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A Day in the Life...

Karen of Bitter-Sweet Diabetes Blog (and Mostly Self-taught Knitter) fame has declared it Diabetes Blog Week. I decided to play along. Click on the banner above for the participants list.

I picked Friday (7 May) for you. Not exactly typical, what with starting CGM, but life with the bigD never feels particularly average to me.

06:00: Whack the clock radio to prevent bad news entering my mind. Realize I should really set it to classical music like I did when I was a kid instead of news. I don't actually hear the stories when I wake up and I'm not sure I want to.

06:10: Roll out of bed and wander towards bathroom, grabbing meter (Wallace) on my way. test: 102 (yippee!) and do the usual just rolled out of bed things. Proceed to pull on workout clothes, making sure not to yank out infusion site while changing, but that's pretty instinctual by now, even when I'm mostly asleep.

06:30: Peel two hard boiled eggs to eat on drive to gym. Today's a resistance and core day so I go for just protein before my workout. I decide to bolus for a few grams of carbs, too, because I've been going high after my Friday workouts. Not sure what that's about.

7 - 8 am: TEAM Fitness at the club. Small class today, but good. I like everybody in my class and we're all a little sleepy. Our trainer is her usual perky self and gets us to do crazy things. My right shoulder is still bothering me a lot in class. I make a mental note to schedule a free(?) assessment at the physical therapy center by the office/club. I also offer a request to the universe that this not be 'frozen shoulder' and me having a very high pain threshold.

08:00: post-workout test: 181 crap. correction bolus. I really need to start doing my daytime basal tests. A recent overnight basal test showed everything rock solid. Now for the ones that require I give up eating rather than sleeping.... I disconnect my pump (Gromit) for my shower at the gym. I hate disconnecting. I hate leaving Gromit in my not super-secure locker. Get dressed and reconnect, finish getting ready and head across the lot to the office, pausing at the car to trade gym bag for briefcase and get CGM starter kit, too (need to charge the receiver for 3 hours this morning).

08:42: test again (174) so I can eat my homemade protein bar (tastes better than it sounds, but the amount of peanut butter means I have to drink hot coffee with it so my jaw isn't permanently glued together. Darn). I like this recipe because it's pretty low in carbs (16g in this piece, most closer to 12), high in protein, not totally gross and not as expensive as packaged ones. Plug in the Dexcom receiver and set a timer for 3 hours (need to charge for start up this afternoon, without overcharging). Oh, yeah, by the way, I'm working here, too - phone calls, drawing, meeting, coordinating with consultants and other departments in the company, answering questions from the Super-Intern who works very hard on my projects and improves my work-place mood significantly.

12:02: lunch, test: 201 (double damn - I know I had the carbs right on that protein bar so basal issue? exercise playing opposites lately?) eat lunch at desk because I'm leaving early (salad, sun chips, vitamin water zero - I'm trying them out for a low-carb flavorful alternative to water which I know I don't drink enough of). Send a few more emails, leave a couple of voice mails, answer phone calls, go over to the gym to look at some details for a minor remodel project with Super-Intern (such strange decisions from original construction that we have to deal with now as we make modifications).

14:05: test: 85 great! the carb ratio + sliding scale bolus put me where I want to be, in good shape to head for home for a short break before training. Meet up with T3, who's coming to training with me for moral support and familiarization with insertion so I have the option to break the rules and put the sensor somewhere other than my belly (and potentially out of my reach). We head over to the library near my house, where we're using one of their meeting rooms for the training session. Plug for libraries: they have all sorts of resources you might not think of! Dawn (Dexcom's local trainer) calls to let me know her previous session ran long and traffic is terrible (it's raining, threatening to turn to snow) so she'll be a little late. I pull the sock I'm knitting (you didn't think a day in my life could go without knitting, did you?) out of my bag and T3 connects to the library's wifi to surf on the iPhone, entertaining me with YouTube music videos.

16:50: Feeling a little off (low? probably just nervous) and wanting to be in a good place, BG-wise, for the training, I test again: 90. Dawn arrives and apologizes, then we get down to business. The training is duplication of what I learned from the online tutorials the night before, but it's good to hear it all again. We ask when the Animas/Dexcom merged system will be ready (no answer), why the receiver can't be an iPhone app in the meantime or at least make the receiver smaller (she promises they're working on it), and a few other geeky engineering-type questions. We stop when Dawn looks like she might be getting frustrated with us as I haven't done the stabbing yet.

bigD gear, clockwise from upper left: Blood Glucose Meter case containing: lancing device, meter (named: Wallace), bottle of strips, bottle of used strips, a syringe, a lucky coin, my pump battery cap torsion device, my business card, extra lancets, and two packs of Annie's Organic Fruit Snacks; DexCom receiver (in need of name); Insulin Pump (named: Gromit).

I ask a few real, practical questions: Belly only? Really? Officially, yes, but we're all aware that CGM users opt for alternate sites with fine results. We'll start by following the rules (set because that's where it was tested during FDA trials). Skin prep - IV Prep for sticky or Alcohol with Benzocaine for pain relief? Officially no; alcohol only. Practically, maybe, but keep the extras away from the spot where the sensor actually goes into the skin. Ok, alcohol it is, at least for now. I get to do one insertion on the foam block to get a feel for it. I have no memory of that when it's time to stab myself, in a spot Dawn selects for being cushy and not scarred by 9 years of pumping. I wonder why they can't collaborate with the pump infusion site injector people. Really, spring loaded seems like a good idea now that I'm long past manual insertion. I plunge it in, hear the first click and realize it's hurting. "Keep going, faster!" Second click. Breathe. Need to retract the needle - that takes a lot of force and I'm supposed to be keeping everything still. Remove plunger, install transmitter. That takes even more force and seems hard to do with the whole 'don't wiggle the sensor; you don't want to shear it off' warning. Dawn helps with the second click there. And we start the 2 hour start up, pack our things and head out into the rain.

Sensor/Transmitter in place - the plastic part is approx. 1"x1.5", the tape is approx. 2"x3". For comparison, my preferred pump infusion set is 3/4"x1" and 1.25"x1.5".

I had promised T3 dinner after this big fun. Prima had been the plan, but I was happy to switch to Cafe Ena (big pasta might not be the best first night test of CGM).

18:25: test: 71
We toasted 7s (Dexcom Seven+ system, to get first calibration at 7:43 (4+3=7) on the 7th of May) and had a great dinner. We talked about the fate of architecture firms in town, workplace dynamics, the fact that bending was more difficult with this sensor/transmitter at my waistline, the Tour de Cure, good food, mutual friends and weekend plans. (See? It's not all diabetes all the time, even on a D-heavy day.)

19:46: tests: 115 & 126 (First calibration requires two tests. This reminds me how frustrated I am that BG meters aren't required to be more accurate. I'm hoping that the arrows on the CGM will help me decide whether or not to treat when the meter tells me I'm on a borderline of too high or too low.)
Watch an episode of Pushing Daisies, Season 2. Lament the cancellation of the show all over again.

20:44: post-meal test: 117 (rock on!)
Watch a second episode of Pushing Daisies, but keep dozing off.

21:50: CGM (in need of a name) alarms low (below 70). test: 95 & 98 Low alarm was wrong.

22:02: Decide to calibrate again so the 12 hour required calibration won't come while I'm sleeping. Test: 99. (That's 13 tests today, 11 if you drop the double for verification; yikes. Still happy with the numbers and wondering if the added attention of CGM is making all the components in my body cooperate.)
Discover that putting CGM receiver on the night stand means I can get far enough away in bed for it to not get a signal. Clip receiver next to pump on my pj waist. Realize that the sort of itchy feeling at the sensor site has moved toward actual pain. It hurts enough to be frustrating, but not crippling. I figure out that stretching flat on my back helps and hope I will figure out how to sleep that way. I wonder how I'm going to get through 7 days like this before I can find a better (less bendy) location for the sensor. The bigD demons creep in, making me frustrated, scared, sad. With impeccable timing, T3 calls to check how things are going, cheers the good BG numbers and helps me shove the demons back into their cage.

Sleep; dream about a traffic jam, a HUGE devoted dog, a cabin.... nothing to do with bigD at all.

PS: by morning, my body seems to have mostly adjusted to the presence of the sensor. It sort of feels like my brain quit accepting the signal from those nerve endings: "Look guys, she's not going to make you feel better for a week so quit tattling that there's pain in that area. If no one's bleeding, I don't want to know about it."

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