30 August 2010

Impromptus at Leisure

             Consistency has always been one of my shortcomings.  I can start any new program or goal with gusto, only to be quickly stifled by my waning interest and quickly my real-life responsibilities take over.  It is the reason I am always on the lookout for new diabetic technology.  If I can have some new gizmo or gadget I will get interested in taking care of myself. For a while.  And then the apathy sets in again until I find my next new thing.   It is also why there are huge gaps in this blog.  I resolve to write consistently and do so for a while and then once again I have let months pass with nothing.  I tried around New Year's when excitement is high all around for all types of new endeavors, but that only lasted a few days.

     I convince myself that my lack of blogging is linked to the desire not to bore people or to put out anything that is less than inspired.  But I think both of these simply are a fancy cover for my lack of discipline.  Rousseau once said, "A sentiment takes possession of my soul with the rapidity of lightning, but instead of illuminating, it dazzles and confounds me; I feel all, but see nothing; I am warm, but stupid; to think I must be cool. What is astonishing, my conception is clear and penetrating, if not hurried; I can make excellent impromptus at leisure, but on the instant, could never say or do anything worth notice." Since I first read that I have time and again felt it resound in my soul.  And if that is, in fact, true, the only thing I need to produce un-boring work is to provide myself with the time and space to get "cool" and that takes discipline.

     Thus, I resolve, once a week, to give myself the leisure so that I may make those impromtus and possibly even do something worth notice.  I've heard it said that to be a writer you need to write something everyday.  I don't know if I will publicly attempt that one yet, so I will set a more realistic and achievable goal, to write and publish a post weekly.  Let's see if I can follow through.

07 August 2010

Practical Dreams

    Sometimes I dream big, owning my own private island with a dock out front and at least four boats tied up to it right next to a perfect right point break and a private tutor to come school the kids for six hours a day while I write and sail and surf everyday.  Sometimes I dream a little more practically.  Owning a MacGregor 26 is more of this kind of a dream. It's got an affordable sticker price, can be trailered so I don't have to pay slip fees, and it is virtually maintenance free if you don't count scrubbing jelly off the deck from my kids peanut butter and jelly sandwiches.  And it is the perfect boat for my Florida trip.  It can sail in just 12 inches of water, it has solid foam flotation so that even if you drill a hole in the bottom it won't sink, not that I'm planning on doing that, and it is totally self-righting so in the rare chance I might be knocked over by a rouge wave, it will pop right back up. You can throw a motor on the boat and go so fast that a harbor would be within minutes if I got word that the weather is making a turn for the worse.
    As I was perusing the MacGregor website, as I do on a regular basis, I noticed that Captain Mike Inmon who runs the MacGregor factory has an offer for a free DVD if you go visit the factory.  Maybe it was all of the old books I had read or maybe just my imagination, but, I was always under the impression that all the boat builders were in some old wooden garage somewhere tucked away on the East Coast.  So when I found out MacGregor was only a 45 minute drive from my house and that I was more than welcome to stop by at any time and learn how they made a boat out of rolls of fiberglass and resin, I put a visit on my calendar.
    Last Friday I made the drive up to Newport Beach and paid a visit to Captain Mike. He greeted me with warmth like a proud papa excited to see me and show me all that his factory held.  We started

05 August 2010

Pancakes and Christine Colby

Today I made pancakes. Lots of small, dollar-sized pancakes. And today I served them to my seven-year-old daughter and her friend who slept over last night.  Shea and Julia, today, are the same age I was when I would wake to a hundred tiny, dollar-sized pancakes and bacon, and being the same age, we ate them all.  Today, I served up those same pancakes without the bacon (Shea has been a self-proclaimed vegetarian since the age of three).  Today I became Christine Colby and I couldn't have been happier.
    You know those moments in your life when you stop and look at yourself as if from the outside and realize you had become the people you had looked up to for so long.  The first realization came during my first year teaching at Santa Ana High School.  Being barely older than the students themselves, I often felt like I was playing dress-up wearing business suits to try to hide my youthful appearance. I had been chased out of the office a time or two because someone thought I was still a student.  During the first test I gave,

Sensor Dating

I have had the great fortune of trying out a new continuous glucose monitor recently. I currently am using the one my insurance says they prefer, but, a friend of mine happens to work for another company out there producing the CGMS’s.  

So, I thought I would give it a try. Being a scientist by training, I decided to run both sensors at the same time to see first hand which is more accurate and which I like more. 

As I did, I was began to get the distinct impression that wearing two sensors at the same time is a lot like dating two guys at the same time (not that I speak from experience, I have rarely been lucky enough to find one guy to date, let alone two at once). 

I realized that Johnny, my first CGMS, had developed a sort of relationship over the last year and a half. The first couple of numbers he spits out with any new site, I tended not to trust fully until I had confirmed them with my regular blood sugar meter.  

Once a day or two has gone by and he was consistently telling the truth, I began to trust what he was telling me. I slept a little easier knowing he was on guard to wake me up if my blood sugars got a little too low or way too high at night. 

I could have a conversation with him (really a series of pushed buttons) to decide on a range of acceptable numbers where he wouldn’t have to alert me. And the more I worked with him the more time I spent in that range, that range that would extend my life by at least a few months if I could stay there permanently. 
Working with Johnny changed my diabetic world. I could finally sleep at night without great fear, I always had an extra set of eyes to search out wayward sugars. He was my first CGMS and I will never forget what he taught me and how he changed my life.  

But then Michelle, my friend with an inside track to new technology, introduced me to Nick.  And Nick was different. Instead of just dumping Johnny, I decided to try having a relationship with both at the same time. 

And that’s where the trouble began.

I set up both sensors to start at the same time so neither one would have the advantage.
Just like a first date where both people are a little bit nervous and not quite themselves, sometimes with a CGMS the first few numbers can be a bit off. Then, when everyone is relaxed and comfortable in their new surroundings, we can really get into the groove of things. 

So, I let both boys chill out for a day and then the testing began. With every new gadget comes new enthusiasm and the race between Nick and Johnny was no different. 

I tested on my regular meter almost hourly. I wanted to see who was more accurate, who would follow my trends up and down quicker. In effect, who was the better partner.  

The problem was that I couldn’t develop any sort of trust with either one. I would be 148 on my hand-held meter. Nick would say I was 120, Johnny 180. They were both off and Johnny was high. 

An hour later I would be 250. Nick says 276, Johnny 221. They’re both off again but Johnny’s low now.  

I did find that Nick was clearly better on one thing, catching my lows. I felt a little low and tested to find out I was 56. I pulled out both guys and set them in front of my face waiting to see who would figure it out first and how long it would take. 

Nick was up just 2 minutes later with a 56. Spot on. I downed some sugar to get back into the normal range and waited. 

Five minutes later Johnny came back with a 85. Still not low enough to set off the alarm. Five more minutes and a 78, low enough to set off an alarm but not accurate enough to convince me on a normal day to go running for the sugar.  

Johnny was a full 12 minutes late and 22 points off.  

Since one of the most important reasons I got a CGMS and that I continue to deal with all the hassles and pain that come along with the technology is to catch lows I was no longer feeling, Nick clearly wins in this category. Huge points in his favor.
I decided that to give Nick a real chance I really needed to start that relationship with just him and so got rid of Johnny for a time.  

One of the things I realized in this time is that Nick listened more. When you use CGMS, two to three times a day you test on a regular meter and feed that data to the CGMS.  

With Johnny reading 158, if I tell him I am really 120, he just says, “That’s great. I accept that you say you are 128. But I still say 158.” There would be no change in his data.  

Nick would listen immediately.  I tell him I am 128 and he replies sweetly, “I had 158, but if you tell me 128 let’s meet in the middle. How about we go with 143?”
Shortly after I started my relationship with Nick, I was moving and after bumping into a lot of furniture realized that we had separated. I mourned the loss, but busied myself with all that moving demands.  

It wasn’t until about a week later when my life slowed down and I had time to go back to Johnny (my supply of Nick's sensors had run out) that I realized what had happened.  

I had charged Johnny’s transmitter, stuck a new sensor in the gun that I use to inject the sensor under my skin to give it access to my blood stream, swiped my hip with alcohol and got ready for the pain to come.  

I sat for a moment while I tried to convince myself to pull the trigger, a process that sometimes can take minutes, my self-preservation struggling with having to purposely hurting myself, and I thought back to when I started with Nick.  

It was surprisingly painless. I kept waiting for the pain to set in and it never did. The sensor is by far way thinner and round, a seemingly petty detail but when you are injecting a long, metal thread into your tissue, the shape can make a huge difference in the way it rips through your flesh.  

The sensor Johnny uses is rectangular. As far as piercing skin goes, rectangular tends to tear much more and cause considerably more pain. 

And it wasn’t just the pain. I realized I missed Nick’s accuracy and how he could yell loud enough for me to hear him while I slept. 

And how he doesn’t have to hurt me as often.  The sensor he uses goes for 12-14 days (off label, of course). Johnny hurts me every 5-6 days. 

And because of that I tend to take more time between when I remove one sensor and start the next. Time I need to have data and reminders. Time that, with sugars swinging more wildly, could add up to more complications and complications that strike when I am younger, really taking days or months or years off my life.  

I don’t have that kind of time to waste. I need all of my days. I have stuff to do.

And so I have gone back to my friend Michelle like a now addicted druggie, begging for any way that I can get my next hit. I have started the paperwork to once again fight with my insurance so that they wil cover a better product even though they usually like to play with their own pre-picked companies that put out an inferior product. 
Lucky for me, the people who make Nick are exceptional people. Not good customer service, although it is, but good people.  

Everyone I have met who works for Nick's company are genuinely interested in helping Diabetics get good technology. They have seen how it can change a person's life and will work above and beyond to help you get what you need.  

And it is never a call to some company somewhere in the world who is working just to get a paycheck.  They are real people with real email addresses and real cell phone numbers who will come over to your house to let you borrow a system and show you how to use it and actually care how you are doing with it.  So battle I will.  

My last insurance battle took 6 months and countless letters and research and follow-up, but at least this time I know I will fight alongside some great people to get an amazing technology. 

Nick, baby, I am coming to get you and I won't stop until you are back in my life.