May 09, 2008

Computers Are Annoying.

This is my brain.  So last night there was another glitch here on SUM.  For some reason, I couldn't log in to my Movable Type database, comments were popping "500" errors, and my poor head - exhausted from weeks of wedding wackiness and a very busy work schedule - started to turn itself into (sugar-free) Jell-O. 

Now it seems that I'm back in the database, frantically posting something to let you guys know four things:

  1. There may be some downtime here at SUM for web maintenance.
  2. There will be downtime anyway, as I'm gone from both work and the Internet as a whole starting next Friday morning.
  3. I'm in the process of moving the blog to a new hosting platform because I can't deal with my favorite outlet for diabetes support melting every few months.
  4. Oh, and Yahoo! sucks.  

Hopefully things will stay solid for the next few weeks, but once I'm back from my honeymoon (and sporting a brand-new name and all!) I'll be making some big changes to the site here.  Hopefully Siah won't get her nose into everything and muck it up.  In any event, please be patient with me as I muddle through these last conversion hurdles and onward towards a website that's not hosted by yahoos.  ;)

But those are all future plans.  Boring until they actually happen.

For now, I need to extend a huge THANK YOU to everyone who has sent their well-wishes to my office here.  I've received more envelopes marked with "Operation Wedding Shower" that are making me smile and making me so damn proud to be a part of this community.  (Formal thank you notes are en route - I'm hoping to have them out before I leave next week, but if you don't see yours by then, please be patient with me!)  I know I've said that very thing many times before, but it's proven time and time again how important, effective, and inspiring a group of commonly-bonded individuals can be on someone's life.  So THANK YOU and Chris thanks you, too. 

We're heading home to RI this weekend to finish up all the loose ends that need to be taken care of because the wedding is next weekend.  (Whoa.)  I'm having the trial "hair do" done this afternoon, then an evening out with the girls.  We'll spend Mother's Day with our loved ones, then bullet back here to CT to spend our last whirlwind week as an engaged couple.

I can't believe how quickly this past year has gone by.  And I can't believe how truly excited I am to become his wife.

Onward to the weekend!   

Oh, and HAPPY BIRTHDAY TO MY MOM!!! 

May 08, 2008

Pumps Are Good, M'Kay?

Pumps are good, m'kay?The Associated Press has issued an article about the safety of insulin pumps, claiming that deaths have been linked to insulin pump use.  What's that phrase again?  If it bleeds, it leads?  Our own Scott Strumello, research blogger extraordinaire, has provided a very fine synopsis of the article - you should definitely take a read.  I was contacted by Steve Sabicer, a representative at MiniMed, and had the opportunity to get a little feedback from their camp. 

How does Medtronic respond to the claim that "insulin pumps can be risky and have been linked to injuries and even deaths"?

Medtronic stands behind the many years of clinical evidence that support the benefits of insulin pump therapy in patients of all ages

  • Insulin pump therapy is proven to improve patient outcomes versus multiple daily injections (MDI) with long-acting insulin (glargine).
  • Insulin pump therapy has shown strong results in pediatric patients as young as one year old.
  • Insulin pump use in children and adolescents may be associated with improved glycemic control and improved quality of life, and poses no greater, and possibly less, risk than MDI.
Do you feel that this article could keep doctors and insurance companies from approving the use of insulin pump?

We don't think this will significantly impact physician or insurance company practices moving forward.  The clinical data in support of insulin pumps is very strong.  In fact, Medtronic has noticed that many physicians have proactively come out in support of the therapy in response to this article. That said, we anticipate patients may be concerned because of the lack of context provided by the AP story. Medtronic encourages every patient to speak with their physician before making any decision about insulin pump therapy.

It's important to note that the article conceded that insulin pump therapy is beneficial for adolescents. They only suggested vigilant training and attention by parents and physicians. Medtronic encourages significant parental/physician involvement and we have designed a robust product training protocol to ensure our patients receive optimal instruction on the use and functionality of their insulin pump therapy.

  • We have more than 3,000 certified product trainers
  • Comprehensive online tools (Pump School Online, web-based training modules) for general diabetes information and product specific training
  • Paradigm REAL-Time CD-Rom product training
  • Code and PIE classes

How is Medtronic planning to address this issue with the media?

Medtronic is available for comment and interview to any journalist, and we also encourage them to contact pediatric endocrinologists and patients who have experience with insulin pump therapy.

What can pump users do to show insurance companies and doctors alike that insulin pump therapy should be available to any insulin-dependant diabetic?

As I said before, we don't believe this story will significantly impact physicians or insurers regarding insulin pump therapy. The clinical data in support of insulin pumps is strong.  That said, if patients are having difficulty getting coverage for their insulin pump, they can visit our website for claims information and helpful tools to demonstrate the case of their therapy.

(End of interview)

I've made no secret that I'm a fan of Medtronic's insulin pump line and that I believe pumping insulin has been one of the best decisions I've made for my diabetes management. What makes me craziest about this article is this line:  "There were two possible suicide attempts by teens who gave themselves too much insulin, according to the analysis."  This statement makes it seem like an insulin pump holds a substance far more dangerous than what I injected for over 17 years.  Point is, pumps are not for everyone, but that decision should be made by the diabetic and their caregiver.  I'd hate to see an article like the one from the Associated Press be something that keeps an insurance company from approving use of an insulin pump.

Scott summed it up nicely by saying, "But blaming the pump itself for problems that are not clearly tied to these Adverse Events seems to be irresponsible reporting at its worst."  Hear, hear!

May 07, 2008

Medtronic UltraLink.

As I mentioned last week, there was a random package from Minimed left on my doorstep.  And being the big geek that I am, I think I actually clasped my hands together and said "Oooh, what's this?"  Funny how an unexpected diabetes gadget can bring such instant joy.  The techno-joy in me implodes and I'm eager to rip open the box and push all the shiny new buttons.

But I've digressed again.  Imagine that?

I've been using the Medtronic UltraLink for a few days now, watching as the results ping directly to my insulin pump.  This is a good thing, because I never, ever entered my blood sugars manually before this.   I'm quick to test but not very vigilant with data management.  Having tools like the Dexcom and now this UltraLink are useful because I can go about my daily diabetes business and then load up the data every few days.  For someone like me, with a schedule that doesn't allow for much mucking around, this convenience is crucial.

UltraLink vs. Ultra2.  Go to your corners and let's have a clean fight.

The UltraLink is a bit bigger than my Ultra2 - not by much but apparently by enough to make the meter case about 25% bigger.  Thankfully, syncing my meter up to my pump was very easy.  I just needed to go into my pump settings, input the serial number on my meter, and viola! it's pinging results with a happy little beep.   The ping is almost instant and the results are logged in my pump, so when I upload my data to Carelink, it's easier to see the Big Picture, with insulin doses and corresponding blood sugars hanging out there together.

I'm all for convenience.  Because I, unfortunately, do not have the time to do all this blood sugar logging.  Making the process all-inclusive is a nice change from "Okay, grab the meter, load up the results to my blood glucose spreadsheet, then write in the insulin doses manually ... what the ... ugh, the thing turned off while I was scrolling through ... I can't remember if this bolus went with that result ... is Nip/Tuck on?  I'm sick of this crap already."

Lancing devices ... aren't they cute?  Awww ...

The lancing device that came with UltraLink is smaller, by comparison, than the older device I was using.  Funny how the meter got bigger but the lancer got smaller.   It's the same one that came with my UltraMini, so I was already accustomed to it's teeny shape.  A smaller lancet device works best for when I am sporting some fancy dress and teeny purse combo, forcing me to ditch my meter case and leave my testing goodies roaming loose in my purse. 

Overall, I'm finding the UltraLink to be a convenient, relatively painless switch over.  I'm still using my Ultra2 in addition to the UltraLink because I don't have enough brain cells these days to make any management changes.  Once the wedding is over and my brain starts to regain a recognizable shape, I will most like swap meters and go with this UltraLink version. 

So, rest o' the blogosphere, what's your take on the UltraLink?  Are you using it faithfully?  Does its size make you a little "eh" about it?   Are you tempted to cover it with stickers and give it a name?  (I'm looking for small squirrel stickers and am planning to call it "Harrison," but that's yet another digression.) 

May 06, 2008

Invisible Macy's Parade.

With the wedding just around the damn corner and our brains turning to oatmeal with every day that passes, silliness is reigning supreme in the Morrone - Sparling household. 

I present ...

Exhibit A:  Invisible Macy's Parade.

LOL Sausage

This is what happens when two highly-motivated, busy, and slightly stressed people are left alone on a Saturday morning with Siah and a camera.  This picture made me laugh so hard that I couldn't catch my breath.  Something about Abby sitting there, staring up from the background and looking so small as Massive Siah leapt from the chair and assaulted the foreground.

But ... she looked like a Macy's Thanksgiving Day parade balloon.  So, never to be outdone, we photoshopped the hell out of it. 

Exhibit B:  Visible Macy's Parade 

Visible Macy's Parade, of course.
 

Twelve days until the wedding.  And all I can do it collapse into giggles half the time.  Hopefully I find time between now and May 18th to grow up a little bit.   

May 05, 2008

3 am Paralysis.

Sticky sweet, from his head to his feet yeah.No sound woke me up.  I'm not sure how long I was lying there awake and staring off into nothingness, but eventually my shirt felt too sticky and my hands weren't responding to my commands.  Flat on my back and listening to the sounds of Chris's even breathing next to me, I wasn't sure what I wanted to do.  Did I want to go back to sleep?  Did I want to try and get out of bed myself?  Did I want to flip on the lamp and finish reading my book?

I knew I was low.  I needed juice so badly and my torso was damp from panic, but I still couldn't stop thinking these completely ridiculous thoughts.  Was I ready to call the church tomorrow morning and confirm the readings we'd selected for our wedding service?  Was that the sound of one of the cats picking at the couch?  I really wanted to just read my book.  Or go back to sleep.  Could not focus on the task at hand.  My brain just wasn't operating.

My eyes slipped shut and I fell into a nervous few moments of sleep, waking to feel those waves of nausea and lethargy wrapping around my body like a snake. 

"Wake up, Kerri.  Wake him up.  Get some help.  Now is not the best time to finish your book."  Internal Motivational Speaker piped up in my ear, yawning.  It was 3 am and she was irritated I had woken her up.  "You're low, kiddo.  Wake him up and ask for help." 

"Chris."  

He woke up instantly, as though he had been waiting for me to say his name.

"Chris.  I need juice.  It's right there on the table but I can't get it.  Please?"  I sound so rational, like I'm in control but inside my body is rattling.

Seconds later, I've drained the bottle and am lying back down, the covers tossed aside and Abby prowling nervously at the foot of the bed.

"I'm dizzy."  My voice felt like it was stuck at the back of my throat, too timid to venture out in full.  "I feel very dizzy, baby.  I'm nervous I might pass out.  Okay?  I need you to know that."

He turned on the light and sat beside me.  "Stay awake, okay?  You drank the juice.  It's going to be better in just a minute."

All I could think about was that damn book, sitting on the bedside table.  I was about 20 pages away from finishing it and it seemed a lot easier to immerse myself in someone else's fictional life than to attend to this low blood sugar.

A few minutes pass.  Chris reaches for my meter and clumsily unzips it.  I can tell just from the sounds that he's not loading up the strip the same way I do, or clicking back the lancet device with the same cadence. Setting up the meter and testing has become autonomic for me and I do it without thinking.  I could hear him struggling, so familiar with the sights but not as fluid when he does it himself.

Shunk.

43 mg/dl.  After juice.  

"Whoa.  I must have been low.  That's after juice."  My brain works rationally, my sentences sound slow, deliberate, but not tangled.   "I can't lift my arms.  My fingers aren't working."  These are not complaints.  These are matter-of-fact statements, spoken to my fiance and hanging there in the air.  "I still feel dizzy.  Can you get the honey?"

Instantly, he's back with that little jar shaped like a bear.  I open the top and wait clumsily for the honey to trickle to the top of the spout.  I take a long pull, my mouth recoiling at the sticky sweetness. 

"Can I sleep?  I've eaten so much.  I'll end up at 300 no problem.   How about we sleep now?"

"How about you lay down and I'll stay awake with you."

I think about that book again.

"Okay.  Just a few minutes.  Then we'll go back to sleep."

Twenty minutes pass.  I regain control of my hands and they reach over to rub his shoulder.

"Thank you, baby.  I feel much better now.  It's okay to sleep now.  I'm better."

This morning, 108 mg/dl.  After all that juice and the honey, I should have been upwards of 270 mg/dl.

I have no idea what causes these late night lows.  Ive only had the Dexcom off for a few days but it seems that this high-stress time is the best time to be wearing it.  I'm dealing with the insurance companies tomorrow. 

(But, for the record, I finished reading the book while I was blow-drying my hair this morning, the little honey bear sitting on the bathroom counter, watching me.)

May 04, 2008

Three!

Don't worry - it's sugar-free.I had no clue it would end up meaning so much to me, this blogging thing.  I started SUM three years ago today, borne out of the frustration that I couldn't find anyone LIVING with this disease, but kept stumbling upon stories of death and complications without effort.  I wanted to find other people who were working jobs, driving cars, having children, trying to find a good vacuum cleaner, falling in love, drinking coffee - and YES, testing their blood sugar, taking insulin, and managing their diabetes all the while! 

I couldn't find much of this online, so I did my part to help create it.  But it's never been completely about diabetes.  It can't be - that's not my entire existence!  For the last three years, I've written about miserable high blood sugars, unnerving lows, experiences with my insulin pump, and my feelings about life with diabetes.  But I've also had the incredible opportunity to share my life with you guys ... writing about my friends, my family, my relationship with Chris (wedding ...two weeks from today holy crap), my foolish cats, and my even more foolish sense of humor. 

There's something highly therapeutic about blogging.  It helps me manage the emotional side of diabetes, the one that doctors and text books don't mention but you and I know exists.   

Thanks to all of you who have been with me from the beginning, and to those who may have just Googled "squirrels are in my pillow" and landed here.  Being a part of this community has improved my health, and enhanced my life.  So thanks to you guys, so much, for everything!

May 02, 2008

Broncos, Bolus, and Butters - OH MY!

The Friday Six:  May 2, 2008 editionHoly late Friday afternoon post.  But it's time for The Friday Six:  Broncos, Bolus, and (Nutter) Butters Edition. 

1.  Jay Cutler has been diagnosed with type 1 diabetes.  I know - Jay Cutler, quarterback for the Denver Broncos!  (Note to readers:  I did not know that Jay Cutler existed until this morning.  I'm sorry - my sports knowledge is limited to Larry Bird and anything Red Sox.  I also keep typing "cutlet" instead of "Cutler" and now I'm craving a chicken sandwich.)  Another pro-athlete joins the diabetes community.  And so far I've seen "type 1 diabetes" called "a treatable form" (as opposed to the kind that eats people?) and "the more serious type."  Sigh.  Let the media blitz begin!

2.  My wedding day is just sixteen days away, and I'm starting to get all twittery with preparation and nerves.  This month's Generation D column is about how I'm preparing to manage diabetes while at the wedding - including hiding a tube of cake gel in the maid of honor's flowers.  Everyone's a little ninjabetic sometimes.  :)

3.  A few days ago, unannounced and almost hidden in the rose bush outside my house, a package from Medtronic did appear.  And inside of it, boys and girls, was a One Touch UltraLink meter.  (This sounds like a ridiculous fairy tale already.)  I'm going to do a ful write-up of the meter next week, but suffice it to say that this thing kicks ass.  Except for the first test I did, it's been accurate (within a few points of my Ultra2), quick to transmit, and it's familiar in that "Hey, it's a OneTouch" way.  Granted, it's huge, but I'm willing to give it a go.  I know a lot of diabetics in the blogosphere received this meter, too.  I'm excited to compare notes next week.

4.  Last night, I hit the lowest low I've had in a while:  36 mg/dl.  I must have overbolused after my post-workout snack.  It started when I was in the shower, as I stared at the shampoo bottle for a few minutes before I realized that my legs were shaking.  Nervous and alone in the house (Chris is away on business), I grabbed a towel and went out into the kitchen.  With waves of panic, nausea, and lethargy coursing over me, I consumed three tablespoons of honey and a pile of Nutter Butter cookies in what felt like one breath.  Thirty minutes later, I was feeling much better.  My blood sugar had cruised up to 212 mg/dl.  And my shirt was covered in Nutter Butter crumbs.  So much for trying to keep things low carb until the wedding.  Blast.

5.  Random:  This website made me laugh:  GraphJam:  Pop Culture for People in Cubicles.  Among my favorites?  The one about judging website author sanity.  And the one about shooting the sheriff.  These witticisms are quick and clever and I am so amused by this silliness.

6.  This weekend, once Chris returns, we will be doing seating charts, favors, and picking out the song to dance to for our first dance.  We don't have "a song," so we're on the hunt for a classy, lovely, and danceable song to debut as husband and wife.  (We do NOT want a song that has an awkward part in the middle, like Stairway to Heaven, where it gets all fast and is uncomfortable to dance to.  Avoiding that.)  Here's what we have so far:

  1. Ben Folds - The Luckiest
  2. The Frames - One Irish Rover
  3. Etta James - At Last
  4. Elton John - Your Song
  5. Billy Joel - She's Always a Woman
  6. Radiohead - True Love Waits
  7. Counting Crows - Colorblind

Do you guys have any suggestions?  I'm open to anything that's sweet, but not overly sticky.  And I so appreciate all of your help with this stuff.  I need to send thank you cards to everyone in the Blogosphere!  :)

I'm off to keep on truckin' towards my wedding day.  Sixteen days?  Ahhhhhh! 

May 01, 2008

Empty or Full?

I am not the one who just lives in the moment - I'm the one preparing for the moments to come, as well.  I live it up and have a great time doing whatever it is I'm doing, but as I'm hanging with my friends or having dinner with my fiance, my brain skips ahead a few hours.

"Do I have juice in my purse for the drive home?"
"Is there enough insulin in my pump to get me through dessert and coffee?"
"How many test strips are left in that bottle?"
"I called in the prescription, didn't I?"
"If this train ends up being delayed, do I have enough snacks on me to get through?"
"Don't forget to bring home the charger for the Dexcom."
"Shoot, did I send out that article?"  (Whoops, not diabetes-related.)
"I need to buff out that scratch on my car."  (Okay, not diabetes-related either, but it looks terrible.)

It's hard for me to tell if I am this way because I'm diabetic, or if I would be this way regardless.  Would I be so prepared and fastidious if I didn't have to worry about the minutiae of diabetes?  Whatever the case, I'm always noticing how much juice is left in the fridge.  I know exactly how many bottles of insulin are in that styrofoam container.  I keep track of the co-payments, the medical insurance, and when it's time to make a doctor's appointment.  (Yet I can't keep track of my email inbox to save my life, but I've digressed yet again.)

I notice how many AAA batteries are stashed in the bathroom cabinet.  I think about when my next site change is.  And when both the insulin and battery life indicators on my insulin pump start pinging, those facts burrow themselves in my brain and stay there, gnawing until I fix the problem.

Empty and empty.

Diabetes causes me to keep a constant tally of moments, a ticker tape of tasks that run through my mind and has me always thinking ahead to the next possible scenario.  Diabetes requires so much preparation in efforts to enjoy even the smallest moments.  This is not a depressing fact - just an honest one.  But after more than two decades of doing this, it becomes autopilot.  And not just for me.

Friends:  "Ready to go ... and do you have your meter?"
My Mother:  "Do you need the carb count on that?"
Chris:  "Is there juice on the nightstand?"
Me:  (smiling because I know they love me and I know they care)  Yes. 

It's good to be prepared.  Thinking ahead keeps me safe.  (But after I refill my pump, I'm going to buff that damn scratch out of my car and send out that article.  And move closer to my wedding - 17 days!)

April 30, 2008

SEO: Get a Pancreas!

Get a pancreas, will ya?After checking my statcounter today, I saw too many search terms leading readers here that made me laugh out loud - I had to share.  Here are today's search terms that made my brain melt:

"finger tips hurt when urinating"
(What the heck?)
"insulin pizza party time"
"I believe in love and rockets" 
(I agree.  I love 'Love and Rockets.')
"squirrels are in my pillow"  
(This is an issue that should be addressed promptly, no?)
"diabetes don't want to prick" 
(Too much of an open door with this one.  Let your mind have it's way with it.)
"needles hurt and make me want sausage" 
(A Siah Sausage?)
"do not have a big wedding" 
(Too late.)

And my personal favorite:

"Get a pancreas!"

Damn straight.  :)

AccuChek Spirit Pump: Help!

Hey guys.  I'm sending out the BatSignal for a reader who is looking for some information:Sueprfriends, unite!

Hi Kerri,
 
I'm looking for information on the AccuChek Spirit pump.  I currently wear a Cozmo insulin pump and LOVE it, but my new insurance only covers Medtronic and Disetronic insulin pumps.  I have worn a MiniMed pump in the past, so I know what that's like, but I'm looking for any user experiences or advice on the Accu-Chek pump.
 
Thanks very much!
Jenni
If you are an AccuCheck pump user, or if you have any advice regarding this pump, please leave some love for Jenni.  Let's show her what this community can do (which is to show what real life with diabetes is all about)! 

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I am not a doctor (oh thank God). I am not a certified diabetes educator. I have no medical degree and I can't even juggle. Nothing on this site qualifies as medical advice. This is my diabetes life - if you are interested in making changes to yours, please consult your doctor.
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