Now that the hazy, crazy shopping days are over, I recall an incident that occurred three years ago and seems apt to this story. On the brink of winter, I bought a bargain-priced pair of ear muffs off one of those typical tables of cheap goods on the streets of Manhattan. A month later trying to maneuver the cheap plastic band of the muffs over my ears on an absolutely arctic day, a few hours later I realized my bargain ear muffs had knocked my very expensive, designer earring out of my ear. Mind you, this is not how I typically dress, but I was on a job interview that day. The point is my $5 ear muffs cost me big time in the end. Bigger point? While shopping is a fun sport, and the odd bargain a real coup, quality is enduring and you usually get what you pay for. So now that the din of 2007 is quieting and 2008 is revving up, don't forsake quality when it comes to your health.
I thought of our shopping behaviors and how we regard our health and our treatment regimen because a pharma rep. recently shocked me with the news that many doctors don't prescribe insulin to their type 2 diabetes patients for fear their patients will shop for another doctor. Call me naïve, but it never occurred to me a doctor would prescribe less than the best treatment for his or her patients for fear of losing them.
If insulin will better control your blood sugar and is the best treatment for you, yet you'll shop for a doctor who'll just tell you what you want to hear and, as many seem to be doing, become your pill pusher, that to me is the worst bargain - a Faustian bargain - a deal with the devil.
The rep gave me a specific incident where he was talking with a doctor, a type 2 himself, who finally after having so much trouble managing his own blood sugars, "threw in the towel," in his words and went on insulin. When the rep asked him how insulin was working for him, the doctor said, "It turned out to be the best thing I could have done. My blood sugars are much better and I feel so much better." "So," the rep asked, "now you prescribe insulin more often for your patients?" "No!" he replied, "If I did, they would leave me and go to a doctor around the corner who will give them the pills they want."
Let's face it, that great sweater in Filene's basement may make you the toast of the party circuit but how many seasons is it going to last? With a sweater, who cares? With your health, I'm betting you want to see a lot more seasons ahead. Choose quality - in your doctors, your treatment, and in general, your quality of life. While I'm not much for New Year's resolutions, the new year seems the perfect time to explore what options will give you the best outcomes for your diabetes, both today and tomorrow.
Looking for a bargain, a short cut, the easy way can cost you dearly in the end. I know. I really miss those earrings.
Pig power on research front
No, not your seldom seen Uncle Frederick. A real pig. Later today when you raise that forkful of honey-glazed Christmas ham, think about raising your own pig for diabetes research.
You can sponsor the care and feeding of very special pigs being raised to cure type 1 diabetes. Dr. Bernhard Hering, Scientific Director of the Diabetes Institute for Immunology & Transplantation at the University of Minnesota, and his team, recently documented a medical milestone. They found pig islet cells transplanted in monkeys reversed diabetes. Now a group of venture philanthropists called The Spring Point Project (SPP) are collaborating with Dr. Hering to raise the next super-pigs and get their cells into clinical trials with humans.
Together, researchers and SPP are raising these genetically superior pigs to produce a large, thriving supply of islet cells. Compared to human islet cells, pig cells are less prone to rejection. They are also building the pig house of all pig houses. In research terms, the biosecure pig facilities. Philanthropic gifts are the only source of capital for the project and that's where you come in.
Check out SPP's donation page. Isn't this truly a great gift for that diabetic someone in your life? Already got them something? Make your donation in the spirit of a new year that may really hold new promise. It's exciting news on the research front, and if we're lucky, in a few years this may truly be the gift that keeps on giving.
Checking in on Amy's blog this afternoon, reading her story, In Which I Contemplate the Details, I feel the type 1 bond wrap snuggly around me and spur my fingers to be part of the, "Try as hard as you might, sometimes you have no idea where you're going to land!" club.
Yesterday I awoke with a blood sugar of 63. No scare there, I felt perfectly fine and I am of the group who like numbers on the lower side of 100 rather than the higher side. I took my usual 3.5 units of Humalog for my steel-cut, slow-cooked oatmeal I make every morning with its dollop of plain, low-fat yogurt, tablespoon of peanut butter, hit of cinnamon, sprinkling of flax seed and wheat germ.
An hour later I was trembling behind my computer. My brain thought, hmmm... low blood sugar? But it was so out of the ordinary following my everyday routine that I ignored my brain's suggestion, and invited this one, it'll pass. But ten minutes later it hadn't and I couldn't ignore it so I gave in, got up, and tested. 56! Dang, 56 an hour after breakfast! How is this possible. Isn't this when all those lovingly prepared oats are rushing into my cells raising my blood sugar?
My husband asked what I thought happened. He suggested maybe it's the few pounds I've lost. Maybe I'm more insulin-sensitive. Nice try, honey, but those pounds have slowly and gradually sloughed off over the last year, nothing's different today than it's been in months. Maybe, he suggested, you mixed up your insulins. Of course, I really had no way of knowing, except that if I had I would now be in a very deep coma and not participating in this conversation. I was completely flummoxed, and then I knew.
I had met a friend for dinner the night before, and while I ate what I typically eat, and enjoyed the same amount of the grape I typically do, I did do something different. I power-walked home. A solid 40 minutes. And there, in that desire to be even healthier, I created a sustained drop in my blood sugar that carried over to the next morning, and most of the day.
So, as another voting member of the blood-sugar-blues-gang, sometimes you just don't know why you're 56 one morning and 186 the next. Sometimes trying to do all the right things, you mess it up even more. But something I know that will always be true is while I didn't ask to be in this diabetes club, I'm awful glad for all the fine company.
Staring out the staff lounge window at the Cumberland Hospital in Fort Greene Brooklyn, just outside the auditorium where I am going to speak, I watch the traffic move along the Brooklyn Queens Expressway. Manhattan's skyscrapers sit just beyond. I look up at the sky and whisper, "Thank you for where you have brought me." This is my second presentation in my native Brooklyn. I'm not being so literal as to be citing Brooklyn in my thanks, but on the larger canvas of my life, to be doing this work.
I am critically aware in this moment that you never know what life has in store. Where you might be a year from now, five years from now. Surely, I never could have guessed I'd be standing in a hospital staff lounge about to speak to a group of fellow diabetics to motivate them toward better diabetes management. Not much more than five years ago I gave my diabetes management little thought.
I always wanted to teach people that our lives are the projection of our thoughts, and so we should plant the ones we truly want to reap, and accept our gifts and believe in our dreams. I just never knew sharing these ideas would have anything to do with diabetes. Honest, never.
When I speak to audiences I stress shifting their focus from the burden of diabetes to the rewards of doing the work — whether it's to spend time with the grandkids, have more energy, pursue a beloved hobby or second career, or give back to the community. Most of diabetes education is about numbers, but the fabric of our life is mostly our thoughts and feelings.
Now at Cumberland Hospital I have finished my hour presentation and a woman raises her hand. After apologizing for coming late she says, "Maybe I missed this but how do you do it? How do you manage your diabetes so well?" The side conversations stop and the room quiets. Everyone is fixed on me. I begin listing all my tricks: my daily one hour power walk, using smaller plates, choosing more veggies and fiberous foods, sweeping most of the carbs out of my diet, and as the preacher in me takes over, the knowledge that my care is entirely up to me and that I don't harbor a single doubt that I am committed to my best health.
18 pairs of eyes hold mine seeking answers from my passionate pontification. I wind down realizing how revved up I am. This rag-tag group of African American type 2 diabetics, one in a wheelchair, one with a cane, who when I began my talk seemed to only half listen, now applaud this slim white woman. I smile shyly almost shooing away their gratefulness out of embarrassment, yet I know they have been moved and the greatest gift I can give them is to accept their gratitude.
This is what they don't get from their doctor or their CDE — the understanding and insight of someone who lives where they live and has conquered the demons diabetes throws at them — at least most of the time. Moreover, many people I speak to are weighted down and held fearful by the loss of family members who have died from diabetes or those currently struggling with its complications. I try to bring them to a place where they can see that the possibility for their life is of their own making, not the legacy of their family members.
Last year I learned something about my own family legacy. I interviewed my parents to get their take on what it was like for them when I got diabetes at 18. My mother told me something I never knew. "When you were diagnosed," she said, "my heart broke." Your father's mother died in her fifties of a heart attack from diabetes and just before it happened they were going to cut off her leg. All I could think was this would be your future." I was shocked to hear her say this, both because it was a revelation and by the information itself. But now that I've addressed enough audiences where diabetes is rampant in their families, I am grateful I didn't know.
Maybe if I had known what happened to my grandmother, who died before I was born, I would not have believed I could be as healthy as I am. Maybe I would have believed my grandmother's fate would be my own, as so many people with diabetes similarly believe. Maybe not knowing allowed me to manage my diabetes and expect that if I did it well I'd be well. In fact, I believe diabetes can be a great stimulus to creating a healthier and happier life rather than falling victim to it and all the negative messages around diabetes. But maybe I would have been derailed on my way to these thoughts if I'd known what happened to my grandmother.
I am pretty healthy after 35 years living with type 1 diabetes and I am resolute that I will continue to control what I can to have the best health that I can. It's never been a secret to me that we create what we expect. Truth be told, that's the good news and the bad. If you catch your thoughts more often and plant the ones you want to sow, I believe you can weight your fate for the better. Ah, see, I am teaching people just what I thought I would so many years ago.
At the North Pole Station
All I'd like this Christmas is for you to take this diabetes away. I'm so tired of it already. All these finger sticks and guessing when my blood sugar’s high or low. Now that I'm in menopause I can barely tell if I'm sweating because I'm losing estrogen or my blood sugar's crashing at 50! And, can we talk...I mean the constant figuring out how many carbs are in a ravioli or bread stick or that fried calamari that will be at the company Christmas party. Some days I just want to lay down and shoot myself. Please, please Santa, would you take this diabetes away?
I'm very sorry you're having a tough time during my favorite season. I only want people to be singing carols and drinking eggnog and feeling good cheer. Unfortunately, it says in my contract, that I'm not allowed to interfere with life's natural occurrences. So here's my suggestion, after you open your holiday gifts, look under your Hanukah bush for the gift in having diabetes. You may have to spend a few days looking so why don't you schedule it for the week between Christmas and New Years while you have some down time? Then you can start the new year fresh.
Santa and the gang
A gift in my diabetes? What are you crazy? Meshuggah? Thanks, but no thanks!
I seek your wise counsel. I wrote to Santa to take away my diabetes but he wasn't helpful at all. Surely you who have studied so much and represent our people who have suffered throughout history can help me with this awful diabetes. It's such a strain, Rabbi. I have to test my blood sugar when I really want to be lighting the sabbath candles. I forgot all about the High Holy days this year because I was so busy counting carbs in the Challah, bagels and honey cake. Rabbi, please, what solace can you offer me? What words of wisdom? Surely you would tell me to just forget about this diabetes thing and study the Torah, right?
Please write soon,
Santa and I just returned from the Caribbean and he told me about your difficulty. He said he told you you should look for the gift in your diabetes. I concur with Santa, there are many gifts to be found in diabetes if you look. For one, my child, you won't have to drink the traditional Manishewitz holiday wine anymore. The Counsel all agree it is much too sweet. Bring out the Chardonnay!
When Santa asks you to look for a gift in your diabetes, he is not saying this because you are not Catholic and he is not bringing you anything, although this is true. He is speaking like our brothers the Buddhists, who profess there is a gift in everything if you look for something positive it can bring into your life.
Let me tell you a story my child. My own Aunt Sheila had diabetes and after she stopped kvetching, she went to a spa and learned how to eat healthy. She shopped along Rodeo Drive and bought a cute little jogging outfit and started running. On her jog along the ocean she met her fourth husband, Marvin, and they're very happy. They just moved into a $6,000,000 mansion in Jupiter, Florida -- right next to Burt Reynolds! Everyone’s plotzing! Darling girl, find a gift in your diabetes, because to be honest, since you're not orthodox, and all I have are these great wigs I got on sale from my cousin Schlomo, I'm not bringing you anything either. And really, it's not very pleasant to whine.
Rabbi, Local Union 107
I thought about what you and Santa said and have decided to become a Buddhist. I picked up the Dalai Lama's book, The Art of Happiness. He says, "Happiness is a butterfly, which when pursued, is always just beyond your grasp, but which, if you will sit down quietly, may alight upon you." I told my friend, Joe, I like butterflies and I like the robe, so these aren't bad gifts. Joe said the quotation meant that we are the source of our happiness, that happiness can only come from inside us regardless of what happens in our lives. Hmmm, I said, maybe I need to learn more. So I booked a flight to Tibet. Now if only I didn't have to drag all this damn diabetes stuff with me....ohm...ohm...oy. riva
Leopard, tiger, you get the idea -- one scary cat, waiting
The Friedman Diabetes Institute, part of Beth Israel Medical Center, opened last month in Manhattan. They’re located at 317 East 17th Street on the 8th Floor. All you need is a doctor’s referral to make an appointment and avail yourself of their free services. There are diabetes education classes and consults, as well as a nutritionist, exercise physiologist and diabetes nurse educator at your service. Did I say free?
December’s calendar shows weekly exercise classes being led by High Voltage, fitness guru whose 'Energy Up' program is helping school age kids in New York City get fitter. Trust me, there’s no other name for her spirit and passion. There are support groups for type 1s and type 2s, classes in medications, healthy holiday eating and footcare.
Did I say all this is free? What are you waiting for? If you live in the New York City area run on those feet you want to protect and learn, learn, learn -- check out your heart, your diet, your knowledge, make some new friends and get started on a healthy right foot in 2008.
Since the 1990’s more diabetes clinics have closed in New York City than are open. This is one of the few centers we have. Did I say it’s free?
Note: I found this quote on Scott's Web log and as I think about getting the information you need to be healthy it seems so apt:
"Living with diabetes is like living with a tiger. If you feed it, groom it, never turn your back on it; you can live with a tiger. If you neglect it; it'll pounce on you and rip you to shreds." By Wil "Printcrafter"