Thursday, July 30, 2015

At the Top of the Mountain

I really like math and graphs and curves, a lot. I do.

And I've been thinking about my Diabetes control, a lot. [forever and always]

So, I decided there are two schools of thought on the issue: (1) maintain extremely tight control and (2) maintain "manageable" control. For the visual learners, it would look a little something like this:



In option 1, the blood sugars are maintained as close to "normal" as possible, likely decreasing complications from the disease. However, this tight control comes at a cost: your sanity. That ball is balancing ever so cautiously on the precipice of a giant mountain with steep sides. One wrong move, one carb counted incorrectly, one 5 minute exercise extension sends the ball over the edge with extreme effort required to bring it back to center (and probably feeling pretty crappy during that process).

Option 2, on the other hand, does not dance so "close to the edge" (pun intended). The slope is more gradual, and small mistakes are easier to recover from. No, control isn't the "tightest" (a different threshold for every Diabetic), but the pro to this management style is breathing room. There is built in breathing room for life's little curve balls and less stress associated with hitting the tight target thresholds.

So, which is better? Ugh....good question. For me, when life can handle it I am for option 1, but sometimes I need to relax a bit and settle into option 2. Choosing which to focus on - health or life - is the ultimate balancing act, and often changes on a daily (sometimes hourly) basis.

Of course, deep down we know that one affects the other - tight control can make life better with potentially less complications, and enjoying life can reduce stress hormones and help the diabetes animal behave.

Monday, July 20, 2015

Midnight Snackin'

Working the night shift is weird for many reasons, one being food!

And Type 1 Diabetes!

And food!

It's strange to shift one's sleep schedule AND one's eating schedule. And it has definitely been a game of guess and check (as in, guess what to eat, check blood sugar, lol). The first night I really don't feel very hungry. Sure I bring along a little snack, but it may or may not be consumed depending on how I'm feeling. The second night I eat my snack to wake up in the middle of my shift; at least my taste buds are awake, maybe they can fly the space station? By the third night, I'm pretty dang hungry around 4am. Lately I've been splitting a Luna Bar in half and noshing on the two halves around 4am and 6am (28 grams of carbs at once spikes the blood sugar a little too much, so splitting it up works perfectly), then I use some delicious red grapes to "fill in the gaps" when I just need a little crunch of something sweet. This is all fine and good during my shift, but what about afterwards?

Well, I usually have something around 20 grams of "slow" carbs when I get home (lately it's been a whole wheat English muffin), then hit the hay for my rest period. The first couple days I wake up around lunch time with some hunger pangs, but by the third day I'm sleeping like a baby through lunch.

I wake up around 4pm and have a small snack to hold me over for dinner (usually around 7pm), then get my snacks together and ready for the next night of shift work.

I would love to say Diabetes plays along with all these schedule shifts, but the truth is, it's a bit of a bear. Often I go low during the day when I'm sleeping, because my body is used to eating during the daytime, so I have to set temporary basal rates to account for missed meals. Then at night it is very dependent on the meal we have for dinner, how much we exercise and my stress level. I test a lot and watch Dexcom almost as much as the space station telemetry!

The truth is, I'm still figuring out the best ways to schedule shift, and each time I have to do it things turn out differently. I guess that's how Diabetes, and life in general, are.

Sunday, July 19, 2015

Sunday Funday

Ok, so the hours aren't great (11pm - 8am). 
And I have to don an eye mask just to sleep. [And Chris has to be extra quiet during the day].
And I watch lots of data, and plan a.lot.
And sometimes I start to see hidden messages and notes in the telemetry squiggles. 

But just when I start to feel real tired there comes an amazing sunrise; actually 5 sunrises and sunsets in just 9 hours. 



The beautiful local sunrise is just an added bonus!


#missioncontrol
#spacestationpilot
#dreamjob

Thursday, July 2, 2015

Wiener Dog, on the Blog

When my great grandma Rose died several years ago her stuff was split up for anyone who wanted something. I ended up with a simple set of daily sayings, sometimes prayers, sometimes phrases or quotes. They are printed on small pieces of paper and held together with two metal rings. The little sayings live in my kitchen drawer so I can reference them each morning with breakfast. Here is what the rolodex told me the other day:

"Don't pray for rain if you are going to complain about the mud."

I needed that little nudge so hard that day, and most days I can use the sayings it spews. 

The little things in life. 


Like trying to take a nap on the couch with a wiener dog hogging the space ;-)

Little things are sooooooo good. 

Monday, June 29, 2015

iPhone photos - an update!

I'll freely admit I enjoy routines. 
But lately our lives have not been especially "routine". 

You may have heard about Tropical Storm Bill? 
Everyone in Houston freaked out, the grocery stores ran out of food and water, NASA allowed us "liberal leave" to avoid driving in bad conditions...and then we got about 4 inches of rain. Don't get me wrong, I love working from home on stormy days 
(I still looooove rain, must be that desert blood in me). 

Our backyard view of TS Bill. 
The impending tropical storm delayed our visitors by one day. Chris's dad and his girlfriend drove from Alabama to hang out with us over Father's Day weekend. It was nice to just hangout, relax, and catch up. On Father's Day the boys wanted to go go-karting, so we went to two different tracks (one indoor and one outdoor). I raced with them on the outdoor track, but I didn't feel up for the "pro-race" at the indoor track. 


I'm trying to get the motivation to clean house and do laundry post-guests...but ugh...sometimes I would rather lounge on the couch and watch Netflix ;-)

Thursday, June 11, 2015

How Diabetes is Like Mission Control: Dynamic Ops

Ok, I know some of you hear "ISS Pilot" and picture me sitting in Mission Control with a joystick and a heads up display. Sorry to ruin your amazingly creative imagination, but it turns out the ISS usually flies itself. So...what do I do while sitting there watching ISS trace over Earth every 90 minutes?

I plan.

Let me explain.

In NASA terms there are two distinct phases of ISS flight: quiescent ops and dynamic ops. Those are big fancy words which essentially translate into "ISS is flying itself" and "ISS is changing how it's flying". As an ADCO Operator, I sit console during mostly quiescent periods. But its us "quiescent" folks that really dig into planning for the dynamic ops. We verify that every detail of the plan is ready for the specialist to execute, including talking to our Russian counterparts, verifying the correct procedures are linked, and double checking all of the analysis.

It turns out a life with Type 1 Diabetes has a similar scheme, except I'm less of an "Operator" and more of a "Specialist". While a dynamic operation for the space station may be something like a vehicle docking or spacewalk, for Type 1 Diabetics something as mundane as eating food without a nutrition label can quickly become a dynamic op. Trivial activities, like exercise or travel, take hours, days, or months to plan...and sometimes even longer to perfect. You see, our personal equations for how our body reacts to food and insulin only cover a normal, or "quiescent" day - a day when all ingested carbohydrates are known and the body is functioning at a steady metabolic rate and hormones are level and everything is unicorns and rainbows. Unfortunately, life is a tiny bit more unpredictable.

For me personally, it takes about 6 hours to plan for a workout session. Since I usually workout in the evening, I have to be overly conscious of what I eat at lunch to ensure there are some fats to slow down the carbs. Then I usually eat a small snack at about 4 pm, followed by a temporary basal rate that decreases the amount of insulin my pump delivers during my workout. All of this leg work is just the prep - before, during and after the workout I am vigilantly monitoring my Continuous Glucose Monitor graph and making adjusts or slowing the workout if the numbers don't match my predictions. But, just like spaceflight, sometimes Diabetes throws in a curve ball.

Here's what happened when I thought I was all set up for a mid-morning workout:


I don't have the luxury of running complex analysis before each dynamic Diabetes op, so I suffice with a more rudimentary approach - [educated] guess and check. Luckily NASA doesn't have to rely on this method very often; there are a lot of smart people, models and history to more accurately predict the outcome during space station dynamic ops [thank goodness :-].

The post-dynamic op period is essentially identical between NASA and my Diabetes management. At NASA we are constantly self-evaluating to improve our flight controller skills, planning tools, procedures, processes, etc. to ensure the next iteration of the event flows even smoother. Diabetes is the same. I take data from each dynamic op (for instance, a mid-morning workout) and determine what I could have done to improve the experience. From my picture it's clear I should have decreased the amount of insulin I was receiving, or ate more carbohydrates for breakfast, or picked a slower-paced workout. Luckily I was prepared for the "next-worse-failure" (another NASA term) by having glucose tablets handy to bring my blood sugar back into range. Looks like I need to increase my model's history for this dynamic op!

Of course my console shifts are not entirely just planning. I'm also there to monitor the system and react to any anomalies (hence the abundance of sims laced with failures leading up to certification), but the same applies to Diabetes. As much as I plan and adjust and replan and correct there will always be anomalies. Maybe the insulin in my pump got hot in the sun and lost effectiveness, maybe the 5k turns into a 10k by the time I get back to my car, maybe there is a stressful life event that affects my blood sugar, maybe my SWAG (scientific-wild-ass-guess) on the carbs in that pie was way off.

It's important to keep one's skills "sharp" (that's a needle pun) both in managing Type 1 Diabetes and controlling the International Space Station - in either case suddenly and unexpectedly one may find themselves in a role where their performance has ultimate consequences.

Monday, June 8, 2015

Patriotic Adventures

It may seem like my life revolves around Mission Control lately. And, honestly, I've been putting quite the emphasis on that since I am just so stinking proud. But Chris and I do have lives outside of work - including fun visits to the sites in Houston. 

On Memorial Day we checked out Battleship Texas with Chris's mom, Pam. It was quite muggy, but the rain held off for most of the day. We all really enjoyed walking through the century-old battleship, moving the guns around, and reporting to the bridge ;-) Fun facts: the USS Texas was used in both World Wars, and was the first battleship to launch an aircraft!



Check out the size of that piston!!
A week later we attended our first Houston sporting event - an Astro's game! Chris got the tickets for all the hard work he has been putting in at Boeing lately. Since we are both such big sports fans (ahemmm....sarcasm there), we really just enjoyed eating the terribly delicious stadium food and people watching. 



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Side note: check out Type 1 Ryan's Adventure of the Week! And send me an email @ nerdyapril@gmail.com if you want to send him your story!!