Category Archives: Type 1 Diabetes

Rheumatoid Arthritis Type 1 Diabetes

Where do you sit?

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I read an interesting article this morning by Dr. Jack Cush on RheumNow and I’m wondering, where do you naturally choose to sit in an exam room?

Dr. Cush’s unofficial statistics show that 55% of patients sit in the chair furthest from the doctor, 25% on the exam table, and the other 20% in the chair next to the doctor’s desk/computer (see his diagram below):

seating

My rheumatologist, endocrinologist, and PCP are all part of the same hospital system. My rheumy and endo have offices set up almost exactly as the image above. I always sit in the chair next to the desk. In fact, it never occurred to me to sit in the chair furthest away, sometimes I use that chair to hold my things. My PCP’s office on the other hand is different. They use a COW (Computer on Wheels) and it is almost always placed right next to the exam table. In all my years of going to my PCP’s office, I don’t think I’ve ever utilized a chair in the room.

I find this interesting because my visits with my rheumatologist and my endocrinologist, are more conversation driven. There is less exam and more discussion. In my PCP’s office, there is more of an even amount of conversation (explaining symptoms) and examination. Therefore, in my mind, sitting on the exam table makes sense.

If you are one of those that sit in the chair furthest from the doctor, think about why you do it. Is it a new physician that you are unsure of? Are you truly comfortable with your doctor? Do you feel at ease asking questions of your doctor? And most importantly, are you playing active role in making decisions about your disease?

Please read Dr. Cush’s article and let me know your thoughts in the comments below!

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Favorite Things Hope Type 1 Diabetes

Only Human and Type 1 Diabetes

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human

I am a regular podcast listener. In fact, I love my podcasts and one of my favorites is Only Human. Today’s episode, The Robot Vacuum Ate My Pancreas, is worth every second of 33 minutes. Today’s topic is Type 1 Diabetes and features Dana Lewis (you can visit her on twitter here) and her artificial pancreas system.

There were two specific moments during this podcast that I felt the need to share this podcast with everyone I know. Hearing other Type 1 Diabetics, especially children and their parents, talk about how much their life has changed by using an artificial pancreas, brought me to tears. I cannot fathom being a parent of a child with Type 1 Diabetes- managing my own disease is difficult enough. Hearing a child’s little voice and then the voice of their parent, I could almost feel their relief coming through my car speakers.

My absolute favorite part of this show was when Kenny Malone compared keeping a car at exactly 70mph while driving, to keeping your blood sugar at the perfect number, was amazing. I have struggled for years with getting others to truly grasp the time and attention this disease demands from me. I think this explanation is going to help me tremendously in getting my disease a bit more understood.

Please take a listen (or read the transcript) and let me know your thoughts!

 

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Rheumatoid Arthritis Type 1 Diabetes

It Must Be

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Growing up with Type 1 Diabetes, I was always aware of how I felt and if those feelings were due to my diabetes. Did I feel dizzy? Thirsty? Tired? Confused? These could all be easily attributed to a low or high blood sugar. Once diagnosed with Rheumatoid Arthritis, I added more physical feelings that I could attribute to my disease. Pain, stiffness, muscle aches, popping, cracking, etc. I am constantly putting those feelings into a bucket- the diabetes bucket and the RA bucket. Occasionally there is the “normal human” bucket where a cold, for example, might fall but even the normal bucket spills over into the disease buckets.

what-are-the-symptoms-of-ebola-because-i-am-pretty-sure-i-have-some-of-them-like-this-itchy-index-finger-f72f0

Being a parent to children who currently don’t have any major health issues when I do, can add a strong element of fear to my life. I question everything- “Didn’t he just go to the bathroom twenty minutes ago?” Must be diabetes. “Her knee keeps hurting, yet nothing happened to it.” Must be arthritis. “She keeps sleeping in on the weekend.” “His hands are really achy today.”

No, I don’t spend all of my time analyzing their every move or every sip of water they take. But these little thoughts pop into my head from time to time. Is there anything I can do to prevent one or both of them from developing an autoimmune disease? No. So why harp on it? Because I don’t want them to suffer. Of course I don’t want them to suffer having a disease, that’s obvious. But what I mean is that I don’t want them to suffer through waiting for a diagnosis. With Type 1, my parents were repeatedly told that I had a virus, to let it go. My father, a type 1 diabetic himself, eventually had enough and tested my blood sugar at home. I was immediately hospitalized. With Rheumatoid Arthritis, I spent months going to multiple doctors, telling them something was wrong, only to be told that I had tennis elbow and was favoring my joint. It took me not being able to walk anymore for someone to take me seriously and run a battery of tests. I don’t want my children, or anyone, to experience that fear, that unnecessary pain or stress on their body.

So if I can’t control who will get which disease, what can I do? I can advocate and educate. I can share my diagnosis stories, my disease symptoms, with anyone and everyone. I can share what I’ve been through and what I’ve learned with parents, doctors, friends, family, strangers. I can empower my own children to research their concerns and know that every question they have is important.

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Rheumatoid Arthritis Type 1 Diabetes

Tidepool Love

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Last Saturday I had the privilege of going to my local JDRF TypeOneNation Research Summit. I learned valuable information and got some reminders I really needed (like bolus 15 minutes before eating, duh). Aside from wanting to share everything I had learned and ask everyone I knew to donate to JDRF, I walked away with an important action item for myself. Get set up with Tidepool. And that I did.

Quick background- I have a Minimed 530G with Enlite system. I also have the Minimed Connect which you can learn about here. I upload to Carelink via the Connect and I pretty much just glance at my screen, look over the past few hours, and try to make decisions on my diabetes. Sounds like a great plan, right? Uh, no.

Everything affects Type 1 Diabetes- food, stress, sleep, activity, hormones, etc. I’m fortunate enough to have Rheumatoid Arthritis to complicate things even further. My pain increases my blood sugar so much that I have a higher basal rate in the evening, for when my pain is at its highest.

Wouldn’t it be great to view my Continuous Glucose Monitor data and make little virtual notes on it, throughout the day to reference my pain, what I ate, when I exercised, when I felt stressed, etc.? Maybe it would look like this?

Screenshot (4)

So cool, right? It’s Tidepool’s software (with the best name ever) Blip and it’s corresponding app, Blip Notes. Setting up Tidepool is a breeze- they are one of those wonderful sites where your username and password work for everything- no need to create 5 different combos for one site. You download the uploader (haha) and off you go! Don’t worry if you don’t have Minimed products like me, it works for most of those other companies too.

Even without the Blip notes, the data is impressive and informative. It shows things like how many fingersticks you’ve done (I need to work on that too…), boluses entered, basal tweaking you’ve done, etc.

Screenshot (1)

 

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For me, Blip notes is the icing on the cake. Free and easy to use. You create a new note, select one of your frequently used hashtags (at the top) or create a new one, add your note and done! Super easy, very quick..time and date are automatically added (you can change if needed).
image                             image

I’d love to hear your thoughts on Tidepool- have you tried it? If so, what’s your favorite thing about it?

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Favorite Things Rheumatoid Arthritis Type 1 Diabetes

Giveaway time!

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If you read my Favorite Things Part One post, you already know that I love my NatraCure Arthritis Booties. NatraCure is a wonderful company and they’ve generously donated a pair of booties for me to give away! The contest starts tomorrow, February 18th at 12am. Good luck!

onfeet-hot_1

 

Guaranteed to deliver relief in minutes, NatraCure Arthritis Booties combine traditional heat therapy with cutting-edge SmartGel® Technology for the proven solution you’ve been looking for.

 
a Rafflecopter giveaway

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2,016 Miles in 2016 Rheumatoid Arthritis Type 1 Diabetes

Triple Digits

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2,016 miles in 2016!(3)

I’ve reached triple digits in my 2,016 miles in 2016 challenge! This week was especially hard. With a nasty blizzard on it’s way, my joints were angry all week in anticipation. I rejoined the gym and was able to use my favorite machine, the Arc Trainer, which is much more gentle on my joints than walking or doing other cardio exercises. If you have Rheumatoid Arthritis or any joint issues, I highly recommend giving it a try.

The other hurdle I’m trying to deal with is my blood sugars plummeting while I exercise. My endo gave me a lot of suggestions on when to start temp basals on my pump, what to eat, etc. but this week was still bumpy. Even after eating a banana and a peanut butter sandwich before exercising, having my insulin completely suspended, I will still drop dramatically during exercise. I hate the idea of having to eat because of exercise, very frustrating. This week I’m going to try drinking Gatorade while I exercise- low cal but has some sugar so hopefully it will keep me in check. If you have Type 1, like me, how do you deal with lows while exercising?

In order to meet my weekly mile goal, I made sure I went to the gym every day, Sunday through Friday, including Thursday night and back Friday morning before the storm. I gave myself a much needed break on Saturday (doubt I made it over a mile). Today my joints are still pretty painful plus I have the added bonus of a methotrexate hangover but I’m hoping to meet my step goal by moving around my house. We’ll see!

 

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2,016 Miles in 2016 Rheumatoid Arthritis Type 1 Diabetes

Still moving..

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2,016 miles in 2016!(1)

It hasn’t been easy but I’ve kept up with my goal of walking/running/crawling/dancing my way to 2016 miles in 2016. There are days that I don’t want to move at all and days that despite telling myself the opposite, I don’t feel better after reaching my goal of 5.5 miles a day…I actually feel worse.

But I’ve kept on. Why? How?

  • I’ve made my goals public. Very public. I talk about them at work, at home. I post on Instagram, Twitter, and Facebook.
  • I’ve broken down my goal into smaller daily/weekly goals.
    • 5.5 miles a day or 38.8 a week doesn’t seem as insane as 2,016 miles
  • I have even smaller goals for steps during the day at work
    • 2,000 by 10am; 3,500 by 12pm, etc.
    • I try to get up and move around every 30 minutes, even if it’s just marching in place

I’d be remiss if I didn’t mention my Fitbit. From weekly or weekend challenges with friends to just seeing my steps and miles go into the “green”, my Fitbit One is a tremendous motivator and makes keeping myself accountable super easy.

How are your resolutions or goals going? What helps you to stay on track?

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2,016 Miles in 2016 Rheumatoid Arthritis Type 1 Diabetes

Resolution to move!

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2,016 miles in 2016!

This year I’ve committed to walking/running/crawling/dancing my way to 2,016 miles in 2016! This resolution was an easy one for me to commit to in theory. Getting my steps in each day makes my blood sugars better, makes them more consistent. Walking makes my joints feel better (my knees haven’t gotten this memo yet but they’re working on it) and will strengthen the muscles around my joints, providing them with better support.

So how does 2,016 miles translate to daily goals? I need to get between 5.5 and 6 miles in each day. This is about 12,000 steps or so depending on the activity I do. On days I’ve been feeling strong, I’ve tried to get a little more than 6 miles to cover the days where my joints are angry and having nothing to do with any resolution I’ve made.

Every Sunday I plan on updating this graphic to keep myself accountable. I track with my Fitbit and they calculate my weekly miles to make it easy for me.

What resolution(s) have you made? Are you still going strong on Day 10?

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Rheumatoid Arthritis Type 1 Diabetes

Injecting Emotions

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I get emotional after my methotrexate and Enbrel injections. Sure they hurt but this is after the pain has subsided. The tears come. I took the time this morning to think about why I get so teary. 

  

Type 1 Diabetes is real for me almost every minute of the day. I don’t have periods of coping, I’m on insulin, via a pump, attached to me 24/7. Sure a high or low might rock me for a moment but I’ve had the disease for over 27 years and I’ve come to terms with it. Does it suck? I guess. But in the big scope of life, it’s manageable. Bolusing for meals is second nature…I often don’t have to think about setting up a temp basal if I’m trending low. I just do it. 

Rheumatoid Arthritis is different. It isn’t a quiet disease. There is pain that brings me to tears, makes me truly want to give up. Pain wakes me at night, makes it difficult to drive. Fatigue hits me like a wrecking ball, I truly believe I could lay down anywhere, at any time, and sleep. 

Taking my weekly injections are a reminder that my disease is winning. Seventeen injections of Enbrel and things aren’t even predictable or controlled yet. Adding methotrexate back in is a gamble. I could easily get an infection (as I have before) and I have a guaranteed weekend of fatigue and nausea. 

I cry after my injections because it’s a moment where I don’t have control. I can’t take these drugs and get immediate results like I do with insulin. I take them and hope that this is the week I’ll feel amazing, I’ll feel something. And the honest truth is, deep down, I don’t think that’s ever going to happen. This jerk of a disease will somehow always manage to come out on top. 

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Chronically Grateful Rheumatoid Arthritis Type 1 Diabetes

Who on your healthcare team are you most grateful for?

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Day 2 of the #ChronicallyGrateful challenge: Who are you most Grateful for on your healthcare team?
  
Having multiple chronic illnesses is hard. Having both Type 1 Diabetes and Rheumatoid Arthritis is especially difficult. One of the standard treatments for RA is prednisone which makes life with diabetes hell. Other issues aren’t as well known. Stress can raise your blood sugar and so can pain. Rheumatoid Arthritis causes tremendous pain and I am often battling with my blood sugars as a result. 

I’ve had Type 1 for over 27yrs and have always felt the need to be a “perfect” diabetic which translates to “perfect” blood sugars. At my last endo visit, I told my doctor how hard it had been to manage my blood sugars while my disease flared. She looked at me and said “you’re doing the best you can”. Those little words meant the world to me. She saw me as a person, not just a “person with diabetes”. 

Therefore, the person I am most grateful for on my healthcare team is my wonderful endocrinologist. 

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