December 9, 2006


I am staring at trash bags. Hmm. Trash bags.

No, I don’t need trash bags.

Do I need paper towels? Yes. Yes, I do. But I don’t feel like carrying them. Paper towels are big.

The bottles of Windex are merging into one another. It’s funny how they make Windex in lots of colors now. Something about that seems kind of un-American, even to a lefty chick like me.

I remember that what I really need is dinner. Yes. That’s why I’m in this store, even though the clerks are rude and the prices staggering. I’m very hungry. I would really like some pot roast.

I don’t know how to make pot roast. Well, I did make it once. It was good. But I don’t remember how I did it, except that it took a long time. I’d better just get something to microwave.

I need milk, too. And something else. What was it?

I’m not sure. Maybe I’ll get some brie cheese. Yes. Oh, this is expensive. Is there a small one? Why are all the numbers fuzzy? Here’s a small one. I’m really hungry. Is it okay to eat brie cheese for dinner?

Something isn’t quite right. Something.



Yes. I prop the test kit on a display of crackers. I don’t feel low. Maybe I’m too high.

61. Pish. That’s nothing.

Hey. I’m low in a grocery store.

Woo hoo! I’m low in a grocery store!

I can eat anything, anything at all.

These opportunities are rare. It seems very important to select the Best Possible Treat.

I wonder where the dark chocolate is. I picture myself blogging later about dark chocolate. You will all nod appreciatively and comment on your favorite low-busting indulgences.

I can’t find the chocolate. Maybe I should just eat something, anything. No, I should drink something. I should drink some juice. Where is the juice?

The front of the store has a cooler with bottles of everything. There should be juice there.

I wander in that direction. It’s crowded. The cooler is blocked by a line of people. I look at them. I know there are words, words I could say that would prompt these people to move. Then I could reach the juice.

Other people don’t have trouble thinking of words. I remember K and her 27 at the movie theater. That's a lot lower than I am now, but she had all the words she needed.

If I were K, I’d have words too. But I’m not K. I’m V, which is usually fine but at the moment seems a little inconvenient.

Happily, the line of people moves while I am trying to string together a few syllables. The first bottle my hand grasps is cherry Coke. Though speechless, I have the wherewithal to check to see if it’s diet. It is not. I open it and drink.

Gods. This stuff is good. So good. So effing good! I’d forgotten.

Briefly I’m thirteen again. Cherry Coke has just been invented. I am watching Monty Python & the Holy Grail for the first time ever, with my first-time-ever boyfriend. We’re eating Rocky Rococo’s pepperoni pizza.

Life is resplendent with laughter, possibilities, and carbohydrates.

I pull out of the flashback before the part where Zoot’s twin sister begs Sir Galahad for a spanking. (Way too embarrassing. Folks did not joke about such things in West Des Moines, Iowa, in 1985.) Already I feel a little steadier. I pay for my randomly selected comestibles, including the half-bottle of soda. I even remember my PIN number in the checkout line.

At home I clock in at 96. The brie is splendid.

December 3, 2006

Is That an Insulin Pump in Your Pocket, or…

…Are You Just Happy to Text Me?

(a play in three brief acts)

Dramatis Personae (in order of appearance)

Nellie: a purple Minimed Paradigm 515; successor to Charlotte

Dinner Companion: one of Violet’s recent one-date wonders

Violet: devoted owner of Nellie

Thanksgiving Ladies: Violet’s charming holiday hostess and her guests, each some thirty years Violet’s senior

Movie Companion: an entertainment-oriented version of Dinner Companion

Act I
Scene: a chic Italian restaurant in Chelsea, NYC

Nellie: Beep. [pause.] Beep. [pause] Beep.

Dinner Companion [slightly annoyed]: Texting?

Violet: Insulin.

Nellie: Beep.

Act II
Scene: a holiday meal at a beautiful colonial farmhouse in Orange, Connecticut

Nellie: Beep.

Thanksgiving Lady #1 [peering into Violet’s lap]: What is that thing?

Nellie: Beep. [pause] Beep.

Violet: It’s an insulin pump…

Nellie: Beep.

Violet: …for diabetes.

TL #2: Oh, I thought it was a cell phone!

TL #1: So did I.

TL #3: So did I!

TL #4: Is it all right that you’re eating pie, dear?

Scene: a movie theater in Gramercy

Movie Companion: [yawns, stretches, and casually drops arm around Violet. Very high school.]

Violet: (!)

Nellie: …

Movie Companion: [unintentionally gropes Nellie, who is clipped to Violet’s waist]

Violet: [face contorts as she suppresses urge to snort]

Movie Companion: …

Movie Companion: [removes arm from around Violet]

Nellie: Beep!

November 27, 2006


And to make an end is to make a beginning.
The end is where we start from.

--T. S. Eliot, "Little Gidding"

For almost two years Pumplandia has served as an outlet for my frustrations and hopes as they pertain to diabetes and to life in general. It has helped me connect with brilliant writers and compassionate human beings--and even, almost miraculously, a few individuals who are both. To some extent, I hope, this site has also been a public resource for PWDs and those who care about them.

Recently, the actions of one person have presented me with a difficult choice between writing this blog privately or not at all. (This individual isn't part of the OC; it's a personal matter.)

Discontinuing the writing isn't an option; my connections to this community are too important to give up. Pumplandia will therefore be shifting to an invitation-only format over the next week. Friends and known members of the OC will receive an invitation via e-mail with instructions on how to access this page. (Unfortunately, use of the invitation requires a Google account, which is free but may be irritating to some folks.) I am also happy to share access with verified medical personnel, researchers, industry types, ADA/JDRF folks, and so forth.

If we’re pals and you don’t receive an invite by 12/4, please drop me a line, as it’s surely an oversight.

If you’d like to continue to read Pumplandia but are not known to me by an e-mail address, please write to and introduce yourself. If we aren't already acquainted, please include a reference to a mutual friend or active member of the OC who will vouch for your identity, or a verifiable professional credential related to diabetes. I regret that I cannot invite readers who lack a reference of this sort.

My hope is that all the people who are meant to read Pumplandia will find their way back to it over time. Thanks for your interest and support.

November 12, 2006

Moderation in all things...

...including moderation.

I realized this morning that the reason I haven’t posted for a while is that I’ve been feeling sheepish.

Lately I can’t seem to follow the rules. Recent posts include the occasional reference to donuts. I left out mention of the scones, pancakes with syrup, dark chocolate, toffee, fried everything, Chinese food with luscious sweet sauces, pecan pie...

Pecan pie!

I hadn’t eaten pecan pie for more than two years. (It’s still good.)

These various excesses have left me of late with numbers somewhat above average, to put it gently. It’s partly the choice of foods and partly the sheer difficulty of guessing how to cover them. Which reminds me of another interesting phenomenon: my usual habit of estimating carbs on the high side out of preference for lows over highs has fled. I keep taking too little.

I could chalk all this up to stress or travel, but I’ve had plenty of periods of stress and/or travel in the past. I’ve kept pretty well to my food guidelines for most of them. Something different’s going on.

I think there’s a need to rebel now and then, even for compliant Violet. Maybe especially for compliant Violet. Truth is, if I had to believe that I could never binge again for the rest of my life, I don’t know how I’d cope. The world of food is too replete with pleasures to concede them all forever.

It’s a better strategy, I know, to have a little treat now and then as opposed to an enormous one every day (or twice a day, ahem). The former is my usual way, and I’ll get back to it soon, if for no other reason than that I’m starting to feel binged out. Yet I think there’s something to be said for claiming an audacious freedom now and then. It reminds me that I’m still alive in ways that can be measured by means other than an a1C test. It reminds me that control is a choice—yeah, the right choice, but still a choice, not an absolute, not a prison.

It reminds me that while I may have this silly disease, it doesn’t have me. Huzzah! And I mean that in a most immoderate way.

October 26, 2006

Notes to self

1. Do not transport POC meter in bag next to frozen lunch entrée. POC meter refuses to operate at temperatures below [insert random number between room temperature and that of a frozen lunch entrée]. When you find yourself going low on the subway, you will be unable to test and will have to make a random guess as to how many glucose tablets are needed to retrieve yourself from the hypoglycemic brink. By the time POC meter regains room temperature, it will mock you with a number well over 200.

2. Stop eating donuts.

3. Remember to take insulin with carbohydrates. (Ahem? Hello? Diabetes, anyone?) You do this by pushing the buttons on that purple thing. You know, the life-saving medical device attached to your body? Yeah, that one.

October 21, 2006


When you truly possess all you have been and done, which may take some time, you are fierce with reality.

--Florida Scott-Maxwell

How I love that phrase: fierce with reality. Fierce! Check that out. Yeah, I’d like to get me some of that.

Okay, what do I do again? Truly possess all I’ve been and done?


That sounds uncomfortable, to say the least. Just for starters, I’d have to acknowledge that I ate a not insubstantial donut yesterday. (75 g of carbs. 75!) And it’s a pretty slippery slope from there, believe me.

Still...fierce. Hmm.


Donut jests aside, this fierceness project has preoccupied me ever since my ex and I split up. What I've wanted is to reach a new understanding of myself, a more profound and nuanced sense than I currently have of how I came to be at this funny little crossroads in my funny little life.

I didn’t have sufficiently apt words for this quest until last weekend, when I started rereading William Bridges’s The Way of Transition and found the above quote used as an epigraph. Aha, I thought. Here’s the thing I’m trying to do. And how gentle a caveat: “may take some time.” Yes. It does.

In a perhaps unsurprising way, given whose brain we're considering here, I find it’s easier to possess the things of which I’m ashamed than those of which I’m proud. Gargantuan Mistake #16, Shameful Error #42, Self-Absorbed Foolishness #23--these and others stand out in sharp relief against the occasional Violetine accomplishment or act of kindness. The myriad ways in which I’ve hurt myself and others simply WILL make themselves known at every opportunity. What cacophonous voices those little buggers have. They yell a lot.

Which brings me to today.

Two years ago today, I was diagnosed with diabetes. (The story of that week is archived in three parts: here, here, and here.) Looking back over these two little years that feel like ten--two years during which, not so incidentally, I made a new life and then participated in its crash-and-burn free fall--I realize that possessing all I’ve been and done in relation to this one small area of diabetes entails much more pride than shame.

There, I said it.

Pride because: I read and learned; I changed my diet not to the point of perfection (witness the aforementioned donut) but at least to a point where I could thrive physically and mentally; I found a way to connect with others that not only feels true to my natural introversion but even nurtures it; I started on the pump despite its numerous accompanying anxieties; I was afraid; I was brave; I persevered.

These aren't small things to have done and been. They're rather significant. A lot of them are choices I could have made differently.

Diabetes being only one small part of my life, I have many other things to ponder, understand, possess. But today I'm willing to celebrate a few small victories and to feel a bit fiercer thereby.

October 17, 2006

In which I overthink a new topic

Pursuant to #11 below, I’ve been looking into volunteer possibilities.

Well, there’s no place to start like the glaringly obvious: diabetes. The OC is full of people who are doing their part. Am I?

If by “doing my part” you mean whining periodically or perhaps chronicling my awkwardness, then yes--yes, I am. Otherwise, well...not as such.

It’s clearly the right thing to do, to contribute time and energy toward the causes of helping people cope, helping to raise money for the search for the Shmure, and so forth. Couldn’t begin to argue against it. But there’s a wall of (self-centered, irritated, irritating) resistance within me.

I think it’s an internal tension similar to the one described here. There’s a continual negotiation between Diabetic Violet and the Rest of Violet over how many of my waking hours I’m willing to sign over to this disease.

Diabetic Violet (hmm, perhaps she should be Violet with Diabetes out of respect for folks who hate “diabetic”?) knows that making a positive contribution to D-related causes would be a healthy—dare I say mature?—adaptation to my circumstances.

The Rest of Violet does not want to be quite that diabetic (have quite that much diabetes???), thank you very much. She’s shooting for the middle ground.

VWD points out that I’m always whining about isolation, about not knowing enough nonvirtual people who are tackling the same issues I am. D-related volunteer work is an obvious way to change that.

ROV does not want diabetes to become the mainstay of my interactions with other humans. Period.

VWD thinks ROV is in denial.

ROV thinks VWD is a priss.

OCers, where are you on this subject? (Um, not the question of whether VWD is a priss. The volunteering thing.)

Happily for both Violets, one can have a positive impact on the world in quite a few ways, huzzah! So for now I am shelving the question. I’m attracted to working with animals or maybe, if I can pull together the emotional fortitude, something like this program, which provides companionship to people at the end of life.

ROV figures diabetes will be around a while longer, after all. She will still be needed when she's ready.

October 7, 2006

Commitment to reality

I’ve been pretending to myself, these days, that I’m not paying attention to research. I pretend I’ve accepted and adapted. Cure, shmure. I’ll be delighted if it happens, but I’m not holding my breath. I am fine; I am strong. I cope, I manage, I deal. I am Getting On With My Life; I possess a Healthy Detachment.


It’s come to my attention that what I actually do, these days, is to glance sidelong at the research news, pretending not to look but in fact making quiet note of every development. (It’s an interesting talent, reading websites without consciously acknowledging that I do so.)

I’ve had to confront my tendency toward surreptitious monitoring after last week’s news that the Edmonton protocol is essentially a flop.

In a nutshell for the non-D-obsessed, this experimental procedure entails a noninvasive transplant of islets, those little jobbers in the pancreas that make insulin in a healthy person. In type 1, the immune system mistakenly eradicates the insulin-producing cells, leaving their former owner with diabetes.

So: insert happy, functional islets from organ donors, salt liberally with immunosuppressant drugs, cross fingers.

Variations on this procedure have been attempted for years with limited efficacy, but the most recent study had encouraging results at 1 year following transplantation. About half of patients were manufacturing all the insulin they needed, and a large percentage of the other half were manufacturing some and achieving improved blood glucose control thereby.

Last week brought the news that at the 2-year mark, only 16% of patients were still functioning without insulin injections. It seems that the immune system continues to recognize the islets as invader cells and systematically destroys them. Unless/until more effective immunosuppressant drugs can be found, the Edmonton protocol is not a viable cure.

Certainly I had no conscious fantasy of ever receiving a transplant and a cure via this process. I’m more realistic than that.


I’ve written elsewhere about my mind’s habit of making contracts with the universe. What I realized this week is that I’ve done it in this area as well: If I do my job as a patient and forge ahead with gentle optimism and courage and blah blah blah, if I extend myself toward other PWDs and do my bit to help us all cope, I (and the rest of you) will be rewarded someday, someday, with the cure.

Truth be told, there is no such contract. There are no guarantees. Optimism may be mentally healthier than pessimism(?), but none of us can know if or when a cure may be found. There’s a tightrope to walk here—I suppose it’s properly called realism—that lacks the comforting safety net of my previous subconscious understanding with the universe.

So it’s time to renegotiate. What it must be, all it can be, is something like: If I do my best to take vigilant care of my diabetes, if I do my best to connect with others in my situation, I will be as physically and mentally healthy as I can be for as long as possible. In the meantime, a cure may or may not be found.

Bah. I liked the old contract a lot better.

October 1, 2006


I recognized her from the back: a logically impossible feat because, as Kerri observed moments later, there are no butt shots posted over at Six Until Me.

Maybe it was the hair. Maybe it was the “oh crap, I’m looking for someone I’ve never met in Grand Central Station at rush hour” posture. Somehow I just knew: here she was, the gifted writer and sensitive, hysterically funny soul whose blog has enriched my life for what must surely be hundreds of posts by now.

I hurried over and said her name. She turned. “Violet?” My name isn’t really Violet, as K knows, but who I could really be other than Violet, to her? (For me it was a moment of secret wish fulfillment, as my nom de keyboard is what I would have named myself, had the choice been mine.)

Being of a quiet disposition, I had wondered if this meeting would feel awkward. No such thing. We hugged and babbled and laughed as we forged our way through the crowd to an exit. Wandered down Lexington, found a diner. I was on Day Five of my attempt at vegetarianism, so I ordered a portobello mushroom and cheese sandwich. For the balance of the evening, I glanced enviously at the bits of turkey on K’s chef salad. (I made it, for the record, to Day Seven, then capitulated to carnivorous longings. Last night I actually dreamed of steak. Medium rare.)

We talked and talked, nonstop. I described the Winter, Spring, and Summer of My Discontent and their numerous reverberations. We discussed the challenges of moving to a new place. We pondered the exhilarating weirdness of New York. We talked about blogging, what it means to each of us.

And of course we talked about diabetes. K had received bad news. I admired her attitude: frank, honest, unsettled but absolutely unwilling to be defeated.

The legendarily cool and compassionate Chris joined us for the last half hour. He’s real, girlfriends! My gosh. It’s not often in my current life situation that I’m around people whose love for one another simply shows in all their words and gestures. K and Chris are two such people. Meeting them both was a gift, a warm and heartening interlude during a time that’s been, often, less than reassuring about the questions that plague me around true love (is it even possible, does it last, how will I ever find it for myself, etc etc, ad nauseam).

Isolation is one of the hardest aspects of this disease for me. Here’s to its eradication.

September 24, 2006

Subject line: Feet

Since I began living alone again, my mom has called almost every day—so often, in fact, that when I don’t hear from her I wonder why.

She likes to keep in touch. And she wants to know how the transition is unfolding, how I’m liking the new neighborhood, whether the money part is going okay.

But mostly she calls so often because she’s haunted. She can’t shake the fear that I’ll have a nighttime hypo I can’t wake up from, no one will know I need help, and I’ll end up dead in bed.

“Just checking to see if you’re on your feet,” she often says to my answering machine, usually after calling me at the office and not getting an answer for some reason or other. Her voice—a lilting Virginian singsong that’s always signaled “home” to me, even though I’ve never lived in Virginia—sounds just a little more cheerful than necessary. “Give me a call.”

It’s been not even two years for Mrs. Violet, just as it has for me. We’re still neophytes in several respects, including how to cope with the mercurial nature of this disease. But I don’t have trouble with hypo unawareness. And I follow the drills we all know: test before bed, eat snack if needed, test during the night now and then. I watch my basals (currently 0.15 overnight, what the hell?) and tweak as needed.

I take care of myself, I’m not afraid, and I’m not about to die in my sleep. (We all have to believe that, right?) That works for me. But for a parent? Harder, much harder, it seems. And Mrs. Violet is a person for whom the wolf is always at the door.

I think I’ll begin a practice of daily morning e-mail. Subject line: feet. Text: Good morning, I’m on them, I love you.

It’s the least I can do for the one person in my life whose voice sounds like home.

September 20, 2006

Change is complex, or, A conversation with my colon

Violet's colon: Rumble. Grumble.

Violet [concerned]: Everything OK down there?

V's C: Rumble. Rumble. Grumble.

V: Hmm. I sense a disturbance.

V's C: We are displeased.

V: We?

V's C: We do not like some of the gifts recently offered to us.

V: Us? What are you, a collective? Like the Borg?

V's C: We accept the offering of bread. The oatmeal we also accept. Meats and cheeses we acknowledge as appropriate gifts.

V: ...

V's C: But what is this thing called "fruit"?

V: Ohh. That. Right. Well, fruit is tasty and full of nutrients and fiber. It's good for us. Err, good for me.

V's C: We do not like this "fruit."

V: You'll get used to it. I promise.

V's C: It disturbs us. It causes distress.

V: Well, that's really my fault. You see, I didn't eat much fruit for a long time, so you got out of the habit of dealing with it, and now I'm trying to make changes--

V's C: Fruit is your fault?

V [alarmed]: Um--

V's C: We do not accept the gift of "fruit."

V: Well, you have to. It's your job.

V's C: Grumble. Rumble. Rumble.

V: Aww, come on. Fruit is Nature's Dessert!


V: ...


And so the negotiations unfold. I guess this may complexify my recent interest in vegetarianism...

September 17, 2006

Things I learned this evening

1. I may be bionic, but I am not in the Universe for the purpose of using power tools.

2. Especially drills.

3. A crooked coat rack is better than none.

September 15, 2006


In a continuation of our assualt on the Other D, Dr. Two-Fifty graduated me to a Big Girl dosage of generic Zoloft 10 days ago. (It’s pale yellow, for anyone who shares my fascination with the antidepressant rainbow.)

A lot has changed:

1. What is this current of vitality flowing through my body? How come I keep thinking about going dancing at Culture Club, the cheesiest club in New York? Oh, right: energy. That thing that makes walking places enjoyable instead of a truncated death march.

2. Aha, I AM creative. Who knew? I, for one, had entirely forgotten.

3. Hello, intellectual curiosity. I remember you.

4. Greetings, sex drive. I remember you too. Vaguely.

5. Nonbloggable thoughts, don’t let the door smack you on the ass on your way out.

6. I can name my emotions and inhabit the painful ones without feeling instantly compelled to numb them via external means (TV, food, glass of wine, computer games).

7. I feel gentle toward myself.

Whoosh. This is a lot of change. Am I, for lack of a better term, hopped up on goofballs? I phone Dr. Two-Fifty to present my concerns.

“I think maybe we need to decrease the dosage,” I say. She asks why; I present the above.

“Are you behaving impulsively?” she inquires. “Spending a lot of money, or making sudden decisions, or placing yourself in dangerous situations?” She’s wondering if I might be having a manic episode, which is not part of my history but could be triggered by an excess of this type of medication.

“No,” I say. “Nothing like that. But I feel kind of buzzy.”

“Here’s what I think.” Dr. Two-Fifty sounds quite perky. “Maybe the dosage is too high. But all the things you describe are suggestive of recovery from depression.”

“Oh,” I say. “Right.”

“The buzziness may go away in a few days. If it doesn’t, we can reduce the dosage—but I don’t want to reduce it unless we have to, because it sounds like it’s helping you. Call me on Monday and we’ll see how you’re doing.”

Sure enough, two days later I am feeling less buzzy.

I’m not giving the medication all the credit for these transformations. I’ve been working hard to help myself in other ways—therapy, writing, making huge and painful life-changing decisions, opening up to people more than before. Maybe it’s all beginning to come together.

I worried about the trampling of my personality, of some essential Violetness, via antidepressant medication. But I don’t feel less like myself. I feel more like myself. I feel connected to myself and to other people. I feel aware.

It’s pretty cool, to put it mildly.

September 13, 2006

No poetic title comes to mind

Mrs. Violet has prediabetes.

Son of a b*tch!

Already I feel this irrational (?) urge to defend my mother from the blamers. No, she’s not obese. Yes, she struggles with her weight and with exercise. No, she doesn’t pig out on a daily basis. Yes, she overeats now and then. Piss off.

I know two other people who have been faced with this situation. One of them, my oldest friend, made major, very challenging changes in her diet and exercise patterns and got her fasting BG down to 80ish. The other, my ex, has ignored the problem for a year and a half, though he has type 2 on both sides of his family and lost his dad to complications.

Two paths, two sets of choices.

I wonder about other paths. Is there a path in which the PWP tries her damnedest, but her efforts cannot stave off deterioration into D-Land? Yeah, I bet there is. How about a path in which supreme effort leads to only temporary improvement? I bet that path exists too.

Then again, at least there’s a chance, however uncertain, for Mom to make a difference through her own efforts. As a type 1, I didn’t have that opportunity. I wish I had.

When I was diagnosed, the words tumbled out of her mouth like a confession: “Diabetes is the disease I’m most frightened of."

A few months later, she apologized. “That probably wasn’t what you needed to hear at the time,” she observed.

“Well,” I answered, “I needed to take it very seriously, and you helped me do that.” And she did. Maybe I can do the same for her now.

September 12, 2006

Food for brain & soul

Pursuant to #5 below, some nonfiction I’m reading:

Five Flights Up and Other New York Apartment Stories by Toni Schlessinger: an anthology of her Shelter columns from the Village Voice. Interviews with denizens of the city in and about their homes. At once fascinating, comical, and comforting as I adjust to my new quarters.

The Hard Questions for an Authentic Life by Susan Piver: bought long ago and allowed to collect dust on bookshelves in two states. Its time has come. Fantastic, thought-provoking questions about many areas: family, friendship, love, spirituality. Very clarifying.

On Becoming a Person by Carl R. Rogers: Published in 1961 by one of the revolutionaries of modern psychology, an argument in favor of what Rogers terms “client-centered therapy,” in which the patient and therapist build a healing relationship. This is hardly news 45 years later, but it was radical stuff when written. What intrigues me most about this book is (1) how courageously yet humbly Rogers puts forth his ideas and (2) how the journey of self-discovery he describes brilliantly articulates what I hope to gain from my own therapeutic process.

And pursuant to #14, after considerable overspending on iTunes, I offer a few songs for inspiration of many kinds:

Colin Hay, Beautiful World: a paradoxically melancholy celebration of simple pleasures. I'm so charmed by this song that I listened to it at least 6 times before I realized/remembered (well, okay, I actually read it online, but then I remembered, truly I did) that Colin Hay was the lead singer of Men at Work. How mortifying to my distinguished lineage as an 80s pop junkie that I didn't make the connection immediately! Bonus: one of the verses is about tea, my favorite nonalcoholic beverage.

Joey Ramone, What a Wonderful World: Whoa, this song rocks. Irresistible. NB: Not for gentle moments.

REM, Find the River: Opposite mood. "You have to go to task in the city, where people drown and people serve...Don't be shy, your just deserve is only just light years to go." This song was mysteriously written about Violet’s journey to New York to open an office for her company years before the fact. Isn’t that remarkable? If I could be reborn as any psychic gay man on the planet, hands down I would pick Michael Stipe.

Smashing Pumpkins, Tonight: “Believe, believe in me, believe...that life can change, that you’re not stuck in vain, we’re not the same, we’re different tonight…We’ll crucify the insincere tonight...Believe in me as I believe in you tonight.” Wow. Sign me up.

The Slip, Even Rats: Click the link to hear this beauty for free. Then go pay Apple a buck to download it. It's only fair! Confession: my exposure to this one came via Guitar Hero. (Yeah, I beat it on Expert. I’m not at all sure what this says about me, but there it is.) I absolutely love this song. Something brilliant going on in the brain of whoever wrote it. A spot-on political message, too.

10,000 Maniacs, These Are Days: “These days you might feel a shaft of light make its way across your face...and when you do, you’ll know how it was meant to be, see the signs and know their’s true, you’ll know how it was meant to be, hear the signs and know they’re speaking to you.” Natalie, she can seriously tap into those agnostic yearnings, yes indeed.

Finally, three delectably fluffy treats from my growing-up years:

Big Country, In a Big Country: Does anybody else remember how frickin' cute the lead singer of this Scottish band was? You know, in the video with the gorgeous green fields and cliffs and suchlike? Tell me I'm not the only one who remembers.

Nenah Cherry, Buffalo Stance: "No moneyman can win my love, it's sweetness that I'm thinkin of." Love this beat. Ten points to anyone who can explain to me what a buffalo stance is. I was never cool enough to know.

Tom Tom Club, Genius of Love: Just. Plain. Fun.

Any suggestions for my next reads/downloads?

Reasons for blooming

I used to blog almost exclusively about diabetes and other health issues. I shared my ideas about other topics in different ways. Or I didn’t share them at all.

I liked the compartmentalization: it felt safe, tidy, to do most of my diabetes-related processing in cyberspace, anonymously. In the 20 months since my first post, only three people who had met me in real life knew that this was my blog. One is a close friend. Another is Scott, whom I met in my pumpers’ support group in Minnesota and whose blog inspired this one. The third, my ex, never read anything I wrote here, seemingly because he felt so much anxiety in relation to all issues medical.

Grow or die, right? OK, fine! I pick growth. The landscape of Pumplandia, as a blog and as my way of living, is changing. I’m starting to meet D-bloggers in person for the first time. Those folks already know the online me, and soon they’ll know the “real” me as well. I’m also sharing my blog with a small number of other people, some new to me and some not at all new, for the sake of openness and authenticity.

With these shifts and the many other changes in my life, I no longer want Pumplandia to be so compartmentalized. I’m remaining anonymous, and diabetes will always be a major focus here. But I’ll no longer limit my posts to issues relating to health. As in my recent posts, a lot more of the Whole Violet will appear. I’m a little freaked out about this--who gives a rip about your weird-ass life, says an evil, simpering little voice in my brain--but I’m mainly looking forward to sharing more of myself with the kind and brilliant OC, in all its richness and variety. Thanks for reading this far. You guys are helping me stay sane.

Violet, Subway Spy

This happened a number of weeks ago, not long after the Mr. Bright Eyes episode, but I didn’t manage to post about it at the time:

On the F train again, morning commute, sleepy but lucky: today I have a seat. One of the things New York has taught me is that my sense of personal space is, or rather can become, considerably more flexible than I once realized. When I first began taking the train during rush hour, it killed me to be squashed up against other passengers. Now it only kills me if the people I’m squashed up against are screaming at or (actually, if you’re a stickler for accuracy: and/or) making out with each other, happily an uncommon occurrence.

My adjustments to the demands of rush hour notwithstanding, any train ride with a seat is a ride that begins well. Today I am squashed only in the sense that I’m between two men who can’t really help that they are larger than the 16-inch ass space allotted by the geniuses who designed the subway cars. Oh, and in that the woman standing in front of me, pole-hanging, is on the verge of depositing her briefcase in my lap. This makes it a little hard to solve my sudoku puzzle.

I give up and start people watching. Foggy, peculiar Violet isn’t terribly good at sudoku anyhow. (NB for readers sharing the battle against the Other D: the regained ability to complete sudoku puzzles in the hard and expert categories could be a sign that your antidepressant is working! Stay tuned for further updates.) Next to me is a youngish fellow, early 20s, with an Eddie Bauer vibe: semi-casual but neat, khakis freshly pressed, highly presentable. I commence a game of What Job Is This Person Going To? and decide he’s a summer intern at some corporate entity where he is permitted not to wear a tie. He looks like the kind of fellow my mother wishes I had dated in my young adult years instead of, well, the fellows I did date.

Along with his smart workday-casual ensemble, Eddie Bauer has on one of those rubber bracelets that hipper-than-Violet people wear in support of their favorite causes. I strain to make out the lettering without seeming to be staring: ETES.

Hmm. As in…? Yes. When my neighbor turns the page of his New York Post, the message reveals itself: CURE DIABETES. How agreeable.

There are many reasons, I suppose, that a young, Eddie Bauerish guy might be wearing a diabetes bracelet. But one reason in particular comes to mind. I check out the opposing wrist. Aha. A chunky gold medical ID. And there, twining out from his pants pocket over his belt and back under his clothing, too subtle to be detected by anyone not looking for it, is a teeny-tiny length of tubing.

Eddie Bauer, it appears, is a pumper who prefers not to cut tubing holes in the linings of his pockets.

Immediately I feel a bizarre but earnest solidarity with my fellow traveler. Here we are, a pair of strangers on the same path, bumping into one another by chance. It’s been so long since I spoke in person with a PWD other than my therapist that I consider the Big Reveal. But I remember, too, how disconcerting and invasive it was for me to have my diabetes called out in public at a moment when I wasn’t ready for it. Eddie Bauer, with his sporty bracelet, might not see it that way, but I’m not about to presume.

Nor can I connect with him more subtly via taking out my own pump, as it’s tucked away under my skirt. I briefly ponder a gratuitous revelatory blood test, but the proximity of Pole Hanger with Briefcase would make that extremely awkward.

Instead, I sit quietly amidst the roars and rattles of the train, enjoying this moment of proof that I am not alone, not at all alone, even in the thick anonymous crowds of the rush hour.

For those who are wondering, by the way, Eddie Bauer was considerably cuter than Mr. Bright Eyes. Score one for Team D!

September 8, 2006

24 Things That (Mostly) Do Not Fit in Boxes, or, Recultivating a Violet

Goals, small and large, short term and long, for my life in my new home. Like the things that do fit in boxes, these appear in no particular order of importance:

1. Diabetes: see Walking, Food below. Visit blogosphere more consistently. Find support group?
2. Cats: pet numerous times daily
3. Dogs: visit dog park near office whenever possible
4. Brain: read some fiction every day. Try to pick something not related to work.
5. Brain II: read some nonfiction every day, also not related to work
6. Sunlight: ½ hour of natural light per day is proven to help combat the Other D
7. Therapy: obviously still called for, ahem
8. Exercise: buy athletic shoes that Do Not Hurt. Attempt to walk in them regularly.
9. Food: fruits, veggies must return
10. Creative work: do The Artist's Way, for real this time
11. Service: start a consistent practice of doing something helpful to my new neighborhood/its residents
12. Political: contribute time, money, ANYTHING to the effort to keep this guy’s cronies from succeeding him in office
13. Spiritual: ponder. Investigate.
14. Music: more & new urgently needed. iPod on subway = happier Violet.
15. Work: catch up (heh).
16. Money: send that stuff in for insurance reimbursement. Use budget software. Think about needs vs. wants in spending. Contribute to a worthy cause.
17. Home: sweep up the cat hair a little more often. Hang the coat rack. Enjoy the quiet.
18. Culture: partake regularly of New York. Find freebies.
19. Family: call Mrs. & Brother Violet more often. E-mail that cousin who lives in NY. (Why? Well, to get Mrs. Violet to quit bugging me about it, if nothing else.)
20. Friendships: take active approach to nurturing
21. Sex: not at the moment, thanks for asking.
22. Gratitude: increase. Not the stuffy, forced kind. The real, joyful, “Morning Has Broken” kind.
23. Awareness: increase exponentially. Remember relationship between journaling & consciousness.
24. Fun: will hopefully follow naturally from all of the above?

August 31, 2006

24 boxes

If you had to put your worldly goods into 24 boxes, what would make the cut? (Not counting pets. Or litter boxes. Or cat carriers.) Here are mine, fresh from moving to a new studio apartment this week and not in any order of importance, as will quickly become obvious:

1. clothes (big huge wardrobe box)
2. clothes, shoes, purses (ditto above)
3. things Mrs. Violet, my mother, calls “linens” (and I call towels & sheets)
4. 4 big plates, 4 small plates, 4 tea mugs, some Tupperware, utensils, a few wine glasses
5. a cookie sheet, a casserole dish, a stock pot, a skillet, canned food
6. books to keep nearby at all times
7. more of same
8. books to store up in the loft
9. more of same
10. more of same
11. diabetes supplies & sundry medicine cabinet junk
12. CDs & DVDs
13. stuff that belonged to my dad before he died
14. letters & photos
15. precious objects (commonly referred to by the highly inadequate term “knickknacks,” humph. Include little animal figurines kept since childhood, candle holders, incense-burning equipment, & my house fairy from cherished friend & blog reader V.)
16. more precious objects
17. dolls & stuffed animals kept since childhood
18. journals written sporadically since 5th grade, which Mrs. Violet is charged with burning (NOT READING) in the event of my death
19. more journals
20. more journals
21. computer & associated gizmos
22. cat supplies + misc stuff such as extension cords
23. pictures, the hang on the wall kind
24. misc stuff (my one screwdriver, cleaning supplies, jewelry box, batteries, flashlight, all the stuff I now have nowhere to put)

Things that didn’t make the cut:

1. About a third of my clothes, maybe half
2. Half of my books
3. Most of my kitchen stuff and all of Mr. Brooklyn’s, since he didn’t take his when he moved out
4. Some CDs & movies
5. The wedding china & crystal & flatware I have dragged around the country since getting divorced (that would be the ex before Mr. Brooklyn)—not because I wanted them but out of mom-related guilt, as Mrs. Violet loves them & never had her own. (She’s taking the crystal.)
6. Certain precious objects that weren’t really all that precious and/or made me cry to look at them (reference #3 & 5 above)
7. A LOT of misc stuff that I really just didn’t need, such as the flute I hadn’t played for 15 years, board games that never got played at all, snow boots from my Minnesotan days

Finally, things I learned:

1. I need less than I thought. I hope.
2. It’s more fun than tragic to have a moving sale. My moving sale suggestions: Price things very low for good karma. If you live in a melting pot area, count the number of languages and accents you hear at the sale. Observe that it feels better to see your things go to people who will use them (or resell them for a profit, ahem) than to hoard them. Invite your most heart-tugging customer to come back at the end and take unsold things for free.
3. A moving sale can be cathartic. You can free yourself of baggage of various sorts by removing objects from your life.
4. Even so, there is a real and sometimes deep sadness to divesting oneself of things that hold or once held significance. This should be named and honored along with the other aspects of the process.

August 17, 2006

Psychopharmacological-istic-whatever, Part II

Thank you all for the supportive comments below. It’s very heartening to reconnect with the OC.

The kind Dr. Two-Fifty, after much nodding and compassionate murmuring, is switching me to Zoloft. It’s light blue, so I’m immediately biased in its favor vs. the pea green hue of Cymbalta. (Yeah, I do realize the inherent absurdity of ranking antidepressants by color. It’s just something I have to do.)

The next four weeks will be wacky, as they include tapering down Cymbalta + ramping up Zoloft at the same time. Dr. Two-Fifty instructs me to expect to feel a little weird and not to give up hope. Okey-dokey.

I’ll be distracted during the interim by the process of moving, as my oversized cats and I are heading for Manhattan. We have rented 150 cozy square feet of studio apartment in a charming, eclectic neighborhood. The rent is a mere (ahem) $350 more per month than I paid in 2005 for 600 square feet in Minneapolis. For New York, this is considered a steal. Mrs. Violet (my mom) is coming to help, and I can’t wait to see her.

My numbers are a little weird, trending to the low side. Is it really possible for an adult to need less than .20 units per hour for overnight basals? I guess it is. I forget, too, that I’ve been doing a lot of walking for the apartment search. That’s probably a huge factor. I’m grateful not to be running high, but I did test at 67 at 3 AM the other night. That hasn’t happened since I lived alone, pre-Mr. Brooklyn, so I’m a little anxious. I had a good snack last night and woke up at 83. It would be nice, wouldn’t it, to not have to worry about this stuff during big stressful life changes?

August 13, 2006

Trials and errors

This has been a fairly rough [insert block of time of your choice: week, month, season, year, century] so far, and I find myself—no surprise here—struggling with small and large tasks relating to the physical world. This is a longstanding Violetine trait; it simply gets a little worse when I’m stressed. Today, for example, not long after burning myself over the eye (literally: on the eyelid & surrounding territory) with the curling iron, I took a peek at Nellie’s status screen. I found, much to my chagrin, that I had gone six days without changing my set. Six! Hmm. I had no idea. I need to set up a reminder system on my calendar (ha) or take some other constructive action (heh). Otherwise I’ll wind up with some kind of hideous infection.

I went off the pill recently. Not trying to have baby; just not in need of the pill. Enough said? Yes. As noted here, the use of BC pills has a significant effect on my insulin needs. Basals & carb ratios have gone down for 2/3 of each day. I’m now using a remarkable 25% less insulin over the course of a typical 24 hours, and I still woke up at 78 this morning. (NB: I am NOT complaining. I am delighted.) I have yet to figure out how unusual/usual this phenomenon is among PWDs, but my first appointment at Naomi Berrie is coming up soon, so I’ll throw this question at them and see what they think.

Meanwhile, my adventures with Cymbalta are coming to a close. Dr. Two-Fifty and I have concluded that it isn’t helping enough with the other D. She’s going to put me on something else, but she wants to see me in person first. I’m sure she’ll be impressed with the curling iron burn, which looks like someone relatively feeble tried to give me a shiner.

Last but definitely not least, I send bouquets of flowery purple support to Lyrehca, who awaits very important news this week. Send her your good thoughts, please.

June 19, 2006


This morning at work I was feeling a trifle low, so I went digging in my bag for my piece-of-crap meter. It wasn’t there.

Hmm. I reviewed my steps that morning. Had the meter gone into my bag? I couldn’t be sure. I looked in the bag again, ferreting through its many pockets. No meter, piece of crap or otherwise.

Well, for crying out loud.

I’ve done this before, of course. I’ve left my meter at home, at work, in an airport. (I have a backup at home, none at the office. Foggy, peculiar Violet in action.)

I’d never been in a situation where I felt low and couldn’t test. The most straightforward solution--consume a lot of carbs--would probably leave me over 300 by the time I got home or obtained another meter. So I tried to assess my lowness by feel. It wasn’t a bad one, at least not yet. Just a little shaky. Reminded me of when I get symptomatic in the 70s.

I ate two Milk Duds (4 g). That was all I had in the box. I ate one glucose tablet (4 g). I contemplated going to the fridge for juice. Decided to wait.

A few minutes later, I felt normal again. Then I felt a little nauseated. Maybe I hadn’t been low after all, in which case I should take some insulin. No, no. Foolishness.

Online, I researched the NIP formulary. Hardly any brands of test strips are approved. I decided to buy a One Touch Ultra Smart. Looked for coupons online. No luck.

I spent the next two hours feeling sorry for myself (well, also working a bit). Meters aren’t cheap. I know better than to go out without my meter. Stupid diabetes. Stupid forgetfulness. Stupid everything.

Finally, I dragged my ass down to Walgreens. The meter of choice happened to be not only in stock, but hugely on sale. It only cost $30, plus $26 for test strips. Maybe NIP will reimburse me, though I don't have a prescription yet.

The OTUS is clearly much better than the piece of crap, with many customizable features that I will probably never use. POC will become my office backup.

I tested at 105. Phew.

June 2, 2006

Observed on the F train

Yesterday, while hanging on to a pole during the subway ride to work, I noticed a shiny-eyed young fellow in a business suit watching me with a rather animated expression on his face.

I am not, to place this event in context, of an appearance or personality that generally attracts the attention of men on trains. I have my charms, I think, but they are the subtle, quiet kind. I move through the world relatively unnoticed most of the time.

I glanced away from Mr. Bright Eyes, then back again. He looked away quickly. Caught!

A moment later, it happened again.

Hmm, I mused. Perhaps this is not such a bad hair day as I’d thought. Or maybe the Cymbalta has already added a mood-disorder-treatment-in-progress glow to my countenance.

Then I realized that the man wasn’t looking at me. He was looking at Nellie.

When I wear a dress, I usually stash my pump in a thigh pouch I got from Minimed, which has an elasticky band with an adjustable Velcro closure. But I have a few dresses that are cut such that I can conceal the pump in the side of my bra, under the strappy part that goes around the ribcage. It’s easy to pull out (in private) for dosing, and when I’m standing, sitting, or lying down, my arm covers the pump, rendering it almost invisible.

When I am hanging on to a subway pole high above my head, however, I appear to have an absurd rectangular attachment bulging under my clothing, inches to the right of my not-quite-so-bulging breasts. It was this protrusion that had caught the eye of my observer. He was trying to figure out what the hell it was.

Realizing this, I felt a little mortified at my vanity. Foggy, peculiar Violet has an admirer! Ahem. Not.

Some of you, I know, would have taken the opportunity to educate Mr. Bright Eyes as to the nature of Nellie. I’m not so bold. However, for the sake of pride, I did refrain from switching arms to conceal the pump. (Actually, the persons surrounding me were so closely packed in that I couldn’t switch arms, making it expedient to decide that I wouldn’t even if I could. So there, Mr. Bright Eyes.)

On the plus side, this small adventure made me realize how completely accustomed I’ve become to wearing the pump. I used to be very focused on concealing it from people to avoid just the sort of attention I received from my subway companion, but it’s so much less of a Thing now that, apparently, I’m able to forget it completely--at least on a train full of way too many humans and way too few seats. This may symbolize a form of progress. Or it may just be another example of what it’s like to be Foggy, Peculiar Violet, who also forgot to put on her medical ID bracelet yesterday and nearly took twice the correct insulin dose with her dinner due to misreading the nutritional info on a box...

June 1, 2006


I feel pretty sheepish now about Dr. Two-Fifty's moniker. I really ought to make it a policy to meet the docs before I take the gloves off in the naming process. Dr. Two-Fifty, had I met her first, would be properly named something spirited and optimistic (such as Dr. Pluck), for reasons I'll explain below. But for the sake of continuity, Dr. Two-Fifty she shall remain.

The waiting room of Dr. Two-Fifty's office is filled with flowers. There are six vases full. (It's a large waiting room.) It smells a little like a funeral home, but it looks very nice. Dr. Two-Fifty emerges to greet me. She is smiley, quirkily dressed (for a shrink working in a hospital, anyway), and has a firm handshake.

She spends an hour with me, during which we cover my recent life history (egads), discuss the workings of insulin pumps (with which she was not familiar), factor in family-related issues, and talk about drugs. Particularly the latter, of course, since that's why I am there. Dr. Two-Fifty feels very confident that I am experiencing a biological depression. She has a lot of interest in prescribing Cymbalta for me. Three things point that direction: the clear compatibility with diabetes; the fact that it's a chemical cousin of Effexor, which Mrs. Violet (my mom) has used with great success, meaning that it might work for me as well; and the possibility of side benefits with a (non-diabetes-related) pain condition I've had for many years. Cymbalta is good for unhappy nerves of all sorts--it's used for diabetic neuropathic pain as well as depression--so it might be soothing to more of Violet than just the brain.

Ah, but then there is the problem of the NIP drug formulary, which, as noted below, classifies Cymbalta as a "step" drug. I bring out the formulary list of brain meds and show it Dr. Two-Fifty.

She wrinkles her nose. "What does 'step' mean?" she asks.

"It means that before they would approve Cymbalta, you would have to tell them that we tried other meds and they didn't work."

"Outrageous," Dr. Two-Fifty declares. "Well, that's no problem. I can do that."

"You can?"

"Sure. It'll take a few phone calls, so you probably wouldn't get the prescription for a few days, that's all."

I am impressed. This must be what part of those two hundred-fifty dollars are for.

Then I have a small light-bulb moment. It is 7 PM on May 31. The NIP insurance goes into effect at midnight on--yes--June 1. All I need to do is get the prescription filled tonight, assuming GOI (Gentle Old Insurance) will approve Cymbalta. Then I will have my pills. And NIP is supposed to honor all transferring prescriptions as long as the doc says it's okay.

Moments later, Dr. Two-Fifty is googling Walgreens. We find a 24-hour pharmacy 4 blocks away, and off I go.

I took the first dose this morning, GOI having been quite cooperative. I miss them already. Cymbalta is a small capsule the color of canned peas. (Ouch. I was hoping for purple.) I'm starting on half the usual starting dose, as Dr. Two-Fifty believes a gradual transition is much more comfortable and safe. I hope that doesn't mean it will take longer to work (if it works at all), but of course it might. Meanwhile, I have the satisfaction of thwarting NIP, which has improved my current mood considerably. A good start.

May 31, 2006

Roof repair

Today I’m seeing Dr. Two-Fifty (as in hundreds of dollars per session). She’s not my new therapist; she’s the shrink the therapist is sending me to for meds for the Other D.

I’ve thought and read and fretted a lot about taking this step. This kind of internal debate is a cliché of postmodern American life, yes? Medicate the problem vs. staying with it (whatever that means) in search of personal growth or insight or at least some nonchemical cure. There’s a faction out there that posits the choice of medication for depression as the easy road, a turning away from the harder, worthier path of dealing with one’s shit head-on and with authenticity.

I thought about personality (what is it and why and whether medicating my brain will undermine some essential Violetness that I won’t want to lose and whether, if I do lose it, I will be able to get it back). I thought about how, before resorting to medication, I should probably explore exercise or yoga or at least not lying around on the couch all the time. I thought about how an antidepressant could mess up my BGs--from what I can learn, almost all of 'em have the potential to do so, though they often don't. (Cymbalta, one of the newer ones that does not, is a "step" drug on the NIP formulary, meaning that Dr. Two-Fifty has to try me on other drugs first and turn to Cymbalta only if they don't work.) I read about the myriad other side effects to which I can look forward, depending on the drug of Dr. Two-Fifty’s choice and my body’s personal, idiosyncratic response thereto.

Then I thought about my other thoughts, the nonbloggable ones, and I came to understand that sometimes you reach a moment when you have, say, a large and gaping hole in the roof of your home, caused maybe by the antics of squirrels or your roommate's fondness for illegal fireworks or the mediocrities of bargain-priced shingles or the little kid next door who likes to hit his baseball up onto your roof several times every Saturday--the cause is not the point; the point is that the hole is there--and outside the thunder is clapping and the lightning is sparking, and you know that the rain on the way is not just any ordinary storm but the kind that generates Significant Media Attention. At such a time you do not look into your toolbox and say to yourself, I will work alone, using only the small nails and the small hammer to repair this hole because by doing so, I will grow immeasurably in my knowledge of carpentry, and that will make me a better person. No, you pull out every tool that might help, small, large, and in between, and you give one to your roommate, another to the kid next door, and whatever remains to the squirrels, and you all go to work on the damn hole.

In other words, you Take. The. Freaking. Drug.

May 25, 2006

Of nickels and NIPs

First, my thanks to the commenters who offered feedback below on the Naomi Berrie Diabetes Center. I really appreciate the input. I'm looking at other options, though in the meantime I may end up there for a maintenance appointment. Foggy, Peculiar Violet also entertains a vague hope that her doctor there will be Miraculously Different.

Meanwhile, my company has changed insurance providers. A very strong plus is that I now have a network here in NY, whereas previously all my medical stuff was out of network and had to be paid up front, then reimbursed. (Ow.) Some of the other changes are more complex:

1. The highly-recommended-by-multiple-trustworthy-persons Dr. Carol Levy is not in the network. Rats. I could pay her up front, but I'll only get 60% back from the New Insurance Punks (NIPs). Multiply by 4x a year, and you see why I may end up at Naomi Berrie (whose providers are NIPpers).

2. I have a deductible now of $300. (Previously, I paid a higher premium to avoid a deductible, but that option is no longer available.) It doesn't apply to office visits or prescriptions, but it does apply to test strips and pump supplies. That means my first batch of strips, normally $90, will cost around $330, every year. After that, though, I will have 80% coverage, same as I previously did.

3. My current test strips aren't on the formulary. So I need to change to a different brand. That's okay; my meter is a piece of crap anyway. But now I need a new prescription. Maybe Dr. Reassurance will give me one. Hopefully this will be okay even though Dr. Reassurance is not (you guessed it) in the NIP network.

4. Luck of the diabetic: my current insulin, Novolog, IS on the formulary. Woo hoo! If I were still on Humalog, I'd have to change. It's not the end of the world, for me, to change between those insulins, but I do need more H than N, so I'd have to rework all my ratios, using many of the precious $330 test strips.

5. Lab work is 100% covered if conducted within the doctor's office. If not, it is 80% covered. Huh? What difference does it make where it happens, as long as the doc has ordered it? To NIP, the difference is apparently critical. (I think this is a ploy to get patients to come to the all-in-one NIP clinics, which adorn the city and suburbs of Minneapolis much as Starbucks coffee shops adorn Manhattan.) Of course, there are no NIP clinics in New York, and as noted below, it seems to be rather unusual to have blood work done in a doc's office here. Maybe they will do it at Naomi Berrie. Otherwise, I'll be paying 20% for my A1C, thyroid, cholesterol, etc. etc.

6. That said, if I keep my diabetic butt properly NIPped by remaining in the network, my annual out-of-pocket max is $1500 (plus my premiums, of course). Hey, that's not bad! And easier to attain with the jumpstart offered by the $330 test strips! Throw in some pump supplies and a few prescriptions (plus some lab work), and I should hit the max around September or so--not this year, when I'm starting at $0 on June 1, but in the future. Then it will be freebies through New Year's, huzzah.

My quiet ranting aside, this is good coverage based on what I know so far. I don't think I have much to complain about, assuming (major assumption) that I can get acceptable care from the NIPpers. One of the first experiments will occur next month, when I will visit a gynecologist whom I chose based on her office location, gender, and the fact that we have the same first name. (I had to draw the line somehow...)

All this makes me terribly curious about the diabetes costs incurred by the OC. How does your insurance treat you? And if you don't have insurance, how (the hell) do you manage?

May 11, 2006

Plan C

I can’t get into the Naomi Berrie Diabetes Center until the end of August. Ouch, but no surprise to Realistic Violet, who makes an appearance only rarely these days, and usually after the fact of some disappointment or other. (Foggy, Peculiar Violet is the star of the season; she was somehow sure that the clinic would welcome me with open arms within 2 weeks.)

I guess I’d better get that bloodwork done at Procrastination Lab in the meantime. Hmm.

Meanwhile, the OC has revealed its graciousness yet again, this time in the form of Lyrehca, who has offered a referral to a therapist who has type 1 and works with many PWDs. Said therapist is actually fitting me into her schedule tomorrow. Score five automatic points for therapist. Double points for Lyrehca.

(Wow, I managed as a New Yorker for 7.4 months without requiring mental health services!)

I can’t afford this, of course. But even more, I can’t afford not to go. So: off I go.

May 6, 2006

Plan B

For the record: I tried.

My sense of sheepishness about the neglected bloodwork finally caught up with me. I trotted myself to the lab early this morning, only to discover that the information sheet I'd been given did not match the actual hours of the facility. It's not, in fact, open on Saturdays.

Bemused, hungry, and annoyed, though not necessarily in that order, I returned home, ate some toast, and put myself back to bed. I accidentally slept until almost 1 P.M.

It's occurred to me this week, finally, that a number of my behaviors and feelings of late--difficulty coping with the demands of daily life, insomnia and/or oversleeping, thoughts of worthlessness, extreme mood swings, etc. etc. etc.--align perhaps more than coincidentally with the symptoms of depression.

And are we all aware that there is a higher than average association of diabetes and depression? Yes? Good. If not, take a look here.

This isn't to suggest that anybody who's having trouble handling self-care is necessarily suffering from depression. There's more than that going on with me, as noted above. These issues run in my family, too. So I think I need to seek more information, evaluation, blah blah blah.

In her comment on the post below, Julia mentioned the Naomi Berrie Diabetes Center. Anyone out there have experience with this clinic? I've had my eye on it for a couple of months, and I think it's time to make an appointment. The staff includes a psychologist, so maybe they can advise me in a manner that doesn't require my rechecking each piece of information in triplicate. (Though--who are we kidding here?--I probably will anyway...)

May 2, 2006

A confession

One of the several quirks of the office of my new endo, Dr. Reassurance, is that it has no laboratory for drawing blood.

Actually, I really can't judge whether this is a quirk in the larger scheme of medical care in the U.S., or whether I was just lucky/spoiled in Minnesota. My old endo had a miniature lab with a trio of technicians who could draw blood faster than I could sit down in the chair, almost. My old primary care doc did too. The blood was sent elsewhere for analysis, but it was drawn then and there, on the premises, no escape.

Dr. Reassurance, whom I saw in March, gave me a form with orders for the bloodwork she wanted done and a list of the places I could go to make my donation of bodily fluids. One of them is 8 blocks from my home. It's even open on Saturday. All I have to do is call the day before, fast that morning, and show up.

The form is still sitting on the kitchen counter. It's been 7 weeks.

What the hell is my problem? I haven't had my A1C done since November. I know better than this. I'm mortified and ashamed.

Am I afraid of the number? A little. Not a lot. It will be somewhat worse than the last number, and Dr. Reassurance will probably call. I know a lot more about pumping than she does, though, so I rather doubt she'll have much to tell me that I haven't read or heard before.

Am I resistant to entering New York City's draconian new diabetes tracking system, in which my a1C will be reported to the city health department, which will monitor my results and conduct voluntary interventions of its own devise? Yeah, somewhat. That whole deal pisses me off more than I can articulate at this hour of the night. Others in the blogosphere have already said it better than I can, anyhow. (Hint to NYC: if you want people to control their diabetes better, put some fucking blood labs inside the offices of health care providers so that patients don't have to make 4 (or more) annual trips to the lab PLUS 4 to the endo PLUS 1 to the primary care doc PLUS 1 to the OB/GYN for chicks PLUS 12 to the pharmacy.)

That's a grand total of 22 health-related voyages I'll be making per year as a New Yorker, if anyone's counting, assuming I have no problems of any kind other than diabetes. Oh, wait. Forgot the eye doctor. Dr. Reassurance also wants me to see a podiatrist. (Yeah, right. Suck my toes.) So now we're up to 24.

And therein lies the real reason, I think, that the damn bloodwork form is nesting so comfortably on my kitchen counter. Am I lazy? Yes. Whiny and ungrateful too. Also just damn tired of marching myself all over creation for the sake of the disease, even after only 20 months.

I guess I'm a little burned out right now.

I didn't have this problem during my first year after dx, when I poured endless energy into self-education, self-help, self-everything. I was a little diabetes-managing machine.

Year Two has lost that shiny, luminous glow. I'm still two+ years from trying for a baby, so my A1C is not currently the magic beacon to motherhood I once imagined. It's not that I don't care. I do. I'm testing and watching the sugars and the boluses and all that daily stuff, with reasonable success. I just can't seem to manage this lab thing. And now I'm mortified that the date on the form is almost two months old. They're going to yell at me at the lab, I just know it. Or else Dr. Reassurance will.

Maybe I can find a new endo and start all over, with a clean slate and a pure soul. And maybe I can relocate my sense of humor, which I think I left behind on the F train a few weeks ago. (It's really hard to check your blood sugar while standing in a packed and moving subway car.)

Meanwhile, maybe I can use the back of the form to chart my recent blood sugars. Err...that is...I could if I'd been writing them down. Ahem.

April 13, 2006

Travels with Nellie

A few brief notes on overseas travel:

1. I always worry about security issues when I take my pump and supplies through new airports. Nellie and I navigated the airports of Rome, Bologna, and Brussels without disruption.

2. That said, for the first time ever, I was asked to produce documentation of my need to carry diabetes supplies. This was in the Brussels airport, pre-boarding for my flight to return to the U.S. I had my endo's letter with me, and it was accepted without question. (The agent was also willing to accept something called a "health card," whatever that is.) The letter was briefly taken from me, and I was told that it would be shown to the pilot. It was returned to me within a few minutes and I was allowed to board.

3. The same agent asked me in a rather pointed way, "You are carrying only the supplies you need for this flight, correct?" She was tipping me off as to what to say, it seemed: she practically winked at me as she spoke.

I was carrying a lot more than that, of course--to be specific, my entire stash of leftover pump supplies and backup syringes from a week-long trip. Nobody in their right mind would board an overseas flight with exactly 8 hours worth of supplies and no more. Imagine if the plane were diverted or had mechanical problems or who knows what. I bring all my supplies in my carry-on, period.

I answered, "I'm carrying what I need plus backup in case my pump has problems." Technically true, depending on how broadly one defines "problem."

That worked for the agent.

4. Had I followed the advice of Dr. Reassurance (see post below) on adjusting the pump clock for the 6- to 7-hour time change--she said to simply update the time when I arrived and watch for trouble, my body would catch right up--I would have had serious lows.

Insulin needs are indeed closely related to physical activity, so it makes sense that over a period of a few days the body would adjust to a time zone change. But I hadn't wanted to make such a drastic change all at once because it would have placed my highest basals, which are more than double the lowest, right smack in the middle of the period when my body was expecting the lowest dose. It seemed moronic to blithely change the time on a delicately calibrated medical device without making ANY compensation for the fact that my body, for the first couple days, was pretty sure it was 11 PM even though the actual local time was 6 AM.

One of my pump resources, SMART PUMPING (published by the ADA), recommends that for a time zone change longer than a couple hours, you should adjust the pump clock by 1.5 per DAY until you're caught up to local time. That made a lot more sense. In the end, I took a sort of middle road and made up my own adjusted basal regimen with the main premise being that I really couldn't handle a major low on this business trip. I allowed myself to run slightly high until I felt very confident that my body had decided to catch up to local time.

I also had to adjust for my different insulin-to-carb ratios throughout the day, a topic not addressed in any of my books. I went a conservative route here too, using my lunchtime ratio for both breakfast and lunch (instead of taking significantly more insulin at breakfast as I normally would). As far as I could tell, over 7 days my meal ratios NEVER normalized to local time. Again, had I reset the pump clock per the advice of Dr. Reassurance, I would have seriously screwed myself.

Hmm, a very practical post for Violet. I'll navel-gaze more next time so that you can all feel confident the real Violet hasn't been kidnapped by aliens and replaced with a stoic number cruncher...

March 12, 2006

Ruminations, month 18

Well, I'm trying to think about coming back here. It's not feeling great.

I'm bored and angry and eye-rollingly apathetic, almost simultaneously (though I realize that isn't quite possible), with having diabetes. Somehow the idea of participating in my online D-existence feels like acquiescence--which is in another person's parlance simply "healthy adjustment" to reality, but there you are. I'd like a few months or a year of denial, thanks.

The zillion finger sticks a day: mind-numbing. The set changes, hauling crap around everywhere I go, crunching tablets on the subway, feeling guilty about keeping shoddy records: yawn, yawn, ennui. I don't mean to sound pathetic or self-pitying: what I'd really like to feel is neither, but just normal.

That said, I also know I should be grateful for a little boredom. Nonboredom for the diabetic typically means loss of control, complications, hypo unawareness, or some charming combination thereof. Boredom means your life is not currently, immediately threatened. Huzzah.

Another reason I'm cranky, a perhaps less boring one, is that I'm getting ready to go overseas for the first time--for business, alas, rather than pleasure--and I'm more than a little anxious about the D ramifications of the six-time-zone change combined with an intense work schedule. My new endo, Dr. Reassurance (she's a separate post), says all I need to do is reset the pump's clock and expect a bad day while I adjust. Um. Okay. That seems weird somehow. I need to research this further during the next, eek, 12 days. I'm so sick of diabetes that for the first time since dx I am entirely behind the curve in researching how to take of it and myself. Normally I am all over this kind of shit.

Anyhow, the tests and suchlike (hmm, I initially typed "sucklike," heh heh) from January turned out mostly okay, and the follow-ups to the not-quite-okay one turned out okay too. So I still don't really know what's been up, but the meds are continuing to help me overall. This is a good thing.

I feel like I've veered off the trajectory of the hegemonic narrative, to borrow some English grad student BS lingo, of the adult-onset diabetic. Shouldn't I be well on my way, at this point, to sunshiney gratitude for the gifts my disease has brought, as dissected in numerous posts across the blogosphere a few months back? Shouldn't I be philosophically wry, in a charming, admiration-invoking way, about how much worse off I could be, and also how if I'd been born a century ago I would already be dead? Well: I do have times when I feel philosophical in a positive sense, but right now it seems mainly clear that the whole business of having a chronic disease Just Never Goes Away and is Terminally Tiresome. Which makes inhabiting this online world, as full of grace and support as it often is, in some ways very sad for me. I would like to be less centered on diabetes, not more, and I don't know how to balance that with the positive aspects of writing here and allowing myself to care about others who are writing their stories as well.

January 11, 2006

Six points for Dr. Bruce

The reception area of Dr. Unknown is shabby: carpet worn through, paint chipped and filthy. A sign requests my patience during a time of building-wide renovation.


Along with my other symptoms, I now have a headache. Wait, didn't I already have a headache? Yes, yes I did.

I've arrived early in anticipation of filling out numerous forms. There is only one, with four lines, plus a privacy disclosure.


Dr. Unknown's receptionists, an ethnically diverse triad of chattiness, are discussing the romantic misfortunes of one of their group. "What you need to do," one advises, "is get your OWN apartment, your OWN condo, and tell him to..."


The triad is interrupted not only by the hammering above but by a male voice. They address the speaker as Bruce.

Bruce, I recall, is the first name of Dr. Unknown. Hmm. First-name basis with the desk staff? Chalk up one for him. And for the triad, for that matter.

I wait a while longer. Dr. Bruce personally fetches the patient ahead of me. And then he fetches me. "Ms. Violet?" he inquires and shakes my hand.

Another point for Dr. Bruce.

We go to his office, a crowded but neat room featuring pictures of his family, a teddy bear, various physicians manuals, a Monet print, a book about Tibetan healing, and a volume of Margaret Bourke-White's photographs.

We talk for a long time about why I'm there. He asks questions and takes notes. He doesn't rush me. My history raises no eyebrows: he is familiar with an adult getting type 1 diabetes, he understands my obscure gynecological problems, and he seems to know insulin pumps, too. I grudgingly award him another point.

He suggests that there may be various explanations for my symptoms, not only fibromyalgia, and that we will keep open minds for the time being.

Then there is an exam. Dr. Bruce takes my blood pressure himself. Is his nurse absent? Or is he just incredibly self-sufficient? I've never seen a doctor do the "nurse" stuff. He seems very natural about it. Okay, one more point.

Dr. Bruce: 4. Anti-Dr. Bruce: 0.

After the exam, we return to his office and talk further. He explains that fibromyalgia is not a hasty diagnosis. First we must rule out other possibilities, of which there are many. He will do scads of bloodwork to this end. I shouldn't be frightened, but one of things he'll check for is lupus. He doesn't think I have lupus, but as it's an autoimmune disease that can cause symptoms like mine, he would be remiss in not checking. But he really thinks I have a virus, something that will go away as I heal over the next few weeks. Many viruses, he says, can cause muscle and joint pain and terrible fatigue. One is parvovirus, which usually strikes kids, but in adults can cause symptoms much like mine. The bloodwork might tell us, or might not. Time will also tell us a lot. If I still feel this way in 6 months, he will be more inclined to consider fibromyalgia.

I'm cranky. He's making sense. But I'm supposed to sit around and feel like crap until he decides I've been sick long enough to be diagnosed? I am on the verge of subtracting a point.

"Of course," Dr. Bruce continues, "what you probably want is to feel better right away. We can address that."


Dr. Bruce prescribes a muscle relaxant for bedtime, which will help me fall sleep and should assist with the problem of pain awakening me. I will also take an anti-inflammatory twice a day for pain. There's one that's prescribed more often than the one he's giving me, he says, but it can affect blood sugar, so we don't want to use it.

Two more points.

I am to call next week and report on how I feel. He'll tell me about the bloodwork and we'll decide what to do next. Unless something of concern shows up, in which case he will call me first.

I fill my prescriptions, return home, and google parvovirus. Hmm. Could be. Not sure. Meanwhile, the drugs do help. I had less pain last night. It was hard to fall asleep, but once I did I slept almost all the way through the night for the first time in weeks. This morning I'm feeling pretty good, some small pains but not much. A huge improvement.

Woo hoo. Woo hoo hoo!

January 8, 2006

Stree, or where I've been

1. Really tired. Tireder than tired. Grocery-shopping-leads-to-mandatory-napping tired. Missing-out-on-going-to-bookstore-with-Animegirl-because-too-tired tired.

2. Really sore. Freakishly sore in muscles not being used and some I didn’t know I had. Bizarrely sore in joints that don’t look swollen. Made sore by slicing chicken and by doing nothing at all. Sore enough to lose sleep, worsening #1.

3. Really fuzzy in the head. Unable to concentrate for large chunks of the day. Language-related cognitive errors, e.g., typing the wrong words in memos, such as publishing interesting when my brain was thinking publishing industry. Awkward lapses for an editor, these are.

4. Really anxious about the above, too focused on every bodily sensation. Doing my hypochondriac, excessive researching thing. Full of theories. Current frontrunner is fibromyalgia, which my mom has and which fits my current situation almost exactly in terms of symptoms.

5. Spinning wildly from #4 to an unknown future in which my hopes and plans for work and family are cast into doubt by yet another decline in health.

As all this has been going on for several weeks, I’ve broken down and sought medical intervention at last. Oh good, a new opportunity to be disdained and patronized by health-care professionals! Tuesday I’m seeing a rheumatologist. I can only hope this encounter will lead to numerous suspenseful bloodlettings, diagnostic screenings involving machinery, and multiple follow-up appointments before I’m told nothing is wrong me with

Whoops. I’ll leave that in as a demonstration of #3. Hell, at least I caught it before I hit the “publish” button. I know--everybody does stuff like that all the time. My brain just doesn’t feel like itself. Language is supposed to be my safe area.

Anyhoo…before I’m told nothing is wrong with me that a laboratory can find.

The idea that I may have another chronic medical problem is a little too much for me right now. Maybe it’s all stree. Whoops, I meant stress. Ahem. (What’s stree? Stress induced and/or experienced by a tree?) But I don’t think stress all by itself is supposed to effing hurt this much.

My current goal, energy permitting, is to detail Whatever May Come in the most sardonic possible tone for your amusement and mine. Oh, and to not be ill. That would be cool too.