Thursday, August 23, 2012

Battery Caps and Needle Nose Pliers at 2am.

Don't get me wrong, I absolutely love and adore my insulin pump. But a few weeks ago we had a teensy weensy incident that ended up being one of those comedy of errors things that made me realize how ridiculous technology is sometimes.

Let me set the scene for you:

It's about 2am, the house is dark, I'm sleeping, my husband is sleeping, all is right in the world. All of the sudden I'm jolted out of my deep slumber by my head buzzing.  It's my insulin pump needing attention. I keep it on the "vibrate" alert mode, and when I sleep I tuck it under my pillow. So, you can see how at 2am when it started vibrating it would've rattled my brain a little bit.

My pump was alerting me that I needed to change my battery. No big deal. I knew this was going to happen soon since I'd been keeping a close eye on the battery symbol on my pump for days and knew that I'd need to "power up" soon. I'm a cheapskate, and I like to get as much power out of one battery as I possibly can, so I usually wait to change the battery until my pump alerts me to do it. This time the alert happened in the middle of the night, but that's the price I pay for saving a buck or two at the store.

Any way, back to the story. The pump alert jolts me out of my sleep. I groggily fumble with the pump to see what it needs, realize that I need to change the battery, and proceed to stumble around in our dark house trying to find the extra batteries I keep.  I get the battery, find a penny with which to unscrew the battery cap and start unscrewing it. And keep unscrewing it. And keep unscrewing it. My sleepy brain thinks "huh, this is taking a lot longer than usual," but because I'm half asleep I continue to unscrew the cap for probably another 5 minutes until I finally realize that something is very, very wrong.

I know that I only have about 30 minutes of power left in my battery, so I end up on the phone with Animas' tech support at 2am. (Thank goodness for 24 hour support!).  I told them what was going on, that I couldn't get the cap off, and they had me try a few things. Then, they pulled out the big guns and told me to hunt down a pair of needle nose pliers. At 2 am. I said, "um, I don't think we even OWN a pair of needle nose pliers" and the tech person hemmed and hawed a little bit but just kept insisting over and over and over again that I NEEDED to get some needle nose pliers. At 2 am. Seriously, this was their fancy tech-y fix. They wanted me to pinch that cap and yank it off with a pair of needle nose pliers, and could offer me no other immediate solution. In fact, when it looked like I was never going to be able to get needle nose pliers right at that very second, the rep asked if I would be able to procure some the next day to see if I could yank the cap off to see what the problem actually was before they sent me out a replacement pump  Um, no.

Well, we were actually able to find a pair of needle nose pliers in my husbands multi-tool, and we yanked that dang cap off, and this is what we found:

One of the plastic threads on the screw-in cap (which was brand new!) had just split off! Luckily, I still had the old cap, so I was able to put the old one back on and make my pump usable again. To Animas' credit, they sent me a new one for free (don't even get me started on how annoying it is that I have to pay for a new battery cap every 6 months and that it is NOT covered by my insurance). I like Animas, I really do. But I think the materials they use for their pumps are CHEAP. (But that's for another post, which I will be writing in the not-so-distant future).

So yeah, if you have an Animas pump, you might want to invest in a pair of needle nose pliers. Just sayin'.

Tuesday, August 21, 2012

On Student Loans and Health Coverage.

So, I spent a few minutes today going through some old bills & explanation of benefits for my health coverage during the time I was in graduate school. I shredded and threw out a ton of stuff I don't need to keep any more, and while doing so, I mentally added up the amount of money I spent on my own health care during graduate school. It was SIGNIFICANT to say the least.  Which kind of bummed me out. How did I manage to pay all those health care costs on my piddly  little grad school stipend and with my part-time job? Oh yeah, student loans.

But, then I realized that it somehow made me feel better about how much money I owe in student loans, which is also significant. :)  I guess it made me realize that I wasn't actually wasting my loan money, or taking out loans that I didn't need. So, there's that, I guess?

Anyway, I'm glad that chapter of my life is over. I liked school, but I will NEVER EVER EVER EVER EVER go back, if I can help it!

Saturday, August 18, 2012

Thoughts on Lowering my A1C and why Casseroles are the Devil

My latest A1C is 6.1!!!!!!


I have worked really hard for this! Here are some of the things I have done/have realized while I have been working so hard to lower my A1C even more:

1. Getting Type 1 as a child, with little to no transition care from pediatric endocrinology to adult endocrinology sort of screwed me over for awhile. And this is why:
  • As a child, when I was taught carb counting,  I was taught that a carb is a carb is a carb and that if I make sure to count all the carbs in something, I can eat whatever I want. This is not true! I get why they tell this to people, though. It makes the shock of getting diabetes not so bad. Also with kids, a lot of endos don't set as strict glucose targets for safety reasons.  As an adult, I've learned on my own that some carbs are crazy on my blood sugars, no matter where on the glycemic index they fall. The best advice I ever got with regards to what I can and cannot eat is "Eat to your meter." For example, foods that are exactly the same on the glycemic index can have completely different results in my body. I wish a doctor had told me that a carb is NOT a carb is NOT a carb and that I can't eat whatever I want.
  • As a child, my blood glucose goal range was a lot less stringent. I have these psychological barriers to having a blood sugar under 100 because my pediatric endo always told us "don't go to bed without a snack if you're under 100". Therefore, my brain just automatically thinks that 100 is the cut off point. Ugh. It has taken me a lot of will power to get over this one! A CGM has helped a LOT with that!
2. Stable blood sugar = low carb + high protein+strict eating schedule.  Unfortunately, all those crazy low-carbers I used to make fun of had something right. Lower carb diets and higher protein diets DO make for more stable, in-range readings. Also, even though analog insulin is faster these days, it still isn't fast enough, so in order to optimize my insulin usage, eating every 2-2.5 hours keeps things nice and stable. I definitely don't do this all the time, because I absolutely HATE eating on a strict schedule. I'm a big proponent of Intuitive Eating,even though I'm not always the greatest at it--as in I can down a bag of Peanut M&Ms faster than Usain Bolt can run the 100m dash. My husband, or any old roommate can attest to this. And (Peanut M&Ms aside) eating when I'm not hungry is not something I like to do. Also, eating when I'm not hungry brings back traumatic memories of having to eat in random places at specific times as a kid, and crying through my snack  because I had to eat at that time because that's what my kiddie diabetic-exchange meal plan called for. Oh the days of NPH! Grrr! (Seriously, I'm surprised more Type 1's don't have eating disorders. Is there a study about this somewhere? I know that the phenomenon exists, but does anyone know if it's at a greater proportion than the rest of the general population? I'm curious.)   So, yeah. I'm still trying to find balance with that. But a regular schedule does help immensely, even though it's not practical or even necessarily healthy. 

3. Salter Kitchen Scales=my new best friend. This right here is why diabetes is obnoxious and why I hate dietitians. You really do have to weigh and measure every stupid thing you eat in order to get the correct carb count (or memorize what the carb count is, or take a WAG)! I avoid casseroles to begin with (my husband thinks they're gross and doesn't even like the word casserole), but when it comes to carb counting, CASSEROLES ARE THE DEVIL. Especially casseroles made by someone other than me. 

4. Getting comfortable being "low" and the 15-15 rule.  Like I said above, I've had to adjust my psyche to deal with anything under 100 before bed time. But, I've taken things even further, and just gotten comfortable with letting my blood sugar hang out in the 70s without treating. And I've tried to treat with glucose tabs a lot more than with regular food. And about the 15-15 Rule. This is the rule that ALL the doctors tell you to use for how to treat a low. "Eat 15 grams of CHO, and test again in 15 minutes. If you haven't started to come back up, eat 15 more grams and repeat."  What's the point of having a carb ratio then?! Sheesh. When I follow the 15-15 rule, I have rebound highs. I wait at least 20 minutes to test now. If I do end up eating more, I'll do it 1 glucose tab or so at a time (4 grams/CHO).  It's better to eat what your carb ratio tells you you need to eat, IMHO. 

And that's enough. This post is getting long, but I just wanted to get some of these things down in writing, so I remember what I need to do to get to the place where I'm currently at. And something important: This is what I need to do for my particular brand of diabetes. Your diabetes may vary. Some people don't need to do this to get nice results, some people need to do other things. That's the thing about diabetes, there is no ONE prescribed method of treatment that will work for every diabetic. It's all trial and error.