Diarithmetic

20140630_091649Diabetes is not for dummies. People who keep tight control of their diabetes must be either mathemeticians or own (and know how to operate) a Texas Instruments calculator like the one pictured on the right.

Let’s do the math: That’s one unit for every ten carbohydrates, plus one more unit for every 40 mg/dl over my target mg/dl, minus an expected value of glucose fluctuation based on “strenuous” exercise, minus the derivation of the stress coefficient when the variance is greater than the sum of the ml/dg, times the square root of pie . . . sugar-free, of course.

It’s even more difficult for us athletes with diabetes. (I count myself as an athlete with diabetes because I ride a bike and own silkscreened spandex.) Apparently, we must have a degree in physiology as well. Here’s the beginning of a long, technical article I recently read on the ADA website:

In intense exercise (>80% VO2max), unlike at lesser intensities, glucose is the exclusive muscle fuel. It must be mobilized from muscle and liver glycogen in both the fed and fasted states. Therefore, regulation of glucose production (GP) and glucose utilization (GU) have to be different from exercise at <60% VO2max, in which it is established that the portal glucagon-to-insulin ratio causes the less than or equal to twofold increase in GP. GU is subject to complex regulation by insulin, plasma glucose, alternate substrates, other humoral factors, and muscle factors. At lower intensities, plasma glucose is constant during postabsorptive exercise and declines during postprandial exercise (and often in persons with diabetes). During such exercise, insulin secretion is inhibited by β-cell α-adrenergic receptor activation.

Let me simplify the paragraph above and make it more practical for you: If you have type-1 diabetes and you exercise really hard . . . umm . . . never mind. I believe I got to >80% VO2max just trying to figure it out. I think it has something to do with something my liver does at intense exercise that’s different than when the exercise isn’t as intense, but I’m not sure what that means because now my blood sugar is really low and my brain stopped functioning properly.

Here’s what I do know: Caring for diabetes, like other things in life, is a holistic pursuit. It’s not just physical; it includes the mental, emotional, social, and spiritual dimensions as well.

Oh, and let’s not forget my favorite, the “humoral factors.” After all, laughter is the best medicine.

Tribute to a Diabetes Hero

Many of my heroes as a teenager were athletes; Their Sports Illustrated covers plastered the walls of my room. Heroes like Pete Rose, David Thompson, and, well, Christie Brinkley. Oh, and Ron Santo, a Chicago Cub who, like me, lived and played baseball with Type-1 diabetes. And did I mention  Christie Brinkley, who, as far as I know, didn’t have Type-1 diabetes, but she always looked so happy playing whatever sport it was she played?

I took those magazine covers down from my walls a long time ago, and some of those heroes have fallen on their own. I’m not a huge fan of elevating other humans to superhero status, because not one of them (or us) is perfect (although Christie was pretty close). Every single one of them (and us) needs second chances. And, to tell the truth, not one of them truly impacted my life. But one hero has influenced my entire life.

My mom and me in Idaho, about one year before she left earth

Her name was Betty. She’s been gone for more than twelve years now, but my mom’s impact on my life, especially my life with diabetes, lives on. My mom is the person who gave me the courage to live a normal life, regardless of the highs and lows that would come along with diabetes–or any other circumstances of life. She gave me lots of grace and second chances, more than I deserved! And she taught me about God, the ultimate Giver of Second Chances.

I think my mom understood how to live with (or despite) the circumstances that life threw her way. She grew up during the Great Depression with an alcoholic and abusive father. Her own mother died when she was a young teen. My mom often went to the store and got a soup bone, took it home and boiled it with any vegetables or scraps she could find (if they were lucky), and that was dinner. Mom was a strong and yet very loving woman who loved life and never complained about her circumstances but made the best of every situation.

I wrote a tribute for my mom and read it to her at her birthday party a couple years before she died. Here’s part of it:

Mom, you were my hero when I was diagnosed with diabetes at age 11 and I spent three weeks in the hospital. You encouraged me as I made adjustments. You were my strength through it all. You gave me my shots when I couldn’t do it myself. You taught me how to care for my health. You made sure I went to a diabetes camp so I could see I wasn’t alone. Years later, when I went to a special diabetes seminar, I learned how well-adjusted I was. There was only one reason for that: my mom.

Maybe, like me, a parent was or is your hero, your support and encourager along the way. Or maybe it has been another relative, a teacher, or a friend.

Or perhaps you are that parent who is caring for a kid like me with diabetes. Thank you!

Who is your biggest hero when it comes to living with diabetes? Share your story about them in my comments section! I and others would love to hear about them. Better yet, tell them yourself in your own tribute. And then share your tribute here and tell us how it went!

 

The Year I Was Banned from the Olympic Games

Image1972 was a big year for me–the year of the Olympic Games, and I was participating.

I was 12 years old and won 27 gold medals. At least I should have.

The other competitors, Tim Ward, age 11, and Jeff Ward, age 10, competed too. The events all took place in my backyard, garage, basement, and around our neighborhood on Matson Avenue. I designed and crafted each of the gold, silver, and bronze medals by cutting pieces of cardboard into circles, coloring them with the appropriate crayons, punching small holes in the tops, and looping pieces of string through the holes. I draped all the medals on one of my dad’s ladders that hung in our garage. As each event concluded, the top three athletes met in the garage and stood atop boxes at different levels to receive our cardboard medals. I played the National Anthem on my cassette player.

It’s true. I had a decided advantage over Tim and Jeff because of my superior athletic skills. The fact that I planned all the events helped too.

There were the usual events, such as weight lifting, 100-yard dash, marathon (once around the block), cycling (I was the only one with a 10-speed), high jump (using all of the pillows and cushions in the house as a landing mat), and discus throw (amazingly, we broke only one of mom’s plates). Then we had some “unconventional” events. These were sports I was particularly good at or ones I knew Tim and Jeff couldn’t do well. Like chess. Air hockey. Bumper pool. (I had an air hockey and bumper pool table in my bedroom). Algebra (the Ward brothers hadn’t gotten that far in math yet). Against Tim’s protests, we didn’t have the football or baseball throw. Tim was a pitcher and could throw a ball a mile. I did give in to the one-on-one basketball tournament and because of it I got my one silver medal.

About a week into the competition, I couldn’t be caught in the medal race. Tim had a bunch of silver medals and Jeff had a ton of bronze. This is when “the scandal” began. Jeff said I had to submit to drug testing. He claimed he had incontrovertible evidence that I had been shooting up.

He was right. I took insulin shots twice a day. I had been diagnosed with Type-1 diabetes a year earlier. Jeff said he and Tim had all the evidence necessary to prove I had an unfair advantage because of the “performance-enhancing drugs” I was taking. They had seen me taking shots, they had found broken syringes in our garbage can, and noticed my markedly improved performance after eating what looked like sugar cubes.

The urine samples I was forced to provide were unnecessary. My diabetes was no secret–I had told them about it so they could understand why I sometimes had to stop playing to eat some sugar. I tried as hard as I could to convince the Ward brothers that insulin wasn’t a drug and that it gave me no advantage in our competitions. I showed them the pamphlets I had received from the hospital. I had my mom testify on my behalf. I provided an official statement from my doctor. The Ward brothers weren’t convinced. It was put to a vote; I lost two to one. I was suspended for life from the Matson Avenue Olympic Games and stripped of all my medals.

I was devastated. For about two days, when baseball season started and my Little League team allowed me to play. In my first at bat, I hit a line drive up the middle, knocking Tim to the ground. I laughed when I reached first base, where I promptly ate a sugar cube and stole second base.

Camp Hamwi and THE Shot

Relying on your mom to give you your insulin injections has its disadvantages, especially when she’s mad at you and hasn’t taken (what she called) her “nerve pills.” Like the time when I was 13 and I got mud on her freshly cleaned kitchen floor, and later when she gave me my shot, she wiggled and twisted the needle around in my arm before pushing in the insulin. She swore her hands were slippery from floor wax, but I knew better.

As I indicated in my last post, it took me a while before I learned to give myself my own insulin injection. I really wanted to do it myself, but I couldn’t pull the trigger, so to speak. You see, the nurses in the hospital taught me to JAB the needle into my skin. It was like throwing a dart, except you don’t let go. I tried over and over: 1 … 2 … 3 … and every time my JAB would stop just short of my skin. So Mom would graciously give me my shot … again, and I’d try again next time.

This went on for a couple years, until I went to Camp Hamwi.

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Postcard home from Camp Hamwi, Central Ohio, circa early 1970s

Camp Hamwi was the diabetes camp I attended for three years. It was a typical summer camp with cabins, a swimming pool, and a creepy camp counselor named Al. The camp was for juvenile diabetics but it included pretty normal camp activities: kayaking in the lake, hikes in the woods, and late-night spin-the-bottle games. Of course, I and my other 13- and 14-year-old cabin mates got to sleep by singing the classic camp song, “99 Bottles of Beer on the Wall.” The camp counselors taught us about testing regularly, eating right, and getting enough exercise each day. They must have forgotten the warning about how bad it is for juvenile diabetics to drink that much beer.

Each day, I saw all my fellow campers giving themselves their shots, which gave me motivation, but it was HOW they were putting the needle in that helped me most. They didn’t JAB; they simply put the end of the needle against the skin and gave it a little push. So I tried it and … success!

I was so excited I wrote a letter home to my family:

Dear Mom & Dad,

Finally for the FIRST time ever, I gave my self my own shot and nobody helped me! I just stuck it in. Having a GREEEEAAAAAT time here and learning a lot.

Have to be saying bye till Saturday unless you decide not to pick me up. Maybe that’s better, but I HOPE not!

Bye! Mike

(NOTE: Thirty years later: After my mom passed away in 2001, my siblings and I were going through her keepsakes, and I found the letter. Mom had kept it all those years.)

The camp counselors rewarded me for giving my own shot by putting me in charge of the bonfire that night. They rebuilt the camp the following year, but Al has never been seen since that night.

*   *   *   *   *

NOTE: The events of this post are based on true events, although some minor details have been fictionalized. Camp Hamwi was a great place with no creepy counselors or underaged drinking, so go ahead and send your kids there. I’m sure they’ll love it. By the way, I now wear a pod but when I do give myself a shot I still do it as I learned at camp. Also, I still enjoy bonfires and playing spin the bottle, but I now do the latter only with my wife.

Support me in my ride to beat diabetes in the 2015 TdC here!

Support me in my ride to beat diabetes in the 2015 TdC here!

How NOT to Teach an 11-Year-Old Boy to Give Himself a Shot

Mike_11ishI could give a shot to an orange, a grapefruit, and a nurse, but I couldn’t inject myself.

I was 11 years old and had just been diagnosed with Type-1 diabetes. I spent the next three weeks in the hospital, where the nurses schemed to teach me to give my own shot. After three weeks of trickery, deceit, and blackmail, they finally gave up on me and told my parents to take me home for Christmas. I saw one of them slip my mom a $100 bill.

First they tried to model how easy it is to give oneself a shot. One-by-one, each of the nurses came into my room and stuck a hypodermic needle in her arm, and then told me I could do it as well. I began to really enjoy this daily game. I asked them to send in my older sister and my sixth-grade math teacher.

Then they attempted reverse psychology: I was to give one of them—the young, wide-eyed, just-out-of-nursing-school neophyte—a shot of saline solution. The idea was that if I could give someone else a shot, I could give one to myself. Really? I was a preadolescent boy. It didn’t hurt me to put that needle in her arm, but I could tell by her expression that it hurt her. She didn’t think it was as funny as I did.

Then they pulled out the big guns: No dessert if I didn’t give myself my shot. But my 9-year-old roommate had just had surgery on both feet, so when everyone left, I took his dessert. I knew he’d never catch me.

Eventually, I was able to give myself my own shot, but I’ll save that for another post. In the meanwhile I did learn quite a bit from my experience. For instance, when you inject an orange with enough saline solution, it becomes a little water bomb—perfect for terrorizing your roommate and your older sister.

 

Living Healthy with Diabetes and Proving the Doctors Wrong

When I was diagnosed with type 1 diabetes at age 11, Doctor Stagaman told my mom I probably wouldn’t live past 40 and definitely not past 50. He also told her there was a good chance I wouldn’t be able to have children.

I don’t know what it is about me, but I really, really enjoy proving doctors wrong!

I have had an intimate relationship with diabetes for nearly 43 years. I’ve seen diabetes care progress greatly over the years, but it’s just that, care for diabetes so that I can stay relatively healthy and live longer. But there is still no cure.

clinitest1When I was first diagnosed, several times a day I used Clinitest tablets (which have nothing to do with an ex-president) that I would utilize to test my urine. I felt like a chemist, using a dropper to put just the precise amount of urine into the test tube,  placing the tablet into the tube, and then watching it  fizz and change colors. This was fun for about a week; then it became cumbersome, and it was a very inaccurate way of determining my blood-glucose level. (Basically, testing your urine tells you what your blood-glucose level was several hours ago.) Today I can test my blood in 3 seconds and I know it’s accurate, which means I can control my diabetes better.

While I appreciate better diabetes care today, a cure would dramatically change my future and the future of my friends with diabetes. I don’t really want this disease or the complications. Today, I have some retinopathy in my eyes and a bit of nerve damage, but I can live with these things. Yet I’m seeing people I know and care about dealing with complications such as blindness, amputations, kidney disease, and even death. That’s why I’m doing everything I can, short of sin, to raise money to beat diabetes.

This may sound odd to some, but I am thankful for diabetes. Why? For one thing, I am very conscientious about my health, diet, and exercise. I’m now 53 years old and I want to see my four children–in your face, Dr. Stagaman!–get married and have kids of their own. I want to keep living healthy through all the highs and lows of life for as long as I can.