A Study in Endocrimology

Little known fact: Endo's are "human beings" too.


Lesser known fact: They have lives outside their medical offices.


Littlest known fact of all: They have friends. Friends to whom "blood sugars" do not come up on a regular basis. Friends with whom they go bowling with,eat cupcakes without asking the said carb count of,and generally have a pretty normal,diabetes-less existence.

When I think of an Endo, it would be hard to imagine being friends with one. (however much of a wonderful person they are) The instant I step into one's office, an aura of guilt surrounds me (I could be the best PWD on earth and I think that would still be the case) & does not let up until I'm well on my way home.(and every once in awhile, a "lightning bolt" accusation just serves to really charge up the atmosphere)

Perhaps its just me. I have to say, that yesterday's appointment went better then most..& also,much more through. Blood Pressure normal,blood sugar about 100 points lower then what it usually is(it is ALWAYS after some meal,so it's always elevated),weight gain 7 (total)lbs...a1c pending. My Endo started out by complimenting me on my much improved control,and I mean really complimenting me.(I really don't recall if that's ever happened before)I am used to negativity right off the bat so I really don't know how to take that switch in tactics.Reviewed the past 5 days of blood sugar logs pretty throughly. I go in every month (rotating between her,and the CDE)for a comprehensive review (so it's only been 2.5 months since I last saw her).

Before I married/moved to this area, all of my diabetes/eye care was done at a University down South..and my former Endocrinologist,after I told her I was moving,recommended my current Endo (my Endo was a resident physician down there,a million years ago).Well,they are still friends and hang out occasionally & though I'm sure my ex-Endo doesn't recall me in the least my Endo is aware of the fact that I used to live down there/have her as an Endo/etc. (I guess the answer to the question "Who do Endo's hang out with?" would be, other endos)That area will always have a place in my heart..& that hospital,where I began my life with diabetes,went through 3 eye surgeries,test drove an artificial pancreas,began insulin pumping,was diagnosed with Bartters Syndrome,learned of life/death/and the value of every minute(be it good or bad),and just generally grew up through is a part of my history,& a part that I kind of share with my Endo.(that makes her less of a white coat,in my opinion)

We discussed how insulin requirements would change...apparently every T1 at least doubles their total insulin requirements(and most triple, or even quadruple). That is not something I am looking forward to,but apparently it's a gradual rise(and given the frequency of tweaks,you won't even be aware of most of it) It is hard to imagine blowing through that much insulin every month,like it was water.

By the end of the appointment,I'd almost managed to forget about my a1c results..my endo left the room to get them.

"6.9."

I was happy/estactic with that(given that I worked my tail off to get there)so the remainder of that conversation was largely tuned out by me. I've never been below 7,and how people can just pop out 5.0's like it's nothing is a mystery to me. I know that she'd like to see it lower,but pregnancy does not suddenly turn diabetes care into a piece of cake.(it's still unpredictable diabetes) I'm going to savor this number,& keep plodding on.(toward better)

Friends for Life:Green Armbanded Moments

Life is about the moments...the good & the bad.And that's what we're doing right here...we're making moments,we're making memories,to be treasured. (a loose paraphrase,it's been 3 weeks & I don't recall it verbatim) -Tom Karlya,FFL banquet, Orlando 2011





(the color bands of the conference...green was diabetes,orange was not diabetic,and yellow was celiac disease)

Going into this conference, I knew that it would be a bit different. The clock will never go back(to one's carefree,stay-up-to-the-wee hours,childless days) & I wanted to tie up all the loose ends that I never felt I have,in prior years. (I've had my fun,it was time to make this one a bit different) The first step to that,was getting on "Staff"




as a childcare assistant. It's also a job that comes with a few great perks,most notably free conference registration,free banquet tickets,and a free hotel room, which means the only thing Staff pays for is the plane ticket there/from.(& I dunno,maybe the speakers even get that payed for) Definably the best babysitting gig I've ever done. (yes,you lose your mind after 2 days but there are still good moments,& lots of time to unwind from the kid stress.) In the interest of disclosure, I will say that no one there knows(or cares) that I blog...these thoughts are my own & I would say them regardless.


The first "real" day of the conference always starts on a Thursday,but Wednesday is the day of focus groups,the day when the diabetes companies pick our our minds.(as to what we want to see in technology)
The first session of the day was an adult "Meet & Greet" hosted by Kerri & Scott..(group photo below)





I was then supposed to go to the childcare planning meeting,but no one was in said room,(and the leader wasn't responding to email/voicemail) so I said to heck with it & just went to another focus group. I didn't know what else to do (even the hotel "event boards" showed it to be in that room, & I wasn't just going to wait around at a room where nothing was happening.When I got out of that,my voicemail inbox was swarming with frantic calls ("Where ARE you?!?!") and the actual room was as far away from the room they told me.(as humanly possible) As they didn't bother to call until 30 minutes after the "meeting time" (nor did they bother to pick up their phone & tell me the correct place) I don't really think I was at fault there. I went there,intro'd myself to the CDE, and got instructions. I made it a point never to be late again (even if it was their fault).(CWD needs better communication to their staff)

After that,I stopped by the free Retinal Screening...which is offered every year by Dr.Ben Szirth(& team-a group from New Jersey).There was a bit of a wait,but I'm ok with that. I go every year (they don't put drops in,but they do check inter-ocular pressures & take photographs) Last year, it showed that my L lens was beginning to cloud up...and this year,my R lens is following suit. They always recommend follow up with an opthamologist, & given that you're supposed to see one in the first trimester of pregnancy anyway(didn't happen,but it is on the schedule) I don't feel that it's anything that's snowballing out of control,but when it does become necessary for lasaring I hope it doesn't affect any aspect of vision)

Grabbed some lunch (from the food court),wolfed it down, & for
the 1:30 session, I dashed over to LeeAnn's diabetes art workshop. Didn't know anybody (else) there,but the two teens I sat across from were certainly entertaining.(if nothing else) This is my "self-portrait ".






I guess all of the other adult T1's were having fun in the Infamous focus group...I was so rattled by whacked-out schedules by that point that I didn't have any clue what was going on. After that, I attended another focus group...(I don't remember what company sponsored it...)




It was lengthy,but not unreasonably so...and for 35 Disney Dollars you find yourself agreeable to even 1.5 hours of invasive,"Circle of Love", type questioning. It was geared toward kids (with D) & their parents,but guess what,there were adult pumpers there(and an adult pumper with their pumper child) so there was certainly a good representation from most parts of the D-Sphere about how pumps & meters should interact. That was the closest I got to an actual "therapeutic" session...for I couldn't go to any on Thurs-Friday. That done, I went back to the room for an hour's nap before the Exhibit Hall opened at 6. The Exhibit Hall,upon the official "Grand Opening", is immeadietly flooded by 2,500+ eager souls intent on grabbing as much diabetes swag as humanly possible(like an invading army). And while this is going on, the hotel staff sets up a buffet dinner right outside.(so the plunderers can refuel & get right back to plundering) But being starving(& low),I headed straight for the DRI's "Popcorn Machine"& the free samples they were giving out, I couldn't wait for the buffet. Had some dinner,went back to the Exhibit Hall,lugged stuff back to the room,& had a mini-meltdown (in the Florida humidity)when my room key ceased to work anymore.(I sure wasn't going to lug it all back to the convention center)My roommate came through however,(after multiple,panicky calls) & after dumping everything off we went back to the convention center for beverages & to get a new room key.(& I stopped off at Blogger Central,where everyone was sitting by the lake & tweeting(DSMA chat) merrily away. It was like geek central,though on occasion,someone actually did say something out loud. It was also REALLY cool though my phone service seemed to be at least five minutes behind everyone else's,as evidenced by snippets of conversation that I'd finally "get" later on.





(the live,streaming Twitter board in the exhibit hall)
Morning came way too fast...&it was up & at 'em for a quick bite to eat before a day spent babysitting.


My "Mickey Breakfast."

I was at the appointed room by 8:30,although there was some confusion as to which room I really needed to be in.(the "under 2's" were staffed by a professional childcare service,which I found to be pretty odd) Eventually,I was stuck with the 3's & 4's and as the room filled up with crying,screaming children, I tried to find a far corner & make it look like I was doing something essential so I would not actually have to tear a little darling away (& comfort that little darling). A couple kids quickly found the bubbles,& most of my morning consisted of making sure they didn't spill soap all over the carpet/room/universe. Which means,that my hands were also covered in bubble soap & I didn't check my blood sugar all morning,& by the time lunch rolled around (we got 1.5 hours for lunch,the parents would pick up their kids) & I'd washed my hands a "LOW" greeted me,flipping me completely out. I went into the 5 yo room(right next door) & panickly announced that I was low & could I have something? The Diabetes Educators in that room(who hadn't gone to lunch yet)assisted me in the consumption of a vast amount of Carbohydrates(and checking again,to make sure I'd come up). I'm aware that adults with diabetes (much less staff) are supposed to be role models for the kids & not get into these circumstances in the first place,but it happens to everyone...those lows that catch you totally off guard.DE's rock.(and what is the point of a diabetes conference,if not "making new friends"...you'd better believe that they remembered my face for the rest of the conference) Had lunch,got over being shaky,perused the Exhibit hall briefly,went back to the kiddo's for the afternoon. One little boy marched right up, told me he had an insulin pump,& asked if I did too. (the answer to that was yes,but I doubt that he'd know what a Pod was since most of the kids used traditional pumps)It was completely adorable & stole my heart(having diabetes at only 4 must be really hard on the parents-the kid doesn't even grasp what it is yet) but then I discovered that there was not one,but TWO little boys,(TWINS) both with diabetes,both with pumps. Both were very cute,but they were also typical brothers...intent on slugging,hitting,pushing,& completely annihilating the other. It was a relief when "nap time" came around & they sacked out completely. It was even more of a relief when 5 pm rolled around & I could check out for good,it had been a really long day. (reinforcing in my mind that I DO NOT WANT TO HAVE TWINS)
(also that day,Jackson,the CGM'ng dog with diabetes visited..a few of the kids were interested,the rest were not)


Went back to the room, got ready for the banquet, & tried to find some adult bloggers to hang out with. I then bumped into the Roche medical director(who actually remembered me from the previous year...which is odd,because generally,people can't wait to forget me) & in the course of that conversation, lost track of everyone else & spent the next ten minutes looking over the huge banquet hall for some. I finally found some.(Lee Ann,Scott Strange,Karen & Pete, Jess & husband,and I think Jacque?)

Crystal Bowersox performed...(& she's even better in person then she was on American Idol!) it was incredible listening to her,she really can sing.And I will forever think that she should have won it.(she was by far,the better singer,but tween girls(& their mass texts) will forever decide in favor of the young male performer. She answered questions for the kids...about diabetes,& performing on American Idol.




Every year,there is a slideshow of the previous year's conferences....& every year, I get all choked up thinking of the incredible people who come/give of themselves to help kids with diabetes be all they can be. But in the middle of my getting choked up,the infamous diet coke earring picture flashed across the screen & I was more mortified then anything else.(ayeeee!how did that end up there? Never mind, I know how ( Thanks,Scott) it was just somewhat shocking,to say the least. I mean,I'm an adult with D & a solo picture of me has never graced the FFL screen.But I survived the mortification.)




I then rocked out on the CWD dance floor (near Lorraine & family & Michelle & family....)



(Michelle Golliday & I)
The next day, was much like the previous...but by 10 AM I was completely worn out & functioning on autopilot. It wasn't quite as hectic,although I made at least 15 bathroom trips for the kids & 7 of those were for 1 kid who didn't have diabetes.( I was beginning to think that he really did) The main CDE took about half the kids to play in "Sports Central" while the rest stayed in the room. I helped with crafts,games,etc. By 4 pm,everyone was pretty ready for the parents to just come already though. Joe S.came in & all the kids had a free for all jumping on him.(does he still have a back,I wonder?)





By 5, I was beyond worn out & in dire need of a nap(31 kids/12 with diabetes...for two days,inside too small room) which I did, for two solid hours. Didn't want to miss the Adults With Diabetes dinner,so I managed to show up(just an hour late) at 8. The ID checker at the door asked if I was 21,asked again,& had no problem with not seeing an ID. I figured that was because there was an open bar,but didn't bother to check the bracelet he slipped on my wrist. I didn't plan on drinking( no matter how alluring those Blueberry Mojito's looked),later I'd find out that with the armband,you could get 1 free drink.(not quite unlimited alcohol) I guess I should have given it to someone else who could drink,but I didn't know.


Sam Talbot is a former Top Chef contestant.(with type 1 diabetes) And in the same way that Chystal Bowersox can really sing,Sam can really,really cook.(he was giving demos of how to prepare the food on that evening's menu) Problem was,it was a bit too spicy for my pregnant taste buds so the greater portion of that meal was the desserts(mini cheesecake,brownie,fruit tart) and water. Tandom(the event sponsor) had a raffle giveaway(Snuggies,a camera,a couple gift cards to high-end shoe stores in New York) & Sam signed autographs/posed while the adults with type 1(spouses,etc) randomly mingled/shot the breeze. There was one person there(an OB nurse with T1) who went to college where I grew up,works in the state I live in,& could tell you more about the nursing program at my school then I could myself...it's a small,small world. (& a most bizarre one,I was afraid she'd have some sort of sixth sense about me & ask if I was pregnant)

After that, I figured I'd head over for dessert/scientific discussions with the faculty.(more for the discussions,not the food) I'd gotten about a hundred feet,when one of the CDE's saw me & waved me over to join the group of all nurses unwinding from their hectic week with the help of lots of red wine.Certainly they needed it,but I was getting tired again(& there was no caffeine or alcohol on board to help with that) & about an hour later,excused myself...only to run into the blogger group on the outside patio. Stayed till midnight there & then went back to crash.

And that was the week,in a nutshell. Sat. my roommate & I moved to another Disney hotel.(so were not around for the last "farewell" breakfast) FFL will always be exhausting,but it will always be worth it...you meet new friends,reconnect with the old, & feel that diabetes does not suck quite so badly. There's also no "type" discrimination at FFL...although the vast majority of folks have type 1,if you've got diabetes,you're wearing that same green armband as the T2 next to you. I think it's nice not to fight...1 week out of the year.In a sense,I feel like I've "grown up" with CWD (not really,but I have known some of those folks on the chat rooms since I was 18 & as green with diabetes as they come). After 5 conferences, I finally got to "give back" although I think that probably should have taken the form of another age range. I enjoy talking with the parents of the kids with diabetes too...it gives me insight as to what life is like for them.

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100 Days

On the 99th day of pregnancy,my body gave to me
A raging,snotty,stay-in-bed flu .

Yesterday's Babyscope:

Jul 20, 2011
Staying Healthy
As if you didn't have enough pregnancy symptoms to contend with, you're also more susceptible to colds, flu, and other bugs when you're expecting. That's because nature wisely suppresses your immune system during pregnancy to keep your fetus (a foreigner to your body) from being rejected. The key to staying healthy during pregnancy is to engage in some germ warfare. More than ever, the best defense is a strong offense. Wash your hands often (and carry liquid sanitizer for times when a sink's not handy), don't share drinks or food or toothbrushes, and avoid sick people like the plague. If you think you've caught something, check with your practitioner ASAP, who will treat what you've got with your special needs in mind.

Wow,seriously? Talk about great timing.(telling me after I've already caught the thing,how about 3 weeks ago?)I wash my hands a billion times a day as it is.(so much for that,I suspect someone gave it to me at the airport) The wording of that is also quite interesting ("foreigner to body?" whatever happened to it being the most natural thing in the world?)


100 degrees outside.

100 degrees inside.(me)

100 days of pregnancy.

100 (what my blood sugar should be,& is so NOT,& not from lack of trying,fever raises my basal insulin requirements)

As for symptom relief,the only thing you're really allowed to take is Tylenol.(Sudafed in some cases,but I'm not one of those cases) My "special needs" mainly consist of keeping the blood sugars in line,(emailing Endo 2x/week)& keeping hydrated. Can't use my CGM,because Tylenol messes up the readings so I just have to check a zillion times a day. And is that helping,not really, I need my CGM to alert me before(not after) the fact.

I'm pretty sure that if Michelle Duggar had diabetes...there is no way she'd go through pregnancy 19 times. It's possible,but that doesn't mean that there's anything easy about it.(the real question is,it possible for me to do it.I'm 50/50 on that one.)

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The Ugly Meter(that could)

Once upon a time, in the land of Meterville(aka Heidi's Closet) there lived a young Freestyle meter.


As meters go, he wasn't very "fancy" or revered,& the young meter felt that he had little to offer the world. He wasn't an Omnipod, One Touch, or Reveal...and couldn't directly beam readings into the pump of choice. He had no fancy backlight.( for the popcorn chewing, diet-coke swagging,testing-in-the-dark patron with diabetes) Yes he was small,& cute,but in the cutthroat world of diabetes technology where does that ever get you? In despair,the young meter wished to be run over by the nearest 2,000+ lb vehicle but as a case of last resort,decided to pay a visit to the oldest (and wisest) resident of Meterville.



Grandfather Accuchek...the very first meter of them all. Grandfather Accuchek possessed more knowledge then any of the other meters,for it was he that had trained that young PWD oh-so-many years ago. The young meter loved to listen to Grandfather's stories(of diabetes care back in the '90's) for it made him feel shiny,young,& special...not just another generic meter.

"What can I do for you today,oh young one?"

"Oh Grandfather, I need a special function,for all of the other meters are so much better then I. I don't have a backlight,manage pump info, or are waterproof. If I had a superpower,like being able to instantly analyze the carb content of any given food that would give me some credence,but I'm just another dumb,useless meter!"

The old meter looked at the younger one & sighed. "You have much to learn,young Meterwan. Listen to your owner, for the day may come that YOU are the meter of the hour."

"Yeah,right. I'm just trash!" moped the young meter. And he went away angry,that the older meter would not help him.

One day,there was quite the commotion in the land of Meterville. A big diabetes Exposition was going on,& all the brightest & best meters were selected to attend,to represent just how far technology had really come. The young meter watched the other meters leave,& cried bitter tears that he wasn't going to.

But then came that night....that terrible,terrible night. At 1 am,young meter was awoken by sweaty,shaky hands grabbing,jabbing,trying to insert a test strip into him by the light of the hallway haze.

49.

Young meter wanted to scream out "Eat Sugar!" but seconds later was knocked onto the floor in the PWD's mad rush to do just that.

56.

Picked up again,he could feel the hypoglycemic heartbeat madly vibrate to his own inner core. The minutes,& hours passed...and the heartbeat slowed, the sweat cooled,and shaking fingers slowly uncurled as the body fell into a sleep of exhaustion.

That day,the young meter learned that it's not so much the fancy features of a device...it's the ability to do the job.(that ultimately matters) In a pinch,you need a meter that delivers.

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Dear Beanie Baby

It wasn't a day like any other day...for starters, it was Friday, May 13...the last day of the semester/nursing convocation party. Great day to get a little life-changing news. Got up,dragged myself to the lab for a blood draw,& then went home to prepare for the convocation. Bittersweet moment,for I was feeling the emotions of having survived the 1st semester along with the hundreds of other students there. After the ceremony,there was a light reception,& I drove home...stopping at a store for something & my phone beeped with a voicemail. I decided that whatever it said,I needed to be sitting down for the news.

"Hi,this is your doctors office-Congrats! Blahblahblah."

It was true. It was real. It was at that moment,when visions of my latest blood sugar ran like a horror sequence through the soundtrack of my mind,that I knew I needed to pick up the phone & tell the one person in the Universe who needed to know right then & there.

My Endo. And she picked up right away,gave me my next step of marching orders,and congratulated me. But having been down this path before, I waited the weekend before telling my husband(after the repeat blood test showed continued rising levels).

And every day since then, I've awoken every morning expecting the worst. It's a hard burden,those critical weeks of the first Trimester...when every blood sugar,every random stabbing pain,everything you put in your mouth influences another life. (have I been a bit psycho? why yes, I have)

But today, I am 13 weeks...feeling not as miserably sick,& ultrasound shows Beanie Baby to be right on track.(3 inches long,& growing by leaps & bounds)



I think it may be doable after all.
(not quite as nervous now...although it's still not very "real" yet,still no tummy budge)
I can't say that the concept has even become real yet,I guess it's good that it takes 10 months to have one.(but yes, we're really excited, & it's incredibly hard to not tell anyone until 8 weeks later!) It was worse at FFL, I had the uncontrollable desire to blab it to everyone I came in contact with & I couldn't, because I needed today's confirmation that everything was still on track.

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Oh, Baby....

His name is Mac,& I suppose this means that I have gone totally Apple-holic.(hook,line,& sinker) Bought it off my dad over the weekend.(aka,my b-day/Christmas gift rolled into one...my old PC is pretty ancient/buggy/slow)

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Phases

I have type 1 diabetes, & my islet cells don't work worth two beans.Or do they?

If you were to measure my c-peptide,it would be non-existent, at 0.0 mmol. I know this,because with diabetes research studies,they are always measuring c-peptides...and as mine goes,it is always non-existent.(some long-term type 1's still do retain a slight production) Researchers theorize that producing insulin may have protective powers against the crazy high-low destructive variability(that is type 1, in a nutshell) So much for any protection for me (should that be true)

But there are times,not related to exercise,illness,temperature,or the phase of the moon...when I could swear that my pancreas is doing something.And when it begins,the lows just go on and on and on(seemingly unending).

Last night was such a night. 95 at supper(a zillion carbs of spaghetti), 65 by the end of supper. Bolused half(because of the low),and waited for the pasta factor to just hit en masse. 45 minutes after supper...70.Ate some candy. 30 minutes after that...72. Ate 16 grams glucose tabs. 30 minutes after that...55.And so on,till about 10 pm,when,sick of eating,I cut off my basal rate for an hour,& threw the big guns(chocolate milk) at it.11 pm-76.Cut off my rate for another hour,had another cup of chocolate milk & prayed that it would work because the next step would have been experimenting with mini-glucagon dosing to try to avoid going to the ER. I was scared that it wouldn't work,but 3 hours later I awoke to a lovely 296 which I bolused half of what I normally would(1.5 units) effectively knocking it down to 106 this morning. I think I probably ate around 300 carbs last night,it was absolutely insane.Rarely does my mind go to the "what if this doesn't work?" scenario,& it makes me realize that I have absolutely no plan(aka "panic-free") way of handling something like this(mainly because it very rarely happens) I have had days where I'd have 7-8 lows a day,because of whatever wackiness was going on,but it was a controlled chaos,& I could keep on top of it. There was nothing controlled about last night...never in my life has a bolus of 2.5 units(plus 1.5 basal) done that. People think that insulin production is a wonderful thing, a dream that they'd give anything to see again but I am not so sure,in the context of T1 diabetes it is just a major pain in the butt. You'd have to figure out just how much less insulin you need(and no answers are forthcoming from said pancreas as to how much it's producing). The world of diabetes is not cut and dried(as to what can/will happen),& more then anything, I just want stability. I'd rather take a relatively consistent amount of insulin & have great control then little insulin & be crashing every five seconds.(of course, I'd much rather just not have D in the first place but that's not one of the options)

I hate diabetes.


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Winning The Battle, Losing The War

Prioritizing. It's something that I'm none too good at, and by now, the list of things that I've been meaning to blog about is so long that I'll never in a million years catch up so why even try?

And plus, I've been having serious disenchantment with my blog platform. After 5+ years, it just seems so incredibly basic and blah(which was good in the beginning,but now it's overly simplistic). I know next to nothing about developing a website,but there has to be better platforms out there. Change needs to come. As emotionally attached as I am to "The D-Log Cabin", even that may have to go. There are posts in here that I'm sure are none-to-complimentary(too many names) toward certain parties,and I have to think that one day,some online stalker playing "Connect-the-Blogs" could play havoc with that. I try not to put too much private info on my blog but I'm not sure I've been terribly successful in that.

Most of my energy,emotional & physical, seems to be consumed by the diabetes these days...and it seems like I don't have enough energy to blog. It's not that it's hard(to dash off a 20 minute post), it's just that,given the choice, I'd rather collapse into bed. I hope that changes,but that's the reality for right now...winning the D-Battle, seriously losing/behind on every other part of my crazy/ busy life.


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The Runaway

It's been missing for two full days. I know it isn't in the car(checked) or house (for with the number of lows I've had, I'd have heard the alarm,the battery was fully charged)

Where is it? Where was the last place that I went that it might've fallen out of my pocket? Let's try the doctor's office.

"Excuse me,but did I leave a medical device there on Wed.?"

"Yes,it's here. We were wondering who's it was."

Success, relief. How I didn't realize that sooner is anyone's guess.




I'm not a parent,but I think I know exactly how it must feel to get your kid back safe & sound..a little bit angry ("Bad, BAD Dexcom!") a whole lot scared, and a whole lot relieved. The day I leave a device like that in an airport is the day I NEVER see it again. Everything is getting labeled/phone numbered,against the day that it does happen again.

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The DiabetiThon

The road stretches straight ahead
Miles and miles, off into the darkness
and yet it seems so oddly familiar
like an endless loop
for I am no hero,& I have been here before
drop-by-drop,counting the gallons lost
hole-by-hole, playing Connect-the-Dots with the scars
Diabetes: 5000 Me:0
seeking to lessen the damage
in this Diabeti-Marathon
I run to live
and my prize is being alive
for in this race,there is more taking then giving
kidneys
heart
eyesight
every other complication under the sun
Am I doing this right?
no one can tell
Although confirming my failures is easily done
and yet I think at least I'm 75/25
and good for many more rounds around the track
but the monotony is stifling
and I am tired to my core
day in,day out
it never ends
Can a human being live this way?
I want to believe in a cure
but the passage of time
jades the most enthusiastic of people
so I settle for survival
and I wait for the sun to come up
the diet coke to kick in
And then I see that I'm not the only one running this race.


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The Problem With 80

The problem with 80,they say
Is more, that it stays not that way.
It soon starts to drop
And more eating of glop
Is repeated oft times in a day.

I personally have no problem with an 80, or even upper 70's, but as it creeps down into the lower 70's it gets into my cranky zone & I start feeling low. My Endo can't understand this ("You aren't low. You're just too high most of the time.") implying that I should just suck it up & embrace it for all it's worth,& one day it won't feel so bad.

My Endo does NOT have diabetes. I can't tell my body to love a 71,(which,with the strip margarin of error is probably more like 64) and when I'm dropping, I feel it. And with anything in the 70's, the odds are 100% that I will drop(be it on basal alone) Yeah,my blood sugars are quite a bit more stable these days and my goal is to be near 100,but I don't know if I'll ever be comfortable with upper 60's/lower 70's. I'm glad that I feel my lows(quite well) but numbers like that seem to me to be flirting with fate.(raises hand,been there,got the tshirt)

Yeah, me and the Endo have an oil and water relationship these days..I sometimes think she wants me dead. I don't intend to go from a low though,and as previously mentioned,I think she's from the Land of Textbookidemia & isn't really listening to my point of things(hypos KILL too). I mean, I've only been doing this for 12.5 years(longer then she's been practicing) I think the fact that I don't eat the kitchen sink (treating with the minimal amount of carbs) shows that I have improved in that regard.

Anyone else have an exasperating Endo?(She's good,she's just driving up the wall)


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A Story of a Great Doc

There are bad doctors. There are so-so doctors. There are good doctors. And lastly, there are exceptional doctors,the ones that you will never,ever,ever forget.

This is the story of an exceptional doctor.


It was the best of times,it was the worst of times. It was many years ago,and my health was non-existent with a storm of puzzling,vague,weird symptoms that made my life non-livable 24/7/365. It's hard to get into what that was like,
for it was no kind of a life at all. There were doctors(and more doctors),and tests,and weird abnormalities that did not fit any specific disorder. It was a long,depressing process...and guess what,I was told that I was depressed.(which I was,by that point,but it made me mad to be told it was all "in my head") After the World's Worst Seizure,(and a subsequent workup at Big University) no one told me it was all "in my head" anymore,but answers weren't exactly forthcoming either.And then I went to an ENT(quite possibly,the only specialty I hadn't seen,by that point) I had all these symptoms that were being treated,and no "big picture."

It wasn't hard to like him,this young,charismatic doc with a boundless sense of optimism. He had a plan,& that plan involved figuring out WHY I was as dizzy as a drunken sailor 24 hours a day.After several tests,it was discovered that my eyes/ears didn't track well with my equilibrium & so I underwent "balance training" to try and fix that. What did I have to lose,my brain was on the fritz anyway.Eventually,things got better in that regard(as well as the rest of the health drama) but I think the best thing he gave me was the renewed sense that I was right,& not nuts,no matter what the medical profession did/did not find.A couple years after that,he took out my tonsils and since then,he's been my allergist doc.(all is status quo in that regard too,my allergies haven't been that bad this year) I don't think he ever once chewed me out about anything D-related,(in direct contrast to any other doc I've ever had)which makes him an extremely rare HCP.

Diagnostic Skillz...he's got it.

Bedside manner...he's got it.

Surgical prowess...he's got it.

Cuteness...he's got that too,& let's be honest,anything that goes easy on the eyes is conducive to the healing process. (even for married folk,though that's where it stops)Everybody likes him, he's that kind of a person.

There are good doctors,in every specialty,and when you meet one...you will know it forever.They go above & beyond the Hippocratic Oath,& make the world a better place.They make medicine what it is meant to be. And I think that whatever your definition of a great doc is,there are probably elements of most of the above in it.


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Pictured

Pollen and Puddles




(contents of purse.80% Diabetes Related.No wonder my arm sprang Neuropathic issues on me.(cruel,cruel irony,if diabetes itself doesn't do it carting around all the supplies will)




(fast-forward, please)




(Now Pause!)




(mail treasures...must do book review soon)




The dreaded SoxPox, which is 100% lethal.(attempting to "cure" it...is futile, it gets tossed.)

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iPhone

Beautiful Things

I'm well aware that I flunked out of #Dblogweek, but I'm still going to do this final post as a sort of combination of the last three posts that I missed.Awesome things plus Snapshots plus deep and profound thoughts.

#1 Friday was the final day of nursing school..and the big Nursing Convocation.Passed my final exam with an 88(and how that happened,I dunno,because it was so hard I was only sure about 65% of it),earning me a B for the course(and an A&B for the other courses). It felt quite odd to be done,and smooshed into an auditorium with hundreds of other 1st,2nd,3rd,and 4th Semester students. But it felt good too,for as hard as 2nd Semester is reported to be,with the first semester under our belts we can take on the world now.It almost felt like we should be tossing hats up in the air(along with the graduating class),we made it.(stupid,I know,but it feels like I've been in school forever!) And then(after the various awards,etc.) there was cake,and punch,and a subsequent spiking of bgs to undesirable levels...goodbye,school!

2. Blood sugars can be beautiful. Unfortunately, the effects of Tylenol upon a Dexcom sensor are disastrous,& the effects on consecutive days makes you wonder why you're even bothering. So I'm not going to show you a nice,flat, Dexcom line(because quite frankly, I don't have any) but stable blood sugars are a wonderful thing.(not that I even have that,but I'm trying)

3. My last a1c was down by 0.2.And considering that the "cheat" one I had done(my Endo never knew about) was up by a good 1.1, I consider the fact that I dropped that sucker a good 1.3 in a month's time nothing short of miraculous.Nursing school is the dearth of good control.

4. Summertime,summertime...so much to do,& so little time!Two major trips next month,& I'm sure August will be here before I know it.And September.
(yikes,I'm old) My to-do list is a mile long,& I hope to make a sizable dent in it.

5. All of you awesome people in the diabetes blog'o'sphere (and offline,online). It was great reading (some of) the #dblogweek posts.(what I could get to)

6.











(and the best is yet to come!)

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Just Ten?

Ten things I hate about you, Diabetes - Thursday 5/12: Having a positive attitude is important . . . but let’s face it, diabetes isn’t all sunshine and roses (or glitter and unicorns, for that matter). So today let’s vent by listing ten things about diabetes that we hate. Make them funny, make them sarcastic, make them serious, make them anything you want them to be!!

I don't subscribe to the theory that hating something means that it has dominance over you, that it's "won". And while I try not to be that person who goes around saying "I hate diabetes!" with every breath, I wouldn't also say that I love it..yeah,it has some good points, but the fact is, I do hate it. I guess, for me,hating it makes me want to fight that much more to make sure it doesn't win. So here are ten of the things I hate about this disease...

1. I hate how, after coasting along (per Dexcom) at a nice, stable blood sugar all
evening, within twenty minutes of me falling asleep my liver commences to hard-core partying and dumping out glucose,spiking me to 250+ (which I don't wake up for until 4-6 hours after the fact). Wake up with a parched throat and not knowing what the heck just happened(pump failure? or just good 'ole Dawn Phenomenon?) This is a re-occuring theme, no matter what time I go to bed.(9,11 or 1)

2. I hate the little "wave" the Dexcom does all night,dipping either above or below the High/Low alert and going off every ten minutes...not great, when you just want to sleep. What's it taunting me to do, throw it in the drawer and ignore it?

3. I hate low blood sugars, and how they knock you out of commission (no matter how hard you're trying to act that they didn't).

4. I hate that I just can't exercise, without mathematical calculations on the order of a Phd.(and eating as many calories as Michael Phelp's) I'm pretty sure I'd exercise more, if it weren't for you.

5. I hate that I just can't jump in the car and go somewhere...I have too much "essential" stuff that must be packed.

6. I hate how many young,(and older) innocent lives you've claimed...it saddens me so much.

7. I hate that ignorance about you is so widespread,even among the medical community. How can we fight/prevent/cure something so misunderstood?

8. I hate getting Real Person Sick and watching the diabetes control go completely off the deep end. And I hate ketones. (though I have no problem with drinking vast amounts of Diet Coke, at any hour of the day or night.)

9. I hate the scars (from years of guillotine lancing devices)on my fingertips...I don't think my fingers are as sensitive as they should be,and I worry I won't be as good a nurse, because of it.

10. I hate how much it costs.(pure and simple) So much for trying to save money..even if you wanted to, things are always popping up that make it impossible to do so. I can think of much better ways to be spending it all.


Come back tomorrow, for a cheerier post.

#Dbloopers: The One that Never Was

Diabetes bloopers - Wednesday 5/11: Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realize that things can (and will) go wrong. But sometimes the things that go wrong aren’t stressful - instead sometimes they are downright funny! Go ahead and share your Diabetes Blooper - your “I can’t believe I did that" moment - your big “D-oh” - and let’s all have a good laugh together!!

When I was a teenager, & still going to the pediatric diabetes clinic of Major University Hospital, I looked forward to receiving their periodic "progress reports" post appointment. These Reports would be mini-summaries of everything that had been reviewed at said appointment,and more importantly,would contain The A1c & of course I was dying to know that. It would always take them 3-5 weeks to get The Reports sent out.(hundreds of kids seen each in clinic,you can see why it took so long) There were no instant a1c analyzers in those days, & waiting(for it to show up in the mailbox) was a burden that had to be born.


So anyway, on that spring day in June(2001), when said report finally did arrive(1 month later), I ripped open the envelope in eagerness, wanting to see what my a1c(post pump-start) would be. I flipped to the last page, where "10.2" greeted me (in all it's glory).

"WhaaaaaaaaaTTT?" I muttered crossly, & pitched the paper to the floor. "No way!!!"

(I've had bad a1c's before,but nowhere close to 10+!)

Picked it back up, to see whatever "love notes"(such as,noncompliant teenager refuses to obey instructions) had been written about me.


Read.

Read some more.

Each report was completely anonymous, & written in the 3rd person...much like a medical record. (no names) But when I got to the 2nd page, & read "he" the lightbulb went off for me...this wasn't my report. They'd mixed mine up with someone else's. Thank goodness, because I sure didn't want to be the owner of that a1c.


So I picked up the phone,& called about it.


"Yes, we must have mixed it up. Can you please disregard it(too late,I've read it) and send it back to us...your a1c was 7.4."

"Oh yes,yes, yesssss! I got in The 7.5 Club!" I danced around the room,impervious to what the secretary was thinking about me(at that point in time) I didn't care, I was a D-Star!

The 7.5 club was all the people who had gotten under a 7.5, and their names(while not being inscribed in bronze, were still recorded in the quarterly diabetes magazine...and out of hundreds of patients, there were probably only 100 who made it in there. A select few were in there every time, & they were like the straight A students that annoy the stuffing out of you,they're so perfect) It was my goal in life to get into the 7.5 club...and I'd managed to do so before I had to move on from the pediatric clinic.(I was already too old,& needed to cut the ties before hitting 20) Thanks to pumping,I'd done it.(I would not get that low again in a long,long time)

So this wasn't my particular "D-Blooper," but it was the one that had the happiest ending.(I never loved a mistake MORE then I did at that moment,nothing like going from despair to euphoria in 2.5 seconds)

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A Letter To My 17-Year-Old Self

Letter writing day - Tuesday 5/10: In February the Wego Blog Carnival asked participants to write letters to their condition. You can write a letter to diabetes if you’d like, but we can also take it one step further. How about writing a letter to a fictional (or not so fictional) endocrinologist telling the doctor what you love (or not) about them. How about a letter to a pretend (or again, not so pretend) meter or pump company telling them of the device of your dreams? Maybe you’d like to write a letter to your child with diabetes. Or a letter from your adult self to the d-child you were. Whomever you choose as a recipient, today is the day to tell them what you are feeling.

Dear Self,

I'll cut right to the chase,you feel like your life has just come to a complete and irreversible end.Your eyesight is tanked,your chosen career path is now "off limits", and your new medical regimen feels like the cruelest,strictest imposition ever imposed. (you are a freak,who the heck has "snack time" at the age of 17?)Not to mention,you're still scared out of your mind whenever a "236" flashes across the screen of your monster Accucheck Advantage,envisioning all the complications it will bring.(those feelings will pass,you are not doomed to a certain death with bgs like that...sometimes,such numbers are unavoidable)

Those feelings will get better with time...& you will choose another career path,filled with the shoes of some of the finest individuals to walk this Earth.

Trust your gut,self. Doctors and CDE's will disappoint...they don't know it all.You're going to find out that while the management responsibility is largely yours alone, the burden needs to be shared.Strike that-MUST BE SHARED. Are you listening? Go out & scour the Internet,do what you have to do to get that support.(if nothing local) Because without it,you shall feel like the Worst PWD on Earth.(and very likely will have this confirmed by medical providers) You aren't that,self, no one is.You need to feel that you are not alone. You'll meet incredible role models(and 1 or two ax murderers/esses with diabetes, and you'll feel that you aren't so much the quirk of the town. Millions of PWD live with these challanges,all over the world.

You'll learn that "Diet" is not necessarily a four letter word and you'll learn to hate OJ and Kendall alcohol swabs,forever.

You'll stumble to find how diabetes can possibly fit in a romantic relationship and you'll learn that in the one that was meant to be,it was never an issue anyway.

You'll become an aunt(x 9) ,& you'll say goodbye to the only grandparent you ever knew.

You'll hear many,many lectures and you'll learn to tune them out(the ones inside your head/heart are not that easy to get rid of)

You'll have a few 600+ blood sugars,and you'll stare stupidly at the meter(having forgotten how to drive,you'll mainline 5 units to the gut & wait till you come down to 598 before magically,you can semi-remember enough to get home through the hyperglycemic haze)

You'll pass out,vomit on strangers,& ride in ambulances as both a patient and an EMT.

You'll total two cars and drive an $100,000 fire engine(murdering orange cones left AND right).

You'll participate on Jeopardy & jump off great heights on Fear Factor.(simulating skydiving).

You'll go to Europe and Hawaii & get more of a global perspective.

You'll vote in three Presidential elections & become forever a political junkie.

You'll finally enter nursing school...and feel a bit overdue when the youngest member of the class is ten years your junior.

You'll have other health issues...whether from crappy genetics or Murphy's Law,who knows.(they will put the diabetes in perspective)

You'll learn about the workings of the Health Care System...on both ends.

You'll learn that thinking about mortality,is not an issue to be put on the back burner for the later years.(as you come face to face with it on more then one occasion)

You'll throw your meter at the wall,gorge yourself on carbohydrates,leave your infusion set in for 15 days,& rebel against the powers that be...on more then one occasion. And at the end of the day,you will realize that the problems you perceive that diabetes has caused you are minuscule to the problems of trying to survive,in a 3rd World Country,without the means to treat it. Public mortification does not last forever.(& also,the Universe has it's own problems...& is not revolving around you) And while your at it,self,do something good for someone else every once in awhile.(it will also help lessen the crappyness of said disease) Plus,it's the Golden Rule.

To thine own self be true Self...always and forever.It's a good life,self,now go out & live it.

-An
Older You
(who still wants a cure,like,yesterday)

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#Dblog Week- You Say Potato, I Say Carb Bomb..

Admiring our differences - Monday 5/9: We are all diabetes bloggers, but we come from many different perspectives. Last year, Diabetes Blog Week opened my eyes to all of the different kinds of blogs (and bloggers) out there – Type 1s, Type 2s, LADAs, parents of kids with diabetes, spouses of adults with diabetes and so on. Today let’s talk about how great it is to learn from the perspectives of those unlike us! Have you learned new things from your T2 friends? Are D-Parents your heroes? Do LADA blogs give you insight to another diagnosis story? Do T1s who’ve lived well with diabetes since childhood give you hope? Pick a type of blogger who is different from you and tell us why they inspire you - why you admire them - why it’s great that we are all the same but different!!


Living with diabetes is difficult, on every level. Type 1's, Type 2's, Parents of Kids with diabetes, spouses...neither of these roles is easy. But,in my humble opinion,having diabetes is easier then having a child with diabetes. I read alot of inspirational blogs & I'm in awe of parents who manage 2,3 sets of diabetes(or even their own) while I can barely manage my own. They find the courage from their children(and within themselves).People like Meri and Trev and many, many others..they're just incredible. I mean, just being a parent is hard, much less of a kid with diabetes. They're also part of the few that really GET how hard diabetes really is. And even though I do not get how hard that is,(to be a parent of a CWD) I would say that it humbles me (and amazes me) that kind of selfless love.(one night of 4-5 hours of sleep does me in, much less constantly) Your children will thank you, one day. And even though there's ten million ways of "managing" diabetes (specific to the individual themselves),the way certain foods have a disastrous post-postprandial effect (upon the PWD's blood sugars) is just one example of the bonds that all (or most) of us share.(type 2, type 1, LADA, parent of CWD, spouse, etc.)


Viva la difference!

Countdown

I had a horrible night, a night(or rather,weekend) of nonstop horribly high blood glucoses. Most in the mid 300's,and the rest in the 200's. Changed pump setup,took five million injections...no impact. I know I have ketones,& quite frankly despite living off non-caloric liquids I still feel like if I started to vomit, I wouldn't stop. So,at 7:30 this morning, I switched to yet another vial...waiting to see if an injection of that actually did any good on my 298 blood sugar. It was like magic,an hour later I was 218 so I ate a very light snack,changed out,& bolused for that. Nerves were high anyway...it was the morning of Student Evaluations & we met at the Barnes & Noble (coffee nook)to get it done. I was number 5/7,so there was plenty of time to think the worst. So my clinical instructor told me my presentation grade(51/60,which was better then I thought) & her form on me as a whole(I need to talk more,which was kind of irritating,just because I don't run my mouth 24/7 it's some sort of character flaw?it's just not me,it doesn't mean I don't talk enough.I think I went above & beyond the call of duty in that regard) Told me I was very honest(which I take to be a good thing) & overall, I was a good student. So that went ok...all things considering. Blood Sugar post anxiety-trip was 176,& I promptly went out & stepped on the freshly-painted curb,smearing my tennis shoe in a bright yellow blob.(There were no signs,just some guy telling me after the fact what I'd just done.Lovely) Stomach still feels like a bundle of worms,& throat is still dry as the Sahara but I hope that at least I can get back to some semblance of control.(at least it's under 200)

Now to study for final exams.


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Thoughts from the Fifth and Sixth Week

1. I used to think that the idea of ME,non-conventionist of the D-world,becoming a CDE was absolutely never going to happen.How could I ever tell a patient something that 3/4 of the time I never did myself? And then, I got out into the real world & realized that I have the equivalent of a PhD in all things diabetes. I'm not just saying that,I've been pumped & primed & have been to 10 zillion research events(etc.) since Day 1. And while I may never be that Role Model, I have more then just book knowledge...I don't look at a patient & label them "noncompliant" even if there is something clearly going on. I look at them & see an internal battle to stay in control of something,& I see a medical professional that doesn't have the time or patience to delve into the mysteries of the diabetic psyche or what's really going on here.And I fume when I read the words "noncompliant" or "uncontrolled" when to boot,there's been no documentation of a visit with a mental health professional or a CDE.I guess the vast majority of docs/nurses will just never understand,there is so much more to diabetes then avoiding sugar/taking shots.Even type 2,(and how the Sam's Hill is it NIDDM when the patient does take Lantus at night?yeah,I'd say that insulin is required)most of them get shoddy or no education & it's no wonder ignorance/stupidity runs rampant all over the world. I may never be a CDE,but it is my responsibility to care/advocate for better D-care for my patient(when the occasion warrants it).There's just so much wrong that sometimes it feels like I'm just a speck of sand on the seashore,ignorance is going to be around long after I'm gone.

2. I came out of the D-Closet & confessed that yes,that it was my pump. It didn't kill me to do so.(& my two classmates aren't the D-Police)

3. 3/4 the class flunked the week before's (Monday's) exam,which made me feel better about the 82 I got...and thought was pretty bad. It was hard,but not that hard.(I've been a solid B in all four tests)

4.Last Clinical was last Wed. It was bittersweet, I'm not feeling ready to move on to the madness of the 2nd Semester. I know I have been babied/coddled in this one.
---------
1. Professor "Coordinator of the First Semester Yearlings" will be following us into the 2nd Semester. (to coordinate us there,too) I dunno,but I think it would be better to have all new teachers...& especially where her teaching is concerned. It's through, but it can get so dry and boring that you just want to run screaming from the room after 45 minutes.(much less 3 hours) She'll be teaching Obstetrics.
2. I didn't do well on my client presentation..it was too short by 2 minutes(I couldn't get my YouTube video working), the slide references weren't quoted right, and my nursing DX was all wrong. I dont know if I got the minimum 45/60 required points, but my fears of failing out of the course have been allayed somewhat as I am told that I only have to make 282 total points to pass( I'm at 225 right now). I can get up to 60 for the presentation,& up to 50 with the final exam. So I could totally fail this & still do well on the final, I have wiggle room.Thankful for that,because I don't want to repeat this thing!(the other two courses I got an A and B in but this is the main course,serving mortification & guts on a daily basis. Also,lots of $$'s.
3. In an unprecedented move of unexpected sweetness, one of the other students brought SF applesauce today. Yeah,SF does not equal carb free but it does equal less carbs...and applesauce is applesauce,fairly harmless on the gut. I was actually touched that she was thinking of me (when she made that decision for the whole group)
4. Tomorrow, we go to the Senior Center & see how the healthy older adult lives.(in contrast to the morbidly obese, COPD,nursing home inhabitants)
5.


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