Choicetimes

I believe that we are here, on this planet, as human beings, to transform ourselves.  Transform means to change in form, appearance, structure, character.  I think this thing called life is set up like a game.  I don’t mean to trivialize it by comparing it to a a game but, nevertheless, I see it as a game.  Every game has an objective.  Every game has rules.  There are strategies involved.  Having continual increasing knowledge about the game helps.  There are skills involved and many who participate in games practice to hone their skills.  There is a way to measure outcomes; to keep score.  I think that the objective in the game of life is to transform.  To change.  Specifically, I believe that, in all areas of life, it is a transformation from a desire to receive for the self alone to the the desire to receive for the sake of sharing with others.  This is a Kabbalistic (From Kabbalah) concept.  But there is a problem.  In order to be here, to experience and engage in life we must have certain needs fulfilled in certain time periods.  A lot of these needs are, most of the time, fulfilled automatically without us even being conscious of it.  When one of these needs fails to be fulfilled then we become conscious of it and it becomes a desire, often times a burning desire.  Most of these needs are physical in nature.  There are a lot that are not depending on the awareness level of the individual.  A few examples perhaps:  We need to breathe, often.  Our bodies are set up in a way that allows oxygen in either through the nose or the mouth.  We have a throat that acts as a tunnel for oxygen to travel to the lungs.  The lungs do their thing and oxygen is transferred into the blood cells and is carried through the veins and vessels to each individual cell and they stay alive and carry on with what they do.  In the absence of oxygen, a blockage in the nose, mouth, throat, a problem with the lungs or a disruption or block in the veins and vessels then this system that fulfills a critical need ceases to work and we quickly become conscious of it, if in fact we are able to stay conscious. Suddenly, this unconscious fulfilled need becomes a burning desire and we will not be very interested in transforming ourselves into a sharing being.  No, we will be pretty focused on getting air and will probably kill another if that would help at all to provide us with even a slight chance of fulfilling our desire to breathe.   Well, this whole Type 1 Diabetes thing can been seen in the same way.  Allow me to elaborate.  If you are a Type 1 Diabetic then one day in the past you learned that you “got” it.  Not a good day.  Not a day easily forgotten and not one that most of us like to revisit.  It was the day that you became conscious that a very critical need stopped being fulfilled; a need that parallels the importance of breathing, albeit with a 3 to 4 month time period prior to fatal malfunction as opposed to a 3 to perhaps, 10 minute time period to solve the breathing thing.  The process involved in Type 1 diabetes is very similar to the process of breathing.  Instead of oxygen being sent to the cells it is glucose. And instead of the lungs being the organ involved it is the pancreas.  Both glucose and oxygen are sent via the blood cells to all of the other cells.  Instead of breathing it involves eating.  And just like if you could not get oxygen to the cells the body will die so it is with not getting nourishment ( in the form of glucose ) to the cells.   An analysis of the situation yields four things to contemplate, in my opinion as someone who was diagnosed 31 years ago.  First, an understanding in the breakdown of the process that resulted in having to address this need.  Second, what is it that needs to get done in order to get the glucose to the cells in the most effective way.  Third, what is the desire that is associated with this situation.  And finally, for extra credit, how do I transform this desire from a desire to receive for the self alone to a desire to receive for the sake sharing with others? (more…)

If you have been reading these blogs you know that I have had Type 1 Diabetes for over 31 years now.  I was diagnosed at age 14 and am about to turn 46.  I have only been on the insulin pump for 2 years.  Prior to going on the pump I struggled to attain A1C results below 8.  Now my A1C’s are between 6.1 and 6.4.   And I don’t have very many low blood sugars.  I was surprised to find out recently that not all people with the pump are getting A1C’s below 7.    I was also surprised to learn that 90% of Type 1′s are not on the pump.  I really should not be surprised.  I mean it took me 29 years to get there.  Nobody wants to be hooked to a pump.  Especially if it is not going to make a significant difference in one’s life.  I am here to tell you that from extensive experience with the disease and a really hard look at some of the significant issues that lead to balancing blood sugars that no other insulin delivery system comes close to the pump.  I want to outline these issues with the goal of persuading you to consider the insulin pump for your insulin delivery system.  The closest alternative to the pump is injecting one dose of Lantus combined with several injections of a short acting insulin (humalog or novolog) to cover meals and make insulin corrections.  Lantus is used as the basal and the short acting insulin is considered the boluses.  There are other insulins like Humulin N but these are dark age therapies.  The Lantus approach is called the “Poor Man’s” pump because it seeks to simulate the pump through multiple injections.  But it is so inferior to the pump that there is almost no comparison.  The thing is that the pump itself is not the answer.  Insulin dosage and delivery is but one aspect of controlling blood sugars.  I am sure that there are plenty of people on “The Poor Man’s” pump that are doing better than people on the pump because they have a better handle of the other aspects.  These other things are food intake, exercise, general health (especially one’s weight) and most important perhaps, one’s attitude toward the disease.  The last two years I have experienced a transformation that I have been seeking since diagnosis.  I struggled with understanding how to control my blood sugars.  I became depressed and reached times of wanting to give up believing that I had a limited impact on my success.  This created feelings of hopelessness and helplessness.  Looking back I see that I really never did give up and through the blessings of good fortune and support from others I have made it to today.  And today I am thriving.  I am in the best health of my life and I feel better than ever.  The insulin pump was the tool I needed to get over the hump.

I would like to put forward one perspective of many I have been contemplating.  All of my working career I have been involved in systems and procedure assessment and development along with the corresponding Training protocols to support the system utilized.  I am using my work experience and applying it to Diabetes management.  As a trainer I have learned a few things.  First, you can train 3 things;  you can impart knowledge, you can develop skills and you can enhance attitude or the optimal thought context approach to be applied to the task(s) at hand.  Second, it is critical to have a clear understanding of the primary objective of the system.  And third, we learn most effectively via metaphor or analogy.  The knowledge and skills that must be internalized and mastered to have success in the management of the disease are not overbearing but seem to be illusive without the proper thought context.  And the optimal thought context is only achievable with courage, discipline and a desire to excel.  Difficult characteristics to foster when one is knocked hard across the head with a diagnosis as serious as Type 1 Diabetes.  It took me 29 years to get there so I know.

The primary objective with Type 1 diabetes is a desired range of blood sugar readings.  My range is 80 to 120.  Of course, I am not there all the time but that is where I want to be.  If I am not in that range I take action to get back in there.  There are several metaphors and analogies I am working on.  To conclude this posting I would like to share one of them with you and show you why the insulin pump is superior.Think of yourself as an Automobile.  There are several types of Automobiles.  There are big ones and small ones.  There are fast ones and not so fast ones.  There are fuel efficient ones and there are gas guzzlers.  There are new ones and there are old ones.  Your body is the Automobile.  If you have Type 1 Diabetes there has been a malfunction.  Sorry, but that is the truth.  Specifically, the malfunction has occurred  with the accelerator.  The cells in the body responsible for the production of insulin have been destroyed.  The immune system has decided that they are foreign invaders and has attacked and killed them.  This malfunction is a fatal flaw.  Without insulin the body will die.  Without the accelerator the automobile is immobile.  It can’t get the fuel to the engine.  Insulin is the accelerator.  The food we eat is the fuel.  Your general health will determine whether or not you are a sports car or a beat up old Chevy truck.

So how do we use this analogy to understand and better handle our diabetes?  First and foremost, get yourself in the best shape you can.  Get to a weight that is ideal for you.  Exercise vigorously.  Drink water.  Take vitamins and supplements.  Get your lab tests every three months.  Second, use premium fuel.  Eat well.  If you drive a sports car you have to put premium gas into it.  It won’t run properly without it.  Third, fix the accelerator as best you can and learn how to use it.  This is where the pump comes in.  Remember, Insulin delivery is the accelerator.  The pump allows you to create an accelerator that is dynamic and state of the art.  You can adjust it any second of the day as opposed to “The Poor Man’s Pump” where you can press on it once with the Lantus injection and perhaps up to 8 more times with short acting insulin.  Last thought in this posting………….When you are driving you are constantly looking at the speedometer to check and make sure you are pressing the accelerator properly.  Check your blood sugar at least 8-10 times per day.  Your blood sugar readings are your speedometer.  You want to stay in a specific, predetermined range.  You are driving blind if you don’t check.