All posts by josephshoer

diabetes blows

This is somewhat of a personal note, but every now and then being a type 1 diabetic really frustrates me and I just have to unload a bit.

Don’t get me wrong, medicine has made great strides in managing diabetes. If you observe me for a randomly selected 1% of every day, I will seem fine. And I can for the most part do anything that a healthy human being can do. I can go hiking, or waterskiing, or kayaking. I can go out in the heat and out in the cold. I can fly or ride in airplanes.

But catch me during the wrong 1%-of-the-day sample, and this crap can be really annoying to me.

I’m on an Animas IR1250 insulin pump. Every three days, give or take, the reservoir in the pump runs out of insulin and needs to be replenished. I also have to replace the infusion set where the pump’s tubing goes into a subcutaneous cannula, to avoid picking up any infections where the cannula pierces my skin. This process usually takes me 15-30 minutes, and involves sticking myself in the abdomen or hip with a 1″-long needle. This needle goes in at an angle and is supposed to end up just below the skin; then I take out the needle and leave the cannula in place. Sometimes this is fine and simple.

Saturday I go to do a normal change, and encounter a couple problems that I have to deal with on a regular basis. First, I weigh 142 pounds. I don’t have a lot of padding or extra skin. The infusion sites aren’t supposed to get clustered up too densely, so I kind of end up struggling to find a place to put them sometimes. Second, this injection isn’t exactly like going to a nurse and having her stick a needle in your arm; she doesn’t feel what you feel, she just goes ahead and pokes you. In, out, bam, done. It’s better that way, at least, on an intellectual level. But when I’m doing this to myself, I tend to go really slowly sometimes. Especially on those occasions when I don’t miss all the nerve clusters on the way in. When something hurts, reflex tells me to either stop what I’m doing or pull back, not keep going.

So anyway, on Saturday I’m looking at my hip for a place to put this infusion set, and I ended up choosing wrong or going in at too steep an angle, because pretty quickly I get this really weird twinge and all my reflexes scream HALT. But I try to override that, because that’s what I have to do, and I end up with HALTHALTHALTSTOPOUCH and my hand practically jerks away on its own. I figure I was probably getting into muscle tissue rather than skin and fat. So I yank the needle out and SURPRISE out comes a bunch of blood. Great for improving my disposition, you know. Standing with my weight on one leg, twisting around to see my hip better, holding a needle that I have just used to wound myself, looking around for some kleenex and neosporin, and knowing that I have to do it again in order to stay alive.

Well, after stomping around my room in consternation for a bit to cool off, and developing a bit of ache in some hip muscles, I decided to move to a different site in my rotation and put a new infusion set in my abdomen, instead. This one seemed to go okay, so I pack things up and go do whatever it was I thought I would be doing an hour previously, before this happened.

Today, that infusion set totally failed. My blood sugars had been running in the high 200’s (yours is probably 100, maybe 120 if you just ate) and wouldn’t come down in response to extra insulin. So I watch the infusion site while I’m trying to give myself a correction bolus and find that, hey, look, insulin is just pumping out and pooling on the surface of my skin. Fat lot of good that does. This sometimes happens, and someone explained to me that it’s because insulin can act like a growth hormone, so sometimes a little knot of tissue forms right at the end of the cannula where insulin is going into my body, and that knot can plug up the cannula and the insulin from a bolus just ends up forcing its way back out the hole in my skin and onto the surface. Anyway, this is supremely annoying, because then I have to change the infusion set again. This wastes insulin (which is expensive), pump cartridges (which are highly specialized and therefore expensive), and infusion sets (which are also highly specialized and therefore expensive). It also causes physical pain and emotional stress, for obvious reasons. Did I mention that I hate needles? IV’s make me squeamish. It is for this reason, basically, that an anomalous high blood sugar is a way to make me instantly aggravated. It’s more effective at that than a bad grade, or a rejection letter, or Fox News.

So today it was time to leave work and change the infusion set early. This one also seemed to go okay, except that when I pulled the needle out of the cannula, it hurt like CRAP. And when I gave myself the first bolus a minute ago, it burned. So now I might have fixed the previous problem, but I face the prospect of burning pain every time I want to eat any carbohydrates and have to bolus again.

FML. I’d like some stem cells, please.

I’m going to rail against Apple ads for a minute

Here’s a quick paraphrase of how a typical Apple Mac ad goes:

Cut to a white background. John Hodgeman, dressed in a suit nobody’s worn since the 90’s, is on the left. Justin Long, looking like he’s about to audition for the guy in ‘Best in Show’ who met his wife when they were in adjacent Starbucks, is on the right.

Hodgeman: I’m a PC, and Windows 7 just came out.

Long: Well, I’m a Mac. Wait a minute, PC, isn’t Windows 7 a kind of Windows?

Hodgeman: Uh – you – uh – yes, Mac. I suppose so.

Long: And isn’t Windows inherently bad?

Hodgeman: I guess you’re right. That means Windows 7 is inherently bad.

I can’t begin to tell you how sick I am of these TV spots. They are just so…spiteful. They rarely ever have anything positive to say about Macs, and they never have anything substantive to say about PCs. They just say, over and over again, “Macs GOOD, PCs BAD!”

Particularly the Win7 ads. The whole campaign seems to revolve around the assertion that Windows is just bad in general, and therefore Win7 is bad. So far as I can tell, the writers and directors of these ads never laid their hands on Win7. I’ve been using it since early October, and I have yet to even press Ctrl-Alt-Delete, let alone see it crash or even bog down.

It’s really telling to compare this style of advertising to Microsoft’s Win7 ad campaign. First, they showed cute kids, unicorns, and puppies, played over glowing quotes from reviews. (Wait – you mean they showed evidence for their claims?!) Then, they showed short TV spots focusing on some new feature on Win7 and how it’s useful, presented by a normal, average-looking person. It just shows how militant Mac is, iwth their tiny minority market share.

I think this mirrors the contrast between Steve Jobs’ and Bill Gates’ characters perfectly. Apple hasn’t produced anything new in years (Apple today = OSX + iPods), while MS has been evolving new features and putting forward new services. MS has even been opening up a bit, while Apple’s business practices are all about locking their devices down to prevent anyone from doing anything that rubs their snootily discerning noses the wrong way. While Jobs is just full of vitriol at his competitors and tries to survive on hero worship from his devoted minority, Gates just doesn’t care. He’s off filling impoverished schools with computers and trying to cure AIDS in Africa.

Fortunately, one of the Discovery Channel “Boom-dee-atta” ads came on immediately thereafter and made me feel better!

research news

My lab’s recent microgravity flights gave us some good data to demonstrate that we’re not totally crazy with this flux-pinned spacecraft idea. In fact, it actually works. We were able to get mockup CubeSat-sized spacecraft to pin together without touching, and use magnetic fields to form a non-contacting hinge.

An article just appeared in the Cornell Chronicle about our stuff.

We’ll be applying to fly a refined experiment on the Vomit Comet next summer, as well, through the NASA FAST program. (Check out the link to our video on the FAST front page!)

good stuff, lost in the noise

Here’s what I hate most about the partisan bickering that’s been going on lately: the reactionary GOP has been so busy opposing anything and everything that the President of the United States says that events like this have been submerged in all the rapid-news-cycle media hoopla.

Mr. Obama gave a short speech on the value and necessity of science and technology, and on his proposed efforts to boost science and math education in American schools. (He also acknowledged dignitaries such as NASA adminsitrator Charlie Bolden, Apollo astronaut Buzz Aldrin, Shuttle astronaut Sally Ride, and a 14-year-old who is the youngest person to discover a supernova.) Now, these things ought to be the kind of things that every American can agree with. Okay, every sensible American; I guess I just wrote about some of our citizenry who think that science is valueless. Still, the positive response to an event like this ought to be overwhelming. If only the constant coverage of so-called “tea parties” didn’t override it.

Anyway, this is the kind of event that makes me really love our President.

got off easy

A judge has sentenced Dale and Leilani Neumann, Christian fundamentalists who were convicted of negligence in the death of their diabetic daughter when they prayed for her healing rather than contact any medical professional. They get six months in jail, to be served one month out of every year for the next six years. I think they got off easy. They are guilty in my mind of criminal insanity and hubris, and at the very least, their two remaining children should now be wards of the state.

One purported definition of “insanity” is to repeat the same action or set of actions, over and over again, seeing the same result each time but somehow expecting a different one. When their daughter felt faint, the Neumanns prayed. When she could no longer walk, the Neumanns prayed. When she could not eat, the Neumanns prayed. When she could no longer even speak, the Neumanns prayed. And when her breathing came in ragged, shallow gasps, the Neumanns prayed. Only after her breath and pulse stilled did they think to contact EMS; by then, of course, it was far too late. These parents have demonstrated that their convictions are more important to them than the safety and health of their children. They have also demonstrated an inability to form a workable understanding of the world from observable phenomena. Insanity that endangers lives: these people should be put away for psychiatric evaluation.

I’m reminded of that pseudo-joke – or, more appropriately, the modern parable – of a man with devout beliefs who hears on the evening news one day that his city is in the path of a terrible hurricane. “I’m not worried about that,” he says to himself, “because I know that God will save me.” The hurricane hits, and as trees and power lines crash the ground around his house, a policeman comes to his door. Yelling over the wind and rain, the officer offers the man a ride out of town. “No, thank you,” says the man, “I trust in God to save me.” Hours later, the city floods and the man flees to the roof of his house as the water level rapidly rises. He sees a family paddling down the whitewater of their street, and they backpaddle for a moment to draw closer to the man. “Come quickly!” they cry, “we have room for one more! We can save you!” But the man refuses again, telling them that he knows God will save him from this predicament. The water continues to rise, and the man eventually drowns in the ruins of his home. His soul finally comes in contact with the God he always believed in, but, his faith shaken by the hurricane, the man cannot help but shout, “God, I believed in you all my life! How could you leave me on that house to die?” God retorts, “What are you talking about? I sent a TV newsman, a police officer, and your neighbors, all to help you!”

This brings me to my second point: for the Neumanns to refuse to contact medical professionals is arrogance, pure and simple. They were, in essence, refusing to admit that their fellow human beings could help their daughter. Not only were they refusing their fellow men and women, but the were refusing their daughter – putting their own beliefs, even in the face of dwindling supporting evidence, as more important than her life. If there is a God who created people in the image of God, then people and their capabilities are at least representatives of divine power. Even if you take issue with that statement, then you must admit that people do have the capability to treat type 1 diabetes, which caused the Neumanns’ daughter’s death. So, unlike in the parable I reproduced above, there was no uncertainty to the outcome in her case – without insulin, she would die; in the hands of medical professionals, diabetes would be easily identified and treated. She would still be alive. Her parents refused a course of action that would have kept their daughter alive in favor of a course of action that they could plainly see was allowing her condition to deteriorate. This level of pride, to “stay the course” when a quick, easy, and known solution exists but would require some ideological capitulation, is staggering.

I have type 1 diabetes myself. I know that my treatment regimen revolves around human ingenuity and technical proficiency. God did not create the insulin pump that keeps me alive. God did not hand down to humans the techniques for cajoling pig pancreatic cells to produce human insulin. And God certainly hasn’t waved a mighty hand to miraculously cure me. No, for those first two items and hopefully for the third, human intelligence is responsible. Human training. Human learning. Human teaching. Human experimentation. Human courage. If a God is in any way responsible, it is solely in allowing human brains to evolve such that we could produce the advances in science, medicine, and technology that would lead to insulin production, glucose monitoring techniques, subcutaneous insulin infusion pumps, and the education of those who must treat themselves. For me to rely on wishful thinking to hope my diabetes away would be negligence. If someone else was responsible for treating me, for them to rely on wishful thinking to hope my diabetes away would be criminal negligence.

More amazing astrophotos!

If you don’t already check the Astronomy Picture of the Day each day, you should. Today was a special treat, linking to the Gigagalaxy Zoom project. That web site uses as its dataset three images at tens-of-thousands-by-tens-of-thousands resolution, and you can zoom in on features of each image through a nice Flash interface that includes descriptions of the cosmic bodies you see. The three images are composites of thousands of exposures, and represent three levels of telescopic magnification towards the center of the Milky Way Galaxy.

My favorite zoomed-in segment is the Pipe Nebula in the middle-level image:

Center of the Milky Way
Center of the Milky Way

You can see the zoomed segment with its description by clicking here and then clicking on the short, wide rectangle that highlights a dark squiggly nebula in the center of the image. Just look at the number of stars behind the dark nebula! This is the kind of image that makes me feel that I’m very tiny, that the beauty I see in the natural world on Earth is an insignificant fraction of the wonders in the Universe. And it makes me want to get out there and see things!

Best of all, you can download ~26 MB high-res versions of the three base images from the Gigagalaxy download page.

Saturn

Nicole pointed this image out to me:

Saturn at Equinox
Saturn at Equinox

It’s a natural-color mosaic of 75 images downlinked from the Cassini probe when it was 20 degrees above the ring plane. “Natural color” here is astronomer-speak for “if you were hanging outside an interplanetary spacecraft in a spacesuit 20 degrees above the Saturnian ring midplane, this is what you would see out your helmet visor.”

Full description: http://ciclops.org/view/5773/The_Rite_of_Spring?js=1

HE FINALLY SAID IT

From the President’s speech to Congress on health care reform last night:

I’ve insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

Man, I’ve been thinking about the public-college comparison for *years.*