Friday, July 30, 2010

A Campfire Collection

The most recent annual camping adventure took me up to Interlochen, Michigan for a week and allows me to trade in the real life stresses and online universe for much-needed relaxation outdoors. Here's a Friday Lite post with some snippets of My D-Life Around The Campfire and nearby places.

Moonlight, Campfire, & The Darkness Outdoors: This was my 5th year in the past decade on a summer camping adventure, and the the third straight in late July heading up to the northern part of Lower Michigan with friends. But it was my first where I wasn't pumping, but rather endured Multiple Daily Injections. My sugars were pretty steady or even slightly Low a majority of the time, and only a few times did they rise Higher when overeating and not compensating with enough insulin. Daytime was easy enough. But after dark presented some challenges. Being at a Michigan state park helped, as there were lighted restrooms, showers, running water and electricity. Washing the hands was easy enough, and a trip to the lighted restroom near our site gave me the ability to easily give myself a shot whenever needed. I carried a few syringes in my small little case, and kept the four 10-needle bags in a larger case that stayed in the master suitcase inside the tent for safekeeping, along with extras of all other supplies and meds. This system worked out pretty well, and in my opinion was just as good as the years before when I was pumping (actually, even better as it was my first camping trip that I was truly and actively engaged in "good" D-Management.)

All The Diabetics: Actually, it was the original Beyonce version known as "All the Single Ladies." One night, the tune began playing at a camp site next door. I couldn't get All The Diabetics out of my head, and the outstanding SugaSheen tune was on my mind for the rest of that evening. A quick Tweet let the DOC know, too. As I recall, that text-Tweet was the first time I'd breached my no-online contact rule. Oh well. A few times it made me wonder about the carb-counts of campfire snacks, and it reminded me to test my blood sugar. But it also made me think about the awesome DOC and how I missed keeping in touch with them.

Parking Lots and Microbrews: Despite being away from the DOC, though, the camping vacation did lead to an actual D-Meetup and a sighting of another likely Type 1. First, there was the parking lot encounter at Tom's, the local grocery store, on our first full day. Suzi had gone back inside the store to buy stamps we'd forgotten, and I was left to load up the vehicle. The young woman was parked in the spot next to me, and when she opened up her trunk, I saw the purple Minimed Paradigm dangling from her waste band. "Nice Minimed," I said, receiving a glance of acknowledgment. "Thanks! Are you diabetic?" I introduced myself and briefly recapped my tagline of a history, specifically my ongoing pump hiatus that's taken me back to MDI for a few months, and learned she'd been Type 1 for about 15 years. She was from the area and her young daughter in the car and was already running late, so our 3-minute conversation didn't last longer. A few days later while dining at a Traverse City microbrewery, we observed a man who was wearing a Cozmo on his belt. Didn't talk to him though, and there wasn't really any reason for that. But, that was two other Ds in the course of a camping week - what a small little D-World!

Not For The Fish: Two friends have boats, and so that took me out on the massive lake a few times during the week. Being on the boat meant maneuvering how I'd navigate the Low Waters should they splash my way. Day trips weren't an issue, as my wife carried some emergency Sweet-Tarts in the bag she brought. But the more complicated time was my fishing (casting?) excursions on the water without her. My tackle box gave me an option. It was soon stocked not only with Sweet-Tarts, but a pack of Skittles and a tube of orange glucose tablets. Only ate one roll of Sweet-Tarts while camping, though it wasn't on the boat. Later turned out that the other rolls of Sweet-Tarts in my swimsuit didn't survive a short trek through the lake water, and I ditched them rather than gamble with the possibility of Swimmer's Itch in the throat. The safe sugar options in my tackle box ended up being left on a friend's boat, and it journeyed back to Southeast Michigan instead of finding its way back to my vehicle for a return to Indiana. Maybe I'll pick it up before next year's camping vacation, though I doubt the sugar will still be edible by that time.

Waterlogged Meter. Not everything was safe from the lake water, though. On one journey to the boat that involved a short little walk through the waist-high waters, I stuck my little black zip-up case into the beer cooler for some safety. Unfortunately, I forgot about it and it got trampled by beer cans inside, ending up at the bottom in the melting ice water. Half a vial of test strips and a lancet were sacrificed, but the main casualty: My trusty One Touch UltraLink meter (the only one I've had to connect with my Minimed 722 and the only one with ALL of my readings for the past few weeks since I'd last uploaded.) One of my last results on there was 141 from earlier in the day when we were out on the boat, but now for the fishing leg of the trip my meter was a goner. Later replaced batteries and dried it out, but there was no salvation. The meter was lost - it's sleeping with the fishes (those who escaped the glucose-neighboring lures in my tackle box). After getting back to Indiana, I phoned One Touch and explained the situation and they're sending me a replacement. Should receive it by August 1. So, there's that.

A Cherry-Glazed D-Feast: Another post-vacation treat was what we brought home from this part of Michigan, which is very near Traverse City and is pretty much cherry wine country. Dozens of wineries are scattered throughout the area, and we ventured to several during our trip. We came home with about a case of wine, most being some variety of cherry wine. Also got a Cherry Barbeque Mustard from one of those wineries, which not only was a great dip with Wheat Thin crisps but also served as a key ingredient for an outstanding D-Feast. Being that I missed the first D-Feast Friday on July 23, here's my contribution for both that Friday and this one today!

Barbecue Mustard Glazed Pork Chops with rice and Michigan Cherry Spiced Wine.
  •  Ingredients: 1/2 inch thick bone-in pork chops are what we use, but it really doesn't matter. Rice. Corn.
  • Preheat grill-pan to medium-high, spray with "Pam for Grilling"
  • Once heated, place porkchops on pan. Do not move after initial placement on pan.  This will help create the crust (Thanks FoodNetwork!)
  • After cooking for a couple minutes, check for lines and flip over. This is where the 2008-award winning Cherry Barbeque Mustard comes into play. We bought it at the Chateau Grand Traverse Winery, but it was just sold there after being produced at Brownwood Farms. Place about a spoonful (adjust for taste) on the cooked side of the pork chop.  Repeat on the second side.  
  • Continue flipping and adding glaze until done and according to taste.  These specific chops took about 10 to 15 minutes to cook and 3 to 4 spoonfuls of glaze.
  • Add Uncle Ben's 90-second microwave bags of rice (my favorite with this is the Garden Variety, but really you could probably have anything that compliments the chops.) 
  • Pour a glass of the Cherry Spiced Wine from The Cherry Republic Winery in Traverse City.
  • If interested in dessert, you may also enjoy a small portion of Doug Murdick's Fudge from Traverse City. It isn't exactly carb or sugar friendly, but it is Awesome.
  • Enjoy!!!!
  • For me: this total was just about 100 grams. Each teaspoon of the sauce is 5g, so with four servings it was 20g for me. The rice, corn, wine, and fudge all added to that carb count - totally worthwhile D-Feast, in my opinion!
Lilly's Returning Home Award: Of course, aside from the wine and treats brought home, I returned to an even cooler award received by mail. A package from Eli Lilly here in Indy. It was my very own Lilly Diabetes Journey Award for 25-Year Insulin Medal, dubbed to be "a celebration of (my) hard work and determination" in living with diabetes for a quarter century (as of Spring 2009). I'd applied about a month ago and had already received the Joslin Award, and this was the second to arrive. The official tag for it: formerly known as LillyforLife, this recognizes diabetes patients who have successfully managed their disease with the help of insulin for 25, 50, or 75 years or more. Since 1974, Lilly has presented more than 2,000 insulin medals to people affected by diabetes. These individuals serve as an inspiration to all people affected by diabetes, for learning how to manage their disease and adapting to the ever-changing technology of diabetes care throughout their diabetes journey." My award: A personally engraved medal in its own red box, complete with a consent and release form for "Interviewing, Photographing, and Videotaping." Not sure where that'll lead, but it'll be interesting I'm sure. This was a cool little gift to get upon returning home.

Well, that's all there is. Riley (our happy D-Dog) was thrilled to get home for not only a bath, but also to be reunited with the Shadow Cat - who appeared to check out the ruckus upon our return but appeared dismayed that we spoiled her week-long run of the house. All is back to normal now and we have only the memories and Campfire Tales for 2010, but we remain happy with that reflection and the anticipation for what we're hoping will be an even greater adventure next year. That is, if the stars align for what's expected to be an awesome CWD 2011 conference. The waiting and planning now begins...

Wednesday, July 28, 2010

Camping for Causes

Camping is awesome. I love it. But what's even cooler and more AWEsome is when those summertime camping adventures are all in the name of good causes.
Charity. Advocacy. Support. = Good Causes, indeed. Especially when you're talking about Diabetes, or other conditions that need to be cured and can use all of the help we may be able to offer.

Breast Cancer and Camping: Our recent weeklong adventure to Michigan was not only a time for relaxing and escaping from everyday stresses, but also a time to contribute to the Breast Cancer Susan G. Komen 3-Day for the Cure, which is an event featured on a page of its own - Causes to Care About. This is our camping cause because the trip organizer is one of several of my fraternity brothers and friends participating in the event on Aug. 13-15, 2010. Dubbing themselves Team Sisters, Misters, and Blisters, the group has pledged to walk more than 60 miles each to raise a combined total of $10,000. They're 53% in, and have a ways to go in the few weeks left before the event. So, not only did we have the regular camping adventures this year, but we also had the trip organizer and Walk Participant wearing t-shirts advocating for the upcoming event. He also mentioned his need to really start walking more to be ready, but it's to be determined on whether that goal will be met. Can't help with the exercise prep, but I do want to do what I can to help on the financial front. We pay some money for the camp site reservations and overall expenses, but any extra goes toward this great cause. I'd encourage anyone else to do whatever is possible - as this is something that not only touches those involved in the Michigan walk, but also nationally as it goes toward the greater good to combat breast cancer.

D-Camp Calendars: You may recall that I've blogged before about the Diabetes Youth Foundation of Indiana's Camp Until A Cure, which is based in Noblesville on the northside of the city. I spoke there a few months ago from the perspective of an Adult Type 1, and recently was asked to return to participate in a cool fundraising idea that one D-Mom came up with. Her plan is to create the first-ever calendar about the camp for 2011, featuring a photo of a PWD or D-Family on each month's page in order to raise money for the camp. The photo shoot was July 17, that Saturday just before we left the state for our annual camping adventure. The mom has a photography passion and got some great shots around the site, and we had participants of all ages there to take part! Met some really cool people for the first time, and touched base with other familiar faces. A flyer I received says that 100% of the proceeds will go to provide scholarships to underprivileged children so they can attend what's the only locally-owned camp for Type 1 kids. Ads and sponsorships are possible, and any questions or followups can be directed to calendar designer Felicia Tindal (who's daughter was diagnosed in July 2009.) The calendars will be on sale at the DYFI's 9th annual dinner and silent auction on Friday, Nov. 19, 2010 and also on the organization's website.

"Sex, Drugs, & Rock N Roll": Not only is there a cool calendar coming out, but there's also word that the DYFI executive director wants to put together a Teen D-Camp Weekend in October. Some of us Adult Type 1s may go to camp to talk to the teens about various issues about getting into those early adulthood years while Living With Diabetes. More to come on that down the road...

Cynthia Kahn Memorial Scholarship for Extreme Weekend: The Diabetes Community lost a passionate advocate and leader earlier this year, when Cynthia Kahn died from her family suspects was a diabetic Low. I wrote a tribute about her here. On Thursday, Cynthia's family is assembling in Orlando for a memorial by the University of Central Florida's College of Medicine - where she had worked since March as head of public services for the Harriet F. Ginsburg Health Sciences Library. But to the point of D-Camp, we reflect on Cynthia's passion for the Extreme Weekend for Children With Diabetes, a twice-a-year camp in northeast Maryland that is run by the non-profit group Adventures For The Cure and gives kids a chance to do intense sports while keeping up on D-Management. She'd twice volunteered as a camp counselor there for diabetic kids between 8 and 17, and leaders say she was instrumental in making the Extreme Weekend camp what it is today. Most recently in April, she had attended the camp and loved the experience, and she'd even wanted to start a similiar local camp like that in Orlando where she'd moved earlier this year. In her honor, the AFC has created a Cynthia Kahn Memorial Scholarship Fund to help children who cannot afford to attend the camp on their own without some financial assistance - the group webpage reports that about $2,300 has been raised so far. Another worthy D-Camp Cause.

Adult D-Camp: Finally, we have one that isn't focused on money. But rather, a concept pitched recently by beloved DOC member Sarah Jane (@sajabla), who runs Sarahndipity.She mentioned at a recent D-Summit that it would be SO COOL to have a D-Camp focused on Adult Type 1s, kind of like what many of us experienced as children. The concept was very much welcomed, and last I heard she was exploring the southern Missouri area and guaging response. We'll see what exciting things come from this, but it may be destined to be another great Camping For a Cause idea that gets many diabetics together for a fun time!

With so many great causes and other diabetes or condition-focused charities and organizations out there, it's refreshing to see some like this that can also embrace camping adventure. Hopefully, you can find some place to get both of those worlds, too!

Monday, July 26, 2010

From the Archives: Hey Sherlock, no sh..

 Our annual week-long camping vacation just ended and I'll be playing catchup for a little while, so I'm tapping some of the archived posts from back in the days when you might have just seen this as The Corner Booth, without a specific D-focus. This one originally appeared March 31, 2007, but remains relevant today as many studies continue to provide nothing more than a reassurance of what's already out there and known. Not all, but many. Have you observed any particular studies (mice or pigs or otherwise) that might tickle a comment? Let me know, and of course thanks for visiting!

Breaking news: "Sedentary behavior linked to high blood sugar." Another one this week: "Active Self-care Improves Blood Sugar Control."

Really? Are you kidding me? We had to spend valuable time and resources on studying this? As if no one could have guessed this from talking to a person who's EVER BEEN TO A DOCTOR before??? Or actually lives with diabetes, or knows someone with it? Wow. I'm stunned.

Here's the sendentary story, and the self-care story. Favorite parts include the first one comes from the International Diabetes Instutute in Australia, where a doc and colleagues examined the link between TV-watching and BG levels in non-diabetics. Thousands participated. On the other, it's out of Harvard Medical School. The first is a research fellow, while the U.S.-based one was spearheaded by a psychiatry prof who's also "Research Fellow Affairs director at the Joslin Diabetes Center.

A quote on sitting around-study: "The findings reinforce the case for a strong focus in diabetes and obesity research on sedentary behaviors, such as television viewing, in addition to the now well-established base of evidence on the importance of increasing physical activity," (Dr. David W.) Dunstan commented to Reuters Health. "It is possible that other sedentary behaviors may have an additive effect on risk, in that TV viewing may be a marker for a broader pattern of sedentary lifestyle that includes a variety of other forms of sitting time."

From the do-your basics analysis: "Conversely, those with poor blood glucose control 'spoke of being 'tired' of the pump,' the researchers note. They described feeling discouraged and 'frustrated' that the pump did not 'fix everything' and that 'it's still a lot of work.'" (as opposed to insulin injections, which were cakewalk...)"

That study also concluded, and here's a fascinating fact to stun everyone: "The researchers found women to be more concerned than men about body image and social acceptance with insulin pump use."

Someone please explain to me (like I'm 2) how these tidbits are possibly considered news, or provide any new information to the medical community? Are we honestly supposed to believe the medical profession, and diabetes docs particularly, weren't aware that high BGs were possible in non-diabetics? C'mon - diabetes is out there in "pandemic proportions," people. Wanna guess why? (Thanks for connecting the dots on this issue, also, Reuters - Poor journalism, or just press-release writing...)

What a waste of time and energy.

Maybe, if we devoted research time and money from these types of things to other avenues, we'd be closer to a cure. Not just restating the obvious. Or putting a report out for the sake of resume-padding. Someone in the medical news coverage biz needs to examine worthy v. unworthy research and the money/effort spent on this. Would make some fascinating findings, I'm sure.

Monday, July 19, 2010

Gone Fishin'

That time has finally arrived.

As usual this time every year, it's time for me to unplug and unconnect. Typical regular life duties are being put on hold for a week as we head up to northern Michigan for the annual camping trip. No work meetings. No tweeting. No D-Blogging. Few phone calls. As little stress as possible. There, we'll spend a week in our tents and hanging out in the company of a dozen close college friends over campfires and good times. While it's tent camping, we are within the comforts of a state park. Once our workweek finished on Friday, we headed home to get all packed up before hitting the road on Sunday morning. Our drive is about three hours longer than pretty much everyone else going, as they all live in the Southeast Michigan area where we're from. But now that we reside in Central Indiana, this means an 8-hour drive north along the Mitten State's western coastline with periodic pit stops for us and the dog. The Shadow Cat will gladly run the house, with occasional check-ins by neighbors and friends. Of course, diabetes always goes where I do and like always I hope that it decides to cooperate for this year's camping adventure in Interlochen, just 20 minutes or so south of Traverse City, Michigan.

We refer to this summer break as a time when we've "Gone Fishin." A time when we've locked up to do something we love. Basically, this mantra recognizes an outstanding marketing campaign created by the state of Michigan's tourism bureau a few years back, to bring outsiders into the state to visit. There's a number of these great ads on video and radio, all with Michigan-native and actor Tim Allen speaking the Robert Frost-like words that create incredible images. I invite you to listen to my favorite, posted below, that makes me all warm inside and look forward to my annual camping trip even more.


There's also this great one called "Play Time," which captures so much of what this trip does for our souls - a time we long for most.

A few exciting D-events were on the agenda before we left Indiana behind for a week - a fundraising event at the Diabetes Youth Foundation of Indiana's Camp Until a Cure, and then an Indiana D-Meetup featuring the stellar lineup of Cherise (@Diabetic_Iz_Me), Mike Durbin (@mydiabeticheart), and Jenny (@ninnifur). We all met at the Children's Museum of Indiana, and it was without doubt going to be a great time. Tune back in next week for recaps on those happenings, but in the meantime there is only thoughts here about camping...

Oh, I so welcome this time in my home state of Michigan... Full of lovely landscapes, miles of majestic scenery, wonderous waterfront communities, and images of natural perfection that just can't be replicated. If you haven't been, I encourage you to visit. Particularly in the fall, when you can watch the colors change as the seasons do.

With that, may your week be rich with scenery as beautiful as the camping scenes I'm about to embrace. I'll look forward to reconnecting later in the month, but in the meantime I hope the D-Lives treat you kindly, the BG levels stay level, and life in general stays pleasant.

Friday, July 16, 2010

Becoming A Prince or Princess, Despite Diabetes

In preparing for a week-long annual camping adventure that'll take me away from the online universe to campfire connections of northern Michigan, here's a guest-post from a fellow Indiana Type 1 named Megan Bartholomew. This young woman lives in the same county as I do south of Indianapolis, and earlier this year was selected as one of the Indy 500 Princesses for 2010. Through that role, this 22-year-old Type 1 reached out and touched the Diabetes Community that's so close to her heart. We met up for coffee a month or so ago after the 500 Race Weekend and had a great time talking about any number of topics, and I mentioned that it'd be awesome to have her write here at The D-Corner Booth. She agreed, and so now I'm honored to share her story in what hopefully will be just the first of her entries here. Enjoy!
  - - - - - - - -  - - - - - - - - - 

Hi everyone! My name is Megan Bartholomew, and Mike asked me to write a guest blog a couple months ago.

I was 12-years old when I was diagnosed, but my older brother had been diagnosed when I was 7, so diabetes wasn’t something that was unfamiliar to me. However, as far as Type 1 diabetics go, we couldn’t be more different. Daniel was only 5 when he was diagnosed, so the slightest amount of excess insulin (regular and NPH then) caused severe hypoglycemia. He had more severe low blood sugars, with seizures and glucagon administrations, than I could begin to recall. I've been very blessed in that I have never had a seizure, never taken glucagon, and never been in DKA.

Now at 22 years old, I'm a triple major (math, biochemisty and biology) at Indiana University. After finishing at IU in May, I plan to pursue a PhD in integrative cell biology, specializing in immunology with an intent to do diabetes research. Aside from that, I was also a 2010 Indianapolis 500 Festival Princess. As ambassadors for our hometowns, the festival, and the Indianapolis Motor Speedway, each of the 33 princesses selected was required to plan her own outreaches. These activities could involve going to nursing homes, elementary schools, city clean ups, etc. The philanthropic message of the program is without a doubt the most important part, and the responsibility of promoting that goal lies with the girls selected. From nearly 250 girls who applied, only 33 were selected to represent the city during a time that brings so many new people to Indianapolis.

Since diabetes is an issue that is so near to my heart, I choose to do several outreaches with the JDRF and the Diabetes Youth Foundation of Indiana. I talked to parents at support groups, letting them know that it is possible for their children to go away to college and live on their own. I met kids who had never met an adult who had Type 1 diabetes. I encouraged kids to come to camp, to learn more about their own diabetes. And along the way I learned some pretty powerful things about myself.

When Mike asked me to guest blog, I swore that I would not make this a weepy “don’t let diabetes hold you down” and “you can do whatever you set your mind to” generic Hallmark card that anyone who has heard any successful person with diabetes speak about over and over again. What I wanted to do was let all of you see a candid view of my life, regardless of my diabetes. I was blessed enough to get to experience some really awesome things as a 500 Festival Princess. Underneath that sash and tiara, I’m a totally normal college student. I go to classes, I hang out with my roommates, I workout, I go to meetings for student organizations that I’m involved in, I go on dates with my boyfriend, I shop and get pedicures with my friends, I study a lot. Occasionally, I go to the bars and have a drink or two. I make sure that I check my blood sugar a lot, and I won’t go to sleep with a blood sugar that is under 180 if I’ve had any alcohol.

The only difference between me and other college kids? I check my blood sugar and wear an insulin pump. Some people have red hair and freckles.
 - - - - - - - - - - - - - - - - - - - -
So, that is Megan's intro. My personal take is that she's an amazing person, advocate, and role model for the Diabetes Community. She epitomizes the mantra that "Diabetics can do anything they want, regardless of their Diabetes." She proves that, and serves as an example to Children with Diabetes that they can be princes or princesses if they want to be. But don't just take her word or my endorsement of her awesomeness. Listen to what one mom, with a newly-diagnosed daughter, has to say. With permission, I've included this email response from an Indianapolis-area D-Mom about her thoughts on hearing Megan speak at a recent JDRF Support Group meeting:

From the perspective of the newly-diagnosed, it sure is helpful and reassuring to see those who have been dealing with D, taking charge of their lives and health and emerging relatively unscathed. There's certainly no shortage of information about the health ramifications of Highs and Lows and long term consequences, so I can't tell you how much it means to this mother of a 7-year-old girl who's worried about her daughter facing a lifetime of this disease to see examples of people living successfully with D.

I'm glad that T1D has not gotten in the way of Megan being able to become an Indy 500 princess and the advocacy that she's doing is wonderful. Not knowing others with diabetes, I have to imagine that it's reassuring for Kyriana to meet others dealing with the same issues she is. Meeting Megan and getting to wear her crown was the highlight of Kyriana's day. When we arrived home after the (JDRF) support group, she made me upload the pictures I took right away so that she could take them to school to show her friends the next day. I'm sure the fact that Megan, like she, has T1 and can be an Indy 500 Princess made an impression on my daughter. I'm hoping that Kyriana will continue to meet successful and healthy people living with T1 who will inspire and motivate her and serve as a reminder that she can prevail.

As a mother, I was struck by Megan's determination, motivation, and achievements. After talking with her, I'm not surprised that diabetes hasn't interfered with her becoming an Indy 500 princess. What made the biggest impression on me is how Megan is living her life and isn't letting diabetes get in her way. I listened to her talk about living on campus, the hours of paperwork she had to do to take the MCATs, the fact that she is a triple major, her goal to do diabetes research... All while having good A1Cs and Blood Glucose control. my little girl will always be a princess to me but meeting Megan gave me some reassurances that my daughter can (to borrow the phrase) "be all that she can be." It may be harder and she may have to be stronger, but a world of possibilities is still here.

Wednesday, July 14, 2010

Being a "Pre-Diabetic"

I've never been a fan of the term "pre-diabetes."

Of course, I'm no medical professional. I'm not able to dispute the scientific validity of this term and how it's utilized. Online research tells me that the CDC has reported that one in four people (roughly 57 million people) have pre-diabetes and therefore have a higher risk of developing Type 2 within 10 years. But as a jaded and skeptical Type 1 for now more than a quarter century, I have reservations with this "diagnosis" and how the existing medical establishment throws this around in what I'd describe as a reckless manner.

For example, take my wife who was recently told at an employer-offered health screening that she has "pre-diabetes" because of a single fasting blood glucose reading of 113 mg/dL.

Yes, that's right. 113. One one three.

(Waiting, allowing that number to process...)

This is where I let Suzi jump in and tell the story, as it happened to her...

The health screeners were testing the "Big Bad 3" (Cholesterol, Triglycerides, & Blood Sugar, along with basic height, weight, and BMI (Body Mass Index). Employees were told no drinking alcohol within 48 hours of the testing (wine festival on Sunday meant FAIL here), no drug use within 24 hours (Tylenol because of previous FAIL meant another FAIL), no eating or drinking except for water within past 12 hours (FAILED by an hour), and no tobacco use within an hour of test (Non-smoker, so PASSED - woohoo!).

I had hoped to be able to back out of the screening, due to the failures; but I also failed at that; so at 7:56 a.m., I trotted over to begin the torture (really wasn’t torture – but nobody likes be told what's wrong with them…) Started out with filling out what would be my results form; then my height, weight, and blood pressure were taken.  Next, I moved over to have my blood drawn – not by vein, but by finger poke; which hurt afterward. Pretty much all the result came back normal without any sign of a problem, though I did fail a couple simply because they weren't "real" fasting results as I'd failed on that front.

Then, there was the BG test which came back at that number of 113 - one that I might add Mike would pay to have consistently throughout the day if possible, and compared to his 149 fasting result earlier in the morning before work. After texting back and forth in joking about the whole situation for a few minutes, the Nurse Lady ended the wait with an interesting discussion about my blood sugar.
Nurse Lady: "Have you had a problem with glucose or diabetes?" 
Suzi: (internally – define "problem" with diabetes, because that answer is a big YES thanks to Mike's Type 1...!) "No, not that my primary care/family doctor has said…"
NL: "Well, your fasting glucose level is 113."
S: (trying not to laugh) Oh. OK…"
NL: "This means you are pre-diabetic. You have a chance of developing diabetes."
S: (again, holding back the laughter...) "OK."
NL: "There is really nothing that can be done. Try eating some more whole grains and cutting back on the sugar. We like to see blood sugars in the range of 60-99. Do you have any questions?"
S: "Nope, I’m good.  Thanks." (head to door, trying not to let laughs or giggles escape but again FAILING on that effort and they slip out. NL looks at me like I'm nuts.)

I called Mike on my way across the parking lot to "break the news." (since he's a newspaper man!)

"Guess what honey!!!  I’m pre-diabetic, at a non-fasting blood sugar of 113! Don’t be jealous."

Mike: "Oh No! Guess we’ll have to take you out back like Old Yeller..."

Yes, I did say that. I also made a comment initially about how this would be an ideal blog topic, before venturing into whether this result had any merit. Obviously, we think a lot about the validity of this type of health screening where these initial "diagnosis" warnings can come up.

In recollecting the events, I'm told that the health screeners were perplexed that the other test results came out normal but the BG reading was "so high." Their faces showed fear, and they didn't know what to do. This is where I get angry (again speaking as a longtime T1, not a medical professional or educated student on this topic).

Jaded humor and joking aside, I get that they're simply doing what society recognizes as the right course here. I understand that there are non-diabetic "normal" guidelines" in place that guide these screenings and so much of the medical community.Standards have changed recently so that now, the "normal" range is 60-100 and anything over that range is unequivocally "pre-diabetes." Any fasting result over 125 mg/dL means someone is already diabetic, the standard says.

I recognize that we have an apparent epidemic on this planet of Type 2 diabetes, and all of that is a cousin to what I experience within the Type 1 World. It's different. But I'm not a fan for how many medical professionals, insurance companies, wellness and health screeners, and so many others fan the fires of fear-mongering to people who may not know anything about diabetes except that it means you could die someday, go blind or plummet into kidney failure, or lose a limb. You know, because someone's aunt or uncle once did.

To me, "pre-diabetes" is a term that went "out of style" years ago and is generally used only by "old school" doctors, or those younger medical pros that were taught via the "old school" method. I believe that basically everyone is "pre-diabetic," in that if we don't watch what we eat or sit on our butts all the time without any excercise, then we'll likely put ourselves into the high-risk pool of developing Type 2 diabetes. Some of us unlucky souls may have genes that pave the pathway to some form of the D no matter how healthy and meticulous we are, while others may not ever develop any variety no matter what warning signs they display. That's just the way it is.Just because you're diabetic, it doesn't mean you are overweight or lazy or a bad eater pounding packets of sugar. And vice versa.

Yes, there's a huge and ever-growing trend in Type 2 diabetes worldwide. Yes, it's good that the medical establishment and these health screeners are trying to raise awareness in some way. That's what Oprah did. Yet, in doing this, and in doing it the way it's being done in SO MANY instances, damage is also being done because of sub par education and knowledge out there about diabetes overall. It's my believe that these "pre-D" standards and warnings are simply trying to combat a problem that we haven't gotten a handle on, and one that must mean something because docs and health pros and the ADA and studies say so.

In my view, either you're Diabetic or Not. Like pregnancy. If you aren't, then you are "pre-D" and should assume there's a chance someday that you could develop the condition unless you do what's best for your health. But no, so many need someone telling them they're "pre-diabetic" before they'll even think about taking the leap toward change. That, I think, is a fundamental key to the epidemic problem in the first place.

Sure, we need to call diseases and conditions something. If you are Type 1, then you don't produce insulin because for some reason your body attacked its own beta cells to the point of no-insulin production. LADA has its own definition, and so do others like Type 2 where your body stops producing insulin or develops resistance over time. You fall into anyone of these categories, then you've GOT diabetes. If not, then you're NOT diabetic. But to say you're "pre-diabetic" because there's a risk that someday you could develop diabetes?? C'mon. Every non-diabetic then is pre-diabetic, just like every person has the potential to get hit by a bus when crossing the street near a school at rush hour. But you don't label these people as "pre-bus casualities" because there's a risk.... You take the necessary steps to prevent that event from happening - using a crosswalk, looking both ways, or simply waiting until bus-time is over. You might get an occasional warning sign, but you're not told that you're going to get run over and there's "nothing you can do about it."

But what do I know? This is all from the perspective of a cynical Type 1 who often thinks he's correct even though that's rarely the case. No one should ever take the writing here as gospel or disregard whatever standards are out there, as established by much wiser minds than mine. Simply my personal take on something that bugs me, and grinds my bacon. Take it as you will.

Tuesday, July 13, 2010

Back to the Future... July 2011

If I had a time-traveling DeLorean, my first stop could very well be Orlando, Florida in July 2011.

That's when the annual Friends for Life Conference will be happening. While I hear it's always a great time worth attending, next year is expected to be an even more special time for Adult Type 1s. That is because Jeff Hitchcock, the creator and editor of Children With Diabetes that's been holding the FFL Conference now for more than a decade years, wants to develop a conference aimed specifically at the needs of Adult Type 1s.

This is awesome news. But please, don't take my word for it. Please, leave The Diabetic's Corner Booth and travel over to Diabetes Daily where my friend and fellow D-Blogger Scott Johnson has already written about this and is garnering incredible feedback about the idea. The planning and direction is already underway, and with now less than a year to go, deadlines are quickly approaching to get this established. So if you haven't already, go take a look and let him know what you think. I've closed comments on this one in order to allow visitors here to not have to repeat the commenting over at his online home.

After reading Scott's great writing, you'll see even more why it's going to be a L-O-N-G next year planning and waiting for the FFL Conference. Sure, we can keep in touch through the blogosphere, Twitter, Facebook, email, and even in smaller D-meetup settings, but it doesn't diminish the AWEsomeNESS of having hundreds and thousands of Type 1s come together in one place. That's an irreplaceable experience, and one that might make us wish that Doc Brown could just give us a way to get Back to the Future so we wouldn't have to wait.


1.21 JIGGAWATTS!!!!

But alas, there's no flux capacitor that could take us up to 88-miles per hour to get to July 5-10, 2011 anytime sooner. We must wait, and help plan. Everyone can be a part of this by offering thoughts about what they might want out of the conference. Hopefully, we'll all be able to see each other there!

Monday, July 12, 2010

Buried Alive With Diabetes

So, I had a strange dream the other night.

As it turned out, this dream came at a time when my blood sugar was running High. Awaking about 3 a.m., a blood test revealed a 350 mg/dL. Trip to the bathroom. Thirsty. So, I had an orange flavor-ice and took a correction bolus. Then, I began reflecting on the nightmarish-vision that had been on my sleeping mind just a while earlier.

What if I was buried alive for an extended period of time, without an insulin pump or any insulin? Not only would it suck being buried and all the not-fun issues that go along with that, but I'd also be battling the High symptoms - thirst, urination, slugginess. Not a pleasant times.

That had been my dream. Being stuck in a coffin, with a lighter, and no insulin pump. Only on MDI (as I have been now for a few months), but unfortunately I didn't have any supplies. No water bottles or pop-cycles or push-up flavor-ice to hit the spot. Some burning foot neuropathy to go with it. NOT cool.

I blame the Sparlings for this dream. (I'm wicked excited about the much-anticipated release of Buried later this year, and it's obviously seeping into my dreams). Without that movie and Suzi's recent comment that she saw a preview while at the theater, this High-induced dream may not have happened. Oh well. I'm sure it also didn't help that an episode of Criminal Minds had been on my screen earlier that evening, with someone being bound and gagged and locked in what could have been a large coffin underground somewhere. Crazy mind games. That's what dreams are, though.

There's also the fact that Living With Diabetes in itself can sometimes seem as though we're being Buried Alive, being locked in a small place and covered with dirt and sand in a way that we just can't move or escape. That's how I've felt lately, with High Blood Sugars. But, I know there's a way out.

All of this creates the weirdness of my mind at night, of course coupled with strange movie and TV scenes and High Blood sugars. Thankfully, I had insulin handy to correct (plus a flavor-ice).Maybe, Buried will give me some sage advice on how to handle being buried alive should that ever occur.

Friday, July 9, 2010

Accolades, Cupcakes & Community (Plus The Cat)

This post is somewhat overdue, but it's been a couple crazy Fridays in a row... and so it's finally the right time!

As you likely know, I had the honor of attending the second Roche Social Media Summit on June 29, traveling to Orlando to meet some of my fellow Diabetes Online Community members for the first time. But before I found myself Leaving On a Jet Plane for that trip, there was some fun "You've Got Mail" action that brightened the day and added coolness to my D-World:
  •  From Boston With Love... You may recall that I celebrated my 25 years of Living With Diabetes in the spring of 2009, and was eligible to receive the quarter-century recognitions given out by both Eli Lilly (in Indy) and Joslin Diabetes Center (in Boston). My mom, who has been Type 1 since the age of 5 and has celebrated her own half-century Diaversary, told me about the two awards and suggested I apply. So, last summer I vowed to pursue these awards. Well, it took longer than that and I really didn't get around to getting all the letters and needed documentation until this summer. The one or two page applications aren't all that burdensome, it was just a matter of getting some letters from current and former Endos and those who could speak about my initial diagnosis back in 1984. Finally getting all that was needed by mid-June, I mailed off the materials to both places and prepped for at least a month of waiting before hearing anything. But as it turned out, Joslin took MUCH less time and quickly sent out my cool 25-year personalized certificate. It came in a red certificate holder and complimented my chronic condition care that had someone gotten me to this point where I could receive some type of recognition for it. It's got the signature on it from Dr. Kenneth E. Quickel, President and CEO, and briefly delves into the history of the award dating back to 1948 before congratulating and sending "best wishes for continued good health." A cool bonus is that it's dated June 22, which happens to be my D-Mom's birthday! That's awesome timing, I think. Now, I'm just waiting on the medal from Lilly to complete my 25-year set of honors!
  • Carb-Free Cupcakes from Cara, over at Every Day Ever Hour. You may recall that she had a contest. A fun contest, where you could win awesome Carb-Free Cupcakes. Actually, they are not yummy eat-them-up cupcakes like the ones Cherise has become a master at making. Rather, they're cupcake-shaped crayons made by Gaddy Nipper Crayons. Apparently, I had made a comment on one of Cara's blog posts and been entered into a contest where she later pulled my name from a hat - the prize being these crayon cupcakes. The cute little care package arrived by mail and I got a picture message from home that they'd arrived! It was an awesome gift, so thank you so much for the AWEsomeness, Cara! You rock.
Those two mail greetings brought the Diabetes Community to the forefront of my mind amid some massively stressful times at work, and set the stage for what would prove to be an amazingly awesome time in Orlando among fellow DOC friends. Meeting some of the people I've been following and reading and interacting with online for so long (years in some cases), and being exposed to the incredible passions of these D-Advocates, was about as cool as you could imagine. I felt at home, away from home, among these great people from across the country. We had some great discussions, but also so much excitement - there was the Hat de Roche, the Ninja Welcoming Committee (boo hoo for delays, but glad G made it!) an ER visit (boo hoo hoo, but fun), PhotoBoothFun, WiiGames & PingPong For Charity, FunFactDance, and Bennet's B.S. or Gosh Darn Signage. An all around great time, with many people who aren't afraid to BE BOLD. (See more goofy Flickr Photos at DBloggerSummit here.)

This experience was an award in itself and as good as a cupcake (or bacon), and it's already evolving into more awesome meetings as we're hoping to setup an Indiana D-Meetup next weekend when Sarah Jane comes through the state to visit. Community is what it's all about, online and offline, and these gifts and friendships are some key points that make it all worth doing.

Of course, this story wouldn't be complete with an additional tale about The Shadow Cat. Obviously feeling neglected and not part of the Community, Shadow apparently decided at some point to interject herself into this whole crazy Diabetes Community and make her presence known. First, she has more frequently been stationing herself next to or on top of my laptop keyboard - an apparent attempt to communicate with Siah about World Domination. Secondly, on my first real day of relaxation on Saturday (post-Roche), I awoke and stumbled downstairs to find:

Yep, that's Shadow - who at the time was sitting half-asleep on top of my Joslin Certificate, which I'd left open on the arm of the couch after reviewing it one night. As I whipped out the camera, she of course decided to start darting away but I managed to get a shot of her taking one last sniff of the certificate! It is quite clear to me from these two instances that Shadow is no longer content playing second string to this thing called the DOC... Rather, she's going to be be a part of it. Or else. I now worry that our future is destined to play out like the Psychedelic, Mayflower-Fish Friskies Commercial. We should be afraid, very afraid. But at least, we'll be an award-winning Community complete with Cupcakes and Fun Adventures as we endure the Cat Wars. At least.

Thanks, Shadow, for bringing it all together for the weekend.

Happy Friday!

Wednesday, July 7, 2010

Diabetes v. Diabetes

"Diabetes is the only disease that fights with itself."

Except for Multiple Personality Disorder, which may have exponentially numerous battles with itself...

The comment came Sara Knicks during the Roche Social Media Summit, in a discussion with the American Diabetes Association about how we're all in this together yet it often seems as though this national organization aimed at diabetes seems so very disconnected from our Adult Type 1 community.

It captured a mood of the room at the time: that there is a Type 1 vs. Type 2 vs. Every Other D Type Out There mentality, and that the face of the ADA seemed more focus on the Type 2 "epidemic" than any other variety of diabetes - even the Type 1 it was created to focus on. We were discussing those points but also how the ADA and JDRF seem to often be butting heads on fund-raising efforts and event-planning, seeming competitive and mutually exclusive of each other even though we're all fighting for the same goal - to raise money to stop/cure diabetes. We talked about how the ADA has the color red, while the JDRF has adopted blue as its own color... Unlike breast cancer that has the universal symbol of pink, Diabetes doesn't have its own universal color. This creates an identity crisis, of sorts, which combines with the frequent debates that come up between Type 1s and Type 2s and others about the variations of the disease.

Our friend Chris Stocker over at The Life of a Diabetic, who unfortunately ran into rental car obstacles and couldn't make it, told a story recently that was exactly on point. Basically, his girlfriend wanted to buy him a medical alert bracelet with a color charm, but couldn't decide on whether to get a red or blue one - the ADA color versus the JDRF's blue. Which one is it? This was exactly the point raised at the Roche summit, one that went not only to the identity of diabetes all together but overall touched on topics such as what the face of diabetes looks like depending on the organization asking for your money at a particular time.

Later at the dinner table, we were all discussing how a continuing dialogue is needed on the topic - especially between the ADA and JDRF point. The Wise Wil Dubois posed a question at one point - "Is there some universal fundraising event that could get these two organizations, and others and all of us, on the same page to focus on the larger diabetes message?" I thought this was a stellar question.

In response, I think that an answer may be in what Manny's already been a strong advocate for: World Diabetes Day on Nov. 14. With the little blue circle to represent diabetes universally. To me, that seems like an excellent starting point to bridge the gaps, to merge the colors without stepping on each individual organization's toes. I was really encouraged by the ADA rep at the summit who told us that the group is really making a concerted effort, for the first time that she'd seen, to really communicate with the JDRF leaders on these issues on where they do and don't overlap in goals and daily operations. Maybe, we'll see more collaboration down the road when one of the groups holds an event and the other realizes that it might be better to hold off on their end to not interfere.

Diabetes isn't going to have a universally known "pink" color behind the cause, but hopefully before long we'll have more of an identity so that an internal identity battle isn't being waged and sometimes taking away from what our fellow diabetics are doing. We're all in this together, whether we support the ADA or JDRF.

Now, it's just a matter of figuring out what I'll be doing for WDD later this year, and how specifically I can help further that working-together dialogue between our local diabetes-related charities. More to come on that as the year progresses! In the meantime, I leave you to ponder how your own ADA and JDRF affiliates have butted heads and how you might work to bridge any gap that exists on whatever level locally from your own corner booth.

Monday, July 5, 2010

Thanks, Roche - For So Much

This is a longer one, but there's really no way around it. So much to recap, to be thankful for, and to say thank you for. So, that's the focus here... With more recaps and thoughts to come down the road about the second Roche Diabetes Social Media Summit!

Who knew a Person With Diabetes could be so happy with blood sugar readings in the 200s??

Well, I am. As are the other three dozen Diabetes Online Community members who came together in Orlando recently for the second summit that Roche Diagnostics put together. A main reason is that it shows that Pharma is listening to what we patients want and don't want, and making changes based on that. It's an encouraging and positive step foward, one that hopefully others start thinking about.

This was a followup to the first one in Indianapolis last year (which I didn't attend), and a direct result of that conference and feedback from many of the same DOC members who gathered this year. They created a slogan and logo, Passion Power Purpose - something that's somewhat cool but I could debate the merits on. Anyhow, what they've done and are doing with this is something that I'm not going to dismiss because it's clear what the results are after seeing the followup from last year's initial summit.

Here is the slideshow covering the day's activity. Lisa Huse, Director of Strategic Initiatives at Roche Diagnostics' Diabetes Care division, told us that she understands people with diabetes better based on the past 11 months than she's felt in the previous 11 years with the company. A slide said the message from last year was for Roche to keep it real, address D-costs, actively advocate for the patient community, and help the community amplify its voice.

That's happened. She explained that the company's executives are looking to the online community during their decision-making process. They are listening and changing. One part of that is using those "real BG numbers" in their Accu-check ads rather than the typical "perfect 104 mg/dL" that we see in commercials. But they're also helping low-income folk obtain the costly test strips at a discount, and they want to work with other industry players to establish consistent standards.

This is all AWEsome news. And I say thank you for that.

Roche has also launched a major initiative called the Diabetes Care Project, which was founded by Roche and the National Minority Quality Forum and has partnered with the AADE and Healthways and is aimed at establishing personalized health plans to improve the care of people with diabetes. They also created something with Genentech called the Diabetes Patient Member Research Community, which is a private invitation-only group of 300 Type 2s basically representing Roche's customer base to supply feedback about what they like and don't like, or where the company can go. Roche leaders at the summit say this is a starting point and it may lead to similiar involvement with the Type 1 community, and that could be coming down the road. Enough of those attending volunteered our support and participation if that happens! These are huge initiatives that are inspiring to hear about, and it's refreshing to see a company take these steps and welcome the participation and involvement from our community.

Again, these are positive moves and I feel the need to say thank you.

Compared to what I've read online about last year's event and comments from those who attended in 2009, there was much less focus on Roche this year. One big emphasis was on the Accuracy front, and we had a group activity that was both fun and informative, as well as frustrating as it demonstrated some of the hurdles and inadequacies in the whole Blood Test Strip debate. We broke up into small groups and got little Fact and Fiction cards to answer some questions, such as "All meter manufacturers are required to test for at least the 100 most common interferences, such as skin oil and food residues?" That's when we held up our little signs (or as Bennet from YDMV decided - the Gosh Darn or B.S. versions). The activity allowed us to debate accuracy standards and offer thoughts on what we'd be willing to sacrifice on the High or Low end to get there. After realizing that perfect accuracy wasn't doable, everyone found trade-offs and our group ended up deciding the best solution might be 15/10 (within 15 points off on the Low end and 10% on the High side). Other options were 5/30, 10/20, or 15/15 - as this was an over 75 mg/dL scenario and most agreed that the Higher end is what you correct for with insulin, that became a focal point. But there's no right answer and this showed us there's a lot to think about.

After that activity, Roche brought in representatives from the American Diabetes Association and American Association of Diabetes Educators to listen to us about our concerns and how we'd like to see everyone work together toward more. Surrounded by other D-Bloggers and people who are so incredibly passionate about diabetes advocacy, I felt truly at home and among my own people. Even though I missed last year's summit and have never met these online friends in person before. It was an honor, and truly a life-changing experience.

Though I didn't speak up during the presentations or main event, everyone of my concerns and points that had been on my mind to bring was mentioned by others - the whole ADA v. JDRF issue, disappointment with the ADA Expos and fundraising, the CDEs about how receptive they are to social media and patient education, and how impossible it is to get any information about the group. The reps really took the criticism well, from how they don't seem transparent to how many Type 1s feel forgotten by the ADA that has a public perception of being focused on Type 2. They admitted faults and expressed a genuine interest in working together on improving those issues, as well as just working with the patient community more down the road. We were listened to, as Adult Type 1s, and it's clear this is a new starting point that will continue.

The AADE was different, as the organization sent a public relations representative who apparently didn't realize the importance of something: public relations. Her body language radiated defensivness and an unwillingness to listen, and it felt in a way like we were standing in front of a brick wall having a discussion with ourselves. Many expressed frustrations that patient "experts" with an interest in helping educate aren't tapped more, and that our own expertise doesn't seem to be matter unless we go through the specific certification process that is almost like climbing an insurmountable mountain. The AADE made it clear that there's a certification board that is more appropriately the ones to address these concerns to, but these reps didn't seem at all interested in advocating for change or working with us in making this concern know - despite a national shortage of Diabetes Educators (and Endocrinologists). The message: The AADE works for their members only. It seemed as though they didn't seem to get the fact that, if they don't do something, they won't have a membership and will become extinct. Still, as a patient community with diabetes, the next step is getting the message to the National Certification Board for Diabetes Educators - with or without the AADE's advocacy and assistance.

After the afternoon sessions and a great discussion time at dinner, we all broke up for some fun games - traditional ping pong, and Wii bowling and tennis. Chris Bishop and I teamed up and got to the final round, not able to triumph over Dana and Dayle in the end game. But we were semi-finalists, and as a result got $250 split up between us that Roche had announced would be donated to a charity of our choice (winners got $500). Hearing who all the donations were going to, I decided to send my $125 to the JDRF to ensure that everyone was getting a piece and it wasn't all going to one specific place (sorry, Manny!) In the end, Roche has let us know that the donations came out like this: Diabetes Hands Foundation - $875; Diabetic Rockstar - $500; ADA - $500; Diabetes Sisters - $250; and JDRF - $125.
So, thank you on that front, Roche!

Overall, this was an incredibly life-altering event that I'm incredibly thankful to have been a part of. (Photos can be found on the Flickr Group, DBloggerSummit2010.) Obviously, not everyone could be a part of this. But I'm confident the discussion and conversations that happened represent the larger Diabetes Community and that the dialogue in Orlando will continue online and offline and lead to even more discussion and change. It's clear that Roche knows the excitement of bringing so many DOC members together is a driving part of this that trumps most everything else, and I personally think it means a lot to see they want to engage the Diabetes Community in this way.

Yes, Roche paid the tab for travel, lodging, and incidentals. Some may be suspicious about that, but I'm not concerned about it for two reasons: 1. I know my own ethical standards and that I'm not going to get bought off or endorse something based on it - this comes from journalism ethics as well as just overall character. 2.) Roche asked for nothing in return - not a blog, not any kind of endorsement, not good reviews (which I wouldn't be able to give anyway, as I'm not an Accu-check user.) If I didn't like this event, or don't like a product that I use and think it's worth blogging about at all, then I'll certainly put that out there. There's no reason to think that there's anything shady going on, as far as I know based on my experiences.

Based on the willingness to bring some of the Diabetes Online Community members together, engage us in fun and informative discussion, listen to us and make internal policy and product decisions, and to make donations to D-charities, I say thank you to this company. But even more significantly, I say Thank You to every single person who was there and made this what it was in 2009, 2010, and hopefully beyond. It was such an honor to be in the presence of so many passionate people.

Thursday, July 1, 2010

A Quick Photo Recap on Roche Diabetes Summit

The second Roche Social Media Diabetes Summit is finished, and it's back to the real world that for me is not D-focused. The pharma giant brought the 37 of us together in Orlando earlier this week, and here's the proof in a photo. This was an awesome experience and my mind is on massive overload, so there will be more updates and recaps to come - but first, must focus on the day job and get some needed work done. In the meantime, here's the group that came together.