Monthly Archives: February 2014

What’s your fantasy dual-chamber pump hormone?

Related Post: What else do you want?
 
 
We still have about three more weeks of winter left here in the USA. I don’t know about you… but I could really use a healthy dose of Spring right now.

That has me thinking: I know that dual-chamber pumps have been in development for some time. I believe the idea is for one chamber to be able to pump insulin, and the other to pump glucagon. Or in some cases, the second chamber would pump amylin, which is a hormone designed to help us with gastric emptying.

So… what if I could just, at least for a little while, hook up a little Spring in my hypothetical, dual-chamber apparatus? Late Spring, just after you throw that coat off for the last time, but before it gets blazing hot. Change into your shorts after work, hang out on the back porch all night kind of Spring.

That would be very nice. What else would I like to have infused via my dual-chamber gadget?

Maybe something that could help take the edge off of remembering the depressing episodes of my life. I already lived them once. I don’t want to ever think about them again. Or relive them. Come to think of it, maybe Spring is the perfect antidote for that. Or serotonin. That might help me remember a few things that I seem to forget these days too.

But serotonin couldn’t give me the warmth that I’m looking for. So I’m still looking for Spring in a bottle vial reservoir.

I could certainly use something to motivate me to get to the gym at 5:30 a.m. I’m going, but I’m still dragging myself out of bed to get there. I don’t need anything like an amphetamine. I need something that will make me feel good about getting up and going, but not a performance enhancer.

And I would love something that would help me give exactly the perfect answer to every question, whether it’s diabetes-related or not. Aside from the confidence builder that would be, think of all the money I could make on Jeopardy! Though technically, the questions are answers on Jeopardy, and the questions are answers.

Where was I? Oh yes…

Those are just three things I thought of really fast (‘cause, you know, it’s Friday), that could be really great go-withs to infuse in a double-barreled insulin pump. What’s the fantasy hormone you’d like to include in yours?
 
 
 

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Like these links.

First, a couple of great deals from companies run by PWDs (People With Diabetes). Then a couple of posts that you’ll want to pay close attention to.

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Ethan Lewis at Level Foods has let me know that his Level Life Protein Bars and Shakes have made it to the shelf in your local Target store! He says you can find them in the Diabetes aisle. I don’t know what a Diabetes aisle really is, but I’m thinking you’ll find them near the pharmacy.

But wait… there’s more! You can pick up a coupon for $4.00 off your purchase by clicking here.

But wait… there’s more! Ethan’s also holding a contest on Facebook this month. Find your Level Life products on the shelf in your Target store, take a photo, and upload it to their Facebook page. Once you do, you’ll be entered into a contest that includes weekly prizes like a $50.00 Target gift card and Level Life hoodies. Still a couple of days left… get to Target and remember to take your phone.

Also: Be sure to watch this space for a Level Foods giveaway in the near future…

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From Christopher Angell at Glucolift comes great news: They are now fully stocked again with the best-tasting, low-chalkiness glucose tabs anywhere. You can get all flavors, in all configurations. And if you order soon, you can get 20 percent off any order over 50 dollars by going to BuyGlucolift.com and using the coupon code GLISBACK.

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Allison at The Blood Sugar Whisperer wrote the quintessential definition of what advocacy is all about. She reminds us that advocacy cannot be quantified. It doesn’t have to be flashy:

“Being a diabetes advocate means making a difference in the life of someone with diabetes. There’s no qualifier on that.”

So true, so true. If you haven’t yet, I encourage you to go read what she has to say. See if it doesn’t charge you up.

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C, writing over at C’s Life With D, is a Registered Dietitian and a Certified Diabetes Educator. She’s starting to wonder why a lot of people online seem to be making sport of bashing their CDEs.

She has a point, and I’ll even go so far as to say there’s a lot of Diabetes Online Community bashing going on about healthcare professionals in general.

I think if you read her piece, you’ll start to see why we all (myself included) need to cool our jets.

Like with the Miss Manners dustup last week, it’s important (at least for me) to remember that we should all be allowed to say what we want about a newspaper columnist’s advice, or about our professional care team. But with great freedom comes great responsibility. Try to mentally put yourself at a party where both sides of an issue are present. Remember that whomever you’re speaking to now has the opposite point of view of the person you’ll be speaking to in five minutes. What do you say? What will you say if you have five more minutes to think about how you’ll say it?

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It’s a busy week here. If you’re in the Mid-Atlantic, don’t forget about the JDRF Type One Nation DC Research Summit taking place in Bethesda, Maryland on Saturday. Find out more and register at jdrfsummit.org.

Happy Wednesday!
 
 
 

We’re not EVER perfect.

I feel kinda silly posting this on the same day that Scott E. posted something very similar over at Rolling in the D… But, what the hell? Here it is.

But be sure to go over and read Scott’s post too. You’ll probably get more out of it anyway.

This story is nothing that should shock you. But it’s something that happened yesterday, and I think it’s an important story to tell.

I suspect I don’t get a huge amount of viewers here, but I do recognize there are some. Somewhere between some and huge is where my viewership is right now.

Anyway… It’s easy as a writer, and the person who basically oversees everything that gets posted here (after all, it’s my blog)… It’s easy to make everything about my life seem perfect and special. It’s even easy to make it seem like those moments where I’m not perfect are not exactly my fault.

Well, yesterday, I woke up, remembering I needed to change my infusion set. I had about 5.5 units of insulin left in my reservoir. Of course, those of us with a Medtronic pump know that 5.5 units means that you really have (probably) many more units than that left.

Knowing this, I had breakfast without changing my set. And I had a couple of chores around the house to take care of, so I didn’t change my set after breakfast either. I also didn’t change after getting my hair cut, or even after lunch. It wasn’t until we were nearly out the door headed for a movie that I finally remembered to do my set change. At this point, my pump was probably showing something like this for five hours or so:

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So apparently, just in the nick of time, I finally got that set change in. The reservoir had a little insulin left, because it was still pumping, but once I pulled it from the pump I could see there wasn’t much.

It wasn’t an epic fail, of course, but it’s something that happens in the course of day after day, year after year living the diabetes life. You’re bound to forget something now and then. You’re likely going to make a mistake once in a while. How do I know this? Because I make mistakes too.

Don’t let it get you down. Don’t let it make you feel like someone you read occasionally has his shit together, and you don’t. Because that is simply not true.

Instead, just pick up and move on. With diabetes, it’s good to be able to remember things. But don’t spend any time feeling bad about one thing or one day. Don’t ever let something from yesterday cloud the joy you’re seeking today.

By the way, we did make the movie. Monuments Men is a good one. Great acting all over the place.
 
 
 

A Champion Athlete from Trinidad.

Today, I’m thrilled to bring you our latest Champion Athlete With Diabetes, and the first guest post here at Happy-Medium.net!

Corey Melke is a U.S. expat living with her husband in Trinidad. She’s been living with Type 1 diabetes for about a year and a half, and she writes about her life (with some fantastic recipes too) at her blog, Learning Patience.

Corey’s story is the perfect example of perseverance in the face of adversity. She never let her setbacks define her… In fact, she seems to have used them as touchstones for even greater accomplishments. Don’t ever tell Corey she can’t do it– She’ll prove you wrong! Take it away Corey…

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Ever since I was little, i played sports. Softball, basketball, swim team, track…i tried it all. I loved the thrill of competition and it helped me stay in shape. But when college was over and work started, working out kinda fell off my daily to-do list. My vegetarian diet helped keep my weight in a decent spot, but I was not strong or frankly, all that healthy. It wasn’t until I met my husband that I decided to make a lifestyle change and get healthy. That meant more sleep, less drinking, working out at the gym and starting to run. At first, I couldn’t even make it a block without stopping. Running did not come easy to me, it was a real challenge and it had been way too long since I felt that thrill of working hard to achieve a non- work related goal. We ran 5k’s together, mud runs and a 10k right before we moved to Trinidad. In one year, I had gone from couch potato to runner girl!

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Moving to Trinidad, 3 years ago, meant a world of new experiences and lifestyle changes and not working. Not working meant being able to workout whenever I wanted, but it also meant I would need to be more focused than ever, because it’s just as easy to be lazy or snack whenever you want. One day, a blog friend convinced me to train for my first half marathon, something I never thought I would do. I agreed, but with loads of hesitation and fear of failure. It was then that I signed up to the Daily Mile, a website where you can friend other runners, track your workouts and get support and advice from others. It has been a critical part of my success. As the race date got closer, my friend got injured and I was devastated. I felt like I could never do it without her, but the next morning I ran 13.1 miles. I did it under 2 hours too, definitely one of my proudest adult moments. There was no crowd cheering me on and no shiny medal handed out at the finish line, it was just me and my determination to succeed.

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After that, I was hooked. I wanted to run faster, participate in a “real” race and i wanted a medal. I was lucky enough to be selected as an Ambassador for the Women’s Half Marathon series and planned to run in September in Nashville. Training was going great until one Sunday afternoon when a simple photo op at the pool, changed my life forever.

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The picture is fantastic, eh?! When I landed in the water my right toe touched my right heel and I sat on my foot underwater. I basically crushed my foot. When I surfaced, i was crying without even knowing what had happened. Getting injured underwater is very weird. There really isn’t time to feel pain because you are focused on trying to hold your breath. I saw a specialist the next day and was told I had a fracture, I needed a aircast for 6 weeks and all would be OK. If you have ever been injured when you are in the best shape of your life, you know its dreadful.

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I followed the Drs. orders and was soon pool running and my life was almost back to normal. While on a vacation in the US, I was told I could finally take the aircast off and even go for a run. I cannot explain how amazing those 3 miles felt. But while running, I had noticed that my eyes were really dry. I mean like my eyelids were sticking to my eyes, dry. Weird. Later that day, I felt sick, my mouth was dry, my appetite gone and I had no desire to drink wine at all. You can laugh at the wine comment but it just might have helped saved my life. By the time my husband arrived a couple days later, I knew something was wrong. I felt worse, much worse and I went to the ER. At first, I was told I had jet-lag and to go home, but I pressed for more tests. Then, the the lady who said I was “fine”, told me that I had diabetes. The nurse told me that I was a Type 2 diabetic, which didn’t make sense to me – I was healthy, in shape and had been a vegetarian since 6th grade. At that point, I was in a state of shock. The nurse showed me how to test my blood sugar and gave me Metformin. At that point my blood sugar was 835. I was released, I took 1 pill and we went home to figure it all out. I sat my husband down and told him and we all just kinda sat there. The next morning, I hoped a run would help clear my head, but as I started on down the driveway, I couldn’t breathe. I fell to the ground, gasping for breath and then somehow managed to crawl back into the house for help. I felt like I was dying, I couldn’t get a full breath in and it was terrifying. After a quick call to the pharmacy, my dad just looked at me and said “You have to go to the ER, now”!

August 10, 2012

Turns out, I was not a Type 2 diabetic, I was a Type 1. I was in DKA, just minutes from passing into a coma and that pill was making things much worse. DKA occurs when the body cannot use glucose as fuel because there is no insulin in the body. So, the body burns fat instead which produces keytones. A urine test showed my keytone level was over 90. That week I lost almost 10 pounds. I found out that I never should have been released from the hospital the day before, in fact, I was so sick, I had to spend an entire week there. Going for that run saved my life, it helped my body process the Metformin faster, which took my breath away, which then alerted me to go to he hospital. Our original plan was to get on the boat and spend all day on the lake. If I wouldn’t have gone for a run, the Dr. told me that sometime that day, I mostly likely would have lapsed into a coma and could have died. My endocrinologist say its hard to determine how long I had T1D, I had probably been controlling my own BS with running. Then, when I was side-lined with the aircast, my BS just kept creeping higher and higher and higher.

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Figuring out my new life of insulin shots, counting carbs and all that other fun stuff that goes with having this horrible disease was hard, but realizing I was only 4 weeks from my BIG Nashville race and I wasn’t going to be able to run in it, was even harder. I was banned from running for another 2 weeks. All of my organs were shutting down and I had lost almost 60% of my vision, a result of having a high blood sugar for so long. My body was broken, my cells needed more time to repair themselves and eventually my sight would return. After two long weeks of resting, I was finally able to start running again. Running with diabetes was much more difficult than originally expected. Keeping a steady blood sugar while burning 800-1000 calories and running in almost 100 degree temperatures is a huge challenge.

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I went to Nashville anyways and competed in the 5k. Although it stung not to be running the half, I’m glad I went and did my best, I even placed 2nd in my age group! The amazing folks at the WHM series offered me a re-do in St. Petersburg, FL in November, 2 months later. I was thrilled and started training again. Once my training runs got over the 8 miles mark, I soon realized how training with T1D would be MUCH HARDER than originally thought. I had to learn how to fuel properly before, during and after my runs. No more not eating post workout, I experienced a couple extreme BS drops and was soon reading all I could about athletes with T1D. The more I learned, the more I felt overwhelmed. My endocrinologist told me I needed to slow down. She had never seen a new T1 who had gone from a 11% A1C and almost dying to a 6.2% A1C in three months and running 15 miles a a week. It was then that I got my first Dexcom, we call him Dex in my family.

No more sore fingers from testing 10-13 times a day and no more scary nights wondering if I would wake up all sweaty with a low. Dex saved my life and continues to help me be as healthy and as safe as I can be every, single day. Sure, he can be annoying at times and sometimes he’s off a little bit every now and then, but I simply could not imagine my life without him. So, with Dex, my training improved and I was more confident on my runs. But just as things seemed like they were getting better, on my last long run before my big race, I felt more than the usual pain in my right foot.

It was then that my Dr. told me that his original thought, that I might have a LisFranc injurya very complicated injury that 50% of people need surgery to repair, was right. He told me to pull out of the race and head to the US. Against my Dr. orders and against my husband & parents wishes, I went to Florida and i ran that race anyways. I don’t suggest running injured but after all I had been thru earlier that year, I wasn’t going to be stopped.

 

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The next day, I headed to Houston where I was told that I needed surgery ASAP. The middle joints of my foot were separated more than 5 times the normal amount. He was shocked I was even able to walk on it, let alone run a half marathon. 3 days later I had surgery. The surgery took over 3.5 hours and required 11 pieces of titanium to fuse 4 bones together.

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Foot Hardware 3

The next 7 days were complete hell and that was with pain meds every 3 hours! I don’t think I have ever gone thru something so incredibly painful in my life, EVER. Growing bones isn’t as easy as one might think. I had to get off the pain meds ASAP because they were throwing off Dex & I couldn’t handle that.

I would be in a non-weight baring cast from Dec 22 until April 1.

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When the cast came off, I couldn’t wait for rehab.
I had no idea how difficult the process of just learning how to walk again would be…

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I had rehab 3-4 times a week, every week till June. On June 20, my birthday, I ran 4 miles.
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Then, I found a half marathon in October in Houston and signed up…my BIG comeback run! I was going to show diabetes and my stupid LisFranc injury who was boss. Don’t tell me I cant run again!

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On October 27, in the pouring rain and cold, I finished in 2:02. I did it and crossed that finish line with a smile on my face and tears in my eyes. The next day I visited my foot surgeon with my much deserved medal around my neck. He was beyond thrilled. He told me that the chance of me running again was slim, he just didn’t want to tell me that from the beginning.

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I’m currently training for 4 races in the Spring and I’m running faster than ever before. My last A1C was 6.1% and I currently am using the latest and greatest Dexcom, which I wear on the back of my upper arm, and I am on injections, Levimir (2X day) and Apidra My diabetes will be always be a daily challenge and a pain in my ass the rest of my life but it will never stop me from achieving my goals and living life to the full! You can follow my island life, training, travels and recipes over on my blog, Learning Patience. Last November, I even traveled to Africa and saw a cheetah kill, it was pretty amazing!

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Life tried knocking me down not once, but twice and I still got back up. Without sounding too cheesy, LIFE IS A GIFT, don’t waste it. Break a sweat each day, eat healthy and colorfully, drink loads of water and laugh as much as possible!

xoxo from Trinidad

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Thanks Corey! You are an inspiration, and very worthy of the designation Champion Athlete With Diabetes!

So maybe you’re thinking: “Hey, I’ve been working hard… where’s my medal?”. To find out how to get yours, click here.
 
 
 

No CGMs on Medicare? What????

On the heels of the Spare A Rose, Save a Child campaign, I’d like to ask for your help on another very important issue.

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Sue Berger, also known as Sue from Pennsylvania over at Test Guess and Go, is on a quest. And her quest is one that speaks to me, because in a little over 13 years, I’ll be right where her husband is. I’ll be 65 in 2027, and that means I’ll be getting pushed off to the Medicare system here in the USA.
 
 
 
Why is that a concern? Well, among other things, being on Medicare means you can’t have a CGM anymore. Oh, if you have deep pockets, you can buy one outright. But Medicare will not pay for a CGM. Doesn’t matter if you have one prior to age 65. Doesn’t matter if you need a CGM due to hypoglycemic unawareness, or just because it might help you actually stay healthier. It won’t be approved by Medicare.

Sue is working hard to change that. Up to now, she’s carried on a nearly single-handed campaign to get Congress involved. And guess what? Congress is now involved! Representative Carol Shea-Porter (D-NH) has introduced H.R. 3710: Medicare CGM Coverage Act. The resolution (H.R. stands for House Resolution) allows for coverage of continuous glucose monitoring systems if recommended by a doctor. In case your civics classes were decades ago like mine, the Act would have to pass the House, then get a majority vote in the Senate, without any changes to the Act. If the Senate approves changes to the Act, then it goes back to the House for another vote on the amended bill. If both houses of Congress finally agree on the final language, the Act goes to the President for his signature. So it might take a while, which is why your help is needed now to help get the ball rolling. Now.

As Sue mentioned in her post on this issue, a lot of the Diabetes Online Community has asked how they can help with her crusade. Well… here’s your chance. According to Sue, there are three things you can do to help get this wrong righted:

– The most effective step you can take is to ask your own Representative to cosponsor the bill. Good news! There is one co-sponsor so far, Representative Matthew Cartwright (D-PA). But we need many more!

– Call your Congressperson’s DC office and ask for the email address of your Congressperson’s Legislative Assistant for health issues.

– Email the Legislative Assistant the text of Shea-Porter’s Dear Colleague letter (available on Sue’s post), along with a personal note. That way they will understand why the issue is important to you, the constituent, and they will also have the Dear Colleague to show their boss so that he/she will know how to sign on.

As sue says, “The only way to fight Medicare’s denial of the CGM is to get the guideline changed. The best thing that we can do now is to let our voices be heard and join with Congresswoman Shea-Porter and her new cosponsor, Congressman Matthew Cartwright [D-PA17] in asking Congress to pass H.R. 3710, the Medicare CGM Coverage Act of 2014.”

This is a very important issue for me, because I’ll be in the Medicare system toward the end of the next decade. And if you live in the USA, you’ll be in the Medicare system at some point too.

At the beginning of this month, the DOC did a lot to help kids in developing countries get the insulin they need to survive. Let’s spend at least part of the second half of February fighting for those older Americans who, through no fault of their own, cannot get coverage for a CGM just because of their age.

To view Sue’s post at Test, Guess, and Go, click here.
The post also includes a sample letter you can send to your congressperson, and the Dear Colleague letter from Rep. Shea-Porter. She also has a kind of resource guide for bloggers to help with getting the word out.

 
 
 

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