Do you ever have those dreams in the middle of a dead quiet night, that you're falling, and you die? And you think that its real, that maybe you died. You wake up and try to determine if you're in some kind of in-between place, where everything around you seems too calm and still so your sleep addled brain tells you that your gone. Then you hear a dog bark, or a siren, or a terrifying Darth Vader possum hiss and you know they're the sounds of being alive.
My life has another soundtrack that helps to remind me I'm alive. I play it on repeat every day; so constant that I almost know the lyrics. It starts with a mechanical click of springs sliding and locking into place, followed instantly with a dulled thud. Then begins a silent 5 second countdown that might continue on in silence, or end in 2 digital beeps. Silence is good. Beeping is bad. If I beep, even my husband knows what that means - that my day has not started well. Beeps are either followed by angry swearing (and my husband knows he can get a few more minutes of shut eye), or clumsy rustling in my bedside drawer, the slight hiss of air as a foil seal is punctured and loud gulping and breathing noises as I smash down a juice to treat a low. I don't really hear any of these though. If I am low then my aural senses become dull and disconnected, replaced by a ringing that I can't stop.
The pattern repeats itself, over and over throughout the day. The click of the lancet, the silence or beeps of the glucometer.
My pump plays a different tune to add to my diabetes medley. "Pah-tunk", "pah-tunk". This is the sound I recognise as an interaction between myself and King. Pah-tunk to select bolus. Pah-tunk to unlock. Quiet ticking as a bolus is delivered. I have silenced King, annoyed with his constant chatter. Still he communicates what he needs. The vibrations are audible against my skin, against my mattress, or against thin air. When I am connected to CGM, and in danger, he screams. I cannot ignore the shrill, piercing cry that King makes to alert me to an unresolved low at 2am.
Every 3 days Kings' continuing song is punctuated with a change in rhythm. I add in the clinking of a pencil against a new reservoir to get rid of the air bubbles. The whirring of King's motor as it rewinds. The steady beeping King makes to indicate that insulin is filling a new set line. A pop as the new set is pressed and inserted into my skin. If I am lucky enough, a click of my CGM transmitter sliding onto a new sensor.
These are the sounds that let me know I have life, and am lucky enough to afford to live it.
Thursday, 13 April 2017
In the diabetes world there is a lot of focus on insulin sensitivity factors.
Insulin sensitivity is how much insulin your body needs to effectively convert your carbs into energy and keep your blood sugar in check. When someone is said to be insulin resistant, their body is needing to use too much insulin to get the job done. When they are sensitive they require less insulin.
It's better to be insulin sensitive. If you google insulin sensitivity there are dozens of articles telling people how to increase their insulin sensitivity and reduce insulin resistance. There are medications that can be used to help patients who are insulin resistant to lower there sensitivity. Exercise is known to increase sensitivity. There are things you can do.
If you're like me, there are no articles or words of advice. I am insulin sensitive. My doctors congratulate me on this, but are always scratching their heads in confusion as to what I can do when I go through episode after episode of unprovoked hypoglycemia.
At present, some of my basal rates sit at Zero. Zero Point Nothing. From 1pm through until 5pm everyday I receive NO insulin through my pump. King sits on my hip merely for decorative purposes (and so I dont forget to reattach later).
I eat my lunch at 12.30pm and don't give insulin for that either. About 2 days out of every 5 I still find that I can go low mid-afternoon. With no insulin on board. No insulin via basal. Frustratingly, I cannot go into negative insulin. All I can do is eat something which feels unnecessary and only serves to put on any weight I might lose through good exercise routine. Being insulin sensitive means that I find it very difficult to maintain exercise habits, as often I have to consume vast amounts of food to even attempt exercise. 3 days ago I had to eat 200gm of carb to exercise. 90 before, 30 during and 80 following exercise. All on no insulin. My blood sugar was on 4.3 1 hour before exercise rose to 7 after eating..and eating...and fury-drinking some sprite, before dropping back to 3 15 minutes into my walk (oh, so strenuous) and finally settling on 4 after the forced post-exercise meal.
There are no answers for cases like mine. Being LADA, I may still be producing my own residual insulin. It seems unlikely given how quickly my blood sugar can rise if I do get my carb counts wrong at other times of the day, but its possible.
The suggestion has been to try exercising early in the morning. I start work at 7.30am though, so I am not inclined to get up at 5.30am for a run. I am not a morning person. A nice morning lie-in is not yet another something I am willing to give up for diabetes.
Insulin Sensitivity is over-rated.
Wednesday, 5 April 2017
|Piggabeen Hall, down the road from our property|
Living rurally and away from town centers meant we relied on tanks for a lot of our water needs which meant we had to be conservative with our water use, especially at the Piggabeen property. Cleaning off after a day of playing in mud, scrambling up trees, sitting in old rusted out tanks and traipsing through chin-high grasses was sometimes a challenge. There was a bath in the house, but we were limited to a few small centimeters of water in the bottom of the tub, barely enough to cover our toes. If we remembered early enough, we could have showers which we would do as quickly as possible because the hot water timer was set to 2 minutes of warm water before becoming freezing cold. Showers could only be taken during the day, because the shower and toilet were in an outhouse which had no lighting and was shared by cane toads at night.
When storm and rain events happened we took full advantage of the pouring water, running around the yard with a bar of soap to enjoy a shower that lasted more than 2 minutes, and getting equally as dirty in the mud as we did clean in the rain.
In a really good storm, there was a dividing ditch that went from the start of the 500m long driveway and past our house. It had been dug to keep cattle and other animals from getting into the farmhouse (except horses, somehow they figured out the small footbridge and were always getting into the yard, or even the house). The ditch ran off into a creek behind the farm house. As kids, it was the best idea to go as far up the driveway as possible, get into the flooded ditch and ride the current until we got to the house, then hop out and do it again. It was not at all hygienic and we'd often be riding through the water next to cow patties, rotting wood and other unknown items. We just knew we had to scrub really hard in the bath afterwards.
|The driveway into our property. The tree line at the far back is where Piggabeen Creek ran.|
Storms and flooding were usually a fun adventure. The tanks would fill up and we could drink water from cups that we left out to collect the rainwater, which tasted way better than the metallic tasting water that came out of the tanks.
On the flip side, we understood well that too much water could be dangerous. The usually calm creek behind the house would rise and flow heavily and fast, out towards the Tweed River. Riding the ditch could become very dangerous if you didn't get out in time and ended up in the creek.
My mums property was on the outskirts of Murwillumbah and roads could flood quickly, cutting us off for a few days, unable to go to school - which as kids, was awesome. The house itself was never in any danger - it was on high ground. Mum was always prepared, and if she thought we might be cut off for a few days she would fill up all the containers and the bathtub so we would have enough water. She grew her own vegies and fruit and made her own bread so we didn't have to worry about food so much. Helicopter drops were also a good back-up option.
My grandparents still live in Murwillumbah. They live on high enough ground that they were able to stay in their homes over the last week when many others were evacuated.
The importance of being prepared and having a plan is something I learnt on the land. It can't account for all situations but it can help.