Exenatide ("Byetta":) or "Lizard Spit"

"Exenatide (also Exendin-4, marketed as Byetta) is the first of a new class of medications approved for the treatment of type 2 diabetes." (Reference wikipedia.com) This drug called
lizard spit is an injectable drug that works with metformin and may greately improve one's A1C.

More detail on this substance.

This stuff is very expensive; about ^$200⁰⁰/_month and this would be very damn expensive for something that just amounts to a supplementary substance for me. Then, too, there is the matter of it being injected twice a day. I would have to take my metformin two hours before eatting (with a snack) and inject one hour before eattting.

I was quite excited about the prospect of getting better blood sugar control by using this and then I read the bad news! I don't want to touch this stuff!

disbetes screening day

Here is a letter I wrote in an attempt to start a diabetes screening programme.

14 February 2007

Director, Nursing Program
Dodge City Community College
2501 North 14^th Avenue
Dodge City, Kansas 67801

Dear Ms. ,

This letter is to confirm what we discussed on Monday, 12 February 2007.

I propose that the Dodge City (noon) Lions Club and the Nursing Program of the Dodge

City Community College work together in producing a morning Diabetes Screening Day. We all
know that a morning fasting test is the best way to screen for diabetes. Producing this would
involve advertising the event, students to do the medical work and obtaining consumables.

The Lions would deal with advertising via the local newspapers (English and Spanish)and the local TV affiliate. Part of this would be obtaining permission of the American DiabetesAssociation (ADA) to publish their Diabetes Risk Test in both English⁽¹⁾ and Spanish⁽²⁾. We would also arrange for handing out pamphlets and contacting other civic organizations. There is aDiabetes Support Group which meets on Thursday evening once a month at the hospital; I willcontact them and ask for their help in this matter. I will also ask the ADA affiliate in Wichita forany advise or help that can provide. We can also talk with the School Superintendent and schoolnurses with respect to extending an invitation to students. We would have to get legal help increating parental permission forms and liability release forms⁽³⁾. Could the college legal staff arrange this?

The Lions could ask various pharmacists in town (i.e.Wal-mart, Dillons or Walgreens) to
supply blood test meters and test stripes for free or at cost. The Lions can arrange to buy any
consumables if necessary. You would have to advise us on the number of test meters we should
obtain and the number of test stripes we would need.

We would like your students to take blood samples for blood glucose readings and
probably blood pressure readings and heart rates. Taking the blood samples would give your
students working with random members of the public.

There are multiple reasons for this joint activity:

* Diabetes has become a growing concern and may be approaching epidemic status,

* Many people are ignorant of the various forms of diabetes,

* People are unaware of the warning signs of diabetes and who is at risk,

* The public is not always aware of the behavior that lead to diabetes (i.e. obesity)

* This action would bring favorable attention to your Nursing program and DCCC

* It would bring favorable publicity to the Lions

* It would benefit the public for years to come should this become a recurring event.

Depending on your class schedule and final exam schedules, a date in April 2007 might
meet the criteria of having enough time to make arrangement and yet not be "too far in the
future". Arrangements for supplies and obtaining volunteers could probably be done in February. The real problem would be in getting publicity, and that would take several articles and letters to various civic organizations. Thus, a target date in April would probably be appropriate.

Since Lions is an International Organization, a successful screening day could lead to
other communities emulating us and thus aiding our future. A successful screening day could
lead to other colleges taking this up as well. The complications of diabetes are expensive and
will only grow more expensive in the future. Unless and until a "cure is found", diabetes will be
a major world wide concern. A successful anti-diabetes campaign could be profoundly important in our future.

Very Respectfully,

Lion Michael

Enclosures: how you help save sight
what you should know about diab etic eye disease
what you should know about glauoma

Footnotes:
1. http://www.diabetes.org/risk-test/text-version.jsp (English version)

2. http://www.diabetes.org/espanol/recursos-examen.jsp (Spanish version)

3. The ADA may be able to help with legal issues.

"Chromium" as a diabetic support source,,,

Reference: diabetes treatment?

Supposedly 200mb of "chromium" per day will help you metabolozie insulin. The following quote is taken verbatum (in the spirit of something called "fair usage") from the referenced article:

Chromium

What it is: Your body needs this mineral for the hormone insulin (which lets cells turn sugar into fuel) to work effectively. Insulin resistance, linked to diabetes, is thought to make you fat. The effective dosage seems to be 200 micrograms per day.

Why try it: Chromium seems to slightly limit weight gain in people with diabetes or pre-diabetes. And in one study, people who didn't have insulin trouble lost about three pounds more in 10 weeks using chromium than those who didn't. But experts say the mineral may be most useful for people with insulin resistance.

Why not: Years ago, there were health concerns about one form: chromium picolinate. Later studies found it to be safe, though, says Adriane Fugh-Berman, M.D., associate professor in the complementary and alternative medicine master's program at Georgetown. But case reports have linked chronic use of 600 micrograms or more per day to kidney and muscle damage. (Health.com: A guide to today's hot diets.external link

I don't know how effective this will be but I'll start taking it. After all, my A1C test is only 3 months or so away...

a death by neglect...

Mummified body found in front of blaring TV

It was bad enough that this 70 year man died alone in his house and that no one noticed he hadn't paid his

• electric bill
• gas bill
• water bill
• phone bill
• income tax
• property tax
• medical bills
• hadn't contacted his MDs
• hadn't paid is medical bills
• and had mail piling up

He was also a blind diabetic and his neighbors knew this!

At first, I was outraged and thought poorly of the neighbors. Then, I realized I don't know my neighbors. Oh, I know the neighbors to the west but not the other neighbors. If I were retired and a widower, I could easily die and not be missed for quite a while! Oh, I'd like to think my brothers would check up on me but this is via email (usually) and my email connection is automatically paid by credit card. I suppose the credit card company might notice non payment after a couple of months and cut off my card, thus leading to the internet provider calling me?

The real horror of this story is the isolation of this old man. He was blind; how could he go shopping and take care of his house? How could he buy new clothing and shoes? What happened to his "Medical Support Team" and why didn't they check up on him? Didn't the shopping clerks notice that the "old blind man" hasn't been coming around for a while?

Now, in Dodge City Kansas, the Dillion's clerks would notice! The WalMart clerks would probably be glad the old blind man had stopped bothering them! (I'm probably being unfair to the WalMart employees; I'm still pissed off that I got sick after eatting some Peter Pan Peanut butter, serial number starting with "2111", which I bought at the Wichita Kansas Sam's Club!)

How could so many groups interested in getting his money just ignore him?

How could he be so isolated as to die and his body be mummified? Well, this did happen in Hampton Bays, New York and those folks have probably got the East Coast fuck-um-he's-not-family-and-I-don't-have-to-care! attitude. (I've been told this is a healthy attitude for high density population areas and that I'm naive to think otherwise...)

foot problems...

I wore my 1986 Army jungle boots during the recent snow storm. Actually, I didn't wear them during the storm but afterwards. This was fine as I was lazy and didn't tie them up properly. I decided to be "proper military" about tieing them up (even if I've been out of the Navy since the day before Thanksgiving 1988!) and tied them up. This did something to my right foot and kind of deforemed or brused it. I spent the next several days having trouble walking until my foot adjusted to walking when I got up in the morning. That is several minutes when my foot was cramped. (Not very pleasant when I had to get up at 0315!)

I got over it.

Day before yesterday, I noticed red friction marks on the "index" toe and 'bird" toe of my right foot. I put band aids over these friction marks and they didn't seem any worst the next day. I didn't have any band aids available this morning so I didn't bother. (Doesn't that sound like the kind of bullshit that leads to infections that lead to losing one's foot???)

It was hard to tell but these toes didn't look much different tonight.

Anyway, if I'm going to start walking again and lose weight, I'll have to buy new walking shoes. I'm also going to have to get at least one pair of nice, comfortable dress shoes (is that any oxymoron?) and I suppose we'll go shopping when we "do a Sam's Run" to Wichita this coming Saturday.

I deserve good shoes!

I want to keep my feet!!

I don't want to end up like my late Father and youngest Brother!!!

several about Diabetics...

One of the latest emails from the ADA talked about the threat of pneumonia. The threat to "old folks" is that pneumonia weakens their bodies for the illness that kills them...

"That what doesn't kill us makes us stronger."

Friedrich Nietzsche

"That which doesn't kill us makes us vulnerable to that which can kill us!".

Me...

---

There was a rather horrifying statistic about the incidence of diabetics in children. This is both type 1 and type 2. I've got to wonder how this will impact on military recruitment when these kids come of age.

I can see the Armed Forces not "ingesting" the type 1s but the type 2s will be a different matter.

Then, I thought of the "boots's" feet. ('Boots' is the old expression for enlisted recruits...)

---

Then, I thought of the "boots's" feet.

I remember the boots ("boondockers") and "low cut" dress shoes I was issued in Navy Boot Camp in September 1970. The leather was very rough and everyone got blisters. Some of these blisters bleed and that made them possible infection sites.

The second Thursday of December (the 14^th), I got a blister on my "left index toe". This appeared to be infected so my family MD had me on anti-bodies for ten days.

Around Christmas, I was outside barefoot and scrapped by right heel on the shoe. Fortunately, I still had two antibotic pills to go when this happened.

So, no infection and skin is growing over the "wound" site.

I was diagnoses as a type 2 on 7 May 2004. I've been "lucky". I have to wonder how many diabetics would be "booted out" of Boot Camp with serious foot wounds or possibly misxsing foot parts.

I doubt it the V A is ready to deal with this...

Oddly low...

My morning fasting score (taken after I walked the dog) was 89.

89?

This is the 2^nd lowest I've ever had!

I did have trouble with the reading this morning. Sometimes, the test stripe doesn't go in v;ery well and I have to pull it out and put it back in again (not in sexual manner...). This morning, I "wetted" one side and nothing happened. I squeezed more blood out of my finger and "wetted" the other side of the stripe. It took two tries but it worked.

I probably should have tried again. Also, I normally test off my forearm but today it had to be the finger. I had put on a long sleeved t=shirt when I got dressed and didn't want to pull the sleeve up...

I ain't no saint myself...

For years I bitched about my youngest brother's inability to control his blood sugar. I have days wshere I eat a "big" meal at nivht andmy score is comparatively low the next morning (104 -120) and other nights where I have a salad and my score is 135 to 145 two hours later; nights where a steak, small potatoes and veggies give me a smaller score.

I called my youngest brother and he said he was averaging 251; basically at least 100 points then my "normal" highest...

I was wearing a black socks and black dress shoes that don't fit worth a damn. The skin on my 2nd and 3rd toes of my left foot were reddened from friction but hadn't blistered up. I wrapped a band aid on one of the toes and wear and tear dropped off. I'm going to have to go to the diabetic shoe store in Garden City to get myself a decent pair of dress shoes.

I'll need them this comning year....

Brother's status - good news...

My youngest brother finally got around to calling teh Social Security people to look into getting onto disability. He had been told early this year that:

1. he would be rejected the first two or three times and
   
2. he would probably not make it anyway and
   
3. he would have to deal with his medical and other bills for 8 or 9 months
   

He called and was told "you should have called years ago!

It looks good for him...

Four days later, still no news and no emails...

Charlie's status...

My youngest brother was in hospital in late November. He had gone in with the vomiting and had a heart attack while in the emergency room. They put him in Heart CCU (Cardiac Care Unit). Two days later, they decided to try a quarduptle bypass. I couldn't help but wonder where they would get the blood vessels from. After all, his reight leg ends at mid theigh and his left leg about 5 inches above his ancle. This means the vein used in his surgery in March 2006 was wasted. He had a serious infection of his left foot back then and they had taken a vein from high in his left thigh and had used this to replace the trashed out veins then in his lower left leg. After a while, they simply had to whack off his left foot. It was very painful for all and especially him to lose that foot but it still bothers me that saving the foot had wasted a vein that might have eventually gone to save his heart.

Anyway, they called in the cardiac surgeon and tried angeopathy vice open heart. The surgeon said is was a "no go" [or words to that effedt]. Then, the bette rspecialist was called in and he decreed that Charlie probably would not survive open heart surgery; if he did survive then his kidneys would have been totally trashed. So, this better surgeon decided to try angipathy again. Being the better "cutter", he succeed.

So, my youngest brother was declared suitable to be released.

Our other two brothers and I are quite concerned. We worry about what he eats (pizza and coke cola, beer and wine), his apparent unwillingness to walk on his prothesis and his over willingness to use the wheel chair and his apparent unwillingness to work on his own behalf.

We were happy that Charlie had a group insurance plan to cover his hospital stay. He had been fired in early November (he was out sick too many days) but still had the company medical plan until the end of November 2006.

That is a damned shame! If he had lost the insurance, Charlie would have gone back on COBRA and would have had total coverage. Instead, his "company group insurance" was only good for $5,000 and his bills were about $100,000!. This means he owes $95,000! He will lose all his money (including his inheritance) and anything of real value to pay off his hospital bill.

Folks like Charlie need free public health care, if only because they'll never be able to pay back the very, very large hospital bills they run up. I'm not rich and we can't afford to carry Chrlie's debts and pay his bills. This is already causing problems between my wife and me and between another brother of ours and his wife!

on Soy Yogart...

I read a article called "Soy yogurt could help control diabetes" the other day that asserted "eating soy yogurt" will help diabetics by lowering their blood sugar. I tried a small container (6 oz) of a Strawberry/Vinalla flavoured soy yogart this afternoon. It looks horrible but actually tasted good. The article didn't state the minimum daily dosage. Given the container I ate cost 99¢, I don't know if the $6⁹³/week will be worth it. However, since there was only one other container in the cooler at the 14^th Street Dillions, I don't think this'll be a problem

I looked up the recipe for soy yogart from my copy of "Sailing The Farm". Then, I sniffed the little bit of milk we had in the fridge, tasted it (it hadn't really started going bad) and fired up a batch of home made milk yogert.

I've found my raw soy seeds from last year or so and they still seem fine. So, following the instructions in "Siling the Farm", I'm going to make some soy milk tomorrow and buy another container of the soy yogurt and try it with soy "milk".

mystery of sugar...

I had a salad, with low cal dressing and water. Two hours later, my blood sugar reading was quite high (171 I think but I'll have to look it up). The dismaying thing about this is I've eatten stuff that should have "flashed" to blood sugar easier than a salad and (perhaps) too many slices of salami.

I am going to correlate meal type and blood sugar one of these days.

My "Nurse Case Manager" or "Diabetic Coach" Karen and I...

This is my "Nurse Case Manager" or "Diabetic Coach" Karen and I at the Diabetics Seminar, at the Dodge City Senior Center, on 24 October 2006. (Yes, my name is "Mike", I live in Dodge City Kansas and too many people can identify me. Still, I feel the desire to be secretive about my "real" name.)


Me and my "Diabretic Coach" Karen ("Diabetic Educator" actually). I don't have permission to give her full name and any locating information so I won't...
"My" Karen and another nurse.

dying by abundance

______In this Slate article, ("Please Do Not Feed the Humans" or "The global explosion of fat") William Saletan discusses how our species evolved in an environment of food scarcity. The recent (last century) abundance of food has happened too fast for evolution to counter said abundance with improved inherited "time to stop eating" mechanisms and anti-obesity, anti-diabetes, anti-heart attack mechanisms, etc. We're being killed by the survival mechanisms that allowed our ancestors to survive long enough to beget us!
______I remember worrying about losing 10 pounds in high school. I also remember girls being mocked for being 5 to 10 pounds overweight. Now, I'm probably 50 pounds overweight and can't seem to lose that weight. Sadly, I work with young men who are overweight to the point of looking pregnant.
______Decades ago, I noted that poor blacks in southern Mississippi seemed to be the most obese. I later realized they were eating cheap and very high calory foods. A fairly snotty and apparently anti-American Brit ("The end of obesity?" by Gwynne Dyer) commented on this as well. This Brit expected the obesity epidemic to fizzle out due to "global warming" and a return to food scarcity by the end this century. (I take a certain amount of comfort in the realization that diabetes and probable heart problems and simply age will render me dead well before then. I was born in 1951...)
______In spite of my gloomy belief the human race will kill itself off in the next century or two (probably via that old standby, killing over religious differences). Perhaps not the death of the entire species, maybe a small enough fraction of the current overpopulation will survive and humans will once again be were they were for so many millienum: on the endangered species list! (I smirk whilst reading this but I really hope it doesn't happen. I want the various kids in my family and the families of friends to survive. I'd be lying if I said I worried about foreigners...)
______So what is the point of this blog? Well, given that type 2 diabetes is caused by obesity and there has been an explosive increase in both childhood obesity and childhood type 2 diabetes, then we need to be worried. Twenty years ago, "childhood type 2 diabetes" simply didn't exist (supposedly).

comments on "needle" versus "oral medications"...

______I had a conversation with a Diabetes Educator and a fellow Type Two. This woman muttered "I don’t want to go on the needle".
______I replied "me neither".
______The Diabetes Educator said in a very earnest voice "I’m not a diabetic but if I were, I would skip the pills and go straight to injected insulin".
______When I told my diabetics coach yesterday, I said "she is not a diabetic and doesn’t understand the fear of having to use the needle for the rest of my life. I don’t want to use the needle until I’ve tried everything else".
______She commented that "the needle" isn’t such a bad fate. Sorry but I don’t agree and want to keep from having to use injected insulin for as long as I can.

Saving the Diabetic...

This is a ADA news release about the killing of a Senate Bill that would have made life much harder for Diabetics. If you're a diabetic or know someone who is, it is still worth your while to
_______* find out how "your" Senator voted and
_______* send them a thank you or a "Foxtrot Uniform"

http://www.diabetes.org/uedocuments/enzi051106.pdf

I sent an angry note to both of "my" Senators, both good apparachiks.

Happy Day! Good News!!

______Well, I had my dilated eye exam and Dr. Tarwater said there were no problems with my eyes! I was quite happy to hear this!
______After he asked me who my eyeglass doctor was (Dr. Copeland), I told him I was planning on getting my eyes examined in October. He then told me that I might want to put that exam off as Dr. Copeland was being treated for cancer. This is very sad; I like Copeland and folks I know not only like him but like his family as well.
______It was a mixed event: my eye health was fine but Dr. Copeland is now.

Good news!

Results of my Blood Work (23 May 2006)...

           Lipid - Perfect

     Cholesterol - 152 total

Good Cholesterol - 52 (50 is minimum)

 Bad Cholesterol - 86 (100 is maximum)

   Triglycerides - 68 (160 is maximum)

  Hemoglobin A1C - 7 (adequate)

PSA 1.21 (good as it is less than 4; last year was 1.37)

Lost 7 pounds since last year

My feet (my old "personal" picture...)

Actually, this is my dog and our new cat sleeping on the couch and actually gettihng along with each other...
My feet!

good eatting and horrible numbers!

Dinner: At the High Street Brfewer and Cafe in Eugene Oregon:

Appetizer: tater tots with cheese dip

Hamberger (1/3 pound) with Tillamooh cheedar cheese and a fried egg

plus great french fries

and two glasses of a great microbrew beer!

The hamberger was so good it deserves to be mentioned by it's name ("Wilbur's Jumbo Deluxe Burger") and it's description "Bacon,Tillamook cheddar, & a fried egg" on their menu.

Events have consequences and so did my "little" binging...

Then, 2 hours and 30 minutes later, I took my "two hours after eatting blood reading" (the above figure of 201!).

For most folks, that might seem too high. But for me, it is quite high and will probably fuck up my A1C test in late May! (28 May 2006: This little binge probably had it's part in my getting an increase in A1c from 6.8 to 7.0! in late May!) However, it was well worth it!

Dinner: At the Golden Crown in Beaveron, Oregon, the number 9 and a beer.

This food was quite good but was quite bad for me! Two hours after eatting, I had the highest blood sugar reading I've ever recorded! This was:

For me, this was a shockingly high value. I just knew that it really help fuck up my A1C test in late May (and I rather think that it did!). Alas but it did give me a really strong hint on what I shouldn't eat. Also, I could take comfort in the fact that I go to this restraunt perhaps once a year and almost never go to Chinese elsewhere. Kind of a reassurring thougth, kind of...

Of course, I being a highly intelligent type who takes bad news in stride and knowing that I should do nothing to jack that frigging reading, didn't go out for a walk but had a beer instead...

Ok, I may be fairly intelligent but sometimes I just sigh and do the easy but bad things...

Besides, I felt better after having that beer. (I didn't get around to telling me wife just how bad bad was...)

pictures of my feet...

Given that my brother Charlie doesn't have feet, I get a certain amount of reassurrance in knowing that I still do.








My wife accidentally "cut off" my big toes when she took this photo.










An attempt at photographing my damaged left little toe. I ran my left foot into something about four months ago and the toenail may have stopped growing.

Another shot of my left foot.

A nice shot of my feet!

Who says my dog and cat (one of them anyway) can't get along with each other?

I just picked a scab...

My brother Charlie has a serious ulser on his left foot. He finally admitted that the ulser was on the side of his left heel and that he had developed a blister there.

A blister?

Wasn't he taking care to ensure his shoe fit well? (With no right foot, saying "shoes" is rather redundant and sentimental.)

Well, the blister had scabbed over and he picked the scab!

He picked the fucking scab? Well, that lead to an infection and that lead to him going to the emergency room in January with a serious ulser. He knows his blood sugar is way too high and also knows the threats of foot injury.

There is something very scary about my brother's leg loss. He has been a diabetic for 26 years and his blood sugar is why too damn high. (He thinks an A1C of 7.5 is normal.) I've been a diabetic for almost two years and I'm having trouble with my own blood sugar. I'm worrying that I might someday end up in the same fucked up situation as my brother.

"Natural" cure for Diabetics???

I didn't read very much of this and simply have the opinion they are advertising a natural "diet" as a cure (for Type 2 diabetics anyway).

This sounds like advertising BS. But, then, I've read that a lot of people in Sauda Arabia swear by eatting locusus as a diabetics cure (I don't recall where I read this.)

picture of something very important to me...

"My feet! Something that eventually goes away from the diabetics in my family..."

PAM (Pissing And Moaning)

I'm still PAMing (Pissing and Moaning) about my blood sugar "score" from last night. I'll quote from myself:

"We did go out to dinner last night, to celebrate me having taken the A1C test. We went to Arby's and had steak and garlic mashed potatoes and a really decadent desert!

It was wonderful.

Two hours after I finished eatting, my blood sugar was 225!

Two hundred and twenty five!

That is the highest I've seen it on a test I did myself. So, I guess that wonderful desert really is sweet poison. I won't be doing that again any time soon!"

It may be "bad form" to quote myself but my "publisher" (me) says "go for it!. And, since I always obey my "publisher", I did "go for it!".

I still remember getting my butt chewed by some clown on a Science Fiction talk list by violating some rule I'd never heard of. A couple of other people wrote me and said this "clown" thought he was the ultimate expert on whatever the subject was and jumped all over anyone who had a differeing opionion.

Another time, I posted on a BBS (in Moline Illinois) a "survey" from an email humour magazine. I was blasted by a number of angry people and the BBS admin kicked me off that BBS "for my own good".

Damn people! It was just a joke! (It was in 1995 from a humour magazine run from MIT.)

Charlie is back home...and I quoted BGEN Jack O'Neille!

My brother Charlie refused to let the surgeons cut off his left leg at the knee and talked them into alternative surgery. The MDs said his arteries from mid left calf on down were basically trashed. They wanted to whack off his left leg. (So what if poor Charlie would be stuck in a wheel chair and legless? The boys in the body shop -er- prosthesis creation centre need the work! The girls in the their rehab department need the work! I guess that hospital just isn't getting the surge of walkering wounded or perhaps I should say unwalking wounded from the various wars...)

Instead, the surgeons took a healthy vein from Charlie's left thigh and used it to replace a trashed artery in his left calf. This replacement went from a healthy sourse to the ulser. The ulser is being given a plentiful blood supply and is healing.

"Well and good!"

What the fuck is he going to do when the next ulser opens up on his left foot? The supply of "good veins" in his left thigh is very, very, very limited! Soon enough, his thigh will be in grave danger...

But, he saved his leg and that is a wonderful thing.

He also refused to go to a rehab centre because he simply wanted to get home. This was short term smart (sort of) and long term foolish. He would have benefited from (another) course of rehab...

"Or not"
        BGEN Jack O'Neille from Stargate

A1C day...

Bottom line: My A1C was 6.8. My MD wants that lower...

Six months ago, my A1C was tested at the local clinic and was 6.8. Three months ago, it was tested at the VA Clinic (actually, they sent it off to some undisclosed location) and was 7.2. So, I went on the wagon, started eatting at least one salad a day and really really cut down on the carbs.

I also got more enthused about the walking (still can't force myself to do shitups and pushups...)

So, my MD, not referring to the outside test had Midge (his nurse) call me at work with the results and told me "the Doctor wants that to come down. Cut out the carbs" Well, I'm in complete agreement with Midge and Dr. Hotstetter on that...

We did go out to dinner last night, to celebrate me having taken the A1C test. We went to Arby's and
had steak and garlic mashed potatoes and a really decadent desert!

It was wonderful.

Two hours after I finished eatting, my blood sugar was 225!

Two hundred and twenty five!

That is the highest I've seen it on a test I did myself. So, I guess that wonderful desert really is sweet poison. I won't be doing that again any time soon!

ah...the joys of "phone home"...

I called my Mother last night and after talking for under five minutes, she said she was sick and hung up. I called my youngest brother to see how he was doing and after a briefer phone call, he said he had to go to the bathroom and hung up. So, either I've irritated both or I've called so many times lately that getting a phone call from me is no big deal. Well, I think it should be...

I think I'll put off "phoning home" for a week or two. My wife suggested that I call one of other two brothers, to see if they're sick as well. However, I decided to pass on that one. I've called them both less than a handful of times in the past decade. None of us would really know how to react. Their wives and kids certainly wouldn't...

A1C coming up...

Every three months, I'm supposed to have a blood test to determine my A1C level. So, for the past three weeks or so, I've been trying to "finese the test". That is,'m trying to "eat good". It has been damned hard; I've been on the wagon for this three weeks and have been getting far more cranky (I guess I'm a bit more in love with gin and tonics or beer that I'd like to be.)

I expect to get a score of 6.8 or so. If it is 7.0, then at least it'll be lower than my last score (7.2). If it exceeds 7.2, then I'm going to have the dispairing feeling of "what's the point"? If going hard core doesn't work, what will work for the rest of my life?

no news...

I tried calling my brother's hospital room but got no answer. I also tried calling my Mother and had to leave a note on her voice mail. This was two days ago and I'm just hoping all is well. I'll have to call again tonight.

Chalie is getting better...

My brother told me that he'll be sprung from hospital as soon as the "swelling in his scrotum" goes down. That'll be good, very good! He's been in hospital for about 2 months and is desparate to:

* get back to his apartment,
* have privacy from well intended stranger,
* have privacy from bumbling folks entering "his" room by accident,
* cook his own food,
* decide when to sleep, etc.,
* look for a job,
* be able to move about society as he sees fit!

The appeals judge decided Charlie was wrongfully fired and that he is entitled to unemployment and most especially back unemployment!

The morals of the story are:
* A long term diabetic can have horrible health and
* Some companies will shitcan employees who have the gall to get sick!

It makes me quite grateful that I've got a good union to back me if I eventually fall ill like my brother Charlie! I'll know then that the union dues I've paid all these many years is finally paying off...

rain on the parade or the possible downside of inhailed insulin...

This extract from an article on Slate (http://www.slate.com/id/2135087/) by Emily Biuso on Saturday, Jan. 28, 2006, is a bit less upbeat...

"The new insulin product, which will be sold under the brand name Exubera by Pfizer, may be available as soon as this summer. But the picture isn't entirely rosy: Some doctors are worried that Exubera's risks to lungs have not been properly tested and that inhaled insulin causes minor declines in the amount of air the lungs can hold. The FDA recommended that asthmatics, smokers, and others avoid the product, and the long-term effects are still unknown.

The WSJ points out that it's been a good week for Pfizer: On Thursday, the FDA approved another of the company's drugs, Sutent, as a treatment for two kinds of cancer."

This was quoted without permission but should be adequately sourced to avoid violating copyright...

My MD thinks I'm still at least a decade from needing needles (injected insulin) and so I'll wait to see the long term results. I'm in no hurry to add the expense of yet another medication...

bad boys, bad boyz...

We've probably all seen dibetics injecting insulin in the evening prior to eatting some cake or doing some drinking.

* My late Father used to inject before having a few beers too many with a steak dinner and eatting some cake. (This according to family stories; I didn't personally witness it.)

* Christmas of 2003, we were at my brother Charlie's house. He gestered me into the kitchen and he injected whilst telling me that "I'm going to have some of Roxie's cake".

* My boss and I both knew a man in Chicago who was caught injecting in the office "kitchen"; Carl explained he "was going to a party tonight and I'm going to have some choclate cake". This was about 1993; Carl retired around 1998; Carl died of heart failure in either 2001 or 2002.

I suppose you could say "Carl retired from life 'in either 2001 or 2002'?" Or maybe this is too morbid...

The dosage had to have been a WAG (Wild Ass Guess) or if they'd bothered checking their blood sugar level a SWAG (Scientic Wild Ass Guess)!

Maybe being able to inhail insulin could lead to a different senario:

The good news is such dibetics might do the "exhail, take a deep breath and hold it as long as you can" routine (I use an asmatha inhalor occassionally) and could be getting that added insulin needful for drinking too much beer or eatting too much cake!

The following conversation could occurr:

"Mike is snorting something."
"You don't suppose he's snorting coke?"
"Nah! He's too damn cheap! He's a piss beer drinker!"

"Piss" beer referrs to Budwiser and not the outstanding Michlob...real Michlob, no "lite" beers and certainly not that horrid/horrible Michlob "Ultra"!

DISCLAIMER "Michael" most emphatically discourages the useage of illegal drugs. "Michael" firmly believe that one can get fucked up quite adequately on legal drugs...

good news about inhalable insulin...

This article is basically "good news coming":
27-JAN-2006 FDA Expected to OK Inhaled Form of Insulin

This article, ironically issued the same day as the previous article basically says the "good news is here!:
27-JAN-2006 FDA Approves Inhalable Version of Insulin.
Here is a confirming article from CNN:
same good news!

A nice news source for diabetics.

Charlie as of 28 January 2006

He's not answering his phone and our Mother is distraut!

Something is very wrong with my brother and the MDs apparently can't figure it out. He's now got swelling including what my Mother told my wife, "swelling in his scrotum". (A big of graveyard humour here: My brother always joked about having "big balls" but that was a joke and this isn't a fucking joke!)

Last night, at work, a friend of mine asked me "how is your brother doing"? So I told him. His wife is a surgical nurse and Tim has absorbed enough of that mindset to realize how serious my brother's conditions really are.

I'm scared and would go out to Oregon if I thought it would do any good...

talking with Charlie, post surgery...

I just called my brother and this was the first time I've gotten thru to him since his surgery.

"Charlie, I've been trying to get a hold of you."
"Hi, Mike, can I call you later? I'm getting sick to my stomach."
"Utrrr, uh, bye."

I don't like to think I make my brother "sick to my stomach" so I'll blaim the "pain meds" and the lingering infections. I think I'll go walk now and enjoy having feet (even if my right toes are sore). So, I won't be home if he calls later...

news on the medical front...

The local cardiologist spoke at Lions Club.

Here are some quotes:

"Seventy percent of diabetics die of heart problems." (My Father died of congestive heart failure.)

"If you have a diabetic, you have vacular problems." (Can't argue with that...)

"The single best exercise you can do is walking." (Thank God for that! Walking is about the only heart helping exercise that I like and certainly the only one I can do with screwing up my feet due to stress fractures. If there are indoor swimming pools in town, I neither have heard of them and have to assume they'd be too expensive should they exist...)

"[It is] very important to watch your diet." That can be hard to do and losing weight can be damned hard - if not nearly impossible at my age - to do!

We faced the embarrasment of letting Dr. Kahn order a salad that turned out to be loaded with bacon. It wasn't deliberate. Lion Kathie and I were mortified to learn that a Muslim had been allowed to innocently order a pork product (i.e. bacon).

He spoke of future plans to bring in a heart surgeon and that southwest Kansas could exceed the minimum number of cases per year (200/year) that a "cardio" surgeon needs to keep in practice. This is both good in the sence of us getting a "chest cutter" and bad in that so many of us would need this surgeon. Such is the life that comes from living in a society of abundance...

eating bad and poverty (an antedotal link)

I went to high school in Biloxi Mississippi and lived in base housing on Keesler Air Force Base (my Father was Air Force). At the  basel theatre, the folks who sold popcorn, coke (nothing diet mind you) and candy were a black family of Mom, Dad and (presumedly) Oldest Daughter. At the time, I was worried about being 5 to 10 pounds overweight. All three of these folks had to have been 30 to 50 pounds overweight. They were obviously working at the theater to supplement the Dad and Mom's incomes.

I was ignorant enough to wonder how they could afford to eat enough to be so fat. I later learned that it wasn't from eating too much, it was from eating the wrong food!

I was laid off November 1989 and it wasn't until 1995 that my new job began paying me well enough for us to have decent food. I ate so much white rice with soy sauce and a little bit of tuna that my boss told me to eat something else. So, having gotten a bit of a pay raise (this was 1991), I started taking baked or mashed potatoes and overly cooked hamburger to work (not always but enough to be noticed). My boss gave up on tryng to get me to eat right. That was too bad...

The result of eatting what I later learned was the wrong food was:

* I gained 70 pounds,
* My blood pressure went up and I may have had a stroke (I'm being treated for hypertension)
* I became a type 2 dibetic (I'm being treated for this with metformin.)
* I eat much better and exercise now but I can't seem to lose that damned weight...

So, I have the answer to my question of why those three poor black folks were so fat. They ate what they could buy and what they bought was very bad for them!

CAVATE TIME: These black salespeople may have been well off and may have been working at the theater simply to meet folks coming to the theater. Sounds good but isn't consistent with the culture of Southern Mississippi in the late 1960s and they never struck me as being willing to talk with the audience (mostly white folks that we were). I could be wrong but I strongly feel I'm not. Alas...

latest and not very greatest on my brother...

At 4 pm, 18 January 2006, my Mother called and left this message on the answerig machine:

"Charlie is in a lot of pain and throwing up."

The surgery lead to beaucoup pain and the pain meds coupled with the shock led to a lot of vomiting. The vomiting means he can't keep anything down and that also will make getting his blood sugar under control a real bitch for the medics. I wish them all well!

What I wrote in irony is apparently true in fact: vomito ergo sum (I vomit, therefore I am)

Under the circumstances, it has suddenly lost it's humour.

NOTE: "Beaucoup" (bo' - coo) is French for "lots of".

some venting, some frustration, some fear...

I just called my brother's room, gave the person (a woman) who answered my name and asked for my brother. I then was put on hold and hung up after 3 minutes.

I called again, said who I was and that I was calling long distance. The same voice told me "I told you, you've got the wrong number". I snarled back "No, you didn't. I want to talk to a nurse". The bitch hung up right after I said "didn't". I was so tempted to call back and spit out "BITCH" to her when she answered the phone but I won't. I'll just bitch about it...

I'll call our Mother and maybe email my brother...

...two minutes later...

I just got my Mother's answering machine and left a message asking about my brother. He is probably in recovery or ICU and I don't have that umber. On the positive side, if they'd whacked his leg off or if he'd died on the table, someone in the family would have called by now. My family has a bad history of not giving out bad news...

I have to go to work in 20 minutes and this aborted telephone tag and venting this is keeping me from "At All Costs" by David Weber.

Now, about 15 minutes later, I'm feeling guilty about being rude to this bitch, who is a patient at the hospital. Oh, well, she didn't handle it very well either. Normally, I'm a very nice person but when I'm scared, I tend not to be quite so sweet.

partial news...

About 5:20 pm PST yesterday, my brother Jim called the house and reported that Charlie was still in surgery. That was the last word received when I got home at 11:15 pm CST (9:15 PST). So, I guess "no news is good news.

I'll have to call him this afternoon and just hope he remembered my work email address.

pre-surgury for Charlie...

I talked with my brother Charlie about 8:10 am Pacific time. As of then, they were planning on doing the vein transplant and will operate sometime this afternoon (Oregon time). He sounded up beat and alert but mentioned that he'd not had much sleep. It seems the nurses had been coming in every thirty minutes during the night to poke a hole in one of his fingers in order to check his blood sugar. This seemed excessive to me but then medical folks have their own strange ways.

My Mother, family friend Steve or our brother Jim will call me at work tonight with the results or call my wife. If this doesn't work, Jim has my work email address. Since Jim knows it is bad form to send bad news via email, I'll just have to hope he didn't see the need to email me (assuming that he doesn't email).

As I was writing that last sentence, I could just picture the disdain on my 8th grade English teacher's face; worst, I could picture the much more massive disdain on my 9th grade English teacher's face! (Maybe that's why I'm not fond of public school English teachers to this day???)

status on my brother Charlie...

As of last Thursday night, my brother Charlie was sort of scheduled for the vein replacement surgery on Tuesday 17 January 2006. Fortunately, however, his MD was very reluctant to see this happen. The good MD, while expressing his support for Charlie and stating that he would not derail the operation, thought it futile. It sounded like Charlie was beginning to come around to this viewpoint.

I do worry about him...

My brother Charlie remains in hospital...

I called my Mother last night to ask how she is doing and how my brother Charlie is doing. She said the surgeons were going to do a artery replacement. The veins in is left leg are closing up and not allowing sufficient blood flow. That is the reason the ulser on his left heel isn't healing. So, the surgeons want to take a "healthy" vein and run if from the "healthy" arteries nearest the ulser to the ulser. The premise is this will lead to a much higher blood flow and healing.

I told my Mother, "if the veins are so bad, then he's lucky to still have the leg."

She sniffed and I finally realized that I should have kept my big mouth shut. "You don't want to talk about this?"

"I can't", she said and I changed the subject.

Charlie was born after my parents thought their "family making days" were over. Since I was 14 when he was born, I became the built-in-baby sitter and (happily) the doting oldest brother who did his best to spoil "his boy". His life has not been a wonderful as we had hoped it would be; the juvenile onset diabetes, along with some other problems, lead to that. (It is admissions like this that keep me from blurting out who I am; I just don't want the family to know I'm pulling "a Howard Stern" and am letting the one or two readers of this electron rag "see the private parts". Oh well...

Back to practicing medicine without a license.

But, if the other veins are shot and are letting very little blood through, this seems like a pointless and ultimately futile operation. If what they told my brother Jim is correct, Charlie will end up losing the leg anyway. In my opinion, he will have suffered a useless operation. On the other hand, he would have kept that left leg a few days or weeks longer and will be able to scratch his calf or stretch it or even walk about on it for that extra time.

That alone may make this replacement worth doing...

I called him last night (after talking with our Mother) and he couldn't talk. He'd suffered a severe reaction to the (anti) "pain meds" the night before and had spent the night vomiting. (Something I'm used to from a couple of bouts of food poisoning in the local area.) His being a type 1 diabetic meant that he was losing any food he may have eatten and was unable to keep down anything.

So, the infection probably jacked up his blood sugar and the vomiting may well have lowered it (or raised it, I'll have to ask the "American Diabetics Association").

But, back to his leg. Even if this operation simply lets him keep his let for days or weeks longer, he will have had the leg that much longer. That is a good thing, even if his "co-payments" will continue to escaliate. What the hell, he's probably so in debt that only bankruptcy under the old rules could have saved him. Under the new rules, he fucked! Ah, another thing we can thank "our" Congress-critters for!!! (If irony were cash I'd be rich after that statement!)

It also galls me since I'm a life long Republican (but think the individual is more important than the company so maybe I'm really a Democrat?).

Maybe it really is the carbs??

Day before yesterday (10 January 2006), I should have gotten off work at noon and had lunch about 12:20 pm. Instead, I worked overtime to 1:30 pm due to a computer system I was changing passwords going tits up. Well, only one of the computers went tits up and we were able to force it to accept a new "root" password...

I left word at 1:35 pm (or so) dropped off a suit coat at the dry cleaner and thought of going to "a nice place" (nice for diabetics anyway). But I was hungry and didn't...

Being very hungry, I went to King's Buffet and had entirely too much "oriental" food. I had one plate of chicken and beef, about a tablespoon of noodles and maybe a third cup of sliced potatoes. Then, another plate of chicken, pork and more chicken and about the same amount of potatoes. Desert was a small bown of ice cream (which I didn't finish) and part of a creme puff (which looks a whole lot better than it tasted!)

I figured it was going to be a good thing I'll have about 5 hours
and 20 minutes between getting done then and testing my blood sugar at 7:15 pm. At 5:10 pm, I ate a salad that was mostly lettuce, several slices of peperoni, some cheese and a half cup or so of cottage cheese.

Desert, of course, was Pepto-Bismol...

I thought my blood sugar would be too damn high. It was 104!

Yup, 104!

This is better than many of my morning fasting readings.

Either the machine is off (unlikely) or the lunch I'd had was basically meat with very little in the way of carbs. My dinner was salad with very little in the way of carbs.

This business of trying to "manage" my diabetics often perpluxes me...

my diabetics coaches advice!

Go Diabetic Go!

Go Diabetic Go!

Go Diabetic Go!

Rah! Rah! Rah!

Actually, she didn't but she was encouraging and gave me some good advise.

"micturre ergo sum"...a diebetic's motto...

"micturre ergo sum"

This is my new motto and is Latin for "I urinate, therefore I am" (roughly translatted). Actually, in Latin,

"micturre" means "to want to urinate ",
"ergo" means "therefore" and
"sum" (roughly) "I am".

Hence, "micturre ergo sum", "I piss (urinate), therefore I am".

Noreme's Coffeecake

NOREME'S COFFEE CAKE;

Noreme is an old friend of my mother, someone she went to college with in the late 1940s. So, this recipe has been tested by my family for about 55-57 years now ...

1 stick oleo (or butter)

1 cup sugar

2 eggs

1 tsp vanilla

1 cup sour cream

2 cups flour

1 tsp baking soda

1 tsp baking powder

Mix sugar and oleo until puffy. Add eggs, vanilla and sour cream, then beat. Add dry ingredients and mix. Pour half of batter into greased baking pan (a loaf shaped pan).

Mix 1/2 cup sugar with tsp cinnamon. Pour half of this over the batter.
Put remainder of batter into pan and pour remaining topping over this batter. Bake in 350 F oven for 45 to 55 min.

prayers needed for my youngest brother...

My brother, Charles Andrew Bell, is one very sick man. He
is now 40 years and was a juvenile onset (around age 13)
type 1. He apparently is not shaking off the infection
that his ravaging his system. He has been in hospital for
several days now. Our Mother said he is now able to keep
some liquids down; they have debrided (i.e. removed) dying
or dead tissue from his left foot. This is most ungood and
pre-stages bad things.

Prayers for Charlie are needed!

One of our other brothers send me an email that included
this:
<blockquote>
"I think ultimately Charlie is not good. The vascular
specialist checked him and said the blood pressure in his
left leg was not good. So, you can read between the
lines."
</blockquote>

I can "read between the lines" just fine!

We're worried about him losing that left leg. He is
already having problems getting around and in holding a
job; losing a second leg will make a bad situation much
worst. He is the kind of person for whom welfare was
intended. We can only hope the State of Oregon will
agree...

Supporting him is stressing out the family quite a bit.

Now, if he can overcome the leg infection, the stomach
infection (which comes from a general systemic infection),
learn to live with no legs and get a job with an employer
willing to accept a hard worker (with an angry attitude)
who is going to be running up the company's medical bills,
then maybe I can hope to send him an AARP application in
ten years. (Family joke: when a family member hits 50, I
send them an AARP application and poems about getting old.
That is payback time! That will teach them for having
farted off my 50th birthday!!!)

I fear that he won't live that long and the waiting is
most distressing...

Presidental "Happy Holidays" message (AKA "Merry Christmass Message") for 2005

To all DOC employees (DOC is Department of Commerce)

President Bush sends the following Holiday Message to the Employees of the Federal Government:

"I send greetings to all Federal employees and your families as you celebrate this holiday season.

Federal service is a high calling and an expression of responsible
citizenship. By working to improve lives, advance prosperity, and protect
our homeland, you strengthen our country and help many realize the promise of America. Your spirit of professionalism and dedication
reflects the best of our society and contributes to the success of our
great Nation.

Laura and I send our best wishes to you and your loved ones during this
season of hope and joy. May God bless you, and may God continue to bless
America."

Signed George W. Bush

A facsimile of the letter can be viewed at http://www.osec.doc.gov/hm.tif

__________________________________
This message is authorized by ExecSec

meditations on my brother Charlie...

My youngest brother, Charlie, is back in the hospital with a very serious stomach infection and has been unable to eat or drink anything
since Monday, 12 December 2005. That was the day he was admitted to hospital. His right leg was cut off in mid thigh last year and now
his left foot is both infected and the infection is resisting the antibodies. He is unemployed and out Mother is paying his bills...
We are quite concerned for his foot and the curing of this infection (again?). My wife thinks I may be a bit over concerned with Charlie's
survival but I'm not sure. I do think he'll survive this episode (I hope and pray) but I think one of these near future years, he won't survive...

There is a rather horrible irony here.

For years, before I was diagnosed, my wife and I talked about "he isn't taking good care of himself". (Even he has admitted to this.) I used to
bitch: "He's not getting his blood sugar under control; how hard can that be?"
Well, having been "officially" a type 2 diabetic since 7 May 2004, I can answer my own question. "It can be damned hard!!!"

My Diabetics Coach changed me from a schedule of checking my blood sugar before dinner to checking it two hours after "taking that last bite". (I still do a fasting blood sugar before breakfast.) The results have been alarming. My AM or fasting blood sugar counts are generally good and in the 105 to 120 range, with a few spikes to around 133. My evening "sugars" suck!
They've been from 156 to 170!
The best I've had was two hours after eating a couple of pork chops, a small potato and about 1.5 cups of over-boiled broccoli flowers. I've also
found that "Lean Cuisine" meals aren't the diabetics best friend but in terms of portion control, they bet the crap out of what I prepare in
terms of portion control if not in terms of value. (i.e. in terms of carbs to blood sugar)

Back to my brother's sad story...

My brother was laid off but this layoff was perverted into a firing; the true reason for the firing was not that he'd screwed up his time sheets (his
immediate supervisor had read and blessed them!). The real reason was he was costing them a lot of money! Imagine a diabetic getting sick and actually using his medical insurance! This can't be allowed to happen! The
employees are supposed to be healthy and management is supposed to get a bonus for medical insurance not used! (This is just a wild ass guess but is probably accurate...)
Well, we can't have this sickly man being sickly so SHIT CAN HIM!
It was done...

Well, my feet are still good but I sure didn't tell our Mother that I'd stubbed the middle toe of my right foot and it has developed a bright red
blister. My wife talked me out of going to the Family MD and that was just as well: the swelling has subsided to what looks like a scratch. For a couple of years before I was officially diagnosed, I noticed that I was healing slower and slower. When I first started blood testing on 11 May 2004, I must have "stabbed" myself in the forearm 8 times. Those "wounds" healed very quickly. Lately, the needle holes have been taking two or three days to heal.
I have noticed a lot more "for diabetics" products.
The "diabetics comfort socks" are US$ 11.50 each and are 2.5 sizes too small. Their highest size is shoe size 12.5 and I wear from size 14 to
size 15.

Diabetics did lead to "erectile dysfunction" but Viagara cured that! I feel like I'm 40 again! (To quote my father-in-law; I'm 54...)

Discover Magazine article on diabetes...

A very interesting and somewhat alarming article:

http://www.discover.com/issues/dec-05/features/diabetes-insulin-resistance/?page=1

An interesting speech on diabetes by Congressman John Murtha

Congressman John Murtha of Pennsylvania made this speech.
It is quite interesting in what it says about diabetes,
what it says he's done and (mainly) the web links he
gives.

This is well worth checking out!

http://www.house.gov/murtha/diabetes.shtml

I wonder if "my" Congress members have done anything about
diabetes???

a nice research article...

Here is nice article about the relationship between depression and
coronary heart disease (CHD) among Type 1 diabetes.

http://www.scienceblog.com/community/older/1999/E/199904075.html

"Inhalable insulin gets FDA panel OK" - article on CNN...

I just read an interesting article on the CNN Health page
about inhalable insulin. This sounds interesting but also
sounds a bit like something that may have been pushed thru
too quickly

You'll have to connect the next two lines or simply go to the highlighted "article" above:
http://www.cnn.com/2005/HEALTH/conditions/09/08/ inhaled.insulin.ap/index.html

Dear Michael,

Thank you for contacting your American Diabetes Association. I received your e-mail regarding meters.

The cost of a blood glucose meter and diabetes care supplies is often covered by health insurance. But some insurance companies will not reimburse you. Find out what your insurance company covers and get approval before you buy. Some insurance companies and/or health care systems have special arrangements for certain meters or systems. If you have an established health care team, you should discuss choices and cost before you buy. You can usually find a deal on meter trade-ins with rebates and special purchase offers. Check with your doctor and diabetes educator. Keep an eye on ads and compare prices before you buy.

In the past, before the advent of blood glucose meters, urine testing was the only method for gauging blood glucose levels in one's system. But it is, and always has been, a very imprecise method and does not provide a complete picture of diabetes management.

In most cases, for example, glucose is not detectable in the urine unless the blood glucose levels have been above 180 mg/dl, which means that urine tests are virtually useless at detecting hypoglycemia (low blood glucose levels).

For this reason, and others, health care providers recommend that those interested in attaining good blood glucose control use blood glucose meters, not urine test strips or tablets.

Urine, however, contains many other substances and is still very important in diabetes care. For example, if the body burns fat for fuel in the absence of insulin, poisonous ketones are produced, and these substances find their way into the urine. Also, when the kidneys' filtering processes begin to become impaired, microscopic amounts of protein (microalbuminuria) begin to spill into the urine, which is an early sign of kidney disease.

Urine testing kits are available for testing three different substances in the urine: glucose, ketones (some kits can test for both glucose and ketones), and microscopic amounts of protein (microalbuminuria). Urine tests, though no longer recommended for blood glucose control, still play an important role in diabetes care. They can detect the presence of harmful ketones; new tests can even measure indicators of kidney health.

Home urine glucose tests are available in strip form. They may or may not be less expensive than blood glucose test strips. Insurance companies may not pay for urine test strips, however, because blood glucose meters are now held as the standard.

Strips are either foil-wrapped or in vials, and are marked with shelf-life dates. Strips should be stored according to manufacturer's recommendations, because the chemicals on the strip will react to light, temperature, and changes in humidity. Foil-wrapped strips may be a better choice if strips are infrequently used, to preserve the integrity of the strips.

Urine specimens must either be collected in a clean, dry container (one would then dip the test pad into the collected specimen), or by passing the test pad through the urine stream to saturate it. Timing for the result varies.

Results are obtained by noting the presence of a visible color change on the test pad of the strip. A color scale will indicate the result, either in an estimated quantitative value (example: 250 mg/dl, 300 mg/dl), as a percentage (1/10 percent, ¼ percent, etc.), or a descriptive term (for example, trace, small, or large). People who have problems with color perception or poor visual discrimination are not candidates for using color charts and should use other methods.

Improper handling or storage could skew the readings. There are also certain medications and vitamins that potentially could alter the urine color, causing false results. Check with your health care professional about interfering agents if you plan to use home urine testing products.

Ketone bodies (acetone, acetoacetic acid, and beta-hydroxybutyric acid) are by-products of burning fat, rather than glucose, to fuel the body.

Ketones are a waste product. If they build up, they can lead to very serious energy problems in the body, resulting in diabetic ketoacidosis. The body tries to dispose of ketones as quickly as possible when they are present in the system. Urine test strips can detect ketones as the body tries to rid itself of these poisons.

Ketone testing should be performed by people with type 1 diabetes when their blood glucose is high (usually greater than 240 mg/dl), or as directed by their physician. All people with diabetes who are sick, under stress, or who have blood glucose over 300 mg/dl should also test for ketones, as should pregnant women with any type of diabetes (type 1, type 2, or gestational). And, of course, anyone who suspects onset of ketoacidosis should test for ketones immediately. Check with your diabetes health care professional about the ketone-testing guidelines and record-keeping methods he or she recommends.

Please note: Urine ketone strips will detect only some of the ketone bodies produced by the body, not all of them.

Ketone strips are available in foil-wrapped packets or vials. Follow all manufacturer's guidelines and procedures.

Test results are revealed through color changes, which indicate the presence of ketones, either quantitatively (for example, 5 mg/dl, 15 mg/dl, etc.) or by descriptive terms (for example, negative, trace, small, or large). False positives may occur if you are also using certain medications or vitamins, or if the strips have been handled or stored improperly.

New blood ketone testing meters more accurately detect some ketone bodies and may be preferred by some providers, as previously noted, or they may be used in combination with urine strips.

Talk to your doctor regarding what chemical reactions take place in order for the meter to read the results. Blood glucose meters are small computerized machines that "read" your blood glucose. In all types of meters, your blood glucose level shows up as a number on a screen (like that on your pocket calculator). Be sure your doctor or nurse educator shows you the correct way to use your meter. With all the advances in blood glucose meters, use of a meter is better than visual checking.

Step-by-Step Blood Glucose Checking

Wash and dry your hands.

Prepare the glucose meter. Each meter works a little differently. Read the instructions carefully. At first, you should practice with the meter under the supervision of the doctor or diabetes educator.

Choose your spot. Don't test on the same finger all the time. Choose a different finger each time you check. Prick the side of the fingertip, not right on top. The side hurts less and is less likely to bruise.

Prepare the lancet and finger-pricking device. Like meters, each finger-pricking device is different. Read the instructions and follow them carefully.

Place the finger-pricking device against your finger and push the button.

Squeeze out a drop of blood. Some people have more trouble getting the blood out than others. If it's hard to get a drop of blood out, try hanging your hand down and gently shaking or squeezing the finger. If it is often troublesome to get a drop of blood, ask the doctor to recommend a different lancet or finger-pricking device.

Place the blood on the test strip and put the test strip in the meteraccording to manufacturer directions. Wait for the results.

Record the results in the logbook

Here are a few common problems that can cause inaccurate readings:

Hands are not clean & dry (you forgot to wash them, there's powdered sugar on them from that doughnut you just ate, or you used an alcohol wipe and the alcohol is interfering with the meter) I no longer eat powered doughnuts...alas...

Blood drop is too small

Codes on strips and meter do not match

Dirty meter

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Information from ADA, request for...

My email to the American Diabetes Association "ask line":

Subject: diabetes testing...

Good morning,

I remember reading that after diabetes was "discovered' in the early
1920s, patients had to boil their urine and basically pull a chemistry
lab experiment one or more times a day. I have a rather horrified
fascination with this and would like to read more on the subject. (My
blood meter works just fine!)

My father and my brother both used the "Pee Test Stripes" in the 1980s.
I'd like to read more about their accuracy. When I told my Mother (the
retired RN) that I had been diagnosed and asked about the "Pee Test
Stripes", she said they were very inaccurate and disgusting to use. She
seconded my MD's recommendation that I buy a meter. For that matter, why
are insurance companies calling the metes "medical devices" and not
paying for them yet are paying for the test stripes?

I use a test strip based blood meter. I called their "help line" and
asked how the machine works. I was asked for my name and phone number
and told a "specialist" would call me. A couple of days later, the
"specialist" called and told me that "the blood has to seep into the
test strip" and then told me how to use the machine. I've known since I
started using one 11 May 2004. I asked her what chemicals were in the
strip, what chemical reactions took place and how the meter read the
results.

She didn't know...

Can you help me with this?

Tks,

Michael

A grandmother at risk...

Yesterday on CNN, we saw an extroverted young boy (maybe
10 years old) take a reporter to meet his grandmother. His
grandmother said she was a diabetic and it was obvious
that the lady hadn't had much to eat based on what was
around her. She was sitting on what might have been a
raised street. I don't know if she was able to test her
blood sugar and I sincerely hope she is a type 2 and not a
type 1; she obviously did *not* have refrigeration.

On the bright side, type 2 is supposedly very predominate
among the "minorities" and I hope this black grandmother
was another of us type 2s. (For what it is worth, I am one
of the white type 2s.)

My wife and I are wondering what is being done to
save/support the insulin dependent diabetes in this
disaster. If there was *ever* a time for James Lee Witt to
have been running FEMA, now is it!

A nice letter to the editor...

A nice letter to the editor:

http://dodgeglobe.com/stories/083105/opi_20050831009.shtml

Your driver's license and *your* state laws:

If you want to read your state laws vis-a-vis your
driver's license, read this material from ADA:

http://www.diabetes.org/advocacy-and-legalresources/discrimination/drivers/pvt-licensemap.jsp

Good news wrt the A1C...

My A1C in May 2004 was 7.9 (high!), in May 2005 7.5 (also
a bit high) and in August 2005 6.8. This is below the
magic figure of 7.0 so my family MD (Dr. Hostetier) and my
optomologist (Dr. Tarwater) are both happy. So was my
Mother when I told her; I wrote two of my brothers but
haven't heard back from them. One will probably say
"that's great!" and the other will probably brag of his
being lower. Oh, well, J and I were always competing...

Perspective...

A couple of nights ago, my wife and I saw an ad on TV that I immediately
mocked. It was a group of people complaining about the stress of having
to fill out the paperwork to get their diabetics supplies and the pure
agony of having to wait in line for their supplies. Then, of course, the
ad mentioned the name of the company that would be their salvation by
doing the paperwork for these folks. They would not have to wait in
line.

I said that obtaining diabetics supplies and waiting in line wasn't much
of a problem for me. My wife said those folks were probably type 1
diabetics and having to test their blood sugar four times a day. That
made me pause and admit that I was probably wrong. (Come to think of
it, this company's offer does sound like a good idea.)

I guess I've gotten spoiled since our family doctor fills out "scripts"
when I phone him and the clinic pharmacy folks fill the forms in for me
and fill the order quickly. The clinic pharmacy also has the cheapest
prices in town; I've checked the "new" drug store, which advertises
having the lowest prices in town and the clinic pharmacy beats them all
by a goodly margin.

I really don't have it too bad.

Sure, I have to test the blood morning and night, Tuesday and Friday.
That is a lot better than four times a day, every day.

I have to take a couple of pills a day. That is a lot better than a
bloody needle, one or more times a day!

My feet are in fine shape. I'm not struggling to get from wheel chair to
wherever like my youngest brother Charlie has to.

While my wife doesn't especially like talking about diabetics, I don't
have the problems that my youngest brother has. He was in hospital with
nearly intractable bacteria infections a number of times and the
surgeons kept whittling off portions of both his legs. (His right leg
ends at mid thigh now and his left foot is basically a stump.) All this
was too much for his wife and they divorced. Oddly enough, after the
divorce, they regained their friendship and are good friends again. (We
might even see RoxAnne again some day but we live in Kansas and they
live in Oregon; visits are rare.)

I am still "young" to this disease and can take metformin without
problems. Our family doctor says it could be 10 or 15 years before I
have to go to stronger medications and he isn't looking for me to go
onto the needle for at least that long! (My 85 year old father-in-law is
on the same dosage of metformin that I am as is another gentleman I
know, who in his middle 70s. A number of my fellow Lions are diabetics
but there is such a conspiracy of silence that I'm barely aware of who
is a diabetic, let along the level of treatment they are receiving!)

I know folks who have survived cancer and some that may not. I think
they'd trade places with me, medicine wise, health wise, if they could.
They might think it would do me good to be in real medical trouble and
to see just how bad bad can be. No thanks! I'll take what God has given
me and be grateful it isn't worst! I can appreciate how bad a bad
situation can be!

I will continue to work out (walk upwards of an hour a day anyway), try
to avoid bad food, try to keep a hopeful mind set and keep seeing the
family doctor when I need to. I read an article by some over
overeducated clown with a PhD who said that folks who actually used
their medical insurance were taking advantage of the system and were
ignoring the costs they were passing along to other folks! Balderdash!
Not going to an MD or dentist when needed ultimately ends up costing
much more. If I'd gone to my MD in June 2004 when I fainted and then had
trouble breathing, I'd have paid a lot less than what the emergency room
charged.

A couple of weeks ago, I was having a bit of trouble breathing because
of a respiratory track infection. I thought about going to the MD and
when my boss said "you shouldn't have come in to work", I immediately
called the clinic and got an appointment. Then, I took the rest of the
day off to rest.

I probably would have had a great deal of trouble sleeping that night
had I not gone to medical and that would have led to many more problems
the next morning. Problems like maybe having a traffic accident. Then, I
would have gone to the MD.

Finally, I have to repeat myself and realize that while I have things
much worst than I did 20 years ago, I know of people who are worst off.
I guess that I can't really "bitch mightily". (No, I don't know the
source of that quote but seem to remember it was said by Saint Abe
Lincoln.

Glorious Landing!!!

We watched the landing of Discovery on the TV at work. The
whole office sat around from about 6:45 am CDT to about
7:15 CDT to watch this.

It was quite a relief to see that everything apparently
went well. As one fellow said "I bet there are no atheists
on there!" He was probably right. Any atheists on-board at
the start of the mission most likely were not at landing
time!

It was glorious and well worth watching!

It's nice to know that NASA can still do stuff correctly.
Now, they just have to come up with a far better orbiter
and I fear that they won't be able to do so...

wrong attitude...

I've simply got the wrong attitude toward "testing my
blood"! That is, I check the blood sugar level twice a
day, twice a week (Tuesdays and Fridays actually). I've
realized that I'm going about this the wrong way but have
not let myself get concerned.

I am treating the testing as if it were a school test or
one of the annual weigh-ins we had to endure in the Navy.
The correct attitude would be to adjust my exercise and
food and see if this is producing the desired results. If
it was, great! If not, then I'd have to adjust the
exercise and food.

I've not been able to get on an "even keel" and I'm not
sure that I could even get my wife to really go along with
a rigid schedule. Actually, that is not quite true: she
has been trying to help me "eat right". (I can't blame
myself, now can I???) It's just that neither of us are
very big on eating a lot of fruit and certainly not big on
eating two or more veggies a meal. We just weren't raised
that way!

She likes to joke about me being a "meat and potato man"
and that is true! I also like a good gravy to go with the
good "meat and potatoes". We haven't had regular deserts
in decades and only very seldom have salads with meals. I
guess my diabetics coach is going to have a lot of talking
to do with me if I want to stay healthy...

Just blathering along as it is near 11 pm and nearly time
for me to get off shift...

ripped up elbows...

This past Saturday, my wife and I were working security at
the local museum. We were checking driver's licenses and
handing out "beer bands", actually. (Folks weren't
supposed to be able to buy beer without one but I was
later told that the serving crew was selling beers to
people who looked old enough any way.) I was placing my
elbows on the surface of the table when I realized that
there was a flap of skin on the table. It seemed the
surface of the table (made of a slightly rough plastic and
marked "LIFETIME") had been rough enough to abrade the
skin off both my elbows.

Neither elbow was bleeding but I asked for and got band
aids to put on both. I put liquid band aid on both elbows
when we got home. That was a good idea as both elbows
seemed to be on the verge of bleeding.

For the next couple of days, it hurt to put pressure on
either elbow and I had to be careful getting out of bed.
(This is even more ridicious that it sounds!)

That was Saturday and it is now Wednesday evening late and
neither elbow is very much healed. Years ago, they would
have scabbed over by Monday. I guess this business of
diabetics screwing up my healing is living down to it's
potential!

Who would have thought it?

bad sweets, good sweets...

According to the MD who talks on Fox News "Sunday House Call", aspartame is very bad for you and saccrine is the best artificual sweetner for you. Basically, this MD said
that any of the artificual sweetners are better for you than sugar and gave this discussion of the best and worst. So, I'll have to see iff'n we've got saccrine at home for
my oatmeal...

betrayed by my diet sodas!!!

The following rather horrifying quote came from:
bad news:

"FACT:
DIET SODAS ARE NO SALVATION FOR THE OVERWEIGHT: As the U.S. population has grown increasingly overweight, the marketing of diet products to help control weight has
burgeoned. But do diet sodas help reduce obesity? The San Antonio Heart Study took a closer look (#1058). The opposite was true. The group that drank diet soda had the highest incidence of overweight, compared to those who
drank only regular soft drinks (lowest incidence) and those who drank half of one, half of the other (in between). This "raises questions about the advisability of reliance on these products for weight control," say the
authors."

ADA 65th Annual Scientific Sessions: Abstract 1058,
Presented June 12, 2005.

This begs the question: what am I going to drink now that I realize that my Diet Pepsi has been back stabbing my diet attempts and I find regular sodas too damned sweet. Also, water is fine but boring! I suppose that I could "move to" fruit juices or veggie juices (i.e. tomato
juice).

I wonder if my "diabetics coach" can offer suggestions when she call on 2 August? Maybe she can explain what happened to the information packets she was going to mail me

the possibility of hypoglycemia in spite of taking metformin...

An interesting article about metformin> (part of which I have quoted below) gave a list of sympthoms. I've have had them if I exercised a lot or simply not eatten much. I hadn't expected hypoglycemia with type 2 diabetes and metformin:

Metformin does not usually cause hypoglycemia (low blood sugar). Nevertheless, hypoglycemia may occur in the treatment of
diabetes, as a result of skipped meals, excessive exercise, or alcohol consumption. Know the signs and symptoms of low blood sugar, which include hunger, headache, drowsiness, weakness, dizziness, a fast heartbeat, sweating, tremor, and nausea. Carry a non-dietetic candy or glucose tablets to treat episodes of low blood sugar.

However, I think the odds of me dropping into hypoglycemia are quite small so I don't think I'll start carrying "non-dietetic candy or
glucose tablets" quite yet.

I trust that I have properly "sourced" the quoted material above...

My progress (or lack thereof) and attitude changes...

On 13 June 2005, my health insurance company (I feel silly calling them a "provider") sent out a letter advertising a free Diabetics Help Service. This would amount to a nurse calling me once a month to see how I'm doing. Well, my first reaction was "I'm doing fine and that I don't need any hand holding from a nurse". Then, I got to thinking that maybe I did. I didn't spend any time trying to figure out why; I figured the answers would come to me if I just waited. I called their number and set up an appointment. I wasn't convinced that I needed it but I was willing to check it out. I did not want to have someone ragging me about my weight or my inability to reduce it. (Kind of a flashback to all those years in the Navy fighting my weight problems.) This morning, at work, I heard my boss talking about someone he knew who had diabetics and ate what he wanted. This friend had a job that keep him on the road a lot so the man ate a lot of fast food. Apparently, he is on the verge of losing a foot and doesn't want to (no shit?). I mentioned how my youngest brother and my father had both lost legs because they had not taken their diabetics seriously. Then, I said "that is the scarey thing" and meant it. That got me thinking that maybe I should be taking my diabetics more seriously. True, I walk religiously (half hour to an hour a day) and try to control what I drink and have basically gone on the wagon. Still, I weighed myself yesterday and if I read the clinic scale correctly, I've gained four (4) pounds! The first several months, I was eating God Awful mixtures of vegetables and small amounts of meat (chicken or beef or pork) and wasn't losing weight. I find that I've settled back into a "more normal diet". Alas! We had our every-other-Thursday-lunch-for-those-working-the-day-shift luncheon. For the second time, I made homemade vanilla ice cream. My chilli, soups, etc. have never gotten a decent reception at work but my ice cream went over verybig. Very big indeed! 6 cups of whipped cream 2 cups 2% milk 1.5 cups sugar 2 tablespoon Vanilla extract Mix the whole lot very throughly and freeze in a mixer. This was very discouraging given that I was thinking that I felt like I'd lost weight last week. Isuppose I really need that nurse after all... When she calls, I'm doing to tell her about the walking and the inability to lose weight. Maybe she can send me a low cal, lose weight, diabetic friendly diet. I know that I'll "bitch mightily" (an Abraham Lincoln quote, I think...) but it might help save my life. At least, I'll be able to hear Dr. Hosteller tell me that I've lost weight when I go in for a blood test in late August (2005).

Bad foods that have now been rehabilitated...

Eat fiber" for breakfast, etc.

Here are some once bad foods that are now supposedly good for you". This list includes eggs and dark choclate. Maybe the joke in that old Woody Alan movie about choclate sundaes being great for you had more truth in it that we thought at the time...

Ways to prevent or at least to reduce the chances of developing cancer...

Here are nine (9) "helpful hints" on ways to prevent cancer. Well, if not prevent cancer, then at
least to reduce the odds of developing these diseases.