D-vangelism: 7 Secrets to Being an Effective Diabetes Ambassador without Being Weird

from the website, www.americanmedical-id.com

Full disclosure: This is not my tattoo. But it does look like a cool idea, and I’ve thought about it. From the website, http://www.americanmedical-id.com

I admit it: I’m a D-vangelist. Everywhere I go, I look for opportunities to tell people about my savior. Insulin saved my life 42 years ago, and am not ashamed to stand up and testify.

A couple of weeks ago I was at a water park, wearing my pod on my arm. The guy behind us in line asked me what it was, so I used his question as an opportunity to educate and advocate. About 10 people had congregated around us, and they all heard the good news of modern diabetes technology.

Over the years I’ve learned a few secrets for talking effectively about my diabetes without being weird about it:

  1. Wherever you are, be there. Like it or not, you and I take our diabetes wherever we go. You can either accept or reject the role that goes along with that to be an ambassador for diabetes. My opinion: If you decide you don’t wish to educate others about diabetes, you give up your right to complain about people who say stupid stuff about it.
  2. Let it shine. Don’t hide your diabetes under a bushel … no! (Sorry, I was roped into teaching Vacation Bible School a number of years ago.) Look, I am a PWD (Person With Diabetes). I have been for nearly 80% of my life. So I own that. I’ve never been one to hide my pump, pod, or now my CGM (which I started yesterday). I don’t purposely show them off, of course, but I don’t see a reason to conceal them either.
  3. Be prepared. When we go out, PWDs are careful to take everything we need—tester, glucose tablets, insulin, and other supplies—with us. I’d never leave the house without being prepared for highs or lows. I think we should also be prepared to tell people a little about the highs and lows of living with diabetes when asked. Who knows more about it than those of us who live with it every day? You don’t have to know everything about diabetes; just share your story … briefly!
  4. Be natural. Try not to force the conversation. Simply answer people’s questions … and then stop talking. You don’t need a pitch or a speech. And don’t use this as an opportunity to make yourself the center of attention. If people keep asking questions, answer them, and then move on. If they stop asking, view that as a sign.
  5. Control the Diabeteze. We PWDs—whether we’re T1Ds or T2Ds, whether or not we wear a CGM, regardless of our latest BS (or BG) (mg/dL or mmol/l) or A1C, regardless of whether we’ve ever gone into DKA and had to upload our PDM to our endo or CDE—tend to use all kinds of diabetes nomenclature that PWODs (People Without Diabetes) cannot understand. Communicate to be understood. Drop the d-jargon.
  6. Be real. A conversation about your diabetes won’t be weird if you just be yourself—unless, that is, you are weird. It’s OK to talk about how you deal with your diabetes, but, of course, keep it generally positive. Sure, it’s fine to say it can sometimes be a pain in the butt, but don’t go on and on about how horrible your life is. Nobody wants to hear it. Who likes a Diadebbie Downer?
  7. Love. That may sound weird, but what I mean is that as you talk to people, put them first. When you start with a humble attitude, it frees you to simply provide answers for people and help them to understand diabetes more.

 

How Living with Diabetes Is Like Living with Your Spouse

diabetes-and-marriageIn the Facebook group, “You Know You’re  Type 1 Diabetic When …” Randall Dennis quipped, “I have decided that I love my diabetes because it has stuck with me longer than any of my wives.” That got me thinking: How is living with diabetes like or unlike living with a spouse? First, here’s how living with diabetes is LIKE living with a spouse:

  • Some highs and lows are expected.
  • Daily tests are a part of life.
  • The longer our life together, the more complications seem to develop.
  • Almost certain interruptions occur when I’m watching a great game on TV.
  • The littlest thing can set off a confusing chain of circumstances I can’t control.
  • Has required numerous “lifestyle adjustments.”
  • An error in judgment can reap both short-term and long-term consequences.
  • My commitment to care can make all the difference.
  • “Stop attacking me! I’m not the enemy!”
  • When I forget to do something I’m supposed to do, I will suffer.
  • When I’m feeling low, a little sugar can make me feel MUCH better.
  • Our life together has made me who I am today.

I’ll share some of the ways they are different soon.

Add to the list! What are some other similarities between living with diabetes and living with a spouse?

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TWO MORE POSTS ON DIABETES AND RELATIONSHIPS

Diabetics in Love

The Diabetic Dad and the Delayed Delivery

 

The Cyclist in “Stop Diabetes” Lycra

20140804_195638It was the perfect day for a bike ride for me, and it was an embarrassing one for my wife.

At 7 a.m. I clicked into the pedals on my dark blue Specialized Allez road bike and pushed off toward my friend Ed’s house. I looked up at the cloudless pastel blue sky with yellows and reds radiating from the east. Goosebumps appeared on my bare arms, not so much from the beauty of the morning, but from the surprisingly chilly 68 degrees for August 3.

We were riding in a Bike to Beat Cancer training ride (I’m training to ride 100 miles in September), but I was wearing my grey “Stop Diabetes” jersey, shorts, and socks. I ride to stop diabetes as someone who has lived with the disease for more than 42 years. I’m riding to beat cancer because my mom and many friends have been impacted by it. Our friend Carol just lost her long battle last month.

As Ed and I rode the 17 miles to the meetup, where we’d start the 30-mile training ride, we were happily amazed that we hit every green light for the first 15 miles. As we approached one red light, I joked that I had a preemption emitter (the device emergency vehicles use to change red lights to green) in my helmet. As soon as I said it, the light turned green.

We met up with 20 or so other cyclists and then rolled through the quiet small town at the beginning of the ride–the streets were ours this early Sunday morning. Then we spun along the Ohio River for miles. The pace was even, slow enough for cyclists to talk and point out views across the river and quick enough to feel the cool air in our faces. Just as the sun began to warm up the atmosphere, we glided into a park for a long but gentle climb, the overarching trees providing the shade needed to prolong the crispness of the air for a few more much-appreciated minutes.

At one brief stop I looked around and saw nothing but smiles. This ride didn’t feel much like training.

We picked up the pace on the ride back home as both the traffic and the temperature intensified. I registered a personal best on the steep climb from River Road to SR 42, and we were just 10 miles from home. I rolled down my driveway at 67.5 miles, feeling as if I had another 10-20 in me.

This is when I read the text from my wife telling me she had a story to tell me.

She had left the house shortly after I had that morning, driving my daughter to work. On her way back home, she saw a cyclist wearing grey “Stop Diabetes” jersey, shorts, and socks. So she rode behind the bike for a while and then pulled up alongside, yelling out the window, “Hey, Sexy!” The cyclist in grey Lycra looked over at her and said, “Excuse me?” The two pulled off the side of the road where my precious wife tried to explain to the stranger that she thought he was me.

Turns out the “other man” in the grey jersey is involved in the American Diabetes Association and the Tour de Cure in Louisville as well. And apparently … from the rear … he looks like me.

I’m not exactly sure how I am supposed to feel about my wife’s case of mistaken identity. I’m honored she thinks I’m sexy in Spandex. That is, if she had actually yelled it at me. To this point, no woman has ever pulled alongside me and said, “Hey, Sexy!” and now I’m wishing someone would. I’m also miffed that my wife hasn’t paid enough attention to differentiate me from some random cyclist. Afterall, his bike was red.

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Want to Read More of Mike’s Stories About Cycling?

Living Healthy with Diabetes Is Like Mountain Biking

How to Look Past the Obstacles: Use this mountain biking skill to live healthy with diabetes (or any life circumstance)

 

The Incident: A Not-So-Model Diabetes Patient (or “Grandma Got Run Over by a Wheelchair”)

marioandretticarIt all started innocently enough. The hospital nurses gave me a model car to put together, probably to keep me in my bed rather than romping through the hospital hallways with the other kids on the children’s floor. This was back in 1971, and hospitals were not yet in the practice of moving patients out as soon as possible.

I had just been diagnosed with type 1 diabetes and admitted to Good Sam hospital (see my earlier post on my hospital adventure). I had made new friends with kids who had cancer and heart conditions, as well as those who had had numerous surgeries to correct birth defects, just to name a few of their conditions. One of my roommates, a young kid who had a serious heart condition, was taken to surgery one evening, and he never returned. One of my other roommates woke me and the kid next to me up with screams in the middle of the night and then cried inconsolably the rest of the night. He said he knew our friend had died. I thought he was crazy until the following day when a nurse told us that indeed he didn’t make it through the surgery. No one was there to console us or provide us with counseling.

Maybe that’s why my fellow children’s-floor friends and I were so out of control. I’m sure we simply didn’t know how to handle all we saw and were experiencing.

It all culminated when I ran over a little old lady in the hallway. One of the big kids (and by big, I mean he was maybe 13) was pushing me in a wheelchair through the halls. I was Mario Andretti, speeding around the Good Samaritan 500 Racetrack. The other race teams had already given up. We were the undisputed 4th-Floor Wheelchair Race Champions. What I didn’t realize was that at some point the kid pushing me had given me a big shove and then let go. An older woman stepped out of a room directly in my path, and I suddenly found I had a very unwilling passenger.

She could have just enjoyed the ride, but instead she had to make a big deal out of the incident. (Incident was the word the nurses and hospital administrators kept using.)

So suddenly I had a model Lotus racecar to put together, which was kind of fun for a short while. But the tires had a piece of rubber that needed to be cut away in order to attach them to the rims. I asked a nurse for scissors, and she complied, probably to keep me busy and out of trouble. As I poked out the stubborn rubber section of a tire, however, I plunged the scissors between my index and middle fingers (I still have the 42-year-old scar). Seven stitches and I was good to go, sans the scissors.

Several days later I was in isolation, away from all my fun friends, with a serious case of Staphylococcus. It was the worst. No more races, no more friends to play with; they didn’t even let me finish building my model car. Finally, the doctor let me go home, where I carefully finished assembling the Lotus.

Several weeks later, my doctor removed six stitches from between my fingers. One of the stitches somehow fell down into my hand. He wanted to send me back to the hospital to let them find and remove that lost stitch, but the hospital said no, ostensibly because he could take care of that in his office.

That was fine with me. The kids back in my neighborhood and I had sled races to run and a new model car to pommel with a BB gun.

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MORE STORIES ABOUT BEING A KID WITH DIABETES

Living Healthy with Diabetes and Proving the Doctors Wrong

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

Camp Hamwi and THE Shot

The Year I Was Banned from the Olympic Games

The Diabetic Dad and the Delayed Delivery

Jordan baby picMy wife and I were in the delivery room about to give birth to our first child. Now, before I get too far into this story, I need to explain that my wife, Heidi, is from New Jersey. If that fact means nothing to you, go to Netflix and watch a couple episodes of “Jersey Shore.” Or don’t and be thankful.

Anyway, Heidi was something like 27 centimeters dilated–I’m not really sure; I’m a guy–and the nurses were calling for the doctor. Unfortunately it was dinner time, and because I live with type-1 diabetes, I needed to eat. So I hurried down to the cafeteria to get some food. Fortunately, Heidi did a good job of clenching for 15 minutes till I returned.

By now my blood glucose had dropped really low, so I sat in a hospital lounge chair and began to eat. I wanted to be sure I had the energy I needed to remind Heidi how to breathe properly and anything else she ordered me to do.

Heidi, with all the compassion a Jersey girl after 32 hours of labor can possibly have, told the nurses that if I passed out from my insulin reaction to just shove me in a corner out of the way and take care of her. The nurses laughed but Heidi was very serious.

Just then the doctor walked into the room, just as I began eating my strawberry cheesecake. He quickly assessed the situation and said, “It’s time to have this baby!” He looked over at me eating dinner and inquired to no one in particular what was going on. When a nurse informed him that I had diabetes and needed to eat, he tapped his fingers on the side of the bed and said, “OK, so we’ll wait for dad to finish eating.”

Heidi did not agree with his prognosis. But you have to understand: she wasn’t thinking clearly at the time. I’ve never seen her so mad or heard her scream so loudly.

So I left the last few bites of cheesecake on the tray. Twenty minutes later we welcomed Jordan Michael Mack into the world. I got to cut the umbilical cord, which I did with a steady hand thanks to that cafeteria run.

The whole thing was incredible. Mom and baby were healthy and did well, and dad was able to finish those last two bites of cheesecake.

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MORE DIABETES-STORY HUMOR

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

Camp Hamwi and THE Shot

The Year I Was Banned from the Olympic Games

Diabetics in Love

 

Living Healthy with Diabetes Is Like Mountain Biking

I’ve learned a lot about living a healthy life with type-1 diabetes on my mountain bike.

Mike after fallNow, let me be clear. I’m not writing as an expert professional cyclist or an expert endocrinologist. (I’m not a doctor, although my wife does sometimes call me “Dr. Love.” Actually, that’s not true at all, but I wish it was.) I’m just an ordinary guy who has lived with diabetes nearly 43 years and is somewhat obsessed with riding my bike. Let’s put it this way: the guys in my mountain biking group used to call me “Crash.” (I had to earn my way out of that nickname by riding crash-free for exactly two years. I received a certificate and everything.)

I do know one thing: a vital skill in mountain biking is to look down the trail, past what’s right in front of you. When you look five to twenty-five feet down the trail (depending on the type of trail), you can identify potential hazards and challenges and create a plan of action before you reach them. Take it from me, constantly looking just ahead of your front tire results in a jerky, stumbling ride and some painful blunders.

It’s the same for caring for my diabetes. I can live either by default or design; in reactive or proactive mode. It seems to me that most people live most of their lives by default. In other words, life happens to them.They’re looking, figuratively speaking, just ahead of their front tire.

When I am struggling to keep my blood sugars under good control, I’ve learned that’s often a sign I am not being as proactive as I need to be with my health. I may not be getting enough exercise or I’m not testing my blood as I should or it’s been a while since I’ve seen my endo. (By the way, an “endo” is not a good thing in mountain biking. It usually ends in a “face plant.” And no, tulips are not a part of a face plant.) Or I’ve eaten an entire gallon of dark-chocolate-chip raspberry ice cream (because, after all, raspberries and dark chocolate are good for you), not that I’ve actually ever done that.

In mountain biking as well as in caring for diabetes (or anything, for that matter), we want to make decisions before we actually get there (wherever “there” is at the time). It helps to know where you are going, not just where you are at this moment. I talk to people with diabetes all the time, and many of them live in reactive mode. Their longest range plan is what they are having for lunch.

You’ve probably heard the old expression, but it’s true: A failure to plan is a plan for failure. And for those of us who live with diabetes, that plan for failure can be deadly.

When I’m mountain biking and I start thinking I might crash, guess what often happens? Yup . . . Wham! (Face plant … right into the tulips.) But when I am looking down the trail with positive expectations, the ride flows and is fun.

I see a lot of negativity among my diabetic friends. Some call this “realism,” but the truth is you can make your realism either positive or negative; it all comes down to how you think. When I am thinking negatively on my bike, I’m most likely to have a bad fall. When I’m thinking positively, the ride is fun.

mikebike2My life with diabetes is fun. It’s exciting, thrilling, adventurous. Yeah, I crash sometimes. Yes, sometimes I have “mechanical failures.” But as I do on my bike, I make the necessary changes, get back in the saddle, and keep pedaling!

I encourage you, whether you are dealing with diabetes or anything else in life, to take time regularly to “look down the trail.” Here are some questions to help you do just that:

  • What’s your long-term goal? (One of mine is to see my children get married and dance at the receptions.)
  • What are some mid-range goals? (One of mine is to ride a “century” [100 miles] on my road bike. I have a chance to do that this September in the Bike to Beat Cancer.)
  • What short-range goals do you have? (For instance, get my A1C below 7.)
  • What will you do to get there? What are your strategies and plans? (Ride at least 50 miles/week; test my blood at least 5x/day and send readings to endo; and so forth.)
  • Who is keeping you accountable for all this and who is your support system? (My wife, my friends, my cycling group buddies.)

All this helps me be prepared, so I don’t freak out at little challenges or even big obstacles along the trail. In other words, no more endos.

How are you doing? Are you being proactive with your diabetes care? Are you looking down the trail? What are some of your goals, strategies, and plans?

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.