Traveling & Surprise Vacations

I hate being all over the place. Scatter-brained checklists everywhere and anxiety laced with panic setting in.

I don't do well with living out of bags. Especially because I always like to be prepared and look appropriate for the destination. Which means that I have no idea how to pack light. I'm always thinking about pouring rain and cold breezes or bug bites and emergency situations. I wanna have six of everything but I know that impossible to carry that much stuff around comfortably. As it is, I always get looks of worry from lugging around and overstuffed duffel bag plus my school backpack (which houses my laptop and other random things). Regardless of the situation, I always end up with one too many "emergency" outfits and things that I don't touch at all, but in the same token, I ALWAYS forget something I wish I had brought.

On my latest excursion to no where terribly exciting to see family, I managed to forget to bring along an extra Dexcom sensor for Eggy mostly because I assumed, I'd get at least the extra 3 or 4 days that I needed to survive the extra 3 or 4 days I was out of town. Unfortunately, traveling makes me sweat and fidget with seatbelts which coincidentally makes Eggy's sensors peel. And that peeling was what led to the stingy feeling in my side that comes from the sensor coming a little bit out and then going back in a little bit (because those things are dull yet extremely sharp all at the same time). So I pulled it right out thinking I had an extra one.

I panicked for exactly 3 minutes. And then I breathed a great big sigh of relief. Because, yes, despite how much I love my CGM, I love my time without my CGM. One less D-tech thing I have to carry around. Plus, no serious fears of losing it (leaving it in the bathroom, slipping out of my pocket during a walk in the park, running out of my car, taking out the trash, and the list goes on). I enjoyed my Dexcom vacation a little longer than I had to and now I've got a new sensor in about 5 days later.

The alerts are nice. The Dexcom 7+ Sensor System is way more fun than I had I with 6 months of Minimed's shell-shaped Guardian/Paradigm sensor. It works better and is more functional for me when I can hold onto/remember where I put Eggy. But yea, sometimes it stresses me out and sometimes I bolus/eat without actually doing a finger-stick. Not all technology is good and useful (ESPECIALLY if you overreact to it). And even when it is good or useful, sometimes few days without it makes you remember to smell the roses, or the alcohol wipes on your finger tips, more often. I enjoyed my vacation so much, I think someday probably not until winter break I may want to take a full technology break: no Dexcom, no pump, no smartphone (GASP, could be hard). Of course that silly meter has to come along, but hey I can have my dreams right?

Diabetic Art Work!

So I was wandering around online (aka not apart from my laptop for hours) and I noticed that lot of the cool blogs out there have diabetes artwork (d-art from now on) as part of their website templates and designs.

I was a little bored and kind of sick of the layout of mine so I decided to try out my hand. Now please be patient while I get around to "transforming" my blog, but here's a preview of my diabetes supplies climber. I really want to come up with a name for him. Let you know when that part of my creativity starts spewing.

Technology: Benifits and Drawbacks

So I'm a biomedical engineer (BME). When I started college, I really wanted to be playing with stem cells, but I picked the school who's BME program was all biomechanics, aka movement analysis and prosthetics, because they gave me lots of money to go there. As I took more and more classes, I realized I really enjoyed bioinstrumentation, aka fancy medical devices, because on any given day, I can be found carrying at least three of them on my person.

I was psyched when I saw that the DSMA (Diabetes Social Media Advocacy) was hosting a discussion week about medical devices. Unfortunately, because my social life is sideways and upside down in the summer, I haven't been able to join in to any of the convos. but I read the transcripts and try and listen in on at least some of the radiotalk on Thursdays. Then, I found out that it was this month's blog carnival, and I've been scheming about what to write about since I saw it. **I go back and forth with a lot of these issues because while I understand why they exist, I still think it sucks**

Because I'm on the up and up (I think) on how device development works, I know that bringing serious innovation forward to existing devices is hard. Partly because of how the FDA approves changes and partly because of how big business works. After that comes all the cool stuff I'd like to see happen with our current D technology.

Regulation of medical technology is hard. Period. It's a little backward in the US but it's not always better in other countries either. EACH country has different approval mechanisms. Some are easier and believe it or not some are harder to gain regulatory approval. So yes, while I'm jealous about the Animas Vibe coming out in the UK, I understand why they started there.

Regulatory approval is like those car seatbelt alarms. While they annoy the daylights out of you and they're pesky, the ONLY reason they're there is to help keep you alive. They're not really trying to hold back innovation and cool new technologies. They exist to keep us safe from medical fiascoes like the Pinto (read car that burst into flames) for the car industry. Also keep in mind, while some of what they do and their procedures make no sense, NOTHING in the medical or political world is close to perfect.

So the big bad world of big business makes it really hard for a basement tinkerer to come up with something really cool in terms of D-technology. They have lots of money and lots of resources. When larger companies absorb smaller companies, sometimes awesome things happen and sometimes awful things do. This goes back to the previous point but it's really tough and expensive to win regulatory approval as a small firm between the amount of money for the trials and the amount of paperwork to ensure you actually thought the idea through. A lot of times people have to sell their ideas to bigger companies so that they make it to the hands of everyday people like us. I was a little sad when I read the Deltec Cozmo pump (pump with meter attached) was going out of business because I was so psyched at how different it was from the other major pumps in the market. While I don't know their reasons, I do understand the pressures from a very competitive market.

As far as my hopes for D-technology, I'll break it up in 2 ways: Near Future and WAYYY out there. Everyone thinks that smaller is better when it comes to technology (see anything about cell phones and mp3 players). While smaller is cooler in some cases, bigger is also better too (especially for the older peeps with D). There are some populations of people with D that don't get as much attention as they nearly need. The two in my mind are the uber-technophiles like me and those kids who are diagnosed early on (because if I see a commercial selling my diabetes supplies with medicare once more, I may scream at the TV about how I'm not old enough for that by decades).

As far as technophiles, there's tons that we wish we could do with our D-technology. 1 integrated device to carry around instead of 3 or 4 would be awesome (are there security concerns? sure, but can't we decide our data risks personally?). Looking at our data in different forms and playing with it find trends that important to us. Customizing our devices sometimes plays a big role (see bg meter via iphone). I think someone brought up the incredible point of putting a light where the strip goes and the blood gets sucked in so we can test in the dark (think movie theaters, bedrooms, camping trips). Even some fluorescent or glow in the dark action on strips (I know you're supposed to keep them in a cool dark place but still) would be cool. It amazes me that not all pumps come with remote controls and there aren't smartphone widgets for inputting d-numbers to track. I HATE that I have to put carbs and bgs into my pump and then my dexcom. If tracking is SO important, why do they make it so impossible? I want more options. Can't we decide how complicated or simple we want our medical devices to be? I can get a less powerful version of an iphone for less money than the brand new one, but I can't do that with my medical devices? Can't I upgrade the processor or order more software to tinker with it myself at MY OWN RISK? (Although to be honest, I think that's more the FDA then the companies)

For kids? It's been a while and I was diagnosed close enough to puberty that I've always been pretty much the same size. But I met a d-dad at an interview who was telling me about how disappointed he was that his son couldn't live with an insulin pump because it's too big for him. With all of these miniaturization and customization skills that companies have, they haven't figured out how to make pumps and devices sized for kids. Ones that have smaller reservoirs and fewer options than the regular-sized adult ones would make their lives that much easier. They've started coming out with cellphones for kids that can gradually be transitioned to real phones. Why don't they have grow with you insulin pumps targeted to the ages of 0-12 years?

There are also things that most diabetics are disappointed and confused by. Like the accuracy of our testing devices. Why can two identical meters be so far off? (Variables. Temperature. Test strips. Tolerances in device specs. Testing locations. Blah blah blah. Seriously?) If we can send people to space, why can't I test my blood sugar when I'm snowboarding because my meter is too cold or at the beach because its too hot?

As far as the future, I'm right there with everyone for a cure or at least an implantable pump. I understand the difficulties with reservoirs and batteries as well as scar tissue and glucose monitoring physiology. I just would love something that would make me worry less 24/7. I'd be happy to forget that I have diabetes for more than an hour (most days, not even that).

I know that technology isn't instant like microwave noodles. It takes time and money and a lot of innovative minds. But I can't lie and say that I don't want more. More accuracy. More options. More simplicity. More sizes. I want more, and I want it soon.

This post is my July entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/july-dsma-blog-carnival/

Favorite Pricking Spots

So I spent a fair portion of my time with my CDE talking about alternate sites for my infusion set, but it hasn't really occured to me that I need to be rotating my finger stick sites around.

I'm the very first to admit how poorly I managed my diabetes for years. 1 stick every once in a while to make sure I was... alive.

Now that I've gotten over my D-burnout and into a regular pattern of checking my bgs and remember my boluses, I've realized that my finger stick pattern has changed. MY favorite finger spot was the right side of my right ring finger. A few years ago the finger looked awful and gouged. For some reason, my new favorite finger has become my right middle finger. It's not in as bad shape as my ring finger was but it's getting there.

I've started adapting to using my left hand a little more often now, and I know that you can pretty much stick yourself where ever you think you can manage to strike blood (palm, forearm, etc.) I remember being not terribly shocked when the pamphlet inside the pricker device said not to use anything other than your finger tips for hypoglycemia or rapidly changing numbers (physiology says that the blood in your forearm lags behind the blood in your fingertips). Despising exceptions (because well, golly gee, IF I knew I was low, then that kind of defeats the point doesn't it) and already knowing how inaccurate meters can be (UGH & RAWR), I've always just stuck to my fingers.

So my question to all of you is where are your favorite spots, why are they your favs, and do you always pick your fingers?

Diabetes Wonder

I have gone from feeling like a diabetes burnout super-freak to feeling like the diabetic wonder-child.

Today, I visited a Certified Diabetes Educator in...3 or 4 years. My mom and I had an awesome relationship with my last CDE. When I outgrew the peds clinic and my parents moved to NH, I transferred to Dr. Awful and hadn't seen a CDE since. What that meant is that some of those awesome Diabetes skills I had acquired over the years (aka knowing what to do in emergencies, how to rotate my sites, tips and tricks) had gotten a little rusty over the years. For instance, my pump broke and I tried giving a shot into my arm muscles instead of arm fat. If you're really that curious, remember that I highly recommend AGAINST it.

Anyways, I had a few discussion points I was interested in: Alternate sites because my stomach is starting to look like Swiss Cheese; Adjustments to my Insulin to Carb Ratio: More tips for dual wave bolusing cause what I've tried so far hasn't quite worked.

All in all her answers while mostly textbook were all laced with the same theme: You're an empowered, smart, and motivated Diabetes patient aka wonder-child. She raved about how good everything looked and how I should stick to what I'm doing with some slight modifications here and there.

Now all in all, I haven't been anywhere near a good diabetic patient in years. What changed? I got a Dexcom and started reading more about awesome diabetics online. Actually, truth be told, the reading was probably what motivated me to switch to the Dex. Point is that behind every "good" diabetic is a lot of people: Doctors, Family, Friends. Ultimately, having someone who knows what it's like living with this crazy condition day after day really gives you a kick in the pants. It makes you aspire to be better and remember that you're human. So, thank you DOC for motivating me to take better care of myself.