Really? Okay.

Have you ever had to crank up a basal rate so high that you wondered, "How am I not dying right now"?

And have you ever, then, seen a line so steady on your CGM graph that you could swear this was a dream/nightmare/did breakfast make me hallucinate?

That.

(Not complaining - just a bit in awe that something that colossal is producing results like this right now.)

A Case For Everything, and Everything In Its Case.

Now that I'm in the process of turning food into a tiny human, I've been told by my endo that I need to start entering all of my blood test results into my insulin pump. At first I was miffed about having to do an additional step (several times a day) on top of all the other steps I'm already doing, but when we had to print off separate charts for my Ping stuff, my iBGStar readings, and my Dexcom graphs and charts, I realized what a pain in the ass I was being if I didn't help her out just a little.

Besides, it's not like she's making me use the Ping remote meter for testing again - while I like my insulin pump, I can do without that chunky, clunky, fat snail of a meter. The iBGStar app provides a lot of meaningful information for me, and going back to life without it... well, I don't want to.

But what this does mean is that I now have one more thing to carry around everywhere; one more accessory sitting on my desk during my workday. They all have cases (because, hi, that's what I do), and while they don't match, it makes me feel slightly better about needing to have so many carry-on items.

Clockwise from top left: a Vera Bradley wallet (modified like so); Fossil cosmetic case that houses all of my
meter crap, an extra pump site, a Humalog pen and needles; Tallygear case for the Dexcom G4
(disclosure: I was sent one free to try out); the bottom of my iBGStar phone case.

In Pump Failure, And In Health.

Some of the most common advice about wedding planning is that while you can try to plan out every detail, it is nearly inevitable that something will still go wrong.  A and I heard this from many people as we planned our wedding, which took place in June of 2009.  A lot of times, however, you don’t realize how good the advice you’re getting is until it becomes reality.

I’ve mentioned before that our wedding day had a couple of minor catastrophes. I’m not talking about flowers being the wrong color or reception food being cold. I’m not talking about hung-over groomsmen or rainy weather. No, when I have a catastrophe, I go big – I’m talking about our photographer not showing up, and my insulin pump dying.

(Let me preface this story by telling you that I’m not sure how I didn’t freak out in a ridiculous fashion about either of these issues. I think my Bubble of Wedding Day Happy must have prevented me from feeling the full force of either situation.)

Pictures were scheduled to start at 9:00 am, with the guys first, then the girls, then all of us as a group. At 9:05, with our photographer nowhere in sight, A got a little worried and got out his cell phone. “Hey, it’s A, just wondering where you are. Hope everything’s okay. Give me a call back.” After a few moments, the photographer called back.

Incompetent Jerk: “Hi, A. What do you need?”

A: “What do I need?  I need you here! Where are you?”

Total Loser: “Um, I’m at home. Why… what’s going on?”

A: “You’re supposed to be here! Right now! It’s 9:10!”

Guy I Wanted To Strangle: “Oh, sh!t. It’s today? I had it written down as next weekend! Oh sh!t! I’m on my way right now….” (Important Detail:  he lived an hour's drive away from where we got married.)

A: “Don’t even bother. We’re done.” *click*

And thus began the couldn’t-be-more-last-minute search for a new wedding photographer. On a Saturday morning. In June; the peak of Wedding Season. (HA!  AHAHAHAHA!  HAAAAA!  /crazed and delusional laughter)

Sheer luck and chance led us to finding someone. And not just someone – a super great guy who’s a well-established photographer in the area. As fate would have it, we caught him on the one Saturday in June he hadn’t booked himself out, because it was his daughter’s birthday. As fate would also have it, his wife was willing to wake him up so we could talk to him (he was still sleeping when we called), and he was willing to give us his whole morning and as much of the afternoon as we needed.  We’ll never be able to fully express our gratitude to him for that.

I also owe thanks to my brother, who was elected as the person who had to go tell me that the photographer wasn’t showing up. That takes courage.

*****************

My wedding day preceded my involvement (or even awareness of) the DOC. I didn’t know that other ladies had pockets built into their wedding dresses for their insulin pumps – so I did on my wedding day what I did every other day; which was to hide it under my clothing via undergarments. More specifically, my Deltec Cozmo pump was between my Spanx and I, and both of us were all wrapped up in layers of satin and tulle.

In retrospect, I can see the trouble brewing. At the time, I thought nothing of it. It’s a waterproof pump! I've had it for four years with no problems!  It’ll be fine!

And, fine it was, until A and I were in the vehicle that transported us from ceremony to reception. We were sitting in the back seat, being excited and nervous (and hungry), when all of a sudden my pump starts incessantly vibrating.

Spanx + wedding dress + sitting down in a car = a pump that’s REALLY HARD TO GET TO.

Upon retrieving it, I noticed that the screen had a bunch of gibberish on it, and that none of the buttons were responding. It kept vibrating, then beeping… and I couldn’t do anything to stop it. Nor did I know if it was delivering any – or way too much – insulin. I had to disconnect and take out the battery.
 
And that's when the tears came.  Why now, Mr. Pump?  Of all days in my life, why did you die today?  And not only today, but two days before I'm leaving the country on my honeymoon trip? 
 
In addition, Deltec/Smiths Medical (the manufacturer of my insulin pump) had announced a couple of months prior that they'd decided to discontinue the Cozmo and leave the diabetes supply market.  In my mind, I was imagining horrid scenarios where I'd try to call the customer service 800 number, and that pre-recorded robot lady would tell me "This number is no longer in service".
 
I was also imagining horrid scenarios where I wouldn't get to eat my own wedding cake.
 
Thankfully, for the first time in my insulin-pumping life, I had asked my internist at my last appointment for some back-up supplies.  It never occurred to me that a pump failure could happen on the actual wedding day - I was thinking about the overseas trip.  My brother once again stepped up to the plate by quickly driving to my house, getting the specified supplies out of my fridge, and bringing them to the reception for me. 
 
After the reception, I got on the phone with Smiths Medical.  Let me just say, they were wonderful.  I explained the whole story.  About how it was my wedding day, and my pump had up and died with no prior warning.  About how I was flying overseas within 48 hours.  And you know what?  They had a new (well, refurbished, but a working) insulin pump at my door within 12 hours of my phone call.  Awesome.
 
That very same wedding advice can (and always should have been) applied to my diabetes life, as well.  You can plan and plan, but things can still go wrong.  The best robot parts can still malfunction, and they can have spectacularly bad timing.  Having back-ups of everything helps to make those small bumps in the road seem a bit less like mountains.
 
And that cake?  It was delicious.
 

Possibly the most worthwhile use
of a back-up Humalog pen ever.

Half-Marathon: Check.

Last month, I attempted (and completed!) my first Half-Marathon.  I had never done anything like that before, and have never historically been a fan of running.  A few years ago, I forced myself to try it again, and it wasn't so bad.  A friend of mine (non-diabetic) does this Half-Marathon each year, so I decided to give it a go with her.  While the race itself was fun, my diabetes didn't agree.  I was able to finish, but was very slow (this may also be attributed to my less-than-stellar dedication to training).  Here's my marathon story:

I woke up at 5:00, and although my numbers had been good while I slept, I shot up to 175 for no reason as soon as I woke up (according to the CGM). I did a blood test to verify, and yes, that was right. I took one unit of Humalog, which brought me down to 125, almost literally right away. This kind of speedy drop is not normal for me.

I got ready, and my brother was here at 6:00 for us to go downtown to the start line, with my husband. (My brother, who is not T1 - and a phenomenal athlete - also ran. My husband met up with me in between aide stations to refill Clif Gels, give me some additional water, and whatever else I might have needed. As another runner said during the race, "He just earned Husband of the Year".) I ate a Snickers Marathon Nutrition bar on the car ride, with no bolus taken for it. I should also mention I turned down my basal to "OFF" at 6:00 am, and didn't turn it back on until after the race was over.

We lined up around 6:40, and my CGM said 83. Then, a few minutes later, 72. Really? I hadn't bolused for the bar I ate, and that was 22g of carb! This is where I panicked a bit. I ended up eating two Clif Shot gels - also about 25g of carb each - before the start. By the time we got to the starting line around 7:15, I was shooting back up, and was 157. I thought, "Awesome! Don't know what happened there, but at least I'm back up where I want to be, now."

Fast forward to mile 2 - I notice I'm over 200. Okay, not panicking yet. I "peaked", or so I thought, around 280 and then it showed that I was coming back down pretty quickly. Again, as a precaution, I ate another gel. This may be where my biggest mistake was, because I didn't drop too much more after that. In fact, I did most of the race over 300, and a good chunk of it "HIGH", which means I was over 400. I started taking a unit here and there after mile 8, not wanting to overdo it and drop too quickly.

By the 12th mile, I was back down to the 300's, so I was probably about 325 when I finished. Who knows how high I really got - but I tested before and after the race, and the CGM was accurate both of those times - so I have to believe those numbers are true. I felt pretty throw-upy feeling around mile 10, and I'm not sure if that was hyperglycemia-related, or not - but I slowed down, and the feeling subsided. I drank half a cup of gatorade around mile 5, and stuck to water after that.

It feels so good to know I was able to finish. I was very slow, and didn't run as much of it as I walked, but I finished, darn it - and that was the point. Finish, no passing out or throwing up. Check, check and check!  I am usually very diligent about keeping my numbers in check, but for this race I wanted to focus on finishing - whatever that meant, diabetes-wise.  I tried to not let the sight of such high numbers bum me out and just focused on moving forward.

I feel like I did learn a lot for next year.  If I'm able to, I'd love to do this race each year, with a new goal - cut time, run more of it, have better numbers during the race, etc.  Let's be clear:  T1 does not hold me back from anything I want to do.  It merely takes a little more effort and work to get there.