tag:blogger.com,1999:blog-86343043945349221102024-02-19T16:42:52.617-08:00Diabetic TruthsT1D. Licensed Clinical Social Worker. Coffee Enthusiast. Animal Lover. Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.comBlogger43125tag:blogger.com,1999:blog-8634304394534922110.post-45975147562160612942019-09-21T09:06:00.003-07:002019-09-21T09:06:38.866-07:00The Role of Privilege in Advocacy - Reflections from the Indianapolis T1International VigilMonday morning I sit at my kitchen table. The reservoir indicator on my insulin pump blinks "LOW," warning me to change my site. As I go through the motions of changing my pod, I hesitate. I've drawn up the last of my vial of insulin, and I need more. I open the clean, white refrigerator in my parents' kitchen and pull out another bottle. I flick off the plastic cap and draw more out. The weight of my privilege settles over me like a heavy blanket.<br />
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I've just returned from Indianapolis, where<span style="font-family: Georgia, Times New Roman, serif;"> <a href="https://www.t1international.com/" target="_blank"><span style="color: #0b5394;">T1International</span> </a></span>held their 3rd annual<span style="color: #0b5394;"> <span style="font-family: Georgia, Times New Roman, serif;"><a href="https://www.healthline.com/diabetesmine/diabetes-advocate-arrest-insulin-vigil#1" target="_blank">vigil and protest</a> </span></span>outside of Eli Lilly Headquarters. While there I had the honor of meeting families who have lost their loved ones due to insulin rationing. The majority of these people were parents who have lost their children - many of them ages 18-26, a now-dangerous age for people living with T1D in the United States.<br />
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I arrived to the hotel where most of the T1International <span style="color: #0b5394; font-family: Georgia, Times New Roman, serif;"><a href="https://www.t1international.com/insulin4allchapters/" target="_blank">Chapter Leaders</a> </span>and families were staying anxious and excited. I had never participated in a protest before, and this was something I felt incredibly passionate about. At the same time, I carried around a feeling of guilt. Guilt that I have a job I love, that also happens to have great health insurance that I am able to afford, with manageable co-pays for my diabetes supplies. Surrounded by families who had lost their loved ones to price-gouging and a greed-fueled healthcare system, it struck me how unfair this all was.<br />
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What gives some people the right to life over others? Nothing.<br />
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At the vigil, we heard families tell their stories. Stories of how their loved ones were found dead, and how they had wasted away from the lack of medicine that they needed to live. It was difficult to hear. As a privileged type 1 diabetic, it is often easy to forget how closely death lurks behind our shoulders. As many of the signs held up at our vigil shared, this could happen to any of us. We are all one bad day away from falling into a dangerous place.<br />
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Eli Lilly is one of three powerhouse insulin manufacturers, along with Novo Nordisk and Sanofi. They are often referred to as "The Big Three," as they control almost all of the insulin market worldwide. Insurance companies, pharmacy benefit managers (PBMs) and the American healthcare system play a huge role in this crisis as well. Research has shown that roughly 1 in 4 people with type 1 diabetes in the USA ration their insulin due to cost - a higher rate than any other high income country surveyed <span style="color: #0b5394;"><span style="font-family: Georgia, Times New Roman, serif;">(<a href="https://www.t1international.com/media/assets/file/T1International_Report_-_Costs_and_Rationing_of_Insulin__Diabetes_Supplies_2.pdf" target="_blank">T1International, 2018</a>)</span>.</span><br />
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So as I sit at my kitchen table, filling my pump with the insulin that I can't live without and have so readily available, I feel a number of things. I feel relieved. I feel angry. I feel mystified.<br />
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One thing I have learned about privilege is that it must be acknowledged, but it goes further than that. Acknowledgement is no good if you then spend your time wallowing, feeling guilty. It's what you do with that privilege that matters. I have my health, and I have a voice. These are privileges that I will <i>use </i>on behalf of those who lack that privilege.Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com6tag:blogger.com,1999:blog-8634304394534922110.post-61589361804330005032019-08-22T14:19:00.002-07:002019-08-22T14:19:35.896-07:00On Display<h3>
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People live with diabetes in many different ways.</h3>
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Some of us are unashamed of our medical devices, and flaunt them every chance we get. Others are more private; keeping devices hidden as much as possible, or even choosing not to use certain devices in order to avoid making diabetes more visible. Most of us fall somewhere in the middle.<br />
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The other day I was speaking with my mom about letting my devices show. During our talk I realized how multi-faceted the decision is. I explained to her that I'm not embarrassed for my devices to show. I don't particularly care what other people think. But some days, it's 80 degrees and I just want to run to the store in my tank top without anyone speaking to me.<br />
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This seems fair, right? Sometimes we want to be left alone, especially if we're shy or introverted. And even if we're not, sometimes we don't always want to get into a discussion with a stranger about such a personal part of our lives. That's what's unique about diabetes. It is so insidious that you often don't think twice about it, but when someone you don't know brings it up it can feel uncomfortable.<br />
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Take going to the beach. If you have a pump or a CGM, it's highly likely that one of these will be on display when you don a bathing suit. And some days, <i>I just want to tan and go swimming</i>. I don't want to talk about diabetes and explain why I'm having that snack. You can be comfortable in your skin, but still not want to be approached. You can be proud of your medical devices, but still want others to respect your privacy.<br />
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You can be a loud advocate, but have your days that you just want to just <i>be</i>.</h3>
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Which begs the question - is this decision wholly on us? I don't think it is. I think that when we decide to let our medical devices show, we're hopeful that the general population will decide to be tactful. That they are kind in their questioning, if they feel the need to question, and that they're receptive to what we have to say.</div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-17915488068068887082019-08-09T11:59:00.001-07:002019-08-09T11:59:10.902-07:00How To Attend a Meet-up as an Introvert<div class="separator" style="clear: both; text-align: center;">
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Contrary to popular belief, introverts don't relish spending the majority of their time in the dim light of their bedroom, hissing at fellow human beings should they dare to intrude.</h3>
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....Much like extroverts don't enjoy spending every waking minute of their lives at raging parties. This is a generalization about these two often referred-to categories of people that we simply tend to make. In reality, what differentiates an introvert from an extrovert is <i>how they re-charge their batteries</i>. So, as an introvert you may enjoy spending time with others, but in smaller doses. You feel re-energized after cozying up with a good book after a social event. On the other hand, an extrovert will seek out others to socialize with to re-charge. Susan Cain does a much more in-depth exploration of this in her book <i>Quiet: The Power of Introverts in a World That Can't Stop Talking.</i><br />
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In today's world, much of our support from other T1Ds comes from online, often from people we've never met. There we are able to connect with others, and often organize monthly or weekly in-person meet-ups - think support groups, but less formal and with more quality food involved.<br />
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I remember my first meet-up. I attended alone, and it was in Manhattan. I was <i>nervous</i>. I anticipated this; I'm an introvert myself. I also anticipated that by the middle of the meet-up and then walking home afterwards, I would feel happy. Reflecting on the night, I would smile and enthusiastically tell my family about the people I met. So I'm here to tell you that yes, you <i>can</i> attend a meet-up as an introvert. Here are my tips:<br />
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Rest Up</span></h2>
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Remember that whole thing about what gives you energy? Even though the meet-up can be a fun and pleasant experience, for an introvert it can still be draining! So you'll want to show up with a fully charged battery. That means spending the day doing what brings you peace - reading, exercising, taking a nap, etc.<br />
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<span style="font-size: x-large;">Do Your Research</span></h2>
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Fear of the unknown makes everything worse. Know where you're going, how you're getting there, and how you're getting home. Most meet-ups will post their location and information about the hosts, so you can get a feel for the vibe with a little research on your end.</div>
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<span style="font-size: x-large;">Don't Feel Bad About Leaving at a Reasonable Hour</span></h2>
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Attending a nighttime meetup but not a night owl? That's fine! Go, enjoy yourself, and leave when you feel it's time. Don't beat yourself up if some people are going out for drinks afterwards and you don't have the energy to join. You still took a huge step - you put yourself out of your comfort zone. Celebrate what <i>you </i>have done, instead of comparing yourself to what <i>others </i>have done.</div>
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<span style="font-size: x-large;">Find a Buddy</span></h2>
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If you're still feeling nervous, make a plan to connect with one person. Whether it's online before the event, or when you arrive. There's power in numbers. And the odds are, the more comfortable you get and the more you settle in, the better you'll feel about branching out.</div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com2tag:blogger.com,1999:blog-8634304394534922110.post-37854487618299614262019-07-11T09:58:00.000-07:002019-07-11T09:58:33.658-07:00What exactly IS self care?<span style="font-family: "trebuchet ms" , sans-serif;">Living in the age of social media means that we're exposed to many fleeting trends, buzz words and health crazes - some of them more legit than others. One of the terms you've probably heard by now is "self-care." Maybe you've shrugged this off as another wellness fad, or maybe (more commonly) you've been thinking <i>sounds great, but who has time for that? </i></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><i><br /></i></span>
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<span style="font-family: "trebuchet ms" , sans-serif;">More than just a fad</span></h4>
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<span style="font-family: "trebuchet ms" , sans-serif;">Self-care is a real thing, guys. My primary exposure to this phenomenon has been through the world of social work and diabetes. But whether you're a social working diabetic or not, you still need self-care. Everyone needs self-care. Yes, even you Mom.</span></div>
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<span style="font-family: trebuchet ms, sans-serif;">Self-care is particularly important for those who are prone to burnout - caregivers, people with chronic illness, mental health/medical providers, and first responders. Ironically enough, these tend to be the people who have the <i>least</i> amount of time for it. But fear not. You may surprised at how simple implementing self-care can be.</span><br />
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<span style="font-family: trebuchet ms, sans-serif;">How do I self care?</span></h4>
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<span style="font-family: trebuchet ms, sans-serif;">First of all, check in with your priorities. Where are you on the list? After your spouse, kids, job, diabetes? The lower you are on your own priority list, the more urgent your need for self-care is.</span></div>
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<span style="font-family: trebuchet ms, sans-serif;">Second, self-care doesn't have to be a huge undertaking. It doesn't have to be a lifestyle change, or a big interruption to your life. Self-care can take as little as 5 minutes of your day. Some tiny self-care examples:</span></div>
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<li><span style="font-family: trebuchet ms, sans-serif;">List (on paper or in your head) 5 things you're grateful for</span></li>
<li><span style="font-family: trebuchet ms, sans-serif;">Watch a funny video</span></li>
<li><span style="font-family: trebuchet ms, sans-serif;">Pet an animal</span></li>
<li><span style="font-family: trebuchet ms, sans-serif;">Write in a journal before bed</span></li>
<li><span style="font-family: trebuchet ms, sans-serif;">Stretch</span></li>
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<span style="font-family: trebuchet ms, sans-serif;">See? Not so bad. Self-care is basically anything non-harmful to you or anyone else that releases those feel-good endorphins, or lessens our load of tension. For people with diabetes, it could mean taking a break from our CGM. It could be taking a break from Instagram, or unfollowing someone whose posts you keep comparing your BGs to.</span></div>
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<span style="font-family: trebuchet ms, sans-serif;"><br /></span></div>
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<span style="font-family: trebuchet ms, sans-serif;">It may seem like a silly indulgence, but remember - if you're not taking care of you, you eventually won't be able to take care of anyone or anything else.</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com2tag:blogger.com,1999:blog-8634304394534922110.post-91182245942737563662019-06-28T17:40:00.004-07:002019-06-28T17:40:57.065-07:00Staying Sane with Your CGM<h4>
<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">You may be reading the title of this blog and thinking it's contradictory.</span></h4>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">I <i>need </i>my CGM to stay sane, you mumble to yourself. What is this girl getting on about?</span></h2>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">First of all, if you're on a CGM and don't get obsessive with your data, kudos. If you don't let the steady stream of numbers wear on your self-perception and sanity, I'm impressed. I'm also skeptical. Because how could we <i>not </i>become obsessive? The data is <i>always there</i>. At any given moment, we can see what's going on with our blood sugar trends and levels. As someone who's lived for over 20 years without this insight, I must say it's like finally being given the gift of sight.</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">So if you think you're not over-dependent on your CGM, ask yourself these questions just to check where you're at:</span></div>
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<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Can you eat a meal/go to the bathroom/go on a date without having your phone or your receiver by your side?</span></li>
<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Do you catch yourself having a knee-jerk reaction to up or down arrows, and then going high or low due to over-correcting?</span></li>
<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Do you have a significant increase in worry during the warm-up period when you start a new sensor and you don't have access to continuous readings?</span></li>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">I can tell you personally that since starting CGM use, at least one of these has always been a "yes" for me. And that's okay - the CGM is a great tool and we <i>should </i>use the data. But sometimes the constant checking and over-correcting can do more harm than good.</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">So, to keep myself sane, these are some hacks I've implemented:</span></div>
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<ul>
<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;"><b>Turn off the "Quick Glance" feature. </b>Quick glance can be a blessing and a curse. It's super helpful for things like work and driving. However, during downtime it's easy to tap your phone awake every 30 seconds to check the BG that's fixed to your screen. I take little vacations from quick glance and usually notice a healthy decrease in how often I check my phone. </span></li>
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<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;"><b>Use your receiver at night. </b>By now you've probably heard about the impact technology can have on restful sleep. If not, here's the quick & dirty: the closer to bedtime your screen time is, the more interference in getting good Zs. Most experts say to power down an hour before bed. So what I've started doing is powering <i>on</i> that little receiver that many of us have long forgotten, and keeping it on my bedside table. This way I can check my number if needed without getting roped in by Facebook notifications and text messages.</span></li>
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<li><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;"><b>Set parameters for yourself. </b>Significant change can often come from small steps, if you follow them faithfully and make room for them to become habit. Setting firm, <i>specific</i> rules for yourself can be helpful. For example, "checking my phone less" is too vague; whereas "checking my phone every 1 mile during my run (thanks John from <a href="https://www.typeonerun.org/podcast" target="_blank">Type One Run Podcast </a>for this tip)" will likely yield more success.</span></li>
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<span style="font-family: helvetica neue, arial, helvetica, sans-serif;">When I'm feeling particularly frazzled by my sugars and staring at the little dots on my Dexcom graph, waiting impatiently for the next one to appear, I remind myself this: there were not always CGMs. There was a time (a <i>long </i>time) where we ate, tested, gave insulin, and let Jesus take the wheel. We tested again when we were symptomatic or eating again. <i>It's possible </i>to survive without the CGM. We<i> can stand</i> to not know our blood sugars every 5 minutes. This re-framing and self-talk helps me work myself out of a data frenzy. Use the CGM tool as a shield, not a sword that you keep falling on.</span></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com4tag:blogger.com,1999:blog-8634304394534922110.post-33607497549754766342019-06-09T17:46:00.001-07:002019-06-09T17:46:47.502-07:00Back to my Roots<h4>
<span style="font-family: Georgia, Times New Roman, serif;">
I grew up at summer camp.</span></h4>
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<span style="font-family: Georgia, Times New Roman, serif;">
More specifically, at diabetes camp.</span></h3>
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<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
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<span style="font-family: Georgia, Times New Roman, serif;">So when I officially registered for <a href="https://beyondtype1.org/" target="_blank">Beyond Type 1</a> x <a href="https://www.connectedinmotion.ca/" target="_blank">Connected in Motion's</a> 2019 Maine <a href="https://beyondtype1.org/events/" target="_blank">Slipstream </a>weekend, I was more than a little excited. I mean, this was the stuff of (my) life. Camp is in my blood. And now to go back as an adult, doing adult things (AKA drinking wine, higher rope courses, etc.)? I was extremely privileged to have this opportunity.</span><br />
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="font-family: Georgia, Times New Roman, serif;">Maine did not disappoint. Seven hours and seven states north, my diabuddies and I pulled off the interstate and into the quaint town of Winslow. After about ten minutes, we approached a sign, almost masked by the leafy trees, that read "Camp Caribou." We had arrived. The camp was nestled at the end of a long dirt road, on the edge of large lake. It was abundant with all the camp necessities - volleyball court, waterfront, dusty wooden cabins and, of course, campers!</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_ESQRveSX9cbFOrxzQka6OOKl7TbyrwOxNydnbgZ6vNFGoikzS8Xem8KZAtRGdpJAlgVXHghtDTn8V_pJ0N_of8OyFjt88mrabgrwIl4tHDeMBwtHJhShsxc64S2RkLphLhdvYs3NXDM/s1600/20190531_192716.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Georgia, Times New Roman, serif;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_ESQRveSX9cbFOrxzQka6OOKl7TbyrwOxNydnbgZ6vNFGoikzS8Xem8KZAtRGdpJAlgVXHghtDTn8V_pJ0N_of8OyFjt88mrabgrwIl4tHDeMBwtHJhShsxc64S2RkLphLhdvYs3NXDM/s320/20190531_192716.jpg" width="180" /></span></a></div>
<span style="font-family: Georgia, Times New Roman, serif;">Over 80 adults living with type 1 diabetes, along with staff living with it as well, attended Slipstream. I felt a rush of nostalgia as we unpacked our bunks, did awkward icebreakers, and had a nighttime bonfire. It was so nice to be able to have an open and honest discussion about living with type 1. About its ups and downs, and about the responsibilities that come with being an adult with this disease. I was amazed to hear the different walks of life people came from - some had been living with type 1 for less than a year, while others had spent over 40 years with it. People came from out of town, out of state, and even out of country! I nestled into my cot that night smelling of bug spray with a smile on my face.</span><br />
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<span style="font-family: Georgia, Times New Roman, serif;">The next day was full of opportunities to play outside. I climbed a 50 ft wall at high ropes, did some paddle boarding, and played a spontaneous game of volleyball with my fellow campers. Throughout the day, sessions were held exploring everything from mindfulness to technology, all with a focus on type 1, and led by people living with it. </span></div>
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<span style="font-family: Georgia, Times New Roman, serif;">I was lucky enough to grow up attending <a href="https://www.campnejeda.org/" target="_blank">camp for kids with type 1</a>. It was so nice to see other people who had never had this experience before have it for the first time. Listening to their awe about being surrounded by other people with diabetes was touching.</span><br />
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<span style="font-family: Georgia, Times New Roman, serif;">So what do you pack for a weekend at camp?</span><br />
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<h3>
<span style="font-family: Georgia, Times New Roman, serif;">
Bug Spray.</span></h3>
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<span style="font-family: Georgia, Times New Roman, serif;">Seriously. You're gonna need it. Spray it outside the cabin. And even though you use it, you'll still leave with bug bites.</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<h3>
<span style="font-family: Georgia, Times New Roman, serif;">Layers.</span></h3>
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<span style="font-family: Georgia, Times New Roman, serif;">Maine is COLD compared to NJ. I regret not packing a second sweatshirt. Bottom line, pack a variety of layers. And always pack extra underwear.</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<h3>
<span style="font-family: Georgia, Times New Roman, serif;">Warm Pajamas.</span></h3>
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<span style="font-family: Georgia, Times New Roman, serif;">No matter where you are, in the woods it's cold in the morning and at night. Grab some pajama pants and fuzzy socks. And an extra blanket.</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<h3>
<span style="font-family: Georgia, Times New Roman, serif;">An Extra Pair of Shoes.</span></h3>
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<span style="font-family: Georgia, Times New Roman, serif;">Ya know, just in case you get thrown in the lake. Or fall in.</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com2tag:blogger.com,1999:blog-8634304394534922110.post-21978264384453158862019-03-29T12:57:00.002-07:002019-03-29T12:57:37.616-07:00Another angry blog post about insurance<span style="font-family: "georgia" , "times new roman" , serif;">...Because what else is new, right?</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQ31dFwEJINpWPVsHTo8N-aJVIhVuiK_vGKGydVZTVmBoizbdjY1d7VeZb0wD6m6ORxc62BpOUjPBMK71ZR0in3OThcJE9N4rloSqQG-scn2IbpYIhv9V79e7q2Hl6yOxGzPsz1hQomUc/s1600/Nick+Young+24032019193814.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="999" data-original-width="799" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQ31dFwEJINpWPVsHTo8N-aJVIhVuiK_vGKGydVZTVmBoizbdjY1d7VeZb0wD6m6ORxc62BpOUjPBMK71ZR0in3OThcJE9N4rloSqQG-scn2IbpYIhv9V79e7q2Hl6yOxGzPsz1hQomUc/s320/Nick+Young+24032019193814.jpg" width="255" /></a></div>
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">But seriously, what I want to vent about is insurance deciding what is or isn't medically necessary. Let's break this down: </span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">You go to your physician, who attended upwards of 8 years of schooling to become a MD. They evaluate you, hopefully take your input as a patient, form a medical opinion and a plan of care, write a prescription or two and send you on your way. You go to your pharmacy to pickup your medication, only to find that your insurance company has denied coverage of this prescription. They feel it is not medically necessary, or they have a "preferred alternative" that they do cover.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span><span style="font-family: "georgia" , "times new roman" , serif;">This is something we've unfortunately all grown used to. But let's just pause a moment. And let that sink in.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">First of all, <i>preferred by who? </i>Not by me, the person who's going to be ingesting/injecting/applying the medication. Not by my doctor, who prescribed medication in the first place. But I mean, what value are our measly preferences in this situation, right?</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span><span style="font-family: "georgia" , "times new roman" , serif;">Second of all, our <i>insurance </i>company is determining what our medical needs are. So what, then, is the point of seeing a physician in the first place? Why not just go directly to the insurance company and seek their medical opinion? Oh, that's right. Because they're not physicians.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">To play devil's advocate, doctors are employed by insurance companies to conduct clinical reviews of prescriptions. However, are these doctors the most appropriate people to be doing this review? In short, no. When my Fiasp was up for review to determine what level of coverage it would receive, the review was conducted by a PhD. No shade to PhD's, but if someone's reviewing my insulin needs, I think it should be, maybe, I don't know, an endocrinologist? Perhaps my endocrinologist? One who isn't employed by a company that profits from denying coverage of the medication I'm seeking? I mean, we are literally asking people to make a determination that will either harm their own company, or harm us. And they've never met us. Which way are they more likely to go? Does conflict of interest not play a role here?</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">It's a very backwards system, to say the least. We go to doctors to get appropriate care. But then we're met with roadblocks to actually receive that care. For people with chronic illness, dealing with this for a lifetime is draining and aggravating. We should explore a system that makes it easier for people to live their best, most healthy lifestyle. An ounce of prevention is worth a pound of cure. If we keep people healthy, we avoid future hospitalizations and prolonged illnesses. And in turn, avoid future expenses our insurance will have to cover. So what is the end game for them? Are they just stuck in that phase of childhood development in which they have no ability to engage in delayed gratification?</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">End rant.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">(For now).</span>Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-52388388204554071022019-03-15T15:30:00.002-07:002019-03-15T15:30:15.380-07:00Community Versus Identity<span style="font-family: "trebuchet ms" , sans-serif;">The other night I was snuggled up at home, catching up on the latest episode of <i>The Good Doctor</i>. I was drawn in to a particular sub-plot of the episode. One of the main characters, who is receiving chemo, finds himself being pestered by his neighbor in the treatment room to join their cancer support group. Long story short, the character resists for the whole episode, arguing that he doesn't want cancer to define his life, it's not who he is, he doesn't need a support group, all that jazz. In the end, he comes around, and joins his chemo neighbors for a game of cards. </span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Throughout the course of this, I couldn't help but think about how many times I've heard this dialogue before - whether it's about diabetes or any other chronic illness. People don't want to be defined by their condition (understandably so). Because of this, it's common for people to push away when approached with support groups or communities for people who share their diagnoses. We want to be more than our diagnoses, so we don't want to over-identify with it.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">But here's the thing - there's a difference between <i>identity </i>and <i>community</i>. Belonging to a <i>community </i>of type 1 diabetics doesn't mean that you yourself are only diabetes and nothing else. Your <i>identity </i>is still yours. Sure, diabetes and the community are a part of your identity, but they are not the whole thing.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">We can't always change what we're living with. We can't make diabetes go away. So why not find solace in the fact that there are others out there who share our struggle? You may find that <i>they </i>don't like to over-identify with their disease either. You may not even talk about diabetes when you're together. But having that support system there undoubtedly inserts a positive aspect into living with a disease that you cannot change.</span>Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com2tag:blogger.com,1999:blog-8634304394534922110.post-53442482655282014332019-03-01T08:55:00.003-08:002019-03-01T08:55:27.491-08:00Where is the love?<span style="font-family: "trebuchet ms" , sans-serif;">Healthcare has been a hot button issue lately here in the states. Of course for those of us who live with a chronic illness, it has always been an issue. But with the 2016 election, healthcare along with many other public policies have come to the forefront of the nationwide conversation. And frankly, the conversations have been quite alarming.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">There is an overwhelming population of people who believe that healthcare has to be earned. That the right to live is not an inherent right for all humans (even though our US Constitution specifically states otherwise). People feel that if you work hard, pay your dues, and play by the rules, you will A: Stay healthy, and B: Be granted great insurance coverage, God forbid anything should happen to you. This logic is flawed. Chronic and/or acute health issues can happen to anyone, at anytime, for a variety of reasons. As a species, humans don't like to believe this. It creates what's called "cognitive dissonance," which is when we are presented with a reality that doesn't match up with what we've always believed. It therefore causes dissonance, or disruption, so we do everything in our power to ignore the reality and continue on with our faulty beliefs. We cannot reconcile reality with our wishes because it causes discomfort.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><br />Most people grow up hoping or believing that they will have good health. This is normal - it's a positive outlook on life. However, as we grow older we tend to experience certain realities - maybe we're diagnosed with type 1 diabetes, someone we love is in an accident, our parent gets laid off and we almost lose our insurance - and we are able to shift our beliefs accordingly to read more like this: things may not always be easy. Things could happen to us and our family. But for some people, this adjustment doesn't happen. They continue to believe that bad things come to those who deserve it and that healthcare should be earned.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
<span style="font-family: "trebuchet ms" , sans-serif;">So is the issue that people are inherently bad and have complete disregard for others? I hope not. No, what I think is happening in the majority of cases is that people are simply rigid in their beliefs due to concerns about their own self-preservation. And this needs to change. We need to challenge our beliefs because they are flawed. Yes, it is a frightening reality to accept - that we could be struck with an illness or hit by a car at any time. But we are doing more harm than good by holding on to the flawed belief that we are in total and complete control of our health or our circumstances. It is not reality.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
<span style="font-family: "trebuchet ms" , sans-serif;">The reality is, every human has an inherent right to live. And for some humans, what they need to live - and live well - is a bit more extensive than what others need. So I challenge you all - what belief do you cling to that begrudges others their inherent rights? How can you start to chip away at that belief and re-frame it?</span>Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-27128084238973523472019-01-25T08:05:00.002-08:002019-01-25T08:05:43.481-08:00Using Anger as a Tool - The Global Insulin Crisis<span style="font-family: Trebuchet MS, sans-serif;">Being a social worker means I'm rarely surprised by anything. We are often witness to every kind of bizarre and disturbing occurrence out there. We work in the medical field and see people struggle with a complicated healthcare system while trying to care for themselves or their children. But every news story that blasts through the screen about another diabetic dying from insulin rationing hits me like a punch in the gut.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">Insulin prices have been slowly climbing over the past decade. It's a reality that seems to have been kept under wraps - except, of course, from the patients and families who have been struggling in silence each year their copay goes up. As someone who's been privileged enough to not have this issue constantly weighing on me, I could easily turn a blind eye to it. Mutter "yeah, that's a shame," and go about my everyday life. I'll be frank - this path is tempting. This is a <i style="font-weight: bold;">beast </i> of an issue that has numerous parties involved, and differs from nation to nation. In a recent <a href="https://www.nytimes.com/2019/01/18/opinion/cost-insurance-diabetes-insulin.html" target="_blank"><span style="color: blue;">New York Times</span></a> article regarding insulin prices, Danielle Ofri wrote, "It's hard to know where to direct my rage." And it is. It's overwhelming. Where do we begin? The only answer I can formulate is this: we start with raising our voices. And this has already started: with numerous articles like Ofri's, <a href="https://www.youtube.com/watch?v=SCzzDqhi8aA" target="_blank"><span style="color: blue;">protest trips to Mexico to exhibit pricing differences</span></a>, TV news features, and type 1 advocates blasting pharmaceutical companies on social media. Now that the fire is catching, we have no choice but to roll with it.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">To be clear, insulin prices are an issue everywhere - not just in the USA. While insulin in Mexico may be affordable for us, it is not the case for most residents of the country. Insulin prices looked at as a percentage of income paints a better picture of the bleak reality. Aside from countries like Canada and England who have universal healthcare, insulin prices are unmanageable for most populations. The cost of living with diabetes takes up the bulk of individuals' or families' income, leaving people scrambling for rent, food, and other necessities.</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcvSSOSRwHBmDmWVrioERf98U_qjd9UOB70Sh7oyEAZv9rAFTdUg4_UCCbMgaksfpAWnJoEfbmpE2NvzMtIF_lKUdyEz3sejwvhT0kgsUyoAxtpJosvAsMFrhTRMUhI640my3DEW_iE9A/s1600/Share+of+Income.png" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><span style="font-family: Trebuchet MS, sans-serif;"><img border="0" data-original-height="959" data-original-width="649" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcvSSOSRwHBmDmWVrioERf98U_qjd9UOB70Sh7oyEAZv9rAFTdUg4_UCCbMgaksfpAWnJoEfbmpE2NvzMtIF_lKUdyEz3sejwvhT0kgsUyoAxtpJosvAsMFrhTRMUhI640my3DEW_iE9A/s320/Share+of+Income.png" width="216" /></span></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">Info-graphic created by T1International</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">While coming up with the money is the initial struggle for most, an issue that is specific to the US is the ability to then get your hands on insulin. You need a prescription. You need that prescription submitted. Maybe it gets denied. Then it needs pre-authorization. Then it gets approved, but you have a bigger co-pay than expected. Then you have to download a co-pay card (if you qualify). <i>And then</i> you can pick up your insulin. This process can take days at best, weeks at worst. And contrary to what many people may think, not everyone has the time to be battling on the phone with insurance and refereeing between the doctor, insurance, pharmacy and pharmacy benefit managers (PBM). We do have lives outside of diabetes.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">This issue isn't specific to insulin, either. The price of test strips are exorbitant. They are considered a luxury in many 3rd world countries. Even here, some insurance companies (mine included) only cover enough strips for 3 tests a day. To get coverage for more, a letter of medical necessity is needed. <i>In what world does someone with type 1 only need to test 3 times a day?</i> It's clear that insurance regulations don't seem to be based on diabetes care best practices recommended by physicians.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">As I said, it's a beast of an issue. And it angers me. <i>A lot. </i>Instead of sitting on that anger or turning a blind eye, I decided to <a href="https://www.t1international.com/get-involved/" target="_blank"><span style="color: blue;">get involved.</span></a> Becoming an advocate for T1International is step one for me. T1International is a non-profit that takes no donations from pharma companies and advocates for people all over the world to have access to the medications and education they need.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">Enough of suffering through this issue in silence. We're demanding change. We're not waiting. We want #insulin4all, and we want steps to be taken towards it starting <i>now. </i>If you want to get involved, check out <span style="color: blue;"><a href="https://www.t1international.com/" target="_blank"><span style="color: blue;">T1International</span></a>,</span> search the hashtag #insulin4all on social media, and check out what other diabadasses have been doing below.</span><br />
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<ul>
<li><span style="font-family: Trebuchet MS, sans-serif;">Libby Russell at <span style="color: blue;"><a href="https://ihavethesugars.com/" target="_blank">I<span style="color: blue;"> Have the Sugars</span></a> </span>is selling statement tees to benefit T1International.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">Robin Cressman <a href="https://liberateinsulin.com/" target="_blank"><span style="color: blue;">raises her voice</span></a> and led a group of type 1s across the border to purchase insulin in Mexico to protest accessibility and pricing issues. </span></li>
</ul>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com3tag:blogger.com,1999:blog-8634304394534922110.post-78520100864261103822018-12-20T17:07:00.002-08:002018-12-20T17:09:12.352-08:00The Power of Words<blockquote class="tr_bq">
"Words are, in my not-so-humble opinion, our most inexhaustible source of magic." - Albus Dumbledore. </blockquote>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwSwmCEz77EI4LWdLUgUQJumUomi3GhD6Njl4o9fWEMGLIaE3I-U8ABrJSbk-FvDv9q-5Ir_h0LxqzGp2R9MycSYEufDvAiU6xx5sW0wX-o82n7TB0Tpf2xNhNacUYfCyDZuP5TnrH63Y/s1600/IMG_20181216_155324_681.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1440" data-original-width="1440" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwSwmCEz77EI4LWdLUgUQJumUomi3GhD6Njl4o9fWEMGLIaE3I-U8ABrJSbk-FvDv9q-5Ir_h0LxqzGp2R9MycSYEufDvAiU6xx5sW0wX-o82n7TB0Tpf2xNhNacUYfCyDZuP5TnrH63Y/s320/IMG_20181216_155324_681.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sticker from <a href="https://pimpmydiabetes.com/" target="_blank">Pimp My Diabetes</a></td></tr>
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<span style="font-family: "georgia" , "times new roman" , serif;">There has always been conversation in the chronic illness community about language - whether to say "diabetic/asthmatic/etc." versus "person with diabetes/asthma/etc." Some people don't like being on the receiving end of a label, while others strongly identify with one, and others still have no preference. I don't believe there is one simple answer as to which is best. I believe it's best to explore with the individual how they wish to be identified when referring to their diabetes (or any other chronic illness). It's also important to remember that that person is a <i>person</i>, whether they are comfortable with being called by their illness or not. They may be comfortable with you calling them a diabetic, but don't forget - that's not all they are.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">So many nuances exist in communication. If someone casually asks "you're diabetic?" versus a brash "you're <i>a diabetic</i>?", I'm likely to have different reaction. There's so many nonverbal cues - body language, tone, facial expression. No one wants to feel that someone is accusing them of something, and most people don't like to be the recipient of sad puppy eyes. The words themselves aren't the whole picture. But they're a big part of it.</span><br />
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<h3>
<span style="font-family: "georgia" , "times new roman" , serif;">Compliance vs. Adherence</span></h3>
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<span style="font-family: "georgia" , "times new roman" , serif;">I've talked before about the word <a href="https://diabetic-truths.blogspot.com/2018/05/the-stamp-of-compliance.html" target="_blank">compliance</a> in the medical field and the negative connotation it can have. The word "comply" is so similar to "obey." People living with chronic illness are already stuck with a disease they didn't ask for. Admonishing them for not "obeying" to this illness will convey that you're on the illness' side, not theirs. Because of how long and how heavily the word has been used, it's gained a derogatory nature . Hearing "non-compliant" being used to describe someone feels like hearing a dirty word. It stains a person's medical record, strikes trepidation into most providers, and causes bias when assessing a person, whether you realize it or not. There have been recommendations to switch to the word "adherent," which to me makes more sense and is kinder. Asking if someone is adhering to their regimen acknowledges the patient's role in their illness, while creating a comfortable space for them to have a conversation about what their barriers are to self-care.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Control vs. Manage</span></h3>
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<span style="font-family: "georgia" , "times new roman" , serif;">Recently I was listening to Rob Howe's podcast, <a href="http://diabeticsdoingthings.com/" target="_blank">Diabetics Doing Things</a>, and came across his interview with Erin Aker, founder of the <a href="http://www.diabulimiahelpline.org/" target="_blank">Diabulimia Helpline</a>. In her interview she talked about the word "control," an</span><span style="font-family: "georgia" , "times new roman" , serif;">d how detrimental it can be for mental health.</span><span style="font-family: "georgia" , "times new roman" , serif;"> While control is important for diabetes management, intense desire for control can manifest into different forms of anxiety. Especially when it comes to managing a chronic illness that is so </span><i style="font-family: georgia, "times new roman", serif;">difficult </i><span style="font-family: "georgia" , "times new roman" , serif;">to control. </span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">While I've had my own struggles with control and fear of losing it, I've never given much consideration to the power the word itself holds and how we can shake that power. Aker talked about using the word "management" versus "control." I felt like a light bulb went off in my head. Such a simple shift - swapping out one word for another - could make such a difference. If we keep thinking about our diabetes in terms of control, we're more prone to become obsessive. Re-training our brain to use the word "manage" eases some of the pressure. It is a more benign word, from a mental health perspective. I encourage everyone in the chronic illness community to consider what Aker talked about.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">What language do you prefer when it comes to your diabetes? Do you have a preference? Many people say words don't matter to them as much as the content of the conversation. Comment below and let me know your thoughts.</span>Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-19964405123307826102018-11-30T16:43:00.000-08:002018-12-07T16:00:02.242-08:00Making Endo Visits Suck Less<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: "verdana" , sans-serif;">It's no secret that we all dread going to the endo. No matter how much we like our docs, there always seems to be a level of anxiety that accompanies us to the office. If nothing else, this visit is a strong reminder of the chronic illness that we are living with and managing every day. After more than 20 years of doctor visits and a handful of different endocrinologists, I've learned some ways to make these trips suck a little less.</span><br />
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<span style="font-family: "verdana" , sans-serif;">Treat. Yo. Self.</span></h3>
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<span style="font-family: "verdana" , sans-serif;">This idea was actually inspired by my older brother. Like most normal humans, once a year he goes for blood work. He's not the most comfortable with docs and needles, so after his appointment he stops for a Snickers bar. After hearing my mom talking about this I thought, <i>why don't I get in on that?</i></span></div>
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<span style="font-family: "verdana" , sans-serif;">It doesn't have to be candy (unless you're low). It can be something a little more betes-friendly, and it doesn't have to only be before/after your endo appointment. When I go into the pharmacy to pick up my medications, I look for a little something for myself. Whether it's a mini-cactus for my office, a Justin's PB cup, or a new face mask; it makes the trip a little happier. </span></div>
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<span style="font-family: "verdana" , sans-serif;">After my endo appointment I'll do a little something more - stop at Starbucks or Playa Bowls, or I'll book a facial for the same day. It can be something small (or big!), but you get the general idea - do something pleasant for <i>you.</i></span></div>
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<span style="font-family: "verdana" , sans-serif;">Write out your questions.</span></h3>
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<span style="font-family: "verdana" , sans-serif;">If you're like me, you have a lot of thoughts that gather in the couple months between appointments. It's easy to let these float around in your head and then have your mind go totally blank once your butt hits the exam table. This can lead to feeling flustered and defeated after the appointment. Something I've started doing is writing down my thoughts and questions as they come, and bringing the list with me when I go to the doctor. That way, when my doc asks how things are going I actually have something productive to work on.</span></div>
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<span style="font-family: "verdana" , sans-serif;">Stand your ground.</span></h3>
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<span style="font-family: "verdana" , sans-serif;">It's essential as a type 1 to have an endo who is willing to work with you. Someone who is on your team, not trying to act as your boss. If you have ideas - taking a pump vacation, switching insulin, trying a sensor - speak up! This is your time to advocate for yourself. Your doc may not be on board right away, but they should listen to your input and hear what you have to say. After all, you are the one living with this disease 24/7.</span></div>
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<span style="font-family: "verdana" , sans-serif;">Bottom Line.</span></h3>
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<span style="font-family: "verdana" , sans-serif;">Medical management can be boring, at best. But mixing in little joys and treats when we can acts to improve our outlook and quality of life.</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-53295157923412730682018-11-23T14:40:00.004-08:002018-11-23T14:40:32.358-08:00Trust & Type 1<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: "trebuchet ms", sans-serif;">Trust is essential in any relationship. It allows us to feel safe. It gives us permission not to worry; not to have doubt. When we have trust, we can rely on our significant other. As someone with type 1, I rely heavily on my medical supplies. But what supplies earn that trust? And how long does it take to earn it?</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">The glucometer.</span></h3>
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<span style="font-family: "trebuchet ms" , sans-serif;">This is the OG diabetes tech. It's what I've been using since infancy. When I was a baby, my parents used to prick my toes to test me (I was diagnosed at 13 months old). Because of this, my glucometer often feels like my lifeline. It's been there literally my entire life, giving me the data I need to treat myself. Granted, there are days that my numbers are so wacky that I stare at my meter in frustration and wonder, <i>are you lying to me?</i></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The meter has evolved over the years - becoming slimmer, quicker, and requiring less blood from my callused fingers. But the idea is still essentially the same. Prick the finger, get the number, react accordingly. I would say that I rely heavily on my glucometer - because I trust it.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The pump.</span></h3>
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<span style="font-family: "trebuchet ms" , sans-serif;">Coming along in my grade school years, the pump took some time to earn my trust. When it first came out, I remember writing in my diary in wonderment, marveling at the fact that I didn't have to use MDI (multiple daily injections) anymore. I remember putting my "very last syringe" in my memory box the night before my pump training. It was a <i>huge </i>deal for me.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Maybe because of this, I was crushed when I had a rough go of it the first time around. I struggled with highs; had one particularly traumatizing, painful, kinked catheter; and site changes for some reason terrified me. I eventually went off the pump for a year or two until my parents & I felt I was ready to try it again. I've remained a pumper since then.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">But still, there are days where I feel that doubt niggling at the back of my mind. What if my pump malfunctions? What if I can't get my insulin? What if I get too much? Can I <i>really</i> trust this device functioning as my pancreas? Clearly, this doubt isn't significant enough to cause me to switch back to MDI, but still, it is there.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">The CGM.</span></h3>
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<span style="font-family: "trebuchet ms" , sans-serif;">Thus far in my diabetic life I've had two CGM experiences - Medtronic Enlite and Freestyle Libre, the system that I currently use. I was weary of this tech at the beginning, and was adamant that I didn't want something else attached to me. I was also a high schooler, and annoyingly stubborn. As I got older, I began to grow curious. But alas, it wasn't meant to be - my insurance did not think that this (statistically proven life-improving) technology was "medically necessary." So, I went without until I enrolled in my own insurance this year.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">If you follow me on <a href="https://www.instagram.com/diabetictruths/" target="_blank">Instagram</a> or read my blog, you know that I'm in love with my little Libre. But it's a new love. It's still deepening. The trust still needs to grow. I get asked all the time, "So you don't have to prick your finger anymore?" And I wince, because I know I really don't <i>have </i>to as often as I do. But kicking an almost-26-year habit is hard.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">To be fair to myself, there are discrepancies between the readings, and for the Libre it is recommended to check via finger stick before making treatment decisions. Still, there is room for improvement on my end. I feel the doubt trying to drown me, telling me "just make sure" or "just prick your finger, it's no big deal." I am hoping that with time, I'll develop a functional doubt:trust ratio.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Bottom line.</span></h3>
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<span style="font-family: "trebuchet ms" , sans-serif;">As human beings, we're comfortable with what we know. We are, in fact, creatures of habit. It's been my experience that people who were diagnosed at a younger age, or many years ago, are more familiar with the older tech and are more weary of relying so heavily on the new stuff. But those diagnosed during this stage of the game, where CGMs are the norm, feel much more comfortable trusting in their gadgets. A big part of this is about feeling safe. I feel safest testing my sugar the old-fashioned way, because it's what I knew for <i>so long</i>. </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">My hope is that with time and practice, my trust will continue to deepen. My other hope is for you to know that if this is something you struggle with as well - you're not alone!</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-21242336193880672192018-11-18T13:34:00.000-08:002018-11-18T13:34:39.843-08:00Planes, Trains & Snow Delays - Costa Rica 2018<br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><i>Pura Vida.</i></span></h2>
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<span style="font-family: "georgia" , "times new roman" , serif;">"Pure life." It's the phrase of Costa Rica, where I spent the last 6 days. I can say with certainty that the country measures up to this saying. It was <i>beautiful:</i> lush with wildlife, green forest, and full of amazing views and experiences. Every day, especially those where we ventured outside the resort, felt full of life.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Me and my best friend, who I've known since babyhood, traveled together and this is the farthest south we've gone so far. The flight from Newark was about 5 hours. We stayed in the northwestern part of the county, in the province of Guanacaste. This was my first trip with my Omnipod as well. Overall, my diabetes wasn't troublesome during vacation.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">What I packed.</span></h3>
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<span style="font-family: "georgia" , "times new roman" , serif;">To say I over-pack for vacation is an understatement. But hey, better safe than sorry, right? For this trip I knew I would have to change my pod twice, so I packed six pods - four more than needed, just in case any didn't work or fell off in the jungle. I packed extra batteries for my PDM. An extra pump - my old Medtronic - with two infusion sets and reservoirs to go with it if needed. A full vial of insulin, an extra glucometer, charger for my glucometer, some extra lancets, and two full bottles of test strips. Oh, and low supplies.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">For my lows I packed a big baggie of gels, and two juices. I've learned recently that you can bring your juice through TSA at the airport in your carry-on. If you inform them why you're carrying it, they will swab it and let you bring it through. We didn't check any baggage, so this was super-helpful. I also have a small army of pills I take daily, so I filled up my 7-day pill case and packed all the bottles as well - that way I can show what the pills are and that they are prescribed to me, if needed. </span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Lately I've been using <a href="http://www.vialsafe.com/" target="_blank">Vial Safe</a> to keep my insulin safe during travel. I kept my PDM, libre, and glucometer with a gel in my Clark double zip bag from <a href="https://www.myabetic.com/" target="_blank">Myabetic</a>. This was my go-to bag for vacation - brought it to the beach, carried it in my backpack at the airport, and used it as a little clutch at night. I also brought the new Jay sling bag from Myabetic which I found VERY helpful during our excursions. It fit lots of stuff and is more sporty and water-resistant than the other bags, which was good because it <i>poured </i>during our rainforest walk. When we went zip-lining, I was able to clip it around my waist like a fanny pack. All of my extra supplies go into </span><span style="font-family: "georgia" , "times new roman" , serif;">my zippy "All My Diabetes Shit" bag by <a href="https://www.casualtygirl.com/" target="_blank">Casualty Girl.</a><span id="goog_472690350"></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Keeping the shoogs in check.</span></h3>
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<span style="font-family: "georgia" , "times new roman" , serif;">Something I've learned about myself is that I run high on vacation. Whether it's the adrenaline, the high fat food my body isn't used to, the drinking, or a combo of the three, I'm not sure. What I did this time is created a "Travel" basal program with doses .2 units higher than my regular basal. It worked well with a little tinkering. After dinner I still would need a jacked up temp basal for a couple of hours. It's amazing how sensitive our bodies are to change. At home I really don't drink with dinner and we eat very healthy. Even having 1-2 drinks on vacation and eating food that was richer but that I didn't necessarily think was "high fat," my sugars would skyrocket without that extra basal.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Something else I strongly recommend is <i>water</i>. It's so important to stay hydrated when you're laying out in the sun, especially if you're drinking. I grabbed a water with every drink I had, and every hour or so out by the pool even if I wasn't drinking. It just makes my body feel <i>better</i>. </span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Excursions.</span></h3>
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<span style="font-family: georgia, times new roman, serif;">As lovely as it is to lay by the water, have some cocktails and just <i>do nothing</i>, mixing in excursions is a must for me on vacation. I love to see the country I'm in, learn about its history and its people, and experience everything I can in the time I have.</span></div>
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<span style="font-family: georgia, times new roman, serif;">Our first trip was to Diamante Eco Park, which has an animal sanctuary and an aerial zip-lining course. We got to see monkeys, jaguars, sloths, and toucans! I never realized how beautiful toucans are and now have developed just a <i>tiny </i>obsession with them.</span></div>
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<span style="font-family: georgia, times new roman, serif;">After the animal sanctuary it was off to zip-lining over the mountains. I've zip-lined before, but this was something else. The second zip was Superman style - face first. It was <i>high</i> over the ocean, and we could see our resort in its entirety from above. Definitely not for the faint of heart, but an <i>amazing</i> experience for those who love these kinda things.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVZP89Veao1Rv-austU5ZGu-cMj6HzYDjwllNTnuhu2V4gagrBjAsQM6WvdxgjfdqrXT3wKg9-Gu7wOGM1zPDxJtx1JIjldYTwGDJP8jv0gINd3Q6gPatip215c5iuzKs89jWh0shskWU/s1600/46440376_10217533918483873_3469010192664887296_n.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVZP89Veao1Rv-austU5ZGu-cMj6HzYDjwllNTnuhu2V4gagrBjAsQM6WvdxgjfdqrXT3wKg9-Gu7wOGM1zPDxJtx1JIjldYTwGDJP8jv0gINd3Q6gPatip215c5iuzKs89jWh0shskWU/s320/46440376_10217533918483873_3469010192664887296_n.jpg" width="320" /></a><span style="font-family: georgia, times new roman, serif;">Our second trip was much longer. We took a bus to Lake Arenal, which was about a 3 hour ride. However, we had a great tour guide who taught us all about the history of the country and showed us all the sights. We had lunch in a local town where I met a little cat and fed her some of my tilapia. After lunch, we took a boat across the lake and had an <i>amazing </i>view of the volcano. Afterwards we stopped at another eco-park and took a walking tour through the rainforest, followed by some time at a hot springs lodge, then wrapped up the day with dinner at a <i>beautiful</i> hotel up in the mountains over the lake. There are tons of eco-hotels in the mountains near Lake Arenal that I would love to stay at one day. The views are amazing and you really are surrounded by the beauty of the country.</span></div>
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<h3>
<span style="font-family: "georgia" , "times new roman" , serif;">Airport Shenanigans.</span></h3>
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<div>
<span style="font-family: "georgia" , "times new roman" , serif;">I'm a fairly light packer, so I try not to check baggage unless absolutely necessary. For this trip, I brought a mini-suitcase as a carry-on, and a big backpack for a personal item. Some airlines also allow you to carry a medical bag at no additional charge - make sure you look into this! It can be super helpful, especially if you have to check some bags.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Coming home to New Jersey, we were expecting some snow. <i>Some </i>snow. We were not at all expecting the hot mess that was to come.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">In retrospect, we should have had some sense of foreboding when the hotel phone rang at 2:40 AM. Our shuttle ride was scheduled for 3:20 AM, but there must have been a miscommunication - the driver arrived at 2:30. We scrambled our things together and hustled down to the lobby, still half-asleep.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">Things went relatively smoothly after that until we got to Houston. We had a layover there, and once we landed and had lunch we saw that our flight was pushed back an hour. Okay, not so bad. However, <i>just </i>as we were about to get on the plane, we were stopped. There wasn't anymore room for carry-ons. We would have to check a bag. Quickly, I crammed all my medical stuff into my backpack and forked over my little suitcase. We boarded, got comfy and waited.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">And waited.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">And...got delayed another hour.</span><br />
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<span style="font-family: georgia, times new roman, serif;">Once we finally took off, everyone's nerves were a little frayed. This didn't improve when, two hours into the flight, the pilot made an announcement that Newark was totally iced out. We would be landing in Cleveland and waiting the storm out. It turned out that we would have to wait until the next morning to fly back home.</span><br />
<span style="font-family: georgia, times new roman, serif;"><br /></span>
<span style="font-family: georgia, times new roman, serif;">Small calamities like this are why it's <i>so</i> important to be over-prepared medication-wise. Also, to have everything essential on your person. We had no access to our checked bags overnight. I may not have had a toothbrush, but at least I had my insulin.</span><br />
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<span style="font-family: georgia, times new roman, serif;">After an airport dinner with our fellow stranded souls, we made our way to a hotel airport, punch-drunk from exhaustion and missing our pets. At the end of the day though, we were happy to be safe and sound from the ravages of the storm.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZkk38k1xYDVlj_JCLVf_H1mA-IGz_QDYYjYLlRzkf54TPP8tW1I0VNHxT7KXBk_-aSXb_1K-zYTt_2IatISoT63OVAYtQmk9Ztu_sFdACMYZ3LtAFyJwK0LSQ3jGB7MWvJJ4DRqmnRgE/s1600/46276208_10217533887723104_6175176374710435840_n.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="528" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZkk38k1xYDVlj_JCLVf_H1mA-IGz_QDYYjYLlRzkf54TPP8tW1I0VNHxT7KXBk_-aSXb_1K-zYTt_2IatISoT63OVAYtQmk9Ztu_sFdACMYZ3LtAFyJwK0LSQ3jGB7MWvJJ4DRqmnRgE/s320/46276208_10217533887723104_6175176374710435840_n.jpg" width="176" /></a></div>
<h3>
<span style="font-family: georgia, times new roman, serif;">Bottom Line.</span></h3>
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<div>
<span style="font-family: georgia, times new roman, serif;">Bottom line from this trip: Be prepared. Over-pack. Visit Costa Rica if you love the outdoors and love outdoor activities. And again: Over. Pack.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi9LAo3hLITA9_ZAZTk7-rPxRSbuyd4Bw4ChDNZqS4Wk3dayxBxzq1AqpprwIjALxbEAAX-w_SgKGBhWeAqD33RASlWDZeHg2g0P33uk5fWovvWqTiUu5jGdZBctzPwtgilQ_AAPvwG35A/s1600/46379420_10217533889843157_1604930008936087552_n.jpg" imageanchor="1" style="display: inline !important; margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="960" data-original-width="960" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi9LAo3hLITA9_ZAZTk7-rPxRSbuyd4Bw4ChDNZqS4Wk3dayxBxzq1AqpprwIjALxbEAAX-w_SgKGBhWeAqD33RASlWDZeHg2g0P33uk5fWovvWqTiUu5jGdZBctzPwtgilQ_AAPvwG35A/s200/46379420_10217533889843157_1604930008936087552_n.jpg" width="200" /></a></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-56517195816971041232018-10-26T18:22:00.002-07:002018-10-26T18:22:50.058-07:00This is Halloween (with Type One)<span style="font-family: Trebuchet MS, sans-serif;">It's cold outside. Colder than it was before the sun completed its journey, down below the line of mountains in the distance. There is a bite in the air, and as I take off on my run I see my breath come out in puffs.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">As I get farther away from the warm glow of my house I touch my running belt compulsively, feeling for everything - gels, glucometer, pricker, test strips. It's all there. My finger tips are aching already and I haven't even made it to the lake. I feel my pace quicken.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">Running in my town is different than I imagine road running in other places is - there are no 24/7 convenience stores, no stores at all actually, and I'm far more likely to see woodland creatures than other humans while on my journey. I think this increases my trepidation - I can't dash into a 7/11 and buy an apple juice if I under-pack. And as I make my way around the water in the stillness of the night, I start to wonder if anyone would see me if I went down. It's getting increasingly darker the further I go, under the hood of the trees with the woods edging up to the opposite side of the street. What animals come out at night? I can't remember.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">As I approach one mile I've already decided I'm only going for two today - I'll loop around and turn back instead of completing the circle around the lake. I'm feeling the muscles in my back cramp up and thoroughly spooked by how poorly I can see. I wave my reader over my Libre sensor and am happy with the result - 146 - at first. But as I start into the second mile I feel a niggling in the pit of my stomach. Is the dark inhibiting my ability to feel my low? What about the cold?</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">I dig out my glucometer supplies and prick my finger as I run, a delicate skill I've learned to master. The number flashes on my meter - 76. The darkness acts as my friend then, hiding the annoyance on my face and bearing witness to the soft curses I whisper as I tear a gel open with my mouth. I toss the used test strip and methodically squeeze the gel into my mouth with my hands and teeth. When its done I cram the wrapper into my belt. I pick up speed. <i>I'll sprint the rest of the way</i>, I think, and this lasts about half a mile, until I feel the gel turning over in my stomach and the muscles seizing in my back. I slow my pace down again.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">I feel the dark closing in on me, and I feel the urge to test again. <i>Not until at least five minutes have passed</i>. I reprimand myself and I keep running, fighting off thoughts of being too cold to feel my sugar dropping or of a feral raccoon surprising me in the darkness.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">Finally the five minutes pass. I do my dance of testing while running again and feel simultaneously proud that I waited the full five minutes, and annoyed that I went low during my run. The number flashes - 89. I let out a loud sigh.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">The lights from the beach come into view and I fall into an easy stride, trying to lower my heart rate and slow my breathing. I hit two miles and slow to a walk. My house is around the corner. I think of how we have no street lights here and how my friends in Bergen County find this terrifying.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">When I make it through the front door I declare to my mother that I don't like running at night. She's thrilled. My sugar stays steady throughout dinnertime, and I tuck my fears away. Until next time.</span>Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-1920802089317903462018-09-27T16:33:00.001-07:002018-09-27T16:33:24.956-07:00Data Overload<span style="font-family: "trebuchet ms" , sans-serif;">Technology's advances in today's world have become a hot-button issue. Is it as helpful as it is hurtful? Is the constant connection to the blue screen just too much? Rudimentary statistics have come out regarding the pros and cons of tech, but it may be too soon to tell what the long-standing impacts are on our overall well-being. When it comes to diabetes tech, the concerns are no less significant.</span><br />
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<h3>
<span style="font-family: "trebuchet ms" , sans-serif;">Continuous glucose monitors</span></h3>
<div>
<span style="font-family: "trebuchet ms" , sans-serif;">Probably the biggest advance in diabetes technology since the insulin pump, Continuous Glucose Monitors (CGMs) have become widely used tools by both type 1s and type 2s. Whether you're a Guardian, Libre, or Dexcom user, you no doubt know how much this technology has impacted your diabetes care. These little guys check our blood sugars without us having to finger stick, tell us if we are trending up or down, and even tell us the speed at which we're trending. They alert us, our phones, and even our loved ones if we so choose. It sounds amazing to most people, but there's a downside here.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
<h3>
<span style="font-family: "trebuchet ms" , sans-serif;">Too much of a good thing?</span></h3>
</div>
<span style="font-family: trebuchet ms, sans-serif;">What's helpful about a CGM can also be harmful - we are inundated with data. This constant stimulation can be super overwhelming, especially for someone who's had diabetes since long before this tech was available. Before CGMs, you would test, bolus, eat and then not think about your BGs so much until you were going to eat again or if you were symptomatic. We didn't know what was going on in between our finger sticks. Now, we know immediately when our sugars begin to rise or drop. The issue is, once we see those dreaded arrows, it's difficult for some of us to just observe. We feel the need to correct, even though our sugars are <i>supposed </i>to rise after meals. That's just what happens. Just like sugars start to drop when we exercise. There is a constant pressure to have the straightest line possible, but is this really realistic? Trending down doesn't mean we are bound for a hypo, and trending up doesn't mean our IOB won't bring us down like it's supposed to.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXC9SdOzs3WM2CO8GzA4FkLAJkm4VmFJCtkintGtFc-KuTMhTx70dpBt_A_igpxbcrLloV5BNmbqVos2J_V4noQMtEZqkctjQliseSqmPTWyOhyphenhyphen88nVudc7rC9GTf28oQjsxnGheqB1lw/s1600/Screenshot_20180921-123908_Instagram.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXC9SdOzs3WM2CO8GzA4FkLAJkm4VmFJCtkintGtFc-KuTMhTx70dpBt_A_igpxbcrLloV5BNmbqVos2J_V4noQMtEZqkctjQliseSqmPTWyOhyphenhyphen88nVudc7rC9GTf28oQjsxnGheqB1lw/s320/Screenshot_20180921-123908_Instagram.jpg" width="180" /></a></div>
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<h3>
<span style="font-family: "trebuchet ms" , sans-serif;">A common vibe</span></h3>
<div>
<span style="font-family: trebuchet ms, sans-serif;">If you don't believe me that this awesome technology has a downside, I'm not the only one feeling it. I recently read a <a href="https://beyondtype1.org/mefirst/" target="_blank"><span style="color: blue;">post</span></a> from <a href="https://ihavethesugars.com/" target="_blank"><span style="color: blue;">Libby Russel </span></a>for Beyond Type 1, reflecting on her experience using a Dexcom. This spot-on hits all the frustration that comes with wearing a sensor. Reading about Libby's struggles and her relating her Dexcom to an overly attentive boyfriend was super relatable (and hysterical). Data overload is also touched on a lot in <a href="https://www.betacellpodcast.com/outofrange/" target="_blank"><span style="color: blue;">Out of Range</span>,</a> Beta Cell's podcast with Craig & Laura. And an overwhelming <i>seventy percent </i>of Instagram followers who participated in my poll agreed they over-correct based on sensor data. These little arrows can wreak havoc on our peace of mind.</span><br />
<span style="font-family: trebuchet ms, sans-serif;"><br /></span>
<span style="font-family: trebuchet ms, sans-serif;">Now, don't get me wrong. CGM is an amazing tool to better know your patterns, and is essential for people who don't feel their lows. But it can be a tough road, learning how to calmly observe our numbers without overreacting and panicking. It's a skill that takes practice and fine-tuning. But we're used to that, huh?</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-40794439949486491322018-09-13T14:35:00.002-07:002018-09-13T14:35:12.110-07:00Back to School with Type 1<span style="font-family: "georgia" , "times new roman" , serif;">It's that time of year again! Fresh pencils, new notebooks, and football games. Back to school is upon us once more. </span><span style="font-family: "georgia" , "times new roman" , serif;">Whether you (or your child) are heading back to elementary school, high school, or packing up for college, you need a game plan when it comes to your T1D.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
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<h2>
<span style="font-family: "georgia" , "times new roman" , serif;">Know your rights</span></h2>
<div>
<span style="font-family: "georgia" , "times new roman" , serif;">If you attend public school, it's important to know that you have certain rights as a student with type 1. Under the Americans With Disabilities Act (ADA), public schools are mandated to provide reasonable accommodations for students with a disability. The ADA classifies type 1 diabetes (along with many other chronic illnesses) as a disability. The goal of ADA in schools is for every child to have access to the education they deserve.</span></div>
<div>
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></div>
<div>
<span style="font-family: "georgia" , "times new roman" , serif;">There are many organizations out there that advocate for families who feel the school isn't complying to ADA guidelines. In New Jersey, the one I most commonly refer families to is <a href="http://www.spanadvocacy.org/" target="_blank">SPAN</a>. You can also reach out to your local universities' law clinics, who may offer pro bono services to families. You'll want to look for a clinic that specializes in education law.</span></div>
<h2>
<span style="font-family: "georgia" , "times new roman" , serif;">Terms to Know</span></h2>
<div>
<ul>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><u>504 Plan</u>: More commonly referred to simply as a "504," this is a documented plan that lays out the accommodations you or your child require as a student with type one. Examples include access to water, being allowed to test in class, and bringing a buddy to the nurses office.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><u>Child Study Team</u>: This team typically consists of a school social worker, psychologist, counselor, and the student's teacher and paraprofessional (if applicable). While a 504 doesn't necessarily mean the CST will be involved, they may be a good team to approach if you have questions regarding your accommodations, how to set up a 504, or if you're concerned the school isn't adhering to your 504 plan.</span></li>
</ul>
<div>
<span style="font-family: "georgia" , "times new roman" , serif;">Setting up a 504 can often be done with the help of the principal and the school nurse. You will need a letter from your endocrinologist specifying the accommodations that you need, and explaining the medical necessity for them. Most pediatric endocrinology offices are familiar with 504 plans and have templates for families. If you're struggling, ask if your endo has a social worker you can speak to. Also, Beyond Type 1 has a <a href="https://beyondtype1.org/school-downloadables/" target="_blank">template</a> for a 504, and other useful resources & information for going back to school with type 1.</span></div>
</div>
<h2>
<span style="font-family: "georgia" , "times new roman" , serif;">Tips and Tricks</span></h2>
<div>
<span style="font-family: "georgia" , "times new roman" , serif;">As someone who has done diabetes all the way from pre-K through grad school, I've had many experiences, both positive and negative, and am happy to share my tips and tricks.</span></div>
<div>
<ul>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><b>Get a jump on things. </b>Do you know who your school nurse is? Your teacher? All your teachers? If you do, contact the school and see if you can set up a meeting before the semester starts. This way, the staff will be familiar with you, familiar with type 1, and familiar with your plan of care.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><b>Be an advocate. </b>It's an unfortunate reality that some schools don't follow the regulations they are mandated to comply with. Don't let them get away with it. Be an advocate for your child, and teach your child to grow into an advocate themselves. If you need help, utilize the resources discussed above, or try reaching out to your local JDRF chapter.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><b>Have a low box (or two). </b>Low boxes at school are <i>essential. </i>All you need is a pencil box and your low supplies of choice, with an extra meter for good measure. I used to keep a low box in my classroom, and in the gym for gym class. Whenever we went outside, our gym teacher would have the low box in tow. Also, it's quick to grab during a fire drill or an evacuation - you never know how long you'll be outside.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><b>Know your nurse. </b>If you're lucky, your nurse will be your number 1 person at school. My K-3 nurse was one of my best friends at school. It's good to have someone in your corner, and someone to look out for you. Also, make sure your school is prepared if your nurse is out for the day - who is their back up?</span></li>
</ul>
<div>
<span style="font-family: georgia, times new roman, serif;">Bottom line for back to school: know your rights, be prepared, and stand up for yourself (or your child). Ask for help when you need it. You got this.</span></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-1769214477411726242018-09-02T14:24:00.000-07:002018-09-02T14:24:06.898-07:00Internalizing Our Numbers<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimGk171H7JYt3eJx6BsiKz3zYTJo-sz3cvptUPSKlKAJIAXiyiQzHV6kaS3ElfOi7KIoau7DXPLc1z-1u6BhRcSmcw18KH-AHVvXvL23MFQRrpt_tnYCRbqvV440HGL9u6GA3G4G9fIO8/s1600/Screenshot_20180902-171333_Instagram.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimGk171H7JYt3eJx6BsiKz3zYTJo-sz3cvptUPSKlKAJIAXiyiQzHV6kaS3ElfOi7KIoau7DXPLc1z-1u6BhRcSmcw18KH-AHVvXvL23MFQRrpt_tnYCRbqvV440HGL9u6GA3G4G9fIO8/s320/Screenshot_20180902-171333_Instagram.jpg" width="180" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Instagram: @diabetictruths</td></tr>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvGZkoUWzR_BHPvr4CEvNIGqQGdIBAjm2ki24NQhbQeWiYDp4QpA8e3UK4JhaSh1yLj9cV7l1Tu_LbcstHZGMYz-pVaisTU9kCiUQmtutZNhnDvuvQOZvHXq3gV-Uv49HfR0RGVjEIYIU/s1600/Screenshot_20180902-171322_Instagram.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvGZkoUWzR_BHPvr4CEvNIGqQGdIBAjm2ki24NQhbQeWiYDp4QpA8e3UK4JhaSh1yLj9cV7l1Tu_LbcstHZGMYz-pVaisTU9kCiUQmtutZNhnDvuvQOZvHXq3gV-Uv49HfR0RGVjEIYIU/s320/Screenshot_20180902-171322_Instagram.jpg" width="180" /></a><span style="font-family: "georgia" , "times new roman" , serif;">There's a lot of bad habits we accumulate as type 1s. Not changing our lancets, scattering our used test strips all across the globe, over-treating our lows...the list goes on. But a particularly bad habit we have is internalizing our numbers.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">When I say "internalize," I mean we take our numbers too close to heart. We see them as a direct indicator of how good or bad we are doing at life. </span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">When I say numbers, I am referring to many things - our sugars, our A1Cs, our percentage of time in range. </span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span><span style="font-family: "georgia" , "times new roman" , serif;">Over-identifying is something I talked about in my last post about <a href="http://diabetic-truths.blogspot.com/2018/08/type-1-and-guilt.html" target="_blank">guilt</a>. We tend to see our numbers as a direct reflection of who we are as people. And we put a lot of stock in the numbers we are inundated with on a daily basis. We're all familiar with the dreaded trip to the lab to get our A1C checked, and the tense waiting period until we get our report card delivered to us by our doctor.</span><br />
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<h3>
<span style="font-family: "georgia" , "times new roman" , serif;">A word to healthcare providers</span></h3>
<span style="font-family: "georgia" , "times new roman" , serif;">To be clear, numbers are an integral part of diabetes. Aside from our gut feelings, they are the only somewhat clear indicators we get in this ambiguous, ever-changing disease. Also, doctors love numbers. Numbers are data. This is definitely a factor in the development of this habit. We have the message "lower A1C" drilled into our heads by our diabetes team. We see the looks of disapproval when our numbers are higher than preferred. And for sure, we all try our best to keep our numbers in a reasonable range. There is no doubt that numbers in range keep us in better health. But numbers are also rigid. They are a spot, a speckle on the vast map of our life with diabetes. And taking numbers at face value can lead to unnecessary stress. It shouldn't be that a high A1C result delivered by a stern endo causes a slow spread of shame across our psyche.</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">For example, consider A1C. Anyone on a medical team who hears an A1C of 10% will not be able to stop themselves from spiraling off into a lecture of how awful you are doing. But maybe your last A1C was 14%. Or maybe your health insurance termed last month and you've been rationing your insulin. There are so many factors that are hiding behind the numbers. This is an important thing to remember if you are a healthcare provider, or if you know someone with diabetes. Don't jump the gun. Gently explore what is going on with your patient from a non-judgmental, not-knowing place. It's so easy to delegate people into the dichotomy of "bad/good" A1C," which then often translates into "bad/good" diabetic, or "bad/good" person.</span><br />
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<h3>
<span style="font-family: "georgia" , "times new roman" , serif;">Being kind to ourselves</span></h3>
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<span style="font-family: "georgia" , "times new roman" , serif;">On our end, we must work to be kinder to ourselves. In the world of social media, it's especially easy to fall into the trap of comparing our numbers to others'. It's easy to see another person's flat line on their Libre and assume they're having a great day. But, as we all know, there's usually a deeper story. Work goes into those numbers. Stress. Blood, sweat, and tears. And sometimes they're not the numbers desired.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">So, the first step is, stop comparing. Focus on <i>you</i>, and <i>your </i>care. Your body is different from any other body, whether it's a fellow body with diabetes or not.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Next step, take your numbers in context. Remember they are only a piece of your diabetes. Use them to inform how you care for yourself, but don't make a mountain of them.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">And finally, advocate for yourself. Don't let others make you feel badly about your numbers. They are yours to feel how you want about. If your doctor or your partner or an annoying stranger is solely focused on the numbers, speak up. No one deserves to feel ashamed of their care. We're all doing the best we can.</span></div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-80562484702771137732018-08-24T07:56:00.000-07:002018-08-24T07:56:01.473-07:00Type 1 and Guilt<span style="font-size: large;">There is a specter floating around in the type 1 community. It haunts people and parents living with type 1, coming out to play during our lowest moments. The specter is guilt. Feeling like a burden.</span><br />
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<span style="font-size: large;">There's definitely a difference in the kinds of guilt experienced by those who have type 1 and those whose loved ones have type 1 (namely, parents). Parents of type 1s may experience guilt in several ways: guilt that their child is sick, guilt that they couldn't prevent it, that they couldn't protect them, that they could have caught it sooner, and so on. Upon diagnosis parents often need to be reassured that there was nothing they could have done to cause their child's diabetes, or anything they could have done to prevent it. Very often, it is parents' keen eye and instinct that bring their child in to the doctor or the emergency room. They took care of their children, as most parents do, to the best of their knowledge and ability.</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2m2pvqBMr_e2zPlxxj4YkB_Os6DKdtkPJbKLUucLr30yXLOh6wTHFT_0VbFM7cVAuZPES8_l3oLjwFmN4Z3DFCwNPoOw7Nz1tZQ9yb8pz8-TydU8UISX8PZBMqyggiq1VviCaoB9Eszo/s1600/IMG_20180808_090730_468.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><span style="font-size: large;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2m2pvqBMr_e2zPlxxj4YkB_Os6DKdtkPJbKLUucLr30yXLOh6wTHFT_0VbFM7cVAuZPES8_l3oLjwFmN4Z3DFCwNPoOw7Nz1tZQ9yb8pz8-TydU8UISX8PZBMqyggiq1VviCaoB9Eszo/s320/IMG_20180808_090730_468.jpg" width="180" /></span></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Parents of type 1 answered a 50/50 split of feeling guilt regarding their child's diagnosis. (Instagram: @diabetictruths)</span></td></tr>
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<span style="font-size: large;">For those who have type 1 themselves, the relationship with guilt can be more insidious. Even for those who are diagnosed young (myself included), guilt will worm its way into thoughts and feelings about diabetes. I have a vivid memory of having to be picked up early from ballet class after a low at around age 10. After 15 minutes of sitting and wallowing in my sorrow, my mother arrived to get me. "Sorry I'm such a burden on you and Dad," I spat as a hello. I remember her being appalled - her and my father never complained about having to take care of me. Why would I say such a thing? Was I being a drama queen? Not exactly.</span><br />
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<h3>
<span style="font-size: large;">
Feeling like a burden</span></h3>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv6riDGJMkv298XT8gSDEXZSoB-idjFYZ7vWdVIcnV7D2UAq2Gxp2dhPbCamms4lrOy820GTZRD1ar75uygNsUHjuxpflTfr8bNL84TJLTlIwVuVzEuRDEgBC6ek9q9xTJn9A2bpjTd20/s1600/IMG_20180808_090643_314.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-size: large;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv6riDGJMkv298XT8gSDEXZSoB-idjFYZ7vWdVIcnV7D2UAq2Gxp2dhPbCamms4lrOy820GTZRD1ar75uygNsUHjuxpflTfr8bNL84TJLTlIwVuVzEuRDEgBC6ek9q9xTJn9A2bpjTd20/s320/IMG_20180808_090643_314.jpg" width="180" /></span></a></div>
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<span style="font-size: large;">When it comes to feeling like a burden, it seems that I was far from alone in my feelings. What I've found - on social media, at work, or listening to different type 1 podcasts - is that the majority of type 1s struggle with this feeling from time to time. </span><br />
<span style="font-size: large;">However, this issue isn't just specific to diabetes. The Kidney Disease Quality of Life Survey (KDQOL), administered to dialysis patients ages 18 and older, specifically asks the same question I posed to other type 1s on my Instagram. The <a href="https://www.rand.org/content/dam/rand/www/external/health/surveys_tools/kdqol/kdqol36.pdf" target="_blank">KDQOL </a>asks in its "True or False" section how true the statement "I feel like a burden on my family" is. Feelings of guilt and shame aren't just things that diabetics struggle with - it seems that any chronic illness that significantly impacts daily life poses a risk of this side effect.</span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4X5dVUC7tgT8Og__CPLC01gyVUJmZURFV25brRwoPhtX3db1SIpdsk4VIgd88vH3KBTiX1Cg2HrJ79VBBATgnI1G2V2dzFBNvXz0ujXFviUJjlKp1TjzZ5hM42jy43O2A9ZUB2AEj3Ds/s1600/IMG_20180808_090653_521.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-size: large;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4X5dVUC7tgT8Og__CPLC01gyVUJmZURFV25brRwoPhtX3db1SIpdsk4VIgd88vH3KBTiX1Cg2HrJ79VBBATgnI1G2V2dzFBNvXz0ujXFviUJjlKp1TjzZ5hM42jy43O2A9ZUB2AEj3Ds/s320/IMG_20180808_090653_521.jpg" width="180" /></span></a><span style="font-size: large; text-align: center;"><br /></span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCLuoxf6m_82m8D-3FJCfsRMFA1D9ep6Gyvm18dmobAhxEHfqNP5L-1n5bT2VsgoGKw265EU1YoWskTVY3vJ1z-SS99cAcdLzSf_LUPozY1cEZlBZtaIw9Hpd6b3suMlSw4pyYt4j8mM0/s1600/IMG_20180808_090720_105.jpg" imageanchor="1" style="clear: left; display: inline !important; float: left; margin-bottom: 1em; margin-right: 1em; text-align: center;"><span style="font-size: large;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCLuoxf6m_82m8D-3FJCfsRMFA1D9ep6Gyvm18dmobAhxEHfqNP5L-1n5bT2VsgoGKw265EU1YoWskTVY3vJ1z-SS99cAcdLzSf_LUPozY1cEZlBZtaIw9Hpd6b3suMlSw4pyYt4j8mM0/s320/IMG_20180808_090720_105.jpg" width="180" /></span></a><span style="font-size: large; text-align: center;">On the upside, it seems that people living with type 1 don't feel this way all of the time. More commonly, they feel this way on bad diabetes days. Like all negative thoughts, guilt tends to creep up on us during difficult moments. If our sugar levels are really out of whack and we have to rely heavily on our loved ones, we're more prone to feel like a burden or a bother. </span><br />
<span style="font-size: large;"><span style="text-align: center;"><br /></span>
<span style="text-align: center;">Also, if diabetes interferes with plans or social activities, it seems the majority of type 1s are reluctant to break the news to those they are spending time with. It would make sense that this is reluctance stems from that same fear - feeling like a burden. Ruining the day for everyone. Interrupting the fun with your diabetes. These thoughts can be seriously detrimental to our state of mind - thoughts like these increase shame, guilt and embarrassment, which can lower our sense of self-worth.</span></span><br />
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<h3 style="text-align: left;">
<span style="font-size: large; text-align: center;">Why?</span></h3>
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<span style="font-size: large;">Guilt and shame are feelings. Feelings are a direct result of our thoughts - how we perceive what is going on around us. So what thoughts are we having that feed these feelings of guilt? </span></div>
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<span style="font-size: large;"><br /></span></div>
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<i><span style="font-size: large;">I have to cut this hike short. My sugar's going low.</span></i></div>
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<i><span style="font-size: large;">This is awful. I'm ruining everyone's day. </span></i></div>
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<i><span style="font-size: large;"><br /></span></i></div>
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<i><span style="font-size: large;">My mom gets so worried about me. I am such a burden to this family.</span></i></div>
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<i><span style="font-size: large;"><br /></span></i></div>
<div style="text-align: left;">
<span style="font-size: large;">The issue with these thoughts is that without realizing it, we are over-identifying with our diabetes. Yes, our moms are worried about us. But is it you yourself that is the stressor on the family? Or is it your diabetes? It's often hard for us to remember -<i> they are two different entities</i>. Parents may have been devastated about our diagnosis, but it is our <i>diabetes </i>they are upset with, not <i>us. </i>We might be upset that we have to cut the hike short, but it's <i>diabetes</i> that interrupted the day, not us.</span></div>
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<i><span style="font-size: large;"><br /></span></i></div>
<div style="text-align: left;">
<span style="font-size: large;">This isn't to say that we should shirk all responsibilities that come along with diabetes. Even though diabetes is a separate entity, it is still something we have some control over. Rather, this is about changing our thoughts regarding diabetes and ourselves. It's about changing the way you talk to yourself (otherwise referred to as <i>self-talk</i>) about your type 1. Diabetes may be an integral part of who you are,<i> but it is not you yourself.</i></span></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-17894546052934549262018-07-28T17:42:00.001-07:002018-07-28T17:42:25.242-07:00Resource Hub<h4 style="text-align: center;">
NOW IN PROGRESS</h4>
<h2>
Who doesn't love resources?</h2>
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As a social worker, much of what I do is provide resources. Whether it's for finances, prescriptions, mental health, or community support, there is an abundance of resources to be found and shared. The more time I spend in my field, the more I realize how the type 1 community would benefit from many of these resources. This is why I'll be constructing a resource hub that will become a permanent page of my blog. You can find it next to the "Medical Disclaimer" bar. This will be an ongoing project - I'll continue to add resources as I come across them. Most importantly, I want to hear from <i>you guys</i> - know of a resource that I don't have on my page? Have a good or a bad experience with one of them? Let me know!! The resource hub will go live on Thursday, August 2nd, so stay tuned.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwBVhfp2ES1G8kN5iMwflPF8W97JuyyvRLuAVcj4Nx1s-BoKWD-az4_a017axbmST1bhDPWxVC-Kmj56nbMSVqNoSqB4GeAqoDTszvehZr2d7hnBNMkDSKs36lWgzffwSZPvWHLKV43-A/s1600/DSCN2703.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1291" data-original-width="1600" height="258" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwBVhfp2ES1G8kN5iMwflPF8W97JuyyvRLuAVcj4Nx1s-BoKWD-az4_a017axbmST1bhDPWxVC-Kmj56nbMSVqNoSqB4GeAqoDTszvehZr2d7hnBNMkDSKs36lWgzffwSZPvWHLKV43-A/s320/DSCN2703.JPG" width="320" /></a></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-52010043988219393852018-07-08T16:09:00.002-07:002018-07-08T16:09:57.275-07:00Thoughts on a Fractured FootAs I write this, I stare pitifully down at my left foot and right knee. Each is carefully draped with an ice pack. My left foot is wrapped in an Ace bandage, awaiting an evaluation by an orthopedist for the fracture in my fifth metatarsal bone (think - the pinky bone of your foot). The swelling in my right knee seems to have gone down, but I'm over-icing it as a precaution. We still don't know what exactly is causing the knee swelling - it flares up after running or excessive walking. But a fracture in the left foot means crutches and weight-bearing only on the right leg. Which means pressure on the bad knee. Which means excruciating pain and more inflammation. My Omnipod sits inconspicuously on my left thigh, an afterthought. I use my PDM to bolus for my Sunday night ice cream, then spend five minutes over-thinking how much Aleve I should take before bed.<br />
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I'm not good at being still. Resting and elevating has been a challenge for me. Sure, I got to watch Moana and take a nap on the couch, but I like to be <i>moving.</i> Laying in bed last night, I didn't sleep much, unable to stop focusing on the pain in my knee. The more I lay around and think, the more often I came back to the same thought - <i>am I being a huge wuss? This is </i>temporary.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrVcD20QDEnxslrtBe0GF_oSgjhFENkFsHs8VKzlrCOztB8-narb0oPuCFjsCH2a2PnehM7VqT2h96kVK6u-g4hAE1S890bq9G5-_niWVPIy0Su-3IsVxibqqtmv-Q2vKiwvXoR5P1Mj0/s1600/boot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1429" data-original-width="1440" height="198" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrVcD20QDEnxslrtBe0GF_oSgjhFENkFsHs8VKzlrCOztB8-narb0oPuCFjsCH2a2PnehM7VqT2h96kVK6u-g4hAE1S890bq9G5-_niWVPIy0Su-3IsVxibqqtmv-Q2vKiwvXoR5P1Mj0/s200/boot.jpg" width="200" /></a></div>
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I mean, I've lived with type one diabetes every day of my life for the past 25 & 1/2 years. It comes to me as naturally as breathing. The pricks, the pokes, the highs, the lows...but this - struggling to get around - this is new for me. And its gotten me thinking. We struggle with what we're unfamiliar with. Someone from the outside looking in would probably assume that taking care of my diabetes is incredibly stressful. They would see the broken foot and think it was small potatoes compared to my daily finger pricks. But not me. For me, diabetes continues to be a nonchalant part of my daily life, while this foot fracture has me tossing and turning, butt-scooting and crawling around my house.<br />
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At the same time, I think that what we go through prepares us for what is to come. Time has passed and I've been given a boot for my broken foot. I've grown to have a love-hate relationship with the boot - much like the relationship I have with my diabetes supplies. I talk to it, I give a pat after it helps me get around, I consider naming it. I feel living with a pump has predisposed me to have a certain level of amicability towards health-gear. I realize the necessity of it and try not to begrudge it for doing its job.<br />
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We as humans are creatures of habit. It seems that for most of us, <i>hard </i>and <i>easy </i>are subjective - what's new is hard. Type one, for me, is easy compared to broken foot. And yes, in case you were wondering, I did decorate the boot. We'll see about the name.Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-67045078693066871332018-06-28T15:25:00.002-07:002018-06-28T15:25:33.487-07:00Disconnected - switching to Omnipod<div dir="ltr">
I'm reluctant to write another post with a positive review, since the day after I raved about my <a href="http://diabetic-truths.blogspot.com/2018/06/my-libre-experience.html" target="_blank">Libre </a>I put in a new one and had a day of completely whacked out readings. The universe has a funny way of doing stuff like that. So I w<i>on't</i> say that my switch over to the Omnipod has gone well.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiA-9kDE0r2UrNaCqB5eOfmjtKrUnikd9WVLMtp8Ht1BYmBJbhAZlgZlQ3Tr51V-xp3PzB6EzbiEULl1c1Iw05ChwbhGarQF6lXwqkgDdp1MjKHXxrov2-xi5eYk0SSlDN63oKt_s8t9aw/s1600/pod.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1600" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiA-9kDE0r2UrNaCqB5eOfmjtKrUnikd9WVLMtp8Ht1BYmBJbhAZlgZlQ3Tr51V-xp3PzB6EzbiEULl1c1Iw05ChwbhGarQF6lXwqkgDdp1MjKHXxrov2-xi5eYk0SSlDN63oKt_s8t9aw/s200/pod.jpg" width="200" /></a></div>
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I first started on a pump when I was 9 years old, and have been on one ever since. That's 17 years on a Medtronic. Needless to say, this was a big change for me. The adjustment has been interesting. I still find myself reaching for my waistband when I want to bolus. I catch myself guarding my waist when I walk through doorways or change my clothes. But after the initial disorientation, I've found myself feeling pretty liberated. Right now I have the pod on the back of my arm, and I feel like I can dance around and there's nothing attached to me.<br />
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For those of you who are unfamiliar with the system, there's two major parts to it. The pod, which is the insulin pump itself. The pod carries the insulin inside of it and sticks to your skin like a pump site would. It's changed every other/every two days. Then there's the PDM, which controls the pod through a wireless connection. The PDM doesn't have to be near the pod for you to get your basal. It just needs to be within communicating distance when you bolus. This is nice because when I go for a short run, I can set up my temp basal and leave my PDM at home. Or at work, I can leave it in my lunch bag and don't need to carry it around the hospital with me.<br />
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<h4>
The Switch</h4>
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My first step in switching to the pod was to call the company (<a href="http://www.insulet.com/" target="_blank">Insulet</a>). I explained that I wanted to try out the pod, and they sent me an empty sample pod. I wore this for a couple of days and decided to give the real one a shot. If you're currently using a competing company for pump therapy (i.e. Medtronic, TSlim), Insulet will send you a month's supply of pods with a PDM. If you don't like it, you can keep the PDM at no cost and keep using your old system. This was reassuring for me because it felt like such a big change to dive into without a safety net.</div>
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Insulet has you complete a form so that they can verify coverage with your insurance company. This is another important thing to consider before making a switch. Luckily the pods were covered at the same percentage my Medtronic supplies were, and will end up being about the same cost out of pocket every three months.</div>
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<h4>
What I Like</h4>
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<i>Less Supplies: </i>Since the pods have their reservoir inside of them, its only them you have to worry about. This makes for easier packing, storing and traveling with supplies.</div>
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<i>Insertion: </i>I'm not sure if it's mental or what, but just sticking the pod on and pressing a button without ever having to see the needle or hear that loud click makes it seem like an easier and less painful insertion.</div>
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<i>Freedom: </i>As I mentioned before, the ability to dance around without worrying about something falling off your hip is just pretty exciting after 19 years on a tubed pump. Plus, the pods have gotten much smaller since they first came out. They may be more noticeable than a pump site, especially in the summertime, but for me it's worth the extra asks and looks.</div>
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Dash System</h4>
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Something else exciting on the horizon is the recent FDA approval of the <a href="https://beyondtype1.org/omnipod-dash-system-from-insulet-receives-fda-clearance/" target="_blank">Dash</a> system for the pod. This will include a slimmer PDM that will be able to communicate with the Contour Next test kit, made by Bayer. This was the system I was using with my Medtronic pump, which is nice because soon it will be compatible with my pod system. The Dash will also use Bluetooth technology for its connection with the pod, which seems to be a precursor to more advanced technology (smartphone apps, the works).<br />
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<h3>
If you've been thinking about switching over to the pod, I've say give it a shot. Worst case scenario, you don't like it and go back to your old system without having to shell out any money. If you're on MDI, request a sample pod and see how you feel about wearing it for a couple of days.</h3>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com1tag:blogger.com,1999:blog-8634304394534922110.post-77310233010138782752018-06-15T17:38:00.001-07:002018-06-15T17:38:32.867-07:00From packing to poutine and everything in between - my Quebec City adventuresIf you follow me on <a href="https://www.instagram.com/diabetictruths/" target="_blank">Instagram </a>I'm sure you know that I recently got back from a 5-day, 4-night girls' trip to Quebec City. For anyone who's never been, I highly recommend it. The sights were beautiful, the food was amazing, and the shopping was seriously detrimental to my wallet. We stayed right near Place Royal, a quaint little square with a killer breakfast cafe. Everything in the city was walking distance for us. We also took a ten minute drive to Parc de la Chute-Montomorency, a local park where the stunning Montomorency Falls are located. They have zip-lining and cable cars, and the park itself is amazing just to explore on your own.<br />
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<tr><td class="tr-caption" style="text-align: center;"><i>Place Royal</i></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><i>Montomorency Falls</i></td></tr>
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What I packed</h4>
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Whenever I travel, I am nutty about packing medical supplies. Being in Quebec 5 days, I was scheduled for one site change. In addition, I brought three extra pump sites and two extra reservoirs. I brought the remainder of my Fiasp vial along with one unopened bottle. The vial of test strips in my kit was full, and I packed an extra vial of these along with about 20 strips for my Libre reader which doubles as a meter. For lows I brought two bottles of juice, three gels and of course the emergency Swedish Fish I keep in my car. I had a backup meter, a backup pump, an extra pump battery, and all the necessary chargers.<br />
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Now this may sound like a lot of supplies to most people, but believe it or not I spent a solid amount of time preoccupied about my test strip supply. Would I have enough? What if I ran out? Could you buy Contour test strips at a pharmacy in Canada? I was frustrated that these worries plagued me while I was trying to enjoy myself. I ended up having more than enough supplies, and no emergency trips to Canadian pharmacies needed to be made.<br />
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What I ate</h4>
Being on vacation calls for indulging. These means a lot of guesswork when it comes to carb counting. Throw drinking into the mix, and it's easy to see why my sugars tend to run high when I'm away. During my trip my blood sugars were primarily in the 200s. I wasn't happy about this, but I also tend to be more cautious to avoid lows when I travel. We were doing a lot of walking, which made me more hesitant to bolus too much. This is something I hope to work on in the future, especially as I grow more comfortable with my sensor. It's been especially tough getting back to work and real life because as my blood sugars level out, I am having hypo symptoms in the 100s.<br />
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What I saw - and who saw me</h4>
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<div>
The beautiful views in Quebec City are endless. Whether you climb to the upper part of the city to get a full view of the Chateau Frontenac and the city below, or wander along Quartier Petit Champlain to do some shopping on the colorful cobblestone streets, your eyes are in for a treat. We sat at the Port de Quebec and got a view of the upper part of the city from below, and climbed to the bottom of Montomorency Falls after ziplining over them.</div>
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<tr><td class="tr-caption" style="text-align: center;"><i>Chateau Frontenac</i></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><i>Petit Champlain</i></td></tr>
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Since I've started wearing my Libre, I've gotten more comfortable overall with my diabetes being "out" and people asking questions. While in QC I decided not to worry about hiding my pump or my Libre. This was partially because I wanted to embrace who I am as a diabetic, and partially a social experiment. Would as many people ask me what the heck was on my arm as I am used to in Jersey?<div class="separator" style="clear: both; text-align: center;">
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During our five day stay, I got two asks. One about my Libre, and one about my pump. Obviously I didn't spend enough time in Canada to do a thorough experiment with a random sample and all those things I learned about in stats class. My overall feeling was that people ask more often here. Are Canadian people less nosey? Anyone from the area please feel free to comment your thoughts below.</div>
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To sum up, Quebec City was a little slice of European-style heaven nestled within road tripping distance from NJ. I had a wonderful time and would absolutely go back. When it comes to type one and trips, I think it will be a continuous battle. You can't take a vacation from diabetes. But each experience helps me grow and learn how to travel better with type one. One thing I know for sure is that I will never stop exploring. Diabetes will just have to come along for the ride.</div>
Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-15905318277630679122018-06-03T17:42:00.001-07:002018-06-03T17:42:53.315-07:00My Libre Experience<div dir="ltr">
<span style="font-size: large;">By now I'm sure many of you have heard about or seen pictures of the <a href="https://www.freestylelibre.us/" target="_blank">Freestyle Libre</a> system. For those of you who haven't, here's how it works:</span></div>
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<span style="font-size: large;">The system has two parts: the sensor and the reader. The sensor is itty bitty and gets inserted into the back of your arm. It stays in for up to ten days. When you want to get data, you click on the reader and simply wave it over the sensor. It gives you your current BG, along with a graph of your previous readings for as long as you've been wearing it. The reader also tells you if you're trending rapidly up or down, slowly up or down, or running steady.</span></div>
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<span style="font-size: large;">Unlike the Dex or Medtronic system, the sensor doesn't automatically give you your numbers - you have to wave it to get the data. This means there's no alert system if you're about to go low or if you're creeping up. The reader works through clothing, and it has a built in Freestyle meter as well.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3DuVmDuPydunlfRcgmiMyX-Gq0R81W8NeT-4Dbhxi-i64wUZJENn1wf13M5UtPki-pnpxkdD4kmpzilSuw4O4jPkLOdQMmeqsa0HYWyMWjTfdlxi5CW8a9BHuK2FL1F3aJ8f7jIMBX1Q/s1600/12hrs.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-size: large;"><img border="0" data-original-height="1600" data-original-width="900" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3DuVmDuPydunlfRcgmiMyX-Gq0R81W8NeT-4Dbhxi-i64wUZJENn1wf13M5UtPki-pnpxkdD4kmpzilSuw4O4jPkLOdQMmeqsa0HYWyMWjTfdlxi5CW8a9BHuK2FL1F3aJ8f7jIMBX1Q/s320/12hrs.jpg" width="180" /></span></a><br />
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<span style="font-size: large;">Journey to Libre</span></h3>
<span style="font-size: large;">I started my journey, of course, with insurance issues. When I first attempted to pick up the system at the pharmacy, they told me that insurance covered none of it. This was when it first came out in the US, in the beginning of 2018. It was also VERY difficult to locate a participating pharmacy that had it in stock. After a frustrating failed attempt, I spent a couple of months on the Enlite system, as it was covered by my new insurance. I did get some good data with this, but I went through too many inaccurate readings and failed insertions. My mind drifted back to the Libre. I decided to go through the company, and let them battle it out. They reached out to my endo to get a prescription, and went back and forth between her office, the pharmacy, and insurance. The system ended up being partially covered, and the out of pocket is less than the Enlite system for me.</span></div>
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<span style="font-size: large;">Bringing the Libre home was <i>super</i> exciting - at this point I'd heard more and more about how convenient and accurate it was, and was itching to try it out. I was especially excited to use it while <a href="http://diabetic-truths.blogspot.com/2018/02/running-while-diabetic.html" target="_blank">running</a>. I've been on it now for about a month, and am thrilled so far. The readings are accurate, I'm pricking my finger less, and I feel like a spy from the future every time I wave the reader and get hours of data. Not to mention I have the system decked out in gear from <a href="https://pimpmydiabetes.com/" target="_blank">Pimp My Diabetes</a> and <a href="https://www.etsy.com/shop/ShopT1Dchick" target="_blank">T1D Chick</a>. There are certain aspects of the system that I can see some people being hesitant towards, depending on their situation. Below I've detailed my pros and cons.</span></div>
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PROS</span></h3>
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<span style="font-size: large;"><i>Accuracy</i>: My libre is almost always spot on. I trust it, which is a big deal for me. Small discrepancies tend to happen when I'm rising or dropping quickly, like with most CGMs. </span><br />
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<span style="font-size: large;"><i>Size</i>: You cannot beat it in the size department. The sensor itself is roughly the size of a quarter and flat. The reader is tiny as well, even in a case. Because it's so flat to your body, it's harder to rip out on accident. </span><br />
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<span style="font-size: large;"><i>Duration</i>: Sensor change is every 10 days. Enough said. </span><br />
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<span style="font-size: large;"><i>Dual meter</i>: The reader can also be used as a meter with Freestyle Precision Neo strips. These strips are super convenient too- they're wrapped individually in foil so you can fold them up flat. I use them for when I'm running, at work, or need to carry less bulk. Then I don't have to carry my usual meter as well. </span><br />
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<span style="font-size: large;"><i>Cost</i>: Even with the lower rate of insurance coverage, the out of pocket still ends up lower than the Enlite for me. The original market price of the system is lower than other sensors. </span><br />
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<span style="font-size: large;"><i>Minimizes alert anxiety</i>: If you feel your lows and highs and aren't reliant on the alerts on the Dex/Medtronic, this can be a good option for you. I tend to have alert anxiety, in which I get alerted that I'm dropping or rising and tend to over-correct. The Libre eliminates this for me.</span></div>
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CONS</span></h3>
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<span style="font-size: large;"><i>No alerts: </i>If you <i>don't</i> feel your lows and highs, this system may not be ideal for you. While it's easy to scan and check your BG, you don't have the peace of mind that may come with the alert system.</span><br />
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<span style="font-size: large;"><i>Not technically "continuous"</i>: Because you have to scan the reader over the sensor, the system isn't <i>technically </i>considered a CGM. It isn't automatic - you have to put the little bit of effort into it.</span><br />
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<span style="font-size: large;"><i>Insurance</i>: Because the system is so new, it's less likely to be covered by insurance. Or if it is, it may not be completely covered. I anticipate that as time goes by and more people use it, more insurance companies will offer more coverage.</span><br />
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<span style="font-size: large;">Bottom Line</span></h3>
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<span style="font-size: large;">Bottom line is, if your insurance will cover it, I highly recommend trying it out. It's small, accurate and fun to use. My coworkers in the medical field are in awe of it. Plus, it's always fun to hear people guess what the heck is on your arm. So far I've gotten:</span></div>
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<ul>
<li><span style="font-size: large;">A penny (this guess was from a 3-year-old)</span></li>
<li><span style="font-size: large;">A radiation sensor</span></li>
<li><span style="font-size: large;">Miscellaneous crap stuck to my arm ("Hey, you've got something stuck there")</span></li>
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<span style="font-size: large;">We'll see what guess comes next...</span></div>
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Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0tag:blogger.com,1999:blog-8634304394534922110.post-14795405771966843972018-05-27T10:45:00.000-07:002018-05-27T10:45:00.174-07:00The Stamp of ComplianceIf you're a type one, you've likely accumulated a litany of diagnoses over your lifetime. Hashimotos, celiac, lupus, the works. They pile on, accruing in your chart over the years. Maybe this bothers you, maybe it doesn't. There's constant debate about the power of labels and how one's diagnostic label can help or hurt them if they over-identify with it. But the more time I spend in the medical field, the more I notice a label that doesn't seem to yield any benefit: <i>compliant. </i>Or, for our purposes, <i>non-compliant.</i><br />
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Over time, doctors need to monitor your diagnoses and how you are managing your health. But seeing <i>non-compliant</i> or <i>history of non-compliance</i> tacked onto a patient chart tends to create an image in a provider's mind before they even meet their patient. There is a level of judgement that inevitably occurs once your diagnostic labels include compliance issues. Much like words that we no longer use due to the negative connotation and derogatory nature they became so closely linked with, <i>compliance </i>is beginning to get a bit of a bad rep. Why? To start, let's look at the definition:<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxrNOXuGqPGH626pfdkjD5myzY68NyXzE53nzUx704ex_09TCV3xEfP9GALAKKHiXFvJH1orXGbbO7Ji6RG8yxMCjxg5sZx50prmeveWn7XgqWfC3yzWCIIAEEjbpzxqMF461hz-ROZVI/s1600/compliance.PNG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="289" data-original-width="610" height="151" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxrNOXuGqPGH626pfdkjD5myzY68NyXzE53nzUx704ex_09TCV3xEfP9GALAKKHiXFvJH1orXGbbO7Ji6RG8yxMCjxg5sZx50prmeveWn7XgqWfC3yzWCIIAEEjbpzxqMF461hz-ROZVI/s320/compliance.PNG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">source: www.dictionary.com</td></tr>
</tbody></table>
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<i>Obeying. Yielding. </i>Not exactly words I would appreciate being used towards me as a patient. "You must obey your diabetes regimen." I'm trying to live my best life, not surrender at battle in Winterfell. I've heard certain healthcare providers talk about a shift toward using the word <i>adherence</i>, which I personally think is better. The bottom line is, the word compliance has developed a stigma. To have such a strong label as a diagnostic tool on a patient's chart is a risky move. It becomes easy to say, "This patient is non-compliant. I better not get my hopes up. They're probably not doing what they're supposed to."<br />
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This label extends beyond diabetes - it applies to all chronic illnesses, whether it's ESRD, epilepsy, or asthma. It can be so easy to say, "Well, this patient's non-compliant. They don't want to care for themselves," when this may not be the case. There is another approach. When assessing patients and families I prefer to ask, "Are you able to take your medications/follow your diet/etc. as prescribed?" Asking from a place of non-judgement and not-knowing allows space for the patient to ask for help if they need it. Maybe they aren't taking their medication because their insurance doesn't cover it. Maybe they're struggling with an underlying anxiety or depression, or could just benefit from some educational counseling. Simply labeling someone as non-compliant and leaving it at that eliminates any possibility for improvement. And people living with chronic illness deserve a chance for improvement. Being stuck in a place where they are struggling to care for themselves doesn't have to be a place where they remain.<br />
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So what now? Other than <i>adherence, </i>what words would you prefer to have used, as a patient or as a provider? I am curious to know.Diabetic Truthshttp://www.blogger.com/profile/14282178715720431744noreply@blogger.com0