Eat it...just eat it!

THE CAKE IS MINE!

Okay. So we all know that whenever someone thinks of diabetes, food is one of the, if not THE first associations to come to mind. Most of the general public, since they have little to no experience of living with Type I, still have the antiquated  belief that we subsist on celery and unprocessed cheese and shun anything vaguely "starchy."

Well. I don't know about you, but that doesn't fit ME at all.  In fact, I have a relationship with butter cream frosting that could only be described as "complicated." And although I generally describe my eating habits as healthy and well balanced, I am not perfect by any stretch of the imagination.

What drives me nuts though, is when other people feel as though they have the freedom to "audit" me and say that I "shouldn't eat that." Oh, yeah, thanks for that memo. Because without your reminder, I would go into complete "diabetic shock" (don't you love that phrase?) due to my poor choices and ignorance.

Wow. I just realized how harsh that might sound, and I recognize that MOST people really do have the best of intentions when launching the whole "can you eat that" conversation. You have to understand that even complaining about these types of occasional comments makes me feel a little cliche, but because it is so prevalent, I feel the need to mention it. Not only because it feels good to vent, but also because it is one of the most common pet peeves for any diabetic.

LET THEM EAT CAKE!!

Aside from the directive and invasive comments though, I also find silent judging and questioning to be problematic. You know, like when you feel the eyes of  your spouse's boss  following every trip your hand makes to the bread basket...

Maybe I have a problem with trying to please everyone, but am I the only one who has ever "audited" what they ate in order to not freak out other people?  Don't get me wrong; I take most opportunities to further diabetes education and chat up the miracle of carb counting, but there are times when it isn't appropriate to dominate the dinner discussion. Or I am just too tired to explain myself for the 1, 345,624th time.

A hypothetical case in point: abstaining from the dessert tray at a family reunion party because my sweet great aunt** would be soooo worried if I had a molten chocolate explosion cake with an ice cream chaser, and my type II great uncle would be jealous and bitter and confused that I am indulging when he really can't (according to his treatment plan, not my judgment). Of course, I then remove my emergency cookie dough stash from the freezer when I get home so I can get my sweet treat fix that overtook my soul when I saw the dessert tray.

**Occasion and relationships have been changed to protect the adorably clueless



So...what are your food auditing experiences? When, where, and why do you find yourself silently altering your food intake in response to others?

Addict Roll Call: Moke and Lepsi fans unite!

 Almost every diabetic I know LOVES diet soda, typically one of the two Diet Cola varieties since it is usually the only kind that is readily available at every gas station or restaurant. Although I am a HUGE Diet Moke fan (names have been changed to protect the innocent), I understand that some people appreciate Diet Lepsi, (which I personally think tastes more like runoff from a feedlot, but it will do in a pinch) and I will still like (but maybe not respect) you if you are a Lepsi fan, but the common denominator between Lepsiers and Mokers alike is a deep and undying appreciation of your special brew.

Lest I be accused of only being addicted to the caffeine, I want to reassure you that I am currently enjoying cans of CAFFEINE FREE Diet Moke. Not to say that I don't supplement with the *real* stuff. I just love soda!

But, aside from hearing your testimonials to the amazingness of Diet Lepsi and Moke, tell me about your love affair. Did you like your diet soda even before you got diabetes? What role has diabetes played in your appreciation of the cola? And if you are feeling really brave, you can admit how many sodas you (or your "friend") drink every day. What lengths would you go to to obtain a fix? AND, if you are of the rare breed who doesn't enjoy it...how did you quit?:)

Cheers! I raise my cup of diet bliss to you! It is amazing how much happiness can be found in 64 ounces of fountain-y goodness.

Humor, with a side of blood

At age 14, within the first 6 months of being diagnosed, I made a "Top Ten list of things to NEVER tell a diabetic." At the risk of embarrassment, I hesitate to disclose that I am not sure where this original list can be found. See, it was saved on ummm...a disk. A floppy  floppy disk, not even a 3 1/2 inch floppy disk. On an Apple II GS computer with a program called "Bank Street Writer" You can start laughing now; I don't mind. Think of all the character building experiences us "old skool" folks have had before the modern conveniences of flash drives, high speed internet, and email.

At any rate, the things on the list included something like the following:

*You can't eat that!
*My great aunt Bertha had diabetes and she had both legs amputated and went blind.
*If I get some of your blood on me, would I get diabetes too?
*You must have eaten a lot of sugar to get diabetes so young!
*You're low! Let me bring you some Diet Soda really quick.
*Sometimes I wish I had diabetes because I want more attention
*Do you have the really bad kind of diabetes?
*Oh, my doctor said i have "just a touch" of diabetes
 *Oh no! Your blood sugar is 100! That is so high!
* I know how you feel, I have had a cold last month and it is miserable to be sick all the time.

The list brought a lot of laughs to a lot of diabetics (or at least a lot of polite people humoring me), and I think making the list helped me process and positively handle some of the stinky aspects of diabetes management. If, for example, I had a negative experience at school with the nurse, I thought "Ooohh...that one is TOTALLY making the list."

Recently, on a popular social networking site (perhaps you have heard of "Facebook"?)  I stumbled across an amazingly awesome thing called "Type 1 diabetes memes." It is full of witticisms, caption contests, and photos that celebrate the culture of IDDM. So, a shameless plug from someone who has absolutely nothing to gain from the recommendation. If you are on FB, have a sense of humor, are a type I or have a close family/friend with type 1, check it out. It is great to find not only funny bits about IDDM, but find a bunch of people who are in your proverbial shoes.

Laughter is the best medicine, right? I find it much more useful than my insulin pump. ;)

Fun with moving

The last time I wrote (TWO YEARS ago... my, how time flies when you are busy with toddlers!), I was a bit agitated with finding diabetes care in a new city. The big secret behind THAT post was that I was already pregnant with our second child, and it was super imperative that I find good physicians to be sure we were both healthy. After I called my doctor from the BDC, he made a few calls and opened the door for me to get in and see one of his rock star physician colleagues. A big shout out to Dr. Thomas Moore and his staff in San Diego. Thanks for a great experience!

Now, two years later, I am in the same boat AGAIN (although I am not pregnant). Due to my husband's job, we now live in the Fresno, CA area, which is about 6 hours away from our recent home in San Diego. Back to the not-so-fun-and-deductible-reaching drawing board of finding health care. Sigh.

This time around, I decided to try and find health care professionals ASAP after moving. After a great deal of research and yelp-ing, I had several appointments with different providers and after a few misses, I think I finally found a "hit" with a good diabetes doctor. Of course, this journey was not without its pitfalls. Finding babysitters to watch my 3.5 year old and 1.5 year old  in a brand new area was tough, finding the actual offices was difficult (thanks for the faulty GPS, not-so-smartphone!), and finding a compatible doctor was hard. BUT! I think we have a winner.

Sooooo....things seem to be happy on my end here. How about you? What have been your positive and negative experiences with finding good diabetes care? Any tips for finding a good doctor those who have just been diagnosed?

A trip to the Dark Ages...

I have been incredibly spoiled in my diabetes care. Right after my diagnosis at age 14, our PCP sent me to the Barbara Davis Clinic (BDC) because he recognized that my care there would be much more complete than what he could give. Thank you Dr. Chesley--it was the best referral you ever made.

The BDC is an amazing center for the research and treatment of insulin dependent diabetes. I have participated in several research studies there, and the treatment options are cutting edge technology. The blood test that measures average glucose levels (an A1C) is taken via a finger prick and the result is available within 4 minutes. The staff really understands TYPE I diabetes and do everything in their power to help you control blood glucose levels. There are dietitians, nurses, and diabetes educator on hand IF YOU NEED THEM. My doctor is superb and knows that what works in theory doesn't always work in a type I body. I never feel censured when, after trying my best, my numbers are not perfect. Quite frankly, I find myself running out of superlatives to describe my experience at the BDC.

I love the BDC so much that I have been flying back to Colorado every 3 months to attend my appointments. I have been searching for a good diabetes doctor here in San Diego, but
1. Most have waiting lists of 4-5 months
2. Most are not accepting new patients
3. Most have no clue about the fine details of Type I.

A quick delineation between the different kinds of diabetes. Most diabetics in the world have Type II, also called adult onset, which means that the body either 1. Doesn't produce ENOUGH insulin, 2. Doesn't USE the insulin the body produces efficiently, or 3. Both 1 and 2. Gestational diabetes is basically Type II while a woman in pregnant. Due to the hormonal roller coaster or pregnancy, 1-3 can occur.  The treatment of Type II diabetes focuses on helping your body "remember" how it is supposed to work: a healthy diet, exercise, etc. Occasionally oral medications are used to help the body use insulin more effectively, and in the end some patients will end up using insulin.

Type I (juvenile diabetes) is an autoimmune disease, which basically means that the body's immune system destroys some part of the body, in this case the insulin producing cells of the pancreas.  IMMEDIATELY upon diagnosis, someone with Type I MUST begin taking insulin. Without insulin, the body doesn't work...sugar from food, and naturally produced glucose from the body, clog up the kidneys, eyes, circulatory system, and the body doesn't have any fuel, since the glucose stays in the blood. AT this point, if I didn't take any insulin, I would be dead within a few days. Not to be melodramatic or anything. Only about 8% of all diabetics have Type I.

There are tons of treatment for type I, and I use an insulin pump combined with a continuous blood glucose monitoring system. I have two needles in me...one is attached to my pump via a tube and gives me insulin. The other senses my blood glucose level and sends a message to my pump so I can see what my blood glucose levels are.

So much for my "quick" explanation. At any rate, hopefully you can see that the differences between the kinds of diabetes.

AT the beginning of January I tried to get my foot in the door with an endocrinologist here in San Diego. Yesterday I finally had my appointment.

The doctor I went to knows about insulin pumps and continuous glucose monitoring systems, but is clearly used to dealing with the other 92% of people that have diabetes. He really wanted to focus on making diet and exercise changes so "I don't use so much insulin." Really? I exercise about 6 hours every week, and eat a fairly stringent diet. I have been dealing with my diabetic body and how it works (or actually, doesn't work!) for 18 years.

The doctor was pleasantly surprised that I "know exactly what I am talking about" in terms of what is happening with my body, and that my eye exam and kidney tests were current. He was a little shocked that I had just been in to see my endocrinologist in Denver in January, and was amazed that I go there every 3 months (which is the absolute recommendation for check-ups for Type I).

After spending 15 minutes with me, he said "Well, our time is up so next time we will cover some more issues at your next appointment." The kicker is that this doctor is so busy that his next opening for an appointment is at the END OF JULY. In the meantime, he will have a bevy of people calling me: the diabetes educator who "knows" about pumps, the dietitian, and a different diabetes educator. AT this point, I feel like I am a diabetes educator myself (quiz me on a carb value...any carb!) and DON'T NEED the calls. I need a knowledgeable doctor who can help me tweak some insulin rates and uncover hidden pitfalls I might not think about.
He sent me down to get a blood draw for my A1C value, where the line to GET said blood draw was over 45 minutes (keep in mind that my 16 month old was at a babysitter's house and I had already been gone for close to 2 hours) and then I would have to wait 3 days for the results. I went straight to my car, gently wept while driving to pick up the baby, and then got mad.

I feel like I was enjoying living in a sparkling house complete with remote controlled appliances and a bidet, and now I am thrust into a broken-down shack with an outhouse. I guess the commute will continue.

Fun with lows

When I got married, I got a rude awakening. I always thought of myself as one of those lucky diabetics that doesn't "get weird" when I get low. It turns out that I do have some interesting quirks that come out when my blood sugar dips, which my husband pointed out to me.

Occasionally (not every time I am low) I get really quiet, or take a long time to answer a simple question. I  stumble over my words (probably because my tongue gets numb and tingly) and I have been known to laugh at random comments like a hyper third grader sucking helium. It is important to note that I don't notice when I do this, which is why I was surprised to discover this about myself.

I have never "freaked out" (phrase taken verbatim from one of my friend's parents..."Jeanette, I don't want you to freak out on me") and I am lucky enough to wake up when my glucose is dropping (it makes for some interesting dreams...whatever is happening in my dream changes to reflect a low blood glucose level...once I dreamed that my blanket turned into a blueberry pop tart, which is weird in and of itself since I only like strawberry pop tarts, and I ate my entire blueberry pop tart blanket but was confused because I was still low, which is when I woke up and ate a strawberry pop tart).

Anyone with diabetes or anyone that has a loved one with diabetes probably has some entertaining stories about being low. Let's hear them! Laughter is the best medicine.

Once upon a time...

Everyone has a good story to share, whether it is about the time your car broke down on the freeway and you were rescued by a motorcycle gang wearing tutus, the time you singlehandly managed to cause a power outage for the entire city, or the time your pants fell down in the school cafeteria when you were in fourth grade.

People who have been diagnosed with a chronic illness, like diabetes, all have a good story to share about the time they were diagnosed. Sadly, not all of these stories are filled with humor and warm fuzzies, but most stories are poignant experiences detailing changes in identity and lifestyle.
I was diagnosed when I was 14 years old, the month before I started high school. I had been feeling tired and thirsty all summer, but we chalked it up to me being busy with early morning swimming team, theater workshop, and fun on the lake boating and camping.

My mother had the feeling something was wrong, and her fears were especially piqued during a short road trip. I drained our family's two gallon jug of water within the first 45 minutes of the trip, and was so desperate for water that I tried to fill up the jug with sprinklers from a rest stop. The water was a horrible rusty color and there was a sign that said "water is non-potable," but I tried to drink it anyway. Luckily it tasted so bad that I wasn't able to drink much.

At our destination, the water also tasted bad, so I satiated my thirst with regular soda. In hindsight, that made everything worse, but of course we didn't know that at the time.

A month after the trip I was preparing to go camping. I thought I had a bladder infection, so we went to the doctor to get it taken care of before going into the wilderness. While I was providing the urine sample, my mom asked the doctor if he could run a diabetes test as well. He thought she was being overprotective, but did it anyway.

When the doctor returned to the exam room several minutes later, his face was grave as he explained that I had a little bladder infection but an abnormally large amount of sugar spilling into my urine. He sent me down to the lab to get a blood draw and said he would call with the results the next afternoon.

That same fateful Friday my older brother had a collision with a car which totalled his bike, and my sister found her treasured opal necklace crushed in the garage. My mom loaded  us, the three kids, into the car and took us to the fire station, where my dad was at work. She had us share our woes with him, and I went last. I said in a rather casual manner "yeah, I might have diabetes." I remember my parents exchanged a meaningful glance, but I still wasn't letting it sink in. It was, after all, not a real diagnosis. If something was really wrong the doctor would have done something at the appointment.

Everyone else was worried, but I was fairly cavalier about the situation.  I even tried to wheedle my mother into taking us out for ice cream, because if I DID end up having diabetes, I would never get the chance to have ice cream again. She did not comply.

The next morning, at 7:30 AM, we heard the phone ring. I knew what the call must be, and I was right. A few minutes after the end of the murmurs on the phone, my entire family came into my room to wake me up (like I was asleep!). I went into the hospital immediately, and the rest is history.

Looking back at my diagnosis story (can you believe this is the short version?), I think of the emotions felt not only by me, but by my family and friends. The support I felt at the hospital was incredible, and sometimes I have to remind myself that diabetes is not just MY disease, but a condition that affects the important people in my life.

I also am reminded about how blessed I am with how far technology has come since my diagnosis in 1993. My first meter took 45 seconds to get results, I was on several injections a day, and I was told that I couldn't eat anything where any form of sugar was one of the first three ingredients. Wow. Now I have my pump, a continuous blood glucose monitoring system, and a great carb counting system.

What is your diagnosis story? I'd love to hear it!