Changes to pharmacy staff

I've been lucky, I think. I have gotten my prescriptions from the same pharmacy for over a decade. In that time, I have been on multiple medications. Had a few ohmygod I broke a bottle can I have a new one moments. Spent a LOT of time, especially as an adult, having in-depth conversations with my pharmacist about the effects of any specific medication. These conversations have increased in frequency since I entered the grand world of antidepressants.

A few years ago my pharmacy hired a new guy. I LIKED this guy. He looked up my file, knew what I was on, and would coach me, explain to me, reassure me everything I thought to ask about.

Today I had a very different experience.

We are switching from med A to med B. I entered this conversation expecting to be told what to expect as I stop taking med A (I imagine there will be withdrawal effects), as I start taking med B (hello, side effects), and as I increase the dosage of med B (impacts on my blood sugars, if the past is anything to go by).

What I got was drastically different.

I got a kind, soft-spoken old man who explained to me that I am to take one a day for 7 days, then 2 a day.

That's it folks.

Does it matter when in the day I take med B?
*shrug*  "No, it shouldn't. "

Will I notice any symptoms as I change from one medication to the other?
*kind smile*   *vague gesture towards the product leaflet I hold in my hand* "Ohhh,  maybe... it's mild. Anything is so mild. Maybe nausea...but mild. Not for very long. Mild."

Will this affect my blood sugars?
*eyes widen* "Oh, you have diabetes? It shouldn't affect..."
*he flips through the product leaflet, sees the little blurb where it mentions the drug may affect blood sugars*
"Oh it might, yes. But *shrug* a little bit. Not too much. If it's too much, you go back to the doctor."

Should I worry about changes in my insulin or carb sensitivity?
"Oh. You take insulin?"
"Yes, since I was 4."
"Oh ok. You ask the doctor for the tester [this is a statement,  not a question]. You check every 2, 3 days, maybe check every day and see what happens. Can you check every day?"
"I check my blood sugars 7-10 times per day."
I feel like screaming. I should not have to explain this to you. You have my file, you've just neglected to even skim the surface before handing over these drugs and trying to send me on my way.

He nods his head. "OK then. You check...good."  He looks at me, gives me a half-smile,  and gently pushes the bag of pills across the counter.

I sigh and turn to the other pharmacy staffer. I tell him I also want to pick up a bottle of glucose tablets and a box of alcohol swabs.

Once the useless tit of a pharmacist leaves the counter, I ask, "When could I come back and talk to [the other guy]?"
I'm told with a sad look that he's no longer working there. My face must have given me away-- I'm pretty sure the dismay was pretty evident.
He thinks for a sec "We have another girl...at our other location. She's good. She's a lot like the other guy. She's over there during the week, and here on Saturdays. You could come back Saturday, or... "
He grabs me a business card for their other location. "Call her. No-- call me first; I'll make sure she has a copy of your file available.  Then call her. She'll be able to help."

Today I'm thankful for that utter gem of a human being who saw my panic and stepped in to offer a solution.
Today. There's time later for being furious at the new guys complete failure to do his frigging job. For today, I'm just relieved that the new guy, that quiet, irresponsible man, isn't my only source of information about my medications.


Telling an edited version of the story

I realized something slightly ridiculous today.


I told a lie about why I ended up waking up with a high BG this morning. I was out with a group of friends, but the migrane that's been edging in since I first woke up was getting louder and angrier by the minute. I spoke to the hostess to politely excuse myself so I could go home to sit in a very quiet room with the lights dimmed, and this kind, wonderful friend of mine asked what was up.


I told her, as well as her parents who had just arrived to the soiree, that I woke up with a high blood sugar and a splitting headache and it's been getting worse all day. I then shrugged. It must have been a kinked pump cannula or something, I explained. That's definitely why I woke up high.


It's not, though. I was 4.3 with 1.5 units of insulin on board when I checked before bed. I'd just started a new cgm and was still in the 2-hour warm-up period, so I had no cgm graph to indicate whether I was stable or dropping. I was uncomfortable going to bed at that number with insulin still on board, so I chugged back a juice box before brushing my teeth and going to bed.


I was, in case you can't tell where this is going, very mistaken about the effects of my on-board insulin. I woke up at 14 -- by far not the worst blood sugar I've ever seen upon waking up, but still high enough to give me the headachey, fuzzy-mouthed irritability that comes with a few solid hours of high BGs.


The part that's truly baffling though, is why did I lie? I'm positive my friend could not give less of a shit about the finer details. Why not just admit that I was scared of going low overnight, so I overreacted? There would be no judgement from this friend; no chastising me for not waiting it out or setting an alarm to check overnight. No finger-wagging or tsk-tsk-tsking at how I jumped the gun and treated a low that hadn't happened yet.


I know my actions weren't ideal. I think my reasons (fear of going low) are perfectly reasonable, but still I obviously overtreated. Why did I hide that information? Why treat it like I have something to hide?


Still figuring out the exercise thing

I think I found one of the most uncomfortable feelings basically ever - or in the top 10 at least. It starts with a high blood sugar, but not too high - something around 13 or just over.

13, by the way, is high enough for your body to start producing ketones. Did you know this? I did not remember this. Could happen though. Differs for everyone, but it's still possible.

So let me get back to the least comfortable feeling ever. That feeling when you exercise and in order to exercise you set a lower temp basal so you can exercise safely, but then following your exercise, you spike because your temp basal was probably a little overkill. That's okay though, right? Better safe than sorry. Having BG sitting a bit higher, maybe 12-13, post-exercise is certainly preferable to mid-exercise lows.  (For me, anyways. Lows while I'm fighting traffic on my bike would be mildly unpleasant, probably.)

That post-exercise spike leaves you sitting at 13. You wait to correct the 13 because you're grocery shopping and picking up things for dinner, only by the time you get home your blood sugar of 13 has turned into 13 with  large fucking ketones.

And dinner? Forget dinner. Instead of dinner, you get to be thirsty as fuck while simultaneously fighting the urge to hurl back up all of the water you just chugged.  Fighting rather unsuccessfully, I might add.

Add to all of this the incredibly defeating feeling of failing at exercise, failing at diabetes, and the infuriating helplessness of the fact that THIS. IS. NOT. FAIR.

THAT, ladies and gentleman, makes my top 10 for most uncomfortable way to spend my Friday night.


First successful bike ride of 2016!


I made it! After two false starts last week (having some issues with my bike chain), I successfully made it home from work today. I set a 60% temp basal starting 4 hours before I left and continuing 30 minutes into my ride. It's a bit excessive, true, but I wanted to be extra-cautious since lately I've been tending to run low in the afternoons.

Both times last week when my chain got jammed and I couldn't get it un-stuck, the resulting high blood sugars were pretty miserable. I used the same temp basal (60% for 4.5hrs) in anticipation of a 60-minute cycling commute, so after getting home by car I would inevitably be stuck with a stubborn high BG for most of the night. The frustration from a failed ride is one thing, but dealing with the highs afterward made a missed bike ride into a whole different experience*.

I have to say I'm pretty thrilled that I finally made it home by bike. I'm also pretty pleased that I managed it with no lows.

Next task: see if I can manage a stable 7, WITHOUT lows, throughout my ride, instead of the 10 shown above.  Unlikely, but hey! A girl can dream, no?

A crappy one. Briefly; only for a night, but still. Feels pretty crappy.

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