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[IP] Personal update [was: Thanks, Jim - again]

Jan Hughey [mailto:email @ redacted] wrote:

> But, Jim, there is something glaringly missing from you 
> identification: YOU
> ARE ONE OF US. A Type 1 pumper. Maybe some here think you 
> enjoy the diabetic
> complication possibilities and/or probabilities, freedom with 
> a tether,  and
> you are here to only represent the *government.*  YMMV

My apologies.  I've thought about updating my profile, and I guess I should
(I subscribed just before I had my training).

So I'll use this as an opportunity to give a little personal history.

I was diagnosed the day before Thanksgiving, 1997.  At my dx, I fit the
classic pattern of a type 2 diabetic: overweight and sedentary.  The only
thing that didn't fit is that I'd had a physical (including labs) late the
previous spring, and at the time my blood glucose was normal (94 mg/dL

I had been losing weight, but I attributed that to going swimming with my
son almost every day.  I had started drinking more water, but I felt that
was a conscious decision because it was a "good thing to do", and, of
course, I had the accompanying increased urination.  A random blood test
(for insurance) detected the higher BG, and a subsequent test confirmed (240

I was started on glyburide, began walking and dieting to lose weight, and it
wasn't long before I was able to control my BG with diet and exercise.  That
continued for another six months until I went to a restaurant that had
apparently switched their Coke and Diet Coke dispensers, and I suddenly had
a BG of nearly 300 mg/dL.  I was never again to be able to control with just
diet and exercise.

My next visit - finally to an endocrinologist (not that anyone didn't *want*
me to see the endo - my needs were being met by the CDE and nutritionist up
until then), and started on Rezulin.  Rezulin had absolutely no effect on
me.  The endo then voiced his suspicion that I was, in fact, type 1 and
ordered tests to check for anti-islet cell antibodies, for which I was
positive and elevated.  I immediately stopped oral meds and started using
insulin.  I also had been studying, and after a little discussion, decided
to go immediately to MDI, using Ultralente and Humalog.  A short time later
I added NPH to cover my dawn effect.  At that time, I started the campaign
to go to a pump - having studied enough to know that the pump is the best
currently available means to get close to normal (i.e. non-diabetic) BGs.

**** Brief digression ****
I have been highly motivated to control this damned disease from the
beginning.  My son, Matthew, was in kindergarten when I was dx'ed.  Earlier
that fall, a classmate of his lost his father in a car accident.  While the
boy was away, the school told the children, and said that this boy may
behave strangely sometimes, such as suddenly starting to cry, getting mad
for no apparent reason, etc.  They also told the children that it was OK to
talk to the boy about it *IF HE BROUGHT IT UP*.  All of these things did

It came home when Matthew asked me when I was going to die.

I gave him the best answer I had, that no one really knows when they will
die.  But I also told him that I would to whatever was in my power to be
around for him for a long time.  A month and a half later I was dx'ed.

I took about five minutes to go through the entire four step grieving
process (denial, anger, bargaining, acceptance) before making up my mind to
learn as much as I could about diabetes (I've now read Joslin's Diabetes
Mellitus cover to cover about three times!) and to do whatever is necessary
for me to control it.
**** End of digression ****

Last summer, I approached my endo about getting a pump.  His response was
immediate: "There's no way they're (Kaiser) going to get you one."  But he
also said, after a little more discussion, that he'd put in the request and
support me all the way.  He was right - it was turned down before they even
had any of the supporting letters from the CDE and nutritionist, lab tests,
etc.  My control was "too good" to merit getting a pump.  My first response
was "If I let my control go to hell for six months, *then* will you OK the
pump?"  Actually, I wasn't quite that blunt, but that was the gist.  The
bottom line was that my persistence paid off, and I am now using a MiniMed
508 with Humalog and Silhouette infusion sets.  My training took three hours
with the trainer coming to my home, and I started immediately with Humalog -
no saline, no trial runs, etc.  I am still very much in a learning mode as
I'm just ending my honeymoon phase with type 1 dm.  My TDD has gone from 25
u/day when I started to just under 40 u/day, and I'm getting ready to
reassess my basals and do some adjustments.  I also had the opportunity a
couple of months ago to be the first Kaiser Permanente Georgia patient to
use the CGM system.  The current expectation is that I'll use it
approximately every six to nine months as a system check (at least, that's
the way my endo is recommending it).

Finally, and for what it's worth, my endo is Joshua Barzilay who has
published rather extensively about diabetes related matters, most recently
on the association between cardiovascular disease and DM.  He has also
recently published a book about drinking water safety.

I will add that I have found everyone's experiences to be very helpful to me
in assessing my own efforts at using my pump, and for that I thank you all.

Jim Handsfield
mailto:email @ redacted OR
mailto:email @ redacted

The opinions expressed are my own and do not necessarily represent those of
my wife who runs this house and makes more important decisions than I do.
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