Thursday, December 30, 2010

Ringing Out The Old Year

I don't know about you, but any recent luck o'the averages I may have had has been irrevocably ruined from the Christmas holidays.

Ok I tried to be a good D...truly I did. But the goodies called my name,(over and over) the set changes became fewer,the Dexcom crapped completely out,(of warranty,too) & I just stopped caring what I was,I just wanted to have fun for once.(without inconveniencing anyone with a low). Throw in some hormones and you have the next episode of "Blood Sugars Gone Wild."
All of which equals an average bg in the mid -to-upper 200's.

Yep-not good on the a1c, & unfortuently,the holidays have not yet ended..there's still my side of the family.( New Years Day). I need to get back to regular life, routine really helps.(that and knowing the carb count!) Fortuently,my next a1c isn't till April so there's lots of time to undo that damage. I sure don't want an a1c in the 9's.(after making significant progress on that front)

I'm also starting on a low dose of Levothyroxine (25 mcg) to improve my TSH. My Endo was not wild about the idea,but she agreed to start it.My thyroid antibodies have gone up,my TSH is in the middle of the spectrum(still normal,but not "good") Hence the minuscule dose of (Synthroid). I need my thyroid at optimal levels. It was hard to get my Endo on board with it,she muttered uncomplimentary things under her breath(as to the overkill tactics of certain other specialties) but did agree to start it. It's not going to make me hyperthyroid, it can only help.

Have a Happy & safe New Year,all!

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Thursday, December 23, 2010

Elevator Shift

(this is a story of an elevator encounter of the life-altering kind)

It was his eyes that told the story. They were the sort of eyes that you could go swimming around in,lose yourself in the passage of time...and wake up to find that 20 years had gone by,unbeknownst to all involved. There was a lifetime in those eyes.(magnetizing)

It was the summer of 2003,& I (was very single & uninvolved,ok folks?) had gotten on the hospital elevator,punched my floor number,& was set to tune out the various individuals on board..for I could think of nothing else beyond my impending "Diabetes & Driving" impatient study.(involving a simulated driving game & "controlled" hypoglycemia,I would murder virtual cows right & left.)

"Are you going to the hole?"

I semi-turned, & looked at the person who had asked the question. "The Hole?"

"Yeah-admission?You look like you are." He coughed,& the spasms wracked his thin frame. It had the sounds of cystic fibrosis,of chronic disease,of a life spent in places like this against one's desire & will.

"Ah,yes,the hole. I am indeed."
(I wasn't quite sure I wanted to spill out my medical history in the very public elevator to a guy I didn't know) And did I really have "the look?" I thought PWD were not supposed to look sick. Not like I had any wires or tubes coming from random orifices on my body.(yet)

"Take my advice...don't let the residents near you,they're real bloodsuckers & can't hit a vein to save their lives."

(this advice did not seem to phase the several white coats on board,although,I laughed. Loudly.)

"Duly noted". I was looking in the eyes,& feeling sorry for the suckyness of the situation for people with such chronic diseases & lucky just to have diabetes. We were the same ages...& yet I would likely live 40 years beyond what he would. I didn't know the half of the depths of the disease & dying process. And yet,he was living with his disease in the same way millions must...most of the time,it felt like I was ignoring mine.

The elevator clanged,6th floor.

"Take care." (I felt I needed to say something) "Hope you get out of here soon."

"Yeah,same to you. Stay cool."
IV pole in hand,he took off towards the nursing station on the heart/lung floor. And I continued onto the 8th floor,where the diabetes study awaited.(it was the most grueling,most demanding study that I have ever done,& 48 hours into it my electrolytes would drop(caused by the blood-letting & insulin clamps)resulting in them dropping me from the study early. I had no complaints to that,since they were still giving me full compensation & I just wanted to go home & die quietly,it was the first time my (as yet undisclosed) Bartters Syndrome would cause a problem & it would take months of unsuccessful dosing before I would see a nephrologist,& be diagnosed. At that moment,however,6 additional hours into IV's I just wanted the Endo to let me go home.I hoped I would be ok,and I no longer felt like I was having a heart attack right there,& although still very shaky I could walk out to my car & drive so she let me go.I went home & crashed for the rest of the weekend.)

I couldn't shake the sense that not only old people die in hospitals...22 year olds did too. All. the. time. And yet,they were one heck of well-adjusted individuals...they lived their lives knowing that day was sooner,rather then later. I think most PWD think "it will never happen to me" whereas most other chronic diseases know it will happen to them.(I'm not saying diabetes is a cakewalk but compared to CF it is)

That day,I got another perspective on life with a chronic disease.(& another idea of what I wanted to do with my life,should I ever become an RN(research,peds,or a CF nurse coordinator) This day, I still want to do something along those lines...& next semester, I shall be joining those nursing student ranks.(at last) The world needs more then a few good nurses.I know what being a patient is like...& that will make me a better nurse.


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Friday, December 17, 2010

The Top Seven Holiday Gifts(for the PWD)

#1 For the Dexcom(er) (or Navigator user) in your life... I recommend one of these. You can get small camera & phone cases at any office supply store.(such as Office Depot,Staples) And I've found it to be much more useful then that generic "skin" they provide.(for the Dexcom) Yes,the skins look snazzy,but that feature really doesn't help me locate the Dex any quicker from the depths of my handbag...nor does it have a clip on the back.This does,and it's solid-does not get knocked off five seconds later.And I can find,& unzip it quickly,because it has a unique shape compared to the hundreds of other things that reside in said handbag.



#2 Music Player Cases

(looks like small backpacks)




I'm a fan of jazzed up meter cases...& these are perfect for the job,holding the meter,strips,backup vial,infusion set,syringe,roll of glucose tabs,& the Multiclix lancing device.(IMO,the greatest lancer ever,& no,I'm not being paid by Roche to say so,I am way too uncool for the likes of Roche. The Multiclix is just awesome...& better then the Delica,IMO.
These cases have several zippable compartments & a belt loop and are really quite the on-the-go accessory of the year.And I'm sure they exist in solid colors..for the male PWD in your life.

#3



I found this ornament at CVS..& it immeadietly found a warm fuzzy spot in my heart.(& a place on our tree) Love,love,LOVE anything diet coke themed.

#4


Cup-Cake-y lip gloss. (I prefer the CVS, or Bath and Body Works brands) So very yummy,and completely free (of the need for insulin). Of course, this often has the side effect of making one hungry for REAL cupcakes (and a trip to a real,live,cupcake establishment. More on that in a future post.) A gift card to a cupcake place is also an entirely appropriate present. (if the individual can cover such dietary excursions with insulin...I realize that not everyone who reads this is a type 1/family member of a type 1.Moderation is a must, for anyone.)

#5 If it's jewelry you're looking for,the JDRF and ADA have several new unique choices.(ideas gotten courtesy of Diabetes Living magazine)

- "Katie's Cure" (designed by a 12 year old with type 1)(Proceeds to benifit individuals living with type 2 diabetes,but that's completely beside the point) It's a very pretty design.

- JDRF charm bracelet. It would be cool if you could have the date of dx engraved on this(for $50,that should REALLY be an option)& I'm not sure I'd ever buy this,unless I had more money then I know what to do with..but I like the design.

- Diabetes Awareness bracelet. Hand engraved, in your choice of multiple diabetes sayings.($75)

- If you're looking for something much, much cheaper(and who isn't, these days) head over to the DRI & snag yourself an "I'm Tired of Diabetes" bracelet. It's made of recycled tires(environmentally friendly!) and the cost ($14.50 won't bust the bank.

-Finally, you can get an official Bret Michaels "Live to Rock, Rock to Live!" bandanna or an ID (I decide) tag from the American Diabetes Association.

#6
The Stupid Sock Creature. (now if they would only make the Stupid Hand Creature,they'd be all set) Good for a few laughs(and endless hours of preschooler amusement)

#7 And lastly, you can get a free Bayer Contour USB meter (along with 25 strips) at Walgreens. (until 01/01/2011) Go here, print out a coupon (for $20 off) and they'll adjust it down for you (it's on sale for 9.99). Or, you can find $10 off coupons for both the USB and the Bayer Didget in their pharmacy diabetes magazines.This is not just another "free" meter offer..this is a snazzy meter( with strips), which makes it a pretty generous deal, IMO.

Thursday, December 09, 2010

Twelve Years

Dear Diabetes,

Tomorrow marks 12 happy years of being joined at the hip.And like every morning since then, I've woken up,checked my blood sugar,& taken insulin. Some things blur with the passage of time.I don't remember what an 1100 blood sugar feels like but if I see or smell a Kendall brand alcohol swab my mind takes me back to that moment in a flash. No other brand but Kendall does that.It was a night of strange smells,sights,& sounds...which may well be imprinted permanently in my memory.


Like I do every year, I'm celebrating our Anniversary with great fan-fare. (I hope you don't mind if I bring along my husband) Dinner, and a movie (Voyage of the Dawn Treader)sounds like the perfect way to end the day. One thing about our D-Date,it seems to be a popular day for new movies to come out.

You and I have worked our butts off this year,& have gone from a number that was so bad I couldn't even blog about it to a most-recent 7.1.While that isn't under 7.0,it's a .8 improvement over the last time & was met by enthusiasm from our Endo & deemed acceptable enough for plans involving future offspring on this Earth.(we will keep working on said a1c,obviously) I really wish my a1c had dropped more,but it is what it is.Further testing revealed several whacked out hormones (trouble with the thyroid,yet again) & the jury's not out yet on whether I'll have to start Synthroid/ other drug.As anyone's with D who has gone this route knows, it's not just the simple matter of getting your a1c in line. But with an endocrinologist & a maternal-fetal medicine specialist working on it, I'm sure they'll get those hormones precisely where they should be.(unlike blood sugars..those levels are easier to get into line) There is much to say on this topic,but the relief of not having one's Endo stare in horror at one for even considering the thought is the victory of the moment. I have faith that it can happen.

Bring on 2011!!




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Monday, December 06, 2010

December De jour

It's that time of year again...the snow lies thick on the ground(or soon will,if it's anything like last winter), it's bitterly cold and nasty and doesn't lend well to functional toes,fingers, or glucometers. Starbucks & Swiss Miss are absolute must-have's.(yes,I drink Diet Coke year-round but in winter I need something to warm me up) And it seems that life gets even busier, as the "flurries" of day-to-day tasks cascades into a blizzard.(Look for me sometime in January,as I don't expect to be doing much blogging)

On the agenda this month:

*Aforementioned school paperwork, most of which is financial-aid/scholarship oriented. Also a CPR recertification course and yet another physical exam(does the one I JUST had in October (for my surgery) count? Of course not) which shall involve booster shots and blood titers(for every known communicable disease out there). Medical school can't involve any less paperwork.

*Changing health insurance plans.(this being that magical time of the year known as "Open Season," which, for my non-US readers is when one can switch(or get) health insurances without fault for pre-existing conditions.For an individual with a chronic disease,this is one of the few opportunities to get instant coverage. ) My husband leaves this to me, as he rarely gets sick,takes no meds,and has never had a cavity in his life.(in other words, the opposite of me) Our current plan has hit rock bottom-everything costs a ton, & injectables go completely off the formulary beginning next year. Although this is to be expected with all the recent insurance company/Obaminination changes,our particular plan has essentially doubled EVERYTHING-monster deductibles,no diabetes education coverage,etc. and the time has come to jump ship.(before we sink) I'm grateful for the choice of several options,but it will be a monumental choice as I consider what parts are vitally important to me & which parts are less so.

NEED:

- diabetes supply coverage (for pump supplies,insulin,strips, and CGM) via mail order with acceptable copays.
- NO cap on the number of test strips.
- catestrophic coverage cap
-low pharmacy rx copay
-outpatient infusion services covered (this is a biggie,because if I need more magnesium infusions it is very expensive & not otherwise affordable)
-coverage of injectables (such as Symlin)
-good dental plan
-free Diabetes Education Visits
-complete lab & tests coverage

I'm very much looking at this from the diabetes point of view..I want the freedom to see my own endo and follow my own diabetes plan. Access to an educator is a must on my list,(and one that current insurance decided to stop covering completely) since few endo's have the time to work with you on the nitty-gritty, day to day stuff. I guess after all these years I should know how to get myself out of the holes I dig,but they have perspectives that I often times, don't. I live it..the questions and problems never go away,& have numbed my brain so that if the answer were right in front of me, I wouldn't be able to see it. I need the fresh perspective.
I've heard only horror stories about HMO's,and I'm not sure I'd be brave enough to go that route. Freedom in physician choosing is very important to me, and I'd rather concede on a less important point(like the amount of the copay). You have to choose the plan that makes the most sense financially. Life is about more then diabetes..surgeries,tests,random stuff comes up and those possibilities must be considered as well. Decisions, decisions.(and I can't make this one lightly)

* Getting every last RX filled before the deductable/max reset to $0 and everything costs an arm and a leg again in the New Year. (to be done, prior to switching insurances, obviously) We don't have an FSA(flexible spending) account...that's probably something I should seriously consider. Could really save money there.

*Regular Christmas-y stuff..presents to buy, foods to cook,etc. and a week long stint on the Left Coast(come December 22) to survive. I cannot say I'm looking forward to the body scanner/patdown choice.(at the airports)

*Endo appt., continued hand therapy. Things are much improved on the arm front, there's now only a small localized patch of elbow numbness,a slightly weak pinky,and pain only if I lift something heavy. The scar is even starting to fade.

So that's what on the agenda, this won't be my last post of the year,but I won't be doing very many of them. Stay warm and safe, everyone.

Wednesday, December 01, 2010

The Envelope

I got an envelope the other day. It was gorgeously thick & screamed out "Non-Rejection" without me having to open it. But open it I did,with my heart hammering away in my ears & my stomach doing flip-flops in my esophageal tube.

Guess what. I am not "rejected" but I am also not accepted, I'm in that fuzzy grey area known as the WAIT LIST.

So I had to go to Orientation, a 3.5 hour affair which was great for everyone who made it into the Spring 2011 RN program but most disagreeable for the rest of us.You sit there,pretending you belong,but you aren't really "in." You're a wannabe who is hoping someone drops,but you still have to fill out the forms,get the all-inclusive Cootie Report filled out,CPR, and have your financial aid,etc ready to go at the drop of a hat for if someone does drop out & you could get in.

Maybe I'm at the bottom of the "wait list" & maybe I won't get in at all. I hate this not knowing.(it goes purely off GPA) It's the 5th layer of Dante's Inferno,doing all the work & still not getting in & more & more I wish they'd have just rejected me outright.People have till Jan.18 to drop the course...that's a long time to be without an answer.(Everyone who is on the list knows exactly what to plan for) I'm in a state of educational limbo(knowing that I qualify but should I just reapply? or just scrap the whole nursing idea entirely) & it's just really hard & depressing right now.

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Sunday, November 28, 2010

A Surgery, A Rice-ectomy & The Diabetes Transplant Summit

It went exceptionally well. Although my blood sugar was not well behaved in the least(the instant I rolled out of bed @4:30 am, it began to skyrocket) 165 at 5 am,and 265 2.5 hours later when the nurse took it.

I was the first patient of the day..so as soon as they got me back there, changed,and an IV in, it was a whirlwind of anesthesiologist/nurse/surgeon & it seemed like no time at all that they were all ready. I really wasn't(as evidenced by my blood sugar-gave a several unit correction & cued the anesthesiologist that this sort of excursion was normal for someone who was nervous. I get like that prior to any sort of "nock out" procedure. And I know that sounds stupid,but that's how I am. The dude in the other unit(2nd patient of the day) was not anxious in the least.(I envied his nonchalance) I didn't like the blood sugar,but there's really not much you can do about something(hardcore correction) w/out flirting with hypoglycemia.(they were perfectly ok with it) My sole request,was for a hearty dose of anti-nausea meds,I wasn't worried that worried about the pain.(they did a nerve block & a pain med so I knew it wouldn't wear off for awhile)But I have learned that anytime I go under,there will always be nausea (waiting for me) when I wake up. The anesthesiologist (who caters to cowards) was very accommodating in that last request. Nothing was going to make me any less nervous,but at least the atmosphere was very upbeat.

And just like that,I was waking up from a dreamless dream (some 2 hours later),arm almost completely encased in white plaster at a 90 degree angle. There was no pain, or nausea(much to my surprise) just that fuzzy headed disorientation that takes some time to go away.

Blood Sugar: 276. Happy day in the morning. I corrected(one handed),& discovered just how hard it is to check your blood sugar with one hand.(I use the Multiclix,so I had to cock first,& attempt to hit my pinkie as I pushed down with the thumb) Sat up,getting acclimated to the thought of going home & got hit by a horrible wave of nausea & started dry retching. The nurse got me a smelling salt/nausea killer sort of thing, which smelled really horrible but did indeed knock that nausea into submission. Tried again 15 minutes later to sit up & was fine. The nurse also gave me some alcohol swabs(I never knew that those were nausea busters), RX's,and then the husband drove me home. Nerve block wore off about 5 hours later but I still was not in any great pain. More then anything, it itched.(the crazy,rip your skin to shreds itch) My mom helped out that first day.

The next morning, I dumped my glass of water into the cabinet drawer, flooding my iphone in the process. As soon as that registered,I grabbed it out, attempted to dry it off,& did an emergency Rice-ectomy (container,cover iphone with rice, leave for 24 hours) not knowing if it was truly the end for my phone or not.

That evening,I stuffed my arm in a sling & husband & I went to The Diabetes Transplant Summit. And there's not really much I can add to that(Kathy has said it all) but it was a very interesting experience. One of the participants made a statement that really stuck in my head,and that was "Good control doesn't do you any good if you're dead." Hypoglycemia is a very serious problem..& kills people every year.(how many,I'm not sure,but even if it were just 1 death that is a tragedy)
For these people, hypos were constant, severe, and life threatening. Every single day they dealt with that reality. They had the transplant(s) to fix that particular issue...not very many of them had secondary complications from diabetes. (although that can be another reason for having a transplant) One of them, Gary Kleiman, has been on immunosuppressents more then half his life(he had a kidney transplant in his 20's) For them,having to take immunosuppressents was an acceptable trade-off. None of them has to worry about severe hypoglycemia..even the ones who have to take small doses of supplemental insulin.(over time, the islet's die) And I must agree,if I were in such a situation I would take life w/immunosuppressents over no life at all. I think everyone who goes into those transplants is absolutely informed about the risks they're taking..but the bigger risk is not having the transplant. And I respect their choice,& the courage it takes to do that.

They are working on raising genetically "pure" pigs, for (future) large scale porcine islet harvesting. Of course,this is all stuff for the future...but it's a fascinating concept (pig islets & some sort of localized immunosuppression=possible cure?)

By the end of all that,I really wanted to go home,take painkillers, and not go to any more social events for the next week. It was exhausting,but events like this only come around once in a blue moon...& I'm glad I went.

(the next morning,my iphone powered right up...so it all ended well)

Monday, November 22, 2010

The Little Chevy That Could

This is Nugget.



Nugget is my 3rd vehicle, the last two having met unfortunate ends involving collisions & ex-cops & Northern Virginia intersections.Nugget is a product of the 20th century...they don't make Chevy Cavaliers anymore.(I've had several interesting run-in's with fellow Chevy Cavalier owners,they absolutely loved theirs.Apparently,it's a sub-culture..much like the DOC.And I do love my car,but it is a very basic car & it's racking up the miles..doesn't have as much gumph as it had in 2005.So,when it does quit,I have no problem moving on,and getting something from the 21st century.Technology is not a bad thing.)
And I believe I have matured, (in matters pertaining to vehicular operation)for Nugget is definatly the longest lived vehicle in the lineup. It was a Christmas Eve(make a rapid decision NOW) sort of deal,required by the family members tired of carting me around on a regular basis.

However....

It was a chilly November night,(about 2.5 weeks ago)& I'd had a long day(making the 4 hour trip down to Virginia to complete the research study). Spent several hours at the research study,went to a buffet & stuffed my face with everything I probably shouldn't,bought a gift for our 3rd wedding anniversary(and gotten carded for the first time in my life,which was very annoying.Worse then that-I asked the cashier if she needed to see some ID and she declined. So long, golden 20's) and was headed across the mountain to spend the night at brother #2's house (brother #1's kid had the plague).

Before doing so, I filled up the gas tank(for the 2nd time that day)& hoped the compensation would be quick in coming..for I'd spent a small fortune in gas from all those trips. And yes-it was absolutely worth it(free strips,pods,etc.)but if they didn't have both monetary & supply distribution it may not have been. Research studies can be educational, but they can also be a pain in the butt.(4 times down there=stick a fork in me, I'm done)

It was about half way up said mountain, as Nugget huffed and puffed away like the little engine that could, when it happened.


"YAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAEAHHHHHHHHHHHHHHHHHH!"

Instinctively,my foot let off the accelerator,my eyes closed, and my body tensed
as I waited for 60 mph-flesh-on-metal-contact as a large buck glided strong,gracefully,purposefully, right in front of my vehicle.There was no time to hit the brakes or swerve..it went that quickly. It was like one of those Kodak moments-where the subject has just woken up,and the flash goes off right in their startled eyes.

Several heart-stopping seconds later, when there was no consequent cascade of deer vs car vs airbag vs chest vs flying off road, I opened my eyes. Apparently, large deer had successfully missed my car (and the one slightly behind, in the other lane) and made it to the median strip of the interstate. It took me awhile to truly relax after that,for I thought my car was a goner. I've hit small rodents before (NOT on purpose) but its the first time a deer jumped in front of my car. And I know its a common problem...the sides of the road have alot of dead animals this time of the year.

I'm just grateful nothing happened,for that deer was huge & absolutely would have totaled my car.Nugget lived, to run another day.

Friday, November 19, 2010

Ten Days

It's unbelievably great to finally NOT have a full arm cast on my arm.Its stiff,sore,numb,and looks like a staple gun went to town from my wrist past the elbow but the surgeon says its progressing well.Therapy starts next week. (it may take months to fully regain function)
(before picture)



Dr.Hand: Any questions?

Me: Can I blog now?

Dr.Hand: As long as you keep it light, don't over do it.

Me: Ok.

Man I've missed blogging.(had to get that out)

Tuesday, November 09, 2010

SIX things (#Dblog Day)

Hey, there.




Don't hit the back button just yet...I'm here to let you in on SIX earth-shattering revolutions about diabetes. Things you may not have known,but things you NEED to know because by 2050 you may be one of the "1 in 3" Americans who has type 2 diabetes. Or perhaps, you may be 1 of the billions elsewhere..diabetes is by no means limited to the North American population. The fact is, it's sweeping the globe,and if we don't get some answers soon both types will continue to wreak damage and destruction in their path. Most of my tidbits will be from a type 1 perspective, but the types have more in common then they have apart. (I feel...type 2 ain't no cakewalk either)


#1 This insulin pump is not an "intelligent" system. Far from it, I have highs,I have lows, I still have to feed my glucose meter blood 7-10 times a day & for the trouble,I get a so-so a1c. Diabetes is difficult 24/7/365. Diabetes sucks, even when it doesn't. A pancreas is a difficult organ to mimic.(In my opinion,the most difficult) And everyone's needs are different..it's all trial & error.

#2 Don't go it alone. The Diabetes Online Community is a support group wherever you are..places like TuDiabetes,Diabetes Daily,and Children with Diabetes Forums. You may feel like you know everything there is to know (and are a rock unto yourself), but take it from the introvert,you NEED support.(in one way or another,be from spouse/family/friends/other)And only other people with diabetes(or parents) truly get what you're really going through. You never realize just how much you needed it until you find it.(and then it's like,where has this been all my D-life!!!?)

#3 Ingested sugar will not kill you. Elevated blood sugars are what leads to complications...if you have type 1 diabetes,you cover that dessert with insulin,and if you have type 2 diabetes,you follow your health care provider's recommendations. I often have the exact opposite problem..I'll overbolus,& end up low, trying to avoid the high. It really bugs me when people don't realize that practically EVERYTHING has carbohydrates in it yet feed me the sweet potatoes when I'd rather have the brownie because it's a "vegetable" & must therefore be safe. Really,really, bugs me.

#4 Diabetes is Expensive. Even if you have insurance,they may not cover much,and if you don't have insurance,you probably don't
have the means to do more then stay alive. 1 bottle of fast acting insulin is now well over $100..pump supplies run hundreds of dollars per month,test strips soar into the upper stratosphere (despite not improving in accuracy),the costs of CGM'ing are over $300/month,(without insurance)
doctor bills,lab fees,other meds, the list goes on. And all of this is still cheaper then not taking care of the diabetes & developing complications. Something needs to be done to make it less expensive.(what, I don't know,I don't favor gov't takeover but how can you curb an epidemic if people can't even afford to treat their disease?)

#5 Insulin is not evil. Insulin is not bad. Insulin is not "a failure." Insulin is perfectly natural,non-D's produce sufficient amounts of it but if you have diabetes,you must inject it. (in one way or another) Insulin will not cause you to go blind, lose your toes,require kidney dialysis-improper management/cumulative effects of diabetes will do that. And I will guarantee you that there are many individuals(who have been on insulin for eons) who are happy,healthy,and have all their toes. Insulin is life,and we all need it.

#6 All types of diabetes need to be taken seriously. Any elevated blood sugar is a blood sugar that is going to cause damage,down the road.Type 2 diabetes is progressive,& often has co-morbiditating factors irritated by higher blood sugars. Whatever type you have,you must do your best to manage/control it.

Thursday, November 04, 2010

"Waiting"

(from the poem archives, dated December 6,2001. I thought it would be appropriate for National Diabetes Month)

"Waiting"

Last night I dreamed there was a cure
And folks were lined up at the door
This cure was real, there were no pills
No side effects, no doctor bills.

One shot, forever free to be
From this dreaded thing they call the D
Islet cells, that won't die off
Each time I get a stupid cough.

The freedom was a sight to see
The joy was real, unbridled, free
We chucked our meters,took a bite
This food would not cost us our sight.

(addendum)

Nine more years have come and gone
Since yesteryear's whisimcal song
We're waiting still, who knows how long
It's all so very,very wrong.

(it's weird how fast time passes when one is waiting on a cure. I'm sure that fifteen years from now,I'll be looking back at 2010 (in much the same light-like,whoa, those were the dark ages of D-care) & there still won't be a cure. Which I'm expecting,but it doesn't mean that I don't want one,bad)

Monday, November 01, 2010

A Lot to SAE

Sarah, over at Sugabetic has designed an awesome logo that very much represents what National Diabetes Month is all about.



I'm aware that my advocacy efforts will not go very far this year. And I can't do NaPoBloMo (for what would have been the third year running). My education will be limited to direct contact (i.e."Do not touch the pump. Do NOT touch the pump.")with health care providers.

In the works for November: (D-related)

November 3: DSMA. (Twitter chat)

November 5-6: Research study ends.(for now) Return (crappy Dexcom)equipment,fill out forms, participate in focus group. I really,really,really need the break. It's just been one disaster after the next lately,on every front. I really need to unload everything bothering me (equipment failures,communication failures,algorithmic failures) and get back on track. It's one thing when it works,its another,when it doesn't.

November 9: National D-Blog Day.

November 10: THIRD ANNIVERSARY.(actually,the have-surgery-on-your-arm-day) Will move the actual celebration of said day to the 8th,or 9th)

November 11- Diabetes Transplant Summit. I am really,really, really hoping to attend this, but I'm not going to assume that everything is going to be hunky-dory enough to do so. But at least the husband would drive me..if we choose to go.

November 14- The Big Blue Test. I shall move my pinkie finger up and down for 14 minutes,and then test my blood sugar.(in honor of the concept,and not being able to do any more then that)Which will probably make my blood sugar go up,not down,but last year's 35 minute sweat-a-thon had the same effect...so yeah,it's not about the blood sugar,it's about the education.

November 1-November 30 Have the best control possible...an a1c looms mid-December,& it takes hard core committal to bring about real change in an a1c. If you want it,its absolutely about those overnights and post-meals & pre-meals. Deciding to get serious about control (1-2 weeks pre-appointment) does not work. (been there, done that)

Wednesday, October 27, 2010

Dear Insulet

Dear Insulet,(Makers of the Omnipod)

Today marks my 2nd phone call to your corporation, in two days. You see,on Monday I had a pod that gave up the ghost a scant 1.6 hours post-insertion. So, I did what I was instructed to do...& called. And found out you guys can't replace it,because it's part of a clinical trial,yadayadayada. Ok, that's fine,at least your rep provided helpful info on occlusions.

So tonight,it happened again...post bolus. Only it was the actual pod that started shrieking (not the PDA) It didn't stop,& the only info coming up on the PDA was "low reservoir." I panicked, & called you guys again,needing reassurance that I could shut it up if I inserted a new pod.

"Hello, may I help you?"

BEEEEEEEEeeeeeeeeeeeeeeeeeeeeeeeeeeeEEEeeeEeee(etc.)ppppPP

(yes you can help me,save me from this insanity of this darn pod!)

"One moment,let me look up your info."

BEEEEEEEEEEEEE

(4 minutes later)

"I'm sorry,all technical questions are to be referred to the study endocrinologist. All I can do is make a note that you called."

You have to be kidding me,lady. It's 7 pm , office hours ended at 5, and I have NO way of getting in touch with them & you can't tell me how to get this thing to shut up short of running over it with a 2000 lb Chevy Cavalier?


"I was told I should call Insulet with technical issues."

"I'm sorry, we really can't. Call X(someone else)."

Awesome. Pod is continuing it's Shriekfest,much like a screaming infant refusing to be consoled.

Fortuently,when all else fails,you can send out a Tweet & get an answer in two seconds flat. I went ahead and deactivated the pod,it continued to shriek. Next,I poked it with a pin & that took care of it,25 minutes of shrieking later.

I'm just annoyed that I'm not considered a "real" consumer & if the darn thing dies,Insulet is no help whatsoever. (neither is the endocrinologist,4 hours away)If the AP ever does materialize,it will be no thanks to you guys.

Sincerely,

Alarming on The East Coast




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Sunday, October 24, 2010

A la Foodie Extraordinaire

Comfort Food is...




A half open grilled ham sandwich w/tomato slices & heavy on the mustard/mayo.





A cup of raspberry tea on a cold,rainy day.





The bottom of a Nutty Buddy.(solid chocolate tip combined with waffle cone = ahh moment)




Actual,fresh fried potato chips at a Renaissance Fair.





Something only I would eat.( don't ask)




A Diet Coke.




Fresh peaches,home made ice-cream. Out of the universe,good.



But I also think food is much more enjoyable when the blood sugars are 85, versus 285. It tastes different(even beyond the appetite issue), it tastes better.(IMHO) I was never someone who enjoyed the mental calculations of food/insulin..post dx,food became more of a drag(then anything else). I still like it,eat too much of it on occasion, (like anyone else-diabetes or not)but it lost it's innocence & spontaneity the minute I had to go on a diabetic diet. (eons ago) You can never quite be as blissfully ignorant as you were pre-dx,even though you now have the freedom to cover any carb with insulin.However,with an 85,I also feel more inclined to branch out in my carbohydrate repertoire since I'm not already high.(with a 285, I go more for the meat/veggies) I wish I had that freedom..24 hours a day,to eat what I want,when I want.(blood sugars still dictate much of it) Food can be both enjoyable & a total drag.


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Friday, October 15, 2010

D-Feast Friday: Easy Peach Cobbler

I've had a real craving for all things Peaches lately..& here's an easy & delicious recipe for Peach Cobbler. (no idea on the carb content, sorry!)

Ingredients

* ½ cup (1 stick) unsalted butter
* 1 cup Splenda
* 1 cup all purpose flour (white, mixed grain or whole wheat works fine)
* 1 Tablespoon baking powder
* ¾ cup milk (low-fat or non-fat are fine)
* 3 cups sliced fresh peaches, peeled or skins left on
* ½ cup firmly packed brown sugar(or Splenda brown sugar?)
* ½ teaspoon cinnamon

Options:

You can add 1/2 cup chopped pecans - they taste GREAT in a peach cobble.

You can also add other fruits: blueberries and blackberries are particularly good in combinations with peaches. Just add 1 cup of either to this recipe in step 6.
Directions
Step 1 - Preheat the oven and prepare the peaches

Preheat oven to 350°F (175 C). Wash, peel and slice the peaches. You can slice them thin or thick as you prefer! Note: you can dunk the peaches in boiling water for 45 seconds, then into ice water, and the skins will usually slide right off.
Step 2 - Melt the butter

Melt the stick of butter in a medium sauté pan over medium-high heat until it bubbles and turns golden-brown. Be careful: it will burn quickly and easily!


Step 3 - Add the butter to a baking dish

Pour the butter into an 8-inch square baking dish.
Step 4 - Mix the dry ingredients and the milk

In a medium bowl, stir together the 1 cup sugar (or Splenda, or blend), the 1 cup flour, 1 tablespoon baking powder, 1/2 teaspoon cinnamon and 3/4 cup milk.


Step 5 - Add the batter to the baking dish

Pour the batter on top of the melted butter. Do not stir.

Note: the photo shows a dark brown batter because, instead of 1 cup sugar, I used 1/2 cup Splenda and 1/2 cup brown sugar; just to cut the calories some.


Step 6 - Add the peaches

Without mixing, arrange the peaches evenly on top of the batter.

Step 7 - Add the brown sugar

Evenly sprinkle the brown sugar over the cobbler.

Step 8 - Bake the cobbler

Bake the cobbler for 40 to 45 minutes at 350 F (175 C), until the top turns golden brown. The batter will migrate from the bottom of the pan to cover the peach slices partially.

Serve warm or at room temperature; preferably with peach ice cream. Yield 6 to 8 servings.

Random Friday Blobs

#1 I'm home today,quite unexpectedly,the plan was for another research study visit. However, the research coordinator is MIA (really, really, not like her..no email or phone confirmation, and phone messages go straight to voice mail) and I am not driving 8 hours round trip without some sort of confirmation. Call me unreasonable,but you can't even get into the building(unless someone lets you in) & I am not making that trip for nothing. I'm kind of worried about her,because she also has diabetes and I just hope she is ok. I also hope someone answers her voicemail & tells me what to do next, because I'm days away from (study supply) depletion, and while I have no problem using my own, I really don't think that is protocol & I don't wish to be kicked out of the study for that. I have the endocrinologist's (home) phone number,& may use it(I think this classifies as worthy to be bugged about)

#2 Hand Surgeon is back from his vacation,& a date is now set in stone.Unfortunately(again,sheesh, is this Friday the 13th?) the two (date) options were November 10 (wedding anniversary) or December 8. I really don't want to have surgery on November 10,but waiting till December really seems un-doable,it hurts too much. The only good thing about it is diabetics always get moved to one of the first surgeries of the day,because we've been fasting and might crash and burn if they don't do it asap. Not true, when one is on a pump,but I am not one to look a gift horse in the mouth,let them believe what they want to believe. It won't be hand surgery,it's at the elbow-an anterior transposition of the ulnar nerve (sub-muscularly,which the surgeon feels is more effective for thin,younger patients). Cast for 10 days.(no blogging/Internet except for what I can do one handed) Goodbye, (online) social life. I am glad I am in this research study, though,because it is a heck of a lot easier to fill/insert an Omnipod one-handed then it is a traditional set.(or reservoir fill) As for the Dexcom..I may just put one in right before and hope it lasts 10 days. It's darned if you do, and darned if you don't sometimes..you can only hope & pray that surgery does more good then harm.
I want it to fix everything but I'm aware that in some people,it causes permanent damage.

#3 On October 6, the diabetes community was saddened by the passing of Christopher Saudek,MD an endocrinologist at Johns Hopkins, and a real insulin pump pioneer. I enjoyed his talks with the local pump group,& he was a really nice, decent,interesting individual.(far and beyond his passion for all things diabetes) His is a legacy rich in helping thousands of people with diabetes (throughout his 35 years in practice) Unfortunately, he didn't get to see a cure but he believed in one passionately. I will never forget him.

(he wrote this book,and autographed it for me)

Sunday, October 10, 2010

Ode to My Diet Coke



















Nectar of the gods, I salute thee.

I take a swig
and am transported

far beyond the world of SWAG boluses and fingersticks

to a simpler moment
to a simpler time
when none of it mattered
and a Coke was a Coke, not a nutritional nightmare

diabetes-free
yet diabetes friendly

It is addicting
It is powerful
It is a force of nature
It hits my blood stream like a glass of Orange Juice on a 55 mg/dl, & I am revived.

oh fountain of carbonated goodness

pure
odorless
flowing
swirling
enchanting


immersing my taste buds in an explosion of delight

you come in Diet Coke, Caffeine Free Diet Coke,Cherry Coke Zero, Diet Cherry Coke, Vanilla Coke Zero, Diet Coke With Lime, Coca-Cola Zero, Diet Coke Plus, Sprite Zero, Fanta Orange Zero, Vault Zero, Diet Barqs, Fresca Citrus, Fresca Peach, Fresca Black Cherry,Minute Maid Light Lemonade, Minute Maid Light Raspberry, Minute Maid Light Orangeade, Minute Maid Light Cherry Lemonade,Diet Nestea Lemon Sweet, Diet Nestea White Tea Berry Honey

the crack for the crack-less
the energy for the sleep deprived
the icing for a non-existent cupcake

this I want, this I need, this I crave
(addicted much? umm, yes)

I will raise my glass, and drink, to you.

Thursday, October 07, 2010

No #Dblog Day: EMG Results




This is not the cheeriest of blog posts, but short and sweet is what I need right now.)
Non-complicated,(or caused) by certain disease processes.(unlike the rest of my life) Soon as the doc gets back from playing golf in Bermuda,we can discuss surgery options.(it's nothing that's going away)








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Wednesday, October 06, 2010

Life as a Pancreas: Part I

I no longer doubt what my next a1c will be.




















Granted, I don't know the precise number, but I'm sure it will be under 7. Yes, sure. (can't say I've ever felt that feeling before) I'm not cured, I have not "gone Atkins", nor am I am in training for an Ironman. (last time I went to the gym? don't ask)I just know that this clinical trial & me were meant to be.















I still have highs, but they're not a daily occurrence. No lows whatsoever in seven days. And that is exactly what the first phase of the Artificial Pancreas is supposed to initiate-elimination of the extremes. Perhaps this is not a huge deal to those who already keep their bgs "tight" but as a card-carrying member of the 250+ club, I could not be more thrilled. (to not go above that, multiple times a day) My TDD has dropped 20%, my insulin/carb ratio's have doubled(1/10 to 1/22) and I do not feel like this is my diabetes anymore. My diabetes loves insanity, not order. In the 70-80 range, I don't feel like stuffing my face(1-2 tabs cure the slight jitters). And the overnight Dexcom reading is not a series in insanity(typical night:either spike,drop,spike drop or monster spike) its either slight drop, or slight rise. Stability is not a River in Egypt..it is possible for me,and possible for anyone. I don't know if it's them,(I go off preprogrammed suggestions most of the time) or just the direct contact of the Omnipod/versus traditional pumping..I suspect it's some of both. (and mandatory 3-day pod changes really, REALLY help)



















That being said, it's not all sugar-free cream puffs..my skin doesn't like the Pod tape,& I have some slight rashes from that. I will start using Tegaderm, should it continue to be an issue. I also cannot correct for a high,(premeal) because the Omnipod does not have a food IOB (and invariably, some insulin is still around from the last meal/snack. If I corrected, I would have to eat more, to keep from bottoming out post-meal) I am not happy that it doesn't have meal IOB,but it's something one could get used to. Because my decisions are not truly my own(I'm supposed to be trusting this thing, most of the time) it gets a little tricky, & I'm not really sure what I should be doing. (Study Endo hasn't called me back yet) I want to do what's best for my diabetes care,and it is a "behavioral study" but I'm new to this pump, and have no real clue what I'm doing. Certain things I love, certain things I hate,and certain things I do not know how I feel about it.(as of yet) Had to switch to Freestyle test strips, and as a die-hard One Touch fan that was really, really difficult.(although,bg comparisons showed them to be within five points of each other,so that helped convince me that they are just as (in)accurate) Right now I'm not doing much of anything, besides using the pump/meter/cgm & getting acclimated to it. Friday, I'll begin "tagging" events in the PDM (as previously mentioned, this is primarily an observational phase of the project, and they want to know what makes PWD tick.) That also entails filling out multiple psychological tests like the Beck Depression Inventory,which is every bit as dry & depressing as you may have guessed it is. But it's necessary, so I continue to plow through it.

Saturday, October 02, 2010

09/29/10

My eye exams are not ever what could be called,simple. Because I am a PWD with a complicated eye history(nearsightedness,cataracts, strabismus surgery,& optic neuritis) with primarily one institution, I prefer to go, there. Yes, I could have 10 years of medical records shipped lock stock & barrel up here,but I don't see the need. It is the place that has always been there,the place that took me through 3 eye surgeries and many worried hours of waiting. It is a place where residents share their personal Oreo stash & are always there for emergencies,to the point of first-name basis(over the course of 8 weeks).It is a place where miracles happen,it is a place of hope.

I have an emotional connection to the place,more then words can say.Starting over again,especially at an academic medical institution just has no appeal at all(especially not Hopkins,they lose everything). I can always find an excuse (family,etc) to make the eye appt down where I always went. This time,I was able to squeeze in an eye appt in the morning & the study trial appt in the afternoon.






That morning, I duly arrived @ 9:55 & took a seat. Dr. McAussie (not real name) called me back & put three sets of numbing drops in,took history,tested near/far vision,etc.And attempts to find a working eye pressure thingie. The stardard (blue light special)one that came with the machine didn't work, so he got one that looked like an EKG machine,which didn't work either.The next one looked like an oral thermometer & he stuck it in both eyes..that worked,to the relief of all involved. Chill time in the waiting room, & then it was off for visual fields & a Hess test.(all straightforward) Add three more sets of dilating drops,& it was back to the waiting room for the next half hour. Back in, bright lights & irritating mirrors producing copious amounts of streaming lacrimintation & auroral blobs. Everything looked good,no retinal changes,double vision is stable,& the right lens is beginning to scum up(the left,is progressed in scumming up). Nothing that needs treatment. (it's there,happens to practically everyone,just monitor it) Went off to get it cleared with his attending,& said I was good to go. Blood sugar was 410, by that point,so just had a sandwich/ water in the cafeteria...& spent the next few hours dealing with a bad hotdog(ingested 16 hours previously). Eye exams are never quick,but this one only lasted 2.5 hours.(fairly quick for them!)

By 4:30, my blood sugar was finally descending into the 200's & my gut was empty,which was good,because it was Omnipod Training at the Diabetes Research Center.(and the last thing I needed was to spend most of it in the restroom)






There was a group of six trainees,plus the study coordinator & Omnipod rep. Both of whom use the Omnipod.One of the trainees is a control subject...she doesn't have D,but she's doing it all along with everyone else,pumping saline.(that's both weird,and cool) Training went ok,loaded up on a ton of supplies & then drove straight home.(to beat the approaching monsoon) I was dead by the time I got home, 4 hours later.

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Monday, September 27, 2010

Omnipods & Eye Exams

Tomorrow I take off down South,where awaits an eye exam & the next step of the Artificial Pancreas Project.And while I am not thrilled about the switch in insulin pumps...it will definently be the learning experience of the year.I may love it or hate it,but it will not last forever...& I shall survive.Yes folks,I shall be trialling the Omnipod..stay tuned!!(I am also exceedingly nervous,given my uncanny ability to accidentally rip things off/lose devices) I shall be using that, together with their Dexcom,to manage(not manage) my diabetes for the next few weeks.(someone hold my hand & tell me I can do this)


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Friday, September 24, 2010

The Not-So-Funny Bone



(Orthopedic waiting room)

Today, I went to the orthopedic doc, my wrist/hand has been bothering me for several months. Wrist brace/anti-inflammatory meds have not done a whole lot of good. At first, I thought I'd broken it,because it all begun with an injury. My PCP said nope, it was likely a nerve problem & referred me over to the orthopedic practice.

Because it was a satellite office, there was only one doc there that day...and the patients stacked up like cord wood. It took an hour to finally get around to me. Didn't really mind, that happens sometimes,fortunately I didn't have any other pressing obligations the rest of the day.

Doc O came in, asked a few clarifying questions,and proceeded to poke around on my arm & delivered his opinion, which was it looks like a nerve entrapment at the elbow, possibly the wrist as well. The fingers/thumb on the left hand are significantly weaker then those on the right.(fortunately,I am right handed) All of which is common, in individuals with diabetes.(yay,yay,yay) He asked about my control,and said it didn't really matter if my control was stellar...accumulated sugar has a way of causing problems, regardless. Next step is EMG/nerve conduction studies,& I should add an elbow brace to the wrist brace.

(this is the area of pain/numbness)

If it is compressed,it will mean surgery.(I don't really know how it could not be compressed,given the symptoms)There are multiple scenarios that could be occurring-and maybe it is diabetes,just screwing up the entire deal. I really would like it be something fixable,as opposed to "just live with it." Yes, I have diabetes,but I also do alot of typing, etc.,and the whole thing did begin with an injury. I would appreciate docs NOT slapping diabetes as the cause, right off the bat.

Tuesday, September 21, 2010

Wave of the Future

I got that feeling again.

"Take a look at your Dexcom...in five years,it will be an obsolete piece of junk,gathering dust in the closet with the rest of your diabetes antiquities."










Errrr,seriously? This is one of the greatest technological breakthroughs,ever,(cgms in general)& just like that,the 7 (&7+)will be downgraded to nothingness?

The future beckons...& it's name is the Animas Symphony.Not at the FDA yet,& who knows when it will be,but it will be oh-so-cool when it is(& gets approved). Hopefully be around the time my warranty on this pump is up. I love the name,it's surely music to my ears to have an all-in-one device!

Having diabetes sucks,but the improvements are coming,fast and furious,& I have hope that I(& many other PWD ) will live long enough to benefit from them. Medtronic is steamrolling ahead with their artificial pancreas studies, JDRF-Animas is doing their thing...& rumor has it,that yes,Steve Jobs is in cahoots w/Dexcom integration into a phone(the iHelp,which may or may not be true,but would be totally rad if it were true)









and it's all a tad overwhelming,like standing on the edge of Niagara Falls,so much technology & potential to manage/cure diabetes. No one knows much yet about harnessing that awesome power,to the greatest good.

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Saturday, September 18, 2010

The Great AmeriCanadian Road Trip:Niagara Falls

Day 2,we enjoyed the Canadian side of Niagara Falls.







(thankfully,the breakfast nook had sf syrup.And Diet Coke,so I was good to go)






Breakfast.



















Standing on the ledge...
the amount of water that goes over every second is astounding.
Going "over the falls" is like flinging oneself off a 20 story building & hitting concrete at 200 mph,the undertow is very powerful & that is what kills people-they can't get back to the surface.


Mist:





We opted out of the boat ride,it looked lame anyway.You don't go anywhere near the waterfall.(s,there are two)But the Journey behind the Falls was pretty cool,you go down an elevator & right up near the (Horseshoe)Falls.The iPhone stayed in my backpack,as one gets exceedingly wet from the blowing mist.


Right time,right place for a rainbow!







(the Rainbow Bridge)






Forays into the Gift Shoppe..



























Went to see the IMAX movie about the history of the Falls. The first person to go over(in a well padded barrel)was a schoolteacher(& her cat). They both survived,but no immortal fame & wealth would result...she would die,penniless,17 or so years later.





There have been quite a few attempts,& a few deaths to boot.Not a good idea,even if you survive,you have to pay the fines/perhaps do jail time because it is illegal to go over the falls.











We can cross that place off the Bucket List now..it was pretty cool.

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