Wednesday, August 27, 2014

A Bucket of Gratitude

We all have seen how insanely popular the Ice Bucket Challenge has become.  Stories of how much money ALS has raised since this went viral versus how much money it had raised in previous years are astounding.  What is equally moving is the stories of families touched by ALS.  I dare you to watch any of them without a box of Kleenex.

Last week on the Diabetes Advocacy Facebook page, I shared with you Moira McCarthy’s thoughts on this phenomenon and whether diabetes should be doing something similar. Reading about how ALS had touched her family brought tears to my eyes and I was so glad that my son “only has diabetes”.

I have not watched many of the ice bucket videos.  I have seen a few that have auto-started on my Facebook feed but for the most part I simply have said “I hope that they are donating” and “Better them than me but it is for a good cause.”  There are a few from friends who state that they have a personal connections to ALS that I do make sure that I watch .

Maybe that is why I played this next video.    It was from a Facebook Friend who had a child with diabetes who said that ALS had come to call. I was curious.  Would it be her father? Grandmother? I was sure that it would be sad but I had been following the many blessings in their lives. They had recently moved across the country into a dream house. They had enjoyed an amazing summer spent traveling throughout this great country of ours.  Life was very good for them, wasn’t it? After listening to her tell her family’s story, well let’s just say that I was again left very grateful that all my son had to deal with was diabetes.

I know that diabetes kills. I know that diabetes is serious.  I know that things can change in the blink of an eye.  In the past month we have seen depression kill Robin Williams.  We have seen countless stories of how ALS has impacted and destroyed lives.  I have seen a family devastated when a father tried to save his drowning daughter only to be killed instead. Life and death happen. We deal with the cards that we are dealt but some of us have greater challenges to face than others.

In a blink of an eye it could be worse–so much worse. Diabetes can be cruel but life with diabetes is getting better. Highs are still brutal in their destruction of the body.  Lows are still deadly especially when they happen at night or when a person with diabetes is alone. There is hope however. Technology has created major changes.

We have the bionic and artificial pancreas projects.  We have CGMs, rapid insulin, and smart pumps.  We have apps to count carbs and apps to get us out of trouble.  We have a wonderful community of people living with diabetes who get it and support us every day.  Diabetes sucks but after seeing what others live with…well I will take diabetes with a bucket of gratitude.

gratitude bucket

Wednesday, August 13, 2014

What's in a Name?

If there is one positive thing to come out of the tragic passing of Robin Williams, its the fact that so many people are talking about depression.  There is a huge effort to help people to understand the dark insidious nature of this disease--and the fact that it is a real disease not just a feeling of melancholy that we all experience now and then.

Clinical depression is a prolong sadness that has a chemical component that most often requires specific medications to begin to improve. It requires the use of a medical doctor and can be physically debilitating.

The most interesting thing that I have read in the past 36 hours or so since I heard about Robin Williams' passing is a debate that I hear in the world of diabetes all of the time--people would pay more attention to this disease if it had a different name.  People think of depression as fitting things like "rain on your wedding day and a free ride when you already paid" to quote Alanis Morrisette.  These are not exactly issues that lead a person to take their own life...unless they are already experiencing a much deeper pain.  There is a feeling of a need to disassociate the mental illness from the emotion.

In the world of diabetes, we see this same desire often.  People feel that the label Type 1 diabetes does not go far enough. It doesn't show the true nature of this disease.  It does not remove itself far enough away from another condition that is often associated with poor diet and the ability to be "cured" with diet and exercise.

Personally I am always led back to Shakespeare when this debate is brought up.  "What's in a name? that which we call a rose By any other name would smell as sweet."  Okay, diabetes is not as pretty as a rose and when you can smell "sweet" when dealing with diabetes we know that you are in serious trouble but you get the point. A name means nothing. It is all about the awareness.

Type 2 diabetes is not limited to people who are overweight. It is not magically cured by diet and exercise, but it is able to be managed that way unlike Type 1 diabetes.  Type 1 diabetes will not be cured with insulin.  Wearing an insulin pump does not mean that you don't have to think about diabetes ever again.  Misconceptions.  Fallacies. Misinformation.  It happens with every disease.

The general public is ignorant about many things. I knew nothing about diabetes until it tried to steal my son in March of 2000.  I now know more than some medical professionals but I know little about Multiple Sclerosis or other diseases. We educate ourselves to what is important to us. It is our job as people who have become experts is to educate the outside world to the important parts of our conditions.

They do not need to know how to carb count but we must work to teach the general public that there is no known cure for diabetes...unless you are a mouse.  An insulin pump does not mean that you have diabetes "really bad" and it does not cure your diabetes. It is a management tool that requires work and fine-tuning but is preferable by many to help maintain better blood glucose levels.  Myths must be debunked to create better understanding and support.

Much of the same can be said for depression. It is important that the stigma be removed--just as the stigma of diabetes needs to be gone.  No one "caused" either condition.  Both require medical attention and serious work to be able to manage.  Ironically depression is twice as common in people living with diabetes as it is in the general population and if you have depression but don't currently have diabetes, don't worry because people living with clinical depression are more likely to develop type 2 diabetes!

Robin Williams is getting people talking about depression. Mary Tyler Moore, Brett Michaels, and Nick Jonahs have all done the same thing in the world of Type 1 diabetes.  Our goal as people who live with these conditions each day is to make sure that the conversations do not end and to take this opportunity to educate people on the realities and dispel the fantasies.
rosePlease remember that if you are experiencing a prolonged sense of sadness that is impacting your daily routine or having thoughts of suicide, please contact a medical professional. If you are having trouble dealing with life with diabetes, a counselor or life coach may help you to find new coping mechanisms.

Tuesday, August 12, 2014

Diabetes and Depression

I don’t want to get out of bed. What difference does it make any way? I am tired. I don’t matter. I can’t take it any more. I can’t lift this dark cloud that hangs over me. I am poor company. My family is much better off without me. I don’t make a difference in the world. I am just taking up space. No one would miss me. What is the point?

Does any of that sound familiar? Many of us have had some or all of these thoughts to varying degrees. Yesterday’s passing of Robin Williams showed us that money, fame, and talent do not protect you from the devastating reach of depression. Sadly, if you live with diabetes, you are also twice as likely as the rest of the general population to be effected by depression.

The Diagnostic and Statistical Manual of Mental Disorders characterizes clinical depression “as having five of more of the following symptoms during a 2 week period and represents a change from previous functioning with at least one of the symptoms being a depressed mood or loss of interest or pleasure.  The other symptoms included a diminished interest or pleasure in almost all activities most of the day, may appear tearful,  significant weight loss or gain, insomnia or hypersomnia nearly every day, psycho-motor agitation or retardation never every day, fatigue or loss of energy nearly every day, feeling worthless or excessive or inappropriate guilt, diminished ability to think or concentrate, or indecisiveness, recurrent thoughts of death, recurrent suicidal ideation without a specific plan or suicide attempt.  These symptoms are not brought on by medication or other physical condition and impair ones social, occupational or other important areas of functioning. ”

Everyone has those days when the world seems dark and bleak.  People living with diabetes however are cautioned by experts to watch a bit closer for signs of clinical depression in their own lives.  Gary Scheiner mentions this issue in his book “Until There is a Cure“.  He and others note that the pressure that comes with diabetes care, the need to “get it right”, and be the perfect diabetic can lead to failure and a deep sadness that can spiral into clinical depression.

We are also reminded that the people with diabetes are not the only potential victims.  Parents of children with diabetes may also find themselves in a pit from which they cannot see the light. We often experience our own guilt for first somehow allowing our child to develop this disease. There is the guilt over nagging them to test or inject.  The feelings that we are robbing our children of a “normal” childhood by forcing them to take responsibility for their diabetes care too soon can be overwhelming. The list of reasons for sadness go on in both those living with diabetes and those who care for them. The challenge is to recognize the symptoms and get help.

The Mayo Clinic feels so strongly in this that their website specifically cautions people living with diabetes to be very alert to signs of depression.  If you feel that you are suffering from clinical depression, please see your doctor.  Just as you take insulin to deal with the imbalance in your body thanks to a non-functioning pancreas, it is important to take medication that can help to work with brain chemistry that has somehow found itself out of balance as well.

Counseling, therapy, and even life coaching can help to deal with the daily stressors of diabetes care.  They can help you to deal with triggers and create coping strategies but they will not fix the chemistry if you suffer from clinical depression. If you are struggling with a diabetes diagnosis, please look for support from others. If you feel that the depression and sadness has become prolonged or overwhelming, please see your doctor. Together you can  create a plan to help you find your way forward again.

robin williams
Thank you for the years of enjoyment and sharing your talent. May you find the peace in death that you were unable to find in life. RIP

Wednesday, August 6, 2014

Summit Diabetes

Earlier this summer, I received an email from a young lady who was embarking on an adventure that looked really interesting. I meant to take a much closer look sooner but the email came in while I was away and then managed to get lost in my inbox.  Today I decided to seek it out again and see what she was up to.

The young lady’s name is Haley Maurice.  She is now 15 and was diagnosed with Type 1 diabetes at the age of 7.  Her plan for this summer was adventurous for any teen but even more exceptional when you remember that she is living with type 1 diabetes.

“On July 16th, my brother Ethan and I will be backpacking 221 miles from Yosemite National Park to the top of the highest peak in the continental United States, Mt. Whitney, to raise funds for JDRF.

We’ll be trekking in this high alpine terrain for an estimated three weeks, conquering over 46,000 ft of elevation gain and venturing deep into the back country of the Sierra Nevada Mountains. It’ll be just us out there, with only two resupply points along the way to pick up more diabetic supplies and food to fuel us for the entire duration of the hike. We’ve been vigorously training and setting up our fundraiser for the past three months and are aspiring to reach our fundraising goal of $1000 per mile ($221,000) for JDRF.”

A few days ago, I hiked a 1.7km trail that has a 500 ft decent.  That was enough of a challenge for me.  I can’t begin to imagine 221 miles and 46,000 feet with blood glucose testing, site changes, insulin adjustments, treating lows, and carrying food and shelter.  I further was not sure how I would feel if it was my child with diabetes doing this.

Silly, of course I know how I would feel. I would be nervous and proud.  I would be terrified of all that could go wrong but would trust in the other sibling to help out in emergencies. I would be proud that my child would take on such an amazing adventure for a good cause.  I am guessing that Haley and Ethan’s parents probably felt much the same way.

In looking at the Summit Diabetes website and exploring some of their social media posts, I see that the two siblings were for the most part successful in their journey. Yesterday they noted…

“We made it!!! 221 miles of hiking from Yosemite to Mount Whitney!

Unfortunately, we didn’t make the top of Whitney as a freak snowstorm nearly froze us to death this morning just a quarter mile from the top.”

What an amazing feat! I am so impressed by these young people. I am impressed by their courage, dedication and stamina.  When Haley contacted me, she was asking for only one thing, for me to share her story and that is what I hope to do here.  Please look at their video, check out their website and the amazing pictures of their adventure.  If you can, also contribute to their goal of raising $1000 for every one mile that they hiked this summer.

Congratulations Haley and Ethan!


Friday, July 25, 2014

The Bionic Pancreas Moves Closer to Reality

For the past year or so we have been hearing clips about the Bionic Pancreas Project.  I was lucky enough to have heard  Dr. Ed Damiano present about his  work at the CWD Friends for Life Conference in Toronto.  It was the first time that I was truly excited by what was happening in diabetes research.

This was a project that was privately funded and motivated by a father’s love. There was no political agenda to hold things up.  There was only his passion and desire to see his son safe when he could no longer be there to watch him at night.  His drive pulled at my heart and for the first time gave me hope.

This summer, clinical trials are continuing.  More adults are getting to experience life with the bionic pancreas.  More children are getting to experience it as well. According to the latest video, they are now reaching the stage to change the design making things more streamline.  This is moving quickly to become a reality!

Being me, and spending so many years advocating for access to better treatments regardless of income or insurance coverage, I can’t help but wonder what direction this project will take.  To me, and I am sure to Dr. Damiano, this device is the diabetes equivalent of a pacemaker and should come under the larger umbrella of our health care system making it available to everyone who is insulin dependent.

At this stage, they are far from knowing how things will proceed in terms of distribution.  We will have to wait.  While we wait, I will continue to work to see access to insulin pumps and CGMs for all people with diabetes regardless of age.  I will continue to put money into my son’s RDSP just in case he does have to purchase the system out-of-pocket to begin with.  If need be, we will advocate for access for everyone to this life changing technology but for now, I will watch and cheer from the sidelines.  I will hope that this will be the technology that changes the life of my son and all of our children with diabetes (no matter what their age).

Tuesday, July 15, 2014

Support in the Strangest of Places

I am an avid reader. I have loved to read since I was a child. If I could find a way to read for a living, I would be a very happy and ideally very rich person.  I read everything. I read action books, mysteries, spiritual books, diabetes books, and most recently a book about a mother of a girl who has anorexia.

I am not exactly sure what made me decide to open this book and read it.  Perhaps it is my own struggle with my body image. Perhaps it was the fact that is was a mother telling a story of her struggle with her child's potentially lethal disease.  Whatever it was, this book quickly showed me that being a parent of a child with a disease--any disease, sadly puts you in a club with more similarities than differences.

Brave Girl Eating by Harriet Brown, first hit home when she wrote "you're not to blame, you're not alone, and you can make a difference in your child's life".  What a powerful statement! It needs to be a poster in our diabetes clinics.  It is a statement that each and every parent of a child with diabetes needs to fully understand and embrace.  As I have said before, we carry our own guilt and are further burdened by the misconceptions of others. We need to know that we are doing our very best and that is all that any one can ask.

For some reason, Ms. Brown seemed to make more than one comparison of life with anorexia and life with diabetes.  I am not sure if she knew someone living with diabetes or in her research she found some similarities but she does make reference to living with the disease on more than one occasion.  She also makes many statements that could easily apply to living with a child with diabetes.

She talks about feeling overwhelmed by her daughter's illness and then feeling guilty about it. "I can take a walk, read a book, shut out the anorexia for a little while. But its insider her. She can't get away, not for a second." How many  parents of children with diabetes have felt that exact same way? How often have we felt guilty because we could sleep through the night when our child went away to camp or when we went on vacation and left them with a responsible parent or loved one? It hurts us to know that we can leave it behind but our children can't.

She talks about things like her daughter lying to her about food and again the issue crosses over easily into life with diabetes.  In our case, our children tend to reach an age where they lie about food intake, insulin dosing, or bg level readings.  The violation of our trust is devastating either way and in both cases the lie is brought about by frustrations with a disease. It isn't any better no matter where it comes from. The pain and sadness as a parent is equally overwhelming.

Ms. Brown talks about wondering if her daughter's behavior is because of anorexia or simply because she is a teen?  When my son was small and would fall asleep during the day, I would panic and test him.  Was he sleeping because he was a toddler who was tired or was he low and had passed out? If he threw a tantrum, was he being a child full of spite and temper or was his rage fueled by high blood glucose and therefore he may not completely responsible for his actions? How did I decide? How did I find a balance with punishment? Like the author, I struggled.

In Brave Girl Eating, the author also talks about stigma.  In this case the stigma of a mental illness. In diabetes, we know that there are many stigmas and fighting the public's misconceptions can often be almost as difficult as battling bg levels.  To make things even worse, there are an increased number of people living with diabetes who also are dealing with eating disorders (is it any wonder when their lives revolve around food 24/7) as well as depression.  They must understand this book in more ways than I can begin to imagine.  How painful.

Ms. Brown also speaks to the idea that anorexia has taught her to live in the moment. Ironically diabetes has had a similar effect on my own life.  Learning to live life four hours at a time was the only way for me to cope.  Nothing else mattered. Tomorrow was too far away but his NovoRapid would kick in within four hours and it could fix that high, maintain his perfect reading or be just enough to send him low and create more havoc for me.  Four hours--just get through four hours and then go forward.

As I mentioned, ironically she notes the similarity to diabetes more than once. In learning to live with the new normal of life with anorexia, she wrote, "I told her if she had diabetes, she'd have to test her blood sugar every day; at first it would be a pain, but she'd get used to it.  It would become just one of those things she had to do, like brushing her teeth.  It would become part of "normal" for her."  We know that diabetes is a bit more than testing daily.  We know that you never really get used to lancing your finger each day, but it is something that has to be brushing your teeth.  It is something that you somehow have to come to accept in order to move forward with your life.

Its funny where you find inspiration and camaraderie. I started this book because I was in part looking for insight into my own body image issues.  I finished this book realizing that parents of children fighting illnesses may have many more similarities than we thought possible.  When we open our minds and our hearts, we find support in the strangest of places.

Wednesday, June 11, 2014

The Weight of Guilt

As I started to read Ginger Vieira’s book Diabetes Burnout, I was hit by an incredible sense of guilt.  Did I push my son too hard? Did I expect too much? I was later vindicated but I was reminded  the overwhelming guilt that comes with being a parent of a child with diabetes…or maybe its just me.

Well meaning people share with us many “reasons” that children develop diabetes and somewhere in the back of our mind’s ( well my mind anyway) we ask was that it? Was that why my son developed this disease? Did I not breast feed my son long enough? Did I feed him cow’s milk too soon? Was vaccinating on schedule a bad thing? Was there a family history that we missed? I know that I didn’t feed him too much junk.  I know that it wasn’t two years of chocolate bars that did this to him but maybe that first time that he seemed off months before I should have realized that he was seriously ill and that it wasn’t just the flu?

Eventually I realized that I couldn’t spend all of my energy feeling guilty about the “what ifs”.  Diabetes took up enough of my energy on its own…but that led me to a new source of guilt.  Had I denied my other son because diabetes took so much of my energy? My older son never complained but it was a question that popped into my head now and again.  We went to diabetes related events and he met many new friends. He always seemed to have more fun than my child with diabetes.

I was there for my oldest son in his events and activities.  He knew that when there was an issue that required someone to stand beside him, I always did.  I was also there for the softball games, school events, report card days, sick days, and driving school.  I was pretty sure that I had successfully found a balance.

But what about a balance with diabetes and my youngest son? Did it take over everything? Did he hate me because I punished him for diabetes related offenses? Did he feel that I had robbed him of his childhood by focusing on testing and injecting when he wanted to play and forget it all?

My children seem to be well-adjusted. We have memories of family vacations and times spent with each other. We communicate regularly.  I guess I didn’t scar them too badly–I hope.I didn’t have to feel guilty about robbing my children of their childhoods.  Diabetes changed things but it didn’t destroy it.

One other area of guilt seems to always flutter on the sidelines.  I know I am not alone in with this one. I have heard other parents mention it. Its the guilt that comes when our children go away and take diabetes with them.  It’s that time when they go to the other parent’s house, spend the night with a friend or with grandparents.  It’s that time when they go to camp for a week or move away from home. It is then that a new guilt moves in.  I no longer have to think about diabetes 24/7.  Oh I still wake at night. I still look at a meal and automatically count the carbs and dose insulin in my head.  I wonder what my child’s blood glucose level is at any given time.  I worry and wonder if he is taking proper care of himself, but I have a break.  I  don’t really have to be awake at night. I can enjoy that extra glass of wine without fear of dealing with a low later that evening.  I don’t have to remember to test after that walk.  I have it easy.  It’s not fair.  The guilt becomes stifling.

As a parent, I want to carry the burden of this disease for my son but I can’t.  I want to give him a break but I can’t even if I  get one! It doesn’t seem right. I must be a terrible parent…but maybe I am not.

When my son is with me, I help him with care when he wants.  When he has an issue and he is away from me, he calls and asks for help.  We talk about readings…when he is ready.  We talk about other things as well.  I work hard to make diabetes the last thing I ask him about not the first.

Guilt doesn’t get me anywhere. It’s a backwards looking emotion. Life didn’t come with a guidebook.  My children were not born with a manual attached.  I do my best. We all do.  Guilt must be released not harbored…and I do.  I have made mistakes but my kids are okay.  They are strong.  They are relatively healthy.  They are smart.  They do me proud.  Why waste energy with guilt? Move forward and smile.  It’s the only way to go.

Gifts like this make me realize that all is very well indeed.
Gifts like this make me realize that all is very well indeed.

Thursday, June 5, 2014

Dealing with Diabetes Burnout..A Book Review

Ginger Vieira recently released her third book called Dealing with Diabetes Burnout,  How to Recharge and Get Back on Track When You Feel Frustrated and Overwhelmed by Diabetes. I was once again lucky enough to be given a copy of the book to read. As I prepared to write my overview of the book, I  took a glance at how many pages of interest I had marked off. A lot! That means that this was a wonderful book with many excellent points for me to share!

I really wasn’t sure what to expect when I began reading this book.  What would I learn? Would much of it apply to me? Who would this book fit? Well, I learned quite a bit. I gained a new perspective and I can think of quite a few people who this book would help.  Most importantly however, it is a great hands on resource for people who live with diabetes–Type 1 or Type 2.

This book doesn’t just give you a bunch of information and feel good stories.  It is filled with exercises and activities that Ginger challenges you to do to help you deal with your own diabetes burnout.  She doesn’t chastise you for the fact that “I haven’t checked my blood sugar in three weeks (ehh…months)” –a fabulous title of one of the chapters of the book.  Instead she reminds you that you are being asked to manage something that your body is supposed to do on its own based on a variety of other physiological and hormonal processes. (page 21).  She tells  you to look at all of the great things that you are doing and praise yourself for the one thing you are getting right. “developing the ability to step back and see what wasn’t working–rather than blaming yourself–is the trick to creating a new plan that will lead you to your goal.” (Page 33)

This theme is further emphasized by all of the great chapter titles like “I want to be perfect by tomorrow (or I’m giving up!) where Ginger notes that some times are not ideal for change. She suggests that you create your own personalized “pick up plan” to help you refocus in times of stress.

Ginger offers tips on how to handle support from well-meaning people who really don’t get it as well as how to best make use of people who do get it and do want to help.  She shows you how to use technology to make your life a bit easier as well as great real life tips for those of us who would just like to live a healthier lifestyle but find ourselves giving up too soon.

Being a parent of a child with diabetes, as I began to read this book I felt horrible.  I was a failure.  I was the parent who struggled to understand how you could “forget” to do something that you have done all of your life.  Did I push too hard?  Should I have been calmer when his doctor praised him for testing more than once per day and I was looking to see 8-12 readings per day? I was sure that I had totally ruined my son’s childhood.

Thankfully I got some reprieve from my incredible guilt when I moved into the chapter called “Crazy Little Thing Called Love”.  Here Ginger talks about raising a child with diabetes and how truly difficult it is to do. She highlights many of the fears that we have.  The torture we go through when our child is low and disoriented or the failure we feel when they are high and we are positive that we alone are responsible for the kidney damage they may one day have. She offers more wisdom and options to dealing with our children and how to get through to our teens. I was left knowing that I hadn’t scared my child completely…well at least not in that realm.

Nearing the end of the book, I came across one of the very best quotes I have ever read on the issue of diabetes care and one that should be framed and read by everyone dealing with this disease (especially us guilt laden parents)….
“Doing the best any of us can do in life with diabetes does not have to mean perfect blood sugars all the time. Sometimes our best is awesome and sometimes it’s not quite so awesome but it’s still our best in that moment.  And that’s okay.  It has to be, because “perfection” is a crazy expectation.”  

Dealing with Diabetes Burnout is a fabulous resource. If I had one criticism of the book it would be having too many personal stories illustrating various points in the book. Reading through page after page of examples of other people’s burnout was taxing on my incredibly shrinking attention span. That said however, I have no clue as to how I would have cut back on some of the submissions that were used.  They were often very powerful stories that needed to be shared.

Who should read this book? Anyone living with diabetes because as Ginger Vieira notes, at one point you will go through some form of burnout.  To a lesser degree, parents of children of diabetes (no matter what age your “child” may be).  This book will give you insight into the emotions that your child may be dealing with and will also give you a few tips to help you in your own life as well.
diabetes burnout book

Tuesday, June 3, 2014

Diabetes Greeting Cards

Yes, you read that right...Diabetes Greeting Cards!

I often get requests from people who want to share a post on my blog. They want to write about how to cure your diabetes by eating their miracle food. They want to tell my readers all about their awesome socks that will instantly cure all that ails you and things that you didn't even know were ailing you. Once in a blue moon, someone will send me something relevant and I will think about posting what they send me.

A few weeks ago I received a request from a woman who wanted to promote her greeting cards. My first thought! She called me Barb and not "Dear Advocacy". I decided to read a bit further. They had a really interesting concepts, they were cards for people with diabetes but they weren't stupid. They were actually kind of cute. Enough from me on the subject though....

I'm Nene Adams and I'm an insulin dependent Type II diabetic. I've also been a greeting card designer since 2007.

Following a stay of several weeks in the hospital for a diabetes related medical problem, I was inspired to do some research into diabetes. I learned a lot, including the fact that there seemed to be very few greeting cards designed specifically for diabetics.I thought there needed to be more and better choices for a group of people the mainstream card retailers were ignoring.

Me and my partner, Corrie Kuipers, have teamed up with a few other talented artists - Doreen Erhardt, Betsy Cush and Sharon Fernleaf - to create a line of greeting cards for children and teenagers/young adults with diabetes. The messages are positive and supportive, not just a generic "get well." The images are colorful and often humorous in each artist's distinctive style.

We hope these cards will help inspire and encourage diabetic kids and their loved ones.

Thursday, May 29, 2014

Mom! It looks like I've Been Shot...Again

In honor of Throwback Thursday, here is a humorous post from May 4th, 2010. Enjoy!

Last night I wrestled my son to the ground and later heard about the consequences. You see said child, admitted that no he hadn't been spending his time mulling over the perfect gifts to purchase for his devoted mother for either Mother's Day or her birthday.  In some countries I am sure his actions would have constituted a hanging offense but in our house in meant that I tackled him, interrupted his Wii game, pinned him down and tickled him.  Thankfully I still have a few pounds and an inch or two on him so I can still win. 

The downside to this fun when you have a child on an insulin pump who wears sites in his leg is obvious to those of us who live there.  After the screams of "I've gotta pee!!!!", came the grumblings of "You pulled out my site!".  With the cost of pump supplies being covered for us, it felt good to say "Well, just go and change it."  Once upon a time, I would have cried at the $20+ that I had just wasted even if it was in the name of fun. 

Being a teen, my son was in no rush to change the site and Mom had visions of highs for the rest of the evening.  The longer he waited, the less insulin he would get, the higher his bg levels would climb I was sure.  Again, being a teen and being my son, he stated that the site was salvageable and he had simply taped it in place.  I was worried.  Was the site really still in? Yes he assured me as he headed off to the shower.  His grumbling about being bested by his mother had been replaced by the comment that if Mom could wrestle him then wrestling with his brother should once again be allowed (It was discontinued after brother's elbow met son's eye and left a nasty shiner).  I attempted to burst his bubble but he still was quite proud of his logic as he headed off for his marathon shower. 

Once he undressed he proclaimed "Mom, I look like I have been shot!"  What did that mean? He told me that there was blood all over his leg.  I said that was it, the site was gone! He had to change it.  He proceeded to shower and I never got to really check out the damage.  He kindly left the dead and bloodied site in the shower for me though.  Ironically he was disgusted when he found it on top of an envelope later.  I had taken a picture and left it for him. He told me that the site should be in the garbage! Um, who left it in the shower to start with? Oy!

Monday, May 26, 2014

Another Corner Turned

The weekly bg reading review that I had dictated in September has long gone by the wayside. I occasionally ask about readings on the phone or over text conversations but I try to keep it to a minimal.  If my son gets into real trouble, he calls or texts me with his SOS.  Diabetes care is remaining in the periphery of our relationship as he strives to make it on his own. We still talk about care and I still like to know what is going on but I think I truly have turned a corner in my new role and acceptance of it.

A couple of weeks ago, I suggested that we have a phone conversation about his readings in the coming days.  My son told me that he had an upcoming appointment with his CDE.  I then suggested that we wait until after the appointment and then we could discuss what was or wasn’t done and see how we felt about it.

My son thought that was a great idea and we set our new date to chat.  Last week that day arrived.  I knew that my son’s readings had been uploaded by his educator (my son has managed to lose two cables for his pump and I feel bad contacting our rep for a third one). I went online to see what the readings looked like.

As I opened the screen I laughed and laughed.  There were a lot of boluses and insulin cartridge fills but I only saw two readings. I laughed some more! For a change, it was not me who got to look at no data and try to sort things out. It wasn’t me to go…”What gives?” only to be told that he had used other meters but didn’t have them with him. This was not my problem.  I laughed some more
It felt good to have that burden lifted. Whether there were or were not readings, I was not the one who would bang their head in frustration and begin the tedious task of trying to track down information. The smile remained on my face.

Later that evening I called my son and we discussed his appointment.  It had gone well. He had readings on a different meter and the two of them had discussed the area my son knew was a problem.  My son was pleased that he wasn’t told what to do but asked his opinion on the problem.  Suggestions were made by both parties and my son left happy.

Mom wasn’t needed.  For a change, that felt okay.  My son was happy. He had made his own decisions. He had been able to talk to someone about his care and share his knowledge. It was a win-win situation as far as I could tell.

I will still call and talk readings. I will still be here to troubleshoot and to cheer from the sidelines but my son really is taking charge. He can do this. I always knew he could but the fact that he is doing it makes me feel a bit better…well for today anyway.

Friday, May 23, 2014

Age Shouldn't Matter

Last week, during blog week, I told you about things that get my dander up and make me want to scream from the roof tops until they are fixed. One of those things was access to insulin pumps and supplies. Since the day that I realized that there were more options available to my son than the insulin regimen we were currently on, I was adamant that all people with diabetes should have choice in their treatment options.

People living with diabetes should be able to decide if they want to use Lantus over NPH. They should be able to choose Apirdra over regular insulin.  They should be able to see if a Continuous Glucose Monitor or an insulin pump is for them without having to sell their home. That sounds extreme doesn’t it? Sadly it isn’t.  Despite living in Canada with its socialized medicine, Canadians are still not always able to access the best treatment options for them.  They may not have private health insurance or their insurance may not cover the devices that they desire to use.  The result is that they go without or go to extreme measures to get the medical tools that they desire to keep them healthy. For me, that is not acceptable.

My son began using an insulin pump 11 years ago.  I had wanted a pump for him since the first time I heard of the flexibility that it allowed but financially it was not an option.  His father had medical insurance but insulin pumps were not covered. What changed 11 years ago? My family stepped in and said that they would come together to pay for the pump.  They wanted the very best for my son.  It is a moment that I will never forget.

Over time things have changed thankfully. Provinces have begun to cover insulin pumps–for children.  Those over 18 have had to find good insurance, high paying jobs, go back to injections out of necessity rather than choice or move to Ontario (the first province to cover all people with Type 1 diabetes who wished to use insulin pump therapy).  In my own province of Newfoundland and Labrador, changes have been made as well, the age limit for assistance was moved to 25.

Today my son is 16.  He is heading into his final year of high school and looking at career options. The most important part of his career choice is to find one that is either very high paying or offers great benefits. What he enjoys seems to be second on our list. That is discouraging and gets my dander up.

If a person wishes to use an insulin pump to best control their diabetes care, then they should have that option.  Age, financial status, or occupation should not dictate what type of therapy they can receive.  With this in mind, advocates in provinces like British Columbia have created petitions to ask their government to expand coverage and remove age restrictions. Pensioners are having to go back to injections because their private health care coverage ends at retirement.  Young adults who are beginning careers and new families are having to rethink how they will move forward because of cost constraints brought on by managing their diabetes care
This is not right.  Age should not dictate whether you get an insulin pump or not.  Insulin pumps provide just as many benefits to adults as it does to children.  Adults with type 1 diabetes who are using insulin pumps often find shift work much more manageable.  They tend to see less diabetes related down time because they can micro manage their disease with greater ease.  The addition of Continuous Glucose Monitoring systems to their care can help them to anticipate dangerous highs or lows that could have otherwise sent them home for the day.  Increased productivity and work time for people with diabetes has a larger impact on society as well. People living with diabetes who are able to work are able to contribute to the provincial tax coffers through their employable earnings.  They are less likely to have complications or dangerous blood glucose swings that could send them to the hospital.  Our young people with diabetes are able to look at jobs in the province rather than having to move to areas with better pay and better benefits.

The rewards definitely outweigh the costs to the provincial governments and our health care systems. With this in mind, I have created a petition that will ultimately be presented to the government of Newfoundland and Labrador asking that they expand their insulin pump program.

Please consider signing and sharing this petition.  The more voices we have, the stronger we are.  This is a very serious and real issue.  The stories and needs behind the petition are heart breaking.  I have spoken to a government employee who have had to rent out her homes so that she can have extra money to be able to afford her diabetes supplies.  I have listened to medical personnel who have had to rely on financial help from a life partner in order to continue pumping.  I have sat down with members of the police services who pay the equivalent of an extra car payment each month just to keep themselves pumping and healthy.  There are also people who are in minimum wage jobs who have no choice but return to injections after they turn 25 because they just can’t afford to pay for their rent and their insulin pump.

This needs to change. With your help it will. Please support this initiative for all of those who choose to use an insulin pump.
NL pump petition

Thursday, May 22, 2014

The Bad Kind

The other day, I sat down to begin reading Ginger Vieira’s new book “Dealing with Diabetes Burn-out“.  I had only read the introduction when I wanted to cry.  Why is there so much judgement surrounding diabetes? Why do people living with diabetes feel that they are either good or bad? Well, as Ginger points out, its because there is so much good and bad mentioned when talking about the disease.

Your readings are good or bad.  They are not the result of a carb counting error or a pending illness that you cannot foresee. They are a good reading or a bad one.  The food you eat is either good food or its bad and a diabetic shouldn’t eat it.  Your A1c when you see the doctor is either good or bad.

The constant judgement does not end there. I was listening to a conversation a few weeks ago and quietly cringed as I heard someone mention that a person had diabetes “really bad”.  Another person had mentioned that someone had died because they had the “bad kind of diabetes”.  I wanted to say that there is no good kind!  You can only hope and pray that a person with diabetes has all of the knowledge, supports and tools that they need to care for themselves in the best possible way.  It wasn’t my place to educate at that time.

The good kind I assume, is the kind that is managed by diet and exercise  but is it really that good? You still have to live with guilt for each piece of food that enters your mouth.  You must be constantly wondering when that bullet will hit its target and you will get the dreaded sentence–”You have the bad kind of diabetes”.

What is the “bad kind of diabetes”? Is it when you have to have needles? Is it when you are on pills? Is it when you are overweight? Is it when you are two and don’t know why you have to be stabbed and poked at all of the time? Is it when you have to be hooked up to a machine 24/7? When does it become “bad”?

Personally, it is always bad.  In all of those cases, our bodies have rebelled against us and are not working as they should.  We have to fight and struggle to compensate. Using insulin actually can make it easier not worse. Modern insulins allow people with diabetes to be able to match insulin to food amounts in a way that their body, without insulin, can’t.  That’s not such a bad thing. It allows them to have that piece of chocolate cake without concern of a crazy high a few hours later.

This distinction between “good and bad” actually has a negative impact on treatment as well. While insulin injections or insulin pumps are not an option for a person living with Type 1 diabetes, it is often seen as a last resort for a person with Type 2 diabetes.  Sadly this is not the case.  Studies have shown that giving a person with Type 2 diabetes insulin earlier can actually preserve some of their beta cell functioning and make their lives a little easier.  Unfortunately, that “good and bad”  issue stops that from happening. People fear that they will be “bad” if they are on insulin.  This further translates to the thought that  those who live with Type 1 diabetes and need an external source of insulin to keep them alive must have it “really bad”.

I thought about other diseases and wondered if any others have it “bad”.  Cancer has stages.  Diseases like MS are referred to has having “full blown MS” versus the early stages.  I could not think of any other disease that allows people to have the “good kind” or the “bad kind”.  Is it the lifestyle component but if it is why do we not hold that same standard for other “life style” related diseases? Is it because in the other diseases they understand that lifestyle is only a small component? People will say that Type 1 diabetes is NOT a lifestyle related disease but that does not stop the public from blaming the lifestyle of the mother of a person with diabetes.  We are blamed for things like not breastfeeding long enough and other equally ridiculous notions.

What is the answer? How do we fix this? I don’t think that there is a quick fix.  I think that we continue as we have been. We educate people who ask us if we have the “bad kind of diabetes”.  We work with the media when they try to get it right. We are kind but firm with those people who are ignorant of the facts because we may have once been ignorant as well. Finally, we find a cure so that no one ever again has to be judged because their body has failed them.

Saturday, May 17, 2014

Looking from a distance

Diabetes Blog Week
Today is Saturday’s snapshots. At first I was a bit troubled by this.  What does my life with diabetes look like these days? Well its different than even one year ago.  Should I show pictures of my son’s life? I decided that I shouldn’t.  My pictures would be of my life with diabetes…living with it at a distance.

Now when I find test strips at the bottom of my purse, I don’t swear and wonder how they got there, I think of my youngest son and smile instead.

My conversations are often done via text rather than in person…

IMG_1494But we still get a chance to spend time together and share care when we can.

Friday, May 16, 2014

Hello...I am a Glucometer

Diabetes Blog Week
Write a short story personifying a diabetes tool you use on a daily basis. A meter, syringe, pump, pill, etc. Give it a personality and a name and let it speak through you. What would it be happy about, upset about, mad about?  (Thank you Heather of Unexpected Blues for this topic.)

Hello, my name is Fred and I am a glucometer.  You would think with a job as important as mine that I would get a lot of respect but I don’t.  I am shoved in dark pockets, thrown around and basically taken for granted. Its a very rough life.

I am expected to be ready for service at all times of the day. It doesn’t matter if I worked hard all day, they still expect me to be bright-eyed and shining at three in the morning. And when I say shining, I mean that they really want me to light up all nice and bright showing them glowing pretty numbers. When they are done with me, they just toss me off to the side again.

My job is tireless.  They smear blood all over me.  They curse at me when they don’t like what the reading is.  Like that is my fault? How is it that I control what their blood glucose is going to be? I deserve a lot more respect.

The only time I get respect is when the parents or the doctor take a look at me.  They know how important I am.  They look at my display as if they are reading a holy gospel.  They value me and my knowledge.  My owner? Well, he looks at me like I am a rock, a burden that he is forced to carry around. I am the unwanted younger brother that he has to take everywhere.

Why does he have to think of me that way? It hurts my feelings. I am just trying to do my job. I am trying to work with him to keep him healthy.  I know that it can be tedious. It’s not picnic for me either. I mean, I have to be on all of the time! There is no time when I can be just a little less accurate. I have to bring my A-game every time we meet.  Its exhausting but I don’t get any praise or appreciation.

He just doesn’t get it and some times I get mad as well and when I do, I get even in my own way.  When he just grumpily and shoves a strip in me and expects me to instantly produce results, I come back and tell him “Error 4″.  Oh does that get his goat! He has to retest and take his time to treat me a little nicer–getting all of his blood just so on the test strip so that I will read it for him.  After he has done that, I reward him by saying “HI” but he doesn’t often see the humor in that one. I don’t understand why.  Isn’t it important to be friendly now and then? Perhaps if he could be a little nicer, we could work together a bit better and I wouldn’t have to resort to cheap jibes.

Maybe one day he will get it. One day he might understand how important I am! Oh well, at least he takes me most places. I usually only hear about the spots that we go to from the inside of a pocket but at least I get to tag along.  It’s not easy being me.  I guess it’s not easy being him either, but I still say, “work with me dude! It will make things so much easier!”  Darn! I shouldn’t have said that so loud, here comes another check. Back to work!

hi meter

Thursday, May 15, 2014

Four Hours, Just Four Hours

Diabetes Blog WeekYesterday we opened up about how diabetes can bring us down. Today let’s share what gets us through a hard day.  Or more specifically, a hard diabetes day.  Is there something positive you tell yourself?  Are there mantras that you fall back on to get you through?  Is there something specific you do when your mood needs a boost?  Maybe we’ve done that and we can help others do it too? (Thanks to Meri of Our Diabetic Life for suggesting this topic.)

Is there a mantra that I fall back on to get me through a hard diabetes day? Absolutely! It is one that I share with newly diagnosed adults and parents who are struggling to get through. I remind them to look at life in four-hour blocks. If you take everything in four-hour strides and you can ride through anything.

When diabetes seems to be kicking your butt every morning, look at how things are going between lunch and supper. Are things okay? Give yourself a mental high-five and celebrate that victory rather than dwelling on the post-breakfast spike that this threatening to drive you over the edge.

Do overnights seem overwhelming? Again, break it down.  How are things from snack until 12 or 1am? What is life like in the deepest part of the night? Are things settled before breakfast or has chaos been awakened in those four hours? If you break it down into six four-hour periods, life becomes a bit more manageable and instead of seeing all of the bad, you can savor some of the good.

Why do I have a four-hour mantra? Because early on I learned that my son’s Humalog was supposed to last about 4 hours.  He was injected at 8am for breakfast, then at noon for lunch, around 5pm for supper and then again at 9pm for his nighttime snack.  I was going crazy trying to see a perfect 24 hour day. I realized that looking at a complete day was never going to make me happy. The only way to see success was to look at small chunks of time.  Coincidentally, that was also how we would make changes to his regimen.  Was his breakfast ratio of carbs to insulin off? How about at bedtime? Life was naturally being broken down into 4 hour chunks for me so why not work with that?

Now I know some of you will say, but we are using a pump so that won’t work for me.  Yes it will!  Chances are high that you are still doing things like having breakfast, lunch and supper.  You are probably still going to bed at one point as well. All of these events can be broken down and again my four-hour mantra applied.  Was I a successful pancreas this afternoon? Yes? AWESOME!! Let’s break out the happy dance!!! Did I have an issue after supper? Okay, let’s look at what can be done.

Life is less overwhelming in four-hour shots. It can be applied it outside of diabetes as well.  Are you wanting to change your eating habits? Did you have a great breakfast? Pat yourself on the back. Over did it at lunch? Do better tomorrow. Can you see how easily this works?

Life can be overwhelming.  As we discussed yesterday, life with diabetes can make it worse.  Taking life four hours at a time has allowed me to focus on what I need to change and to praise myself when I get it right…and we all need a lot more praise in our lives.

Wednesday, May 14, 2014

Fighting the Darkness

Diabetes Blog Week 
May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope? (Thanks go out to Scott of Strangely Diabetic for coordinating this topic.)

I love being part of Diabetes Blog Week because of the vast array of topics that make you stretch yourself, think and explore new avenues.  Today’s topic is one that is very personal and very difficult. I have dealt with some of the dark issues surrounding being a parent and living with a child with diabetes in last year’s webinar “Normal is Just a Setting on the Dryer” as well as throughout my blog over the years.

Most likely you have heard about the strong correlation of diabetes and depression for people living with the disease.  Diabetes presents many management challenges in learning how to be a pancreas.  It presents financial challenges in being able to afford the best care to be able to obtain your best bg levels.  Diabetes is often looked upon as something that the patient themselves caused.  Bg levels and A1cs are often judged as “good” or “bad”.  It is therefore not surprising that the stigmas and challenges of the disease can quickly become overwhelming.

As a parent, we do not have the same direct issues as our children with live with diabetes but in some respects perhaps its a bit worse because we carry the blame for it all. We ache when our child is having to deal with any of those issues. We desperately want to take all of the pain away from them.  We feel that we would gladly carry this disease to save them such pain and anguish.

Parents struggle with their guilt.  How did we let this happen to our child? What could we have done differently? Should we have breastfed longer? Was it a vaccine that caused this? Did we pass along faulty genes? It is our job to protect our children and we may feel that we have failed to protect them in the most profound of ways…we allowed them to develop type 1 diabetes.
Now I know intuitively that this is not the case. I know that I did not cause my son’s disease but was it my fault that he was so sick before he went into the hospital? I am educated. Shouldn’t I have known something was wrong? If I am honest, I did know that something was wrong. One day in the summer prior he was pale and sick…but it was just one day and we assumed he had a bug.  Before his diagnosis when he had thrush and was not himself, we had taken him to the doctor.  He said my son was fine.  I did take him back to my own doctor a few days later when things did not improve. I could not have prevented this but still the guilt lurks.

The guilt can get in the way of parenting a child with diabetes as well. We have so many issues swarming in our heads.  We have failed our children once by allowing them to get diabetes (yes, parents may have a bit of a God complex), so now it is vital that we work to keep them as healthy as possible. We get frustrated when our children lapse in their care. We become terrified when they are in the care of someone else. Will they be able to manage? We struggle to find a balance between allowing our children to learn on their own and the need to look after them at all costs.

In my own case, there were times that I would reprimand my son for forgetting a meter or strips when I really should have thought of them myself.  The frustrations of not being able to keep his bg levels always perfect, of seeing him sitting inside waiting for a low to come up when his friends were playing outside, the injustice of him having to carry so many supplies and medical devices just to go to a friend’s house would overwhelm me and boil over into anger at the silliest things. I would then worry that I had left my child with nothing but horrid memories of an ogre parent.

As my son has grown, I have come to my biggest challenge yet…letting go and finding my new place.  For the past 14 years, my one focus has been being a mom.  I managed to stay at home with both of my boys as they grew. I was able to devote a lot of my time to diabetes advocacy efforts and the care of my children which included 24/7 diabetes care for my youngest son.  My nights were spent fighting highs and lows.  My days were spent reminding him to test and bolus and helping him to count carbs.

One day it all changed. My son decided to move back to his home town and felt it was time for him to learn to care for himself. I was lost. I would wake up in the night and there was no one to test. I would sit down at a meal and I didn’t need to count those carbs. Yes, the world of diabetes advocacy still existed but did it still need me? There were many new parents who were just as passionate and they had children at home to speak about.

I had experienced depression before when dealing with a child with diabetes. As I mentioned, the frustration, guilt and anxiety can be overwhelming.  I got through with the help of some amazing online friends as well as supports in my life that were there to pull me out when I got too far down.  It was important for me to talk to people who lived there and got it, as well as people who had no clue but just wanted me to enjoy life with them.  That balance saved me on more than one occasion.

Having my son move away was different. Yes, I had many friends how also had children move away but their children had moved away for school.  Their children were out of high school and they seemed to have strong identities of their own.  I didn’t feel that way. Yes, I had a strong identity but in part that was because I was a parent of a child with diabetes and I spoke firsthand of bg testing and the challenges of raising him. Who was I now? I was not sure. I had started to expand myself and create a new business venture but it was not heading the way I wanted it to…and then my son was leaving. I was now a complete failure. I had no idea how to get out of the darkness this time.

Once again, my heart knew I wasn’t a complete failure or a bad parent (just as it said I was not the reason my son was diagnosed in the first place) but I still felt that way. The move wasn’t personal it was about a young boy wanting to stretch his wings and go back with lifelong friends rather than continue to hang out with his mother in a city that had not provided the same life-long friends. I had to get over myself. It has taken a lot to get used to the change. It has taken a lot to find my new place even in his life.

I don’t have a cure to get out of the darkness that can accompany raising a child with diabetes. I don’t have an answer that has worked for me. I still stumble and wonder “what do I do now?”  I am lucky in that I have a very supportive partner who is patient. I am slowly dipping my foot back into a bit of advocacy work.  I am working to find my way in life.

Diabetes is a challenge in itself but it also brings many hidden challenges for those who live with the disease inside of them as well as for those of us who just carry it in our hearts. The only thing we can do is move forward.  Seek help when you need it–from friends, from family and even from the medical or counseling community. There is nothing wrong with support. It is the only thing that gets us through and its strength can carry us through anything.