To test, or not to test...

DSMA Blog Carnival Question: What types of decisions and frequency of diabetes related decisions do you make in any given day?

My man, Shakespeare (or Hamlet), had the question phrased right even though he missed my topic. There are so many questions that role around in our minds all day long. Especially as a diabetic, the questions seem like they never end. I don't think that it's ever "noble" to choose laziness or indecision over responsibility or action but I can't say that I always represent myself as Queen of my diabetes...

I had a professor in my Freshman year of college tell me that computers are dumb machines. You tell it what to do and that's exactly what it does. So if it's malfunctioning, there's a good chance the problem lies between the keyboard and the chair (aka you told it something other than what you meant to). Whenever I think of decisions, I think of that little snippet of wisdom.

Making diabetes decisions isn't as nearly as easy as writing a computer program (okay, that's pretty difficult sometimes). I can't say if this crazy number appears, then I need exactly this much insulin to fix it (even though I wish I could). I constantly have to keep track of all these extra variables (sleeping, eating, exercising, etc) and my simple little if-statement blows out of proportion with extra clauses. If I ate, did I eat more protein, more carbs, or more vegetables? If I bolus, did I account for how long it takes my body to break down an apple versus pizza? Did I remember to subtract some for all the extra exercising I'm planning? Is it enough aerobic exercise or is it anaerobic and am I going to need more or less insulin? AND how do all of the answers to these gigantic questions come together?

The toughest decision I make is the one I run into most often. Should I test my blood sugar? Do I ever really want to test? NO. It's really that simple. But without knowing that little piece of info, it's like wandering around in the dark without knowing anything about where I am. Yes, sometimes I'll treat based on what my Dexcom (aka my blood sugar etch-a-sketch) says, buzzes, or screams at me. I don't feel good about it, but gosh darn it, it's a whoooooooole lot easier. I wake up every morning struggling with that decision. It plagues me at lunch when I realize I left my tester at my desk or in my car, and I really don't want to go wait any longer to eat. It nags me at night when I haven't checked, but I'm already tucked into bed. The way I understand it (and explain to everyone else too), I'm SUPPOSED to test:

• Whenever I wake up (yes it can happen more than once if I nap) [Let's guess once for this example]
• Whenever I go to bed
• Before I eat (Between 3 and 6 times a day) [That's why eating 6 meals in CRAZZZY but good for you nonetheless]
• 2 hours after I eat (Between 3 and 6 times a day) [post-prandial test. I despise them]
• Before I exercise
• After I exercise
• Before I drive my car
• Anytime in between when I feel "off"

So for anyone keeping track, that's a minimum of 10 times and a maximum of 16 times I "should" test everyday assuming I don't feel low or high all day long and don't drive. If I sleep for 8 hours, that means I’m testing about once an hour if I divide that maximum number up evenly. Do I ever test that often? Sometimes. Everyday? I'd lose my mind. Usually it's between 4 to 7 times a day that I stab my cute little fingers. I really can't stand doing post-prandials unless it's in preparation for a snack or I feel off.

For brevity, I won't talk about the decisions revolving around food or actually bolusing insulin. They occur way more than 3-6 times a day (somedays it feels like I’m hungry every second of the day). I won’t talk about the decisions I make in fear of low blood sugars (like drinking an extra swig of juice), high blood sugars (why, yes I’ll treat those double up arrows even though I know my continuous glucose monitor will be nose diving in ten minutes), and glucose roller coasters (how long can I go, eating nothing but vegetables and drinking nothing but water?). AND we really won't discuss my aversion to changing my infusion sites or sensors (REALLY REALLY hate it) and the decisions that those devices add to the situation (yes, I should put those extra supplies in my bag even if I'm going out on the town).

What makes diabetes really overwhelming is that I can't pass some of those decisions along to someone else (like when I tell my roomies to decide what our plans are for the evening). These silly diabetes decisions stick to me like glue. And when I decide to do nothing or be lazy, I end up paying the price with a hyperglycemic-hangover or a hypoglycemic-slump.

If I could build a little decision making diabetes robot or some sort of awesome diabetes-centered Magic-8 ball, then I would in a heartbeat. I'd save my decision making power for more important life and fun decisions. I'd instantly forget about how many silly Diabetes decisions I have to make every moment of every day and instead, spend more time deciding how big my smile should be or the minimum amount of sunshine I need to soak in a day to appropriately fuel that grin.

This post is my October 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/october-dsma-blog-carnival/

Updates?

Things are crazy. As the usual. So bullet point time!

• In case you missed it (because I forgot to mention it), I did a guest post for Kim (textingmypancreas.com). I think that the post was awesome [the title says it all: "I Get By With (Or Without Real Life) Help From My Friends"], and if you're not already reading about her awesome dog, Billy Corgin, you're seriously missing out!
  
  
• When I was volunteering at the UNite for a Healthy Future event in NYC, some awesome peeps from HealthiNation.com were shooting a video about the one and only d-community superstar Manny Hernandez (aka the creator of TuDiabetes and founder of the Diabetes Hands Foundation. They asked to interview me (I still don't understand why but anyways). Apparently, they really liked what I had to say because they used some (or lots) of it. Check it out here!
  
  
• I have approximately 3 different d-meet ups scheduled at 2 week intervals with super awesome diabetes rockstarsss (more about that after they happen...)!
  
  
• I almost had a no hitter yesterday minus the crazy coming down from a bad infusion set over night (but we won't talk about how I didn't really eat dinner and drove 2 hrs [yes, I'm okay and nothing eventful happened]).
  
  
• On Friday afternoon, an economics major interviewed me for about 1.5 hrs about chronic conditions for a really cool design project. He was originally going to work towards a focus on sickle cell anemia and/or cancer patients, but I think I may have changed his mind a smidge (Listen, I'm not saying that Diabetes is cooler. I just think the patients might be a little more awesome).
  
  
• I have another cell biology exam in 2 weeks and I'm trying really hard to bust my butt with the studying (didn't do as well as I needed to on the 1st one), which inadvertently means...
  
  
• I've become hooked on diet coke again, which advertently means...
  
  
• I'm trying to get back to drinking more water, taking my vitamins (every day, ugh), and eating healthier. Sweatbetes? Hopefully I'll get to work on that soon.
  
  
• I think there may or may not be a DSMA blog carnival in the near future if I can manage to sneak more time away later...
  
  
• This weekend's sugar-filled bake fest with my college friends ended with Apple Crisp (x3), Apple Pies (x3), Apple Crumb Pies (x2), Apple Cider Doughnuts (2 batches), and Apple Pie Cookies (yes, we went to an orchard. yes, the apples that we ACTUALLY baked came from a grocery store). I picked up pumpkins as well for some well needed pumpkin pie and pumpkin oatmeal cookie things. Definitely for a later time... Apparently requests for my baked goods are now coming in from ALL OVER THE GLOBE. Must make friends with the mailman...

Back to work for me now!

The Man, The Myth, The Legend...

So once upon a time, there was a beautiful and brilliant diabetic girl who spent 13 years holed up in her own world of academics, rocks, and sweet flour-y things. Despite being diagnosed at a very young age, she had never really known any other fun and enthusiastic kids with diabetes. She never went to camp (for reasons that are still unknown but mostly amount to too much studying) and never really participated in interactive outreach events (there were a few JDRF walks I vaguely remember as a kid and a couple of expos). One day (not too long ago), the light switch went on. There must be other people out there like me. People who live and breathe with music. People who bake things covered in real sugar. People who skydive, rock climb, and ride their bikes across the country. People who REALLY live life to the fullest in spite of a silly chronic condition. So she went hunting on the Internet and built a life. A persona. A circle of friends that she had never really met...

My very first "real" Diabetic meet up was the UNite for a Healthy Future event in NYC just a few weeks ago. But it was a little unusual. I met amazing and fantastic diabetics with crazy lives. People like who I had run into online that looked and sounded nothing like I would've expected. People who did make my eyes gleam like a fan girl despite my subdued manner. It was spectacular and I met all of these people who shared great stories and skills. People who didn't look at me funny when I tested my blood sugar or chomped down on glucose tabs.

My second and third Diabetic (swap-story)meets were JDRF walks. I did two in NJ along the shore. I met lots of families. I did pump bumps with kids. I met mom's and dad's who littered me with stories about how well or poorly their children with Diabetes were doing. I smiled and enjoyed the sun and answered questions.

Not to say that those moments weren't special and that I'll forget them, but this Sunday night was different. I was anxious. Excited. Teeming with energy. I wanted to run and jump and scream and shout. I was wandering into a big city by myself to meet just one stranger. One specific stranger. A stranger who anyone (and everyyyyyyyone) could tell was special in the way he related to others. In the way he spoke. In the way he tweeted song lyrics. I had seen a lot of his posts on Twitter and said to myself, "He's way too awesome. Why would he care what I have to say." But I think he's already demonstrated in his short time stateside that what I (and every other diabetes blogger) do matters.

I knew he was meeting up with people in Kansas City. I didn't even know he was going to be in NYC until a week ago. Already signed up for a 4 day conference in Hartford, I knew I was going to miss the bowling extravaganza. I, for some reason, assumed he was leaving on Sunday before I'd be back in NJ. And then, on a whim, I tweeted him. And he responded. And said he was leaving Monday. And my adrenaline kicked in.

He called and my knees shook in the wind (like a well composed fan girl). "I'll be the one with an accent," he nonchalantly concluded with. I didn't need to ask for clarification. After seeing a picture (or several dozen) and hearing his voice (both on the phone and on a DSMA webcast), I didn't have a hard time placing him. He just looked different. More alive. Less pixel-y. Thinner and taller. And I instantly felt less alone.

I don't really know how to describe the rest of the evening. We just grabbed coffee, sat in Times Square, and talked like we were new-but long lost friends. I sat there in awe of him and he just kept telling me how smart I was.

AND to top it off, I got meet Caroline (@carobanano) who I can only describe as PURE sunshine. She reminds me of my favorite roommate from college. Singing at the top of her lungs (she has a fantastic voice in case you didn't know). I'm definitely planning to go back and see her in Brooklyn. I already have a teeny-weeny SURPRISE present for her.

Like the three sugar-free Musketeers: We soaked in the lights. We posed with Batman. We made funny faces. We grabbed dinner at the Ruby Tuesday's in Times Square (and died a happy death over their cheese biscuits). We discussed music (the difference between Coldplay and the Cure). We rushed for trains that weren't quite there (neither my roommate nor I can appropriately read a weekend timetable). We just laughed (at Shhs and Soda-names) and enjoyed each other's companies. I savored each moment.

Looking at us, you'd never know we had diabetes. You'd just think we were friends. And now, that's all I ever have to say we are. (And friends will ALWAYS see each other again. One way or another).

No D Day!

So today is the day. The No D Day. No Diabetes talk. Not on Twitter, Facebook, Google+, or where ever else you love to talk online about your best friend for life, Diabetes. To see some awesome stories, go here and check out George, the guy who came up with this fantastic idea.

(For a little bit, I thought No D Day was supposed to be a little like Fight Club. The first rule of No D Day is that we don't talk about Diabetes. We don't say the word. It's really about finding out more about who a person is without Diabetes. But the thought made me laugh.)

So I anyone who has been reading about me already knows about my love for Rock Climbing (thus the blog name) and Ultimate Frisbee (the 10 or so discs on my wall shouldn't tip you off at all). You know I'm a giant science lover (but one who has social skills and can rock a dress), which is apparent from my 6 years of higher education for Biomedical Engineering with many more ahead of me. So what else don't you know?

I love to bake. Not cook. Because while I can whip up some delicious stuff with herbs and spices, my stomach really loves the satisfaction of good cookie or fresh pie crusts.

Apple Heart Pie!

Turtle Cheesecake

Pumpkin Pie from Real Pumpkins!

(Why don't I have pictures of my cookies? They all get eaten up too fast...)

Other cool things about me? While I don't sing nearly as much and as awesomely as Zooey Deschanel on the New Girl (if you're not watching it, you have to see the pilot!), I sing along to anything whether or not I know the words. I'll sing loudly and softly. In bed. In the shower. Especially in my car. I used to sing in the choir from grades 1 to 10, and then science took over my life (all those AP Classes saved me some time in undergrad). I'm thinking of joining some sort of casual singing group (in all my extra free time...). Also, despite not celebrating Christmas, I absolutely love Christmas carols. Once when I was in high school, I actually got to sing at Carnegie Hall with the NJ Children's choir. That was an incredible experience.

Other random tidbits?

I don't own a TV. If I did and I had cable, I might never get out from in front of it (happens with Netflix/Hulu sometimes).

I'm really lazy with certain chores. One time, I actually bought myself something to wear for 2/3 more days from Walmart because I had avoided doing laundry for 3-4 weeks.

I love filing my schedule to the brim. Back to back appointments 24/7 if I could. I like being busy, and I've learned to stop complaining about it. I can't handle the restlessness of having nothing to do. I've only recently started being more prompt for things. Otherwise, I'd always be running between 5 and 15 minutes late.

Sweatbetes Week!

So it's the first week since I've moved to this new-old place (moving back to the state when I grew up but an hour away from the actually city I grew up in) that I've managed to do something awesome and outdoorsy. The awesome part of this week is that I got to do both things that made me so happy as an undergraduate after not experiencing either in a while (2-3 years and 2-3 months). Mind you that sweatbetes and I (while on fairly good terms) haven't hung out in a while...

Ultimate Frisbee and I used to be best friends. I was one of the few women that played in our small college's mostly male intercollegiate team (apparently I'm not eligible for intercollegiate play anymore [alas getting old really does happen]). My living room at my old apartment was decorated with my large (and ever growing) frisbee collection. A disc is never more than an arms reach away for me, but unfortunately, I haven't been playing Ultimate in a very long while. Our friendship got strained by real life issues. Pick up games can be hard to find sometimes because of the number of people required (5+ on a team) and my schedule for the last few years has been, well, unpredictable so playing in a league has been out of the question.

After scouring the internet for hours, I found a pick up game that is fairly consistent and not too far away. Despite my fear of being wayyy to out of shape (isn't round a shape?) to handle the required running, I dusted off my cleats and walked to the park a few blocks from my house. There were many more people than I was expecting and the game was intense as always. But I survived. And felt amazing as I left.

There's something freeing to me about making a little piece of plastic fly. I forget about my diabetes. I forget about my schoolwork. I forget about my problems. It's enthralling and cathartic to run my heart out and make a Frisbee soar. I can feel the wind it feels (as crazy as it sounds). I missed it. I'm glad I didn't let a little anxiety keep me down. Or low blood sugars. Glucose tablets cure me (Thanks to my Dex for warnings!).

In addition to squeezing in an hour and a half (with breaks) of Ultimate, I managed to go rock climbing at a gym with one of my buddies from high school. He's learning for the first time, but I'm getting back into learning technique & balance so it's not a bad fit. We're trying to make it a regular thing. [In case you didn't know, my love of rock climbing is what lead to the name of the blog ;) ]

The silly thing about rock climbing and diabetes for me is that unless there's a 30 minute hike to where the climb is, I need more insulin to get my act together otherwise after one climb (aka 40-50 ft in my case), I'll be in the low 200s while I start in the low 100s. So after some experimenting (a la Ginger Vieira), I've learned that an extra bolus before I climb helps keep me in range. No lows while climbing = more fun!

Why do I love climbing? It doesn't quite make sense. I have a fear of heights, so I never look down on the view of a climb until I've done it at least once comfortably. There's something about the puzzle aspect (where do my hands and feet go exactly?) and the amount of finesse required to accomplish overcoming a giant wall that is extremely rewarding. I love the feeling of leaving all my energy on the wall. If I'm not tired by the end of a day of climbing, it wasn't fun. I forget about the D when I'm trying to solve a climb. My brain gets into the zone. Sooo much better than playing with equations all day long.

Sweatbetes 3X this week is a win. I'm trying to squeeze in some at-home stuff/school-gym stuff. Step 1: Gym bag with necessities in my car. I'll keep you all posted on how it goes.