Friday, December 31, 2010

Recounting Ten

As we usher out 2010 and welcome in the New Year, I'd tried to go through all my posts for this past year and do as others have done - pinpointing my favorites or finding one per month that stands out. But that just didn't happen and the clock was ticking down. So, instead, you get a recap of the highlights that are at the top of my mind.
Those are just some of the highlights in my mind. I'm sure there are many more important and worthy items, but with less than a day left before 2011 begins, there just isn't time. So, enjoy the above and feel free to skim the archives and let me know what your favorites are!

Happy New Year!

Wednesday, December 29, 2010

Blood Meter Stole My Socks

Recently, my blood meter stole my socks.

Yes, that’s correct - you aren’t reading that incorrectly. Here, I’ll explain.

The Mystery of the Missing Socks began like this...

Getting dressed for work one day, I resorted to my routine of scanning some online activity while putting on my black socks and shoes in preparation for that day’s beginning.

I realized that I hadn’t tested before my shower that morning as usual. So, I turned my attention to a blood test. My black handheld blackberry-sized case was sitting in the usual spot on the half divider-wall at the top of the stairs, so I stood up and made my way over there to test. Test came back just above 100 mg/dL, and a sense of triumph enveloped my mind as I walked my sockless feet back to where I’d been sitting.

Scanned more headlines, emails, updates, and tweets. Then realized, I couldn’t find my socks. They weren’t on my feet. Not in hand. Not underneath the laptop now back on my lap. Not on the floor. Or table next to me. At the top of the stairs next to my blood meter. Not on the carpeted stairs, maybe a casualty of gravity catching hold.

Nope. Still nowhere to be found. I searched for about five minutes, retracing my earlier steps and trying to pinpoint where they might be. To no avail.

Suzi wasn’t home, so he wasn’t the culprit. The dog was curled up in a ball on the nearby couch, indicating she hadn’t taken them. Cat was in hiding somewhere, so I pinned it on her.

They’d either gotten up and run away, or this was the work of the mischievous cat putting her World Domination Plan into motion with this strategic sock theft.

Oh well. I finally gave up and retrieved another pair from the top dresser drawer in my closet. Emerging from said closet, I put the newly-retrieved spare socks on my feet and covered them with my shoes before giving my tie some attention and setting out for the start of the workday.

Of course, THAT’S when I found the missing socks.

Apparently, in my haste to test my blood sugar, I managed to put them down next to my blood meter case and then proceeded to open said blood meter case and cover up the nearby socks. As both are black, they blended together and were hidden to the quickly passing eye.

So yes. My blood meter really did steal my socks.

No, I didn't use this as an excuse for being late to work or not having my deadline-assignment completed on time. But if it wasn't for diabetes...
At least I was able to solve the Mystery of the Missing Socks, this time.

Monday, December 27, 2010

Santa Endo-Claus

Three months ago, I set up my appointment with that seasonal celebrity of the Diabetes Community known as Santa Endo-Claus.

Like many mythical figures of the past and present and storybooks, this character varies for each Person With Diabetes and appears in whatever way he or she might best recognize. In my little corner booth of the world, Santa takes the form of Dr. P.

While I do like the Christmas season, I have been somewhat nervous about this appointment. That's because of my experience Inside the Endo's Office back in September when it was revealed my internal office A1C was 7.8%, a tenth of a percentage point higher than the last visit back in the summer. My results had been higher in the few months prior to that, and we both determined it actually may have been a bit closer to 8 thanks to some recent Lows possibly artifically-deflating the result.

We vowed to work together and bring it down by Christmas, and for a while that happened. Things were better. But in the past month, I've seen a wave of higher BGs and haven't been as cautious, careful, and attentive as I should have been. On that morning before my appointment, the 12-week average displayed on my Minimed Carelink program was 180 mg/dL. My meter showed me a 30-day average of 198 mg/dL. Using the formulaic self-calculation, that average translates roughly to a 8.5 on the A1C chart. My more short-term averages have been less worthy of even talking about. That's just not acceptable, and I really hoped my A1C wouldn't get that high after I'd kept my averages lower in the 160-average range in the first couple

In order to hit the 7.0 mark that had been my goal, I needed to have an average of about 154 mg/dL. That wasn't expected, but I was hoping that it would be down closer to that level than I'd been in the past year.

All of this is what brought on the hesitation for this pre-Christmas visit. But I knew, whether it was Up or Down, that Dr. P would be appearing in the form of Santa Endo-Claus to bring me either a gift or a lump of coal. No, she doesn't have a white beard. Her red jumpsuit has been swapped with a white lab coat. The big bag of goodies is instead a clipboard full of medical tidbits about each one -  some Naughty, others Nice.

That day was a bit hectic with work, so I was a little worried about last-minute work issues surfacing and putting my visit in jeopardy. Fortunately, that didn't happen and my 11:30 a.m. visit went on without a hitch.

Arriving in the waiting room and settling into a seat among the five or so others already waiting, I snapped a couple photos of the waiting room that now had a Christmas Tree! Then, went in for the appointment and waited for Santa Endo-Claus to come down the chimney, er, exam room.

All was good. Weight was similiar to before. Cholesterol revealed I wasn't eating too many eggs. My heart beat was calm and not in "I just shoveled the driveway clear of wet heavy snow" mode. My eyes could see and my feet felt the little brush being moved about the skin.

When Dr. P (I mean Santa Endo-Claus) entered the room, we discussed how I was not pleased with my blood sugar control lately and just felt burnt out. Not a result of basals being off or anything, just my slacking in doing what's needed. She asked if I'd ever thought about pancreatic transplants or Symlin, to which I responded I wasn't really interested in either because of the likely side effects.

As she sat reviewing my numbers, an assistant popped her head in the door and said: "A1c: 7.5."

Well, hallelulah! A slight drop, from the 7.8 seen back in September which had been up from the 7.7 over the summer and even higher numbers before that.

Santa Endo-Claus concluded the drop was likely a result of my not having as many swings as I'd had before, either on the High or Low side. Even when I've gone into the 300s or 400s, it hasn't been for long and I've gotten things back down quickly. And I've taken more care into correcting correctly for Lows.

Personally, there's one additional point that must be credited for my drop in the past year: That is the Diabetes Online Community. I firmly believe that being involved so actively through the blogosphere, Twitter, Facebook, and just generally in the Diabetes Community, I have improved my health and become more motivated to put the work in. My burn out hasn't lasted as long, and I've found incredible support in conquering it more quickly and getting back on track. So, to everyone in the DOC: Thank You All!

So, it seems I'd gotten a Christmas Present and not a Lump of Coal, after all! Number is still higher than we'd like, but at least I'm moving in the right direction. We vowed to get under better "control" by the next visit in March.

While I didn't achieve the 7.0 or Under that I'd set as a goal at the start of 2010, I'm better off now than what I was when the year began. And there's a clear plan on improving in the coming year. So, bring it on 2011! Let's get this going!

Friday, December 24, 2010

Christmas Cookies and Poetry

As Christmas Eve comes around and paves the way for Christmas Day, a tradition in our house is to set out some Christmas Cookies on the night before.

You know, in case a Big Jolly Fat Man in a White Beard and Red Attire shows up for a visit. No, not Wilford Brimley and his diabeetus. We're talking about the stealthy ninja known as Santa Claus.

Of course, diabetes is a stealthy stalker, too, so we must be reay for both Santa and one of those middle-of-the-night Blood Sugar drops that can strike the seasonal slumber. So, we put out these cookies, gingersnaps (for GingerNinjas???), a glass of white milk, and of course a handy apple juice just in case we need a boost... Maybe if I'm up treating a Low with some Christmas Carby Goodness, I can even catch a Meetup with Santa for a snack, and hit him up for any free blood meter strips, pump supplies or CGM sensors he might have in that magic Christmas Bag of his.

While we wait to see if that Santa D-Meetup comes to be, I leave you with an Xmas Eve poem:

Twas late in the night before Christmas, and all through the house
Not a Puppy or Kitty is stirring, nor is my spouse.
My blood sugar's steady at one-hundred-and-three
And there won't be a need to wake up about 3.
The wife is all nestled snug in our bed,
With visions of No Paramedics or Reactions dancing hopefully in her head.
We'll sleep well in knowing that Low Sugars won't be,
But if that should happen, Christmas Cookies for me..
Then Christmas will come and the fun will begin,
Before the day's worth of D-care starts over again.

"Happy Christmas to all, and to all a good-night...."

Wednesday, December 22, 2010

Our Diabetes Christmas Tree

Tis the season.

Our Christmas Tree materialized in the living room a couple weeks ago. The burnt out strings of lights have since been replaced, ornaments are hanging tight, and the angel is lounging from a looking spot at the top. Our Diabetic Spirit is also singing strong as the D-Supplies have also made their entrance for the second year in a row. More spirited than last year's debut D-Tree, but some of the regular fixtures have returned.

  • Pump tubing tinsel, hanging again without worry of being yanked loose by a jumping dog or sneaky aggressive doorknob. Plus a Glucose Tablet on a pump tube string. And a nearby emtpy One Touch Ultra Blood Test Strip Vial being recycled for D-Tree use!
  • We have the controversial Sugar-Free Chocolate M&M from year's past. Yes, it is sugar-free despite claims to the contrary. Two other ornamenty versions of the bite-sized candies dangle nearby, fully capable of claiming the sugar-saturated status unlike their sugarless neighbor. That's my story and I'm sticking to it.
  • Lancets, in the form of a hanging lancet ninja star on a string, er, piece of pump tubing. Because really, if you aren't going to change them regularly, you might as well get some good decorating use from them.
  • Reservoir and infusion set combo. They're always connected to me, so by extension they have a place on the D-Tree. Nuff said.
  • Old insurance cards on pump tubing string. I keep all my expired insurance cards, and am now making use of them creatively.
  • A Green Pickle. Pickles are yummy treats for many in the Diabetes Community, but this ornament actually stems from an inside-joke between a group of friends. We all went camping one summer years ago and rented a pontoon boat that was green, and thus we named it the Green Pickle. Tree ornaments for everyone ensued, and still decorate our tree.
  • Mug O Beer. I do love my beer. No Christmas is complete without it. Cheers!
We have many other ornaments, but these are some fun central ones higlighted for this post.

Already, the Christmas Kitten Shadow is guarding from the nearby couch arm and stays alert in a purring slumber, making sure the seasonal goodies aren't disturbed by Dog or Man or anyone else.

Now, this D-Tree may not be a Little Charlie Brown Christmas Tree. And our pets may not be the real Garfield or Odie But hey, it's the Hoskins Family, with all the trimmings to compliment our lives and Hoosier Household. We proudly mark the season in our own ways, and love doing it.

So, we're very excited about the holiday being here and being able to see and spend time with family and friends. All D-Life aspects aside, it's a time to remember what we have and how lucky we are in life.

Here's to December and Christmas 2010!

Tuesday, December 21, 2010

A Total Twitter Eclipse

History happened early Tuesday morning, with a total lunar ecplise coinciding with the Winter Solstice that marks the longest day of the year.
Courtesy of FortPhoto, Michael Menefee on Flickr:

This hasn't happened in 372 years - since the year 1638. Last time this dual happening of the astronomical occurred, my first American ancestor Bartholomew Hoskins would have still been around to observe it from the eastern skies of pre-colonial Virginia. And Galileo de' Galilei, the father of modern astronomy, was still alive and drinking wine in Italy.

Being a history-lover and occasional stargazer, I decided to observe this rare cosmic event. It's the first and last time this would ever happen in our lifetimes, so I wanted to at least try and see it.

As the prime viewing time was 3:17 a.m Eastern Time, I decided this would coincide perfectly with my late-night Blood Sugar test. The alarm-clock went off shortly after 3 a.m. and I brushed off the sleepiness to venture outside. My BG test came out at 295 mg/dL (thanks to some earlier wine drinking & snack-enduced SWAGing), and after a grumble and correction bolus, I put on a sweatshirt and coat and journeyed outside for the show in the nighttime sky.

Complete cloud cover, the thick kind that produces snow and very cold weather, dashed my hopes of seeing anything. Couldn't even tell where the moon might be in the sky, had I been able to see anything. This apparently wasn't isolated to Indy - the upper Midwest, Great Lakes Region, East and West Coasts, and even the nation's inter-mountain areas where blocked. So much for history-viewing, right?


This is the 21st Century, and we have tools that my long-ago ancestor from 11 generations ago just did not have back in his day - the Internet and Twitter.

Firing up the laptop, the Twitter-verse came alive with photos, descriptions, and videos of what others were seeing across the country and even the world. One woman in Tallahassee, Florida displayed some great photos on Flickr. NASA had a live video stream, courtesy of the Huffington Post online. A professional photographer in Seattle displayed a photo of the coppery-toned moon on his professional blog. And a fellow D-Blogger Khurt Williams over in New Jersey captured a video of this in a fun, entertaining way.

Apparently, some people hosted online and offline lunar eclipse parties. Some posted Facebook messages and Tweeted about it and newspapers and media outlets across the globe covered this. Reports say the full eclipse effect lasted about 72 minutes but was visible in some partial effects for a few hours, gradually darkening and looking like a "copper penny" as the moon turned a reddish, coppery or orange hue, sometimes even brownish. A camera aboard the International Space Station was able to catch several dramatic views of the eclipse from 220 miles above Earth.

These online images conquered the cloud-cover here in Indianapolis and elsewhere, giving the world a view into these historical events in a way that just didn't exist back in 1638. Now, maybe it was cloudly that night or maybe Bartholomew Hoskins just didn't care. But it's still kind of cool that we're experiencing the same type of celestial event that happened then, and we have a way to see it no matter where we happen to be looking to the sky.

What does this all mean? Well, I'm not a superstitious person, but it's intriguing what historical lore and legend tell us. The Persian king Darius III's defeat by Alexander the Great in the 331 BC Battle of Gaugamela was apparently foretold when the Moon turned blood-red a few days earlier. And an eclipse is credited with saving the life of Christopher Columbus and his crew when they were stranded without supplies on the coast of Jamaica. According to legend, Columbus looked at an astronomical almanac compiled by a German mathematician and realized that a total lunar eclipse would happen on Feb. 29, 1504. He called the native leaders and warned them if they did not help, he'd make the Moon disappear the following night. That warning came true, prompting the terrified people to beg Columbus to restore the Moon -- which he did, in return for as much food as his men needed. He and the crew were rescued on June 29, 1504.

So. there it is. How we're all connected and all that cool celestial jazz. I lived it up. Wonder what will happen the next time a total lunar eclipse coincides with the Winter Solstice on Dec. 21, 2094.

Monday, December 20, 2010

Chocolate Diddlers & Diabetes

Recently, the CBS show Two and a Half Men had a great episode entitled, "Chocolate Diddlers or My Puppy's Dead."

One scene in the beginning brings diabetes into the script, weaving both humor and mis-information that I thought needed to be written about.

As the clip is central to the point of my post, I've included a link below. The only one I could find is the full episode online at the CBS site, and unfortunately you have to wait through a couple commercials totalling about a minute until you get to the scene at issue. But specifically, the point you want starts about 6:45. I recommend starting at 4:45 to get the full scene putting the song into context.

:) :) :) :) :) :) :) :) :) :)
:) :) :) :) :) :) :) :) :) :)
:) :) :) :) :) :) :) :) :) :)

"C is for chocolate, D's diabetes. Do your kids a favor, and buy a box of Wheaties. Chocolate Diddlers YAY!"

Personally, I got a kick out of this. I'm a huge fan of the show and we record and watch it religiously every week, always maintaining a theme of laughter during the episode.

I loved the song and thought it was hilarious, but even with that I found myself wondering outloud: "I love the beat, but honestly I think I'm supposed to not like what that song is about." Funny as hell, but spreading myths and misinformation... Hmm.

Basically, the song is saying that chocolate is bad and causes diabetes, and so parents should avoid this chocolate cheerio like cereal for the good of their kids' health and go with something healthier, like Wheaties.

That's just not the case. But how can you be mad at Charlie Sheen's song or the writers' use of it on a show that's so freakin' funny? Where is the line?

We Type 1 diabetics and our caregiving Type 3s know that it's not a matter of just "avoiding sugar" in preventing diabetes. Those of us diagnosed as kids, many of us heard and felt the blame from non-diabetics and the general public about how we somehow "caused" our diabetes. The fact that this is an autoimmune chronic condition not associated with weight, lifestyle, or eating habits is too often lost on the general public. Though Type 2 is a different animal that sometimes does involve lifestyle habits such as eating and exercise, that is not specifically the cause and not always the case and it's not commonly the issue with most Children With Diabetes. Basically, it's not a matter of just "avoiding sugar," as Charlie's song implies.

Am I off on this? Am I seeing this with a biased foundation, as someone who has grown up with Type 1 and have that history of being accused of causing this by eating candy or too much sugar? Is this song actually spreading a myth, or is that a stretch that I should just get over - look at the comedy rather than the message?
In this case, it seems to me that Two and a Half Men is spreading a misconception. Despite all the humor and the fact I found it pretty darn funny, even now, I think some advocacy is in order.

So, I'm going to write a letter and see where it goes.

What do you think?

Thursday, December 16, 2010

A Defining Question

Story of My Life. Particularly this week.
Robert Duvall, portraying newspaper editor Bernie White in the 1994 journalism movie The Paper: [Reading in a dictionary] "Deadline: A date or time before which something must be done."

Uh huh. Right...

At least there is coffee. Lots of it. And steady blood sugars - well, we can hope...

Wednesday, December 15, 2010

Not Yet Singing... Crystal CGM Persuasion

A year ago, I wrote a post called Crystal CGM Persuasion. That Summer of 69 Song is about thoughts of a bright future where everyone lives in peace and harmony, and it's registered as an appropriate way to describe what I hope will become my reality once starting on a Continuous Glucose Monitoring system.

In the past year, I've trial-tested both the Navigator and Dex briefly and investigated everything from comparisons, costs, and future expansions that might factor into this decision-making. Ultimately, I decided on the Dex. But, with a several month Pump Hiatus and some mid-year insurance changes, my timeline was pushed to the end of 2010 - at which time I'd again investigate the feasibility of starting on the path to Crystal CGM Persuasion.

For me, this was a way to "groove to the melody of knowing you'll always be aware of where your blood sugar levels are at, and which way they're going. All in the name of tighter control, without the sudden and consequential night-time or any-time Lows... all in the hopes of a Diabetic Eutopia of Even Greater Control."

With everything happening during the past year, I've had some Dexing Decisions on the mind. Though I've hoped to start down a new path by now, it's sad to say that I'm not yet ready to sing that song. It's not yet time to sing that groovy CGM song.

The reason is two-fold: it costs too darn much, and my insurance company took too long in telling me what I'd need to pay so I could plan before my current deductible resets to $0 on Jan. 1. That just happened recently, and the window now isn't open long enough. My insurance coverage has a Durable Medical Equipment cap of $2,500 which both my CGM and pump supplies fall under. Making sure I've got enough left over from that cap to pay for pump supplies is the first priority, and adding a CGM to the mix would push me to that ceiling. Plus, recent gum disease treatment has led to an incredible amount put on our Flex Account that hadn't been planned, meaning that we'll also have significantly less available for pump supplies, blood test strips, doctor visits, and various medications as the insurance year goes on. We must get through the end of May, and there's just not enough on tap to last that long as it stands even without a CGM.

But with the deductible resetting, maybe that's a sign to move forward in 2011.

So, somtime this next year, I'll re-examine the options. Product advances and upgrades may also add even more options and give me something else to consider. We'll see what happens.

There's no doubt that a CGM would be an incredible benefit for my D-Life - it would help alleviate some of the Lows that I've endured in the past year, some of which have dropped me way below the 50 mg/dL mark and even warranted paramedic visits to the home. But, we just aren't yet ready to sing. I'm confident of the Crystal Blue clearness that'll come with CGMing, but it'll take a little longer to be able to sing that tune.

That's sad that the financial end can be so restricting at the front-end, even though it's pretty much guaranted to lesson the overall long-term costs of my D-Life for whatever insurance company provides my coverage. But that is the way it is, and though it's not yet a reality, I'm looking forward to the CGM chance once it gets here. So, I'll just have to keep up the current routine and live vicariously through fellow Diabetes Online Community members who have started on these devices. Only for a little longer...

So, in the meantime, I'll just hum in my head until it's time to sing out loud.

Monday, December 13, 2010

Vending Machines and Diabetes

A question came my way recently from an old high school friend in the hometown.

His question came in the form of a Facebook message, and stemmed from his work in the vending machine business as someone who stocks those treasure-chests of food with all the Less Than $1 goodies for both People With Diabetes and our non-D counterparts.

Whether it be the peanut buttery or cheese snack crackers, the chili cheese Fritos or Potato Skins, or the Skittles or candy bars that often help me out in the time of Lows, this old friend plays a part in supplying those to possible consumers – whether it be the working professional, hungry wanderer, college person, or younger student in secondary school.

He asked: “The perfect guy to ask about diabetes. So....can you get diabetes? Or are you born with it, and it finally shows up at some random part of your life? I have talked to 2 guys on my route who have just recently found out that they are diabetic. I just didn’t know how that worked.”

Ah. Another chance for Diabetes Advocacy arises, and offered an opportunity to educate those who aren’t directly touched by any type of diabetes personally. Hope that I helped make this Type 3 coworker a little more aware of what it is and isn’t.

In explaining some basic differences between Type 1 and Type 2 diabetes and how the latter is more associated with lifestyle issues such as diet and exercise, he elaborated a bit on the background of his question.

Old Friend: “Thanks. I was trying to see of my line of business was making me responsible for people having diabetes.”

Ah ha... I see. This focused my D-Advocacy and what may be needed on this question of the day.

We can probably get into a pretty worthwhile debate on the merits of vending machines and their part in the health behavior of our nation. But that wasn’t my focus here, but rather to pinpoint what I see to be the relative D-Advocacy points about the basics. Not getting into the general debate of whether vending machines are good for us or not. Some may say so, some may not. All to varying degrees.

The vending machine industry has been under fire these days, mostly from the health-conscious folk and those crying foul that schools offer so many vending machine options for students. A recent University of Michigan study from September 2010 shows these products compete with school lunch programs, and there is some link to obesity and unhealthier lifestyles being developed.

Actually, today President Barack Obama signed into law a measure aimed at cutting down greasy foods and extra calories in kids by giving the government more power to decide what can go into these vending machines - read: they'll likely be stocked with less candy and fewer high-calorie drinks.

And with the massive Health Care Reform Act, the industry faces new concerns from just one sentence in those sweeping 2,000 pages of reform: a provision requiring vending machine operators with 20 or more machines to provide a sign in close proximity to disclose the calorie count. This already law, but apparently everyone is awaiting FDA guidance on how to proceed.

Despite all that, vending machines aren’t the enemy to me. True, some are Greedy and I’ve done my best to advocate against those criminally-minded machines. But for the most part, I see vending machines as a tool in my daily D-Life challenges.

I'd also say that we don't need carb or calorie counts on a sign or posted anywhere inside or nearby. Seriously, we’re not talking exotic unknowns of the carbohydrates neither-worlds here. This is pretty straightforward stuff, and I’m fine with them currently being listed on the bags or wrappers of the snack itself. Having it somewhere else isn’t going to improve my health and change my choices… if that was such a concern, I wouldn’t be using the vending machine in the first place and would go get a snack somewhere else.

Now, it’d be different if I got something from them every single day and based my meal plans around what snacks might be consumed today. But I don’t. And I don’t think most people do that. If they do, then there’s something more pressing to address in that person’s life. IMHO.

So, with all of that in mind, I offered my thoughts to my old high school bud – saying that, in my opinion, he shouldn’t be too worried about causing diabetes of any type because there is more happening than simply people crafting their meal plans on what’s stocked behind the glass.

“I wouldn't worry too much about it... I don't think it's the vending machine snacks that are making people obese and possibly playing some small part in the Type 2 diabetes numbers. There's much more to it than that, and I'd argue with anyone who suggested vending machine (venders or connoisseurs??) were responsible in any way. Actually, on the flip side with Type 1 - I'd give you props. Can't count the number of times this Type 1 has depended on my office or some other vending machine for Skittles or some other snack when my blood sugar went too Low... I'd be lost without you and those vending machines!"

And that's where I left it. Until some of those very smart researchers instruct me otherwise and conclude that vending machines do, in fact, cause diabetes. In the meantime, I'll just keep feeding my change in the snack slot whenever the need arises.

Friday, December 10, 2010

Semi-Organized Rambling

My name is Michael Westen, and I used to be a spy.

No, wait. That's not exactly right. At least I got one part of it correct: My name is Michael.

It's Friday. That means it's a perfect time for some bullet points to tie all my random thoughts together into one semi-organized blog post. Hey, at least we can pretend. Here we go:
  • You May Have Missed It: But something called the Special Diabetes Program got Congressional attention this week, renewed at $150 million in federal funding for another two years through 2013. The Senate passed HR 4994 on Wednesday and the House followed on Thursday. Though the news headlines reflect how this legislation delayed doctors' Medicare cuts to the tune of 25%, the D-aspect of this legislation didn't get much attention. But it deserves coverage, because this means continued federal funding for Type 1 research and some other D-Management funding for at-risk minority populations.
  • DOC Awards: The nominations are announced. In my opinion, the ENTIRE DOC deserves an award of some kind, because every single person who Tweets or blogs or emails or just interacts makes this community what it is. You all make me smile, laugh, cry, fume with anger, write my own responses, form opinions, educate, entertain… Yes, I am just listing various adjectives because they all apply! I’ll expand on this a little more before long, but please don’t forget to cast a survey vote in the various categories before Dec. 31.
  • All I can say is #BluntLancet. The Band. You know it. Live it. Love it.
  • The JDRF sent me a Christmas card. No, actually - it's a Season's Greetings card. Sends the best holiday wishes and it's signed by the Powers That Be over at the now 40-year old organization. A nice gesture, that made me feel all smiley inside.
  • Today is my holiday party at work. A pitch in lunch starting at 11:30am, followed by fun and festivities and a snapshot of the past year's business. Some prizes will likely be given out as usual and the annual gathering means a half-day in the office, too. So more time to interactivewith the DOC the rest of the day!
  • Our Christmas D-Tree is up at home! But the Vlog isn’t yet complete, so stay tuned for that down the road…. In the meantime, feel free to reflect on the 2009 Diabetic Christmas Tree in the Hoskins Household. I also leave you with the thoughts that: Hollywood’s best known and lesser-known actors and actresses kick up the holiday spirit in the 25 Days of Christmas on ABC Family and also on the Lifetime Channel. I’ve recently admitted to the Facebook World that I am a fan of these flicks, and the truth remains. Live with it. They are feel-good flicks, but do mark the season.
 That's it. Have a fun Friday and weekend. See you next week!

Wednesday, December 8, 2010

According To Mr. Strickland

Courtesy of my Google search for "Mr. Strickland" & "Slacker"
I am a Slacker.

Just like the high school principal from Back to the Future saw it, when it came to Marty and George McFly.

Call it slacking. Burnout. Laziness. Or my own interpretation of a vacation in pretty much the only way I'll ever be able to know one.

The array of names all translate to the same style of self-care in my D-Life these days. Lately, I've been the Slacker in Charge as far as my diabetes management. I am nose-to-nose with being a slacker.

Not testing as regularly. Eating carbs without dosing for them. Like those bags of peanuts, or handfuls of Vanilla Wafers, or just a pack of crackers. I was hungry, and just didn't care. Just like not uploading my pump data to the laptop, or writing blogs or participating in the Diabetes Online Community as much.

And I'm OK with this, for the most part.

Slacking can be like a vacation of the mind, for us People With Diabetes.

Between the end of the year activity, financial struggles, work and life stress, and hanging out with some none D-friends recently who felt the need to bash my D-nerdiness on various levels... I've felt relatively burnt out and have just resorted to slacking.

The One Touch Ultra Link shows my 7-day average is 206, while the 14-day average is 183 and 30-day average is 162. Obviously, I've been runner higher more recently. Hopefully, not to the extent that it'll damage my hopes of a lower A1c come Christmas week. But we'll see.

You know what? I just don't care right now. It is what it is. I'm generally frustrated with life and people and pretty much the world. And not in a good mood, as we move into the Christmas season. I have just needed a break. A vacation so to speak.
We all get to that point. It is what it is. Hopefully, it doesn't last too long. Soon, Mr. Strickland won't have much to hang on me as far as slacker-ness. I'll be a new and improved, re-energized Person With Diabetes.
Just like George McFly. History is gonna change. Or this D-Future, that is.

Monday, December 6, 2010

The Domino Effect

One falls, the others are close behind.

That's the Domino Theory. It's what is happening now with the diabetes dominos and our circle of dominos necessary for the best health possible.

We People With Diabetes have much to fear, because some of those dominos have already tumbled to the ground and more are staggering.

Fellow D-Blogger Wil DuBois recently wrote about this over at Life After Dx, with Scott Strumello following on this footsteps. They spell out what's happening:

Medicare changes are on the line, nationally and at the state levels. Indiana is one of those. Currently, Medicare’s “guidelines” allow for one strip per day for diabetics on oral meds (Type 2s) and three strips per day for insulin-dependent diabetics (Type 1s and some Type 2s). Getting those one-or-three strips covered requires some paperwork and record-keeping on the Medicare-recipients part, but it is possible to get more strips if a doc pushes to override. But now a proposed Medicare rule change would make this "guideline" permanent and make it so docs couldn't request an override for additontal strips.

Most importantly for all of us non-Medicare folk: Whatever Medicare does Medicaid does. Whatever Medicare and Medicaid do private insurance does. It’ll be a falling domino effect that’ll fall on your head faster than you can read this post.

This scares the hell out of me, as we're already watching this unfold at the state level. We see the state of Washington is doing legislative research about how state-funding might be limited to one strip a day for children. Others states are closely watching these types of issues, as they've already experienced the falling domino of being cash-strapped and in need of massive budget gets wherever possible. These states have little money and insurance company fueled propoganda, specifically since Type 2 diabetes management is the more common public perception of what's needed, could be pursuasive.

Does the blood strip makers in Pharma have more power and influence than Big Insurance? Well, that lobbying battle may be what it comes down to. We'll see whether one of those players has the power to stop a falling domino.

But some docs and endos are also taking up arms to defend us patients. Dr. Steven Edelman was calling on his fellow docs to “stand up as advocates for the rights of our patients to receive quality care and for our rights as physicians to practice appropriate medicine."

We must help and join the fight.

Call the Congressional switchboard at 1-866-220-0044. If you give them your zip code they’ll connect you with your Senator’s office. You can also find your elected lawmaker's number through this online directory. Each Senator apparently has a Healthcare Liaison. Give that person your thoughts on what blood testing means for you.

Personally, I've had insurance try to limit my BG strips to only about three a day. I appreciate and am incredibly glad my Endo was able to override that and insurance improved a higher amount, leading to my better health. But we're at a crossroads here, and our very health and lives are in jeapordy because of the bottom line.

One domino falls, so do they all. Unless we step in and block that from happening.

As Wil did, I leave you with this quote from Martin Niemöller about the Holocaust:

They came first for the Communists,
and I didn't speak up because I wasn't a Communist.
Then they came for the trade unionists,
and I didn't speak up because I wasn't a trade unionist.
Then they came for the Jews,
and I didn't speak up because I wasn't a Jew.
Then they came for me,
and by that time no one was left to speak up.

Please, speak up.

Friday, December 3, 2010

Too Much On The Mind

Today is Friday. I have a lot on my mind.

But too much to write about or even comprehend.

So in my stead, I give you Shadow.

Yes, that is pump tubing on my head. No. I'm NOT happy about it.

Taking a break from her Plotting for World Dominiation, Shadow imitates what this coffee-saturated and sleep-depraved week of deadlines is doing to me. Some diabetes, much is not. Too much going on, too little time to process it. Tapping my energy, stealing my words, blocking my writing mind. So that's all.

See you Monday.

Thursday, December 2, 2010

Not Abe Lincoln's Civil War

My name isn't Abe Lincoln and I'm not sporting a cool top hat or bad-ass beard the way our historic wartime president once did. But I do have a cat. And a voice. And a place as good as Gettysburg to get my point across about an important discussion playing out in the Diabetes Community.

That issue: We apparently have a Diabetes Civil War waging. So says the Chicago Tribune, and other so-called journalism organizations newspapers and media outlets.

The Nov. 22 story sparked some protest from many of us People With Diabetes, mainly over how it characterized the division between the various types of diabetes. The headline and subhead say it plainly: “Diabetes’ Civil War: People with Type 1 diabetes, outnumbered and overshadowed by Type 2, fight for recognition, resources – and a new name for their disorder.”

Many have written about this already and opinions are flying. The theme: Fight Diabetes, Not Each Other. Yes, I echo that mantra. No need to repeat what's already been written and spoken, in the online sense. You can find it TuDiabetes. Allison Blass over at Lemonade Life wrote a great post in response to this article, and I echo her point. Sara Knicks wrote a brilliant post over at Diabetes Daily about this article and her thoughts, reiterating a point she made during the 2010 Social Media Summit that “no other disease fights with itself.” Good one there, too.

But there are even wiser minds guiding us here. Abe Lincoln made the point back in 1858 very clearly, one that applied not only to our country's Civil War but also transcends to the D-Front now: "A house divided against itself cannot stand.”

We can’t be united when we have so much division among diabetics. Getting into useless debates about which type of diabetes is "worse" gets us nowhere and only makes tempers flare and the non-Ds less receptive to what we're advocating. Promoting one more than the other is what brings us all down, and doesn’t achieve equal awareness that is so needed out there when we’re battling an uninformed public, space-crunched and rapid-fire media, politically-motivated Congress, and people trying to raise their TV ratings or sell snake oil without enough concern for the full picture.

Morning Addition: I'm a member of the media. Newspaper reporter style. Someone who went to J-School and strongly believes in watchdog journalism that gets people what they need to know in order to have the ability to decide for themselves. As someone who's worked in the past for a weekly newspaper and a 6-day daily newspaper and am now several years into a twice-a-month speciality paper, I know the hurdles regular reporters face - always on deadline for Web and print, more phone calls, less time... Reporters just don't have the time to truly understand what they are writing about. That's not an excuse for crappy journalism, but it's an incredibly important reason we must understand for why our quality of journalism has failed on every possible topic - including diabetes. The public is fickle and doesn't have time, so they want it quick and now. And that (coupled with costs and revenue woes in the profession) creates this pressure system on our Fourth Estate. So, we need to help them. We need to find those local people who illustrate the numbers and the trends about diabetes. We need to give them notice, and follow-up even when the editors aren't convinced. We need to feed them sources who actually know WTFructose they're talking about. WE. But sadly, that doesn't always work. I failed in my attempts to convince some of the local papers to do this specifically for World Diabetes Day or even by the end of November, and one of them was even the former paper I worked for. Apparently, it just wasn't worthy-enough for mention despite my spoon-feeding them the makings of a great, powerful, and influential piece. That happens. I haven't had a chance yet to count and catalogue the amount of D-Stories that did appear in November, but that's a work in progress... as are the media awareness efforts.

But the blame can't just be pinned on the media or the general public, though. It's us who are at fault in much of this perception of a "D-Civil War." Honest Abe said: You can have no conflict without being yourselves the aggressors… “We are not enemies, but friends. We must not be enemies. Though passion may have strained it must not break our bonds of affection.”

Well said, Mr. President.

In the end, I just want us to be able to work together as a Diabetes Community to educate people about the similarities and differences. I turn to those Civil War quotes to guide us, to help us realize that this is a different kind of war we’re facing - it’s a D-War, one that I hope doesn’t have a North and South but a united country of People With Diabetes fighting the good fight.

Now, let's do what Abe Lincoln did - go grab our cool hats, be all articulate in our contemporary tongues, and bring our cats along to make our stand together. You know - since cats make all the difference. And as we do all of that, I've decided that I am going to make my own plan for the next local D-Meetup where both Type 1s and Type 2s may be present: Wear an Abe Lincoln mask and walk around saying "Four Score and Seven Years Ago..." Just because it's the cool thing to do. :))

Wednesday, December 1, 2010

Sometimes, you're just hungry

"I'm hungry."

Well, what is your blood test?


That's not Low enough for you to be hungry.

"But I am."

That's also not High enough for you to be craving food.. You know, if you're body is trying to trick you into thinking your hungry when in actuality you are not hungry."

"It's higher than I thought I'd be based on how hungry I am, but it's not too bad. A small correction. But I'm still hungry"

There's no reason you should be. It's not lunch time yet.

"I didn't eat any breakfast and really just snacked some last night after a smaller dinner. All I've had this morning is coffee. Maybe I'm just hungry..."

No, your diabetes must be trying to trick you. Wait for lunch.

"I don't wanna. I'm so hungry."

No, you're not. Just drink more coffee.

"Sometimes, I might just be hungry. I am going to drink more coffee, but I'm going to eat something too."

Whatever. Eat what you'd like. Just make sure to correct for the 213, and dose for the carbs you eat.

"That's the plan, Stan."

Who the heck is Stan? Why don't you ever listen to me? Do you think I'm Stan, and that's why you ignore me...

"Shut up."

Fine.... Ooooh! Pumpkin brownies!!!!! Woo Hoo!!!!!


This was the conversation I had with myself Tuesday morning while working. In the end, I won! Got to eat a snack about two hours before lunch. And that fought off the crazy inside-the-mind rambling that otherwise might have continued... :))

A D-Life is often about diabetes, but sometimes it's not. Sometimes, you're just hungry. Or thirsty. Or tired. Or whatever. Life can be just that - life. Shining through the diabetic clouds, for better or worse.