But now, I'm a slightly more responsible adult, and I'm trying to wear a medical alert bracelet as often as possible.  I do a lot of solo traveling, so having something that lets people know I have diabetes in the (hopefully never) instances when I can't speak for myself is a safety net I don't want to pass up.  And thankfully, medical alert jewelry isn't as ghastly as it was back when I was diagnosed. 

This bracelet is one I received from the team at Lauren's Hope, and it's pretty enough to wear every day, but the alert plate is big enough that I feel confident it will be noticed as a medic alert ID.  

I asked for the inscription on the back, because I have this fear of being in some kind of situation where my pump will be accidentally disconnected, and I want any kind of emergency personnel to know that I am insulin-dependent.

It's pretty.  I love it.  Birdy loves it.  ("Pretty, Mama!"  Then, "Eat?"  One track mind on that kid.)  It's functional.  And it's point is to save my life, if such a need arises. I'm hoping I can go at least a few months without breaking this one, clumsy bird that I am.

(Okay, disclosure time.  Lauren's Hope sent me this bracelet for free.  They also sent one to Abby.  They did not ask me to write about it, but I think they could safely assume that I would.  They're offering a discount code for SUM readers, if you're inclined to order anything for yourself.  My biases are disclosed, per usual.  But my opinions, also per usual, are my own.  And this disclosure, per usual, is too long.)

(My favorite part:  " What would happen if you ate a chocolate bar?")

At the twenty-three minute mark of my workout, I started to feel a little strange.  Heavy.  Like each foot had a big, fat chicken sitting on it, trying desperately to hatch it.  My arms were over-cooked spaghetti noodles.  And from the shelf, just a few feet away, I could hear the Dexcom buzzing over the sounds of Colbert's applauding audience.

"Twenty-three minutes ... I can get to thirty." 

Stupid, stupid, stupid Kerri.  This is the same brand of stupid where I think I need to test my blood sugar at 3 am before any drinking juice, despite the fact that I'm damp with nighttime sweat and dizzy.  And the very same brand of stupid where I clean the house instead of treating the low.  When the glucose is sapped from my cells, my brain doesn't know how to prioritize. It's like I need to challenge myself, taking control of a situation that's rapidly spiraling out of it, despite the fact that the smart and safe thing to do is treat the low.  But my brain doesn't function properly when I'm under a certain blood sugar threshold.

So instead of stopping my workout and going upstairs to raid the fridge, I pushed through the workout for a few more minutes, until that rational part of my brain spoke up.  

"Um, Kerri?"

I keep moving my legs, concentrating on the computer screen halfway across the room that was broadcasting the Hulu show.

"Hey, Kerri?"  My Internal Motivational Speaker pipes up again, more forcefully this time.

"Unh." 

"You need to go drink some juice."

I'm so low and so confused, but still trucking forward with this workout.  In my mind, I'm an elite athlete and moving with pop-and-lock precision.  But in reality, I'm loose and fogged up, my knees buckling every few seconds.  My whole body is screaming at me to STOP but my brain is drunk with power (seeing as how it's probably the only part of my body receiving any glucose).

"I need to get some juice," I say outloud, like I just thought of it.  I can hear my Internal Motivational Speaker sighing.  The ellipmachine shows a completed time of 18:58 and my brain is rattled by the fact that the numbers aren't round and complete.  (What is it about that need for symmetry and control when my blood sugar is in the trenches?  Why can't I force myself to focus on what I need, instead of what my OCD flare-ups are re-prioritizing for me?)

Once upstairs in the kitchen, my meter shows me at 48 mg/dL.  The grape juice enters my system almost immediately, firing off the synapses that were previously on snooze.  I start to relax.  I start to come up.  My brain switches back on in full.  And I realize how stupid, stupid, stupid I am.

"I'm an idiot," I mutter, wiping the sweat from my brow.

"I agree," the voice in my head mutters back.

(But damn it, once I was back up in range, I finished my workout.  Am I stubborn?  Yes, yes I am.)

This past semester, I decided to test out my survival skills and study abroad in Copenhagen, Denmark.

... okay so it wasn’t quite as dramatic as the Hunger Games-esque experience I was secretly hoping for, but I did have my fair share of diabetes moments that required some survival-of-the-fittest techniques (or as survival-of-the-fittest as a first world country can get). Prior to departure, I knew little about Copenhagen other than it has good pastries, lots of bicycles, free health care, and the largest number of happy people in the world. [Editor's note: Is this true? Are the Danish super happy?]  All things I’m strongly in favor of – so why not?

I knew I would encounter some challenges with diabetes, so I tried to take as many precautionary measures as I could. The biggest one was ending my nearly two-year pump-break and going on a shots-hiatus. I reconnected ole yeller [Editor's note again: I'm going on the assumption that Ole Yeller is the pump.]  back in July, about a month before leaving, while working at CBC, where I was surrounded by diabetes experts. This gave me time to readjust to pumpster and figure out some basals and ratios. I’m more in check with my diabetes while on shots, but I knew my life abroad would be hectic and I’d need some extra flexibility. Best. Decision. Ever.

For the most part, I feel like diabetes didn’t really impact my life in Copenhagen. I had an incredible time, and the majority of my daily life wasn’t too out of the ordinary. With the exclusion of:

1. Weird carb counting (so this whole package weighs 534.7 grams and 100 grams has 29.8 carbs and each cookie feels like it weighs three billion grams soooo I guess I’ll just bolus for 12 carbs)
2. Biking everywhere all the time (I love incognito exercise. Unless it’s 7:30 am and I need to bike 30 minutes to class and my blood sugar is 43)
3. Living alone

The housing I chose gave me my own room, kitchenette, and bathroom. I lived basically completely alone for the first time. This was great because I secretly love being alone. But this also absolutely terrified me –What if I have a really bad low? What if I have a seizure? What if my pump breaks and then my back-up pump breaks and then my insulin all goes bad and I go into DKA and I’m too stubborn to tell anyone and then I slip into a coma? Thankfully, these things didn’t happen. I had my fair share of lows, but my dear friend Dexcom helped me catch them before they ever became too severe. And I had multiple run-ins with fairly massive ketones, but never to the point of needing medical attention. Phewf.

But my biggest dia-abroad-fail moment ended up costing me quite a hefty sum of money. One night, after leaving my meter and Dexcom in my apartment and with my pump was trickling on its last few drops, I lost my keys. My super intendant wasn’t answering his phone, so I couldn’t get the master key. So I coined some first world survival techniques and called a locksmith. But he ended up needing to drill through my lock, destroying it. Between the locksmith and the new lock, I ended up paying about 2500 Danish Kroner – around $500. Ouch.

This little fiasco was one of a few I’M GONNA DIE WHAT AM I DOING HERE moments. But they were always short-lived, thanks to this beautiful new thing called the Internet, where you can almost instantly talk across the globe to people with diabetes. I know my diabetes wasn’t as well managed as it has been in the past, and maybe I could have paid a smidgen more attention to diabetes. But looking back, I wouldn’t do it any other way. I didn’t let diabetes hold me back from biking everywhere or trying new foods or from traveling to seven different countries. I not only survived and avoided any real disaster, but I explored, learned, and grew; both as Julia-with-diabetes, and as just plain Julia.

*   *   *

Julia Romano has had Type 1 diabetes since the ripe old age of twelve, and is currently a junior studying psychology and theater at Skidmore College. In the summer, Julia ventures to Massachusetts to play with dianuggets (“dianugget”: a wonderful and adorable child with diabetes) at Clara Barton Camp. Julia loves elephants, knitting, and fanny packs – hoping to someday knit a fanny pack for an elephant. She isn’t sure where her life will end up post-graduation, but she knows it will probably involve grad school, laughter, and children with chronic diseases.

I know these pictures aren't representative of how my diabetes is controlled, on a day-to-day basis.  There are way more times that I'm muttering "You stupid jerkface pancreas ..." than moments when I want to whip out my camera and take a snapshot for posterity.  But I like having these happier photos outnumber the ones that make me grimace, because when I need a lift, it's nice to have a catalog to draw from.  This is what I chose to document, visually, because it inspires me to earn this photo opportunity again, you know?

I chose to document this, because it made me feel good.

May will mark the end of my seventh year blogging at SUM (and starts the eighth year - jeepers), and when I look back through the archives, I'm weirdly proud to see a diversity in what's documented.  There are some really high moments (high as in "emotionally high," not "OMG, how did that 312 mg/dL sneak in there?" high), like when the Bird was born or when Chris and I got married.  And then there are low moments, like trying to be a strong advocate for PWDs while going through burnout, or when blue candles start peppering our Facebook feeds. 

And then I look at other people's blogs (holy crap, there are a lot of us!), and see that they're chronicling the good, bad, and decidedly 'eh' of life with diabetes.  The real stuff.  It's crazy how honest we are with the Internet.  I see people writing about things online that they might not be sharing with their doctor.  Or their coworkers.  Or their very closest friends. But it's shared here, and there's a power to sharing our stories.

I'm amazed at what we chose to document, as a community.  From celebrations of a no-hitter to scoring a quality pair of blue shoes, to difficult moments of feeling burnt out and admitting that we're struggling, what we document shows our strength as a community.  We're not afraid to share the stuff that really scares us, or empowers us, and we have one another to mark different milestones with.  What we share, as a global community, could help any one of us improve our health, emotionally and physically. 

Diabetes isn't a perfect math where you can just solve for X.  Usually, we're solving for "why."  And part of that equation is acknowledging, and appreciating, the sum of our community and what we document, every day.

It wasn't a matter of not trying other CGMs - I did give the Minimed system that was available in 2007 a try, but it wasn't a good fit for me.  (Here's a detailed post about why I wanted a continuous glucose monitor and my experiences with trialing both systems, and also has a lovely .gif of some soap on a box.  So there's that.)  The Dexcom has been a huge safety net for me, especially during the before, during, and after of Bird-Building.

More often than not, this system works for me.  It's spot-the-eff-on and it often triggers me to double-check my meter results when they appear to be roaming around unsupervised.  I rely on the Dex.  It wakes me up when I'm low, it rattles my cage when I'm high, and Birdy thinks it's the best thing since Siah's tail.

So when it's off, I'm thrown.  Last night, before I went to the gym, my meter gave me an 87 mg/dL and the Dexcom was in the same range.  When I came home from the gym, I was 215 mg/dL, but the Dex was lazily meandering in the lower range, yawning and eating potato chips and watching Are You Being Served.  Not even remotely tuned in to the fact that I was above 200 mg/dL.

"Nope."  I said, yanking the sensor out of my thigh.  

"Ouch," I said, as the new sensor slid into my other thigh.  (Usually they don't hurt, but this one burned a bit on reentry.)

I don't know what causes some Dex sensors to give up so easily.  And I'm not sure what makes me so stubborn.  This troubled little sensor gave me pause earlier in the week with a result much higher than my meter, but because I'm dia-frugal (read: aware of the cost of these sensors, and see also: aforementioned stubbornness), I restarted the sensor instead of pulling it out and putting in a new one.  Whatever the cause of this hiccup, I'm glad I caught this one as it went rogue, and I'm thankful I didn't make any treatment decisions based on the Dex's "recommendations."

New sensor is in.  So far it's in line with my meter.  And today I will test its legitimacy with plenty of coffee.  

[Dexcom disclosure]

Like in the Children's Museum in Providence, where a giant, rotating piece of art flows between a mermaid, a circus clown, and a unicorn. 

Or the fact that my daughter's pajamas are covered in teeny, colorful cupcakes.  (Also, she pretends to talk on the phone for long pockets of time.  Animated conversations with the ether.  I think she's prepping herself to be a blogger ...)

Actually, the diabetes-related rub here is that my blood sugars were great when I left the house, but after being nailed for speeding, I've since shot up to 217 mg/dL and am holding steady, despite bolusing.  The effects of stress on my blood sugars are direct and sticky.  (Also, just for the record, my shirt is blue.  Blue Fridays FTW?)

After a few weeks of feeling really tuned-in and de-sludging myself, I appreciate that diabetes reminders are everywhere.  Sometimes I need them; helps me stay in control.  But I don't always decide to notice them.  Artwork at a museum can just be artwork.  Pajamas are just pajamas.  And the piss-poor driving decisions made by this mama are just that: piss-poor.  ;)

A few minutes later, things are as they were.
I'm no longer sounding all drunk, with a slur.
The waiter comes back with his menu pad out
And we tell him the entrees we'd like to try out.
Our date night moves forward without any trouble.
(The waiter's confused, but i don't burst his bubble.)
It's not a big deal; it was just a quick thing.
But it's always a riddle, what diabetes will bring.

During my months of deep diabetes burnout, I didn't go to the gym without literally dragging myself there.  (Literally.  Like tying myself to the bumper of the car and putting a brick on the gas peddle, eeking myself down the road until I had couriered myself into the parking lot.)  I went, but not with excitement or vigor or any kind of desire to do anything other than plod around on the treadmill and hit the 33 minute mark so I could put the mental gold star on my chart.  

Finding the motivation to exercise can be as challenging as the motivation to stay tuned in to diabetes.  I think it's because there isn't an instant payoff - walking out of the gym after one cardio session and I don't feel like I can pick things up and put them down.  Similar to how a week of intense diabetes monitoring doesn't immediately drop my A1C.  It's a slow burn, and not seeing the immediate results of hard work makes sticking with the program a little tricky.  (Versus the consumption of delicious cheeseburgers equaling instant and delicious gratification.  Cruelly unfair.)

Before the baby arrived, Chris and I would go to the gym together.  His dedication to a consistent(ly annoying, sometimes) gym schedule has always impressed me, because I'm very easily distracted by things and would oftentimes wander off to check on ... hey, something shiny!  But when it was just the two of us, heading to the gym was something we did together, and something we did almost every day.

Then pregnancy.  And baby.  And that whole "ugh, I feel a bit strange in this new post-baby body."  And then the "Wait, I want to shed the rest of this weight and be done with it."  But I relied too much on Chris's schedule before, and since going anywhere alone together (oxymoron much?) requires wrangling in a babysitter, I needed to find my own inspiration, my own reasons, my own routine. 

A way of feeling good about exercise, instead of always muttering "Oh, eff you, exercise," in my head.

So, even though it feels scattered and even though my head isn't always "in it," I'm back to regularly exercising.  At least four times a week, I'm either at the gym doing a cardio workout (with a nice, long cool down where I take 20 minutes and read a book, which is the only time I ever have to read) or in our basement, using the ellipmachine and catching up on episodes of Uncle Stephen. 

It feels relaxing.  It's nice to have an hour to myself, where I sweat and keep an eyeball the Dexcom graph and let my mind go blank for a little while.  And even if the effects aren't immediately obvious in my A1C or my level of fitness, my mental health is already benefitting.  Like I said, small steps.  Focusing on the emotional and psycho-social stuff.  For me, that's the only way to reclaim my health.

That, and it's the only way I'll ever finish reading a book again.  

My first day of orientation at my new job brought a lot of stress. From getting on the shuttle bus and asking a total stranger if I couild sit with her, to sitting through a lecture about the Nurses Union I now belong to while having no idea what they were talking about, to that low blood sugar that hit right before our lunch break.

Luckily, that day I sat next to a nurse who I had had a "pre-orientation" meeting with, so I was a little more comfortable in this room filled with 75+ strangers (and at a table near a super cute male nurse - made the boring day a little less boring).  Through chatting with her, I found out that her husband has type 2 diabetes, so she knows what this whole diabetes thing is all about.  I told her what my Dexcom receiver was (I had it sitting next to my coffee on the table) so that she wouldn't think I was texting throughout the lectures.  (And then we talked about how ridiculous it was that the muffins provided for breakfast were covered in brown sugar on top.)

Then I saw that 54 mg/dL on my Dex about 15 minutes before the scheduled lunch break. As I chomped on two glucose tabs (I was symptom-free at this point) my new nursefriend next to me looked over at me. She looked down at my Dexcom, studied my face for a few nurse-seconds and said:

"Are you okay?"

I nodded, and continued chomping.

Then the nursefriend just smiled, and went back to listening about parking passes.

If you have diabetes, you know why this made me feel so comfortable. There was no stress from her side conveyed to me. She didn't freak out and ask someone for juice. At no point did she have a worried look on her face. She just knew. My new nursefriend understood that those three words - "Are you okay?" - were all it took. If I needed help, she gave me the opportunity ask, but she also gave me the opportunity to take care of myself, knowing that someone was looking out for me at the same time.

I'm quite sure that it is extremely difficult to be a person who cares about someone with diabetes, without actually having it yourself. One minute, we want you to fall all over our low blood sugars and and stop time to help us, and the next minute we want you to completely ignore the fact that we even have diabetes. And there is no reason for us to feel this way; we just do and probably always will. But sometimes you type 3s get it spot on. You just know what way to react is best, every time, and for that I am grateful.

New nursefriend's future patients sure are lucky to have her.

*   *   *

Again, Abby, I'll assert that your future patients are lucky to have YOU.  And for others who are disclosing and dealing with diabetes in new situations, how do you prefer people handle your diabetes?

Small steps are what move me forward best.  What helps you start stepping out of diabetes burnout moments?

Actually, I have a little bit of an idea.  My mother-in-law loves the Cooking Channel and she watches a lot of the cooking shows.  Sometimes she tells us about a delicious recipe she saw, or wants to try.  My MIL is my link to the cooking community (because we all know my talents are limited in that department ... see also my contribution to D-Feast and that thing about froast).  She's the one who told me who Sam Talbot was.  And she filled me in on Paula Deen.

My personal knowledge about the woman is limited, though. 

What I do know is that she was diagnosed with type 2 diabetes about three years ago.  And in the last few days, she's come out as a spokesperson for Novo Nordisk's diabetes drug, Victoza, with her web presence at the branded "Diabetes in a New Light."

But holy crap, the Internet has plenty of opinions about this woman.  The Huffington Post said "Paula is now suffering from the popular perception that money bought her new-found honesty." Anthony Bourdain Tweeted, "Thinking of getting into the leg-breaking business, so I can profitably sell crutches later."  Run a Google search on "Paula Deen and diabetes" and your web browser will collapse from the weight of opinions. 

I don't know the woman.  I have no idea if she is drinking her own KoolAid (or, in this case, eating her own glazed doughnut sandwiches).  But after all the emails I've received and all the posts I've seen in the DOC, it's hard to ignore this discussion.

On one hand, why not talk about her diagnosis after it actually happened?  Why wait for Pharma dollars?  Amy Tenderich shared her opinion: "Building a food empire on unhealthy foods and then being diagnosed with a chronic condition with a known correlation to food and obesity has to be difficult, not to mention embarrassing.  I can understand why someone wouldn’t be anxious to put themselves in that kind of spotlight — although it was inevitable eventually."  Paula Deen said herself:  "I had to really get myself into a place when I made the announcement. I would come with information, and I would be armed to be able to help others." 

Disclosing her diabetes when she felt best-armed to discuss it?  To each their own.  Continuing to market her less-than-healthy recipes?  She can do that, too, you know, even if the media wants to go apeshit on her for doing so.  If doughnuts end up on my plate, it's not because Paula Deen put them there and then crammed them into my mouth.  I think we need to own our own actions, and not be so quick to blame celebrities for being the voices in our heads.

On the other hand, what I also know is that she, like me, is a person living with diabetes.  Paula has type 2 diabetes, while I have type 1 diabetes, but the fact remains that she is part of the diabetes community.  And just like everyone else, she has her right to disclose whatever she'd like, whenever and however she'd like. Not all of us talk about our weight.  Or our A1Cs.  Some of us in this community only disclose anonymously online, never whispering a word about our diabetes to our "real life" friends.  We all share at a level that we alone have the right to dictate.  So Paula Deen and her decision to "come out" as a type 2 diabetic is her call. 

George Simmons said it best, in my opinion:  "Everyone is a hypocrite when they're first trying to change."  For me, as someone who is deeply immersed in the diabetes community and relies on it for psycho-social support (just as crucial as insulin, in my opinion), I want someone to be there for Paula Deen as she adjusts to this new normal.  I'm not a doctor or a journalist ... I'm a person with diabetes, and I want to support my fellow PWDs.  So her past is slick with butter and glaze?  That was then.  She has a chance to change now - and not to impress "us," but to take better care of herself. 

What also made me laugh was Marcus Grimm's take on this, from a PWD point of view.  Here is Marcus's video (and here is Marcus's blog, Sweet Victory - read him; he's awesome):

(For me, I'd also have to add, "I need juice," and "I promise not to blog this.") 

Thanks to the outreach of a PR company, on behalf of Lifescan, I received a first look at the new VerioIQ glucose meter.  And I am relieved, relieved, relieved.

When I was in California a few months ago, I spoke with the Lifescan team about life with diabetes and the impact of the diabetes community.  I also, in sidebar conversations, voiced my concerns about meter accuracy, precision, and overall "trustability."  During our discussions, the VerioIQ was mentioned, and I couldn't wait to see it for myself.

So when it arrived last week while I was in NYC, I couldn't wait to get home and crack it open. 

First visual impressions:  It looks jazzy.  As Kim mentioned, this thing looks less like a glucose meter and more like an iPod.  At my friend's house last night, I whipped it out to test and she was all, "Hey, is that a new meter?" and I was all "Yup - interesting looking, right?" and she was all "It's way cooler than the other ones" and I was all "Holla."

Aside from a streamlined look and a really nice color screen, this meter has a light.  On the end.  Where the strip goes.  This development has been missing from One Touch meters, in my opinion, and is what made my experience with Freestyle that much better.  But the VerioIQ lights up, so even if you're testing in the middle of the night in the pitch dark with a cat weaving around your arms, you can see what's going on.  Very helpful.

I also like the way it charges; this meter has rechargable batteries, and I like that I can plug it into the wall and charge it up, instead of toting batteries around with me.  I'm not sure how long one battery charge lasts, but I'll find out soon.

UPDATE:  From the PR company, responding to some of our comments here:  "You mentioned not knowing how long the battery lasts.  FYI, when fully charged, the meter will perform tests for up to two weeks between charges.  The meter also provides several alerts when the battery is running low – this is to help prevent the situation you mention, being stuck without a charged battery.  However, if someone doesn’t charge the battery and the battery is completely discharged, you will not be able to test. 

If battery power is too low to do a blood glucose test, you can connect the meter (via USB or AC adapter, both included) for a 60 second rapid charge.  After the rapid charge, you will need to disconnect the meter from the wall outlet or computer before testing your blood glucose.  After testing, reconnect your meter and complete the charge."

First strip impressions:  The strips that come with the VerioIQ are completely different.  They look like little golden pitchforks, and they are thinner than my other One Touch strips.  They also suck the blood in from the side instead of the top, which is a different adjustment.  And according to the Canadian Lifescan website, these strips have "SmartScan™ Technology [that] analyzes your blood sample 500 times to correct for common interferences and deliver precision with every result." 

Oh yeah?  I tested these strips against the Ping meter, the Freestyle, and my Dexcom CGM, and so far, so good. The VerioIQ is almost SPOT ON with my Dexcom trends, and repeat testing (three times in a row) hasn't showed me any uncomfortable variability.  The results are no more than 25 points from one another, and I'm hoping this is a trend that continues.

First overall impressions:  I want to like this meter.  I do like it so far, but I'm not one to jump on the "I LOVE THIS!" bandwagon without doing a little more (literal) testing.  Like I said, accuracy and precision are my most coveted bits, and I want this meter to be the gold standard.  I've been a One Touch user for a whole pile of years now, and my insurance also gives priority to this brand of meter.  (I know - making decisions based on insurance sucks, but if it supports a meter I like, I'll roll with it.)  I want this meter to help me make decisions that will help me improve my A1C.  I want this meter to represent true progress in blood glucose management technology.  Sure, it looks cooler and more in line with today's technology, but I want it to WORK. 

So far, I like it.  I hope this trend holds.  If it does, I'll build a special little house for the VerioIQ to live in, and I'll make it lunch every day.

ANOTHER UPDATE:  The PR company also reached out to confirm that the meter is FDA approved and is currently shipping to retailers, to be available to us in 4 - 5 weeks.  Rock and roll!!

[Disclosure time:  I received this meter for free, in addition to 50 test strips.  I was not asked to write about it, but I'm pretty sure they knew I would.  I'm okay with that.  My opinions about this meter, One Touch, and bleu cheese are all my own.  I have an existing relationship with Animas Corporation.  I also have one, small, gray cat that is for sale.  Any takers?]