Twas the night before Christmas Eve....

I have my new Cozmo pump!

It came last week, after my insurance company finally agreed to allow me to get a new one since my warranty was up. Cross that off the list of things to press my insurance company for. I was a little sad that I had to change to a different color. This one is dark blue, my old one is more of an aqua blue.


A friend of mine had minor surgery this week. I took her to the outpatient surgery center and was the “responsible driver.” I brought my computer and a book to read. I didn’t get to read a single page. I spent the entire time in a waiting room with other people, who all wanted to sit by Dixie and me and ask all about her. Dixie was, of course, nothing but well behaved and delightful.

I sometimes forget about all of the attention she brings.

I am always pretty happy to talk about Dixie and explain to people about the job that she does. But sometimes I am just in a hurry, and give a short scripted answer. Many people want to tell me about their personal pet that has some unique ability to do something special. Mostly, people just want to share how much they love dogs, and how beautiful they think Dixie looks.

There is something special about the way she looks. The only way I can describe it, is that she is charming. She looks at people with her big, brown eyes, and carries herself with such confidence. It’s hard to ignore her.


I’m now officially on winter break from school. Dixie loves the last week of school. Many kids brought her presents, and she really appreciates all of them. The crinkle of a bag during this season sends her running. She thinks that anything in a small, paper bag is a present for her.

I’m heading to stay with family tomorrow (Christmas Eve). All the presents are wrapped and Dixie’s travel bag is ready to go.

Merry Christmas and happy holidays to everyone. May your blood sugar remain in the average range, and your pump sites stay viable.

Merry Woof-Woof!!

Winter snow and a healthy glow

It’s been a good week.

It's pretty and white outside. About 7 inches of snow have fallen in the last week. Dixie is thrilled! She loves being outside, tromping in the snow, and making "dog" angels.

I saw my endocrinologist last week. She did all the usual including looking through my logbook (on my computer!) and doing the sensation testing on my feet (passed with flying colors!) She called Dixie my “furry continuous blood glucose monitor.” She also ordered a bunch of labs.

I have mentioned this before. I.hate.to.have.blood.drawn! I seriously abhor it. I get squeamish just thinking about it. But I bravely made my way to the lab and waited for my name to be called. There were many people there, so it took a while. I watched the lab techs to decide which one I hoped would call my name. (I like to scope out the techs and watch their style.) I never get the one I want. But on this day, I saw the one I wanted and started thinking positive thoughts about her calling my name. It happened. Dixie and I followed her to the chair, and she asked me about what Dixie’s job was. I told her and then she said, “Hey, I have diabetes too” and whipped out her pump. She understood my fear, and was so nice about drawing blood. She got it on the first try, which always makes the whole process easier.

Anyway, I digress. I just got my lab results back yesterday. A1c= 6.3. I looked back at my old lab slips for the last 5 years, and that was the only result that wasn’t 6.4. I am pretty happy about it, though I really hoped that (based on my recorded numbers and averages) it would be 6.0. I guess the good news is that my A1c’s have been consistent for the last 5 years.

Other lab news. My endo tested me for a vitamin D deficiency. I asked if she wanted to test for that because she was seeing “symptoms” in me. She just said that it’s more common in people that live in states that have cold, sun-less winters. It’s also more common in people who don’t eat many foods that have high levels of vitamin D, or foods that are fortified with it. I don’t drink milk, don’t eat cereal, and haven’t slurped any cod liver oil lately. The test came back positive for a deficiency. I’ll head to the store this weekend to pick up some. My kidney function is normal. (creatinine and a/c ratio) My GFR is >60 which indicates healthy kidneys. Phew! My endo keeps testing my potassium, and I keep forgetting to ask why. It is always in the normal range—but are people with diabetes more likely to have problems with that? Guess I’ll have to ask next time. My cholesterol was fine, as well as my liver function (ALT). The other thing that she tested for was gluten sensitivity. Lately, I have been feeling icky when I eat a meal with a lot of gluten. I kind of thought that test would come back positive for gluten sensitivity, but it didn’t. I just know that I feel better when I really limit the amount of gluten I consume.

The other good news this week is that my insurance company has finally agreed to cover a new insulin pump! They originally said that they would only cover one (this year, as they report that new pumps are only covered every five years, even though pump warranties are only for four years) if a “catastrophic accident” happened to my current pump. The other way that they would cover it would be if my doctor would tell them that I must have a new (meaning different brand) pump to be in good control. I refused that route. I like my Cozmo, and am not interested in another brand. So all is good. A new pump will be shipped shortly.

A good week.

I’m getting a new pump.

I’m healthy.

It’s almost Holiday break at school.

Yahoo!

Seven

The Rules:

1. Link to the person’s blog who tagged you. (thanks Colleen! :-)
2. Post these rules on your blog.
3. List seven random and/or weird facts about yourself.
4. Tag seven random people at the end of your post and include links to their blogs.
5. Let each person know that they have been tagged by posting a comment on their blog.


MOLLY'S SEVEN:

1. In college, I worked a summer at Deli Express. Making sandwiches on an assembly line is a heck of a lot harder than you would think!

2. Growing up, I was so afraid of dogs. I would get low being around dogs because it was so stressful. Kind of funny to think of that now, since I spend 24/7 with a big, black dog.

3. My dad bought us gerbils when we were young to teach us responsibility. The last set of gerbils we had were three little guys that lived in a cage in the basement. We were supposed to be learning responsibility by feeding, watering, and cleaning the cage. One day I went down to feed them and the gerbils were gone! Apparently it had been a month since I had wandered down there. The gerbils had died. I won’t go into detail, but there was some cannibalism involved.

4. I love diet soda. There isn’t really a time during the day that you won’t see me near one. My favorite kind is diet mountain dew. I’ve been trying to cut back, because of all the bad press about diet soda. But I really don’t like non-fizzy drinks.

5. I was the first female bag girl hired at the grocery store near my childhood home. The uniform was a button up shirt and blue slacks. The manager asked me what my dress shirt size was. (Apparently he forgot that women don’t measure “dress shirts” the same way that men do)

6. I am the middle child in my family. My sister is three years older, and my brother is three years younger.

7. I used to be an assistant coach for a high school girls hockey team. I played hockey as a child (until I left for college) and LOVE the sport. I coached for seven years. I gave it up because it was becoming another full time job, on top of my teaching career.

DIXIE’S SEVEN:

1. Dixie loves furry toys with squeakers in them. She isn’t hard on them either…she is very gentle with even the smallest toys. If they rip, it’s because she likes to play “tug” with a person. The picture above is Dixie with her new toy at school.

2. Dixie’s favorite treat lately is “real chicken breast wrapped around a slice of apple.” (That’s what the package says) They also sell "chicken wrapped around banana" and "chicken wrapped around liver" and she likes those too!

3. She loves presents. The first holiday she celebrated at school, some of my students brought presents for her. She figured out that gift bags=good things. Now, whenever she sees a gift bag, she wags her tail and tries to put her head in the bag. She hasn’t really figured out that some presents aren’t for her.

4. She has a big dog bed at school that we call her “couch.” Kids love to lay in her couch with her for snuggles.

5. Dixie is afraid of paper or plastic bags that have groceries. She hates unpredictable noises and movement. It’s very hard for her to ride in the car after I’ve shopped. She is stressed the entire time. We’re working on some desensitization.

6. She caught and killed a rabbit at school. She was ecstatic. I was mortified.

7. Dixie loves having her low-back scratched. She will turn around and face her back end to people in the hopes that she gets a good scratch.


Dixie and I don’t think that there is anyone left to tag! If you’re reading this and haven’t been tagged “You’re IT!!”

Happy WDD!

O.k. So as you can tell, I was playing around with blogger today. I know the picture is huge at the top...I'm still trying to figure that out.

I still have not figured out coverage for a replacement pump.

My doctor wrote a letter of medical necessity. I talked to the corporate health benefits people. They told me that there was NO WAY that a replacement would be covered. The only exception would be if my current pump breaks. Then, it would be considered “medically necessary.”

Since I was dealing with the insurance company about the pump situation, I decided to bring up the glucagon issue again. I was transferred between 5 different people. Finally, I talked to the “caseworker” assigned to my claim. (let’s just call her Mrs. Notveryhelpful) I asked why my appeal never was approved. Mrs. N said that she just happened to be working on my claim the day that we talked. (hmmmm, I find that very hard to believe. That would be one hell of a coincidence!) She said that it was rejected. Again, I brought up the fact that it was covered last year. She was surprised by that. She jiggled around on her computer for a couple minutes and then said, “why, you’re right. It was covered last year, and should be covered now. It looks as though your pharmacist just coded it wrong. Tell them to submit it as an emergency kit.” I called the pharmacy and asked them to try resubmitting it as an emergency kit. The pharmacist said that she wasn’t sure how to do that. I gave her Mrs. N’s direct number and told them to call her directly. An hour later I received a call from the pharmacy telling me that the glucagon would be covered and ready for pickup in an hour.

I guess that I missed d blog day. I so love reading blogs of people who share this dam diabetes. And thanks to those of you who reply here, sharing kind words and/or giving me information. ☺

By the way... Happy World Diabetes Day.

The picture above is from last night. I poked my finger to test, and blood came out of an old poke hole. I hate when that happens. It makes me mad that I poked if I could have just squeezed my finger to get a drop. Of course you can see Dixie in the background.

Pump and stuff

My insulin pump warranty has expired. I have been happy with my Cozmo, so I sent the form to Smith Medical to start the process of getting a new one. I thought it would be simple. Then I got a call from the rep handling my case. It turns out that my insurance company will not cover a new pump for another year.

What. The. Heck.?!?!

Has anyone else had to tackle this battle with their insurance company? I’m not sure if it’s even worth the effort after the glucagon fiasco this summer. The company never ended up covering that.

Dixie and I just spent the weekend in New Mexico, to visit a friend who was celebrating a birthday. The flight went as smoothly as it did when we traveled to Atlanta in June. This trip we flew coach. We sat in the bulkhead seat so we had more room than in a regular seat, but it is still pretty tight traveling with a 60 pound dog. I had an ear infection, so that made the flying part uncomfortable for me. (in addition to my big anxiety about flying anyway!)

Dixie had a great time on Halloween. She ended up just wearing a simple costume. I found a furry green collar that had little stuffed bats sewn on to it. She didn’t mind it, and it looked like a costume. At school, we called her the “bat-mobile.” It made the kids laugh.

I loved Halloween as a kid. I know, I know… it should have been my least favorite holiday celebration. But my mom made it special. I went out trick-or-treating with my friends. When I got home, I turned the candy over to my mom. In exchange, she gave me a basket full of surprises. She would find little toys, cool looking fruit, and lots of sugarless gum and fill the basket with them. I never minded giving up the candy. Some of it was saved, and used for low blood sugars. The rest was given to others. A few neighbors would give me money or pencils—things that were diabetic friendly.

I have an endo appointment in a couple weeks. I'm not sure why I schedule these appointments except to get my prescriptions filled and a lab slip for an A1c. Don't get me wrong... I really like my endo. She listens to me and gives me as much time as I need. Which, to be honest, isn't a lot. I'm a rule follower. I go because I'm supposed to go. I hope for an A1c under 6.0. (most likely isn't happening. A realistic hope is for 6.4 or less.) All these years living with diabetes and going to endo appointments, and I still get worried for weeks before my appointment.



DIXIE TIDBIT:

Dixie really loves looking out the window on the airplane, especially during the taxi part of the flight. This was a problem because I only like to travel in the aisle seat. Fortunately, the man sitting next to the window on the way back LOVED dogs and invited her (after asking for my approval) to put her front paws on his lap and look out of the window. She was in heaven.
Dixie and I met up with a woman that we know in New Mexico who has a service dog that alerts her to sounds. (she is hearing impaired) Dixie had fun meeting up with another working dog! I'm sure that they talked to each other about their jobs--comparing notes. :-)

(The picture above is of Dixie and her new friend. Notice how much harder it is to get a good picture of a black lab, versus a yellow lab!)

October decisions

My life has been crazy since my last post.

I’m super busy at work. Too many kids, not enough time to help them all.

Here’s what’s on my schedule of things to figure out right now:

1. Dixie needs a Halloween costume for school. Two years ago, she was a clown. Last year, she was a skunk. She doesn’t really like things that attach to her head, as most “dog costumes” in stores seem to require. The skunk costume was perfect—all I had to do was spray some white hairspray on her back. I guess that she could be a zebra and I could spray lines all around her, but the hairspray takes a while to come off, and she’d have lines on her until July. I need an idea for this year. Anyone?

2. My Smith Cozmo pump warranty expired. I got the form filled out to get a new Cozmo, but then I started thinking. The new pump that I get will be mine for four years. That's a long term commitment. Should I be exploring other pump options? I’m not sure how I feel about the Omnipod—it seems so obtrusive. I don’t want a Minimed pump. I know, I know, I could be continuously monitoring my blood sugar with their pump. I just don’t like the company. That leaves Animas and Accucheck as the other major competition. I like my Cozmo. I like Smith Medical as a company. Does that mean that I just get another Cozmo? How do other people choose their pump?

3. I’d like a new job. Working in public schools is depressing. Public schools are broken. It’s becoming darnright impossible to do what’s best for kids. And, what you ask, keeps me tethered to this job?? The health insurance part. I hate diabetes for that.

4. I need to figure out some low carb breakfast options that can be eaten in the car on my way to work. I sleep as late as I possibly can. I shower and dress like a frantic maniac so that I can get out the door. I never “cook” breakfast. I rely on breakfast bars, dry cereal, or other carby items. I don’t like the protein bars. The texture makes me gag. I have found a microwaveable pita and egg sandwich that is pretty low in carbs. (18g) I need some new ideas.


DIXIE TIDBIT:

Dixie and I are starting to work on the “bring me” command. I’d like to teach her to bring me a little bottle of Gatorade when I’m low. She has GU in her vest, but she doesn’t wear her vest at home. I was thinking of putting several little bottle of Gatorade in a basket on the floor. (I can’t use juice boxes because Ella, my rat terrier, would chew them up)

Dixie likes learning new things, so I bet this will happen pretty quickly.

Diabetes Dreams

Molly’s Top Ten Diabetes fantasies:

1. Eating a carbohydrate-laden snack without caring what the carb value is, what kind of bolus to give, or when I’ll need to test next to find out if I gave the right amount of insulin.
2. Taking a shower without a quick set sticking out. And it doesn’t count to take a shower without the quick set because it’s infusion set change day. I want to take a shower not thinking of where to attach it next.
3. Having pre-filled insulin cartridges. (for you Minimed users—that means filled reservoirs) I get so sick of filling those things up. I always need one filled at the most inconvenient times!
4. The calluses on my fingertips melt. That way I would be able to use depth setting 1 on all of my lancet devices like all my non-diabetic friends are able to. (when they ask eagerly if they can try testing, and I have to change it to #1 and they bleed profusely. I have it on 3 and barely can get a drop sometimes.)
5. Not worrying if a pair of pants has pockets on both sides to put my pump in, depending on what side of my body the infusion set is in.
6. Going on a camping/canoeing trip without having to stash GU packets in every backpack; without having to think which side of my stomach to put the infusion set in so that it won’t rip out when I throw the canoe up over my head; without having to pack excessive food “just in case” I’m low a hundred times; and not having to bring every diabetic supply under the sun. (infusion sets, inserting device, quick acting insulin, syringes, test strips, alcohol swabs, lancets, ketostix, back up blood glucose meter, long acting insulin, and pouches to keep them all waterproof and temperature controlled.)
7. Being able to take a nap because I’m sleepy without wondering if I’m sleepy because I’m too low or too high, or dropping.
8. Using the bathroom without thinking about how far I can pull my pants down (with my pump in the pocket of my pants) without pulling my infusion set out, or without having to figure out what acrobatic act I need to do to get my pants down without ripping out the set in the first place.
9. Drinking whichever soda appeals to me when I go to a convenient store to grab a cold one. There are more choices of diet soda than ever before, but never the kind that looks so good when I’m standing at the case. (…like Tahitian Treat. Man, I’ve always wanted to drink that)
10. Having a poke free day. No testing, no set changes.

DIXIE TIDBIT:

Dixie’s fantasies:

1. Molly listens the first time that I alert her, and not 10 minutes from the time I start pawing at her.
2. More time at the leash free park. Man, I love to run!
3. Liver. I love liver.
4. More camping trips. They are so fun.
5. A bigger back yard. See #2.

Happy Anniversary Camp Needlepoint!

(Dixie at Camp looking for squirrels)


Saturday was the 50-year anniversary celebration for Camp Needlepoint.

Camp Needlepoint is the ADA- Minnesota camp for kids with diabetes. (don’t laugh at the name. Apparently the other name that was almost selected fifty years ago was Camp Dipstick!) It’s held every summer at Camp St. Croix, in Hudson, Wisconsin the last two weeks in August.

I started going to camp in 1977, and was a camper every summer until 1985. In 1986, I was a counselor in training. In 1987 I became a counselor. In 1993, I became part of the administration staff. Camp was a huge part of my life. I loved it there.

Dixie and I were there for the reunion. My mom came too. We wouldn’t have missed it.

We had a great time catching up with old camp friends, medical personnel, etc. that I hadn’t seen for years.

My mom cried looking at old pictures of my friends and me. She took pictures of us. I shared memories and stories with her. We watched a video of pictures from the last 50 years. She cried during the video—especially when she saw pictures of little me. She would lean over to me and say, “camp changed your life.”

It did. I grew up there.

I gave my first insulin injection in Cabin 7 when I was eight years old. I met other people with diabetes, some who are lifelong friends. I canoed, I camped, I rode a horse (BUT only once because I am afraid of horses. Always have been. I rode the horse once, but had to get off early because my blood sugar was low from being so scared!) and I learned from other kids with diabetes. I wrote letters to friends after camp was over every summer saying “only 380 days until camp!” It was the one-week of the entire year that I was in the majority.

It was an amazing place, and it was special to have been able to be there to celebrate camp and all that it gave to me.


DIXIE TIDBIT:

Dixie was a little confused at camp.
She alerted me many times during the day. Not because I was low, but because someone around me was low.
When we got home, she crashed. I’m sure that, even though the camp part was fun, she was exhausted from keeping tabs on everyone with diabetes. :-)

Weekend chaos

(Dixie and Ella resting in the BWCA)

I’ve been struggling with my morning blood sugars since I’ve been back at work. That means that for the last three weeks, I have been waking up higher than I like to be. I’ve gradually increased my overnight basal rates, even though I’m not sure why on earth they suddenly need to be increased.

I decided to do middle of the night testing over the weekend to find out where the problem was happening, since I refuse to do it during the workweek and I don’t have a snappy Dex Seven to easily guide me.

I go to bed on Friday night around 11pm. Blood sugar is 112. I wake at 2:30am. Blood sugar is 200ish, but I changed my site before bed and knew that would happen. I give a correction. I decide, in my sleepiness, not to wake up at 4am. Dixie gets me up at 9am and my blood sugar is 48.

Saturday afternoon, I went to lunch at Fuddruckers. (A hamburger joint) I had a burger and fries, and a couple glasses of diet cola. I had tested 82 before lunch, so gave a regular bolus, no correction. Dixie was pestering me all through lunch. I didn’t have a tester with me (argh!) and didn’t feel low, so I just ignored her.

Bad idea.

I did some shopping and then went home. I was feeling horrible. I tested the minute I walked in the door.

328.

WHAT?!. I gave a serious correction. Tested 45 minutes later. 320. What the heck. I checked my infusion set, pump, etc. All seemed fine. My pump site was new. I wasn’t changing it.

Then it came to me. It was the pop at lunch. I KNEW that it wasn’t diet. I drank several glasses. Crap.

At this point I decided to bolus for the bazillion carbs I had consumed in regular soda. I guessed at 70 carbs. I never drink regular soda. Ever. So I didn’t even know what the actual carb value was. All I knew was that I was feeling horrible.

Test another ½ hour later. Down to 305. Another correction. (You can probably guess where this is going to put me in a couple hours.)

Four hours later I was 28. I tested twice. 28 again. This would have been a super time for the dang pop that I had earlier. Instead I had powerade and cookies.

Saturday night I decide to check the basals again. (Obviously still brain damaged from the highs and lows of today…what was I thinking?! This wouldn’t be a great night for checking.) But, I woke up at 2:30. BS= 108. Sweet. Got up at 8:30 the next morning. BS=160.

I turned up my basal rate last night between 4am and 6am, and went to sleep hoping for good things.

It’s amazing the smile that I can get from looking at the Freestyle, in the dawn of morning, with a simple 78 on it.


DIXIE TIDBIT:

Dixie would like me to mention that she tried to tell me that there were problems in the restaurant, but I wouldn’t listen.

I should have.

Sorry Dixie!

Pencils, books, and teacher's dirty looks

School is back in session.

It’s bittersweet. Summer is over. But it’s fun to see the kids. It’s especially fun for Dixie who loves her boys, and spent the summer without seeing them. She had some fun reunions last week. But it was a hot week. Temperature highs in the 90s, and a school without air conditioning. Not a good combination.

The beginning of school always brings crazy blood sugars. It’s always a time that I have to tweak my basal rates and readjust my carb ratio. I like to wake up in the morning with blood sugars in the 65-80 range. If I’m higher than that, I feel so sluggish to start my day. This week I haven’t had one blood sugar in my target range. So you can probably guess how my mornings have been going.

Back up to Labor Day weekend. After fighting with my medical supply company for a half an hour, they agreed to Fed-ex overnight me ONE Deltec cartridge. (because heaven knows that I can’t possibly really need more than that. I must be trying to “fool” the system!) My friend, Scott, very kindly offered to share one of his with me if the Fed-ex order didn’t come before I needed to leave for my trip. What a guy! Thanks Scott.

It was great to get back to the BWCA. It was just the kind of relaxing that I needed before starting school. I sat on a little beach at the campsite and read a good book, took pictures, and stared at the waves and clouds. We made trail pizza and hot pots of soup. It was peaceful and wonderful.

You may remember my post about glucagon and that my insurance company (prescription coverage) wouldn’t pay for it. It was submitted to my medical insurance and they also have refused to pay. I am so frustrated. I know I should be calling the company and fighting it, but I don’t want to.

I’m sick of dealing with people at companies who don’t have to spend their days living with diabetes. I’m sick of having to justify why I might need a couple extra test strips or a few more cartridges for my pump. I’m just sick of it. It’s one thing to live with diabetes and all the frustration that it brings trying to manage the disease…but it is too much, on top of that, to have to deal with insurance companies, claim personnel, and medical supply companies.

Yes, I know, be thankful that I have good health insurance. I am.

I just dream of things being simple.



DIXIE TIDBIT:

Dixie is certainly happy to be back at school, although it seems like she wishes that summer vacation had lasted longer. After she goes outside for her lunch break, she is reluctant to come inside. It’s as if she’s saying, “Hey, it’s great out here. Sunny, warm, and there is so much to smell. Come on, we were outside all summer. Don’t make me go back in that school!” It takes us both a while to get back into the routine.

Cartridges woes

When I was in the BWCA a couple weeks ago, I decided to half fill my pump cartridges, so that I wouldn’t heat up the entire 300 units of insulin day after day living outdoors in the hot sun. Seemed like a good idea at the time.

Yesterday I realized that I only had one cartridge left in the box. O.k., no big deal. My medical supply order from the company in Florida was scheduled to come on Wednesday. Last night I filled the last cartridge and put it in my pump. When I screwed on the luer lock for my quick set, I heard a click. Hmmm, that was odd. Never heard that sound before. I didn’t really investigate the noise.

I went to bed about 10:30pm. I woke up (I think because it was raining so darn hard) at 1:47am. I felt horrible. I grabbed the tester and poked. 367. WHAT??? I remembered the click sound, and so disconnected my quick set and primed the line. Nothing. No insulin. It pooled up around the top of the pump. CRAP! I didn’t have any cartridges left. The one in my pump was apparently broken, and I was high as a kite. (with small ketones, might I add)

I did the only thing that I could think of. I took my used cartridge from the garbage can (where I had thrown it hours earlier, minus the screw on top), wiped it with alcohol, and filled it up again. I put it in my pump and gave a gi-normous corrective bolus.

I called the medical supply place today. The woman tells me that my order had a problem with UPS, and that it wouldn’t be coming until Friday. I calmly explained the contaminated cartridge I was currently using, infested with probably more bacteria than I’d really like to know about. She put me on hold for 20 minutes, trying to pass me through to the “diabetes division.” After the 20 min, she came back on the phone to ask me to give her my number so that she could have a rep call me. THEY NEVER CALLED. I called and sat on hold again, ending up having to hang up to head to a training that I needed to give at a local summer camp for environmental education staff.

So here I sit. Contaminated cartridge of insulin pumping into me, germs and all, without a replacement en route.

I leave for the BWCA at 4am on Thursday morning. Gotta figure out something by then.

I’ll have to get back on the phone tomorrow and offer to sell my soul in exchange for one lousy, overnight-aired, cartridge.

Dam diabetes!

32 years and still going strong!!

32 years ago today I was diagnosed with Type 1 diabetes.

My mom took me to my pediatrician for my “entrance to first grade” physical. They did a urine test. The doctor told my mom that she needed to take me to Minneapolis Children’s Hospital so that the diagnosis could be confirmed with a blood test. The clinic that I went to was so small that it didn’t have it’s own lab.

I remember riding in the car, and my mom telling me “…if you’re good for the blood test, we’ll stop on the way home for a chocolate ice cream cone” at the local drugstore. (a big treat!) They did the blood draw and we waited for the results. I don’t remember much after that. I guess they told my mom that I had diabetes and that I would be admitted to the hospital for education, etc. (for 5 days! Imagine that.) My mom called my dad to tell him, and later that night, he punched a hole in our bathroom door out of frustration and sadness. I don’t know what my blood sugar was upon admittance. I’m sure that it wasn’t much higher than 200. I didn’t feel sick. I hadn’t been losing weight. It was caught early. I didn’t actually start taking insulin for about a month after diagnosis. I must have been in the “honeymoon” phase. Too bad this was so long ago, or the honeymoon period could have been lengthened. For a six year old, this was pretty crazy. I was hospitalized and taught to check my urine; my parents learned how to give injections, and how to help me follow a meal plan. But I felt FINE!

I never got the chocolate ice cream cone.

When I finally started taking insulin, I took one injection each day, in the morning. I didn’t start taking a second injection until a year or two after my diagnosis. I tested my urine four times a day, attempting to void ½ hour before the actual test. I learned to pee on command.

I remember my mom packing my lunch and snacks for school. She sewed little pockets in all of my shorts and pants so that I could carry a pack of lifesavers wherever I went. (this was WAY before glucose tabs and gel) Sometimes I would come home from school with a couple missing lifesavers. My mom would ask what happened and I would tell her that I had “a little reaction.” (the rule was to eat 7 lifesavers when I felt low. Sometimes I just wanted a lifesaver or two, so I came up with the “little reactions.”) I went to the nurse’s office every day before lunch so that I could pee in a cup and the health aide could test it. She would write the test value (Negative, Trace, +1, +2, +3, +4) on a little sheet of paper for me to put in my backpack. I followed a “meal plan.” I still remember the plan. Breakfast was 2 breads, 1 fruit, 0-1 fat, 0 vegetables, and 1 milk. There was no exchanging—if I was supposed to have 1 milk, I couldn’t switch and have an extra “bread exchange.” I put Sweet -10 liquid saccharin on my breakfast cereal and used it to mix with unsweetened kool-aid. If I was hungry between meals, I could choose a snack from the list of “free foods.” All those foods sucked. Rhubarb (raw), pickles, raw veggies, 1-tablespoon ketchup, or 1 tablespoon whipped topping. Seriously. Can you imagine telling your hungry 6 year old to choose one of those yummy snacks?! Does a picture of a little kid chomping on a stalk of raw rhubarb fill your head?! As you might imagine, I came to love pickles.

I started going to Camp Needlepoint. The counselors and medical team used to carry pouches of sugar cubes. You would get 4 big ones, or 6 small ones if you were low. (I don’t know how they checked if you were low…I don’t think I ran off to the bathroom and tested my pee every time I felt low…) I learned to give my own shot there when I was 8 years old. The last day of camp that summer, they called my name and I got to stand on a bench while the entire group in the dining hall clapped for my accomplishment. I remember that. I was one of the few kids that were taking two shots a day. Most were still only taking one. I was pissed about that. I remember standing in line at the bathroom before meals waiting to urine test. My friends and I used to just dip our diastix in the toilet water at bedtime snack time, (to ensure a negative reading) so that we would get to have more smunchies. (a favorite bedtime snack. Sugar free Chocolate pudding mixed with peanut butter, a dollop of whipped cream on top, then frozen between graham crackers. They were the bomb—at least back then they were. Compared to the rhubarb, smunchies were the Taj Mahal.) I remember the introduction of glucose tabs. You know the ones. Those big, white BD suckers. I still gag at the thought of those. I choked down more than I care to remember. I was a camper, a counselor, and an administrative member. I spent 20 of my summers at camp. I grew up there.

Diabetes is part of who I am. I don’t remember living without it. I got an email from my mom last week.

“Oh how I admire you, Molly, for all the years of everything you have had to endure...you are my inspiration. No words can say how proud of you I am.”

I don’t feel like I “endure.” If I had been diagnosed later, perhaps I would have a different feeling. Maybe I’d remember how much easier life was before my diagnosis. But I was just a little kid, and this just seems like the way life is to me.

I’ve met many cool people because I have diabetes. I have a really awesome dog because I have diabetes.

So raise your glass today (a diet soda or calorie free beverage will do, although I’ll certainly be having a cocktail!) to celebrate.

32 years with diabetes, with only a little hypoglycemia unawareness to show for it, is a pretty DAM good reason to celebrate.



DIXIE TIDBIT:

Today, Dixie is secretly thinking that how happy she is that I have diabetes, or she would not be in my life. And secretly, I’m thinking the same thing too. ☺

We're back!

I am back from the Boundary Waters Canoe Area. What a great trip!

It’s hard to put in words, the experiences that we had.

There were quiet mornings, sunny afternoons, and loons calling. We lay in the tent listening to morning birds. We cooled down by jumping in the cold water. I watched the sunrise and the moon appear. We loved sitting in the breeze reading Harry Potter out loud. We ate steaming bowls of soup made on a little stove. We munched pistachios and drank sugar free kool-aid while sitting on the shore of a lake listening to waves roll in on the rocks. It was bliss.

I ended up bringing my expired glucagon, as my prescription was not approved. Apparently it is now in the appeal stage, and I will be notified in another 30 days if my health insurance will agree to cover it since the prescription coverage will not.

I brought two new meters (Freestyle Lite) that my friend from Michigan brought with her, courtesy of her friend that works for Abbot. I liked the bright light and the bigger numeral display. Otherwise, it isn’t much different than the Freestyle Flash. It does use different strips that she also brought for me.

On the third night, we headed into the tent, tired from the day. Each night that Dixie entered the tent she crashed hard. Living outdoors was exhausting for her. That third night, around midnight, I awoke to scratching. Dixie was still laying on her thermarest, but had one paw extended and was hitting me. I tested and was 42. I opened a zip lock baggie and got out two GU packets. I ripped open the packages and slammed them. During this time Dixie rolled over and went back to sleep, as if saying, “my work is done.”

It was very hot and humid, and I had a harder time keeping pump sites in for more than two days. Many times during the day, and especially after a portage, I lifted my shirt to wipe sweat from around the site and to check its integrity. I usually fill my Cozmo cartridges the whole way up. (300ish units) For the trip, because of the heat, I only filled them halfway. I kept the spare cartridges in a Frio cold pack that worked marvelously. I had also purchased a Frio pump pack, and kept my entire pump in that during the hot afternoons.

So what were the challenges of the trip? Black flies that bit and bit and bit. (especially around the ankles) Long portages (a mile at a time) carrying a canoe over my head. Hot nights in the tent, trying to get comfortable. (most night it was too hot for a sleeping bag so we just slept on our sleeping pads) Falling while carrying the canoe, landing with it on my head, and spending the rest of the day with a headache. But even with those things, it was incredible.

I’m already thinking about my trip next summer. ☺



DIXIE TIDBIT:

Dixie loved the trip. She sat on top of the food pack in the canoe, and her sniffer worked overtime. She did a great job, not only in the canoe, but also on the portages.

The flies really got to her. She had a couple of afternoons of swollen bumps around her eyes and on her snout, but nothing that a couple doses of benadryl didn’t remedy. She was a trooper.

If I haven’t mentioned it lately…. Man, she’s a good dog. The best.

Argh!! Insurance company!

I leave on Monday for the BWCA. I am nearly ready.

The food pack is almost ready. I have packed all our meals in individual zip lock gallon bags. Each bag includes all the food and condiments needed for the individual meal, as well as a couple paper towels (for clean up) and handi-wipes. Breakfast is in one sack, lunch in another, and all the dinners in a third stuff sack. Snacks are in their own stuff sack.

The equipment pack is ready. It holds the tent, first aid kit, water filter, and small miscellaneous pieces of equipment. (duct tape, sun shower, rope, etc.)

We will have two personal packs. Two people will share each pack. These packs will include sleeping bags, headlamps, personal gear, clothes, diabetes supplies (in both packs for safe keeping) and entertainment. (Aka: the new Harry Potter book that will be read aloud each day)

I called my doctor for a glucagon refill. I went to pick it up early last week. (I wrote about it in my last entry) The short version is that is wasn’t covered by my insurance company because it is a “diagnostic aid.” My doctor filled out an exemption. I got a letter on Wednesday that said “…your claim is: denied. Reason: other.” I called the insurance company and asked what “other” meant. A rep. told me that glucagon is a diagnostic aid and their company does not cover diagnostic aids. I asked this man if he knew about the BWCA. He said yes. I said that it would be far more costly to have to pay for me having to be airlifted out of the wilderness than to cover the darn glucagon. (I know, I know, it wasn’t very nice to say…but I was really FRUSTRATED by that time) It seems so absurd. I have been getting glucagon prescriptions filled since I was six years old. Suddenly my insurance that covered it last year won’t cover it.

I looked up glucagon on the Eli Lilly site. I guess I never knew that it had another use other than for severe hypoglycemia.

This is listed on their site under indications for glucagon:

For use as a diagnostic aid:
Glucagon is indicated as a diagnostic aid in the radiologic examination of the stomach, duodenum, small bowel, and colon when diminished intestinal motility would be advantageous. Glucagon is as effective for this examination as are the anticholinergic
drugs.

My doctor is making one more attempt to provide documentation that this prescription will be used for hypoglycemia and NOT as a diagnostic aid. She sent a new form on Thursday. As of today (Saturday) it is not covered.

I’m planning to take my old glucagon that expired in June 2007.

Here’s hoping that I won’t need it. Chances are good since I haven’t needed it for the last 19 years.

I can’t wait to leave.

Monday morning I’ll be off to the great NorthWoods. What a great way to spend your birthday. Mine is that day☺!



DIXIE TIDBIT:

Dixie is all packed.

She has her pack full of food (I dehydrated meat patties for her to eat—a mixture of turkey, cooked brown rice, egg, baby food carrots, fish oil, and bone meal) She also has a bag of dehydrated chicken and cookies.

There are aspirin and benadryl in the first aid kit for her.

She will sleep in the tent on an old thermarest pad.

I have her lighted collar and back up leash.

She can’t wait to go.

Getting Ready

I’ve been busy getting ready for my yearly BWCA trip. It is my big vacation. It is the place where I feel the most powerful and grounded.

For those of you who aren’t from Minnesota and aren’t familiar with it, the Boundary Waters Canoe Area Wilderness (BWCA or BWCAW, sometimes referred to as the bee-dub) is a 1.09 million acre wilderness area within the Superior National Forest in northern Minnesota and is under the administration of the U.S. Forest Service. The BWCA is renowned as a destination for both canoeing and fishing, and is the most visited wilderness in the United States. Motors are not allowed, so the only way around this vast wilderness is paddling in a canoe. (or kayak)

I’ve been going to the BW since I was a kid. My dad introduced me to it, taking my siblings and me as little kids and teaching us how to love that place. I am the only child to continue the adventures as an adult. Every summer for the last 12 years, I have gone with a group of women and spend a week there. The group changes each year. There are three of us that are the “core” group, and we bring another 1, 2, or 3 women each summer. This summer there will be 5 of us going, as well as Dixie.

There are “entry points” on the eastern and western side of the BW. A permit is required to enter at these points during the summer. I apply for our permit in January. As it is a protected wilderness, a limited number of people are allowed to enter at each point every day.

The trip that we take involves moving every day. We pack up our sleeping bags, tents, and equipment each morning, and journey to a new lake and new campsite. Campsites are designated by red dots on the maps, and include a fire grate and a box latrine. Some days our journey is long, other days it is medium. We paddle the length of lakes and then unload our canoes and carry all of our packs and canoes over a portage to another lake. Sometimes we do 8-10 portages/lakes per day. Some portages are quite short—30 feet. Others can be up to a mile or mile and a half long. The paths are primitive and are challenging with elevation changes, rocky and uneven paths, swamps, and/or thick brush and trees.

We drink water from the lakes, sometimes using a water filter, and sometimes just dipping our cups in the middle of large lakes. We eat dehydrated foods, and cook over a stove fueled by tiny propane tanks. We swim, we see animals, and we have peace and quiet.

Having diabetes happens to complicate this adventure.

I pack insulin in Frio pouches to keep it cool. I bring long acting insulin and syringes in case I have a pump malfunction. I require all members of the group to carry GU for me. I test tons. I check my blood sugar every night before we hang our food pack in a tree, just in case I’m low and need to have a quick snack. I’ve gotten low before, when the pack is already up the tree, and it’s a pain to have to untie and get it back down. I pack all the food, and I’m always guilty of packing way more than we need. It’s the diabetic in me—worrying about whether there is enough to keep me safe. I change my pump sites with the aid of friends holding pieces of equipment so I don’t have to put delicate supplies on the ground.

I emailed my doctor earlier this week asking her to call in a refill for my glucagon and levemir prescriptions. (and directions of how on earth to dose levemir) For safety, I always bring two glucagon kits. Being 20 miles by canoe from the car, and another 30 miles from a town requires preparations like that. I went to pick up the meds, and the pharmacy tech said “that will be $172.67.” What!?! My copay is $14. That can’t be right. The pharmacist came over to tell me that it wasn’t covered because it was deemed a “diagnostic test.” What?!? I told them that I didn’t want it if I had to pay full price. I called the insurance company today. The lady on the other end said that my insurance wouldn’t cover “formularies.” (meaning “name brand”) I asked her what the generic equivalent was. She said that there wasn’t one. Hmmm, then why wouldn’t it be covered. She told me that I needed to call my doctor to get a “formulary exemption.” Seriously. What a joke. Needless to say I sent another email to the doc today asking for that exemption. I’m going to be in the wilderness, for crying out loud. Far away from medical care. It’s not a luxury item.

Sigh.

The good news is that I leave for the trip on my birthday. What a great way to celebrate.


DIXIE TIDBIT:

Dixie will be coming on the trip. She likes riding in the canoe and sleeping in a tent. Let's be honest... a dog living in the wilderness for a week. It probably can't get any better for her.

Last summer, on the sixth day of our adventure, Dixie ran off (she wasn’t on a leash) midway through a portage. When we realized that she was missing, it started storming like crazy. We called and called for her. We ripped through the woods trying to find her. She didn’t come.

It got late and my friends told me that I had to go to a campsite and continue the search the next day. I don’t really even remember how I paddled away from that portage. I layed awake that night, praying that I would find Dixie, praying that I wouldn’t have to leave her to die alone.

The next morning four of us went back to the portage and continued looking. Two other women paddled their canoe around the big lake looking for her. A couple hours later, their canoe pulled to the portage where I stood, and Dixie was in the middle of the canoe. She was exhausted and covered in scratches. She had traveled over six miles and was found by a counselor working with Voyageur Outward Bound campers. It was a miracle.

Dixie will be on a leash the entire time.

But, as you can probably expect, I am nervous about it.

(The picture above is Dixie and me finishing a portage last year. She has her pack on that she carries her food in, and I have a canoe above my head with a pack on my back.)

A bunch of firsts

Dixie and I had a safe journey to and from Atlanta.

It was a pretty smooth trip. Dixie did great on her first airplane trip. On the way to Atlanta I sat next to a nice fellow. He was really kind. Helped me get my stuff in the overhead compartment. I asked if he knew that there would be a dog next to him and he said no. I asked if he was o.k. with that and he said “Yes.” Dixie was very mellow. She was most anxious during the taxi on the runway part of the flight. She put her front paws on my lap and hit her snout in my armpit. There were two men behind me who were very kind. They asked if I would let Dixie back to visit them. She was as interested as they were, so I let her go back to them. The two men took turns petting her. Then she crawled under the seat and layed on my feet the rest of the trip.

I have to say that flying first class is nice. It’s like going to a spa and being pampered. I had a lovely salmon and field greens salad, along with a tiny container of Ben and Jerry’s ice cream for dessert. (Yes, it had the carb value on it. And yes, I ate it.) The photo above is of Dixie in seat 1-A. She had hoped to sit in the seat during the trip. I snapped the photo before she moved to the floor.

We arrived in Atlanta, picked up my luggage and went outside to the shuttle. The shuttle driver wouldn’t let us ride because she said, “dogs have to be in cages.” Two managers later we hopped aboard.

Dixie had her first plane ride, first shuttle ride, first taxi ride, first major league baseball game, (Atlanta vs. Washington) and first bus ride. I’m so proud of her. She was a trooper.

I appreciate Minnesota nice so much now. I had so many people in Atlanta scream in fear of Dixie, refuse to ride elevators that we were in, and restaurant owners tell me that I couldn’t come in their restaurant with a dog. (again, several managers later and I eventually was able to enter) It was a pain. Kids came up to me several times and asked if Dixie bites. I’ve never been asked that before.

I left Atlanta on Thursday. I went through security, and Dixie set off the alarm. (like she had in MN. There, they escorted us aside and patted her down) A man asked me to step into a “waiting area.” This was like a glass hallway with a locked door. I waited about 10 minutes. Finally a woman came over and opened the door and grabbed me by the arm to lead me to a chair. She told me to sit. She said “raise your left arm.” I did. Another guy came over and started to pat down Dixie. I asked the woman if she could wait a minute so that I could focus on Dixie while she was being patted. The woman said “NO!” The process took another 5-10 minutes. (it felt longer) It was humiliating.

We boarded the plane back to MN. The pilots asked if she could stay with them during the flight. The man next to us was really nice and said that he had a couple labs at home. Dixie was more anxious during the return flight. I wasn’t feeling particularly well, so I thought maybe that was why. We both slept most of the trip. The flight attendant brought Dixie a pillow. ☺ Nice people.

I got into the MN airport and a friend picked me up. I was feeling pretty horrible. Got home and took my temperature. 101.7. No wonder I felt so bad. I had a cold, and spent the entire weekend resting. I’m still not over it yet. When Dayquil is on board, I can keep my temp around 99. Ugh. Aren’t colds supposed to happen during winter? A summer cold?! What the heck. Fortunately it hasn't caused much havoc with my blood sugars.

It's good to be home.

The summer begins

It's been a nice start to the summer. Dixie and I had a couple of days to relax, and then started working at a summer camp for kids with sensory processing problems. We've been busy commuting back and forth every day for the last seven days. We leave for Atlanta on Sunday and have started to get ready for that trip.

So here's my answers to the current meme going around.

THREE NAMES YOU GO BY:
1. Molly
2. Mol
3. M

THREE PHYSICAL THINGS YOU LIKE ABOUT YOURSELF:
1. My hair. Same as my dad…it’s thick.
2. My cheeks. Good color
3. My feet. (docs always tell me how great they look. So does my massage therapist)

THREE PHYSICAL THINGS YOU DON'T LIKE ABOUT YOURSELF:
1. My weight
2. My height
3. The scars all over my stomach from years of pumping.

THREE PARTS OF YOUR HERITAGE:
1. Swedish
2. Irish
3. Not sure what else.

THREE THINGS THAT SCARE YOU:
1. Doing new things by myself.
2. Possible complications from diabetes.
3. Flying.

THREE OF YOUR EVERYDAY ESSENTIALS:
1. Insulin (with dexamethasone so I don’t have an allergic reaction to it)
2. blood tester
3. low food (Gu, airheads, fruit snacks)

THREE THINGS YOU ARE WEARING RIGHT NOW:
1. rubber ducky lounge pants
2. My insulin pump and groovy patch
3. Glasses

THREE OF YOUR FAVORITE MUSICALS:
1. Oklahoma (only because I had a part in the high school play)
2. Joseph and the Amazing Technicolor Dreamcoat
3. I haven’t seen Mama Mia… but I was around Abba music as a kid, so I bet I’d like it.

THREE OF YOUR FAVORITE SONGS:
1. Closer to Fine
2. Suddenly I see
3. Accidentally in love

THREE THINGS YOU WANT IN A RELATIONSHIP:
1. Love.
2. Laughs.
3. Passion.


THREE OF YOUR FAVORITE HOBBIES:
1. Hanging with Dixie.
2. Canoeing and camping.
3. Softball.

THREE THINGS YOU WANT TO DO REALLY BADLY RIGHT NOW:
1. Go to the BWCA.
2. Eat something without having to calculate carbs and give a bolus.
3. Sit in the hottub.

THREE CAREERS YOU'RE CONSIDERING:
1. None really… As I’m off for the summer, my job seems great now. ☺
2.
3.

THREE PLACES YOU WANT TO GO ON VACATION:
1. Alaska.
2. the BWCA.
3. any hotel where I can get away from home, forget about daily life, and relax.

THREE KIDS NAMES YOU LIKE:
1. Zachary
2. Josiah
3. Katie

THREE THINGS YOU WANT TO DO BEFORE YOU DIE:
1. Move into a new house. A bigger house with room for Dixie to run around.
2. Start a consulting business
3. Become more organized.

THREE WAYS THAT YOU ARE STEREOTYPICALLY A GIRL:
1. I cry during t.v. shows or for sad commercials.
2. I love massages and other body work.
3. I’m super sensitive.

THREE WAYS THAT YOU ARE STEREOTYPICALLY A BOY:
1. I love wearing baseball hats. All summer.
2. I love watching sports on TV.
3. I hit people when I’m enthusiastic. (sometimes harder than they expect)



DIXIE TIDBIT:

I gave Dixie her Frontline medicine on Monday. The ticks have been out in full force. I hate doing Frontline because it seems so wrong to use those toxic chemicals. Dixie’s been under the weather ever since. When I woke up on Tuesday morning, there was a huge drool stain on her bed. Then she was just punky all day. She seems better today but still is pretty slow.

She woke me up this morning when I was low, and clipped me in the lip and now I have a scratch. Small price to pay for her work.

MN Nice asked about Dixie’s coat and how shiny and healthy she looks. She eats dog food (Natural Balance duck and potato) with brown rice and a little chicken. Her coat has always been shiny and glossy.

No more pencils, no more books...

We had our first Minnesota OC get together on Sunday. Scott, Amber, Sara, and me.

It was fun. We talked and talked about everything. Lows and favorite low foods. Infusion sets and inserters. The finer points of pumps. The carb value of a Burger King chicken tender meal and bread bowls. We laughed. A lot. It was awesome!

Being around other people with diabetes is so important. It’s nice to be able to talk about what’s happening (diabetes) without having to explain everything in the process. Thanks guys! I had a great time!

Today was the last day of school. Done for another year, and now I have a couple months to decompress. It was a crazy day. I had to say good-bye to my sixth graders who will be moving on to junior high. I saw the joy in the first graders who proudly shared that they were almost second graders. I hugged my special friends and said good-bye to parents who I’ve spent a lot of time in the last couple years figuring out what was best for their child. I said good-bye to a good friend who may not work with me next year and shed tears.

It’s a whirl of emotions. Sad, happy, relieved and proud.

It was a good year. My staff touched kids in many ways and helped them to become confident, strong students. I am proud of our accomplishments.

I’m exhausted.


DIXIE TIDBIT:

The end of school has been difficult for Dixie.

Most of the kids I work with happen to be boys. Dixie so loves “her boys.” (boys who have a special relationship with Dixie) The last week has been a different schedule, as many of the kids have been on field trips, or coming at different times or not at all. Today, no kids came to my classroom; except for quick check ins.

Dixie sat by the door and pouted. She would hear kids in the hall and perk up, only to put her head back down and sigh loudly when she realized the kids weren’t coming in the room. Finally the last hour, several of "her" boys came to see her and say good-bye. She wagged her tail like crazy and smiled. (when she is really happy she opens her mouth and shows her teeth—a dog smile.)

She’ll have a hard time for a week or so, and then will fall into our summer routine.

We both will.

Doing her job

8:28 a.m. A big, black paw hitting my shoulder awakes me. It hits me a few times. I reach out and pet the paw, and close my eyes--trying to get back in my dream.

The paw hits again, only this time on my face. I reach out and pet and attempt to coerce the dog to lie down and snuggle.

“Come on buddy. I’ll pet you. Lay down.”

Now the dog is standing over me, digging with her paws near my face.

8:32 am “FINE! I’M UP. O.K. I’ll TEST!”

Grab the testing kit next to my bed. The dog gives a heavy sigh and curls into a ball and rests on the bed. No more pawing me.

Fumble it open and slide a strip into the machine. Turn the light on so I can see where to put the blood.

Pick a finger to poke. Push the button. No blood.

“Dam, I need to put a new lancet in here.” It’s probably been a month since that lancet was changed.

After three pokes, I finally pierce a finger and squeeze blood on the strip.

The light goes out- sample was accepted.

Beep. 55.

Grab a juice box and slurp the whole thing down.

I reach over and pull the dog close to me. I kiss her head.

“Thanks. Good low. Good dog.”

The dog sighs and rolls over so that I can rub her belly.

We both fall back to sleep for 20 minutes.

She’s content.

I’m safe.

New diagnosis

I don’t understand the treatment for Type 2. I don’t really know a lot about medications that are available. I read Diabetes Forecast and have stopped skipping through the Type 2 articles and actually reading them. I’ve tried to understand this “other diabetes” because many friends and acquaintances have that disease.

A woman that I work with at school was diagnosed with Type 2 about a month ago. Her doctor (at a major medical center in the twin cities) sent her home with a prescription for Metformin, directions for its use, and a scheduled appointment for diabetes education four weeks from that time. She filled the Metformin and started taking it. I asked if she was testing, and she said that the doctor said that she could wait until the education class.

The education class was last Thursday. This woman left work early to attend it.

She came back to work on Friday. I asked how the class was. She said that she couldn’t be in the class because she had to meet individually with her doctor. Apparently her blood sugar was high. They did a “1AC” (A1c) and it was 19.8. My jaw dropped.

19.8. OH… MY…GOSH! I didn’t know the test range went that high. Isn’t that a serious medical condition?!?!

I ask if they gave her any insulin. She said no, that the doctor had just told her to keep taking the Metformin, test her blood sugar twice a day, and come back for a follow up appointment in another month. What?!

I wish this were the only time that I had heard about that kind of plan for someone newly diagnosed with Type 2. But it wasn’t. I’ve heard stories like that more that once.

Why aren’t people with Type 2 treated aggressively? Why wouldn’t this woman be instructed to test more frequently, to figure out if the Metformin was enough? Where’s the meal planning information?

Diabetes is a challenging chronic illness. I am constantly out there researching what is new and possible for my management. I’m an informed member of my health care team.

I have friends that are not. They take the back seat in their diabetes management. When I suggest that they ask their doctor about new things, they are reluctant. Their control often reflects that.

Heck, I have a family practice doctor who is my "primary care physician." It's the rule to have a doctor to call that, and it can't be a specialist like my endocrinologist. I see her if I have an illness or injury. She has suggested, many times, that she just manage my diabetes. No way. Although I appreciate her willingness, I'm not settling for anyone but an endocrinologist who specializes in diabetes. I have friends that do see just a general practitioner for their Type 1. They are also often the ones who aren't aggressively managing their disease.

If health care providers aggressively helped manage people’s diabetes, would the rate of complications be so high? Is our health care team content with basic management?

It seems like people with Type 1 are diagnosed, and expected to make major life changes immediately. MDI, insulin pumps, carb counting, sick day management, ratios, etc are all started quickly. Why not with Type 2 diagnoses? Why is the management plan for Type 2 so gentle, so slow? First try and lose some weight, test a couple times a week, take a couple pills. Where’s the urgency?

Is it our society that has made Type 2 “not a big deal.”? Lose a little weight, exercise, and you will be healed. It seems so simple that I fear people don’t understand the seriousness and the complexity of diabetes. The woman I work with told her doctor that she “…didn’t want the needle.” I hope her doctor told her that diabetes isn’t really a disease where you can “choose” your treatment. Certainly your life choices will affect the level of intervention that is needed—whichever kind of diabetes you have.

I've certainly read other people's blogs who are living with Type 2, and they seem to be very educated about treatments, etc. Maybe I just know the people who aren't...

I hope that people with diabetes, despite which kind, get attentive medical care that gives them the chance at having a great quality of life.



DIXIE TIDBIT:

Yesterday I got a hair cut. (as my students would say “you got lots of hairs cut.”) The woman called my name and walked me back to her station. She looked uncomfortable. She told me that she was afraid of dogs. I assured her that Dixie was well trained and had passed an exam that allowed her to be in public places without people having to worry about their safety. I don’t think that she bought it.

She was clearly nervous during the whole process. Dixie was perfect. She just lay on the floor with pieces of hair dropping on her. It’s awkward. It’s the first time anyone has ever said that to me.

It made for an uncomfortable 20 minutes.

(the photo of Dixie is from school. She had just alerted me - by jumping on the table and hitting me with her paws. It's her last behavior, when I've ignored all the other alerts.)

Traveling by plane

I just found out that I was approved to attend a technology workshop in June that is in Georgia. I was thrilled that I was selected. It’s a great opportunity. Teachers don’t often get chances to travel to state of the art conferences.

Then I remembered that

I
hate
to
fly

It’s not the flying part that I don’t like. It’s the build up to the flight. I worry the entire ride to the airport. Mostly about not getting an aisle seat when I check in. I have had times that I wasn’t able to get a seat assignment prior to arriving at the airport. This creates even more anxiety. I get this picture of myself sitting in a cramped seat without elbow room. I’m sure that the plane I’m getting on is unbearably hot. And the takeoff is probably going to be delayed, so I will have to sit in the plane sweating and squished—probably in a middle seat.

Once I actually get on the plane I am o.k. I realize that there is room, the temperature isn’t close to sauna like, and there is air to breath. I can usually just take my aisle seat and set up my dvd player and be quite content.

I guess that you could say that I am a reluctant traveler. Friends and family that have flown with me cringe at the thought of sharing that opportunity with me again. They say that I make them nuts. (They, of course, say it in a gentle way)

So I squirm a little thinking of it.

Then I realize that I will be flying with Dixie for the first time.

Oh no.

Holy smokes.

I can probably cope with flying alone. But flying alone with Dixie. Ahh!

How do you even fly with a dog?! How will I convince my lab that flying is no big deal when I’m a basket case?!

I spent a day or two panicking about this, but then realized that I would make my life much easier, eliminate many of my worries, and fly first class. (no, my district won't pay for first class, just coach. So I'll be paying the difference) I call Northwest and talk to a very nice woman who gets my ticket squared away (and it’s really not much more than coach—I can’t believe it!). She asks if I would like an aisle or window. Of course I say aisle. Then I mention that I have a service animal that will be traveling with me. She asks if it is a dog or a monkey.

A MONKEY? Who’s heard of a service monkey. Whenever I think of trained monkeys, I always get a picture in my mind of that movie – can’t remember the name- but it had a guy and his monkey who rode around with him in a truck. The monkey wore a little red, hooded sweatshirt and jeans. Very cute. Then I thought of the monkeys that you see on public television that are trained to use sign language to communicate. I don’t think I would want a monkey pulling at my hand and using sign language to tell me I should test my blood sugar, or screaming at me if I didn’t promptly treat a low.

I tell the woman that Dixie is a dog. Then she asks if she is a Chihuahua. (WHAT?!) I tell her that she is a 55 pound lab mix. She says that I will need to sit in seat 1-A, which is the “handicapped” seat. I assure her that I’m not handicapped, and don’t need a special seat. (although friends would say that I’m handicapped by my wacky traveling behaviors:-) She says that it’s the seat with the most room, so Dixie will have plenty of space to stretch out. Oh, o.k.

I got off the phone and took a deep breath. I can do this. I’m sure Dixie will love Atlanta.

I’m all lined up to travel. If anyone happens to lurk by and read this, and works in the airline or vet business, I’d love to have some tips for flying with a dog.

Questions

I got a recent email from someone interested in knowing more about Dixie and her training. I'm posting my response here so that others who might have the same questions can see my answers.

What trained skills does your dog perform for you?

Dixie is a trained emergency medical response dog. (EMRD) As I’ve written before, she alerts me when my blood sugar is high, low, or dropping. She knows how to push a switch to activate Life Alert if I’m not responsive. She knows basic obedience skills—sit, stay, lay down, heel, come. I trained her to push “handicap buttons” at public buildings to open doors. She is trained to put her “paws up” which was initially used to teach her to use her front paws to alert me.

If I go to an alert dog school, what can I expect? What will happen there?

I can only speak as to what training was like at Great Plains Assistance Dog Foundation, as that’s the only place I’ve trained. I spent three weeks at their center in Jud, North Dakota. They have two, on site apartments. (really two separate little houses) The apartment that I stayed in had a furnished kitchen including stove, fridge, oven, pots, pans, silverware, etc. It had one bedroom that had two twin beds in it. There was a large bathroom (handicapped accessible) with a shower. (no tub) I trained with the trainers and Dixie Monday thru Friday. Thursday was community access day. We went to Jamestown, ND to practice public access at stores, restaurants, etc. Saturday and Sunday were days for Dixie and I to rest and spend time together as well as to go to Jamestown for shopping. (She stayed in the house with me after the first day when we met) Training included working on the B-5. (basic 5 – sit, stay, down, heel, come) I usually had about an hour to an hour and a half off each afternoon for lunch. It was exhausting. I brought movies, activities to do, books to read…and did none of them. When I wasn’t working with Dixie at the training center, we were working together in the apartment or crashed. The staff there was great. They are a great bunch of hard working folks that want to help you develop the best relationship with your service dog.


Why did you choose alert dogs from other therapies?

I had an untrained mixed breed dog that used to wake me in the morning if I was low. She died and I realized how much I had come to rely on her. I connected with a woman who was “hooked” in to the service dog organization, and she helped me to find Great Plains. I have had hypoglycemia unawareness for many years, and have always had to rely on other people to help me manage or tell me when I was low. CGMS have never really appealed to me because I struggle just having enough viable tissue to use a pump. (I’ve been using a pump since 1992) I was worried that having another sensor would make more of my tissue not viable. Plus, I love dogs. As a special education teacher, I also support animal interactions for students. Dixie has been amazing with my special ed kids. They love her and she loves them.

What advantages do you think that an alert dog has over other therapies (i.e. Continuous glucose monitoring systems)?
I think that for me, it was all about saving my tissue for insulin and not using it for a sensor. And CGMS aren’t furry and nurturing to kids. ☺

What has been the biggest issue with the public and your dog?

I get sick of the questions from the public. Some of the repeated questions are: “Are you almost blind?” “Is that a seeing eye dog?” “Your dog is in training for a blind person, right?”
I can’t go very many places without having questions asked. Most of the time I am happy to share information about Dixie. I do feel a certain amount of responsibility to educate people that there are service dogs doing all sorts of jobs. But it does get old. At school, kids know the rule about not petting Dixie, and are cute about just waving to her the hall. We don’t go down a hall without a bunch of waves, smiles, and “Hi Dixies!” The adults have the most trouble remembering. Parents walk into the building and just start petting her, then realize her vest says “Please don’t pet me, I’m working” and stop.

Why is your alert dog important to you and your lifestyle?

Dixie and I are a team. She has changed the quality of my life. I don’t carry around the guilt I used to have that my friends had to constantly notice if I was low, because I couldn't. One of my colleagues said, shortly after I was back at school with Dixie, that she felt like she didn’t have a job anymore—she was so used to helping me when I was low. I am able to keep my blood sugars in a reasonable range without worrying about running higher to avoid lows.

I'm a dog person.

And she is a really, really good dog.

New Deltec

I got my upgraded, complimentary Deltec pump with new features. I have it up and running and have dabbled into some of the features that my old Deltec didn’t have. (hypo manager, disconnect feature, etc.) I like it. I like the fact that the company made improvements to the pump and then passed along those improvements to their customers, free of charge. That feels good. The only drawback was taking the “test” on the internet after watching video clips that describes where and how to use the new features. It took me close to an hour to do, but now I feel like it was worth it. All I have left to do in the process is send Smith Medical my old pump in the provided, postage paid box.

As a teacher, I use an Apple computer. That’s what I have access to at school, and it’s what I have at home. The CoManager software that is available is only usable on a PC. I’ll have to figure out a time to get access to a PC so that I can at least name this pump. Not sure if I should name it Squirt like my last pump, or if it’s time for a new name. I don’t like looking at the home screen and seeing the name Cozmo on there. I need my own name. Any ideas?

I was reading Scott’s blog, and it seemed like something that I could have written. I’m sick of diabetes. Tired of site changes and strips. Sick of carrying supplies with me. Frustrated with overbolusing for meals and then having to eat more when I’m not hungry. Sometimes I feel like I’m just coasting along, and don’t even really think about all that I’m doing. Then it changes. Everything feels like more work. I get mad about little things in diabetes care that don’t usually faze me. Today… it feels exhausting.

Hopefully tomorrow, it won’t.


DIXIE TIDBIT:

Dixie and I went shopping today. We were getting ready to go home, and I opened the back hatch of my car for her to jump in to. She sat and stared at me. I encouraged her to “hop in.” She sat and stared. So I got out my Flash and tested. As soon as I opened the case, Dixie jumped in the car. Blood sugar = 78. Not horribly low, but too low for her. I had a couple sips of powerade and waited about 10 minutes. Retested and was at 85. I drove home. Man, she’s a good dog! I’m lucky.

Vacation

What a ride the last two weeks.

I have been running in overdrive at school. I’ve been swamped with new assessments, lots and lots of paperwork, and major meltdowns from kids. I’m pretty confident that all of the special education staff has been feeling this way. At the end of the day we all look at each other and just shake our heads. (or laugh like crazy—one extreme of emotion or another)

Just when I thought I couldn’t possibly make it another day, it was the end of the week and time for spring break. Ahhhh!

I spent the week at the Gunflint Lodge outside of Grand Marais, MN. It’s just across the lake from Canada. (funny thing…on the menu at the lodge, domestic beers were listed. The last one in the list was Labatt, which is a Canadian beer. Next to the name it said “domestic because we’re nearly in Canada.”)

It was fabulous. Renewing and invigorating. I took a lantern-lit sleigh ride through the woods in the middle of a lightening storm. I read a book. I walked in the woods and watched the deer eat corn out the front window of the cabin. I went in the indoor hot tub a bunch of times, and I ate great meals cooked for me at the lodge. (AND I didn’t have to plan them, buy the groceries, or wash the dishes. Sweet.) Dixie loved romping through the woods and chasing after bunnies and the many deer. Yahoo vacation.

Diabetes was in good form. No major lows, no pumps sites falling out. Dixie had a pretty light workweek too. That’s nice because she also really needed a vacation. The last week at school she was also dragging. We were quite the pair.

Now it’s back to the grind. Here we go again…


DIXIE TIDBIT:

The more bonded I am to Dixie, the more I understand her alerting behavior. It’s important for us to be together all the time so that she has many opportunities to learn all the ways I am when I am low. People often ask why I don’t leave Dixie at home when I go shopping or out for dinner. It makes perfect cognitive sense to leave her. I made it all these years without her help. It isn’t about how I can do without her; it’s about us being a team.