D is for Diabetes; D is for Deadpool

THIS JUST IN.

I am eligible to join the X-Force. Why, you ask? Because Deadpool is looking for someone with diabetes to round out his team in a recent trailer for Deadpool 2.

I suppose it's better Peter than me, though. I would not look so badass jumping out of an airplane. I'd be too busy peeing my pants in terror, I think.

Insulin-resistant Type 1 counts as both Type 1 and Type 2, right? Maybe they'll hire me for some behind-the-scenes snarky hero stuff. It would be like a fanfiction crossover in which I'm Penelope Garcia from Criminal Minds. It could work.

Deadpool--call me! Just give me a minute to answer in case I'm treating a low or something.

The Three Little Pumps

Once upon a 2018, a Type 1 like myself had three pump choices...

Pump A: Tubeless. Doesn't hold enough for my insulin needs. A big no.

Pump B: My current brand. I like it, but I've never loved it. I may have lied and told someone that I loved it. It has some physical problems that have happened to me consistently, causing me to have traded my pump in at least 3 times before my warranty expired. The physical issue means that I have to have assistance with changing my cartridge. My hands are not strong enough to slide the cartridge on or take it off by myself--I usually have Matt do it for me. I want to avoid this problem in the future (and will blog more of the specifics at a later date).

Pump C: The brand I first used when I got my first pump in 2000. I don't have anything against them. Have I loved everything they've made? Meh. But I am ready for a change, and I know their CGM is no longer inferior to the other one I've used. I didn't expect to get static from my insurance company in trying to get this pump approved, mostly because I've gotten other pumps through the same insurance since Matt has been working at the same company for 10 years. I remember needing some pre-auth stuff, but I did not expect my insurance to go through 2 rounds of pre-auth and a consultation with my endocrinologist to prove my pump was "medically necessary".

Am I trying to prove a point here? Is this one of those "idle chatter" types of blog posts? Maybe a little of both. I have Type 1 Diabetes. I think that is enough of a medical necessity to acquire an insulin pump. The end. 

We used to have what, 5 or 6 choices of pumps at one point in history? And we all need insulin to survive, and studies show many people have tighter glucose control on pumps. I wish I understood more about the nonsense that dictates the behavior of insurance companies. That's all I have to say for today.

THIS JUST IN: Controlling Your Diabetes = Not Medically Necessary

CONTENT WARNING: Sarcasm ahead along with non-sarcasm. Good luck.

"Dear Member:

The purpose of this letter is to confirm that pre-auth [for your insulin pump with CGM] has been denied for the following reason(s):

Your provider asked us to provide a special type of insulin pump that can also continuously monitor your blood sugar. This was requested to help control your diabetes. This request has been denied as not medically necessary."

Neat! Did you guys know controlling your diabetes isn't medically necessary? Wow, what a relief. All this time I've been worrying about this garbage A1C that I have, but it turns out I shouldn't have to care at all.

Okay, in all seriousness, the letter goes on to explain they cover "these types of insulin pumps" for people with recurrent, life-threatening low blood glucose levels and also poorly-controlled pregnant women.

Maybe they would cover a pump without a CGM and a separate CGM system. I've never had trouble with pre-auth for Dexcom, surprisingly. Buuuutttt they would probably also say I don't need an insulin pump because my diabetes is poorly controlled in the wrong direction (highs instead of lows).

Just remember, kids, in the US of A we have the GREATEST HEALTHCARE SYSTEM IN THE WORLD where NOTHING IS EVER WRONG and PRESIDENT OBAMA RUINED IT FOR ALL OF US. It is sheer, tremendous, tremendous, big perfection.

Disruptive, Unique, Beautiful and Diabetic

Are you still out there, readers? I assume that you are. I've remained quiet in my little space here. Why? It's hard to say. There are a plethora of reasons.

People are saying that blogging is dead; long live blogging.

Every blogging site is promising a "beautifully designed" and "unique" and "amazing" blog/site/whatever. But content is always king, right? I should give you some content to read.

Over ten years ago, when I started Dorkabetic, we (the Diabetes Online Community) were all blogging away, meeting each other via comments sections and daily readership. Now the DOC is so huge I can't keep up. I remember when we all started using Twitter, and now the world *is* Twitter. And Instagram. And...Snapchat? I don't have Snapchat. I'm being an old, crotchety Xennial about it. 

{Author's Note: I should probably learn Snapchat. Give me a good reason to start?}

I am looking at some big diabetes changes on my personal horizon. I want someplace to talk about them. If you've just found me, or if you've been following me forever, I hope to see you around. 

I want to talk about paperwork. I want to talk about insulin pump choices. I want to talk about my perspective. I want to talk about...the Freestyle Libre if I get one? I want to talk about geekery as it relates to diabetes.

Can we do this? Can we start again? Are you with me?

Good.

National Poetry Month, Diabetes Edition.

Aside from the spacing/kerning that makes me twitchy, after who knows how long, I finally wrote a poem about diabetes I'm mostly pleased about. It's freeverse. It's meant to be performed [if I like it, maybe I'll video?] aloud. I originally posted this to Facebook, but have since taken it down so I can share it more widely (and hopefully more copyrighted-ly) with you.

to Anyone Who Has Ever Said "Needles!..."

I just blink pleasantly as you finish,

Because I know your monologue by heart:

"Ohhh, I don't know if I could ever do that.

Needles are the worst! I'd be so afraid!"

I'm not here to belittle a legitimate phobia,

But I am also jaded enough to gag

On your sentiment.

If you required a needle

Injecting anywhere under your skin

To stay alive each day

You'd do it.

After 27 years of this,

On days your body doesn't feel

Like a walking pincushion,

You can feel like a healthy person,

Or a husk starving for water and sleep,

Or a ravenous scavenger, devouring anything in sight to stay alive.

When you wake with the sun,

Sometimes you remember to thank some unknown

That you woke at all,

Or you can thank a juice box meant for a toddler,

Thank that bag of old Skittles from your purse,

Thank your giant water glass, a vial of insulin, a small syringe..

You prepare for your work day,

Stuffing medical necessities in a commuter bag,

No matter how short the commute.

Load a series of devices that chart and graph and calculate

In with your belongings, alongside the phone, maybe the smart watch,

And try not to feel like a collection of numbers running for a bus,

Don't grouch at the lady in line for artisan coffee

Who tsk-tsks at your selection of an artificial sweetener.,

Don't give your officemate a speech

When she offers what she believes to be body-positive encouragement

Because you joke about the carb count of the free bagels.

When you visit your doctor,

Notice how you feel like a walking data set.

Daydream in the waiting room

About the other data sets sitting nearby.

Who has better numbers?

Do insulin pumps dream of electric islets?

Because you love math geeks, do you want them

To analyze your standard deviations when you can’t look?

Is it hilarious that you suck at tipping

And algebra and doing your taxes

But you can rattle off a correctly calculated ratio

To decrease your blood glucose after eating?

When the mother of a child with diabetes

Calls you "brave", just warmly smile

And share something positive.

Is there bravery in acting as your own organ?

Is it brave to function as a normal person?

Smile. Say something nice to her.

Don't let on there's a tingle in your toes

And extra blood vessels somewhere in your eyes.

Pretend you don’t have a pillbox tucked away

With pills to encourage your serotonin and dopamine.

They don't want to hear this.

They see your 27 years of what you consider “good enough”
As a miracle, a celebration, sometimes you might feel it too.

27 years of the day's tiny stabbings

Produce a quiet pride in the right light,

27 years of unwanted but well-meant concern,

27 years of advertisements that the cure is 10 years away,

27 years of other people's opinions

On your meals and your body and your medication doses

And you haven't punched a single person?!

Maybe it's bravery after all.

Election Day USA 2016

Shred the Patriarchy.

Let it be known that I'm voting for the candidate who will not completely repeal Obamacare and the many steps forward it has produced for healthcare in this country. I'm voting for the candidate who has fought for people with disabilities and health conditions, never mocking them or telling the terminally ill to not bother voting.

I'm a Nasty Woman, one who has a nasty chronic illness and knows how nasty health insurance is in this country. I'm old enough to remember hearing that "we need healthcare, not HillaryCare".

I don't know what's to come for this country. I know everything Hillary stands for is not perfect, but I also know she's no racist demagogue. I'm With Her. I'm excited that finally, hopefully, a woman will preside over the US. I'm voting for her because I feel like her campaign has been the one most based on logic and plans over hearsay and non-specific promises.

I'm leaving work in a few minutes to go vote. Pennsylvania polling places close at 8pm, but remember, if you are in line at 8pm, you should still be permitted to cast your ballot. If they are out of "I Voted" stickers, I'm making my own when I get home.

Political News of the Day: Semi-Fictional Characters Edition

(A non-diabetes related post for your amusement.)

Watching the first Presidential debate last night definitely required the gin and tonic I had in my hand. I was glad to hear that Hillary Clinton picked up on several of the issues addressed by Bernie Sanders during his campaign, and I was almost heartened by Trump's first ten seconds of speech--but then of course that turned into the shit-show we were expecting. 

Over-talking. Mansplaining. Using words like "bigly". Many of us saw it, tweeted about it, or at least saw the highlights and the tweets. 

My achievement of the night was the joke I made. Trump stated something to the effect of, "There are military leaders in this country who definitely support me." 

Of course there are! In fact, these are the leaders I came up with:

• Admiral Akbar
• General Grievous
• Captain Crunch
• The Skipper 
• Sergeant Slaughter
• General Anxiety
• Major Boredom
• Captain Caveman
• Colonel Klink

I am not willing to take bets on the likelihood of Trump nominating any of these military greats to his Cabinet. Honestly? Captain Crunch has too much integrity to stick with this group. 

Nominated Lady

Thanks to some amazing reader or readers out there, I was just nominated for a Wego Health Activist Award as "Best Kept Secret"! 

I'm not trying to be a secret over here, but maybe I need to take off this mask? Turns out I'm not actually Catwoman! (Sorry if you thought I was.)

I am Hannah, hear me roar! Ten years in this blogging game. Today, I am celebrating this little victory.

Occlusion Conclusion

"Argh, I know!" I say out loud to no one in particular. The "someone" I'm addressing is my Tandem t:slim insulin pump, tucked securely in my bra. BEEP BEEP BEEP! is the response I receive.

I've been feeling kind of weird and overly tired for the past couple of weeks, and I realize my pump keeps throwing occlusions. Can I tell you how much I hate occlusions?

For those not in the know, an occlusion is basically a clog somewhere in your pump line. It can be caused by kinked tubing. It can be caused by the cannula getting bent in your infusion set. It can be caused by some invisible factor (seriously, I can't see what 3/4 of these problems are right now).

I'm calling customer service tonight. No ifs, ands, or buts. I will not rest until they send me a new pump. This is hideously frustrating, because if my pump isn't going to give me the right amount of insulin, what's the use of a pump at all?

I need to resume my fully functional cyborg status. Charge up that Dexcom G5 and let my robot pancreas do the work I tell it to! No more slacking off, t:slim. You're making me feel bad.

For Kycie, David, and all the other kids who didn't make it.

I could have been them. Taken from this earth far too young, before I'd even hit double-digits in age.

I can only remember bits and pieces of the day I was diagnosed. I'm not even sure what the exact day was, but it was in July of 1990. I couldn't breathe. My mom and dad rushed me to my pediatrician right away, where I started throwing up bile. I remember being hurried from the pediatrician's office to the hospital, right across the street. I can recall being a little scared, and a lot uncomfortable.

I was eight years old. All I knew was that I wanted someone to fix me, and the whole thing felt very surreal. I learned I was in something called diabetic ketoacidosis. (Maybe it was all the Sesame Street I watched when I was even smaller, but I first thought they were saying something that sounded like Spanish: quequitoacidosis. Pretty sure that is not a thing.)

Yet, it's what I found out later in life that rings true to this day, and brings pain to the hearts and minds of parents, caregivers and healthcare workers alike. Diabetes wasn't anyone's first thought when I first got sick. 

My pediatrician was deeply bothered by the fact that he missed it--my mom had talked to him a couple of weeks before about how I seemed to have the flu in the summertime. Some nasty virus was spreading around kids that summer, so nobody really thought anything of it. It was unusually warm, and I spent a lot of time outside at Girl Scout day camp, so no wonder I was drinking all the time, right?

So there I was, in the hospital, sicker than I'd ever been. Knock on wood, I will never end up that sick again.

Twenty-five years ago, I was one of the lucky kids. Even today, with all the technology we didn't yet have when I was growing up, not all kids are so lucky. What a bittersweet way to realize it's my diaversary.

Don't ever hesitate to ask for a glucose test for your kids. 

Take This Diabetes and Shove It

An Ad, to Be Placed on Freecycle or the Giveaway Section of Craigslist

Free to a Good [or Bad] Home - Type 1 Diabetes (Philadelphia or Anywhere)

The beta cells in my pancreas quit working after 8 short years. My immune system attacked them, and instead of going back to doing their f**king job, they decided to just sit and panhandle around the Islets of Langerhans, like that's some kind of vacation for them. I've tried to give diabetes a chance for 25 years, but you know what? I'm done.

Surely there is some soul out there who would like to adopt my diabetes and give it a good home. Or maybe you know an unsuspecting Men's Rights Activist right-wing homophobic politician asshat that you want to teach a lesson. Either way, please come to this address [Hannah's House or Place of Employment] and help yourself.

Type 1 Diabetes has been a challenge to love. Most recently, an insulin pump site of mine got pulled off in the middle of the night, so I woke up around 6:30am with a raging "HI" staring deep into my soul from my glucose meter. Through gritted teeth I said, "Hello yourself" to the screen and injected a buttload of Novolog as I replaced my infusion set, drank two giant cups of water and went back to sleep, nauseous. A few hours later, at work, that buttload of Novolog kicked in all at once, so while my blood glucose clocked in at 200, my body was trying to tell me I was a solid 65 with shakiness and a case of the woozies.

Diabetes is sometimes a gentle nuisance, and other times it makes me want to cry, scream, and throw things across the room. That's not a terribly healthy behavior, so obvious my Diabetes would do much better if it were rehomed.

Please stop by this weekend. Type 1 Diabetes can be yours for the exclusive price of FREE-NINETY-NINE! I will even throw in all the fancy gadgets and tropical fruit punch glucose tabs!

I can also just leave it on the curb. Come grab it, as I only have this one case of Type 1 Diabetes to give away. If you're also interested, I will set out some plantar fasciitis, macular edema (right eye only), and arthritis of the lower back, also free.

It's a whole new kind of summer fun!

The Darker Days of Fall

Autumn is usually my favorite season. It's the time of year when the chill that I so love comes back into the air, when everything feels crisp, and rich colors dress the trees. I am one of those people who's into pumpkin spice lattes and chai, fresh seasonal apples and of course, cider. Halloween is usually a treat for me because I adore dressing up in costumes. 

But you may notice I've been absent from blogging about how it's okay to eat candy at Halloween with diabetes. You haven't yet seen any silly posts wherein I dress up my insulin vials. Actually, you haven't seen any posts from me at all since mid-September.

I'm still in the midst of a job search, applying, hoping, going through the motions. I try to be excited while attempting to not get hopes up too high at the same time. It's a competitive market out there, especially in the city. I've seen so many of you getting new job and career opportunities, and I'm so happy for all of you, but trying to manage a twinge of jealousy at the same time. I've looked at my Facebook feed and more than once whined at the laptop screen, "When's it going to be my turn?"

I shouldn't whine. I know better than that.

I think it's easier to whine when things have just been difficult all year. A grandparent-in-law's passing, a broken humerus, surgery, losing my job. What's really been keeping me away from blogging are two things I haven't had the words to talk about.

That better A1C I bragged about a little while back? It may have temporarily been a fluke, either of office equipment or my body itself. At my most recent endo visit, it was right back up again. That sucks, but it's not the part that's been weighing on me. I saw a retina specialist because it was discovered that I have DME in the right eye. The left eye isn't perfect either, but it doesn't have the severity of problems that my right eye does. I've had an Avastin injection, and my first follow-up visit after that is this coming Monday. I want to write about my eye in more detail, but I figured I should come out about it first.

The next thing that is difficult for me actually just hit yesterday. A good friend of mine from the Philadelphia poetry community passed away yesterday morning. He helped us run the slam I work with--he was like family to all of us. He was one of the hardest-working people I knew, pursuing his artistic dreams on the page and on the stage. He did spoken word and theater. He acted, directed, wrote, and was a hip-hop artist. Earlier this year, he turned 30. He was diagnosed with cancer right about the same time. At the slam, we opted to not send a team to the National Poetry Slam this year so we could donate a portion of the proceeds of our shows directly to him. Even through his illness, he looked forward to getting back to coaching youth poetry teams and making next year's NPS squad. I am going to miss MJ in numerous ways, some I'm sure I haven't even realized yet. I do hope that soon, in the coming days, we can give this NOLA son and renaissance man the jazz funeral he deserves.

Waiting on the Retina Specialist...

...and my whole day has been like:

If it's not one thing, it's another. 

On the Market

I had a job interview this afternoon. I think it went well, but it's always difficult to tell with such things.

I once had a job interview which ended in me being asked when I could start, and they said they'd contact me about when I could come in to fill out my hire paperwork. They never called me. Not even an email.

One time, I submitted a resume to a company and was called back that same afternoon for an interview the following day. Then I had a second interview a couple of days later. Needless to say, I nailed it.

So this time? I don't know. Everyone was very pleasant, and as I said, I think it went smoothly. Fingers crossed.

As a sidenote, because diabetes touches everything in my life in small ways, charging my insulin pump (yes, I am rocking a t:slim if you'd forgotten) was as important as brushing my teeth and styling my hair while I was getting ready for the interview today. I mumbled at my pump while I reattached my tubing, "Don't you start beeping on me in the middle of a meeting, please."

It was a beep-free meeting indeed. Not even a buzz.

Being unemployed is...odd. On one hand, I am glad to be away from the stresses of my last job. I'd had that feeling that it was time to move on anyway. On the other hand, it's a somewhat stressful time of wondering what my next move is going to be. I feel like I can count on uncertainty, but luckily I feel like I can count on everyone I know for support. Thanks, friends.

Let's hope my next adventure starts soon.

The Best in a Year

So last week, I learned I had the best A1C I've had in over a year. Certainly, your first thought is this:




And while my first thought about it probably should have been something like this:




I think I looked more like this:



Wait, wut?

With everything I've had going on, recovering from my broken arm & surgery, going through the stress of returning to work, going to physical therapy and everything else, I'm actually doing better? How did this happen? I didn't feel like I did a whole lot that was terribly different or special.

So yes, I am celebrating this small victory over here, but I know there is still much to improve and a lot to think about. With some good efforts, my numbers can hopefully be a lot better, and not just one marked improvement, but a lengthy period of improvement!

I imagine that this whole thing just serves to remind me that, in the end, ultimately, I HAVE THE POWER, not diabetes.

By the power of Greyskull! (I found this via an image search and I don't know who to attribute to...)

Not Quite in Arm's Reach, or What Happened When I Broke My Humerus

I come from a long line of klutzes.  Sometimes I trip, lose my balance, or flounder around while walking because my ankle decides it doesn't want to stay upright.  I think it was one of the latter two reasons that caused me to fall from the top step of my front stoop onto the sidewalk on March 28th.  This resulted in my first-ever major broken bone, my first-ever ambulance ride, my first-ever arm sling, and my second-ever surgery.

There are many places in which your arm can be broken.  In my case, it was my humerus--and before you say anything, it wasn't funny at all.  For those not in the know, the humerus is your upper arm bone.  Think of it as the bone that connects your elbow and your shoulder.  Now, imagine the pain and annoyance that comes with not being able to use your dominant arm for anything without considerable pain.  They say bone pain is some of the worst pain imaginable, and they are right.  Healing from surgery was less painful than trying to walk up the steps in my home with a sling on my arm.

Many things became difficult to do with only my left hand, including brushing my teeth and texting.  Video games could not be played on the Xbox.  I couldn't open any bottled drink.  I had to have help washing my hair and half my body in the shower, and for a while I couldn't get my arm wet, so I'd have to don a trashbag raincoat for my right arm first.  Still, no task seemed more daunting in terms of asking for help than diabetes management.  Things you can't really do with just one hand include:

-Drawing up insulin into a syringe
-Unwrapping an Inset infusion set, as well as cocking the insertion device
-Checking blood sugar
-Changing out everything on my pump
-Pouring orange juice to treat a low

So that's...nearly everything diabetes related you could do within a day?  At least my pump was always within reach!  With the T-Clip, I had no problems hooking my t:slim onto the strap of my sling.

The last time I had anyone else use a needle on me for diabetes management was probably the first time I tried a Dexcom Seven in Gary Scheiner's office, when the tech was so new he inserted my sensor for me.

"Well boys," I announced to Matt (the hubs) and Harper (the housemate), "I'm going to need a lot of help from you guys, and this includes a crash course in setting up my insulin pump and jabbing me with infusion sets."  Let me just say that in the nearly 16 years that Matt and I have been together, he's never given me a single injection.  We've known Harper for over two years now, and he is the kind of guy who can pass out at the sight of his own blood, so naturally I was concerned about asking him for help with needle things.

But what happened?  Everything worked out just fine, and I think I was more nervous about someone else sticking me with a needle than the guys were about learning everything.  Great partners and trusted friends are true treasures to have in an emergency.

I just wanted to take some time today to send a huge thank you to my two biggest caregivers/house helpers in the month and a half I was out of commission.  Blood sugars were monitored, infusion sets were placed, laundry & dishes were done, and meals were cooked!

I am back at work, driving again, and starting physical therapy next week to return my arm to its strength and full mobility.  So while I am not cleared to lift anything that's over five pounds, it's good to be back.  If you really want to see it, I'll show you my badass surgery scar sometime.

Where's Hannah?

I broke my right humerus (upper arm) last Friday. I have surgery to fix it tomorrow. I sure do miss typing with two hands. See you soon, readers!

<3

Hannah

Teaching an Old Dork New Tricks

My tongue was stuck to the roof of my mouth again. It wasn't the same kind of stuck you get when you eat a peanut butter sandwich with no drink.  It was that dry-yet-syrupy cling that comes along with a high blood sugar.  My Dexcom sensor had failed in the morning (more on that later), so I pulled out my kit, tested, and clocked in at about 350 mg/dl.

I'd been crusing between 117 mg/dl and 160 mg/dl all morning, which were good-looking numbers for me compared to some I'd seen lately.  The culprit for the high, I believe, was putting sugar in my coffee and forgetting that fact.  (Cringe all you want, I freely admit I choose my vices and consume artificial sweeteners.)

I knew I needed to correct this bad boy before I felt any more gross, so I pulled out a syringe and drew up my correction by hand.  I was wearing a thick sweater and couldn't inject through my clothes.  I know my boss likes to watch the security camera from time to time, and I was not in the mood for her to be asking what I was doing with my shirt, and if I was feeling okay.  I was, however, wearing a thin skirt.

I looked down at my thigh.  Hmm.  How bad could it be?  My abdomen has always been, and genetically will forever be, plump and squishy to some degree.  It just makes me more fun to cuddle.  My thighs are mostly muscle.  Aren't you supposed to be able to pinch up an inch of fat where you inject?  Do I even have that much on my legs?  Maybe I'll just do this.  I mean, I've had diabetes for how long now? HALP OH GAWD I THINK I'M ACTUALLY GOING TO TRY THIS.

So that's when I did my first-ever thigh injection.

Note--I am not complaining about my body or trying to body-shame anybody else here.  It's merely fact: I come from a line of women with fat stored around the midsection.  I have slender arms, and legs, and I'm busty, which gives me more opportunities to hide my insulin pump.  I see this as a win.  I've never used my arms either, and for the record, my mom is too weirded out to do insulin shots on arms or legs too, so I know for a fact I'm not alone.  What a digression....).

It stung like hell for a few seconds, and then it was over.  I don't think it worked any better or faster than my usual injection/infusion sites, but it did work.  I'm not sure it's something I'd want to repeat terribly often, but after 23 and a half years with Type 1, I guess it shows you can learn and try new things all the time.  People talk about using their thighs, their arms, their bellies, their "side-butt" for sites.  It's purely a personal choice thing, with the exception of problems with absorption or other issues.

Where do you like to inject?  Where do you put your infusion sets and glucose sensors?  Do you think I should keep trying new things, or just stick with what's working?

Mind Your Manners, Miss[es & Misters]

Gentle Advice Columnist:

"Proper" etiquette may sometimes be in the eye of the beholder.  Not all people lift their pinkies when drinking tea.  Some people double-dip their buffalo wings in the shared dish of bleu cheese dressing without a single afterthought.  Some men will hold a door open for a woman and allow her to pass by, while others will hold it open about halfway until the woman takes over. (And until recently, Ms. Hannah did not realize it was potentially recognized as rude to wipe one's nose on a cloth restaurant napkin. Ms. Hannah was clearly born in a barn.)

It seems, Gentle Advice Columnist, that in your opinion, it is rude and unsightly for a diabetic to do their blood tests and "medical procedures", as you called them, in public. You suggested that people should test in the bathroom or another private room. Some of Ms. Hannah's colleagues and peers have taken to the internet to badmouth and rail against such advice. What this blogger sees is an Advice Columnist who may not have any experience with diabetes.

You say you "draw the line at drawing blood", and it's true the sight of blood makes many people uncomfortable; however, for people with diabetes, a little blood is a fact of life multiple times a day. The diabetics of this world are not drawing out syringes full of blood from their own arms.  A blood glucose meter reading takes approximately 5 seconds, and plenty of people with diabetes never have a second thought about plopping that meter on the table in front of everyone, conducting their diabetes business. (It is not even a blip on the etiquette radar, much like Ms. Hannah hastily wiping her nose on a cloth restaurant napkin.) It's often just a tiny drop of blood, or a quick poke with an insulin pen.

The good people of the Diabetes Online Community typically call things as they see them, and in your column, they saw ignorance, intolerance and perhaps even ableism. These days, it is unavoidable that people share details about their personal lives online. Some people, including this blogger, discuss things that some people find unacceptable to share with unauthorized individuals or strangers. Everyone in this country is entitled to health information privacy, but a number of folks choose to disclose their visible and invisible illnesses and disabilities in a very public way.

Gentle Advice Columnist, Ms. Hannah is certain that what has angered those in the DOC the most is your seemingly rigid and outmoded stance about what is proper for diabetes management in public, as it seems you have no experience living with diabetes yourself.  Additionally, Ms. Hannah would like to note that answering questions in the third person may make you seem haughty, holier-than-thou, and inaccessible to younger readers who prefer their advice more off-the-cuff. (She would also like to note that writing in third person while trying to relay a personal opinion is pretty effing difficult, so kudos to you for doing it for so many years. Clearly, you have a good editor.)

Ms. Hannah's initial reaction was anger as well. "Where does this woman get off, telling me I need to run to the loo for a five-second blood test? Perhaps she will perish in a fire," she said to herself. Soon, this blogger realized that was an overblown reaction, having never taken kindly to some strict viewpoints about politeness. Another thing she realized is that every person is different. People with diabetes have just as much a right to disagree with you as they might to agree with you.  In fact, allow this blogger to lay out a shocking fact for you:

Ms. Hannah has tested, changed insulin pump infusion sets, injected and applied continuous glucose monitor sensors in public restrooms. She has also tested her blood and injected insulin in front of party guests, out at dinner, and even while working the door at a poetry slam. Is she wrong for doing it in one place and not the other?

There is no reason for either to be wrong, because it seems the sort of thing to be based on situations and personal preferences. Ms. Hannah does not do things involving needles and/or blood in the sightlines of friends who go pale and woozy at the mere sight of needles and/or blood. While she wants them to understand her Type 1 Diabetes, she does not want them passing out into their craft brews and plates of vegan brunch. That's bad news for everyone.

To make up for any accusations of potential flip-floppery in her opinions on etiquette, here are some rude things Ms. Hannah has done which may shock and appall you, Gentle Advice Columnist--perhaps much more than any quick injection in public:

--Licking a finger following a blood test
--Not disposing of sharps in a proper biohazard container
--Hitting "ignore" on a phone call from Ms. Hannah's mother
--Removing wedding rings to apply hand lotion
--Sitting on, not hovering above, the toilet seat in a dive bar bathroom
--"Breaking wind" at work when I am alone in the office
--Asking friends with bleeding paper cuts if they would like their blood glucose checked
--Hoping her blood glucose would drop low as an excuse to not bolus for a donut
--Wiping her nose on a cloth restaurant napkin

That being said, this blogger advocates individuals continuing to do what is best for them, and learning how to educate others along the way. People with diabetes and other medical conditions that require constant monitoring or potentially obvious medical interventions in public should not be obligated to choose "Team Tidybowl" over "Team Test Strip on a Lap, or Inside a Purse, at the Airline Gate". Ms. Hannah also feels that PWD should not be jerks who yell "DEAL WITH IT!" at people uncomfortable with diabetes-related bloodletting and poking. Perhaps the polite thing is for the PWD to explain what they are doing and advise the squeamish to look away until they're told it's over?

Gentle Advice Columnist, the DOC may have had choice words for you in the past couple of days, including telling you to eat a number of...unseemly things. Ms. Hannah advises you eat something, too--a cupcake, while sitting down to chat with someone with diabetes about the realities of what they see as proper in polite company. After that, you may truly be able to dispense applicable diabetes etiquette which is relevant to everyone's interests.

Best regards,
Ms. Hannah

PS: For the record, I agree with you sometimes. I think baby gender-reveal parties are unnecessary. And as a person who has drawn hearts, smiley faces, and written stuff like "Woo hoo we can't wait to see you!!" on wedding RSVP cards, I did rather enjoy the way you dissed them in the letter just above the diabetes letter that caused all this controversy.

Jerkuary

That's right, January.  You are dead to me.  You have been nothing but trouble, trial, and tribulation.

How's that? you ask.

This is the third time my car has been in the shop this month, possibly for all of the same problems each time.  This has resulted in less of a surplus than was planned this month, so some payments I was really hoping to double up on are not really getting anywhere.

This is the month I've had to take a bus to the El train to another bus to get to/from work while my car is in the shop.  The total trip one way is about an hour and twenty minutes.

Work stress.

Frozen pipes in the kitchen.  One kitchen sink overflow as a result.

Painful muscle tension caused by work stress and the general crappiness of this month.

Matt's grandmother passed away.  She was a wonderful woman who will be dearly missed.

Definitely not getting out enough, due to aforementioned car issues.

There was, for certain, a lack of poetry.

Oh, and snow.  Lots of snow.  Snow that gets in the way of travel plans--this is how we were not able to attend Matt's grandma's funeral.  This is how I had a FIVE AND A HALF HOUR commute home last week during the storm.  This is how my snow shovel, which I'd only had for three weeks, was stolen from the front of my house and swapped with a small rake.  I can't make up stuff like this.  If they wanted to borrow a shovel, they just had to knock and ask me!  What am I going to do with this rake now?

And if you are only here to read about diabetes stuff, let's throw in a few sticky, gross, eye-blurring, tongue-drying high blood glucose readings that were tough to bring down, even with site changes and injections.  Oh, right, I attribute that to all the jerkiness of Jerkuary!

Jerkuary did spare me in a few ways.  There were some generous SEPTA employees who took pity on me for not having the proper fare or who rushed us all through the gate without having to pay for the already-late subway.  There was the incredible Balkan brass band show Matt and I attended.  There was the kindness and ingenuity of Matt's brother, who set up a Google+ Hangout session on a smartphone so we could virtually attend the funeral service that we couldn't travel to.  There were friends, hugs, Hello Kitty slippers that I got for $5, there were recipes tried and well-received.

But really, Jerkuary, I'm glad you're heading out of here.  Next month is my month:  February.  My birth month tends to hold lots of good things.  At this point, almost anything could be an improvement.