Times are changing

Hello faithful readers...
I hope this update finds you all healthy and empowered to be your own diabetes self-managers...
Changes are coming up with the program. Nothing major and all for the better!
Sanford is our "Mother Ship" as far as the network Diabetes Programs go. We have decided to change up our curriculum for those newly diagnosed. A couple of months ago, we all purchased the "Type 2 Basics" curriculum from the IDC (International Diabetes Center) in Minnesota. They are pretty much the "Diabetes Education Gurus" of the world. I finally had the chance to start implementing it into the program and am very excited about it. I am thinking that I may be able to figure out where I can offer classes more often throughout the month. It will all depend on the availability of the dietician as we would teach together. So, don't be surprised if I send an informal survey your way to get an idea of what my newly diagnosed patients are looking for when it comes to classes. This basically suggests 4 classes over 6 months... it would be a change but according to the Adult Learning Theory... much easier to retain the plethora of information that we need to lead healthy lives while living with diabetes. (:

Posted by Carianne (Cari) Roorda

August 2009

Hello friends...
I am still loving my pink Medtronic Pump with the Real-time CGMS. I can say that it has saved me from several bad lows already.

I had been using the original teflon canula sets but recently started having a real problem with my sites. It seemed that for about 12 hours they were perfect, but then started getting irritated (itchy, red) and also I noticed huge swings in my blood sugars. It was like I wasn't even bolusing for my food! I decided to try an old bent-angle-needle "Polyfin QR" set that I had on hand and instantly my blood sugars stabilized- I have since been using the steel needles with way better luck and much more predictable sugars. Yesterday, after pumping for almost 10 years now...I ended up with my first "infusion site infection". I think it may have been related to dirty lake water seeping under the tegaderm dressing that I had covering my site. It was soooo painful and swollen, red and hot yesterday. TMI here, but if there is ever drainage from a site- especially if it's not clear- CALL THE DOCTOR. I called my endo as soon as I pulled the old site and he immediately started me on a 5 day course of Cipro. After just 2 doses the infection is improving- thankfully!I have seen some pretty gnarly site infections and this really freaked me out! The funny thing is that my sugars were FINE (up until the Cipro-lol) so I couldn't believe there was an infection in there...

Now on the Cipro I was having some mildly elevated blood sugars- I am trying a "Temporary Basal" of 110% my normal rate (or 10% higher) and it seems to be covering the resistance nicely. It's weird with this class of antibiotics (called Quinolones) because one may cause hypoglycemia, while another one will cause severe hyperglycemia... luckily I know how to manage that when it does happen!
Let's see...what else is new? Well, I am changing my office hours to 4 mornings (actually M-Th, 9-1) a week this year during the school year. I will, of course adjust my schedule to meet the needs of my patients when necessary.
Stay tuned for upcoming events this fall and winter!

Posted by Carianne (Cari) Roorda

Update

Hey all,
I just wanted to put up an update. I know I see many of my readers out and about, but for those of you that don't know I am back to wearing a Medtronic pump. I am hoping for insurance approval for an upgrade...but won't know until Monday. I am wearing the Minilink transmitter and
the new 522 pump (in PINK!)
and I love it! I miss being "untethered" but I also am liking the "lower profile" site again. Honestly the CGM makes it worth the tubing! Also I am pretty thrilled with the Carelink software and how useful it's been in checking out trends and troubleshooting. (:

Posted by Carianne (Cari) Roorda

Sanford aims to cure type 1?

OK, First of all I should make an update on my eyes- I did see a retinal specialist in Sioux Falls who said if at all, that I had "exceedingly mild" retinopathy and that he would expect this or worse since I've had type 1 for 16 + years now. YAY! What fantastic news. Also that I don't need to see him again unless I have any active bleeds pop up.

So on to the topic at hand. This weekend my family and I went up to the Sanford Imagine Festival and had a wonderful time! Rascal Flatts is one of my favorite groups, so I was more than thrilled to see them live! What great entertainers. Aly & AJ and Sheryl Crow were on as well and were wonderful!

The icing on my cake of a weekend is that Sanford announced that they will be "curing type 1" as their project- working with the JDRF to cure type 1 diabetes. They will be building a research center in Sioux Falls to accomplish this. I can't express enough the extreme joy that I feel in this announcement. Who'd have guessed that when I moved to Iowa 8 years ago, I would be within an hour and a half of a drive from where we just could possibly cure type 1 diabetes? I don't know how or when but I tell you I MUST be a part of this! I would work for free if it meant helping to find a cure. No, I am not leaving OCAHS, but I would love to add this to my plate- in several years of course, as I know it will take a while to get things going. Now I know where my education will take me, that is for sure. I am looknig into ways I can gear up for a part in the research with a Master's degree. Like I said, I don't know how or when but I do feel like I was meant to be involved somehow.

Posted by Carianne (Cari) Roorda

Retinopathy....

I officially have "mild nonproliferative diabetic retinopathy". You might remember last year that I had a small dot hemorrhage in my right eye at my dilated eye exam. This time I had 4 in the right, and 2 in the left. It really hit me hard...I know at my stage (having D for over 16 years) most people have some form of diabetic retinopathy...
but I think I have been secretly holding out the hope that I am still the invincible Cari I used to be.
Now I am humbled by the reminder that I am NOT invincible, but just as vulnerable to the complications of diabetes as anyone else. I am going to strive for the most minimal blood sugar fluctuations by being more strict about bolusing for meals ahead of time and avoiding simple sugars. The more stable my blood sugars, the less likely that I will suffer a larger hemorrhage that will rob me of my vision and being able to look into the eyes of my 2 sweet little boys...It's hard to be writing this but I do want everyone to know that I struggle too, and that is the point of this blog - so I can relate to all of you on a deeper level - yes I have the knowledge and training, but ultimately I am also a person with diabetes- and I refuse to let it take any of my quality of life- no matter how long I have it. I am going to meet with a specialist after this whole ordeal and gets some more detailed pictures of my retina so we can see just exactly what is going on in there. For those of you who don't know much about the treatment- this stage is just a wait and see and pray and take control of those A,B,Cs ( A1c, blood pressure, and cholesterol!).
Stay tuned....

Posted by Carianne (Cari) Roorda

Cool online newsletter

Today I was cleaning out the "Favorites" on my computer and came across this link:
http://www.diabetesincontrol.com/
It is a neat weekly newletter available online with some really great articles.
I have talked to many if not all of you about resistance training and muscle building as a part of your exercise routine- here is a great article on Resistance Training:
http://www.diabetesincontrol.com/results.php?storyarticle=5633
Hope you find that informative!
Now get out there and enjoy the beautiful sunshine! (:

Posted by Carianne (Cari) Roorda

Prediabetes info

First of all, I wanted to put a link up to direct those looking for "Prediabetes" information to the ADA's website. (Highlight and copy and paste into your browser's address bar)

http://www.diabetes.org/pre-diabetes.jsp

The ADA site provides great diabetes education articles and columns in addition to the info you can access under the "Resources" tab located at the top of this page.

Another thing I wanted to mention is that we will not be having a support group this month due to the weather and flu outbreaks. I hope to see you in July, which is the next time I will host the Sioux County Diabetes Support Group here in Orange City. The topic remains undecided at this time.

On to brighter things- I really hope this weather warms up so we can all get moving outside- Good for the soul- and for the blood sugars!Email me if you need some motivation to get started on an exercise or healthy eating routine so you can have a healthy summer.

Posted by Carianne (Cari) Roorda

That was easy!

In my last post I discussed trying to get set up with my new Omnipod system (www.myomnipod.com). Well, I have been "pumping" (podding?) with the Omnipod since last Thursday. Two words: Life Changing! I LOVE this new tool! It provides so much more discretion - also just the little things that had become so second nature to me- like getting wrapped up in tubing every night- are a thing of the past. Omnipod's slogan is "Making diabetes a smaller part of your life" and I really have to say that it DOES DELIVER that. I can check my blood sugar right in my PDM and it is instantly ready to be used in my bolus wizard. (In case you don't know it is the calculator built in to your pump that tells you- based on your personal pre-sets- how much insulin you need to cover your carbs while also considering your current BG and your BG goals)
If you have any questions about it, feel free to call me, or come to the next NW Iowa Insulin Pumper's support group at the Sioux Center Community Hospital on the 19th of this month and I will be available to show you exactly how it works. Have a fantastic week!

Posted by Carianne (Cari) Roorda

Happy New Year!

Is it really that time again? 2008 is here and what a perfect time to make healthy changes and goals for your Diabetes Self-Management.
My personal goal is working to get set up with the Omnipod (www.myomnipod.com) in order to further improve my blood glucose management and quality of life.
I am excited to have been with OCAHS for almost a whole year now, and feel so blessed to be doing my job and helping fellow PWD live healthy lives. I hope and pray that this new year means positive change for each of you. There are so many amazing developments coming out in Diabetes care. Not the cure I was promised "within 5 years" of diagnosis, but pretty great all the same.

Posted by Carianne (Cari) Roorda

Tonight's group

I am excited about the support group tonight! I have a lot of food prep to do beforehand (: so won't be in the office after about 2 today. I hope we have a great turnout!
I also wanted to say that on the 27th I am pleased to welcome Tim Palmer from Dexcom to the area- he will be speaking to the area educators that afternoon and then to the pump support group in Sioux Center.
Stay tuned for more information!

Posted by Carianne (Cari) Roorda