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.
Tuesday, February 26, 2008
Monday, February 18, 2008
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.
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.
Tuesday, February 12, 2008
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.
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.
Thursday, February 07, 2008
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?
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?
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