Unplanned Pumpcation with surprisingly good results

Take away message of this post is: Using Lantus a long acting insulin with no peak, for one day, kept me within my target range: no hypoglycemia.

This was a pleasant, unexpected surprise. I started to feel better, less tired. I couldn’t believe how easy it was to adjust my eating pattern to a grazing with small amounts of food. Few prunes here, a handful of walnuts later, a handful of carrots later, an 80 calorie greek fat free yogurt later, one hard boiled egg, a serving of green peas, a cup of pumpkin soup, and later a protein bar after a workout of strengthening and yoga and rowing. Hmmm, maybe this is something I should try for a while, and taking a longer Pumpcation.

Here’s what happened: The other day, as I prepared to fill a new pump cartridge I realized that I had inadvertently thrown out the new bottle of nNvolog and kept the empty one. Dang!

I didn’t have another bottle as a back up because my pharmacy didn’t have enough Novolog on hand to fill my entire prescription. I can only refill my prescription on the last day of my 30 day supply. Why doesn’t Walgreen’s, aka Duane Reade in Manhattan, carry more than one bottle of Novolog at any time? Why don’t they realize that they have a customer that buys 3 bottles every 30 days. The insurance company and Walgreen’s want to wait as long as they can to pay. I suffer because it usually ends up in risking going without insulin for a brief period, AND it is twice as much work. I have to the pharmacy twice to pick up the remainder of the prescription.

Please share your pump vacations if you want, and state how your control was compared to your usual regimen on a pump.

29

29. When you hear someone say the number 29, what comes to mind? Is that the answer to the question “How old are you?” Anything is still possible at age 29. No one thinks of 29 as old. You are young and desirable. I was 29 when I was 29. Occasionally I am 29 years old, when someone asks me – because you just don’t ask a woman of a certain age how old she is. That is an unlisted number. But I was 29 a few days ago. Really, I was 29mg/dl. 29 is an undesirable number if you are a person with diabetes. You want to be 80-120 mg/dl which is generally considered normal, non-diabetic fasting range. When you are dependent upon insulin to keep you alive, you live with the ongoing risk that it also could possibly kill you within 4 hours of taking it. There is a narrow margin of error for PWD who are on relatively low doses. The lower your dose, the more sensitive you are to insulin. Sensitivity varies from individual to individual based on many factors: for example, weight, resistance to insulin, what you eat, time of day, level of activity, temperature conditions, whether or not you are sick with something else, stress, menstrual cycles, pregnancy, oral and other medications. One drop of insulin drops my BG approximately 75-80 mg/dl slowly over 4 hours, when sitting still. That’s a tiny drop of insulin for a big drop in blood sugar. Nothing bad happened, thank goodness. It snuck up me while I was laying on my bed. I did not have my CGM on because, well that’s another story. I did sense hypo symptoms, I was calm, I tested my blood, and then I panicked. Like when the broken leg doesn’t hurt until you look at it? Yeah. So I went straight for the huge bottle of apple juice and my bottle of Glucolift, sat down and started guzzling. Within a few minutes I was feeling it go up, and I kept testing until I reached 82 mg/dl about 20 minutes after the 29 mg/dl reading. I was 29 once before, and 32 once, and 42 and 49 many times, so I had confidence that I would recover. But it was scary. I look for patterns, and invariably when I have a severe low, like this one, it is because I ate at a restaurant and miscalculated the carbohydrate content. Eating out is also the usual culprit of severe highs, because I miscalculated by underestimating the glucose or carbohydrate in the food. That’s why I like to eat at home, where I know exactly what’s in the food because I prepared it. In Real Life: I prefer to revisit 29 only in my photo albums, not in blood glucose. I aspire to be be 80-something with an 80 mg/dl-something average blood glucose level. In diabetes speak, it is hip to be 80-120 mg/dl. #showmeyourG

#showmeyourG

#showmeyourG

#showmeyourG

The lovely Miss Idaho 2014, America’s Choice for Miss America, “owns” her diabetes by proudly wearing her insulin pump visibly on the outside of her clothes, even her itsy bitsy teeny weeny bikini. Building on the success of her show me your pump campaign, Hypoglycemia Awareness, “Ha!” created the next step after the pump with the magenta G icon to show where we carry our preferred Glucose; such as, glucose tablets, gels, gummy bears and our glucagon kit. Send a pic of where you carry yours. We want to know where you wear your G icon and whatever else you would like to share. But don’t share your Gummy Bears, you might need them for a hypo!
#showmeyourG

September, 2014 is the 1st Hypoglycemia Awareness Month

September is Hypoglycemia Awareness Month

Because one day is not enough to raise awareness of hypoglycemia in all corners of the world.  This will be an ongoing effort as diabetes continues to be diagnosed at break-neck speed.   This special month of the year is a perfect time for children to have prescriptions for glucagon, insulins, and all the other diabetes supplies renewed.   It is a time for  conferences with the school nurse, teachers and coaches about the specific needs of a t1 student.    It is a time when many school age children need a physical for sports or a new school.   Adults have a nostalgic feeling from childhood that it is time for a new pair of shoes.  A new “school year” begins in September:  everyone is finally back at work  from summer vacations, so decisions can finally get made.  May the annual budget planning commence!    September has the added benefit of being “Honey Month.”   What better industry to share an awareness month with “Ha!”

I squirm at the thought of my diabetes sisters and brothers being out and about town, alone, in public,  potentially in harm’s way, without enough of anything to treat severe hypoglycemia.   A friend with t1 here in NYC that I met through my Meet Up for Hypoglycemia Awareness made a comment that lingers with me:

“My greatest fear is to be on the subway begging strangers for candy.”    -anonymous New Yorker with t1

Begging for candy from strangers…. It strikes me that a passenger asking strangers on the train for candy might easily be misconstrued as a homeless or mentally ill.  These needy folks are ignored by New Yorkers who are wearing Beats or otherwise deaf to pleas for help.   If the PWD (person with diabetes) was already beyond the point of being intelligible, speaking in broken phrases, shaking and sweating, it may not be possible to go into the “I have diabetes and my blood sugar is dropping.   I need something sugary.”   There usually isn’t time for a lesson from  “Hypoglycemia 101” when insulin peaks without enough glucose available.

With “Ha!” and Hypoglycemia Awareness Month, we would like to raise the level of general awareness for hypoglycemia as we already have for an allergic reaction treated with an EpiPen to rescue someone experiencing a reaction to a bee sting.

Giving a fellow passenger candy if he asks, without being able to enunciate a reason for it may save the day for you and everyone else on their way to work in that train.   How do we achieve that level of common knowledge?   The most effective ways may be for employers and municipalities to incorporate it into their training and posting it, as for CPR.  Public service announcements in the media are another way to reach a wide audience, as well as well-placed messages on billboards, buses, subways, radio, TV, social media

“Ha!”  now offers people with diabetes a practical and, eventually, universal way to own and minimize their risk for hypoglycemia.  Place a sticker of our icon of a magenta “G” on the pocket of your backpack or purse or briefcase that holds your preferred method(s) of oral treatment, as well as a glucagon emergency kit.  You can train your family, friends, coworkers, physical trainers, coaches, teachers, neighbors, bartenders of your personal Cheers, bridge club and fellow church members; in short, the people who are around you all the time, to look for the G when you are having a low blood sugar and are in need of glucose .   

Please share your questions, ideas and suggestions with me.   Thank you for your time and kind consideration,

Zoe