Archive for May, 2010

My First Weekend at Bearskin Meadow Camp

May 29th, 2010

After a calm but incredibly cold night up at camp, I started my first day of Work Weekend slightly frozen and quite apprehensive.  Everyone was incredibly kind, but it was all new. 

All of it.

(Not only was it all new to me, it was all at 5800’ elevation; I was out of breath kind of a lot the first few days!  Everyone was.  Good times!)

I met one family and kind of latched on; they had three sons and the middle son had diabetes.  They were a fun family and always had a fun story to share. 

We were all working hard, yet with a camaraderie I didn’t experience often.  People started talking about “Bearskin Magic” but I couldn’t recognize it yet.  I saw parents involved in their kids’ lives and their kids’ diabetes, which was cool enough for me. 

No one said the word “diabetes” at a different volume than any other word.

Maybe that was the magic they were talking about?

I remember playing cards in the dining hall that second night and having a great time talking to the son with diabetes.  We were having an animated conversation and his mom told him it was time to check his blood sugar.  He did, and was low.  I continued to talk to the boy as his mom went to get him some apple juice.  When she came back, I was still chatting away with him.  We were having so much fun that I had to remind him a couple times to drink the juice that was in front of him.  His mom later told me I’d do just fine working there that summer because of the way I treated him when he was low and distracted from treating the low.

None of it was a big deal.  No drama.  Just life.  Life with diabetes.

I guess it’s that Bearskin Magic that is making me cry about this as I type.  It seems like such a little thing, overall, but wow it isn’t.  I would be crying if I were at Work Weekend this year, too, since I cry a little each time I’m up at camp. 

Camp is a very special place.

We all carry our diabetes in different ways; ways that change with our mood, with our glucose levels, with what happens in our daily lives.  Spending even that first weekend someplace where the world looked the same, where we had stories we shared about what got us to camp and stories we shared that had nothing to do with camp or with diabetes gave me an opportunity to see that I wasn’t alone.  It gave me a chance to see some people whose attitudes I wanted to imitate and gave me a chance to be immediately accepted into a kind group who knew my pain, accepted it without mention, and also had a load of good fun to share with me, too.    

Like I said yesterday, sending myself to work at summer camp was the best decision I’ve ever made.  Everyone deserves the same opportunity to feel accepted into a group no matter what mood they’re in, what their glucose meter says, or how many times they’ve been low or high that day.  We all need an opportunity to have others share the weight of of living with diabetes we carry without rest.  We all deserve a chance to sing a song rhyming “glucose” with whatever we can think of to make it work.

We are in this together.  It’s really the only way to get through, and the only way that makes “getting through” worth it in the end.

(Now that I think about it; what rhymes with “glucose”??)

Memorial Day Weekend 1998

May 28th, 2010

I made a big decision and acted on it twelve years ago, this Memorial Day weekend.  It turned out to have been one of the best decisions I have ever made.

I decided to go to summer camp.

I was about to turn twenty-one when I started thinking about it and had just left my third college, midway through the second semester. 

I decided I needed a change; one that would take me as far from business management classes as possible.  I thought of what I enjoyed doing—working with kids, and working hard.  I looked at applications to work on a Disney Cruise line.  Seriously; how fun would that be?? 

But then I thought about what it would be like to live on a boat for however long, and what it would be like to be out there on the ocean and have something happen with my diabetes.  I knew there were doctors on cruise liners, but I also knew that a cruise ship doctor isn’t going to be a great diabetes doctor.  So I kept looking at job options for myself.

I had lived with diabetes for ten years, but things hadn’t been working for me.  I knew my doctor wasn’t happy with me, and simply kept telling me to come back every 2-3 months.   I had been on a pump for a year and a half, but I just knew my body wasn’t happy with my typical A1c.  I knew it wasn’t working. 

I knew if I didn’t make a change with my diabetes, something was going to have to give. 

I thought it would be me.

I found an application to work at a summer camp for diabetic kids.  I had attended a summer camp after being diagnosed, and it was okay.  Not stellar, but okay.  It was worth a shot.  *I* was worth it.

After going through the application and interview process, the Diabetic Youth Foundation hired me to be work as the Arts and Crafts person for the summer at Bearskin Meadow Camp.  They suggested I come up to the camp over Memorial Day for what they call Work Weekend; as many families and staff come up as possible to de-winterize the camp and get it open and ready for the summer.

Nervously, I said okay.  My sister and I drove up and were doing okay until we entered Sequoia/Kings Canyon National Park and saw the piles of snow by the side of the road.

Ut oh.

Snow?!?  At summer camp?!

What had I gotten myself into?

I’ll tell you more about it tomorrow.

It’s No Secret— And It Really Is The Truth

May 27th, 2010

(I’m probably not the brightest bulb here when I share the secret of exercise.  It would be maybe smarter for me, as a trainer, to keep it from you and make you pay to exercise with me and never share the truth.  So please, benefit from my perhaps shortsightedness.)

The funny thing to me is that this isn’t a secret at all!  It’s more like the magic a lot of people somehow miss about exercise. 

Are you ready?

You’re supposed to enjoy it.

Yes, that’s all.  Exercise is supposed to be fun!

I can tell you all kinds of reasons and explanations for why exercise is important, and why you benefit from regular vigorous exercise.  I do think you should know at least some of what exercise does for your physical self.  But that’s like telling a smoker why they should quit—seems obvious in a “no, duh!” kind of way, yet startling in its ineffectiveness.

So what to do?

Find something you enjoy doing, and make it work for you as your exercise.

But how do you find something you enjoy if you haven’t exercised in a while?

Well, start with answering some of these questions:

Do you remember what you liked to do when you were younger?  Why did you like it? You’d be surprised how many adults still enjoy a game of soccer or a bike ride; your age should only mean you are wiser, not more sedentary.  If you really enjoyed flying a kite, or creek walking, or if you were a cheerleader, there are tons of ways to make those fun “kid” activities translate into fun exercise as an adult.

Is there something you’ve always thought would be cool, but thought it was out of your league?  A lot of people think that it would be cool to climb Mt. Everest.  But what about the gym down the street with a climbing wall?  Baby steps may be baby, but they are still steps toward a goal.  Oftentimes, taking those baby steps leads you someplace new and exciting.

Do you have a dog that just adores water?  What if you take your dog for a walk and try to keep up with her as she sprints toward the duck pond?  Goofy fun that you didn’t think about when you were a kid was actually exercise then, and it can be exercise now.  You just have to go for it!

 What kinds of sports do you watch on TV or online?  Do you watch the World’s Strongest Man competition when it comes on ESPN?  Think it’s fun to watch and think about carrying a tree or pulling a fire truck?  Make a few calls to some fitness centers and see what kind of wacky group classes they offer. 

You’d be surprised what is out there for those curious enough to find a fun new way to exercise. 

Life is short.  Go have some fun!

What I Run With

May 26th, 2010

I usually run three to four days a week and run anywhere from three to twentysomething miles on any given Run Day.  Some of you may be considering running further than you’ve run before, or even are wondering how I can do the mileage.  It isn’t difficult for me; it’s therapeutic.  The runs themselves aren’t always “fun” but I never ever regret a run I’ve finished.  Ever.

I thought I’d share with you my list of what to bring on my runs.  I’ve ranked them from short to long, meaning I always take the first few things and only take all of the items if I’m running longer than 10 miles.

  1. Glucose.  Used to be Gu, but those packages are sticky to carry around.  Then I moved to Shot Blox, and then Jelly Belly Sport Beans.  I like the Sport Beans because the package is resealable like a Ziploc; but I’ve seen with my CGM that they take 15-20 minutes to enter my bloodstream.  I’ve got more experimenting to do to see what works best; I may go back to Gu if it works faster than the more solid forms of glucose.
  2. Shoes.  I can run in a lot of different shoes.  I have “running shoes” and “not my running shoes” but I’m not happy running more than 3 miles in my not my running shoes.
  3. A house or car key.  Wherever I am, I either need to get back to my car or get back home.  If I’m on a treadmill, I leave that off to the side.
  4. Socks.  Always important to consider, the longer I run.  My sock thickness determines how my shoes fit, and how my shoes fit determines how my feet survive, and if my feet aren’t happy, I’m not happy. 
  5. My Road ID.  I use the Shoe ID; I figure the EMT personnel will find it quicker than they might find my pump and know what to do.  My RoadID currently lists my name, quick important things like “Insulin Pump”, “Organ Donor”, “NKDA” as well as my current motto: Keep Going!
  6. Chapstick.  I can’t stand running without chapstick on.  I don’t know why, but I’ll go home and get it if I’ve forgotten it.
  7. A watch.  Preferably my favorite running gadget ever: my Garmin 405CX.  It’s good to know how long I’ve been out, what pace I’m running at, and how much more there is ahead.  I like to play with the numbers in my head as I run.  If I’m not using my Garmin, I’ll grab my Timex.
  8. Fluid.  May be water only, may be a mix of Gatorade and water, may be all Gatorade.  Depends on my plan for the run, the weather outside, my starting blood glucose, and how I’m feeling about the course.
  9. My heart rate monitor.  I wear it with my Garmin.  It’s not necessary in any way, but I like again to work out the numbers as I run, and I like to have the data after the run.
  10. My meter.  I used to check and run simultaneously, but I’ve lost things out of my fingers (the cap of my lancing device is now in someone’s rocky yard; it has been six months and I still look for it every time I run past) when it’s cold and I’m running so in general I slow down and walk the 10 seconds it takes me to check.
  11. My Fuel Belt. I spoke with customer service to get myself a pocket that would hold my meter.  I take this with me on every run longer than 8 miles, and sometimes on shorter ones too if I think I’ll need the supplies.
  12. More glucose.  The longer I run, the more fuel I’ll need.
  13. My phone.  I’ll map out my anticipated course on my computer and leave it on the screen when I go out, so that in case my husband needs to find me he knows where to look.  I take my phone if I have a reason to, if I want to take photos, or if I think I should have it.  It is also helpful to see a map of where I am sometimes!
  14. My iPod.  I only take this with me on really long runs that I’m dreading.  I listen to talk shows like Wait, Wait, Don’t Tell Me.  If I listen to music I forget to listen to the traffic; tuning out like that is too dangerous for me so I skip the music in order that I can skip the hospital.

I can’t believe I have FOURTEEN things I take with me on long runs.  And this is just a quick list for things I take on every run; not to mention any weather-specific gear!  No wonder it can take me 30 minutes to get out of the house some days…

Exercise Can Increase Your Quality of Life

May 25th, 2010

If an A1c of less than 7.0 is the goal for people living with diabetes, it is understandable that a higher A1c may be necessary from time to time.  One of those times is adolescence, when self-management is new and when hormones and major physical changes occur, throwing everything out of whack.  I discuss a study of teens below that I think would have identical results in adults.

A worldwide study of more than 2,200 type one teens looked at the relationships between hours spent on schoolwork, hours spent watching television, hours spent doing physical activity, and hours spent on a computer not related to schoolwork in relation to the teens’ A1c levels.  The purpose of the study was to determine differences between diabetes centers, but the relationships they found between A1c and activity are interesting and informative. 

The study concluded that, not surprisingly, a better quality of life coincided with a better metabolic control (here, measured by the A1c) for teens.  (I’d say for adults as well!)  This mirrors the DCCT results from a number of years ago that conclusively set our management path ahead in order to minimize complications from diabetes.

So how do we help teens to obtain a better quality of life when we all must always keep our diabetes in the forefront of our brains?

The study showed that the more hours the teens spent on schoolwork, the lower their A1c.  They concluded that was a direct result from the studying teen being more conscientious than other teens living with diabetes.  So, it’s a good thing for our diabetes if we are conscientious in other aspects of our lives in addition to our diabetes care.

They didn’t find any associations between the hours a teen spent watching television and A1c, but they did show that the more hours a teen spent in front of the computer for entertainment, the higher the teen’s A1c.  So, it’s a bad thing for our diabetes if we sit around all day and veg out.

But of particular note in my life and one that mirrors the goals I have for Diabetes Outside, the study observed a positive relationship between physical activity and psychological health.  While no relationship was determined between exercise and the teens’ A1c levels, the fact that the teens felt less worry, had a greater perception of their own health, a greater sense of well-being, and an overall better quality of life when they exercised is impressive.

 In the end, we are all looking for a balance in our lives between living a good and happy life and living it as long as possible with diabetes.  It would be relatively easy to succumb to the numbers game and weigh and measure our food each meal, use a calculator whenever we checked our blood glucose levels, ate healthy 100% of the time, and on and on.  But would that increase our quality of life

Maybe, but not for me.  I like to spend my time living, not counting.

Yet the simple truth is, exercise can and will increase the quality and likely the duration of all of our lives.  We were not born to sit; we were born to walk, run, crawl, and move.  If you’ve been fortunate enough to consider yourself an athlete, you know that the quality of your life with exercise is much higher than the quality of your life without it.

So let’s get going!!

If you or your family needs some help, let me know.  That’s what I’m here for.

It Really Does Take A Village

May 24th, 2010

It takes a village, or a team, or whatever you call it, to make it through your life.  Especially when you live with diabetes!  In addition to your regular team members including family and friends, you probably have at least one doctor, a certified diabetes educator, a dietitian or nutritionist, and then those I consider who are in the bullpen or on the bench: your eye doctor, podiatrist, dentist, pump trainer, etc. 

What a crew.


Most importantly, does everyone on your team play well together?

When it comes to family members and in particular parents of kids and teens with diabetes, these family relationships are crucial in management of the disease.

That’s when it gets tricky; adolescence.  Adolescence is when the parent needs to begin taking a back seat—likely it will feel like the team manager has to become a regular player and the regular player must start to transition to team manager.  If you’ve ever had a job with a boss, think about changing places with that boss and all the tricky weird emotions that would come up between the two of you.


No wonder it’s difficult!

It is essential, though, for parents to help kids transition intelligently into self management.  A 2008 study looked at these family relationships and behaviors and how they translated into A1c results and DKA events of more than 2,000 teens. 

Again I caution parents that this needs to be a TRANSITION; any overnight change may result in your kid feeling abandoned with their disease.  You need to be the one who is understanding, compassionate, and yet you are the one who needs also to lead the transition

Your kid hasn’t done the teen years before—you have. 

In a result I’m sure may be perplexing to parents, the more overly involved adolescents reported their parents to be, the higher the adolescents’ A1c and the more episodes of DKA experienced.   This makes sense if you recall your own teen years: the more your parents wanted you to do something, the less you wanted to do it!  But it is crucial to understand that a teen’s job is to figure out how to separate from their parents so they can live on their own in the world.  If diabetes is in the mix, then it will be a tool used by both to exert control over the other.  A parent wants to exert control by dictating a blood glucose check; a teen wants to exert control by skipping that same check.

Another piece of data that came out was that 22% of the teens reported that their parents acted as though the diabetes was the parents’ disease rather than the teen’s. 

To be blunt here, the parent isn’t the one experiencing the physical manifestations of the disease.  The parent isn’t the one with the bruises from a shot.  The parent isn’t the one with the sometime confusion resulting from a low, or any of a myriad of other aspects of living with diabetes.  The diabetes belongs to the diabetic.

It is the parents’ job to play on your teen’s team.  Be as valuable a player as possible, but don’t go out there and play without permission from the team manager if you’re playing to win. 

If you need some help on this strategizing and what may work with you and your family, let me know.  That’s what I’m here for!

With a good team in place, and a good strategy in place for joint management and eventual total transition, you will all win, every time.

Go Team!!

Oh Yeah That Other Part of Living with Diabetes

May 21st, 2010

I know it’s Friday and all, so I maybe shouldn’t bring this up.  But alas.  I’m going to go there. 

Health insurance.

Yup.  I went there. 

It’s an aspect of many people’s lives, and not a happy aspect at that.  And I’m a lucky one since my husband works for a global corporation.  But they are self-insured so many laws that apply to most insurance plans don’t apply to his plan.  (Some laws that mandate certain coverage don’t apply to self-insured plans; wacky loophole.)

I consider myself an educated consumer when it comes to health insurance, not only because of my unusual ability and affinity to reading the small print (handy for my career as an attorney) but because I worked for more than a decade in a medical front office doing medical billing. 

And yet things change every year.  This year, my husband and I made a bad decision when it came to our November elections for 2010.  That one is costing us several thousand dollars, and it’s only May!!  It is an added stress to living with a disease that seems entirely unnecessary.

My pump costs roughly $6,000.  My pump set of tubing, catheter, and reservoir costs I think $15 per set that I change every three days.  I’m incredibly fortunate that my strips are covered at 100% so I don’t pay anything out of pocket for those.  My insulin cost $360 the last time I filled the prescription (including my deductible; this next refill shouldn’t cost that much!).  And yet it’s an insulin that has worked well for me, so I pay for it

My mail order pharmacy sent a letter today that said they weren’t going to fill my refill request until July 16, 2010.  Um.  Well, that’s not so much an option as I’m on my last vial of insulin.  I can’t wait.  I filled it February 2nd and the box says I was due for a refill last month.

So I had to call them and ask what they want me to do.  Lucky for me, the woman took a look, spoke with her supervisor, and five minutes later advised me that there was a glitch in their system and they are sending me out my insulin.


But I don’t want to avoid the question why an insulin syringe is considered a prescription/pharmacy item but a pump tube is considered durable medical equipment.  They serve the same function and unlike some durable medical equipment like a wig or wheelchair, pump supplies are one-time short term use.  I had a different plan three years ago that considered my pump supplies a pharmacy item.

I know many many others have it much much harder than I do.  I know I’m a lucky one that I have fairly good coverage.   It’s still an added and I think unnecessary stress to have to deal not only with my blood glucose fluctuations and micro- and macro-vascular complications but the administrative side is very simply a pain.

In my experience, we don’t talk much about the administrative side of having diabetes.  I wonder why we don’t.

Potato, Pohtahto

May 20th, 2010

Again I read a study abstract about diabetes.  You’d think I had better ways to spend my time!  I do, but it’s kind of interesting what people think about and what they care to study.

Anyway, this one looked at a number of adults with both type one and type two diabetes and how they saw their disease.  I’ll explain the study more in a few days after I’ve looked up all the words I didn’t understand.  (There were a lot, and it was only the abstract!)

But it is good stuff I think is worth thinking about for each of us.  Does it matter to you, internally, what you say to yourself and to others about your diabetes?

The psychologist I went to hear speak a few weeks ago wants to ban the term “diabetic”.  At camp we made a conscious shift from “having diabetes” to “living with diabetes”.  The study focused on whether you see yourself as “diseased” or if you see your diabetes as separate from yourself and your body.

If you’ve been reading, you probably know or suspect where I’m at.  If you haven’t, here’s the rundown: I have diabetes and live with it; it doesn’t much matter to me what you say in terms of me being diabetic or me having diabetes; my body is separate from my identity so I don’t see myself as diseased.  My pancreas doesn’t work right and when I was too young to know it, my body destroyed my beta cells.  Now I have to deal with it every day.  But my disease is mine.  All mine.  Just like my pancreas.

A lady asked me once if I ever realized that I have been ill for so many years.  I still don’t know what to do with that question.  I don’t think the expression on my face was very pretty.  Because “ill”??  Well, yes, a chronic disease.  Not chronic like a cough but chronic like, well, forever and always and inescapable. 

But ill?  Hardly.

I have to take my diabetes with me and factor it into each aspect of my life, every day.  And I do.  But if I had to describe myself to someone else, the term “diabetes” wouldn’t come up. 

It just isn’t me.  Just like my body isn’t what makes me me.  What makes me me is what I do with what I’ve got.

It’s why I say what I do: you have one body in this world.  Use it well

I see my body as a tool of my existence.  Mine is a little banged up at the edges and a little bit more on the inside due to my diabetes. 

So call it what you will; say I have diabetes, say I live with diabetes, say I am diabetic, say I’m “dee-a-be-tee-co” like a lady in one of my favorite movies Dave.   Call it a disease, call it chronic, call it whatever you want.

I’ll be busy, using what I’ve got to make a positive change in the world.

Wanna come?

Is ADA’s Forecast Magazine Off the Mark?

May 19th, 2010

I don’t get the American Diabetes Association.  I mean, I get what they are trying to do with their Stop Diabetes campaign.  (Although, I wonder how possible it is to stop a disease I already have…but I get that they are trying to have us all feel empowered.  Which is great, fantastic, and wonderful.) 

I think sometimes the ADA misses the distinctions between type one and type two diabetes.  Especially when it comes to Forecast Magazine.  I don’t think anyone who works on Forecast Magazine has an idea about what life is like with type one diabetes.

Seriously.  It’s a total shame some of what appears in that magazine.  I am afraid for those new to the disease and their parents, who likely look to the ADA’s Forecast magazine for guidance and support.  I think sometimes the magazine steers them in the wrong direction.

As an example: in the April 2010 edition there is an article: A User’s Guide to Insulin.  The Q&A segments are scattered throughout the article. 

The first Q&A on the first page:

Q: Should I take insulin if I’m only having a small snack with very few carbs?

A: Probably not.  People with type 1 diabetes, and those with type 2 who use mealtime insulin to cover carbs, need to cover most food with insulin, but not if it is a snack of 15 grams of carbohydrates or less.

I don’t understand.  I’m not sure if this is my fifteen years of using an insulin pump, but this is absolute crazy talk in my world.  I take insulin for every carbohydrate that enters my body, or if I don’t take insulin for it, I’ve considered taking insulin and opted to not take insulin for a good, well-considered reason.  (Like, I’m low or I’m exercising.)

I also don’t understand why they are still talking about regular insulin.  Remember R?  There are some great newer faster insulins out there that work well either in a pump or in conjunction with long-term insulins like Lantus or Levemir; I’m not sure why R still holds a place in this national magazine.  Maybe it’s being used for those with type 2?

(I’m sure this post today is revealing all kinds of things you didn’t know I don’t know.  I would love to find out what is working for you, and if you think I’m way off base with my reaction to the Q&A.  Shoot me an email at amy[at]diabetesoutside[dot]com or respond on the Diabetes Outside Facebook page!)

Then again, the pages after the article provide instructions on How to Make A Perfect Salad and they literally say “begin with lettuce”.  Maybe I’m asking the ADA for too much with their monthly magazine.

But I don’t think so.  I’m still concerned for those newly diagnosed people who don’t yet know what information to use and what information to discard.

If something doesn’t strike you right, ask questions.  Be an active participant in every aspect of your life with diabetes.  YOU DESERVE GOOD INFORMATION THAT WILL HELP YOU IN YOUR LIFE.

Pumptastic Living

May 18th, 2010

I apologize in advance to anyone who may find themselves humming later…

Life is weird.  Yesterday, I had a significant pump issue.  Today, I’m a big fan yet again.  I guess that’s why the song goes “you take the good, you take the bad, you take them both…”

Yesterday, I had a site less than 12 hours old and suddenly found myself at 385.  What?!  Not 30 minutes before that my CGM had told me I crossed the 200mg/dl threshold. 

So I took a shot and changed sites.  My catheter looked like a “7” instead of an ”I”.  No wonder I was so high; I hadn’t been getting the insulin I expected! 

My doctor recently told me that she saw that I go low about 8-12 hours after an event like this; apparently sometimes the insulin I take via my pump to correct for a high glucose gets “stuck” in my scar tissue and takes hours to work out into my body.  So yesterday I tried to avoid that low and was rather conservative on my boluses.  I ended up taking two shots and miniscule boluses all day.  I was a little higher than I like to be, but I did avoid the low.  At least I think I did, and it’s already been more than 24 hours.

But I was pretty exhausted.  It’s really rather frightening to have to face the physical side of diabetes in a thankfully unusual way like that.  385 and no insulin isn’t fun for anyone!

Diabetes is unlike a lot of other diseases, though; I would have appeared perfectly normal to anything but the most detailed observer. 

So yesterday I can’t say I was a fan of my pump.  Or rather, my pump catheter that kinked when I think I sat down and must have leaned forward, bending the catheter in my lower stomach and preventing any insulin delivery.

And then today I got a surprise gift from a bootcamper.  He attended the 6am class and returned during my 7am class with the gift because he knew I had a very small 7am class and may not have been looking forward to the 7am hour.  (Incidentally, it wasn’t true but that isn’t the point.)

It is a scene I’m sure many of us have faced; someone who doesn’t live with diabetes gives us some sort of food that we know “costs” a lot of insulin and yet the gift giver has no idea how we have to see food and only wanted to be kind and give us a little something.

So today my gift was a surprise mocha from Starbucks.  It was very nice of my bootcamper; he had gone to Starbucks after his class and returned to the park holding this mocha for me in his outstretched arm. 

I generally have a rule that I don’t eat or drink during a bootcamp class unless I need to.  I think I’ve blown that rule maybe 4 times over the past four and a half years.  Today was one of the times I blew it.  A warm mocha on a rainy morning in a park?  I can do that! 

Thank goodness I was wearing my pump.  I could bolus for the high carb mocha and enjoy it, without too much trauma.  Yes, I’ll spend the rest of the morning juggling my insulin and food as a result of the 30+ superfast carbs I hadn’t planned for, but I can do that.  No, it wasn’t in my plan for today’s eating.  But it was a nice gesture from a nice man who appreciates what I do in his life. 

AND THERE YOU HAVE THE FACTS OF (pump) LIFE… the facts of life!!

(Sorry; I couldn’t just leave it hanging like that!)