Thirty

Today, my dear husband turns 30!!  We are doing what we can in the midst of a hectic and emotional week to celebrate him and all of his thirty years on this earth.

On Wednesday, he followed the Italian tradition of bringing treats to share with your friends to his volleyball practice.  Today, we're taking three cakes he baked to share with our choir friends (they are BIG eaters).  We thought we'd give them an American style birthday celebration.  Tonight, we'll be going out to dinner with a couple of our American friends at a restaurant in our new neighborhood that we've been wanting to try.

Us last weekend, at the Christmas Market in Trento

Last year, on his 29th birthday, I started thinking about what we might do to celebrate this milestone of his.  I assumed that I would probably be living in Italy, so I would come home in time to throw him a party and celebrate Christmas.  As you know, those plans changed.

And how grateful I am that they did.  I can't imagine what my life would be like here without him.  It wouldn't be nearly as much fun.

Today, I am celebrating him and am so, so grateful that he was born thirty (!!) years ago today.  Nick is my best friend, my partner in all things, and my biggest fan.  I am incredibly lucky to have such a supportive, adventurous, fun-loving husband who cooks, cleans, and loves me even when I'm being ridiculous.

I could never be me without him.  Happy, happy, happy Birthday, Nick!!!

Remembering

I'm going to remember him like this:

We lost my grandfather on Monday, Dec. 12 in the early evening.  How I wish I could have hugged him one last time.

My sweet, sweet husband asked me last night if I wanted to do something, anything, to commemorate him here since we won't be able to return for the memorial service.  I'm not sure exactly what we'll do, but I know that I plan on telling Nick all of my favorite stories about my grandpa.  Many of them involve the innumerable family float trips we took during the summer when I was growing up.  He loved the outdoors.

I'm looking forward to being with my family when I do get to return to the States in just a few weeks.

Wordless Wednesday: Loving Christmas in Italy

Looking for the bright side

Today, I'm wearing this dress:

I'm not as bare-legged or bare-armed today as I was when this photo was taken in May, but still.  This is what I'm wearing today.  Oh, and look to the right?  I'm wearing it in my profile picture too!

You see, I'm wearing this dress today because I can.  Because I'm trying to remind myself that there are perks of not wearing an insulin pump.  And after last night, when I gave myself my first injection in well over a year, I really need to focus on the positive.

Last night, Nick was at volleyball.  I was home by myself after we had grabbed thick-crust pizza and two scoops of gelato, successfully draining my pump of every last drop of insulin it contained.  It was a farewell dinner of sorts, knowing that such meals aren't really possible on MDI (multiple daily injections).  No extended boluses here....and I typically make the choice to not eat like that when giving a correction dose of insulin means ANOTHER shot.

As I gave myself one last pre-bedtime correction from my pump, I prepared myself for what was about to happen.  I reviewed my basal rates and my carb to insulin ratios so that my first day on MDI would be as smooth as possible.

And then I removed the infusion set from my leg.  I headed to the fridge to let my Lantus pen warm up a bit before giving myself an injection.  As soon as I opened the butter compartment, I started crying inexplicably.

Well, maybe not really inexplicably.  I was in mourning for the lifestyle that I've been living since I got my insulin pump in September 2010.  I was dreading (still am) the shots.  I was feeling rather sorry for myself, and then got mad at myself because there are other things going on in my life that more warranted a cry fest like this.  That I should be grateful that I have access to this insulin, that I CAN keep myself alive, even if it means MDI.

I gave myself my Lantus injection.  It wasn't perfect because I bled for a bit after.  I started brushing my teeth, held my hand over the injection site on my leg, and was blubbering to myself when Nick came home.  He was concerned and confused.  I explained to him why I was upset, and he did everything he could to make me feel better.  He got mad with me, we hated on diabetes together, and then he did his best to distract me with funny stories.

And I decided that I would wear a dress today.  Of course, this isn't impossible with an insulin pump, but it does involve some tricks.  But today, I get to wear it without an ACE bandage strapped to my leg and without reaching down the front of my dress to program a bolus.  And it was nice to sleep through the night, with no partial wake-ups when I turn over just wrong and crush my hip with my insulin pump.

And I know this isn't forever.  I will be going back on my pump in just two weeks when we go to Paris for a few days.  Even more exciting?  I just got the news I needed to book my plane ticket back to the States for shortly after Christmas, where I'll be able to restock my supplies.

I'm keeping my chin up and my Novolog pen handy.  I can do this.  I am grateful for life-saving medicine.  I can take a little pain and annoyance.  This isn't a catastrophe.  This is fine.  I can do this.

Too great a distance

There are some things that I don't put out into the world of social media.

That's true of all of us, I'm sure, but I think that I set my threshold pretty high.

There's something that has been on my mind constantly for nearly two months now that I have not written about here, on Facebook, or on Twitter.  I guess the reason for that is because I'm not too comfortable grieving in public.  I'm just not.

About six weeks ago, I found out that my grandfather has cancer.  Lung and brain.  The prognosis was about 2-4 months.

What I'm about to write after all of this is perhaps another reason I'm not entirely comfortable putting my grief out there: it starts to be incredibly selfish.  But maybe that's human nature?  We make most things about ourselves, right?

I was devastated, just like the rest of my family.  I still have all four of my grandparents.  I grew up in the same city where they lived (and where they still do) and saw them often.  I know this makes me very lucky, but it also makes the prospect of losing one of them just awful.

I've spent the last ten years moving further and further away from home.  First, it was just four hours away to college.  Then it was a plane ride or a 12-hour-drive to Colorado.  Then it was to Philadelphia, even further from Missouri.  And now, I've landed in Rome for two years.  Too far away.  Too many hours ahead in time.  A quarter of a world away.

There are a number of factors involved in getting back to see him and be with my family at this time, and I hate that there are things preventing me from rushing back to see him, how it hurts to say, one more time.  But that is how it is.  Thoughts that something would happen to someone I love while I lived so far away naturally crossed my mind, but I tried to banish those thoughts, to know that I'm not in control of any of it and I can't not live my life for those reasons.  I hate that this is now happening.  My worst nightmare.

I suppose that I'm writing about this today because it seems that things have gotten worse.  He had been living at home still, by himself, and now he has been moved to a home where others can take care of him.

And I'm still here.  I can't fly to the States now, and I fear that I won't see him again.  That I won't have gotten to tell him how important he is to me, how much I love him.  That I'm not there with my family.  That instead I'm here with my little family and my little life.  That if I do make it back in time, that he might not even know me, that the cancer has progressed too far.  It's hard to reconcile all of my emotions.

So instead, I'm sitting in my office in Rome, trying to find the will to pull myself together enough to be productive today.  To accomplish the tasks on my to-do list.  To not be paralyzed by guilt and regrets.  To think happily about the last time I saw him, in July when I went to Missouri for my last visit before moving to Rome.  He was happy and healthy.  The same Grandpa I've always known.  I know that he wants me to remember him that way.

Sometimes the distance is too great.  This is one of those days when I'm feeling it the most.

A semi-permanent pump vacation?

I've been thinking for quite awhile about writing this blog post.  I've been hemming and hawing over this blog post, much like this decision, for a couple of weeks now.

I think that in the very near future, I will likely be taking a semi-permanent pump vacation.  How can I think of abandoning my funny purple life partner, you ask?  It comes down to simple economics: my supply is running low.

Here in Italy, I currently have one full vial of insulin plus enough for one more reservoir.  I also have about 3 weeks worth of pump supplies left, assuming that nothing goes wrong.

I'm also down to only three CGM sensors left.  I haven't been wearing my CGM for about a week now as I would rather have the choice to disconnect than to do so because I have no other choice.

Now, in the States, I left a fair amount of supplies behind.  I don't know the exact number of insulin vials, infusion sets, reservoirs, sensors and test strips which wait for me there, but I know that they aren't here right now.  I'm working on rectifying that, but I'm trying to think everything through as far ahead of time as possible.

Also living here in Rome with me are five pens of Novolog and two pens of Lantus.  I really keep these for backup more than anything else, but I've noticed that my two Lantus pens expire in May.  I'm not one for wasting precious supplies.  Then again, I only have about 100 needle tips with me.  That means as long as I don't need any correction doses, I have 25 days worth of supplies.

I have a prescription in the States for needle tips and I could get that filled and shipped to me.  I also could behave myself and get myself to a doctor here to write me prescriptions.  However, when I asked my doctor friend in choir about getting a script for needle tips, he mentioned that I need a codice fiscale in order to do fill it.  I don't have one of those....and getting one while I'm in Italy.....I haven't done any research on how to do so.  Eep!

I have been working on getting my supplies over here to me rather than in the States where I no longer live.  That will take time, and I'm trying to plan as much ahead as I can.  I know that even once I get those supplies from the States, though, that eventually I will run out.  And then this question will come up again.

Here, before I write any more in this lengthy blog post, here's a picture of me from this weekend, taking advantage of life on an insulin pump: the spontaneous purchase of two cannolis from this AMAZING Sicilian sweets shop in our new neighborhood:

And I ate my half of both with relish.  Figuratively, not literally :)

Insulin pump supplies are expensive.  More expensive than insulin pens and needle tips.  There is the possibility of eventually buying in to the Italian health care system, but I have a feeling they won't cover pump supplies as much as they'll cover pens.  My doctor friend from choir who studies diabetes was so surprised to see one that it makes me think they are complete rarities.  Of course, I could pay for them out of my pocket, but being a graduate student does not make me very wealthy.  We watch our centesimi closely here.

Life on an insulin pump is so much closer to normal than life on shots.  Plus there's the whole injecting-myself-with-needles-multiple-times-a-day part that's not so fun.  I will be held hostage to a regular eating schedule with no possibility of spontaneous cannoli purchases, unless I'm willing to give another injection.  And then, I have to make sure I eat enough to cover the entire unit of insulin, or otherwise I'll go low.  No fractions of units on a pen!

Since I don't know exactly when my supplies will get here, I'm starting to toy with the idea of not using up all of my pump supplies AND THEN switching to pens.  Because if I do that, I'll be on injections when we go to Paris next month.  And TRUST ME, there will be lots of spontaneous purchases of carb-laden delights.  I need the flexibility of a pump for that trip.  Otherwise, the only memories of that trip will be watching Nick eat macarons, crepes, and baguettes while I pout and try not to drool.  I have no desire for it to be like that.

So what will I do?  First, I will be doing what I can to get my supplies here ASAP so I can delay this inevitable decision.  But I know I'll have to figure it out eventually.  Do I prioritize my money or living as normal a life as possible?  Would I rather be poorer and eat food as I wish and as I've done so for the last 14 months or do I take care of my bank account first?

Decisions, decisions.  I thought I had my mind made up, but after writing this I am not so sure anymore.  I spend an awful lot of time on this blog lamenting about diabetes, so my apologies for the lack of positivity right now.  Diabetes means lots of hard choices, and I'm absolutely sure this won't be the last.

Thankful, 2011

Another year, another Thanksgiving.  But this year is so different in so many ways.  Instead of spending the day cooking at home or visiting with family, I'm at work!  I won't be eating any turkey today.  I won't struggle with how to bolus for an insane eating fest like I did last year.  I won't watch any parades.  I'll just go about my day as usual, working and then heading to choir practice this evening.

I must admit, I am a bit sad to miss out on a traditional American Thanksgiving.  Although we've been unable to travel back to Missouri for the last several years, Nick and I, every year since we've been married, have made a much too large meal, once for us and two friends and two times for just the two of us.  We have so much fun spending the day in the kitchen and then enjoying the meal we prepared. 

I suppose we could have made ourselves a big meal, put our order in for a turkey and wrangled all of the other ingredients, although it would have been difficult.  But, we just moved to a new apartment in the last two days and we have choir rehearsal tonight, which means a good amount of time on public transportation and wishing our Roman friends a Happy Thanksgiving :)  We've been invited to a big T-Giving dinner on Saturday, so we're looking forward to that.

I'm trying to stay positive, though!  I have so much to be thankful for.  SO much.

Lately Blogger is giving me trouble and won't let me upload photos, otherwise this would be an illustrated post with drool-worthy turkey photos, and other images to illustrate my thankful list.

Without further ado:

• My family.  That word encompasses so many people since I have such a weird and wonderful family.  I have 6 siblings, 4 nieces and nephews, 2 moms, 2 dads, more grandparents than I'm willing to count because I'm afraid I'll miss someone.  Then there are the aunts, uncles, and cousins whom I love so much.  And finally, I have a wonderful family that I acquired when Nick and I got married.  I'm so grateful for all of them.
• My friends.  Really, I consider so many of them family.  In Missouri, in Colorado, in Iowa, in Pennsylvania, and now hear in Rome, we are so lucky to have incredible friends.
• The opportunity to live in Rome.  Even though life here can be quite frustrating, in so many ways, I am so grateful that we are here now, that we are happy and thriving, adventuring and exploring.  I know that this is a once in a lifetime thing, and I'm not wishing it away.
• My cats.  Those sweet babies make our life that much better.  Totally worth the hassle of bringing them to Italy!
• Finally, Nick.  He sees the best and worst of me and manages to love me the same at both ends of the spectrum.  He encourages me.  He makes me laugh.  He loves an adventure. He's willing to give up our lives and move to a foreign country for two years.    I couldn't be me without him.  I am so thankful that he is my partner.

Happy Thanksgiving to all!!  

My three favorite (?) things, all together

Happy Monday!  We had a slower than normal weekend, but I wanted to write about one event which featured most of the things I write about on this blog.  In one fell swoop, this event brought together art and visiting things in Rome, singing, and diabetes!

How is this possible, you ask?  Well, our choir sang in a concert on Saturday night at a church in central Rome.  May I present to you San Lorenzo in Lucina:

 We met for rehearsal on Friday evening at this church.  I had visited this church once before, a few years ago, and was glad to come back.  It's quite ancient, with an original foundation dating back to the fourth century.  Obviously, it's undergone expansion and renovation several times.  Plus, there are two seventeenth-century artists buried here: Nicolas Poussin and Adam Elsheimer.

Now, this concert was sung mostly by the men in our group, with a couple of brief sections where some of the women sang as well.  I was one of the 15 or so sopranos and altos who sang with the men.

Let me back up for a moment to last Tuesday.  We were at rehearsal going through this music, when we get to a section which has a mezzo-soprano solo.  Our director asks who wants to sing it.  Nobody volunteers immediately, so he asked me if I would do it.  Then I froze and said, "Non canto i soli."  I don't sing solos.  This is true.  It's been something like 6 years since I sang in front of anyone by myself.  I used to sing them often, in high school, and then something happened when I got to college that left me terrified.  I don't know exactly what happened.  The idea, though, of singing in this church made me all fluttery inside, so I agreed to do it.  Yay!

So, at Friday's rehearsal, we finished the pieces with the women singing and we were dismissed.  Since Nick was still singing though, I of course stuck around.  I listened for awhile and then decided to use the time to really have a look around the church.  That's when I recognized a sculpture by Bernini that I had COMPLETELY forgotten was there.  So I stood outside the chapel where it sits, and wished that I could go inside the chapel for a better look.

And then one of the priests, who had started talking with Nick and me before the rehearsal and was quite young and VERY friendly, came to listen to the rehearsal.  And then I explained to him that I'm getting my PhD in art history and could I please go into the chapel to have a better look?

So instead of looking at the bust of Gabriele Fonseca from a view rather like this:

 

And instead got to see it more like this:

Oh, I love Bernini!  So moving, so lifelike.  Yesssssss.

Ok, so art history/visiting things, check.  Singing, check, with the added bonus of singing in that incredible space.  So how does diabetes fit in?

Well, Saturday evening was the night that a good number of people in my choir found out I have diabetes.  I don't really hide it, but I also don't announce it.  After the concert, we headed back to a room at the church to change out of our concert attire.  In these instances, modesty does not really exist.  This was somewhat shocking the first time this happened, as the men and women all just strip down to their undergarments in the same room without inhibition.  That's not really my style.  But, sometimes you don't really have a choice.  When I was changing (as inconspicuously as humanly possible), I clipped my insulin pump to the front of my dress while I put on my pants.  Another woman was close by and saw it, so she asked what it was.  I explained to her and she launched into "Ohhhh, scusami!!"  I think she thought I might be embarrassed by it or that it was too personal to ask about, but I reassured her that all was fine.

Then, one other woman came up to me after I had finally managed to throw my jeans and sleeveless top on.  For the first time ever, I have my CGM in my arm (and it's actually going REALLY well!). She saw it, looked confused, and asked what it was.  I did my best to explain continuous glucose monitoring technology in Italian, and she understood pretty well because her mother has Type II.  And then I showed my CGM to my doctor friend (who I mentioned in this post) and several other people noticed it and started asking me about it.

And, I should let you know, my solo went pretty well!  There were a few moments that I could have done a better job if my nervousness weren't interfering, but all was fine.  I was happy and my director and choir seemed happy with it. It was quite the eventful evening!  Who knew that the things I blog about the most would come together like that!

Traveling....

Finally!  Here are a few photos of our recent trip to Spain!

Our first Ryanair flight.  And yes, that is a mustache that Nick is sporting.  It was temporary, and has (thankfully) left us:

 

Spain spotted!

 

 We saw some BEAUTIFUL Basque countryside, as we spent hours on the bus traveling around to various cities for concerts

 

 Nick and I on the boardwalk in the beach town of Zarautz, our home base:

 

Our hotel tempted us with these every day:

 One of our concerts was in this church in Borja:

 

Our choir at the competition.  We didn't win, but it was still an incredible performance:

 

And, dinner on our final night at a sidreria with all of the other choirs in the competition.  Nick LOVED this place (and blogger refuses to let me center this photo):

Next up, we leave for here in 34 days :)

We are SOOOO excited!  It will be a trip filled with more Christmas markets than we can handle, lots of incredible food, art, and so much fun.  It's our Christmas gift to each other rolled up with Nick's 30th birthday gift.  We can't wait!!

It's World Diabetes Day!

Today is World Diabetes Day!!  In honor of it, I'm wearing blue.  My lovely life partner, diabetes, has decided to honor it by keeping me out of range (HIGH) for the last six hours.  It's like it wants to make sure that I know it still exists, especially today.  Boy, am I grateful.

I also wanted to post a photo of the postcard I mailed last week as part of the World Diabetes Day Postcard Exchange:

Now, the exchange encouraged creativity, but here's the thing.  Despite my love of art and art history, I have virtually no creativity in me.  I'm going to say none.  Probably even more important, I don't have any sorts of arts and crafts supplies, and when you live on a budget, these sorts of things are not going to get purchased for a single project.  Thus, I let Rome do the talking.  I just added a diabetes twist to it.  Here you have the Bocca della Verita', the Mouth of Truth, as seen in the movie Roman Holiday with Audrey Hepburn with a small addition.  There are lots of famous round things in Rome, but I think that this was the perfect one to bear the Blue Circle in honor of World Diabetes Day.

Every day, millions of people around the world, like me, must always be thinking about their bodies, about what goes into them, about how they are feeling, about whether this disease is cooperating or not.  Multiple finger pricks, injections or changing of insulin pump sites, making sure we have some fast acting sugar handy, dealing with the mental fog of a high or a low number, planning ahead in every way.  Taking care of ourselves is a huge and difficult job, but the complications are scary enough that we must try.  Every day, we must start again, despite frustrations, despite numbers from nowhere, despite the burden.  And sometimes it isn't enough.

I've had this disease for 21 months now.  It's followed me around the world.  It will always be with me.  I hope for a cure.  I hope to raise awareness that we need a cure.  That our life support - insulin - is not enough.  That this disease affects millions of people, in every country.  That too many people cannot get the support that they need and lose their fight too soon.

It is a fight.  It's a daily struggle.  And today is the day to recognize this.  I hope you're wearing blue too!

Mamma mia....

I'm in something of a quandary.....I have so much to blog about these days but so little time to do so!  It's true.  I'm managing to work, have fun, and then when I come home I just want to relax rather than write.  But, I am going to do my best to cover the last week or so here...albeit without any pretty pictures.  Nick sort of commandeers the camera now and puts the photos on his computer.  Then, when I find the time, I upload some to facebook.  After that, sometimes they appear here.  Sometimes they don't :)

• Spain was so wonderful!!!  This is what I hope to show you some pictures of in the very near future.  We spent a lot of time on a bus traveling through the Basque region.  It was breathtakingly beautiful.  We stayed in Zarautz, a beach town with lots of surfers, and then sang in Pamplona, Borja, and Tolosa.  From the bus, we also saw Bilbao (although sadly we could not see the Guggenheim from the highway) and San Sebastian.  I loved getting to go to some cities that I might not otherwise have the opportunity to visit and we had such a wonderful time with our choir friends!  Check out Nick's "Spain Week" on justvasgo.blogspot.com for some pictures and his take on our experience.  I did learn something very interesting though.  All Spanish rest stops sell whole legs of Iberico ham.  Interesting, no?
• We found an apartment!!  We looked at a few this go around, and while this is not the nicest nor largest, it is well connected and is actually in our price range.  It is larger than a studio and has been completely restructured with brand new appliances, bathroom, and furniture, although that last part has yet to be delivered....We did look at one that was SO beautiful, but it would have made our financial situation just too tight.  We have to make sacrifices, and maybe it will get us out of the house more!
• Let's talk about diabetes for the next few bullet points, ok?
• First, I've been doing a few things for Diabetes Awareness month!  I just finished my postcard for the World Diabetes Day Postcard Exchange!  Sadly, I am severely lacking in creativity, so I let Rome do the talking.  I'll post a picture of it on November 14, World Diabetes Day.
• Also, I've been updating my facebook status occasionally with diabetes myth dispelling!  Let's hope I'm reaching some of my friends.
• Yesterday was also the 7th annual D-Blog Day.  I, unfortunately, failed to make a scrapbook page....but I do want to blog about the topic as soon as I can.  The topic this year is writing about why you find the Diabetes Online Community important.  I have some thoughts on this, so I'll save it for later.
• I've been having some wacky blood sugar numbers lately.  They were atrocious in Spain.  I've never seen that many 300 + numbers since I was diagnosed!  And maybe what's so frustrating is that I can't really pinpoint why.  I had (and still do) a bit of a cold, I wasn't walking as much, I was eating more food, perhaps my carb counting was off, or maybe it was all of these things. Or maybe I'm finally reaching the end of my honeymoon phase and I need to up my basal and bolus rates.  I'm a bit frustrated because I just don't know what to try.  I think I'll wait until this cold is gone and then start testing and tweaking.
• This final point on diabetes also deserves a blog post of its own, but I'll do a bit of a teaser here.  I finally told someone in our choir (directly.....I'm facebook friends with many of them, I eat meals with them, so perhaps they've noticed me testing and bolusing?) that I have diabetes. He has been so friendly to Nick and me since we arrived, he speaks pretty good English, and we found out recently he's a doctor.  So, perfect person to tell.  He asked if I would have some tiramisu after rehearsal (it was someone's birthday), and with a small cream puff in hand, I declined.  He asked why, so I told him.  His eyes lit up.  He said, "You know that I'm a doctor, right?"  And I said, "Yes, an internist."  He said, "But really I specialize in diabetes.  I wrote my thesis on LADA."  And this is how Nick and I reacted: !!!!!!!!!!!!!!!!!  So, definitely more on this exchange later.

And now, back to work.  More to come soon.

Housekeeping on Silver-Lined

So many things to blog about today, so little time!!

• First, today is my babiest sister's birthday!

Happy Birthday, Josie!!  That's her above with her favorite boy, our nephew Braxton.

• Second, I thought I'd post a little Halloween fun before the holiday got too far away.  We went to a party at the apartment of some American friends on Saturday night.  We spent $0 on our costumes.  May I present to you a Roman umbrella vendor and the Hamburglar!

Neither costume translates perfectly to pictures since they both require actions.  So, without further ado, here we stage The Great Hamburgling:

We hope you enjoyed that.  Neither of us can stop laughing every time we see these pictures!

• Third, today marks the beginning of National Diabetes Awareness Month!  I think my readership is a bit more aware of diabetes than the majority of the world, but it is still an important time to focus on this disease which affects millions of people around the world.  We don't get the same kind of publicity as Breast Cancer Awareness Month, which can be frustrating.  Not that breast cancer awareness isn't important.  Obviously it is.  I have a friend who was diagnosed earlier this year at the age of 27.  She has undergone a double mastectomy, reconstructive surgery, radiation, and is about to start chemo.  So, breast cancer awareness is IMPORTANT.
  
  However, so is diabetes awareness!!  It's a disease that impacts someone for the rest of their life, never goes away, never lets a person off the hook.  And it doesn't just affect those with the disease.  I know that it's on Nick's mind, perhaps not as often as mine but still.  He sees how it affects me, obviously lives the fact that it affects our marriage and almost any situation in our life in some way.
  
  There are so many myths that fly around about diabetes, many of which can be quite offensive.  For example, an acquaintance from high school recently posted a quotation on facebook, something her husband said which she thought was funny.  He said something along the lines of he thought he would catch diabetes from his lunch, with too much sugar in the sweet tea.  And two people "liked" this.  After mulling this over for several minutes, trying to decide if it was worth intervening, I posted the following:
  
  "I've gone back and forth for about 5 minutes about whether I should comment or not.....do I stand up for people with my disease and then seem humorless? Tough call. Anyhow, looks like I decided to comment."
  
  So, I think that my Diabetes Awareness Month advocacy will take the form of attempting to dispel some common diabetes myths via my Facebook status updates.  It might not be much, but maybe someone will learn that it's not appropriate to say certain things, especially to someone who lives with this disease every day.
• And finally, we are leaving for Spain tomorrow!  We'll be headed to Tolosa, a small city in the Basque region, for the European Grand Prix for Choral Singing.  Hopefully we'll get to see the town a bit.  I just keep thinking about all of the Pintxos we'll be eating.....yummmmmmm.  I'm assuming we won't have internet access while we're gone, but we'll be back in Rome on Sunday.  And then, who knows!  We've got several things in the works for some upcoming adventures....

Part III of the epic cat and ribbon saga

So it seemed that the worst was over once we realized that the ribbon was no longer inside our cat (are you confused?  See Part I and Part II).  However, this proved not to be the case.  I don't know if Colby agrees with me or not, but it was definitely the hardest for me.

When we left the vet, they mentioned that we could remove the catheter from his arm ourselves, or we could bring him back to their office so they could do it.  After some discussion, and some further consulting with my facebook vet, we decided that it would be less traumatic for us to do it ourselves rather than shove him back in his carrier and take him to that place he hated.  Surely this wouldn't be too difficult to do ourselves, especially with careful instructions sent to us by the aforementioned facebook vet.  We decided that Nick would do the cat wrangling and that I would be responsible for tape and catheter removal.

We gathered our supplies and then found the sleeping Colby.  And so we began.

We soon discovered that this was, in fact, going to be much more difficult than we imagined.  Unfortunately, the vets didn't really shave his arm.  They just trimmed some fur.  There were many layers of tape, all stuck to fur.  There was no chance of ripping any of this off quickly or slowly.  I had to cut even more of his fur.

I started by cutting a vertical line down the tape in order to get better access to his fur.  He didn't like any of this handling of his sore paw, but we didn't have a choice.  I managed to get a section of tape removed from the opposite side of his arm from where the catheter was.  And then I found a section that was attached more to skin than fur.  Not knowing this (and it being pretty difficult to see), I nicked him just a little with the scissors.  Once I realized what was happening, I of course stopped and felt just awful.  I didn't hurt him much and there wasn't even any blood, but I felt so horrible contributing to his pain.  We decided to give him a break.

Then we had round two and kept steadily making progress.  We had to stop this time around because I felt a bit low and didn't want a low blood sugar to prevent me from carefully trimming his fur and the tape.

Round three actually made some progress right around the tape of the catheter.  I have never seen so many layers of tape in my life, and some had to just be ripped off.  Otherwise, I had no access to removing the catheter.

Finally, round four, we pulled off even more tape and freed the catheter.  I removed it, held gauze over it until it stopped bleeding, and then rewrapped his paw in the hopes that it would prevent him from messing with the insertion site.  Of course, that gauze didn't last more than a few hours.

Later that evening, he started acting like his usual self again.  He did have a couple of small pieces of tape left on his fur, but we knew those would find their way off quite soon.  We were so glad that he was eating and acting normally, but the ordeal seriously scarred us (ok, maybe just me) for some days.  I felt awful at having to hurt him to help him, but he seemed to understand that to a certain extent.  He didn't like us messing with his paw, but he never tried to scratch or bite us.  He never even hissed or growled.

And it's so appropriate that I concluded the epic saga of Colby and the ribbon on this day because it is his birthday!!  Our funny ginger kitty is 5 years old today.  He's celebrated by napping, chasing his sister, and eating.  What could be better?

One crazy day becomes three....

See this adorable little boy? 

He caused us quite the headache last weekend after eating a ribbon that was about a meter long.  Nick and I decided that we would call our vet in Philadelphia (via skype) as soon as they opened to see what they thought we should do.  We realized that this could be a really bad situation, but before hauling this heavy cat around Rome in the middle of flood, we wanted to make sure it was absolutely necessary.

Turns out I didn't need to call the vet.  A former uncle of mine (I realize that sounds quite weird....used to be married to my aunt) is a vet and we are friends on Facebook.  As soon as he got online, I pelted him with questions.  He was incredibly helpful and even sent me the names and numbers of some Italian vets who have been associated with the company he works for.  He let us know that things could be very bad, although they could also be fine.  We opted to play it as if it were the worst case scenario.  After a few phone calls, and me finally giving up on being able to understand automated messages in Italian, my friend Carla did some investigating for us.  She found us a 24-hour animal hospital just 4 tram stops and a 10 minute walk away.  Off we went!

Of course, we received the attention of EVERYONE on the street.  Italians LOVE cats, and several nonne wanted to know his name, where we were going, etc.

When we made it to the hospital, we didn't have to wait long.  We even met with three vets who each spoke some English.  We managed through the two languages to explain what had happened.  Since he had eaten in the many hours since he ate the ribbon, endoscopy wasn't an option.  An ultrasound would not show a ribbon.  No point in trying for a difficult surgery when the cat was acting normal.  They sent us home with the instruction to buy him some paste that's good for hairballs (and, um, greasing the wheels) and to come back if he vomits.

Nick took Colby (that's the cat!) home and I headed to the pet store to find this stuff.  As I'm almost to the pet store, Nick lets me know that he vomited.  Twice.  Of course.

So we went back to the hospital, and the vets were perplexed to see us again.  They decided to do an ultrasound.  They shaved his poor belly, pinned him down, and tried to see if the ribbon had knotted up and caused a blockage.  My little boy was miserable, and they found nothing.  They decided that it would be best to keep him overnight (it was 8:00 pm by this time), not to let him eat or drink, to see if anything else happened.  First, though, they wanted to give him some fluids and so they put a catheter in his little arm.  Nick helped them hold him down while they trimmed his fur and put the needle in him.  It was so hard not to cry, hearing him so scared and in pain....Finally, we took him to the cage where he would be staying the night, in a room with several other animals: two big dogs below him and two noisy cats right next door.  I was heartbroken.

I tried to tell myself that this was for the best, that the worst case scenario was worse than leaving him there overnight.  That we would see him tomorrow.  That everything would be ok.  They told us to come back the next morning at 10 am.

When we got there, they told us that nothing had changed over night, but that he was so nervous and stressed from being there that he wouldn't eat, drink, or use the litter box.  We got him out of his cage and took him to one of the rooms so that he could relax a bit.  After 15 minutes or so, he finally calmed down enough to use the litter box, but not to eat or drink.

The vets decided it would be best to just bring him back home and keep him under careful observation.  If he didn't eat, vomited, or didn't use the litter box, we should come back.  If he started to pass the ribbon, but it didn't completely come out (ew, sorry), to come back.  They also decided to leave the catheter in, in case he had to be brought back and needed more fluids.  He hated that thing in his arm, but we dealt with it.

We watched him closely.  I went to buy the fiber-filled food they suggested and to pick up enough groceries to keep us stocked for the whole weekend (it was Friday by this point).  Nick kept tabs on him.  He wasn't really acting himself, but we chalked that up to the stress of his hospital stay.  We even woke up twice overnight, once each, to check that he was doing ok, to ensure that he hadn't vomited, and to check the litter box for evidence of the ribbon.

When I got out of bed on Saturday morning, I went to check the litter box.  My quick inspection, one that wasn't altogether thorough, showed no progress on the passing of the ribbon.  I got back in bed and read until Nick woke up.  When he finally did, he discovered that I had overlooked something.  He took one for the team and investigated what had been left in the box overnight (I am on euphemism overdrive!) much more thoroughly than I had.  And, he found the ribbon!!  We had lucked out.  He had eaten enough food that some had collected around the ribbon, preventing any of the awful things that could have happened to our poor kitty's digestive system!

Hallelujah!  Amen!  Thank God!  I was so relieved that he would be ok.  Now, what about that catheter in his poor little arm......

Stay tuned for the third installment, coming soon!

One crazy day

In reality, this post covers more than just a single day.  However, the drama can all be traced back to a single day of our life in Rome, one 20 October 2011.

It was raining that morning when my alarm went off.  It has rained very little in our 7 weeks living in this city (although that will be changing soon...November and December are RAINY).  So when I heard the rain hitting the scaffolding outside our bedroom window (have I talked about that?  It's been there for weeks....they are using our terrace to hold a good chunk of it), and the occasional thunder, I kept hitting my snooze.  It felt so nice to doze and listen to a good thunderstorm, one that would fit in well in Missouri, not any of the last three cities I've lived in.  Colby was snuggling with me, like he does in the morning, and I was happy to postpone my day at the Vatican Secret Archives.  I'll just get there a little later, I can still apply for my tessera at 9:30 instead of 9:00.

Finally, I pulled myself out of bed.  Colby stayed on my pillow.  I climbed out of bed in the dark, since Nick was still sleeping, and soon noticed that I'd stepped in something wet.

Great, I thought, I found some cat puke.

Step number two quickly revealed that, in fact, the whole floor was wet.  What was going on??

I wake Nick up and tell him I need to turn on the light because the floor is wet.  As soon as I do, I see our entire floor covered in water!  Everywhere, there's at least half an inch, and I'm soon to discover more in other parts of the apartment.

I look back by the bed, and see Colby now sitting on the floor in one of the only dry spots left.  How on earth did he find that??

As I walk through the apartment, with my yoga pants hiked up, I discover water pretty much everywhere.  And, I'm starting to hear voices in the hallway.  It turns out that the water has leaked under our door!!  I make myself presentable as quickly as possible and open it.  Turns out, ours wasn't the only apartment flooded.  Also, can I just say here that my Italian vocabulary regarding flooding is seriously wanting?  And, such stress renders me unable to understand a word of it.

We do live on the lowest level of our building, but we're built into a hillside.  What on earth is going on??

Remember that scaffolding?  Turns out that the debris from the construction work has never been cleaned from our terrace and has clogged the drain.  That terrace is just outside the door in the above photo.

We rescued the kitties very early on and let them use the bed as an island:

Now, there are positives and negatives of having a stone floor.  Positives include no water damage!  Negatives include the fact that it is cold and that even "drying" the floor means that it is still somewhat wet until it air dries.

After we get the place mostly cleaned up, Nick and I finally sat down to have some coffee and some breakfast.  Then, Nick tells me a story about how the floor was not wet at 5:30 am.  He knows this because he woke up to the sound of a cat gagging, as if the cat is about to throw up.  He finds Colby, that demonic orange kitty from the above photo, in the process of eating a ribbon.  Similar to curling ribbon, these nearly meter long ribbons come with the garbage bags in Italy.  So, Nick saw it happening and tried to pull it out of his mouth.  He only got a few inches worth....and thus our cat ate a huge, huge piece of ribbon.

I do not react to this well.  I demand to know why didn't he wake me up??  Didn't he know that was dangerous??  Cats can't eat things like that!  Nick tries to get me to calm down, telling me that surely it will be fine.  I tell him I'm 90% sure it is not fine.....

After we clean up a bit more, I turned to Dr. Google (oh, did I mention that a good portion of our clean up happened in the dark because the circuit kept flipping?) and realized that I was RIGHT!!

Stay tuned for the rest of the story......this is getting way too long!

When only the shower is free

Wonder of wonders, today was Free Shower day.  Wearing multiple medical devices on one's body means that this almost never happens.  But, the stars aligned and I was able to shower with no pump connection site and no sensor.  One of the major reasons that this so rarely happens is because I typically change my pump site at night and I shower in the morning.  It's partially my own fault.

So why was today different?  I'm glad you asked.  I did something I'm not supposed to do: I wore my pump site longer than three days.  Insulin pump manufacturers recommend changing your site every two to three days to prevent infection.  Granted, I only wore my pump for about 12 hours longer than I should have, so my risk of infection was slight.  But I had my reasons.

Two days ago, I realized that I still had plenty of insulin left in my reservoir.  That if I were to pitch this pump site when I was supposed to, I'd be wasting more than 10 units of insulin.  On certain days, when I eat fewer carbs than normal, 10 units can cover me for an entire day!

Now, I'm sure there is a way to conserve this insulin, or to put that reservoir in the pump after changing the infusion set.  But then I'd have to refill the cartridge or change it the next day anyway.  I suppose that's a possibility, but I've never done it.

Anyhow, after I realized that I had this much insulin left, I started pondering leaving in my site an extra day.  I've never had any site become even slightly infected.  Don't people do this sometimes?  Will not following the rules this once really cause problems?  But, it's a slippery slope.  Would I keep doing it if it worked this time?

You might ask why I considered being so stingy with my insulin.  Really, it's also being stingy with my pump supplies.  I'll get to that in a second....

So I talked it over with Nick.  I like to do this when I'm considering doing something abnormal, to make sure my logic checks out.  Nick did not like this idea.  He didn't like the possibility of infection, and didn't see it as worth it to take a risk like that.  He pointed out how much trouble and money it would be if I did develop a serious infection.

And he's right, although the likelihood of that is slim.  But then I pointed out to him that our lovely insurance policy would cover any doctor's visits or hospital bills associated with a complication.  And this leads back to why I'm becoming so stingy: it's so ironic to me that our insurance company will cover an illness or complication of diabetes, but it covers NOTHING in the way of making sure I can properly care for myself. All of the insulin, all of the pump supplies, all of the CGM components must be paid for by me.

Before we left the States, I hoarded supplies like crazy.  I refilled my insulin well in advance of running out.  I refilled my prescriptions for insulin pens and needle tips to make sure I had plenty of backups.  I ordered as many test strips and pump and CGM supplies as my insurance company would cover.  Now, I left some of these behind in Philadelphia with a friend (Hi, Michelle!) because I knew I would be returning to get my visa in a fairly short amount of time.  Because of this, I'm now starting to see my piles of hoarded supplies grow smaller and smaller.  I only have two more vials of insulin in Italy.  I think I have about 6 weeks worth of CGM sensors (and yes, I'm using expired ones because I don't really have a choice) and maybe 6 weeks of infusion sets and reservoirs.  Once I restock from the States, I think that I'll last until about March or April.  And then what?

Since I will have to pay for everything out of pocket, I think that I'll have to go back to 4-5 injections a day. The Lantus pens I have with me expire in May of 2012 and my Novolog pens expire in March of 2013.  Being in a very tight financial situation, I also want to make sure I'm not wasting any of these things.  But I think about what my diabetic life was like before my insulin pump, and I dread going back to injections.  Sure, it would be nice to not have my pump, my 24/7 companion, attached to my body, and I would love to wear dresses with ease again.  But, I live in a country that runs almost exclusively on carbohydrates.  PASTA. PIZZA. GELATO.  I'm swimming in carbs at all times.  It's true that I could ignore these and eat low carb or eat very small portions of these, but I want to live my Roman life to the fullest.  That includes eating cucina romana.

In the end, I know that diabetes makes me not normal and forces me to adapt to whatever situation I'm in.  I'm just being a bit of a whiner about it right now.  I hate that in order to maintain the normal I've been enjoying for well over a year, I will have to spend over $1600 for a 3 month supply of pump supplies and CGM sensors.  Plus insulin.  Plus test strips.

I knew that moving to Rome would require sacrifices, and I know that all will be well, even when I run out of pump supplies.  I'm just dreading that day and what it will mean: choosing to maintain my normal life or my bank account.

Dove sono?

Seriously, where am I?  Or better yet, where have I been?

Somehow, we have managed to transplant our busy Philadelphia lives to Rome.  And I think this is a good thing, except for the fact that I don't have a lot of free time and I don't get enough sleep!

My typical schedule involves me going to my library or to another library or archive Monday through Friday during regular working hours.  Then, we have something going on nearly every evening of the week.  We started going to a pub quiz with a friend on Mondays.  Tuesdays and Thursdays we have choir practice (which means us being out of the house from about 6:45 pm until 11:45 pm.  Wednesdays are sometimes free, but we also sometimes try to catch up with friends then.  Fridays are usually free, where we try to decompress after a long week.  The last three to four weeks, I've also been dedicating at least a few hours an afternoon or two a week to giving tours or following others so that I might be comfortable leading those myself in the future.  Oh, and I forgot to mention, Nick just joined a volleyball team!  They practice twice a week, on Mondays and Wednesdays.  Fortunately, it isn't too far from our apartment.

And then on the weekends, I keep us running.  We usually sleep in a bit, but then I always get us out of the house to explore the city and see the sights.  We don't go too crazy, but I like to make sure we aren't wasting any of our two years here.  There is so much to see and do that we must take full advantage of our free time.  Or at least that's what I think!

If I had to choose, I'd much rather be too busy than trying to find ways to fill my time.  I think it just goes to show that Nick and I are pretty good at enjoying life, no matter where we happen to be living.  Fortunately, we agree on this approach to life!  We are definitely do-ers :)

Summary of this post: We are busy and it is hard to find time (to blog) in the midst of working hard and playing hard.

Spoke too soon...

Dear Diabetes,

I wasn't aware that you read my blog!  Yesterday, I wrote the following:

"The lows could be sneaking up on me in the night rather than right before lunch or bed....None of these things are happening, and so I'm grateful for that."

And last night, you treated me to my first middle of the night low in a LONG time.  Thank goodness for all of that water I chugged after getting home late from choir practice.  If I hadn't needed to use the restroom, would I have woken up?

And you, CGM, would you please do your job?  I thought we were in this together, you alerting me to those evil hypo excursions.  You said I never got below 75.  Liar.

My 2 am bathroom trip was a little more wobbly than I expected.  I realized I was low, so I ate several glucose tabs like it was my job.  Only then did I decide to test: 49.  EEP!  Should I wake Nick up?  Then the shaking got really bad.  I ate a few more tabs, then sought out more in the kitchen.  Two bites of nutella....overtreating?  Yes.  Did it make me confident that I would get out of that hypo and could go back to sleep safely.  Definitely.

Sure, diabetes, I spiked back up, but I was only in the 120s when I woke up.

Lesson learned: no writing on the blog like I've got this thing figured out, or rejoicing in what's NOT happening.  I didn't know you had internet access.

Yours (though I wish I wasn't),
Jasmine

Every Day is Different

It's sort of crazy to think about, but it's been exactly four weeks since I left the US.  This means I've gone through 4 CGM sensors, 8 infusion sets and reservoirs, approximately 200 test strips, and far too many glucose tablets.

In these last four weeks, I've been trying to assess what needs to change in my day to day diabetes care.  You would think that this should be pretty straightforward, that as someone who has had diabetes for 19 months, I should be able to determine what steps to take to keep my numbers in check.

Since I wrote these posts, I have gone low too many times.  Perhaps others diabetics find this normal, but I rarely went low more than twice a week, if that.  I find myself in a tricky spot, though because every day is different here.  It probably doesn't help that the battery in my food scale died shortly after we arrived and we haven't yet found a replacement for it.  Thus, all of my boluses are guesses.  Sure, I'm a pretty educated guesser when it comes to this, but it would help if I could have this tool to have a more accurate carb count to tell my insulin pump.

I am also rarely using temporary boluses.  Part of this is because I eat things like gelato pretty frequently when I'm walking around the city.  I use sweet treats to help keep my numbers up even when walking all over the city.

But then there are days like today when I unexpectedly had to walk at least a kilometer more than I usually do because of some protests blocking my bus's typical route.  Since I didn't know what bus would be running where I want to go, I just walked.  Fortunately I'm able-bodied and my bag wasn't too heavy.  I thought for sure I'd go low, especially since I thought I might have overbolused for breakfast.

But it didn't happen.  When I tested about an hour after arriving at my office, I was in the 130s.  Strange.

Lately, I've been lower than I like to be right before bed, which drives me nuts.  I often don't want to eat anything else or am so tired of the flavor of glucose tabs.  I've also been a bit higher than I prefer when I wake up in the morning.  I know that all of this might be fixed if I was just willing to do some basal testing, to see if my rates are ok for my current lifestyle.  But then every day is different.  Who knows if my bus is going to come?  Or if I'll be deviated?  Or if the tram will stop for no reason?  Or if I'll take the bus which drops me off at the bottom of the hill or the top?  My activity level is just so varied right now.

Once again, thank goodness for my CGM, because I think I'd be in trouble without it.

We'll see if things level out, or if I can spot some patterns in my CGM data when I next upload it to Carelink.  I'm trying to remind myself, though, that things could be much worse.  The lows could be sneaking up on me in the night rather than right before lunch or bed.  That I could be getting lots of stubborn highs.  None of these things are happening, and so I'm grateful for that.

I love that every day has something new to offer.  I guess life in Rome is sort of like diabetes in that way, every day offering something different.  If only one didn't play with my health.

Catching up

Just a quick post to note that both Nick and I are still alive, although we are STILL without internet at home.  Oh, Italy.  You are SO Italian.  Apparently, the internet bill is in our landlord's cousin's name. She is currently abroad in Australia and did not pay the bill.  So, he paid it.  But it just isn't that simple here, to just come back on once the bill is paid.  Poor Nick.  At least I get to check my email when I go to work!

It's been another busy week.  I spent the last three days at the Vatican Library where I did have internet, but felt guilty for using it too much and to do anything besides check email quickly.  You never know who is sitting behind you and can see you checking facebook instead of reading the manuscript sitting open in front of you.

I've been looking at all sorts of interesting things, some relevant to my project and some less than.  It's been a challenge to acclimate my eyes to writing like this:

This is not a document I've looked at, just something you find when you google "paleography"

It's a challenge, but I'm hoping it will get easier.  I took a course on paleography a couple of years ago and am so grateful that I did!  It doesn't make my reading abilities perfect, but I at least understand common symbols and have several strategies for trying to decipher the more illegible parts.

We are making sure that we have plenty of fun on the weekends.  We visited one of the churches on the Forum on Saturday, one that I had not yet been to.  Nick acted as my photographer, taking over 300 pictures for me to study from.  Then on Sunday, we packed a picnic and spent a few hours at the Villa Borghese.

We are also really enjoying being a part of the choir we joined, despite the fact that the rehearsals are FAR from where we live.  We have to take 2+ buses, one of which we stay on for at least 40 minutes.  But, it's been an excellent chance to practice Italian and still get to sing, which is such an important part of our lives.

This weekend, all of the civic museums are open for free, all around Italy.  I'm sure we'll take advantage of that, avoiding the pricy tickets while seeing some of the best collections in the city.

Hopefully we will be back to normal in the very near future, with more posts on Nick's blog and a bit more action here as well :)

The Thirteen Mile Hike

I have been extraordinarily busy this week, what with shadowing tours to prepare for my new job as a guide, a trip out to Ostia yesterday to visit an excavation, and a trip way out to the suburbs Tuesday night to attend a choir rehearsal (more on that later....).  Plus, today I had lunch with an art historian who is in town briefly, who I've met a few times before, and somewhere in there I have to work!

But, I wanted to tell a little story here about how I survived a 13 mile hike around the walls of Rome WITHOUT GOING LOW!!

This is a semi-annual event that the Rome campus of my home university sponsors.  An archaeologist/art historian leads whichever undergraduates (the dean invited us along) are willing on an epic 8 hour, 13 mile walk around the city's Aurelian walls.  The walls more or less correspond to the perimeter of the orange area seen in the map below:

Our walk deviated just a little bit from this.  Rather than walking all the way around the Vatican, we stuck to the original walls which used the Tiber as the barrier for part of the way.

I knew ahead of time that this would be tricky, that so much walking in the hot, hot heat would make maintaining stable blood sugars much more difficult than usual.

So, Nick and I packed up lots of snacks, plenty of glucose tabs, and a juice box.  Funnily enough, it didn't cross my mind to set a temporary basal rate until about 2 hours into our walk.  Weird.

We got to the Lateran at 8:30 am and then walked with the 50 or so other people.  We'd stop every once in awhile for a 5-10 minute lecture about what we were seeing.  It was a really fantastic way to see parts of the city that I had never seen before and also to mentally connect how the different neighborhoods which I had visited before actually interact.

Porta Maggiore, one of our first stops

Throughout this walk, I relied heavily upon my CGM.  Thank goodness for this technology!!  Those of us with lazy pancreases (pancrei?) not only have to worry about too high of blood sugar, but also the fact that our bodies can't stop us from going too low.  A walk of this caliber, without the proper preparations, has disaster written all over it!

Part of the walls on the east side of the city

Basically, I kept a careful eye on my sensor graph, checking it at least every 15 minutes or so.  This way I could see if I was holding steady or trending down.  As you can imagine, there was a lot of trending down.  I knew that even if the exact number showing on my pump wasn't correct that at least my graph would give me a good sense of where I was headed.  Whenever I started to trend down (and my number NEVER showed more than 130 or so), I would eat a snack or throw back a few glucose tablets.

Piazza del Popolo, strangely devoid of too many popoli (joke courtesy of Aleta)

One of the hardest parts of the trip, physically, was the hike up the Janiculum hill.  This picture doesn't quite do the incline justice:

Since I knew it was coming, I drank the juice box about 20 minutes before we hit this hill.  Juice boxes in Italy probably should go by a different name, since the liquid is much more like nectar than juice.  So, I drank about 24 grams of carbohydrates to prepare me for this hill.

And then there are the downhills:

The posse of undergrads along for the hike.

The hills of Rome are much like the ups and downs of my CGM graph that day.  I'd head down, and then treat before a low hit and then I'd go back up.  Just like the hike.  Up and down.  Down and up.

I probably should have been more responsible with actual testing.  I only did so about three times during the hike, mainly because I knew that number would only be a single, brief moment, sure to go down again quickly because of the walk.  

At the end of the exhausting and hot day, I was really pleased with how well Nick and I had planned for the day.  I wasn't so pleased with how my hips and feet were feeling, but that's another story.  At the end of the 13 miles, our leader bought us all a soda for our troubles.  For some reason, I did not take advantage of the moment and drink a full sugar Fanta, opting instead for the Sprite Zero.

After another 30 minutes of travel (after resting, of course), we climbed the hill back up to our apartment.  Because diabetes is what it is, I did go low shortly after getting home, but that was much better than going low while out and about.  I kept a careful eye on things the rest of the night, not correcting before bedtime.  I didn't want any overnight lows sneaking up on me.

And that is the story about how this D-Queen survived a hike around the walls of Rome.  It was a long and tiring day, but such a unique opportunity and way to see the city.  I'm so glad we did it!

Diabetes and Bridging the Cultural Gap

I've been hard at work this week, which I'm going to take as a victory since I live in Rome.  There is so much to see and do in this city that managing to corral myself in a windowless office in a library for 30ish hours this week seems like a triumph.  But!  That is why I'm here.

Of course I'm also here to eat things like this:

And visit some incredible small towns with my amazing husband:

I'm trying to placate the "masses" with some pictures here.  There are many more on facebook....if you are my facebook friend :)  And of course on Nick's blog.

Anyway, onto the real point of this post.  Work.  Wednesday was my first real day of work at my library, a German institute in the heart of Rome.  Monday was my orientation, and with a strike on Tuesday I stayed home.  As I was getting ready to leave the apartment, I started asking Nick what he thought I should do about disclosing my diabetes.

I only know a couple of people here by name right now.  I don't speak German or Italian all that well (I can manage in Italian, but my German is equivalent to a toddler's).  At this point, I don't even have an office mate.  What should I do in case of a worst-case scenario?  What if I get a dangerous low with no symptoms?  What happens if I pass out and nobody knows what's wrong with me?  Sure, I wear a medical bracelet, but I'm still not sure if that's a typical thing one does in Europe.

After discussing it with Nick, I realized that I really have no idea what, if any, stigma diabetes carries in either  German or Italian culture.  I don't even know the proper words to discuss it in German (a search yesterday revealed that diabetes is Diabetes :) and diabetic is either zuckerkrank (literally, sugar sick) or diabetisch).  It's difficult enough disclosing my disease in the US, a culture which still has so many stereotypes and wrong information about the big D.  Based on the fantastic series on Diabetes Mine, featuring non-Americans living with diabetes around the world, I've learned a lot about the struggles of my international counterparts.  The picture isn't always pretty.

So, I decided not to tell anyone.  Yet.  There is another American working here, who already knows, but she hasn't yet arrived at the library for the season.  And after a couple of days working in my office, I realize that I actually have very little interaction with others unless I seek it out.  Generally, I'm not disturbed at all and I see other people when going to get library books, using the restroom, or saying hello to another fellow who went through the orientation with me on Monday.

Of course, I keep glucose tabs and other snacks with me and in my office.  I considered bringing my glucagon pen in, just in case, but realized that in addition to disclosing my diabetes, I would have to train someone on that big scary needle.  I can't imagine that that would reassure them that diabetes is just a big inconvenience and means very little in terms of my capabilities or who I am as a person.  I don't imagine that I would be in a situation where I could inject myself, so I'm just keeping an eye on my sensor and testing frequently.

I'm sure this will change as I get to know people better and especially when I get an office mate.  He or she will see me testing my blood sugar.  That's pretty difficult to hide.

I do feel rather conflicted about all of this, though.  I'm not ashamed of my disease.  I'm all about trying to educate people about it so that hopefully certain stigmas will eventually disappear.  But at the same time, why allow people to attach that to me?  I'm already that American girl whose language skills need lots of work.  I want to be viewed positively, as that American who has a really interesting research project.  

It's a weird and new balancing act, one I hope steadies soon.  I'm trying to focus on the great things about living in Rome rather than this thing that I can't change about myself and my body.  Besides, I've got plenty to worry about aside from fretting over telling people about my diabetes, like my visa drama (!!), or even more important, finding that next amazing cup of gelato!