The Great Divide in the DOC

Posted on September 19, 2013 by Laddie

I’m Abby the Black Lab and it has been a while since I have written a blog post. Lately I have been utterly distressed by a great divide that I see in the DOC (Diabetes Online Community) and I think it is time to bring this to the attention of my readers. You probably think I’m going to start talking about the Type 1 versus Type 2 wars that periodically surface on the Internet. Are you kidding? My subject is not nearly as trite as that.

No, it’s the dog people versus the cat people. The canines versus the felines. The lovable, loyal, goofy, tail-wagging dogs versus the slinky, aloof, meowing and menacing kitty cats.

The cat aficionados have long been led by Kerri from Six Until Me whose cat Siah is a media star who poses in laundry baskets and attempts to dominate the DOC as an “internet celeb-kitty.” The dog people are more decentralized in their leadership. Canines have conceded Twitter to the cats, but think that we rule Facebook. The blogosphere is probably a toss-up, but my opinion is that dogs are truly superior in their contribution to their PWDs (people with diabetes). Duchess is a diabetes service dog who daily keeps her owner Tarra safe. Meri’s boys are protected from the abyss of low blood sugars by Lawton the Yellow Lab. All human hearts have melted seeing photos of Kim’s corgi watching over the new baby “Rabbit.” Black labs like Riley owned by Mike Hoskins insist that their owners exercise by taking them for daily walks.

Cats meanwhile are tiptoeing across keyboards and writing meaningless blog posts with the tag line “zxzxzxdjjj.” Pissed-off and non-sleeping kitties are considered newsworthy. Oh yeah, Chris of @iam_spartacus fame has some feisty looking cats and @KarenBittrSweet claims to have the world’s cutest cat. Videos of Grumpy Cat are ubiquitous, but if I want to see grumpy, I can look at my owner Laddie when her meter says 286.

Fortunately the DOC universe of cats and dogs has recently been in a state of equilibrium with only a few ripples of discord. The dog people tried to sneak one under the rug in Twitter and Facebook with the purchase of a Scottish Terrier named Bella by Cherise. Someone needs to tell Bella that if she wants to become an icon in the DOC Canine Hall of Fame, she should learn to walk on a leash. Also tell her that if she’s going to be a supporter of people with diabetes, lancet devices should not be on the menu. The cat people have lost some heroes as Kerri and Pancreassasin mourn their beloved friends who have gone to the scratching post in the sky. (RIP Prussia July/2013 and Pancreassasin 2week kitty August/2013).

But the calm has been shattered! Earlier this month the cat people added a new superhero to their roster in the guise of a young child named Birdie. Smiles and cute Batman Princess costumes are not adequate to camouflage the chaotic schemes of this young and seemingly innocent feline-loving child. With no attempts to disguise her evil intent, this child suggested that the family cat Siah was lonely and needed a friend called…. Loopy.

The Loopy hullabaloo has not been all. Another scandal has been exposed in the DOC and I, Abby, a supporter of all people with diabetes, have been accused of consorting with the enemy. A photo of a certain black lab being nuzzled by a gray feline has been splashed across the headlines. I confess. I am guilty. I like cats and cats like me.

Every year I put “Kitten” at the top of my Christmas list. Unfortunately my owner Laddie is allergic to cats, so no personal kitty is in my future. I am extremely fortunate that when Laddie travels, I get to go to Linda’s house and visit my friend Nikki. Nikki is a shy cat, but I have learned to approach her slowly and lay my head down acknowledging that cats are supreme. She rewards me with purrs and caresses of her head against mine. It is a magical glimpse of heaven for a lucky black dog who is showered with love by a beautiful princess gray cat.

My romance with Nikki has some important lessons for everyone. Although you seemingly-civilized people with Type 1 diabetes sometimes argue with those who have Type 2 diabetes, you pancreatically-challenged doofuses should remember that you are stronger together than apart. Diabetes in all of its evil forms is the enemy and you should join hands and conquer it together.

More importantly, we dogs and cats should toss aside our petty differences and stop the harassing hisses and barks. With a united army of canines and felines, we can fight a cosmic battle against our common enemy. A enemy who taunts and teases us in our own yards and through our own windows. An adversary who seems to think that dominance is achieved through water-skiing videos. We have seen the enemy and the enemy is……..SQUIRRELS!

Hiking with Diabetes – Part 2

Posted on August 1, 2013 by Laddie

I started writing the second part of this series and got bogged down in too many temporary basal rates and 50% boluses. So now I’ll start over on a different tack.

Slowly, but surely, my hiking plan has come down to a couple of rules. Although my blood sugars may go on a different adventure every hike, these rules/guidelines seem to remain constant.

The first rule is that safety must be the primary goal of my insulin and food regimen. Actually safety starts with my preparations for the hike. I have a printed list that I use every week. On the surface it may seem a bit neurotic, but it’s very easy to go down my list every Thursday evening and confirm that I’ve packed my Glucagon kit, extra snacks, a second tube of glucose tabs, and extra socks. My list has all the basics including a hat and hiking boots. That might seem like overkill, but one person in my group did forget her boots one week and hiked 11-1/2 miles in the Goldfield Mountains in sandals. So don’t laugh too hard at my list. Then I do another last-minute list for Friday morning: water in my camel reservoir, lunch, my phone, and a bottle of water for the car.

I’ve been brainwashed by many people on the Internet who claim that they never go above BG 140. With lower-carb eating, consistent exercise, a pump, and a CGM, I often try to be “perfect” and make corrections on readings that should maybe be left to simmer. Slowly but surely while hiking, I’m learning to see readings in the 130’s and 140’s and leave them alone rather than correct them. Most of those readings eventually end up in a good range. Occasionally the 145 turns into a 185 and that warrants a correction. What’s frustrating is that I can never figure out why one week 145 goes to 95 and another week it goes to 200. But I’m working hard to accept that I feel good at 140 and I don’t feel good at 65 with two arrows down on the Dexcom. So the second rule is: leave the heck a 140 BG alone!

My third rule is to ask for help if I need it and to stop to rest if necessary. This rule is not always related to diabetes. Our hikes are hard and occasionally everyone needs a rest. Well, maybe not Caroline. But the rest of us occasionally get over-heated, sore feet or leg cramps, so it’s not always me. Part of being strong is the willingness to accept weakness.

My fourth rule is to do my best to understand my limitations while having confidence that I am prepared for the hike and that I am strong enough to complete it no matter how difficult. The hardest hike that I have ever completed was a 2012 13-mile loop around Weaver’s Needle in the Superstition Mountains. Some of the elevation changes were exhausting and the day was much warmer than anticipated. This year in 2013 I chose not to go on one hike because I thought the combination of difficulty and heat would be too much for me. So I think I’m doing a good job of balancing the goal of pushing myself while being sensible to not put myself in a dangerous situation.

My fifth and final rule is to enjoy every minute of every hike. Be safe, but not frightened. Be strong, but admit weakness when necessary. Trust that I have my diabetes under control while checking constantly to make sure that I am in control. All in all, a sensible rule to live a successful and active life with diabetes.

Hiking with Diabetes Part 1

Posted on July 29, 2013 by Laddie

I am lucky to be able to escape winter in Minnesota and spend several months in Arizona. Although I’ve always been active in sports such as tennis and golf, I have expanded my athletic repertoire to include hiking. I belong to two women’s hiking groups in Arizona. My primary group is a serious gung-ho group that hikes 8-12 miles with significant elevation changes on a typical Friday. Many of the places we hike are in mountainous areas where we have no cell phone coverage. My second group is more casual with shorter hikes on more populated trails. Although I certainly carry food, glucose tabs, and water with my casual group, I am not too concerned with diabetes causing a problem. So most of my comments below are related to my more rigorous and remote hiking excursions.

Although I’ve always made sure that my hiking companions know that I have Type 1, I’ve never done much else except ensure that my pockets and backpack have plenty of glucose tabs, granola bars, juice, and other food. This year it finally struck me that it was absolutely insane to repeatably go out into the no-wheres of Arizona without a Glucagon kit.

I stopped getting Glucagon kits years ago because I’ve never needed one and they expire so quickly. My husband would call paramedics 100% of the time before he would ever give me an injection. If I’m low at the grocery store or mall, no stranger will know to find the orange kit in my purse.

This hiking season I finally got a new Glucagon kit. Fortunately my hiking group includes a former RN and a former school principal who has a sister with Type 1. Even if they weren’t along, the others in my group are strong and confident women who would take control if needed. I wrote up a sheet to share with everyone describing the levels of hypoglycemia and directions to use the glucagon kit. I indicated that I would handle mild lows myself and they would probably never be aware of them. I wear a Dexcom G4 which gives me some guidance as to what is going on with my blood sugar. I also have a One Touch UltraMini attached to my belt and I have perfected testing while walking without falling off a cliff.

My favorite advice for moderate hypoglycemia is if they ask me if I am OK and I say “yes”, don’t believe me. I am getting better about admitting that I am low when asked. But old habits die hard and I don’t want my false bravado to fool anyone into thinking I’m safe when I’m rapidly getting into trouble. I also described symptoms that they might notice such as slurring of words and vacant eyes.

I discussed severe hypoglycemia and indicated that at this point I would be unable to eat food or drink juice. Although the Glucagon kit comes with instructions, I wrote up a clear and more succinct page of instructions using some of the images from the Glucagon website. I also mentioned that Lilly has an iPhone/iPad app if they want to review that. The weakness of that app is that the instructions are just a copy of the printed material that comes with the glucagon kit. Too wordy for an emergency situation IMO.

I feel confident that I will never be in a situation hiking where a Glucagon kit will be needed and I hope that my confidence is not misplaced. I am very aware that if I experience severe hypoglycemia, Glucagon will be only part of the solution. My hiking companions will still have to arrange for emergency help to evacuate me if I am sick from the Glucagon or the effects of severe hypoglycemia. In areas where there is no cell phone coverage, that might mean spitting our group with some hiking out for help and some staying with me. This whole scenario is something that I never want to visit, but my safety motto is to be prepared.

I often joke with my hiking companions that my aim every Friday is to not end up on the evening news. Unfortunately lost and injured hikers are a regular occurrence on Arizona newscasts. So far I have succeeded in that goal through hundreds of miles of hiking. I’ve been sore, dirty, and exhausted many weeks, but never on the news. Hallelujah!