Tuesday, December 16, 2014

Pump vacation reflections

I wrote earlier this month about taking a vacation from my pump. I recently returned from that vacation and thought I'd share my thoughts about it. 

As mentioned earlier, my family and I headed to Turks & Caicos. It was amazing. Beyond beautiful. Unfortunately the Nor'easter caused strong waves and what not in the ocean which went all the way down to Turks & Caicos. Not a huge deal but it resulted in a red flag everyday for the ocean. The red flags meant no snorkeling, no sailing, no scuba diving, no stand up paddle boarding, etc. Have no fear though. Plenty of time was spent in the sun by the pool. 

I wore my pump and CGM until around 3:30 in the morning when we took off. I checked my blood sugar and bolused for my breakfast which I ate as I removed the CGM and pump from my body. I waited until I got to the airport and through security to visit the ladies room to test and take my Lantus. My blood sugar before leaving was 135. At the airport it was already in the mid-200s. Yikes! I couldn't get the first insulin pin to work or the second one. I finally tried a new pen needle and it all worked. Phew. 

While traveling all day I stayed on top of my blood sugars and took lots of corrective insulin. My brother-in-law mentioned that it takes awhile for the Lantus to build up in your system and I probably shouldn't have waited until the very last minute to remove my pump and switch to injections. 

I checked my  blood sugars quite often throughout the trip and took quite a few corrective doses. Only a handful of times did my blood sugar reach the 300s but thankfully never went above 392. The lowest blood sugar I had was 73. I would have preferred to stay between 80 and 140 but I knew going in my blood sugars would be wonky and not nearly as greatly controlled as when I'm on my pump.

I struggled with carb counting. Especially with the alcoholic beverages. My beverage of choice? Frozen lemonade with vodka. Yum! Most of my counting was of the SWAG method. SWAG -- Scientific Wild Ass Guessing. I tried to load up on the cheese slices at breakfast for protein and the fact I wouldn't have to bolus for it. Except for about three breakfasts and the desert for one dinner, everything was a la carte. I think this helped immensely because I wasn't tempted with a ridiculous amount of food options at the buffets. Because with buffets there are times when you just want a tiny nibble of this and that and things you want to try you've never had before. It all piles up and next thing you know you are taking all the insulin in the world. 

My endocrinologist sent me to Turks & Caicos with six insulin pens of Novolog. She was worried six wouldn't be enough. I didn't even completely use one pen. I felt she was enabling me to eat and drink whatever I wanted. So I took advantage of that and found myself at the American themed restaurant which had cotton candy during the day. It was delicious. I should have drank more alcohol though. I'm a slacker in that regards. 

She also sent me with three Lantus pens and I didn't even completely use one. I am not complaining as I feel fortunate to have this extra insulin. I get where she was coming from though. We set my I:C ratios and Lantus doses but we didn't know how my body was going to adjust, what I would be consuming and how much corrective insulin I would end up needed through the week. Better to have too much insulin than not enough. 

I returned home late on a Friday evening. I stayed on the shots until I had completed breakfast Saturday morning. By lunch time my blood sugars were kicking ass. Yay! I didn't put a new CGM sensor on my body until Sunday evening after dinner though. I waited because I wanted to make sure my blood sugars were stable on Saturday with switching back to the pump before putting a new sensor on. Then Sunday became a little crazy so I waited until I ate dinner. 

By Monday morning I was beyond thrilled to be hooked back up on all of this stuff and I'm definitely appreciative of how much easier it makes controlling this disease. However, I loved my week not being hooked up to it all and I wouldn't second guess taking a pump vacation again in the future. As long as I'm returning to sunshine and water and warm temperatures. 


Wednesday, December 3, 2014

Stitch Fix number seven

I received my seventh Stitch Fix the week of Thanksgiving. As I mentioned in my last review, I was pretty excited because I requested items for my upcoming Caribbean vacation. I wasn't sure what they would come up with considering it is winter time and they probably didn't have a large amount of beach wear available to choose from. But I wasn't worried because I've almost always been pretty pleased with the fixes they've sent. 

Even though I had a date planned for that evening, I had enough time to at least open and take a quick glance at everything. I requested a "resort evening wear" dress to wear one night at dinner. My family gets pretty dressed up for these dinners because it is fun to dress up when you usually don't get to. I had purchased a dress a few weeks prior at my favorite local boutique (and also had one from there which I bought for a date that didn't happen) to wear. I also found a beautiful dress at The Loft to take. Additionally I ordered two dresses from Francescas but knew I was going to return one and was undecided on the other one. The decision hinged on what Stitch Fix sent me. 

Here are the two dresses they sent me: 
Side note: I left the paperwork that comes with the fix at home so I'm not able to tell you what the brands are. I'll update later this week. Sorry! 

The long maxi dress was very soft but it was just wrong. I'm short...barely five feet tall. That much pattern over my entire body looked horrible. It was just bad. Not flattering at all. Also, there were two strings to tie into a bow at the waist but they were just randomly attached to the dress. The strings didn't cinch the waist or anything. It was also far too casual for our evening dinners. Verdict: Return

The dress on the right was dressier and has beautiful colors. Although again, not a huge flowery person but it the flower pattern wasn't overwhelming for me. I tried it on and nope. As is often the case, far too big on the top half for me. There was also an oddly placed snap where the dress meets in the middle below the chest. Why? You don't need to unsnap it to put the dress on or anything. The snap confused me. When I looked in the mirror from the front and from the side I just didn't feel beautiful. If I had, I would have easily taken it to the tailor to be fixed prior to the trip. Verdict: Return

I had also asked for a casual outfit to wear on an excursion or sightseeing. They sent me two shirts for consideration: 

The shirt on the left. I loved the color of it. In fact, when I provided feedback on my fix I told them so and encouraged them to send me a different shirt of that shade of blue. I hemmed and hawed over this shirt. It fit great and didn't look bad on me. I just wasn't sure about the cowl type neck. I'm not a huge fan of the cowl neck. I could easily wear the shirt with shorts, jeans or even a casual skirt and even to work. Ultimately, I called my mom on FaceTime to get her opinion. She wasn't sold on the shirt and said "I've seen better." Verdict: Return

The shirt on the right  is beautiful. I loved the navy and white. It has a unique middle section of the front where there is a layer underneath of the dark blue held closed with  hooks and buttons. The pattern is nice too. It is also a shirt my oldest sister would absolutely love. I tried it on and it was far too long. If it was any longer or if I was far more promiscuous I could consider wearing it for a mini-dress. Also, I prefer fitted or at least slightly fitted because the loose cuts like this shirt make me look boxy and sometimes pregnant and that is not a look I'm going for. Verdict: I was sad I had return it. 

The last item they sent was this necklace:

It is a cute necklace. I liked it at first sight. When I tried it on it I was sadden because the chain is so short the necklace doesn't have much dangle to it. Since I had already decided to return the previous four items I decided to keep the necklace so I wasn't out my twenty dollars. This is the first time this has occurred. I have already worn it several times though, so that is a plus. And who knows. Maybe I'll take it on vacation with me. 

So, that was my seventh fix. My next one should arrive in mid-January. In my note to the stylist for the next fix I requested another pair of Just Black jeans from one of my earlier fixes as well as appropriate winter clothes for dates (should I ever get another date) in the climate I live in. I requested no outerwear though. 

The other thing I requested? I requested for one of my first two stylists because they did a great job. The very first one was spot on with my style although her fix wasn't the most successful due to sizes. Not her fault. The second stylist...she got me. She was near perfection. I'm hoping to be reunited with one of those stylists for my next fix and if so I will continue to request them each time. 

This fix was indeed not a winner but many of my previous ones have been. (Go back and read those on the blog). I realize I have a unique body for clothes (my tailor continually informs me I have a very, very special body) and I'm not always sure of my sizes so I can't blame Stitch Fix for those issues. They are certainly trying. I also think because my first several fixes were so amazing I have built very high expectations for my future fixes. I need to reign that in because otherwise I'll rarely be pleased. I also think due to the surge of business (because really, it is an amazing service/company) they are potentially going through growing pains. 

If you haven't already experienced Stitch Fix and want to, I'd love it if you use my referral link: https://www.stitchfix.com/referral/3392664https://www.stitchfix.com/referral/3392664

Tuesday, December 2, 2014

Pumping vacation

I've been dreaming of sunshine, warmth, sandy beaches, blue waters and a plethora of adult beverages a lot lately. Granted, I'm almost always dreaming of some of those items (no, not the beverages). If I spend too much time thinking about sunshine and warmth and sandy beaches, I become disappointed with myself because I have yet to determine a way to make my permanent location somewhere with sunshine, beaches, warmth and blue water. The reasoning for these things consuming my mind lately is it is time for my December getaway to the Caribbean. 

And it cannot come soon enough. 

My family shall visit the beautiful islands of Turks & Caicos. And like all of our previous Caribbean vacations the days will be consumed by lounging at the pools and beaches, playing in the water and drinking. The evenings will be filled with dressing up for dinners, enjoying quality time with each other and just relaxing. 

My pump isn't waterproof and it probably shouldn't sit out in the strong sun for hours and hours. Before I agreed to go on my pump, this was one of the things I was concerned about. How was I supposed to enjoy the sun and the water if I had to have something attached to me all the time? Could I still wear a bathing suit because if I'm out in the sun I'm going to have minimal clothing on to maximize the opportunity to improve my tan. Duh. 

I did some research online and saw several blog posts about "pumpcations." They were a slight comfort. Before completely agreeing though to the pump, I interrogated my doctor and the Medtronic sales rep. I specifically discussed in-depth about my family's Caribbean vacation. From the research and interrogation, it was confirmed it was possible, if I so chose, to stop using my pump. 

And here we are with my trip quickly approaching. 

My beloved endocrinologist left for a fellowship in the summer. I saw the other one in her office in September and laid the ground work for my vacation. He said, yes, I could go off it and to visit him in less than three months to make a game plan (and for him to give me free insulin pens). The appointment was scheduled for November but I didn't see him. Apparently they scheduled me with a visiting P.A. from another hospital. I'm not complaining as she was pretty awesome. I could tell she took the time to read my medical records and notes from my previous doctors. I hope I am able to continue to see her until my original endocrinologist returns...if she returns

I explained to her the purpose of the appointment and also gave her an intense overview of my plans for this trip (laying out, snorkeling, surfing, windsurfing, maybe even scuba diving). She agreed, it was best to switch to the pens for the trip considering how little I would probably actually wear my pump. 

And so, she and I determined what I should take for my long-acting (Lantus) insulin and my insulin (Novolog) to carbs ratio. I'll upload the info from my CGM and meter on the Wednesday before I leave so she can do a final review of our plan and make any needed adjustments. She even gave me some free insulin pens to make sure I wouldn't run out while on the trip. I still had several from my pre-pump days which don't expire until 2015 and 2016.

I'm excited to be pump and CGM free but I'm also terrified. I know my control won't be nearly as great. Having had such an amazing control for the past year I need to remember this and not get worked up and stressed if my numbers aren't perfect. Easier said than done. 

I'm also confident that by day two of the trip I will dearly miss my pump and CGM and be anxious to have them back. The other thing I am confident about is my body will be thrilled to have a break from all of the insertions as I'll be able to use often ignored areas for my injections (arms, butt, legs). 

Have any of you ever taken a vacation from pumping? Any advice for a newbie to this concept?