The Upside to Diabetes

I don't have anything deep and meaningful to say. Feeling light-hearted.

So today we're lumbering off down the road less traveled and listing (yes, a list, again) potential good side effects to come from having diabetes. Yes, I know these don't make up for having diabetes. Its just fun to imagine the super-powers it can give you.

Self-Imposed Compulsory Disclaimer: I'm not suggesting you take any of these potential good side effects of diabetes as gospel. Some of them may be illegal. I'm not sure.
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- You know that rule in Event (and other) Cinemas, were they don't like you to bring in food from other places? Totally doesn't apply to a diabetic. Go to Woolies, buy your real and completely not-watered down coke for $30000 less and walk right in. They can't take hypo treatment off a diabetic.
  I actually use this one all the time to bring lollies in because the lollies available are really not nom.

- Parking fine? You can't legally move your car if you're below 5 (so long as you take insulin or oral hypoglycaemic agents). You just had a reaaaallllly long hypo. That lasted 4 hours. Whilst you were shopping in Myer. Yup.

- Once upon a time I forgot to vote. I got a fine. But its all good because I had a log book full of hypo numbers to photocopy and send in. Fine wiped. All cheer.

- Leaving work early to go to your endo appointment. Which may or may not happen every Friday afternoon, enabling you to beat the coast traffic. Arriving at the Coast early win.

- Occasionally I struggle to climb up to the top of the small mountain of cups, plates, knifes and cheese graters in my kitchen and shudder as I submerge my fingers into scalding hot water to wash them all up. But I can always count on a mid-wash up hypo to stay my hand as I get into the gritty pots and pans. Advantage? I got to do all the easy to clean cups & plates, and my partner has to do all the hard stuff like pans and grills, despite the fact that he cooked with them.

- Vacuuming = hypo. Therefore the vacuuming is no longer on my job list ever again.

- Skipping queues at the pathology collection place and never having to do a fasting blood test ever again. Gotta be above 5 to drive, no breakfast = not above 5 = never making it to the pathology place.

- Basically anywhere that you aren't supposed to eat, diabetics can. People are ignorant to diabetes, both fortunately and unfortunately, and many still labor under the delusion that we must eat at specific times and stick to absolute strict routines or we die. Instantly, on the spot in front of them. I'm one of those people who snacks a lot...small amounts of food over the course of the day, and hate going to things where I can't eat. Not a problem anymore because I just say I *have* to eat and viola: stuffing face with chocolate whilst everyone else around you mutters crankily in time to their hunger-starved growling stomachs.

- Pretty cases & skins for pumps/meters.

- Fussy eater? So am I. "I have diabetes, I can't eat that". This includes mushy peas. They have carbs, right?

- On occassion I get to pretend to be a doctor. That thing on my hip is totally a pager. It's nice to play dress-ups and pretend-games when you're an adult, because people don't realise that that's what you're doing, and will treat you all respectable-like when they think you can cure their disease. Also doctors get to the start of the line, because they have to go save lives. That said, hypos also get you to the start of the line, because otherwise you die. Instantly, on the spot in front of people.

- One day when I've had too many annoying questions about my pump, I'm going to tell somebody that my pump is a new police tracking device and I was just let out of jail. I'm really looking forward to this day.

- The world makes more sense when everyone and everything in it is diabetic. Completely mundane things all of a sudden have explanations. I think we already covered how JK basically chronicles diabetes in Harry Potter. Think about strange things that have happened. Add diabetes. It clicks into place.

- Diabetes gives me bigger boobs. How? Add pump to bra. Viola. Almost-sortof-pretend cleavage. And if I want to dress up as a dude? Pump in pants. Bulge happening down there. The funny thing is, this happened accidentally once when I was using a flesh-coloured pump thigh belt that I had pulled up too high. Peeked out under my dress. Kept getting the weirdest stares in the bank.

- Legally carrying sharp objects. Spare lancing device lancets can be used for opening things when no scissors are around.

- Laughs.

- Stories. What stories have you collected since D that are unique and could only happen to a diabetic?


Biggest Super-power? THE DOC BABY!!! I never felt community until Morty decided that I was the one from the prophecy, tried to kill me and gave me pump-shaped scars on my forehead...I mean stomach.

How to Be An Exemplory Patient

As a diabetic I spend a lot of time in doctors offices. Working in one as well means that I already know how to get the most out of my appointments. People may not realise this, but getting the most out of your appointments starts in the waiting room...with me, the receptionist.

The 10 basic laws to being a good patient (at a specialist). Good patients get cookies. Follow these if you want a cookie:

1. Show up on time. Why do I even need to mention this? Especially if its your first appointment at a new clinic. Then you show up  early. If you're late I get cranky and I may just ask you to come back another day, irregardless of if you rode a llama or jet-skied across the pacific ocean to get here. And if you are going to be late, please have the decency to call and explain why as soon as you know you will be late.
Generally if the patient is on time, the doctor is too...makes everyone happy. If the patient is late the doctor is late...makes everyone sad...and then people yell at me for something I have no control over, making me the saddest person in the waiting room.

2. Bring your paperwork. Referrals laying on your desk at home aren't going to get you that Medicare rebate that you probably want back to help pay next week's rent. If you do forget it, ask your GP to fax a copy over or ask the receptionist if it is alright to email it or post it later that day.
It's also a good idea to try and bring any relevant results. If you know that you have not been given a copy we will happily track them down on our end if you can tell us the pathology, X-ray or otherwise company that you have used. It also means that we have it already there and waiting when you arrive, and often the doctor has also then had enough time to look over your results and have a bit of an idea what you're coming in for.

3. Referrals expire every 12 months. Don't argue with me about it.  I know its not fair. I know that you have a condition that requires life-long management. So does the doctor. Unfortunately we're not Medicare and we didn't make that silly rule. I can let you in on a little secret though: you can ask your GP for an 'indefinite' referral which will last, you guessed it, indefinitely. 

4. Tell the receptionist when you book what the issue is regarding, and if you have any secondary contributing factors that might warrant special attention. Like pregnancy. Pregnancy is a magical golden ticket to the highly coveted #1 spot on my waiting list.

 This not only helps with scheduling times, but it also reassures you that you have indeed been given a referral to the right type of specialist. GPs sometimes make mistakes and an endocrinologist can't really help with the removal of a superfluous 3rd nipple. Don't be embarrassed - we've heard it all and we aren't going to laugh at you or blab it around. We also don't want an in-depth description of your entire medical history. One word or a short phrase is fine, i.e: Type 1 Diabetes, testosterone deficiency, PCOS, etc.
In the end we just want to be able to schedule in the most efficient way possible and give you the full amount of time you will need to get your problem sorted. 

5. Following on from #4, if you are seeing a doctor in regards to needing a medical certificate/report for work or driving, taking part in a lawsuit or doing work cover, again tell the receptionist before you book in. Anything noteworthy at all, tell the receptionist. The last thing I want to do is hit you up with an extra fee that you don't know about for writing an insurance report because I wasn't told that that's what you needed.
Often times as well medical certificates will require you to do further testing or to follow special provisions before the doctor will sign off on it, and we can't advise you that if we don't know that's what you want.
Similarly if you have any specific needs - i.e. an interpreter, let the surgery know. Medical centers get them for free and its much more beneficial for everyone if we can communicate clearly.

6. If you do need a medical certificate to drive, etc. DON'T leave it until the last minute and expect the receptionist to move heaven and earth to get you an appointment in the 2 day time-allowance you have asked us to fit you into. Basically, that's not gonna happen. We'll see you in a month's time when we have an available spot, because the pregnant lady with Willy Wonka's magical golden ticket has priority to the chocolate covered doctors room (NB - Doctors room aren't actually covered in chocolate).
The same is 100% true for scripts and medication - Ringing up your doctors surgery and telling them that you ran out of Carbimazole yesterday is not something we want to hear and feel pressured about. If you haven't been keeping a close enough eye on your medication please try and get an appointment with your GP as soon as possible. They will be able to give you a script as your specialist usually sends them a letter detailing all your current medications and any changes made after each appointment. It may also not be possible for your specialist to give you a script 'pronto', as specialists may only work a few days a week at the clinic you attend.
If forgetting to refill scripts/medications is an issue for you, I would suggesting asking your chemist about your eligibility for a Webster Pack.

7. The minute you know you can't make an appointment, please call and advise the surgery. Simply changing your mind and not turning up with no indication to the surgery is very rude and disrespectful as well. Wait times for specialists can be quite lengthy and the sooner we know the sooner we can offer it to someone who really wants the appointment.
 Deciding to go to work instead of your appointment is not a valid excuse. Specialist appointments are normally booked months in advance, so if you couldn't find the time to ask your work for time off that's not the surgery's problem. You are also depriving the doctor of their income when they have already gone to work, looked up your results, come up with an action plan and much more for you. How would you feel if you went to work and your boss decided to turn around and tell you you weren't getting paid for an hour of work because no customers came in during that time? I'm guessing you wouldn't be happy either.
There are obviously some very excusable circumstances, like having a run-in with dementors, that we will forgive non-attendance for; but if at all possible please try to call when you find a quiet moment between hurling curses and conjuring patronuses to call and tell us you can no longer attend.

8. Treat staff the way you want to be treated. Generally I'm an all smiles receptionist and if a patient treats me well, I will go out of my way to try to help them in any way possible. You want the receptionist on your side. We can do amazing things, like getting you that 7.40am appointment that is normally booked out 6 months in advance.

9. Look after your blood forms, scripts and whatever other miscellaneous volumes you have had piled upon you during your appointment. There's only so many times your house can burn down or your pet canary can develop a taste for inky-green script paper. Some practices may charge a replacement fee on these if you become a repeat offender.
If you know you tend to lose things you can arrange with your pharmacy that you will drop scripts off directly to them on your way home from the doctors and they will happily take care of it for you. Its also worth enquiring if blood test forms can be kept in your patient chart at your doctors until you need them, at which point you can come and collect it.
Many surgery's will have policies against posting scripts, due to those crazy people who will unfortunately try to use other people's scripts. If it is a specialised script the doctor may also have to go through the PBS to get an authority number for your script, and this can be very difficult to reissue so they obviously don't want it going to post-office limbo.

10. Relax and ask questions. Make sure you know where you're going and how much it will cost. Feel free to ask - no question is stupid if you aren't sure of what you should be doing. If you leave a message on a surgery answering machine remember to include your name and contact number - its surprising the amount of people who think I know their voice off by heart from a message recording. Unfortunately I don't remember, and its very awkward when it becomes clear to the patient that I don't think about the sound of their voice as much as they obviously think about mine.

IDF World Congress

IDF has come and gone. Too quickly. I could not cram nearly enough information into my overstretched brain during my 2 day stint in Melbourne.

I was lucky enough to be sent down to Melbourne by Diabetes Australia, as part of the Diabetes Australia Young Leaders Program. I met some amazing other young leaders from Australia, and then eventually some amazing young leaders from other corners of our world.

The symposiums and forums I attended were very informative and gave me insights into diabetes that I had never considered before. I learnt new things from the relevance of birth weight and link between weight and Type 1 Diabetes, to the importance of social media in connecting diabetics, saw studies which highlighted such interesting tidbits as the fact that BOTH type 1 and Type 2 diabetics believe the stigma of the other type impacts upon them, and that neither type believes that the other type has to deal with the stigma. I found out that women in India find it very hard to be able to get married as they are considered damaged goods who cannot deliver healthy babies.

I heard a crazy guy rant about how we should all be looking up our diabetic equipment so that 'they (doctors) cannot get to it', and how we should never trust doctors. It turns out that that crazy guy was quite involved in IDF and headed the rights and responsibilities area of things. He also somehow thought it was quite appropriate to show pictures of hot cartoon chicks, because as he stated, to the embarrassment of those sharing his forum - he "likes to look at them". I did wonder if he had had one hypo too many.

I learnt too much about complications. Complications make me sad.

I saw statistics everywhere. This example, shows that 382 million people worldwide have diabetes. Half of this number are diagnosed. Half of those diagnosed receive care (so we're looking at 1/4 of all diabetics receiving treatment). Half of those receiving treatment achieve their targets, and half of those achieving their targets achieve the desired outcome of all diabetics - which is to live complication free.

I was riveted during the talk about 'the point' of diagnosing diabetes in countries where that's as far as treatment gets - diagnosis. What could be the point of diagnosing patients, if just to tell them they will die from their diabetes - there are no treatment options. No supplies. Tales were recounted of mothers leaving their diabetic child at a hospital - because abandoning that child means their other 5 children will be able to eat or get an education, when treatment for that 1 child would cost too much. Also because abandoning that child gives them a chance at getting treatment. What a horrible decision to make.

Most of all IDF taught me great appreciation for my well-being and access to treatment. It's not always easy being a Type 1 diabetic, but I'm not being left by my partner because of it or being left to die. I feel very humbled by the experiences of others.

I thank each and every speaker who came to IDF to share their knowledge about the diversity of diabetes and it's global impact.


Aptly, the last moment - the 1 moment that absolutely struck me down at IDF, was during the last event I attended; the IDF and Australian young leader's dinner. This was the moment that really made me stop and think about the state of diabetes globally. I was eating dinner with the New Zealand representative among others, when the boy sitting in front of me whipped out a strange injection device I had never seen before. Being quite a brazen person, I had no qualms with asking what it was. (Hey, I was curious...only knowledge to be gained here). He replied that it was an Innolet Device (which we actually have at work, I've just never bothered to look at one before). Then he followed up with a matter-of-fact statement that he had received it from the INSULIN FOR LIFE program. To which I quickly realised that without that program he would probably be dead. The very real kind of dead, that isn't caused by missing out on a great handbag sale (which is what many of us might think is dead). I pretty much wanted to burst into tears and send him all my insulin stocks. The Young Leaders themselves were recipients of charities designed to keep them alive and provide them with the basic essentials that we, as diabetics, need to survive.

For me, nothing made me stop and take a good hard look at my own privelleged life more than that moment. New cause to champion? I think so.

Uncertain

Sometimes things happen in the land of diabetes that we live in, that remind us of how - for lack of a better word - fragile, this disease can be. How vulnerable and uncertain of yourself it can make you feel.

For me, that thing was a 2.6. It should have been a 'no biggie'. We all get hypos. The thing that freaked me out, and made me feel unsettled was that I wasn't going to catch it.

I went to bed at a healthy 6., with 10 minutes of IOB left. A non-issue. At some point just after going to bed my pump started vibrating and telling me to 'Check BG' as it had been 2 hours post meal. I sleep through this every night. My partner is ALWAYS the one to wake me up to clear this message.

Hugh came to bed about 1 hour after me, and as usual fumbled around with my pump to turn the check BG alarm off, and as usual woke me up in the process. I felt fine. I acted normal. We never check my BGs during the night. For some reason he decided to ask me to check my BGs. Grumbling, I did so. 2.6.

After I treated it (I felt like death once I got up), I was left wondering and puzzled as to how it had happened. I had barely any IOB. Like piddle amounts. I got to bed with IOB every night.

I riddled that it was due to a combination of me being too awesome for my own body, and the heat. After I riddled it, I got scared. Scared that I didn't feel it. Scared when I realised that I wasn't going to feel it, or wake up. Scared about what might have happened if Hugh didn't wake me up and make me check, for a reason unknown to us both.

And now I feel a whole lot less confident in my abilities to manage this disease. I can't force myself to get hypo symptoms. I can't force myself to wake up. I don't know how many times I have missed a nypo before.

Its times like this, when I feel vulnerable and naked to my disease, that I wish I could take a break. Not even from it all, just from the insulin. The cause and answer to all my prolems as a Type 1 Diabetic.

Other people can take breaks from their meds (although never advised). I just want that day, the day  where I don't have to worry about hypos and measuring the exact units for a meal to stop both highs and lows. I want a day where I can trust my own body to do the right thing by me and keep me alive. And not have the same thing that keeps me alive, be the thing that has the potential to kill me. As unlikely as it is, it does happen. And nights with 2.6's remind me of that.

It's Raining (free) Meters

If I'm in a diabetes slump, such as now, there's usually a few things that I have found will motivate me to get back into it. One of these things is new diabetes toys.

I was thrilled to be a part of walk for a cure this past Sunday at Chermside, Brisbane.

The walk of course had sponsor tents set up. I managed to bag quite a few free things: 1 Medtronic drink bottle, 1 Johnson & Johnson drink bottle, coloring & activity books with Lenny the Lion (Yup! Giant kid at heart), Lenny the Lion masks, briiiiight orange Medtronic shirt, Accu-chek cap (which I happily used on the walk!), mini tick-tacks, lollies, water, a squishy purple stress-ball pump and my favourite of the day: A NEW meter! WITH TEST STRIPS!!!

Obviously this prompted me to revisit exactly how many meters I have now amassed in my short career as a diabetic. The answer was 10, although 3 of these are double-ups. 10 free meters. (Hint: never pay for a meter. There is always a way to get it for free). 

I present to you in high definition colour*: 

The history of my meters: A comparative tale.

1st Meter:

My 1st ever meter was the Johnson & Johnson One Touch Verio Standard. 1st meter so naturally I got quite attached. It had no special features really. It had a very dark screen that would light up to a funny green shade if you pushed a certain button for a supremely long time. I have no idea what button that is anymore. Somewhere along the line I managed to collect a 2nd one of these meters, which has never even been turned on.

2nd Meter:

Ok, I did tell a lie earlier about never purchasing a meter. I did purchase this meter, and with no intention of ever using it. I bought it on a full-cash back sale exclusively for the lancing device. It was the Accu-Chek Performa Nano. Looking at its tiny little body, it looks like it would be great for when I walog. But it takes coding, so I dead-set refuse to use it. Too inconvenient. Therefore I have turned it on once or twice to use up the free strips that came with it (rule of D life #1: Never ever waste a test-strip).

3rd Meter:

The Freestyle Exceed. I was given this by my DE on my 1st visit. She thought I was cray cray for still dip-sticking it when I wanted to go ketone hunting. Hence: New meter in my hands. Its great that it does ketones. I would recommend every T1D to keep one at hand just for this function. In terms of glucose testing, its not for me. The testing strips are all individually wrapped, creating a lot of waste. It also takes a ridiculous sample size (although nothing compared to the ketone strip sample size). Last but not least I have taken several side by sides of all my meters, and it consistently shows up as being the lowest reading meter (which some people like). On the plus side, its really pretty.

Basic meter, but it does Ketones, which no other meter does. 

4th Meter:

When I was started on my pump, it was a requirement that I get the Bayer Contour link so I could have my meter 'talk' to my pump. So I ordered several thousand boxes of strips (as you do) to set it up with. I hated it. To put it bluntly. My DE loved it. Ok, I liked the fact it talked to my pump. But I was used to a high-reading meter, and this b*tch kept telling me I was low. All. The. Time. I got fat from this meter constantly treating non-existent hypos. So I scrapped it after a few months worth of use, much to the dismay of my DE, who still tries vehemently to convince me to use it as I never bother to input my readings into my pump. For those who use CGM, I believe it works brilliantly for that as that seems to be what the CGM likes to calibrate to the most. The other downside to the Bayer as well is that pharmacists do not stock the strips so you have to be pretty on the ball with ordering ahead of time.

3.4 on the left - I got hypo numbers very frequenlty with the Contour Link, but never seemed to feel them. 10.0 on the right - this was the highest number I could find in the meter memory. Screen is good with big, easy to read numbers.

5th Meter (and current Meter):

I am now back to my faithful One Touch Verio, compliments of Johnson & Johnson. However now I am using the upgraded version, the One Touch Verio IQ. IQ because its smart and awesome. (Can we tell I am biased?). It reads high, which I love - but this may be a downside for other users who like lower reading meters, particularly children. It has a beautiful colour screen which shows a sun in the day and a moon at nighttime, just in case you wonder why its suddenly dark outside. It has a light-up testing port for those middle of the night checks. It is rechargeable. It has a pattern log to identify low and high patterns at different times of the day. Also importantly the One Touch family have the smallest testing sample of all the meters I have used. It also uses the same strips as the standard Verio so I can carry one of those as a back-up. And I have a pretty decal for it. Seals the deal, obviously. Cons: The lancing device is crap. Swap it for an Accu-Chek multiclix or soft-clix.

See the pretty moon and low pattern.

6th Meter:

I honestly don't know why I have the Freestyle Insulinx, let alone 2 of them, given that I have a pump. The only reason I own them that I can think of was that it supplied a days worth of free test strips with each one. For non-pumpers or people wanting to transition to a pump I think its well-worth harassing and haranguing your local rep for one. It has an in built bolus Wizard (which does need to be set-up by your Healthcare professional) for tighter control and easier carb bolusing and corrections. It reads fairly high, similar to the Verio, so I have actually used this as my meter on one day when I forgot to charge my IQ. An exciting feature for this meter is the touch screen, helpful for the touch-screen generation who probably no longer understand what real buttons are. You can also customize your background image, and keeping stuff personalized can actually be a motivator for me with diabetes (see my One Touch IQ above).

Touch screen with a bolus wizard

7th Meter:

This is the 1st time that I rue the fact my sensitivity is set on my IQ. I got my Accu-Chek mobile on Sunday at the Walk for a Cure and love it! ALL IN ONE! It totally helps that I got 50 free test strips too. Its just...handy. I threw it in my bag today when I ducked down to the shops and that was amazing not to take my whole kit. I was slightly annoyed when I turned it on earlier to check a reading without wanting to test that this process (turning it on) forces a new test area to rotate in, and therefore you lose a test, which can be a waste of money. Maybe I'm doing it wrong though. It is big and clunky, but the soft-clix lancing device which is nearly painless. The strip film is a lovely feature because its vastly reduces strip rubbish. It is now my dedicated in-car testing meter. :)

 In-built test strips. Big display, but a big meter too.

*May not necessarily be high definition. Or colour.

Leave your Diabetes At Home

I haven't written in a while. I couldn't. I didn't have the words to express how I felt. About diabetes. About how frustrating it can be. About how sometimes, it feels so hopeless to just continues on. About the ways it can impact on your life.

I have been PISSED OFF. Even that doesn't quite cover it.

I think it started with Japan. It started with the lows. It started with the highs. It started with the heat, with the nearly-full vials of insulin I threw away. It started with the more-than-regular set changes. It started with waking up all night for many nights with exercise induced lows. It started with cursing and blessing CGMs. It started with trying to do it all, do everything and get everything from Japan that I wanted to, but couldn't because sometimes diabetes elbowed and shoved its way to the start of my 'attention' line. You can't chastise diabetes like you would a rude customer who butts in ahead of you for service in a store, because diabetes can do so much worse than swear at you if you tell it to wait its damn turn.

I really can't forgive diabetes for Japan. I just wanted a trip away. Just a trip away. With Type 1 Diabetes, you can never have a trip away. It comes with you everywhere.

I did the right things. I had so many doctors appointments in the lead-up that thats all my diary consisteted off. I took an ENTIRE carry-on suitcase full of supplies, when I really could have used that space to smuggle back Pikachu. I bought CGMs, I wore CGMS. I planned.

In the end, it doesn't matter what you plan for because diabetes doesn't work to plans.

I think I broke at about the 15 day mark, in Nagasaki. When I went from 11 to 20 within 2 hours after yet another vial of insulin gave it up, exasperated in the heat. When all I wanted to do was go for a walk in the gardens. But I had to do a crazy tram dash back to the hotel to get some cool insulin from the fridge and lower my BGLs, get rid of the insane high headache and extreme nausea.

I couldn't forgive diabetes after that. I turned my back and played the 'I can't hear you' game until it prised my hands from ears and screamed straight into my face that I had yet another BGL of 20-something to treat. Which was about twice daily.

Don't get me wrong, I loved Japan. I had a ball. But the 3rd wheel of diabetes was not at all welcome.

I'm trying to pick myself back up now. I went to my educator's appointment on Monday with not a single reading written down. I hadn't saved a single BGL into my pump. I was wearing a sensor so my educator could at least look at that. She normally wears a happy face when she sees me. On Monday she had obviously visited the Happy Mask shop in Hyrule Castle Town and traded it for something much sadder.

I told her that I wasn't feeling particularly kindly-inclined towards my diabetes and I did't want to think about. She made lots of mumblings to herself and then changed my basal rates. Which I knew needed to happen, but I was too cranky to think about it.

Then to seal the deal that she wasn't happy, I was sent home with basal testing. Which I never do even though she's been asking me to for a year. While I'm cranky at diabetes, the last thing I want to do is starve myself for hours for it. But I had made the mistake of taking my boyfriend along because I was jealous that other betics sometimes have their support people with them and I never have mine, so I agreed to let him come. So he is trying to enforce basal testing. Not happy Ashleigh.

Working hard on becoming tolerant of Morty again, but I feel this may take awhile.

Japan: 5 days in

It has been quite a hectic few days in Japanland. I have never been so happy to have CGM. This one so far is holding up extremely well and has been nearly always bang-on with its readings, to the point where I have felt comfortable giving my fingers a little break and testing only at wake-up and before bed unless my CGM says I'm close to hypo, & I'll test then to confirm.

D has NOT been behaving itself so I am running my sugars higher at between 10 - 14. If I take insulin with a meal I will be low at 1 hour post meal but if I don't take it I reach about 15. Tokyo is extremely hot and if you add a BGL of 15 to the humidity it makes for extreme tiredness that makes travel hard. So we have settled on a routine of no insulin for breakfast, 1 to 2 units for lunch depending on car content and about 2 u for dinner.

Basal wise I am pretty much on suspend from the moment I wake up until we are back at the hotel at night - suspended for about 12 hours a day. I have discovered that I also need to do a temp basal at night. I'm not sure of the rate yet as I am still waking up with hypos (which has never been an issue before) at about 3 - 4am and then again from 6 - 8am. I'm quite thankful for the CGM for this, as normally at night I silence it because of pressure problems, but surprisingly it hasn't had these this time - must have picked a good spot. I don't feel hypo at all when I wake so smiles all around for CGM just rescuing my butt 2 times a night.

Total insulin usage has dropped from 40u a day to about 15.

At home I tend to be a bit* fixated on getting good numbers, but right now I just want to enjoy my holiday without D getting in the way. If I have higher BGLs for 3 weeks then I have higher BGLs for 3 weeks.

To sum up with a positive note about D in Japan: I bought this ultra-deliciously cute case to use as a day kit when I get back to Aus:

Its inspirational as well. My fave is 'Take it easy, I can assure you everything will turn out fine'. Ahhhh happy bear.

Japan: Nikko Edomura Wishing

Japan: Take 1

My 1st day in Japan has come and gone. It was adventurous and exciting and you can read what I did at my other blog, 'Tonyobyo in Tokyo'.

Being that this is my diabetes blog, I will be chronicling my diabetes in Japan. Which so far has been a bit of a challenge. All I can say is: Thank gosh for CGM and 10kg cabin baggage allowances (I will upload a photo later of the massive amounts of D stuff I managed to squish into 1 bag).

The plane trip, diabetes wise went ok. I ran myself higher, at about 10 - 13 to avoid the post-landing hypo that I always seem to get. I changed the time on my pump and was set to go diabetes wise for that day.

Today went not so awesome. I did a set change - 1st set change in the Northern Hemisphere for me! That was fine. I inserted my CGM, for which I had bought a new box of sensors just for our Japan trip. The CGM had kicked in and asked for a calibration at about 10.30am. I calibrated with a BG of 7.1. About 1/2 an hour later I was getting alarms from my CGM and caught my hypo at 3.7. Yay for CGM! My CGM was accurate the whole day which was great - I think I stopped about 4 or 5 more potential hypos that would have added to the 3 I did have.

Definitely recommend CGM for ttravel for that peace of mind and abilitgy to manage before the event in terms of hypos/highs.

The rest of the day I spent battling becoming or actually being low in the extreme humidity of Tokyo. My estimation at the end of the day was that I had had my pump disonnected or on suspend for about 8 hours all up during the day. I even tried a temp basal of 30%, which didn't work.

At dinnertime, despite having been on suspend for 3 hours (aka NO insulin delivery for 3 hours) my BG fell to 4.1 again so we had a rushed dinner at something that resembled a Mo's burger, but was called 'Buckers' or something equally as weird. I gave myself only 1/2 the recommended insulin at dinner and ended up on 4.5 2 hours later.

The highest I reached all day was 10.9, with the lowest 3.3 thanks to my CGM.

Excuse my Red undies in the background

Tomorrow is a new day. I'll try a 10% temp basal (which will equate to less than 0.05U/P/H) tomorrow and see how it goes.

The Pre-Japan Travel List

PUMP

1 ½ boxes of infusion sets

1 ½ boxes of reservoirs

30 Alcohol swabs

3 spare batteries

CGMS

transmitter

charger

5 x sensors

10 alcohol swabs

Clear over-tape

INSULIN

scripts for NovoRapid & Lantus

6 vials of insulin (NovoRapid)

NovoPen Echo & instructions

1 x box of pen needle tips

BLOOD GLUCOSE MONITORING

8 x boxes of testing strips

2 x IQ meters (+ recharge cable), 1 x standard Verio meter

1 x double-pack spare batteries for non-rechargeable meter

Lancing device x 2 + spare lancets

MISC

Doctors note

Hypo stash (Jellybeans, glucotabs)

Sharps clippers or container

Alan (aka Calorie King)

Ketone strips & Ketone meter with spare batteries

Tape

Id Card with emergency contact

Cold pack

Glucagen

Medical ID bracelet