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October 29, 2010

A Tale of Two Docs: Part I.

The Hunt for Better Doctor ... in October."So you are here for ..."  the nurse asked, tapping the keys on the computer keyboard and not making eye contact with me.

"I'm here to see if I'd like Dr. NoWay to be my primary care physician.  I'm here to see if I like her, and this office."  I said, already annoyed.  

From the moment I walked into this doctor's office, I was uncomfortable.  The people in the waiting room looked exhausted, like they had been there since birth and had slowly aged and melted into the seats.  The walls looked like they hadn't been painted since 1985, and everything had this damp, dingy undertone to it.  It seemed sad.  Hopeless.  But I had hope that I was judging a book by its cover, and that I could find my new primary care physician here.

"Yeah?" said the receptionist.  "You need to fill out these forms and then sit over there until we call you."  She handed me a clipboard - still without even looking at me - and dug a pen out from underneath a pile of papers.  "And I need your license and insurance card.  Like now."

Oh boy.  I gave her my license and insurance card, and sat to fill out the forms.  Even though I had barely walked through the door of this place, I knew it wasn't the right fit.  

I'm an empowered, engaged patient, but I'm also a picky patient.  Since taking my health into my own hands (namely, once my mom stopped coming on my doctor's appointments with me), I definitely have a choice in who is part of my health care team.  Just because they're covered by my insurance or recommended by another doctor doesn't mean they'll be a good fit in my life. I need to be able to talk to this person.  I need to feel comfortable being a little vulnerable.  I need to feel like they care, even just a little bit, about more than just billing codes.

Initial doctor visits are like first dates - you go on them to see if you want to see them again.

And this doctor's office wasn't getting a second date.  Because the following statements were uttered during the course of my visit (by the doctor, the nurse, and the receptionists):

  • "You have diabetes?  Maybe after you lose the baby weight, you'll be off insulin?"
  • "For your wrist pain, you can take Advil three times a day."  (Never mind the whole diabetes/kidney thing, right?)
  • "Your license photo looks new."  (How is this relevant?)
  • "You test your blood sugar?  Like once or twice a week?"
  • "You were diagnosed with diabetes as a kid?  But you went on insulin only for your pregnancy, right?"
  • "An insulin pump?  That's when your sugar gets really, really bad.  It must hurt a lot to wear that."
  • "You're here to interview me?  Are you a reporter?"   ("No, I'm a potential patient.  Stress on the potential part.")
  • "I can't find your name on your insurance card."  (My response:  "It's there on the card?  Next to where it says "Name?")

Dr. NoWay herself was very nice, and I think she had her head on straight.  But honestly, it was the staff who worked in her office who put me over the edge.  They were rude, uninvolved, and uninterested, across the board.  And I mentioned this to Dr. NoWay.

"I have to admit - I'm on the fence about whether or not I want to have this office handle my primary care.  You seem like a good doctor, and I feel comfortable with you, but - and I'm wicked embarrassed to say this - your staff seems like they are on the moon.  They can't find my name on my insurance card?  Come on!  How can I feel confident that they'll take your medical direction and process it properly for me?  Their inattentiveness could result in a screw up for me.  And I'm not willing to take that risk."

Dr. NoWay explained that the office had recently experienced a shift in staffing, and that everything was a work in progress.  And I understand that.  I have empathy for that.  But I fear that, too.  I'm fortunately accustomed to clinics like Joslin and Beth Israel, where people have their ducks in a row.  I don't worry about the competency of the people answering the phone or scheduling appointments.  I don't feel weird giving them my home address or my social security number (which is something I felt odd sharing with this PCP office - can't explain why).  This new PCP place wasn't cutting it.  I definitely can't manage my health at a place where I feel uncomfortable and insecure about the care I'll receive. 

And it's not just the Joslin Clinic that's been awesome - my medical team in Connecticut was new to me, but ended up being awesome.  Dr. CT was fantastic, and so was her staff.  But I did have my fair share of Dr. Idiots.  It's part of the health care management process - weeding through the mess of doctors to find one that fits with both your personality and your medical needs. Every medical relationship has ups and downs, but it has to have more ups to be effective in improving my health.

As a chronic illness patient, and someone who doesn't feel shy about requesting competent care, I think interviewing doctors is essential.  We spend a lot of time managing our medical conditions - we shouldn't have to waste any time wishing we were seeing a different doctor. 

The search for a local PCP continues.  But I did see a Physical Therapist that was a very different experience ... more on that Monday.

October 28, 2010

The Day the Dexcom Died.

It's weird, because even though I spent almost 21 years without the assistance of a continuous glucose monitor, I'm hooked on the thing now.  It's a second device, it's another site stuck to my body, and yet I'm happier with the extra hardware than I am without it.  

Because, to be honest, testing as frequently as I had been in the past is a little trickier with that baby bird rolling all over the house.  I'm back up to about nine times a day, but that's a far cry from the 15 times I was rocking out with during pregnancy.  (And for me, as a type 1 diabetic with blood sugars that go berserk due to the influence of emotions, not just food, testing is a saving grace for me.) 

So I feel much more prepared with the Dexcom filling in the gaps between actual finger pricks.

Which is why, when I saw this error message on Monday, I bugged out a little bit a lot:

Dexcom error message ... surrounded by BSparl's panda toys.

I was in the shower at the time, with BSparl in her little bouncy seat on the bathroom floor, and we were chatting about soap and bubbles and how Abby the Cat is far too fat to climb trees, when the Dexcom let out a little BEEEEEEEEEP from the bathroom counter. 

"Whoa, settle down there,"  I said to the receiver.

BEEEP!  (It was a shorter, sadder one this time.  I was concerned, because I'd never heard that noise from the Dex before.)

"You okay?"  I asked the inanimate object.


it was like that moment in Braveheart when William Wallace is being tortured at the very end, ripped open and crying out for "Freedom!!!!"  The Dexcom let out that last, extended wail and then threw out the error message. 

"Oh damnit, I think it's dead now," I said outloud.

"Mmmmm mmmmmm!"  said BSparl, waving her little arms excitedly.

And when I examined the receiver and saw the big, fat exclamation point o' death, I knew the receiver was toast.  So I sent a spastic email to my friends at Dexcom and they overnighted a new receiver.  And as soon as FedEx arrived, I slapped on a new sensor and felt better.

It's strange how I have a hard time imaging my diabetes management without things like Humalog (I was diagnosed in the era of cow and pork NPH and Regular), insulin pumps, continuous glucose monitors, and meters that don't take 120 seconds to give you a result.  This CGM is a far cry from the Clinitest tubes of my diagnosis. 

"Back in action, kiddo."  I said to BSparl, throwing the Dexcom egg into my purse as we prepared to go for a stroll.

"Yaaaaaaaaaa!!!!"  She laughed, and threw her hands in the air, and burped loudly. 

(You stay classy, BSparl.)

[Dexcom disclosure

October 27, 2010

The Big, Bad Wolf.

Yesterday, I was up in Boston proper for a meeting of health activists from the WEGO Health community, brought together as part of a panel of patients who were willing to share their perspectives with Pharma.  My fellow panelists - Alicia Staley, Rosalind Jaffe, and the diabetes community's own Karen of Bitter-Sweet Diabetes - and I talked with a group of representatives from Pharma who had questions about getting involved in the social media space.  (Did you know Pharma wants "in" on the social media space?  Can you tell?)

The WEGO Health Socialpalooza panelists and moderators
Kerri Sparling, Rosalind Jaffe, Jack Barrette, Karen, Alicia Staley, and Bob Brooks. 
(This is the happy photo. And because they all humor me, here's the serious one and the goofy one.)

The discussions were extensive, and we talked openly about what we, as patients, thought Pharma was doing "right" and then our opinions on what was missing from the social equation.  The WEGO Health moderators provided a few questions to the panelists prior to the panel, and my answers were sent off a few days earlier, while BSparl was taking a nap. (Which means I was too exhausted to craft up fancy answers and instead blurted out knee-jerk responses, which were included verbatim in the slides.  Which makes me reconsider using the "draft" option of my email to preserve mine and everyone else's sanity.) 

Here are the questions we were sent, and my answers:

What rules of the road should companies follow when they engage your communities online?

  • Always be authentic (aka don't be a big, fat liar)
  • Do not judge the actions of online communities (see also:  "Diabetes Police*")
  • Contribute to the conversation, don't just try to sell us stuff
  • Don't fear the blogosphere:  Show us your face!

What health or pharma company social media efforts are resonating with your community online? [I don't speak for "the community," so I instead listed efforts that resonated for me, personally.]

What would you tell companies to encourage them to support your communities online?

You need us.  In so many ways.  So come talk to us.  We want to hear from you.  Also, bring cookies (And with this slide, the WEGO crew had included a photo of some lovely chocolate chip cookies.  I appreciate being humored.  I also love cookies.)

Pharma isn't the big, bad wolf.  The industry as a whole gets a bad rap because there are some dodgy apples in the bunch that ruin Pharma's overall image.  I think that same principle applies to just about everything (there are always jerkfaces in certain groups).  I think that Pharma companies attending events in effort to engage with patients is a good thing. 

"But they only want to profit off our disease.  They want to tap us because they make money off us." 

Good point.  But while that is true on some levels, it's also true that just having them in the room with us is a start.  Because if they're in the room, they can hear us. And if they hear us, they just may start to listen.  

And damnit, there is a chance of cookies.

*  I hate being policed, especially by people who don't know me.  I can take criticism well, and constructively, but I do realize there is a certain risk that comes with putting my personal health information out there for all to see and analyze.  That kind of disclosure opens me up to a lot of scrutiny and judgment.  Part of what I wanted to convey to the attendees of this discussion was that judging people within these communities is a crap idea.  Unless they know what it's like to live with these illnesses, don't just pop in and make disease management suggestions or judgments.  And definitely don't jump in and try to link to your products.  Support and accurate information go a very long way in making a difference in our health and lives.  Don't rag on the diabetic who clamors for cookies.  ;)

October 26, 2010

It's Nothing.

Tricky little sucker, ol' Blue.When I was pregnant, my eyes were constantly monitored by the combined team at Beth Israel and Joslin.  Actually, diabetic retinopathy is the sole reason for my c-section delivery of the baby, because the spots they saw were too close to the macula for the medical team to advise "push" for me.  (And if you are inclined to comment about how c-sections are evil and how I should have pushed anyway, save your comments for someone who has the option to chose.  Because my kid is asleep in the other room right now, and I can't exactly shove her back in and try again.) 

After the baby arrived, I was scheduled for several follow-up appointments with the goal of checking out my kidney function, the healing of my c-section incision, and the progression of my retinopathy.  But then things got all jumbled - my six week follow-up turned into a seven week one, and it was hard getting into the city with a newborn, and then we moved again ... excuse after excuse, but I have yet to re-dilate my eyes.

A few days ago, I noticed a little ... you know, I can't really describe it accurately, but it's a something in my eye.  Right eye, lower right hand side, sort of like a Pac-Man ghost you can't quite catch.  I've Googled it and some have described it as a "floater," but in any event, it's new.  It's not there all the time, and it usually comes into play after several hours of computer work, so I'm inclined to chalk it up to eye strain.  Or exhaustion.  Or a combo of both.

It could literally be nothing.

Or it could be something.

And because diabetes is a piece of garbage, I have to check this ghost out.  So I'm calling today to make an eye dilation appointment.  This is one bit of follow up that I can't duck out on, especially since the worsening of eye complications kind of goes hand-in-hand with BSparl building.  I'm on new medical insurance, so it could require some juggling and hoop-jumping, but I can't let today end without that appointment secured.

Eye complications are one of those things that I've always had a healthy fear of, but with the advancements in the treatment of both retinopathy and diabetes as a whole, I'm confident that if there's an issue ferreting around in there, I can deal with it.  It's the lack of knowledge that kills me.  I don't do well with fear, and I definitely fear the unknown.  I'm aiming for answers, regardless of what they are, because I need to nail this thing. 

It could be nothing.  But if it's something, I'm ready.

October 25, 2010

BWE10 Outtakes.

Every conference comes with dragging that camera around all day long.  And while the camera bag strap is digging into my shoulder (maybe my new 5 Million Dollar Home one from Crumpler won't give me that kind of trouble?) all the livelong day, I grumble about bringing the camera everywhere.  But when I go to upload the photos, I'm always glad I brought it.  Here's a quick look at BlogWorld 2010 through my lens:

Oh a giant cup of happy!

There was a giant cup of coffee that was aiming to break a world record for ... most giant cup of coffee.  And it broke both the record and my heart.  Oh I love coffee.  It's keeping me sane and productive these days.

Hanging out in Center City.

A group of us met up in Center City at P.U.B. one night in Las Vegas.  (And yes, that's George Simmons you see grinning in there - he drove out from LA to hang out!!)  Aside from the waitress hating us for not ordering much food (but many drinks - so she can shut it), it was a good night.

Kerri Sparling, Scott Johnson, Scott Hanselman, and Amy Tenderich

We attended Scott Hanselman's session on 32 Ways to Make Your Blog Suck Less, and afterward, the diabetics united for a quick picture (taken by our diabetic-in-spirit photographer, Jenni Prokopy).  Scott's session made me feel like I had a lot of blog work to do, from web redesign to URL structuring ... I realized that some of this is way over my head.  (Or at least over the head of someone who is doing both design and editorial on a site.  I would love to redo my blog, but I'd surely end up chucking half the useful stuff into the bin by accident.  So I'm leaving it alone for now.)  Check out Scott's blog for more details on making YOUR blog suck less so you can have a small anxiety attack about all the things you don't know.

Vegas at night.

And this photo is from the bar on the top of Mandalay Bay - I think it was called Mix.  The view of the Vegas strip was spectacular, and I joined the crew of people leaning against the railing and snapping off photos.

There are a bunch of other photos.  Like the one of the giant coffee cup in all its glory.  Or the shots we took in the Southwest Airlines booth, making it look like we were hanging out on the wing of a plane.  Or the Ford that we all signed with our handprints, leaving crazy trails of magic marker on our hands.  Or our photoshoot with the Chinese dragon in Center City.   Or the Grand freakin' Canyon from the plane.  (Ignore the one of Jenni with the wall boobs.)  More photos on Flickr!

October 22, 2010


Dear Pancake,

Little peanut, you are a Beatles fan.  Already.  I can't believe it, but you are instantly soothed by Yesterday, Here Comes the Sun, and Imagine.  (And you are also too little to care if I get the lyrics wrong, hence "Yesterday, I'm not half the mom I used to be.  There's a Siah hanging over me …")

You are now six months old.  And you are fiercely independent already.  You want to put your own socks on and feed yourself with your own spoon and chew on whatever you damn please.  You like pulling yourself up when I hold your hands and you are frustrated when your chubby legs can't support your weight.  Patience, little bird - your time for walking will come before we know it.  For now, you'll need to be content with rolling like a hamster ball all over the living room.

You have a tooth threatening to poke through any day now, and you constantly rub your sore gums with your fingers and occasionally with your toes.  You have developed this new, coy little smile when you tuck your chin in and press your lips together and grin.  Waitstaff at restaurants love this face, and they bring the bread basket faster when they see you.  Don't think this is going to be your "I get everything I want" face, because I'm not ready for that.  I'm also not sure if you're vying for a pony this early, but no way, kiddo.  We have three cats.  No more animals.  Talk to your dad about a hermit crab or something.

You and I read books every day.  You are obsessed with Guess How Much I Love You (only I feel a little like a dirtbag every time I read "Little Nutbrown Hair" … what kind of name is that for an animal??) and Love is a Handful of Honey.  You always look at my face at the same moments in the story, and by the end of each reading, you've attempted to eat at least three of the pages.  You are hungry for learning, birdy.

You sleep in your Big Girl crib now, in your very own room.  I watch you on the video monitor all night long, listening to the sounds of your sleep machine in the background.  Sometimes, you shuffle around in there, sighing gently and foraging for your thumb.  You are a champion sleeper, and my new mom sanity has been restored now that you are happily lights out for the night.  (But I must admit - sometimes I scoop you up in my arms before I head off to bed, because I need hugs from you as often as possible.)  

And now?  You are starting to chow on solid foods.  ("Solid" being a bit of a stretch.  There isn't much solid in those jars of Earth's Best sweet potatoes and little cups of rice cereal.)  The first time we touched the spoon to your lips, your dad and I almost cried from laughing because all you wanted to do was suck on the spoon.  But you've come a long way since that afternoon, and now you're able to polish off a serving of solids and only wear a third of it on your chin and a third on your bid.  Soon you'll eat more than a third!  And eventually, you'll be able to eat without us laughing at you.

BSparl at the ripe old age of six months.

Nothing warms my heart more than your smile.  Nothing makes me happier than the sound of your laugh.  And nothing brings me more joy than watching you eat tutus.

I love you,
Your Mommy.

October 21, 2010

Look Forward to Today.

We stand together, even when things get really tough.Last night, I woke up at three in the morning and listened to the sounds of the crickets outside my bedroom window.  Not a human sound could be heard.  When I closed my eyes, I could hear my own heartbeat.  And even though I don't spend the majority of my time worrying about diabetes complications, my mind went immediately to the news I heard yesterday, about another young child with diabetes taken while she slept.   (The both tragically named and tragically accurate "dead-in-bed" syndrome was to blame.)  She was 13 years old, her parents were active and engaged in her care, and there wasn't anything that anyone "did wrong."

The Children With Diabetes website describes "dead-in-bed" happening "after having [the patient] having been observed in apparently good health the day before.  No cause of death can be established."  The article also goes on to say, "In a recent review, clinical reports strongly suggest that nighttime hypoglycemia is a likely prerequisite of the event, but that the death is sudden and probably caused by cardiac arrhythmia. It is postulated that early signs of nerve damage (autonomic neuropathy) can result in a disturbance of the autonomic nervous system." 

I don't know what to think.  I can't comfort myself with the fact that I have access to a blood glucose meter and I'm testing my blood sugar regularly.  Or that I've been to the doctor more in this year alone than I have been in all other years combined.  I don't feel confident that I have 24 years of what some have called "borrowed time" under my belt.  Even the CGM, with its protective bells and whistles and warnings of both highs and lows, doesn't offer me solace right now.

I felt scared.  I'll admit it.  I felt so sad for her family and for all the families who have had to weather this kind of storm.  Because there isn't any rhyme or reason to this disease.  Even when signs all point to "fine," there's a chance your body can just give out.  And that's something that keeps you up at night.  It's something that kept me up last night.  My brain was spinning and grief for a family I didn't even know was prickling.

This is scary, without a doubt.  This is the kind of stuff that I, as a blogger, want to pretend doesn't happen.  I want people to find my site, and the sites of my fellow diabetes bloggers, and feel comforted because we're all alive.  Our health levels vary, but we're all alive.  And the idea of the parent of a newly diagnosed child stumbling upon this story breaks my heart, because this is not the rule of diabetes.  

Dead-in-bed is the exception.

I wondered if premature deaths in people with diabetes are rising, or if we're just hearing about them more often.  I used to be the only diabetic I knew, but then the Internet introduced me to hundreds of others living with or caring for the same disease.  And now I have an extended family of people with compromised immune systems.  So I wonder if these tragic deaths have been occurring for as long as I've been diabetic, only I haven't heard about them so readily because information didn't spread at the rate it does now.  And as awful as the feelings must be for those who have lost a loved one, I wonder if it would be worse to not have the larger diabetes community to lean on for support?  Would I feel better not ever hearing about these difficult times or would I rather deal with diabetes alone?  I think everyone's experiences vary, and emotions run high in times like these.

I thought about my daughter, asleep in her crib, and the instinct to protect her from everything rose up in my throat.  But I can only do so much.  I can only protect her, and myself, from so many things.  The rest becomes part of life and part of circumstance.  I can't make myself lose my mind with paranoia, even though I love her endlessly.  I need to let her live her life.  Just as my mom lets me live mine, despite her fears as to what role diabetes may play.

We do our best, as parents.  As children.  As diabetics and the caregivers of diabetics.  As people.  Tragedy will come and go in all of our lives, but the best is all we can do.  Life goes on for those of left behind.  And we can't exist in fear.  Even though it can be so scary at times.  We owe it to ourselves to be as educated about diabetes as we can, as empowered as patients as we're able to be, and as healthy as we can manage.  We lean on one another for support in these difficult times, and we look forward to today for inspiration. 

Hug your loves ones today.  As many as you can (even your cats).  Because when it all boils down, we're all we've got.

October 20, 2010

A Friday Six on the Wrong Day.

The Friday Six:  Wednesday edition.  :)Too many bloggy bits to share today to wait for Friday.  So here's today's Friday Six ... only the Wednesday edition.  :)

The ADA I grew up with wasn't exactly known for it's outreach to the type 1 community, and to be honest, I always felt that their methods were antiquated.  Until very recently, when I met Dayle Kern and listened to her speak passionately about the efforts being made by her organization (the ADA) to reach out.  And the proof is in the post pudding, it seems, because the ADA has started their own blog.  With Dayle at the forefront of the ADA's social media outreach, I think things are going to start looking up for Big Red.  

2.  Also, there's a new meet-up group being put together in the DFW area in Texas.  Lindsey Guerin, blogger extraordinare at Blogabetes, is heading up the charge.  Here are the details:  "We'll be meeting once or twice a month. Anyone is welcome...diabetics and their families included. We'll be doing events like movie nights, bowling, dinners, and just general support. Our first meetup will be October 20 at 7:30pm, hopefully."  You can reach Lindsey at lindsey_guerin@yahoo.com.  For more information, check out the TuDiabetes group and the Facebook page.  (And October 20th is tonight.  I'm sorry for putting this up last minute!)

3.  The crew at Johnson & Johnson grabbed some videos at BlogWorld last week, and they happened to catch me after my panel was completed.  The interviewer wanted to know what prompted me to start my blog and what motivates me to keep writing it.  So I answer that question, at a freaking breakneck speed.  (Apparently, the three hour time difference of Las Vegas and the constant flow of coffee made for a fifteen thousand word per minute delivery.)  Here's a link to the video!  (And here's hoping they post the outtake, where Manny Hernandez decided it was a good idea to make faces at me while I was recording, causing me to laugh like a lunatic and ruin the whole take.)

4.  And in other video news, there's a new video up at Animas, talking about the battle for better body (because that's such a journey at this point - the gym is not bringing me back to my jeans fast enough) and featuring a special guest at the end.  (Actually, three special guests, if you count Creepy Kerri Impersonating a Low Blood Sugar and also the Abby cameo.)

5.  On Halloween morning, Team Six Until Me will be walking for the JDRF Walk to Cure Diabetes.  So far, fundraising has been a little scattered, but the Sparling family is ready with their costumes, so we're halfway to prepared.  :)  If you are able to make a donation to our JDRF team, I'd very much appreciate it.  And if you aren't able to donate this year, please consider walking in your own local JDRF walk team.  Every little bit helps, be it awareness raising or fund raising. 

6.   Lastly, Huffington Post blogger Riva Greenberg is bringing the spotlight back to diabetes with her post "Curing Diabetes:  How Close Are We?" Her interview with Diabetes Research Institute's Dr. Camillo Ricordi relays a lot of terrific information, but this one quote from Dr. Ricordi is enough for me:  "I started this work to cure diabetes. My goal has not changed. I will keep working until I get the job done." 

Enjoy your Wednesday - I'm off to rake the yard.  (Fall is so aptly named a season.)

October 19, 2010

Remote Access.

An ode to the remote for my insulin pump.  Sung in the tune of D.  

Remote, O remote, how I'm glad that you're mine.
You make bolusing easy, you beep so devine.
With you at my side, I no longer must fuss
About pushing the buttons to take a bolus.

Because now - O now! - I worry much less. 
I can bolus without fumbling 'round in my chest.
I don't look like I'm sassing, and I must confess:
I don't reach with my hands down the front of my dress
To gain access to buttons on the front of that thing.
Now?  If I bolus? I thump on my Ping.

As much as I don't want to wear a device,I love that the Ping meter acts as a remote for the insuiln pump.  Badass.
(I'd rather my pancreas up and play nice)
I'm thankful that I can remote from my meter.
Makes living with diabetes just a bit sweeter.


[Animas disclosure]

October 18, 2010

Social Networks: Compatible or Competitive?

I was in Las Vegas, but it wasn't all just spending quality time with blogging buddies.  There was work to do - we were there for the Social Health track (sponsored by Johnson & Johnson, MedPage Today, Alliance Health, Campaign for Nursing, and WEGO Health) to help inform others about the discussions taking place in the medical blogosphere, and the power of these communities. 

The panel that I was participating on was Social Networks & The Medical Blogosphere:  Compatible or Competitive, with fellow panelists Kevin Pho and Bryan Vartabedian, moderated by the fabulous Kim McAllister.  The big question was "Are these social networking technologies helping or hurting the blogosphere?" 

The BlogWorld Panel - Kerri Sparling, Kevin Pho, and Bryan Vartabedian
Our BlogWorld panel:  Kerri Sparling, Kevin Pho, and Bryan Vartabedian

We, as a panel, gave this a lot of thought as we prepared for our discussion, and we ultimately settled on the answer of "Well … both." 

Blogging was the first online venture I participated in.  Back in 2005, I started my blog to help me connect with and participate in inspiring a community of other people with diabetes.  At first, I started posting several times a month, then once a week or so, until I realized that I've been posting every weekday for the last three years.  The posts are written by me, for the most part, and the comments are from the readers I have been blessed enough to have over the years.

So I blogged for a few years, but then there was this whole crop of different social networking tools that came on the scene with prevalence and relevance, with Facebook and Twitter leading the pack.  Our panel was trying to figure out whether or not these new tools were helping move the blogosphere forward or assisting in clipping its wings.

For me, the blog is my online home.  It's public-facing, open to any reader (whether they comment or not - I love the lurkers), and it's where I write daily about my life with diabetes.  While I do have a Facebook page (two, actually - one for my family only and then one for everyone else) and an active Twitter account, I would delete both of those profiles if it came down to choosing between them and my blog.  I like having "home base."  It makes me feel safe.

But my blog is almost always a once-a-day post, with comment moderation and responses.  I don't have a running, real-time discussion on my blog, like I do on networks like Twitter and Facebook.  (Maybe because "social networks" have mobile apps?  Is it true that online adventures are going more mobile, and anything that's not easily accessible from a mobile device will be left behind?) 

One of the questions was about whether or not participating in social networks impedes content creation and participation on your blog.  While I do agree that lots of comments take place on Twitter and Facebook, instead of in the formal comments section of my site, I don't think this detracts from my site.  Actually, I think it helps extend its reach, in a controlled way.  Links are reTweeted all over the place and Facebook friends often leave comments on the Six Until Me page, so the discussion is taking place in a lot more venues, giving the chance for diabetes-related commentary to reach outside the confines of our little (but powerful!) blogosphere.

Sites like Twitter and Facebook help to drive traffic back to blog content.  Also, Facebook helps provide a more "shielded" area for health care discussions.  Twitter helps flesh out the patient personality behind the blog, giving real-time access to disease management strategies.  Twitter and Facebook also offer a place to share links that might not inspire a full blog post (or ones that don't have any diabetes relevance at all). Posting pictures and thoughts that I'd prefer to have either in short-form or "behind the wall."  Each different posting venue (i.e. blogging, Tweeting, or Facebook) has its own set of pros and cons.  But, without a doubt, all three can be time-consuming.

But there can be waaaaay too much naval-gazing on fast-paced sites - Twitter in particular - ("I just ate a croissant and am now covered in flaky bits.")  and it can be challenging to make a discussion point within the 140 character limit.  Also, applications like Foursquare can be very dangerous if people are givingThe battle of what tool will conquer the medical online community! too much information about their regular day's business.  Sharing information like that opens Tweeters up to stalking issues. 

What's the future?  I think blogs will remain in the mix, and a big part of the discussion. If a blogger can retain their editorial integrity and keep their online presence consistent, blogging and social media can and will go hand-in-hand.  I believe that people will phase out of the "Oooh, how many 'likes' do I have today?" and will move away from the popularity contest aspect of social media.  Instead, good content will rise to the top.  As it always does, regardless of the newest and shiniest tool.

Do you think Facebook and Twitter are going to kill the blogosphere? (Is a "blog" become like a rotary phone?) Or will dedicated bloggers stand the test of time and new technology?  

October 15, 2010

Vegas Meet Ups!

Since I arrived here in Las Vegas on Wednesday morning, it's been a revolving door of some of my favorite people in the medical blogosphere.  And it makes perfect sense, since this is the BlogWorldExpo conference and the Mandalay Bay is teeming with bloggers.  Thanks to the Social Health track that ran yesterday (much more on that tomorrow), I've had the pleasure of meeting up with plenty of familiar faces.

There is so much to tell, and so much information to relay, but for now, I'm going to rely on the power of pictures (because this three hour time difference is seriously kicking my productive rear):

Taking a break between tracks.
Scott Johnson, Jenni Prokopy, Amy Tenderich, Kerri Sparling, and Manny Hernandez

Scott is our bodyguard.
Mollie Singer, Kerri Sparling, Scott Johnson, Jenni Prokopy, and Jackie Singer

They say that what happens in Vegas stays in Vegas, but I'm excited to share all the stories with everyone ... once I have a nap, that is.

(And, total sidenote - Happy Birthday to my little sister today!)

October 14, 2010

Lows on a Plane.

I just want to get these motherferning lows off this motherferning plane.Yesterday morning, I boarded my flight at 7:15 am.  (Which means I was up at 4 am, and then crossed into the strange time-space continuum into the Pacific time zone, which means I am bleary-eyed and totally confused about what time it actually is right now).   Since it was such an early flight and since I'm trying my hardest to avoid taking medication to fly, I decided to take this trip without my trusty xanax prescription.*

*  It's in my bag, but I'm not planning on using it.  It's only if I have a wicked panic attack or something before the flight.  

With the Dexcom plugged in and doing its thing, I felt pretty on top of the diabetes crap.  My blood sugars were holding in a nice pattern of the low 100's, and my snacks were heavy on the protein side, so I wasn't anticipating any serious issues.  

About three hours into the flight, I noticed that the music piping through my headphones sounded off.  I couldn't put my finger on what the issue was, but there was something decidedly swimmy about the sounds.  Then I felt a vibration near my foot - the Dexcom wailing and twitching inside of my purse.  I reached down and retrieved the little football-shaped receiver to see a "LOW - Under 55 mg/dl" on the screen.

Five minutes passed and I still felt horrendous.  My meter flashed me a 48 mg/dl.   I needed a liquid solution to work through this low.  So I got up from my seat and went back to where the flight attendants were sitting.

"Sure thing."  She reached for a plastic cup and started to fill it with ice.  

"Not a problem."  She handed me the aluminum can of orange juice and I chugged half of it down without breathing.  

"You okay?  Do you need to sit down?"

"I'll be fine in just a few minutes.  Thanks, though."

And I went back to my seat, plugged my headphones in, and listened to some music while my blood sugar started to rise.  A few minutes later, I noticed the stewardess was kneeling by my seat.   I took my headphones out.  "Hi again!"

She smiled.  "My sister's husband has diabetes, so I know how you can be totally wiped out after one of those lows.  I can't wait to call her when we land, so I can tell her I saved one of you guys!"  She smiled, patted my arm, and walked back to her seat.

I laughed to myself.   "One of you guys."  Like we're diabetes collectibles.  (We should totally have baseball cards.)

October 13, 2010

Interview with a Fellow New Mommy: Kim Lyons.

According to her website, Kim Lyons' goal is to "help the world become a healthier place ... physically, mentally, and emotionally."  I can subscribe to that.  Trainer from the Biggest Loser and national fitness guru, Kim gave birth to her son, Jake, about four months ago.  And I can attest to the fact that the girl has gotten herself back into shape right quick - I met up with her at the TCOYD conference in Providence a few weeks ago and she looks like she bounced right back.

Kim agreed to chat with me about fitness, pregnancy weight gain, and coming back from the post-partum body changes.  (And now I feel even more inspired to get my rear end in gear!)

*   *   *

Kerri:  As a prominent figure in the fitness world, how did you deal with the weight gain of pregnancy, both physically and emotionally?

Kim, pregnant.Kim Lyons:  As a trainer, I have a simple straight forward approach, No Excuses, period. I have heard them all, too tired, not enough time, this or that hurts, no money, etc. Bottom line, I will find time in your schedule, I will energize you with exercise, I will work around injuries, and I will give you thousands of exercise you can do for free with out a gym! I simply do not entertain any excuses.

When I found out I was pregnant, I was so excited. It not only explained my odd cravings and complete zombie state of mind but it explained my “less then aggressive” workouts. I’ve spent 15 years learning to listen to my body and for weeks my body had been screaming “slow down”. There really was no pushing through. I’ve been tired for workouts many times before and managed to still get in an intense workout. This was different and as soon as I saw the results on that little white stick it became so clear.

I never thought of pregnancy as a challenge. It was going to be simple, I’d just go about my normal routine and I’d have a little basketball belly.  All of the sudden, my hormones were a bit off (I cried about folding laundry), the scale went nuts (I gained 10lbs, not 3lb, in the first trimester), and the comfort level of my bed took on a whole new meaning! I quickly realized that, more then ever, I was going to have to crack down with my own motto and make a no excuse plan for myself.

That plan included mentally accepting the massive changes that were going on in my body and coming up with an exercise and nutrition game plan! My workouts needed to be short, effective, and accommodate for the changes in my body. My nutrition was no longer about maintaining a six pack, instead, it was about supporting the little life inside me. My little bionic body was no longer selfishly mine to beat up with daily workouts and a strict low calorie diet!

I truly thought it was going to be easy, but the truth is, there were many times when I looked in the mirror and cried. I felt so guilty for being so vain about my six pack, perfectly sculpted arms, and tight little buns. I have spent the last 15 years of my life studying the human body and how to get anyone, big or small, into top shape. For the fist time in my life, I was faced with a new challenges, I wasn’t in 100% control of my body. It wasn’t all about me anymore!

My vision of just gaining a little basketball belly was replaced by the mirror image of my arms smoothing out, my hips widening, and my boobs taking on a life of their own! The closet became my worst nightmare!
The good news is that as I settled into the pregnancy, I took on a new frame of mind. I decided to really embrace the daily changes going on in my body and follow my own no excuse approach. This workout includes a few of my favorite moves to help you keep your body in shape during your pregnancy, prepare your muscles for lifting and carrying your new little baby, and having a great and healthy body in the years to follow.
Most challenging…

The most challenging part of exercising while I was pregnant was the extra weight and the lack of flexibility in my mid section. Everything became awkward and difficult, even simple daily movements. Reaching down to pick something up no longer was a simple thoughtless movement, instead I had to think, wide squat-like stance, toes out, not to fast, sit back in the heals, and keep the abs tight as possible to support the back.
I gained 30 lbs during my pregnancy and I felt everyone of them as I walked up and down the two flights of stairs in my house. Walking became great exercise where before I never huffed or puffed or broke a sweat on a daily walk.

Most enjoyable part was that during my pregnancy I took the time to stop and smell more roses! Literally!! Usually I exercise with such focus and intensity that I don’t take time to slow down and smell the flowers. While I was pregnant I went on walks with friends, spent quite days in my home doing these exercises between errands and emails, and even worked out at the same level as some of my beginner clients. Once I set my mind to except slowing down, I really enjoyed it!
Kerri:  Babies are a lot of work, and taking care of them takes up a good chunk of our days.  As a Kim Lyons and her little kidlet, Jakenew mom, did you find it difficult to work in working out into your schedule?  What helped you get back into shape so quickly?

Kim Lyons:  I do find it challenging, new moms don’t have much time for themselves and when there is some down time sleep and other “to-do’s” tend to fill the time. However, at the end of the day we make time for the things that are most important and that is exactly what I had to do. I allowed myself to be flexible with when I got in my workouts, but I didn’t allow myself to skip them. I began slowly with 30 mins min exercise a day. Some days I was able to get in a bit more. I think a lot of women feel guilty asking someone to help out while they go work out, but it’s so important for mom’s to make time to exercise. It cannot only help with self esteem, but it can also help women avoid post partum depression.

Of course being in the public eye and returning back to work about a month after having Jake was a huge incentive! I have had so many women over the years say “wait until you have kids” or “you obviously don’t have kids” and I wanted to prove to everyone that you can do it. I had someone say that to me at a conference not long ago and I was so happy to say, “Actually, I have a 3 month old baby.”  Her face was priceless. It’s not easy, but I don’t except excuses from my clients and I sure the heck wasn’t going to allow myself to make excuses!
Kerri:  My husband and I are excited to make playing and running around a part of our daughter's upbringing.  How do you plan to instill the values of physical fitness and regular exercise into the life of your child?

Kim Lyons:  I want Jake to see exercise as fun. I grew up playing outside, climbing trees, playing tag, and playing sports. Now it seems kids just sit around and watch TV, sit on the computer, or play video games. Our food is getting worse and our kids are becoming less active. I don’t care if Jake is a super athlete, but I’m going to make sure he finds something active that he loves. I’ll expose him to martial arts, gymnastics, soccer, football, baseball, and anything else he wants to “play”! We’ll spend weekends and free time riding bikes and going for hikes instead of sitting around eating fast food!! Kids learn everything from the examples their parents set!
Kerri:  What advice do you have for someone who is looking to achieve a new level of fitness?  Any inspirational tips or suggestions on how to make fitness a priority?

Kim Lyons:  Achieving a new level of fitness requires total commitment and consistency. It’s important to find things that you enjoy whether it’s in a gym or not. It’s also important to have a support system. Find friends to help hold you accountable, put dates on the calendar, and set goals!
Kerri:  You work closely with the diabetes community, with appearances at the TCOYD conferences and other diabetes outreach events.  What made you get involved in the diabetes community?

Kim Lyons:  While working on The Biggest Loser I saw the impact that exercise and proper nutrition can have on people with diabetes. However, most people that have diabetes or are pre diabetic go to the doctor not to a trainer! Don’t get me wrong, they need to go to the doctor, but it is a trainer that can help get these people moving and eating properly. I saw a huge need for some help in the diabetic community and I have really embraced them. I am so passionate about helping people live healthier, happier lives.
Kerri:  What kind of difference are you looking to make in this community?

Kim Lyons:  I want people to see that diabetes is not the end of the world! With proper exercise and nutrition it is totally manageable. My goal is to help educate people about the common complications of diabetes, primarily pDPN [diabetic nerve pain].  pDPN can be very painful and many people give up on exercising. However there are so many ways to treat pDPN and exercises that they can do. I’m involved with the “Take the Next Step” campaign and travel around showing people these exercises.  You can also see them on line and read all about pDPN at www.diabetespainhelp.com
Kerri:  Through your experiences with the diabetes community, have you learned anything about this disease that surprised you or changed your previous perceptions?

Kim Lyons:  It surprises me how many people with diabetes don’t take care of themselves. We only get one body and one life and I just want to help people learn how to manage there diabetes and get back to doing things they love. There is so much information out there, it can be overwhelming, but at the end of the day if they take one step in the right direction it could save their lives.

Kerri:  Any other thoughts you'd like to add?

Kim Lyons:  I have an incredible on line training website that embraces all elements of living a healthier lifestyle. We help everyone from all over the world and have an incredibly support group of trainers, challenges, retreats, prizes, live chats, and a daily video blog from me! It’s really fun and amazing to see how much people love it and are achieving incredible results. The site is www.FastTrackToFatloss.com

*   *   *

Thanks, Kim, for both the information and the inspiration.  And your kid is a cutie - does he like older women?  Like almost six month olds

October 11, 2010

No Pancakes for Pancake.

Before BSparl was born, I spent a lot of time focusing on the pregnancy.  (You guys know this - my blog was littered with "I can't get my A1C low enough!" posts before she was conceived, and then the "OMG I need to protect this growing peanut" posts while she was inside.)  I was so focused on the Get Pregnant/Have Baby process that I sort of forgot to look into the Once She's Out adventure. 

Chris and I learned how to be good (we hope) parents as we went, gaining knowledge from books, websites, our doctors, and that thing called trial-by-fire.  (Something about changing the diaper of a wiggly three week old in the dead of night helps your brain learn the process real quick.) Like any other new parent, we worried about just about everything.  But there was one unique thing that we were concerned about, and it was BSparl's chance of developing type 1 diabetes.

I've written before about The Thought and how we do our best to keep it from ruling our life.  Honestly, we don't give it much of our attention at all - we know the warning signs of diabetes, and if they ever present themselves, we'll pick up on them immediately.  But I can't go dipping a ketone stick into her soggy diaper every day because I will make myself absolutely insane.  

There are a few things I can do to help "prevent" type 1 diabetes.  And I use "prevent" in quotes because the genetics are what they are, and I don't think I can do much about them.  But there's this weird, antenatal checklist that I felt the need to follow, in effort to keep any diagnosis at bay as long as possible. 

Topping that list?  Breastfeeding.  As I've mentioned over and over again, breastfeeding your child is NOT what makes you a good mom.  It's jut an option for feeding, and one that I chose.  But part of the reason I chose to breastfeed was because of the research that pointed towards breastfed babies having a lower incidence of type 1 diabetes.

Pacifiers are out the window now that the kid has discovered how delicious her thumb is."But Kerri, you were breastfed!  And you were the only one who was breastfed in your family.  What gives?"  I know, right?  (See also:  crapshoot)  But one thing I came across in my research on raising BSparl was the importance of vitamin D in relation to type 1 diabetes.  Breastmllk doesn't contain much vitamin D (if any), and my pediatrician and I decided that adding vitamin D supplements to BSparl's bottles was a good idea.  So at the two month mark, I began supplementing the kiddo with Tri-Vi-Sol drops.  

And the third poke on this trident of attempted prevention is the decision to go gluten-free for the baby.  Research on type 1 diabetes in children pointed to some studies about how a gluten-free diet may help prevent a diagnosis in NOD mice (oh those frigging mice - always gettin' cured).  Will it hurt my child to avoid gluten for the first year of her life?  Not even a little bit.  So BSparl will enjoy rice cereal and vegetables and fruits and protein, but the Pancake won't have any pancakes until she's a year old. 

One thing we didn't decide to do was the soy protein route.  Research on the cow's milk protein and the soy protein gave me all kinds of reasons to go with, and to avoid, both kinds of formula.  I was completely torn.  (But Bsparl wasn't - she hated the soy formula and puked it up regularly.)  After talking with my team at Joslin and then my pediatrician, it seemed that using whatever formula worked best for the baby was what I should go with.  So once we were done breastfeeding, we used Earth's Best Organic formula with DHA and Iron.  Going organic for BSparl was something we wanted to do not just because of the diabetes component, but because of all the crap that's in "regular" food.

Could it all be weird science and old wives tales?  (Not that the NIH tells old wives tales.  They tell old lab coat tales.)  Perhaps.  I could be working hard to ward off a diagnosis that isn't coming, or pointlessly trying to avoid one that is.  But these are the parenting decisions Chris and I made as a team, and it's not a recommended course of action for other parents who have a history of type 1 diabetes in their family.  It's just what we decided to do.  To each set of parents their own.  We do our best, and that helps me fall asleep at night. 

That, and sheer exhaustion.  :)

October 10, 2010

An Apple a Day.

Fall is here in New England and it's shaping up to be a very pretty one.  Chris and I decided that since BSparl is now more mobile and fun to take places (i.e. she only poops every other day, so we know we have one full day of "safety" while traveling), we'd give a go at her first apple picking adventure.

Ye olde apple tree

We sampled an apple or two before picking some, just to make sure we liked the ones that were on tap.  (Once, Chris and I went to a berry picking farm and ate way more than we had picked and then we had stomach aches for the rest of the day but we were happy.  /pointless story about berry theft)

Apples on the tree.  Exciting, no?

There were golden delicious, red delicious, macoun, and smooshed apples everywhere.  BSparl hung out with me in the Baby Bjorn, and I spent most of the afternoon making sure she wasn't being poked in the face by any branches. But she was amazed every time her dad climbed up into a tree to retrieve apples, because he would just shimmy up there.  (I was impressed, too.  Can't lie.)

Kerri and the Baby Biscuit, apple picking

BSparl is getting bigger, and walking around with her in the baby carrier is actually a bit of a workout.  My blood sugars edged towards the lower end of the 90's all day long (I sound like a diabetes meteorologist - "Partly low with a chance of highs.") and I grabbed bites from an apple here and there to keep my blood sugars from crashing. 

But now I'm faced with bags of apples on my kitchen counter and this increasing desire (but lack of knowledge) to make a pie ...

October 08, 2010

Stubborn Fool.

Last night, I went to the gym later in the day - around 7:30 pm.  Chris was home with BSparl and I couldn't wait to have an hour to myself and to watch Project Runway on the gym televisions.  (Yes, a month of hospital bedrest will indeed make you addicted to weird reality tv shows that make you talk about what an obnoxious sasshole Gretchen is, as though you know her.  /digression)

I'm on the elliptical and plugged in, watching tv while I work out.  About four minutes in, I see this weird spot in the bottom right hand corner of my right eye.  Nothing too dramatic, but just this nagging little floaty thing that makes my eye feel like it has a filmy cotton ball covered the bottom portion of it. 

I continue my workout, and at the seven minute mark, my sneakers feel like cement blocks and that eye thing is still foggy.  And this thought actually goes through my head - "Should I test?" - but because I am a stubborn fool, I don't quite yet.

I reach for the Dexcom receiver, only to realize it's at home on the coffee table.  So I walk for a few more minutes, not realizing I'm listing to one side and hanging on to the hand rail.  (But once my brain starts musing about how I'd maybe wear some of those Project Runway outfits, it dawns on me that I should probably test like right now.)

A bright, shiny 43 mg/dl smiles back up at me from my meter.  The eye thing, the cement feet, and the headache suddenly magnify.  But I am a stubborn fool.  And for some stupid, stupid reason, I decide to keep going.  I bring the treadmill back to a 0% incline and reduce the speed to 2.0 miles per hour.  The sports bottle I brought with me, filled with juice, is drained in a millisecond, and then I just plod along.  Plod, plod, plod.

Internal Motivational Speaker pipes up in my ear.

"Kerri.  Get off the treadmill, you stubborn fool.  You are going to hurt yourself.  Your blood sugar is way too low for you to be physically exerting yourself."

I keep plodding.

"Are you ignoring me on purpose?  Because I can go all night, lady.  You'd better listen up and get yourself off the treadmill and sitting tight until your blood sugar comes up."

I furrow my brow.  "I don't want to.  This is the only time I get to myself all day long and I am determined to banish this abdominal fluff and seriously?  This low is making me so mad at diabetes crap that I want to throw something.  So no, I'm not stopping.  I'll go slow.  I already drank the juice.  And I'll test again in a few minutes.  But I'm not stopping."

I know I should have quit as soon as I saw that low number, but I didn't.  I am stubborn.  I walked slowly and unsteadily for a few more minutes, and then my sneakers felt a bit lighter.  And my eye fog was lifting.  It wasn't until the Project Runway outfits started to look ridiculous again that I felt completely better.  Quick blood sugar check showed me an 81 mg/dl.

"This could have ended badly, you know," said my Internal Motivational Speaker as she filed her nails. 

"I know."She totally looks like this.

"You're a stubborn fool, Ms. Kerri.  You need to listen to me sometimes, even when you don't want to."

"I know that, too."

"Okay.  Next time, you sit out for a few minutes, just to be on the safe side." 

"Fine.  I will."  I glanced up at the tv again.  "Dude, Gretchen looks just like Skeletor."

"She totally does."

October 07, 2010

The Inside Track.

Today's post is an interview with a screenwriter who lives in my house.  He wrote the film Buried, starring Ryan Reynolds and directed by Rodrigo Cortes.  His name is Chris Sparling, and he has some thoughts he'd like to share with our fabulous diabetes community.

*   *   *

In theaters October 8thKerri:  Hi, Chris.  Welcome ... to our home.

Chris:  Thank you for having me.  (He grins, tolerating my ridiculous questions.)

Kerri:  So Buried came out in limited release on September 24th, and it's been expanding into more theaters ever since. 

Chris:  Yes, it's a very expansive film.  (He smiles again.  Ruefully this time.)

Kerri:  The full release is October 8th, right? 

Chris:  Yeah.  It's going a little wider this weekend, but there are still some theaters that won't be getting the film until after October 8th. 

Kerri:  How do you feel about the finished product?

Chris:  I couldn't be happier.  I saw it for the first time back at Sundance and, like everyone in the crowd, I just marveled at what Rodrigo had done with my script, and the incredible performance that Ryan turned in.

Kerri:  So what has the response to the film been like?

Chris:  We couldn't have asked for much better from the critics.  I think right now it's at 87% 'fresh' on Rotten Tomatoes and Roger Ebert gave it 3 1/2 out of four stars

Kerri:  What about "real people."  Like actual people going to the movies?

Chris:  For the most part, they're enjoying the film, too.  It seems that if people aren't liking the film, they went into it thinking it's something that it's not.

Kerri:  Like a cartoon?

Chris:  No, they definitely knew it wasn't a cartoon.  But I think some people thought it was a horror film.

Kerri:  Guy in a coffin kind of sounds like that, doesn't it?

Chris:  In 99 out of a 100 films, that would be the case.  It would be a horror film.  But that's what makes Buried different.  Even though it's a horrific situation that the main character is faced with, it's not a horror film:  it's a dramatic thriller.  It's not about torture, and you're not going to be scared by this movie - unless you're severely claustrophobic.  Buried is an intense, movie-going experience - and a lot of people have been surprised by the amount of drama and social commentary in the movie.

Kerri:  Wow.  That's a serious answer.  Have you been practicing that?

Chris:  No, I think scripts are over-rated.

Kerri:  Hang on, let me get my rimshot.  Okay, so did you know that the whole diabetes community has been rallied behind you and your movie?

Chris:  Yes, I have.  And I've been so incredibly grateful for that support.  

Kerri:  Did you know that George and Scott went to see your movie the other day together?

Chris:  Yeah, those guys are awesome.  I've had the pleasure of meeting both of them and I can see why they're such rockstars in the diabetes community.  They're genuinely kind human beings.

Kerri:  And Scott didn't even get mad when the baby puked on him at CWD.

Chris:  I still owe him one for that.  

Kerri:  So overall, you've had the critics giving high marks to Buried, but you've also had a whole pile of people with diabetes who've had your back.  We've been following and supporting your journey since it was announced last year, and I'm telling you, the theaters that are screening Buried better have plenty of juice on hand because their seats are packed with insulin-pumping PWDs. 

Chris:  All I can say is thank you.  That's what I've always found amazing about the diabetes community, is that it's not just about the people who are living with diabetes, but the people who love them, too.  And that's the way it should be, because at the end of the day, we're all in this together.

Kerri:  (mimes violin playing on her shoulder)

Chris:  Kerri, I'm serious.

Kerri:  I know.  I'm just so proud of you, and I know our daughter, our friends and family, and the whole diabetes community is proud of you, too.

Chris:  Thanks.

Kerri:  And Siah is also proud of you, you know.

Chris:  I can't stand that cat.

*   *   *

Buried opens nationwide on October 8th.  You can like it on Facebook, or on Rotten Tomatoes, or on IMDB.  If you'd like.  And, as always, thank you guys for all of your support.  It means the world to me and my family.

October 06, 2010

Appreciating the Dexcom.

After BSparl was born, I was overwhelmed with adjusting to life as a mom, and diabetes took a backseat to just about everything.  I was healing from my c-section, attempting to snap up all the snappy things on BSparl's clothes, and figuring out how all the pieces were coming back together after having been completely blown apart.

I experienced some extreme diabetes burnout, where I stopped exercising, cut way back on testing my blood sugar, and the Dexcom receiver collected dust in my bathroom cabinet.  

But I've been really trying to get my act together here.  Now that we're quasi-settled in our new house, I'm back at the gym, testing with an increased frequency, and tuning back into my diabetes management.  I couldn't force these issues, though.  I needed to get things rolling again once I was really ready, and not beforehand.  With BSparl a little older (almost six months old!) and her schedule actually resembling something plot-table, I knew it was an okay time to start focusing on myself a little more.

I'm resolved to make exercise part of the equation once again, and I'm doing well with that goal.  And to be filed under "TMI," I'm keeping my glucose meter on the bathroom counter and am testing after every visit.  (Sounds weird, but it helps me remember to test and helps shrink the gap between blood sugar checks.)  And I'm back to Dexcom'ing it 24/7.  

I didn't realize how much I missed this thing until I took a few weeks off.  

Dexcom warrior rides again!

It's easy for me to slack off when I'm avoiding my glucose meter.  Mostly because my glucose meter doesn't scream at me every few hours.  But the Dexcom does.  Once it's on and calibrated, it BEEEEEEEEEP!s every time I'm high, low, or if it needs a blood sugar number.  I am the puppy to its Pavlov, and having this sensor stuck to my body doesn't feel as cumbersome as it did when my stomach was swollen with BSparl and then recovering from birth.  I feel ready for this information again, instead of overwhelmed by it, and I'm ready to make use of this data.

In the last two weeks, my meter average has come down from 179 mg/dl (ouch) to 148 mg/dl.  And I'm hoping that I can bring it down a little more in the next two weeks, hopefully while avoiding the extremes on either end of the spectrum. 

While I know plenty of people with diabetes wrangle in their numbers without the use of a CGM, I seem to be better off with one.  Something about that constant stream of information keeps me both accountable and tuned in.  Even though I'm not a fan of wearing a second device (hello, skin real estate issues), my health is better for it.  Sometimes it takes coming back from a round of diabetes burnout to remind me why I fought so hard for this device in the first place.

[Dexcom disclosure]

October 05, 2010

Change Just One Thing.

If diabetes were a goldfish, I'd flush that little sucker.Recently, I was asked to answer a few questions for a company that was looking to better understand people with diabetes.  I expected a list of questions ranging from "What color meter do you prefer?" to "List all medications you are taking to treat your diabetes, and why." 

Instead, the questions were more touchy-feely than I had anticipated.  And a few of them were hard to answer.  The one I struggled most with was "If you could change one thing about living with diabetes, what would it be?"

My first response was to shrug.  "Everything?  I'd change everything?" 

Then I regrouped a bit.  But still, an answer wasn't jumping into my head as easily as it had for the prior questions.  Somehow, "What or who serves as your motivation or inspiration?" was much easier.  

I'm only guessing, but I think if diabetes comes into your life when you are older, there's a distinct "before" and "after" to your life timeline.  You remember when insulin injections or pumps or glucose meters weren't part of the equation.  You know what it's like to drink juice purely for pleasure.  You have a sense of what you're missing, of what's changed.  I'd imagine that concept makes a diagnosis both easier and infinitely harder, on so many levels.

Diagnosed as a kid, I don't have many pre-diabetes memories at all.  I'm not feel sorry for myself, but it's just a fact.  I don't remember life without any of this medical stuff, and there is no "before."  Just "after."  Only the after part isn't this big dramatic change - it's just "life."

So when asked what I'd change about living with diabetes, I don't have enough life without it to lay claim to a quality answer. I don't give a lot of thought to the meters or the pumps or all the physical trappings of diabetes.  I don't mind because I don't know any differently. 

But I wish I could lessen the emotional impact of diabetes on my life, and on the lives of the people I love.  I wish diabetes wasn't such a fickle mess, and that my mother could safely assume that I'll wake up just fine every morning.  And that my husband wouldn't view the Dexcom as his safety net when he travels without me.  And that I wouldn't have seeds of concern when I'm alone with my daughter.  I wish this stupid disease didn't come with so much worry, and I really would love to change how that worry bleeds into the lives of my loved ones.

If I could tie diabetes to a balloon and let it soar out of my life, I totally would.  If I could flush it down the toilet like a goldfish, I'd do that, too.  I'd let a bear maul it.  I'd allow my diabetes to stick a fork into a plugged in toaster.  And if I had the opportunity to shove it in a microwave like a Peep at Easter, I'd do it in a second.  I'm not a fan of this disease, especially when it makes people worry. 

So I guess my first response was sort of right.  "I'd change everything." ... only I'd add balloons, microwaves, and bears.  ;)

If you could change one thing about your life with diabetes, what would it be?

October 04, 2010

How Do You Bolus for Art?

Over the weekend, Chris and I took a trip up to The Balsams hotel in New Hampshire.  We were there for an event for Chris's side of the business, and part of the event included a dressy dinner with food that was far fancier than the turkey and cheese sandwiches my pallet is accustomed to.

The welcoming sign

So here's a problem I've never encountered before:  when the food looks like something from MoMA, how do you bolus for it?  Our menu included items like foie gras and tuna tartare with carrot gelee ("gelee" = carrots that enjoy Glee, at least in my head), and I didn't have a clue as to how to actually eat it, nevermind the concept of carb counting it.  It's moments like these that make the Dexcom indispensable.  By keeping an eyeball on the graph, I felt more comfortable going to bed that night, knowing that I wasn't bottoming out.  It was a tricky dinner, of plates with an architectural and artistic flair and I bolused willy-nilly for them.

And by "willy nilly," I mean that I cranked up a few tenths of a unit every course.  it was trial by foie gras fire.  I wasn't sure how to shoot for the salted caramel-tangelo sorbet, or jambom de Paris.  (Can you tell I'm copying these words right from the menu?  I was relieved when the tenderloin arrived, because I knew what it was.)  I mean, how do you bolus for art?

Thankfully, the grounds of the hotel were far less intimidating than the food, but no less impressive.  The garden alone, comprised of more than 1500 flowers that are planted during the course of one, single day (check out this time lapse video), held my attention captive for quite a while:

Part of the hotel - tell me that doesn't look haunted to you??

The hotel itself was a living, breathing entity with more history and charisma than your average Doubletree.  This place looked as though it was the inspiration for countless short stories, and we heard that Stephen King used The Balsams as his mental catalyst for The Shining.  Chris and I (directionally-challenged, as always) ended up happily lost in the beautiful halls of this hotel more than once during our short stay. 

The gardens at The Balsams.

And despite the five hour drive, the lack of coffee (I need to have a second pump just to ensure 24 hours of caffeination), and the fact that my infusion set rolled off my arm the precise second I lay my head down on the pillow to go to sleep (was awesome: had to leap up and put in a new infusion set at 1:30 in the morning), it was a leaf-peeping drive and a quality getaway.

October 01, 2010

Joining the Gym.

We moved at the very end of August, and when we left our apartment, we also left behind our gym.  Lovely, right-there-in-the-building gym that was easy to get to because it didn't require getting into the car and trekking across town.  I worked out for the majority of my pregnancy, thanks to this gym, and only stopped when pre-eclampsia started to make my body its home.

Yesterday morning, I weighed myself and saw that I'm back to my pre-pregnancy weight, numbers-wise.

"Whaaaa?"  I said, looking into the mirror and assessing the various areas of squish.  "This is not how I looked before that little biscuit of a BSparl arrived."

Weight, for me, has never been a numbers game.  I've never cared in the least about what winks back at me from the scale, but more how my clothes actually fit.  Over the years, my weight has fluctuated due to muscle mass, stress, season (summer = ice cream), and work schedules, but overall, I've remained the same general size.  

But when BSparl came into town?  (And by town I mean "uterus.")  Chaos.  My body has taken on shapes I have never seen before.  Contents definitely shifted during landing, and I'm looking at a whole new me when I see myself in the mirror.  And honestly, I'm not the biggest fan of what I see. 

Some things, I'm fine with.  Like the scar from the c-section.  It's a sizable sucker, but it's proof positive that my baby came from my body, and I'm reminded of that every time I see her.  Some women call it a badge of honor.  I'll take that.  The stretch marks?  I'm less snuggly with those, but every week they fade a little more and every week I notice them a little less. (And Palmer's cocoa butter helps.)

Other changes in my body can be filed under "changeable," and now that BSparl is five months old, we've moved, and my travel schedule is about to lighten up over the holidays, I'm fixin' (nod to NBF) to get myself back into shape. 

So last night, I joined a gym.  And I worked out for the first time since we moved into our house.  Granted, it wasn't the most aggressive of workouts, but I was there.  I spent 45 minutes on the cardio circuit, and even though my weight didn't shift even a smidge, I felt worlds better when I left.  Like I wasn't just sitting at home, wishing I was making a change.  There I was - making it.

At the end of December, I'll be in Marco Island with my family and my extended CWD family (including my daughter's favorite spit up target, Mr. Scott Johnson), and I want to feel good about how I look when I'm there.  I have three months to reign things in, and I know that - for me - with exercise comes better diabetes control. 

Hear that, Larry?  You thought you shook me off for the last few months?  Pfffft.  I'm comin' for you.

Shhhh!  Larry is always watching.

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