Monday, May 31, 2010

Abandoned for Now, Not Forgotten

He sits on a ledge on the second floor of my home, each day peering over the side and pondering whether he should plummet to the carpeted stairs below. A suicide leap, as it might be. The reasons are probably what many face at down-times in their lives: feelings of being all alone, abandoned, not loved or appreciated by anyone. Simply, they have nowhere to turn and it all seems like too much to handle.

During the past two months, that's been the case in my house. We have a possible jumper, and those thoughts of being abandonment likely flood the system despite the reality that I do, in fact, have nothing but love and respect and appreciation for this wonderous creation of God.

Who do I speak of, you ask?

You may know him by other names or even the opposite gender, but in my household we know him by the name of Bacon Gibbs. Yep, my Minimed 722 insulin pump. Who has the name honoring both the wonders of those meaty strips as well as the NCIS character we all love by the name of Leroy Jethro Gibbs, former star of movie classics like Summer School.

As you may recall, I've been on a Pump Hiatus since the end of March. My continuing Pump Hiatus is the first time in nine years that I've been without pumping on a constant basis. This is in no way an indication of my feeling about pumping, because this was by all practical purposes a life-changing conversion back when I began in 2001. Rather, it is a time to let my body heal and just to step back and once again try injections, as I'd done each day for 17 years before pumping.

Intitial reports reveal that I haven't been a fan of Multiple Daily Injections (MDI), simply because of the fact that you must inject yourself many times a day as because bolusing isn't as easy, the food-effects are delayed, and there's that crazy long-acting Lantus complicating life so you're not just on a fast-acting regimine like before. You've read about the First Month Unconnected and that my D-Radar appears to be Raspberry Jammed these days. These issues remain true, now that I've arrived at the end of my second full month.

Overall, my body is healing - the goal of my embarking on this non-pump journey in the first place. So there's that, which is nice. It also nice that my regular syringes and the Lantus Pen Needle Tips cost nothing thanks to my insurance, which is a welcome change from the high-cost pump supplies I'm used to ordering. Those are two of the big positives. Plus, there's the simple notion of not being connected to any device and having to discconect and reconnect, adjust my sleeping habits depending on where my site is located, or examine whether a bent cannula or kinked tubing is at fault for higher-than-normal BGs.

But I miss my pump. Reasons stack up. For example, those carb-evil foods of pizza and chinese food (two that I love and have never traditionally had issues with while pumping) are delayed even more than before, and so the three-hour delay I'm accustomed to lasts as long as the eight hours they talk about in D-textbooks. Insulin absorption is also off and means that my Humalog takes longer to actually start working, I've found. So my pre-meal boluses need to be earlier and it takes longer for my corrections to bring my BG numbers down. It also means that what injection/infusion set sites worked before no longer do the job - Stomach and Abdomen were best pump sites, but absorption doesn't work there for injections; instead it's my lefts or arms that haven't been great pump sites for me.

Not to mention that it's more of a hassle to have to inject insulin by needle at a restaurant or out in public, as it brings more trepeditation from folk rather than just some button-pushing on the device at my waist. And, it's simply more to remember - that you did, indeed, inject your bolus and aren't just imagining that it happened.

Like a recent morning when I had to attend an early morning court hearing for work, and rushed to get out the door earlier that day. In doing that, I bypassed my Lantus injection at the normal time of 7:30 a.m. As I walked by the place at home where it sits patiently and waits for my twice a day attention, I even thought about whether I'd taken it and assumed I had. It wasn't until lunch-time that I realized my error, and likely why my BG numbers somewhat higher despite my activity and lack of food or coffee at that point in the day. Of course, I don't carry my Lantus Pen with me and leave it at home, so I either had to choose to head home at lunch or just wait until my 7:30 p.m. injection - I opted for the latter, as work has been busy lately. That just highlights the issue of having to remember one more thing, rather than just having my Humalog all at my waste-line or in a bottle that I carry with me always.

After going through several Lantus Pens in the past two months, I've now started the final from the box of five to run through before getting back on my pump therapy. It's possible I might just go through one of them and store the other in the fridge, but I'm not that sure yet. We'll see, maybe after discussing it with my Endo at the next visit in early June. Either way, I'm looking at transitioning back to pumping and getting re-settled by the time at the end of June when it's off to Orlando for the Roche Summit. That is the plan, at least. We'll see if it changes.

I just hope that in the meantime, before my Pump Hiatus officially ends, Bacon Gibbs can hold out without jumping off the ledge to the stairs far below. Maybe I'll have to show some attention, picking him up, putting a battery in him, and pushing some buttons just to show I care. Because I do. And I miss him wholeheartedly, not regretting for a single moment the choice back in college of starting a pump. I look forward to our reunion and hopefully a better, more appreciative relationship that will lead to lower A1C numbers by the end of the year. We will do it together, because that's what Bacon Gibbs & I are: a D-Team!

Friday, May 28, 2010

An Ant Trap for Diabetics

Early this week, we discovered an Ant Infestitation in our kitchen. They were climbing on cupboards, countertops, crevices in the sink, on the stove and wall, and appearing in freaky numbers inside a lollipop-filled ceramic cookie jar that sits on our counter. Despite frequent counter cleaning and spraying, it became obvious that the ants weren't going away and there might be more dubious behavior at work here. So, it was time to go Gibbs on these invading ants. Time to eradicate them from our home. There was only one thing we could do...

We formed our Ant Elimination Plan.

First, I engaged in counterintelligence recon and watched the Dreamscape movie Antz, in order to better understand their world and better enable myself to put strategery into place. Then, we stocked up on Ant Elimination Tools such as Borax, bleach, fresh ant traps, and counter wipes - complimenting the massive jug of HouseGuard bug killer already in our arsenol.

The mission began. Examining the various places in the kitchen where they could be entering our homebase, we discovered upon pulling the stove out from the wall that there was indeed an entry point they were invading through - our newly-built house from five years ago had settled, and the counter had slightly pulled away from the wall. This resulted in an apparent space behind our kitchen cabinets, and that was where they were coming in from.

We cleaned, scrubbed, washed, sprayed, and did hours of Ant Elimination Work each night to ensure they'd be gone from our eating and living spaces. We also sprayed outside beneath the siding for any possible entry points, and inside we laid sugary traps that they could take back with them to kill off the entire colony. It appears to have worked, but there of course was a catch - a price paid.

My D-Control was chaotic.

All of the intense cleaning activity meant more-than-usual exercise, Borax-laced counters that deterred the usual meals, and a disorganized kitchen that meant you could misplace important Blood Test Supplies in the mess. On the first night, we ate sandwiches for dinner and I went Low - into the 40s. It happened again the second night. One of these resulted in my thinking that I was being attacked by these ants, so the only way to get away was to stand on a little kitchen rug helplessly. A ceramic pot may have been broken, because those ants are powerfully muscular and moved the microwave and pushed the pot to the floor. We blamed it on the exercise and allowed the Skittles to rescue me from those depths.

Of course, this led to my being catapulted into the 200s, a "glucoastering" effect throughout the night, and little sound sleep. Being exhaused the next day, and having an equally-exhausting work day, I came home and became frustrated with the unorderly and Borax-covered countertops. I didn't eat dinner for the fear of leaving a crumb that would bring the ants back. So, I went upstairs for a brief power-nap.

Woke up three hours later. Low, to another test in the 40s. Skittles once again helped bring me up, with some Saltine crackers and cheese to lay a foundation.

On Thursday, in getting ready in the morning, I found myself navigating around the mess on the kitchen table and countertops and managed to walk out the door without my blood meter kit. No meter, no insulin. Just the lunch, which I'd remembered to take from the fridge. Once again, the ants played a part in this.

Reflecting on the activity, one consistent memory comes to mind each night when the treachory was likely afoot: our Shadow Cat was perched underneath a table, peering at us with disgust probably imagining our demise. I'd be willing to bet that it was the cat's doing that these ants were in the house in the first place. After, we've known for a while that cats are plotting World Domination and it's only a matter of time before they strike. I wondered if Shadow took the initiative to organize these ants into an army, for the sole purpose of screwing with my BGs... Hmm. If this a piece of the larger World Domination Plan, she carried it out like a pro. Some in the Diabetes Online Community spread word that they'd had crazy weird BGs during the week, and that exhaustion in their own D-Lives was interfering with good control... This could be a sign that the plot is being carried out on a larger scale. I've recently uncovered a secret rebellion document on How To Tell If Your Cat is Plotting To Kill You, and the answer is clearly Yes.

Clearly, these cats will go to any length. This includes setting Ant Traps designed to lure in People With Diabetes so that we leap into action, don't eat, let our BGs go low, and just lose a sense of our control. We survived this round of plotting cat attack, but we must always be on guard. Their World Domination Plot appears to be at hand. It may just start with the Ants and a pack of Skittles...

Wednesday, May 26, 2010

Diabetes is "just along for the ride."

Living with Diabetes can be crazy enough.

But try being a racecar driver living with diabetes, and you've got the makings of what should be dubbed a D-Life in the Fast Lane.

That's the world Charlie Kimball lives in, but he's behind the steering wheel on this one. The 25-year old, European-born professional racecar driver was diagnosed in 2007 with Type 1. He currently holds the distinction of being the only licensed driver with diabetes in the history of the Indy Racing League, which is pretty much something in the racing world.

Beginning with go-kart racing at age 9, Charlie sidestepped his admission into Stanford to follow a dream of professional racecar driving. He started racing in Europe in 2002 and built up an impressive racing resume, before his Type 1 diagnosis derailed his racing program in the middle of the 2007 season. But he didn't let that stop him, and he returned in 2008 to compete in some of the most competitive racing categories in the world and proving that life with diabetes won't restrict him from traveling at more than 150 miles an hour or prevent him from reaching his dream.

Charlie has said publicly that he returned to raising not only to reach his own personal dreams, but to also help raise awareness for Type 1 and diabetes in general. He's a spokesman for DexCom and equipment provider American Diabetes Wholesale, and has partnered with Novo Nordisk to help raise awareness.

As it's Indy 500 time here in the Crossroads of America, Kimball came to the city earlier this week and stopped off at Methodist Hospital where he participated in a lunchtime event dubbed Racing With Insulin (a play off his Twitter account (@racewithinsulin) and his blog http://www.charliekimball.blogspot.com/).

I was one of the first to arrive, and even though I wasn't an employee they let me stick around and chat briefly with Methodist staffers and those with Novo and the American Diabetes Association. When Charlie arrived, he wasn't wearing his track suit but disappeared to go put it on. He emerged a few minutes later, sporting the outfit proclaiming his Novo partnership and his own use of Levemir Flex pens. His helmet had a cool little Novo FlexPen graphic, and he had pictures showing his car that also displays the company name.

He's on Multiple Daily Injections and doesn't pump because it's easier at this point to toss a couple pens or syringes in his bag while traveling worldwide for racing. He does use a Continuous Glucose Monitor, though - actually, his CGM is velcroed to his steering wheel right under the car data input so he can see it at all times. "It's just another part of the dashboard I have to watch," he says, admitting that his Endo came up with the idea. He also has packs of orange juice hooked up into his helmet so he can respond quickly to a dropping BG by sipping through a straw. However, he hasn't had to use it yet.

"It's between 35 minutes and one hour. It's really physical. It's really hot; there is a lot of exertion and the mental focus needed to control the car at nearly 200 miles per hour burns blood sugar off, so I typically try to get in the car a little higher than I would on a normal day and I will get out after it is burned off," he said, noting that he tries to keep his levels at 180-200 at the start of a race, and that they usually drop to 100-130 by the end. If it came down to using the orange juice through a straw tool and he couldn't boost his BG in time, Kimball says he wouldn't hesitate to park his car.

He was quite interested in hearing about some of my own experiences in Living With Diabetes for 26 years, and said he was so impressed with any of us "longtime" Type 1s since he was only a newbie himself. He mentioned that he hears from many parents of Kids With Diabetes worldwide who point to him as a hero. Some say their child has just started getting into go-carts, and they look to his experiences as guidance. That's an honor and what inspired him to push the D-Awareness, he said, but he said the true inspiration comes from us longtime People With Diabetes.

We exchanged stories about others who serve as vocal celebrity voices on the topic - Brett Michaels, Gary Hall, Will Cross, Crystal B, Kris Freeman, Nick Jonas, Nicole Johnson, and even a local college girl from Indiana who is a current Indianapolis 500 Princess despite her childhood-diagnosed Type 1. So many people to look up to, and we agreed that we're all sharing in the role of being advocates to some degree.

Despite living in Indianapolis now for six years, I'm not much of a racing fan... But I didn't disclose that, and promised that I'd tune in this week to watch Charlie race in the Firestone Freedom 100 - the biggest 40-lap race on the Indy Lights Series that's held on the Friday before the Indy 500 and offers a glimpse of what the Indy Racing League and probably the Indy 500 will look like. This is his second year in a row racing at Indy, and now he's in Race 4 set to start Friday at 12:30 p.m. (EST) (shown live at 12:15 ET on VersusTV, as part of the Carb Day coverage Roll on Indy) Charlie notes also for follows who might be diabetic but not racing fans: "Carb Day" means Carburetor Day, not Carbohydrate!

Anyhow, as the hour progressed we posed for some pictures and he autographed a cool photo souvenir before we parted ways. I headed inside to walk back to my car, but decided to hang around and see what trouble I could find. Wandering the hospital, I observed a group of four hospital staffers trying to figure out what the race-themed event was outside in the courtyeard. One lady in blue scrubs, with a big red RN badge, asked if there was any "diabetic food" at the event outside. Another one of them repled, "No. It's just health, regular-person food that we can eat for lunch, too." One of the men started moving toward the cafeteria, telling his colleagues proudly that he wasn't going for that "healthy food," but instead was heading to White Castle. I smiled at all of this, as this was just very funny to me, and continue wandering the hospital.

Of course, my own eavesdropping on the medical community in its own little building took too long and I felt myself getting Low, pretty quickly. A 42 mh/dL laughed at me and I made my way to the cafeteria for a cookie and banana, before.heading to the parking garage. Eventually, I got my BG back into the 80s before getting behind my own steering wheel for the drive back to work.

Overall, this was a great experience and it was an honor to meet Charlie Kimball, especially in the same week he's going to competing at the Indy Motor Speedway. Now, all I have to do is get a CGM and velcro it to my steering wheel and hook up a cool OJ-straw device in my SUV... Then I'll be all set! But regardless of my own D-Driving, I'm confident that Charlie is set and am looking forward to his success in this year's race and his overall career!

He wants to be the first driver with diabetes on the grid at the Indy 500, Kimball says, and he's confident that it's a question of When, Not If. Then, he wants to win that race. But as far as as his D-Life goes, his goal is to prove that he's in the driver'se seat and diabetes "is just along for the ride."

Monday, May 24, 2010

Back to D-Camp

A return to Diabetes Camp for the first time in more than a decade was on the agenda for Sunday morning. The point was to talk about my 26-years experience of Living With Diabetes, and talking to some newly-diagnosed familiies at the Diabetes Youth Foundation of Indiana's Camp Until a Cure.

This was the first time in many years that I'd be back to a Diabetes Camp since leaving Michigan, and I was nervous but very excited to have this opportunity. I had a plan and was all set to start as the weekend rolled around, and my outline planning before Sunday convinced me that all was in order for success.

But, my morning bowl of Cheerios got in the way. To be accurate: my bowl of Cheerios didn't get in the way. That was the problem.

The night before, a bedtime blood test showed 118. All was good so I went to sleep. Woke up at 3:30 a.m. to an alarm clock that was slightly louder than I'd planned, and pulled myself up to go test. A 61 mg/dL flashed at me on the One Touch Ultra screen. I helped myself to a half-banana and some saltines with cheese, then returned to bed for another three hours or so. My morning test was 200, slightly higher than I'd hoped but fine given the circumstances. Calculated for a slight correction and factored for the two-serving bowl of Cheerios with milk and a banana on top, then headed for a quick shower and final preparation for getting on the road to D-Camp.

As it happens, my mind started going over the main points I planned to discuss and it totally slipped my mind that I had already dosed for breakfast. Walking out the door, Suzi asked: "Do you want to eat something?" I managed to realize this was a good idea, but again got sidetracked and forgot about the Cheerios. Instead, walked out the door with only a partial banana - without eating the 40 grams I'd already taken the insulin for about 30 minutes earlier.

The Low hit while we were on the road for our 45-minute drive. Couldn't focus, shaking hands, somewhwat blurry vision. Fortunately, Suzi was driving. The realization of my missed breakfast after bolusing came to mind, and I tested. BG: 57. Figures. We stopped in downtown Indy to make some copies of Online Resources Handouts I'd put together, and grabbed some breakfast. I devoured a donut as we once again headed to camp, where I did two subsequent tests that revealed all was fine - I was hovering the 80s.

Of course, this morning Low tangled with my best-laid plan and scrambled my focus somewhat. But it all turned out great in the end, and was a lot of fun. Sprawled out on about 30-acres, the ADA-accredited DYFI Camp and has been around for about five years in Noblesville, Indiana and is the state's only one dedicated to Type 1. Last year, they expanded the focus to also include other special needs children, such as autism. This was the Spring Family Weekend where more newly-diagnosed families got a chance see what the camp offers so they might send their child or children there in the summer. Reaching out and talking with the director a few months back, we discussed my involvement and I agreed to come speak to the families this weekend. Specifically, the topic would be my own 26 years of Living With the D but also the Diabetes Online Community that I've actively plugged into during the past year.

About 10 pairs of parents gathered in a small community room at the camp, while their D-Kids were off with counselors and staff enjoying the sunshine and playing outside. Enjoying camping obstacles such as the magical Low Ropes, which aren't to be confused with or connected to Low Blood Sugars, but rather heighth off the ground. I was told the High Ropes were 65 feet off the group, and we joked about how I shouldn't explore those while wearing a pump as it might result in an expensive replacement.

Some of the faces I've seen before, most weren't. But we all shared that connection that didn't make me feel like a stranger at all, even if I did appear to have three heads towards the beginning. Of course, Suzi was there in the front row and made me shine and look better, as always.

Discussion went into my online activity and D-Blogging: how I'd lived with diabetes mostly by myself since age 5, going through school as the only diabetic and not being exposed to others except in special visits to D-Camp or JDRF functions. Then, after moving to Indiana and starting a blog to keep in touch, started D-Lurking and eventually blogging specifically about my D-Life. Twitter. Facebook. Tu Diabetes. Juvenation. Children With Diabetes. How these online resources are changing how we interact, and how they're connecting us Type 1s.

Some talk of the "horror stories" came up, such as severe Lows and how some might get violent or mean when severely low. How the paramedics have visited my home, and how we must take great care before Driving With Diabetes. One D-Dad with a young daughter mentioned he was already nervous about this, and I did my best to ensure that it's manageable and a CGM might be a wonderful tool in helping catch possibly bad Lows in life. One D-Dad, who works as a sheriff's deputy, talked about his own observations about how diabetics can appear to just be intoxicated, and that window stickers or medical alert bracelets can help quickly tell an emergency responder about a person's D-Situation.

Essentially, the message I tried to relay was that Life With Diabetes can be tough, but so can any aspect of life. It becomes a part of your daily routine, and while there are concerns and maybe advanced planning aspects, it doesn't prevent any child with diabetes from growing up to live successful and productive lives. Part of that involves seeing the fun side and keep a sense of humor, such as laughing about substitute teacher tricks about eating in class or leaving to test blood, getting to the front of the line at amusement parks or buffets in Vegas, or just the weird looks people give when you talk about "Being High" and "Shooting Up" out in public. How we decorate our Christmas tree with D-Supplies, and how our D-Ninja Lance helps us keep our ninja-skills to battle diabetes. There were some laughs, and we had a great discussion.

The sheriff's deputy D-Dad mentioned that since his daughter was diagnosed last year, I was the first adult with diabetes to talk about their experiences, outside of nurses and medical professionals who may have been living with Type 1 themselves. He found it assuring to hear me speak about being successful and happy after 26 years, and that felt pretty good. I listened intently at times when the parents asked questions (see me there to the right, being a listener), and did my best to answer with honesty, modesty, hope, and knowledge that Your Diabetes May Very. Of course, I assured the audience that I was no one to model anything after and that Suzi would be the first to confirm this. More laughter.

We wrapped it up, and made our way to the mess hall to enjoy some lunch. Talking with the director before departing, we agreed to keep in touch. I'm looking forward to making way back to this DYFI Camp before long, and volunteering as I'm able. I hope more adults find the time to do the same, and provide these parents - especially the newly-diagnosed - with that valuable lesson: that despite the D, anything in life is possible. Their D-Kids will grow up, and they can be all that they want in life.

Saturday, May 22, 2010

Dining for Free Diabetes

We recently participated in a local effort dubbed "Dining for Diabetes" at multiple Chili's restaurants in Indianapolis and the surrounding suburbs, one that I understand has happened in other spots throughout the country. Basically, you print out an online voucher or coupon and 10% of your total bill is donated to the JDRF. It ran from Sunday to Thursday, and so we thought it would be a good worthwhile time to grab a meal there and take part in a good D-Cause. Of course, we waited until final day to head out to our local restaurant in Greenwood, on the city's southside.

However, our charitable meal attempt almost failed.

Arriving at the later part of the dinner-hour near 7 p.m., we saw a somewhat packed front lobby area and opted to sit in the bar area at a high-top table. This would ensure quicker service and an even more relaxed setting, we assumed, since it wasn't a very busy time and the bar area wasn't too full.

At first, it took way too long to even get a drink order placed. Two different waitresses acknowledged that we were there and greeted us, but failed to step away from whatever else they were doing to actually wait on us. Suzi and I had both waited tables at restaurants in the past, and so we take notice of the wait times - this instance wasn't justifiable, we concluded. Finally, someone came to take our drink orders and I was pleased to get a 23-ounce beer that could be considered colder and more frosted than I typically get. This was pleasing and made it worth the wait.

I ordered a bacon cheeseburger with some veggies, while Suzi ordered a chicken sandwich. Blood test showed a slightly elevated reading, so I did a SWAG on the carb count and excused myself for the meal and correction boluses injection and also my evening Lantus Pen shot.

On the way back to the table afterward, I crossed paths with a manager who was discussing meal comps with a hostess. I didn't think anything of it at the time. Returning to our table, I found Suzi there without any food present. She mentioned the food was taking longer than it should, and someone had come by and said it should be out soon. Within minutes, another lady came by and informed us that they were working on it in the kitchen. Minutes passed...

Finally, the manager I'd passed earlier emerged with our plates in hand and arrived at our table, apologizing and handing us the delayed food. Apparently, they'd messed up the chicken sandwich a couple times in the kitchen and had to redo the orders. Suddenly, I flashed to the previous conversation I'd heard him having with the hostess in the hallway, about comping meals.

My mind shifted to a specific thought while he was talking: "Uh oh.... What if they want to comp this meal??? What does that do for our 10% contribution to the JDRF??? You can't very well donate on a free meal."

While I normally am not one who's going to step away from a free meal if there's justification for it, this suddenly appeared to be a threat to our hope of being all charitable that evening.

My turned my focus to the manager and what he was saying.

He informed us that due to the food delays, he'd be offering us any dessert for free.

That seemed to be a good middle ground solution, I thought. Doesn't endanger our donation, and also "makes up for" the delay we'd experienced earlier. While it had been a little annoying, it wasn't as if I was Low and faced those hypo-related dangers.

We ate, and capped the meal with what they called a "White Chocolate Molten Lava Cake." This is a vanilla spongecake with holt melted white chocolate (lava) inside the cake, scoop of ice cream on top to seal it inside, and a white chocolate sauce topping for decoration and yummy goodness. A SWAG gave me a bolus guess of 6 (as I ate half and assumed this might cover it), though I later learned this was somewhat off - online nutrition info showed full cake was 152g, meaning I'd need about 15 units to cover the full dessert. Half would be 7.5, according to my Insulin To Carb Ratio. Close, but not exact.

After everything and not counting the $6 dessert, our bill came out to about $23. We balanced the tip based on the full amount and lack of prompt service overall, and made our way out with the receipt. In the end, we ended up donating about $2 to the JDRF. We presented the coupon to the waitress, and I mentioned the whole Dining for Diabetes to the manager to get a sense of the participation level in the past week. He was clueless and didn't know, pointing out that "a few" had been dining for the cause but nothing much that he's observed.

I may check with our JDRF Indiana to see what they know, and could even check with the regional folk at Chili's to get their response about participation. I'd like to know how it all turned out.

My verdict: While it was a good meal and the dessert was great, the overall experience and the ensuing "glucoastering" BGs thanks to the burger and chocolatey dessert just didn't make it worthwhile. Not for a donation of roughly $2. Next time, I'll just write a $20 check to the charity and prepare my own, easier-calculated meal at home where I can eat at my own pace and not face delays or surprises.

Then, it'll not only be healthier, grocery-store bought food from my own fridge and pantry while making a more significant D-Donation.

Friday, May 21, 2010

The Hunt Is On

The Hunt for Adult Type 1s has begun in Central Indiana.

At a recent JDRF Indiana Outreach Committee meeting Monday on the northside of Indianapolis, those people attending focused on the topic of finding more adult Type 1 diabetics who might be interested in getting involved in this area's chapter of the now 40-year-old national organization. Most of the active members and volunteers are Parents of Children With Diabetes, who are the very ones in fact who founded the foundation back in 1970 to focus on cure research. You have some adult diabetics who've been very involved for years, but they are a minority. We want to increase that presence and what the JDRF means for us overall... At least here in Indiana.

Sure, being a member of the ever-expanding Diabetes Online Community through blogging, Twitter, Facebook, Juvenation, has connected me with many awesome adult Type 1s nationally. But I haven't met many inside Indiana, and that's something I'd like to see change. The JDRF efforts seem to be a great place to start.

In my opinion, determining how to do this coincides largely with knowing the reasons why Type 1s may not be that involved in JDRF in the first place. A part of this may very well be that the JDRF does great with newly-diagnosed children, the older kids, teens, and their families, but historically the organization almost seems to stop caring once you turn 18. Many of us Type 1s have felt forgotten, and in those young adult years where you really move forward on finding who you are and making a place in this world, the JDRF falls far down and eventually off the priority list. Personally, this happened with me in college and in my 20s. Particularly in that the JDRF seemed so aligned with those always saying a cure is coming "withing five or 10 years" and that all is about the cure, and nothing else. As you go on in life and become more "jaded" about whether a cure will be found, the cure-focused tunnel vision of the JDRF loses out even if you still maintain individual hope that one could someday be found. Not to mention the fact that kids are more the marketable and telling Faces of Diabetes that win over politicians and make people want to contribute money to.

Fellow D-Blogger Scott Strange, a veteran Type 1 for 40 years who runs Strangely Diabetic, posted about this recently and echoed many of the thoughts I've had on the subject of the JDRF: "Honestly.. I just feel that I personally have little use for the national organizations. They seem willing to use me for funding but offer so little in return that can improve my life on a daily basis. And I dearly hope that a cure can be found so no one else has to go through this."

As a kid and teen, I was involved in the JDRF up in Southeast Michigan and participated in walks and rides each year, raising money and doing some general advocacy work for the local JDRF. There's been D-camps and volunteering at the local chapter office doing office-tasks. But in the end, my regular life took over and it was clear that the JDRF wasn't as much for me, as it had been in those earlier pre-18 years.

In the past year or two, the realization hit me that the JDRF does, in fact, affect my world and it has historically done that in these 26 years of Living with the D. It's been largely connected with my involvement with the Diabetes Online Community, seeing other younger and older adult Type 1s who have remained involved and have discussed their own perspectives on all of this. I began to see more that finding a cure is the priority, but the JDRF has in funding that research and leading the way changed the way the world thinks about Type 1 diabetes, how society reacts to it, how schools manage those issues, and how technology is developed for better management short of that end-all cure. Insulin pumps, CGMs are just two of those examples that have changed the way we live with this chronic condition, and I've benefited greatly from it. That is worth giving back to the JDRF in time and advocacy, just as it intimately fits in with a larger goal of being more of a Diabetes Advocate in general and doing whatever I can from my own little corner booth.

So, the new goal is to reach out through Facebook, Twitter, the D-O-C, and in person to engage more adult Type 1s who may have also been "left out" but may want more. The JDRF created an Adult Type 1 Toolkit to help re-engage this segment and it contains some great info. I'll be talking with my Endo in the coming weeks about reaching out to those Adult Type 1s she knows, hoping we can connect - other volunteers are doing the same for this region. A goal in all of this may be what's tentatively being dubbed the Adult Ambassadors Initiative - basically involves bringing more adult Type 1s into the JDRF fold, getting them to be the faces for this group, be spokespeople and take on sort of mentorship roles. Maybe talk to kids and families who sometimes might look to us as inspiration.

I've identified a few individuals who could fit nicely into this role, though they aren't yet approached on this and may not want to get involved in this way so they'll remain nameless at this point. But one high-profile person has already been ID'd and could be a key advocate: NFL defensive end John Chick, a 27-year-old Type 1 who was diagnosed at age 14 and most recently signed on with the Indianapolis Colts. He's been an ambassador for the JDRF in the Canadian province of Saskatchewan, where he played for the Roughriders in the Canadian Football League, and word is he is already getting involved here in the Hoosier State. So, that's an incredible high-profile name and face to have on board. A D-Meetup could be in store before long...

Getting to these other fellow Adult Type 1s may involve answering for them a key question: What does the JDRF mean for you now, and what can it offer your life?

To again echo Scott Strange: "For me, advocacy has to be about directly working with, talking to, listening to, and learning from the people that I can maybe help in some small way. We (Adult Type 1s) need to just be able to get together, whether we even talk about diabetes or not. It is so comforting to know that you are in the presence of people who are not going to judge you, not going to lecture you. Folks you can honestly make an instant connection with because you have something in common that is so in-grained, so intrinsic to you all."


So, while it's not Red October, it is a worthy mission and one worth pursuing. It's all a work in progress, but every initiative has a beginning and this is it. My hunt begins.

Wednesday, May 19, 2010

A Butter Compartment Suprise

You could have heard me gasp.

Recently, I nearly fell over when opening up the fridge in our kitchen to retreive a new bottle of Humalog from the Butter Compartment, a common place for keeping insulin and glucagon for us People With Diabetes. Heck, some of us have even given our D-Blogs creative names to reflect this trend (like Lee Ann, who runs The Butter Compartment!).

As the door opened, I flipped open the clear, hazy plastic door where the bagged boxes of insulin sit peacefully on top of the five-pack box of Lantus Pens. On top of the Humalog boxes was the red glucagon container in its own prescription-coded pharmacy baggie.

But to the right side of this storage area, there was a sight that just blew my mind. Something completely unexpected...

There, despite my belief at the time that it was in fact a dream, was a stick of butter. A stick of butter! Fullly wrapped in paper inside a ziplock baggie. A mostly-used little quarter stick sat nearby. In the Butter Compartment. How outrageous!

This was just not a normal happening in my D-Life, or for any PWD. Treachery had to be afoot, I determined.

"What the.... Why is there BUTTER in the butter compartment?" I yelled across the room, beckoning for an answer from my wife who quickly responded from the living room.

"That's where it lives. It's always been there."

She quickly added: "Leave it alone."

Mystified, I stared at this half-used stick of butter that my mind never recalled being there before. The full stick of butter stared right at me, as if to mock and challenge my questioning wide eyes with an all-tough attitude. Even the little bite-sized quarter stick glared at me, as if knowing it was being protected by the Mother Butter Stick and I couldn't touch them. There was a certain confidence they radiated, and it made me mad the longer I looked at the compartment in front of me.

"Oh my God," I muttered at a near whisper, still standing with the fridge still wide open as I peered inside as if I was observing a never-before-seen historic event. "I don't believe this."

The salad dressing and BBQ sauces on the shelf below ignored my judgemental eyes, not wanting to get involved in the crisis happening up above. They may have feared for their own existence.

In the end, I couldn't resist: had to move the butter. Down to a spot right above the meat drawer. Where it belonged. Not in the Butter Compartment, where my life-saving D-supplies had always conquered. There had been times in the past where I simply had too much insulin stocked to have it only occupy the butter compartment. In those instances, it expanded outside the trusty compartment area, but never abandoned it for another site. Oh no. Never. There's comfort there, when there's so little comfort elsewhere as far as diabetes.

Upon learning that I had in fact moved the butter (despite her instruction to the contrary), my wife's response: "Fine."

I smiled. Knowing that she'll learn to live with it. In the meantime, at least I'm at peace again knowing that my insulin is the sole occupant of our butter compartment - as it should be. I've put right what once went wrong. All is fine in my D-World, as normal as it can be.

Monday, May 17, 2010

Size Does Matter

Three years ago, I posed a question: Does Size Matter? You may not recall this, as it was roughly two and half years before my activity in the Diabetes Online Community became regular. At the time, I was a D-Lurker learning the ropes and reading the great words of those who fellow D-Bloggers.

Today, I revisit that 3-year-old question and am armed with an answer: Yes, Size Does Matter.

As it relates to Diabetes Supplies such as Syringes and Insulin Pumps, of course. (C'mon, people. Focus. Here, not on the Mind Gutter.)

Pluto knows it, after being demoted a couple years ago to the dismay of millions of former schoolchildren who had their childhood foundations shattered.

But the question lingered as it related to my diabetes on several fronts. Most recently, my answer arrived in the 4th week of my Pump Hiatus, which you'll remember I began to help my war-torn infusion site riddled body heal a bit. A new reality has evolved with Multiple Daily Injections, one that I'm glad is only temporary until my pump and I are reunited. But with the shots, this means I'm exposed to at least two different needle types each day (at breakfast and dinner times).


  • I use the 1/2 cc syringes by BD that hold 50 units of Humalog for food and correction boluses - hopefully as few times as possible, but typically three or four times a day depending on when I eat and any corrections I might need. This needle is not very intimidating, in my opinion.

  • Then there's the Lantus SoloStar Pen, which holds 300 units and meets my skin twice a day (14 units at 7 a.m. and 10 units at 7 p.m.) This plastic pre-filled prescription device has a tiny little needle, which is even more reassuring than the above-mentioned syringe but can at times seem a little too short. Just means a little extra care to make sure you don't fidget and pull the needle tip (sold seperately) out by mistake.
  • Of course, there are times when massive carb counts or corrections all combine to larger boluses that sway me to swith to a larger, thicker needle. Enter the 1 cc syringe that holds 100 units and counts the units by pairs. Oh, but it's intimidating! Moreso than the other two little ones I'm using more often. But it means pushing the plunger less and keeping it in the skin a shorter amount of time, which is the appeal that outweighs the longer needle going deeper into my insides (read: more potential to hit something like a vein, muscle, or fatty tissue resulting in PAIN!). While it's not the shortest needle, it does the job better.
For the record, I'm by no means afraid of needles. Just would like to avoid them as much as humanly possible, which for a diabetic is just setting myself up for failure on this avoidance effort.

There's a subconcious childhood mentality here: we can't deny the fear we experience as children (or adults) when a huge needle comes toward us. In my case, the comfort level is never as high as when I'm able to personally put the syringe into my skin. At my own pace. Me in control of when it goes in, how long it stays, and how it gets yanked out. That helps some...

Still, even in control, the larger the needle, the more anticipation there is. Images of piercing pain, gushing blood, subsequent bruising, and lack of insulin effectiveness come to mind. It makes me want to inject as quickly as possible.

So, just like was the case with Pump Styles and Reservoir Sizes, when it comes to Syringe Sizes and the Intimidation Factor: size does matter, indeed. Fellow D-Blogger Sara Knicks has found this to be true, also, when it comes to infusion sets.

You knew it. Don't be ashamed. Admit it. Accept that It Is What It Is.
Now that we've cleared that up, please feel free to let the mind return to the gutters.

Sunday, May 16, 2010

Dreaming a Little Non-D Dream

Today is the final day of Diabetes Blog Week. More than 100 of us D-bloggers have written about a specific topic each day, as coordinated by Karen over at Bitter-Sweet Diabetes. In this last installment of the Diabetes Online Community series, she asks us to: Dream a little dream about Life After A Cure. To wrap up Diabetes Blog Week, let’s pretend a cure has been found. We are all given a tiny little pill to swallow and *poof* our pancreases are back in working order. No side effects. No more insulin resistance. No more diabetes. Tell us what your life is now like. Or take us through your first day celebrating life without the Big D. Blog about how you imagine you would feel if you no longer were a Person With Diabetes.

On the First Day of Life After a Cure...

I'd wake up and have a bowl of Cheerios. Because the Os rule. Then, I'd have a bowl of Fruit Loops - generic Fruity Os style, because once again Os rule. And I wouldn't have to take a shot or pump a bolus. And I'd venture out into the world to start the day's all-important business.
The mission that would take up the remaining time of my day and ultimately my full-time role in life would begin, replacing the injections and D-Management that had previously been my reality: hunting down every doctor who ever told a Type 1 kid or parent that diabetes would be cured within five or even 10 years. I'd take a syringe and stab them in the abdomen, arm, or leg with it - ensuring that I hit a muscle so that the pain seizes them completely and radiates throughout their body. Blood would likely gush, as I've seen so many countless times in my own life. Whatever the amount of years past my 26 years, I'd stab in another limb and muscle, repeating while yelling, "Five Years Gone, A-Hole. Within 10 years, it'll be over!"

Then, I'd find the next doc and repeat the process.... Again and again and again... Until researchers found a cure and ensured that no other little kid would ever have to endure the same kind of lifestyle and subsequent anger. Now, I don't mean for this to deter any D-Dads or Moms and Those Kids/People With Diabetes from hoping for a cure sometime in their lifetimes. That is a valid hope. What gets me is for how so many say, with actual belief, that a cure is "Five Years Away..." Us longtime Type 1s have been hearing that for decades, with the basic qualifier that all is needed is a little more money to get it done.  I'm not a fan of that line of thinking, even though I agree that more funding for a cure is necessary and a big part of our role as advocates.

But, as soon as we get to the Cure Stage, and if I'm around, I'll take what chance I may have to remind those who told me it was just around the corner. When it really wasn't. Yes, I'm bitter. Can't you tell? But, in the end, at least I'd be cured.

Actually, if there really was a cure, I'd immediately cancel my health insurance for no more worries would be had on the chronic condition front and pre-existing conditions wouldn't be a worry. I'd use whatever money previously paid in monthly premiums and instead stock that up for a couple months, as well as all the cash saved in what had been spent on pump supplies, insulin, blood test strips, Endo visits, lab tests, etc.... Then I'd throw a HUGE bash and invite all of us former PWD who once belonged to the now-defunct Diabetes Online Community. We'd all be celebrating, so what better way to bring us together for a big celebration! Now THAT would be a great way to mark the end of diabetes, together, and the formation of the....

Cured Diabetics Online Community (CDOC)!

A new online community would be born with a cure, as well! AWEsomeNESS, even more!

..

Saturday, May 15, 2010

Drawing the D-Wild Card


This is the fifth installment of Diabetes Blog Week, as envisioned by Karen at Bitter-Sweet Diabetes. Our regularly assigned topic today is to offer some snapshots of this chronic condition in our lives. However, in that I've stopped my D-365 Project on Flickr thanks to the free account limitations and my non-desire to purchase the larger account size, I'm tapped and somewhat burnt out on the D-Photo train of thought. So, I opt to take advantage of the Wild Card option available in just this kind of topic-blocked moment. I offer one photo before jumping into the Wild Card Topic, which also goes to the heart of simply trying to have what one might consider a BG Nirvana Moment(s)...


With that, the topic is: Blood Sugar Nirvana or Moronic Moment. Blog about the time you ate a meal that tends to spike you to the moon, but your perfectly calculated and timed bolus kept your blood sugar happy. Or tell us about that time your brain had a little diabetes-blip and you did something you think is “stupid”. (Because chances are, we’ve done it too!!) Go ahead, brag about your triumph or commiserate about your d-blooper.

As fitting the mood set by the photo above, Diabetes is a Balancing Act. Rarely do I achieve what I've set out to achieve as far as having a consistent day of great BGs. When High, chances are I didn't intend to be High. When Low, the same is often true. Sure, I do achieve those BG Nirvana moments but they usually aren't calculated measures on my part. They come out of nowhere, sometimes caused just by the changing of the wind or the sun's movement in the sky. Recently, I had a day that didn't see any test above 160 - this was success for me. Sure, there was a Low that day that I was aware of and caught, but it wasn't anything bad and this was an acceptable part of the day. Of course, it's nothing I could re-create and there's nothing special that happened that day. Just another day of Living with the D... Tough to predict, this diabetes is.

Ok. I'm going to go all Yoda now on the DOC: "There is no try. Only Do, there is."

So there. Go out. And do achieve BG Nirvana Moments. Good luck in getting there.

Friday, May 14, 2010

Eye Witness Accounts on Exercise

My initial post on this Day 5 of Diabetes Blog week, "Exercise... Not So Much" made me feel lazy. By no means am I lazy and without any activity in my life. I don't want to give out that impression. So, in order to set the record straight (if even in my own head), this Second Post was born. You will see that I do, indeed, get exercise. But please, don't take my word for it. Hear it straight from those in my household who know best... my cat and dog.

The Wise Shadow Cat:
Full disclosure: I'm not a willing participant in this blogging event - I was bribed with tuna, and I firmly believe the keyboard may have been laced with catnip. However, since I'm here, I might as well make some use of it and spread my wisdom... Plus, any other cats (Siah, Siah???) who may be reading as part of "The Plot" for World Domination...

Yes, the Moron who calls himself Daddy sometimes does move around and get exercise. I've witnessed it, sadly. You can't call it very successful exercise, though. You see, he sometimes chases me around the house and tries to capture me. Being a superior being, I am usually able to wisk away and escape without any trouble. There are times he prevails, though... He sometimes traps me in laundry baskets. Or tricks me with rattling bags of treats or tuna containers, much like that Idiot Dog gets all stupidly excited whenever he starts opening a slice of cheese.... He sometimes sneaks up like a Ninja while I'm lounging on the bed and picks me up. These instances are few and far between, because he's slow and not the most coordinated of fellows, but they do happen from time to time. Though I doubt you will, please don't think less of me for this occasional lapse in escape-artistism. You DON'T want to be on my bad side when the cat-pocalypse comes crashing down upon you...

Riley Dog (fondly referred to as the D-Dog):
Hi! My name is Riley. I am a dog. I love my mommy. And my daddy. And you. I love to lick, and be a puppy (even though I'm about 5 years old).

The gray kitten asked me to tell you that yes, daddy does exercise. He LOVES to play with me, and I love to play whenever he's around! Not like the kitten, who just wants to get away and doesn't show any affection unless she's in need of food or a sand box cleaning. Sure, she sometimes does run around the house late at night, chasing some invisible mouse that no one else seems to notice. But whenever daddy wants to chase her, she's just not up for it - that's just plain weird. But NOT ME... I LOVE to play and get exercise!

See those TOYS over there? I will tug on my rope or Motor City Tire Toy like there's no tomorrow! Lately, I've started playing with an odd-shaped frisbee and love tugging on that, too! Whatever works.

Sometimes daddy takes me OUTSIDE (Yay!!!), and somtimes we even go on WALKS! (or, as they call them in trying to trick me: W-A-L-K-S.) I like going outside. Whenever my collar jingles and my leash buckles chime, I get all happy like a kangaroo and bounce up and down with joy. Because I'm a dog. That's what I do.

When I first came to live here, mommy and daddy took me on WALKS more often. But that doesn't happen as much anymore. When we aren't going OUTSIDE or for a WALK, I usually get to go outside and run around when mommy and daddy get home from work. When it's nicer outside and not raining (I don't like rain!), daddy will come outside with me and chase me around the backyard. We don't have a fence, but I know where I am not supposed to go and don't go outside that area - it would be B-A-D. It's fun to run around the backyard, and daddy usually can't catch me because I'm faster than he is. Most of the time, he can actually stand just in the same place and I'll just run circles around him while he makes a move towards me every once in a while to keep me going... I guess that's not really much exercise on his part, but it is for me. And it's fun. It's even more fun when daddy brings out a yellow tennis ball and we get to throw that around and play catch. I really like that, but sometimes I lose the ball under a couch or table and it disappears for a while so we don't get to play. That makes me sad. That's about when I decide to stalk the cat... It passes the time, at least.

So, that's about it.

I think that is all the cat wanted me to tell you. I shouldn't stay any longer, because that might make her mad and we don't want that. Maybe in the meantime, I'll go sniff and see if there's some treats left around until daddy gets home. Or look out the window and see if anyone is coming to see me. Or maybe I'll just rest on that nice comfy bed with a bedspread that mommy and daddy make up JUST FOR ME. Who knows... The day is full of possibility.

Wait... What was that I heard? Did the garage open? Is that a car door?? Who's that? Who's here? Who's at the door?... Someone to see me?????
DADDY!!!!!!!!

Exercise... Not So Much


We are asked by Karen today to write about the wonders of exercise... Love it or Hate it? Do we have regular exercise routines? Trouble finding the motivation to exercise? How are food and insulin intake managed to avoid bottoming out during a workout? This is the day to tell all about exercise habits, or lack thereof.

When I was 5, my exercise activity was playing baseball. Did it as part of a league. Tee Ball at first, then moved up the ranks as the years moved on. My dad was the coach. Good times that gave this little Kid With Diabetes the needed exercise. When high school hit, the ball and bat got traded in for the swim team. Did that for all four years, in addition to all the other regular exercise tasks this teenager had going on. College brought a more sedentary likestyle without swimming or regular sports activity, meaning the exercise routines were getting fewer and farther between. Sure, there was the regular campus walks and such, but the team sports went away. Now, there's the career and married lifestyle that admittedly isn't as exercised-focused as it should be.

We adopted Riley from the Humane Society in mid-2007, and one of the goals in doing that was to help us weave more exercise into our lives - regular walks every morning or evening, before or after work. That hasn't happened. We work on making it so. But, now it seems like the work-related walks in downtown Indianapolis during the day or the evening/weekend lawn mows are the extent of the activity. That is sad. And something we're trying to work on in the Hoskins Household - it is a work in progress, along with many other things.

Some have suggested getting a Wii, as it apparently can be packed with exercise games that are fun individually or for the whole family. If it didn't cost so much, I might be more open to the idea... Yet, that doesn't replace the good, old-fashioned kind of fun we had as kids playing outside. Running to play "guns" or "lasers" with friends, a quick round of catch with dad or some friends, a pick-me-up game of hoops or baseball, or a visit to the nearby playground. That's the kind of exercise we're supposed to have in life.

As a wise blog-reader and commenter wrote (below), back in those days it wasn't exercise that had to be part of our routine because it was good for us... It was just playing. Good, old-fashioned fun with friends and running around without a care in the world. Making sure you had more sticks or little Muscle Men then your friends and could make it home in time before the street lights came on. Yes, those were good times. When excercise was just a part of the game because it was fun...

So now, as an adult who "should" excercise, I'll rely on Riley and some more regular W-A-L-K-S to get the blood flowing and exercise energy cranking. I'm sure both my body and the dog will be grateful. I may even put some air in the deflated bike tires and cruise around the neighborhood, pretending to be a 10-year-old and trying to forget about all the adult-stresses in life. In the end, it might just be a little fun that also happens to be good for me.

Thursday, May 13, 2010

To Carb or Not To Carb?


This is the fourth installment of Diabetes Blog Week. Today, I blog about what I eat, as that's what Karen asked us to do in setting the foundation for this whole thing. The point in her mind is that some believe a low carb diet is important in diabetes management, while others believe carbs are fine as long as they are counted and bolused for. She wants us to talk about meals, snacks, special occasions... Whatever we deem food and bolus worthy.

To Carb or Not to Carb? That is the question Shakespeare didn't ask, but should have as it would have given us food-calculating diabetics some guidance.

In my opinion, the problem with so many in this country is that we don't respect the mantra of "good in moderation." Whether we're talking about food or alcohol beverages, this is a key. Yet, so many are afraid of things all together. Carbs are evil, I've heard some say. Just stay away. It's an old-school thought that doesn't deserve a place in our modern times where insulin pumps and CGMs are so mainstream. We can eat those tricky carbs, bolus for them with our fine-tuned pump options, watch the trends on our continuous monitors, and tweak as needed. Sure, everyone's D-Lives differ and a change in the sun's position can mean a variation in D-Management. Still, the philosophy is the same. Granted, I'm no CDE or dietician or medical professional with training in this area. But it doesn't seem that complicated to me, as someone who's now lived with Type 1 for more than a quarter-century. It may be easier to not have carbs, but that's just a personal train of thought to avoid the hassles of calculating or adjusting for what's eaten, in my opinion. Plus, isn't it a fact that carbs are the best source of energy for athletes or really for anyone? Again, this is the non-medical professional rambling about something I once heard or read in literature... Whatever.

Now, I'm not meaning to shoot down anyone who doesn't eat carbs or prefers the no-carb Atkins Diet - to each their own. I just don't care for it, and love my carbs. Love my pasta. Love my crackers. My bread and dinne rolls. Keep em coming, and I'll bolus for them as needed.

Obviously, life was different before carb counting. Back on the pre-MDI days even when it wasn't multiple injections with "boluses," but a couple shots a day with R and L mixed in together. Then, the predictability of anything - especially food and carb-heavy meals - was even more of a challenge. But those days are gone for this man, and I personally find carbs nothing of a danger outside of the usual issues.

For me, the answer to that big Q Bill Shakespeare didn't answer is clearly: To Carb. Of course, moderation is the key so I don't develop that Oh So Familiar Hoskins Family Potbelly passed down the line... My diabetic metabolism solves that issue, but I still keep an eye on the carb intake to not go overboard.

Let it Be, I say. Bring on those carbohydrates!

Wednesday, May 12, 2010

My Lawnmowing Partner

This is Day 3 of Diabetes Blog Week. Today, the topic is entitled "Your Biggest Supporter." As Karen pitches it: "Sure, our diabetes care is ultimately up to us and us alone. But it’s important to have someone around to encourage you, cheer you, and even help you when you need it. Today it’s time to gush and brag about your biggest supporter. Is it your spouse or significant other? Your best friend, sibling, parent or child? Maybe it’s your endo or a great CDE? Or perhaps it’s another member of the D-O-C who is always there for you? Go ahead, tell them just how much they mean to you!"


I'd planned on some elaborate post being the end-all-be-all tribute to the wonderous person I consider my biggest supporter. Words. Poetry. Picture prose. Something grand, as that's what is deserved. Heck, even in realizing that it wasn't going to play out that way and it was self-defeating behavior to even think I could write something eloquent to capture it all, I pondered changing tunes and going with a funny anecdote about my Cat or Dog and the support (or non-support?) that they give me. But in the end, it didn't materialize that way and I've run out of time or creativity. Maybe, it's because words can't describe how significant a part of my life this person is, and how much a foundation and fixture I've come to rely on this person's ability to not only put up with my personal craziness, but also everything rolled into my D-Life.

So, to offer just a tiny glimpse of this person's support that can't possibly encompass everything or do justice, I give you a story to contemplate.

On Monday, I escaped work a little earlier thanks to the many extra hours I'd put in the previous week. Part of the early-leave was to get home for a much-needed lawn mowing before the forecast and visibly approaching rainstorm set in. Without even changing out of my work clothes, I pulled out the lawnmower and started what I expected to take an hour or so to complete. Our smaller, unfenced backyard came first - as it grows to lengths we fondly describe as "the forest" thanks to the dog doing her business out there. I started the mowing, and did about a quarter of the back before the lawn mower decided to quit on me.

Frustrated that my starter-cord pulling was leading nowhere, I cursed out loud, kicked the air, and journeyed inside to pout. Being an experienced lawn mower herself, Suzi followed me outside to investigate what I was griping about. A quick investigation revealed that it was, as she noted, on level ground. Yet there seemed to be little gasoline inside. I wondered why I hadn't noticed that when peering inside myself.... Realizing the red fuel container in the garage was empty, we concluded a quick drive to the gas station was needed. I fussed, glaring at the cloudy and darkening sky that appeared to be laughing at me. Suzi decided to drive by herself, and she told me to go inside and sit down for a rest before she returned. I obliged. After she left, I noticed my vision was blurry. I was even cold, despite spending 30 minutes outside cutting part of the grass. Something wasn't right. So, I did a blood test and found: 51 mg/dL. This was interesting, especially since I'd tested at 345 about three hours earlier. Apparently, my correction bolus had worked and combined with the exercise to drop me down Low. Things started clicking into place, and my earlier lack of observation and deduction and patience seemed to make more sense.

Instantly, I spotted the candy packs of fruit-flavored Royal Rolls on the kitchen table where I sat. These were long lost but recently-discovered Christmas gifts from my aunt, and they're basically like LifeSavers. A roll of 6 little candies equals 18g, so I unsealed a new one and stuffed the candies into my mouth. Before long, I felt the effect. Added some PB and Saltines to the mix to help it all stay with me and prevent a future drop.

Suzi returned, filled up the fussy lawnmower with fresh gasoline, and offered to finish for me. I stayed inside and managed to bring my sugar level up with some more Royal Rolls, then joined her outside and grabbed the edger to start trimming the non-lawnmower parts of the grass. Our teamwork prevailed, beating out the rainstorm that didn't arrive until later that evening.

So often, Diabetes can get in the way of our regular life tasks. This is just one of them. Outside observers may not see anything special about this lawn-mowing example, but it's just one of the many that we share in working as a team. Some may have different opinions, or handle Lows or Reactions or Highs or Anything D-Related differently, but she does a marvelous job in putting up with me and responding in the best way possible. We've come a long way in the decade since we've been together, the five years of marriage this September. We still have a long way to go because it's a lifelong journey. But every day and every moment is speal, regardless of how stupid diabetes wants to be and the curve-balls is throws at us. I've written about her responses before, from the Wrestling Diabetes to Calling the Paramedics and Conquring my Delusions of Being Attacked By Apple-Cider Poisoning Aliens. Sometimes, it's just routine daily tasks such as carb counting my meals, helping me with D-Math, asking how an Endo appointment went, or checking out my day's Twitter postings to see what's up. Simple or complex stuff, all the same. No matter the situation: I know that in the end, when the D gets in the way of my metaphoric lawn-mowing, there's someone there to support me and help out.

Of course, there are very many others who support me and have done so throughout my 26 years of living with the D - mom, dad, family, friends, co-workers, bosses, swimming teammates, fellow students, fraternity brothers, and OF COURSE the Diabetes Online Community... There are just too many to name, as Kelly puts it: "It Takes A Village."

Everyone is irreplaceable. And I can't say Thank You enough. Because without Suzi and everyone else, I'd be a goner.

Tuesday, May 11, 2010

Not Candy or Drugs

This is Day 2 of what's being dubbed D-Blog Week by the Diabetes Online Community. No need to read them in order, but here is Monday's post if you're interested. The second installment: Making Lows Go Away. This is where we get to talk about our favorite ways to treat a low, whether it be by juice, glucose tab, or secret candy stash. You just might find a new trick to add to your D-Arsenel Belt in treating a Low, learn what brings blood sugars up fast without spiking too high, or even just getting a laugh at common tales or stark differences between us People With Diabetes.

Glucose Tablets have always been my thing.

As a kid, you had those little white squares that just resembled hardened sugar and came in little silver-wrapped packages. They were "for emergencies only..." But that didn't stop me. Even without a Low, sometimes I'd go for one. If you were watching, you might notice that the numbers dwindled and the squares would just magically disappear from the bottom bathroom drawer where they were kept with other D-supplies of the day. In the mind of a child, I was all sneaky and brilliant because, seriously, who would think to eat these like candy when they're really a medical treatment for a low blood sugar? Surely, not a diabetic. It must have been someone else, I'd reason.

Ha!

In "sneaking" those white tabs as a kid and teen, I'd take them to school and could sometimes be seen popping one in the hall (whether I was Low or not). This did, at least once, cause a stir about what I was injesting. I remember having that conversation in one of my first days of high school. It also came up in later years when I was at a swim meet, and strangers saw this. It never got to the point I've read that other D-Kids have faced, with officials putting drug-user or dealer notes in their school records, but it was a pain to even have to assure a teacher this wasn't what they thought it might be. (Equally exciting was when strangers at a swim meet would see me injecting a clear liquid in a syringe!) Of course, I won all of those battles when someone cared to call me on them.

Anyhow, because of my fondness for them despite being told repeatedly that these are "not candy," glucose tablets evolved into my preferred method of treating Lows once I entered adulthood. Sadly, B-D has discontinued those little white square tablets and the smaller, round, multi-flavored tablets that come in jars or sleeves are the new norm. These are handy as I can keep a sleeve in multiple spots: my car door, desk drawer, work briefcase, inside coat pocket during the colder months, and in the wife's purse. Larger jars sit at the ready on the nightstand next to my bed, on the microwave downstairs, and in the car console. Plus, I have a nifty 4-tab holder on my keychain for those warmer no-coat months when I'm away from those above-listed places and just don't have any glucose tablet sleeves with me.

Of course, there's other methods I use, such as the tiny less than a buck tube of gel frosting that can be used in the case of a severe Hypo. Suzi has used this from time to time to coat the inside of my mouth, to avoid the Glucagon or calling the paramedics for a late-night visit. I've also recently discovered Royal Rolls fruit-flavored candy, which come in rolls of 6 and are basically like LifeSavers - love em! Each full roll counts for 18g, so it's a good little boost when needed. In addition to these quick-sugar fixes, I accompany those with something more of substance like a piece of toast with PB or some PB crackers from the vending machine at work. Really, though, you want the truth? When my sugar goes low, while I prefer those above-mentioned items, I'll take Whatever Works.

So, that's how I like to Make a Low Go Away.... Just give me a Glucose Tab. So says the man who's been told he's a user, dealer, or plain old diabetic with a sweet tooth!

Monday, May 10, 2010

Day in the Life...By the Hour

You may notice that this is the second part of my first installment. After reading several other D-Blogs today, I decided that a breakdown of my day was in order. It may not be "typical," but it's as close to routine as I sometimes get. As always, Your Diabetes May Vary because mine does every single day, no matter what I do.

6:15 a.m. Alarm clock screams at me. Volume bars get pushed down (my makeshift Snooze) and my head drifts back to the pillow, craving more sleep before the hectic Monday begins.

7a: Pull myself out of bed. Dog is there to greet me with a lick on the face. I pet her, slip on my sandals, and move out of the bedroom to do a BG test. It says 124 mg/dL, down slightly from the 136 at bedtime shortly after midnight. Nice. Ready to roll!

7:30a: All showered off, now ready to throw on the work clothes. First, I head to the computer out in the upstairs living room to check the day's news so far and send out a few work emails to start the day, then pull out the Lantus Pen for the morning shot of 14 units. Get dressed, check my test strip vial and make sure there's enough syringes and Humalog in my "man purse" before heading out for the office. Today, the wife is driving me in as she has the day off. So that's nice! No traffic nightmares today!

8:30a: Arriving at the office, my phone message light is already blinking and there's nine emails from when I checked at home an hour ago. A few relate to the breaking news item that's pending for later in the day and the rest relate to work deadlines. Grab my first cup of coffee. I think about the BG impact it'll have, but choose not to care as I need the caffeine for a deadline morning...

10:00a: Finished writing and turned in two stories, plus made revisions on others. So now I take a break to watch President Obama announce the newest nominee for the U.S. Supreme Court. It's Kagan, and I saw her a week ago on my trip to Chicago! While I'm watching, do my mid-morning BG test: 224. Figures, as I'm now used to the mid-morning boost that comes naturally but also is fed by my already several cups of coffee. About to hit the men's room to correct (as I'm on a pump haitus and am currently avoiding the upper body areas), but the news distracts me and I get sidetracked.

12:30p: My head is pounding. Taking a look up from writing, I realize that it's lunchtime and that I'm hungry. It also dawns on me now that I hadn't corrected two hours earlier when I should have. BG Test: 206. Fine. Not high enough to make the head pound, so it may be a simple stress-enduced mind jab from the day's happenings so far. Whatever. Still writing a work-related blog for the day, I decide that it's time for lunch regardless. I'll correct and take a lunch bolus, before scarfing down a fruit cup in my desk and bag of chili cheese Fritos from the vending machine. Of course, my breaking news story is about to go up at 1 p.m., and something catches my attention and distracts me.... (again).

2:45p: Headache went away, but now there's that sweater-mouth feeling indicating the sugar is High or Going Higher. Again, I realize that I've not corrected from earlier. Normally, I'm not this forgetful. But sometimes, a journalist's deadlines just come out of nowhere... Swearing under my breath, I test and see a 212 - that's a lie, I know it. Mr. One Touch UltraLink is trying to trick me. So, I'll wait...

3:30p: BG = 345. A-Ha! I KNEW it! Fine... Off to men's room to correct. 8 units. This time, nothing distracts me and the injection goes into my behind. I hope it orks and doesn't screw up. We'll see. Read some D-Blogs to calm down, and move on to a little more work before the day ends.

5p: Test shows 101. Perfect. Cut out from the office a bit earlier today, just in time to go out and mow the grass before the approaching storm sets in. Somehow, a sleeve of saltines finds itself into my hands... I snack on them, rationalizing that the grass cutting will level it all off.

6:30p: Though it's not a daily ritual, the lawn mowing needed to be done today. However, a Low interfered and forced a task-swap with Suzi while I went inside briefly and tested (a 48). Apparently, the correction worked and is still working from earlier. Munch on some Royal Rolls Fruit Candy that I got from my aunt for Christmas (a roll of six are 18g, so I eat them all.) Then, off to trim the sides with the edger. At least all the outside work is done before it rains.

7:30p: Pre-dinner test is now 165, so I'm nice and corrected from earlier. Time for second round of Lantus today, this time 10 units. Where to inject, where to inject..? Need to remember where the day's injections have already gone, so that I can appropriately rotate sites. I choose: a right leg site. Those usually work! And, it's dinner time! Heated up BBQ chicken breast from the other night, mixed veggies, three dinner rolls, and 1/2 cup of applesauce. Total carbs: 70g. Since I am on a 1:10 insulin unit to carb ratio, it's easy math this time (7.0 units). Plus, I'll grab my four daily pills from the plastic day-of-the-week pill case on the microwave since they evaded me before leaving the house this morning. Then, I'll let the insulin and food mix and hang together for a few hours.

10p: It's May. Time for a Law & Order sweeps episode! Dun dun! Sometime near this time, I usually plan on an evening blood test as I settle in for my last prime time show of the evening. Hopefully, I avoid the evening snacking that sometimes happens despite my best attempts. Usually, I'm be running a little higher in the 180s to low 200s or so if I calculated the dinner carbs and bolus correctly. But even if a tad higher, it'll come down by bedtime and be all good. Either way, I'm ready to watch Jack McCoy and Crew kick some legal butt. We make sure all the D-Supplies are sorted and on a commercial break I do a test, only to see the BG Verdict come in at: 51.... Dun Dun! Guilty... Guess I'll have to eat some more Royal Rolls this evening, after all. The D-Dance throws me a curve ball! Oh well. I'll do a little dance... get down tonight. Still going strong.

This next part is a predictive look into the future - an educated guess, based on experience:


Sometime around the Midnight Hour: After the evening news and Jon Stewart, a night-time test. Hopefully, the candy did the trick and my BG has settled into a safer level. If it's 180, I'll call it a night. If still too Low, a piece of toast with PB to get me through the night. May take in Keith, Rachel Maddow, or Hannity depending on what the mood says at this hour. Then, will hit it and get up for that 3 a.m. test to make sure before it all starts again.

This is a typical day, plus or minus a few unique aspects that happened today. Regardless of what is happening, the blood tests and injections only take a moment. A few brief seconds of of my time that really don't take away from anything. That's true. But the consequences, the emotional aspects, the mind-games and fluctations that are tough to predict each day no matter how similiar your actions are from the previous one, all throw your clock and daily routine off. It's never the same. At least not for me. And now you know. Take it as you will.