Low moments.

Published on August 27, 2010 in Lows. Closed

I felt the low start to creep in about 15 minutes after lunch. I was just a little lightheaded, and had the telltale heaviness to my body that I get when a low starts to set in. In the middle of running errands, I was annoyed to have to deal with this. I sighed as I reached into my purse for a GU pack. It was the last one I had with me.

I gulped down the GU and headed for the check out of the store, a thin line of sweat starting to bead on my lip. I  feel like crap, I thought to myself. I pulled out my DexCom and saw the arrow pointing straight down. I told myself to calm down and wait for the GU to kick in.

By the time I walked out of the store, my vision had started to blur and I felt weak in the knees. The drops of persperation on my lip had broken into a full-fledged sweat. I limped to my car and snatched my glucose tablets out of the center console. My hands shook as I twisted open the cap and began shoveling the powdery tablets into my mouth. My head spun, I felt faint, and I had to concentrate on the act of chewing the tablets. I swung my feet out of the car door, dangling them like a Muppet while I forced down the chalky sugar. I felt so shitty I wanted to cry. This was the worst low in a long time.

I moved back into the driver seat, full well knowing that I wasn’t driving anywhere for at least 15 minutes. I cranked the AC as I poured sweat, my body’s reaction to the extreme lack of glucose. Help me! my brain screamed, SUGAR. NOW. it begged. Just wait, I told myself, you’ve had 40 grams of carbohydrate at this point, it will come back up.

And it did come up of course. But not before I had lost almost 30 minutes of my day. Not before I ingested 200 extra calories after a full lunch that I didn’t want. Not before taking me to almost passing out. Not before making me feel like a failure for forgetting the insulin on board from 10am that had caused me to stack my lunch bolus. Not before sucking the life out of me for the rest of the afternoon.

Sometimes, I really hate this disease.

Guest Blogger Matt Neal – BMX rider, Type 1, and all around badass!

Published on August 25, 2010 in Real Life and sports. Closed

Hey guys! I am so excited today to have Matt Neal guest blogging for me. Matt was diagnosed with Type 1 diabetes last year at the age of 28, just as he was on his way to building a successful BMX bike riding career. But read his story below and you’ll find out that Matt doesn’t let that hold him back – in fact, he’s taken on diabetes management with the same passion he has for BMX riding – and in the process is showing everyone that he won’t let that – or anything else – hold him back! I loved reading his story to learn how someone with an unusual sport manages their diabetes, and I know you guys will enjoy it too. Take it away Matt!

My name is Matt Neal and I have been very active my entire life. I always enjoyed being outside and playing sports when I was a kid. I went to school with a few kids that raced BMX and I enjoyed riding with them after school. I kept bugging my parents to let me start racing with them. Finally, my dad took me out to the BMX track for my 10th birthday. I was hooked! I loved racing and started taking it more seriously after a couple of years.

I was very fortunate to be able to travel around the country racing different events. I was even more fortunate to experience a great deal of success in the sport that I loved. I was top 10 nationally in my age group for several years and I even got 2nd at the world cup when I was 18. I turned pro for a few races at the end of my career before hanging my bike up to finish my degree.

Fast-forward about eight or nine years and I got the itch to get back on my bike. I started riding again and went to a couple of national events. I was riding decently for not racing for so long but I was a little off. I didn’t feel like I had the power that I should and I started losing weight, a LOT of weight. I couldn’t gain a pound to save my life and I knew something was wrong.

I completed a health screening at work and my fasting blood glucose was 358 and my fears were confirmed, I had diabetes. I was officially diagnosed Feb. 20, 2009 with Type 1 at the age of 28. Believe it or not, I felt very fortunate to have a manageable disease. I took some time off of my bike again to get a handle on my blood glucose and I knew I wanted to race again. So that’s exactly what I did! I started racing at the beginning of this season. I’ve been doing really well so far. I have two wins in the Arizona State Series and I have won a national main event!

Diabetes adds a whole new challenge to racing BMX. I test my glucose levels a LOT on race days. National races are especially difficult because you don’t know exactly when you are going to race and the races take place all weekend long. They are also challenging because my adrenaline tends to raise my levels. My target level for race time is 150 mg/dL so I always keep my meter, insulin, and carbs close by. I recently started using the Dexcom CGM system. I have raced one national event with it and it was awesome to have the extra data. It helped me to keep my levels stable all weekend long and made it easier for me to be close to my target before all of my events.

The main thing I try to do to optimize my blood glucose at races is to make small adjustments. I try to eat small meals and snacks throughout the day to avoid having big spikes or crashes. It also helps so I don’t have a really full stomach when I need to race. I tend to have a few extra carbs at breakfast to bring my levels up. If I have a tougher race coming up and I know my adrenaline will be kicking in, I will try to get my blood glucose up to about 120 mg/dL because I know that adrenaline will take it up even higher while I’m warming up. If I know that I have a while before I race I will take a small correction to bring my levels back down to 100 mg/dL and then eat something to pick me back up when my next event gets closer.

After the race day is over, I try to have a few extra carbs at dinner to replenish/refuel and make a small correction to bring my levels back down. I make sure not to overcorrect because I tend to run lower the day after as my body is recovering and using up more glucose.

Overall, racing BMX with diabetes has been a good experience. It makes me feel even better when I beat other people who don’t have to manually control their blood glucose all day long. It makes those wins even sweeter!

Relief…for now.

Published on August 25, 2010 in Complications and Just a thought. Closed

Phew. It’s over, and the news was good – another complication-free eye exam has passed, and I’m another year deep into living with diabetes without any issues. Victory dance ensued in the parking lot of my doctor’s office. No – really.

As I mentioned before, that eye exam conjures so much emotion in me – it’s as if the fears of complications I keep tucked in the back of my mind are unpacked right before that appointment. And although fear can be a powerful motivator, it’s not my weapon of choice.

Kerri Sparling, my personal hero and favorite d-blogger, posted recently about a video that’s circulating “to create awareness about diabetes” for World Diabetes Day. And although I’m all for awareness, I don’t like fear tactics. Threats about losing limbs and sight have always been a reason for me to keep my diabetes in check, but the real motivation for me actually stems from the hope that I can live without any of those issues if I work hard. The difference is the fear of something going wrong versus the hope that nothing will – for me that’s a positive spin I need to put on things to stay motivated. As I’ve said before, if I let the dark rainclouds of fear come creeping in here too often, I feel like giving up. But hope, well hope keeps me happier.

But fear seems to be the weapon of choice for many providers out there. I can’t tell you how many patients I’ve talked to who have been threatened with lopped off limbs or losing their sight by their doctors. And working in the industry, I know waaaaay to many people who don’t take this disease seriously and need a healthy dose of that tough love. I also know firsthand from providers that they have patients who just won’t do what they have to do to stay healthy – fear might be the only option that gets results. But what would the right motivators look like in a perfect world? What would be the ideal way for us to have patients take care of themselves? And is fear appropriate to use when all else fails?

What motivates you guys? Do you use that fear to keep yourself in check? Or does positive thinking help keep you on track. I’d love to hear from any providers out there as well – how and when should fear be leveraged as a compliance tool?