CGM Truth or Dare??

Last week the curtains were pulled back to reveal a 24X7 movie of my BG control. There was no red carpet rollout for the premier, but it was a big event for me nonetheless. I started on a new Minimed pump and CGM last Thursday.

First, I was giddy with being able to see so much more about what is happening, and just kept looking at the trends in a distant sort of way, as if they were not really connected to me. This week, reality is starting to sink in, and I'm faced with some things that I need to change if I want to improve my control. Like cutting out the late night snacking, and upping my basal rate after I workout. Both of those things are scary to me in their own ways. Even though I may have suspected them before, now the data is smacking me in the face and hard to ignore. No more namby pamby..."I'm not really sure what's happening so I'll just keep doing what I want to." I know this is a good thing, but as with facing any challenge, there is emotion and resistance to overcome.

So I guess it's really more of a game of truth AND dare now, isn't it?

To reschecule or not to reschedule....

....that is the question.

I had to cancel my endoc appt. 2 wks ago due to a stomach bug, and have yet to reschedule it. I guess there are two components to my reluctance. First, I have the feeling my A1C will not be stellar. I'm always thinking that though, and am usually pleasantly surprised with the results. So the bigger factor is that I still feel like I don't get much help from my endoc other than ensuring a signature on those prescriptions.

When I mentioned to a friend at church who is a nurse that I had to cancel my endoc appt and mammogram last week, she got this worried look on her face and said something like "Oh, wow, that's not good, will you be OK until you can get in to see your endoc?". A nice well-meaning question, but pretty far off target. I replied, "I've been at this a long time, and really the endoc doesn't tell me much I don't already know." Probably sounded arrogant, but it's true.

Last time, I asked him for help in avoiding lows while running. He said I could fax him some numbers and handed me a worksheet with blanks for only before and after meals, no space for a pump basal rate, etc. I asked if I could send him a spreadsheet instead that included room for more testing, carb intake, etc. surrounding exercise, and he said they preferred all patients to use their (totally inadequate) form. This really should not upset me that much since I have a history of not doing a very good job of logging anyway. But it was just a sign of being alone in managing my diabetes, and has rattled around in my brain since then. Were it not for this wonderful online community, I would feel very alone with it indeed.

On the plus side, he did suggest I look into CGM's, and would likely be willing to help me get one. He was also very helpful when I had a pump malfunction that required me going back to shots for a little while. I'm probably looking for too much in a doctor, and this one isn't bad. So I guess I just need to book that appointment. Maybe I'll call...tomorrow.

I'm also curious...how many of you feel that you genuinely get help with your specific issues from your endoc/diabetes team? Am I expecting too much?

Am I Borg?

Had a weird dream last night. I was on an elevator with a bunch of strangers when I realized that my infusion set was in my cheek. No, not THAT cheek, the one on my face! It was the same feeling as the "realizing you are naked at school" dream. So what does this mean? Do I secretly want to be a member of the borg collective? Or could it be that I still feel self conscious about my pump? Or is it that I think it might be better if others had to truly come face to face with at least one reality of diabetes? It really is a hidden disease in so many ways, even for those of us who are pretty open about having it. How about you? What weird D related dreams have you had?

Multitasking

Multitasking is a way of life. I ususally blame that on e-mail, voicemail, blogging, cell phone, blackberry, and other technological "advances". But I realized this morning that it has invaded my site change routine. While changing my set and cartridge, I also brushed my teeth, applied base makeup, and worked some conditioning cream through my hair. You know, there are those pauses while the pump realizes you've pulled out the old cartridge, and while the new cartridge is loading. Perfect time to trim your nails.

So is this odd? Do you multitask as you are changing out your set/cartridge? What things do you accomplish amongst the whirring and beeping of a cartridge loading?

REQUEST FOR CGMS: DENIED BY INSURANCE

I didn't ask to have to worry about whether I will go low when I go for a run or even a walk, go to sleep, or God forbid, while I drive. I keep my blood sugars higher than recommended sometimes because there are so many unknown variables and the lows are debilitating. In case you are wondering, it's not a simple case of counting carbs and taking the right insulin doses. There are hormones, activity levels, and stress to try to "quantify", which is of course impossible. That is where a CGM could really help. Since we cannot account for everything, the best we can do sometimes is react to it. A CGM will help us to react faster, and to avoid the short term disaster of a severe low behind the wheel, as well as some of the long term damage that our bodies are racking up due to BG's that are too high as we try to avoid those lows based on as many test strips as we can afford. It would also help me to not lose heart in my battle to remain as healthy as I can.

My doctor suggested I look into getting a CGM, but so far I have found that I cannot afford it. Aside from the initial outlay for the device, the ongoing costs are roughly $400 per month. Trust me, I have no desire to wired up like a cyborg with my insulin pump and yet another device. But it is difficult to know that I cannot afford to come one step closer to a normal life. I don't know whether to address this to the insurance companies, the CGM manufacturers or our government, but I sincerely hope that all of them will hear our plea.

I Just Might Make It

It seems like a long time ago that I signed up for the Diabetic Runner Challenge (see emblem on the lower right side of my BLOG). The challenge was to run 500 miles this year. I know the emblem says 1000 miles, but I picked the wrong emblem :(.

The last 6 months has not been a stellar time for me in terms of logging a lot of miles, but I did enjoy a few 5K's in the spring with progressive personal records, and have been doing a few shorter runs per week. Now it's mid-year, so figured I'd check my mileage total. Total miles logged on my Garmin....284. Woooohoooo, I just might make it!

Keep on Keepin' On

Is it just me, or have others of you searched the news from the ADA conference looking for something to get excited about and come up lacking anything of substance?

Don't get me wrong, I'm so grateful for the tools that I have to manage my diabetes and realize how far things have come. I'm also grateful for the researchers who take a long term view and are patient enough to conduct their studies. But taking a shorter term view, say of the last 5 years, I just don't see anything that changes the way I LIVE with this disease. None of the studies and none of the devices. There still is not a closed loop pump/monitor. Continuous glucose monitors are not finding favor with insurance companies. There is continuing debate about the costs/benefits of tight vs. supertight control of blood glucose. I'm still not sure if the variability of my BG or the average is more important in preventing long term complications, and I don't know if it's more important to avoid the lows (other than to make myself not feel horrible in the moment and avoid passing out). I exercise because I like the way it makes me feel, but still don't know if the surrounding BG excursions do more harm than good. I haven't even seen meter sizes shrinking to smaller than my current Flash, or a pump that makes it worth ditching my Cozmo.

I guess I'll just keep on keepin' on! I'll admit I haven't read everything that has come out of the conference, so maybe I'm missing something big. How about you, anything coming out of the conference going to change the way you LIVE? Maybe I'll ask my endoc the same thing tomorrow.

p.s. I almost forgot, I did like the study that suggested it might be a good thing that I have gained a little weight since diagnosis. Still don't find it to be particularly useful though.