Monday, January 31, 2011

Birthdays and Stars

Tuesday marks my 32rd year.

Thirty-two years since I entered this world on Feb. 1, 1979.

But while birthdays are celebratory and this is just another one, I'll be looking to the stars to mark this anniversary and think about what lies ahead. There is always good and bad, and so it is when my birthday rolls around each year.

Eight years ago, I was on a mission. A mission to buy an engagement ring. This was in the works for awhile at the time, and I woke up early to get myself ready for the monumental purchase. That Saturday in 2003 was when I bought the finger jewelry that would stay in my coat pocket for a little more than a month before the actual proposal came to be.

That was a positive, but that day had more in store than I had planned.

About 9 a.m. Eastern that day, the Space Shuttle Columbia was destroyed upon re-entering the planet. All seven astronauts on board were killed. This national international tragedy changed the mood, and tempered my excitement when arriving at and entering the jewelry store a little after 10 a.m. I'd sat in the car and listened on the radio to the news coverage, and thought about changing my own plans. But, I made a decision to proceed as planned. To complete my mission, and reach for my own stars. Maybe, in some way, a recognition of the stars those 7 had traveled to and encouraged so many others to do.

This wasn't the first time tragedy had struck for those reaching for the stars, though. Even more memorable was the Challenger Explosion on Tuesday, Jan. 28, 1986 about 11:38 a.m. - this time as the seven crew members were starting their flight. The shuttle disintegrated over the Atlantic Ocean off the coast of Florida, and all crew were killed.

So, in reflecting on these global tragedies that have hit through the years, I look to the sky and the stars in marking another birthday. I've reached for many stars in my life already and reached some, but others haven't aligned and more remain sparkling up there in wait for me to come get them.

That is what this 32nd birthday means to me. I'm looking to those stars that remain high above, and will do what I can to reach for them as often as possible.

Live your dreams. Reach for the stars. And even if the stars don't align or you can't reach them, remember those people and events that have inspired you to dream in the first place.

Friday, January 28, 2011

Buried In Nightmares

On a recent weekend night in the darkened confines of my own home, I watched the movie Buried.

Those in the Diabetes Online Community may be aware that this 2010 movie is the brainchild of Chris Sparling, screen-writer extraordinaire and husband of Kerri over at Six Until Me. The movie was released in limited spots in September and October, and the one location in Central Indiana didn't present an opportunity for me to attend at that time. So, I've been eagerly anticipating the DVD release date and subsequent appearance on our home TV network's On Demand roster.

That time finally arrived.

As I couldn't convince or bribe my loving wife to watch with me, I turned off the lights and settled in for the solo movie-watching experience in my comfy green chair upstairs. Just by reading a synopsis of the movie, anyone knows that the premise is that a U.S. contract truck driver is kidnapped in Iraq and buried alive in a coffin. That's all I am going to say, as to not spoil anything.  But let me say: I'm a fan, and it certainly kept me on the edge of my seat and I felt the anxiety and fear and confinement to some degree that actor Ryan Reynolds was going through.

[\Begin Digression: From a guy who calls himself a "writer" and has always fantasized about one day writing a novel or screenplay, I must now stand up from my blog booth and just applaud. Well done, Chris! /End Sucking-Up-Digression.]

But the movie experience isn't the end of the story here. No, not by far.

After the end credits scrolled and I tried to get a night's rest, I found it difficult to fall asleep. Every time my eyes closed, I envisioned scenes from the movie and the blackened confines of a coffin, so some instant coffee kept me awake for a bit before the sleep finally set in.

In bed, that's where the nightmares began.

As you might guess, I was buried alive. In a coffin. Groping around in the darkness, I found my insulin pump in my pocket but no infusion set connected. The pump back light provided a dim glow inside the coffin, and that's when I saw it.

A small hole near the bottom left corner of the coffin. With creepy spiders clawing their way inside. These weren't normal spiders though - they grew larger when they got inside. And the infusion set that wasn't attached to my body was, to my horror, part of the spider legs that clicked across the wooden coffin floor towards me.

Oh. My. Lord. Oh my. Fear doesn't even describe what I felt. Horror.

Though it seemed like hours, I'm not really sure how long this horror lasted. But the sight of these Infusion Set Spiders click-crawling towards me seemed to last forever in slow motion, and they didn't seem to ever get to me. All I knew, I was buried alive with little oxygen and surrounded by a growing supply of these creepy crawlers invading my new home.

That's when I woke up. For real, in my own bed. A vibrating pump next to me revealed that my infusion set was indeed connected to my stomach (and no spiders to be seen), as was a nearby CGM sensor. That is what was alerting me that I was hovering in the 400s - had been for several hours post-dinner, and just couldn't get it down.

It was 3:30 a.m. I was as High as a Kite, but in some weird way, I was somewhat relieved that I wasn't Buried with those scary sci-fi D-Supply Spiders clicking toward me. Rather, my post-dinner time snacking and SWAGing led to high BGs that in turn led to the some scary dreams, fueled in part by the movie-watching that evening. Not to mention I was likely starting to see the effects of an approaching sickness.

A few days later, a thread surfaced over on the Children With Diabetes forums asking whether nightmares actually caused high BGs or whether the Highs caused the nightmares. My experience has always been the latter, but some opined that the adrenaline rushes during nightmares raised the BGs. So, I pose the question now to the rest of the Diabetes Online Community:

What caused these D-Supply Spiders to enter my dream world - the outstanding screen-writing of Mr. Chris Sparling, the High BG levels alone, or a combination of those puzzle pieces?

I'd be interested in hearing your thoughts on this, and whether you've experienced any nightmares and high blood sugars and pondered the relationship between those two.

Whatever the answer, one thing is clear: I may have to avoid watching these kinds of movies by myself, in the dark, late at night, just before bed, while having High BGs. Just to be safe and make sure I don't again get Buried in Nightmares.

Wednesday, January 26, 2011

State of the Diabetes Union

Our nation's president gave the annual State of the Union Address on Tuesday night.

Lots of politics, followed by many pundants analyzing what was said and what it all means. While I'm a politico newshound myself, I decided to deviate from those points and focus instead on the politics of my own D-Life.

Photo source, thanks to a Google search.
It's the State of the Diabetes Union, if you will.

As the president spoke and then the reaction responses appeared on the TV, I was drinking a cup of tea in order to combat a common cold. Listening to Michele Bachmann speak as the Tea Party representative made me instantly regret this beverage choice. Listening to the political responses and reactions, it also made me ponder how difficult Diabetes Advocacy to new Congress members on Capitol Hill in March might actually be, when I disagree with so many of these people's stances (more on that later).

But putting real politics aside, I turned to the Diabetes Online Community and interjected a little humor into the evening's events via Twitter:

Me: "My Blood Sugars aren't being bipartisan. They are being the conservative BG Party of No. I blame the Tea Party, and the liberal Cupcake-Eating DOC."

Mike Durbin who is also a Hoosier, proclaimed proudly that he's a member of the "Bacon Cupcake Craving Party. Another third party, it seems.

I asked: "Do you allow for split-ticket voting in your party, or is it straight-party balloting? The result could create glucoastering..."

Mike responded, "You can vote which ever way is best for you. As long as you don't vote to do away with Bacon Cupcakes."

Being fiscally responsible and knowing the budget needs attention, I responsed: "Well, we do need to cut carbs and reduce boluses. Stop relying on govt insulin. Support the Free Market, baby."

Mike made a very good point, that Bacon Cupcakes are special and should be exempt from cuts. But earmarks are earmarks. So using insurance company logic derived directly from the BG Party of No playbook, I'd have to deny the cupcake claim and review it further during an appeal process. Maybe even form a budget-carb committee to explore this further, getting detailed information such as Letters of Medical Necessity and Half-Assed FDA Nutrional Label Info.

Overall, it's been a productive year. Lots of applause, some disagreement, and much progress on the diabetes front.

Though I didn't meet my campaign promise of hitting an A1c of 7.0 by the time the past year ended, I managed to reduce it by more than a whole % point - 8.8 at the start of the year to a 7.5% in mid-December. Wonderful progress, I'd say. My Lancets are still flooding the unemployment line, but my blood strips are gainfully employed 8-10 times a day and dutifully recording their time worked via Minimed Carelink. Less IRS paperwork and more efficiency, you see.

The Diabetes Online Community by a sweeping super-majority of support gave me incredible Health Care Reform. Oh, and I think our U.S. Congress did a little something about those pesky pre-existing clauses, too. The DOC is one of my top campaign contributers and contributing more each day, on top of the invaluably wonderful greatness of my Loving and Supportive Spouse, my Type 1 Mom and Type 3 Dad, and so many others. Including the many Facebook Friends plus Blogger and Twitter Followers.

The work done isn't without its critics. Endocrinologist Pundits, D-Police, and the Generally Unaware Public are always presenting a challenge and voicing their thoughts on anything we put out there. We try to legislate our D-Lives, but those Endos try to amend what we do and toss in their own "better" ideas. It's tough to keep track of where we stand, because our numbers go up and down like a CGM every test - and the message might hinge on what station (or blood meter) we're using. Who knows what's accurate or not?

Regardless of the urgency, they scream like a sleep-stealing CGM who thinks the sky is falling with every new number we register. After a while, we have to stop listening but just want for those big issue trends.

The future's looking bright, just in part because President Obama talked about connecting more people online and I like what that could mean for expanding the Diabetes Online Community even more into those largely untapped, rural areas. And he wants to encourage innovation and awesomeness, which I think is just a flat-out invitation for more #BluntLancet creativity and merchandise-selling in the coming year!

So there you go. My own personal State of the Diabetes Union for where we've been, where we are now, and we're we're going.

Now, my goal for the future is clear: Reach those Independent BG votes in order to bring my A1c poll numbers down even more, so that by the time we reach the monumental 2012 D-Season we will have accomplished that "Hope and Change," and be able to chant, "Yes, We Can - and DID."

Sunday, January 23, 2011

To My Local Newspaper

This post is in response to a pair of diabetes-focused stories in the weekend edition of the Johnson County Daily Journal, which is my hometown newspaper here in Central Indiana and a county paper that I think surpasses the Indy Star on most levels. For disclosure, I'd worked as a reporter at this paper more than five years ago and it's what brought us to Indiana in the first place. The editor I'm writing to is also my former boss, and likely as a result of that past employment this letter will never be published there. So I'm posting it here. Since the Journal locks down its content to only subscribers and I'm not a fan of that practice, I have opted to not post the two stories in their entirety to respect that policy. But I'm including enough to give everyone a feel for how the stories were written.
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Dear Local Newspaper Editor:
The Daily Journal in Johnson County, Ind.

On Saturday, you ran a story with the headline, "A New Day: Pancreas transplant eliminates Greenwood woman's diabetes." The story centered on a longtime Type 1 diabetic who, after Living With Diabetes for 40 years, underwent a pancreas transplant and was effectively cured of the daily D-routine as she'd known it. More than a year later, she's doing great and feels "normal." An accompanying story details the risks and bigger picture about these pancreas transplants, and how Indiana University Hospital is one of the leading and highest-volume locations for these procedures nationwide.

Being a Type 1 diabetic for almost 27 years since the age of 5, these stories hit home for me. I greatly appreciate the stories and found them to be very interesting reads on a transplant process I’ve wondered a lot about. Overall, I found these to be good articles that rise above most of the others I've seen published locally and nationally on the subject of diabetes. You captured the basics of Life With Diabetes, from the experience of having a Low blood sugar to the daily routine of finger sticks, insulin pump sets, and Continuous Glucose Monitor sensors. The secondary story also does a great job breaking down the differences between Type 1 and Type 2 diabetes, more than is typically seen in other media and most reporting on the topic. Honestly, I can’t say thank you enough for that.

Two concerns stuck out in my mind after reading the main story, though.

One concern with the story is that it embodies a common misconception that diabetics can't eat anything with sugar - the "You Can't Eat That" mentality. The woman in story talked about how she historically hasn't been able to eat sugar. Reese's Pieces Peanut Butter Cups, or barbecue ribs and baked beans. Actually, we CAN eat any of those things and more - we just have to accurately calculate the carbs contained in any food and dose insulin accordingly. But, even with that D-Math and ability to eat something, it doesn't mean some choose to and many veteran diabetics still live off the "avoid sugar" mentality as much as possible. Many in the medical profession still voice this, as well. That is likely the case with this woman profiled. The public then gets the idea that diabetics shouldn't eat sugar or cookies, and we regular get asked those questions as children's birthday parties, office pitch-ins, holiday feasts, and so on. It's frustrating, but not the end of the world. This isn't necessarily an "inaccuracy," just something that fuels an old-school myth that really isn't the case in this modern world of diabetes management.

The story did have an inaccuracy. While most of the basics were accurate, I found one line that unfortunately fell short of being correct: "If her (blood sugar) levels were too low, she was injected with a dose of insulin."

No, actually that's not correct. It would be correct if describing someone with a high BG - that's when you need insulin to lower your levels. But when a Person With Diabetes has a Low blood sugar, that means they already have too much insulin in their system and must get sugar to raise up their BG levels. Injecting more insulin could be dangerous, potentially even deadly.

Sure, us diabetics know this basic and won't get confused about it. To the non-diabetic, this error may not be a big deal. But it is.

Recently, the mother of a 7-year-old Child With Diabetes recently told me that a school teacher tried to make her daughter take insulin after testing for a Low one day. The teacher was confident that her knowledge was correct, that the girl needed more insulin. My understanding is the school didn't have its own full-time nurse there, and so it was up to the teacher to supervise until the nurse could advise. For whatever reason, that response was delayed and so the teacher was trying to convince the child too take insulin. Because that's what she thought. If it wasn't for the resilience of this little girl who knew better, this no-nurse situation could have ended badly.

Personally, I've had people in my life who have said this same thing - whether it be colleagues at past jobs, or acquaintances who've observed my Lows at times and tried to help.

Coupled with the first misconception, they might think it's because I ate a cookie one day and then went Low, and didn't take my insulin. And so I'm going to lose a leg, go blind, or have kidney failure, or pass out and die.

I worry that the inaccuracy in your story could spread that misunderstanding in the public, and it could reinforce the lack of knowledge out in the public. Kids and adults with diabetes could be put in danger by these inaccuracies, and that's a concern.

Which is why I've written this letter to you today.

Again, while I appreciate the publicity on this important pancreas transplant issue and even general Life With Diabetes, I do want to make sure we're getting the right message out to readers. I'd welcome the chance to keep in touch on these diabetes-related topics in the future, and help as much as I'm able to. Thank you.

Friday, January 21, 2011

Beer Math Calculations

You might say I'm a beer lover.

By no means am I an expert, connoisseur, or stuck-up sipper of the hops and barley brews. Simply someone who enjoys and appreciates a good beer, particularly those of the micro-brewery genre. Though I very much enjoy a good domestic bottle or name-brand beer any day of the week, I also love to explore new tastes and beers, and find it fun to not only try new ones that haven’t crossed my palate before but also talk about beers with those who share in that enjoyment. A friend and I regularly talk, a mix of joking and seriousness, about starting our own microbrew someday. We’ve even come up with the brand name, and just have to put it all into play.

With all of that said as background, I recently found myself in the mood for a good brew.

Exploring all the options and deciding against a light pale domestic choice but also not wanting to venture into any exotic or adventurous territories at the time, I narrowed it down to a pair of contenders: a favorite English ale known as Boddingtons and Guinness Stout from Dublin, Ireland. Both come in pints, looking like over-sized cans for the thirsty, and have nitro-tap cans. But they are two different worlds in terms of beer. The Boddingtons is lighter and smooth, with a deep gold color and is creamy and smooth, one that doesn’t weigh you down and is best served cool, not cold. The Guinness is a thicker “meal-worthy” beer that is also malty and creamy, best served cool not cold, and has some sense of chocolate and coffee in it.

Not able to decide between those two wondrous beverage options, I made a decision to purchase both brands that come in 4 one-pint cans.

This is where my Diabetes carb-counting kicked in, and I soon began pondering what each particular brand cost as far as carbs I needed to bolus for. Both are “bolus-worthy” in my opinion, but I just didn’t know off the top of my head what to count for each. The research began.

Boddingtons didn’t list that information on the box or can. So, some quick online research revealed that each was just about 10g of carb. For me, an Insulin To Carb Ratio of 1 unit for every 10 carbs translated to a 1.0 unit bolus for a beer.

Turning to the Guinness, my research intensified as I recalled this common struggle to ascertain what kind of carb-count this particular beer possesses.

On the can, it says: 12 ounces is worth 9.9g of carb.

HOWEVER.

The pint-sized can does not contain that amount of beer. Instead, it contains 14.9 fluid ounces.

See the confusion there?
So, rather than just telling me what I need to know, it tells me the carb count for LESS THAN THE FULL CAN of beer inside. Rather than just being all simple, Guinness gives me part of the formula needed to calculate the carb count for the full 1.2 servings inside. Um. Yea.

My mind starts analyzing various formulas, addition, subtraction, division, fractions, and all those D-Math nuances that I try to avoid if at all possible. Luckily, my wife came to the rescue with a quick Beer Math Calculation and saved me before my tongue became too parched for a drink.

In total, the carb count comes out to 12.3g, or 1.2 units of insulin. It's not difficult in the grand scheme of D-Math, but seriously, Guinness. Why The Fructose don’t you put the ACTUAL amount of beer in that can on there, rather than listing some other amount and making me figure it out???? Must you complicate the simple pleasures of beer drinking? I'm not sure how it works in Ireland and I certainly get that most beer-drinkers aren't in the habit of basing their beverage choices on the nutrional information, but some of us just don't have a choice in the matter. Please, help a beer lover out.

Of course, there's always the lingering concerns about how beer can raise my BGs up in the short-term but drop me down later on, the length of drink-time could play into my calculations, or that combining it with favorite shelled peanuts or fatty food may change up the effect. All of those are parts of the equation that I must be mindful of.

Mmmm. So, bolus-worthy beer!

Now, this is where I may have to remind that I'm no medical professional and am certainly am not advocating for or against alcohol consumption. That's up to you, and I encourage to consult your own applicable drinking laws, medical professionals, and personal preferences to decide what effect beer or liquor may have for you.

Aside from the D-Math and Beer Math Calculations, I remain convinced that both my Boddingtons and Guinness were and are both totally bolus-worthy.

Whatever the case, I hope you do what's best and most enjoyable in your world. And that, if beer is the choice, that it's not so tough to figure out the boluses as I've found with the above-mentioned beloved beer.

Cheers and Happy Weekend, whether it’s beer-filled or alcohol free!

Wednesday, January 19, 2011

Admissions and Ice Cream

I've asked some friends in the Diabetes Online Community to help keep the corner booth discussion going from time to time. So, here's your first co-host: the wonderfully-fun and creative Kim from Texting My Pancreas, who says she's honored to be guest-posting and promises "not to throw any wild parties" and will "try to remember to water the plants" in my absence. While I don't discourage any great #dprom-like parties and am happy to see my personal plant-killing practice will be on hold for a bit, I'm honored to have Kim on board! Please welcome her over here with a comment, too!
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Hi, Kim! (*Me waving)
The small piece of laminated paper could have easily gotten lost in the sea of celebrity headlines and polypropylene-wrapped candy bars, but my eyes still found it.

Beep! Beep!

It wasn’t professionally designed, but for me, its message couldn’t have been more attention-grabbing. “Our store manager is doing the JDRF Ride to Cure - will you round up your purchase to the next dollar to help sponsor her?” My eyes lit up.

Beep!

The cashier had come to the end of our long line of groceries, and spoke aloud the total for me. I responded “Can you round it up for the Ride to Cure?” She smiled, nodded, pressed a few buttons, and I swiped my card.

For the next ten or so seconds, I debated. I weighed it back and forth in my mind. Should I? Shouldn’t I? Does it even make any difference if I do?

It’s a decision I make every time something like this comes up: When an individual or business is fundraising for diabetes, and I agree to participate, do I tell them they’re fundraising for... well... me?

On one hand, I feel a little weird about mentioning it - as if I’m putting that cashier in some sort of weird position, where they have to come up with a response. “Oh... um, I’m sorry?” “Wow, that really sucks.” “Then why are you buying three kinds of ice cream?”

But yet, if I say nothing, it bothers me. I like to think that putting a face to the disease for that person might help positively reinforce the fundraising efforts they’re doing. When I remain quiet, I’m not doing everything I can to advocate. Perhaps bringing up the fact that I have diabetes will make the cause seem more personal. Or, it might just creep them out.

As we drove home, I shared with my husband what had been going through my mind when I agreed to donate. “I wanted to tell her ‘Thanks’, but I didn’t know if I should.”

“You could have - then she could have known how cool you are.”

“You’re right. Hi, I get to wear a machine all the tiiiime! And I have a drawer full of neeeeedles! I’m really good at fooooood maaaath! My fingertips have freeeeckles!”

(It was past 11:00 at night. I was exhausted and loopy.)

My point is: I think either answer can be okay. Sometimes you feel like waving high your diabetes flag, and sometimes you just want to buy your ice cream and go to sleep.

Tuesday, January 18, 2011

The Ricki Lake Blunder

Fellow Diabetes Advocate and Huffington Post writer Riva Greenberg asked for some help with an article she wrote recently on the heels of Ricki Lake's statement on Good Morning America that "juvenile diabetes is preventable." She notes that the Huffington Post rejected it for the first time in 50 submissions. They agave no reason other than "it's not a fit for us." Riva thinks it's worth a read and continues the conversation that type 1 needs more visibility and that type 1 and 2 are confusing to the public. So I've posted her article here as a way to help spread  the word, as Riva wants.
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(Recently) on “Good Morning America” actress and former talk show host, Ricki Lake, said juvenile diabetes was preventable. She’s since apologized. “This was a mistake on my part and in no way was meant to offend anyone dealing with the very serious disease of juvenile diabetes.”

Photo Source: Access Hollywood.
 Lake was speaking about her new book and AllStride program to combat childhood obesity when she made her mistake. “I commented that juvenile diabetes was preventable when in fact it is type 2 diabetes. This was a mistake on my part and in no way was meant to offend anyone dealing with the very serious disease of juvenile diabetes.”

I’m not offended. In fact, I’m a little delighted. Her mistake only confirms the public’s confusion about type 1 and type 2 diabetes. Even Lake’s interviewer smart guy, George Stephanopalous, didn’t catch her mistake. Now that is one thing I am sorry about. That the error was not snuffed out in its tracks and may deepen the confusion for those who didn’t catch Lake’s apology.

You’d think Lake, who’s advocating stemming the tide of childhood obesity – linked to the rise of type 2 diabetes in children – would know better than to confuse juvenile diabetes (type 1) with type 2 diabetes (adult onset diabetes). Type 1 diabetes is an auto-immune condition, not related to weight or a sedentary lifestyle and it’s not preventable or reversible.

Lake probably does know better, and it was probably a glitch of the mind, just a slip of the tongue. Then again, she actually made two mistakes. The name “juvenile diabetes” was changed to “type 1 diabetes” in 1997.

Then again you’d think Dr. Oz, “America’s doctor,” would know better. When he appeared last year on Oprah Winfrey’s program on diabetes he actually said, “Type 1 is also called juvenile diabetes and you are born with it.” Oh, my, born with it. That’s a pretty HUGE mistake! Just to clarify, while type 1 diabetes occurs more often in children than adults, you are not born with it.

Do I blame Lake for her blunders? Not at all. These are the type of mistakes the general public make all the time. Most people don’t even know there’s such a thing as type 1 diabetes as we are so overshadowed by all the media and pharma attention on type 2 diabetes. I am less understanding however how Dr. Oz could get it so wrong.

Maybe you’re thinking what’s the big deal? The big deal is multi-pronged. I believe the lack of recognition of type 1 diabetes and understanding its daily life-threatening nature, impedes urgent and necessary funding toward a cure.

The fact that type 1s are judged harshly by the public for “causing their condition” is just plain hurtful, just as much as to type 2s. The fact that we are invisible against the large canvas of type 2 diabetes is often painful. The fact that the public is so misinformed and uninformed may actually hinder life-saving treatment when a type 1 needs it.

So let’s go back to that “life-threatening” part: As a type 1 every day, every few hours, I have to test my blood sugar and then often do something to return it to a near-to-normal, safe zone. If my blood sugar’s too low I can fall into a coma and die. If my blood sugar’s too high my body can produce toxic acid in my blood stream called ketoacidosis, and over time I will likely succumb to a premature heart attack, blindness, amputation, host of nerve conditions and have a life span 15 years shorter than if I didn’t have type 1 diabetes.

If you’re interested, you’ll find a side by side comparison of type 1 and type 2 diabetes in“The type 1 versus Type 2 Diabetes War.”

One thing I noticed in the diabetes community regards Lake’s mistake was upset from parents of children with type 1 diabetes. If you want a little window into living with type 1 diabetes ask any parent who has a child with it. A mother or father who has to hold their five year old down every day to give her several injections a day. Who has to poke their child’s hurting, tiny little fingers all through the day to get a read and regulate her blood sugar. Who has to force their child to eat when she doesn’t want to and stop her from eating when she does. Make her move when she doesn’t want to and stop her from moving when she does.

Most parents go to sleep fearful every night that their child will not wake up due to a dangerous blood sugar drop overnight that can not always be predicted or prevented.

I have asked these parents what it’s like. I also know that children with type 1 diabetes grow up and become the person sitting next to you, sitting unseen with her invisible life-threatening disease.

I think type 1 diabetes needs the recognition that type 2 diabetes has gained. I think the roughly 3 million people with type 1 diabetes, living in the shadow of the almost 25 million with type 2 diabetes, deserve to be acknowledged for what they live with and what they do to keep living, every day. For their courage, for their hope, for their tenacity.

So Ricki, while some say your mistake has added to the myths of diabetes, I thank you for what it has also done – brought more media attention to type 1 diabetes than we’ve had in a long time.

Friday, January 14, 2011

Chocolate Milk & Cocoa Happiness

The other night, I wanted some hot cocoa.

But spending money on some single cup at a coffee shop or finding some of those hot cocoa singles didn't seem appealing. So, the choice was made to grab some of the yummy Hershey's chocolate syrup from the local grocery store. (Read: Wal-Mart, as we try to conserve money as much as possible.)

On the store shelf, we saw various options - regular, lite, calcium added, sugar free. As well as the Wal-Mart brand of Sugar Free. There were also crazy flavors like Strawberry and Dark Chocolate and all kinds of others, but my focus was on simple non-fancy chocolate syrup.

Being a carb-counting diabetic, my eyes went from the yummy pictures on the front of the squeeze bottles to the backsides where the nutrional information was listed.

Those carb counts were as follows, for a 2 tablespoon serving:

Regular: 24g
Strawberry/Dark Choc: 23g
With Calcium: 23g
Lite: 11g
Sugar Free: 5g
Generic Brand SF: 4g

Determined to have a combination of the lowest carb count possible as well as that hallmark Hershey's goodness and a photo-worthy product, I opted for the 5g Sugar Free choice.

Woo Hoo! :))

Went home and made the milk, adding a couple little store-bought treats into the mix and adding to my pump bolus.

Only later did I actually remember the original mission was for hot chocolate, so I made a plan to eventually convert my chocolately beverage into that steaming format.

In both forms, the message was clear: AWESOMENESS does come in cocoa and chocolate syrupy forms.

And That. Is. All.

Wait.. no, actually it's not all. There's more, after reading Karen's recent post over at Bitter-sweet. Just because I happened to go with the Sugar Free option this round, doesn't mean I must. I've actually sided with regular versions more than once and bolused accordingly. That just wasn't my choice this time. And it made no difference in my opinion, and fit the mood perfectly!

Though, a word of warning: With each cup of Chocolate Milk or Cocoa Happiness, you may or may not experience what I'm now dubbing the "Cocoa Effect."

Renata from The Diabetic Duo actually left a comment earlier, that combined with a pretty bad Low last night and made me want to add this little tidbit (with the always-important disclaimer that I am not a medical professional nor do I play one in the blogosphere): "Do you find when you are having a 'full carb' cup of cocoa that you need to bolus for less than the actual amount of carbs? Just wondering. (He) will go low if I bolus him for the 24 grams that is in a pouch of cocoa...so, I have learned to count it as 15g..."

Converted my :( into a :)) - YAY!
I've never been a big cocoa or chocolate milk drinker and haven't had much exposure to this, but it could be the case for my recent Low that is otherwise unexplained. It didn't help that the wonderous Larry the Loaner CGM at my waist choose that 2:30 a.m. time period to go into CAL ERROR mode (probably because of the rapidly falling BG at the time). I owe my wife an incredible apology that can't begin to be expressed in blog-words, but needless to say this particular Low left us both feeling very grumpy. Just like that guy over there on the huge mug.

So, that's something to keep in mind. It may or may not matter, but always good to be aware just in case.

But other than that, I wish a Happy End of the Week to everyone! Hope it's a Friday filled with Chocolate Milk Happiness for everyone.

Wednesday, January 12, 2011

Musings of a fruit salad

Though I try to refrain from doing this, the need to recycle an old seldom-read post is too great to pass up. A hectic week of work deadlines and time passing too quickly have combined to bring me to this hour, without a suitable D-Topic to write about anew. So, I give you one that originally ran in early 2007 in my early days of blogging here. With that, hope you enjoy this Blast from the Past!
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A fellow D-blogger Ryan Bruner recently noted how we are often inspired at the oddest moments in life, and how we can realize someone's incredible nature at the most inopportune times. He shared a story about his wife. So here, I thought I'd take a moment to share one of mine.

This story illustrates some aspects of my wife's personality that I find the most inspiring, life-changing, and all around refreshing in comparison to my own. Her creativity, inspiring ability to take care of others (well, me of course), and just simplistic sense of what's happening around her. Not to mention her ability to make me relax and have a laugh when stressed out.

So there we are lying in bed recently during the early morning hours - in the 3 a.m. realm to be exact. I'd just returned from my latest round of middle-of-the-night blood testing, which has been a week-long ritual to help get nighttime basal rates under better control. Anyhow, my sugar was low at that point in the night, low enough to need a boost. So, I resorted to an apple juicebox and some grape-flavored glucose tabs. This stressed me out, and I wasn't a happy camper at this point.

Climbing back into bed and slipping under the covers, I updated Suzi on the BG reading and my sugar intake, giving her a kiss in return for helping me remember to wake up and tend to the test in the first place. Sensing the fruit-flavored breath, she made a comment that I my breath smelled like a fruit salad.

Yes, an apple and grape fruit salad.

How creative, I thought. We shared a laugh, still half-asleep. This came - as you may recall reading in a previous blog - a previous observation this week, when I'd punctured a juicebox with a knife during a low and subsequently made it "pee" into a glass. Nothing like late-night, low bloodsugar creativity to inspire. Musings of a fruit salad - that's what it was.

I am grateful that Suzi reminds me of that day in and out, all the while keeping on me to maintain blood testing, carb counting, good health all around. She makes me a better person, and is as the cliche says: "My better half." That's all we can ask for.

Monday, January 10, 2011

Lines of the Bee

Getting stung by a bee isn't my idea of a good time. Actually, it terrifies the fructose out of me and I firmly believe that these stinging insects are, in fact, evil. The yellow and black stripes clearly mark the evil intent of these sinister insect aggressors, and I've written about this before.

But none of that really matters now, as I've resorted to getting stung on a regular basis, at least on a temporary trial run, and the stinger stays inside me 24-7 anywhere from three days to 2 weeks.

The bees, er... sensors that enjoy stinging me

Take a look, right over there ---->

See, doesn't this really sorta look like a BEE WITH A STINGER???? One that plunges into your body, sinks below the skin, settles in underneath that subcutaneous layer, and then lounges there for as long as possible.

Yes, as you may have guessed: I'm talking about a Minimed Continuous Glucose Monitor, of the Paradigm 523 Revel variety.

A fellow Type 1 my mom knows up in Michigan (previous guest-poster known as Vampire Girl) had a number of extra boxes of CGM sensors that she wasn't going to use by the time they expire, so she pawned them off on me in hopes I could make some use of them. While I did put out a message in the Diabetes Online Community about the availability of some extra supplies, but after not hearing anything made the conclusion that maybe I could get some use of these myself.

Previously trial testing two of the three CGMs (as it was in early 2010), I'd tested out the Abbott Freestyle Navigator courtesy of my mom's use in late 2009 and then later did a trial-run of the Dexcom 7 Plus. I hadn't heard positive news about the Minimed, but wanted to try it out myself before making any final decision. Especially since I use a 722 Paradigm myself and it'd be nice to have pump and CGM all in one unit, if accuracy and everything else was the same.

So, the chance came at me and it soon became clear I'd be able to trial-run the Revel, courtesy of a loaner from the local MM pump rep Ryan Seller who I met at D-Camp last year. He hooked me up with a colleague of his and the trial test began a week ago. My first observation about the sensor: it looks like a bee, with all those strips. The CGM trainer laughed in agreement, then we moved on to the basics and got it all started.

In the seven days, I've been initially impressed with the Revel 523 CGM, which I've decided to name Larry The Loaner (you know, since it's a loaner device)! Though it looks like a bee, the first sensor actually didn't hurt going in and I hadn't had any pain or uneasiness with it in me during the initial days.

Of course, the first hurdle I faced was not realizing that this new CGM-capable device was, in fact, a series model lower than what I currently use (didn't know my loaner would be a 523, versus a 723 that's a step up from what I use now). That meant I was expecting to be able to use the 300 unit reservoirs rather than the smaller 180 unit versions actually needed for the 523.

DOH!

Luckily, my mom had left a bag with some unused 1.8 ml reservoirs.. and I also had a few leftoftver from a misorder from Minimed in the past. So, I've got enough for a few weeks of this trial run, it seems. So that's a bonus!

Then there's Accuracy... Well, it ain't perfect. But it's not expected to be.

The 3-hour straight line, prior to a taco meal!
 I've also found that Larry is most accurate when numbers are between 80 and 200, but lose the accuracy as they get very Low or go into the 200s. None of my numbers have hit 300 in the past week, in large part because I'm watching and aware of what is going on. Mostly, I'm watching for the trends and trying my best to not just chase the Highs or Lows. That's easier said than done, though.

The first week has shown some trends in morning "dawn phenom" highs, pre-lunch and late afternoon dips that I'd already suspected were happening. But having it presented in actual CGM line charts and data is like seeing documented proof of a long-suspected hypothesis. Sometimes, the glucoaster effect is present - particularly following meals, and it's certainly interesting to try and time the CGM and insulin delays with the food effect that are all combining to change the course of your BGs.

After day seven, my BG average for the past week was 157 mg/dL. Can't argue much with that, though I'm cognizant of the fact that it's likely because of the increase attention.

The sensor isn't flappy as I'd heard was the case from others, though I have had it taped down and that hasn't been an issue. On Sunday morning while still in bed before 6 a.m., I managed to turn over and felt the rip of the taped sensor from my stomach. An "Oh Eff" crossed my lips and my eyes opened. That debut sensor managed to stay on, though, and some extra tape strips helped secure it back on for the rest of the day. We'll see how long that lasts, but I'm hoping to get as much life out of this first sensor as possible.

So there we are. Overall, I am happy so far after Week One with Larry the Loaner. In the time we have left, I will be watching and trying to learn from whatever Lines the Bee may show me.

A video blog may be on tap soon, but I just haven't found the motivation or time to get that done (also have been putting it off until I can get a long-overdue haircut). So we'll see, but I'll keep everyone updated as the trial test continues for this unspecified period of time.

Larry is also looking forward to some guest-posts here, too, and word is at least one of his fellow CGMs may even be interested in stopping by and saying hello before long! So, stay tuned!

Friday, January 7, 2011

Pump Tubing Perils of a D-Blogger

Yes, I'm a diabetes blogger.

Yes, I wear an insulin pump - the kind with tubing.

Yes, I'm one of those "old schoolers" (from the 90s) who doesn't care for the laptop touchpads and instead prefers a real live mouse, via USB.

Yes, this does periodically present a peril. The tangled-type, of course:

Gotta love those Stewie sleepy pants sported on my day off!

That's what happened on a recent weekend while trying to hash out some blogs with laptop on my lap and the mouse nearby. All turned out OK, after a little untangling.

No sets pulled out. This time.

That's just the way it is. Another moment in the Day in the Life of a Type 1 diabetic.

Who happens to blog.

Wednesday, January 5, 2011

Flexing Scripts Over The Counter

Rules have changed when it comes to insurance flex account coverage on Over The Counter medications.

The new health care reform law requires a doctor's prescription for any OTC medicines that someone might want their flex spending account to pay for. Insulin is exempt and anything else you might normally have an Rx for isn't affected, just those on the shelf items such as cold medicine and aspirin. The IRS says this applies only to "medicine" or "drugs," and not those supplies such as band-aids, crutches, contact lens solution, or blood glucose test strips and kits.

For me and many People With Diabetes, this specifically comes down to glucose tablets that are sold in the pharmacy aisles or endcaps. Since these are basically something you eat and can be dubbed a consumable "medicine" or "drug," the new Flex rule applies.

To be clear: The new rules don't limit these over the counters and don't stop a person from paying for these by cash or credit. Just not flex, unless you can basically prove it's necessary for your insurance company to pay via flex account. In a time of high health care costs and people use their insurance to pay for things such as aspirin and cold medicine, this new move is a necessary inconvienence.

I get it, but don't have to like it.

Now, there's nothing stopping me from going into my local pharmacy store and just using my non-insurance payment methods to get needed glucose tablets. At $4.50 per jar, one or two spread out every couple months isn't going to break the bank. But this is a needed item to help treat my diabetic Lows, which often seem to happen at the most inconvienent times and require some quick fixes. They're the most handy, and it's just logical to me that if my insurance does cover these, then I should make use of that.

My Endo likely won't have much of an issue in writing a script for these. However, I've learned from our insurance company's Flex Benefit people that we no longer are able to use the Flex debit card for any OTCs, prescription or not. Apparently the fed govt says that after Jan. 15, these flex debit and credit cards can no longer be used. Rather than putting that burden on the pharmacists to determine whether an OTC is Rx covered, the law change just don't allow this card use any more. So, we can pay there and then - if we've got an Rx -- request reimbursement at a later time.

Again, I get it and understand the reasons but just don't like the inconvienence of it.

This makes people think twice about using their Flex Accounts for these OTC items that may not actually be needed. It does a needed service, because many people do abuse these Flex Accounts and have sums leftover at year ends and go on OTC spending binges to use up those amounts. So, maybe now the Flex Account use will be a little more realistic. If people really need something, say like glucose tablets, then they can just pay another way and get reimbursed later if they go through the prescription-obtaining process.

Anticipating this change that took effect Jan. 1, we went out on New Year's Eve and stocked up on glucose tablets. All that was on the pharmacy endcap were 4 plastic jars, so that's what we bought. Along with the Rx items that were due for refills, it was productive visit that was convienently all compiled onto the same receipt for easier record-keeping later on.

Now, that has all changed.

This Employee Benefits Legal Blog offers a recap of the changes, and this IRS Q&A offers some good information for inquiring minds.

But this can all be avoided entirely.

All one must do is go for Smarties instead of glucose tabs. You know, the bite sized versions of the flavored sugar tabs that are better tasting, cost less money, and avoids the health care hassles of insurance companies, prescriptions and pharmacies.

To avoid having to Flex Prescriptions over those Over The Counters, then this may just be the way to go!

Monday, January 3, 2011

Vroom Vroom, Diabetes

Indiana motorists can now join the effort to Stop Diabetes and proclaim that message for all others on the roads to see.

A new license plate is available in Indiana starting in 2011, recognizing the American Diabetes Association's Stop Diabetes movement and one of the 11 speciality non-profit recognition plates the state legislature created in the past year.

Available to motorists for $40, the plate cost includes $25 that is a tax-deductible donation for the ADA. It doesn't replace the juvenile diabetes plate that's available in some but not all spots in Indiana, but is the only D-plate offered and recognized statewide. This new plate is the first of its kind in the country and other states hope to follow suit, according to the ADA's Indiana spokeswoman Joy Mahoney.

Money raised from this plate will be used to fuel the ADA and Stop Diabetes movement here in Indiana, specifically for education and programming to serve people with diabetes, healthcare professionals, caregivers, and the public. Not to mention all of the organization's other research and advocacy efforts.

You can see the official state BMV page and plate details here.
So, we decided to help out the new plate promotion effort at the Indianapolis Auto Show recently. This basically involved spending some time on New Year's Eve at an ADA table setup inside the auto show, held in the Convention Center in downtown Indianapolis. Hundreds of new model and concept cars from dozens of dealers, and a new license plate for a good cause to complete those new vehicles!

Both Suzi and I had the day off work, so we volunteered our time and energy. Plus, we got free tickets to the Auto Show - a bonus, indeed.

We had a great time. Our fellow table-watcher and advocate was a fellow Type 1 diagnosed 46 years ago, and it was great being able to meet and talk with him about so many D-topics. A handful of people came by the table during the three hour shift, from a newly-diagnosed Type 1 to some others with personal or family connections to diabetes. Sure, many weren't interested and walked by without much of a look or interest in the plate or cause. It might have helped having some attention-grabbing show or performance nearby, such as a live shoot of a new SugaSheen music video nearby where we could then hand out some ADA license plate info. But we didn't have that, and I think we did our best to spread the good word as much as possible to those passerbys.

Outside of advocating, we enjoyed the Auto Show. Now, being from Detroit that's home to the North American International Auto Show each year, we know what a real auto show is all about. I've gone to a handful through the years before moving to Indiana, both as a newspaper reporter covering the event to just a spectator and potential consumer checking out the latest cars and automotive creations. This was a great effort and showing here in Indianapolis, but we kind of viewed as a cute little event compared to the one with thousands of cars and incredible performances inside a much larger venue in D-Town. We kind of felt like patting the Hoosier event organizers on the head and saying, "Awww, Indy, how cute." Like a little bridge across a stream trying to compete with the Golden Gate. The little engine that could, so to speak. Size and scope, that is. Historically, Indy has been around for 97 years while the international one is in its 23rd year.

Don't get me wrong, it's a great show in Indy and we had a great time.  More than 400 cars and about 40 car makers. We indulged in our fantasies of what would be fun to drive: an extended cab pickup truck that Suzi had her nostalgic eye on with memories of her former S-10 truck, or the Mustang convertables or crazy XBox video game green and black truck that had DeLorean doors and a big screen hitch-hookup on the backside. Ford had a robot named Hank setup for a great funny show at the top of every hour, and we also signed up for a test drive opportunity in the next couple months. Overall, we had a great time.

If we ever do indulge in fantasyland video-vehicle buying, at least we'll have a license plate for a great cause to compliment our new ride! In the meantime, we'll keep this option in mind next time our plate renewals come up. Maybe you can too, or even push your own local ADA or D-organization to advocate for a similiar plate!