Interview with Extend Nutrition!
A few days ago, I had the honor of being interviewed by the team over at Extend Nutrition. In case you’re not familiar, Extend Bars are a specially formulated snack bar that were developed by world-renowned endocrinologist Dr. Francine Kaufman to help prevent overnight low blood sugars. After several attempts of trying to create the perfect concoction in her own kitchen, Dr. Kaufman finally created Extend Bars, which help control blood sugar for up to nine hours. Today, the brand has expanded their line to include a variety of snacks, and their website has a host of diabetes resources, including a blog and multimedia section which is where I landed. Their head of marketing and I got on the phone the other day to talk about bikes, blood sugars, and being a diabetes zen master. Click play to listen to the interview! And visit Extend Nutrition’s website to learn all about their cool products.
Diabetes: Your most annoying coworker.
I woke up low on Tuesday morning – 53mg/dL. I forced down a tablespoon of frosting before showering and getting ready for work. By 8:30am I had hunkered down at my desk to get some paperwork done while I waited for a work delivery to arrive at my house. Between 8:30 and 10:30am, time completely disappeared into the black hole known as my job. I was on the phone, on email (sometimes at the same time), I talked to my boss, I planned a training with a co-worker, I put out a proverbial fire for a customer, I unloaded my car so my delivery boxes could fit in, I loaded up my sample fridges. I did a whole ton of extremely important things on my work to-do list.
One thing I didn’t do? Check my blood sugar. I didn’t click in to my DexCom, even though it was right there on my desk. I didn’t do a finger stick test before nibbling on the egg whites I made myself while on the phone. I just didn’t bother to check in with my diabetes at all. And that oversight landed me at 202mg/dL by 10:30am when I finally paused and thought to myself “I’m kinda thirsty.”
Although it seems like it might be a nice thing to forget about your diabetes sometimes, the end results are never pretty. I hate it when distractions are what cause me to have a d-management slip up, because I’m normally thinking about this disease all the time. I also hate the fact that I can’t even go two hours without a diabetes problem – I should be able to throw myself whole-heartedly into my work for that long and not have to think about something else.
But that’s the thing about diabetes: no matter how long your work hours are, diabetes is working longer. It’s always on call, and it’s always doing something in the background, even if you’d like for nothing more than for it to be quiet for a minute. If diabetes was a co-worker, it would be constantly faxing, emailing, conference calling you and screwing up your meeting schedule all at the same time. And you’re not even allowed to move cubicles to get away from it. Talk about a hostile work environment!
Surf’s up! But where’s my BG at?
Summer is on the rapid arrival here in San Diego, and that means warmer days and warmer ocean temperatures. And it means I’ve been able to try out my birthday gift (a surfboard!) that I got back in December, finally. On Saturday, my fiancee and I went out in our wetsuits and put in a solid 45 minutes of surfing. If you think that doesn’t sound like much time, I dare you to try and paddle past just one Pacific ocean wave set without completely running out of breath. It’s an ass kicker and I may be in shape for kickboxing, but not for surfing. This is part of the whole “getting back into it” thing. Anyways….I caught three pretty darn good waves in that 45 minutes, so the day felt like a success to me, even though I got pummeled by an additional three waves in between the successful ones.
I tested before I went out in the water, and I was at a nice, round 100 mg/dL, but since I had bolused for breakfast only two hours before, I decided to eat a snack just to be safe, plus I turned down my basals by 50%.
I haven’t yet devised the perfect waterproofing system for my DexCom yet, so I was out there sans device. And although my basals were down and I knew my BG was at a decent number and I’d had a snack, I couldn’t shake the “low paranoia” that often accompanies water sports for me. When you’re duck diving under waves, gets thrown off your board, and physically working so hard, it starts to feel like you’re low all the time. Something about being in the water makes me have trouble recognizing how I’m really feeling. As I tire from paddling, I get convinced I’m going low. It’s similar to my trouble with distance running: when I’m training for a half marathon, I get sweaty and fatigued, which happen to be low symptoms as well. That’s why running with my DexCom has been such a game changer for me – I now no longer over do the carbs on my long runs. Similar feelings are true for surfing: the pounding water and the physical exertion mask my ability to sort out how I’m really feeling, and the physical symptoms of a low become clouded.
That said, even though I felt like I was heading low, I finished my surf with a BG of 99 – I’d guessed right on my need for more carbs and a reduced basal rate so that worked out. But my enjoyment of surfing was somewhat interrupted by my low concerns. It’s time to get the DexCom a fully functioning water-proof contraption, and I’m going to start by using the flexible, water-proof camera case my fiancee gave me for Christmas (he’s good with the gifts, eh?) and seeing if that fits comfortably under my wetsuit against my chest. If I go low, it will vibrate and I can GU-pack it right there in the water (I always tuck a GU in my wetsuit for surfing adventures). Let me know if anyone else out there has some good ideas for waterproofing Le Dex!
What you can learn from your local diabetic Ironman…no really…
At this year’s Tour de Cure, besides it being one of the biggest days of my life, I had the pleasure of meeting a diabetes hero of mine named Mari Ruddy. Mari is a two time cancer survivor and has also had diabetes for decades. She’s also an avid cyclist, and when she went to her first bike ride to benefit cancer research, she was amazed at the outpouring of support the cancer survivors at the ride received. Then she went to a diabetes ride and there was…nothing. Out of her disappointment, Mari created the Red Rider program, which all Tour de Cure rides across the country have now adopted. The program gives every single person who rides with diabetes in a Tour de Cure a free jersey that proudly proclaims their status on the back. On the day of the event, you know who all the people are with diabetes by their bright red jerseys, and the amount of support us folks with diabetes receive is amazing. Mari’s idea was born out of her frustrations, and became something so incredibly positive and uplifting. It was so fun to finally meet her and get a chance to pick her brain.
As it turns out, Mari hasn’t stopped with her creative ideas: she now runs Team Wild, a cycling and sports camp/advocacy group for women with diabetes. When I talked to her about Team Wild, she said something that fascinated me: she told me that if all people with Type 1 diabetes were able to train like an elite-level athlete, and have the opportunity to understand their diabetes through the lens of a pro sportsman, we’d all have better management.
Whoa – wait a minute was my first reaction. Not everyone has the desire to even get on a bicycle, let alone ride for a 100 miles on one or train for an Ironman. But she further explained that that wasn’t her point. The idea is that if just for a few days or weeks, a person could see how exercise, food, rest, stress and everything else that goes along with sports training affects their blood sugars, we’d all have a better understanding of our bodies, this disease, and how to manage it. And that’s an idea I fully stand behind. Elite diabetic athletes like the members of Team Type 1 train with some of the best endocrinologists, CDEs, dieticians, and exercise physiologists to understand what their diabetes is doing all the time. They use the latest technology to understand patterns, and what works for them and what doesn’t. Often with diabetes, the more you know, the better you manage. Why not train like an athlete for a period of time and gain invaluable insight to your personal diabetes?
Fortunately for those of us who don’t have access to Team Type 1’s fleet of experts, or even the latest gadgets, there are several diabetes camps for adults cropping up throughout the U.S. Team Wild is one of them (camps in Colorado and other locations), and Diabetes Training Camp in Pennsylvania. If you ever went to diabetes camp as a kid, then you know it was an amazing experience to be around a bunch of people who know exactly what you’re going through. Now imagine that same experience as an adult, and a chance to reboot your diabetes know-how. Unleash your inner athlete, and kick some ‘betes but while you’re at it. Sounds pretty fun to me!
Things that make me feel like a rockstar include:
Bolusing so perfectly for this potentially disastrous meal of fish tacos (protein + carb + fats usually = blood sugar land mine)…….
….that my CGM looked like this the next morning. Steady as she goes, all night long, nary a beep or a blip to disturb my slumber.
If only every night could be like this. Happy Friday folks!
Forward Facing Defense
Its probably obvious by the very fact that you’re reading an open blog written by me that I’m very public about having diabetes. I tell people at the gym that I have diabetes, the people I work with, all my friends – shoot, I even tell the grocery store cashier that I have diabetes whenever they ask me why there’s so few carbs on the conveyor belt. I’ll talk to anyone about having diabetes. I’ve also built a life for myself around this disease – my work, my hobby (this blog), and my volunteer work are all about diabetes. Someone asked me the other day if I ever feel like I need a break from living so entrenched in this subject. Looking at my life and the amount of time I spend talking about diabetes, its natural to think I seek respite from this topic occasionally.
But what people don’t know about my public diabetes persona is that in a way, it’s a kind of therapy for me. When I was a teenager and landed myself in the hospital with DKA, it was because I wanted to hide having diabetes. I was embarrassed and ashamed of it – I didn’t want to be different from anyone else so I just ignored it. And sure enough, being the insidious disease the ole ‘betes is, it snuck right up and bit me in the ass.
After being hospitalized, I realized there was a certain power in beating people to the punch. After my DKA and the summer of recovery that followed, I went off to college and told all my new friends and roommates right away that I have diabetes. That way, we could get the questions out of the way right off the bat. Go ahead, make your jokes about “shooting up,” ask me if I ate too much sugar as a kid, question why sometimes I HAVE to have sugar - get all of those stereotypes and questions off your chest and THEN we can have a real conversation about what it means to live with Type 1 diabetes – and a real conversation about the rest of me.
The outward facing attitude about living with diabetes that I adopted in college has stuck with me. I’m more comfortable putting everything out there before someone else does, and so for me, that’s a way that I deal with and compartmentalize having this crazy disease. It’s not for everyone – if someone is more comfortable staying mum about their ‘betes and that works for them then that’s great too. We all have to disclose the level of detail we’re personally comfortable with.
But for me, I like to let you know about the diabetic elephant in the room, and then move on to just being me.
Diabetic elephant….now that’s a scary thought – how much insulin do you think one needs!?
Thank goodness he’s CPR certified….
The scene: Alexis is going “gym shopping” in hopes of finding a workout facility closer to her home. It’s Sunday morning at 10am, and she’s just walked in to a local gym specializing in kickboxing and MMA. Her hopes and spirits are high, but her blood sugar is a little low, so in the interest of safety, she decides to disclose her ‘betes to the instructor of the class she’s about to take.
Me: “Ok great, I’m so excited to take your class. Just so you know, I have Type 1 diabetes and I….”
Fitness Instructor (who could physically be confused for the Incredible Hulk, but mentally confused for…a toaster): “Awwww whoaaaaaaa! Diabetes?!?? Well I’m CPR certified but if you go all weird on me I’m calling 911 and getting the heck outta here! Hahaha!”
Me: “Um. Right. So CPR won’t help you with a diabetes emergency. But calling 911 would be a good start. Anyways you don’t have anything to worry about – I’ve never had an emergency at the gym, but occasionally I need to come off the heavy bag and check my blood sugar, ok?”
Fitness Instructor: “I give one water break about half way through the class.”
Me: “Yeah. Um. Ok. So let me see if I can explain this better: In order to PREVENT an emergency, sometimes I have to check my blood sugar in the middle of class. I won’t wait for a water break to do it. Ok?”
Fitness Instructor: “Do you have to prick your finger with the little thingy?”
Me: “Yes. That’s a glucose meter. It measures the amount of sugar in your blood.”
Fitness Instructor: “I saw this commercial on TV that says you don’t have to get the blood anymore and stab your finger. It checks it without blood. Why don’t you get one of those?”
Me: “That sounds…really cool. I’ll look into it. I’m going to go warm up now….”
Scene.
Alexis did not join that gym. But she does continue to patronize Comedy Hour at this gym on a regular basis.
The Tape Wars
At any given time, my body may looks like a canvas for dried glue artwork. The adhesives on my insulin pods and my DexCom sensors often leave behind a sticky signature, and sometimes it can take quite a bit of work to get it off. I change my pod every three days and my sensor every seven, so it seems like there’s always something being moved and re-set and newly-infused that leaves behind a gummy shadow of itself. Sometimes I get so tired of scrubbing away at the residue that I give up and just leave it. Which means you run around with a tape-gunk ring on your tummy (like in the pic below) that makes you feel like you’re the smelly kid from Charlie Brown with the flies over your head. Diabetes residue. Gross.
Tables turned.
I have written MANY blog posts about the obnoxious things people say to people with diabetes out of ignorance. It seems like every day I get a comment or a question that’s offensive/prying/downright rude, and all because the person asking doesn’t know anything about what it means to live with diabetes.
But last weekend, I found myself on the other side of those questions, in those exact obnoxious shoes. My older sister is seven months pregnant, and me, knowing nothing about being pregnant, found myself saying things like:
“Are you feeling ok?”
“Should you be carrying that?”
“Did you get enough sleep?”
“Do you need more sleep?”
“Do you want to sit down/not drive/not carry that suitcase?”
“Are you allowed to eat that?”
ME. I said that! I asked her if she was allowed to eat whatever it was that she had ordered as if she isn’t a grown woman who’s been pregnant for seven months and is also one of the smartest people I know and entirely competent at keeping track of what one should and should not be eating while pregnant AND DID I MENTION I’VE NEVER BEEN PREGANT?
Seriously, I could not believe myself looking back on the weekend. There were so many times I checked in with questions that are essentially already being answered by her very action (e.g. if she’s not supposed to carry something, she won’t carry it – no need to ask the question while it’s happening. She knows what to do.).
My sister isn’t only smart, she’s also incredibly kind and patient, and so she never once over the weekend gave me a smart-ass answer to one of my questions, even though I am sure some of them seemed ridiculous. But in retrospect, it truly helped me understand where some folks are coming from with their diabetes questions. Sure, we all get the off-the-wall, completely-based-in-science-fiction questions that NO ONE should be asking, but most of the time, people are just concerned and they don’t know any better. And can you really blame other people for worrying about your well-being? No. Good intentions are often at the root of these inquiries. Especially if they are someone you care about. Like say your pregnant (and very patient) sister, who’s likely going to read this post – thank you for letting me be annoying 
Things that drive me nuts include:
This.
Especially because I was about to bolus waaaaaay to much for dinner to correct the high my DexCom was showing. Glad I checked with a finger stick!
Technology: Amazing when it works, the biggest pain in the ass when it doesn’t.