It's The Little Things (Like a finger prick)

For months I have agonized over my finger pricks. I assumed that each lancet device was the same and that no matter which one I used I'd have to deal with black dots at the tips of each finger and looking like I had deformed fingers each time I got out of the pool. I thought each lancet device would be as uncomfortable as the one that came with my freestyle flash and take as many tries to draw blood as that one. Oh how I hated this evil little gray device of torture:

The grey device of torture once decided to break apart as the pharmasist was seeing what type of lancets I used just to bring the pain to someone else. I can't count the number of times the protective plastic fell off leaving the prick of death to be exposed giving me an unexpected jab when I went to test!

After 4 months of discomfort I decided to try a new lancet device and I can't be thankful enough that I went with the Accu-Check Softclix:

For the past week I have lived in finger prick bliss. During sweaty workouts I don't have to worry about my hand pulling off the only protection I have from the lancet of death, I've only had to reprick myself once out of 50 tries, the holes are healing and the black dots are gone! Maybe I'm turning soft in my old age but I'm glad to say good bye to the grey finger prick of death and hello to blue buddy.

Sleep & Blood Sugar

From Saturday through Tuesday I woke up each day at 5am. Saturday I woke up early due to the birds chirping in Lake Placid, Sunday to get to the Ironman to volunteer, Monday to sign up for the 2008 Ironman and Tuesday for a flight up to Boston for business. While I would have been much happier staying in bed and waking up at 7 the early days let me learn alot about how my body reacts to environmental changes and made me aware that I experience some dawn phenomenon.

Each night I went to bed with my bs around 100 (give or take a few points) but at 5 am each morning my blood sugar had raised to about 140. Without a correction my blood sugar would drop below 120 by 7:30 am. Had I not had such a crazy schedule I never would have learned that I did encounter a spike in those early morning hours and wouldn't have been able to discuss the necessary pump adjustments with my endo.

By Wednesday I was absolutely exhausted. I had my finance class Tuesday evening and didn't get home until about 9:30 pm; my bs was a mess on Wednesday. I had a reading of 197 after my turkey sandwich for lunch and really had incredible swings. After getting to the gym and returning to my regular sleep pattern my bs has returned to the 90 - 110 range. Have others of you noticed the dramatic effects a chaotic change to your normal routine can have on your bs?

Time to Ring The Bolus!

I had an incredible past few days. On Friday Courtney and I drove up to Lake Placid to volunteer at Ironman USA. Although we both got a bit sick from the 40 degree temperatures at night and didn't get nearly enough sleep the whole weekend was a blast. I never thought that handing out water to so many sweat soaked athletes could be so much fun. The smiles on someone's face during the marathon portion of an ironman when you call out their name and tell them they look strong is just an amazing feeling - I was in complete awe of these athletes and have tremendous respect for each of them.

Since my college football days ended I have been looking for a new athletic challenge. I have been seeking a way to perform in front of crowds and test my body's limits. Diabetes has given me the opportunity to make endurance sports even more challenging than what they already were and lets me "fight" something during them. I was so inspired by what I witnessed on Sunday that I woke up at 5:20 am on Monday to get in line to sign up for the 2008 Lake Placid Ironman! On July 20th, 2008 I will swim 2.4 mile, bike 114 miles and run 26.2 miles.

I can't wait for my training to start and I'm really looking forward to sharing my blood sugar challenges with each of you. During the race we saw 2 people with insulin pumps and 2 people wearing Tour De Cure bike jerseys. Last week I did my due diligence to make sure it was an ok decision to sign up for this race and spoke with some amazing Type 1s who have successfully completed ironmans or other triathlons in the past. Jay Handy of the JDRF and Tom Kingery of the future Team Running on Insulin both spoke to me at length about the training requirements of the race but more importantly helped me embrace my enthusiasm for this challenge. Through this event I hope to show all those diabetic kids or adults that we can challenge our physical limits and can compete in insane athletic events. Now it's time for me to live up to my blog name and Ring The Bolus; this next year will have more sweat, more pain, and more commitment than any athletic endeavor I've tackled in the past and I can't wait!

So that's why you change the infusion set!

I've been on the pump for a couple weeks now, up until Tuesday I hadn't had a problem with it. I had planned on changing my infusion site that evening when I got home from work - however, during a pretty tough speed workout at the gym the tape adhesion started to peel away from the skin a bit - no big deal I thought it will stay there until I get home. After I finish my run I notice that the adhesionison is half off so I hustle over to Duane Reade to pick up some athletic tape. As I walk up Broad St - I feel a pinch at my side and then realized that the damn thing fell out! Luckily I kept some extra infusion sets at my office but didn't have the minimed inserter - so for the first time I had to jam that big needle into my gut; not fun, I like the inserter much better!

I wanted to see how long 1.4 mg of insulin would last in my pump for so I didn't change the reservoir after the infusion site change - last night at the Yankee game I was greeted by a low reservoir warning - no big deal, I had enough left for the basal during the game and 1 bolus. But I learned two valuable lessons from this - change your infusion site every 3 days (not 4) and 1.4 mg of insulin will last me 5 days, I'll just keep learning this stuff as I go.

Endo Follow Up

This morning I had my first "true" follow up with my Endo. I've read other blogers accounts of their 3 month visit but I had yet to feel the anticipation of a new A1c. I entered the office, sat down in the testing room and anxiously waited until Dr. Goland called me into her office. Upon meeting me in the waiting room she had a huge smile on her face and pointed at a number in my chart.... 5.6!!!!!!!!!! Back on April 2nd my A1c was above 16 and during one of my early visits about the pump (mid May) my A1c was 7.8 - having a "normal" A1c let me know that all the hard work and sacrifices that I've been making since my diagnosis are paying off and that I am handing diabetes a "defeat" each day. The challenge to maintain this healthy level will continue to motivate me to run, lift, bike, swim and challenge myself athletically in whatever way possible. I may eventually have to find something besides chicken sausage and artichokes to eat but for now that's working too!

What made the office visit even better was getting to meet about 25 kids who go to the Naomi Berrie Center's summer camp. Each one of the campers is a patient at the center and about 2/3 wear pumps. I had no idea that the center ran such a program and was thrilled to meet all of them. Kerri who is working with me on the "Friends of the Berrie Center" fund raising effort saw me sign in and said I have something to show you... she took me to one of the back offices where I saw 25 of the happiest kids I've ever seen with bright yellow t-shirts on. Today they were all going to play tennis and earlier in the week they went to the zoo. The Berrie Center takes a family oriented holistic approach to diabetic care and seeing the smile on those kids faces really drove that point home. The office is more than a medical center it is a place of support, hope and confidence for all of us who struggle with the disease.

Pumping It Up!

Although I'm less than a week into my pumping life, I couldn't feel more liberated or be happier about the results. In addition to having awesome bs control during the ride on Sunday I was able to eat a delicious lobster roll with fries on Saturday night and eat POPCORN AT THE MOVIES following dinner!!!! When I was first diagnosed with diabetes I guess I shed away from putting myself in a situation that would be hard to control, like eating movie popcorn, having some french fries or sleeping in a bit. Now that I'm starting to understand how to use a square wave or dual wave bolus and how to adjust my basal rate I feel like I can once again eat all those foods I love, in moderation. I'm not sure if it is the confidence of knowing that my insulin can be constantly adjusted or that I don't have to stab myself to be able to eat but I feel as if the pump has lifted 1,000 of pounds off my shoulders.

One of my biggest frustrations with diabetes was going to the gym and being really worried about getting a low from lifting or running. Last week I had some problems adjusting my basal rate prior to working out and encountered a low while on the treadmill and another low after a secondary muscle group lift. I guess I didn't reduce my basal rate enough prior to exercise or bolused too much for my Clif Bar.

For me, lifting is a way to reduce stress and lets me clear my mind of all the things that are bothering me so any disruption to that routine is tremendously frustrating. Pre lift I like to have a Clif Builder Bar so I have enough energy to work my butt off for an hour and 15 minutes. While on lantus/ novolog I would eat my Clif Bar without a bolus and then have to bolus after my lift to account for any sugars I didn't work off. However, yesterday by reducing my basal rate to 50% 45 minutes before my workout and bolusing .5 units for the Clif Bar I ended my lift with a blood sugar of 89! I can't tell you how much a regulated blood sugar aids in recovery.

NYC Tour De Cure & Life on The Pump

Yesterday Team Fat Bird completed the NYC 62 Mile Tour De Cure. Unfortunately Team Fat Bird was reduced from a team of 5 to just Courtney and me but we represented well nonetheless. I woke up at 5:45 am, had a protein shake and reduced my basal rate to 30% for the next 7 hours. Nothing gets you ready for a ride like Cyndi Lauper at 6:30 in the morning! The ADA really needs to work on their music choices, the last song I heard before starting the ride was Foreigner's "Waiting for a Girl Like You" - now I'm about as big of a fan of 80s rock as you can find but seriously if you're going to play Foreigner can we at least get Juke Box Hero????

Although most of the about 40 people who did the 62 mile ride missed the turn at 54th Street the ride was amazing. I've ridden the GW Bridge to 9W North route 3 or 4 times this year but doing the ride with so many people who are raising money for our cause was great. The best part was riding out onto the pier in Piermont to have this gorgeous view of the Tapanzee Bridge (that's Courtney in the picture with me):

Best of all - I DIDN'T HAVE A LOW THE ENTIRE RIDE!!!!! Pre-ride I had a protein shake and a 1/2 a bagel; about 10 miles in I had a Cliff Bar and followed that up with 3 carb booms throughout the ride. I can't believe how much easier life is on the pump! My purple pancreas is just amazing - just a complete difference in endurance compared to multiple daily injections.

I think the ADA could have organized the ride better, and marked the course much better. One big frustration was we couldn't find the rest stop in Piermont and the rest stop on 9W had run out of water! Additionally, Battery Park has tremendous foot traffic on Sundays. The only people who came into the Tour De Cure area were ones trying to buy a water - alot of awareness could have been raised yesterday but they would have needed a more organized effort to fully take advantage of that opportunity.