Friends in low places....

I'm popular. I have lots of friends. Well, sort of. I have lots of FaceBook friends, but only see about 50 of them in any given year. I do, however, have a handful of close friends that I cherish deeply. Most are evil bitches, such as myself, with sick senses of humor and husbands that run the other way when we are all together. To me, my diabetes is an after thought. To some of them, its something unknown and scary at times. This, I find fascinating.
My bestest friend (lovingly referred to as my Nestor) and I attended nursing school together. So she has a medical background, and a pretty decent grasp on the whole 'betes thing. She's tested my sugar and administered insulin while I was in drunken stupors, she makes fun of me when my pump tubing gets hung up on things, and she feeds me when I'm low. It ain't no thang to her.
On another front, I have a newish friend, one whom I get along with like she was my and the Nestor's long lost triplet (scary, huh?). She has a medical-like background, but no experience with the 'betes, other than drawing labs on patients that require testing. I have been very surprised at the level of discomfort I have placed her in when describing a glucose of 32 mg/dL...or 500 mg/dL (I had a bad pump site, NO judging).
I'm an educator...eradicating diabetic ignorance is my thang...so why do I find educating my new friends about my chronic disease so awkward?? Do I sit her ass down and give her "Diabetes 101"? Do I print out info from JDRF? Or do I let her wing it, and learn as we go?? WhyTF am I struggling with this? And how do I assure her that my almost 20 years of experience as a diabetic is legit, and she doesn't have to call Dr. C when I look like I'm about to fall over or puke?
I laugh, because SO many people are diabetically naive, and some of the things that people believe to be true, are total CRAP! Just yesterday, Dr. C and I celebrated the fact that we haven't assassinated one another all week (I've been working as his nurse) with a jumbo cupcake. ANOTHER Dr in our practice passive-aggressively berated us! Said there was something "wrong" with 2 insulin pumpers eating cupcakes, and that it didn't exactly set the right example. I almost flew across the counter. UMMMM oh yeah??? Well my MoFo cupcake was good, and I'll eat another one in front of you, just because I can (please make it red velvet, this time)!!!! But then I get annoyed that my new friend brings me a peach bellini mix with 8,000 carbs in it. How DO I set the right example? How DO I reach this happy medium??
SURE!! I can eat cake and drink alcohol, but No, no thanks...that sushi roll makes my sugar spike so I can't eat it...oh, and that bellini mix, no way...I'll go sky high. Am I making this up as I go along? Does anyone else do this???

Maybe we need to set up a "New Friend Orientation 101 Basics, Version 1.1" for all new peeps in our life? Heck if I know. But if so, I'll bring the cake and margaritas!

Love,
a confuzzled Nurse Kelley

PS. Dr. C just told me I looked "off"...well maybe because my sugar is 49...so YES, I just wrote this ENTIRE post under the influence of hypoglycemia...Yeah, I kind of rock like that.

The sick of it all

So, I'm sick. No, not with diabetes. Diabetes is just that little thing in my life that has given me everything I love in my life. I'm actually sick, with something that does not want to live in my stomach, apparently. RUDE.
So enough about my ass and vom problems. It has just made me think about a little thing us edumacators like to call "sick day management". My sugs have been elevated, I've had ketones...and not really wanted to eat much. At least it's not the herpilie erpolies. Still not fun. I've been hydrating and cranking up the temp basal, and sipping some Vitamin Water Pure, low carb, but has electrolytes and vitamins, and isn't too sweet. Golden Pineapple is my flava fave! In fact, you should buy me a case and send it to me, it's the least you could do.
Are you up on your latest sick day plan? Parents, do you have pedialite, Gatorade, ketone strips? Having these things (and knowing where to find them) could save you a trip to the ER for ketosis. For habitual vommers, I will even give them an Rx for Phenergan suppositories (as in, insert per rectum) to have on hand, and several patients have said they are literally life savers (no, not the candy...the rectum invaders...well, I guess we COULD call em rectum candy...but I digress).
Also, keeping your Endo or educator in the loop is a good idea. I had a mom, cool, calm and collected, shoot me a text about what was going on with her daughter this weekend.....that way I was aware and could intervene if needed. Your endo's office may have a nugget of info that is down right helpful in the event of an illness.
If you aren't familiar with any of what this post is referring to, make it your priority to speak with your Endo and/or educator about it at tour next visit.
Happy hump day!

Peace, love & 'betes, 
Kelley

(PS. I may, or may not, have written this in the bathroom on my iPhone)

Eat Me

Soooo my Book em, Danno post about telling people to shove off in regards to a T1's diet was quite popular. It has also raised some questions and concerns.

Why do we get, essentially, punished for lowering the sugar content in our diet? For instance, say Momma wants a Sno-Cone, why am I charged more for the sugar free variety? So I did a little research. A pint of Bahama Mama syrup (sweetened with sugar) is $6.25, the sugar free variety is $8.25. BULL shit. So my fat ass saves money...for continuing to be fat?? This blows my mind.

Also goes a long with the sweet vs. un-sweet tea. "Unsweetened" implies that a special un-sweetening process has been applied to previously tea sweetened with sugar....no? In the last year, suddenly, I'm served mother effing SWEET-enough carbs to equal TWO pieces of white bread-FUPA causing-TEA. Why is this??? Is America not fat enough??? And some are excusing it as "ohhh hwellll, we are jusssst Souttthherrrrn...", oh yeah? Because 50 years ago we weren't diagnosing type 2 diabetes in tweens and teenagers. So when you are out, with your grossly overweight family, please refrain from ordering your children SWEET tea. Water or milk should suffice...and will wash down those chimichangas just fine.

And DON't get me started on High Fructose Corn Syrup!! Arrrrghhhh!!!

PSA: All diet drinks ARE sugar & carb free, Caffeine free varieties ARE NOT sugar free...why is this so confusing?

WHEW...ok...I should breathe...haha Rant: OVER.

Peace, Love & Diabetes,
Nurse Kelley

Its all fun and games...until somebody gets eaten

So this post is going to address a very serious subject affecting diabetics EVERYWHERE. What is so serious and requires your utmost attention?? Yes. Zombie Apocalypse. Yes, I went there. I'm adressing it. Here and now...finally. Well....sort of.

This summer I have had a high number of insulin pumps malfunction. Mainly Medtronic Revel's and OmniPod pods. The companies don't feel like adressing my concerns, so I guess I will blame it on the heat (I'm in Texas...we've had several weeks in a row of >100 degree heat!! You should visit). Anyshit, I have been inundated with patients having to call the helplines and request new pumps, pods or PDMs. And it is SHOCKING how many of them (95% if my genius ass had to guess) that have NO idea what their settings are. Or have a backup plan. Or even know what to do! C'mon, guys.

1. We went over it in your pump training & follow ups
2. You have RXs for long acting insulin
3. What would you do if you didn't have your educator's cell phone number and could test her anytime of day or night????

Emergency preparedness is a real thang, ya'll. Hurricanes Katrina and Rita was proof of that. Our area was filled with our coastal neighbors, and many of them had been without diabetes medications, testing supplies or pump supplies in days. We donated what we could, but it was shocking how many of these refugees had no idea 1. What medications they were taking, let alone the dose 2. That without these medications, their sugars would run amok 3. That you can't reuse ONE pump site...indefinitely. Some sad shat, yo.

I challenge you, as diabetics, and parents of diabetics, to make sure you have an emergency kit, including all of your pump settings, supplies, and contact information for your healthcare provider, inside. Have it in a central location, that is easy to find, in case of an actual disaster.

Crap happens, and I understand that. Dr. C and I were attending the 2009 Scientific Sessions of the ADA in New Orleans, and discovered we had BOTH run out of Novolog, AND had not packed enough pump supplies. Oops. Good thing there was 1,000 reps i attendance, as well, to bail us out!!!

Try not to have nightmares...and be prepared.
Peace, Love & 'betes, ya'll.

Book 'em, Danno

Sooooo, one day last week I was standing at a counter in my office (that we share with 5 internal medicine docs), and it was early, clinic had just opened. Often times, in lieu of coffee, I will have a diet something-or-another. This morning I was enjoying a Cherry Coke Zero. Now, in efforts to liken it to regular Coke, I think Coca-Cola has changed the print on the can to look more like the "leaded" variety. I was visiting with my administrative assistant when one of the docs walks up and clears his throat, I look up, and then he nods at my can and says "Ummmm, should you be drinking that??", to which I point out the "Zero", and he replies, "Oh..Ok...just checking". WHAT THE FRENCH-TOAST. So what?! What if I HAD been drinking a "regular" Cherry Coke?? I have type ONE diabetes, its my right to eat whatever the flip I want...when I want...and for you to MIND YOUR OWN BUCKING FUISNESS!!!!

Nothing enrages me more than to be given a blanketed opinion regarding my diabetes. Type 1s account for less than 10% of the diabetic population, almost all publications and media releases are targeted for the other 90+%...TYPE 2s. THEY watch their diets, THEY cut out table sugar, THEY take pills....I however, have a gland that doesn't produce ANY insulin, so I do what a pancreas would do: I match my insulin to my carb intake. Does this mean I should be drinking a regualr Coke? Not really...I have enough dimples in my ass. And as most of you know, insulin can, and will, make you fat if you aren't careful. Its my first inclination to become angry, shake my fists and throw things at uneducated people's heads.....when really all they need is a little education.

Hi, My name is Kelley...YES, I can eat that...YES, I took my insulin....YES, my doctor knows about it...and YES, I would like to punch you in the thyroid. I don't need the Food polic, or the blood sugar police....that's what Dr. C is for...he is my endo, and I try to discuss my food and sugar issues with HIM, and him only. Would you walk up to an obese person and ask them if they should be eating that donut? Or a hypertensive patient and ask them if they should be eating that soup? UM no. So why is it that people feel so entitled to call out diabetics? Its mind baffling.

So, sports fans, how do you deal with the food/diabetes/blood sugar police? I'm looking forward to reading these responses!!!

Excessive Compulsive

No...I'm not dumb...I may be blonde, but I'm certainly not dumb. Excess. Yes...it's ruining society. But for blogosphere purposes, I shall stick to discussing the excess that pertains to those of us blessed with the 'betes.

In the wake of leaving Company X, dealing with sick kids, coming back to private practice AND being a badass in general, I have dealt with some wonky ass blood sugars as of late. Stress is a bitch. I have the highest A1c that I've had in over a decade. NOT.HAPPY. Anyone know a good endocrinologist?? (Haha just joshin ya, Dr. C). So, yeah...pure suckage on my part. There would be days when I would be getting ready for bed and realize "Holy shitballs!!! I haven't tested since yesterday!". What a douche canoe.

On top of having craptastic control of my sugars, I've also been hopelessly insomnial (did I just make up a word?). No sleep. Dumb sugars. Big life changes. On the upside, I've been able to avoid a massive yeast infection. SCORE.

Thank God for my boys. They keep me sane. They ground me and make every ounce of suckage totally worth it. My friends and family are pretty decent, tambien. So, in spite of all of this suck...I turned to drugs. Yes. Drugs. Well...ok, they are prescription drugs. And also, non habit forming. Ok..shit...I took home some prescription sleep aides. Seemed like a good idea at the time. Put the kids down, kiss Dr. C g'night, pop a pill, wake up pissing sunshine & shitting unicorns. Little did I know, sleeping pills + my diabetic self = no es bueno. They said "Eff you, CrumpNstuff". Asshats.

It all started with my lifelong problem with overnight hypoglycemia, and my eternal affinity for cookies and milk. As any type 1 knows, stopping at 15 grams of carbs to treat a low ain't easy, ESPECIALLY at night. Add a sleeping pill to the mix, and holy McEffBalls, batman! I wake up with an empty package of Graham crackers, a milk mustache and maple syrup for blood. Yet, I wasn't too intoxicated to check my blood glucose to verify my nocturnal hypoglycemia. Dumb. So this has actually happened a handful of times...sleeping pill...night time low...binge eating correction...wake up in the 300s with a fuzzy recollection of said events.

It is SO hard to stop at just 15 grams. It's hard for my patients, too! The body's alarm system (a rush of stress hormones) is TOO effin efficient. Our body is told to eat to treat the low....problem is, hormones don't speak English. El problemo, Houston. How are we to trust that this tiny amount of juice or food is ENOUGH? When you are low, there's no fighting that feeling of urgency. Cookies NOW inside my stomach MILK, no JUUUUICE...wait, didn't I buy candy DAMMIT it's in the car, but oooooooooo I could eat the shit outta some fruit roll ups..yeah, so you know what I'm talking about.

Since I'm the "expert", I recommend 15 g juice boxes (my fave are Apple & Eve), your fave mini candy or 100 calorie packs if your low isn't too shabby. You also can't go wrong with the ole fashioned glucose tabs, unless they are Sour Apple or Watermelon....well, because, that's just plain diirrrrrty.

So, blog fans, how do you combat this issue? Pad locks? Bed restraints? Food police? Hit me back with your input.

Stay classy, insulin army,
Nurse Kelley

I'm Baaaaa-aaack

Me + Corporate America = Epic Fail

Apparently my cursing, drinking and smart assing is frowned upon in this eastablishment! That, and I wasn't able to follow the 400+ patients I have seen over the years through Dr C's practice. Not to mention I was spending time away from my spawn, and I hated that! Product X did me wrong, so I left! Simple as that. I will miss the money, but that's about it.

Dr. C is heavy into Medtronic pumps, and had slowly started prescribing more of Product X, so it will be interesting to see where that dynamic goes. I learned that endo offices are ALL soap operas, not just mine...so that was reassuring!

I love to talk, flirt, joke and be loud. That's me. I incorporate myself into my diabetes teachings, and I think that is why I have done so well in this arena. I have always maintained that to treat diabetes you need insulin, education and a little humor. So to be told to not be myself, to clean up my FaceBook page, to refrain from posting on my blog or writing my book...it was devestating. I belong in a place where I can be myself, my patients have full access to me, and can call me whenever they need something. That's the way, uh huh, uh huh, I like it.

I had first thought it was a mistake to leave Company X, but the love and open arms that awaited me at BVEndo was heart and soul warming. Such an affirmation that I am where I need to be, with who I'm supposed to be with and that I'm doing the right thing. PLUS, camp is coming up!! Wooohooooo!!

So, I know this post is boring, but I'm just getting my toes wet again, and am so happy to be able to post again RESTRICTION FREE!! If you have anything you would like me to post on, I am always open to suggestions!!!

Love, Nurse Kelley

PS.
Effa YOU, Company X!!