Month: July 2013

Diabetes In Boston

This week I’m at the Leadership Institute for Academic Librarians (LIAL) at the Harvard Graduate School of Education in Boston, Massachusetts. This is the 15th year of the LIAL, and the Class of 2013 is made up of roughly 100 librarians from all over the world. I can say “world” because the group is made up predominantly of librarians from the United States, but also Canada, China, Saudi Arabia, South Africa, and Trinidad and Tobago.

Welcome to Boston

The first thing I’m not supposed to do is tweet about LIAL. Or Facebook about LIAL. Or probably write this blog post about LIAL. So I won’t share all of the intimate specifics of LIAL, but I feel that I have an obligation to share some of what I am experiencing without necessarily divulging the deep, dark, sordid secrets of my fellow librarians.

Because diabetes is a part of every single thing that I do, I don’t feel shy about sharing some of the other sides of my life every once in awhile. How am I ever going to be able to sell that line about “I am more than just my diabetes” when I’m not willing to share more than just my diabetes? Besides, there have been some diabetes moments, so it’s not all librarian mumbo jumbo. Which is lucky for you, because that means you get to learn a little bit about Martin Librarian as well as the usual rants and raves about my living with diabetes. Consider it as entertaining as when someone farts in church while the preacher is taking a breath mid-hellfire and brimstone. I will be that fart of fresh air for you.

Like yesterday, when I was getting on my plane in Atlanta, a nice couple in the front row reached out to me and pointed out my Medtronic insulin pump that I had clipped to the outside of my jeans pocket. Turns out they work for Medtronic (or did, I’m not sure…boarding the plane was a little chaotic). There wasn’t much time for chatting, but they were very happy to see someone wearing a device that they are so proud to have been a part of developing. That made me happy. Not so much because they work for Medtronic, but just that MY diabetes made someone else’s day. Because, let’s face it, sometimes it’s a real dump in the pants.

(And that’s the 2nd fart joke I’ve made in one blog post. I should be ashamed of myself. I’m not. You’re welcome.)

Since I arrived in Boston, I’ve pretty much been going nonstop. So far I’m managed to break one iPhone case, one set of earbuds, discover that I didn’t bring enough socks, or any workout clothes, I didn’t complete near enough reading to feel prepared for class, and that the minibar is no substitute for a fridge in a hotel room. On the positive side, I won an argument versus a cab driver with a stereotypical Boston bad attitude, found an honor system book sale on the street, and saw socks in a store window tonight that have stripes made out of eff words on them. I’m sorry if you’re easily offended, but I WILL be going back to get me a pair tomorrow when they are open. You don’t let that kind of opportunity pass you by.

Several times so far this trip I’ve been asked about diabetes, which is awesome. Probably becauseĀ I have it tattooed all over me. Yesterday, a nice woman that I was sitting next to on the plane from Atlanta to Boston asked me about the differences between multiple daily injections (MDI) versus using an insulin pump for people with Type 1 diabetes. Today, after getting off of the phone helping out a fellow T1D with a diabetes challenge, a librarian colleague and I had a conversation about Students With Diabetes and my passion for helping people with diabetes, and especially my unique perspective as a medical librarian with Type 1 diabetes. I absolutely love it when my diabetes world intersects with the real world in a positive way, and that I’m making progress integrating it with Martin Librarian world.

I also sat next to a nice librarian lady today (named Ripple, which may be the coolest name ever) who had a Mickey watch, same as mine. What are the odds? She’s the first person I’ve ever met in the wild with a Mickey watch like mine, and who isn’t six years old.

Mickey watches at LIAL 2013

I’m learning a lot this week, and will share more as I can. There is a TV inside the mirror in my bathroom, so I’m going to go watch SportsCenter now.

TV in mirror

(3rd fart joke. You didn’t even see that one coming!)

Dog Food Soup

Marker. Brand. Name. Characterization. Classification. Hallmark. Identification. Number. Stamp. Sticker. Tag. Ticket. Trademark. Type. What do these things have in common?

They are all labels. Each and every one of us makes our way in a world that is riddled by an incalculable number of labels. Everything that we interact with is dictated by some form of label.

We go to the grocery store and we make decisions about what to buy based on a number of different labels. We look at brand names, price, nutritional info, ingredients, and even if the product has an appealing design element to its packaging, and we make a decision about whether or not we want to purchase and consume it or not. Let’s face it. We would probably buy dog food and eat it if the labels passed our various conscious and subconscious criteria for consumption. I’ve seen some cans of dog food where the photo looks just as appealing as Campbell’s Chunky Soup. But don’t take my word for it…

Dog Food Soup

Seriously?! Prime cuts in gravy! And it even has an easy open top! I’m sold.

I hear my fellow people with diabetes talk about labels quite often too. Type 1. Type 2. Juvenile. Adult-onset. LADA. Overweight. Underweight. High. Low. Insulin. Pills. Pump. Pens. Pricks. Gels. Tablets. Injections. CGM. Sick. Well. Brittle. Compliant. Non-compliant. Unaware. DKA. BG. A1C.

Diabetes Beans

So let me get to the beans of it all. I don’t understand the anger that some people have with all of these labels. We live with them every single day, and we make decisions based on our understanding of labels on a near constant basis, but as soon as someone attempts to label us, makes a mistake, tries to empathize, or even tries to give advice (even if it is misguided), we get our underwear completely in a wad and pitch a fit. Ever heard any of these?

“How dare that person give me advice about MY diabetes? Telling me what I should do. They don’t know me! They can’t imagine what I have to deal with everyday!”

“How dare that person compare me to those fat, lazy people with diabetes. They chose to be that way! I didn’t choose this! This chose me!”

“Yes, I take insulin. NO! I don’t have the BAD kind of diabetes!”

“How sick am I? HOW SICK AM I?!”

There are all these things that people say that we just get so bent out of shape about. Newsflash: People are stupid. I mean, we’re smart. Sometimes. But we can be really dumb. Every single one of us. We often have no idea when we should just keep our mouths shut because we don’t have enough background information to know any better. So we say something. Sometimes with the very best intentions. And we make mistakes. And not one of us is immune to it.

Fact #1: Nobody knows your diabetes better than you. Nobody. Not even your doctor.

Fact #2: That’s okay.

We want so much to not be labeled. We don’t want to be judged. We don’t want to be considered sick. We work so hard on our diabetes, our weight, our outfit, our hair, our makeup, our jobs, our school, our families, and whatever else we define ourselves by that we get really upset when someone else doesn’t understand or appreciate what we go through and how hard we work each and every day. We get even more upset when they get it wrong.

But if you think about it, can you really blame them? They don’t know your situation anymore than you know their situation. I have to tell myself that all the time. I only know what I can see, and what that person is willing to share with me. In reality, that is only the tip of the iceberg to who that person is.

I talk to so many people with diabetes. People from all walks of life. There are always a few that have a chip on their shoulder because they are one type of diabetes and are angry at people with a different type of diabetes because they don’t want to be compared. Or maybe they are just angry themselves, and are projecting. I don’t know. I’m no psychologist.

So the Type 1 accuses the Type 2 of doing it to themselves. It’s their fault that they have Type 2 diabetes. They ate themselves into that situation, when they should get up and move around and stop being lazy. Anyone with Type 2 diabetes, it’s their own fault. And they want the two types of diabetes to be differentiated even more, calling one something completely different than the other, because it’s an absolute travesty for someone with Type 1 diabetes to be compared to someone with Type 2 diabetes.

Or maybe the Type 2 doesn’t understand why the Type 1 chooses to give themselves insulin when they could just exercise and eat better, and stop eating sugar, and not have diabetes anymore. That person with Type 1 is just lazy, and by using insulin is taking the easy way out. That person with Type 1 diabetes is such a disgrace, and it is a low down dirty shame that they are compared to the hard working Type 2’s in the world! The person with Type 2 diabetes wants the two types of diabetes to be called something completely different, because they don’t want to be compared to those self-righteous know-it-all good-for-nothing lazy Type 1’s.

The reality is that Type 1 diabetes is an autoimmune problem, where the body’s immune system is attacking insulin producing cells in the pancreas, rendering the person incapable of producing insulin on their own. This is why a person with Type 1 diabetes has to take insulin via injections or a pump, because they have no way to produce it themselves, and without insulin to lower their blood glucose levels and convert carbohydrates into energy, their BG levels go sky high.

Type 2 diabetes is where the body has become insulin-resistant; it doesn’t want to process the insulin it is producing properly, resulting in higher BG’s. Yes, this can sometimes be controlled by diet and exercise, but sometimes it requires medications as well to make the cells in the body less resistant to the insulin that is being made. In some cases, a person with Type 2 diabetes has to eventually take insulin injections too, similar to a Type 1, because they can’t produce enough insulin themselves that meets the requirements of their insulin resistance.

Ready to have your mind blown? Not every person with Type 2 diabetes is overweight and lazy. Just like not every person with Type 1 diabetes got there by eating too much cake.

Cake is delicious. Don’t ruin it with diabetes.

It’s just labels. It means nothing. It doesn’t matter what can we come in, Alpo, Campbell’s, Type 1, or Type 2, we’re mostly all the same inside. We’re a little more of this, and a little less of that. Sometimes we’re better for one purpose, sometimes another. Sometimes we fit in a can perfectly, other times we’re a mixture and don’t make any sense at all.

But we’re all in this together. We don’t have to understand each other completely. We’re lucky if we understand each other a little. We do, however, have to understand that diabetes is not our fault. Forget the science. Forget the stereotypes. Forget what you think you know about diabetes. You know YOUR diabetes. If someone makes a mistake, gives you wrong information, makes assumptions about your situation, try to walk in their shoes. Maybe they are just trying to help. Maybe they are trying to make sure you don’t feel all alone. Or maybe they are the ones that don’t want to feel alone.

Or maybe they are just an a-hole. Yes, there are those people in the world too. However, I’ve found that most people are good. Most people are kind. Most people do legitimately care if you give them a chance, even if they don’t completely understand.

Be patient. Be kind. Accept that we don’t know everything, or the same things. We have much more in common than we often realize, and we’re certainly much stronger together than we are on our own. Diabetes, regardless of type, is much easier to deal with in a community of people who understand some of the nonsense of pricks and pinches and pills and possibilities.

Once you get past the labels, we’re really not so different. Kind of like dog food soup.