November: Diaversary and more

Posted on November 15, 2013 by Laddie

In recognition of November as Diabetes Awareness Month, Sue from Pennsylvania, Sue from New York and I have written blog posts for publication this week. Sue from New York wrote about her appreciation for medical devices that keep her safe. As the spouse of a man with Type 1, Sue from Pennsylvania wrote about the importance of diabetes Awareness in November. Today I am writing about my November activities and my 37th Diaversary.

November is a busy month for the Diabetes Online Community (DOC). November is Diabetes Awareness Month(DAM), American Diabetes Month, or National Diabetes Month depending on whom you’re talking to. Regardless of the name, November is a month dedicated to increasing awareness of and advocacy for diabetes. On top of that, November 14 is World Diabetes Day, a campaign developed by the International Diabetes Federation (IDF) and symbolized by the Blue Circle logo.

I have been impressed by the advocacy efforts of many of my fellow PWD (people with diabetes). Christel at theperfectd has spent the month being a Diabetes Awareness Month guide (a DAM guide about damn diabetes!) and writing daily informational posts about diabetes. Kerri at Six Until Me started the Diabetes Photo-a-Day project with a list of word cues for daily photos showing the life of someone with diabetes. George at Ninjabetic has been writing a daily tribute to special people in his diabetes world. Cherise from DCAF organized a 24-hour Twitter Chat on World Diabetes Day with a different host each hour. Cynthia at Diabetes Light has invited her readers to submit a quote and photo so that her blog can feature daily quotes by people with diabetes. I was honored to be asked by Cynthia to participate in her project and my quote, photo, and definition of success are featured on her blog today.

I started the month with stress and guilt that I wasn’t doing enough for diabetes awareness and feeling left in the dust by my more ambitious fellow bloggers. By the time I realized that I should have considered doing an “everyday” project, I was well into the month and excused myself with the excuse that it was too late for this year. I do have a few ideas for next year.

But then I compared myself to where I was a year ago. I started blogging in late May 2013 and along with my two co-bloggers, Sue from New York and Sue from Pennsylvania (actually three co-bloggers if you count Abby the Black Lab), have published at least two posts every week. For the first time in my life, I wrote letters and sent Tweets to my elected representatives regarding the Strip Safely campaign. For the second year I participated daily in the Big Blue Test. I tweeted in the DCAF 24-hour WDD Twitter Chat. Even though I do not own a glue gun, I participated in the World Diabetes Day Postcard Exchange for the first time.I know that I am not a DOC leader for November activities, but I have been an active participant and I give lots of kudos for everyone’s efforts in promoting diabetes awareness in November.

Abby the Black Lab was a diabetes advocate on World Diabetes Day. She wore a bright blue bow tied to her collar for our trip to the dog park. Interestingly enough, the first two people who asked about her bow had family members with diabetes but did not know about WDD. She educated at least 10 people about the importance of National Diabetes Month and World Diabetes Day.

For better or worse, November has always been a special month in my diabetes life. Today, November 15, is my Diaversary. I was diagnosed with diabetes 37 years ago on November 15, 1976. I didn’t know the exact date until a few years ago when I decided to register with the Joslin Medalist Program. Luckily my local hospital was able to provide me with my medical records which were stored on microfiche. I had many vague memories of my diagnosis and they were backed up by the hospital records.

So Happy Diaversary to me. After 37 years of Type 1, I rejoice to be living a healthy life with no major complications of diabetes. I rejoice that I am part of the DOC which provides me with daily friendship, support, and inspiration. I thank every one of you for the fabulous things that you do to improve the lives of everyone with diabetes. I am proud that my life has intersected with yours, although I wish that none of us had to deal with diabetes. Every day I continue to learn and grow. I hope that I can continue to say that until I have earned my Joslin 50-year medal and maybe my 75-year medal. To everyone in the DOC and to all of my family and friends, I hope that I have been able to give you at least a fraction of what you have given me.

UPS and FedEx: Helpful Info

Posted on November 11, 2013 by Laddie

Many of us with diabetes purchase our medical supplies and prescriptions online and have them shipped directly to our homes. There is nothing more frustrating than to come home from work and find your insulin on the front porch in -10 degree weather (Minneapolis in January) or +110 degree weather (Phoenix in July). Some of us have waited all day in an upstairs apartment for the arrival of a new pump only to find a sticky note at the building front door announcing a failed delivery attempt.

Depending on where you live, these problems can be avoided with a little advance planning. I live in a suburb of Minneapolis and have both a FedEx Office and a UPS Store within 10 miles of my house. By using online tools and programs provided by FedEx and UPS, I am able to route my packages to these stores and avoid a lot of the frustration that accompanies botched package deliveries.

Most of my medical supplies come from Edgepark and are shipped through UPS. I receive an email when my supplies ship along with the UPS tracking number. After that I benefit from a program called UPS My Choice. The slogan for this program is “Get Home Delivery on your Schedule.” You need to sign up for this program ahead of time and there is no charge for enrollment.

With the UPS My Choice program you get free-of-charge delivery notices along with an approximate delivery time. You can use the Authorize Shipment Release to request that eligible packages be dropped off without a signature. Most importantly you get the ability to schedule a delivery time that fits your schedule, reroute the package to another address, or reroute the package to a UPS Store where you can pick it up at your convenience.

If you enroll in the free version of the My Choice Program you must pay $5 each time that you use the reschedule or reroute options. When I know I won’t be home for a delivery that has a 3-month supply of test strips, CGM sensors, reservoirs, and infusion sets, it is worth $5 to me to know that I can pick up the package at the UPS Store without worrying about temperature extremes, theft off my front porch, or signature requirements.

Another option is the UPS My Choice Premium Plan. An annual fee of $40 entitles you to unlimited reroutes and reschedules of your packages. Because I don’t use the service enough to justify the $40 charge, I choose to pay $5 per use. But if you have a home business or buy everything on Amazon along with lots of medical deliveries, this plan might be a better deal for you.

FedEx has a program called Hold at Location (HAL) where you can ship or redirect a package to a FedEx Office location. When a package is set up for transit, you can have the sender select the HAL service. They would address it with your name, the address of the desired FedEx Office, and select Hold at Location. Many large companies won’t bother doing this for you and sometimes you don’t know ahead of time which vendor they are using to ship your package anyway.

What I do with FedEx is wait until I have received the tracking number from the shipper. At that point I can go into the FedEx tracking site and select the option of redirecting it to a nearby FedEx Office location. This service is available for FedEx Express, FedEx Ground and FedEx Home Delivery packages. I can do this before any delivery attempt is made or after I have received a door tag when I missed the delivery. It is incredibly convenient and unlike UPS, there is no charge for this service. I reroute almost all of my temperature sensitive and/or valuable packages to FedEx Office so I don’t have to deal with staying home to accept delivery.

When I signed up for UPS My Choice a few years ago, it took a day or two before my account became active. Therefore I suggest you sign up ahead of time so your account will be ready to go when you need it. With FedEx there is no requirement to register ahead of time.

Be sure to understand the rules and restrictions of these programs. For example, FedEx Office will only hold your package for 5 business days and in most instances, the person to whom the package is addressed must pick up the package and show a valid photo ID. Know that not all packages can be released by an online signature if the shipper requires a delivery confirmation signature.

To find out about or enroll in UPS My Choice, click here. To learn about FedEx Hold at Location, click here. If you live in a rural area/small town or have special needs and can’t find a solution online, call UPS (1-800-PICK-UPS) or FedEx (1-800-GoFedEx) to learn about how they can help you. Even if you can’t reroute a package to a store, you may have the option of rerouting it to another address or setting up a delivery appointment.

There are many complications and frustrations in our lives with diabetes. Hopefully you can use options provided by UPS and FedEx to at least make receiving your medical supplies a little bit easier.

Diabetic Pants

Posted on November 4, 2013 by Laddie

I love the ubiquitous joke about “diabetic socks.” I didn’t know that socks could get diabetes. Ha! Ha! Ha! That joke has been around the block a few times. Although Best of the ‘Betes Blogs has added a category for the Best Comment of the month, I don’t want to see any comments questioning whether pants can get diabetes. Really, I mean it, no comments.

Now that we’ve gotten the guffaws out of the way, I want to tell you about my new favorite slacks. My aim in life is to keep my pump, CGM receiver, glucose tabs, Fitbit, and phone on my person at all times. Usually there are just not enough pockets to carry everything even if I’m willing to live with unsightly bulges or pants falling down because of the excess weight of my necessities. Occasionally I’ll use a SpiBelt to carry my pump and Fitbit, but I don’t find it comfortable enough for everyday use. And I never like the idea of lifting up my shirt to answer my phone.

I wish that my hiking pants from REI weren’t so baggy, so casual, and well, just “so hiking” pants. They have tons of pockets but the look doesn’t translate to life beyond the trail. I’ve bought cargo-style shorts and cropped pants from Chico’s for several years. They’re OK, but in recent years the quality has gone down hill. They require ironing which is difficult because the seams shrink after washing and nothing lines up well. They are also lightweight and designed for spring and summer wear.

I hit the mother-lode a few weeks ago when I discovered Comfort Cargo Pants at L.L.Bean. I’m sure the word “Comfort” is enough to scare away my younger and more fashionable D-friends, but I live in the Midwest and am approaching Medicare age. My standards are high enough that I don’t wear baggy sweatpants out to lunch and I thank Scott Benner, D-Dad and author of Life is Short, Laundry is Eternal, for reminding me to never let my fashion standards dip that low. But after that, practicality and comfort rate high in my book.

These slacks are great. They are what L.L.Bean calls Classic Fit which means that the waistline is at the waist rather than lower on the hip which has never worked for me. They are made of a cotton dobby fabric and are heavy enough for comfortable wear in the fall and winter. You can even buy them in a flannel lined version for true outdoor winter use. (I personally choose to go to Arizona for the winter rather than buy flannel lined slacks….)

The pockets work perfectly for me. Many reviewers criticize the top front pockets for being too shallow, but they are a good size and location for my insulin pump and Dexcom G4 receiver. I often use upper thigh locations for sensors and infusion sets. Deep pockets can result in my pump and CGM receiver bumping against the sites, so I often prefer more shallow pockets. The side pockets on the legs are deep and because of the heavyweight fabric, they are sturdy. My iPhone easily fits in one of the pockets with no sagging or risk of falling out. Glucose tabs, my Fitbit, and occasionally a house key end up in the other leg pocket. I haven’t used the rear pockets, but they could easily accommodate a small wallet.

The color of my pants is Gray Birch which to me looks like a standard light khaki. I’ve ordered a pair in Sage, but they are back-ordered until late November. The third color is Navy which I probably won’t order. Unfortunately they are not available in black. The available sizes are 4-20 with lengths Petite, Regular, and Medium Tall. For me they are true to size and require no alterations. I am 5’9″ and the regular length seems fine. However, I have ordered another pair in Medium-Tall to see what I think of the longer length. L.L.Bean has another style of cargo pants made with a light stretch fabric and a draw string waist called Southport. I personally don’t like the styling of these slacks, but they have good reviews. Men will also find numerous options for cargo pants on the website.

Now that I have done a blog post on fashion, it won’t be long until I start posting recipes. That statement should be worth a mention in the humor category of Best of the ‘Betes Blogs because those who know me understand that I hate to cook almost as much as I hate to shop.

Disclaimer: No one asked me to write this review and I paid full price for my L.L.Bean merchandise. I did get free shipping. Before you get too impressed, check out the website. Everyone gets free shipping.

Ghouls, Goblins, and Gum

Posted on October 31, 2013 by Laddie

Although I’ve never been fond of dressing up in costumes, I am a big fan of Halloween. With the children grown and out of the house, I don’t buy pumpkins anymore or do much decorating. But I love the chill in the air, the blowing leaves, and the constant ringing of the doorbell with ghosts, skeletons, princesses, and action heroes awaiting hand-outs of whatever bounty Target or Costco has enticed me to buy.

But wait! I have diabetes. This year is my 37th Halloween with Type 1 and believe me, I have consumed more than my fair share of Snickers, Peanut M&M’s, Almond Joys, and Kit Kats. More than once between trips to the front door, I’ve munched on a candy treat with the plan of having just one. Not once have I ever stopped at one. As I have mentioned in numerous blog posts, I don’t do moderation well when it comes to chocolate. But I am still naive enough to give it a try every year.

Minnesota women are famous for the vast quantities of food we provide at potluck suppers. Fear of running out of hot dish, jello salad, or snicker doodles is handed down from generation to generation. It is therefore genetically impossible for me to risk running short on Halloween candy. I have no choice but to toss one or two extra bags of Hershey bars into the cart and thus ensure that the glut of candy extends well into November.

In recent years I have worked hard to reduce the amount of junk food I eat. I have no doubt that carb restriction is one of the most powerful tools I have for reducing the range of my blood glucose excursions. I am miles away from eating a perfect diet but I continue to strive to do better every day. At the same time I strongly believe that the health of our nation and our children is negatively impacted by the glut of fast-acting carbs. Not only is crap food not good for people with diabetes; it is not good for anyone. Oh sure, Halloween is just one day so let’s forget good nutrition and just have a treat. The problem with treats is that they are everyday occurrences in our world and they long ago stopped being an isolated indulgence.

So you probably think that I am on my way to being a Bah Humbug Scrooge of Halloween. A despicable know-it-all neighbor screaming obscenities at pets and children. A grouchy old lady wearing curlers and a faded housecoat in a suburban cul de sac. The Witch of Minneapolis.

And you are wrong!

Last year I decided to quit handing out candy and buy sugarless gum and stickers instead. I went to Costco and spent about three times my normal Halloween budget on packs of sugarless gum. Not small packs, but full packs with 14-18 pieces of gum. I also bought sheets of stickers to attach to bags of Goldfish crackers for the youngest goblins. It was a huge success and almost every trick-or-treater was thrilled to receive “a whole pack of gum!” The little ones were equally pleased with stickers.

It was a small victory for my psyche and I am proud to have made a statement and walked the walk of my convictions. After last year’s victory, I decided to repeat the sugarless gum handout this year and hope that this will continue to be my Halloween tradition. One thing that I will not do this year is indulge in leftover goodies. I had not chewed gum in recent years before enjoying some of the extra gum last year. It seemed like a fine idea until I pulled out a filling and broke a tooth. A new crown and a thousand dollars later, I decided that Halloween should end when the doorbell stops ringing. All excess treats, whether gum or chocolate, should either self-destruct or be thrown to the birds.

To The Girl

Posted on October 21, 2013 by Laddie

I went to college in the early 1970’s. In many of the dorms the communal bathrooms were in the basement and were reflective of the the university’s history as an all-men’s school. It was typical to walk down two, three, or four flights of stairs to take a shower or use the toilet. The following letter tells the story of a guilt-laden memory from those years.

2013 ADA Expo in Minneapolis

Posted on October 14, 2013 by Laddie

Saturday was the American Diabetes Association Expo in Minneapolis. It was the first time that I have ever attended this event because I had always thought that there would be little for me there. Although I enjoyed my 3-1/2 hours there, I think that was the case.

I was warned that the event was heavily oriented towards Type 2’s and that was partially true. There were many booths like Medifast, SlimGenics, and Extend Nutrition whose target audience is definitely Type 2. Similarly it was easy to stereotype the Active Living and the Healthy Eating areas as having a Type 2 emphasis, but really the intent was to get everyone, diabetic or not, exercising and eating healthy foods. Type 1’s were definitely not ignored because the major pump and CGM manufacturers had a strong presence. I particularly enjoyed the opportunity to see Medtronic’s new Enlite sensor and the smaller Omnipod. Because I continue to second-guess my decision to go with the Animas Ping a year ago, I could hardly bear to look at Tandem pumps….

I think that a lot of my disconnect was that in recent years I have learned a huge amount about Type 1 from personal experience, reading, and involvement in the DOC. Therefore almost everything at the Expo was too basic and generic to appeal to me. Of course it would be unrealistic to expect anything different because those of us in the DOC who are highly involved in our care are a small percentage of people with diabetes. I had hoped that the talk by a well-known local endocrinologist about getting off the high and low rollercoaster might be interesting. He was an engaging speaker, but unfortunately 30-45 minutes is not enough time to move beyond superficial ideas especially when you are addressing an audience of Type 1’s and Type 2’s.

There was a large screening area where free cholesterol and A1c tests were available. You could get risk assessments and screening for strokes, PAD, high BP, dental problems, and sleep apnea. I had a brief eye exam that included photographs of my retinas. Because I had never seen a podiatrist in my 37 years of diabetes, I had a foot exam that confirmed that everything was okay. I didn’t participate in many of the screenings because my annual physical was just a few weeks ago. If it had been several months since my last A1c, I definitely would have taken advantage of that test.

As is common at events like this, I came home with a bunch of free stuff. Two tote bags were appropriately royal blue and ready for #BlueFriday. Several toothbrushes, dental floss, glucose Quick Sticks, and a pedometer were part of the loot. I’ll definitely use the sizable tube of foot cream and the USB hub that I picked up. Other than that, I was very good at refusing things that I had no use for. Somehow I ended up with too many handouts and magazines that ended up in the recycling bin.

Chances are that I will never go to this event again. But if you’ve never gone to an ADA Expo, I’d say that you should go and see what you think. If you’re considering a pump or CGM, it’s a great place to see different devices and make contact with the local reps. If nothing else, it’s an opportunity to see that there are a lot of people in the world with diabetes along with many healthcare providers trying to help us and a ton of companies trying to sell us stuff.

Stories

Posted on October 10, 2013 by Laddie

The Diabetes Community is a treasure chest full of stories: your story, my story, your child’s story, your friend’s story, your neighbor’s story, a stranger’s story. Many of the stories are inspirational. Some of the stories make you laugh. Others make you cry. Some are reminiscent of Pollyanna with cheer and helpfulness in every sentence. Others visit the dark places in your soul where you rarely dare to venture. Some frustrate you because the author appears to have a backpack of helium balloons and yours is filled with rocks. Others guiltily make you feel giddy because the writer is seemingly screwing up his diabetes much worse than you are. Each of these stories reminds you that although you sometimes feel alone in your diabetes journey, you are not. You are part of a community: a family with a secret pinky handshake or at least a pump in the pocket or a meter in the purse or a Calorie King book in the car.

Some stories are told in words. Others are shared in photos or drawings or comics. You can find some on YouTube and others you can download from iTunes. Many tales are typed on iPads and desktop computers while others are written with tears smeared across giant cupcakes in the boo hoo zone. Some stories are elegantly written blogs while others are a brief cry for help on Twitter or an explosion of anger on a message board.

Lately I have been reading a lot of stories.

I just finished reading My Sweet Life – Successful Women with Diabetes and My Sweet Life – Successful Men with Diabetes. Each book contains approximately twenty-five life stories written by “successful” people with diabetes. These books are the work of Dr. Bev Adler, a psychologist and CDE who specializes in helping people cope with the emotional challenges of living with diabetes. She was diagnosed with Type 1 in 1975 and she brings her experience with diabetes to everything she does. Her story is the first chapter in the women’s book. Although I was familiar with her books, I first “met” Dr. Bev on Twitter @AskDrBev.

One view of success is that it is measured by the “important” things you do with your life and many of these storytellers fit that mold. Charlie Kimball is a well-known driver in the IZOD IndyCar Series. Kelli Kuehne played golf on the LPGA Tour for thirteen years and Zippora Karz was a soloist with the New York City Ballet. Dr. Jason Baker is an Assistant Professor of Medicine and Attending Endocrinologist at Weill Cornell Medical College in NYC and the founder of Marjorie’s Fund, a global initiative dedicated to the education, care, and research of Type 1 Diabetes in the developing world.

But being well-known is only one way of thinking about success. Success in living with diabetes might be thought of as taking the hand you’re dealt and using it to empower you rather than limit you. The storytellers in both of these books write of hard times with diabetes, both physically and emotionally, and not one of them claims to be “perfect” at living with it. But they have all come to terms with diabetes, and many have made diabetes their life work. There are doctors, nurses, CDE’s, psychologists, and authors. Many of the writers are well-known figures in the Diabetes Online Community and you’ll see stories by Kerri Sparling, Scott Johnson, Kelly Kunik, Amy Tenderich, Gary Scheiner, and too many others to list. Others have taken diabetes along for the ride in various professions, life adventures, and parenthood. I was familiar with many of the authors and others were completely new to me. It was a reminder that not everyone with diabetes hangs out on Twitter or writes a blog….

Stories from the DOC are not new to me. I am a faithful listener of DSMA Live and I regularly read about 50 blogs. I am less active on message boards than I used to be, but I keep up with several friends whom I’ve met through TuDiabetes, Insulin-Pumpers, and the ADA Type 1 board. I dabble in Twitter and Facebook and make new connections almost daily. I have been lucky to meet many of my online friends in person and these relationships are incredibly rewarding.

I really do hate diabetes. But I cherish all of the stories and relationships whose threads have been woven into my life because of diabetes. Maybe we could write a new story:

Thanks to Dr. Bev Adler for providing me with complimentary copies of her books. I enjoyed them tremendously. If you would like to read her books, they are available at Amazon.com. A portion of the proceeds from the purchase of the books is donated to the American Diabetes Association.

Snippets of My Childhood

Posted on October 1, 2013 by Laddie

Today is No D Day when those of us who normally blog about the D-word take time to open windows into other parts of our lives. Sue from New York, Sue from Pennsylvania, and I have each written posts with memories and photos of our childhoods. Thanks to George of Ninjabetic for organizing this day, and click here to read other No D Day Posts.

I was born in Greenville, South Carolina. I was the youngest of three children and my mother always said that I raised myself. Some of that was the result of benign neglect, but mostly it was personality-driven. I always wanted to do things myself and didn’t want anyone helping me or watching over me. For better or worse, I don’t think that I’ve changed very much.

I grew up in the South where women and little girls wore hats and gloves to church. My father wore a hat to and from work every day along with his suit and tie. Little girls wore dresses to school and on cold days added a pair of slacks to keep legs warm. I went to an Episcopal day school and remember bobby-pinning a lacy chapel cap to my head every day for worship services. Boys seem to escape most of the hat requirements, but the plaid and striped jackets that my brother wore in many photos seem a worse punishment than hats.

With one set of grandparents in Washington State and another in a suburb of New York City, we were not strangers to airports and train stations. I don’t remember the small plaid suitcases, but I do remember the brown tie shoes. The brown tie shoes that turned into black and white saddle shoes as I got older. The saddle shoes that I was mortified to wear because the popular girls at school were wearing Bass Weejuns penny loafers and later on loafers with tassels. I think that I got a few years of loafers before going to girl’s boarding school in 9th grade and returning to uniforms and brown tie shoes.

*We spent a couple of weeks every summer at Pawley’s Island, SC. I have wonderful memories of hot days in the sun and homemade biscuits, fried shrimp, and hush puppies. I can still smell the Coppertone oil that my sister and I used to enhance her tan and unfortunately my sunburn. My brother got daily entertainment by pretending he was a shark and attacking me in the ocean. As much as I love the ocean, I still wonder what creatures are lurking in the shadows.

Lots of memories from long ago.

Argh! Frozen Shoulder

Posted on September 26, 2013 by Laddie

I am an expert on frozen shoulder. Believe me, it is not something that you want to be an expert on.

Frozen shoulder is the layperson’s name for adhesive capsulitis and is a shoulder condition that results in stiffness, decreased ROM (range of motion), and often incredible pain. If you want medical jargon and links to a lot of the literature about frozen shoulder, I suggest you check out a 2008 article by Manske and Prohaska. Or just Google the term and you’ll find tons of information. Suffice it to say that if you get frozen shoulder, you can’t move your shoulder very well and it hurts a lot.

I will be using term “frozen shoulder” only to mean adhesive capsulitis. Some people and even doctors describe any shoulder stiffness as frozen shoulder. If you can get rid of your “frozen shoulder” by doing a week’s worth of exercises in the shower, you don’t have adhesive capsulitis.

Diabetes is a huge risk factor for joining the frozen shoulder club. Other risk factors include hypothyroidism, hyperthyroidism, Parkinson’s disease, cardiovascular disease, being middle-aged, and being a woman. I win on four accounts: woman, middle-aged, Type 1 diabetes, and hypothyroidism. You don’t need to be middle-aged to win the lottery because I have a young Type 1 friend Cynthia who suffers greatly with frozen shoulder.

Adhesive capsulitis has 3 stages, each which can last 3-6 months or longer. Following along with the “frozen” analogy, the first stage is called the “freezing stage” and may be excruciatingly painful as the ROM of the shoulder slowly decreases. When I had my first frozen shoulder, I slept in a reclining chair alternating ice packs and a heating pad for a few weeks because it was painfully impossible to lay in bed. My next two frozen shoulders were moderately painful, but very manageable.

The second stage is the called the “frozen stage”. It is characterized by decreasing pain along with increasing stiffness. My experience in this stage is that strengthening exercises may be helpful but any stretching beyond gentle is futile. With the shoulder capsule totally immobile and full of adhesions, it won’t stretch and you run the danger of injuring other parts of your shoulder and neck if you push it too hard.

The third stage is the “thawing stage” when your shoulder slowly returns to normal. There is only minimal pain with the stretching exercises and you can feel the correct things stretching. Most people eventually have a full recovery from adhesive capsulitis although people with diabetes are less apt to achieve total remission. Some people end up having surgery to release the shoulder, but my doctors are very anti-surgery for the condition. The vast majority of people only get frozen shoulder once or at most once in each shoulder. Unfortunately another prize for having diabetes is that you may get it repeatedly.

The exact causes of frozen shoulder are not known but terms like collagen fibers, platelet derived growth factor, glycosylation, poor circulation, inflammation, and fibrofatty infiltration are tossed around. Like most things with diabetes, doctors are quick to blame poor blood glucose control for the condition. Upon diagnosing my third frozen shoulder in May of this year, my rheumatologist immediately asked “What was your last A1c?” Rightly or wrongly, I was somewhat offended by the question because my A1c’s are always quite low and within the lab normal range. On the other hand, I have Type 1 diabetes and my blood sugars are miles away from being “normal.” So maybe I shouldn’t get so huffy.

What most doctors don’t know is that recent studies, including those led by Thomas and Yian, indicate that A1c’s are not associated with the development of frozen shoulder. These studies found that the strongest correlation for those with Type 1 was with duration of diabetes. Similarly in a Finnish study headed by Arkkila, A1c levels for the previous five years had no correlation to the onset of frozen shoulder. In fact, the Type 1 patients with frozen shoulder had a lower mean A1c than the Type 1’s without the condition. Ironically for me, two of my three frozen shoulders have coincided with the lowest A1c’s that I have ever had.*

Frozen shoulder used to be listed on the last page of diabetic complications and was considered to be somewhat unusual. More and more it is now being highlighted as a common problem for people with diabetes and it is often listed on the front page of complications.

I am not going to give a blow-by-blow account of my frozen shoulder history. A synopsis is that my first one occurred on the left side after a shoulder injury in 2001 and was incredibly painful. Along with physical therapy, time was the biggest healer and I was about 90% healed within a year. My second one occurred about four years later on the right side. It was not nearly as painful or debilitating as the first one, but it took longer to resolve. Number three is back on the left side and I’ve had symptoms for about 6 months. I am optimistic that I will achieve at least a 90% remission.

I am not so confident that this will be my last dance with frozen shoulder.

Sue from New York is a contributing author to my blog and we are very close in age. She has written about her frozen shoulder experience in a post which will be published on Monday. It is uncanny how similar our stories are. When you read her story, you will be reading mine.

Diet Coke: Friend or Foe?

Posted on September 23, 2013 by Laddie

I have been working on the follow-up to my Food post with a detailed description of my low-carb meals and snacks. Unfortunately last week I really struggled with blood sugars. There was no way to write about a “perfect” diet because nothing about my diabetes was perfect. So I figured I would write about Diet Coke instead.

I have not had a Diet Coke since August 15. According to my iPhone goddess Siri, that is 39 days or 1 month 8 days or 5 weeks 4 days or 0.11 year. I have not had one cup, one can, or one sip. Nada.

Usually it is hard for me to give up Diet Coke, but this time it’s been fairly easy. One reason is that I spent a queasy weekend in New York City starting on August 16. It had nothing to do with Diet Coke because both my husband and I had the tummy yuks complicated by bumpy taxi rides. But somehow in my mind, the Diet Coke the day before seemed linked to my queasiness.

As someone with Type 1 diabetes, I have been fairly accepting of a Diet Coke habit. There are so many restrictions in my life that it’s been easy to ignore the caffeine and artificial sweeteners in my favorite beverage. The Internet is filled with the risks of diet soda including kidney damage, metabolic syndrome, cell damage, and rotting teeth. How much those risks are coincidental and how much is cause and effect is debatable. So make up your own mind.

What is actually my biggest concern is the phosphoric acid in dark colas. I was diagnosed with osteopenia in 2007 and spent five years on Fosamax. There are some studies that indicate that phosphoric acid in dark colas might be implicated in bone loss. I have other osteoporosis risk factors, so one might argue that I should avoid Diet Coke.

The last time I gave up Diet Coke I allowed myself one day a week to indulge with no limits on the amount. It worked quite well for several months. I played a silly little game to keep me motivated. On my digital calendar I added a daily task titled “No Diet Coke” repeating forever. The box each day was colored blue. At the end of each successful day I changed the color of the box to pink to reward my success. The box on the day when I drank Diet Coke stayed blue and was renamed “Yes Diet Coke.” After a while I got tired of doing the calendar changes. I kept the one-day-a-week habit for a while longer. But then one-day-a-week went back to three or four and eventually back to seven. Because I had never pledged to do this forever, I didn’t feel too bad about the resumption of my addiction.

When asked about Diet Coke, most of my doctors have indicated that as long as you limit it to about one can daily, the risks are probably very low. But that’s not how I drink soda. First, I don’t like Diet Coke out of the can very much. I prefer fountain soda and alternate between the 32-ounce cups for $.69 at Super America and the equivalent $.89 refills at Holiday. (It’s all about location because how far should you drive to save 20 cents?) Secondly, I don’t drink the soda all at once. I like to nurse it all afternoon and add more ice as needed. It keeps me company in a friendly sort of way. Third, as I’ve discussed when it comes to food, I don’t do moderation well. I’m an all or nothing girl.

The danger of viewing Diet Coke as a friend is that my mother always considered cigarettes to be her friend. They kept her company, soothed her, gave her hands something to do, and were there for her every day. Emphysema and lung cancer put the friendliness of her friend in doubt.

Although I like the idea of staying away from Diet Coke permanently, it likely won’t happen. I refuse to beat myself up over it or view it as a failure. I’ve got enough inner demons and don’t need to add more guilt to the list. I’m currently drinking a lot of sparkling water/club soda and enjoy that very much. But it’s not available at most of the places where I would normally get a fountain soda. When I take the grandkids to McDonald’s, I savor my Diet Coke while they play on the indoor playground and then get a refill to take home. Or I’ve been known to have a 2- or 3-Diet Coke visit with Scott Johnson at the Golden Valley McDonald’s. Iced tea is an option and might just have to do. Of course now that Scott has a new bicycle and computer, he might start wanting to meet somewhere more upscale. Yeah, right….

So today I didn’t have a Diet Coke. I didn’t have one yesterday either. But I’m making no promises about tomorrow. And that’s just the way it is.

Test Guess and Go

Even with testing, diabetes is a guess every day.

Author Archives: Laddie