Don’t Be Rude!

Do you remember the last time someone was intentionally rude to you? How did it make you feel? Did you dwell on it? Did it sit on your mind for a period of time after the exchange was over? Maybe not. Perhaps you’re the type of person who has thick enough skin that other people’s comments simply slide right on off your shoulders. Or maybe you’re in denial. I don’t know, I’m not a therapist or psychologist. But I DO know that most people who say they aren’t affected by rudeness, still are.

To be rude is defined as being offensively impolite or ill-mannered. The best example that comes to mind is several months ago when I pulled out into traffic into the path of an oncoming vehicle (allegedly). The person took active steps to follow me to a red light and went on to call me by a plethora of inappropriate names and insult me for cutting him off. To this day, I can neither confirm nor deny that I ACTUALLY cut him off, as it’s not my nature to go pulling out into traffic if there’s a risk of a collision. But whether he pulled into my lane or was speeding or I DID cut him off, I can’t be responsible for other people’s perception.

So, why are people rude? Rudeness breeds suffering, the elimination of which is at the very heart of my beliefs, yet it seems that people do it with impunity. As much as we often don’t like to think so, many of us are rude to others in the way we interact with others, the things we say and the things we do. Sometimes this rudeness happens without our knowledge that we are doing it.

Most of us spend our childhood being taught by our parents (and grandparents) that’s it’s wrong to be rude, disrespectful even. But as we reach adulthood, a sense of entitlement often makes us disregard those teachings in relation to how we interact with others and how we treat them. Although none of this is anything new, it’s important to remember not to escalate the situation or reciprocate the behaviour.

A person’s behaviour, whether rude or not, will often be rooted in their own self-esteem and perspectives. That person who bumps into you in a public place without apologizing may be going through something that actively occupies their thoughts. There’s a good chance they weren’t even aware they bumped into you. The person who screams or swears at you in public for taking a parking space or possibly cutting them off in traffic has likely forgotten about you ten minutes later and the interaction isn’t worth the stress you allow yourself to feel as a result.

As difficult as it may be to smile and walk away sometimes, rudeness is one of those behaviours that feeds on itself. If you let someone’s rudeness get to you, you’ll likely be rude to someone else and so on and so forth. Kindness is the best reaction to rudeness and walking away from the situation is always best. Don’t contribute to the suffering in the world. Light knows, there’s enough of it as it is. After all, you can only control your own words and actions; never those of others. ☯

Lazy People Need Not Apply!

Laziness is insidious… Once it gets its greasy claws into a person, it can be pretty difficult to shake ’em off. There are ALL sorts of explanations for laziness, including psychological issues ranging from lack of self-esteem or fear of success, all the way to physical deficiencies that include lack of certain key vitamins like B vitamins, Vitamin D or certain mineral salts.

In the case of someone with Type-1 Diabetes, laziness takes on a whole new meaning. For some, it’s an unintentional result of how they deal with their condition. Fluctuating blood sugars, stress from treatment or lack of rest (since we never tend to sleep all that well) can contribute to feeling sluggish and lethargic. These feelings can often be contributed as laziness by the unaware, and it’s a label I faced often throughout my school years.

Years ago, way before the advent of frequent daily testing, carb counting and my trusty insulin pump, I would often suffer high blood glucose levels during the school day. Especially since lack of education made it so that I never assumed there was a problem with “sugar free” foods, despite their high carbohydrate count. I would often find myself sprawled on my desk, snoring softly as a teacher would walk over and crack a metre stick on my desk. Sometimes it wouldn’t even wake me. I wonder how much more I could have accomplished if I had better control of my levels, back then.

But every now and again, I would encounter someone who is genuinely lazy, for no medical reason, and simply chooses not to bother with their own care. I encountered such a woman over a decade ago. I was dating a woman whose mother had Type-1 Diabetes. She suffered from a leg discrepancy and was only in her early 50’s. We were at her home for a family meal the one night, when someone came in with a 2-litre bottle of soda. She immediately requested a large glass of the soda, to which I “helpfully” pointed out how much sugar it contained and asked when the last time she had tested her blood.

She laughed at me. In fact, the entire family joined in her laughter, as though the concept of testing her blood sugar was anathema in her household. I watched in horror as this woman quickly gulped down almost 50 grams of carbohydrates as though it was water, followed by a full meal. Whether she was using long-acting insulin injections or not was a mystery, but she certainly didn’t inject herself BEFORE the meal. If I consumed that many carbs without an insulin adjustment, my blood glucose levels would skyrocket dangerously (and I’m currently only in my 40’s).

Sadly, the woman in this story passed away just a couple of short years ago. I’ve wondered how much longer she could have lived, with better health and better quality of life, had she simply taken her self-care in hand and worked to keep control of her Diabetes. And this is the important takeaway: having Diabetes means you can’t afford to be lazy. There are too many fine details we need to pay attention to, including maintaining supplies, knowing what foods we’re eating and keeping a tight control of blood sugars and other complications.

I’ll admit that I’ve been guilty of waking up in the middle of the night to a pump with only a few units left and rolled over, content to change out my set once I woke up. Despite my best efforts, laziness hits me occasionally as well. But considering that someone with type-1 Diabetes already has a shortened life expectancy, it’s important to test blood sugars often, work out frequently and do your best to maintain your health. You not only owe it to yourself, but to your family. ☯

Step By Step, Day By Day…

I tend to harp on Diabetes a lot and complain about the many complications that accompany the disorder. And rightfully so, considering how many issues Diabetes can cause in one’s daily life. Just one day can be a chaotic turmoil of problems that can affect other areas of your life. Enter: last Saturday night…

I started Continuous Glucose Monitoring about a week and a half ago, in anticipation of turning on the Auto Mode on my new insulin pump. Auto mode is pretty sweet as it takes a lot of the guess work out of trying to keep blood sugars in range. Working in tandem with the CGM, auto mode tracks your blood sugars every five minutes and makes adjustments on that basis. If it sees that your blood sugars are starting to climb, it’ll increase your basal rate. If it’s starting to drop, it’ll reduce your basal rate or suspend your pump until you even out.

The reviews have been quite positive, considering this particular Medtronic pump has been in use in the United States for the past couple of years. The benefit has been that Canada has gotten to take advantage of their findings without suffering all the trial and error up here. The only active involvement on the user’s part, is the occasional finger prick throughout the day to calibrate the CGM and telling the pump how much carbohydrate they’re eating.

I feel it’s about as close to having an artificial pancreas as one can get, although I have no doubt that the next twenty years could yield some even better technologies. But Auto Mode does require a number of things. For one thing, you need to have a certain amount of sensor data accumulated before activating it. As previously mentioned, you also need to check your blood sugars through a traditional finger prick at least two to four times a day to calibrate the sensor, which is a pain in the ass.

Anyway, I’ve explained all the bell and whistles associated with my new pump before (Presenting, New Medtronic 670G), so you can click on the link for more info. But as with any new technology, there will ALWAYS be trial and error. And that’s what happened to me last Saturday. Let’s examine the timeline, shall we?

Monday, June 22nd: I attend the local MEDEC Centre for CGM and Auto Mode Training. MEDEC means Metabolic & Diabetes Education Centre. This is where I obtained all of my pump training and is also the office my Endocrinologist works out of. Once the training was completed, I was walked through the process of installing CGM and did so in the office, prior to my departure;

Tuesday, June 23rd: Less than 24 hours after first installing CGM, I removed it. Issues late in the previous evening caused a sensor error that couldn’t be corrected. It requested a second calibration and subsequently requested that I install a new sensor. My pump trainer was contacted and we discussed everything from possible scar tissue to simply having bad enough luck to have installed a faulty sensor. He also recommends installing a new one. My fears at letting a machine control my well-being are renewed and I stubbornly refuse to install a second CGM. Not today, SkyNet…

Wednesday, June 24th: After a full day of negotiating with myself, I decide to install a new sensor. I also did it while accompanied by my wife, since she would be the one who would need to apply the adhesives in the event I choose the back of my arm as a sensor site. I cycled a 60k with one of my friends the previous day, which I felt justified my not installing a new sensor right away. I’m pretty good at convincing myself…

Thursday, July 2nd: I’ve worn a sensor for a full week at this point and the pump is now requesting that I replace it. I marvel at the perks I’ve enjoyed during the week, including the pump suspending itself if I hit lows and spending much more time “in range” than I’m accustomed to. I feel somewhat better physically, but I’m absolutely exhausted, either by the hot weather mixed with thunder storms or because my body is finally staring to relax. Or maybe it’s the fact I’ve effectively cut out energy drinks (I say, as I compulsively scratch my forearms and rock back and forth);

Friday, July 3rd: This day taught me an important lesson. I started the morning by doing some intensive yard work in the sun. I followed it up by doing a MetaShred Workout and 30 minutes on the punching pad a little while later. Two workouts, two showers and extended time in the hot Sun taught me that sensor adhesives have a distinct limitation on how well they can stick to a grown man’s belly. In my hubris, I didn’t make a nice, smooth seal of adhesive all the way around the sensor. The result was water getting under the adhesive and drying/evaporating, which ultimately dried out the adhesive and caused the sensor to lift. It lost its footing in my flesh and popped out. One day into a new sensor and I’m forced to replace it because I rushed through the installation. Lesson learned…

Saturday, July 4th: When installing the new sensor last night, I took extra care in applying all the adhesive pads. I basically treated it something akin to putting a new diaper on my newborn, Alex. If I don’t ensure the edges are covered and the bands stick properly, he’ll introduce me to a new level of hell by spewing a volcanic jet of baby waste out the sides. So I essentially treated my sensor with the same amount of attention. And they say that you can’t learn anything from diaper changing! But it’s during the evening and overnight that the proverbial full diaper hit the fan…

  • 4:00 pm: My wife bakes a banana bread. My wife’s banana bread is my kryptonite! If I could sit with the pan in front of me and eat the entire thing, I would. Hence, the reason she cut the recipe down to a third of the sugar. A fact I was made aware of AFTER I bolused for my usual two pieces of bread;
  • 4:50 pm: My pump alarm goes off and suspends due to a low. I mention it to my wife and become aware of the lessened sugar content. I’m frustrated at the low but tickled pink that the pump is doing its job and I get to keep eating, so I cut myself two more pieces of banana bread. This was a mistake I would pay for later…;
  • 8:00 pm: The low and the accompanying correction I dealt with is followed up by my usual feeling of fatigue. My wife is also quite tired and we agree to go to sleep early after getting both kids to bed. I think to myself that I may ACTUALLY get a solid 8 hours’ sleep for a change. Then, I realize that my blood glucose is skyrocketing and a correction is necessary. It takes over an hour to finally fall asleep;
  • 3:10 am: I am awoken by a beeping I can’t identify. In my sleep-induced haze, I check my phone before realizing it’s coming from my pump. It tells me that it’s lost sensor signal and to move the pump closer to the sensor. I swear and mumble softly as to not awake my wife, since both items are tethered to my stomach. How much closer do they need to be??? But I had apparently rolled onto the sensor, which caused a problem. I decide to ignore it and allow the problem to correct itself. I go back to sleep;
  • 3:30 am: Damn it all to hell! I just manage to fall asleep and the pump starts blaring at me that it needs a calibration. Apparently, my timing was off and I should have tested right before bed. I decide to be lazy and press the pump’s “snooze” option;
  • 4:30 am: The pump once again tells me to get up and calibrate via finger prick. I give my pump the proverbial middle finger and hit the snooze button again…;
  • 5:30 am: GET UP AND CALIBRATE YOUR DAMN PUMP, SHAWN!!!! Fuck you, pump! You’re not the boss of me! I’ll do as I damn well please… (as I get up, walk downstairs to my office and test my blood sugar) I curl back up into my blankets, give my pump a last cursory glance to ensure no issues. Blood sugar is normalizing and I feel my eyelids getting heavy. I go back to sleep;
  • 6:30 am (roughly): Baby Alex starts crying as he realizes that its morning and he considers it a firm injustice that we have the temerity to leave him in his crib. My eyes pop open with the cartoon sound of smashing glass and I fight off the urge to start weeping. My wife, who is the ultimate champion of our household, musters from her slumber and rescues the baby from the torture chamber that is his crib;
  • 8:30 am: I awake to the dulcet sounds of Joe Satriani’s Always With Me, Always With You for only the second time in many months, since I usually awake before my alarm goes off. I step away from the bed with an accumulated two or three hours’ of sleep. My wife made coffee. She rules.

Lovely, eh? The life of a Type-1 Diabetic is sprinkled with these lovely days of difficulty and lack of rest. I’m confident that once I get used to it and the Auto Mode is in full swing, I’ll feel better about it and things will get easier. When I first started the pump, I had all sorts of difficulties and there were days I was ready to chuck it out the window. But I couldn’t imagine life without an insulin pump, now. As long as my patience holds out and I stick with it, Auto Mode may just be the ticket to getting my Hemoglobin A1C’s below 7.0, for the first time in over a decade. Here’s hoping… ☯

The Sound Of Silence…

Last week, I awoke to a quiet house. I’m never a fan of Monday mornings… They usually mean I have to get some work done and the week has started, the calm and free time of the weekend has evaporated and dealing with the outside world sets in. But anyone who has children and lives in a “typical” family-oriented home will understand why silence can be a bit of a surprise, sometimes even concerning.

My usual Monday mornings involve a colourful choice between an infant wailing for food or a parent’s attention or my rambunctious five-year old son who thinks that my abdomen makes a pretty good trampoline if I’m quietly sleeping. In fact, since the advent of COVID-19, I’ve set an alarm every weekday morning but have never reached it as my children usually wake me up before I get there. Which is fine, right? That’s pretty normal for a family household.

But last Monday, I awoke to the dulcet sound of Joe Satriani’s “Always With Me, Always With You,” which is my morning wake-up alarm. It’s a smooth, guitar-based instrumental that allows me to wake without being jolted out of my slumber as though someone has connected a car battery to various parts of my body. Anyway, after a moment’s confusion I realized that I couldn’t hear a sound, which in this household is an abnormality.

A mild sense of panic set in as I wondered what was going on. The temperature was in the low teens with a steady rain, so I knew my oldest wouldn’t be playing outside (at least I hoped he wouldn’t) and Monday is a day off for my wife. I stepped out of my bedroom to find my son snoring softly in his bed with his iPad playing cartoons next to him. This is an oddity in itself because he went to sleep here in my downstairs office, last night. This means that at some point, he transitioned upstairs to his bedroom without waking anybody; a miracle unto itself.

The baby was quietly sleeping in his crib and I found my wife sitting on the couch, tinkering on her phone. We said good morning and chatted for a few minutes before it was agreed that my wife should go back to bed and sleep while the baby sleeps. I got a cup of coffee and toasted an english muffin and escaped to the solitude of my basement, which is where I do all my research, indoor workouts and my writing. I settled in and enjoyed my breakfast in a quiet solitude that any parent can agree rarely happens.

So, I sat there… Took sips of my coffee and actually played Mega Man 2 on a badly coded game emulator on my computer. I read a few chapters of a book and checked out a few things online and enjoyed the silence. And you know what? I honestly don’t understand the folks who claim they can’t stand being in silence. It’s wonderful. You can be alone and collect your thoughts, you can enjoy some much needed down time and it’s good for your overall mental well-being.

Eventually the bubble bursts, and it didn’t take long for my son to track me down and begin demanding breakfast. But having that little bit of quiet time every now and again can make a huge difference in one’s life. I highly recommend it. Whether you have a workout, read a book or flat out do NOTHING and just relax, everyone should enjoy a little calm and quiet. Every once in a while. ☯

The Most Unlikely Sources…

Something important to bear in mind is that inspiration and learning can come from some very unlikely sources. Every Sunday, I try to choose someone that has taught me something, guided me or inspired me throughout my life. I hate to admit it, but it’s been a challenge. I’ve mainly tried to keep this contained to martial artists, including the likes of Michele “The Mouse” Krasnoo, Bill “Superfoot” Wallace, Ronda Roussey and even Miyamoto Musashi. All of these folks have had an impact on my life and have inspired what paths I’ve chosen.

But I’ve also made a point of including people who have inspired or guided me in other ways, like my father. Ultimately, we can find inspiration in negative places as well. I only say this because the subject of this week’s “inspiration” post is someone who has had about as much negative (if not more) influence on the general public as positive. I am referring to a reasonably well-known action star named Steven Seagal.

It may be considered an unpopular opinion by some, but Seagal played an integral role in my interest of the martial arts. After all, he’s a master of Aikido, studied/taught in Japan and starred in a number of action movies that came out during those impressionable years when I was young enough to be impressed but old enough to think, “Hmm, this martial arts stuff is pretty cool!” He moved to Japan and studied Aikido there, and claims to have also been the “first non-Asian to open a dojo in Japan.” Whether this is true or not is anyone’s guess, but he’s had a colourful life prior to returning to the United States where he began acting in movies.

He has starred in almost five dozen movies, although a good number of those beyond the mid-90’s went straight to video. I first saw him when I was ten years old in a movie called Above The Law. In it, he plays a police officer and martial artists who uncovers a government conspiracy and helps put an end to it. Sounds pretty heroic, right? In fact, the majority of his movies have involved the protagonist being some sort of military/police/operative who ultimately saves the day. But that’s the whole point, right? We usually WANT to see the hero win. As a kid, I was awe-struck by Seagal’s ability to use grappling and striking as a means of defeating even the most difficult of enemies. And all of his films up until the late 90’s were pretty bad-ass. I can still watch some of them with deep enjoyment, although much more criticism on his martial arts technique.

Then it gets a bit convoluted. Seagal identifies as a Buddhist and martial artist. This holds some special meaning to me, being a Buddhist and martial artist myself. But it stands to reason that someone who practices a religion devoted to the elimination of suffering in the world should be doing just that, shouldn’t they? Seagal has been the subject of a lot of controversy recent decades, including allegations of sexual assault, violence against the people he works with and has ongoing feuds with the majority of his Hollywood counterparts, notably Jean-Claude Van Damme, as a prime example. Not a very Zen-like approach to life, especially a blessed one such as his.

In recent decades, Seagal has become something of a walking joke when one considers his strange political views, ongoing opinions about how other martial artists aren’t “true martial artists” and his apparent lack of self-care where his body is concerned. The man has ballooned up to the point that he almost looks like a cartoon character! My wife and I recently watched him on Netflix in a film called Maximum Conviction, where he starred alongside Steve Austin. Once again, he was portrayed as some sort of specialist who simply couldn’t be defeated. The movie basically starts out by having him beat up a prison inmate who happens to be over twice his mass!

I’m not saying that a genuine martial artist would be unable to defeat a larger opponent, but given the fact that he was 60 years of age in that movie, couple with how he’s let himself go physically, one needs to face reality at some point. It’s no surprise this was yet another straight-to-DVD movie. Even WITH Diabetes, I consider it a point of health, personal care and importance to try and maintain my physical fitness to the best of my ability; a task I feel that I’m still on top of, despite my gut slowly trying to overtake my efforts. But I digress…

My point is, Seagal helps to provide guidance in a very specific way: he’s shown me how NOT to be. His behaviours definitely don’t fall in line with someone who is a true student of the Buddhist or Martial Way. His concepts and abilities with the martial arts have been questioned for decades, both for their authenticity and truth behind his claims. None of this is how a true martial artists or Buddhist would be intended to behave. When I need to know how NOT to comport myself, I need only think of Steven Seagal. ☯

Don’t Judge A Book By Its Cover, Even If The Cover Should Reveal What’s Inside

I remember a story from years ago when I was a manager at my hometown’s local pharmacy. Yes, I was a pharmacy manager… In general, it was an uninteresting job. But like most things in life, there can be lessons to learn behind the scenes, if you’re willing to listen. This is one of those lessons…

I was helping the merchandising staff get some stock out to the floor and I was working in the painkillers and vitamins section with one of the pharmacy technicians. The pharmacy staff were always a little “holier than thou” with the front store staff as they believed that the dispensary was the only reason for the location’s existence. So, there would sometimes be a BIT of tension there. Especially since I technically had no direct authority over them as they fell under the umbrella of the Pharmacist/Owner.

Anyway, I was shelving painkillers (Ibuprofen and Acetaminophen) and the tech was shelving some vitamins. We had a plastic bin for damaged and expired goods on a wheeled cart between our two respective aisles. At one point, we took a break and I glanced down into the bin and noticed a coupled of expired items I had tossed. I also noticed a full, unopened box of multivitamins sitting in the bin. I picked them up and checked the expiration date. They were good until the following year.

I asked the tech why the vitamins were sitting in the throwaway bin. The tech took the box from my hand and showed me where the cardboard was slightly damaged on one end. That was it. The ends were still sealed and by proxy, the bottle of vitamins inside was still sealed tight and the vitamins were in perfectly good condition. I explained to the tech that we couldn’t throw out the box of vitamins based on a bit of scratched cardboard as there was nothing wrong with the bottle inside (part of my responsibility included shrinkage).

The tech pursed her lips and turned her nose up, explaining that she wouldn’t buy a damaged box and couldn’t see any customer doing so either. I asked her, “Why not? If the bottle and the vitamins are intact, there’s literally nothing wrong with it, why would you not still purchase it? Who cares if the box has some scratched up cardboard on it?” She simply shrugged and had no viable answer to give me. I was at a loss and a little bit confused, as my feeling was that the little bit of damage on the outside didn’t take away the value of what was contained within. Apparently, she didn’t agree…

This is an important lesson for the world in general, especially in today’s society of social media filters, photoshopped pictures and everybody’s immediate obsession with their outside appearance. Bullying is at an all-time high, and people’s ability to resist or stand up to it is at an all-time low. But the unfortunate reality is that the first thing people see when meeting us is what’s on the outside. And more often than not, their assessment of you is over before they get to know what’s inside the package.

The Buddhist in me thinks that this is a sad state for the world to be in. The loud, French martial artist with the attitude in me thinks that I don’t give a shit what other people think about me one way or another, but not everyone is as thick skinned. Either way, the important thing to remember is that first impressions are simply that: a first impression. Until you’ve taken the time to look beneath the surface and see what the second, third and fourth impressions may yield, judgements should be reserved and withheld. ☯

Hot In The City, Hot In The City, Tonight! 🎶

Summer is upon us, and I couldn’t be more exhausted. Or miserable! This time last week, we reached temperatures in the low and mid-30’s (Celsius) and I’ve been hiding out in the cool recesses of my basement ever since. I know, I know… I should stop complaining as winter temperatures in Saskatchewan can often hit -50 degrees Celsius and then there’s the shovelling. But I don’t function well in the heat, and would opt for an Alaskan cruise or deep-cave exploration as opposed to laying on a hot beach.

Diabetes doesn’t like heat, either. In fact, according to an article posted by the CDC, people with either Type-1 or Type-2 feel and experience heat a lot more than the average person. Why? Quite simply, nerve damage caused by Diabetes can affect the sweat glands, making it more difficult for Diabetics to cool themselves as efficiently. We also tend to dehydrate much easier, since when the heat starts to dehydrate us our blood sugars rise, we urinate more and lose more fluids… Wash, rinse and repeat.

The other issue is that heat simply slows down the will to move and you tend to want to lay in the shade and do nothing. This is one of the reasons why people in South America tend to go “siesta” in the afternoons, when the sun is at its peak and temperatures are highest. Maybe they have the right idea. Besides dehydration and other typical complications, high heat will also affect how your body processes your insulin doses, so more frequent blood glucose testing (if you aren’t using CGM) may be required to ensure you don’t hit too many highs and lows.

Your equipment carries an entirely different batch of issues. Insulin is the biggest problem, as it requires an ideal temperature range to be effective. Having insulin in direct sunlight or extreme heat will not only damage its effectiveness, but it may cause the medicinal ingredients to evaporate and turn your insulin into nothing more than very expensive water! But your equipment is no different, including insulin pumps, glucometers and even test strips will be adversely affected by the heat. So it’s important to keep these things packed in a cool receptacle when travelling outdoors for any period of time.

Yes, the summer season is nice to get out and get fresh air and enjoy the outdoors. But the heat can sure throw a monkey wrench into the daily life of someone with Diabetes. Especially since kids find themselves out of school and your routine may be royally shot to hell. But as long as your drinking plenty of fluids (non-alcoholic), using sunscreen and have a cool, air-conditioned environment to take breaks in, you shouldn’t have too many problems. Stay cool! ☯

It’s What’s Inside That Counts…

No, this isn’t a post about inner beauty and about how everyone is beautiful! I’ll save THAT conversation for another day, as I do have some definitive thoughts on it. But if you’ve had Diabetes for the amount of time I have, you’ve been through some shit. And you’ve put up with some shit. Diabetes is shit… That’s the takeaway! But in all seriousness, the topic of today’s post are physical scars, which are mostly inside. And having Diabetes or using the associated therapies can leave a number of different scars.

Let’s begin with the digits, shall we? The fingertips… Part of effectively treating Diabetes is the frequent testing of one’s blood sugar levels. Although I was limited to testing only once a day when I was first diagnosed, as a result of financial constraints and my parents being unfortunate enough not to know better, the ideal situation is to test at LEAST five times a day or more. This would include when waking, before every meal and before hitting the sack at the end of the day.

As I got older and took control of my treatment, I started to test my blood sugar more and more in order to avoid many of the complications I had as a child. The result of this is that my fingertips lost sensitivity and accumulated hard, shell-like scarring. This type of scarring is true scarring, same as you’d get from an injury or a wound. It happens due to the accumulation of a fibrous protein called collagen, and is the body’s way of helping to heal the wound. Although the scar tissue may soften over time, it never truly goes away. Even if I have feeling in my fingertips nowadays, you can still see the scar tissue if you look closely (especially since I still do finger pokes.)

The more problematic scarring (because let’s be honest: as long as the needle pokes through the tissue and draws blood, fingertip scarring is no kind of a big deal), is Lypohypertrophy. You can check that term out on Google or Wikipedia if you wish, but the gist of it is a visible lump under the skin near your insulin injection sites. Besides being painful, it can also affect how your insulin is absorbed and the length of its effectiveness. I’m just going to refer to them as “Lumps” for the rest of this post…

People forget that insulin is a growth hormone and because of that fact, the Lumps you find at your injection sites are often an accumulation and/or growth of fat tissue. This is generally caused by using the same injection site repeatedly, but does go away over time. Depending on the severity of the Lumps, it can take several days, weeks, even years in some cases for them to completely heal and disappear. But they generally do, over time.

Here are a few ways to avoid developing Lypohypertrophy:

  1. Rotate your injection sites: This is something you should be doing anyway, but you want to avoid using the same spot over and over without allowing it some time to heal. In fact, my pump trainer was telling me about a Type-1 who only uses one side of his abdomen per month, allowing for a full calendar month for the other side to “heal” and for Lumps to disappear. I don’t go to THAT extreme, but I do switch sides with every new infusion set;
  2. Use a fresh needle: I used to be EXTREMELY guilty of this one. Either from laziness or trying to be cost-saving, re-using the same needle over and over can be terrible for you flesh (see illustration below). Even after one use, the point of a needle begins to warp and change shape, requiring more pressure to breach your flesh and causing more damage on the way in. This can lead to actual scarring as opposed to just Lumps. It will also increase the chances of inflammation and infection;
  3. Leave some space: If you are injecting on the same side and are close to the previous injection site, make sure you leave at least an inch of space between your current site and the new one. Like I said, insulin is a growth hormone. If you inject too close to the previous site, absorption and effectiveness can still be an issue;
  4. Give yourself time to heal: Alright, this one may be riding on the coattails of #1, but it’s important. Like anything else, injection sites need time to heal and get better. No matter what you may read online (this blog included), your body is unique and your healing time will be yours alone. So make sure you’re giving it the time it needs before poking into your preferred injection area.
Microscopic view of a needle tip after repeated use

Obviously, if things seem kind of wonky with a previous injection site, such as discolouration, throbbing or pain or the tissue is hot to the touch, you should seek medical attention as it could be an indication of a worse injury or even infection. I’ve just complicated matters for myself, since CGM requires a second injection site and is supposed to last for seven days. So I get to yo-yo two different injection sites with different change times and try to prevent reusing those sites too frequently.

At the end of the day (or week), those Lumps will disappear as long as you stay true to fresh needles and fresh injection sites. You may develop Lypohypertrophy on occasion even IF you do all these things, so don’t be surprised if you get the occasional Lump. Just be sure to take care of them properly and you’re good to go! ☯

Happy Canada Day!

Alright, so this is a re-post of last year’s Canada Day. But in reviewing it, I decided that there was little I could add or modify that does this post any justice, so I’m sharing it again.Other than the fact that July 1st carries a bit of a dark stain in my personal life (those close to me know what I’m referring to), my country holds a big place in my heart and I think our national holiday is an important observation on the yearly calendar. Enjoy…

O, Canada! My home and native land… Alright, for those of you who know the anthem, that was pretty cheesy. But today is our National holiday, celebrated on July 1st because Canada became a country on July 1st 1867. For my fellow bloggers and loyal readers who may not be from the Great White North, here are some quick facts about Canada to help you understand what makes us awesome…

The common misconception is that Canada was first discovered in 1534 by French mariner Jacques Cartier. Although it is the accepted belief, the discovery of an abandoned outpost in the Province of Newfoundland suggests that Vikings may have come to Canada as early as 500 years before Cartier.

Vikings aside, French and British settlers began colonizing in 1602. British colonies and territories joined together in 1867 through confederation to become a self-governing country that we know today as Canada.

Although self-governing, Canada continued to be ruled by the British Crown until as recently as 1982, when our Constitution was patriated. The British Monarchy is still considered our head of state.

Our country has the second largest landmass of one country, in the world. Our borders touch three oceans (Atlantic, Pacific and Arctic) and our country has 10 Provinces and 3 Territories. As of today, Canada has a population of over 37 million people and we boast a unique multiculturalism unseen anywhere else in the world.

What else is Canadian? Well, I’m glad you asked… Five pin bowling, the wonder-bra, Trivial Pursuit, the vehicle Odometer, the egg carton, North American time zones, the electric wheelchair, the first plastic garbage bags, the paint roller, the first internet search engine, the first pacemaker, basketball, ringette and hockey, the world-renown Royal Canadian Mounted Police and of course, insulin! (You’re welcome world!)

We thoroughly enjoy our food. In fact, we’ve invented a mouthful of it (see what I did there?)… Poutine, Nanaimo bars, instant mashed potatoes, the California Roll, Chinese buffets, peanut butter and butter tarts, caesars (the drink), Hawaiian Pizza and Coffee Crisp bars!

And contrary to popular belief, we didn’t invent donuts but Tim Horton’s donuts is Canadian and its coffee brand is world-renown. One of the fun and unique things about Canada is that you’ll find local cuisine and dialects specific to particular corners of our nation.

There’s so much more, but I’d need more than a blog post to cover it all. Suffice it to say that Canada has a lot more to it than beavers, moose and donuts. If you have the benefit of living here, hopefully you’re doing something to celebrate today.

If not, come pay us a visit! I’ll grab a two-four of Molson Canadian and some Timbits and I’ll tell you the rest of the story. Stop on in, eh? ☯

Another Piece To The Puzzle

I started CGM last week. For those of you who may be unfamiliar, CGM stands for Continuous Glucose Monitoring, and it’s a device that measures my blood glucose levels every five minutes and communicates them with my insulin pump. In some ways, it’s the same as my FreeStyle Libre, with the exception that my FreeStyle doesn’t communicate with my pump.

Although having a device that instantly tells my pump whether it needs to suspend basal delivery because of a low and maintain a better percentage of “time in range,” it stands to reason that a more complicated device will theoretically have more issues. And I have found this to be true with CGM. The FreeStyle Libre has been good to me overall, providing little in the ways of problems and interfacing with my phone for a quick, easy means of checking my blood sugars.

When I started the insulin pump in early 2015, I was resistant to CGM. Hell, I was resistant to the pump itself, but the medical professionals through my work kept “encouraging” it, and since they were footing the bill I figured, why not? And no, that isn’t a brag about the fact my pump was covered by my medical insurance. I’m well aware that most people don’t have that benefit, so I’m grateful rather than bragging.

But given the potential violence of my work, I felt that it wouldn’t be ideal to have a device hanging off my gut, around the clock. I also didn’t want to feel tethered to a machine, having grown up watching my brother hooked to machines all his life. I conceded to try the pump, but I refused the CGM as it would be a second module attached to the body and I felt as though one was enough. I mean, come on! Life with Diabetes is difficult enough without turning myself into a cyborg, am I right?

Hello, CGM! Welcome to the party! (Pointing out my freckle is not necessary, thank you!)

My endocrinologist did it right; sneaking the FreeStyle Libre into my life, calling it the “poor man’s CGM” (although it’s far from being cheap, by any means) and allowing me to get comfortable with the prospect of a second device on my person. I have been using FreeStyle for about two years now, and with the advent of my new pump that I started mid-March (Presenting, The Medtronic 670G), I decided to stop being such a stubborn princess and try the CGM that my pump is designed for. (Don’t get any ideas, I’m the only one allowed to call me a princess… And maybe my wife…)

So, here are the problems… Because this is me, and of course there are problems… The first glucose sensor I installed at my pump training failed within hours. Either from a faulty sensor or from scar tissue (which I’ll be covering the day after tomorrow) we don’t know. But it was a pain in the ass, nonetheless. Installing the sensor is tedious, involving more steps than refilling the insulin pump AND using enough adhesive to make Red Green‘s duct tape jealous. (If you don’t know who that is, click on the link and I apologize for aging myself so severely)

This happened last Monday. I was frustrated and I already felt as though the CGM would cause more problems than it was worth, so I shut the option off on my pump. I’m also a bit old school and it takes me a while to put the fate of my well-being in a machine I’m unfamiliar with (Not today, SkyNet!). On Tuesday, I went cycling with a friend and felt it wasn’t a great day to re-install, so I went without it. On Wednesday, I realized that I was actively avoiding it, so I installed a new sensor and started the whole thing up.

I also needed to demo the installation for my wife, who will be the one helping me install it on my tricep, should I decided to use that as a potential site (cue the naughty nurse jokes, here.) Here’s the thing: it’s been helpful. I’m eating an entire murder of crows admitting this, but having the ability to simply glance at my pump screen and see my trends and know what I may be currently sitting at has been nice. Also, my pump is set to automatically suspend my basal rates if I hit 4.0 mmol/L, making it a whole lot safer for me at night. Now, I just need to see how the device will hold up to extreme exercise or cycling, and how I’ll handle a punch to the gut when I return to karate, for the jury to fully have a verdict.

I guess my point behind all of this, besides pointing out how stubborn I am, is that although we don’t have a cure for Diabetes yet, technology has carried us lightyears beyond where we were in the early 80’s when I was diagnosed. When I think about the brick of a glucometer I used to carry around, only testing my blood once a day, “eat no sugar” being my only mantra and the fact that I was excused from most if not all sports due to the fact that “Diabetes makes it dangerous to play sports…” Pffft… what bullshit! If I only knew then what I know now. But I digress…

My point is that we’re getting there. Different technologies are at least making Diabetes manageable in ways it never could be, before. Will we have a cure someday? Like a significant percentage of the Canadian population, I sincerely hope so. I just don’t know if it’ll be within my lifetime. In the meantime, I’m well on my way to becoming a cyborg. ☯