Diabetes by the Numbers

252 - Last blood sugar reading 684 - Highest blood sugar on record- although it may be a bit inaccurate since the new meters don't go higher than 599 28 - Lowest blood sugar on record- They say you're supposed to pass out at 30 102 - Favorite blood sugar- high enough not to worry about lows and not the "perfect 100" that everyone else strives for 15 - Pounds dropped at diagnosis 19 - pounds gained after starting insulin 8.3 - Last A1C blood test 5-6.9 - "good" A1C range 7.0 A1C I want 5.5- A1C that I would "shit bricks" over 9+ - A1C that makes me cry 36 - Number of A1C test results I have had to endure 8 - Mini boxes of candy I had last night on Halloween 10 - how much I hate Halloween on a scale of 1 to 10 because of the constant temptation of packages of candy just small enough not to register on the "to avoid" list

1,460 - Number of shots I took before giving up the shots and getting an insulin pump, never to look back 42,340 - Number of times I have sliced a tiny hole in my finger to extract enough blood to give to the machine who will grade my diabetic efforts for the last few hours and give me a result that will either make me smile or make me curse, but either way will better inform me of my enemies tactics and how I can outsmart him. 2,867 - Number of curse words spilled from my mouth in reaction to diabetes 1 - Number of entire boxes of Rice Krispies almost poured over my head in a state of low blood sugar 528 - Number of crying spells brought on by my enemy 2 - Number of E.R. visits due to freakishly high blood sugars 1 - Number of official D.K.A.'s because a box of recalled pump infusion sites got out to me and happened to get used at the same time I was battling the flu (and yes I am pulling out every reason in the world that this one was NOT MY FAULT) 2 - Number of crazy docs who thought they knew more about my body than I did and set me up to do or believe down right stupid things like I would never be able to walk barefoot or that to have 7 different basal rates on a pump is "not necessary" 3- Number of amazing docs who know I live with my body and my enemy daily and who work with me to sharpen my battle plan, who give advice on new research, new tests or new technologies to fight the bastard 14 - years I've had diabetes 12 - years I spent trying to battle diabetes on my own 1,000's friends I feel like I have through Insulindependence.org who help lend support and comfort as we fight together 20ish- the actual number of friends I have made through Insulindependence, though their support makes it feel like more 764 - the Number of times I've said to myself, "Now why didn't I join Insulindependence sooner?" and replied to myself, "Oh, Yes, That's right, they've only been around since 2005!" 864,357- people I wish I could tell to become a part of Insulindependence- It will change the way you attack the enemy 62 - boxes of pump supplies, glucose monitor supplies, sensors, tapes, I.V. Prep, glucose monitor strips and other assorted supplies in my closet/pharmacy 42,120- used blood glucose monitor strips I've sent to the landfill 24 strips currently in various crevices in my car 56 strips currently in my wallet/monitor case 138 strips in the trashcan in the bathroom 2 strips in my running bag 33,476 words written in my slightly humorous (but only to the warped minds of the world) memoir on life with diabetes and sailing solo through the keys 16,534 words to write by November 30 to be a winner in the NaNoWriMo or the National Novel Writing Month 551.13 words per day to write to meet that goal 665 words written so far today, oh wait make that 674. 16 Times I've said since I committed to NaNoWriMo last night, "Oh Crap! How am I ever going to be able to pul this off?" 14 sailing books I own and have read- most of which end in hideous disaster and ruin 3 boats I own, though the largest of the fleet is 15 inches long and attached to a stand so it doesn't tip over on my desk 12 - number of feet of the boat I will build this Spring Break 2- number of children who will help me build it 22- feet of the boat graciously donated for me to use for my trip this February by the Key Lime Sailing Club, my favorite sailing club in the world 4- days I will spend sailing alone int he Florida Keys 100- nautical miles I will cover from Key Largo to Key West 480- GPS waypoints beamed to the satellites and then back to mapmytracks.com where anyone can follow along as I sail 168- messages sent to the social networking sites to update everyone of everything I am doing, seeing, hearing, smelling and eating along the way 7500- dollars that I am trying to raise to benefit the oceanic recreation branch of Insulindependence.org 765- dollars I have already raised (thank you, by the way, to all those amazing people who have helped out in this) 105- days left to raise the additional $6735 64.14 -dollars to raise each and every day until I sail 872- times I have said "Oh Crap! How am I ever going to be able to pul this off?" 4696 miles to fly 63 miles to drive 5 sunsets to watch 3 manatees to talk with 82,354 skeeters to avoid 459 pictures to take 152 minutes of HD video to take so I can edit it down to the 3 minutes I am not looking like a total dork 6840 minutes I will be truly enjoying myself as I seek to take some time away from my everyday life to reflect on what diabetes has done to my life and what the fight against letting it take over has done for my character and my life 40,000 words I will have left to write to finish the memoir expressing those new revelations I am sure to have while spending 6840 minutes alone on a boat in the middle of the sea (well, ok, maybe not the middle of the sea, but far enough away from land that it will feel like the middle of the sea) 17 minutes I have just forced you to read far too many numbers 63 useless numbers that have now been stored somewhere in your brain taking up valuable space that could have been used to remember your telephone number when you move into the retirement home when you are 89 1 person you have now far too many unrelated details about that may come together to form a slightly clearer picture of (sorry Mrs. Fullenwider for ending that one with a preposition)

There's Always a Way

With so many limitations placed on diabetics by doctors ("You'll never drive a big-rig for a living"), the media (in that news-casterly fake empathy, "Diabetics must watch and measure every thing that goes in their mouth"), and the general public ("Should you really be eating that cookie with your sugar disease and all?"), I sometimes surprise myself but setting up my own barriers.

A few weeks ago, I concluded and posted a blog stating that I should never (a word our pre-marital pastor told us should never be uttered in marriage) take a sleeping pill because it makes waking up and treating low blood sugar very difficulty and could lead to a very dangerous and even life threatening situation. I was certain it was now on the list of things I will never do, right next to eat a scorpion, hike Antiacrtica (I hate the cold), and drive big-rig for a living (I really didn't want to do it, even before the doc told me I shouldn't). The thyroid problems I have been having lately have made it so that it is very difficult to get any sleep of good quality. Its like trying to sleep after consuming 30 cups of espresso and downing a bottle of no-dose. Your mind never really slows down enough to get good sleep. Vivid, anxious, haunt my dreams all night and my body is constantly tossing and turning trying to calm down enough to get comfortable.

After a particularly bad stretch of horrible nights, I revisited the thought of a sleeping pill. I started playing around with how it might be possible. What if I had someone wake me up every hour to test my blood sugars. But, that kind of defeats the purpose of getting a good nights sleep.

O.K. So what do I have? I have a Minimed Continuous Blood Sugar Monitor, Johnny, but, he sometimes won't catch a low until I have been in the 30's or 40's for about a half hour. (For reference, the docs tell you you'll pass out at 30 and if nothing is done, you'll die.)

But I can change the range for which he alarms me. So I tell him to buzz me when I get to 100. One hundred is in the normal range, but I find if my sugars drop, I can feel them going low while Johnny still says I am 100.

And I recently have fixed a series of nighttime lows by reducing my basal rates in the first part of the night. I haven't had a low overnight in 4 days. I can also purposely run my blood sugars a little high, not high enough that I will wake up the next morning feeling hung over, just high enough to guarantee no lows. So I indulge in an extra mother's day cupcake that my daughter made all by herself (yes, I am a little proud that my seven year old can already bake). The evening becomes all about getting everything in order before I take the pill. Sensor in at 6. Calibrate it at 8. Check to make sure it is accurate and trending along with my regular blood sugar monitor which requires a stick every half hour.

At 9, I pop a pill and eat my cupcake. 9:30 and 10 come with more checks of the blood and at 10:07 while watching another episode of my dumb T.V. shows (as Tony calls them), I can feel the pill take hold and get the distinct feeling that I should get into bed rather quickly before I pass out for the night on the hard wood floors of our living room. I wake up the next morning.

I wake up the next morning. It's a funny world when you are appreciative that you actually wake up, when death at night is a constant possibility and every night you lay down could be one that ends up with you coming to while staring at a ceiling that has become so familiar you can recognize which room in the ER they have wheeled you into by the pattern of the roof tiles and lights.

But it is also a life where sleeping through the night is a huge accomplishment. Another battle you have fought valiantly and won. One more notch in your belt of all of the ways you have never let the disease win. My Junior High math teacher always said one day when I grew up I would use all of the skills I learned while solving one stupid word problem after another. I can tell you I do it every day with almost every decision I make to get a leg up on this disease.

So fight on, and make sure you are not adding barriers to the ones the world has already placed for us.

Inside the Mind of a Diabetic

If you have ever had the unusual pleasure of having a meal with a diabetic you might have noticed that moment when they look off to the left, appearing deep in thoughts somehow not entirely related to the current conversation. If you have ever wondered what it was running around in their head, here is a small glimpse into the things they have to think about on an almost constant basis.

A little background, last weekend I went on a sailing trip to Catalina with 4 fellow sailors. It is an entirely new situation for me as far as dealing with diabetes goes. Most of my adventures since acquiring this "medical challenge," as my mom puts it, have been very active, hiking the grand canyon, running triathlons, surfing for hours on end. This one would involve sitting or standing for hours on end which can be a total disaster with diabetes. I, also, would be stuck on a boat if anything went south.

Friday morning I wake up high, 241 at 5:30. Correct with 1 unit for every 50 points above 100. 240-100=140/50=Push 2.8 units. I'd been battling bronchitis for 5 days, the extra bacteria will send my sugars higher than usual. I haven't worked out in 5 days so my body will not be as sensitive to insulin until I get in two to three good workouts. Driving in the morning will also send my blood sugars higher than if I drove in the afternoon.

All of this means I will need more insulin. My basal rate, the amount of insulin constantly dripping into my system from my pump to closely mimic what your pancreas does naturally and so much more accurately, needs to be raised. I would have gone 120% of normal for just the sickness, probably another 15-20 % for the car ride, so I decided on a 145%. If I go too high my blood sugar will crash, so I am always afraid of going too high with a higher basal rate, but being high on a trip doesn't sound too good either.

I got to my parents house in Seal Beach, dropped the kids, had a few moments to get a bite and clear my head. I hit Jack in the Box for a soda and went across the street to Starbucks for a breakfast sandwhich (caffeine blasphemy, I know, to bring soda to Starbucks, but I just can't get into the whole coffee thing.)

Check my blood sugars, 271.

My correction was an hour and a half ago so its halfway done with its job, which should have put me at 160. So 271-160=171 more to correct for. 171/50=3.2 but I don't want to overdo it so I pump in 2 more units to correct and 1.5 for the breakfast sandwich, skip the Symlin because it can make me nauseated and no one needs that kind of help when their about to get on a boat.

Get on the boat and take off at 10. Check sugars again. Now I'm 361. That's pretty crappy. Correct again. (361-100)/50 gives me 5.2 units. Sitting on this boat motionless is going to add to the crappyness so I up my temporary basal to 155%. Try to sail.

I spent most of the morning trying to get my sugars down. Eventually I upped my basal again and corrected a lot. I managed to bring it down to the 200's by lunch, but it didn't get much better than that. We anchored that afternoon and, after a quick swim in the surprisingly warm water, we hiked across the island (only about a mile) to watch the sunset over the pacific side of the island.

That walk couldn't have been more welcome. A chance to stretch my legs and get my body a little more sensitive to the insulin. On that walk I got into the good zone, actually I kind of overshot it, but was brought quickly back in thanks to the PowerGels I always have in my pocket while sailing.

The rest of the days went just like the first, 300's in the morning, even with high basal rates and lots of correction, and afternoons that were good once I got on land. It was odd to see the immediate difference in my blood sugars on land and on sea. While on the boat my sugars were very obstinate, they dug in their heels and did not want to come down. Once on land they became perfect, that level line between 80 and 120.

As I start to plan my insulin regimen for my upcoming trip I start to wonder, was that a morning thing versus an afternoon thing (there are different hormones circulating around your body depending on the time of day that can make your body more resistant to insulin) or was it a land versus sea thing? Or maybe a little of both?

Looks like I will have to go back into the lab and do some experimenting, change some variables and then analyze the data. Maybe a morning sail and then an afternoon sail and then check the sugars? Will a run in the morning before I take off fix the problem? I can sit on the couch all day on Sunday watching football with perfect blood sugars as long as I've had a long run in the morning, this might be similar.

Maybe some sort of exercise on board? I thought about doing some squats while at the wheel last weekend but I didn't have the guts to start aerobicizing in front of everyone. I was already the weird one who had to draw blood on an hourly basis, and gladly swam half a mile to get to shore to buy a soda to get my caffeine fix . I didn't need to add to that impression by doing squats while on watch.

While I'm alone I would have no problem, but can you do squats safely while on a 25' boat as opposed to the 31' that we were on? Maybe some pushups wheile I anchor? Maybe some dancing wildly to loud music might do the trick.

Will my activity level change on a smaller boat, will it rock more, will I have to balance more? We had 5 people to manage the boat last weekend, sailing alone will certainly mean more work. Will the increased work load help with my blood sugars, and if so how much? Will stronger winds make a difference? We motored most of the way out and back so there was very little scurrying about the deck to adjust the sails. The stronger trade winds in the Keys will definitely change that.

While down below in the tight quarters I bumped into a corner and ripped out the sensor in my leg that measures my blood sugars every 5 minutes and then reports it to my pump. I yelled at Johnny for not holding on tighter to my leg (if boys can name their cars that just get them from Point A to Point B, I can certainly name the Continuous Glucose Monitor that has already added years to my life).

So next time I should probably move it to a safer spot, one that won't be as likely to hit a counter (not that I need to explain where exactly that might be) and probably bring an extra couple of sensors. I only brought one on this trip because I had no idea how I would shoot a 2-inch long, way-too-thick needle into my thigh on a rocking boat when I can hardly bring myself to do it while on land. In July, I can just go ashore, I suppose, and do it in a bathroom stall in some run-down Florida restaurant (note to self: bring lots of rubbing alcohol).

Things like this ran around my head during the whole weekend. My brain was wracked with math and strategies and analyzing every variable to make a sad attempt to keep my blood sugars stable, while the others simply enjoyed the sea and the sun and let their pancreas do all that hard work for them.

So next time you see your diabetic friend start to go to that place when they stop listening to you just for a brief moment, pause, just for a second, to give them a chance to zip through the math, and then go ahead and finish that story about that time when you were just 18 and could still stay out all night and not feel it in the morning. They'll appreciate the gesture.