Oh for wrist’s sake…
Its been eight months since I went in for carpal tunnel release surgery in my right hand, and I’d love to be able to say things are picture-perfect. But with the way the last few weeks have gone, I can’t say that with confidence. In addition to still not having my full strength back in my right hand, I’ve got other issues cropping up.
Back when I was diagnosed with carpal tunnel via the ridiculously archaic method of being electrocuted while needles were stuck in my hand muscles (I’m dead serious – THAT is the method available in modern days to diagnose carpal tunnel-its like a horror movie), both hands came back showing carpal tunnel issues. Even though my left, non-dominant hand came back showing more damage than the right, I opted for surgery on the right hand first because 1.) I had more discomfort in that hand and 2.) it’s way more of a pain in the ass to get surgery on your dominant hand than the other. I wanted to get rightie over with in order to minimize future gimp-ness.
As I’ve blogged before, the carpal tunnel release was mostly a success, but after a few weeks I still noticed numbness in my pinkie and ring fingers on my right hand. The doctor let me know that in addition to the carpal tunnel entrapment I’d had, there was also some ulnar nerve irritation going on (awesome!) That could be easily “treated” by following the super-scientific methodology outlined in this post, but it’s unfortunately exacerbated by one of my favorite activities – cycling. However annoying it is, this issue I’m willing to live with.
In the past few weeks though, it seems my left hand has decided to let me know just how uncomfortable it is via painful, lengthy, wake-you-up-in-the-middle-of-the-night pain from numbness. Sometimes it’s so bad I have to lay there opening and closing my hand for 5 full minutes before the feeling returns from pins and needles. It feels like my wrist and middle finger are on fire, and I can’t tell you how frustrating it is to not be able to sleep through the night again. This one, I am not willing to live with. Sleep is important people! And not to mention I have enough crap waking me up in the middle of the night (CGM, having to pee if I’m running high, my own snoring…don’t tell anyone that last one…)
But, because I’d like to avoid surgery if at all possible, I’m trying everything else I can before I head back to the OR. This means being diligent about icing my wrist, wearing a super-sexy wrist brace to bed, and popping the ibuprofen after activities that could irritate it. I’ve been using an ergonomic keyboard and desk set-up for years now, but without changing professions, I can’t avoid heavy computer use and will have to look for other ways to assuage the symptoms.
By the way, the fact that I just wrote an entire post about carpal tunnel syndrome makes me feel like I am 90 years old. Bugger. If anyone out there has other suggestions about coping with the “carp,” holla back.
Just a wee bit lower would have been awesome…
Been running literally between 153 and 174 for SIX hours, including lunch and when I lowered my basals before working out. Then, an hour spin class pushes me through the 200s….let me say that again: spin class made me go up? Is this the same class I needed two GU packs just to avoid a low in last week? ‘Betes, you make no sense. But I already knew that.
Mind the gap…
This past Saturday, I volunteered at two ADA events that reminded me just how sharp the disparity of healthcare is in this country. The juxtaposition of the two populations at these different events was stark and stirring – and made me remember that diabetes care is just as much about the luck of the draw as it is personal effort.
The San Diego Feria de Salud was held in National City on Saturday, which is an annual health fair event aimed at the Latino population here in SD. Latinos are considered a high risk group for Type 2 diabetes; a mixture of genes, socioeconomic status, and deep-seated lifestyle traditions contribute to this population’s growing diabetes epidemic. Feria de Salud is an opportunity for Latino folks without access to good healthcare to get important screenings and check-ups at no cost. This year Feria also offered H1N1 vaccines in addition to foot exams and glucose tests.
Walking up to the local gymnasium that housed this event, English faded behind me and Spanish words began to fill the air. The line for health screenings was out the door, wrapping partially around the building, packed with men, women, and hundreds of children. The lively beats of the local Spanish radio station played in the background to keep those in line entertained.
Inside the gym, dozens of vendor tables lined the walls, offering everything from low-cost clinic services to insurance to flu vaccines. Shortly after my arrival, a group of second graders took to the “stage” to perform a traditional Mexican dance. If you closed your eyes in that gym, you would have no idea that you were in America. Everyone is speaking Spanish, the lively chatter and laughter filling the room.
I check in with the ADA director, and while we discuss how well the event is going, a man asks in broken English if there are eye exams available. The director shakes her head and tells him, sorry, not this year. He turns, disappointed, to his wife and children telling them “No tienen examen de ojos,” to which his wife, frustrated, replies “Pero dijo en la radio y la tele si hay…” (“but they said on the radio and TV there would be…”).
I think about the eye doctor I see every year for my full diabetic eye exam. I think about his comfortable waiting room, full of ads for $8,000 Lasik corrective surgery. How he turned one corner of his office into a mini-eyeglass boutique that sells the latest Gucci frames to his wealthy customers. How I simply show my insurance card to the front desk manager and I’m seen by the physician, without cost. How I have the ability to take the best care of my diabetes because of the fortunate position I’m in.
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Isn’t that just the best?
Thank you, Diabetes Technology. And everyone have a wonderful weekend!
Thanks for that, ‘betes…
Anyone with diabetes knows that you spend hours upon end thinking about your disease: counting carbs, dosing, crunching numbers, treating lows – there’s a lot of time dedicated to diabetes. But what surprises me is how having diabetes has directly affected where I spend my time. Both my job and extracurriculars are more often diabetes-related than not.
I work at a pharmaceutical company that makes diabetes drugs, and I’m often tapped to give the “patient perspective” on living with diabetes and using our company’s product. Just this week I gave two such trainings, and was asked by a representative to come out for a field ride for more of this exchange. On Tuesday, I got up in front of 1500 people at our all-employee meeting to promote the Tour de Cure San Diego. Later that night, I went to Tour de Cure Committee planning meeting. Thursday I’ll help with corporate team recruitment for the same cause, and this weekend I’m hitting two diabetes events in my community. In just one week, I’ll have dedicated 14 hours to diabetes-related activities – not counting managing my own!
The fact is, diabetes is 24/7. Because of the dedication this disease demands, it can’t help but shape decisions and pathways in your life, including career and hobbies. It’s no mistake that I work at a company that makes diabetes products – it makes my day to day more meaningful to me even if the individual tasks don’t seem related. I volunteer with the ADA because it increases my network of support, and allows me to have an impact in the fight against diabetes.
I suppose one might think that since I already have to manage this disease all the time, I’d be more inclined to choose activities that weren’t so diabetes focused, so I could take a “break.” But the opposite is true: entrenching myself in the diabetes community, allows me more control over the disease by offering support and purpose to my life. In fact, I feel lucky that I have a passion in life – there’s plenty of 20-somethings out there trying to figure out what gets them amped. Having diabetes certainly doesn’t define everything I am, but it has given me a certain identity and in turn the opportunity to make an impact – and in that respect I am so thankful to have diabetes, to have this opportunity and purpose. It’s nice to say “thank you” to diabetes today, isn’t it? 
Past Post: The Case for Pharma Reps
Before I was a real-live blogger myself, I had the chance to guest post for the original dia-blogger herself, Amy Tenderich, author of the well-know and well-respected DiabetesMine blog. She and I met when she was the guest speaker at the inaugural Celebration of Strength Luncheon for Women with Diabetes, hosted by the Behavioral Diabetes Institute. Writing for Amy’s blog was part of the inspiration to start my own blog, and I always be thankful for the opportunity she gave me. Here’s a re-posting of my October 2008 entry. And be sure to check www.diabetesmine.com for the details on the 2010 DiabetesMine Design Challenge – a contest that challenges creative thinkers and innovators to come up with the coolest and most helpful new diabetes gear!
My Life as a Compliance Analyst: The Case for Pharma Reps
I met Alexis at the recent BDI luncheon for women with Type 1 diabetes. She seemed bubbly and smart, and I felt an instant connection. When I discovered her job title was “Compliance Analyst,” I just had to hear more about that. Turns out it’s not quite what you think, but fascinating nevertheless.
A Guest Post by Alexis Pollak —
Compliance. It’s not a word people with diabetes are fond of. “He’s not compliant.” “She’s a non-compliant patient.” These phrases get thrown around pharmaceutical companies and doctors offices all the time. As if we should all be graciously agreeing to have diabetes and all the responsibilities that come with it. But since taking on the role of “Compliance Analyst” in the pharmaceutical industry, the word now has a completely different meaning to me.
I have had type 1 diabetes for 15 years, and as I entered the confusing decade known as your 20s, I knew I wanted diabetes to be incorporated in my career. Through trial and error, I finally found my niche in the pharmaceutical industry. The drugs my company makes are groundbreaking, first in class medications that have given people with diabetes new options that are truly changing the way people care for the disease. This company was a perfect fit for me: dynamic, challenging, up-and-coming, and on the cutting edge of diabetes treatment. However, if anyone had told me a year ago that taking any position with the word “Compliance” in the title would be dynamic, challenging, and even fun, I think I would have laughed in their face!
What I did know about the position initially was that the manager was one of the best in the company, the title was a step up from my current position, and it had “room for growth.” What I didn’t know is that it would open my eyes to the core of the healthcare struggle in America, in particular to people with diabetes. My job duty as a compliance analyst is to maintain knowledge of the various regulating laws and policies around pharmaceutical activities, and ensure that the company stays within those guidelines. Regulating bodies include the FDA, the Department of Health and Human Services, and the Pharmaceutical Research and Manufacturers of America (PhRMA) Code. Most regulations center around training for sales and marketing teams, as well as keeping a close watch on the interactions that sales reps have with physicians.
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I promise to tell the whole truth…
As most of you can tell from this blog, I’m pretty open about having diabetes. Even though there are often negative reactions when you “put it out there,”(“oh, you have diabetes because you ate too much sugar, right?”), it hasn’t stopped me from sharing my thoughts on the disease, or doing whatever I have to do to take care of my health. That includes this blog. Since I interact in the diabetes community so much, I often find the opportunity to mention that I have a blog. I started this site because I found such tremendous support from the online community that I wanted to take a greater role in that population. And most often, the feedback I receive from readers is that it’s an excellent source of support and that it helps communicate what its like to live with diabetes to those that don’t have it.
That’s not to say that the feedback on my blog is always good – and I wouldn’t expect it to be! They say you’re not a real writer until you have critics, and I would never be so naïve as to think everyone will always like what I write – I’ve got the negative comments to prove it! But one thing I never expected to feel was guilty about making a negative impression on a newly diagnosed person with diabetes.
A few weeks ago, a friend reached out to me asking for my blog site. Someone her husband worked with had just been diagnosed with diabetes in his late 20s, and she wanted to pass the blog on to him. I did so and hoped that it would help him know that he is not alone with this disease and that there are tons of people out there that know what he is going through. I ran in to my friend last week and she brought up the newly diagnosed acquaintance.
“He said it was really hard to read your blog” she told me.
Gulp. “Really? Why was that?” I asked, already feeling upset.
“Well he read about a really tough day you were having and I think it was discouraging,” she told me.
“Oh. Well, shoot, that’s a bummer, because I write about the good days too” I reminded her.
“Yeah, I know, actually the day I checked it though it was about a really bad day too – something about being a on a rollercoaster with your blood sugar.”
Crud. That was a really bad day. “Yeah, that was a tough day, I see what you mean.” I told her.
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The weekend included, but was not limited to, the following…
This weekend was full of ‘betes snapshots – both literally and figuratively. By literally, I mean I took a lot of pictures. By figuratively, I mean there were many funny, annoying, awesome, awkward, and interesting diabetes moments this weekend. Moments that made me stop and think about the way my frame of reference for everything in life is around diabetes, whether conscious or not. There were dozens of carbs counted, one call in to OmniPod customer service, two hidden injections at a dinner party where I got self concious, one random low, several uncomfortable highs, two kinds of mac and cheese causing most of those highs, one glorious 20 mile bike ride, copious amounts of coffee, and one wonderful, liberating, totally “free” shower in which I had both my CGM and pump off (very rare these days). Here’s a few snapshots of my diabetes moments from the weekend:
Friday, going on day 11 of my seven-day sensor, I realized it was getting a wee bit ghetto as the tape was peeling back like a cheap temporary tattoo. Give it up Lex, give it up. Just because those sensors can last 14 days doesn’t mean it has to.
When I got home from work on Friday night, I noticed that the arrows on delivery boxes from Amazon.com look suspiciously like the DexCom’s arrows…..that Amazon box is headed for a LOW!
I spent Saturday afternoon through Sunday morning pump and CGM free, which felt great in some aspects, but completely foriegn in others, as these devices have become so much a part of me. When I went to put all my gear on Sunday morning, I couldn’t help but notice how much garbage a double site change generated. Check out the carnage:
Sunday, although it involved a wonderful bike ride after watching that wild USA vs. Canada hockey game, there was a large pizza that occured before said bike ride. And by large, I mean tremendous. I mean so big you wonder how the %$* anyone could ever bolus correctly for it. Check out this monster (beer added to show scale. And to be consumed).
It was an awesome and satisfying weekend overall. And as usual, diabetes was there the whole time, and I made it fit in to the weekend and all of its activities too.
‘Betes and the boats…
I love trying new sports, so you can imagine my excitement when my boyfriend said I could come along to his Outrigger Canoe Paddling Practice on Mission Bay this past Wednesday night. I participate in a variety of sports – it’s not unlikely for me to go running, biking, and kickboxing all in the same week. But water sports always present an equipment challenge for me – you can’t test in the water, and bringing ‘betes equipment in a boat is always a Murphy’s Law guarantee that it’ll be the one day you tip over. Not good if you happen to be carrying your $1,300 DexCom receiver. So what’s a diabetic girl to do when she wants to get her paddle on? Get creative! And if you’re lucky enough to have an amazingly resourceful, super-adventurous, multi-sport participating boyfriend like mine, he’s got his waterproof camera case which just so happens to fit a DexCom receiver in it. Nice! Check out how snug it was:
The only drawback was that I couldn’t just click in to the Dex at will because the hard case prevented me from reaching the buttons. But since I made sure I was steady before we pushed off, and I had turned down my basal, I knew I wasn’t headed for a low right away. During the short breaks between paddling pieces (a “piece” in paddling is simply a segment or leg of the journey), I was able to open the case quickly and see where my blood sugars were, assuaging any fears the this would happen again. And just to be safe, I had more GU packs tucked in my jacket than I knew what do to with.
We spent about an hour out on the glassy bay, gliding through the water as a team, pulling the water behind us with our 
synchronized paddling. It was enchanting to see the city lights around the bay, and to feel the calm water below us yield to our paddles with each stroke. I can see how people get hooked on this sport – if I had that much fun on a chilly winter evening in February, I can’t even imagine what a blast it is on a summer day. And more importantly, with a little extra creative planning, I proved to myself again that there’s nothing I can’t do just because I have diabetes.
Attempting to be under control.
I’ve had a consistent string of high BGs this week that started on Sunday and haven’t let up since. And I can’t help but notice the tickle in the back of my throat. I’ve already ruled out broken pump/inactive insulin/sugar-instead-of-Splenda-in-my-coffee. Henceforth, those two issues = I must be getting sick.
I’m amazed at how quickly feeling a little under the weather can bump the BGs through the roof. I’ve already taken double the amount of insulin I normally do this morning, and I’m just barely cruising under 200. I don’t want to over do it, because we all know how well the “rage bolus” works out, but I’m frustrated, thirsty, and had to pee like 17 times already this morning due to my body trying to get rid of some sugar (and also aggressive amounts of coffee. Sorry. TMI.)
I’m trying to keep the liquids going to stave off an impending cold, and keeping my meals super-duper low carb today so I don’t end up taking gallons of insulin, but its frustrating. I can’t take most of the over-the-counter cold meds, and I certainly can’t hit up the Gatorade, orange juice, or any of the other vitamin-super-powered drinks out there. I’m just here with water, copious amounts of green tea, and sore fingers from testing so much.
I’ll still hit the gym tonight – since I don’t have a fever it should be ok for me to exercise and hopefully sweat out some of this bug, but I’ll have to pay extra-close attention to the BGs since I’m already running high. Ugh. Makes me tired just thinking about it.
Sick days with diabetes suck extra much. Here’s hoping this passes quickly 