Wednesday, March 18, 2015

Please Continue to Hold...

(Current estimated wait time is... 8 minutes.)

I'm on hold for the third time today with the third business. All I want to is order a Dexcom transmitter. My warning went off on Monday that my transmitter battery is almost dead. Now, I knew that my transmitter was getting old, so a month ago, I contacted my DME supplier, their name rhymes with DredgeShark, about getting a replacement.

Two weeks later, I found out my order was canceled. Why was it canceled? I called DredgeShark, and they didn't know why. They said they would get to the bottom of it and send me my sensors and transmitter.

(Please continue to hold and we will be right with you...)

I just called DredgeShark, because my transmitter is going to turn off any day now.  They told me my insurance company is no longer contracted with DredgeShark to provide Dexcom sensors.

Why didn't they tell me this three weeks ago? What am I supposed to do now?

I called my insurance company.

(Please listen carefully as our menu options have recently changed.)

My insurance company agent had no idea what a CGM was. After putting me on hold for half an hour, I suggested calling Dexcom directly to find a company to help me get sensors and a transmitter.

(All agents are busy assisting other customers.)

So, right now I am on hold with Dexcom. I really hope I can go directly through Dexcom.

Tick tock. Tick Tock.

OK, I talked to Dexcom. Now I have to wait and see if my insurance company will let me order supplies directly from them. I sure hope so. 

DredgeShark has become a nightmare. I ordered insulin pump sets online a month ago, and DredgeShark deleted the order instead of processing it. So, I ordered on the phone. Did they send me my supplies? No. Instead I got an email telling me I had to fill out forms for Medicare before my supplies would be approved. I'm not using Medicare! So, I called them back a third time with my information and now once again it is processing. Maybe. I hope.

This sucks!

I am running out of sets. I'm frustrated beyond words. I need insulin pump supplies to function. It's not like I am ordering books, or a new cell phone case. It feels like my life is on hold.

(Your call is important to us. Please stay on the line and a customer service representative will be with you shortly.)

(This call may be monitored for quality and training purposes.)

My Dexcom is going to shut down in a few days when the transmitter dies. And there's not a damn thing I can do about it.

(Please continue to hold while we play irritating music in your ear. Thank you.)




Monday, January 26, 2015

Dog Diabetes VS My Diabetes

When April was diagnosed with diabetes last year, I was surprised how similar her diabetes is to mine.

A normal blood glucose range for a dog: 80-120
A normal blood glucose range for a human: 80-120

Low blood sugar in a dog: 70
Low blood sugar in a human: 70

Amount of glucose needed to raise April's low blood sugar: 15-30 grams (or more if epic low)
Amount of glucose needed to raise my blood sugar to normal: 15-30 grams (or more if epic low)

April's blood sugar after stealing a sandwich: 300 or higher
My blood sugar after eating a sandwich and (ahem) forgetting to bolus: 300 or higher. (Not that I ever forget to bolus.)

Symptoms of high blood sugar in a dog: Excessive thirst, peeing by the back door, weight loss.
Symptoms of high blood sugar in human: excessive thirst, peeing all day long, weight loss.

Symptoms of low blood sugar in a dog: stumbling, glassy eyes, confusion, shaking.
Symptoms of low blood sugar in a human: stumbling, glassy eyes, confusion, shaking.

Treatment of low blood sugar in a dog: vanilla frosting and mini donuts.
Treatment of low blood sugar in a human: glucose tablets. (Donuts? Baklava? Cookies? Cake?)

One big difference is April uses only insulin N. I get Reli-on brand from Walmart because it is 25.00 a vial. My insulin is covered by my health insurance. I use NovoLog. April has two shots a day. I use an insulin pump.

April gets 21u of NPH insulin twice a day, for a total daily dose of 42u. Because I am a human, and don't eat kibble out of a dog dish, I get a different dose of insulin every day. Sometimes my total daily insulin dose is less than my dog. Sometimes I get the same amount of insulin as April. (January 5th was the last time we had the same total daily dose.) When there is Chex Mix in the house, I use a lot more insulin. April is just as tempted by Chex Mix as I am, but she lacks opposable thumbs, and if we put it on a high shelf, she can't get at it. Except for when she finds a bowl on the table. Then, all bets are off. There are times when I wish I could correct April's high blood sugars, but since she is on NPH twice a day, I can't correct. All I can do is try to control her food.

April eats one can of dog food, and one scoop of dry food, twice a day. Except for when she doesn't. You see, April is a weimaraner. Weimaraners can do this:




I am so incredibly glad that is NOT MY DOG. However, while I was writing I heard a loud ripping, crunching sound in the living room. I went in. April stole a brand new bag of corn chips and managed to rip open the bag. No! Those are Dad's chips! Crazy dog!

Look, I try really hard to keep April eating only what she is supposed to, but April is still a weimaraner. Sometimes April eats cat food. Sometimes she gets in the garbage. Sometimes she steals a sandwich off the counter. This makes her blood sugar go bonkers, because I can't just count the extra carbs and cover them with extra insulin. Not being able to correct makes me unhappy, but I am learning to shrug it off.

April is 12. If I test her blood sugar six times a day, count all her carbs, and micromanage her diabetes, she will probably live another 18 months to two years. If I roll my eyes and laugh when she gets in the garbage, eats random snacks, and steals sandwiches, April will probably live another year and a half to two years. Realizing this has helped me ease up and worry less.

Why was April low over the weekend? I have no idea. Lows happen to both of us. So do highs. We both do our best to live well with diabetes, and in the end, that is all that matters.

Sunday, January 25, 2015

Thank heaven for 7 Eleven

I was on the bed reading. My husband came in with April the diabetic dog. Steve said, "April has been a little wobbly." I looked down on the floor. April had stumbled and fallen. Steve helped her stand. She fell again.

April is 12-years-old, which is 89 in human years. Maybe she had a stroke. Or maybe... Steve grabbed her glucose test kit. I tested her blood sugar. It was 27 mg/dl (1.5 mmol)

 That is sugar reaper territory. April wasn't even shaking anymore. She was just lying limp on the couch. I looked at the number, and at Steve. Both of us said something that rhymes with, "Puck! Goalie mitt!"

The dog needs carbs. Lots of carbs. Now! I searched the kitchen. What do we have? Caramel sauce? No. Orange juice? No. Smarties? No. Glucose tablets? No. Honey? No. What can I give the dog? I found a Poptart. 35 grams of carbs. OK. OK. This will help. I ripped open the wrapper. Chocolate! Crap!

Then I remembered, on the dog medicine shelf was a tube of green cake frosting. It was almost empty. Five grams of carbs per teaspoon. That's not going to be enough.

"Steve, go to 7 Eleven and grab some powdered sugar donuts."

He grabbed his coat and left. I sat on the couch and squeezed cake frosting into the dog's mouth. April perked up a little and licked the frosting. The tube was nearly empty when Steve came home with donuts. April didn't bark when he came home. She just stayed on the couch looking limp and glassy-eyed.

My husband ripped open the package and handed me a donut. April gobbled it. And she gobbled the next one. She ate five out of six donuts. I gave part of the last donut to Honey, our non-diabetic dog, because she was standing beside me drooling.

Within half an hour, April was up and romping around the house. We tested her blood sugar a second time and it was 127. Crisis averted. The Sugar Reaper left.

This experience reminded me once again how important it is to have carbs ready to go, both for me and our dog. Now we have a new tube of vanilla cake frosting, and another package of 7 Eleven Powdered Mini Donuts, on the shelf. We're ready for the next time the dog is low.

Speaking of low, Dexcom is telling me that I'm low. What the puck? Hang on a sec while I confirm. Yep, I'm low. Finger says BG now 68. Weird. I did not expect that. I was 257 about an hour and a half ago.

We're not going to name names here, but someone had eggs and waffles for breakfast and (ahem) forgot to bolus ahead of time. I remembered to bolus about 10 minutes after breakfast, which is why my BG was only 257 and not 357. Did I just write ONLY 257? That, right there, says a lot about my life with diabetes. Facepalm.

After eating waffles, my pump, XPU Mark II, calculated I needed a boatload of insulin. I used my pump, gave myself an amazingly large bolus, and here I am low an hour and a half later.

Move over April. It's my turn to eat some medicinal donuts. Who knew 7 Eleven could save someone's life? Thank heaven for 7 Eleven.

Saturday, December 20, 2014

Researcher Needs Volunteers

 If any of you are dealign with diabetic kidney disease, a medical research company could use your help.

Here are the details:

My name is Laura Greer, I work with The Henne Group, www.thehennegroup.com, a small medical research company in San Francisco. We are contacting you to see if you can help us with our new project. We are looking for people, patients who are managing Diabetic Kidney Disease. We will be conducting in person interviews in different cities across the US. starting on the third week of January and participants will receive $100 as a thank you incentive to compensate for their time and effort.

No attempt will be made to sell anything or influence their thinking, and all participation is confidential.

If you think you can help us to spread the information of this study please feel free to post this email or to contact me by phone or email. If you know anyone who is interested, they can contact us on our phone number 415-348-2986 or 877.737.5782 x 286.

People can see if they qualify to do the study by taking this survey:
http://surveys.thehennegroup.com/survey/intweb.dll/project/cawi/1416_DKD_CAWI

My direct line, if you have any questions is 415.348.2918
 

Friday, December 12, 2014

Did I remember or forget an insulin shot?

When it comes to looking after my own diabetes, I have my pump to help me. I can look at my history and see if I remembered to bolus for that chocolate doughnut. Remembering if I gave my dog her insulin shot is becoming a problem.

I knew the day April was diagnosed, giving her insulin would become a routine. Routines are good and dangerous. My typical morning begins the same way:

1. Get up and take care of business.
2. Take April the diabetic dog and her best friend, Honey outside.
3. Come back inside with the dogs and clean up any puddles April left overnight.
4. Greet daughter while she feeds her cat, Cyclone.
5. Feed Fresh Air and Sunshine, my twin cats
6. Feed April
7. Feed Honey
8. Give April her shot--21u NPH.
9. Drive Evelyn to work

Unless, Evelyn has to be at work early. Then I do steps 1-3. Skip ahead to step 9, add a step 4.5 and feed Evelyn's cat, Cyclone. Then I do steps 5-8.

This morning I took my daughter to work early. I came home and fed all pets. Did I remember April's shot? I think I did. Wait, did I? Oh no, I can't remember. Open fridge, find an empty syringe. OK, no I didn't give April her breakfast insulin. Give April her shot. Whew.

Then there is Saturday morning. Saturday morning I sleep in, and my husband feeds April and gives her a shot. Unless, he is napping on the couch and I don't want to disturb him and then I give April a second breakfast and a second shot. OK, that happened once, but wow did that suck.

Do you know what a dog looks like with a blood glucose of 22? I do. Shaking, trembling, stumbling, glassy-eyed and very scary. Did you know a dog will not eat glucose tablets, or drink juice, or eat Smarties, or caramel sauce? We stuffed her mouth full of vanilla frosting. Followed by more vanilla frosting and peanut butter once her BG stabilized. That was so scary. Never again.

Steve and I now have a system in place on weekends. I assume he gave April her breakfast and insulin, unless he says otherwise. So, double insulin doses won't happen again. 42u of NPH at once scared the crap out of us. Morning pet feeding is a daily routine for me and it's hard to skip feeding April on the weekends. Steve reminds me and that helps.

Honey and Sunshine 2013
In the evening, I feed all pets again in the same order: Cyclone first, Fresh Air and Sunshine second, April is fed third and Honey is fed last. The hierarchy keeps things peaceful. Dogs are pack animals. Animals higher in status eat first. Humans-->cats-->dogs is how we avoid any food aggression in our home. I can feed a cat that is sitting on top of a dog, and not worry the dog will snap at the cat. There is only one alpha bitch in our house: me. Everyone knows their standing, and everything is peaceful between pets.

Remembering insulin is the only pet problem I have. I think I will start marking syringes with blue and orange marker. Blue for breakfast, orange for dinner. That way I will know at a glance if I gave April her insulin. If I see a syringe with a blue line on it in the fridge, I forgot April's breakfast insulin. If I see an orange mark, and it is morning, I remembered and replaced the syringe for dinner time.

This could be helpful for people, too. If you use syringes, marking them with marker could let you know at a glance if you gave yourself a shot or not. Timesulin caps for insulin pens are a good idea, too. I use the history function on my pump every day to keep myself on track.

April doing her thing in 2014
Looking after a dog with diabetes requires some extra patience. High blood sugar leads to excessive thirst which leads to puddles in the house. On the plus side, keeping April's blood sugar steady is easier than it is for people, because she is content to eat the same food at every meal. Except sometimes she steals bread off the table. Or gets in the garbage. Still, most of the time we have a good balance and I am grateful.


April is a normal dog who happens to have diabetes. We're doing all we can to look after her. She will be 12 in February, which is old for a weimaraner. She is about 89 in human years. April has two autoimmune diseases: Addison's disease and type 1 diabetes. Both April and I have multiple autoimmune diseases and we both do what we can to deal with it. April hasn't let it wreck her life. I won't let it wreck my life either.

Since I mentioned my pets, I think it's fair to add a few pet pics. Here are the Smith Family kids:


 Cyclone, my daughter's cat. (She pays for his food and vet bills. Her pet, not mine.)


A good mouser and a good boy. I love my grand-cat.


Fresh Air and Sunshine are my cats. Fresh Air is wearing a tuxedo. 
Sunshine is all black and softer than mink. They are both rescued barn cats and littermates. 
They came to live with us in November 2013.
 
 
 We call them "the twins." If you took a gumdrop, dipped it in honey, and rolled it in powdered sugar, it would be no where near as sweet as these two cats. They are amazing friends and I love them dearly. I've had cats for 25 years. These two may be the best cats I've ever known. Fresh Air purrs when he sees me. I don't even have to pet him and he starts purring. Sunshine makes me laugh because she's a clown and kind of dopey in a sweet sort of way.
"There are two means of refuge from the miseries of life: music and cats." - Albert Schweitzer

Honey. My retired service dog, chemo buddy and all around best friend. She is much younger in this picture. Honey just turned 12 in August.


The one and only April, my husband's dog and our loyal friend.


"When the Man waked up he said, 'What is Wild Dog doing here?' And the Woman said, 'His name is not Wild Dog any more, but the First Friend, because he will be our friend for always and always and always.'" —Rudyard Kipling



Monday, December 1, 2014

Good Vibes


I am vibrating with excitement for two reasons today.

Reason number 1: Check out Kerri's blog. YES! OH YES!

Reason number 2: I won NaNoWriMo. For those who have no idea what that is, National Novel Writing Month was in November. I sat down on November 1st and began a novel. I completed a 50,000 word novel draft by November 30th. I have always wanted to do the NaNoWriMo challenge, but I've never been able to do it.

Until this year.

After four years of creative drought, finishing a novel draft made me feel alive again. I love blogging, and writing non-fiction, but writing stories gives my life meaning. I've been lost and disconnected inside without having a story to write. I knew the only thing that would heal me was writing fiction, but I couldn't find my storyteller voice. It was stuck. I was stuck. I've been sad inside for many years, because I couldn't write a story.

Last month, I found my voice. I wrote an entire novel in a month. I feel like I've reconnected with myself. It feels good to be back home.



Wednesday, September 17, 2014

Trying out the Comfort Short

I've been using Inset 30's since I started pumping. Once I got over the fear of the introducing needle, I learned how to put on a new set without too many tears.

The one thing I couldn't get used to was the sound of the insertion device snapping. I'd wince every time I heard it. Line up the little plastic feet against my skin. Adjust the angle. Adjust it again. Take a deep breath and get ready to squeeze the trigger buttons. Wait. I didn't do it. Take another deep breath and SNAP! Wow, that's loud. Way too loud. Scares me silly every time. SNAP! Knowing it just jabbed that long needle into my flesh was bad enough. The SNAP sent me around the bend. There had to be a better way.

After I use my Inset 30, I reach in the center of it with a needle nose pliers and pull out the plastic needle. I toss that plastic bit in the sharps container and recycle the rest of the freaky little race car. I have hyperacusis from myasthenia gravis. The little muscles that move the bones in my ears get weak. When that happens, the entire world is way too loud. Sound hurts. It's like someone put in earbuds with the music full blast. Only, it's every sound everywhere and there is no escape until MG decides to move somewhere less annoying.

I needed to change my set. The eeeeee-eeeeee-eeeeeee of my pump rewinding was so loud I left the room. I couldn't deal with the SNAP from the Inset 30. So, I looked inside the Inset 30, and discovered I could rip the needle and the set loose from the insertion device. This left me with a long needle with an unused set still attached. I fumbled around a bit, and discovered I could put in a set without the insertion device.

It was quiet. It didn't hurt as much because the needle wasn't pushed into my skin with a spring loaded SNAP. After I taped it in place, I realized maybe I should look into a different set. My next order was the Comfort Short.

From Here


This picture from Animas makes the set look less intimidating. Flip the set over and the needle is a lot longer. Still, once I got over the fear of sticking that long needle in my skin, I found I like the Comfort Short.

There are two differences I've noticed.

1. The connection from the tubing to the set is not universal. There is only one way to connect it. Flip the connector upside down and it won't click in place. This is different from the Inset 30.

2. The tubing is more opaque, and the texture isn't as smooth. The plus side? My cat doesn't seem to like chewing the tubing.


The Comfort Short is not for the needle phobic. There's nothing between you and the reality of a long needle going into your skin. But, you can go at your own pace, and there's not a loud snapping noise. I think it's going to work well for me. YDMV.

Saturday, August 23, 2014

16 Years Cancer Free




My cancer free anniversary came and went without me even pausing to notice it. Sixteen years ago a tumor was wrapped around my aorta twice. Sixteen years ago my sternum was split in half with an electric saw. Sixteen years.

I was 29. Now I am... not 29.
My daughter was eight. Now she is 24.
Weeks after my surgery, my husband and I celebrated our 9th wedding anniversary. In just a few days, on September 9th, is our 25th wedding anniversary.

During the last 16 years, the trees in my garden have grown taller. My dark hair has fallen out from chemo. And grown back. And fallen out again from more chemo. And grown back all over again. Now it is streaked with gray.

After my surgery, I got carded at the liquor store. Now my daughter gets carded. Through my bifocals, I watch her pull out her ID. When she pours herself a cocktail, I wrestle back the urge to tell her, "Hey, what are you doing!" Then I remember she is 24 and I am... not young anymore.

Aging means aches and pains in the morning. It means middle age spread. It means wrinkles and gray hair. And it means you have survived. You survived close calls and near misses. You survived failures and set backs. You have been knocked over, and pushed down, and held down, and stressed to tears. And gotten back up again. You have learned to deal with pain, because pain is as much a part of life as laughter. No one tells you this. You learn it the hard way, the ugly way, the way that leaves seven inch surgical scars that still ache 16 years later when you turn your head to back up the car in the driveway.

Aging is the most amazing thing that can happen. It is proof you lived, even when death was an option. Aging is a gift to be celebrated. Gray hair, scars, and all.

Disclaimer

I am not a doctor. I do not have a medical degree. Nothing on this site qualifies as medical advice. These are lessons I'm learning at the University of Catastrophe. What I find to be correct answers in my classes may not be the right answers for you.

If you are enrolled with your own major at the University of Catastrophe, please consult your doctor, therapist, attorney, auto mechanic, veterinarian, plumber, dietician, arborist, acupuncturist, manicurist, mother, local dairy council, shoe shine boy, or other equally qualified professional, for advice and assistance.

If you email me your personal information will not be shared without your permission and your email address will not be sold. I hate spam. Even with eggs.

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