The American Finale

Dear Fox,(aka American Idol)


You had us all captive last night, what with an unexpected Brett Michael's appearance and a literal Pants on the Ground rendition. To be honest, it was a bit overkill(hurry up with the results already!) but I guess you wanted to make Simon's last night memorable.

I can now see why Simon really,really wants to get out-American Idol has degenerated into a "tween girl appeal" vote. You can be the best,but unless you're appealing to the younger set,you will not win American Idol.

And Crystal Bowersox was, quite simply, the best. The judges can't say so but the real champion last night walked away without the title. Crystal-you've inspired a nation & helped bring awareness to type 1 diabetes(in addition to being an amazing singer). And my hope for you, is that you get a record deal & outsell Lee DeWyze into obscurity. I hope you have only the best diabetes care from here on out,no one should have to beg for a medicine that keeps them alive. I hope you know that you are the REAL CHAMPION.

As for you, Fox,I hope that someday A.I. will be more then a popularity contest. Perhaps you should consider having two champions..a male, and a female. Until you do, the hearttrobs will continue to take the title & the really good singers will never win.

Signed,

A-sometimes-watcher-of-American-Idol-when-the-mood-and-the-circumstances-align

Fear Factor, x 100

What is it like?



















It's like strapping on a jumpsuit and doing things out of anyone's comfort zone each and every day of our lives. We all have things that take us there..a brutal gym workout, an exhaustive medication regimen,an evening with the Food Nazi's. What scares me might not scare you, and vice versa. For me, it's bolusing for carbs. Each and every day of my life, I jump off that (alligorical) building, trusting that everything will work out..the parachute(aka carbs) will slow the descent, the Dexcom will navigate me to a good postmeal,and that other things won't pop up to complicate the whole landing process. Most times it works, sometimes, I crash and burn. The fact that you've done it a million times without incident doesn't make up for the hundreds of times you haven't. Because the bad thing is knowing that you may not get it right, and it's not like practice makes perfect, diabetes can change on a whim.You just have to trust there is a ground,and the risks are quite low that anything will happen.The goal is to try to minimize those times you crash and burn.(double-checking carb counts,glucose & extra supplies on hand) Diabetes is one heck of alot scarier then even skydiving.

The Waiting Game

Waiting.

Wishing the email would come & put me out of my wondering misery.

I am really glad there are people like Ellen Ullman,tireless advocates for the rights(and needs) of not just kids with diabetes,their families,and adults with diabetes.I've known Ellen since forever(through CWD for 10 years,& met her for the first time in 2005) she is just amazing.(both in person & online) She is an article guru, sent me an article,name & email info for this guy at Yale who is big in the world of Bartter's research,suggesting I inquire about DNA research.I didn't have anything to lose,it's not like the NIH has anything (that I can find)going on in terms of research into the disease.To hope that they might give me a $2000 genetics test (for free) is a hope I didn't want to let myself feel.(yeah,I'm good at getting freebies but not that good) The researcher promptly emailed me back with all these questions,namely to determine if it was just a pointless exercise,if it was Classic Bartter's you don't need a genetics test to confirm that. Then he wanted a boatload of medical records,which (because of vacation & school & doctor's offices being a typical PITA) took 1.2 months to acquire,sort,fax relative info to him.

Now I wait, and try not to be impatient.(but with every "ding" to my email inbox,it just intensifies the feeling)Perhaps they should just scrap the whole mess & name a disease after me so no one will have to scratch their heads any longer.I'm still afraid to hope for the genetics test(although if anyone could afford it to give 'em out,it would be Yale),but the input will (regardless) be invaluable to me,whatever he says.Cross fingers & toes. In the meantime,I wait...be it a week,a month,or a year.


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The Top Fourteen Lisence Plate Ideas

The Top Fourteen Diabetic License Plates
1. TYP WERD (type weird)
2. CURE 4ME
3.A1C ROCS
4. MY IPUMP
5. SUGR LOW
6. DM SUCKS
7.GR8 ENDO
8. DRV HYPO
9. THE OC
10.BLEED RD
11.5MOR YRS
12. NO SHOTS
13. BETA BUM
14. DKA PRO
And plates I have actually seen..
1. ISLET TX
2.MINIMED
3. NSLN PMP
4. SWET PEE.

I love trying to figure out what the abbreviations on lisence plates mean.

Day 7: Wishin' for Bliss

There are many things that would
make up the day of a just-cured PWD. Freedom...from absolotuly everything D-related, dropped on one like a bomb.I'm not sure I would fully grasp the utter magnitude of such an occasion until it actually occured.But the biggest thing,for me, would go beyond the disengagement from food restrictions.(any food and in any quantity at any time of day,with no worry about blood sugars,amount of carbohydrate,etc. would still be awesome, don't get me wrong) It would be the freedom NOT to have to do ( a multitude of) diabetes tasks.

For over 11 years(since Day #1) diabetes care has been my responsibility, a 24/7/365 proposition.As you know,most docs don't even know anything about it & so you're just flying solo,no one can take that from you.Even if you're really sick,you can never stop the responsibility.They'll treat you for the other stuff,but the D is up to you.But for 32 hours in my life,it was not my responsibility,it was not my concern,& I kind of liken the feeling to being cured. My diabetes care(all of it) was in the hands of an endocrinologist & I was not permitted to even know my blood sugar for a 10 hour stretch. Weirdest experience of my life.She'd read the blood sugar that the lab tech would hand her,& tweak basals or bolus or make me eat and otherwise attempt reasonable control & I'd just sit/lie there,wondering what my blood sugar was & what I was really doing there.( besides watching bad tv,earning $12/hour and being completely useless) It really didn't feel like my diabetes,it felt like I was her human science experiment.It's like forced disengagement from something you cannot ever forget,& while being incredibly difficult it was kind of nice.(not to have to worry) It's just hard,giving up all that "gotta know" patient perogitive.(FTR,she did such a good job of it you'd think it was her diabetes;after the study ended she informed me of my bgs) And so,I think that first day without diabetes would probably be spent carbogorging & checking once or twice anyway,just to be sure I really didn't have diabetes anymore! I would need that reassurance.

I also think that I'd want to stay up for the full 24 hour stretch...to just enjoy the awesomeness of an entire day without diabetes. No highs,no lows,no food restrictions,party till the beta cells come home. Perhaps basking on a beach somewhere,Margarita(s) in hand,without a care in the world.That'd be glorious.(and man,I cannot WAIT.) I want it to be right now.

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Day 6: Snapshots of a D-Life,part II

The Happy Couple.(registered at Animas and Dexcom)



JDRF walk! (hangin' with the cow)




Yeah...I should do more of that.(class ends in 4 days,maybe I'll have more time...)




Worth it,worth all of the 6.9 unit bolus.



Every 'betic girl should have a pair!(or diet pepsi,whichever you prefer)

Day 6:Snapshots of a D-Life(part 1)

(BlogPress is not cooperating,so this will be in two parts until I can make it to a real computer to combo it)


(about two days worth,boy do they accumulate rapidly)



My insulin holder.(necessity is the mother of invention)



Supplies!(for the next 6 months)



Extra,Extra-read ALL about it!(another reason to attend FFL,it's a really funny newspaper)


Case in point.

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The Exorcisest

Somewhere on the East Coast...

It's 4 pm, and a PWD is preparing to go to the gym.But first comes the mental checklist:

-pump?(check)
-Dexcom?( check)
-workout gear?( check)
-money?(check)
-iPhone/music player?(check)
-glucose tabs/juice?(check)
-syringe/insulin?(check)

Moderatly satisfied that she's covered every possible scenario,she heads out,first stopping at the fast food place for a salad. She checks her blood sugar(167),boluses for the salad, and waltzes into the gym,intent on a productive workout.All goes well,until she snags her tubing on the door to the locker room & yelps in pain as the infusion set rips itself out. Guess what-no backup set.She decides to keep an eye on it,& just keep the workout short.

First Stop,weights.That goes well,but the line on the Dexcom soon skyrockets.(stupid anaerobic activity) Ends at 238 mg/dl.

Takes a correction,via shot.Does 15 minutes of running.Feels like it's going nowhere, so ends early.Dexcom dips slightly.

Gets home,starving & proceeds to eat most of everything in the refridgerater,& invariably goes low anyway.

That's why I hate exercise,it makes me twice as hungry (no matter what I eat before,or during) ,sends my bg all over the map,and makes me ache all over. I don't go to the gym as often as I should,but I do get exercise around the house with housework,etc.(and walking to my classes 2x a week)I want to learn to swim this summer,that would be alot more fun the sweat-a-thon that the gym is.Exercise is too much work for very little reward.(or so it feels like)

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Carb-o-nation

"I never met a carb I didn't like."(Author unknown)

"Food, glorious food!" -Oliver Twist

I love food, but it doesn't love me. Anything beyond 40 grams of carbs has immediate and disastrous effects upon my blood sugar..but I still love carbs. Doughnuts(with the cream filling), spaghetti,cereal waffles,bagels,Twinkies,chips n'dip, ice cream with decadent dripping chocolate syrup,all variety of pasta dishes,pizza,subs,biscuits 'n gravy, mashed potatos, breads,you get the general idea. I cannot live on egg whites and celery sticks. I can generally do pretty well with reducing the after-meal spikes(especially thanks to help of Le Symlin)but there are still foods that are really, really, disastrous and I fail every time.

Like cereal. Any kind or brand, hello 400 mg/dl.

And Chinese food. Not quite a 400, more like 260 for 3-4 hours while I bolus repeatedly and wonder if it will ever come down.

So I restrict those,(as in, eat once or twice a year)and I try to not eat humongous carbohydrate meals.(not just for the aftermeal spike, but because all that insulin catches up and makes me plummet. And its not just a matter of poor timing,it's when I take a good deal of insulin for a meal,the action of it gets pushed out several more hours(for some bizarre reason),it's like Superbolus and it takes forever to out of the system. I guess that's good if you plan to eat again anyway,but sometimes I'm simply not hungry and there's no freedom in being married to your insulin. I guess I could get the cereal bolus down(with some experimentation)but anything involving a pre-meal bolus of 30+ minutes has me more then a little leery. There are other breakfast foods that are more predictable(that don't require pre-bolusing) & I'd rather stick with them.

I eat alot of protein,to help smooth the spikes(sometimes too much and that has bg effects too) And multiple snacks throughout the course of day-like cottage cheese, graham crackers w/pb, soyjoy bars,popcorn w/cheese,ham sandwiches.All carbs are fine(in moderation) and if 3 chocolate bars equaled 45 carbohydrates you can bet I'd eat 'em all. Unfortunately,that's not the case.(and that's not to say that I don't go carb wild and eat like I haven't, for a week) It all depends on whether or not you can get(and keep) those numbers where you want them. For me, small meals and frequent snacks work better.

Sometimes it may appear that PWD don't have any freedom in their diet..but in reality,we're like most of the rest of the non-pancreotically challenged crowd.It's a matter of intake vs.outtake,& the rest of America has to deal with that issue too.
(if you eat too many calories, whether from fat,protein, or carbs, you will gain weight)As a nation, we eat too many calories(and carbs are a major contributor to that)But carbs aren't evil if you can handle the calories/bg rise.(it's the diabetes that's evil) Although, if you're type 2..it may be a whole other ballgame,I'm writing this from a type 1 perspective. If I don't have carbs, I just cannot function. That's my take on the whole issue.

My Type Three

I had planned a better post then this,but A.I'm drop-dead exhausted from school exam stuff B.I have a massive stabbing pain in my lungs and C.Its raining cats and dogs.My biggest supportor is my husband,& he deserves all a better post then this.If I survive another day,I want to give that to him.


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GoGo, Mr. Low

My favorite way to treat a low(besides not having one in the first place) is juice or glucose tabs. If I'm 50-70,I drink a 25 carb juice box. If I'm 60+, I drink half the juice box. And if I'm below 50, out come the big guns(3 tabs, plus the juice). Or glucose liquid, which is the fastest thing short of glucagon in me.(and has saved my butt on multiple occasions) It just depends on how fast I am dropping, how much IOB is on board, and & whether or not CVS just ran a sale on post-holiday candy. (like peeps,sweettarts,smarties,Airheads,jellybeans, candy corn,cotton candy,and similarly fast-acting carbs)I like them all, but usually don't crave them when I'm not low.(so it's not a great temptation) There are a few things I don't like at all(low or not)-orange juice,any type of coke,and orange glucose tablets.(everything else is fair game)I drop very quickly,the last assisted low I had,(Halloween '08) despite drinking two juice boxes I went out of it 20 minutes later(fortunately it was at the infusion center,so all they had to do was swap out the magnesium bag with D50 & ship me down to the ER,if a low could be termed convenient, that would be it. Consequently, I would rather overeat(and be at least 100+ mg/dl). It's not the best thing for my a1c,but it's best for my peace of mind.(and the pocketbook,who wants to spend hundreds of dollars on ER copays)

Then there are the times when the hungry gene just doesn't turn itself off & after treating the low, I just eat and eat and eat myself into a massive high blood sugar.Anything and everything goes down the hatch.(you know you're hungry when you eat week old beet salad,ewwww) Moderation is the key..you just have to find something that works for you,and be comfortable in that knowledge. Sometimes that's easy, and sometimes it's not,but that's the goal.

Diabetes Blog Week-A Day in the Life

(It's National DBlog Week,(courtesty of Karen at Bittersweet Diabetes),and though my life is generally pretty dull..I'm doing this post regardless. If you haven't committed yet, join in the fun!)

4 AM- My bladder wakes me up,my Dawn Phenomenon has gone to town and jumped from 150(10 pm) to 298. I am not going to waste precious sleep time trying to determine just whats gone wrong here,set,insulin,delayed fat kicking in,other hormones? I whip out a syringe and mainline 3 units of precious liquid into (plenty of)adipose tissue.Need this sucker to come down, quickly.

7:30 AM- Wake up, blood sugar check. Now down to 112. Dexcom confirmed to be in the same ballpark, at 121. Shoot up 15 mcg of Symlin. Eat breakfast(usually 2 waffles w/syrup,1/2 cup cottage cheese,a fig, and Diet Coke)Bolus for breakfast.

9:30 AM- Insert 2nd pump set, prime and fill Deltec for magnesium administration. Hook up, let run.(opposite side of body) Can someone say Bionic Woman?(2 pumps,Dexcom,iphone continuously on/near person)

10 AM- take multitude of other meds(amiloride,claritan,advil,Nasonex,multivitamin).
Wish it wasn't just diabetes to take care of every day. It's a full time job,keeping all these other meds in line.(or it just feels like it-I know it's really not(comparatively,to those individuals who take half the pharmacy on a daily basis)
Study. Check blood sugar again. (176)

12 PM- 101 mg/dl. Eat lunch. (Sandwich, chips,piece of fruit)

1 PM- Call CDE, review recent overnight bgs.

2PM- CDE calls me,to tweak overnight basals.(with Endo input) It's definatly a basal issue...repeated overnight checks show this to be the case. Switch times of when basal #2 starts, to handle dawn phenomenon.

3-6 PM- Class. Check blood sugar,doodle on iphone, and occasionally, yes,learn something.

4 PM-299. Crap. (didn't bolus enough) Bolus for that.

6 PM- 67, and tanking like a log. Treat. Drive across the street to McDonalds and order 100+ worth of carbohydrates from the menu and gorge down every one of them. Another Symlin injection. I have no self-control.

7 PM- Decide not to go to the gym.(claim blood sugar exhaustion) Head home,clean up.
Twitter.Facebook. Watch TV. Do laundry. Put out recycling and next day's trash.

8 PM-155. That's a decent number, postmeal.
9 PM-BRAAAP.(crosses the 180 mg/dl mark,which is my "high"mark on the Dexcom) Bolus correction.
10 PM-BRAAAP. (dips below 180 briefly,heads over it,and sits on 181) Durn delayed fat.
10:30 PM-BRAAAAP.(dips below 180) Finally heads down, for real.
11:30 PM-144. With that, it's off to bed. Looking forward to doing it all over again tomorrow!

The Forecast Diaries

I'm always excited when I get a new issue of Diabetes Forecast. Back when it was ADA Forecast, that is.


They are,for the most part,non-existant & rarely come up on Ebay.(every few years) I have some from the 40's,50's,and 60's,and this one is from 1971.My goal is to own the complete shebang(it may not even be possible,how many people keep outdated diabetes mags circa 1954?)I used to have most of them from the mid 1980's to 2005,but I had to get rid of them (due to space constraints,I had 200+ magazines in my small apartment) I kept the Dec.1998 issue,(for obvious sentimental reasons) and the May 2001 issue(because of my Reflections article in it). The modern day stuff is nothing great,but I love collecting the old issues.(as time goes by,I might even bump the "old" criteria to the 1980's,officially making myself into an antiquity as well) I don't know when Forecast became Diabetes Forecast...sometime in the late '70's,perhaps?

So when it arrived,I eagerly tore into it,searching for "Dave's Diary" (when we last left our hero,he was out to a picnic lunch with his fiancée,which he handled perfectly and had lovely blue urine tests to prove it.)Much to my dissapointment,o'le Dave had semi-retired from the article updates,but he came back this one time to "thank" the lady you see on the cover, for her many years of helping diabetics with their diets.(she contributed to the Forecast food articles) So there was that,she sounded like a very selfless,giving person.(as a Catholic sister)

There's usually at least one "real life" interest story in the magazine,and the one in this one was a real humdinger of one. The individual was Lowell Palmer,who by 1971 had already lived 51 years with diabetes,49 of those with insulin.Dx'd as a junior in high school,he was basically told by the doc to take it easy,no exercise,limited carbs.Advice he ignored,and pretty much did as he wanted.(with regards to extreme exercise) And that worked in his favor..he didn't deteriorate quite as fast.I don't know about you,but prior to my diagnosis,exercise was the very last thing on my list of desired activities.It just made me drink 4 gallons a day vs 2. And I dropped off the basketball team,it was just pure torture. It must have helped preserve his beta function.(individuals really vary in the time they go before being dx'd) He put off going to collage for a year,but when he did,he started to rapidly deteriorate,despite being on the restricted diet.(1200 calories a day,40 carbs,69 grams protein,89 fat) Tanked 15 lbs to 120,& the doc actually did bloodwork which showed his bg to be 280 with high urine sugar.He didn't have the money to go to a diabetes specialist & no one knew about the discovery of insulin.Went back to school,got
sick during exams.He went home,went into a coma.(when your beta cells finally do poop out you get really sick,really fast)His room mate then called his doctor.The doc came out,&assissted by the roommate,put him in the back of the doc's Model T Ford and away they zoomed(in the middle of a December Blizzard) to Massachusett's General Hospital where he got the first ever injection of insulin.(that they'd ever given) He briefly came out of the coma but went back in it when they ran out of insulin.They got more in,& he came out of the coma.In 2.5 years,he lost 50 lbs(weighing in a scant 112 lbs at hospitilization). Insulin was not yet "standardized" in terms of how much a unit would lower blood glucose,and how much carbohydrate it would metabolize.A vial of insulin only contained around 50 cc.(and cost $2.50) In 1923 this was no small expense,as he went through a vial a day.In exchange for free insulin,he volunteered to be a lab rat & help (Eli Lilly?) them standardize the insulin concentration.He kept careful food records along with collecting urine & (simultanious)blood samples,(storing them in small vials) which he took to the lab each night.Eventually the H-10 gave way to U-20 and U-40 insulins gave way to U-80 and U-100,and the long acting insulins hit the market(in the late 1930's).It's interesting how we have come full circle and (popular opinion) dictates that short-acting insulin is (in most cases) the best way to go again.Diabetes fads rise and fall,but the realness of the disease remains.
After graduation,the issue of employment arose.To circumvent the issue of discrimination(the job required a physical exam,& if said urine test showed sugar there was no way the employer would hire him), he went to a HR rep who had diabetes himself(and I guess,fudged the results).40 years later,he retired(with only 30 days of time taken off for health reasons). That's pretty incredible.

Tune in tomorrow for the start of #dblog week!

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Blue Cross Blues

Dear Blue Cross and Blue Shield,

I'm writing to you today because I feel that the best thing you could possibly do for me is to NOT put me on your case management program.I know it's helped alot of PWD,but it never did a whole lot for me.I've refused to call you back(for quite some time,actually I think it's been 3 years) ever since the last convo that took place...

"Hi, I'm Sue! Can I speak with Heidi???!?"

"This is she."

"Oh,hi Heidi! I'm a nurse case manager with BCBS and we're helping people manage their die-uh-be-tus better. Can I ask you a few questions today?"

"Sure."

"How many times a day do you check your blood sugar & what do your numbers run?"

"7-10 times a day...they range from 50-400."

"That's just horrible. Have you discussed thus with your doctor?"

"Yes.That's just life with diabetes."

"But it's not normal,are you following your diet?"

(Mental headslap as it dawns on me that taking this call was a huge mistake)

"I try to eat healthy,yes."

"You really need to monitor everything so that you won't have any complications.Do you know what can happen with uncontrolled blood sugar levels?"

"Yes." (grrrrrrrrr)

"Oh,good.I can send you some information about diet and exercise,would you like that?"

"Thanks,but I have all the info I need,I see my doctor and educator reagerally."

"And have you had the A-1-C test?"

"Yes,many times,the latest was 7.9."

"Oh that's much too high.You need to get that down."

"I realize that,& I'm working on it."

By the end of the conversation,(besides feeling like I wanted to bawl) I vowed never to engage in conversation another one of your copy-and-paste phone nurses about any aspect of my D. A promise I kept.

Until today,when I politely let it be known that I wanted off the Bug The Patient To Death list. I know more about my diabetes then you guys do,& what I don't know I have a CDE/Endo who are totally awesome.I am satisfied with the care I get there, please just leave me alone. Neither your diabetes knowledge nor your bedside manner is anything I'd wish on a newly dx'd diabetic.


Sincerily,

A Not-So-Enthused Plan Member





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Almost There

As the semester winds down & final exams loom ever nearer,I've come to the realization that I don't care two beans about being accepted into Big State School's BSN program & would much rather do the community collage thing. It's cheaper,it's nearer,& it's much friendlier to my overall health.Of course,the soul two determinants on that are A.county residency and B.GPA.They go down the list of applicants and pick the top acheivers.Based on previous years,I'd probably make it in but not if there are 15 more people like my overacheiver,A+,taking 13+ credits classmate.One just never knows.All I can do is survive the next 18 days...and wait for the aftermath.There's an endocrine/reproductive exam,my presentation,a cumulative final,and a CPR refresher course to finish things up.It's hard to believe that I'm really there,that I've survived two semesters of anatomy,a boatload of psych courses,microbiology,chemistry,
two math courses,and a million other courses that I've been working on for the past ten years(while working FT).It's hard to believe that it's really all done,that I can actually go to a degree program now.If I don't get in this fall,I'll just apply again,maybe take a course to improve my gpa slightly & beef up the resume,etc.I just don't feel like I can commute two hours a day to do that other program.It'll be hard enough.


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