Sunday, May 16, 2010

Me after D

Day 7 of Diabetes Blog Week: Life after a cure.

My biggest issue with this whole diabetes mess is how much I have to think about it. It's not one of those things where you pop a pill once a day and you're good. Doing math at every meal and snack. Remembering supplies. Waking up low in the middle of the night, what should I eat? How do I treat perfectly so I wake up not high and not low? Planning a pregnancy over a year in advance. Worrying through nine months of pregnancy. Will diabetes affect my child? My husband? Do we have enough money for supplies? Insurance nightmares. A1Cs. Complications. SWAG-ing. Etc, etc, and so on.

It is mentally. Freaking. Exhausting!

So what will I do the first day I don't have diabetes? Well, even though this is a magical, hypothetical land where a perfect cure exists, I'd probably check my blood sugar. A lot. I kinda feel like I'd be paranoid after almost 20 years of diabetes that my sugars would run rampant if unchecked. Of course I'm pretty used to feeling my highs and lows, so I'm sure I'd be able to tell if my sugar was outta whack, but still. I'm pretty sure it would take a couple of days for it to really sink in. Not only that, I also think it would be pretty sweet to see gorgeous numbers after meals, snacks, desserts, crazy days at work, etc without any interference from me! ;-)

Other than that, I'd freaking take a break from all the worry and annoyance. It would be so nice to just relax! Sometimes I feel like I never can just goof off, relax, take a break. Even on vacations, my mind still has to be sharp as I chase my sugars all over the place. (For me, new environments and routines tend to mean crazy sugars until I get it figured out.) Even if I said I didn't care about my sugars and ate whatever I wanted and never paid attention to boluses or postprandial blood sugars, it would only take a few hours before I would pay the price. I have both the luck and misfortune of feeling my highs pretty severely . . . and they feel awful. So it's a double-edged sword, it's either "no rest for the weary" or do what I want and feel like crap. Not much of a trade-off.

So as lame as this sounds, the number one thing I would do, is NOT WORRY ABOUT IT. Take a break. Relax. And know that everything will be okay. I don't really feel like diabetes keeps me from doing the things I want to do. If I really want to eat that yummy fill-in-the-blank, I will. I'll SWAG it and follow my sugars. So there isn't any one magical thing I would eat or drink or do. Just being able to make any of the decisions I already make everyday and not having to worry about all the different possible consquences would be heavenly.

Diabetes will always be a part of me. It helped shape who I was growing up, for good and for bad. I can thank it for making me a taaaad OCD and also for making me pretty good at doing math in my head. It helped me be more disciplined and more self-aware. It also took it's toll, taxing me both mentally and physically at times.

Even if (when!) I'm cured, those parts of me will still be there. What diabetes will never let me do, though, is not worry about every single decision I make. My mind has to be ON 24-7. And I look forward to the day I can turn it off, even just for a second. . .

~Layne

PS: Well, that about wraps it up for D-Blog Week. It's been fun, y'all! Loved meeting all the new (to me) folks. See you next year!

Saturday, May 15, 2010

Life in pictures

Day 6 of Diabetes Blog Week: Diabetes snapshots

My supply drawer. This is just the "easy access" drawer. There is a spot in a closet nearby for the rest of my "stash." ;-)

This is my work bag. Different than my other purses because it's big enough to carry all the must-haves to cover me at work. (I'm sure the ladies get it . . . and the peeps who work long shifts.) It is complete with my badge, key to the call room, my favorite pen and my fruit leather for quick treatment of those pesky lows. And my ugly blue supply bag for emergency refills, site changes, etc.

This is the afore-mentioned ugly blue supply bag. I probably got this pretty soon after my diagnosis, it's that old. It's held up pretty well but I didn't use it all that often. There was an ice pack designed to go in it that had slots for insulin. Now I use it because my pump supplies fit in it. I carry everything I need at work, "just in case." Extra batteries for meter and pump, strips, cartridges, wipes, Humalog, and insets.

I wasn't very hungry for lunch and I probably didn't eat as much as I thought I would (and bolused for). I got low afterwards (60-something). I treated and this is what I was 20 minutes later. Hmmm . . .

This is apparently where all my dead strips go to die. And btw, holy crap, I need to clean out my case!

But really it's not my fault, 'cause those suckers dig in and hide from me! I hate it when they get in there . . how do they do that?

My stash of insulin. All I use these days is Humalog in my pump. I used to use the butter compartment for storage but this method has proven more stable.

Instead, the butter compartment houses . . . well, butter for one. Plus all the insulin that I can't use anymore: Lantus (now that I'm back on the pump) and Symlin (not insulin, but I still can't use it while we are trying to knock me up).


This is the official Low Treatment Center in my fridge. Milk, if I'm being good and patient. And OJ if I'm too low to be accountable for my actions and must raise my blood sugar yesterday!

~Layne

Friday, May 14, 2010

Lightbulb!

Day 5 of Diabetes Blog Week: Wild Card

Okay, I know that today is supposed to be about exercise, love it, hate it, habits, tips, etc. Well, that's easy. I hate exercise. I need to get over myself and do it anyway. But there's not two ways around it. I hate it. I hate sweating and I live in Florida so I sweat sitting down! And when I sweat I get itchy (I know, weird, but I've always been that way). And I'm easily bored and have no TV to stare at while on the treadmill. So when it comes to exercise, I kvetch and complain and do my best to ignore it's existence, meanwhile feeling disturbingly guilty as that dusty treadmill stares at me from the other side of the room.

Well, that didn't take long, did it? Now onto more pleasant topics. Since I obviously don't have too much to say on this topic, I'm choosing to use the "wild card" option for today's post. This is an awesome option that Karen gave us for those days when the topics just weren't up our alley. She gave us two wild card options to choose from "Blood sugar Nirvana" and "Moronic Moment." Let's see if you can figure out which one I picked:

So back in January, I got started on the Animas Ping pump. I had been on a pump before but never one that used a specific meter. Considering all the meters I've been through in the last 19 years, I really liked my previous meter and was a little bummed to switch. My favorite things about the Freestyle Lite?
  1. No coding.
  2. Nifty backlit screen for testing in the dark (i.e. in the movies or middle of the night lows).
  3. Even niftier light for the strip so you can see where to put the blood in the dark. (NONE of my old meters had parts that lit up!)
  4. I also liked that it didn't have as many errors as my other meters.
But having the Ping, a meter that was also a bolus wizard and could be used as a remote for my pump, was pretty freakin' awesome too. So I went with it.

So for the last few months I've been testing in the dark. And a couple of weeks ago, Cara blogged about testing in the middle of the night. Funny enough, we both use the same trick of shining our pump light over the meter so we can actually see the darn thing! So here's the stupid part:

I've been annoyed since letting my Freestyle go that I can't easily test in the dark. I've even considered stashing my Freestyle in my nightstand drawer so that I could at least use it to test at night. Problem is, I use my meter as a logbook and those night-time lows are important to record. And with the Ping I can't make an entry based on a test from another meter. So I kept on using my Ping meter and grumbling under my breath.

Until the other week when, for some reason, I let my finger linger (I rhymed!) a little too long on the "OK" button. And the backlight flashed on! A bright shiny blue! My meter. Has. A. Backlight. Awe-some.

Wait? Now I'm officially retarded.

Did I see that little sunny-looking icon over the "OK" button? Sure. Did I press it hoping it would actually do something . . I dunno . . . light-y? Yep. However, apparently I don't have the magic touch. So I'm feeling pretty dumb that I've had this meter for nearly 6 months, kvetching the whole time that it doesn't have a backlight and testing in the dark . . . all the while with that little button just sitting right there. Mocking me.

DOH!

~Layne

Thursday, May 13, 2010

Carb-a-licious

Day 4 of Diabetes Blog Week: To Carb or Not to Carb

Okay, so here's my deal with carbs, or really food in general. I'm not really going to go into details on what I make for dinner or the foods that make me weak in the knees. I have a food blog for that. I just want to discuss my philosophy here. When it comes to diabetes and my diet, I'm done with being old school. After being diagnosed in 1991, I started using the "exchange" method to manage my diet. Starches, Veggies, Fruits, Meats, Fats, Sweets and Dairies. I think that's all of them. Who knows? Anyway, it was stupid. And I hated it. And I hated weighing my corn and green peas before dinner when I was 8 years old. I was still using N and R (again, old school insulin) and was pretty tied down to what I could eat, how much I could eat and when I could (or should) eat. What if I was hungrier than that? What if I wasn't hungry? The whole system just blew.

In 1996, when I was 14 years old and several years out from my diagnosis, my doctors really wanted me to start considering the pump. At first I wasn't interested but over time they were able to sell me on it. And the biggest selling point was the freedom. You have a basal rate that holds you steady and if you want to eat, you can bolus for the food. If you aren't hungry? No need for mid-day snacks. Is it a special occasion and you want to eat a big celebratory meal? No problem, count your carbs and dial up your bolus. The pump was supposed to mimic what a pancreas would do. (You know, in those normal folks who have one that works. Personally, mine's a slacker.) I loved the freedom. I loved not weighing my foods and thinking in terms of exchanges. It was a wonderful way to manage my diabetes!

So much so that 5 years later when I was sick of the pump, the first thing I asked my doctor about going back on shots was if there was any way to keep my management the same if I got rid of the pump. Luckily for me that was right around the time when Lantus was coming out. This peak-less insulin acted as my "basal" and gave me the freedom to "bolus" with Humalog for meals and high blood-sugars, just like the pump, only with shots.

So I've been eating what I want for years now. As far as I'm concerned, as long as you are counting carbs as accurately as possible and bolusing responsibly, I'm in the camp that says we can do the same things as all those folks with a working pancreas. Now there is one caveat to that. Because I can't always be sure how many carbs are in things without a label (sometimes I swear that restaurants wash their lettuce in sugar water!), there is always the risk of not bolusing accurately.

So with any carbs that I take in there is a "risk" of not being able to accurately predict what it will do to my blood-sugars. But this can be the case even if I know the carbs. Sometimes blood-sugars just do what they want despite my best efforts. It's all about learning how my body responds to things and giving it my best damn guess. And then following my sugars like a hawk to make sure that they behave. But, personally, I don't feel that I should have to avoid carbs at all costs simply because there's a chance they could make my sugars whacky.

As with everything else in life I just try to maintain balance. Do I eat the Krispy Kreme donut every time I walk by it because it's glazy-goodness beckons. No. Why? Well, first I'm doing my best to keep my hips and thighs in check. And second, while Krispy Kreme's are bolus-worthy for sure, you can't justify it every day of the week. But again moderation is key even for people who don't have diabetes. It's just part of life.

~Layne

PS: Does anyone else want a donut now? :-/

Wednesday, May 12, 2010

S-U-P-P-O-R-T

Day 3 of Diabetes Blog Week: Your Biggest Supporter

It may not be Aretha's classic tune but it's just as important. When I think about who is my support, my mind goes straight to Brad. At first I thought, maybe it's lame to always call out your significant other as "the best" anything . . . your best friend, your favorite person, your biggest supporter. Maybe it is. But it's also true. Hey, doesn't the fact that I married the guy mean that I think he's pretty freakin' awesome?

Who else is woken up in the middle of the night by the faint glow of my meter as, in a fog of sleepiness and a low, I check my sugar and then stumble off to the kitchen for some food?

Who stands with me in the kitchen, in the middle of the night, with just the oven light to see by (because all other lights are WAY too bright) as I chug my juice?

Who puts his arms around me and snuggles up with me in the dark on the couch in the living room while we wait to make sure the juice does it's thing so we can go back to bed?

Who deals with the cranky chick who feels like crap because her blood sugar is 300 and she is in the middle of her period (likely the reason for the 300 blood sugar) and nothing she's doing for herself will make her feel any better, except ranting and raving like a lunatic seems to do the trick?

Who patiently waits for that same cranky-pants to run out of steam and even manages to make her giggle after she's made an idiot of herself?

Who lets me sit down and have a real good cry every few years when the whole diabetes game has caught up to me and has just played a little too dirty for a little too long? And when, even though I've had diabetes for close to 20 years, some days it just seems all too fresh and raw. So I break down, throw a pity party, feel crazy for asking "why me?" when I should be used to it all by now. . . while he sits there, holding me, letting me cry and telling me I'm not crazy, it really does suck.

Who (just last night) could make me shed totally different kind of tears when he tells me that he thinks I'm brave and strong, that I'm a fighter who has never let diabetes get in my way, that he's proud of me for taking offense when someone tries to label diabetes as a "disability" and that he thinks the fact that I don't think of myself as a sick person is why I've been able to accomplish so much? (Dude, how much more supportive can you get?)

Who, when we are out to dinner with friends, will sit and wait for me to finish testing my blood sugar, counting my carbs, plug everything in and bolus before he even picks up his fork? While his food sits in front of him getting cold and everyone else as the table is digging in?

When I run out of insulin in my cartridge and it catches me completely by surprise and I need to do an entire set change uber quick because we have some place to be, who knows exactly where all my pump supplies are and exactly what to grab?

And who is my go-fer for all this stuff without me even having to ask, so that I can start the process of ripping out my old site and disconnecting everything?

When I have a scary, panic-inducing, knee-weakening, head-spinning low, who runs and grabs all the things he knows (from experience) that I need to treat with? And who keeps checking my sugar to make sure I'm coming up? And who lets me sit back and zone out (like I always want to do when I'm low and nobody is around but can't let myself)?

Who saw me hit the snooze over and over one morning, not wanting to wake up, all sweaty and disoriented and asked, all knowing-like, "Are you low?" when the thought hadn't even crossed my mind? (I swiftly told him how brilliant he was for nailing that one on the head!)

My husband is not just my biggest supporter, he is my support. My cheerleader. My partner. He has a working pancreas and yet he chooses to do this everyday with me because he loves me. He gets so much about it. We have our own diabetes language. He knows my symptoms, sees them from a different perspective. Knows all the crap that drives me crazy about diabetes and celebrates the little triumphs with me. (Treating a late-night low and waking up to a perfect number? Score!)

I'm seriously so lucky to have found a partner in life who is as kind and supportive as Brad is. And I love that he has never minded being as much of a partner in my diabetes as he can be. If I'm feeling a tad too wobbly to run to the kitchen and grab something to treat a low, he goes for me. If I have to do a quick site change, he grabs the stuff while I prep everything. If I'm in the movies and need some light to check my sugar, he whips out his phone and shines it on my meter. If I'm high and can't seem to get my sugar to budge, he will troubleshoot with me. Do I need his help? No, not really. But is it so, so, so nice to have? Does it make me feel a thousand-times less alone in this thing? Absolutely, one hundred percent, YES.

~Layne

Tuesday, May 11, 2010

Making the low go . . .

Day 2 of Diabetes Blog Week: Making the Low Go!

How do I treat a low? This one is something that I may keep thinking I have perfected after, oh, 19 years with diabetes. But no. I have my favorites but there are times when they like to throw me a curve ball and either not work at all or work too well and I spike to the 200s. Just telling it like it is.

Anyway, if I'm fine, not about to do anything and have the ability to patiently wait for my blood sugar to rise, my treatment of choice is milk. Yep, plain ol' cow juice. Think about it. It has about 13 carbs in a 8 oz glass, just the right amount to bring up a low. And it's chock full o' protein to keep me from crashing later. And it doesn't give the those nasty rebound highs like OJ can. The cons? It can take forever for it to feel like it's working and for my symptoms to subside. So I tend not to use it at work where I need my wits restored to me FAST or if I'm having one of those scary, shaky, panic-ridden lows where I just need my blood-sugar up NOW.

For those kinds of lows, I resort to my old stand-by: orange juice. I've been using it forever. I loved it because it tasted yummy, I could guzzle it down and it hit me fast and brought up my sugars right away. But it's almost 30 carbs per glass! And all the simple sugars in it would spike my sugars a little too high and then drop my sugars again a few hours later. Nowadays I'll still use it, but only for specific times. For example, if I'm heading out to dinner with friends and am feeling low before I leave the house, I'll drink half a glass of OJ before I go. It brings my sugars up fast, but since too much since I only drink half a glass or so. And I don't need to worry about it dropping me later because I'll be eating a meal soon. So it definitely works as a quick fix but I always need to make sure that I follow it up with something. (At work, I have juice boxes in the fridge in the call room. But when I'm running around I carry around a piece of fruit leather. I like Pomegranate and Strawberry, yummm. It's convenient and acts relatively quickly. It's only 11 carbs though, so I almost always need to follow it with something to stay up. But it works as a quick fix for work.)

And, of course, peanut butter is my stand-by protein. Absolutely necessary to keep my blood sugars from plummeting again after I've gone to all that trouble of treating. I'm not a spoonful of peanut butter kind of girl, so I usually grab a few graham crackers and slather on the PB goodness. And (to my husband's deep dismay) if I have been baking and have chocolate chips in the house, I may sprinkle a few of those on too. Hmmmm. Not too many because I don't want my blood sugars going to far the other way. But Oh. My. Golly. The combination of PB and chocolate makes me swoon.

None of this stuff really keeps well in a car (in Florida) so I just keep glucose tabs in m y glove-box for the road. I've never been a fan of glucose tabs but I'll chug them if I'm on the road and got nothing else. And, of course, if none of my old stand-bys are available I'll wing it with whatever is around. A vending machine goody. A regular soda from a drive-through. I don't like treating this way. It's messy and I never know what my blood sugars will do afterwards. When I resort to stuff like this, I usually watch my sugars like a hawk for a couple hours until I'm sure I've steadied out. Not fun but you gotta do what you gotta do.

~Layne

PS: There are those shaky, scary, panic-inducing lows where I just cram any and everything down my gullet until I feel like I'll explode because I feel like if I don't I'll DIE. I'm not proud of those times but sometimes lows are scary and it's hard to control yourself. I'm admitting this because I'm choosing to believe we are all guilty of this from time to time (please tell me you're guilty of this from time to time!) and I don't think it's fair to come on a public forum and act as though I've got it all figured out. I don't. And that's just the truth.

Monday, May 10, 2010

A day in the life . . . .

This week is Diabetes Blog Week, the brainchild of Karen over at BitterSweet. Kicking off D-blog week is supposed to be a "day in the life" post relating to my diabetes and how it touches different parts of my day. And it will be. But 8 days out of every 14 are "weekend" days for me. Don't get too excited. . . because it means that I work 24 hour shifts for 3 days every 2 weeks and when I get home after this marathon-of-a-shift I'm exhausted and sleep the better part of the next day away. But it's a nice trade-off for having so many days off in-between.

Anyway, since my job as a Neonatal Nurse Practitioner is so unique (and is a job that tends to wreak havoc on my blood sugars) I decided to chronicle what an average day at work is like for me. Beware: This is loooooong. Because my shift is looooong. You have been warned.

5am - Hit snooze.

5:09am - Hit snooze and curse the alarm clock.

5:18am - Turn the alarm off, sit up in bed and seriously consider quitting my job. This is an un-Godly hour to be awake!

5:35am - Always in this order, I have peed, brushed my teeth, gotten dressed (thank God for scrubs), done my hair, tested my blood-sugar, kissed my husband goodbye and climbed in my car. Off to work in less than 20 minutes! Morning routine? Down to a science.

6am - After I'm on the road a little bit, I usually crack open my fiber bar. I have found that if I don't eat something before work (especially on my drive in) I'll crash half-way through morning rounds.

7:30am - After a 2-hour commute, I pull into my parking space at the hospital. I bring out my meter and test before going in. Usually I'm high 100s, low 200s. I used to have oatmeal before work but my Endo was convinced it was to blame for these spikes at the beginning of my day. Since switching to the fiber bar my spikes are lower (they used to be high 200s), but still there. Maybe it's the stress of the long shift ahead, or the irritation of morning traffic, who knows? I deliver whatever correction is needed, I pin my hair back (because I don't like driving with it up) and scroll through my pump menu screens in order to change my basal rate to the "work" basal program. It's on.

8am - I've finished getting report on the kiddos in the NICU. Usually I'm familiar enough with them that I just get the updates, but occasionally there will be new happenings or new admissions that I get the full scoop on. Once I'm up to date, I print out my census report (list of all my patients) and head over to the NICU to check labs, look at x-rays, examine my kids and determine what needs to be done for each one of my patients that day. (No, I'm not their mother. Yes, they are "my kids.")

10am - After gathering all my info for my kids, morning rounds with the attending physician usually starts around this time. Unless the attending is seeing his patients . . . . or is late to work, or busy with something else, or is cranky, or has just decided to do something different that day. Ya know. If the attending is ready to round, the practitioner team (myself and 1 other nurse practitioner that covers the more stable patients) work our way around the NICU with the attending, stopping at each bedside to discuss the patient, his/her progress, setbacks, labs, ventilator settings, etc. I review my plan for the day with him, ask his preferences on certain things and discuss options for our plan of care.

11am - Oh shit! My fluid orders are due by noon! Total parenteral nutrition (or TPN, an IV fluid that has electrolytes, sugar, protein, and fat) is given to infants who are unable to feed enterally (or via their stomach). A premature baby's intestines are also premature and often unable to digest food properly. As we slowly work up on enteral feeds, we give babies TPN so that they have the nutrition they need to grow in the meantime. What goes into each baby's TPN is calculated based on their lab results and clinical status and these orders need to be written by noon. Sharp. Gotta hustle.

12pm - After writing fluid orders and getting maybe one or two notes written, I'm freakin' starving! By this point my blood-sugar is usually low, usually 60s or 70s. Normally I don't feel too symptomatic. Again, I always plummet after getting to work. Used to blame the oatmeal for spiking me and them dropping me but obviously that's not it. So I grab the other practitioner I work with that day and we'll drop by the cafeteria, grab food, drag it back up the the call room and nosh on it while trading gossip and other fodder. (What? Like you don't do the same on your lunch break?)

1pm - Now the official note-writing begins. My LEAST favorite part of my job. Remember how I was talking about all the information I gathered earlier. Labs? Exam? Xrays? Plan of care? Orders? Yeah, well all that has to go into the daily progress note on each patient. Not. Fun.

3pm - Deliver printed and signed progress notes to each patient's bedside, check on them, see how they are doing, write any languishing orders and answer any questions that the nurse has about the baby.

3:30pm - About this time everyday starts the quiet time. The other practitioner on with me has usually finished her notes and orders and is ready to go home. She checks out to me and lets me know if there is anything I need to look out for with her kids. (Since she sees the less-sick babies, usually this isn't an issue.) Usually around this time, there is a lull. A peace. If any baby needs a procedure done, this is the time I have to do it. Place a PICC, adjust umbical lines, pull out central lines, do an arterial stick for labs, re-intubate, etc, etc. If there is nothing like this that needs doing, I can read my work email ::cough:: BLOGS ::cough::, watch TV in the call room, call Brad, or read a book. This time is my own. I might get paged for a delivery. Or if I'm feeling the need to cuddle a baby, I'll find a cute (stable) baby to hunker down with. (This is the BEST part of my job and makes me wonder how I could ever consider quitting!) Sometimes I go down to Labor and Delivery (L&D) to see what's on the board but usually that's just asking for trouble. So I stay away. Trust me . . . they'll call if they need me!

6pm - Usually it starts to pick up again about this time, the nurses are ready to change shifts and want to get everything squared away with their patients before handing them off to the night-shift. I'll get calls for orders, updates, etc. Occasionally a parent will stop by and I'll go into the unit to given them an update about how their baby is doing.

7pm - It's the nurses change of shift. Best advice I ever got? Eat dinner during change of shift. Then nobody will bother you! Brilliant. It took only once for me to test and bolus for dinner and get paged or called away for an emergency. Big-time low blood sugars and no dinner in my belly equals a serious bummer. So I eat when I can and hold bolusing until I'm finished or get called away. Amen.

8pm - The night-shift nurses are there, so I make the rounds to see who's on and usually end up answering more questions about the kiddos. Also, the attending down in the newborn nursery has gone home which means I have to attend all high-risk deliveries. If a baby arrives via C-section, if there is meconium-stained fluid (dangerous because it can lead to meconium aspiration syndrome), if a vacuum or forceps are required for delivery or (of course) if a baby is premature, I will get notified via my Nextel walky-talky-thingy . . .and I'm off.

FYI: The NICU is on the 6th floor. And L&D is on the 3rd floor. And hospital elevators are really slow. So 9 times out of 10, I end up flying down the stairs. And maybe you are wondering why I get low at work? Hmmmmm. . . .

10pm - Usually at this time I start trying to lay down and get some sleep. Sometimes it works and other times, not so much. And there is no telling when a busy night will hit you. The calmest of days can be the busiest of nights. The other weekend there were only 2 babies on the board in L&D and both delivered before 10am and it was relatively quiet in the NICU. I thought I was in the clear. Then at 9:30 at night, a woman walks into the ER, not knowing she's pregnant and precipitously delivers a very premature baby. Hello! Admission time! Time to resuscitate, intubate, gown up, place umbical lines, start IV fluids, adjust ventilator settings, check labs and write it all up in the admission note. Other times, it's a nice relaxing night, with a few calls from nurses regarding residuals (GAH! Residuals! The bane of every neonatal NP's existence!!), blood gases, ventilator changes, or other abnormal findings. Ya just never know.

If I get low at work, this is when it happens. My lows at work happen before lunch and throughout the night. I have a stash of juice packs in the fridge in the call room and bring extra snacks with me for lows. Occasionally, I'll get low during an admission and have to excuse myself, but not often.

6am - If I'm actually sleeping (YAY!), my pager will go off about this time so that I can get up and check labs. AM labs should be ready by now and I look them over on all the babies on my team and enter them into their records. I'll also check out any blood gases or xrays that were taken. If any changes need to be made, I'll make them before the next practitioner comes on.

7:30am - My relief is here! I give report and I'm out! Usually I drop by the cafeteria on my way out to get a Diet Dr. Pepper for the caffeine . . uh, I mean the drive home.

8am - I check my sugar before hitting the road (usually it's good, low 100s) and about a third of the way through my drive I'll bust out my other fiber bar and bolus. I may have been known to, you know, in the past, grab a Krispy Kreme donut along with my soda at the cafeteria. Just because I'm low. And I'd forgotten my fiber bar. And they taste good, dammit! But only on special occasions (read: really bad nights). ;-)

10am - I am finally home. I stumble in the door, drop all my work stuff and walk the dog. Then I change into my PJs and test again. Usually I'm 150s-170s. But I don't correct because I tend to drop right after I get home from work. I climb into bed and my "nap" usually lasts 2-4 hours, depending on how much sleep I got the night before at work. But since I'm sleeping through lunch, my sugar tends to drop.

2pm - Wake up and check my sugar. Usually I'm on the low side. I'll eat a large snack/small meal to cover my low but no so much that I'm not hungry for dinner at a normal time when Brad gets home.

I told you. Long. Freaking. Day. But the babies make it all worth it. ;-)

~Layne

Thursday, May 6, 2010

Diabetes Blog Week

So Karen over at Bitter-Sweet recently had a brilliant idea. And as a result, he has organized the DOC (rallied, really) into participating in the first annual Diabetes Blog Week. (I say annual becuase I hope it will become an annual thing, but nothing is official yet. ;-)) If you are wondering what D-Blog Week is all about, think mini NaBloPoMo with assigned topics.

I'm so excited about this! I loved NaBloPoMo and the idea of doing the same thing (for a shorter period) along with all of the DOC sounds awesome! And the best part is, Karen has already assigned the daily topics. No having to wonder what to blog about! So see you (a lot) next week!

~Layne