Tuesday, March 30, 2010

Grumpy = happy

A mere two weeks after our endo appointment day overlap (and too-short visit to Sbux), @amblass and I are finally having our coffee tete a tete! Does looking forward to something count as a cheerful post?!

I have no words.

Except maybe WTF???

A coworker - someone I've been sitting near for just a handful of months, but with whom I have never once discussed the D or anything of that ilk - just sent me this email:

So my general doctor left the city and I need to see a doctor soon. I know you have an array of doctors.

Also, do you have an ear, eye nose, throat doctor? I think I have a sinus infection.

Thank you,

I have no idea where to begin. Obviously, she has been listening in on phone calls/appointments I've been making. I'm not shy about diabetes and my pump is readily visible, but I do not discuss doctors or my meetings with them with anyone outside of our little diabetic community or my close friends and family. And wth is up with the word choice? "Array of doctors" - like they're some cute, rainbow collection of shoes I have because they're just so irresistible? Or the fact that, because I have to deal with doctors and my health so much, clearly I would also have an ENT - I mean, someone as diseased as I am must have visited every specialist known to mankind at least once, right?

I'm sure I'm overreacting (maybe it's the crap weather?), but at the moment I'm just agog.

Goal for today: more cheerful post later!

Thursday, March 25, 2010

Note to the world: Never tell a T1 you imagine the "health stuff is a work in progress"

Because I will get really, really irritated with you and my response would probably be something like this:

The health stuff is, as it often is, crap. Woke up skyhigh this morning and, as such, had one of my infrequent bouts of BG vertigo - ended up coming in to work at 10:45 since I couldn't stand up without falling over until roughly 9:00. It's always hit or miss, and I take it rather personally when I miss. The variables are such that you never really know why it's a miss, and that's frustrating. And demoralizing. And rage-inducing. Suffice it to say, taking care of myself is nearly a full-time job. I hate that that's the case, and it pisses me off that I could be doing so many other things with my time and attention. Yeah, sure, that last doctor appointment was a good one. But I have another this Monday, I'm making a cardiology appointment, I'm carrying a notebook with food logging, I am constantly covered in/carrying equipment - "work in progress" isn't quite the way to describe it, since you couldn't say breathing is really a work in progress, right? It's just as relentlessly THERE as breathing, just as important...but try to imagine writing down each breath, remembering to breathe every time you need to do so, carrying around a tank of oxygen everywhere you go (and sleeping with it! and showering with it!) because the air doesn't carry enough for *just* you and others like you, having 5 different specialists monitoring how well your breathing is going, and then actually not being GOOD at breathing - constantly hiccuping, or having asthma attacks, or miscalculating and not breathing deeply enough and passing out all the time - and knowing that you're likely to die from complications that accrue with every error you make while trying to breathe. That's a little bit more accurate a description.

Tell me a story

Industry wisdom talks about how hard it is to sell short story collections - they regularly yield groans when they're announced on a list. While sales figures may support that wisdom, my own personal love of them makes me Pshaw whenever a publishing person starts sighing.

I. Love. Short. Stories. To be able to grab a reader in such a shortened format, to really nail a character, grab the heartstrings, really involve someone in a short batch of pages - that, to me, takes a special kind of talent. So it's no surprise that I've picked up two collections in a row for my subway reading: Robin Black's If I Loved You, I Would Tell You This and Mary Gaitskill's Don't Cry.

Oh, what different reading experiences! I DEVOURED the Black. Every single piece was worth reading, every single character worth knowing - it was exquisite, and I wish I could go proselytize about it on the street corner. (I suppose I'll have to just embrace the Internet!) She achieves what a short story writer rarely does by making each piece feel different; their commonality was a certain heartbreak, a prevalence of melancholy, but each individual piece felt distinct from the next. Collections often seem to hold stories that bleed into one another. You can see how the author has a theme or a character in their head, and seems unable to keep that from recurring time after time.

Like the second collection I'm still reading, Don't Cry. I keep slogging through pages, hoping that it will change and one story will leap off the pages at me, but I'm not going to hold my breath. One piece blends into the next - unending riffs on violent sex and hate-filled female characters who seem angry that they're not the boss of everyone around them - on and on with people I don't want to know, lives I find I have zero interest in peeking in on.

I would recommend avoiding the Gaitskill like the plague (and am working really hard at not abandoning it halfway through - I don't like orphan reads), but would suggest you run run run to get the gorgeous debut from Black, which goes on sale March 30.

Wednesday, March 24, 2010

The FoPo in full effect

We had a PowerPoint presentation at work today. As it was a more fun/informative thing than anything else, they decided to do it during lunchtime. The initial invitation said to bring your own lunch and come to the conference room. This morning, they offered to buy pizza.

All well and good, but pizza is - in addition to not being a Karen favorite - a MEF and I just didn't feel like dealing with the dual wave and all the ensuing BG watching. So I went to the cafeteria and got my stand-by work-day salad lunch and brought it to the conference room. Of the 23 people invited, no less than 5 people commented on the fact that I wasn't eating pizza. The comments ranged from "You're so good!" to "I wish I had your willpower" to "My, aren't we healthy today."

I never know what to say to these people. I want to say, "How about you back the eff off and mind your own plate?" but don't want to be rude. I don't want to mention the D because it's not their frigging business why I do or don't eat something, and I absolutely loathe the idea that they'd walk away feeling pity for the poor diabetic girl who doesn't eat pizza - heaven forbid I encourage their evil FoPo ways. I also don't want to just nod and smile and let them think it's okay to comment on someone else's eating habits. What's a girl to do? At this point I just kind of grimace at them until they walk away, and feel proud that I remained calm...

My Old Spice man, tanning, and nutrition lessons = amazing

Last night's ACT1 group meeting (and beyooooond!) was incredible. The meeting itself was the kickoff to the ACT1 spring speaker series and featured Alenka Ravnik, a nutritionist at Mount Sinai. I gotta say - like most T1s, I've done the nutritionist thing and I've always left the building congratulating myself on not stabbing the skinny little twerp who tsk-tsk-tsked my eating habits and then offered ridiculous suggestions to revolutionize my life:

Twerp: And then, for a free snack, you may have four pumpkin seeds!

Me: Four pumpkin seeds?

Twerp: Or a pickle!

As I'm struggling a bit with my new meatless ways (and the new TDD of insulin I'm on because of it), I thought I'd suck it up and give it another shot - at the very least, I figured it would lay some groundwork for my CDE appointment on Monday. I was more than pleasantly surprised by the evening.

Alenka - in a fabulously trilling accent - offered a lot of great advice for a room full of women who all had different goals, different questions, different backgrounds...and all have the eating issues (carb counting, MEF status, carb backlash, alcohol bolusing, etc.) that all we T1s deal with on a daily basis. No small feat! Some of my takeaway tips:

Vitamin D: Studies have shown that vitamin D deficiency and T1s are well acquainted. The cheapest, easiest way to ensure you get enough vitamin D without overdosing through pills (it's a liposoluble, just like A, E, and K)? 15 minutes of sunshine, three times a week, on your face, hands and neck. Other sources include fortified milk and shiitake mushrooms (rich in the vitamin as they absorb UV rays while they grow - bonus points to Dana, the star pupil and source of much hilarity that evening).

Omega-3s: Wonder nutrient! Obviously found in a bunch of animal sources, but for folks like me we can find them in walnuts, flaxseeds (which should be refrigerated, lest they become rancide, and always be ground before consumption), chia seeds, and algaes (seaweed and the fun green stuff found in miso soup).

Yogurt: Wonder food! Especially plain Greek yogurt, which still has the awesome good bacteria but has less carbs and twice the protein of regular yogurt. Plus, it's processed in the town-next-door to Gloversville - upstate represent! (right, CALpumper?) I think the catch-phrase we learned sums it all up beautifully: "A yogurt a day keeps the yeast away."

Fresh vs Frozen: Per Alenka, frozen is better! (I was surprised, too.) Once produce is picked it starts to lose all the good stuff that's in it. When an apple is shipped from New Zealand or wherever, it takes some time to hit your shelf - you can't be sure how long it took from picking to your tastebuds. Frozen produce, however, gets picked and then processed on location - it's had less time for all the good stuff to shake out. I don't know about apples (I'll stick to my Empires from slightly north of us!), but I'll be buying frozen veggies whenever I can't get to the greenmarkets of NYC.

The hour and a half flew by, and we didn't really have the chance to discuss all the pressing stuff (like drinking!) we wanted to talk about. A good sign for a speaker series, although a bit of a bummer since I was learning a lot - I'll keep notes from my session with my CDE, and hope to have a lot more food for thought (ba dum ching!) after that appointment.

The beyoooooond was as good as the group meeting itself - I got to hang with @amblass for real this time! - lots of chatter, lots of laughing, lots of good food. Most important, though, was the fact that we discussed the Old Spice man commercial at length:

Monday, March 22, 2010

What's for dinner tonight? Glum pride!

Dinner tonight was mixed vegetables - 60g of pre-measured carbs, plus fiber and all sorts of lovely vitamins - with a dab o' butter, garlic, sea salt and pepper to taste.

Glum: I'd rather have had Papa John's cheesesticks (with marinara! mmmm).

Pride: I didn't.

Score one for Karen!

Friday, March 19, 2010

My mortal enemy

I woke up at 299 this morning. I knew I was going to wake up near there, of course. I went to bed around 70, but still set a nice square bolus of 3 units to catch the BG Backlash. When Dex woke me at 2:30, I even popped an extra unit in there when I saw that long square wasn't cutting it. But I still failed to wake up in the zone. Why? Chips and freakin' salsa.

Everyone has their Mortal Enemy Food(s). My big MEFs are pizza (not so shocking) and chips & salsa. When I eat these foods, it is a given that I will wake up somewhere in the stratosphere - I have never in my 16 diabetic years gotten it right.

Over the years, I decided to basically break up with pizza. It was a good decision, and I never really miss it. But the salty goodness of tortilla chips? The zesty spiciness of salsa? The satisfying crunch of chip and zing of dip? It's like crack. Or heroin. I need chips & salsa methadone.

I'll explain.

Long ago, I realized pasta was also a MEF. But it wasn't the pasta I loved - it was the sauce. (I blame my mom's delicious, bubbling vat of sauce that would cook all day on Sundays. Mmmm.) So now I do "diabetic pasta" - green beans smothered in a river of pasta sauce. I still get a sauce delivery vehicle, but I don't get the BG Backlash afterward. It works for me, and I've found that replacement foods - stuff that satisfies a yen or a mood, but isn't as complicated as the real thing - are really the smartest way for me to approach MEFs.

What the heck could I use for replacements?

Tuesday, March 16, 2010

Rah-rah, sis-boom-bah, kick D in the pants, ha ha ha!

Yesterday was the dreaded A1C appointment with my endo and, since I'm a glutton for punishment, I'd also scheduled my dilation with my ophthalmologist. A double-whammy for anyone, but as a self-flagellator with a graduate degree in beating myself up I was primed for a day of sulking and self-lectures.

It's been a rough couple of carb-heavy months since I stopped eating meat (beans everywhere!) and I'm still adjusting my body and my brain to the pump - I was figuring low 7s on the A1C if I was lucky, a jump from my 6.7 in November. And, with a jump on the ol' A1C, who's to say that doesn't mean my eye spots have proliferated?

As usual, I spent the two weeks before in a complete mess of nerves, lugging around logs for the doctor and trying to wrangle my all-over-the-place stress BGs. The only silver lining I had going into Monday was the totally crazy opportunity to meet @amblass who just happened to have an appointment with our doctor a mere 30 minutes before I did. (Our T1 world is so small sometimes....)

Long story short:

  • 6.4 on the A1C (I actually yelped and waved my hands around - I think I scared the doc), which I'm still not sure how I managed
  • The eyes may or may not have stayed stable. Apparently, Dr. Eyeballs has better equipment at the center--he wasn't sure if my right eye spots was always two little spots or now has a friend who's hanging out with it. After 10 minutes being reassured about how I shouldn't freak out (including Doc E taking pictures of my eyeball insides, which look like yolks or some other nastiness, so I could see for myself what the spots look like), I think I finally believed that it was a good report.
B took me out for a celebratory diner breakfast - all the hard work for that sub-6.0 (food scales! more measuring and counting!) could wait for one more day.

Friday, March 12, 2010

Diabenglish, or a Reenactment of Bedtime Conversation with B

Me: "Ugh. I'm having phantom set pain."

B: "From which one?"

Me: "Not even a recent one! Just a random two and a half inches below my current one."

B: "Do other PWDs ['pweeds'] have that?"

Me: "Pweeds? Is that how it sounds in your head?"

B: "Well if pwnd is 'pweened' then PWDs should be 'pweeds'."

Me: "It's always pee-doubleyoo-dees in my head."

B: "That's like Diabetics of Mass Destruction."

Me: "Even better."

Thursday, March 11, 2010

Wedlock (but not the kind you're thinking...)

For the 400th time this week, I had to return to my desk to grab Dex from his usual keyboard-cozy position under my monitor - I'd forgotten to grab him on my way to the bathroom. This "D'oh! Grab Dex!" boomerang move happens all the time at home and work, and every single one of those times makes me think of this super-cheesy sci-fi movie:

The premise: keeping prisoners in your prison is way easier when they're self-policing. So how do we make them behave and stay put? Strap a collar on their necks, link said collar electronically to another prisoner's, and if those partners are separated by more than 100 yards, the collar blows up! As no one knows who their partner is, no one strays too far.

Can you see why this reminds me of my relationship with Dex?

Boot-pumpin' ain't easy...

Me, my boots, my pump on the Times Square subway platform

I whack this thing untold times during the day when it's clipped to my boot, and it goes something like:

  • I freeze where I am, and begin my mantra: GAH!dontfalldontfaldontfalldontfall
  • I secure the floppy pump
  • I roll my eyes
  • The New Yorkers around me roll their eyes

Wednesday, March 10, 2010

Mad Men Barbies!!

Sigh. And of COURSE Joan's is hot. Some girls have all the luck....

(Side note: My second Barbie post of the day. Scary? Funny? I'm unclear.)

Diabetic Ken and the Artificial Pancreas

I know it's distracting, but if you try really hard I bet you can manage to take your eyes off this amazing, slightly-creepy Diabetic Ken doll picture for just one second to talk about the gear he's sporting. (It's similar to mine, in fact, although I'm currently hitched to a Dexcom CGM. And I don't have his svelte abs.) The CGM and the pump are incredibly useful tools in disease management - I love/hate my gear, and rely on that technology to keep me alive. But as any T1 knows, our disease is unpredictable (Kiss My Variables!) and the tech is imperfect. So I've been a little freaked out about the artificial pancreas project (diaTribe has an excellent summary piece that you can read here).

This new partnership between the JDRF and Animas/Johnson & Johnson has a stated goal of "automating how people with diabetes manage their blood sugar." It's a good goal, and one I could totally get behind - after all, I miss my pancreas and it did automatic management quite well for 15 years! But like most PWDs, I'm a bit of a control freak about my health management. I am in charge of myself, and nobody else is the boss of me.

The idea of making something that runs on batteries the project manager for my life gives me the heebie jeebies, and those HJs are only made worse when you consider the Dexcom/CGM issue. I simply cannot rely on anything the Dex says. It provides a steady stream of invaluable data, but I would never in a million years allow that trending data to dictate what insulin my pump is providing:

The pump would house a sophisticated computer program that will address safety concerns during the day and night, by helping prevent hypoglycemia and extreme hyperglycemia. It would slow or stop insulin delivery if it detected blood sugar was going too low and would increase insulin delivery if blood sugar was too high.

If I can't trust my CGM to provide 100% accurate data, how am I supposed to trust it with my insulin dosing - and my life? I realize this is a project, i.e. they're working on it, it's not finalized, and that actual implementation is likely years and years down the road. I know that there have been awesome studies and everyone is all super-jazzed about the outcomes of said studies. Whooptidoo. What I want is for the JDRF and J&J to say "Hey, T1s!
  1. We know that the existing tech from which we'll pull a lot of our artificial pancreas stuff is kind of meh right now. We promise we'll have some PERFECT CGMs out there - we're talkin' fingerstick-free levels of awesome CGM - ages before this whole thing goes live, so you have some time to play around with it and learn to trust in its awesomeness.
  2. We know that we make it sound like it'll be this fabulous invention where you don't have to do anything anymore but that won't be the truth. You'll still be monkeying with sets, playing with insulin bubbles, stabbing yourself, and spending oodles on equipment and supplies...not to mention your time and effort.
  3. We know this is a lot for you guys after years and years of caring for yourselves. So we're going to ask for your thoughts and feelings, talk to your patient advocates, and make sure we have your support as this project progresses.
  4. We promise to remember that "Insulin Isn't a Cure," because it is NOT. We're just trying to make your lives better and healthier while we still plow gobs of money and time into finding that cure."
I won't hold my breath, obviously, but a girl can dream....

Tuesday, March 2, 2010

"Blub!" - Dex. "Gah!!" - Me.

I spent the weekend in San Diego visiting my little sister. My flight left Friday morning, and if you're from the New York metro area you're probably already inwardly groaning. Another big snowstorm hit our fair town late Thursday night into early Friday morning, which meant yours truly - with an 8:29 flight - was slogging through 5 inches of snow before 6:00 a.m. to get to LIRR and the airport.

I should have taken the snowstorm, the 2.5-hour delay, the missed train, the lack of shoveled walks, and all the ensuing airport drama as an omen for the weekend. But I didn't.

Instead, I powered through and my flight actually got off the ground. Napping and two coffees made me feel a bit better about things and I thought a weekend in sunny California would redeem the rocky start. A rainy Saturday forecast put the kibosh on that idea, but my sister and I kept our chins up (and our mouths full of delicious fondue dinner!) and planned on shopping despite the weather. One dressing-room-door mashed finger later (it bled! profusely! but the shop people were so freaked by the blood I felt weird using the bonus bleeder for testing. sigh), and I was beginning to wonder what the hell was going on. I hadn't seen any black cats or walked under any ladders, but the weekend was beginning to feel a bit off.

Saturday night found me excited to try out dinner at Sushi Deli - I'm working hard at learning new food options, now that I'm no longer eating meat. I got out of the car, negotiating the river of water gushing by at the curb, and stood up...only to hear a clatter and a gasp from my sister.

Dex had taken a dive from my pocket, and was floating downstream on a current of rainwater. I dropped to my knee, grabbed him, tossed my bag to my sister, and started wiping him off on every dry clothing surface I could find. I turned him off and proceeded to whack, curse, and rub that little guy - if mouth-to-mouth was an option, I would have done it.

I don't know that he was in the water for more than 10 or 15 seconds, but the little water droplets in the screen couldn't be a good sign. I was heartbroken. I'd had the receiver for just about four weeks and was head-over-heels in love with the gadget. Gone already?! No way could I afford a new $1,000 receiver, and my insurance sure as hell wouldn't cover a new one so soon. I spent dinner pretending I was having a good time, but was totally self-flagellating on the inside - "What a waste! How irresponsible! Shame!"

Once we'd arrived back at their apartment, I dumped poor little Dex in a bowl full of uncooked rice (yes, it did feel a bit like a creepy burial ritual), crossed my fingers, and didn't touch anything until morning.

I waited until the very last minute the next day to take him out of his rice grave. I pressed a button and held it until - miracle! - there was that high-pitched screamy start-up noise. The screen booted, Dex initialized, and HALLELUJAH he found the sensor! I can't remember the last time I felt so relieved about anything. (Maybe pump approval?) I don't think I even realized how much I'd been holding my breath, worried that he would be completely dead.

The rest of the weekend was fun, but I felt like the Dex incident kind of hung over everything. I was constantly patting myself, groping in my purse, confirming that he was safe and snug and working hard at getting all those BG readings.