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."

Tuesday, October 27, 2015

Mopping Up After a Nightcap Hypo

My watch said 10:56p, and as I walked toward the glass gas station door, the time written on the glass told me closing time was in roughly 4 minutes.

Though the glass, I could see the gas station attendant mopping up around the counter. The shiny wetness told me he'd already cleaned the floor in the two food aisles where I planned to beeline toward once going inside.

As I pulled the door open, he tossed a semi-annoyed look at me and the black dress shoes I was tracking inside.

"Did I make it?!" I asked, glancing at my watch for no reason except to show him how concerned I was with the time.

He didn't respond, but I really didn't care because this wasn't a pleasure visit to the gas station.

No, I had a mission. And the vibrating Dexcom G4 on my belt reminded me that there was a more critical point to all of this.

The 48 on my Dex receiver and CGM in the Cloud connected Pebble watch reminded me of the more critical point to all of this, the nightcap hypo that had dragged me from crawling into bed at a nearby hotel.

This wasn't the kind of night cap I'd wanted.

Here I was, on a two-day work trip, just close enough to home that I could make the 90-minute drive but far enough where it was better to just stay the night locally. I'd been walking around a college campus for a good chunk of time, and after finishing up the day's event snagged some lower-carb food and a drink at a nearby restaurant. I had just found my way to the hotel for the night and after ironing my shirt for the following morning, was ready to crash for the night.

Then, I heard the vibration and "BEEP BEEP BEEP"of Dexcom on the nightstand.

I'd been ignoring the down-trending arrow for awhile, assuming at some point my dinner would kick in and start boosting my blood sugar. But that hadn't happened, and now I was dropping dangerously low.

Two straight down arrows. Already Below 55. And then, it dropped into the 40s.

Nothing in the backpack or quickly-packed dufflebag, I discovered. An out-of-state work trip a couple days earlier meant that on my one day off, I hadn't restocked with a cracker pack or anything of substance to keep my BGs balanced.

In my Hypo Mind at that moment, I didn't realize that I did have a jar of glucose tabs but it was buried in my duffle bag.

This was a smaller hotel just outside of the college town I was in, and the vending machines in the hallways only had drinks. I bought an orange juice with the $2 in my wallet, but this wasn't going to keep my sugar steady and it would start dropping once I actually went to bed.

I needed food.

This low I could feel. It wasn't completely impacting me yet, but I knew it would be minutes before that started setting in.

So that meant going outside the hotel to the gas station a block away, on the corner. I choose to drove and not walk in order to not risk going lower thanks to the exercise. Keep in mind, I'd already gulped down half a bottle of Sunkist juice from the vending machine, so I knew it was just a matter of time before I would see the surge upward.

 Pulling up to the gas station, the pumps were already dark and I could tell it was almost closing time. But I needed food.

Once I walked inside, it was a simple task -- once I could focus enough to figure out what I needed to buy -- of grabbing a few snack items. Pop tart, a candy bar, another OJ, and a pack of Nutter Butters.

Stuff that was all in one place on a shelf corner, and had some substance in case I dropped lower overnight at any point again.

"Is that all?" the gas station attendance asked me, once he put his mop down and was behind the register.

"Yep, just these. Nothing fancy."

"Some late night snacking, I take it..." he offered, searching for more of a reason as to why I barged in disrupting his mopping routine.

"Pretty much. Stocking up."

That's all I said.

In my head, I fumbled around with thoughts of justifying my purchase. Maybe that this was pretty much for medical reasons, and how this could be a moment of diabetes advocacy. I felt guilty. Both for the thought that I was contributing to society's perception of unhealthy late-night eating, and also that I didn't "advocate" or anything.

But nothing more needed to be said in that moment. I had my food, paid and let the attendant go about his closing-time mopping.

And I went back outside, ripped open the Nutter Butters, and began mopping up my low blood sugar symptoms for the night.