Trip

Guess what?
I'm going to be at the quilt for life in Washington DC! I'm super excited. I've always wanted to go, and now that I have a square in it(#601), I decided to make the trip. This trip was in limbo for a very long time, but it is finally happening! I'm going to meet up with Allison and some other bloggers for lunch on Monday. This is the first time I'll meet any other blogger. I'm excited (and nervous!). I'll be staying with a friend from the area. She's also diabetic. We met a long time ago at camp, and have been good friends ever since. We don't get to see each other often, so it will be awesome to see her again. This will be my first time traveling along, so I'm nervous about that, but I'm being dropped off by one friend and picked up by another.
I'll tell you all about it when I get home!

But Why?

I can't even explain how crazy this summer has been. It was supposed to be a nice, relaxing summer with lots of time to sleep in and chill out. It has not been that way in the slightest. Without going into too many details, I've ended up staying with my brother and sister-in-law for an extended period of time to care for their two children, who are turning 1 and 3 years old this summer. My three year old niece is quite intelligent, and curious about everything. Since the very beginning, I have never lied to M about my diabetes or my pump. When she asked "What's that?" and pointed to my pump, I would always reply that it was Aunt Jen's pump. She never asked beyond that. Until now. She has reached the "why" stage. I scrambled to answer when she pressed about why Aunt Jen wears a pump, and why I need medicine. So I've come to the fine folks of the DOC to help. What do you tell the young children in your life about your diabetes and diabetic supplies? Does anyone know about any good books that would help explain? A book that has a pump in it would be very helpful, since that is what she is asking questions about.
Thanks in advance! I have a lot of things to post about, so you should be seeing me a little more often!

I was going to apologize for not posting in so long, but I've accepted that this is how I blog. I post in spurts when I have time. And lately, I have not had time. Just about every day I write a blog post in my head, but rarely get the chance to fight for a computer (my family has one computer on dial up internet). It's usually not worth it.
Since finishing classes earlier this month, I have been busy working for my parents. Most of the time I love it, except for the times that I hate it. I have been having a lot of lows lately. It is my goal today to start logging my sugars so that I can really figure out what's going on. I realized that I needed to do something the other day when I finished my second gallon of juice since I moved home. That is a lot of juice, and a lot of calories that I never should have had to consume.
In other news, I still don't have work back from my insurance company about a CGMS. The doctor's office said it could easily be another couple of weeks, so I'm not holding my breath.
That's the quick review of what's going on in my life. I may post again soon. I might not. Who knows.

Alternate answer

This was a question that came up on a practice exam for one of my classes.

A type one diabetic is prescribed to take Regular and NPH before breakfast. The client give insulin at 6am before breakfast. The nurse should teach the client to:
A. Avoid snacks between breakfast and lunch
B. Delay dinner until after 6pm
C. Eat a low carbohydrate lunch at noon
D. Have a snack at 3pm

So what do you think the correct answer was?

I have to give them a little credit for saying a type one diabetic, and then following it with a question about insulin, but couldn't they have picked any of the insulins created in the last 10 years? One that doesn't promote a strict diet and schedule? I would like to add an alternative answer

E. Consult their endocrinologist for a prescription for Novolog and Lantus.

Dread

There are certain words I'd rather not hear on my voicemail on a Friday afternoon. Near the top of the list is "Hi, this is (name) from (name)endocrinology clinic. I'd like to speak with you regarding your blood work. I'd appreciate it if you give me a call as soon as possible." I called her back as soon as I got the message, but I had to leave her a voicemail. I had blood work drawn 3 weeks ago. I hadn't heard anything, so I assumed everything was fine. But I guess not. The office closes is about 5 minutes, and I'm doubting she will return my message. It is going to take a lot of will power not to worry about this all weekend.

UPDATE: Just like everyone suggested- it was nothing. My LDL was 109. While I'd prefer it was lower, it is by far not the end of the world. The nurse just asked if I had been taking my statin regularly (I have) and said they would get back to me. I have no idea why the urgency, but everything is just fine. I just need to get my butt in gear now that the weather is nice and work out more, and eat healthier! Winter is not nice to my health.

I love

Allison posted this challenge, and then Hannah joined, and now I present my list.

The challenge: I challenge you to make your own list or leave a love of yours in the comments. The only catch? You can’t include a single person you know on your list. No “I love the way my husband laughs” or “I love hearing my little girl call for me.” It’ll be tough, I know. But this particular little exercise is about stripping away everyone who defines you and figuring out what you (not his partner; not their mother/daughter/sister/friend) love.

I love feeling like I have accomplished something.
I love looking through library books and wondering what they have in store for me- will they be exciting and interesting or will they be boring?
I love waking up before my alarm after a great nights sleep
I love being able to lay in bed at night, watch a movie and drift off to sleep.
I love taking walks outside when the weather turns warm
I love hearing a song on the radio that I used to love and haven’t heard in ages
I love it when I get a great blog post idea AND have time to type it up in a way I like
I love sitting down after a busy day and knowing I have made a difference
I love standing in the chapel and hearing voices lifted to God in such a beautiful place
I love the anticipation of a long trip
I love Colorado mountains
I love the rush of an OR suite
I love diabetes camp- even after 12 years
I love grilled cheese
I love comfy, broken-in jeans and hoodies
I love chick flick movies where everything is OK in the end.
I love it even more if music/dancing is involved.
I love winning games.
I love beautiful flowers
I love helping a customer and feeling like they really appreciated my help
I love the sounds of camping in the fall
I love seeing mail in my box at school
I love free stuff
I love surprises
I love an unexpectedly great picture
I love chocolate ice cream with Reese peanut butter cups
I love a cold drink of water
I love googling things to answer random questions
I love that people think I know everything random and knowing that I don’t
I love blue and purple mixed
I love seeing campus filling up now that its warm.
I love thinking up this list.
I love that it only took me about 10 minutes.
I'd love for you to do one of your own.

Jen needs...

Jumping on the meme badwagon. I totally had planned on doing a Raise Your Voice post, I even had a good idea, and then I didn't have time to do it before clinical, and no energy after, so it didn't get done. Too bad.

Jen needs...a session or two with a therapist. Hmmmm. Might not be a bad idea!

Jen needs...a break. AMEN! 15 days until summer break!

Jen needs....human anatomy lessons. That might be true. I didn't do so well in anatomy, but so far, i haven't had any problems in nursing clinicals.

Jen needs...someone to comfort her. Sure, why not.

Jen needs....a boyfriend. No thanks. No time (just kidding. kind of- anyone know any single decent guys? Because I don't!)

Jen needs... to find a self righteous, conspicuous "I'm better than you" charitable position so she can keep charming the sheep into thinking she matters. I'm speechless.

Jen needs...understand that Adam does not carry his violent responses beyond his tools Yeah....I don't get it

Jen needs...a new computer While I am interested in a Mac, my Gateway is working just fine.

Jen need...her Oscar beauty rest Rest yes, for the Oscars? I can safely say that will never happen.

Jen needs...to take some time and be by herself. Yes please. One is never alone in college. I live with 17 girls. Privacy? HA!

Announcement

I remember when I was a camper, at every meal, someone would get up and say, “Are there any announcements for the good of the camp?” Everyone would break out into song(I DID say it was camp!) Announcements, Announcements, ANNNNNNNOUNCMENTS! Pile ‘em in a corner, pile ‘em in a corner, pile ‘em in a corner and we’ll watch the flowers grow... I’ll stop there for everyone's sanity. The campers LOVED this song, especially when the person with the mic didn’t mean to say it. Once the singing was done, counselors would stand on their chair and scream to the rest of the camp what accomplishment their camper had made. “Scott gave himself his shot for the first time today!” “Sarah joined the belly shooters club!” Things like that. The camper would stand up on their chair, be filled with embarrassment and pride as the whole camp clapped and cheered for YOU. I had 2 announcements made about me during my time as a camper. (And a few more as a counselor, campers LOVE standing up and making announcements about their counselor, so I tried to give them chances) The first announcement made about me was when I did my own injection for the first time my first year at camp. I remember that day very clearly. I was SO proud of myself. This whole long story is to try to explain to you why I am so excited, and slightly sad, to be making the following announcement: (I can’t hear you singing!)

YESTERDAY, FOR THE VERY FIRST TIME, JEN PUT IN HER PUMP SITE WITHOUT AN INSERTER!!!!!!!

Yes, it’s true. After many, many years of using Quick-sets, I finally did one without the blue bubble. And it went great. Now, are there any other announcements for the good of the DOC? :-)

I broke it!

I don't know how, but I broke another pump. This time it was the cap that goes over the cartridge. The cap is sitting at an angle, and I no longer trust it to deliver properly. The Cozmo people are sending me a new cap overnight along with a spare. I was suppose to already have one, and I must have placed it in a VERY safe place. But since it didn't break until late Wednesday night, I won't be getting my new pump until some time today. That means a call to the endo for some Lantus pens and shots for a day and a half. And then after I took the shot of Lantus, I remembered I had my old Minimed 508 stashed in the closet. I took it out and put the batteries in it. It still works! I'm putting it on to take boluses and then have the Lantus for basal. It is making me appreciate all the features my Cozmo has. The Minimed pump does two things: delivers basal and delivers a bolus when you tell it how much insulin to give. Simple, but it does the job. When my new pump gets here, I'll be happy to take the batteries out of the dinosaur pump and re-retire it. And maybe I should stop dropping my pumps so often. :-)

Impluse

I made an impulsive decision today. I an my endocrionologist appointment today. My A1c was 7.1%, which is good, but I don't feel like it fully reflects my control, and I've been trying and trying to break through that 7% barrier. As my endo is looking through my log sheets he asked if I had tried a CGMS. I said yes, and without thinking, I blirted out "Yes, and I want one." I had planned on going in and asking if they had a Dexcom for me to trial (they don't), and I walked out starting the process to fight for insurance approval. I made it clear that I don't have the time or the stamina in me to do a lot of fighting, but his office is putting together the paperwork for me, and submitting a claim for a Guardian. I'm a little shocked. I don't really expect to get approval, but it would be really cool if I did!

Whoa!

The Navigator has FINALLY been approved! I didn't think this day would ever get here! I'm very interested to see if it lives up to the hype or not.

Thanks to Diabetes Mine for the heads up!

Spring Break

Tomorrow, at 5pm, my Spring Break will begin. I am SO ready for a break. My head might explode from everything I have been cramming into it lately.
I'm heading to Kentucky for a mission trip. I've never done anything like it before, so I'm excited and nervous.
I hope we can make a difference in the area, and that we'll all get the mental rest we need.

CGMS, pumps and surgery, part 2

After waking up in the recovery room, I settled into my room for the night. Oddly enough, I was on a Women's health floor- I guess the hospital was really full. I had difficulty falling asleep, and just laid there staring into space for a while. My nurse was awesome. I checked my blood sugar using their meter (hospital policy that wasn't worth fighting) to confirm a blood sugar in the mid 200's. I corrected, and assumed I would come back down slowly. Boy, was I wrong. I rose steadily into the 400's where I stayed. No matter how much insulin I gave, I would not come down. So in addition to the pain from surgery, I now was dealing with the pain of a high. Needless to say, I didn't sleep much that night. Finally around 8am I asked them to page my endocrinologist, since I wasn't getting anywhere on my own. He had me inject a whopping 15 units and change my site- why I hadn't thought of that, I don't know. I had brought a spare site with me, just in case, so I put that in. And waited. An hour later, I was still in the 400's. I talked to my endo again, and he asked me if I thought the second site was bad. In the course of questioning, he found out I had used my own insulin, and not the hospitals. He got upset at the nurse at that point, and said he would be right over! The outpatient clinic is across the street from the hospital. He took a couple of sites and a new bottle of insulin over to me! After another shot of 15 units, I finally started to come back down. My nursing care after the night shift was frustrating. When my breakfast tray came, she was upset that I didn't want to eat anything. I was 400! I had large ketones! I was trying not to throw up all over the place, let alone think about food! Then she asked me how I felt. I replied that I felt gross. I cannot describe how I feel when I am really high other than that I feel gross. If there were other words, I would use them. She would not let it go, until finally I just rattled off the classic symptoms of a high to make her go away.
They would not release me until my blood sugars came down, but I had to leave before 10pm or I would have had to be readmitted. I didn't want that to happen because I had a feeling the diagnosis would have been something like DKA- which was not my fault. I did the best I could under the situations. My insulin needs stayed high for the next week or so, I was running my basals around 150%. I knew it was possible for insulin needs to run higher, but I underestimated how much it would affect ME.
The whole experience was quite eye opening. I saw things from the patient's perspective. Let me tell you, I think I'd prefer to be the one giving care. It's a whole lot less painful.

Summer plans

I just got an email that I got one of the externships I applied for. This should be a good thing. Competition for these positions is quite steep, so I was lucky to get one.
The thing is- I don't want it. It is my last summer of college, and I want to enjoy my time. I have to decide what is more important in the long run, the experience and the money, or enjoying my last summer at home and doing things I really want to do like volunteering at my diabetes camp.
Becoming an adult sucks.

Edit: Thanks for the congratulations. I decided not to take it. I talked to someone who had it last year who said he was tired and stressed most of the time, but it was a great experience. I really do not need more time spent tired and stressed. I do that enough during the school year.

CGMS, Pumps and surgery, part 1

Having appendicitis has been a fear of mine for a while. I realize that might sound strange. I have a long family history of it- including my brother and sister in law in the past 2 years. I know my sister in law doesn't factor into the genetics, but it does contribute to my anxiety. Up until now, I had never had surgery. The thought of having to have surgery with no time to prepare scared me silly. Add to it the fears that I would run across health care providers who were uneducated about diabetes and pumps, well, I just didn't ever want to deal with appendicitis.
However, it wanted to deal with me. Much like diabetes, it entered my life suddenly and without welcome.
Sunday afternoon my parents helped me move into my new house. I started to not feeling well, but figured it was something I ate. By the time we got everything inside, I couldn't hide it anymore, broke into tears, and told my mom that I didn't feel well and wanted to go home. I grabbed a sweatshirt, my meds and my pillow and went home. I spent the rest of the night on the couch dealing with epigastric pain and nausea. It was not fun. Finally, around 3am, the stomach pain resolved, but lower right quadrant pain appeared. I was so relieved, because I truly felt better. I could actually sleep. When I woke up that morning, my mom asked me how I was feeling, and I told her I was getting better. I didn't want to eat, but other than that, I started making plans to return home. I avoided her question on whether the pain had really gone away or moved. Eventually she realized I wasn't walking standing straight, and was not doing anything but sitting on the couch. After she convinced me to let her test my rebound tenderness, I finally agreed to go to the ER. I spent the whole ride there telling her we were going to feel stupid when it was nothing. I was playing the denial game. After an IV (which, miracle of miracles, was in the first try!), and a CAT scan (with no oral contrast- hurray!) I found myself waiting in pre-op. After I got the results that it was indeed appendicitis, the time from the ER to the OR was about half an hour. Before that, things moved slowly. There was very little doubt in the ER doc's mind that it was appendicitis, and after 4mg of Dilaudid with no pain relief, I had to agree. Entering the OR was a strange experience for me. I was numb. I would not let me mind wander to any of the "what ifs." I had just spent some time in the OR in my last clinical rotation, so the surroundings were familiar, and I knew what was going to happen, so that helped my uneasiness. I was still kind of freaking out about what they were going to do with my pump and the Guardian...until I met the anesthesiologist. He was admittedly a technology geek. He came in and said..."So I hear you’re diabetic, what are we going to do with you?" I showed him my pump and the CGMS. And he asked a bunch of questions about how they worked. I showed him how to do a temp basal, and how to check on my blood sugar. Another doctor came in to talk to me; the anesthesiologist said to him something to the effect of "look at all the cool stuff this girl has! I just press this button to look at her blood sugar, and then I can titrate her insulin if I have to! Isn't it cool?" I knew then that I would be OK. I went into the OR, and everyone was talking and being calm and casual, just like they always are. And even though I was the one on the table, instead of standing in the corner watching, I felt at ease. All the fears I had about having surgery were answered. In true fashion, when I woke up in the PACU (post anesthia care unit or post op), the first question I asked was- What's my blood sugar? I knew I would be OK when the nurse could answer me right away. I was 180.
The rest of the stay in the hospital was not as uneventful, but that is another post.

It's time to play Find Jen's Pump!

I toss and turn in my sleep. I've also been told I kick. I sleep like a baby most nights, so I don't really care what I'm doing in the process of this sleep. If I ever get married-, my husband will just have to learn to deal with it. Or buy a big bed. :-) I keep my pump in place in a flannel case around my waist so it can't roam too far.
I had a rough night last night. Shortly after I went to bed, I woke up at 330. I corrected, but apparently I fell asleep before I could put my pump back in my case An hour and a half later I woke up to recheck. I could feel the pump vibrating from somewhere under the sheets, but for the life of me, I could not locate it. So I resorted to following the tubing. (I use the long 43" stuff). The path it took was just crazy. It went up over and around my arm to underneath my back. One would think I would have felt it there. By the time I finally found it, I was 180. The pump recommended I take 3 grams, but that seemed a little ridiculous to me, so I went back to sleep. Once again, I didn't put the pump back into the case- heaven knows why. At 5am, I woke up very obviously low. I always have the preoccupation that I HAVE to check before I treat, even when I know with absolute certainty that I am low. Again, I had to resort to following the tubing. I followed it up shirt and back down underneath it to where it was neatly at my side. That's right- I managed to put my pump under my shirt while sleeping. Now that's talent! I was low- 59 in fact. I guess I should have listened to the pump and taken a tab. And woken up enough to return my pump to its case. Although entertaining the next morning, playing "find the pump" at 5am while very sleepy and low is just not very much fun.

Guardian, take two

I really wanted to post on this a long time ago, but sometimes life just gets in the way.
I picked up the Guardian and some sensors on December 16, with not a lot of expectations. I am happy to say it surpassed every one of my expectations.
It was not dead on, but I no longer expected it to be. It DID catch highs and lows. I did see some trends. I realized I really need to change my habit of bolusing during or after meals. It is just unfair to expect the insulin to "catch up" and compete with the food spikes when the food has such a head start.

I really think the Guardian is a great tool. I really want it back. It caught one low in the middle of the night before I woke up, and that is exactly what I wanted it to do. I was sad, rather than relieved like I was last time, to return the unit after a month.

I don’t know the cause of my last poor experience with the Guardian. The only thing I can figure is that I got some bad sensors. Absolutely everything else stayed exactly the same. It makes me happy and give me hope for the future that I had a successful experience the second time around. I loved having that data. I value the reassurance when I start to feel funny I could look and see where I was and in what direction I was heading. Nothing could replace the feeling it gave me going into surgery having it at my side (more on this later).

I am currently flirting with the idea of trying to pursue insurance coverage. I don't know if I am up for the fight or not. My insurance company won't cover more than 200 test strips a month, I kind of doubt they would pay for something as progressive as a CGMS. I'd love to hear of users of CGMS- do you pay for it out of pocket, or did you get insurance to cough it up?

If I never hear the word "diabetes" again, it will be too soon

I am sick and tired about hearing about diabetes. Why then, some might ask, am I writing about this in a diabetes blog that is part of a whole right of diabetes blogs? Because it is not the OC that I am sick of. Strangly enough, the OC is one of my escapes.
I am sick of hearing about diabetes in my classes. Every single day diabetes comes up. Whether it be as an example of how to teach a client or risk factors for one condition or another- it comes up. I am sick of hearing about how people with diabetes have to drastically change their diet. How they must exercise daily to lower their blood sugar. How having diabetes puts them at risk for every fricking condition under the sun. How they all have bad feeling in their feet. How if they do not control their sugars by taking their pills, following their strict diet and exercising daily they might have to use insulin! AAAAAAAAAAAAHHHHHHHHHHHH!!!!!!!!!!
If I'm lucky- the words "type two" come up, but rarely. I'm sick of fighting the battle. At first, it was funny. Me and a couple of friends kept a tally to see how many classes it DIDN"T come up in. I'm past the stage of it being funny. Now I'm sick of it. There ARE other chronic conditions out there that people have to adapt their lifestyle for. I do not have to follow a special diet. I have better feeling in my feet than my endocrinologist (according to him). I do not not have a I pump and test up to 10 times a day because I'm so out of control, I do it to be IN control!
I now understand WHY medical professionals have such a jaded view of living with type 1 diabetes. Because this stuff is ramed down their throats every. single. day. I might have a little more patience the next time I deal with an ignorant nurse- and throw in a little education.

Clinical

Today was one of those nightmarish days. I have clinical rotations at the hospitals on Mondays and Tuesdays. Today was my first day back after surgery. I was not on top of my game.
I do not usually tell the nurse I'm working with that I'm diabetic. It is generally unnecessary information, and a lot of people in the medical field have preconceived notions about diabetes that I just do not need to deal with. I generally manage my blood sugars pretty well during clincals, so it's not an issue.
Today, however, I did not manage well at all. I went from an astounding(not in a good way!) 426 to 59. Within 2 hours. Right around 3pm I started feeling thirsty, and since it had been a few hours since I had last checked, I thought, why not- my lunch bolus could be a little off. I washed my hands, pricked my finger and waited. And waited. And waited. As Cozmonitor users will know, the longer it takes to get a results, the higher it is. My anxiety level rose with each passing second. I almost gasped out loud when I saw the result. As soon as I saw it, I realized I had no backup supplies with me. It would be another 4 hours before I could get insulin if my site was bad. I took an astronomically large bolus and prayed for the best. 2 hours later, I was 59. I guess the site worked after all. I will be putting extra supplies in my bag, and hope that tomorrow is a better day.

time flies

I didn't mean to be gone this long, but I think very rarely do people plan their blogging absences. It started out with the craziness of finishing up a semester. It continued with the holiday busyness. Then it had been so long that I thought I'd just wait until I got back to school and high speed internet. Then came the appendicitis, the surgery, and the hospital stay. Finally, catching up with missed classes. All that brings me here, with my return to blogging. I am hopelessly behind on reading, and definitely on commenting. I opened my feeds of the blogs I read to find way over a hundred unread posts. I just deleted them all. There is no way I'd ever catch up. I hope to start posting more. I'm setting a goal for myself of once a week. I know that's not a lot, but that's the goal. There are so many things I want to tell you all about. My first alcoholic drink. My experience with surgery. My second experience with the Guardian. My second alcoholic drink. Hopefully, I'll post about those things with time.
I'm here to say I'm back. I hope to see you around to DOC.