November 28, 2009

Sanofi Go Meals iPhone Ap

My quick review: I gave up.

Go Meals was too something to be useful. The serving size data was inconsistent. Oh and it has a huge restaurant fetish.

When I can't SWAG a number to bolus the kids, I want a fast reference. How many carbs are in a cup of Mac and Cheese? What my world needs is an easy to use food database. This isn't it.

My dear friends across the pond have a great word for this kind of thing: Rubbish.

When it opened, Go Meals wanted to put food on Today's Plate. First it wanted to know if I was cooking or eating out. Seriously it opened by asking if I would like to Restaurant. Apparently Restaurant is something to do.

You are not going anywhere until you pick either Add Food or Restaurant.

You have to pick one or the other. That is the design of the ap. I picked add food. It wanted to be sure that I didn't mean to restaurant 'cause Restaurant Foods was the second option on the add food menu. Before the food store.

You can Always choose Restaurant

Oh and just in case I needed a Restaurant and didn't know where one was, (just a half a mile from the railroad track?) I could hit the Go Meals' Restaurant button on the bottom navigation bar at any time. Like say I was in the food store and couldn't cope with the concept of cooking. Go Meals was ready to help.

I skipped over Restaurant and picked Grocery & Generic Foods. I typically use a blue box. It isn't generic but it is one you may have seen on TV. They have Mac & Cheese shelf space in every food store in the country. It wasn't listed.


I gave up on Mac. How about spaghetti and meatballs? I found that in the Generic Foods the serving size was per "svg."

I don't know how much a "svg." is but SRV to me is Stevie Ray Vaughan. So is that a Stevie Ray Vaughan of pasta by volume or weight?

How Many SVGs in SRV?

Other spaghetti and meatballs came in more traditional volume based servicing sizes. That is good but consistency on serving sizes would be a plus.



I gave up again! I decided to go to Restaurant. One with Golden Arches.

I looked up chicken "Selects" at Mickey D's. I couldn't find just the brand name strips in the ap. I could find a meal (3 pc) with.... With something. I am guessing fries and a Coke. Wonder what serving size fries and a Coke?

I am think way big because this is after all America and extra value means extra food. I know we bolus for a less than that what Go Meals said the carb count is when we do go to McD' for a chicken select meal.

(3pc) with... what?

I gave up yet again and tried to look up an everything bagel from back at the super market. I found pizza three cheese bagels.


I playing with this thing I did add all these foods to my "Plate." Once there, it wasn't real clear how to get them off. So I had Trader Joe's Mac, two types of spaghetti and meatballs, a value meal and pizza bagels. Probably also a partridge pear tree but the serving size of partridge was in SRVs.

I gave up on Go Meals.

In fairness, there are a number of positive comments on the iTunes Ap store.

YDMV.


Other links:

November 27, 2009

Amy’s Restaurant aka Alice on Insulin

Amy's Restaurant: 
A Parody
 for Fight It Friday. With the deepest apologies to Arlo Guthrie. This is for my friend and drinking buddy Chris. GO HERE and chip in a buck or five to help folks who need insulin and don't have insurance.

Oh and a you run across other Fight it Friday bits, how about posting a link to the in the comment section? Thanks.


Amy's Restaurant:

This song is called Amy’s Restaurant, and it's about Amy, and the restaurant, but Amy's Restaurant is not the name of the restaurant, that's just the name of the post, and that's why I called the post Amy's Restaurant.

You can get anything you want at Amy's Restaurant
You can get anything you want at Amy's Restaurant
Walk right in it's around the back
Just a half a mile from the railroad track
You can get anything you want at Amy's Restaurant

Now it all started two Thanksgivings ago, that is two years ago on Thanksgiving, when my friend and I went up to visit Amy at the restaurant, but Amy doesn't live in the restaurant, she lives in the church nearby the restaurant, in the bell-tower, with her husband Ray and Fasha the dog. And livin' in the bell tower like that, they got a lot of room downstairs where the pews used to be. Havin' all that room, seein' as how they took out all the pews, they decided that they didn't have to take out their used strips for a long time.

We got up there, we found all the used strips in there, and we decided it'd be a friendly gesture for us to take the used strips down to the city dump. So we took the half a ton of used strips, put it in the back of a red VW microbus, took sharps and meters and implements of destruction and headed on toward the city dump.

Well we got there and there was a big sign and a chain across across the dump saying, "Closed on Thanksgiving." And we had never heard of a dump closed on Thanksgiving before, and with tears in our eyes we drove off into the sunset looking for another place to put the used strips.

We didn't find one. Until we came to a side road, and off the side of the side road there was another fifteen foot cliff and at the bottom of the cliff there was another pile of used strips. And we decided that one big pile is better than two little piles, and rather than bring that one up we decided to throw our's down.

That's what we did, and drove back to the church, had a thanksgiving dinner that couldn't be beat, went to sleep and didn't get up until the next morning, when we got a phone call from officer Manny. He said, "Kid, we found your name on a prescription at the bottom of a half a ton of used strips, and just wanted to know if you had any information about it." And I said, "Yes, sir, Officer Manny, I cannot tell a lie, I put that prescription under those used strips."

After speaking to Manny for about fourty-five minutes on the telephone we finally arrived at the truth of the matter and said that we had to go down and pick up the used strips, and also had to go down and speak to him at the police officer's station. So we got in the red VW microbus with the sharps and meters and implements of destruction and headed on toward the police officer's station.

Now friends, there was only one or two things that Manny coulda done at the police station, and the first was he could have given us a medal for being so brave and honest on the telephone, which wasn't very likely, and we didn't expect it, and the other thing was he could have bawled us out and told us never to be see driving used strips around the vicinity again, which is what we expected, but when we got to the police officer's station there was a third possibility that we hadn't even counted upon, and we was both immediately arrested. Handcuffed.

And I said, "Manny, I don't think I can pick up the used strips with these handcuffs on."

He said, "Shut up, kid. Get in the back of the patrol car."

And that's what we did, sat in the back of the patrol car and drove to the quote Scene of the Crime unquote. I want tell you about the town of Rocheville, Indiana, where this happened here, they got three stop signs, two police officers, and one police car, but when we got to the Scene of the Crime there was five police officers and three police cars, being the biggest crime of the last fifty years, and everybody wanted to get in the online story about it. And they was using up all kinds of cop equipment that they had hanging around the police officer's station. They was taking plaster tire tracks, foot prints, dog smelling prints, and they took twenty seven eight-by-ten color glossy photographs with circles and arrows and a paragraph on the back of each one explaining what each one was to be used as evidence against us. Took pictures of the approach, the getaway, the northwest corner the southwest corner and that's not to mention the aerial photography.

After the ordeal, we went back to the jail. Manny said he was going to put us in the cell. Said, "Kid, I'm going to put you in the cell, I want your wallet and your iPhone." And I said, "Manny, I can understand you wanting my wallet so I don't have any money to spend in the cell, but what do you want my iPhone for?" And he said, "Kid, we don't want any tweet suicide notes."

I said, "Manny, did you think I was going to hang myself for littering?"

Manny said he was making sure, and friends Manny was, cause he took out the toilet seat so I couldn't hit myself over the head and drown, and he took out the toilet paper so I couldn't bend the bars roll the toilet paper out the window, slide down the roll and have an escape. Manny was making sure, and it was about four or five hours later that Amy (remember Amy? This’s a post about Amy), Amy came by and with a few nasty words about Tim on the side, bailed us out, and we went back to the church, had a another thanksgiving dinner that couldn't be beat, and didn't get up until the next morning, when we all had to go to court.

We walked in, sat down, Manny came in with the twenty seven eight-by-ten color glossy pictures with circles and arrows and a paragraph on the back of each one, sat down. Man came in said, "All rise." We all stood up, and Manny stood up with the twenty seven eight-by-ten color glossy pictures, and the judge walked in sat down with a seeing eye dog, and he sat down, we sat down. Manny looked at the seeing eye dog, and then at the twenty seven eight-by-ten color glossy pictures with circles and arrows and a paragraph on the back of each one, and looked at the seeing eye dog. And then at twenty seven eight-by-ten color glossy pictures with circles and arrows and a paragraph on the back of each one and began to cry, 'cause Manny came to the realization that it was a typical case of American blind justice, and there wasn't nothing he could do about it, and the judge wasn't going to look at the twenty seven eight-by-ten color glossy pictures with the circles and arrows and a paragraph on the back of each one explaining what each one was to be used as evidence against us. And we was fined $50 and had to pick up the used strips in the snow, but thats not what I came to tell you about.

Came to talk about the betes.

They got a building down New York City, it's called the Diabetes Clinic, where you walk in, you get injected, inspected, detected, infected, neglected and selected. I went down to get my physical examination one day, and I walked in, I sat down, I got good and drunk the night before, so I looked and felt my best when I went in that morning. `Cause I wanted to look like the all-American kid from New York City, man I wanted, I wanted to feel like the all-, I wanted to be the all American kid from New York, and I walked in, sat down, I was hung down, brung down, hung up, and all kinds o' mean nasty ugly things. And I waked in and sat down and they gave me a piece of paper, said, "Kid, see the Certified Diabetes Educator, room 604."

And I went up there, I said, "CDE, I want to test. I mean, I wanna, I wanna test. Test. I wanna, I wanna see, I wanna see blood and gore and guts and veins in my teeth. Lick dead calloused finger. I mean test, Test, Test, TEST." And I started jumpin up and down yelling, "Test, Test," and the CDE started jumpin up and down with me and we was both jumping up and down yelling, "Test, Test." And the Endo came over, pinned a medal on me, sent me down the hall, said, "You're our boy."

Didn't feel too good about it.

Proceeded on down the hall gettin more injections, inspections, detections, neglections and all kinds of stuff that they was doin' to me at the thing there, and I was there for two hours, three hours, four hours, I was there for a long time going through all kinds of mean nasty ugly things and I was just having a tough time there, and they was inspecting, injecting every single part of me, and they was leaving no part untouched. Proceeded through, and when I finally came to the see the last man, I walked in, walked in sat down after a whole big thing there, and I walked up and said, "What do you want?" He said, "Kid, we only got one question. Have you ever been arrested?"

And I proceeded to tell him the story of the Amy's Restaurant Massacre, with full orchestration and five part harmony and stuff like that and all the phenome... - and he stopped me right there and said, "Kid, did you ever go to court?"

And I proceeded to tell him the story of the twenty seven eight-by-ten color glossy pictures with the circles and arrows and the paragraph on the back of each one, and he stopped me right there and said, "Kid, I want you to go and sit down on that bench that says Group W .... NOW kid!!"

And I, I walked over to the, to the bench there, and there is, Group W's where they put you if your A1C may not be good enough to join the DOC after committing your special crime, and there was all kinds of mean nasty ugly looking people on the bench there. Mother rapers. Father stabbers. Father rapers! Father rapers sitting right there on the bench next to me! And they was mean and nasty and ugly and horrible crime-type guys sitting on the bench next to me. And the meanest, ugliest, nastiest one, the meanest father raper of them all, Tim, was coming over to me and he was mean 'n' ugly 'n' nasty 'n' horrible and all kind of things and he sat down next to me and said, "Kid, whad'ya get?" I said, "I didn't get nothing, I had to pay $50 and pick up the used strips." He said, "What were you arrested for, kid?" And I said, "Littering." And they all moved away from me on the bench there, and the hairy eyeball and all kinds of mean nasty things, till I said, "And creating a nuisance." And they all came back, shook my hand, and we had a great time on the bench, talkin about crime, mother stabbing, father raping, all kinds of groovy things that we was talking about on the bench. And everything was fine, we was smoking cigarettes and all kinds of things, until the Endo came over, had some paper in his hand, held it up and said.

"Kids, this-piece-of-paper's-got-47-words-37-sentences-58-words-we-wanna-know-details-of-the-carbs-time-of-the-carbs-and-any-other-kind-of-thing-you-gotta-say-pertaining-to-and-about-the-carbs-I-want-to-know-attending-physicians-name-and-any-other-kind-of-thing-you-gotta-say", and talked for forty-five minutes and nobody understood a single word that he said, but we had fun filling out the forms and playing with the pencils on the bench. I filled out the massacre with the four part harmony, and wrote it down there, just like it was, and everything was fine and I put down the pencil, and I turned over the piece of paper, and there, there on the other side, in the middle of the other side, away from everything else on the other side, in parentheses, capital letters, quotated, read the following words:




("KID, HAVE YOU BOLUSED YOURSELF?")





I went over to the endo, said, "Endo, you got a lot a damn gall to ask me if I've nolused myself, I mean, I mean, I mean that just, I'm sittin' here on the bench, I mean I'm sittin here on the Group W bench 'cause you want to know if I'm moral enough join the DOC, lance women, kids, houses and villages after bein' a litterbug." He looked at me and said, "Kid, we don't like your kind, and we're gonna send you fingerprints off to Washington."

And friends, somewhere in Washington enshrined in some little folder, is a study in black and white of my fingerprints. And the only reason I'm singing you this song now is cause you may know somebody in a similar situation, or you may be in a similar situation, and if your in a situation like that there's only one thing you can do and that's walk into the endo wherever you are ,just walk in say "Endo, You can get anything you want, at Amy's restaurant.". And walk out. You know, if one person, just one person does it they may think he's really sick and they won't take him. And if two people, two people do it, in harmony, they may think they're both Twitterers and they won't take either of them. And three people do it, three, can you imagine, three people walking in singin a bar of Amy's Restaurant and walking out. They may think it's an organization. And can you, can you imagine fifty people a day, I said fifty people a day walking in singin a bar of Amy's Restaurant and walking out. And friends they may thinks it's a movement.

And that's what it is , the Amy's Restaurant Anti-Massacre Movement, and all you got to do to join is sing it the next time it come's around on the guitar.

With feeling. So we'll wait for it to come around on the guitar, here and sing it when it does. Here it comes.

You can get anything you want, at Amy's Restaurant
You can get anything you want, at Amy's Restaurant
Walk right in it's around the back
Just a half a mile from the railroad track
You can get anything you want, at Amy's Restaurant

That was horrible. If you want to find a cure and stuff you got to sing loud.

I've been singing this song now for twenty five minutes. I could sing it for another twenty five minutes. I'm not proud... or tired.

So we'll wait till it comes around again, and this time with four part harmony and feeling.

We're just waitin' for it to come around is what we're doing.

All right now.

You can get anything you want, at Amy's Restaurant
Excepting Amy You can get anything you want, at Amy's Restaurant Walk right in it's around the back Just a half a mile from the railroad track You can get anything you want, at Amy's Restaurant

Da da da da da da da dum
At Amy's Restaurant

November 24, 2009

FTNW: DexCom & Continua Boards

DexCom Appoints Nicholas Augustinos as Board Member.

I keep wondering about Continua and the diabetes world. More to wonder about:

From the News Wire -
Source: DexCom, Inc.
On 4:11 pm EST, Monday November 23, 2009

DexCom, Inc. today announced the appointment of Nicholas Augustinos as a member of DexCom’s Board of Directors.

Mr. Augustinos is the Senior Director of the Global Healthcare Solutions business unit at Cisco Systems, Inc., where he leads Cisco’s efforts to develop connected healthcare solutions. Prior to Cisco, Mr. Augustinos was a Partner and Senior Strategic Consulting Expert, Global Health Services, for Computer Sciences Corporation. Previously, Mr. Augustinos served as Vice President of the Care Data Exchange group with CareScience, as Vice President of Sales and Marketing with Healtheon/WebMD, and as Vice President of Administration with CliniShare. “Nick brings more than twenty years of broad-based experience and thought leadership in healthcare. As healthcare delivery and technology evolves and improves, Nick’s vision and experience will help drive DexCom’s future innovations,” said Terry Gregg, President and Chief Executive Officer of DexCom.

Mr. Augustinos also sits on the Board of Directors of Continua Alliance, a non-profit, open industry coalition of healthcare and technology companies collaborating to improve the quality of personal healthcare. The Alliance was founded by Cisco, Intel, Philips, Samsung, Sharp and Kaiser Permanente, among others.

November 23, 2009

FTNW: Sanofi-Aventis iPhone ap GoMeals

Update: I got a copy from iTunes. Played with it a little. I will share thoughts later.

From the News Wire

In one of the latest forays by the pharmaceuticals industry into mobile technology platforms for chronic disease management, Sanofi-Aventis has launched the iPhone application GoMeals, designed to help diabetics make the healthiest food choices.

The food-tracking tool powered by CalorieKing can provide the nutritional content of many foodstuffs sold in grocery stores, or for the meals and snacks offered on restaurant menus. Similar to the weight loss application LoseIt that tracks food intake, physical activity and provides nutritional data for many foods, CalorieKing's database contains information on over 25,000 foods and over 200 menus for US restaurants.


more at:

http://www.independent.co.uk/life-style/health-and-families/health-news/lab-launches-an-iphone-app-to-track-and-manage-diabetes-1826526.html

What's a Buck?

Value Menu. A buck.
iTune song. A buck.
Coffee. A buck.
Coke. A buck.

Insulin Priceless but on Friday - one day one buck.

Black Friday: Help my friend Chris* help someone who needs a hand. Click the banner.


*Yes there is some truth to the rumor he and I managed to get thrown out of a hotel bar and take 20 people and a fictitious stalker with us. But honestly we were all way better off in one of the ladies' hotel rooms anyway. Sadly there may be pictures with circles and arrows and a paragraph on the back explaining how each one was to be used as evidence against us, but that is another story.

Of Mice and Men: Bombay Version

In mice; an implantable glucose bio-sensor develped by the Indian Institute of Technology.

http://www.topnews.in/smart-biosensor-rule-out-pricks-diabetics-2239066

Once injected, the bio-sensor would help monitor blood sugar levels for up to six months using an external hand-held device.

“India is poised to become the diabetes capital of the world. Developing a sensor that is non-invasive is the need of the hour,” said Professor Rohit Srivastava, Department of Biosciences and Bioengineering, IIT-B.

Most blood sugar monitoring methods involve pricking the fingertip to draw blood. IIT-B’s bio-sensor, called a smart tattoo, appears as just a dot in the skin when injected. Using near-infrared waves — which have shorter wavelengths like those used by the television remote control — emitted by the hand-held device, the patient can get his blood sugar count.

“The bio-sensor with a dye-attached glucose receptor will attract the glucose present in the fluid, send signals to the device and record the count,” said Srivastava adding that the device would work for any demographic region and for any type of diabetes.

A four-year effort, the research has reached the animal trial stage and the biosensors are being currently tested on mice.

November 21, 2009

Scott on Insulin

Someone who writes brilliantly (a phrase that here means Scot Strumello) has a new post on inhaled v oral insulin v what the world really needs.

It is sad he posted it on a Saturday night. I feel responsible. Make me feel better and go read it so his use of quality weekend time is not in vane:

http://sstrumello.blogspot.com/2009/11/business-of-diabetes-generex-vs.html

FTNW: Roche Buletooth Pump / Meter

Roche has an upgraded pump / meter combo on sale in Europe. That is good their pump needed some smarts.

From The New Wire on the other side of the pond:
http://www.accu-chek.co.uk/gb/products/insulinpumps/combo.html

System Features and Benefits

  • Two-way Bluetooth® wireless technology between the two devices - with the ACCU-CHEK® Aviva Combo meter, you have full remote control over pump functionality and can deliver a bolus in a fast and discreet way and have full visibility on pump status and activity – right in the palm of your hand. No need to access the pump.
  • Bolus calculator on the ACCU-CHEK® Aviva Combo meter - Quick, easy and discreet bolus delivery with assistance from a fully customizable bolus calculator

Ark Series: Index

I wrote a series of post in reaction to a church service that hit home. Well three services. They were a series and so is what I wrote. The series spoke to me and various stages of my life with the kids’ diabetes.

This is a index page those post and other Zen like YDMV posts:

Ark 1: Floods

My story as an old guy with a beard, a double diabetes deluge on a boat.

Ark 2: Floating

I learned while adrift that floating is hard.

Ark 3: Arc

Finding new territory.


Bad things happen to good people.

Bad things happen to good people. It isn’t God’s will that they happen but part of God’s providence. There is a distinction there that is small but significant.

Empathy

November 20, 2009

Ark 1: Floods

My story as an old guy with a beard, a double diabetes deluge
on a boat.



I know the rule of polite society that says I’m not supposed to talk about religion. I’m not all that polite.

I think religion is about life and doing good. My religion is about my life. Hopefully it helps me do the right thing.

Writing helps me sort through and find what I really think. This essay is a reaction to a church service that hit home. Well three services. They were a series and so is this. The series spoke to me and various stages of my life with the kids’ diabetes.

Since living with the variations of diabetes is the point of YDMV I figured I would share my thoughts. It has been a couple of years since I have sprung philosophy on y’all. Now, like then, you may not recognize me as the author. Now, like then, I hope it is a pleasant surprise.

Before I go into the series here’s my basic philosophy: Good stories are allegorical. Same goes Bible stories. I can find a message about my live in them someplace, if I look. For example, I don’t have to be Thomas Aquinas to figure out that Jesus told stories that meant more than just their face value. The whole tiny grain of mustard seed growing to large branches isn’t about growing herbs. It is about a little truth growing to be important in life.

Stories are like that. More than meets they eye. I try to see the whole. I am not real good at it but I try. Sometimes I find something to see.


Which brings me to the Ark series. It came in three parts:
  • Floods
  • Floating
  • Covenant
It is a story that featured Noah and a flood. That was about where the expected ended.

So we got a flood. A big flood. A life changing killer flood.

Floods. There is the spring flood, the 100 year flood and the ever popular 500 year flood. Everyone faces floods in life. I think everyone reading YDMV knows floods. Not the water type, the life altering, spiritual challenge, break your heart flood.

Feel free to raise your hand if you think you know what I am going on about.

The guy who gave the talks, Chuck, said that we all get all the floods. We are all busy making plans and Bam! We get hit with a flood. Mine was less a diabetes diagnosis or two per se and more our school’s reaction to them.

Feel free to raise your hand if y’all know that school and diabetes flood too.

Now the floods aren’t there to punish us or specifically be trials (see my previous musings linked above). Here was an interesting part Chuck brought up that I never thought about, the floods are there to help wash away stuff. Stuff that is in my head and heart. In the bible story these things are playing the parts of “The giants, heroes of renown.” In short that part of myself I put up on a on a plinth. My own rigidity, selfishness and maybe even my own home grown doctrine about how I make value of stuff in myself.

What I understood him to be saying was a flood is a change that happens and in it we loose some bad stuff and maybe gain some good stuff. While god may work it out for the best in the long run, it doesn’t seem like there is anything worthwhile going on as the water rises. Not that there is a whole lot of alternative - it is on the boat or in the water.

None of us got a choice. Our families got type 1. We were all overwhelmed. Bring on the flood. Yet somehow, before hand we built a boat. Apparently god called us to build it in the back yard. I am not so sure I knew I got the call.

What is an Ark? A vestal to hold us and what were bringing aboard. As in an emotional life boat. Chuck’s message was the Ark was faith and that faith is the ability to see with the eye of love. OK I’ll take that on faith and I’ll loop back later.

So what is in the boat?

Noah is in the boat. The heroes we built up - not in the boat.

Noah is some unselfish part of ourself, some part that somehow walks with god. Even in the deluge that part gets on a boat. So do a lot of animals. Clean and unclean and we all go floating.

And it keeps raining. Forty day and forty nights. I’m getting a flood and it keeps coming. Folks I am here to say diagnosis is only the first day of rain. It is overwhelming. You get into your life boat with the best and worst of life. It keeps raining. Every day. The water keeps rising.

It isn’t a pleasure cruise.

Nobody tell us how long we are gonna be floating. Hell it just keeps raining.


Nobody knows how long the dazed and confused feelings at diagnosis are going to last. It rains for forty days and nights - the water rises for a month and a half! It just keeps coming. (And those jack asses at training are talking about a Honeymoon! - WTF!) There are clean and unclean animals in the boat with us, hope, kindness, fear, guilt.

There is no land to be a landmark. It is all under the water. We have no clue where we are.

Adrift.

One Window.

Surrounded by the best and worst animals of life and it’s mate. Oh and we better get to work doing stuff. We are in a place we have never been before and doesn’t matter if it came from love or fear the stalls need to be mucked out 'casue we are knee deep in it.

In our case we gave shots and poked steel shards in our kids’ arms and fingers and try to pretend it was all OK. We smiled and that smile was a big lie to keeps the kids alive. Bad and good and it's mate.

Is this sounding familiar to anyone yet?

In my case the flood was not just a child or two being diagnosed with diabetes. The deluge was being set adrift when our church school administration turned those kids out rather than even considering trying to follow best care practices. Noah got on a boat while a lot of what I thought I valued drowned.

I am not sure who Noah was. That is, what part in me was Noah. He may have been that part that cared as much about the next T1 kid as my own. I know that as I cried and cursed my sister, the single strongest supporter my wife and I had in our floods, kept telling us that we weren’t just going through this for just our kids. That we were in it for all the T1 kids who will sadly but without question follow. I would like to think that but I am not sure. I am OK with not being sure.

I know I went for a long rudderless ride and how I saw the future a few years ago isn’t where we are. And now in retrospect maybe that isn’t necessarily a bad thing.

As for the Ark, well that is real tough because I wasn’t particularly looking out with love a lot as my personal floods kept pouring in day after day. Somewhere in the time the kids were kicked out the first time, I was unemployed and home with them, inventing stupid meter tricks to keep them entertained, I became aware of the online diabetes community. That was something I could look at with love.

I met many of those folks last summer. Looking back I can see how ridiculously important they are to me. But that is getting ahead. This essay is about staying above rising water.

This is about personal floods. We have had’m. Don’t recommend’m. In point of fact everybody get them and that what the Ark story is about.

For some of us the flood is a T1 diagnosis (or two.) We think diagnosis is the flood but it is just the first day and the sky is dark grey and keeps raining. We are adrift with the best and the worst, hope, kindness, fear, guilt. At 34 days into a forty day flood the boat stinks, we are sea sick, there is no sign the rain will stop and humidity does nothing for the smell.

Noah is in some part of us. Some part part walks with god even when there is a flood and walking is not an option. If nothing else I find comfort in the idea that the story doesn’t end in the flood on day 34.

Next up: Floating or what you learn alone and adrift.

The Ark series that inspired this is partially available on line at http://vimeo.com/6708135 Partially in that all talking is there sadly the music of the services isn’t. Each service featured amazing music, rock for the most part but the music is most notable for a hauntingly beautifully version of Somewhere Over the Rainbow that brings tears to my eyes thinking about it. The full service is with tunes available on a DVD. They don't have an online store but you can email and he can get you a disk.

Ark 2: Floating


I learned while adrift that floating is hard.




During the deluge following diagnosis each day’s flood brought something new if not welcome. Somewhere around the day 34 came the emotional realization that type 1 is forever.

That was that day’s flood. If nothing else it was a change from the prior day’s flood.

It rained a flood and kept raining but at least the rain was flowing. After the deluge of emotion that comes with a type 1 diagnosis comes a drifting emotional separation.

The changes stop coming.

Without the rain it is still.

I just try to live with it.

Hanging on day to day.

Adrift.

Emotionally detached.

Quiet.

I go through motions.

One step at a time and hang on.

One blood test pretending it doesn’t hurt.

One shot without wincing.

Count carbs like it is normal.

I wonder what I did to cause this.

Or deserve this.

It is hard.

Lonely.

Rinse.

Repeat.

All the while I am sticking surgical steel needles and lances into the children six, eight, a dozen times or more a day. It no longer count as a rainy day, as the flood, because it has become a routine.

One that that will never stop.

What I thought was part of the flood isn’t. It is part of drifting. Just grab on and try to float. I want to go back to the way it was. That isn’t an option.

It would be a lot easier if I could float with out some of the stuff I brought on board. Like the strange feeling I did something to bring this on. Or that I didn’t do the poking, measuring and shots that I had to do just exactly right.

Floating is hard.

I am alone. Made more so when well meaning but uninformed people pass on silly but hurtful suggestions that I caused this or some simple cinnamon snake oil will cure it. It is so much easier to shut the world out and float alone. So I do.

But floating in isolation is hard and I brought guilt aboard.

Guilt lives in the type 1 universe in ways I don’t even begin to appreciate. It is part of the official canon of some medical practices, “You need to be more compliant.” Guilt has a great PR agent who repackaged it as 'ownership.'

For now, in the drifting stage, know that guilt is one of the things we brought onboard two by two, clean and unclean.

Floating is hard.

Floating is looking out and seeing nothing but water. We do the best we can. There is chatter and commotion coming from all the good and not so good emotions that we have brought along floating.

If we find while floating the grace to just hold on one day at at time we are doing great. Some where in that isolation and suffering we learn about compassion.

In the second of the Ark series Chuck said of floating, “We get a deep deep level of compassion because we can look at somebody who is suffering and honor their suffering without giving them some trite formula. We can honor how hard it is that day... that gives us the ability to serve, to be human to one anther.”

That hit me.

Every July, I marvel at the community at Friends for Life. When I heard Chuck say that I realized compassion is a huge part of the diabetes community. Many of us are likely to to simply say the people at FFL “Get It.” Now when I say that I realize I don’t just mean juvenile diabetes. I mean they understand and honor struggle because they have been or maybe still are floating. They honor suffering without some trite formula.

Guilt is a trite formula.

It is worse than the hurtful suggestions that we caused this and cinnamon snake oil and we give it to ourselves. We don’t need it. We can be compassionate enough to ourselfs to turn our back on diabetes guilt.

The end of Noah’s floating begins when birds brought him back leafs. I am going to bring this essay on floating to an end by offering two leafs. Two wonderfully compassionate essays to help separate diabetes and guilt. These are gifts from good friends Scott Strumello and Kerri Morrone Sparling.

Float well.

Grab the leafs when ready.

Next: Ark to Arc.

The Ark series that inspired this is partially available on line at http://vimeo.com/7187279 Partially in that all talking is there sadly the music of the services isn’t. Each service featured amazing music, rock for the most part but the music is most notable for a hauntingly beautifully version of Somewhere Over the Rainbow that brings tears to my eyes thinking about it. The full service is with tunes available on a DVD. They don't have an online store but you can email and he can set get you a disk.

Ark 3: Arc

Finding new territory.



Just to recap:

First there were floods. Overwhelmingly devastating events only starting with diagnosis. Not just one event but an ongoing series of emotional deluge. In these some things we held important didn't get on the boat. Some part of us did get on the Ark with all kinds of emotions good and bad.

Next we went floating. No rudder, no compass, no GPS, no land to be landmarks... It took some courage to float. We worked through each day step by step. It was lonely. Maybe we learned true compassion and maybe even extended that to ourselves by not letting guilt take control.

Noah’s flood ended. So will ours. He sent out a dove. Three times. The First time it came back but with no sign of life. The second time it brought back an olive leave and the third time was the charm. The bird didn't return.

After the flood that started with diagnosis we go floating, isolated. Eventually we want reach out to see if there is something other than water beyond the horizon. We send a dove. At first it comes back with nothing - the floating isn’t over. I think it is significant that we are ready for it to be over and reach out our hand with a dove. We are ready for something, anything, new relationships even if we don’t at first find them.

The second time the bird brings back a little leaf. There is something out there we can’t see. That is exciting.

The third time the dove stays on new land.

If the bird had not come back the first two times my Noah part would have thought there is nothing out there, even though I wanted something to be there. My Noah would think the bird died, exhausted and fell into the sea, probably eaten by sharks too. But it came back. It proved it could. I think that my Noah needed the bird to come back and me to keep reaching out. By coming back to Noah outstretched hand the bird helped pull him to new territory.

Having proving both it can come back and there is land out there someplace, growing leafs, I gotta think Noah is starts hoping it doesn’t come back. I gotta think Noah get the idea that, ‘If the bird finds a better place than this stinking boat so can I.’ The outstretched hand becomes letting it go with the expectation of no return.

OK that all well and good - here how I see that in in my flood.

A leaf moment for me was meeting a guy name Willie at a JDRF event a few years ago. He was in the corner of an empty room. He became an island. His daughter had been recently diagnosed and they were just back from Friends for Life. We hit it off. His enthusiasm for Friends for Life convinced us to go. What a gift that was, a leaf from new territory full of incredible new heros.

Why did we get along so well? Maybe my drifting taught me some compassion and I could honor their struggle without offering them a trite formula. Maybe the other way round. Who knows? Probably both. I found new territory from a new friend.

Looking back there was a virtual Alfred Hitchcock scene of birds dropping leafs on me. I just didn’t see them for what they were. I guess I was too busy floating and wasn’t ready. I mentioned Kerri and Scott’ pieces on guilt at the end of Floating, here’s just a few other though there were many many more:
  • I anxiously looked forward to new episodes Christel Marchand’s diabetic feed podcast. I got to meet her this past summer and she is far more dynamic than I could have guessed and I had ridiculously high expectations.
  • I read and wrote on ADA and CWD’s forums where I joked regularly with Nick. I wrote Bad Thing Happen to Good People for him.
  • I became friends with Mark who explained who the parents are the primary care give for type 1 kids. Doh!
  • I met folks who could invent Tim. I know inventing Tim makes no sense. In that is the brilliance of how welcoming the natives of the new territory are, from facing a similar deluge they can simultaneously create and mock a boogieman to laugh at and honor floods.
  • Joe explained explained unrealistic expectations as when to smoke another bowl.
  • Ellen got accused of peeing on someone's online Cheerios and that was a chance for me to send a message.

I admit it. I was so used to floating I mistook the all the leafs falling from the wind that pushed me to new land as just another day tossed about on the seas. There was a whole diabetes online community out there dropping leafs like rain drops in the deluge.

Through all of these folks I realized what it means to see with the eye of love that I had to take on faith back in the first of these essays, “..faith is the ability to see with the eye of love. I’ll take that on faith and I’ll loop back later.” Here I am.

From these folks I have learned that looking at somebody who is struggling and honoring their suffering without giving them some trite formula is often little more than the courage to share my own experience without any expectation of return. I love these people for showing me how to do that. To a woman and man none claims to be a perfect diabetic or parent. They simply shared their daily triumphs and challenges. They honor each other’s struggles and in doing so are simply human to one another.

Thanks for taking me in. What a place to find. What a promise to join.

The Noah story closes with a rainbow. A covenant. Chuck said you can can only see a rainbow when with the sun at at your back and the storm passed. The Ark series talking about the end of the rainbow. That the pot of gold is when the storm clears there is the chance to know the intimacy that god intends for all of us.

The ark becomes an Arc, a connection, a promise.

Coming out of my storms I have found a lot of people I would have never know, who’s struggles I honor and am honored to have shared with me.

That is that is my Arc story. I am a little amazed at what came out writing it. If anyone finds value here, great! It's yours with no expectations.



There is a pot at the end of the rainbow.
I couldn't resist.



I say it down there in the fine print but it worth saying up here. The music that went with the series was outstanding. There are a number of renditions of Somewhere Over the Rainbow. Marguerite singing with Brian on acoustic guitar is unbelievable.


The 3rd part of the Ark series that inspired this is partially available on line at http://vimeo.com/7401547 Partially in that all talking is there sadly the music of the services isn’t. Each service featured amazing music, rock for the most part but the music is most notable for a hauntingly beautifully version of Somewhere Over the Rainbow that brings tears to my eyes thinking about it. The full series is with tunes available on a DVD. They don't have an online store but you can email and he can set get you a disk.


November 19, 2009

FTNW: Oral / Inhaled Insulin

Someone way smarter than me (Scott Strumello. Paging Mr. Scott Strummello. Please pick up a white courtesy phone...) needs to read this and explain what the heck it says.

http://seekingalpha.com/article/174252-oral-lyn-vs-afresa-how-generex-will-beat-mannkind

ADA’s Reply

I talked with ADA’s National Office Public Relations group re: Serve Marketing. ADA was very kind and did a little digging. This is what they came back with:

  • The ADA has no current or ongoing relationship with Serve.
  • This shock campaign is in no way condoned by the ADA.
  • ADA expressed dismay at the piece.
  • ADA feels that the link on Serves web page that shows ADA as a client of Serve is misleading.
  • They were very clear in the use of the word misleading.
  • ADA’s legal department is contacting Serve to have the ADA logo removed from Serve’s site and the inference of ADA as a client of Serve taken down.

November 16, 2009

November 15, 2009

Severe Serve Shill

My dear friends at Serve Marketing asked my two cents on their YouTube bit. I responded with moderation. (You should have seen the first draft!)

I posted on the YouTube comments section of there little bit too. There were a number of folks who on YouTube that had more favorable views. Serve made a comment in their own name. One fellow took me to task as a member of the chronically offended. Well what I find particularly offensive is that guy, one Gary Mueller, is in fact the founder of Serve Marketing and the registered admin contact for the URL the ad promotes but some how he forgot to mention that in his YouTube comments.

For some strange reason I can't comment there anymore.


So here is more about Gary, here he is on Fox News: http://www.youtube.com/watch?v=AhqPc0xfrXw

A simple whois turns up:
Registrant:
Serve Marketing
727 N Milwaukee St
milwaukee, Wisconsin 53202
United States

Domain Name: DIABETESISNOPICNIC.COM
Created on: 27-Oct-09
Expires on: 27-Oct-11
Last Updated on: 27-Oct-09

Administrative Contact:
Mueller, Gary

Ethical, Duplicitous? Doesn't really matter.

With the internet comes is a new form of literacy. A heightened level of know what you read and watch. It isn't always easy when some folks post under multiple names. Snake oil salesman can pretend to be about service.

As Carolyn points out in a YDMV comment, it appears there is some kind of a relationship between Serve and ADA. Ouch.

I hope not.

November 14, 2009

Adherence

Diabetes adherence should be how well the tape on the CGM sensor works.


Sadly only people with a CGM see it that way. Amy has a good bit up this week on Adherence and Compliance. My favorite line is: "The term “adherence” made me bristle, too, because it sounds like that dirty word, “compliance.”"

Go read it. I'll still be here when you get back.


Google Scholar has 203,000 articles on diabetes compliance (regular Google has 6 Million) and 129,000 on diabetes adherence. While I’m sure there is a pant load overlap - anyway you shake it that a lot of academic puffery. Either word seeks to collapse all of the management effort required to live with diabetes into a simple little one word solution. OK two if you want adherent compliance. If patients with diabetes would just be compliant everything would be groovy for the medical academics. They make it sound like people with diabetes can’t do one simple thing, comply (or at least adhere if they can't comply!)

The lovely and charming Mrs. YDMV (one of us should be lovely and charming and with me being in the equation that pretty much leaves her to be the lovely and charming that I surely am not) wrote an assignment for a nursing class on of of those quarter million academic papers. That paper was one that got it. It being a word that means idea that compliance isn’t just one thing.

The article pointed out there are one heck of a lot of steps involved with complying. In fact it broke down into minute steps all the stuff that needs to be done to manage diabetes. For example consider a shot. A shot needs to be drawn, based on a calculation of how much insulin is needed. Then hold the vial correctly, push air in equal to the units to be drawn out draw out plus a little more and push back the bubbles and extra. There is proper storage of the insulin, sharps management, logistics to keep the inventories of insulin and supplies on hand so a shot can be draw and on and on…

YDMV readers hold theses truths to be self evident. We live it.

I think there is a lesson in here for us parents too. How much of all that stuff our kid do counts as doing their bit of their diabetes management. What little bit that they don't do constitutes as not doing their share of care? Are they moving in the right direction.

From 35,000 feet diabetes management looks easy. Just comply! It is when your get up close and personal that it becomes a zillion little things.

How about we turn this around. First as parents we need to score as much as possible as doing their share. Remember the long term goal. It is having them move out and be confident that they will care for themselves. This is no different that with a non T1 kid. I know. I have a teenager in college in New York City. There is a certain parental confidence it takes to send a teen of the the Big Apple.


Lets take this turning around of compliance one step a different direction. Hello industry? How about you comply. You adhere to a set of micro steps that work for successful diabetes management. Let start with standards that work to bring all the tools and steps needed to manage a patent’s health into one common non proprietary information system. All meters should speak the same data language, through industry standard connections. Same goes for all you CGM and pump makers.

It our diabetes. Our data. Not your proprietary lever to keep us buying your stuff.

Carey Potash wrote this week about number of the day. Everyday has a host of numbers of the day. As Carey points out what is a good number in their life may not be so awesome to another family managing diabetes. YDMV.

People with Diabetes deal with enough variation. I think it would be great if we could eliminate the counter productive variations between all the tools that collect information families need to manage diabetes. A shot needs to be drawn based on a calculation of how much is needed. Why do we put up with every different pharma or device manager maker inventing new ways to deal with numbers? Hell most need a special $29.95 cable to get the numbers into proprietary software that doesn't do much other than be an accessory to consumable sales.

It is insane. It’s getting worse.

Here is an example: when we got our first pump the lousy software that came with it at least could download a number of different manufacturers’ meters. They tried to comply. The new lousy software only downloads their brand of meters. No need to explain - it says the strip name right on the pump.

I understand. We want to manage diabetes. You want to sell strips. Our interest only partially overlap.

Besides what is a few more steps messing with numbers on the ground as long as the medical journal articles can still talk about compliance from 7 miles away like it is one simple thing?

Up close diabetes management isn't one even on one day. It a lot of discrete steps one day a year and doing them again and again on the other 364.

More *#@* from Sevre

Barf. As I read this they will "explore" making a distinction between t1 and t2 in some cases (not all) but are really looking to get their crappola into wider circulation.


... I will explore putting a Type 1 diabetes description and disclaimer in some of our campaign materials. Also, when we are a part of upcoming longer format tv and radio news stories we will talk about the difference.
Thanks again for your feedback.

November 13, 2009

Contour USB II

Everyone who saw the Contour USB used the same one word.

COOL!

The initial responses to this thing were fantastic. Styling counts. My 16 year old T1 said it was about time Bayer stepped up their game. We joked about teachers mistaking it for an iPod - that is a design compliment.

This Meter is cool. The old Contour - not so cool.

Interestingly everyone who used it a has a similar response the first test. They all like Bayer’s method of tagging before or after meals. That being, it asks for a tag while it is counting down the blood test. There are two plusses here. 1) You log the blood check as before or after a meal. 2) It give you something to do while the meter thinks. Bayer calls this AutoLog. Nice use of the five second it takes to calculate a number.

I wondered if AutoLog would get old. Delaney used it the most of anyone and she didn’t ever complain about the AutoLog feature.

All of y’all out there in DOC land asked the same question - how much blood? Well it is a regular Contour strip. It uses a lot - 0.6 μL. That a ton more than our Jazz meters use.

The color screen is way easier to read than any meter I have seen. Big kudos there. I never took it out into direct sunlight and can’t say if that is an issue or not. The screen does a nice job of changing to tell you what the buttons do. Maybe it is just the landscape layout but it seems easier to line up the button function and the button than most meters.

Also in the cool feature department is the illuminated test strip port. Makes confirming a late night CGM reading a lot easier. Every meter should have this.

I am not a fan of Bayer lancing device. Mostly because it seems bigger than it needs to be. Now this may be a design play for the older lest dexterous type 2 market, I don’t know, but size matters to me and their lancing device is too big. Here it is with a smaller WaveSense pokie. As previously noted the colored lancets were a big hit with the tween and 4 year old TDL.


On the topic of size, somehow the case for The fairly small Contour USB meter is bigger than a Jazz case. As previously advertised in my world smaller is better.

The real deal here is the USB port. After everyone (Delaney, Connor and TLD) gave it a test blood test there were enough data points to test out the software. Plug and play. It was easy enough.

No cable. Standard USB Plug. WoHoo! Score Bayer! Not only groove styling but actual standardized connectivity, functionality anyone with a computer can use!

The software is fairly straight forward. I grabbed a few screen screen grabs and a few pictures are worth a lot more more than a bunch of my words. So here goes:


Nice straight forward log book. Different colors for in range, low and high.

You can click and see your log book into a nice groovy chart. Same color scheme. Just a note here when you look at the log in the meter the in range is white text and high and low are both orange. I guess the meter programing geeks and the software that is going to live in the meter geeks didn't get the same memo on how to use colors.

Pie charts for Thanksgiving dinner dessert.

And you can setup the meter at the keyboard. That green blob there is teling me the default seetings for high and low are different than what I put in the merer. One quick click solved that.


I agree with the teenager the Contour USB puts Bayer back into the game with good design and a significantly smaller form factor. Yo Tim across the pond, you need to check one of these out.Mostly all good. The sample size is a tad big, so is the case. My views on case colors is that with two type 1 kids around (three when we babaysit TLD) you need to be able to tell what meter goes with what kid at a glance. Color helps a lot.


If you are using Contour strips now get one of the these bad boys. They rock. If you are on a meter you don’t love give it a try.

Bayer Dudes.
Y’all need to come back to Friends for Life. Bring guitar hero and this meter. You will get converts. WaveSense needs a run for their money and so far you are it.

Sevre Explains Diabetes to Me

'cause Apparently I don't Know

Hi Bennet,

Thanks for your feedback. Our ad is a prevention message and is not designed for an audience that has already has diabetes (especially the much more rate type 1 diabetes which make up only 5-10% of all cases). We are talking to the the families of the 9 million overweight children who are at risk. The rate of obesity among our children has tripled since 1980. Being overweight is one of the leading modifiable risk factors for type 2 diabetes.

The CDC, American Diabetes Association, and the US Department of Health & Human Services all agree that diet and exercise is the best prevention for type 2 diabetes and that's the message we're focusing on. The problem is that when you tell people "exercise & eat right" they tune it out. But when they're caught off guard and learn about the devastating effects, they're more likely to change their behavior.

Thanks again for your feedback.

Heather Aldrich
Executive Director
Serve


November 12, 2009

Hi Nate

(A friend of the guy who sent the email posted a comment below pleading Nate's case as being sucked in by the markting firm. Seemed reasonable so Nate is off the hook and out of the post.)


I am glad you love YDMV.

I hate your ad.

It is total crap.

It is a stereotypical blame game piece of self-righteous garbage. Do you make ads blaming kids with leukemia too?

You said you can’t imagine my families struggles. You sure can’t.

One of the things that you can’t imagine is how hurtful it is when uninformed self appointed media volunteer parachutes into the public discourse on diabetes with fatuous and highly judgmental misconceptions about what our lives are like.

While type 2 is rising with younger americans, most of the children with diabetes in our country have type 1. Type 1 is an autoimmune disease. Even wikipedia knows of type 1 that “most affected people are otherwise healthy and of a healthy weight when onset occurs.”

Your piece is crude sensationalism. It promotes misconceptions that says more about your ignorance than anything salient about diabetes. Clearly Serve Marketing is more concerned with being a provocateur for it’s own self aggrandizement than doing anything useful to promote understand of how devastating diabetes is.

Your email spoke of a lack of understanding and the need for a wake up call. Both are very true. You suffer from the former and need the later.

You are looking for a viral response to you video. I expect you will get one but not exactly what you expect.

Bennet


Read the email and watch the video. Let me know if I understated my reply. If I did, feel free to drop an email yourself.



Here's his email that sparked this:


From: Nate Date: Thursday, November 12, 2009, 6:46 PM

Hello Bennet,
I am writing you to tell you that I really enjoyed reading your blog. I can not even imagine the struggles you and your family go through on a daily basis. I loved your post about your son the Jedi. I am glad that with his condition he can still just be a kid. I also really liked your breakdown of the new Bayer Contour USB device. You are the first blogger that I have found that has gone over new technology. It was very refreshing.


My name is Nathan and I am a volunteer for Serve Marketing. Serve Marketing is a non profit organization that does marketing and advertising work for social causes. This month is American Diabetes Month and Serve Marketing has created a viral video ad to raise the awareness of diabetes in children. Everyone is aware of diabetes, but few people understand how devastating the disease can be. We believe that people need a wake up call on this issue. The first step in changing the behavior of people is to make them aware of the issue

This is a web-only public service announcement designed to catch parents off guard and let them know about the devastating consequences of diabetes and encourage them to find out the steps they can take to help prevent it. We are looking for opinions from diabetes bloggers such as yourself. So if you could please take a look at the ad and tell me what you think it would be much appreciated.


http://www.youtube.com/watch?v=7EKXBuClORA

Thank you so much for your time

Nathan

November 10, 2009

FTNW: Implantable Glucose Sensor Research

Researchers are developing a tiny implantable wireless device to monitor blood glucose levels. (PhysOrg.com)

It still way off in the future.

A team of researchers in chemistry, pharmaceutics, and engineering is developing a long term implantable biosensor that could dramatically change the way of life for millions of people diagnosed with diabetes.

Prototypes of the device are smaller than a grain of rice yet embedded with an array of highly sensitive, microscopic electronic chips, sensors, and transmitters.

The device would be injected into a diabetic patient subcutaneously using a hypodermic needle. Patients would then wear a special watch-like monitor that would receive transmissions from the sensor so they could track their blood sugar level throughout the day.

http://www.physorg.com/news177018067.html