When the compass points south

My navigation through life is based on a five-pointed compass: The five cardinal things that make up 90% of my life. They are:

My family.
My diabetes.
My clinical work.
My writing.
My university work.

Normally, two of the five suck at any given moment and give me total stress. But at the same time, normally, two of the five give me great joy at any given moment. And normally, the fifth one is somewhere in the middle. All told, this keeps my universe in balance.

But the last six weeks or so hasn’t been normal. No, it’s been a perfect storm of all five sucking. I was stressed on all fronts. It wasn’t pretty, and I was in an extremely dark space. But the normal balance has been restored as mysteriously as it went out of whack, and I have no scars on my wrists to show for it. See? Even my dark sense of humor is fully recovered!

So anyway, in the middle of all of this, on February 27, I broke my New Year’s Resolution. Right. The one about how I was going to post every Wednesday. Well… two months is a pretty good run for a typical American New Year’s Res, right?

But since you haven’t heard from me for a month, some updates are in order before we get back to work. Some of you may recall that over at Diabetes Mine I had said I wasn’t sure I would stay on the Tandem t:slim pump because I was so vexed with the number of “are you sure” warning screens between me and my insulin. I was beginning to think I’d be better off, and less stressed, just going back to MDI.

Well, I’m still on the pump, but it was a damn close thing. Here’s how it went down: One night, after a particularly annoying day, at the end of a particularly annoying week, in which all this high-tech feldercarb I wear wasn’t doing me a damn bit of good, I had a classic DHF—a Diabetes Hissy Fit. I ripped out the infusion set and threw the pump in the corner. Hah! Take that fucking FDA and your fucking over-protective meddling design-for-the-safety of the stupidest diabetic on the planet requirements! I’ll show you!

I rummaged around in the fridge, muttering a continuous string of profanities, expletives, and curses until waaaaaaaay in the back I found a vial of Levemir and one single unexpired Humalog cartridge for my Luxura insulin pen.

Then the first problem reared its ugly head.

Apparently we’d moved my Luxura pen into storage during some first-of-the-year house cleaning. Crap.

Well, fine. I’ll just suck some insulin out of the cartridge with syringes until I can get to town. Where are the damn syringes?

Oh. Right. I donated every last one of them to needy patients at my clinic. Double damn. No way to take the Humalog or the Levemir.

I had to go get the pump back out of the corner and put it on again, swearing that after the weekend I’d pick up everything I needed at the clinic and be done with the meddling over-protective piece of shit once and for all.

But that day turned out to be the critical tipping point. Four days later, sitting in my office with boxes of syringes and three Luxura pen samples steps away, I’d gotten over it. The hissy fit had passed.

That doesn’t mean that I’m exactly in love with this pump. No. Far from it. But we’re getting accustomed to each other. I still find the slowness of the tube fill to be painful. The touch screen doesn’t always like my fingers. The number of warning screens still drives me batty, but I’ve learned to sail right through them without looking at them—totally defeating their purpose. And I still hate the fact the reverse correction doesn’t kick in until 70 mg/dL.

But I do like the fact that I don’t have a low every morning at 10:30 anymore, something I couldn’t really avoid on the basal shots. In fact, I’ve lost four pounds from reduced glucose tab consumption. And while my blood sugar is far from perfect—and probably never will be—it’s not too shabby. Well… that’s my perception anyway. Let me plug in my CGM real quick and we’ll get the truth of the matter:

OK. I’ve seen worse. My average blood sugar over the last week was 142, equivalent to an A1C in the mid-sixes. I’m running some nocturnal and early AM lows the last few days, as I’m eating smarter recently. In fact, just yesterday I reduced the basal for the second time in a week and it reminded me of how much I appreciate the extraordinarily easy programing the t:slim sports. And speaking of lows, another thing I’ve finally gotten into the habit of is setting a 30-minute zero-insulin temp rate when I have a low. No more throwing fuel on the fire. You can’t do that with basal insulin!

Oh, and back to eating smart for a moment, I have to give a shout-out to the folks at KIND, who have done the next best thing to curing diabetes: They developed a line of gluten-free, natural ingredient, no sugar alcohol added, low blood sugar-impact food bars that actually taste good! They’re called the Nuts & Spices line. I’ll talk about them more in the near future, but just know for now that they are amazing. Yeah, I know that some of my post-breakfast trace lines don’t look too impressive, but those are days I was running low and didn’t bolus for the bars at all. If I’m in target in the morning, and bolus the net carbs, I can damn near flat-line my blood sugar! And they keep my hunger at bay until noon. The kind folks at KIND sent me some samples a while back, and I liked them so much I ordered a whole case online!

Anyway, now you are up-to-date. I’m more or less back, and I’ll try to post more often, but I won’t promise weekly posts. My April is looking pretty crazy. Just last week, one of the front desk girls, who was trying to schedule one of my patients for a follow-up, called me and said, “Do you realize you only have three open appointments left for all of April? And may I remind you that we are still in March?” Holy crap. Well, it’s nice to be popular.

However, just to whet your appetite, in the coming weeks I plan to talk about:

The return of the ??? Monster. Yes, the classic disease of the Dexcom 7+ can infect the new G4 systems, too.

The truth behind the t:slim’s power plug cover.

The secret story of the girl who says “fuck” more than I do.

The icon on the t:slim pump that’s actually a hidden button!

Why the new OmniPod will suck just as bad as the t:slim—perhaps worse—when it comes to federally-mandated over protectionism.

Why some of my books are beginning to speak for themselves; and what my relationship to the 34th best-selling biotechnology book in the country is.

And why my wife thinks healthcare reform sucks. Stay tuned.