Insulin Pump Demystified

Helpful new read

2007-01-25T10:53:00.000-05:00

Hi Friends--

Whether you are recently diagnosed or a diabetes veteran, pick up a very helpful book: "The Ultimate Guide To Accurate Carb Counting" (The Marlowe Diabetes Library). Written by CDE and diabetes author Gary Scheiner (who wrote the forward to my "Insulin Pump Therapy Demystified"), this guide breaks down the nuances of carb counting with clear explanations that will benefit us all. From how to accurately read lables (did you know to subtract the Fiber listed from the total carb count?)to understanding the glycemic index, Gary Scheiner gives us true guidance to tighten up our carb counting and so improve our diabetes control, while actually giving us a few laughs along the way. Spread the word and add "The Ultimate Guide To Accurate Carb Counting" to your bookshelf. For more info on the Marlowe Diabetes Library, go to www.marlowepub.com/diabeteslibrary.

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It's been a busy time in my kitchen, as I've been eliminating gluten and casein from all of my cooking because of allergies that my son is having. That means no wheat/white flour, oats, barley and rye...as well as no dairy. It's actually been a healthy way to eat--I'm using more brown rice, corn tortialls, lots of fresh vegetables, protein and fruit. My son is still going through withdrawl from bread products and not all of the gluten-free substitutes do it for him. But we're committed and are experimenting to see what works. The best news is that this new approach to cooking and eating is helping my bloos sugars to stay more stable--brown rice pasta, for example, works much better for me than white pasta. And it's actually good! If white flours cause your BG to spike, it might be worth trying the gluten-free path...

Peace,
Gabrielle

January 2, 1982

2007-01-01T19:23:00.000-05:00

Tomorrow is the 25th anniversary of my Type 1 diagnosis; it came on the day just after New Year's when I was ten years old. I can still remember everything about that morning in clear detail...peeing into a cup at home, my Dad (a doctor) taking it with him to work, getting into the car with my mom and riding to the hospital, meeting my dad in the cafeteria where my parents explained what was going on before we went upstairs to the pediatrics ward.

Of course, I couldn't grasp that morning the dramatic effect that diagnosis would have on my life to come. But I do remember just wondering, in the midst of learning about insulin and practicing injections on an oragne, if my life would ever be "normal" again. What did it mean to have a disease? Was I going to grow up and be healthy and go to college and fall in love and have kids and all of the other things that my 10-year-old self dreamed of?

I wish I knew then what I know now--that in fact, my life has been better than normal, that the challenge and hurt of living with diabetes has opened my heart and I think has largely made me into the sensitive, compassionate person that I am. I wish I knew that growing up not taking mortality for granted could be an incredible gift--that because I had a sense that life is not a given, I have always been open to living fully, taking chances, and loving freely with all of my heart.

On the other side, I'm glad I didn't know about my struggles, about my years of rebellion, of not eating well, of being like every other college student and drinking too much, of ignoring my diabetes. I'm glad I didn't know how often I would be struck with pure terror during my pregnancies, desparately afraid that my children wouldn't make it out of my womb alive.

But in the end, living with diabetes for me has been all of the above and I can't imagine what my life would look like now if I hadn't received that diagnosis that day. But I do know that I am ready, fully open to record that other day, the day yet to come, when I recover, the day that I am cured of diabetes, do not need to take insulin by pump or injection ever again. What a day that will be. And it's coming. I don't know when. But I believe it is...

A happy, healthy New Year to you--
Gabrielle

And a Happy New Year...

2006-12-25T10:57:00.000-05:00

Wow...Chanukah is over, New Year's Eve is just around the corner, friends are celebrating Christmas today, and I felt a great sigh of relief. The holidays were too hectic this year. Every time that I thought my buying was over, I forgot about one more gift...between my children's teachers, the whole family's health care practictioners, and my husband and my colleagues, as well as our family and friends, my list was longer than ever. I love the spirit of giving but need to find some way to make my shopping more manageable next year.

In the midst of it all, my little family gathered each night of the eight that make up Chanukah to light our Hanukkiyot, the menorahs that are special for Chanukah. One really creative one was made by my almost four-year-old son, George, in preschool. He was so excited to light the candles each night that during our short ritual of singing the blessings and lighting the candles, the stress around me did seem to slip away. George held onto the shamash, the helper candle used to light the other candles, with my help and lit the candles on his very own Hannukiyah. Fred, George, June and I danced around the kutchen to Chanukah songs.

It was a small, simple moment but in the darkness of this winter season and in the stress driving at all of us in our daily lives, I will hold onto the memory of lighting the candles and singing with my small children.

The new year is coming and I will try and once again focus harder on making my health and well-being a priority.

Wishinh each one of you moments of light in the new year--
Gabrielle

Check out my interview...

2006-12-04T22:57:00.000-05:00

with Pittsburgh Stter Kendall Simmons at:

http://www.diabeteshealth.com/browse,1038.html

Hope he inspires you as he did me!

All best,
Gabrielle

Moderation actually worked!

2006-11-29T10:33:00.000-05:00

Yes, I freely admit that I ate until my pants felt tight on Thanksgiving. But unlike over indulgence in past years, I actually ate mostly healthy foods on my plate--lots of roasted vegetables, turkey, some mashed potatoes and stuffing, small amounts of the candied sweets. We took our usual break for dessert and then I bolused more insulin and enjoyed a moderate slice of both pumpkin and pecan pie, smothered in a layer of non-dairy whipped topping. It all felt so good, and an hour after it was over, I tested in at 236. Could have been worse--a few more units and I was down to 146 before bed.

The next few days, I went easy on the leftovers and didn't beat myself up about eating such a good, extra-large meal. I really enjoyed dinner and left it at that. I went through the Thanksgiving weekend with my family not worrying about the scale, but just focusing on the experience of it all.

I heard a bit of my favorite cooking show, "A Chef's Table" on NPR today and the guest, a dietician, talked about the way our bodies all cycle into a carb-craving mode this time of year. It all connects to the darker nights and the way we instinctly tucker down and preserve our energy.

It's helpful to know, since I so often go into the November--March weight gain cycle. This year, I'm going to focus on low-glycemic index carbs and try and keep the moderate approach that worked so well on Thanksgiving going. It's only December 2nd, so I feel a bit premature in feeling optimistic, but awareness is the first step.

Wishing you all energy and vitality as winter approaches--
Gabrielle

Slowing Down

2006-11-18T21:40:00.000-05:00

It's been a strange fall here weather-wise--lots of rains, dips into the 40s and rises back up to the 70s. Now Thanksgiving week is approaching and the weather is settling into the 50s. It feels like deep fall now, with winter weather just around the corner.

My rhythm really slows down this time of year; I feel it happening. I know it's natural, but I resist it. I want to stay inside, curled up, I'm less eager to get out for the walks that I need. I'm in a bit of a lazy rut and I feel it in my body. I've maintained my weight for the last two months, but haven't dropped a pound. And now the holidays are coming and I really want to be mindful of what I'm eating so that all of my weight loss efforts from last spring and summer don't go for naught. Not to mention that my blood sugars often go bouncy-bounce throughout the holiday season...and I'd like to bring a bit more attention and control to that arena this year.

I feel all of this intellectually, while my body is saying "sit on the couch, eat, forget it." Maybe the first step is paying attention to this tendency, to just being aware. Maybe I can work with my body this year, find some way to kick it into high gear, maybe doing some more yoga, maybe just putting on an extra sweater and making myself get up and go walk.

I am looking forward to Thanksgiving dinner though, I must admit.

Wishing you blessings,
Gabrielle

Halloween: Crash and Burn

2006-11-02T11:09:00.000-05:00

GROSS. That is how I feel after too many days of yes, eating Halloween candy. It started innocently enough a couple of weeks ago when I saw big bags of candy on sale at the grocery store. Who puts candy on sale before Halloween? Being the bargain shopper that I am, I bought three bags.

Then the question was: where to store them that my 3-yr-old son wouldn't find the? He's pretty good at finding secret places, that kid. So I figured I'd just leave them in a bag in the car, under the passneger seat. Big mistake! I don't usually eat candy, not Halloween type of candy, anyway. I try to be conscious of what I put into my body and if I do eat chocolate now and again, I'd rather do the really good stuff, a Lindt bar or something along that line.

But having bags of Tootsie rolls and snickers and butterfingers and twix in the car with me all the time pushed me into a bit of a fetish state. You know, at a red light, I knew the bag was there, waiting for me to dip in. What fun! I'd take a little twix, bolus, and enjoy.

Let's just say that by Tuesday night, I had to go out and buy more candy to replace that car candy, the fetish candy, and then there I was, hours after taking my kids around the neighborhood for Trick or Treat, faced with more bags of extra candy since this year's turn-out of ghosts and goblins was on the light side.

Gross. I can feel those little packets of m&m's around my waist. It's over now. I am way done. I haven't been on the scale in a week bu ttomorrow morning I am getting back on. Halloween begins my annual cycle of "weakness"--indulging more than I should through November and December. I know many of us do it, but i don't want to get sucked in once again. I've worked hard to lose weight and even if I can bolus to manage the extra carbs, I know that eating junk does nothing to help my overall health.

Fortunately my kids are young enough not to notice if their treats suddenly get put in the trash. George was more excited about calling out "Trick or Treat" than actually eating the candy. No more snickers for me!

Really inspiring!

2006-10-20T19:56:00.000-04:00

I had the real pleasure of interviewing Pittsburgh Steeler Kendall Simmons a few days ago--Kendall was diagnosed with Type 1 diabetes a few years ago and is going on a campaign to raise public awareness about diabetes. I interviewed him for "Diabetes Health" magazine--look for the article in an upcoming issue. Now, I must disclose that I was a little bit intimidated to talk with Kendall because I am basically football--illiterate. This admission comes with the disclaimer that I grew up with a Dad who is a die-hard fan (especially of the Steelers & Eagles) and married a man who may be an even bigger fan (Eagles specifically, with respect for the Steelers). Yet all of those Sunday afternoon and Monday night games pretty much washed over me, just specks on the screen, as I went about my business. Yeah, I've paid a little bit of attention during the Super Bowl, but that's a national holiday, after all.

So Fred prepped me a bit for the interview and my Dad assured me that the Pittsburgh steelers are all stand-up guys, and in the end, Kendall was probably one of the nicest, most down-to-earth people I've interviewed. He talked about what it was like to go from feeling at the top of his game, having won "Rookie of the Year" to getting extremely sick during training camp before his Type 1 diagnosis came. He talked about needing to change his eating habits from basically eaiting whatever he wanted (Kendall is 315 pounds) to learning how to count carbs. He talked about how he needs to manage his insulin so that he can go out and block 400 lbs of weight as an offensive lineman, without worrying about being too high or too low sugar-wise.

But mostly what inspired me was his attitude that he had simpley worked too hard in his career to let his Type 1 diagnosis get the best of him. And that is what he is out there in the world talking about.

His message brought me back to thinking about, though I don't need to go out and tackle anyone (barring my 3 and 1/2 year-old from time to time) on a daily basis, I do need to keep my diabetes management at the top of its game so that I have the strength to manage whatever comes at me in life. Stress at work, at home, parenting, financial pressures, worries about the state of the world...I have a lot on my plate, as each one of us does. It's too easy sometimes to just give in to it all, to lose motivation, to feel a little self-pity, to let your sugars swing out of control.

Talking with Kendall gave me a good shot in the arm, no pun intended, and I'm watching myself a little more closely this week. And--not a word to my husband or Dad--I think I'm going to follow the Steelers for the rest of the season.

Peace to you,
Gabrielle

Getting closer to a new pump...

2006-10-11T10:30:00.000-04:00

Last week I had an appointment with my endo, the fabulous Dr. Levetan (see her web site www.curedm.com) and her equally fabulous diabetes educator, Susan, and took a step closer to choosing a new pump. I actually listened to Susan's insights and experiences with all of the new pumps that are out there and took home literature to read about the Animas and Deltec pumps and the MiniMed pump with continous glucose sensor. It's a big decision but I am feeling ready to take advantage of the new advances in pump therapy--and am relaizing how much easier it will be to have a pump that does the math for you in terms of carb counting and how much insulin is in your body, as opposed to using my D-tron plus, which doesn't include those features. In my heart of hearts, I want to get a pump with a sensor...it's the best technology there is, and right now, I'm going through some big hormonal shifts connected to my cycle and it would be great to have a sensor giving me a heads-up about my sugars suddenly going too high. I really need it...last night, I was 140 an hour after dinner...then was 276 two hours later, having eaten nothing else. This is the kind of crazy, sudden blood sugar spikes that I've been experiencing. Even as a I write this, it's feeling apparent that I should do for the sensor. I'm just bummed out that insurance is not covering it, but I think I'll just have to suck up paying for it out of pocket.

Susan mentioned that Deltec will be coming out with a pump/sesnor combo, too--maybe within a few months--so I may want to wait for that and see which company will give me a better deal. It stinks, but you have to act like a smart consumer when it comes to diabetes supply decisions. I am still feeling stung that my husband's new health insurance plan only pays for the cost of 70% of my strips.
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Did you see the AP newswire in yesterday's paper about a man with Type 1 diabetes who was in a major car accident and survived for four days in his car, with a fractured leg, before someone found him? It was all because he kept a box of crackers in his car, he ate them and was able to grab his insulin. Amazing story. This morning I made sure to put extra snacks in the glove compartment. It's horrible to think about the possibility of such an experience, but stupid not to be prepared.
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Wishing you all much safety and good health!
Gabrielle

A sweet new year...

2006-09-26T21:39:00.000-04:00

This past weekend was Rosh Hashanah, the Jewish New Year, the celebration of the creation of the world. It is one of my favorite holidays. I love the opportunity to think of starting the new year with a clean slate, with a fresh start. In Jewish tradition, we perform the act of "Teshuvah" which translates into repentance. We go to people whom we have hurt, and ask forgiveness. We go to God and pray for forgiveness for sins that we have committed against the Holy One. It is a time of introspection and reflection. Now we are in what are called the "Ten Days of Awe" which come between Rosh Hashanah and Yom Kippur, the Day of Atonement. Much is on my mind. I use this time to look inward as much as possible, and try to do an honest accounting of where I am falling short, in both my deeds and intentions.

One of the themes and rituals for Rosh Hashanah is about a "sweet new year." We dip apples into honey and make a blessing over them. We wish friends and family members to have a sweet new year, we cook apple cakes and honey cakes to serve on our holiday tables. This metaphor pushes a button in me, someone living with Type 1 diabetes for over 25 years now. What does "sweetness" really mean to me?

Yes--now with the pump I can eat my apples and honey, and even my honeycake and rugalech and all kinds of goodies, and still keep my blood sugar under control. But the idea of "sweetness" is still a complicated one for me. I think about the sweetness that was denied to me after my diabetes diagnosis and the bitterness that filled inside me in its place. I think about the way people have often used the adjective "sweet" to describe me, only to be shocked when they discover the tough-as-nails part of my personality that lies beneath the surface.

"Sugar works better than vinegar" my Grandmother used to tell me and I watched as she used sweet talk to get things done. I've often modeled that tactic and been successful as a result, laughing coyly as she used to do, once the mission's been accomplished.

I am wishing for a sweet new year, though the word "joyous" feels better to me than "sweet" because of the baggage that I've just described. A joyous year for my family, for my friends, for everyone. A year of sweetness and joy and hope and peace and also, especially, for health--without which, we don't have very much of anything at all.

L'shana Tovah--a sweet New Year--to each of you (Jewish or not!)--
Gabrielle

Stress & my sugars

2006-09-17T20:51:00.000-04:00

My life is a little bit crazy at the moment, but a lot of the craziness is good. My husband and I just found a lovely little home in a neighborhood that we desire--one with excellent public schools--in a suburb of Philadelphia. The price was right, so we made a bid and our offer was accepted. Now we have to sell our current home, in this not exactly seller's market. I'm confidant that we will, but keeping a home perfectly clean and uncluttered with a 3 and 1/2-year-old and 1-year-old in the midst is a challenge, to say the least.

So over the last couple of weeks, I have to say that the stress of it all has been having me ride the blood sugar rollercoaster. You know that one? My bg is fine at one reading and then shoots way up high at the next. What's happened in between? Just a few major adrenaline rushes as the phone rings and I find out that a potential buyer is on the way. This weekend has been the worst. We spent Friday and Saturday preparing for today's Open House and I'be had more lows in the last 48 hours than I think I have all summer long.

Which reminds me that no matter what is happening in my life--whether it is a stressful or relatively peaceful time--I have to make blood sugar management a key priority. I don't want to be riding this rollercoaster througout the selling process and move...

Wishing you peace in your life!
Gabrielle

PS: Philadelphia area readers--you can check out a link to my house at http://www.mlsfinder.com/nj_trend/neilkugelman/index.cfm?action=listing_detail&property_id=4809467&searchkey=bda38d42-ce07-aa67-0b8a-6564aad30349&npp=10&sr=1

One year ago...

2006-09-01T19:50:00.001-04:00

...I was 37 weeks pregnant and watching CNN obsessively, trying to understand what was happening to Hurricane Katrina victims. Granted, I couldn't sleep so well because of my size and getting sucked into the Katrina drama held me at a safe distance from the anxiety around the fact that I was going to give birth very soon, but my obsessive watching came from a deeper place than just needing to escape. As someone living with Type 1 diabetes, I'm pretty damn grateful to be living in a more or less safe environment, in which I can depend on getting the insulin, medical supplies, food and water that I need to live. I can't imagine having my very life (including pump supplies and strips) swept away in flood waters like that or being one amongst the thousands horded into the Superdome, desparate for insulin. Seeing scenes of horror like that on our very own US soil threw my sense of security compeletly out of whack. Add being so very pregnant into the mix and forget it. Every time a couple came on TV talking about being separated from their baby who was being held in the NICU of a Lousiania hospital, I became a total and complete wreck.

But Katrina was very far from Philadelphia and my daughter June Elizabeth was born, healthy and pretty happy, in a lovely, suburban hospital where we both recived the best of care, on the 6th day of September, 2005. When we sent an email to our friends and family, Fred & I requested that people send in donations to benefit Katrina victims in lieu of gifts for June, who was truly already so rich in so many ways. It was a small gesture, but feeling so helpless in the face of such great devastation, I took comfort from it and felt it gave June's life a beautiful karcmic beginning.

And now I am here, getting ready for June's birthday this week, watching Spike Lee's brilliant documentary on HBO "When the Levees Broke", remembering exactly the feelings that I was holding just one year ago. The word that comes closest to describing the feeling is "vulnerability." To depend on insulin to live is to be vulnerable. To be 37 weeks pregnant is to be vulnerable. To have faith and hope and trust is to be vulnerable.

I am still holding onto small measures in my daily practice of trying to show humanity and compassion. It feels like there are so many forces in the world right now that are about war, violence, greed and destruction. I look at my small children and want to make a better world for them. It sounds cliche, I know, but it is real for me.

With peace to you,
Gabrielle

The time is coming...

2006-08-25T21:35:00.000-04:00

The time is coming...I've set an appointment for early October to meet with Susan, the diabetes educator who works with Dr. Levetan to discuss getting a new pump. Susan herself has Type 1 and has tried almost every pump out there. It's truly amazing what has come out on the market in the four years since I've written "Insulin Pump Therapy Demystified." I realize that my Disetronic D-Tron Plus is way behind technologically in what's available (besides the fact that its products and accessories continue to be recalled...), but again, I'm at a "comfort" place in knowing how it works and now I need to push myself beyond this zone to find the best pump out there that will help me manage my diabetes. Setting the date to meet with Susan was the first step and I won't be able to stay immobilized after that.

Meanwhile, I'm not happy that summer is ending...I want to hold on to my afternoons at the pool with my kids, the light evenings, sitting on our deck, my less frantic work schedule. But the time is coming and I will remember this summer fondly in many ways.

With peace to you--
Gabrielle

Get inspired!

2006-08-13T21:53:00.000-04:00

I've gone a long time since posting--sorry.

I have a decent excuse: I've been busy doing nothing. My family and I took a week away and enjoyed the beautiful beach and town of Chincoteague, VA. Now by doing nothing, I mean that I was still taking care of my young ones--June, 11 mos, was very interested in eating sand and George, 3 and 1/2, was not always sure what he made of the ocean and frequently asked to go to the swimming pool, instead. Still, for my husband and I, the week away meant taking time away from everything work-related...which felt truly refreshing. Now that I'm home and have pretty much cleaned the sand out of all of our clothes, car and luggage, I'm trying to hold onto that "in the moment" energey that I felt during vacation even as I catch up with emails and work deadlines. At least I can try...

But I have been wanting blog about some very inspiring news--the day before our vacation, I had an appointment with my truly wonderful endocrinologist Dr. Claresa Levetan. Dr. Levetan, whom I've written about in other postings, is the phsyician who helped me to manage my blood sugars during my second pregnancy and for that, I am eternally grateful. But besides being a wise practioner, Dr. Levetan is a well-known research scientist and the work she is doing towards finding a cure for diabetes is absolutely inspiring...please read all about it at her web site: www.curedm.com.

Her research involves the discovery of a novel human peptide and a receptor associated with islet regeneration. Called Human proIslet Peptide (HIP), it stimulates the differentiation of adult pancreatic progenitor cells into insulin producing islets. The CureDM approach is to restore, maintain and protect new insulin producing islet cells in patients with diabetes...meaning that we would never have to rely on taking insulin on a daily basis again.

Please read about it...get inspired...spread the word...support her work. My fingers are crossed.

In peace,
Gabrielle

In the news

2006-07-26T21:51:00.000-04:00

I don't pay as close attention to the daily news as I should. I don't want to be a stereotypical mom of young children who can only talk about diapers and feeding, but some days, that's mostly what's going on in my world. I do try to watch the news at least once a day and listen to NPR when I'm driving, but some days I fall asleep with the TV on and some days there's fussing or whining from the back seat that makes it kind of hard to pay attention to NPR.

But in the last week or so, I've been paying very close attention to the crisis unfolding in the Middle East...so much so, that I barely have had a chance to process Bush's veto last week of the bill that would give more funding to embryonic stem cell research. I'm just now catching up on the news item. And reading about the veto, and the politics leading up to it, just makes me compelety pissed.

You might like the President. You might respect him, think he's doing a decent job. I don't, and not only because I disagree with his foreign policy. I can not tolerate his stance on this stem cell issue. It is just mind-blowing to me, as someone living with Type 1 diabetes, that any human being is standing in the way of supporting research that will ultimately save millions, millions, millions of lives.

I don't know about you, but I want the Type 1 cure to come soon, and I know that researchers are really close, and I know that those stem cells could help them out. And this is all selfish, yes, for my own benefit--but I also speak this way because as someone living with Type 1, I feel like I have a sense of empathy and urgency for anyone living with a chronic illness.

I understand the President's perspective that the 5-day-old embryos have the potential to become human lives (or maybe he considers that they are lives); but a recent poll by USA Today shows that 61% of American disagree with this idea. Who is representing us? The majority of Americans want to save the lives of people suffering from chronic illnesses. Which, by the way, will help people all over the world. Woudln't it be awesome for an American scienetist to cure alzheimers or diabetes?

Sigh.
**********

On a more uplifting note, here's a news item that hasn't gotten much press:

World-class aviator and diabetes patient advocate Douglas Cairns has recently flown his plane to Orlando as part of a national tour to help raise awareness of diabetes and to inspire the 20 million Americans living with diabetes to take control of their condition.

In 1989, Douglas, then a Royal Air Force (RAF) pilot in the UK, was no longer permitted to fly fast-jets after being diagnosed with type 1 diabetes. But now his determination and love for flying has inspired him to prove that diabetes need not limit the scope of people's dreams and ambitions.

Learn more about his flight at http://www.diabetesworldflight.com/index.html

In peace,
Gabrielle

Product happiness, Product disappointment...

2006-07-19T20:20:00.000-04:00

Part of living with diabetes means living with paraphenilia. Diabetes paraphenilia. Whether you are a pumper or not, you've still got to shlep around a meter, glucose tabs, insulin or meds...the list goes on.

So, like many people living with diabetes, I've become a bit obsessed with my paraphenilia. It's amazing how something as little as a new meter case can improve your outlook--and even your management.

I'm happy to report that I just discovered one of the coolest pumping products ever: groovy patches. Go now--check them out at www.groovypatches.com. Designer Dina Klavon has created a very fun way to make sure your pump stays in place (I'm feeling that now in the heat of the summer!) while also making the pump into part of your fashion statement. How cool is it for kids who are into sports to have a sports patch? For teen girls to switch patches with outfits? Discovering Dina's patches brought a smile to my face...and reminded me that a sense of play can go a long way in dealing with the drudgery of diabetes.

But on the other side of diabetes paraphenilia-ville, I was surprised to come home the other day and find a fedex envelope from Disetronic at my door. My order for my D-tron plus supplies wasn't due to arrive yet. When I opened the envelope I discovered an "Urgent Product Recall" for Disetronic D-TRONplus Power Packs (batteries)--seems that when the batteries' design was recently changed by the manufacturer, the result is that now the pump does not have time to recognize the power supply decrease and the pump may shut down before the alarm is triggered. That's nicee. All I need in my rather hectic life (two young kids, writing assignments, part-time job, attemps at cleaning my house and talking to my husband) is for my pump to shut down with no warning.

Up until now, I've been 100% loyal to Disetronic, even after the DTRONplus was recalled shortly after I started using it. I've felt that, despite its underdod status in the pump companies, that Disetronic has been reliable and that their customer service has been there for me. Frankly, I really can't handle anything else from them being recalled. That's it. I'm done. I'm due for a new pump next year--and whether I go with the Omnipod or a traditional pump, I've just decided that Disetronic is no longer part of the decision.

Hope that you are well--and enjoying the summer--
Peace,
Gabrielle

Symlin Pen?

2006-07-09T20:41:00.000-04:00

I've written several posts about my experiences with taking Symlin, and I must say that I'm still feeling like I'm in process of mastering how to use it with my insulin. I'm not overbolusing and getting low anymore, but I still sometimes fail to extend my bolus enough to cover the two-hours after eating and taking symlin when some insulin is needed. But all that being said--my blood sugar control, post-meal, is absolutely better since starting symlin. I'm due for an A1c next month--my first since starting symlin--and I'm curious to see where my levels are.

But one thing I haven't been able to get over--having been on the pump for seven years now, I just can't bring myself to carry around a vial and syringe with me. Many days I'm on the road around lunchtime and might have dinner out (at a restaurant or eating with friends) 1-2 nights a week. At those times, I would rather push a few buttons and bolus rather than bolusing and shooting up with symlin...even if my post-meal blood sugars may not stay as even. Carrying a vial and excusing myself to the restroom (I could never bring myself to take out a syringe at a table)brings back memories of the old days, and I don't like it. Just thinking about backing up the symlin and a syringe makes me more grateful than ever for my pump.

But I've heard good news...that the makers of symlin are coming out with a pen. That I can deal with: one thing, convenient to carry, dial it up, shoot, done. I will carry a pen. As I continue to get better working with symlin and insulin, I am looking more and more forward to that pen coming out.

Are any of you working with symlin? How's it going for you?

In peace,
Gabrielle

The Omnipod is looking better...

2006-07-04T19:24:00.000-04:00

Happy 4th of July, everyone! Hope you've had a long weekend to enjoy cook-outs and fireworks. It's been a real treat for my husband and I to have four days off together. We spent two of them at my brother-in-law's beautiful home in Connecticut, which has a big inground pool in the backyard. It was great having the convenience of a pool in the backyard--if it was nap time for one kid, one of us could still swim with the other. The weather was mostly sunny, just a few clouds, a real treat.

But by the middle of the afternoon yesterday, I found myself getting tired of my on-and-off routine with my pump. The D-tron Plus is definitely not waterproof, so I test and bolus as needed before getting in the pool, and leave my pump in a cooler before getting in.

It's not a bad routine, but with little kids getting in and out of the water more frequently than I would if I were swimming on my own, it can get old. I had just spoken to someone who switched from a pump to the Omnipod about a week ago, and she really loved that the Omnipod stays on, during showers and swimming. I'm still worried that I'll lose the Omnipod's PDAS system, but after this weekend's pool and pump routine, I'm willing to give the Omnipod more serious consideration.
**********
I made a really big mistake yesterday: after nearly 20 years of not eating a hamburger, I decided to try two. And they were good! I became a vegetarian at age 15 for moral reasons (those of you who were into "The Smiths" circa 1986 can relate to my "Meat is Murder" inspiration), but then lost my certainty about the evils of being a carnivore during my 20s, and returned to eating fish (which I really love) and poultry. Wanting to eat as healthy as possible, I decided to avoid red meat altogether(which I was never that crazy about, anyway). But yesterday, those burgers on the grill smelled so good and flooded me with childhood memories of summer barbeques. I ate one (on just half a roll), then went for a second (you know, to finish the other half). This morning, my stomach was not happy with that choice. I don't think my body knew what I put inside of it. So, that's it for now for me for hamburgers. Maybe I'll try again in another 20 years...

Happy 4th!
Gabrielle

Just a little high...

2006-06-22T21:15:00.000-04:00

Summer's here and I love it! Granted, we're running our a/c when it's really humid out, but I still prefer this weather to the cold. We spent a lot of last weekend at the pool and it's a lot of fun to see our baby (9 mos) discover the water and to see my three-year-old son get stronger at kicking and paddling.

One drag about the summer is that because of the heat, this is the season when I usually get more low blood sugars than at any other time of the year. Does that happen to anyone else? The heat and humidity--I guess really the sweating that goes with them--can cause my sugars to drop quickly. Even when I'm testing more, I'm not always able to adjust my insulin correctly for really hot, outdoor days.

So my tendency is to want to run a little bit on the higher side, so that I won't get low. Not high-high, just "a little high." Let's say I'd rather test at 160 than at 80. At 160, I know I have somewhere to fall. At 80, a low could come on quickly and take me really low.

But I realize that this kind of thinking--clinging to the higher side--has its consequences. When I was pregnant, I got over my fear of lows, for the baby's sake. I knew what was expected, and I made my best effort to get my numbers there. I did get low sometimes, and fortunately I always kept juice or glucose tabs with me, and I was testing so much that I always caught the low before it got really low.

So now...I need to keep reminding myself that I have done it, I can overcome my fear of lows. I should not spend this summer clinging to the high side. It's simply not the healthiest way to live.

Easier said than done. Summer is here, more humid days are ahead. I am going to try and keep my fear in the open, acknowledge it so it won't get the best of me. My tendency when I test on the low side of normal is to lower my basal rates or eat a few crackers--do something to push the number up. Just a little.

But now I'm pledging not to do that...so that when I look back on the summer from the vantage point of the fall, I can say it was a great summer. In terms of my blood sugar control and maybe more importantly, in terms of facing my fear. That could have benefits for creating wonderful summer memories, for years ahead.

Wishing you peace,
Gabrielle

Diabetes everywhere...

2006-06-12T20:55:00.000-04:00

Do you ever have one of those days when it's just diabetes, diabetes, diabetes everywhere? I'm having one of those days. It actually began last night when my Disetronic D-tron plus clip case broke. I am so utterly dependent on my clip case--the way I like to wear my pump is clipped onto my bra, that's it. I used to sometimes put it on my belt or even in a "thigh thing", but for the last few years I prefer to keep it clipped where I know it's safe and secure. Sure, it means sometimes reaching down my shirt in public to bolus, but what can you do?

So my clip case broke and I had to tear apart my closet to find the leather back-up case that I hate. Not wearing my pump the way I prefer made me keep noticing it...thinking about it...becoming annoyed by it. I started realizing how most of my days as I go about the business of my life, I barely notice that it's there. Anyway, the kids were already asleep last night when I decided to catch the last half-hour of "60 Minutes," a favorite Sunday evening ritual. When I turned on TV, a new epidsode of "dlife" was being Tivoed (my husband has set it to tape for me), so I decided to watch that instead. Did anyone ctach it? The show was focusing on the way diabetes is portrayed in tv and film--an issue I find very compelling. Having been totally depressed as a teenager when I saw "Steel Magnolias," I was delighted to see some discourse about how popular media can educate or misinform the public about diabetes.

And then several times today when I caught the news, I heard stories about the ever-growing diabetes epidemic...and it's great that the media is putting attention n how Type 2 diabetes is growing in this country...but when I see those kinds of reports, I must admit I feel a bit of a tug. I worry that all of the public health focus on Type 2 will only mean less education, awareness and research dollars for Type 1.

But then...I remembered that this week is the week of the American Diabetes Association's 66th Scientific sessions, a gathering of physicians, educators, researchers and companies sharing the latest innovations and updates in diabetes research and care. This is news that I want to hear. Bring it on! If you want to follow the Scientific sessions, check out the blog of Dr. Richard Kahn at http://www.diabetes.org/blog/index.html.

In peace,
Gabrielle

35 and feeling good

2006-06-07T22:54:00.000-04:00

Today I turned 35. It's going to take me a little while to grow into this number. In my mind, I've still been around 30 these last five years. I know it's just a number and that age is all relative to how you feel physically/spiritually/intellectually/emotionally...but somehow being closer to 30 than 40 felt nice. Easier. 35 sounds really grown up to me. Which I guess I am.

It's been a really nice birthday. Fred and I went out last weekend to celebrate, friends threw me a birthday lunch yesterday and today I've gotten phone calls and emails from friends near and far. That has been the best gift. A friend that I went to college with, whom I haven't seen since 1994, who's a filmmaker living in England, sent me the most beautiful, inspiring message over email. My brother called from Western Kenya. My cousin in Chicago whom I've been playing phone tag with for months made sure to call. And that's the beginning. It's just hitting me now, how sweet it is to be connected to all of these lives, to just be alive and to be living in the consiousness of all of these wonderful people. People who hold me and remembered me today.

Is there a way to express the gratitude that I am feeling in this moment through the actions of my life? I hope that I do. I think that for those of us living with Type 1 diabetes, the awareness of the gift of life can be that much more ever-present. Living with the awareness that but for insulin you wouldn't be here can give a sense of urgency and immediacy. It does for me, at least. I mean, mostly, that awareness is tucked away in some recess of my mind, but when I stop and refelct on the big picture, I recognize that the awareness of life's preciousness is always there, driving me.

What I am learning, at 35, is that the drive doesn't have to be to succeed in an external way, to show the world that "I am someone." Someone important and cool. That used to be so important to me, to be someone who impressed people. Now, I don't really give a shit about that. What I want to be is someone who is patient, a humble person, someone open to learning and growing. Someone who gives and recieves love easily. This kind of success is not always easy for me to achieve, but I'm working at it one day at a time.

I got on the scale this morning and I was two pounds above where I had set my birthday goal. But I felt happy--it was closer than I'd come so far. My weight loss goal is symbolic of where I hope to be in all of my growth--and it felt fitting that I wasn't quite there today. It made me remember that life is a process...in every way.

Happy Birthday to me. 35 years old, 25 years living with Type 1 diabetes. I am so very happy to be here, to be alive. I read a beautiful peom once--I wish that I had kept it--about how each of us marks the day of our birth, but that the day we die on goes by us as we live, unmarked. How would we live differently, if we knew that day?

Wishing you peace,
Gabrielle

Elliott, my crush is growing...

2006-06-01T21:02:00.000-04:00

This is all very embarressing. I just have not been able to stop thinking about Elliott Yamin. And it's not at all like my crush American Idol Season 4 heartthrob Constantine, no, this is a crush of total spirit. What can I say, the more I read about this guy, learning about his struggles and how out there he's been about his diabetes, hoping to educate the public, I just melt. He is moving me! One celeb speaking out about the benefits of insulin pump therapy has the potential to improve millions of lives.

Sigh. This is not a physical thing, I swear. But I am smitten. Really. Read some of these links and let me know if you get hooked on this "Idol" too:

http://ourworld.cs.com/jonienfp/Elliott.htm

http://www.yaminmachine.com/

http://www.styleweekly.com/article.asp?idarticle=12371

In peace, Gabrielle

Pumping "Idols"

2006-05-28T20:00:00.000-04:00

I've been an American Idol fan since season 1, but this year, I never got completely connected to any of top 12 finalists. Blame it on my crush on last season's sultry Constantine, but I never felt like any of the 12 really grabbed me in the same way.

Now the season's over, Taylor Hicks is our Idol and when I watched both him and runner-up Kathryn McPhee being interviewed by Ryan Seacrest on the Larry King show Friday night, I drifted off to sleep.

But now--now that it's over--I realize that I was actually watching the most exciting season of American Idol yet! How embarressing--I just found out, in the last few days, that two contestants--Elliott Yamin and Kevin Couvais--have Type 1 diabetes and are pump users!

Actually, I was into Elliott's voice, I just never fell in love with him completely. But now, I am crazy for him--Elliott is out there, speaking about living with Type 1 and hopes to use his new-found celebrity (for those of you who don't watch, he made it to number three) to educate people about diabetes. Go Elliott!

Kevin is a high school student, clearly not on the same kind of career path as Elliott at the moment, but you've got to give him props for both competing with much more mature talent and also being open about his diabetes and pump.

In our celebrity-worshipping culture, having celebs speak out about the pump and and about diabetes in general is now doubt an important strategy for educating the general public. I can tell you that when Nicole Johnson (Baker) became Miss America in 1998, it was the first time that I really considered switching to a pump. Elliott--and Kevin to a lesser degree--could make wearing a pump into a cool thing for the millions of kids out there living with Type 1.

Elliott, I'm so sorry I didn't jump on your boat when my voting would have helped you, but let me praise you now: You rock! (BTW, read more about Elliott at http://www.idolonfox.com/contestants/elliott_yamin/).

Happy Memorial day--
Gabrielle

The Allure of "Omnipod"...at least on film

2006-05-24T19:42:00.000-04:00

Some time ago I posted a blog entry about how I'm always losing my blood glucose meter and so I know I would never make a good candidate for the new Omnipod insulin delivery device, with its non-attached insulin delivery/meter device. How could I possibly consider the Pod when I can guarantee that I'll lose the device completely essential for operating it?

But...I signed up to be on Omnipod's email list and I'll have you know that their marketing people are good. Really good. I just got off their web site (www.MyOmniPod.com) where I watched a little movie clip (go to the "Products" heading)all about the Omnipod, and now I'm convinced that it's for me. I won't lose that device...the sleek-looking people in the movie clip aren't running around losing it. In fact, they're just mostly running--what with being free of tubing, free of pain from manual insertions and even being free of pain from blood sugar testing (does anyone actually consider pricking yoru finger "pain?"). That's what the movie clip promises, at least.

Omnipod's marketing people are so good that I'm honestly torn between viewing it with complete "there must be a catch somewhere" cynicism and forgetting my legit concerns because who among us wouldn't mind being free of tubing and wearing an insulin delivery system that is a bit more discreet? This feeling of being torn tells me it's time to get out from behind the computer screen and start talking to some real people who've tried the Omnipod to see what their experiences have been like. Just as when I started researching pump therapy--which lead to writing my book--I began by talking to pump users to hear the true story, right from the source.

So with my apologies to everyone in the advertising/marketing world, I promise to share the true scoop with you all. And if you are using the Omnipod--or know someone else who is--please get in touch! Is it really all that?

In peace,
Gabrielle

People are reading...

2006-05-18T20:09:00.000-04:00

I must admit, it was pretty exciting to open up "The New York Times" Style section this morning and see my blog quoted by reporter Ruth LaFerla:

http://www.nytimes.com/pages/fashion/

In fact, Ruth had called me last week--she came across my blog entry about shopping for a bathing suit while doing research for today's article about women ordering from "Land's End." We had a long talk about why tankinis are excellent choices for women wearing the pump and I explained some of the fashion dilemmas that pump wearers face to her. None of that made it in, which kind of bummed me out.

Our pool opens Memorial Day...and I've backslid a bit this week in terms of my weight loss goal, seeing a couple of punds creep back up on the scale. Now the countdown is on and I'm going to use it as an excuse to really watch what I eat.

Peace,
Gabrielle

Happy Mother's Day (I know it's belated, but still...)

2006-05-16T21:00:00.001-04:00

Sure, Mother's Day can feel like a complete "Hallmark" holiday...but since becoming a mother myself, I appreciate that there's a day on the calendar when I can pause and reflect on how my life has changed since having kids. And can have a ready-excuse not to lift a finger around the house ("June is poopy again...and it's still Mother's Day, honey...)for the better part of 24 hours.

This year, my Mother's Day was really, really nice. When I picked George up at his preschool on Friday afternoon, he came running out with a little terra cotta pot that he had painted. There were pretty buttons that had obviously been hot-glued on, a blue satin ribbon tied around it, and a small green plant inside. "You made this for me, George?! Thank you!" George gave me a big smile. "Dottis made it," he said. (Dottis is the teaching assistant at his school). "Well, you painted it...that's the part I like most," I told him. When we got home, I put the planter up on my kitchen counter. Whenever Georeg looked at it, he chimed in with his "Dottis made it" mantra. "Dottis helped," I tried to explain, "but you did the special part." Looking at the pot and the carefully placed buttons, I could see that Dottis had done most of the work. Still, how great is it to have a hand-made present from your three-year-old, even if a nice sixty-five-year-old woman gave it some of its aesthetic flourishes?

When Sunday rolled around, I was showered with some very cute and lovey cards from my husband, flowers, and a new Morissey CD that he knew I would love. Even more cool, Fred watched the kids all afternoon while I used a gift certificate that I had received almost a year ago to have an hour massage at a fancy spa. It was heaven.

After the massage, I stopped at Starbucks for iced coffee and when I got home we ordered dinner from my favorite Mexican restaurant. We took a walk in the neighborhood after dinner, it was sunny and cool after an afternoon rain, and I couldn't help but feeling just complete and blessed and satisfied.

My days with my young kids are tiring and sometimes frustrating and almost always challenging in some way or another. But let me tell you, rarely does a day go by when I don't thank God for these children and for the opportunity to become a mother. Having a healthy pregnancy and Type 1--despite all of the medical advances in recent years--is still hard, hard work. The hardest thing that I have ever done in my life.

I am thankful to have had a Mother's Day like this one--with my pot from George & Dottis, my massage & Mexican food, the cards from Fred that I am looking at right now. Thankful to be just like my other friends, laughing about it all on Monday morning, "Yeah, me too, back to picking up the toys again..."

Happy (belated) Mother's Day to every mom with diabetes!
Gabrielle

Appreciating Symlin

2006-05-13T16:55:00.000-04:00

In my last post, I mentioned that part of what's been helping me to manage my blood sugars lately is learning to work with the nuances of symlin. I've been injecting symlin for the past several months and find myself appreciating its effectiveness more and more as I learn to work with it better.

For those of you who haven't read up on symlin yet, I really encourage you to do so at www.symlin.com. For those of us living with Type 1, symlin is the first "medication" to come along since insulin to help us live with diabetes. In fact, symlin is a hormone that along with insulin is lacking in people with diabetes.

The trick for me in taking symlin has been learning how much I need to cut back on my bolus to come out with an even post-meal blood sugar. I started out taking the recommended 2 units of symlin and have now worked up to ten and find that I need to cut my meal bolus by about 40%, and take part of my bolus as a two-hour extended blous. It's been a process of record-keeping and mistake making to get me to this equation. I've had some nights where I've bolused more insulin with my symlin and come out with a post-dinner low and other nights where I took too small a bolus and ended up with a post-dinner blood sugar of 220--250.

But now that I have my equation, my one hour post-meal blood sugars are much more often in the normal range than ever before. Because I rarely eat 30 grams of carb at breakfast or lunch, symlin has only been part of my dinner plan. And I still don't pack it up and take it along with me anywhere--I just hate the inconvenince of having to pull out a syringe in a public place before I eat. I'm much happier just pressing a button, thank you.

But since I've found my "magic equation", I'm tempted to start packing up my bottle and syringe when I hit the road. And yes: if you've heard about symlin's other benefit--appetite suppression--it is true. I feel more full after eating dinner when I;ve taken symlin and am less prone to go for after-dinner snacking. Very nice!

Any other symlin users reading this? What has your experience been like?

In peace,
Gabrielle

PS: dlife Top Ten awards

2006-05-09T15:34:00.000-04:00

Forgot to pass this item along:

You can vote in the first annual dLife Top Ten awards. Voting ends May 12. Just go to http://www.dlife.com/2005awards to participate. No membership is required. The dLife Annual Top Ten awards recognize those individuals or organizations that inspire, motivate, and improve the lives of men, women, and children living with diabetes. The editorial board of dLife has nominated 24 visionaries who, throughout 2005, made a difference in the lives of people with diabetes.

Peace,
Gabrielle

Feeling some progress

2006-05-09T14:13:00.000-04:00

Life has been feeling intensely full, personally and professionally, during the last few weeks. My closest girlfriend in Philadelphia is moving in a couple of days and though I know we'll stay in touch and stay close forever, I am feeling the loss of her friendship in my day-to-day life already. For the last few years, she and I and our kids (her girls are four and 1/2 and 18 mos)have been playing together every Tuesday afternoon, and it's time that I look forward to all week. As I get older, I realize just how much I value the relationships in my life, and my friendship with Jane over the last 8 years has been one that's strengthened me and made me a better person because of both the love and support that I've received from her and also because I've grown from watching the way that she faces the challenges in her life with faith and optimism.

Jane's moving is just one piece of the fullness...this past weekend, we celebrated my father-in-law's 80th birthday with a big party and now, tomorrow, my brother is coming to visit us for a few days before he leaves for Nairobi on Friday to live with his fiancee there through August. I am so happy and excited for him and looking forward to us having time to connect before he leaves.

Professionally, new opportunities for writing, teaching and educational consulting are coming my way...which signifies to me that my energy is shifting. When my daughter June was born last September, I knew that I would need to lay low for a while and try to just maintain what I had on my plate. Any new work opportunity seemed way too overwhelming. Now she is 8 mos. and I feel like I'm getting my "sea legs" as a mom of two. It's exciting to think about new professional challenges, but I'm also aware that it brings up feelings of sadness for me, too...knowing that my time as a mom of a newborn is over. I want to try and balance my time "moming" with my time working in a way that feels both stimulating and sane...and as any working parent knows, that is a constant balancing act.

In the past, times full of transitions were often when my diabetes management would start to suffer...but right now, I'm managing pretty well. I've lost another six pounds, can see my weight goal in site, and am keeping my blood sugars pretty stable most days. I'm starting to learn thr nuances of symlin, which I take with dinner most nights and now occaissionally at lunch time, too. It is helping my post-meal sugars to stay more even for sure.

It feels good to feel like I'm making progress. I feel centered and grounded even as my life is moving and shifting, as it always does and will.

Dexcom in action

2006-05-03T21:10:00.000-04:00

If your curiosity about continuous glucose monitors was piqued by the "Washington Post" article that I mentioned a few entires ago, you might want to check out another site:

http://www.insulinfactor.com/article_dexcom.html

You'll find a detailed blog written by athlete Matt Vogel, who has Type 1 diabetes and does triathalons and other intensive sports. Matt is wearing the Dexcom continuous monitor and is not being paid by anyone to write candidly about his experiences with it. Reading his blog is helping me get a sense of Dexcom's strengths & weaknesses.

I think I really want one! How about you?

Blotting Out High-Fructose Corn Syrup

2006-04-29T13:34:00.000-04:00

A few weeks ago while I was driving, I caught part NPR's Fresh Air show, with host Teri Gross interviewing author Michael Pollan about his new book "The Omnivore's Dilemma: A Natural History of Four Meals." Pollan was describing the way many of today's foods are so highly processed, and about the dangers of ingredients like high fructose corn syrup that is used in so many of the products found in our grocery stores. The over-use of high fructose corn syrup has been linked to America's growing obesity problem and the rise of Type 2 diabetes.

"I'm glad I know to avoid products that are over processed," I thought as I listened to Pollan. Living with diabetes for as long as I have, I've gotten pretty good at discerning food labels and for the most part have internalized knowledge about high-carb and low-card foods and which foods are high and low on the glycemic index.

But nonetheless...I do have these weird times when my blood sugar just shoots up, even though I've thought that I've bolused my insulin correctly. Pollan's words stuck in my mind...and I started going through my fridge, freezer and cupboard to look for places that high fructose corn syrup might be lurking.

And there it was--in salad dressings and in ketchup, in the Breyer's popsicles that claim on the package are made of "all natural" ingredients that I gave, daily, to my son. I realized that I need to be more vigilant about reading labels and shopping consiously...so that I can buy foods that won't give me blood sugar spikes, and that will be healthiest for my family.

I remember hearing another interview with Dr. Andrew Weill who recommended that people buy most of their groceries from the aisles on the perimeter of the grocer store, filling carts with fresh produce and dairy items. So true. I'm happy that I caught Pollan's interview and plan to read his book...but first need to go to do some reading in my pantry.

Peace,
Gabrielle

Continuous monitor article link

2006-04-25T20:18:00.000-04:00

My Dad just sent me a link (Thanks, Dad!) to a Washington Post article about the new continuous blood sugar monitors that are coming out on the market this summer...it is definitely worth reading about:

http://www.washingtonpost.com/wp-dyn/content/article/2006/04/22/AR2006042201354.html?

Reading the article just made my day...and made me think that I want to find out--right away--what my insurance would cover for this kind of monitor. I know it's not a cure, but it really sounds like a tremendously helpful tool for tighter blood sugar control.

Let me know what you think!

Peace,
Gabrielle

Checking at the playground

2006-04-22T17:51:00.000-04:00

Thursday afternoon was gorgeous--sunny with a breeze. After I picked up George from childcare at 1PM, we headed to a nearby playground. It was full of parents and kids enjoying the day.

Both of my kids were swinging (I just put June, almost 8 mos. in a baby swing for the first time the other day and she LOVES it!), and as I pushed them, I noticed a mom and a son sitting on a bench behind the swings and I thought I saw him poke his finger and then wipe it with a tissue. Looking closer, he had indeed done a blood sugar check and then jumped off the bench and took the swing next to George.

The mom came up to push him and I smiled at her. "It looked like you were just checking his blood sugar," I said. "Oh yeah," she said, kind of caught off guard. "I know all about that," I said. "I've had Type 1 since I was a kid." Her face softened. "Yeah...I needed to see where he was at before playing," she said. I nodded. "How old is he?" I asked her. "Six," she said, and then she turned away. "I'm looking for my friend and her son."

Her friend and her son came just then and the boy with Type 1, a very sweet-looking red-haired kid, jumped off his swing and started climbing on the monkey bars with his buddy. The moms went off to talk together and I was left wishing I could have talked some more to the mom. I wondered when her son was diagnosed, how he was doing, if he was on the pump or if they were thinking about it.

I watched the boy playing and saw how healthy and happy he looked...how the quick blood sugar check was just part of his afternoon routine. I wanted to say more to the mom...I wanted to tell her that she must be doing a great job and that living with diabetes can be really hard. I wanted to tell her that I was ten when I was diagnosed and that I've grown up to be a healthy and happy (mostly) person. I wanted to tell her that her son is going to do just fine, even when he has moments when he rebels or gets angry at having diabetes. I wanted to tell her that I truly believe that a cure is going to happen, most likely before her son ever reaches my age, so when she's feeling really down or dark, just to hold onto that idea.

But the mom was happily chatting with her friend and I knew that she really might not need to hear anything I had to say. She might be doing just fine with the whole thing and might have plenty of people in her life who support her. I watched her son playing, and the more I thought about what I wanted to say to him, the more I realized that I was really talking to my ten-year-old self, newly diagnosed, who was terrified of living with diabetes and afraid that I would not grow up to be healthy and strong.

I got a little teary, watching the red-haired boy climbing away with his friend...and then I noticed that George had gotten off his swing and was sitting with some other kids eating snacks and it appeared that he had taken another little boy's potato chips and was munching away. Nothing like children to bring you back to the present moment!

"Not your chips," I shouted, grabbing smiling June from her swing. George looked at me with his mischeivous grin. I ended my inner conversation and rooted for George's pretzels in my bag. I left the playground realizing that my ten-year-old self, vulnerable and scared, still needs reassurce at times.

In peace,
Gabrielle

Leafing through "Land's End"

2006-04-19T19:36:00.000-04:00

A few weeks ago when my mom asked me what I wanted for my upcoming birthday, I realized that I needed a new bathing suit--since last summer I wore a maternity one and my suits from years past are pretty shot. I absolutely love summer and take every opportunity to swim that I can. Last year, we joined a really great pool at a shady Girl Scout camp that was a true respite from the summer city heat. We're going to join again, so a new suit is in order.

My mom and I both know that a great new suit means one thing--leafing through the Land's End catalog. For a woman like me (and I guess this applies to most American women out there) who's not going to appear on the cover of "Sports Illustrated" anytime soon, Land's End has actually made the process of buying a bathing suit into something not completely mortifying.

There are suits made of material that makes you look slimmer; there are tops and bottoms that you can order separately to address any "problem areas" in the various parts of your torso. For us pump users, there are great tankini options which, in my experience, is the best way to go to the pool or beach with a pump. Wearing a tankini, I just clip the pump onto the bottom half of the suit--and volia!--I'm set. I suppose you could do the same thing with a bikini...if you are someone who wears a bikini. But speaking for the rest of us once again, I wish to thank the inventor of the tankini--whoever and wherever you are--which became popular the very summer that I started pump therapy.

This year, leafing through Land's End was a bit less fun, knowing that I needed to find a suit to accomodate both my pump and also my "I'm a mom now who had two c-sections" stomach. Sigh. Maybe actually ordering my birthday suit (ha, ha) will give me that extra motivation push. I'm about 8 pounds away from where I'd like to be on my birthday (June 7th).

****

On another note, I encourage anyone with Type 1 to take a few moments and fill out a quick survey about living with Type 1 for an Australian diabetes organization called "Reality Check." The survey can be found at http://www.surveymonkey.com/s.asp?A=125566936E82851. Reality Check puts out a great e-newsletter called "Yada, Yada"; you can subscribe at www.realitycheck.org.au.

Peace,
Gabrielle

Bizarro Carrot Episode

2006-04-17T20:33:00.000-04:00

Have you ever eaten a food that you thought you knew how to bolus for...and were just completely off? That happened to me tonight. I've been cooking lots of vegetables. I love vegetables. I love them in salads and cooked every way possible; I usually steam, broil or roast mine.

Passover (still going on) is a springtime holiday and so tonight I made several vegetable recipes that seemed full of spring time spirit: one was pan-seared asparagus and the other was roasted baby carrots. The carrots, coated with olive oil and tossed with salt, pepper and garlic, smelled incredible roasting in the oven. I baked them at 425 degrees for about 35 minutes and they were just beginning to char when I took them out.

I made baked salmon for the entree and we sat down to eat. I was running a bit on the high side all day and was 156 before dinner, so took an extra unit of insulin. I figured the meal was pretty low carb--and just bolused for the carrots.

I don't know what hit me...I've never had a problem eating carrots before, but tonight my hour after-dinner blood sugar was 293. Yikes! Did I somehow eat a chocolate ice cream sundae with my meal and have total amnesia? There was virtually no other carb in the meal besides the carrots, so I'm blaming them for the high number. I'm wondering if the method of roasting them somehow wreaked havoc with their sugar/carb content?

Sigh. I love carrots and these were tasty ones. Do I make them one of my foods to avoid? When I first went on the pump, I was able to analyze which foods--even when I bolused for their carb content--were impossible for me to eat and keep my blood sugar on track. Bagels were the biggest culprit, though now I do fine eating a Thomas' whole grain version. But roasted carrots? Come on.

I will try the recipe again...just in case this was all some other kind of strange flukey blood sugar moment. I did enjoy eating them, at least.

Peace,
Gabrielle

Night time lows

2006-04-13T10:05:00.000-04:00

I made it through the first night of Passover pretty well...the food at my mother-in-law's seder (Passover dinner) tends to be pretty heavy in carb and in the rush of getting ready, I left my symlin at home, so I just tried to bolus as I ate and adjust for eating matzah products rather than the whole grain carbs that I've been trying to eat. I was 113 before dinner and by the end of the night before we left her house, I tested at 169.

It's about an hour drive home and I went to bed without testing again. At 2AM I woke up pretty restless and knew I was feeling low...I tested and was 61. I was thankful to have woken up at 61, rather than dropping lower. I went downstairs and poured a glass of grape juice that I knew would bring my sugar up pretty quickly.

I was still feeling shaky after I drank the juice and my impulse was to eat or drink something else...I wanted to quelch that shaky feeling. I hate feeling low. When I was pregnant and keeping my blood sugars as low as possible, I would often drop from 70 to 60 fairly quickly...and then eat too much and bounce high. I learned to drink a small juice box and wait 15 minutes and test again before taking anything else. That small juice box always did it--raised my blood sugar enough to be normal, without being high. But waiting that 15 minutes always felt like waiting out an eternity; I want the shaky, low feeling to be over instantly, even though I know my body doesn't work that way.

So I did drink some more juice, went back to bed and woke up about 5AM when I heard June crying. I was 236. Sigh. Overcorrecting. I took a bolus and by 6AM was back on track. Today we got to VA to my sister's house for our second seder and I'll be taking my symlin along and testing a little bit closer today.

In peace,
Gabrielle

Someone else's complications...

2006-04-09T20:41:00.000-04:00

My husband Fred just ran into a very old, dear friend of his...I'll call him "Joe." Joe is an extremely talented musician who sings and plays banjo and used to hang out at the club that my husband managed for eleven years. Fred and Joe had lost touch over the last few years, but ran into each other last weekend at the club's closing party. Joe moved from Philadelphia to St. Louis not too long ago, but came back to say good-bye to his old friends at the club.

Joe has Type 1 diabetes. When my husband and I first started dating, I had just started pump therapy. I remember how much Fred wanted to share what I was doing with his friend Joe. He talked about Joe's various health problems--besides diabetes--and thought the pump could be a great thing for him.

When I asked Fred, maybe a few months after we'd started dating, if he had talked to Joe about the pump, he told me that he had...but that Joe was not interested. He had his routine down with taking shots. That was that.

Over the next few years, whenever Fred and Joe talked, Joe was going through some kind of health crisis, not neccessarily diabetes related. I would ask Fred if Joe might want to talk about pump therapy or even borrow a copy of my book, but Joe never showed any interest.

When Fred saw Joe last weekend, he was sad to find out that Joe is losing the eyesight in one of his eyes to complications of diabetes. When he came home to tell me that, I wasn't shocked. In fact the first words out of my mouth were, "I'm not surprised."

I had trouble falling asleep after hearing my reaction to that news. I thought that I sounded like a heartless bitch. Shouldn't someone with diabetes be more sympathetic to someone going through something like that? But what Joe is experiencing, I realize, is a fear that lives just under the surface of my psyche. I do everything I can to keep that fear in place: testing frequently, learning about the latest technology in diabetes care, going to my endo frequently, keeping my A1Cs in the under 7 range. Hearing about someone else who wasn't able to keep diabetes complications at bay unnerves me...because it is just too close to my deepest vulnerability.

I am sorry for Joe and for what he is going through. And I have learned a lot but looking at my reaction and facing what it means to me.

Karma Day

2006-04-07T22:57:00.000-04:00

Yesterday, I felt just like Earl Hickey from one of my new favorite sitcoms "My Name is Earl": Karma was definitely trying to tell me something. A few days ago, our microwave broke. I didn't realize just how much I depended on it (re-heating coffee, babyfood, etc.) until it went. It is a 1992 model that fits in above our stove and was here when we moved in. My husband Fred tried all of the circuits, but nothing changed...the microwave was gone.

I voted to go shopping for a newer model but when Fred priced them online, we saw that the above stove models were a bit pricey. So he called a Sears repairman (it's a Kenmore model) who came out to the house yesterday. The nice, big, tall repairman ("Hi, big tall man," my son George greeted him)looked at the microwave and asked me in a most polite tone, "Ma'm, did you know it's unplugged?"

Truly I did not (to our fairness, the plug goes in the back of a cabinent over the microwave and in the three and 1/2 years that we've lived in the house, it's never come unplugged before), but after writing the nice big tall man a check for $69.55, I decided that I would always check the plug in the future should the microwave mysteriously go again.

Then the phone rang. It was another polite person, this time calling from my medical supply place. She had phoned yesterday to see if I was ready to re-order my test strips. What a lovely convenience. I told her yes, and expected them to be shipped as usual.

But she was calling back to let me know that since our insurance policy had changed as of January 1st, I would now owe the medical supply place 30% of my order. For a three-month supply, that stung. When my husband's health insurance changed, we had hoped it would save us money, not cost us more. I gave her a credit card number over the phone, sighed, and said good-bye to that money, too.

But that money won't be like my expensive lesson about looking for an appliance's plug. That will be ongoing money out of my bank account every time that I order strips. I've been so lucky to have all of my supplies paid 100% up until this point. I'm truly bummed out and angry. I test a lot--8 to 10 times/day. I will not test less because of the awareness that 30% of the cost is coming out of my pocket. But I will miss that money.

What is karma teaching me here, I keep wondering? Maybe to be aware of how fortunate I am to have insurance. Maybe to remember how many people out there with diabetes can't afford basic supplies. Maybe to hold onto my anger and advocate more for a just health care system, in which everyone in our country has access to the medicine and health supplies that they need.

I'm not sure yet what exactly the lesson is for me, but I was happy to get through the rest of the day with no more polite interruptions.

Peace,
Gabrielle

Passover is coming...

2006-04-04T20:30:00.000-04:00

In just over a week from now, I will sit down with my family to celebrate the Jewish holiday of Passover. Passover is one of my favorite holidays because of its rich traditions and the many opportunities for spiritual growth that come with this time. The essence of Passover is celebrating the tale of the Hebrew slaves' Exodus out of Egypt--that once we were slaves, but now we are free. Freedom is not to be taken for granted. Our experience of being oppressed should make us sensitive to the suffering of others; our tradition states that "all who are hungry" should come in and join us at our holiday table.

Some of the most interesting customs connected to Passover involve food. Throughout the holiday (which lasts over a week), we give up eating all products baked with yeast, as a way to remind ourselves--gastronomically--of the Exodus story. The Hebrew slaves rushed out of Egypt becfore their bread could rise. Instead of eating bread during Passover, we eat matzah ("the bread of affliction") and matzah products. Many Jewish people also give up other starches like legumes, corn, barley, etc., even though they don't contain yeast.

So, though I love Passover and look forward to taking some time for extra introspection during the holiday, I always feel a little nervous about how switching from my usual diet to a matzah-based one will affect my blood sugar control. One piece of matzah contains about 20 grams of carb, but in the past couple of years, I found that I needed to bolus less for matzah than I would for a piece of bread containing the same carbs.

One advantage of me reducing carbs of late is that Passover won't affect my diet as much this year...I can still eat my morning yogurt, all of my fruits & vegetables, cheese...and substitute matzah for the crackers or bread I eat. If I do a protein like fish or chicken for dinner with lots of veggies and a little matzah (which might be baked into a casserole or fixed in one of the thousands of creative ways that Jewish cooks have figured to make the stuff more edible), then I should be okay.

The challenge for me is that when a holiday comes, there's always extra of everything around--desserts that I wouldn't normally eat, for example. One Passover tradition is eating macaroons, since they contain no yeast. Eating the kind that comes out of a "Manishevitz" can is pure nostalgia for me...taking me right back to the Passovers of my childhood. One macaroon can easily become two, four or six. :(

So this Passover, I will try to keep my mantra to eat healthy right in front of me, calling to me when I get weak. I would like to use the days of Passover to focus on cleansing, on springtime, on renewal of spirit...

Diabetes can feel like an awful oppressor, like the worst taskmaster. We are not free of it yet, but we can stand up to this boss of ours, at least, look it in the eye and fight to gain control.

Ready for the time change...

2006-04-01T19:46:00.000-05:00

Fall back, spring ahead! As much as I love springtime and the daylight that comes with it, I usually dread waking up that one hour earlier when it's time to set the clocks forward. But this year, my kids have broken me in already, waking up between 4:30--5:30AM most mornings this week. It's fascinating, the way they seem to be more instinctually in tune with the season...ready to wake up with the sun. It's been a tiring week, but my body is actually adjusting to waking up earlier and so the benefit is that tomorrow won't feel like such a long day to get through.

I am a warm weather person and can feel the way my overall mood is already shifting into a brighter state. I love being outside this time of year, watching the flowers in my neighborhood start to awaken. A few tulips have popped out of the ground in my small front yard...I had forgotten about them. In the next week or so I'll fill my window box with pansies and add some more annuals around the tulips.

This season is reminding me about renewal and awakening...in nature, both outside and inside of ourselves. Last year at this time I was entering my second trimester and worrying about how I'd manage through the summer, dealing with diabetes and pregnancy and taking care of my 2-year-old son. Now that little boy is a more grown-up 3-year-old, my sweet baby is here with us, and I can give new life to other dreams. Mostly, I think my biggest challenge to realizing all of my dreams is patience. I want things to happen now, I love the quick fix. This spring, I want to slow down more and dream more and appreciate the small steps that I'm taking towards my goals.

Dealing with extra fatigue this past week made blood sugar control that much more challenging...but I feel back on my game today. I lost almost three pounds over the last few days, so that is encouraging, too. Spring is here and this time tomorrow night, there will still be light outside of my window. That will be sweet...

Losin' my Meter...

2006-03-30T20:34:00.000-05:00

It's a familiar scream in my house. "Fred, I can't find it! Anywhere!!!"

"Where did you test last?" my husband asks me.

"I don't remember. If I remembered, I could find it!" I answer.

"Okay, calm down. It's got to be here. I'll find it."

"I've looked everywhere, it's gone! I need to test...I think I'm getting low."

"Yeah...think you forgot to look in your purse. Here it is."

"Oh, okay," I mumble, temporarily humbled. "Thanks."

And so it goes--a variation on this incident occurs at least three times a week around here. I'm not sure what it is. I really don't think I'm consiously trying to lose my meter. I just test on the run a lot. For example, I could have tested last in my office, where I'm working, when I here a kid wake up over the baby monitor. Off I go, leaving the meter near my keyboard. Or I might have it next to me on the couch when I'm trying to stay up to watch E.R., but when I inevtabaly fall asleep and wake back up around 2am, I won't remember to look for my meter on the floor by the couch. I'll expect it to be in the upstairs bathroom, where I try and keep it most of the time. But since it's 2am, I'll feel a strong urgency to find it...won't be able to, will wake up Fred...and the scene above takes place.

I'm writing about all of this because I am very, very, very curious about the new "Omnipod" insulin delivery device. Have you seen it? Just the idea of wearing a "pod" rather than a "pump" lures me into thinking that progress has been made. And it seems like it has...the pod has no tubing. It's pretty small. No cartridges to deal with. You just stick it on and replace it with a new pod every couple of days. How cool is that?! Less stuff to shlep around.

Only, you program in your boluses and basals with a device that includes a blood sugar meter that comes separately...a device that you hold, a device that you must have to deliver insulin through the pod, a device that you--well, I--could lose.

So I'm thinking that the pod probably would not create much progress for me, after all. :)

Peace,
Gabrielle

Updates on the scale

2006-03-28T19:29:00.000-05:00

It's been over a week now that I've been "blogging," so I want to write about where I'm at with my weight loss goals. Siiiiiigh. No progress this week. In fact, I'm up a pound. This is the week before my period, which always means a couple of pounds in water weight gain...but still. I think that if I want to get these last 15 pounds off, I need to watch everything that I'm eating more closely, even during "this week."

For some time, I've been struggling with setting my basal rates correctly in the ten days or so before my period. I become extremely insulin-resistant (any women readers out there go through this?) due to changing hormome levels. I end up increasing my basals during this time...but the challenge is how much to increase, when. If I increase too much too quickly, my blood sugars can crash. Starting out slow, though, usually results in a couple of higher-than-normal days. I tend to settle somewhere in between...unfortunately, even record-keeping doesn't help me to master this dilemma because each month is truly different in terms of when the insulin-resistance hits.

So my basals are set at what feels the right place now, but the weight is just there. I'm hoping that now that spring is officially here, getting out for more walks--combined with watching my food intake more carefully--will help me get closer to my goal.

Yesterday it was about 55 degrees here and I put my kids in their double stroller and walked up a really big hill. My neighborhood--Manayunk--is the hilliest in Philadelphia...it looks a lot like San Francisco, or Pittsburgh even. I made it up the hill pretty quickly, even with pushing the stroller. And that felt good. That was a new feeling. That made me remember that even if the scale isn't showing it right now, I am getting into decent shape. Just got to keep moving up those hills...

On June 7th, I turn 35. It's kind of just hit me that this is a signficiant birthday. I won't be in my "early 30s" anymore. Maybe living with diabetes is making me think a bit harder this year about mortality, in general. I want 10 pounds off by my birthday, that's a new goal. I want to keep living this next year with daily awareness of how my emotional/spiritual/intellectual/and physical health interact. I'm feeling happier now than I ever have in my life...and I want to honor that feeling in my body, as well as in my spirit and mind.

In peace,
Gabrielle

2006-03-25T20:04:00.000-05:00

Today I received my copies of the latest "Diabetes Self-Management" magazine, which includes an article that I wrote last fall about pregnancy and diabetes. It was exciting to see the article in print. I wrote it after June was born...feeling more determined than ever that there need to be more resources out there for women with diabetes who are planning pregnancies. Having a non-eventful pregnancy and giving birth to a healthy child is absolutely possible for us--but doing so takes a huge amount of knowledge, hard work and support.

One anecdote that I didn't include in the article is about my switching endocrinologists after finding out that I was pregnant again. Immediately after finding out I was pregnant, I put a call into my endo. I wanted to check in with him, get help adjusting my basal rates and move my appointment up (it was schedule for 7 weeks from then). I phoned his office and his receptionist took a message with all of that information, and I waited for his call. I was pretty eager to get in touch with him because the first trimester is so critical in terms of blood sugar control; birth defects in the fetus can occur if sugars are too high. So I waited...a couple of days went by and no return call. I was going to call back again the next afternoon, when I got home from seeing my high-risk ob/gyn.

At that appointment, my Dr., Nancy Roberts, suggested that this time around, I see an endo who works at the same hospital as my ob/gyn team. For George's birth, I wanted to stick with my endo--whom I had been seeing for five years at the time--even though he was affiliated with a different hospital from my ob/gyn team...whcih did result in a lack of communication between them. So, I agreed with Dr. Roberts to see an endo at Lankanau hospital where she practices and long story short, Dr. Roberts made a phone call and I left her office, took the elevator down a floor, and went to see a new endo, Dr. Claresa Levetan.

Dr. Levetan, it turns out, is a leading diabetes researcher and also a fantastic clinician. I was in tears by the time I met her, so stressed about my sugars being out of target range. She was extremely resassuring, connected me to a continous glucose sensor which I wore for the next three days, so we could collect as much data as possible about what was going on with my sugars. Within the week, she helped me set basal and bolus rates that helped me reach my blood sugar goals throughout the rest of that trimester and she was a tremendous help throughout my pregnancy.

I wanted to get back in touch with my former endo and let him know what was going on...after all, I had been seeing him for 7 years by this time and was grateful for his help in getting me started with the pump. I decided to write him a note and explained my decision about wanting an endo and high-risk ob/gyn team at the same hospital; I explained that I had called his office to let him know about my pregnancy, but obviously the message hadn't gotten through. I thanked him for all of his help and promised to get in touch after the birth.

A few days later, I came home to a phone message from that endo. He wished me well and said that he had gotten the phone message and hadn't gotten a chance to call me back. I was stung to hear that. No time to call me back? A patient who is pregnant and needs help adjusting her basal rates?

I am so deeply thankful for Dr. Roberts' call, for my trust in her, for meeting Dr. Levetan and for all of the miraculous things that fell into place that allowed me to give birth to a healthy baby. But this incident is a reminder to me that people with diabetes--pregnant or not--need to be advocates for themselves...and need to remember that our doctors don't always make the best judgements. This was a painful way for me to learn this lesson, but now I am more empowered about seeking ou what I need from my doctors to help me be as healthy as possible.

In peace,
Gabrielle

Yoga Benefits

2006-03-23T18:28:00.000-05:00

This morning I stretched for the first time in probably a good month. I haven't been able to find a way back into a regular yoga routine since somewhere in the middle of my pregnancy with June, and I've started feeling its absence in my body. I began doing yoga in 1997 and found myself totally taken with the way practicing the asanas helped me to clear my mind, tone my body and learn how to "just be" in the moment. Managing my stress through yoga practice also yielded benefits for my blood sugar control. Especially after starting pump therapy, I was able to measure just how much a stress-induced adrenaline rush could make my blood sugar soar. Daily yoga helped me to internalize a sense of calm...a calm that I could easily lose on a daily basis...but still know that I had tools to find a way back to it.

So...in my mind, I've been wanting to carve out a space--somewhere in my life--to get back to yoga. But there is just so much to do--personally and professionally--during my small windows of free time that I just haven't made it happen. But this morning, the house was quiet...June was having her morning nap and George and I were reading books. "Let's stretch together," I said to him.

At age three, he is definitely into the "mimicking" phase and jumped right up and stood next to me. I stood in mountain pose and he imitated me. I reached my arms up high and he did the same. I did a forward bend down to the floor and George followed. We were both laughing as we stretched up and down, side to side. At least I knew I was breathing! After about 10 minutes, he lost interest and went back to his books, while I continued practicing asanas for another five minutes. Soon, June woke up and the moment was over. It was certainly not a perfect kind of practice, but I loved stretching with George and the feeling of tension releasing throughout my body as I stretched. I remembered how important it is to really be in my body, to notice when I am stressed or tense. For me, carrying unreleased tension can undercut my best efforts at blood sugar control. And breathing and stretching through moments of high anxiety can help to counter the effect of stress hormones on my blood sugar.

Probably nothing has been as helpful as my yoga practice in preparing me for parenthood. Spending as much time as I do with two young kids is truly an exercise in being in the moment. When I can stop my mind from racing and running, I can appreciate the blessings of our simple, mundane moments...the richness of the every day.

When things settle down even more in my life, I hope to get back to an ongoing pilates practice, too. A couple of years ago, I was fortunate to meet Colin Reynolds, who also has Type 1 diabetes and wears a pump, and is an amazing pilates instructor. Colin is an inspiration--he is in such fantastic shape and is using pilates to help people with diabetes. Colin gave me simple routine to do at home, which helped me to get back into shape after George. I had a few lessons with him last December and have managed to squeeze in some pilates time here and there since.

Today taught me that waiting for the perfect time just means...waiting. Meanwhile, for the sake of my health--emotional, physical, and spiritual--I'll keep stretching away with my 3-year-old. If I can give my children a way to calm themselves through yoga poractice, that will be a huge benefit, too.

If you live in the Philadelphia area and want to know more about Colin and his awesome work, check out www.vitalitystudio.com.

In peace,
Gabrielle

Experimenting with Symlin

2006-03-21T20:07:00.000-05:00

For the past two months, I've been using Symlin in addition to insulin to help manage my blood sugars. For those of you who haven't heard about Symlin yet, check out www.smylin.com. It's basically another hormone that works with insulin to keep blood sugars from peaking too high. It is the first medication that is being prescribed for people with Type 1 to work with insulin...since insulin was first bottled and prescribed.I'm thankful for the opportunity to try it--and that something else has come out on the market to help people with Type 1. So far, it is helping me to lower my post-dinner blood sugars and keep my sugars more even throughout the evening. The only problem for me right now is that symlin is only supposed to be taken if you are eating at least 30 grams of carbs (or you can risk low blood sugar) at a meal. Since I've been on my weight loss campaign, I'm not eating that much carb at breakfast (a non-fat yogurt) or lunch (usually salad, cheese and a few crackers). I'm more into grazing right now and that is working well for me...I usually grab a piece of fruit between breakfast and lunch and again between lunch and dinner.The one thing that is also a drag for me about taking symlin is returning to syringes--yuck! After seven years on the pump, I'd forgotten how inconvenient they are. I don't mind the actual drawing up the needle and sticking it in...I just so much prefer the convenience of insulin delivery by pushing a few buttons.On Saturday night, my husband and I went out to dinner for his birthday and as I was throwing things into my purse, I thought, "I really don't want to pack up a needle & bottle of symlin." I mean, I don't need it in the smae way that I need insulin...or obviously it would be packed! It just brought up memories for me of leaving the table on a date to go take a shot before dinner. Pulling out my pump and pressing a few buttons has spoiled me.I've heard about some people with Type 1 who LOVE symlin and are actually wearing TWO pumps: one with insulin and the other with symlin. I'm not there yet, but we'll see..If you're taking symlin, please leave a comment about how it's working out for you.In peace, Gabrielle

Daily Ritual

2006-03-18T16:56:00.000-05:00

Since June was born six months ago, I have added a new ritual to my morning routine: stepping on the scale. For years, I had scale-phobia and dreaded that part of my doctor appointments more than anything else. It's been an ongoing challenge for me to balance optimal blood sugar management with achieving my "ideal" weight; before I started pump therapy, I was at my thinnest that I've been in my adult life, but my daily blood sugars were out of the healthy range. When I started pump therapy seven years ago, I gained a good twelve pounds in the first couple of months...but my blood sugar control was the best it had been since being diagnosed. Part of that weight gain showed that my body was healthier--processing sugar rather than spilling it out in my urine. But a lot of the weight gain--which I openly admit--came from my now being able to indulge in desserts, chips and other high-fat foods that I used to avoid...because now I could just blus enough insulin to cover the carbs & fat and still come out with a blood sugar in the healthy range.
I caught on quickly that that way of thinking and eating was not healthy for me or anyone. Still, I struggled with getting the extra weight off. Over the next couple of years, I gained significant weight with each of my pregnancies. Now that I am on the other side of that, and have decided not to have any more children, I have set a new goal to try and maintain optimal blood sugar control AND reach a more ideal weight. Thankfully, I've taken off all of the weight from my pregnancy...but still have 15 pounds to go to my goal.
Standing on the scale each morning forces me to acknowledge where I am in terms of reaching that goal. This has been a helpful tool. Yet, I also don't wantthis ritual to determine my mood for the day. I don't want to punish myself if I'm up a pound or two or reward myself if I've lost half a pound. I want to take in the information, use it to help me, but not allow myself to get caught up in my weight equating my self-worth.
Growing up with diabetes since age ten, I have battled the feeling that the numbers on my blood sugar meter defined me. I would look and the number and label it either "good" or "bad"...and there was no separation between the number and me. If the blood sugar was good, I was good; if it was bad, I was bad. It has taken me a long time to recognize my blood sugar as either "high" or "low", rather than good or bad. Part of accepting that is acknowledging that as hard as I work at blood sugar control, there are factors...sickness, stress, my menstrual cycle...that can undercut whatever steps towards control that I take.
As I work out my relationship with the scale, I'm trying to bring that awareness to my process of losing weight. Today I lost one pound. And I did step away from the scale with a lighter step...

Starting my blog

2006-03-17T20:20:00.000-05:00

Finally! I have been wanting to start this blog for some time. My baby, June Elizabeth, is 6 months old and between caring for her and my older son, George (3 and 1/2), and taking care of my diabetes--not to mention writing, working part-time and occassionally cleaning my house--it just hasn't happened until now. But here we go...
Some of you know me as the author of "Insulin Pump Therapy Demystified" (Marlowe & Co, 2002), in which I shared my experiences--and those of nearly 100 other pump users--in becoming adjusted to life with the pump. The insulin pump truly changed my life, allowing me to step into the driver's seat in terms of my diabetes control and I wanted to write the kind of book that might have helped me when I was confronting my doubts and fears about trying a pump. Writing and publishing my book has been one of the most rewarding experiences in my life, especially when I connect with people for whom my book was helpful in their decision to choose pump therapy.
Since 2002, I've continued writing about diabetes in various publications including "Diabetes Self-Management", "Diabetes Health" , "Yoga Journal" and others. But lately I've been amazed by how the world of blogging is connecting people with diabetes in a completely new way. Just exploring all of the blogs about diabetes makes me feel less isolated and more in community with others who are dealing with the same daily challeneges as me.
And so now...I am adding my voice to the diabetes blog world. What you'll find here are postings about my current challenges to achieve the most optimal control I can: balancing self-care with care of my young children; attempting to lose weight and get back into pre-pregnancy shape; lowering my a1c; attending to my emotional and spiritual health as I pay attention to my physical health; and hopefully keep my sense of humor along the way.
I look forward to your responses to my postings!
And for more information on "Insulin Pump Therapy Demystified", check out my web site www.insulinpumpbook.com.
Peace,
Gabrielle