Wednesday, August 3, 2011

How Diabetes Disrupts My Life

I've always known that diabetes has a tendency to disrupt and/or rule my life on occasion, but the last several days have really made me realize just how much it impacts my routine, especially my ability to do things out of the ordinary.

Exhibit A: My Insulin Pump & CGM.

First of all, let me just say that I love my pump.  It's given me a slightly-closer-to-normal life than I feel I'd have if I were doing shots, which is great.  And by "doing shots," of course I mean MDI, or Multiple Daily Injections, not anything involving alcohol...just to clarify =)  I love that I don't have to leave the table at a restaurant to give myself an injection in the bathroom, because I was never comfortable doing it in public.  And by "doing it in public," I mean injecting insulin into my person.  (I swear I didn't think that this post would come out sounding quite so dirty!)

Anyway, aside from the convenience factor, being on the pump has also given me a level of control over my blood sugar that I don't think I'd be able to achieve with MDI, the primary reason being that I use the "square/dual wave bolus" options A LOT--Like virtually every meal.  And that's something that would be nearly impossible to do with injections.  (For those of you unfamiliar with pumps or Medtronic's in particular, the square wave bolus allows you to administer your mealtime (bolus) insulin over a period of time rather than all at once, which comes in handy when you're eating foods with a lot of fat and/or protein.  The dual wave bolus is similar, but divides your total bolus up into some given upfront and the rest over a specified time period...useful for meals that involve the aforementioned fat/protein as well as more simple carbohydrates.)

For those two reasons alone, my pump is priceless to me.  But that's not to say that I don't resent it (along with this disease) from time to time.  The past few weeks, I haven't worn my CGM (Continuous Glucose Monitor) sensor as often as I probably should.  If it's due to the crazy marks it leaves on my inner thighs (the site of choice since I've been pregnant) or the constant beeping, I've simply had the urge to be free from it here recently, at least for a while.  So when my last sensor went kaput a few weeks ago, I just didn't put a new one in and enjoyed the temporary freedom from it for a while.  My diabetes management didn't suffer much at all-I only had a couple of highs that probably could have been caught with the CGM, and both were after eating some amazing homemade birthday cake my mom made me, so they weren't that surprising.

Sunday night, though, I decided I better get back on the CGM bandwagon and make sure I wasn't missing any consistent lows or highs.  I put a new sensor in, and was back in (beeping) business by Monday.  For whatever reason, though, the numbers I was getting weren't jiving with my meter at all.  That afternoon I hit 209 two hours postprandial (following another slice of the aforementioned bday cake), while my CGM was showing I was holding steady in the 120s-big difference!  I was frustrated, but I corrected it & moved on.  Then later that evening, I was on my Gazelle after supper and got the obnoxious HIGH PREDICTED alert.  For some reason, that alarm sends me up the wall-whether from what it means or the annoying all-caps reminder, it just makes me want to scream.  My screen was showing double up-arrows, so I set my pump to deliver a little more insulin and finished my 30 minutes exercising.  By two hours postprandial, I ended up at 54 and was dropping fast-LOW PREDICTED.  Thanks for that.

I know, I shouldn't bolus from the CGM results.  But it's just so dang hard not to do when the thing is SCREAMING AT YOU IN ALL CAPS(!!!).  So, after I was setting comfortably at 101 post-low treatment, I set the low alert silence to last through the night so I wouldn't be waking up every five minutes due to the incorrect "low" numbers it was showing then.  Yesterday, more of the same, so I finally shut the thing off and restarted my sensor thinking that maybe some good calibrations would do the trick.  Today it's been better, but it's still not spot-on.

The thing about all of this CGM alarm craziness is that it wears on my already-thin patience and sanity.  I didn't realize how much I didn't miss the constant BEEPING until my peaceful couple of weeks came to an end with the new sensor.  Don't misunderstand me-the CGM is an AMAZING invention that has helped me fine-tune my diabetes management and pump therapy in a way that would be impossible without it.  BUT, as with everything else diabetes-related, it doesn't come without its drawbacks, and sometimes the cons can seem to outweigh the pros even though they definitely don't in reality.

Another of the ways that diabetes has taken over my life recently is due to the logistics of travel with a pump.  My hubby and I haven't been on a decent vacation since our honeymoon a year and a half ago, so we've been grasping for chances to get away, if only for a weekend.  The thing is, these attempts are complicated by the very real limitations of being on an insulin pump.  We can't accept last-minute invitations to the water park with our friends, and now that I'm pregnant, even a well-planned water-related vacation is out of the question due to my reluctance to switch to shots for the weekend...the reason being that the last time I was on shots was in January, and I don't want to completely throw off my diabetes management routine (and overall awesome blood sugar #s) for a weekend at the lake, no matter how great it would be to spend time with the hubby's family.  We don't get to see them very often, but I also don't want to risk damage to our little one, no matter how remote the risk of a few higher-than-normal #s.  In this case, the long-term definitely outweighs the short-term, so I had my husband tell his sister that although we want to join them, it just isn't possible right now.  I could be a good sport and go anyway, but I know that it would mean being landlocked in the extreme heat by myself, so I'd rather just stay at home.  I also explained to him that although I may make it look easy and effortless (ha!), dealing with this disease is an everyday challenge even under the best of circumstances, and can be downright maddening when I don't have the standard level of control I'm used to...I'll be the first to admit that I'm a bit of a control freak when it comes to all things diabetes-related, especially now that there is another little life that is directly dependant on my decisions.

Although my hubby understands the dilemmas I face thanks to my diabetes, I know that deep-down, on some level, he has to resent this disease as much as I do.  After all, it isn't just my life that is limited by diabetes, his is too-and if it sucks for me, I know it has to suck for him.  The past several weeks, though, have been especially impacted due to the simple fact that I'm pregnant in addition to having diabetes, which adds a whole new level of limitations.  Even if the water itself didn't limit me from 90% of the activities at the lake, being pregnant prevents me from doing the other 10%.  Please understand that I'm not complaining about being pregnant; I'm just explaining (as I had to do with my husband the other night) that it does realistically limit some of the activities I can do.

We talked about going to Carlsbad, NM, with some of our friends, which I was all for...Even I can walk through the caverns and the zoo they have there!  But just today at lunch, some of my hubby's friends were talking about the vacation they just got back from in Colorado that involved white water rafting and such...his eyes lit up, but all I could think was "Not so fast, know that's out of the question on SO many levels!"  Hopefully one of these days we'll agree on a mini-vacay that involves activities we can both participate in and enjoy, but until then I have a feeling I'm going to be resenting my diabetes for all the limitations it puts on my life-and my husband's.


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