Wednesday, June 27, 2007

When to Break the Rules

When living with diabetes, there are the "right" things to do regarding treatment. All the things the doctor tells you to do and not do, the techniques the pump companies insist you follow, for example.

Thing is, in real life, times come about when the "right" way isn't going to work, and you're left without a decent backup plan. It is times like these that a MacGyverism can become necessary. (If you're not familiar with a MacGyverism, well, you'd have to be a fan of the TV show MacGyver...but basically, it means thinking up a solution to some problem on the spot with the tools at hand.)

I ran into such a case just yesterday. Mostly because I'm an idiot...but, unfortunately, idiocy can overcome the best of us from time to time. Anyhow, yesterday, I happily headed off to work, ignoring the fact that my insulin pump reservoir said I had all of 4 units left. Of course, when it says I have 4 units, it really means I have 14 units. But 14 units wasn't going to be enough to cover the fact that I had just eaten 40 carbs, and need to last out the day. But, since I only work 20 minutes from my home, I figured I'd see if I could make it.

Well, at 2:30 pm, my BGLs were tending high, and I got the dreaded empty reservoir alarm. But I still had a couple hours of work left in me. I dreaded having to head home, fill my reservoir, and come back again.

So, I broke the rules. I did something that isn't recommended. First, I disconnected my infusion set and rewound the pump. (Always disconnect, because rewinding a pump could actually suck insulin and/or blood out of you if you remained connected.) Second, I removed the reservoir/infusion set line from the pump. Then, using a handy-dandy ink pen (capped, of course), I gently pushed the reservoir plunger down, utilizing the remaining and otherwise unusable ~10 units of insulin left to fill up the tubing. One completely filled, I reconnected and used the pen to inject several units of insulin...being VERY careful to watch when I had run out, and the tubing started filling with air instead of insulin.

Then, I disconnected the infusion set again and retested a bit later. BGL was dropping, and I had enough insulin in me to last me until I got home.

Sure, the whole thing is not recommended. You'll never find a doctor or Minimed representative suggesting this technique. And, in fact, I would never recommend the technique. It was plain silly of me to have forgotten to fill my reservoir before I headed off to work. But, sometimes desperate times call for desperate measures.

Thing is, diabetics have to do this kind of thing all the time. You are living your life daily with a disease that is unpredictable, being controlled by humans who are even more unpredictable.

Of course, my insurance company refuses to pay for enough insulin to allow me to keep a spare vial anywhere. They will only cover precisely the amount I need. I guess they fear I'm going to sell any extra on the black market or something. Sigh.

Thursday, June 07, 2007

It Ain't Easy

I've been dutifully exercising at the fitness center since mid-January, and for the past couple months, actually going five days a week. I've improved my strength tremendously, such as going from being able to leg press 130 lbs (10 reps) to leg pressing 230 lbs (10 reps). I can even do bicep curls of 25 lbs (10 reps), up from 10 lbs when I started.

I'd give myself a pat on the back, except that one of my main areas of weakness hasn't really improved much at all. Flexibility. I still can't touch my toes. (Well, I can...but only if I go really really fast, which, after the ripping sound it made in the back of my leg, I figured isn't such a good idea.) I also found that there comes a point where you plateau.

I should be proud of myself for reaching a plateau. I had read about the elusive concept in the past, but never really knew what it was like. But here I am...on a plateau. Because, try as I might...those strength numbers stopped improving about two months ago.

Worse yet, if I miss a couple days, or have a long weakend...err, I mean weekend...I find that I've actually gone backwards, and the following week is spent making up for what I lost.

I'm not at all sorry about this, however. I'm far more in shape now than 6 months ago. Even my wife can tell the difference. I like being able to move furniture and do various heavy-labor tasks that, before, wore me out. I like the fact that my pants, which in recent years had to be upgraded from a size 32 waist to a size 33, is actually a bit loose-fitting now. I can use the third hole instead of the second hole on my belt. I can even see my...uh, mini-me...when I look down, without having to suck in my stomach.

But despite the positives, what I'm realizing is that I'm not in my twenties any more. Okay, yeah. I knew that. But I didn't realize just how much those ten years can change you. You have to work at keeping in shape, where before, it seemed almost natural. They say that, once a man hits 30, his testosterone levels begin to drop. Testosterone helps build and maintain muscle mass. (Evidently, it also means greater risk for testicular cancer, so loss of testosterone isn't all bad.) So, now, to maintain, or even gain, muscle mass takes serious effort on my part.

When I started out, I had dreams of having arms the size of my thighs, and thighs the size of...well, something bigger than my thighs. I had dreams of seeing very distinct muscular lines covering my abs. But, I'm afraid, I'm no where near that. I still have a gut that sticks out (just not as far as before), and I still get winded climbing up the second flight of stairs at work.

I'm a diabetic. I have been for 25 years now. If there is one thing I'm constantly aware of, its that the disease is silently trying to damage me. I won't give in without a fight, however. Eating my oatmeal is no longer good enough. Gotta work at staying healthy, so that I can live well beyond 55 years old, which was the life expectancy of a Type 1 diabetic when I was diagnosed. I'll hit 80 if it kills me! (And, after a mile on the treadmill, it sometimes feels like it just might!)