Munchin'

all photos Eva Joos

For over one month now, I have been using Dexcom CGM. It's been great, learning about what food and exercise, stress and emotions do to my body. It's interesting to see how a simple Latte Macchiato affects my blood glucose in no time in a negative way and how 45 min of paddling in the pool makes the insulin work a whole lot better. I'm coming to conclusions I would never have accepted without this device. My favorite coffee is now reserved for low blood sugar episodes. I keep my snacks to anticipate in dropping blood glucose.

It strikes me, that I have so many lows lately. I have to eat all day to kick the lows in the butt. How come I don't remember real coke tastes awful? I hate what it does to the enamel of my teeth.. I don't want all that sugar in my mouth. In the last weeks I have eaten so much candy I'm at risk of getting type 2 diabetes! LOL

No, seriously, I'm gaining useless pounds because of the hypo food. That's a big dislike. I've done so much to obtain my ideal weight. Don't want to spoil that because of lousy lows. The thing with low blood sugars is, that you don't even enjoy the food you are forced to have. If you have like 5 lows a day or you have a low in the middle of the night that asks for more than 50 grams of carbohydrates, I get upset. Looking at my food diary, I eat more carbs from treating lows, than there are in my meals. That is no good.

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My basal rates need to get looked at. I need to interfere more when my Dexcom shows dropping blood glucose, to be ahead of that low. It still means extra carbs when I don't really fancy them. Okay, I can have my Latte, but it's not the same. If you have diabetes too, you will know what I mean..

I am flashing back

Can I have a Vespa?

     Are you out of your mind? No way! Don't even go there!

Why can't I have a Vespa?

     Because Vespas are dangerous. Because you are only 16! Because I say so. Because there are one  thousand reasons why you can't have a Vespa!

What if I buy my own Vespa?

     You are not going to. Forget about it. Not in one million years.

I can't recall the exact conversation, but it must have been something like this. I was really upset during that conversation. I knew in advance I was not going to win the battle, but at least I could try. I did ask the question and the answer was no, just like I had expected. I remember the disappointment. I remember the tears. And I remember the disapproval of my parents. Why did I even bother to ask, if I knew the answer was going to be a firm NO anyway? Why were they so opposed to me getting a Vespa? Was it really for the reasons they gave me? Or didn't they want me to grow up and get independent?
I remember I didn't ask a second time. That was not done where I grew up. If your parents gave you a clear NO for an answer, you didn't ask twice. You didn't even dare to ask again, because that would only make things worse..

Our youngest one has asked us the same question. Excuse me, not the same. She doesn't want a Vespa. She wants a Honda Dax. I understand her longing for independence. I recognize the feeling of wanting to grow up and doing whatever you want to do. She wants to go out. She wants to feel free. Her dad is ready to give in. He had a motorcycle when he was her age. I didn't. I wanted one, like I described a couple of minutes ago. I never got one. I got myself a car though. I worked on the week-ends and during the holidays, so I could save money to buy my own car. At the age of 18, you are pigeonholed in the ADULT category and you get to decide what you want to spend your money on. I try to reason with Eva. I want to convince her to get a job first and save money in her bank account. It's not just the money for the purchase of the Dax. It's a whole lot more...

She will need a place to park her treasure. She will need money for insurance and gas and maintenance and a helmet (a good, decent one, to make sure her brain doesn't get all mushy in case she .. aaarrgghhhh I don't even want to go there!). She's not being reasonable about it. She is angry and disappointed and frustrated with me. I'm sure at this stage, she hates me. I know she wanted this Dax for her 16th birthday. She got a one year membership on her favorite fashion magazine. It's less dangerous and it was something else on her wish list.. That her boyfriend rides a Honda Dax, isn't helping much either....

The discussion is not closed yet. We're not done. There is room for discussion. It doesn't have to be a battle. I don't like this wrangling. I hate it as much as she does. I just want her to think about it. To consider my objections and to find answers for the questions I have asked. I want her to start saving money to buy her little treasure. If only she would make an effort.. then we can talk again, in some time.

Totally last minute

There is so much left to do. Clothes need to get ironed, lunch boxes have to be filled. She's spending some extra time in the bathroom, not knowing when her next shower will be. I can tell she's getting nervous. She has been looking forward to this trip all year. As a sixth grader, it will be a wonderful way to say farewell to highschool and her classmates. It will be an exciting trip. It will be a whole lot of fun but emotional at the same time. Them kids will have to spend long hours on the bus but they won't get bored. They will have a good time, I'm sure of that.

Italy is a beautiful country. Lana wanted to go there as an exchange student. Things didn't work out as expected though. We have welcomed an Italian exchange student into our home and it was a great experience. There is a small chance Lana and Ilaria will unite again next week, in Milano. Wouldn't that be great???

We were invited to discuss the program of this trip. I wish I were 18 again.. these students will have the time of their lives. Knowing Lana is fond of art and history, she will take extraordinary shots of her stay in Italy. Her pictures will keep the memories alive. She will cherish those moments in her later life, looking back to her time as a student in highschool. Have a wonderful journey sweetheart. You have worked so hard this year. You truly deserve some time off with your friends. Have fun!

Jibber jabber

I can't believe it's snowing again..
     Don't you just hate snow?
I know.. people get depressed and they no longer want to come out of bed.
     What do you think about it, Rita?
I'm not listening to your babbling, what were you saying?
     Hey missie! Is that an iPad you are working on?

I nod and I smile and I keep typing. Three pairs of male eyes are watching me. I can feel their presence and their staring. They are not used to having an intruder in their hangout. They are trying to figure out why I am sitting there, having my cup of chicken soup (I hate it when the water isn't hot enough, leaving lumps of concentrated powder in my mug) and tapping the keys on my tablet.
Rita is nice. She smiles at me. From the corner of my eye, I can tell her hair has got thinner since the last time I was there. I wonder if she's feeling well. I can see her scalp through the almost white strands of hair. I know I will never ask her about her health. We don't converse like she does with her other clients. They have beers and she sips her coffee. She gives them another draft and their voices get louder and harsher by the number of beers they have.
I keep typing. I check Facebook. The comments on the diabetesforum I frequent are numerous tonight. Rita asks me if I want another mug of soup. On the house, she says. I'm not looking forward to having another lukewarm soup, but I smile back at her. She looks tired. I overhear her conversation with the man near the coffee machine. She says she wants to close the pub. She's tired. She's had enough. The man agrees and puts his hand on her arm.

Two of the regulars are leaving. They ask me if I can add them on my friendlist on Facebook. I think they are funny. I also think they have had one beer too many. One of them has a vulgar laughter. He can't find the lock on his car door. Like I said.. too much beer.. Do you think someone is waiting for him at home? I don't think so. Why would he spend his time with Rita? Because of the beer? Because of Rita? Who knows..

It's time for me to go. I put away the iPad and I pay for my soup. I won't go back for a while. I hope Rita will still be there when I come back..

Tricky situations

I had this weird situation in the middle of the night. Going to bed, I had this feeling of a low coming up. Right there and then, my Dexcom warned me and I had 4 pieces of candy before my head hit the pillow. I was so tired and could only think of ZZZZZZZZ.. Just before I closed my eyes, I switched off the low and high alarms on my CGM, so I could have a good night of sleep without being alarmed of highs and lows. I hear you say: isn't that what CGM is supposed to do? Warn you of dangerous situations? Of course.. The thing is, I normally don't have real high numbers at night. So it's no problem to turn off that alarm. I do get quite some warnings though, that my BG is dropping below 70. That's not really a dangerous situation, so I decided to turn off that alarm too. Don't worry: there is still the < 55 mg/dl alarm that you can't turn off. That's also the alarm you wouldn't want to turn off, since it can prevent you from getting into serious trouble.

Anyway, I put the Dexcom beside my pillow and closed my eyes. Not too long after that first low, the < 55 mg/dl alarm went off. I guess I was too tired an tried to ignore the alarm. But my Dexcom didn't agree with me, so he kept buzzing. In the end, I did respond, but I wasn't aware of it. I overdosed, by eating way too much candy and way too many cookies. Somewhere in my brain, there must have been a spot that told me to bolus for the excess carbs. How weird is it, that I tried to "bolus" on my Dexcom.. It is not possible since there is no insulin involved in CGM, but I did enter 15 grams of carbs in my receiver..

This morning, my husband told me that my alarm had gone off several times that night. That I hadn't responded to them at first. That I had eaten candy and cookies and that I had pushed some buttons on the Dexcom. I had no idea what he was talking about, so I plugged in the receiver in my notebook and downloaded the data. There it was! The subconscious is really freaky! It makes me take action in some daze and that does worries me. So I asked him to wake me up, if I am too low to respond to the alarm. I need to be awake completely, not in some twilight zone. I don't want to give myself a shot of insulin without being fully awake. This time, I only bolused myself on the Dexcom, meaning I didn't give any insulin. I just entered data. But what if I'm low in the middle of the night and I bolus myself on my glucometer? THAT is scary... To keep myself from doing stupid things, I am no longer taking my meter to bed with me. I have my Dexcom. It will wake me up - sometimes I will need my hubby to help me wake up - and I won't have the tools to shoot up insulin. My insulin pump is hidden in a band around my waist underneath my pj's. Okay, I have had high numbers all night, but I corrected those in the morning. And I have learned a lesson once again.. The buzzer is not annoying enough at night. I need that high Hypo Repeat signal.. sorry hubby...

Be the best you can be

18 has always been your favorite number.
18 is a magic birthday.
18 is a milestone into adulthood.
18 comes with privileges and legal implications.
18 means you can vote, buy a house or get married without our permission.
18 also means you can get convicted for crimes and go to jail.
18 years, years full of joy and excitement, adventure and interesting stories.
18 is the birthday when your parents get a bit emotional for they finally realize you will start to build a life of your own.
18 means, you no longer need 24/7 parent supervision. We will always be advisors and parents, but we no longer need to parent you.
18 means, you are allowed to spend your money the way you want to spend it.
18 means, you can travel by yourself or with friends.
18 means, you are old enough to get your driver's licence.
18 means, you no longer need our permission to go abroad.
18 means, you are old enough to have a boyfriend (just kidding).
18 means, you can still have fun and do crazy things, without the burden of going to work every day.
18 means, you will start college and make a future of your own.
18 means, there is an apartment waiting for you to be decorated, so you can move in there and have a great place to study and meet with friends.
18...

Are we ready to let go of the reins? I believe so. You are ready too. We love you sweetheart. Have a wonderful 18th birthday. Remember we will always love you and we will be here whenever you need us. Don't worry, we're never that far away. Welcome to adulthood!

I wanna make you happy

You are my little girl. Of course I want to make you happy. No doubt about that. I want to give you all my love and I wish you all the best in life. I like to observe you. There are moments where you are really focused on what you are doing and there are times that you are so distracted. I often wonder what's going through your mind. You do tell us things, but like all teens, you like to keep things for yourself and that's okay too. Just want to let you know that you can talk to us about anything. Your family is here for you.

Happiness is out there for you to grab it. It is our job as parents to educate and raise you and help you grow up. It is your job to find opportunities to grow in life and build up a personality of your own. I can tell you are working on your self esteem every day and you're doing well. You have changed so much over the years and you have become a young lady with a mind of her own. Happiness is not about money or buying things. It is good to think about what brings you happiness. Happiness doesn't cost money. It's about the little things in life. It's about love and friendship and good times. It's about that wink a boy gives you when nobody else can see it. It's about the hug our whippet Inthe gives you when you come home from school. It's about the smell of that cake you made for your friends, the moment you open the oven door. How about a wonderful text message when you're not feeling your best? The little arms reaching for you when you babysit 4 small children? That is happiness, sweetie. Those are moments to cherish and remember... Those are moments that are there, on a daily basis. If only you open your heart to let them in.

Nitty-gritty

I have known my friend for almost 2 years now and we have gone out for lunch on numerous occasions. In fact, we have made it a monthly meeting and there is always so much to talk about. Not that I know anything about programming software, but I think he's interesting and fun and wise at the same time. When it comes to diabetes, he's a bit of a mentor to me. His insight in the matter is terrific and so are his numbers. His numbers are so within range, that they are the numbers of a non-diabetic person.
We normally order the same lunch and we drink the same soda. Well, he orders coca cola zero and I'm hooked to diet coke. Don't think that's what makes the difference in our BG though..

Foto Jan Adriaensen

I like to try out different restaurants and different types of food. My friend is used to stick to food he is familiar with, because he knows what that type of food does to his bloodglucose. Nevertheless, he has always joined me in what we order and still, his numbers are great. We don't know where things go wrong, but he ends up with numbers that are not much higher than the number he started his lunch with. My numbers stay within range for about half an hour and then they skyrocket up to 400 and back down. Since we have made some improvements in my diabetes treatment, my BG doesn't go that high anymore, but I still saw a 270 on the screen of my Dexcom. I admit, things have been worse, but that 270 is still way too high for my own good. I still enjoy going to lunch with my friend and I am not afraid of the challenge, but I would rather have my numbers share my enthusiasm in a much lower range. I know my endocrinologist is not impressed by the theory, but I do believe there must be a way to prevent my bloodsugar from peeking that high during lunch meetings. I'm convinced that several factors could help me out: the stats and readings of my CGM ; the efforts of both my diabetes nurse and my diabetic friend to interpret and alter the settings ; me thinking straight and counting my carbs more accurate. I'm sure there will be many more lunch dates before we will have cut out all of the bad numbers, but in the mean time, we will enjoy each others company..; 

To each his own

People ask me why I would want a second device attached to my body. How weird is it, that I haven't asked myself that same question? It's that awkward moment, when people give you that pitiful look even when you don't feel sorry for yourself. To me, diabetes is part of my life, just like cooking, going to work and taking care of the household is. I get that wearing a transmitter on your arm is not sexy. Does it bother you? It doesn't bother me at all. In fact, I don't give a **** about what other people think about it. It's there to help me get better control and to make me feel better once the fluctuating blood glucose numbers are more within the area I want them to be.

Can everybody see that transmitter? Well.. I do wear clothes, you know. Yes, there's a little lump underneath my sleeve and maybe you will notice that. There's a little lump in my stomach area as well, where my infusion site of my insulin pump is hiding. People thought the same about this site in the past: what if people notice?? Guess what? I have never ever had anyone ask me what that lump underneath my shirt was. To be more honest: when I give a lecture on My Life with Diabetes, I always ask people to look for the "lump" on my body. Not one has found it so far. Sometimes I even have to pat down my body to find it myself... because it has become a part of me. I forget it's there. I now forget about the transmitter on my arm. Because I don't need to worry about it. It's fine by me. I have come to terms with it. So don't worry about me or my health. Even though you would not even think of wearing one (it's not even worth the discussion because you don't even have diabetes), to each his own. I have a wonderful family. I have a long life ahead of me. I want to live it the best way possible... in the end you will all benefit from the advantages of my Dexcom, because it will make me happier..

I wanna jump for joy

For more than 3 hours, I believed I was cured from diabetes. Despite the infusion site in my tummy, a tube going from that site to my insulin pump, the transmitter in my upper arm and my glucometer sitting on the table, for once I truly believed I could have a wonderful meal without worrying about what it would do to my BG..

Before the waitress handed us our menu, I poked my finger to check my BG. The meter read 139, my Dexcom said 144 and a steady arrow. I thought it would be a good idea to try out pasta, since pasta can be tricky for D's. Spaghetti all'Amatriciana is what I ordered and a diet coke to accompany it (I was driving, so no wine this time). I looked around us to see how crowded the place was and decided I could bolus my insulin right there and then. Okay, that's when the tricky part came: how hungry was I? How many carbs was I going to have? I know I can finish my plate if I want to, but I knew I wouldn't. I like to stick to maximum 60 grams of carbs for a meal (preferably 40). I hit the button and told my insulin pump I was going to have 60 grams of carbs. Pasta adds up easily and since I didn't bring a scale (I hardly ever weigh my food at home unless I need to scale products in recipes), my eyes would have to remain alert and warn me when to stop eating.

Dinner Date on the Dexcom G4

About half an hour later, the plates were brought to our table by a very nice young lady and we were starved and ready to eat. My BG was still in the same area - that's what a peek on my Dexcom screen told me. My friend and I talked and babbled and enjoyed our dinner (I skipped the bread, since I didn't want different types of carbs in my meal).  I saw her enjoy the bread (and privately counted the amount of carbs in those 3 rolls) and I didn't envy her at all. I added some more fake Parmigiano Reggiano to my pasta and dug in. I really enjoyed the good time with my friend and the taste of my meal. In the back of my head, I told myself to remember this place and come back some other day with my family.

Since my friend was in a hurry, we had Latte Macchiato instead of dessert (I don't regret that decision either). I couldn't explain to her how happy I was with this dinner date. Interesting and warm conversations, great pasta and perfect numbers! What else could I ask for? It has been a long time since my numbers were so great during a dinner date. I not only have a wonderful diabetes nurse who helps me understand and alter my settings, I now also have this great CGM. I'm hooked... Dex is mine, for good. As in: YES, WE BOUGHT IT!

Déjà vu

A pleasant family dinner around the kitchen table. We are all babbling and having nice conversations.
She is poking her food with only her fork, one of her feet on the chair and her knee sticking out above the table. Daddy reprimands her to put her foot down and keep her knees below the table. She rolls her eyes, mouth wide open and gives him that "gimme a break" look. She keeps talking and doesn't give in. He asks her again and she's getting annoyed now, saying: that's the most comfortable way for me to sit, okay? And he replies: would you sit like this in a restaurant?? NOT! And she talks back: are we sitting in a restaurant at this moment?? NO!

Was it my youngest daughter or was it me? She says it's her genes. There's nothing she can do about it... This sounds so familiar.. I have a déjà vu.. and it's not the first time.

Expect the unexpected

My numbers weren't that bad, but they weren't very good either. With an average of 147 mg/dl over the last 3 months, I expected my A1c to be higher than the last 7.3%. For two years, I had been able to keep my BG lower than 7% and that was prime time for me. It is important to keep that A1c low to prevent complications in the future. So yes, that 7.3% was a bit of a disappointment, although it was still a whole lot better than previous numbers.

This morning I had my bloodwork done at the hospital. I don't mind when nurses poke a needle in my arm to draw blood. Later that day, I got notified by my nurse that I took a wrong guess. My average BG was better than I had expected! I was gobsmacked and didn't believe her at first. But at the same time, it felt good.

I just started working with CGM. I'm curious to know if it will help me improve my numbers. That's why I wanted to have my bloodwork done this week. I'm motivated and driven and ready to kick ass!

Oh! I nearly forgot! My last A1c shows a wonderful 6.9%!

In case you missed it

Not even one more month before we will pack our bags and leave for Kissimmee, Florida. Can't wait! I'm sure we will have a wonderful time. For the first time, we will travel with the inlaws and an aunt. It will be a completely different vacation, but that's okay. We get along real well and the apartment is spacious enough to find some privacy from time to time.
Yesterday we got the confirmation of the rental car that will be waiting for us at Stanford Airport. It will be a huge monster this time, because there will be 6 of us and loads of suitcases. It will be kinda weird to be traveling without our oldest daughter this time, but it's reality: the girls are growing up and starting to live a life of their own. She will have a great time in Italy, we're sure about that..

Having diabetes and traveling shouldn't be a problem. There is some more preparation to do though: I have to order a spare insulin pump, in case the other one breaks down (I'm pretty sure it won't happen, but we won't take the risk). The application has been sent, so that's one item I can cross off my checklist. I need a document from my endocrinologist, stating that I need my diabetes supplies. Check. This time I would like to take the Dexcom G4 as well. Not sure yet how I will arrange that, but I'll contact the company. I would be more at ease to drive that monster car loaded with family if I had CGM to warn me from upcoming lows. After all, you need to be focused and I'm not familiar with all the new roads that lay ahead of us. I have to see my diabetes nurse for extra pump supplies and glucose strips. Don't want to be short of glucose strips or infusion sites while enjoying the Florida sun..

My suitcases will be packed just the night before we set off. I never worry about the contents of my suitcase. As long as I have plenty of medical supplies, I will be fine. I feel butterflies jumping up and down in my tummy.. So looking forward to going away for a while...

I suck..

I really suck at reading user manuals. Most of the time, I just throw them in the bin, together with the box the device came in. This time, I'm glad I didn't. I started using my Dexcom last Wednesday. I'm still testing this thing, so I can't throw anything out until it's completely mine. And then I get in trouble, when signals appear on the screen and I can't interpret them. I get lost when signals like ???? appear and make me wonder why the thing is asking me questions??? The problem solving notes in the manual explain it all, but guess what: I haven't read them. Well I have read them, diagonally.. Because I always think that I know better... I have numbers I can call and coordinates to mail people who do read their manuals or who are more familiar with technology than this nitwit. They always help me out, but it would be smarter if only I would read my own manual. Okay, okay! I will read it! I already got started, until someone distracted me and told me I didn't blog this week. So the manual is still by my side and I can read some of the words from the corner of my eye. It's like being back in highschool. I would know quite a bit of everything, but I wouldn't focus enough to get the whole of it. I'll be a better student this time. At least, that's the goal..