Insulin Pens Don't Have Ink

Currently, diabetes makes me feel like how my cat looks

noreply@blogger.com (Sarah Spiller) — Mon, 25 Jun 2018 14:00:00 +0000

photo via me, the obvious best photographer of the century

I have no recollection of how or why this picture of my cat ended up in this previously untitled blog post, but I'm rolling with it.

Anyways, hi! It's been about a year since I've last posted (I blame college, as usual), and wow has my diabetes been a certain five letter word lately. Part of the blame is on me; I definitely was not doing my finest carb counting. (Sorry I abandoned you, measuring spoons and carb labels.) Add messed up basals, ISFs that aren't working, that awkward month after spring semester, plus a week of camp, and you've got yourself one nasty math problem.

After 2 nights of no sleep because of that aforementioned math problem, I was exhausted. I'm 99% sure I cried every day. On night 3 of frustration and sleep deprivation, I decided to ring up the on-call endocrinologist at o'dark thirty. I explained my situation and she told me: "Try giving yourself shots and changing your site because you really need to come into the office, so we can look at your blood sugars." AKA what I had been doing, while waiting for my appointment to come up. (I had actually changed my site 3 days in a row, so I had that site-changing thing covered.) I'm sure you already figured this much out, but I was just a little mad. (Shocker, am I right?)

I called my dad the next evening to vent and he suggested going off my pump for a few days to figure out what the problem was. Begrudgingly, I did. I like my pump; it makes my life easier, decreases the amount of needles I insert into my body, has my CGM on it, and remembers my basals, ISFs, and carb ratios for me. My pump also makes me lazy. It allows me to constantly cover food 15 minutes after I eat it, lets me forget my ISFs, and keeps all of the data the doctor needs for me, so I don't have to do much or look over any data. By the time I went on my short pump break, the cons definitely outweighed the pros.

Since I had no clue what was going on in my life, diabetes-wise, and I was on shots (which do not remember carb counts, insulin dosages, or ISF factors), I did the thing I hate. Logging. I used Tidepool Mobile, which is a no-pressure app that lets you take notes. That's it. You you only tell it what you want to; it's very low-stress.

As I typed my 3 word blurbs, mainly consisting of my blood sugar, carbs, and insulin given, I started noticing trends. My blood sugar wouldn't go down to around 100 until I used my lowest ISF, I needed more Lantus than my current total basal was giving me, rage bolusing doesn't actually work (note to self: seriously, just wait 1 1/2 hours before giving yourself insulin!), and covering food before I eat it is much more effective than covering it afterwards. A lot of these seem like easy things to realize, but when you've been diabetic for over 14 years and haven't been paying attention for a while, you tend to forget the basics.

3 days after going on shots, I changed my ISFs from anywhere between 1:40 and 1:50 to just 1:40, I raised my basal to equal 22 units, around 2.5 units higher than I was getting before, and I am committing to waiting until my pump finishes giving me insulin before I dive into my food. (Patience is a virtue, even when it comes to diabetes, apparently.)

I put my pump back on today, even though three days of data isn't really enough to make the perfect changes. It just feels so weird to be without my pump. (And I want to see if I actually fixed my issues or if I need to go on a pump break. Which hopefully I don't because a pump break seems like a VERY big change and we all know how I feel about change.)

So what exactly is the moral of this story? Sometimes you need to take 80 steps back, take a giant breath (even though you REALLY hate doing that), and go back to the basics. It might just help.

Postscript:

JUST KIDDING. Moral of the story is definitely that my cat understands my feelings on a spiritual level.

And now that I've written this blog post and got out my ~creative energy~ I should probably stop putting off studying for my chem exam tomorrow. #pleaseprayforme

CGMs, Logging, and Too Much Information

noreply@blogger.com (Sarah Spiller) — Sun, 04 Jun 2017 20:38:00 +0000

I wrote this a long time ago; like almost a year ago. Since then, I've been diagnosed with anxiety and depression which explains a lot that's going on in this post. I'm still publishing this without any edits from the last time I worked on because while I know there are so many benefits of CGMs, I also feel that it's important to talk about the negatives, so everyone with or without diabetes can understand the big picture; so people remember that CGMs, pumps, and logging still aren't a cure. They can cause issues on their own. Mindy also has a ton of great posts about issues with CGMs, similar to mine, so I urge you to read her posts, as well.
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via Beyond Type 1

If you know me well, you probably know that I can get a little obsessive and I am quite the perfectionist at points. I'm pretty Type A. (I have a planner with 17 check boxes for each day that I can write in things down to the hour in, if that tells you anything.) Naturally, this can translate into my diabetes self-care. I never really realized I had a problem with it; I always thought that feeling burned out after a few weeks of writing down every blood sugar, every food I ate, how much insulin I gave myself, and checking my CGM many times an hour to watch for spikes (and obsessing over when I spiked below the yellow line) was just proof that I'm pretty much a failure and trying to make fine-tuned adjustments to get my A1C down to below 7 was a useless measure. That sounds dramatic, but it was honestly and truly how I felt.

It took about two years for me to even realize that my methods of logging and meticulous attention to every blood sugar that my CGM supplied to me was a problem. The first hint that this wasn't exactly normal was when during my first year as a CIT at camp, my clinician told me after seeing my logs for multiple that I didn't need to test my blood as much because camp was a time to relax on my diabetes management. I, of course, brushed it off and told him that I was fine testing more often because it made my blood sugars better. I also got compliments later that week about how good my blood sugars had been. I got home and told this story and honestly felt proud that I was supposedly "testing too much," since, after all, I did have some of the best blood sugars out of all the CITs. (Of course, they were also having a much more fun and relaxed week, which I would much have preferred looking back.)

I'm pretty sure my obsession with numbers began to manifest when I got my CGM. I loved the data and all the numbers it could give me, so naturally I took advantage of it and checked my blood sugar as much as possible on my CGM. I got my first CGM halfway through my freshman year of high school, which was about a year and a half after I had struggled with my own obsessions with wanting to be skinny, which lead to unhealthily dieting and counting calories in an attempt to lose weight. This gave me a sense of control over my life that I desperately wanted; getting a CGM also gave me a sense of control over my blood sugars, and therefore my life. Naturally I had to do all that I could to ensure that all 288 readings on my CGM were in between the lines. Looking back on it now, I didn't realize that this want to keep my blood sugars perfect all the time was particularly unhealthy. After all, who doesn't want to keep their blood sugars perfect 24/7?

My second realization of this lack of normality in my personal view of my CGM graph and logging strategies came at camp again, a little more than a year later. I ended my last summer before college at Camp Kudzu and was already a little exhausted by this point. I had just been traveling the week before and camp is also pretty fun, but pretty exhausting. On top of that I was stressing because I've always felt like I've been the odd one out amongst the CITs, so I was feeling left out (to no fault of theirs, I'm just not good friends with most of the girls because we didn't all go to the same sessions every year growing up) and the cabin I was working with for the week was also causing me a lot of stress. Add exhaustion, plenty of stress, and a lack of sleep due to my blood sugar going low almost every night until 1 or 2 am and you will get the perfect storm for a CGM induced breakdown from me.

I had my CGM with me at camp because I have always hated having to take my CGM off. Whenever I would run out of sites or my battery would die, I would constantly test my blood (until it got exhausting for me) because I was sure I was missing some low or high blood sugar that my CGM would have told me about. Having my CGM at camp made all of the crazy blood sugars that come along with suddenly being put in a very different environment for an entire week all the more visible and obvious to me. As a CIT 2 I was allowed to, for the most part, do all of my insulin dosing, blood testing, and typical camp diabetes care, as long as I checked in with my clinician in the morning and at night during the CIT meeting.

During our Tuesday night meeting, that perfect storm I mentioned earlier took place. I was exhausted after a stressful day of being at camp and my blood sugars kept going low for a long time, spiking up to the mid 200s then dropping back down and staying low. As I was showing my graph to my clinician, I began crying out of frustration. Seeing the graph go up and 3 or 4 times, despite my best efforts to stay around 100 was making me incredibly angry at myself for not being good enough to at least be flatlining. I was already making my clinicians a little annoyed because I was purposely running my blood sugars lower than what camp wanted me to be at (I was staying between 80-100, while camp wants 120+) and I think at this point they realized what was going on before I even did.

My clinicians promptly told me that they were taking away my receiver from me because I was having an information overload. They gave it to the head staff that stayed with CITs in our cabin and told me to take a break. Naturally, I did not want this to happen at all, as my CGM is my security blanket of control over my made up ideal of being able to achieve perfect blood sugars.

After not looking at my CGM for what seemed like a lifetime, (which in reality was less than 12 hours) I was given it back the next morning after promising to only check my CGM once per hour. This was an incredibly difficult challenge for me, as I was so used to checking my CGM every 10 or 15 minutes, but I did make it through. I began by choosing my one glance per hour carefully, in an attempt to get the most out of that one check. As the hours and rest of my week at camp went on, I began to realize that I had stopped checking my CGM and hadn't even noticed it. My blood sugars were a little higher than what I wanted them to be, but I wasn't spiking as much because I wasn't micromanaging my blood sugars every five minutes.

A few days later, I talked with Mindy about my CGM issues and what had happened and logging came up and I admitted that logging has always been an issue for me and she told me it was for her, too; in fact, she doesn't even log anymore because it has a similar effect on her as it does me. I was shocked and relieved to find out that I wasn't the only one that had issues like these. She also talked with me about my CGM and asked me a question I haven't quite got around to dealing with yet: does your doctor know about your relationship with your CGM? My answer was and still is simply a no.

I haven't mentioned it to my doctor at all because a) it's always awkward to randomly bring up my mental health in relation to logging and CGMs in conversation (especially when your parents are in the room) and b) I'm probably changing endos to an actual adult endo soon, so I don't see much of a point to bringing this up. I'll definitely mention it to my new endo, but I'm just not sure where to go from there.

I haven't logged since I got back from camp, besides when I upload to diasend to have two weeks worth of logs for the endocrinologist and I have been doing a lot better about not checking my CGM obsessively. My big question is where do I go from here? I would love to get my A1C down and to have better blood sugars, but I'm not sure what I can do without obsessing over every single number. Is there anything to do or am I just kinda stuck?
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You don't have to answer my questions, as I'm getting professional help for my anxiety now and we're working on my obsessiveness. Let me know if you all also have CGM issues in the comments, I'd love to talk with you!

New Year, New Pump! (Maybe)

noreply@blogger.com (Sarah Spiller) — Tue, 03 Jan 2017 05:00:00 +0000

My parents are pestering me to write a new blog post, so here mom and dad, this is dedicated to you. Also, I'm very aware that my last blog post made me seem a little unstable (To be fair, I kind of was at that point.) and well, that is college for you. Change is not my favorite thing on the planet, as I'm sure you all can tell by this point, but college has gotten much better for me since I wrote that post 4 months ago. (So don't worry too much about me, things are looking up!)

Anyways, on to the excitement! I got a new pump! And a shiny, brand-new t:slim X2, no less! Are you waiting for the rave review and for me to tell you how happy I am to have moved into the modern era of pumping from my scratched up, old Animas Ping? Yeah, I'm sure you figured out that isn't how I'm currently feeling about my new pump. I've been on practically the same pump since I began using one 11ish years ago. I started off with an Animas IR1200 and then went to the Ping and have stayed with it until now. I'm also not a giant fan of change, so that is not really helping me out in this situation. The best way for me to explain my feelings, naturally, is through a list of pros and cons, so here, for you is a list of t:slim X2 pros and cons.

Out with the old and in with the new? Maybe?

Pros:

I can finally type in my carbs/ blood sugar super quickly, rather than having to press an up or down arrow for 15 seconds to get a carb count/ blood sugar in my pump.
It's smaller and just looks nicer, and (hopefully) there is no paint for me to chip off of this pump.
Being able to have profiles that include not only basals, but also I:C ratios, ISF, and bg targets is super nice. I know this will come in handy at camp and being able to change everything for one time point instead of each setting separately is quite convenient.
The biggest thing about this pump for me is that it can be updated to keep up with new developments in technology. At this point, just being able to see my CGM on my pump isn't that important, but the possibility of it having an auto-off algorithm for low blood sugars using my CGM is pretty nice. Since updates can roll out for this pump, I will be able to stay caught up with new technology instead of having to purchase a brand new device once the technology becomes available.
Tandem's customer service is awesome. When I upgraded, they were super proactive about keeping me updated with any new info involving getting it approved and I like how they can text me now if they need info.

Cons:

The clip on the t:clip case is awful. It sits too low on the pump, so my pump is constantly unclipping from my pants or wherever it is, which is extremely inconvenient. I'm currently using it without the case and putting it in the waistband of my jeans because the clip is basically useless to me. (Thankfully there is a fix: trying one of these attachable clips. I still think that Tandem should have a better one available for consumers.)
I can't see the exact amount of insulin in my pump until around less than 50 units. Why? If my IR 1200 could do it 10 years ago, Tandem's pump should be able to, as well. (And why is it that after I first refill my cartridge, all it tells me is 120+ even though I put in around 180 units to start with?)
I miss seeing my basal rate on my home screen. I know it's one tap of the screen away, but I like seeing it all the time.
I can't feel my pump when it vibrates at night. My Animas was much "louder" in that sense and it was much more likely to wake me up, while this pump barely vibrates and I don't notice it a lot, even when I'm wide awake.
All of the warnings are a little obnoxious. I get one warning before I change my temp basal to 0% and then a warning 5 minutes later that I have set my basal below half of my normal basal. Yes. I know. I did that for a reason.
Sometimes when I'm putting in carbs or insulin, the touch screen will press the incorrect thing/ I have to press the same place twice or the screen will randomly turn off. I can press the power button and it comes back to where I was, but this is a little obnoxious.

These are my feelings and Mindy's (I love her, by the way! We talked at camp about me and my CGM obsessiveness, which is a post for another time... ) post on CDN made me feel better about my choice of a new pump, while Kim's post (also love her, she's pretty much been my DOC hero for years) made me worry a little. So basically, I'm still kind of conflicted about the whole thing. A positive step is that I did put my t:slim back on after taking it off last night. (Baby steps!)

I'm pretty sure there is a 30 day grace period for new pumps after training, so hopefully I can figure out what I want to do by then. (And I haven't even been trained yet! Also- please don't operate a pump without training that is against FDA approval and I cannot recommend that. Especially if you've never used a pump before.)

So there's my hot take on my new pump and my slightly conflicted feelings. Maybe I'll grow to love it or maybe I'll be the only person my age to like old technology better. I guess we'll just have to see. (Don't worry, I'll keep you all updated either way.)

Happy New Year!

noreply@blogger.com (Sarah Spiller) — Sun, 01 Jan 2017 23:57:00 +0000

I just wanted to pop in and say Happy New Year before I go back to my regularly scheduled blogging. 2016 was definitely an interesting year, to say the least and even though I know the new year is technically just another day, I'm still excited to see what it holds! I'll save you the recap and just quickly mention that my 2016 ended on a high note because I finally was featured on Beyond Type 1's instagram! I submitted my photo and story and after 6 or 7 months, it finally got posted!

Meet @sarahspillerr "I live beyond by not being ashamed of my diabetes. This has allowed me to easily talk to others about my diabetes and to able to advocate for myself and others through blogging and going to summer camp with other kids with diabetes. I strive to be a role model for people my age and younger, so they know that living with diabetes isn't a sentence to a life of boredom; it's merely another challenge that can be overcome in life. (A challenge that also happens to make you kind of amazing.) My name is Sarah and this i show I live beyond!"

A photo posted by Beyond Type 1 (@beyondtype1) on Dec 30, 2016 at 7:52pm PST

That was an exciting way to end my year, diabetes-wise and I'll also take this opportunity to shamelessly self promote my instagram and twitter. (Sorry guys, I had an opportunity and had to take it...)

Have a fantastic new year, I'll talk to you all soon!

I Guess I'm in College Now

noreply@blogger.com (Sarah Spiller) — Thu, 01 Sep 2016 04:00:00 +0000

Well hello everyone. Since I'm posting this you can now rest assured that I am still alive after my first (almost) month of college. Do I like it so far? Absolutely not. Will I survive anyways? Probably. My first weeks of college have definitely not been my favorite weeks of my life. Let's just say I cried and called my parents almost (sometimes simultaneously!) every day the first week. I still haven't finished my Diabetes for Dummies binder for my roommate and I'm running behind on everything else, too. That's college for you though, isn't it?

Rush week was exhausting, but also super fun. I was worried that I would be low all the time, since everyone is constantly walking to new houses in the hot August sun. Thankfully, there were snacks at all of the houses throughout the week, so that never happened and I got to stockpile a bunch of snacks. In case you aren't familiar with rush, it's basically a week of speed-dating to find find a group of girls you get along with and are similar to, so you end up in the right sorority. Rush days can run from 6 AM to 7 PM some days. To add to the stress, you have to be asked back to by the sororities, so there is a chance that even though you paid to participate in the entire week of rush, you may not be allowed to. I did end up getting into a sorority, which I loved, but I dropped out because I'm not all about the #collegepartylifestyle and the cost of being in the sorority was too much for me to justify right now. (Plus I don't have enough time at the moment.)

Besides rush and crying episodes, my life hasn't been too exciting. I missed my first 8 AM class Monday and I blame the fact that for the last month, my blood sugar has been low and it takes until 1:30 or 2 AM to go to bed, and then I'll get up and be low again. It's awful. My friends from camp recommended eating something with protein before bed and starting a -10-20% temp basal to make sure my bg doesn't drop, so I'll be trying that ASAP. Let's cross our fingers and hope that works because I'm exhausted by all of these lows. (I guess on the positive side, my A1C is probably great because I'm low all night...) Update: my blood sugar has now been running high for the last two days. Go figure.

The aftermath of a month of lows: juice boxes, granola bars, and two empty jars of glucose tabs.

I'm getting involved in UGA's College Diabetes Network chapter, as well as Wesley, choir, quiz bowl, viola lessons, and probably 20 other things I've forgotten, so I'll be sure to update you all on how those are going as time goes on.

Moral of the Story: I'll let you know when college becomes fun.

Life Updates

noreply@blogger.com (Sarah Spiller) — Sat, 30 Jul 2016 16:21:00 +0000

I wanted to go ahead and update everyone on what's going on in my life, in case I go MIA on the blog for a bit. I began writing this while on vacation in Isle of Palms, which is a barrier island off of the coast of South Carolina. I love it because it's not too touristy, but is also not completely in the middle of nowhere. (Which is always preferable, for me at least.) My life is about to become crazy because I have so much going on.

I came back from vacation Thursday because I leave for camp on today, so I had a day to unpack, relax, and then re-pack all of my things for camp. I get back from camp the following Saturday, then I'm going to a Twenty One Pilots concert with my sister that night, and after all of that, I head off to move into college on Sunday. Needless to say, my life is going to be extremely busy.

This is my motto for the next few weeks/ months because of all of the change that's about to happen:

A photo posted by Sarah (@sarahspillerr) on May 31, 2015 at 11:35am PDT

I'll be going through sorority recruitment before classes start ad the classes begin on August 11th, so I'll be thrown into the mix of college life pretty quickly. That probably means that my blog posts will slow down a bit. I'll definitely have plenty to write about: camp, rush, college, and everything else happening, but I'll probably have to take more time writing posts since I'll also have tons of classes to study for, viola lessons, and everything else going on in my life.

So don't worry too much if I'm not posting as much. I still want to blog and I will, I might just have to figure out how to budget blogging into my schedule before I get back to posting weekly.

Orientation & the DRC

noreply@blogger.com (Sarah Spiller) — Tue, 26 Jul 2016 04:00:00 +0000

I got back from orientation a few hours ago and I am absolutely exhausted. I had so much fun, but there was so much to do, so I am inevitably ready to sleep for 12 hours and I already took a nap on the car ride home. Needless to say, so much happened at orientation that I couldn't talk about it all, but I'll try my best to talk about as much as possible!

Day 0: (aka the day before orientation)
My dad and I took the 1 1/2 hour drive to UGA from our house because I had an intake appointment for the Disability Resource Center. (Which will now be referred to as the DRC because 3 letters is easier to type than 24. And I'm a little lazy.) I never had a 504 plan in high school, so having to get all of the paperwork from my endocrinologist and knowing what to ask for, accommodation-wise, was a little strange. At the Dawgs for Diabetes campus tour I went to last November, it was recommended that all diabetics going to college get involved with their campus disability resource center, since they can do a number of things to help out diabetics on campus. This includes writing letters of introduction to professors, so they know you are diabetic and also so they can list out the accommodations requested. I asked to be able to have food and water in class. (In case I have a few professors that don't usually allow any in their classrooms.) I'm also asking to have the ability to move test days/ have more time on tests in case my blood sugar suddenly drops or my blood sugar has been running high all day, since my ability to concentrate on anything decreases when my blood sugar is super crazy. (Side note: I don't plan on abusing that just because I haven't studied for a test. Even though I'm sure it may be tempting at some points...)

At my meeting, my dad and I met my disability coordinator. She's the person in charge of making sure I receive all of my accommodations and is the person I can call whenever I'm having any issues related to my diabetes and doing things on campus. She was really nice and we went through my medical history, my previous accommodations in high school, (aka none) and talked about teacher letters. She said that those might be emailed to teachers, but I might also have to take them to my professors myself, which I don't mind, since I plan on introducing myself to teachers anyways. She also gave me some tips about the gym; apparently, bags aren't allowed in the actual gym, so if I ever have issues bringing my blood tester or supplies in, I can give her a call and that should be cleared up. My meeting lasted around 20 minutes and was pretty to the point, which I can always appreciate.

We spent the rest of the day going to the music school to ask about the cost of private music lessons, since I'll be continuing viola lessons at the university. After that, we went to Target to get a shower caddy and sheets, since I was going to stay in the dorms for the night. Then, we headed back to the hotel and I worked on doing my alcohol and sexual assault online education courses that I'm pretty sure all colleges require now. (That's an hour and a half of my life that I'll never get back.) During the marathon of online courses, my mom called to let me know that my CGMs had been shipped (finally) and, needless to say, I was happy about that. We ate dinner at Taziki's Cafe, which has yummy Mediterranean food. (I recommend the grilled veggie gyro; it was delicious.) Of course, we had to go visit Insomnia Cookies for dessert. Everyone in Athens is obsessed with their cookies (probably because they deliver until 3 AM) and I got a Chocolate Peanut Butter Cup cookie, which was so good (and ~~probably~~ definitely had tons of carbs).

Cue my obligatory Athens photo at the MLC: (I took this same photo last time I went to Athens.)

A photo posted by Sarah (@sarahspillerr) on Jul 15, 2016 at 4:47pm PDT

Day 1: (aka day one of orientation)
We had to be at the residence hall I was staying in for the night at 7:30, so I could move in and leave all of my stuff in my room. I was on the ninth floor and let me just say, I'm very thankful that I'm only on third floor in my actual dorm. After this, orientation began. Cue 20 million different panels/ meetings that included introductions to orientation leaders, talking about life at UGA, learning about the specific college your major is part of, and how alcohol inherently leads to anything and everything bad that ever happens on campus. As I was leaving the music major room to ask a few questions about minoring in music, a mom stopped me to ask if I had a pump and we talked about how her younger daughter was diabetic. She asked about what I was doing diabetes-wise to prepare for college and asked if my roommate knew about my diabetes. We talked for 5 or 10 minutes while my dad and my friend played Pokemon Go. (I refuse to play it.)

Later that day, I ended up getting on a bus super late and made some remark about how holding on to the straps on the ceiling of the bus would be fun, since I'm super short. A guy offered his seat to me, since he was way taller than me (which was very nice of him). I sat down and had to cover the lunch I just ate and got into a conversation with his mother about diabetes and endocrinologists. She told me that if I'm looking for a new endo, she recommends SEED, since she goes there. (That's two diabetes encounters in one day... I couldn't believe it.)

My friends and I had dinner made by the dining hall and let's just say that the veggie burgers, cupcakes, and everything else there was definitely a food highlight. I got back to my room after going to the resources fair, where I talked to a few people at the College Diabetes Network Booth and a ton of other organizations. This is also the point when I walked up nine flights of stairs to get to my dorm. #notfun I also found out that community bathrooms are not as bad as I thought they were and then I proceeded to go to bed because all of this in one day was absolutely exhausting.

Day 2: (aka the final day of orientation)
My roommate and I woke up late (as usual) and rushed to get to breakfast. Thankfully, we were only five or ten minutes late. I went to more sessions about how alcohol is bad. (Do you see a reoccurring theme here?) There were sessions about Greek Life and then I had my advising meeting, so I could start registering for classes. There were a few chemistry related class crises, but those were thankfully fixed. My dad and I also managed to lock the keys to our car in the trunk in the midst of all of this and having to break into the car to get those was definitely interesting. After all of this, we could finally head home. Orientation was super fun, but so tiring, so I was glad to be home.

Hopefully you guys didn't mind the word dump, but I wanted to share as much information about the DRC/ orientation as possible. Also a reminder for anyone going to orientation: make sure to bring snacks/ low supplies for nighttime because dining halls take forever to get to and I'm not sure if there are vending machines in the dorms. I forgot to bring glucose tabs, but the school gave everyone puppy chow, so luckily, I had something to eat for my annoying low that night.

If you have any questions about the DRC or orientation, feel free to comment below and ask thos or shoot me an email!

Trouble in (CGM) Paradise

noreply@blogger.com (Sarah Spiller) — Thu, 21 Jul 2016 15:00:00 +0000

Okay, I have been having quite the trouble getting my new CGM. I'm upgrading from a Dexcom with Share to a G5, which you wouldn't think would be that big of an issue, but apparently it is. This all started about a month ago in the middle of June when my transmitter started giving my a low battery alarm. I figured I could call customer service and ask if I could upgrade, since I've had my current one forever and I would love to be able to see my CGM data on my phone. I called on the Sunday I started having low battery alarms and was nicely told to call back Monday during business hours, so I could talk to the people in charge of upgrades to get started

After calling them during lunch hours at the day camp I was volunteering for, I was told that I would need to call my distributor (Liberty Medical, which recently bought out my old distributor, Neighborhood diabetes) to get everything ordered and ready to go. I then called Liberty, and was told I was approved to get a new one; all they had to do was confirm my insurance info and then send out my prescription to my endo and I should have it in the next few weeks. Two days later, my mom got a call asking to confirm some insurance info, so I called Liberty back and gave them my info, assured this would happen pretty soon, especially since my transmitter was dead.

A few weeks later, I still hadn't gotten my shiny, new CGM, so I gave Liberty a call and they told me that they were waiting on my endocrinologist to send in their prescription. I gave my endo a call and left a message for her assistant and my call was never returned. Yesterday, I got fed up with all of this and gave Liberty another call. Apparently my endocrinologist still hadn't sent over my prescription, which was ridiculous, since it has been almost a month. I called the doctor's assistant twice and left a voicemail, but wasn't sure if I had called the right extension, since there was no message saying I had reached my endo's assistant, just a generic voicemail message that said to leave a message after the beep. At this point I was furious because no one was telling me anything and I couldn't reach an actual live person. My mom told me to call the practice manager to talk to him, but he also didn't pick up, so as a last resort she recommended calling the scheduling department because they usually have to pick up. After calling twice, someone finally picked up and I explained my situation. She said she could transfer me to the person in charge of CGMs. Relieved, I let her transfer me and then got a voicemail message saying that this person was on vacation until July 27th. I was so fed up with this at this point, but I left her a message and hung up.

At this point I was desperate for at least a transmitter and I called Dexcom to ask if they could try to send me a replacement transmitter until I could get my new CGM. I was told to call Liberty because they are in charge of all distribution, so I did and the woman on the line told me she couldn't do anything to help. After that I started crying because I was so mad at everyone for seeming to not care one bit about whether I have an actual, working CGM. My mom reminded me that we had an endo appointment the next day, so we decided to talk about it with them, in person. That way they at least had to talk to me, rather than sending me to voicemail.

The next day, my mom asked if she could speak to the practice manager and talked to his assistant. Apparently the endo sent the prescription last week and that Liberty should already have it. I called Liberty and explained my situation for the 10,000th time, and after talking to the documents department I was informed that they did in fact have the prescription and had been in possession of it since July 1st. An entire week ago. They told me that they would now be sending my insurance the info for approval and I asked how long it would take: "Oh probably 7-10 days for approval; we're not sure when you'll get your CGM." Great. So now I'm waiting for my CGM for an unspecified amount of time.

I'll be calling back next week to make sure everything is still going into motion, so I know what's happening, since Liberty obviously has no clue what the heck is going on. My endocrinologist also mentioned that Liberty has been moving very slowly ever since they merged with Neighborhood diabetes, so that's always promising.

While I was sitting in my dad's hotel room the night before orientation, (There will be more to come about that soon!) he called my mom to let her know that we were safely at the hotel. While on the phone, my mom told him that my CGM had been delivered to my house! I honestly thought I was going to have to call them sometime Thursday during orientation, so this was definitely a pleasant surprise, even though I couldn't use it until Thursday night. I asked my dad to call Liberty to check and see if my Dexcom sites had been shipped too, since you never really know with distributors these days. (See above post...) Thankfully, my sites came too, so all is well for now. At least until 3 months from now when I have to order more sites...

Moral of the Story: I can finally wear my owl GrifGrip and that is the real important thing here.

I'm Being Opinionated, For Once

noreply@blogger.com (Sarah Spiller) — Tue, 19 Jul 2016 16:20:00 +0000

Disclaimer: I don't usually like to get involve in very opinionated things around the DOC, but today I felt like I wanted to get involved, so naturally, this post is really really long, so if you don't want to read it, please don't feel obligated. This is my own personal opinion on the possible FDA re-labelling of CGMs, so feel free to disagree because it is an opinion, but please don't be mean about it. (Even though I know the DOC isn't mean, I have to include that.) Oh and a final note: take my opinion with a grain of salt. Now, enjoy reading this too long and MLA cited post about why I don't want the FDA to re-label CGMs.
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After reading Ally's blog post (Apparently I've been very inspired by her lately!) about the pending FDA approval of CGMs as devices that can be used to dose insulin off of, I realized I totally agreed with her opinion on the matter. Before reading her post, I hadn't thought much about whether or not I supported the FDA re-labeling of CGMs. I understood that most, if not all of the DOC support this re-labelling, as it could potentially increase accessibility for patients that have difficulty receiving approval from doctors or insurance for use of CGMS. This change could also potentially help the members of the DOC campaigning for Medicare's approval of CGMs as devices covered by their policies. I am in no way against any of these things. I love my CGM and wish that everyone had the same access to these medical devices, since they are extremely helpful in diagnosing blood sugar problems and patterns; unfortunately, I don't think this re-label of CGMs would reach the desired goals of many activists and this re-label could lead to many undesired consequences.

The FDA is planning on having a hearing with its Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory Committee to discuss "a proposed change in intended use of Dexcom, Inc.’s, Dexcom G5® Mobile Continuous Glucose Monitoring System (CGM) device so that, in addition to tracking and trending interstitial fluid glucose concentrations, patients can use the device as a replacement for their blood glucose meters and make treatment decisions based on the interstitial fluid glucose concentration reported by the CGM" (Warner). This panel will be open to the public to comment on and possibly help influence the decision makes regarding approving CGMs as devices that can be used for dosing purposes.

Most diabetes advocates have been supporting going to this meeting and advocating for this approval by the FDA, since "[many] individuals are already making treatment decisions off CGM readings, but currently, this is considered 'off-label.'" ("They Are Not Waiting. Neither Should We.") As an individual that occasionally uses my CGM to dose, I know that the FDA's approval of this simply doesn't matter to me or the many other diabetics that also use their CGMs to dose. The FDA also doesn't approve the use of CGM sensors in places other than the abdomen, yet many people, me included, put their sensors on their arms, legs, and hips without regard to the agency's current stance on this. Because of the fact that most diabetics already do these things, I honestly do not think that re-labelling CGMs as a primary care devices will change anything that diabetics using CGMs do.

Many people also support this re-label because the, "CGM needs a label replacement claim before it can qualify for a Medicare benefit category. Until that happens, Medicare will not even consider covering it." ("Sign diaTribe's Letter to the FDA Supporting Use of Dexcom CGM for Making Treatment Decisions - Due By July 13.) If Medicare refuses to support coverage of a device that is not labelled as a 'primary care device,' then the problem is not the FDA's lack of a certain label, but instead it is with the rules that Medicare has put in place to be used when reviewing devices for their own coverage approval. Yes, this re-label may solve the singular problem that diabetics are having: needing Medicare to cover CGMs, but it isn't solving the overall problem that could affect our community later on, if a similar situation occurs to the diabetes community, or the countless other communities also affected by Medicare's rules regarding approving certain medical devices. This solution to the problem could lead to the intended result of having CGM's approved for Medicare, but it could also be a dead-end. This re-label would simply lead to Medicare considering coverage for CGMs; it is not a guarantee.

I am less concerned about the re-label's possibility of success when seeking Medicare coverage, and more concerned about the actual safety of making this re-label without scientific research in support of this. Many report that CGMs have more accuracy than the average blood tester has, since the Mean Absolute Relative Difference (MARD) of the Dexcom G4 Platinum is 9.0%. According to Dexcom, "CGM accuracy is measured by [Mean Absolute Relative Difference] from a patient’s reference values obtained from blood glucose measurements from a lab analyzer, YSI (Yellow Springs Instrument)" ("Dexcom G4 Platinum CGM Performance & Accuracy"). A lower MARD indicates higher accuracy of the readings from the CGM when compared with the actual blood sugar of an individual, so this number is amazing and much more appealing than the 15% margin of error most blood testers have. This MARD, however, does not show that readings from interstitial fluid (the fluid used to test blood sugar levels with CGMs) are often much less accurate in times of blood sugar instability. According to the study "A Tale of Two Compartments: Interstitial vs Blood Glucose Monitoring," interstitial fluid readings are only truly this accurate when blood sugars are stable, while they are much less accurate when blood sugars are rapidly changing, which is often when CGMs are needed the most to be used for blood sugar monitoring and potential dosing. The study states the following:

Because continuous glucose sensor manufacturing has not progressed to the accuracy and precision of blood glucose meter strips, sensor glucose signals must be calibrated against corresponding blood glucose meter levels. Such calibrations transforms the sensor signal into a glucose value and assumes that the plasma-to-IF glucose gradient remains relatively constant. This assumption will not be valid if sensors are calibrated during rapid changes in plasma glucose, which is a major source of sensor error. The effect of sensor lag on performance is most obviously seen during periods of rapid glucose rate of change (either up or down). Sensor levels may trail glucose levels by 5–10 min during periods of rapid change, but the most important effect on lag is to introduce error during calibration, which affects long-term sensor performance. Moreover, changes in plasma–interstitial gradient in certain physiological conditions, like insulin-induced hypoglycemia, may be misinterpreted as sensor inaccuracy (Cengiz, Tamborlane).

This study proves that interstitial fluid testing, when compared to blood testing can be much less accurate. As I read Ally's post, I actually had to retest my blood because I had been running high that night. My CGM said I was 248 with a straight right arrow, meaning that my blood sugar wasn't changing much, but my blood tester told me I was 301 and 329. (I double checked, to make sure it wasn't a fluke.) That is up to an 81 mg/dl difference, or a 2 u of insulin difference, which is huge for me. Covering for the 248 would have brought my bg down some, but not into my target range, and I would never know better if I only used my CGM. This huge difference is a major issue for me and I don't want to imagine accidentally covering someone for a false high and then having them go low because of it.

If studies done by scientists show that blood readings from CGMs are not as accurate as our meters, I'm going to trust them. My own personal experience shows this, too. Sometimes my CGM is more accurate than my meter, instead of being the other way around; however, that is because I don't wash my hands/ use an alcohol swab/ change my lancet before every check. That is something I could change (if I felt it was worthwhile); on the other hand, my CGM sensor checking my bg from my interstitial fluid cannot be changed by anything I do, so it's inaccuracies are not caused by user error, but by device error itself.

This potential re-labeling could also lead to a forced choice or lack of access to test strips and blood testers because if CGM's are given the label of a 'primary care device,' insurance companies may decide that since blood testers are also of equal importance (even though blood testers do not have this label, interestingly enough) and they will force consumers to choose one or the other, rather than being able to use both. Insurance companies may also simply disregard the label because blood testers and CGMs will be considered equal, but test strips and blood testers will still be incredibly cheaper than CGMs, so they will naturally lean towards only covering the cheaper of the two options. If insurance companies choose to approve individuals using both devices, they may begin to limit the number of test strips being allowed for daily use. Since CGMs must be calibrated only two times per day, this may be the new allowance of prescribed test strips for a day. Two test strips. That sounds awful and could lead to huge issues when someone is trying to ensure their blood sugar readings from their CGM are accurate, especially in times when blood sugar is increasing or decreasing rapidly.

If we want CGM's to be approved as accurate testing devices, why not go the scientifically proven route and petition for scientists work on improving CGM technology, so they are actually more accurate, instead of petitioning law-makers and FDA officials to support the re-labeling of a device that isn't supposed to be used for the purpose these officials are approving it for? Yes, this will lead to more CGM access, theoretically, but there are better ways of going about this. If we don't want to wait for science, we can work on teaching law makers, representatives, and healthcare company executives about how important CGMs can be for supplementing blood testing and improving blood sugars for diabetics. By doing this, law makers and representatives can push for CGMs to be covered by all insurance companies, including Medicare, which seems to be a large reason why people are supporting the campaign. We could also attempt to help influence law-makers to attempt to change the requirements for device coverage from Medicare, which would not only help the diabetes community, but also many other health communities.

Being 'off-label' also hasn't stopped anyone from putting CGM's in their arms or legs, using sensors for more than 7 days, or dosing with their CGMs, so this vote shouldn't change anything in that area. Instead, this action may lead to a situations Ally described, where people may accidentally cover a CGM high that is actually a mid-100s bg or people's access to test strips may be drastically reduced to off-set the costs of CGMs. And no one wants these things to happen.

The potential pay-off of making the "off-label" choices you already make approved by the FDA, and the possible increase of access to CGM's for all isn't worth these uncertainties to me and I don't feel comfortable supporting a cause that could unintentionally lead to the endangerment of people's lives.

Sources:

Cengiz, Eda, Tamborlane, William V. "A Tale of Two Compartments: Interstitial vs Blood Glucose Monitoring." Diabetes Technology and Therapeutics. June. 2009: S-11-S-16. Web.

"Dexcom G4 Platinum CGM Performance & Accuracy." Dexcom. Dexcom, n.d. Web. 19 July 2016.

"Sign diaTribe's Letter to the FDA Supporting Use of Dexcom CGM for Making Treatment Decisions - Due By July 13." The diaTribe Foundation. The diaTribe Foundation, n.d. Web. 19 July 2016.

"They Are Not Waiting. Neither Should We.." We Are DPAC. Diabetes Patient Advocacy Coalition, 28 June 2016. Web. 19 July 2016.

Warner, Jill Hartzler "July 21-22, 2016: Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory Committee Meeting Announcement." FDA. US Food and Drug Administration, 24 May 2016. Web. 19 July 2016.

An Endo Update

noreply@blogger.com (Sarah Spiller) — Tue, 12 Jul 2016 15:00:00 +0000

Today was my third quarterly visit to the endocrinologist and as usual it was exciting and simultaneously unexciting because that's how endocrinologist appointments go. The night before, I introduced my little sister to Diasend because both of us are eternally lazy when it comes to logging and this program makes it easy to upload data from all of your medical devices onto one easy to read chart that my endo likes. (And it's a little important that the endo likes it, since she is the one helping interpret the data.) My sister has a t:slim, so she can easily plug in her pump and upload data. I felt inspired to do the same with mine, but mine is an Animas Ping. That means that I had to pull out an IR Reader.

At this point you may be wondering: "Sarah, what is an IR reader?" Oh well in the ancient days when I began using Animas pumps, they used these things to wirelessly transfer data from the pump to the computer. I even remember using one to change the song for my pump alarms. They may seem innovative/ easy to use, but it's not the wireless/ bluetooth type thing you're probably thinking of. I have to take my pump off, suspend, it, place it on a flat, non-moving surface with the back facing the reader, and hold it as still as possible until the green light that confirms it is lined up stays solid green. This process takes way too long and I may have had to hold my pump in place for an amount of time that made my arm sore. #thanksanimas (Here's a video if you care to know how this thing actually works.) Now back to your regularly scheduled endocrinologist-themed programming. Let's skip to the next day because all that happened after that was complaining about the previously discussed ancient technology and printing charts.

I was awoken at 6:45 in confusion because we had to leave at 7:15 AM to get to our appointment at 8:45. (You know, to compensate for Atlanta traffic.) Apparently everyone is on vacation and we didn't get the memo because we got to Atlanta at 8. That's uncalled for record speed. So of course, we did what any group of tired people that got up way too early for a doctor's appointment would do: we went to Starbucks. In case you were wondering, I got a hot chocolate with a shot of hazelnut (because #nutella) and an egg and cheddar biscuit, my mom got an Earl Grey tea and a blueberry muffin, and my sister got a iced green tea lemonade. I'm sure the endo was very happy that we all had a bunch of sugar before coming over.

We left Starbucks and arrived fashionably late (by two minutes) because that's just how we are. I signed us all in and I got to sign my own HIPPA release, so my parents can still see my medical files. (The excitement of being an official adult.) My mother also talked to the office about my CGM upgrading issues. (There will be a whole blog post for that next week because the story behind that is too long and exciting for just half of a blog post.) Thankfully, those should be mostly solved by next week and I should be getting a CGM soon.

My A1c, which never seems to change according to my sister, was 7.2%. (It went down by 0.1%, so her point may be proven.) I'm not complaining about it, but I definitely want to work on going below 7%. We changed some of my sensitivity factors, since I always seem to be going to bed high as well as my evening basal to combat highs. I'll be sending logs in next week after I test those changes, so we should be able to see if those help out soon. We also talked about college and talking to my roommate about diabetes, as well as the Disability Resource Center, since I'm being put into their system next week. I'm doing this mainly so I can have testing accommodations. I'm having my official meeting with the DRC next week, so I'll share more about that in the next few weeks. I'm also super excited for my sister because she will be getting a Dexcom soon! I love my CGM and I think it will help her a ton, so I'm psyched for her.

I'll update you all on how my basal/ ISF changes worked, my CGM woes, and college, so stay tuned for that. I promise it's coming!

Weird Dreams

noreply@blogger.com (Sarah Spiller) — Thu, 07 Jul 2016 15:00:00 +0000

Sorry for the lack of posts last week. I'm trying to begin posting weekly, but sometimes it takes to for exciting diabetes related events to occur...
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I should have known that a few days after reading Ally's post about having crazy, diabetes related dreams that I would have one too. I really should have. But I lack the foresight that hindsight bias thinks I should have, so here we are with a blog post about it instead. I digress. On to the dream.

In my dream, I was sleeping and then woke up with low blood sugar. (And as my friend and I talked about the other day, those are always the worst because you don't think you actually need to wake up in real life.) It was one of those really bad lows where I didn't even have the physical motivation/ strength to move the four inches to get my blood tester, so I was mentally yelling at myself to move and get up because I knew I needed to test my blood or things would have gone downhill.

After mentally yelling at myself, I woke up and was totally freaked out, thinking that I needed to test my blood because I was obviously low. It turns out I was actually in the high 100's and didn't have any blood sugar issues. It took me a few minutes to actually realize that most of what had just happened was actually a dream. I don't recommend having this kind of dream. It sucks.

I've heard of low blood sugar induced weird dreams, but I never expected to have an actual dream about something so real, if you know what I mean. It was definitely a chilling dream to have and I'm glad I don't have these kind of dreams often. (#fingerscrossed it doesn't happen again)

Moral of the Story: As soon as you read about it on another blog, it will happen to you.

I Feel Personally Victimized by Food

noreply@blogger.com (Sarah Spiller) — Tue, 21 Jun 2016 15:00:00 +0000

On the way home, I was thinking about Waffle House and how it ruined my BG the one time I ate there, and then I thought about all of the restaurants and foods that seem to always wreak havoc on my blood sugar. So I bring you my definitive list of places and foods I can't eat (at).
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Movie Theaters
Every single time I go to a movie theater, my blood sugar is high or it goes up really quickly. I blame the butter-filled tub of popcorn I enjoy eating and the strange movie theater carpets. I should also probably cover my popcorn before I eat it, not in the middle of the movie when I suddenly realize that I've forgotten to cover it.

Waffle House
I already don't like Waffle House because it's just kind of gross in there, but the following story definitely adds to my distaste for the place. The morning before my AP Macroeconomics exam, my class met up at a Waffle House near to school to eat and chat before the exam. I got a waffle and some eggs and of course put syrup on my waffle. Needless to say, my blood sugar went up to the 300's (even though I covered my breakfast) and stayed there until their convenient drop to the 100's right as the exam ended. My site may have also been bad, but I'm not 100% positive. Thanks Waffle House.

Pizza
No one likes pizza's strange effects on blood sugar. My sister told me that on her first day of camp this summer, pizza was served and all of the counselors and clinicians were not exactly happy because a couple hundred diabetic campers were about to have some weird blood sugars. I'm pretty sure way too much of the camp's supply of insulin was used that night. And I'm also pretty sure that I use up way too much of my own insulin on pizza night as well.

A picture from one of my many Starbucks runs. Also featuring the keys that are currently lost.

Frappuccinos
This is the most tragic item of all on my list. If you know me, you know that I love Starbucks and frappuccinos, so when my dad mentioned to me that I should consider putting them on my banned food list because I always complain about being really high hours after drinking them, I was not very happy. I'm still mourning it to this day. Now I enjoy Iced Chai Tea Lattes and Strawberry Açaí Refreshers with coconut milk to make sure I get my Starbucks fix.

Ice Cream
After years of experimenting with combo boluses, I've finally figured out how to bolus for ice cream. (I do a 60:40 combo bolus over 1 hour, but of course YDMV.) But before approximately a month ago, I would cover my ice cream and then go low an hour later. Every single time. (Who knew ice cream could actually lower blood sugar. Maybe I should eat it more when my A1C needs to go down...) My sister also complained about how that wasn't really a problem, but it stopped me from eating ice cream. And does a teenage girl deserve to be deprived of her ice cream? I think not.

Instant Oatmeal
This super easy to make version of oatmeal is not so easy to deal with when it comes to my blood sugars. It causes a major spike and then a huge drop all within a few hours after breakfast. The instant oatmeal phenomenon also affects my sister, and I'm pretty sure she's more hurt about it than I am.

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What is one of the foods/ restaurants on your banned list? Or do you have any bolusing suggestions for frappuccinos? (Because I really miss them. #addict)

My Tips for High School Students with Diabetes

noreply@blogger.com (Sarah Spiller) — Thu, 16 Jun 2016 15:00:00 +0000

As an official high school graduate, (and as a person that appreciates advice) I thought that it would be a good idea to share what I learned, diabetes-wise during high school. This includes anything from dealing with teachers and students to having fun. (And the crowd was shocked when they heard people with diabetes could have fun.) I hope these tips can help a few people out. Or just provide you with entertainment for the next couple of minutes.
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1. Introduce Yourself
Seriously. Go introduce yourself (and your diabetes) to the school nurse and all of your teachers at open house or during the first few weeks of school. Having a school plan and supplies in the nurse's office will make your life and her life easier if anything ever happens to you/ if you're having a really bad blood sugar day. My school nurse usually emailed my teachers to let them know I was diabetic, but I also took it upon myself to introduce myself to my new teachers. I would always do this because teachers often skim through emails and it's a lot easier to put a name to a face when you introduce yourself, rather than by looking through an email and roster.

2. Get a 504 Plan
Not having a 504 plan is one of the (many) mistakes I made in high school. Luckily, I didn't ever need one at school because my teachers were very understanding about my blood sugars and didn't mind if I had to take a test at another date or time because of an awful high or low. I recommend a 504 plan because if you ever want to apply for accommodations for standardized testing, or if you have a less-than-understanding teacher. If you want accommodations to allow for extra breaks due to blood sugar issues during your SAT or ACT, they will ask for legal proof of your disability and the accommodations you already receive at your school for testing; it is so much easier to apply for these when you already have a 504 in place. You can find info about making your own 504 plan from Children with Diabetes and Beyond Type 1.

3. Figure out a spiel, if you want to answer people's diabetes questions
Tons of people will see your pump, look at your CGM site, and watch you test your blood, and some of these people will have questions. If you don't want to answer their questions, you can just tell them you don't feel comfortable talking about it. If you're fine answering questions, come up with a short blurb that explains what this whole diabetes thing is and what your devices do. Mine goes something like this:

"I'm a type 1 diabetic, which means that my body can't convert the food I eat into energy, so I give myself my insulin, medicine that allows my body to do this conversion through my pump. I test my blood so I know how much insulin I need to take, along with using a CGM. My CGM is a tiny device with a wire under my skin that tests my blood sugar every five minutes and this displays on my receiver. It tells me what my blood sugar is and if it rising or falling, which helps me figure out what I should eat and how much insulin I can give. Any questions?"

Short-ish and simple. (Kinda...) Having this little speech already in the back of your mind makes it easy to explain everything to the general public, without using up too much of your own time.

4. Take advice from the boy scouts and be prepared
There will seriously be days when your pump site leaks, your blood sugar is through the roof, and your parents won't be able to bring extra insulin/ sites/ shots. Learn from the billion times I forgot to bring extras to school, (I may be the most forgetful person I know. Oops.) and keep an extra site change, shots, insulin, and glucose tabs with you. Throw them in your locker, backpack, purse, or leave them in the nurse's office so you'll always be prepared for the worst.

Did you know? Cognitive function is impaired with a BG under 70 mg/dL ( ~3.9 mmol/L) and over 250 mg/dL (~ 13.9 mmol/L). No test taking or diving please! Do you ever notice your brain go a little fuzzy when you have a high or low BG? #KnowledgeDrop

A photo posted by Beyond Type 1 Daily (@beyondtype1daily) on Jun 8, 2016 at 3:20pm PDT

5. Know your limits and respect them
Recognize the point when you can no longer focus in class, take a test, or properly study due to your blood sugar and figure out what to do about it. Ask to go up to the nurse, so you can get your blood sugar up or down and be able to step away without getting too worked up over it. I tried to stick it out my physics class when my blood sugar starting going low and let me tell you, it didn't work out well. (Learning about the intricacies of torque while having a blood sugar of 60 just doesn't work.)

6. Learn how to react to people's words
Sometimes people, even your friends, can make a comment that suddenly puts you in an awful mood because it reminds you that you are the different, diabetic one. Most people don't realize how harmful their words are and end up making some pretty dumb commentary on diabetes and the things people with diabetes have to do. If your friends or others consistently say stuff that is rude and hurtful, call them out on it and ask (preferably nicely) for them to stop. If they don't, they really aren't worth spending your time with.

7. Remember that most people won't make diabetes a big deal
Unless you are constantly bringing up your diabetes, people usually won't care at all about it. Of course, know that sometimes making a deal out of it (if you need to slow down because of high or low blood sugar) is necessary and okay. You shouldn't feel bad about your own self care.

8. Find a support system
Having a group of people you can vent to about diabetes, without having to explain the entire backstory of diabetes to is vital. Talk to camp friends, go on twitter, instagram, or tumblr and search through #diabetes to find someone to talk to. Everyone needs friends to help them get through the worst of DKA/ diabetes burnout/ life with diabetes in general so find these friends and stick with them.

9. Don't take diabetes too seriously
High school is stressful enough as it is, and adding in diabetes to the mix can make it even worse. Don't worry about having bad blood sugar days or the high you get after going out to an amazing restaurant with friends. Don't forget to cover your food, but don't forget to have fun too. Find a cute bag to throw your diabetes stuff in, (I'm partial to this bag from Myabetic or this clutch from Prikkedeif) cover your devices with cute stickers from PumpPeelz, (I love the citrus print, these cute blue flowers, or the option for your own custom skin), and hold your site in place with a cute seahorse. Do fun stuff and don't let diabetes be something that stops you. High school is a time to have fun, (and of course to do schoolwork to get into college) so take advantage of that.
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Now that you've read through these, do you have anything to add? Or could you do your girl (aka me) a favor and give me some tips for surviving college with diabetes, since that will be my next endeavor?

P.S. I totally wasn't sponsored by any of the companies I linked to in this article; (even though I would love to be!) I just love their products and wanted to pass them on to others.

As Usual, I Forget Everything

noreply@blogger.com (Sarah Spiller) — Tue, 14 Jun 2016 15:00:00 +0000

When one of my friends invited me (and a bunch of of my other friends) to go to a house in, and I quote, "the middle of nowhere," I wasn't the most eager. (I'm not exactly a fan of the middle of nowhere, especially when there is no internet connection.) But after a little convincing from my family and friends, I decided to go. I packed up all of my things for a three day adventure to a house on a river and of course, ended up with an entirely full carry-on bag, Northface backpack, and tote bag. I like being prepared, and a trek into the middle of nowhere definitely required that much stuff. (Obviously.)

As I packed up everything the night before, I realized that I didn't have any extra insulin in the fridge or in my bag. Of course, it was probably 12 in the morning, so I just decided to ignore it and hope I could take my sister's extra insulin, instead of doing anything about it. Fast forward to the next morning. I wake up and tell my dad that I have no insulin and he kind of freaks out, (sorry Dad) and of course, Anna's extra insulin has also gone missing. My dad desperately tried to fill my prescription and then we had yet another great revelation: my dad can no longer fill my insulin prescription because I turned 18 a few weeks ago. (Imagine how much more happy my dad was after that...)

My dad frantically made me an account, so he could fill my prescription and then we had our third realization: CVS doesn't open until 9 and my friends and I had to leave by 8. This story ends with me calling a random CVS in Birmingham on the way to the river house and all of my friends laughing at me as I explained to the random pharmacist why I needed my prescription transferred from where I live to Alabama. Comments included: "Sarah you told that person way too many details!" and, "They probably didn't even care."

We stopped at the CVS and I picked up my insulin; I asked if anyone had a cooler in the car after I grabbed it, and then I found out that my friend's mom's car has a cooler built in to it. Who knew? She, of course, let me use it. (And was also as excited about this new discovery as I was, since she had been waiting to find a practical use for the cooler box.) After that little adventure involving insulin, a few more things seemed to go wrong.

The beautiful view we had at the house. Photo credit goes to Michael, since I apparently forgot to take pictures.

At one point on the river, my pump site came out, so I had to walk up 207 steps to get back to the house. (Those steps were evil and let me tell you, my legs burned after walking up them.) My blood sugar also seemed to always be obscenely high before meals, so I sadly had to wait until 10:30 pm at one point to eat some absolutely delicious ice cream. (I'm sure the billions of bags of doritos/ cookies/ cheez-its I ate were the cause of that, though. #irresponsibleeating)

All of the mishaps didn't cause too much of a dent in the fun I had that weekend. I jumped off of a cliff into the river, (side note: don't cannonball from a two story high cliff) helped rescue a canoe my friends flipped over (my t-rescue skills from camp finally came in handy), swam in the lake for forever, and played a ton of fun board games. (I brought Sorry and it was everyone's favorite.)

Moral of the Story: Bring a site with you on the 207 step trek to the river. Because your current one will fall out.

When Sisters Share Everything, Including Pumps

noreply@blogger.com (Sarah Spiller) — Tue, 24 May 2016 18:51:00 +0000

I'd like to categorize this under weird stories that only diabetics with diabetic friends would really understand. As soon as my dad witnessed this happen he told me that I had to put it on the blog. So here's a post for you, dad.
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The other day, I was at my robotics team's banquet, which I had spent the last week planning and the 5 hours preceding the it buying food and making awards to make sure this event actually happened. In the midst of all of this errand running, my sister and I were home for about an hour, so I could make awards and we could both get ready. While frantically running around, finishing making awards, and stuffing four cheesecakes, two pans of baked ziti, and a bag filled with pictures and more all into a single car, my sister forgot her pump.

Of course, no one realized this until after we had gotten to our destination: a lake house 30 minutes away from our own home. Suddenly my sister looked and me and said, "Sarah, I forgot my pump." I looked through my tiny purse (life lesson: don't carry around a tiny purse, in case of emergencies) and realized that I didn't have any extra insulin or shots floating around. So, when it was time to finally eat, I did the most logical thing possible: I gave my sister insulin through my pump. Sketchy? Absolutely. Weird? Definitely. Successful? Yes.

Medically, I can't (and won't) recommend this to anyone. It just felt so weird and wrong on some sort of fundamental level, but it did technically work, so I can't disapprove of it too much. A few days later, we were sitting in the car drinking frappucinnos (which are now blacklisted, but that's a story for another day) and I made a comment about how my pump had run out of insulin. Anna offered me her pump for a quick bolus, but I laughed and declined. It was a only fifteen minute ride home and it wasn't worth committing another pump sacrilege.

#DBlogWeek Day Five: Tips and Tricks

noreply@blogger.com (Sarah Spiller) — Sat, 21 May 2016 02:51:00 +0000

I'm currently sitting in my last mandatory class of high school writing this, so that is exciting. I'm also very tired because I stayed up way too late working on yesterday's AP Lit time capsule and I've netted maybe 4 hours of sleep at the most; if I seem like I'm rambling a ton or I just don't make sense, that's probably why!

Let's round out the week by sharing our best diabetes tips and diabetes tricks. From how you organize supplies to how you manage gear on the go/vacation (beach, or skiing, or whatever). From how you keep track of prescription numbers to how you remember to get your orders refilled. How about any “unconventional” diabetes practices, or ways to make diabetes work for YOU (not necessarily how the doctors say to do it!). There's always something we can learn from each other. (Remember though, please no medical advice or dangerous suggestions.)

As soon as I read this prompt, I thought back to #DBlogWeek two years ago and remembered writing for a similar prompt. I loved reading through everyone's tips and I learned a few new tricks myself. I'm excited to look at everyone's new tricks and happy to share a few of my own!

CGM Sites: Seriously, I have no clue how Dexcom expects their sensors to stay on for seven days with the adhesive they put on sensors. Without any help, my sensor lasts maybe three or four days. To solve this problem, I use Opsite Flexifix to keep my CGM in place. I cut out a rectangle a little bigger than my CGM and its adhesive, then cut out a hole in the middle to make sure the sensor itself isn't covered in tape for a week. I usually keep an old CGM site around (even though that sounds kind of gross) so I can make sure I'm cutting things out correctly.
Keeping Your Pump Attached: This is more of a girl issue because dresses are a major problem when it comes to figuring out where to put my pump. Nike running shorts (or compression shorts) are perfect to wear under a dress and won't fall when you clip your pump to them. Some people attach their pumps to their bras as well, but I have no clue how to do that without it looking like I have a strange rectangle in the middle of my shirt.
Priming Your Pump: Whenever you're priming your pump, put your pump on its side with the tubing being held straight up in the air. This will get rid of those pesky air bubbles at the top of your cartridge. I feel like I read this on either Kerri's or Kim's blog (so there's me giving credit for the idea) and it changed my life completely. I can't believe I had never thought of this before.
Organizing Supplies: I organize my supplies using these fabric bins and putting them inside of a shelf and it makes my life so much easier. They are color coded for ease of access when I'm frantically trying to find a site. I use green for my sites, since my sites are green; blue for my cartridges; and orange for my CGM sites, since the boxes they come in are orange. It's a super simple system and it's so much nicer looking than having cardboard boxes all over my room.

Those are my newer tips and tricks that I have discovered since last #DBlogWeek's post and I seriously hope that I learn a bunch more by reading through everyone else's posts as well! This has been an awesome #DBlogWeek and I'm so glad Mrs. Dugan convinced me to come back to blogging, especially because it was just in time for me to jump in to the week's topics. I'll be writing a lot more often, so stay tuned for more!

If you love learning about new tips and tricks that make your life a little easier, check out the page with all of today's blog posts here!

#DBlogWeek Day Four: The Healthcare Experience

noreply@blogger.com (Sarah Spiller) — Fri, 20 May 2016 02:03:00 +0000

I apologize for how late this is going up; I've been finishing up my final project for AP lit and am currently taking a tiny break from that to write up a blog post. Well, let's jump into it!

Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What's your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!

I go to the doctor. A lot. More often than most do, to say the least. I'm at the endocrinologist four times per year, my pediatrician once a year, the dentist twice a year, and my eye doctor once per year. That's probably six more doctor's visits yearly than the average person has in two years. To say that I have plenty of experience with doctors in an understatement. This means that I also have plenty of time to form opinions and gripes about what I'm constantly having to deal with, whether it has to do with my actual endocrinologist visits or The System. (Capitalizing it makes it seem more menacing. It worked, right?) Here, in bulleted form (because I love lists) is my list of potential improvements for The System.

For the endocrinologist: Please. Please. Please. Make the wait time shorter. I really abhor sitting in your office for 45 minutes waiting for my doctor's appointment. Sitting and watching other people wait just isn't that exciting. I also wish that you guys could download data from my blood tester and CGM at your office, so if I forget my logs at home, or if you want to see certain data, you can get all of it there. That would make life for everyone so much easier. (And I wouldn't have to use all of the printer ink for my CGM graph.)
For the health insurance company: Actually, the insurance company my family gets coverage from, Cigna, is pretty amazing. We (knock on wood) have never had issues involving getting new pumps, getting permission for CGMs, or choosing what insulin or blood testers we want. Hopefully that will stay the same after Anthem and Cigna officially merge.
For Neighborhood Diabetes: You guys are required to distribute my CGM supplies. Why? I don't know. If you all could kindly actually put my supplies on auto-refill, instead of forcing me to call every three months, order supplies, and ask for auto-refill for the 80th time, that would be lovely.
For Animas customer service: You guys rock. I called you all one at 3 am and you still helped me out. A+.

Honestly, I am lucky enough to have an awesome endo and insurance company. I know not everyone is this lucky, and wish that other insurance companies could get it right, instead of forcing people to pay out of pocket for CGMs, to use only one type of insulin, or to only use one type of pump. That is awful and I wouldn't want to live without having a choice of what I get to use to deal with this condition that I didn't choose. I want all insurance companies to remember that patients are people too, and that all people deserve choices.

Thanks for sticking around through #DBlogWeek day four! If you want to share your opinion or read other's on The System, you can chek out all of the posts for today's topic here.

#DBlogWeek Day Three: Language and Diabetes

noreply@blogger.com (Sarah Spiller) — Wed, 18 May 2016 23:52:00 +0000

Well, today am officially an adult, so that obviously means that I now have a new, enlightened viewpoint on life itself and I will be showcasing that today. (Just kidding... Do I really even count as an adult if I just turned 18 today? I digress.) I woke up at 5 this morning to take a shower and it's currently 7:05 AM as I begin writing this, so I'm super early to the blogging game today.

There is an old saying that states “Sticks and stones may break my bones, but words will never hurt me”. I'm willing to bet we've all disagreed with this at some point, and especially when it comes to diabetes. Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. For some, they don't care, others care passionately. Where do you stand when it comes to “person with diabetes” versus “diabetic”, or “checking” blood sugar versus “testing”, or any of the tons of other examples? Let's explore the power of words, but please remember to keep things respectful.

When I read the prompt this morning, I thought of something John Green said in his latest video: "Language exists to facilitate communication; to make my thoughts transparent to you and yours transparent to me." This statement can be considered a universal truth, after all what else could language be used for? Language enables me to share my perspective with you and allows you to respond and share your own perspective with me. That being said, I honestly don't mind being called diabetic or someone saying I'm testing my blood, rather than checking it.

I use these words all the time, and they don't have negative connotations for me. When I hear someone ask, "Are you testing your blood sugar?" I don't automatically think that he or she is implying that I am just some big human science experiment or that every blood sugar is a grade that I either pass or fail. I call myself diabetic, so I don't have a problem with others calling me this. Yes, I am a person with type one diabetes, but I am also a type one diabetic. Either works for me.

Often, it isn't the words themselves that hurt me when it comes to diabetes, it's the tone. A person's tone can completely change what something means; if someone asks me, "What is that?" in a confused tone of voice, that is an innocent question. If someone asks me the same question in a judgmental tone, of course I'll be offended. It isn't this person's (or anyone else's) place to judge the chronic illness I live with or how I manage it daily, and that is honestly the reason why so many have been hurt by people's words. Because they feel judged or chastised for something they simply cannot control. (Have you seen how annoyed I get when people are judgmental?)

Something I have come to realize, which I touched on a little yesterday, is that being offended by people's words, being angry about them, and dwelling on them won't help anyone. It won't help teach someone why what he or she said was offensive and rude. It won't make you feel better or live a happy life. It will just breed more anger and hatred in both parties. When someone's thoughts and actions are full of stigma, instead of yelling at him or her, take the opportunity to speak up to explain the reality of your situation. If someone makes a joke about eating too many sweets causing diabetes, calmly explain that diabetes, no matter what type, is influenced by genetic predisposition, as well as a variety of other factors. It's as simple as that. If he or she doesn't listen, don't stress out, just move on. Laugh off their ignorance later with the DOC and some friends and move on.

We all give words the power to make or break our days; I know some words hurt more than others, but us humans seem to focus on the negatives much more than the positives. Focus on the good. Focus on the friendships, the fun camp memories, and the great times you've had because of your diabetes; don't focus on the few complaints or jokes people have said at the expense of you and your diabetes. Others' language can make their uninformed thoughts transparent to you, and yours can make the truth of the matter transparent to them. It's a simple as that.
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Do you have some of your own thoughts about language that you want to share with others? Do you want to read more posts about today's topic or just learn more about #DBlogWeek? If so, check out all of the info here.

#DBlogWeek Day Two: The Other Half of Diabetes

noreply@blogger.com (Sarah Spiller) — Wed, 18 May 2016 01:00:00 +0000

In the midst of graduation, my birthday (I turn 18 tomorrow), and all of the stresses associated with life, I was reminded by my amazing AP Language teacher from last year (the person that had me write this) that this blog existed and she encouraged me to start writing again. #DBlogWeek is happening at a perfect time because I have no clue what to write about at the moment, so I am super thankful for the week of prompts! Let's jump into my first blog post of the year! (Oops...)

We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk?

Diabetes, thankfully, hasn't put too much strain on my mental health. I am so grateful that I was diagnosed at 5 1/2 years old because I don't have to live with memories constantly reminding me that I was once non-diabetic. I watch my little sister struggle sometimes with her diabetes and I know that part of it is because she can remember being able to eat what she wanted without covering her blood sugar or having to test her blood. While my mental strain is never too high because of diabetes, I do still have little worries here and there: the possibilities of complications; how annoying testing my blood is; and how easy it is to forget insulin are a few of these small worries that ebb and flow through my mind.

Unfortunately, diabetes does affect my emotions. A lot. High blood sugar = being annoyed at everyone, difficulty focusing on anything (which is especially fun while I'm taking tests or my AP exams), and me being a general pain for most people I'm around. Low blood sugar = being shaky, talking too fast and nonsensically for others and myself to understand, and staring down other people's food as I search for something to make my hunger disappear. After over a decade of diabetes (wow, that's quite a long time), I've learned that sometimes I just have to be patient. Trying to do a physics problem when my BG is 504 is just not going to happen. Eating only four glucose tabs will do the trick when I'm waiting for my blood sugar to go up, even though I feel like 8 is a better short term plan. Diabetes is a huge lesson in patience (and I've been in a love/hate relationship with patience for years). I've also learned that the people that make the most ignorant comments of all, often just need more education than your average person. There's no point in wasting my time or energy on being bitter and angry, when instead I could be educating and changing someone's view of the world.

Whenever I'm have a worry-filled day or just a bout of burnout, I try to treat myself. Whether I am watching my favorite movie, reading a new book, or just making some of my favorite tea, I try to do something for me to make myself feel better after having a rough day. Doing something for myself makes my day a thousand times better and gets me out of a negative mood (which I'm trying to work on). Talking with the #DOC, whether it is through twitter, blog, or video, always helps. Misery loves company and sharing your experiences with others that actually understand what I'm going through helps me get through my rough days and I'm sure it will help you, too.

Remember when times get tough, that you are more than your diabetes and that you always have the DOC, friends, and family to talk with.
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If you want to get involved with #DBlogWeek or read more posts about today's prompt, you can check out the link up to the responses to today's prompts here!

In the Advocacy Spirit

noreply@blogger.com (Sarah Spiller) — Sun, 01 Nov 2015 21:39:00 +0000

Last time this year, I was not in the advocacy spirit; I was going through burnout and honestly just didn't want to yell to the world, "I'm diabetic!" If you're in that boat right now, don't feel bad. Everyone goes through it and I totally get it. Advocacy for an entire month is overwhelming, to say the least. This year, I'm ready to jump back in to the advocacy game. It probably helps that I've been gone for months, but I ready to wear blue on Fridays, post photos on Instagram on the daily, and talk it up about diabetes all month long. I can guarantee that I won't be blogging every day because I don't have the time to write actual blog posts daily. (College applications, standardized tests, and school can be to blame for that) Either way, I'm going to be more present this month and tell anyone that wants (or doesn't) to listen about diabetes because it's important and here until there's a cure.

If you're looking for somewhere to start, advocacy wise check out some of these websites:

T1D Looks Like Me // A JDRF initiative that requires a simple selfie and a quick filter to show that there is no specific person that looks diabetic. They are also hosting meetups throughout the US during November for Diabetes Awareness month
Beyond Type 1 // A social media based advocacy platform with ideas for fundraising, advocacy, and resources for any diabetic in the modern age.
#DiabadassChallenge // An Instagram challenge for November centered around diabetes, which is great way to educate others about diabetes while also helping you find other diabetics by simply searching through the hashtag.
World Diabetes Day // The IDF's yearly campaign focused on diabetes awareness and advocacy. A great place for so much information about diabetes and advocacy that your head might explode!
Blogs // Blogs are great places to find inspiration for advocacy. A few of my favorites are Six Until Me, Diabetesaliciousness, Texting My Pancreas, Coffee & Insulin, and Very Light, No Sugar.

I hope you are as excited as I am for this month!

A New Adventure

noreply@blogger.com (Sarah Spiller) — Fri, 12 Jun 2015 13:00:00 +0000

At #dsma on Wednesday, we were asked a simple question: "What's missing? What isn't working? What doesn't need to be changed? What would you like to see?" I thought about it for a moment and then tweeted this:

Q1: I think the need for a POSITIVE community online and offline for teens hasn't been met. It's discouraging for me as a teen. #dsma
— Sarah (@meow_its_sarah) June 11, 2015

I was honestly surprised that more people hadn't noticed this gaping hole in the #DOC, but then I remembered that the #DOC is mostly filled with (amazing) adults. While there are places for college-aged diabetics, there aren't many places for diabetic teens that want a positive community of people to talk to. Project Blue November has a panel of teens that answer submitted questions about a given topic each month, but there isn't really room for discussion there. Tumblr is also a place where most teens go to talk diabetes, but it is often a negative place for a teen to go. Many people on tumblr go to escape, so there is a lot of negativity (I'm not bashing this awesome project, just giving everyone an example of how tumblr seems to be for teens) surrounding diabetes there.

I've been hoping that someone else would realize this and get on it, but after seeing this tweet, I've come to accept that I'm going to have to do something about this. So here I am telling you that I will start a tweet chat for type 1 diabetic teens. I don't have a hashtag, (though I'm thinking about #t1tchat. It hasn't been used and is short and sweet.) I have no website, haven't talked to many people about it, but it will happen. I'm hoping that I can start it by the beginning of August, but I need your help to get it done.

How can you help? Simple. Find blogs, tudiabetes accounts, twitter accounts, facebook pages, google + accounts, tumblrs, and anyplace else on the web there is a teen with type 1 diabetes and send their links my way. You can email them to me, (inulinpensink@gmail.com) tweet/ direct message me, (@sarahspillerr on twitter), use any other social media link on the sidebar, or just comment on my blog to let me know.

I'm on the hunt for people too and I'm definitely going to create a home for this chat on the internet soon. If you have any suggestions or think you could help, I'd love if you could comment below or email me!

Moral of the Story: I'm ready for a new adventure.

Necessary & Proper Adjustments

noreply@blogger.com (Sarah Spiller) — Tue, 09 Jun 2015 13:00:00 +0000

You know how there is always the tiny caveat in the fine print on the registration page for that new yoga class you're dying to take or at the end of that article you just read about running? The one that tells you to, "consult a doctor before participating in physical activity." Yeah that one. You know else they need? One that tells you to consult yourself before you participate in physical activity.

I'm enrolled in online gym and health (it's about as exciting as it sounds) because of scheduling issues at my school because I'm in chorus and STEM at my school. I'm required to keep an exercise log throughout the class which means that I actually have to do more than yoga, since I have to participate in physical activity that gets my heart rate to my 'target range.' Today I innocently decided to try running.

I put on an old t-shirt and my trusty (read: 4 years old) norts and laced up my Nikes (read: also old) to prepare for my run. I decided to bring our chiweenie with me, so I sneaked the leash past our fast asleep Yorkie and our preoccupied outside Heinz 57 and ventured outdoors with the dog. My blood sugar was 152 and my CGM said gave me a , so I assumed I was good to go. Wrong.

This may be completely irrelevant, but who cares? I like it.

I spent 34 minutes ~~torturing myself~~ walking and running with the dog and was exhausted/ hot/ sweaty/ thirsty/ miserable. I took a shower for obvious reasons (see aforementioned sweaty) and went to my room to call the local Apple-fixing store to see if they could explain an issue I'm having with an old iPhone. As I was struggling to read the IMEI number off of the back of the phone to type it in, I realized I was probably low. (I think Apple uses size 3 font on their phones.) I checked my blood sugar and there was an unpleasant number on my blood tester: 32.

I freaked out and ate about 90 carbs consisting of two juice boxes, a slice of peanut butter toast, a banana, and an unknown amount of pringles, in that order. That probably wasn't the wisest of decisions, but at the time it felt right. (This sounds like someone explaining a bad decision. Oh wait...)

What I'm trying to say is: adjust your insulin or eat something before you decide you're going to start your next health kick. Otherwise, you'll end up, as my mother so eloquently puts it, "inhaling everything without covering it."

Moral of the Story: + =

FOMO

noreply@blogger.com (Sarah Spiller) — Thu, 04 Jun 2015 15:00:00 +0000

It's a real word, according to the Oxford Dictionary. We all know (or if you don't know, you do now) that it stands for the fear of missing out, but is there a word for knowing that you're missing out? That's how I'm feeling at the moment while my little sister is at camp while I'm here not doing much at home.

I wake up every morning at 11:30 AM (mostly because I stay up way too late watching the X-Files) and think, "Wow, they're about to eat lunch and I'm laying in my bed doing nothing." (#livingthedream) I read The Skimm, (an awesome email service that finds the important news, summarizes it, & puts it in less daunting terminology) test my blood and take my Synthroid, (yay endocrine system problems) and then watch X-Files to wait my required 30 minutes before eating. (Or in this case I forgo that ritual to instead write this blog post.) I'll forget my feelings of missing out for a while, but then at night, while I stare out of my window into the not-so-dark sky, (because there's a full moon tonight) I feel it again. That sounds super dramatic, I know, but that's my story and I'm sticking with it.

Camp is my favorite place in the whole wide world and it makes me so sad that I couldn't go with Anna this year, but I know second session is going to be amazing and that CITing is going to be the best. Absence makes the heart grow fonder, right? Well if that means that wanting to be at camp right now will make me camp even more fun, then I REALLY can't wait for camp this year.

I'll leave you with a video of one of my favorite camp songs ever:

Moral of the Story: Love is wider than the miles between you and me, camp.

It's the Dexcom: Parenthetical Pediatric Edition

noreply@blogger.com (Sarah Spiller) — Thu, 21 May 2015 15:00:00 +0000

So now that I've had my mandatory mental breakdown, I think it's time for things to resume to their normal operations. So first let's go ahead and talk about my newish toy: the Dexcom with Share. It's actually the same thing as my old Dexcom. Except it actually charges and it seems to be more accurate than my old one. Maybe it's the software update? Whatever it is, I like it. I also have the special pediatric (in parentheses) edition because apparently there is a difference between the normal G4 with Share and the pediatric G4 with Share. (Update: there are two additional warning screens to tell me that my CGM is not 100% accurate. Because apparently that makes a medical device suitable for children?) I'm also hapy that Dexcom printed the 'Rx only' text on the back in a darker color so maybe potential thieves will get a clue and realize that what they are about to steal is a medical device. Not an iPod. (I can't believe I wrote that post as a freshman. Now I'm about to be a senior. Oh my gosh.) I digress. I haven't actually tried the all-important 'share' feature because I have a Galaxy S5 and having to carry around my iPod just to see my blood sugars seems kind of counter-intuitive. I am debating getting an iPhone because a) share app and b) the Apple health app looks so cool.

#cgmonpoint

In other good news, Monica Vesci is coming back! The brand used to make tons of adorable clutches that had enough space for your diabetes and regular essentials. I always had my eye on their clutches, but they shut down their store for a while and basically disappeared. Now the brand is back and is soon starting up a Kickstarter to begin selling clutches again! I'll let you all know when clutches can be bought because I am super excited for these to be sold again. (FYI, I'm not endorsed by the brand, but I wouldn't be sad if they sent me a free clutch... #desperate) And also cute accessory/clothing related: I found out after buying some of J.Crew's chino shorts that their pockets are big enough to hold my pump! That means I don't have to wear my pump on my shorts all the time! YAY!

And here is my obligatory blurb about camp. Because it's about to be Summer and everyone knows that means Camp Kudzu! I have the amazing opportunity to be a CIT (Counselor In Training) for camp, which means I'm almost a counselor and I'll get my own cabin to be with during the week and I am so excited! I won't be going to cap with Anna because my parents accidentally signed her up for first session instead of second session, but I'm still super excited to be going. I can't wait to be back at camp walking way too much and having way too much fun! And did I mention that this year's music party theme is Disney? How awesome is that?

Moral of the Story: I'm currently in need of money for cute accessories and Disney themed attire. Donations to my non-existent bank account are appreciated and encouraged.

#DBlogWeek Day Three: Clean It Out

noreply@blogger.com (Sarah Spiller) — Thu, 14 May 2015 01:41:00 +0000

Yesterday we kept stuff in, so today let's clear stuff out. What is in your diabetic closet that needs to be cleaned out? This can be an actual physical belonging, or it can be something you're mentally or emotionally hanging on to. Why are you keeping it and why do you need to get rid of it?

I'm sitting on my bed surrounded by a shopping bag filled with shorts from J.Crew, my viola lesson books, and my AP Calculus binder writing the prompt for #DBlogWeek three days late. I never promised I would be on time, did I? Even if I did, I'd probably still be late. So why have I decided to even start writing for a prompt due two days ago? Frankly, I'm in desperate need of TLC from the DOC. I've been running high every day for the last few months and I just don't seem to care. It doesn't help that I've been sans CGM for the same amount of time, but that's still no excuse. Anna got her t:slim a few weeks ago and I'm trying not to be, but I am completely jealous. She had to work so hard to get her pump and her A1C was lower than mine when we went to the endo last and I feel like a failure because here is my 13 year old sister who has been diabetic for four years dealing with her diabetes better than I am. I'm supposed to be a great role model and positive when in reality I'm over here eating three cookies and forgetting to cover them and/or just not caring enough to cover them at all.

This all started because I read some blog about how the healthy habits of type 1 diabetics are the same as the habits of people with eating disorders and considering the fact that in seventh grade I spent a good portion of my time not eating for vast expanses of time because I thought I was overweight and ugly and worthless made me equate healthy diabetes to unhealthy eating, so now I'm here supposed to be writing some blog about how I can do everything I want with diabetes even though I'm just writing about all of the things I do wrong, so that's just great.

I'm not one to incessantly complain about my diabetes because I hate it when all someone does is talk about how miserable his or her life is because of diabetes, but I'm just sick of it all today. My positive 'diabetes doesn't ruin my day' facade is not going to work because I'm honestly experiencing the worst diabetes burnout of my life. I'm miserable with high headaches and feel low when I'm in the 80's and 90's because I'm high so often and sometimes I spend too much time thinking about the fact that my feet might be trash by the time I'm in my 50's or 60's and how my whole body might shut down and I might be absolutely miserable before I die. Normal teenage stuff, right?

Have I ever talked about how when I get home I probably eat 100 carbs worth of snack food and I just don't care? Or how when I was in elementary or middle school I ate an entire bottle of glucose tabs? Yeah I don't think so. Because those are things I don't like to talk about. I don't like being the weak one and complaining, but if anyone else on this whole entire would understand any of that, it would be the DOC. So here I am cleaning out my metaphorical closet because I don't want to carry this anymore.

Do you feed off of the thoughts of other diabetics like yourself or are you just interested in reading more about cleaning physical and metaphorical trash out of people's lives? If so, here is the link for today's #DBlogWeek post.