Diabetes Blog Week 2015 Day Four: Changes (Where No D Has Gone Before)

Today's topic is Changes.

Today let's talk about changes, in one of two ways.  Either tell us what you'd most like to see change about diabetes, in any way.  This can be management tools, devices, medications, people's perceptions, your own feelings – anything at all that you feel could use changing.  OR reflect back on some changes you or your loved one has seen or been through since being diagnosed with diabetes.  Were they expected or did they surprise you? (Read all posts here)

I have been watching a lot of Star Trek: TNG with my husband lately (it’s my first run through the series), and though it appears that they’ve cured a lot of things in the 24^th century or what have you, when it comes to changes, I’ve really got my eye on that replicator, and how useful it could be with diabetes as it is now. There's a reason they call it the Enterprise D, right?

The food replicator could create anything you needed, with whatever nutrition you needed (I’m assuming it makes food that tastes the way you want it to with only the requisite survival calories, as otherwise it would be very difficult for the entirety of the future population not to weigh 600 pounds apiece). Chocolate sundae, 20 calories, five carbs please! Or, if it couldn’t do that, at very least it would be able to tell you exactly how many carbs there were in your food. No more SWAG-ing.

I got this, don't worry

Or, you could be, like, “hey, replicator…replicate some insulin into my pancreas” and the replicator would be like, “hey, man, what do you think this is, kindergarten? I just whipped you up a brand new pancreas.”

And Bev would be like, “who cares about all that? I’m an awesome space doctor and will just wave a buzzing thing over you and you’ll just be fine. Don’t worry about vision complications. You won’t get them, but in any case, we have sweet visors now.”

Anyway, yes, the replicator. Changes for now, right? You could make instant Dex tablets and Glucagon, and expiry dates would be a thing of the past. You could replicate medications and replicate out the side effects, and you wouldn’t have to pay half your salary to do so -

And Bev would be like, “why are you bothering with Glucagon? If Picard can have an artificial heart, you can sure have a perfect artificial pancreas. Or, here, let me just wave this buzzing thing as you lie under a silver lamé blanket for a few minutes and you are totes fine! Enjoy your space adventure.”

(I know it's really called a "medical tricorder.")

But what I’m really talking about, of course, is the replicator! You could use it to make beautiful crystal blue circle jewelry, and signs for your diabetes walk. You could create petitions with hundreds of thousands of signatures for funding for research. Maybe you could even fund research with a replicator. You could create perfect footwear, which would never damage your sensitive feet. You could ask the computer, “Computer, what is the status of my blood sugar?” and Majel Barrett’s voice would always reply, “a perfect 5.0!” (this is the FUTURE and everyone uses METRIC like Canada, you know).

Then Bev would be like, “hey, I’ve cured you twice already. Stop worrying about this crap. Go to the Holodeck and beat the shit out of a personified version of your immune system for a while for some catharsis, or talk to Troi, I don’t know. Diabetes is OVER. Did you not see the buzzing thing?”

And you’d be like, “Working pancreas! ENGAGE!”

Sorry, I got sidetracked. I was talking about the replicator and all the cool things we could use it to make to solve most of our problems, but I guess we’d just be replicating a bunch of band-aids.

What we need is that buzzing thing, and the cure.

Make it so.

Damn straight.

At Seventeen (Mice, Mice, Baby)

Today marks a couple of milestones. One of my very dearest friends turns 30 (Hi, Chris! I love you!) and my diabetes diagnosis turns 17 (two inexorably linked events in my head; as I've said before, the first day of diabetes + birthday cake is really effing confusing for a twelve-year-old).

I was going to say hi, diabetes diagnosis, I hate you. In some ways (many ways) I do hate diabetes as much or even more than I always have. It's pretty awful. The roller coaster ride, the wheel of fortune, the tower of terror...I could just keep naming rides and metaphors, but you get the picture. Diabetes is unpredictable and wild. It's just like a seventeen-year-old (or, as I imagine a wild seventeen-year-old to be; diabetes rebellion aside, my teenage wildness looked a lot like mildness).

My D is seventeen
I've had some very bad years
I've had some much better years
They happened very recently
I found the D-O-C
Much lower A1c's
My D is seventeen

On the other hand, my D has been the biggest learning experience of my life, and I've always said that I love learning! My D has made me a ton of friends, and I love friends! My D has given me so much to write about, and I love writing! It's funny; if a genie materialized before me right now and told me he could cure me, I would say yes in an instant, but if he said "I can make it so you never had diabetes in the first place," I don't know what I would say. It's made me a better, more controlled, more compassionate person. In some ways, it's made me special. I still think it had a hand in getting me into my first-choice university, which was an incredible experience and has affected my life in immeasurably positive ways.

I learned the truth at seventeen
That while D sucks, you have the means
To only suffer, or to smile
We're only on this Earth a while

In any case, today I choose to smile. Here is a cupcake my sweetheart gave me for my Diaversary (Bailey's frosting and chocolate cake). He's a guy who's in it in sickness, in health, and in cupcakes! I love him very much.

When I was newly diagnosed, I was told that there would likely be a cure in five years. I know most of us in the same boat could finish that sentence. I really held on to that idea. In a way, my first five years (until I actually turned seventeen) of diabetes were me in denial, trying to mark time until the cure was found before I went off to university. In a way, the healthiest (though most depressing) thing I've ever done is to basically "Let It Go" - let go of a hope for a cure in my lifetime. I'm not going to say I wouldn't welcome it, but I want it to be a nice surprise, not a "what took you so long?" To that end, I know we're all sick of seeing studies that report "A CURE!" - in mice only. As a Diaversary present to myself and you, I present my most elaborate parody ever. Please put on Vanilla Ice's seminal tune, "Ice, Ice, Baby," and rap: "Mice, Mice, Baby." I love you guys! I don't love fake cures.

Yo, D-O-C, let’s kick it!

Mice, mice, baby, mice, mice, baby
All right, stop. Commiserate and listen
I know these scientists are full of ambition
Ideas grab a hold of them tightly
One experiment and they’re on the nightly
News – it’s a cure? Yo, we don’t know
Though I know we want to think so
It seems so extreme, a dream too true to handle,
But please, remember to breathe, it’s a scandal

Calm down. Don’t rush the lab rat room
It’s hard to think when some hope pierces the gloom
But deadly, to wish instead of taking care of me
Less than five years, who cares about A1c?
Hate D or leave D, you still better play
Don’t put off to tomorrow the tests of today
Diabetes is a problem and maybe they’ll solve it
But this cure won’t do much unless they can evolve it

MICE, MICE, baby
They cured some MICE, MICE, baby
They cured some MICE, MICE, baby
Not humans, mice, mice, baby

Now that conclusions are jumping
With the hype kicked in, the media are pumping
Make a quick point, they anoint, but they’re fakin’
It’s as much of a cure as a diet of bacon
And we’re equally burned, ‘cause they show us a symbol
Of progress when evidence isn’t so nimble
And a high horse is ridden by those in the know
Breaking the news to the newbs caught in the show
It’s just “cure” v. 5.0
How much smoke can a headline blow?
If I gave this cure a try, then my meter would say HI
Not a chance, I just have to keep getting by
Diabetes will pursue me and I can’t stop
A mouse won’t live five years, me neither, I’ll drop
Then I’ll be dead.

Yo – so you know what, buddy? I appreciate the studies.
I’m glad the tiny beasties no longer have the ‘betes
No more sad squeaky sugar-filled mousy entreaties
But my body’s not a mouse’s, a mouse’s isn’t mine
And when is the day when they tell me I’M fine?
I feel like a chump with my ear to the wall
Running after a cure like a mouse stuck in a ball
Platitudes ring out like a bell
It’s hell, just a shell, well, don’t fall under the spell
Falling hopes are dashed real fast
Optimistic’s just sadistic and I’m running out of gas
My bumper needs a jumper ‘cause the deck seems stacked
I’m just trying to survive with a pancreas that’s cracked
D-Police on the scene, you know what I mean
They pass judgment, act like I’m a mean sugar fiend
Diabetes is a problem, but that doesn’t solve it
And this cure won’t do much unless they evolve it

MICE, MICE, baby
They cured some MICE, MICE, baby
They cured some MICE, MICE, baby
Not humans, mice, mice, baby

Take heed, because I’m a high glucose poet
If this applies to me, well, then why don’t you show it?
It’s the D-O-C’s town, and we’re going to make a sound
Enough to shake and kick holes in the ground
‘Cause there’s fast, safe and cheap, or there’s slow, drag, and kill
My BG is always changing but advances seem so still
Strip safety reform, that’s a hell of a concept
Not sexy, but fixing “the D got her as she slept”
The closed loop system, with low suspend will aid
This ninja-like feeling of life lived on a razor blade
So sharp, other people say “damn,
How you measure out a life in shots and milligrams?”
I keep my composure with goals, some strict, some loose
If I’m high, then I’ll cry, if I’m low, I’ll drink juice
Diabetes is MY problem, and I’m going to solve it
With my friends worldwide, we’re going to evolve it

NOT mice, mice, baby
They cured some mice, mice, baby
That must be nice, nice, baby
But we’re not mice, mice, baby
No more advice, vice baby
‘Cause there’s a price, price, baby
We’re STILL not mice, mice, baby!
Not quiet mice, mice baby

Yo, man, let’s get out of here! Word to your support network!

-Ilana

Strips Do Lie (Stripkira Feat. Highclef Jean)

A while ago, I wrote a fairly popular post (called Liar) about the revelation that test strips could read +/- 20% of reality and still be within FDA guidelines; the idea was that this was one more lie that people with diabetes have to deal with (and, in fact, deal with it several times a day). When you don't know where your glucose level really is, how can you properly manage yourself? I hear that the FDA is welcoming public comments on their proposed new guidelines for safer meters and strips (you can read about it at StripSafely, here). While I doubt they would publish the following, I thought that I've already gone the angry route, so why not the lighter route?

In my college years, "Hips Don't Lie" was omnipresent at the clubs on party nights (here it is for reference). It popped into my head the other day, and I thought, your hips don't lie? Well, my strips DO lie! 

Thus, I present to you: "Strips Do Lie," by rising pop star Stripkira, featuring Highclef Jean (though a part of me wishes it were Notorious D.O.C.). I did the best I could with the song's incredibly loose meter and rhyme scheme (I hate slant rhymes, but the original's full of them!):

Blood up in here tonight,

No Error Fiving, no Error Fiving

Capillary action up in here

No Error Fiving, no Error Fiving

Strip Safely, Strip Safely

I never really knew that strips could fail like this

Turns my chart data into gibberish

Am I high (si) or low (si)

Or somewhere in the middle (who knows, si) -

Strip Safely, Strip Safely

Oh strippy when you read like that

You make a woman go mad

So be wise and keep on

Reading the signs of my body

And I’m low tonight

My strips do lie

And I’m starting to see the light

All the aggravation, the tension,

You must see this is short of perfection

Hey strip, I can see your numbers changing

And it’s driving me crazy

You don’t seem to know where you are ranging

Accuracy is hazy

And when you have such a margin of error

Nobody can ignore the way you treat my body, strip

And everything so unexpected – one-test it, two-test it

And oh the numbers so different

Hey strip, I can see your numbers changing

In a forty percent span

And so I don’t really know what I’m doing

I can’t seem to make a plan

My will and self-restraint

Have come to fail now, fail now

See, I am doing what I can, but with bad info

That’s a bit too hard to calculate!

I never really knew that strips could fail like this

Turns my chart data into gibberish

Am I high (si) or low (si)

Or somewhere in the middle (who knows, si) -

Strip Safely, Strip Safely

Oh strippy when you read like that

You make a woman go mad

So be wise and keep on

Reading the signs of my body

And I’m low tonight

My strips do lie

And you know that isn't right

My life hangs on each injection,

You must see this is short of perfection

Oh you know I’m low tonight

My strips do lie

And it’s giving me a fright

If you’d be a little more accurate

Oh, I’d even change out my lancet

No Error Fiving

No Error Fiving

Strip Safely

Strip Safely

The Diabetes Phantom Tollbooth

As a child, my favorite book was The Phantom Tollbooth, by Norton Juster, with pictures by Jules Feiffer; much like Anna Quindlen of the New York Times opines, I thought it was "the best book ever." Shockingly, it was one of very few books that I discovered by seeing the movie adaptation first; I accidentally came across it during a visit to Florida, and my parents were deprived of much of an afternoon at the beach as I refused to stop watching. The story features a young boy named Milo, who is always bored, and is never satisfied with wherever he is or whatever he's doing. One day, a box arrives, "for Milo, who has plenty of time," and Milo grudgingly assembles a cardboard tollbooth with some mysterious coins and a child-sized toy car. Once through the tollbooth, he winds up on a quest through a series of magical lands that teach him the value of letters, words, numbers, senses, sights, sounds and the magic that knowledge unlocks. The book is filled with wordplay and puns, and it inspired me to pursue writing (an effect I'm sure it had on many curious children).

To me, the Phantom Tollbooth's many fantastic locations and wonderful puns can be applied just as easily to diabetes as to any other aspect of life. Here's a look through The Diabetes Phantom Tollbooth:

The book opens on you, newly diagnosed with diabetes. In a funk, depressed, you don't want to be where you are. A mystery package shows up, with a note: "TO YOU, WHO MAY THINK YOU NO LONGER HAVE TIME." When the Diabetes Tollbooth arrives, first, you have to put in your coins to get through. When we're talking about a toll, that's definitely a word I associate with diabetes.  Mental, physical and financial, you've got to pay these tolls to get through life.

Driving along the road, you first encounter The Doldrums: Here's where you get stuck early on in the book and in diabetes. It's grey, boring, and sad. No thinking is allowed, and certainly no laughing. You can get dangerously stuck in the Diabetes Doldrums, and it's difficult to get out; the Doldrums want you to stay, and they want to consume you. The Doldrums are a poor representation of life, but they're easy, if you don't care what happens to you. Everyone gets stuck once in a while, but the trick is to get out! Tock, the "watchdog" in the book, represents the wonderful Diabetes Online Community, with a CGM in his belly. Your best friend, he keeps you on track, telling you to think, imagine, and dream. It's hard work, but it moves you forward.

Next, you encounter The Whether Man: The Whether Man in the book knows that it's more important to know whether there will be weather than what the weather will be. He reinforces the need to always be prepared for any circumstance. He also knows there is no "wrong way" ahead; just your way, and my way, or someone else's way. Your diabetes may vary!

You finally come to your first city: Dictionopolis: Here we learn that words mean something, and impact the way we feel about our condition, our lives, and ourselves. Words like "brittle," "the bad kind," "noncompliant" are shown to be powerful negative weapons, that are combatted by words like "hope," "community," "friendship," "meet ups," and "ice cream." Here we also find that you can make it further by listening if you don't have all the info, rather than speaking, for like the Dictionopolis car, it "goes without saying." Often, people will be forced to eat their words, just as they do in Dictionopolis, so it is really important to think before one speaks, and to say something nice and tasty. Half-baked ideas are served for dessert, and just like real desserts, they're tasty and intriguing but dangerous if you eat too many, or take them too seriously. If you give your diabetes Short Shrift, you may be arrested by him (Officer Shrift), but you can be let out of jail if you display a Faintly Macabre sort of humour.

Your job in this world is much like Milo's: you have to find your sense of Harmony. Your sense of self has been split, with this diagnosis; the words you use to describe your world, your life, your self - they don't match what the numbers say. The numbers are out of whack and need constant correction. The words are fighting with the numbers as to which is more important, and have banished the princesses of Rhyme and Reason, who understand that words and numbers must be given equal importance. Nothing can be set right until Rhyme and Reason are returned. Armed with new words, you set out on your quest with Tock, the Humbug (how you sometimes feel) and the BEEtes (a giant bee that spells everything out for you).

Along the way, you meet a boy who grows to meet the ground, and you understand you must grow to meet your own set of challenges. You complain, and complain, but then you meet Dr. Dischord, who wants to cure the world of pleasant sounds so all you hear is noise, and you realize that constant complaining can purge your ears of the wonderful sounds of the world. Chroma the Great, who conducts the sunset, helps you to see the rich colour and texture diabetes can bring to your life, even though you must conduct your own symphony. Sometimes, like Milo, you get too ambitious and your colours go out of whack, or you seem to lose days at a time to this vicious disease, but with help you can get back on the conducting track and it might seem as if nothing had ever happened.

You get to the point where you're starting to take charge of this diabetes thing, when you encounter the Valley of Silence. It's so tempting to stay with the status quo and be quiet about what's "wrong" with you, but you see the injustice for all in remaining quiet about what needs to be done, and letting the message be controlled by a select few media narratives. You break the silence for good with activism, blogs, diabetes walks, petitions, videos. You spread the message of need and success far and wide.

The Dodecahedron

Now that you're interacting with other people and organizations, you suddenly find yourself on The Island of Conclusions. You get to this island by jumping; jumping to conclusions. Here we find many representatives of the media who deal with diabetes, and many other individuals who we deal with on a daily basis. As soon as a reporter assumes an older person has Type 2, or that there is only one type of diabetes, or that a thin person can't have Type 2, they would be off to the island. As soon as someone assumes you ate too much sugar as a child, that you brought it on yourself, could cure yourself with a diet, or that diabetes is easy to deal with and insulin is the same as a cure, they would go right to the island. We would love to actually send these people flying to the Island of Conclusions, where we wouldn't have to deal with them until we jumped to a few conclusions of our own (why isn't my BG coming down? Must be bad insulin. Couldn't be the pasta).

You finally find yourself in Digitopolis, the land of numbers; you try to figure out how all this math works and how it's going to be relevant to you living your life. While you figure out that averages don't tell the whole story and that you can run forever and not reach infinity (or, as we call it, perfection), you find some valuable tricks for your arsenal, guarded by the kindly Mathemagician (who may well have the face of your endo or your CDE).

The Dodecahedron shows you the many faces of diabetes, and you're introduced to Subtraction Stew - or, its real name, insulin. Insulin, like Subtraction Stew, is the only thing that can make you feel hungrier after you've eaten bowl after bowl of food. But, if you don't take it, Subtraction Stew takes on a whole new meaning: nothing you eat is actually absorbed into your system, and you can get thinner and thinner the more you eat; as the Humbug observes, it's like eating bowls of "FAMINE!" Eventually, you learn that, while they don't always add up like you would like them to, just like the words that don't always tell the right story, numbers are absolutely valuable tools that you must use to better live your life. Sometimes, they can even be fun, like when that pencil the Mathemagician uses as a wand pencils in a "no-hitter"!

The Mathemagician and King Azaz of Dictionopolis

The two sides of you have slowly agreed to work together, but you must make the final push; you have all the tools you need, but you and your few friends set out to find Rhyme and Reason alone. The Castle in the Air, that mythical-sounding place of true harmony, awaits. It can't be real; can it?

The scariest and most taxing part of the journey toward Rhyme and Reason is fighting your way through the steep, dark Mountains of Ignorance, which teem with demons of all types.

The Terrible Trivium is at the head of the demon pack. The Terrible Trivium gets in your way, big time. He is a minor demon, who puts you off taking care of yourself. He tells you to fritter away your time on other, meaningless tasks, because "in five years, there will be a cure." You must use your numbers to look at the real situation and pull yourself away from this seduction, reminding yourself that he has no real face.

Other demons chase you and you must fight them: the Demon of Insincerity, a false friend who sounds big and scary, but has no real power; the Overbearing Know-It-All (just listen to me; I know more about you than you know about yourself), the Threadbare Excuse (I was too busy to take care of myself), the Gelatinous Giant (just try to struggle out of these mountainous insurance claims! You must fight him with activism) and the snake-oil salesmen who form the twin Gorgons of Hate and Malice. It's a hard struggle, and it feels like a lifetime, but you make it to the stairs at the base of the castle, where you encounter one last gatekeeper: the Senses Taker.

The Senses Taker, who wants to take all your senses, is a frightening reality. Here is where you truly learn the power of your words, and yourself. You fear the loss of yourself, your identity; more tangibly, you are terrified of the loss of sight, of heart, of feeling in your limbs. But you fight back with love and laughter, because, in the end, nobody can take your vital sense of humour. Past the Senses Taker you go, and up those precarious steps with every fibre of your being and those friends by your side, and you open the door to the Castle in the Air.

And there Rhyme and Reason have been, waiting for you, all along.

You feel whole. Your journey is complete. You're a hero: adulation, banquets and all. Your A1c is the best it's ever been. Your endo wants to throw a ticker-tape parade. But then, you have to say goodbye, and really step out on your own, to a future that could be just as scary as this parable got at its worst.

You wake up. You're suddenly far away from Digitopolis and Dictionopolis. Tock, the Humbug, the BEEtes; they're not always with you. You've come so far and learned so much, and you recognize its worth. But you know there's so much left to be done, and learned, and experienced. Today, like yesterday was, and like tomorrow will be, is the first day of the rest of your diabetic life.

The tollbooth is gone, but you find a note left in its place, and in its own way, it means everything.

It says, "TO YOU, WHO NOW KNOW THE WAY."

The Chronic (D-Blog Week, Day 5)

Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions? 

Today’s D-Blog Week prompt is all about “Trading Places” – if we could have a different chronic disease, other than diabetes, what would we switch to, and why?

This prompt amused me, because when it comes to chronic diseases, they’ve never seemed to be an “either/or” proposition; rather, it seems like an “and” proposition. You have THIS chronic disease! And oh, also, you have THIS chronic disease! And THIS ONE TOO! You get a chronic disease, and you get a chronic disease, and if you look under your seat, EVERYONE in the audience gets a chronic disease!!

That’s why we have the term “co-morbidities,” because misery loves company.

In many ways, “choosing” a different chronic disease seems like minimizing someone’s pain; it’s almost mean. I know that if someone with another chronic illness said, “oh, I’d rather have Type 1 Diabetes; it seems easier than what I’ve got,” I might feel indignant and wounded. It’s that feeling when someone says, “at least you don’t have cancer.” I would never want to have cancer; it is an absolutely terrible scourge, and fuck it six ways from Sunday. However, the “at least” qualifier bothers me, because, again, it minimizes my condition’s impact on my life. I’ve written somewhat extensively on the cancer/diabetes dichotomy and why one is easier to receive sympathy and donations for; much of it has to do with, in my mind, the status of the chronic illness as an atypical, unpleasant and uninteresting progressive narration.

Cancer gives you a villain; it’s a life-or-death struggle, there are peaks, a climax, and the person is either hero or tragic victim at the end. Even with the idea of a possibly-ending remission, that’s just the set-up for the sequel; the “I Still Know What You Did Last Summer” villain popping up again.  Few chronic illnesses offer such a satisfying journey. This “cancer narrative,” while popular, is equally problematic for many people living with cancer, because it often casts them as victims when they don’t want to be. The concept that you “beat” or “lose” to cancer indicates a judgment on the person’s strength or strength of character; like a sport, a “loss” indicates that you just “didn’t want it enough,” which is maddeningly unfair and untrue.

That’s why I feel awkward and uncomfortable about choosing a disease instead of the one I have. My “grass is greener” is someone else’s “bête noir.”  However, if I had to pick, I would go for the one thing I have curiously never had: seasonal allergies (if that’s even considered a chronic illness).

My entire life, the one malady that has been curiously missing from my rap sheet is that of allergies. I am allergic to sulfa medication and nothing else. Twice, I have done a 60+-item scratch test at the dermatologist’s; twice, the only thing that has reacted has been the pure histamine control (so I really am skin reactive; I’m just allergic to nothing). Ironically, the one thing my skin is “allergic” to is being touched or scratched; I’m dermatographic (you can “write” on my skin and occasionally produce hives). So, just like everything else, my body isn’t rejecting outside stimuli; it’s rejecting myself, as usual. Stupid self-hate-filled body.

I realize that seasonal allergies can be a source of much consternation and misery (speaking to my cousin a few weekends ago confirms this). And I don’t want major food allergies; quite frankly, I’d rather be diabetic than be deathly allergic to some food that I had to avoid all restaurants for. But mild, recurring seasonal allergies that I can’t get rid of but goes away two weeks into spring? Sounds good to me.

This, of course, is cheating somewhat; I suppose an equal “chronic” illness should be something I have to deal with all the time, like what I have now. I guess it could be something that’s usually all right, but “flares” in nasty ways. But, I have to say, if it counts, give me a few weeks of seasonal allergies any year, over this. If seasonal allergies have a narrative, it’s that of a villain who comes back to make an impressive cameo over Sweeps Week, and then disappears for another year.

That, I could deal with.

-Ilana

Di-ronic

This began with an "empty cartridge" alarm waking me up at 6am on a Sunday. My apologies to Alanis. Warning: much like the original, many of these situations do not fit the technical definition of irony (however, I think this song might have a higher percentage of actually ironic incidents than the original).

A young girl, turning thirteen

She gets diagnosed…on her best friend’s birthday

Getting low but not drunk

From your chardonnay

It’s a death row pardon

But you still have to pay

And isn’t it Di-ronic

Don’t you think?

When you exercise

And your blood sugar strays

You eat utter crap

Oh and NOW you’re in range

When the media say

Type 1 and 2 are the same

And who would have thought

It figures

Mr. Play It Safe

Was afraid to drive

He tested every time

Just so he’d stay alive

One day his BG crashed

He’d only gone for a block

The news said – treat him with insulin

He’s in diabetic shock

And isn’t it Di-ronic

Don’t you think?

It’s like everyone

Thinking you should be fat

It’s some clueless guy

Asking can you eat that

Your endo knows you less

Than #dsma Twitter chat

And who would have thought

It figures

And D has a funny way of sneaking up on you

When you think everything’s okay and everything’s going right

But D has a funny way, of helping you out when

You think everything’s gone wrong- it makes you the person you are today

An immune system

That’s just making you sick

The nurse judging your whole life

From one finger stick

It’s like you’ve got one strip left

And all you get’s “Error Five”

It’s nearly dying of a low

From the substance that keeps you alive

And isn’t it Di-ronic, don’t you think?

A little too Di-ronic – and yeah I really do think

You do the same thing,

Get a different result

And you always think

That it must be your fault

Your D’s juvenile

Though you’re now an adult

And who would have thought

It figures

Well you never sought

But now you can’t hide

The province pays for pumps

But not the insulin inside?

“Oh, it’s not that bad;”

Well it’s just your whole life

And who would have thought

It figures

And D has a funny way of sneaking up on you

And D has a funny, funny way,

Of helping you out

Helping you out

Law and Order: Special Pumper's Unit

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With all the furor over insulin pump security earlier this year (that is, the possibility of rogue outside wireless control of one’s pump), all I could think of was that it would make an excellent Law and Order episode. Intrigue! Medical drama! The perfect crime! Unless the cops could crack the case at the last minute, that is…

I had started my spoof episode and completely forgotten about it. I found it last night, and am determined to share it with the world for National Diabetes Awareness Month. It will be serialized. It will be silly. It will be very strange.

It will be…Law and Order: Special Pumpers Unit.

 If anyone is indeed concerned with the possibility of remote bolus control, or think I’m making light of the possibility of serious injury or death from an insulin overdose, I do not mean any offense. Laughter, for me, is the best and sometimes only defense.

V/O: In the pancreatic justice system, the people are represented by two separate yet equally important substances: insulin, that lowers blood glucose, and glucagon, which raises it again. These are their stories.

Well, more specifically, the guys who fight crime related to those substances, really.

I mean, you can’t really just have a show about insulin.

It’s not a very good actor.

It just sort of…puddles and dries up.

Are we…are we still rolling? Can we just cut to Doink Doink already? Come on, I -

CUT TO TITLE CARD: Law and Order: Special Pumpers Unit

Sound cue: DOINK DOINK (echoed by the Beep Beep of a pump, or possibly the whir of insulin delivery)

(Lights up on a corner of Central Park; two young women, stylish, early 20s, about to eat lunch. CONNIE is testing her blood glucose level.)

DENISE: Hey, how’s your salad? I hear the place that took over the bodega actually has some decent produce.

CONNIE: Tell you in a second – gotta test.

DENISE: Does salad even have carbs?

CONNIE: Denise, life is unfair. Everything has carbs. Hold on. (Puts in strip, pokes her finger). Bleh. (Tests) Eh, it’s ok.

DENISE: Are you changing that pokey thing every time?

CONNIE: Dude, witness my lack of health insurance. Lance and me are going to celebrate our six month anniversary, and I'm sure he's going to take me somewhere nice if I give him a year.

DENISE: You named your lancet Lance.

CONNIE: You know me. This comes as a surprise how?

DENISE: Yeah, all right.

CONNIE: I don’t even test as often as I should – despite the nagging- and you know it. Pokey things don’t grow on trees. Well, they do, they’re called thorns, but lancets cost money. Besides, lots of black dots on your fingers aren't in style this year, according to Vogue.

DENISE: Doesn’t it hurt more if it gets blunt?

CONNIE: No pain, no gain?

DENISE: I don’t think that-

CONNIE: Look, maybe I just like blunt trauma, okay? Now shut your pie hole and eat your sandwich.

DENISE: That’s hard to do with your mouth shut. Wouldn’t it technically be a sandwich hole in this instance?

CONNIE: Not if we go get pie.

DENISE: This is true.

CONNIE: Time for insulin roulette. High and the house pays 2:1. Low and its 3:1.

(CONNIE boluses from her meter)

DENISE: So that thing just transmits insulin?

CONNIE: It tells my pump how much to give.

DENISE: Where’s your pump?

CONNIE: Only my doctor knows for sure. (Pause) It’s in my pocket. (Pulls out pump) Here.

DENISE: Shiny as always.

CONNIE: Pumpy got style.

DENISE: Ah yes, Pumpy. And this is why your debut novel won’t be hitting the shelves any time soon.

CONNIE: Shut your sandwich hole.

DENISE: Actually, The Adventures of Pumpy and Lance might be a big seller in certain circles.

CONNIE: Pumpy would never run off with Lance. (Gestures to her site) He's pretty attached.

DENISE: I need someone attached to me at the hip like that. At least Pumpy is more reliable than James.

CONNIE: James might as well have been a small computer. Emphasis on pocket-sized. Hey, he finally stopped calling me.

DENISE: Thank god. That calls for a celebration. Pie tonight?

CONNIE: Pie is a go. I’m just going to take a nap at home after this. I love us being self-employed.

DENISE: You’re going to nap again? You know we need the designs by…we’re kind of really behind.

CONNIE: Yeah, whatevs. I’m on it. Oh, yeah, and if anyone asks me if I can eat the pie…

DENISE: Yeah, I know the drill. Punch to the face.

CONNIE: This is why you’re my besty!

DENISE: Cool. Just let me set up a reminder text. Two pies, apartment, 6pm.

(Zoom in on pump. Shady figure in the background pushes buttons on a device. We see “basal rate” selected.  The number of units start rising, and rising. Pump reads, “are you sure?” “Ok” is selected).

SMASH CUT TO:

DOINK DOINK

Major activity going on at the station. JOE filling out paperwork at his desk. Pictures of him with adorable children. Poster above his desk reads, “My Other Pump is a Lexus”

JOE: NYPD, Special Pumpers Unit. Joe speaking. What’s up. (Pause) DAMMIT!

CUT TO:

JOE doing the walk and talk with FRANK.

FRANK: So she OD’d? Or miscalculated?

JOE: If she did, it was a pretty severe miscalculation. She went so low that she never woke up. She’s in the hospital, and in no shape to tell anyone anything. Her friend Denise found her after she didn’t show up for pie.

FRANK: So she even missed out on pie. Damn. Was she depressed at all?

JOE: I don’t know, Frank, did she have an incurable, expensive, unpredictable chronic disease that she had to think about all the time?

FRANK: I really have to stop asking that question.

JOE: Yeah, you freakin’ yutz. We know she wasn’t insured, so testing could have been an issue, she could have relied on guesswork.

FRANK: But she tested at lunch.

JOE: Things change quickly, Frank. Anyway, according to what this Denise gal told the police, she had just dumped her loser boyfriend and they had both left their jobs to start a business together.

FRANK: Loser-free, not working for The Man, and the promise of pie. Something here just doesn’t add up to an overdose.

JOE: I agree. Let’s check this out.

(Cut to THE SUSPICIOUSLY LARGE NEW YORK APARTMENT, I MEAN WHO CAN AFFORD THAT, REALLY)

JOE: Hi, this is Joe Langerhans, special pumpers unit. Frank Banting, my associate. We came as soon as we heard.

DENISE: It’s good of you to come. Would you like some pie? When I came home with them I tried to wake her up and…there’s plenty left over.

JOE: That depends. (Makes a note in his jotter.) What kind of pie?

FRANK: Joe, don’t look a gift pie in the mouth. The mouth…of the pie.

JOE: Pies don’t have mouths, Frank.

FRANK: Pies are mysterious creatures, Joe.

DENISE: Pumpkin or strawberry-rhubarb?

FRANK: Ooh, pumpkin, please.

JOE: Strawberry-rhubarb. A pie after my own heart. I like my pies with that subtle tang of sourness and regret.

DENISE: Yes, it’s a real “a la recherche du pie perdu.” (Blank looks from the men) Never mind. (Leaves; men are silent for a minute)

FRANK: Oh! Proust! That was a Proust reference, Joe.

JOE: I know damn well it was a Proust reference. Proust is nothing to joke about.

DENISE: (Enters with pie) Pie.

FRANK: Madam, this Simple Simon thanks you.

JOE: That’s a fairly self-aware description, Frank. (To Denise) Thank you. (Takes out what looks like a speeding radar; flashes it over the pie. Instead of flashing “Your Speed:” radar flashes: “Your Carbs: 42” JOE nods and boluses, starts eating pie.) Now, we should get down to business.

DENISE: Wait, what was that thing?

JOE: Secret…D-Police stuff.

DENISE: But it just scanned and-

JOE: It’s experimental. In fact, it’s not even real. We don’t have the technology, how could we? (DENISE stares at him) Okay, I’m trying to work out a cheap prototype before Pharma copyrights and charges out the nose for it, all right? Whatever. How long have you known Connie?

DENISE: All our lives, almost. I remember when she was diagnosed when she was ten. I was sure I was going to get it too because we hung out so much, shared sodas, everything. I was scared, but then when nothing happened I was almost disappointed. First, she was getting so much attention, and second, to ten-year-old me, I thought that meant I wasn’t her real best friend. When another kid in our class was diagnosed two years later, I secretly thought Connie was cheating on me and she’d only want to hang out with her from then on. Luckily that girl turned out to be a dia-bitch-chick.

JOE: So are you jealous of the attention Connie receives on a regular basis?

DENISE: Yes, if I were still a pre-teen, I sure would be. Me, I’m just thankful I don’t have to deal with any of that crap. The misconceptions alone…

FRANK: Was Connie a responsible diabetic growing up? Did she experience any highs or, more importantly, lows?

DENISE: Well-

JOE: You’ll have to pardon my partner, Denise. I don’t even know why we let pancreanorms on the team. Frank, for the last time, asking if a diabetic experienced highs and lows growing up is like me asking you if you have ever felt hungry, even though you ate earlier in the day. It’s like asking an asthma patient if he’s ever felt shortness of breath even though he has an inhaler. It’s just a thing that happens.

FRANK: I still think it might be important to try to establish a pattern.

(Jump cut to THE LAB, where JEFF is enhancing a logbook on a screen; we see an absolutely random chart generated)

JEFF: Aw, screw it, these numbers never make logical sense anyway. I don’t even know why we do this. I mean, what the hell happened here?

LAB TECH: Let it go, Jeff.

JEFF: I will not! Okay, people, let’s run the numbers backwards and square everything. Maybe that will work. (We see the chart on the screen shift and the dots begin to form the letters “Paul Is Dead” as we cut back to Denise’s apartment.)

DENISE: Well, honestly, she did struggle with the numbers through college. But really, who doesn’t make a total mess of themselves at some point? Her parents told her that a boyfriend or random hookups were fine, as long as they checked her glucose level at 3:30am. It was certainly a way to separate boyfriend material from the immature from that one really creepy fetishist. But anyway, she’s doing much better in recent years. She loves her pump.

FRANK: Ah, yes, Pumpy. It seems Pumpy did not entirely love her back.

DENISE: Pumpy kept her alive for years! Show some respect.

FRANK: …Sorry, lady.

DENISE: It’s…it’s okay. I just don’t like anyone talking shit about Pumpy. I don’t think it was his fault. There’s a reason you’re here, right? You suspect someone who isn’t portable.

JOE: We do.

DENISE: So?

JOE: So you and Connie have a business together?

DENISE: Such as it is. Yes…yes, we do.

JOE: How’d it come about?

DENISE: It was all Connie’s idea. She convinced me to quit our jobs as paralegals – decent salary, actual benefits- and go into a design-focused business. Housewares, mostly, but we do a line of cute pump-compatible dresses. You’d think someone would have thought of that before.

JOE: What did each of you do?

DENISE: She was the creative, I drew up the business plan and work sales. We outsource construction.

JOE: How’s the business going?

DENISE: She was designing our major cupcakes and unicorns line. It was going to be awesome, but it was taking some time and we’d lost a few orders. We were struggling a bit, and maybe that got her depressed. I mean, she was eating salad for lunch. That’s not the food of someone who’s feeling robust.

FRANK: Is there anything else we should know about?

DENISE: James, for sure.

FRANK: James?

DENISE: That loser, James. Connie’s ex. He was gross and abusive and always made diabetes jokes. He kept telling her she brought it on herself, and she’d cry. He told her she wasn’t dieting hard enough. She finally wised up and dumped his ass. He wouldn’t stop calling her for weeks. Inadequate little rat man. Really good with computers though. He was designing our website, and it looked amazing.

JOE: What’s the address?

DENISE: Oh, please don’t go there. Ever since she broke up with him, it now redirects to Goatse.

JOE: Noted.

DENISE: Can I help you with anything else, officers?

JOE: No, I think we’ve got some good leads here. Pie for thought.

DENISE: Are you going to talk to James?

JOE: Might be our next stop. Certainly one of them.

DENISE: Can you kick his door down violently?

JOE: We’re supposed to knock, first.

DENISE: I won’t tell if you won’t.

JOE: Noted.

FRANK: Thanks for all your help, and the pie.

DENISE: Well, someone should get to eat it. I don’t want to anymore. Have a nice day, officers.

JOE: Ma’am. (Nods; the detectives leave the apartment)

JOE: Well, we’ve got a few places to go.

FRANK: Hey, Joe?

JOE: Yeah?

FRANK: Did you hear how she talked about Pumpy? What was that about?

JOE: No idea, Frank.

FRANK: I mean…do you think…do you think there’s something going on, there? Between them? Sounded like a jealous defense to me.

JOE: It’s an insulin pump, Frank.

FRANK: But she seemed…passionate.

JOE: It’s a small plastic box that vibrates, Frank. What use would a woman have for a relationship with one of those?

FRANK: ……

JOE: ……

FRANK: ……

JOE: Yeah, okay, but not with a pump. (Pause) Let’s go talk to her pharmacist and forget this ever happened.

DOINK DOINK.                             DOINK.

(Pharmacy. We see a pharmacist stocking shelves in a rhythmic fashion, much like a New York delivery driver).

PHARMACIST: Yeah, I seen her. I seen her…just two days ago.

JOE: You, uh, seen her?

PHARMACIST: I mean I know…I saw her. Sorry, I don’t know what came over me. I have a Master’s.

JOE: That’s right you do.

FRANK: He’s a stickler for grammar.

JOE: Now Mr. Master, where did you see her last?

PHARMACIST: She came to the counter, like usual. Right before closing, like always. If you don’t mind me saying so, she seems very disorganized.

JOE: Well, she has a faulty organ, so…

FRANK: Joe, quit it. What did she come for, sir? Was it dangerous?

PHARMACIST: Oh, very. We won’t release it without papers. (Confused pause) It was insulin. She wanted insulin. She has a prescription for it and picks it up every few weeks.

JOE: She doesn’t pick up a three-month supply? Most people do.

PHARMACIST: Look, she can’t afford it, she buys a vial at a time. I don’t ask questions.

JOE: Maybe you should ask why it’s so expensive.

PHARMACIST: Believe me, I wish I knew. I’d give her more, but my arms are tied. They find stuff missing, they call in D-Fraud.

FRANK: D-Fraud…that is one awesome job, though. Though, obviously less so for you.

JOE: Not enough money for insulin. And yet she could live in an apartment spacious enough to contain more than one boom mike.

FRANK: Joe.

JOE: How is that even possible?

FRANK: (coughs) Fourth wall, Joe. Fourth wall.

JOE: She could afford an apartment with four walls, and not insulin? Usury!

PHARMACIST: Look, guy, the pharmaceutical industry isn’t on trial here. I saw her, she came in, she took the insulin, she left. Said thanks, you’re a lifesaver. She always said that.

FRANK: She seem sad? Agitated?

PHARMACIST: Nothing out of the ordinary.

FRANK: You like her?

PHARMACIST: Sweet girl. I mean…you know what I mean. Always nice, always smiling even when stressed.

JOE: Thanks for your time.

PHARMACIST: Look, you catch this guy, you let me know. I got all sorts of nasty stuff you can use.

JOE: You got?

PHARMACIST: Have. Have.

JOE: Master’s?

PHARMACIST: Master’s.

Will Joe and Frank solve the crime? Will Connie wake up and eat pie? Is it James, or some mystery suspect who will be introduced at the last minute without adequate motive or backstory? Will the lab techs ever find a pattern in a logbook? Will the pharmacist develop a solution to his crippling case of Truck Driver Grammar? Some of these questions will probably be answered in Part Two if anyone cares, so tune in whenever that's updated!

Coming to a Bestseller List Near You

Coming soon from Random Fasting Glucose House Publishers: A new noir crime drama

Find thrills, chills, highs and lows with: The Insulin Thief

John’s pancreas might be firing blanks, but the gun he carried shot the real kind. Other men have their hearts stolen, he mused. Why couldn’t I have been so lucky? There was nothing more to say – his insulin was gone, and nobody had seen it go; or if they had, they weren’t talking. To make matters worse, he was getting low on cash – he seemed to be bleeding it out even faster than the stuff that caused his meter to beep.

Joe was dealing with an insulin thief, and he wanted answers, sooner rather than later; the thief had worked fast, and for all he knew, was long gone. Half the time he couldn’t tell if he was shaking with rage or hypoglycemia.

Joe’s finger tensed on the trigger of Lancet, his beloved .45. Big Pharma knew something, he was sure of it. He could never quite figure out Big, or what he was up to. The man certainly loved his excess, and never passed up an opportunity to shake Joe dry. Of course, he had dirt on Joe – who didn’t? But to Joe, the brazen blackmail meant Big was scared; as usual, he was slowing down an investigation. He had pressed this notion the last time, and it had not gone over well. “Blackmail is such an ugly word,” Big crooned, almost lovingly. “I prefer to call it…insurance.” And to show he wasn’t bluffing, he raised Joe’s “premiums.” Hans Langer, Big’s cartoonishly German assistant, had escorted Joe out. Joe saw the briefest flash of pity in the man’s Teutonic visage, and as he was shoved through the golden door, he thought he heard the briefest, accented whisper…”you’ll find what you seek…on the islet.”

What that meant, Joe had no idea. But he couldn’t pass up even the barest hint of a lead. He was running out of glucose tabs, and he was running out of time.

He was going to find that insulin thief, and he was going to make him pay.

-Ilana