Thursday, March 10, 2016

Happiness and 32 Years With Type 1 Diabetes

You know, I am very happy with my life.

We can complain all day long about This or That, but when the rubber meets the road, the undeniable fact is that I'm doing OK. I've got more to smile about than not.

Especially when it comes to diabetes.

I am 37 years old and today marks my 32nd year of living with type 1 diabetes. At least, according to my self-proclaimed diabetes anniversary day.

Oh, and it just so happens that today's also the birthday of Mr. Chuck Norris -- so that's even more awesome.

We can find so many things in life to gripe and cry about. I do quite a bit -- from insurance coverage woes, to carb counting and meter accuracy to complications and everyday stress that throws my blood sugars into a tizzy.

Yep, I'm rolling with some mild complications (retinopathy and neuropathy, among them) after my three decades of T1D. Nothing too serious, just hovering there in my world like a dark cloud that sometimes appears in the sky but most of the time isn't visible.

And I have a pretty serious post today over at DiabetesMine, about an insurance hassle that's come up relating to my CGM sensors. It has me a bit worked up, but I'm confident all will be OK. Shit happens, and when it comes to D, I am ready for that.

But on a diaversary day like today, it seems a good time to reflect on how good I've got it. Too often,  I don't spend enough time appreciating all I have. The simple moments that make me smile.

Right now, I'm focused on the little things in life that seem to almost be trivial enough to not register -- but they are, in fact, the most important aspects of what my world is at this moment in time.

It's trash day and I did my duty and collected the garbage cans around the house and compiled everything in the big can that goes out onto the carb, along with the blue recycling bin. But then I overslept, and so my wonderful wife finished the job and dragged everything out to the curb.

Yep, she's awesome.

Most of the dishes are washed, but not all of them -- because, I'm not that motivated.

Some of the laundry is clean, yet it still sits in the clean laundry basket waiting to be folded -- and it's been a few days, so it very well may end up with the unclean laundry baskets and just get tossed in the washer again.

These are the simple life truths, and last night sitting around after the Midnight Hour, I found myself appreciating them even more.

Today, this will be a normal deadline-driven workday. I'll be working at a remote office and facing a daily commute, something that I'm not accustomed to. After work hours, my wife and I will go out to a dinner together -- nothing fancy, but just enough to be special. Because, we are together. And I know 100%, that without her I would not be here to mark this 32nd diaversary.

Sitting here (last night), I think of her. I'm watching West Wing on Netflix -- because it is Election Season, and we're all wanting a president like Jeb Bartlett. But that aside, it's my appreciation and love for life and my wife that shines through. Those eyes make my heart leap with joy, and I can hear that hallmark laugh of hers and it brings a smile to my face.

Life with diabetes can be tough. But I know, all will be fine.

Tonight, there will be a toast at dinner marking this Year 32. It will likely be a Michigan microbrew or a fine Bourbon to mark the occasion, and I'm pretty sure we'll throw a dessert (maybe even a cupcake!) into the mix from there.

And while there may not be a Beta Cell Bash to mark the occasion as in years past, and I'm bummed to not be heading to this year's Diabetes UnConference in Vegas like I did last year, I know this one is just as special as all the rest. Here's to being alive -- thanks to insulin, inspiration, love, support, and the latest and greatest technology.

Can't wait to see what's next, as I move toward future diaversaries.

Monday, February 29, 2016

Hello From The Other Eye Docs


Hello, it's me.

After all these years, we're fully established back in Michigan after more than a decade in Indiana. And with that, comes finding the new doctors -- including my trusty diabetes-focused endo Dr. G, and that ever-important eye specialist who's going to see me (!) through whatever vision and retina woes may come my way.

Making a new appointment at the start of the year and going through all the insurance referral hassle thanks to the new HMO, that appointment finally came at the end of February.

No, it's not with Adele. So sorry for that opening -- couldn't resist.

I've never been to this eye clinic before, but this doctor's name was on a list of about a dozen others given by Dr. G. Along with his eye credentials as an expert in this field, I put some faith in that. The whole appointment took about 2 hours to go through the new patient process and enter in all the info that apparently didn't transfer over from the electronic forms I'd filled out ahead of time.

And apparently, this office didn't have my files from Dr. Funky Eye back in Indiana and so they didn't have my basic eye and health history. Even though I'd made sure to fill out the required authorization forms and confirm all this had been done back in January... (sigh).

After everything, I met with Dr. Eye Glass who was able to get a look at my eye strength and figure out what I needed as far as contact lenses and new glasses. It's been about 5 years since my current pair of glasses, and she noted how it was time for a slightly stronger Rx. I also mentioned that I'd started experiencing that "Bifocal Effect" during the past couple years, and had trouble reading with my glasses or contacts without using a cheap pair of reading glasses.

She suggested I try a new high-tech lens, Sync 8. Apparently, it's aimed at younger generations or those who find themselves starting at computer screens, smartphones, TVs and all the other near and far distance things in life. They're supposed to basically be like bifocals without the traditional lines or tiered design. Dr. Eye Glass also pointed to another high-tech feature dubbed ReCharge, which reduces by 10% blue light that comes from smartphone and computer tech.

Both sounded fine by me, so that's the plan in the coming weeks - to pick out a new pair of frames and get them ordered up.

I was happy after seeing Dr. Eye Glass, and sat back in the waiting room with my eyes dilating as I waited for my new ophthalmologist. I didn't wait long.

After some initial intros, he and I delved into my record -- which didn't have much. Even though my eyes were dilated, I swear he rolled his eyes at me a few times when after my responses to questions about basic eye and health history, relating to diabetes and the diabetes retinopathy I was first diagnosed with retinopathy in 2007.

Sure, the retinopathy had never really gotten worse over the years and was always confined to the levels of "keep your blood sugars under control." Even in 2011, when it did get a bit worse than it had been before. So, I was sure that it had gotten even worse since the last time I saw Dr. Funky Eye in Fall 2014.

He shined the blue and very bright white lights into my eyes to get a peek behind the retinas, and after a minute or two, he wheeled his stool over to the desk to jot some notes into his file. Holding my breath, I could hear my heart pound as I waited to hear how much worse my retinopathy had gotten.

"Your eyes look wonderful!" he said.

And then he said nothing else. There was no "But" coming after that, it seemed...

My heart did a little dance, but I was also a bit unsure.

"You mean, it's still in check and the retinopathy isn't any worse?" I asked.

No. Actually, he didn't see any signs of retinopathy.

Hmm. OK, but how is that possible when I haven't really been doing any better D-management wise in the past year or two....

He didn't answer. There was probably an eye roll going on there, that I couldn't see. So, I decided then that his pseudo-name would be DR. EYE ROLL.

Also, he did another look into my eyeballs and Pffted -- YES, he actually Pffffftd! --- when I mentioned the optic nerve hypoplasia that Dr. Funky Eye had previously diagnosed me with back in 2009. This was when we noticed I couldn't see the lower half of anything out of my right eye, thanks to my optic nerve not being fully formed there.

There was also no sign of that, Dr. Eye Roll told me.

Double Hmmm.

We chatted, he seemed a bit rushed, but happy that my eyes were fine -- especially for someone with type 1 for 32 years. He suggested a field vision test next time, in a year from now. Even though I'm pretty confident the whole array of tests in that first 90 minutes of my appointment included those very same type of vision field tests.

At that point, my confidence in Dr. Eye Roll completely faded and I decided we may not be seeing each other again (seriously, no pun intended).

Sure, I am happy to hear no retinopathy. But I think a second opinion is warranted.

Still, I do like Dr. Eye Glass and plan to return to this clinic's optical shop to snag my new lenses. Just, I don't think Dr. Eye Roll is going to be my new Eye Guy going forward.

We'll see...

Monday, February 8, 2016

Hello Again, Mr. Mumbles

Several years had gone by since the last time Mr. Mumbles visited our house, and quite a bit has changed. But one thing that hasn't is the fact that once again, Mr. Mumbles met Mr. Diabetes in way that wasn't too much fun.

One day after my 37th birthday, I found myself in the dental surgeon's chair getting two teeth removed.

A bridge had come loose just before Christmas, and a subsequent dentist appointment in January after the bridge was removed discovered the teeth underneath weren't salvageable. So, setting the appointment as early as possible without interfering with my actual birthday, I scheduled the extractions.

The experience itself wasn't all too bad, as I specifically asked to be put under. We got to play a fun round of "Find A Vein" until they punctured both elbow joints and my left hand, before settling on a particular visible vein on the top of my right hand. Under pretty quickly, and the teeth were extracted.

Then, the true adventure began.

That first day after is when the pain set in, and aside from looking like a pitiful chipmunk, that old chum Mr. Mumbles came to visit. Last time Mr. Mumbles came to visit was 2012 for a root canal, and before that was 2008 after a tricky root surgery under my gum.

All of this, is part diabetes and part oral hygiene over the years. I've been told my teeth and gums are particularly susceptible to decay and dental horrror, for whatever reason the Diabetes Gods saw fit for me.

Once I got home, we were already well-stocked on pudding, applesauce, yogert, Poweraid, and gel packs for hot and cold compressions. Not to mention pain pills and my 7 days of antibiotic.

Since I wasn't eating much, my sugars tended to run lower -- except that first couple days, when I was fighting off the pain and immediate surgery aftermath when I stayed in the 200s most of the time. But I made sure to keep up my food intake and dose accordingly, and when my CGM wasn't connected I tested frequently to make sure all was OK on the blood sugar front.

I had assumed by the weekend, I'd be all set and back to my regular self. But Mr. Mumbles remained for a few more days, preventing me from going to a much-anticipated Michigan DiaBuddies meetup and also a Superbowl gathering with friends. I later learned on Facebook about 30 people showed up to the D-Meetup, and there were even Blue Circle Cupcakes! Bummed totally, I am.

Next step in a couple months: getting an implant or two. The whole process is supposed to take about six months or so, and I am hoping by Fall we can get all of this finished up.

I don't like Mr. Mumbles all too much, so the fewer times we can visit is preferred.


Saturday, January 16, 2016

Mountains + Valleys + Mittelgebirge of Diabetes


A new day begins.

All is smooth, as I coast along the waters and taking in as much of my surroundings as possible as I go about my daily business.

My waters get rocky and I make a dash to the coastline, journeying onto land and venturing toward a spot that's somewhere between a short hill and high mountain. Was that water the Atlantic Ocean or the Great Lakes, and are those Mittelgebirge of Central Europe or am I still in my beloved Midwest, seeing a small jump thanks to an afternoon energy-boosting snack of Michigan-made almonds and cheese-stuffed mushroom.

Not sure, but wherever I am and wherever I'm heading, I am ready.

Dinner takes me to China. Spicy Kung Pao beef with fried rice, an egg roll with sweet & sour sauce, and Wonton soup. Pre-bolus, with 40% now and 60% stretched out over three hours.

Enter the Chinese mountain climb, but one that only takes an hour before I start descending.... down, down, back toward sea level until I plummet too far into the Chinese Valleys below my hypo threshold.

Correct, correct, climb back up. Ever so slowly and cautiously, taking it easy and not overloading because I'm not ready for another climb.



My journey continues, as I creep upward. But all I want now: Sleep. That will go over well, after this somewhat tame Glucoaster of a day. This one was a success, part of my new D-management strategy for 2016 to hone my climbing skills up and down the slippery slopes.

Today's journey was OK.

Where will I end up tomorrow?

Saturday, November 28, 2015

Sometimes I Lie

Confession time.

Sometimes, I lie about my diabetes data.

Just like I did back in my teen years, I tell fibs when it comes to my blood sugars. But unlike those days back in the 90s, this is real-time D-lying and it's mostly during the middle-of-the-night hours.

The reason: To shut my D-tech up when it's getting on my nerves.

When it's late at night, and all I want to do is sleep, my Dexcom CGM sometimes decides that the sky is falling and my blood sugar is Low. So, it decides to start vibrating incessantly and then beeping just to make sure I haven't missed the alerts.

Of course, I am connected to CGM in the Cloud and thanks to the trio of Dexcom SHARE/Nightscout/xDrip my real-time data is streamed to my wife and she's able to know where my BGs are hovering at that given time. She gets alerts on her Pebble Watch, just as I do simultaneously on my 4 CGM-connected devices (G4 receiver, regular Android phone that has Dexcom SHARE app, secondary Android phone for Nightscout/xDrip apps, and my Pebble watch).

All of those alerts bug the hell out of me, when it's the middle of the night and sleep is all that's on my mind.

Those times I'm traveling, alone in a hotel room... and the Dex goes BEEP BEEP BEEP to let me now I'm 60 and dropping. With a straight down arrow.

And knowing that I managed to forget to stop at the nearby store or front hotel food stop, to buy a snack to boost my blood sugar in the middle of the night. Maybe there's a $12 candy bar or orange juice in the mini-fridge. Or there's a vending machine right down the hall, assuming I have a couple dollar bills in my wallet.

If not, my emergency glucose tabs in my suitcase are on hand 95% of the time (when I didn't forget to pack them).

Whatever the food or drink or glucose option, my blood sugar is usually on the way upwards within 10 minutes.

That doesn't mean my Dexcom's caught up, or the data being sent to my wife many miles away (sometimes 3 time zones away) is showing this treatment.

Nope, according to Dexcom: I'm still at 55 or so.

That's when I lie.

I calibrate my Dexcom and tell it I'm actually higher than what the device thinks at that moment. Maybe it's 85, or depending how sleep-deprived and grumpy I am, I may lie and tell it I'm in the 140s just to boost it above the "Low 70" threshold.

And then, when it's comforted, I go back to sleep. Knowing my wife won't be worrying, even though I've already texted her I'm OK or we've exchanged calls saying all is good and I'm treating.

Usually within 5 hours, I am waking up and able to re-calibrate to make sure the CGM data is back on track and not way off. This hasn't been a problem, the handful of times I've "lied" to my Dexcom. Typically by lunch-time, we're back in line and spot-on as to CGM accuracy.

Sure, I get that lying to my CGM isn't how it should work.

I'm like a teenager writing in my handwritten BG log, fudging numbers before my endo visit (yes, I did this). Except now I'm using tech to do this, and be lazy.

The honest to God truth: Diabetes tech can be a bitch, even when it's saving your life. First world problems and whining D-tech trains of thought aside, it is what it is. This is just me complaining, stepping beyond all the perspective and access talk that comes with diabetes tech these days.

Most of the time, I know why I'm Low. It's not a case of my not knowing what's causing these, and prolonging the issue just because I'm lazy. No, it's simply that the low-carb meal that I dosed for but miscalculated for is hitting me now in the middle of the night. And I'm just not prepared to deal with it, thanks to sleepiness or whatever else.

No, this is a relatively small gap of time where I know I'm going to be OK, and will likely be in the high 100s or 200s before long, but I just don't want to endure the repeated alarms of my D-tech that hasn't figured out I'm actually OK yet.

Every time I've lied, it's for my own peace of mind for sleeping and my wife's that I've done this. And I am OK with that, because it doesn't happen too often and I am always OK when doing this, at very little risk of dropping Low again.

Sleep is important, and during busy travel when it's even more precious, I am OK with fudging my CGM data and data-sharing info. At least, during the overnight hours.

Lying isn't my standard protocol. But sometimes, I say, "Fuck It. Let there be sleep."