Wednesday, March 31, 2010

2 + 2 = 5

As a teenager, I sat in the cold unpersonalized classroom listening to the obese man in the front of the room. He sat at a raised podium-like desk, spouting strange phrases focused on numbers and angles and how they all connect. A blackboard in the background was littered with figures and symbols, but none of it made any sense to me. Mr. High School Math Teacher broke from his monologue and pointed a question at me, grimacing as I shot back an answer that indicated I was clueless and didn't much care about what he was talking about. His face contorted as if in pain, and he held up and shook a large textbook as if to say, "This is important to your life and you should care, Mr. Hoskins."

In response, I gave an answer that hadn't been said aloud to a teacher before: "No, it's not important to me. I'm never going to use this in real life. If you can tell me how that's going to be important to my writing career, then maybe I'll take more of an interest."

That was in 10th grade, my final year of the two required for high school math. That led me to college, where I went into journalism and sidestepped math for philosophy. What I'd give to go back in time, kick that kid in the head, and pay more attention in math class. That sophomore year's classroom math denial was years before I'd find it necessary to become a Human Calculator, responsible for Diabetes Math on a daily basis. Math has come back to haunt me so often, but even moreso since I recently began a Pump Hiatus for the first time in nine years.

On my trusty insulin pump, routine scenarios such as Carb Counting, Correction Calculations, and Insulin On Board Adjustments were simple. Punched a few buttons and the math was done. Without taxing my mind or having to tap into my sub-par mathematical abilities. But now, without that pump, I'm on my own. Going online or looking at nutrition books or sheets is easy enough, and occasionally I can muster the skill to add up the items on the list and draw up a needle for that amount. Occasionally is a key, here.

But food labels confuse me. And EVERY bite of food carbs means you face a Stowaway Math Problem (see George and Scott's awesome YouTube video on this!). For example: measuring out 1/3 cup that costs 13g for each serving, and I'm eating 3.5 servings. Plug that into the equation with an insulin-to-carb ratio of 10g (which I refuse to change because that's a simple number that offers HOPE for easier calculations.) Then factor in a correction bolus for a 202 mg/dL, and adjust for the snack or correction bolus taken a couple hours ago that hasn't yet worn off completely...

Ugh. Seriously. Even though I typed that above graf, my mind tuned out right after the spot about measuring a 1/3 cup portion. Had you been here watching me type, you likely would have observed my eyes glazing over. There's numbers, symbols, lines, graphs, angles, and weird herioglyphics floating across my sightline... Ugh. But this is such a regular part of life, and food-makers don't ease the difficulties, either. Like when you order a pizza, and the pizza-makers own website says one slice out of 8 costs so many carbs... Yet the pizza you've received is cut into 10 slices! WTF?! C'mon! It's like they're trying to make my D-Math more difficult!

Luckily, I'm not totally lost to the Dark Mysteries of the Math World. Thanks to my wife Suzi, who's a banker and math guru. She's got the skill.

This means that while Suz is the calculator, I'm left to say what I want to eat, possibly help in cooking and preparing it, and letting her fill me in on what it all costs (in the Hoskins Household, that's our lingo for carb counting: How much does this "cost?"). It's a great partnership. Admittedly, though, I'm the weaker link as I'm just lost without her.

Anyhow. In the first days off the pump, I kept Bacon Gibbs handy simply for the math. But then he refused to solve any math problems without having a filled, ready-to-go reservoir. So reluctantly, knowing the implications of my actions, I took out the battery and resolved to tackle the Dark Arts of Mathematics. Thanks to my phone that has a built in calculator, my work and personal computers that have desktop calculators, and any other number of calculators spread out in my world. the daunting task is at least manageable. Suzi is a lifesaver, too.

But I'll admit that even outside the addition and subtraction, the D-Math is more difficult without a pump. No constant basal stream to help guide down BGs at any given time. No extended boluses, especially for food items like pizza and chinese. The Lantus Pen injections I'm taking each night at bedtime appear to wear off in final stages of the 24 hour period. And the peaks and leveling off periods are different.

I'm just a little "off." This could just be the first week, in that my body's just getting used to the differences. Hope so. Because math is tough enough, without having to factor in these other nuances. Fellow D-Blogger Jim Huck, a math teacher by day, recently delved into this topic with a bit of humor that struck a cord and had me laughing out loud - a common happening when reading his great writing. He presented a D-Story Problem:

Johnny is a type 1 diabetic who tests his blood sugar at 6pm and discovers that he is 240. He had eaten 3 slices of Round Table Pizza at 5PM (when his BG was 118), which had 72 grams of carbohydrates and 30 grams of protein. He had already taken 4 units of Humalog at 4:45 PM, and his normal insulin to carb ratio is 1/13. Since the pizza has a lot of fat, Johnny expects that it will take about 3 hours for the pizza to finish digesting. Taking into account that his meter has a 20 percent margin of error, the food label has a 20 percent margin or error, his insulin dose at 5PM could have been off by as much as 39 percent, and now that his blood glucose level is up at240 mg/dl, his correction ratio could be off by as much as 30 percent. The question: How much beer will Johnny need to drink to forget that he has diabetes? Round your answer to the nearest six pack.

That's it exactly, Jim! At least some of us PWD are math teachers, have math-inclined spouses and family members, or simply can rely on insulin pumps for some math help. It does us well, even if we didn't capture the pride of our High School Math Teachers. We should form a D-Math Club, with Mr. Huck leading the way!

As far as the math goes, I'll look forward to returning to my pump in a month or two. Then I won't need to be a Human Calculator as much. Maybe then, 2+2 won't equal 5. Well, maybe it won't. I'll never be the person who could have answered that question posed so many years ago by Mr. High School Math Teacher, but at least I can look back and know that he had a point. Consider this my semi-public apology: Mr. H.S. Math Teacher. you were right. I should have paid more attention to you, because math is important to my life. Especially my D-Life. Wish I would have known it then.

Sunday, March 28, 2010

Parting Is Such Sweet...

My eyes opened. Groggy, barely able to take in the morning sunlight streaming in through the bedroom window. Kicked the covers off my body, lifting myself up and swinging my feet toward the side of the bed to stand up and welcome the new day. The dog appeared, wagging her tale and putting her front paws on the bedside to greet me with a wet nose and good morning kiss.

As I stood, my hands habitually went to my waistline to feel for my Minimed Paradigm 722 at its usual spot. Nothing. Eyes only slightly ajar, my hands surveyed the bed and felt underneath the pillow in search of the stray pump. All while I gained my footing, and prepared to take the first step away from the bed. Still nothing, and the thought of my pump tubing becoming taught and pulling loose my sight entered my mind.

Panic. Eyes opened fully, and I scanned my surroundings in search of my missing lifeline. That’s when it hit me: There’s no connection. For the first time in 9 years, I am not attached to any insulin pump. Unconnected. Unhinged. Free.

This was the start of my Pump Hiatus, which began about midnight Friday/Saturday. The first two mornings seemed surreal as I grappled with the reality that my Bionic Limb wasn’t attached, but set aside for that nostalgic routine of injections. Hello, MDI. Hello, again.

Parting is such sweet sorrow... but sometimes it’s necessary. Just as Juliet said it to dearest Romeo, so I say it to an insulin pumping lifestyle that I've enjoyed since the summer of 2001, my final year of college. We are sad to part ways temporarily, but it's sweet as I will be healed when the two of us finally reunite.

Don't get me wrong. I love what pumping has done for me through the years. The daily flexibility and ability to achieve tighter control is amazing and irreplaceable. Not to even mention the CGM choices we now have, which allow us to have a more constant tracking of where we're at in D-Management. It got me down to a 6.1 A1c at one point, and that's proof that it can be done.

But all of that means constantly being connected to a device. Suzi calls me the Bionic Man, and the pump is a Bionic Limb. It's always there, minus the short and periodic disconnections for showers and other personal moments. When sleeping, you must sometimes adjust to where it's placed on the body. It can be knocked off your body if you aren't careful. Sometimes, the sites just don't work or the infusion sets malfunction. Kinks. Blockage. Sets coming loose or getting knocked off. It can be frustrating, aside from just having to find a new spot of Real Estate for the site to go in the first place. There can be gushers, and it seems in my case they always spring up when I'm wearing a white dress shirt.

It’s become a routine struggle, an emotional trigger point that leads to my breaking down out of sheer frustration that my body just doesn't support my pump usage.

For those reasons, I've reflected more fondly on the days before "bolus" and "basal" become a part of the daily vocabulary. When you took a shot in the morning and went about your day. Sure, the control and flexibility wasn't there, but you didn't have to lug the pump and set with you all the time. There were no bionic limbs. In a way, I’ve missed that "freedom." Those were the days since March 1984 and that final year of college.

Nine years later, I've realized that my warn-torn body needs a break and this is the best time for it. My body needs time to heal from the pump infusion sites that, against the FDA guidelines, sometimes have stayed in place for more than the recommended 2-3 days. Most recently, a left leg site didn't work and after a few days evolved into a blusher that may have been slightly infected. As I'm simply out of Real Estate, and struggle so much with the frustrations of even changing a site, Dr. P and I decided that a break would be the best move.

Will try a month then see if another would work out.

Needles and pen needles are free, thanks to insurance. So this also helps on the financial front by being able to put off ordering new pump supplies for a bit. That’s an added bonus. Initial two Lantus Pens come from Endo’s office as samples, which is also bonus that avoids having to pay for them at the start. Three should get me through a month, so at least I can wait a couple weeks. Picked up my initial Lantus Pens on Friday afternoon, with direction to stop pumping at midnight and taking my first long-acting injection. I’m on a 28u bedtime basal, which is slightly less than the total 30 pump basal Humalog units. Got a prescription filled for the smaller 50-unit needles for the small bolus amounts I’d be taking for food or corrections, and tried to keep those to a minimum. BGs ran a little higher for the weekend, in getting used to the new style.

It was interesting having to hand-calculate all the carbs and corrections, rather than having the pump automatically do the math. Grrr. The first night of chinese food was interesting, but BGs came out quite nicely. Injections arne't as precise with shots as it is with pumping, I came to remember once again. But the freedoms…. Oh they’re great.

Showering without any connection. Being able to sleep on any side, in any position. Wrestling and playing with the dog without having to worry about tube tangling or sets being knocked off. I’m sure the workweek will bring similar joys, like not having a device attached to my belt or having to worry about tube tugs whenever the shirt is tucked or untucked. Of course, there's challenges: relearning the differences and how my body reacts to different foods with injections, not an hourly basal. Carrying needles with me and making sure the Humalog is full. Having to take more shots when more food is added. Of course, remembering I'm not connected or restrained by tubing.

Good times. So, the Journey begins...

Friday, March 26, 2010

Bzzt, Bzzt, Bzzt

Imagine a Crazy Diabetic Man, loose in the streets and wanting to do harm. Armed with syringes and little lancets and always in search of people to stab. You don't have to speak to or bother this man, just somehow stumble across his general vicinity and he may come after you. Stinging you relentlessly.

This isn't an episode plot for Criminal Minds or Law & Order. Actually, it's a reality. No, not a reality show, but something that is happening. Whenever the weather is warm. You see, this type of aggressive, evil, and crazy-stabbing-with-a-sharp-object happens each spring, summer, and fall. You've likely observed this behavior. Possibly, you've been a victim yourself already.

The simple truth: We aren't talking about Crazy Diabetics here. It's about Bees. Wasps. Hornets. Anything That Buzzes and Stings. I write this as a warning to all who might encounter them.

You see, I don't like bees. Or wasps. Or anything really that has the ability and desire to sting. While I'm not a fan of bees by any means, wasps are must worse. They are like the evil cousins of the casual, only-aggressive-when-challenged bees that just want to make honey and sniff flowers. No, these things are pure, unadulterated evil. They know me. Watch for me. Taunt me. Stalk me. Attack. Pure Evil.

I am quite terrified of them, to be perfectly honest. Ever seen a grown man scream and run away like a small child running from the Boogeyman? Yep. Been there. Done that.

Once in college, a stroll through the woods near a little mansion on our college campus led to one Flight of Fear. We were walking ever so peacefully, hand in hand. All was well in the world. Then, out of nowhere, it happened. There was a BZZZZZT in my ear. A buzzing that couldn't be mistaken for anything but a bee, hornet, wasp, or other Creature From Hell that was probably gathering with friends to sting me beyond repair. I jumped about a mile high, and instinctly brushed the swarm away from my body. Then, I ran. It turned out this wasn't a stinging insect. Actually, it was the vibrating pager at my waist. At the time, I didn't have an insulin pump but similar situations have materialized with the pump in later years when it's decided to vibrate, imitating that fearful buzzing sound.

As a newspaper man post-college, I've been confronted by these evil little insects while interviewing a state senator at a waterfront boat race. Yet, in the presence of him and the family, I managed to make a circle around a picnic table before dropping the costly hot dog in my hand and "bee-lining" it to the parking lot. That was somewhat embarrassing, but I make no apologies for it.

Last year, one maliciously landed ON ME as I was innocently walking down the street toward my office. Landed right there on my black pants, on the upper right leg. It stared at me. I was mortified. First, I froze and tensed up in terror. Then, reaction hit. Dropping my work bag, I did a crazy-man dance in place and booked it toward the front of the building at full speed. Swerved to avoid the homeless man in my path, who was dutifully minding his own business and sweeping the sidewalk. Left the bag in that spot for about five minutes, to ensure that the stalking wasp wasn't hovering nearby like a sniper, waiting to strike with a sting on my exposed skin. Fortunately, I made it out of that unscathed.

What causes this bone-shuddering fear, you ask? Am I allergic to stings? No, I'm not. But that shouldn't matter. Does there really need to be a reason? Why shouldn't we be afraid, very afraid, of these little stinging insects? If I ran around carrying a lancet or syringe and stabbing people, there might be some uneasiness created whenever I draw near, right? Right!?

It likely goes back to a situation as a child, when I was stung on the eye. My little cousin and I were outside my grandparents' house, doing whatever it was as children we did. Memory tells me that he had a baseball bat and for some reason was swinging it at the nearby hedge. There apparently was a hive inside those bushes, as was later discovered. My cousin was swinging away, and at one moment I happened to look over his way... Just in time to actually watch a bee streaming toward my little face and fly into my eye. Pain.

This bee was huge. Probably about the size of a basketball. It came at me with the force of a bullet, angrily seeking out vengence for the baseball bat swatting near its home. It probably told its friends. Being that I was one of the two people there, and now years later have lived to tell this tale, you can count on the accuracy of my firsthand, eye-witness account. Trust me.

I'm sure helping the fear was a the tale my grandfather once told me, about a friend of his dying after a bee flew into his open beverage at a Memorial Day Parade, stinging him on the inside of the throat. Oh, it makes me tense up just thinking about it.

Anyhow, this is likely the foundation for my fear of Anything that Buzzes.

This past summer, these above-mentioned wasps made decisive battle moves in our ongoing war. They made homes in strategic places around key areas of my home - by the front walkway, near the garage door, close to the porch, and near windows that I might someday forget are being targeted and open for a breath of fresh air. They are smart. They watch me, flying around with their little black bodies invading my turf. Grilling isn't safe. Playing with the dog is a risk. Lawmowing is possible, but only if you're outside a 10-foot area surrounding the house. And you must be careful at that. Sitting out on the porch with an open drink? Now that's just insanity. A death wish. Hell, I'm lucky I can even dart quickly enough in and out of my garage when it opens to run and fetch the mail.

Usually, I am armed with one of my many cans of wasp-killer that are placed in multiple points inside and outside the house. Just in case. You never know. With wasp hives hidden in the siding and little barely-visible crevices of my house, you must always have the right ammo in case of attack.

Sympathizers will say that bees and wasps have a purpose, that they do good for the environment. Baloney! I don't buy it. Sounds like propoganda to me. I refuse to believe it. They're bent on aggressive domination, and I won't be pursuaded otherwise.

With spring sprung and warmer weather consistently on the horizon, the inevitable presence of wasps in my life is here. I contemplate how I'll deal with them this year. I contemplate whether insulin could be used in the counter-attack, in defense of my body and home. While it might be viable, I'm not about to 1.) Waste my costly life-saving serum on Those Things.. or more importantly 2.) Get close enough to inject insulin into something that has a needle attacked to its body and is bent on stinging me - not once, but over and over and over and.... Nope. Not gonna happen.

So instead, I'll arm myself with cans of spray. Eye my surroundings carefully. Watch my back whenever outside. And know, that even if I can't see it, there might be a Crazy Diabetic-With-Stingers stalking me and waiting for a moment to strike. And sting. Sometimes, all you have is a quick Buzzing before the sting arrives. Just like a CGM vibrating a warning when BG levels get too High or Low, this Buzzing might be a sign in itself. A sign to run. To get out the can of spray. To ward off the stinging that might be moments away. Maybe these little evil insects wear Insect Insulin Pumps themselves, and that's what is buzzing... Really. It doesn't matter. Point is, there's a warning and you can do something about it.

With that, I wish you well on the battlefront. And hope, truly hope, that this post saves your life someday.

Thursday, March 25, 2010

In A Nutshell


Sometimes, pictures speak 1,000 words. This Is It, in a Nutshell. Here's to hoping we can all keep it together long enough to matter. Or at least long enough to make it to a time when a Blog of Substance can be summoned from the depths of the mind. Here's to hoping for better Health, ongoing D-Living, and Everything Else that's tapping time and energy. We go on...

Wednesday, March 24, 2010

Glucoastering

We know that Living With Diabetes brings High and Lows, and that often it seems as if we're riding a curvy rollercoaster that never ends.

That was my Tuesday. It sucked.

Woke up to 167 just before 6 a.m. Ok. That's fine. Disconnected for a shower, got dressed, went to office. By 10 a.m., I'm at 335. WTF?!?!

It seems that whenever I use the Quicksets, it doesn't connect properly and I end up going high. Went to office men's room, took off shirt (thanks, arm site) and dis-re-connected a couple times to ensure the link. Corrected. Half hour later showed 351. By noon, the correction was working - down to 191. Getting better... Ate lunch, bolused, worked. Three hours later: 97. Then, the trend that I've seen on consistent days: dropped Low by the time the afternoon was ending and commute home was near. Hit 60, which a day earlier had been 43. Was still dropping. Ate some glucose tabs, grabbed some leftovers from breakroom, and waited to be at safe driving-levels. By the time 6 p.m. came, back up to 120. Ate dinner and dosed, but went back up to 247 by 10 p.m.

With that, I'm totally tapped. Combined with overall life stresses and frustrations about running out of pump sites on my warn-torn body, I am exhausted. Just want to keep it together for rest of the week. On deadline and busy with work, plus a D-related lunch meeting on Wednesday. So this post is about my ranting about the Glucoastering Blood Sugars that ruined my day. Someone on Twitter came up with this term recently, but I honestly don't recall who it was and don't have the energy to dig up that info to credit the appropriate person. Whoever it was: You Rock in Verbage.

So, that's that. But, as the song says: "Tuesdays gone.... with the wind." So I have that going for me...

Oh... There was one great highlight to Tuesday: Ninjabetic's Birthday! The Diabetes Online Community united in wishing him a happy bacon-filled birthday, and I echo that sentiment. Hope your day was a great one, G!

Here's to a more-stable Wednesday & Beyond.

Tuesday, March 23, 2010

D-Alert Day: For Us, Too

Today is March 23 and it's the American Diabetes Association's annual Diabetes Alert Day. Always falls on the fourth Tuesday of March, and this marks the 22nd year. Basically, this awareness campaign is designed to make people more aware of Type 2 diabetes and offer them ways to assess their own potential in developing this condition.

As this date approached, I began pondering a question that usually comes to mind everytime this Tuesday rolls around - What does this really mean for me, or anyone who's already been Living With Diabetes for any period of time? Particularly for those Type 1s who were diagnosed as children? The name almost implies we should be involved in it, but really does it even apply to our worlds? It often spurs some resentment for the misconceptions that are so prevelant in our society, relating to the differences between types and how it's portrayed inaqeuately under the same umbrella term. Type 2 is the "epidemic" and rightfully deserves attention, but so often everything else D-related gets pooled into that same box and the nuances are lost. I've written about this before, that Type 1 diabetes is Not An Afterthought.

Wanting to get past the Blame Game and not be a D-Downer, I did a quick online search using Google and some of the my most regularly-read D-Blogs. Of course, several have blogged about this through the years. One that stood out was Amy's post at DiabetesMine back in 2008. She encouraged all existing PWD to "Make This Our Own" day in a few ways. They're worth repeating and practicing.

1. For those who already have diabetes, consider this a “Tell-A-Friend Day.” Talk to someone in your life about what it’s like to live with diabetes - ideally someone who doesn’t yet know the basics, like the difference between Type 1 and Type 2. If everybody “told two friends and they told two friends,” we could do a lot towards educating people. I'm going to reach out in the name of Diabetes Advocacy.
2. Make a donation. Doesn't matter if it's a few dollars or a large chunk of the paycheck. Maybe today is a good day to go to the Children With Diabetes or JDRF sites and show them that we stand behind them.
3. Do something "mentor-ish." Maybe checking out local programs, through the ADA or JDRF or even a local diabetes education center. Sometimes, Children's Hospitals or Endo Offices have these types of activities and are always in need of more help. The idea is to help somebody new to this whole Living With Diabetes issue, to share what you've been through and help them through it.

All in all, this is a part of being a Diabetes Advocate and helping people understand what this chronic condition is about. Too often, Type 1 is lumped together with Type 2 diabetes. That causes society to look at us Type 1s and wonder if our diabetes is "bad" or "uncontrolled." simply because we're on insulin, and not "just pills," and because we must count carbs or test so frequently. Thanks to recent televised words from Those Claiming to Be Knowledgeable, millions were led to believe that the more insulin you use, the "worse your diabetes is." As a Type 1, I want people to know that this isn't my fault or the fault of my parents; I was diagnosed at age 5, and no lifestyle changes could have prevented this autoimmune disorder, and that it's not manageable with just a pill, diet, or exercise. Sometimes, you can't recognize Lows coming on because they strike suddenly, causing you to lose control of your ability to think rationally or control your body. Sometimes, sugars go High for unexplained reasons and all you can do is react to bring them down to safe levels as quickly as possible.

Type 1 is a different animal than Type 2, even while some of the D-management methods are similiar.

With Diabetes Alert Day, we can use this time to focus energy on Type 1 education, despite the day being directed at Type 2. It could also send a message to that Type 1s, while a minority of the overall Diabetes Community, have a voice that can be heard.

Monday, March 22, 2010

Just Because...

Lawmakers made Insurance Industry Reform History with a 219-212 vote on March 21, 2010. This may reshape how Americans deal with wellness and illness overall, particularly those of us in the Diabetes Community who have faced the arbitrary, profit-driven unfairness of our current health insurance industry.

To be clear: I don't understand much of this package, and do think there are good and bad elements in it that will continue playing out through the coming decade and beyond. In my eyes, this isn't a cure. Rather, it's possibly akin to the creation of home-use Blood Glucose Meters (widely inaccurate as the FDA is exploring, but still very essential in our daily lives.)

With that, I offer some coverage from the trusted Indianapolis Business Journal (Disclosure: my employer, though I work for its sister legal-newspaper) that has an ace health industry reporter covering this beat. Here are some highlights that I've taken from this, with my thoughts following in italics:
  • When the law takes effect, companies like WellPoint Inc. (Anthem, BCBS, & Others) will no longer be able to deny coverage to those with expensive medical conditions - the ever-crippling pre-existing clauses that we PWD know so well. These insurers will face limitations on how much more they can charge a sick person than a healthy one. By 2014, individuals will be forced to have insurance and companies will have to offer insurance—or else pay a fine.
    • First part, I completely agree with. Mostly for reasons that SixUntilMe's Kerri talks about today. It offers me a sense of relief, after a lifetime of fear and caution. Secondly, we can argue politically about the anti-capitalism theme and mandates on individuals... Not totally convinced on the merits, but I am trying to have faith that this will provide motivation for the insurance industry to make needed changes with us in mind. 
  • Expansion of insurance coverage will be paid for with a new Medicare payroll tax on individuals making more than $200,000 a year and families making more than $250,000. Much of the rest of the money will come from $12 billion a year in new fees on the health industry: Drugmakers will collectively pay $2.7 billion a year. Health insurers will pay $6.7 billion a year. And makers of medical devices will pay $2 billion each year.
    • Tax the rich. But that's not all. Then, tax everyone else who may not be rich but may be a consumer of devices such as insulin pumps or CGMs, drug-makers who will pass on these taxes as business production costs to the patient users, and private insurance carriers that will do the same and pass on these taxes to the insured.... Possibly resulting in people having less access, less affordability, and more people having to search for better insurance, or turn to these "high-risk pools," state-run exchanges, or govt-subsidized plans. Hmmm... Just don't know. This scares me. And believe me, I'm by no means anywhere in the rich bracket. Nor do I have anything like a Cadillac Plan that will face a similar issue.
  • More people with insurance is good news for just about every sector of the health industry. It should mean fewer unpaid bills at hospitals and more customers available to doctors. It also means more people will be able to afford expensive prescription drugs, such as those made by Indianapolis-based Eli Lilly and Co.
    • This makes logical sense to me. And That Is All.

  •  The bill creates a pathway for generic versions of biotech drugs to come to the U.S. market for the first time. However, Eli Lilly and its Peers successfully lobbied for 12 years of exclusivity on their biotech drugs, a big increase from the 5 they currently enjoy on chemical pills. Patents can extend those periods of exclusivity even longer.
    • I think I agree with this, because my mind goes to the generic possibilities that might make brand name-makers more mindful of the costs. Plus, generic insulin = Yes, Please!
In the end, I have Hope & Faith that this is a starting point that will lead to Change. As the ADA puts it in their reaction to the House-passage of this hcr:

“Today is a day for celebration for the 23.6 million American children and adults who are living with diabetes. The passage of health reform.. finally tears down the wall that keeps people with diabetes from the health care they need,” said ADA board chair Nash Childs. “With the passage of health reform ‘just because you have diabetes’ will no longer be a lawful excuse to deny coverage, to charge exorbitant rates, or to take away care just when a person with diabetes needs it most. It gives all Americans with diabetes a fighting chance at controlling this devastating disease before they face blindness, amputation, heart disease, and kidney failure."
 
That arbitrary insurance theme of denying us "Just Because" They Can haunts me; it's haunted me ever since I've been old enough to know what was happening. This this is a start. I do worry about the hidden costs and impacts of this, but that uncertainty is anything but certain and could not even exist. With this, I feel like I'm an American whose voice HAS BEEN HEARD that something had to be done. (Yes, there were these voices out there! Oh my!) Now, I hope that the industries that make decisions about my Quality of Life will also hear my voice on this and not just go about their business as usual without listening. THAT is the reform we need in this country, and to me this represents a step in that direction.

Importance of Accuracy

Accuracy has been a long-discussed topic in the Diabetes Community, but most recently it's been the blogging rage because of an FDA meeting on blood glucose meter accuracy. Last week, several fellow D-Bloggers posted their thoughts on this topic - KellyK, Kerri, Samantha, and ScottS to name a few.

Of course, I'd be remiss if not to mention Jim Huck, who has an incredibly funny post on the topic. Being a math teacher, he poses this scenario:

Johnny is a type 1 diabetic who tests his blood sugar at 6pm and discovers that he is 240. He had eaten 3 slices of Round Table Pizza at 5PM (when his BG was 118), which had 72 grams of carbohydrates and 30 grams of protein. He had already taken 4 units of Humalog at 4:45 PM, and his normal insulin to carb ratio is 1/13. Since the pizza has a lot of fat, Johnny expects that it will take about 3 hours for the pizza to finish digesting.

Taking into account that his meter has a 20 percent margin of error, the food label has a 20 percent margin or error, his insulin dose at 5PM could have been off by as much as 39 percent, and now that his blood glucose level is up at240 mg/dl, his correction ratio could be off by as much as 30 percent.

The question: How much beer will Johnny need to drink to forget that he has diabetes? Round your answer to the nearest six pack.
Outstanding, Jim. Simply AWEsome.

Anyhow, on to the FDA meeting that spawned this Accuracy Talk...

This two-day meeting happened March 16-17. To get at what criteria should be changed "in order to promote greater public health," the FDA sought input from physicians, nurses, healthcare providers, industry representatives, diabetes educators, professional societies, consumers and even patient advocate groups.

In covering this event, Reuters wrote it like this: "At issue is whether incorrect meter readings stem from problems with the technology or other issues such as patients or doctors and nurses not using the devices properly. Other problems can include trouble with test strips, blood samples, hand washing and other factors that can impact results."

Those Operator-Error excuses seem to be what the industry is hanging it's hat on in why inaccuracies happen, outside the mentality that any 20% deviation is allowable. A similar theme was expressed at another recent FDA meeting, where Insulin Pump Failures were explored and manufacturers and industry-insiders indicated that it's not their fault mistakes happen; it's the patients not doing something properly.

I take offense at both of these messages, and it makes me seriously wonder if the FDA is getting the full, accurate picture on all of this? Consider this statement by industry consultant Barry Ginsberg, (an MD & Ph.D who heads the New Jersey-based firm Diabetes Consultants: "How much accuracy you need depends on who you are. Those with Type 2 diabetes who treat their condition with diet changes and oral drugs don't need to monitor their blood levels as closely as those with type 1 diabetes who take insulin."

Are you serious???? Accuracy only depends on who you are? Wow.

In reflecting on this issue, I began pondering the luxury of being able to be inaccurate as much as 20% percent of the time, or being permitted to be "off" by that much at any given time....
  • Being a journalist, accuracy is my top priority. If I was allowed to always maintain a 20% error margin, this would mean that names and titles would be misspelled, and facts would simply be wrong. This doesn't instill public confidence, and I'm sure that the FDA meeting leader wouldn't appreciate having their names and job descriptions butchered.
  • As a responsible member of society, I pay taxes. Yet, I'm sure that the IRS wouldn't be pleased to receive up to 20% less of their owed money each year. Same goes for state and local income taxes, as well as property taxes.
  • Driving is a large part of my life - in the most daily of routines such as commuting to and from work. A necessary part of this means obeying traffic laws, staying in my own lane of traffic, and not running red lights or traveling at a pacer higher than the posted speed limit. Next time this doesn't happen, and the police decide to pull me over, I'll go with the 20% error margin excuse: that I was within that range above the limit, or that the specific traffic law I violated wasn't part of the 80% being obeyed that day.
  • Being on time is important and I must meet deadlines in both my personal and professional lives. When a meeting begins at 8 a.m., I must be there at that time - not 8:10, or 8:20. On Time. Or else the meeting starts without me, I get into trouble, or something else consequential occurs.\
  • As a Type 1 diabetic, I take insulin. Calculating is extremely important. If I take too much, my blood sugar levels drop. That could happen at bedtime, resulting in dangerous lows. If that happens, I might not wake up. The paramedics might have to be called, resulting in your tax dollars being spent on me and my medical emergencies rather than on your company's new driveway entrance that you've requested be constructed from the local municipal board. Nope, sorry. You don't get that business benefit because your inferior product is contributing to the tax dollars being spent on something else. Thanks to your inaccurate blood test meter readings and my subsequent Lows. Our Loss, and Yours.

  • However, this 20% error margin isn't the world we live in - except maybe when you're talking Blood Glucose Meters. These above examples may seem like an Apples & Oranges Comparison, but I don't see it that way. We all must live with accuracy and standards in this world, but some are not expected to be held to that same standard on a topic that literally means Life & Death for so many People With Diabetes. As well as those non-diabetics, who feel the ripple effects of our lives in numerous ways.
In my Quarter-Century of Living with Diabetes, I've seen mostly-cosmetic advances in BG Monitors - meters have gotten fancier, smaller, and come in multiple colors and sizes. But they're no more accurate than back in the 80s.

We must do better. Now. Not a decade or two from now, when it's more financially feasible or companies feel better about it. We're long-overdue for this improved accuracy.

Raise Your Voice on this important issue. Submit a public comment the FDA prior to the April 20, 2010 deadline. Here's how:
Go to the Regulations.gov page on Blood Glucose Meter Accuracy, which can be found by the Docket ID "FDA-2009-N-0604.” Questions about posted comments can be directed to the Dockets Management Public Room at (301) 827-6860.

For reference, here's my FDA comment:
I am a Type 1 diabetic who was diagnosed at the age of 5. At age 31, I represent the 10% or less who have this chronic condition form of diabetes. Regular blood glocuse testing 8-12 times a day is necessary to effectively and adequately manage my condition, so that it doesn't result in higher costs for prescriptions and complications that is most likely with inadequate control. When I began testing at home in the 1980s, the standard for error margin was roughly 20%. Despite our advances in diabetes management and technology in the quarter century since then, that standard remains a reality today. This inaccuracy could mean the difference for someone taking too much insulin for food they eat, resulting in a Low bloog glucose level that impacts their driving ability or puts them into a coma. Results that are actually higher than displayed also means that People With Diabetes are not able to accurately correct with insulin and bring their blood glucose levels down to regular ranges, meaning they stay at these elevated levels longer and ultimately are impacting their long-term health. Overall, this drives up the cost to society: police and ambulance services needed, any hospital services that might be needed, and the bigger cost for prescriptions and medical care needed as a result of unstable blood sugars. To classify this inaccuracy as "no big deal" is simply irresponsible, particularly at a time when we as a nation are discussing overall health care costs and reforms for the insurance industry. We must do better.

Friday, March 19, 2010

Never. Ever. Often. Always.

NEVER forget how much....



Your puppy loves you. Or how much love you should show each day. Just like you should never forget to test your blood sugars and take care of your diabetes.

But sometimes, it happens...

So, if you EVER forget to test or love your pup or kitten, just remember: You'll pay for it.

 With a sad, depressing look. Or a High or Low Blood Sugar.

Then, you'll have to play with puppy or test your sugars OFTEN to balance it out, using all the tools in the shed.

This will teach you to ALWAYS love your dog. To ALWAYS remember that you must take care of your diabetes. There isn't a break - that love and D-Care is always around. If you try to take a breather, there'll be more work and care needed in the end.

Of course, you may also learn another important lesson from someone who could have predicted how it all was going to turn out:



The Cat knew all along. Because the Cat is ALWAYS the smartest one in the room. No doubt.

So go on. Live, Laugh, Love as much as you need to - anywhere in between NEVER EVER and ALWAYS. Find your balance. And all will be right with the world.

That. Is. All. Happy Weekend.

Thursday, March 18, 2010

2.516667

Over the course of five days recently, Minimed Customer Service has been a regular part of my life.

151 minutes of my life, to be exact. Little more than 2.5 hours. Can't say how much of this was On Hold Time, but I'd venture to guess most of it. As a result, I've become very accustomed to the company's On Hold Tunes, to the point of knowing how the system often quips in with an automated message affirming how important you are as a customer and that someone will be "right with you."

Through all of this Holding different tunes play in the background. An instrumental of Solitary Man may be streaming through my phone speaker, but that's not what I hear: Nope. To me, it's the Jeopardy theme music, taunting me as my fingers quicken their table-tapping pace. As the frustration grows, Eye of the Tiger begins playing in my head as I feel a Rocky Balboa-like adrenaline surge. Blood starts boiling and I'm ready to start tossing punches at the Unknown Minimed Rep Who's Yet To Answer The Phone. Yo, Adrian!

Luckily, I have speaker phone and the ability to multi-task while waiting for a live person, who may or may not be able to answer my questions and provide some type of "excellent service" so promised for whatever my concerns are at that particular time. Never before have I had Customer Service issues with Minimed, those echoed by so many in the Diabetes Community. But, it appears the inefficiency finally found its way to my little D-Corner Booth.
For these 2+ hours, I was in search of help on three overlapping issues relating to my Paradigm 722 or the necessary supplies.

1. A battery issue is the first problem. My pump (affectionately named Scarface, for the reason that it has a scratch across its face) is eating the battery life much too quickly. Say, within a day or so in some cases. It's not the battery type. It's not a question of my backlight or remote or meter linking. I've been pumping for 9 years, 7 of those with Minimed. I know when something isn't working properly. We tried a new battery cap, and when that didn't work, Minimed agreed to replace the pump. This took up about 30 minutes.

2. New pump received. However, I want to download the data from Scarface before sending back and starting use of the New Pump, which is tentatively named Bacon Gibbs. That means using the MM Carelink Program, which requires a special USB. The one I have doesn't work - so trying to resolve this meant devoting more than 36 minutes of my time on this topic one day. The Customer Service Rep. seemed fairly clueless, and after more than a half hour informed me she couldn't help me outside the basics that I'd already tried before even calling. As it turned out, my call was on a Saturday evening - which falls outside the PC Software Dept's hours (M-F). She said the specific department was open between the hours of 8-6, and it was currently after 7 p.m... I reminded her it was Saturday. That didn't seem to register. That I HAD TO WAIT UNTIL MONDAY. It was like talking to a wall. Finally, I hung up on this woman.

Phoned several times the following Monday while at work, but couldn't spare more than five minutes on hold so had to postpone it until after work hours. Finally, got through on the commute home. The message told me up to 15 minutes of waiting, and of course the "next available representative would be right with you." About 20 minutes later, a customer service girl came on the line. As much as I tried, I couldn't bypass her quickly - it took 10 minutes to get her to realize that I needed the actual PC Software People to help. Another 20 minutes of On Hold Time.

After 50 minutes, and another five recapping my issue, the PC Software Rep wanted me to do everything again that I'd already done for Clueless Customer Service Rep. I explained I wouldn't, that I'd done this already and it should be in the notes, and that I simply needed a new USB. He did offer one piece of advice, about wrapping my pump in aluminum foil and trying again - the purpose was to eliminate any possible other wireless activity that may be interfering. While I wasn't in front of my computer and coudn't do this, he said the only way to ensure that wasn't an issue was to do this while on the phone - if not, then I'd have to do it and call back. Of course, no way to guarantee I wouldn't have to wait 40 MORE MINUTES to get right to them in that department, after going through the main switchboard. Not wanting to waste even more time, I kept him talking and got to the computer to try the "Foil Trick."

It didn't work, so he finally agreed to ship another USB. That call came out to almost 68 minutes.

3. Of course, this all made me recall another Minimed-based issue - billing. Had ordered supplies back in November and December (one order, they split billing in two because of 2 shipping times). However, in billing me, they mistakenly billed my wife's deductible instead of mine. She's the policyholder, I'm the patient. But they didn't grasp this, and so the insurance EOB had it wrong. Really, the amount was the same and our deductible reset in January, so the only practicle impact would be on lifetime maximums - hers would get the hit, not mine. After many phone calls, it became clear in January that Minimed had to resubmit this. That's been pending for 2 months. So, I called to check.

The Billing Dept. Rep couldn't tell me why this hadn't been resubmitted. Insurance had confirmed earlier that day (after a quick 10-minute call) that it wasn't yet resubmitted by Minimed. So, the MM woman told me first it was insurance's fault. Wrong! She then said it was resubmitted, but couldn't tell me when. After holding for a few minutes, she realized that I wasn't going away and told me it was still being processed for submittal. She couldn't tell me why it hadn't been resubmitted, and took offense at my asking. She informed me that it wasn't my fault, and it would have to be paid for by my insurance. I verbally dismissed her lack of knowledge about my insurance and Flex Account circumstances, which dictate otherwise if I don't have the accurate paperwork by end of May. She told me I was wrong, about my own insurance coverage and Flex. I asked her how she knew this, and she says: "Because that's just not how insurance companies operate."

This led to some venting on my part. In the end, after about 13 minutes, I heard that this has been sent to her supervisor for "an expedited review and immediate processing for re-submission to insurance." Won't get a phone call, though. No need to call back to confirm this has been done, she says - trust that it'll happen. If it doesn't happen, it must be insurance company's fault.

I laughed, said, "Whatever. Fine. Thank you for your help on this." Hung up.

One last phone call on Wednesday, just to make sure the Old Pump Sending Back W/In 14 Days Policy doesn't overlap with the New Carelink USB Being Shipped, creating problems that could lead to my having to pay for said Old Pump not being sent back in a timely matter. I was assured it wouldn't be a problem, and this nice Customer Service Rep read back the note he made in my account. This was the most productive and helpful call, of the entire 2.5 hours I'd spent on the phone with Minimed. Total time it took: 8 minutes, 27 seconds.

Wonder if they'll pay any of my phone bill? For the waiting time? It should be like a pizza - if it doesn't arrive in said amount of time, you get it free. That should be the case if they say 15 minutes, and it takes them twice as long to get on the phone. Especially if they're worthless and don't even offer help to fix the underlying problem you called about. This same logic should apply to all Insurance Companies and Service Providers, which are the frequent call-receivers of our lives and frequently leave us in Holding Patterns. This is a policy discussion that should be happening, me thinks.

But as it stands now, It Is What It Is. I rant and rave. Just to vent.

In the end, it's 2.516667 hours lost on the phone to Minimed. Time I'll never get back. (sigh). Just another aspect of Living With Diabetes.

Wednesday, March 17, 2010

There Will Be Blood

Slow start this morning. Woke up just after 7 a.m. to a 433 mg/dL. Grumble.

Didn't sleep well last night, and apparently I'm accused of being restless and stealing covers. This was probably due to the High, which tends to make me a pain to be in the same bed with at night. Or so I'm told. Anyhow, this was one of those nights and now I knew the BG number to blame.

Looked down at my infusion site on my right side leg. Redness. Grumble.

Skillfully peeling the tape and Silouette stickiness away from my leg, I yank out the site.

Fortunately, I wasn't wearing anything with light colors. Anticipating what ultimately did happen, I had strategically placed a towel to cover up the newly-washed bed sheets that I had no interest in covering with blood. The foresight was to my advantage, it turned out. We had Blood. A Gusher.

With that, I've added another war-torn mark to my body. A Hallmark for any Insulin Pumper.

Grumble.

Not ready to deal with the frustrations of finding another usable site, I turned to a needle and injected the 10 units of correction bolus needed to bring me back down. (Side digression, this led to a depressing discovery, as I realized that I simply am now unable - at age 31 - to fully turn around and inject a needle into my rear-end. This hasn't ever been a problem that I remember, but there's been few injections needed in past 9 years of pumping and the few injections have been in my stomach or legs.... This may not seem like a big deal, but it is to me. This was always a safe site for me, since I wasn't and am not a man with fat in those needed injection sites... Places I need it most, it isn't there. So, I used my sitting spots. And now, I'm so out of shape I can't get there. This isn't a bright moment for me. But, I digress. Point: went with a leg injection, instead.)

Showered. Looked at clock, about 8:30 a.m. My plan to be at work early isn't happening, I thought to myself. Oh well. Prepped a site on my left abdomen. Insertion...

PAIN. Mother F'er! Yep, hit something on that one.

Yanked it out. More blood. Frustrated.

Grumble.

Put on my work clothes, including a green dress shirt in honor of St. Patty's Day. Exchanged some work emails. Talked to a law professor for a story I'm writing. Read a wonderfully funny blog about Cats and Working From Home... That's when I made the decision to work from home, at least for the morning. First to actually be able to insert a new infusion seet, then to get blood sugars back under control. Hate it when the D interferes with work, but it does happen.

It's about 10 a.m. Tested. 293. Still high, but it's coming down. Grumble.

Think about new site, but don't have the patience yet to deal with it. More work tasks.

Have been relatively productive in my work duties, despite the D-hurdles so far. That's one really nice thing about my day-job: the flexibility. I can work on my stories from my home office, as long as there's a phone handy. Emails exchanging. Reading of court documents or whatever the newest story entails. My boss is very understanding and awesome, and in these frustrating times of crappy infusion sites or Highs and Lows that result in lost time, it helps having those kind of people in your life.

It's now about 11:30 a.m. The morning is coming to a close, so it's time to think about getting to the office. Time to find a new site. My stomach and abdomen are war-torn, and it looks like there's been lost battles happening there. Really, I need to find new Real Estate. But, at this point, I'll go with the opposite leg for now. Don't like these sites as much, because they make me feel as though I can't do regular things like run and play with the dog, bend down normally, and not have to sit without being all cautious. But, they do tend to work for a couple days. So be it.

Test again. 147. Finally came down after that injected correction earlier. I'm happy with this. But a new site is still needed to keep that number in range.

A new infusion set sits on the table, glaring at me. Daring me to attach it to my body. My pump smirks. I'd like to throw them both against the wall, but that probably wouldn't be a financially wise move to make. Grumble. I grab the set, rip open the IV Prep, and prime the new site.

Here's to hoping there's no more blood. I've seen enough for today. Just let me be in peace. For now. No matter the fate of this infusion set debacle, if this latest one turns out OK and works for the next few days, I know there's a future I can't avoid. One with the inevitable reality that, yes, in the end no matter what you do: There Will Be Blood.

Cat: Happy St. Patrick's Day

For The Record: Not MY cat. Found this video online at YouTube, and couldn're resist posting it on here. My cat would never play along like this. Never.

Monday, March 15, 2010

Passionate Men

His eyes tear up. His voice wavers, his face emotional as pictures of his daughter and her future fiance flash on a large screen at the front of the room. That emotion is only so brief, before the man's composure returns and he returns to talking about his mission that wouldn't exist without that daughter.

Another man stands in the same room that day, sharing stories and talking about his own experiences with his teenage daughter. His eyes tell their own story, one that clearly shows he simply wants his girl to have the chance to live a full and productive life, to grow up and be happy like the first man's daughter who now has a promise ring to be engaged. Standing on a beach with a sunset in the background, the embodiment of happiness and perfection that makes the heart melt with joy.

Both men share a passion for their children. But their bond goes deeper, in that each daughter is a Type 1 diabetic. That's why these two men, and so many countless other parents of Type 1 diabetics, do what they do. These men and those like them (D-Moms too!) are on the cutting edge in their respective worlds, and what they do overlaps with countless others and is reshaping how we all Live With Diabetes.

That first man is Jeff Hitchcock, president and CEO of the influential Children With Diabetes organization that touches millions of diabetics, families, and people throughout the world. His daughter had been diagnosed in 1989 at 24 months old. He recalls not having any connection to other parents struggling to care for their D-Child. So this diabetic dad in 1995 tapped into the relatively new Internet and created an online community for those living with diabetes. We know now that this was a pivotal moment in spawning the still-evolving Diabetes Online Community, and CWD has become one of the powerful players connecting so many of us and touching millions of lives. J&J-Animas in 2008 acquired his company and it now fits into that corporate plan, but Hitchcock's creation began with a passion spawned by his daughter's life with diabetes. They have yearly conferences nationally and reach out globally. But while all of that is inspirational and important, this leader's eyes sparkle the most when speaking about his now 22-year-old daughter living a successful life. That's when he's not the CWD Creator - he's simply a passionate D-Dad. Who had a great idea and the passion to get it off the ground.

Mr. Hitchock came to The Children's Museum of Indianapolis on Saturday and a few dozen people came out to hear him speak. About his family's story, CWD history, upcoming conferences, and general diabetes issues and care suggestions from his perspective.

One person who attended the event was James Jordan, a D-Dad from the northside of Indianapolis who is also passionate. His daughter was diagnosed at 3, just a month before her 4th birthday, and she's now in her early teens. As a result of her diabetes, he's developing a very remarkable concept in diabetes management through his company Strategic Data Management. Using a Business Intelligence platform, Jordan is creating a new web-based portal designed to help diabetics combine all of their insulin pump, blood meter, and CGM data into one place online and get that to their doctors quickly and efficiently. Two local hospitals are piloting this portal and many big players are expressing interest in this concept. Here's a news release. And a recent Q&A in the Indianapolis Business Journal.

"I’ve always been very frustrated with the tool set being provided by the name brand manufacturers," Jordan says. "The tool set is very complicated. You look at it and you’ve got to be a Ph.D. to know what you’re looking at."

Personally, I met Jim and his wife Lynn and their daughter back in January for the first time. At a meeting about their new concept that really got started back in late 2009. Saw what it was, and started using it personally. Others in the Indianapolis area have also signed on to trial-test this online tool, and Jordan says so far it's very positive from users and health care folk who've seen it in action. While it's still in its infancy and being developed by Jordan mostly in a volunteer off-the-clock capacity, I am impressed. It crosses the lines we typically see created by companies who want to sell their own products and stop People with Diabetes from merging everything in the most efficient way. It hits that unfilled-need of giving doctors a way to get all of that merged data in an efficient format that doesn't have to change based on the patient.

In the coming months, Jordan's goal is to have paying customers. The business model: selling this to the medical and service providers, to the device manufacturers, to the payers. But it's free for the consumer. They hope to work with providers and be able to use the system to submit a claim for the work that doctor is doing on the portal as far as reviewing and managing data - since it's basically "free time" now built into general overhead costs. This would fall under preventive maintenance, and it'd helps them get paid for their time. Among some local hospitals and Endos - both pediatric and adult - Jordan is talking to "big players" that also includes the JDRF and state FSSA. Being in Indy, a healthcare corridor where players like Lilly, Roche, and Wellpoint-Anthem are based, Jordan's concept is in a prime place to get some footing before expanding beyond the Hoosier homefront.

On Saturday, Jeff and Jim met and had a conversation. Two D-Dads. Two great minds. A math man and a tech business man. Lots of passion. Standing nearby and watching these two talk, and seeing them both speak individually to others about their respective projects, their passion shined through more clearly than any business-model or bottom line. You could see it in their eyes, expressions, emotions, and body movements. You know and don't have to question the motivation for what these two men are doing.

This brought a smile to my face. To my heart. It provides me with Hope.

This is how progress happens. This is how we're going to Find a Cure. Because of these kind of people. This kind of passion. Who do what they do for their kids. All kids. Those Kids Who Grow Up. The families touched. Everyone who ever lives with diabetes, whatever the variety or when it enters their life. What drives Jeff and Jim is echoed across the globe, in all of us and those we know. That passion is changing our world.

Who knows what the future holds.

Friday, March 12, 2010

Bacon, Cats & Diabetes

A trend is afoot.

You must have seen it. It's pretty obvious. At least to those in the Diabetes Online Community who frequent the Twitter World.

Not a day goes by (usually) that Bacon or Cats aren't brought up in some form, and while it's sometimes random, there is often a connection to Diabetes specifically mentioned or implied. Blogs. Vlogs. Videos on YouTube. Tweets. Photos. Random Internet articles and Google searches.

All portray a simple reality consisting of Three Themes:

1. Bacon Rules. There's no question there. (We must honor Ninjabetic, the Almighty Bacon Lover and Connoisseur!) We have the concept of Bacon Cupcakes. Gifts of Bacon Toothpicks. This AWEsome video about Bacon Rockets, and a Rap about Bacon. Twitter's even ventured into the arena of creating Bacon Avatar Tributes. Wow.
2. Cats Are Everywhere. They seem to frequent our Diabetic lives. We've latched on to the Colorful Daydreaming Friskies Cat Mingling with Pilgrim Turkeys and Sailing on the Mayflower video. We believe this is proof of what our cats think. Most of us have voices for them. We have the stars, such as Six Until Me's Blasted Cats. We honor those Wonder Pets Who've Gone Before (such as Stacey's wonderful ferrett Elvis and CALpumper's kitty Katsi), honoring them with our love and insanity. There's many more - too many to list - that frequent our lives. Most of these furry felines seem to be plotting our demise, which isn't surprising given the PWD at issue here. One likely reason for this plotting is we chase the cats and pick them up, but also taunt them with Insulin Pump Tubing and Test Strips and even create little Tubing Hats for them to wear. That's probably why they want us gone. We suspect there's some larger Cat Plot of World Domination afoot, and so some of us are stocking up on catnip in anticipation of this apocolayptic cat event. It'll be a game-changer, for sure.

3. Diabetes Makes Us Crazy Like a Fox. Like zombies lured to the smell of fresh brain, we are drawn to insanity for yet unknown reasons. The above two points about Bacon and Cats proves this, and we turn to the DOC and online universe to spread our insanity as broadly as possible. One's insanity creativity and humor bounces off the Diabetic Waters and skids along even more, creating ripple effects that impact so many other lives and inspire our own insanity (er, creativity and humor). Our mental states frequently fluctuate just like our oft-rollercoastering blood sugars, creating a vicious cycle that is really quiet funny. This is probably why we turn to fun and humor, and hallmarks like Bacon and Cats.

Wow. What a phenomenon.

Some have recently pondered the connections between these three, wondering about the genesis of Twitter-talk surrounding them and what it means for the larger Diabetes World. That's a valid question that deserves more exploration. I'd say it's all about Community Spirit and being part of something bigger than ourselves.

Whether there's sanity there or not, really isn't the point - the point is we are Crazy. Someone should explore that and why Bacon and Cats are an apparent sympton or remedy to our craziness.

Somewhere, a scientist or university must be conducting a study about the connections between these three topics. You'd think it would be pretty justified, since there's already studies out there on everything else in the world you'd never think would be necessary. Like the ones I wrote about in 2007 that showed: "sedentary behavior linked to high blood sugar," and "Active Self-care Improves Blood Sugar Control." Seriously. C'mon.

Those all illicit a "No Sh...t, Sherlock" reaction, at least in my own little Corner Booth. You'd think a more intriguing review of Bacon, Cats, & Diabetes would be well worth the time and effort. To me, and really I can't be alone in this (or can I??), it only seems fitting that someone invest in funding a study on this. What a mindblowing research report that would be, full of potential for video and blog-writings and illustrations!

Short of a D-Cure, Closed Loop, or Artificial Pancreas, the results of this research could very well be one of the most beneficial and telling tales of our Diabetes Lives.

Just sayin'. Or maybe I'm just crazy. Whatever. I'm off to chase the cat and find some bacon.

Wednesday, March 10, 2010

Dia-versary (26 years)

The year was 1984.

No, this isn't an Orwellian story full of perpetual war, pervasive government surveillance, and public mind control. Though, it does have some of the same elements in a sense: perpetually battling Highs & Lows in a Never-Ending War, a need for pervasive surveillance of one's health, and the requirement that one constantly be disciplined to control mind and emotions.

You guessed it. This was the Start Of My D-Story.

It was most likely March, but could have been early April. Clearly, it was sometime just after my 5th birthday on Feb. 1.

That's when Type 1 Diabetes came into my life.

An exact date isn't known, as we didn't catalog that and any diagnosis records from Children's Hospital of Michigan in Detroit have long since been destroyed. However, we know it came on the heels of my birthday following my maternal grandfather's death in late January that year.

However, despite the exact date uncertainty, I've now made an executive decision that March 10 is going to be the actual Dia-versary for me. The reason is that today I received a 2-day rush delivery from Minimed - a replacement Paradigm 722 pump that is being swapped for my current Paradigm known as Scarface that has been sucking up too much battery life. So, this package arrived and made the day. And now I've named my new pump Bacon Gibbs - (thanks to creativity of several, including CALpumper!). Awesome.

So, the arrival of Bacon Gibbs seemed like a perfect anniversary gift to mark my 26th year, so that's what I'm using it as. Today is the day. From now on.

But in marking that yearly date on the calendar, it means looking back to that time in the 84 - a year when Ronald Reagan was our country's leader, when we saw movie classics like Terminator, Ghostbusters, Karate Kid, Temple of Doom, and Sixteen Candles. Of course, it was also a month when the NFL's Baltimore Colts packed up trucks and moved to Indianapolis in the middle of the night.

My Diagnosis Tale: An overnight visit to the paternal grandparents' home wasn't uncommon, as I was the first grandson and had many spoils as a result of their love. But the unfolding of events that day were anything but common, at least up to that point in my life. Awake often during the night. Excessive thirst. Frequent bathroom trips. Moodiness (for a 5-year-old). My grandparents explained these symptoms to my parents, who instantly knew there was a problem - as my mom has been a Type 1 since she's been 5.

Urine tests, which were mostly all that was available at the time, showed results that were very high. A quick visit to the pediatrician's office had that doc pointing to diabetes, but him wanting to send me for blood tests and admission at Children's. My mom recalls standing in the hallway crying, and having a staff member at this doctor's office saying to her, "Don’t worry, it’s not that bad.” Her response: “You obviously don’t know what is involved in this or what it is, or you wouldn’t have the nerve to say that to me.”

Once at Children's, tests confirmed the suspicions and I stayed there for three days, since I'd been diagnosed early in the "honeymoon" phase and since my parents already knew most of what they were instructing - diet, injections, other management aspects.

Once out of the hospital, memories aren't many as I was so young. There's one I do remember, and I've catalogued in my mind as: "My first injection." This may not be the case, but it's good enough for me as that's how I recall it. At this time, I was sitting on the couch in my grandparents' house and refused to let it come near me. There was an orange. Their Brittanies (family dog, up til my time) were present. I didn't want the shot. But, ultimately, the reality prevailed and I ended up with my pants down and the needle going into the behind. The first of many injections, which would last for almost two decades until the time when an insulin pump came into my life.

Despite some incredibly scary high A1C tests during my teen years and rollercoastering management styles through my 20s, I'm still here. Reached the big 3-0 and Beyond. Married, still alive and kicking without any hardcore complications interfering. Yes, there's some neuropathy and retinopathy that are at early stages. Then, again, some issues may just be coming with "older age" (HA!)

This really isn't a special year to mark, not like last year's achievement in being my first Quarter-Century Dia-versary. But, each one I suppose is important to recognize. So, there's that. In the coming months, I'm finally going to carry through on getting my 25-Year-Awards from both Lilly and Joslin.

The D-Adventure continues, now that I've passed the Big 3-0 in age and am settled at the uneventful 31. I'm thankful for how much stronger the experience of these 26 years has made me. Here's to celebrating that, and hoping for many more Dia-versities and hopefully a cure during my lifetime.