I am sitting outside this evening in Arizona basking in blue skies, mountain views, and warm temperatures. I am feeling good and it seems that my arthritis has gone on hiatus. Diabetes is just being diabetes and I am doing my best to ignore it and leave the work up to Control IQ. The coyotes are howling and I hope it is with joy at the day and not for a recent bunny kill. Doves are cooing and a pair of Gambels quail is investigating my geranium pot as a potential nesting spot. Weird crane flies are everywhere with their whispy daddy long-leg look. A pair of mallards has determined that our swimming pool might be their new home.
But coronavirus is out there. On paper I am at high risk for a poor outcome should I get sick with the virus.
I wrote the above paragraphs 10 days ago when I was still living in the world of social distancing as a snow day. I knew that things weren’t a holiday but I wasn’t tired of being alone and wasn’t yet worrying about how diabetes would impact my prognosis in the coronavirus epidemic. I wasn’t yet worrying about how horrible it will be to get critically and painfully ill. (I haven’t even had the flu since the 1970’s.) I wasn’t yet worrying about how one of my sons will survive financially when he and his wife both need to work but have no childcare. I wasn’t yet worrying about the endgame of most of the country staying at home.
I didn’t have a pit in my stomach yet.
I do now. Not every minute of every day but often at 2:30am for several hours. Not all day every day but a lot of the time. It usually disappears when I get to FaceTime with my children and grandchildren. I normally spend a lot of time alone and social distancing is not difficult for me. It allows me to go on solitary hikes in the desert and spend hours every afternoon doing computer jigsaw puzzles. Interestingly I have not been able to find a new Netflix or Amazon Prime series to binge on and I have very little concentration for TV. But other things keep me entertained.
But the pit in my stomach and the stress of the unknown is never far away.
When will it be safe to return to normal? Has our world forever changed and what was normal will never be part of our lives again? Does our country have the leadership to weather this crisis? Will we have enough healthy medical professionals to care for us through this crisis. Will an economic recession destroy as many people as the virus?
Nothing that I am thinking or feeling is different from most other Americans.
I am writing this post from a life of privilege. My husband and I are comfortable at our Arizona home and we are able to walk around the neighborhood, hike in the nearby desert, and even play golf touching nothing communal on the course. We have enough food to last for several weeks. He has a job and is able to work remotely. I have several months worth of insulin in the refrigerator and diabetes supplies in the closet.
But I know that I am ill-prepared diabetes-wise should I get sick. My husband knows nothing about my pump and CGM. I am not sure that it matters much. If I am too sick to minimally care for my diabetes, I should be in the hospital. If I am hospitalized with coronavirus, my husband will not be able to visit or care for me. Plus he would also likely be sick since we are living in the same house and sleeping in the same bed. There is a good discussion on TuDiabetes about a diabetes checklist for the hospital. I think it is unreasonable to think that my pump and CGM would be supported in a coronavirus crisis, but I like the idea of a file card screaming that I have Type 1 diabetes and require a long-acting insulin. Now that I am a senior, doctors tend to not understand that while I have a lot in common with people with Type 2, I am different and will quickly die without insulin.
Good things in my life: My husband and I are together and I know that he will take care of me to the best of his ability. I am able to FaceTime with my children and grandchildren. I love them and they love me. We have started a family blog and are sharing words, photos, and videos. My fitness instructor in Arizona is doing a MWF class live on Zoom. My yoga instructor in Minnesota is doing classes twice a week on YouTube. I have a diabetes online world with young and old friends alike. I have friends in Arizona and Minnesota who keep in touch. My husband and I are working hard to use our food efficiently and are varying meat and meatless dinners. Although it may be a blood sugar bomb, we are having French Toast for dinner tonight. Thick white buttermilk bread with lots of eggs, milk, and syrup.
Thick white buttermilk bread with lots of eggs, milk, butter, and syrup.
A definite good thing.
Bright yellow brittle bush blooms with a bee (yikes!)
Mallard lovebirds at my pool.
A paint with water picture by my 2-year old granddaughter.
my Montesa community in Gold Canyon counts zero C-19 cases, in this large and locked down community. PS I have my first tele-med appt on Monday…routine. but a new thing for me
Scary time we find ourselves in, right? Like you, I’m trying to count my blessings, but the anxiety is still pretty palpable…
Here on Staten Island the sun is shining and the two pink magnolia trees are blooming in our backyard. But the Mayor also predicted today that fully 1/2 of NYC residents will likely contract the virus at some point.
So it’s an emotional balancing act we must perform on top of our usual balancing act of blood sugars.
HI Laddie, I enjoyed your blog. Your writing is first rate! It is very different here in the Hudson Valley, NY. Snow a few days ago, but becoming much warmer now. Maybe very warm weather will see the number of coronavirus cases significantly reduce by June. A trouble-free Summer would be grand!
Hi Laddie- I loved your post. I think we are about the same age and I feel the same way. I have not left our home on Cape Cod in 15 days and I will probably be here until some intelligent person says it may not kill me. I am quite sure if I got it I would die, and since in some places they are already being forced to decide who lives and who dies. I have T1D x 62 years, and comorbidities of having heart disease, chronic kidney disease, and I take immunosuppressants for the beta cell transplant I had 19 years ago. So, I surely not be on the top of the list for that ventilator. Anyway, enough griping about things I can’t do anything about. I wanted to ask you about your use of Control IQ. I have that as well, but I still have not let go of manipulating to keep my TIR to under 180. I find that the basal increase and the boluses don’t kick in, in time to correct it. I think I may not have my carb ratio and correction figured correctly, but my endocrinologist is not concerned about post-prandial spikes because I am usually in range 90% of the time. If I recall you are one of the people on who uses a much lower number for TIR. But, I am not willing to give up my all my carbs. I do use carb replacements like cauliflower rice, etc. but every once in while I like to have a sandwich with one lousy piece of bread. So, how is it working for you to use the control IQ without jigging around with it. I set a few different profiles and switch back and forth several times a day. I know that is probably idiotic, but it keeps me in range. I am just curious, if instead I should try to get my ratios etc squared away better. My Doc is 80 miles away in Boston, so I only see him a couple times a year, and I have always done pretty much what I wanted to stay in control. Thanks for listening to my rambling. I guess Coronavirus is making me talk more. LOL
I am frustrated with the targets not being low enough. Mostly the problem is that our insulin doesn’t work fast enough to correct highs. Also although my G6 sensor works great most of the time, occasionally it reads super low and then my insulin suspends and then I go super high. I periodically turn off Control IQ but then quickly turn it back on because I think I am better with it than without. I might be better to just be back on Basal IQ but that is not an option. Plus in these coronavirus times, I don’t think it matters whether my average BG is 100 or 110 or 120 or even 130. I just keep doing my best,
I am about three weeks into control IQ, and share some of the frustration that you and Laddie have commented on. I am certain that my ratios are wrong and I am beginning to do basal testing.
I have done a few overnight tests, Which are easy because I’m not eating anyway. I mistakenly interpreted the relative flat lines to mean my basal rates were correct. However, when I looked at my history, I saw the control IQ was increasing and decreasing my rate quite a lot to achieve that flat line.
I think I need to study a few days worth of *that* data to figure out what rates I should try during that period on a new profile. Once I feel pretty good about that segment of time, I’ll have to do something similar for mornings, afternoons, and evenings. It’s always been the case for me anyway, that until my basal rates are reasonably correct,I’ll have significant issues at meal time.
I also expect to find that I have been using basal instead of bolus for some of my meal coverage. But I would expect my meal time ratios to become more aggressive once I get the basal ratios closer to correct.
Of course, blousing ahead of the meal will be even more important … Ive never been consistent enough with that.
During The next several weeks when my usual variety of activities is quite diminished, I’ll have a good opportunity to focus in on this tweaking and to keep a log for myself and eventually for my CDE and Endo.
Laddie..ty for your thoughtful commentary. Always enjoy your thought!!!
as always, I enjoyed your post. I’m finally feeling like I’ve become friends with CIQ, though it took nearly 2 months…
Here are my recent results: My TIR (70-150) is back to being equal to, or better than BIQ – between 86-92%, which I’m happy with. All my numbers are about back to what they were, which I was content with, but I’m definitely doing less micro managing and look at my pump fewer times a day. This is actually KEY for me – not as much sugar surfing, and not as much micro-correcting… I am in sleep mode all the time, and I needed to lower my basal rate (from .35 to .3) which reduced the amount of time it was suspending, and then I had fewer rebound highs. I also made my carb ratios more agressive (1:19 instead of 1:20) and my sensitivity factor as well (from 100 to 90). All together these worked for me. NOT perfect, but better, so I can relax more and let it do its thing, which is the idea!
Re Covid -19, I’ve had most of those same fears and hours awake at night. I’ve decided that I feel quite safe now, staying home. I also watched https://vimeo.com/399733860 which really helped me feel more calm and hopeful.
Hope you stay well and continue to find good things in your day!
Hi Laddie. Thank you so much for sharing your thoughts and feelings as we try to navigate this crazy time. I thought I’d share what for me is the best Western series I’ve ever seen. My husband and I are watching it for the third time, and still loving it. Called ‘Godless’. On Netflix. It’s more of a miniseries, and certainly dark, but binge worthy. Takes place inNew Mexico, not so far from Arizona. Thanks for what you do and hang in there.