Friday, April 30, 2010

The Marveling D-Universe: Intro

A ninja stands on the mountain top, peering out over the California countryside and singing songs of hope for all those who may need it.

His mad ninja skills are always sharp and he advocates for the cause. Same goes for others, who use their lives and powers for a greater good. From Boston to California, Canada to Mexico. In the United Kingdom, Germany, and Australia. (Most recently, breaking news told us of a sighting in Minneapolis!)

However, there are villians out there trying to thwart those heroic plans.

Like the strategically schemeful Siah and Shadow Cats, who are bent on world domination and plot to conquer the galaxy. The Diabolical Doctor and Wicked Witch of Chicago, who spread fear and misinformation to trick the general population into believing they're the saviors. Or the Diabetes Police who appear to be nice and well-meaning but really strive to oppress and control lives.

This is the reality happening in public and behind the scenes every day in the Marveling D-Universe, where forces of good and evil constantly engage in battle. It's a never-ending Conflict of Cure v. Complication.

Of course, in this both fictional and non-fictional place, we have Heroes & Villians:

Those clear Heroes, who may fit into bigger respective Hero Groups
- Mrs. Six (who fights in the name of BSparl)
- The Lemonaide Lifers, led by Allison.
- Ninjabetic (+ sidekick Ninjabetic Jr.)
- SuperShan, who comes to the rescue with BG Meter+GlucTabs...
- D-Mom, who represents parents who are constantly waging war in the names of their children.
- Manny Marauders (via TuDiabetes.com)
- The DEX-Men (sometimes known as the Real-Time Guardians or Navigators)
- The One-Touchables, fighting crime against diabetics.
- The Paradigmers... They're pumped up.
- The Juvenators (a subgroup of online heroes within the JDRF)
- Crusaders for a Cure

Some straddle the line, doing what's necessary and always fighting the good fight:
- D-Pirates, who embrace thee pirate talk an' aren't fraid' to pilage ye treasures to hoist tho colors in thy name o' D. AARRRGGG, Mateys!
- D-Mob, which includes a number of folk who may get mad and raise their hands in opposition, but loyal beyond compare.
- League of Extraordinary Endos: sometimes they empower, sometimes cripple with criticism.
- The D-Ninjas: Led by Lance and Little G, these little ones sport lancet ninjastars, lancet tubing numchucks, and other Mad Ninja Skills to combat the villians but sometimes cross into gray areas.
- Siah & The World Dominating Cat Clan: bent on seizing control of the galaxy, they relish in their frisky-filled greatness and conquering all who oppose them.

The Villians:
- The D-Police, who try to convince you they're right and you're wrong on anything diabetes related.
- Diabolical Dr. Oz & The Wicked Witch of Chicago (i.e. Oprah)
- The Brotherhood of Complications, which includes key members such as Sugar-Booster, Mr. Hypo and Mrs. Hyper, KidneyKill, VisionVaporizer, HeartHurter, and Perio.

This is an ever-expanding universe made up by the Diabetes Online Community. More will join the roster. Some will fall. Alliances will be formed and sides will sometimes switch.

There is theme music - All the Diabetics by SugaSheen. Not By Choice by SuperG. The Type 1 Mom Song. YouTube Song and Tunage of all sorts to fit the mood.

Periodically, you'll be able to read the continuing D-Adventures that make up this world. There will be sub-plots within chapters. Occasionally, you may find guest-bloggers appearing to tell their own side stories outside the continuing D-Universe Saga.

You can read The Adventures of Little G. There's the soon-starting Lance Files. Endos who reduce us to tears, or inspire us to battle the D. One such adventure is that of Ninja Lance and Shadow Cat. He brandishes his purple lancet ninjastar to keep sugars in check. But finding pump tubing in a nearby room, Shadow wears it on her head in hopes of intimitading the hand-sewn ninja with mind games.

In this unfolding series, be ready for fiction to meld with reality and the daily D-Life Adventures we People With Diabetes. Analogies and random tidbits will feed the fiction, and send us into places that are both escapes and capturing the endless Cure v. Complication Conflict.


Stay tuned for more of the Continuging Marveling D-Universe here at The Diabetic's Corner Booth...

Wednesday, April 28, 2010

A Month Unconnected

At the end of March, I started a Pump Hiatus that was my first break from insulin pumping since I'd began it nine years earlier. This was a chance to help my war-torn body and infusion sites heal some. This in no way signalled any unhappiness with the concept of pumping, which was a life-changing experience in June 2001 and has allowed flexibility and better health in the near-decade since then.

Now, it's the end of April. I've been doing at least two shots a day in that time, sometimes as many as six depending on how many times I eat or correct in a day. I've written some in the first month, such as a post about my Raspberry Jammed Diabetes trending without a pump.

Overall, my verdict after a month: I miss my pump and all the benefits brought into my world. Life just hasn't been the same. My definition of "normal" has changed, and it's not a change I'm too enthused about on reflection.

The Minimed 722 (who we'll fondly refer to by the proper name of Bacon Gibbs!) has remained on the dividing wall near the stairs in my upstairs gameroom, sitting by itself and looking sad. There's a gleam of hope each time I approach, offering the possibility that the time has finally come to end that loneliness and reconnect. But alas, instead my hands grab a nearby syringe for my Humalog or even a Lantus Pen needle tip for that twice-a-day injection. Bacon Gibbs' goes glum, again, and sits in a funk until the next ray of sunshine comes near.

On a positive note, it has been nice not being continuously connected to a device. No infusion site to navigate around in sleeping, showering, getting dressed, or other moments where care is necessary. That frustration of having to switch and find new real estate has evaporated.

But the negatives so far have outweighed those gains, in my honest opinion.

Sure, you can live successfully and adapt quite nicely to Multiple Daily Injections (MDI). I was on injections for the first 17 years of my D-Life, and though I deviated from good control frequently, it wasn't because of impossibility - rather it was a question of motivation on my part. At times, my control was fine and proved that injections were

As my Endo, Dr. P, says: it's not about the pump most of the time. It's about the person. They have to want tight control.

I certainly want tight control, but decided after some boiling point moments earlier this year, that it was time to give the pump a rest temporarily.

Easier said than done, right.

After nine straight years of pumping, it's been tough to adjust to. My BG sugars are all over the place and I fear my already too-high A1C may be jumping even higher. The differences in how the insulin works in my system and food reaction times are all throwing monkey wrenches into my clogged system, and it's not making this control game any easier. Plus, it's always nice to have a record of carbs, corrections, BGs, and basals at your fingertips - something that's been an adjustment in having to more meticulously track these events in my memory banks.

One thing that this hiatus has truly taught me: it's how wonderful pumping really is, and how much you really do have to appreciate it. By knowing what you're missing, it's easier to hold an appreciation for a device that you can sometimes take for granted. This wasn't always the way, and technology can break - but when it works as a tool in your health management, what a wonderous experience it can provide. I'm thankful for that.

So, the time has come to think about reconnecting. Four Lantus Pens remain in my butter compartment. That means I'll likely get through May on the MDI and plan for June to get back into the pumping routine. By the time the summer routine gets underway, complete with a brief Orlando trip and weekling camping trip to Michigan, I'll be ready to once again be a Pumper.

Here's to June, when my D-Life goes back to "normal."

Monday, April 26, 2010

Wild & Wet Weekend

We had a wild two-part weekend, all to support Type 1 diabetes research and the Indianapolis Humane Society.

First, it was the annual JDRF Indiana Promise Gala in downtown Indy. I'd helped setup on Friday morning, one of about a dozen people who helped unload auction items from the truck and arrange in numerical order so they could be easily handed out to winning bidders on Saturday. Being black tie optional, we put on our Sunday Best and headed to the Marriott hotel in downtown Indy for the Saturday evening event, where the second floor was decorated in jungle and wildlife theory on point for the Wild For a Cure theme. More than 600 people attended, organizers said. Being that my company the Indianapolis Business Journal was one of the event sponsors, so the company got some free tickets for us and three other couples - otherwise the costly $200 per person event would probably be off limits. President of Pacers Sports & Entertainment, Jim Morris, was the Living & Giving Honoree and a local family with a 6-year-old son diagnosed with Type 1 about a year ago was the Find a Cure Family. They had a touching story, of courses, and spoke about the need to contribute for a cure.

Our complimentary dinner was outstanding as usual, and the speakers were great. Bid items brought in many thousands of dollars, with the highest-bid item being a 7-day trip to Steamboat Springs, Colorado for four people (about $11k). The 5-month old Golden Retreiver puppy named Couper went for about $3500, if memory serves. These items were off our affordability charts, but we had some pre-dinner silent auction fun by being the highest bidder on a 2-person, one-day getaway to the Cincinnatti Zoo with an overnight stay anytime this year (plus 4 free tickets to a baseball game in mid August for the Cincy Reds and Florida Marlins). Combined with our pair of $25 glasses of champaign as part of the Promise Toast fundraiser, we ended up walking out spending a "reasonable" amount that was slightly more than last year's Gala. All in the name of the JDRF's push for a cure, of course!

We endulged in the post-event coffee bar, went downstairs and sat and talked for a bit, then headed home. End of a good charitable day.

Of course, that was the  first "wild" half of the weekend. The 2nd "wet" part was Sunday...

The Indianapolis Humane Society's 7th annual Mutt Strut. Where we get to take our lovable 5-year old black lab Riley to the Indianapolis Motor Speedway for a 2.5-mile trek around the famous brickyard track. However, this year we had a hitch: Rain. Lots of it.

My day began about 5 a.m., when thunder and lightening pierced my sleep. My BG came in at 103, but weather forecasts clouded the mood as storms were forecast for the rest of the day. Being a "rain or shine" event, I plugged into the social media scene for updates by @MuttStrut updates on Twitter and Facebook and saw all was on as planned. We prepped the golf umbrella and weather-proof clothing and made our way to the Mutt Strut. Once navigating the traffic and parking nightmare, we arrived to a dog and person-packed Speedway that brought out poncho-wearing dogs of all sizes. Most were saturated, and our Riley was no exception. This was completely opposite from the 2009 event, which was hot and dry and resulted in several dogs having to rest in the doggie pools spread out around the track. Instead, they had too much water this year! We loaded up on many free doggie treats and products from the booths, and then journeyed out to the track. Walked for a bit in the steady rain and took some photos. Every once in a while, Riley would shake off her wetness and be ready for more. Despite the rain, she had a great time seeing so many other dogs.

Our SUV was filled with wet dog smell on the way home, but luckily we brought a towel to dry off Riley slightly. She rested the rest of the day, as did we once getting home.

If you're interested, I've put some photos on my Flickr Page from both The Gala and Mutt Strut, so check them out! You will also notice that our D-Ninja Lance, came along for some of the festivities. We allowed him to tag along for the Mutt Strut, but didn't know he tried to come with us to the Gala. He stowed away in the car, but we discovered him. He was flipping through the booklet about auction items, getting all excited, until we told him he'd be left inside the for the night. When we came outside later, we found he'd had his own little party and apparently got drunk off little bottles of mouthwash.... He had his fun, too!

In addition to those events, it was also fun to hear that I'd continued my award-winning journalistic work by winning two awards from the state chapter of the Society of Professional Journalists - a first place for a three-part series on wrongful convictions and exonerations, plus a second place award for a story about the nuances when a baby is legally considered a "child." So, now the award wall in the home office has some more items to display for some work done in 2009! Good stuff.

Overall, it was a great weekend devoted to a pair of worthwhile causes! Now, we wait for the next Gala and Mutt Strut adventure in 2011... At least there's much to do in the meantime before then!

Friday, April 23, 2010

Preview of an Active Weekend

This weekend brings much fun and festivity, all in the name of good causes.

Mostly significantly, the annual JDRF Indiana Promise Gala happens Saturday night in Indianapolis. We attended for the first time in 2009, as my company is one of the third-highest level sponsors (Eli Lilly and Roche are two of the highest level sponsors, for the record). Being Type 1 for 26 years, I'd never had a chance to attend a Gala before and it was awesome. We lost out on some of the fun silent auction items before the dinner and ceremonies began, but managed to buy a charitable drink for a good cause. This year presented another opportunity through my employer to attend this annual event and I jumped at the chance. Since I've become more involved in the JDRF, it has even more meaning. The theme: Wild For The Cure. Many auction items that will surely draw some charitable giving, including a 5-month old Golden Retreiver male puppy! (Value: A Bonding Experience... Priceless!). Last year, a puppy was the highest-bid item of more than $1,000... No reason to think this adorable little guy won't garner the same response! Anyhow, many more great items that I'm sure we'll put a bid on and see what happens.

While that event happens Saturday evening, I'm taking the morning off work Friday to help set up. The hotel is just a couple blocks from my office in downtown Indy, so it works out perfectly. This has been a particularly grueling work week on deadline and I've struggled to get my work done early (as that word is interpreted by a procastinating journalist who can aruge about the definition of "deadline"...) But, all turned out on track with a little extra work in the evening hours and paved the way for a Friday morninng of volunteerism! Although, this meant missing out on some other D-Advocacy that popped up last minute: word came in Thursday night that one of the few Indiana Congressmen who'd been difficult to arrange a JDRF Promise to Remember Me meeting with finally had some time... an hour away from downtown Indy. Not able to personally attend, but some others noted they could - so at least that worked out and work deadlines, plus both JDRF Volunteering and Advocacy, can all coexist this time around!

Anyhow, after helping put the Promise Gala together in part, we'll have a chance to see the event come alive on Saturday and hopefully hear from those able to secure that meeting with Rep. Mike Pence.

That's only a part of the weekend, though. The rest isn't D-Focused, but is also exciting.

Another big event is the Indianapolis Humane Society's Mutt Strutt, where thousands assemble with their pets for a 2.5-mile trek around the Indianapolis Motor Speedway. Our own Riley (the D-Dog) has enjoyed this yearly event each spring since we adopted her from our local Johnson County Humane Society in June 2007. It begins Sunday morning and usually lasts a couple hours,  but we all have a blast and Riley is completely worn out for a nap for the ride home and rest of the day. We've made our $50 donation and are ready to Strutt it Up!

Those two events make the weekend most active, though this year we do have a change from the past - we won't be attending the annual Society of Professional Journalists dinner reception the night before. I've learned I'm receiving two awards for stories written in 2009, which adds to the wall in my home office. We don't find out ahead of time what place awards these are, as that's announced at the event itself. The honors are exciting, but that's not why I do the journalism and really I'm much more excited about the Promise Gala and Mutt Strutt.

Have a great weekend. Let's hope the cats don't choose this weekend for World Domination, so you can stay tuned for Monday updates from The D-Corner Booth.

Wednesday, April 21, 2010

A Glimpse of Understanding

Disclosure: This blog post was originally written by Scott Strange (@Strangely_T1) who writes Strangely Diabetic. Seeing what a great work it was, I decided to personalize it to spread the "Understanding." So enjoy, but realize that most of this isn't my original work.

Here is your glimpse inside my Life With Diabetes. Read at your own risk, realizing I'm a 31-year husband who's had Type 1 diabetes since age 5, is by no means in good control, and doesn't pretend in any way to say anything that could possibly be construed as advice to be applied to your life.

As a PWD (person with diabetes) there are certain things that I do everyday without really even thinking about them. Having been diabetic since 1984, diabetes is like having brown eyes and brown hair. It's a way of life. Something I've lived with since age 5 and will probably live with every day until I die.

There is no cure. No treatment that can make it go away. This is something that must be managed every, all day, no matter what else is happening.

At 26 years of living with diabetes, that's more than 9,490 days so far.

That reality is something that a person without diabetes just can’t truly understand, even as much as they may want to. Sufferers of other chronic conditions can get a glimmer of it, I’m sure. But I know, as a diabetic, that I have no idea of what it is truly like to have a condition like rheumatoid arthritis, lupus, hodgkins lymphoma, or any of the multitude of other conditions that people can be afflicted with.

When I was 5 years old, I learned that I had a disease. I would always have this disease and it would kill me. Kids are often smarter than given credit for, so even tho parent’s want to protect their KWD’s (kids with diabetes) from stories of complications, given today’s media stereotypes, that is just impossible to do. So from an early age we learn that we can go low in the middle of the night and maybe have a seizure and possibly die. We learn that DKA (diabetic ketoacidosis) can put us in the hospital for days and possibly even be fatal.

And it is not only media, but friends. Will parents not want this KWD to be invited to a sleepover? Will another parent want to serve that child snacks or treats? What about Halloween? School functions? For a child who just wants to be "normal" and fit in, this can be a very solitary disease.

We learn that managing diabetes is much more an art than a science. We learn that it is like holding the ball on the 50-yard line. While balancing on one foot. With our eyes closed. You know you are eventually going to get hit, but you don’t really know from what direction it is coming. Did I mention the monsoon we’re standing in?

My first thought when the alarm goes off in the morning doesn’t involve the snooze button, it involves me asking myself how I feel - Low? High? Grabbing the Blood Glucose Meter to see what it says, trying in a still asleep fog what it said either at bedtime or the 3 a.m. hour when I got up to test.

Disconnecting everything to shower. Making sure I don't knock off the pump infusion set by washing my body, or by putting on my clothes. Checking my feet. Remembering to reattach everything. Making sure my meter is in my work bag, and there's enough test strips in the vial and extra pumping and testing supplies just in case before I walk out the door. Am I Low, do I need to some carbs before I drive?

In case you haven’t noticed, I haven’t started the work day yet. By this time, the clock reads only 8 or 9 a.m. and there are many many more minutes and hours of D-Living tasks to keep in mind.

The day at work is much like anyone else’s: stressful at times, meetings, deadlines. But my D-Life adds other worries to the list: will this high-stress situation drive my sugars up and will I correctly compensate for it? Does extra coffee in the morning mean I'll see a higher BG, and have to bolus for it? Did someone bring in breakfast and that means I need to calculate a carb count before eating? Is the meeting at a time when it is not too unusual for me to have a low, and should I eat something beforehand? How will an approaching deadline affect my schedule?

As is sometimes the case, what if my sugar goes Low and that complicates my work? What's the best way to bring it back up and make sure I don't have a reaction?

All of this goes on while monitoring my condition. Are my numbers reasonably normal for that time of day? Are they high? Did I miss my carb count or do I need to change my pump site? Are they low? Did I miss my carb count, have a little extra exercise or has my insulin resistance and/or sensitivity changed? Are the highs and lows happening at the same time for a few days in a row? Do I need to start making small adjustments to carb ratios, basal rates and/or insulin sensitivity? Are the lows dangerous enough that I need to make some big adjustments to get my numbers high and then tweak settings to bring them down or are they minor enough I just tweak to bring them back to a normal range?

Will new people I meet care that I’m diabetic and what diabetic horror stories will they tell me? Do I let those stories slide or let them know what I really think about hearing that?

We hit dinnertime.  How much will I miss my carb count by when I go out to dinner with friends? If it's a place I know and frequent, the food count is easy - but if not, then how easy will it be to figure out? Will the restaurant have carb info on all their meals? Are they even remotely accurate? What about a spontaneous night out with The Wife after work - did one of us remember to bring the Lantus Pen for the post-dinner shot that will last through the night? Hmmm. Advance planning sure does come in handy.

Once at the eating location: Should I test in the car before going in, or when ordering the food? How long will it take the food to arrive? Should I take my insulin when ordering or when my meal arrives? If injecting with a needle, should I excuse myself and head to the restroom stall for that bolus? Remember to pick test kit up off table before leaving and test before driving home.

So now I’m home for the evening. Like everyone else, we PWD’s deal with all the other things in life that non-PWD's have: family, work, friends, hobbies, bills, taxes, favorite shows, telemarketing calls, what’s for dinner? How many carbs will be in that?

Why am I having trouble reading right now? Is my sugar low? Yes it is, that’s right! I sometimes suffer from hypoglycemia unawareness. The meter shows 42. Will 15 carbs be enough? Am I actually capable of getting to the carbs? How much insulin do I have on-board? Is this low a reaction to a bolus at mealtime or a reaction to a basal rate that is too high? Or is it just one of those WTF moments where there is no explanation??

Did I get my sugars back up or am I still chasing this low? Did I have too many carbs, and will I go high for eating too much to compensate? If I did, do I want to correct before I go to bed? If I do correct, should I pull myself out of bed at 3 a.m. to get up and test? If I don't, will I be able to wake up at all or will my wife have to stuff honey into my mouth or call the paramedics? Will I ramble like a crazy man and get violent because of a Low? Or, is it just not worth those possibilities and it's better to keep my sugars higher for the night? If I do, am I risking complications like blindness or heart attack at some point in the future?

If all goes well, I'll make it safely to tomorrow - which is another day, another 8-10 finger sticks, 150 carbs to count, more results recorded, a thousand scenarios getting played in my head about the day and the future. But that's not my concern at the moment. For now, today is ending and that's my concern.

Now I lay me down to sleep, I pray the Lord my levels to keep.

Monday, April 19, 2010

All Heart & Smiles

Life is so often about attitude.

We all must have Heart. That's a given for those of us who are human beings. We need a Functional one to pump our blood, while we also need to have an Emotional Organ that spurs Spirit, Passion, Laughter & Love. Necessities for a full, quality life.

The same can be said about our mouth. We must have the functional aspects of healthy teeth to chomp down our food and simply be able to talk and smile. But an important half of that same equation is the ability to use our mouth for spreading smiles, and being a voice in whatever we chose to be advocate for.

I like to think I've got both the functionality and emotional aspects covered for both my heart and mouth. But that may not be the case.

Though I'm only 31, I'm worried about already losing a part of that essential equation made up of Functionality and Emotions. Without one part of each equation, you can't have a Healthy Heart or Stellar Smile.

For about a year, I've been noticing some "uncomfortableness" in my chest - to the tune of likely heart burn as no tests or anything else showed problems. Wouldn't exactly describe it as "pain" or "tightnessm," just more of a slight ache or even more of a heart burn - like feeling periodically. Not associated with exercise or eating, to indicate activity or heart burn might be a cause. In recent months, it's been getting noticeably more pronounced. But the blood work and regular doc visits didn't show any visible concerns.

My Endo wanted a stress test, though. We set it up to go through my main PCP first for insurance purposes, rather than initially heading to a specialist for more-expensive testing there. The appointment with Dr. W was the first step. Attaching the sensors to my chest and legs, I layed perfectly still and let the EKG machine do it's thing. EKG Lady told me first that everything looked fine. Dr. W later confirmed that the test showed the electricity was pumping as it needed to, and nothing appeared wrong at this stage. It's only a snapshot of the basics, he cautioned. A treadmill and stress test, followed by something having to do with dye, was also part of the process to get the full picture. He said the word "nuclear" and my mind started to wander, but he reassured me it was nothing radioactive that would turn me into an alien. At least there's that. We parted ways and promised to followup one the stress test was complete.

I was cautiously optimistic, compared to how I'd felt before visiting Dr. W's office.

A day before, a Combo-Punch from both Endo and Dentist gave way to news that diabetes-caused gum disease was likely impacting and bringing down my overall health, to the point that my thryroid is even more out of whack, fatigue has rolled in, and the heart "uncomfortableness" has become more noticeable. Thanks to wonderful caps on insurance that doesn't reset until June, the cost is prohibitive at the moment to get the needed gum treatment. Without it, the chances of heart trouble are higher.

One medical professional said: "If there's a perfect storm of medical issues, you've got it."

Wow. Great. There I go again. Being all revolutionary and unique. CRAP.

Honestly, this all has me on edge.Trying not to over-react and get all concerned about every ache or itch, but I'm scared.

I've just entered my third decade. Yes, a quarter-century of that has been a rocky marriage with Type 1 diabetes. I've had Scary High A1Cs in my younger years and D-Management was always the priority it should have been. The risk and warnings have always been there. Stats tell the reality: Diabetic adults have heart disease death rates about 2 to 4 times higher than non-PWD, and heart disease was noted on 68% of diabetes-related deaths in one study in recent year.

On the dental side: I've never had the bestest dental habits throughout my years, but I think I've done an average job - apparently not good enough. The past decade has presented numerous cavaties, root canals, and now gum disease. I've been told that diabetes is likely assisting in all of this happening. Those risks have been there, too: diabetic young adults are twice as likely to develop gum disease, and those with A1Cs greater than 9% are nearly three times more likely to have severe periodontitis. Plus, a third of diabetics have severe periodontal disease with loss of attachment of the gums to the teeth. The same goes with gum disease.
But neither the Heart Risks or Gum Fears have never fully set in until now.

The initial EKG was a bit of good news. But seeing the full picture may have to wait. Thanks to insurance caps and a nearly-tapped flex account, I simply can't afford to pay for the stress test on my own at this point. Too many other bills to pay. Some other pressing health issues that must be addressed first. Not to mention the regular D-Supplies required to simply live. Insurance resets June 1, so we'll see what happens then.

A priority will be the gum disease. While dental insurance is ridiculously insufficient and it's tough to pay for that procedure, it's determined that it may be an underlying cause for how I feel. It may be impacting the heart. So, we'll start there. And see what happens.

In the meantime, we wait and try to remain positive. Brushing. Flossing. Eating healty. My D-goal remains the same: to continue pushing for better D-Management and Lower A1Cs. This has been a priority and it will continue to be a main one as I strive for overall health improvement and optimism.

No sense dwelling on the "what ifs" or negative aspects. Even if there is an issue worth stressing over, I'll cross that bridge when the time comes. Knowing that whatever I may not have in Functionality, I'll make up in Spirit, Passion, Love & Life. For as long as I need to.

Life will be full of Heart and Smiles. No matter what the doctors and test results say.

Saturday, April 17, 2010

Crashing Into Uncertainty

Crashing.
Into the shivering waters of uncertainty
Where Low is the only height to achieve.
Trickery tricks me into thinking.
Comprehension Exists.
Crashing beyond.
Common it becomes.
57. 36. 43. Fearful figures.
Cloudy vision casts into sight.
Warped memories invade my mind.
Crazy conversation steals confidence.
Can't escape
Clouds of Uncertainty.
Lower than they should be.
Craving-carbs, but cashless.
Quick surge needed.
Until I can soar higher
Toward safety, sanity.
Comprehension.
For now
Causes completely unknown.
A combo of two, maybe one.
Mixtures soaring too high.
Catapulting me downward.
Into a wave of uncertainty.
Change is needed. Now.
Certainly.
That's the only certainty.

Wednesday, April 14, 2010

For Accuracy's Sake

The night hour was late. I suspect it must have been bedtime.

Earlier that night, I had eaten an easy carb-counted meal and dosed appropriately for it. That followed a Blood Glucose of 120 mg/dL. Certainly, a bedtime BG in the mid-100s wasn't an unreasonable expectation.

A 457 mg/dL flashed across the screen of my One Touch UltraLink.

"What the...?!?!?!"

I backtracked, not believing it.

All food calculations had been right, enough time had passed, no extra stress, no tea or coffee, etc...

My mind flashed to the recent debate about Blood Glucose Meter Accuracy and the existing error margin rate of 20%+/-, and how "patient error" is so often blamed for the inaccurate results rather than some device inadequacy. This must be a more inaccurate reading, I concluded.

Convinced, I became determined to get an accurate reading. Enough blood. Correct coding from test strips. Hands washed and dry.

Then, another thought came to my mind: What if "higher" blood remnants are clinging to the used-lancet in my finger poker? Hmm. When is the last time I really changed that little finger poker? Don't know. Maybe.... Hmm.

Changing the lancet, all the stars were aligned for a more accurate reading not tainted by any spot of "patient error." Finger pricked. Blood puddles on fingertip. Soakes into strip. Five... Four....Three...Two.... AND: 452.

Well. Crap. Fine.

Got over the frustration and corrected, then went to bed to get some sleep for the next workday.

But over the coming days, my mind couldn't get past the whole Lancet Changing issue. So many of us in the Diabetes Community reflect on the point that we rarely change these little lancets. Not nearly as much as we should, with every finger stick as the FDA recommends. Some of has habits of doing it once a week, or every time we change a vial of strips, or once a month, or... You get the point.

Ellen (@CureT1Diabetes) started a forum discussion over at Children With Diabetes directly on point, and someone rhetorically asked about members ever going through a full box of lancets. I started wondering that myself. Know that I have, but couldn't begin to say how long it took or when the last time that happened. Another realization: in my 26 years of living with Type 1, I doubt I've gone through 26 boxes of lancets. Now that makes you think.

Of course, Bennet made the great comment: "Remember, when you change your lancet, don't forget to change the battery in the smoke detector." Awesome.

More seriously, though: Patients may call it slacking, or not that important. But others, like those working at BG Meter Companies, this may be what they describe as "patient error." Basically, results can be off because of any number of things we do. This is one of them.

In March, I wrote about the Importance of Accuracy from a patient's perspective. Here's a step into what those at the recent FDA meeting described as the "patient error," to try and appreciate that aspect. Especially as the April 20, 2010 public comment deadline draws near. 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.

Maybe we should pay attention. It's tough, but there's a reason.

We all want accuracy when basing our lives on these numbers. And, while we have much way to go as it relates to improving the meters themselves and pushing for better standards, we PWD have our own improvements to make. We, too, can do better.

Monday, April 12, 2010

Wrestling Diabetes

A Morning Low this past Friday turned me into a wrestler.

A D-Wrestler.

The opponent: Suzi, my D-Wife.

We were forced to wrestle against diabetes. Stories are that it was quiet the competitive match, and it wasn't pretty at times. But we pulled through, and it's taught some lessons.

That night before, I'd gone to bed on Thursday night, still on newspaper deadline and prepped for a pretty active Friday morning trying to finish what needed to be done. Bedtime BG was 495, a consequence of Date Night that yielded great wine and dining in downtown Indy. Though I'd done a slight SWAG (Scientific Wild-Axx Guessing) for dinner, the result was still somewhat surprising. Took my night-time Lantus Pen shot, an hour or so earlier than the night before. Calculated the bolus, realizing that it might be worthwhile to check at 3 a.m. just to be safe. Headed off to bed and throughout the night all appeared well.

Suzi got up for work early, and all appeared fine about 7:30 a.m. I recall getting up and wandering around, but for whatever reason I didn't test and went back to sleep after she'd left.

Hours later, my absence at work led my bosses to start calling. No response, they contacted Suzi at work. She rushed home.

Found me asleep on the bed. The dog was sitting beside the bed, with her head resting on the side as her sad brown eyes watched her daddy.

Suzi tried to wake me, and word is I glared at her wide-eyed and out of it. She knew instantly what was up (or down, actually).

Getting the frosting from kitchen drawer downstairs, she came back and forced it down my throat. Apparently, I struggled. At one point, I was screaming like a banshee trying to prevent her from stuffing the frosting into my mouth. She sat on my chest, holding my arms and forcing me down.

Fortunately, it worked. Suzi emerged victorius, pinning me down with the Chest Pin, Arm Hold, Honey In Mouth Move.

Had it got any more crazy, she probably would have turned to the Glucagon shot in the butter compartment downstairs. Or if really bad, may have summoned the paramedics to avoid any Low Swings to the Face. In my Crazy Low Mind, it doesn't appear that Suzi this time was an Alien trying to Poision Me with Alien Apple Cider. We're fortunate to not have had a repeat on that front.

The Low started subsiding, and I came out of it. Weary. Chest and arms sore. But stable.

By this time, it was 12:30p.m. A BG showed: 52 mg/dL. Enhaled more glucose tabs, and then shortly after munched down a fabulous PB&J for some substance

Spent rest of the afternoon working from home, after apologizing to the bosses and getting my head on straight. It was about this time I learned that U.S. Supreme Court Justice John Paul Stevens had announced his retirement earlier in the day - of course, as this is huge and a big deal for my job. Hustled to get back on track, without any more wrestling adventures. Stayed in a Higher BG state, but kept it higher to keep the sanity. Eventually, the glucoaster leveled out for the weekend's start.

The whole experience is just another consequence of the unpredictability of going from pumping to multiple daily injections. Should be talking to the doctor early in the week for some changes. Hope the wrestling matches aren't a part of the D-Life for much longer.

Wednesday, April 7, 2010

Raspberry Jammed Diabetes

You may know that I'm a fan of 80s movies. Particularly comedies such as Caddyshack, Weird Science, the Breakfast Club and Others that offered humor as an outlet. These helped shape my earlier years, and now they offer some mindless release and laughs into an often sobering adult life. Another favorite is Spaceballs, a 1987 sci fi parody that mocks movies like Star Wars and Star Trek and has become a cult classic. This movie goes beyond greatness and is simply a stellar creation of the highest form, fitting right into the Hoskins Hall of Movie AWEsomeNess.

So on that movie homage note, I honor Spaceballs with my analysis of some recent D-Life happenings as it relates to the first 10 days or so of my continuing Pump Hiatus.

You may recall my most recent post on Good Friday about My Burning Bush Toe, or the neuropathy-impacted body part that's become a radar-like tool in my D-Management. Over time, I've noticed that when my BGs go higher (say 250 or more) I get what amounts to a warning in the form of some foot or toe pain. Nothing much to fret over, but just a noticeable sign that something's slightly "off." Accurate a majority of the time, and that signals it's time to correct. But lately since stopping my pump therapy for the 1st time in nine years, that Radar has been off key.

Or, in the Lingo of Spaceballs: My radar has been jammed. (Here's a YouTube Video of that Rockin' Jammed Scene, which really In My Honest Opinion can only be topped by the A-Holes Scene.)

Lately, when my BGs feel Low or High, they more commonly are not. Feel like 300? Well, the result instead has been 100 or less. Low feeling, even blurry vision has yielded results that aren't Low or High, but in the low 100s or so. It's strange, as if substituting the constant hourly basals for 24-hour Lantus injections and MDI of Humalog boluses has changed my predictive senses. This may be a body adjustment period as I get back into the swing of non-pumping, and it will fade as I get more used to this change. That's a key: giving my body time to get used to the changes.

But in the meantime, it's clear that my Pump Hiatus is responsible for jamming my D-Radar. Not only that. It's throwing off my entire scope of control as I've known it for nine years. My numbers are off, my reactions to various foods and situations is bouncing me all over the place. Nothing I've traditionally done while pumping seems to be working. Overall, I'm just "off." D-Jammed.

(Sigh). (Shoulder slumping...)

Enter Dark Helmet: "There's only one man who would dare give me the Raspberry. Lonestar!"

MDIs: you are my Lonestar. Thanks for throwing a monkey wrench into my predictive senses. But more significantly, I say to Diabetes: You are indeed, a Major A-Hole.

As Dark Helmet would say: "I knew it. I'm surrounded by a-holes...

"Keep Firing, A-Holes!"

Exactly. I keep battling the D, each day. Doing what I can. Firing laser missiles into the dark abyss of Diabetes Space in order to fend off Highs, Lows, and Glucoastering BGs. Instead of light sabers we diabetics use insulin, blood meters, and CGMs. Rather than the Force (or Swartz), we have the Diabetes Online Community. This networking also helps learn new D-specific Jedi Mind Tricks to help in our never-ending battle against the Dark D-Side.

In the end, even if or D-Radars and overall D-Management is "jammed" and our tools aren't fully whipping the D into shape, one resounding message carries us through the tough times: "May the Shwartz Be With You."

Tuesday, April 6, 2010

Pursuing A Passion

This is a story about sports, but at its heart it speaks to the passion that we all strive to pursue in our own daily lives.

To those of us in the Diabetes Community, an Indiana man named Brad Stevens could have been a piece of the larger puzzle we experience in Living with Diabetes. We should be thankful that he didn't, but we should also take a lesson from his playbook.

Out of college with an economics degree, he found a place at pharmaceutical giant Eli Lilly here in Indianapolis. He scored a gig as a marketing associate, with his job description including metrics and incentives for a sales group. While it may not have been directly tied to anything related to diabetes, that could have been a part of his career or future role in marketing the Big Pharma's involvement in the Diabetes Community.

But it wasn't meant to be. While living a comfortable life as a recent college grad, the Lilly spot didn't entice him as much as his lifelong passion for basketball. He'd played since he was 5, and was a high school and college player. A modest and humble one, at that. He didn't see that being his career, so he went for a "real job" at Lilly. Though he was volunteering outside Lilly, he wanted more. So, he quit Lilly to pursue that passion. He took a job at Applebee's, and his girlfriend at the time went back to law school in case his dream didn't work out. He volunteered to work at Butler's basketball camp and he soon worked his way up the ranks, taking the head coaching job in 2007.

In an interview with the Cleveland Plain Dealer on April 3, Brad's wife is quoted as saying: "We were 23 and realized this was our chance. Five years down the road, we were probably not going to be in a position to do that. The more success you had at Lilly, the harder it would be to leave."

In his first year, Stevens led Butler to 30 wins, becoming the third-youngest head coach in NCAA Division I history to have a 30–win season. This year as we've now all witnessed, Stevens broke the NCAA record for most wins in a coach's first three years. The Butler Bulldogs finished undefeated in conference play, becoming the first Horizon League team to do so. At age 33, Stevens led Butler to the first Elite Eight and Final Four in school history, becoming the second–youngest head coach to coach in the NCAA National Championship game. With 4,200 students, Butler was the smallest school to play for the title since the field was expanded to 64 teams in 1985 and fourth-smallest overall. Sports broadcasters and analysists are saying this is the best competive game they've ever witnessed, and the team's journey this season is still being compared to what the Milan team did in 1954 for high school basketball and led to the 1986 film Hoosiers. Meanwhile, Stevens is dubbed a coaching prodigy and compared to John Wooden.

All because he had a passion, and left the ranks of Eli Lilly to pursue a dream.

Since the Final Four came to Indianapolis a week ago (as it does every 5 years, as the NCAA HQ is here), the city has been awash with optimism, hope, spirit. It's brought fans in from across the country. Granted, I haven't traditionally been a Butler fan. Even in the final matchup to get to the championship game, I was rooting for Michigan State - as I am from Michigan, and my dad's got a law degree that has MSU's letters on it. Personally, my alma mater is Oakland University - which got to Dance this year for the second time ever after its Dancing debut in 2005. Sadly, OU got knocked out in the 1st round - but they'll be back. Go Grizzlies!)

Aside from my home-state alliances, Butler has been a favorite of mine and it's grown on me as the season's progressed. This team embraces what basketball, any sport, this city or any city, should be about. It's how we should all strive to pursue our passions and play well to defy expectations. It's been a pretty remarkable season.

Overall, a man's passion is what brought us here. Truly, Brad Stevens is an inspiration who can teach us all - whether we are basketball fans and followers or not. His message is clear:

Do what you love. Do it because you love it, not because of the money or the stability of it. I realize that it's easier said than done in reality, but it's something that can very much heal and rekindle the soul. Ultimately, your passion will mean you do the job well and that will lead to more opportunities than may have ever been contemplated. The playing field doesn't matter - Basketball. Writing. Journalism. Diabetes Advocacy. New D-Management tools. Research for a cure. Wherever your passion is found. Point is, All Roads End Here, in a place where the passion can be found. Who knows... Maybe someday you'll make it into the history books.

Monday, April 5, 2010

D-Meetup of the Mikes

The Easter weekend presented the chance for a new opportunity: my first time meetup with a member of the Diabetes Online Community.

Four of us plugged in DOC'ers (via Twitter and D-blogs) are based here in the Hoosier State, which some may know to be the Crossroads of America. While my abode is on the southside of Indianapolis, two others are on the northside of the city while another is based up in Fort Wayne. Two of us 4 found a chance to meetup on Saturday.

It was a Meeting of the Mike's from Indiana.

Mr. Mike Durbin (a.k.a #mydiabeticheart), who hosts the MyDiabeticHeart blog, was returning from a vacation visiting family in Louisville, KY and was driving back through central Indiana. We'd decided to avoid downtown Indianapolis thanks to the craziness of Final Four Weekend, so we met up at a cafeteria-restaurant about a mile from my house, right off his interstate route home to the northern part of the state.

We instantly hit it off. We're both in the newspaper business - me on the editorial writing side, and he more in the IT end of the newsroom hitting on the tech aspects of the paper. Standing outside after some initial greetings and smalltalk, we delved into newspaper industry discussion that went into how the evolving journalism field is leading to the downfall of so many newspapers.

The conversation continued as we went inside and put some food on the plates, and then we got to partake in a fun little BBQ Sauce survey being conducted. Two types of sauce samples. As a thank you, we received a gift bag full of treats -Lorna Doones, PB crackers, Oreos, trail mix, and a Sugar Free Crystal Light Lemonade On The Go package. Everything a diabetic could want. We enjoyed the food and chatted it up for a while, before deciding to make our way to another spot to carry on the day's meetup.

We journed back to the Hoskins Household a mile or so away, where he was able to meet Suzi, Riley, and Shadow. Not only did Mike get to toss a ball around with the dog and pet the cat, he also learned how we've decided to keep our Christmas tree up year-round and simply change the decorations as the seasons roll on. This didn't seem to be a bother and he was very understanding. He also assured us he wouldn't run screaming from our neighborhood, vowing never to return to the crazy-people's house. (So we think).

Throughout the day, we found ourselves delving into so many topics: traveling adventures, the excitment of petty sharks, career paths, job flexibility, zoos and horse parks, and of course health issues. I can't imagine what Mike's been through with being diagnosed simultaneously with Type 2 diabetes and congestive heart failure, but I appreciate his willingness to share his stories online and take time to be an advocate.

This led our conversation to the Awesomeness of the Diabetes Community, which has connected us and so many others in various ways. We discussed the evolving ways people are getting involved in the D-Community as advocates: summer camps, support groups, hospital seminars, medical conferneces, Children With Diabetes forums, and places like TuDiabetes and DiabeticRockstar. Mike is a board member and actively involved with DRockstar, and has inspired me to focus more attention there (I've signed up, but don't spend a lot of time there as there are so many D-sites and pages to visit...). Anyhow, to be more of an advocate in those places.

We also discussed focusing more advocacy on the D-Complications such as heart disease and periodontal disease, which are included on the list but mostly don't receive the same kind of attention as complications such as blindness, kidney failure, and amputations. I recall when growing up that these were barely mentioned in the overall scheme of possibilities. That should change, as they are definetely influential issues that can be directly linked to diabetes. Some of us in the DOC can be great advocates for this, we concluded.

So overall, the Meeting of the Mikes was a great time in Greenwood, Indiana. I'm looking forward to the chance of meeting other DOC members down the road, either here in the Crossroads of America or wherever our Diabetes Advocacy takes us.

Friday, April 2, 2010

The Burning Bush Toe

In honor of Good Friday & Easter, I offer a Bible-themed post as it relates to my own D-Life. Even if religion isn't necessarily your cup of tea, I invite you to read on for a little insight from my own perspective at the D-Corner Booth.

Those who've been churched likely know the story of Moses & the Burning Bush, which precedes the Red Sea Parting and can be found in the Book of Exodus (3:1-15). The Bible story goes that Moses is called on by God from within the flames, instructed to confront the Egyptians and save the Hebrews by leading them out of Egypt. Basically, I see this as a story of confronting what's tough and doing what's needed, obeying a higher power that may be sending out warning signs to guide you along the way. That's my interpretation, mind you - as someone who grew up mostly "unchurched" but in recent years has embraced the Methodist School of Thought through Grace Church.

As it relates to my own Diabetes, there is a Burning Bush in my life.

Currently, it takes the form of My Big Left Toe. In the past, it's been any one of multiple toes or even an entire foot, but the signs have been found in my "Burning Toe" most recently. Let me explain.

Being a Type 1 who's recently reached the 26-year mark of Living With Diabetes, I've had my Endo and Others tell me in past years that I have the beginning stages of neuropathy in my feet. Not exactly bright shiny news, but I've learned to live with it. At one point it was quite painful, with frequent shooting pains and constant tingling in the toes and feet. When the initial news materialized, it really motivated me to get my health and D-Management under better control. It's sad that it takes these types of Complications to motivate one to do what he or she should've been doing all along, but it does. And it works. My Endo at the Time (Dr. B) told me that the nerves can slightly repair with good control, but that "it will get worse before it gets better." Some of the pain means you're healing, he said. This happened, and I went on with life.

Through the years, it's periodically come back to bother me. Sometimes keeping me up at night. During the day. Sitting at work or relaxing at home. Nothing extraordinary, just a reminder that it's still present. Neurontin helped at times, but I haven't had to take this prescription drug for roughly a year. Things have been A-Ok.

One thing that I've noticed is the neuropathy has become a type of radar alerting me to when my BGs go higher than they should. A warning sign. Anytime over 250, usually.  When that pain appears in my foot or toe(s), it is often a signal that my sugars are running High and I need to correct. I'd estimate that it's accurate about 80 percent of the time. (Reminds me of movie scene from Mean Girls, where at the end the not-so-smart blonde can predict to a point when it's already raining based on what her chest tells her - "There's a 30% chance it's already raining...". My Burning Toe is like that, except more accurate.)

However, since I began a Pump Hiatus most recently, my Radar-Like Burning Big Left Toe has been slightly off. It seems to be burning more often, and it's predictive ability is off. This is also the case overall, as my quarter-century experience of being able to pinpoint my BG levels is off mark. When my BGs feel high, they more commonly are not. Feel like 300? Well, #bgnow 146. It's strange, as if substituting the constant hourly basals for 24-hour Lantus injections and MDI of Humalog boluses has changed my predictive senses. This may be a body adjustment period as I get back into the swing of non-pumping, and it will fade as I get more used to this change.

But despite this "offness" for the time, one thing remains clear: the lessons of my Burning Toe are just as important as those in the Bible's Burning Bush Story and this experience can be an influential part of my life.

In Exodus, the Jewish people are facing troubling times. They're having to pass through the "furnace of affliction" to get where they need to be, but they won't be consumed and will be able to escape. The road isn't easy. The Burning Bush allowed Moses to see what needs to be done, in an illustrative way allowing him to understand in his own way.

Just like the Burning Bush, my Burning Toe is God's way of talking to me in a way I can understand - the neuropathy is clear evidence and quite motivational in telling me what needs to be done. Better control is needed. Another lesson is about the bush burning itself, specifically the mystery of what Moses probably faced at the time: He likely couldn't understand how a flame appeared from the middle, but the bush itself wasn't burning up and roots weren't destroyed. That question can be directly posed in relation to the Burning Toe and Diabetes - how can neuropathy be causing this painful sensation, but the damage be undone?

As long as the roots are alive, there's a connection to life which allowed the bush to return each spring. There may be burning pain now, but it's not the end. This serves as a sign that I can get back on track and reverse a part of the damage. The Burning Bush was a sign to encourage a new nation, a way to guide Moses and The People and prove reliability of the overall symbolism and message. Just like we diabetics sometimes face those same types of signs, whether it be a Burning Toe or other D-Complication that moves us to obey our D-Management. To use the tools we've been given. We wake up each morning with a chance to do what's necessary. Often, it's difficult and we feel inadequate to address it ourselves. But we have help. We can start any day as a new person by turning our backs on yesterday's mistakes, behavior, and beliefs. That's all past history. It's up to us to move on, see the signs, and recognize what must be done. There's hope for today and tomorrow. A Burning Toe might just be the sign we need to start realizing and embracing that optimism.

Hope your Good Friday and Easter Sunday are great. Blessings.

Thursday, April 1, 2010

Flapping the Gums

No time for my chatty-typing fingers to engage you today. I'm off to the dentist's office for a dreaded appointment. Thanks to the wonders of D-enduced periodontal disease, this should be a visit full of poking, prodding, pain, and likely some bleeding. Great times. Not looking forward to this visit. Or the next more painful one. I see soup in my future. Maybe Easy Mac. But, I digress. That's all fodder for a future blog post. In the meantime today, talk amongst yourselves. Flap those online gums in the blogging world. And remember to brush and floss.