Author Archives: StephenS

Hello… I’m Stephen. I live in Baltimore, Maryland, USA with The Great Spousal Unit, Maureen. I’ve been living with Type 1 Diabetes since January 1991. I’ve been a pump user since April 2010, and I’m currently wearing the Animas Vibe pump. Also wearing the Dexcom G5 continuous glucose monitor.

I found the Diabetes Online Community in the summer/fall of 2011, and that discovery has changed my life. I started this blog in April 2012, and since then, my diabetes advocacy has continued to grow. Among other achievements, I’ve attended and spoken up at FDA workshops and participated in clinical trials.

I’ve been thrilled to serve as a facilitator for the Diabetes UnConference. And I’ve been honored to volunteer for Diabetes Patient Advocacy Coalition. You should Google both of those.

I’m currently serving as a member of the State of Maryland’s Advisory Council on Health and Wellness, where I am co-chair of the Diabetes committee. In addition, I’m part of the 2018 Reader Panel at Diabetes Forecast magazine.

I’m always searching for the perfect balance between the highs and lows of my blood glucose level and my life… always searching for the Happy Medium.

Anything you’d like to share? Please let me know… I’d love to hear from you.

Recipe! Flatbread pizza.

October 17, 2014 – 9:42 am

Happy Friday!

Cliche alert: Like you, I’m always on the lookout for low-carb options of my favorite foods. Today, I’ll be showing you just how easy it is to make a tasty flatbread pizza. Not only is it low carb, it’s also about three dollars (or less) per pizza. Let’s begin:
 
 
Preheat your oven to 400 degrees fahrenheit. I’m still working on this; you can probably cook these a little lower, say around 350. The idea is to get all the ingredients cooked through while crisping up the flatbread, but not burning it. A little finesse is required. We’ve also done this on the grill, which requires a very low flame so you don’t burn the flatbread. Regardless, watch it like a hawk the first time.

Flatout-Flatbread

I started with flatbread from Flatout Bread. Good size, easy to use, fits on a cookie sheet. 16 grams of carbohydrates per flatbread. They come in a variety of options, including Garden Spinach and Sundried Tomato. I used the Italian Herb. FYI: Their website contains great recipes from other bloggers.

I like to put a very thin layer of olive oil on the bottom of my cookie sheet, along with some garlic powder or celery salt, to give the crust a little zing. Then I went to the refrigerator.

Ingredients

I just looked for anything that might taste good on a pizza. I found turkey deli meat (for Maureen), salami deli meat (for me), green onions, baby portabella mushrooms, and green olives. I also had some cherry tomatoes left from my garden.
 
 
Classico-Pizza-Sauce

We began the pizza build with Classico Fire Roasted Pizza Sauce. The nutrition label says that ¼ cup carries about 6 grams of carbohydrates, and that’s about the amount we used on each pizza. I’m also a big fan of basil on my pizza; we didn’t have fresh basil, but I sprinkled some dried basil flakes on top of the pizza sauce to give it an extra layer of flavor.

Then we just started piling on ingredients! One thing about the tomatoes: A lot of flavor is in the juice of tomatoes, but that extra liquid can really make your pizza soggy if you’re not careful. These cherry tomatoes worked fine, but we made sure to put them on top of the other ingredients. If you’re using something like a Roma tomato, slice it really thin and place each slice on a paper towel first. It won’t drain all of the liquid from the tomato, but keeping the slices thin will keep from weighing everything down, while still giving you that tomato boost. Yes, I’m a fresh tomato addict.

Once we finished with our ingredients, all we needed was a little mozzarella cheese on top. Here’s a look at one pizza before the cheese and one after the cheese. Looks good, right?

Half
 
 
Well, they were even better when we took them out of the oven. Cook your pizza at 400 degrees for 5 to 5 ½ minutes. In our case, thanks to our 50 year old oven (literally), we needed to finish it off for 30 seconds or so under the broiler to brown the top a little bit.

Flatbread-Pizza

From start to finish, these two flatbread pizzas took about 15 minutes. It may not have taken that long to eat them.
 
 
Carbohydrate count: Let’s see… 16g for the flatbread, 6g for the pizza sauce, maybe 3g for anything else. That’s 25 grams of carbohydrates for everything you see in the photos! A regular store bought or pizzeria pizza of the same size would probably be three or four times that amount. Note: You might want to take the fat content of the cheese you use into consideration too.

Carb counts are estimates only. Check with a registered dietician to find out what a healthy carb count is for you.
 
 
Full Disclosure: I’m not getting anything from Flatout Bread or Classico for writing about their products. They are just what I used to make this pizza.
 
 
 

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A Pump Vacation? More to it than you might think.

October 15, 2014 – 9:12 am

Yeah, about that 3-day pump vacation I had last week: To be honest, it was a little less “Pump Vacation” and a little more “Sudden MDI Freakout”. The reasons for that are ones you can probably think of, but since this was unplanned, I wasn’t really prepared. I was lucky to have done as well as I did, when you consider these factors:

To begin with, I started back on the Lantus for basal insulin. I was still using Novolog for boluses, just like I do in my pump. But it’s been quite a while since I’ve used Lantus, and it scared the crap out of me. Prior to pumping, I had some pretty horrific lows on Lantus, and that’s the first thing I thought of when I did my first basal injection. Here’s the biggie: If I’m injecting for my basal, I need to take exercise and what I’m eating into consideration. Too much (read: ANY) eating without a bolus injection means going high. Exercising without extra carbs or without previously altering the basal injection almost certainly means eating and drinking like a juice-addicted chow hound later on. There’s no such thing as “threshold suspend” when you’re injecting.

Oh, and injections. Part of the flexibility with pumping is the obvious freedom to bolus whenever you need to, without stopping what you’re doing and finding your insulin pen, getting a fresh needle out, and injecting. For everything you put into your mouth. When I had bloused for dinner, eaten, and then Maureen’s family decided to go to Dairy Queen or something for dessert, I had to decide whether I wanted to partake and inject again. I still had to decide whether I wanted to add to my carb count for the day. But part of my decision was based on whether I actually felt like doing another injection.

And the calculations. I’ll admit it… I’m a big user of my pump’s bolus wizard feature. The first time I needed to do a bolus injection, my BG came in at 78 mg/dL. You know what that means, right? Take the 22 mg/dL I was below 100 to figure how much to reduce my bolus so I wouldn’t go low overnight. To my surprise, I found that doing these calculations in my head was like riding a bicycle (in my head). The first calculation took a while, and I practically singed some brain circuitry, but the rest were really no trouble. Good to know I can still do simple math in my head.

But I also had to remember that I was in sunny, HOT Florida. When we went out with my pump on, the air conditioning in the car kept my pump cool, and then we’d quickly go into an air-conditioned building of some sort. But I needed to take the cooler along when I had the insulin pens, or leave them in my pocket the entire time. Which can be tough with a swimsuit on. In retrospect, I should have just kept them in my pocket anyway.

All of this is just a reminder that a pump vacation may seem like a fun idea when you first think of it. But if you don’t do some real planning, you may find yourself in sudden MDI freakout mode, just like me. Make sure you have your calculations down, you’re familiar with what your insulin of choice is capable of, and make sure your meal/carb intake is well planned as much in advance as possible. If you think of these things ahead of time, you can look at even the surprise pump issues with a little less freakout and a little more vacation in mind.
 
 
 

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8 Vacation Observations.

October 13, 2014 – 10:02 am

I’m feeling somewhat refreshed after a week away, but also a little bummed about the change in temperatures at home, and mostly about the dwindling amount of sunshine in the days here in North America. To begin the week, since I seem to be stuck at eights lately, I thought I would offer eight observations from the previous week:

– Transportation Security Administration: We’re still finding different rules in different airports. In Baltimore, take out your iPad, and take off both your shoes and your belt. In Fort Myers, you can leave your belt on, and you can leave your iPad in your bag. But regardless of where you go, don’t forget to empty your pockets. I got yelled at (and I mean YELLED AT) by a TSA agent at BWI, but my pockets were empty. He was very, very unhappy, and came out from behind the barricade he was behind, walking straight toward me, pointing. Until I pointed out that what he saw was my insulin pump, after which he said “Okay, just go through here and we’ll take care of you right away”. With a smile on his face.

– Pump Vacation: I took an unexpected pump vacation for a few days down in Florida. After being in the pool for a while, with my pump in a cooler (inside a plastic bag– thanks Kelly), I took it out, reattached, and started receiving button errors that I’d never seen before. I couldn’t get the ACT button on my Medtronic Revel pump to work at all. I worked with it for about half an hour and started to get some functionality back, but the ACT button was still spotty, so I just took the battery out and went on MDI for about three days. I reconnected Friday night, and everything seems to be okay, but the ACT button still needs a little extra oomph to work properly. I’m happy to report that despite all this, diabetes played a mostly secondary role this past week. But this is a huge wake-up call for me, a big reminder that because my pump warranty expired over 6 months ago, maybe I shouldn’t wait too much longer to decide on a new pump.

– How would you like to be cooked? Why is it that while you’re on vacation, you’re always worried about getting too much sun, but as soon as you’re back, you think you didn’t get enough? Inquiring minds want to know.

– Speaking of not enough: When did I get the mentality that I’ll never be able to do enough diabetes advocacy? When I started this blog, I wanted to help where I could, thinking that I probably wouldn’t be able to do much. By this point, I’ve accomplished about ten times more than I ever thought I would, but it just doesn’t seem to be enough. Oh well… I guess I’ll continue to try to help where I can, as long as there is a need. And unfortunately, there is still a need.

– Reading: My reading at home is mostly at the rate of ten pages at a time. That’s how many pages I can read on the train to work, during my short lunch, and on the train home. Thirty pages per day. So vacation is usually when I get a chance to dive into something without missing a stop (I’ve been known to do that). On this trip, I read the fabulous Billy Crystal autobiography Still Foolin’ ‘Em, which will make you laugh out loud in public places, often. Great background stories on the projects he’s worked on over the decades too. I also read through Blog Inc., by blogger Joy Deangdeelert Cho. It’s mostly about monetizing your blog, which I’m not much interested in. But there are some great tips on blogging in general that I found useful, and that you might find useful too. I especially liked the interview with Emily Henderson on page 115 where she talked about why she started blogging.

– The ATL: Travel both ways this time was routed through Atlanta’s Hartsfield-Jackson International Airport. For the life of me, I can’t understand why an airport that claims to be the busiest in the country makes my wife with arthritic feet walk half a mile (literally) to find out what gate her next flight departs from. And while we’re at it, why do pilots still make an announcement that says “If you need help finding your next flight, an attendant will be at the end of the jetway to help you”? Because those attendants don’t exist. They were “right-sized” out of the company while you were adding 50 bucks to my fare so I could actually take the luggage I’ve never paid extra for before. We did find someone at an empty gate a few gates down, who refused to look up our connecting flight and pointed us in the general direction of where we could find our departure. If we moved fast enough so we wouldn’t miss it.

Bonus: The ATL does include sharps containers in the restrooms. I found this one in the back of the Men’s room in terminal D next to the urinals. Great idea, bad placement.
Sharps-container

– DSMA: Despite wi-fi that was slow as molasses, I was able to sit in on last Wednesday’s DSMA Twitter Chat, and it was still one of the highlights of my week. I think it’s safe for me to say my life would be a little LOT less happy without that crazy hour of questions, answers, encouragement, and support. Even on vacation.

– Finally… Pictures! Here are a couple of sunrise photos from Sanibel, Florida. One, sunrise looking toward Bonita Beach and Estero at low tide, and one showing the famous Sanibel Lighthouse. Enjoy your Monday!
Sanibel-Sunrise

Sanibel-Lighthouse
 
 
 

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Perspective.

October 9, 2014 – 10:02 am

As I sit here watching the sunrise begin another glorious day on the beach, I’m filled with… well, a sense of relaxation, really, and an inherent question about why I’m out of bed this early on my vacation.

But stay with me– there’s a point, and it has to do with…

Perspective.

I’m quite fortunate to have this one week during the year, away from work and other distractions. I know many others who never take more than two or three days off at a time during their entire working lives, unless they wind up in the hospital. In other countries, heck, in our country, sometimes people have to work seven days a week for years at a time just to get by.

I also have this insulin pump that I use (which is giving me fits right now, but stay with me), that helps me manage my diabetes easier. Some people don’t have the luxury of having a choice between pumping or multiple daily injections. It’s just the injections, IF they’re lucky enough to get coverage that will pay for part of it, and IF they can afford the astronomical costs of the things that aren’t covered.

I have access to insulin, the wonder drug which will keep me from dying from the effects of Type 1 diabetes. Many in other countries do not have such access, and lack of access to this simple potion, that’s been in existence for nearly 100 years, threatens their very existence.

I have access to this fabulous Diabetes Online Community, where a wealth of support and encouragement awaits with the simple click of a button. Yet many are left wanting for understanding and education because they are unaware or unable to discover this life-affirming element to their diabetes circle of influence.

I’ll be honest… I’ve made the most of the opportunities I’ve been blessed with. But a lot of those blessings came as a result of where I was born, and the environment into which I was born.

I’m not sure if I have a big focus for Diabetes Awareness Month (which begins November 1, by the way). But I know I would like to do something to help people who, through no fault of their own, have little to no options when it comes to diabetes care. That includes people in my own country, the USA.

It’s easy to sit and complain about things that are wrong in the world. But I never want to forget about the children, the parents, the brothers, and the sisters living with diabetes who need our help. You can find them all over. And you can help them.

If you keep your perspective.
 
 
The Big Blue Test begins October 15. For every test taken, Diabetes Hands Foundation will make a $1.00 donation to a worthy diabetes effort. For more information, go to bigbluetest.org.
 
 
 

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Like these links… Vacation edition.

October 3, 2014 – 9:46 am

I’ll be honest with you… I have vacation on the brain right now. Soon I’ll be off for an entire week for the first time all year. So you may not hear much from me for a while. That’s not a bad thing, right?

Especially because there are so many other great places to go to for interesting stories, and things that expand your knowledge. Consider these reading options this week:
 
 
– Kelley at Below Seven talks about how she’s often put up a happy front to help her cope with her diabetes, and how sometimes that sends a message to people that things are always rosy, when maybe they aren’t:

“I guess my main point or word of advice to others is that if someone seems really happy or bubbly, don’t necessarily think that their life is easy.”

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One of my favorite new blogs is written by Ally at Very Light No Sugar (Catchy!). Ally describes how she made a decision at age three to never cry at the doctor’s office. Ever. Now as an adult, she’s examining that decision and how it’s affected her life ever since:

”I see today that my mentality of always being strong was a survival tactic yet a detriment all at once. Some days I have a quick temper because it is easier to be angry than to acknowledge being scared or defeated.”

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– If you’re new to the Diabetes Online Community, or to diabetes in general, I hope someone has turned you on to Diatribe. Kelly Close and her amazing team do an amazing job of providing useful diabetes information (for all types) in an easy-to-read style. Find out about new drugs and devices going through clinical trials, new products hitting the market, research into things like cell encapsulation and what’s really behind your A1c, and much more. I’ve taken to printing the .pdf version and reading it on the train to and from work.

In the latest edition, find out about Abbot’s Freestyle Libre system, the approval of Eli Lilly’s new drug Trulicity for Type 2 patients, information from the Centers for Disease Control on obesity data on a state-by-state basis, and the always-interesting SUM musings from Kerri Sparling, who talks about the CGM in the Cloud phenomenon.
You don’t want to miss this or any issue of Diatribe.

No, I don’t get anything from Diatribe for saying all this. I just think you’ll find it a useful and necessary part of your life. That’s all.

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– Finally… here’s something to scratch your head over. Is a lack of insulin to the brain responsible for alzheimer’s? When I first read this, I remember thinking “How dare they steal my disease!”. Then I started wondering how deep the research really went, and if there really is a connection:

Is Alzheimer’s Disease Brain Diabetes?

Something for me to think about as I pack.

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So… What have you been reading lately?

I hope your weekend is great, and next week is even greater. Talk to you again soon!
 
 
 

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