Two Weeks

Sunday, August 20, 2006 | 4 comment(s)


It's been two weeks since my last post. And while I've got some good excuses (and some not-so-good ones, too), excuses are lame, so I'll spare you. If I'd been keeping up with my writing/blogging, I'd have posted at least twice about 3 or 4 random topics. Here's my current brain-dump (sorry for the back-log).

Minimed CGMS® System Gold™ (sic) Results
I got my CGMS results back two weeks ago, and although the sensor came out on me in the middle of the day Saturday, I did get a decent amount of data back. Overall, my control was pretty good and the docs were pretty impressed. It's certainly nice to know all my hard effort is worth it. There were a few spikes that I missed when I compared my 15-20 finger tests with the continuous monitor, but they were really few and far between, and not all that drastic. I wish I could share the data with you, but sadly, they only give you print copies of your data and I do not own a scanner (perhaps I'll ask Santa for one for my birthday).

I got to try out the System Gold™ because a Research Fellow (who is actually not a "fellow" in the "fella" sense of the word; she's a she and to avoid confusion (mostly on my part as I'm writing this) I'll refer to her as Dr. H.) was organizing the trial / event / I don't know what to call it and my endocrinologist, Dr. A (also a she), gave her my name as someone who might be interested in participating (which, obviously, I was).

When the data came back, I first met with Dr H. and then aferwards, Dr. A. came in and joined us. Dr. H.'s only suggestion was that I could try lowering some of my carb ratios just a bit or work a little harder on my carb counting to try to tame some of my post-prandial spikes. As I eat almost the same breakfast and lunch everyday and have the carbs pretty accurately counted for those meals, I tried some lower carb ratios over the last few weeks. After having several predictable and consistent lows, I have adjusted them back to be almost where I was before.

  My Carb Ratios 
  Before  Last week  Now 
 Breakfast  10:1   8:1    9:1 
Lunch 12:1  10:1  12:1 
 Dinner  12:1  10:1   11:1 

So, as you can see, not a lot of change, but some fine-tuning for sure. And fine-tuning is where it's at these days for me. I'd definately say the motivation coupled with some empirical evidence to make some minor adjustments was well worth the aggrevation of wearing that bulky monitor for a few days.

And then Dr. A. came in and joined us. She was perky and said "See! I told you so!" a lot. And as I was looking at some of the graphs from the sensor, she nonchalantly leaned over an put a quick little "X" over a spike on the graph I was looking at on my lap, all while talking about something else, and I don't even think to me. I'm sure she doesn't realize that a quick, judgemental, flick of the wrist, can be so insulting, but oh was it ever. And as I walked out of the office a few minutes later, I realized that she had stolen my pen.

Last weekend I flew from DC to Detroit and back to go to a wedding in Kalamazoo, MI. In the past two years or so, I've flown to Costa Rica, San Antonio, TX, and Portland, ME. At each-and-every leg of each trip I have been "randomly selected" to be searched. Whenever I complain about this, the person I'm complaining to inevitably says: "I bet it's because of your beard." It is Not because I have a beard. After I realized there was a pattern here, I found that there's actually been a little code on my boarding pass indicating that I was to be screened. I've said to myself (and out loud to others) that I'm going to contact the United / Delta / US Airways or whoever it was I was flying with to see why I'm always selected for a screening and whether I can get my name OUT of their database. Since I fly so infrequently, however, I have never actually done this.

So I'm preping to travel a day after all the hoopla in London, and I've torn off the bits of my insulin boxes with my name on the prescriptions and added that with the letter I have (from 2002) from my doctor kindly explaining that I have diabetes and that I need to have my insulin and various lancets, needles, meters, and assorted devices with me on the flight in my dopp kit.

To my utter surprise, I was not "randomly selected" to be screened, but the x-ray did find my diabetic supplies and my bag was thoroughly searched. Based on previous experiences, the only difference between being "randomly selected" for a screening and having the x-ray find syringes in your bag, is that you get to keep your shoes on, you don't have to take your belt off, and you don't get patted down and having some man run his hands inside your waistline.

Each way, the "Homeland Security Agent" was kind and even apologetic when I explained that I was diabetic and had insulin in a frio pack to keep it cool. And one of them was more interested in the zip-lock bag of wasabi peas I had with me than in any of my assorted needles or vials of insulin.

While the wedding was nice (as nice as can be when you don't know anyone there (it was for a childhood friend of my wife's, whom I've only met once before (the friend of my wife, that is))), and I had a great conversation with the father of the bride about diabetes drug research (he's starting his own company based on a drug he discovered several years ago for some type II diabetes treatment), there aren't many nice things I can say about Kalamazoo. But there is one: if by some unfortunate stroke of luck you find yourself in Kalamazoo, I can *highly* recommend stopping at Bell's Brewery. It's got a completely drab, industrial looking exterior and is located next to some railroad tracks, which made me think my friends who raved about it (Ira and Emily) must have been drunk before they even got there. But then you go inside. There's a nice big room with a nice bar and tables set up with inlaid checkers/chess boards and an overall nice ambiance. But the real jewel is out a side door to a HUGE beer garden
A Genius Idea, Really
Why aren't there more of these around?! These are a great idea! While I was in England many years ago, I spent much time in beer gardens and pubs. I've been told they're all over the place in Germany, too. I mean: a garden, what's not to like about a garden? Some nice chairs and tables (check, check). Drinking good beer (excellent). Add a lovely garden for such an activity, and you've got yourself a thing of beauty. Oh, it just makes such perfect sense it hurts. It's like those old Reeses chocolate and peanut butter mishap commercials from the '80s.

somehow concealed from the road. Tasting some fine beers and having a brat for lunch before the wedding on a cloudless, mid-70s, Michigan afternoon was easily the highlight of my visit to Kalamazoo.

Logging vacation
I had taken off from work on both Friday and Monday. I keep my logbook on my computer at work and usually when I get into work on Monday mornings, I download my readings and then enter them into my excel logbook by hand. With 4 days worth of data to enter on Tuesday morning, and a decent amount of work to get going on, I quickly declared that I was going to take a 1 week vacation from logging my blood sugars. It's been nice, but there's been so many times that I've instictually searched for my excel logbook to be open somewhere on my computer after testing my blood sugar, that I'm pretty sure getting back to my usual habits come Monday morning won't be much of a problem.

Based on two comments on a previous post (one from Shannon, and one from my brother-in-law, Manus) and a conversation I had with my friend, Cori, I've come to realize that my nifty little pop-up asides are being missed by a few readers. There's a couple of reasons this may be happening:
  1. You have javascript disabled on your browser. If this is why you're missing these asides, I apologize, because I don't know how to make my content user-friendly for those who have turned javascript capabilities off on the browsers.
  2. You are viewing the page on a small screen (a laptop, for example) and/or at a low resolution. If that is the case, know that each bold word on my page serves as a link. If there isn't a little icon next to the bold word indicating that the link will take you away from my blog, then the link *should* pop open an aside to the right of the main content. And occasionally, I put more content in the asides than in the main content. You may have to scroll to the right to see this content if you fall into this category.

And finally, I've got some details
mea culpa
When I was talking to the doc about my CGMS results, I complained about the design of the shower bag for the monitor similar to what I pointed out in a previous post. She informed me that there's actually a double pocket there, that I was supposed to undo the sticky seal, and the insert monitor up and over into the pocket (kinda like a non-zip-lock sandwich bag) and then just close up the sticky seal where the stereo wire hangs out. The sticky was not designed to hold monitor in the bag upside down. Thus it crashed onto the shower floor on me. I'm thinking I'll take 60% of the blame on this one and split the other 40% between poor design and my lack of proper vision without my glasses in the shower (that's the best excuse I can come up with for why I missed this "double pocket").


And just because I'm anal and detail oriented, I'd like to point out that in another previous post I repeatedly refered to the "cannula" that we pumpers have living under our skins as a "catheter". While I think the difference is mostly semantic, it seems strange that after learning the word "cannula" and reading it thousands of times over the past 5 years of pumping insulin, I would start calling it a "catheter". Catheter (in my mind, at least) has such an unpleasant connotation. I think, however, that I did actually refer to it as a "catheter" when that freak-show physician put me on the spot.

Sorry to bore you with details from a detail-oriented freak. Just crossing my "I"s and dotting my "T"s.

to clear up.

4 Comment(s):

Blogger Kevin said...

Thanks for the correction!

I must have been crossing symantec with semantic. Which reminds me of that great SNL skit with Christopher Walken singing "You say potato, and I say potato. You say tomato, and I say tomato." Deadpan hilarity.

Though in reality, it was probably just a dumb spelling mistake (I really suck at spelling).

Either way, 'twas much appreciated.

¡muchas gracias!

Blogger Shannon said...

LOL, neither of those two problems were what MY problem was. It just never occured to me to click on the bold faced words.....

NOW I know what the hell is going on :)

Blogger Scott K. Johnson said...

Hi Kevin!

Glad to know that you got enough data out of wearing that thing to make it worth while - at least enough to make a couple adjustments. Hopefully they will work well for you.

So, after wearing that, and mentioning that you didn't see too much that you weren't already catching in your logs, do you still feel kind of confused about your A1C result?

And I would totally chase her down to get your pen back...

Another reason that people might not see your popup asides (which are great by the way) - using a "service" such as Bloglines or something like that - it just loads it all on the page, rather than "aside".

Blogger Kevin said...


Yeah, I am still confused about my A1c results, but I think that it was much too few data points to really analyze the average blood sugar readings with an A1c test. The technical paper that I referenced before even points out: "With the advent of new technologies that are capable of monitoring PG [plasma glucose] on a 24-h basis (18), it will be interesting to see how our estimate of the relationship between PG and HbA1c compares with estimates obtained using these technologies."

So that is to say, even the "scientists" don't really have a good handle on the relationship just yet.

Before my next A1c test, I will probably make some attempt to better calculate a weighted mean of my readings rather than just taking the arithmetic mean. I could then do some regression analysis and compare my results with the coefficient estimates reported in that journal article.

Oh, I'm going to drive myself crazy, I can just feel it.

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