I get my insulin pump!

This is my new insulin pump. It's an Animas, and it arrived the day before Christmas, in a big box full of all sorts of paraphrenalia. I just got it hooked up on Friday. Right now it is pumping saline so I can learn how to use it without any risk -- a trial run, I suppose. Tomorrow, Tuesday, January 17, will be the day I start with insulin.

The Breast Exam and Fragmentation of the Patient

Today I went for my annual mammogram. It is probably the only non-diabetes related medical procedure I experience.

I find mammograms interesting because they say a lot about medicine. The breast, as the object of examination, is manipulated as if it were an independent part of the woman's body. This fragmentation is accentuated by the fact that the surface where the breast is placed is usually cold. The woman is placed in a position relative to the x-ray machine which is tantamount to contortion, as the breast, the focus of the procedure, is pulled away from the body and placed rather aggressively on the cold, hard surface. Finally, the breast is compressed between two plates up to the point of discomfort, which the technician asks about in an effort to get the most squish up to the point of the victim's tolerance.

Thus, the breast almost behaves as an independent entity during the test. The woman is separated from the breast. That is what fragmentation is in medicine. Another example is a Pap Smear, in which the focus becomes the uterus. In this vaginal exam, the woman is even shielded from that part of her body when a drape is laid over her knees. I had a gynecologist once who seemed to recognize me, finally, when he got down in front of my uterus, as though my cervix had my name on it. Once, as I was getting ready to leave, he quipped, "She stands up. She wears clothes." A patient not laying on a table with feet up in stirrups was something remarkable to him.

There is an obvious effort to make the mammography procedure more comfortable. At my "Breast Clinic," the waiting room is decorated with homey brightly colored furniture, almost cushy. There is a valence across the top of the window which faces the hall. In one corner (much to my delight) is a real desk with a computer on it, with Microsoft Explorer up and ready to go. A couple of times in the past, there has been a stuffed dog laying on the cold surface where the breast is compressed, in an attempt to warm it up. I have since learned that there is a market for mammogram warmers -- an attempt to make the experience more comfortable.

Perhaps these measures are meant to encourage women to have their breasts examined every year. It sure beats a cold waiting room, but the comfy waiting room environment ends when the woman enters the examining room. There, everything is functional, and there is no doubt that the breast at the "Breast Clinic" is an entity unto itself. "It stands up. It wears clothes."

Continuous Improvement in Diabetes Care

It seems that hospitals and HMOs can improve outcomes for diabetics by focusing on improvement of care.

An article about my health care provider, ThedaCare, give results of a continuous improvement program in diabetes care. The following are some of the results for diabetes care:

...through a combination of strategies aimed at improving care for patients with diabetes, ThedaCare has:

Increased the number of diabetic patients receiving a yearly eye exam from 65 percent to 85 percent

Increased the number of diabetic patients with HemoglobinA1c (HbA1c) levels below 8.0 from 43 percent to 60 percent

Reduced the average HemoglobinA1c (HbA1c) level among its diabetic patients from 8.7 to 7.6

It isn't surprising to me that there has been a focus on diabetes at ThedaCare, since the head of ThedaCare is Dr. John Toussaint, an endocrinologist who was my first diabetes doctor in the area.

I am in control!

I have been in control for two days now! I have been testing several times a day, and only once had a value over 200. I am counting carbohydrates and taking only the amount of insulin needed to cover those carbs. It feels great!

I ate a Sees Chocolate...

I just ate a Sees chocolate. Daniel brought them home. I try not to eat them unless I have hypoglycemia. I don't have hypoglycemia. Okay, so how much damage did I do?

There is an insert in the Sees boxes listing the nutritional facts, as they call them. I have a box of assorted chocolates. There are six charts in the little insert. Find the right one! A serving size for the assorted chocolates is two pieces, calories 160, fat 9 g, carbohydrates 20 g. Those chocolates are expensive luxuries in a diet, with all that fat and carbs! Okay, so I only ate one. One little chocolate -- 10 g of carbohydrate, 4.5 g of fat. Very expensive in the diet.

A cure for hypoglycemia is only the two chocolate serving. If it weren't for my kids, those chocolates would be around for a while!

Am I being studied? Nobody asked ME!

I am feeling annoyed today. I went to see the dietitian and diabetes educator, and although things went great with them, I have been wondering about something written at the bottom of my forms. There is a line on the bottom of the form that says "Special Status," and next to that, "Publish." I have seen this before, and in the past it has said, "Study." I have asked what this is about, and I get no answers. It seems nobody knows -- or else I am being put off.

As a social scientist, and a person accustomed to collecting data, it sounds to me as if I were in a study, or being studied, and that the results are going to be published. In anthropology we have a tradition. It's called, "full disclosure." It means that the people who are being studied consent to being studied, that I have told them what the true goals of my research are, and that I protect their identities. I have not consented to being studied nor published. Nothing has been disclosed to me.

UPDATE: I sent an email to my PCP's office, and received back some emails from the nurse (not the person I sent the emails to) giving me the run-around again. At first she didn't understand what I was talking about, and now she is telling me it's probably nothing and not to worry about it. I wrote back and told her to ask and find out. I am not going to accept "don't worry about it." If it's in my file, it's my business.

ANOTHER UPDATE (August 17): I again contacted the nurse at my PCP's office. I told her I was not yet satisfied. She responded that their "MyThedaCare expert" (MyThedaCare is the patient access website) couldn't reproduce the results. She said I need to bring in the form showing the word "Publish" at the bottom. I don't have the form because the diabetes educator took it. I have now sent the diabetes educator an email (also through MyThedaCare) asking her if I could have a copy of the form.

My Syringes

I know the Blogathon is over, but I had to add one more picture: my syringes. These are ultra fine syringes made by BD. They are subcutaneous. I use 1/3 cc and 1/2 cc. The needles are so skinny and small that you can hardly see them unless you're up close. For anyone who is afraid of needles, the truth is, these don't hurt. You don't even feel them.

The Boys Say Thanks!!!

Much thanks also from Ace and Henry, who were underfoot much of the time during the Blogathon, and especially Ace, who demanded constantly I play with his toy. I wish I could have gotten a picture of them both with a ball in their mouths -- a usually pose.

The Venus of Willendorf takes the last shot...

Okay, I promised one more picture of me shooting up. Here I am taking morning dose of Lantus, rounding out where I started my first shot yesterday morning. I do look like the Venus of Willendorf!!! Oh geesh, to lose that weight...

Luv Ya for all the support during the Blogathon!!!!

To Lei, Patty, Sennoma, Terrilynn, Sheana, and everyone else who followed my blog during the Blogathon! Thank you so much for the support for my efforts and for the Juvenile Diabetes Research Foundation! Thanks to the two friends who donated to my campaign and my mom, whose arm I had to twist but who finally came through.

No thanks to the rest of my relatives, those executives and doctors and lawyers and engineers, who did not come through with a dollar. Not even a penny.

I just want to tell everyone how much I got out of this Blogathon for myself. I never realized how all-consuming my life with diabetes is. To have it all down in words and pictures is pretty amazing. I really learned something from this experience. Plus, I had fun!

And it was great getting to know all of you! Let's stay in touch! xoxoxoxo

Candice

Berries

Here I am eating blackberries, and the Blogathon is almost over. I should post myself taking insulin one more time. Shouldn't I?

I'm Awake! I Swear!

It's my medication, I know it is. If I just weren't taking so much medication, I wouldn't fall asleep! It's that bipolar disorder. I have an excuse!

I feel as fat as...

...the Venus of Willendorf. I suppose it's one of those female self-image things, but since I quit smoking and gained weight, I feel pretty rotten about the way I look. I bet she had Type 2 diabets.

Polypharmacy

It's now 2:16 am. I didn't take my pills last night. I have a stack of them for my "head." They call it "polypharmacy." I guess the moral here is that if you have one affliction (say, diabetes) it doesn't mean you aren't going to get another one (say, bipolar disorder). One of my friends once commented, after she was diagnosed with ovarian cancer, that she had been thinking that this was her "big disease." Then she added, "You can think something is your big disease, but then it might not be." Interesting.

Off to take the meds.

Diabetes and the "Art" of Healing

I am a big fan of the NYU Medical Humanities, Literature, Art, and Medicine Database. This wonderful resource indexes medically-related film, poems, works of art and literature by topic, disease, affliction -- whatever topic you might want to find related to medicine.

There are several medically-related topics I enjoy looking up in this database, but of course diabetes is relevant here. The list for diabetes isn't that long, and oddly, "Steel Magnolias" is not listed under film. There is also no diabetes art listed -- but is there any? Hard to know (maybe I will invent some, ala Judy Chicago...I've got some ideas!).

Still, there are 17 works listed under literature that I haven't read. I am especially attracted to the W.H. Auden poem, "The Art of Healing." I know I must have read this recently. Yes I have read it. Here is a quote:

From "The Art of Healing"
by W.H. Auden

Most patients believe
Dying is something they do.
Not their physician,
That white-coated sage,
Never to be imagined
Naked or married.
Begotten by one,
I should know better. “Healing,”
Papa would tell me,
“is not a science,
but the intuitive art
of wooing Nature.”

Uh oh!

Uh oh! I crashed out there for a little while. Maybe I can use my diabetes as an excuse? Uh...I had low blood sugar...no, I had high blood sugar...

Thank God, I'm still here!