Archive for June, 2010

You Know What They Say About “Assuming”

June 30th, 2010

We are all experts at a lot of different things.  I sometimes forget that, especially when it comes to food.  I think we all know about carbohydrates.

My sister sent me an email last week; she was having dinner guests and one of the guests has type 2 diabetes.  I’m not clear if the guest asked for anything in particular, but my sister wanted me to look at the menu because she was worried the menu was “too starchy”.

So here it is:

-Potato and rosemary flat bread (made with gluten-free pizza dough–I KNOW that’s starchy!)

-Herbed carrot soup (has one potato in it for 6-8 servings; no cream, just veggies–but are carrots starchy too?)

-strawberry and lentil salad (the lentils and goat cheese and pecans are the protein, but are lentils also starchy??) 

My sister knows what foods have gluten and what foods have dairy; she has determined that for her, she does better when she avoids both food groups.  It was kind of funny to see that she was having a hard time coming up with a menu.  I assumed she was well-versed in all food counts (carbohydrates, proteins, fats).  I guess not!

I do the same thing with the rest of my diabetes.  I assume others struggle with blood sugar levels and highs and lows all day, every day.  I assume I’m like everyone else, a lot of the time.

It only takes this emailed question from my sister to remind me what happens when I assume. 

I guess I assume everyone knows what I know about living with diabetes because it just makes my life easier and makes me feel less alone when I struggle.  I took the evening off of a work function yesterday because I have had several extreme lows overnight during the last week and haven’t slept well as a result.  I appreciate that I feel comfortable saying that to my coworkers, but at the same time, I’m not sure I like taking the time off for a diabetes-related reason.  Then again, I haven’t been sick all year with a cold or sore throat, so I guess it evens out in the end.

Still, I should remind myself that living with diabetes and functioning for my pancreas does take time, energy, and knowledge of a lot of different things that most people don’t know about and don’t have to know about.  I should remind myself that I deserve a pat on the back and sometimes an extra hour of rest when I need it.  I should be okay with asking for what I need, and not assume others know what I face. 

Because you know what happens when you “ass-u-me”!

 (For the record, I suggested my sister add a rotisserie chicken or roasted asparagus to round out the meal.  I’m not sure what she ended up serving; I just know that usually when friends have dinner together, they aren’t getting together for the food.  I’m sure it was a lovely evening all around.)

Just Around The Corner

June 29th, 2010

The founder of Dogs 4 Diabetics, Mark Ruefenacht,  gave a little welcoming speech at the graduation on Saturday.  He said that when he first started D4D he’d tell people what he was doing and would sometimes get the question “what are you doing that for; the cure for type one diabetes is right around the corner”. 

You know, every single person over the age of 15 in that room let out a groan. 

We laughed, but I don’t think it was funny.  I think it was sad.  We had all been duped after being diagnosed into believing we just had to hang on a little while longer with this disease and wait until we got closer to that corner and found the cure.

Just a little while longer.


We all have to hear from our friends and loved ones that they’ve read or seen that some good research is being done on mice, or stem cells, or what have you.  We all endure the headlines saying you can cure diabetes by eating blueberries instead of ice cream.  We all have to do all of this with a smile on our face and a syringe in our hand.  It’s what we do.

Mark said he responded to those who questioned why that he had lived with diabetes for forty some years, and that cure had been just around the corner for forty some years He wasn’t waiting.  He was being proactive and doing something to improve the lives of diabetics NOW.  (and wow has he succeeded)

I’m not waiting either.

So you know what?  I’m making that my cure for diabetes.

I’m going to say I have cured my diabetes; it feels like I have.  I’m not fighting why I have it, I’m not fighting when can I get rid of it; I’m just going to say okay, this is what I deal with. 

I’m going to say, you know, I understand my feelings of bitterness about my earlier misplaced hope and misdirected energy towards that old cure, right around the corner.  But none of those feelings ever actually HELPED me live with my disease.  So I’m acknowledging them, and moving forward.

I’ve said this before: if you think you just have to hold off dealing with your disease for a couple years and you’ll no longer have diabetes, no kid or adult is going to deal with their disease.  Type 1 diabetes doesn’t get better.  It only gets easier to live with after you can realistically fit it into your life, learn to live with it and really move toward a life you love.

So what if that right there is the cure?  Maybe then we can act to improve our lives with or without our disease. 

Let’s go!!

A Special Accommodation I Could Love

June 28th, 2010

 I got to participate in an amazing thing this weekend; I was invited to attend a graduation. 

Not just any graduation. 

Half of the graduates had worked their entire lives to get to be able to work for the rest of their lives, and it required a more skill and training than most jobs any of us hold.  The other half of the graduates had worked alone for as long as they could remember and had spent a lot of time feeling afraid or at least apprehensive of what went on inside their own bodies.  Those graduates, too, had to put in a lot of hard work and learn a lot to be able to work for the rest of their lives with their partner. 

I think all of the graduates loved nearly every minute of it.

Dogs for Diabetics.

When my friend and I arrived at the ceremony, I was 104.  I had had a juice box in the car on my way there because I felt I might go low and didn’t want to be low in this room with all kinds of dogs trained to sense and alert when I was low. 

So I’m sitting there, and the guy across the aisle from me is talking to his dog and trying to get his dog to sit still.  It was kind of funny because I think the dog was alerting my low; I felt somewhat embarrassed and thought I should have said something to the man. 

I wasn’t low, though, according to my meter.  I was just headed there.

My CGM has been a help to me—I can’t say otherwise.  It generally has been accurate on what my blood glucose was twenty minutes ago.  These dogs on Saturday are twenty minutes ahead of me.  They know what’s going on before any gadget I carry with me.

How amazing.

If you are a pumper and have ever been in a space with other pumpers, you know how you react when you hear someone else’s pump beeping or alarming.  I often forget and have a few incidents of surprise false alarms before I remember what it is like when we’re all doing our own thing. 

Afterwards, it makes me feel kind of alone, that having been with so many others like me was such a surprise.  It’s a little sad when I realize how infrequently I get to experience that similarity in my life.

After the ceremony I was chatting with a few people and three dogs near us were alerting a low to their companion.  Everyone started looking around and asking who it was; the dogs can sense someone’s low within 50 feet!  The man who was low was happy to announce it was him, and all the dogs got a treat.

The dog in front of me during the ceremony alerted her companion, a girl maybe 13 or 14 years old.  When the girl saw her dog alert her, she immediately checked her blood glucose, gave her dog a treat, and ate some sugar.  I guess that’s what she does now; she catches her lows before she goes low because her dog is there to help her catch them.

How cool is that?!

Big Effort, Big Results

June 25th, 2010

When it comes to fitness, I’m always about working hard at something.  Even when you are resting, you are working hard to rebuild your strength.  I want you to be right there and involved in the effort you’re putting in so that you can not only achieve great results, but you can see how your work got you the results you want.  It will help you respect your body and respect your own discipline—two key factors that should go into any and every workout plan.

So, when you’re working out, I want you to be working out for a reason and I want your workouts to be as effective as possible.

When it comes to running or walking, you can get faster or go up a hill to continue to increase your challenge.  But somehow that same principle gets skewed when it comes to weights.  People continue to grab the 5lb free weights after years and years of doing the same activity.  It shouldn’t come as a surprise, then, when you wonder why you aren’t getting anywhere with your workouts—you have stopped challenging your muscles in order to get them to respond.

I’ve said it before and I’ll say it again: GO HEAVIER! 

I include two brief explanations from Cathe Friedrich, a trainer whose videos I have exercised with for years and have gotten great results.

Why do I need to lift heavy weights?

When we weight lift our goal is to apply a load to a muscle that is beyond normal causing as many “muscle motor units” as possible to be activated causing their associated muscle fibers to contract.  A muscle motor is either turned 100% on or it is 100% off.  Through time and practice from birth your brain learns how many muscle motor units it needs to turn on to lift a small glass of water or something much heavier like a 100lb weight bar. In the case of the small glass of water your brain will only turn on a few muscle motor units, otherwise you would throw the glass of water through the ceiling. With the 100 lb weight bar many more motor units must be turned on in order to lift the bar. Since a muscle motor is either turned on or it stays at rest the weight you lift determines how many muscle fibers are worked. If you only workout with light weights you will only stimulate and work a small percentage of your muscle fibers and thus most of the muscle fibers in your muscle will not experience the wonderful benefits of weightlifting and your results will suffer.

Will [lifting heavy weights] bulk me up?

Perhaps the oldest myth in weightlifting is that lifting heavy weights will cause females to bulk. Women just don’t naturally have enough testosterone in their bodies to develop huge massive muscles. I can tell you from my our personal experience and from observing nearly a 1000 people each day using our health club in NJ  for the last 20 years that heavy lifting  only improves a women’s physique. Building muscle takes a huge amount of effort with no room to do much else than focus on lifting hard and heavy and eating constantly to support muscle growth. It is just not that easy to build bulk even for a male….or for those who are predisposed to this genetically.
[Lifting heavy] will enhance muscle definition, increase lean muscle density, reduce overall body fat, increase your metabolism, and improve your overall energy, health, and vitality. If you’re a female and want to look your best –YOU NEED TO LIFT HEAVY WEIGHTS!

Potato, Pohtahto, Part Two

June 24th, 2010

Last month I told you about a study abstract I read that distinguished the psychological health of individuals living with diabetes (both types) based in part on whether they said “I have diabetes” or whether they said “I am diabetic.”

I had to get the study article in its entirety and read it a few times to understand what they actually were doing.  (The study was performed in Portugal and I think just terribly translated.)

They had a total of four combinations for every participant to choose between:

  1. I have diabetes and have lost something due to my diabetes.
  2. I am diabetic and have lost something due to my diabetes.
  3. I have diabetes and have gained something from my diabetes.
  4. I am diabetic and have gained something from my diabetes.

During the study, of course, they used a number of different questions to get the participants into these four groups, and I’m simplifying a lot for the sake of your interest level and the amount of time you want to spend reading my blog.  (Which I must say, I appreciate every day.)

The results were evenly split between those “having diabetes” and “being diabetic.”  But the major differences were seen in the second component, regarding how the diagnosis changed each person’s life.  What it boiled down to was that only 15.7% of the participants said they gained something.  That means 84.3% said they had lost something due to their diabetes. 

What a horrible thing to see the disease that you need to carry with you everywhere at all times as something that caused such a loss in your life.

The examples they gave for “gains” included better dietary habits, more self-responsibility and more self-concern.  The “losses” included diet restrictions, fear of complications and difficulties with daily self-management. 

Now, these questions were worked into a different questionnaire related to depression and anxiety, so maybe those with more traditionally negative outlooks had self-selected into the group to begin with, but I think the conclusions of this study highlight an area that needs immediate attention.

I also should point out that I would hate this study questionnaire.  I hate yes/no questions like this.  I want to take time and explain what I mean!  There are clearly losses, both emotional and physical, with a diabetes diagnosis.  What makes me sad here is to see how few people saw any gains in their lives after being diagnosed that were associated with their diabetes.

The study suggested that the optimal choice was to have diabetes (thereby signaling that the participant objectified the disease as something separate from the participant) and associate gains from the disease. 

I agree.

So how do we get to that point, that we can see more positive aspects as a result of our diagnosis? 

I think it takes work.  Sometimes hard work and sometimes easy work. 

I think it takes a focused and unfailing team of support in your life to remind us all that we are bigger than our disease.  I think it takes a while to recognize that, and it only happens if we recognize that effort as a choice.  We could easily succumb to feeling miserable and different and scared and alone with our disease.  We could fight it every day by not taking our insulin or not checking our blood.  Those are choices we have every day and each day we choose to put our physical needs in front yet continue to move forward in our lives and pursue our goals, I think we win.

I think we need to recognize that we make choices when we have diabetes, and each day we elect to take care of ourselves, we really do give ourselves a gift.  If we stopped taking insulin or stopped checking our blood or taking our meds, THAT would be a loss to me.  We would be in denial of what our bodies need to survive, and how can that denial promote any kind of true positive change?

Look at all you’ve learned since you were diagnosed.  Look at how you’ve grown accustomed to taking care of yourself and your needs.  See how you’ve overcome fears of needles or the sight of blood or what have you.  Look at how skilled you are at knowing the carbohydrates in whatever food is in front of you, and estimating if you don’t know.  You’ve learned what it feels like to be low, and high, and how to go to school or to work and function for your pancreas AND function in the world

You’ve done a great job already.  Yes, there is more to come and yes it takes hard work every day and yes you’ll keep at it. 

If that knowledge isn’t a gain, I don’t know what is.

86 degrees

June 23rd, 2010

“I really don’t believe in fear. I believe in putting in the work.” -Deena Kastor (distance runner and olympic medalist)

I’ll apologize in advance for this rant but I think it’s important to be aware of how our disease is portrayed in the media, how our friends see our disease and how we ourselves see it. 

The ADA sent out their news last week and what showed up on my RSS was the headline:

Many Patients With Diabetes Not Aware of Dangers of Hot Weather.  To this headline, I have two things to say.

  1. Just because I have diabetes doesn’t mean that everywhere I go am I a “patient”.
  2. What specifically is “dangerous” for me as a diabetic?

The thing that really gets me is that DIABETES is right there with DANGER.  This is more of a media gripe than anything, but really?!  Just say my insulin won’t work if it is cooked, and tell me it cooks at any temperature over 86 degrees Fahrenheit. 

You know, what’s written on every box of insulin and every strip vial.

I don’t see how scaring everyone through the use of the word “DANGER” is useful. 

So off I go to the linked article.  It’s a quick one so I’ll include it here.

One in five diabetes patients would not take precautions for hot weather until the temperature exceeded 100 degrees‚ according to a new survey from the Mayo Clinic in Arizona.

Researchers administered questionnaires to 169 patients with diabetes‚ gauging types of personal protective measures against the heat‚ knowledge of safe temperatures, and sources of weather information. The findings showed that some respondents employed a number of heat–related measures‚ including carrying diabetes equipment and medications in a cooler or limiting heat exposure to one hour. However‚ only 39 percent of respondents knew about the adverse effects of heat on oral diabetes medications‚ while 45 percent said they used sunscreen and 36 percent said they left their diabetes medications or supplies at home when they went out in hot weather.

Endocrine Today (06/19/10)

I’m willing to bet that the American Asthmatic Association or the American Polka Dot Association or the American Green Eggs and Ham Association would come up with remarkably similar numbers for these “personal protective measures” against the heat.  Forty-five percent wearing sunscreen is kind of a lot, until I remember this was an Arizona study, and Arizona is a desert so maybe they’re better trained than the average citizen. 

All I know is, whether I wear sunscreen or not has so incredibly little to do with my having diabetes it to me seems rather odd to be linked like this in a research study.

I leave my diabetes medications or supplies at home most of the time I go out.  Not my pump, of course, but my insulin is in the fridge when I’m not replacing my reservoir.  I have no idea about any oral diabetes medications, either, but that seems appropriate as well since I have type one and don’t take oral diabetes medications.

I take my meter and strips with me in my purse and just don’t leave it in the car.  If I was to forget and the strips ended up exposed to the heat, I’d have to throw out the remaining strips.

These don’t seem to me to qualify as a scary word “DANGER” type of scenario that would justify the additional miscommunications to the public at large about my disease.  Does it to you??

Seven little letters

June 22nd, 2010

It hit me again last night when I was working out. 

It’s pretty amazing that I’m still alive.

It’s something that I realized a long time ago and kind of carry with me all the time, but sometimes something happens and I look it straight in the face.  If I had been born before insulin was discovered/invented/derived/produced/manufactured, I wouldn’t be here.

I see it in my diagnosis picture.  I see how close I was.  I know how that felt, and my heart breaks for everyone who came before me who knows how that feels and who didn’t have the fortune I have had.

Me, now a type one diabetic.

Stopped at home after my doctor diagnosed me. On my way to the hospital for my four day stay.

I think about the researchers who spent their professional lives making insulin something we could all benefit from.  I know they didn’t know about me.  I wonder who they did know, and who they were working to save, and who they were unable to save.  I wonder if they ever thought about how those of us today would feel about them.

I see how small the vials of insulin are, and how miniscule a unit seems when it’s in a syringe or priming out of my pump catheter.

It doesn’t feel that small to me.

I looked down yesterday at my legs as I was doing a squat.  I saw my leg muscles and I saw my little pock marks that scar tissue caused after ten years of injections in the same two square inches in my thigh. 

But I also saw legs that have supported me as I crossed countless finish lines, and carried me up thousands of hills, and have grown physically and mentally stronger with every experience.

I thought about the people who don’t need to know insulin exists.  I thought about how many of them don’t realize they are incredibly fortunate to have a body that functions naturally and how very few of them take the time to treat their bodies the way they were intended to function: by moving.

So many of us are doing such amazing things with our lives with diabetes.  I think it’s important to recognize how special it is that not only have we been given the opportunity to continue to live because of the hard work of so many to discover and deliver insulin, but to also recognize that we are special individuals: we have been given a chance to really live our lives

So while I don’t enjoy the stretch marks I have from the weight I re-gained so quickly after I was diagnosed and started on insulin, and I don’t enjoy the scar tissue or the ratty fingertips, I see them for what they are: signs of hard work and innumerable rewards

It’s weird to say to people who are no longer with us, but I need to say it anyway: thank you for working hard to find a way to keep me alive on insulin.

I have one body and it’s been through a lot.  But through that, I have thrived and my body has thrived. 

Let’s keep going.

Lemme See That!!

June 21st, 2010

There is a funky power play in a doctor’s office, if you ask me.  The visit is about YOU and you are paying your doctor, yet there is always an element of fear for me.  Maybe a fear of being judged or a fear of being found out (how many times just yesterday was I above 200?) and we won’t even START with the required weigh-in each time I’m there.  So even though I’m the ever-important subject of the visit, and everyone else would be worthless without my presence, they still hold all the cards.

So really, it’s just odd and for me, rather unpleasant.

And then there’s the privacy element that turns our sense of normalcy on its head.  Get there, sit and wait.  Someone you’ve never seen before opens a door, mispronounces your name and you holler out and hop up “That’s me!” and then you follow that person back into a winding maze of hallways until you reach the weigh-in station or until you’re shut inside a new room.

If it’s an endocrinology office, you get to sit and stare at a poster of the endocrine system, or a poster of an endocrine related disorder.  (My favorite poster from a few doctors’ back had this one of hyperthyroidism; that poor person had the saddest expression and the biggest eyes!  But I digress.)

So you are left alone in a room.  For whoever knows how long.  And that room has all kinds of cupboards and drawers and papers.  (I’m a big—huge—believer in opening those drawers after a certain amount of time.  I can restrain myself for a good 45 minutes, but beyond that, I think they are fair game.)

But what is never EVER in that room?  Your medical chart.

That is what to me is the most interesting part—what someone has said about ME.  Never have I claimed to have a small ego, and the entire point of the visit is for ME to share things about ME with someone else, who in turns writes down either what I’ve said, or what their interpretation is of what I’ve reported.

Yet they never let me see what they’ve written. 

Working for doctors for twelve years and working with medical charts for just as long, I know for a fact that very very few of them are at all interesting.  Yet that knowledge doesn’t really help.  I want to see it!!

Yet I’m not willing to request a copy; I know it isn’t that interesting. 

But I still wonder.

Who Were You and What Was Your World Before You Were Diagnosed?

June 18th, 2010

I have been thinking about what age we all were when we were diagnosed and how that age affected how we deal with our disease.

I think there is a huge difference between the types of diabetes, and one of the reasons I think they are so different involves how old we were when we were diagnosed.  I know many type 2s and type 1.5s see type 1 as just a different variation on their same disease yet I know very few type 1s who think their disease is the same as type 2 or type 1.5. 

I can’t figure it all out, but I think one of the reasons we see the diseases differently involves who we were when we were diagnosed.

I’m not talking about whether we call type one juvenile onset and type two adult onset: I’m talking about how much of the world we knew before our diagnosis.

I guess it’s the same type of idea as a parental divorce: it can be devastating to a child at any age, but sometimes a younger child doesn’t always have quite the division of “before” and “after” as a teen or even adult child does.

Many of those diagnosed with type 1 in teenhood or adulthood marvel at the work that goes into diabetes.  For me, being diagnosed at 10, the work load didn’t make a huge impression on me—I was still learning about the world outside of my grade school; I simply had no comprehension of what “insulin dependent diabetes” was going to mean to me.  The amount of work that diabetes actually takes has been secondary for me—it’s just a part of my life at this stage, and I tend not to see it as something no one else has to deal with.

I know several who were diagnosed later in high school and even college who were able to see the diagnosis as a huge thing that divided them from their friends—and who have struggled with accepting their disease as a result.  Denial was certainly something I carried around with me for years and years, but I didn’t have the thought that “everything was fine before my diagnosis”

I think people who are diagnosed later in their lives (in their 30s and beyond) just have a whole different set of expectations of themselves, a whole pile of misunderstandings of the disease, and a whole different set of fears accompanying the knowledge that Everything Is Different Now.

Again, this is just one of the things I’m thinking about these days.  Let me know if you have an opinion on this one, or if you had a different experience when you were diagnosed.

Workout Partners

June 17th, 2010

A great workout partner can be really tough to find.  You want someone who you enjoy spending time with, who can work out on the same schedule as you, who is in roughly the same fitness level, someone who has roughly the same goals for their exercise as you have for your exercise, and someone who is special enough that you don’t care what they think of you as you huff and puff by their side.  For me, I also require a workout partner to be someone who understands that sometimes I need to stop for a bit and eat some glucose.

Like I said, it’s a tall order and a tough combination to find.

I’ve had two really great workout partners, yet they could not be more different from each other in the way they exercise and they ways they have helped me exercise.

In high school, one of my best friends and I decided we should join the gym.  We joined the Y, went through the orientation on the weight machines, and went together a few times a week. 

We’d be on the treadmills next to each other and catch up on school that day, or whatever came to mind.  She would look over at me huffing and puffing, shake her head and say “why do you think running is important?!” and I’d look over at her walking along and clutching the display for dear life to stay on her treadmill (that she had set at the maximum incline) and shake my head and say “why did you set the incline so high you can’t stay on without holding on?!”

But we’d go together or meet there and know there was a friend at the gym who was on our side.  All the time.  If one of us got sick, the other one would still go, but it wasn’t the same.  Our workouts couldn’t have been more different, but we were still workout partners.

Belonging to the Y with her made me less self conscious when I went and helped me go more often.  I tried out a class or two, knowing she was there and would be supporting me even if she wasn’t in the class.  Sometimes the support involved laughing at what she saw the instructor had us do, but it was still support. 

It’s important to have support in all areas of your life, and exercise is no exception.

The other workout partner is someone I run with.  She’s naturally a much faster runner than me—she’s one of those people who looks like she glides when she runs.  I think it’s amazing to watch.  I often can’t believe she’s willing to run with me, but I see that she gets something from running with me, too.  I think she depends on me for my dependability—I’m always happy to discuss skipping a run, but I rarely actually skip it.  She knows I’ll be there even if she doesn’t make it that day.  I think sometimes that knowledge gets her out there with me.

I also don’t badger or think differently of her at all whether she is there or not—she’s my friend and my workout partner.  No judgments, no criticisms, just sweat and appreciation of what we each bring to the workout.

We ran together today and apparently had an unspoken pact that thankfully we only disclosed to each other after we were done:  neither of us wanted to disappoint the other.  (It is a trait we share– the thought of her disappointing me is frankly impossible yet she’s still concerned that she might just disappoint me somehow.)  When we got to a hill that we would have each walked were we running alone, we each thought the other one wanted to run it, so we both ran up that hill and kept going. 

I had sent her the route I planned last night, and today she made me stick to it when there were several times during the run I offered new plans that would cut the run short.  It was great today, but I know that if either one of us needed to walk for a bit, the other one would probably have walked too—or not—and it wouldn’t have changed a thing.

A workout partner can offer you a lot of support and understanding and simultaneously push you farther than you’d push yourself.  They are very hard to find, but keep an eye out—someone might just be looking for you, too!