Relearning Happiness

I've realized in the last few weeks how small changes can have really big impacts.  I changed positions at work, eliminating some of the stress involved with my job, and I feel like a whole new person.  I have to remind myself after I get in the car and head home that I don't need to worry about the phone ringing with problems I'll need to solve.  When I see employees approaching my heartbeat quickens momentarily until I realize that they aren't going to need to adjust schedules, covers shifts, hire someone to replace them, or work late.  I look forward to parts of my work day instead of dreading getting out of bed in the morning.  Such a small change has made a drastic change in my overall mood.  It has bled over into the rest of my life.  I have more patience and time to spend with my kids and wife.  The time we spend is better because I am in a much better mood.  Going to therapy and making adjustments to my medication both had slow moving effects on how I felt.  I could tell things were getting better but it was happening in half time.  Taking the leap and making a move that I felt good about but knew had some uncertainty in it made the biggest difference of all.  And it happened much more quickly than I expected.  Because of the speed with which it happened I was a little caught off guard.  A had to remind myself that it was OK for me to feel this way.  It was more than OK, it's great.  This should be the norm, not a fleeting moment.  I fell much more like my old self again, able to take joy in the parts of my life I had lost hope for.  Sure I'm not working my dream job, but there are parts of it that I really do enjoy and find little bits of passion in.  Parts of it that I had lost sight of and were hard to find when I was scared just to walk through the door and felt suffocated by the anxiety of facing each day.  In turn I'm finding passion in life again as well.  I'm emerging from this cocoon I had wrapped myself in to protect myself from the world around me.  I don't need every second of free time to recover from the trauma I was feeling from other parts of my life.  I never lost sight of how much I loved my wife, but I'm appreciating it  now more than ever.  Appreciating her and the wonderful person she is.  I'm noticing the little things the kids do that make me laugh and smile, not just the things that drive me over the edge.  I'm enjoying watching them grow and develop their personalities.  I'm slowly getting back into the routine of taking care of myself so I can be there to watch that happen.  And as I learn what it's like to be happy without working so hard at it I am finding it easier to get past the more difficult parts.  I can keep a more positive outlook and remind myself that the moments of turmoil pass and I will soon be content again.  In the grand scheme, the change I made was not all that big, but the things it has set in motion have the possibility to be huge.  I fell hopeful about life again.  Hopeful about getting a degree and setting my life off in the direction I want.  Excited about helping others and making connections in the diabetes community again.  In love with my family and the life we are creating.  A short time ago I was dreading what lay around the next corner, today I can't wait to turn that corner.  Everyday has the potential to be a good day and I am determined to embrace each one!

Broken Record

It has been a long time since I wrote something here.  Like, a really long time.  Months.  I had intentions of posting quite a few times but either life got in the way, I didn't make the time, or I just didn't feel like I had anything worth posting.  I felt like every time I posted something it was the same thing.  I'm in a rough patch.  I'm burned out.  I'm struggling to take care of my diabetes the way I know I should.  So I just stopped posting.  I tried doing a few DCDE and DSMA chats but I just couldn't get into it.  At most I would stick around for a few questions and then just close the window.  Truth be told diabetes was pretty far from my mind.  As much as I didn't want to admit it I was fighting a tough bout of depression and had been for months.  But it wasn't until it started to effect my home life and then my work life that I started to take it seriously.  I needed to beat this, but I couldn't do it alone.  So I bit the bullet and went back into counseling.

I'm glad to say that I'm feeling much better now.  A few slight changes in medications have my mood moving in the right direction.  My A1C is headed back in the right direction and almost back below 7.  It's been a struggle but I have learned a lot over the past few months.  Although I consider myself and advocate for mental health, I have not been comfortable talking about my own.  I was good at talking about it, as long as it wasn't with people who really knew me.  I know that talking to a professional is a great way to stay on track and perfectly acceptable.  It doesn't mean I'm weak.  It doesn't mean I'm crazy.  It means I'm making my health a priority.  People around me knew I had something going on, but they didn't really know what.  I was afraid of what they would think if I knew.  But bit by bit I learned that I could talk about it.  Sometimes I made those moves myself and sometimes I was made to.  I had to talk to my boss about it to make sure my job was safe.  I had to learn to let the people close to me know I was hurting.  I had to admit that, at times, I thought of killing myself because I didn't want to continue to deal with the pain I was in.  But it was all for the better.  I'm slowly getting better at talking about what is going on in my life.  I am getting better and accepting help.  Slowly but surely I am making positive changes in my life.  Which brings me to the changes I want to make here...

Through all of this I was still writing many days.  I just couldn't bring myself to share it.  I didn't know where to go with it.  I considered posting it here but I didn't know if I wanted this blog to go down that route.  This was supposed to be about diabetes, not depression.  And I know there are a few people that know me away from this blog that read it and I didn't know how I felt about letting them into that part of my life.  I even considered starting a separate blog just to post about depression or anything and everything.  Then it hit me.  Mental health is a HUGE part of diabetes.  Not that I didn't already know that, but I needed a reminder.  There is no reason for me not to talk about that here.  I can't call myself an advocate if I'm not willing to talk about it.  And one of the reasons I started this blog was because I thought if just one or two people got a 'me too' moment out of it then I was doing something worthwhile.  I know that I'm not the only one going through this.  So I am hoping to start posting more frequently again.  It won't all be about diabetes.  Chances are a lot of it won't be.  And it probably won't be all about mental health either, but there will definitely be a fair dose of that.

So that's what's been going on around here.  Hopefully I'll see you around.  And if you relate to any of this stuff, hang in there, it will pass.

P.S. I'm also considering moving things over to a new site for a fresh start.  So stay tuned for that.

You Are Not Alone

I bought (downloaded) a new album from the band Motion City Soundtrack and have just gotten around to really listening to the songs.  I've been a fan for a long time and love all of their music.  It's upbeat, nerdy, and well written.  On this album there is one song that really hit home and came at the perfect time for me.  It's called "It's A Pleasure To Meet You"

You are not alone
We've all had our battles with darkness and shadows
I'm here to let you know
It's a pleasure to meet you

Can you feel it, disappearing
It'll happen, you are not alone
I've been there, I'm still there
Oh, and better

Everything is so damn tragic
Time erodes the waves of panic
Take it in

You are not alone
We've all had our battles with darkness and shadows
I'm here to let you know
It's a pleasure to meet you
Today is all we have
So try for a moment to break from the torment
And sing this to yourself
It's a pleasure to meet you

At a distance
There's a difference
Things will make sense
You are not alone
Got to hold on for the moment
Til the next one

Everything is so damn tragic
Time erodes the waves of panic
Get up

You are not alone
We've all had our battles with darkness and shadows
I'm here to let you know
It's a pleasure to meet you
Today is all we have
So try for a moment to break from the torment
And sing this to yourself
It's a pleasure to meet you

Every damn night for years of my life
I've spent driving around this miserable city
Just looking through windows at people
Alone for an answer or reason to live
But every day since, I've been peeling away
At this counterfeit skin just got in the way
I can see my reflection and clearly can say
It's a pleasure to meet you again

You are not alone
We've all had our battles with darkness and shadows
I'm here to let you know
It's a pleasure to meet you
Today is all we have
So try for a moment to break from the torment
And sing this to yourself
It's a pleasure to meet you

It's a pleasure to meet you
It's a pleasure to meet you

I've been struggling lately, which is no secret, and having been back at work for a few days it's been rough, but it's always good to have a reminder that I'm not alone.  There are tons of people out there battling everyday, some fighting the same battle as me, some fighting their own, but none of us are alone.

It's Been A While

This post has been sitting in my drafts for about 2 weeks.  It's something I've needed to address but have been hesitant to post.  I've read it over, almost changed stuff, almost deleted stuff, but in the end I wanted it to be raw and unedited.  I have grown too good at saying it's ok, or editing my thoughts and feelings to make people and even myself believe that everything is fine when in reality there is a whirlwind going on inside my head.  

It's been a while since I have been even looked at my blog.  It's been a while since I looked at anyone else's blog.  My Feedly list is backed up and overflowing.  Just thinking about trying to weed through gives me the beginning of a panic attack.  It's been a while since I participated in a DOC Twitter chat.  It's been a while since I've done much of anything diabetes related other than do just enough to keep myself alive.  That may be a bit of an exaggeration.  In truth, I've probably done enough to keep my A1c right around 8 area that it's been.  And for right now I'm OK with that.  I've been riding a roller coaster mentally for a while.  I've been telling myself that it's not that big of a deal.  That it's temporary.  I tell myself I'll get through it on my own, it will just take a little bit of time.  I was telling myself that until I was confronted with it at work last week and forced to take a good look at it.  Cornered and made to spill the beans about what is going on in my head to people that I had no desire to have those kinds of conversations with.  Forced to admit some things to myself that I haven't wanted to.
   
    My mental state has been causing some problems off and on with work for the better part of this year.  Depression makes the simplest tasks, such as getting out of bed, seem daunting and impossible.  When I do get out of bed, as I get ready for the day the worries and the fear and the dread mount up inside me.  The more I worry the more I feel like I can't face the day and the bigger the mountain to climb becomes.

      "What if I damage someone's vehicle at work because my mind isn't there?"
      "What if I reach my breaking point and lose it in front of everyone?"
      "What if all these people find out how I really feel?"

    None of these are really that big of a deal but in that moment they feel like they could be the end of the world.  Add that to all the things I'm already worrying about:
     
      "What if I have a really bad low while I'm at home with my 4 year old?"
      "What if I'm not a good enough father to my kids?"
      "What if we can't afford to pay for my insulin this month?"
     
    I am really good at saying "Nothing" or "I'm fine" when asked how I'm feeling.  Even if its the person I love the most, the doctor I'm supposed to tell the truth so she can prescribe the right medicine, or the therapist I'm supposed to let in so she can help me feel better.  Taking down the wall and exposing how I am really feeling is very difficult.  I feel weak and I'm afraid to show that.  I'm supposed to have the answers but I often don't.  I'm supposed to be a support system for the people I love but I don't even feel capable of supporting myself at times.  I'm 30 years old but sometimes I still feel like a feeble child, afraid of going out into the world. 

iLet

One of the most interesting and exciting things I saw last weekend at DTreat was the Skype presentation by Scott Scolnick from Go Bionic.  Fresh off the introduction of the iLet at FFL we got a sneak peek at the new device as well.  I'm a bit of a geek and very seldom do I get to feel like I'm seeing new things as they are breaking, so it was very cool for me.  I have to admit that I haven't followed any of the artificial pancreas stuff to closely.  I know its out there, I have read peoples experiences and been jealous, but I don't really know the difference from one to the next.  And I was pretty surprised by how close to market the team at Go Bionic seems to be.  They are awaiting FDA approval for their trial and are hoping to have approval by 2018!

I first wanted to share a couple of things from the trials that have already been done.  The thing that stands out the most to me, more than the change in average blood sugars and highs, is the dramatic change in time spent with blood sugars below 60.  That is a huge deal that I don't think most people think about.  In the outpatient trial from 2013, in 20 adults over 21, the mean blood glucose of participants went 159 to 133.  In the control arm participants had blood glucose below 60 3.7% of the time and over 180 34% of the time.  Those on the bionic pancreas dropped to 1.5% of the time below 60 and 16% over 180.  In the next trial in 2014 the control arm showed a mean blood glucose average of 162 with 1.9% of the time spent under 60 and 20% over 180.  While those using the bionic pancreas had a mean blood glucose average of 141 with .6% of the time being under 60 and 20% over 180.  While the average blood glucose averages don't show a huge drop, the control that participants saw, with time spent between 60 and 180, was pretty outstanding.  A1c's on the bionic pancreas averaged below 7, the goal for people with Type 1.

The information was great, but the most exciting part was seeing the prototype of the iLet!  While we didn't get to see a live model or anything like that, getting to see what it was all about was enough.

Introducing the iLet!

I was furiously trying to write down notes all the way through the presentation but had troubles keeping up at times so some of my info may incomplete but here is what I've got.  The previous trials for Go Bionic have consisted of 4 parts.  A Dexcom CGM receiver to track blood glucose levels, 2 Tandem pumps to supply insulin and glucagon, and an iPhone to put numbers through the algorithm.  Not exactly ideal for real world application.  The new prototype is one standalone unit to do all of these things.  It takes two pen cartridges, one with insulin and one with glucagon, receives data from a Dexcom CGM transmitter and has all the information to run the algorithm on board.  The touchscreen interface can display bg levels, insulin micro boluses, and glucagon micro boluses.  There are screens to show the life of the Dexcom sensor, infusion sets, battery life, and cartridge levels.  Users have the option of pre-bolusing for meals.  The iLet will give 75% of the amount of needed insulin up front and then monitor and adjust from there.  The system is always using previous information to determine needs based on meal, time of day, carb counts, etc.  The more information that goes into the algorithm, the more it can learn and adjust.  The system learns over time and adapts to the user.  All that is needed to start is the users body weight.  The iLet will also come with a bluetooth enabled meter that communicates with the receiver for calibrating the CGM as well as entering blood sugars if the sensor is not active, for example during the two hour warm up period. This eliminates the chance of incorrectly entering a blood glucose value. The system can still be used without a sensor, it just tends to let averages run a little higher and will not administer glucagon.  During those times the user can use the carb count entry menu and the bluetooth meter.  Another new feature is the G-Burst.  This allows a burst of glucagon to raise blood sugars before disconnecting from the iLet.  

Of course the iLet is only as good as the accuracy and performance of its individual parts.  We are still waiting on a more stable form of glucagon, CGM and meter accuracy can always be better, and currently insulin with a fast acting time would be ideal.  The Go Bionic team is working with three companies who are developing new glucagon formulas, one of which is a liquid glucagon stable at room temperature for 2 years.  They are entering animal trials and are hoping to start human trials in about 6 months.  If this is not ready at the time the iLet is released to consumers, the system can be ran as an insulin only artificial pancreas and ready for dual hormone use later.  And as the numbers show, even using the current insulin available use of the bionic pancreas can lead to much better control.  I don't know about you, but I'd sign up for that in a heartbeat.

Disclosure:  I was in no way compensated for this post.  I attended DTreat 2015 in Boise as a facilitator where this information was presented.  I'm just ridiculously excited about it.

DTreat 2015

I got the opportunity to attend and help facilitate at DTreat 2015 in Idaho over the weekend.  If you don't know what DTreat is, it's a retreat for young adults with Type 1 diabetes.  There are a range of topics covered like dealing with burnout and stress, college life, insurance, diabetes in the workplace, and a lot of fun things going on as well.  But most of all it's great to be able to get together with a lot of T1 peers and just have a good time while not feeling different.  Kind of like summer camp for grown ups.  This was my second year attending.  Last year as a participant and this year as a facilitator.  Sadly, this will be my last year participating, as next year I will be outside of the 18-30 year old spectrum (#old).  I am hoping that they will call me back as a speaker or helper in some fashion next year (hint, hint).  It's impossible to cover everything that goes on here, and putting it all into words is something I don't think I can do but I wanted to cover what the highlights were for me.

It was great to see this years DTreat grow some from last year.  There were over 40 T1 young adults in attendance.  A lot of attendees were from the local area with ties to Hodia from being campers previously.  But there were also a lot of attendees from other places; from Virginia, California, Washington, Ohio, Georgia, Michigan, Iowa, and Arizona.  It is exciting to see the event grow and reach more areas of the country.

Every syringe represents someones hometown

The first day was all about getting to know everyone.  As everyone showed and got settled in there was a vendor fair to get lots info and free goodies.  We played some ice breaker games to learn about all the things we have in common and the things that make us unique.  After a few dinner and a few other activities to get the group settled it was time for Game Night!

Pictionary!

Jenga!

Day two kicked off with a great presentation with Annie Schultz who works for TrialNet, and has also worked for JDRF and took part in one of the artificial pancreas trials at Benaroya Research Center in Seattle.  Annie is great and hearing her story was so amazing.  You can see a little of Annie's story here.  She talked about a few other research things going on as well.  The AP trials throughout the country and the encapsulation trials by ViaCyte are definitely something to get excited about!  After that the group broke into guys and gals groups for some more personal conversation.  The afternoon included 'speed dating' where the participants were able to choose a handful of topics they were interested in and rotate through stations in small groups to ask questions about those topics.  I got to man the insurance station.  I'm certainly not an expert but having dealt with buying insurance for 10 years I hope I was able to provide a little assistance to those that needed, mostly students still on their parents insurance who want to know what's coming when they are no longer able to do that.  The day closed out with presentations on getting older and preventing complications and stress and burnout (something near and dear to my heart).  That night we were scheduled to attend a block party concert/fundraiser but we were rained out.  Instead we went to a local sports bar/bowling alley/arcade.  I think it was a good break from all the diabetes talk and a good chance to the participants to bond and have a good time.

Some of our speakers from day two

Our final day kicked off with a Skype session with Scott Scolnick from Go Bionic.  Go Bionic is developing a bionic pancreas, theirs is the only dual hormone system  being trialed in the US.  They also just unveiled their prototype of the iLet at FFL.  I believe we were one of the first groups to get to see this presentation.  I for one was totally geeking out over this.  They are gearing up to start trials for FDA approval very soon, which is SO exciting.  I'm not going to go into too much detail on this because I think it's worthy of its own blog posts which it will get.  We had a couple of attendees from CDN, Dan and Mindy, who gave a great presentation on Diabetes and your rights in the workplace.  Dan and Mindy were great and I'm super jealous that they both get to make diabetes their careers.  Dan works in stem cell research focusing on diabetes, and Mindy is working with the College Diabetes Network.  I'm extra jealous of her because she has gotten to attend FFL and meet awesome people.  We closed out with Taylor leading the group in making "Jars of Happy".  I don't think a lot of the group grasped how great these could be if you ever find yourself battling through some depression.  I still have mine from last year and its great to get a reminder that there is more out there than diabetes and that life can go on even when it seems you don't want it to.  We had one more closing activity and even though it seemed like it had just started, it was over.

Dan and Mindy from CDN

Jars of Happy

I had very good time and I'm sad that it's over now.  I feel so lucky that I was able to be a part of it the past two years and if you are, or you know someone who is 18-30 living with Type 1 diabetes I encourage you to look into this event.  It will be back next year and it is just an amazing experience for young adults.  Taylor and Sydnee did a great job of bringing this event to Boise and have put so much hard work into getting it going, along with the rest of the committee, Gabby and Natalie.  I have already seen so many pictures and connections on Facebook in the day since DTreat ended.  And that's really what it's about.  Building connections and a support network.  And I'm incredibly grateful that it's there.

Adventures in Introverted Parenting

I haven't really been active around here since DBlog week.  There just isn't really a whole lot happening in life on T1 front.  Things are more or less stagnant and I feel a little stuck.  My most recent visit to my Endo showed a slight drop in my A1c bringing it below 8.  While I have been disappointed in my results the last few visits, I am slowly accepting that my A1c really isn't that terrible.  It's higher than I'm accustomed to but could be a lot worse.  The doctor seems to agree with that.  He's asking me to focus more on testing at least a couple times a day 3 or 4 days a week than he is seeing my A1c get lower so we can get some good results to go off of for dosing adjustments if need be.  But diabetes isn't really what I want to talk about today.  In fact its completely unrelated.

When I was a kid I was definitely an introvert.  I was more content being in my room alone or with my brother digging through a pile of Legos, or wandering through the bushes behind our house hunting for lizards than I was going to friends houses or joining a large crowd of people.  I had friends that I associated with school and occasionally had sleepovers or play dates but overall I was happy to entertain myself and more often than not I spent my free time alone.  In High School it was the same.  I had a core group of friends that I would do things with.  But I was never the type to be at someone elses house everyday after school or going out every weekend.  And as an adult, little has changed.  I still need time to myself to recharge.  Some days at work I just want to lock myself in my office and tell the world to go away.  My wife and I have friends over for dinner or go play games with people and I enjoy.  But 9 times out of 10, if given the option, I would probably choose a night in reading or watching a movie over a night out.  I am content being alone or with a small group of people, large groups of people tend to stress me out, and interacting with new people is incredibly awkward for me.  My son, The Boy Genius, on the other hand is the complete opposite.  He is the epitome of an extrovert.  He loves to be around as many people as possible.  He like to be the center of attention.  He warms up to new people quickly and LOVES to talk.  We joke that he is going to be a lawyer one day because he can talk circles around you and will continue to argue his point long after it's been made, even if it's clear that he's wrong.  At least 5 times a day he asks if he can go to a friends house.  I try to impart on him the joys of spending time alone but that just doesn't do it for him.  It's hard for me to understand his need to always be accompanied by another person.  When we're at home, he wants me to be present for whatever he is doing.  If he is watching a show or playing a video game, he wants someone there to watch with him.  If he is reading, he wants you to lay with him while he does.  Meanwhile, I am wanting to sit alone and do whatever I am doing.  Don't get me wrong, I love spending time with him and I'm happy that he wants me involved in what he has going on.  But it can be hard sometimes when opposite things make us happy.  When he wants to go see a new friend, meeting new parents is an interesting experience.  Several of his friends have parents who would like to sit and talk for hours while I am trying to inch closer and closer to the door so I can make my escape.  I'd much rather text to make plans than make a phone call.  I can only imagine what some of the parents think about me.  That I'm stuck up or anti social.  But in reality I'm just super awkward and don't want to embarrass myself.  So each day is an adventure.  Trying to find the balance between his extrovert qualities and my own introverted ones.

Anyone else have this experience?  How have you made it work when your qualities are the opposite of your child's?