Insulin Pump Demystified

Saturday, April 29, 2006

Blotting Out High-Fructose Corn Syrup

A few weeks ago while I was driving, I caught part NPR's Fresh Air show, with host Teri Gross interviewing author Michael Pollan about his new book "The Omnivore's Dilemma: A Natural History of Four Meals." Pollan was describing the way many of today's foods are so highly processed, and about the dangers of ingredients like high fructose corn syrup that is used in so many of the products found in our grocery stores. The over-use of high fructose corn syrup has been linked to America's growing obesity problem and the rise of Type 2 diabetes.

"I'm glad I know to avoid products that are over processed," I thought as I listened to Pollan. Living with diabetes for as long as I have, I've gotten pretty good at discerning food labels and for the most part have internalized knowledge about high-carb and low-card foods and which foods are high and low on the glycemic index.

But nonetheless...I do have these weird times when my blood sugar just shoots up, even though I've thought that I've bolused my insulin correctly. Pollan's words stuck in my mind...and I started going through my fridge, freezer and cupboard to look for places that high fructose corn syrup might be lurking.

And there it was--in salad dressings and in ketchup, in the Breyer's popsicles that claim on the package are made of "all natural" ingredients that I gave, daily, to my son. I realized that I need to be more vigilant about reading labels and shopping that I can buy foods that won't give me blood sugar spikes, and that will be healthiest for my family.

I remember hearing another interview with Dr. Andrew Weill who recommended that people buy most of their groceries from the aisles on the perimeter of the grocer store, filling carts with fresh produce and dairy items. So true. I'm happy that I caught Pollan's interview and plan to read his book...but first need to go to do some reading in my pantry.


Tuesday, April 25, 2006

Continuous monitor article link

My Dad just sent me a link (Thanks, Dad!) to a Washington Post article about the new continuous blood sugar monitors that are coming out on the market this is definitely worth reading about:

Reading the article just made my day...and made me think that I want to find out--right away--what my insurance would cover for this kind of monitor. I know it's not a cure, but it really sounds like a tremendously helpful tool for tighter blood sugar control.

Let me know what you think!


Saturday, April 22, 2006

Checking at the playground

Thursday afternoon was gorgeous--sunny with a breeze. After I picked up George from childcare at 1PM, we headed to a nearby playground. It was full of parents and kids enjoying the day.

Both of my kids were swinging (I just put June, almost 8 mos. in a baby swing for the first time the other day and she LOVES it!), and as I pushed them, I noticed a mom and a son sitting on a bench behind the swings and I thought I saw him poke his finger and then wipe it with a tissue. Looking closer, he had indeed done a blood sugar check and then jumped off the bench and took the swing next to George.

The mom came up to push him and I smiled at her. "It looked like you were just checking his blood sugar," I said. "Oh yeah," she said, kind of caught off guard. "I know all about that," I said. "I've had Type 1 since I was a kid." Her face softened. "Yeah...I needed to see where he was at before playing," she said. I nodded. "How old is he?" I asked her. "Six," she said, and then she turned away. "I'm looking for my friend and her son."

Her friend and her son came just then and the boy with Type 1, a very sweet-looking red-haired kid, jumped off his swing and started climbing on the monkey bars with his buddy. The moms went off to talk together and I was left wishing I could have talked some more to the mom. I wondered when her son was diagnosed, how he was doing, if he was on the pump or if they were thinking about it.

I watched the boy playing and saw how healthy and happy he the quick blood sugar check was just part of his afternoon routine. I wanted to say more to the mom...I wanted to tell her that she must be doing a great job and that living with diabetes can be really hard. I wanted to tell her that I was ten when I was diagnosed and that I've grown up to be a healthy and happy (mostly) person. I wanted to tell her that her son is going to do just fine, even when he has moments when he rebels or gets angry at having diabetes. I wanted to tell her that I truly believe that a cure is going to happen, most likely before her son ever reaches my age, so when she's feeling really down or dark, just to hold onto that idea.

But the mom was happily chatting with her friend and I knew that she really might not need to hear anything I had to say. She might be doing just fine with the whole thing and might have plenty of people in her life who support her. I watched her son playing, and the more I thought about what I wanted to say to him, the more I realized that I was really talking to my ten-year-old self, newly diagnosed, who was terrified of living with diabetes and afraid that I would not grow up to be healthy and strong.

I got a little teary, watching the red-haired boy climbing away with his friend...and then I noticed that George had gotten off his swing and was sitting with some other kids eating snacks and it appeared that he had taken another little boy's potato chips and was munching away. Nothing like children to bring you back to the present moment!

"Not your chips," I shouted, grabbing smiling June from her swing. George looked at me with his mischeivous grin. I ended my inner conversation and rooted for George's pretzels in my bag. I left the playground realizing that my ten-year-old self, vulnerable and scared, still needs reassurce at times.

In peace,

Wednesday, April 19, 2006

Leafing through "Land's End"

A few weeks ago when my mom asked me what I wanted for my upcoming birthday, I realized that I needed a new bathing suit--since last summer I wore a maternity one and my suits from years past are pretty shot. I absolutely love summer and take every opportunity to swim that I can. Last year, we joined a really great pool at a shady Girl Scout camp that was a true respite from the summer city heat. We're going to join again, so a new suit is in order.

My mom and I both know that a great new suit means one thing--leafing through the Land's End catalog. For a woman like me (and I guess this applies to most American women out there) who's not going to appear on the cover of "Sports Illustrated" anytime soon, Land's End has actually made the process of buying a bathing suit into something not completely mortifying.

There are suits made of material that makes you look slimmer; there are tops and bottoms that you can order separately to address any "problem areas" in the various parts of your torso. For us pump users, there are great tankini options which, in my experience, is the best way to go to the pool or beach with a pump. Wearing a tankini, I just clip the pump onto the bottom half of the suit--and volia!--I'm set. I suppose you could do the same thing with a bikini...if you are someone who wears a bikini. But speaking for the rest of us once again, I wish to thank the inventor of the tankini--whoever and wherever you are--which became popular the very summer that I started pump therapy.

This year, leafing through Land's End was a bit less fun, knowing that I needed to find a suit to accomodate both my pump and also my "I'm a mom now who had two c-sections" stomach. Sigh. Maybe actually ordering my birthday suit (ha, ha) will give me that extra motivation push. I'm about 8 pounds away from where I'd like to be on my birthday (June 7th).


On another note, I encourage anyone with Type 1 to take a few moments and fill out a quick survey about living with Type 1 for an Australian diabetes organization called "Reality Check." The survey can be found at Reality Check puts out a great e-newsletter called "Yada, Yada"; you can subscribe at


Monday, April 17, 2006

Bizarro Carrot Episode

Have you ever eaten a food that you thought you knew how to bolus for...and were just completely off? That happened to me tonight. I've been cooking lots of vegetables. I love vegetables. I love them in salads and cooked every way possible; I usually steam, broil or roast mine.

Passover (still going on) is a springtime holiday and so tonight I made several vegetable recipes that seemed full of spring time spirit: one was pan-seared asparagus and the other was roasted baby carrots. The carrots, coated with olive oil and tossed with salt, pepper and garlic, smelled incredible roasting in the oven. I baked them at 425 degrees for about 35 minutes and they were just beginning to char when I took them out.

I made baked salmon for the entree and we sat down to eat. I was running a bit on the high side all day and was 156 before dinner, so took an extra unit of insulin. I figured the meal was pretty low carb--and just bolused for the carrots.

I don't know what hit me...I've never had a problem eating carrots before, but tonight my hour after-dinner blood sugar was 293. Yikes! Did I somehow eat a chocolate ice cream sundae with my meal and have total amnesia? There was virtually no other carb in the meal besides the carrots, so I'm blaming them for the high number. I'm wondering if the method of roasting them somehow wreaked havoc with their sugar/carb content?

Sigh. I love carrots and these were tasty ones. Do I make them one of my foods to avoid? When I first went on the pump, I was able to analyze which foods--even when I bolused for their carb content--were impossible for me to eat and keep my blood sugar on track. Bagels were the biggest culprit, though now I do fine eating a Thomas' whole grain version. But roasted carrots? Come on.

I will try the recipe again...just in case this was all some other kind of strange flukey blood sugar moment. I did enjoy eating them, at least.


Thursday, April 13, 2006

Night time lows

I made it through the first night of Passover pretty well...the food at my mother-in-law's seder (Passover dinner) tends to be pretty heavy in carb and in the rush of getting ready, I left my symlin at home, so I just tried to bolus as I ate and adjust for eating matzah products rather than the whole grain carbs that I've been trying to eat. I was 113 before dinner and by the end of the night before we left her house, I tested at 169.

It's about an hour drive home and I went to bed without testing again. At 2AM I woke up pretty restless and knew I was feeling low...I tested and was 61. I was thankful to have woken up at 61, rather than dropping lower. I went downstairs and poured a glass of grape juice that I knew would bring my sugar up pretty quickly.

I was still feeling shaky after I drank the juice and my impulse was to eat or drink something else...I wanted to quelch that shaky feeling. I hate feeling low. When I was pregnant and keeping my blood sugars as low as possible, I would often drop from 70 to 60 fairly quickly...and then eat too much and bounce high. I learned to drink a small juice box and wait 15 minutes and test again before taking anything else. That small juice box always did it--raised my blood sugar enough to be normal, without being high. But waiting that 15 minutes always felt like waiting out an eternity; I want the shaky, low feeling to be over instantly, even though I know my body doesn't work that way.

So I did drink some more juice, went back to bed and woke up about 5AM when I heard June crying. I was 236. Sigh. Overcorrecting. I took a bolus and by 6AM was back on track. Today we got to VA to my sister's house for our second seder and I'll be taking my symlin along and testing a little bit closer today.

In peace,

Sunday, April 09, 2006

Someone else's complications...

My husband Fred just ran into a very old, dear friend of his...I'll call him "Joe." Joe is an extremely talented musician who sings and plays banjo and used to hang out at the club that my husband managed for eleven years. Fred and Joe had lost touch over the last few years, but ran into each other last weekend at the club's closing party. Joe moved from Philadelphia to St. Louis not too long ago, but came back to say good-bye to his old friends at the club.

Joe has Type 1 diabetes. When my husband and I first started dating, I had just started pump therapy. I remember how much Fred wanted to share what I was doing with his friend Joe. He talked about Joe's various health problems--besides diabetes--and thought the pump could be a great thing for him.

When I asked Fred, maybe a few months after we'd started dating, if he had talked to Joe about the pump, he told me that he had...but that Joe was not interested. He had his routine down with taking shots. That was that.

Over the next few years, whenever Fred and Joe talked, Joe was going through some kind of health crisis, not neccessarily diabetes related. I would ask Fred if Joe might want to talk about pump therapy or even borrow a copy of my book, but Joe never showed any interest.

When Fred saw Joe last weekend, he was sad to find out that Joe is losing the eyesight in one of his eyes to complications of diabetes. When he came home to tell me that, I wasn't shocked. In fact the first words out of my mouth were, "I'm not surprised."

I had trouble falling asleep after hearing my reaction to that news. I thought that I sounded like a heartless bitch. Shouldn't someone with diabetes be more sympathetic to someone going through something like that? But what Joe is experiencing, I realize, is a fear that lives just under the surface of my psyche. I do everything I can to keep that fear in place: testing frequently, learning about the latest technology in diabetes care, going to my endo frequently, keeping my A1Cs in the under 7 range. Hearing about someone else who wasn't able to keep diabetes complications at bay unnerves me...because it is just too close to my deepest vulnerability.

I am sorry for Joe and for what he is going through. And I have learned a lot but looking at my reaction and facing what it means to me.

Friday, April 07, 2006

Karma Day

Yesterday, I felt just like Earl Hickey from one of my new favorite sitcoms "My Name is Earl": Karma was definitely trying to tell me something. A few days ago, our microwave broke. I didn't realize just how much I depended on it (re-heating coffee, babyfood, etc.) until it went. It is a 1992 model that fits in above our stove and was here when we moved in. My husband Fred tried all of the circuits, but nothing changed...the microwave was gone.

I voted to go shopping for a newer model but when Fred priced them online, we saw that the above stove models were a bit pricey. So he called a Sears repairman (it's a Kenmore model) who came out to the house yesterday. The nice, big, tall repairman ("Hi, big tall man," my son George greeted him)looked at the microwave and asked me in a most polite tone, "Ma'm, did you know it's unplugged?"

Truly I did not (to our fairness, the plug goes in the back of a cabinent over the microwave and in the three and 1/2 years that we've lived in the house, it's never come unplugged before), but after writing the nice big tall man a check for $69.55, I decided that I would always check the plug in the future should the microwave mysteriously go again.

Then the phone rang. It was another polite person, this time calling from my medical supply place. She had phoned yesterday to see if I was ready to re-order my test strips. What a lovely convenience. I told her yes, and expected them to be shipped as usual.

But she was calling back to let me know that since our insurance policy had changed as of January 1st, I would now owe the medical supply place 30% of my order. For a three-month supply, that stung. When my husband's health insurance changed, we had hoped it would save us money, not cost us more. I gave her a credit card number over the phone, sighed, and said good-bye to that money, too.

But that money won't be like my expensive lesson about looking for an appliance's plug. That will be ongoing money out of my bank account every time that I order strips. I've been so lucky to have all of my supplies paid 100% up until this point. I'm truly bummed out and angry. I test a lot--8 to 10 times/day. I will not test less because of the awareness that 30% of the cost is coming out of my pocket. But I will miss that money.

What is karma teaching me here, I keep wondering? Maybe to be aware of how fortunate I am to have insurance. Maybe to remember how many people out there with diabetes can't afford basic supplies. Maybe to hold onto my anger and advocate more for a just health care system, in which everyone in our country has access to the medicine and health supplies that they need.

I'm not sure yet what exactly the lesson is for me, but I was happy to get through the rest of the day with no more polite interruptions.


Tuesday, April 04, 2006

Passover is coming...

In just over a week from now, I will sit down with my family to celebrate the Jewish holiday of Passover. Passover is one of my favorite holidays because of its rich traditions and the many opportunities for spiritual growth that come with this time. The essence of Passover is celebrating the tale of the Hebrew slaves' Exodus out of Egypt--that once we were slaves, but now we are free. Freedom is not to be taken for granted. Our experience of being oppressed should make us sensitive to the suffering of others; our tradition states that "all who are hungry" should come in and join us at our holiday table.

Some of the most interesting customs connected to Passover involve food. Throughout the holiday (which lasts over a week), we give up eating all products baked with yeast, as a way to remind ourselves--gastronomically--of the Exodus story. The Hebrew slaves rushed out of Egypt becfore their bread could rise. Instead of eating bread during Passover, we eat matzah ("the bread of affliction") and matzah products. Many Jewish people also give up other starches like legumes, corn, barley, etc., even though they don't contain yeast.

So, though I love Passover and look forward to taking some time for extra introspection during the holiday, I always feel a little nervous about how switching from my usual diet to a matzah-based one will affect my blood sugar control. One piece of matzah contains about 20 grams of carb, but in the past couple of years, I found that I needed to bolus less for matzah than I would for a piece of bread containing the same carbs.

One advantage of me reducing carbs of late is that Passover won't affect my diet as much this year...I can still eat my morning yogurt, all of my fruits & vegetables, cheese...and substitute matzah for the crackers or bread I eat. If I do a protein like fish or chicken for dinner with lots of veggies and a little matzah (which might be baked into a casserole or fixed in one of the thousands of creative ways that Jewish cooks have figured to make the stuff more edible), then I should be okay.

The challenge for me is that when a holiday comes, there's always extra of everything around--desserts that I wouldn't normally eat, for example. One Passover tradition is eating macaroons, since they contain no yeast. Eating the kind that comes out of a "Manishevitz" can is pure nostalgia for me...taking me right back to the Passovers of my childhood. One macaroon can easily become two, four or six. :(

So this Passover, I will try to keep my mantra to eat healthy right in front of me, calling to me when I get weak. I would like to use the days of Passover to focus on cleansing, on springtime, on renewal of spirit...

Diabetes can feel like an awful oppressor, like the worst taskmaster. We are not free of it yet, but we can stand up to this boss of ours, at least, look it in the eye and fight to gain control.

Saturday, April 01, 2006

Ready for the time change...

Fall back, spring ahead! As much as I love springtime and the daylight that comes with it, I usually dread waking up that one hour earlier when it's time to set the clocks forward. But this year, my kids have broken me in already, waking up between 4:30--5:30AM most mornings this week. It's fascinating, the way they seem to be more instinctually in tune with the season...ready to wake up with the sun. It's been a tiring week, but my body is actually adjusting to waking up earlier and so the benefit is that tomorrow won't feel like such a long day to get through.

I am a warm weather person and can feel the way my overall mood is already shifting into a brighter state. I love being outside this time of year, watching the flowers in my neighborhood start to awaken. A few tulips have popped out of the ground in my small front yard...I had forgotten about them. In the next week or so I'll fill my window box with pansies and add some more annuals around the tulips.

This season is reminding me about renewal and nature, both outside and inside of ourselves. Last year at this time I was entering my second trimester and worrying about how I'd manage through the summer, dealing with diabetes and pregnancy and taking care of my 2-year-old son. Now that little boy is a more grown-up 3-year-old, my sweet baby is here with us, and I can give new life to other dreams. Mostly, I think my biggest challenge to realizing all of my dreams is patience. I want things to happen now, I love the quick fix. This spring, I want to slow down more and dream more and appreciate the small steps that I'm taking towards my goals.

Dealing with extra fatigue this past week made blood sugar control that much more challenging...but I feel back on my game today. I lost almost three pounds over the last few days, so that is encouraging, too. Spring is here and this time tomorrow night, there will still be light outside of my window. That will be sweet...