Thirteen Ways of Looking at Dexcom Share Data

Wallace Stevens, an American poet, wrote complex verse that uses precisely abstract language to scuttle between imagination and reality.  Check out his poem, “Thirteen Ways of Looking at a Blackbird” and “The Snowman.”

We’re three days into the semester, so I’m back in the classroom and Henry is in preschool. There are many moments where my thoughts zoom from reality to imagination before and after I look at Henry’s blood sugar on my Dexcom Follow App. I know he is being well cared for, but there’s always the reality of having type 1 diabetes. Here’s the thing: if you have type 1 diabetes, this means within a 24 hour period it will be difficult, and unlikely, to keep a blood sugar between 90-180. And if a blood sugar happens to remain within the 90-180 range, it is a good moment, but it’s only a moment before the insulin keeps working after the carb is digested, or an emotion elevates a blood sugar, or a correctly counted carb misaligns with correctly dosed insulin and the number soars.

If you’re not familiar with type 1 diabetes, here’s a quick primer. A generally safe blood glucose range (for the pediatric person with diabetes) is 90-200. Below 80 is considered “low” or hypoglycemic, and requires immediate treatment because the immediate consequences are seizure, unconsciousness, and worst of all, death. Above 240, or “high,” hyperglycemia, could result in ketones, and in the short term result in DKA or Diabetic Ketoacidosis, which (similar to hypoglycemia), could result in a coma and death. In the long term, blood sugars above 150 could result in complications to the eyes, kidneys, heart, brain, and feet

So, a caregiver or person with diabetes is always walking this impossible tightrope of insulin, carbs, emotions; trading now for later. There’s plenty of room to imagine, second guess, or worry. 

Here’s thirteen ways of looking at Dexcom Share data, with apologies to Wallace Stevens. The images come from one 24 hour period.

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1. Among too many highs from lows.

2. A lesson about banana muffins,

of a mind to never make these again.

3. Pantomime of pancreas is a

slapstick impossibility.

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4. The number is not one, but

frighteningly close. Mother + child

+ pump + glucose tabs = not pancreas

5. The moment before a gut punch

or just after.

6. The line traced in line,

the indecipherable cause.

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7. What do you imagine?

8. Lucid, inescapable numbers?

9. Illusion of perspective—

flown, offline, out of sight?

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10. Euphony, at a line,

a bird to horizon.

11. Not mostly, but once,

a fear usually pierces.

Even when it’s mistook.

12. The insulin or sugar is moving.

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13. It was all night into morning.

It was no sleep into half-sleep.

Have Diabetes, Will Travel: A Summer in Review

5,249 miles

34 days

18 states

1 oil change

16 site changes

4 Dexcom changes

2 vials of insulin

2 Dexcom Receivers

When Henry was first diagnosed with type 1 diabetes, I was afraid to put him in the carseat and drive to the grocery store. What if he was unconscious from a low blood sugar, but I thought he was just asleep?  What if he needed rescue carbs and I couldn’t get them quickly enough?  How was I supposed to drive and watch for symptoms in the rear view mirror? In hindsight, those fears seem silly, but those fears are valid concerns. Slowly, we got back on the road and increased our travels.

Our families live over 850 miles away, so the first winter vacation after diagnosis, we faced the acid test of really traveling with diabetes. We learned a 10% increase in basal would not even touch a high blood sugar caused by sitting in the car for hours on end. We watched the effects of fast food on the Dexcom receiver, as it read HIGH for many hours while we threw insulin at a stubborn blood glucose of 400. We’ve created innovative rest stops, and the less said about this, the better. 

Traveling with children is never easy, and traveling with a child who has diabetes is even not easier. To begin with, there’s the sheer mountainous amount of additional luggage that holds supplies and back up diabetes supplies. You have to calculate for site changes or multiple daily injections (MDI’s) and plan for back-ups if those fail. Insulin should be kept cool, plan for meals on the road (not fast food), and then there’s the absurdly high blood sugars caused by sitting in the car for long periods of time.

Henry can’t do three things because he was diagnosed with diabetes: serve in the military, become a commercial pilot, or a commercial truck driver. I’m OK with this list, but he can do everything else. He can do everything else; it just requires extra planning. Taking grand, long summer vacations is a rehearsal for the other challenges he’ll face while living with diabetes.

We crank his basal up 60% and hit the road, because the effort and payoff is pretty sweet.

meeting Mickey and Minnie at Friends for Life 2015

meeting Mickey and Minnie at Friends for Life 2015

time on the family farm

time on the family farm in the southeast

walking in the Atlantic in Maine

walking in the Atlantic at Maine