Wednesday, January 2, 2013

Order of Operations For Diabetics

Somewhere between a nap and passing a note to a friend, I learned about the order of operations in math class. PEMDAS, or Please Excuse My Dear Aunt Sally, are mnemonic devices to help us solve equations in the correct order. PEMDAS: parentheses, exponents, multiplication, division, addition, and subtraction. This information has come in handy thousands of times since I left high school.

Wait... PEMDAS has never come in handy. Know what would have been handy? A class in how to fold a fitted sheet. All of my fitted sheets are rolled in wrinkly balls in my closet, but thanks to math class I can solve this problem in my head: 12(-5+8)-5 = x  Isn’t that useful?

I taught the order of operations to my daughter when she was in high school. She hasn’t used PEMDAS since her last math test. Neither of us know how to fold a fitted sheet, but no doubt the PEMDAS mind virus will be passed on to her future children. I am already certain my great-great-grandchildren will be rolling fitted sheets into balls while solving equations in their heads.

Still, the concept of needing to do certain tasks in order isn’t lost on me. Adding eggs to pancake batter after they are in the frying pan doesn’t work. The pancakes turn into sloppy dough balls that get super hard after cooking. Not that I have any personal experience with forgetting to add ingredients to pancakes and then trying to cover up my mistake by frantically stirring eggs and batter in a pan. I was frying dog treats that one time. Or at least that is what I told my family while I made more batter.

In cooking, getting the sequence right often means the difference between creating food or glop. The sequence also matters when checking my blood sugar. Diabetes management requires fiddling around with strips and lancing devices. Lancets are made of plastic. They have a ball on top that covers the needle. Loading a lancing device requires placing the lancet in the slot and then removing the ball. If you remove the ball first the lancet pokes ten thousand holes in your finger while you try to load it. Not that I have done this. No one is dopey enough to try and load a lancing device without the ball covering the needle. Well, no one except for me.

Loading the lancing device and sticking strips in the meter felt strange after I was diagnosed. I felt like I had oven mitts on my hands. I kept dropping things. I whined, “I can’t do this!” My husband reminded me I can string a cello. Cellos are far more complicated than my meter. Maybe, but I have been playing the cello since I was nine. Cello strings felt natural to me. Lancing devices and strips didn’t. I fumbled with them for months. It wasn't easy to get used to them.

I check frequently. I check before and after every meal, before I drive, before and after exercise, and before bed. Since I check so often you would think I never make mistakes anymore. That might be true for other people, but not me.

I still insert my strips backward, or try to feed them into the data port. Yes, I have even tried sticking test strips into my iPod. Those technical difficulties, while embarrassing, aren’t the worst mistakes I make. The worst ones are when I forget the blood glucose checking order of operations. The order of operations is as follows.

1. Wash your hands
2. Open your strip container
3. Take out a strip
4. Place your strip in the meter
5. Take a moment for the meter to boot
6. Lance your finger
7. Bleed on test strip
8. Grunt at the result.

I invented the mnemonic Wisdom On The Path To Lower Blood Glucose to help me remember what to do. I still get it wrong anyway. Step one I get right about half of the time. I have eaten a tangerine, forgotten about it, and tested with juice lingering on my fingers. Then I don’t just grunt at the result, I shout something that rhymes with goalie mitt.

Do I get the rest of the steps right? I wish. My usual routine is not nearly so wise. More often than not I will prick my finger before getting out a test strip. Second only to error messages, this is my biggest annoyance. Opening the lid while trying not to drop blood on my pants sucks. Sometimes I find the whole process annoying. However, the wisdom of checking frequently I never question. Even when I get a result that I don’t like, I am always patting myself on the back for the effort. Wisdom On The Path To Lower Blood Glucose reminds me that I am doing the right things to look after myself. And that matters.


  1. Wonderful Marie - just wonderful. I giggled at PEMDAS virus. I too roll my fitted sheets. My kids forget their steps too when checking blood sugars - if checking in the car and they forget the strip prior to lancing themselves they will inevitably invite a sibling to put a strip in for them. My boy will sometimes lance his finger then forget to test - he will simply lick the blood off like it was a tasty treat. Maybe it is the frequency of testing that causes the brain to get all mushy sometimes - having done a test 3 times in a day already the forth time you forget the steps having done them 3 times before. A constant Deja vu feeling? I wish I could string a cello. Happy New Year friend - hoping 2013 has great things in store for you.

  2. "Wisdom On The Path To Lower Blood Glucose" - I love that!

  3. I'll be honest - I *have* used PEMDAS before; but being in an engineering/mathematics field I guess that's to be expected. I've also folded a fitted sheet -- once -- but seeing as how badly it turned out, I've decided that in the future it's easier to just roll it in a ball and throw it in the closet. There's really no difference.

    And just yesterday, I struggled to open my test strip vial and put a strip in the meter while sticking out my bloody already-lanced fingertip, trying not to contaminate the blood sample, the strip, or my shirt. It was tricky.

    Thanks for the humorous look at such a routine, mundane task!

  4. I'm totally agreed with your suggestions and it seems that the balance of glucose is most essential part of the treatment if your are suffering from this evil disease.

    Diets for diabetics



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