It’s currently only offered in 5 states — Florida, Maine, Vermont, Ohio, and Delaware
It will be extended to 6 more states later this year
Health care and other services are provided by phone, text, and video and include online appointments with an endocrinologist, certified diabetes educator, registered dietician, and diabetes supportive counseling.
There’s support for continuous glucose monitoring, mental health support, assistance for paying for supplies and peer guides
The program is funded by Leona M. and Harry B. Helmsley Charitable Trust
Happy new year everyone, or as someone said maybe we should say, “Happy Now Here.” The point being that we focus on the present moment, not what’s to come over this next year. With that I want to share a health discovery I’ve made that’s leading me into this new year.
Two weeks ago I went to the dentist for a regular cleaning. Actually I went to a dental hygiene school where a graduating student worked on me. She said, which I hadn’t heard before, that I have mild gum disease. Basically I have receding gums around a number of my teeth. While they don’t bother me, like I’m not sensitive to hot or cold, or have gums that bleed, the notion unnerved me — and it sent me deep down the rabbit hole researching how to take better care of my teeth and gums.
In this rabbit hole I discovered Dr. Ellie Phillips, a dentist who has practiced for 50 years, and recommends a very different system to gain our best oral health. Hint: it doesn’t include flossing and dental cleanings. In fact, she doesn’t believe in them. Here’s her website and she has a plethora of videos on YouTube.
I’ve learned from her the importance of mouth health, how it affects the rest of our body including our sinuses, heart, it even can influence arthritis and osteoporosis. And I’ve learned a little diligence with a particular toothbrush, toothpaste and mouth rinses can neutralize bad bacteria in your mouth and have the good bacteria flourish.
I have committed myself to follow her complete mouth care system for six months and see what results. The one hour video I just linked you to takes you through what products (all grocery products) to use and what follows what. You can quickly see what she’s advocating, her system, outlined in this free booklet. But watch some of her videos so you understand where she’s coming from.
Literally she hails from the UK where she saw her share of oral health horrors. Then, working at a dental clinic in Switzerland, she learned of a remarkable product that’s an essential part of her oral health system. It’s renown in Europe for neutralizing acidity in the mouth, which creates a hotbed for the growth of bad bacteria. It’s xylitol, yes, a sugar, but one that doesn’t act like sugar, and I can attest will not throw your blood sugar. Here’s a quick Dr. Ellie video on xylitol. The husband, who is Dutch, told me his good friend, who is Finnish, grew up chewing xylitol mints and gum. It’s part of healthcare in Finland and the Scandinavian countries.
Like many of us, Dr. Phillips is a health advocate who is bucking conventional norms and advice in an industry set up to prosper from repairs, not prevention. I’m quite excited to see how this experiment goes. I would encourage anyone who wants better oral health to give it a try.
Note about xylitol from Dr. Phillips, ‘…while xylitol, a sugar alcohol, is generally considered safe, consuming too much of it can lead to digestive issues like gas, bloating, and diarrhea for some people, so it’s important to introduce it gradually (if it bothers you) and monitor your body’s response; however, she also notes that xylitol can actually be beneficial for gut health by feeding good bacteria in the digestive system when consumed in moderation.’ You can also use xylitol crystals explained here.
I posted this letter for the first time many years ago, and then a few more times in subsequent years. In truth, given what we endured this year, 2024, there are many more things I’d ask Santa for, but I’m going to keep my request as simple as it always was.
Dear Santa,
All I’d like this Christmas is for you to take this diabetes away. I’m so tired of it already. All these injections that sometimes leave me black and blue and decisions I have to make. 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?
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, 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.
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 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,
riva
Dear riva,
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.
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 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
With all the changes to healthcare insurance policies I don’t know anyone who isn’t struggling to figure out what their best choice is next year. At least those of us who don’t have an employer who pays our healthcare.
I can’t offer you much counsel other than googling the topic to death and seeing if a Medical health broker can help inform and guide you if you’re over 65.
I’ve been doing both, as well as consulting with my friends, all in similar confusion and disgust. Thus the exhaustion.
Yet thought this little illustration was worth sharing if it brings a smile. Enjoy the day and we’ll keep keepin’ on through it all.
I’ve had type 1 diabetes for 52 years. You may know that. Diagnosed at 18. I was told, like almost anyone diagnosed with type 1 diabetes in any year, “We’ll have a cure in five to ten years.” Well, of course we don’t. Nor do I actually expect one in my lifetime.
That’s not to say I’m not grateful for all the advances we have: better insulins, faster insulins, peak less insulins, smart insulin pens, continuous glucose monitors, insulin pumps now cozy with continuous glucose monitors, looping etc. Most of these advances have come in the past decade. Somehow speed begets speed. Advance begets advance.
Yet, still each year we stand up tall and honor a single day in the year when we attempt to bring awareness to this condition that many of us have lived with a very long time. I’m sure that’s better than not doing so, but it feels like it feeds a complacency. It quiets the masses.
I’d rather we were doing more, if that’s possible, I don’t know. What I do know is, in part, these campaigns promoting diabetes day with blue balloons and roses and the sharing of stories are lovely for the newcomers to our ranks, but this old rank and file member feels these efforts carry a whiff of distraction because we’re still so far from that original promise.
In all honesty, I had no idea when I began writing this post that I’d end up here. I expected to share with you the campaign that Breakthrough T1D (formerly JDRF) is running this laudable day and extend the opportunity to participate. So here it is – ‘What do you want T1D breakthroughs for?’ And, yes, that’s nice.
Yet, wouldn’t it be nicer to no longer have a World Diabetes Day because there’s no reason to recognize an illness that no longer exists.
To my fellow diabetes journeyers, let’s give ourselves a break. 24/7 for a lifetime managing diabetes is really too much to think about. The only way to get through is one day at a time; sometimes one hour at a time. In solidarity, to the ups and downs, the burdens and blessings, the troublesome and magnificent journey.
I’ve spent the past twenty one years speaking to people with diabetes and health professionals around the world, typically about the emotions that come with living with diabetes – and how to flourish.
November 8th and 9th I’m the closing speaker at the Diabetes + Mental Health Virtual Conference. Ifyour mental health is worth $50 you should be there. Health professionals will earn 7 CEUs for attending. As a caregiver, you’ll gain new insights, and tools, how to support your loved one.
This is the third year world experts are gathering online to help us deal with: eating stresses, general and specific fears, perfectionism, stigma, diagnosis trauma, the burden of tech, anxiety, depression, shame, having tough conversations. This is a mecca in the all-but-desert of our diabetes emotional world.
The on-stage experts are too numerous to name, so take a look and also see the agenda. As the closing speaker for the conference, I will share with you what I’ve shared around the world, that we can, and how to, flourish with diabetes. Like ‘Redraw the Frame’ for instance. And, I’m sharing simple calming exercises to stay safe and clear-thinking when you feel overwhelmed.
I don’t recommend things often or lightly but you deserve to live your life less burdened by the ‘scaries’ of diabetes and more knowledgeable and able to manage them when they come.
I remember having this conversation years ago with a friend, fellow type 1 and doctor. He said to me, and I didn’t want to hear it, “Your CGM isn’t going to be accurate or precise in the way that you want it to, rather it’s going to tell you about where you are.” Why, I thought, can’t it tell me I’m 106 or 202 or 57 with pinpoint accuracy? Well, I get it now.
Wearing the Freestyle Libre 3, that delivers blood sugar (although it ‘s really interstitial fluid) results every single minute, I can see how it isn’t precise. Not in that machine-like way we think of precision. One minute I’m 104, next minute I’m 108, next minute I might be 105 or 119. And I have learned to take a pause before I determine if I need to do something about where my blood sugar is.
It’s mind-boggling to think what in the world is happening in my body for these moment to moment readings to be ever fluctuating like this. I don’t know. What I do know is you can’t think any one number is perfectly it. So I am learning to slow down a bit, watch the numbers and look at the trend. That’s really what CGMs are all about. Showing you trends. Indicating about where you are and if you’re climbing or bottoming out.
As I was keeping an eye on my CGM today, I just thought this was worth mentioning.
“In July 2024, a 33-year-old woman with type 1 diabetes was boating on a hot day when her insulin delivery device slipped off. By the time she was able to exit the river, she was clearly ill, and an ambulance was called. The hospital was at capacity. Lying in the hallway, she was treated with fluids but not insulin, despite her boyfriend repeatedly telling the staff she had diabetes. She was released while still vomiting. The next morning, her boyfriend found her dead.”
Above is the opening to an article written by my friend, journalist, fellow type 1 and diabetes advocate, Miriam Tucker. It appears in the August 16th edition of Medscape, “What Every Provider Needs to Know About Type 1 Diabetes.” The article goes on to highlight other cases and situations where lack of knowledge about type 1 diabetes can create life-threatening situations.
Recently I’ve had a number of tests to check the health of my heart. I’ve had high LDL the past few years as do my parents and brother. My clean, low carb diet and exercise routine of walking every day 45-60 minutes and two weight training gyms classes a week has not improved my LDL. It is genetic, not dietary, as for many other people.
The last procedure I had a week ago was an angiogram. Because I couldn’t eat after 8:30 am, my blood sugar was trending low all day. The procedure that was suppose to happen at 1 pm didn’t happen until 4 pm. Three times during those hours I’d had to ask for a few sips of juice.
In the room where they do the angiogram, I had to surrender my phone, where I was hawkishly watching my CGM numbers. When the procedure began I was at 69 mg/dl. I let all the medical people around me know and they put the phone where we would be able to hear the alarm. I trusted stress would soon kick in and kick me up.
Like in my last post about advocating for myself, I believe we owe it to ourselves, our fellow type 1s and our health professionals, who in their heart want to help us, to educate. Unless a provider specializes in endocrinology, it’s unlikely they will have received much, if any, education about type 1 diabetes.
You can be that education. If you’re comfortable, use your interactions with health professionals to share what living with T1D really is. How else are they going to learn?
I love educating others, and not merely in a formal way like this blog and through my presentations, books and articles. I relish seeing another CGM wearer and always make contact. A secret thrill is taking an insulin injection in the middle seat of an airplane. I’m just waiting for one of my seat mates to ask me what the heck I’m doing. Much to my disappointment, they hardly notice.
Still, when I can, I do what I can to help others understand the complexities of this most complex, little understood disease. And I’ve told the husband numerous times if I’m ever in the hospital he needs eyes on me like a hawk so what happened to that 33 year old woman above does not happen again.
I don’t know if this merits a top spot because it’s so ridiculous, or because it just happened, it’s on my mind. and I haven’t bothered to think what the other 9 ridiculous requests could be. I know they exist though.
Yesterday I had my twice yearly visit with my endocrinologist, whom I love. The assistant first greets me to get my weight, blood pressure, download my CGM data and, get ready for it, blood sugar.
I looked at her for a solid twenty seconds and said, “What do you need to prick my finger for, I’m wearing a CGM?” To which she replied, “We need a value in real time.” Huh? I gave her another penetrating stare and said, “No, I won’t do it.” You should know, as background, I had two procedures in the past ten days that required not only taking my blood from a major artery, they missed the first five times, but poking me as well for IVs and whatnot. I had reached my limit as a pin cushion.
“No,” I repeated. “You’re not going to take my blood.” I wasn’t rude but I was firm. I didn’t know what the consequence of my refusal would be, nor did I give it any thought. I just knew I had no more tolerance for needles, let alone the insanity of the request when I’m sitting there wearing a CGM.
“Okay,” she said quite mildly, “I’ll let the doctor know.” Whether she did or not I don’t know, I forgot all about it. My endo never raised the point, and I know had he, he would have agreed with me how ridiculous this situation was.
I just want you to know, when you’re in consultation with your physicians, you have the right to say what you think and feel. You are half the equation in any interaction with a health professional. I’m not advocating rebelliousness for its own sake but if you have a viewpoint that should be considered don’t keep it to yourself. That’s how we start tearing down the walls of hierarchy and coming closer to truly working together.
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