Learn about Civica’s cheaper insulin and helping get insulin to people with T1D in Ukraine

Today I’m bringing you two stories in the news. I’m going to send you over to diaTribe’s newsletter since there’s little point in me rewriting their informative articles.

Nonprofit Civica Plans to Deliver Low-Cost Insulin – in a nutshell, Civica, a new non-profit Pharma with a mission to bring low-cost drugs to the public, has taken on developing low cost insulin. They’re hopeful to deliver in 2024. Read the article for more details.

Help Life for a Child provide insulin to people with diabetes in Ukraine – The Spare a Rose campaign, initiated by the Diabetes Online Community, has for the past nine years raised significant money for Life for a Child. LFaC provides insulin and diabetes supplies to people with type 1 diabetes in nations in need. Through March, under the auspices of IDF Europe, they will be sending supplies to Ukraine. Click on the link to help with a donation of any amount.

Today marks 50 years with type 1 diabetes. A milestone more of us are reaching.

I’m still in awe that the Joslin Diabetes Center gives medals for living with a chronic illness, or condition if you prefer. How progressive, how humanitarian, how kind, remarkable and inspiring. And I particularly like what it says on the back, “For 50 Courageous Years with Diabetes.”

I applied for my type 1 diabetes (T1D) medal a shocking eight years ago. I was writing about the medal for the Huffington Post and the woman I was interviewing encouraged me to apply. So I did. Of course, as I say at the end of the article, I only had to tell the husband where he was taking me for dinner to celebrate. But then I couldn’t have foreseen Covid.

You might want to know how it feels to cross the 50 year threshold. Of course it will be different for everyone. In truth, I was more giddy thinking about this day’s approach than how I actually feel today. But then that’s true with most things, isn’t it? The anticipating is really where the joy is. But I do feel proud, relieved, grateful, and somewhat empty. Maybe that too has to do with Covid. Were these normal times I’d be celebrating with friends all week, all month.

I do feel hopeful, however, for all who are behind me. In 1972 lying in my hospital bed, the cold doctor who attended me, gave me the 15 year shorter lifespan talk. Yet today many of us with T1D are living longer than people without diabetes. Largely because taking care of ourselves, we are healthier than the general population.

What follows is a bit stream of consciousness, various things, times and events that come to mind, for to do justice to 50 years of living with type 1 diabetes, I’d need to be writing a book. So, travel with me if you like for a glimmer of years gone by.

One of the first things that comes to mind is the historical gratitude 50 years has given me. You can only have historical gratitude if you’ve lived a long time with this disease. (Okay, yes, now I’ve said illness, condition and disease and still don’t know which is correct.) I was lucky, my diagnosis came after people needed to boil their syringes each day. I began on plastic syringes, not unlike those we still have today, although the needles were longer and not nearly as thin. My one remaining older syringe below.

Of course, then insulin pumps came, continuous glucose monitors ( I use Dexcom G6), DIY looping, and better and faster insulins. Even type 2 medications are being weighed for benefit for type 1.

The first few years after my diagnosis, still completing college away from home, after the honeymoon period ended, when I went to the doctor at the college clinic, the thought was I had type 2 diabetes (after all I was 19 not 9) and I was put on pills. That lasted until I graduated, moved back home and saw an endocrinologist. Horrified, he put me back on insulin immediately. Misdiagnosis is not an unusual story for those of us diagnosed at my age or older.

It wasn’t until I’d had diabetes for 30 years, when I was 48, that I went to a diabetes educator. I was getting married that year and wanted to be as healthy as possible for the two of us. Hmmm…is that a little like saying, “We’re pregnant”? Ah, but I digress. This is when I decided, having just lost my job, through no fault of my own of course, that I wanted to help others with diabetes.

I began by interviewing people with diabetes to capture their unique, and common, stories. Then I went to diabetes conferences to learn. Then I was invited to attend conferences to present what I call Flourishing with Diabetes. I wrote online for magazines and seven years for the HuffPost, this the article that went viral. I wrote three books and continue to write this blog. The last several years I’ve presented to health professionals at global conferences the Flourishing Approach. It’s an emergent way of working that creates safety, connection and trust between professional and patient, and tends to yield improved outcomes for both.

Over these past 20 years I have worked as an advocate, coach, patient expert, writer and innovator. Each year from the very first I would say with a sly smile, “I’m in the xth year of my 20 year overnight success.” And here I am, 20 years later.

The husband I acquired 20 years ago has been my biggest supporter. He has often accompanied me to conferences, sometimes presented with me, and always had, and has, my back. When there was concern about sharing one’s numbers from your Dexcom, we had only one incident. Looking at my Dexcom reading on his Apple Watch early in this experiment, he said, “You know your blood sugar’s 63.” I said, “Yes, I know, I’ve handled it.” He then said, “Does it bother you that I tell you?” I replied with a smile, “Not yet.” And it never has. I want someone to have my back.

I’ve had hypoglycemic incidents. Luckily only three were extreme, and luckily none needed a trip to the ER. One was in London, where I found myself in the middle of the night staring into the bathroom mirror trying to figure out what I was doing there. The 29 mg/dl on my meter let me know. Another was on Fire Island, where I’d walked much more after dinner than I expected. I had trouble locating my friend’s house where I was staying because my foggy brain couldn’t read the map on my iPhone. The third was after swimming in my friend’s pool where the husband was discharged for juice and spilled half of it running back up the stairs in his semi-panic.

But now, at the 50 year mark, for me it’s not about looking back so much as looking forward. Not in terms of how many years do I have left, but how easy or difficult will my diabetes be to manage? Today I can rely on a working brain and a husband. Who knows what the future will bring. I do know there is a small movement to address the many of us who are living long with type 1 diabetes and how care should evolve as we age.

There are so many things I could tell you. Maybe one day I will as I figure out how I want to move forward. But if you’re curious there is more than a decade of blog posts that precede this one, and tons of articles online.

All I know is today it is mild and sunny. The husband is on the other side of the living room on a conference call and tomorrow, the nicest day this week, we will go out for that celebratory dinner. Not at some posh place in Manhattan, but just as enjoyable, we’ll be sitting outside, under a tent that leans partway into the street, at our favorite local Italian restaurant.

I will tell you, as people say at the end of their lives, it went so fast. I suppose that explains this feeling of emptiness, a quiet shock. Can it really be 50 years, day after day, that I’ve been managing everything that living with type 1 diabetes entails, and of course, my blood sugar? I really can’t believe it. I guess that’s good, you know.

So on this auspicious day – it’s not lost on me either that it’s 2/22/22, (2 being the number of partnership, relationship and collaboration) I just want to say thank you for coming with me on this journey. Thank you Joslin for your whole heartedness. And thank you, each of you, who have crossed my path and allowed me and supported me to do this work.

Bezzy is the new name for social media dedicated to type 2 diabetes

Bezzy, from Healthline Media, has just created and released a flock of online communities for various chronic conditions, and one of them is type 2 diabetes. Bezzy is the creation of Healthline Media. You can read more about it here.

I think this is great as there are few online communities for people with type 2. The online space for diabetes often goes by the acronym, DOC, Diabetes Online Community, yet, I would guess 90+% of the communities are by and for people with type 1 diabetes. I get it. The label of Type 2 often comes with stigma, i.e. “You created this yourself!” and “fat and lazy” buzzwords. Maybe the world is slowly waking up to the falsity of these statements. Type 2 diabetes is a condition of insulin resistance and bad food, unsafe neighborhoods, illiteracy, healthcare deserts and genetics all contribute.

On a Bezzy site you’ll be greeted by writers who live with the condition, community members and “guides” and peer connections, empathy, support, resources and ideas for living well with the condition. More specifically you’ll find:

  • Daily live chats that offer ways to engage with other members, moderated discussions, and spaces for safe sharing. 
  • Access to content exclusive to Bezzy, including content franchises, essays, and tip-based content written from the lived experience of condition advocates, that helps members know they’re not alone. 
  • Bezzy’s matching feature pairs users with similar interests and characteristics on a daily basis who are likely to form deep connections. Some individuals have met in person, become best friends, and even fallen in love! 
  • 1:1 messaging is available for members who don’t feel comfortable sharing in a group. 
  • Facebook and Instagram live chats on social, community-focused programming, and narrative-driven storytelling offer a variety of new and interesting ways to interact.

In addition to type 2 diabetes, Bezzy’s communities currently include Multiple Sclerosis (MS), Breast Cancer (BC), Inflammatory Bowel Disease (IBD), Chronic Migraine, Rheumatoid Arthritis (RA), and Psoriatic Arthritis (PsA). If successful, there will be more communities coming.

Entrepreneur and data analyst gives you new, and easier ways, to participate in diabetes research

Ben Fershtman is an interesting guy. He’s the Head of Open Innovation at Israel Defense Forces Medical Corps and a health-tech entrepreneur. Ben contacted me wanting to share his new website. It makes joining diabetes research trials easier. When I asked Ben what moved him to create this service, since I know diabetes is often personal, he agreed. He has a few relatives with type 1 and type 2 and when he started looking into it, he realized the difficulties many people have getting proper treatment and devices. Working in medical innovation made it a natural.

To learn more about participating in research and trials, read Ben’s post below.

A few weeks ago, I (Ben) was speaking to my friend, Brenda, who was having trouble with hyperglycemia more often than she would have liked. “The rapid insulin just takes too long, I wish it was really instant,” she told me. Being able to bring down her blood sugar faster would help her live a more normal life without inconvenient interruption. 

As it turns out an ultra-rapid insulin treatment was beginning to be tested on humans. Brenda, who was interested in joining this research, struggled to figure out how to join the research on her own. That’s exactly why I created My Diabetes Research https://www.joindiabetesresearch.com/home, a new website that’s devoted to helping people with diabetes find and join diabetes research studies.

If you’ve ever considered participating in diabetes research, chances are you heard about it in the news or from your doctor. However, if your doctor isn’t conducting the research, how can you get involved? This is the problem that has kept our team up at night. Diabetes research is not only vital to understanding and treating diabetes, but it also can have benefits for participants, such as free treatment, payment to participate, and better information about their own health. 

When My Diabetes Research set out over a year ago to help more people participate in diabetes research, we wanted to make sure that the process was as easy as possible. We built our website, JoinDiabetesResearch.com https://www.joindiabetesresearch.com/home so that you can search for research studies and find the best options given your needs. We strive to help patients understand the risks and benefits of each study and to connect directly with researchers in order to enroll in the study.

This seems simple, but lots of patients struggle to understand which studies they qualify for. At times there are issues contacting the research team. And most problematic, is how few people are aware of the options available to participate in! Many research studies fail only because they can’t find enough participants. 

Across the U.S., researchers are conducting studies that can be as simple as a free eye exam to as experimental as stem cell treatments. Many efforts are occurring to better understand how exercise and diet affect blood glucose levels, which traits put people at risk of diabetes-related eye conditions and the Holy Grail — to cure type 1 diabetes. 

At the end of the day, research is important for everyone with diabetes and anyone willing to participate is a hero in my eyes.  That’s why I’m writing this, and why I built My Diabetes Research — to make research opportunities more accessible and encourage more people to take part. 

So talk to your doctor about joining a study, check our website to see what you might qualify for, and become a part of the change in your own life, and the lives of so many others. Slowly, but surely, I believe we’ll come to a point where anyone with diabetes will have far fewer obstacles to living a healthy life.

New cost-saving drugs website

Mark Cuban Cost Plus Drug Company’s online pharmacy launches with the lowest prices on 100 lifesaving prescriptions.” Cost Plus is a direct to consumer pharmacy. It reflects the current need, with 1 in 10 Americans needing to skip doses of their medicine due to cost. I need to credit my friend Scott Strumello who posted this on Facebook. I trust Scott, he’s all over the cost of diabetes medications and how companies make their money.

Scott also tweeted, “So far Mark Cuban Cost Plus Drug Company has already beat the price on rosuvastatin calcium 10 mg tabs (generic Crestor), AND I had bypassed my own insurer’s pharmacy benefit to buy it for less elsewhere. His cost: $7.50 for a 90-day supply, which is half of what I was paying.

As shown above for the diabetes meds, they don’t carry insulin presently, but there are a few type 2 pharmaceuticals you might do better on. For myself, I looked up Levothyroxine, which is the generic for Synthroid. Here, I have to say they were not cheaper than the cost-saving app, GoodRx. After paying $18 for a 90 day supply on my Medicare United Healthcare plan, I found on GoodRx I could get the same supply for just under $13.00. At Cost Plus, it’s listed for $4.20 – but that’s for a 30 day supply – so 90 days will cost you $12.60, which is just about what I got it for on GoodRx.

So while you may do better, when you look up what you want to price, you might want to compare it to Good Rx or any other cheaper cost drugs app. That said, given this is the online venture of a pharmacy business, I’d say it’s a bit of hope shining through the darkness of the overinflated cost of drugs.

A page on the Cost Plus website below

“There is no vials here,” said the pharmacist

Pam and her husband Dave in the Italian countryside

Late last year I got an email from Pam Saylor, a writer living with type 1 diabetes. Pam offered to do a guest post here for you. I’m always open to guest posts by the way. This story below is from Pam. Much like her travel book, Braving the World: Adventures in Travel and Retirement, Pam’s post takes us on a journey to the Vatican City with diabetes playing a major character. Sit back, relax, have a cup of tea and read on.

Thank you Pam.

§

It was hot and our bus moved slowly.  I lifted the hair off of the back of my neck and leaned towards the bus window hoping to catch a breeze.  The sounds of Rome’s morning rush hour traffic came in through the window—blaring car horns, motorcycles revving their engines, and the wheeze of buses stopping and starting.  I closed my eyes and fanned the back of my neck with my passport.  It seemed like hours but was probably only twenty minutes before I felt a gentle jab in the ribs from my husband Dave, who was sitting next to me.  Startled, I looked at him and he pointed at the electronic display at the front of the bus.  The next stop was ours.  We were on our way to the pharmacy in Vatican City to buy insulin—and I didn’t have a clue what to expect.  

Only a year before our bus trip to the Vatican City pharmacy, in 2016, early retirement unexpectedly became an option for Dave and me.  We jumped at it.  Dusting off the dream trip we had imagined for years, to live for one entire year in Italy, we began serious planning to make it a reality.   

Like giddy kids, we bought two one-way tickets to Rome.

But buying the plane tickets was the easy part.  Trying to figure out how life would work for me, diagnosed as a Type 1 diabetic only three years earlier, was harder.  Trip planning was thrilling and exciting, but I had a lot of questions. Would I be able to buy insulin in Italy?  Would it be affordable?  Would my prescriptions be accepted at pharmacies?  The unknowns of our dream trip woke me up at night. I couldn’t rely on the typical advice for short-term travelers and take “double the diabetes supplies that you think you will need.”  That advice didn’t apply to me.  I didn’t have a year’s supply of insulin to take to Italy.

As a confirmed planner and anxious list-maker, I researched every single detail that I could before we left the country in 2017.  I found an online group of expats in Rome who assured me that all Italian pharmacies would have insulin.  That was the good news.  They also told me that Italian pharmacies would not accept my American prescriptions.  That was the bad news.  Another helpful expat chimed in to tell me about the Vatican City pharmacy inside Vatican City.  This pharmacy not only accepted American prescriptions, but it had cheaper prices and lower taxes than a typical Italian pharmacy.  And so that is how, after only a few weeks of living in Rome, Dave and I came to be on a bus headed to the Vatican City pharmacy ready to test the advice of an anonymous online source and buy insulin.

Arriving in Vatican City, we hopped off the bus.  With passports and prescriptions in hand, Dave and I walked to St. Anna’s Gate, a little north of St. Peter’s Square where the Pope held his weekly outdoor audience.  I went first through the gate and handed my paperwork to the guard on duty.  Slowly and carefully he examined the papers and then handed them back.

“You must leave.” The guard sounded stiff and unhappy.  My stomach dropped and I looked at Dave with wide eyes. Now what? The guard continued talking. “It is not yet time to open.”  I glanced at my watch.  It wasn’t 8:30 yet.  We left and after an espresso, returned to the gate where the same guard slowly and carefully examined my paperwork again—as if it might have changed in the last 10 minutes.  These security guys did not mess around.

Once through the gate, we went into the small office next door and handed over our passports to a guard behind thick bullet-proof glass in exchange for a clip-on visitor’s pass.  Following the signs outside, we walked to the building marked Pharmacia and entered.

The room was already full of people.  On a screen near the ceiling, digital displays flashed red numbers.  This was a familiar setup—like the deli counter at the grocery store back home.  I needed a number.  Squeezing past packed bodies, already smelling faintly of sweat in the hot room, we got to the ticket machine and I pulled out a numbered ticket.  Waiting for my turn with a pharmacist, I wandered around the room looking at the shelves of cold medicines, lotions, and soaps for sale.

When my number flashed on the overhead screen I hurried to the window and handed my insulin prescription to the pharmacist in the white coat.  He disappeared into the backroom and returned with a box of insulin pens instead of the insulin vials I used to fill my insulin pump.

“Do you have insulin vials?” I asked.  Opening my purse I pulled out the small bag of diabetes supplies I carried.  I handed my vial of insulin to the pharmacist.  He turned it over in his hand and read the label, frowning, he disappeared again into the backroom.  When he came out, talking to another man in a white coat, I saw them shaking their heads.  Returning to me, he said, “There is no vials here.”

Some insulin was better than no insulin and I knew I could use the insulin pens to fill my pump, so I accepted the pens in place of vials.  One box of NovoRapid a/k/a NovoLog insulin pens (five pens per box for a total of 1500 units of insulin) cost a total of €46 or $56.

After paying for my insulin, I found Dave in the crush of people and we left together to collect our passports and catch the bus home.  I bounced down the pharmacy steps into the warm sunlight with the all-important box of $56 insulin in my purse.  

We still had eleven months of travel in our futures and I did not know then if I would be able to buy affordable insulin down the road.  Visa problems had forced us to change our travel plans and now our year-long dream trip would include living in Croatia, London, and Venice.  

But my trip to the Vatican pharmacy gave me confidence that things would be all right, somehow, one way or another.  I would find a way to solve problems.  This adventure didn’t come with an answer sheet and that was okay.  I would figure things out one day at a time and wasn’t that what diabetes had already taught me?

§

Pam is a retired paralegal and a contented travel addict. Her book, Braving the World: Adventures in Travel and Retirement, is her first book and is available on Amazon at http://www.amazon.com/dp/B091BCNVWQ To see pictures of her year of travels, visit Pam’s website at www.bravingtheworldbook.com

How to deal with higher blood sugar from a cortisone shot

As much as I know about diabetes, I really wasn’t sure how to deal with the blood sugar rise from cortisone shots. And yes, I’ve had cortisone shots before – one for my trigger thumb last year, one some time ago for another sticky finger, and most recently shots for a tailbone that decided to grow a bone spur, or at least make me aware one was there.

I got the cortisone shot Friday afternoon around 2:30 pm and within a few hours I was already watching my blood sugar rise, and rise, and rise (on my Dexcom CGM). And even though I was injecting half unit, after unit, after half unit, it was like I was treating with water. I really got the visceral experience of being insulin resistant, which I am not. I was fearful, frustrated and fretting.

Of course the fear is of taking too much insulin and when it will all kick in, particularly while sleeping overnight. Through the evening my blood sugar rose to just over 180 mg/dl and then came down to about 167 and hovered there all night. That afternoon and evening, all I did was keep dousing myself with extra insulin, and watching the numbers on my CGM.

The next day I googled what to do about this. Surprisingly, this did not occur to me the first day, fool that I was. The best article that I found was on Healthline, “Yes, Steroids Spike Blood Sugars – So Beware.” The bottom line is, as diabetes educator extraordinaire Gary Scheiner, actually had emailed me the last time I had a cortisone shot:

– most people need to raise their basal insulin by 50% starting about 6 hrs post injection, then double their basal on days 2 and 3, then taper down.  Some need to triple their basal.  The humalog doses can remain as-is (correct any highs and cover meals as usual); the extra basal takes care of the insulin resistance caused by the steroid.  

So that’s exactly what I did. I took my Tresiba dose of 6 units/day up to 9 units for days two and three, and watched it. Today, day 4 I’ve dropped it down to 7 units and tomorrow anticipate going back to 6. Watching my blood sugar today, it looks like it’s back to normal.

This simple tip has worked like a dream. Still, it’s scary when you normally take a small amount of insulin and merely think of doubling or tripling it let alone do it! Terrifying actually. But unfortunately that’s what’s required for most of us when we get a cortisone shot.

I hope this offers some help next time you get a cortisone-induced rise in your blood sugar. I’m confident you’ll sleep a whole lot easier. I know I have.

Connected to the circle of life: Go forward with kindness

I was going to write a sort of year end wrap up and post it last night, but perhaps it was fortuitous that I was at my mother’s house and so could not access my blog. Perhaps it is better that I just post today an email I got in the last few days with a sentiment I so appreciate, a way to go forward into 2022.

The email was an email blast from a site/podcast called Sounds True. Sounds True was founded by Tami Simon and she’s the interviewer on the podcast. I have enjoyed many of the “new age,” spiritual interviews I’ve listened to. I also notice that during this time of incredible distress for the world and us, pockets of spirituality are sprouting everywhere. So I’m going to share this email with you on this, New Year’s Day.

Dear Riva,

I was on a solitary retreat in the Colorado mountains when I discovered how a very small action can make a huge impact. 

I had been meditating for several days as part of a 10-day solo retreat. And I had gotten in the habit of taking a walk each day toward the sunset hour when it felt like it was definitely time to stretch my legs and get outside.

On one of these walks, I saw a person in the distance headed toward me. I hadn’t seen a human being for several days, and I felt a strange adrenaline rise as I noticed him in the distance walking in my direction. This person I didn’t know continued to approach, and when we were about 10 feet away from each other, this stranger smiled at me with a genuine sweetness … and kept on walking.  

That was it; that was the small action. 

And for whatever reason (maybe because I had been meditating all by myself for several days), this human act of softly reaching out to me with a gesture of connection broke my heart right open.

Your words matter. Your phone calls matter. Your emails matter. Your genuine smile matters. The way you hold space for another matters. With the smallest of gestures, we lift each other up

Here on the last day of 2021, I want to remind us all that we matter … to each other. My sense is that we have no idea how many people we touch in small ways with huge impacts. Thank you for every act of compassion you share. I feel grateful to be in connection with you.

I’m committed to bring more kindness into ordinary days. Little feels more important right now. As Simon says, “With the smallest of gestures, we lift each other up.” As I have often said, even with diabetes, look up and see your possibilities.

Happy New Year

Dear Santa, will you please take this diabetes away?

I’ve posted this six previous times on this blog, the first being in 2009 best I can tell. Hey, when something’s good, enjoy it again. Merry, merry, happy holidays.

Dear Santa,

All I’d like this Christmas is for you to take this diabetes away. I’m so tired of it already. All the time stabbing my fingers for blood and guessing when my sugar’s too high or too low.

Now that I’m in menopause I can barely tell whether I’m sweating because I’m losing estrogen or because my blood sugar’s crashing at 50 mg/dl!

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 lie down and shoot myself. Please, please, Santa, would you take this diabetes away?

Sincerely,
Riva

***
Dear Riva,

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: although you’ve already opened your holiday gifts, go back and look under your Hanukkah 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 Year’s while you have some down time? Then you can start the new year fresh.

Best wishes,
Santa and the gang

***
Dear Santa,

A gift in my diabetes? What are you, crazy? Meshuggah? Thanks, but no thanks!

Riva

***
Dear Rabbi,

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 the Torah 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 go shopping, right?

Please write soon,
Riva

***
Dear Riva,

Santa and I just returned from the Caribbean, and he told me about your difficulty. He said he told you to 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 that 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 that there is a gift in everything if you look for something positive that 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 healthfully. 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 million mansion in Jupiter, Fla. — right next to Burt Reynolds! Everyone’s plotzing! The house was in foreclosure so they have even more money to decorate!

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.

Shabbat Shalom
Rabbi, Local Union 107

***
Dear Rabbi,

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 quote meant that we are the source of our happiness, that happiness can only come from inside us, regardless of what happens in our lives. Hmm, 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.

My new treat: a protein shake for lunch

I am not one of those people who enjoys drinking my meals. So when my friend told me that for the past few months she’d been making and enjoying a protein shake for lunch, I thought, yuck not me. But, I am now among the converted.

I tried it largely because many days I do a version of intermittent fasting. I make a cup of coffee when I first wake up. Yes, tis true, I put cream in it, but I sort of don’t register this as breaking my fast. Some will argue, but so be it. That cup of coffee with cream around 8 am fills me up until around 10:30 or 11 am. And here’s something interesting: It’s not that I’m trying not to eat, I’m literally just not indulging in the habit of breakfast, and so find I’m not hungry those first few hours of the day.

So, most days I eat my breakfast – yogurt, a half slice of cinnamon coffee bread (I make myself), a spoonful of almond butter and two spoonfuls of tahini – around 11 am. That means I’m once again not hungry at the proverbial lunch hour. Instead around 2 pm I have an edge of appetite and make myself a protein shake. It’s just perfect to fill that little hole in my stomach with something filling, nourishing and tasty. There are a zillion protein shake recipes online. Take a look.

My shakes (only been doing it a few weeks) are a variation on a theme. Typically, I use a third of a banana, to keep the carbs low and add some berries, which are already low in carbs. I add a few spoonfuls of plain greek yogurt, a cup of almond milk, the green in the picture above was made green by adding some red Swiss chard, (you can add any green veg that doesn’t have a strong taste, many use spinach), then, while the serving size appears to be one scoop, I’m using half a scoop (after all, I am not protein deficient) of my Plant Fusion vanilla protein powder, 4 ice cubes (the ice cubes add heft) and I blend it all in a blender my mother likely gave me when I moved into my first apartment after college.

There are a lot of protein powders out there. I bought this one I’m using above in Whole Foods but I see they also sell it on Amazon, which is the link I included above. I bought PlantFusion because I read all the nutrition labels of all the choice, and this one seemed to hit the trifecta of low carb, healthy ingredients and price.

When I told my friend I was making using that old blender my mom gave me, she said, “Why don’t you get a Nutribullet?” Whereupon I replied, “Why should I? This is doing all I need!” The defense rests.

So if you’re tired of what you’re eating for lunch, or you’re experimenting with different ways of eating, you might consider trying a protein shake for your breakfast or lunch, whatever suits you. My prejudice of not wanting to drink a meal has disappeared. It’s so tasty, satisfying, filling and nutritionally sound. It’s been a wonderful discovery for me, and I don’t see that stopping anytime soon.