Double Digit Diagnosis Day

Five plus Five equals...

A) a cure for diabetes, times 2
B) the cost of 8 test strips
C) the number of people diagnosed every 80 seconds
D) how many units you have left in your reservoir at 2 am

On this date in history:

A) Bill Clinton was being impeached
B) Nicole Johnson was reigning Miss America
C) Gas was under $1.00 a gallon
D) Al Gore had not yet invented the Internet so we were forced to spend our time in much more productive ways

But it was more then that, it was the day that turned everything upside down.

4:01 pm, the world stopped with the words, "You probably have diabetes, your blood sugar was off our meters and you need to go to the ER right now-ambulance or car?"
The NP directs this question to me, not my mother. Slightly odd to deliver the bombshell and then ask the teenager want they want to do about it.

Numb brain. Number body. Long drive to University ER. On the way, I drink over 100 carbs of milk and go to the restroom four more times. The triage nurse awaits, and asks me my blood sugar. I repeat what the paperwork says(1100), she checks, and says "Oh-you were telling the truth!" which slightly offends me. Taken back immediately and the intern and resident show up, again, immediately.

Tonight's Project: Show, Tell, and Run a billion tests on the kid to make sure its just a nice, simple case of DKA.

Tonight's Project Manager: the intern. Otherwise known as Dr. Bill. I have the dubious distinction of being their highest bg, ever, and that is deserving of a constant stream of individuals entering, asking,(not)asking, poking, prodding, and otherwise making sure there will be no sleep that evening. Along the way, I'm told what lies in store(shots), and oddly, it doesn't disturb me at all, I feel too crummy. However, the chosen words of comfort from Dr. Bill do.("We're not going to let you die!") Not the best thing to say to a freaked out teenager who was unaware that they could die from this. To his credit, he didn't let me die(checking on me every 5-10 minutes to make sure I wasn't in a coma) Along with being asked to breathe ketonic yuck breath occasionally, a very odd experience.

So to you, Dr. Bill Hurtig, now probably out there in rich-powerful Attending Land(or private practice) I wish to say Thanks. You handle DKA with the best of 'em.

The rest of the experience is fairly straightforward, crash eduction/envying my room mate's unlimited food choices/giving the first shot + no one passing out. Stuff everyone does.

Five plus Five equals yeah, now I really feel like it was a long time ago. Wondering what the next 10 will bring. More intriguing, very cool individuals into the OC for sure.. but I'm rather hoping for a cure.

(yeah, this'll do-hope the luck continues...)

A Penny Saved & A Dollar Earned

(Size 8 shoe for length comparison)
My receipt, post coupons and CVS extrabucks printed out.(I'm one of those crazy coupon people you would rather not get behind)
Initial cost: $188.50
Final Cost: $21.48
(received $21.49 back in more extrabucks so I saved a penny on what I spent)
The cashier then proceeded to pay me the highest form of flattery there is...

"I want to be just like you with the coupons and stuff when I grow up!"

Far from making me feel old, it made me feel on-top-of-the-world-awesome. I'll treasure that compliment for the rest of the month.

Blizzard!

Or as much of one that will ever be seen in these parts.(sigh..)

Of Socio-Economic Matters

Sometimes I sit in sociology class and silently fume, wondering how the instructor and my classmates could ever arrive at the conclusions that they do.
Last week, we discussed lobbying. Lobbyists are firms hired by special interest groups to take their cases before the the legislators. Lobbyists shmooze and booze the legislators with gifts until the the legislators cave and push those bills through. Lobbyists are often former legislators and know Joe Senator(s) + play the insider card for all its worth.
Lobbyists aren't the scum of the earth, the legislators are. Taking gifts/bribes should be illegal and you should be kicked out of Congress for doing it. I realize that this would eliminate 99.9% of the Congress but if you don't make strict consequences for something it isn't going to stop. And then we got on the topic of drug reps doing the same thing and I think that's a little differant, the doc still has an obligation to his patient.If the doc wants to be bribed, I don't see a problem with it, as long as the patient is getting good care. Obviously, I don't know much about drug reps and someone else can educate me on why thats a horrible idea. We don't elect doctors- we do elect Congressmen and they need to be pandering to the overall good of the people, not to the will of Corporation X. Lobbying can be good(more research for diseases) but the system is all wrong. Legislators are only thinking about making the special interest groups happy. Everyone says they shouldn't be doing it, no one wants to suggest radical methods to STOP the corruption.
Then, we got to discussing the rich, evil CEOs and I'm thinking, get a life, people. Yes, by and large they are not the phelanthropic sort but we pay our sport gods millions a year without batting an eyelid and then complain bitterly about shelling out for a CEO(whose jobs encompass much more personal responsibility and extreme stress) I believe CEO's should be well paid, they have important decisions to make. I don't believe their severance packages should be so well padded, they should get the same as the next dude.(have some concern for the company going under) And as it relates to the automabile crises...I think that its partially due to the recession, partially the fact that everything made in this country is slapped with such high taxes its just cheaper to buy foreign. If Congress can't see the importance of getting a fairer tax system, they'll have to continue to bail out the big dudes on a regular basis.

(1 day of finals done...2 to go!)

The Insulin Machine

About six years ago, I went through a patch of being resistant to all forms of injected, snorted(j/k), pumped, forms of insulin administration. Lived in the 300-500's, double-triple-quadruple-checked EVERYTHING, no even injected insulin could bring my blood sugars down. Average TDD during this time: in the 60's. Back then, that was about double of what I took.

Happy days are here again, I've changed my sets,cartridges, lines, insulin vials, taken injections, checked the pump, doubled basals...and yet my average blood sugar remains at a level that you'd probably rather not read about. Constant ketones in the urine. Getting up three times a night to take shots.(and do other things) At this point, when not even injections are working trusting one's pump is not an option.

And I'm not sick. Nor are hormones in the picture. Last time, my endo said that stress could absolutely do all that but this just started this week. Yes, I'm stressed(final exams are two days away) but I'd have thought that would have started several weeks ago..

For occasions such as this, I will be consulting my endo. Because it doesn't look like I'm any closer to solving this thing.

December 5, 2009

I've set a goal for myself to have my JDRF themed cross stitch:
(that's part of it)

done, by this time next year. And then, I hope that JDRF loves it so much that they'll auction it off at one of their big-wig-fancy-pants auctions. Its unique, its special, and it deserves a home in some mansion, somewhere. (not sure how much people would pay for it but its surely got to be more then I could get if I sold it on Ebay) I want to do my part to fund diabetes research.

Choices

When I was a young 'un with diabetes, each and every blood sugar test was an occasion for a complete stress-a-thon. Usually a parent would be watching, and I'd pray that God(or the diabetes gods, whichever one you believe in)would send down a number that would not put my parents in complete freak-out mode. Every number was carved in black and white granite..black with death or white for bright and shiny. In the 45 seconds it took for the number to pop up on Monster Meter I got pretty nervous.

Now I'm older, and wiser- I realize that it's all relative. (unfortunately, I haven't yet convinced myself that this also applies to A1cs.) I've still seeking perfection. Every morning, I have a habit of picking out a different perfume scent for the day(because I am a Bath & Body Works addict and love 'em all)


and similar to that, you've got to pick out the right management for your D that day. Type A personality is not going to get you too far with this highly imperfect disease. You've got to learn to adjust, and adapt, and realize that the awesome control you get when healthy and running marathons is not going to be your lot when you're sick, in pain, and doing your best just to stay afloat. Every day you've got a different sort of D to deal with, and though you may prefer the sweet Rose like lull of a uneventful day, its likely going to be the rough and rocky Water Deep or Trouble. (from my retail days, I'd say that I've smelled most of the perfumes and colognes out there)

Back to the Future

CAPTAIN'S LOG, STARDATE 2032 A.D.

I open my eyes and grope under my pillow, desperately searching for my Dexcom, so I can see if I'm in-range enough not to have to check, confirm, and correct, on my meter.

But it isn't there. Groaning, I head downstairs, hoping its on the counter top and not lost.

There's a strange teenage apparition (or rather, two of them): sitting at my table,laughing, and inhaling CocoPuffs at lightening-warp speed.

"Hey Mom," the older of the apparitions says cheerfully. "Breakfast?"

"Sure," I reply, dazed. "A diet Coke, 2 slices of toast,(w/jam) and some scrambled eggs."

She presses some buttons, and a machine whizzes to life(like the one in Chitty-Chitty-Bang-Bang) Presto, breakfast.

"Your meal has a total of 45.8 carbohydrates."

Immediately, my tube-less pump starts to vibrate, asking me to confirm the amount of insulin needed.
"You seem low, Mom. Did you scan this morning?"

"Scan?"

"Yeah, like HELLOOOOOO- with the GlucoGadget? Like you do a zillion times a day?" She rolls her eyes, opens a kitchen drawer, and removes a small device which she then proceeds to use to "scan" my forehead, like I'm the upc symbol on a package of bacon at the local supermarket.

"You are 72 mg/dl."

"Drink this," she flips a box of OJ in my general direction. "I gotta run to my job..but no way I'm missing the party tonight. It's sooooo cool that there is finally a cure for diabetes. Ciao!"

A cure. I really must be dreaming.

Shaggy-haired boy looks up from his third bowl of CocoPuffs. "I need money."

"Son, that's enough sugar for the morning, go finish getting ready for school." I can totally do the parenting stuff, I know how teenagers think.

He grabs his baseball cap, slings it on backwards, and shuffles off.

So I'm 81 mg/dl. But what's this about a cure TODAY? I pick up my Iphone-like device(iphones by then will be obsolete) and dial my endo's office.
"Hi, it's X."
"Hey, don't forget about your 9 AM appointment this morning!"

"9 AM????"(it's now 8:22) Whatever this is all about, I'd better be hustling. My bag is already packed, by the door. Just gotta blitz through the shower.

8:59 AM. I arrive at my endo's office, where the staff greets me with humongous smiles and direct me to the operating suite where I am prepared for surgery.

My endo arrives. Wow, this is sure not 2008 any more...both of us sport more gray hairs then an elephant.

"Ready, Heidi?"

Of course I am.

The needle slides easily into my abdoman, she pushes the plunger and hundreds of encapsulated islets travel up my portal vein to free me from diabetes.

"All done."

I start to cry, the tears come faster and faster until through the blurry haze I can't see my endo anymore.

"I won't know what to do with myself after this."

She laughs. I continue to bawl.

"Thank you."

"My pleasure." She rests her hand on my shoulder. "You'll have to be monitored, of course, but this treatment has had a 95% success rate and the kinks have all been worked out..your body won't kill them and they're fixed not to overproduce or under produce insulin. You should be good to go, for the next 40 years."

I drift off on a cloud of morphine-induced euphoria, her words echoing in my ears.

And later that day, proceed to party hardy like there is no tomorrow. Because after that, there will be no more tomorrows with diabetes.

(the account is entirely fictional, except for the part where I bawl. Which I will, when there is a cure for diabetes)

Meme'd Round the Blogosphere

From Allison....

(go ahead, give it your honest opinion.Time for a reality check.)

1. Who are you?
2. Are we friends?
3. Something I have and YOU want?
4. Give me a nickname and explain why you picked it.
5. Describe me in one word.
6. What was your first impression of me?
7. Do you still think that way about me now?
8. What reminds you of me?
9. If you could give me anything what would it be?
10. How well do you know me?
11. How do you see me in the future?
12. Ever wanted to tell me something but couldn’t?
13. Are you going to post this in your blog and see what I say about you?

I hope to answer some of the them(on other blogs) later today.

Family Ties

The year was 1862, and the Battle for the Shenandoah Valley raged hard-it was vitally important to divert the Union forces from shacking up and burning Richmond. That summer was a game of cat and mouse all over Central and Western Virginia, and Stonewall Jackson played it well. Later, a famous painting of him was done at a fence at a certain small farm in New Market. It was several years before Sheridan would do his damage, and the Valley was still rich in crops,green, and photo(or picture) genic. Anyway, 146 years later the hill is still there,(but not the fence, nor the tree) it has been in my uncle's family since before forever. It is so cool to think that there, history was made.(saw the picture in their house)

The family get-together was the usual eclectic group of far-righties and far-lefties trying to be pleasant to each other(this was accomplished by the far-righties not talking about the subject at all)...the house was packed with people. Had bolused aggressively for a post-breakfast high and found myself 84 with lunch still an hour away so I had to chug juice. My relative with diabetes was there, and I never know what to say because as a teenager, my mom took me to the hospital to see her and scare the bejabbers out of me. (the complications of diabetes) I was scared all right but it spurred me to teenage turn-off. Now I know I should be more of an adult + actually have a conversation with her but that was not the best of experiences and I'd rather not know.As long as she's happy(which she appeared to be) and having the best health possible I wish her well. Lunch was good, afterwords we viewed my dad's video, played games, toured the farm, ate more food, and gradually dissipated down to fewer and fewer people and then we left.
A good Thanksgiving, overall.

Post Turk(um)

I came.

I saw.

I gained at least 5 lbs by overeating...

And I played with my very cute niece.


that is all....(two papers await to be written + CVS demands to be visited(at least once, tomorrow)

A T-Day B-Day

Have a great Thanksgiving all....

I'm off to inflict my cranberry salad upon the relations + to celebrate my husband's birthday today.(I won't say how old, he wouldn't like it)

Bolus well, be happy, and check blood sugars often.

The Horse with Type 1 Diabetes

Tuesday, 25 November 2008 00:18

His name is ‘Justin Credible.’ He’s one month old, and he’s believed to be the only horse ever documented to have been born with Type 1 Diabetes.

The colt’s owners, who live in Carlisle, say they’re working around the clock trying to keep him alive.
Justin Credible, a Kentucky Mountain Saddle Horse born from a world-champion (show-horse, was a surprise to David and Monica Hufana from day one. He was born before his mother seemed ready. Right away, he seemed malnourished; they thought that was because his mother was not producing milk. So they sought help from veterinarian Nathan Slovis, at the Hagyard Equine Medicine Institute.

“He came on in as any other foal that has a lack of calories,” said Dr. Slovis, “We thought, ‘oh, we’re going to get this foal out of here in 48 hours.’”

But that is not what happened. After giving the colt fluids and anti-bodies, the colt’s glucose levels went through the roof. Tests showed signs of an abnormal pancreas; the organ which produces the insulin that regulates glucose. It seemed too small to do the job. The diagnosis: Justin Credible had been born with the Type 1 Diabetes. Dr. Slovis says it is the first documented case of its kind.

They began treating the colt with insulin meant for humans, and his energy has come back.
“He’ll buck, he’ll run, he’ll jump,” said David.

But he’ll never have a normal life. He has seizures, and no freedom to graze through pastures. “Grass is full of sugars, and you know diabetics have to watch their sugar levels,” said Dr. Slovis.

His owners, no longer have a normal life either. Every 4 hours, they draw blood to test his blood sugar levels. Every 8 hours, they give him an insulin injection.

Monica even quit her job as a horse trainer to care for him, as medical costs add up. So far they’ve racked up a $4,000 bill. While David works, Monica makes homemade wreaths which she sells at a Carlisle gallery, for extra money on the side.

“You do fall in love with them, you can’t help but to do it,” said David about his horses.

And they do love the little colt, as if it were their own child. Their hope, is that in time, they won’t be forced to make a difficult decision.

“If his quality of life isn’t what it should be, if he can’t run and be a horse and have a good time, then we obviously won’t continue,” said David.

If the owners are able to keep up with the current treatments, they believe the horse’s life expectancy could be around 10 years. The Hufana’s are looking for donations, which can be made out to their farm in Carlisle, called ‘Sanctuary Farm.’

(Now that's a cause I would give to.)
How does one measure a horse's blood glucose- from the ear, like a cat? (I'd take care of it- I could never euthanize a cat/or dog/whatever just because of the inconvenience of getting it shots)

Loser's Best

NaBloPoMo is offering a consolation prize (it's #21)for the best "why I didn't post 30 days this month" excuse.

I think I have a pretty good shot at that prize.(more so then the others...that blogroll is in the hundreds!)

Ping'ed

There's a unique moment, once every four(or more years) when the UPS dude walks down up to your door, rings the doorbell, you sign, and he hands you a humongous box filled with special D-goodies.


(in Limey Green!)along with 5 boxes of cartridges/assorted manuals/cases/accessories/infusion sets.(I still love the Cleos, don't think I will be switching to anything else)
Maybe I've gone to the dark side, but Smith's Medical doesn't own me + I want to experience another pump's features. Deltec of course still works, but it is out of warranty. I am, of course, pumped.(finally a meter that communicates with the pump,Freestyle test strips were never covered by my insurance company so I couldn't use that feature with my Deltec. This one uses One Touch strips.)

The Line Between the Two

I've been thinking about the concept of using CGM's in the hospital and have come to the conclusion that that there is just no way it could EVER work.

Patient "M" is extremely sick, in the ICU. Patient M's blood sugar is going up and down like a pregnant women on steroids. Patient M could really benefit from stabler bgs and fewer hypos. Patient M, however, is being pumped full of acetaminophen/narcotics and that pretty much voids out the usefulness of a CGM.(acetaminophen makes the moniter read HI) Throw in the occasional (or not so much,if they are in the ICU they might have a few of those) MRI and the staff had better remember to remove the sensor or the patient will be dead. (due to the metal in the sensor) You think about the lawsuits waiting to happen, it's rare for staff to be acquainted with pumps, let alone CGM's. (I have a question for anyone who has ever been
in the hospital, with a pump...assuming they even permitted you to continue using it, did they even ask if you were changing the site every 2-3 days? I don't, so it doesn't disturb me,but many people are prone to infection + that needs to be addressed. Breeding ground to further issues, is the pump site infection.)
And for infection prone patients, it is something else for the staff to forget. (changing it occasionally) In its current form, CGM's would be a headache for use in the hospital setting. I'd far rather have frequent bg checks then rely entirely on the CGM it is a good thing that there are many more type 2's then type 1's in the hospital or even more staff would be required.(so I think) There are so many D's in the hospital, they make up like 2/3 of the patient population.(according to Diabetes Forecast) The CGM is a very valuable tool, but someone has to be following it, tweaking, looking at patterns and another characteristic of non-endocrinologists is they are REACTIVE,(aka the "sliding scale") rather then proactive. I realize I'm lumping all of them into one generic group but its a case of guilty until proven innocent. Until someone demonstrates their D-savvyness, I do not assume that they've got it. And I would not use a CGM without meter confirmation. A CGM, does not replace the need for meter monitoring.

I think the answer lies in being more proactive with management, rather then the highly unpractical, time-consuming, expensive CGM. How about an insulin pump or IV insulin drip rather then then NPH/Regular shots?(for starters) Or how about not serving juice, jello, and various other high glycemic foods to skyrocket the patient's blood glucose even more? The goal is to prevent complications, not encourage them. I'm not sure things will ever improve, to where they should be, even in the enlightened hospitals. I wish I could tell this to a few hospital CEO's, better blood sugars translate into money(and lives) saved.

Dr.Pepper On Call

Here:


Good luck getting through,3/4 of America is hammering the site.

Adoption Hurdles

My brothers/sil's adoption is going along swimmingly...baby was born this morning, all is good with mother and infant. I guess that nothing is a sure bet until 30 days have passed, the mom can still change her mind but hopefully I'll be an aunt AGAIN, real soon, can't wait to see the baby!(next week)

ICD 250

Everything is about diabetes.


Everything.


Even if it isn't.


Especially if it isn't.


Because there is an ICD code for it, and it makes life so much simpler.


I want a cure. Now. I am not just a number, and that number should not define every aspect of my life.

The Dollar Special

I distinctly said Diet.

"Medium fries, a double cheeseburger, and a small diet Pepsi,please. I've got coupons."

"That'll be $1.09."

Everything tasted weird- the fries were having an off day(tasting like a chemical), the burger was blah and the drink just couldn't be explained. Or (I thought) the drink tasting weird was because of the food...Bolus for everything but the drink.

1.5 hours later, HI. I take a shot, because I think it is my infusion set's problem but within an hour the shot drops me to 425 + I deduce that it must be the drink,I could not have gotten diet. Much later, when I'm 288 and take a corrective bolus it drops me nicely to where I'm supposed to be, no resistance problems. And that would be highly unusual, to spike 400 points on pure caffeine alone.(I've spiked about 100 before) I think I didn't get diet, I think I got something else.

(just lucky for me I didn't get the large drink or I'd have gone into DKA)

I think I should get some diastix and start testing(for sugar) every(restaurant) drink from here on out,nothing is more scary then a blood sugar gone HI.

The Placebo Effect

This is scary. I guess the vast majority of people take the prescribed medication, and have no desire to know exactly what they're taking but it is no wonder people end up in ER's with allergic reactions and other adverse effects(even antibiotics could react with other meds), they have no clue what they're taking.



I would want my doctor to be honest with me,tell me if there was nothing else that could be done. False hope is worse then no hope.

A Glimpse Inside My Library

(because I have too many diabetes books!)

Journey of a Diabetic by Lawrence M. Prey


An excellent autobiography of one man coming to terms with his diabetes. Will make you cry. My own copy is personally autographed by the author(I wasn't around back then, but its withstood the test of time) I got it on...Ebay.(where else!)

The Sun, The Rain, and the Insulin: Growing up with type 1 diabetes by Joan McCracken,MD.



Written by an endocrinologist, about the diabetes camps she hosts. An account of a summer in the 80's. (it's not all obsolete, and some parts were extremely funny)

Diabetes is not a Piece of Cake by Janet Merilles, RN.


Not very complementary toward pumping..but overall, very insightful. Should be required reading for any Type 3(to understand what we really go through)


Showdown with Diabetes by Deb Butterfield.



You've probably already read this..but if you haven't, it's a classic. Get it. Read it. Let it penetrate your brain, soak in its wisdom.

A Field Guide to Type 1 Diabetes(by the ADA).


Handy little pocket guide to diabetes, it pretty much covers the basics. Nothing I didn't already know, but it was free so I took it.

I’ve made my decision about the pump I’m going to get. Now to take the mountain of paperwork to the endo's office, which she'll absolutely love. This is a whole new insurance and who knows how much of it they will cover(I've been fortunate, but good fortune usually doesn't extend to 100% coverage 3x in a row) It's really not necessary to get trained on this pump, I can do it on my own but since my endo isn't going to be seeing me again till Feb. I am sure she's going to make me see the CDE anyway.(sigh)

The Youtube Sunday Time-Waster

This is ingenious..kind of like the Choose Your Own Adventure books from my youth...highly addicting!

Nothing Profound

This NaPoBloMo thing- not easy. I am so tired I just want to be curled up in bed for the next 10 hours and here I am, fulfilling my daily post requirements. So all I have to say is, Office Depot ROCKS. They just changed their reward program, instead of turning in 3 ink cartridges a day for a discount on your purchase you can now turn in all 25 for a $75 gift card at the end of quarter. Multiply 75 by the number of days in two, three months and you can see how good it gets. Better then Staples 3 carts a day (total of $9) cumulative program.

So if you read that Office Depot has declared bankruptcy(sometime in late Feb.), I will be part of the cause. Too good to be true.(and it will not last)

Diabetic '007

Dear Guardian Angel:

I really wasn't (intentionally) in training for the next James Bond movie. Honest. Flipping cars and acrobatic stuff just isn't me. The hill was wet, steep...and though I admit to traveling a bit too fast for the conditions by the time it registered that the car next to me had stopped(aka red light) it was too late to stop. Not without fishtailing and causing even more of a scene. So for 15 seconds I sped through the intersection, expecting the crunch of death at any minute.

None came. When it was safe, I pulled over and promptly hyperventilated. And though Gary Hall claims that adrenalin can send his bg up and over 100 points per 45 second race, the line on the Dexcom didn't change at first. Until about 35 minutes later, and it marched up about 50 points. And I wasn't low.(so I can't even blame that, I was just being very, very stupid)

But that's ok, because I'm still alive. A good World Diabetes Day, for sure. Thank you, Guardian Angel,I know I am a real handful at times.

Welcome to Mordor Flats

Dateline: November 13, 2007. On the big island of Hawaii, at the Volcano House Hotel.
(The Hawaii Chronicles...Part 3. Continuing the honeymoon saga. No pictures, because they were all ruined when my digital camera went kaput.)

Ah, breakfast. Another stuff-me affair of bacon, sausage links, rice+beans, eggs, juice(yes, I was being bad, I was nowhere near low at 143 mg/dl) but I wanted juice) milk, pineapple, and a Danish pastry. Also, some fruit that looked like cantaloupe was decidedly NOT. Husband liked it, I didn't.

After that,we set off on Crater Drive, to see the sights. Huge craters(called candelas) jotted the shale shacked landscape. Smoke "vents" blew out of the veginous hillside, seemingly from nowhere.

Further on, at an Observatory, we saw green glowing sulfur piles in one of the larger candelas. No molten lava greeted the eye- the last one was in 1983. I was pretty bummed about that, why do people say the thing could erupt at any time? It's been dormant for about as long as I've lived on this planet. Borring.(the view is worth it , but honestly, its just smoke. You can take a $200/person helicopter ride to view the active part of the volcano,(its in a closed-off section of the park) but I'm not a big fan of heights and it wouldn't be worth it.(would much prefer to see it standing on the ground) Mark Twain had it pretty good-he got to see the lava flows LIVE (which he writes about in the book "Roughing It") Bet that was pretty cool.

Then we drove through what is, quite honestly, the most destitute piece of real estate on Planet Earth. (hence the name, Mordor Flats) It reminded one of various Lord of The Ring scenes, miles and miles of black rock. Got out of the car, and were greeted by sulpheric waves so strong we both started coughing. Sulfur, boys + girls, is not the best thing to be breathing- kids, pregnant women, and heart-lung patients shouldn't be anywhere near the stuff. To me, it smelled like burnt pancake syrup. Didn't stick around long to view the sulfur stink piles any closer, hopped back in the car to view some more lovely craters.

Then we did some walking trails and went back to the hotel for lunch. Ate sandwich, chips, swapped out resevoir, 140 mg/dl. All that walking did wonders for the breakfast pig-a-thon. Got a flashlight from the gift shop, and it was off to...

The Thurston Lava Tubes
Wherein, hundreds of years ago, the caves were carved out by lava. Nice little(lighted) cave walk, but without a guided tour. Then we got to the (optional) unlighted part and the fun began. 337 meters of pure spelunking blackness, pierced only by our flashlight and my periodic panicky moans. There were no maps, no assurances that it wasn't going to split into 4 paths and get us hopelessly lost in a maze of caverns. And the roof, leaked. There was a pile of rocks that looked eeringly similar to a grave and put me in freak-out mode even more. But then, we met a group coming back and they told us it got narrower and eventually ended. We proceed and see it drop off into a huge cavern, so we go back.
Then, we attempt to drive up to Mauna Koa's scenic overlook. A the beginning of the route, someone's car is smokin' in the parking lot but no one's cellphones work so they have to take a hike to the ranger station. 11 miles of winding, harrowing roads, you haven't lived till you've know the fear of either a head-on collision or plunging off the side of a mountain. Lots of weird white-silver trees and white/purplish flowers. (Another scene from Middle Earth) Occasional lava-flow remains pile. Got to the top, and it's too cloudy to see anything. Plus, my bg was close to 400 and I was in cranky, I want to be somewhere with a bathroom and water fountain mood so we didn't stick around long. Took another half hour to get down. (fortuantly, we were well stocked with water bottles)
The only tv at the Volcano House gets only one station.(and it's an Arizona vs Oregon game) The Volcano House...is a good three hours from civilization and the only accommodations inside the park. People go there for the convenience/history(Mark Twain went there, when he was in Hawaii), not for the cutting edge of luxury. And it's expensive, very. (like everything else in Hawaii, so we decide to skip dinner and snack on chocolate bars) A day ended, a misty rain starts to fall and it gets much more Novemberish.
PS: the header picture is from the Volcano National Park-I took it with my cellphone, and thus it survived.(when the others did not)

Notes from a Spinning Planet: Progress Notes

I sit, waiting, for the doctor to appear-shoes squelched tightly against tile, toes curled, sweaty hands gripping chair arms in death grip...

"Hello."

"Hi."

"Your labs look great, with the exception of your blood sugar, which is high, the last one was 185."

He fixes me with the all-knowing look.

(Not again...)

"It's very important to keep your diabetes under control."

Great. How to put this is diplomatic, physician-approved, terms. Deep breath, going off the deep end never helped one's case.

"I understand, and I do try, but I'm not your typical type 2 patient and type 1 diabetes is impossible to prevent post-meal spikes. My kidneys aren't going anywhere." (the regular function of them is perfectly fine)

He does not look convinced.

"Proper management is ESSENTIAL, you don't want those problems too."

He's a nephrologist, and I'm his type 1 diabetic patient- I guess he has the right to rag some. How many patients has he seen die because they neglected their D? probably quite a few.

I wish he would stop it though. I get that I'm at prime risk for everything under the sun. I take my health(and D) seriously, and I'm trying to manage it. Unfortunately, Doctor-Patient Communication 101 must not have been a class taught in medical school some 44 years ago and I get the feeling he thinks I'm just spouting off excuses.

"Why is it so hard for you?"

Check yes on that theory. It's not that it's consistently "hard", it's more like D has a freakin' mind of it's own and even when it's easy the insulin peaks at odd times, the hormones surge whensoever they wish and the effects of exercise hit at 4 AM, leaving the total deal somewhat of a crap shoot. And I can't explain all that, the million factors of managing bgs. I respect his expert opinion on the management of my electrolytes, but the nagging guilt parade over my bgs has got to stop. I've got to find a way to communicate that to him, because he is a very hard-nosed, do-it-my-way kind of doctor who stopped learning new info a long time ago. Finding another doctor isn't possible, the wait list for nephrologists is 1-2 months and I still have to get infusions. I need him, to manage it. It is doing much better,and I will soon only have to have it 1x/week.(on the good news front)

Sold

(a quarterly Ebay rant)

Every once in awhile, you run into an individual who really takes the cake. The world of Ebay is a world of dark, deep, mysteries..and sooner or later you'll step into a hole and get sucked up to your eyeballs before you realize what's happening. Lawsuits, all the rest,it's not pretty out there. I've been pretty fortunate but I've stepped in those holes too. Account hacked,disagreements.. it's somewhat amazing to me after all these years that I'm still on there. My latest joyride involves a buyer, who, after receiving his item, decided it wasn't as advertised and demanded a refund. Since he'd already used up the item,(gift certificate) I gave him a partial refund, based on what he thought the item was worth. End of story, right? Nope, after one month he files a chargeback through his cc company and Paypal goes and sucks the money from my account for the total cost of the item. Investigation commences, I provide proof of PP refund. Several weeks later, PP concludes I should get about 1/3 of the chargeback back. (only because of the partial refund) I call Paypal(aka India) and eventually get to talk to someone in the US because the problem is pretty complex. They say its up to the cc company, and that can take up to 90 days by law. What peeves me is this guy did not have an "unauthorized" use of his cc, like he claimed to the cc company, you can see his trail of wild, happy spending(history), he's just unhappy and out for blood. So: A. I essentially give him the item, free B. I'm out of 1.5x the value of the item. The only thing I can do is wait for the decision of the cc company, block the bidder, and leave him positive feedback.(because Ebay now has this wonderful feature that you can only leave a buyer pos. feedback) Lesson learned: get delivery confirmation on everything, even if the item is dirt cheap because when it comes to dealing with cc companies they will always trust their customer's "Unauthorized Charge" lines and the DC is a gold-stamped alibi. I am such a dummy when it comes to dealing with things like this, if the cc company decides in his favor I'll just let it go because it's not like I have a leg to stand on. Screwed is screwed.

Slit Sagittal Suture, insert new brain...

Yes, We Did

What's red, green, and white.. and has been living in freezers for the past 366 days?


That's right- the top tier of our wedding cake. Finally get to eat it, newlyweds no more.

D-Blog Day 2008

Oh yeah. That thing called diabetes, which I am duly obligated to blog relentlessly about-it's time to blog about it again. Today of all days. (you know when you just don't want to do it..it's the very day you HAVE to do it.) Ugh.

Well, diabetes, you have made me a stronger person and you have given me many cool cyber-pals and real life-pals and I can't say that it's a total lose-lose situation.
But today will always have a note of sadness mixed into it, diabetes didn't create it but it's there. We should have an National Type 3 Day-those people are the backbone of our lives.
(unfortunately, type 1to type 1 contact is rare, sporadic thing for most of us)

Decision '08

Lazy Saturday, until the mail arrived. Walked around the neighborhood helping with a food drive and got chased by a dog. That ended it being fun.(I hate dogs)

Smith's Medical has informed me that my pump warranty expires in December. Man, how time flies. I have not even thought about getting a new pump. I like my Cozmo- but perhaps I should go with something different. This will be pump #3 for me(Minimed 508, Deltec).

Acck- decisions, decisions. So, you tell me- what pump do you have, and what do you like/dislike about it's features? Please vote in my poll.

By the Light of the LightSaber

Dc Dollars(at play)

As anyone who lives or works in the DC area must know..the week of Jan.20 is crazy. Every four years, the party faithful besiege the South Lawn to witness their man take the oath of office. And this year, you can bet that it will be much more insane as the Democrats hasn't had a chance to party hardy since 1996. (Bill Clinton) The throngs of loyal Obama-ites that will spend any amount of money for this most momentous occasion is great. I didn't believe it till I saw it, but the instant it became clear who the next president would be hotel prices went berserk. According to the paper, a stay at a Motel 8 will cost you $600 that night.A guy on Craigslist rented his house out for $5,000 that week, and most others are in the $1,500+ range. I am slightly envious that we don't live closer to DC and can't do the same. Although I neither wish to attend or watch it on tv, that's a business proposition that is pretty sweet. Supposedly one can ask their CongressPerson for tickets, although they won't be giving them out till Nov.17. Yes, I'm a cold hard calculating Republican who has no scruples about what I'd do with those tickets, if I managed to get some.(but you didn't read it on this blog)

Marylanders are in kind of a bind right now-Frank Kratovil and Andy Harris are still duking it out for a Congressional seat and it won't be known who has it till they count all those absentee ballots. (not cool, I want my good or bad news right now)

Anyway, the point is, Inaugural Week is not about the poor and underprivileged at all, it is nothing but a massive show of money. (on both sides of the aisle) It's like the biggest waste ever, George Washington wouldn't be doing something like this. Not that I think they shouldn't celebrate but they do it in overkill. My word, we're going to be paying for enough fillet mignon dinners for the next four years as it is. We treat our presidents like kings.

Storks

(quick post before I dash off for the entire day)

A few nights ago, I dreamed I was delivering a baby. The patient was yelling and I was too ("It's coming! I can't help it!" "Nooo- you've got to wait for the ambulance!") in sheer panic. It is one thing to deliver Manniken Annie's baby(EMT class) and quite another to do it live.

"Breathe, Breathe!" I said, as much for my benefit as for the patient. Maybe I would get my stork pin. (something every EMT looks forward to, it's like a badge of honor that you delivered in the field)

"Aughhhh!"

One push, two push, three push, four pushes..and the baby is in my arms, I'm drenched in blood and the amniotic sac is on the ground,(I think that actually bursts-in reality) the umbilical cord is still tying baby to mom. I take a knife cutter and hack the cord loose,and tie, hoping I did it at the right place. (extremely graphic dream)

"Where is that ambulance???"

There is something wrong with the baby, she has a hole in her head and proceeds to bleed to death in my arms. The ambulance never comes. The mom cries, and I cry because I didn't know what to do. Didn't want a stork pin anymore. In reality,I've never witnessed a live birth so anything other then a straightforward one would be a total disaster. Babies are so little, so delicate. No margin for error. It was the sort of dream that leaves a vivid impression on one, life is so fragile.

The Presidential Present

Election morning is like Christmas morning...you wake up to all these presents under the tree. Some of them you like, some of them you dislike, but the biggest present of all you want to be above reproach, pristine, amazing.




When its the one thing you didn't want..it hurts.Even though the people have spoken,and that's what great about America.
Merry (pre)Christmas, America-you'll find out what's in that Obama box soon enough. And it won't be what you expected it to be.
And with this post, I've no doubt eliminated 99.99% of my 10 readers.Lecture over.

The Coke Zero Vote

After going to do my civic duty this morning, I popped open a can of this:


Took a big swallow, took another swallow, and felt something that was definatly not liquid.


That, ladies and gents, is a piece of gravel. Or coal, its hard to tell. I know CocaCola wants Americans to get all of their vitamins and minerals but that is a extreme way of getting them. It's not as bad as finding a mosquito encased in your Hershey's chocolate bar(like one of my bros did) but still...rather shocking. I never expected to be drinking rocks.

Thank you, Coca-Cola, for making my day incredibly special.I only regret that I didn't kill a filling on it and have to go to the dentist to make the day even more special. I'd vote for you(over Pepsi) any day of the year.

The Top Ten Food Joints for the PWD

#1 Carb Hut. Raise your hand if you've got bolusing for pizza down to a T. I'm still learning because I love all kinds of doughy deliciousness.

#2. Pizza Boli. Plural of pizza bolus? (yep, this place is real)

#4 McHappyHemoglobinA1c Place. Hold the bread, pass on the ketchup, and slap on a slice of rubbery low-fat processed cheese. Yummy.

#4 Salad Bell. I'll have the one without the deep fried tortilla chips.

#5 Daiquiri Queen.(rather self-explanatory) Time to get very, very drunk.

#6 Applebgs. Maybe the more burned something is, the less carbs it has. (at at Applebee's, burned is a sure bet)

#7 Endogans. Wouldn't it be cool if the waiters could tell us how to bolus for anything on the menu?
(think Hooligans, with a medical twist)

#8 Five Meters. I'll have the One Touch with a side bucket of peanuts, please.

#9 The Peking Postprandial. Chinese Food- what else!

#10 Dunkin' Disasters- donuts so carb-infused that there ain't no hope of guessing the correct insulin dose needed.

NaBloPoMo

Does it count if you back-post to make up for a day late? Guess I'll find out.


I should not be doing this at all(I am the most insanely busy I have ever been) but this is my one and only opportunity to perhaps clear my list of everything I've been meaning to blog about. A ton of stuff. So here we go.

Nanobots to the Rescue

The Halloween Hypo

I had a severe low this morning. The worse, since June '07.

There was juice.

There was candy.

And then, there was stupor,D50, and a trip to the ER. I was not wearing my Dexcom.(predictably, or this wouldn't have happened) I feel stupid.(I should have been wearing it)

Tonight's Plans: sleep, sleep, and sleep. I am zonked.

Meme Time

1. Where is your cell phone? pocketbook
2. Your significant other? Glenn
3. Your Hair? Brunette
4. Your Skin? Fair
5. Your mother? Elma
6. Your favorite thing? ipod
7. Your dream last night? none
8. Your favorite drink? diet
9. Your dream/goal? healthyness
10. The room you’re in? computer
11. Your ex? none
12. Your fear? Dogs
13.Where do you want to be in 6 years? pregnant(yeah, I'm crazy)
14.Where were you last night? here
15.What you’re not? rude
16.Muffins? blueberry
17.One of your wish list items? laptop
18.Where you grew up? Virginia
19.The last thing you did? cleaning
20.What are you wearing? coat
21.Your TV? Dunno…
22.Your pets? cats
23. Your computer? HP
24. Your life? rollarcoaster
25. Your mood? tired
26. Missing someone? yes
27. Your car? Chevrolet
28. Something you’re not wearing? belt
29. Favorite Store? CVS
30. Your summer? Busy
31. Like someone? yes
32. Your favorite color? blue
33. When is the last time you laughed? Tuesday
34. Last time you cried? Last week
35. Who will respond to this? dunno
36. Who’s Answers are you anxious to see? everyone

pass it on!

Because

Because we seek control, we mutilate our fingers 10 or more(or less) times a day and insert sharp objects into our skin to deliver medication. This may be the 21st century, so is still so much that is archaic about this disease. (like peeing on a test strip)

Because we seek control, a "perfect pregnancy" not only exists, it must exist. The challenges of a normal pregnancy with all the fun of diabetes thrown in. Mentally worrying over every high; every slip up is not only bad for you, its potentially disastrous to the little one you're carrying.

Because we seek control, yearly visits to the eye doc to have painful dilation drops and(potentially) lasers beaming up the the bad vessels in our eyes is the gold standard of good care.

Because we seek control, our exercise routines consist of eating twice as many calories as we burn off, in the attempt to prevent low blood sugars.(or treating them)

Because we seek control, we're up at 3 AM, dealing with a high or low blood sugar.

Because we seek control, a new pair of shoes is judged mainly on it's ability to not cause calluses/infection/subsequent amputations, not it's visible appeal.

Because we seek control, a hospitalization is not the time to turn over your D-care to the experts because most of the time, the experts know even less then you and you'll be even sicker if you did it their way.(Except if your endo is on staff and even then they ignore her orders)

Because we seek control, the "stackable" bolus that we took at 10,12, and 2 has just now hit the fan and we're tanking like a rock and have to start eating again.

Because we seek control, we trust our lives to a liquid that loses potency out of a very delicate temperature range. Freeze or bake, (it's toast) you're toast.

Because we seek control, exercise is twice as important to us then to the non-diabetic. Keeping the bg down, keeping the heart healthy- heart disease is the highest morbidity for the D and you don't have to be old to have a heart attack. You just have to be D.(according to the medical profession)

Because we seek control, we're forced to ride out huge chunks of time in the 80-100 mg/dl spot and be as cranky as heck that we can't overeat and end this feeling of hyponess. Or at least I do. Not that it isn't an excellent bg range, its just when you're used to much higher it makes you feel fairly irratable.

Because we seek control, we drive great distances in search of the perfect endocrinologist.

Because we seek control, denial isn't just a River in Egypt- it's a one-way ticket to Complications City.

Because we seek control, we spend hours of our free time glued to the internet in search of information and support.

Because we seek control, we're a little OCD about the type of meter we use and if it's not the right kind we don't really "trust" it.

Because we seek control, it's not just physical control we must achieve, it's also mental. Not responding in anger to the idiot who asks "Should you be eating that?" is often difficult, if not impossible. Unfortunately, it is an occurrence that will repeat itself thousands of times throughout the life of a PWD and one that you'd suppose you'd eventually get used to and a pro at handling.

Because we seek control, no a1c is truly low enough and if you're over 8, you'd rather not discuss it, especially if the rest of the blog-o-sphere is under 7.

Because we seek control, we chose salad over fries-making the choice not only for ourselves but for the loved ones who want us around a little longer.

Because we seek control, we realize that the state of medical care available today is abysmal for many people and something had better change or we'll all end up with type 2 diabetes, complications galore, and no one to care for anybody.

Because we seek control, sometimes we have to ditch the books(and the subsequent studying for the horrendous test the next day) to go the pump club meeting. We need to know that we are not alone.

Because we seek control, we realize that perfect control really doesn't exist + all we can do is our best. To live, to laugh, and to love-to stick it to the D. Whatever your philosophy, life is a journey, realizing that the D is part of it but not all of it and not something that should own you.

The House of Horrors

Me thinks this has great money-making potential-a night in the Lincoln Bedroom.(that's a man-eating Christmas cactus in the pot...and you've got your fat cats to jump up on the bed in the middle of the night) As an extra bonus, the guest would be treated to the occasional treat of a hypoglycemic wild-eyed crazy person clomping down the stairs at 3 AM on their way to the refrigerator. (yes, I probably look like a ghost at that hour) The only drawback: our house isn't White...

On a Friday Streak

On my way out the door this morning, my pump tubing got caught. This was a first- in terms of that this door was the front door and I'd already locked it. I had to leave the pump there, go get my keys from the car, and unlock the door. I wasn't wearing the pump, I've had alot of extreme sensitivity nights and last night I just took it off, it was so impossible to get my blood sugars up. Suffice to say, not a great idea- I still needed some insulin. Fell asleep, woke up high, took a slight bolus and took the pump back off. Woke up 150. Off I went to the infusion center, to get my magnesium infusion and I bolus for breakfast. Dexcom shows a steady trend up to 210,(at the time of bolus)I don't correct for that. Goes up to 300, and then it tanks right on down to 152. For the second time this week, the IV lock comes loose and blood starts to seep into the pillow and blanket. Delightful.(on Monday it blew blood all over the bathroom) Fortuantly, I'm sitting down and it doesn't seep much before a nurse comes to my rescue. This doesn't seem to be my week for luck with IV's and mini IV's.
Anyway, getting back to the blood sugars-I know that bolusing anything at bed is a horrible idea, even if I'm high.(I'll get low) I think I need to cut everything 50% around the board, starting at 11 pm, and post-supper run it on 0% or take my pump off. I'm glad to finally have more sensors, my last bunch expired before I could use them all and I haven't been able to afford any for the past month. CGM's make diabetes so much easier. (goal for new year..get insurance to COVER sensors, a battle I've been too busy to fight) I use my sensors till they absolutely don't work anymore, + get about 2-3x the normal useage out of them. I do get my money's worth but its money that the insurance company should be shelling out, not me.

Friday's Goodie:
(if you're a coffee person- you don't have to be a B&N member to use the coupon)

Have a good weekend,everyone.

Diabetes Humor, Part I

Three guys(a regular Joe Blow,a musician, and a diabetic) walk into a bar.

The J.B. orders a beer.
The musician orders a scotch on the rocks.
The diabetic orders a diet coke.

Half a dozen beers later,the J.B. climbs up on the the bar and begins belting out a drunken melody. Soon, people begin to leave the bar. More people leave, until only the musician, the diabetic, and the bartender remain. The J.B. changes his pitch, and the musician claps his hands over his ears and rushes out. Only the diabetic remains, and he calmly finishes his diet coke, seemingly unfazed by the horrible caterwauling. Eventually, the J.B. gets tired of singing and shuffles out of the bar. The bartender asks the diabetic why he didn't leave.

"Wrong type of key tone" replies the diabetic.

(yeah, pretty lame but its my first attempt at creating a diabetes joke..)

Peaks and Valleys

Overheard:

"I would like the sugar-free ice cream, because I'm interested in making decisions that are healthful for my body."
(6.5 year old nephew)
I think I just about died laughing, in reality he just wanted the chocolate ice cream. Very verbiose little boy.)

Today, I ate an 115 carb bag of chips, half the dip container, 30 carbs juice, 15 carbs instant glucose to treat a low. It was at my favorite store(CVS) and you know how grocery shopping while low goes. Couldn't stop eating. At the end, I was only 356, I've got alot of that post-mountain-climbing-sensitivity thing going on. Had two lows last night.(over the weekend we went down to hike the Blue Ridge Parkway and celebrate oldest bro's b-day)

How to Fail Tests with Dignity

Here.

Been there, done that. No A's given for effort.

The Sweetest Place on Earth

Remarkably, isn't a room full of PWD's gobbling sundaes. Nor is a FFL convention. No, the sweetest place on earth is a certain little town, tucked away very near to an interstate near and dear to my heart. That interstate, takes you all the way to my old hometown. (yeah, I was tempted)

Hershey, PA. The medical center nearby(Milton S. Hershey Medical Center) must get its fair share of touristy types who make wisecracks while waiting in the ER for phenergan because they tossed too many cookies from riding the many wild roller coasters.

"But doc, chocolate has antioxidants! It's good for my heart!"

"Can I have another IV bag of chocolate milk?"

Nurse: "Doc, he's crashing!Do something!"
Doc: "Push two amps of chocolate and stand clear because he's gonna jump off that table a-swinging. He's just in withdrawal."

I'll bet they also diagnose quite a few cases of diabetes, people tend to go a bit overboard on their consumption of chocolate. (saw people carrying huge shopping bags of chocolate)

Nurse: (sniffing) That's DKA.(to self) "Sir, your days of chocolate imbibement are going to have to come to an end- you've got diabetes and after this, chocolate is going to be a treat- not a daily staple."

On that particular day(last Sat.) also cold and drizzly. Went from 76 in one state to 40's in the next. Quite a shock to the system, I was ready to go home. Free Credit Report dot com commercial guy(or his evil twin) pulled up right in front of us, parked his car and strode purposefully toward the entrance, looking as if the weather didn't bother him one bit. Although, if I were making that kind of money off of commercials it wouldn't bother me so much either.
Go inside. Wander over to lunch pavilion, eat lunch. It was buffet style so of course we overate. The pulled pork sandwiches were the only thing that saved me from turning into an icicle, they were lovely and warm. BG 230's.
Went on Ferris Wheel.(we were the only ones)
Went through Zoo America
Went on the "Kissing Tower"
Went on canoe ride(kind of like Splash Mountain but didn't get quite as wet)
BG 179, ate popcorn. Sun comes out.
Went on SkyRide, monorail, antique cars, train
Browesed shops on way out. Both of us hate roller coasters with a passion, no loss there. (we are old boring married people)Got several souvenir thingies for my collections, husband got chocolate. Also got Hershey perfume so I can smell sweet, not just BE sweet. (which is sooo 20th century) BG 238. I swear, its something in the air.

Final stop at the Factory:



Went on tour ride, did some more shopping, then went home. It was a fun day.

Random Youtube Video

I like it.. and it's my blog, so I'll post what I want!

The Ties that (Un) Bind

Dear (life-sucking-former) Work:

You don't owe me anything anymore. Granted, its been almost a year since I walked out your doors, tossed my cap straight up into the rain and danced for the pure joy of never again having to spend a minute more of my time inside of you but there's been the little issue of that final slip of paper I had comin'. I couldn't ignore you completely.


Today, I am truly a free woman.

Hail to the Meters

From the oldest, to the newest.

A Divabetic in DC

"Five, four, three, two, one...."
Confetti erupted as we walked through the doors, into the exhibit hall. I attended
this, an exclusively chick with diabetes event.(my husband had no interest in coming along) There were various booths set up-educational,(5) makeover(4), and caterers. I am not into the makeup deal(on a regular basis) but I thought it would be neat to try it out, see how wild I could look. So I went over to the makeup booth + got wild green eyes and brilliant red lipstick. Then I went over to the food place, but all they had were raw veggies,chicken pieces, and steamed veggies(that looked really gross). I headed back out to the car and grabbed my bag of Doritos because I was starving to death. Chicken, carrot sticks, and diet coke just weren't enough. Went back inside and over to the exercise booth, where you had to go through a mini-exercise session + they really did make it hard. Meanwhile, all this stuff was going on onstage(JDRF, ADA walk members) and musical groups. To get the prize bagpack, you had to go to at least three stations so I went to a "What's your numbers?" station and was told I am officially obese.(BMI=31?) Yep, 5"2, 119 lbs,qualifies me as obese, I guess I should lose about 25 lbs.(heavy sarcasm) But its not a bad number, its just a number.
(the reasoning of these people I simply do not understand)
Went to another booth and pretty much just stated something obvious so that I could just get through it and not have the CDE lecture me on eating every meal,taking your insulin, etc...
(this was pretty basic stuff)

At 3:30, they started handing out awards. And for all of about 2.5 seconds, I had hopes of winning the highly coveted Most Senior Diabetic award.Like I've stated, this was an event catering mainly to the older, type 2 crowd and when you've had diabetes forever you tend to just stay home. Because you already know all this stuff. So I felt like I had a small chance. But then a 12 year, 14 year, 20 year, 27 year, and 34 + 35 year PWD consecuatively squashed those pipe dreams into the cold, hard linoleum. Highly doubtful that I will EVER win such an award. The 34 and 35 year PWD both got nice gift baskets(worth a couple of hundred bucks), they both looked like senior Mrs.America's, they age well. Would be that I will be so lucky. Other gift baskets went to the most travelled(4 hours, from VA Beach), biggest entourage(6 people).

Because I was so bummed out about not walking the runway(I had preconcieved notions that that was what we'd be doing, at some point) I hastily volunteered(along with several others) to demonstrate exercise moves on stage. It didn't much make up for it but I did get several hundred people staring at me and that was definatly an addicting rush. For our troubles, we got a bag with a pack of Splenda.

Went to the CVS Booth- got a handrub-lotion, put hands in plastic baggies, put in waterbag type warmers, take out, take off baggies- felt AWESOME. Headed back out to registration, turned in paper, got prize backpack from NovoNordisk. Of course, the massage therapists and manicurists and caterors had all shut down so for me, the party was pretty much dead. Got a shirt and a wristband and headed out to the parking lot, now a mini-sea and still coming down hard. Good thing it wasn't held outdoors. I highly recommend going to one-if you get the chance. It was pretty cool being with hundreds of other women with diabetes, even if we had absolutely nothing else in common. Being in the racial minority at an event is a little bit awkward, PR people must have taken my picture a dozen times. I am not photogenic and having my picture plastered all over the website has got me a tad nervous.(ackkk)Not sure I'm ready for all of that.

The Unforgettable Call

"You aren't tearing up my golf course," the proprietor, a short, balding man curtly replies as we jump out of the ambulance, ready to do battle against disease and injury.

"But we have to get to the patient-how else are we going to get there?We have a lot of heavy gear," the squad leader asks.

"I dunno- you figure something out. I just don't want ruts the size of basketball courts in my course, and your truck is definatly gonna do that.I don't wanna fix all that."

Roll eyes....Our fearless squad leader, well adept with dealing with all types of difficult individuals, takes it all in stride and decides on golf carts as the means of transportation.

Of which there are only three.

#1 goes to the owner
#2 goes to the squad leader and other trainee
#3 goes to the driver and the bags of gear

And I have to hang off the back of cart #2, because there is simply
no room for me anywhere else. This is a golf course with a lot of hills + rocks
and the prospect of going down them frontwards, let alone backwards,
is not extremely appealing. I will be going down them backwards.

"Isn't this fun?" the squad leader exclaims, as she mashes the accelerator
down to the floor, launching us off on a fifteen foot freefall before impacting earth, making a mini crater.
"Yeah!" squeals the other trainee, jumping up and down off the seat in uncontrollable glee.

I don't say anything, I'm too busy trying not to scream, faint, fall off, or be sick.
This is beyond insane.(not a roller coaster person here!) Jerk,jerk,jerk,
vroom, drop ,thuds, repeat.After about a mile, we finally reach the patient.(It was the scariest ride I have ever been on, bar none)

Initial impression- in no acute distress. Unlike one of the caregivers, whose knees are still knocking so hard you can hear them over in the next county.

"Sir- we're from the rescue squad, what happened?"

"Stepped in a hole, twisted my ankle," he gestures at his right foot, propped up on a pillow.

Beer cans litter the immediate area, one of his buddies is carrying one and if I had to lay good money on it, the patient has contributed greatly to the pile. I take his blood pressure and pulse and he fixes me with an all-knowing look.

"My pulse, is it 76?"

"Uh, yes it is, is that normal for you?"

"It's always 76. Been that my entire life."

I'm somewhat skeptical of that, how is it possible to have a pulse that never deviates, even at rest? Even if you are a fitness buff.

Squad leader stabilizes his ankle, wraps it up in the pillow. Help put him on cart #2 and they take off to the ambulance.(SL driving) Rather difficult I might imagine, but they get there. And the person I drove back with is a better driver and its not so bad.

Back in the ambulance, I again check his blood pressure and pulse. Again, the pulse is 76.I'm starting to believe the patient, it makes the 2nd time. Not that anything is disturbing the patient, who has reached that state of post-beer #5 euphoric eutopic bliss and feels little pain. His ankle was likely broken, and unlike a normal person he's not screaming,cussing, hitting, biting,scratching, flailing, moaning, writhing,spitting, arguing, or otherwise engaged. He's the perfect patient and does everything we ask. The one drawback, he is pretty chatty and during the lengthy ride to the hospital I think we covered all of the 5,000+ events in his life and then some. A third set of vitals...another 76. I believe him totally now.

Sometimes beer is a good thing, it's the great natural anesthesia. But it usually does not make people so easy to get along with. Ah, the good o'le RS days.

Addiction

Very addicting. Nothing I want so far... waiting patiently on my B.O.C.!
(if I conducted my own woot BODC, it would consist of something like the following: 2 meters,5 alcohol swabs, 1 issue of Diabetes Health, a roll of glucose tablets,a small cold pack(for your diabetes case), and a Multiclix)

(B.O.D.C.= bag of diabetes crap)

That Dysfunctional Epithelial Tissue

Primary function of the Epithelial Tissue:

#1 Tends to screw up. Big time. All glands are in epithilial tissue. I wish I knew why islets are so fragile, just like that they're killed by the tcells and the journey of a thousand other afflictions is launched. Islets seem to be the puniest cells in the human body. My islets put up a decent fight(6 month process) but after I was diagnosed, they took no time at all to completely flatline.(starting cpeptide: 0.3, subsequent cpeptide: 0.0) Why oh why, are such vital cells not tougher? I'd rather some organ like the thymus or the appendix go out, and the pancreas NEVER.
(sigh)

Primary function of the external insulin pump:

#1 To (have the infusion set) die, post-lunch, while taking an exam. In that respect,it also tends to screw up at the most vital times. Why can't there be some sort of alarm that goes off when the set isn't in your skin anymore? The Dexcom certainly lets you know when the sensor isn't in the tissue. The pump, has alot of things that need fixing.

I got my upgraded Dexcom, its at home waiting for me when I get back from school! No more having to waste tons of fingersticks(strips!) trying to calibrate the meter to the unit.(via cable) No more cable, you just put your bg in the Dexcom.Yay!

A Case of TMI....

I'm a conspiracy theorist- I believe that school administrators dictate all the instructors to make exams on the exact same weeks. Case in point:
-A&P lab exam, 9/17 (Wed)
-A&P lecture exam, 9/22
-3 page psych paper, 9/22
-5 page sociology paper, 9/24 (Wed)
All three courses hitting the big time over the course of a week. Not just dumb luck, the A&P was more then enough to keep me occupied. I barely have time or energy for all I have to do.I've found that certain monthly events can also negatively deplete electrolytes, whereas the infusion I got Friday would have lasted me till Monday just fine,it ran out Friday night and Monday morning can't come soon enough. No energy whatsoever,and its from low electrolytes, not hormones. (Told you you didn't want to read this!)

Spot the OC'rs

Here:

(there are four, that I can see!) More (of course) were there,if you see more then that let me know.

Ten Things I'd like my Doctor to Know

#1 This isn't a confessional, and likely neither of us is Catholic so don't turn it into a guiltfest. Yes, I messed up. I'm only human, and the large gaps in my logbook void of any carb count info whatsoever can be expected. I'll try to do better.

#2 Don't tell me I'm too young for x, y, and z. Anything is possible, everything is probable, and stranger things have happened.

#3 Don't tell me I lucked out by having a weird genetic thing. Luck is not the term for it, luck is REALLY not the term for it. Trial by fire is the term for it. It's a medical condition and no medical condition is particularly pleasant, especially not one that requires weekly electrolyte infusions + over time,(like about the time it takes for diabetes to kill the kidneys) can cause kidney failure although that's pretty rare. The only cure, is a kidney transplant sometimes they transplant even if the rest of your kidney function is ok. Which mine is. And I don't want a transplant, although if kidney failure ever necessitates one I'd have a double advantage.

#4 I've probably had diabetes longer then you've been practicing medicine so I'd appreciate you showing a little trust.(if you're not an endo, please don't play one) I know how serious diabetes can be.

#5 I dislike insurance companies just as much as you do, they never have the best interests of the patient in mind.

#6 If there's ever a cure for diabetes, I'm taking you out to lunch.

#7 Diet Coke is on top of the food pyramid. I cannot stop drinking it.

#8 This is a partnership + I wish to be treated as comprehending 75% of what you are actually saying. It will eventually sink in.(forgive me if I don't quite understand how the Loop of Henle reabsorbs,absorbs, and fails to absorb) Every case is different, so I'm guessing not even you have things entirely figured out as it pertains to mine.

#9 A hypo, is a force not to be reckoned with.It's like being starved for a week and then let loose at a Chinese buffet, it is very hard not to go completely wild.

#10 Watching more episodes of shows like House...will greatly improve your ability to relate with your patients. That's where they get 99% of their medical knowledge anyway.
(season premiere tonight,btw!)

Lessons of a Yard Sale(Part II)

Lesson Set #1
and last Saturday...
1. If something hasn't sold in 4 yard sales(2 years) it's probably never gonna and it's time to just let go...and give it to charity.

2. The dude who wants to know if you've got any sniper rifles for sale might just be on for something. As it pertains to scaring the heck out of #3, so much so that they'll never come back. No, I don't have any knives or guns for sale + I've no idea why he asked that.(nor do I want to know)

3. More of my favorite type of customer- the type who loudly proclaim something isn't worth it, offer you less then a dollar for the very expensive item, and snuff off in a pout when you stand firm that this price is the lowest you'll go. Grrrr, I bet you have no problem shelling out for the exact same item at JCPenney. At a yard sale, though, it's supposed to be free or nearly so.

4. Items being used by yourself(such as the fan and rocking chair) need to have signs that they aren't for sale because they are invariably the items that people want to buy the most.
Fan? no
Rocking chair? no
Windex bottle? no
Price stickers? no
Nationals baseball cap? no
(the forbidden seems to have the most appeal)

5. Water bottles really sell. WHO knew, my FFL stash is down to 2 now. I am giving the rest to the Salvation Army. I'd never pay money for something I've got zillions of but most people don't attend conferances and don't get zillions of various items.

6. The hot sun is great for the bgs..stayed between 140-170 for 6 straight hours, even postmeal!

7. People who don't like to drink diet soda probably don't have diabetes.

8. The price of everything drops by 10%, every hour.

9. You'll invariably forget to put a box of stuff out and be kicking yourself for missing out on a potential $30+ more in sales.(and it'll have to wait till the next one)
(kick,kick, kick)

10. Playing "Let's stop the Diabetics" is really fun, although most were in the type 2 category there was a young women who got the Ultra Mini(I give away my extra meters) and she coulda been a type 1. Or maybe people just like getting freebies, no matter what it is. Sometimes people are open about the D and sometimes they just grab and run. There was only one women who actually talked to me about it.

11. Drinking $6 worth of Diet Sodas significantly cuts into one's profits.

12. Heavy rains the night before tend to deter people from coming out en masse the next day-sales weren't as good.

13. We should have sold the new neighbor's house,it's kind of doubtful as to when they're coming back. Been gone for over a week now(they headed down with their boat to have some fun in Hurricane Gustav). One has to wonder whether they are coming back.

The First Type 1 Ironman!

Yo, Bill-you forgot to suck your finger.(maybe most D's didn't do that,back in 1983 though...)

25 years later...he's still doing what he loves. Ironman #6, in October.

Stars of the Fallen

Forgetting isn't an option. Ever-the destruction of this country begins with people who could care less about the thousands(maybe more) of hardcore terrorists who eat,breathe, and live to wipe America off the planet.

The Chicken or the Egg: A Diabetes Debate

You know just after you've taken your first course in a subject and are convinced that you know it all?

Yeah, you could say I'm SOOO at that place. (best Patrick Dempsey impersonation)

So, in psych class we've been rehashing all the major theorists + boring doesn't begin to do justice to the term. The summer course was so packed, so intense, that I'm remembering all this stuff and listening to it again is like regurgitating a fine steak.(great the first time, NOT great the 2nd time) I like psych, I'm probably going to end up a psychiatric pediatric nurse at this rate. I am also ready to move beyond the basics- start solving the world's problems or at least understand them better.

But the one thing the prof said caught my attention, the issue of which comes first- the urge to change behavior(feelings) or the behavior itself. I can see both sides, in the tv show What not to Wear they give the contestants a $5,000 wardrobe makeover,new hair style, makeup- fixing the behavior first, and then the feelings of self confidence + initiative catch up.

And then diabetes(or another chronic disease) comes into the picture and things get so blurry you're not sure which theory is right. If the behavior comes first, you might as well forget about it because someone has to want to change. And if feelings come first, past good disease management doesn't necessarily have a positive impact if you're in that blue funk right now. Learned behavior doesn't mean you'll just automatically keep repeating it, regardless of how you feel. And doing it, does not make one happy about doing it. (it's usually the opposite)

I guess it's like Joe S. said in his FFL discussion group...feelings are important, but you can't run your management off them. It's non negotiable, diabetes management. You might displace your feelings of anger and non compliance into being the longest haired, most tattooed individual in your neighborhood but you can't cope with it by ignoring your disease. It has consequences far beyond one's own life- the family,friends, national and global impact of soaring health care costs. Being angry at diabetes is perfectly acceptable, learning how to channel that anger into a more productive end product is the challenge.
What are you guys thoughts on this?
(logic was never my strong point, these are just my weird ramblings)

Rappin' it up for Diabetes Care

One in a Million

Raise your hand if you've ever felt unique, because of your diabetes.


Raise your other one if you're convinced that yours is the freakingist, hardest, most complex case ever.


And now, jump up and down when you hear that the autosomal recessive gene curse has struck again.. and the thing you're being tested for, is something that about 250 people in the US have. That the nephrologist, who has been in practice for 35 years, has never seen before.

Bartter's Syndrome. None of my five siblings have anything weird, or chronic diseases.I'm not sure my parents knew what they were in for, that fall day when I made my appearance on earth. Or that January day, when the screwy genes collided.
There's a few more tests that have to be run, but one thing is for sure, magnesium infusions are going to be a part of life for an indeterminate period of time.

A Labor Day Wish

The past few weeks have been rather difficult, as I come to terms with something every bit as votile and twisted as diabetes is. But accentuating the positives is good for one's mental health, so I'll take a whack at it:
- No school(today)- I don't have to survive through it.
- I'm not in the hospital, ER, or doctor's office. And that's a good thing, I'm tired of all three places. Tomorrow may be another story, but that's tomorrow + I'm trying to focus on making today the best it can be.
-I have a great family,a wonderful husband,and a good life.Overall. I'm not in the path of Hurricane Gustav, having to flee for my life while the house/possessions get demolished.
The sun is shining, there is fall nip in the air, and it's the perfect holiday.

Today is my birthday,and I want to live life, not the other way around.