Game Day

I did it.
It's done.
I rode my bike 40 miles through all 5 boroughs of New York City.
It was pretty fucking awesome.

Unfortunately, I don't have a lot of pictures to share. You know....because I was on my bike.

But it was incredible. In fact, it's what I imagine the apocalypse to be like....before the zombies come in and start trying to eat our faces. Riding my bike up 6th Ave with not a single car on the road as if I (plus 32,000 others) was the only person awake was surreal.

Diabetes management was not nearly as difficult as I would have thought either. Here's how I managed.

First, rather then buy a "too-cool-for-school (or Sizzler)" fanny pack, it was cold enough for me to wear a light fleece with plenty of pockets. I loaded myself up with a snacks, including granola bars and applesauce packets plus what ever additional freebies were given out at the rest stops.

I ate a hearty breakfast of oatmeal, sliced banana, and soy milk eaten with a little less insulin then normal. I figured it was better to go into the tour with a slightly elevated blood sugar then low. When I checked my blood sugar right before the race, it was 168. I lowered my basal insulin to 50% of its normal dosage. Ah, the wonders of the insulin pump never cease to amaze me!

About 5 miles in, my riding partner needed a potty break, where I checked my numbers again. In 5 miles, I had dropped to 98 BG. I ate a mini Larabar without insulin (only 8g of carbs). After another 7 miles, my riding partner needed another break, which gave me time to eat some raisins and half a bagel. This time, I gave myself the proper dosage of insulin, figuring the bagel was going to keep me even (high carbs, high activity rate). At mile 15, we stopped again (she had a very small bladder). This time, I ate a banana, more raisins, and a dose of insulin.

Things were going pretty well until about mile 35. It was the longest stretch we had gone without stopping and snacking. It also happened to the hardest part of the tour, which was the BQE and over the Verrazano Bridge. About midway through the bridge, I was feeling a little shaky and not just from the uphill climb. Luckily, I came prepared with snacks and was able to quickly suck down a GoGo Squeez apple sauce packet (Apple Grape!), a diabetic's best friend.

By the time I arrived at the finish line in Staten Island, I was spent! And hungry! And had a 125 blood sugar! Which meant I could go to town on the free samples and eat an amazing vegan black bean burger with vegan cheddar cheese and relish from Bareburger at the tour's finish line festival.  Holy crap, I'd bike another 40 miles just to eat another burger!

So....that's how it went.

I didn't die. I made through all 40 miles without keeling over from exhausted or hypoglycemia (always a success in my book). I experienced the city in an entirely different, glorious way. I ate a delicious burger. And now have a much better sense of what to expect during the zombie apocalypse (sans zombies).

All and all, quite the happy experience!

Diabetes Police

It is always with hesitation I put up posts that talk about some of the silly/stupid things I might do as a diabetic. Usually the hesitation revolves around the involvement of the Diabetes Police. Dundundun They're kind of like the Fashion Police, only their job is to tell me what I should or shouldn't be doing as a diabetic. It should be mentioned that they are usually not diabetics.

Most of the time, people make comments either out of concern or just plain ignorance. I need to constantly remind myself of that. And, most of the time, I have patience for it. In fact, I like to explain why I can eat what I'd like as long as take insulin, why it's possible for me to get Type 1 at 28, and that high and low blood sugar is just the name of the game in this crazy, messed up world of diabetes.

But sometimes...every once in a while....it really pisses me the fuck off. Can you see where this post is heading?

With the holidays here and parties galore, the Diabetes Police are out in full force. Those who feel the need to comment on what I am eating, how I am eating, and what I should be doing about it. For anybody who thinks that I am not fully aware of what the impact of eating, drinking, blood sugars, and all the rest, you are a fucking asshole! 

Trust me. I know. I'm aware.

But I still need to live my life. And living my life means I may not be the perfect diabetic. It means I forget to bring juice boxes everywhere I go, may not eat a strict low carb diet, and my blood sugar occasionally gets out of range. I'm going to eat an occasional slice of cake, have high blood sugar, have low blood sugar, and occasionally forget a honey packet all while keeping my baby toes, legs, and vision.

It also means that, 90% of the time, I skip the bread at meals. I test my blood sugar multiple times a day. I always take my insulin. I exercise. I carry something with me to treat lows. I take care of myself.

All without the help of the Diabetes Police!

So....are you a member of the Diabetes Police?
Think about it. 

Bad, Bad Insulin

I was worried after Hurricane Sandy that we hadn't rescued my insulin vials in time! Under-prepared and only one cooler to our names, I moved my insulin from the fridge to the freezer to the cooler with fingers-crossed that all three had been keeping it cool enough to prevent from degrading. 

These past two weeks, I have really been struggling with my blood sugar numbers. They've been pretty terrible in fact, hanging out in the 200's like I had been eating cake for breakfast. And you know what the most annoying part of it is....I haven't been eating motherfucking cake for breakfast! I'm getting these high numbers and not even enjoying the crap food to go along with them! WTF, pancreas?!

However, I wasn't quite ready to admit to myself that there are 12 useless vials of insulin sitting in the fridge. I played the usual game:

Maybe it's because I'm getting sick? I'll just wait a few days. Still feel fine. Okay, not that. 

Maybe it's just the infusion site? I'll just change it. Nope, still high. 

Maybe it's just this one insulin vile?  I'll just change that. Hey 210, guess it wasn't just that insulin vile!

Maybe I have lost my ability to accurately calculate carbohydrates? I'll spend the next few days eating only items that I know for sure the carb amounts. F-U 223!!!

Finally, I had to give in and contact my Certified Diabetes Educator. While I am still not fully committed to the idea that 12 vials of insulin have been wasted, they are sending out another three month supply next week. 

I'll let you know how it goes. 

What Do You Do....

...when the power goes off and you have 12 vials of insulin in the fridge?

I may have mentioned before that insulin needs to be kept cold otherwise it will degrade and become less effective, becoming altogether useless. Jerry and I were a little arrogant when preparing for Hurriance Sandy, in that we didn't really prepare at all. Sure, we filled up a few water bottles, had plenty of food, knew we had flashlights somewhere in the apartment, but I think we assumed that we would maintain power and go on our merry ways. I'm sure that's what most people assume....up until the moment the lights go out.

I was hopeful naive in thinking that the power would be out only for a short time. Five days later, we're still sitting in the dark.

My first thought when the lights went out was "What do I do with all my insulin?" Actually, my first though was "Shit, I just made pumpkin mousse and now it's going to go bad." Priorities, people.

I had just received a three month shipment of insulin which means that every single vial I will need for the next three months was in a slowly warming fridge. You think that in all of our "extensive" planning, I would have thought through what to do with these extremely valuable, life-saving vials.

Luckily, Jerry's brother maintained power and has been able to baby-sit my insulin until we can give them a good home again. I'm worried that they still have become too warm in the 24 hours without power, but I guess I'll have to wait and see.

Running Through It

I'm referring to my insulin.

While I mentioned in my post about travelling that one needs to accept that they may use more insulin when on vacation, I wasn't exactly mentally prepared for it. Sure, sure, I sounded all calm and zen about it. I know I'm going to have more high blood sugars. I know I'm going to use more insulin. I know I'm going to possibly have a low in the middle of a massive tomato fight filled with a bunch of Europeans. Yes, yes, I know, I know. It's all fine.

Until it happens.

I heard the familiar beep of my insulin pump, alerting me to a low reservoir (aka running out of insulin). The pump usually gives me a 20 unit warning, meaning that I'm not going to die in the next few minutes. It usually takes me about a day to run through a full 20 units. Apparently, that's not true when I'm travelling in Spain.

You want to hear another funny insulin thing about travelling in Spain? Okay!

I fill my reservoirs up to about the same amount of insulin each time, roughly 80 to 90 units. That usually lasts me three to four days. I've even stretched it to five (unintentionally). In Spain, I barely made it to three days. While supplies are definitely not an issue, it just isn't something I'm use to.

Overall, diabetes had not been a downer on this trip. There were moments where I was annoyed with diabetes or disappointed with numbers, but they were also just that. Moments. Fleeting thoughts that were only dwelled upon until the next glass of Sangria. Which came often.

I was on vacation. In beautiful places. Eating amazing food. I gave myself this vacation.

Travelin', Diabetic-Style

I'm a wicked over packer, but my diabetes brings it to a whole new level! When I go on vacation, I have enough diabetes supplies to keep me alive for 6 months! Great news in case of a zombie apocalypse!

Since I've been doing a lot of travelling this summer,  I thought I'd share with you my Diabetes Travel Tips.

1a. Always bring extra. I bring double the amount I think I'll need when I'm going away with a few speciality items thrown in for ha-ha's. I usually pack syringes, a back-up glucose tester, and even an extra insulin pen (just in case something goes wrong with my pump).
1b. If using a pump, check with the pump manufacturer about a loaner program for travel. Medtronic offers a travel loaner pump for the low bargain price of $50. Well worth it if you think about being stuck in another country and your pump malfunctions.

2. Always have a way to treat low blood sugar. Most people ask why I don't just carry juice with me. One reason is because drinking a warm juice that's been sitting in my purse for the last week is a little gross. The second reason is that having a juice box explode all of your bag really fucking sucks! Because of that, I like to steal honey packets from Starbucks and sneak myself the fun treat of Annie's Fruit Bunnies!!! Tropical Flavor! Ooooo!

3. Play the diabetic card when it comes to snacking. I always play the diabetic card when it comes to bringing snacks on an airplane! I need food, people! I like to pack snacks with and without carbs, like carrots, celery, and granola bars. You may notice the carb count written in Sharpie on the ziplock bags. I portioned out from larger boxes the correct serving size so I knew how many carbs were in each item. You may call this anal. I call it organized!

4. Be prepared to check blood sugar more frequently. Airplanes do wonky things to my blood sugar. So does ingesting large quantities of tapas and Sangria. Which also leads to...

5. Accepting that you may have need more insulin then usual.

6. A letter from my doctor is a must. Not that having a insulin filled beeper strapped to my side or a carry-on bag filled with syringes and insulin viles isn't enough to let TSA know that I have a medical condition, a letter from my doctor is pretty hard for knuckleheads working at the airport to dispute.

7. Think about where you're going and develop a plan. And not just in that day-dreamy "I can't wait to be sippin' on Sangria" kind of way. More in a "Will I be close to medical care in the event something goes wrong?" kind of way. Not nearly as fun and sexy, but a definite must. Are you travelling state-side? Are you going camping? Or are you going international? Can you speak the language well enough to get needed medical attention? Are you traveling with someone who knows enough about your diabetes to explain it if you aren't able to? Again, not fun stuff, but important!

8. Have personal medical information written in the language of the country you'll be visiting. Diabetes isn't something that one can easily explain through hand-gestures. It's best to have something written out in the doctor's own language. If there is a reason to seek medical care on vacation, you don't want to add to the drama by not articulating your pre-existing condition.

9. Write down your pump settings or insulin injection doses. I did this on the way to the airport and put it in several places. Just in case something goes wrong with my pump or if Jerry needed to communicate by dosage needs in case I wasn't able too.

10. Adjust for time differences. I always forget when I travel into different time zones to change the time on my pump. The same applied when I was using pens. When I was using Lantus, I had to adjust for the time change.

11. Remember that diabetes doesn't have to run or ruin a trip. It's just something that's there.

Never Say Never

A few nights ago, I did something, that as a diabetic, I swore I would never do.

After a lovely girls night out with my friends (who I refer to as ABC), I stumbled into the apartment, exhausted and blurry eyed, at 1AM. We hadn't even been drinking! I walked into the bathroom and step on something wet and squishy. I immediately panicked. With two cats in the house, you just never know.

Someone had thought it was a good idea to dunk this toy in the toilet and leave it on the floor for an unsuspecting human. But we're not naming names. 

I digress.

Realizing that an alarm had gone off on my pump, alerting me to a low reservoir of insulin, I knew I couldn't wait until the next morning to refill. Feeling my way like Helen Keller through my bedroom, trying not to disturb a sleeping Jerry, I grabbed all of the tools for changing my infusion site and insulin reservior. One these tools being an obvious one of insulin. Duh, right?

When I was first diagnosed with diabetes, I read many diabetes blogs, talking about the trials and tribulations of being diabetic, taking insulin, living life, etc. One thing many of these bloggers discussed was the annoyance of dropping and shattering an insulin vial. How annoying. How expensive. How smelly. Insulin has very distinct smell. 

In my arrogant little mind, I thought, "How irresponsible! I would never shatter any of my insulin vials."

Guess what I was cleaning up off the kitchen floor, trying to stop the cats from rolling in, at 1:15 AM?

Call me irresponsible. 

Road Trippin'

During the summer, Jerry and I seem to find ourselves in the car for extended periods of time quite often. For the longer trips (2 hours or more), I like to pack snacks. The problem with packing snacks is that we're gigantic fat kids who both have a mild case of ADHD.

Sitting for extended periods of time is not something that is easy for either one us. At one time, I could happily sit on my ass for hours, watching bad reality tv marathons (you know the Housewives of New Jersey has sucked you in too!). But not anymore. And being in the car is even worse! What are we suppose to do for 3 to 4 hours at a time? Talk to each other?! Yeah. Sure.

Instead, we eat. We eat well past the point of being full. We eat until we complain about eating....and then we eat some more. We put the bag of snacks "far away" in the backseat. Only for me to climb over to retrieve the forbidden bag less then an hour later.

For one of our road trips to Virginia, I packed:

• 2 sandwiches (one of each of us)
• TJ's reduced guilt popcorn
• TJ's sweet and salty trail mix (so good)
• TJ's carmel corn (can you tell I have a Trader Joe's obsession?)
• Dried snap peas
• Box of black licorice (for Jerry)
• Kashi granola bars
• Reduced sugar dark chocolate (which I didn't realize had the ingredient that makes you crap your pants until I had already eaten half the bar)
• Fruit leathers

We seriously had to cut ourselves off. Especially me! While Jerry just feels gross and bloated, I end up with a 300(!) blood sugar because I can only take so much insulin to cover 8 straight hours of eating!

For a recent road trip, I planned things out much better. Instead of large bags of food, I brought individual bags of snacks and opted for even more healthy treats that 1) weren't be as appealing and 2) wouldn't severely impact my blood sugar. These treats include:

• Fiberful Fruit Leathers
• TJ's snack-sized bag of kettle corn
• Kashi granola bars
• 2 types of seaweed snacks (for Jerry)
• Baby carrots (good for the ol' blood sugar)
• Trail Mix Snack Cookies (need something naughty)
  

Why bring snacks at all, you might ask? Because you really can't call it a road trip without snacks. Seriously. Check wikipedia. It's there. Because of my expert snack packing, Jerry and I were able to control ourselves, thus giving us more room to be disgusting oinkers and gorge ourselves for the rest of the weekend. Awesome.

Trail Mix "Cookies"

by Bonnie Graham

Cook Time: 14 - 16 minutes

Keywords: bake breakfast snack vegetarian coconut oil nuts oats

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Ingredients (12 large cookies)

• 1 c oat flour
• 1/2 c whole wheat pastry flour
• 2 tsp baking powder
• 1 tsp cinnamon (or ¼ tsp freshly grated nutmeg)
• ¼ tsp sea salt
• 2 packets Truvia (or 4 tsp sugar)
• 1 ½ tbsp ground chia seeds (or 2 tbsp flax meal)
• ¼ c unsweetened shredded coconut
• 3 tbsp coconut oil
• ¼ c maple syrup
• 1 – 1½ tsp pure vanilla extract
• ½ c apple sauce
• 1/3 c almonds, lightly chopped
• ¼ cup sunflower seeds
• ¼ cup pumpkin seeds
• ¼ c dried cranberries or other dried fruit

Instructions

1. Preheat oven to 350 degrees and line baking sheet with parchment paper.

2. In a blender, food processor, or magic bullet, grind oats into a flour followed by grinding chia seeds (or flax seeds).

3. Add all dry ingredients to a bowl, with the exception of the coconut, seeds, and nuts, and mix to combine.

4. Add all wet ingredients to the bowl. Mix well to combine.

5. Add coconut, nuts, seeds, cats.....just wanted to see if you were paying attention...to the bowl.

6. Scoop hefty sized scoops of dough and place them on your baking sheet. Bake for 14 - 16 minutes or until lightly browned.

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To Carb or Not to Carb?

That is (most often) the question.

On my home from work the other night, as I sat in two hours of traffic because some jackhole in a tractor trailer decided to take on an overpass on the Bronx River Parkway, I thought about what I would make myself for dinner. I ran through the list of ingredients in our fridge, playing with the different, satisfying combinations that could be my meal. I remembered that we had flour tortillas.

Hmm...flour tortillas, flour tortillas....I can make a burrito! Yes, a veggie/bean burrito with sour cream and melted cheddar cheese. Sold, my friends!

Then, the question that almost always comes next...how well did I eat today and is it worth the carbs?

Sometimes, yes, it really is worth the carbs. That piece of cake? That cup of fro-yo? Definitely worth it.
That whole wheat and flax tortilla? Meh, not so much.

Having already decided on a Mexican-American style meal, I needed to re-group....focus...plan out my other options. Making dinner is serious business in these parts! That's when I decided on the Burrito Bowl Salad. Basically, I was taking everything that I would have stuffed into my burrito, tossed it into a bowl, and ate it with a fork instead of my grubby, little hands.

It worked out quite well. No additional insulin required. Yay me!

Burrito Bowl Salad

by Bonnie Graham

Keywords: salad vegetarian beans tempeh tomato

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Ingredients (1 big-ass salad)

• 1 1/2 c black beans
• 1 c fresh corn kernels
• 1/2 c red scallions, sliced
• 1 large tomato, diced
• 1/2 c low fat cheddar cheese, shredded
• handful of mint (or cilantro or parsley), chopped
• 1/2 package of tempeh, sliced into 1/4' pieces
• 3 tbsp of taco seasoning, divided (preferred Trader Joe's)
• salt and pepper, to taste
• 1/2 c sour cream

Instructions

1. Toss your sliced tempeh with a little bit of oil and 2 tbsp of taco seasoning, or enough to coat. Heat frying pan over medium heat and add tempeh slices.

2. Toss all ingredients, except for the remaining taco seasoning and sour cream, into a bowl.

3. Pan fry tempeh until a light golden brown. Allow to cool for a few minutes.

4. In a separate bowl, mix together sour cream and remaining taco seasoning. Use this as your dressing.

5. Add cooled tempeh and enjoy your "burrito."

* Indicates that produce was grown locally throughout NY, NJ, and PA.

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Safe and Sound

Leaving work, driving to yet another client meeting, following the route I take on a daily basis....WHAM!....someone hit me and I wasn't even sure how it happened.

Sitting, slightly immobilized from shock, I immediately felt a soreness in my chest. On this day, I happened to be wearing a dress that required me to wear my insulin pump tucked into the front of my bra. I knew that soreness was from the seat belt being pushed against the pump on my chest.

Shit! Please don't tell me I damaged another pump.

Luckily, I was fine. The pump was okay too.

As I sat in my car, waiting for the police and EMT to arrive, my mind immediately went to my blood sugar. Was I low? Was I just shaky from the accident? I had just finished eating a banana before leaving the office, so I knew I wasn't low. Checked my blood sugar and I was at 151.

When the EMT arrived to the scene, he asked me if I was okay. I said, "I'm having slight chest pain, but I'm wearing an...." He interrupted me, "Yeah, I see it. Are you okay? Do you feel pain anywhere else?" Scribbles down insulin-dependent diabetic on his notepad. Questions eventually came, but all knowledgeable, appropriate ones.

No need for explanations of my diabetes, of my pump, of my insulin. He understood.

In all the chaos of crumbled cars, leaky fluids, and liability, it was nice that diabetes was one thing I didn't have to explain.

Johnny Number 5!

People usually have a lot of questions about my insulin pump. The three most common questions I get are 1) do I still have to take my blood sugar or does the pump magically read it for me, 2) will the pump ever spin wildly out of control and overdose me with insulin, and 3) how /when do I change the infusion set or will it just fall out?

For a non-pump user, these all seem like intelligent questions, right? For a pump-user, it is hard not to snicker, roll my eyes, and pat people atop their little, questioning heads. Ah, so innocent, so influenced by popular entertainment that make us think that electronic devices will develop minds of their own and take over the world.

The answer to the first question is yes. I still have to take my blood sugar. The pump is just an insulin delivery device that is subcutaneously injected under my skin, which for the most part, doesn't even produce any bloodshed when injected. Bloodshed. Seems dramatic when it's said twice and bolded!

The answer to question number 2 is that my insulin pump isn't Johnny Number 5. Although...hmmm...hello new name for my insulin pump! Or should I say for my Johnny Number 5?!!!!! Awesome! Anyway, Johnny Number 5 only delivers the insulin its instructed too. It never goes rogue and does it on it's own. In fact, actually administering insulin requires the pushing of several different buttons to ensure I'm not overdosing myself every time I bump into a corner. And pushing several buttons can be quite complicated.

The answer to the third question is one that has recently changed. I need to change the infusion every two to three day, which is something that I do myself. No special medical degree or device (except for this bizarre, oddly sexual looking injector) required. However, my answer to the "Will it fall out?" question has just changed!

The Injector!!

Usually, I have to pry the adhesive tape that holds the site in place off of me. It's like when you were a kid and you left band aids on until they turned all gross and nasty and fell off themselves because peeling them off your delicate baby skin was too painful! Getting the infusion set adhesive off is similar to that stubborn band aid.

That was until recently.

I had just finished my Hot Yoga class and was putting on my pants to walk home. I must have also pulled the tubing when I pulled my pants up because I could feel the set rip out. I thought, "Wow, that's weird," but figured I had just been drenched in sweat and it needed to be changed anyway. Then, the very next day, again, pulling my pants up, I ripped out a second set! What the....?!

Either the infusion sets are weakening or I need start pulling up my pants less aggressively!

Catch 22

Diabetes is filled with catch 22s. Here is one I faced this past weekend.

We had just returned home from the bar portion of Heather's birthday celebration and did what any good drunkards do....hit up the fridge! Of course, I also did what any good drunk diabetic does and hit up the glucose meter! I simultaneously checked my blood sugar while shoving forkfuls of Pumpkin Mac and Cheese in my face, preparing to take a couple of units of insulin, only to be met by a 57 blood sugar.

What?! 57! How the hell did that happen? I didn't even feel low.

Prior to going to the bar, I had plenty of very-not-diabetes-friendly foods coupled with several glasses of wine and a dirty martini.  I figured that between the insulin, food, and booze, my blood sugar would be okay. In fact, I was expecting it to be high. Imagine my surprise to be at 57 and not actually feel it. A little scary. 

I was faced with a real dilemma. I wanted to go to sleep, but couldn't with my blood sugar at 57. However, I had just eated a heaping helping of mac and cheese. Did I want to take the chance of over-correcting for the hypoglycemia and wake up in the 200's? Or do I go to bed hoping the pasta would kick in and not raise my blood sugar too high?

It's the diabetic's catch 22.

For any diabetics who happen to stumble across this blog, my solution was to increase my basal rate on my insulin pump so that the mac and cheese would help raise my blood sugar without causing me to go too high. Generally, my CDE recommends an increase of 10%. Which I didn't know until this morning when I asked her if it was okay that did that....except I raised it to 30%. That was probably too high.

Which is More Awesome?

The iPhone or the Insulin Pump?

It's been about two months since I started on the insulin pump. It has been two week since I joined the rest of the society and got myself an iPhone. Both devices are very exciting! Because they are so awesome, I've decided to put them in a head-to-head competition to see which piece of technology reigns supreme! It's like Iron Chef, only the nerdy techie version!

Let's review. The iPhone is awesome! It allows me to listen to music all day at work, fulfills all of my important "need to know this NOW" googling needs, hone my zombie killing skills, and prevents me from walking one full avenue block in the wrong direction before realizing it! The insulin pump certainly doesn't do that!

The iPhone is slimmer and weighs less then the insulin pump. It doesn't need to be worn on my body at all times. However, this may actually count as a disadvantage. Knowing me and my occasional absent mindedness, it's probably better that the insulin pump is attached to me, otherwise, there is a great risk of me either losing it, forgetting it, or dumping a bowl of oatmeal onto it. It happens more times then I care to admit.

The iPhone can provide me with hours of endless entertainment, where as I would struggle to be entertained by the insulin pump. There's only so many buttons one could push without causing a massive, life-threatening episode of hypoglycemia.

Both allow me to calculate my insulin needs, the insulin pump through the Bolus Wizard, the iPhone through the CalorieKing app. However, the insulin pump is able to provide me with a life-saving hormone that happens to be deficient in my body. It's as close a fake pancreas as one can get (at least without the use of some cloned sheep). The iPhone does not have this capability (although I hear they're working on that too).

The pump also prevents me from having to give myself multiple injections that caused nasty bruises and needle marks on my stomach. Besides making me look as though I have a large tumor on my side, the insulin pump allows me to shoot up in a less instrusive way. Lastly, the pump allows me to give myself a more accurate dosage of insulin to promote overall general health and ultimately led to longer life. Whereas the iPhone may be discovered to cause actual tumors in a few years! Who knows?

It was a split decision and a tough one, at that! But the win goes to...............The Insulin Pump.

But only by a slim margin. And only because it happens to save my life.

See, I do have my priorities straight, Mom!

I <3 my iPhone!

ZA Liability

It was established long ago that I would be a serious liability in the event of the Zombie Apocalypse. And then I got diabetes.

Now, I'm not a big television watcher, but I got sucked into a show on AMC last year called the Walking Dead. This show scares the hell out of me, gives me nightmares, and creates an unreal fear that zombies are walking through my neighborhood at 2 AM. Obviously, I watch it religiously week after week.

After each episode, I try to think of the many ways I could survive the Zombie Apocalypse in spite of diabetes. This includes me looking up how long insulin can last outside of the refrigerator before it goes bad, how long I could sustain on a high protein diet before my body would start to process the protein as carbs, and whether zombies will be attracted to my scent if I ever go into ketoacidosis. You may be surprised to learn that I haven't been able to come up with an answer to that last question, but I'm certainly working on it!

In an attempt to hone my zombie killing skills, I downloaded the iPhone app Contract Killers: Zombies. In this game, I'm responsible for shooting zombies to protect myself and others. Obviously, this is just a game and NOT an indication of my actual performance during the Zombie Apocalypse. But let's just say, my zombie killing skills need some work!

Does being able to see the sight of blood, give injections without problems, remain calm in crisis situations, and crochet some kick-ass scarves help my chances at all? :)

Meaty Balls

I love good, meaty balls. Nice round ones. But not ones that are too big that you can't fit them in your mouth. Because I like balls in my mouth two at a time! Obviously, I am talking about meatballs here. You're so dirty.

I may have mentioned before that I generally don't buy or eat meat when I am at home. And, on the whole, I'm not one to really order meatballs when out to dinner. In fact, the only time I really eat meatballs is when I'm at my parents' house, enjoying them with Sunday sauce.

However, the craving for meatballs does come up for me every once in a while. Well, maybe not so much a craving for meatballs, per se, more like a craving for a vehicle to enjoy copious amounts of tomato sauce besides pasta. Pasta isn't necessarily a diabetic's friend. That whole insulin/carb thing.

Given the lack of meat in my house (both literally and figuratively), I came up with a veggie-friendly meatball using tempeh. Now I know all of you have tons of tempeh just kickin' around your fridge. Here's a good way to use it. You could eat these with pasta or on a sandwich! I hear there's a kick-ass tomato sauce recipe somewhere on this blog too!

Meaty Veggie Balls

Ingredients - this recipe makes about 5 medium sized balls ::snicker, snicker::
1/2 package 3 grain tempeh
1/4 c seasoned bread crumbs
1/2 small onion, small dice
1 large garlic clove, minced
1/2 tsp dried oregano
2 tbsp parmesan cheese
1 - 2 medium eggs, depends on how well the mix holds together
salt and pepper
olive oil

Method
1. Break tempeh up into smallish pieces.
2. Add all the ingredients with the exception of eggs. Mix well.
3. Add eggs to mixture and blend with your hands (it's really the best way to do it). Add a little more bread crumbs if the mix is too wet and another egg if it is too dry. You'll have to play around with the ingredients a bit.
4. Heat a frying pan with olive oil. Shape balls using your hands and place into heated frying pan.
5. Pan fry balls on all sides until nice and golden brown. Serve with good tomato sauce possibly on an Italian roll with melted mozzarella.

Have I used the word "balls" enough in this post? Well, just in case I didn't.....balls, balls, balls, balls! :)

Thingy

"Ummmm, sooooo, what is this thing?" as she hands over my insulin pump. "I just call it 'the thingy.'" Giggle, giggle, twirl of the hair. 
And then I bitch slapped her.

Ok, no, not an actual bitch slap. But certainly a mental one!!!

When I first began wearing my insulin pump, figuring out what to do with it during yoga class was a bit of a concern. Usually when exercising, I simply disconnect the pump and put it in my bag. But my yoga studio was a bit more challenging.

I take a Hot Vinyasa yoga class every week. The room is heated to 98 degrees and is generally very humid and wet. Heat and mositure is not an optimal combination for anything filled with insulin. Insulin will degrade faster in higher tempatures. Unfortunately, the only way to know if that has happened to your insulin is when you're actually trying to use it.

I could just put it in a locker, right? Except this yoga studio doesn't have any. They have open cubby holes in a large, open "locker" room. That whole trust and be trusted crap! Now, I'm not paranoid or anything. I don't think any one is walking away with my insulin pump, but it's not necessarily a piece of equipment I want just lying around.

This left me the option of asking the front desk if they would hold it for me. I had some hesitation about doing this. It would mean disclosing to people I don't really know that I'm diabetic. I'm fine sharing with instructors who will need to know to pour honey in my mouth (or eye, if the situation is really dire :)) if I ever get too low in class. But do random front desk staff need to know my business? Especially ones that giggle, twirl their hair, and refer to my life-saving device as a "thingy?"

It's been working out pretty well. I just hand it off to whoever is working at the front desk when I sign in for my class. And they all take it from my hands like I'm asking them to hold Baby Jesus for me! The way the gently take it from my hands and delicately place it behind them on the counter lets me be reassured that my "thingy" is safe.

Breakfast Cake

Cake for breakfast? My mother's so disappointed. 

Don't worry, Mom. It's a healthy breakfast cake! I promise!

Sure, it looks like a muffin, but it definitely taste like cake with a slightly custard-y texture.

The way I figured it, this breakfast custard cake thing has about 24g of carbohydrates. Given what a normal piece of cake would be, that's not too shabby. Plus, it's good for you since it's made out of oat bran, little sugar, and no artificial flavors, colors, preservatives, etc. With this and a glass of milk, I only insulin for 34 grams of carbs (which for me is 2.2 units of insulin).

Vanilla Breakfast Cake

Ingredients

1/3 c oat bran 
2 tbsp unsweetened applesauce
3 tbsp milk
1 large egg
1/4 tsp baking powder
1 - 1 1/2 tsp vanilla extract
1 1/2 tsp sweetener of your choice (Brown sugar adds a nice flavor, but I usually opt for the truvia!)
pinch of salt

Method

1. Preheat oven to 350 degrees and grease a small ramekin.
2. In a small bowl, whisk the egg.
3. Whisk in applesauce, vanilla, and milk.
4. Mix in oat bran, sweetener, salt and baking powder until just combined.
5. Pour into well-greased baking dish, spread evenly, and bake for 32-36min, until a toothpick comes out almost clean.
6. Slide a knife around the edge and flip out onto a plate. 


For interesting variations, you can replace the applesauce with pureed pumpkin and add the usual pumpkin pie spices. Or you can stick to the original recipe, but add a tablespoon of cocoa powder. 

Under the Great Big Sea: Scuba Diving and Diabetes

I am now typing this as a certified Open Water Scuba Diver!! What what?!?!?!

When we first started talking about going scuba diving, I was a little nervous. I had the typical fears of anyone who was first trying it out. I won't be able to breath. I'm going to freak out and die. A SHARK IS GOING TO EAT ME!!! You know. Your run-of-the-mill, totally normal anxieties. However, there was one fear that was somewhat reality-based. I'm diabetic and could potentially have a low blood sugar 70 feet down in the great big sea. It was a scary thought.

When I went to good ol' Google for some help and advice, I couldn't really find anything. I came across one woman's blog post, which really was quite helpful and realized that I definitely wanted to do a post on scuba diving and diabetes in case anyone, like me, was out there looking.

I'll probably do this in a two-part post. One to actually give the details of what I did to prepare for diving as a diabetic and another on my actual experience on getting my certification. Here's a nice little step by step plan, that probably only diabetics would be interested in. But, hey, it is a diabetic's blog afterall!

STEP ONE - Get Endocronologist Approval (get approved medical form here)

PADI (Professional Association of Diving Instructors) recommends that you be on insulin treatment for one full year before diving, but really it's just to ensure that you have good blood sugar control, which I do, for the most part. I had my endo fill out this form and brought it with me to the dive shop. I've heard/read that other places, like Australia have a lot more stringent protocols with diabetics and their medicals.

STEP TWO - Decide Method of Injection

Having recently gone on the pump, I was inclined to stay on it during my dives; however, it generally wasn't recommended. I decided I was going to just use pens on our trip, but once I got down there, I did a combination of the two. This probably wouldn't work for all diabetics. My insulin needs are still relatively low at this point that a couple of hours without insulin didn't send my blood sugar out of control. Also, because our first few dives were from the beach, I didn't think my clutzy self could fuck it up and drop the pump in the water. 

Another thing to consider in using the pump instead of the pens when scuba-ing is that you do risk ruining the infusion set you are currently wearing as it will be saturated for an extended period of time. With pens, you won't have to worry about that.

STEP THREE - Checking Your Blood Sugar

This is two fold. You need to check your blood sugar getting into and out of the water. The woman in the blog I referenced before checked her blood sugar three times before entering the water, once at 30 minutes, again at 15 minutes, and once more before entering the water. This was to ensure that her blood sugar wasn't dropping going in. I wasn't so diligent but I did ensure that my blood sugar was high, like 190's - 200's high. This was actually a perfect range since my blood sugar dropped with each dive.

I was diligent in checking getting out of the water as well. I should have done a better job in tracking blood sugar drop in reference to depth and amount of time in the water, but I was on vacation! Overall, my blood sugar dropped anywhere from 50 - 100 points.

STEP FOUR - Snacks

This was actually the first step on the list, but thought it might come off as a little irresponsbile. :) It is important to have some kind of gel/snack with you that can be used to raise your blood sugar, even under the water. I opted for honey packets. They would be something I could easily suck out of the package if I need to do so under the water.

Usually, on the boat, they served fruit and cake after each dive. Not exactly diabetic snacks. I won't lie though. I had me some cake! Remember that whole vacation thing! But, if I had had better self-control, I also brought familiar snacks with me. Familiar in that I know usually by how much they might raise my blood sugar, like my favorite Kashi granola bar.

STEP FIVE - Letting Others Know

When first talking about getting scuba certified, I was concerned about what role diabetes would play in shops allowing me to dive. It, technically, hasn't been a year since starting insulin. I had a few people suggest to me that I just not share my disease. While it is compelling to skip the disclosure altogether, I thought better of it for many reasons. My personal safety, the safety of the other divers, and the unfair responsibility I would place on my buddy (Jerry) in the event anything went wrong were the top three.

It was important for the dive shop (Scuba Gamma), the instructors, and dive masters to know. They didn't necessarily know what to do with that information, but at least they were aware.

Overall, besides the blood sugar testing and pounding granola bars before entering the water, diabetes didn't really impact on my scuba experience. However, I am really glad I took these precautions so that I could focus on my real concern about scuba, that grumpy Great White known as JAWS!!!! Haven't you seen Jaws 2, 3, and 4?! He comes back, people!

Soy Diabetica!

I have been practicing my Spanish for my trip with Jerry to Cozumel.

The first sentence I learned was "Soy diabetica, sin azucar por favor," which means "I am a diabetic, no sugar please." I figured it would come in handy. It's right up there with "Donde esta el bano?!" and "Puedo tener otra bebida alcoholica, por favor?" These sentences mean "Where's the bathroom?!" and "May I have another alcoholic beverage, please?"

That should give you a picture of the vacation I plan on having!

Oddly enough, despite the fact that I just started using the insulin pump, I an considering not using it while on vacation. Instead, I may go back to multiple daily injections with insulin pens while we are away. There were several reasons for this decision, but the biggest one was due to a new hobby Jerry is roping me into, scuba diving!

Because I would need to disconnect from the pump for several hours at a time (meaning there will be no insulin at all in my body), my blood sugar rise and probably making it pretty difficult to control. We'll probably go scuba diving several times throughout the week. I also run the risk of ruining the infusion set (the piece that's actually in my body that receives the insulin) because I'll be spending long amounts of time in the water/wet. The biggest reason in my mind, though, is that I'm pretty clumsy and I can see my foolish ass accidentally dropping that expensive piece of life saving equipment off the side of our vessel.

And then Jerry would have to kill me.

So my mother wouldn't be able to.

Zoinks! The Fanta!

My very first episode of hypoglycemia scared the crap out of me. I was in the hospital and woke up to use the bathroom. The feeling reminded me of those drunken college nights where 10 cent beers and $1 tequila shots seemed like such a good idea! Only this was worse. My head was fogged and spinning. I was in a deep sweat. My thoughts didn’t quite make sense and my legs felt like jelly. I thought that, at any moment, I was going to crash.

I swore that night I would NEVER experience hypoglycemia AGAIN! (TRUMPETS BLARE)

How naïve I was! Hypoglycemia is a part of diabetes. Granted, my goal is to reduce the number of incidents I have (and never be as low as that night in the hospital), but to think I will never be hypoglycemic is unrealistic. I have accepted it. Sometimes, I forget that others around me aren’t quite as comfortable.

This occurred to me this past weekend when I was at a beer festival. We had rented a house for the weekend and this was our first night up. At first, it was just Jerry, Tom (J’s bro), and me. Jerry and I had bought some prepared frozen food to hold us over until other people got to the house. We had bought a Kashi roasted vegetable pizza and an Amy’s tofu lasagna. Pizza…lasagna…can you think of anything more carby?!

I took the units I thought appropriate to the meal. As Tom and I talked in the kitchen, I could feel “the slow down” kick in, the mind slow down that is. Where developing coherent thoughts and linking them to actual words becomes challenging.

I take my blood sugar, 48. I’m not proud. That’s pretty low, but it happens. I ask Tom to go to my car to get me a juice box. I would have gone myself, but I thought it would have put a damper on the weekend if I passed out while walking to my car. Tom quickly comes back with the juice box and starts to question me about the hypoglycemia. Why is it happening? Why do I need juice instead of taking more insulin, etc.? All questions I would normally not have a problem answering if it wasn't for the slow down.

Suddenly, Tom stops talking (remember, this is Jerry’s brother. It’s a real event when they stop talking!). “Are you okay?” he quickly asks.

“Yeah, I’m fine." I quickly take a seat.
"Are you sure?" he asks again.
"Yeah, I just need to lie down. Come check on me in a few minutes to make sure I don’t die” I joke as I already feel the affects of the juice kicking in. Eventually, Jerry comes into the room to check on me. I’m feeling better and he somehow convinces me to do a headstand. Sure, why not?

Later, Tom shared that all the color drained from my face. When Jerry came to check on me, I said "I think I scared Tom." I knew I would be okay. And Jerry knew I would be okay. But Tom wasn't as sure.  It is only because Jerry and I have been through the experience before. I forget how scary that first hypoglycemia was for us. And it is a good reminder of how scary hypoglycemia can be, especially if it is enough to silence a member of Jerry’s family for a few minutes. J