Saturday, March 31, 2007

Hey Sherlock, no sh....

Breaking news: "Sedentary behavior linked to high blood sugar." Another one this week: "Active Self-care Improves Blood Sugar Control."

Really? Are you kidding me? We had to spend valuable time and resources on studying this? As if no one could have guessed this from talking to a person who's EVER BEEN TO A DOCTOR before??? Or actually lives with diabetes, or knows someone with it? Wow. I'm stunned.

Here's the sendentary story, and the self-care story. Favorite parts include the first one comes from the International Diabetes Instutute in Australia, where a doc and colleagues examined the link between TV-watching and BG levels in non-diabetics. Thousands participated. On the other, it's out of Harvard Medical School. The first is a research fellow, while the U.S.-based one was spearheaded by a psychiatry prof who's also "Research Fellow Affairs director at the Joslin Diabetes Center.

A quote on sitting around-study: "The findings reinforce the case for a strong focus in diabetes and obesity research on sedentary behaviors, such as television viewing, in addition to the now well-established base of evidence on the importance of increasing physical activity," (Dr. David W.) Dunstan commented to Reuters Health. "It is possible that other sedentary behaviors may have an additive effect on risk, in that TV viewing may be a marker for a broader pattern of sedentary lifestyle that includes a variety of other forms of sitting time."

From the do-your basics analysis: "Conversely, those with poor blood glucose control 'spoke of being 'tired' of the pump,' the researchers note. They described feeling discouraged and 'frustrated' that the pump did not 'fix everything' and that 'it's still a lot of work.'" (as opposed to insulin injections, which were cakewalk...)"

That study also concluded, and here's a fascinating fact to stun everyone: "The researchers found women to be more concerned than men about body image and social acceptance with insulin pump use."

Someone please explain to me (like I'm 2) how these tidbits are possibly considered news, or provide any new information to the medical community? Are we honestly supposed to believe the medical profession, and diabetes docs particularly, weren't aware that high BGs were possible in non-diabetics? C'mon - diabetes is out there in "pandemic proportions," people. Wanna guess why? (Thanks for connecting the dots on this issue, also, Reuters - Poor journalism, or just press-release writing...)

Maybe, if we devoted research time and money from these types of things to other avenues, we'd be closer to a cure. Not just restating the obvious. Or putting a report out for the sake of resume-padding. Someone in the medical news coverage biz needs to examine worthy v. unworthy research and the money/effort spent on this. Would make some fascinating findings, I'm sure.

Thursday, March 29, 2007

Sleepwalking

Restless nights and needed 3 a.m. bloodtestings to help garner better control are taking their toll. Today was a prime example. Since waking up, I've felt as though I'm sleepwalking through the hours, dazed and not fully conscience. This was the first day I can recall seeing bags under my eyes, though I'm sure they'be been present before. Riding the elevator up to my second-floor office, I stood in the elevator in a daze for about a minute before realizing I hadn't moved. Why? Apparently I'd pushed the first floor button, telling the elevator I wasn't really interested in going there.

Rest of the day was much the same - trying to meet deadlines with the helpful boost of coffee. Low sugar at lunchtime made things interesting, as always. But managed to get through the day.

Ultimately, I'm willing to deal with a week's worth of tiredness to help get a feel for how the nighttime sugars are looking. Getting basals precise makes it worthwhile.

Now, I've eaten my mac and cheese for dinner and am quickly plotting my bedtime, which will come several hours before usual. Catch up time! Here's to being refreshed come the morning!

Wednesday, March 28, 2007

Bueller, Bueller...Still waiting

It's always amused me how those not frequently frequenting doc's offices complained about their wait times. "If the appointment is at 9 a.m., then I should not be sitting in the waiting room much longer after that," the argument often goes. My response: "You obviously haven't spent much time in doc's offices."

Well, today was a case in point. I still found it ridiculous, even recognizing how much I sounded like those I've been amused by. Today brought a hospital visit for needed bloodwork at the lab, and a thyroid X-ray. All in all, this should've taken 20 minutes - max. No such luck. As I've been accustomed to visiting a small county hospital and doc's offices that have been able to perform these procedures, my judgment on wait times are off. Significantly. My visit entailed going to a large, multi-faceted hospital in a booming are on the southside of Indianapolis. This meant being directed to five different spots, numerous check-in windows, and a half-dozen waiting room areas that equated to a combined 2-hour experience. The immediate welcome lady in the first seconds inside the building should have been a sign of things to come - she directed me to the surgery checkin desk, after showing her a prescription and noting my need for the "clinical lab." After she directed me to the wrong "not pre-regestered" window, the next woman directed me to a third person who couldn't confirm my appointment (made by my endo a week ago) and had to call her office. This meant waiting. Going to another window. When that didn't yield results, I decided to forego the x-ray and head to a recognized, smaller lab in the nearby professional building on first floor where endo's office is located. More waiting. Finally getting to speak with someone, this woman informed me that I'd "missed" my earlier x-ray appointment and that I needed to go to the hosptial area. Arguing didn't work, and thus I was escorted by yet another snowball/er, elderly woman, back to one of the first areas I'd visited. This time, she managed to find the file and checked me in.

More waiting. Then, got the much-anticipated name call. Along three other people. We lined up, and were escorted down a maze of hallways to...to... yep, you guessed it: ANOTHER WAITING AREA! Two others were already seated in the smaller room with chairs. We all laughed about the waiting mystery and proceeded to start investigating the newest round of magazine selections. Finally, the procedure came. Had to lie on the rock-hard bed for the 10 minute scan. Of course, the gooey jelly substance smeared on my neck found its way to the inside of my dress shirt collar.

Leaving, the woman who'd escorted me through the maze began leading me toward the strategically hidden exit. I informed her on the way about my needed lab work for A1C and urin test, which confused her and said I'd have to go somewhere else. Figures. That all led to more waiting in yet another room, this one with a TV, before getting summoned 20 minutes later. A young, teenage-aged lab girl tried to get blood, but had to stab both arms before succeeding. My once-great veins have gone and become not-so-good, it seems. Of course, her comment to me while seeking a blood-worthy vein: "Have you eaten or drank anything today?" Hmmm... fasting....No comment.

As a result of my morning excursion, the entire day was off. This of course is a deadline week, so that only complicated the day even more. Getting to work, 27 emails graced my inbox and three voicemails were waiting. Most needed some type of attention, whether it was the delete button or a response. Very intense day. But, at least the tests are done. Now, I get the suspense of waiting to hear the results and what my latest A1C is. Just glad the wait doesn't involve traveling to the hospital.

Tuesday, March 27, 2007

Peeing apple juice

Once again, there was little sleep last night because of continuing pains in the legs and feet. Thanks, neuropathy. Anyhow, managed about four hours. Waking up to the voice of my wife, I managed to spit out a few words that - at the time and especially in hindsight - didn't make complete sense. Sensing something was wrong, I pulled myself out of bed and stumbled downstairs to the kitchen. A blood test revealed a common number: 49, which is becoming a more frequent happening these days for some reason (push for tight control?).

So, I went for the new juiceboxes Suzi had bought the night before. Of course, in my low state, the airtight transparent sealing wouldn't rip off. The nearby knife holder offered some hope, and I took the smallest one there and sliced away. This, as should have been expected, resulted in a puncture wound in the juice box. Apple juice proceeded to leak all over the counter. Should have foreseen this happening. Suzi came down and rescued me, demanding I fetch a bowl or cup to catch the escaping juice. I did. That's when we made the comment and shared a laugh at how it looked like the juicebox was peeing. Hey, mornings are crazy enough without low sugars.

Headed upstairs to get ready for work, as I was now running late. Jumped in the shower and - again - shuddered from the coldness. But the warmth of rising blood sugars soon returned.

Reactions aren't fun, but this again wasn't bad as I caught it before it progressed into the rambling/drunkenness-without-alcohol stage. A positive from all this is I'm seeing some consistency in my nighttime and morning readings, albeit lower than they should be. The 49 number happened twice in two days about 8 a.m., coming after 3 a.m. tests in the mid-to-high 100s and bedtime readings much too high. Now, the mystery of navigating this blood sugar puzzle continues and I throw that proverbial dart at the magic number and hope to hit the bullseye. At least I'm getting closer.

Remembering when....

My diagnosis came at age 5. The memory vividly entails a regular visit to my grandparents' house. Frequent urination. Unquenchable thirst and a bad taste in the mouth. I recall those, but not any fatigue or mood swings that we've all come to recognize as high BG symptoms now. But then, at that age, it was just odd and didn't register at first. My grandparents noticed, though, and mentioned this to my parents - my mom has been a Type I most of her life, as well, so she instantly knew the signs. So, the diagnosis came.

But aside from the diagnosis story, my grandparents' house also sets the scene for this blog's theme - insulin injections. There, on the coach in their front living room (the same one they have today), I remember that cold, metal needle injector. I remember being told, "It'll hurt a little." My mom injected it into my left. I struggled, and cried. A thought that still comes to mind today: "How will I ever get used to this?"

Well, it happened. We all know that. Second-nature. Teen years brought denial, and skipped injections that inevitably led to high blood sugars. That sadly carried over to college, until I met the angel who's now my loving, supportive and incredibly forgving/understanding/reality-checking/inspiring wife. She changed me.

But those insulin injections, which as child seemed like would be a part of life forever, are now non-existent. I don't recall the last time I filled a syringe with insulin and pumped it into myself. Had to be for a quick, high - but nothing comes to mind. Now, it's the age of the insulin pump. In May, I'll celebrate six years of pump therapy.

Do I miss the injections? At times. When an infusion set sits in a site too long, and you get those noticable marks to show it. I'd rather not take my shirt off as much as when on injections, for that reason alone. And, with injections, there was almost a way to forget about diabetes for a while when not injecting. With a pump, you're always connected - hell, even when disconnected during a shower. The only relief is when it's time for a site change, and you can take a repreive for a short time in between. Now, as I'm dubbed by my better half, I exist as "bionic man." You are always aware of the connection, and it can at times be limiting - don't move to quickly or suddenly, as you might come loose. Or, watch the tubage, as it could catch a doorknob or get caught in the chair.

Now, don't get me wrong: I'm all for pump therapy. I'm an advocate, 100 percent. My mom has called me the poster child for Minimed, relating to my incredible (albeit it shortlived) good control that came with my first pump. The potential for tight control exists, undeniably. My first months brought an A1c of 6.4 - my best ever, a polar opposite from the teens I had in my teen years (and once, have gone as high as 21!). Those conversations of being dead in 10 years never sunk in.

I'm paying, of course, for my behavior earlier in life. Complications are setting in. No one to blame but myself. But now, with Suzi's inspiration and help, I'm getting that under control. It's amazing how marriage opens up a world you'd never much noticed or cared about - yes, a future can exist. It has to. And it'll happen no matter what I'm doing and what condition I'm in. There's inspiration right there to be better, strive for tight control. And the pump is, at this point in time, the best way to achieve that.

Maybe, someday, our children will be the ones sitting on the grandparents' coach getting an infusion set attached for first time, wondering how they'll get used to it, and then later in life have a closed-loop system or artificial pancreas to resort to. Maybe even a cure.

Monday, March 26, 2007

Trends and changes

Since starting a new endo late last year, I've come across a concern: she seems very apt to make changes to my basal rates after a single day's worth of tests. Her key communication method is fax - she expects this weekly, at the minimal. I've also grown up using the rule of thumb that you take a look at three days worth of results at least before making changes, to make sure you're seeing an accurate trend in the results. In mentioning this to my endo, her response was that with a pump, the changes are "instantaneous" - there's no need to wait. I'm not sure I agree with that; For example, one night may entail a inadequate carb counting or dosing for food, or a different routine of exercise. You can't see what's really happening with that basal by looking at just one day's results. This train of thought seems to be an almost old-school mentality merging with a contemporary push for pump therapy - someone who doesn't understand exactly. Maybe I'm off. She's a highly-recommended and commended endo, and has much creditentials, but I'm wary of this advice. So, I'm taking the suggested changes cautiously and watching my results carefully before making specific changes. Better safe than sorry.

Awake

Those who know me realize this isn't an odd time for me to be fully awake. Midnight majesty, golden hours of writing, yada yada.... Tried going to bed, but some pain in the feet and legs kept me up - too uncomfortable and didn't want to disturb her sleep. So, I'm up. Haven't had this much trouble sleeping in a while. Blood sugars are in much better control, so maybe it's the "getting bad in order to get better." Been there before. Hope that's the case. So, here we are.

With that, I give you 10 random tidbits at this 2 a.m. hour.

1. I'd rather be asleep next to my wife, snuggling and sleeping soundly.
2. Waiting patiently, with yawns, for that nightime 2:30-3 a.m. blood test.
3. Massive coffee, tea drinking to ward off the yawns - wonder what actual effect they have on my BGs.
4. iTunes playing.... Mistakenly didn't delete all the Xmas tunes, it seems. Oh well - Blue Christmas is a good, all-year round tune, right? Can't go wrong with The King. Nor Sinatra.
5. Must fax my blood readings to endo Monday morning.
6. Hope a new pump is on the horizon this coming month....Want a Cozmo. Bye bye, Minimed.
7. Cat is fully awake in and in her prime play mode.... I should get out the laser level and start her chase... Too bad I can't count that as exercise and get lower BGs from it.
8. Deadline week at the paper - it'll be a busy one, at least in first couple days.
9. Lab work set for 9 a.m. Wednesday. Hope the A1c has improved, and urinanalysis doesn't yield bad things...
10. Ezekiel 25:17 - "The path of the rightous man..... shepard the weak through Valley of Darkness... brother's keeper... " Pulp Fiction - good movie. Mmmm, royale with cheese.

Ok. The yawning is overwhelming. Blood test time. Then, a long overdue good night. The pain has subsided, at least as I sit here on the computer plugging away. So, we'll attempt that sleep thing again. Night night.

Sunday, March 25, 2007

What's in a name?

My wife calls me bionic-man. Yes, the pump brings the nickname. But, in return, I feel no need to name my insulin pump. This seems like an odd thing to do - more of an adoloscent, or womanly thing, to do. Why do this? Mine is charcoal gray, and when I switch to the Cozmo, I'll likely go with the color more resembling black. No need for pink, purple, blue, or strange colors. Again, no my kind of thing. Elvis, Ralph, Fred, or Bob aren't the kinds of names for a medical device, or inatimate object such as this. Of course, this train of thought hasn't stopped me from naming our 7-foot ficus tree - "Spaudling," you know, from Caddyshack. We were going to go with Finch, but a former ficus in my good bud's condo had taken that name already. But, what's good for the ficus isn't good enough for the pump. That's where I draw the line.

Saturday, March 24, 2007

Changing pumps


Hoping for a new pump. Have been on the Minimed since starting pump therapy in May 2001. I've never had much problem - my mother has always told me I'm the poster child for them, while she is the polar opposite and had nothing but trouble with the company and device. She's changed to the Deltec Cozmo, and that's a route I'm hoping to take soon. Mostly, I like the features the Cozmo has much the same as Minimed, except I'm very impressed with it's connecting blood meter and computer connectivity. The largest concern I've had with Minimed is the customer service - they're not that bright, it seems. And, usually takes more than one call to sort out problems. Never fond of that. On that customer service note, it turns out that the pump rep who sold me the Minimed (up in Michigan) now works for Smith Medical (the Deltec people). Good person, so that has helped sell me on it. And he's connected me to another good person in this Indy area. So, it's been good all around. The doc is going over the possibility and I hope to hear in the next week the liklihood of this change and how quickly it can happen.

Wednesday, March 21, 2007

The journalistic fire inside

This makes me furious. By law, school administrators have the right to censor student newspapers. But many don't. They see the point of allowing students to, for the most part and with guidance from an advisor, debate and discuss issues pertinent to their lives. These are teenagers who will be soon entering adulthood, college, society - they're the ones our country will ultimately rely on. We should allow and encourage their critical thinking of differing perspectives.

But here's an example of a school that's obviously blind to that train of thought.

Dozens of people who attended a school board meeting to support a suspended journalism teacher left frustrated when they were not allowed to speak.
The student editor of the Woodlan Junior-Senior High School newspaper said some staff members quit on Tuesday, the day after East Allen County Schools officials placed teacher Amy Sorrell on paid leave pending a review of whether her contract should be terminated.
The action came two months after the student newspaper published a sophomore's editorial advocating tolerance for homosexuals and officials responded by requiring the all future issues be approved by the principal of the 700-student school east of Fort Wayne.
School Board President Stephen Terry told those attending Tuesday night's meeting they would not be allowed to discuss Sorrell's suspension, saying the board might in the future hear an appeal if she was fired.
"It's to preserve the rights of the teacher," Terry said.
He said his decision was based on state law, but when a teachers union representative asked for the specific law, Terry ruled the question out of order.
"I think it's kind of ridiculous that they're not going to listen to the parents and students and taxpayers that are here," Sorrell said after leaving the board meeting.
Cortney Carpenter, a junior who was editor of the Woodlan Tomahawk, said she and at least two other students quit the newspaper staff Tuesday after Principal Ed Yoder told the class that it must resume publishing the school paper and print a district policy naming the principal as the publisher.
"We decided that it was wrong and we couldn't do it, and all the things we had done up to that point would be meaningless if we decided to back down," she said.
School district officials have said newspaper classes are expected to publish newspapers as part of the curriculum.


Sure. They may have right. But it's wrong. And stupidity. Why do we feel the need to stifle debate and discussion? Especially on issues such as homosexuality. Do people honestly believe that by ignoring this, it'll just go away? No high schoolers, who yourself may be confused, you can't talk about this and hear both sides objectively - even during this time of life when you're beginning to discover who you are. Let's pretend it doesn't exist. I can't understand that. Never. Regardless of religious, moral, sexual beliefs - people adopt this behavior. It happens. Just like school officials sometimes abuse students. Our elected leaders sometimes misuse our tax money. And businesses may try to rip us off. But pretending these things don't exist, ignoring the issue entirely???????? Sticking your heads in the sand... I hope you all suffocate and choke on it.

A wisp of sales for Indiana-made inhaled insulin

An AP story on Wednesday.

NEW YORK -- Pfizer's stab at giving diabetics insulin without needles is getting more praise than prescriptions so far.

Exubera, a powdered form inhaled through a special device, was introduced last year in a targeted launch to specialists, a debut analysts deemed disappointing. While doctors applaud Pfizer Inc.'s effort to find a new way to deliver insulin, some are concerned about the drug's long-term effects on the lungs, cost and insurance coverage.

Observers fear Exubera, which is made at a Terre Haute, Ind., plant, won't fare much better as Pfizer expands the sales effort to primary care doctors.

"I think Pfizer will wish they had never gotten into this. I doubt they'll regain their investment," said Dr. John Buse, president-elect of the American Diabetes Association, who participated in Exubera's trials. "There is no advantage to Exubera and there may be a safety risk. I see it as my job to talk people out of (using) it."

Pfizer won't disclose Exubera's development costs but said it is a major advancement in diabetes care because needle-phobia keeps many patients from using the insulin when they would really benefit from it. Susan Silberman, Pfizer's senior vice president of worldwide commercial development, said Exubera's performance is meeting expectations.

"I think we have to manage this product differently," she said. "Insulin is intuitive. What has changed is the approach to delivery -- so (marketing) is about the education."

Pfizer already has hired approximately 900 part-time diabetes educators to explain the product to doctors and patients, and more will be added, although the company won't say how many. A small, non-branded ad campaign for the drug that doesn't mention Exubera by name started recently, and a bigger direct-to-consumer marketing effort will debut during the second quarter.

Company executives touted Exubera as one of the new drugs that would revitalize Pfizer's stagnating sales. Others, such as smoking cessation treatment Chantix, are performing well.
But some analysts said Exubera's lackluster debut is worrisome because Pfizer needs more blockbusters. Its best-selling drug, cholesterol agent Lipitor, loses patent protection as early as 2010 and development of its successor drug was scrapped last year because of safety problems.

Exubera, which Pfizer is codeveloping with Nektar Therapeutics, was introduced last September but sales for 2006 weren't report.

Les Funtleyder, an analyst at Miller Tabek & Co., doubted it would meet his sales target of $200 million for this year. Assessing Exubera's market share and the number of patients on the drug is difficult because of the way it is sold. Patients need to buy a kit which includes the device but then also need to regularly purchase blister packs and release units, which help create the mist.

"Exubera isn't going be a big driver," he said. "Pfizer needs every dollar in sales. It (Exubera) is a negative."

Others aren't as quick to judge. Deutsche Bank analyst Barbara Ryan said that while the launch has been slow, Exubera still could reach $1 billion in sales in the next few years.

Silberman insists Exubera represents a good value because its needle-free status means more people who should be taking the medicine will start, allowing them to better manage their diabetes and saving money in the long run.

Insurers don't necessarily believe Pfizer has demonstrated Exubera's value. WellPoint Inc., the country's largest insurer, is either not covering Exubera or placing it in the most restrictive tier, with higher copays, depending on the plan.

Indianapolis-based WellPoint estimates that Exubera costs 11 percent more than one popular brand of injected insulin and 22 percent more than another.

Pfizer hasn't offered enough evidence that patients will use Exubera before they begin injecting insulin or that it would really improve quality of life, said Brian Sweet, WellPoint's chief clinical pharmacy officer.

"We want to see more documentation of the value of the product," he said.

Doctors also worry about potential long-term side effects from constantly inhaling the powder into patients' lungs. Pfizer has two years of data showing the drug is safe, but doctors want to see results from longer-term studies.

"If I can treat patients now with something I know is OK, why give them something that might (eventually) hurt their lungs?" asked Dr. Michael O'Dell, director of the Family Residency Program at the North Mississippi Medical Center in Tupelo, Miss.

He added that few insurers in his region cover Exubera and that "the delivery system is still a little clumsy."

The inhaler is the size of an eyeglass case when closed. Once expanded to expose the inhalation chamber that holds the insulin mist, it is the size of a pepper mill. Patients insert blister packs of the dry powder insulin into the device, press a button and then press a lever which creates the mist. The patient inhales the cloud, sending the insulin into the lungs where it is absorbed into the bloodstream.

Some doctors said the blister packs come in limited strengths that can make it difficult to prescribe the correct amount of insulin. Also, Exubera is fast-acting insulin that is taken at mealtime; some patients still need the long-acting insulin that is delivered through needles.

Dr. Robert Fafalak said he has prescribed Exubera for patients who were hesitant to use insulin even though the pills they were taking weren't sufficiently controlling their diabetes.

"I have patients that are doing much better now. They have their sugar under control, and I think that gain outweighs concerns about long-term effects," said Fafalak, who practices in New York.

Jamie Villastrigo, 51, a secretary who lives in Boerne, Texas, began taking Exubera three years ago as part of a clinical trial and has become a fan. She doesn't pay for the drug because she is still in a clinical trial.

"There is a concern about the cost and whether my insurance will pay for it," Villastrigo said. "But I've still got another year and a half in the program. "

Villastrigo said Exubera hasn't affected her lungs and has allowed her to cut her daily insulin shots to one from four. She maintains that the device is easy to use, and she has no qualms about using it in restaurants or public places where she'd never pull out a syringe.

"It is just easy. It gives me more freedom," she said.

Tuesday, March 20, 2007

Inspiring

Here it is. The midnight hour once again. I sit sipping tea, drowning in St. Elmo's theme music on the iPod, resting in the green recliner with feet up and watching the cat curl up in a ball to rest near by feet.

Anyhow. Good time for self-reflection, late night reading. And, of course, blogging. So I've put down my Lee Strobel "The Case for Faith" briefly to flip through our just-released edition of Indiana Lawyer, a plethora of diabetes magazines picked up at the endo's office today (plus a copy of Time swiped in compensation for the 70-minute wait...).

But. Here's the inspiring part. An article in Diabetes Vital describes how "Ironman" Andy Holder was diagnosed with Type 1 at age 36, and learned to control his sugars while undergoing the "most extreme mental and physical challenge" he could think of - a competition entailing a 2.4 mile swim, 112-mile bike, and 26.2 mile run. Why? Well, he didn't want his kids to not know him in those healthy years. He states in the article: "The first night that I had to give myself an insulin injection, it hit me that my son(s) was going to grow up always knowing me as 'diseased.' I wanted my sons to see me as something more." The article ends by saying that he's proof people with diabetes can live without limits and strive for the highest aspirations.

That all hits home. Complications are a scary topic by themselves, but that added psychological impact makes us all think about tighter control and managing as best we can for today - and tomorrow. It's not just about us. Hopefully, those days when we thought like that don't come back to haunt us too much down the road.

On that note, I hope to someday: "See a werewolf drinking a pina colada at Trader Vics. His hair will be perfect.... A-ooooo, Werewolves of London. A-oooo." Sorry. This isn't a reaction blog, I promise. Just maybe time for new iPod song....

Monday, March 19, 2007

Shuddering in the shower

Anyone who's diabetic (especially long-termers) knows about the coldness that comes with reaction. I re-lived that today with a morning low, with blood sugars dipping below the 46 reading after-the-fact. Sleeping in - no oversleeping - isn't really a new concept on my part. But today it was a little much. Waking up, I sensed the low but didn't fully recognize the demon as it was. So, to the shower. Water's on, but not hot enough. Turn the hot water knob to the left. Still shivering. More. Worked for a moment, but the coldness quickly returns. After standing in the water shivering for about 15 minutes, it finally dawned on me - yep, this is a reaction. Ended shower, went downstairs for sugar. Of course, it wasn't that easy. Jar of glucose tablets (grape) are work on the desk. No OJ made. No candy nearby. I contemplated the glucagon (Yuck-a-gon) in the fridge, but thought better. Finally found some of the wife's cranberry apple juice (yuck!), so endured the 10 ounces. Had a bagel with PB. Snatched a random square of cornbread in a glass dish that sat on the stove overnight. That all started helping. A test moments later yielded the 46. But, it was on the way back up. Mmmmm... warmth returns!

This wasn't the worst reaction ever, by far. Unfortunately, there's been worse. At school. At work. Driving. Swinging at people we love. Some came with getting started on the pump, others came with tight control, and that seems to be the only bonus (short-sighted and selfish as it may be) to not count carbs or keep sugars under control. The most frustrating was when they happened without explanation, but all were unwelcome. Here's to hoping they don't happen again, or if the reaction does arrive, that it only brings a little shuddering in the shower.

Saturday, March 17, 2007

Diabetes and the Law

Legal issues intersect with every aspect of life. Including diabetes. So, in browsing the Internet recently, I came across a California attorney specializing in legal issues involving diabetes. Everything from employment and labor disputes, issues with the BMVs and drivers licenses, HMOs and types of care. The attorney is based in Santa Monica, named Kriss Halpern - here's his website. Interesting stuff. Brings to mind the recent story about the troop they wouldn't let serve in Iraq at first because of his diabetes, or another couples ones here from northern Indiana - police not recognizing signs of low blood sugars, and misinterpreting reactions to be signs of drunkness or resistance... Resulted in beatings, arrests and other litigation-sparring situations. One from last fall, when the family of a diabetic man challenged the police assertion that he smelled of alcohol when officers touched off a violent confrontation that ended with the man in a coma. Suit came from that one. Lot of contentious issues, so always good to have an attorney or someone with legal (or perceived legal) knowledge on tap.

Wednesday, March 14, 2007

This little piggy

Isn't going to the market - he or she may be pushing to cure diabetes. So they say in the news.

Pigs may hold the key to curing juvenile diabetes, and the Emory Transplant Center (at the Emory Univ. Hospital in Atlanta, GA) just received $2.5 million to unlock the puzzle. The Juvenile Diabetes Research Foundation is funding the center's efforts to study whether implanting parts of a pig's pancreas into a human diabetes patient can help find a cure.

Last month, the BBC reported that a U.S. team has reversed diabetes in monkeys by transplanting the islets from pig pancreases, according to a study in Nature Medicine. The University of Minnesota hopes to start trials in humans by 2009.

So, that leaves me with the question: does that result in more, or less, pigs to roast? Either way, at least the pigs are doing something good with themselves and benefiting us humans. Hope we can someday return the favor. (Here's my disclaimer: Apologies to all animal lovers and PETA-types...No offense.)

Tuesday, March 13, 2007

Does Size Matter?

Insulin pumps. (C'mon people...)

One of the top four high-tech tools to help better control diabetes is smaller, hidden insulin pumps. Like the Omnipod, which is tiny, disposable, worn directly on the skin, and concealed under clothing - weighs only 1.2 ounces. “It’s a completely different animal. It’s the size of a small half-kiwi or a small Matchbox car,” Elizabeth Vivaldi, director of marketing at Insulet Corp. (maker of the Omnipod), says in a news release. Another person says: “You can hide it. People don’t need to know." Many people resist conventional insulin pumps. They’re typically worn on one’s belt like a small cell phone, with short tubing to deliver insulin through a needle inserted under abdominal skin. Many people dislike hooking up the pump and they try to conceal the tubing.

See, I don't see the point in all this. Are we embarrased? And if so, about what exactly? The pump? Diabetes? How some outside observers might mistake it for a cell phone or pager? I'm confused. I've actually enjoyed wearing my Minimed versions on my belt, using a holster that allows it to easily slide out for access. Great conversation starter, and have met a good number of people as a result - those with pumps, those who know others with them, or just curious about the contraption on my belt. It also helps educate security checkposts, which are now quite accostomed to seeing mine and know what this is. If we hide our pumps, it seems more likely we'll get more suspicious looks when they need to be out in public.

Now, I'm not advocating the huge, gaudy devices that once existed (similar to "car phones" before cell phones came to be so common...) But, there's a line - can't we get too small? Isn't this about better controlling our health and diabetes, not necessarily looking best or conviencing the world around us first? The argument of course: why should we hide? You're the one who's embarrased by it, not me.

Saturday, March 10, 2007

Family life

We'd like to start a family. My wife and I are about a year-and-a half into marriage, and have decided it's time that we'd like to bring someone into the world.

The fear, however, is how diabetes will be a part of that.

From the pre-family stages, to my health and role-modeling, to what potential effect my own diabetes will play on our child's. They say it's genetic. That's a fear of mine - that I'll continue this condition and pass it down. The stats aren't in my favor, but nothing's definate. All of this has, of course, led me to want to keep my sugars and life in order and in stable order, though it's more as of late than anything. Better late than never, another saying goes.

I've always said, or thought at least, that a cure isn't for me - it's for the future generations of children that can be salvaged from having to go through something that I have. No child should have to go through that. That's why I pray for a cure - to help and save them. But, it seems that by helping myself and being in control of my diabetes, I can do something to help beat the odds that I'd be passing this on. Obviously, no parent wants to pass something like this down to their child. There's got to be some psychological stuff that can come from that - on both generational levels. My mom's been diabetic her life - chances are it's heriditary. But, I have no grudges or bad blood because of it - unfortunate, but that's the way it goes (though my adolescent years may have led to some hurtful, teenage rants in spite - which I now regret, but realize that I could face years down the road.)

As with anything else, you can't live in fear and let that dictate your life. So we're taking steps and moving on as much as possible. We are keeping my life in better control. Lately, church has come into our life and we're starting that avenue for prayer, guidance, and whatever salvation we may find or need. Maybe some answers will be found there.

I'd like to hear from some other diabetics who've been here. Discussion always welcome.

Wednesday, March 7, 2007

Confessions and complications

Here we are. Dreams are finally happening in life. Happily married to a wonderful woman, ready to start a family, own a beautiful home that's more than I ever thought possible, good paying job, and doing quite well for myself. I'd like to say I'm healthy - but that would only be continuing a pattern of denial that has entailed more than a decade of my life and is now becoming more "complicated." So, no more. The fruitions of these dreams mean it's a time in life where I finally must face the reality of a disease that I've too often ignored and shrugged off. But those crimes of my past are finally catching up all at once, and it's unfortunate that it's taken this long to push away the denial that has created this twisted, unwanted relationship with diabetes.

It's been 23 years. Neuropathy has nudged slightly, sometimes more forcefully, in recent years. Those tingling, numb, and fire-like feelings in the feet have become more common. It's come and gone, but sometimes been enough to keep me awake at night away from my beloved wife and comfort, sitting up in the dark or even just twitching on my side of the bed. Pain in the feet, upper legs is becoming more common and intense - Today it struck me on the upper inside leg leg while making a usual walk on lunchtime in downtown; had to stop for a moment and relax. Learned this year that retinopathy has finally hit, though about as minimally as it can at this point. And, the side effects of neuropathy (sweating, etc.) are noticeable. Then there's the heart. Have also started notice some pain and discomfort on the left side, even underpart of left arm - which causes concern. Getting that all tested.

Years ago in my mid-teens, the doc warned: "If you don't..... You won't live to see 20. Well, I may be on borrowed time now, but it doesn't make it any easier.

What's wrong with me? What's my mental block? Another blogger asked recently in a rhetorical manner... "What makes me so special that I can beat the odds?" It's not about beating odds; none of us can. Laziness, lack of willpower, a spoiled life that now hinders my ability to adhere to the basics of diabetes management. Only recently I've started testing at least 6 times a day. Using the OneTouch UltraSmart. Averages are still way too high, but it's a start. A long overdue one, but nonethless a step in the right direction.

So here goes. Getting to that point where I should have been all along. But a place that is where a family man, and healthy, well-managed diabetic needs to be. Cheers to low A1Cs.