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Where are your insulin injection sites?
Ahhh, the feeling of being able to FINALLY itch underneath an insulin injection site (or a pump site!) when you change it!
Sometimes it feels like rainbows and puppies and magic all in one go (or is that just me….?)
Especially if the site has been a little oddly placed (hey, it happens), and some piece of clothing has been irritating it too.
Naturally, this isn’t as much of an issue if you are on injections. But still, those can sting pretty badly too. Looking at you, Lantus!
But how do you make sure that you don’t end up injecting in exactly the same place the whole time?
Again, this wasn’t as much of a problem when I was still on injections.
Although I have a lumpy belly from injecting insulin in the same spot for too long, causing extra fat to deposit there.
And although I haven’t used that area for over a year now, it doesn’t get much better. I still have hope that it will go away, but starting to come to terms with that it might not.
Anyway. Now with my pump and CGM set up, because the sites are on there for 3+ days, I find it much more important to really rotate my sites.
So far I’ve mainly used the back of my arms for my CGM. I find it really handy, it’s out of the way, I can’t feel it in my sleep and it leaves more skin real estate for the more frequently changed pump sites.
Being so lucky that my insulin pump (OmniPod) can be placed wherever there’s enough fat on your body to inject into, I’ve been getting a little creative (against the official instructions, of course. But what’s a girl to do after a few site swaps?!)
So, a relatively new place I’ve used for my pump sites is my back.
You know, the middle (right below the bra line, ladies!), where many of us may have a pinchable fold.
I’m so glad I gave it a try, because I’ve had such good results there.
I have yet to try putting the pump on my thigh…. I don’t know, something makes me a little iffy about it, even though I used to rotate my Lantus shots between my hips and thighs.
Here are my 6 tips to keeping those sites rolling:
- Mirror your sites on each side every second time you change your pump infusion set. This goes for injections, too.
- Place you CGM and pump sites on the same side to sleep easier.
- Start adding more imaginative sites to your list; see my example on my back above.
- Your basal rate settings might change with different site placements. I have a different one for my lower back and arms than my stomach, back (higher up) or hips.
- Dare to test different sites! Just because the “official” rules “state” that it “isn’t advised”, if it works for you – use it!
- Pay attention to that you actually do rotate your sites. Your body (and blood sugar) will thank you and show gratitude.
And hey, please don’t be ashamed for your pump and CGM sites! It’s really nothing you can do anything about, you need them to keep you alive. And: don’t forget to #showmeyourpump !
Where is your favorite pump placement? How could you get a little more creative with them?
Grain Free Thanksgiving
Happy American Thanksgiving! (Well, almost)
This year, we cheated a little.
As in we already had our Thanksgiving last weekend.
I’ve seen some questions on how to make a grain free Thanksgiving meal. Luckily, this is exactly what I had last weekend.
It was a great day; we had some friends over, cooked together, laughed, drank delicious wines and ate beyond-glorious food. And we didn’t watch football. How very un-American of us! But almost the best part was that while the boys were cooking, the ladies got their nails done, while drinking some bubbly. (thank you Sam!)
You might be wondering how on this green Earth we pulled together a completely grain free menu. Well, to be honest, it wasn’t all grain free, as some cornbread stuffing and a pumpkin pie were present. But the rest, and the dishes that I put my focus on were all grain free.
And as we’re so close to Thanksgiving, literally hours away, and I am so very thankful that you’re part of my world, I’m sharing The Menu, as well as some options, with you today. There are of course many, many other alternatives and options for a grain free Thanksgiving, but here’s what happened last weekend:
Grain Free Thanksgiving Turkey
I sincerely hope the turkey you get IS grain free…!
One thing I can recommend is to rub your turkey in the deliciousness that is duck fat. The flavors get intense and I’ve never had a juicier bird. I “blame” the duck fat.
Grain Free Thanksgiving Stuffing
I already mentioned the grain filled stuffing with cornbread before. But we also had another one, made entirely out of meat. (again, thank you Sam!)
It was minced meat with sausage, duck meat and some herbs. And it was heavenly.
As alternatives for stuffing, here are three fantastic (sounding) ones:
Best Ever Paleo Thanksgiving Stuffing
Apple-Cranberry and Veal Stuffing
Savoury Sage & Sweet Apple Stuffing
Grain Free Thanksgiving Sides
Moving swiftly on to the side dishes of the glorious grain free Thanksgiving meal!
On our buffet last weekend we had the following ones. Note that none of them are complicated or weird to make. Just really simple, honest food:
Brussels Sprouts with Bacon
Cut the Brussels sprouts either in halves or quarters across. Cut the bacon into smaller pieces. Fry the bacon first and then add the Brussels sprouts to it. Cook until the sprouts are sproutin’ done! :)
Kale Salad with Avocado
Cut the kale off the stems and into smaller pieces (or rip it, if that’s more fun). Put it into a bowl. Open an avocado and put the meat in the kale, and then use your hands to mix it all together until the kale wilts a little. This removes the sometimes overpowering taste of kale. Add salt and pepper as desired.
Broccoli Salad with Pomegranates
Shred raw broccoli into a bowl. Add pomegranates and some olive oil. Mix.
Butter-fried Cabbage
As an extra idea, I suggest cutting cabbage into thin strips and frying them in butter until soft and, well, buttery. Few things on earth beat that combination.
Grain Free Thanksgiving Gravy
My husband makes the world’s best gravy, second only to what my grandmother used to make. (Sorry honey!)
Last weekend, he took the juices from the turkey, put it in a pan and added butter, bone broth and red wine and let it simmer until it reduced into gravy.
This is so simple, but of course doesn’t give you thick creamy gravy. For that you need to add either cream or coconut cream.
Grain Free Thanksgiving Desserts
Everyone’s favorite part, of course, is dessert.
Except when you’re more stuffed than the turkey and feel like you might just cry. Then you’ve done Thanksgiving wrong, and I recommend you start from the beginning.
Ha, no just kidding!
Do make sure you leave some space for dessert though. It’s well worth it for these two recipes!
This one I made for last weekend, and holy-turkey-day was it fantastically yummy! The super talented Kelly from The Spunky Coconut really got the flavors together in this one!
Salted Caramel Pecan Pie without Corn Syrup
And, because it’s very traditional, I’m also giving you a link to a great grain free pumpkin pie from Mark’s Daily Apple, click here.
You can serve any or both of these with whipped (coconut) vanilla cream.
If these recipes and ideas just aren’t enough, or they just don’t tickle your fancy, I HIGHLY recommend Danielle Walker’s e-book Thankful, with 20 recipes for Thanksgiving and other Holiday events.
Over to you, what did you have on your Thanksgiving table this year? Share the awesomeness in the comments below.
Also, don’t forget to be #thankful!
Diabetes Interview: 30 Questions
Sometimes, working on my own can feel slightly schizophrenic.
I know you have tons of questions for me.
And today you’ll get some of them answered!
I’ve done an interview with none other than my fabulous self. I asked myself, included the ones from you (and googled some) questions to answer.
So here we go, here is the GrainBrain.ch interview with Hanna Boëthius:
Beginning
GrainBrain: What type of diabetes do you have?
Hanna Boëthius: I have Type 1 Diabetes.
GB: How long have you had diabetes?
HB: I was diagnosed with diabetes at the age of 2, 29 years ago now.
GB: How did you manage, growing up? Did you hide your diabetes?
HB: I had my moments. Up until the age of about 10, my parents had full control of the diabetes and me. That’s also when I learned how to do my own injections, which gave me a little more freedom. I can’t say I ever took pride in having diabetes before.
Being a teenager with T1D was difficult for me, I wanted nothing else than to be like “everybody else”, and I felt the diabetes hindered me in that. Starting at about age 16 I started hiding the diabetes more and more, at times even ignoring it.
It was a stupid move on my part, as it brought me to the ICU on the night of my high school graduation with a life-threatening DKA (diabetic ketoacidosis), but luckily I survived, thanks to the excellent health care staff around me. This complete roller coaster of taking care of myself vs not doing it continued a few years after that too, purely because I didn’t achieve the results I was promised and that I was working towards.
GB: Was it tough on your sibling, with you being the center of attention?
HB: Oh yes, most definitely. What she actually feels about it, you’ll have to ask her, but I think she has found it very tough.
GB: What was hardest for you and your family — emotionally? Or financially?
HB: A little bit of both, I think, but mainly emotionally. I’ve always been fortunate enough to have excellent health insurance.
I know my mother was terribly afraid of needles until my diagnosis, and then got over it because, well, she had to. And to get over something you’re afraid of is incredibly difficult. So it has affected my whole family in many, many ways.
Also having to deal with the doctors visits, the low blood sugars, the high ones, the inexplicable ones, the food, the insulin, exercise, hormones as well as other factors that influence the care of diabetes is life changing. And definitely not just for the patient, but also for the ones around them.
Treatment
GB: What treatment do you use to treat your diabetes?
HB: Medically, I use insulin and check my blood sugars often.
GB: How often do you have to test your glucose levels?
HB: It’s gotten a little easier with my newest acquirement of a CGM (continuous glucose monitor), but I still measure up to 10 times a day. Before that it was 7-12 times a day, depending on how I felt and what I was doing.
GB: Do you use an insulin pump or injections/pens? How often do you need to inject?
HB: Since about a year, I use an insulin pump. Her name is Doris, and we’re a great team. But for the other 28 years I’ve used syringes first, and then insulin pens. So I know all about feeling like a human pin cushion!
The benefit with an insulin pump is that it injects small amounts of insulin every 5 minutes, giving the body a smoother supply of insulin, rather than injecting huge lump-dosages and hoping for the best.
The reason I changed was a lifestyle improvement, but also to cut down the margin of error of the big dosages I mentioned.
GB: What kind of insulin do you take?
HB: I use NovoRapid in my insulin pump.
GB: What insulins have you had throughout your diabetic career?
HB: Oh, I don’t think I can even remember them all! But a selection of them is: Humalog, Lantus, Levimir, Protaphan, Humulin, Actrapid…
GB: How well do you think you manage your diabetes?
HB: I think I’m doing better now than ever before!
I take much less insulin and other medications now, my blood sugar is more stable and all my laboratory results and measurements are better than they ever have been.
GB: Can you recognize the symptoms of a low/high blood sugar?
HB: Yes, most of the times I can.
GB: What symptoms do you get?
HB: When I have a high blood sugar, I get sleepy, my brain feels like toffee, I’m lethargic and I can’t concentrate. Sometimes I’m insatiably thirsty as well.
When it’s low, I feel jittery, I might shake, I can’t see properly, and I can’t concentrate then either. But although that’s exactly what I need to do, I rarely feel hungry, that comes afterwards.
GB: How often?
HB: It depends on what I’ve been doing. Stress, too little exercise and water, and too many carbs make it go up. And too much exercise and insulin makes it go down. It’s a careful balancing act.
GB: How do you treat a hypo?
HB: I’ve learned to become more patient. Before I used to eat whatever I found, and too much of it, making my low blood glucose race up to be too high.
Now, I reduce my basal rate on my pump to -80% for ½-1 h and eat 4-8 carbohydrates in form of glucose tablets, depending on how low it is. Usually I’m back to my awesome self within 10-15 minutes.
The worst thing for me is waking up with a low blood sugar in the middle of the night and then falling asleep again, once I’m ok. Getting up the following morning is a real struggle. It’s (much) worse than waking up with a hangover!
Food
GB: What do you eat for breakfast/lunch/dinner? When?
HB: I actually eat very simple food. Clean, whole foods that have been minimally tampered with is my preferred choice.
I always eat proteins, good, healthy fats and vegetables. And I don’t eat grains anymore, as it impacts my blood sugars too much to handle. It’s not worth it.
I very rarely eat breakfast nowadays, but rather do a form of intermittent fasting, which has tons of benefits. But mainly because I’m not hungry then, and also because that gives me another couple of hours of stable blood sugars. For lunch, around 12am-1pm, I very often have a mixed salad with fish, meat or eggs and avocado and olive oil. Or a vegetable soup, or an omelet. And for dinner, usually around 7pm, it’s usually some kind of cooked/warm vegetables and meat or fish and some great fats.
If you want to see what I eat, you should follow me on Instagram where I have my “food diary”.
GB: Do you vary your insulin dose if you eat something that is not really good for you?
HB: Of course, that’s what I have to do to feel well. But I try not to eat things that I know aren’t good for me very rarely. And if I notice it wasn’t good for me, blood sugar-wise, I give a correction dosage as soon as I notice it.
GB: Do you eat snacks in between meals? Soda?
HB: Very, very rarely. I’m not hungry between meals, which is something I make sure of by eating what my body needs at meal times. And soda makes me feel terrible, even the diet ones, so that’s not usually on the menu either.
GB: Do you eat vegetables? Drink lots of water?
HB: I eat TONS of vegetables every day! They are nutritious and taste great. I have no problem substituting things like pasta or rice, which are frankly quite tasteless, for yummy vegetables.
I make sure to drink 2-3 liters of water a day. I notice on my blood glucose straight away if I haven’t had enough water.
GB: Do you ever skip meals?
HB: Mmmm, no not really. Apart from breakfast, like I mentioned before.
GB: Do you find the diet restrictive?
HB: Absolutely not. Actually, I vary my eating a lot more now than I used to before. And judging by the fact that I feel so much better eating like this, I only see benefits to it.
Completely besides the point is that I’m a nutrition coach that hates the word “diet”…. Ugh!
GB: Do you get annoyed when people ask if you should be eating a certain food?
HB: Not nearly as annoyed as I get by the word “diet”!
I actually don’t get that question too often, especially now that people have realized that I know best myself what I can and can’t eat. But I see it as people trying to look out for me rather than let it annoy me.
Exercise
GB: Do you exercise?
HB: Yes. It’s essential to my well-being, so I exercise pretty much every day.
GB: What do you do?
HB: For many reasons, I’ve found that the form of exercise that suits me the best are walks of varying length, intensity and geography. Sometimes I wish there would be more variation in my routine, but I do enjoy my daily walks a lot.
More
GB: Do you do anything else to manage diabetes better?
HB: Yes! Diabetes management goes WAY beyond just eating, medication and exercise.
I have found that having a daily routine helps me manage diabetes, as well as various forms of stress reduction, like meditation, breathing techniques, massages and self-love, keeping up motivation, the right supplements, along with exercise, eating the right things, drinking enough and taking the right medication.
GB: What is the hardest part of being diabetic?
HB: The constant worry. And keeping up with the roller coaster, both physical and emotional.
GB: And the best part?
HB: How it’s shaped me as a person. It’s taught me self-discipline, celebrating the small things and victories, made me stronger, more resilient and to find happiness in every day.
GB: Does your diabetes cause you any other problems?
HB: I try not to see the limitations of diabetes, and at least not let them limit me. But of course there are moments I have to sit down and take it easy rather than going at full speed…
GB: What would you like a non-diabetic to know about having diabetes?
HB: There’s much more to diabetes than eating and taking insulin. And blaming people for having diabetes is not exactly right either, it only creates a social stigma. That stamp is difficult to get rid of.
GB: What would you tell someone who has just been diagnosed with diabetes?
HB: I would tell them three things:
1) Take a deep breath, I know it’s overwhelming.
2) Your doctor doesn’t have all the answers, you’re your own best doctor.
3) Keep at it, it takes time, but when you find what works for YOU it’ll all be alright.
GB: Who do you get support from? Who treats you?
HB: Oh I have a whole team of teams!
My first priority is Team Hanna, which consists of my body and I. Secondary is my husband, then family and friends. Thirdly, I have assembled a real Dream Team of medical staff consisting of an endocrinologist, diabetic nurse, diabetic educator, ophthalmologist, podiatrist, and dermatologist.
Is there anything else you’d like to know about me or diabetes? Ask them in the comments and I’ll answer them too!
PS. Did you see my Diabetes Advent Calendar yet?! Sign up for the ADVENT-ure now!
Healthy Holidays in One Step
It’s that time of the year again!
Stores are filled with holiday cheers and people seem to start getting a little lighter mooded, most of them looking forward to the holidays.
And I heard this year’s first Christmas song yesterday!
As you may know, I’m not exactly a fan of how sugar coated the holidays are. Every year, your sugar consumption explodes toward the end of the year. Sugar destroys so much more than it gives, and this constant overload just isn’t worth it, in my opinion.
And the sugar you eat now, still has an impact weeks and even months from now (A1c tests, anyone?)
So, in the middle of this Sugar Avalanche, made out of chocolate, candy canes, Rudolph cookies and mince pies (and the sugar bomb that is mulled wine), what are your options? What is an easy step to take if you just wantto make your life a little healthier during the holidays?
If there’s ONE STEP you can take to make your December just one (or 24) bits healthier, it’s to swap out the usual chocolate advent calendar.
Packed with sugar and chemical stuff beyond belief, most advent calendar are a health hazard.
“But what’s wrong with just ONE piece of chocolate a day in December?” you’re asking?
Essentially, not much. But for me it’s about the inherent need for sweets this time of year, and not the fact that you actually want them.
As a few alternatives, I’ve compiled a list of healthier advent calendar ideas for you.
If you (or the one you want to surprise) are into taking care of your body and beauty, I have some great tips for you right here:
Or, I’d happily take ANY of these advent calendars on this wonderful list (hint, hint), from clothesandcamera.com:
Or why not try a tea one this year, where you get a different flavor every day? (An example right here)
While we’re on beverages, for your whiskey.loving partner, why not get a whisky calendar, where one kind is hiding behind each door?
Do you have a brainiac on your hands? A daily puzzle or Sudoku of some kind would keep them busy until Christmas.
For the kids, why not try one of the Lego or Playmobil calendars (available anywhere)?
Or, alternatively, why not make a Random Act of Kindness calendar for your kids? Get ideas on how: http://www.everydayroadtohealthy.com
For the classic holiday celebrator, try a “normal”, paper calendar. The Metropolitan Museum of Art in New York has gorgeous ones: http://store.metmuseum.org/holiday/advent-calendars/icat/adventcalendars
There’s also the alternative of an advent candle, counting down the days while spreading blissful peace. (Why don’t you meditate while you’re watching the candle burn?)
Or make your own!
It can be filled with loving messages, vouchers, cinema tickets, experiences, happy thoughts, affirmations, home made healthy snacks, supplements, spices, magazine… suited to the receivers tastes and preferences, of course! For kids, this could include stickers, colouring pencils, small toys, or, like I mentioned above, Random Acts of Kindness!
For the framework, you can just use envelopes, small paper bags, matchboxes or individually wrap them. Be sure to have a look at Etsy to find quirky alternatives as well, here is a link: https://www.etsy.com/ch-en/search?q=advent%20calendar
There are also countless digital advent calendars around, just Google it and find your favorites. That way you can have (way) more than one! :-D
What is your favorite type of advent calendar? Let me know in the comments!
70 Things Only Diabetics Recognize
Happy Diabetes Awareness Month!
November is here and with that comes Diabetes Awareness Month mentioned above, as well as World Diabetes Day on the 14th. Don’t forget to put it in your calendar, and let’s raise money for research, party like it’s 1999 and, first and foremost, spread knowledge about diabetes!
To kick this month off, I made a list.
A list of 70 instances or thoughts that any diabetic can easily recognize. This list is by no means exhaustive, nor complete. But it might be a little funny at times.
Let’s go:
- GOOD NEWS at the doctors office
- Having a low blood sugar in public
- The fear of passing out
- Forgetting supplies
- The feeling of a sinking blood sugar
- The feeling of an unexpected blood sugar
- New diabetes related gadgets (it can’t be just me?)
- The feeling of an unexpected A1c level
- The taste of gross glucose tablets
- Over eating for a low blood sugar
- Being a math genius – every day!
- The smell of insulin
- Realizing that your life depends on said supplies
- “Did I bolus for that?”
- Redefining the meaning of a roller coaster
- A needle hitting a nerve
- Being able to finally itch under an itchy site!
- The fountain of blood that can appear after an injection
- Insulin induced weight gain…
- Carrying an arsenal of medical supplies
- The soreness after sleeping on a medical device
- Tasting food or drink and feeling just how loaded it is with sugar!
- The feeling of having bolused EXACTLY the correct amount
- How you feel after a night of wrestling with your diabetes
- The feeling of a high blood sugar
- Saying: “I’m high, I need to shoot up!”
- Not being understood
- 5.0 mmol/l / 100 mg/dl
- Meeting a new doctor, trying to throw out a joke and get crickets back
- The Numbers Game
- Carbohydrate counting like a boss – instantly knowing how many that pumpkin has
- The desert mouth you get from a high blood sugar
- Dropping your test strip on the floor. Outside. In the rain.
- Being proud of yourself
- Balancing an umbrella while checking your blood sugar
- “I’ll just finish this and THEN I’ll check my bg” “LOW”
- Paying for medical supplies
- Painful injections/pump site insertion/finger prick
- “Does this dress hide my pump AND cgm?!”
- Seeing another diabetic when you’re out and assuming you’re friends
- Fear of judgment
- Social stigma
- Getting stupid comments and remarks
- Seeing a diabetes meme and totally being able to relate
- A smooth CGM curve
- Going low during exercise
- Diabetic Jetlag (travelling across multiple time zones with basal changes)
- “Did I have too much wine for dinner or am I low?”
- The Sweaty Shakes
- Feeling strong
- “Am I high or just thirsty?”
- Not giving up, even when it would be darn nice to
- Feeling like a Negative Nancy, although you really don’t mean to
- Ugly meter cases
- Treating a hypo just right
- The Disappointment when you’ve done everything according to the “books” and nothing is like it should be
- Feeling insufficient
- Getting advice that would help, but you’re just not ready to hear them yet
- Having to be a constant worry for the ones closest to you
- “Is it hot in here or am I low?”
- Assembling your care team
- Developing a fighter mentality
- The Diabetic Online Community
- Keeping blood sugar logs
- Not being like everybody else
- Constantly making changes
- Sleep, sleep, sleep
- Theory vs Practice
- Letting go of expectations
- (+1) The hope of a cure, even if it is distant in the future
What did I miss? Is there anything you think should be added to my list? Please let me know in the comments below!