I use the right fork. Know the difference between a red wine glass and a white wine glass. Can adjust my greeting to a stranger based on their culture. But damn… apparently when it comes to my diabetes manners, I’m the queen of the Clampetts.
There’s an electric undercurrent of negativity towards Miss Manners in the diabetes community over her column titled: Do diabetic testing in private. It behooves everyone to gallivant over to that page so you can see the ludicrous response she gave to someone regarding how to behave when traveling with diabetes. (And the responses? Delicious.)
She thinks that if you have diabetes, you should be relegated to the airplane lavatory when you inject insulin or check your blood sugar.
Restrooms exist to provide a proper location for such necessary activities when away from home, and those who use them have no business monitoring the respectable, if sometimes unaesthetic, activities of others.
Here’s my response to her response:
No, thank you.
Hell, no, thank you.
It’s not like I’m removing a glass eye to wash it. Changing a colostomy bag. Shooting heroin. I’m using a lancet device to retrieve a tiny drop of blood that is placed directly on a test strip. Once it’s done, I’m good to go.
I’m not getting up and clambering over the frail octogenarian to get to the back of the plane where I’ll stand waiting for one of the two lavatories, watching the person in front of me do the “I gotta go” dance. I’m not going to contort myself while holding my breath due to the previous occupant’s obvious gastrointestinal issues with beans and cabbage. I’m not dragging my diabetes gear and having nowhere to put it.
And bathrooms are dirty. Dirty. Ewww.
Never you mind that single aisle is crowded. The drink carts are launched, cold lunches barreling down the single aisle, and I’m going to go to the bathroom? Nope. There’s a limited number of stupidly expensive sandwiches with wilted lettuce on them, and I’ll be damned if they run out before I get one. (I don’t fly much anymore and I miss my upgrade status. Moment of silence.)
People have a problem watching someone check a blood sugar? I’ve seen people on planes clip their fingernails. Throw up. Eat an entire 12″ hoagie with extra onions. Drink to excess and become verbally abusive to those around them. I would take some injecting insulin over them every day of the week. It’s less offensive.
Miss Manners? Let me tell you a little story:
At the age of 16, I was in the bathroom of a Burger King in my hometown. The bathroom stalls were all being used and I needed to inject my insulin, so I hiked up my sleeve, wiped an alcohol swab over the back of my arm, and inserted the needle while a woman comes out of the stall… and freaks out on me.
“You shouldn’t be doing drugs here!!!”
She thought I was a drug addict and that I was shooting up. Before I could say anything, she went running for the manager.
I was so horrified and ashamed that I left out the side door of the restaurant, crying. (I didn’t even have a chance to start the injection, so no hypo to add insult to injury.)
It took a long time before I was comfortable checking my blood sugar in public or even bringing notice of my diabetes anywhere. (I didn’t want to even wear a medical ID.)
Miss Manner’s column shows that the public still doesn’t get it. If I didn’t have to check my blood sugars by pricking my finger, I wouldn’t. If I didn’t have to take insulin to keep me alive, I wouldn’t. But these days, my opportunities to educate and advocate happen everywhere - including when I travel. I refuse to hide this disease for anyone. It’s part of who I am. A strong woman with a lot of good manners. I don’t scream out: “Hey, I’m going to squeeze my finger until blood comes out! Wanna gawk at me?” I quietly and respectfully check in the confines of my seat. But I am not going to hide it.
So, ma’am, I will not go to the bathroom to check my blood sugar or inject insulin. I will not RSVP to your rationale.
And if you think diabetes activities are unaesthetic, what about blowing your nose in public? People do that all the time. If you think any unaesthetic activity should be done in the confines of a lavatory of an airplane, the airlines will have to retrofit all of their seats to have a toilet underneath, because we all do unaesthetic things… everywhere.
I took a little blogging break last week. It wasn’t intentional; I had other things cooking on the burners and gave them the time that was due to them. In the end, it all goes in the same pot, but it was strange to not write. (And that’s the extent of my chef metaphors.)
And now I sit with a large amount of caffeine, thinking about the good things that are happening in the diabetes world. In no particular order…
The Power of Community
According to an unofficial total (but from a source I trust), the Spare a Rose, Save a Child campaign raised…drumroll, please… $26,519. That’s a lot of insulin. That’s a lot of love. That’s a lot of lives that will be saved because the Diabetes Online Community raised their voices as one. I am in awe of the power of this community. For those who shared the message, thank you. For those who donated, thank you. (And it’s not too late to give a rose… )
Just because we’re not shaking the gates in person doesn’t mean that we aren’t working on ensuring blood glucose meter accuracy isn’t on our minds. Larry Ellingson has a guest blog post over at StripSafely.com, asking us all to join him in calling for congressional oversight of meter accuracy. I had the pleasure of meeting Larry at the DTS meeting in September, and I’m glad he believes as we do: whatever it takes to make sure we stay healthy and safe.
Think meter accuracy is not important? Larry gives another statistic that scares me (and it should scare you, too!):
A second survey confirmed that 27 percent of patients with type 1 diabetes had experienced health problems due to inaccurate blood glucose meter readings.
The FDA can only do so much at this point. It’s up to us to rally together to bring Congress the news: we need their help. Bennet and I will be putting together some points that you can use when talking with your representatives soon.
It’s an i-port Advance
Medtronic announced the i-port Advance, an “all-in-one” injection port. For those who take multiple daily injections, it basically takes the place of injecting into different places… and into the injection port. You insert the i-port Advance and for the next 72 hours, you inject into the port.
Injection ports aren’t new. I remember using an injection port years ago. (I don’t remember why. It was probably a sample or two to see if I liked it, but obviously I didn’t care for it, because I didn’t use it for long.) If you have needle phobia, it’s a great way to ease the fear of having to inject more than once a day. If you micro dose fast acting insulin for optimum control, this may be a great way to avoid seven or eight injections each day.
There was a study done in 2008 about the impact of insulin injections on daily life and the results didn’t surprise me much. The study showed that out of 500 subjects, 29% of them stated that injecting insulin was the hardest part of their diabetes care. Fourteen percent of the subjects said that insulin injections have a negative impact on their life. So… obviously there’s a need to help alleviates some of the negativity. The i-port Advance is one way to do so.
The Future of Glucagon
For anyone carrying around that red hard case in the bottom of a bag or a purse or next to your bed, you will nod your head when I say this: Glucagon is a pain in the ass. (Sometimes literally.)
The Glucagon Emergency Kit has been around for quite a while, but unless you’re with someone who knows how to use it, it’s useless. If you pass out, the last thing a stranger will do is rifle through your bag looking for something to help you. Even if you’ve shown a friend or a work colleague how to use it, when push comes to shove (or push comes to drop on the floor), it may be too complicated.
True story: I would give a little primer about my glucagon emergency kit to my staff. New team member = pull it out and go through the motions. I would end every discussion about glucagon with this: “Call 911 first. Then attempt to inject me.” Then the discussion would be who would draw the short straw to do this. I trusted my team, but knew that glucagon was a last resort.
These days, I’m hopeful that glucagon will be available in an easier delivery mechanism - and perhaps even not by injection! Mike Hoskins over at DiabetesMine has a great article about Next-Gen Emergency Glucagon, in which he discusses the big issue: stability of glucagon. (Currently, once mixed, it’s good for 24 hours. After that, pfftt.) But even more exciting? This:
Assessment of Intranasal Glucagon in Children and Adolescents With Type 1 Diabetes - Yes. It’s a clinical trial that currently is recruiting kids for an intranasal dose… Could this be more awesome? Nope. I am hoping that this is what’s in store for all of us. I’d be much happier giving a primer about: Hold this up to my nose and squirt. Wouldn’t you?
By the way, there’s also a trial for adults: Effectiveness and Safety of Intranasal Glucagon for Treatment of Hypoglycemia in Adults. You can get a little more info here: Evaluate the Immunogenicity of a Novel Glucagon Formulation. The company behind this is AMG Medical, Inc. out of Canada. I’m eager to see the outcome of these trials!
So, as I sit here this morning, I’m buzzing with excitement (or is it caffeine) with hope for the future. What are you excited about?