The Best Big Brother Ever

Today my big brother Billy would have been 40 years old. Much is said about a man turning 40; they say men leave their wives for younger women in short skirts, buy expensive cars, start to dye their hair, or all of the above. Billy's physical limitations would not have allowed any of those things of course, although he did usually favor one lady over another at the State School, and he did have a certain twinkle in his eye when he got his new wheelchair.

I knew Billy as well as anyone. He and I were very close in a way that only a few people can really understand. Those with mental and physical handicaps very definitely develop bonds, and the bonds with their siblings are very strong. I see it often in Brenden and Emma. How many 10 year old boys will happily play with their little sisters, or quickly stand strong to defend them? I also see it in my wife's cousins, Holly and Haley. Their brother, Britton, is profoundly locked away by Autism, but he knows and loves them and vice versa.

That was how Billy and I were. And I know him well enough to know that if he were "normal," he never would have been any of those things that some 40 year olds become. His spirit, strength, and courage were too strong to be overtaken by higher indulgences. He preferred Hee Haw on a little TV to "Baywatch" on a wide screen. The Price is Right won out over "Lifestyles of the Rich and Famous."

Those who know how to cherish and appreciate the simple things are the truly powerful ones, and that will be the gift he left all who knew him.

Dear Wal-Mart

I love you Wal-Mart.

I love your low prices. I love that I can get just about anything I need in one trip. I love that you have twelve different kinds of peanut butter and every variety of soft-drink that any person could ever need. I love that you are always open, and I love the little old man that hands me a shopping cart as I walk in the store.

I love you Wal-Mart. Why don't you love me?

Why are your parking spaces always occupied by an abandoned shopping cart?

Why do you have 50 check-out lanes crammed tightly together when there are never more than 10 of them open at a time?

Why don't you understand that sometimes all I want is a hand-held basket?

Why do you always have shirts in every size BUT XL? Or size 34 pants?

Why do you have perfectly-manicured grass outside, but disgusting bathrooms inside?

Why are the rudest people, and the longest lines, always found in "customer service?"


I really do love you Wal-Mart. But sometimes you just aren't worth it.

D-Commerce

Type 1 diabetes has taken a lot from my family. A lot. It's given some things too. There aren't many families where dad and daughter can form their own band with musical pump alarms as the only instruments.

One of the things that it has taken away from us (and lots and lots of others) is the 2-income household. We've done OK on just what I've been able to earn over the years from working 1 full-time job plus any number of part-time ones from being a college instructor to a security guard at professional wrestling events.

But that's not really the point. The point is that one person in my house is working her ass off and doesn't earn any "income." As some of you know, Amy is an absolutely brilliant designer of little girls' clothes, and has been known to make a stunning cake or three. The clothes she makes are incredible, as are the cakes.

So that brings us to today, where Amy is slowly rolling her line of insulin pump pouches out in the market. To be sure, there is no shortage of pump pouches available for sale, but I think that there is an under-served market for pump pouches that are hand-sewn, high-quality pouches made of high-quality fabrics. Typically, her pouches are beautiful, practical, and very well-made.

Swing on by her site and check them out. She's busily adding more to her site, so it re-directs to a listing on Etsy, but check back often as I expect her site to be up and running soon. And if you're so inclined, you might give one of her pouches a try. You won't be disappointed.

www.toosweetboutique.net

The Diabetes Olympics

Participating in an athletic event when you have type 1 diabetes can be a serious pain the butt. A single game of soccer, softball, or flag football means hours of chaos:

1. Afternoon basal adjustments
2. Carefully timed meal boluses that won't peak just as you are up to bat
3. Hoping you have long enough in the dugout for your CGMS to re-acquire the signal
4. Carrying a juice box like a kid heading to camp at the Y

So it occurred to me that type 1 diabetics should have our own Olympics, and I have helpfully come up with some events. Don't ask me to plan the thing, I'm more of a "big idea" guy.

1. 100m Set Change: Participants must sprint 50 meters, pick up a vial of insulin, and sprint back. The winner is the first person to change their infusion site and clear all the bubbles from running with the insulin.
2. 200m Pump-Dangle Sprint: Participants must run 200 meters with their pump dangling between their legs, just like when your pump detaches itself from your pocket and makes a run for it.
3. 400m Insurance Hurdles: Participants must sprint 400 meters while clearing a hurdle every 50 meters. Hurdles shall be made up of insurance agents, appeals paperwork, and DME exemptions.
4. 100m Hypo-Treatment: Participants must bolus themselves down to 60 mg/dl, and then run 100 meters to a juice box. First person over 80 mg/dl wins!
5. Syringe Darts: Participants must, using only a mirror, throw an insulin syringe into a small marked target 10 feet behind them. The target represents an area of skin not scarred by infusion sites.

Parents of kids with type 1 would also have their own special events. I think they are fairly self-explanatory, but would generally resemble a rodeo more than the Olympics:

1. "Test a 3 year old."
2. "School-Nurse Roping."
3. "Testing in Pitch Dark."
4. "Make a Kid Drink a Juice."
5. "Hide the Chocolate."

I especially like the "School-Nurse Roping," but of course you can use whichever barrier to basic education that makes you giggle.

That is all for now. Stay tuned for my letter to Wal Mart.

The First Day of School

Tomorrow kids all over our small, central-Texas town will be hustling about, gathering their backpacks and lunches, pencils and paper, glue sticks and folders, and other over-priced goods in preparation for the first day of school. They'll rise early in the morning (some earlier and easier than others), dress in their new school clothes, and have a good breakfast to prepare for the day. Soon enough, the newness of it all will wear away, as the joy of the first day of school slowly drifts into routine.

For most kids, school is routine; but for kids with diabetes, it is anything but. For Emma, school will never be routine.

School for the child with diabetes is first and foremost a triumph. Diabetes is a horrrible, horrible disease that, just 80 years ago, was a death sentence for kids. We did not have insulin to inject, and once we did, we didn't have glucometers to test with. As macrabe as it sounds, that a child like Emma, diagnosed at 9 months old, survived to see kindergarten is a triumph of modern man.

School for the child with diabetes usually depends on the school, state, principal, superintendent, nurse, and parent. That's a lot. There are schools that still consider diabetes something that can be controlled by "not eating any sugar." They think diabetic "episodes" can be managed by a single teacher in a room full of children.

Diabetes is not a mini-series.

It cannot be managed in "episodes." That would be rather like handing a knife to a child with hemophelia and teaching the educator how to call 911. Once you have an "episode" the damage can sometimes not be undone.

Believe it or not, there are parents out there that have to fight, and I mean FIGHT, just to get the school to allow their child to test their blood sugar in class. Our school's principal actually suggested that until Emma could walk to the nurse's office alone, they would send another child (another FIVE YEAR OLD) down with her.

Words fail me.

School for the child with diabetes means having to explain, every year, what that thing on your arm is, and not to touch that tube please, and why you can have a juice when no one else can, but you also can't eat the second piece of birthday cake. It means studying for a test isn't enough, you also have to worry what will happen if your blood sugar gets low and you can't think. Or if it gets too high and you have to go to the bathroom RIGHT NOW.

School for the child with diabetes means glucagon, spare pump supplies, insulin stored in the office, syringes, glucose tablets, and Tegaderm.

Will the kids ever get to know me? I mean, I'm gone all the time to see an endocrinologist, a nephrologist, a rheumatologist, and an opthamologist.

School for the child with diabetes means that the first pool party you are invited to will be your worst nightmare. It's hard enough to put on a swimsuit as a teenage girl, harder still when you have a pump and glucose sensor. Will they know why you had to bring some juice with you? Will you have to explain it AGAIN? When you are asked to dance for the first time, will you risk him touching the infusion site on your back that you've spent so many years trying to hide, or will you just say no?

It means wondering if that cute boy will notice you, or the patches of rough skin on your arms scarred by years of infusion sites and glucose sensors. Will he be perfect enough that he will put up with your moodiness AND your pump? What will that other girl, the one without the tubes and the scar tissue, say to him to convince him you're not good enough?

Why can't my big brother be in the same school with me every year? He makes me feel safe.

No doubt there will be many parents with tears in their eyes tomorrow morning. Most of them will be proud and a little nostalgic that their little one has grown to be a kindergartener right before their very eyes. I'll be right there with them, but the feelings will be more complex. Kindergarten will be a trial run, a way to prepare Emma (and her teachers) for all that is to come in the future.

I hope my brave little girl loves it.

Don't Say I Didn't Warn You

We're 7 months into the new administration, and I would like to take a few minutes to make sure everyone out there knows the facts. I know there are many of you that supported Mr. Obama for president, and I would expect that most did because "he wasn't George W. Bush." I get that, I really do. That's probably why Bush beat Al Gore to begin with, people were just tired of Bill Clinton. I know what you're thinking, "This is a diabetes blog!" All I ask is that you stay with me a bit and you'll see the connection when I get to "Obamacare."

There are many, many disturbing things this president and his allies in Congress have done, but what's scary is how much more he wants to do but isn't telling you. And no one else is telling you either. Conservatives often rail about the "liberal media," which members of the media then brush off as preposterous. I would challenge you to research this independently and find that, regarless of the source, you'll find that about 80% of national "mainstream" media journalists say they voted for Obama, and that 60% of them describe themselves as "very liberal." There is an agenda, don't pretend there isn't. Terry McCauliffe, head of the Democratic National Committee, readily admits that the liberal media helped Obama get elected. (It's on Youtube, check it out.)

The two most important pieces of legislation in recent memory are either already in the Senate or being written as we speak: Cap and Trade, and Health Care Reform. Here's what you need to know about both.

Cap and Trade is supposed to be about cleaner energy and a focus on renewable resources. Here are the facts:

1. The bill was debated for exactly 5 minutes in the House, which seems rather short for a bill that is 1400 pages long, not to mention that House Democrats added 317 pages at 3am.

2. The bill will double the cost of the average American's electric bill. DOUBLE. And that's just an Obama administration estimate. The reason for this is that the people who wrote it, ultra-liberal Democrats from the Northeast don't USE coal energy! Their homes are heated with oil! This is an energy tax folks, plain and simple.

3. An EPA official can walk into your house and inspect it for "energy efficiency." If it doesn't pass, you get a fine and have to spend thousands to upgrade your home.

4. You will not be able to sell your home until the EPA gives you approval to do so. In other words, it has to meet the EPA's standard for being "energy efficient" or you can't sell it. So now your home you wanted to sell for $150,000 will now cost $160,000 or so, depending on how much you have to spend. Inflation, anyone?

5. China and India don't have Cap and Trade, which means that what remains of American manufacturing will shut down virtually overnight and move (along with American jobs) overseas. And the cost of American products? You got it, through the roof.

6. Remember what happened to the price of food when oil went through the roof? Same exact thing. Obama wants everyone to buy an expensive energy-efficient car (despite the fact that Americans obviously don't want them). If you're banking on ethanol, forget it. It costs $1.25 to produce $1 worth of the stuff.

7. And finally, not to worry too much, because in order to get this monstrosity through the House, the Obama administration bought off moderate Democrats with billions in "exemptions" and pet projects. So some people will get something out of the deal.

Healthcare Reform: This one's actually much simpler to oppose than Cap and Trade.

1. Imagine the politician you hate the most. For some of you, it's George W. Bush, or Reagan, or Carter, etc. Now imagine that person in charge of YOUR healthcare.

2. Name one well-run government agency that always stays under budget. Just one.

3. Private insurance WILL fail if there is a government plan. If you owned a business and were spending huge sums of money on healthcare premiums, wouldn't you unload it as long as you knew there was a government "safety net" healthcare plan? You bet your bacon they will, and as employers bail, private insurers will go kaput. When that happens, the 50 million people projected to be on the plan will balloon, along with the $1.7 trillion price tag.

4. When the cost skyrockets, as it no doubt will, the call will come to contain costs. How many of us have struggled to explain why a pump or CGMS makes sense over NPH. Now imagine explaining that to a government bureaucrat that thinks you just take a pill to control diabetes. It's simple economics to a bureaucrat; the cost of a person on a pump in a year with fast-acting insulin and supplies will easily top $10k. NPH and syringes may only cost hundreds. If you didn't know anything about diabetes and your job was to contain costs, which would you pick?

Finally, I just want to reiterate how dangerous of a financial crisis this country is in. Ever heard of George Soros? He's the ultra-liberal billionaire founder of Moveon.org, and he's saying we're doomed to runaway inflation within 20 years. Warren Buffet? Heard of him? Richest man in the world and Obama voter. Let's just say he's having second thoughts. According to the polls, most Obama voters are.

By 2019, our debt to GDP ratio will have grown from 59% to 82%. That's bad. And people won't loan you more money when your debt ratio is that high. That's bad too. In other words, our debt won't be sustainable, and that's just with the stimulus money. Some 80% of the stimulus has not been spent. It's not too late folks to stop it. It's not too late to stop Cap and Trade, and it's not too late to stop government healthcare. You don't even have to admit you might have missed on this one, just don't miss in 2010.

I know we all look at California and the mess that it's in. California is what Obama wants for all of us. Many of California's major employers have fled the state because of its high taxes and liberal agenda. Where have they gone? Texas.

Liberal-run California was issuing IOU's because it's broke. And in conservative Texas, we're wondering "What recession?"

Bring on the Lows

So I have been very, very good on my diet for several days now. I've had light breakfasts of egg beaters, turkey bacon, and a slice of whole wheat toast. Lunch has consisted of lean protein and vegetables or salad and a banana or apple. And dinner has been grilled chicken or pork with steamed vegetables. I like to throw in a few "sugar-free" cookies afterward for dessert. Of course we all know what that means. No sugar = lots of carbs. I've done yoga, kickboxing, running, and walking to get more exercise.

I haven't seen a lot of difference on the scale just yet, but I know it will come. The biggest difference has been my insulin intake and the improvement over all in my blood glucose readings. Before my diet, I was using 80-100 units of insulin per day, 48 of those in basal. Now I am using 40-60 units per day total. And I'm also having lows. Lots of them, too. In particular I've had a low BG every night for the last three nights, and today I had a pretty nasty one at work. I literally had to sit in my cubicle and wait for the Coke to kick in, because I lacked the energy to stand.

My old endo, whom I miss terribly, always said that lows were an unavoidable by-product of good BG control. And he's right, they're going to happen, but tonight my wife took my pump and made some basal adjustments, so hopefully that will help reduce the quantity and severity of the lows I've been having. That's the advantage of having an endo that lives with you.

So here's to better BG control, and hopefully some pounds are melting away!