About Diabetes Beyond Borders

Tracy was diagnosed with Type 1 diabetes at age 5 weighing a mere 31 pounds. At that time she injected with 13mm length needles/syringes once daily with Lente and Regular insulin. She tested her sugar through a Clini Test tablet and a test tube with her urine. At the age of 16, after experiencing a severe hypoglycemic event, living with Type 1 diabetes for 11 years, Tracy decided that the ideal career choice was to pursue nursing. After her initial prenatal visit with her GP and his harsh but loving comment that she had more than one life to live for, Tracy began testing more than once or twice a day. She was terrified that she would not have a healthy baby and she would not someday not be able to 'see' her baby. Making the Dean's List, she graduated from Nursing in 1991, 8 1/2 months pregnant with her daughter. Less than two years later, after the birth of her son, Tracy felt it was in her families best interest to practice in an environment where her infant son & toddler daughter could be as well. As a result she began working full time within a Daycare setting. As well as distributing medications to infants & children she spent the remainder of her time working with Special Needs children. Upon an insurance physical by her physician, after being asked to take 25 steps up and down on the 'step' to get up to the examining table and short of breathe before finishing, she was read the riot act. Not even 30, she was in terrible shape. It scared her. She wanted to begin and progress through the steps it would take for her to be in the best shape she could so that she would be an example for her children on all levels. She attempted to start running and using a stair climber at home. On the days she could not accomplish these objectives, walking, gardening and activities with her little ones was essential to increasing her physical well being. While completing her Critical Care Certificate, Tracy operated a home daycare so she could be home until her children were in school full time. During that time Tracy joined a Kickboxing/Karate club with a friend to participate in Kickboxing classes. She loved it so much, within a year she had joined the Karate club and was working toward her black belt. In October of 2000, Tracy's son Kurtis was also diagnosed with Type 1 diabetes increasing her motivation & passion to move her career further towards working in the field of diabetes so that she may set an example for both of her children's futures. At that point Tracy was provided opportunity to work within a hospital setting, initially on the Medical/Telemetry floor and subsequently the Intensive Care Unit. She gained valuable experienced working on other various units as well. Eventually, Tracy became the person co workers referred to with regards to patients who were hospitalized with Type 1 and Type 2 diabetes. At that time, she signed up with Team Diabetes through the Canadian Diabetes Association to train and raise funds to run a full marathon in Amsterdam, Netherlands. Successfully, Tracy raised $5,500 through various fund raising activities and ultimately completed a half marathon (due to injury) for the CDA in Amsterdam. A huge undertaking given that the main means of dropping high blood sugars as a child was to run with her dad, who was an avid runner. That left her feeling that running was a difficult task and not an enjoyable activity. Amongst the other fitness activity experiences mentioned, Tracy has played many sports such as ball hockey, floor hockey, acquiring her purple belt in karate, training for a tri a triathlon, resistance training, and road biking. At that point, with regards to her career, she felt it was best to be involved in prevention & education as opposed to the care of those who had already experienced complications as a result of their diabetes. In 2003-2004, Tracy spent 2 weeks each summer at a children's camp sponsored by the Canadian Diabetes Association. There she was able to educate, assist in treatment of high & low blood sugars as well as become a mentor for staff & children living with Type 1. During those 2 years she participated in a 3 day long portage/camping adventure with twenty 14-15 year old teens with Type 1 diabetes. After a lot of researching & networking she began working for Novo Nordisk Canada Ltd as a Diabetes Consultant. During almost 5 years with the company Tracy developed close, trusting relationships by providing education & products to all levels of healthcare professionals through continuing health education events, use of clinical studies and provision of relevant literature. Through hard work and focus she acquired exclusive contracts for 85% of her hospitals. She shared several best business practices throughout her tenure. As well, she was part of four new product launches. Tracy also provided presentations to new company hires as well. During her time with Novo Nordisk she completed her accreditation certificate for the Council for Continuing Pharmaceutical Education. When the time came to expand her professional and personal portfolio with Medtronic Canada Ltd as Territory Manager, Tracy was first out of 60 reps at Novo Nordisk with regards to sales and growth. She received several awards throughout her tenure. Two years following that, Tracy worked for Medtronic Canada Ltd. As well as working with Health Care Professionals within her team of three, Tracy provided group education demonstrations and classes to people living with Type 1 and Type 2 diabetes, as well as spending time in their homes, demonstrating the use of an insulin pump and it's associated technologies and supplies. Tracy was part of a major product launch with Medtronic as well. She was also the recipient of a quarterly President's Award for achievement of sales. She was on a number of advisory committee's from a Marketing, Multi-Cultural and Competitor perspective. After her tenure with Medtronic, Tracy decided to fly solo under the business "Diabetes Beyond Borders" securing several contracts providing diabetes marketing, education and training. Her main focus with Diabetes Beyond Borders was to provide motivation, empowerment, passion and education to people living with Type 1 and Type 2 who want to take it to the next level of balancing their activity & fitness with their diabetes management. As well, she developed materials for a large on line pharmacy which sold insulin pump supplies. She travelled throughout Ontario providing education with regards to insulin pump infusion sites, cost analysis and choice to Nurses and Dieticians educating and supporting their patients at Diabetes Education Centres. As well, she provided insulin pump starts for Medtronic and Roche in the community. Tracy was then approached by the Founder of one of the largest Diabetes Education Centre's for Type 1 diabetes in Canada. She was asked to become a Diabetes Nurse Educator for the Centre. She spent 1 year educating within the guidelines of the CDA guidelines but also providing the practical experiences she experienced as a person living with diabetes and a Mom of a PWD. Within that year at the Diabetes Education Centre, she was approached by Bayer Canada Inc. to apply for a sales position. Today Tracy is now a Territory Business Representative for Bayer Canada's Diabetes Care division providing education around blood glucose testing and how important it is to connect those results to therapy making decisions. Entering into her 40th Anniversary living with diabetes, she has been on Insulin Pump therapy for 14 years and continuous glucose monitoring 24-7-365 for 6 years.

Playing the Game

“If you’ve had a good time playing the game, you’re a winner even if you lose.” – Malcolm Forbes

Such a beautiful Saturday!

Such a beautiful Saturday!

It’s Saturday afternoon.  The house is clean, errands done. The sky is blue, the sun is warm and inviting.  It’s time to give my body and mind some love and go for a bike ride.

This is not a leisurely bike ride.  My intention is to make my heart pump fast and hard. I am looking for an adrenaline rush.  I want my muscles to burn while I push my peddles and ache afterwards in thanks for making them work hard.

I hate to bring fanny packs or extra baggage to carry my emergency supplies in case of a low blood sugar.  Instead I have a favourite pair of Lulu Lemon capris that work perfect. Two pockets on the outside of each leg.  One pocket for lifesavers, house key and money. One pocket for my iPhone for music and to record my time, distance and route on MapMyWalk or Run or Bike.  In the pocket in the back of the waist is room for my Burt’s Bees lip chap.  I NEVER go anywhere without my trusted Burt’s Bees!

These items I describe are not the only ones I carry with me.  I am attached to my Continuous Glucose Monitor transmitter and sensor on my outer, left thigh.   Clipped to the right strap of my tank top is my insulin pump.  I keep it there when I work out so I can check my CGM graph to keep my sugars in check.  I check this on my ride based on how I feel.

Today’s work out starts out on a positive note.  My blood sugar is 7 mmol/L (126 mg/dl). Based on this, I decide to eat 1/3 cup of Prana Organic Maple Almonds.  I don’t want my sugar to spike up quickly with a rapid acting carb but I don’t want my sugar to drop fast mid workout.  I figure the almonds are the perfect match for today.

It was a good ride!

It was a good ride!

As I walk in the door of our home, I look at my pump again.  It is a beautiful thing!  I end with a BG of 6.2 mmol/L (94 mg/dl) with one arrow going down which is not bad but I’m a little worried I will go low.

AND this is where it turns into another huge learning curve.  Even after living with Type 1 diabetes celebrating 40 years this Fall.  I am always playing the game.  I am forever learning.  Because the rules are never the same.  They are always changing.  There is no formula.  I need to stay on top and adapt to these changes.

Looking at the screen of the CGM on my pump, I have to make a decision.  Do I take a chance and ride it out?  Risk having a low blood sugar?  OR do I set a temporary rate on my pump to slow down the flow of insulin?  AND/OR do I take less insulin for my post work out snack?

An uncomfortable way to learn.  I hate high sugars.  Especially when I make the wrong choice and cause it.

An uncomfortable way to learn. I hate high sugars. Especially when I make the wrong choice and cause it.

This is what I decide to do:

1.  I set a temporary rate for 50% for one hour.  So, for one hour I will ask my pump to give me 1/2 the amount of insulin I need to sustain me in a fasting state.

2.  I measure out 1 cup of lactose free chocolate milk my post work out snack at 22 grams of carbs and decide to only take insulin for 12 grams.

AND that is when my evening from hell begins.

I spend a better part of 4 hours trying to get my sugar from a stable 13.5 mmol/L (243 mg/dl) back down to target.  My head is fuzzy.  I feel angry at myself.  AND the extra sugar in my brain is not helping.

I evaluate what I could do better next time.  What rules in this game am I going to change for next time?

1.  I always need a post exercise snack.  I don’t think milk is the answer.  I think it is too high in the Glycemic Index.  It spiked my sugar almost like juice does.  I will choose something that is solid food with a combo of complex carbs and protein.

2.  I will take the full amount of insulin for the snack.

3.  I will not panic with one arrow going down and I will confirm the sugar on my pump/CGM with my blood glucose meter.

4.  I will wait to set a temporary rate on my pump until bedtime instead of immediately after exercise.  I do believe that part of the spike involved a glycogen response from my liver as I rode hard and my stomach told me I performed in an anaerobic state for the last part of my ride.  My stomach felt heavy and I lost my stamina as my muscles failed.

“Many times what we perceive as an error or failure is actually a gift. And eventually we find that lessons learned from that discouraging experience prove to be of great worth.”
Richelle E. Goodrich, Smile Anyway: Quotes, Verse, & Grumblings for Every Day of the Year

I am an Endless Legend

This morning I scan Facebook for motivation and laughs.  I hate the news. Rarely do I search out news.  I am skeptical in its presentation versus reality.

Within the search, I find this.

Seb’s video motivates me.  Focus on today.  Small steps.  That’s all I hear.

Tonight I find a hoodie with my Maiden name which has a saying….

“I am an Endless Legend.”

And I feel like I can be a Super Hero.  Yep that’s right.  Click on the link to see what motivates me to write about it.

http://www.sunfrogshirts.com/DOUGHTY-3254-White-29514080-Hoodie.html?23035

My maiden name is Doughty.

Today our temps reach above 0C.

I am closing in on living with Type 1 diabetes for 40 years.  Exercise, activity, healthy eating and keeping myself in shape and healthy is important to me.

BUT, It’s been a rough few months exercise and otherwise for me. Winter and I don’t get along as far as energy and ambition.  The month of February in Ontario was the coldest on record since 1875.

Word on the Weather Network is temps will reach upwards of about 6C.   It will feel balmy if it is true!  No wind would be nice too!  I haven’t heard about the records set for wind this winter but one must exist!!

Today I work from home finishing up some Admin that’s been driving me crazy. The sun shines bright all day. The bright sun gleaming through the windows blinds me at times. Despite that, I embrace the intensity of it.

Suddenly the hope appears with the time change and the increase in the intensity of the sun.

About 5pm, I take a break from the Admin work I focus on all day.  I put on my ear buds and hook up my music. I make my way to the ‘super mailbox’ up the road to get our mail. It feels so good to get out.  I can’t stop looking to my left, smiling at the sun as it made its way down the sky to sleep for the night.   Today, I am thankful for the gift the sun has given.

I wish the roads allowed for me to put on my running shoes and go, but I can’t stand wet feet…and not good for the well being of them either.

Knowing I can’t let this time go, I take the ‘long’ walk home.

Thankfully, we live right off the Trans Canada Trail…it is just a few minutes walk from our home. I am excited to make my way there as soon as the snow melts and puddles aren’t ankle deep to get my running gear on and go…for miles and miles.

Despite the fact I wear my Blundstones, to keep my feet dry tonight, I want to run so bad. It is so hard not too.

In anticipation of this, I find a post on FB of a T and hoodie that include my Maiden name…and I fall in love. So, I ordered a few work out T’s and a hoodie.

And one for my Dad…cause if it wasn’t for him….I wouldn’t be an Endless Legend!

What do you do to motivate yourself to move?

P.S. Pink is my favourite colour…of what I ordered, I picked a bright pink tee…and I while I wear my fav colour I will remember while I am running or lifting weights…. “I am an endless legend.” for so many reasons.

Tried and True Recipe….Feeds 8…Not in My Experience

I found this recipe, I am guessing, about 18 years ago.  It was an instant hit. So much so, in particular, my daughter Cayla would request it.  She asked me to send it to her when she lived in France and then in the Chilcotin Mountains of British Columbia. She asked me to send so she could make it for the families she worked for as an Au Pair.

This year before she left for her adventure living in Wellington, New Zealand we had a ‘Farewell’ party.  I asked what meal she would like me to make for this occasion.  My famous Picadillo was the request without hesitation.

We sit down at the table with Cayla, my parents and my husband, Steve.  We begin to partake.  Steve says “Why haven’t you made this before?”  He loves it.

Oops.  I don’t know why.  Kids left.  On their own.  Changed up the menu.

Once again the love of Picadillo is becoming tradition.  I forgot how delicious it is!   And it has a nice stable impact on my blood sugar.

Before Cayla left for Wellington, she took a pic of the recipe.  When my husband Steve committed to working in Ottawa for 4 months, he took a pic of the recipe as well.

I make a huge batch of it for myself almost every week.  I freeze some for suppers which I can heat quickly in a pot on the stove (I choose not to own a microwave) as well as thermos lunches while working.

This is the ecipe and pics of tonights creation.

Enjoy!

Ingredients

2 tbsp olive oil

2 medium organic onions, finely chopped

1 large organic bell pepper, finely chopped

6 organic plum tomatoes, chopped

salt and freshly ground black pepper

1 tsp minced fresh organic garlic

1 tsp ground cumin

1 tsp ground coriander

1 lb lean ground beef (I use only lean ground sirloin)

1 lb ground pork (I haven’t tried substituting a lower fat meat such as ground chicken or turkey but I would think it is just as delicious)

3/4 organic balsamic vinegar

2 tbsp capers, drained

1/2 cup tomato puree

Optional garnish:  Sour cream

Directions:

Heat the olive oil in a large skillet or pot over medium heat.  Add the onions and peppers. Cook until they are tender, 10-15 minutes.  Then add the tomatoes, salt and pepper to taste; garlic, cumin and coriander.  Given our winter and today’s temp of -35C, I decide to add some colour with a yellow pepper instead of a green bell.

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Turn the heat up to medium high and add the meat.  Brown the meat, using a spoon to break it into tiny pieces.  Add the balsamic vinegar, capers and tomatoe puree.

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Reduce the heat and simmer for at least 1 hour.

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Be creative in how you chose to serve this…in a wrap or taco…whether it be wheat, gluten free or lettuce.  The Picadillo world is your oyster!

I prefer to serve it in a bowl with lactose free sour cream.

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Looking forward to hear if it becomes a family favourite in your home as well.  Serves 8 (that’s what the recipe says…I have never experienced 1 batch lasting for that many people!)

Attempts at Perfection & It’s Failures

“Have no fear of perfection – you will never achieve it.” – Salvador Dali

I can’t get my head around it.  Does anyone with diabetes who is motivated in their management think they can’t achieve perfection?  Yes I said CAN’T.

As a Person With Diabetes I think that not only can I achieve challenging feats beyond my day to day life, such as ascending the Peruvian Tundra to over 15,000 ft BUT I can also achieve perfection with my diabetes.

As a PWD I know that this mindset is superfluous.  BUT, I still want to pursue it, just in case I can achieve it.  You never know, right??  Isn’t that a great goal to set and pursue. Almost like a cure, really.

BUT….yes, I said BUT…I am reminded of how the attempts of trying to be all that to my endocrine system and diabetes management isn’t that simple. Even after coming into 40 years of living with diabetes and being a Mom of a PWD for 14 years.

I am reminded on our flight to Peru, no matter how hard I attempt to make my diabetes perfect, I cannot.

IMG_1326

Upon take off I am aware of the potential impact the air pressure can have on my insulin pump delivery.  The rule of thumb despite there is not total clinical evidence with regards to this is to disconnect on ascension and descending. Why?  The talk of the town is that upon take off the pressure can change the delivery of insulin to cause a low blood sugar. During the flight the pressure change can create air bubbles resulting in missed insulin after landing.

I have experienced this throughout the past 14 years of travel on an insulin pump but was not aware of the ‘talk’ that circulated about this until the past few years.

So, whether clinically relevant or not, I decide to take heed to try and avoid this.

We are prepared for take off at Pearson.  Status quo.  Prior to boarding I check my Continuous Glucose Sensor.  All is good in my diabetes world.

As the plane positions itself for take off on the runway I disconnect from my site with the intention of reconnecting within a few minutes after the rapid ascension is complete.

I am excited.  I am thinking about our trip, the flight which is 21 hours with stop overs.  In my mind I am running through what we packed versus the list I print and check off.  I am nervous.  I am landing in a city that has an elevation of over 8,000 feet.  I am worried after the stories I am told of elevation sickness.

The airline steward serves our snacks.  I give it to Steve.  Packed full of gluten. I don’t need a snack anyway.  I’m not hungry.  I look at some magazines.  I do a Word Search.

Several hours pass by.  I start to feel like the Sahara desert lives in my mouth. My stomach feels like a brick made a home in it.  My chest feels heavy.

I question these feelings.  Why?  It feels like I am high.  How come?  I don’t clue in to check my sugar though.  I attribute it to the elevation, the dry air, the excitement.

The steward comes around again.  Offers snacks.  I pass mine onto Steve’s again.  Maybe if I eat and drink a ton of water I’ll feel better.  I take one of my gluten free bars out of my bag.  I bolus, I eat. I feel like crap.

Is it the flight?  The cabin pressure?  I just can’t make sense of it.  Obviously my brain cells are not firing on all cylinders.  Doesn’t being on guard all the time with managing diabetes do that to a person?

Then…I get an itch at my site.  And so I scratch. It is so itchy I must lift my shirt enough to place my hand under so I can make skin to skin contact to find satisfaction. While scratching I realize my tubing at my site is flopping back and forth….I am NOT attached to my site.

I forgot to re-connect after take off.  That was 3 hours ago.

In my effort to achieve diabetes management perfection, I fail.

Now, forgiveness is mine. I am so insulin sensitive that I only end up with a BG of 11 mmol/L.  I check for ketones as well.  They measure at only 0.3.  So…I correct for the gluten free bar and basal rates missed as well as a small amount for the trace amount of ketones.  It takes several hours to come down and even though my sugar is only 11, I feel like I’m on the edge of DKA.  I  know what it’s like, I’ve been there.

We land in Peru and I am almost in target.

After that incident I make a promise with myself.  Disconnecting on a flight to achieve perfect blood sugars is not a goal I wish to achieve.  For what I wish to achieve I fail.  I avoid a potential low but instead end up high and feeling terrible.

What’s the lesser of two evils.  I can’t answer that but I will tell you I will no longer disconnect my site.

Where to Start…Our 12 Day Crazy Busy Trip to Peru…The Intro

I have heard this song “Home” by Edward Sharpe and the Magnetic Zeros off and on while listening to Songza.com for the past few years. Yes, the tune is catchy but the words hit the deepest chord within me.

What is Home?

The days my daughter Cayla and my son Kurtis were born I found my home. They were and still are the centre of my being and when they were little that was where I trusted I belonged. Where I felt beyond comfortable. I was in my realm. I always wanted to be a Mom. I knew I would protect them as best as I had in me to the death. They have been, still are and will always be a part of me and the core of my being.

Growing up my Mom was very fond of the story of Ruth and it seemed she quoted a verse in particular often and in a very fond way.  I didn’t understand the impact it would it have on my life until the past few years.  And so I also associate this Blog series on our trip to Pero to what Ruth says in Ruth 1:16.

Ruth 1:16 (ISV) | In Context | Whole Chapter

16 But Ruth answered, “Stop urging me to abandon you and to turn back from following you. Because wherever you go, I’ll go. Wherever you live, I’ll live. Your people will be my people, and your God, my God.

Besides my children I have never trusted anyone so much in my entire life as I have my husband Steve.  Even early on in our relationship with the decisions I made, I felt he always had my best interest at heart.  I trust he will love and accept me, diabetes and all. Never once has he ever had to say to me “Trust Me.”.  My gut just says I should. One should never have to say “Trust me.” to make one believe they should.   Actions speak louder than words.

In our conversations in the past many years, aside from our trips, Steve has been to 42 countries.  A majority of them have been for pleasure, as well, some for business and missions.

Of these countries he often speaks fondly of Peru.   He tells me it is the most beautiful place on the earth.  Then I must go there!!!

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We are aware of ‘rumours’ that Machu Picchu may not be open to the travels Steve experienced years before.

So, when do we go?

Well, life is funny like that.  In 2014 both of my children announce that one is moving to Edmonton, Alberta and one is moving to Wellington, New Zealand.  They won’t be home for Christmas.

For all the Mommies out there I can hear and feel your overwhelming voice of sadness and “that sucks”.  YEP!  It really sucks.

In early Summer I say to Steve that I can not see a Christmas tree standing tall, all lit up with the kids ornaments for the past 23 years hung in all its glory and no kids.  I threaten fetal position in front of the tree.

And so I ask.  Can I please go away with you to the most beautiful place on earth.  And it is written in stone, so to speak.  We commit ourselves to a trip to Peru to experience Machu Picchu on Christmas Day and Plaza Des Armas in Cusco on New Years Eve. One of the top 10 places for New Years in the world!

I am excited but as I research and speak more to those who have been I get nervous.

Despite my nervousness and apprehensions based on others fear mongering, Steve reassures me I can overcome anything that comes our way while we vacation in Peru. Just like Vietnam and Cambodia.

We are a spontaneous pair.  Our Vietnam/Cambodia trip begain with “hey do you want to go to Montreal for a long weekend?” and 3 days before taking flight instead of Montreal, we book a flight with no plans except a hotel ‘base camp’ for Vietnam and Cambodia…for the same price.

There wasn’t a glitch in that whole experience  (except running out of underwear in which I realize I barely fit into even a large size of women’s Cambodian underwear!)  I look back on that trip and it was worth every minute. So much so, we both want to go back.  Despite all the low blood sugars from the heat and humidity as well as losing my beloved Continuous Glucose sensor because it just couldn’t adhere to my skin. (I know how to make that baby stick now!!!)

Despite our challenges and crazy, spontaneous trip while in Vietnam and Cambodia, I experience great apprehensions with Peru.  The two potential issues I am most concerned about are elevation sickness and keeping safe from gluten and wheat so as to avoid a reaction, at worst a severe one.  The stomach upset is one thing.  The hives are another.

I am proactive with elevation sickness and speak with my family physician.  He advises I don’t need anything, I’ll be fine. He was just there and all was good.  He tells me I will be okay. This gives me reassurance.

I admit, on this trip I am not fully proactive in my celiac disease as I should be.  I am still in a learning curve.  This is my first trip as a person living with Celiac disease.  We assume given the Peruvians very large crops of corn and potatoes…there would be very little wheat.

Not so.  Stay tuned.

I’m OKAY!! Really!?

Wedding Cruise5With the exception of the time we dated in high school, my husband Steve is diagnosed with Type 1 spousal diabetes for just under four years.

It may seem silly but I assumed in all this time he knew diabetes like I did.  I can’t even tell you why I thought he would learn 39 years of living with Type 1 diabetes as I have experienced by observing signs, symptoms and random sharing of how I feel in certain situations.  He has never had formal education in the less than 4 years we have been together.

The moment I understood I need to share my life with diabetes more?

We arrived in Lima, Peru.

After settling on the last leg of our journey we decide to head out in search of a few markets and sites for some art pieces.

On the way back, my pump alarms that my sensor is telling me my blood sugars is 4 mmol/L.  My sugar is going down.  Stupidly, I have no sugar on me…Steve is so good he usually does have lifesavers in his pocket…but he has none.

I feel it is lower than 4 mmol/L.  But I am stubborn.  Steve asks if I want him to go into a store and get sugar.  I say it’s OK .

First, when my sugar trends towards low but I feel like I am not in danger, I don’t treat with rapid acting sugar, I set a temporary basal rate.  I think it’s a control thing.  I want to change the stupid system that really works…just to see if I can make it better.  I am so anti-sugar….I really want to take it…mental block.

So…I say to Steve, it’s okay, I’ll set a temp rate.

And we keep walking.

And several minutes later I become dull.  And quiet.  I lack my bubbly, sunshine Type A personality.

Steve knows but doesn’t know.  He hasn’t experienced such an extreme moment like this.

I personify strength.  Knowledge.  Power.  Ability.  I am never the victim.  He trusts that. Even thought his gut tells him different.

DBB Hypo Peru

So he trusts me and my choice.

Until I mumble I want ice cream.  And he asks further questions.  And I am indecisive and vague.

We end up in a grocery store a few blocks away from our hotel.  He asks me several times what I want to get….I don’t know.  In my mind I want to ask him to help me.  Save me from this terrible prison in my mind of wanting to be in control.  Not to ask for help.  I will take care of myself.  I won’t confess I have failed.  I won’t ask.  I refuse.  I won’t.  I have done this since I was a little girl.  My (mis)behaviour trumps my voice.

I am no good to anyone.  I know it.  I am too far gone to say that.

Steve finally suggests and I agree.

We pay out at the cash and I inhale.

Many minutes later Tracy returns.

Later that night we debrief.  He tells me…”I knew, but I didn’t because you know!”, but I did.  And I failed to tell him.  Thankfully he saw it today. Exactly what I just described.

He tells me “…from now when when you say “It’s okay, I’ll set a temporary basal rate.”  I am going to pop into a store and buy some candies.”

And he will tell me.  “You need this candies”.  And I now I will take them.  Regardless of how bad I want to be in control.  Because, we have this consensual contract.

It’s good to share my diabetes.  A liberation.  Enlightening.  It is a relief to give a very small piece of it to someone else.  Even though it is only a very small piece of what my mind thinks of 24-7-365, if feels good. Despite how much control I want.  And how hard it is to let go.

Travelling with My Pharmacy

DBB Huchay Cusco Blog

There will a few posts/Blogs about my travels to and within Peru.

BUT..

I feel this post in particular is a huge one and is pressing upon me to prioritize even though it’s not in order.

We spent Christmas Eve in Agues Calientes. We planned to climb Machu Picchu Christmas Day.

I became very ill with a very high fever and ultimately sinus congestion, sore throat, fatigue among other things.

I am proud of the way the situation turned out as I recovered very quickly compared to most times I experience this. My husband questioned if I should take part in the venture to Machu Picchu but I insisted despite feeling down and out I would not miss such an amazing opportunity. This is a chance in a lifetime!!! And so we did.

With that being said, after we returned to Cusco a few days later we made plans to take part in a two day trek up the Andes mountains, through the Peruvian Tundra. We would then be hosted by a family overnight before descending back down the next day to another town a few hours away from our starting point.

We reach an elevation of 15,100 feet. Understanding that breathing would be a challenge at the best of times, I am overly concerned that with my congestion and swollen throat it would present greater issues.

On our way to the drop off point 1 1/2 hours away by jeep, I ask our guide to stop at a pharmacy to buy cold medication to help keep the symptoms from being too overwhelming throughout the climb.

As I walk into the pharmacy I take note this is the very first lesson I learn.  Never assume I can go away for 2 weeks and be healthy the whole time. I usually pack cold medications, gravol etc for those ‘just in case’ moments.

This is the first time I didn’t take my personal pharmacy with me. Sigh.

Our guide Henry takes me into the pharmacy in Cusco. I tell Henry in English that I need an anti-histamine/anti-inflammatory. I expect something along the lines of Advil Sinus & Cold or Buckley’s.

After the Pharmacist asks Henry a few more questions in Spanish….”Is it altitude sickness?”…”No, I had a very high fever, sore throat and sinus congestion.”…He recommends a product.

I take a ticket to the cash booth/dispensary at the front of the store. She gives me the box of medication. I am so relieved I will have the meds to help with the congestion, I don’t consider that I didn’t tell the pharmacist I have T1 diabetes OR that I took time to read the ingredients.   At this point I don’t make the connection that Dexametasona (in English “Dexamethasone”) is a steroid!!! I mean, come on, I am a Nurse. I should know the 5 R’s!!

AND I can’t buy a steroid over the counter in Canada! For good reason!

I am told to take one pill now (it is 7:30am) and again at supper. I can take it twice a day for a few days.

Within an hour I can feel the relief. I am overjoyed….until…

Fast forward to that evening and into the overnight…AND the next day…my blood sugars begin to climb…and climb…and climb.

I take insulin corrections like drinking water with no change. Not even a flicker in my Continuous Glucose monitor display. My finger pokes confirm all is not right within my diabetes world.

I reflect back on when we arrived in Cusco. Within a day I was setting temporary basal rates on my insulin pump for low blood sugars and now??? I am insulin resistant in the Andes Mountains??

I play scenarios in my mind. Is it the altitude? Is it dehydration? Is it the anaerobic feedback from the intense activity which leads us to experiencing burning leg muscles, shortness of breathe so bad our lungs are burning?

When I work out at the gym and do intense heavy weights my sugars spike. When I do hill training when I run I get the same effect. Is this the same?

At this point I haven’t made the connection yet that the cold meds contain steroids.

I do think that in part, the intensity of the climb did cause an adrenalin surge that did cause my need for more insulin….pair it with an exogenous steroid in my cold meds and here is a recipe for blood sugar disaster.

My key take away?

Bring my own cold meds and pharmacy.

If ever in an emergency that I require medications while in another country, make sure to tell them I have diabetes.

If and when I decide to ascend to 15,100 feet (or higher), take note and act that if it feels anaerobic, increase my insulin rates to accommodate to it.

No doubt it is a tough balance to achieve but I wouldn’t want to throw my hands in the air and not keep playing the game. Next time I want to improve on this experience. I accept my sugars will never be perfect in these situations especially, but, I will do my best.DBB Dexalor