diabetes blog – Page 2 – Very Light, No Sugar
Posted on October 12, 2015 October 13, 2015 by Ally Posted in cure diabetes, diabetes, diabetes blog, vignette	Tagged diabetes, diabetes blog, vignette	4 Comments
A Few Good Nurses
For a couple of years, I have kept this story close to the vest, mostly because I felt quite vulnerable sharing it. I still feel sensitive, but the timing is now right to tell the tale. We are seeing many headlines in the news about nurses today. As far as diabetes blog headlines go, I hope you’ll take a few moments to read this one and to thank a deserving nurse.
Winter. I had recently started grad school and I was optimistically trying to do #AllOfTheThings. This included a regular, intensive gym schedule, a disciplined diet, and very little sleep- just the right ratio of “healthy” ingredients to convince myself that I was not running on vapors in reality.
I booked an appointment with my diabetes nurse, as I was experiencing more frequent insulin pump site problems. We needed to find viable locations for site changes, or perhaps to discover a different type of infusion set that worked better for my body type. Also attending the appointment would be a nurse employed by the insulin pump company.
At the appointment, we had all of our diabetes ducks lined up in a row: various infusion set types, reservoirs, alcohol swabs, IV prep, and Humalog vials.
Historically, I stuck to the abdominal area for pump site changes. We wondered if significant scar tissue had developed, causing the numerous pump site failures.
“Alright, can I take a look at your sites?” D (diabetes) Nurse asked.
“Yeah…” I replied, eyes darting to the floor. I felt weak as I handed the control of the situation over to the healthcare professionals. It’s my body, but now I have to trust someone else with it.
D Nurse gently felt around for scar tissue, but did not find much despite my long-term insulin pump usage. P.S. (pump site) Nurse from the pump company inspected the same areas and came to the same conclusions: no scar tissue, but not much pump site “real estate” to work with.
“Geez, no wonder these sites are hurting you. You don’t have much padding to use!” P.S. Nurse said, making eye contact with D Nurse as if to communicate, “This might be a difficult appointment…”.
In terms of pump sites, my extra sit-ups after the gym workouts were not helping matters much. (Now that I am in my last semester of grad school, I assure you that extra sit-ups are a thing of the past!)
“You can try leg, back, or upper butt sites whenever you feel comfortable. But for today, if you want to continue with the stomach, we can do that,” D Nurse said.
“Okay,” I replied nervously.
We all knew what was coming: the “trial and error” method of identifying infusion sets that would work well for me. The nurses had to be sure that I was inserting the sets properly and that we were not overlooking a better option. Like many diabetics, I have endured thousands of needles in my lifetime. Although unpleasant, at some point you get accustomed to the momentary pokes and prods and you do not dwell on them. Regardless, even at the age of twenty-five, it was a harrowing thought to know that my stomach would soon be a pincushion.
First, I showed them how I inserted my sets. The process was automatic and quick. The nurses agreed that I performed every step correctly and we could cross my name off the list of possible suspects causing the site failures.
“Your skin is tough- literally and figuratively. I think you may be getting some resistance from the insertion devices, which could be kinking the cannulas as they go into your body. Can I try an insertion?” P.S. Nurse asked.
I nodded and allowed her to try without protesting.
“Okay, that was good but I felt the kick-back with the inserter. What if we manually put the site in? You could insert the needle by hand, without an insertion device, and perhaps you can curtail the bent cannulas that way,” P.S. Nurse suggested.
Whaaaat?! I wanted nothing to do with that idea, but was also willing to try anything to get the sites to work better. I made a feeble attempt at manual insertion and watched as the needle bounced back off my skin. Defeated, I slumped down in the chair.
“Do you mind if I try it?” P.S. Nurse asked.
I liked how she always sought my permission before attempting anything. The control was still in my hands to an extent, even though she now held the needle.
“You’re doing so well. You’re so brave,” D Nurse whispered. She wiped the dried blood off of my stomach using alcohol swabs, distracting me while P.S. Nurse prepped for the final insertion.
And just like that, it was over. P.S. Nurse swiftly launched the needle into my side, and I did not feel more than a minor pinch. We high-fived and hugged afterwards, proud of our hard work.
That appointment lasted a few hours. While it may not have been as draining as receiving chemotherapy or undergoing heart surgery, I can tell you truthfully that it was an exhausting afternoon for all of us. Emotions were high in the face of uncertainty, and we had to trust and communicate with one another. If it hurt, the nurses were right there to make it hurt less. Likewise, I had to admit when it did hurt, when I did need their help.
In my lifetime of medical appointments, I have felt the cold stainless steel of stethoscopes from nurses and doctors alike. I can attest to the other tools that nurses use: infusion set needles, alcohol swabs, bandages, medical tape, bear hugs, TLC. A few good nurses can change the entire course of an appointment, making it go from “scary” to “It’s going to be okay” as they work steadfastly to heal their patients. Nurses often handle the difficult moments behind the scenes, with little fanfare. They comfort patients like me when we are scared. They make it hurt less. And they deserve to hear “thank you” more often in our society.
Posted on September 17, 2015 September 17, 2015 by Ally Posted in diabetes, nurses	Tagged diabetes, diabetes blog, nurses	2 Comments
One Step Back, Many Steps In
It has been almost one month since I took a step back from blogging. I can’t quite say the same for live-tweeting my stream of consciousness, but I did my best to avoid reading feverishly about diabetes technology as promised.
My tiny blogosphere roar does not make the world go ’round. But, for me- and hopefully for the people who read my blog on occasion- Very Light, No Sugar will always be my own little piece of the larger diabetes puzzle. Blogging is how I shed light on the thoughts that have bounced around in my head for over 24 years of living with type one diabetes. Reading others’ blogs has been empowering and unifying; many of those same thoughts bounce around in other heads, too. Putting my feelings on (virtual) paper makes them real- a part of our shared experience of diabetes. Changing up the blog post pace allowed me to reexamine why I chose to blog in the first place.
By taking a step back, I was able to let others step in. Before the mini-hiatus, I probably did not realize just how much I needed those little moments with big meanings because I was caught in an overwhelmed, overtired haze.
Emailing back and forth with various #doc buddies who offered unconditional support and understanding, paying more attention to the humorous side of diabetes via the Twitter and Facebook jokesters, and spending a few days on Cape Cod with my family allowed me to hit the figurative “reset” button. And let me tell you, the “reset” button is more refreshing than pounding the “snooze” alarm three times each morning.
It’s good to be back, even if only at “training wheels” pace for the time-being.
Posted on July 16, 2015 July 16, 2015 by Ally Posted in blogging, diabetes	Tagged diabetes blog, doc	Leave a comment
Wicked Witch of the East?
“Woah! Is that normal?!!” my friend and coworker, Jack, exclaimed as we sat on the bench at lunchtime.
“You mean these Incredible Hulk feet? Yeahhh, not so much,” I replied.
Filed away in some teeny weeny “Future Useful Information” cabinet in my brain, I recalled how months earlier my doctors described that I may notice some swelling in my feet as I transitioned from the insulin pump back to multiple daily injections after a decade of pumping.
In layman’s terms regarding “Swelling Feet 101”- because I have a very basic understanding of this very complicated medical scenario- we would expect to see some swelling, particularly of the feet, due to my body readjusting to normal-ish blood sugar values.
While experiencing the high frequency of my insulin pump problems in the fall/winter, my body was more or less in a prolonged ketonic state. With almost every site change, ketones built up, and it took hours to recover. On especially rough days, I sometimes experienced multiple site failures, pushing the recuperation process even farther behind. Once the problem was rectified, it was time for another site change, and often this process began all over again. Not fun.
When ketones pop up, your body burns fat for fuel, and you dehydrate and do not absorb food properly. Hence, the overall zombie apocalypse feeling that ketones carry. During this time period, I was gaunt, hungry, and tired. My body became accustomed to this unhealthy status quo of spilling ketones, flushing them out, and starting all over again once a new problem arose.
Shots mostly erased this high ketones song and dance. Insulin was regularly getting into my body via injections, so the ketones did not have a chance to compound like they had in the past. Although I felt infinitely better without ketones, my blood sugars were far from stellar for the first few months back on shots. There was a lot of back and forth figuring out proper basal rates, insulin to carb ratios, and correction factors. And, in diabetes’ signature fashion, it usually changed its mind once we seemed to iron out some details.
I am still not the poster child of superb blood sugars or a brag-worthy A1C, but my numbers are beginning to stabilize. Interestingly, I am seeing improved blood sugars with a significantly-reduced basal regimen. In the past, the basal was too high, prompting big crashes and consequential reactionary blood sugar spikes. In other words, the diabetes rollercoaster had a lot of peaks and valleys.
So, recently when my feet looked like the Wicked Witch of the East’s heels poking out from under the house that crushed her, it was actually a positive thing. Luckily I had a doctor’s appointment the following day, which confirmed that this was the swelling we had initially expected. It had not appeared when first back on shots because my blood sugars had remained erratic, despite the lack of ketones. Now, my body is getting more of the fuel that it needs and the insulin to cover that fuel, so as it rehydrates, there may be some temporary swelling.
As with anything diabetes-related, it’s never really simple, is it? Thankfully, in this situation, the unpleasantness is only brief and will not cause any permanent problems. The only other issue is that I am having muscle spasms in my feet and legs quite frequently. I have experienced muscle cramps since childhood. Although this is nothing new to me, I could do without the intensified “Charlie Horse” occurrences. The doctors believe this number will decline as the swelling in my feet lessens over time.
Finally, my high heels game is taking a hit here. But who doesn’t want to wear sandals or Sperry’s in this awesome weather, anyway? Bring it on! #ItMakesSenseIfYouHaveDiabetes
Posted on May 27, 2015 May 29, 2015 by Ally Posted in #ItMakesSenseIfYouHaveDiabetes, diabetes blog, ketones	Tagged diabetes blog, swollen feet	Leave a comment
Posted on April 26, 2015 April 27, 2015 by Ally Posted in advocacy, cure, diabetes, diabetes blog, diabetes social media advocacy, diabetic online community, ePatients, healthcare, try	Tagged advocacy, cure diabetes, diabetes, diabetes blog, diabetes social media advocacy, diabetic online community, try	3 Comments