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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!

Good signs from inside NASA

Apparently a group in the Exploration Systems Mission Directorate put out the following white paper. If true, I have to say I agree with it and I think it’s in line with the “Mars First” option likely to be put forward by the Augustine Commission as one of several options. Hopefully these broader, more visionary options will trump the “Save Ares” crowd.

http://www.spaceref.com/news/viewsr.html?pid=32268