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February 29, 2008

The Leap Year Six.

The Friday Six:  February 29, 2008 editionHappy Leap Year ... day!  (Sounds like kind of a crap holiday.)  Here are The Leap Year Six.

1.  Since I last Friday Six'd, I was trying desperately to minimize stress levels.  Over the last two weeks, I've been working less at night, freaking out less at work, and peppering my days with less insanity.  The results?  I'm breathing easier.  Just acknowledging the stress made me deal with it better.  And posting about it helped, too, because disclosing my desire to chill out held me accountable.  I exposed myself to the internet (have fun with that one, Mr. Google) and I was obligated to follow-through.  Sooooo, after that long-winded explanation, I'm feeling pretty chill, thank you very much.

2.  To that effect, Generation D has been updated for February.  And thank goodness for the extra day this month, or my article on diabetes and stress would have been wicked early for March.  :)  I hope you enjoy it!

3.  Here's something that made me laugh my ass off:  my favorite dLife marketing maven sent me a link this morning to Garfield Minus Garfield, which is hosted off a Tumblr blog (which an interesting blogging platform.  Very minimalist.).  The gist of the site is as follows:  "Who would have guessed that when you remove Garfield from the Garfield comic strips, the result is an even better comic about schizophrenia, bipolor disorder, and the empty desperation of modern life? Friends, meet Jon Arbuckle. Let’s laugh and learn with him on a journey deep into the tortured mind of an isolated young everyman as he fights a losing battle against lonliness in a quiet American suburb." 

And oh, how I've laughed and learned.  This one is the office favorite: 

Image credit to Garfield Minus Garfield

4.  We're this close to finalizing our wedding invitations, thanks to the amazing design talents of our friend Matt.  The guest list is just about finalized, too.  I had another dress fitting last weekend and the pump pocket is looking good - just a few more tweaks.  For you MarriedBloggers, any ideas for bridal party gifts?  I don't want to disclose what I've been thinking about doing (because my bridesmaids all read the blog) but I'd like to hear what you  did.  I cannot wait to take pictures of all this stuff and share it with you guys - the wedding is barely two months away - I am so excited!

5.  Oh, and then there's Molly the diabetic spot-nosed monkey.  Of course.  She has a book (of course) and a set of inspirational posters (of course).   This poster, of Molly enjoying lunchtime snacky bits with a duck and an armadillo (of course) is my favorite. 

And 6.  I'm looking forward to bringing in the month of March in RI, hanging with Batman and maybe visiting the butterfly conservatory in MA.  It sounds like a very cool place to take some interesting pictures with the Nikon. 

Have a stellar weekend, FR's, and I'll see you on Monday!  :D 

February 28, 2008

Diabetes in the News.

Newspaper IconThe internet is a-buzz with piles of diabetes-related newsbits, ranging from the good, the hopeful, and the downright distressing. Here's a recap:

The Good:  Our very own Landileigh was quoted in a Wall Street Journal article today about Google's online health records.  Congratulations, Landileigh!!

And also, TuDiabetes has surpassed 2,000 members.  Congratulations to Manny and the whole TuDiabetes family!

The Hopeful:  The BBC has reported that mice with type 1 diabetes started producing their own insulin after taking a cocktail of different drugs.  It's great to hear that those mice keep getting cured, and I'm cautiously hopeful that the clinical trials will prove to be inspiring as well. 

The Downright Distressing:  As reported by the New York Times this morning (and a big hat tip to Scott, who alerted me), the JDRF International in NYC is under investigation "after an internal audit showed that hundreds of thousands of dollars was missing."  While a few bad apples don't represent the entire organization, it's disconcerting to see the JDRF in this position.  After over two decades with type 1 diabetes, I am deeply saddened to see this organization stumble.

But, never one to leave things on a negative note, I did come across this YouTube clip of The Type 1 Mom Song, which I found to be both very well done and it made me giggle.  (Hat tip to Heidi.) After the range of news I've read in the last hour or two, I needed a good laugh

February 27, 2008

No Birds?

We get so much stuff in the mail here at work - ranging from tasty Edible Arrangements to hand-written dissertations about diabetes to piles and piles of diabetes-related media publications.  (Sometimes there are sussies, which are the very best bits of mail.)

We've also received Omaha Steaks, which I had never heard of before my last job. "No gifts" policy?  Pffft.  Food has no boundaries, it seems.  And along with these steaks, there was a package of conversation starters (this one was Set 3) with little chatty prompts written on it.  Relatively general stuff, like "Where is the most beautiful place you have every been?" (My answer:  St. John) and "If you were in total solitude for one year, how you would spend your time?"  (My answer:  alone)

But among these somewhat generic questions was one I didn't see coming.  One that gave me a pause and then made me burst out laughing.  This treasure of a query was buried last in the bunch:

"What would be different about the world if there were no birds?"

Oh, I couldn't stop giggling for some reason.  No birds?  The silliest answers kept leaping to mind.  My car would have no bird crap on it.  Carrier voles would replace carrier pigeons.  Sesame Street would have been graced with a big, yellow aardvark.  Hitchcock would have been taunted by sea lions?  This question made my imagination run rampant, and sent me into a fit of giggles every time I pictured a bunch of bears sitting on telephone wires, teetering awkwardly and growling at passerbys.

No bears were harmed in the making of this photo.

So to you, my dear Faithful Readers, I pose this question.  What would be different about the world if there were no birds?

February 26, 2008

Countdown to Wedding.

Over the past two months, I've been slacking - big time.  I've been indulging in desserts on the weekends.  I've been going away with Chris and enjoying decadent dinners at French restaurants and sipping cappuccinos every chance I had.  Work has been extremely busy and I've been putting in plenty of hours.  Freelance projects have included some late nights to meet deadlines and some trips into the city for different events, so I've only been able to get four workouts in per week. 

And I've seen a bit of a flux in my body - nothing noticeable on a scale but I don't feel as strong as I did a few weeks ago and I feel a little sloppier.

No more of this namby-pamby crap "I'll do my best and see what happens."  Change needs to be made and I just need to plain make it.

So, with the guidance of my fitness-freak fiance and armed with enough information to safely manage any diabetes disaster, I'm starting a whole new regimen.  I will roll with this until my wedding date, after which time I will be on my honeymoon, happily married, and not plagued by the white dress stress.

My plan is to take a standard approach to every day, eating almost exactly the same thing daily and following as much of a schedule as possible.  I know that when I eat similar items, I see similar blood sugar responses.  I'm hoping that a more finely-tuned diet will eliminate blood sugar fluctations and help me keep better tabs on what I'm eating.  (Because those almond Hershey kisses on my co-worker's desk are delicious and I keep snaking them throughout the day.  No more of that for the next two and a half months.)

I'm going to try to follow this meal plan at least Monday - Friday:

8:30 am:  Oatmeal and walnuts, with my morning cup of tea.

10:00 am:   Yogurt.

Lunch:  Salad of baby spinach with baked chicken, cherry tomatoes, and portabella mushrooms with balsamic vinagrette dressing.

2:30 pm:  Apple and peanut butter.

5:00 pm:  Breakstone cottage cheese double.  (These things are delicious.)   

Dinner:  Eggs, or soup, or chicken and that zippy white bean salad, or something else healthy along those lines.

Bedtime snack:   Light, low-carb snack, like nuts or a cheese stickPhoto credit:  www.rewardlicious.com

As far as the workout goes, I'm changing things a little, but not completely.  Generally, I'm at the gym Monday - Friday and doing 15 minutes of weight training, then a 30 minute cardiovascular workout.  I'm doing a variety of weight exercises (like tricep dips, push-ups, box jumps, jumping rope, lunges, I'm exhausted just writing this stuff, ab exercises, etc.) and doing 2 minutes walking - 10 minutes running as my cardio workout

Re-reading this, it sounds so regimented.  BORING.  But I've worked very hard over the last few years to change my body and I'm so hopeful that this new routine brings me to a new level of fitness and diabetes health overall, making me ready for my walk down the aisle. 

Because I tried on my wedding gown again this weekend and it fits like a glove.  A glove without much room for weight gain. 

No more nervous nibbling - it's time to buckle down and make this work. Let the sweating begin!

February 25, 2008

The Blogs That Bond.

Six Until Me has existed for almost three years now and over the last three years, I've had the opportunity to meet some of the best people.  And on Saturday afternoon, I had the chance to hang with some of my favorite bloggers and take in a play at Trinity Repertory Company in Providence, RI.  Shannon, Julia, Nicole, and I watched a terrific play, took in some tasty sweet potato fries (okay, I had the fries), and chatted about all kinds of stuff.

The play we saw was Some Things Are Private,  which was a docudrama about "a provocative look at who determines 'what is art?'"  It centered on the work of Sally Mann, a photographer whose collection Immediate Family drew criticism from many circles, claiming the nude images of her children were not innocent or "slice of life" but instead pornographic. 

"What is private?" was a line that was offered up several times throughout the play, pointed at Sally and her decision to go public with her family's private lives.  What is private?  It made me think about the four of us and our decisions to blog, women sitting together who have decided to make their private lives public.  Whether we are writing about our children, our lovers, our disease, or what makes us laugh, we as bloggers are putting our private lives on display for the public to consume.  Some times, this is a terrifying feeling, knowing that your life is chumming the waters for people you will never know.  And sometimes, it is the most therapeutic feeling in the world, letting your thoughts float out freely and being bold enough to do it day after day, inviting strangers into a life they wouldn't otherwise even glimpse.

What is private?  Is it my moment with low blood sugar in the wee hours of the morning?  Is it an argument with my loved ones?  Is it being ushered into the flowing folds of my wedding gown as my maid of honor honor watches?  Is it dinner out with my old college roommates and laughing at our chaotic pasts?  Is it that moment of fear, that moment of laughter, that moment of insecurity, that moment of complete and unabashed bravery?

Blogging is a very unique undertaking, sharing our lives with strangers.  In rare turns, these strangers become our friends and part of our lives outside of the blog, letting us sit together for an afternoon of remarkable theater and easy conversations. 

Our photographer was the host at the pub. Sorry he was off-centered!
 

February 22, 2008

Prospectin'.

Two minature grizzled old prospectors sit on the corner of my desk at work, chewing tobacco and watching me work. 

"Blizzard's a-ragin' outside." 

"Yep, reckon 'tis."  

Leans towards spittoon - clang.

"Pilin' on up yonder.  I think she's fixin' to go home early and work from the confines of that there apartment."

"Seems that way.  With all them vermins."

"Cats.  They're cats, not rodents."

Clang.

"Makes no matter to me.  So should we give her a good scare before she leaves?  Rustle'er up a bit?"

"Yessir.  Let's wrangle up that pump site and shift it off course like a tumbleweed makin' its way through the desert."

Blank stare.

"She's wearin' jeans, Old Timer.  Let's rub the seam of the jeans against her infusion set until it spins a bit and comes loose from the site."

The piano stops playing abruptly. 

"You mean you want to stop that there insulin from gettin' in her?"

"A'yup."

"Okay, but just for a few minutes.  Just so she gets all riled up and has a little This here is a tumbleweed.  :: clang ::ol' fit.  A-hee hee hee!"

Kerri:  So I uncross my legs while sitting at my desk and notice that I could feel the cap of my site scraping against my jeans.  How the heck did that happen?  After a quick consultation with my thigh in the ladies' room, I noticed that the tubing had come loose from the hub of the set, leaving me without insulin.  I checked my blood sugar and saw a harmless 87 mg/dl, so there was no need to freak out. 

Then I noticed the two minature grizzled old prospectors with their spittoon, sitting on the corner of my desk.  I'd been done hornswoggled.

It was as this point that I decided I was burnt out and needed the weekend. 

February 21, 2008

Where Do I Hide My Insulin Pump?

I had dinner this week with a woman who has been type 1 diabetic for over two decades, like me.  She lives in my proverbial neck of the woods, so we met up in Fairfield and hung out for a while.  (Read:  Almost three hours.)  How is it possible to find something to talk about with a complete stranger for three hours?  Oh yeah - the diabetes connection!

One of the things we talked about was pumping, and how we handle wearing our pumps.  R has been pumping for three years, me for four, so we're relatively new to pumping insulin but veterans to diabetes.  R has a 15 month old son whose cute little feet occasionally kick against her pump when it's clipped to her hip, and she also expressed the same "where the heck do you put it?" question when it came to dressing for work.

"Mine?  Right now?  It's in my sock."

"No kidding?  Right in your sock?"

Being the shy and timid human being that I am, I hitched up my pants leg and showed her.

"Here.  It's attached at my thigh, the tubing goes down the side of my leg, and my pump rests against my shin bone.  The only thing that's a bit of a hassle is reaching down to bolus, but I was over that within a few days of wearing it here."

"Wow.  I may have to try that!"

I'm very fastidious about integrating my pump into my wardrobe.  I've written about this several times before and am sometimes met with the "You shouldn't be ashamed of your diabetes - you should wear your pumpinBLOGnito with pride!" response.  Please know:  I wear my pump with plenty of damn pride.  I'm proud to be taking these steps towards controlling my diabetes and I'm proud of the access I have to such progressive medical technology.  But be warned:  I'm also proud of being sort of incognito about it.  "You have diabetes?" they ask, not sure.  And I like that uncertainty.  I like being healthy to the point where people are surprised when I reveal my diabetes.  And also like seeing my reflection and noting no evidence of diabetes unless I know where to look.

Pumping - yes, very proud.  And subtle about it - also very proud.  This topic comes up so often when I'm talking with other young professionals that I'm always happy to share my techniques, and to learn any tricks from them. 

So when I heard this voicemail message on my phone this morning, I laughed out loud. 

"Kerri, hey it's R from dinner the other night.  I'm calling because I wanted to tell you that I've been doing the sock thing and I'm so, so excited.  You've revolutionized where I put my pump.  So far, it's wonderful!"

I was barely able to contain my grin.  Here's to the power of sharing ideas! 

February 20, 2008

Strip.

I am a relatively clean person.  I don't like dirty dishes, hampers filled with needs-to-be-washed laundry, and I despise knowing the cat box has those teeny morsels of yuck in it.  Sometimes, late at night when I should be getting ready for bed or relaxing on the couch, I'm hit with these cleaning fits.  I'll scrub away at every last stain on the counter, reorganize my underwear drawer (yes, it's organized for the most part), or start chucking the expired items from the fridge. 

I clean up my desk whenever I leave the office.  I can't stand messy piles of paper or a filthy, unwashed coffee cup with that tell-tale ring of grinds the bottom.  I don't like when the garbage can isn't emptied every night.  

Clean.  I like it that way.

So why, oh why, do I find myself completely and utterly inept when it comes to properly disposing of used test strips?  

These little buggers are everywhere.  I've written about them before (stuck to Chris's face, on the floor at the gym, and even discussed in dictionary entries), yet I still haven't found a way to solve the problem.  I test anywhere from 8 - 15 times a day, so these used strips accumulate and are inadvertently stashed in parts of my life like those hidden picture things from Highlights for Children

Glucose meter strip on the floor.

On the floor just next to my garbage can. 

(And that's a sticker from an apple.  I couldn't get it to peel back up.) 

Bag o' stuff.

At the bottom of my massive work bag (with many other assorted bits).

Even in the damn camera bag.

Even in my relatively-new and almost always zipped camera bag.  How the hell did it get in here?

Crafty little testy suckers.  I do my very best to make sure I do not leave a pocket of test strips when I visit new places or people, but I always find a pile of them hanging out in the spots I frequent the most:  my car, my office, and my home.  I keep trying to get them in the garbage can but it's like the bin takes a step to the left every time I go to toss one out.  Are garbage cans across the country uniting to thwart my best intentions?

I need to sharpen my disposal skills.

February 19, 2008

Crazy Eights (a meme).

Tagged by Courtney at Traveling Thoughts, I'm overdue for a meme these days.  Bring on the Crazy Eights! 

8 Things I’m Passionate About.
   1. Writing.
   2. Love.
   3. Friends.
   4. My family.
   5. Being healthy.
   6. Fantastic and evocative music - all kinds and styles and volume levels.  
   7. Reading everything I can get my mitts on.
   8. Diabetes advocacy.

8 Things I Want to Do Before I Die.

   1. Have a child.
   2. Visit Europe.
   3. Find a hidden treasure.
   4. Bury a time capsule and then open it twenty years later.
   5. Drink wine at a restaurant in Italy.
   6. Live to a ripe and feisty old age.
   7. Learn to play the piano.
   8. Make a difference.

8 Things I Say Often.

   1. "Let's get coffee."
   2. "I can't find my kit."
   3. "Can I borrow a pen?  I swear I'll give it back."  (I never do.)
   4. "Do you have any snacky bits?"
   5.  "Blaaaaaaahhhging."
   6.  "I love you."
   7.  "Damn it!"
   8.  "Where's my camera?"

(It seems that I ask a lot of questions.)

8 Books I’ve Read Recently.
   1. The Glass Castle by Jeannette Walls
   2.  Me Talk Pretty One Day by David Sedaris (oh, how I love him)
   3.  The Princess Bride edited by William Goldman
   4.  Writer's Market 2008
   5.  19 Minutes by Jodi Picoult
   6.  The Thirteenth Tale by Diane Setterfield
   7.  ...

Those are the books I've read in the last few weeks.  I can't remember two more.  That's shameful!  I used to read all the time - at the hairdresser when I was little, on the bus, in the shower (yes), during lunch breaks at my old job - but lately I haven't had much time for reading.  

8 Songs I Could Listen to Over and Over.

   1. With Or Without You - U2
   2. Street Spirit - Radiohead
   3. Fitzcarraldo - The Frames
   4. Hysteria - Muse
   5. Sweet Virginia - Gomez (acoustic version)
   6. Paperback Writer - The Beatles (I used to foolishly think this was my theme song.)
   7. The Blower's Daughter - Damien Rice
   8. Happy Birthday (cha cha cha) - Sung by my nephew, C.

8 Things That Attract Me to My Best Friends.
   1. They make me laugh.A hot cup of Meme.
   2.  They're inspiring.
   3.  I can count on them for ANYTHING.
   4.  They're patient with my chaotic schedule, short fuse, and disappearing acts.
   5.  They love me as I am.
   6.  They make me want to be a better person.
   7.  I consider them family.
   8.  They are open to change.

People I Think Should Do Crazy 8s.
   1.  Whoever would like to fill their day with a meme.

February 18, 2008

Assessing the MiniLink.

No More Medtronic MiniLink for me these days.The MiniLink trial has ended.  And I have plenty to say. 

The Good:  First off, Medtronic's level of customer service was unprecedented, which isn't unique for this CGM experience, but for my past four+ years with Medtronic on the whole.  My representative was attentive and drove all the way frickin' down to me from Boston, spending several hours explaining the ins and outs of this technology.  After I was hooked up, a local rep contacted me and offered to walk me through any issues.  Also, my contacts at Joslin were quick to touch base and see if I needed a hand with the insurance hurdles.  Overall, everyone on Medtronic's team made navigating this system as easy as they could.

The MiniLink CGM is smaller than it's predecessor and that shows me the kind of technological progression I need to see in order to become vested in a product.  The shape of the transmitter is rounded and aerodynamic, helping it to lie flat against the skin and remain pretty incognito.  And I didn't need to sport one of those wacky shower patched when I bathed, which was a definite plus.

On the second through the fifth days of a sensor, the numbers were within 50 points of my meter and I saw trends in my afternoons that I had no clue were happening.  Thanks to the CGM technology, I was able to isolate a basal issue and tweak accordingly.  And I loved - LOVED - looking at the graphs and seeing where I had pockets of lows or highs.  Useful information, when it was providing the right data.  

The Bad: 
The CGM has the best intentions, but only when calibrated in ideal circumstances, and my schedule lately hasn't provided many moments of plateau.  The results aren't too shabby when I'm calibrating at the right times, but it missed three bad lows on my overnights - 43, 39, and 34 mg/dl, respectively.  (And when alarms did go off, I couldn't hear them with the pump against my waist and buried underneath the winter blankets.  With the alarm set at 70 mg/dl and not being on the sensor's first day, it should not have missed three of these.)  That's the whole point of the damn thing - to protect me.  It did respond more accurately when I was edging towards a high, which was helpful.
 
But wearing it?  I'm not sure how you do it and not go nuts.  I'm going to work and going to the gym every week day and the sensor did not make dressing for either event very easy.  When I wore it on my arm, I bonked it against door frames and snagged it on sweatshirts.  When I wore it on my thigh, it ached against my muscle tissue.  And the three times I wore it on my abdomen, it was disagreeable because I do not like wearing anything device-esque on my stomach and it felt intrusive to me.   The transmitter doesn't lay flat and seems flop around unless I tape it down with an inordinate amount of medical tape.  And when I didn't have it taped down solidly, it shifted around a bit and tugged the needle out of place, which I found to be very painful.  I do not want any more pain than is necessary, and bloody, botched sites do not bring me any peace.

The Honest: 
  Unfortunately, MiniLink and I did not see eye to eye this round.  I'm not comfortable making any efforts to have my insurance company pay for something that I found to be frustrating, and I definitely am not in a position to pay out-of-pocket just to have one to play with.  I'm not comfortable using the MiniLink for my own diabetes management, but I don't plan on discouraging anyone from using it in theirs.   
 
BUT - and this is huge - I am an adult.  I can test my own blood sugar, dose my own insulin, and communicate how I feel.  I can completely see how a CGM can help a parent of a diabetic child feel like they have a "translator" for their kid's diabetes.  I've rec'd several emails from people on the Children With Diabetes board who asked me about the MiniLink and I recommended it, and other CGMs, to them for that reason.  I can also see how people who have more time to commit to learning this device and spending several weeks making it work in their lifestyle could benefit from the technology.  Maybe now isn't the right time for me to be wrangling in a device that requires plenty of fine-tuning and patience.  But if not now, when?

I hope to retry the Dexcom 7 and see if there have been improvements made from the 3 series I tried last July.  I know that different companies keep coming out with new versions of the continuous glucose monitoring systems, but I just want one that I can rely on, to a certain extent.  Bells and whistles and colors and shapes don't mean as much to me as accurate numbers. 

February 15, 2008

The Stress Management Six.

The Friday Six:  February 15, 2008 editionStress management has been on the top of my list for the last few months, and I've finally made it the priority it deserves.  I know that all of this cortisol coursing around in my body isn't good on several levels (contributing to higher blood pressure, hyperglycemia, impaired cognitive function ... wait, what was I saying?) and I can't let this go on any longer without making considerable efforts to change.

So, I'm taking on the Stress Management Six.  My ways of dealing with the chaos that comes along with ... life, it seems.  

1.  Better Manage My Time.  Between work, personal projects, and the wedding, I often feel overwhelmed by the tasks that need to be done and instead of tackling the "to do" list, I end up intimidating and spinning my wheels.  I need to really isolate the things that need to be done and prioritize them appropriately.  Do I really need to update my Twitter status every day?  No.  But do I need to make sure that the wedding invite list is completed by next week?  Yes.  Knowing what truly takes priority and not assigning myself too many tasks can help make better use of my time.

2.  Sleep.  Oh blessed sleep.  I have a tendency to stay up too late, throwing off my whole mindset for the next day.  More sleep is pivotal to achieving a lowered stress level.  So I'm buying new pillows.  And mushing my face into them for at least 7 hours a night for starters, aiming for 8 once I get closer to the wedding.  Part of getting more sleep also means cutting waaaaaay back on the caffeine.  I'm used to be a four-cup-a-dayer, but I'm trying to cut back.  Over the last month, I've worked my way down to two cups, and this week it has only been one cup of tea a day.  I'll eventually switch to decaf tea, I think.  Weaning off the caffeine will help lower stress, help me sleep, and keep my brain from imploding due to the jitters.  (I'm like Tweek from South Park when I have too much coffee.)   

3.  Meditation.  After speaking with my doctor this week and describing the anxiety and stress issues I've been wrangling with for a few months, she strongly suggested a meditation class to help keep me centered and help me let go of the things in my life that are tossing me into the spin cycle.  So I'm currently looking for a meditation class near my office or house.  (Which, here in Western CT - aka Soccer Mom Central - shouldn't be that hard.  It's all the rage to sit on a yoga mat and breath deeply these days.) 

4.  Breathing Exercises.  Even if I'm trying my best to avoid stressors, they will still find me.  (They have some kind of honing device, I think.) I need to find ways to deal in the heat of the moment.  I've found some breathing techniques that I can use while I'm, oh, say sitting in traffic, watching the email inbox total climb into the stratosphere, or for those moments when I mash my hand in the bathroom cabinet by accident. 

5.  Disconnect From The Internet.  I spend entirely way too much time on the computer, especially for someone who is completely social and chatty.  It's unnatural for me!  When I am at work, almost all of my day involves the monstrous computer screen (I do so enjoy the WorkMac, though), but I need to make more of a habit of disconnecting when I go home at night.  Usually, my evening includes the gym, dinner, and then more computer work.  Chris and I are resolving to spend less time online in the evening and more time hanging out.  Work can't suffer and tasks need to be completed, but being online all day and all night doesn't do much for my stress levels.  I need a freaking break. 

6.  Take A Freaking Break.  Lately, I've been mostly work and not enough play.  ENOUGH OF THAT.  I am young, healthy, and part of a wonderful network of friends and family.  I'm resolving to spend more time with my friends and less time mucking around on work-related items.  Last weekend was nice, spending it exploring a new city.  This weekend, Chris and I are tucking ourselves away into a bed and breakfast - no cell phones, no internet, and no tasks.  And next weekend, I have some fun plans with friends on tap.  Life is going by so quickly these days - I need to take some time to actually enjoy it and make some memories. 

So the plan is way less stress, which should have a positive impact on my diabetes and my overall health in general.  And if that doesn't work, I may have to move permanently into a hut on the side of a mountain.  Only it will have running water.  And a wireless connection.  ;)

Have a stress-free weekend and I'll catch you, all mellow and whatnot, on the flip side.  Yo. 

February 14, 2008

Falling In Love.

I have had diabetes for over 21 years.  Memories of life before diagnosis are scarce - just snapshots from years that were so few in numbers. 

Life has always included, for better or for worse, diabetes.  It is my reality, a part of my life that doesn't stop my world from spinning but does give it a decidedly dilgent tilt.  My family has always loved and accepted me, and I am very lucky for that fact.  New relationships, be they friendships or romantic ones, have always been laced with that slight fear of "Will they accept me?  All of me, including this condition that I manage every day?"

In many ways, I have been very lucky.  I have had the benefit of friends who love me for who I am and who also keep juice boxes in the glove compartments of their cars and find squashed "emergency" granola bars at the bottom of their purses. My employers have been understanding and patient with my scheduled doctor's appointments and my food items stashed in every desk drawer (sometimes in other people's desk drawers, too).  I am so grateful for these people who make my life exciting, fun, and accepted.

But now I stand here, barely three months from my wedding day, engaged to a man who has not only been patient, understanding, and compassionate with my diabetes, but he's made it a part of his life.  It's something we manage together - whether it's a middle of the night low blood sugar, our constant encouragement towards physical fitness, or his arms around me when I'm feeling crummy - and I feel so blessed.  I never feel like I'm carrying this burden by myself.  Knowing I have his support makes such an impact on my health, and my happiness.

We will make our vows to love one another in sickness and in health.  And I know, in my heart, that we already do.

Happy Valentine's Day to the man I love, and to my friends and family.  And to you out there in the blogosphere, for being part of a support network I could have never dreamt of but am so honored to have in my life.

Happy Valentine's Day from Chris.

February 13, 2008

Ketones.

Headache.  Check.  Eyes that weighed at least a pound apiece.  Check.  Mouth full of sweaters.  Check.

Looks like they're all here - the symptoms of a high blood sugar.

Sitting down to catch up on some emails, I absently fish my meter out of my gym back and lance my fingertip.  I hit send, graze against the new infusion set on my left thigh, and see a meter result of 420 mg/dl.

"Oh, that is just fantastic."

Taking out my pump, I calculated the massive correction bolus and felt the quiet sting of the insulin as it coursed through the infusion set I had placed an hour earlier.  Normally when I'm at an elevated blood sugar, I feel lethargic and generally Crumbs Morrone, but this one had a different feel to it entirely.  My stomach felt like it was playing host to a hamster wheel, and my headache was blinding.

I brought the ketone strips into the bathroom and watched uneasily as the pad on the ketone strip turned a deep purple.  Large ketones.  I hadn't seen those suckers since my days at Clara Barton Camp.  I never, ever have ketones, and I test regularly for them.  So where did this come from?

My stomach in knots, I wandered back into the living room and filled Chris in on the situation. 

"I'm high.  Like crazy high - 420  mg/dl.  And I just tested for ketones.  I have large ketones.  I feel like complete shit, and my stomach is really nauseous."

He rubbed my back.  "So what do we do?"

"Drink a ton of water and try to flush out the ketones, I guess.  If I can't keep the water down, we're off to the emergency room."  It dawned on me that I had the process of treating a low blood sugar down to a science, but navigating a serious high was unfamiliar territory.  Normally, I just bolus and wait for the numbers to fall, but this high came with an added bonus of ketones.  The word "ketones" was enough to send me scouring for my old Joslin manuals from 1986, breaking open that red binder and searching for the antidote. 

I drank several bottles of water and willed myself not to throw up, even though my body disagreed with that decision.  "Do not throw up.  Do NOT."  The mantra ran through my head and I tried to relax on the couch, drinking water all the while.  After about an hour, my blood sugar had fallen to 248 mg/dl and the ketones had retreated to "moderate."  Three hours later, my system was flushed clean,Ketones ... huh ... what are they good for? ketones were down to "trace," and my numbers were hovering around 170 mg/dl.

But I was still confused - where is the emergency room threshold?  DKA is defined by Wikipedia as "a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA."  Okay.  And Joslin had it beaten into my brain that ketones + vomiting = emergency room.  This is serious stuff.  But there is that gray area where large ketones are present and proper management steps are being taken, should I still be under the care of a medical professional?

I opted to stay home and wait it out, since I wasn't throwing up and my blood sugar was falling from that obscene high.  And today, at my doctor's appointment, I asked Dr. Connecticut about when I should be checking myself into the ER due to high blood sugar.  She confirmed that as long as I wasn't throwing up and that my blood sugar was coming down, it was okay to treat at home.  She did add that if I was showing signs of another infection, like a urinary tract infection or a sore throat, that the emergency room should be on my "must see" list.

Over 21 years with this disease and there are still uncertainties that touch in at any given moment. 

February 12, 2008

No Cheese Steaks.

The drive to Philadelphia isn't long at all - about as long as it takes for Chris and I to travel home to RI for the weekend.  Unfortunately, Route 95 doesn't offer much more than the Bronx and NJ factories as the view.  (Save for one quick spot where you can see the NYC skyline - the only pretty view.)  But highways aren't known for showing the best that a state has to offer. 

It's the places off the exit ramps that are the best. 

Our weekend in Philly was very fun and we explored as much of the city as we could in our short jaunt down to Pennsylvania.   We stayed at the Club Quarters hotel on Chestnut Street (nice hotel, very small rooms) and were walking distance from plenty of restaurants and holy crap a lot of shopping opportunities.  We spent Saturday night at The Caribou Cafe, dining on French cuisine and listening to the live jazz band, then capped off the night with a few glasses of wine at Tria

Sunday morning, we were up bright and early and headed out to see some decidedly geekier spots (Well hello to you, Liberty Bell!) before hitting the Philadelphia Museum of Art and the Franklin Science Institute.  The art museum gave us the opportunity to perfect our Rocky stances.

Awesome.

And the Franklin Science Institute had a giant heart display that you could walk through, exploring each section of the heart.  As you walked from atria to ventricle, you could hear the heart pumping and the sound of blood whooshing by.  Very cool. 

There also happened to be a huge Star Wars exhibit.  Not that I noticed.  Or got all excited.  Or grabbed a Storm Trooper for a Philly photo opportunity.  Nooo, not me.

Kerri and the Storm Trooper.  Of course.

(I have a full photo set of our trip to Philadelphia on Flickr, if you want to take a peek.)

The trip was awesome and I've been wanting to visit Philadelphia since we moved out here.  It's a city that's easy to feel comfortable in, which made it easier to explore.  We're already planning a trip back in the next few months, and checking out a few of the other restaurants that were tempting us.  :)

Oddly enough, we didn't have any cheese steaks.   

But the one downside to this trip was that we were still on crazy timetables.  Twenty-four hours isn't enough to really take in a city, no matter how hard you try.  We're still craving some downtime for the two of us, so we're jaunting off again this weekend for a quiet getaway to completely disconnect from our stressful schedules.  No phone, no internet, no "must be here at this time" schedule.  Nothing but rest and relaxation.

Sounds good to me!   

February 11, 2008

Worst News Story - EVER.

This is easily the most distressing news story I have ever read:  Bride dies during marriage's first dance

According to the article, "During the couple's first dance, Sjostrom complained of being lightheaded. Efkarpides thought his wife, a diabetic, needed sugar, but she collapsed."  She was a type 1 diabetic in her 30's.

I have a whole Philadelphia wrap-up ready to post, but this tragic wedding story deserves both our attention and our prayers for their family. 

February 08, 2008

The Birthday Six.

The Friday Six:  February 8, 2008 edition1.  This morning, as I drove into work, my phone rang and the voice of my 5 year old niece-to-be sang "Happy Birthday" to me.  My father's phone call gave me a rendition not unlike Marilyn Monroe, which made me burst into a fit of giggles.  If you haven't guessed, today is my birthday.  I am 29 years old.  I'm engaged to be married, working in a job that I love, and a proud part of a wonderful family.  It's nice to take a moment and realize how much life has to offer.  And how much it's already offered. 

2.  In that vein, Chris and I are off to Philadelphia this weekend to explore.   Yes, we will be running the steps of the Philadelphia Museum of Art and taking Rocky-style photos.  We'll check out the ol' Liberty Bell.  We're also interested in dining out downtown - any recommendations for a good, birthday-worthy restaurant? 

3.  Also, wedding plans are rolling along quite nicely these days.  We almost have our invitations ready to be printed and we're working on compiling the address list as we speak.  The wedding shower date has been set (but I know no other details - sneaky bridesmaids!) and my next dress fitting is on February 24th.  I need to find some comfortable shoes to wear on my wedding day - something with about a two-inch heel and comfortable enough to party in.  What kind of shoes did you ladies wear on your wedding day?

4.  In non-birthday news, I had the pleasure of sitting and chatting with Bertalan Meskó of Science Roll, a future clinical geneticist from Hungary who plans to specialize in personalized genomics.  He's a Web 2.0 pioneer, a blogging phenomenon, and significantly taller than me.  Aside from all his professional accolades, Berci has been a personal online acquaintance for over a year and it was great to finally meet him in person.  We talked about Web 2.0, the effects of patient blogging on the medical community, and had some drinks at The Playwright in New Haven.  It's strange how blogging provides such comfortable common ground.  The far-reaching effects of blogging still amaze me.

5.  This StrongBad email has had Chris and I laughing like idiots for several days now.  We try and recreate the techno song while we drive to the gym.  How could you not?  It's catchy! 

The 6.  And lastly, my trial of the Medtronic MiniLink CGM has come to a close.  I'll have a full wrap-up on Monday, but I really appreciate all of the feedback I've received from you guys in the blogosphere.  Having all of your perspectives, and developing my own, has made exploring this option easier.

Have a great weekend, everyone.  I'm off to celebrate!  :)

February 07, 2008

My Own Accord.

I'm reading through the pile of emails about the ACCORD (Action to Control Cardiovascular Risk in Diabetes) - there are several already this morning - then clicking through to the Dallas News, then to the NY Times front page headline. 

It's all about what sells, right?  Getting the attention of people?  Telling them that "tight control can kill you"?  Anything to get people to click through, right?

Tight control, whether you're type 1 or type 2 diabetic, keeps diabetes-related complications at bay.  This is a fact, proven by countless studies and evidenced by a whole host of patients.  To start telling people that tight control will kill them is irresponsible.  As stated in the dLife Today blog:  "It's important to note that the increased risk was slight, and was specific to only a subset of patients who had two or more risk factors for heart disease outside of diabetes or who had pre-existing heart disease upon entering the study."

But these specifics aren't what sell papers.  Headlines like "Patients getting aggressive diabetes treatment have higher death risk" are the ones my friends and family will click on and become fearful of, knowing full well that I am diabetic and use an insulin pump (considered aggressive treatment).  Thanks to all of the media chatter, people are up in arms about this study, assuming at first glance that results apply to all people with diabetes.  Click here ... for nothing to happen.

Kelly Close of diaTribe and Close Concerns said it best:  "... if you are type 1, you can read this piece with interest, but know that ACCORD has zero to do with you. If you are type 2 and newly diagnosed, keep moving on your plan - ACCORD has zero to do with you. If you have had type 2 for awhile but don't fall into the "high risk" profile, keep your goals intact."

Mom, this study doesn't apply to me.  My control goals remain the same.

February 06, 2008

Kerri's Seriously Zippy White Bean Salad.

It's not often that I have the chance to use the "Food" category on this blog.  I'm a bit of a cooking disaster (known for such dishes as "Ew!" and "Is it supposed to hurt?")  But I've thrown together something that I thought was tasty.  And it is low-carb.  AND it doesn't taste like garbage. 

Yes, I was shocked, too!

I have found that eating low-carb makes blood sugar management a little easier.  Not having the spikey bits after meals keeps my numbers more in range and less "riddled with chaos."  However, I like bread.  And pasta.  And that whole "feeling full" thing. 

Turns out a good dose of fiber gives me that full feeling without sending my blood sugars straight into orbit.  I had a really tasty white bean salad dish at a restaurant the other night, and dared myself to recreate it last night at home.  While it wasn't exactly the same, it was still tasty.  I put in too many red onion bits, so it has some serious zip to it, but it tasted good and didn't tease me towards the 200's. 

The seriously zippy white bean salad.

Kerri's Seriously Zippy White Bean Salad 

  • 2 cans of white cannelini beans, rinsed
  • 1/4 red onion, minced
  • 10 slices of pepperoni, chopped
  • 1/2 cucumber, chopped
  • 2 tablespoons of extra virgin olive oil
  • salt
  • pepper
  • lemon juice

It's this simple:  Add all the ingredients to a mid-sized sedan (just kidding - use a bowl),  mix together, and add salt, pepper, and lemon juice to taste.  Eat with mouth.  Beware of hot onions.

A simple recipe goes a long way for a culinarily-challenged blogger like myself.  :) 

SUM Tags: , , ,

February 05, 2008

Jet Lagged.

I was on a plane, high above the clouds, looking down onto the world below me where everything looks too small and too distant to be affected by a number.  Cruising altitude.

I felt his hand on my shoulder, shaking me a little bit. 

"Kerri.  Kerri, wake up.  You're really sweaty.  Wake up." 

Was it the captain speaking?  No, it was my fiance.  I was half-draped off the edge of the bed, pulling the long-sleeved blue t-shirt away from my body.  The space above my collarbone was damp.  My hands went to it, blotting it with my sleeve.

"I'm awake."  I could hear my own voice but it sounded like it was coming from the end of a long tube of Christmas wrapping paper.  "I'm going to test." 

I unzipped the meter case, lanced the end of my finger, and watched as "39 mg/dl - do you need a snack?" popped up on the screen.

"Oh,"  Everything was nonchalant and dreamy.  "I'm 39." 

Chris sprang from the bed and returned in just a few seconds with a glass of grape juice.

I drank it down in a few gulps, being careful not to let any spill out.  "I'm pretty low.  I don't feel that low."  The words sounded so matter-of-fact, like we were discussing the thread count of our sheets.

"Did the thing go off?"  He motioned to the CGM as he rescued the empty glass from my unsteady hands.  I reached down for my pump and clicked a few buttons. 

"No.  It says I'm 74 mg/dl.  But it's showing this crazy sharp dip - see, right there? - so it knows I'm dropping."

"Feeling better yet?"

"Not yet.  I changed my site before we went out tonight.  That always happens - I change my site, I end up higher, and the correction bolus crashes me down so hard."  This conversation is happening as my blood sugar hovers around 40 mg/dl.  Aren't people supposed to be on the cusp of a coma or something at this point?   How is my brain busy explaining the mechanics of this crisis?  Where is the SkyMall catalog?  I'm still mid-flight on this low.

I clicked off the lamp and we both settled back into bed.  As my blood sugar rose, I felt increasingly worse, shivering and cloudy-mouthed, my mind racing and my hands clenching against threats Rocketman.unseen.   I felt like I was landing now.  But the closer I came to landing on the safety of the ground, the more terrifying it became until the landing gear in my mind touched down and I was okay.  Safe at 130 mg/dl.

The alarm went off this morning - my blood sugar was 119 mg/dl.  I collected my baggage from the night before and rubbed the sleep from my eyes. 

Today, I'm feeling a bit jet-lagged. 

SUM Tags: , , , ,

February 04, 2008

The Saddle.

Continuous glucose monitors are expensive to purchase and maintain, with costs approximating around $900 for the device and $40 for the individual sensors.  Insurance coverage for this technology is tough to wrangle, even though there have been a few break-throughs in the last month or so. 

Bottom line:  This stuff is expensive.

I have a box of MiniLink sensors in my fridge that I am able to trial at no cost to me, and I have access to several Minimed representatives that have been very helpful in getting me rolling.  I owe it to myself to give this thing another try, aiming to be more levelheaded and patient as I adjust to this technology.

Other Bottom Line:  I'm a fool not to take advantage of every opportunity I am given. 

Therefore, after a weekend home in Rhode Island spending time with friends and family and generally chilling out, I came back to work today feeling calm, collected, and not ready to give up. I'm not the giving-up type.

This afternoon, during my lunch break and at a level of low stress, I installed another MiniLink sensor.  I'm going to try this again.

Admittedly, I have a short fuse.  Things piss me off pretty quickly and are often thrown as a result.  I'm a little ashamed of my hot temper and I have trouble controlling it sometimes.  So when the CGM was pinging away, beeping and hollering and throwing inaccurate results, my fuse was lit and my temper flared.  My numbers weren't steady as a result and I ended up contributing to the problem.

I was frustrated with this thing.  Chris and I talked about it, weighing pros and cons and figuring out ways to integrate this device into my already busy agenda.  Wearing a CGM may not be the best decision for me at this point in my life, but I need to give this a solid and fair trial.  Instead of letting myself fly off the handle because the results aren't completely accurate or the device isn't completely comfortable, I need to just take what I can from this experience.   

I'm going to wear this sensor and see what I can learn from it.  I'm not expecting precision.  I won't let it replace my blood sugar tests or dictate my insulin doses.  I'll simply wear the damn thing and see whatYes, it's My Little MiniLink ... Pony.  happens.  I'll download the numbers from my pump and see what kinds of trends I can isolate from the data. And I'll continue to give you guys an honest assessment of how I feel about this technology.

Either way, I am very lucky to have access to this kind of device and this kind of outlet for discussion.  I need to make the most of it and hopefully learn something about it. 

In the process, I'm hoping to learn a little about me, too.

February 01, 2008

The Sussy Six.

After a stressful day yesterday, I needed a good nap and ... oh wait, is that a sussy?  Just in time for The Friday Six??

Today, my sussy came in the dLife mail delivery!  Turns out my secret sussier was Kristen (aka kkonmymind), my Flickr buddy and fellow Nikon D40'er.  Her gift was very sweet, including a data card for my camera, some tasty chewing gum (I'm admittedly addicted to gum) and a beautiful little bride-and-groom trinket to hold photos of friends and family.  Thank you so much, Kristen!  I love my sussy!  (And currently your letter is being held by the bride and groom.  They are taking good care of it.)

Sussy from kkonmymind!

In the land of off-site writing, the latest issue of diaTribe is out, with an all-new SUM Musings column talking about hypoglycemia.  Also, Generation D has been updated at dLife, with a focus on fitness.  It's an honor to be writing for both sites, so if you haven't up as a subscriber to diaTribe or as a member of dLife yet, do it today!

With today being the first day of February, I've successfully completed my first month as a member of Diabetes365.  It's a very interesting experience, taking daily snapshots of diabetes and seeing how a month of diabetes stacks up.  Have you checked out the Flickr group for D365

I stumbled upon this website about a Japanese origami artist who makes wildly creative and frighteningly realistic paper versions of industrial products.  Check out his V-12 four-stroke engine, which actually works.  I am so impressed.  

In other nonsensical news, I have come across a video game starring, my favorite one-armed dragon, Trogdor.  If you're into burninating and potentially being sworded, give this a go.  It's a great way to waste five minutes, and to laugh your ass off at the pinnacle of silliness.  And if you're looking for more old-school computer nonsense (for your TRS-80 computer from Radio Shack, perhaps?), check out this game

On the recommendation of my terrific eye doctor, we're heading home to RI this weekend and I plan to crash at my best friend's house and chill out.  Hopefully February will be filled with stress-free weekends and some cool moments.  With my birthday just around the corner (Shannon's is tomorrow - be sure to wish her a happy one) and my wedding getting closer every day, there's definitely some fun to be had.

Have a great weekend, everyone.  See you Monday!  :)

SUM Tags: , , , , ,

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