Sunday, January 31, 2016

Advice for Parents of T1D's

A wonderful interview with Barbara Anderson about parenting type 1 children. Barbara is a clinical psychologist, and a teacher of pediatrics. I wish all parents of T1D's would read this. She gives excellent advice.

Saturday, January 30, 2016

My Life With T1, Part 11

My Life With Type 1
.......Part 11.......
It was August of 1970 Anita and I were in Kingston, NY, far from familiar surroundings in Virginia. People talked so differently! We walked into a little shop and the young woman at the counter asked "Can I help yous?" What did she say? I thought "yous" might be like a plural for "you". I had never heard that word before. I talked with a southern drawl, and people told me I sounded like Andy Griffith, and Jimmy Stewart. After 45 years of living in NY I still have a little of that southern accent. You can take an ole' boy out of the south, but you cannot take the south out of the boy.
I was nervous about teaching in a NY college. The students had a much better high school background than most of my students in the southern colleges. High schools in the north are typically given much higher ratings than those in southern states. My fringe benefits package in NY was vastly superior to what I had in the south. In all the colleges in which I taught in the south the fringe benefits were very poor and almost nonexistent. During the beginning weeks of my first year teaching there there was a strike by the teaching staff at my college. I could not believe it! The best salary and fringe benefits I had ever imagined, and the faculty wanted more, along with higher salaries. I could not relate to any of that. I explained my feelings, and my fellow faculty members seemed to understand, but classes were not held while faculty picketed in front of the college. I did not participate in the picket lines. I just watched. Some of the faculty members were arrested and jailed for one night. The community college is a state college, and striking by faculty is illegal in NY State. I was happy that I was not arrested, but I was sorry for my friends who spent the night in jail. After a week or so the bargaining between the faculty and the county ended. Fringe benefits were even better, and there were faculty wage increases of 20% retroactive for the preceding year, and another 20% for the year in progress. The faculty won at the bargaining table, big time! I got the benefit of the raise for the current year, and that was a big bonus that I felt I did not deserve. I did not participate in the strike in any way. If a faculty in a southern college even talked about striking, heads would roll and it would never take place. Things were sure different in New York.
My years of teaching at Ulster County Community College were very enjoyable. My diabetes gave me very little problem. Dr. B. became my doctor in the late 1970's, and my diabetes control routine changed drastically. I started carb counting in the late 1980's, but was not keeping any logs until a few years later. I had much lower test results with the use of a glucose monitor. I eventually adjusted to lower blood sugar, and my diabetes health was improving. I had more frequent hypos though, and that was a major concern. My A1c's were taken in the mid 1980's, and they gradually improved. Dr. B. knew that I had frequent hypos, and in the late 1990's he had me use an NPH/Humalog mix. I had many highs and lows, but better A1c's because the high and low readings gave a good average blood sugar level and good A1c's. I think I may have had A1c's in the 7's at that time. I eventually convinced Dr. B. to let me use separate vials of NPH and Humalog. That way I could take meal boluses with my Humalog, and my carb counting could really help me. Dr. B. had hesitated to do this because he thought that my taking separate doses of Humalog would give me even more hypos. He was right. I had some very serious hypos, and there were 3 or 4 visits to my home by the paramedics. On one occasion I spent a couple of days in the hospital. Dr. B. knew about the hospital episode, but I did not tell him about the other hypos. I did not want him to take my Humalog away from me. My A1c's were in the 6's and still improving.
In the mid 1990's I had a new problem. I had been gaining weight with these new modern day insulins. That had actually started in the early part of that decade. By the mid 1990's I had gained 57 pounds. I worked so hard to keep my weight under control, but I kept on gaining. I had been running a lot of high blood sugar, and I had increased my dosage by 40%. My next A1c was much higher. In 1998 Dr. B. had new blood tests done which showed I was experiencing insulin resistance. That is a Type 2 symptom. At that time I was a Type 1 with a Type 2 symptom. A type 1 with insulin resistance is a "double diabetic". That does not mean I was both Type 1 and Type 2. I was autoimmune, and my pancreas did not produce insulin. That clearly made me Type 1, and not Type 2. Many Type 1 people have insulin resistance.
My performance on campus was not so good in the mid 1990's because of these new developments. I felt so run down, and I became tired so easily. My energy was zapped after my morning classes. I still had afternoon classes, and on some days, evening classes to teach. It was just not possible for me to have any enthusiasm when I met those later classes. I had nothing left in me. My last good year was 1993. After that year everything went steadily downhill. I was 54 and I had intended to retire when I was 62 so I could start drawing social security. We were heavily in debt. We had put both of our sons through six years of college. I taught lots of overload and summer school in order to finance their education, but my earnings were not enough. We took out a second mortgage on our home, and we borrowed money until we were not permitted to borrow any more. Our sons had their MS degrees and good jobs. That was very important to us. I struggled with my teaching until 1997. Then something wonderful happened. The county offered retirement incentives to retiring faculty members. I announced my retirement, and I received 70% of my annual salary as an incentive. That enabled us to pay off all our remaining debts. I retired in June of that year and we were out of debt. A miracle just when I needed it. I still had higher than usual A1c's and a roller coaster type of control. I continued part time teaching. We needed that extra money until I qualified for social security. I desperately needed to lose weight, and get better control.
In the very late 1990's Dr. B. told me there was a new med called Avandia being used in Europe. It was not yet introduced in this country because there was a chance it caused liver damage. By 1999 it was considered safe, and I started taking Avandia tablets twice per day. In just a few days I started improving. My insulin dosages returned to normal. A few weeks later I had regained my energy. My part time teaching was fun, and my teaching improved. I almost wanted to become full time again, but that was impossible. My full time position had been filled, and I would also have to give up my retirement income if I was full time again. I was happy, I felt great, and I was really enjoying my retirement. My weight was my only big problem at that time.
In the early 1980's we decided we needed mortgage insurance on our home. I went to a local insurance company, and they told me it would require a physical examination. A very old semi-retired doctor had me fill out a form. He asked me for a urine sample. He tested the urine with the special tape used for that purpose, and it turned a dark green. That indicated high urine sugar. He said he could not recommend me for mortgage insurance based on that urine test. He walked outside with me, and we stood by my car. At that time I had a been diabetic for about 35 years. He told me that I was very lucky to have lived so long without complications. He went on to say he had known another male diabetic like me who was doing very well, but had high urine sugar almost all the time. Less than one year after he had seen the man he developed kidney failure, and was going blind because of his diabetes. The doctor told me I should not expect to live much longer than I had at that time. He wanted me to prepare for dying. This reminded me of the doctor visit in Richmond, VA when I was told I should not expect to live beyond my 40's. I paid very little attention to this doctor with his antiquated ideas. The next day I went to the local Metropolitan Life building. They called Dr. B. on the phone, and they learned that I was doing very well after 35 years of diabetes without complications. They offered me a mortgage insurance policy. We also got one for my wife. I wish I had gone to Metropolitan in the first place. The insurance policies gave us peace of mind. We never had to use them. Our house was fully paid for in August of 1995.

Tuesday, January 26, 2016

My Life With T1, Part 10

My Life With Type 1
......Part 10......
After Anita and I were married on May 31, 1964 we drove away while all our parents and siblings standing there waving at us. We drove a mile or so and I realized that I did not ask for our marriage certificate. I thought that might be important, so we turned around and went back for it. The minister who married us was a Dean at the college, and the son of the dorm mother who was responsible for our getting together. I told her that if the marriage did not work out I would know whom to blame. She said she was not worried. She was a very sweet lady. So her son signed the marriage certificate, and we were off to Niagara Falls. I had seen the falls previously, but Anita hadn't. It is one of my favorite places. We loved it there, and our honeymoon was great !!! I cannot remember anything we did there except see the falls.
That summer I was scheduled to teach for the third time at Roanoke College. That gave Anita a chance to really get to know my parents, my sister and other relatives. They all loved Anita! When the summer session ended we drove back to Bridgewater, and I started my second year of fulltime teaching. We were living upstairs in a three room apartment that had no air conditioning. It was miserable until the cooler weather arrived. The teaching that year was fair, I still was not sure I wanted to make teaching my permanent profession. Anita fit in very well with the faculty wives at functions she attended. Some of the wives had been her teachers and it seemed strange to her being a member of the faculty wives group. That was my last year at Bridgewater since I lacked the PhD that was needed for tenure status.
In the the years that followed I taught three years at Wingate College in NC, and our first child, David, was born on Sept. 21, 1966. I wanted a son because I was the only male child with my last name who could continue my branch of my family tree. We were so happy, and everything was perfect. We left Wingate in 1968 and moved to Richmond, VA. I taught two years at Virginia Commonwealth University. My second son, Gary, was born in Richmond on Sept. 9, 1969. I left VCU after two years because of my not having a PhD. My uncle in Roanoke called me a gypsy math professor. It was time to find a place where I could get tenure and stop all the moving around. I looked high and low. All college teaching positions available required a PhD. Even the community colleges in Virginia required a PhD for tenure. Time was running out when I discovered that the community colleges of New York required only an MS degree. There was a job opening at Ulster County Community College near Kingston, NY. I got the job and we moved to Kingston, NY in August of 1970. Kingston is a small city of about 30,000 people, and it was the first capitol city of NY state. It was burned during the Revolutionary War but, was rebuilt in later years. The present day capitol is Albany, Ny and is located 50 miles north of Kingston. Kingston is a very historic city. Reenactments of the burning of Kingston have been held in the fall, and people came from all over to watch the spectacle. People dressed in colonial garb carrying old muskets, and the British storming the mock village in their bright red coats made an interesting display.
We were very hesitant about moving to New York. I had always heard southerners say the people were unfriendly, and we would not like it there. Nothing could be further from the truth. People in Ulster county and the surrounding regions are very friendly, and wonderful. We have always had good neighbors during the 45 years we have lived here. I loved teaching at the community college. I made many wonderful friends there. My students would sometimes laugh at my southern accent, but I eventually lost most of that accent through the years. I will always have an accent though. There is an old saying : "You can take an ole boy outta the south, but you can't take the south outta the boy".
I had some rough times with hypos while teaching in NY. I was using Humulin N & R insulins and NPH insulin later on, and I had more low blood sugar than I had ever had before. I had a few lows while teaching, and my vision would get blurry. I ate sugar from my briefcase, and apologize to my students. I did not want to have the reputation of a teacher whose performance in the classroom was hindered by diabetes. I never missed a class meeting during my 34 years of teaching because of my diabetes. I will always be proud of that fact. I also attended every class meeting when I was a college student except for one day in graduate school. I was too weak and sick with the flu to climb to the fourth floor where my classes were held. There were no elevators.
I had hypos at night after using the new insulins, and Anita had to bring me out of those hypos many times. I wished so often that I could go back to the beef/pork insulins. I rarely had hypos with the older insulins, but I had so much high blood sugar then. I still did not know about carb counting in the 1970's. Dr. B. insisted that I stick with the newer insulins.
In the late 1980's I learned about carb counting, and I bought my first glucometer. I had a high blood sugar reading almost every time I used that contraption. I did not like it! All those highs could not be correct! I wanted to throw it away. Anita convinced me to stick with it. I soon realized that the highs were indeed correct, and I had to adjust to that fact. I had always felt normal and good with high blood sugar. That was my perpetual state of being from 1945 until the early 1980's. I soon saw that many of the hypos I had been having occurred when I was in the low 100's. Those are now called false hypos, but they sure felt real to me. It took me a long time to adjust to using carb counting to control my blood sugar more effectively. I started feeling comfortable with my blood sugar in the low 100's and even in the 90's. Carb counting had turned my life around. I had lots of hypos, but they were no longer false hypos, and I had highs too. I knew I was experiencing much better control than I had ever seen before. Dr. B. was my guide through all these changes. I feel that he is largely responsible for me being alive today.
The picture shows our sons, David and Gary, soon after we had moved to New York, in 1970.

Saturday, January 23, 2016

Early Life, T1, Part 9

My Early Life With Type 1
.......Part 9.......
As I have already stated, my blood sugar ran much too high from my diagnosis in 1945 until the 1980's when I discovered that I was supposed to eat a low carb diet. I did not know about carbs being part of the equation prior to that time. I could only test my urine to get some idea of my blood sugar level. Of course urine sugar does not necessarily correlate well at all with the blood sugar level at any given time. I did not know that though. I always tested my urine before eating, and limited my portion sizes and types of food accordingly. Through the years I had learned that certain foods were not good for me. I could feel my highs and lows quite well. (Much later on I discovered the highs I felt were like 250 or greater and the lows were actually in the low 100's.) I knew that too much fruit, pasta, bread and the desserts Mother made for me made me feel high if I ate big portions, so I limited these portions so I could feel better. I knew nothing about carbs, but this was still a very crude form of carb control. I am sure that it helped during my teen years, and until I learned what an important role carb counting could play in the 1980's. I never was more than 5 pounds overweight until the 1990's. Weight was not a problem. I did not keep a log until I started carb counting. No doctor prior to the 1980's ever suggested that I keep a log or limit my portion sizes on certain foods.
My wife and I moved to different locations several times during our early years. I had an MS degree, but not a PhD. To get tenure at a four year college a PhD was required. I was a full-time teacher at two four year colleges in the south, but I was allowed to teach only two years at each of them because I did not have a PhD. We moved from Bridgewater, VA to Wingate, NC then to Richmond, VA and finally to Kingston, NY between 1964 and 1970. Every time we moved I looked for a new doctor, but I never found one I especially liked. They were OK for diagnosing and writing prescriptions, but none of them knew much about diabetes. Either knowledge about diabetes progressed very slowly prior to 1980, or the doctors I saw were just not keeping up with any advancements being made, and so I learned so little during all those years.
While we were living in Richmond I found a specialist in diabetes listed in the yellow pages. I do not remember if he was an endocrinologist, but I do not think he was. It was 1970 and there may not have been endos at that time, at least not in the areas where I lived. I was very excited about this diabetes expert, and I made an appointment. His office was very crowded, and patients were spending, on the average, about 15 minutes with him. He saw me for the first time, and looked at my blood test result that his lab technician had performed on me when I first arrived at his office complex. He frowned and said the result was very high. I do not remember the level now. He spent so little time with me even though it was my first visit. He gave me a book about diabetes that had been written about 20 years earlier. I am almost certain it was written in the early 1950's. I do not remember the author or title of the book. He told me to pay particular attention to a certain page. That was a very strange doctor visit, very short and not at all informative. I was very disappointed. I liked my previous GP's better than this so-called expert. I went to my car and immediately turned to the page he felt was so important. There was a chart on that page. In the leftmost column there was a list of ages at time of diagnosis and in the adjacent column there was a prediction of age at time of death. According to that chart I was supposed to die in my late 40's. I was 30 at that time so this suggested I had less than 20 years to live. I was terribly depressed!!!!! I went home and showed Anita. She hugged me and gave me the comfort I desperately needed, but that chart nagged me terribly for many years after that day. Anita and I discussed the office visit, the doctor, and the book. We decided I would not see the doctor again. We threw the book in the trash can. We knew that I had no complications, and I felt good even though I had high blood sugar almost all the time. We wanted to believe that I was an exceptional individual, and the statistics in that book did not apply to me. Actually that did turn out to be the case, but we did not know that at the time. It was merely wishful thinking.
We moved to Kingston, NY in August of 1970. I had to go that far to find a college where I could get tenure and advancement in rank without a PhD. Only an MS degree was required in the community college system of NY state. We were very impressed with the job I had there. The fringe benefits were fantastic. I looked for a doctor, and found a GP with a heavy German accent. He was the best doctor I had had at that time. He knew much about diabetes, and he spent as much as 30 minutes with me on each visit. He tested my blood himself, while I watched. It was high but with his instructions I learned a little about carbs, and certain things I should eat in very limited portions. I followed his advice and before he was in semi-retirement in the late 1970's I had the best control I had ever had. My urine sugar still showed high much of the time, but I also had frequent lows. I began feeling very high in the upper 100's whereas I had previously felt good at that level. It was extreme highs well over 200 that had made me feel high and, somewhat sick prior to that time.
In 1977 I knew that my doctor was about to move out of the area, and I needed another doctor. A neighbor recommended a new doctor who had just opened up his practice. He was from Thailand, and had a heavy accent. He was a specialist in internal medicine. His office was in the basement level of the Kingston hospital. He was in charge of the dialysis department at the hospital. He spent a lot of time with me on my first visit. He obviously knew very much about diabetes. I was so impressed, and I thanked my neighbor for recommending him. Dr. B. was the best doctor I had ever had, and he is still one of my doctors today. He is only a one year younger than me, and may retire at any time. He has helped me so much. He has had many diabetic patients, and they talked about him in the waiting room. Everybody liked Dr.B.
He told me to buy a glucometer in the late 1970's. I had never heard of one. It was the AccuChek meter, perhaps their first model. It was much bigger and more cumbersome to operate than today's meters. It took a much longer time to produce my blood sugar level. Almost every time I used the meter it showed me a high number. Many times it was a little over 200. I did not trust or like this crazy meter! It could not possibly be correct! I felt good, how could all these highs be correct? This had to be a defective meter. But no, it was not defective. I realized for the first time that I had been running very high blood sugar for 35 years. Dr. B. confirmed my suspicions and we talked at length about it. What a revelation!!! Why hadn't I developed terrible diabetic complications after 35 years of high blood sugar? Dr. B. could not answer that question, and he still can't today, but he did tell me he had other patients who had diabetes for a long time, and many of them were on dialysis or had heart, or eye problems. In the early 1980's I started keeping logs of my BG levels, insulin dosages and number of carbs eaten. It was a very new experience for me, and I enjoyed making out those logs and watching my control gradually improve. I was on Humulin N and R at the time I first saw Dr. B. I stayed with those insulins for quite some time. I had thrown my old glass syringe away, and was using disposable syringes. They were great. No more boiling the glass syringe and needles every morning in order to sterilize them for repeated use.
A1c testing was available in 1976. Dr. B. started giving his diabetes patients A1C testing in 1980. My first A1c was higher than he wanted. I kept on plugging away, and kept improving, but it was still too high. Dr. B. asked me to consider going to the Joslin Clinic in Boston for diabetes treatment. I was doing so much better, and I kept on improving, so I did not want to go to Boston. Later on he asked me to consider using an insulin pump. Again I refused, because my A1c was getting better and better. He saw room for improvement, and wanted me to pump. He never pressed me to make changes if he saw I was opposed. Now I wish that he had insisted that I use a pump back then. I started using vials of Humalog separately from my NPH and I had the best control ever. I had been using an NPH & Humalog mix prior to that time. Dr. B. had hesitated letting me use the vials of Humalog because he knew I had hypos rather frequently. I had been taken to the ER once during the 1980's when Anita was not able to bring me out of my unconscious state. There were two or three other ambulance visits when the same thing occurred, but the shot they gave me each time worked so quickly. I immediately stood up and walked around. I was fully aware of my surroundings, and I told the guys I did not need to go to the hospital. They had me sign a paper that allowed me to stay at home. This has not happened in recent years. My hypos are not nearly as bad or as frequent now.

Tuesday, January 19, 2016

Early Life, T1, Part 8

My Early Life With Type 1
........Part 8........
In August of 1963 I moved out of my parent's home, and set up a room
at a lady's house in Bridgewater, Va. She was an elderly lady, and a
substitute dorm mother, She was living there by herself. I was free to
use the kitchen, and watch TV. All that for $75 per month. It did not
seem like such a good deal back then.
I started teaching at Bridgewater College that fall, I was 24 at that
time. I had diabetes for 18 years, and I had no complications, even
though I ran high blood sugar so much of the time. I still did not
know about carb counting, and I ate many carbs every day, but I
avoided sugar, just like the doctor said. I was using the test tape
method of testing my urine. A little urine placed on the strip of tape
would make it turn various shades of green. The tape was initially
yellow and if it remained yellow after inserted in urine then there
was 0% sugar present. If there was sugar then the tape turned green,
the darker the shade of green then the higher the urine sugar. I used
that type of urine testing for many years. I do not remember exactly
what kind of beef/pork insulin I was using at that time. I just know
that certain improvements were made, and there would be some
occasional changes, but it was still insulin from pigs and cows. It
kept me very much alive. I had a good life and good health despite my
high blood sugar levels.
Teaching was going reasonably well that fall, but it was much more
challenging because I had a full schedule of five classes. It was very
different from summer school. I had noticed that the head of the math
department, who was about 5 years older than me, was dating one of the
coeds on campus. I discovered teachers were permitted to date students
as long as the students were not members of their own classes. There
was another young male teacher who was not at all good looking but he
was dating a very attractive female student. I thought "Hey, if they
can do it so can I!!!" I looked at the 1963 college yearbook, and
started with the senior class. I made a list. Bridgewater College was
a small college then and had less than 700 students. I shared an
office with the head of the physics dept. and he knew many of the
female students on campus, at least by reputation. He looked at my
list and immediately said no to all of the seniors on the list. They
were either married, engaged or had questionable reputations. I asked
the dorm mother where I was staying, and she confirmed his decision.
Oh well, on to the junior class. There was one very attractive gal
named Wanda. She was a junior and a physics major. My office mate knew her well. She had the same kind of reputation as Mary Louise, very
intelligent, straight A student and a good reputation. I called her
that evening and we had our first date on Friday of that week. She
agreed to date on Fridays only so I called her "my girl friday" like
in the book "Robinson Crusoe". She wanted to get a PhD in nuclear
physics, and she was a very interesting gal, but I saw no real future
in our relationship. I could see a pattern developing. My girl friends
had been very pretty, and very intelligent, with great reputations.
Why was I able to get dates with such young ladies? I found out later
on that dating a teacher was a really big deal among the girls in the
dorms there, and so I felt I had a chance with just about any girl I
chose. Back to the yearbook. Let's see, one for Saturday, one for
Sunday,....... Can you tell I had delusions of grandeur? I had more
juniors and some sophomores in a list in my little black book. I
showed the list to my dorm mother friend. She looked very carefully at
my list and said date this one, her name is Anita, she is wonderful,
and forget about the others. That was not my plan, but I agreed to
give Anita a call. After a few dates with Anita I was not so
interested in calling any more girls, so I just stuck with Anita and
Wanda. I dated Wanda on Friday, and Anita on Saturday, Sunday,
Monday,..... I guess the dorm mother had hit the nail on the head.
Anita was different in a very positive way. Beautiful, so sweet, and I
felt very comfortable with her, like I had with Mary Louise. I looked
for that little black book one day, and it was gone. I have wondered
if the dorm mother had cleaned my room one day. saw my list, and threw
it away??? She really did like Anita. I DID TOO!!! I stopped dating
Wanda, and Anita and I were going steady. Anita eventually told me
that the girls at her dorm had helped her fix her hair, pick out the
dress she wore, etc before our first date. I think the whole campus
knew we were dating. At that stage I was even dating her on Fridays.
Dating every day of the week. I wonder if any other couple ever did
that. HMMM!
I took Anita home with me for the Thanksgiving weekend. Mother loved
Anita! Daddy did too! Hey, this is getting serious here!!! Anita and I
had already admitted our love for each other. When the semester was
over I went home for Christmas, and Anita went to Falls Church, VA to
be with her family. It was agreed that I would go to Anita's house the
day after Christmas so I could meet her family. Late on Christmas Day
a terrific snow storm hit Roanoke. The roads were plowed late the next
morning, but the driveway at our house had about 18 inches of snow. My
parents insisted that I stay home, and wait to see my sweetie when the
spring semester began. They were out of their minds!!! I shoveled the
driveway, and packed my car while Mother was screaming at me. I
started up the hill on our driveway. Too much ice, it was bitter cold.
My tires were spinning, and Daddy helped me put chains on the rear
wheels. I still could not make it up that hill. I was about to give up
when I saw daddy coming with his tractor. He pulled my car up the hill
to the road, and off I went. The roads between Roanoke and Falls
Church were slick and dangerous but nothing was going to stop me. It
took me about six hours, normally it would have been four hours. I
found her house, and I met her parents and her brother. Nice people!
That evening we went downstairs to the rec room where there was a
fireplace, all warm and cozy. I proposed marriage that evening, and
she said yes!!! HURRAY! Months later her Mother said she knew that we
were engaged, she could tell by Anita's grin as we walked up the
steps. We were going to keep it secret for awhile because we had been
dating for less than two months, but they knew. We planned our wedding
for May 31, 1964. We were married after 7 months of courting. We
celebrated our 51'st anniversary on May 31, 2015. We have had a
wonderful marriage, still going strong!!!
Anita read this after I finished in 2010.. She proof read all my chapters. She
said it was to find misspelled words and grammatical errors, but I know
she had other reasons as well. She was an English major in college.
She howled all the way through this chapter.
The first picture below shows Anita when she graduated from high school in 1962. The second shows us with our firstborn, David, 1966.

Sunday, January 17, 2016

New Diabetes Tech, 2016

Anticipated new diabetes technology for 2016, from DiabetesMine.

18 Truths, type 1

Riva Greenberg is one of the very best authors and bloggers on type 1 diabetes. She has written three wonderful books, and is an author on the Huffington Post. Read the article below, if you are a T1D, or have a loved one with T1D, you will appreciate this article.

Wednesday, January 13, 2016

Early Life, T1, Part 6

My Early Life With Type 1
........Part 6......
Dr. Walpole, head of the math department at Roanoke College, wrote a letter to the Statistics Dept. at Va. Tech on my behalf. They offered me a Fellowship for doing graduate work. The National Institutes of Health was the sponser of that fellowship. Va. Tech, at that time, was one of the top four schools in the country for graduate level statistics. There was much demand for statisticians nationwide at that time. Dr. Walpole had been my teacher for several courses during my undergraduate years and he thought I was a good candidate for the Fellowship. He must have written a glowing letter of recommendation. The fellowship paid all my expenses including room and board and there was some left over. I was in awe of the other beginning graduate students in my classes in the fall of 1961. Many of them had come from big name schools like Dartmouth and Stanford and some were from foreign countries. I talked to them and they made me feel so small and insignificant. My background was indeed insignificant compared to theirs. I was very insecure and felt very much out of place.
Now let's get one thing straight! I am not super intelligent. I made good grades in high school and undergraduate college but I had to study long and hard to get my grades. I had friends who studied much less and still made better grades than I did. I have better than average intelligence but I am nothing special. These other beginning graduate students talked circles around me, how could I possibly compete? A "B" average was required in order to remain in graduate school and to keep my fellowship. I thought I would be very lucky to keep that average. I never worked so hard. I tried working in study groups and I was so depressed, I could not understand what they were talking about. I had to hoof it on my own. A high "B" student from little Roanoke College did not have the preperation that an "A" student from Dartmouth did. There was no comparison. I hated that year in grad school. I squeaked through with a "B" average and the posted grades showed most of the other members of my class had "A" averages for that year. I was not sure I wanted to return for a second year but I did not tell anyone at Tech that.
I had always been a shy kid and had great difficulty standing before a group and communicating. I had to do something about that. I went back to Roanoke College one weekend that spring. I talked to Dr. Walpole about a summer school teaching position. Someone had already been hired but that individual learned that he had cancer just two weeks before my visit that day and he would not be available to teach that summer. Dr. Walpole was delighted I wanted to teach. My mouth dropped and I wanted to run to my old chevy and drive away. Was this actually happening? What was I getting myself into? HELPPPP! I agreed to take the position. I was to teach four classes that summer. That is unheard of in this day and time. A max of two classes is allowed at colleges for summer school now. Teaching four summer classes is like teaching eight classes in a regular semester. I taught Elementary Algebra, Finite Math, Calculus I and Calculus II. I approached my first class in June and I was petrified. My knees were so weak that I thought I would collapse. I sat down fast so I would not fall down. Calling the roll gave me some relief. I don't remember how I got through that day, but I did. Actually I was doing very well by the end of the week. I was amazed.
I was not able to test my blood sugar. I don't know if I ran high or low but it was probably high. I did not know until about 23 years later that counting carbs was necessary for good blood sugar control. No hypos, that was the only good thing about running high blood sugar. I was so accustomed to running high that I did not notice anything peculiar. I always felt that way. It was my perpetual state of being. If I was high there was nothing I could do. There was no fast acting insulin like Humalog available then. I took one injection of my beef/pork insulin in the morning and that was it.
I became a successful math teacher that summer. I was doing this to force myself to lose some of my shyness. I did not intend to ever teach again. I did not know what I would do after graduate school but teaching wasn't so bad! How about that!!!
I told my students at the end of summer school that they could call me at home (my parent's home) and get their grades so they would not have to wait so long for report cards to be released. One of the students who called me was Mary Louise. Cute little thing! She made an A in both Calc I and Calc II that summer. She had the highest grade in both classes. I gave her the exam grade and course grade and then we talked for awhile. It was so easy to talk to her. I felt so confident and at ease. I asked her for a date. She was only three years younger than me. She was happy to go out with me. We made a date and after I hung up I remembered I had a date scheduled with Linda the same day. I called Linda and said I was too busy finishing summer school. So, I lied, but I was really looking forward to dating Mary Louise!!!

Leonard Thompson, T1, 1922

Leonard Thompson (1908–1935) is the first person to have received injection of insulin as a treatment for Type 1 diabetes.
Thompson received his first injection in Toronto, Ontario, on January 11, 1922, at 14 years of age.
On This Day In Diabetes History - Leonard Thompson - The Boy Who Lived 

Monday, January 11, 2016

Time Out, Humor

Time out for a little humor....

Now that I am getting on in age, I am thinking about memorizing the following Seniors texting code. I believe in being well prepared.

ATD: At The Doctor's
BFF: Best Friend Farted
BTW: Bring The Wheelchair
BYOT: Bring Your Own Teeth
CBM: Covered By Medicare
CUATSC: See You At The Senior Center
DWI: Driving While Incontinent
FWB: Friend With Beta Blockers
FWIW: Forgot Where I Was
FYI: Found Your Insulin
GGPBL: Gotta Go, Pacemaker
&nbs p; Battery Low!
GHA: Got Heartburn Again
HGBM: Had Good Bowel Movement
IMHO: Is My Hearing Aid On?
LMDO: Laughing My Dentures Out
LOL: Living On Lipitor
LWO: Lawrence Welk's On
OMMR: On My Massage Recliner
OMSG: Oh My - Sorry, Gas.
ROTFL-CGU: Rolling On The Floor
&nbs p; Laughing.. And Can't Get Up
SGGP: Sorry, Gotta Go Poop
TTYL: Talk To You Louder
WAITT: Who Am I Talking To?
WTFA: Wet The Furniture Again
WTP: Where's The Prunes?
WWNO: Walker Wheels Need Oil
WMDP: Where's My Darn Phone?
GLKI: Gotta Go, Laxative Kicking In
CRS: Can't remember S**t!!

Friday, January 8, 2016

Early Life, T1, Part 5

My Early Life With Type 1
........Part 5........
At the end of part 4 I had started college, but I want to fill in with some missing material. I will go back to college later on. lol
I have read about young diabetics who cheat and rebel. I was diagnosed at the tender age of 6. I loved and respected my parents, and I did not question their demands involving my diabetes care. I was NEVER to eat sugar or candy or other items containing sugar unless I was having very low blood sugar. I followed that rule to the letter. Mother was so good to make me wonderful desserts sweetened with saccharin. I loved her desserts so much that I was not tempted to eat their sugar sweetened desserts. Some of my favorites were banana cream pie, cherry vanilla custard pie, baked custard pie, chocolate pie, rhubarb pie, peach pie, and raisin pie. The pies had homemade crusts that were very thick, and they were divided into five pieces for my dinners, and suppers. Can you tell I liked pies??? There was also applesauce cake for my birthday and again for Christmas. The cake contained lots of nuts and raisins, and applesauce to make it stay moist. None of these desserts contained any sugar so they were OK for me, right? We thought they were. Can you imagine how many carbs were in these desserts? A typical breakfast had two kinds of meat, perhaps sausage cakes, and thick ham slices which I ate with my eggs. There were homemade biscuits with lots of butter, and I would dunk them in my saccharin sweetened homemade apple butter. That and a big glass of milk from our own cows completed my meal. Is it any wonder that I had terribly high blood sugar? The breakfast was so large because both of my parents were raised on a farm and they, and their families worked hard and needed that food for energy as they set out to do their farming chores. I do not think my parents knew any other way to live. We had three large meals every day, and I am certain I must have eaten more than 500 carbs per day. When the peaches were ripe in our orchard I would climb up on the lower branches, and reach up for a mellow, juicy peach. They were as big as a grown man's fist. I would eat one, and my tummy would hurt. I was covered with juice, so I would go home to wash up. Daddy always sprayed our fruit, and every time I ate our fruit I was eating dangerous chemicals. We did not know any better. It never hurt any of us so far as I know. We had plums, grapes , strawberries, raspberries, apples and pears. I ate too much fruit, but I loved doing that. I was in charge of the melon patch. I planted cantaloupes and watermelons each year. They required sandy soil and lots of water. The were left on the vine until they were fully ripe. They taste so much better that way than when they are picked green, and ripened afterwards. The same is true with all fruit and tomatoes. My mouth is watering as I write this.
Daddy milked the cows at daybreak, and cleaned their stalls. Then he ate breakfast, and went back out to hoe or plow the garden, water and prune trees and shrubs. He did so many other things. He would then go home for dinner, and sleep on the floor for an hour afterwards. He then reported to the post office where he worked from 2pm until 11pm with a one hour break for supper. The lunch pail Mother packed for him was unbelievable. He ate some of what we had at home for our supper. Daddy would get home late, and try to be in bed by midnight. I have never known a man to work so hard. On some days he made time to pick up a load of shrubbery at my uncle's nursery, and plant them at people's houses. We told people that Daddy had three jobs. The farm, the post office, and the nursery. Daddy had a lot of muscle, and was never much overweight. None of us were ever much overweight, even though we ate food like there was no tomorrow. I was always skinny until many years later when I started using modern day insulins. We worked hard, and we all loved each other so much. Good food, hard work, and lots of love. That is my recipe for a successful family, and growing up well.
My parents never smoked cigarettes, or drank alcoholic beverages. They were my guiding light, and I intended to follow in their footsteps. When I was 10 a young lad named Bobby, two years older than me, came to our house. He was in my homeroom when I was in fifth grade. He had failed two times, and had been held back. He had never ridden a horse, and he wanted to ride our old work horse. So Bobby, Larry and I climbed aboard, and we rode through the pasture. Bobby offered us cigarettes. Larry and I had never smoked, but we did not want to be called chicken, so we smoked a couple. After Bobby went home we decided we would continue smoking after school each day. Larry took a pack of Lucky Strikes out of his father's pickup truck, and we headed to his back property where no one would see us. We smoked our way through several packs in a few weeks time. Larry's Father eventually caught on. He was missing his packs of cigarettes, and his Mother had smelled the tobacco odor on Larry's clothes. One night after dark Larry and his parents came to visit. That was most unusual and I knew something was up. Larry would not look at me, and he hung his head down. The jig was up. My parents were shocked to hear what I had done, but they did not punish me. It was not necessary. I was so ashamed that I had disappointed my parents, whom I loved so much. I think they knew I would never do anything like that again, and I didn't. My urine sugar had been 4+ every morning all that time I had been smoking. Now we all knew why. I had not been eating well either during that time. Smoking was the only bad thing I ever did as a child. My parents were good examples to follow, and my sister and I were good followers.
After I was grown I found that my Mother and Dr Davis had been working together for my "benefit". Mother would phone him, and tell him things that she wanted him to tell me, before she drove me in for my appointments. "Now Richard, you can't drink or smoke. that will make your diabetes much worse." That was after my cigarette episode. "Now Richard, you can't participate in gym at school, that will make your sugar go too low, and you may have low blood sugar." I do not know exactly how Dr Davis expressed himself on these occasions, but I can still hear his voice, and his advice. I always trusted him without question. I was very disappointed in my Mother, and the doctor, for their plotting and scheming. He also questioned my going to college, but he did not sound so forceful as he had the other times. Mother admitted that she had called Dr Davis about college. I was onto their wicked ways! HA!! Never again! I never argued with Mother about this. I just told her I was disappointed in her and she apologized. Daddy did not know anything about this. Maybe he never did. I never told him.
Mother had a very hard time with my diabetes even though she was an excellent caretaker. She had terrible asthma during most of my preteen years. I remember her smoking cigarettes that contained a kind of medicine. She would inhale the smoke, and the medicinal vapor entered her lungs, and helped her to breath more freely. There was no tobacco involved. These cigarettes were prescribed by our doctor. Mother would have a terrible time with her asthma after each of my hypos. She was a very nervous person, and took medicine for her nerves. She also had large varicose veins. They were causing her many problems, and she would wear elastic stockings to give herself some relief. A doctor suggested that she have the varicose veins removed from her legs. The surgery was very successful. She stopped wearing the elastic stockings, and her asthma improved. After a few months she never again had asthma problems. I was still having hypos at night, and that still made her nervous, but no more asthma. Is it possible that the surgery had some connection? It does not seem likely, but we were all very happy that her days of terrible asthma were over.
When I had just started eighth grade I had intestinal flu. I stayed at home several days, and I could not keep anything in my stomach, not the medicine the doctor had prescribed, and not even water. My parents thought that since I was not eating then they should not give me insulin. They were afraid I would have a hypo. They did not check this out with the doctor. After several days of no food, no water, no medicine and no insulin I was so weak I could not lift my arms, and I was barely able to move my head. The doctor came to our house. He called an ambulance. I stayed in the hospital almost two weeks. I recovered very well, and returned to school. I hope that those of you reading this know that you need your insulin even if you are not eating. You still need your "basal" insulin under these conditions, but you do not need your "bolus" insulin if you are not eating. Of course I did not have basal and bolus insulins back then. I continued to use the animal insulin for many years.
Something has always bothered me about my past. I had so much very high sugar prior to the 1990s, but I was healthy, without diabetes related complications. I must have had DKA, don't you think? I never heard of DKA until I joined diabetes online support groups in 2006. I never tested my urine for ketones. My doctors never mentioned it. How did I avoid terrible sickness if I had DKA? Had my body adjusted to having high blood sugar, so that it became my normal state of being? I know that does not make any sense, but I have no other explanation.

Wednesday, January 6, 2016

Early Life With T1, part 4

My Early Life With Type 1
........Part 4........
I was not a very good student during my first few years of elementary
school. I made a lot of C's but I never failed a grade. I studied hard,
and my Mother was a great help. She was a good tutor. She was the
valedictorian when she graduated from her high school. Impressed?
Well, I guess I should tell you that there were only four students in
the senior class that year. She attended a very small school house in
the area where she was raised. When she started school it was a one
room schoolhouse, and one teacher taught grades 1-12.
I had hypos during the night about once per week, and then ran high
blood sugar during the day. All those carbs caused the highs. Mother
was afraid I would have a hypo while at school. She approached the
teacher at the beginning of each year and explained my condition. She
said I should not exercise like the other kids. She convinced Dr. Davis
to write an excuse before school started each fall. I never
participated in play period or gymnastics of any kind. I sat and
watched the other kids. Mother would not have it any other way. My
classmates knew I was different, and they ignored me but never made fun
of me. I tried to make friends, but I was never very successful. I
became very withdrawn, and terribly shy. I hated my diabetes, and
blamed it for my misery in school. I never blamed my
Mother because I also feared having a hypo in school. Mother always
brought me out of my hypos at night by feeding me water containing a
lot of sugar. I knew there would not be anyone to do that for me at
school, so I sat and watched the kids play, and felt comfort in knowing
I would not have a hypo. I would have been so embarrassed if I had had
a hypo at school. I never did have a hypo in grades 1-12.
By the time I reached fourth grade I started making better grades. In
the sixth and seventh grades I made several A 's and B's, not many
C's. I was always the best in my class at spelling. I took great pride
in my ability to spell complicated words. I do make typos though. You
may spot a few. When I reached high school my Mother still wanted me
be excused from gym classes. I was rather good at basketball, at home.
Daddy nailed a basketball hoop to the side of the corn crib, and I
became very good at making baskets. I played and worked hard at home,
but always under Mother's watchful eyes. I still had that fear of
having hypos in high school, so I agreed to not participate in gym
classes. I wish now that I had rebelled and taken gym. I was still
withdrawn and shy in high school. I made a few friends though and my
grades were very good. I graduated number 13 in high school in June,
1957. My math teacher in my senior year found that I was not intending
to go to college. She begged me to go. I considered it but I knew my
parents would not approve.
My parents told me I could not go to college. They thought I would not be
successful because of my diabetes. None of my relatives had ever gone
to college. Many of them had good jobs and good salaries They lived in
fine homes. My parents did not understand my being so obsessed with
going to college. What they did not understand was that I was deeply
hurt by their telling me I would not make it through college because
of my diabetes. I had to show them I could do that, and do it well!
I had a good mind, and I wanted to use it in a meaningful way.
They begged me to apply for a job at the post office where my father worked. I could become become a post office clerk, and he could watch over me. So I had to choose between standing at a counter
selling stamps and weighing packages, or going to college. The only
coed college available was Roanoke College, just 20 minutes away. If
there had not been a college nearby I would never have gone to
college. My parents were disappointed in me, and Mother cried. They
were so dead set against my doing this that they refused to pay for
any part of my tuition or my college expenses. They were kind though,
they gave me free room and board. Daddy let me drive his older Chevy
instead of trading it in when he bought a new car. He kept the car in
good shape, and paid for the gas. I had no money of my own, so I had
to get a job. I started working at a supermarket the very month I
graduated from high school. I worked about 30 hours per week and
started off at 75 cents per hour. Every few months I would get a raise
of 5 or 10 cents per hour. I saved enough to pay for half of my
tuition for the fall semester. I was supposed to pay the other half
later during that semester. College expenses were so much more
reasonable back then. If someone was working at a grocery store to
pay for tuition in the 21'st century, it would be impossible. My being able
to live at home, and make enough money to pay tuitions, made it possible
for me to go to college.
I wanted to become an architect. There was a pre-engineering program at Roanoke College, and I chose courses that would enable me to transfer after two years to Va. Tech, to become an architect. I made all A's and B's (mostly A's) during my freshman year, except for chemistry. I was not ready for college chemistry. I talked to the chemistry teacher and she understood my problem but she could not do anything for me. I received C's in both semesters of chemistry, but I knew almost nothing about chemistry when the spring semester ended. Not having had the high school prerequisite chem course made it almost impossible for me. I felt the C grades were a gift. I was very grateful, but I felt guilty about it. I made new friends while in college, and we visited each other's homes. We played golf and went bowling many times. Good friends. I had a crush on several girls while in high school and during my freshman year of college but I was too shy to ask them for dates. I had my first date ever during my sophomore year of college. My shyness and lack of confidence kept me from dating until then.
One Saturday night I had to stay after hours at the grocery store to help with the mopping detail. Every aisle had to be clean and bright before we went home. I was so tired. I had not been on mop detail before. I got in my car and headed home. I thought my strange feelings were due to my fatigue. I turned a corner and collapsed at the wheel. I did not remember anything after that until I was awake, and my parents were standing over me with a crowd of men behind them. Several cops too. I had had a hypo. I never straightened the wheel after the turn so my car went off the road and down a steep hill into a creek bed. The car went between two vertical posts that were supporting a huge bill board. The people were measuring the distance between the posts and the width of my car. They said the opening was about two inches more than the width of the car. How could my car have passed between the posts and not touch either one of them??? I was not hurt and the car did not have a scratch on it. The guys standing in back were from a bar across the road. They had seen my car leave the road, and they found my parent's phone number in my wallet. Everyone but my parents thought I was drunk. I had never been drunk in my life. I had never tasted alcohol. My parents told the cops about my diabetes. I really don't think anyone there believed their explanation. There was no ticket though, and a big wrecker pulled my car up the hill later that night, or on Sunday. I was back at college Monday morning. It was like the whole thing was just a bad dream. I had many hypos during my early years during my sleep, or after a lot of exertion. There was no way for me to test my blood sugar before starting home that night. Glucose monitors were not available until many years after that. I had to go by the way I felt. It was that way for about 40 years until glucose monitors became available in the 1980's. My parents thought that God had protected me and that was why I was not hurt. I wasn't too sure about that, but I was certainly happy about having my car back and going to classes Monday morning. I never missed a class during my four years of undergraduate work. I never had a bad hypo on campus, but I had many lows, and had to eat sugar from a small container in my pocket.
There were no glucose tablets for a long time to come. Sugar worked very well. I remember having lows during tests, and my teachers never let me take a make-up test. I took my test with my class or not at all. I had a low during a calculus test that was so bad that my vision was blurred, and I could not read my test paper. My teacher would not believe me. That was the only math test I failed in college. There were only three tests and a comprehensive final exam in each math course I took. My failing grade on that test resulted in a B grade for first semester calculus. I made A's in all of my other math courses in college.

Sunday, January 3, 2016

My Early Life,T1, Part 3

My Early Life With Type 1
........Part 3.......
I was diagnosed in 1945 at 6 years of age, and I remember when my
family visited my grandparent's house for a family reunion in 1946. My
parents, grandparents, uncles and aunts were all gathered in the
living room, and I was in an adjacent room playing with my cousins. The
door to the living room was closed, and their talking became so quiet.
I pressed my ear to the door and listened. Someone asked my parents if
I was going to die. None of my relatives knew anything about diabetes,
but they knew it was very serious, and it could lead to my death back
then. My mother said she did not know what might happen to me, and
that the doctor did not know either. The rest of their conversation is
all a blur, but hearing that part of the conversation left a permanent
impression, and a fearful memory that I will never forget. Playing with
my cousins no longer interested me that day, or the next. At six or
seven years of age, I knew something about death, and I was very
I do not remember my relatives saying they were sorry for me, or
asking why I couldn't eat this or that. Relatives never talked to me
about diabetes until I was much older, and even then it was just a
quick "How is your diabetes?" and then the conversation changed.
People we talked to, and even friends, were not told any details about
my diabetes. I did not discuss it with my friends until I was in
college. There was still little or no knowledge about diabetes in the
general public for many years to come.
Now, in the year 2011, all the people in that living room have died.
Some of my cousins, younger than me, have also died. I am still
hanging on, and healthy, after 70 years of type 1.
We went to visit one of Mother's uncles not long after the family
reunion. It was early evening, and my aunt wanted to serve refreshments.
She took me by the hand and led me to a room down the hall. It was
kind of dark in there, but I could see well enough to eat part of the
big apple she handed me. I wasn't really hungry. I could hear the
rattling of dishes where the rest of them were having cake and
lemonade. I didn't care that they were eating their cake, I was hurt
because my aunt did not want me to be with them. I never liked her
after that visit. Of course I was permitted to join them after they
were finished, but I just wanted to go home. I never got much of an
explanation for what had happened. I suppose my aunt thought it would
be cruel to have me see them eating cake.
My doctors never told my family about the terrible complications that
type 1 diabetics could have back then. Not knowing the potential bad side
of diabetes made it much easier for all of us. Of course, I was not eating
the way I should, and there was no meter for testing blood sugar, so I'm
sure I was having poor control much of the time. There are records in
later years that show that so many type 1 diabetics died early deaths for
many years. I managed to survive and thrive, and it is difficult to say how
I managed to do so. Modern day research has shown that many of us
type 1 diabetics diagnosed so many years ago have lived very long
lives, with no serious complications. The Joslin Medalist Study in Boston
has conducted a thorough study of 1000 of us who have lived with type 1
for 50 years, or more. Many interestings things have been revealed by this
study. Dr. George King, head of the study, hopes to find the factors that
have enabled us to do so well, for so long.