The Little Things

NPP and I have been getting along very well over the first week of our relationship.  My blood sugars have been incredibly steady and my bolus ratios actually work like I expect them too again; I fear that OPP was on the fritz for the better part of a year.  I really wish there was a guide book for all the little things that a diabetic encounters during the course of their disease.  Most of the daily adjustments we make become second nature, but every so often I am reminded of how much thought and practice it took to get accustomed to this new way of life.

Tuesday evening after physical therapy I met my sister out for dinner at Suenos, a tasty Mexican restaurant in the Chelsea area of Manhattan, for taco night.  We started the night with some guacamole and then split a delicious trio of taco meats and we made our own tasty delights family style at the table.  With the massive amount of corn I was about to consume I started plugging away on NPP to pump up the bolus.  I figured that my meal would be about 160 grams of carbohydrates, but for the life of me couldn't figure out where my dual wave bolus function went.  I also could not fathom why my pump kept locking me out of administering a regular bolus saying I had exceeded my mass bolus limit!

Now a step back, due to all the medical regulation required for medical devices the device pretty much has to be error proof.  Additionally, tons of children use insulin pumps so there need to be a ton of fail safe mechanisms so a 5 year old does not inadvertently give themselves 20 units of insulin.  So on each pump there are settings that open up more menus for a higher level of customization of insulin infusions.  It's kind of like unlocking a secret level on a video game except in this case it lets me eat, not just spend more hours getting callused thumbs.

After staring at NPP for a good 3 minutes I finally remembered that it came with factory settings - not Ed customized settings!  With that realization I began beeping away expanding my max bolus from 10 units to 25 units and unlocking the magic menus of square and dual wave boluses.  Had those two functions not been available to me there was no way I could have eaten the meal we ordered.

Over the past month I have gotten just a small taste of what blood sugar management must have been like prior to pens that could give you lantus or novolog in micro-adjustments or insulin pumps that can change the level of insulin in your body at the push of a button.  The advancements in medical technology have made it possible for me to eat a carb-riffic meal of tacos, compete in Ironmans and go about my day like any other 31 year old would.  And the amazing thing is, it's not the big advancements that have helped totally change blood sugar management, it's the small things that let insulin calculations become more precise.  I know that the advent of insulins that react differently in the body (i.e., lantus v novolog) revolutionized care but the incremental changes to deliver that insulin more precisely has provided alot more freedom.  From a 30,000 foot level we all manage this disease pretty similarly but when you get down really close to individual management you see how unique this disease is for each person who has it.  The past few weeks have made me realize how much all those little things add up and reminded me why it's so important for our collective experience to be shared.