No Man is an Islet

Speaking of the bell toll of mortality,
Donne proclaimed no man an island.

"Every man's death diminishes me
because I am a part of mankind."

I was not.

I danced in the ether,
swabbed and prepped and ready for piercing.

I drank moonlight through juice box straws,
awoken from sleep in trembled panics.

I rode the waves of high and low like a carnival ride you can't disembark,
the thousandth trip rocking your body one hit too hard.

I dogpaddled breathlessly in an a-1-sea,
treading band-aid-smelling, fast-acting waters.

When something of a dream came floating past.
Thousands of broken beta cells, each with a story.

They reached out and grabbed my hand,
disrupting my soliloquy.

Seeking relief, support,
an answer, a friend, a cure.

We each struggle with the undertow,
but together ride the crests and falls.

Thousands of lancetted hands,
clasped together in friendship.

Cleo? More like Clean-off!

I am so sick of the Cleo 90. How is it that the little bastards rub off like cheap band-aids (yes, my sugar is over 300 right now - what do you mean I'm being b*tchy? what's it to you?!), but the gray-gunk adhesive skidmarks stay forever?



This is the third one I've had fall out and leave me dangerously high with no fricking warning - and I've only been wearing them for 2 and a half weeks! I've had another five that came off with the insertion device. If I see one more of those little purple f'ers tonight, I'm liable to hurt someone.

Confessions of an Idiot

So today I'm at my local Tom Thumb grocery store, scanning a loaf of bread at the self-checker. It's a busy Saturday afternoon and my husband is getting a haircut there in the strip mall, so I thought I'd go buy bread and lunchmeat. Harmless, right? Well, there I am, scanning away. A man crosses over to me, points his finger in my face, and says "by the way, YOU'RE AN IDIOT!!!!" so loudly that everyone in the checking area is now staring at us.

Several thoughts crossed my mind as I followed this finger of judgment to the object of its scrutiny.

...because Kroger's prices are better?
...did I cut him off in the parking lot?
...am I trying to pay with my library card?
...it couldn't be...I mean...not seriously...it wouldn't be...my Obama '08 t-shirt??

When, in my retarded mind, I discovered how this man so quickly recognized what an idiot I was, there was little to say. He was walking off self-satisfied and I couldn't seem to wipe the big stupid idiotic grin off my face. He was so right. And he was simply doing his part to prove how genuine and neighborly the Right can be, lovingly pointing out the error I had been too stupid to see. My life was changed.

The man at the scanner next to mine looked over and said "What in the world was that about?" I said, "I'm gonna go out on a limb and guess it was the t-shirt." He must have been an idiot too because what he said was "Well, I'm sorry that happened to you. I sure hope it didn't ruin your day." And bamm-o, this idiot had faith in people again.

The first man was so right though. Only an idiot would believe in a cause enough to support it against anger and hatred it may summon in others. Only an idiot with canvas shopping bags and a hybrid car would believe that one person can make a difference in the environment. Only an idiot would believe that we could have a president who hadn't grown up in privilege and who understood the Constitution not just casually but enough to have become a professor of constitutional law. Only an idiot would believe in concepts like all her neighbors having access to medical care and no tax breaks for the wealthy. Only an idiot standing alone buying bread for her family would be accosted by a man twice her age and feel righteous anger for an unsolicited attack...and laugh about it.

But this idiot has a voice. A vote. And a right to use those two V words - even in Texas. And just to prove what an idiot she is, as a liberal she'll defend your right to call her names and be vicious because, unlike you, she still believes that America is a free country, built on a democratic government - a civil contract among its different peoples of different beliefs/races/cultures, rather than an intolerant nation state like the governments it sought to differentiate itself from. She believes in compromise without compromising your ideals. She believes in coexisting without disrespecting. She believes in YOUR ability to change, even after you've run her car off the road or peeled off her bumper stickers or called her a name at the grocery store. She believes we can be better than this.

And sometimes I think it's only the idiots who still believe that.


Sorry to all who were expecting a diabetes-related post...if it helps, my sugar is 318 right now and I'm obviously pissy and aggressive. Expect a post on the new Cozmo pump I got this week once the BG comes down and my comfortable stupidity sets back in.

The Unknown Road

We have a common misreading in American culture of Robert Frost's "The Road Not Taken." Maybe it's our American pride, our blazing-new-territories kind of attitudes, our love of individualism. I don't know why, but we don't see anything but the last three lines of that poem. Every high school valedictorian, freshman English teacher, and pandering politician believes that the poem is championing taking the untrodden pathway.

If you take a closer look, the poem describes being at a fork in the road and having to choose. The traveler can't take both pathways. So he examines them. This is where we as Americans stop understanding. He says the second is "just as fair" and that the "passing there / had worn them really about the same," that "both that morning equally lay" untrodden. He chooses the second one not because it has any specific advantage. He chooses it because he cannot split himself and take both paths.

In the last stanza, he sees himself in the future, "somewhere ages and ages hence," justifying that choice by claiming that the road he chose was the right one - the untrodden one, the greater, but if that were the truth, the first 17 lines of the poem would have set it up differently. The poem is not about blazing the new trail and going against the flock. The poem is about how to deal with the reality that you couldn't choose both paths - and the other might have led you somewhere greater. You'll never know. So "with a sigh" you tell your story as if your choice was the braver. It's self-deception.

This is not a new reading of the poem. It's what any college poetry professor will say regarding the piece, and the ironic interpretation that Frost intended. But I've had the text in my head a lot recently.

I stumbled onto this discussion in an online diabetes forum: "if you had had the choice between a life with or without diabetes, would you have chosen diabetes?" I considered my response before reading the other posts. But after reading people's responses, I felt I couldn't post. I felt that anything I could have posted would have been misread as negative. The respondents seemed to categorically choose diabetes, citing the claims that it made them the strong, responsible activists for their own health that they have become. Were they just making lemonade from their lemon of a pancreas?

I can't help but see the ending lines of Frost at play. If I had had the choice, standing in that yellow wood, between diabetes and no diabetes, I would never knowingly have chosen to have a difficult chronic illness. I believe that I was growing into a strong, bright, positive person before the condition manifested itself in me and that I would have been the same strong, bright, positive person I am today without struggling with and against an illness. Yes, I'm sure it has contributed to my strength. I don't deny people's experience of the personal growth they know through their diabetes. But there are healthy experiences in our lives that develop character, too. I don't believe that I "needed" diabetes to fashion me into the me that I know and love today. But, as I explain in my mushroom analogy, it's not something I can separate myself from anymore. I didn't have that choice. For one biological reason or another, perhaps randomly, my body destroyed its own pancreas. I accept it. I have never been one to shake my fist and be angered that there is still no cure. I'd settle for awareness, education, and research. I have lived with diabetes for as long as I remember. I have accepted it as a part of my life that I didn't have a choice in. And I just kept right on living.

I suppose there is always the argument that, if things hadn't gone just as they've gone, you wouldn't have the life/family/spouse/happiness you have today. Sure, that may be true. But you don't know that. I might still have met and fallen in love with my husband. Again, I can't know anything other than the trail I took.

But, seriously, if given the choice, how could you really choose this path? What kind of myth would I be participating in to find myself "ages and ages hence" claiming that diabetes was the better choice for me? I can't help but find it self-deceiving. I'd like to think that I would have been me either way. I happen to be me with diabetes - but only because there was no fork in that road. But, seriously, if someone had been able to give me the option back on that day of my diagnosis? "Bring it on" would have seemed an ignorant and masochistic response.

I'm not so arrogant as to claim that the hypothetical split in the road might not have yielded a better option. So in the safety of an imaginary scenario, sure. I'd happily turn down the diabetes. It's a chance to divide yourself into both of those half-travelers and see what life might have been like. What's the worst that could imaginarily happen?

Party of the First Part

So Kevin and I went to a party Friday night. My friend Shanna celebrates her friends twice a year with a chili night and a spaghetti dinner. Last night was the long overdue spaghetti dinner. A vegetarian with fabulous recipes, her food is always so good that the carnivores in the bunch are convinced from the first bite (myself included). But still, as we all know, party food can be a horrific experience. The snacking, the desserts everywhere, the "when exactly is the food going to be ready and how long ago did I take my insulin?" questions we diabetics have to deal with. I've always left parties with sugars in the 300s.

When I spoke to her on the phone last week and asked if I could bring anything, she answered "dessert." I had to laugh. Yeah, sure, the diabetic on Weight Watchers. Which sinful thing I shouldn't be eating should I stress about preparing for next Friday night? But I knew I could do something inventive and tasty. After all, my cooking skills get better all the time. So I found a recipe on dLife for Mexican Chocolate Cake. The ingredients, though odd, all happened to be lurking in my pantry Friday morning. And I had new silicone cupcake cups I hadn't opened (another wedding gift I'd yet to use). So what was supposed to be a cake that served 8 could become 12 smallish cupcakes. I had enough to make two batches.

I have an off-limits shelf at the top of our small pantry. No, this is not where I keep Hostess and her friend Little Debbie. It's where I keep baking powder, chocolate chips, powdered sugar, cocoa, etc. That way when you want something that's bad for you, you really really have to mean it. Besides the expected ingredients for a chocolate cake recipe, it called for egg beaters, toasted almond slices, lowfat buttermilk, and the unexpected kick of ground chili pepper (I had some ground chipotle chili pepper, thanks to my husband's love of spicy foods) - all of which I happened to have and needed a use for.

Well, as you can see, they turned out cute as a bug and they were a huge hit among her health-conscious, risk-taking party guests. Everyone commented on the unexpected spicy aftertaste that the chili pepper and cinnamon brought out. I think they have a more muffin consistency than cupcake, but they're good.

As for dinner, I was a little high before things even began, so I took insulin and the food was ready in time for my bolus to kick in. I had a couple bites of a veggie lasagna roll and a bell pepper stuffed with orzo and artichoke hearts. Very reasonable. Where I failed as both a weight watcher and a diabetic was in these amazing little finger sandwiches - cheese, pesto, and roasted pear on tiny crispy rolls. I had four. I probably ate triple the points I arrived at the party with. But all in all, the party was a success. Bedtime BG: 110.

Head Over Heels

Today was my first trip to the podiatrist. I actually had a good time. I had some x-rays done, met the good doc, then answered various questions about my medical history. I was really proud when the first few questions yielded good answers:

Blood pressure problems? No, sir.
Heart problems? No, sir.
Smoker? Nope.
Drinker? Not a drop.
Retinopathy? *pause* In remission?
Surgeries? Tonsils and Appendix.
As a child? No, as an adult - '03 and '01 respectively.

Okay, well, I knew not every question could have a peppy answer. After all, I'm not at the podiatrist because I was bored. My left foot has been KILLING me. For the last two weeks, walking has been very painful. I hobble around, limping, trying to figure out the best way to stand on my left heel, knowing that they tell people with plantar fasciitis that they shouldn't walk on the balls of their feet. But DAMN. This is a lot worse than the old, familiar morning heel pain.

While the x-rays were being developed, he did the requisite neuropathy testing. I've never failed the tuning fork at my endo's office, but figured he probably had some other toys to try. He pulled out a machine that looked like something Thomas Edison would have put together (see above photo). It was a black case with a dial and had a wand with a vibrate-y nub on the end (essentially a type of tuning fork itself) and he held it to my toes. I sensed the buzz immediately. He was impressed enough that he tried it again. He said he was going to put me down as a 10. Apparently, this is a good thing. I'll take being a 10. Then he pulled out a small acrylic box of white sticks, each with a different length of filament (called monofilament wires) and asked if he could try some tests he doesn't get to do often. I closed my eyes and had to tell him which foot he was touching with the filaments. We got through the first filament and then even the next one down before my fabulous feet had the man thoroughly impressed. My feet are heads above the rest, apparently. I was so proud I actually secretly thanked my mother for obsessing about my diabetic feet as a child.

So why does my left one hurt SO BADLY? He pressed his thumb into my heel and I yelped.

And that brings us to the x-ray. There is a bone spur at the base of my heel where the plantar fasciia connects to the heel joint. It looks like a nasty little hooked beak of bone that juts up into the bottom of my foot. Even though it looks mean, that's not actually what hurts (so they say). But it does prove that my plantar fasciitis is legit and has become severe. Bone spurs are a side effect seen in 70% of people with plantar fasciitis. As the fasciia becomes more and more inflamed around the joint, your body deposits calcium in a ridiculously stupid attempt to solve the problem itself.

Prognosis: thankfully good. He sprays some very cold spray (called "cold spray" - I saw the can and we joked about it) onto my instep near the base of the heel and gives me a cortisone shot. (My blood sugars are at LEAST 100-150mg above normal ever since - oh joy.) But that will kickstart the anti-inflammatory effect my foot has been aching for, pun intended. Tomorrow I will start on anti-inflammatory pills. He says they shouldn't effect my blood sugar levels. That will be a relief.

I went home with generic orthotic insoles (insurance doesn't cover the customs and I can't help but feel like I just bought bargain bin when I could have had designer footwear). I promised him that I would do the stretching exercises he showed me four times a day and return to him in three weeks. I can go back to the gym, but no weight-bearing exercises - for cardio, I can do a bike. The exercises are essentially wall push-ups where you keep your heels squarely on the floor, about shoulder width apart, while you lean into the wall (including your butt) for five second intervals. I'm to intersperse that with 5 standard calf raises on my tip toes. Total of 5 sets of each, four times a day. I can wear the orthotics in either athletic shoes or heels (I know, I was surprised too), but I shouldn't wear any flip-flop or mule footwear, as it causes your p.f. to grip and contract when we're wanting a good long s t r e t c h.

So I'm home. I've kicked my feet up, fussed at my husband a lot (hey, my sugar was like 300. back off, folks), and just finished my last set of stretches for the night. My sugar is at a nauseating 229 now and my basals are at 150% until I come down off my steroidal high. I'll know it's time to return my basals to normal when my sugar crashes. That's like knowing when it's time to hit the brakes by the appearance of a tree limb stuck in your windshield. But that's how you play this game.

All in all, the podiatrist was a good experience and I feel pretty relieved that the problem is what I thought it was and is treatable. I feel fortunate, vindicated, and - when my sugar finally comes down and I can return my basal rates to normal, I will add - slightly less pissy about my week.

Trick or Treat

Chronic. As a type I diabetic, one grows weary of this word.

Every illness, injury, or condition I've acquired always seems to be accompanied by that word: chronic. It means that they can treat you, but they don't know how to cure you. They can improve your quality of life, but there will still be suffering and frustration from time to time.

Do you remember when treat had a more positive connotation?

If I even so much as utter - scratch that, spell - the word "treat," my dogs celebrate. There is a run to the kitchen pantry where delicious little bits of doggie snack await them. When my friends pay for dinner, it's their "treat." When we decide to go to the movie on a Friday night, we're "treating" ourselves. Ice cream is a delicious (and sinful) summer "treat."

I remember my first Halloween as a diabetic. I had always liked trick-or-treating. Mom and I decided that we'd throw a huge halloween party instead and invited my whole camp fire girl troop. We bobbed for apples (I won), pinned the tail on the donkey, and had a pumpkin seed spitting contest. I dressed up like a witch. It was the best party ever. It was the first time that something had been a true improvement over life pre-diabetes. I declared that parties were way better than trick-or-treating and the tradition stuck in our house for many years. So there were more than just the two options - trick and treat are not binary oppositions. You could also party!

With diabetes, I don't think you can trick yourself. Or at least not for long. And not successfully. You can't really "trick" yourself that candy with sorbitol tastes just like the real thing. You can't really tell yourself that you're not really diabetic or that it's okay that you didn't test your blood sugar yesterday. And "treating" yourself is not as celebratory as it sounds. You treat, you watch, you treat again, you wait. Sometimes you can work the real "treats" in. Sometimes even as "treatment," which the youcan'teatthat'er's always try to fight us on.

You learn to grow patient about treatment. And sometimes you're not. You impress new doctors with your notebook full of questions and the intimate knowledge you have of your own body. I've seen an MRI of my brain, CT scans of my sinuses, sonograms of my kidneys, laparoscopic photography of my appendix, ovaries, uterus, and gall bladder. I've seen my vocal folds on live camera, as well as video of my bladder in a cytoscopy. I've seen x-rays of my hands, teeth, feet, ankles, and neck. I've even seen rare motion x-rays of my whole skull, opening and closing my mouth. I know what the backs of my retinas look like thanks to topographic imaging as my ophthalmologist watches my high eye pressure and for signs of retinopathy. I know which veins aren't worth tapping on both my right and left arms. And I know what kind of IV to ask for, what size intubation I need in surgery, and what my last A1C was. I know that my cholesterol fluctuates and what my BMI is. I have an endocrinologist, a diabetes educator, a urologist, an ophthalmologist, a dermatologist, a podiatrist, a chiropractor, a dentist, and ENT, an OB/GYN, and a GP. At other times, I've had an orthopedic surgeon, a colorectal surgeon, a psychologist, and an orthodontist. Insurance companies hate me. They see me coming with the word CHRONIC branded to my forehead. They know I'm expensive.

The etymological origin of the word "treat" is the Latin tractare - to drag about, handle, deal with. Chronic stems from the Greek word for time: chronikos or chronos. Treatment is essentially that - dealing with it through time. Occasionally, you'll need a party.

Test and treat, check my feet, bolus for some carbs to eat.

And now for the roses...

So they prick me, and so do I bleed.
The thorns on the tender stem, protecting itself, reminding.
My fingers prickle from injuries garnered twenty thousand times or more.
They are too stubborn to recoil from the lance.
I squeeze one more droplet, dark and red,
from my traumatized fingertips,
having learned to court the cactus flower.

In my youth, roses were enticing blooms,
climbing my neighbor’s backyard fence.
I would stand in the street and stare,
drinking in their tempting perfume,
knowing it was forbidden to pluck,
but touching a petal anyway, careful of the thorns,
savoring the velvet on my then-unbruised fingers.

After a jolting heartbreak, Roses was a word
on the wrapper of a fresh roll of toilet paper.
In my most private grief, blubbering into a wad of tissue,
I felt the intrusion of this timeless symbol of my revoked love and passion
when all I wanted was a good cry in a bathroom stall.
I folded the wrapping and placed it my pocket,
telling myself that I’d want to remember this moment.

Today, in my prime, I am still tempted by smells which,
by any other name, are still too sweet.
I still feel intruded upon by the prick of the thorns
when my hands are sore and my mind is tired.
But the rose, with its cascading folds of soft, strong petals
is nevertheless the bud I chose to carry in my bouquet.
Thorns and all, the flower is fierce, feminine, and somehow gentle.

Roses thrive.

Mushroom and Roses

Today makes 18 years for me as a Type I diabetic and my first blogging experience as a diablogger. So I'd like to introduce my blog.

There’s this species of mushroom, Armillaria mellea, that scientists kept finding growing along the northwestern seaboard back in the late 90s - mostly in Oregon. Anyway, they continually dug up the honey-colored stalks and killed them, hoping to save the trees from root rot in the national forests, but the growths would come back, again and again. What they finally discovered was that it was one giant fungus – growing under the state, spanning for over a thousand football fields and weighing in at over a hundred tons – and what they had thought were multiple occurrences were really just parts of this überfungus rearing its ugly honeyed head up above the surface of the ground.

So what I've always wondered is, when a climactic, traumatic, personality-forming event happens to you when you’re still a little, little child, is there any part of your adult form that is untouched by that? You can work to pull and dig and uproot piece by piece of your rotten core as it pokes out into your visible psyche, but what if we're made of it – the hurt, these events, the guilt, your baggage – what if your whole soul is just one spongey fungus? How far back do you have to go before you're at the beginning, before you went down that path? Who would you have been without that trauma?

And it's described many parts of my life, from abuse to bad relationships to...*drum roll please*...diabetes. Kerri's "Six Until Me" back-story reminds me of my troubled relationship with diabetes over the years and this analogy I've gone back to in multiple circumstances. The question "who would I be without diabetes?" is not a valid question. I am the only me that's ever been and that me comes with diabetes mellitus - the honey-sugared syndrome. I don't get to pull off the stalks for a day. It's underneath. Deep, deep, deep within.

As for the roses, that's another post. :)

Insulin Pump - A Poem

This is something I wrote in March of 2001 as a college student wearing a Minimed 508. Thought some of you might get a kick out of it.



Insulin Pump
Someone in the U.S. dies every 3 minutes from diabetes and its complications.
- American Diabetes Association

*beepbeepbeepbeepbeepbeep*
I look down.
NO DELIVERY
Here we go again.

I have to stop whatever I’m doing…immediately.
I go grab my little black bag, set it on my bed.
Run and wash my hands real quick –
a tedious step I really can't skip.

I unzip the bag.
*beeepbeeepbeeepbeeepbeeepbeeep*
I KNOW!
gray button, green button,
go back to unzipping my bag.

I pull out a package with a reservoir syringe in it.
Peel it open hurriedly.
Cycle the syringe.
Set it down for a sec.

I open up the *beeeepbeeeepbeeee(-package-)beeeepbeeeepbeeeep*
with the infusion set tubing in it.
Get out a vial of insulin.
Does this bottle have enough in it?

Back to the reservoir.
I draw in 220units of air and inject it into the vial
and the 220units of liquid come barreling
Bernoulli-style into the syringe.

Several minutes of tapping against the hard plastic
until the top knuckle of my index finger is
bruised from thumping the air bubbles
back into the bottle. Can't have air bubbles.
The bends, you know. Missed doses and such.

Off with the needle now.
Attach the reservoir to the end of the infusion set –
caps to be unscrewed, connections tightened.
Prime a good 20 units through the *BEEPBEEPBEEPBEEPBEEPBEEP*
tube. Load the little injection gun.
I take the old reservoir out of the pump and replace it with the new one.

I unzip my jeans, lift my shirt,
and carefully peel the last three days away
along with some medical tape and a tiny catheter.
For about a minute and a half, I'm free.

D_is^connect_ed.

I should strip my clothes
and run naked down the sidewalk,
a marionette without strings.

*BEEEPBEEEPBE---*

I press the gray button 6 times, the green button,
the up arrow 50 times, yes, 50 times,
the green button, the down arrow 11 times,
the green button.

I watch the tiny droplets drool out of the needle’s tip.
My 90-second vacation's over.
I swab down my abdomen with a sticky IV prep,
choose the spot for my 3-day umbilical cord,
and kiss the lips of my injection gun to my unsuspecting underbelly.

*POP*

Layers of tape over the newborn hole,
a soft quarter-clockwise turn of the needle hub before I remove it,
leaving a hair of a polyurethane tube
like a straw from my gut to God.

gray button 6 times, green button,
up arrow 5 times, no I said
5 this time, the green button,
the green button again, yes again...

Gather up my now-useless garbage.
Biohazard: do not open.
Dispose of properly.
Zip up. Clothes and case.
Velcro. Clip it back on my jeans.
Another three painless days of life guaranteed.
Small price – five thousand dollars and ten minutes.

*Click*