Sunday, January 24, 2010

Driving While Diabetic

One of the scariest situations Diabetics can face is being behind the wheel with a low blood sugar, particularly one that's dropping even lower.

Recent new stories have told some horror stories of this happening across the country: here in Ohio, and a tragic story here in Orange County, California. Regardless of the particular facts of each situation and whether that person involved did or didn't do what they should have as far as Testing Before Driving, some reader comments question why these and all diabetics aren't prevented from driving completely. An Outright Ban. Those stories come on the heels of a study showing tight-control leads to even more crashes and driving incidents of diabetics.

Of course, in writing this blog initially, I'd forgotten about an outstanding blog post in November 2009 by Shannon over at LADAdeeda, touching on this very topic that's so very dear to her. She was more harsh and on point, but we relay the same point of personal responsibility - especially when it involves situations like those found in the news articles above. So, here's a revision with a shout out and accompanying revisions that came to mind after re-reading her post.

I've faced this scenario myself. Sadly, more than once. Generally, I test before I am going to drive. MY policy is to not get behind the wheel if my blood sugar is 60 mg/dL or less. If it is Low like that, then Eat and Wait. Test Again Before Driving, just to make sure. Seriously, the test itself takes less than a minute - even on the older monitor models. We're not talking routine-changing time here. But the pre-driving testing doesn't always do the trick to stop the practice. For a Key Reason.

I have, on occasion, faced dropping blood sugar levels that have caused me to lose awareness and get behind the wheel. Without Being Fully Aware of It. Now, it wasn't as if I'd made the decision to started driving, knowing I'm low. It just kina happened. (Not an Excuse. Just saying.)

Once it happened during lunchtime when I was en route for food. At a safe level prior to driving, I managed to quickly drop and create confusion about what I wanted to eat, therefore continuing the Food Search Drive and creating even lower sugars. That time, police pulled me over and called paramedics who IVd me back to normal levels. Luckily, no one was injured.

Early last year, I dropped quickly about the time I was leaving work. Walking outside and during the block-length walk to my parking garage, my levels dropped incredibly low. Luckily, I managed to not get behind the wheel in this state - actually, I got confused and found myself riding up and down the parking garage elevator for 30 minutes. Phoned Suzi, and she was on her way to me when I eventually had enough sense to eat Glucose Tabs and sit in waiting, in my car, but not turning on the ignition to drive. Luckily.

Scariest Driving While Low incident happened in August 2009. Did a test and was in the 90s before getting ready for an interview mid-afternoon. Turns out, though, I was dropping even lower and somehow decided to leave the office for my interview, even though it was a phone-based interview that required me only to be sitting at my desk. But I left the office. Wandered to my car. Drove home (a 20 minute drive mid-day, without traffic). I recall thinking that I was going to interview my dog because I missed her, something that just doesn't make sense in a Normal State of Mind but in a Low Reaction State, is not out of the ordinary. Apparently made it most of the way, but missed my expressway exit and had to drive another 5 miles south, getting off and then getting lost in this Low State as I manuevered the back cornfield roads on my way back to my subdivision - still dropping. I recall seeing the road, and not realizing why the drivers were on the wrong side of the road. Ended up driving into a ditch directly in front of my subdivision entrance. Learned later that someone called 911, reporting that I was driving erratically. Police responded, and I decided to put it in reverse to get away from the officer who was trying to steal my keys. Before I could, he reached in and grabbed the keys from the ignition.

Paramedics arrived, and strapped me into the ambulance where they began pumping me full of sugar and bring up my levels. They took me to the hospital, and after this incident I'm still paying off about $1,200 post-insurance coverage resulting from this incident. Learned later that I'd also taken out a speed-limit sign on the grassy side of the road, which I'd apparently driven up onto at some point in aimlessly driving the area. It caused damage to my red Ford Escape, as can be seen here.

This could have been so incredibly worse. Luckily, someone above was protecting me and other drivers nearby that day. I'm blessed, and eternally grateful for that.

Am I an unsafe driver because of the above incidents, and because I still drive? Should I voluntarily surrender my license? Should there be a law aimed at preventing my ability to legally drive, absent of or based upon my history Driving While Diabetic History?

I don't think so, but it does concern me.

I'm in relatively good control, and have what I consider to be a responsible practice of testing before driving. My practice is also to have quick-acting sugar on hand, just in case. Like Shannon and others in the D-O-C, I keep a full-sleeve of Glucose Tabs in my driver's side door and also (in the winter) have one in my coat pocket, as well as other candy placed in the center console. But when I push for Tight Control, my sugar levels sometimes drop to scary-levels and that can happen despite the best Before and During Preparation. Sometimes, you don't always have the ability to recognize these dangerous situations. At night when sleeping, and unfortunately when driving is going to happen. This has motivated me in the past to avoid tight control, and instead keep my sugars higher to avoid this from happening.

I've pondered: Is it better to stay higher, risking possible future complications that may never materialize, to be safe now and not endanger myself, those I love, and strangers? OR do I push for tight control, and do all I can to prevent these situations but face the reality that they could happen no matter what I do? It's an ongoing mental and emotional struggle.

Practically, I can't afford to not drive. We just don't have adequate public transportation here in Indy that I can take advantage of. So, with this, I'm eager and motivated to fight for a CGM - a device that can catch and alert me to those dangers of both Night-time Lows At Home but also Driving While Low incidents. Recently, I've trial-tested two CGMs (Navigator and Dexcom) and these have both caught some Driving While Low episodes. I've tested beforehand, but then managed to dip lower while driving. The alarms notified me, and allowed me to inhale some glucose tabs to curb the drop. Otherwise, I may not have felt them coming on before it was too late. (Note: We won't debate that it wasn't the smartest decision to make in Driving While Low, Snapping a Photo for D365 While In Motion.... Agreed it's bad, but I feel I had it under control. Just sayin.)

We can easily sit back and read of these above stories, shaking our heads and wondering why the Diabetic didn't test or take better care of themselves, or as an extreme just stop driving if they realize this could happen. What should be a big fear for any PWD is how these above situations, and those highliy-publicized tragedies, will stand out to lawmakers and create a justification for law changes. Despite all of those who test before driving, who've stopped voluntarily, or who use a CGM for the prime reason of keeping this in check. They stand out and could provide a foundation for those arguing that Diabetics shouldn't be able to drive, no matter what. I fear we could someday have a misdemeanor or felony, Driving While Diabetic (DWD).

In the UK, a Diabetic must inform the licensing agency of their diagnosis or health condition, as it may impact driving. Apparently California has this rule, according to an article found here. Courts have addressed this in some fashion already: The Supreme Court of the United States ruled in the 1971 case of Bell v. Burson that driving is an "important interest" that can't just be taken away from a licensed driver without a government agency's providing procedural due process. In 1983, the California Supreme Court found in Berlinghieri v. DMV that the revocation or suspension of a license "can and often does constitute a severe personal and economic hardship, and a lower California appellate court found in the 1993 case of People v. Superior Court that a person with insulin-dependent diabetes is not automatically subject to license forfeiture or nonrenewal, and an agency may do so only if the diabetes affects the driver's safe operation of a motor vehicle.

Maybe all of us diabetics should have a CGM, if we're going to drive. But requiring this could create any number of legal and practical issues, among them the one that spawns a whole other debate about health insurance coverage of these CGM systems, and that inevitable fight many of us face about getting coverage for these in order to prevent the above driving disasters or night-time lows. This isn't the time to blog about that, for fears of digressing...

Reflecting on this, I think the overall point is that Diabetics must be even more aware that meticulous care is necessary before and during our drives. We must always be keen to where our sugars are, even if the numbers just before appaer to be fine. That's not enough. A CGM can offer peace of mind, but until we get to the point where it's 100% accurate AND more people have them, we must take on the task ourselves. Or give up driving voluntarily. We must prove that just because we're diabetics, we aren't destined to create crashes or erratic driving. Though it's possible, we can be just as prepared as anyone who gets behind the wheel.

Still, it comes down to personal responsibility. Realizing that even with the best preparation, sometimes you can't stop the Lows While Driving and that may mean sacrificing what you love to do. It comes down to you. I personally believe that, and would hate it even more if laws changed because of those unprepared diabetics who allow this bad driving to happen because of poor control. It's our job as Diabetics not only to prevent this kind of stuff from happening in our own driving worlds, but also to make sure those bad examples don't dictate driving laws for all of us.

Friday, January 22, 2010

Advocating

We all need mentors. People we look up to. Those who inspire us in some small or big way, sometimes even in the little fact that we share something in common that makes all the differences pale in comparison.

I've had my share growing up. Journalism teacher in high school. Journalism advisor and mentor in college, and post-graduate life. Fellow journalists turned friends who taught me the real-life ins and outs of doing this profession the way My mom, who taught me how to live with diabetes even if I didn't always listen to those lessons earlier in life. Dad who taught me how to do my best, sign my name to something, and be a good man who can stand on his own two feet. My wife, who teaches me to Calm Down and gives me the ability to Live, Laugh, Love a little each day. There's many, as you can see.

But it dawns on me that I've not truly embraced my Inner Advocate. In the newspaper world, I've participated in a few workshops or panels through the years to share the lessons of journalism. In my neighborhood, I've been active and coordinated a Neighborhood Watch program for the past four years, and also been an active participant in our HOA and worked with the larger community on various issues. But as far as Diabetes, my advocacy has yet to take shape.

This was one of my 2010 New Year's goals. Maybe, now is the time.

Recently, I've started trying to hook up with any existing D-Support Groups in the Indianapolis area. There isn't much in the immediate area, or through my endo's office that deals mostly with Type 2s, but there is more available on the northside of Indy (about 30 minutes from where I live). It's mostly pediatric, but it's a start. The JDRF support group meets once every other month, but there's a chance it might become a more frequent happening as more get involved. We'll see.

I am also getting more involved in the JDRF Advocacy efforts, and will likely soon start working to score meetings with our Indiana federal legislators about diabetes issues, through the Promise to Remember Me Campaign and other avenues. Had a conference call Thursday night, which offered some good insight into what others are doing.

Of course, one of the more exciting things locally I've become a part of recently involves the creative enterprising spirit of two D-Parents, James and Lynn Jordan. Attending a meeting on Wednesday on the northside of Indianapolis, I was able to meet them and a small group of D-Parents who are experiencing this rollercoaster ride through their children's diabetes. The Jordans are parents of a 13-year-old who's been diabetic for 10 years. They are in the business technology field, and he's an IT guy who's been working on that side of health care for years. Basically, they're developing a web-based portal through their business Strategic Data Management, which will help diabetics better track their data and share it with their docs. At the moment, it's child-focused, but that can change as it's flushed out and developed. I'm excited to be a part of this and help it develop, and maybe even use my journalism experience to help get the word out.

While there, we talked about D-Life in the 80s and 90s. How things were so much more different than they are today. Back in my day, pumps weren't mistaken for cell phones or iPods. Pumps weren't common, but of course neither were injections. Camp was a topic, and though I went as a child, I've never gone back to volunteer my own time. That's something I would like to remedy, and will investigate the possibilities in the Indianapolis area.

There were about seven of us at this recent meeting, and I was the only Type 1 adult there. Great people. Lots of stories to share. Met this one woman, who's the mother of a 7-year-old daughter diagnosed about a year ago. In talking to her, I felt a connection that I really wanted to offer all the help I possibly could. You could see the fear in her eyes, especially with talk of unexpected night-time lows. The unpredictability of diabetes. Uncertainty about her daughter being able to do a sleepover with friends. We talked for some time, and I suggested she check out various aspects of the Diabetes Online Community, such as JDRF's Juvenation and TuDiabetes.org. She hadn't heard of either, but seemed interested in looking.

It all really hit home, and made me think even more about what I've done (or not done) in my life as a Diabetic. Sure, as a kid I participated in the JDF Walks and Rides for a Cure, and raised money and even carried that on through college. Even volunteered some doing clerical work and event coordination. But that's about it. Up until the 2009 Promise Gala in Indianapolis, where Suzi and I attended and were really struck by the good work happening. It's the first real D-event I've been a part of since moving to Indiana in 2004. It was inspirational. That also paved the way to my getting more involved with the Diabetes Online Community, which has been a light in itself and shown how important advocacy really is. Now, I draw inspiration and take lessons from those like Kerri, George, Kelly, Lee Ann, Crystal, RachelSarah, Scott, Shannon, and everyone I've met through the JDRF. Like them, I want to offer whatever help is possible - in practical advice, but also in simply showing that you can live a full, active, productive life as a Type 1.

So, while the blogging will continue here at The Corner Booth, it's time to also let the D-Advocacy begin. Maybe I can help give back something that so many mentors in my life have given to me.

Tuesday, January 19, 2010

All or Nothing

That's how it so often seems for those in the Diabetes World.

Either, you give Diabetes your ALL which means you never ever get to even think about stopping continuous testing and carb counting and worrying, or you give it NOTHING and watch as your health and life falls apart. It's All or Nothing.

But it doesn't have to be.

True: It feels as though we NEVER get a break from this management lifestyle. We ALWAYS must keep in mind: our blood sugar numbers, our carb counts, our activity levels, our pump site or injection site uses, amount of supplies on tap, the cost of healthcare, our jobs that provide the all-significant health insurance we just can't afford to live without. It's mentally overwhelming, ALL the time. Sometimes we can hide it or push ahead, but even if we're not hit right away there's some emotional aspect of diabetes building up that will eventually boil over the filled-too-high boiling water on the stove. It's bound to happen eventually.

Sometimes, we just need a break. Even if we're not allowed one, we have to induldge that craving and take the plunge. For our own sanity.

I go on these breaks from time to time. (gasp... oh my!) Yes, I'm lazy and live by the Procrastinator's Creed quite often. But it's not just that. It's a simple need for a rest, even a short-lived one. Testing 8-12+ times a day goes down the tube. My carb counting isn't accurate, but a guestimate. I let the diabetes worries just pass on by for some temporary relaxation in that aspect of life. We're not talking weeks on end here. Simply, a couple hours or a day or so. Maybe a week, scattered management here and there. We're not talking about sidestepping all needed care all the time, where suddenly I feel as though I'm no longer a diabetic. No, the testing still happens and the pump is still attached. It's just my focus 24/7 as is so often the case.

Horror stories tell us that if you don't stay under control, you're going to lose a leg or go blind or face failing kidneys. Yes, with continued mismanagement and lack of care this is probably inevitable. But if you're A1C results and regular care is sufficient, these scattered breaks won't kill you.

(For The Record: I am not a medical professional and am not advocating anything as written above or below; simply, this is MY own perspective as a 30-year-old Type 1 diabetic for 25 years based on my own experiences. Read: Disclaimer, if you ever choose to hold me personally accountable for what's written in this blogosphere that you've decided to adapt to your own life.)

While it doesn't solve anything, it does offer a brief piece of mind and soul and I'm pretty confident that my numbers are accurate enough that I'm not spinning out of control while auto-pilot is on. After 25 (almsot 26) years of this lifestyle, I feel qualified and well-versed in my inner workings to know when something is up and a test is needed or something needs monitoring or adjustment.

I trust that. And knowing that it's only a brief hiatus, it does me well knowing I can "get away" with it without damning myself to the ever-present uncertainty of that complications abyss. Maybe I'm not the most responsible diabetic out there. But I feel like I'd simply lose my mind if I didn't drift away from constant-control every once in a while.

All or nothing? Not exactly. There's a middleground.

That Middle Ground applies to other aspects of our D-World, as well. Recent news relating to The Cure comes to mind. As most likely now, the JDRF (Juvenile Diabetes Research Foundation) has been making headlines recently in their non-cure focused avenues. Like partnering up to make insulin pumping more effective. Like working toward an artificial pancreas that could make daily living more manageable for diabetics. New treatments for both Diabetes and MS.

Some have applauded these efforts and initiatives wholeheartedly; some have criticized them as not being Cure-Focused and taking away what should be the JDRF's first priority; others have had mixed feelings for the above and other reasons.

To me, it signals what I see as another sign of that all-too-common All or Nothing Mentality.

"If the JDRF isn't focused on the cure, then it's not doing what it should be. They should be devoting ALL of their resources to finding a cure, and if not then the mission statement should change."

I find this to be a reckless train of thought. Like my above self-diagnosed need for a periodic break, there's room for middle ground. We need these public, private, and nonprofit partnerships. It's going to take ALL of us to find a cure, but we don't know how. Every piece of research we do to helping treat this disease, is a small little piece of the puzzle that could somehow reveals that GOLDEN NUGGET needed to complete the puzzle. We should be supporting that investment.

Sure, I'd like to see a cure developed. Yes, it's frustrating that there's isn't a cure after all these years. That docs have been selling us the myth for decades that a cure is only "Five Years Away." That it's coming SOON. Maybe it is, maybe it isn't. Maybe I'm more cynical as someone living with the D for 25+ years, or that I'm a journalist. I live life by the notion that they're won't be a cure in my lifetime, but if there is - WOW. What a great surprise! Sure, I have the hope we may see one. But I don't live my life based on that hope, and it's not going to shatter me if it doesn't happen anytime soon. None of that means I'm not going to invest into cure-research, though. Or just as important research that can mean something to so many of us, short of finding a cure.

In the meantime, before that times comes when a cure is withing a tangible distance and we know that for a fact, I find it reassuring that the JDRF and Others are working toward a practical daily "cure" away from some of the headaches and hassles we deal with now. So that someday not too far off, we may not find ourselves taking a break as often because the treatments and management tools are so much better based on what's being done. All the while, that foundation for Finding a Cure is getting stronger.

Personally, I'm excited about that Middle Ground, in between those two extremes of All or Nothing, because it offers so much possibility.

Friday, January 15, 2010

A Friday Whirlwind of Greatness

Life's been crazy nuts lately. Work Deadlines. Back to Back Meetings. Writing. Reporting. Planning. Diabetes Rollercoasters. Everyday Stresses. Sleepless Nights. Mental Exhaustian. You name it... The whirlwind has engulfed everything, leaving little time for life's pleasures. Like Blog Reading or Humor Writing. No time to be Off Cooking Bacon. No comfort from My Ninja, Lance.

Obvously, it's time for a break. Right. Now.

So, here's to the end of a crazy tornado week and what will hopefully be a great weekend of sleep, catching up, and just relaxing. Without Tax interfering with my becoming a mental jello-bowl with plans to just Veg Out.

Seriously, it's needed. About all I can muster up the mental strength for right now are some movie quotes from classic flicks. The classics, in which I'm able to recite half-asleep and even in a state of Low Blood Sugars.

This isn't the Master List and only represents a snapshot tainted by my current mood and exhaustian, but here goes:

"Did you get that memo??"

"It's not that I'm lazy, it's that I just don't care."

"And here's something else, Bob: I have eight different bosses right now. Eight bosses. So that means that when I make a mistake, I have eight different people coming by to tell me about it. That's my only real motivation is not to be hassled, that and the fear of losing my job. But you know, Bob, that will only make someone work just hard enough not to get fired."

"Sounds like somebody has a case of the Mondays."

You don't frighten us, English pig dogs. Go and boil your bottoms, you sons of a silly person. I blow my nose at you."

"So, I jumped a ship in Hong Kong and make my way over to Tibet, and I get on as a looper at a course over in the Himalayas..."

"Hey, how come Andrew gets to get up? If he gets up, we'll all get up, it'll be anarchy!"

"Negative, Ghost Rider. The pattern is full."
"YOU CAN'T HANDLE THE TRUTH!"

"Coffee! Coffee... Coffee NOW!"

"I'll have a half double decaffeinated half-caf, with a twist of lemon..."

"1.21 JIGGAWATTS... 1.21 jiggawatts...." "WHAT THE HELL'S A JIGGAWATT???"
"I'm surrounded by Assholes... Keep firing, Assholes!"

"Whose motorcycle is this? It's a chopper, baby. Whose chopper is this? It's Zed's. Who's Zed? Zed's dead, baby. Zed's dead."

THE END.

Tuesday, January 12, 2010

Escaping The Escape

The wheels of my mind have been spinning recently. A question has been popping up - why. Why diabetes? Why High? Why Low? Why isn't this easier? Why so overwhelming? Why so exhausted? Why this? Why that? Why everything?????

I've wracked up my brain, searched my soul trying to connect the dots between 2010 and the long-ago time these questions began. When the vicious daily D-cycle started. Suddenly, after so much analysis, it clicked recently. Those past and present dots came together and bridged a gap between 2010 and 1984, when it all began and started what is now a continuing, frustrating, and often overwhelming journey that many in the Diabetes World seem to know all too well.

Simply put, it goes to this simple fact: Growing up, I wanted to be MacGyver. You know, the globe-trotting Secret Agent Man who could do anything in any situation with the simpliest of household items. Lock-picking with inside of a lightbulb. Bubble gum to patch gas tanks. Hockey ticket to diffuse a bomb. Paperclips and Duct Tape. While some might have cared more about Richard Dean Anderson's start on General Hospital, the appeal for this young, newly diagnosed Diabetic Kid was the man known only as MacGyver. It was cool, and I even got a red Swiss Army pocketknife just like him and I'd regularly educate my dad and friends about the cool McGyverisms seen each week.
The show lasted until the early 90s, when I was weaving my way through middle school. By that time, another favorite show came on in 89 - Quantum Leap. Each week, I could escape my Life As A Diabetic Child and transport into other people's bodies at key points in history, taking on their looks and facing whatever interesting or dangerous situation they might be facing at that key moment of body-switching. What could be better looking to a kid wanting just escape his own life?

Eventually, that show ended on a note of hopelessness - that Sam would never return home; he was destined to leap for the rest of his life. X-Files followed, and then there was Sliders (alternate universe cruising regular folk). Imagine "sliding" to an alternate world, where diabetes never existed, where it existed but you'd never been diagnosed, or a place where a cure has already been found???

Eventually came Stargate SG-1with MacGyver leading a team of alternate worlds in the galaxy!) - the latter has come evolved into a fascination with the newest Stargate series, Universe. Of course, there's also Smallville, Heroes, Chuck, and usually anything on Sci Fi to feed my fix.

You may notice a theme. Since my diagnosis in March 1984, I've been a regular lover of Sci Fi and the more creative. Sure, there were others. But mostly, it was the Sci-Fi World that captured my imagination. That's probably also why I'm a writer... I could always escape into my writing and just not focus on ME. Started out with escape-craving fiction and soul-expressing poetry, and eventually it evolved into the money-earning career of journalism.

In part, I truly believe that it's been because of my diabetes and a desire to escape. To find a place where this wasn't my life. Where I could be anything. Do anything. And not be limited. Not face the depression that has come and gone, and even been present as I've plugged along more successfully at times.

After the McGyver and Quantum Leap days and well into my X-Files and Sliders Days, I battled depression as a teenager.. Stats tell us that depression is something like 3 times more common in people with All Diabetes Types than in the general population as a whole. Apparently, I'm one of those to some degree. Never been medicated, but went to a counselor at one point. Didn't think it did any good, as I was a teenager being "rebellious." We parted ways at some point, and I don't recall much of what we talked about - except that Diabetes was a theme and I had an overwhelming sense of hopeless because of it.

As a child, it was not wanting to be different. Same as a teenager, but with added aspect of trying to find myself even when wanting to fit in as an adolscent. Dating. College. Marriage. Real jobs. Thoughts of family, and children who could someday become diabetic because of my own lack of care through the years. Guilt. Depression. All fueled by rocky diabetes care, which creates even more emotional ups and downs. Exhaustion. Even crazier D-rollercoasters. A vicious cycle. Humor helps, as does sarcasm and cynicism. To a point.

A key changing moment in my life was meeting Suzi in 2000. She changed me. She showed me there were reasons to want to be a part of this life as fully as possible, and that I was important. I smoked briefly in college, and she motivated me to quiet and not look back. She put a focus into my life, showed me that there was something worth living for, and that despite the challenges this Diabetes doesn't equate to death. That it's not hopeless. We're in it together. Have been since September 2005. With her inspiration, I eventually find my way back to journalism and writing. Now, we're living in Indiana after moving from Michigan and we look forward to starting a family when that's meant to happen.

But through the years, despite the TV shows or Method of Escape, that Depression has remained. Like a weed waiting below the soil to spring again. As always, lurking beneath the surface and flashing its face mostly when The D-Life or other aspects of reality get tough. While I love my wife and she's stronger than most give her credit for, I simply felt it was better to keep some of my feelings and worries and depression to myself rather than bring her down, or impact her world. I'm a guy, and it's my job. My journalism experience takes over and I fend off any visible sign of emotion, instead opting to stuggle internally - it's almost like an epic battle between Good & Evil, but not.

In late 2008, we found Grace United Methodist Church. While Suzi grew up Methodist and we married in her United Methodist Church, I grew up unchurched and hadn't even been exposed to even the simplist Bible stories except for a few random days in my childhood. Our new journey with Grace offered a new channel for my fears and worries to express themselves, and it helped in finding faith and being able to regularly have Conversations with God. With this relationship that I'd never experienced before and growing spiritually, I found myself being more at ease. About Life. Diabetes. Everything. Managing the guilt, frustration, and hidden depression seemed so much easier when I discovered that I wasn't doing this alone. Not to mention that my Sci-Fi shows like Heroes, Stargate, & Smallville offered some escape each week.

Lately, even as my Family Focus and D-Life has become more of a priority, it seems as though the depression has come sneaking back into my life more regularly. The frustrations have mounted in so many different aspects of life, and this has all caused me to crave an escape even more. My work life has gotten busier and more razzled, and we've slacked in going to church even as my health has improved. I've stopped talking to God as much as I had. Now, at age 30 there are times when I feel just as lost as when I was 10 or when going through adolence. At times, I simply can't sleep and stay up to cry and be alone with my thoughts and fears without showing it to anyone. (Except maybe the dog, who just wants to offer unconditional love but is always ready for a 3 a.m. walk outside.)

I've never been medicated. And blog readers, please rest assured: Suicide has never been anything more than a passing, scattered thought in the throws of depression. Once again, my wife serves as the bringer of sunshine who talks me back from the ledge (metaphorically speaking about the cliche, not her influence). Despite my worry fear and self-diappointment, I look at her and know that there's hope. There's a reason to manage this all, diabetes and everything. That's why I do it. I've been wrong, though. Not only in cutting off communications with God, but in trying to struggle with this personally without the love and support of my wife.

So, I'm going to put some plans in place. Talk to My Wife More. My Pastor. My God. Counseling. D-Support Groups. Take a leadership role in JDRF Advocacy. I'm going to find those Active Conversations with God that helped sooth my soul in the past year. Get my worklife back together and manage my daily time more efficiently. Balance out the Diabetes Frustrations and frequent-rollercoastering blood sugars. It may very well start with a haircut. I am currently looking pretty shaggy, and it fits a lifelong pattern that the more shaggy I feel the less productive and worthwhile I feel. It's time to get a trim and start anew, fresh and productive.

In researching this online, I found a TuDiabetes thread from 2007 that Manny had started. It's here, and is also includes a link to a Vlog about Diabetes and Depression. (Warning: Can be rough to watch).

Aside from all of the above, there comes an important lesson: If you don't talk about this, it conquers you. The Craziness will win. Even when there's no visible sign, it's likely just hiding below the surface like a ninja, just waiting for a moment to snipe you off. It's not gone, and you need to recognize it still exists and can harm you if you aren't careful. The deeper you get, the easier it gets to just let the denial and depression in place and consume your entire life. To the boiling point, where you lose everything you think is important. For me, I've been submerged in the deep end for so long I've forgotten how to swim on my own - the depression is always there, like a weight, able to pull me under. Even as I seem to be going strong and staying afloat.

Find any essence of hope in your life and focus on that, communicate as much as you can, and look to the future. We're only here for a short time. It's just not acceptable to live a life off balance, because there's too much sunshine. Know that you're lucky. And even if you're Not MacGyer, the New And Improved MacGyver Coming Soon, or Jack O'Neill or Sylar, Your Life with Diabetes is one of hope and adventure and anything you want it to be. There's not a need for escape. Not when you have these Happy Thoughts to reflect on and share your life with. Life is good, even with the D.

Thursday, January 7, 2010

Soccer v. Basketball

Differences between Type 1 and Type 2 diabetics is an issue that can divide and draw emotional reactions from many of us Living wth the D. For example, this was the focus of a marathon Tweet session with Shannon earlier this week, leading to her awesome and insightful post at LADA-dee-da, and a similar TuDiabetes discussion in the past day or so.
I have my own thoughts on this topic that largely stem from the misconceptions spewed by the general public and media about how "diabetes" all appears to be the same disease of lazy, fat people and if you have it then it's somehow your fault. I take great offense to this: maybe it goes back to the situations as a child when people would say to my mom, upon hearing that she and I were diabetic, that "Oh, well you should have fed him better and he wouldn't have gotten it."

While the D-Community really needs no reminder that no definate causes have been found for either, even though some can link certain lifestyle choices to Type 2, that fact apparently escapes the attention of news media trying to spin a few. As a result, stories such as ABC Nightline's recent "Death By Diabetes" help spread the inaccurate and irresponsible views on this. As depressing as it was to watch, this story enraged me - as a Person With Type 1 Diabetes and as a journalist. The same can be said for most of the newspaper and television stories on this, and that is probably a sad reflection of the inadequate state of our country's Fourth Estate. I've penned a letter to these reporters, their bosses, the American Diabetes Association and JDRF, and a couple journalism organizations and media-watchdogs to bring attention to this - hope to hear something this month.

However, with all of this, I saw what seemed to be the most accurate and applicable analogy that could have been used to describe the differences between Type 1 and 2. Credit goes to Dino, a Type 1 in California who made this point in a blog comment and captured it so well. He says:

"It's like the comparing two athletes: a soccer player and a basketball player.

Things in common: both athletes are playing a game with a ball, tying to score points, running around, playing defense. Differences: one athlete is kicking a ball into a net, the other is throwing a ball into a basket...completely different games.

Can a soccer player and a basketball player work out at the same gym, doing similar routines? YES


Will they both benefit from a healthy lifestyle? YES


Are there rules of universal sportsmanship that both athletes should adopt? OF COURSE

But will a soccer player benefit by practicing basketball free throws? NO


And will a basketball player get better by learning how to bounce a ball off his knee or head? NO

This is why when it comes to MASTERING their respective sports...basketball players play and practice and learn and bond with other basketball players and soccer players do the same on their end. It's natural.

This is why retired soccer players don't coach pro basketball...

Imagine if the general population didn't know, and didn't care to know the differences between basketball and soccer. They just kind of lumped everyone together as "athletes" irrespective of the sport being played. It's just idiotic, and there would be a lot of ticked off "athletes" on both sides.

Saying diabetics are all the same...diabetes is diabetes" is like saying "athletes are all the same...sports are sports."
 True, in a most generalized and ignorant fashion, but utterly and completely wrong in so many ways at the same time.

In the end, as Dino and others say, these are two completely different diseases that share some common elements. We Type 1 Diabetics Who Faced Diagnosis As Young Children didn't have to "re-invent" our established lives as a result of diagnosis, yet those who face that didn't have to lose their childhood to this or have parents who face their own nightmares on a daily basis because of the D. Maybe part of the issue is that Juvenile Diabetes has more of a "face" in those children diagnosed, and in that they have their own organization devoted to those Diagnosed As Children and Type 1 Parents. It's more difficult to define an image for the adult-onset types, and these categories are broadly addressed along with juvenile diabets in the mission of the American Diabetes Association. We all get older and if diabetic will be living with it, while not all adults living with diabetes went through the same hurdles as a child or teen.

But those similarities must be what unites us, and the differences can NEVER be an excuse or justification for exlusion, rudeness, or meanness between the two types. United We Stand, or Divided We Fall, or so it goes. Manny Hernandez, founder of TuDiabetes, says it perfectly and does a remarkable job in this video about the Diabetes Differences and what we can learn from each other. It's worth a listen, and everyone should also take some time to get involved in the TuDiabetes Essay Effort currently underway to share their stories.

Regardless of whether we're a Soccer or Basketball Player, we must all make sure that each group has the chance to work with their sports traineres and coaches and has the right equipment for the game. We're all playing sports, and that unites us and means we can come together in those shared-aspects and help educate those others who may not be aware of or fully understand the differences.

Wednesday, January 6, 2010

Happy Thoughts

Seriously, too much is happening and it's all way to mind-engulfing. Deaths of diabetics. Blame. The slacking PR and Press world. Ponderings of what type of diabetes is considered "tougher" to live/learn with. Came up with a handful of blog posts to write, but somehow failed to muster the fortetude to fully write any of them. Just too much going on. I'll probably get to them before long, just not now.

My creativity is tapped. To steal and mend a classic movie quote:  "The money's gone, the brain is shot. But the liquor we still got."

Well, my sleep is gone and the brain is shot, but the good happy thoughts I still got. So that'sd what I'm going to spend some time with, before getting back on the blogging bandwagon. Tapping some happy images to guide you through this hiatus.

Hopefully they brighten your day a little as they do light up my world. I'm off to bury myself in work deadlines, deal with my plastic pancreas, and handle whatever else is out there. Just retend I've gone OTCB..... or more specifically: OFF TO COOK BACON.

Like I said, the good stuff. Happy thoughts to balance out the bad stuff in the world. Peace out. Enjoy the fun below...



Riley Dog eying Shadow Cat.
                                                                           Christmas 2009
 Crazy Days!


XMAS NINJA LANCE.T COOKING BACON (He's put down his Lancet NinjaStar and Lancet Numbchucks to cook breakfast here. But, he's always on guard.



Talk to you when I talk to you. Later.

Monday, January 4, 2010

Clouds In Our Coffee Cups

Once, there was great Coffee and Conversation in The Corner Booth. Hence the name of the blog. Endless refills, analytical conversation at any hour of the day or night. Back in those days, we sat for hours on end and pondered what seemed like the great mysteries of our day. Those seemingly ever-present Clouds in Our Coffee Cups.

But alas, that was in Michigan, before the move to Indiana.

Now, those times are gone. The Corner Booth has been replaced by the Diabetes Online Community, Email Conversations, Facebook, Twitter, and the overall boundless blogosphere. Real Life Coffee & Conversation still happens, just not as often. The big world does seem a little smaller, but those Clouds still find us.

For me, I regularly find myself confined to the office breakroom where free coffee flows from seemingly endless coffee cups. Each day during the work week, I bring my Detroit Skyline Coffee Mug into the room and fill it up. Countless times. Probably not the best thing in the world to be enhaling massive amounts of caffeine-filled coffee all morning and into the afternoon, especially for someone Living with Diabetes. But, it is a reality. I've given up Diet Coke successfully (=almost 2 months now!!!). But not coffee. I've been a coffee-drinker since my mid-teen years. I'm a newspaper man, a journalist, and the coffee-drinking comes with the deadlines and insatiable need to cover the news and tell a story. It's as much a part of me as this Disorder of Pancreatic Failure.

Following the extended holiday breaks and slower pace during December, I eased back into my work routine Monday morning and prepared for the rest of the legal community to do the same. My D-related and non-diabetic New Year Resolutions are plentiful (see Expanded Resolutionizing), and I strived to make a start on them today. All in the company of a good cup of coffee. Amid my work, I happened to look down at my desk at one point where my coffee cup beckoned to me. I caught a surprise.

It was a WTF moment. Glanced again. Then just shook my head and started to smile as I looked at what sat on the desk in front of me:

Yes, that's a test strip floating in my coffee. No clue how it got there. But indeed, it was doing the backstroke and looking up at me, laughing that it had spoiled my next sip of java. Thinking back on the experience and the events leading up to it, there's certainly the possibility that the cause of this may have been: a mid-morning test that revealed an unexpected and unexplained 232, which led to swearing and the tossing of my Meter Case across the desk. There may very well have been flailing test strips involved.

Anyhow, this was the result. I chuckled. And my mind wandered. I thought about the test strip in there, mocking. Doing the backstroke, as if emersed in a giant round pool designed specifically for it to look up at me and laugh. Of course, there was also the image of it drowning in the Dark Waters of Diabetes, the caffeine saturating it to the point where it was full of energy but unable to escape thanks to the higher-than-normal blood sugar that just kept it treading water.

Realizing that I was indeed at my desk and supposed to be prepping for a phone interview, I flushed these images aside. Those are Clouds in My Coffee Cup, but ones for another day. Being the D-O-C member that I am, it was indeed a priority to immediately Tweet about this new find. Got another good laugh out of it privately, then decided to pose my One Touch Ultra Meter and Test Strip Jar next to it. All in good fun.

With that, I moved on to the breakroom and emptied the mug. Rinsed it out with hot water. And proceeded to refill it. Aahh. Good stuff. Going back to work, it dawned on me that this deserves a spot not only on my D365 Project wall, but also a blogpost all its own. There was a deeper message here than just a used test strip floating in my coffee....

This was a clear sign that no matter what we do, Living with the D is always present and able to throw us a surprise - sometimes funny or good, sometimes just frustrating to the point where we want to just dump out the day's coffee and give up. We see these clouds everyday: the used supplies littering our desks and homes, the lows that come out of nowhere like a punch in the stomach, inopportune pump site malfunctions, insurance coverage wars, Unwanted Pregnancy Blood Sugar Swings, Swapping Symptoms, Flat Tires That Force Us To Walk in the Freezing Cold So Our Blood Sugars Fall, Eye Failures And Ensuing Pirate Talk, or whatever else may come our way. All while the rest of life keeps chugging along, despite us and our D. Life isn't distracted, and neither should we be by these too-distracting moments.

Sure, it surrounds us everywhere. Our D-365 Projects attest to this. But there's more happening with us than just diabetes. We see this reflected in the eyes of our Loving and Supporting Spouses, Friends, and Family, in the joys of playing with our pets, in our non-diabetes roles, and just little moments when the sun rises or the moon shines a certain way. We must always be on guard and able to roll with the punches. Making sure we don't swallow the unwelcome stuff or even take it too seriously, but instead realizing that we must be strong and carry on. To just empty out the cup and fill it back up the way we need to. And move on.

There will always be Clouds in Our Coffee Cups, but we have the strength to simply laugh at those challenges, empty out the nastiness, and fill our lives back up with the good stuff. To have both Laughter & Tears. Every Day, Every Hour, Every Moment. You know, to make a sort of Lemonaide Life.

Friday, January 1, 2010

Expanded Resolutionizing

On New Year's Eve, a conversation began at a local brewpup south of Indianapolis. The key players were myself and my wife, Suzi. Others, such as the Oaken Barrel regulars and bartenders, chimed in periodically. Our focus: New Year Resolutions.

"I don't believe in them...," I began.

"But I do have one for 2010: that is to carry on what began in 2009. That's my resolution."

My statement referrenced the ninja-like diabetes care I'd really started pushing at the latter part of this year, keying in on what I should've been doing all along.

Regular testing. At least five or six a day, but often more. Results coming in most commonly below 200. Accurate carb-counting. Basal and bolus tweaking to avoid lows. Regular contact with my Endo. Continued contact and support - giving and receiving - from the Diabetic Online Community, via Twitter and Facebook and blogging.

Seemed like good enough resolution-making too me. Particularly since my checklist was already checked off, as I'd started it before Jan. 1 and simply had to continue what was already happening.

However, some other D-bloggers went out and made their own resolutions and put them out there. This inspired me, and made me realize I resolved to do more than just keep up my own D-care. I had given a Christmas gift to my parents that vowed to do more, volunteer and participate with the JDRF, and tht had to be a part of this.

Plus, thanks to Kerri at Six Until Me, I now have the Beatles song, You Say You Want a (Resolution)" in my head. Thanks, Mrs. Sparling!

So, here goes - Expanded Resolution-Writing for 2010.

- As stated above, continue the above tasks that began in 2009.
- Be a more active D-O-C member, reading more blogs and leaving more comments on those I visit.
- Obtain my 25-year Diabetes Awards from Lilly and Joslin, even though I'll be in my 26th year of Living with the D.
- Meet with Indiana's Democratic Sen. Evan Bayh, through the JDRF, to discuss legislative priorites relating to health care and diabetes.
- Take up an effort to support a non-national D-organization or effort, such as Zip The Cure or Diabetes Research Institute, or a local D-Camp that you can actually see helping people.
- Volunteer with the Indy JDRF in person and online.
- Try to once again attend the Indy Promise Gala in April.
- Meet in-person at least 3 other members of the Diabetic Online Community, in which I consider my inspiration and constant support.
- Test the other two CGMs, and decide whether I want to purchase one.
- Lower my A1C to 7.0.
- Actually fundraise and participate in the 2010 Walk for A Cure in Indianapolis.
- Make it through another year (this time turning 31 on Feb. 1) without any complications.
- Give more credit, thanks, and appreciation for everything done by my Loving Supporting Wife, Fellow Diabetic Mother, and Father Who's Supported and Lived with PWDs for So Many Years.

So, there it is. My expanded list. Hope others have their own goals, and find the ability to meet them in this New Year!