The Diabetic's Corner Booth

One Word

2012-01-31T08:38:00.000-05:00

Sometimes, the only word you have is: "Doh."

Then you find a new set, a new site, and move on.

Just keep pumpin', just keep pumpin'...

World Domination Unrealized

2012-01-26T01:55:00.000-05:00

Those of us in the Diabetes Online Community have long speculated that cats are plotting world domination and that eventually they'll get the better of us.

Our cat, Shadow, has been in on that plotting for awhile.

But as it turns out, Shadow won't be around to see that World Domination come to be. Her years of cat co-plotting will go unrealized.

We said goodbye to our beloved Shadow earlier this week. Like some friends in the DOC who've lost their beloved pets and shared that online, we too are now sharing our story of Shadow.

Also fondly referred to as "Beaner," "Mitten," "Kitty," and "The Grandcat" among other names, our 10-year old korat named Shadow saw her story come to an end on Monday, Jan. 23, 2012.

She'd been a part of our life since our first year moving to Indiana in 2004, and came to us via a copy-editor that I'd worked with at the time. Shadow had been wandering outside and apparently had experienced a near-miss by a car, and she was picked up. My co-worker sent out an email asking if anyone was interested, and I took a chance. The name came because of her grey shade, and her ability to dart around and disappear like a shadow - we kept the name. The rest is, as they say. into the history books.

We had a fun ride. A move into our first house, complete with a "trip" down the new stairs. The dog's arrival. Visiting the Kitty Tooth Fairy. Late-night writing. Her taking on various professional jobs. Meeting the DOC and learning about world domination. Hanging out in suitcases, laundry baskets, and just being scooped up in my arms. Chasing the laser level, and the invisible mice in the house. Actually scouting one out in our apartment once, and helping me capture it. Psychedelic Frisky commercials. Jumping up on the chair arms for some petting and purring. Pump tubing on the head. Blog hijacking and blood meter stealing. But overall, no matter what else was going on, the experience of having a family and being loved.

She had been suffering from kidney disease for some time, and over the past year it's gotten progressively worse. To the point where lately, she's had difficulty breathing. Her eyes have been highly cloudy. Clumpy fur, lack of self-grooming, constant water drinking and increasing signs of dehydration. Slower-moving. Eating problems. Not wanting to play, or torment the dog. Overall, just not her same kitten mitten self. We've had her on special food and have been doing some home-medication off and on, but that had run its course and more was needed, but we just couldn't provide for her.

Our final photo.

I've known this was coming for awhile, but I've been too afraid to truly admit it. Growing up, I was never a cat person. Always wanted a dog, and never had one, but never envisioned I'd have or even want a cat. But Shadow changed that, and it's hard to imagine my life without my first pet (childhood goldfish aside).

We took her to the vet on Monday for an evaluation, and it became clear that the time had arrived. With her history of kidney disease, the vet was somewhat amazed she'd lasted as long as she had without any more advanced problems. But she said the kidneys were small and she was on that line where any little stress could do her in. Yes, we could take her home and let nature do it's thing - but there was no degree of certainty of how much time, or what quality of life, Shadow would have left. So, we opted to save her the pain and make sure her quality of life didn't suffer more than it already had.

Decision time was upon us, and there was no sidestepping it this time (I'd been delaying this and rescheduling vet visits for awhile).

The "death shot"... :(

A single shot was all it was going to take, the vet said. Of course, Shadow was a fighter. She had some world domination plans left in her, and so as the vet was sticking the needle in her leg, Shadow made a dash for the door and caused the vet to pop the vein with the needle. So, a sedating shot was needed and that made her drowsy. We stayed with her for the final moments until she was gone.

It was tough. I cried. And I really, really miss my Shadow Kitten. I still look around and see her, call for her and expect to feel her nudging against my feet or poke her head up onto the footrest. I never thought I'd be a cat person, but Shadow changed that.

So now, we say goodbye to our Shadow. She'll be missed - by us, by her sister Riley, by those in the DOC who are furry and not. World Domination remains unrealized for Shadow, but I'm sure the plotting will continue with her - and so many others - in mind.

This isn't over... Eight lives left, people. World Domination WILL BE realized!

Depleted

2012-01-25T00:00:00.001-05:00

Batteries die. Reservoirs run dry.

Devices we use simply need recharging.

These devices are just like our bodies. They need energy, insulin, motivation. A boost to get back in the game of doing what they're supposed to be doing.

What is depleted must be refilled, recharged, reconnected.

How long it takes, is up to us. We can remain in that place or step forward, immediately or down the road. The choice is ours.

But we move forward. Toward a place where the battery bar is full and the energy level is strong. Where the insulin is full and we have what's needed to do what's needed.

The hope is there, even in the abyss. Even when we're depleted.

Beginning Again

2012-01-22T22:44:00.000-05:00

I'm not gonna lie: this one is a little deep, dark and depressing.

But I have to reflect briefly before circling back to the present task of Moving Forward.

A lot has been going on in my mind. I'm not healthy, not happy. Things have been tough, and it really has nothing to do with diabetes. At least, not directly that I know of.

Sleepy all the time. Consumed by self-doubt. Reclusive. Emotionless, humor-deprived, non-focused, irritable, unhappy. Personally, professionally, emotionally, mentally, physically, internally and externally.

For too long, I just haven't been "me." In a sense, I've been wearing a mask.

Not talking or meeting or being curious as I've traditionally been. The writing hasn't seemed to flow, and what does happen to appear on my screen doesn't seem right or as interesting as I know it truly is. I'm bankrupt in the context of who I've always been. That's led me to scary mental places where I can't even recognize myself. The person looking back at me in the mirror doesn't smile, and when he does it's not real. Dark bags are under his eyes, and you can just see that he's tired - no matter how much coffee or Diet Coke he drinks.

How long has it been going on? Not sure. Probably more than a year, but it's slowly progressed and gotten worse as the months and weeks have gone on. Lately, in recent months, I've hit the tipping point more than once and have felt myself melting down.

Admitting, sharing, or even acting on this hasn't happened - that'd be my solidifying my own failures, creating "excuses" why I'm not able to handle this on my own.

The online community has helped boost me, as has being around and having discussions with those that I love. But I've strayed from the path I need to be on, and lost focus. Life storms and stresses have been overwhelming, and that's just fueled the frustrations and negativity to the point where I'm completely burnt out. Everything, including diabetes - I'm so afraid of where my A1c is hovering, that I've been avoiding that needed Endo visit.

So, what's to blame?

Depression has been building, and burying me under the weight of a thousand pounds of concrete. But even aside from that, a key factor is probably that I hadn't been taking my hyperthyroid medication on a regular basis. There's honestly no reason that comes to mind, except that I've had a sense of "hopelessness" during the past year. This is probably self-circulating and I was shooting myself in the foot, but it is how life has been.

Until recently.

Some friends got together in Kansas City and a life-changing experience opened my eyes once again.

I drove 1,022 miles to be a part of that, carrying a weight that's existed for so long. There was a lot of fun and memory-making, but it wasn't until the return trip it all set in. Half-way on the drive back, as 10th Avenue North played on the radio and the sensations of that weekend replayed in my head, the full force of how far gone and where my journey had taken me finally set in. And that's when I pulled to the side of the interstate, near a road sign that said Indianapolis was 200 miles away, and cried my eyes out.

And talked to God.

And wrote, with a pencil supplied from the hotel room and the notepad I use to tell people's stories.

My heart opened, and for the first time in a very long while, I truly saw some light ahead. Even as a beautifully weary sun set below the horizon to the West, and a hopeful moon was ready for the challenges ahead.

Sharing is so important. For too long, I haven't. When everything seems to depressing, why would you want to bring others down? The guilt is just never-ending. But it's only through sharing that you can move past this.I see that I need help and I'm starting to get it. I've been ashamed of my failings and senses of inadequacy, and haven't reached out even to those closest in my life. And that's why I've only perpetuated this cycle. Not anymore.

Maybe, there is something I can do to get past this. Maybe, the message of "You Can Do This" isn't far-fetched and unattainable. Quite possibly, a light at the end of the tunnel actually does exist and can be reached. It takes effort, and one can't do it alone.

One man traveled 15,000 miles (kilometers?) to be a part of that group, and in doing so he's opened my eyes again. He has saved me. The friendship and sense of community that brought him here, that he credits for saving him, has indeed also saved me. And for that, I'm eternally grateful.

Since that experience, several friends have written about their own struggles and I've related to them completely. Seen myself in what they've been writing about their challenges, and I've found hope and guidance in how they're moving forward. That's helped me make some progress in my own life, too.

Through the eyes of something bigger than yourself, you see how you haven't been alone and that you have been carried. Those Footprints that you've heard about before, somehow magically appear in the sand on the beach.

I know I can walk on, because so many are there to help walk along with me and carry my tired soul for a few steps if needed.

Moving forward, a single step at a time. One pill, one blood test, one handwritten letter rather than an email or blog comment, one actual conversation, and real face-to-face talk. Truly living. Each day.

I have an appointment at my Endo's office this week, and I've scheduled an introductory session with a counselor in the comings weeks. As I wrote recently in another post, now it begins again. Moving Forward. And I know I'm not alone.

Thank you for bearing with me, and simply for doing what you do in my own life. You have and continue to make a difference, and I can't appreciate that enough.

Dear Paula Deen

2012-01-19T12:49:00.001-05:00

Welcome to the Diabetes Community, Paula.

Though it’s a bittersweet welcome, one that no one deserves or hopes for, I’m grateful that your Type 2 diabetes diagnosis announcement comes at a time where you don’t have to be alone. Where you can find some friends who “get it” and know what you’re going through.

I applaud your courage and willingness to share your health story, especially in such a public way. On your own terms, your own timing.

Confession: I’ve never watched your show. Yes, I knew who you were before all this news materialized. And maybe once or twice, I’ve caught a glimpse of your cooking and personality while flipping channels or when passing through a room where you happened to be on the screen. No offense to you or your southern-creations – just not something I’ve ever embraced. And it has nothing to really do with the food types or ingredients, it’s just not something I’ve ever really paid much attention to. Even though I'm certainly a fan of food.

Now that you’ve unleashed the news for the world’s eyes, my hope is that you can use your D as an advocacy tool for the millions who watch and love your cooking show, to teach more general lessons about how we as a society need to better manage our health, our eating habits, our whole selves. That’s something you’re obviously doing, by embracing a campaign with a Pharma company and making personal changes and even re-creating some of your food dishes to be more D-friendly.

I could care less that you waited, that you held it close. Naturally, I'm cynical and skeptical and operate often on the mantra of "Your Mom Says She Loves You... Prove It." But I also have faith, and I'm trying to see the better positive side of people and not assume the worst all the time. So, I take you at your word that it was a personal family decision ultimately made for the reason you offered: Because you didn’t know anything about D then, and you wanted to “bring something to the table” before announcing this to the world. You did this on your terms, and I applaud you for that.

A lesson we can all take from this, though: You would have come out on this 3 years ago with little knowledge or information, and people would have criticized and judged you. You did this now, and people criticized and judged you. The point: you can't control human nature through timing.

Now, is there any hypocrisy in this - that you made changes personally in eating, exercising, lifestyle and health but yet continued to do everything on your cooking show exactly the same way? Mayhaps so. And just because you never said "eat this everyday for every meal" doesn't mean you preached moderation.

But none of that rises to the level of justifying claims that you "did this to yourself" or that you "deserved" this diagnosis. Not at all. I’m sorry that you’re experiencing criticism, judgment, blame…Science doesn’t tell us what causes any type, but sadly our society – even our own D-Community – can be quick to point fingers that a "contributing factor for one person" was the sole cause of another person's diagnosis. Poor media coverage fuels misconceptions and lumps all the types together, with little explanation or clarity except a big proclamation that “MILLIONS OF PEOPLE HAVE THIS SILENT KILLER.”

It's that war of battling misconceptions that connects us as Advocates, as regular People With Diabetes - beyond the blood testing and D-Management and shared moniker of diabetes. We impact each other, and what's said about your diabetes carries over into the general public's mind about anything related to any type or issue of diabetes. You’re a part of that now, just like the rest of us in the D-Community whether one "advocates" or not and regardless of a person's feelings about this type or that. Awareness through Unity is how we educate the masses, sidestepping the blame and the differences and focusing on the real information.

Maybe with your celebrity-status you can help battle some of those misconceptions and teach people what is and isn’t true about Life With Diabetes. I’ll be eager to see how you use that spotlight.

Again, thanks for sharing and being willing to advocate on behalf of yourself and others who are at various points in their D-journeys. At least you’re on the food channels, and not MTV where your “True Life” D-story would take on a different tone. No, that’s a whole different blog post right there…

Not Going Dark, But...

2012-01-18T12:11:00.002-05:00

Many players in the online world are protesting the pair of Congressional proposals that target the online universe- Stop Online Piracy Act (SOPA) and Protect Intellectual Property Act (PIPA).

I'm not going dark here at The D-Corner Booth - in part because this is a diabetes blog, and I can't block out my D for a day. Blood tests and insulin-doses are ongoing, as are the thoughts in my head. So there.

But know this: I'm not a fan of censorship, and if this legislation does what critics think it will, then I'm totally against it. I'm not a lawyer, I only cover them as part of my real-person job, so I don't have any worthwhile insight about what the law says or doesn't say and how that may hold up. My experience covering legislatures and courts tells me that lawmakers typically are vague in crafting legislation and don't understand the impacts or practical realities of what they're drafting or passing into law, and the courts consistently find this when ruling on enacted laws.

So, take what you will from that.

I'll have none of this, Congress...

Now, I'm going to now refer you to a passage from a CNN story posted today about this whole web-protest to the Congressional efforts that sparked this controversy. I find these particularly insightful, personally.

SOPA's supporters -- including CNN's parent company, Time Warner, and groups such as the MPAA -- say that online piracy leads to U.S. job losses because it deprives content creators of income.

The bill's supporters dismiss accusations of censorship, saying the legislation is meant to revamp a broken system that doesn't adequately prevent criminal behavior.

But SOPA critics say the bill's backers don't understand the Internet's architecture, and therefore don't appreciate the implications of the legislation they're considering.

My thoughts based on the above notes: It doesn't matter what the law was "meant" to do or not do, the point is what's written and what it CAN be used for if someone chooses to do so down the road. The path to Hell is paved with the best intentions, as the saying goes.

Here's a couple news stories I found informative:

http://money.cnn.com/2012/01/17/technology/sopa_explained/index.htm

http://www.cnn.com/2012/01/18/tech/sopa-blackouts/index.html?hpt=hp_c1

And if you care to protest, then here's where you go:

http://downagainstsopa.com/takeaction.php

Power to the People, whether it's online or in person! Use your voice - we have one for a reason!

- - - - - - - - - - - - - - - -

UPDATE ON JAN. 20: "WE DID IT!!!"

Headline One: "SOPA and PIPA postponed indefinitely after protests"

However, it may not be over just yet: "Protect IP, SOPA supporters vow not to give up fight."

And so, we keep watch. As good U.S. citizens must do. We won't give up the fight, either. Count on it.

Your Lows May Vary

2012-01-12T03:00:00.001-05:00

As Bennet has wisely established as a mantra, Your Diabetes May Vary.

The same applies to Lows. Kerri (Shelby?) wrote about this very recently, which was actually funny timing because I'd had that same topic on the mind after a conversation the day before with my own mom. She's lived with Type 1 for more than five decades, since she was a young kid, and we were doing an interview about our own individual, joint, and differing D-Life experiences. Lows came up, and that got me wondering how our experiences varied.

I've written about some of my examples in the past - violent thrashing and struggling, believing my wife was an alien or robot or Communist trying to gain control of me, the dog trying to eat my head, and the dream-like states of being outside my body and then waking up to the paramedics hovering above me. You get the idea.

But I wanted to know about my mom's, so I asked. She responded by email:

I did (have reactions) and remember my mother pouring juice down my throat. She also always carried one of those little boxes of raisins in her purse to give me when I didn't feel well. The only glucose tabs were those white ones, which I would lock my jaws against and refuse. When I was a kid, a lot of it had to be done on what I said I was feeling, because there was only urine tests and they were so far off. They might show you weren't low but you could have dropped low in the meantime. Also I only took Lente insulin, a pig and beef combo, and it wasn't real stable. If you didn't eat your meals on time and didn't eat all of your food, you had lows. There wasn't anything you could do about it as that was all there was.

I never had anything bad like the seizures you did. When you first had them, we were terrified. The endo clinic said it wasn't because of the diabetes and by the time we could get the seizure under control and do a blood test, you wouldn't be real low. So they never thought it was from low sugar. They made us see a neuropsychic guy who did a bunch of head tests, like CAT scans and stuff, but they never figured out what it was from. The seizures only lasted a couple years and then they stopped.

It wasn't until years later that some other parents at a JDRF meeting said their kids, usually boys, also had seizures with low sugars.

If by violent lows, you mean kicking and striking and generally being mean, I do do that. It's just that your father is much bigger than me and can easily sit on me and keep me down to cram stuff in my throat. It was easier when you were small and I could sit on you to get juice down you. Once you became as big as me, it became much more difficult.

In our household, Suzi and I have an understanding that if I'm in "violent Low mode" and she can't easily get at me with frosting, juice, or glucagon, then it's best to step back and summon the paramedics. That's just how we do it.

Reiterating the questions I'd asked in my post back in late 2009, I'd be curious to get feedback on others' experiences when Low.

- How often you do/have had these happen (maybe pre-CGM days, if applicable)?

- Stories that stand out, for better or worse?

- Worst (most dangerous) examples?

- What brought you out of that reaction?

- Scariest part - the dream state, emotions, guilty, etc?

- Lessons learned?

- Whatever else might be pertinent, relevant, or randomly of interest

Whatever our experiences might be like, hopefully they are few and far between. And, you know, the aliens and robots don't really take control of us.

The First, 90 Years Ago

2012-01-11T02:00:00.074-05:00

Everyone has for the past year, even a little longer, has been going on about the anniversary of when insulin came on the scene and changed the face of how people with diabetes could live, not just survive.

First, there was the date on Halloween 1920 that the esteemed Dr. Banting actually came across the idea for what would become life-sustaining insulin.

Then, there was the development of that idea in 1921.

Of course, then there's the date that creation came to fruition and the first person actually received the benefit of insulin. That was Jan. 11, 1922 - exactly nine decades ago.

A 14-year old boy named Leonard Thompson was dying at Toronto General Hospital, but it was this newly-developed drug known as insulin that gave him a chance to live. Even though it was initially unsuccessful, a revised formula was successful and it changed everything. No one really paid much attention outside the medical community, until August 1922 when the now-infamous Elizabeth Hughes hooked up with Dr. Banting in Toronto and made headlines with her receipt of insulin.

Elizabeth chose a lifetime of silence about diabetes. That was the way of the world, at the time. She's especially meaningful to me, not just because of her history-making insulin injection but also because as an adult, she was able to move to Michigan and become one of the founding trustees of Oakland University where I went to school and graduated. Elizabeth became Elizabeth H. Gossett, married to the then- general counsel for Ford Motor Company and a pivotal player in the local arts and civic community - but diabetes wasn't a part of that. Her adult endo was Dr. Frederick Whitehouse in Detroit, the medical professional my own mother now sees. I had the chance to talk with Dr. Whitehouse a handful of months back, and he talked about his experience with Elizabeth Gossett.

"It's my opinions that Ms. Hughes Gossett was a 'closet diabetic person.' These people with diabetes commonly did not 'wear their disease on their shirt sleeve' like many do now. I believe the current atmosphere for the person with a chronic disease is much more healthy than before. You had diabetes, (that meant) you were 'damaged goods' and might have no job, no insurance, no full life, and be advised not to reproduce, etc. The family often kept their chronically ill family member in the back rooms."

When Elizabeth died of pneumonia at age 73 in 1981, her Michigan obituaries didn't mention diabetes or signal her significance to the Diabetes Community. It wasn't until years later her family even started mentioning it and talking about it openly.

Still, Dr. Whitehouse describes as really a "remarkable woman" who did what she did to live successfully with diabetes, regardless of how much or little she talked openly about it. She set the standard for how generations lived and managed their conditions from the very start in 1922, and created the foundation for living successfully.

Just as we celebrate those who've accomplished their dreams despite diabetes, from driving race cars to climbing mountains and swimming or skiing in the Olympics, Elizabeth was one of the first to reach that dream of living a "normal" life. We owe so much to her, and to Leonard.

Of course, to Dr. Banting and all those who set in motion what happened 90 years ago.

Now, we just need to make sure everyone has access to insulin when they need it. That becomes our mission that we can hopefully do something about by the time we reach the 100-year anniversary.

I'm Surrounded By...

2012-01-09T00:00:00.024-05:00

This clip captures my mood perfectly right now, as I reflect on our country's politics and those vying for the presidency.

http://youtu.be/sen8Tn8CBA4

I'm surrounded by assholes, apparently. But I guess I already knew that. (Sigh).

Presidential hopeful Rick Santorum apparently thinks that insurance companies should be able to deny coverage for people with pre-existing conditions. He's also of the belief that those who aren't denied should have to pay more to receive benefits, because they're sick and cost more to insure.

Not all the ~~fools~~ GOP ~~political hacks~~ presidential wannabes think the same way, and some have specifically said that despite wanting to repeal the Affordable Health Care Act they want to make sure insurers can't prevent pre-existing denials outright.

But apparently, that's not how Rick rolls. Or so his sometimes-inconsistent video statements seem to indicate.

To a New Hampshire high school class, on why people with pre-existing conditions should be denied coverage:

More recently at a New Hampshire event, discussing the "sick-person premium" concept:

I saw these above clips after seeing an impassioned post Friday evening by a friend and fellow D-Advocate, Kelly K, over at Diabetesaliciousness. It's worth a read, if you haven't had a chance.

For me, I think that some of what he's said has been taken out of context. I get the business, economic arguments about what insurance is and isn't supposed to be and some of his logic seems sound to me. In a free market system, that's how a product-buying system should work - and while there are many aspects that influence the health care insurance discussion in that context, it's a simplistic and not-outrageous way to look at it. In the context of pre-existing conditions and people "causing" their own health issues, that DOES happen a lot. Sometimes, people get chronic conditions as a result of their lifestyle choices. It's the way our culture and global society operates. Obviously, not for everyone. Not to most in this Diabetes Community of ours, since many of us didn't do anything to "cause" the conditions we're living with. He's painting with a broad brush, but it does have some legitimate foundation.

But with that said, let me be clear on what I think overall about Mr. Santorum:

Rick, you just don't get it.

You think that because your child has a genetic disorder that's dubbed a "pre-existing condition," and you have the resources to go out and actually buy insurance for a little more than everyone else, that you're suddenly at the American people's level in understanding what we deal with?

I'm sorry, you don't. As a former senator who voluntarily left his job and is anything but cash-strapped, you're just not able to. Here, let me look to this recent Associated Press story that pretty much justifies the claim that you're out-of-touch with middle American on this "just pay a higher insurance cost" message:

Losing his Senate seat might have been the best thing that ever happened to Rick Santorum's bank account. In 2006, the Republican presidential hopeful earned about $200,000 from his Senate salary and book royalties. From January 2010 to August 2011, he earned at least $1.3 million as he cashed in on his 16 years in Congress by working as a corporate consultant, political pundit and board member.

Rick, I invite you to sit with me and any of the other 2.5 million others out there in the U.S. who are living with Type 1 as adults, or the million or so Parents of Child With Diabetes. Most of us are the ones who don't have the luxury to say, "Gee, I was diagnosed with a chronic condition through no fault of my own but it's OK to just pay a little more for my care." Or: "Really, insurance companies, if you want to just deny coverage because you think it might be bad for your business to insure me, go ahead - that's cool."

There isn't much choice to NOT have insurance, you see, because we already spend so much of our wages on D-care and supplies (thanks to crappy insurance coverage) that we can't afford to pay any sort of "sick person's premium" just to have the same or worse crappy coverage. We simply need it, and if we can't afford it, our lives are drastically different.

I didn't ask for a lifetime of this, of medications and a never-ending cycle of management, but that's my reality whether I can afford it or not. You and your well-to-do political buddies (many of whom have GOLDEN LIFETIME INSURANCE COVERAGE) telling me that I can negotiate a price with Blue Cross or UHC for something I have no control over is absolutely absurd. That's assuming I can even get past the entry-level customer service reps who typically don't grasp the basics of what I'm talking about anyhow.

We're not buying a car or maintaining a windshield here. We're talking about living and dying, being able to be in a condition to live our lives and work and play. Let's keep the debate on track, Rick. After all, I'm not going to make my case for sunscreen by praising how bright the moon gets at 2 in the morning... Apples and oranges, Rick. I'd hope you can grasp that.

Driving a car is not the same as living a life with a defect in a major organ. Rick, you have no clue what it's like to live in this world TOTALLY dependent on the medical system to survive. And so, with every ounce of passion in my heart, I write:

Screw you and your rhetoric, Rick.

It's time to stop blaming "sick" people for the sins of corporate greed.

Life, Liberty, and the pursuit of Happiness - those words are supposed to mean something. They're unalienable rights and aren't supposed to be contingent on a person's pocketbook having enough green to allow for it.

2012 is my chance to secure those rights and what I see going toward ensuring them, for myself and others. This country's elected leaders derive executive and legislative powers from the consent of the governed (Read: ME AND MY FRIENDS), and if you become destructive to the ends of taking away our unalienable rights, then it's our constitutional right to abolish your governing.

Consider it done, Rick. Bring on the election, assuming you even get that far. Tell your friends. It's on.

Oh, hey Hannity... before I forget: You're an idiot, too. Just wanted to tell you that.

Now, I'm going back to my own Indiana lawmakers who are boycotting the Statehouse over the right-to-work legislation... again. Seriously, people. Can't we stop this political nonsense?!?!?

Moving Forward

2012-01-04T08:00:00.002-05:00

I haven't been to see my Endo since March.

By my hand-counting, that's close to 10 months.

There's been a couple visits scheduled, one in the summer and one a few months ago. But, knowing that I've been slacking on the D-Management front and dreading the expected A1c that I know is higher than it should be, I have been putting the visit off.

The last time my A1c was done, it came out at 7.9% - up slightly from the one just before Christmas 2010 when it was 7.5%. I'm sure it's higher now, probably somewhere closer to 9%.

(My 30-day meter average is 220, which comes out to 9.3 and my past couple weeks are about the same - as are the past few months or so.)

For inquiring minds, it's not a matter of not knowing what to do. No. I am testing about six times a day, have a pump and now a Dexcom 7+. And while I'm certainly no expert and probably know little in the grand scheme about diabetes management, I've been doing this for 27 years... so I know what's at fault and what isn't: Simply, it's a matter of willpower - or lack thereof.

I've been struggling a lot in the past year on several personal fronts, and that's all led to some depression that has clouded pretty much everything in my life. Sometimes, I just don't care. More to the point: I feel that way a lot lately. Even when I'm testing often, the numbers are commonly in the 200s and 300s and that's what I have grown accustomed to.

There's a matter of underlying hopelessness, that nothing I do really matters. That it doesn't make a difference and it's really not worth it. Even the brightest moments and sparkles of happiness aren't enough to counter the corrosive, pervasive, and overwhelming feelings of depression.

I've kept a lot of this bottled up and have guarded this, but despite that effort it's been spilling out into most areas of my life. Recently, I've started taking some steps to deal with that and that's a work in progress.

After reading some recent posts my friends in the Diabetes Online Community - (Kerri's post here, Jess wrote one, and Melissa wrote one - I've made an appointment. This was in December and the soonest available was January, so that's planned for a few weeks from now. Actually, to be honest: I didn't take the initiative to schedule it. After I reached out to my Endo and CDE about getting a referral for someone in the counseling world, my Endo's office phoned to let me know the referral was in the mail and that my Endo wanted to get me in for a visit ASAP. So, really, it was her, not me.

But the visit is finally going to happen, regardless. That's the point. I'm hoping that I haven't hit the double-digits, but no matter the result it's a matter of asking "What Now?" rather than focusing on the judgmental and critical aspect of the number.

To be clear, if my A1c is high, it's not going to be a surprise. And it's not a matter of not knowing how to improve my D-Management. It's not like we're talking about changing some bolus or basal rates here in order to fix what's going on, although that may be necessary. It's a matter of dealing with the emotional and mental mind games that are causing my slacking.

So, I'm ready to do what's necessary. I've been avoiding it for too long. Now it's time to move on, deal with my demons, and get back in motion on my D-Management. Really, my life.

When your life is clouded by the darkest clouds, and you have the ability to manipulate the weather, how can you possibly not try to move those clouds out of the way for some needed sunshine?

No more avoidance.

The time to move forward is now.

Liquid of Langerhans

2012-01-01T00:01:00.000-05:00

Fellow diabetes blogger Kelly K reminded me the other day that, with the year's end approaching, it was time to refill my prescriptions. That brought a check of the fridge butter compartment and a realization that I was, in fact, on my last bottle of insulin.

Wait a sec...is that BUTTER in that butter compartment?! WTF?

I phoned in a refill late in the night a day before Christmas, so we vowed to avoid the next day's shopping craziness and pick it up after the holiday. Another day passed and Suzi grabbed it on the way home from work. All was good and I had another three bottles (one month's supply) safe and snug in the butter compartment. That was that and all was well with the world.

But after reading a recent post over at Six Until Me, my mind started working about that insulin lounging in the butter compartment. I got curious about the real cost of the life-sustaining medicine being pumped into my body on a daily basis. The real cost. Not the after-insurance "feel good" amount that takes away the reality of what it truly costs to have this life-sustaining, Liquid Langerhans.

My mission became clear. I had to know.

Unable to find the receipt showing said cost of just purchased insulin, we made a return trip to the local retail pharmacy to retrieve that financial 411. There was someone at the counter ahead of us, so I perused the nearby D-supply shelves and toyed with the idea of buying a home A1c test or snagging an extra jar of glucose tabs. Suzi snapped me back to reality once it was clear the Nice Pharmacist Guy was patiently eying us and waiting for us to approach the counter.

Me: "We were just in the other day refilling a prescription... well, actually, she was for one of my prescriptions... and we needed to get a copy of the bill showing the cost breakdown. Is that possible?"

NPG: "The co-pay amount?

Me: "Actually, the full retail cost before insurance. Does it have that?"

NPG: "Of course. Just a receipt? I can do that."

We laid out my identification and told him it was for the Humalog, and he quickly hit a button on the keyboard and made the printer came to life. NPG grabbed it and brought it over, asking if that's what I was looking for with the co-pay amount of $40 listed on it. I glanced at the top of the sheet, to the left of that amount, and saw in fine print a different line that said, "Retail Value: $419.99."

An internal "YIKES" tried to escape, but I suppressed the sticker-shock.

Me: "That does it. Thank you, very much."

He went about his pharmacist duties, and we left to walk around the rest of the store for a bit as my mind tried to process the D-Math of a different kind.

Looking at that number again, it simply astounds me - $420 a month, or $1,260 for a three-month supply of insulin. Geez, there must have truly been gold in that liquid of langerhans!

Of course, it's tough to not recognize and be VERY thankful that we have health insurance that wipes out a majority of that total. Luckily, I'm paying less than 10% of the total cost. For all it's woes and failings, insurance is an incredible blessing. I just hope that those without the option currently are someday soon able to get at least a taste of the coverage... (keep the health care reform, cough cough).

Anyhow, knowing the total cost of my insulin addiction, it was now time to check for money savings that might be available elsewhere. Doing some online research with our insurance company, I learned that getting a three-month supply of insulin through the mail order ExpressScripts (Medco, who?!?!) would save us about $20 a month ($80 per year).

Backstory: Through a previous insurance plan with a longtime employer, we had the luxury of a 90-day supply from the same retail pharmacy for about the same as it would have cost from out-of-state medical supply company, so that's the option we chose. Insurance changes in early 2010 switched up insurers (and decreased coverage) and capped the retail pharmacy supply at 30 days. I didn't have the energy at the time to switch to mail-order, and so I just stayed with the local shop. Fast forward to now. After Kerri's post, I wanted to know what it really cost to get insulin and whether there might be some money-saving options available elsewhere.

It looks like mail order might be on the horizon! There's something reassuring about having a butter compartment full of insulin, rather than being on that last bottle and bringing all the uncertainty of possibly running out or dropping and shattering it at the worst possible moment when BGs are sky high. So, once this monthly supply runs thin, it looks like we'll go after the mail-order method.

In a world where this Liquid of Langerhans appears to be laced with gold, any little savings helps out.

Looking Back on Eleven

2011-12-30T05:00:00.000-05:00

As we usher out 2011 and once again welcome in a New Year, I've tried to go through all my posts for this past year and keep up the tradition of highlighting the monthly happenings in this little corner of the Diabetes Online Community... you know, my own Corner Booth. So, here's a time to reflect over coffee, conversation, and community.

January
Indiana got a new diabetes license plate, and I started my own ride with a Minimed 523 CGM, affectionately named Larry The Loaner.

We had an early start on celebrity media awareness, after Ricki Lake made a boo-boo when talking about the differences in Types 1 and 2. However, unlike many media outlets and celebrities who make errors like this and much worse, she stepped up and apologized. These things happen, but it's so telling when a person has the character to admit when they're wrong.

February
I had fun getting started as a board member of the Diabetes Youth Foundation of Indiana and volunteering at my first event! Even got my blood meter pinstriped, all in the name of D-Camp!! Oh, and I got hassled by a court bailiff about using my CGM and testing my blood sugar while sitting in the courtroom.

March
Had the privilege of trekking to our nation's capitol for JDRF Government Day, thanks to my roles as a diabetes blogger and also a part of my local chapter's grass roots advocacy arm. It was an amazing experience full of outstandingly passionate people, and I was so grateful to really feel like we Adult Type 1s are Not Forgotten Anymore. Of course, it was an honor seeing so many friends - and Sprinkles.

April
We attended our 3rd JDRF Promise Gala in Indianapolis and had a blast! And at least there we saw no incidents of Assault with a Deadly Lancet, blunt or otherwise. Apparently, that only happens in schools.

May
How can D-Blog Week not rise to the level of being a monthly and yearly highlight?!?! Seriously. The 2011 lineup was great, and I had so much fun... particularly when thanking those random souls from my diabetic past. But one person I'm grateful isn't a stranger, but a fellow PWD and friend, is IndyCar driver Charlie Kimball who made his debut appearance in this year's Indianapolis 500!!!! Way to go, Charlie!!!!

Another personal highlight this month, although I didn't get around to writing about it until a few weeks later, was a visit to the Eli Lilly headquarters in Indy with my mom. It was truly a memorable moment we'll both remember!

June
Summer is busy, but the highlight for me was the third annual Roche Social Media Summit in San Diego that I was lucky to be a part of. Friends, community, advocacy, bacon, and Diet Coke... how can you go wrong there? Especially when Bennet takes his whiteboard and tries to jump out of a huge cupcake...

July
Ice cream and diabetes = nuff said. Hear me, Southside Times???? Yea, you heard me - and all of US. Take that, Wendell!

Aside from all that drama, it was good to have some media awareness lessons. Plus, there were some other newsworthy happenings - such as the 21st anniversary of the American With Disabilities Act and my own personal milestone of a Decade of Site Changes.

August
Apparently, someone thought it'd be a good idea to try and hack into an insulin pump. And then tell all the reporters about it. And that got some Congress-folk fired up. But the ever-watchful Diabetes Community again piped in to try and set the record straight.

September
Got all artsy again for D-Art Day, and also managed to miss out on a possible D-Meetup with a random passerby on the streets of Indianapolis.

October
Traveled to Kansas City for #Simonpalooza and had the incredible, life-changing opportunity to meet Simon, who traveled from Australia for a three-city North America tour to meet some members of the Diabetes Online Community.

November
The JDRF made a historic announcement that it was changing its logo, motto, and message to be more inclusive and multi-pronged toward LIFE with diabetes, AS we journey toward a cure. They even used a startling statistic to make their point, in what some view as a controversial way. Overall, it was the perfect month to do that, being Diabetes Awareness Month that included a great World Diabetes Day experience here in Indy. Lot of adventures, advocacy, and awesomeness.

December
Amazingly, the FDA kept a promise on something many of us have been working toward for a long time. So there's that, and an announcement came that our beloved dog and cat (Riley and Shadow) won a Halloween D-costume contest! And had great company, with Sara's kitten clan joining in the fun!

Overall, 2011 Lessons:
It's been a tough year with many ups and downs, personally and professionally and related to diabetes and not, but there's hope and optimism as we move forward.
This community is full of family, friends, passion and purpose. It's life-changing, and knowing you and being able to share some online space has made my year - my life - so much better. So thank you! Can't wait to see what's on tap for 2012 and Beyond!!!

Real-People Sick 2: A Christmas Sequel

2011-12-28T00:00:00.006-05:00

So, about two weeks ago I had The Plague. This was the stomach version of an illness that took me out of work for a day, incapacitated me for about two days and led to no solid foods for almost three days.

As mentioned in a recent post, Suzi had the same bug about 10 days earlier and we’d thought I had sidestepped it – but that wasn’t the case. Thus began my fun times of being Real-People Sick.

Well, about a week after I was sick, which was a good three weeks after she’d initially been sick, Suzi got what we called The Voice Stealing Virus of the Throat. Basically, coughing and lack of ability to speak, at least in a non “I’ve been chain-smoking for 30 years” raspy voice. Luckily, that too only lasted a max of a couple days.

My sickness sequel set in just in time for Christmas. A few days beforehand, I’d felt a slight tickle in my throat and I recall muttering, “I’d better not get sick on Christmas.”

It happened. The Real-Person Sick Sequel had been approved, scripted and shot on the spot.

Christmas Eve wasn’t bad, but I took some cough syrup to try and make things better and thwart whatever might be on the way. Waking up at my parents’ house in Michigan on that Christmas Sunday morning, my throat felt horrible. The Cough had set in, and it hurt in my upper chest. I could barely talk, and it was that same raspy voice that sounded like the woman walking into the store in the movie Fun With Dick and Jane.

Sugar-free = respect the D, even when sick.

Talking was a challenge, so I tried to avoid it as much as possible throughout the day and evening. Same on Monday, our final day in Michigan when we met with about 10 friends for breakfast. It was a bummer, because I’d not seen these people since Christmas the year before and was looking forward to just chatting a bit. But, I did my best to stifle the coughs and keep a continuous flow of water and warm coffee to ease the throat. Sugar-free cough syrup and cough drops were always on hand, and that did help.

We traveled back to Indiana that afternoon and early evening, and I went back to work on Tuesday - but unfortunately was voiceless and ended up going home mid-day. My boss was understanding, since everyone seems to be sick these days, and she was appreciative I felt the need to not torture everyone for the full day with my raspy voice and plague-spreading interactions. The sneezing was in full effect by that time. It's possible I might also be out Wednesday... we'll see how that plays out.

Of course, this has all caused my BGs to run higher no matter what I've done. The Christmas dinner was a larger one with some treats and cider, and so those post-meal higher BGs were just a symptom of that feast. But the sickness kept me hovering in the 200s or higher most of the weekend and through Tuesday. On Tuesday, my sites decided to be cranky, and even two changes didn't seem to appease my fussy pump that kept mocking me with a "No Delivery" alert. I could get only a few units in at a time, and there was no telling whether it was actually in my system doing anything or caught in limbo somewhere. Eventually, I yanked the site and went with injections for a few hours until I could muster up the motivation to put another site in

Oh well. We all get sick, and real-person sick can be just as challenging and bothersome as anything D-related. Here’s to hoping that the Season of Sickness doesn’t linger around any longer, and things get back to normal (you know, chronic condition normal) sooner rather than later.

And really, I'm hoping this isn't a trilogy... because my birthday is about a month away.

D-Gifts for Christmas

2011-12-26T06:00:00.059-05:00

As a couple, we celebrate Christmas by not splurging much on each other but usually going for an array of fun, creative little gifts for each other. Maybe one or two we can enjoy together, like tickets to a play or an event, a movie or whatever. And then we might do a "real" gift that sticks around for a bit and means a little something.

Now, I won't share all the little exchanges we shared this Christmas. But there are three that we thought would be fun to put into a blog post.

1.) Candy, Candy, Candy (said in the Garfield Halloween special voice). You know, in case of Low blood sugars.... (wink). Because, really. Why eat glucose tabs when you don't have to?

2.) D-Notepads: I'm a writer, you likely know. Well, in the last few years I've been mixing my time up with a lot of my real-job newspaper writing and also diabetes writing in the blogosphere and elsewhere. Sure, most of it's in the Diabetes Online Community, but that mean I don't write posts out by hand, jot notes down, or even pen long ideas and strategies about D-Camp or local D-advocacy efforts. That's led to mixing of the notes, and having to flip through countless notebooks trying to figure out where "that" D-note is located among the many pages of interviews and journalism notes. So Suzi made a simple little EVER-PRACTICAL gesture: four notepads specifically for my diabetes writing!!! Each one has a "D" written in bold market up in the corner, AND they're even color-coordinated by season (black for winter, green for emerging spring, red for the red-hot summer months, and blue for the cooling off in fall). You rule, my love.

3.) And last, but certainly NOT least...

I GOT A PANCREAS FOR CHRISTMAS!!!!!

A Plush Pancreas, to be exact.


Purchased from www.iheartguts.com

His story, as revealed on the little card attached: Located above the intestine, this Peter PANcreas likes cookies, cake, candy, and insulin and dislikes diabetes. His favorite book is Intro To Endocrinology and he hopes to meet "somebody sweet." He says: You'll enjoy getting to know my lesser known parts like the Islets of Langerhans, sphincter of Oddi, and ampulla of Vater.

Dude, I got a pancreas for Christmas!!!!!!

Then, up in Michigan, my parents got me a gift that I know the DOC would appreciate - particularly Scott Johnson.

A Diet Coke ornament!

Not this blurry in real life, I swear.

So there it is. Some D-gift fun, mixed in with all the rest of the great holiday gatherings and activity. Hope yours' was a wonderful one however you spent it, and here's looking forward to the final days of 2011 and the start of a new year!

Christmas Cookies & Poetry

2011-12-24T08:00:00.002-05:00

(Originally published in a 2010-version, revamped now for 2011.)

As Christmas Eve comes around and paves the way for Christmas Day, a tradition many have is to set out some Christmas Cookies on the night before.

You know, in case a Big Jolly Fat Man in a White Beard and Red Attire shows up for a visit. No, not Wilford Brimley and his diabeetus. We're talking about the stealthy ninja known as Santa Claus.

Of course, diabetes is a stealthy stalker, too, so we must be ready for both Santa and one of those middle-of-the-night Blood Sugar drops that can strike the seasonal slumber. So, our twist on the tradition is to put out these cookies, gingersnaps (for GingerNinjas???), a glass of white milk, and of course a handy apple juice just in case we need a boost... Maybe if I'm up treating a Low with some Christmas Carby Goodness, I can even catch a Meetup with Santa for a snack, and hit him up for any free blood meter strips, pump supplies or CGM sensors he might have in that magic Christmas Bag of his.

While we wait to see if that Santa D-Meetup comes to be, I leave you with an Xmas Eve poem:

Twas late in the night before Christmas, and all through the house

Not a Puppy or Kitty is stirring, nor is my spouse.

My blood sugar's steady at one-hundred-and-three

And there won't be a need to wake up about 3.

The wife is all nestled snug in our bed,

With no visions of paramedics or reactions dancing in her head.

Whether we're here in Indiana or up in Michigan

hopefully the sugars will cooperate and bring us a win.

We'll sleep in well, knowing that Low sugars won't be,

But if that should happen, Christmas Cookies for me.

Then Christmas will come and the fun will begin,

Before the day's worth of D-care starts over again.

"Happy Christmas to all, and to all a good-night...."

Our Christmas D-Spirit

2011-12-21T19:57:00.004-05:00

Once again, tis' the season.

Our Christmas Tree materialized this year just after Thanksgiving, a tad bit earlier than years' past. We also moved it to another spot in the house, to change things up for 2011. But most of the Hoskins Family Christmas Tree remains unchanged.

Our Diabetic Spirit is also singing strong again as D-Supplies have also made their entrance for the third year in a row. More spirited than last year's D-Tree, and some of the regular fixtures have returned.

I've wondered some about whether it's "weird" to have diabetes device and management supplies adorning our holiday tree. But you know, my thought is that a Christmas tree is supposed to include ornaments that reflect important moments and aspects of one's life. Pictures of family, kids, friends. Items that mean something to you. And so, I think diabetes fits into that - these things keep me alive, after all. So yes, they do have a place on our Christmas Tree.

Pump tubing tinsel, hanging again without worry of being yanked loose by a jumping dog or sneaky aggressive doorknob. Plus a Glucose Tablet on a pump tube string. And a nearby emtpy One Touch Ultra Blood Test Strip Vial being recycled for D-Tree use!
We have the controversial Sugar-Free Chocolate M&M from years' past. Yes, it is sugar-free despite claims to the contrary. Two other ornamenty versions of the bite-sized candies dangle nearby, fully capable of claiming the sugar-saturated status unlike their sugarless neighbor. That's my story and I'm sticking to it.
Reservoir and infusion set combo. They're always connected to me, so by extension they have a place on the D-Tree. Nuff said.
Old insurance cards on pump tubing string. I keep all my expired insurance cards, and am now making use of them creatively.
A Green Pickle. Pickles are yummy treats for many in the Diabetes Community, but this ornament actually stems from an inside-joke between a group of friends. We all went camping one summer years ago and rented a pontoon boat that was green, and thus we named it the Green Pickle. Tree ornaments for everyone ensued, and still decorate our tree.
Mug O Beer. I do love my beer. No Christmas is complete without it. Cheers!

We also have added a few others that were gifts last year.

Glass Globe Filled With Test Strips, a gift from my mom last year. Thanks mom! This is awesome and a great new addition to our tree!

Riley & Shadow Ornaments, also ornaments that were gifts from my crafty mom (anyone else sensing a theme, here?!)

We have many other ornaments, but these are some fun central ones highlighted for this post.

Now, this D-Tree may not be a Little Charlie Brown Christmas Tree. And our pets may not be the real Garfield or Odie But hey, it's the Hoskins Family, with all the trimmings to compliment our lives and Hoosier Household. We proudly mark the season in our own ways, and love doing it.

Aside from the tree, we also spent some time recently creating and decorating a gingerbread house, courtesy of a store-bought kit containing directions and all the pieces. Not the same as the homemade ones we'd made years ago, but still a lot of fun! (By the way, total carb count listed on the box = 936g. Plus a couple in-house extras, I'd guess it's somewhere around 1100g of yumminess!!)

So, we're very excited about the holiday being here and being able to see and spend time with family and friends. All D-Life aspects aside, it's a time to remember what we have and how lucky we are in life, even when times are difficult and there doesn't seem like much reason to celebrate.

With that, I say to everyone: Merry Christmas 2011!

Cold Ninja Fingers

2011-12-19T00:00:00.004-05:00

Blood tests in the winter are always a challenge.

Cold temperatures do wonders on the hands to make them not want to bleed when poked by a lancet.

This seasonal hindrance happens often during this time of year. And it's annoying. Because, really... If I need to stab my fingers, I'd like to only do it ONCE. Not multiple times. With each one creating a stinging sensation thanks to the cold.

We need Ninja Fingers to survive this D-Life, but even our finger-piercing endurance isn't enough to conquer the cold temperatures.

What works, when the hands are freezing cold? Here's a few tricks of the trade I've embraced through the years.

Gloves help. No, not the cool mitten-style finger-flap ones Kim discovered. Rather, my own black leather ones that match my leather jacket or work dress coat. Not the greatest, but they help a bit.

The warmth radiated by a hot cup of coffee. Kerri would appreciate this, I'm sure. Of course, it only works without the gloves on.

Fists. Clenching. Like all angry-like. Pretend you're a boxer, like Rocky.

Rub the hands together, like you're trying to start a fire.

Rub them on the back of my leg. Or sit on them.

Run them under hot water. Just be careful not to hold them immediately under boiling hot H20 without a little prep, because that doesn't feel good.

And, when jumping into the vehicle after being outside in the cold, boosting the heat and using that to defrost the fingertips before doing a blood test. Which is a necessity before hitting the road.

Those are the most helpful tricks I've found.

But even with those little tricks, which occasionally do work, sometimes you just can't prevent the repeated, stinging finger stabs.

I'd rather not experience the Cold Fingers in the first place. But, I guess there isn't much that can be done. It's not like I can be like a hermit and stay indoors all winter... No, that wouldn't work. Sadly.

Is it spring yet? My ninja-fingers can't wait.

Real-People Sick

2011-12-12T12:58:00.001-05:00

I’d meant to do a light and fun post this past Friday, breaking up the deeper thought-provoking posts from earlier in the week. But apparently, there was a different plan in place for me.

“Real person sick” was the new adventure to navigate.

The week after Thanksgiving, Suzi came down with a stomach bug. Our friendly primary care physician designated it as “The Flu.” Despite all the cautionary warnings to do the opposite, we haven’t had flu shots in a few years. No consequences. Apparently, this year was the hiccup when the flu came calling. She came down with it, and it lasted a few days before she was finally back and work and in good form again.

We thought I’d avoided it.

Last Thursday proved us wrong, and I got a “healthy” dose of being “real-person sick” in a way that was, for me, a first in several years. Not the respiratory kind of ill.

Anyhow, it wasn’t a pleasant day. A very busy and hectic work day was derailed and I also had cancel a much-anticipated JDRF Outreach meetings that morning. Wasn’t even able to work from home, as I’m typically able to do. Nope. Spent most of the day in bed, tossing and turning and eventually battling a fever that went up to 100. The same routine mostly on Saturday, though I did improve as the day went on. Not eating anything made me weak, and even more restless.

Then there was essentially two days of not eating regular food, only grape Gatorade and regular 7up. Toast and soup the following day seemed to be OK, and some chicken and a biscuit on Sunday night about took me over the edge.

A fun ride, indeed.

But even as the “real-person sick” subsided, the diabetes front was having a ball causing chaos.

Not being able to keep any food down, Suzi threatened to drag me to the ER if it got to the point where I wasn't able to eat after two days. Being stubborn, I eventually made it happen and we avoided that scenario.

You’d think I’d be battling Lows, since it’s hard to stay High when you don’t have the energy or interest in eating anything. But no, the illness kept me elevated mostly through Friday and the weekend in the mid to high 200s, sometimes a tad higher. Even with “rage blousing” and increased basal, the numbers wouldn’t drop.

Through all of this, my Dexcom plugged along like a champ. When the sickness struck, that was day 21 of my first sensor. And it kept going all day, through Saturday, and even through Sunday pretty darn accurately. In the end, we lasted 23 days together until Sunday even when I VOLUNTARILY decided to remove the arm sensor for a “free” shower.

My pump site was another story. It was time to change my site on Friday, yet I just didn’t have the energy to do that over the weekend and on Saturday night I just disconnected completely. Went most of the day, and into Sunday afternoon, on only multiple daily injections of Humalog. At times, my sugars went into the 300s and I couldn’t tell whether the feeling in my gut was “d-related” or “real person sick” related.

Frustrating feeling, indeed.

Lessons:

You know you’re sick when you don’t feel well enough for Twitter updates.
Flu shots might still be a crap shoot, but they also might be justified.
Drinking grape Gatorade and regular 7up just doesn’t "feel right." Actually, it feels like I'm committing a crime.
The dog is very sad when I’m sick. The cat could care less, and seemed bothered that I was invading her "alone time."
My wife rules and takes excellent care of me.. and there’s just no way to express how awesome she is.
Even when you’re really sick, missing a day at work puts you behind. Immensely.
I’ve had no coffee or Diet Coke since Thursday… this is either really depressing, or the start of something important. To Be Determined.

Defined By Diabetes?

2011-12-07T00:00:00.002-05:00

“Diabetes doesn’t define me.”

That phrase has been on my mind lately.

Does it, or doesn't it? And honestly, do I want it to define me or not?

I'm not sure.

Some people don’t like the use of “diabetic” in describing themselves or their Children With Diabetes because they feel it implies someone is defined by diabetes. So they go with Person With Diabetes instead. Others don’t talk openly about their diabetes or share stories, for the same reason of not allowing their condition to dictate their lives.

Two athletes come to mind specifically. They are about a decade apart in age, one in the late 20s and the other in the teenage years. Both in the same professional sport. Yet they differ on how they treat diabetes when it comes to their athletic experiences, for the sole reason of how it might be viewed and if they’ll be defined by it. One is a vocal advocate about diabetes and doesn’t hide that it’s a part of the athletic experience, and makes a specific point to say how diabetes doesn’t limit the ability to successfully participate. While the other doesn’t make it known, out of fear of being defined by diabetes and designated as someone who might not have won as a result of this condition.

I agree with one approach more than the other, but really it’s tough to fault the other perspective.

In my mind, I think there’s a fine line between being defined by diabetes and how it’s a part of your life.

It’s an interesting two-sided coin. On one hand, we work tirelessly to be “normal” and not be seen as the “diabetes person.” But then at the same time we so openly and honestly share our good and bad D-life experiences and highlight the fact that we are, in fact, Living With Diabetes. Can we have it both ways? Can we define ourselves as diabetes patient-advocates as part of a Diabetes Community, and not be “defined by diabetes”?

I think it depends on the context of how we’re being defined.

If diabetes defines me, then I want it to be on MY OWN TERMS.

No, I don’t want it to define me in ways that aren’t on my terms. Lost time because of Lows or Highs. Complications that steal aspects of my happiness. Opportunities or experiences denied or fine-tuned because of my health, rather than my qualifications or experience. Being treated differently.

But if and when I share details of my health, I want to be able to. I don’t want to be forced to hide or down-play my diabetes.

For more than two decades growing up with diabetes, my health wasn’t the focus of my life and I wasn’t very open about it. Diabetes didn’t dictate the direction of my life, at least at the conscious level, putting me into a D-related field or turn me away from one. Even though I wasn’t hiding it for the most part, I just didn’t wear it on my sleeve. Blood testing, insulin-taking, the D-life routine were still parts of my life. Obviously. But my D-Management wasn’t as much an open-focus as it is now, and because I wasn’t thinking and communicating about it all the time, it was almost less of a dominating force in my life.

These days, I openly write and share stories and am proud to be a member of the Diabetes Community. Communicating about diabetes is a regular part of my life now. But that doesn’t mean I allow diabetes to “define” me, as far as limiting non-diabetic world opportunities and experiences.

With such a diverse Diabetes Community, many people have different views on this specific issue. Some see that not talking about their diabetes at all is the way to go, to ensure that they aren’t “defined” by their diabetes. While others choose to share, and

It’s our own choice, in the end. How someone may or may not be defined by diabetes doesn’t mean the same thing for everyone. As the mantra says, “Your Diabetes May Vary,” as does the way you make it a part of your life and share that with the rest of the world.

Don't Need the DOC

2011-12-04T17:43:00.010-05:00

I've expressed my fondness and support for the Diabetes Online Community many times. This community is, to be all cliche-heavy, an inspirational and life-changing community full of amazing people.

But every once in a while, it serves us all well to step back and realize: Not everyone needs this DOC. They simply don't need or want what it offers, whether it be the personal connections or networking or world-changing advocacy. Those fellow Persons with Diabetes who do fine managing without the camaraderie displayed in the DOC.

And that's cool. Nothing wrong with that. Some say they don't have the same struggles that many of us do, or that they don't need to tell others about their lives with diabetes. They deal with the daily D-Life situations on their own terms, on their own, in their own way. Without having to discuss it or educate or advocate to others.

I used to be that way. For most of my life, actually. I didn't know I really needed the support until I found it, and now it's difficult to imagine life without these individuals who make up this amazing community. We share honestly and do what we can for ourselves and anyone else who might be reading. There's a personally fulfilling sense of importance that I see in that.

While it's important for us within this community to recognize the DOC isn't for everyone, I think it's also important for those non-DOC folk to recognize the significance these friendships and story-telling experiences have on us. One way isn't better - they're just different and we're all doing what we think is best for us.

No one is perfect, and we all make mistakes and can learn from others. I learn a lot from my friends, find little tips and tidbits that end up benefiting my life. But just the same, many things don't work for me and I have no interest in adopting as my own. It goes to the phrase, Your Diabetes May Vary. It's important to recognize and respect that mantra.

Belittling someone's views doesn't help anyone, and it certainly doesn't help make your point seem valid. It just clutters the community discussion with negativity. If someone doesn't support your views and ideas, that doesn't mean he or she is wrong. There's no need to belittle each other, to bring personal attacks into a discussion simply because we have an issue with another person's perspective. That's just not what this is all about.

Sadly, the lines can become very blurred when it comes to personal blogs. These are places that allow us to say what we feel, where we basically don't have to censor ourselves and can "say it like it is" without holding back... Honest and open communication that takes on a life of its own.

The power we have is being open, welcoming, and embracing of all views whether we agree or not. There's always the potential to criticize and be negative, voicing our opinions behind a computer screen. But hopefully we can rise above that, and respect the idea of a community whether we're a part of one or not.

After all, we all live on this same hunk of rock in the middle of space and breath the same air.

Rinse and Repeat

2011-11-30T00:00:00.002-05:00

Bolus. Eat. BG Monitoring to follow.

Rinse & Repeat.

Just like I have for a lot of years.

Simply enough, right?

Not so much for me, apparently. At least not lately.

My newest habit appears to be forgetting at least one of those two important parts, totally throwing off the third leg of that three-part routine.

The monitoring part doesn’t exactly turn out the way it should, thanks to the lack of one of those key influences that makes the numbers go up and down.

Usually, it’s the first.

Taking insulin for breakfast before I head out of the house in the morning, and then walking out the door and forgetting to grab the toast, pastry or mini-muffins I’ve already bloused for.

Bolusing ahead of time for that morning trip to Starbucks and then, upon seeing a long time-stealing line at the drive-in and being too lazy to go inside, I cancel the plan despite.

Planning to make up for my earlier forgetfulness by grabbing a vending machine snack at work, yet realizing I have no spare chance or dollar bills on hand. And then totally getting side-tracked once I make it to my desk.

And so many more examples.

Of course, sometimes it’s the second carb-consuming part.

The whole carb calculation and eating food” part plays out fine, but it’s the forgetting to actually push the pump buttons and make sure the insulin is delivered that is the issue. And then not realizing there’s been a dose until the high BG hours later.

We’re not talking rocket science or memorizing the periodic table here… it’s simple cause and effect (what’s with the science blog talk…???). Should be too tough, yet it’s a common occurrence in my own D-Live.

And probably many others.

I often read posts and hear parents of Children With Diabetes come down on themselves for forgetting in one of those two ways and then feeling all guilty. Like they’re the “worst parents in the world” and it’s like some crime they’ve committed.

Hey, it happens. To us all. No matter the age. So, CWD ‘rents: It’s no big deal. You haven’t lost your superhero-ness. You still rule. (as I reassure myself of this simultaneously).

So are the days of our D-Lives.

Now, I’m off to check my CGM and meter to see if I’ve managed to miss a bolus or carb consumption any time recently…

Rinsing & Repeating.

Mountain Peaks and Ski Slopes

2011-11-28T00:00:00.045-05:00

I’ve never been a fan of skiing.

Cold weather isn’t my favorite, and I have no desire to climb toward the sky and then pretend I’m a snowball and plummet down a hill.

But the body apparently doesn’t agree with the mind. Or maybe my CGM didn’t get the memo.

It seems that my new Dexcom CGM (aka Johnny 5) is a fast fan of the ski slopes and mountainous terrain, evidenced by these snapshots from a recent 24-hour period.

Made it up to the very Highest peaks.

Broader Mountain View

Jumping Off The Mountain Edge

Time to ski down the slope...


A "smooth" path ahead, at least.

And J5 isn't lying. Well, at least not most of the time. About the trends.

The One Touch meter confirms it: there’s some internal body action going on, in the mountain-jumping and slope-riding sense. Apparently, that must mean my opposition to skiing is in the mind alone. The body and BGs don’t seem to agree, and are hitting the slopes every chance they get.

They appear to climb up High to get some kind of sugar-rush of just being up there. Then, my BGs dive down toward the ground all too quickly – sometimes not even telling me they’re stepping off the edge for the free fall.

A little off, but dipping down...

This usually happens in the evenings and night times, but periodically near the lunch-hour. They seem to cruise along at a safe and steady pace during the daytime hours, plotting the next mountain climbing and ski slope adventure.

Luckily, I’ve been able to catch myself before hitting the ground at full force – thanks to J5 and my other D-Management tools. Maybe, in a metaphoric sense, those gadgets and devices are like skis, equipping me with some ability to navigate the Ups and Downs and magically dodge the trees and obstacles that come flying toward me on the ride down.

Hmm. This can’t be luck. Maybe, there’s something else going on here.

(Looks down at feet to see if there are giant test strips strapped to my feet. Nothing there, but what is that there on the floor near my shoe...????)

Could it be? A little mini ski….!?!?!?)

Maybe I'm a skier after all.

Let's Go Blue

2011-11-26T16:14:00.001-05:00

Every Friday in November was devoted to wearing Blue.

A color meant for advocating the diabetes message and spreading awareness.

We had blue circles, clothes, wristbands, lighting, and everything you might think of.

So, with that logic in mind and continuing the blue-streak... How is it that there are actually people in the world who ARE NOT fans of the University of Michigan??? You know, the team that has the awesome chant "Let's Go Blue!"

Seriously. Everyone in the Diabetes Community should be Michigan fans. I think it's pretty clear.

Don't ya think?

Yep. Especially after Saturday when the Wolverines finally won The Game (at the Big House) for the first time since 2003.

C'mon. You know you wanna be a Wolverine fan.. just say it: "Let's Go Blue." See, you're already halfway there.

(wink and smile)

GO BLUE!!!

Introducing Johnny Five

2011-11-22T06:02:00.003-05:00

I have a Dexcom!

Yes, I'm now sporting my own little oval Continuous Glucose Monitor.

With that, I introduce you to my new friend who's taken on the name Johnny Five.

Yes, I name my D-devices - because if I must wear them with me all the time, then I might as well make it as fun as possible. This particular name comes from the fact that I'm an 80s movie fanatic and the Short Circuit movies are totally bolus-worth.

This isn't my first round at the Dexcom rodeo - I'd done a trial-test for a few weeks back in early 2010 and liked what I saw. Trial-tested the Navigator for a few days before that and then earlier this year used a loaner Minimed 523 for a few months before making a decision that the Dexcom could be a part of my life. There's pros and cons about each, and I say this one is better than nothing... so here we are on the grand ole CGM ride together.

Wearing Blue!!!

J5 arrived by UPS this past week, just in time for Blue Friday where we connected and posed for some photos. A full day at the office, then we went to a D-Camp gala on Friday night and had an "interesting" Low experience that evening - one that @TypeSuzi has already blogged about from her perspective.

Together with our friendly Minimed Paradigm 723 ("The Don of Rage Bolusing"), J5 and Crew are doing fantastical so far.

Mr. Johnny Five rests on my belt-line in a black leather case most of the day, and then when we get home J5 usually lounges on a nearby table or in my pocket before bedtime - when he strips off his case and sleeps on the nightstand. Ready to vibrate should I reach the higher-set level in the 200s.

Well, J5 caught the drop...

We are still on Sensor #1 and there's nothing to complain about. Trends are being caught, accuracy isn't all too bad most of the time, and overall I'm feeling more accountable in my D-Management and trying to not upset J5 and put him on a glucoaster ride. He hasn't had many ???s where he's basically said, "Malfunction. Need input." Nope, that's only happened once after I was cocooned in my bedspread and cutting off the transmitter signal.

So far, so good.

Hopefully, J5 can help me stay on track and get back to where I need to be and not dreading the Endo visit that I've been avoiding for way too long. Here's to a new day, with more input and a lower A1c down the road.

A Glimpse Into My WDD 2011

2011-11-15T05:00:00.014-05:00

The Indianapolis-version of World Diabetes Day on November 14, 2011.

My day, in blood sugar readings from start to finish: 352, 116, 65, 103, 154, 144, 143, 107

And then there was everything else, a few moments captured by camera-phone snapshot.

At the #adainwdd11 event in Indy


The Lilly Fountain, colored (aqua) blue.

Indy's Soldiers & Sailors Monument...

... lit up in blue - for Diabetes. NOT for the Colts.

The Blue Hair Challenge

Hanging with Charlie Kimball.

The Indy Blues Brothers of Diabetes??

BUT LASTLY, NO DIABETES EVENT IS COMPLETE WITHOUT....

D-DECORATED CUPCAKES!

Carb counts listed (each cupcake = 36g)!!!

It was a good day, indeed.

There was much advocacy. And just as much fun.

Now, it's time to let some of the blue soak out of the head before getting at the bigger lessons of this WDD 2011...

Boldly Blue

2011-11-11T14:19:00.001-05:00

We’re in the final days of the Big Blue Test, and we haven’t yet hit our goal of 8,000 people participating!

So, we need to get on that.

If you aren’t familiar, here’s the promo video below and some basic background can be found online at the Big Blue Test site.

Originally, I’d planned to participate every day between Nov. 1 and Nov. 14.

But I slacked and dropped the ball, and have only done a two-test and exercise routine a handful of times since Diabetes Awareness Month began.

Generally, my results haven’t changed much. A couple have gone down some, a couple have gone up.

Two tests stand out in my mind.

- On Sunday, Nov. 6, a Big Blue Test happened in downtown Indianapolis. Kim and her husband were in town from Nebraska for a friend’s wedding, and so Suzi and I along with Cherise and her daughter gathered in downtown Indy for brunch and to hangout. After eating, we tested outside the restaurant and then walked Monument Circle for about 15 minutes before testing again. Cherise captured some video, more video, even more video, and the post-exercise BG results on her Flip. (For the record: I was the only one whose numbers went up.) But at least we had fun and participated together!!

It doesn't say No #BigBlueTest

- On Thursday, Nov. 10, I took to the streets of Indy and ventured back to Monument Circle for my exercise. That meant jogging up and down the two dozen + steps for almost 20 minutes. Now, I don’t trust the change because I had a correction in my system from about an hour earlier… but the results I entered were 228 pre-jog and then 140 post-exercise. BONUS: a Monument security woman decided I apparently looked suspicious hanging around and jogging up and down the steps, and hassled me about loitering. A simple explanation cleared it up, but the whole notion of this being “loitering” just blew my mind. (Me to Security Lady: “No, actually I’m doing the Big Blue Test.” Her initial response: A blank stare.) I walked away. And then I went back and did the same thing on Friday.

Those are the most memorable experiences so far, but I believe this final weekend and the World Diabetes Day festivities may bring even more creativity and awesomeness – here and worldwide!

As of early Friday afternoon, 2,700 people had participated – 1,817 living with diabetes, and 881 not living with diabetes.

We need to boost our numbers over the weekend and as much as possible on World Diabetes Day on Monday!!!

I hadn't advertised or promoted this through my work much, but did that early on Friday and got a great response from my co-workers - some asking questions and saying they'd not only participate but spread word to those they know!

Even more than that, we now have some last-minute creative incentive to add to the mix of awesomeness that’s been going on out there in the Diabetes Community….

The other day, I was Twitter-taunting Todd Siesky who is PR manager at Roche Diagnostics – the main supporter and contributor behind the Big Blue Test. I proclaimed randomly that he should dye his hair blue. His response: “Such action could possible cause Earth to cease rotation...”

But that following morning, an email found its way to my Inbox saying that Todd had an idea, and that maybe this could be used as a creative motivator to get more participants in the Big Blue Test. A few more emails and the plan was born: If we don’t get to 7,000 participants by Noon on Monday, then Todd/Rob Mueller/and Manny Hernandez WON’T dye our hair BLUE or wear a wig and make crazy videos about it.

Manny has even done a little video explaining this "Blue Hair Challenge" that the Accu-check team is on board with! So that’s some additional motivation to participate right there. (I’ve also been informed that I’m not able to get past participating in this whole blue-hair experiment, either… Oh boy.)

And by extension, I believe this may just add to the bag of fun that so many in the Diabetes Online Community are dying their hair blue. While this could be scary, we hope it’s somehow fun and motivational. And an awareness-builder to just spark conversation and advocacy from all those we may come in contact with during our day on Monday.

Oh, and WEAR BLUE!!!!

So that's it. The things we do in the name of Diabetes Awareness…

One Promise Made

2011-11-10T03:00:00.005-05:00

Just like last year, I'm participating in the Promise To Remember Me Campaign and meeting with my area's elected leaders in Congress to discuss diabetes.

On Monday, a group of eight advocates came together to meet with Rep. Todd Rokita, a Republican congressman who's been in office for less than a year after winning in November 2010. In total, we had 130+ years of Type 1 experience either present or represented in the room.

Our group included three Adult Type 1s - myself, fellow DOCer Jeff Neitzel who was diagnosed 27 years ago at age 13, and another man diagnosed 26 years ago at age 14. Jeff's mom was also there, representing Jeff's sister who was diagnosed almost 40 years ago. We also had a grandmother, a mom, and a family whose 6-year old daughter was diagnosed at 16 months old.

See me there, in the back 4th from left... WEARING BLUE!!!!

Being a freshman lawmaker, Rokita hadn't before heard the JDRF pitch and wasn't familiar with the group. So, he got a brief intro of the history and mission. Then there was an update on the current status of the Artificial Pancreas and efforts to obtain guidance for outpatient clinical trials. Rokita asked some basic questions about the JDRF and its research funding, saying at one point he'd like to see more private sector funding of this research, and he also wanted to know about the number of people worldwide with Type 1 and what research has shown us to date about the causes and genetics.

We then went around the table and everyone described some their day-to-day struggles with type 1 diabetes, particularly in dealing with Lows. One mom told about her teenage daughter's Low earlier that day that meant she didn't feel up to attending the meeting. Another mom talked about her daughter's anxiety and night-time Lows. We shared some stories about the costs of supplies and insurance, how we don't have the ability to get some great help because of regulatory delays, and how we are trying to live successfully on the road to a cure.

At the end of our 30-minute discussion, the congressman addressed the three "asks" that we'd pitched: 1.) Joining the informational Diabetes Caucus on the House side; 2.) Putting focus on the FDA and its regulatory process in order to make sure diabetes technology, such as the artificial pancreas, is receiving adequate, timely, and effective review; 3.) Continued government funding for Type 1 research through the NIH.

Rokita made no promises about future research funding through the NIH, but his fiscally conservative and recent-election steam may dictate how he comes down on that. He told us point-blank that wouldn't join the House Diabetes Caucus as some of his colleagues in the state have, because so many of these informational caucuses exist and he’s only joined a select few. But on the third point, Rokita did promise to focus attention on the FDA regulatory process because he’s concerned about that issue and has heard from other constituents outside of the Diabetes Community that it’s a problem. He agreed to speak with FDA Commissioner Hamburg about the guidance document.

So, there's that. That third component - the FDA regulatory process - is the most pressing concern and what needs the most attention, so I count this meeting a win. The rest can get more attention down the road, but the most time-sensitive and significant issue appears to be getting Rokita's attention.

One out of three... Not bad. We can work on the remaining two "asks" down the road. There's time.

Hopefully, future Promise meetings will go just as well here in Indiana and I hope others are getting that kind of feedback and support from their elected leaders. The JDRF Advocacy arm is counting up the meetings nationwide, and as of my writing this at the end of Wednesday there have already been 235 meetings scheduled or held throughout the country. That means we only need 197 more to reach the goal of 432 by the year's end! You can find out more information about meetings or involvement in the Promise Campaign here.

Winds of Change

2011-11-09T12:04:00.002-05:00

A building is nestled at the heart of the city.

Driving into town, you see it standing there taller than others on the skyline.

Tall, strong, proud, confident, capable.

Even if it would rather blend in and not be noticed.

On its face, you can’t tell how the building feels inside.

One moment is bright, happy, radiated by sunlight.

Next it’s dim, depressed, gloomy as clouds above darken the view.

Every moment changes, as the wind blows and the clouds pass by overhead.

Hope with the sunshine, depression with the clouds. The two become one.

Soon, the clouded-view can't be escaped even when the sky is blue and the sun is everywhere.

Below, traffic moves on without noticing the shifting clouds above. Noise continues, traffic lights change, life moves on.

Even as the wind blows and the clouds dance on.

You may see a building standing tall. Strong. Sturdy. Withstanding the wind, even with the clouds occasionally interfering. But the wind is ever-present on the building’s face, in the soul.

Only those who are inside the building know that it shakes and tremors, and just wants to crumble. Yet, the building tries to hide it's true feelings out of fear of inadequacy, rejection, shame.

Someday, it may fall. Unless the structure's reinforced.

Where's the breaking point? No one knows. Not even the building.

It just goes on, each day. Enduring the wind, the clouds, the traffic passing by.

Only time will tell if the building has what it takes to withstand the winds of change.

Fighting for One

2011-11-07T00:37:00.009-05:00

The JDRF ran an ad in the New York Times and Wall Street Post on November 1, marking the start of Diabetes Awareness month and the push for more general public awareness about the FDA regulatory delays impacting our D-Lives.

As many reading this probably know, the ad said that one in twenty people with Type 1 will die from a low blood sugar. (YIKES!!!)

The JDRF ad, featuring Piper, age 8.

That 1:20 stat caught many off guard and generated a mixed response from those in our Diabetes Community, some agreeing with the point of the ad and some questioning the accuracy and source of that information as well as the overall intent of it.

In response, the JDRF offered a Q&A that cited several studies ranging from recent years and dating back decades. A forum discussion began, and then another, with Mr. Artificial Pancreas Aaron Kowalski (a longtime Type 1 himself) responding about the evidence behind the stat - that it comes from the cited data and a ratio describing the chances Type 1s face of possibly dying from a Low during a lifetime.

Much of it made sense and at first blush the cited data seemed to justify the advertisement. But something about it troubled me... There's some concern the 1:20 ratio is based on outdated, pre-1993 data when D-Management was much different. That the stat isn't accurate, or it's exaggerated and more accurately an "apples to oranges" comparison of information. Some believe the number is conservative, because we really don't know how many death-causing-Lows occur and the number is probably very under-reported in just the U.S. alone.

Maybe I just don't get it, because I'm not a numbers guy or a scientist. UPDATE: I did some basic calculating one night recently based on the studies cited by the JDRF in using this stat, and thought I proved to myself that the number wasn't reflective of reality. As it turned out, some misplaced decimal points and bad math doomed my math... (told you I was mathematically-challenged.)

Whatever. This isn't about the stat, really. It's about the reality that people die from these Lows way too often. That is a scary reality that those outside our Diabetes Community don't truly get.

THAT is why we need to do whatever we can to cut these blood sugar swings that lead to Highs and Lows. If we can't cure diabetes now, we need a way to curb these dangerous situations in the meantime.

No, this is not about the stat and it's accuracy, even though that's an issue connected to this and one that spawns a different discussion - about whether any statistical manipulation happens in these types of efforts and overall whether the end justifies the means. I don't pretend to know the answer to that, but do think there's legitimate arguments and concerns on both sides of the discussion.

To me, it's about doing what's necessary to play this game and get needed technology for our Diabetes Community. And to do what's needed, we need BOLD, STARTLING, and TO THE POINT:

Kids die. Adults die. All too often. And instead of bickering about the numbers reflecting the "actual" amount of deaths, we should be focusing on preventing any death that is preventable. Whether it's one, 20, or many hundreds and thousands of people.

Right now, we as a United States are failing to do that. We're behind the eight-ball, when other countries are using a piece of technology to save lives - studies and personal stories prove that. Technology is technology and isn't perfect, just as we aren't, but it helps and can prove life-saving.

The FDA is one of the big road blocks to making this happen. Not the only one, but a hurdle we have the most ability to influence and guide through this process successfully.

Simply, we need this public awareness in order to motivate our lawmakers and FDA regulators that this is important. They need to listen to our patient voices, because we're telling them about what OUR real concerns are and what matters to us most. We are the ones saying that what the FDA is asking about, what they seem to expect before offering approval, isn't what we People With Diabetes are thinking is most important.

We need this type of technology in order to save lives NOW, but also because of the potential it has to help us learn more about the bigger puzzle of diabetes. That knowledge helps us move closer to a real cure. Everything fits together, and as of right now the U.S. is behind where it could and should be in getting this technology out there for our benefit.

Whatever the rate-of-death-from-Lows may actually be, I know it’s too high and even the possibility of this happening is enough to warrant this kind of bold advertising. In my honest opinion. I've been lucky enough in my lifetime to not become one of those who've succumbed to a Low. God knows I’ve been close, on the edge of slipping into that ravine many times. But I've been pulled back, thanks to my own actions or those of my Loving and Supporting Spouse, my parents, and paramedics. Fortunately, I'm one of those 19 who have not died from a Low - and while that makes me happy to some degree, it makes me even sadder because it's not fair to know that there's even one person who hasn't been so lucky.

While I don't see eye to eye with the JDRF in some areas and disagree with the recent marketing push for a new logo, I see this newspaper ad effort as a positive and important one. So, that makes me happy to support this organization on this front.

All of us, and everyone out there in the world, can learn more about the Artificial Pancreas Project and can take action by signing a petition to encourage the FDA to move on this and prevent even more delay. We can make a difference, and it's important we do so in order to stop these deaths-by-Low Blood Sugar from happening however often that they do.

Marketing The Message

2011-11-01T03:00:00.009-04:00

The JDRF has a new message.

With it being November and Diabetes Awareness Month, the time has come for the marketing of that message to begin.

See Disclosure point in italics below

New tagline: Improving lives. Curing Type 1 Diabetes.

New logo: a blue hand with an extended index finger pointing in #1 –style, with T1D written on the finger.

The name is now, simply: JDRF. All words behind that have been eliminated, though it’s pretty obvious what the letters mean and it’s more of an attempt to market the “juvenile” out of the name in order to represent the broader Type 1 community.

I’ve written about this “culture sift” before, after attending JDRF Government Day in March and the third Roche Social Media Summitin June where JDRF CEO Jeffrey Brewer hinted about the coming changes.

Now, the time has arrived.

The JDRF chose the start of D-Awareness Month to unveil this new logo, and with it they have a new marketing campaign that's basically aimed around "Giving Type 1 the finger!" This is all coming out today on Nov. 1, which it’s dubbing the first annual T1Day to highlight the autoimmune condition so often misunderstood and confused with Type 2.

Disclosure: The JDRF National folk contacted me toward the end of October asking to send me some advance information about this T1D campaign (I assume this comes from being involved in JDRF Government Day back in March), and I provided my address. A package arrived with one of those foam fingers... They asked for my help spreading the word, to which I didn't agree or disagree to do. But I am and do plan to offer my honest opinion about all this.

Honestly, I’m not sure what I think about the new logo, tagline, accompanying videos and marketing campaign. I’m all for Diabetes Education and Awareness but some of this just seems a little, I don’t know, put through a PR spin-cycle rather than being authentic and real. Maybe I’ll ponder it for a bit, listen to the responses out there before writing more.

What does resonate right now is the passion, heart, and rationale behind this new marketing push.

Hearing Jeffrey Brewer’s voice earlier in the year, listening to him talk about why this was happening and getting at the feeling behind this change. That the entire Type 1 community, both young and older, are represented by the 40-year old organization that’s gone through more one than makeover over time. Really, it’s not the marketing push behind it. No, it’s the heart and soul of this organization that I feel closer to now than I’ve ever felt before.

This year. I’ve felt in my heart and brain a culture shift at the JDRF – both at the national level and in many of the local members of my own community here in Indiana. I’ve seen it spread through the online ripples, touching so many lives that need it. And truly, it’s inspirational and awesome being a part of all this.

But in many ways, seeing this passion play out at the local levels largely depends on where one might be located.

For example, it’s a problem when those of us in the Diabetes Community reach out to our local chapters and don’t get a response. Or when we do get an answer, but those chapter volunteers or leaders aren’t receptive to our needs. Or when the Adults simply go unnoticed and ignored, until fundraising time draws near. These types of scenarios happen in many places, and so whatever national may be marketing or advocating it’s simply not reaching the local levels.

This is a more fundamental problem that needs attention from both national and local levels, and no amount of logo or tagline marketing will solve it. I hope this emphasis on Type 1 will lead to more attention and gap-bridging in those areas that need it. I hope that the marketing of this message leads to more attention on the implementation of the mission that is so strongly embraced at the top levels and some places around the world.

That’s the hope. And I’ll do what I can to help facilitate that.

As far as awareness, aside from this marketing push, there's some important things happening and those deserve recognition.

The JDRF is advocating about the Artificial Pancreas Project, and on Wednesday (Nov. 2) at 2:30 p.m. there will be a press conference with a whole bunch of Congress members, diabetes clinicians, and PWDs urging the FDA to issue "clear and reasonable" guidance on the Artificial Pancreas. This will also include an "exciting announcement" about the said project petition.

This press conference will be live Tweeted, too - just follow along the hashtag #AP100k.

More generally, the JDRF will be posting ongoing Tweets and Facebook status updates at 1-minute past the hour throughout T1Day. One of the hashtags I've seen = #T1D.

So, that is what's on tap from the JDRF for the first day of Diabetes Awareness Month.

Let the marketing and media push of the real culture shift begin.

Halloween D-Fun

2011-10-31T00:00:00.000-04:00

Our annual JDRF Walk happened Saturday morning in downtown Indianapolis and we had a great time. Both Suzi and I walked, along with the Riley dog who's been excited to participate in past walks.

This was the latest it's been scheduled, and given the timing so close to Halloween the theme was "Say Boo To Diabetes." So, we had some fun and dressed the Riley Dog up in a D-themed costume.

She became an insulin pump. A "Puptronic 2011" pump, to be exact. All with a little homemade artistic magic by Suzi, using stick-on felt designs on a University of Michigan doggy coat.

The Manufacturing Process

Manufactured by @TypeSuzi

Excited to be an insulin pump!

Showing off her costume at the Walk!

Relaxing, just before the walk begins!

Posing with dad and the Animas pump guys.

Happy Dog, smiling for a photo!

And so that was our weekend walk. We had a blast, along with about 3,000 others.

Now, we're ready for Halloween.

As I've written in years' past, I have never felt that Halloween is about the candy. It's everything else. More important than the candy, I recall the fun times of the holiday. The costumes. Being with friends. The pre-season pumpkin carving, party-going, hayrides, and haunted houses. That was more exciting and memorable. We have the great movies: Garfield's Halloween Adventure, It's The Great Pumpkin, Charlie Brown; Night of the Living Dead and Return of the Living Dead. Of course, we have to have the candy bowl stocked and ready to go near the doorway.

However everyone else is planning to spend Halloween, hope it's a great one filled with some fun!

Happy Halloween!!!

The Message Behind Blue

2011-10-24T00:00:00.001-04:00

I plan on wearing blue on Fridays in November because it’s Diabetes Awareness Month.

The plan also extends to World Diabetes Day on Nov. 14.

Did so last year, and will continue that practice in 2011 and beyond.

Without a doubt.

Just like so many others in the ever-expanding Diabetes Online Community. As evidenced by this Facebook page and video created by Cherise.

Thanks, Mom! (@jath622)

But I’m not just planning to wrap myself in blue clothing, put blue attire on my dog, and watch for monuments and fellow diabetes advocates to “Go Blue.”

No, the plan is for more than that.

I want people to know WHY we are wearing blue. By people, I don't mean my fellow Knights of The Diabetes Jedi Order. I mean regular folk.

Simply, most people don’t know that someone wearing blue on a particular day, or even on a regular basis for a month, is doing it for any specific reason. They don’t get blue is the color representing diabetes. Heck, even the Diabetes Community itself can’t agree on a universal color (like breast cancer has with pink).

That has been my frustration before. Last year, I wrote a blog about how frustated it made me when the monument in downtown Indianapolis was lit up in blue on the Sunday of World Diabetes Day but how NO ONE grasped it was for diabetes. Rather, everyone thought it was in honor of the Indianapolis Colts who also don the color blue. There was no other signage or designation showing why it was lit up in blue, and so the potential for a great D-Awareness message was essentially lost.

Same thing happened on days when I wore a blue shirt, but managed to walk out the door without my little blue lapel pin. No one assumed I was wearing blue for a reason, and it's not like you're just going to run around town or your office declaring, "I'm wearing blue because November is the month of Diabetes Awareness and this is our color!!!" Most of the time, I remembered to wear my little Blue Circle of Advocacy on my shirt and that sparked some advocacy moments. The blue pin and wrist Act NOW bracelet actually spark questions, and allows for some real life advocacy moments where you can educate people who aren't familiar with this diabetes cause.

So, that's what I am planning again.

I'm hopeful that my local JDRF and ADA chapters will embrace both the blue color use and overall D-Awareness efforts, as well as my D-Camp organization and the local businesses in town such as Eli Lilly and Roche Diagnostics. Coordination is a key, and despite some efforts in the past number of months to make this happen, it's yet to fully come to fruition. Which I'm somewhat bummed about. I'm also not happy that I've been unable to receive any response from the City of Indianapolis to my inquiries about what more can be done to add context to the Blue Lighting of the Soldiers & Sailors Monument. We'll see what happens on these various fronts.

While I love the fact that so many in our community are embracing the color blue, and the message is so vibrantly "Wear Blue!," I do not want the message to get lost because we're preaching to the choir, that we're not simplifying this effort to those in the general non-D-world.

Maybe I live and work in a place where people don't go around asking why you're wearing blue, randomly. It's just not that special of a happening, in my world. So I don't want the message to be lost and will be doing what I can to make sure it's not.

What is that message? According to the IDF:

Love this Blue Circle frame!

"The significance of the blue symbol is overwhelmingly positive. Across cultures, the circle symbolizes life and health. The color blue reflects the sky that unites all nations. The blue circle signifies the unity of the global diabetes community in response to the diabetes pandemic."

As a color, blue also has specific meaning for those of us in the Diabetes Community - back before the home blood meter days when urine testing was the only way to determine where a PWD's BG was at, the color blue suggested normal blood sugar because the urine was free of glucose. This isn't to say anyone actually remember this and used it in the rationale for choosing blue.. but historically, it makes perfect sense for blue to be our color.

So there it is. Blue, it is. I'm ready for that message go global and more mainstream public.

An Awesome Community

2011-10-17T15:20:00.001-04:00

Don’t ever doubt that you make a difference.

One person, telling his or her story, is all it takes. That person can reach someone else when they might need it most. And change a life, in small or big ways.

That’s what Simon says the DOC has done for him.

That’s what the DOC has done for me.

And so many others echo that same sentiment, from online blogs and Twitter-chats to real life meetups in random settings. From 1-on-1 get togethers to large-scale “events” with groups of PWD.

You look around the roster of people who gathered from more than a dozen states, all in the name of one individual from Australia who seems to embody the spirit of this community so well. A friend, life-changer, and awesome person.

Most of us had a great time, and the words are just starting to trickle out of our hearts even as the thoughts and feelings are still being processed in our heads. Not everyone could be there live in person, but many could follow along online thanks to the technological wonders we have today and, more to the point, everyone in our community was there in spirit. This organic meeting of friends is something to write home about. It's worth recognizing, because it shows the power we have in each other's lives and what we are willing to do in order to see those who mean so much to us. Those in our own lives who've made such a difference.

For me, a 1,022-mile drive between Indy and Kansas City was the chance of a lifetime and well worth it.

Just being around these people is amazing, inspiring, supportive, motivating, happy-inducing.

Simply: AWESOME.

And that’s all there is to it.

Others have said written it so much better than I can, so if you haven't had the pleasure yet, please drop on by and read their thoughts on the multi-state experience that was #simonpalooza.

Victoria

Kim

Sara

Scott Strange

Babs

Bob

Allison

Jess

Others on the NYC arm, including Karen, Kerri and Briley

And of course, this incredible video:
You Make a Difference

Setting The Stage

2011-10-11T01:20:00.004-04:00

All I can say is WOW.

A weekend in Kansas City with a group of about 30 friends was beyond words, and so far I don't have the energy or ability to express the awesomeness of it in writing.

But, to start, i thought we could set the stage with some great photos:

There was Diet Coke...


Oh yes, there was.

@MHoskins2179

'I'm NOT addicted to Diet Coke. I can quit anytime I want.' - @scottkjohnson says, with 3 cans on table. #simonpalooza

9 Oct via Twitter for BlackBerry®

How'd YOU react seeing this after deboarding a plane???

Stunned or Scared?... :))

Then, there was the Airport Group Greeting:

<-------- US

SIMON!! ----->

Simon, overwhelmed to the point of needing to sit down.

The #Simonpalooza KC Leg's Airport Welcoming Group - Photo provided by Sara's Camera

After fun, food, more fun, and even more fun, we heard the rumors of Blunt Lancet actually be spotted on their tour!!!!

Jeff Mather, Kelly Rawlings, Kim Vlasnik, & Mr. Simonpalooza.

Before dinner on Saturday night in Kansas City, we even stumbled upon a a four-man quartet who decided to audition for the #simonpalooza tour!

They were impressed by the band name, Blunt Lancet...

The #simonpalooza KC Tour even had its own mascot for the weekend – BELLA!!

Becca on alert for Lows, with Heather.

It was truly a great time!

Most noteworthy, community and friendship were on display for everyone to see, in person or via the online universe, and it was simply spectacular.

More will be posted down the road, as I’m able to process everything and find the time and energy to get it into words. Hopefully, this sets the stage.

In the meantime, you can find great recaps in other places from those who were there. An essential starting point is Moments of Wonderful where Sara created an amazing video with a now-household D-Message: You Can Do This. You can find that here: http://momentsofwonderful.com/2011/10/293/

Another Day of Gremlins

2011-10-07T02:16:00.002-04:00

So, here we are again.

The day we write about anything EXCEPT that chronic condition that we are living with. No D Day, some might know it as. An annual tradition that's the brainchild of our own bacon-loving Ninjabetic. This means no blogging, Tweeting, or Facebooking statuses on that subject.

George describes it this way: "We are more than a disease, a lot more and tomorrow is a day to share some of that. There are many facets to each one of us and since we do talk so much about our D lives, we maybe miss some other cool stuff about each other. It’s not easy. It is a serious exercise to avoid all D talk but, I think it is a positive step in seeing that life is more than diabetes. We are more than diabetics or People With Diabetes. We give diabetes a lot of attention, let’s spend one day and give the rest of ourselves the spot light."

Many articulate No D Day posts can be found here.

But for me, it's a replay from the Corner Booth back in 2010, apparently.

Just like last year, I'd neglected to mark this on any calendar and didn't even remember it until earlier in the week, and I had little time to get my sass in line for a specific Non-D post. My mind rolls through ideas, trynig to find the best one: Pull one from the past? Write about journalism, or the future of newspapers? Politics? My Faith? Our homestate of Michigan? An Ode to Diet Coke? That Crazy Shadow Cat or Riley Dog? My Hoskins Family Genealogy Project that traces my roots back to Bartholomew Hoskins who came to America back in 1615...?

So many topics, but I couldn't settle on one as the time rolled toward the deadline.

This exercise began at 12 a.m., and as the midnight hour rolled around some questions began surfacing about how this all would practically play out: Is there a specific hash tag to use? Can we mention "diabetes" in our posts without actually writing about it? How much can we delve into this concept without crossing some line of actually delving into the topic we're meant to avoid? Oh, the mind games. And then there's those pesky time zones, which meant some of us in the Eastern and Middle parts of the country would hit the "No D-Day" roadblock before those to the West...

I began to feel like a Gremlin.

Instead of not being able to feed the cute little Mogwai after midnight, I wasn't able to post or write about my health. I thought about the food-stuck-in-the-teeth issue from the movie, and wondered what happened if I wrote something before 12a, but it got lost in cyberspace and then actually went online after the deadline. Pondering these issues and still struggling to pinpoint a particular post topic, I even managed to spill a glass of water on myself.

Luckily, there were no adverse effects as was the case with Gizmo and the Gremlins.

Up late, I wished I had thought about this earlier rather than dealing with it at such a late hour. With work deadlines hanging over my head, I staying up to write stories and the pressure was weighing down on me. At that point, it became painfully obvious that I was in need of a Flying DeLorean with a Flux Capacitor, to rewind time and got back to an earlier point in the week.

But, alas, here we are. Last year, when there were Gremlins In My House, I settled on Movie Quotes as my blog topic. This year, out of desperation, I'm turning to those handy-dandy bullet points for some quick, scattered bloggy thoughts:

Coffee, have lots of it. Sleep, need more. Stress, cut it out please. Oh, laughter makes it all seem better.

Words: My life is about writing, journalism. And at a twice-a-month newspaper, doing some freelance writing, blogging here, and doing countless emails and comments and Tweets each day.... my mind kinda melts when I think of how many words I must create each week. Sometimes, I just want to stop writing and not craft letters together.

But one combination of words that made me smile -> "cartoon ninja throwing spammers." That was a search time for my blog recently, and it made me grin. While I'm assuming this searcher meant to search for "spanners" or those ninja-hand tools, I couldn't help but picture it the way it was written. And yes, I do often want to throw email and tweet-feed spammers around... and having a ninja do it would be golden.

#simonpalooza. Two continents. Three states. An awesome Australian and many many friends. What more can one say??? Yes, I am traveling TODAY to Kansas City to meet with Simon, who is traveling to the U.S. for the first time ever. There's about two dozen of us in the Midwest, traveling from that area and surrounding states, and the epic adventures are guaranteed. Some tweeting is expected, so watch for common hashtags: #simonpalooza #BluntLancet #imintheband ... craziness will ensue. Follow some of us, including the star @STroyCrow over on Twitter. Blogging updates will be following before long, too.

Sadly, our last Tigers game back in 2009

Detroit: GO TIGERS!!! You knocked off those NY Yankees in the single-elimination Game 5 on Thursday evening, and now you advance to the American League Championship Series (ALCS). And of course, that first game is on Saturday... while above-mentioned #simonpalooza is ongoing. I'm a proud Detroit import, and am wearing the D logo with pride. Here's to hopefully getting to the World Series for the first time since 2006!

I love my wife, and while I'm very excited to be getting away for a weekend from real-life to hang with some great friends, I am sad to be away from her. She is one of my heroes, and I don't tell her that enough. Except on special occasions such as our anniversary, the sixth we celebrated back on Sept. 24. Miss you, but see you soon!

Who's that? Dean Martin and a Barelli sister...?

All of this talk about Detroit, hanging with my wife, and relaxing to watch some good TV made me reflect back on the recent three-part PBS series Prohibition... which we watched with interest and absolutely enjoyed. See, we grew up in Southeast Michigan in the suburbs not far from Detroit - our roots are there. I love history in general, and topics such as The Purple Gang from that era fascinate me. In fact, this all took us back to our days in the D and even a Halloween gathering about a decade ago where we donned our 1920s attire - we were straight out of the Prohibition era! Since it's now October and Halloween is quickly approaching, this seems like a good time to toss out into the public realm some photo evidence. See, there I am, a muckraking newspaperman with flask in hand with my lovely flapper by my side! And yes... I still own that hat.

Um, I think that's it. And my clock is after midnight... and all appears OK. Just gotta go downstairs and make sure there's no Gremlins hiding out in the kitchen.

So that's that.

Happy Weekend, my friends. See you on the flipside of KC!

The ‘Other’ Side of Community

2011-10-05T05:00:00.005-04:00

A simple message came across my Twitter-feed, in response to one I’d sent about an article regarding the idea of the Diabetes Online Community.

The individual on the other end of that Tweet was the article’s author, a respected pediatric endocrinologist who’s been Living With Type 1 diabetes for more than four decades and has been described as a luminary in the field of D-Management.

His message about the online D-Community: “Caveat Emptor!”

Or: “Let the buyer beware, when engaging in this potentially-dangerous online health community that might be trying to give medical advice or sell a product to those with diabetes. Online flash mobs are a risk, and they can certainly be a danger in the diabetes community as well.”

The Tweet that got me to the column/letter/article in a Texas newspaper in the first place: “With Diabetes Social Media sites there is potential for much good but also the potential for 'bad.' See if you agree:" Article link was here.

Clicking on the article, I saw a headline: “Be wary of diabetic-related social media sites.”

So I read. And some passages screamed out at me:

Social media sites for diabetes are enticing. People frustrated by brief contact with their doctor and not getting their calls returned or questions answered in a timely fashion will logically turn elsewhere for help. Getting a quick online response from a person you think has gone through what you are experiencing is very seductive.

The power to share common experiences is an overwhelming force. The dark side of social media in diabetes is its equally powerful potential to disseminate myth and misinformation. Health care professionals are involved with many sites, even if only as casual observers and not active content contributors. But even this is not meant to be a replacement for the attention provided by a health care professional who knows your medical history.

Social media applied to diabetes best fulfills the adage "double-edged sword."To quote another ancient wisdom: "caveat emptor": let the buyer beware.

Ok. First of all, I totally get that privacy is a concern when we’re talking about sharing anything online. Especially in the health care context, when medical decision-making and lives are on the line. That “be careful” message isn’t off base, at all - it's imperative. Not to mention in these days of widespread identity theft. But these warnings must be given in the correct context. While this uncertainty and hesitation certainly might be true on its face, and I wholeheartedly agree that people SHOULD be careful when it comes to online writing about health or otherwise, what bothered me about this article was that NOWHERE did it mention the D-Community that I’ve come to know and embrace in recent years.

Nowhere did it talk about a place where real stories are shared. A place of support. Friendship. Fun. Advocacy. Important context about the health care industry and regulatory environments. Yes, information and education and learning and adapting is a part of that… but that’s not really the “focus” – it’s about the people and connections, as a community. We are honest people sharing our experiences, not people out to make a buck or sell some snake oil (even though I understand these issues do exist online and do find their way into this community).

It makes me wonder: Has this person EVER ventured into this community? To an online site such as TuDiabetes or DiabetesDaily? Engaged in the blogosphere or #dsma discussions on Twitter? Has he ever experienced the support and community that our members share in, the sense of being part of something so “life-changing” and bigger than ourselves that it’s tough to even describe?

Certainly didn’t seem like it, from my reading of this article.

Seems like it may just be observations from a distance, general warnings localized for the diabetes readership, touching on this from the outside looking in.

And that’s a shame. Because the "good' of the online community needs to be better represented to those who might not be aware of what's out here. The article seemed to tell only half the story, glossing over the other side without even trying to balance out the overall point of what’s being written.

For me, it wasn't about answering a specific question about my diabetes; it was about offering a way to address the unspoken, oft-unrealized feeling of isolation that comes with a chronic condition. The sense that you're being taught the textbook management and living guidelines, but not how to actually live with it. When I stumbled across the DOC and began seeing it expand, it addressed that feeling that I’m not alone, that I can lean on friends when I’m feeling burnt out or down about my D-Life, and that being open and talking about my diabetes is an important part of coping that helps keep me accountable.

None of us proclaim to be doctors or experts, or “doctor replacements.” Most, if not all, of us have visible statements posted declaring this. There’s a simple mantra our community lives by: Your Diabetes May Vary. What works for you, may not work for me. We offer support and tell our stories. We do our best not to judge our fellow DOCers, unless someone specifically requests that or the situation warrants it.

All of the “dangers” that exist in this 21^st century model of interacting are very important, but you can’t ignore the other part of the story. The side to what good this does present to those who are open to it. I think it’s important to make sure that other side of the story is known so that people can see the life-changing positives the Diabetes Online Community offers.

Maybe this is what some in the medical profession see the community as - a place where dangerous medical advice and information is being doled out to the detriment of their patients. Maybe the risks don't outweigh the potential good, and so it's better to warn PWD about and not talk up the community online? I don't know. For me personally, the benefits far outweigh whatever vague, general risks might exist in a network of strangers.

I have no doubt there are "bad" apples and that caution is important. But we can't live our lives in fear of what could happen - because then we'll never experience any of those moments of wonderful that might be so close, so life-changing. That is something worth recognizing.

The Joslin Experience

2011-09-30T05:00:00.002-04:00

My mom was diagnosed with Type 1 when she was five years old back in 1958. She was recently able to travel to Boston to the Joslin Diabetes Center as part of the 50-Year Medalist Study, after being encouraged by her current endo Dr. Fred Whitehouse at Henry Ford up in Detroit. This is her account of that experience.

- - - - - - - - - - - - - - - - - - - - - - - - - - -

The 50 Year Medalist Study hopes to test about 1,000 people. I was number 652 in the testing process. Joslin has given out approximately 1,500 of the medals so far. When I received my medal in 2008, I did not volunteer to participate in this study. Since then, I've been encouraged by several people I hold in high regard to do so. Upon thinking about it and talking to the study coordinator, it seemed like maybe something good would come out of it.

Why are there people after 50 years with few or no complications and people after 10 years with major problems? Do some of us hold answers to things like this? Maybe we do and maybe these studies could lead to something positive in the future. When the study was first started, they didn’t really know that after 50 years, Type 1s produced any insulin – now we do, as a result. You have to look at this as a hopeful and positive experience, and think that something useful and good will come out of it.

That’s why I participated.

Before you go, you’re sent a detailed questionnaire about your life and medical history that takes about two hours to complete. You are flown to Boston and put up for one night in a hotel near the Joslin. You must fast for 10 hours before the testing. After you enter the Joslin Center, your height and weight are taken. You are given an ECG to study your heart function.

Next, the test called a Mixed Meal Tolerance Test (MMTT) is done. For this, an IV is inserted into your arm with a four line port. One line feeds saline through to keep the line open. The other three ports are used to hook blood tubes in at half hour intervals to withdraw the many tubes of blood that are needed. The total amount of blood taken is about 158 mLs over the two hour period. At the start of the testing, your insulin pump is stopped. Then you are given a Boost-type milkshake to drink within a 3 minute period, and the initial blood is taken. Blood is then taken every half hour for two hours total, your pump being off the whole time. The purpose is to see if your body makes any insulin. Some Type 1s, even after 50 years, still make insulin.

You also provide a urine sample. Another sample kit is shipped to your home for you to mail back a test tube of urine for a second test. These are for kidney function tests. Your eyes are dilated and examined by the retinologist, including having “eyeball pictures” (known as Optical Coherence Tomographs) obtained on each eye.

At the end of the testing that lasts approximately five hours total, you’re given a report from the retinologist and a copy of pretty pages of printouts of the eyeball pictures. The rest of the test results are mailed to you in about 2 weeks. This includes the lab work that was done, including the follow-up urine you mailed back to them.

You’re given the results of the MMTT, showing if you make any insulin. You are not given the results of this one test in writing but only orally. The reasoning behind this is that it is a very specialized c-peptide test. If you might be producing insulin and the results were given to your physician’s office, Joslin wouldn’t want anyone to ever be denied a pump because of this specialized test. Some insurance companies use a c-peptide as one criterion for a pump. Seems like a logical answer to me, knowing how insurance companies work. But this wouldn’t be a worry for me, as I didn’t make enough insulin to even register on the test.

Being at the Joslin is a unique experience for someone who has heard for many years that it is the epitome of good diabetes care. Although the current site is not the original location that Dr, Joslin lived and practiced (it’s about three miles away), there are some brilliant people working there today.

It is a large complex and it would be wonderful to have one place to go for everything – eye care right in the same place as the endo care. Although I live in a metropolitan area, my care is very spread out. It seems ideal to have it all together.

The 50 Year Medalist Study is a continually-evolving entity. When it started in 2005, blood tests and an eye exam were all that were done. The MMTT was added in 2009. They have done approximately 150 MMTTs to date. Each time something is added to the study, a new grant has to be applied for. So it’s not a quick process to add another test in. Once you become part of the study, participants are kept advised of new findings and results which come out of the study. They are also advised when new things are added into the study.

Ideally, Joslin wants you to return every three years to be retested so they can keep a running log on how you’re doing and what’s happening with your health. Also, if new tests are added, they will be able to give you the newly added tests. Another thing that is discussed briefly with participants is the organ donation program of the 50 year medalists. If you are willing to donate some of your organs upon your death, Joslin is doing studies of them. Papers are given to participants to take home and review for consideration.

Upon completion, I was given a T-shirt that says “50-Year Medalist” on the front and “50 years of success with Type 1 diabetes” on the back.

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Thanks for sharing this, mom. Your story and what I've heard from others, including a video put together over at Six Until Me, is very inspirational. Though I'm only in my 27th year of D-Living, I hope to reach that half-century milestone at some point and can only imagine what we'll know by then because of all this ongoing research now. Thanks for being a part of that bigger picture, and for what you do to help, love, and support me - then and now.

Please Play Nice

2011-09-22T12:44:00.002-04:00

Our driving experiences bring us together, typically twice a day. Sometimes more.

Insulin Pump: you stay fastened on my belt-line, keeping up my insulin fix as we travel along. You occasionally get to move around and escape that plastic holster, in times of coffee-bolusing or minor comfort-adjusting. That usually lets you brandish that tubing around with reckless abandon, and that’s a concern.

Seatbelt: the law tells me that you must stop hanging around when I’m behind the wheel. That means you have to get all clickety-snuggly in that slot to secure my safety, and usually equates to sharing personal space with Said Insulin Pump.

Obviously, I’m right there with you both. The Diabetic Driver who gets stuck in the middle as you try to wrap yourselves around me with care, all in the name of simultaneous driving and blood sugar safety.

I know. Things can get confusing, when we’re all jumbled together. Especially when we’re Already Running Late.

But you two must co-exist. There’ll be no tangle-dancing or knot-attempts, OK?

We aren’t rocking in tubeless patch pump world. And no magnet attaches my butt to the seat. It is what it is, and I need you both to recognize the pitfalls we can encounter on these regular rides.

No rough-housing, like we’ve had before. The kind that’s led to mass confusion and insulin set sacrifices. We’re in this together, and that means respecting boundaries.

So please, play nice.

And I promise to do my best in getting us to where we’re going.

Thank you, kindly.

Visible On My Own Terms

2011-09-19T00:22:00.004-04:00

So, last week was Invisible Illness Week and many of my friends in the online diabetes and health communities took to posting about this and answering 30 questions relating to their views on living with an invisible illness.

I didn't.

Life was busy. And I had enough real-world writing to do for my day job.

The weekend came, and as much as I appreciated reading the other posts and pondered doing up my own List of 30, I simply couldn't bring myself to do it. 30 is a lot, after all. And I'm not the greatest fans of just doing MeMes, anyhow (even though I wrote one up in 2010.)

But in reflecting on my own Type 1 diabetes over the weekend, it dawned on me: I actually did want to write something about this topic.

Simply, a message: My D was in fact INVISIBLE for most of last week, but it's not anymore in that same way. And it's by MY OWN choice.

See, I'd taken a pump hiatus a month or so ago. Tried one a year ago and had great success, and so I got to the point during the summer where it was time to try one again. Just a way to give my body a break from the every few day routine of connecting a new infusion set and going through that process. A mental break from pumping, a healthy "vacation" from that usual D-Management method, if you will. My life became one of a handful of shots a day. And in some ways, it was very freeing not being connected to a device 24/7.

One day, I saw another fellow Person With Diabetes outside my office building who had an insulin pump. He had a visible sign on his belt-line, but I didn't have my own pump to share and display. My diabetes was, even more than usual, "invisible" at that moment. I was Already Running Late and didn't have time to stop anyhow, so there was no meetup.

I'd been thinking about re-starting my pump, and this experience helped motivate me to re-start on my pump a day later. So, a few days into what was Invisible Illness Week, I made a move to make my diabetes not so invisible anymore. And it's once again something that is displayed for the world to see, should they choose. And if they don't just shrug it off as a pager...

So that's that.

I've now re-connected to the world of insulin pumping, and in a sense, here's me embracing this year's theme of “Deep Breath, Start Fresh."

Yes, I'm "normal" looking for all intensive purposes and for the most part my Type 1 diabetes doesn't present itself in situations where I don't want it to. Even when my pump is out there for all to see. It's important that my diabetes be something that is visible or invisible on my own terms. And though that sometimes isn't the case, most of the time it is. That is something I'm very grateful for.

And now, I choose to wear my pump again and make it a visible part of my life.

Five Weekend Words

2011-09-16T15:01:00.004-04:00

A friend and fellow D-Blogger had a post today about a recent Twitter-exchange that I'd missed out on. It inspired me to follow in those footsteps, with this post.

If you could customize your blood meter countdown (to replace the 5,4,3,2,1...), what would your 5 Words be?

Here are my top answers:

This Meter Will Self Destruct.
(Read: Blood Meter Nirvana = Mission Impossible)

Or:

Do you feel lucky, punk?
(Talking meter would say this in Clint Eastwood's Dirty Harry voice)

Possibly, could also be exchanged with:
"Go Ahead, Make My Day."

And Finally:

Turn Around Before Zombies Attack.

Possibly to be interchangeable with:

"They're Coming For You, Barbara."

(Because Diabetes and Zombies go hand in hand.)

What would your number-replacing-words be? Feel free to copy and paste your response to Jess's post. Or just not answer here if you've already done so at Me And D.

Happy Weekend!

Already Running Late

2011-09-14T22:05:00.005-04:00

I was running behind Wednesday morning.

Late to work, thanks to traffic woes. Courtesy of the construction on Indianapolis expressways and the drivers who simply shouldn't be allowed to take up space in the traffic lanes.

While I was going to be late, we're not talking an extraordinary amount of time - just enough to ensure that I'd be walking into an important meeting at work minutes after it was set to start. Or that I'd be responsible for delaying it. A phone call to let my boss I was en route and all seemed OK, but I wasn't eager to prolong my delay any more than necessary.

Finally made it downtown after the construction and congestion. Came to a halt on fourth floor of my parking garage. Sacrificed a quick moment to test, dreading the result (300+ mg/dL, in case you were wondering). Lifted my shirt and took my morning Lantus injection that I hadn't had time for earlier while still at home and also grabbed some skin to pinch for a correction bolus.

The fact that I was High just added to my mood, even if it was Wednesday (aka #dsma day) and cause for automatic D-Community Happiness. Composed myself and headed down, hopping down some stairs and then crossing a couple crosswalks toward my office building about two blocks away. The front door was just around the corner, meaning I was only moments from seeing my boss and colleagues in that morning meeting.

That's when I saw HIM.

A Random Guy At A Parking Meter.

He was a complete stranger, standing off on the side of the sidewalk feeding some money into the new parking meter boxes. Had never met him before... but on his belt line was something oh-so-familiar and made this man a member of my extended family: A blue-colored Minimed Paradigm insulin pump!!!!!

It was like a scene from Kerri's own blog, where you might not be surprised to hear the line "I See Pump People."

But this was my own world. And he was right there. Ten feet away, but getting closer as I hustle-walked along. Had I stretched out my arm, I could've grabbed his pump. Or smacked him on the back, like a long lost friend re-connecting after eons of being apart.

I really really really wanted to jump toward this D-peep, pointing like a nerd to his pump and screaming, "HEY THERE, FELLOW ADULT D-PEEP, NICE PARADIGM PUMP THERE! WHAT A SMALL WORLD!"

But I didn't. Instead, my mind moved quickly and tried to weigh the two things competing for my attention at that moment: the need to get to that important work meeting, and the incredible desire to meet a fellow PWD right there in Indianapolis.

Hmm. I was already late.. what harm would another couple minutes mean???? I could do a quick intro, say hello, offer a business card with contact details, and move on.

Yet, then it occurred to me that I was indeed still on a Pump Hiatus and wasn't wearing my insulin pump. Instead, I'd have to explain that and possibly even get into the why for this little break... Why I wasn't wearing any signs of my diabetes on the outside, and appeared to be just some random person.

My mind envisioned this imaginary conversation: introductions, pump-gawking explanation, and the rest of the conversation that could/would likely begin, despite my really not having time to talk. I flashed to that awkwardness of needing to get away quickly, even though I was the one who'd made the first connection.

So, I resisted the urge and kept walking. Eyed his pump as I walked by and tried to etch an image of his face in my mind for later reference... then got to my office and went inside. Because I was already late.

On the elevator ride up, I regretted not saying hello to this fellow PWD. But I committed to blogging about it. And then I found a cup of coffee and made my way into the meeting. Then had a busy day that didn't allow me to think about the missed D-encounter until getting home that evening.

And that's when I wrote this blog, about my Pump Person sighting from the Streets of Indy. We're apparently everywhere, us PWDs. And that must mean that there's a whole bunch of Nerd Parties of One going on, or we're all destined for the same shin-dig where tackle-hugs are par for the course. (Did some say FFL? Or Simonpalooza?? Adult D-Camp whaaa...???)

Anyhow. I end with a message to you, Mr. Pump-Wearer Who Feeds The Parking Meter on Pennsylvania:

"Sorry we couldn't connect today, but I hope we get that chance again... when neither of us are running late and there isn't a work priority already waiting. Steady BGs your way in the meantime, until the next encounter on the streets of Indy comes our way."

Carnival Time

2011-09-12T00:00:00.155-04:00

Summer has been pretty intense in terms of weather, personal and professional aspects of life, and diabetes in general. Very busy, chaotic, and up and down. Now that we're in September and Labor Day has come and gone, I've finally gotten a chance to reflect and slow down. I took some time to look back on Diabetes Blog Carnival entries - and apparently I've been delinquent on these posts for several months. So, here's a rundown of those entries I hadn't written for several months, making this a Summer Selection of D-Carnival posts.

For September, the entry is:

If I didn't laugh about the used blood test strips that follow me around, then I would be totally overwhelmed by the fact that I was being stalked by a line of bad D-decisions in my life.

You know, because those darn little strips are everywhere. On the floor. In my shoe. Beneath my desk. On floorboards of my car. Even in my coffee cup from time to time.

It's like they are trying to taunt me about all the things I do wrong... since it's pretty clear that "I am perfect... perfect at being imperfect."

The Diabetes Online Community has taught me humor as a coping mechanism, and I think that is why management in recent years has been so much "easier" to deal with than in the past. Laughter is the best coping mechanism, and in being able to keep a sense of humor and share that, I know that I am not alone and don't have to shoulder this life of d-management all by myself.

For August, the entry was:
Let’s discuss the lack of diabetes education, supplies and insulin for PWD’s living here and in other countries. What can we do?

In my opinion, so much of what can be done is being done already - just not across the board. We have so many scattered efforts in the real-world Diabetes Community, and we just haven't connected the dots in advocacy and story-telling to let the broader community know about what's being done. I think building our infrastructure is a way to get this done. Using tools such as DiabetesMine, the You Can Do This Project, patient-advocate communities and efforts such as TuDiabetes and Diabetes Advocates to connect these dots and tell what's happening. And then getting publications such as Diabetes Forecast, DiabetesLiving, diaTribe, and all those in the non-D community to spread word even more broadly.

For July, the entry was:

Over the years diabetes technology has come a very long way from the days when syringes were boiled and sharpened, and sugar was checked using droplets of urine and fizzy tablets in test tubes. Today we can choose from an array of blood sugar meters, insulin pumps, carb counting apps, data uploading programs – technology is woven into our diabetes lives. But although technology has come a long way there is always room for improvement, right? So this month give us your complaints, your ideas and your technological wishes and tell us: What improvements or adjustments would you make to current [diabetes] technology?

I'm really thinking that we need a D-technology app along the lines of a food-wine pairing... But instead of matching up the appropriate food and wine, it would match up our specific D-happening (Highs, Lows, Spouse Assistance, D-Meetup Planning, Camp Adventures, etc.) with a particular DOC resource. Example: I have a Low while at work, and this technology tosses my way a note about Kim's recent post on a related experience. Or I am getting involved in my local D-Camp, and it lets me know how Kerri's been a part of Camp Clara Barton. Or even that I'm curious about setting up a legislative meeting to talk diabetes with my Congress-person, and it alerts me to what Scott Johnson has done on this front.

Technology could very simply affirm patients that they are not alone, and prove it by connecting them with those who've gone through that same situation before.

That could be the latest and greatest thing, and it's only a matter of time... I'll await the news that this concept is pitched during the next DiabetesMine DesignChallenge.

For June, the entry was:

When it comes to diabetes, sometimes it seems things change more than they stay the same. Every so often, we may start to notice things going a bit out of whack and some new blood sugar patterns emerging. Part of being an informed and educated patient is learning to identify these problems. So this month we’d love to hear: What are the best resources you have used to help trouble shoot?

Without a doubt, it's the support of the Diabetes Online Community. Not only have I been able to find some new ones to cope and view certain situations, and expand my perspective and mindset about a particular issue, but I've learned new tools and tricks that I may have not known about before. Like how to fine-tune temp basals during the periods of exercise, times that I'd seen "super-charge" my body but I hadn't ever really recognized it before. Having that online resources of people who truly live with diabetes and "get it" has been so incredibly important and eye-opening.

For May, the entry was:

Friends, parents, spouses, care takers – we sometimes call them Type 3’s (or Type Awesomes) and they are the awesome people who support people with diabetes and help us in times of need. And sometimes those times of need turn into an experience that really makes us laugh later on. So this month, tell us: What is a funny diabetes experience you had with a Person Without Diabetes / supporter / T-Awesome?

Once, I thought my wife was an alien trying to force poison apple cider down my throat during a Low. Another time, I thought she was a Communist trying to torture me for being from the U.S.A. Those were some scary low situations that may have involved the paramedics being summoned to my home, but my wife was a trooper and did what was necessary - and now, we are able to laugh about those times. And every so often, she threatens to alert the Communist Aliens to come take me away when I'm acting up and not listening to her as I should... (she's such a team player; i.e. Loving and Supporting Spouse).

These posts have been my May-September entries in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information for the latest month over at http://diabetessocmed.com/category/dsma-blog-carnival/

Farmer and the D

2011-09-02T11:19:00.001-04:00

Are those CGM farm animals alerting farmer to a Low?!

I found myself singing this song recently, while sitting at my kitchen table:

"Lantus in the leg. Lantus in the leg. Hi-ho, the derry-o, a shot of Lantus in the leg."

Go on. Sing along. You know you want to.

Now, I can't tell you What the Fructose a dell or derry-o even are, sine I'm not a farmer and I didn't care enough to Google it. But I do know it's a catchy tune. So that's all there is to it.

(Humming to myself... Snapping my fingers to the beat.)

Now, just imagine what it'd be like if Old McDonald Had a D-Farm...

Diabetes Art Day 2011

2011-09-01T00:00:00.053-04:00

I'm happy to be participating in the second annual D-Art Day, created by the fabulous Lee Ann Thill from The Butter Compartment. You can visit this specific page to check out a roster of the many others who've created some fantastic d-themed art.

My pair of 2010 "Kitchen Creations" can be found here.

But for 2011, here are my two newest artsy-attempts....in an attempt to simply do what Lee Ann says: Create. Communicate. Connect.

So, enjoy!

Our D-Lives are a non-stop game of chess, made up of some of these pieces...

Diabetes on the Mind... sorry it's not the most clear. If only you could spin the computer as you read what's on my mind...

Oh, and I'd be remiss as a husband if I didn't mention the great D-Art creation made by Suzi, posted over at Laughter & Tears. Check her yummy masterpiece out, too!

To Those With Congressional Concerns

2011-08-29T02:35:00.000-04:00

As predicted, the whole Pump Hacking issue in the news has led to some of those unintended consequences we in the diabetes community feared.

Word came recently that two influential and high-ranking Congress members have taken an interest in this "pump hacking" issue and requested that the Government Accountability Office conduct a review of the Federal Communications Commission's (FCC) actions in regard to wireless medical devices. Both Democratic Reps. Anna G. Eshoo from California and Edward Markey from Massachusetts pushed this after reading about this "pump hacking" issue in the media.

So unfortunately, now comes the necessary response to not only these particular elected individuals but also to others who have a Congressional-voice and may be brought into all of this. I am sending the below letter to my own House and Senate leaders from Indiana, those who are on this committee, and to the FDA that is concerned with these issues. I encourage others to do the same to get the word out.

Also, what do you think of my letter? What needs to be addressed that isn't currently included, or re-phrased? Do you think that this kind of advocacy can make a difference? Thanks in advance for any feedback.

Dear Reps. Eshoo and Markey:

I’m writing to you both in regard to your recent letter to the U.S. Government Accountability Office on Aug. 15, which relates to your concern about wireless health technology security in response to recent media coverage.

As someone who’s been living with Type 1 diabetes for most of my life and has been using an insulin pump for a decade, this is an issue I have a personal interest in and believe warrants my writing to you both about this. I’m a patient-advocate who writes a personal diabetes blog and uses social media to share my story, and with that I wanted to take a moment to write to you about this topic.

First, thank you both for what you do generally and for specifically taking an interest in this important issue. I share your concern that wireless security be protected and these medical devices be secure, and that device makers and those in regulatory roles should ensure this happens.

However, I believe that currently happens and this “hacking” issue should not take away from those real-world concerns that already present a true danger. As you move forward, I hope that you ensure the focus of this review does not take away from the regulatory process that's already burdened by delays at the FDA level and puts the United States behind others worldwide in offering these types of medical device innovations.

While these “hacking” possibilities do theoretically exist in this 21st Century, I’m personally not concerned and have faith in the process we have reviewing these issues. I continue to trust that the medical device manufacturers are aware of these possibilities and address them accordingly, and that the FDA already addresses them thoroughly with existing regulatory procedures in place. Although a threat may exist in theory, the practical risk is non-existent and shouldn't be blown out of proportion. Please don’t let these far-fetched, unlikely scenarios hold up these valuable life-saving tools for those of us Living with Diabetes and facing these concerns every day. It’s so important for the FDA to prioritize these risk and evaluate them objectively, based on what the real concerns are.

For example, hypoglycemia is currently costing the lives of American children and adults – those high stakes mean that this guidance is incredibly important and must be done adequately as soon as possible, in order to not remain behind the rest of the world in providing innovative technology to protect lives. The FDA is studying something called Low Glucose Suspend, which is offered outside the U.S. and is proven to save lives. But that innovation is not offered here and the FDA has only recently started seriously exploring this issue; we need this option in our country because people are dying as a result of low blood sugars too often and this could help prevent that.

Even as that serious issue exists, few Congress members use their voice and influence to discuss it. Instead, you are focused on a matter that’s essentially next-to-impossible chance these devices will be hacked. That comes as many of your constituents struggle to get your attention on an even-broader matter that is incredibly important and time-sensitive.

Not only can the U.S. move forward on that technology aspect, we can also be a part of a bigger conversation worldwide about improving health and lives. The first-ever United Nations (UN) High-Level Summit on Non-Communicable Diseases (NCDs) happens Sept. 19-20, 2011, and heads of state from across the globe will meet in New York City to discuss important health issues such as diabetes, cancer, cardiovascular disease, and chronic respiratory diseases. A similar event in 2001 raised the profile of AIDS/HIV internationally, and the same must be done now. More can be found online here: http://www.ncdalliance.org. Unfortunately, neither President Barack Obama nor our country’s top leaders have expressed an interest in attending – even to just have a seat at the table to listen and learn, symbolizing to the world that we care about these issues even if we can’t officially support or commit to anything specific. That is a travesty that politics can trump over some so universally significant.

As a voter who observes all of this from the patient perspective, I am disappointed that members of my Congress are focusing so much energy and resources to these less-significant issues – even as higher-priority matters demand attention in the U.S. and abroad. I’d hope that senior members of the House Energy and Commerce Committee such as yourselves could help spread more awareness about this necessary balance and where our country’s attention should be focused.

I appreciate your consideration, and again for what you do overall. I’m also forwarding this letter on to other members of your committee and my own representatives in the House and Senate. I look forward to observing your reflection and support on these matters.

Most gratefully,

Michael Hoskins

Greenwood, IN

Don't Keep Swimming

2011-08-22T00:00:00.025-04:00

Somehow, there's a tell-tale sign that a suddenly-influential Low is creeping into my world while I'm at work:

“ I miss my dog.”

And that seemingly-innocent thought leads to all kinds of hypo-craziness, apparently.

That realization came earlier this week, actually on the EXACT SAME DAY that similar circumstances played out two years earlier. On a Thursday afternoon in mid-August, at 3:30 p.m.

Then: Aug. 18, 2009. Now: Aug. 20, 2011.

My parents happened to be visiting from out of town then, too.

Uncanny coincidences can’t even describe the eeriness of this latest example of Lows in the Workplace, that mirrored those that played out in 2009. These hypos can come out of nowhere and punch you in the gut. Or, as Kim from Texting My Pancreas says, it’s like you are being hit with a “huge Incredible Hulk fist made of concrete and carbonite.”

And so it was.

Just as before, I found myself at my desk thinking about my black lab, Riley. Missing her. Wanting to see her, jump around, wrestle and just have some fun. That led to suspiciously-unusual amounts of focus on this thought, and an eventual decision that maybe I should cut out early to make my way home to see her.

On that August afternoon in 2009, I tested and came out in the low 100s and all seemed OK. Even though I didn't feel totally cool, the test apparently proved otherwise and I was already pressed with work duties. I had something to take care of at 3:30p, and so I made my way out of the office - where the plummeting blood sugar soon caught up to me and presented itself. In the end, it was an experience I’d describe as one of the scariest in my life, and one that truly Changed My Life.

Not this time, though.

When this Low hit, I was ironically reading Kim’s latest post about Lows in the Workplace, when it all came together and clicked.

I’d had trouble focusing on my work, so tried a quick blog-read distraction despite my dropping BG. In mid-comment as the touchscreen buttons became more elusive and unclear, everything made sense in a moment: sweating merged with coldness, concentration evaporation, blurry vision. Rationale thought was nowhere to be found, even though I probably thought everything seemed completely normal at the time. I could keep working away and not be dissuaded, and just deal with the D-matter once my work was finished.

"I'm Fine," went through my mind (of course), followed closely by the thought of "Pay No Attention, All Is Well Here" and "Go About Your Regular Work-Tasks, Please."

Obviously, not. A blood test proved the point, and Skittles were my solution to the sudden 62 mg/dL.

Tried to stand up, and darn near fell over and caused a ruckus there in my office. Found some change and, despite seeing the multi-flavored glucose tab jar in my desk drawer there, decided that the break room vending machine would offer a better remedy. Stepping downstairs away from prying eyes, I inhaled the candy quickly – but not so fast as to sacrifice the chance to snap a quick Blackberry photo of my meter and Skittles posing together for Twitter distribution.

Not too long after that, things began to seem real again – that flurry of surrealness was passing and I made my way back to my desk to pick up where I’d left off earlier before plummeting. Back at my desk, I glanced at the calendar and it suddenly dawned on me: It was the SAME TIME as this type of thing happened before. Two years ago, in fact. That’s when a Low hit even more suddenly than it did this time, and despite trying to do everything right, too much went wrong.

I’m glad it didn’t get too bad this time.

Just an annoying happening, likely a causality of two specific events: 1. That being my 3rd day of a Pump Hiatus where I’ve returned temporarily to twice-a-day Lantus shots and Multiple Daily Injections of Humalog boluses; and 2.) Pressing work deadlines that day that kept me on my toes but led to skipping lunch. I’d been hurrying all day, telling myself to press on and that I could easily do. Maybe even subconsciously telling myself “You CAN do it” and diabetes wouldn’t “hold me back” this time. Hindsight is 20/20, obviously. But at the time it made perfect sense for my tunnel-vision type of workday.

Stories like this are scary and not cool, but they seem to happen to so many of us PWD. Why do we do this type of thing, thinking we're "fine" when we'r really not? Maybe someday someone will provide a clear answer to this psychological D-mystery. The best we can do is deal with it as needed rather than trying to “just keep swimming” until a later time… because soon enough, we may find ourselves drowning as a result. Better to find that live jacket while we still have the strength to swim.

Hopefully, in the future, I'll recognize my severe dog-missing and lack of focus as clear signs that it's time to test and do something, as happened this round.

Post Apocalypse D-Management

2011-08-19T00:00:00.007-04:00

We were watching the disaster-themed movie marathon on Sci Fi recently, and a crazy D-scenario came to mind: What if THAT particular apocalyptic situation played out and those of us People With Diabetes had to maneuver our own survival? Hmm.

This particular flick was a 2009 TV-movie Polar Storm, with the plot basically being that a comet collides with Earth and knocks the planet of its axis, throwing off its magnetic field and causing some crazy EMP bursts that randomly appear and short any electronic device going at the time. So, any cars or cell phones - and anyone touching those at the time of the burst - would pretty much be out of luck.

(Disclaimer: the fact that I was actually watching this movie should in no way signal my endorsement for others to watch it, or hint that my thumbs are in any way pointing upwards when describing the quality of this screen-writing... It was just a way to pass some time without having to exercise the mind. Seriously.)

Anyhow. As some of this transpired on the screen, I glanced at Suzi and wondered aloud: "So, let's say hypothetically this really happened... would my insulin pump be affected? Would I have to disconnect it?" We speculated that would probably be the case. A few minutes later, a character with a pacemaker saw that very scenario play out and leave him dead on the street. Our suspicions were confirmed, indeed.

So, if a meteor ever crashes into Earth and throws off the magnetic field, guess I'll be unhooking the insulin pump and going the syringe-and-vial route.

Or, maybe I'm already in apocalypse-prep since I recently went on another Pump Hiatus and am a few days into that Multiple Daily Injection routine again. Nothing against my pump, just pretty much the same reasons as mentioned last year when I took a needed break - mentally and emotionally - from my trusty pump. Hoping I can lower my A1C again by a whole % point just like before!

Even if I can't, at least I'll be working toward better management more diligently.

And, you know, will be ready for D-Management Post Apocalypse Style. This is not to be confused with the Zombie Apocalypse, that I'm already prepared for with my arsenal of lancets. Now, D-Mom and I need to fashion some sort of lancet-shooting device to combat the zombies... that's a work in progress and options are being explored.

Hopefully, whatever the end-of-the-world disaster may be, it holds off until I can bring my BGs down... or something like that.

He Does The Beta Cell Bash

2011-08-17T00:00:00.002-04:00

One of my fellow Diabetes Advocates Cara recently came up with a great idea to reach more people outside of the diabetes online universe and bring them into this community. Her "Your Voice" project is a wonderfully-clever spin on guest-blogging and a way we can all embrace to expand the DOC's reach and bring more people into this outstanding community of connections and support.

This guest post comes from Michael K. Schwab, a 51-year old Type 1 diagnosed almost four decades ago who I had the pleasure of meeting at an Adult D-Meetup in Indianapolis earlier this year. We got to talking about careers, music, and exercise and he agreed to guest-blog for me about his own adventures from career choices, exercise fun, and musical talent. Let's just say: You've all heard The Monster Mash... well, here's a guy who's going to make The Beta Cell Bash the newest thing for the D-World (something that very well may make him eligible for a future Blunt Lancet Tour or upcoming D-Prom-A-Palooza some day!)

You can find Mike over on Facebook, and as well as at The Indiana Cure Chasers since he's the coach of the JDRF Ride Team Indiana. So, with that - take it away, Mike!

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Death Valley ride in Oct. 2010

My sister asked me recently how often I checked my glucose when after first being diagnosed with Type in March 1973, and she seemed astounded when I replied that, I went to my endo every three months and he’d draw a tube of blood and let me know the results the next day. A lot has changed since then. I can’t remember the last time that I had to pee in a cup and do my in vitro urine test. While it’s been a gravel road at times during these 38 years, I count myself lucky to still be what I like to call an “original equipment” diabetic (meaning no complications or replacement parts).

Currently, I work in a business to business sales position for a musical import company and sell musical things to music stores to make my house payment. But it didn't start off that way.

When graduating from Purdue in 1983, there weren’t a lot of jobs available at the time. I managed to get hired for an Industrial Engineering position, but flunked the physical when the company doctor found out I was T1 and had a 7.1 A1C (a brand new test at the time). My general practitioner at the time told the company doctor I was basically a walking time bomb, so instead I became an Over the Road Trucker for 14 years, and spent a dozen of those years driving with the woman that I was married to for 24 years. Up until the last few years that we trucked, the DOT had not allowed insulin-dependent diabetics to operate tractor trailers, so it wasn’t something I made known.

A few years previous to our exodus from the trucking biz, we began doing music. I taught myself how to play guitar when I was 32. In short, getting out of the truck allowed us to pursue music on a more serious level. We started a gothic band, were able to garner some radio airplay, and toured regionally until 1998 when we jumped genres and did what a lot of people described as Celtic-Goth-Alt-Rock. Eventually, we evolved into a Celtic Acoustic Rock Band.

It was through the band that I started pumping in about 2002, after hiring a drummer who was on a pump and talked me into trying something new. I had a lot of trepidation and was worried about ripping out the infusion site (which I do), that I would be hard on the casing (which I am), but all in all it has turned out to be a stellar piece of T1 control equipment! That was about 10 years ago and while I still take the occasional short breaks from my R2D2 unit and go back to Lantus and Humalog, I’m very happy to be a pumper!

Playing at Victory Field in Indy in 2000

In 2004, we decided to use the band to found a fundraising event we dubbed, “The Beta Cell Bash” and raise money for the JDRF Ride Team. At the time, this cycling team was doing a single venue event in Death Valley where each member of the team would raise $5,000 or more for the privilege of riding 105 miles in the hottest, driest desert in North America. The event lasted for 3 years until the break up of the band in late 2006, with our final show in late November after a great run of more than 1,500 shows, coast to coast tours, getting an award from Billboard Magazine, multiple year finalists in the JP Folks International songwriting contest, and playing in front of audiences that most musicians only dream about! We were able to go out on top in front of a sold out crowd at Radio Radio in Broad Ripple (Indiana).

But when we went out at the end of that year, it led me to a new adventure that has turned into a passion for endurance exercise – all to help out the D-Cause!

I’ve always been active, which may have been my saving grace with my T1 and general avoidance of complications. During the trucking years, we lifted weights 5-6 times every week and competed in power-lifting. Later, I somehow fell in love with cycling and endurance sports in general. In fact, I’m now a triathlete (A.K.A. a triabetic) and am currently working towards a long term goal of qualifying for the world championship Ford Ironman event in Kona, Hawaii.

My cycling has gone from two 100+ mile events to a plan for at least eight events this year and another eight in training rides. My yearly mileage hovers around 7-8,000 miles and my longest single day ride to date was in July when I rode 165 miles between Indiana’s state lines. Also, I’m preparing right now for my 4^th Death Valley century ride this October and I am coaching the JDRF Indiana Ride Team. What a turn for the good my life has taken since November 2006, when Beta Cell Bash ended!

Now, we’re exploring the possibility of bringing back The Beta Cell Bash for 2012 – we’ll see what the future holds!

A D-Camp Director's Insight

2011-08-15T00:00:00.000-04:00

Badge created by Meredith from With a Side of Insulin

One of my fellow Diabetes Advocates Cara recently came up with a great idea to reach more people outside of the diabetes online universe and bring them into this community. Her "Your Voice Project" is a wonderfully-clever spin on guest-blogging and something we can all embrace to expand the DOC's reach and bring more people into this outstanding community of support. So, I asked Cara if I could point some of my upcoming guest-posters from my own D-Community offline and she agreed that'd be cool.

So, here's the first: Jenna Holt, a 24-year old Type 1 diagnosed about seven years ago and the newest leader of the Diabetes Youth Foundation of Indiana that runs the Camp Until A Cure. You can find her on Facebook, and with that I'll let Jenna take it away:

- - - - - - - - - - - - - -

I was diagnosed late in the game, at age 17. People liked to comment on whether it was easier being older and able to understand what was going on, or if by knowing a different lifestyle my whole life was harder to change. Well, after contemplating it for a while, I decided that neither is worse than the other. It was simply a change to be dealt with. What was hard was being different. An example: going to volleyball practice and being told that I was lazy by teammates when my sugars would drop below 50 because I would have to sit out and treat from exercise. I was still rather new at “living with diabetes,” but lazy was not a characteristic used to describe me. I was the only one in my school with diabetes, which meant a lot of confusion and myths. This continued through college. I didn’t really go out of my way to find a support group or people who were like me. I knew who I was, had great friends (most knew I was diabetic but not enough to be a resource), and was enjoying life. I guess I was old enough to take care of myself and not worry about finding others who could understand, who could empathize versus sympathizing.

But the Diabetes Youth Foundation of Indiana changed my life three years ago, and it can be summed up in three words: passion, hope, and inspiration.

I found out about an organization that runs a camp for children with Type 1 (just like me.) I jumped at the opportunity to get involved. Year One I was a counselor, talk about an indescribable experience. I had worked with kids all my life, although I took a different path from teaching. I am convinced that kids are better teachers than most adults I know. That being said, Year Two with DYFI brought me back as the Diabetes Education Instructor. The previous statement about children being teachers still held true - Not only are these kids resilient, but they are intelligent. They have to be.

This past January, I became the DYFI’s executive director. In all my time working with the camp, I was greeted by several counselors and staff “just like me.” These people understood what was going on when I was cranky (one of my defaults of being low), and I finally fit in. Maybe this is where my goal of reaching out to more children and teens with Type 1 has become such a focus of my new position with DYFI. I know there are kids out there who are just like me. In fact, I have had the privilege of meeting some of them. I would like to believe that what you don’t know doesn’t hurt you; however, I always felt something was missing. I was right.

This past camp season proved to be nothing short of amazing. We had over 180 kids from all over Indiana and a few other states who came together to enjoy being kids while learning about how to properly take care of their disease; and yes, this includes diet. With over 30 new campers, our DYFI family grew! Watching them learn from each other and form lasting friendships is something that is hard to put into words. Imagine that one moment in your life that gave you goose bumps, where you realized that something was taking place, something bigger than cheap thrills or material items. That moment where you felt a renewed hope, a feeling of inspiration. This is the best way to describe those three weeks of camp.

Mike asked me if I’ve had any lows while at camp, and there have been for sure! Last year, we had our sugars posted in the Diabetes Ed room for all the kids to see and ask questions. I had some lows and some highs, as did all the staff. I never had an extreme low, but last year I do remember having to go to the infirmary to get some glucose-- there was one day I couldn't keep my sugars up. I would keep track of the (six D-member) staff's sugars before breakfast, lunch, dinner, and bedtime and this gave kids the opportunity to say "Hey, you had a high... how come?"

See, even PWDs CAN skydive!

Overall, DYFI is an amazing organization. Part of what makes this organization so great: it’s family members. The kids, the parents, the staff, the volunteers, the supporters, the board members, the family and friends of these people, those who take a stand against myths and negative perceptions in the community all make up this family. Growing up in a rather small family, I always dreamed of having a bigger one. Without even realizing it at the time, my dream came true. I now spend my time working to serve this family. Through fundraising, grant writing, frequenting support groups, and any other opportunity that comes my way, I hope to be able to raise more money and reach more kids – particularly kids who may be feeling what I was feeling. I don’t think I could ask for a better way to spend my time.

Passion is something that will take you farther than anything else. This is a passionate family with a passionate director. With this combination, DYFI will inevitably continue to serve children and their families. Like I mentioned previously, DYFI has changed my life. It is my hope to help change the lives of others in the community.

Focusing on Hope

2011-08-12T00:00:00.009-04:00

We remember, and in your memory we focus on the future...

Those in the Diabetes Community who we've lost too early.

Most recently.

And over time.

Then, there are those shining beacons that we've lost from outside the D-World, whose lives and spirits touch us all.

Eleanor Josaitis, co-founder of Focus: HOPE in Detroit, who was a beacon of hope for that community and died Aug. 9.

Even in loss, we go on.

"I pray for the wisdom to listen,
and the courage to act."

- Eleanor Josaitis, of Focus: HOPE in Detroit.

Dear FDA

2011-08-10T00:00:00.013-04:00

Finally, the FDA is exploring a diabetes innovation that is long overdue: Low Glucose Suspend. Basically, the CGM-component allowing an insulin pump to detect what your blood sugar is at and shut off it reaches a certain threshold that's too Low for comfort. This allows someone who may very well be sleeping overnight to not drop any lower with continued insulin before being able to treat, wake up, or at least become aware that something isn't right.

Worldwide, this is already available and the U.S. is simply behind - mostly because of the FDA's reluctance to approve this and ask the important questions to assess why this option is so necessary.

But now, that's happening. The FDA has released some draft guidelines that are up for public comment, and want to hear what everyone thinks about the proposal. Bennet over at YDMV has a great write-up about this, and he is just one of the many Diabetes Advocates who's hoping the broader Diabetes Community will get word about this and make our collective-patient voice heard on this.

What they're looking at includes how they should allow Low Glucose Suspend, how that might stop delivery of insulin to people who've already had too much insulin or are already Low, and how a system that cuts off insulin might increase risk of raising one's Hemoglobin A1C over time with higher BGs.

To post to the FDR public docket go here: http://www.regulations.gov/#!submitComment;D=FDA-2011-D-0464-0001.

Everyone is also encouraged to copy their comment into an email or letter to the elected officials at both the state legislature and Congressional levels, so that more eyes are brought into all of this. Below is a copy of what I've sent to the FDA and am mailing to my elected representatives.

Dear FDA...

One of my greatest fears as someone who lives with Type 1 diabetes, is not waking up because of a Low blood sugar. Local paramedics have made multiple trips to my home because of overnight Lows that have resulted from an inbalance in my blood sugars, issues that have occurred without any warning despite all the management care that I take each day and night. Even with the multiple blood tests, meal management, and accurate insulin dosage, Low blood sugars happen and have dropped me so low that I am not able to wake up or function on my own. They have caused me to thrash and even become violent, hallucinating and trying to harm my wife as she tries to get more fast-acting sugar into my system to counter this hypoglycemia.

Both children and adults with Type 1 diabetes have died as a result of these overnight hypoglycemic events, and even those happening during the daytime hours, causing them to lose awareness suddenly without warning.

One way to prevent these tragedies and potential risk would be a Low Glucose Suspend, an option that is currently available on insulin pumps outside of the United States. These work effectively and save lives, however this is not available in the U.S. because of the FDA’s regulatory review process. If someone is going Low in the night but does not realize and have the ability to wake up to suspend his or her insulin delivery, then this Low Glucose Suspend system would allow that person to have a safety net preventing them from continuing to receive insulin – dropping them even lower and into a possible coma.

I am pleased that the FDA is finally considering this, and do hope the realistic concerns of people with diabetes are addressed – the hypos and the balance of juggling these Highs and Lows in our daily lives. Not the slight increases in Hemoglobin A1c numbers, which are just one indication of a person’s D-management and really mean nothing if that person dies from an overnight low.

Our A1c tests are not perfect, and are simply one resource in a very large and ever-expanding tool box that we use to manage our diabetes efficiently and practically. Living with diabetes is preferable to dying because of diabetes, something that is more likely now as a result of not having this Low Glucose Suspend capability.

As a country, our current regulatory system preventing this life-saving option means we are behind the eight ball on this technology and losing innovation and dollars to other places globally that have Low Glucose Suspend available. I’m hopeful that the FDA develops guidelines bringing us more in line with what’s available worldwide, and also aids in the development of future innovations such as the Artificial Pancreas.

Since the FDA started taking comments on this topic, some news reports have circulated about potential risks to those using wireless medical devices such as insulin pumps and continuous glucose monitors. While these “hacking” possibilities do theoretically exist in this 21st Century, I’m not concerned and have faith in the process you have reviewing these issues. I continue to trust that the medical device manufacturers are aware of these possibilities and address them accordingly. While a threat may exist in theory, the risk is non-existent and shouldn't be blown out of proportion. Please don’t let these far-fetched, unlikely scenarios hold up these valuable life-saving tools for those of us Living With Diabetes and facing these concerns every day. It’s so important for the FDA to prioritize these risk and evaluate them objectively, based on what the real concerns are for those using these devices. Hypoglycemia is currently costing the lives of American children and adults – those high stakes mean that this guidance is incredibly important and must be done adequately as soon as possible, in order to not remain behind the rest of the world in providing innovative technology to protect lives.

Thank you kindly,

Me.
(A Pancreatically-Challenged Taxpayer Who Loves Cupcakes and CAN Eat Ice Cream while preparing for the Zombie Apocalypse.)

Hacking Into Real Concerns

2011-08-08T07:00:00.003-04:00

So, there was this hacker’s conference in Las Vegas recently.

That was where Jay Radcliffe, a security researcher and fellow Type 1 diabetic, gave a presentation about his findings that someone could remotely hack into insulin pumps and continuous glucose monitors to manipulate data and even control the devices.

Some specialty publications picked up the story, as did the Associated Press and then basically the same story ran in a number of newspapers nationwide, including U.S.A Today. Eventually TV media-players like Fox and CBS picked it up with their own variations, too. Headlines and stories reiterated the basic point of what Jay said at the conference: 'Hackers can do this to kill people using these devices, and we should all be concerned."

This issue came up earlier in the year with an MSNBC article on hackable medical devices, and this is the latest highlighting a topic that may very well be possible and a concern for those of us using these devices.

That's where we are now. This has all sparked discussion about how Jay presented his findings about this security flaw, the realistic concerns this may or may not present, the media portrayal of all this, and potential unintended consequences this could have on public perception, the regulatory review process, and our patient-community that needs and lives with this kind of technology every day.

Frankly, I’m a little split on this whole issue. First, I am not even sure how I feel about Jay's presenting this at the conference and giving the media a “pump-attack” story in the first place. Would it be different if he discovered this and just blogged about it online? Should he have kept it hush-hush and just contacted the device manufacturer(s) without letting the masses know? Is this reasonable proactive awareness on a potential security flaw, or a needless scare tactic being used to prove a point?

I've read that Jay used some sensational skull-and-crossbone images to promote this at the hacker's conference, and contacted the press ahead of time. And it does appear that this was self-promotional, rather than a "protect my fellow PWD" message... But I don't know. It's tough and I am torn. But really, that's not the point. The media response to all of this is.

From what I’ve read, pretty much all of the articles – whether it be the specialty hacker/techie publications or the mainstream newspaper stories – seem balanced and fair. They are essentially reporting on what Jay presented on. The AP story that ended up nationwide didn’t "sensationalize" the story, or do what that terms means when it comes to media sensationalism, and it doesn't strike me as an example of irresponsibly playing this up. It focused on Jay's research/presentation, offered responses from the FDA and medical device industry, and included objective perspective from another researcher on this type of thing. I don't see anything editorially or journalistically wrong with that.

They are reporting on a story, just as a local reporter would write about a local county government meeting where someone does a Power Point on how rezoning a property will lead to mass development years down the road - you are just reporting on what they tell you and getting the different sides. Even if the readers disagree with the rezoning and what one person says future development might look like, and the readers despise the fact that anyone would even discuss this in the first place, it's still information that is worth getting out to people so they can use their own minds to decide for themselves whether it's an issue or not.

Here, Jay said publicly that he hacked his pump and others could do the same, that it could be done to kill someone. The media isn’t overplaying anything; just reporting on what he said is possible. Two examples stand out, from what I’ve seen published online: CBS and a techie blog that do seem to use overly-sensational language to make the point. While I don’t like that on its face, even those writings overall balanced things out in their coverage based on what Jay put out there.

We can’t shoot the messenger; in this case that's the media and even Jay Radcliffe. Just because he talked about it and the media wrote a story, and people may react negatively to it and it could have unintended consequences, doesn't mean the story shouldn't have been told or written.

This comment from the MSNBC article sums up my feelings on this, i think:

"Pretending a problem doesn't exist is a great way to turn it into a crisis. Security through obfuscation is a joke and a policy that has been discarded by every decent security researcher in the field. Sticking your head in the sand doesn't solve anything and it is only (through) identifying problems openly that solutions can be developed and deployed."

However, I think the Diabetes Community does need to be concerned now with any potential unintended consequences from all of this. I do think we need to keep perspective on how minimal this really is as far as something to be concerned about when talking about D-devices. My response would go something like this:

1. Medical device makers - we trust you in recognizing these issues and addressing them as needed.

2. FDA: We hope you will hold companies responsible in addressing these issues, but not needlessly hold up technology when a company has addressed these potential concerns. This isn't a practical issue for anyone who uses these devices, and shouldn't overshadow the real world problems the diabetes community faces without these products and the developing innovations out there. Overnight lows, swinging blood sugars, and long-term complications resulting from these BG issues are what the focus should be when evaluating the devices.

3. Media: Please maintain the practice of fair and balanced coverage, both on the potential security risks as well as the practicality and FDA response to all of this. Let’s not sacrifice accuracy in order to sell more papers or get more viewers or page visits. That is our responsibility, as the Fourth Estate. We need to make sure this doesn't become a big deal, when it's really not.

4. Insulin pump users: Calm down. This really isn't a big deal. Avoiding Lows and DKA are much more important. Oh, and making sure the TSA isn’t needlessly hassling us and our fellow PWDs with over-the-line security procedures.

These are just my views. Others have and are writing about this from their perspectives, as well – I encourage you to read those posts. Some of those include:

- Manny Hernandez at TuDiabetes reached out to the medical manufacturers for a response, and so far he's posted this Q&A with Medtronic and then this one from Animas.

- Bennet over at Your Diabetes May Vary wrote about this.

- Kerri at Six Until Me has a great interview recap with Jay Radcliffe himself.

- Scott Hanselman also has a more tech-specific analysis of this issue and the initial media coverage.

- Kelly Booth over at Trials & Tribulations has also written on this topic.

- Pearlsa shares some thoughts on this, since she blogs at A Girl and Her Reflections.
-D-Dad Matt at Type 1 Online talks about this from his view as the parent of a CWD, and as someone in the IT industry.
- Bennet also has this brilliant post going at how we should keep this all in perspective, and not get overly concerned about this when the reality doesn't dictate it as a big deal.
- Sara's post at Moments of Wonderful talks about the hackers that really don't care about us.
- Scott Strange has a simple message, that the threat is real but the risk is essentially non-existent.

You can also follow discussions on Twitter using #pumphack as a hashtag.

Overall, I agree that the D-Community should get our collective voice out there to the medical device makers that we trust them to handle this, and to the FDA that this isn't what they should be worrying about because it’s really not that big of an issue in the bigger picture. The focus shouldn't shift from the benefits, and true live and death dangers that exist by NOT having these resources available.

Take That

2011-08-06T17:22:00.006-04:00

Yes, I CAN eat ice cream.

Loved this hot fudge sundae, with a cherry on top...

(SWAG = 50g -> I'll leave your mind working on how that D-Math worked out...)

Take THAT, Wendell!

And THIS...

See that window to the right there? I believe that's the office of a certain publisher...

So, Take THAT Southside Times...

Even on your own FRONT STEPS, I have no problem eating ice cream.

And so can the rest of the Diabetes Community.

Not matter what you say or write, those of us Living With Diabetes are more than capable of eating ice cream even as we do what we do in managing our D-Lives and overall health effectively.

DON'T tell us otherwise, or pretend to know what's best for OUR worlds.

This is what I think of your writing...

Thanks for playing.

Cutting Clinical Trial Red Tape

2011-08-04T00:00:00.000-04:00

A news story came out recently in the Washington Post, discussing the federal government's proposed sweeping revisions to the rules governing scientific research on human subjects. Apparently, this is the first change in two decades to the "Common Rule" that governs nearly all human-clinical research financed by taxpayers and it protects those in the trenches doing this work while also streamlining the oversight and paperwork required of scientists.

Here's a news release on that from the HHS on this rule revision. That release says this:

The current regulations governing human subject research were developed years ago when research was predominantly conducted at universities, colleges, and medical institutions, and each study generally took place at only a single site. Expansion of human subject research into many new scientific disciplines and venues and an increase in multi-site studies have highlighted ambiguities in the current rules and have led to questions about whether the current regulatory framework is effectively keeping up with the needs of researchers and research subjects.

Revisions to the current regulations are now being considered because HHS believes these changes will strengthen protections for research subjects in a number of important ways.

Comment is sought on the following:

Revising the existing risk-based framework to more accurately calibrate the level of review to the level of risk.
Using a single Institutional Review Board review for all domestic sites of multi-site studies.
Updating the forms and processes used for informed consent.
Establishing mandatory data security and information protection standards for all studies involving identifiable or potentially identifiable data.
Implementing a systematic approach to the collection and analysis of data on unanticipated problems and adverse events across all trials to harmonize the complicated array of definitions and reporting requirements, and to make the collection of data more efficient.
Extending federal regulatory protections to apply to all research conducted at U.S. institutions receiving funding from the Common Rule agencies.
Providing uniform guidance on federal regulations.

Honestly, most of that went over my head. I truly don't understand what it means, for those researching, conducting clinical trials, or participating on the other side of that research. Curious about the impact of this in the diabetes research arena, I took the question to a someone I know who has a better idea what this might mean to us.

That is Indiana University researcher Patrick T. Fueger in the Department of Pediatrics, whose diabetes research focuses on pancreatic beta cells and islet proliferation.

He says, "This could be a great thing. I’d have to read the proposal in its entirety to be certain of that. The whole process to get a study approved is filled with red tape. The proposal seems to minimize that while maintaining the protection of human subjects. The biggest benefit will be streamlining research that uses surveys and interviews. Right now, you have to get your survey approved and if you change one question (even just deleting it) you have to get a new approval. You have to talk about the risks of filling out a survey. I think I did one once and listed paper cuts as a potential risk to the study participants. Most researchers are pretty ethical and police each other in many ways. Streamlining the approval process and cutting out some red tape is a welcome update to this facet of research."

Nothing is final at this point. Published on July 25 in the Federal Register, public comments are being accepted for a 60-day period. It's listed as an Advance Notice of Proposed Rulemaking (ANPRM), entitled Human Subjects Research Protections: Enhancing Protections for Research Subjects and Reducing Burden, Delay, and Ambiguity for Investigators. Comments can be submitted here, using the ID number HHS-OPHS-2011-0005.

Ants Crawling All Over Me

2011-08-01T00:00:00.020-04:00

Ever feel like something’s crawling on you?

That's how I have been feeling lately. And it drives me nuts.

My mind is trying to convince me that there are ants crawling on my feet, lower legs, and even upper legs and arms.

Late last week, the Diabetes Online Community got a glimpse of my craziness when I randomly tweeted:

GET OFF ME!!!! (Me at desk, yelling at imaginary ants crawling on my arm...)

Yes, that's what it felt like.

However, there haven't actually been ants crawling on me... Instead, this has been a mirage created in my mind by the return of mild neuropathy. An unwelcome acquaintance who's crashed my D-Life party in the past, and sadly appears to be back knocking at the door in the form of those annoying imaginary ants. You may recall the story of my Burning Toe and how I've handled the on-fire feeling in the past. Lately, it's not reached the level of shooting pain or burning. Rather, the neuropathy's been presenting itself through a tingling sensation. The kind where it feels as though something (read: ANTS) are crawling on me. On my toes. Feet. Legs.

Everywhere, whether I'm sitting on the couch, at the kitchen table, laying in bed, or at my desk in the office. It's a bit unnerving. And it freaks me the Eff out.

But that's what I want to tell you about, because that's why I got into this whole blogging about my diabetes thing in the 1st place. To tell those "real" stories about what these early signs of complications are really like and how people just like me are dealing. Not the horror stories focusing on fear and “amputation” and “death.” I wanted to hear the versions that doctors never told me about what D-Complications actually feel like before those extreme end-game stages.

Actually, back in 2005 as a newly-married guy, those early toe-tingling and foot burning experiences from early neuropathy is what took me online to search for those just like me. And that's how I found Kerri and so many more of those real stories my soul was searching for. And so much more.

So, maybe this all means it's a good time for me to share my own real story about this.

About what it's like when it physically feels like there are bugs crawling on you, but you know there's something more medically sinister at work. About how you then ponder the other D-Complications that could be crawling around unnoticed inside, lurking and waiting to show themselves. Is there more going on... What about the fact that I can barely wear contacts anymore as I once did, thanks to weakened eyes and the mild retinopathy that still lingers? Or how my teeth and gums are wounded soldiers in the war-zone that is my mouth, a battlefield plagued by strained nerves and root-canal welcoming forces? Or my drowning mental state that everyday tries to stay afloat, even while carrying the heavy bricks of depression and worry? Or all the other issues that may or may not be actually connected to diabetes but make me feel like I'm fighting a losing battle.

Good. Bad. Ugly. And Everything in Between.

Including this one, about the D-Complication we'll refer to as Bugs of the Mind.

Now, some relevant info that pertains to these metaphoric insects: I'm sure that the actual presence of ants in my house hasn't helped. They swarmed earlier in the year and times before that, and we went all Chuck Norris on them with an Ant Elimination Plan. They went away. But now they've returned with the recent heat-wave, and on several occasions in the past week or so I've seen them in the sinks, on counter tops, and even on the living room couch and floor. A couple times, a stray ant has accosted me and made the daring attempt to scatter across my skin. I've aimed to execute these loan scouts, and searched for hidden base camps in the usual or even unlikely spots in the house - but have found no widespread invasions like before. Of course, all of this has convinced me I'm surrounded by ants and am under constant attack - even though I know that's not actually the case.

That fuels the mind games that Ants Crawling All Over Me.

I've written before that this D-Complication has appeared as a warning sign that my D-Management is in need of improvement, and so that's what I'm going with here. No need at this point to turn to any medication, as I'd done years ago when the pain was impacting life. My BGs have been all over the place, making even regular glucoaster rides on D-Coaster Day look like a calm line. Bringing Larry The Loaner CGM back into my life briefly has been helping lately, and hopefully soon that leads to the symptoms calming down.

This CGM may very well be a Mental D-Ant killer. Or so I'm hoping... because honestly, this all bugs the crap out of me and makes my skin crawl.

The Microwave Knows

2011-07-29T00:00:00.004-04:00

Even kitchen appliances have diabetes on the mind, it seems.

One evening, my CGM sensor died. Time to start a new one... But I didn't want to.

So, I procrastinated. Did whatever, and soon enough decided to have some some leftover coffee.

Grabbed a coffee cup from the cupboard and poured some cold coffee into it, then proceeded to heat up said cup of java in the microwave.

And that's when I saw it:


Yes, that IS a BluntLancet coffee mug.

Scrolling Microwave Message: "Sensor... Error."

When heating up my coffee, in a BluntLancet mug displaying the "Error 5 - Not Enough Blood" message. Apparently, the microwave knew I needed to change my CGM sensor.

So it told me so with a message of its own: "Sensor Error."

I glared at it. "Who told YOU?!?!" I demanded.

The microwave didn't respond. A cold, judgmental staring contest ensued.

Slammed the microwave door shut, to teach it a lesson.

(sigh)

Diabetes is everywhere. Even the coffee cups and kitchen appliances think so.

There's no escape.

Media Missing The Point

2011-07-27T00:00:00.018-04:00

Newspapers and "the media" makes mistakes all the time. Particularly when it comes to covering diabetes.

The most recent example can be found in one of my own local weekly newspapers, The Southside Times, and a columnist named Wendell Fowler. The Diabetes Community has responded in force to the original column July 15, the response column July 22, and publisher's letter. Everyone has pointed out how Fowler and the newspaper basically sacrificed accuracy to fuel a particular message. In doing so, the writer and publication dragged a local organization's name and reputation down and then failed to specifically apologize for that. Rather, both defended the premise of what had been originally been written and went on to blame the readers for "misunderstanding" the point - and went on to say it was all opinion and everyone is entitled to theirs.

No. I'm sorry. That's not what journalism is about. If you're a newspaper or media outlet it's your duty to make sure that accuracy, fairness, and balance are represented by everything - objective news content, editorials, or submitted opinion-writing. Because PEOPLE listen to that message, and aren't supposed to just assume to know what you mean.

In this case, the newspaper did try to achieve "balance" on its second-week response by running an entire column by a local man, who's not only a longtime Type 1 but is also a medical researcher in diabetes and is on the DYFI board of directors with me. There was balance here. But the fairness element required in journalism totally didn't exist here.

I've written my responses online and in personal communications to Wendell Fowler and the publisher, as well as others at the newspaper, but have yet to receive a response. Which is a travesty in itself, since Journalism 101 teaches entry-level reporters that the first thing you do is call someone back.

All of this has truly depressed me, not only as someone who lives with diabetes but also as a newspaper guy. This isn't the first myth-perpetuating media mistake that we've had to endure. It sadly won't be the last. But it's important for the community to respond to these issues, from local newspaper coverage like this, Chicago Tribune writing about some pseudo D-Civil War, to Oprah's ghastly on-air segment that totally got it wrong and then Ricki Lake's on air blunder (to which she specifically apologized for).

These things happen all too often, but we do our best to speak up and demand accountability.

I've heard some say recently, that it's pointless to try and raise a fuss about these media mishaps. In part because they'll keep happening regardless. Because we're just "feeding their egos" and bumping up page views, not changing any views on these "lost causes" who are going to think the same thing no matter what the response may be.

That bothers me. Mostly, because I'm a media guy. My view: We have voices, and it's important to use them. Otherwise, why even bother having those voices? I think it's important to speak up on these things.

As a reporter, I hate it when errors occur - from typos to misquotes to misinterpretations. Last thing I want to hear is that I got something wrong... but it happens. We're human and are bound to screw up. One thing to keep in mind, though, is that just because someone calls me up and says they believe something IS wrong, doesn't necessarily mean it IS wrong. That claim must be checked, as should everything in a story or column -> (Think: "Your mother says she loves you, well prove it."). But if a correction or clarification is needed, or even a written or in-person apology is needed, that's not something we should turn away from. After all, it's a matter of credibility.

Addition: I'm a member of the media. Newspaper reporter style. Someone who went to J-School and strongly believes in watchdog journalism that gets people what they need to know in order to have the ability to decide for themselves. As someone who's worked in the past for a weekly newspaper and a 6-day daily newspaper and am now several years into a twice-a-month speciality paper, I know the hurdles regular reporters face - always on deadline for Web and print, more phone calls, less time... Reporters just don't have the time to truly understand what they are writing about. That's not an excuse for crappy journalism, but it's an incredibly important reason we must understand for why our quality of journalism has failed on every possible topic - including diabetes. The public is fickle and doesn't have time, so they want it quick and now. And that (coupled with costs and revenue woes in the profession) creates this pressure system on our Fourth Estate. So, we need to help them. We need to find those local people who illustrate the numbers and the trends about diabetes. We need to give them notice, and follow-up even when the editors aren't convinced. We need to do our part as people who actually know WTFructose we're talking about.

Some area already having this discussion. Diabetes Advocates has also been talking about Diabetes Media Awareness, pondering how we could create a Patient-Created Fact Sheet to send to media outlets when the need surfaces. Or being pro-active about it, before any bad coverage comes out. There's also been talk about creating a Speaker's Bureau where some advocates can go out and specifically address this media awareness issue - that's something my local American Diabetes Association chapter for Indiana is doing and I'm excited to see what comes from that effort.

So, what do you think? What can we do individually or as a community to address these issues, and where's the line between advocacy and media awareness and just stomping our feet in a disgruntled way that doesn't really change anything? What do you do as far as media awareness on diabetes, and what works and doesn't work? How do you see the JDRF, ADA, local D-Camps, businesses/pharma fitting into all this?

An Important Anniversary

2011-07-26T00:00:00.012-04:00

This is the 21^st anniversary of the landmark civil rights law known as the Americans with Disabilities Act, which guarantees equal opportunity for those with disabilities in employment, public accommodations, transportation, commercial facilities, and telecommunications, and state and local government services. President George W. Bush signed this into law on July 26, 1990.

Borrowing the definition of "disability" from Section 504 of the Rehabilitation Act of 1973, the ADA aimed to stop employers from making employment decisions based on a person’s current, past, or perceived disability.

Diabetes traditionally fell under that umbrella of protection for nearly a decade, but sadly starting in about 1999 the Supreme Court of the United States dramatically scaled back the ADA definition to the point where it didn't protect certain individuals, such as those of us with diabetes. Basically, the Court ruled that someone could be considered too disabled by an employer to get a job, but not disabled enough by the courts to be protected by the ADA from discrimination - specifically because a particular condition can be controlled by medication or is in remission.

Suddenly, people with diabetes could be discriminated against at work but receive no protection as a direct result of their diabetes being a condition that can be controlled.

An amendment in 2008 brought that protection back for the Diabetes Community, as well as those living with other conditions such as epilepsy, cancer, cerebral palsy, multiple sclerosis, and other disabilities.

These discriminatory acts of diabetes do happen, unfortunately, even with the ADA in place. Fortunately, we have advocates and attorneys like Kriss Halpern, who recently wrote an outstanding guest-blog over at Diabetes Mine - I encourage you to read that if you haven't, particularly given the anniversary we're marking now.

Doing just that, the president is using his voice to recognize that anniversary and what the Act provides. He issued this on Monday:

Presidential Proclamation--Anniversary of the Americans with Disabilities Act

Generations of Americans with disabilities have improved our country in countless ways. Refusing to accept the world as it was, they have torn down the barriers that prohibited them from fully realizing the American dream. Their tireless efforts led to the enactment of the Americans with Disabilities Act (ADA), one of the most comprehensive pieces of civil rights legislation in our Nation's history. On this day, we celebrate the 21st anniversary of the ADA and the progress we have made, and we reaffirm our commitment to ensure equal opportunity for all Americans.

Each day, people living with disabilities make immeasurable contributions to the diversity and vitality of our communities. Nearly one in five Americans lives with a disability. They are our family members and friends, neighbors and colleagues, and business and civic leaders. Since the passing of the ADA, persons with disabilities are leading fuller lives in neighborhoods that are more accessible and have greater access to new technologies. In our classrooms, young people with disabilities now enjoy the same educational opportunities as their peers and are gaining the tools necessary to reach their greatest potential.

Despite these advancements, there is more work to be done, and my Administration remains committed to ending all forms of discrimination and upholding the rights of Americans with disabilities. The Department of Justice continues to strengthen enforcement of the ADA by ensuring that persons with disabilities have access to community-based services that allow them to lead independent lives in the communities of their choosing. Under provisions of the Affordable Care Act, insurers will no longer be able to engage in the discriminatory practice of denying coverage based on pre-existing conditions, and Americans with disabilities will have greater control over their health care choices. And last year, I signed an Executive Order establishing the Federal Government as a model employer forindividuals with disabilities, placing a special focus onrecruitment and retention of public servants with disabilities across Federal agencies.

Through the ADA, America was the first country in the world to comprehensively declare equality for citizens with disabilities. To continue promoting these principles, we have joined in signing the Convention on the Rights of Persons with Disabilities. At its core, this Convention promotes equality. It seeks to ensure that persons with disabilities enjoy the same rights and opportunities as all people, and are able to lead their lives as do other individuals.

Eventual ratification of this Convention would represent another important step in our forty-plus years of protecting disability rights. It would offer us a platform to encourage other countries to join and implement the Convention. Broad implementation would mean greater protections and benefits abroad for millions of Americans with disabilities, including our veterans, who travel, conduct business, study, reside, or retire overseas. In encouraging other countries to join and implement the Convention, we also could help level the playing field to the benefit of American companies, who already meet high standards under United States domestic law. Improved disabilities standards abroad would also afford American businesses increased opportunities to export innovative products and technologies, stimulating job creation at home.

Equal access, equal opportunity, and the freedom to make of our lives what we will are principles upon which our Nation was founded, and they continue to guide our efforts to perfect our Union. Together, we can ensure our country is not deprived of the full talents and contributions of the approximately 54 million Americans living with disabilities, and we will move forward with the work of providing pathways to opportunity to all of our people.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim Tuesday, July 26, 2011, the Anniversary of the Americans with Disabilities Act. I encourage Americans across our Nation to celebrate the 21st anniversary of this civil rights law and the many contributions of individuals with disabilities.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-fifth day of July, in the year of our Lord two thousand eleven, and of the Independence of the United States of America the two hundred and thirty-sixth.

BARACK OBAMA

Focus on ME

2011-07-25T00:00:00.008-04:00

A newsletter came in the mail the other day from our local county-owned hospital.

This is a place that I haven't been to in years, the last time being for a non- D emergency about five years ago. I saw an Endo affiliated with this hospital back when we'd first moved to Indiana in 2004, but that was only for a couple years and I later switched to a different Endo affiliated with a larger hospital outside of the county we live in, but closer to our home than where this county hospital is located.

But despite those changes, I continue to receive semi-regular mailings from the county hospital. I glance at most of them, flipping through and reading about whatever the local health-care topic may be. Then toss them in the recycling bin.

The latest newsletter for Summer 2011, called Focus on You, grabbed my attention immediately.

This wasn't tailored for me specifically, it was just a newsletter the hospital sends out to all those on the mailing list. But it did apply specifically to me, as it focused on diabetes right there on the cover.

So, I read it. Very remedial for longtime Type 1s, but nonetheless a good informative piece for those who might need it. Nothing wrong with it at all, and I was pleased to see it. AND, I learned something and took a couple things from it...

That little orange box on the cover caught my eye, stating: A recent study by the U.S. government found that many adult diabetics are not doing everything they can to prevent the long-term health consequences of diabetes." In the article, the writer says that study by the Agency for Healthcare Research and Quality (AHRQ) found that 58% of diabetics are missing at least one of three crucial tests: Hemoglobin A1c, Dilated Eye Exam, and Foot Exam. Now, I've not looked up this study or information to verify or learn more, but it seems on its face to a pretty reasonable finding.

That made me think about how I've been avoiding my Endo and having the latest A1c done, mostly because I know it's going to be higher and I know what needs to be done; I just haven't been motivated to stop slacking and get my management butt in gear. I had a dilated eye exam back in March, but didn't follow-up as the eye doc had wanted... So I need to do that too. Foot exams come with the Endo visit, and I've already addressed that...

The newsletter also mentioned how the National Institute of Diabetes and Digestive and Kidney Diseases also recommends regular tests on cholesterol levels, kidney function, and blood pressure. While the newsletter certainly didn't present any new mind-blowing information, it did include that tidbit of 58% of diabetics not doing what they should on the prevention front - and reminds me that as of now, I'm one of those slackers. So there's that.

Then, one of the columns inside the newsletter lists the upcoming classes and events - one of those is a Diabetes Support Group for PWDs, family and friends, that a local R.N. hosts. That could be just another way to take all the online D-Advocacy offline to another forum, and find some others locally to meet and talk to.

So, thank you local hospital I don't go to for anything anymore. Glad to be on your mailing list and get info like this. But mostly, thanks for getting good helpful info out there!

Enough Said

2011-07-22T06:00:00.003-04:00

Totally don't care what the carb-count on this is...

It's damn hot outside, demonstrated by my recent Tweet on Thursday:

"Mental image of vanilla ice cream cone (from fair earlier in the week) melted into a messy puddle as I stepped outside into the 100+ degree heat. Total buzz killer."

So, stay cool. Enjoy some ice cream BECAUSE YOU CAN (assuming it hasn't melted in your hand or dish because of an extreme heat wave...)

Avoid those ice-cream haters and blamers.

Oh, and have a Happy Friday and good weekend. Peace out.

Hello, Larry, Well Hello, Larry...

2011-07-20T14:15:00.004-04:00

Given that I've now completed my first decade of being an insulin pumper, I'm at a crossroads on what to do next.

Should I stay or should I go? Temporarily, that is.

Though I'm a fan of insulin pumping, it does take a toll on my mind and body. The signs are evident whenever I pull up my shirt and examine my stomach where I most often put my infusion sets. Last year, I took a several-month hiatus to give my mind and body a break and it did wonders. I wrote about it then, but I'll reiterate it again: In a way, this Pump Hiatus was "freeing" in the sense that I could walk around unconnected and unhassled and just do a shot whenever I might need to consume some carbs. Multiple Daily Injections worked well for me, and that period between March and September resulted in my A1C dropping by a whole % point!

It was pretty cool!

But don't get me wrong: I LOVE insulin pumping. The more detailed control. The D-Math it helps you with. The constant stream of insulin and flexibility in eating and life-living you have.

So, before embracing another break, I'm going to turn once again to Larry The Loaner CGM. You remember him? The Minimed 522 that I was able to borrow from a fellow PWD who is a pump rep in my area. Well, I have many sensors and reservoirs to use it, and I really want to get some use out of the CGM capability that my non-CGM 722 model doesn't offer and I'm not really up to purchasing/hassling insurance about at this point. Larry has been sitting in the house, waiting to return to the owner, but schedules just haven't permitted that.

But finally, we've settled in for another trial-run to get things back to where they should be before that next break. Trend watching and tweaking. "Control," even though I'm not the biggest fan of that term.

So far, it's been a solid experience for the past few days. Haven't actually gone above the 220s, which I don't recall the last time that happened. I've been so used to going high in the evenings thanks to non-accurate carb counting and dosage, that this feels pretty good.

Of course, nothing is perfect - and I say that knowing we're talking about CGM and Blood Meter Accuracy here. Other photos illustrate this problem perfectly:

Um... Stop lying to me, Larry. Totally not cool.

First, Larry starts vibrating to alert me of a Predicted Low.

However, a BG Test shows he's lying. Accuracy of my One Touch meter is not ensured, so we double-check... And get a 130.

Son of a...

"C'mon. What the...," I mumble.

A second check reveals a 162. Still doubtful and now annoyed by this lack of accuracy, I test again and on this third check see a 140 mg/dL.

(Sigh.)

Larry vibrates again, this time indicating that my BG is continuing to dip into the low 60s.

"Whatever, Larry. Stop freaking out. You're obviously hallucinating."

Don't let this little exchange dissuade you from Larry, though. He's actually been pretty reliable since starting back up on Saturday. We'll see how that holds up over time.

Either way, we're doing fine for now. He brings me a sense of accountability and constant monitoring, that I'm actually a part of what my body is doing and that my management is in fact at the forefront and can't be ignored.

That's something, even if it's in my head.

Once we move forward a bit with some real-live CGM data, I will again consider whether it's prudent to embrace another Pump Hiatus.

Larry, glad to have you back at my side, even for a little while. You're looking swell so far, Larry, Still goin' strong. You've warned me when the room starts swayin', Larry, and I know to test when you're crowin. Glad to have you back, Larry. It's so nice to have you back where you belong!