Had a business lunch today and only had 3/4 of a club sandwich…maybe had 20 or 25 homemade potato chips….Took additional insulin to cover and 2 hours after lunch and I am pinging 244 on my Dexcom…..What the heck?  It is times like these that you question yourself and your ability to estimate carbs. I’m guessing I mis figured but that is sure a pretty good size miss.  Oh well…..........what are you gonna do?  Keep on fighting the good fight and just plow on…...it seems to be the only thing that makes any kind of sense to me.. Helllooo insulin….

Ah, the joys of diabetes….........................

I have been blessed to have been using a Dexcom cgms for close to 4 years now and have religiously had my Dex by my side. Amazingly I have not lost it in all that time and have found it to be a great tool in helping me manage my disease. My most recent A1C was 5.9 woo hoo…...and that is because with the pump and the cgms, I can make decisions and get feed back quickly.
In the last 6 months however, I have drowned 2 Receivers and have had to buy new ones because of it..
How…..well, let me paint the picture for you.
Yaaaaawnnnn…..stumble out of bed, clip my Dex to my pajamas…..stumble into the bathrooom, pull up my t shirt…..splash….Dex jumps right into the toilet. Pull it out within 1/10th of a second, and alas it is completely dead. It wont dry out, it just dies. The receiver is not anywhere even close to being water resistant.How did this happen….well, in my sleepy state, I probably got part of my tshirt caught in the clip and when moving my shirt, splash down!!!
It sounds stupid I know, but I am guessing this happens to folks pretty often when you figure the thousands and thousands of folks using them.
After recently spending a bunch of money again to buy a new one, I figured I would plan for the ultimate inevetabilty of my cgms getting wet again.Storms or dropped in puddles, or a sink….what have you.

I looked online for simple solutions….water proof cases and the like….but I couldnt find anything that was small enough, didn’t look like a big ole box on my hip, or was inconspicuous.
My solution…..a small Hefty sandwich bag. I wrote “Reward” and my phone number on the back of the unit in case I ever mistakingly lose it some where. I put the cgms in the bag and slide and stuff it all into my cgms case from Descom. It is very simple and cheap, and effective. The cgms is still visible as the bag is clear and functionality is not affected. You do have to take it out to charge it however…but it’s not a big deal. And you can replace the bag if you ever think its torn.
You may not even think it is a problem for you, and I didn’t for 3.5 years with this never happening to me either. Not me..I said to myself. ..I am extremely careful, I wouldn’t ever drop my cgms into water….Yeah right!!!!
I would recommend you do something….Trust me, you dont want to look at that dieing cgms and think Oh man, its over….Dex is dead…...

As usual, I think it makes sense to look at things from many angles, and then make up your own mind…........................

Aggressive measures to treat diabetics make many of them worse, studies show

Rigorous treatment to bring down blood pressure and cholesterol is not beneficial and increases side effects, researchers say.

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The results are disappointing, researchers say, because they suggest that clinicians may have reached the limit of what they can do for diabetic patients without developing new therapeutic approaches.

But the good news is, the findings “reduce the cost and potential side effects of drug therapy” and mean that patients will not have to work as hard at reducing blood sugars, lipids and blood pressure, said Dr. Denise Simons-Morton of the National Heart, Lung and Blood Institute, which funded the trial.

“The take-home message is that the standard care approaches are pretty good. If we try to go beyond them, it doesn’t provide additional benefit,” she said.

Diabetes has become a tremendous problem in the United States, with at least 21 million people afflicted with Type 2 diabetes—in which cells do not respond properly to insulin produced by the pancreas—and millions more at risk because of obesity. Most diabetics also have high blood pressure and high cholesterol, factors that raise their risk of heart attack and stroke to the same level as that of people who already have suffered a heart attack.

Many doctors have reasoned that aggressively lowering blood pressure and lipids below nationally recommended levels might decrease the risk of heart disease, and ACCORD, or Action to Control Cardiovascular Risk in Diabetes, was created to study the possibility.

In one arm of the study, Dr. William C. Cushman of the Veterans Affairs Medical Center in Memphis, Tenn., and his colleagues at 77 medical centers enrolled 4,733 Type 2 diabetics with high cholesterol and cardiovascular disease or a high risk of developing it. They were randomly assigned to treatment regimens to lower their systolic blood pressure—the top number in a blood pressure measurement—below 140 mm Hg, the standard treatment goal for diabetics, or below 120 mm Hg, the target goal.

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The FDA says:

This is to alert you to the possibility of falsely elevated blood glucose results when using GDH-PQQ glucose test strips on patients who are receiving therapeutic products containing certain non-glucose sugars. These sugars can falsely elevate glucose results, which may mask significant hypoglycemia or prompt excessive insulin administration, leading to serious injury or death. The following provides background information on this problem, a summary of fatality reports FDA has received, and recommendations to reduce the risk. This problem can occur wherever these products are used including in-patient and out-patient healthcare facilities, and at home.

Here is a full list of to known affected Meters/Strips:

List of GDH-PQQ Glucose Test Strips
The following test strips (with associated meters) use GDH-PQQ methodology as of August 2009:
Roche Diagnostics:

• ACCU-CHEK Comfort Curve test strips, for use with:


• ACCU-CHEK Inform meters [model 2001201]


• ACCU-CHEK Complete meters [models 200 and 250]


• ACCU-CHEK Advantage meters [models 888, 831, 850, and 768]


• ACCU-CHEK Voicemate meters [model 0009221]


• ACCU-CHEK Aviva test strips, for use with:


• ACCU-CHEK Aviva meters [models 525, 535, and 555]


• ACCU-CHEK Compact test strips, for use with:


• ACCU-CHEK Compact meters [model GF]


• ACCU-CHEK Compact Plus meters [models GP and GT]


• ACCU-CHEK Go test strips


• ACCU-CHEK Go meters [model GJ]


• ACCU-CHEK Active test strips


• ACCU-CHEK Active meters [models GG and GN]

• Freestyle test strips, for use with:


• FreeStyle meters


• FreeStyle Flash meters


• FreeStyle Freedom meters


• Freestyle Lite test strips, for use with:


• FreeStyle Lite meters


• FreeStyle Freedom Lite meters

TRUEtest test strips
TRUEresult meters
TRUE2go meters

Smiths Medical:

Abbott Diabetes Care Freestyle test strips, for use with:
CoZmonitor blood glucose module (for use with the Deltec Cozmo Insulin Pump)
Insulet:
Abbott Diabetes Care Freestyle test strips, for use with:
OmniPod Insulin Management System

Ran across this the other day, this is definitely a new one for me but perhaps this is old news.

In the middle of the night in a “typical” family home in Florida, a 12 year old girl, named Hunter, sleeps, while her German Shepherd, Diva, lies close by, snoozing on her own bed. All is well with the world…or is it? You see, several times during the night, Diva will get up and check Hunter’s scent. If Diva doesn’t like what she smells, she will alert Hunter’s parents…starting with a nudge, escalating to turning circles or to jumping, whatever it takes to get her job done.

A German Shepherd that can alert you of a dangerous BG, how cool is that?

Find the full story here:
http://www.huffingtonpost.com/carrie-pollare/doggies-rule-the-story-of_b_185379.html

While you could get a tattoo which measures your blood glucose, I can see the benefits having a blood glucose sensor you can pet (even if it isn’t as accurate)

Doggies rule indeed.

You might have heard, but if not please go over to http://www.healthefda.com to get more info and sign this petition.

The FDA has its place for many things and I’m sure they have the best of intentions at heart. But they could be doing a whole lot better in regards to diabetes and new diabetic treatments. While safeguards and rules are important, they have such stringent restrictions it severely limits new and innovative options for diabetic patients.

We need to let the FDA to hear us and try and get some of the restrictions removed or changed, this petition in part tries to do that and more. We need 20,000 petitions by February, so PLEASE sign it in case you haven’t already and forward it to anyone you think would support the cause.

From the Website:

“We, the undersigned, appeal to the leadership of the U.S. Food and Drug Administration (FDA) to reduce barriers to innovation in diabetes treatment development, in the interest of public health.

The FDA’s job is to protect the safety of patients in its use of drugs and medical devices and to advance public health by speeding innovations that make medicines and technology more effective, safer and more affordable. That is its mission.

But we believe the FDA has adopted a stance of excessive caution in its regulation of diabetes drugs and technology that is counter to its duty to serve patient needs.

Specifically, it has established new rules that will impair research and innovation into diabetes therapy. (A copy of the letter sent to manufacturers in November 2008 can be found at www.diatribe.us/fdaletter.)

This worries us. For example, new requirements for additional multi-year long-term outcome studies prior to approval for drugs with no cardiovascular signals will assuredly discourage research and innovation to the detriment of public health.”

Around the Net

Here’s a message from our good friend Manny at TuDiabetes:

Read what others are saying about this:

• http://tudiabetes.com/forum/topics/help-promote-the-fda-petition
• http://www.bernardfarrell.com/blog/2009/01/ask-fda-to-better-serve-diabetes.htm


• http://www.diabetesmine.com/2009/01/the-diabetes-community-appeal-to-the-fda-dont-slam-the-door-on-progress.html

Petition Sponsors

Kelly Close: Editor, diaTribe
Manny Hernandez: President, Diabetes Hands Foundation; Founder, TuDiabetes
Amy Tenderich: Creator and Author, DiabetesMine
Nadia Al-Samarrie: Publisher, Diabetes Health magazine
Marston Alfred: Founder, SugarStats.com
Allison Blass: Author, Lemonade Life
Jennifer Block, CDE: Stanford Medical Center, Stanford University
Nancy Bohannon, MD: Director of Clinical Research, CVD Risk Reduction Program, St. Luke’s Hospital, San Francisco
Bruce Buckingham, MD: Professor of Pediatric Endocrinology, Stanford University
Stead Burwell: CEO, Alliance Health Networks, Inc.
Priscilla Call Essert: Author, My Life As A Pancreas
Gina Capone: Co-Founder, the Diabetes Talkfest Blog
Fran Carpentier: Author, Diabetes, Day-By-Day on Parade.com
Kitty Castellini: Founder, CEO, Producer and Host, Diabetes Living Today – Talk Radio
David Edelman: Co-Founder, Diabetes Daily
Steve Edelman, MD: Professor of Medicine, University of California, San Diego; Founder, Taking Control of Your Diabetes
Bernard Farrell: Author, the Diabetes Technology Blog
Bob Hawkinson: Author, Joy of Diabetes
James S. Hirsch: Author, Cheating Destiny
Irl B. Hirsch, MD: Professor of Medicine, University of Washington
Lois Jovanovic, MD: CEO and Chief Scientific Officer, Sansum Diabetes Research Institute
Francine R. Kaufman, MD: Professor of Pediatrics, Keck School of Medicine, USC; Head, Center for Diabetes, Endocrinology and Metabolism, Childrens Hospital Los Angeles; former ADA President
Tom Karlya: Author, Diabetes Dad
Rebecca Killion: Diabetes advocate
David Mendosa: Diabetes Journalist
Kerri Morrone Sparling: Author, Six Until Me
Jenny Ruhl: Author, Blood Sugar 101
Lisa Shenson: Diabetes Parent & AdvocateScott Strumello: Author, Scott’s Web Log
Howard Steinberg: CEO and Founder, dLife
Virginia Valentine: CNS, BC-ADM, CDE, CEO, Diabetes Network, Inc. Albuquerque, New Mexico

Sign it Now

You can even sign it now via the widget below:

Nedrra Lanakila (N): So MUCH to explore with you. You are to be commended on your earnest efforts! I’ve got to hear the upshot to your personal story: how long, and what happened to you?

Jennifer McCabe Gorman (JMG): I had to. I was 20 years old and my leg was at stake. I didn’t feel like I had any choice at the time. What was I going to do, give up? No way!

Well, the upshot is an amazing, miraculous recovery. When I’m home in the states I will send you a photo of me after the first few surgeries, with a 15 pound external fixator on my right lower leg (like the halo you see on people with broken necks).

N: Okay. Wait. Stop. Backup.

NOW you’ve got to share just a bit about the actual accident please? If you are too sensitive about it I totally understand and support that.

JMG: No, it’s totally cool. Sharing our testimonials, our personal histories of diagnosis, crisis, recovery – all these enable our individual and collective healing. It’s cathartic.

The short version: I was 20 years old. I’d just gotten a scholarship to study for my junior year abroad at St. Andrews University in Scotland, a big deal for a kid from Southern Maryland!

I was working 2 jobs to save up, training hard at the gym. I went to a friend’s party on Memorial Day weekend, his house was about 40 minutes from my parents.

When I drove home, I remember being so tired that the lights by the road were fuzzy.

About 1/4 mile from my mom’s house, I fell asleep behind the wheel of my red Saturn.

I drifted across 2 lanes of traffic and hit an 8 foot iron ship’s anchor dead on.. lol – when I do something I do it big!

It’s a very rural area, and this farm had a ship’s anchor at the edge of a field and a long dirt driveway.
I picked a good place though, because on one side was an oak tree, and the other was a telephone pole.

JMG: Miraculously, the car didn’t speed up, and I didn’t hit anyone else. The impact was about 50 mph. I drove the anchor on it’s side a bit, and the engine block in the car crushed up around me.

Apparently, I woke up when I hit the anchor (I don’t really remember), but couldn’t get out of the car. The block crushed my right leg only, because I had a standard (stick) transmission, and had tried, instinctively, to stop the car.

I only remember bits and pieces. I woke up, looked down and saw my right knree like a blooming onion with bits of bone and seatbelt and all kinds of stuff. Well, bleck. I couldn’t see my right foot because it was twisted completely around.

I was bleeding quite a bit and remember trying to get out of the car since I knew that was a bad thing. But I kept passing back out.

Unbelievably someone was watching out for me. An 18 year old kid named Denny Gibson (I don’t know him: I heard this way after the accident) was walking home from a party.

He heard me screaming and ran up. Then he followed the driveway close to where I crashed, to a house where the owners didn’t believe him. They thought he was some robber punk kid and called the cops.

The MD State Police arrived first, called ambulance immediately. They cut me out of the car and rushed me to our local ER.

Thank god we had good orthopedic docs in our local hospital, who just kind of flushed out the wounds, ‘fixated’ the ankle (turned the foot back around), wrapped me up, and sent me up to Shock Trauma at UMMC in Baltimore.

I was there for 5 days. I kept waking up and asking everyone in sight if I still had my right leg.

Needless to say, everything after that was a moment of celebration followed by concern. Yes, my leg is still here. What happens next? No one really knows. We’ll have to just see.

I ran a 5k 2 years after my accident. Two summers ago, I finished a sprint triathalon at Lums Pond in Delaware. I swam 1/2 mile, bike 12 miles, and ran 3.2 miles ( a5k). This is after 16 surgical procedures.

I work out at the gym regularly, and have a neat, characteristic limp (only after a really long, intense day) and some sweet scars. Unless I tell the story of my injury, most people never know.

N: Oh. My. God.

JMG: It’s not as bad as it sounds. Faith, and family, and the WEB helped me get through. I have been so blessed, I can’t even say.

N: Give me a moment to recover. I was breathing through a clenched fist over my mouth and nose.

So after the doc told you to ‘pray’, you discovered online supportive communities and online medical info.

JMG: Exactly. I learned from someone on mybrokenleg.com that infection was a primary concern after an injury of this type.

Then I went back to the hospital and requested my operative notes (the dictation doc does after surgery).

Sure enough “exquisite risk of infection.” So we were extra vigilant about that. It’s like Amy Tenderich’s blog post a while back at Diabetes Mine about being at a party where she’s touching sugary stuff, then takes her glucose, but forgot to wash her hands.

This is stuff most docs will forget to tell you, because they aren’t LIVING with this thing.

Also, it can be the tiniest, seemingly insignificant portion of advice or information a community member gives you that can be the most valuable.

When I had an ex-fixator, someone at the hospital (Kernan, in Baltimore, specializes in ortho rehab), told me that Adidas made track pants with snaps all the way up the sides (easy to put on and take off over the contraption on my right leg stabilizing the fractures).

Just being able to dress MYSELF made a huge difference in how I felt about recovery. Seems dumb when you try to convey the value that has, but someone who has been there ‘gets it’.

N: Yeah. I get it. But that’s another story!

You tapped into self-determinism and found ways for life to be sweet again and full again and vibrant.

N: So never take never as the prognosis.

JMG: Indeed. That’s an intensely personal approach to ‘medicine’ in which we try to ‘beat’ disease and ignore the severity. You can’t run from that. You have to choose to face it head on.

Or avoid it. But what makes you safer? Definitely facing it to whatever degree you personally can handle.

N: Congratulations! What a fantastic story and an ‘ending’. Definitely leaves us wanting to know more about you and Health 2.0.

JMG: Thanks Nedrra, it’s funny – I feel like I’m just beginning. Health 2.0 is what’s enabling me to meet amazing people like Marston (Marston Alfred, Chief Architect and Originator of SugarStats).

N: Are you doing other things aside from this work in the HIT arena?

JMG: Wow. That’s a long list! Lol

1. Writing for HealthCentral.com on healthcare policy, especially as tech and web-based stuff relates to the millennial healthcare generation.


2. I’ve started up NextHealth.nl with a bunch of amazing folks here in Holland: Maarten den Braber, Martijn Hulst, Niels Schuddeboom, Jacqueline Fackeldey, and Jeroen Kuipers.


3. Writing business ideas left and right, manifestos and blog posts on how to improve healthcare NOW at Health Management Rx.


4. Traveling around to different healthcare events, meeting inspiring people and trying to bring empathy back into our global healthcare conversations.


5. And somewhere in there I’ll get a degree so I can teach perhaps, med students how to incorporate patients into the care spectrum as partners, but that’s farther off!

N: Thank you! I’m looking forward to continuing conversations together.

I know our community will want to know more about what’s happening with Health 2.0, your insights on it and about you. I know I do.

JMG: Nedrra, thank you so much. It is so cathartic to tell and difficult. I just hope more people who have been through the proverbial wringer come back and decide to change the system. Awesome!

To find out more about the Heatlh 2.0 conference being held at the San Francisco Marriot on October 22nd and 23rd, go to http://www.health2con.com/

For more of Jen McCabe Gorman’s views go to her blog at http://healthmgmtrx.blogspot.com, and http://www.health20.nl/ is a website related to Health 2.0 based in Europe and The Netherlands.

http://www.sugarstats.com/2008/10/11/interview-with-jennifer-mccabe-gorman-pt-1-of-3-background-on-health-20/

Nedrra Lanakila (N): So how does HIT (Health Information Technology) help improve patient care and reduce costs, from what you’ve seen over the last 18 months?

Jennifer McCabe Gorman (JMG): Aha – truly excellent question re: HIT and improving care/reducing costs. That has a long and complicated answer, and it will be largely opinion based – as quantitative data on savings is just starting to trickle in from Europe and has yet to be released really in the US.

I think the creation of online communities that allow us to connect to other e-patients creates a psychic methodology for dealing with illness in our daily lives that is not encouraged in the current medical delivery structure, which can be dehumanizing to say the least.

To read more about Jennifer’s viewpoint of online communities, visit her blog at: http://healthmgmtrx.blogspot.com/2008/06/importance-of-communities-in-healthcare.html

JMG: What I’m hearing and seeing, largely here in The Netherlands and in the USA, is that Google Health and Microsoft HealthVault, among other PHR (personal health record) providers such as Dossia, are a good start, but they’re not enough.

N: Tell me a bit more about the psychic methodology. Is that what you see to be the greatest difference that it’s serving?

JMG: The psychic benefits…as a person who is also a repeat orthopedic surgery patient, who had a very unique trauma injury, I had to go online to learn about my condition.

My doctor is one of the best ankle surgeons in the world, but at one point, I asked him what else I could do to get through this, and his response was “pray.”

When I went online, I discovered two completely divorced kinds of knowledge communities (this was back in 2000).

[I found] medical journals for docs, by docs such as Medscape, NEJM, etc. It was there I read that my injury was the most severe of its kind and that I had less than a .02 percent chance (based on literature at the time) of walking without a mobility aid.

Needless to say, that was good info to have, but didn’t help translate what I was going through with surgeries and physical therapy (PT) into my daily life, and more importantly, what I wanted to do AFTER I recovered.

It took the other kind of online knowledge, disseminated through a site that had graphic photos and patient stories, called “mybrokenleg.com” for me to realize in a nutshell what I was in for, how long it may take, how many surgeries I may have to go through, and what I should physically, psychologically, and spiritually prepare myself for.

In other words, it was ‘patients like me’ I read about on the social medical sites, along with medical lingo I read about on the medical research sites, that informed my personal recovery narrative.

Now hospitals and other health care organizations are starting to get that people living with illness and injury want BOTH content (information) and community (empathy/connection) to encourage healing.

HIT, or web-based health information technology, enables us to access BOTH in real time, when and where we want.

But still, it’s separated from the current health care delivery system – there’s no ‘coherence’.

In other words, I [could] learn something as an informed e-patient, but then I have to go back into the brick and mortar world of health care delivery, and convince my doctor that I do know what type of ankle fracture I had, and I can name every procedure – but that doesn’t make me a hypochondriac; it is an asset that I am involved and can save us both time and money by knowing:

1. What happened to me


2. what I want in my healing process.

N: I am ALL eyes on you and grabbing onto every word. Keep going.

JMG: As with SugarStats users who are newly diagnosed [diabetics] and trying to navigate the system, I had to figure out how to talk to my docs, interview them really, to make sure they wouldn’t talk to in a way that devalued my experience – they had to be able to accept I had audacious goals, and be willing to talk openly with me about them and bring their clinical expertise, which is SIGNIFICANT, to bear in solving my big issues.

This meant, not only did I want to walk without a cane after 10 surgeries, I wanted to RUN. I was a cross country runner in high school, and I wanted to do a 5k just one more time.

My doc listened. He told me to try jogging, but warned me that I would have complications. But he listened. He ‘heard’ what I needed from my physical recovery to bolster my spirit and mentally deal with my injury.

I wouldn’t have KNOWN how to talk to him about my prognosis if I hadn’t been able to access the web-based resources that I found online, even in 2000, which was ‘early’ in the evolutionary stage of health info online.

N: You know, this is still a very early movement. Especially when it comes to changing the dynamics between patient and doctor. It’s really great that you had a doctor who listened to you.

JMG: Exactly. He’s an amazing guy – Dr. Andy Pollak at the University of Maryland Medical System (UMMC), in Baltimore, MD. He was also a surgeon for the pro football Baltimore Ravens at the time, and had an ‘interest’ in complex ortho traumatology cases.

This is what I think SugarStats offers – a chance to learn from others and carry that knowledge offline into the ‘real world,’ where things are still moving more slowly.

N: What did you say to get your doctor to look at you as a patient differently and believe that you are educating yourself via the web and TRUST that what you are reading and hearing is helpful and accurate?

JMG: Aha – that’s a tricky one. Using ‘medicalese’ or the lingo that docs use usually results first in suspicion, especially if you are in the ER requesting narcotics (which I never did)!

I was very earnest. I went back and told him I’d read about Hawkins IV talar fractures (talus is your ankle bone), and the recovery rates, complications, amputation rates, and that I wasn’t going to be a statistic.

Docs are PEOPLE like everyone else.

They listen when you are authentic. They really want to help patients who are scared, and want to live with their help and improve via their care.

JMG: And re: costs, I saw that being involved in my care meant I paid more attention. I asked about medications. I asked about dosages. I asked for clarification.

I don’t know for sure how many medical errors this prevented, but definitely some.

In our last post from our interview with Jennifer McCabe Gorman of the Health 2.0 movement and Health2con.com we hear about her own incredible journey of recovery from physical trauma and pain and how she utilized the internet to help navigate and motivate her through it all.

To find out more about the Heatlh 2.0 conference being held at the San Francisco Marriot on October 22nd and 23rd, go to http://www.health2con.com/

For more of Jen McCabe Gorman’s views go to her blog at http://healthmgmtrx.blogspot.com, and http://www.health20.nl/ is a website related to Health 2.0 based in Europe and The Netherlands.