Mending Wall

I have always loved the Robert Frost poem, "Mending Wall". For those not familiar (or those without time to click on the link), "Mending Wall" describes the annual ritual of repairing a New England stone fence between two properties. The narrator views this task as somewhat futile, for nature will just undo their repairs, if not immediately then over the course of the upcoming year. "Something there is that doesn't love a wall," he muses, describing a force which tosses the rocks asunder in an effort to tear it down altogether.

I live in a neighborhood of townhouses, seven sets of 8 homes each. Some of the small back yards are fenced, and there is a fence that borders our development. There are other barriers between neighbors, most of which relate to innocuous things like long commutes.

My husband and I are friendly with many of the folks here. We had the benefit of our neighbor Miss Meg, who made a point of introducing us to the 'old timers' almost immediately after our arrival. Since we are outside on most temperate evenings with our kids, we have met and befriended the other parents. All of this made our move to Virginia from Massachusetts three years ago relatively seamless.

Last week I had the painful experience of learning that my immediate neighbor has been furious with me for the better part of the past eight months. I said something in front of her last Fall, and she misinterpreted my intent, and has been giving me the cold shoulder ever since. There is no space for a physical fence between our properties, but there certainly are barriers between us. I must confess that when I heard her opinion of me, the first thing I wanted to do was to figure out how I could plant something, anything, in the six inch gap between our driveways.

But I can't live like that. While I can respect the physical and other lines that define our spaces, I (like the force that doesn't love a wall) am always looking to reach out and connect. Ignoring the advice of some, I approached her with an offer to talk things out rather than spend the rest of our days here avoiding eye contact with each other.

Today, we had a completely different neighborhood experience. Mid-day, one of the units on our street caught fire. Within moments of spotting the smoke, I was working with people to whom I've never spoken, trying to piece together who's unit it was, whether or not they were likely to be home, and whether or not there were any pets in danger. I hugged complete strangers simply because the look on their face demanded it.

The fire heavily damaged the unit in question, and putting out the fire caused damage to the two adjacent units (which were saved, ultimately, by very effective firewalls). Everybody's good neighbor, the Red Cross, was on the scene immediately, helping affected residents figure out where they'd spend the next few nights, even as offers of spare rooms down the street came forth.

This was clearly a day when fences would just have slowed us down.

It's spring here in Virginia, and we've all started to emerge from our cocoons, such as they are. Come six o'clock, we're hanging outside while kids ride bikes and scooters, chatting with each other about everything and nothing. I love the proximity that a townhouse neighborhood provides. Fifty-six families at different points in their lives; with diverse backgrounds, occupations, skin color and politics.

There's a closeness that comes from the lack of acreage between homes. A place where your son's best friend may live six houses away but that translates into only a few hundred feet. It forces you to confront misunderstandings, if only because avoiding each other is not a viable option. And it makes it possible to stand and watch one of your worst fears realized while literally and figuratively leaning on someone you hardly know.

Giving the People What They Want

Like many bloggers, I have a stat counter set up for this site and, like many bloggers, I periodically peak at the information that's collected. I've noticed a bit of a trend there. Pretty much once a week, at least, someone finds my blog as a result of a search for a phrase that includes the word, "noncompliant".

"Teaching a noncompliant diabetic," for example.

My blog name is obviously a bit tongue-in-cheek, but also comes from the fact that I have been noncompliant off and on throughout my career as a person with diabetes. I've failed to comply in small ways (those moments that elicit a 'can you eat that?' from others) and big ways (long stretches of nearly double-digit A1c's and a wheelbarrow full of excuses).

Really, though, I chose it because it's such a ridiculous concept and label. I'd say 95% of the population is noncompliant, but about 12 million of us in the U.S. have a genetic switch that flipped either on its own or in conjunction with some lifestyle extremes, and we ended up with diabetes, and our noncompliance took on a new meaning.

The other 5%, well they're the ones eating healthy and exercising, and I look at them with admiration and bemusement as I munch on Cheetos and drink my diet coke.

As a noun, noncompliant is defined as "a person who refuses to comply". In the context of diabetes, of course, that means someone who has been told what to do to take care of their diabetes but is clearly not doing it. The person who developed "Diabetes Made Easy" contends that noncompliance stems from a lack of understanding about the disease. She believes that if people truly knew what was going on when their blood sugar was high, they'd do whatever they were told in order to keep it in range.

I disagree, citing my own experience as a person thoroughly immersed in diabetes information yet still often unable to 'comply'.

Fred Kleinsinger, MD counters the lack of understanding concept nicely in his article "Understanding Noncompliant Patient Behavior". Don't be turned off by his seemingly arrogant statement, "Some of the more frustrating experiences I have had as a physician have involved patients who refuse to follow my perfectly good clinical advice". He quickly rejects his 'repeat it louder' technique for a more patient-driven approach.

The other angle here, in my opinion, is that the perfectly good clinical advice isn't always perfectly good or a perfect fit. When compliance means "do what I say because I say so", then the patient is bound to fail. Again, though, Dr. Fred's advice - which is to ask questions instead of lecture - can counter this particular root cause of noncompliant behavior.

How do you help a "noncompliant diabetic"? Well, if it's me, first of all don't hand me such a label. See me as a partner in my own health care. Help me find support outside of the fifteen minutes I spend with you every three to six months. Understand how overwhelming living this life can be. Perhaps, we focus on one part of my diabetes routine for a while, and go from there. It might take time to bring me back into the fold, and it will take adjustments to the 'approved' routine. You know it's worthwhile and I, even when cloaked in layer upon layer of denial and disregard for good clinical advice, know it too.

Smart Pump, Dumb Me

I woke up the other morning at about 5:30 am with that wonderful cotton mouth, dry eyeball, high blood sugar buzz. Reached for my pump to see what time it was and start a bolus - pressed the buttons - and nothing happened. Tried the touch bolus button - nada. Woke up enough to see the pump screen and realized it was completely blank.

Jumped (well, staggered) out of bed and into the bathroom to confirm that the pump was completely non-functioning. I was floored! A pump failure after 2 weeks?

No. A Kassie failure. Just before bed, I had removed the cozmonitor, which requires unscrewing the battery cap. The battery fell out and I popped it back in, upside down.

I completely failed to notice that the pump did not go through its little start up routine, which involves the pump beeping and vibrating and displaying its model number and other info. Hard to miss, right? Apparently not.

One mega combo bolus and 4 hours later, I was down to 132. Note to self: confirm pump is working after unscrewing the battery cap!

s1955 Scares Me

I just looked at the receipts from our prescriptions for last year. We pay a *lot* of money in co-pays. But the amount we don't pay is even more staggering.

Nicole posted eloquently on the issues around s1955 which - on the surface - addresses a pressing need for expanded health care coverage. But the cost, to anyone with a chronic illness, is overwhelming.

I've written letters to both my senators (through their sites) and I want to encourage you to do the same. We fought so hard to require health insurers to cover daily diabetes supplies. I cannot believe that it could all be taken away - or priced out of reach - in one fell misguided swoop.


ETA: Here's the text of the email I sent to family & friends. Feel free to swipe all or part of it.

Hello all,

The Senate will soon consider s1955, a bill which attempts to expand availability of health insurance, particularly though small business employers. This is, of course, a good goal, but the bill has a serious flaw.

s1955 will allow private insurers and state insurance plans in 46 states to circumvent laws which currently require them to cover diabetes supplies, education, and equipment. This means limited or no coverage for blood glucose monitors and testing strips, syringes, insulin, nutritionists, diabetes educators, and insulin pumps. People with other chronic illnesses will be similarly affected.

Not to sound maudlin, but this would be devastating for us personally and for millions of people with diabetes across the country.

Today, we have tools that allow us to live healthy - and long - lives. When I was first diagnosed 20 years ago, I read an outdated textbook that said I had 30 years to live thanks to diabetes. That statistic *used* to be true, but the improved insulins, insulin pumps, and home blood glucose monitoring available today are creating new stats - ones that say John and I can live full and healthy lives with diabetes.

Currently, we pay the highest premium we can to get the best health insurance policy available to us. Under that policy, we pay close to $500/quarter in copays for our diabetes medications and supplies. That's a big number - but only a percentage of the true cost. We are so lucky that we can afford our premiums and copays, but we rely on our insurer to cover the rest.

If you are willing to submit an email to your senators about this using a standard form provided by the ADA, please visit:
https://secure2.convio.net/adap/site/Advocacy?pagename=homepage&page=UserAction&id=792&AddInterest=2401

If you'd like to read more, or would like info about how to contact your senators directly, a young woman I know from my camp days has posted her take on this at http://ohsocurious.blogspot.com/2006/03/your-chance.html

Thanks for reading & considering. Please feel free to pass this email - and my email address - along to anyone you know who might be interested in this issue.

-Kassie

Follow up post here.

Bad Mommy

A few weeks ago, the crappy coughy crud went through our house, and Jake stayed home for 2 days with a fever and cough. I shipped him off to school, fever-free, on day 3 because he seemed well and I had a pump start appointment. On the way home from that appointment, the school nurse called with Jake in her office, for the second time that day, complaining of a headache. The next day, he was still complaining of a headache so I took him to the doctor to prove that he was well.

Sure enough, strep throat. Bad Mommy.

Tuesday, nurse calls with Jake in her office. Sitting down in the classroom, he had a shooting pain from his hip to his knee that had him in tears for about 5 minutes. By the time I got him, he was fine and could walk no problem. Brought him home, but called school an hour later to ask if he could come back (it just seemed so silly to have him missing yet another day when he was fine!). She, who had witnessed his pain, thought it was weird enough to be evaluated.

So, to prove the school nurse wrong, we went off to the ped, who said it was probably nothing but there is some weird hip socket slippage thing that happens in growing boys, so why not get an xray to be sure.

Today, it was off to the ortho because the x-ray was "suspicious for a femur fracture".

How is that possible??? How can a kid have a broken femur and not be howling in pain?

Turns out, they were right. Snapped the edge of the lesser trochanter right off. Not terribly common, but it happens in kids because it's a growth plate area and not fully fused to the bone.

No PE for 8 weeks. No running for at least 4. No biking for at least 2. No cast, and no pain. But an 8 year old boy who can't run just as spring is heating up? Sucks.

And I was ready to send him back to school.

Bad Mommy.

(Ok, I know I'm not a bad mommy. But I totally thought he was milking the crappy cough crud and totally thought he was overreacting to a painful leg cramp. Totally.)

Report Card

I visited my friendly neighborhood endo today. I didn't get into privacy issues with him, in part because my 8 year old came along. I did express my concern that it took a week after Smiths and I both faxed the office for any action to be taken on my pump request (and then only after I left a message for the nurse). He seemed concerned about that, who knows what will come of it.

I decided that my best weapon against their minimed mindset was to rave about my Cozmo. Apparently, I am their only Cozmo patient. They have two folks starting on the Omni Pod and they're very curious to see how I do on the Cozmo. So I'm thinking I need to call my Cozmo rep and tell me he should start cutting me in on area sales.

So now for the verdict. My A1c is down 1.4 from my December peak, and down .4 from the home A1c I did the day after my pump start less than two weeks ago.

So: Mission accomplished. I'm giving myself a wink on the KGP A1C scale. And now we're shooting for the full-on grin by the end of June.

Wasting Away

Nope, not me (sadly). I'm as hearty as ever.

I have 10 units of insulin left in my current cartridge, and it's 7:30 at night. I'm debating whether or not to change the set. Thing is, I really hate wasting insulin. I hate that the tubing sucks up 20 units, never to be heard from again. I really have no idea what drives this aversion (I don't even recycle reliably!) but it's always been a concern.

When previewing pumps, the Cozmo sales rep brought out the new Cleo infusion set - inserter and set in one! - and I could practically hear the drumroll in the background.

My first reaction: is that inserter reusable? He was visably deflated at my lack of enthusiasm, but noted that I was the second person that week to ask. It just seems so wasteful, all that plastic, tossed out every 2-3 days.

Is pumping more wasteful than MDI? Hard to say, if you consider 3-4 syringes each day. And it's not like we have a choice here, there are no eco-friendly diabetes supplies out there. Can't choose to recycle the stuff.

Just a thought, as I go ahead and dump that extra insulin rather than try to squeeze out one more night.

My last walk as Miss Amer.. I mean the Dream Fund Winner

The 2005 Dream Fund Winner started his unbelievable bicycle trek yesterday. This, along with the official press release and his picture replacing mine on the Dream Fund website, has me feeling like my reign is coming to an end. I find myself reminiscing, sort of like the outgoing Miss America musing about the past year in a voice over as she strolls the stage one last time. (Yes, I have a tiara. But that's a story for a different day.)

My first task as winner was to attend and speak at the Bayer DiabetesCare Division annual Sales meeting. I had practiced my speech over and over and came prepared with notecards and an outline. I sat with butterflies in my stomach as I was introduced by the V.P. of Marketing. And then, much to my surprise, I took the stage to a standing ovation.

Seriously, once in your life, you should have a room full of people stand up and applaud you. I get choked up just thinking about it.

For Bayer last year, I also attended the ADA Scientific Sessions in San Diego and the AADE Annual Meeting in D.C.. At those meetings, I stood at the Bayer booth in the exhibit hall, handing out brochures about the Dream Fund and "BLADS" for my book (book layout and design samples). The trick was to try to make eye contact with passers by, and get them to stop at the booth and chat. The mission of conference goers - especially the savvy ones - is the complete opposite: get through to the booths you are targeting, grabbing free stuff along the way, without having to stop to talk to people at every booth.

I wasn't 'selling' anything except an opportunity (pssst, buddy, want a hundred grand?) so my task was a little easier. At ADA (an international, research-heavy crowd) I had a little harder time engaging folks. But the (mostly) women at AADE - they were fantastic and enthusiastic and willing to listen to my shpiel in exchange for the free bag or a handful of Aleve samples (a popular giveaway on the morning after pharma-sponsored galas).

I have to say, it was great fun. Hard work, and hard on the feet, but great fun. I thoroughly enjoyed working alongside the Bayer sales staff and I loved meeting and chatting with people from around the country who care so much about diabetes. My camp/Joslin history also meant that I saw a ton of 'old friends' at each event.

In between all of this hob-knobbing and jet-setting (ha!) I also wrote a book. And to do that, I conducted over 150 interviews with parents who have diabetes. What an utterly terrific experience that has been. I hope the book reflects the support and friendship that I've been blessed with as I struggle to maintain my health while raising my kids. It was challenging work (the prior year's winner had to learn to SCUBA dive... me, I had to face.. AN EDITOR!) but it came together nicely, I think.

Things are actually heating up for me as I wind down my Dream year. I recently learned that I will sign books at the Bayer booth at diabetes events in Chicago, DC, LA, Boston, Tarrytown NY, NYC, San Diego and Virgina Beach between now and December (I'll let you know as each one comes up). So, although my reign is over, I will continue to work diligently on my 'platform issue'.

When I sat down to write my Dream Fund entry, I honestly thought I didn't have much of a chance. My project - writing a book - seemed tame compared to the prior winner and the fund inspiration (who entered an around the world solo sailing race). But just entering the contest - just sitting down and thinking about what I would do around diabetes with those kinds of resource - was an inspiration. As I awaited the outcome of the contest (convinced I hadn't won) I had already started thinking about how I could make my book a reality anyway. Luckily, my project met the Fund criteria and I (as well as the Bayer folks) saw great potential to reach and hopefully inspire many many folks with diabetes.

[cue orchestra as I turn and wave to the audience and the camera zooms in on my face, mascara unsmudged despite teary eyes.]

Go Pete!

Ladies and Gentlemen of the O.C., it is my distinct pleasure to introduce Peter Hoogenboom. Peter has had type 1 diabetes since the age of 14 and has, for the past 22 years, been using cycling as "a powerful tool against the complications of diabetes."

Saturday, March 18th, Peter will head out from his home town in Utah for a 9700 mile bike tour lasting until October. He will ride through some part of every state in the continental U.S. He's calling this little jaunt "The Dream Tour".

Why? Simply put, "to show that having diabetes does not mean giving up your dreams."

Peter is the 2005 Ascensia Dream Fund winner and I couldn't be more excited and proud to share the exciting news of his big adventure.

Please visit Pete's website and wish him well on his journey! As time and internet connectivity allow, he'll be blogging about his effort along the way.

Good Morning Breakfast Lovers!

Good morning breakfast lovers and how-ya-do-ya
We'll wake up to sunshine and how-ya-do-ya
Good!
Morning!
Breakfast!

There's that camp life sneaking in again. That ditty served as a pre-breakfast, rouse those sleepy campers, not quite grace cheer at Barton and it's been running through my head these past few mornings.

Why? Because I have been up and at 'em bright and early for the past 5 days or so.

Why? Because I am not waking up high.

Why? Because I freakin' LOVE my new pump.

The difference is dramatic. Despite the fact that it's Girl Scout Cookie season, I have had only a handful of +200 blood sugars since last Thursday. My meter average has dropped to 139 (oh, by the way, remember how I'm "not into numbers"? Yeah, maybe I'm just not that into crappy numbers.)

I'm even to the point where I'm no longer afraid of breakfast. I was so fed up with waking up high and needing so much insulin to cover so little food, I was barely eating more than a piece of toast, and often waiting until after 10:30 to do that. Now, I'm actually eating! I'm still tinkering with morning carb-to-insulin ratios (that purple pump didn't obliterate my dawn phenomenon) but it's so nice to not be cowering in fear of a post prandial 300.

I'm beginning to think it wasn't my diabetes that was wreaking havoc - it was my lousy math skills. Or maybe my old pump was failing more than I realized. Or maybe this is just basking in the glow of a new gadget (I do feel way more motivated to actually look up carb values, knowing that the pump will make that effort worthwhile). Who knows.

I'm just happy to be a morning person again!

Challenge

OK folks, I'm feeling totally random here, so I throw out this challenge to all of you. It's a twist on acrostic poems.

Post a comment to this entry. Take the verification code and write a short poem. Like so (based on the verificaton code LEMNDO I saw when I commented on another OC blog this morning):

Living,
Every day
Mysterious and
New, despite
Diabetes
Overload

Doesn't have to mention diabetes. Doesn't have to make sense. Doesn't even have to be stamped with your name. Give it a try!

Wow

Let me tell you about the numbers I've been seeing since starting my new Cozmo pump.

Well, actually, I don't focus so much on the numbers themselves. Based on my reading of various blogs and discussion boards, the numbers I'm seeing would probably ilicit sympathy from many other people with diabetes but, in fact, I'm thrilled with them.

I have been within my personal comfort zone since starting the Cozmo. No crazy spikes, no "what the hell did I do wrong that time" moments, no need to slam myself with ridiculous amounts of insulin to bring my blood sugar down from the stratosphere. My number this morning was high for a fasting but I had pizza last night! A long buzzing low at about 11 last night (I need to work on that pizza extended bolus) resulted in some big-time overtreating, so all in all I'm ok with this morning's number.

I'm sure the thrill of the new gadget is coming into play here, and I hope I can milk that for all it's worth. But I am just so happy with the features of this new pump that I must stand up and say,

Meredith: I was wrong! I should have started pump shopping the moment my warranty ran out!! What was I thinking waiting for my 508 to fail? Me and my altruistic tendencies - I need to set them aside where my diabetes is concerned.

If things stay on track, I'll definitely be smiling over my A1c at my endo appointment at the end of this month.

My Date with D

My diabetes and I took a leisurely 45 minute drive down 95 South to the office of Carol, RD, CDE and pump trainer extraordinaire. It's a gorgeous spring day here in Virginia, the boys were settled into school and day care, and I was excited to have some time to focus on "my first baby", diabetes. As anyone with more than one kid will tell you, you have to carve out some one-on-one time for each of them, or they get cranky.

I arrived at the office and settled in. We reviewed the info I had entered into the Cozmonitor software on my laptop. She answered questions, helped me make a few decisions, and stepped me through setting up the cartridge.

Features and options that seemed overwhelming a few weeks ago are now exciting. I think the trainer must have found me terribly goofy. I was enthused about the little things like reminders to check blood sugars and temp basals you give names, like "Walking" and "PMS". Periodically I would just stop and say, "That's so freakin' cool."

At one point, in reference to a procedure just learned, I said, "Piece of cake." I half expected the pump to suggest the appropriate bolus for a piece of cake.

I told the pump trainer about all you ne'er-do-wells who encouraged me to start it on my own, and she said I was very smart to wait. Because I enjoy being called "very smart", I agree with her.

We wrapped up after about an hour and a half, and my diabetes and I stepped out into the warm afternoon. We drove over to Panera and ordered a 1/2 sandwich, 1/2 salad combo, with an apple (for my diabetes). I used my laptop and their free wireless to look up the carb count for that meal before entering my bolus. It seemed silly to not pin down the carb value, since my fancy new pump will take it from there.

I'm looking forward to my next endo appointment and all the data I'll have to present. I have a few weeks of basal and carb-to-insulin ratio testing ahead of me, which should keep things fresh and lively. I hope the thrill of this new gadget doesn't wear off too soon!

On the drive home, the school nurse called with Jake in her office, complaining of a headache. My diabetes gave me a knowing look, realizing our quality time together was coming to an end for the day, and I stepped on the gas to get home just a few minutes faster.

Humbled by Amazon

So, you all know I'm excited that my book is up on Amazon.com. And thank you so much for all the nice comments, you've been terrific!

The first day I noticed it there, I emailed my parents, and my mother immediately went and bought 10 copies. She knew full well she'll receive mutliple free copies, but she wanted to be the first Amazon order. I think, thanks to her, I 'debuted' on Amazon's sales rank list somewhere around #175,500. I'm down to the 600's. If anyone ends up buying the book (and, really, don't until I find out how you can get your free copy from Bayer) I hope they all buy it on the same day so I can acheive Amazon Sales Rank Euphoria.

I don't know how Amazon calculates that number, it's some magic secret formula (I'm guessing. I like the idea of that.) At the end of each day, the system notes where a book finished. On a book listing, you can see the current ranking and yesterday's ranking. If you click on the number next to 'yesterday', you can see what kind of company you are keeping.

Yesterday, I finished #565,643 in Books. One place behind, "Flushed With Pride: The Story of Thomas Crapper"

I kid you not.

It's good to be me ;)

I Must Confess

I don't mind waiting for my pump start. Yes, I could probably put it on and start it myself, but I'm actually looking forward to having someone show me the ropes, and keep me focused on figuring it out for a whole hour and a half.

Some of the best advice I got while pump shopping was from my friend Jane, a PhD/RN/CDE/Mom of two/Person with Diabetes. She cautioned me against underutilizing the technology of the newer 'smart' pumps. They have great features, and should be used! I've never square-waved with my 508, and I don't want to miss out on any of the advances that come with a pump upgrade.

Plus, I really am afraid of breaking the darn thing, and voiding the warranty.

Plus, the trainer's office is near a mall, and I'll be away from my desk all day anyway, so I can totally stop in, right?

Cross your fingers for me that both boys are healthy tomorrow, as I'm rescheduled for 11 AM.

Life gets in the way of Living with Diabetes

High noon today: appointment with a pump trainer down in Richmond. I've successfully restrained myself, haven't put the pump on, haven't even really tried to program it beyond the pre-training steps recommended in the manual. I did install the software on my computer and enter all my current basals, ratios, and preferences. I love that you can do that on the computer and not hunched over the pump, trying to press the right combination of buttons.

At about 4am, Jake woke up looking for a drink of water. When I kissed his forehead to settle him back to sleep, it was on fire. Roused him for some tylenol, put him in the big bed with me, and tried to fall back to sleep.

Instead, I drifted in and out of sleep while reaching out to feel his forehead as he cooled down. In my head, I debated whether or not he should go to school. They're dropping like flies at his school with a late round of colds and flus and strep. I shouldn't be surprised he finally succumbed but the timing, frankly, sucks.

Because I'm anxious to start my new pump, because I'm watching my old pump with a wary eye, and because my husband is out of town and there's no one who can stay with Jake while he's home sick, I actually (briefly) considered dosing him up and sending him anyway.

Briefly.

Of course he and his nasty germs are staying home. Hopefully, the pump trainer has time later in the week to meet with me. I have enough Energizer 357's stockpiled to keep my current pump going. Diabetes gets put on hold in big and little ways all the time. As a parent, the challenge is to keep that from happening too often or too completely. Heck, as a human being, that's the challenge!

I'll need to do something nice for my diabetes today, since it's taking a back seat to my feverish 8 year old.

Promises

I spend a lot of time (too much time) reading diabetes discussion boards. This morning, on one of the boards, a woman asked a question that has been with me all day.

Her question to her peers, tossed out for us to read and hopefully respond, was "if I have a couple of bad months or weeks or days or hours, what is happening inside me? Is it sustained highs for years that will take my kidneys? Or is it literally a couple of months? what?"

To me, her question echoes the mix of despair and frustration that I often feel. There is so much we don't know about diabetes. How can we plan for it? How can we judge our successes or failures? How much of what happens to us down the road can be traced to bad luck, and how much to the months, weeks, days or even hours when too much sugar coursed through our veins? And how much time am I sacrificing now, worrying about whether I live to be 60, 70, or 80 and a day?

Of course, there is no formula, no magic number, no "x days at y bloodsugar = lifespan - x". But that doesn't stop me from yearning for a guarantee. If I'm good, will I be ok? Promise?

Best I can do is look at it this way - every 'good' day is a bonus. Maybe that day will add time to my life, but even it it doesn't, I've had a day when I felt well - I wasn't running to the bathroom, I didn't have high blood sugar cotton mouth or leg cramps, I wasn't sleepy and lethargic and distracted.

I know it's not the answer we want, but it's all I've got.

Now, I can go to my High School Reunion

check this out

They say that breakin' up is hard to do...

Yes, I do have a song for pretty much everything in my life.

Breakup #1 today: Calling the minimed rep as a courtesy to let her know I'd chosen the Cozmo. I was quite nervous actually, but the onus was on customer service and not the rep. She of course asked what features tipped the scales in favor of the cozmo and I mumbled something about being able to program it with my computer instead of on the pump itself, and being able to name different profiles and temp basals.

She mentioned that the 715 could be programmed with the computer, but maybe that was getting into a level of detail I wasn't interested in (?) and that they felt that naming things could get confusing, because (her example) "Bagel" could be a huge bagel, or a mini bagel. I don't know what the heck she was talking about, because at that point I wasn't really listening, I was doing the phone equivalent of looking for an exit.

I did say it was 'goodnight' and not 'goodbye' because I certainly will be watching the emergence of continuous glucose monitoring systems with great interest, and I know that MM will be in the forefront of that effort. Is this the equivalent of saying, "It's not you, it's me" ?

Breakup # 2... on hold, sort of. I can't get an appointment with another endo until the end-o of May. So, for now, I haven't caused a scene and stomped out of my current endo's practice. I meet with the doc at the end of March, at which point I really need to express my dissatisfaction with their pump options.

Funny thing... the PA was enthusiastic about the Omni Pod, which kind of threw me because I went in there thinking he had a Minimed bias. Turns out, the local Pod rep used to work for Minimed. Sigh.

So, long story not nearly short enough, I left the office with the Statement of Medical Necessity (which the PA felt was just way too long, which is probably why I had to schedule a visit and pay a copay to help him fill it out).

Pump will be here tomorrow.

Yay.