Monday, August 30, 2010

D-Meetup: 84 Years of Diabetes

Adult Type 1s are mobilizing in Central Indiana, trying to reach out and bring more of us together in a way that the JDRF hasn't traditionally done or been known for. We want that to change.

Some of us gathered Thursday for the first D-Meet-up of many, which will hopefully bring more into the fold as time goes on. At Joe's Crabshack on the north side of Indianapolis, four of us gathered:

Myself, diagnosed at age 5 back in 1984.
Neal Hoffman, a 28-year-old diagnosed at age 12.
Aaron Walton, a 29-year-old diagnosed about two years ago.
Pat Kinder, diagnosed about 40 years ago when he was in the eighth grade.

Between the four of us, we have 84 years of diabetes. Looking at that time in history more than eight decades ago, we'd be at a time where insulin had just been created a handful of years earlier and D-Management was so incredibly different than it is today. No testing as we know it today. Significantly, we have Novo Nordisk receiving a Danish charter that year to produce insulin. Another monumental moment in 1926 when scientist John Jacob Abel crystallized insulin. This was the first proteins to be crystallized in pure form, allowing researchers to study its structure and how it acts within the body, and ultimately giving them the ability to create stronger and synthetic versions decades later.

That's where our combined years of Type 1 takes us back into history, and I thought that was cool. But this wasn't a meetup about history. Rather, it was an effort to look to the future and how more Adult Type 1s can come together. It's not new that the JDRF is reaching out to us Children With Diabetes Who Grew Up, though some areas are doing better at this than others. (Some others who've written about Adult Type 1 meetups include Scott Johnson in Minneapolis and Scott Strange in Kansas City, just to name a few!) Central Indiana is about a year in to an initiative to beef up its efforts on this front, and after some outreach meetings discussing possibilities this D-Meetup came to be.

Though I'd sat in on an outreach meeting where this concept was brainstormed, I hadn't heard of anything materializing until casually looking at the JDRF Indiana webpage one day in mid-July and seeing an announcement about this "Kick Off Event." Surprised, but so incredibly excited, I immediately checked my calendar and signed up to attend. Over the next month, a handful of others also signed up as Yes or Maybe attendees, while several couldn't make it. When Thursday finally arrived and some just weren't able to attend as planned, the Four of Guys With 84 Years made it out at the end of a crazy workday.

After some intros about who were are and our D-Life synopses, we got down to business. Not to mention some shrimp, crab-stuffed mushrooms, and seafood fondue! We talked about the changes we've seen through the years, and how our own experiences and D-Management habits are different. It was interesting to hear how diabetes helped shape our lives in various ways. Pat was interested in the whole DOC concept, to which I gladly helped introduce him and explain how it's been such a life-changing part of my life in the past year.

We mentioned how we weren't impressed with the ADA efforts to touch on Type 1, and how we thought the Diabetes Forecast magazine just wasn't really worth reading for the most part because it didn't include much that we needed in our D-Lives. Another point that came up was how cool the JDRF Galas are to attend, but coming up with the steep ticket price just turns many people away from the idea. That all needs addressing, we agreed.

Aaron asked me about why I'd gone off my Minimed 722, and I explained it had nothing to do with any dissatisfaction with the device or concept. Rather, it was just a means to give my body a needed rest after nine years of pumping. Neal and Pat mentioned how they found injections were easier for them.

The cool Bag of Hope program came up, and the trio diagnosed as kids reflected on how we didn't have that back in the day of our diagnosis. One component is Rufus, the bear with diabetes, and someone mentioned how the JDRF is talking about coming up with some Bag of Hope for Adult Type 1s. Now, that would be even more cool, I thought!

I shared some of the most widely known D-Bloggers out there who've laid the foundation for what is today's ever-evolving DOC. Talked about how it also helps hear from others in the Diabetes Community (adults and parents and others) about what's happening out there, from JDRF activities to just the personal stories about "routine" D-Life activities. Pat was intrigued by the D-Blogging concept, and we were able to share some nostalgic memories of both the Commodore 64 as well as the ancient Atari-based systems that blessed our younger years. We decided that Facebook and the broader DOC is one way to tap into this crowd, but that going offline and establishing one-on-one relationships is the best move of any. Then, we can all network with the larger groups down the road and even set up more official business-like "events" that people will be more eager to attend with those friends they've established.

So, that's where we are at this point. Some personal meetups that lead to a bigger one. The point: If you are an Adult Type 1 in Central Indiana, then I WANT YOU! Drop me a line and let me know what works in getting together for lunch, dinner, coffee, drinks, or just to hangout for a "pump bump" or "meter clap." I'm eager to connect and meetup! In the meantime, we move onward until the next D-Meetup "event" set for Sept. 30! Hopefully at that time, we can at least get a century of diabetes experience in the same place for some good times!

Friday, August 27, 2010

If I were Robinson Crusoe

Here we are on Friday. TGIF? Not this time. At least, not completely. A quote comes to mind as we hit the last day of this week, and I reflect on the progress made, strived for and not achieved.

"Only Robinson Crusoe had everything done by Friday."
 ~Author Unknown
Hmm.

Sadly, it doesn't appear that I'm Robinson Crusoe. So, this doesn't apply to me. For two reasons: A.) I'm not a castaway on a tropical island. B.) While making it this far through the week feels like a tremendous victory, my To Do List lingers on and continues haunting me. Stealing sleep and stressing me out like a man who dropped his bacon on the floor.

So, as I scramble to end the week on a more productive note, I offer a light, randomly-assembled recap of the week's Highs & Lows plus a preview of what's down the road in the week(s) ahead.

(Warning: Link heavy, but all are worth the mentions!)
  • Rain, please. Seriously. Why the Fuzzle Navel doesn't it rain anymore in Indiana? It cooled down slightly, but is bone dry. I'm tired of this crap. Someone needs to get on this. I'll sign the petition. Just make it happen. My lawn is begging you.
  • Traffic needs to go away. I mean, Why The Hockey haven’t we developed what was clearly promised to us by now?!? Scottie isn’t just beaming us to where we need to be, and I don’t see flying DeLoreans making life any easier. I call shenanigans. As a result of this false marketing, I should not be held accountable for whatever road rage might be necessary by stupid drivers. Clearly, MY being on time for a Supreme Court argument should take priority over the rest of you idiots who are just in my way. Clearly.
  • To Panera Bread: If you list on your menu a price for half of a sandwich, then customers shouldn’t be told you can only sell them a full sandwich. Taking advantage of their Low blood sugar states of mind and forcing them to pay for a full sandwich, plus a cookie, because they can’t think straight just isn’t cool.
  • You do NOT want to screw with me on a morning when I have NO coffee in my system following a few nights of little sleep. To random Man In a Suit on the Street Corner: I apologize to you and whoever was on the other end of your cell phone during my post-Low lunatic rant on the Thursday lunch-hour.
  • Just when the stress stomps you down and causes you to lose the ability to appreciate what you have in life, someone starts firing a gun atop a parking garage a block from your office before ultimately taking his own life. This tragic story happened Thursday afternoon, causing me to step back and re-evaluate everything I have and love and how good life is, despite the stresses.
  • “God is Great. Beer is Good. People are Crazy.” Yes, I like that country song.
  • This week whirled by. But the fastest hour was Wednesday evening from 9-10 p.m. Eastern. That's when the Diabetes Online Community gathers for Diabetes Social Media Advocacy (@DiabetesSocMed) on Twitter (#dsma), an awesome discussion organized by my fellow Indiana D-Blogger Cherise Shockley. This was Week 6, and the dynamic discussion delved into how D-Living may have shaped you into the person you are today, how people mark their diaversaries, songs that might go out to diabetes, three words describing your Life With Diabetes, and whether you think a cure will come in this lifetime. Mark your calendars and join in, if you haven't already!
  • Carey over at dLife had an outstanding post called What if Charlie Had Diabetes?, which explores how parts of Willy Wonka and the Chocolate Factory might have played out if little Charlie Bucket was in fact diabetic. A must-read, equal to the extraordinarily fun one by Jacquie a month ago called Beauty and the Betes: A Diabetes Fairy Tale.
  • Honesty, Inspiration, & Poetry: 1.) If you missed it, K2 over at diabetesaliciousness had a great honest post about recognizing your strength and finding yourself. Worth a read. 2.) Shamelessly plugging myself, I'd invite you to once again check out my non-D post from Wednesday about finding inspiration and achieving your dreams. 3.) Once upon a time, I was a regular poet. My poetic pen does more resting than writing these days, but my eyes still dance at the chance to read whatever poems might be out there. There are many great spots to find it, but always on my list is Crystal's poetry over at Randomly Capitalized. Of course, this all tides me over until I find the time to fully dig into the "No Sugar Added" book that I snagged in late June.
  • Speaking of books, that reminds me. I have too many on my bookshelves. The home office is overflowing. Yet, I want more. I could spend days just wasting away in bokstores and libraries, reading about whatever fits the mood. Most recently, I've set my sights on the works of fellow D-Blogger and Advocate Wil Dubois, who's penned several through the years and I want to read. Another is Richard Vaughn's chronicling of his 64+ years with Type 1, in Beating the Odds. These sound like worthy Christmas gifts (hint hint, wink wink...)
  • My Pump Hiatus ends soon, and I finally get to re-connect to my pump (affectionately named Bacon Gibbs). This will likely happen by mid-week, which also happens to be National Infusion Site Awareness Week. Got a cool box on this in mail this week. Stocked full of goodies. Like cool temp tattoos that I may have to get some use out of.
  • Cats rule. Dogs do, too. While I truly love my Riley Dog and Shadow Cat, there's an almost endless array of doggy coolness and feline frenzy out in the DOC! One of the newest I've come across online is loyal and awesome D-Alert dog Bradley. We must also pay homage to Wren, a courageous cat who's moved on after living with diabetes while on this Earth.
  • The Indiana JDRF put together an Adult Type 1 D-Meetup on Thursday evening, on the northside of Indy at Joe's Crabshack. Despite not having the time because of work, I was so incredibly excited about it and made it up there to meet some new D-Friends! Recap coming on that Monday.
  • Oh, don't forget it's D-Feast Friday. So make sure to check out all the yumy recipes likely posted throughout the DOC. You can find a comprehensive recipe rundown over at Lorraine's D-Feast kitchen-blog at This is Caleb.
  • My wife's birthday is on Tuesday, Aug. 31. She's simply the best, and totally rocks. Totally. Sure, I'm biased. But I'd venture to guess that you'd probably agree with me. So, raise an ice cream cone in her honor. We will have cake. And ice cream. All of which plays into Diabetes Art Day on Sept. 1!
  • Yes, kicking off the month is D-Art Day, inspired by the all-wonderful Lee Ann over at The Butter Compartment. I'll be working on my contributions this weekend, and you'll be able to see MANY throughout the online world.  
  • September is my favorite time of year, best month in my opinion. It'd be even better if Suz's birthday was a day later, but whatever. Love the cooling weather. The Pure Michigan color-changes kick into high gear (I do miss that). Month of wedding anniversaries (including our 5th), as well as the slate of doc visits during what was once back-to-school time. I have an Endo visit Sept. 21, in which I'll be excited to participate in a new fun little Flickr activity that our Ninjabetic created, dubbed Waiting With Diabetes. Now, I just wonder  who the first person will be to get scolded or in trouble for brandishing a camera in a waiting room... (heh heh heh)
So, that's all. Lots of good stuff going on - past, present, soon-to-be. But as I mentioned at the beginning, my name isn't Robinson Crusoe. If it was, not only would I be a cool island-living dude but you also might have more substance here than these scattered thoughts. I might also have had a chance to read all the many many many D-Blogs out there. But it is what it is. So, happy Friday and best weekend wishes!

Wednesday, August 25, 2010

Melinda's Ride of a Lifetime

This post has nothing to do with diabetes. Rather, it's about inspiration. About what's important and how you can achieve your dreams if and when you truly want to.

The main character in this story is Melinda Dennis, a Michigan native that I had the honor of becoming friends with back during our first year of college at Oakland University in 1997-98. She was one of the first people I'd met when starting college, and we had a close-knit group of friends living in the same dorms that had a lot of fun that first year. Though we kept in touch a bit through the years, mostly we lost touch as our own lives progressed and took us to new places and adventures.

But this story isn't about me, our friendship, or our time in college. Rather, it's about Melinda's newest adventure - an amazing "ride of a lifetime" that everyone should have a chance to hear about.

Her journey is the American Ride 2010,  a three-month solo trip that takes her along the country's scenic roads by motorcycle and to 51 of the total 58 national parks. Through 38 states and into Canada. On a 2003 Heritage Softail with some basic camping gear, she's traveling off the highway as much as possible and using the national parks as a guide on her journey that may change based on the moment. No GPS. Only paper, maps, and direction of the moss on the trees.

She writes on her blog: "From the wilds of Alaska to the fall colors of the East Coast, each day is an opportunity to discover something new, meet fascinating people that are guaranteed to become friends, and experience the culture of the unique country that is my home."

WOW. I tell you, that's pretty awesome. If I rode a motorcycle, I might be all over participating in some way. But I don't, so I'll live vicariously through Melinda and her online accounts of the adventure.

As a way to give back something for the opportunity, Melinda is raising money for two worthwhile organizations: 1.) the National Wildlife Federation, which is the largest conservation organization in the country that helps protect wildlife and our beautiful land; and 2.) Patriot Paws Service Dogs, which provides service dogs to disabled American veterans.

"Without the sacrifice of our military men and women through the history of our nation, I would not have a chance to explore this amazing country," she writes on her web page about PPSD, adding that the NWF helps protect not only wildlife but also the lands so that everyone can enjoy these magnificent outdoors.

Even more awesome, I'd say.

How did this ride come to be, you might ask? Well, Melinda's blog tells us about that, too:

"Sometimes, the moments we never expect inspire us to do the things we've always dreamt about. For me, that moment was December 25, 2009, when on Flight 253 from Amsterdam to Detroit, a stranger had attempted to decide my future for me. Being able to walk away from that gave me a clearer perspective and challenged me to do something more adventurous in 2010 on my own terms."

In case you aren't aware of that flight and the circumstances, what Melinda is referring to is the highly-publicized "Christmas Day Bomber", the Nigerian man who tried but failed to detonate plastic explosives hidden in his underwear while on the Detroit-bound airliner. Melinda was one of those 289 people aboard the plane. I recall that day clearly, not only because it was Christmas and because of the wide news coverage of that account, but also for seeing my old college friend on CNN and MSNBC talking about this experience.

Just that summer before, I'd decided to reach out to a few of the former first year college friends and try to reconnect. I knew Melinda was living overseas, but didn't have any contact details for her. So, I called her parents' house up in northern-central Michigan and from there, we connected and exchanged a few emails. It was great to hear she was doing well, with a great job overseas that would bring her back to the U.S. before long, and that she was likely soon-to-be engaged to be married. Another friend doing great, and that made me smile.

Then, Christmas came and this happened. It made me personally appreciate how short life is, and be so incredibly thankful that Melinda was OK.

As she writes on her web page, the experience opened her eyes and set in motion what would become this American Ride 2010.

"With some free time available in the fall, I started listing all of the things I've wanted to do: spend more time with family, go camping, buy a motorcycle, see some U.S. National Parks, and make a positive difference in people's lives... (Those) were the top items on my list. From those reflections, a concept was born, although I must admit the challenge of 51 U.S. National Parks was the genius idea of my fiance."

Just from reading about her adventures in the first weeks, it sounds like a truly great time. She's seen some incredibly beautiful landscapes and scenery, met some generous people, and even had a chance encounter that led to her being part of a historic moment honoring 9-11. While waiting for her bike to have some 20k mainteannce done on Day 18, Melinda started talking with a man there about her ride and soon discovered he's a leader with the Patriot Guard Riders, who would be escorting a shipment of World Trade Center steel beams traveling from NY to Washington, to be used in a 9-11 Memorial in Kitsap County. By luck of running into this man at the shop, Melinda got the chance to be a part of this historic escort on the last leg of the across-country transport. You can read her account of it here.

These are the kinds of life-changing experiences that everyone should be blessed to have in their lives. But while awesome in what it is for Melinda, this adventure also symbolizes to me how much we can embrace our dreams when we really want to. When we find in our hearts what's important, and set out to achieve those dreams because we know we can.

With that, I invite you to visit Melinda's web page or blog. You can keep tabs on how her national ride is progressing, see the bike, and even learn how you can participate in some way. There's a way to buy some cool American Ride 2010 coins that give proceeds to the two charities, and even links to allow you to connect to Melinda if you want to. Don't forget the Facebook page, too! Truly, Melinda is good people. One of the kindest souls you could ever have the privilege of knowing. So, if you have a Harley or are at all motivated to be inspired or even seize the day, reach out and say hello. Or give a little loose change to some charities. Or just dream your own little dream, and find the courage and inspiration to embrace whatever lies in our heart.

Carpe diem!

Tuesday, August 24, 2010

What If...WE are the Cure?

My pancreas doesn't work. It doesn't produce insulin, and that's why I'm a Type 1 diabetic.

To delve deeper: for some still unknown reason my immune system launched an attack on me that destroyed the insulin-producing beta cells inside my pancreas.

Always been common knowledge.

But what if, since my diagnosis at the age of 5, those tiny little beta cells have been trying to repair themselves? What if that long-wanted cure we've been hoping for as long as we can remember is in that little turnover fact? They didn't just stop working for the sake of sitting around to do nothing, but they've been trying to get going again.

What if?

That kind of throws a lifetime of knowledge out the window.

We may be getting close to finding out if that's the case. Thanks to the Joslin Diabetes Center, and one of the longtime Type 1 "survivors" who made a comment to her doctor once about believing her body still making insulin. I've joked about that, and even made that same kind of comment to my Endos through the years.

Well, this woman's comment about still being able to produce insulin at times led to a study of some Type 1s who've received the "Joslin 50-year Award." This woman is a medalist from Virginia who was diagnosed at age 9 in 1945, achieving that five-decade award that my own mom has achieved (diagnosed at age 5 in 1958).

Results of the study were released online Aug. 10 in advance of publication in an upcoming print issue of the journal Diabetes. The paper is called: "Residual Insulin Production and Pancreatic Beta Cell Turnover After 50 Years of Diabetes: Joslin Medalist Study." You can check out more info online here from the Joslin Diabetes Center, affiliated with the Harvard Medical School.

"In our study, we made the unexpected finding that about two-thirds of the medalists still retained the ability to have positive C-peptide results, which is an indication that they could still be making insulin," said the study's senior author, Dr. George L. King, chief scientific officer at the Joslin Diabetes Center in Boston. "It was a surprise because they've had diabetes for so long."

The current study included 411 living diabetes medalists, and a post-mortem pancreas analysis from another nine medalists. The average age of the medalists was 67, and they'd had diabetes an average of 56 years, according to the study. Half of the study participants were male, and the average body mass index (BMI) was 26, which is considered slightly overweight.

Researchers found that 67.4 percent of the medalists had minimal or sustained C-peptide levels, suggesting that they were still producing some insulin. Some of the study participants also had their C-peptide levels measured before and after a meal. The researchers also measured C-peptide levels before and after a meal in age-matched non-diabetic people. They found that C-peptide levels increased about fivefold in those without diabetes. In people with type 1 diabetes, the C-peptide levels in those whose bodies responded to the meal rose about threefold. 

"This study shows that in this unique cohort of people surviving 50 years or more that some still have a nice balance of beta cells; it's not just a progressive death," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

But Zonszein added this may not apply to everyone with type 1 diabetes.

"Some people have a very rapid decay in beta cell function, but many continue to make insulin and their beta cells try to survive. The take-home message is that not all patients with type 1 have no insulin of their own, although they still need [outside] insulin to survive," he said.

So, that's a portion of what the study says. Which is just fascinating and goes against some of the basics we've heard since the beginning. But it makes sense. Think about it: how many times have we thought, maybe just with a laugh, that our pancreases were actually working? When we are Low and just can't get them up immediately despite all the sugar or carbs we consume? Or that we eat a mass amount and yet don't see the usual corresponding spike in BGs? It happens. Maybe not often, but it does. Maybe, the reason is because our beta cells have turned over a bit and produced a little insulin.

Yes, Beta Cell Regeneration isn't new and that research has been developing for years now, but this presents a whole new aspect to ow that can be done and used. Maybe this is the path to a cure, or at least a piece of that puzzle that will eventually lead to a cure.

What if the answer has been inside us the whole time? What if we've been actually trying "cure" ourselves but just haven't been able to? Not yet, at least. But someday.

What If?

Monday, August 23, 2010

The Approaching End

The time is drawing near.

Birthday? Christmas? Hockey season? World Domination By The Cats? Celebratory running down the street naked while wearing only a feather boa... (hmm)?

No, none of those. We are talking about The End of My Pump Hiatus.

You may recall that this little vacation has been underway since late March, when I opted to venture back into the world of Multiple Daily Injections after nine consecutive years of pumping. A personal choice not to infer any unhappiness or success with pumping. Just a way to let the body heal, recoup, remember what it's like to not be Mr. Bionic Limb every hour of every day.

It's been a grand adventure, reminding me of why I went on the pump in the first place. However, this journey has led me to an unmistakable discovery that the mental rigors of MDI do work and it can succeed - in fact, I dropped my A1c from 8.8% to 7.7% between March and June. That ultimately led to my continuing the Pump Hiatus throughout the summer, since it's obviously been working. My A1c is still way too high, but that's a work in progress in the ever-continuing push for Tight Control.

But this MDI-run has always been temporary. Now, on my last Lantus pen, that time has come to transition back. The timing works out quite nicely, actually. Fits in with what Roche Diabetes has recently unveiled as National Infusion Set Awareness Week, running Aug. 30 to Sept, 5. A news release lays out the specifics, but basically the Indianapolis company is doing this to "increase understanding and education about proper infusion site management – and complications that can result from poor site management such as infection, poor insulin delivery and tissue or skin damage." They even have put online a handy little resource guide, a more in-depth one for the professionals, and a video - all of which are being given out to CDEs and docs.

Some justification for all this can be found in a 2007 study in the American Diabetes Association's journal Diabetes Care, which reported that some adult patients experience as many as 12 issues of irritation or infection a year because of poor site maintenance.

I happen to agree, though I've only had one or two known examples of site infection and a handful of irritated sites through my nine years of pumping. The growing inability to find a workable site and my frustration in putting a new site on is largely the reason I chose a Pump Hiatus in the first place. Had I done what I was initially taught and should have been doing all along, a vacation might not have been necessary. Yet, here we are. So now, I approach the end of my Pump Hiatus with renewed energy and a vow to change my sites every two or three days. Maybe this new awareness initiative will help some others learn those lessons, too.

Creatively, Roche (Accu-Chek) has also come up with a fun little idea to help pumpers not use the same sites too often. Temporary Tattoos. The idea is to put them at the infusion site, in order to remind yourself to not insert the next set anywhere on the tattoo before it wears off in about 10 days (site healing time). There's several multi-colored options and you can read about them here. I like that idea, and may try it out myself!

So, by the time September rolls around, I'll be re-connecting to Bacon Gibbs (my trusty Minimed 722). I'm very excited, but nervous at the same time. Bacon Gibbs has been living for several months in a fire-safe in our office, just in case the house decides to burn down or a tornado dances on by. The reunion will be splendid (not Splenda!), I'm sure!

Looking forward to the long-missed convenience of being able to push a few pump buttons for a bolus, rather than drawing up a syringe and deciding where to inject myself. Particularly when out and about, among friends or in public where people may not as keenly accept someone "shooting up" when "High." Yet, there's the uncertainty associated with being connected to a device and placing your well-being in the hands of that technology. Without doubt, pumping is flawed. Sites go bad. They bleed. Sometimes there's no warning. Of course, you can say the same about MDI. Such is the Life of a Person With Diabetes.

Saturday, August 21, 2010

Update: Questioning Everything

This is an update to previous posts, which you may want to read first if you haven't had a chance to check them out yet. 1. Fight For Our Health, and 2. In Case of Zombie Apocalypse.

Both involved my order of One Touch Blood Glucose Test Strips, which was more than the initially insurance-approved 102 per month (roughly 3 tests a day) and significantly fewer than the needed 300 per month (for 8-10 tests a day). My Endo's office had to request the higher amount from the insurance company, which happened after a medical assistant obtained after spending 45 minutes on the phone with a pharmacist and supervisor one day. Getting the order delivered to my home, I saw that they did indeed ship the needed nine boxes of strips that insurance payed for. But they also sent nine boxes of Lancets, which insurance decided not to cover at all. Since I hadn't requested or needed the Lancets, I dove into finding out how this all happened.

Inquiring about this by phone, I was told by Medco that my Endo's office had requested the Lancets. So, I phoned my endo's office to investigate that claim. It took several calls over the course of the week, and I finally connected with the needed person after notifying them I'd be filing a claim about the doctor's office with our state insurance commissioner. That didn't go over well, so Mr. Office Manager immediately worked to help me.

He told me there was, in fact, no order for Lancets to Medco. He provided documentation showing every prescription they'd sent to suppliers and pharmacies, and the Lancets from Medco clearly weren't on the list. So, I went back to Medco.

A customer service representative informed me my doctor's office had actually requested these, despite my documented proof showing otherwise. She declined to send me any proof from her end, saying she didn't have "the authorization" to do so Once she agreed, Customer Service Rep said she was only authorized to send that proof by mail, not a more immediate fax because of this "time-sensitive matter." I asked if her supervisor had that authorization, and after hearing a sigh of frustration, was connected with said supervisor. That woman had no answers, but connected me with a pharmacist who apparently was involved in this specific Lancet order.

He was a nice enough guy. After checking the system, informed me that a medical assistant with a specific name I recognized did request the Lancets, by phone. It was not a written prescription, but a phone request. That was recorded, and if I wanted they could have the call pulled, review it, and call me within 24 hours to play it back to me. I've never had that before, so I was curious to play it out.

The following day, I received the call from the pharmacist. He'd reviewed the call, and said the Endo's Office Medical Assistant did in fact authorize the Lancets. I asked to hear that myself. He played it. But, mysteriously, no specific "request" can be heard for the Lancets. At one point, they just start talking about the Lancet types and what's wanted. The Medco rep asks if a certain style of Lancet is OK, and Medical Assistant inquires with someone unknown on her end, then says "That's fine."

I pointed out to Pharmacist Man that it's not clear that Medical Assistant actually requested the Lancets. Possibly, the Medco rep brought it up first following the Blood Test Strip order, just assuming that the order also included the Lancets. Mr. Pharmacy Man agreed, and said it wasn't clear. I noted that it wasn't a big deal, that I didn't want anyone to get in trouble, and that it wasn't going to be an issue to pay the small amount for the Lancets that I actually should use more often than I do.

Pharmacy Man didn't want me to pay for something that I hadn't wanted, simply because of a mix up. He thought it would be fair to give me a credit or refund on my co-pay. I repeated my nonchalance, but again Mr. Pharmacy Man said he wanted to be fair. I didn't care, but said I would object if he felt the need to refund my $73. So, he did.

I now only owe the $25 co-pay for my strips. And I got 9 boxes of Lancets for free, which will likely last a very long time (at least until the Zombie Apocalypse).

All because I didn't take the word of the invoice or the 1st Medco Customer Service Rep, kept pressing my Endo's Office for answers, then grilled the subsequent Medco Folk some more.

The point: Always question what they tell you. Get names, times, keep track of who you talk to and when. Get documentation, not by mail, but immediately. Go to the higher supervisor levels until someone has the appropriate "authorization" to answer your questions. In doing so, maybe there's a chance things will work out the way they should have from the start.

Wednesday, August 18, 2010

In Case of Zombie Apocalypse

Should zombies ever attack, I have an unlimited supply of weapons to ensure survival.

Here's why.

You may recall my recent post about my fight for and victory in achieving my three-month supply of One Touch Ultra blood test strips. Late last week, the nine boxes of strips arrived at my home. Finding the box on my porch when arriving home from work, I took them inside to investigate. Honestly, I expected some extra issue that I'd have to battle the insurance company or medical supply company about - I'm cynical like that. Inside the box, I found the nine boxes. The invoice told me that the 900 strips cost $813 total, which thanks to my insurance coverage only means a $25 co-payment for me. That's sweet.

However, there's more. In addition to the strips, Medco also sent me nine boxes of Lancets - lancets I didn't request or want and do not need. Of course, the statement shows me that apparently my insurance does not cover these lancets. So, that means I must pay the full $73 amount charged. To reiterate, for something I don't need. That's 900 lancets, on top of the hefty supply of several hundred already on hand.

Grumble.

A phone call to United Healthcare/Medco led to my learning that apparently my Endo had prescribed the lancets when putting in the Rx for my higher-than-normally-allowed amount of strips. Even though I hadn't requested them, and wasn't notified by anyone about this order being placed for me. Medco tells me they have a standard policy of not accepting any medication/supply returns, even in the event the doctor's office makes a mistake. In my mind, I wonder what happens if my doctor orders something like - I don't know, Viagra - and it's something I totally don't need or would ever use. And them I'm pressed with a massive bill, and can't return it. What the Fructose is supposed to happen then??

Grrr.

The amount will be put on my account, and if not paid it remains outstanding and eventually goes through the normal collection procedure, the rep explained. An appeals process exists for me to "ask" for them to review this return, but that takes a month to play out after they've received my appeal forms and that does nothing to change my account status or the balance owed.

Grumble. Grumble.

A phone call first thing Monday morning remains unreturned, and even a followup on Tuesday resulted in a receptionist's lecture about not duplicating messages. (zombies must have gotten to the person I need to talk to...) If I had to guess: I'd say it's protocol to order lancets along with strips - you know, because you're supposed to change the lancet every time you do a test. (Wait for it, wait for it..... HA HA HA HA HA!!!!)

Ahem.

Fine. Whatever. Though it's the principle of the matter in not wanting to be responsible for something I didn't order, these are lancets. It's not a huge amount, and my Flex does cover it. Plus, I should be changing them out more often than I do (pleading the Fifth on how often this actually does happen now). My Endo's office will know soon enough that it's NOT alright to do "assumed" ordering for me again, ever.

In turning to the DOC about this frustration soon after it happened, one ray of positivity came from Katie (@avisualtinkle). She said - "Well, think of it this way: If there is ever a zombie apocalypse, you could slowly kill them with itty bitty pricks to the brain."

I like it. As a Zombie Movie and Game fan, this just spells zombie-style awesomeness.

We even have widespread worldwide support of this idea, even from our allies over across the pond. Initial observations from some like Becky over at Instructions Not Included are that we could even make this work with pea shooters or blow dart weapons, firing the lancets at them.

As any George Romero fan or Resident Evil gamer knows, those zombies can be tricky suckers. All it takes is a blow or spike to the head, but they multiple like nobody's business so the more weapons the better... So, with that, I'm embracing that optimism and will keep my new Lancets. Because you never know when the zombies may attack.

Tuesday, August 17, 2010

Remembering August 20, 2009

This post was originally going to appear later this week on Aug. 20, but that's Friday when I like to keep the posts on the lighter side. So, I was going to go with the day before, but then this whole "Driving With Diabetes" topic came up as one that might be included in the weekly Wednesday night Diabetes Social Media Advocacy (#dsma) discussions. So, I opted for today. To write about how my life changed on Aug. 20, 2009.

That was the day a chain came out of nowhere, wrapped around my neck, and started squeezing. Ever since, the chain continues adding more links and squeezing around my neck to the point where I can't breathe.

But for all the scariness that happened that day and since then, I owe a lot to what happened. It changed my life, in terms of my thinking about God, CGMs, real-life policy issues, financial obligations, and the overall health care and insurance system. The past year has been a time of personal reflection, a spiritual journey, as well as real change in how I deal with my Type 1 diabetes - all as a direct result of what happened that day.

Everything began that afternoon at work. A newspaper reporter, I had an interview at 3 p.m. Wrote on the board that I was leaving the office for said interview. Problem: it was a phone interview, but my mind couldn't remember that important detail. Thanks to a Low. One that I didn't see coming, as I'd just recently done a test that was above 100 mg/dL, had eaten a decent lunch, and done everything else as correctly as I could. Yet somehow, my blood sugar dropped.

I recall missing my black lab Riley, and just wanting to see her. That I needed to get home to see her. Maybe, right after my interview. Wrote on the board. Packed up my belongings, and left the office. Walked to the parking garage and got behind the wheel. Why no BG test? I'd just done one, and as mentioned, it was fine - above 100. No need. But I was already Low, and was still plummeting. Actually, I made it through most of the 10-mile drive home. But probably because my sugar was low, I missed my freeway exit and had to drive another five miles south before circling back. Instead of getting back onto the freeway, I took the back roads. Ended up getting lost on the farm roads that I normally know very well, but just couldn't make sense of in this Low BG state. Eventually made it back to my subdivision, but ended up driving back and forth and around the area, with reports that I drifted in and out of oncoming lanes of traffic. Cloudy memories of driving up on a grassy side median still haunt me. Some called 9/11. I ended up in a ditch just across my subdivision entrance, with a police officer approaching my window. I rolled it down. As this happened, I recall thinking that I had to "escape." Words came at me, but I was fumbling with my key in the ignition (the SUV was still running) and trying to put the vehicle into reverse to drive away. The officer leaned into my window and quickly grabbed the keys from the ignition, then opened the door and pulled me out. That's about all I remember, before waking up in the back of an ambulance at the scene and having glucose pumped into my system. Then, being transported to the local ER despite my repeated attempts from the back-of-the-ambulance stretcher restraints to decline that transportation.

As it turned out, my parents were visiting from Michigan that day - so in my Low mindset while driving I not only phoned my wife's cell (she was working), but I also phoned my dad's cell. So the paramedics grabbed my phone in the confusion of moving me and dialed the last number I'd called, therein alerting my parents to the situation and having them meet at the nearby hospital. It was an all around good time, indeed.

For the record: I do carry an array of glucose tablets in my vehicle as well as Skittles and some crackers. As indicated above, I also test before driving. But sometimes that's not enough, and doesn't prevent these situations from happening. Not in the same way a CGM might, in alerting the D-Driver to a dropping BG while on the road or even before they get behind the wheel after a "safe" test reading.

This was probably one of the most scariest examples of my life. In the weeks after this happened, I'd be hesitant to drive anywhere and would be even more fervent about my testing before putting the key into the ignition. I wondered countless times whether I should be driving at all, whether it's in the best interest of society for a Type 1 diabetic to be behind the wheel. I'd also reflect on the bigger meaning of all this, praying thankfully that He protected everyone else on the road and somehow saw fit to protect me. This was one of two "near-death or likely-death" examples that happened to me in the course of a month, and to me showed that He was a real force in my life looking out for me.

But there's more to this story.

Within a week of this incident, the bills started arriving demanding payment. Even before my insurance company was able to receive, review, and process my coverage for these claims from the various providers: ambulance, ER, the ER doc, and multiple others who apparently were a part of this process.

The 4-mile ambulance ride came out to more than $768 before insurance, which included $97 in mileage for the four miles - roughly $24 per mile. However, the ambulance company somehow calculated this to be $10 a mile with nine miles, even though that's more than double the distance from my subdivision entrance to where I ended up (wonder what route they took???) Anyhow, the first bill from them came within a week, before insurance could even respond. A month or so later, it was clear I was only going to be responsible for $367.

The ER bill came out to $2,797 for less than two hour visit that was largely just wait-time. Insurance picked up most of that, minus a co-pay and whatever applied to my deductible - meaning I got hit with a $468 tab.

Then you have the various doctors who popped their heads in or looked at one piece of paper, such as the unneeded EKG, and it came out to about an extra $100 on my end.

For a grand total: $933. About 25% of the total pre-insurance tab for that day.

For all its faults and headaches, insurance coverage is a savior when analyzing the total payout and cost benefit. You truly have to appreciate that. Still, I just wasn't planning for that additional $933 expense, in addition to the $454 post-insurance amount for lab tests that I'd had done just a week before.

These expenses are monumental, particularly when combined with the mortgage payment and all the other debts and living expenses we have. I'm simply unable to pay them all, though I'm trying to do as much as possible while juggling every other debt and expense in my life. Some are willing to work, others aren't as receptive to the idea. That's an ongoing battle.

What that amount does is make you reflect more intensely on what you could have done, if anything, to prevent this from happening. Had I had a CGM, this may not have happened. I'd done everything possible without one, and it still came to be. But had there been a device tracking my BG level and examining the direction I was going, maybe the alarm would have alerted me to this and caused me to look differently at the 100+ mg/dL snapshot that had been offered just before this all began happening.

So, that is the lesson from all this. I've found my faith and started truly establishing my relationship with Jesus and God. Saw the true real need for a CGM. Lived the dilemmas of Driving While Diabetic and what that means. And came to understand how quickly a "medical emergency" can hit your life, your pocketbook, and have long-lasting continuing impacts every day since.

I regret that this happened. But I continue trying my best to cope, to keep living, to learn, and advocate to those who could be in the same situation some day.

Monday, August 16, 2010

Disclosure: A New Volunteer Role

Transparency is important.

In my continuing effort to determine how my Diabetes Advocacy fits into my life personally and professionally, I've taken on a new role. This is all being approached carefully in a volunteer capacity and won't impact my writing here or anywhere else, but it's a role that I wanted to let you all in the Diabetes Online Community know about. Keeping my credibility is important, so here's full disclosure on what I am getting into...

Back in January, I wrote about an Indianapolis father's passion for helping his Type 1 daughter better manage her health leading him to the creation of an online web portal called s5health. Basically, this new web-based portal is designed to help diabetics combine all of their insulin pump, blood meter, and CGM data into one place online and get that to their doctors quickly and efficiently. Most significantly, it's not tied to a particular product line and also allows PWD the ability to send data directly to their doctors, as well as interacting with others in the Diabetes Community and possibly using it as a "one-stop shop" for many aspects of their D-Management. Similar online resources are out there in some capacity, but from what I've seen they are either tied to a particular product line, charge the patient-users a fee to use it, or they don't have the physician/medical establishment aspects.

I've been using this tool for several months now and impressed by what it offers. So, I've agreed to start writing a blog for this local start-up business in advancing this tool. This involves my personal perspective on this resource and coverage of the industry and those using it. No money is being accepted; it's simply something I am doing in a volunteer capacity a couple times a week - a few evening hours during the course of a week when my time allows. My first intro post, "Passion Will Cure Diabetes," went up late last week.

At a recent Starbucks meeting with the marketing woman, I was clear in saying that this means nothing for The Diabetic's Corner Booth. This doesn't mean I'm going to talk about this resource here at all, or try to cram it down anyone's throats if I do choose to write about it. My editorial content here is simply that - my own. Nothing will change that. For the record, no one expressed any interest in influencing my personal thoughts here and completely agreed that would be inappropriate. That blog, newly named More Than Numbers, will detail who I am and will include a spot where people can see my personal blog and visit should they care to. But that's it.

I get nothing out of this arrangement other than a personal feeling that I'm contributing to something bigger than myself, a tool that's already helping the diabetic community better manage this chronic condition. A larger vision is for s5health to touch more than diabetes, to be a part of the broader health care picture. Yes, it's a "product" I'm advocating for and am indeed marketing it. But that doesn't mean it will spill into my personal blog or change how I write honestly here. If I like something, I'll tell you about it. If not, I'll do the same. So that you have the full picture.

Aside from here online, my new "marketing" volunteerism won't interfere with my professional journalism duties, as I do not cover this particular area and am always aware of potential conflicts that may arise. If there's an issue, I will talk about as needed and decide how to move forward from there.

So, there it is. As mentioned, I've used this online tool and personally believe it fills an unfilled gap in what is currently offered. I'd encourage anyone to try it out by logging on for free, but that's not what I am writing this post for. Do with it as you will. As always, The Diabetic's Corner Booth is about my personal D-Life and sharing my adventures and thoughts with anyone who cares to read about it from time to time. Thank you for that, and I'll look forward to writing, advocating, and interacting the same as always.

Friday, August 13, 2010

D-Dreams: Rafts & Rations

Being that it's Friday the 13th, I thought I'd share a strange diabetes-themed dream that recently entered my sleeping mind. While the particulars may be a little odd or eyebrow-raising, but the themes represent larger points and feelings about the Diabetes Online Community and how we're all in this together. It seems as though some other DOCers (like MsMegan777 and Jacquie over at Typical Type 1) have also been having strange D-Dreams, signs of a larger trend that we're all interconnected both in our real life advocacy but also in the dreamworld.
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First, I was on a river. A rocky river. The sky was dark and cloudy, clearly a storm was moving in and the air smelled as such. Probably somewhere on the East Coast, as there were lobsters clawing at me and trying to snip the pump tubing that hung from my waist. My method of traveling along this waterway appeared to be a raft - no, actually it was a small yellow intertube. How this was safe when the lobsters were clawing, I don't know. But that's how it was. The lobsters didn't appear to be targeting anyone else, though.

Everyone else had seemed to be employing their own floating mechanisms, though I don't clearly recall what the rest of my dream participants were using to manuever through the rocky waters. Some were actual sea-worthy vessels, while others were more inflatable poolside-style. K2 and Crystal was there. Cherise and her daughter were on one of those round amusement park water ride cups. Then we had Manny, George, and Scott who were all up near front on a white water raft, complete with lifevests and helmets and elbow pads while steering the convoy with plastic oars (actually, the oars were spoons).

Kerri was there, too, though clearly BSparl had yet to be born. She needed some help staying on the nearly transparent (purple?) raft, so Suzi volunteered to help her stay on board as we traveled down the river.

Our convoy appeared to be connected by a long pink rope (in the absence of our universal D-Color?), that somehow tied onto our various water carriers and steered us all to the same place. A huge cooler appeared to be fastened to the Pink Rope, though I don't recall it ever being opened in order to see if the contents were in fact beer or insulin. No iPads or laptops or smart phones, from what my memory tells me.

All I know is that we ventured down this river toward whatever unknown destination we were bound for, and when one person almost went overboard, someone jumped in and pulled them out. Once, a hand reached in and grabbed me and lifted me back onto my intertube-raft. Saved by the DOC, it seems!

Suddenly, we weren't on the river anymore. Instead, Suzi and I were being herded into what resembled an old airplane hanger that was now converted into some sort of disaster shelter lined with beds. Not cots, but real queen sized beds with covers and comfy pillows. I don't know why we'd ended up there, but in looking around I did see some of those same familiar DOC faces who'd been on the river. An older lady wearing a military uniform appeared and said something in German, and it then dawned on me that we could be in some form of weird Nazi-run camp. Soldiers appeared and they yanked everyone's insulin pumps away from them, some to shrieks of pain.
 
But I didn't have one, as had been the case earlier on the river. Instead, I had several bags of syringes and managed to hide those in my clothes, along with some bottles of Humalog. A few others had done the same, and so as the weird dream sequence played out in this bed-lined prison shelter, we all had to ration the needles and insulin in order to survive. So, what could have been several people exchanging bottles of insulin instead manifested itself into the old tins used during war-time...

Yet, interestingly, there were no blood tests happening in this weird world. Just Ration Tin Insulin SWAGing, I guess.

This carried on for what seemed like forever, but in the dream world who knows how long it really might have been. At some point, my attention focused to the fact that something was licking my face. My eyes opened, and there was Riley. With her front paws up on the side of the bed, giving me a good morning kiss. And that is where the crazy dream ends...


So, that's one of the D-Dreams from my end. What do I take out of them, aside from the knowledge that the DOC is on my mind in real life and in the dream state? I guess the point is: If I'm ever going to be stuck on a river convoy and imprisoned in a place where pump and insulin isn't allowed, I hope it's with the DOC. And that there's a loving dog at the end to greet me.

Here's to a Not So Twilight Zoney 13th, and a Happy Weekend!

Wednesday, August 11, 2010

Fighting For Our Health

I came home from work on Tuesday to a letter from my current insurer, United Healthcare.

Suzi had the day off work, and had alerted me to the letter after finding it in the mailbox that afternoon. She'd phoned to tell me earlier what the letter basically said, but I was curious to read it for myself.

The letter involved my coverage for One Touch Ultra Blood Test Strips, which I'd learned upon my new insurance beginning in June were "limited" according to the terms of my policy. I wrote about this back in June. Basically, my insurance policy allows for 102 test strips a month of this particular "preferred" brand. Math dictates that's 3.4 tests a day, significantly less  than the 8-10 tests a day that my Endo agrees is the amount needed to best manage my diabetes. 

Back in mid-June, a kind representative explained that it was possible for this larger amount to be obtained, and that my Endo would need to contact UHC and specifically request an "exemption" for this additional amount. Of course, UHC still retained the authority to say NO. At the time, I still had enough previously-stocked strips to last a few months, so I wasn't in danger of running out. A phone call to my Endo's office in early July led to them contacting both the insurance company and Medco mail-order pharmacy for this larger BG strip amount.

This form letter was the answer to that request.

At the top of the tri-folded letter, I saw the words: Coverage Approval.

I smiled, feeling all good about the approval and patting myself on the back for achieving this triumph in the name of my health. Then, I read the 1st paragraph...

"We are pleased to inform you that the additional supply of One Touch Ultra Test S Strip requested by your physician has been approved up to the plan's supply limit for this medication. You will be responsible for paying your co-payment and any additional amount, as required by the provisions of your pharmacy benefit." (emphasis added, to illustrate my areas of concern)

What The Fructose does THAT mean????? This sounds like they're telling me exactly what I'd already been told about "supply limits" that had sparked this whole request in the first place. Hmmm. And what, they're going to try to jack up my cost because of some vague, lawyer-written provision buried in the footnotes of my encyclopedia-length benefit booklet??? Double Hmm.
 
Is this really a win??

Stewing over this while prepping for an awesome dinner made by my awesome wife, I decided to call the insurance company just as I was drawing up my dinner-time meal bolus for a 92 blood test. The first representative was nice, but despite taking three minutes to confirm my identity and getting a rundown of my situation, she informed me that she didn't have access to my full claim status. That meant talking to someone else, who also had to confirm my ID and then needed another explanation for why we were on the phone.

Me: "I just want to confirm the amount of test strips that I'll be receiving."

Mr. Rep: "It's what your doctor ordered."

My eyes rolled, shoulders slumped. Same old game, I thought.

Me: "I know what my doctor ordered. However, I want to make sure you do. And that what you're sending me is the correct amount."

Mr. Rep spent 34 seconds typing into his keyboard, and found the answer: "9 boxes for 90 days, which would be three boxes of 100 strips per month."

A smile came across my face. I had won, after all. Outstanding.

Reflecting on this later with Suzi, I quipped that it was funny to me how this all played out. I took on the voice of the insurance company, in narrating the life of my claim for test strips:
  1. Insurer tells you that your test strips are "Tier 1" and that's great because they are one of the insurance company's preferred brands. That's good for you, the patient, of course.
  2. But you can only have a certain amount, regardless of what your doctor prescribes and what you've been traditionally using to best manage your Type 1 diabetes. When explaining the need for more, they assume you're simply mistaken about the number and wonder why anyone would want to test that much. As if we have a choice to stab our fingers this much, and we choose the highest number simply because it costs our insurance companies more money (you know, the rationale they use in denying claims).
  3. After being reminded that your Endo is prescribing this as a medical professional, insurance company basically says: "Nah, we don't really care what your doctor says. They're welcome to ask us to approve more, but there's no guarantee."
  4. Doctor asks again, echoing what he or she had originally prescribed. A month passes before the insurance company says, "OK. Guess you mean it. That's fine."
  5. Oh, and by the way, do you know about our Health Screenings and Prevention Programs available for diabetics? We'd be happy to send you (more) information on that to help you with your diabetes!"

Yes, I won this time. Typically, I do win. But I don't think I should have had to fight this battle in the first place. Not when my medical professional prescribed something, and despite that the non-medical professionals decide to make decisions about my health based on what it will cost them in the short-term and mean for their stock-holders.

You see this all the time. Take my friend and fellow advocate Kelly over at diabetesaliciousness, who is battling Sticker Shock and unfortunately finding her health decisions in jeopardy because some company decided to jack up a medication's cost for profit's sake. It's just not right. And it's maddening. A direct result is that diabetes has forced us to always be in Fighter Mode, as Kelly puts it.

She's right. We shouldn't have to fight so hard for our health, battling those who purport to be all about our health. But we do. Everything must be in writing. Names. Dates. Times. Faxes. Proof. Never-ending time out of your workdays and evenings to explain, re-explain, and bounce between multiple customer service reps and supervisors to get basic information We understand that protocols are in place for a reason, and that you are in business to make money. But there's a point of reasonableness, a standard, a moral obligation to put people's health - what you market yourself to insure - above the loopholes and shadiness.

Kelly's warning is echoed here: "Insurance Company Practicioners of Bull Sh*t, consider yourself warned - I'll continue to bitch. But more importantly - I'll continue to fight you in order to stay healthy."

Sometimes, we'll win and sometimes we'll lose. Either way, we'll blog about it. We'll advocate and spread the word to others about the ways you operate. The Good, Bad, and Ugly. So that they, too, will be aware of what's necessary to win these fights whenever possible.

Monday, August 9, 2010

The Frog Before Diabetes

You'll probably get a laugh out of this one. Maybe even a head shake.

But, I hope you also get a little more out of it, too.

Being diagnosed at age 5, Type 1 diabetes is pretty much all I've ever known. My daily D-duties have always been my "normal," and growing up in the 80s without any other friends or classmates who were diabetic, I went through my childhood pretty much alone in dealing with diabetes. This was long before the Diabetes Online Community. And diabetes camp only came around every so often. I did what was needed and lived with diabetes, and grew up to be where I am today.

But sometimes I forget there was a Life Before Diabetes. Five years. A time when I likely lived what some might consider a "more normal" life that I have few memories from and will likely never be able to embrace again. Aside from my parents and family members who were around in those pre-D days, but now live a state away and aren't physically there with me each day, I have no one in my life who was a constant part of my life before the age of 5, before diagnosis. Except one.

Froggy.

He's been with me since those early years, before there was diabetes. Now in my early 30s, Froggy remains a part of my life. He still sleeps in my bed. Often in between my wife and I. Snuggles up with us pretty much every night.

(Snicker away, all you want. I am not ashamed to admit that I, a grown man, continue sleeping with a stuffed animal. I'm secure with my craziness.)

The simple reason: Froggy and I have been through pretty much everything together. We've been together since I was a baby, sporting a sailor outfit and sitting in my grandpa's hallmark red chair. Froggy symbolizes some sense of normalcy, in whatever tangible way I'm able to hold onto that emotionally. Like a security blanket, so to speak.

To the right, you can see a Michael Baby with the First Froggy, which was from what I remember the only Froggy incarnation to have that particular style and look. It was at some point before my 5th birthday when I was diagnosed that a smaller, more modern incarnation of Froggy came into my life. My mom reports that First Froggy's fabric eventually got worn out and the same fabric was no longer made. So, the Second Froggy was born and was a Christmas gift from my grandma in 1982 (when I was 3). You can see him to the lower left, along with both my maternal grandparents. From then on, all Froggies have resembled this one through the years and there've been at least four or five generations that my crafty mom has made for me.

At one time, we had more than one Froggy since I'd sometimes leave him at my grandparents' house, forcing my dad to make the drive back late at night when I refused to fall asleep without him. (Yes, I am an only child). Most of the Froggies have had this similar look: the happy frog holding a red polka dot umbrella over his head. His feet are as much a part of him than anything - I've always found some comfort in rubbing them between my fingers. That is very relaxing to me. His umbrella top has a zipper, which in previous generations had been home to storage of some items I never wanted to be without - such as a blood meter at one time. There were times in my younger years when I carried him with me if I'd be spending the night away from home, as it was often difficult to sleep without him. That obviously changed in high school and college, and there were times when froggy was stored in some safe place for a period of my life. No, he didn't sleep with me in the dorm rooms. But he was there, somewhere, if only in my heart. And he's always come back to comfort me.

Now, the Froggy introduction came long before anyone ever dreamed up Rufus, the Bear With Diabetes who comes along with a JDRF Bag of Hope for newly-diagnosed diabetic kids. Or Lenny The Lion from Minimed. (OR AS OF SUMMER 2011, COCO THE DISNEY MONKEY.) Yes, these characters are cute and kids certainly deserve to have someone like them as they set out on this journey. But even had these characters been around in my young days, and become a part of my D-Life, I'd still be more attached to Froggy who served as a connection to that pre-D Life. He knew me back when, got diagnosed with me, and lived with me in every stage of life.

In a way, you might describe Froggy as some kind of coping mechanism that's been a fixture in my life, one that I've never been able to leave behind. Early Years. Diagnosis. School. Teens. Good Times and Bad Times. College. Marriage. Now, married and in my 30s, Froggy sleeps with my wife and I each night. Some may find this odd, but to me it hasn't seemed odd. Rather, some internal reflection has found this has been a way for me to connect to a "more normal" time in my life, pre-diabetes. Froggy is my Old School Support (as Kerri has VLogged on). A sort of Frog Before Diabetes, and we've been together on this journey every step of the way.

Maybe, just maybe, Froggy someday will be able to also know a Life AFTER diabetes. You never know.

I share our story because it's important to me. But maybe you have a Froggy of your own, or something you'd forgotten about as the years passed. I'd loved to hear about it. Maybe, in some way, you'll want to dig out some old boxes in your attic or visit the parent's basement where some treasures from those pre-diabetes days might still be kept. Those D-Parents out there, take note: tangible tokens from our childhood can mean so much to us Children With Diabetes Who Grow Up. In some ways, this may be all we have to connect us to those days. And that can be important, even if we don't realize it at the time.

Friday, August 6, 2010

Blog-Hijacking by the Cat

My fellow cat friends (the Tuxedo Cats - K.C. and Casey, with Perl's help) have found their way to their humans' blogs today. Or so I've read. So, in reading with interest their World Domination Plotting, I thought I'd follow suit and add my thoughts on a technique that's working for me. Not to mention my agreement with the previously-outlined demands for unlimited food bowl filling and no picking us up. However, flattery is perfectly fine.

As far as plotting the human demise in my household, it comes down to this diabetes. I think that's our way in. I'm sure of it. Recently, I tried to steal Michael's blood meter and insulin. Here's a surprise photo snapped of me (probably by the dog) as I sat plotting to steal the BG meter, which I noticed had some Higher readings lately - meaning my other "secret plan to spike Michael's food with sugar" has been working....


However, I dozed off into a dreamworld of Cat Utopia and got distracted by the task at hand. Despite my proximity to the meter, that blasted D-Dog Riley foiled my plot this time. Oh well. I'm here all day, and sometimes they put the dog in the cage upstairs. My time will come.

In the meantime, I'm going to continue reading what my fellow World Dominating Plotters are up to. And since I've heard banter about something called D-Feast Friday, I might as well venture down to the food bowl and see if there is actually a Frisky's Feast in there for me (if the dog hasn't eaten it...)

Happy Friday!

Love,

Shadow

D-Feast Friday: A Summer Heat Treat

With temperatures in the 90s and heat indexes in the 100s this past week (here in Indy), it only seems appropriate that this D-Feast Friday feature something to help with the heat.

So, I give you my favorite Summer Treat!

Pop-Ice!

(Not exactly the same as The Might Icecube that Kerri had higlighted recently, but of the same style of summer treat...!)

This came up during the Twitter-strong #dsma discussion on Wednesday night (If you don't already, you should really really really follow @DiabetesSocMed every Wed at 9p.m. Eastern for some great discussion!!) This post was already planned, but that mention made it even more timely! So, here we are...

Now, really, I'm not picky about carb counts on these - whether we're talking sugar-style or sugar-free. The label on the current non-Sugar Free box in the pantry reads only 6g per treat. I've had Sugar Free versions range from 1g to 4g, just depending on style. So, it's just a matter of how many you may want and how you might care to balance out any needed bolusing.

Whatever the choice, I think these help cool off during these hot summer months and they're just an all around fun little food addition, no matter the time. Random snack. Appetizer. Dessert. With No Cooking Required (just advanced freezer-stocking to ensure proper frozenness!)

Plus, they are relatively cheap (always important in these tougher financial times.) And they remind you of RAINBOWS!!!!

If this isn't your particular taste, then I'd also suggest #2 and #3 on my Summer Treat List: Popcicles/Fudgecicles. Or Light Beer, as the carb count is lowest in this style of ale. Whatever your Summer Pleasure, I hope you enjoy and are able to beat the heat!

Thursday, August 5, 2010

The Institution of Marriage

Stepping up onto My Soapbox. Offering a warning that you may not agree with what I say here, and so this is your chance to simply go away. If not, don't whine later about being offended by what you chose to read. Thank you, kindly. I promise to return to your regularly-scheduled D-Blogging soon enough - with a fun D-Feast Friday post on the way tomorrow!


The Fourteenth Amendment to the U.S. Constitution says:

“No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”

Passed in 1868, this constitutional amendment came on the heels of the Civil War. But it echoes sentiments that were debated and discussed back by the Founding Fathers, particularly Thomas Jefferson. He saw slavery and equal rights an issue that he wasn't ever personally able to eliminate by the time he died in 1826. But decades later, it was one of his greatest followers named Abe Lincoln who put into place what Jefferson hadn't achieved. The 14th Amendment includes the Citizenship Clause, which provides a broad definition of citizenship that overruled the Dred Scott v. Sandford ruling in 1857 that held blacks couldn't be U.S. citizens. It also includes the Equal Protection Clause, requiring each state to provide that equal legal protection to all people within its jurisdiction - the basis for the Brown v. Board of Education ruling in 1954 that began the dismantling of racial segregation in this country.

However, the 14th Amendment's second section used the word "male" in regard to voting and so that constitutional right didn't open the door for women voting and protections; it took a new amendment (the 19th) for that to happen. But eventually, women too achieved some sense of being seen as equals in the eyes of the law.

Now, the battle emerges on gay marriage rights. Men want to be able to express their love, but those who don't believe in homosexuality argue that this somehow endangers the "institution of marriage." As if this Holy Bond is pure now, with a 50% divorce rate that continues rising. Rather than citing Constitutional law, gay marriage opponents cite the Bible and Christian beliefs - despite a little thing called the First Amendment, which specifically puts religious freedom ahead of gun ownership rights. States have moved during the past decade to strengthen their stances on marriage, and some have even tried to amend their state constitutions on this point even when they already have laws prohibiting same sex marriages. California is one of those, after voters in 2008 passed Proposition 8 that banned same sex marriage. But a judge on Aug. 4 struck down this ban based on the 14th Amendment, and now that's being appealed to the Higher Courts.

Conservatives are opposed, saying that this jeopardizes the institution of marriage.

Maybe someone can help explain this to me: When half of our married men and women can't keep the sacred vows they took, how can we as a society say we're trying to protect the concept of marriage by refusing to recognize people who actually do love each other and have the ability to stay married? How does their love endanger you, or call into question your own beliefs or ability to maintain your own marriage vows?

Why in the hell is a bitter divorce and subsequent ugly custody dispute better than two people loving each other and sharing that love and respect with future generations?

With the above-mentioned 14 Amendment, why can't people just get the chance to be happy as the Constitution says they have the right to? Why do segments of society insist on restricting what they don't agree with, contrary to the very fundamentals they cite in trying to get their way on other topics? If we all could somehow just get over ourselves, and stop trying to control every little aspect of life as we see it should be, this world would be so incredibly better. We might actually more closely resemble some place worthy of God's Love. But instead, we bring false religion, politics and selfishness into everything and make life more complicated than it should be, then bicker about why we're not able to just be left alone to live our lives in peace.

Point: Get over yourself. No one is stopping you from disagreeing and living your life as you see fit. So, go ahead and do that. And leave others in peace to do the same. No one is attacking your marriage or trying to change how you live. Return to the favor. How two men or women in California, or down the street from me in Indianapolis, express their love doesn't change how I live my life. I love my wife. My marriage vows are sacred and I honor them. I'm not dictating who you marry, so don't presume you have the legal right to interfere in someone else's decision on that. I pray, but don't ask that you pray to My God or any God if you don't want to. We have that right because some guys in the 1700s and 1800s said so, and they wrote it down. Have the decency to offer the same respect as you receive. Please, and Thank You.

Now stepping down from My Soapbox...

Tuesday, August 3, 2010

Passion, Power, Purpose?

Passion. Power. Purpose.

That was the motto for the 2010 Roche Social Media Summit, held in Orlando that brought about three dozen members of the Diabetes Online Community together to have fun and also advocate our passions.

Let me simply say that being in the presence of such awesomely passionate people, some who I've been reading online for years and interacting with on a daily basis during the past year, was an honor. They are fun. Intelligent. Caring. You name it, the word fits. They are family, and they've had an incredibly positive influence on my own D-Management as well as gotten me back into the advocacy role that I'd largely stepped away from since my early college days.

But there's another side to this experience. There's a feeling that's been clawing at me more in recent months. I've debated posting about this, because it not only illustrates some of my uncertainty about what lies ahead but also because it's something that also has the potential to significantly influence the career I've spent my life pursuing.

Aside from drowning in inspiration and admiration about those I had the privilege of meeting and hanging with for a couple days in Orlando, there were more pressing concerns on my mind. Feelings of inadequacy. Insecurity. Uncertainty. Depression. All because I am unsure about where I fit into this larger Diabetes Online Community. It didn't help that at the summit, I was largely quiet during the main events - a great combination of having too little sleep, too many work deadline and real life stresses on the mind, and overall nervousness about being in the same room as such D-Leaders. The Roche folk described those attending as "thought leaders," a designation that I'd aggressively dispute for myself but wouldn't hesitate to use in describing any of those fellow DOCers who came to Orlando. They are the leaders, the ones with the "power," and so many of them embrace an obvious purpose in what they do. That's not clearly the case for me, and I'm still trying to figure out and shape where I fit into all of this.

What do I want out of it? Is it a tangible effect or one that must be confined to the emotional realm? Can this passion for advocacy become a larger part of my life? How do I balance that passion with the economic realities and struggles that I'm facing? Where does this fall on the priority list, when it's all laid out on the table?

These are issues I'm struggling with at the moment. I feel as if I'm playing Uno and getting slammed with Draw 4 cards, unable to hold onto every card and being forced to drop some. These and similar questions have been building up during the past several months, to the point where I've even started questioning whether my journalism-driven life is truly the place I'm supposed to be. What makes this incredibly difficult is that I love my career. Aside from family, my passion in life has been newspapering as long as I can remember and it remains a key driving force in my life. I am a newsman, and I don't have any desire to leave that behind. This field is a calling for me, something I'd admit to having some skill in doing well enough to make a living at. My purpose is greater than myself, because it's not about me - it's about other people. That is what we do as part of the Fourth Estate: tell stories and help people make informed decisions for themselves. Keep people honest. Chronicling history. Doing our part to affectuate change. (Seriously, can you hear the violin playing in the background here...??)

But Facebook, Twitter, and the Blogosphere are changing my perspective. I've become more interested and involved in that aspect and the social media scene is allowing me to finally embrace something that feels so long overdue. After 26 years of Living With Diabetes, this is really the first time I haven't felt alone with this chronic condition and found some avenue to tell that story in a way that may help others. Connecting with the DOC has been a large part of that, but it's led me to engage in advocacy offline in ways I hadn't done before - with the JDRF, the ADA, the Diabetes Youth Foundation of Indiana's Camp Until a Cure. Support groups. Meetings with lawmakers and Congress People advocating for change.

These new adventures have made it more difficult to balance my workload, though. My days are spent doing journalism, and I spent most of my nights and free time doing some type of D-Advocacy, blogging, or even just reading. I've slept a lot less, and drank much more coffee (the two aren't mutually exclusive...)

Now, I wonder whether some gig like a "social media consultant" might be where I'm heading. That's scary for me, to even think about leaving the field of journalism but also a newspaper and company that I truly love and am so lucky to be a part of. What are the possibilities, the hurdles? I want a family, I want to write. I want to be happy. But I want to be able to afford a lifestyle that doesn't take away from my happiness and leave me without necessary health insurance to fall back on or a paycheck to make the monthly vultures stop circling overhead.

Let's face it: Money talks. Life is expensive, but we have our own financial woes that just make me put more stock in the stability of a career. This by no means feels like a "job lock," because I'm truly fortunate and humbled and excited to be a newspaperman. Especially at the place I'm at now. If I was 10 years younger, not yet married or even newly married, the decision-making process might be an easier one. That's not the case, and I'm lucky to have the wonderful wife and life that I do. But it does make me more grown up, and those ideals and risks of youth have started (just started) to fade. I'm not a kid anymore, and career and lifestyle changes aren't easy.

Could I combine these two passions somehow? I see people like David Mendosa, Amy Tenderich, Gretchen Becker, and Riva Greenberg, and Kelly Rawlings who've done it successfully in their own ways. But could I? Do I even want to?? What has to be sacrificed and what might be gained?

I don't know what path to take, or what lies ahead. I'm passionate, but what passion will win out - journalism or diabetes advocacy? Is there a mix? What is my purpose? What kind of power and purpose do I want, do I need, do I not need? So many questions swirling around up there in the mind, in the heart.

We'll see how this all plays out and what path I end up traveling, once I get past the huge fork stuck in the middle of my road.