The Hill and the Hypo

Last week this happened but I was only just getting back into the swing of things and so only writing about this week. Jetlag day 4 and feeling like a functioning human being again. I must have slept really well because all my aches and pains subsided. See last week's depressing post.

It's also Day 2 of the kids being back to school and day 2 of me getting back into my walking regime. I was feeling so good and my ankle was feeling so good that I decided to try that hill. The one that I haven’t tried in about 3 months due to injured accilles tendon. And go that bit further.

When I reached the top I felt like Rocky!!! I almost did an air fist pump but that would have looked sad - it’s not a very big hill :-S

Anyway, I was well on my way home when I felt my insulin pump on my hip start to buzz to alert me to the fact that my blood sugar was 4.1 mmol with a ↓ Then I remembered that I really should have factored in how much insulin I took for breakfast the previous hour and how I didn’t know then that I was going to go that bit further. Oops!

Luckily, I always carry glucose in my meter case. And I always shove my meter case in my coat pocket. I grabbed a couple of the glucose tabs but I could already feel the river of sweat streaming down my forehead, down my back and down my front. And I knew it wasn’t the moderate workout I I had hoped for. My arms and legs felt like they belonged to Raggedy Ann or Andy. A little further on I took another couple of glucose tabs because I knew this was a serious hypo.

I was still thinking clearly, surprisingly, because I felt that I wasn’t at the point where I needed to call for backup. I felt I could still make it home, shakingly, and flopsy-mopsy style(cos that’s what it felt like) but I could make it.

And I did! I got inside my front door and sat on the stairs, laid back and just wait for the intense heat steaming from my body to stop.

The lesson I hope I have learned from this experience is that I need to factor in previous insulin dose into spontaneity.

However, the likelihood of that lesson sinking in and popping out immediately when needed is doubtful. One can only hope!

Growing Old with Type 1 Diabetes

It was my birthday last month! Sarcastic yah! I turned 44. I know that anyone older than 35 thinks that 44 is young but I am not happy at all about being in my forties, especially because the aches in my joints make me feel older that I am. And because of that achy hip and torn achilles tendon that just won’t heal, I feel that my best, physical, years are behind me. So my birthday is a bitter sweet mix of "hurray, it's a day all about ME" to "Boo, another year older".

But, I suppose, there are worse things in life. And there are some amazing things going on in my life, including but not restricted to, watching my children grow and mature and become amazing young people. I’m so proud of them. I have a lot to be happy about right now. All of this doesn’t stop me worrying about the future, about worrying about growing old with type 1 diabetes.

Every year, my birthday reminds me that one day I will wake up and actually be old! Old with type 1 diabetes. I will be old and maybe my brain won’t be as sharp as it once was. How will I work out insulin doses safely? When will my old age start?

I have been taking care of my own diabetes ever since I was diagnosed but what happens if old age prevents me from doing that? What will that mean for my husband, my daughter and my son? I don’t want them to carry this burden.

Will I end up in a nursing home hoping with staff taking care of me who don't know very much about type 1 diabetes? Should I make a plan to make sure no one has to take on this responsibility?

This is my biggest fear! Getting old and still having type 1 diabetes and the fear that I will not be able to take care of myself any longer.

I do not want to be elderly with diabetes. Full stop. I want a cure before I’m old.

This is a worry I have that is persistently at the back of my mind. I don't allow it to take up much space in my head because it has the potential to drown me. So, just for today I'm letting it out to lessen its influence it has on my outlook on life. Tomorrow I will put it back in and focus on what is good about today.

2016 That's a Wrap

It’s difficult to believe all the goods things that have happened to me through Blood Sugar Trampoline this year, and with all the other diabetes related stuff that I do. Sometimes I have to pinch myself. Every year, when I write my Christmas cards, I include a letter with a bit of a summary of what our family has been up to for the year. When your family lives on two continents it’s important to keep the connection in this way.

It was while I was writing this letter that I realise just how much has happened to me this year because of blogging and volunteering. Here is some of my favourite highlights from 2016;

May - Participated in my first Diabetes Blog Week with 130 diabetes bloggers from ALL over the world. Thank you Karen from Bitter Sweet Diabetes.

May - I was invited to attend the Future Health Summit, Dublin as a Patient Speaker. I gave a presentation on how I became an empowered patient which I later transposed into a blog post.

June - Diabetes Ireland and Diabetes T One Delegation to the Dail.

I was invited to be part of the Diabetes Ireland and Diabetes T One Delegation to the Dail. This was a huge honour for me. And the moment where I truly felt that we, in Ireland, have a hell of a diabetes online community.

At the briefing, we asked the 42 public representatives who attended to commit to developing a multi-year financial plan to implement the services required for all people with diabetes in Ireland. Starting with approving a request for an additional €5 million per year to implement all the recommendations on the Paediatric Diabetes Model of Care, improving not only the quality of life for all children and teenagers with diabetes but for their families also.

Maybe this would be a good time to give our TD’s and Senators a little reminder of this?

September - I won the Littlewoods Ireland Blog Awards Bronze Award for Best Blog Post. This Cinderella didn’t go to this ball though. In fact, she didn’t even write the award winning post :-O hubby did and that makes it all the more special. Plus, he said some really nice things about me, excuse me a minute while I give that post a quick read again;-)

October - The second Thriveabetes took place bring the online community offline for one day and It. Was. AMAZING!

November - Medtronic Diabetes Community Exchange Conference in Barcelona. My very first blogger conference. I met some great and wonderful european diabetes bloggers. It was a brand new world.

NOT TO FORGET the random and wonderful meetings with members of the Global DOC Anna Norton, Gina Gaudefroy and being part of the Type 1 Adult Diabetes meetup in April!!!! (PS hubby says when someone from the DOC says they’d like to meet up I should drop everything and go. Not sure he realises what that means for him:-O )

How is it possible that something as frustrating and mind consuming as diabetes can bring all of this adventure and support.

Thank you, all of you, for your support, motivation, comfort and joy.

Happy Christmas! Gráinne

My Diabetes Checklist

I have lived with Type 1 Diabetes for 23 years. I know how lucky I am to not have any diabetes complications…. so far. And yes, a decent HbA1c does play a role in that, but more than we want to think about it, some of it is down to luck. However, it is a lot of hard work to pull off a decent HbA1c and people are very often surprised when I tell them all the things I do to try to achieve that. Maybe I make it look easy? Or maybe they’re wishing for something easy, but the easy life died along with our pancrea.

So, how do I manage my diabetes?

Managing diabetes is not as simple as taking my insulin and forgetting about it. I don’t just think about my type 1 diabetes at mealtimes - I can’t afford to, so much can happen in between meals.

In my opinion, managing diabetes is about balancing medication and physical activity with carbohydrate intake and stress levels.  Even if I lived every single day the same this would be difficult because of the variables like stress, illness hormones, climate changes, etc.

Here is the “Magic” list of things I do to “manage” my diabetes.

• Blood Glucose monitoring:
  • at least 7 times a day. Before I take insulin which would be every time I eat. And I check about 2 hours after to be reassured that I didn’t take too much or too little insulin.
• Taking insulin:
  • I take at least 3 bolus infusions daily through my insulin pump. I may do an extra fraction of a unit in between those times if needed. My basal/background insulin is delivered continuously through my insulin pump.
• Carbohydrate counting:
  • I’m hopeless at eyeballing the amount of carbohydrate on my plate so I weigh it. I find that my measuring the amount of carbohydrate, my insulin to carb ratio is more accurate.
• Record keeping:
  • there’s a lot to keep record of. I’m a recent convert to a smartphone so I haven’t completely let go of pen and paper to keep track of everything, but I do use an app that makes me feel good about logging information and sends me a weekly email with how I’m doing.
• Physical activity:
  • I held off on exercising until I got my insulin pump and my children starting school made this easier too. My resistance was due to fear or unwillingness to deal with the initial hypos while on multiple daily injections (MDI). However,  the more I read about the longest living people with type 1 diabetes, the more I realised that exercise seemed to be one of their key elements to good control.  Plus, when my joints started to get achy that was an added incentive.
• Attend multiple medical appointments:
  • I used to see my endocrinologist 3 times a year, but this seems to be reduced to oncer every 8 months. I’m not sure how I feel about this. I also visit a podiatrist & optician annually through the National Diabetic Retina screen programme and the community podiatry service.
• Upload my insulin pump and CGM data to a computer programme:
  • I do this at least once every three months and definitely before a clinic visit.
• Prepare thoroughly for my clinic visit:
  • by having my blood work done well in advance, I collect the lab report from my GP and keep a copy for my own records. I make a note of any questions I want to ask and make sure that I have time to ask it.
• A good support system is important to me.
  • My husband is crucial in this; he needs to understand diabetes as much as I do. I’m also a member of a Type 1 Support group and I draw comfort from meeting others just like me who speak my language. I also participate in many diabetes online groups.

• Making sure I know as much as I possibly can about my diabetes;
  • I draw motivation from reputable diabetes websites that I can relate to and by reading stories like that of Bob Krause who lived in San Diego and at the age of 90 has lived with Type 1 diabetes for 85 years and is still hale and hearty. I read about Nat Strand who won The Amazing Race, Charlie Kimble race car driver.
• Making time for all things diabetes related while not letting it take over my life.

Diabetes is frustrating at times but I’m not about to give up. I’ll give it my very best because I have soo much to live for. All of this may sound like it consumes a huge amount of my time but the more you do it the less time it takes.

50 Years Living with Diabetes in Ireland

A couple of weeks ago I wrote about attending Diabetes Ireland’s Health Awareness Exhibition in Dublin and that I was most looking forward to attending the medal ceremony to people who have lived with diabetes for 50 years. Read more about the other happenings on the day here. It was SO worth the 3 hour drive with kids in tow. There were 16 of these soldiers receiving medals. Each one was called up to receive their medal and Kieran O’Leary, Diabetes Ireland CEO, gave a brief biography of them.

As I watched each of them receive their medal I was struck by the fact that by the time I receive mine, living 50 years with diabetes won’t be such a big deal, such a monumental achievement. It will be the norm.

What all of these guys went through from boiling glass syringes, from the embarrassment of testing their urine for glucose to the restrictive dietary regimen. Remember, when these guys were diagnosed they were told that they would never eat sweets again and that they could eat diabetic chocolate.

Out of the 16 medalists, only 3 (well technically 4, cos two women were sisters;-) have a family member with diabetes, either before or after.

Speaking to Kieran O’Leary afterwards, he told me that Diabetes Ireland would like to make this an annual event. They realised that this year only three endocrinologists put forward nominees for medals and that there are many more people who have lived for 50 years with diabetes and more out there.

I would also like to see a 60 year medal as my friend Stan, from Clare is already at that mark and my friend Pauline is nearly there.

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My Thanksgiving Blood Sugar Battle

I’m not American. Nor do I live there. But, I am surrounded by them; married to one and both of my children are US citizens. And so Thanksgiving features strongly in our household. This year, we had an Expat Thanksgiving and celebrated it on the Sunday after the actual day so that none of us were working. It was lovely and it was lovely to be with our american friends living in Ireland.

However, as a person with type 1 diabetes, dealing with celebration feasts are a huge challenge. This one turned into a 24 hour challenge in that the high blood glucose levels wiped me out the next day. Maybe, this is why the Americans make thanksgiving a four-day weekend?

My approach to big meals, like this one, are to have a little of what I love, a very small amount of what I don’t consider worth the insulin, just to be polite, and maybe even skip the potato, because, well, I’m Irish and we had them Every, Single, Day growing up.

My blood sugars did reasonably well, considering. But this year, about four hours after pie, when I thought I was a little in the clear, they started to climb and climb and then hover. It was 2am when my CGM alarmed for the last time and I could get to sleep. I woke the next morning as if I had been out all night.

Monday morning, I had planned to treat myself to a morning of retail therapy in the city and to finish off the last of my christmas shopping. I thought about not going because I was too tired. Then, made myself go because it would do me good and maybe I’d feel better for it.

It did not work! I persevered because I had driven all the way there but when the toy shop told me, after waiting in line for about 8 minutes, that their computers were down and could not issue a gift card, I decided that I had made a serious effort. It was time to go home.

Had this been any other day. Had I not been battling blood glucose numbers the night before, I would have been productive on a superhuman level. My daughter finished early from school and so I only had one school pick up in the afternoon. I thought to myself “Great! I’ll have at least an hour or more to do some writing this afternoon”. That didn’t work either. I could even concentrate on scrolling through my facebook feed. And that doesn’t require any concentration but I still couldn’t do it.

I gave up! I put the iPad down, the phone down and put my head down on the couch with lots of blankets and took a nap! And actually, in between the “Mom, where is the….” and the “Mom, can I….” I did actually nap.

Sometimes, you have to give diabetes a win so that you can prepare yourself to fight the battle again another day.