Navigating Amusement Parks as a Diabetic.

This summer, my family and I bought Seasons Passes for our local amusement park. Because it's summer and summer is hot, it's a nice place to spend a day, and even use the water park to cool off with.

However, being a diabetic also means that I carry insulin and snacks with me.  And most amusement parks don't allow outside food (unless you're awesome, like Disney).  Our local park does not allow food in.  But I can't be standing in line trying to get a snack if my sugar drops, and I can't be standing around in the heat if my sugar is going up. 

We went yesterday (Victoria Day) to our local park and I figured it was as good a time as any to test out some of their policies for patrons with disabilities (diabetes is considered a disability in terms of access and accommodations).

First test - passing security with snacks and an insulin needle in my bag...  When we got to the front of the security line and he opened my bag he saw the granola bar and snack cakes.  I explained I'm a diabetic and I need to carry snacks.  He said it was no problem and waved us through.  First 'test' passed. 

Next, since it was really hot out yesterday, and I had insulin in my bag, I didn't think it was a good idea to be standing in line in the heat while my insulin boiled.  So I asked at the Ride Accommodation window what could be done.  I was given a form to take to any ride I want to go on, and any one in my party could go up the exit ramp to the ride operator and get a loading time.  Then all we had to do was return to the ride at the time on the form, and we could get on.  That way, my insulin could stay in my bag and stay cool, and I could go somewhere air conditioned to make sure the bag didn't overheat.

This accommodation is available for anyone with accessibility issues, ASD or physical disabilities.  So long as the person meets specific requirements (being able to hold their centre of gravity on their own, have at least one good arm and leg in order to hold on to the ride, and be able to hold themselves upright in a seated position).

Alternatively, there is a fridge at the First Aid station where my insulin can also be stored for the day.  The only problem with that is if I need my insulin and I'm on the other side of the park, I could find myself in trouble.  But there are options and it's nice to know that they are there for the asking.

Make sure you know what accommodations are available to you, or someone you know, with diabetes.  Or with any other health issue.  You might be surprised.

First Time Playing Slo-Pitch as a Diabetic

Tonight I play my first Slo-Pitch game in more than 10 years.  Last time I played my kids were very young, I was 10 years younger and I wasn't diabetic.

I have played some form of baseball for a large part of my life.  T-Ball when I was little, Softball when I was a little older (between 8-11, I think).  Slo-Pitch as an adult in a recreational league.

I'd be lying if I said I wasn't a little nervous. 

Not because of the diabetes - I know what to do if I feel low, and I keep myself pretty well controlled.  I've also told my coach (well, Team Rep - we're adults.  We don't need no stinkin' coaches!  Plus, we're a recreational league) and my teammates that I'm diabetic. 

That said, I still have to make sure I am prepared for any possible emergency that may arise.

So, I'm packing my kit to make sure that I am prepared for any eventuality.  Here's what will be coming with me weekly to my games:

 Baseball gear - that should be obvious.

Diabetes gear:

In a cooler I will pack weekly I will have:

A "Diabetes Alerts" sheet, which lists symptoms of hypo and hyperglycemia and how to treat them.
An ID card with similar information. 
Several bottles of water.  It gets hot in Ontario, even at night.  And it's humid here - especially in July and August.
Glucose tabs.  Some people don't like them.  I do.  I'm weird.
Juice boxes.  Probably just one or two.
Granola Bars - they usually travel well, don't go bad, and aren't gross to eat squashed.
A glucose monitor, lancing device, test strips.  If I'm acting weird, I need to be able to test and see if I'm low.
Insulin. I'll have my Apidra (fast acting) with me each week because a) we may go out to the bar afterwards and b) if my sugar goes high, I need to be able to treat that.
Ice packs - insulin doesn't like being out in the heat. 

I also wear a MedicAlert bracelet and recently got this really nice one...

I think that's about it. 

How about you?  What do you keep in your bag when you go out for an extended period of time - or know you'll be spending a lot of time being active?

First Meter Review!

I completed my first review of a glucose meter and am ready to share it with you now.

I started reviewing the One Touch Verio Flex.  This is one I was excited to try.  It comes with Bluetooth capabilities and links to an app on your phone very easily.  I'll go through the process as I go through this review.



The app icon

The Flex is very easy to use, as are most glucose monitors, to be honest.   Test strips range in price based on where you buy your strips.  Costco Pharmacy sells them for about $75 for 100.  Shoppers Drug Mart sells them for about $85. The strips can be used on the Verio, Verio IQ and Verio Flex interchangeably - which is nice if you have strips for one and get a different Verio meter from your previous.







Setting up the Bluetooth to talk to my phone was no problem.  Easy peasy.  You turn on the meter, make sure the Bluetooth is on on the meter and your phone and wait for the app to 'discover' your meter.  Your meter will have an identification name/number that you will enter into the app, and then, your app and meter can chat with each other. 

Chart showing tagged
and untagged readings

One of the great things about the Bluetooth capabilities that I really liked was that I could use the meter as I usually do, throughout the day, and then upload all the information at the end of the day.  I didn't have to enter anything manually unless I used a different meter.  The front of the meter shows whether or not your blood sugar is in range (a range you select in the app, which you can customize in the app - the ranges on the meter and the app may differ).


Manually Entered
reading

Manually Entered and
uploaded readings

What I found very interesting with this meter is that when you manually enter your information, it will differentiate between meter readings and manual inputs with a different font, which is kind of neat.  At a quick glance you can tell which readings came from where.  Same goes for whether you've tagged any of your readings.  The chart (pictured to the left) differentiates between readings that are tagged, and before and after meals. 

Manual Entry Screen

All of the readings are kept in an easy to read format.  You can enter pretty much any information you want to keep track of.  There is an area for notes, so if you take a fasting reading, you can note that.  Otherwise, before and after meals is your only option.  You can also note in the app your insulin dose, and your activity and grams of carbs at your meal.  What I could not find was a capability to access nutritional information for food - which some apps do allow.  You could always look it up with an app such as My Fitness Pal, and enter the food in your notes, but having a search capability for foods is one of those "not necessary, but nice to have" features in some other apps.

All in all, this meter is a great meter - really easy to use, and the app is very user-friendly as well as easy to navigate. I've used other OneTouch meters in the past (reviews for those are upcoming).

One feature that I miss on the Flex and the regular Verio (review upcoming) that the IQ has is that the screen is not backlit, and if you want to test in a darker setting, say early in the morning when you wake up, or if you wake in the middle of the night and need to test, there's no light where you insert your strip (I'll discuss this further in my review of the IQ, but it is a feature of the IQ that I quite enjoy.  I hate turning on my lamp if it's dark and my plan is to test then go back to sleep). 

Opinion:  Great meter for everyone.  The display is large enough to read.  Fantastic for the tech savvy because hey, who doesn't like techy stuff?  I loved the Bluetooth capabilities.

Wish List: A light in the strip port (like on the IQ), and/or a backlit screen; access to a food list for carb calculation through the app.

Tech Savvy Families Use Home-Built Diabetes Device

Okay, this is seriously cool.

Type 1 Diabetics, and I suppose this could be useful for Type 2s as well, are one step closer to an artificial pancreas - if they know how to program a computer, and have an old pump they can use.

Read the article here:

Tech Savvy Families Use Home Built Diabetes Device

Normalizing Diabetes - American Girl does it right.

When I was in high school, I knew one kid with diabetes.  And the only reason I knew she had diabetes was because she did a presentation for my Health class on diabetes.  I knew about diabetes - and in some ways, based on her presentation - it seemed I knew more about diabetes than she did.  She joked about eating chips knowing it would skew her numbers and that she would wind up higher than she should have been.  I knew that it needed to be properly controlled.  But I didn't say anything, because we were 15, and I figured, well, maybe she knows more than I do, since she's the one with diabetes.

Little did I know, 20 years later, I'd be diagnosed with diabetes as well.  And I could totally see why sometimes she would eat something she shouldn't because it gets tedious, and sometimes, telling people you're diabetic isn't something you want to do.

It can be especially hard for kids to explain to their friends why they test their blood, why they take needles and why they need to carry things on them like juice boxes and candies, that they don't eat - unless they have to. 

I remember my sister having a friend in Grade 4 who was diabetic.  One incredibly hot day at the end of the school year, the teacher brought in popsicles (in the days when teachers could actually bring food into the class as a treat without somebody screaming about allergies or unhealthy snacks).  Obviously, this well controlled diabetic 9 year old couldn't have a popsicle - so she said "All I have to do is run around outside for about 10 minutes and that will bring my blood sugar down enough that I can have a popsicle".   She lasted about 3 minutes outside before the heat got to her.  But I think she did wind up able to have that popsicle - with the extra bonus of NOT going so low that she needed more than one popsicle.

These days, kids have so many more options for monitoring and treatment than they did 20 or 30 years ago.  But the stigma of being 'the sick kid' hasn't entirely gone away. 

Enter: American Girl.  Now, I'm not going to go off on my usual rant about American Girl and how ridiculously expensive these dolls are ($100 for a bunch of PLASTIC!?), because in this case, American Girl is doing something right.  They are making diabetes something normal.  They have made a blood kit and pump for the American Girl doll.  At the very least, this company has recognized that American Girls (and Canadian, and every other type of girl) come in many different varieties.  There are Girls in wheelchairs, blind Girls, and now, diabetic Girls.  The New York Times (not my favourite paper, but for a different reason) wrote a blog discussing the new diabetic Girl kit.

The kit itself (which retails for US$24) was the brainchild of a child brain.  13 year old Anja Busse of Wisconsin started a petition to American Girl asking them to make the kit for girls like her.  At 11, Anja was diagnosed with Type 1 Diabetes.  And now, her American Girl doll has too.  But she is well taken care of by Anja, who can test her doll's "blood" with a fake lancing device and check it on the make-believe monitor.  She can attach her doll's insulin pump to her clothes, and make sure any sugar lows are treated with the make believe glucose tabs that come in the kit. (the online catalogue page can be found here).  What's amazing about this... it's currently backordered.  Which means the product is popular enough that they have sold out.  Although it could also mean they don't make that many - but I think the popularity of the request was enough that they have actually sold out.

At the bottom of the page linked above - there are related items.  American Girl really has made it so that "different" is normal.  A quick look at the few products available they carry an "allergy free lunch" for your doll, crutches and a wheelchair, and even a cast and crutches (the "Feel Better" kit) if your real girl breaks her leg.

Kids have a much different and in some ways much more difficult life than we did 20-30, and more years ago.  It's nice that there are companies who make it so that their differences - aren't different.

I have an infection. Now what?

I was going to write a post about the use of cinnamon for blood glucose control (and I will, soon), but I got an ear infection and it prompted me to write about infections and antibiotics with regards to diabetes.

I am very prone to ear infections.  I have been pretty much my entire life.  Becoming a diabetic did not make it worse.  But it did make treating them sometimes difficult.

I remember about 3 or 4 years ago, I got an ear infection and went to the doctor at the walk-in clinic and was prescribed an antibiotic.  Cool.  I started taking the meds and things did not improve after a few days.  In fact, they got worse and the pain increased.  I was practically crying when I went to my own family doctor for help.

She told me that the antibiotic the doctor at the walk-in had prescribed was a good one, but not for diabetics.  She said that that Cipro (ciprofloxacin) just didn't work well in most diabetics, and prescribed me something stronger - Keflex - as well as some antibiotic ear drops (funnily enough - CiproDex - a ciprofloxacin drop).

So, I did some reading into this, and read some papers and while I haven't actually found anything that says Cipro doesn't work in diabetics, I did find that Cipro class drugs can in fact cause wide swings in blood sugars - hypos or hypers(1).  And as many diabetics know, uncontrolled blood sugars can make infections worse, or can encourage them to develop.

So while it's not a matter that the antibiotic won't work for diabetics, but rather that the antibiotic can cause blood sugar swings, that can encourage the growth of bacteria, it needs to be taken into account when a patient presents with infection. On the other hand, the infection itself, can also cause a loss of glucose control.  It's really a vicious cycle when you get an infection of any sort.

If you think you have an ear infection, or any type of infection, you really should talk to your doctor about the appropriate antibiotic to treat the infection, as well as maintaining good blood glucose control. Not every diabetic who takes Cipro has the same effect.  For me, it just didn't seem to reach the infection, and I needed something stronger.  For others, they may not find that they have any problem maintaining control with Cipro, and it clears up their infection.  This, of course, is the main reason why it's important to discuss with your medical team any medications and to contact them as soon as you notice any change in your health - especially if the infection you're treating seems to be getting worse, or you are having problems controlling your blood glucose levels

Another problem with antibiotics in diabetics is that there is often an increased resistance.  The main reason seems to be because diabetics can have recurring and common infections, and therefore are treated with antibiotics more frequently.  This of course, can lead to a resistance after time. (2)  Antibiotics need to be prescribed with care.  But of course, you shouldn't avoid taking antibiotics if you really do need them. 

As always, my advice is to talk with your doctor about your medical regimen and make sure you are getting the best care possible for your particular needs.

I remain, as always,

Gayla Ber
Sugar Free Mamma Be(a)r

(1)http://www.medicinenet.com/script/main/art.asp?articlekey=172680
(2)http://www.medscape.com/viewarticle/803748_5


Other sources:
http://www.drugs.com/disease-interactions/ciprofloxacin.html