The insulin came and so did the rest of the supplies. The box was soggy, I'm not sure what from. I'm trying out the insulins and will see what happens. My father thinks we should just call the company now and demand new, but I'm wanting to try them first. Maybe they're good.

I asked my therapist not to ask me if I'm hypo, because I hate hate hate that question. She objected on the grounds that if my hands are shaking or I'm being quiet or I'm stimming or whatever, she needs to know whether I'm doing the behavior because of my emotional state or because of diabetes. I said that if my hands are shaking, she could just ask me why my hands are shaking!. My therapist said okay to that.
My mother says that if she asks if my hands are shaking, the question are you hypo is implied. I guess it might be, but somehow, it feels like a much much friendlier question.
You could ask anybody why hir hands are shaking.

Two Day Shipping in December? Just Joking!

I went to see my endocrinologist on December 5. He wrote prescriptions for me. Don't remember how many. Within a week, we sent in the prescriptions to Prime Mail Pharmaceuticals. Within another week, they claimed that they had sent the package off by two day mail. Days ago, the package(s?) were supposedly just a couple hour's drive away, within Illinois. Well, it's not here yet.

My father says that as soon as the package gets here, I should call, tell them what has expired, and demand new of whatever expired, for free. I'm actually feeling scared about the integrity of both the Lantus and the Novolog. In this weather, having been in the mail for 13 days now, I'm not so sure that they will have been in decent temperatures. I think that as soon as the new package comes, I am going to open and try out one new vial of Lantus and one new cartridge of Novolog and see what happens.

Do any of you have experience in what happens after your insulins went bad in the mail?

Package from Roche

Roche had (probably still has) an offer for free multiclix, so a while back (can't find in my calendar how long ago) I called. Asked for the multiclix, they asked if I'd like a complimentary subscription totheir magazine, Completing the Circle of Care. I said You betcha.
The woman on the phone told me that if I'd received another Accu Chek offer in the recent past, I'd get a letter telling me that I wasn't eligible. Otherwise, I'd get the multiclix. In either case, I'd get something from them in four weeks.
Well, the package came today. I got a new lancing device, two drums, some posters saying how great the multiclix are, and a copy of the Completing the Circle of Care (folded because of being inside the box.
And you know what? The multiclix really does feel pretty good. I keep managing to misplace my original ones, and having to use miscellaneous others, and I like the Accu Chek. It's also much easier to change the lancets with the Multiclix.
I might not always like Roche's meters, but the multiclix? Two thumbs up. It gets me blood without too much pain.
On a few occasions, I've been out and about and taken out the drum because it was all used and then realized, OOPS, I don't have another drum. And then I have had to manually draw blood or just skip the test. It took me about five months of dealing with diabetes to get into the habit of getting the new drum before removing the old one.

Insulin on my Mind

Last night I was listening to the radio and this song came on and I heard,
"The love you gave me, nothing else can save me, insulin
When you're gone, how can I even try to go on?
When you're gone, well I try, how can I carry on?"

It's this song that could be a love song to endogenous insulin. When you're gone insulin, though I try insulin, how can I go on without insulin?

I googled it tonight and it turns out its just a love song and the word I heard as insulin was ess oh ess. What can I say, listen to it yourself and tell me it doesn't sound like insulin.

Life Masters and Diabetes Reading

is one of those programs that has a nurse call you to talk about your health issues and is paid for in full by insurance. I've gotten a bunch of mailings and calls and today I succumbed and said what the hell, sign me up. So they took my medical info and said a nurse'd be calling.
they wanted to know what my health goals are. I said I'm working out and trying to get more muscular (I have a brother who is a weight lifter and who recently recruited me as a training partner; we lift weights together twice a week), but that what I could use some help on is that I'd like to get an A1c reading below 6%.

I picked 10 diabetes related blogs to read regularly and that I'm gonna comment on in the next month, and I'm putting them in the sidebar. I'll change them in a month or two, regularly, I hope. My rules for picking them was that they had to have mentioned diabetes at least twice in the past two weeks, that at least eight had to be first person diabetes accounts, and that the diabetics didn't have to be type one but do have to be on insulin. Oh, and they had to be in English or Hebrew and I didn't find any Hebrew ones. I can't read any other languages enough to really understand anything as complex as diabetes.

Organ Donation as a Diabetics' Issue

I'm on the Illinois Organ Donor list; if I die it's okay with me if they re-use my parts. Obviously, not the pancreas. I'm really comfortable with the idea of them using my kidneys or liver, not really so comfortable with the rest of it, but whatever.
One of the things that really strikes me about the Illinois organ donation campaign is who they've been featuring. The email I received from them today included this testimony:

I know firsthand the impact that a donation decision can make. For 25 years, I suffered from juvenile diabetes and was in dire need of a kidney and pancreas transplant. Thanks to an organ donor, I received my successful transplants in December 2006, essentially curing me of diabetes.Today, I am proud to serve as Honorary Chair of the Donate Life Illinois Workplace Partners program to help make a difference for the more than 4,700 Illinois residents who are still awaiting lifesaving transplants as I once did.

When I stood in line to get my state ID after I changed my legal name in January, I saw the walls covered in organ donation stuff. There were pictures from kids who received organs, but only one written testimony. It was from another former diabetic who had also received a kidney-pancreas transpant as a young adult. That was really sobering for me as a fairly new diabetic.

I have four brothers, but my blood type is O and they are As. My parents are in their early 50s; I don't think that with A1cs in the lower sixes, my kidneys will fail in the next twenty years, so that would put them in their 70s at least by the time I might need a kidney. There is no absolute upper age limit for kidney donors, but kidney function in people over 65 is usually reduced enough that their kidneys aren't considered good enough to donate.

So when I made my diabetes collage in mostly black and white, I included an organ donor card in color.

The average person who goes on dialysis dies in less time than the average wait for a cadaver kidney. Dialysis is a particularly dangerous option for diabetics. People on dialysis die of a number of causes. One of the larger ones is poisoning. Eating the wrong stuff or too much can be deadly if your kidneys don't work. But when you're diabetic, it's harder to stick to eating an exact amount. Another issue that sometimes kills those on dialysis is infections, which diabetics are particularly vulnerable. One of the other problems of dialysis is depression. A lot of people on dialysis let go of the will to live, for a host of reasons that I'm guessing you can understand.

However, I would still include dialysis as one of the top ten improvements in diabetes care from the last fifty years. I have a friend who waited seven years on dialysis for a kidney transplant; I hope that I would be able to do the same if it came to that.

Receiving a kidney from a living donor has a greater success rate than from a cadaver donor in general, but diabetics sometimes would be better going for a cadaver donor so as to get a pancreas and kidney together, which has a greater success rate than a stand alone kidney. If I could get euglycemia in a permanent sort of way, I would donate a kidney.

Zits or Celiac?

I've had acne for the last six years. Sometimes it has been so bad that people have asked me if I had chicken pox. My mother says it's not really a very bad case, it's just that most people use stuff to disappear their acne. I have never done anything to get rid of the zits. I think that they're sort of ugly but not really worth doing anything about.
In the last two weeks, I've developed big things mostly on my neck and back but also two on my thighs, that might or might not be pimples. They don't do anything if I squeeze them, they're awfully big for pimples (imagine a monster pimple), they itch and kind of hurt, and they're sort of scaly.
I'm wondering if these could be that celiac symptom, dermititis herpetiformis, or if I'm just being a hypochondriac.
I am also wondering: If I used an anti-zit thingy on something that was really a different sort of skin problem, would it still go away? If I used an anti-zit cream and the things didn't go away, would that prove that they're not zits?

Good Pinch, Bad Pinch

Today I was giving my five year old brother a time out, and he pinched me. I held his hands in mine and told him, No pinching.
Then I considered that, and said that actually, there is a time when I want to be pinched. Could he guess when? He calmed down dramatically, puzzled. He couldn't guess. I pointed at my arms and legs and gave the hint that that was where I like to be pinched- could he guess yet? Nope.
He asked his brothers- did they know? Nope.

When I want a shot! I told him. That's when I like to be pinched. Wanna help me do a shot? He thought that that was a great idea. He pinched my arm.
Not hard enough, I said.
This hard? he asked.
Good enough, I said, and stuck the needle into my arm. He pushed on the insulin pen, and the insulin was in in no time at all. He had not let go of the pinch.
Suddenly, he let go, pulling on the pen at the same time. Blood trickled down my arm in a thick line, and clearish liquid pooled by what was quickly becoming a bruise.
He looked at me, alarmed.
Oh well, I said. Good enough. And pulled down my sleeve.

Note to Self: make sure to tell brother to release the pinch, so that when he does I can move the insulin pen at the same time and avoid bleeding.

6.4

So my total history of HbA1cs is:
September 1, 2006: off the charts, over 16%
September 2, 2006: off the charts, over 14%
January 11, 2007: 6.5%
May 16, 2007: 6.3%
August 23, 2007: 6.3%
December 5, 2007: 6.4%

I'd like 2008 to be better than 2007. Sometimes I think about getting a dog or a CGMS. I am happy about the 6.4 because I thought it was probably even higher.

My mother says I'm doing well and that there's not much room for improvement. My endocrinologist says that there's only so much you can do without pancreatic function while maintaining quality of life.

But I am listening when my mother says that the saddest thing in the world is children dying before their parents. I am watching people age and I am thinking that I want to get to be old too. I don't want my mother to outlive another one of her children. I want to live to be 20, 30, 40, 50, even 60 or 70. And that means maintaining low blood sugar or having some really great genes, and I don't think I lucked out in the gene pool.

Endo Visit

I hadn't seen him since August and in the meantime my prescriptions all came in with the labels that say:No Refills Left. Call your doctor immediately!
So we spent maybe twenty minutes deciding on prescriptions. A few things were different: I made sure that we were getting the needles I want (the 5mm, not the 6mm pen needles), I got a prescription for ketostix that come in the foil packets (the endo's been bugging me about that), I now have both a prescription for a glucagon in the mail, plus one prescription so that I can get an immediate refill at the pharmacy if we have to use a glucagon. The prescription for test strips was upped from 8x daily to 9x daily.
I know that a lot of endos use machines to get a fingerprick A1c in the doctor's office, but they're slightly less accurate than the lab results from a venous blood draw, so my endo prefers to do the blood draw. Mostly I think that that's great, but this time I wasn't so thrilled because there was still a red dot on my arm from the previous blood draw, which was two weeks ago. My endo (who draw blood himself) joked that that made it easier to find the right spot to insert the needle. Heh. It hurt. I'll probably have the results on Thursday, maybe Friday.
I had expected to be awkward with the endo because of his refusal to put me on testosterone, and my subsequent visit to another doctor (an internist, even) to get on testosterone. But it was fine- he asked me what dose I was on, and wrote down the other doctor's name, and asked when I was next seeing the other doctor, and what my parents' reactions were, and didn't seem upset.
I looked at the bloodwork from last time; he had looked at my liver and kidney stuff as well as getting an A1c, and only the A1c was outside of the normal range.

The endo pointing out to me that you want to have another glucagon on hand if you have to use one, instead of waiting for it to be mailed in, was sort of sobering. On my first visit with the endo, he made a point of telling me that he believes that mainting an HbA1c below 7% is worth a few seizures per year. I've been well under 7% for the last year, with some pretty low blood sugar readings, but no seizures or loss of consciousness. I have very little hypo awareness.

treasure

My mother is an M.D. but hasn't been in practice since 1992. The most recent place she worked at a doctor was a hospital in Chicago's worst neighborhood, Englewood, where all the medical equiptment is out of date. So when I was diagnosed with diabetes, she was wowwed by how small the lancets were and how little blood was needed for the test strips.
Last night she was looking for an eye chart and I was looking with her and I saw a Soft Touch lancing device. I was like, cool, a lancing device. Lemme try it. So she let me have it and the glucose monitor she had, a whole buncha lancets. My mother pointed out that it would probably get a lot of blood compared to the lancing devices I usually use. But I was like, that's okay, I still want to try it.
I did try it, and it got a little more blood that usual. It only has one setting! All of my lancing devices have multiple settings.
The blood glucose meter she had is the TRACER II. She doesn't have any strips to go with it, and the batteries are dead. I do have the manual. It says it was made by the Boehringer Mannheim Corporation. They are now Boehringer Ingelheim and they make pharmaceuticals but no blood glucose monitors.
Isn't that cool?

I'm seeing my endo on Wednesday and will get new prescriptions; I still haven't decided if I want to switch to just syringes for the Novolog or stay with the NovoPen Jrs. Argh!