Recent Flight

I traveled very early on Wednesday morning to California for my two week vacation. I have been needing some time away from work after all the months of overtime and I know Duchess needed a break as well.  When we are traveling we never know what we are going to encounter. My trip started off smoothly. I noticed while waiting to get on my flight a woman with her pet outside of the carrier it was supposed to be in. I used to travel with my Jack Russel Terrier Jilly on occasion but I always kept my dog in the carrier out of respect for other people. This woman was sitting right across from Duchess ans I had a feeling this is not the last I would see of the dog. Sure enough the woman in mid flight decided that she could take her dog out and hold her but thankfully the flight attendant noticed and took action. The flight attendant told her that she was being disrespectful because of the service dog that was on board. She politely mentioned that she could be distracting a service dog who had a very important job.

Even before we left on our flight we ran into a police dog who was moving around the gates. I have never been prouder of Duchess because the police dog was distracted but Duchess was spot on. She paid no attention to its presence and laid perfectly still at my feet. She also meet another service dog when we arrived in San Jose. This service dog saw Duchess and started to pull on the leash and was trying to move toward Duchess. Duchess again sat down next to me and was so focused on her job she did not even seem to see him. She stayed incredibly focused on task during our trip so far. She even did a night alert last night which is wonderful traveling tends to make a mess of my blood sugars. I was spiking up and down a couple of time during the day which I was not too surprised at. I was so incredibly thankful that I had not problem waking up for my early morning flight. I know the past couple of weeks I had issues with getting up on time to work because of bad lows. I am feeling so relaxed on my second day of vacation. I am really enjoying my trip to Sonoma and San Francisco. The weather has been really nice and the ability to sleep in has been very much enjoyed so far.

Feeling Rather Silly and Forgetful

I am still astonished that I forgot. Yesterday was a really busy day and I was getting ready to leave work my pump sounded off that I had only ten units left in my pump. I did have insulin and new cartridge with me but I knew I had to catch my bus. I figured I could wait till I got home. I got home later than I was planning and had to be some where pretty quickly. So I forgot to refill my cartridge at that point. I figured I would refill it before dinner but dinner came and went. I got busy packing my suit case and finishing up things for my trip that I forgot to get to changing the cartridge. I went to bed last night completely forgetting about the alarm at almost 5pm yesterday. I was sound asleep when I awoke and looked at my Dexcom I was 225 and with an up arrow then I hear my pump sound empty cartridge flashing at me. At that moment I was like what was I thinking I normally really great at changing it out promptly but sadly not yesterday.

I could really tell I was in the two hundred range and I really just wanted to go back to sleep but when I am high I normally have issues trying to sleep. Looking at the Dexcom I missed the first couple of alarms that I was high for almost an hour and a half but thankfully I was able to get my blood sugar heading back down pretty promptly I was reminded yesterday of the importance of not putting off refilling my cartridge because life can get in the way at times. I am usually on top of things but when I am getting ready for a flight I can get pretty concentrated on the task and miss such an important thing. I know this morning I feel completely silly because I missed such a key thing. The good thing is I had a good reminder of the fact that when the cartridge is low warning goes off I need to attend to it as quickly as possible.

Coverage Changes for Prescriptions

I recently got notification from my pharmacy benefit that they will no longer be covering my Novolog insulin. I am really surprised by this considering that Novolog is cheaper than Humalog Insulin. I know my copy is the same but I was really surprised by all the changes I was notified about. They will now only cover One Touch test strips and not cover at all the other brands of test strips as well. They even cut a larger amount of the type 2 Diabetes drugs they cover down to only a few. I know for me when I had pump site issues part of the issue for me was I had been on Humalog for way too long and it was not as affective. So I am really worried about what I am going to do when the Insulin I am doing well on is no longer covered. I find all these changes in my coverages frustrating because they really leave me without choices in the Diabetic products I am able to use.

Thankfully my One Touch Ping does use One Touch test strips and so will the Verio IQ which is covered thankfully. If I was using Medtronic the Bayer test strips would not be covered or the Ominipod the freestyle test strips would not be covered either. So that really limits what options the patients have. I am not sure why the dramatic cuts but the most interesting part of the changes the insurance only covers the most expensive brands. The copay is the same currently regardless of the brand and you would think the insurance company would want the cheaper version of the products covered. I have a feeling they have contracts with certain companies to only cover those products. I am incredibly frustrated this year first by them refusing to cover the 600 test strips a month I need and the having to wait for an approval for the year to get that many test strips and the sad part is that because of my EMS history is the only reason I get the number I am requesting.

I am really hoping they don't have any more big changes because just trying to fill a prescription has become such a chore at this point. Thankfully when I reordered more test strips recently the order came through without issue. I am not a fan of the lets limit the testing as much as possible plan because that increases the odds of complications. I already have some and I am trying to keep things as controlled as possible but with the insurance company not covering much of anything my goal to keep myself healthy will become increasingly difficult.

Trouble On Tuesday

On Tuesday of this week I was late again to work because of a bad low and I was at my wits end. I could not seem to get my blood sugars to stay normal over night and to even sleep much. So I went to a work in appointment that morning. The doctor and I changed over to plan B run them higher and adjust down as necessary. I did do that so far and I actually was high last night because I did have a stubborn low that went for several hours and then decided to shoot up. So thankfully it was not all night but overall I feel better about things after the past couple of days of being able to hear my alarm and get out bed on time for work. I did change my alarms on Dexcom as well to make sure it was because I was blocking the sound out because I was used to it which can happen. I did try the cup but I stopped hearing that but now I am back to where I am more responsive right now which is good. I am thankful to be at least in a place where I am sleeping again and not having lows all night long. I know I struggle with letting things run higher but I am doing it and figuring out what is the best dosage for basal rates. So far the changes have all seemed to be working better and with a little hiccups but I can adjust those as I figure them out.

Overall my blood sugars are having less lows and not really that many higher blood sugars so I just need to keep working on straightening the little things out and I will be in great shape. I have a feeling my vacation will also give me the time to get things all adjusted and just relax my job is way too stressful most of the year and every time I am able to get a break it is a good thing. The only thing that still keeps popping up is rebound highs even when not eating more than 11 carbs which drives me crazy but I have a feeling that soon enough things will be back to normal and I will be on vacation enjoying my time off. It was the strangest thing on Wednesday morning I just could not write about the event maybe I was not ready. I guess some times we need time to process what happens and deal with the events before we can blog about it.

DAD's and What I Have Learned

I know when I started to get Duchess my Diabetic Alert Dog I was so excited but also scared in many ways. The process took quite a while and there was going to be some huge changes in my life which I knew would happen. What I wish I knew when I was looking for a DAD would be numerous things below is a list.

1. How difficult it can be if you decide to take your DAD to an interview because most employers don't want to hire disabled people. I had best of luck having Duchess wait in my friends car while I was in the interview which worked out for me. I could not let them know I had medical Issues.

2. My workplace would not be accepting of my service dog at work. I know in general there are very few service dogs and that makes the process even worse in many ways. Texas is not a very service dog friendly state.

3. I would have issues in College with professors who questioned why I had Duchess until they saw her alert to a low that I had no symptoms of except the professor could see  a change in my eyes. After that things were better. I had to get exceptions to have extended test taking time in case I had a low during a test which did happen. They pulled my medical records and it was never an issue.

4. I spend a great deal of time training and retraining Duchess. I knew there would be work but I had not idea of how much work it would entail.

5. How difficult dealing with the general public can be at times. There has been some incidents of really nasty conversations because they did not believe I was disabled.

6. There is a very delicate balance of work and time off to keep a DAD working. Took me a while to find our balance when I started back to working.

7. That a Diabetic Alert Dog can have bad days like we do. There is days that Duchess does better than others. For the most part she is great but at times she wants to do other things than her job.

8. Having a dog at restaurants or malls etc can be difficult to manage with big crowds and such with worrying about the dogs safety. Duchess has more pairs of boots, vests, leashes etc to help keep her safe and taken care of. So many things need to be taken care of.

9. Grooming standards need to be followed so I brush frequently and bath her frequently so it does take up quite a bit of time but worth the energy spent. Keeping products available if she get wet while going places. A great deal of pre planning.

10. How it felt the first time Duchess missed a low. A DAD will miss some lows but It is so unexpected how you feel. I proceeded to have her smell my hand and arm and she then realized I was low. It can be so easy to forge that yes at the end of the day Duchess is still a dog.

Back on Track

I know nights like last night really make for a long day. I went to bed a little earlier than usual due to being tired and stressed about my blood sugars in general. I wake up around 1:30am  where I was low and I treated it but I was unable to get back to sleep. So I just lay in bed for the remaining hours hoping I can get back to sleep. I know with some bad nights recently and with not waking up at my normal time I was I think making it difficult to sleep. Thankfully I did get a little sleep but not my normal amount which does really help on days like today when I have meetings when I need to be sharp and alert. So I am sure I will be pushing the caffeine today but at least I was not low all night last night and I made more basal changes and probably will until I can reduce the lows completely at night but only having one low was a great improvement.

The weather in Texas has cooled dramatically over the past week or so. Thankfully it is starting to warm back up. Duchess I always try to keep her warm as possible to make it easier for her to concentrate on her job. She was funny yesterday when she pulled her sweater out of my back pack around 3pm and wanted me to put it on. I thought it was interesting that she was telling me in her little way that she was cold. I know working in a 75 year old building that it is quite drafty and can be colder so I always have a blanket on her dog cot for her to lay on or be underneath it. She is quite smart in that she let me know that she was getting cold and wanted to warm up. I know she seemed pretty happy once I put on her dog fleece sweater which she loves to wear when its cold. I know Duchess in general really prefers warmer weather and not cold weather and thankfully we live in Texas where at least most of the time it is warmer. I really appreciate that Duchess is smart enough to let me know that at times when she needs a little extra warmth so I don't have to guess.

Could Not Be Happier

I have to admit I am so loving having my door installed at work. I was worried that it could create more issues but there has been complaints as I expected but overall it really seems to help. I have noticed that Duchess now seems twice as happy at work and since we spend way too much time here as it is. I am always looking for ways to keep Duchess protected because there has been so many issues in my office so far anytime Duchess moves. So with a door being there people will see her less and which should help keep the complaints about dog toys being on the floor. My coworkers don't mind the toys being there and it keeps Duchess busy during really long days. I don't leave them everywhere but she might have antler and rawhide chew out at the same time. Which I am okay with. I have learned so much from this experience so far. I know I really was hoping having a service animal at work would be easier but it has been incredibly difficult and I am not the only person I know to have issues. I work very hard to have Duchess be the best service dog possible but I have a feeling even if she was perfect people would still complain.

I have also learned that I need to protect myself as much as possible in my office. There is actually very few people I trust after all the issues I have had and I tend to keep to myself so people will leave me alone. I know after only a couple of days I could not be more pleased with having the door. I also feel less all eyes on me which is nice and I worry less about people bugging Duchess when we are at work. Even though she has her do not pet patches people will always try and pet. I expect them too but I always try my best to explain why I do not allow people to pet her. Once I explain they usually will leave her alone which is good. Hoping that things will be more smooth sailing when it come to the office issues. I really need a break from all the stress I have experienced because of all the complaints.

Great Reminders

I don't usually get too far off topic but I have been thinking a great deal about other things this week. I know last Saturday Paul Walker an actor passed away. I grew up watching him in movies. My older brother Doug and I used to watch fast and the furious and loved to watch it over and over again. I don't sadly get to hear from him these days. He is busy with his girlfriend and his own daughter Maddyn my niece and his girlfriends daughter. My brothers smile and personality is a lot like Brian the character he played and from the people I know who meet him in person in real life. My brother in so many ways is like Paul was an avid surfer and overall very active person.

My brother has this incredible presence when he walks in the room everyone notices and remembers him. He has a great smile and everyone just loves him. I know the past couple of years I just don't get to hear from him and it feels like I have lost him in many ways. That is really quite true since it has been several years since I was able to see him. I love to go to Hawaii but it is so expensive. My brother rarely ever comes back to the mainland so I almost feel like he is gone. Things really changed drastically after our mother passed away 5 1/2 years ago, I know the relationships between my brother, sister and I have changed so much. The family was so much closer. I know my mom was the reason we all came home. Home has changed so much from the definition of what I used to have of home. My definition is more my friends than my direct family. They are there when things fall apart and when they are smooth sailing.

My own family is very absent when things are not great and really seem to not be very present except for my grandmother. I am so very thankful that I have my blog as outlet for the good the bad and the ugly since our relationships have really changed drastically since my mothers death. I did not realize how much she was the glue for the family. I do miss seeing my brother and sister and especially the relationships we once had. Paul Walkers death really reminded me how much I miss that. I also especially this time of year miss my wonderful mother who gave me so much and I am always grateful. My mothers favorite time of the year was Christmas. I grew up having the most amazing Christmas's where the tree, house and activities all centered around Christmas. I know some things are great reminders to appreciate what you have and the time you do have. I will always wish for more time with my mother but am just thankful for the time I had with her. She was an incredible person who did so much for me and my Diabetes care


.http://www.youtube.com/watch?v=o8UCI7r1Aqw   Paul Walker Memorial Video

Surprised by My Reaction

The whole fiasco about the dog toys and bones that were complained about is officially over as of today. The door was installed and there is already some benefits I am seeing already. The biggest difference is the fact that Duchess seems so much more at ease with having the door in place. There was a complaint from a coworker because they could not cut through my cubicle to get to the copier which I do understand. I told them they can close it or leave it slightly open. I am hoping to give Duchess a chance to experience a more peaceful experience at work than it has been over the past two years. I know my experience with having Duchess at work has been tremendously difficult and so many issues that I never expected.  I know I am blessed to have Duchess in my life but I assumed that it would be easier to have here with me at work. I am disturbed to see all the issues or complaints that have been brought up and all of them have been unfounded.

I know the door will not solve all the complaints but I think management is finding that the complaints are not valid and in fact is not stating  they are not going to address the complaints further because none of them have been true or valid complaints. I know I work with a bunch of complainers but I never dreamed I would be targeted because I have Duchess with me. Duchess is such a wonderful dog and I follow strict service dog protocol for grooming. I bath her weekly and is brushed 3 to 4 times a week. I am not sure how much more I could be doing but I have a feeling there is nothing I could do to change the complaints. Thankfully the door might give me a break from all the complaints hopefully. It really can stress me out tremendously dealing with all the issues I have faced. As much as I hate to admit it I seem unable to always handle really stressful situations like I used to and reducing some work stress will be nice. I honestly already love that I will not be as distracted because the wall is there and I know I will have less interruptions.

Ugh Back to More Lows Overnight

The nights were going so well for a little bit then I am back to the low alert around midnight or if I reduce the insulin I am around 170-180 till around 12:30pm. Then I am dropping again at 4am I have reduced the insulin rates but if I drop it too low then I am moving back up higher fairly quickly. So I have to figure a way to work around these two time periods where my body seems to want to be low every night. I know the night lows have been an issue on and off for quite a while but I do not seem to be able to find the good spot where I am in normal range most nights. I also find that if I can sleep through the night I will have less lows during the days so I need to keep working on getting things adjusted or I might just have to run my blood sugars higher at night but I am also not a fan of running it higher either. I know that will affect my A1c numbers. I know normally I am able to make some adjustments over a week or two and find the right changes and then I seem to be fine.

Sadly this time I think I am going to have to come up with an out of box plan to deal with the craziness I am experiencing. Thankfully everything is manageable but lows can really drag you down after a while. I am not frustrated currently but I am really wanting to find a solution to this issues so I can relax a little more. I know Duchess is tired as well and I would like to keep the lows to a minimum if at all possible. Life would be much simpler with a reduction in these lows. I know traveling at Christmas time I tend to have more lows and I need to get things as smooth as possible. I am always worried about bad lows while traveling as a single woman but thankfully Duchess does keep me safe but recent events have shaken my confidence a bit in some ways. I know Duchess is awesome but I know I can't make that fear go away.

Article on Complications

I was glad to see Kerri Sparling writing about complications. I know I try to discuss mine because I know when I got my first complication there was no information and a great deal of judgements from others. I know the hardest part of having complications was the guilt that maybe if I had tried harder that maybe I would not have a complication or If I had started on a pump sooner things would be different. I know I still catch my self going down that though process and I have to stop myself because the guilt will consume you. Diabetes is hard enough without adding all the judgement by strangers and even my own family. I know my own family will not discuss any complications I have in fact they are the biggest critics of my efforts. I think my family honestly believes that you test take a dose of insulin and test again and its that simple. It has never been that simple. I know the longer I am away from my family the more they seem to forget all the years of the struggle to keep things where they needed to be all the times I had wonderful A1c's.

I never expected my own family to be my harshest critics but they are. I know I get judged by everyone from nurses at the Dr.'s office to others. I have heard constantly if you had managed your diabetes better you would not be where you are today. I have corrected this misinformation every time because I don't need to be judged I just need proper medical care. I have heard comments from my own Retina Specialist how if  you have this one complication you must have all these other one's too. I think part of the problem with complications is that once you have one you have all of them in all the Dr.'s and nurses minds. They also make a great deal of assumptions as who you are as a person because you have a complication. I have never been treated so badly as a patient until I got my first complication. I know a great deal of Dr.'s think I am lying when I tell them what my A1c is and I have to have proof to prove them otherwise. I know my Retina Specialist always seems to not believe that my cholesterol is normal and my blood pressure is normal. I know thankfully my Endocrinologist office views me as a patient who works very hard to maintain good control and manage my Diabetes.

I know I have to live with the fact that everyday for the rest of my life I will wake up with a complication and all the stigmas that go with having a complication. I really wish that more people understand how hard it can be to be a Diabetic and that it is not always as simple as they assume it is. I know I have some really incredible people who have complications and like me it does not stop them or really slow them down. Yes there is more appointments but your life does go on and a little less of the ignorant comments is always appreciated, but sadly they don't teach that in medical school.

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