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.

To The D-Mom I Just Saw in a Comment Thread...

Her name was Donna, and she said that her son is on multiple daily injections rather than an insulin pump, because that is what works best for him, and doing something new would possibly compromise his quality of life.  Good for you, Donna!  You and your son are working with what's good for you, and I think that's the best way to do things.

She did say one thing, however, that I found a bit distressing.  She said it is tough for them to admit within the DOC that they are on MDI, because they are "looked down on" and people treat them as though they "are not up to snuff".

I don't have any children of my own, but being a member of this online community since 2006, this is where I put my concerned-parent face on.  My dear Diabetes Online Community, I am not speaking to any of you as individuals, because I don't know who the culprits are, but I swear we have been over this before.  My friend Bennet Dunlap has a phrase for this: YDMV: Your Diabetes May Vary.  Everyone is entitled to their own opinions, but if someone isn't looking for advice, if someone's treatment plan is working just fine for them, then leave them to it.

Straight up, no-bones-about-it, my insulin requirement is high.  I am jealous when someone bemoans their huge 10 unit meal bolus.  Part of the reason I chose the pump I'm using now (the Tandem t:slim) is because it will remind me to deliver the remainder of a bolus that is over the allowable maximum.  I have had some clicking of tongues and shocked looks when I tell people my total daily dose, and I don't appreciate those any more than Donna appreciates judgement of her son's injections over pumping.

Look, DOC.  I believe in kindness and understanding, and I like to believe in the best in people.  I want to believe everyone is kind, flexible, and intelligent enough to know that what works for me may not even be remotely close to what works for you.  Here's the thing--that is totally okay.

Remember, very few of us are medical professionals, and even so, most of our blogs are no substitute for medical advice you can get from your doctor, nurse, or diabetes educator.

So to Donna, you keep doing what you're doing.  To everyone out there, keep doing what works for you.  And to the naysayers out there, remember, we are not all the same.  Be sensitive, especially if you're going around making assumptions.  The DOC isn't all about sunshine and rainbows and unicorns, but we can all try our best to not make others feel so excluded that they don't want to speak their minds.

End concerned female senior member of the DOC rant.

Diabetes Blog Week, Day 1: Find a Friend

Happy D-Blog Week to all of my friends in the Diabetes Online Community!  I am constantly astonished at how many names and faces have popped up since I started blogging back in 2006.  I certain have been at this for a long time.  It's such an honor to know that I am in great company, and that I can count some truly awesome bloggers among my personal friends!  Seriously, I have been chatting with George and Kerri and Scott J and Allison and Amy and Kelly and many others for years now, and while I do feel a twinge of jealousy when other people are getting invited to d-blogger summits or events, it just inspires me to work harder at blogging.  

It's funny, I often feel like I have a similar position in the poetry slam community.  I'm the poets' poet.  The bloggers' blogger.  I know lots of people whom I adore, and vice versa, and yet I still feel like this relative outsider at times.  I'm not complaining.  I just feel like I'm some best-kept secret that never makes it onto another list.  Can I nominate myself on Find a Friend Day?

I am realizing that sounds a smidge emo and self-indulgent.  I've been focusing on myself a lot lately.  Introspective.  Anyway.

One blogger you need to check out is Nicole Purcell.  She used to write at her own blog, now she blogs for D-Life's Blogabetes, and George already had some awesome things to say about her today.  She is at the top of my "I am totally going to meet this person one day" list.  She has tattoos and is into all kinds of badass music. 

Have you visited Scott E of Rolling in the D?  Definitely my favorite blog name I've found this year, great content, and he was recognized in the Best of the 'Betes blogs in March.  I'm described on his blogroll as having writing which is "humorously quirky", and that also won him some points.  Also, raise your hand if you now have Adele singing in your head because of his blog title.  Thought so.

Jess became a blog pal of mine recently via Twitter.  I feel like we are kindred souls at times, struggling with the same things, trying to get over some emotional hurdles, some things that are challenging us mentally, plus diabetes, plus everyday regular life.  If you aren't reading Me and D, you should check it out!  (Hilariously, work internet has decided her site is NSFW today. Kind of like the day Texting My Pancreas got blocked but came back up the next day.  You guys are some naughty diabetics.)

There's some awesome online friends for you to make.  And if you haven't told someone about Dorkabetic yet, why not do it today? [end shameless self-promotion]  See you tomorrow for D-Blog Week, Day 2!

No Matter Who You Are

So in the week since my birthday and party have passed, I wish I could say I had some epiphany about life or something.  However, it's mostly the same ol' things I always know.

And diabetes-wise?  Well, let's just say I took a quick break from my Dexcom to let my sites rest a bit, but as a result of said Dexcom, I did remember to check my blood a fair amount on my own.  That's one thing I slip up on constantly--remembering to poke my finger at the bare minimum 4 times a day.  Honestly, that is the biggest change I can make for myself this year.

Tonight, I will slap that sensor back on and get back in the CGM saddle.  Tomorrow, I am off to the CWD Focus on Technology conference where I will be among many beeping glucose meters, buzzing robot pancreases (pancreai?), and of course, fellow people with diabetes and their families.  Best of all, I will be in the good company of a bunch of D-Bloggers.  And you know what happens when we get together.

(Author's Sarcastic Note: We eat carbs and drink alcohol!  Noooo!  Call the diabetes police!)

Anyway, I'm sure it will be fun, and informative, and potentially a place where I can pick up some diabetes swag?  Like, a prettier skin for ye olde Dexcom?  Eh, my lunches are already paid for and I get a free t-shirt.  Keep an eye out for pictures, recaps, and everything else.

I have a theme song today.  Just a reminder to put myself out there.  Sometimes my biggest obstacle is my attitude, sometimes it's my fears.  But I feel rockstar mode coming on, and I hope it sticks around.

Here's to a weekend of hopeful things and realizing you ARE a shining star, no matter who you are.  No matter what your pancreas does or doesn't do.