Thursday, July 25, 2013

It's A Small Diabetes World, After All

We approached the table for breakfast, holding our plates of eggs and bacon and slice of French toast on each. The family already seated at the table were strangers, but that wasn't a big deal since we were all "family" at this diabetes conference anyhow.

Hey, we all had bracelets -- most green, some were orange and others were yellow. But it all meant "family" to some degree, so there really weren't any strangers (at least not for long!).

Once we stepped up to the table and did initial intros, the dad welcomed us and motioned that we sit down next to him and his boy, while the mom mentioned she had to run back up to the room with her teenage daughter.

Sitting down, we instantly got to talking about what had brought us all to that conference and respective table. We shared diabetes diagnosis stories, and the dad wondered how I'd heard about the Friends For Life conference in Orlando. I told him about knowing of FFL for years, thanks to some friends in the diabetes blogging community, but that was the first time I'd been able to get there.

"Oh, my wife has a blog too..." he started to say.

As he did, it dawned on me that I had only looked at his name badge to see his first name and where he was from. But hadn't really looked at the last name. Glancing again, I saw the last name and a light bulb went on in my head...

I knew this family!

"Oh my - your wife is...," I blurted out, a cross between a question and exclamation. "I know her!"

Yes, we had stumbled across the Ghosn family, and D-Mom Tina who blogs over at Stick With It Sugar.

Her husband and I shared a laugh and a few more conversation moments before Tina returned a few minutes later with their Type 1 daughter, and we connected the dots... Smiles and huge hugs were exchanged, and that was that. Another first time real-life meetup with people who knew each other from the Diabetes Online Community.

That wasn't the only meeting of its kind at FFL.

Monday, July 22, 2013

Three Years After The Post

While we were off enjoying Orlando and Disney and the whole Friends For Life experience, a comment came my way through email.

It was on a post written more than three years ago, back in February 2010.

The post came just after Christmas 2009, when Suzi made me a Diabetes Ninja modeled after all my talk of "being a ninja" thanks to Super G who's widely known in the DOC as the original Ninjabetic.

Anyhow, a few years have passed since then and we've since handed Lance off to a friend in the community who needed his protection - he's now been renamed, Little G.

Dr. Google or the power of online connectivity apparently came into play, bringing someone to that post. And this comment came from that person:

Just wanted to say to you and Suzi that I loved your Diabetes Ninja toy so much, I made 20 of them to send with my son to Camp Joslin for him and his cabin mates and counselors. I of course made the weapons, including a sword made from the cartridge plunger and needle cover, and a Kendo-style staff. I included a card that states "I am a Diabetes Ninja. Expert. Fighter. With cool weapons. I await your command, Sensei," in a Japanese-style font. I know they will be a HUGE hit, because I gave one to his friend and his parents found him fast asleep that night with the Diabetes Ninja tucked in his arms at a BG check. Thanks so much to your wife for this wonderful way to reach out to these kids, who do become Diabetes Ninjas at camp.

I absolutely loved this comment, and it touches my heart.

So, to the D-Mom who wrote and sent it: THANK YOU!

Friday, July 19, 2013

Playing the Diabetes Card (At Disney or Life in General)

I remember standing on the school gym floor staring up at the rope I was supposed to climb.

My mouth must have been wide open, as I stood gaping up at the ceiling. The top of the rope was so high up there, but for some crazy reason my 5th grade gym teacher believed we should and could climb all the way up -- just to touch the ceiling and then climb back down.

I made a choice that day, even though I knew better. Since my diagnosis before I'd even started kindergarten, I had always been taught to "not use my diabetes as an excuse." This time, however, with that rope staring back at me, I chose to claim my blood sugar was Low and I needed to sit down and have some juice. Nope, I wouldn't have to climb the rope this time.

That 5th grade experience still stands out in my mind all these many years later, and even now in my 30s I'm ashamed that my younger self made the decision to use my D as excuse. I allowed it to dictate what I could and couldn't do, and in doing so probably made others think, "diabetics can't (fill in the blank)." Of course, there's the whole fact that I was lying anyhow.

This memory and feeling came back recently when I was in Florida attending my first-ever Friends For Life conference, and the conversation shifted to how we could "use our diabetes" to get some special treatment at the Disney World and Universal Studios parks.

I heard several fellow PWDs and D-Parents talk up the advantages of having special Guest Assistance Cards (GACs), and one even said, "For the first time, I felt that I was getting something from having diabetes." In other conversations, I heard these cards referred to as "the front-of-the-line passes" and the "no-wait" cards. I've even read blogs since the conference describing them as the "go-straight-to-the-front tickets."


This made me uncomfortable. Honestly, I felt just like it was elementary school gym class all over again. Getting one of these passes and using it to basically cut in line felt like I was using my diabetes as an excuse -- even if I didn't need to. Just as I once indicated I couldn't climb a rope as a result of my diabetes, I was now saying that I wasn't able to adequately prepare and plan to wait in an amusement park ride line like everyone else.

Yes, I was telling people that I was disadvantaged and needed special treatment.

Now, these passes technically aren't specifically meant to cut down waits; they're meant to provide alternative entrances so that we insulin-addicts don't have to stand outside in the heat where our insulin can get easily cooked. But in learning from a park cast member that Magic Kingdom gives out 400-500 of these per day and there are probably a few thousand given out between all the Disney parks, it's pretty clear that not everyone really "needs" these passes... In fact, that's been a discussion going on within the Disney ranks about alleged "abuses" and Disney's reviewing the practice. Update: Disney tightened up that policy in September 2013.

That's not to say we PWDs are "abusing" anything just by getting one of these cards; not the argument here. I get that there's a need. Standing in long lines and walking the parks can translate into low blood sugars pretty quickly. And it's not the greatest idea to stand outside in the mid-July heat of Orlando when you have heat-sensitive insulin in tow. Whether it's in a vial you're carrying or infusing through the pump tubing in a pocket, the 80 to 90-degree direct-sunshine heat and humidity can be an issue for us. In those situations, it may be appropriate for a CWD or PWD to use one of the passes to get into an air-conditioned area to wait or to sit somewhere to wait out the lines. That's acceptable and not out of line, I think.

But even those situations don't mean a special pass is always necessary, IMHO.

Knowing that I was traveling to Orlando in July and would be spending hours at a time outdoors at amusement parks, I started planning before leaving my cooler home in the Midwest. I looked up cooling packs and options online, and finally settled on buying my first-ever Frio cooling carrying case.

This allowed me to not only cart my two insulin vials around, but to also put my insulin pump inside the Frio and attach it to my waistband for when I was out at the parks.

The carrying case was lightweight and stayed cool, even in the heat and humidity. Not too worried about my meter and other D-Supplies, I kept those in their regular case and put that in a leg pocket of my cargo shorts. It all worked out perfectly for me.

My wife and I didn't pick up a GAC, because I didn't see the need. When there were rides with wait times longer than 45 minutes, we made the decision whether or not to stick it out based on how we felt at the time. Where we willing to stand out in the heat? Or forgo that particular ride? A few times, we chose to wait in the heat. Others, we didn't. Regardless of the situation, we waited just like every "normal" person. I carried glucose tabs on me in case my BGs went Low and there wasn't quick access to anything else. This way, I felt that diabetes wasn't dictating my decisions.

OK, it's still reassuring to know that if I ever needed that special park pass, it's available.

My thinking is that I'd prefer not to ask for special passes or accommodations unless it's absolutely necessary. But I don't believe they should always be used just because they can be. We have choices in how we present life with diabetes to the rest of the world.

Whether it's being able to climb a rope in gym class, or standing in line at the airport or Disney, I want the world to know that I'm not "disadvantaged" but can do most anything that "healthy" folks can do. If you don't single me out because of my diabetes and treat me with respect, I will do the same for you.

But if I do ask for help or a special accommodation, I also want you to acknowledge that there's a good reason I'm asking in the first place.

Because there's a need -- and this isn't just an excuse for me to take the easy path. 

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This post written by Michael W. Hoskins was originally published on DiabetesMine in July 2013.

Thursday, July 18, 2013

My First Time at the Magical Friends For Life Conference

There's a new "teen with diabetes" on the block.

Yes, the biggest diabetes conference aimed at children and families living with type 1 is a teenager, and just as for any person with diabetes (PWD), hitting this stage of life is an exciting time with a lot of change in the air.

The annual Friends For Life Conference took place July 9-14 at the Coronado Springs Resort in Orlando, FL, bringing in more than 3,500 people, a 10% increase from last year, including roughly 700 first-time visitors -- my wife and I included!

This was the first time I've been able to attend FFL, and my wife Suzi and I were thrilled to travel to Orlando for a week not only for the conference, but also to return to the spot where we spent our honeymoon back in late 2005. I'm still wrapping my brain and heart around the whole experience, but to me it felt like diabetes camp on steroids. Being surrounded by thousands of people who "get it" and seeing the smiles and friendships of new and returning kids and adults just makes me grin while sitting here at my home office computer.

So many families, so many good conversations and fun experiences... there's no way to recap everything and do justice to the entire conference, but luckily the tweet stream using hashtag #CWDFFL13 was available, offering a "real-time" glimpse into various perspectives from those attending! We also posted a number of photos over on our Facebook page, so make sure to check those out as well.

As many of you know, this whole thing got rolling in 1995 when Ohio D-Dad Jeff Hitchcock founded the online forum that's since become the thriving CWD community. His daughter Marissa was diagnosed with type 1 diabetes at age 2, and she's now in her mid-20s, recently married. In 1999, Michigan D-Mom Laura Billetdeaux, who'd been a member of the CWD mailing group, spontaneously invited folks to come with her family to visit Disney World. Five hundred people showed up... and the rest is history, as they say!

Laura organized that first official conference that following year in 2000, and so opinions do vary on whether last year or this summer's official-organization anniversary marks the true milestone. This is the 14th annual event, per CWD, so there.

There have been 60+ conferences worldwide and they keep adding locations, but the Florida event is certainly the largest and most long-standing in the CWD world. Don't be deceived by the official "Children With Diabetes" moniker -- the conference isn't just for kids and their families; it's open to PWDs of all ages. The number of adult PWDs attending the conference continues to rise. An estimated several hundred came out this year, roughly twice as many as the conference saw a few years back.

Fellow PWD-bloggers Scott Johnson and Kerri Sparling were honored for their advocacy and adult-recruitment that's helped make FFL such a grown-up party in recent years.

Learning So Much

First, the serious stuff: There were sessions on everything from caregiving basics, carb counting tips, to psychosocial sessions and the latest technological advances in the D-world — brought to you by an impressive lineup of recognizable experts. All the presentations and speaker bios, along with reports from each day, can be found on the CWD conference site. One of the big hits was the Bionic Pancreas project presentation by D-Dad Dr. Ed Damiano, which drew a huge crowd that packed the room and was the talk of the conference. We've reported on Damiano's work a number of times, so the content was pretty familiar to me.

Of course, CWD joined the Johnson & Johnson family in 2008, so I was thinking that many of the speakers (I heard) were affiliated to some degree with JnJ/Animas/LifeScan/OneTouch. But it turns out that only 7 of the total 166 official faculty and staff were affiliated with JnJ -- and Jeff Hitchcock tells us that those 7 were involved in FFL before the acquisition -- so neutrality in the programming is ensured.

One of the most disappointing sessions to me was about Health Care Reform's impact on PWDs — which is a hot button issue so I was expecting to learn some important tidbits. All this session did was note that changes are coming in 2014, but at this point there's really no clear answer as to what effect this will really have (?). The speaker works within JnJ's regulatory arm and the session had little detail except for the proverbial tips to "know your stuff" and communicate with employers as this information becomes available. Um, ya think? I snapped some photos of the presentation, which can be found over on our Facebook page.

And then there was the FDA "update" -- which started off on an interesting note as the speaker told us that due to"budget restraints" the agency couldn't send the two planned FDA officials; instead, they sent Dr. Helene Clayton-Jeter who said she wasn't the subject-matter-expert on diabetes. Really, FDA, this is the person you send to a diabetes conference?! Most of the presentation was an overview of the agency's structure and a recap of its new patient-friendly website, so during the interactive Q&A, some of us grilled her on what the FDA is planning to do about test strip accuracy. Fellow blogger/advocate Christel and I told her about the Strip Safely initiative and chatted with her afterward, even after she tried to "blame the patient" when asking about what can be done about ensuring more accuracy. The cop-out answer of "our hands are tied" wasn't well-received, and one of the most interesting notes was a Tweet in response that read: "If planes only landed w/in 20% accuracy 95% of the time, would gov't untie FAA hands?"

While it was an underwhelming session, the speaker at least took down the information and promised to spread word about the Strip Safely initiative. And we took her email down, so she's now on the list of FDA folks whom we'll be reaching out to.

I actually really enjoyed hearing and meeting fellow type 1, Dr. Ken Moritsugu, who now chairs the JnJ Diabetes Institute in Milpitas, CA, and formerly served as deputy surgeon general advising the U.S. Surgeon General (!) He pointed out that one of the biggest challenges in medicine is moving from an acute care model to a chronic one, where instead of focusing on patients "being fixed" by doctors, we're instead advised on staying healthy in partnership relationship with our care team. Ken said that many of the best doctors in the diabetes world still treat our condition like it needs a quick fix, and they get frustrated when we PWDs don't "comply" with their prescribed advice. That was very valuable insight, I thought, highlighting the need not only for doctors to learn how to practice better, but for us patients to keep educating them about how we need this all to work.

As always, the most powerful sessions for me were the ones that hit on psychosocial issues of living with diabetes and offered inspiration, and it was good to see a few talks focus specifically on the issues that significant others experience in living with diabetes (more on that below).
Fun with D

Meanwhile, plenty of "insider" fun did abound -- from "Low stations" with glucose tabs and sweetened juice, beeping D-devices at every turn. Of course, how can you not just glow with pride as you're surrounded by swarms of the famed "green wrist-bands" worn by all the fellow type 1s?

On Thursday evening, there was the FFL Banquet and Ball that had a prince and princess theme this year. Serving asmaster of ceremonies was D-Dad Tom Karlya, who took on the role as "King of FFL" (pronounced Fiff-el) until the stroke of midnight when he turned back into Tom (ha!). After dinner, this was just a huge party where the kids (and many adults) were dressed up as faux royalty, and there were neon bracelets that everyone could wear out on the dance floor.

The exhibit hall here was unlike anything I've experienced before at any other D-conference, as it wasn't all "rigid and formal" and full of product promotions... Yes, there were products displayed, but this entire conference was designed to be a fun time, and there were skee-ball and video games and the zero-carb sno cones for the families as they browsed around the hall, meeting celebs like Olympic cross-country skier Kris Freeman, former pro football player Kendall Simmons, and so much more!

On Community, Sharing, and HCPs

Among the many talks about social media use in the D-Community, one of the most intriguing discussions came during the Partnering for Diabetes Change session on the first day of focus groups. A panel of DOC'ers joined with four health care professionals -- Barbara Anderson, Korey Hood, Jeremy Pettus, and Jill Weissberg-Benchell in a session called Social Media & the Monster Under The Bed.

The panel talked about what to share and how cautious we should all be in sharing information online, particularly in the case of kids with diabetes. A main theme was how to get more HCPs to see the value of social media support. Dr. Jill mentioned that some docs are very conservative and still feel that D-Camp or conferences like FFL aren't "reliable" because the doctors can't monitor the type of information provided in those venues. Korey and Jeremy noted that maybe having a "stamp of approval" would help sell docs on the value of social media, but Korey cautioned that getting big organizations like the ADA involved might prove fruitless since it would likely take the ADA a decade to validate social media sites. Jeremy insisted that the DOC needs to "be in the clinical repertoire," and Dr. Barbara said that only time will bring more HCPs into the view that social media support is valuable.

A Diabetes Balancing Act... Even in Orlando

As "magical" as the FFL experience is, though, I think there's something else that should be shared: you have to be in the right place mentally and emotionally to get the most out of FFL. Even if you're not talking diabetes non-stop, the fact is that you're at this event because of diabetes and at times you really can't escape the feeling that you're drowning in it.

Yes, the camaraderie is great. And I was very inspired by the whole experience, especially some of the sessions like the one run by fellow PWD Sandy Struss, a motivational speaker who encourages everyone to challenge themselves.

But it was also a little overwhelming, and I was feeling defined by my health at times. There were moments when, despite seeing all the energy and kindred spirits, I felt the need to escape and just step out of the D-Universe for a bit. A diabetes burnout session opened my eyes to this specifically. Led by Korey and Jill, the session was an emotional one that made me realize that even talking diabetes professionally all the time can overwhelm me and make me less apt to focus on my own personal D-management as much as I should. This was reinforced for me during the couples' and spouses sessions, where I really got to explore how I feel about my own health and how my feelings about my inadequate management often translate into not sharing with my partner as much as I probably should.

Then in my online life, we talk about diabetes constantly, which I think can sometimes make even the minute details of this illness loom large as something more significant than they really are.

There has to be a balance, and I think that's what this first FFL experience taught me the most.

When we need this community, it's there, which is a huge comfort. But it's also OK when we feel the need to step away and focus on the non-D aspects of who we are. There's a magical "Kingdom of FFL" out there, and when you need it and are ready to embrace it, it can help you move mountains and shake up the world as you continue on the journey of living with diabetes.

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This post written by Mike Hoskins originally appeared on DiabetesMine in July 2013.

Tuesday, July 16, 2013

Magic In The Air

We spent a week in Orlando, for our first-ever trip to the Children With Diabetes Friends For Life conference.

So much to say, so little brainpower right now to make that happen here...

What can you say about being in a place full of a few thousand people who "get it?" Know what you're going through and are living with diabetes just like you are?

It's a pretty remarkable experience.

Now, I'm not always in the mood to talk diabetes. But seeing the kids and families connecting, witnessing the magic of those smiles and hugs and friendships, is something that will live in my mind and heart forever.

But aside from all the diabetes activity that I'll be blogging about over at DiabetesMine soon enough, there was a whole bunch of Disney fun and Universal Park excitement.

This was our first trip back to Orlando since our honeymoon in September 2005, and we had a fabulous time.

And then we also got to experience what was a highlight for Suzi - the Harry Potter part of Universal!

Of course, the Back to the Future ride has been closed for several years now... Sadly, I never went on it back on our honeymoon. So all I was left with this time was a movie poster. Although, we did see Doc Brown wandering around another part of a park with his 1950s mind-reading helmet on as he strolled the set streets where Hill Valley was once set up.

We had a fun time, and there will be more photos on Facebook along with updates as the coffee gets my brain back into the swing of things outside of "vacaction mode!"

Saturday, July 6, 2013

Trains, Taxis & Buses (But No Planes, This Time)

When a road trip that should take three hours one way ends up taking 11 hours, you know the stars are aligned for a story that you'll be able to tell for the rest of your life.

Not Me, it's Steve Martin.
For me, that happened during a recent visit to Chicago for a big diabetes conference in mid-June. My return trip home via Amtrak got a little crazy, and turned into my own version of the movie Planes, Trains & Automobiles.

Except that I wasn't as frustrated as Steve Martin was at the rental car counter, demanding a "f*ing car right f*ing now."

And there were no planes, but there were plenty of stories coming from the trains, taxis, shuttles and buses that carted me around during those five days.

Here's how it all rolled off the tracks (see what I did there!?)...

Monday, July 1, 2013


I am scared to hell about what diabetes is doing to my body.

What it may have already done, and still be doing.

When limbs hurt, wounds don't heal, new bumps or bruises or scrapes or eye issues come at me, I'm afraid of what it could mean.

Once, "they" told me that complications would happen.

It scared me then, and it scares me now -- even as I put on a "whatever" attitude then and a "brave face" now.

Fuck that. Right now, I'm over that.

This is the point where I just want to crawl into a corner and cry, or yell at the wall for being there.

No matter how positive we try to be in this D-Community, it doesn't change the fact that sometimes we can't escape this fear, this negativity, this sense of dwelling on the "what ifs."

Maybe it's diabetes, maybe it's just aging.

Maybe it's a mind trick, worrying about what may not even be reality. But it doesn't matter, because that dread grips your heart and rips at you as your mind goes back to every one of those conversations about complications as a kid. All that comes flooding back.

Sometimes, you're just scared

And you just want to be "normal" without having to worry about the impacts of diabetes.