get too high and over time cause some major damage. Eek!

Low Blood Sugar: Anything under 60 to 70. I generally get a combination of disoriented, sweaty, tired, lethargic, low on energy, and hungry. I've heard that at 25 the brain doesn't get enough sugar and the body can start to shut down and cause unconsciousness, seizures, and a coma. Thankfully I've never been there. Phew!

High Blood Sugars: Anything over 140 is undesirable, although it's not uncommon to see blood sugars in the 200-300 range. The higher the blood sugar the more I feel tired, almost flu like, sick to my stomach, and irritable. It's easier to go high than low, and I've even heard of people seeing their blood sugar up to 1,000. My mom told me I was around 700 when I was diagnosed 13 years ago. Talk about an insulin drip straight to the vein, STAT! The long term affects (5-10 years of consistently high blood sugars) are what all those doctors warn you about. The occasional high happens. I treat it and move on.

Dexcom CGM (Continuous Glucose Monitor, aka "Dex"): A sensor I wear on my abdomen that transmits my blood sugar numbers to a wireless device that looks like an old fashioned cell phone. I love getting updates of my blood sugars every 5 minutes but best of all I can watch the trends in my blood sugars. I know when it's going up or down, and how fast it's rising or falling. This really helps keep me within that desirable range of blood sugars, and it's the one device I wouldn't want to live without these days. Meet Dex:

Omni Pod (aka Insulin Pump): This little pod attaches to my skin, carries insulin, and "injects" me daily with insulin. This wireless, portable, and easy to use machine has done WONDERS for my blood sugars, keeping them more stable than ever. It's probably the closest thing to a working pancreas on the market right now.

Type 1 diabetes: NOT CAUSED FROM EATING TOO MUCH SUGAR! Juvenile diabetes does have some genetic components, although these days most believe that it's caused by a virus that attacks your good pancreas cells, therefore ceasing insulin production in your body. The good news, there is only a 4% chance my children could get diabetes AND neither my parents nor I did anything to cause this diagnosis ... it just happens!

Endocrinologist: The doctor I see every 3-4 months who helps me with dosing and managing my insulin and blood sugars. Having a good one makes all the difference, and if you are in the San Diego area I highly recommend Dr. Einhorn and Chris Sadler. Chris' kind bedside manor, eagerness to be helpful, and knowledge of diabetes is outstanding.

Glaucoma, nerve damage, kidney failure, heart disease, etc.: Nothing for me to worry about ... Yes, these are the things that CAN happen if diabetes is not controlled but being in control pretty much guarantees me a long, happy life without having to worry. I get checked regularly for any concerns, but I have met many women who are living proof that what I am doing now is going to benefit me in the long run. No worries here :-)

Sense of humor: Something I wish I had more of when it comes to diabetes but also something I have learned is good to have when dealing with a chronic disease. Some days are good and some not so good. But hey, it's nice not to be so serious all the time. :-)

Pity VS Empathy

I talk a lot about support in my blog posts. I am continually appreciative of the "support team" around me and for what each of these people do in my life. From people like my husband, parents, and family to the great doctors I have to the many acquaintances in my daily life that know about my diabetes. They all play a very critical role, from small to large, in my every day and long term management of the emotional and physical needs of being a type 1 diabetic.

Support comes in various forms. In my life support is medical. Support is physical. Support is emotional. And support is on-going ... to name a few. As someone who receives a lot of support I also tend to be very "picky" when it comes to which types of support feel genuinely supportive and which types I am sure are meant to be genuine but end up feeling like pity.

Sure, there are times in my life where I wish this would all go away. In no way would I wish the things I have to deal with on a daily and long term basis on anyone. There are days when this battle of blood sugars feels unending, wounding, and exhausting. It takes it's toll on my body both physically and mentally. And I am sure it also takes it's toll on those around me who can't go through what I am feeling but can only try to understand as best they can.

When I write or tell of these things that just truly suck, thank you for the times that you have praised me for my strength. Thank you for the times that you have helped with the financial burden of this all. Thank you for the times that you have let me cry. Thank you for the times you have celebrated great blood sugars. And thank you for being my rock when I am scared, anxious, or angry. I am not looking for pity, yet I thank you all for understanding that this is hard ... yet not impossible.

Pasta, Pizza, and Pie, Oh my!

I absolutely love food. I love fettuccine alfredo, banana cream pie, sourdough bread, and burritos to name a few. I love a lot of foods that are extremely rich in carbs and crave them as I imagine most people often do. For me I get a scent of a sausage and pepperoni pizza cooking in the oven or a whiff of a carne asada burrito ready to be unwrapped and devoured and those foods are ALL. I. CAN. THINK. ABOUT.

For the most part though, that's all it turns out to be for me. Just a thought of something I crave so badly because my brain has trained me to treat these foods like they are the enemy. Don't get me wrong, I love salad, veggies, and meats. I crave those too and fortunately they are much easier to digest in terms of blood sugars, due to their low carbohydrate count. But foods like bread, pasta, pie, and pizza in anything but a very small portion tend to make me feel sick and could potentially send my blood sugars through the roof.

Each time I eat anything, I consider two factors: 1. What is my current blood sugar? and 2. How many carbohydrates am I about to eat? The answers to both of these questions help to figure out how much insulin I will need to keep my blood sugar levels stable. The higher the carb count, the more insulin I require. Foods like pizza, bread, macaroni, etc. have extremely high amounts of carbs, that a lot of the time more than even a quarter of a cup serving makes my blood sugars difficult to manage. Therefore, to avoid sickening high blood sugars I try my very best just to stay away from these choices.


A lot of the time I just feel like screaming and saying, "Screw it! I'm going to eat this enormous serving of pasta and I don't care what happens because it's just too good to pass up." 99.9% of the time I chicken out though and stick to one or two bites of pasta and end up choosing veggies and salad like I probably should. It gets very frustrating though. I look at people devouring the foods I so badly want to stuff my face with once in awhile and selfishly think how jealous I am that those people's bodies are going to end up digesting that pasta just fine while mine has failed to do so.

Pearls of Wisdom

Today I did something I have NEVER done in the 13 years of being a diabetic. I did something that I have never had the urge to do and have pushed back on for a long time. And it's really not that big of a deal, but today I attended a "Woman With Diabetes" luncheon put on by the Diabetes Behavioral Institute, and my good friend and diabetes psychologist, Susan Guzman. Susan invited me to this luncheon a few weeks ago and I went back and forth in my mind about attending for several reasons. The luncheon was only for women with Type 1 diabetes and this would be the first time I had ever even met another woman with Type 1 diabetes, let alone sit in the same room with 50 of them! And to boot, I couldn't bring Pearce to hide behind.

In going with my New Years Resolution of just saying yes, I decided in good faith that I probably should just suck it up and go. It wasn't going to kill me and if I really didn't like it I would never have to go again. Not knowing what to expect I arrived at a private room at The Prado restaurant in Balboa Park set up just for our group. I signed in, donned a name tag, and hesitantly walked through the door hoping that seating was assigned. And wouldn't you know, it was a sit where you want type of event and I was terrified of taking that HUGE first step despite being the friendly, social, and outgoing person that I am. Not going to lie, this idea of socializing with other people with diabetes scared the shit out of me, mostly because it's so foreign to me.

As luck would have it I ended up sitting between Linda (an attorney) and Glenda (a teacher), who are old friends and the veterans of the group, both having had Type 1 diabetes for over 50 years. The next 3 hours flew by as the 3 of us talked about everything: jobs, kids, diabetes (of course) ... The more we continued to share the more I realized we had in common. I mean, besides the fact that they both were in professions I knew about and Glenda's daughter and I went to the same college, I don't know why I was so surprised that these woman knew exactly what I was talking about when I said the words omni pod, novolog, basal rates, and Dr. Moore to name only a few. What's even more amazing is that considering a glucose monitor wasn't available until 1981, and these woman had diabetes for at least 20 years before that, they were both in great health! If there isn't any other lesson for me to be learned here is that, a long healthy life is a possibility, and even more so for myself who has had the amazing opportunity to use the technology of a simple glucose monitor since day one.

I drove home from the event with mixed emotions. If I had to use one word to describe my experience it would be "interesting," and not in a bad way. Honestly, it was emotional for me to let my guard down today in front of people I didn't know. It was and is always hard for me to wear that label of "diabetic." On the other hand, I was so appreciative to know that I share such similar experiences with others. I found it comforting to laugh with Linda and Glenda and to not be so serious about diabetes.

Each of us shared a "Pearl of Wisdom" today, something that we have learned along our journey with diabetes and mine was:

"It takes a village ... support is what gets me through each and every day."

This one's for you Mom and Dad

I would love to start this post off with saying that I wouldn't be where I am today, both physically and mentally, without the love and support of those around me. With that said, I will also note that I know I haven't always made it very easy to let people in to the whole diabetes thing.

It all started with my diagnosis as a very young teenager. I have talked a bit about my feelings back then, but the two people I am really starting to think about are my parents. As Pearce and I start to consider starting a family someday, I can't help but wonder what I might do should our child be diagnosed with a manageable yet seemingly restraining disease. The worry. Fear. Guilt maybe. And many other emotions that must swirl through a parent's mind when their human, and almost irrational, instincts kick in with any news that their baby is in danger.

Back then we were all coping and reeling with the diagnosis in our own way. I can only speak on behalf of my own thoughts, and can only interpret through my parents' reactions what may have been churning in their minds. Emotion wasn't really something our family showed openly very often. Being a teenager at that time probably didn't help, but I found it hard to talk about and interpret the anger, frustration, and confusion I felt. And not being able to successfully communicate those feelings, in turn, led to a lack of communication about the emotions of this all between the three of us.

What I do recognize is the strength my parents displayed. I learned how to be responsible through their actions. Keeping regular doctor appointments. Eating right (most of the time). And eventually learning to really manage the physical and emotional aspects of diabetes by pushing through and being strong. Back then I had no interest in talking about what was going on and NEEDED to learn responsibility. Now that I have worked my way out of those rebellious teenage years, I feel like I have mastered the art of responsibility, and my needs have changed. My parents may not have to drive me to the doctor any more, make sure to ask all the right questions, and give me an injection, but I will still lean on them for support more than ever. Their support has shifted from a physical to an emotional support, something that I am finally ready for and continue to be thankful for every day!

I took a leap, and landed on my feet

It's been a month since I finally gave in and made the decision to get the insulin pump. 2 days ago the pump arrived at my house and even before I opened the box, trepidation ran through my body. I slowly lay out the components of this new contraption on my table and with each piece I touched and examined my brain and emotions were going a mile a minute. The two things bothering me the most were all the questions I had (Was it going to hurt? How will my blood sugars react? How will other people react?) and the fact that like anything in life, change is often scary. Poor Pearce ... he was trying to be so supportive and asking me every other minute if I was okay, but I really wasn't going to be "okay" until I got the thing up and running.

So the next day we arrived at my doctor's office to be trained on how to use the Omni Pod. Without any hesitation on my doctor's end (and much hesitation on mine) he went through the components and had me all set up within 45 minutes. Surprised by the ease of how to set up and use the pump, I wasn't as nervous as I thought I would be leaving the doctor's office. I have to also give a BIG thank you to Chris (my doctor) and Pearce (my oh-so-supportive husband) for being there for all of this. I take so much pride in my independence, but I am really appreciating the times when I can let my guard down and let people be there for me when emotions are running high.

Here's a picture of the insulin pod attached to my arm: (It's about 1 1/2 inches long and an inch wide)

I have to say that this little ingenious contraption is actually quite cool! Before the pod is attached to my body I load it with about 3 days worth of insulin. Next it gets stuck to my body, the "cannula" (VERY small needle) inserts just under my skin, and should stay there for a little over 72 hours. The hand held machine that comes with it programs the pod to deliver 0.4 units of insulin every hour (to keep my blood sugars stable) without me having to push any buttons. When I do need or want to eat, I test my blood sugar on the machine, it asks how many carbs I will be eating, and then recommends how much insulin I should give myself. I can either accept the suggestion or change the dosage and with the mere click of a button the pod is delivering insulin JUST. LIKE. THAT! I have to say, with a machine like this I am missing my healthy pancreas a little bit less ...

24 hours in to using the omni pod I am doing OKAY. I experienced some lower blood sugars through the night and this morning, and after talking to my doctor this morning we've already made some adjustments to the insulin dosages. I have a feeling it's going to take some time to get those just right. Other than that, the sense of freedom and the absence of needles are the best parts about this. I also feel a little silly for getting so worked up about this change, but at the same time, feelings like that are completely normal. It's okay to be scared, because, hey, I am scared every day of this disease. But it's all turned out fine so far, and for that I am thankful.