Molly Johannes was diagnosed with type 1 diabetes in 1997 at the age of four. Molly controls her diabetes with a combination of insulin shots, daily exercise, and a healthy diet. She utilizes a Dexcom continuous glucose monitor to remain aware of her blood sugars throughout her busy days at school. Molly is a sophomore English major at the University of Massachusetts, Amherst. Read full bio

Stair Breaks

Unbelievably, we’re more than halfway through the month of November – how did that happen? In any case, this means that I’m in the beginning stages of hibernation. In a college student’s dictionary, this is defined as the following:

Hibernation (verb): to be in forced isolation, as a result of impending final projects and exams. May or may not result in productive behaviors.

This compulsory state of being means that I seldom leave my apartment, let alone my room. It often causes me to feel restless as my eyes glaze over from staring at my computer screen for long stretches of time.

These stairs couldn't look less inviting.

These stairs couldn’t look less inviting.

In turn, this also means that I don’t get to fit in as much exercise as I’d like each day. Tuesdays and Thursdays tend to be the most difficult days because they’re the busiest. Granted, I only have three classes on those days, but they’re spread out so by the time the last one ends I want nothing but to go home and process what I’ve learned over the course of the day (and maybe sit back for a bit and relax while I’m at it).

However, this sometimes has an undesirable affect on my blood sugars. The lack of activity sometimes results in yucky spikes that make my CGM buzz as well as infuriate me.

Normally, I would just take insulin to correct this. But as I’ve discussed in the past, I try to avoid stacking my doses at all costs. So what’s my next go-to?

It might sound kind of weird, but the answer is stairs. I live in a five-story apartment building, and right next to my apartment’s entrance is a stairwell. It’s kind of the perfect solution because most of the time, it works more quickly than insulin and it also forces me to get up and move around. They’re literally located right outside my front door, and I don’t have to brave the cold or find a spare block of time to make it to my school’s gym.

It’s fairly simple. Just as I’m starting to feel antsy and notice an unfavorable blood sugar, I seize it as an opportunity to take a break from my work and climb the stairs. Usually, after about 15-20 minutes, I’ll notice a difference. It’s a good feeling to know that sometimes control can be as simple as taking a brief timeout from homework just to walk around my apartment building.

Now if only the stairwell wasn’t so bleak and gray, then my little exercise breaks would be visually AND mentally appealing…

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Exams and Unexpected Hypos

If someone asked me what my least favorite part of college was, I would say it’s the exams.

I understand they’re a necessary evil to evaluate my knowledge, but there are few things in this world that are more anxiety-provoking to me. As a result, I get sweaty palms and restless feet the moment the dreaded Scantron and exam packet are placed before me.

The other day, I had a communications exam that evoked all of these symptoms about an hour prior to the exam. At first, I brushed it off as nerves. But when it evolved into feeling shaky and a little dizzy, I realized I might have a bigger problem on my hands.

It couldn’t have been a more inconvenient low. I had just finished eating an early dinner a half hour before, so it didn’t seem possible to me that the insulin had already started working that quickly. I tried to ignore how I was feeling and study my notes, but an inability to concentrate forced me to test my blood sugar.

Yep, I was going down – I was 71 and perplexed. Just 45 minutes before, I was something like 191. Usually, I have to wait about 60-90 minutes to really see my insulin kicking in, regardless of whether or not I’m high before taking the shot.

In addition to freaking about my exam, I was now freaking about my blood sugar. The fact that I had to leave in about 20 minutes to get to the exam room in a timely manner wasn’t helping me keep my cool.

As my CGM started to alert me to my falling blood sugar, I shoved four glucose tablets in my mouth and decided to call my mom. I explained the situation to her and she talked me through it, mitigating some of my concerns. She gave me advice that I already knew to follow, but I still found it comforting to hear it from someone else as affirmation that I had a good plan to follow from that point up until my exam.

Fifteen minutes after the 71 reading, I tested to see if I was coming up at all. I went up to 87 – a minor increase, but it was just what I needed to see and I got ready to head out. I packed my bag, putting an extra juice box as well as a granola bar and Humalog pen in with my regular set of supplies (it couldn’t hurt to be prepared for anything). I set off for my exam, wondering all the while whether I was more worried about doing well on it or what my blood sugar would be doing during it.

A short while later, exams were being distributed by my professor: it was officially go time. Gradually, my mind shifted focus from my diabetes to each of the 100 multiple choice questions. It was all over within an hour, during which time my CGM did not go off once. I walked home and tested again, with a blood sugar reading in the 170s. Not my best, but I was proud of myself for catching the low before it got worse. And I’m pleased to report that I did just fine on the exam, proving to myself again that I can overcome just about any obstacle associated with my diabetes, which is an A+ in my book!

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To Stack or not to Stack

To stack or not to stack...that is the question.

That is, indeed, the question. What exactly do I mean by stacking? This is when a person with diabetes takes multiple shots of insulin in a relatively short span of time.

Personally, since I’m still on insulin shots, I typically will wait at least three hours in between insulin dosages. Once that minimal amount of time has elapsed, I can be fairly certain that the insulin I took earlier has run its course through my system.

I try to avoid stacking at all costs, because it seems to do more harm than good. The most common problem it causes for me is lows. If I’m too impatient for insulin to kick in and give myself a corrective dose, the stacking can work against me and make me go from a horrible high to a horrible low.

So I didn’t really want to resort to stacking, but my disrupted schedule on Saturday prompted me to do so. I ate breakfast at 9:30 and left my apartment at school around 12:00 on a ninety minute drive home. Before I left, I tested my blood sugar to see where it was at: right around 180. I took a small dose in the hopes that I would come down to a better number over the course of my drive.

Around 2 o’clock, I found myself at my parents’ house with a blood sugar of 179. Frustrated, I decided to correct for this as well as bolus for lunch, which consisted of some delicious homemade tortellini soup and a biscuit. I was well aware of the carb-y nature of this meal, so I tried to be a little more aggressive in treating it.

No dice. By 3:30, I was on the road to Boston with my boyfriend and our friends for an exciting evening during which we’d view a screening of The Evil Dead, preceded by a meet-and-greet with the cult film’s star, Bruce Campbell. Over the course of the ride, I kept an eye on my CGM and tested to confirm a spiked sugar of 250. At 4 o’clock, I took yet another shot to correct for this high. Note the time intervals in between each shot – 2.5 hours, 2 hours, and 2 hours…which translates to an inordinate number of stacks for this girl.

It seemed as though I made the right call, though. At 4:45, my boyfriend and I were shaking hands with Mr. Campbell and proudly posing next to him in a photograph. We rejoined our friends and decided to go across the street to a bar to kill some time before the movie at 7.

When I tested at the bar, I was much better with a reading of 140 mg/dL with a single arrow going down. But I had to make a choice: do I skip this one chance to order some drinks and a small appetizer in order to maintain a predictable blood sugar pattern, or do I take another shot and compensate for food and drink alone, assuming that my earlier correction dose would bring me down to my desired target of 100 mg/dL? Clearly, it was a complicated decision with multiple variables.

I went with the former and took a shot to cover a couple bites of a shareable appetizer as well as two beers. I found myself relaxing as my CGM did not vibrate once over the next few hours. It felt refreshing to enjoy my time with my boyfriend and our friends, and I felt comfortable with my stacking. I’m glad to say I survived the guts and gore of the movie, as well as Bruce Campbell’s twisted sense of humor as the night came to a close. My last blood sugar reading of the night was 127, much to my relief and satisfaction.

After this experience, what do I think about stacking? I still don’t love it. I think it’s more anxiety-provoking than anything else if you’re consciously doing it. For much of my Saturday, I wondered if I would come crashing down at some point and curse my impatience. On this occasion, though, it seemed to be the right thing to do as it decreased my hyperglycemic readings. Plus, this particular incident did give me a newfound appreciation for my normal insulin regimen. But when it’s all said and done, for me, stacking falls short.

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Un-fogging the Future

Crystal BallI don’t own a crystal ball. I can’t read palms. I don’t have the fortune-telling prowess of Professor Trelawney (or, more accurately, the centaurs) from the Harry Potter series.

But I find that I am constantly asked, “What are your plans after graduation?”, “Where do you see yourself ten years from now?”, “What do you hope to accomplish in life?”, and other questions of this nature.

Let me state the obvious here: these are HUGE and LOADED questions! As a college student in her final semester, I am asked about my future plans with increasing frequency. It seems as though anyone who asks me about my future is expecting a detailed answer, as if I can simply foresee what my life is going to be like. Whenever I do take a stab at explaining my future, I generally try to say something along the lines of, “Well, I hope to be working full-time for either a publishing or editing company, I think. I want to be able to use my reading and writing skills in a job that makes me happy.” I used to think that this answer was satisfactory, but I still often get the same reaction – a simple head nod or an “Ahhh, I see!”

These kinds of reactions evoke a few different responses from me, all of which I internalize. First, I feel a wave of confusion as my answer doesn’t seem good enough to most people. Then, my mind goes into overdrive as I think about how I should maybe rethink my entire short-term plan and make it more concrete. If I come up with something more specific, maybe, I’ll get a better reaction from people – and then I stop.

Why am I so concerned with what other people think? After all, it’s MY future, my potential job prospects and life plans that I am solely in charge of pursuing. This dawned on me the other night as I was working on an assignment for one of my classes.

The prompt was to write out an answer to a series of mind-boggling questions: What happens to you in the ten years after you graduate UMass? What obstacles might you face? Tell a story or discuss what you might be doing.

I had no idea how to answer these questions, so I just started writing. I wrote about my hopes and goals, keeping everything sort of vague and focusing in on the facts that I want happiness and good health for myself and my family. I talked about the success I will work to achieve. While I might not know exactly where I’ll be ten years, I do know that my motivation, passion, and hard work will help bring me to that place.

Now, what does this have to do with diabetes? I think the most prominent commonality between the two is the drive that pushes me to take care of myself as well as accomplish certain goals that I have set for myself. The incentive to flourish as an individual will always be present for me, particularly regarding my diabetes.

So, while I don’t have the ability to un-fog the future, I do have the ability to control it using my motivation to thrive – not just in terms of my diabetes, but in every other aspect of my life.

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A Nearly Perfect Day of Diabetes

Personally, I find it easier said than done to have good, consistent blood sugar levels on a weekend – forget it if said weekend involves alcohol consumption or an imbalanced diet.

That being said, I think it’s an absolute miracle that I had a nearly perfect 24 hours on this past Friday according to my CGM readings and blood sugar tests. On a normal day, I strive very hard to stay within those lines on my CGM. It’s my goal to stay above 80 mg/dL, but below 180 mg/dL. It sounds simple, doesn’t it? In reality, it involves a lot of hard work.

A nearly perfect day of diabetes

It was made more complicated by the activities I did this past weekend. My friends and I made plans to celebrate the beautiful autumnal weather by participating in the stereotypical fall activities. You know, by carving pumpkins, watching scary movies, and consuming apple cider and candy, among other goodies. We also decided to venture downtown to check out some of the bars in Amherst.

Phase one of the day went by almost seamlessly. I was able to get a good workout in which helped my blood sugars level out in time for the pumpkin carving and candy eating. I don’t believe in depriving myself completely of treats because of my diabetes, but I’m also careful to not overindulge. As a result, I was able to have a bunch of mini candies as well as some surprisingly good sugar free cider without any intrusive buzzing from my CGM.

The fall fun was followed by an evening trip to the High Horse bar. I’m still trying to figure out drinking and diabetes – they don’t exactly complement each other – so I made sure I was armed with everything I might possibly need over the course of the evening. I brought a large bottle of glucose tablets, my humalog pen, my test kit, plenty of needles, my CGM…I wasn’t fooling around, I know well enough by now that it pays off to be prepared.

I was more paranoid due to the fact that I had somewhat of a low prior to leaving my apartment. I think it’s safe to blame it on the fact that I overcompensated for the beer that I drank with my dinner because of its presumed carbohydrate content. I corrected the low in no time, but worried some more when I saw that I was creeping past the 180 mg/dL mark. I didn’t stress too much, though, because I knew I would be walking downtown to get to the bar.

It was great to spend more time with my friends and indulge in a few drinks with them. It was even better to (sort of) forget about my diabetes for a couple hours. Instead of declining drinks because of a high or low blood sugar, I was able to enjoy them because of my persistence in maintaining healthy readings. I stayed constant the entire evening without dramatic drops or highs and it felt fantastic. And when I saw the 24-hour results on my CGM, I was very happy to see scarcely any of the dreaded yellow or red dots littering the screen.

It’s a moment like this that makes me feel better about my diabetes management. It proves to me that I can successfully get past the trickier diabetes obstacles, all it takes is some monitoring and motivation.

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It Takes More Than One Touch To Get A New Verio IQ Meter

Sending off the last faulty One Touch Verio IQ replacement. Buh-bye!

A few weeks ago, I blogged about my frustrations with One Touch and their lack of customer service when it came to some problems I was having with my Verio IQ meter.

Here’s the short version of the story: more than a year ago, I heard about a recall on the Verio IQ meter. I reported my meter to One Touch, and they assured me I’d receive a replacement one in the mail. At the time, Verio IQ meters were on backorder, so I was sent an Ultra Mini meter to use in the meantime. However, I never received a new Verio. When I told my endocrinologist about this, she said it was fine for me to continue using my old one. I did, but when it began to malfunction sporadically, I realized I needed to give One Touch another call, which rapidly turned into three phone calls over a short period of time. They sent me replacement meters a total of three times that were not up to par. Each replacement meter was covered with scratches and looked like they had been previously used.

Naturally, this alarmed me. I still don’t have an explanation for why the replacement meters came in less than perfect condition, but I did receive a phone call from a manager at One Touch that alleviated many of my concerns.

What made this phone call different from the others is that I felt like someone was actually listening to me. I was able to explain the full story to a sympathetic ear, and we were able to clarify a major point of confusion that arose in my case: the meters I was receiving in the mail had not been previously used or refurbished. They were new meters, and it still remains unclear as to why they were flawed. I was very glad to hear this. While I was fairly certain before that the meters had not been touched and that it was a simple aesthetic issue, I still felt comfort knowing that I wasn’t being sent someone’s old meter.

At the phone call’s conclusion, the manager assured me that my feedback wouldn’t fall on deaf ears. They’d look into my complaints, and they would also send me a brand new meter in a box (like the ones sold in pharmacies) that week for my trouble. Finally, the request I had put in from the beginning was fulfilled. Within a couple days, my mom called me and told me that my new Verio IQ would be waiting for me the next time I came home.

Although it was an irritating experience, I’m content with its outcome. I feel better about customer service from this particular company, and I really appreciate the manager for taking the time to call me and listen to me tell my story in extensive detail. In this case, all’s well that ends well!

 

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Purple with a Purpose

Alzheimer's Walk Family Photo

Blue is an important color to me because it represents the fight against diabetes. But others close to me probably know that purple is another color that is just as significant.

Purple is the color of the Alzheimer’s Association. A week ago, my family and I proudly donned purple and participated in our fourth consecutive Walk to End Alzheimer’s in my grandmother’s memory.

On the day of the Walk, I was reminded of how powerful it is when I saw just how many people were there – well over 1,000! Each person was there as either a caregiver, loved one, or a supporter of an individual affected by Alzheimer’s. Despite it being fairly early on a Sunday morning, spirits were high as everyone reflected on the reasons why they were there. There was an amazing sense of community, much like the diabetes one, as we listened to other people’s stories.

The most beautiful part happened during the pre-Walk ceremony. Each participant got to design a flower pinwheel however they saw fit. When prompted, we would lift them in the air and have a moment of silence to remember our loved ones. My family’s team name is Mary’s Little Lambs, named after my grandmother. It was quite a sight to gaze at our little group’s flowers, adorned with messages of love for Grammy, spin in the wind and catch the light of the sun.

It almost felt like she (and my Grandpa) was with us as we set on our walk. The day was bright and warm, without a trace of humidity. As we walked the three miles, my family joked around and sang silly songs to keep our energy up. It’s been indescribably difficult to deal with losing a family member to Alzheimer’s, and it was also our first Walk without my Grandpa around. Instead of dwelling on our sadness, we were able to make it a positive experience and honor Grammy (as well as Grandpa!) by participating in an event that truly makes a difference.

This Walk is a reminder to me that you don’t have to be a bystander when it comes to something like Alzheimer’s or diabetes. You can make the easy and often fun choice to play an active role and support a cause you believe in. Whether it’s through writing a blog like this, having a bake sale fundraiser, or simply talking to others about your cause, you can join a fight to find a cure for these diseases.

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Date Night: Diabetes and Drinking …Oh My!

Sounds disastrous, doesn’t it? Diabetes is tough to manage. Throw in factors like drinking alcohol and spending a night out with your partner and you could have a bit of a meltdown in the process of maintaining a good blood sugar.

When my boyfriend said he was coming to visit me this past Sunday, I was pretty excited. He doesn’t live too far away from my school, but the distance is just enough to be annoying. We visit each other when we can, but we both have busy schedules between school, work, and other miscellaneous obligations. So I was happy to spend a day with him and planned for us to do a few fun things.

I've got my game face on - Donky Kong„JPGWe spent the afternoon eating lunch at the dining hall, strolling around campus, and relaxing with a couple of books and some music. Later in the evening, we decided to go to a sports bar and indulge in some beer and wings. Oh, and a platter of onion rings. Honestly, who can say no to a delicious Southern Tier Pumking with a cinnamon sugar rim? And I mean, it totally makes sense to get a greasy glut of appetizers to accompany it…

However, I started to panic a bit when our food arrived and I saw just how enormous those onion rings were and the thick layer of honey barbeque sauce covering those wings. How on earth would I know how much insulin to take to cover the meal? Just as I was about to freak, I realized I had to take a chill pill. I knew it wouldn’t be worth it to agonize over the carb count while my boyfriend dug into the meal because I knew it would just make me anxious for the rest of the night. So I did my best to add everything up, took my shot, and enjoyed the moment.

It was the best thing I could have done. An hour later, we were at another bar, this one catering to lovers of old arcade games. We enthusiastically played classics like Tetris, Galaga, Ms. Pac-Man, Donkey Kong, and Paperboy. In between games, I snuck a glance at my CGM to see how I was doing and was elated to learn I was not only sitting pretty at 120, but that I was also steady. No shaky lows or thirsty highs for this girl!

And this beautiful pattern continued as we started phase 3 of date night: wine and a movie. Again, I was a bit concerned about the affect the alcohol might have on my blood sugar. But thanks to a little research on low carb wines and careful monitoring, I was doing just as well as I had been earlier. I almost chalked it up to some wonderful sorcery, but I would have been selling myself short. I was responsible for doing the right thing in my diabetes care, despite a few potentially scary obstacles thrown in my path. It felt great and I know my boyfriend was just as glad as I was to see my success.

My Sunday of diabetes, drinking, and date night is a reminder to me to celebrate the victories, big and small, where my diabetes management is concerned.

 

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One Touch Verio IQ: The Replacement’s Replacement…Replaced.

I’ve called customer service over at One Touch not once, not twice, but THREE times this week. Why? It all started with a minor problem my Verio IQ was experiencing…

I wasn’t troubled by it at first. You see, when I would put a strip into my meter and apply a drop of blood to it, my machine would randomly shut down. I would have to pull the strip out, hold down the “ok” button to power it back on, and reset the date and time. When I first had this issue, I freaked out because I assumed that the meter erased all of my data. Fortunately, that didn’t happen. But this continued to occur sporadically and seemingly without any trigger. Around the fifth time that the meter powered down, I decided it was time to give One Touch a call.

Last time I called them, it was about the Verio IQ recall in early 2013. At the time, I was told that new Verio IQs were on backorder. I was sent a One Touch Ultra Mini along with a six month supply of test strips to use while I waited for One Touch to send me my new Verio. They never did.

I remember asking my endocrinologist if it was okay to use my old Verio until I got the new one. I had grown accustomed to it and favored it over the Mini. She said it would be fine, so I continued to use my Verio and eventually forgot that a new one was supposed to be sent to me.

This incident came flooding back to me as I was on the phone with a One Touch representative earlier this week. I was told I’d get a new Verio within a matter of days. Once I got it, all I had to do was ship back my old one. Simple enough, right?

Wrong. When I opened up my replacement Verio, I was not pleased with how it looked. There were bizarre etches along the meter, and it felt oddly sticky. Immediately, I gave One Touch another call. The girl on the phone seemed mildly horrified about my situation, but was super nice and told me they would send me another one within two days. She asked for me to send both the “contaminated” meter and my old one back to them once I got the replacement’s replacement.

I was irritated when I opened up the second meter and saw that it was in the exact same condition as the first. I knew I had to call One Touch again and I hoped that a patient but firm explanation of my problem would convince them to send me a brand new one. Much to my dismay, the woman could not have been colder to me. She said that she didn’t truly understand what I was saying, and reassured me that One Touch was not sending me meters that have been previously used. I told her that I knew that, that it was a matter of how the meters looked. She pretty much blew me off, and since I didn’t have the energy or desire to fight with a stranger over the phone, I agreed to let her send me a replacement for the replacement’s replacement. Confused? Me too.

I shouldn’t have to deal with this, and I’m very disappointed that my problem isn’t being resolved in a more timely manner. I’ve had great experience with this company in the past and I hope that they stay true to their word and send me a pristine meter this week. In the meantime, I have not one, not two, but three Verio IQs in my possession.

Update: The third meter arrived yesterday, just as sticky and scratched as the other two. However, it is functions just as well as my old one, so I’ll keep it for now. Has anyone else ever experienced something like this?

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College and Diabetes: Hello, Senior Year!

And goodbye, normalcy! My return back to school was nothing short of crazy, which means my diabetes has been a bit wild as well.

On Labor Day, my family and I packed up two cars (!) worth of my belongings to bring back to school with me. Honestly, I didn’t realize how much stuff I had until it came to loading it all in. Luckily, with their help, everything was put in its place by mid-afternoon – an impressive feat, considering it’s taken us much longer in years past.

The rest of the day was bittersweet. My parents, brother, and I went out to eat and then went our separate ways. I couldn’t help but cry, just a little, when it was time for them to go. Granted, this was in part due to the fact my brother pulled me into a crushing hug that irritated my hip, but it was mainly because it dawned on me that it signified the beginning of my senior year. Where did time go?

The rest of the week was tiring, to say the least. I was running all over the place, attending classes, decorating my apartment, buying books, reuniting with my friends, and paying close attention to nutty blood sugars. So far, I’ve had to deal with lows. Thanks to my CGM, I’ve been able to catch them fairly early on. But what’s been frustrating is that I’ve had a few instances where I have to keep eating small snacks in order to keep my blood sugar up. I love food, but I don’t particularly enjoy it when I’m not hungry because I just finished a full meal not too long before indulging into yet another snack.

This means that I’ll have to adjust my ratio. I’m not going to like this process. When I’m at home, I have a standard insulin to carb ratio for each meal I consume. At school, though, it seems like I need to take less insulin in the morning and be a bit more aggressive in the afternoon and evening. With this in mind, hopefully I can figure out what works best for me.

I’m also presented with an interesting challenge, one that I haven’t had to deal with yet: food being forbidden in classrooms. Two professors made a point of stating this at the beginning of class. I understand that my classes are taking place in some brand new buildings, and that professors want to encourage their students to respect the property and not make a mess. I also understand that there may be allergy concerns. But what I’m unsure of is whether or not they’ll call me out in the middle of lecture for chewing glucose tablets to fix a low blood sugar. I took the initiative to e-mail one professor about this, and I’ll have to sit face-to-face with the other professor because she doesn’t accept student e-mails. I’m oddly excited to do this because I’ve never explicitly discussed my diabetes with a professor. I’m keeping my fingers crossed that the conversation goes well. So that’s where I’ll be on Wednesday, in between my Human & Animal Alternative Medicine seminar and my English 494: Dystopian Games, Media, and Comics class. And I know you’re probably a little jealous that these are real classes.

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