opportunity?

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I've been thinking about what aimee mullins said about the opportunities her disabilities have presented her. On one level I recoil at the idea of seeing disability or chronic illness this way, fearing that the tired, "be positive", new age-y proselytising is just around the corner. But I don't honestly think she was just saying "look on the bright side" here either. Hm. Opportunity. At the end of the day, that hasn't been a concept I've every really considered in terms of my diabetes. Coping, trying to feel whole, aiming for grace, yes. Opportunity, not so much.

The other day, at a quiet moment, a very clear and simple question just popped into my head. If I were to consider the idea of opportunity in this experience of chronic illness and diabetes, what would that look like and mean? What is the opportunity, if any, does my diabetes offer me? The question just hung there in the air, quietly, lightly, without any judgement. It was a bit profound actually, to hold up this experience I've had, that I'm having at this very moment and turn it around to look at it from a completely different vantage point. What is the opportunity my diabetes offers me? I'd never asked myself that question. Never.

What happened next was surprising. Again, quietly, as if suspended in air, a tentative answer presented itself. If I look at my diabetes and all the hoopla and time I have to devote and details I have to focus on as my true reality, what comes up is this. Diabetes offers me the opportunity to gently, justifiably, kindly tend to my health. It offers me the chance to truly and deeply care for myself. It offers me a life path of nurturing and care, not unlike a gardener tending to their garden or a parent nurturing their beloved child. Diabetes offers me the chance to pay attention to my body, my health and ultimately, to life itself.

That's the answer that presented itself when I asked the question. There it was.

Now I'm not saying that this idea negates all the other things I feel about diabetes, the loss, the burden, the weariness. But it's interesting to add to the "hand of diabetes truths" the idea of embracing the opportunity it presents. I'm not sure I totally buy this yet but I'm certainly open to considering it. Up until now I've only seen diabetes as a thing that gets in the way of living a full life rather than a chance to profoundly celebrate living. At the very least, it's an interesting idea to hold in my heart for a while. And hey, if it brings me some peace and comfort in the process, it's certainly worth the consideration.

inside out.

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I'm heading back from the art center design conference at the moment, sitting in the airport, bone tired. It was a pretty good conference in a number of ways, interesting speakers, a wide range of topics discussed and the opportunity to see people I've come to know over the years but only see at this sort of event. As with any of experience like this, there were some very special presentations and insights I'm taking away and will ponder for days to come. Tops on that list for me was an unexpected exchange between the moderater john hockenberry and one of the last speakers of the event, aimee mullins.

john hockenberry is truly the best moderator I've seen at the many conferences I've attended in my career, bar none. He's brilliant at providing insightful analysis and personal thoughts throughout the event which serves to connect one speaker to the next and keeps the flow and energy of the event high throughout. He's also funny, charming and entertaining in his own right. And, he also happens to be a person who lives with a wheelchair because of a spinal cord injury, which on one level has absolutely no baring on anything, and yet on another more personal one, remains utterly significant for me. I remember the first time I attended this conference and watched this man command the stage with such intelligence, skill and humanity. I remember being moved and surprised in spite of myself. As a person who has struggled with the invisibility of my own health issues, it was truly a revelation to see another person whose physical differences couldn't be hidden, present to the world so wholly and comfortably in his own skin. I remember thinking that I was being offered an opportunity to learn something about my own journey with physicality through his.

Well 4 years later, this is still the case. This year the conference invited an amazing woman to present, the world class athlete, actress and model, aimee mullins, who also happens to be a double amputee. Very accomplished and stunningly beautiful, this woman who'd I'd seen from afar in many magazines and art pieces, was a real force of nature in person. Self confident, strong and positive without being pollyanna or denying of what her physical experience meant, I found myself rivetted by her talk. Again, like 4 years before, I felt as if I was being offered a rare opportunity to learn about my own physical challenges through another person's experience and view. And that felt powerful and precious, like a gift being presented to me by the universe.

But, I'm getting a bit ahead of myself. Before ms. mullins spoke, mr. hockenberry introduced her as he had done with all the other speakers. But this time, unlike the others, he began with a personal story about his own experience in rehab soon after his accident. As he told the story of having an intellectual realization about his body's new, strange reference point and consequent adjustment to moving through the world in a wheelchair instead of a walking person, and of trying to engage the attending physician in conversation about this idea, only to be tacitly dismissed by the doctor. I noticed a pitch in his voice that I hadn't heard before. It probably wasn't obvious to most of the people in audience I imagine, but I heard it immediately. It was that deep, quiet, shock of realizing you'd become something different than you were before, that you were becoming someone objectified and abstracted. In his voice I heard that horrible feeling of being made invisible, of having one's new life experience ignored and dismissed. mr. hockenberry was describing his new physical experience to a person who now only saw him as paraplegic (other) and not as an intellectually curious person too. I may be projecting or all wrong here, but that's what I thought I heard, quietly, underlying his story and voice. He went on to desribe this moment as the beginning of a profound isolation of experience, that in the absense of interest or curiosity on the part of the doctor he was trying to talk to, he entered what he thought was a very singular and particular journey alone.

And I immediately knew what he was talking about. Though in different circumstances and with a very different physical condition, I knew that feeling. I knew that loneliness and feeling of invisibility and dismissal too.

mr. hockenberry then went on to describe how he had met ms. mullins 30 years later and how their proceeding conversation about their personal experience with physical disability was a revelation to him. He described how he quickly realized that here was a person who understood what he was talking about to the disinterested doctor so many years before. Here was a person who was not only fascinated by the ideas of different physical vantage points and the dynamics of navigation, but one who had also developed language and philosophy around it. She fundamentally understood his intellectual curiosity around his physicality and also seemed to embody the fact that the intellectual and philosophical exploration of the experience was key to living life fully and whole. What followed was a remarkable hour of two interesting and accomplished people discussing their physicality, their exploration of it and their development of a philosophy and sense of opportunity around it. I sat in the audience and watched in amazement as these people talked about ideas I'd grappled with for so many years. It was so strange and wonderful to watch two other people consider, explore and even disagree about physicality, disability and the idea of differentness because of it, in public and with such vigor. It displayed a new normalcy, some of my normalcy as a person with a chronic illness, for all the world to see, publicly and without pity or shame. I felt so validated in my own intellectual instinct and curiosity around my own disease process and journey because of this. And beyond that validation, I was lucky enough to witness a real and robust exploration of ideas and viewpoints that I have rarely seen or participated in. Suddenly I realized how unique and unprecedented this was, that this public conversation had moved far beyond the usual idea of loss and struggle, the outside in view of disease and disability that normally defines the conversation, the one where grief and invisibility and struggle are the focus. Instead I was watching two smart, whole people having a knowledgeable and probing discussion from the vantage of inside out. They were demonstrating a new type of normal I'd never really experienced before. Not a less than normalcy but actually a more than view of normal, brought to bear because of this journey with the physical. Asset, not just disability. Opportunity, not just loss. And at the end of the day, what ultimately I take away from this event is that this journey of chronic illness is a profoundly human one, deep, exciting, personal, tragic and full of possibility all at the same time. The more that it's talked about, privately, publicly, intellectually, artistically, personally, the more that becomes clear. To me. To the world. The more it's talked about and explored the clearer the humanity of this journey becomes.

And that's a very, very good thing don't you think?

2nd annual diabetes mine design challenge.

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In the spirit of design matters, check out the wonderful 2nd annual diabetes mine design challenge. It's this kind of activism and vision that can bring about real change. I imagine somebody out there in the world, putting pen to paper as we speak, designing something that wouldn't have been designed before, something that will make our lives better, thanks to this challenge. One person, one challenge, one solution can bring about so much progress and positive change. Much thanks to amy for leading the charge!

Let the designing begin!

worried about worrying.

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In the spirit of full disclosure I have to admit that I come from worrying stock, so I come by the behavior honestly.  My grandmother was a worrier, my mother is a worrier, and yes, I'm one too.  It's in our dna, if that's possible.  Or at least it's part of our family culture, just like being political or not might be.  Or using cilantro in your food.  Or driving a certain brand of car.  Some families do it one way, others another.  In mine, worrying is just something we do. 

So given the fact that I have a natural tendency to worry, it doesn't surprise me that I do so when it comes to diabetes.  Living a long time with any chronic illness, and with diabetes in particular, what with all the details and vagaries you have to manage, presents lots of opportunity for worry.  In the immediate: did I take enough insulin?  Will that walk make me go low?  Was their hidden fat in that meal that will send my blood sugars sky high in the next couple of hours?  Yep, there's lots to get a worrier worrying here.  And then of course there's the long term stuff to worry about.  Complications.  Physical things related to diabetes that you didn't know about until you start having it happen, like frozen shoulder or thyroid disease or whatever.  Who knew until the doctor says "oh yes, diabetics have a higher chance of getting x".  Yes indeed, chronic illness has so much that serves as fodder for worry.

Because I tend worry anyway, and because I have a disease that presents lot's of stuff to worry about, I am realizing how much I'm living in a low grade state of worry everyday.  Worse yet, I'm beginning to realize that this worry state spills over into the rest of my life and quite frankly, is making me become something I'm not thrilled about.  Every pain, every stiffness, every natural aging thing like needing glasses or having a mammogram every year or aching more after activity, everything makes me worry a little.  Is it something serious?  Is it something I need to see the doctor for?  Is it yet another cause for worry?  And then I say no, it's fine, don't worry. But inevitably I think "but what if I'm ignoring something I should be paying attention to".  God knows one thing diabetes has taught me to do is pay attention to the slightest changes and details.  How do I only turn that on for diabetes and keep it off for everything else?  How do I know what is really worthy of worry?  And more importantly, how do get some time off from worry when I never get time off from diabetes?  How do I strike the right balance between appropriate vigilance and too much worry?

All good questions and not surprisingly now I'm worried I won't ever figure it out.  Ok so that's a joke (but not totally)!

just because I have a chronic illness doesn't mean I don't have good taste.

I've said it before and I'll say it again, design matters. Just because I have a chronic illness doesn't mean I don't have good taste. In that spirit, here are a few recent finds of products and prototypes that are shining examples of how medical stuff doesn't have to be clinical or ugly or boring. Say it loud sister!

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This beautiful rfid medical alert bracelet prototype by doria fan makes my heart go pitter pat. I'd wear this beauty in a flash if given half the chance. Groovy, pretty and functional, what more could a girl ask for in a medical alert bracelet?

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These beautiful alternatives to the usual over the counter drugs and bandages we use in our everyday lives come from the company help. Smart and simple design, elegant packaging and a wonderful philosophy behind the company, I know which bandage I'd pick if I had the choice. "While some health problems are large, complicated and frightening, most aren't the end of the world. A kind word and a little help can get you on your way again. Help Remedies was created to make solving simple health issues simple. We find the best solution there is, and take away everything else. By stripping away some of the complexity and fear mongering of the health industry, we hope to make the category friendlier and more accessible, and in doing so empower people to make their own health decisions. We think a little help, honesty and kindness will go a long way." Amen!

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And finally, how cool is this simple, modern, sassy container by urchin for all the unending diabetes supplies I need to have hanging around? I love it's straightforwardness, it's overt utility. I love the fact that something like this makes no apologies for it's contents or job. Take that embarrassment! Bye bye shame. Hello groovy modernity. Hello groovy diabetes girl.

weariness.

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I've been feeling pretty good lately. My diabetes has been under good control and I've been feeling alright about it all. Feeling like all is well even if I have diabetes. And then last week I had one of those weeks. A spate of high blood sugars without a clear reason why. Was it that meal out with friends that kicked it off? Was it the angle of my site and the fact that the waistband of my jeans kept jiggling it out of the locked position? Was I getting a cold (after all I'd woken up with a sore throat one night)? Was it stress from work, stress from a few high blood sugars? Was it some bad choices I had made? Or just bad luck? After a few days and a few nights up dealing with the roller coaster, I was tired and weary.

What's amazing to me about this, is even though I'd been cooking along well for a such long time, it only took a couple of days into a bad spell and there it was. The weariness. The deep, deep, weariness that I forget about on the good days. There is was like a snap of the fingers. Right under the surface, never too far away.

For some reason, that deep weariness always surprises me.

I've since changed out my site and my blood sugars have normalized and I'm back to feeling fine. I guess it was the angle and positioning of my site. Or maybe I'd hit some scar tissue. Or maybe a I overcame a cold that never came to fruition. Whatever the reason, things are better now and the weariness has faded. And I forget about it again, for now.

nutrition data.

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I'm totally intrigued with the amazing site nutrition data. Though it's actually pretty complex in it's breadth and depth, it's goal is to make the science of food more understandable and usable through simple presentation and information graphics. The content on the site requires some time to investigate but the result is hopefully a deeper understanding of what foods do, the value they bring individually and how in the end, they interact together for overall nutritional impact. There are many tools to play with here, to help understand the nutritional value, glycemic index rank, even the "fullness factor" of a particular food as well as to tailor recipes and food combinations to help a person meet their individual dietary goals. They also have a section for diabetes which tells me at first glance that they understand some of the complexity we face in terms nutrition. It's going to be fun to explore this impressive site and see where it takes me. No doubt I'll learn something useful along the way!

really getting it right.

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The other day I noticed something about what I notice. I always notice when I haven't done something right in terms of my diabetes. I notice when I don't correct a high accurately or I've over eaten to counter a low. I notice when I over bolus to cover for a treat or on the other hand, don't bolus enough to cover it. I always notice when I get it wrong.

Last weekend I had a bad low after a day full of gardening. One of those lows that feels like I'm never going to recover, sweaty, panicky, desperate. It's usually during a scary low like this that I overate in the immediate effort to get my blood sugar back to normal. Which was the case this time and I knew I'd pay later in the night with a rebound. At bed I was an acceptable 145 but as predicted was up later in the night with a 300+ blood sugar. At night I become very insulin sensitive and consequently need to take less insulin to cover a high than I do during the day. Which can be challenging to remember when I'm groggy and tired in the middle of the night. But this time I did remember and took the right amount for the night and promptly went back to bed. In the morning, my blood sugar was a happy 98 and I set about my day as I normally would. Walked the dogs, took a shower and got ready for work. And then a funny thing happened. I just stopped in my tracks. I realized something I hadn't noticed before. I had got it right the night before, pure and simple. Not wrong but right, as I had done so many times before. What was different this time was I noticed. I actually noticed that I had got it right.

What occurs to me is what a different feeling I'd have about having diabetes if I noticed all the little successes a bit more. Imagine if I noticed more of the times I got it right and celebrated those moments just as enthusiastically as I berate myself when I get it wrong. The sheer number of little successes it takes to keep my blood sugar in control easily outweighs the occasional mistakes. When I look at the picture this way it occurs to me that the noise and pain I've let surround my mistakes may really be out of proportion. If I let the weight of every 90 blood sugar or perfectly counted carb ratio or correctly figured correction bolus have more value in the overall equation of my diabetes control, the times when I don't get it right become so much more the exception than the rule. A small glitch, not a failure. A slip against a backdrop of getting so much right with a difficult disease.

And maybe at the end of the day, seeing it that way would really be getting it right overall!

asking for what you need.

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I heard a woman speak recently about the need to ask for what you want, to ask for the kind of recognition and feedback you need from the people who matter to you. It wasn't a long speech, 3 minutes perhaps, but it really struck me deeply nonetheless. Her point was that it's our responsibility on some level, to bring visibility to the things we need, to ourselves and others. Though people might not always respond to us in the way we want, the most important thing is that we've made our needs known to ourselves, out loud, in the light of day. I like that. I think it makes sense.

So in that spirit, I approached my 22nd anniversary of my diagnosis a little differently this time. Normally I don't tell anyone about it. My husband knows and now, thanks to this blog, I can tell my friends in the diabetes OC and they too understand how significant that is. That is normally enough. And quite frankly, the subject is an awkward one with anyone beyond this forum. I've never exactly known how to say to my friends or family that "today is the anniversary of getting diagnosed with a difficult disease". I imagined that they wouldn't know what to say and everyone would just feel more awkward around an already difficult subject and given the significance of the day, who needs that?

But as I say, I decided to try something different this time, thanks to that little 3 minute talk I heard the other day. I decided to let my brother know the importance of the day even though he's never really engaged with me much around my disease. My brother and I haven't always been super close though he's really important to me and I know we love each other a lot just the same. I was 27 when I was diagnosed and had already lived separately from him for many years. In a weird way he, like the rest of my family really, understands intellectually that I have diabetes, but practically speaking has no idea what that really means. He's never seen me struggle with low blood sugars or curse the inevitable highs. He's never watched me take a blood test thousands of times over or insert a new pump site, or rip one out either. No, my brother really has no reference point as to what the last 22 years have really been about.

My brother lives in another city so I emailed him last Thursday about something else we'd been discussing and then at the end of the note, simply mentioned that today was my 22nd anniversary of my diagnosis of diabetes. I said I was proud of how I'd handled it but sad about the experience too. That was it. I pushed the send button and went off to a day full of meetings. When I returned to my desk around 4:00, to my surprise, a gorgeous bouquet of multi-colored tulips was there to greet me. My brother, who has never been good at remembering birthday's or anniversaries, my brother, who is not demonstrative in that way, did the absolute, perfect thing. He noticed and acted. Because I'd opened up the possibility for him to do so, he did so. Because I let him in on my world, he had the chance to be kind and supportive back. He didn't have to know the details, he just had to know what was important to me.

On the card that accompanied the bouquet there was a note from him saying how proud he was of me for doing so well with this difficult disease. To say that I cried is an understatement. The fact that he understood this and that he felt pride in my approach, meant so much to me. I know it sounds silly, but I really didn't know that he felt that way. We haven't talked about my diabetes much in the past so to find this out, to see it in words and gesture, really made my heart skip. One small act of sharing, allowed for another act that not only made my day better, but also taught me something important about my brother. Even though he hasn't been a part of my day to day struggle, he has noticed in his way. I guess the world isn't always how it appears at first glance. I guess it's worth asking for what you need every once in a while. In this case, it most certainly was!

carrying on.

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Today is the 22nd anniversary of my diagnosis with diabetes. I am proud of how I've handled it but also so sad to that it ever had to happen in the first place.

This vintage British World War II poster from sfgirlbybay, which I have framed in my office at work, sums up my overall attitude about diabetes these days. Maybe it's because my mom is British so it's sentiment resonates deeply in my dna, or maybe it's just because it feels like it's the only choice I have, but there you have it. 22 years. Keep calm. Carry on.