Friday, January 20, 2017

Attention all Time Travelers in 2017



This is a cautionary note to anyone who happens to be time-traveling to, from or during 2017...


Sorry to say, Time Traveling Explorers, this is real. Yep, it's not a joke. 

Even though the Chicago Cubs seriously did win the 2016 World Series (not kidding), this too is also a part of our current reality.


While many joke about this being a plot from reality TV, and it's really not far off... this is not a scripted make-believe item. This is not #FakeNews (which is a thing all in itself at this period in time).

Beware.

For your own protection and sanity, it's probably best if you just avoid the years 2016-2020 and check back on the state of the world (assuming it's still around) after that.

Make sure to be careful, too -- wouldn't want you to land back here in an even more wicked-whacked future to find some crazy Back to the Future 2 alternative timeline where bullying billionaire Biff Tannen lives in a casino resort tower and is in charge despite being a womanizing, narcissistic, vulgar... (oh wait, never mind.)

😟😞 (((Sad, emotional computer icon known as an emoji...)))

Just be careful, people. Please consider undoing whatever you might have done in the past to screw up our present.

As always, go in peace and love.

And if you happen to go back to before 2016, please passs along a big THANK YOU to all of the presidents and let them know they're truly missed here in 2017.

(btw: Do you have any extra seats on your time traveling vehicle... could I buy you a beer and possibly persuade you to take me along?)


Tuesday, October 4, 2016

Playing Darts

For the past five months, I've been unconnected to my insulin pump and have been doing daily injections and inhaled insulin to keep my blood sugars in check.

All is well on that front, and at this point I have no plans to go back to insulin pumping in the near future.

As some may remember, I've been on a pump break since mid-May -- mostly because of my need to mix it up in my diabetes management, to motivate myself to get back in gear. But also, because of my frustration and disappointment in Medtronic Diabetes and their business decision-making that I, personally, do not feel best represents the D-Community.

Anyhow, with that being said... I'm still perfectly happy "playing darts."

This is a phrase my Loving and Supporting D-Spouse uses to describe my insulin injections. Whenever I ask for her help in doing a shot in the arm, she jokes that it's time to "play darts."

No, she doesn't actually toss the needle at me.

It's just a fun term of endearment we both use, to keep the daily D-tasks more light-hearted and fun in some small way.

This isn't the first time for me "playing darts," so to speak. The first 17 years of my T1 involved daily injections, and once I began pumping in 2001 there were many times I took a short pump break for various reasons. So, this time isn't new, but it may turn into a permanent break... that's still TBD, and I'm taking it a day at a time.

At the three-month mark of "playing darts" in August, my A1C was just about the same (even though I am suspicious that A1C result and think it wasn't showing the full story).

Since then, I've been bouncing around more often on the BG front and have seen some higher BGs over the past couple months due to my own slacking. But I am happy to be experiencing less unexplained hypos, so that's one for the win box.
 
I am hoping that my next visit in November reflects more of my efforts in getting my A1C down to 7%. To me, the treatment choices I've made over the past several months are the best way to get to that goal.



My Personal Afrezza Effect 

 

Afrezza is inhaled, but I've found over the course of a few months that it's barely effective in the evening hours for me. As a result, I turn to NovoLog fast-acting after dinner-time until the early morning hours, when I am happy to start my inhaled Afrezza as needed.

Over time, I've determined that one 4-unit cartridge is more like 2 or 3 units. But even that's not an accurate comparison, because this inhaled form doesn't work the same way as traditional insulin and it's a complete paradigm shift in getting used to its effects.

One thing I have noticed is that since mid-July (or roughly the three-month mark of starting Afrezza), it seems to be taking me more of this inhaled insulin to achieve the same fast-acting response as it did during the first three months.

I have tested this out in several ways -- with no food on board, very low carb and protein, higher "simple" carb meals, little stress and normal temps without any illnesses messing with me. Even have tried paying more attention to my inhalation technique, focusing on that "deep lung penetration" aspect to ensure I'm getting of the powder into my system properly. All of them have shown the same result: a single cartridge of Afrezza just isn't working as effectively as it once did.

 Usually, within 30 minutes I can start seeing the Afrezza Effect on my CGM. At times, it may take up to an hour to reflect any meaningful change, while at other times it's noticeable within 15-20 minutes. All just depends on the day, time and most likely whether a dog wagged its tail overseas...



That doesn't phase me from using Afrezza most of the time, it's just one more piece of information that I use in determining what's needed to keep my D in check. If that means an 8 instead of a 4 unit, or a couple of them instead of one, so be it.

I'm happy this is part of my toolbox to manage diabetes. It's also nice that my insurance company has gotten over its hesitancy in covering this and my local pharmacy seems to have overcome its ineptitude in access Afrezza. For now, at least.

Trying a New Basal Insulin

For basal insulin, I've been using Lantus twice a day.

A new basal insulin that I have just started this week may help on that front. On Tuesday morning, I began using the extra long-acting Tresiba that's supposed to last for 42 hours. This is something my doctor and I decided would be best, since I sometimes tend to miss a basal dose in the morning or evening, and because with Lantus my BGs spike on the tail-end.

So hopefully, Tresiba works better for me combined with Novolog and Afrezza.

At some point, it may be worth investigating new and exciting options in the smart insulin pen world, but that's something to explore down the road once we get into a new year... we shall see.

Appeal of Latest Diabetes Tech?

 

Whether I ever return to my Medtronic insulin pump is TBD, and despite the very exciting recent news of the first-ever Hybrid Closed Loop being approved, I do not have an interest in what the company offers at this time. Specifically for me, data-sharing is a deal-breaker and when MedT tells me that I have to use the 3+ YEAR OLD model and not the newly-designed 630G or hybrid closed loop... um, no. You lose.

More exciting is the Tandem t:slim X2 pump platform that is now available, and while I have no interest in returning to a pump right now, this is the one that temps me the most -- especially since it works with the Dexcom CGM sensor, one that I trust a lot more than the promises of any MedT tech that are still questionable to me.

With those D-tech points aside...

In the meantime, I'm happy using the darts I have and trying to hit as close to the bullseye as possible when it comes to BGs and staying in range.

Saturday, September 24, 2016

Our Wedding Engagement Newspaper


Happy Wedding Anniversary, Suzi!


As I do every year, I sit back on this special day and re-read the newspaper I created to propose back in March 2003. This full eight-page broadsheet is the one I spent about three months creating many months in advance.

It was quite the task, writing my own stories, editing and designing, selling ads to pay for the whole thing, and recruiting a roll of writers made up of family and friends. All of them keeping the upcoming marriage proposal a secret, of course!

I still remember staying out late at night, telling you they were late nights in my real paycheck-providing newsroom job when in fact they were spent at my old college newspaper stomping grounds putting this paper together.

It was tough, but it all paid off.

This is really a place to post the full newspaper, to keep it alive in digital form online. Sure, I have a couple dozen copies left over from the 1,000 created for that night and beyond. And every one of those eight pages has been framed to display in our home, to display for us to reflect on and for all those who might want to look at them.

Our newspaper hits the 21st century blogosphere, for the entire online universe to see as it may want to (likely clicking on the images themselves, to make them show up in readable sizes...)

The Daily News, Engagement Edition. Created for the proposal event on March 15, 2003.

Front Page

Page 2

Link to Front Page Proposal story. And the Page 2 jump.
Link to Speech story. And Page 2 jump.
How'd we catch each others' eye? Here's a Christmas 2002 account of those initial impressions...
Link to the Page 2 story on Sustaining Surprise.

Page 3

Inside Spread, Pages 4-5

Written by one of Mike's good friends from high school. (Click for bigger image)


Page 6
 Link to In the Beginning, a story of Us on Page 6.
Link to Page 6 story 9/11 emails between Mike and Suzi

Page 7
Back Page (The Ad Page)


Happy Anniversary, my love.

Our story continues, and I'm honored to have the chance to live it with you.

Tuesday, September 20, 2016

An Aching Tooth and Diabetes Stigma

I sat silent there in the dental chair, listening to the new dentist ask an array of basic questions about dental history and overall health.

Of course, diabetes came up.

Earlier, in the waiting room, there were the new patient forms to fill out everything about me. All the health and medication issues, and that typical checkbox for "diabetes."

I checked that box, but wrote in "type 1" on the line almost by instinct. I questioned that even while writing it, because I wondered if it somehow implied I was saying, "Not Type 2, or that kind of diabetes..."

Was I fueling misconception? Was I feeding into the daunting cloud of diabetes stigma that exists in the world?

Deciding it was over-thinking, I ignored my concern and wrote it on the form. And then went about completing the rest of the paperwork before seeing this new dentist for the first time.

Nice enough lady, and I was eager to get to the meat and potatoes of why I was there in the dentist chair: Discomfort in a tooth that concerned me.

As the routine goes, she went through the paperwork quickly and read off some of the health and medical related points I'd filled out. That's where she came to my checked box about diabetes.

"Oh, and diabetes... type 1, so that means you've had it since you were a child and it's OK?"

Red flags went up in my brain, but I hesitated.

"Yes, I was diagnosed at age 5, but you can be diagnosed with type 1 at any age!"

"Type 2s are being diagnosed as children more commonly, too!"

"Why the hell would it be OK at any age?!?!"

"It's not really referred to as juvenile diabetes anymore, because most of us with T1D are adults and more are being diagnosed as adults."

"What are you implying about those diagnosed as adults, or those with type 2 or gestational... no one chooses diabetes!"

But, I didn't say any of that.

I recalled writing "Type 1 diabetes" on the form in the first place, and how I'd ignored my gut instincts to just leave it as "diabetes" because distinguishing the types didn't matter at this moment.

Yep, I had pretty much brought this on.

Then I also remembered: My tooth hurt.

And that's why I was there.

So, I politely agreed with her, confirming that I was diagnosed as a young kid at age 5.

And I didn't say anything. I chose not to advocate, for whatever it might be worth.

Now a week later, I feel guilty for not raising my voice and advocating to that Healthcare Provider when I had the chance. I may not see this dentist again for a variety of reasons, but that just means I lost the chance to clarify something about diabetes that she may not have understood.

Especially in light of the latest research from the big EASD conference in Germany, in which a study showed that half of those with T1D are older than 30 years old. It's not just a kid disease, and the use of the word "juvenile" is outdated and inaccurate in many cases.

All of that makes me feel more at fault for not raising my voice to educate this dentist, especially when these folks are on the front lines in healthcare and can actually diagnose diabetes and help keep an eye (or tooth?) on D-management.

By not speaking up, I am a part of the problem in maintaining the status quo that's so saturated with stigma and misconception.

The Diabetes Community has an aching tooth in how it self-identifies and responds to the public, and that stigma is not far off from being that painful tooth that's in need of a root canal.

In retrospect, my silence feels like I just flooded the tooth with ice cold water and am now feeling the painful sensation that comes from allowing someone to continue not knowing about diabetes.

No, I don't always have to advocate in these types of situations. But then, I can't be surprised when someone doesn't know how things really are about diabetes.

And my tooth still hurts.

Thursday, September 15, 2016

Which Don To Respect?


Remember how I used to occasionally reference the "Don of Rage Bolusing?"

You know, that was mostly a term of endearment for my insulin pump. Even though sometimes, I used it to describe myself from time to time. In those times when I saw stubborn High blood sugars that wouldn't budget with normal correction doses, via my insulin pump.

So, I would click a couple pump buttons and dose a wave of insulin... a rage bolus, as it were (hat tip to Kerri). Since I liked to be silly and named my insulin pump "The Don," thanks to my love for the Godfather movies and TV Show NCIS where Mark Harmon plays the character Gibbs.

Yeah, it was all in good fun. A way keep my sanity while keeping up with this wondrously exciting life with diabetes jam-packed with device juggling, management tasks and mental gymnastics.

Well buh-bye, Don of Rage Bolusing.

I've been on a #PumpHiatus for the past four months. There was never a certain date, and as of now I'm not 100% sure if and when I might go back to my insulin pump. This Multiple Daily Injections (MDI) system using Novolog pens, Afrezza inhaled insulin, and a twice-a-day dose of long-acting basal is working fine for me.



With that, I've hung up my hat (at least temporarily) as the "Don of Rage Bolusing"...

Instead, it's now: 

"The Don of Rage Dosing" 

or maybe, too:

"The Don of Rage Inhaling"

(Hat Tip for my Type Awesome Spouse for noting this distinction.)

We'll see what happens next, and which Don ultimately wins out.

Either way, there must be respect.

In the meantime, I'm kissing the ring and trying to control the rage as much as possible. While respecting that fact that it's my diabetes calling the shots and "settling all family business" relating to my blood sugars, more than anything...