Wordy Wednesday – Strip Safely

Unless you’ve been living under a diabetes rock (let’s face it, some of us DO crawl under a rock on occasion with regards to diabetes – no judging) you’ve probably already heard of the Strip Safely campaign. But if not, in a nutshell, it’s this: “Blood glucose test strips are at the center of diabetes life. The FDA acknowledges there are inaccurate strips in the marketplace but has no process to remove them. People with diabetes are at risk from inaccurate strips. Let’s change that.” And with regards to the July DSMA Blog Carnival topic: Test strip accuracy is important to me because I want to be here for a long, long time, and my health depends on the accuracy of the tools I use to manage it.

The rising cost of healthcare seems to be moving in lock step with the increasing numbers of people being diagnosed with Type 1 and Type 2 diabetes. If people with diabetes cannot trust key tools – i.e., test strips used in glucose meters to measure blood sugar levels – we use to help manage our disease and (hopefully) offset potential complications, how can we be expected to keep ourselves as healthy as possible so that we do not further drain our healthcare resources? It only makes sense for insurance companies and others with skin in the game to get involved with this. It’s a win-win for everyone involved if we can STAY HEALTHY. Strips & CGM sort of matching, yay!The picture above shows my blood sugar readings from the 2 main meters I use and my Dexcom CGM. While I’m thrilled that they are all within 10 points of each other, I’m not really thrilled at that number, but hey – it’s the common post-breakfast spike I tend to have and it’s already on it’s way down. Whew.

I feel I have the luxury of “trusting” my meters and their test strips to a good extent because I’ve seen my HbA1c numbers reflect what my glucose meter readings have told me over time. But I know at some higher ends of the glucose spectrum, and some lower ends, things can get sketchy with regards to accuracy. And what about all the other people who can’t afford expensive meters and supplies and have to “make do” with potentially sub-standard strips and meters? Like the campaign says: let’s change that.

The Beach ate my Insulin

Just got home last night from spending a wonderful long weekend at the beach with my daughter, husband, and family friends who also have kids. Anyone who knows me knows that I am more of a mountain girl – I much prefer hiking and exploring the scenic views in the mountains and having a picnic by a babbling brook over baking myself in the heat of summer and cleaning sand out of every orifice of my body. I mean, the beach has it’s scenic views, and the crashing of the waves can be very relaxing….it’s just, I don’t ever feel like it’s worth all the mess and cleanup, and then there is also the planning and packing and preparing just to be able to moderately enjoy a day on the beach. (See the Swimming with Diabetes post for some similar highlights of what has to be done just for a “quick” trip to the beach or any body of water.)

I love all the firsts with my little girl

Touching the ocean for the first time

But I have to say, it was truly a joy to see my daughter experience the ocean and the beach for the first time, and I’m so glad I sucked it up and made the effort to go. She LOVES playing in the sandbox, and loves the pool, so we knew the beach would be a hit. And it was. So much so that, on the way home yesterday when she woke up from her nap, we told her we were almost home. She happily exclaimed, “Beach house!” and we were like, “no, back to our house at home” and she immediately burst into tears.  Trust me, sweetie, I wish we could vacation all the time, too!

And hope it never becomes needed.

Good Mommy, wearing my medic-alert bracelet!
Just in case.

Anyway, back to how the beach ate my insulin…we got there on Friday, and made the short walk to the actual beach front  (just a few hundred feet from the house we stayed in) to check it out. I had planned ahead and changed out my pump infusion set that morning so I had a fresh 300 units to get me through the majority of the weekend. Friday was a great blood sugar day and night – the walk to the beach, plus a sensible dinner and a glass or two of red wine were easy pickings to account for – my sugars were generally steady, and between 80-130. The only negative diabetes thing was that the shorts I wore to explore the beach got a little wet and were rubbing on my Dexcom sensor *just so* that it ripped it off. Replaced the sensor – a little bitter because I probably had another good week and a half left on it.

Saturday morning, we carted a truckload of supplies – sand toys, life jackets, boogie boards, towels, chairs, a tent, and a cooler filled with snacks –  and spent several hours enjoying the sand and the ocean. I played it safe, and spent the majority of the time in the shade of the tent. It really wasn’t even very hot, in the grand scheme of the beach. Maybe in the 80s? So, I wore my pump and CGM while I was watching everyone, and if I went into the water to play, I would put my pump in a Ziploc bag and leave it inside the cooler (not directly on any ice) and make sure the CGM receiver was in a safe non-watery place. (My CGM sensor itself was now applied with Skin-Tac and copious amounts of Opsite Flexifix tape, so I was pretty sure the ocean wouldn’t whisk it off my leg.) It probably took me til Sunday morning to realize something was amiss with my sugars, and to blame it on the pump/potential skunky insulin. So, I implemented a cautious change out, wasting many units of insulin. Grrrr.

See the green tent - my shaded haven

See the green tent – my shaded haven

Sunday was an OK day blood sugar-wise….we visited the NC Aquarium at Pine Knoll Shores, so we were inside during the main heat of the day. But we also went on a short nature hike outside while there, and that got a smidge hot. We also went to the beach again that afternoon. Ironically, my sugars started climbing again that afternoon, and were hanging out in the 180s and 190s no matter what I did (drank tons of water, took more insulin through the pump, used a different bottle to give a shot of insulin, ate something, etc.)

Wheeee, the beach! Yes, I'm wearing a t-shirt. Not fashionable, but I also didn't get sunburned, so there.

Wheeee, the beach! Yes, I’m wearing a t-shirt over my suit. Not fashionable, but I also didn’t get sunburned, so there.

By the time we headed home Monday, I was really tired of high sugars making me feel like crap. We stopped and played a round of miniature golf on the way home (and I putt-putted the best score of my life – 34!!) and that got to be hot – possibly as hot as our days on the beach. More insulin skunkiness caused? I had tons of insulin still left in the cartridge, but got home and immediately changed it all out with a new bottle of insulin and a new infusion site yet again. Finally, my sugars leveled out and started making sense again. I was just so frustrated that I wasted at least a couple hundred units of insulin over the weekend because my insulin got too hot while it was sitting on my body (yes, I wear it in my bra 99% of the time.) I also threw out the bottle that was in my pocketbook, since I had used it to supplement with shots when my sugar was so high, and even the shots didn’t seem to make a dent. Wondering if that insulin was exposed to too much heat at some point in our travels?

Grrrr, I hate wasting insulin. Either this bottle has had it, the insulin in my set has had it, or both.

Grrrr, I hate wasting insulin. Either this bottle has had it, the insulin in my set has had it, or both.

Sweetly Voiced recently wrote about the checklist of items we go through when trying to figure out why our blood sugars may be high (and I wondered about all these things several times over this past weekend) and brought up a good point – why isn’t there a test strip or way we could check our insulin in order to figure out it’s gone bad? I hate tossing an entire bottle, or 200 units left in my infusion set, if it could possibly be something else. In this weekend’s instance, I’m just going to say the beach ate my insulin. You think my insurance company would replace a bottle of insulin for me for free if I tell them that? Ha.

D-girls Night Out

Since becoming more “diabetes aware” in the past few years, I’ve met so many wonderful people online, as well as many local diabetes friends, who happened to be women. We’ve started gathering together for girl’s nights on occasion, and last night was a celebration of one of our group’s 9 year diaversary. Everyone brought a snack to share – no rules, just bring something that tastes good! – and we ate and drank together, shared thoughts about our current pumps and CGMs, discussed a couple of studies people were participating in, and had a relaxing and fun night together. Happy 9 year diaversary, Erika!Two friends are Type 1’s who are both expecting little girls within the next 7-8 weeks. (I was SO proud of myself – I didn’t ask to touch their adorable baby bellies even one time!) I hauled out a bunch of Penny’s baby clothes and had them rummage through for anything they thought they might use.  It brought back such sweet (and sleep-deprived memories) of when Penny could wear those clothes….I still haven’t come to any solid conclusion about expanding our family. Well, I *think* I have, but I still waffle like Bisquick on a griddle. (Does that even make sense as a real analogy? What is my blood sugar right now for me to be coming up with such things??)  More thoughts on babies forthcoming, I’m sure. Babies in Type 1 bellies = awesome

I really don’t think I can express in the short space of this blog post how wonderful it is to hang out with these girls – we are all quite different in our age ranges, our jobs, our family statuses of being married or not, having kids or not (one is even a grandmother several times over!), and still share the common thread of type 1 or type 2 diabetes experience and understanding that I don’t necessarily have with all my other non-d-girl friends. At one point in the night, 4 or 5 of us had our pumps out and were bolusing for the upcoming snacky meal. Pink, purple, blue and grey pumps were taken out from pockets, side clips, and bras, and no one spared a second thought about it. As we shared our CGM readings, there would be a nod of, “geez, I’m high, too!” or the helpful friend going to grab my finger-stick meter so I could confirm if my low reading really WAS a true low or just a wonky CGM sensor. (No wonkiness – I ran low about half the night and even well into today, thanks to a certain red wine 🙂 )Hello, post-red-wine lowsI could talk all day about how awesome each and every one of these girls is in their own way. What accomplishments, what trials, what tribulations they have gone through that were similar or different from mine….yet, we were all knit together last night through the common bond of diabetes.

It’s this camaraderie that encourages me to NOT dismiss diabetes as something negative that happened to me. To never again push it into the background as something I just have to deal with on my own. I look forward to next month’s gathering with them, I’m driven even more to fund-raise and participate in the JDRF walk on November 2nd, to call into the TuDiabetes.org interview with Kerri this afternoon, and to continually stay involved and look for other ways I can interact with the greater community of people I know – online as well as offline – who have diabetes. For years, I felt alone and solitary in my every-day struggle with diabetes. Now, that is the furthest thought from my mind. D-girls Night OutD-girls Night OutD-girls Night Out(Shout outs to two d-blog friends Laura and Carlyn who are regular d-girls night attendees! And big thanks to ALL of you awesome girls who came over last night – you know who you are!)

Swimming with Diabetes

I have loved swimming since I was close to my daughter’s age now. I always feel so free in the pool – weightless and enveloped in such voluminous amounts of water.  Ahhhhhh…amazing and relaxing.  It is really the perfect type of exercise for me because I have bad feet and knees, and it totally removes any issues with those pains.  I prefer indoor swimming because it doesn’t allow that bright-shiny-burning-thing-in-the-sky to turn me into a lobster on contact. Luckily,  I have access to several pools that are pretty shady (in the good way, not the crime-ridden way) so sunburn hasn’t really been an issue.Selfie in the pool

However, swimming is not a lot of fun for me anymore. Due to diabetes and all it’s accoutrements, I have to plan and pack for a nuclear holocaust anytime I want to just have a quick dip in the pool.

My usual checklist includes (I’m sure I’ll still forget something, I always do):

  • Basic pocketbook stuff like keys, ID, cash & cards
  • Cooler bag with water and ice packs
  • Snacks, snacks, snacks
  • Glucose meter case, that includes syringes and a bottle of insulin
  • Tons of sunscreen
  • Bug Spray
  • Dry place/container to put the meter case, pump & CGM receiver
  • Pump site cover
  • Clean clothes
  • Towel
  • Monsterous-sized bag to hold above items

And that list doesn’t even include anything for my daughter, which pretty much triples everything except the diabetes stuff, and adds on swim diapers, pool toys and water floatees.  I need a Mack truck to cart all this stuff to the pool.

On top of all that is the “site consideration” decision tree I have to go through to decide if it’s worth getting my CGM sensor site and my pump infusion site wet/soaked in water, and potentially having to change one or both of them out sooner than I would have if I *didn’t* go swimming. (Or is it worth destroying a Dexcom? Having my insulin go skunky from getting too hot if I hook back up while drying off beside the pool?)  Sometimes I just say forget it, and don’t go swimming because it’s way too much of a hassle.

But the times I actually suck it up and make the effort to go swimming….still amazing. (And I do get some great pictures with my waterproof camera.)2013-07-23_SwimmingDiabetes42013-07-23_SwimmingDiabetes32013-07-23_SwimmingDiabetes2

Diabetapedia and Check-in Day

In looking up a reference URL to link here for DOC (Diabetes Online Community), I came across said link to Diabetapedia.com – am I just slow on the uptake of finding this? How long has this been around? Have any of you guys submitted information to it? And does anyone else think they are kind of stealing Kerri’s tagline? I’m not sure how I feel about this…..I really like the idea of a diabetes-wikipedia-type site, but I guess I am a little suspicious when anything is sponsored/run by “big pharma.” There always seems to be a (not-so) secret agenda of them getting money and marketing from it, and regardless of who provides the information, there’s always something in the back of my mind that questions their motivations and the data that’s given because I feel they have their own agenda behind providing it.  I must noodle on this a bit more.

Switching gears (because I’m a bit off-kilter this morning after enjoying too much Stark Raving wine this weekend), how often is it that we let others in the DOC know that we read what they post, understand where they are coming from, and give them that little piece of moral support that can help them learn a new diabetes tip, or motivate them out of a bad case of diabetes burnout? Probably not often enough! So, today, if you’re reading this blog, please post a comment – even if it’s just a “check!” to say you’re here and you read this.  Chris at A Consequence of Hypoglycemia had this idea, and I’m participating today as well (as soon as I have time enough to read all the blogs I need to.)

Another switching of gears….we got some much needed relief from the heat yesterday at the misty-water-zone area at the Durham Museum of Life & Science. We took Penny there for the 1st time since she’s become a truly aware little person (the time we went when she was 8 months doesn’t count, since all she did that visit was sit in the stroller, sip milk, cry, poop and pee in a diaper, and nap. Oh, how life has changed!)
Kids in the MistFunny with my buddy Seth!One cool kid.

I’ll have Gerard Butler with my wine, thank you

My favorite wines tend to be red….my current red wine of choice is just about any Malbec from Argentina. I’m not a wine snob nor do I profess to know much about wine, but I know what I like to drink, and over the years I’ve (mostly) figured out how wine affects me and my blood sugars. One glass of red wine with a carb-filled Italian dinner actually seems to help keep my blood sugars a little more stable….my guess is, my liver decides to process the alcohol instead of immediately processing the carbs, so I get a bit of a sugar-break. Now, this is just an observation I’ve made with myself and how my body works – YDMV (your diabetes may vary.)

When my eye was drawn to this “Stark Raving White” wine in the grocery store aisle, I felt compelled to buy it, even though white wines tend to affect my sugars more (by having more carbs in the wine itself), and they are not as tasty to me as the reds. Yum, wine. Yum, Gerard Butler.Ah, Gerard Butler! That may or may not be his image on the bottle, but this winery knew how to suck me into buying their wines….put sexy-looking men on the labels. (It’s like I’m back in college, didn’t know what wines I would like, so I bought them based on how pretty the bottle or label was. Sometimes it worked out, sometimes it didn’t. Bleck.) I have no idea if the steampunk-looking dude on the Stark Raving Red bottle is supposed to be Gerard as well – the glasses kind of throw me off – but I’ll happily drink him up as well.

(And here’s your Public Service Announcement from the ADA on alcohol and diabetes.)

Lancets – the good, the bad, the gross

From hanging out in the DOC for a few years now, I think I can safely say that a LOT of us have a very lackadaisical attitude towards lancets. Sure, we use them on a daily basis, and have to have them to support our blood sugar testing, but as for brand names, which ones perform better than others, etc, I don’t see a lot of discussion around it, and no one seems to care a lot about lancets. (Except for the FDA, apparently. What a load of who-ha.)  There isn’t any dedicated research (that I know of) or earth-shattering discoveries being made around “how to make a better lancet.”  I am not talking about non-invasive glucose monitors here, I’m just talking about lancets. Lancets are pretty simple tools we use to break through our skin, draw blood, and use that blood to test our blood sugar.  (True, lancet-devices themselves may differ, but that little piece of skin-poking metal is pretty universal.)

As for our various uses and hygienic standards surrounding how we use lancets….now, there’s another story.  I remember in the early days of having diabetes, I was religious about washing my hands and/or alcohol swabbing my finger before ever jabbing it with a lancet/lancet-device. After each use of a lancet, I would take it out of the lancet-device, cap it with the twist-top from a new lancet, put the new lancet into my device so it was ready for next time, then discard the old one into my sharps container. (I’m sorry, I’m laughing at my-naive-fresh-faced-21-year-old-diabetic-self as I write this. Let me compose myself.)

Fast forward 19 years. I can’t remember the last time I refilled an Rx for lancets or bought a new package of them. The ones I have in my diabetes supplies zones have long-overdue expiration dates on them (I think), but really – what’s there to “expire?” Maybe their sterility could be compromised after so many years? I even have a box of rainbow-colored lancets. Those make me more cheerfully stab my fingers. (Not really, but let’s just pretend.)

Deutsch: Einweglanzette (Nahaufnahme)

A Lancet (Photo credit: Wikipedia)

But if we’re talking about things being sterile – that went out the window years ago. I do still wash my hands – most of the time – but definitely if I’ve eaten recently because I don’t want any rogue food particles to mess up the sugar reading. I am sure I use the same lancet hundreds (yikes, maybe thousands??) of times before I remember to change it out. I have a CGM, but I still finger-stick test at least 5-6 times per day, and more if I’m on the first or last few days of a CGM sensor. In one month, I’d say I could use the same lancet at least 150 times, so it hits 1,000 times in 6 months, easy.

I’m trying to get better at switching out the lancet more often than once in a blue moon. With my recent stupid finger infection, I can see where I may be more prone to infection here in my older age, and even though I am a chronic hand-washer, germs still abound. I have a 2 year old. We are involved in potty training. Dirt and germs are EVERYWHERE. I promise – and I’m announcing this to the world so now I’ll be held accountable – I will try to do better at changing out my lancet, for the sake of not getting any more infections that could have been prevented.

The event that actually spurred (ha ha) me into writing this post was how I find myself using lancets for several things OTHER than their intended use. In these cases, I do always use a sterile one fresh from the box. And if I ever test someone else’s blood sugar, I always use a clean one for them, and replace it after it’s used with a new one for me. I don’t joke about that stuff.

I have used lancets for a multitude of problems….they are perfect for clicking the microscopically tiny reset buttons on various electronics, popping zits, helping dislodge splinters, digging out sock lint from my toenails, and picking out food trapped between my teeth. (Too much information? It gets better.) The other week, I had this weird pimple-like boil on my belly, right at my waistband line. I thought it looked like a zit and I’d popped it a week or so before, but it came back and was looking kind of angry now, so I performed minor surgery on it – using alcohol swabs and 2 lancets. A fair amount of blood was expelled, along with some pimple-juice-like-substance. It went from being swollen and red to flat and healing – that sucker cleared up in no time! (I think I’ve been watching too much Walking Dead. That didn’t gross me out one bit.)

Anyway….what are your thoughts on lancets? Any fun info or amusing uses that you have found for them?