Wednesday, September 29, 2010

D-Fashion for Men

This post comes in the name of equality.

You see, Diabetic Women have their own groups that us guys just don't have. Take DiabetesSisters, a worthy and awesome organization that comes complete with conferences bringing D-Women together from across the country. We see articles focused on our female counterparts, from pregnancy issues to where pumps can be placed on wedding gowns, everyday dresses, or in places that we guys just don't have to worry about. They have cute designs, full of flowers and colors and creative designs. Kids do, too, and you might even have some more boy-focused elements when it comes to D-Fashion.

All of those are important, needed,and worthwhile - don't get me wrong. I understand and appreciate that men and women have different challenges on many fronts. But to me, it seems that us Adult Diabetic Men just have fewer resources for our D-Lives overall. D-Fashion for Men is just one of those topics that doesn't have the same kind of attention.

We have our own D-Fashion options, but they are less visible than what's available for Kids and Women. So, here's my contribution to even the playing field, at least when it comes to this little corner booth of the online world.

The reason was simply that I'd noticed many tweets, blog posts, web pages and business plans focusing on D-Fashion, but most appeared to be designed for anyone but the Professional Working Diabetic Guy.

Many seemed to be for the girls, boys, women, or the more gender-neutral adventurous types. But there didn't seem to be much D-fashion aimed at the man who must blend his insulin pump, continuous glucose monitor, or even carrying case with a business suit or dress clothes. This was simply my observation, and it might not have been the actual case - just what I had noticed. Recently, fellow D-Blogger Scott Strumello posted a gripping question on his blog that beat me to the punch. He asked: Why the Mysterious Absence of Diabetes Man-Bags? I was stunned, as this was the very point I'd been prepping to write and post.

Anyhow, I carry a man purse. I vaguely recall that a meter came in this at one point in my D-Life, possibly the OneTouchUltraSmart meter that I have on hand but don't currently use. Instead, my UltraLink meter that connects to my Minimed 722 is what goes inside, complete with a vial of strips, a lancet device, couple extra lancets, bottle of insulin, syringe, and an extra reservoir in case it needs a change. This whole case is about the size of a now-obsolete handheld PDA. But it's small enough and discreet that I can carry it with me while working and on my feet, no matter where I might be. It can sit on my desk out of the way, as a reminder to test but not really interfering in my daily tasks. Some may say this is boring, but I find it perfect for blending in with my "professional" life.

Aside from that, when it comes to extra supplies like infusion sets, I toss those into my briefcase/laptop bag that usually goes with me from home to office and anywhere in between. I'm usually not out of contact with that for more than a few hours or so, and if it's required then I can access it as needed.

But the "man purse" or D-Case goes with me wherever, whether I'm carrying it during the warmer months or tossing it into a coat pocket during the winter months. Glucose tabs live in an inside coat or jacket pocket, and in the warmer times a few stay with me on my keychain. Then there's my pump, always connected...

Working five of seven days of the week, most of my work attire is at minimum business-casual. So that means khackis on some days, and other times more formal dress or suit pants. So that's what my D-Fashion needs to mesh with. No fun colors or crazy designs, but neutral on those fronts. My Minimed Paradigm 722 has no fancy colors, rather it's charcoal grey. It stays fastened in a holster at my waist, so that I can have easy access when needed but it doesn't interfere. Just like a phone or pager, and most assume that's what it is. Same spot any CGM would go, as can be seen with the Dex when I trial-tested one early in the year.

Of course, what exists under the skin is where all the fun and true excitement can be found! That's where our sensors or sets are situated, in whatever spot of real estate we may be using. But that's also where we can have some adventure, such as I've recently had the chance to do thanks to National Infusion Site Awareness Week sponsored by Roche Diagnostics. You may know they sent out some nifty temporary tattoos to help pumpers mark their infusion sites and rotate accordingly. I embraced this initiative and am sporting those fun tattoos myself!

So, that's my take on D-Fashion for Men. Love it or leave it, that's my take. Do with it as you will.

Monday, September 27, 2010

Inside The Endo's Office

Tuesday may be gone with the wind as Lynyrd Shynrd says, but remnants of my most recent Endo Visit still loom large in my mind and we're already preparing for the next one in the regular three-month cycle.

Coming from work on a Tuesday morning last week, I had an already-busy morning and was trying to clear my head briefly for would likely be about an hour-long visit scheduled for 11:10 a.m.  That day, I had a few different missions: Waiting Room Observations, Big Picture D-Management Discussion, and a Look Ahead at where we want to be and how to get there.

Checking in, the receptionist quickly checked her computer screen and informed me about the co-pay of $50, almost asking as if it was correct.

Me (voice dripping with sarcasm): "I suppose, if Dr. P considers herself a 'specialist.'"

Receptionist: "Well, of course she does. Her work is specialized and her time is valuable."

I smiled, and handed over my Insurance Flex Card without argument. Thinking to myself that my payment doubled in the past few months though my visit times seem to decrease. I concluded that if my co-pays and costs rise, then my visit times should go up accordingly. But, I didn't raise that point and decided this wasn't the time or place for that Insurance Co-Pay/Provider-Reimbursement discussion.

Turning to the waiting room, I scoped out the room for a seat. That's when I saw the flatscreen TV on the wall airing the most recent episode of D-Life. On the screen at that moment was Manny Hernandez, the esteemed founder of TuDiabetes and the Diabetes Hands Foundation, talking about social networking among diabetics and the newest HealthSeeker game on Facebook. I thought this was pretty awesome, to have such a key Diabetes Online Community leader right there in the waiting room with me (and any other person who might be waiting)!

Only one other older gentlemen was in the waiting room with me, but he was hidden behind a middle-of-the-room wall post from where I grabbed a seat in the corner - a spot where I could both see the door where I'd be called in to and the outside door where new visitors would enter. This also gave me a key view of the room to snap some pictures of the room, for George's Waiting With Diabetes challenge. With that, one part of my Endo Office Mission was complete!

The wait-time was only about 10 minutes, meaning I was accompanied back by the nurse about five minutes past my scheduled appointment time. We did the weight routine right around the corner, and then started the walk back to the visit room. That's where I ran into Ryan Sellers, the local Minimed Sales Rep who was chatting it up with a doctor in the office. We said hellos and shook hands, then briefly touched base about his recent Lake Tahoe D-Bike Ride and how he was going to be writing a guest-blog about that soon. In about 15 minutes since arriving, I'd already encountered two members of the DOC!

Once doing a blood test and retest on the office Accu-check Aviva meter, I mentioned to the nurse that was a fine result in the low 200s because it was actually coming down from the post-glucagon 450 a few hours earlier. Her face went white and I thought she might fall over in disbelief, but she didn't say anything and just wrote a note on my chart. Then, she scooted out and I sat waiting for about five minutes before there came a knock on the door.

Dr. P entered the room, with a young blond girl in glasses and a white lab coat trailing behind her. Greetings revealed the stranger to be a Resident Observer who was just along for the ride for a week or two. She was keen on taking notes, but didn't say much and certainly liked to nod - like that one guy in Office Space who stood listening to the boss talk and visibly agreeing with everything that was said.

We started off with small talk, delving into generalities about how things have been and any huge changes that should be noted. I reminded that I'd been back on the pump for about three weeks, and hadn't yet made any changes in order to make sure I was used to it again before doing so.

At some point, it became clear she didn't have my BG readings that had been uploaded the night before onto Minimed Carelink. I'd phoned and left a message earlier that morning, and so she left in search of someone to print off those uploaded results.

Resident Observer stayed behind. I asked how she was liking everything, and she noted that Dr. P was very knowledgeable but quite busy with so many patients. I mentioned we Patients With Diabetes generally don't get much time and that's an issue, but that we take whatever we can get. She nodded in agreement.

Dr. P returned a few minutes later and we started going over the BG results she'd located. She observed my Lows and the trends of hovering in the 60s, but noted generally I was doing better.

But my inside-the-office A1C came back at 7.8, a tenth of a percentage point higher than the last result back in June. This wasn't a surprise to me, as I'd seen higher BGs in the August from my last month of MDIs. Actually, with the more recent Lows in the past few weeks since reconnecting to my pump, I actually expected an artifically deflated A1c. With this final result, I concluded that my A1c is actually hovering somewhere near 8%.

We acknowledged that and knew some work was ahead. Really, this doesn't change my goal of getting down to 7% by year's end. I know it's possible, and think that the basal changes we made will help tighten up the control.

Dr. P determined that my trends of hovering in the 60s at various times of day and the even lower Lows that have led to glucagon-injecting and paramedic visits meant we should adjust ALL of my five basal patterns each day. We lowered them, if even just a tad. I'm to fax my results in a week, she said.
I observed that there was a benefit of having the paramedics come out to the house.

Me: "On a positive note, at least I'm getting my tax dollars' worth and getting to know my paramedics by name."

Dr P: "That's NOT what we want... I am not prescribing that."

The Resident Observer laughed at that, and I agreed we indeed didn't want that.

After all the trend talk and basal adjustments, we discussed my need for Lab Work and I agreed to get that done before long. Then, she proceeded to do the Eyes and Ears check, heart and breathing checks, and see if I could feel the metal brushes in my toes and feet. All good.

When all was said and done, I got about 25 minutes out of Dr. P this time. Which of course, was half of what I'd paid in my newly-revised co-pay amount... But again, not the time or place for that one.

My Endo appointment wasn't the only in the DOC - several others also had visits the same day or week. There was some discussion about this being a coincidence, but I don't buy that. I think it's simple planning: going every three months or so, we've all orchestrated our visits to be timed so that our next one, the fnial one of the year, comes just before Christmas. That way, we can get some results from our Endo just in time for the holiday!

Checking out with the scheduler, I mentioned this scheduling was perfectly planned because it meant I'd either be getting a wante Christmas gift or a lump of coal from Dr. P on my next visit. She chimed in that her impression was that it was perfect timing for me to bring them a gift. Well, of course!

So, we in the DOC have our work ahead for the next three months as we prep for our likely year-end visits just in time for Christmas! Hopefully, we don't put off our "shopping" until the last minute and give ourselves the chance to avoid those lumps of coal!

Friday, September 24, 2010

Five Years

On Sept. 24, 2005, we put rings on our fingers, made some serious promises, and began our life together as a married couple that was the happiest moments in my life.

That also happened to be the time we dripped wax on our hands, nearly tripped walking up the stairs at church, and laughed at each others' total unpreparedness in actually getting married.

Funny and serious, there we were. And here we are.

These past five years have complimented the five we'd been together before marriage, and we've endured so much during our first decade together. Every day has been an adventure and I'm so incredibly honored to be sharing these days with you. We've been through so much. But you've put up with my stubbornness, my legal-argument articulating mind, and endured all the Highs and Lows. And that's before we even get into the whole diabetes aspect of our life.

Ten years ago, life was so much different. Those where the days Before Pizza Had Carbs - or more specifically the time before pumping and carb counting when you didn't need to put on a Human D-Math Calculator Hat. Those were the days of a couple shots a day, and I don't even remember when or how it was introduced. But you were fine with it. And I reflect on how your sister told me later that she'd never observed you study so much to learn about something like that.

But you've done a great job. Putting infusion sites on my body parts, stabbing me with needles in my arms and arse, and picking up prescriptions from the pharmacy. You've become an expert in the Insurance Game Hurdles of This D-Life as our health care insurance supplier. You've been keen to my BG swings and instructed me to test when suspicious of a Confusing Low or Grumpiness-Inducing High. You've tested me when I haven't been able to do so myself. Stayed on the phone with me when Low and wandering around parking garages and downtown city streets, trying to find my car and some sugar. You've made sacrifices to take care of me when needed. Crammed apple juice, honey, frosting into my mouth, and conquered the Apple Cider Loving Aliens who took over your body when I had a Low. When glucagon stabs weren't possible, you bravely summoned the paramedics to our home. You've become a D-Police combatting force in your own right, standing up to those evil forces trying to question or bring us down.
And so much more.

Your love, support and guidance is what inspired me to not only graduate from college, but to take ownership and control of my health and diabetes. You gave me purpose. Made me see that there actually was something in this world worth living for, and that I wanted to be around as long as possible to share these adventures with you. From that moment driving to the Columbus Zoo and switching my gaze from the road to your sleeping face in the passenger seat, I knew that you were the one. I knew that I was in love and that my life was unfolding in a way I hadn't expected.

As this day approached, I reflected on the moments leading up to our marriage. I recall how it was two years post-college when I made the decision to step up and make the future happen, in order to provide for a life together. That was part of my big plan to propose in March 2003, and I spent several months creating that special marriage proposal newspaper that would be revealed to 100+ of friends at the annual fraternity gala. You said "yes," and my life truly began.

Every year, I re-read that eight-page newspaper and smile. Today is no different, and the words of that lead story I wrote under that looming headline of "Will You Marry Me?" still ring true: "Everyone needs inspiration - whether they are a writer, artist, or any other occupation. Just as a poet needs inspiration to write a poetic masterpiece and a journalist needs stories to create a newspaper, I need you to provide the words for my life. Without you, my life would be empty of all inspiration and I'd have no words to share."

In our five years married, we've survived a move from Michigan to Indiana, a couple high-stress job changes, our first home purchase, and the start of a life. Not every moment is peachy. But we're in this together, during the Laughter & Tears. You give me balance. And inspiration. And focus. And so many words that this writer can't even capture.

Now, we've discussed anniversary gifts and decided they weren't important. They don't symbolize our love, our marriage, and we certainly don't need things to feel better about ourselves. A certain part of me had trouble letting go of my gift-plan, because I want to "give you the world" that you deserve, but I let go. Besides, looking at the traditional gift of wood and modern gift of silverware for five years, I don't even know What The Fruity point would be in either of those two gift ideas. Your love is a gift enough for me, and that's all I want.

Tonight, we have an "Anniversary Date Night." The tickets to a charity gala give us the chance to dress up, get a great classy meal, and just have some fun together. Then we have the weekend to relax and enjoy, play some games, take the dog for some W-A-L-K-S, and to just be in each other's company. I can't wait.

With that, I leave you some words of wisdom: "Gunga galunga... gunga, gunga-lagunga."

No. Wait. That's a line from Caddyshack. Though you are better than The Lama in my world, that's not where I was going. Actually, I was going for something from our first movie back in 2000, Return to Me: "What do you expect most from a relationship? A: Companionship. B: Sex. C: Respect." I'd have to go with B: Sex. But let's mark "C" so we get a higher score... "

Ok. Nope. That didn't work either. Hmmm.

Instead of movies, maybe I'd be better off just borrowing the title line of the song we danced to that night five years ago: "Thank You, For Loving Me."

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This post is the intellectual property of The Diabetic's Corner Booth and attribution is always appreciated if you are to use this material. Any reposting of this content without first obtaining my express permission will be considered to be a violation of my legal intellectual property rights. If you are reading this on a blog called Clean Natural Living, then it has appeared on a site that does not have my consent to repost this content in its entirety.

Thursday, September 23, 2010

Needed Musical Talent

Musical talent isn't something that graces my life.

Singing is taboo, or at least it should be... Even in the shower, where the water goes ice cold whenever I tempt fate by starting to sing. Haven't played any musical instruments since my high school drumming days, which lasted about a year. Some say I can dance on beat, but that alleged rhythm and coordination remains a debatable point still baffling the wisest of the wise.

However, I'm fortunate enough to be blessed with musical talent from others when it's needed most. There's church song, which lifts the spirit and makes you appreciate having a voice. Then, there's just great artists on the airwaves who have some outstanding tunage, songwriting, and craft in performing.

Lately, I've been having a tough time and haven't been all too fond of my D-Life. Paramedic visits, Ill-Timed Lows, and overall uncertainty more than usual have been mounting - on top of the regular life hurdles and stresses and deadlines. Nearing meltdown after a long Thursday that seemed to never end, I turned to some trusty iTunes to help ease the mood. And what did I find?

A song called Not By Choice, sung by the fabulous George Simmons, the Ninjabetic Extraordinare. This fellow D-Blogger out in California was one of the first to ever comment on my blog long before it became The Diabetic's Corner Booth, when it was just The Corner Booth. He introduced me to the real DOC, as I know it now. This man has been an inspiration and life-changing force for me, and I had the privilege of meeting him in person this past summer. Now, in a time when I wasn't holding it all together, SuperG came to my rescue with his outstanding musical talent created for World Diabetes Day 2008.

Work has been busy lately, and I've been trying to just stay afloat. But no matter how much I tried to manage my D-Life on Thursday, it came back at me and got in the way. Trying to interview our state's newest Supreme Court justice while going Low wasn't part of my plan, but I had to deal with it. That became so frustratining, adding to everything already piling on.

"You're here with me, but not by choice. Screamed so loud, without a voice."

My bloody hands, tired heart, my spirit broken from the start... I try to blame myself, but that's not right. Maybe I got you cause God knew I would fight."

Listening to George's words hit home, and very much got to me sitting at the computer late at night trying to conquer my deadline writer's block. His music helped ease the mood, clear the fog, and get me down to what I needed to do.

So thank you, George. More than you know. Your song brought me out of a funk, and it also reminded me how we're all fighting a battle that's bigger than ourselves. We have each other. And that's incredible.

"I fight for life, and help others to fight, too."

With that, I leave you with Not By Choice that can be viewed over at George's Youtube channel: http://www.youtube.com/watch?v=Tsic6O0wLlY. Please enjoy it even half as much as I do.

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This post is the intellectual property of The Diabetic's Corner Booth and attribution is always appreciated if you are to use this material. Any reposting of this content without first obtaining my express permission will be considered to be a violation of my intellectual property rights.

Wednesday, September 22, 2010

Stepping In The Right Direction

Six months ago, President Barack Obama signed the Affordable Care Act. Many parts of this new law take effect gradually and are scattered throughout the coming years. On Thursday (Sept. 23), several important reforms become law. Most importantly, these points expand health care coverage to millions of children who previously fell through the cracks of our health care system.

Specifically, these now-in-effect provisions are:
  • Extending Coverage for Young Adults: Young adults can stay on a parent's plan until they turn 26. This doesn't apply to young adults who already have health insurance through a job.
  • Free Preventive Care: New plans must offer free preventive services, such as flu shots, mammograms, and even diet counseling for adults at-rsk of chronic disease (read: pre-diabetics, this applies to you!) This means they cannot charge you a deductible, co-pay, or coinsurance. (Note: This only includes new plans, not those "grandfathered" ones already in effect when the healthcare reform law passed.)
  • ER & Doctor Visits:  If you go to an ER outside your plan's network, you won't get charged extra. Patients will also be able to designate some specialists - specifically a pediatrician or ob-gyn - as their primary care doctor, avoiding the hassle of referrals that might otherwise be required. No clear reading on whether Endos fall into this category, but that's something to explore...
  • Insurers Can't Rescind Coverage: When someone with health insurance got sick, insurance companies would sometimes search for an error or other mistake on that person's application to deny coverage. That practice will no longer be legal. (Note: For most people, this will take effect in January 2011, at the beginning of a health plan's new year.)
  • Insurance Appeals: Consumers will have two ways to appeal coverage decisions or claims: through their insurer or through an independent decision-maker. (New plans only.)
  • No Annual or Lifetime Limits: Insurance companies can't set lifetime limits on key benefits, such as hospital stays. The law also restricts insurers' ability to set annual dollar limits less than $750,000 on individual and group plans. Annual limits will be totally wiped out by 2014. (New plans only.) 
  • Health Care Provider Choice: Patients have the option to select and keep a primary care doctor from among the insurance company's participating provider network. In addition to promoting a long-term relationship between patient and doctor, this provision encourages patients to seek preventive care, which lowers hospitalization rates and costs. The rule also prohibits insurers from requiring a referral for obstetric or gynecological care.
  • Emergency Services Access: Insurers are no longer be able to deny coverage or demand that patients pay co-insurance for the use of out-of-network emergency services. This protects patients who become ill on the road or far from a network hospital.
  • Preventive services covered: All new or renewed health insurance plans must cover preventive services such as vaccinations, mammograms, colonoscopies, and nutrition counseling for obese patients. These services must be free to the patient, with no applicable deductible, co-pay or co-insurance.
Everyone should be aware of these important new benefits and their impact. Some subscribers and employers may choose to stay with their current plans, many of which are exempt from these Sept. 23 provisions. But by 2014, all plans will have to conform to these and other standards. Health care reform innovations still ahead include electronic health records, discount prescription drugs for seniors and state-run insurance exchanges to encourage competition.

The Obama Administration says the new benefits will raise premiums by no more than 1 to 2 percent, and benefit consulting companies report the impact will be in the single digits but may vary from plan to plan. Meanwhile, there's the insurance industry that says rates will skyrocket because of these changes. Uh huh. As if rates have NEVER gone up before and my reading of rate increases every year was a mistaken interpretation on my part. That now, the sole cause of the rising rates is "Obama-Care," and the lying scheming insurance company cats want us to think that had we sat and done NOTHING, the status quo would have made life all peachy and rates wouldn't have to go up now. Uh huh. Sure.

These idiots are of the same ilk of those who once believed the sun revolved around the earth, even after seeing a map of the universe.
Of course, then there's another item that shakes things up and proves that the insurance industry just can't be trusted. News in the days before these 9/23 changes is that major insurers Wellpoint-Anthem, Cigna, Aetna, and Humana say will no longer sell child-only policies. The end of a news story reports this: "Part of the problem for the insurers appears to be the concern that extending coverage for pre-existing medical conditions to child-only policies could be a powerful incentive for parents to wait until their child is very ill before seeking insurance cover. And coupled with the fact it will not be until 2014, that all health insurers will be obliged to extend cover to all individuals with pre-existing medical conditions, regardless of age, this leaves a three to four-year gap when what might happen is that insurers with child-only policies will find themselves primarily covering children with large medical bills, driving up costs to the point that plans could go bust or premiums for other policies could rocket."

Hmmm. Not sure what I make of this. Overall, the net result: fewer options exist for covering children's health. But based on my large amount of trivial knowledge on this, I don't believe it's all that big of deal. The logic seems to make sense to me and it seems as though the insurers have a point (WTF Moment...??!?!) Parents can wait until the last minute to insure their child in these child-only plans, rather insure them as part of the family ahead of time. My reading on the topic from both sides tells me that child-only policies currently comprise less than 10% of the individual market, and existing child-only plans won't be canceled. Only the new enrollment is being nixed. As we've noted insurers will still cover children - including those with pre-existing conditions- in policies that aren’t strictly child-only. Not sure what the potential cost breakdowns might look like, but again it appears the insurers are making a solid argument here.

HOWEVER. There's a larger point: Trust. We patients have little of it when it comes to the insurance industry. History justifies that, because in many cases you just can't trust what an insurance company tells you. That dictates the necessity to talk to five people who give five different stories, before you finally get to the person with the authority to send you documentation of what they're saying. That becomes important later on, when the insurance company GOES BACK ON ITS WORD and tries to screw you over, and you are able to throw the letter in their face. State insurance commissioners and regulators are especially fond of that documentation showing Insurance Company Dishonesty. You know.. Sticking to the promises you make is important. I guess the insurance industry didn't learn that lesson and is fine with going back on its word. Personally, I'm not surprised. But I am biased, since I value my health and doctors' guidance rather than an insurer's bottom line.

With all of this and the new 9/23 provisions, this is a step in the right direction to improving health care coverage and access in this country. But even as these provisions go into effect, these new laws are in danger as we approach the November 2 general election which could shift the balance of Congressional power. Many of those running are voicing their intent to revise and repeal many provisions, and that political rhetoric will likely continue and gain more steam as we approach the presidential election in 2012. Already, we have some who've vowed to repeal these reforms - Tea Party candidates, Sarah Palin, and Mike Huckabee, just to name a few. Some of these fall into the same group that's talking about repealing the 14th Amendment, and reworking the Civil Rights Act and American With Disabilities Act in ways that would be very detrimental to our country's progress in the past three decades. This is a danger and would set us back so incredibly far. We must remember that when heading to the polls and casting our ballots!

What do you think about these new laws? Will these healthcare reform changes affect you? What are you concerned about politically from those who vow to revoke or revise what's put into place?

Tuesday, September 21, 2010

Talking Type 1

Diabetics Unite.

No one needs to tell the Diabetes Online Community about how awesome D-Meetups are. We know it. We love them. Welcome them. Encourage them. As much as cats, bacon, and Tweet-versation.

Tapping into that meeting-loving mantra, the JDRF has come up with a plan for World Diabetes Day on Nov. 14, with what it calls Type 1 Talk. Basically, it's a huge network of local D-Meetups on World Diabetes Day that will all be connected through the JDRF's use of Facebook and a live video streaming Q&A.

Participants will have the chance to meet new people in their community through "events" at homes, offices, community centers. Not just meeting, people will be able to view a live streaming video presentation from JDRF staff and volunteers, ask questions, and then continue those conversations at their local events. People can host their own event or find one to attend, using a new Facebook application being created and unveiled somewhere on or about Oct. 5. Participants will be able to post an event or search for one in your area using this online tool, and you'll also be able to talk with other Type 1 Talk participants and access event materials or resources.

Tentatively , the timing of the live streaming presentation would be 3-4 p.m. Eastern Time to accomodate for the Sunday activities on both coasts. The JDRF encourages local event planners/attendees to set aside time in the beginning for intros and afterward for followup discussions. The JDRF Advocacy wants everyone to submit ideas and preferred topics in advance. In early October, we can vote on the topics for discussion using Google Moderator. I've already introduced one topic: specifically how the Diabetes Online Community is an incredible resource for diabetics to tap into, and the JDRF has expressed some interest in this topic for Type 1 Talk.

Three main reasons for creating this concept: 1.) JDRF Advocates most often say they want connections, more relationships among fellow Type 1s. 2.) The JDRF has been asked what it's doing for WDD and hasn't had a clear answer. 3.) Advocates want more on the progress being made on treatment and a cure.

First, I applaud the JDRF efforts here. This is sorely needed, and I hope this does tap into more of the Adult Type 1 community. However...

One, I'm not all excited about this for a "meeting" aspect... Frankly, I just want to be able to get together and meet with other diabetics and talk about whatever we might want to talk about. No boundaries, as far as I'm concerned.

Mainly, this doesn't appear to specifically address the whole Adult Type 1 demographic, except for the fact that we happen to fall into that larger Type 1 category. So there's that. I admit that I've not historically been much of a JDRF fan, except for my continued and regular involvement in the JDRF Walks back in the home state of Michigan. The organization founded in 1970 has a noble goal of funding research to cure diabetes. While that's important to me, it's not all that I advocate for. Mostly, I advocate for better understanding, awareness, and management of diabetes. Very often the JDRF seems to lose sight of these aspects and critics slam the group anytime they focus on something that's not "cure-focused." So rather than be seen as a "fundraising tool" or "advocate to get more JDRF involvement," I do my own thing and let the JDRF do its own. Scott Strange over at Strangely Diabetic has already written about this a couple times.

That's changing, and this is another step in the right direction to at least getting me back. World Diabetes Day may be a start, on top of my dive into the Politics of Diabetes Advocacy and JDRF Indiana Outreach Committee involvement earlier this year. We'll see.

You can get involved. Setup your own D-Meetup, and key up the internet live-stream connection for what should be a fun and informative presentation! Find out if your local JDRF chapter is doing any Type 1 Talk meetups on Nov. 14. They might not yet be aware of this, so you can contact the national Grassroots Advocacy office.

 What are YOU doing for World Diabetes Day? What Type 1 Talk topics should be mentioned? Please share those ideas. You can leave them here, over at the Juvenation Advocacy blog, or by contacting Melissa Smicker in the JDRF Washington D.C. office at msmicker@jdrf.org or (202) 465-4105. This is your time to talk, so make sure you raise your voice. Thank you.

Monday, September 20, 2010

The Cure Incarnate

Every once in awhile, a Person With Diabetes feels as though he or she is The Cure Incarnate.

We see spectacular blood sugar readings that at first signal good tight control, but eventually the continuing trend defies logic and becomes something more. It's as though you can "do no wrong." We feel as though our insulin-producing beta cells are actually functioning again, and no matter the carbs we eat everything comes out "normal."

This was my experience during the past week. For five days, I had outstanding BG tests. Granted, there were some Lows and unexpected Lower Lows where the paramedics had to be summoned. But overall great numbers.

My definition of "overall great numbers": No Highs.

As of mid-Sunday, my seven day average: 124, two-week average was 143, and month average was 172. At least according to my One Touch UltraLink meter data. Using a combination of online data from both the Carelink program and s5health, my further analysis showed that I was "in range" (my 70-150 target) about 50% of the time. In that larger window of being below 200, I was nearly perfect. I'd gone from Monday to Saturday evening without hitting 200 - to me, this was an accomplishment. Something that made me smile and feel pretty good about my D-Management. I felt Better Than Bacon.

Of course, what shot me back up into the 200s (238 mg/dL to be exact) was the bolus-worthy beer and buffet ride at our local brewpub's Oktoberfest. This annual event is a much-anticipated event in our household, and I'm always looking forward to it. It runs throughout the afternoon, so we managed to get there for what turned out to be a later lunch mid-afternoon. Along with two 28oz "beer boot" mugs that came with the ticket, I also had access to an unlimited buffet of soft pretzels with spicy mustard, sauerkraut, potatoes, and four varieties of German sausage. Not to mention the German chocolate cake that tempted me from the end of the buffet table. Of course, Suzi went and we had some great discussion while hanging out in the beer-garden, though she's not a beer-drinker or German food enthusiast so she went with a regular-menu spread of chicken sandwich, salad, and iced tea. She did get to try some of the chocolate cake, though! Anyhow, spreading my bolus out over a few hours, I enjoyed the meal and fully expected to end my BG streak because of this feast.

Three hours post-Oktoberfest, I tested at 163. (Not bad, I thought.)

But six hours after the feast, I came in at 238 mg/dL. (A-ha! I knew it would happen!!)

Prepped a pump correction bolus and got back to the low 100s within a couple hours, and stayed that way for the rest of the weekend. Aside from a Sunday snacking SWAG bolus that led to a higher 291 mg/dL... All steady aside from that!

Of course, this is all great news leading up to my Endo visit on Tuesday with Dr. P. She'll be quite pleased, I'm sure, except for the likely question and concern about so many Lows in recent weeks. We will probably be able to chalk it up to my being back on my pump since early September after a five-month hiatus, but still we may want to adjust some basals, correction factors, or carb ratios. Hopefully, this will all yield a lower A1C result, down from the 7.7% that we achieved back in June. That, you may recall, was a whole percentage point drop from three months earlier, but still not as low as I'm shooting for. With luck, hopefully I'll be able to have gotten down to the 7% mark this time!

We shall see...

Friday, September 17, 2010

An Invisible Me(me)

The Diabetes Online Community has been full of Diabetic MeMe posts in recent weeks and it seems Kerri kicked off the trend, so here's my jump onto that worthy bandwagon. Seemed like a good time in general, but also because I've been busy with a mix of work priorities, writer's block, and just a sense of burnout in doing so much lately. Plus, it's Invisible Illness Awareness Week and I wanted to catch the end of it before it was too late... So, enjoy this one all about Me!

  What Invisible Illness do I live with? Type 1 diabetes. Yes, that's not a pager or phone at my waist and I'm not carrying a little Iphone case with me everywhere I go - that's an insulin pump and blood meter case, two of the many tools you might otherwise not even notice when seeing me sprinting down the street like a madman (in search of sugar, not because I'm running late to a meeting.) 

When were you diagnosed: My D-Life Adventures began in Spring 1984. An exact date isn't known and the paperwork no longer exists. But we know it was right in this area, because my mom recalls it was just after my 5th birthday on Feb. 1 and after my grandfather had died. With my mom being a Type 1 since the age of 5, she was glad that he hadn't lived to see his first (and only) grandchild diagnosed with diabetes. 

What's your current blood sugar: 77 mg/dL (which means I can't yet go to bed and must eat something...) 

What kind of meter do you use: One Touch Ultra Link. Love it, because it automatically syncs with my Minimed 722 Paradigm pump and makes life so much more hassle-free. 

How many times a day do you test your blood sugar: Usually 7 or 8, but sometimes as many as 12 depending on Lows or whatever else might be happening. 

What's a "High" number for you: 250 or Higher is "High," though I'd prefer to stay under 200. 

What's do you consider "Low": Whenever the paramedics need to be summoned, or more simply when my vision blurs or I have trouble comprehending simple tasks such as spelling my name. A meter reading of 60 or below might signal this "Too Low" train of thought, too. 

What's your favorite low blood sugar reaction treater: Partial to glucose tablets. But I've been getting more used to Skittles. I enjoy tasting the rainbow. 

What was your last A1c? 7.7

What have your highest and lowest A1c been? Been all over the map, from High Teens during my teen "rebellion" years to lowest of 6.1 in late 2001 after initial six months of pumping.

What's your biggest diabetes achievement: 26 years of Living With Diabetes without any complications worth mentioning. Luck, might be a better word than achievement... 

What's your biggest diabetes-related fear: Not death. Everything short of that.

Aside from diabetes, how do you spend your days as a non-invisible? I'm a journalist at a legal newspaper in Indiana. So, my days are about talking to lawyers and judges all day.

What takes your mind off of Diabetes? TV. Now that Law & Order is 86'd, my vote would be for NCIS. Go Gibbs!

Who's on your support team: My wife, first and foremost. Family. Diabetes Online Community. My Endo. Primary care doctor. Coworkers. Everyone else who hasn't been named, but is supportive.

Do you think there will be a cure in your lifetime: Even if there is, I don't expect I'll be touched by it. But, there's always hope.

What is a "cure" to you: Not the Artificial Pancreas. But short of being able to be off insulin 365/24/7 for the rest of my life, I'll take it. 

The most annoying thing people say to you about your diabetes is: "After so long, you should be better at this." (That's a direct quote, and no this person managed to escape a crowbar to the kneecap.) 

What is the most common misconception about diabetes: The misconception by so many that Type 1 is a lifestyle condition we bring on ourselves, and that it can be controlled by eating right and exercising enough. 

If you could say one thing to your pancreas, what would it be: That lazy bastard isn't even worth wasting the breath. But if I did, I'd say: "You're as worthless as a $2 welfare worker."

Why I am participating in Invisible Illness Week: Because it's important for people to know that just because you can’t see my illness and I don't look "sick", it doesn’t mean every aspect of my life isn't affected every day.

Thursday, September 16, 2010

Just Call Me, Mr. Pancreas

Recently, I was pondering funny names and an idea came to my mind.

I could change my name to Glucose. Mr. Glucose Hoskins.

Friends might call me Sugar, for short.

At this point, I honestly don't remember what spawned this train of thought. I'd been reading a court decision that day that delved into this history of surnames, so maybe that was a part of it. But I really don't remember. Just that it was pretty funny to my sleep-deprived, coffee-craving mind.

Tweeting this, the Diabetes Online Community got some laughs and someone observed how wrong it sounded on so many levels. Bernard also opined with a laugh while making the astute observation that it would be a cold day before he'd ever refer to me as "Sugar." We all got some laughs for a few hours, and then the funniness and novelty of it began to fade.

That is, until a news story came across my screen and made the whole name-change phenomenon more timely and pertinent. My mind began swirling some more about whether I actually should change my name, given what I was reading online.

News stories told me that the makers of High Fructose Corn Syrup want to sweeten the product's image with a new name: corn sugar. The Corn Refiners Association applied Sept. 14 to the Food and Drug Administration for permission to use the name on food labels, rather than the one that's highly-controversial because of health concerns about it. The group hopes a new name will ease confusion about the sweetener, which is used in a majority of soft drinks, bread, cereal and so many other food products.

Nationally, consumer concerns that HFCS is more harmful or more likely to cause obesity than ordinary sugar have pushed the consumption levels to a 20-year low. Scientific evidence is scattered on whether that's true, but more research appears to be leading to that conclusion and people are becoming more worried about the possibility. The industry says moderation is key and that "sugar is sugar," despite the fact that HFCS is almost impossible to consume in moderation because it's in so much and that it's not naturally created. Rather, it's a genetically-engineered product that is not naturally derived from corn and so our bodies just don't react the same ways to it.

The Diabetes Online Community has been all over this topic in recent months, most visibility with our own fabulous advocate K2 leading the charge - demanding answers, accountability, and simple logic and truth-telling on the topic. She's written about it extensively over at diabetesaliciousness.

But on the heels of a PR nightmare that it's losing the battle on, Big Corn is now looking at a name-switch to ease those woes and more easily deceive... inform...educate.. tell it like it is...  "market a message to" the uninformed masses. Simply, the group wants to save face for its favorite Artist Formerly Known as Prince - I mean, its cash-cow currently called HFCS.

Yes, that's the truth. That is why Big Corn spent an estimated $30 million in cranking out ads that basically make HFCS opponents look like confused, inarticulate idiots who just don't know the "sweet surprise" of what they're talking about. When that doesn't work, they simply push for a name change to further the wool-over-the-eyes campaign.

This whole name-change concept has also been tossed around about the larger dubbing of Diabetes, on whether we should have labels to distinguish the various types. Should we refer to it as Type 1 diabetes, or should a different name be out there to distingush this chronic condition from the "epidemic" of Type 2?

So, will a name-switch do the job? Does it really matter? Do these name changes practically mean anything, or are they simple marketing ploys designed to make something more pretty than what it really is? Are we really expecting that something will actually be different than what an original moniker seemed to say, mirroring whatever the new name implies?

That must be the case, as Big Corn says.

So, taking these renames at face value for a moment, my decision about changing my name becomes crystal clear: Michael just can't stay, you see, because I'm not an angel. Far from it. But no, I won't be changing it to Glucose, Sugar, Insulin, or anything of the like.

Instead, my new name will be: Pancreas. Mr. Pancreas Hoskins.

Under the Corn Refiner logic, if that's my name then magically my pancreas will work. I'd no longer be diabetic, because my name change would simply tell the truth of how my insulin-producing organ isn't "broken" as any other name might imply. Rather, it works just fine because my name says so.

Realizing how obvious this name-change solution was, this all makes me feel quite stupid. Honestly, very stupid. And it should be upsetting to you and every person who's ever researched or fought for a cure at some point in life. The JDRF and ADA should be livid. Why? Well, because finding a cure was always as simple as changing one's name. Because, as Big Corn wants you to believe, that makes all the difference.

What once gushed in fears of "Oh No!, it's High Fructose Corn Syrup" will now just lead to sighs of relief and smiles: "Aww, it's just like sugar. No biggie."

Shakespear once wrote: "What's in a name? That which we call a rose, By any other name, would smell as sweet."

Personally, I say crap by any other name is still crap. But what do I know. I'm not a farmer or corn sugar producer? So, my logic must be flawed.

I am obviously wrong, thus the only solution is to believe Big Corn and change my own name. So, this is Mr. Pancreas telling you like it is. For short, you might know me as Beta Boy. Just don't call me Sugar, or Fructose.

I wouldn't want to send the wrong message.

Wednesday, September 15, 2010

Power Outage & Paramedics


This is the second of a two-part post, the first you may have noticed earlier in the week about Dennys and Diabetes at 1a.m. We now move into the second half of the adventure...
 
As you might have guessed, winding up in a Denny’s parking lot in the middle of the night usually signals what can only be assumed to be an interesting time. Especially when there are needles, flashes of skin, “magic drugs” and a sniffing dog involved. But that wasn’t the most eventful part of the night. What truly sparked the “adventure” came in the hours after that late-night Denny’s parking lot scene, where I’d gone to help a fellow Adult Type 1 who was without insulin syringes and battling a cranky insulin pump and High blood sugars.

You might remember this detail from Part I: that prior to leaving my house just after midnight, my pre-driving blood test rang in at 57. Well, crap. That’s not going to work, I thought. So, I crammed a handful of orange glucose tabs into my mouth and went all vacuum-like on an apple juice box hiding in the pantry. Waiting about 10 minutes, I retested and determined all was fine for driving. To be safe, I grabbed a mixed handful of Starburst squares from the counter and also a PB cracker pack and went on my way.

The Riley Dog was with me on this late-night adventure, and we made it safely to the northside of Indianapolis in about 25 minutes (without speeding!). It was just about 1 a.m., I handed off the D-supplies, we chatted for awhile, and I made my way home. After pin-balling between a few area Starbucks and realizing that none were open at this late hour, I decided to head home and just brew myself a cup of tea before settling into my deadline work that was going to keep me up for another hour or so.

Getting home, it was just about 2:30a.m. I put water in the microwave, and went to wash my hands for a blood test. Just as I turned off the water and went to grab the boiling water from the microwave, the lights went out. A few flashes over the course of a minute, and it was obvious that the power wasn’t coming back on at that exact moment. I retrieved a flashlight to finish the blood test. My One Touch meter showed me at 215, and I was confident that this was a real test as I’d engulfed not only some Starburst, glucose tabs, and apple juice a couple hours earlier, but also a pack of peanut butter crackers worth 24g of carbs. I grabbed a couple pieces of cheese, just to be safe.

My sleeping wife appeared from the stairway, and she said the inactive bedroom fans woke her up. She called the power company and notified them of the outage. Deciding to wait it out, we sat down in the den for about an hour and chatted before finally deciding to turn in without any power.

A last minute blood test an hour later showed me in the 180s, and I was confident that was high enough for bed. We went upstairs and layed down, only to have the lights, clocks, and fans flash on within minutes. We set our alarms and turned off the lights before settling in for sleep.

About 5:30 a.m. (or I can assume it was about that time), a crazy dream captured my attention. I don’t recall the details of it, but just remember that it was somehow not usual and someone was trying to put honey into my mouth. Only later did I learn this wasn’t actually a dream, but a part of reality: my Diabetic Lights went out while sleeping. Apparently, the 215 and 180 weren’t safe levels to be at. Thanks, Starburst. I see how it is.

My eyes opened about 6 a.m. to strangers in my bedroom. Staring up at the ceiling and feeling something connected to the veins on my right mid-arm, the reality of what was happening became painfully clear.

Me: “You’ve got to be kidding…”

Laughter.

Bald Paramedic Hovering Above Me, Telling The Others Nearby: “He’s coming out of it.”

Another Man: “Michael. Do you know where you are?”

Me: “Wherever I am, I am refusing transportation.”

Once it became clear that I was lying on my own bed, with a ceiling fan above, I glanced around and saw about five paramedics standing nearby. My wife was in the doorway. Apparently, the honey she’d tried to get into my mouth wasn’t doing its thing and my swinging arms weren’t going to make glucagons a viable option this time (per our agreed-upon method of handling hypos). So, she summoned the Paramedics. This was the fourth - we think - that they've been to the house.

Apparently, this time it took longer for me to come out. I tried to fight, which is what spurred Suzi to call 911 but also meant a couple paramedics got to work out and hold me down. There was screaming, or rather some weird child-like whiny moan, I'm told.

Me: “How Low did I go?”

Mr. Bald: “32.” According to my own meter.

Another mentioned that their Paramedic Meter had flashed a “LO” reading, too.

Me: “Outstanding.”

There was something sticky on my face. My tongue helped me discover that this was remnants of honey. I tried to wipe some of it off, but to no avail. Looking around more closely, I realized that there were some familiar faces of paramedics who’d visited the Hoskins Household in the past.

“It’s been awhile… How are you?” I asked. “How’ve things been?”

The small chat went on for a moment or two, as if longtime friends were just seeing each other for the first time in a while. I also asked if they knew why the power had gone out a few hours earlier, and one mentioned that it was because a driver had crashed into a utility pole at some point in the night and knocked out the power to the entire area. Power had gone out at the station a mile or so up the road.

My inquiry was just another sign that I was, indeed, out of it.

After a few moments of sitting on the bed and drinking a juice box, another test put me at 104. A few minutes later I was at 151. The main paramedic man phoned someone, apparently a supervisor, about my reluctance to take up the offer of an Ambulance Ride. He reassured Supervisor On The Phone that I appeared to be with it, and that my wife knew what to do, and he got the OK. I signed the form saying as much. They packed up and left the house, making their way to the two fire engines and ambulance that were sitting in front of my home with flashing lights.

The neighbors were loving this, I’m sure.

As we walked downstairs, we let loose the Riley Dog who was sleeping soundly in her cage while the Paramedics did their work. She was excited that all was OK. I proceeded to let the Diabetes Online Community know what had happened, tweeting that the paramedics were just leaving the house.

Instantly and throughout the morning, fellow DOCers responded with concern. As did my parents, who responded with concern upon seeing my early morning Tweet about the experience. I reassured all that everything was OK.

This didn’t impact my day, which was a crazy busy one on deadline. Suzi notified her boss, as she was supposed to open that morning and this delayed her a bit. But it never came up at work for me; no reason for it to be mentioned. I did think about working from home, but decided that I needed to be at the office and drove in about 8:30a. Of course, a morning interstate accident complicated the commute and put me into a traffic jam for more than an hour. Coffee helped incredibly that day, and the lack of sleep caught up within a day or so.

Thinking back, I must assume that my recent Pump Reunion played a part in this. After being disconnected and on MDI for five months, I’d just reconnected to my insulin pump a week earlier and was likely still getting used to that change. Plus, the candy earlier in the night probably didn’t help keep my levels high enough despite what I thought were some foundational “complex carbs.” This wasn’t a trend as far as basals being off, so I had to assume it was the combination of the above happenings.
 
So, that was the Wednesday Ride – Dennys, Power Outage, Paramedics, a renewed desire to see Hover Cars as we’ve been promised by the Back to the Future movies. Certainly, one for the books. But really, it was just another Day in the Life of a Diabetic.

Tuesday, September 14, 2010

Dennys & Diabetes at 1 a.m.

Get ready for a rocky ride, one that calls for a two-part post.

First, you'll learn why two Type 1 diabetics were in a Denny's parking lot at 1 a.m. on the northside of Indianapolis, exchanging syringes and a "magic drug" while talking of blood and being High. Not to mention every under the sun (or moon) as far as diabetes management.

But that's only the first part, which sets the stage for a Starbucks-free night complete with a Power Outage - both electrically for my neighborhood and metaphorically as it relates to my D-Life. We won't neglect telling how the paramedics came out to visit from there, spilled blood all over the sheets, and manage not to terrorize the trusty D-Dog who'd been detecting Low BGs since the earlier C-A-R R-I-D-E.

All of this before 7 a.m.

It is what it is, in the Life of a Diabetic who tends to avoid sleep way too often but keeps things interesting.

Staying up late Tuesday night in preparation of a busy workday Wednesday, I found myself drifting away from doing the work tasks and instead turning to what was happening in the Diabetes Online Community.

An urgent Tweet caught my eye. It came from a fellow Indy area D-Blogger who lives on the opposite side of the circle surrounding the city (Thinking of a clock, I'm on the southside at 5 while she's up on northside at 1). Her BG had been High for way too long, and after a couple site swaps, she wasn't going any lower. Injections were out, as she had Zero syringes.

My mind flashed back to times in my past when Pump Failures have flashed into my life, and how the syringes that were once a part of my D-Management regime just weren't available. How I needed a shot, but had to make due with higher BGs until that insulin could start working. After a few message exchanges, we coordinated an impromptu D-Meetup where I could get her some syringes and a fresh bottle of Humalog. The location: Denny's up on the north side, about a 37-mile drive from my home.

The time was just after midnight, and after informing and kissing the sleeping wife goodbye, the Riley Dog and I ventured out onto the roadways. Not before doing a BG test, revealing a 71 mg/dL. I scarfed down some Starburst and some PB crackers, waited, and then set out on the car-ride.

We made it in about 25 minutes. Got there, gave her the needles and insulin, and then we found ourselves standing in the parking lot for awhile talking about area D-activities, overall D-management, pumps and CGMs, MDI pros and cons, and D-Police. A wide gamut of topics for 1 a.m. in a Denny's parking lot. At one point, as the dog wandered around and sniffed the parking space we were standing in, I glanced up and saw some people watching us suspiciously from inside the diner. Must have interesting, to see two people and a dog standing out there for a half hour, at one time waving needles around and showing off parts of their bodies where weird medical devices were hooked up to them. I'm sure someone thought about contacting the police about our loitering that must have appeared to be a drug deal for those late-night onlookers.

But, we made it away without any police response that time around.

We said our goodbyes, and then I set for home, craving a Starbucks but knowing that none were open at this late hour and that it was probably for the best. Simply, it was going to be a busy Wednesday and I needed to get some sleep. But the night was far from over, and my adventure was only half-over...

Stay tuned for Part 2, coming as soon as humanly possible...

Sunday, September 12, 2010

"Sticky" Diabetes Management

In a small group at church this past weekend, we delved into a current events course and how these issues of our time can be viewed based on Scripture. The key topic of discussion was one the Florida pastor who doesn't deserve to be named, simply because of his most recent plan to burn another faith's Holy Book. Thankfully, this act of hate didn't happen. But what we discussed was how this particular "Man of God" seemingly wasted what could have been such a wonderful opportunity to express why he and his congregation opposed this religion, and used that as a teaching tool to educate others about those issues. One group member whom I've grown to greatly respect in the past two years of our church-going experience made an interesting point: this highlights the line between Prescriptive and Proscriptive.

As the terms suggest, Prescriptive systems tend to list out all the possible things that can be done legally. Clear lists of what can be done, so that everything is black and white. There are no "sticky situations" or gray areas that you might need to analyze whether those listed items can actually solve a particular problem. Systems based on this structure say you can reach salvation only by doing A, B, and C. If you deviate, then you simply won't be allowed into heaven.

On the other hand, Proscriptive Laws are not mere rulebooks or manuals but serve an altogether different function. Their purpose is more cautionary and they tend to serve like the maps a pioneer uses in his exploration of new land: marking off whirlpools and quagmires while leaving large tracts blank and open to investigation. You have guideposts, or commandments that should direct you in the general direction but they don't set out specifically how you might get there. The system leaves much open, accounting for many of the "stick situations" one may encounter and leaving it open for how to navigate those scenarios based on Scripture, experience, and one's own views.

All of this also seemed to fit in with a recent series of sermons we've had in our church delving into those things in life and religion that may be "Sticky" - love, life, church, missions, and situations.

This was an overall intriguing topic of the most recent Sunday's church group discussion about this current event. But even more interesting was my reflection on this at home later in the day, when I thought this was a particularly relevant issue as it relates to Diabetes Management.

See, many (read some in the medical community, D-Police, and non-People With Diabetes) have Prescriptive views of what it means to manage our health - "Follow the rules, and you won't be High or Low and there won't be any long-term complications." But if you have Highs or Lows or complications, then you must not be doing what's required and you are wrong."

Then, there's the Proscriptive view that most PWDs actually know to be the way it works: "We have guideposts on D-Care and do our best with testing, carb counting, bolusing, and exercise, but sometimes you can't always control what happens and we see a High or a Low. Or worse."

Our modern civilization embraces the Proscriptive sense more than Prescriptive, showing us both pros and cons and allowing us to choose which way we see as the best. The biggest advantage that Prescriptive Law has over its Proscriptive counterpart is that it is comprehensive, but that also means it leads to those gray areas that some Prescriptives might be uncomfortable with. Anything is possible, and they lose control. They can't accept that uncertainty exists, and so they turn to that ultimate list of Dos and Don'ts and become convinced all the answers can be found there.

To me, that relates as much to the Qua-ran Burning episode as it does to D-Care. One group maintained that Islam is of the devil, but never outlined why they believed this or accepted that extremists who contorted these religious beliefs with hatred didn't represent all possible ways one can embrace Islam. We can pretty much assume this congregation in Florida follows the "Prescriptive" view of the world and Christianity, in that those not following what they believe to be God's word must be evil. But they lose sight of the love, tolerance, religious freedom, and "embracing your enemy" themes that are so potent in the Bible and in our society. We must not take Scripture out of context, confine it to a list of Dos or Donts, and expect to find our solutions for any possible problem.

Just the same as with Diabetes, where we know that so many possibilities exist and that we have some basic guideposts to keep us healthy. We go through our lives with diabetes, knowing that we're shooting for the 70 to 120 range, the great A1c numbers, and what we really shouldn't do because it could lead to not-so-fun experiences. We use our "Bibles", our "pastors", and our own experiences to base our decisions and do what's best as we see it to be. Navigating whatever "sticky situations" might come at us.

I have faith that He's guiding me and giving me the tools I need to manage my soul and D-Life. I know that, with His guidance, my options are pretty much limitless and the answers will be found, even without those definite black and white situations when things get sticky.

Friday, September 10, 2010

Indiana & Raiders of the Lost Tuk

We won't have huge boulders to outrun. No leather whips, snake pits, temples of doom, or power-hungry tyrants and bloodthirsty cult worshipers.

Even so. Feel free to call me Indiana.

Not because I'm named after the dog, but because I'm a Hoosier. At least that's what they tell me after living in this state now for six years. Just don't ask me to define what that word means - nobody here knows, even the lifers. But more significantly, you can refer to me this way because for the 1st time since I've lived here we are actually taking part in our Central Indiana Walk to Cure Diabetes on Oct. 9. That makes me Indiana, officially.

Every other year that we've had this walk, something else has interfered and pulled us away from participating- work, out-of-state travel, conflicting church charities. So six years have passed and we haven't found a chance to be a part of the type of event that I spent many of my younger years participating in, fundraising for, and generally just very excited about. Now, in my 26th year of Living With Diabetes, that adventure has returned and I'm very excited about it.

We are participating in the Central Indiana Walk to Cure Diabetes in downtown Indianapolis, as part of Team s5health. This is one of five walks happening statewide throughout the year, and the JDRF raises more than $2 million combined. Nationally, the walks raise roughly $100 million a year. The eight-person team goal is $5,000, though Suz and I are modestly only looking to raise a little bit each to help out. We will do what we can. Oh, and so is our Riley Dog! She's very excited to be a part of the walk this year, her first ever. We're also pretty confident that she won't have to raise any mula to get out there, but just to be a good sport we'll make sure she's sporting a past JDRF Walk shirt just for good measure!

Sadly, though, a feeling of sorrow seeps in as Walktoberfest draws near (not to be confused with Oktoberfest, which is nearly upon us beer-lovers!). The reason for that sadness is that there are SO MANY fellow DOCers who have their own walk teams and it's just not possible to attend or contribute to them all. A good chunk of online friends are traveling out to California to be a part of Team Ninjabetic, which happens to fall on George's 20th diaversary. There's many others, too, and I see from a scan of the JDRF Walk Central database that many fellow D-Bloggers are participating in their own walks throughout the country. I'd love to be a part of them all, since we are all in those for the same goal - to raise money for the JDRF efforts toward a cure. But that's just not possible, so I must settle on the joy that so many of us are involved and doing what we can in our own little corners and there'll be chances to read about the adventures through the blogosphere.

Now, the shameless plug: If you're so inclined to contribute to our local walk team effort, you can find a link to our Team s5health up above and then also off to the right there in the form of a Shoe Logo. As mentioned, Suzi and I are both participating in a family-created business team. So, there's that. Every dollar helps, as you know, and whether it's thoughts or dollars contributed, we're so very appreciative.

Despite this approaching excitement, though, I reiterate that we won't have rolling boulders or Lost Arks and that is somewhat of a bummer. However. We DO have news of another effort aimed at raising $5,000 for the JDRF, a team effort known as Raiders of the Lost Tuk.

Not sure about you, but I'm simply impressed by all the great Indiana Jones references going on here.

Ok. You may have heard of this, but if not here goes: The Rickshaw Run is a 2,000 mile, two-week trek across the entire sub-continent of India, all in the name of charity. At the heart of this trip is the mode of transportation - an Indian auto-rickshaw, also known as a rick, tuk-tuk, or simply “tuk." The Autumn 2010 Run starts September 11th, and this D-focused team known as Raiders of the Lost Tuk is racing alongside 60 teams from around the globe in an effort to raise much-needed funds and awareness for a worthy cause. No rules, and participants are up against sweaty jungle heat, dirt tracks, monsoon rains, and Himalayan peaks. One of the participants, Jim Matheson, is a longtime Type 1, and it's been pretty interesting watching the trip preparation video that includes packing all the needed D-Supplies. It's a once-in-a-lifetime experience, and more importantly, for a good cause!

To me, this is cool on a few levels - not only does it raise money for the JDRF and that's great for the entire Diabetes Community, but it also goes to the point that we Persons With Diabetes can do anything despite this chronic condition - just look at race car driver Charlie Kimball, mountain climber Will Cross, and Olympic gold medal swimmer Gary Hall or Olympic skier Kris Freeman, to name a few. Now, that list of accomplishments can include trekking across Indiana on automatic rickshaws!

As you can see, we have a lot of good causes on tap for the Diabetes Community. Hope the generosity is free flowing, despite the tough economic times, and that everyone someone finds their place for giving back and being a part of the big cause. Maybe you can even get a chance to network with more people in the community and find a place where you can ignite your passions as an advocate.

Sure, staying home and watching Raiders of the Lost Ark, Temple of Doom, The Last Crusade, or Kingdom of the Crystal Skull might sound more relaxing and inviting. But you never know what possibilities exist until you reach out and give it a go!

I promise, you won't have to dodge boulders or leap over snake pits. But you can pretty much find a place to crack that bullwhip of generosity and get your own theme music of appreciation. We can all be Indy Jones, whether we live in Indiana or not.


Keying Indy Theme music, the Raiders March by John Williams: Do do do doooo, do do do...

Wednesday, September 8, 2010

Back in the D-Saddle Again

Aerosmith said it best when they coined the phrase, "Back In The Saddle Again."

So, in honoring that great rock song and also the classic Gene Autry film by the same name, I offer my own D-Version of that saddle-ness recaptured.

Now that my five-month Pump Hiatus has come to a close, I've reconnected to my trust Minimed 722 Paradigm and am back in the pumping game.

It's been a long MDI adventure, but one that I'm glad to have experienced. You may remember that I had no issue with my pump as far as how it enabled me to live a more free D-Life. Just with not rotating as often as recommended by the powers that be, for nine years of mostly continuous pumping, took a toll on the body. It just got to be too daunting and frustrating to endure the pump site changes every handful of days, and the prospect of non-working sites and gushers just got to be too much. So, we took a bit of a break.

That led me to realize that it wasn't the pump that was dictating my D-Management trends, but rather my own hands. Having to stab myself with a needle every time I ate, or when the sugar was high, gave me more reason to think before putting anything in my mouth. Not only was it the simple fact of not wanting to stab myself with a needle, but it was also the convience factor of not wanting to take the time before a meal. Especially when out in public. The hiatus helped me not be so lazy, and as a result I saw an A1c drop by a whole percentage point. Granted, some things were more difficult - like adjusting to the dawn phenomenon and how the insulin-life lasted longer. But ultimately, it was a good experience.

My first days back to pumping were good, with mostly stable BGs and just a couple that went into the low 200s - a direct result of my SWAGing when it came to carb counts. Dipped down into the 50s a few times, but nothing that I couldn't handle and get back up to safer levels soon enough. Over the weekend, we did see a couple higher ones thanks to pasta and even more reckless SWAGing, but it was so much sweeter to correct by hitting a few buttons rather than injecting massive amounts via syringe. Bonus, there!

Not only was bolusing easier, but tracking is much easier too! I was able to not have to rely on my memory as much and recall whether I'd taken the insulin or Lantus at a particular time. My pump memory helped on this front, and then I was able to upload those details onto the Carelink program.

Getting back into the Minimed game helped me once again wonder about whether I wanted to start exploring a CGM. You may recall that earlier in the year I'd trial-tested the Navigator and Dexcom, but hadn't gotten around to the MM before stepping away from pumping. Now, that's on my mind again and I'm curious about what Minimed offers through the Guardian, the Paradigm Revel, and of course whatever is in the pipeline.

A D-Meetup at lunchtime Friday solidified my curiosity. Meeting with Ryan Sellers, a longtime Type 1 who happens to be our Central Indiana sales rep for Minimed. We had a chance to talk personally and delve into these issues when meeting at Panera Bread. As Ryan was in sales mode, we talked about his starting at Minimed a few years ago and how he'd gotten into that area, then delved into differences in pumps and what's in the pipeline. He noted that he's taking part in the Tour de Tahoe bike-a-thon that the JDRF is participating in for the first time later this month, and we agreed that he might guest-blog about that experience once he returns. So, this was an all around great D-Meetup!

So, the return to pumping has been good so far. Looking forward to getting back into the swing of things, and then hopefully venturing into the CGM sandbox at some point before long! Exciting times ahead!