This prompt makes me think of this:  "Type 1 diabetes?  At least it's not [insert other health condition here]."

I am not comfortable with this prompt.  Mostly because it makes me feel lucky for how things are, and at the same time apprehensive about how they make shake out.  And I can't reconcile those feelings; I can't bake them together into something I can swallow.

I feel lucky that, of all the chronic illnesses that I could be living with, I have type 1 diabetes.  "Lucky" actually feels like a dirty word, the wrong word, and I wish there was a word that would better exemplify that it's not "luck," but thankfulness for treatment options, coupled with thankfulness that I was born and raised in a country where my educated, employed parents had access to not only the drug I needed to stay alive, but also the means to provide education that would help me make choices and decisions that contributed to improved health outcomes.  This thankfulness comes part and parcel with an appreciation for how invisible type 1 diabetes can be, and how I don't look, or feel, very sick on a day-to-day basis.   I'm grateful that, even though my immune system has buckled in that one sense, I can survive.  I feel lucky.  This disease requires a lot of effort every day simply to hit stride with "normal," but most of the time, it's not something that keeps me from having a good day.

And exactly at the same time, every day is laced with an apprehension that I can't quite put my finger on.  While low blood sugars are brief in duration, sometimes they are so intense and honestly scary that they leave me nervous for hours, or weeks, afterward.  Sometimes the threat of a low is enough to kick apprehension into gear, like when I'm cramming extra glucose tabs into my Spibelt when I go for a run, picturing myself a few miles from home and wandering, disoriented and severely hypoglycemic.  Before I go to bed at night, every single night, I check the IOB on my pump and the graph on my Dexcom and I try to calculate the probability of an overnight hypoglycemic event that might be easy and quick to treat, or that may be the moment that changes everything.  And while high blood sugars aren't comfortable while they play out, I am apprehensive about what that 150, 190, 250 ... 300 mg/dL does even during it's brief visit.  Even though my body appears to work and seems healthy, this disease makes my body unable to self-manage blood sugar levels, and sometimes the worry about what is happening to the actual cells of my body is enough to fill my mind with troubling thoughts about what may happen, despite my efforts.  This apprehension now is without my dealing with marked complications, without other health conditions in play.  And that makes me more apprehensive about how the future may unfold.

This disease is a mental bowl of marbles, some black with worry, some white with hope, but mostly filled with gray ones of varying shades, where worry and apprehension and hope and fear and joy and life mix together.  "At least it's not [insert other health condition here]." But isn't that every health condition?  Doesn't everyone who is living with a chronic health issue, or taking care of someone with one, deal with a very constant and unique thread of chaos and comfort, braided tightly?

I wouldn't want to switch with anyone.  And I wouldn't want anyone to have to switch with me.  I don't like anyone's body being compromised in any way.  But at the same time, everyone who is managing a health "something" becomes part of my extended community.  Through diabetes, I hope I am learning about empathy, and hope, and not only other people's health conditions, but the human condition.

My smallest accomplishment?  My littlest friend:

Enough said.

[For more posts on Accomplishments, Big and Small, check out these links!]

I remember calling out for my mom, but the words lost their form and letters fell into a heap on the staircase.

I remember my mom sitting on the kitchen floor with me, breaking graham crackers into smaller bites and putting them in my mouth, dinner burning in pans on the stove.  I remember my mom's eyes being very wide but she wasn't crying.  I remember a glass of juice.  I remember it was hard to chew because I was crying but I wasn't sure why, and then there's a sharp edit in my memory, where I don't have any recollection of what happened next. 

As quickly as it came, the low blood sugar passed.  I don't remember what caused it.  I don't remember recovering.  I don't remember what my face looked like, or how empty my eyes must have been, or what I sounded like as I crawled up the stairs, calling for my mom.  I don't remember thinking about it for days afterwards.  I don't remember feeling affected by it for more than those few minutes.  

I think about my mother, cleaning up the cracker crumbs and placing the juice glass in the sink, salvaging what was left of the dinner she was cooking, trying to forget.

[For more posts about Memories on D-Blog Week, check out these links.]

Oh yeah.

EXERCISE. 

We, the undersigned, understand that exercise isn't just for bringing down a high blood sugar.  It's not just "for people who have diabetes."  Exercising your body is something that everyone, regardless of health status, should be attempting to do on a very regular basis.  Sitting at the computer and writing emails?  Necessary for work and financial survival.  But going for a walk - or even a run? - and getting your heart rate up and your blood flowing?  Necessary for the continuation of your life.

As a person with diabetes, I put an undue amount of focus on my A1C level, or on the snapshot blood sugar grinning back up at me from my meter.  These things matter - quite a bit - but there are a lot of other aspects of my health to take into consideration before stamping me with the seal of "good health" approval.  (That seal looks like this.) 

What matters, in addition to these diabetes-related health obligations, is my overall health.  The stuff that matters to most bodies, not just our pancreatically-challenged ones.  Namely, exercise.  

I feel that, growing up with type 1 diabetes, I regarded exercise with too much apathy.  "I have type 1 diabetes - it's about managing my blood sugars and my insulin, and making sure I'm eating foods that don't have a crummy impact on my blood sugars." But having diabetes doesn't make my A1C paramount over all other health issues.  It's part of a bigger whole, but an in-range A1C doesn't cancel out an unfit, untested, under-exercised body.

I petition - or am I pledging?  Hoping?  I petition to let go of the laziness, to make the effort, and to embrace exercise as something just as important as testing blood sugars and taking insulin.  I pledge to keep my body moving, even if I feel too slow, too awkward, too embarrassed, too big, too challenged.  I am hoping that our community can be part of the movement towards movement, a group of people who go against the grain of the laziness that's taken over our country. 

"Oh, you have diabetes?" 

"Yeah, and I exercise all the time.  Even on days when I don't feel like it, or when I'd rather sit in front of the television or muck around on the computer."

We, the undersigned, promise to keep moving.  Keep running, or walking, or swimming, or tennis'ing, or skipping, or yoga'ing, or footballing (of either kind), or dancing, or gardening, or lifting, or cycling.  We, the undersigned, know that our bodies need exercise as much as they need fitness, more than they need cupcakes. 

We, the undersigned, pledge to run like a velociraptor is chasing us.

"Thank you."  You're great.  You really are.  I've been a patient of yours for years now and your patience for your patients knows no bounds. You're also smart, as you've been dealing with adults with type 1 for a long time, and you rarely view my diabetes as something that happens outside of the context of all the other stuff in my life.  "You don't live in a vacuum," and I always laugh in my head because I picture Henry the Vacuum, and it's a hard mental image to shake. 

You don't give me the stink eye when I tell you I don't have weeks worth of logbooks available, but you do make me own the fact that you need at least two weeks of certain numbers (fastings, before meals, before bed) to make assessments of my blood sugar needs.  Accountability helps, and I at least know what the bare minimum data points that you need are.  And because of your prowess when it comes to type 1 diabetes and pregnancy (and all of the assorted fun-and-games that can crop up in tandem), I was confident in trusting you to help bring my dream of motherhood to a healthy fruition. 

"I'm sorry."  Even though I cry in your office almost every time, you don't make me feel creepy about it.  I don't know what it is - pent up anxiety?  emotions that I keep bottled becoming uncorked when your office door shuts? - but it's a knee-jerk response.  My emotional response to diabetes seems to rear its head when we're talking about the basic mechanics, because I think I'm frustrated at the fact that being "compliant" doesn't always lead to awesome lab work results.  Or peace. Or more sleep.  Or any guaranteed awesome. 

And I'm also sorry for being a sometimes scatterbrained patient.  I know the point of my being there is to review numbers, and make adjustments to medications, etc. and I do feel horrible when I don't come armed with all the information you need to help me make sense of diabetes.  However, our relationship is a two-way one, and even though we have a good repertoire, there are things we can work on.

"Please."  Please don't think that my scattered records equal out to apathy about day-to-day diabetes management.  (I test my blood sugar, but I don't always log it.  And I take my insulin, even though I'm not always plotting the doses on a spreadsheet.)  Please find a way for your office - the insurance company? - to reimburse you for reviewing CGM data.  Please don't leave me waiting in your office for over an hour, finally starting a 10 am appointment at 11:30 am - I'm supposed to be 15 minutes early, but it's okay if you're 90 minutes late?  Please ask your office staff to respect the fact that I may not know all the details of what is and isn't covered by my insurance, and please encourage them to treat me respectfully when I call to make appointments/ask a question.  Please don't judge me for changing my lancet every mumble mumble.  And please, for the love of God, find some way to increase your availability.  I am scheduling my appointments six months out and in the times when you need to reschedule/I need to reschedule, it makes for horrible rescheduling.

Doctor/patient relationships are just that:  relationships.  I think (hope?) ours is good.  I am confident I am getting good care from you, and I hope you feel that I'm a patient worth dedicating your time to.  Type 1 diabetes takes a fair amount of work to manage, and I'm thankful to have you on my team. 

Now can I petition for a coffee machine in your waiting room?

Kerri: How does diabetes impact your perspective as a parent?

Holly (dx'd with T1D at age 22):  Even though I have T1, I feel a huge responsibility to provide her with a solid foundation on what is healthy and nutritious to eat. She has been eating solids for only 6 months, and I'm constantly wondering if what she's eating is healthy enough. Is she getting enough vegetables? Protein? Too much fruit? I thought I thought about food a lot as a diabetic! 

Brittney (dx'd with T1D at age 11):  I think being so health aware as a person for so long, knowing and analyzing every little thing that goes in my mouth, and every bit of exercise I do (or don't do!) makes me more aware of how my daughter is growing up. She's just recently started eating solids (we skipped the purées and went right to "real people food") so she eats off our plates. It's made me make sure both my husband and I are eating only natural, no added sugar or "crap" kinds of foods. I want her to grow up thinking that eating healthy and being active is the norm and just part of every day life. Not something that you have to "work" at.

Gina (dx'd with T1D at age 25):  Before I had my son, i never really thought about caring so much about my personal health like I do now. I mean yeah I took care of myself but, not  really the best way I should have. Now, I have a little person to care for and I want to make sure that I am around as long as possible to watch him grow up. The thought of not being around for him, scares the living crap out of me. So yeah, I am going to try and do everything in my power these days to make sure that I am in tip top shape, mentally, physically, and healthfully!

Lindsay (dx'd with T1D at age 26):  While my perspective as a parent hasn't been impacted by my diabetes as much as I thought it would while I was pregnant, having Kate has made me more aware of how critical it is to take care of my own health even more now because it's not just me.  I need to be here and be healthy for HER.  That's a perspective I never would have had or appreciated had I not been diagnosed with diabetes.

Kerri: Does diabetes help you appreciate motherhood in a particular way?

Jacquie (dx'd with T1D at age 12): Motherhood makes all the diabetes crap worth it. I feel like it drives me to take better care of myself, too. Now I understand how my mom must have felt when I was diagnosed, and I have more ambition to stay healthy longer. Also, it's nice to finally put so much effort into the care of something that's NOT diabetes. Diabetes and babies are both hard work, but you can only put cute onesies on one of them.

Shannon (dx'd with T1D in 1992):  I appreciate motherhood more than words can say. I have wanted to be a mom since I was a little girl. When I finally grew up and got married, I found it difficult to get pregnant.  And it's a chicken and the egg scenario .. I was diagnosed with PCOS when I was 18, and was told it's common in diabetics, but nobody knows which one "causes" which.  I was able to conceive my first son (now 5 yrs old) with shots and with my twins (3 weeks old) I had to do IVF.  So having gone through all of that, and not knowing exactly how much (if any?) of a factor my diabetes played in the process... makes me appreciate being a mom because I had to work so hard and wait so long to BE a mom.

Stacey (dx'd with T1D at age 8):  Heck to the yes! I worked my behind off to have this baby (almost 3-year old) girl! We began preparing a year in advance and fought every month of the pregnancy to keep my BG's under control. Even with the constant attention to detail I ended up in the ICU at the start of my 3rd trimester with DKA. DKA with an A1C of 5.8. Yeah, no one knows how it happened but it did. Bottom line, I worked my ass off to become a mother!

Gina:  I appreciate motherhood so much more now because it has been such a long road because of diabetes. I struggled for years to get a pre-pregnancy A1c number in the recommended range of 6.5% or lower and felt so defeated time after time when I couldn't reach it. I never even thought I was going to have kids, and was actually talking to my husband about adoption instead. I became extremely depressed because of it and actually left my job to pursue the "perfect pre-pregnancy number". Well, I never did reach that A1c number until after I found out I was pregnant, but I really busted my butt to get it down and it was the first time I felt like a mother. My son and I were perfectly healthy the entire 9 months! He is now 6 months and thriving.

Karen:  I am FIERCE with a mental to-do list, and I can pack a diaper bag in about 30 seconds flat. I'm used to having diabetes contingency plans - glucose tabs, backup batteries, spare supplies - and that just naturally transitions to kiddo contingency plans. If nothing else, it gives me a great sense of "I've got this." And motherhood rarely inspires confident feelings of competence ...

Holly:  Since my [diabetes] diagnosis was so dramatic (DKA, >1400 mg/dL), I have often thought "I'm not supposed to be here." So I look at Jewel and become incredibly grateful because I get the opportunity to be her mom. It also makes me extremely cautious with my numbers (not wanting to go low) because my biggest fear is going low while home alone with her.  

Kerri: What do you want your kids to understand about diabetes?

Shannon:  I want my kids to know what diabetes is, but that mommy is ok. I have always taken shots, and checked blood sugars, treated lows, etc., in front of my 12 yr old stepdaughter and my 5 year old, so they're aware of it and I allow them to ask questions ("What is insulin? Why do you have to wear an insulin pump? Why do you have diabetes?")  My son understands that mommy has her own juice boxes.  I did not know any other diabetics growing up, and none when I was diagnosed at age 17. If/When my kids cross paths with diabetics in their future, my hope is that they won't be that person that we all know that has a diabetes horror story - they can tell people that their mommy has diabetes and wears an insulin pump because her pancreas doesn't work.  

Karen:  That it's serious, something that has a big role in our lives and can't be ignored, but that I take care of it and myself so there's nothing for her to worry about. My sincere hope is that my disease will help her appreciate her body and instill good habits in her - eating well, living an active life, and just being more cognizant of what a gift a healthy body can be.

Lindsay:  I am hopeful that by learning about her mommy's disease, she will learn compassion for others dealing with their own issues and challenges.  I can already imagine her sidling up to a buddy who wears an insulin pump and putting that little one at ease by saying "Oh my mommy has diabetes, too."

Stacey:  Right now, at almost three, I just want her to understand that my diabetes will never hold up our lives for longer than it takes Mom to treat a low.

Jacquie:  That it's not the end of the world. It's just a thing we've got to live with.

Happy Mother's Day, ladies. You are all amazing.  xo

That pretty much sums up my weekend in Raleigh, NC for the Diabetes Sisters Weekend for Women conference. 

I've attended one other Diabetes Sisters event, and the same sort of sentiment applied to this most recent one:  it's oddly comforting to be in a roomful of people who "get it."  Especially people who "get it" as "it" pertains to being a woman with diabetes.

I was in attendance to present about diabetes and sex.  Okay, fine, it was billed as "SisterTalk: Creating Better Relationships & Marriages, Moderated by: Rhonda Merwin, PhD; Panelists: Brandy Barnes, MSW, Daphene Kimball, RN, Anna Norton, MS, Kerri Sparling," but it opened with discussions about intimacy and diabetes, because that's what was on people's minds.  Topics ranged from "How do you disconnect from/deal with diabetes devices in the bedroom without feeling owned by them?" to "How do you strike a balance with extended family members who are over-involved/judgmental/uninvolved with your diabetes?"  Despite the fact that the panel discussion was presented to a large room, the discussions were close and intimate (and better left un-blogged), and it was a real honor to talk with the attendees alongside my fellow (very entertaining!) panelists.

Other sessions at the conference included Smart Sisters Live Longer: Unlock the Secrets of a Long, Happy Life with Diabetes, where three panelists shared tips on living a long, and healthy, life with diabetes.  Panelist Connie Hanham-Cain, RN, BSN, CDE passed around her recently-earned Joslin 50 Year medal, and it struck me that even though I feel like I've had diabetes forever, I was only halfway to earning mine.  But seeing those women on-stage, holding their own and owning their diabetes, inspired me.

Riva Greenberg also conducted a session on Igniting Your Diabetes Power, encouraging women to tap their strengths in order to best-manage their diabetes.  (It was in here that I met a new friend, Brittney, and her 8 month old baby girl, who served to ignite my ovaries while Riva was igniting diabetes power.  Adorable kid.)  Riva is an amazing speaker and it was such a pleasure to sit in on her session, watching her work the room.  Unfortunately, I didn't have to chance to attend the sessions hosted by fellow DOC'ers Amy Tenderich and Ginger Vieira, but from what I heard and saw through the Twittersphere, their sessions were fantastic.

During the lunch session (with keynote speaker Mother Love, whose poignant and entertaining speech about her journey with type 2 diabetes brought the audience to a standing ovation), a tally of "years with diabetes" was totaled:  

That's a powerful tally.  (And of course I don't know how many women were actually in the room.  That would help, eh?  Instead, let's just pretend there was someone who was really, really old and has been living with diabetes for 453 years.  Their A1C is badass.)  And seeing that number embodied by smiling faces is more than inspiring:

The Diabetes Sisters events are great for reigniting and inspiring, but it's also an opportunity to meet some really amazing women who just happen to have diabetes.  And who just happen to be awesome. 

The next event is in San Francisco, CA in October, so check it out if you're in the area!

[Disclosure: The team at Animas made it possible for me to attend this event, and they paid my travel, lodging, and expenses.  Full details on my relationship with Animas here.  Also, if you're interested, Pingu dances pretty well.]

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 feeling 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. 

Suitcase packed up, Birdzone tucked in and asleep, and teeth brushed, I was ready for bed at 11 pm.  Oh, hang on a second ... the Dexcom is blaring.  What's that, you say, oh technological safety net of mine?  78 mg/dL and TWO arrows down? 

I popped three glucose tabs into my mouth from the jar on my bedside table, and wiped away the glucose dust from my Dexcom receiver (somehow convinced it would seep in).  Should be a quick fix, right? 

But the low didn't stop there.  Over the course of three hours (that's 11 pm to 2 am), I nursed a low blood sugar that refused to give up.  I housed eight glucose tabs, half of a banana, some peanut butter, and a liter of frustration before seeing a steady climb on my Dexcom that was mirrored by my meter.  It was a cruel tease, where the Dexcom would show a little bit of a climb (Weee!! 62 mg/dL headed on up to 80?  I'll take it!) but then my blood sugar would tumble again and I'd test to see a 58 mg/dL.  

It wasn't until just past 2 am that my blood sugar had been stable for more than a minute.  And despite all that food, my meter still didn't put me over 100 mg/dL until the morning (which started at 5.45 am because that's when Birdy decided it would be fun to wake up and then I had to leave for the airport at 7.45 am ... weeeee?).

What is it with these tangly, clingy lows?  The ones that are ripe with symptoms (three hours of tingling, numb lips and a tongue that felt like it was water-logged, and that panicked, racing-heart feeling where you could consume the contents of the fridge without feeling bad about then ordering a pizza) and take a dog's age (is that seven years?) to come around.  Can I blame the late-afternoon exercise?  The insulin pump site change?  Hormones?  Logic?  Reason?  The incessantly horny spring birds shagging outside my bedroom window?  What makes one glucose tab fix one low, when it takes an entire fleet of cupcakes to sate the same number?  

At this point, I'm either wishing for mint-flavored glucose tabs or glucose tabs with little bristles so that my teeth are re-brushed as I chomp on them.

It's the day-to-day head game of diabetes that messes with me.  It's doing everything "right" and still having an unexplainable high blood sugar.  It's doing everything "wrong" and ending up at a mysterious 112 mg/dL.  It's worrying about complications that haven't yet come to pass.  It's gracefully dealing with the ones that have.  It's preparing for the worst and hoping for the best.  It's the complicated relationship with food, numbers, hardware … and with mortality.  Having my emotional health intact is what best equips me to handle the physical demands, in all their chaotic capacities.

I didn't realize how alone I felt until I was so far from Clara Barton Camp that I was too old to be a Couselor-in-Training.  It wasn't until I realized the only other diabetics I knew were ones I sat next to in the Joslin waiting room, and I always wanted to lean over and say hi but I was too nervous they'd think I was weird.  (They might be right, but that's neither here nor there.)  Despite the support of my family, and my friends, there was still an ache to find other people who didn't need diabetes explained to them, but who just understood without effort or bias. 

Diabetes doesn't define me, but it does explain so much of me.  It explains the scattered pile of used test strips I leave in my wake.  It explains the subject matter of the stories I chose to publicly share.  It explains why my daughter knows that Spiderman fruit snacks are sometimes a "treat" and sometimes "medicine."  And it explains why the Internet, for all of its cruelty and callousness in other arenas, remains a place where people can come together with their diabetes trouble and triumphs and find community, solace, and someone who will give them the "Me, too" they are in search of.  The Internet hasn't saved my life, but it has made it better, and I'm forever grateful to be a part of a community that, for all its diversity, remains strong at the core of its "sames."

"What's a blog?"  I asked Chris, back in 2005.

"It's like an online diary.  Only everyone else can read it.  You might be able to find other people who have diabetes?"

And just the promise of maybe finding others was enough to start me down the path of sharing my story.  Eight years ago this past weekend, I started blogging, and for me, sharing these stories has made a world of positive difference in my diabetes health, and in my emotional health.  I don't feel alone.  I am proud of, and inspired by, what this community has transformed into over the course of the last eight years, and I'm prouder still to call so many of you friends. 

I didn't expect to find others.  I hoped to.  I didn't expect to find friends.  But I did.  And I had no idea how my health would be impacted - in such a positive way, by strangers from on the Internet simply saying, "I understand."  But it was, and continues to be.

Thank you guys for letting me share my stories for eight years.  I remain forever grateful.

It's something like a phenomenon. 

And it's definitely part of the reason an insulin pump works for me, because without the ability to tweak that morning basal rate, I'd be dealing with highs that frustrate me endlessly since they aren't the product of breakfast or stress.  They just are.  

I forget, though, how important that basal crank is for me.  I take basal bump from the pump (two points for rhyming, or for honesty) for granted sometimes, because once it's programmed, it's a done deal.  It's not until I travel outside of my timezone that I have to start juggling the dosing details again, making me run low at strange times of the day until my body clock adjusts to whatever timezone I'm in.

This happened last week when I was in Hawaii, which is six hours behind Rhode Island.  So noon here in New England is six in the am in Hawaii.  For me, that means my body wants the basal rate jacked up at the wrong time, and it results in blood sugars that are tough to track and attack.

Usually, I change the time on my pump as soon as the plane reaches cruising altitude, and I try to adjust to the local time zone as soon as possible.  This time, for the first time ever, I forgot to change my pump on the ride home.  And then neglected to change it until ... um, yesterday morning, when I looked at my pump at 11 am and saw it boasting a 5 am time.  Which explained the weird, ill-timed highs this week in the morning hours and the strange double-down arrows at lunchtime.

And the whole reason I didn't notice the time difference between the clocks at home and the clocks on my pump?  What caused this time-insulin conundrum?  What eliminated the need to peek at my pump to tell me what time it is?

It's almost too simple.  Too ridiculous. 

I bought a watch.

I've thought about the name change discussion, and I've been trying to figure out what my opinion on it is.  You'd think a person who has had type 1 diabetes for a long time would have an opinion, right?  One that jumps out and smacks me in the face with its conviction?  Nope.  I have to be completely honest:  I don't really care if the name is changed.  Or if it's not changed.  I have a surprising amount of apathy about this whole issue. 

My diabetes has been classified, in one file or another, as "brittle."  And "IDDM."  And "juvenile."  And "type 1."  None of these classifications have made the public understand jack about my disease.  It's been the dizzying combination of advocacy groups, patient grassroots efforts, PR efforts, and research advancements (just a few in the long list of contributing factors) that has given society any kind of knowledge about the disease that I have lived with most of my life.

Growing up with type 1 diabetes, I didn't understand that there was a different kind I could have.  I had no concept of type 2 (or NIDDM, at the time) diabetes, or gestational diabetes.  As far as I knew, anyone who had diabetes didn't make any of their own insulin, and they all went to Clara Barton Camp.  If I didn't have diabetes, I wouldn't know much about it.  Isn't that the way things like this work?  I don't have an acute understanding of other health conditions because I'm not managing them on a day-to-day basis, but I do try to have an extra level of respect for people who are dealing with different health issues, regardless of type or origin.  It wasn't until I was older - much older, like in my 20s, that I had a strong understanding of the different types of diabetes, and even now, it's a constant process of learning.  And it wasn't until that same time that I also developed a sense of how society views diabetes - as a disease they think is preventable, and that it's what "fat, lazy people get."

Is this stereotype true, or fair?  No.  But it's what society thinks, and in my opinion, a name change isn't going to immediately peel back that layer of frustrating ignorance.  It's what we all do, as people touched by diabetes either through community or employment or passion ... or a combination of the three, that WILL change society's perception and understanding of diabetes. That's why we have the JDRF, and the ADA, and the Diabetes Online Community, and a lot of et ceteras.

A lot of the posts that have touched on this name-change issue have some very well-thought out opinions on their support of the petition, or lack of support for this petition.  (See Lee Ann, Manny, Amy, Bennet, Wil, Sir Bob, and the comments in the actual petition, for starters.)  I wish I had their strong convictions on this topic.  In my opinion, signing doesn't mean you're embracing an angry and stubborn "us and them" stance, just as not signing doesn't erase decades of stereotypes and misconceptions across the board. We, as a community, have talked about name changes before.  There was a piece on Diabetes Health that tackled the name-change petition, and a commenter on there let loose with a sentence that pretty much summed the whole mess up for me: 

"What we need more than anything else is an understanding in the general public that diabetes is a disease, not a character failure." -  Diabetes Health commenter Don M

Signing the petition will take a few minutes.  Not signing it will take no time at all.  Either way, YOU get to decide what you want to do.  The reason there are so many voices in this community is because so many voices are necessary - diabetes is not the same for any of us, regardless of type, or age, or A1C. The diabetes community is diverse enough and hopefully mature enough to handle this kind of discussion without going so painfully apeshit.

And once you decide to or not to sign a petition, or to give a crap entirely about any of this kind of thing, mark the moment by dancing wildly in your kitchen for twenty minutes, because exercising is something you can do right now to have a positive impact on your diabetes management. How about a petition to make us all exercise our bodies as much as we run our mouths?  :)

My Dexcom rash started last August, soon after a business trip to San Diego.  The rash was instant and seemed to crop up out of nowhere, with one sensor leaving behind nothing more than the wee pinprick of the sensor insertion to the next one leaving a trail of weeping, swollen skin in its wake.  Not comfortable, and difficult to pinpoint the cause. 

"It's an allergy," said the Internet.  And my doctors confirmed said allergy, only without any real suggestions as to how to fix it.  The inhaler trick worked, but then there was a concern about putting that kind of steroid on my skin consistently.  The Toughpad has been the best solution so far, but even that can leave a red ring of distress, depending on how battered the site becomes.  

It's not just the "wearing the sensor" part that is problematic.  It's what's left behind on my skin when the sensor is pulled off.  Even with the Toughpad, my skin's aftermath is irritated.  Not nearly as harshly as before, but enough so that I can't put another sensor in that area for weeks.  (And if the skin is subjected to super cold environments, aka the Blizzard of 2013?  Even the skin patches that hosted sensors months ago suddenly became scaly and red, itching madly and making my skin uninhabitable for sensors.)  Which frustrates the hell out of me because it's one thing to find an allergy deterrent, but now I need to find something that soothes my skin enough to make sensor reapplication palatable? 

See also:  What the effity eff.

But a miracle cure for the skin aftermath was found last week, in the undulating oceans of Hawaii.  I was in the ocean for the first time since last August, and almost immediately, the skin patches formerly known as "ew" were calmed.  Smoothed.  After a few rounds in the water, the scaly irritation was gone, and I was actually able to confidently re-start a sensor thanks to the lack of itching.  (Yes, I'm already planning on filling a bathtub with sea salt next winter, in efforts to duplicate the ocean while nature dumps more snow on New England.)

Now that I'm home in Rhode Island and the weather is actually (finally) becoming spring-like, I'm looking forward to being back at the beautiful RI beaches, happily playing in the water but also using it as a side dish of medical cure-iosity.  The ocean hasn't cured my allergy, but it seems to have made the aftermath so much better, and I'll take that progress.  Anything to keep the freaking itch at bay.  Yo.

Just like with everything else, a break now and again is a good thing.  Like with diabetes crap.  Even though I have as many dead test strips in my meter case from this past week as I would any other week, I didn't 100% care about all of the results or the graphs.  (Ironically enough, I had a good run with blood sugars this week - maybe a few more lows than I'd like, but my Dexcom graph was steadier and significantly more in-range than out, and I felt really good, despite the six hour time difference between Honolulu and Rhody.)  My health didn't go un-managed, but I loosened the reins a touch and it seems like my care flourished instead of suffered.

Same goes for a break in work-related bits and pieces.  An out-of-office reply isn't a bad thing (except for that one time my out-of-office reply included a mention of the Thunderdome, and that generated more "WTF?" replies, which then prompted more auto-replies, and then everyone in my inbox hated me.).  And it's okay to close the computer and let things go unchecked.  Even though it can be unnerving to let the work things pile up for a few days, it feels good to take that break, too, and I feel more productive and focused by the time I leap back in.

Over the next few weeks, there will be a bit more spotty service on the blog for a dozen different reasons.  I'm on the road a lot this summer.  I plan to see how many sand castles Birdy and I can build on the beach and how many blades of grass we can examine in extreme close-up with her binoculars.  (I don't judge her for her strange little habits.  Hopefully she extends me the same courtesy when she's 13.)  Chris and I would like to to spend more time looking at one another and not having our essence sapped out from the Glowing Screens like those little critters in The Dark Crystal.  And I have a few big writing projects that will be eating up a lot of my brain and my time.  But mostly?  A little breathing room is good for me. 

For anyone.

Today marked the fourth new experience, testing out the waterproof capability of my pump, because we took it swimming in the plunge basin of a waterfall in Hawaii. And despite being submerged and potentially knocked around on a few rocks, the little bugger kept on ticking. (In that insulin-dispensing sort of way.  With the word "dispensing" making me immediately think about Pez.) 

I do forget that pumps and CGMs aren't commonly sighted in the wild, and I am reminded of this every time I wear a bathing suit.  Even though Chris and I are used to the CGM lump and the housing-and-tubing circus of the pump, I forget that other people don't usually adorn their bathing suits with medical devices.  As I eased into the fricking freezing water of the plunge basin, a woman already in there was concerned about my "wearing your cell phone in the water, honey!"  I told her it was a medical device for diabetes, and she, in turn, told us the noodle she had rented from the lifeguard wasn't particularly buoyant.  (A fair exchange of information, I thought.) 

When we made the walk back to our car, drying our bathing suits as we walked because the idea of putting dry clothes over wet bathing suits was gross (and also, what's hotter than wearing socks, sneakers, and a bathing suit?  Everything Nothing.), I remembered my pump and CGM were in plain sight, and people were taking a second glance as they passed by us on the trail.  In regular clothes, the devices are barely visible, but in bathing suits (or, as Birdy calls them, "baby suits"), they're on full display.  And sometimes that makes me feel a little shy, or awkward.

But the awkwardness passes quickly when I look at the Dexcom graph and see that the hike up to the waterfall caused a downward trend in my blood sugars, letting me catch a low before it hits.  I sport these devices because they help me stay on top of things, and that system works for me, both at home and while I travel. 

Cyborg vacations rule.