Lifting Me Higher

Spread the Love - Sunday 5/19 Link List

Today's Prompt: As another Diabetes Blog Week draws to a close, let’s reflect on some of the great bloggers we’ve found this week. (Thanks to Pearlsa of A Girl's Reflections for inspiring this topic.)

What a great week! I'm going to list my favorite post from each day.

Day 1 - Sharing
Heather at Unexpected Blues is someone you should be reading. Brilliant, lush writing. Gorgeous images. Beautiful human being. Her post on Monday reminded me of the relationship I had with my endocrinologist in my early 20s.

Day 2 - Petitions
Meri begged diabetes to get a few hours sleep, kick up its feet, relax once in a while. Oh, how lovely that would be.

Day 3 - Memories
The post that moved me the most this week was Karen and her Grape Jelly.

Day 4 - Accomplishments
Ilana reminded me that I don't exist separately from my body. Accepting diabetes as part of my personal definition is something I've struggled with for a long time and she stated a solution so matter-of-factly.

Day 5 - The Trade
In his post about "the trouble pile," Bob shared an allegory about realizing that your own sack of troubles is not worth changing out for someone else's. He also points out how often we probably all joke inappropriately about situations or conditions which might be genuinely painful for others.

Day 6 - Art
Heidi wrote a poem that spoke to me. I loved her lines about "maybe tomorrow will be better...maybe the same...maybe worse." And Reva made some awesome D-body art.

Podetry

Diabetes Art - Saturday 5/18 Link List

Disease is never beautiful,

But the human condition is.

Compassion, Dignity, Determination,

Blossoming in adversity.

Pied Beauty

Freaky Friday - Friday 5/17 Link List

Today's Prompt: Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? (Thanks to Jane of Jane K. Dickinson, RN, PhD, CDE and Bob of T Minus Two for this topic suggestion.)

As many of my bloggy brethren are pointing out today, chronic conditions often come in boxed sets. You might not get just type 1 diabetes. You can end up with its pesky autoimmune family members, too - its little cousin Celiac, its uncle Hashimoto, its crappy sister Crohn's, or grandpa Arthritis. The list goes on.

Me? I got Diabetes' sweet great aunt - Vitiligo.

As chronic conditions go, I'll be honest, she's a peach. Well, not a peach so much. Maybe a speckled peach.

She's quiet. She wouldn't hurt a fly. She's just a little odd-looking. You rarely even notice her. Maybe you'll walk past a mirror and catch her there. Or she'll photobomb you when you're working on your best duckface.

Seasons of Love

Accomplishments Big and Small -Thursday 5/16 Link List

Today's Prompt: We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes.

5 weeks, 5 years, 50 years... I'm somewhere in between.
I'm going on 23 years into this.
Nearly 1200 weeks, over 8,000 days now, with a chronic disease.
How many days do I have left to go? What have I done so far?
Is having kids my ultimate accomplishment?
Will I ever see a Joslin medal?
Am I halfway through my life with diabetes? Or am I just beginning?
What will I do yet?
How do you measure?

In the words of Innigo Montoya, "No, there is too much. Let me sum up."
And let me do it in an ever-so lovable and slightly cheesy, Broadway style.

12 Million 29 Thousand 8 Hundred Minutes
12 Million 29 Thousand since my start
12 Million 29 Thousand 8 Hundred Minutes
How do you measure a diabetic heart?

In doctors, in blood tests,
In midnights, in cups of coffee,
In carb counts, in shots, in laughter, in strife,
In 12 Million 29 Thousand 8 Hundred minutes.
How do you measure my diabetic life?

How about love? How about love?
How about love? Measure in love
Seasons of love, seasons of love.

12 Million 29 Thousand 8 Hundred Minutes
12 Million 29 Thousand rises and falls
12 Million 29 Thousand 8 Hundred Minutes
How do you measure a hundred thousand close calls?

In truths that she learned,
Or in times that she cried,
In babies she birthed,
Or the way that she'll die?

It's time now, to sing out though the story never ends
I want to celebrate the love and support of my online friends.

Remember the love
(Oh, you got to, you got to remember the love)
Remember the love
(You know that life is a gift from up above)
Remember the love
(Share love, give love, spread love)
Measure in love
(Measure, measure your life in love)

Seasons of love
Seasons of love
(Measure your life, measure your life in love)

That's how I measure mine.

Low Point

Memories - Wednesday 5/15 Link List

Today's Prompt: Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. (Thanks to Jasmine of Silver-Lined for this topic suggestion.)

This is the story of my most epic overtreat.

I had to be 12 or 13 years old. My mom was in charge of orchestrating local Cub Scout leader trainings for much of my childhood. Saturdays were often spent keeping myself entertained in some empty community room of some local church while watching the adults buzz around doing their thing. I'd help carry supplies in and out, help sign people in at the registration table, help keep the donut and juice table stocked.

Well, I was alone, I was low, and Domino's had just delivered dozens of pizzas for lunch.

You see where this is going.

Tripping on Strips

We, The Undersigned - Tuesday 5/14 Link List

Today's Prompt: Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)

Unrelated announcement: Today marks my 200th post at Sweetly Voiced!

I have some serious things I'd petition to change, but I'm almost tired of hearing myself complain about them (like meter accuracy and, I don't know, METER ACCURACY).

So instead, I'm going to take a lighthearted turn.

I'm petitioning test strips.

Clean yourselves up!

Seriously, I find you in my washing machine, my food, my car, my purse, my garage, my fridge. Affixing yourself to my baby's diaper. Stubbornly stuck to the bottom of every waste can.

Not just my own strips either. I see your friends. I see them in parking lots outside restaurants. Hanging around like the little hoodlums you are. Lounging in public restrooms. Under tables.

You're like little bugs, scurrying from the light.

Except, you know, you can't move.

Stop making excuses. Throw yourselves away.

Endo, Endo, Through My Window

Share and Don’t Share - Monday 5/13 Link List

Today's Prompt: Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see?  (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.) (Hey, that's me!)

Social media has provided people with diabetes today with an enormous network of support. We can tweet a disappointing blood sugar, insta a photo of a carb fest we're about to eat, or rant via Facebook about a conversation we cannot believe our dietitian had with us. Understandably, many are skittish about our health care practitioners (HCPs) eavesdropping on us in that safe, sacred space.

I believe, however, that HCPs have a place in social media. I love following the endocrinologists and nurses whom I follow through various outlets. I learn stuff. And I get a sense - especially from those who also have diabetes - that this is just as hard for them.

I am not afraid of my medical team. I am not afraid for them to know that this disease is incredibly challenging for me. I'll own up to weaknesses. I'll express dissatisfaction with a product or a change in regimen that one of my team suggested. And I don't feel I say anything that I wouldn't own in person. That's just how I am.

But that doesn't mean that I would want them to abuse my oversharing. I would not expect them to use my blogging as a how-to (or a how-not-to) to their other patients without asking me first. I would not want them berating me for something they saw me say online, but I would expect them to approach me with constructive criticism if they saw something and had suggestions that would help my care.

My team is extremely cautious about my online adventuring. They have told me that they worry that I might say something that will get me in trouble with an insulin manufacturer or a pump company and do not want to see me held liable for libel. I respect that. But it won't change me reporting what I run up against out here in the wild.

If I don't want something seen, I don't blog it. I didn't announce my second pregnancy on my blog until mid-second trimester even though I had planned to throw caution to the wind and really "tell all" the next time I got pregnant. I found myself guarded though - didn't want family to pry or worry about 'another' pregnancy with diabetes. I don't blog about private family drama. I don't write negatively about people in an identifiable way. Even the endocrinologist I didn't get along with received a somewhat tender and apologetic handling.

But what is it that I think HCPs need to see?

I hope that they see how much more we need than what they provide in an office visit 3-4 times per year. I hope they see that they should be directing us to social media - where we can get a 24/7 lifeline for a disease where every minute counts. A disease that is intricately tied up with depression, disordered eating, burnout, motivation, complicated feelings of success/failure, and social isolation. I need them to see that we're out here for 361 days a year when we don't have endocrinologist appointments and figure out how to help us in that space.

Parents

Click for the Diabetes Hero - Sunday 5/20 Link List.

Today's prompt: Diabetes Hero. Let’s end our week on a high note and blog about our “Diabetes Hero”. It can be anyone you’d like to recognize or admire, someone you know personally or not, someone with diabetes or maybe a Type 3. It might be a fabulous endo or CDE. It could be a d-celebrity or role-model. It could be another DOC member. It’s up to you – who is your Diabetes Hero??

For every mother or father who blames themselves unfairly because of their child's diagnosis...

For every mother or father who hides the tears from their child while they secretly worry about their lifespan, that summer camp, the school field trip...

For every mother or father weighing a donut, making 'special' treats for the party, asking the waiter to be sure that soda was diet...

For every mother or father who has to poke their baby with a needle, change their pump while they cry and beg for a reprieve, force feed a juice box at 3am...

Today I want you to know that you are heroes to me.

Snapshots

Click for the Saturday Snapshots - Saturday 5/19 Link List.

Today's prompt: Saturday Snapshots. Back for the third year, let’s show everyone what life with diabetes looks like!  With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures.  Post as many or as few as you’d like.  Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves.

Today was a lovely day - spent with my family, spent with my friends at a little boy's birthday party, spent with my (adored) former students at a wedding...

But from a diabetes standpoint, it sucked.

Hell, from a d-standpoint, a lot of days suck.

Late to the birthday party - because pod fell off. New pod.

Lots of delicious party food, including random pieces of half-eaten cookie that Sweetie shoved into my mouth. How do you bolus for that?

Rush home for their nap. Rush to wedding. Rush home for Hubster and the littles. We all rush to wedding reception.

Lots of appetizers, including the handfuls of chocolate pieces that Sweetie shoved into my mouth. I didn't bolus for that.

But I chased my daughter around the dance floor for a good half hour - which I count as moderate to heavy exercise.

But by the time I got home, I just had this feeling. This feeling like there was no insulin in my body. I don't know how else to describe it. It feels like a high, it feels like ketones, it feels like dehydration...but I can just tell that there was no insulin in my body.

So here are my snapshots.

 

I'm thankful for that last one.

Assumptions

Click for the What They Should Know – Friday 5/18 Link List.

Today's prompt: What They Should Know. Today let’s borrow a topic from a #dsma chat held last September. The tweet asked “What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?” Let’s do a little advocating and post what we wish people knew about diabetes. Have more than one thing you wish people knew? Go ahead and tell us everything.

This topic is reminiscent of the DBlogDay topic from 2010 - the 6 Things I Want You To Know About Diabetes. And it remains one of my most visited posts to date.

But I have something else on my mind for today.

Assumptions.

My friend Susan has taught me a lot over the years and one of my favorite quotes from her is this:

"Wow. What is that like for you?"

It's what she asks me when we talk about my diabetes. It's what I've learned to ask her in regard to her anxiety and depression.

And now it has become what I ask the newly diagnosed. It's what I ask a frazzled parent of a type 1. It's even what I asked the man who got me a can of coke (for a low blood sugar) in Key West when he told me that his Golden Retriever had diabetes.

We all think we know so much. We especially think we can judge others because we know so much.

I know what it's like to be ME with diabetes, but I don't know what it's like to have been my friends or relatives.

I have never struggled with an eating disorder, depression, body image issues, seizures, becoming an astronaut, running an Ironman.

I've never been the mom of a kid with diabetes, but so many parents I can think of have their own unique situations - parenting a diabetic since babyhood, parenting one toddler with diabetes and a little girl with Crohn's, parenting three diabetic boys at once, parenting one creative elementary aged boy, parenting a child with both celiac and type 1.

Each story is unique.

Yet we are so quick to judge our relatives who "ate their way to diabetes." We are so quick to assume that Aunt Sue lost her feet because she didn't try hard enough. We are so quick to assume that we know better.

Every time I see a really hard-hitting anti-smoking commercial, I nod in agreement and say "There's a good one."

My husband, an ex-smoker, always says, "It won't work."

"Why not?" I asked one day. "Why won't knowing how harmful it is make someone want to quit?"

"You know you should exercise, right? You know it will make you healthier, stronger, make you live longer? But you don't do it, do you? Why not?"

"Because I don't want to."

"Exactly," he said.

Probably 99% of us at one time or another believe that people cause their own diabetes (type 2 especially). That they just don't listen to their doctors or make the changes they have to make.

First of all, that's a misconception about type 2, fueled by media hype and undereducated family doctors.

Second of all, give Granny a break. Making changes is crazy hard.

At best, major lifestyle changes may hold her diabetes diagnosis at bay for a couple of years. Maybe it will keep her off meds. Maybe it will add years to her life.

But she is tired. She has eaten a certain way or led a certain kind of life for longer than you have. She doesn't want to have to go through this. Making sweeping overhauls is hard and it's no magic bullet. There's no guarantee that she won't develop type 2 eventually. Lifestyle is only a part of it. Be supportive in her efforts. They are difficult and they are just part of the battle.

And if it's type 1 diabetes that your loved one is poorly controlling, a little support goes a lot further than a little derision. Who made you the diabetes police? You don't know what it's like for them, weighing, measuring, calculating, spiking, plummeting, shaking, raging...24/7.

Assumptions. Maybe you don't know what you think you know.

Try asking instead, "Wow. Diabetes. What is that like for you?"

A Ouch

Click here for the Fantasy Diabetes Device - Thursday 5/17 Link List.

Today's Prompt: Fantasy Diabetes Device. Today let’s tackle an idea inspired by Bennet of Your Diabetes May Vary. Tell us what your Fantasy Diabetes Device would be? Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc. The sky is the limit – what would you love to see?

No sooner are you diagnosed than you start imagining a device that could make all of this easier.

Case in point: Melissa, age 11. Spring of 1991.

In fifth grade, my science teacher gave us the opportunity to participate in the Invent America contest, an educational contest designed to spark creativity among kids grades K-8. It was my first school year with diabetes and I knew instantly what my fantasy invention was.

The Sugar Sensor

I envisioned a pocket-sized (I was a visionary) blood glucose monitor that would read your BG level through a sensor pad.

No more pokes. And it took just seconds.

Here was my description:

"What is the need or problem solved? Diabetics can test their blood glucose level without the pain or bloody mess of pricking their finger. It can fit in your pocket or purse.

How does it work? Wipe the sensor pad with the special chemical solution. You press the O (on/off) button.  You then press the T (time) button and the machine will have a 5-second warm-up time and then a beep will sound to indicate the machine is ready. You then place your index and middle fingers together gently on the sensor pad. While the machine counts off 10 more seconds, special sensors in the sensor (---> on back)...pad take a blood glucose, or blood sugar, reading through the oils on the surface of your skin. You then press the O button.

How is it made? It's made of high impact resistant plastic, a built-in timer, electronic sensors, and a J battery (believe me, there is one)"

That last bit cracks me up. J batteries. Oh my goodness. The meter I was using at the time took these monsters. They were impossible to find. I can't tell you how many drugstore and supermarket clerks my mother puzzled with descriptions of this elusive battery. There was one supermarket with a photo department in the next town over and there were usually 2 or 3 of them hanging on the shelf.

And now we can use our iPhones to check our blood sugar. My, how far we've come.

Still, when I see those misleading commercials (aimed at Type 2s, usually) that promise "pain-free" testing, I have to ask, when is that part coming? Will we ever ever measure anything in human blood without a needle involved?

Perhaps my "skin oils" sensor didn't make any sense, but it showed that, as Pollyanna as I seemed about my diabetes throughout those days, the stress of all the poking was in the back of my little mind.

I love having a CGMS (continuous glucose monitoring system) - even when it isn't perfectly accurate or reliable. But it hurts like a beeAHTCH to insert those sensors. With a needle.

I love having the ability to infuse insulin directly into my skin with a catheter I can barely feel, but I have to poke a sizeable hole in my body to make it happen every three days. With a needle. And I have my FOURTH site infection in a year right now. Luckily, I don't think this one is infected with MRSA like the first two were.

One of my only true FREAK-THE-F-OUTS where diabetes is concerned is the very real threat that a long-time veteran of the disease faces.

What am I supposed to do when I run out of real estate? What happens when it's all scar tissue? When it's all calloused? When I'm constantly at risk for staph from open wounds infusing liquid into my subcutaneous tissue? What happens when the drugs to fight the staph stop working?

What will I do when poking myself puts me as much at risk as NOT poking myself?

As I'm just about to hit "Publish" on this post, Sweetie, for the first time ever, is pointing to the pod on my arm and saying "A ouch. A ouch." I said, "No, Sweetie, a pod. PODuh." She looked at me and confirmed: "A ouch." Yes, baby. A ouch.

Mighty Mighty Math Powers

Click for the One Thing to Improve - Wednesday 5/16 Link List.

Today's prompt: One Thing to Improve. Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at.  Today let’s look at the flip-side.  We probably all have one thing we could try to do better.  Why not make today the day we start working on it.  No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

If "needs improvement" items were monkeys, I'd have a barrel full.

For the last 6 years or so, managing my diabetes has been the first and last thing I think about everyday. That's a change from the 'chasing my tail' method of my younger days.

And it has shown in my great A1cs, improved standard deviation in my blood sugar, and the whole baby thing.

But the thing about diabetes is that it's never good enough.

I test 6-10 times per day - awesome, but, like most veterans, I don't change my lancet. Ever. And when I say that to people without diabetes (as I did today), you can hear a pin drop. Ew, they think. Eh, I reply. I'm still working through the 2nd or 3rd drum on my multiclix I've had since before my wedding. There is a box of lancets in my supply cart from 2001. But that's not an area where I plan to expend any energy.

There are 3 big ones where I'm going to admit to failure though:

Carb counting
Managing insulin during exercise
Analyzing trends

I eat pretty healthily - homemade, organics, whole grains, lean proteins, almost no sat fat (except for occasional sweets), but I know I SWAG my carb counts terribly. You couldn't even call it SWAGing. It's more like RWAGing ('random wild ass guessing') because the 'scientific' part is all hullabaloo for me.

I am often so so wrong. I'm trying to be better, but I'm annoyed that cooking from scratch - which makes my meals healthier - makes carb counting that much harder. No one slaps a nutritional label on my crockpot for me and tells me how to SWAG my minestrone. Is it 30g? 50g? 65g a bowl? How much is a bowl? 3/4 cup? 1 cup? What if I use lean beef and wheat macaroni? KILL ALL THE THINGS!!!!!!!

*breathes* Okay, what was I saying?

I'm also awful at managing exercise. I don't mean the getting out there and doing it - everyone is awful at that. I mean balancing the trifecta of insulin/food/activity. If you think I'm bad at the Food-to-Insulin See-Saw, you should see me sliding around on the Triangle of Terror.

Last night, we decided as we sat down to dinner (30g rice, $;@?g for the avocado tomato corn salsa on my grilled chicken) that we would indeed do our 2mile walk to the park and back with the kids. Okay. Crap. Okay. Here goes. I can do this.

I was 77 mg/dL before dinner, so I took no bolus insulin for my plate. As we start to head out the door, I'm 93. So far so good. Putting shoes on didn't screw me up then. I reduce my basal insulin by 50% for 90minutes. I grab every edible thing in the pantry and throw it in the basket of the stroller and I suck down a juice box (15g). Miraculously, I stay flat at 90 for the first mile (22minutes). We spent 12min at the park. By the time we are home, I'm at 80 on the CGMS. Best I've ever done. Test blood sugar. 70s. Still functioning on reduced basal, but expecting to continue dropping. So eat 30g. Wait patiently...still dropping...Decide to bake 4 dozen sugar cookies for party today. Handling the sugar on my skin (perhaps sampling some too) raises my blood sugar to 300. Oh f*ckitalltoblazes. I just can't win. I will be my own undoing.

Which brings me to pattern management. I can't make accurate changes to my dosages on my own. Lots of people can. Maybe I don't have the same eye for the details. If I do log my numbers, meals, and activity, I can't make sense of it. I literally hand over my pump and CGMS to my CDE (aka the Evil Genius) and she figures it all out and hands it back to me.

To be honest though, I know I could. I feel like it's a failure of spirit. My numbers are frustrating to me because I feel them. To her and you and my endo, they are just data.

I can't see the forest because I keep smacking my face into tree trunks. She can step back and say, "Look at the lovely Spruces."

I need that. I need to be able to hand it all to somebody and just say, "Here. Fix it."

But she won't always be there. I would like to learn how to fix my basals and ratios myself. I have a brain. I have a book. I have a calculator. I just don't have the will.

I need to solve for "why."

Dumb Luck

Click for the One Great Thing - Tuesday 5/15 Link List.

Today's prompt: One Great Thing. Living with diabetes sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”. But today it’s time to give ourselves some much deserved credit. Tell us about just one diabetes thing you do spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well!

Today I'm asked to describe an aspect of diabetes that I'm really great at.

And I keep coming up short.

There was a time...we will call it the nineties...where I was great at logging my blood sugars. Never missed writing one down - from diagnosis at age 10 through at least age 18. I carried one of those kitschy four-color pens and diligently logged breakfast, lunch, dinner, and snack each in its own bright color, even notating my dosage and where I gave my injection. (In those days, I also changed my lancet four times a day. Haha.)

But all of the logged data in the world (aka 'compliance') didn't have any effect on my A1cs. I floated between 11-16% for my first three years with D. By age 16, I was pretty consistently hanging in the 9-10% range where I would stay until age 24.

So I suppose I was also good at surviving.

I hear dParents talk these days about their kids' A1cs creeping into the 8s and 9s as though their child is teetering on the brink of oblivion.

I don't know whose perspective is closer to the truth, to be honest.

I just know I'm pretty awesomely healthy considering those stats. Considering I stopped logging and, for too many years, stopped believing my efforts had any measurable outcome on my blood sugar management.

But I survived to build a career. I survived to build a marriage. And with the combined encouragement of a supportive spouse, the DOC, and the right mix of doctors, I learned to manage my diabetes really well and so I survived to build a family.

I wish I could tell you how, but this disease is spectacularly unfair. Compliance bought me no victories; indifference bought me no tragedies.

But I'm here. With confidence and grace. I'm still here.

Warrior Princesses

Today marks the first day of the third annual Diabetes Blog Week, hosted by Karen at Bittersweet Diabetes. (Click for the Find A Friend - Monday 5/14 Link List.)

Today's prompt: Find a Friend. It seems the most popular thing about Diabetes Blog Week is that it helps us find blogs we weren’t reading yet and connect with some new blog friends.  With that in mind, let’s kick off Diabetes Blog Week by making some new connections.  Think about the d-blogs you read that you think we may not know about and introduce us to one that you love!!  Let’s all find a new friend today!    (Special thanks to Gina, everybody’s Diabetes BFF, for helping me title this post!)

If you read blogs by people with diabetes, then you probably already know the who's who of the DOC. These guys and gals set the tone years ago for authenticity and advocacy in diabetes writing. I am a johnny-come-lately to this bunch and am happy just to join in the fray.

That being said, it would be impossible to follow every post by everyone who is worth reading. I've met at least 50 of the DOC bloggers and I'd read all of them if I didn't need to, you know, function. Most of us try to catch the posts we see and that's the best we can do.

But I can think of at least two bloggers I never miss if they broadcast that there is a new post - Sarah Mart at smartDpants and Lee Ann Thill of The Butter Compartment.

Maybe it's because they seem like women I'd love to hang out with but haven't had the pleasure.

Maybe it's because they have struggled with D for at least a decade longer than I have and I consider them warrior princesses who know how to rock it old school.

But more likely it's because they are both smart mouthed, intelligent storytellers and I see a bit of myself in them.

Chicas, today I would tip my hat to you. If I ever wore a hat.

Voices

The final prompt for Diabetes Blog Week 2011 is to chronicle what you've learned from participating in the blogging community - either since discovering the DOC or during this week of blogging.

My initial thoughts drift to all of the new voices I've discovered this week that I had never had the pleasure of hearing before.

People like Haley (an inspiring teen with diabetes blogging at Naturally Sweett), Mike (of What Some Would Call Lies), Penny (of A Sweet Grace) and Reyna (hilarious - of Beta Buddies) and Joanne (who is a part of a local group of D-parents I stalk and I had no idea was behind Death of a Pancreas until I found out she won Chick-Fil-A mom of the year and I put two and two together (and got mor chikn)).

As a voice teacher, discovering new voices is both my work and my pleasure. Every single voice is unique - actually having a mappable, traceable vocal fingerprint that is unlike any other voice's that ever existed.

That always blows my mind when I think about it in terms of singers.

But when I think about it in terms of D-bloggers, it warms my heart.

Each of us has something to share and there is space enough here in the big blue DOC to share it. All week, we read one another's stories, made each other laugh and cry, and offered big, sloppy low blood sugar kisses and finger-pricked high fives.

We're here. Each of us. Coming out as health activists, real people living with a very real though invisible disease. And we become more united with events like this.

We took the time this week to knock on our neighbors' doors and borrow a cup of...um...poison. Yeah. For cookies...made with poison.

Smooth CGMSailing and Flatline Glucoasters to all...and to all a good night.

The Long and Winding Road

Today's Prompt: A Diabetes Snapshot.

I'm taking that literally. Here is a snapshot of my A1c over the last 21 years.

(Click for larger)

Awesome...in Moderation

Today's prompt is a twist on asking ourselves about the awesome things we've done DESPITE diabetes and instead asks us to consider what awesome thing we've done BECAUSE of diabetes.

In the whirlwind of real life meetups I've had, fundraising walks, my journey into d-blogging, and online sharing via twitter and forums, it's easy to tick off a list of memorable moments that coming together with other diabetics has brought me. Moments and friendships I would not have shared were it not for this common interest that brings us together.

But the truly awesome thing I've been able to accomplish because of diabetes would be the contributions I have been able to make to my home social network - TuDiabetes.org - as an administrator, helping to keep the community running smoothly for the last three years. I can honestly say that I wouldn't have been involved were it not for the big D.

I joined the community in June of 2008, just before the 18th anniversary of my diagnosis. I was newly married, wanting desperately to be given the green light to get pregnant, and my insulin pump warranty had expired and I needed info on what else was out there. The Diabetic Online Community (DOC) was precisely the kind of pool I needed to splash around in.

I quickly jumped in with both feet, sharing experiences, talking insulin pumps and pregnancy planning with members across the globe. The first people to comment on my profile wall to welcome me I now consider some of my dearest friends. I'd never imagined that an online community could feel so warm, so easily navigable, so family-like.

Within two months, I was asked to be one of the first admins on the administrative team. Working side by side with Manny, Andreina, Kristin, Jeff, & Landi, we began to add structure to the way the site was moderated and maintained, learning as we moved forward - from our mistakes and our successes.

As a member, I shared trials and triumphs, posted photos and artwork, wrote poetry, mourned losses.

But as an admin, I was given a unique opportunity to keep my community SAFE, uphold the values that made me want to be a member there, keep threads friendly and keep content fresh.

Fast forward to 2011. I am now the lead administrator, senior member of the team (with the exception of Manny), and I'm the frazzled mommy of a toddler. Hundreds of messages fly through my inbox every week from our team of admins and discussion moderators. I don't think the community has any concept of how much we communicate behind the scenes.

My team has been amazing - past and present members included. Their perspectives, their leadership, their judgment...we've managed to strike that delicate balance of quality full-time commitment from volunteers with limited time to give because they are managing their own families, careers, and yes, their own diabetes.

And then there is our fearless leader. I admire Manny Hernandez to a degree I can't express. He is big brother, listening ear, source of information, social media guru, and ALL HEART rolled into one extremely likable person. Reading the way he consistently reflects the values of our community in the way he responds to members' concerns strengthens my resolve to give back to the community in every way I can.

And what I have done - and I won't claim to have done it alone - is to help streamline what our team does for the community everyday. I create how-to documents, answer technical questions, and handle training of new team members. I have been instrumental in creating and maintaining a message template of the many different kinds of notifications we use in contacting members in violation of our terms of service. I've helped orchestrate the hierarchy of the admin team, including how admins rotate through moderation responsibilities and how we document violations and contact members.

I'm fiercely protective of the admin team. When our decisions are challenged or our motives questioned, I make sure that our team is united and that we clearly articulate our position. Any one of us might be speaking from the anonymity of the Red Hand, but I'm always confident that it's said with one voice. Always reflecting Manny's vision. Always reflecting TuD's values.

This has been one of the first times in my life where I've really been part of a team. And it's a team with diabetes at the heart of everything we do. Our decisions aren't always well-received, but they are always well-intentioned.

I have the opportunity to draw from my strengths with the written word - be it carefully crafted diplomatic responses or snappy shutdowns - and my strengths in leadership (I'm definitely a "decider" - and a cranky one at that).

Diabetes brought me there. And it's because of how that community has improved my life with diabetes that I'll continue to serve with loyalty. It has been an awesome opportunity.

"Where your talents and the needs of the world cross, therein lies your vocation."---Aristotle

10 Things I Hate About You

Today's prompt: 10 Things I Hate About You, Diabetes

Time

I hate the time you take out of my day - out of my conversations, my getting ready to go somewhere, my meal prep. I hate always having to step away to deal with your crap.

Work

I hate the energy you zap, how you peppered my pregnancy with your nuisances, how I feel chained by the ankle to your regimen. Test, treat, test, treat. The second I stop paying attention, you take the wheel and drive us over a cliff.

Interruption

I hate the way you sneak into my quietest moments and yell "Surprise!" as you interrupt me with your pump errors and low blood sugars and loose infusion sets. Whether I'm rocking my daughter to sleep or teaching a voice lesson or performing a recital, your intrusions are never welcome.

Expense

You're a damned expensive disease - whether it's the insurance, the doctors, the drugs, the technologies, the accessories, or the medical supplies, I remember reading once that I can expect to spend a third of my income on you each year.

Ups

I hate feeling high. That unsettling, cotton-mouthed, nauseating, sleepy feeling combined with the rage of fight-or-flight stress hormones that make me unreasonably aggressive toward the people I cherish.

Downs

I hate the second and third lows of the day. I hate feeling like I'm constantly slapped down in my place, reminded of my vulnerability, thrown back on the floor any time I try to get up. I hate not being confident to walk ten minutes in any one direction because I don't know if I'll be able to make it the ten minutes back without a low blood sugar. I meet diabetics who are athletes, who run marathons, who play sports. Me? I'm afraid to walk to the park with my toddler.

Misconceptions

I hate the way people without diabetes think they know what my needs are, what my diet should be, what my history must have been. I hate the way the media has painted it as a disease we deserve.

Variables

I hate when my blood sugar is 441 and I don't know whether it's because my pump malfunctioned, my insulin went bad, my site came loose, that soda wasn't diet, or I miscalculated lunch. There is rarely a simple explanation for the worst days.

Complications

I hate fearing what feels like the inevitable. Wondering when it will strike out of nowhere. Waiting for the other shoe to drop. I hate how you hit my friends, one after the other, with neuropathy, retinopathy, heart disease, essential tremors, etc. I wonder when I'll piss you off enough to make you hiss and snarl at me with the worst you've got.

Identity

I hate how you claim a stake in my identity - as though you and I are symbiotic, as though I needed you here to be all I am now. I hate that each of the scenes of my life have had you pressing your face to the window, knocking your insistent knock like a pesky neighbor who can't be ignored. I struggle to define myself with you there in the shadows.

And I hate that.

Diabetes Boobers...er, I mean...Bloopers

Day 3 of Diabetes Blog Week (#dblogweek) asks us to consider the lighter side of the big D - those funny, embarrassing, or ridiculous moments that diabetes has brought into our lives.

I had trouble with this one.

When I "oops" as a diabetic, it's usually a pretty big "oops."

Oops. I left my insulin in Germany and boarded an 8-hour train ride to the Czech Republic for the weekend.

Oops. I suspended my pump during a low and forgot about it until 5 hours later when I started vomiting. During Ryan's voice lesson.

Oops. I didn't refill my pump cartridge before my singing gig and fainted in front of 800 people while singing because I felt so nauseated from the skyrocketing blood sugar.

Oops.

I know I've had genuinely funny moments, too, though.

There was the time my cat was on a mission to defeat my vibrating Cozmo while I was in the shower.

There was the time I participated in the ADA walk and was so busy chatting it up about diabetes that I walked into a fire hydrant and busted up my shin. Funny if you know my dad is a firefighter.

Or the time (this last Spring Break) when I dropped into the 40s at a meetup of D-parents and they all started whipping out bananas and glucose tabs - every flavor I could imagine. (There is no better place to go low than in a gathering of D-parents.)

But the one that jumps out at me was when my boobs beeped.

I was a junior in college and was being inducted into a prestigious honors society. My essay was one of only three selected to be read aloud and I was receiving a special award along with my new membership. So I was pretty dadgum proud.

My no-frills parents and I were seated at a banquet table with an associate provost and a vice president of the university.

In the middle of the room.

And my Minimed 508, nestled fairly discretely in my cleavage, decided that its cartridge was in urgent need of refilling.

For those of you unfamiliar with the MM 508, when it was empty, you knew. Everyone in a two mile radius knew. It screamed. Progressively louder. Six beeeeeeps in succession. And there was no silencing its beeeeeeeeeping until you'd refilled it.

My first instinct was to try to muffle it.

I pawed at my breasts with the grace of an 8th grade boy.

Heads turned. My boobs squealed.

I don't remember how I got it to stop. I know we didn't run back to my dorm room. I know I never carried pump supplies on me back then, in the spring of 2001. I vaguely remember going out to the bathroom. I'm guessing I stepped away, yanked it out, and removed the battery. Or maybe I just ripped the whole infusion set out and stuffed the pump in a purse, hoping it would hush.

I'm sure I came out and finished a big dinner with a smile on my face and no bolus on board, trying to appear elegant in an environment that felt far too uppercrust for my modest upbringing.

I went on to deliver my speech that night and impressed everyone when the microphone died and I used my vocal training skills to project the rest of it without a mic. I remember getting to shake hands with the university president.

I know that when I look at the pictures from that night, I remember that I felt sick and high the moment they were taken...

...But I felt like that a lot of the time, to be honest.

My college days were not wild, misspent, or noncompliant, though my then-endo often accused me of as much.

But my A1c was over 9, my blood sugars were high all of the time, and I didn't have any support.

I didn't know an entire blogroll of people who would have groped their own boobs if they heard a loud beep at the dinner table.

Statistically Significant

The second prompt for Diabetes Blog Week asks us to write some kind of letter. The recipient can be real or fictitious - an endocrinologist, a pump or meter company, diabetes itself - or you can write a letter to yourself as a younger diabetic.

You know, my very first venture into the D-OC was my husband emailing me the link to Amy Tenderich's Open Letter to Steve Jobs in 2007.

I was in righteous agreement with her, shaking my head affirmatively as I considered how out of date and out of touch the technology behind our insulin pumps and meters and continuous monitors was.

Just last year, in a dinner with some engineers from Abbott concerning the Freestyle Navigator CGMS, I remarked how important I felt a dedicated backlight button was to a device like a CGM. The engineers seemed puzzled.

"How would you like it if every time your phone rang in the middle of the night, you had to sleepily figure out a complicated key sequence to get the backlight to turn on so you could see who was calling?" I asked.

"Oh," they answered.

Similarly, I described all of the other user-friendly options we wish we could see in our devices and they seemed dumbfounded. Timestamped data on the onboard graphs, a test strip port light, range enough that you can use a device while naked, battery life meters that actually measure actual battery life, and...most importantly...meter accuracy. Yes, meter ACCURACY - something companies compromised over a decade ago in the name of faster testing results.

I'm fed up with meter companies' mediocre attention to detail and lack of empathy for their patient customers. (Probably doesn't help my mood that I was on the phone fighting with Abbott yesterday morning about the Navigator CGMS's interminably indefinite "inventory interruption" that has had my transmitter backordered for over a year.)

So here is my letter.

Dear CGMS and meter engineers,

Do you know that I take a different dosage of insulin for a blood glucose value of 136 mg/dL than I do for a 145 mg/dL?

But that's not statistically significant, you reply.

Not to you maybe.

If your meters can be as much as 20% off of lab values (and more in some cases) and I have to base my dosing decisions upon incredibly loose data, how can I ever hope to achieve "normal" control?

If my blood sugar is actually 120 mg/dL and your device tells me that I'm 161 mg/dL, I inject insulin into my bloodstream that my body can neither use or dispose of and then I go low.

Will my medical team blame the meter I used? No. They will tell me I must not be reporting something or that my basal rates might be off or that I didn't wash my hands thoroughly before I tested. They will actually seem puzzled and ask, "Why did you go low here?"

It's never your fault, meter company, is it? You fly your little butterflies and American flags across my tv screen, brag of faster (but less accurate) results and new bright color options for my meter, tell me that coding is my biggest annoyance (really?), and that I can test from my arms (MUCH less accurate). You have smiling rock climbers, fishermen, grandparents...all with blood sugars of 104 mg/dL.

But you and I both know we can't rely on that number, don't we?

Significantly,
Sweetly Voiced