A Change

Okay, I've made a jump to a new site located here:
The Jagged Edge

Please let me know what you think of it.
Take care!

Mark

Pasta!

Growing up with diabetes is challenging. I was constantly reminded how deadly going too high or too low (in terms of blood sugar) can be, especially at bedtime. Over the years, I've focused on tips and tricks to manage my bg numbers when eating pasta or pizza. Frankly, I love both. Pizza will always be a staple in my diet. That said, being on MDI (multiple daily injections) has cramped my pasta eating abilities.

While on the pump, I could set a small temporary basal before bed to account for the carbs in pasta. Guess what? On MDI you can't do that. I had a wonderful baked ziti dish for dinner last night. Complimented with fresh baked garlic-buttered bread. My bg before bed (11 pm) was a respectable 118. This morning, much to my dismay, I jumped to a disgusting 257.

Thankfully I had my bottle of Novolog ready for the correction, and now I'm sitting at a 130 (even after breakfast). As soon as the hot, sticky summer heat is past, I promise to go back on the pump. Believe me, I can't wait.
Enjoy the summer!

Mark

Predictability

Yes, predictability - intransitive verb - to make a prediction. For our purposes today, to ably predict how much insulin we need for food.

My inner child spoke. "Okay, yesterday for breakfast you had a 1/2 bagel with two slices of cheese and a diet coke. Your post meal bg was 150 which fell to a 68 before lunch. Today, you had the identical same breakfast and your post meal bg is a 248. You took the same insulin. You had nearly identical morning bg numbers (129). What gives?"







(My life...sometimes)

I've heard that diabetes loves routine; it loves predictable moments. However, I don't believe it. Better yet, I am doing the same thing today as I was doing yesterday. So, my inner child asks a very good question. What gives?

Our life equations go something like this:
A(x) x B(x) x...= God only knows

Bg numbers, food, possibly exercise, stress, hormones, other illnesses, can all play dirty. There is no predictability about them. I ate the same food, took the same amount of insulin, and halfway expected around the same post meal bg. But no, that didn't happen. It's this unpredictable disease that takes a toll on us.

Nothing like a little insanity to begin my day. :-)

Medtronic STAR 3 Trial

I saw the original headline from Diabetes Health, so I can't take credit for finding this. However, I've become more and more fascinated with studies using a continuous glucose monitoring system (CGM).

Alas, Medtronic has conducted and published their study here:
STAR 3 (website)
STAR 3 (pdf)

I have argued this point before, so I'll do it again. I believe the CGM is probably the most significant and vital product of our time. And arguably, more important than the insulin pump.

Why?

At the end of the day, our blood sugar levels determine the functionality of our lives. Damage to our bodies can occur if we are not in control. I'll be the first to admit that I didn't take care of myself for many years and it led to minor complications. I'm better now, but only because I try to keep my sugar levels in control. I have my good days and my not so good days. I test myself approximately 8 times a day. Do I plan on using a CGM in my near future? Sure do!

And in other news...
This diabetic is taking a break from pumping this summer. I've tried everything just short of duct tape to keep my infusion set on in this heat, and I can't make it stick. I usually apply Mastisol, and generally it works great, but for some reason my sweat is dissolving it. Strange, but true. Going back on shots hasn't been too bad though. It has made me think twice about whether to eat a snack. Hello weight loss and more time in the pool! When given lemons, make lemonade...sugar-free preferably.

Keep strong!

Mark

When Diabetes Just Works Out

Imagine a possible worse case scenario:
You are a type 1 diabetic, who wears an insulin pump, and who is on a mission trip deep in the mountains of Tennessee. Halfway there, your spidey senses tingle that you forgot something; something important. Instead of worrying about it, you continue onward believing all will be well.

Next, you realize that you need to change out your pump (or pod since I wear the OmniPod) beginning on the second day of the trip. You gather all your supplies and go through the motions, when you realize what you forgot - a new bottle of insulin.

Okay, rule number one: don't panic. I had 110 units left in my old bottle, but I usually fill a pod with 150 units for three days. Thankfully, I had a number of things going for me which made this worse case scenario not so bad.

Thankfully this mission trip involved A LOT of outdoor, physical activity. Next, I tend to eat much less when I'm hot and sweaty. So with pump in hand, I maintained a temporary basal for much of the time on the trip and ate very little carbs. Lo and behold, when we got home late Sunday evening, I was down to 40 units and averaging a 130 bg. Not too shabby. (Just a FYI, I managed to burn 10,000+ calories on each working day.)

And what would I have done if the situation were much worse? Easy. The nearest pharmacy was 10 miles away, so there was no reason to panic. However, even for me it was a reminder that we can never be overly prepared for a trip; for nothing beats a good backup.

Stay adventurous!

Mark

Diabetes and the Desk Job

Okay I don't know about you, but my 'd' and me have a rough time with having a desk job. Of course I've held a desk job for over 14 years, so this is nothing new. Personally, I am struggling with the lack of activity. Or maybe it's just me in my 'old' age...

My blood sugars do okay, but not as good as if I were physically active. I do try to get up, stretch, and walk around, but we all know how well that works.

Any ideas? I also wonder about those of you who have diabetes and a physical job. How well does a physical job work for you? What troubles do you encounter and how do you handle them?

Friday!

It's Friday! One word that is particularly coming to mind today: FREEDOM! Ah yes...

So far, we here in Atlanta, Georgia are having a somewhat mild and wet summer. Not that I'm complaining, but after winter I was looking forward to sunny and 90 degree temps. The summer actually began sunny and I started to work on a great tan. But alas, my tan decided to leave me and I've returned to my pasty self. Ugh!

My diabetes also loves summer time. I love being outdoors; hiking, biking, fishing, walking, throwing the frisbee, etc. My blood sugars enjoy the 48 hours of stability.

So, for all you 'd's out there, get active this summer and enjoy the 'fruits' that come with it. (Couldn't help the puns there.)



Have fun!

Mark

A Little Jealousy

Sometimes I get a little sour of fellow diseases and/or chronic illnesses. For example, while watching the TV last week I saw a public service announcement (PSA) for autism. In the PSA, it mentioned that autism was diagnosed more in children than diabetes.

I'm sure the autism folks weren't specifically picking on diabetes as I believe other chronic illnesses were mentioned. However, I still get a little angry when such a comparison is made.

Of course I also feel a slight (note: very slight) contempt at those who celebrate their defeat of cancer. I love those who do indeed fight off cancer. My wife and I have a very dear friend who went through a year of tests, chemo, more tests and more chemo to successfully beat cancer. Believe me, I am very grateful that she won her battle. And while I understand that many die from cancer, it doesn't lessen those of us who fight diabetes every day and cannot break free from it. (By the way, diabetes is the sixth leading cause of death in the United States; fifth if you just look at diseases.)

Now, not to get anyone in a sour mood but, it puts diabetes in perspective compared to other diseases. And, of course, explains why I sometimes get a little miffed when unjust comparisons are made. Okay, I'll get off my horse now. :)

Fight on!

Mark

Today's Thoughts

Okay, so I'm seeing a number of d-posts lately talking about a rather "sensitive" subject: carbohydrates or 'carbs' for short.

This particular food group is either your really good friend or your worst enemy. I try to see carbs in a positive light. Our bodies need them for energy, but if your body resembles - say - a russet potato, then there's a problem. Worse yet, I am one of those idiots that can't say no to a good carb in either solid or liquid form. :)

The trouble is, the older I get with my diabetes (my diabetes is over 33 years old, while I am now over 41...AARP card anyone?), the less my body properly digests carbs. Is it a sign of gastroparesis? I don't know and I will get tested. But until then, the less carbs for me, the better.

And in other news...
Had a bummer OmniPod pod removal the other day. I replaced my expired pod with a new one. When I removed the old one, a nice trickle of blood came screaming down my abdomen. Nice. In a matter of seconds, I had a blood stain on my shorts the size of a plum. This was not at all pleasing to my wife or kids. "Dad, it's like you've been shot!" exclaimed my oldest son. Nothing says "diabetes" like a good blood stain.

Finally, yes I am not writing as frequently as I would like to. Even though school is out for our boys and life is starting to calm down, I am still busy. I do keep up with many of the d-blogs out there. So, even though I'm not posting as much, I'm still in the game.

Laugh, live, and love...

Mark

Ugh! Diabetes Moments

So far, 2010 has been filled with Ugh! moments.
For instance:

1. My OmniPod shutoff without warning only to find out later that it was due to low batteries.
2. I tried unsuccessfully to go back on shots for a day, but after 6 injections to correct highs (!?!), I decided the pump is much, much better.
3. Cortisone steroid shots and diabetes DO NOT play well together. I fought high blood sugars for 4 days - taking over 80 units of insulin per day (when I normally take 35 on average) - and thanking God no one managed to piss me off. My endocrinologist was very sympathetic and steered me in the right direction.
4. Why is it every time I try to eat less, I end up eating more... Less gut, less butt. It's very simple.
5. Number 3 was to repair the trigger ligament in my left thumb. Cortisone shots FAILED. Now having surgery next week. Thankfully, the surgery is very minor.
6. And speaking of OmniPod, Insulet has been promising some combination of pod/CGM for over a year now (may be 2?) without even the slightest hint of what it will look like or functionality. Hey Insulet! Throw us a bone, would ya?
7. Last, but not least... The more I aim for perfection, the less likely I will ever get there.

Love and be loved,

Mark

The Hardest Day of My Life

It's been over 4 hours now since I gave our oldest dog, Chloe, to God. We had her for 15 wonderful years. She was more than just a dog to me; she was my daughter.

To make a long story short, I physically rescued her when she was just 13 weeks old. An irresponsible person left her in a car in over 100 degree heat. I freed her and fought for her in court and from there on my wife and I became her parents.

Chloe loved our two children from the day they were born. She became a herder to them. On many times she prevented them from getting hurt. The boys would often cuddle on her soft fur and she would be patient with them. She loved to lick their faces to make them giggle.

Chloe loved the outdoors. I fondly remember watching the cool spring air run through her long hair. As for a samoyed, she was cunning and very fast. She would often bring me adult blue jays or an occasional chipmunk.

She also made the best guard dog anyone could ever ask for. Her 'wolf-like' features were formidable for visitors at the door. I once told a delivery guy that if she didn't approve of you, she would let me know.

I will miss my smiling girl, but I know without a doubt, that she is in a much better place.

Chloe, enjoy the wind of Heaven and the new love you have found...

Too Late?

I suppose it's too late to wish everyone a Happy New Year... Ugh.

What have I been up to? Well, considering that I've fought off two infections in the last month, caring for sick family members, caring for a family (who are very, very, very good friends) who are going through hell on earth, and trying to keep my diabetes on track is just the start of my life. I sometimes feel that God has made me a member of his personal "Army Rangers", and I'm on-call 24x7. Yes, life has been that challenging.

I am blessed though that I am alive and, as I gaze out our kitchen window to 2 inches of snow, know that I am loved.

To me, that's what life is all about; to love and be loved.

Health Update

Thank you all for your kind words and encouragement during this trying time. Here is the latest...

I have forced myself to cut wayyyyy down on caffeine. For as long as I can remember, caffeine has been a very close friend of mine, e.g. everywhere I went, I made sure there was a caffeinated soda or coffee in my hand. Now, Sprite Zero, decaffeinated coffee, and water are the norm. (I'm actually drinking decaf coffee right now. Oh the humanity!) It's been tough, but when your health is on the line, you learn to adjust.

In addition to caffeine, I'm eating less milk chocolate. I know, I know... "diabetics shouldn't eat chocolate any way...", well that thinking is sooo 1950's. Now let's move along.

I am drinking more water than ever! Sometimes I think there's got to be something better, but it's really good for me and my IBS. In addition, I'm eating smaller meals and try (emphasize, 'try') to stay away from high fat, greasy meals. Occasionally, the bloating and other yucky stuff that comes with IBS happens. BUT, I just deal with it.

The worse part of this whole ordeal is the not knowing. I'm still discovering what foods are good and what are bad. For instance, I used to love eating snack crackers. After having some, they cause me severe intestinal cramps. This is just an example. Again, I may not understand all that is happening, but I need to deal with it.

I welcome any advice from those of you who suffer from IBS and diabetes.

A Medical Hurricane

I haven't posted in a while, because I simply needed a break. However, I have a confession to make: I have Irritable Bowel Syndrome or IBS. It's painful and uncomfortable and the list goes on. I've been fighting it for a awhile, but really didn't want to tell anyone. My IBS is brought on by stress. A combination of work and family stress, along with an irregular diet and lack of regular exercise, caused the equivalent of an internal hurricane.

And this hurricane put me down for several days last week.

Sadly, I couldn't stop this hurricane; I could only alleviate it. I ate little and drank lots of fluids. Even as I write, the last of the hurricane is rumbling through. In addition, you probably are wondering about my diabetes. How did I manage through this storm?

I was constantly testing my blood sugar and adjusting as necessary. Yes, I had many highs and many lows which just added to the storm. Yet, it could have been much worse. Personally, I'm angry with myself that I didn't deal with these issues sooner. I know better, but failed to take action. I hoped that this storm would just dissipate. Clearly, I was wrong.

I know there will be a next time. I know life is going to keep throwing me curve balls. I'm aware of the signs... BUT, I can't promise that I'll handle it any better. All I can do is try to keep my stress down and learn to let some things go.

A Time of Change

I love the fall season. I love the temperature change to the 60's. I love the sight of brilliant colors. Fall reminds me of change.

In the last 2-3 weeks, I have changed job positions, my diet, and different life routines. For example, my job has become very, very active again. I've gone from a sedentary job - lots of sitting with little to do - to actively solving issues. My blood sugar levels have been very happy with me.

Our family is slowly making a change to an 'organic' diet. We are trying not to purchase foods that have been grown or processed with steroids or chemicals. We made this decision based on how we feel after eating healthier choices. Life is too short and therefore, we must do what is right for us and our children. It's been tough, but so far, so good. (And, no, I'm not giving up a good beer!)

And what does a different life routine mean? Well, I've made the conscious decision to spend less time on the computer (and iPhone), including Twitter and Facebook, and spending more time being active. As a family, we are exercising and spending more time outside.

I am at a point in my life where the more simple I keep things, the better. I'm tired of stressing over, "the little things". I'm not perfect and refuse to live perfectly. But, I do want to enjoy life to the fullest and these changes are helping me do just that.

Enjoy your fall! :)

Where is Mark?

Just a quick note, I am in midst of changing jobs and life has been very, very busy. That's good for a person like me who loves being thrown in the fire. I'm not afraid of getting my hands dirty. (I'm not afraid of a bar fight either, but I don't do that anymore.) Alas, this comes with a down side; no diabetes OC, no Twitter, etc...

To all my d-friends, I miss you all very much and hope all is well.

Two things... First, my sister (who is also a type 1) and I are looking at getting a continuous glucose monitoring system. I'm too darn old and tired for bg roller coasters.

Second, beginning Sunday, November 1st, I will be training for the 2010 JDRF Ride to Cure Diabetes. My goal is 30 miles, since this will be my first time.

Be Healthy - Have Fun - Enjoy Life

Mark

This Isn't Funny

One of my favorite muscians are the Dave Matthews Band. I've listened to them since the early 90's and have followed them off and on throughout the years.

If you have time, watch this video and think about how it relates to our lives:

http://www.youtube.com/watch?v=ew8hmVIGKcM

Just for today, this moment in time...

Battling A Cold

Update:
Just got back from my PCP. No influenza 'A'. Just a virus with a bad cough. Whew! But boy, that nose swabbing is quite the experience. And yet I didn't flinch, cough, or complain... :)

______________________________________________________________

I hate colds.

I hate them, because they throw a temporary cramp in my lifestyle; a kink in my hose. Not that I have a typical runny nose, cough, temperature cold. No, I have a deep cough that just won't go away. Worse, it keeps me up all night. Just when my mind wants to sleep, my body coughs a deep bellow that awakens everyone. Last night, I slept may be 3 hours. Of course I still managed to go in to work. My body feels fine aside from the cough. No achiness. Go figure.

And what about medicine for the 'ol diabetic? Good question. I've been taking Vick's 44 Cough and Cold syrup before bed and Robitussin expectorant during the day. All to no avail (although it worked wonders for my oldest son's and wife's colds). So now, off to my primary care physician to get rid of it once and for all.

Lastly, I can't tell you how many times I've been asked about getting the flu shot. Yes, I will be gettin' it on October 1st (it's through work & you can't beat free).

So...sorry for the bland post. Things will be better in the days to come.
Have hope and keep smiling!

A New Diagnosis

What if someone you loved very much was diagnosed with diabetes? Maybe not even a loved one, but a friend, an acquaintance, or a stranger? What would
you say?

What if that person was a child?

…a teenager?

…or an adult?

What would you say to the parents of a child, who have just spent several days in a hospital wondering--every waking moment--what the future holds for their child?

And what of a teenager who feels that their life is just starting and now they have to deal with this disease?

Or how about an adult who has tasted a “normal” life and doesn’t understand why?

What would you say?

Could you honestly look in to the eyes of a sleep-deprived parent and tell them, with a straight face, that everything was going to be okay?

When I was diagnosed as a child, with type 1 diabetes, negativity was the norm. There wasn’t much hope for living beyond 21. I was told to prepare for a slow death. Was I encouraged to do well? Sure, but I wouldn’t last with this disease as an adult. Thanks for playing.

My diagnosis was over 32 years ago. I am now 40. I’ve had my share of battles with diabetes, but (and note my words here), I still have the will to win. I still have the will to live a long, awesome life.

When I meet a newly diagnosed patient – especially a child – I ask them one question: What do you want to be when you grow up? Many sheepishly reply, “a doctor, nurse, police officer”, or the occasional “engineer”.

“Guess what?” I tell them with excitement. “You can! And don’t let diabetes stop you from being who you want to be.” Smiles follow and parents are relieved knowing that their precious child can live a long, productive life.

This writing is a gentle reminder that we, too, can be and can do anything we want when we properly manage our diabetes. The only boundaries we have are the ones we place on ourselves.

Properly manage your diabetes and…

...let your dreams take you wherever you want to go.

Diabetes History Quiz

I am not a physician, nor a medical professional, so please consult them if you have questions regarding your health.

Have fun!

1. Name the tool nurses and doctors used to show newly diagnosed patients how to give themselves a shot and, in some places, is still used today.

2. What is the name of the product used to test sugar AND ketones in your urine?

3. Name the lancet device that closely resembles a guillotine.

(still give me shivers...)

4. Can you name at least two brands of disposable insulin syringes that were available in the 70's?

5. Doctors and nurses taught a key phrase when mixing either Regular with NPH, Regular with Lente, or Regular with Ultra Lente. What was it?

6. Who were the two gentlemen who discovered insulin? (arguably the easiest question here)

7. According to Dr. Francine Kaufman, which country in the world far exceeds the United States in diabetes care for type 2s? Hint: Go to dLife.com and watch this episode.

8. Is it better to wash your hands, with soap and water, before taking a blood test or use an alcohol swab?

9. Can you name the physician who fought for many years advocating tight blood glucose control to prevent diabetes-related complications?

Last, but not least...
10. Name any blood glucose monitor that takes 5 seconds or less for a result to appear.




Answers
1. That tool was, and is, an orange
2. Keto Diastix
3. The Autolet lancet device
4. BD & Monoject
5. "clear before cloudy"
6. Frederick Banting and Charles Best
7. According to the episode, Finland outscores the United States in type 2 diabetes care
8. Either way is preferred, BUT your fingers should be completely dry before testing
9. Dr. Richard Bernstein
10. You name it!