Diabetogenic

Lipstick and a smile

July 11, 2019 in Hypo, Peer support, Real life | 3 comments

The other night, I cancelled going to a party – a cousin’s kid’s 18^th– at the last minute. I seriously never do this. And I absolutely hated doing it.

But I’d had a couple of hypos during the day (Fiasp is absolutely kicking my arse) and I was feeling exhausted. These hypos weren’t what I’ve become used to dealing with (i.e. Loop hypos for me generally look like an alert telling me I’m going to head low, me ignoring it, alert saying I am really about to be low – but not really low because Loop is doing its thing, me having a couple of fruit pastilles, and that’s it). These were the types of hypos that spin me around, turn me upside down and resettle me feeling completely discombobulated. It had been a while.

After the second one, I was so knocked out that I lay down for a bit and ended up getting an hour’s sleep. It was mid-afternoon and when I woke up, I felt no more refreshed.

I contemplated going to the party – I had a shower and started to put on some make up. I looked fine – no different to how I usually look. If I’d gone, no one would have known any different.

Earlier in the day, after I’d already had the first hypo, Aaron had posted a photo of me online. The next day, when I mentioned to someone that I had cancelled plans the evening before thanks to a lousy diabetes day, said ‘Oh. I saw a photo of you online in the morning and you looked great.’

They didn’t mean this in a nasty way, or that they thought I had just cancelled because I couldn’t be bothered going out. It was just a comment. And they were right – I looked exactly the way I would look any other weekend morning when I was having breakfast with family and friends

The next day I was messaging a friend with diabetes and mentioned I’d cancelled my plans at the last minute the night before. ‘Oh babe,’ she said. ‘How’s the hypo hangover?’ and then she detailed all the things that are the inevitable fallout of nasty (and nasty-ish) lows; the things I’d not mentioned to others who’d asked after me.

I told her she had nailed exactly how I was feeling. I told her what had happened, and I didn’t hold back, and I didn’t minimise it. I knew she wouldn’t worry or be unnecessarily concerned or wonder if it was anything more than what it was. I knew she would know – because those feelings are wound into the DNA of diabetes and the people living with it.

Plus, she would know just how I felt about the last-minute cancellation, and feeling that I’d let people down.

‘So, I bet you’re feeling even more crap about cancelling that about the hypos now, right?’ she said.

I laughed. ‘You know it!’ I said to her

‘Don’t you sometimes wish that when you were having a shitty diabetes day it couldn’t be covered up so easily with lipstick and a smile?’ she said, hitting me right in the guts with that comment.

Because she was so right. Lipstick and a smile. That’s every diabetes day. It’s there when I’m feeling great and all is going well; when diabetes is behaving and not impacting on me much at all. And it’s there when I’m feeling crap and diabetes is casting far too large a shadow over my existence for that day. But for most people, they couldn’t tell the difference.

Managing this hypo with iced coffee…and lipstick and a smile.

No big deal

July 8, 2019 in Diabetes, Healthcare team, Real life, Travel | 1 comment

Diabetes is a big deal. Most people living with diabetes can talk to that. But are there ways that we can reduce its impact in small ways that may just add up to something meaningful?

I was thinking about this when I saw Dana Lewis tweet an update from her most recent travels. She does this often – a photo and a comment as she has breezed through security, and I love that she does. Dispelling myths that travel with diabetes has to be a logistical nightmare involving routine strip searches and confiscation of devices is only a good thing, and hopefully will show that diabetes shouldn’t be a reason to delay a trip somewhere.

I’ve made it no big deal by never declaring that I have diabetes or that I am carrying diabetes kit, because why the hell draw attention to something unless necessary? If, for any reason, an alarm sounds, or I get asked about what I’m wearing or carrying, I have a clear, polite, stock standard response that usually does the trick.

That doesn’t mean that travel is never going to involve diabetes-related questions, but there are certainly ways that can minimise just how much of an issue it all is – or even stop it starting to begin with! Dozens and dozens of flights, more security check points than I care to think about … and the times there was an issue can be counted on one hand. No big deal.

The longer you live with diabetes, the better you are at finding shortcuts to make life easier. And reducing just how big a deal every day occurrences are is one way to do just that.

For example, being weighed at diabetes consultations (in fact, most consultations) is a no-no for me. I’ve made it clear to my endo why I don’t want to be, the circumstances under which I will agree to it, and why I find it difficult.

By the way – I know that being weighed is actually a big deal for a lot of people, me included. There’s a lot tied up in stepping on scales. I’m certainly not trying to minimise the minefield that is weight and being weighed. I am just trying to explain how I have been able to remove a lot of the angst just by doing something simple and being clear about my wishes.

Apart from a few times where I have had to repeat my position more than once, it’s never been a problem. It’s actually interesting how HCPs respond when you ask why they need to do something. ‘We need it for our records,’ is never a good enough reason for anything as far as I’m concerned – certainly not how much I weigh.

I get the position of privilege I am coming from here, by the way. I know that I am assertive enough to state what I want and expect, back it up if necessary, and having that confidence means I find it easier to navigate the often treacherous waters of diabetes and getting what I want. I am comfortable saying no and holding my ground, and I can’t remember the last time that wasn’t the case.

Diabetes is a huge deal, so working out ways to make things a little less big makes sense to me. I don’t have the time, inclination or energy to waste on things that really can be minimised. What is important and a big deal (or what isn’t) for me, will be different for others, but I do wonder if sometimes we make more out of things that we really don’t need to. Because, really, sometimes it’s good to shrug our shoulders and just think ‘no big deal’.

#TravelWithDiabetes – no big deal

Selective

July 5, 2019 in Communication, Diabetes, DOC, Social media | 2 comments

Let’s imagine, just for a moment, that a television program or newspaper claimed that there was a cure or treatment for type 1 diabetes that you could brew in your kitchen with a few pantry items.

It’s not really all that hard to pretend that this scenario is real: almost every week there is something somewhere that claims to be a way to treat diabetes, and sometimes, this mythical treatment is for type 1 diabetes.

What happens when we see this? Well, usually, it starts with some low level ranty outrage from a first responder who caught the piece and feels that they need to share it with the diabetes world (hashtag – DOC).

Then, as it gains momentum, others get onboard, because we all love a little SoMe outrage. Inevitably, there will be some comments about how ‘This might work for type 2 diabetes, but I/my child has type 1 diabetes, and I/they did nothing to cause it and this is the serious type of diabetes so stop it now.’ (Because adding some ‘type wars’ to the discussion is always helpful.)

There will be blog posts written about it (possibly/probably by me) and someone will demand an audience with the reporter, so they stop perpetuating myths about type 1 diabetes.

Right?

The outrage can be exhausting, but I do get it. We don’t want people to simplify our condition, of have people thinking that there is an easy fix. We want people to understand that it is hard work to manage diabetes and that every time there is a claim that it can be easily treated, people move further away from what it is really like. We want people to know that, so we talk about it loudly and everywhere.

So, after watching the ridiculous claims from Medicine or Myth the other night, I turned to Twitter to see what people were saying about the idea that hemp kombucha was miracle cure or to hear the criticisms about the poor study design of the trial.

Was there a barrage of people questioning the idea that simply drinking 100ml of a fermented drink a day could possibly be all it is going to take to treat the incredibly complex health condition that is type 2 diabetes? Or tweet after tweet probing whether the ‘trial’ that decided that we’re on a winner with Kombucha would pass any sort of test? Was there a choir suggesting that this was really all a lot of hocus pocus and it was undermining just how serious type 2 diabetes is – and how hard it is to treat it?

There was now tweet from Jane Speight…

…and that was pretty much it. (It is a very fine tweet, and that #sciencefiction hashtag deserves accolades!)

And there was no one up in arms about the way the merry band of doctors was talking about type 2 diabetes in such sensationalist and stigmatising ways. If they had been talking about type 1 diabetes, our response would have been swift.

What we saw on this program this week is actually dangerous. We can’t dismiss it as yet another ridiculous claim from a nut like Pete Evans, or Sarah Wilson, or the latest footballer’s wife. We can’t attribute it to an Instagram wellness guru. Instead, we saw three qualified healthcare professionals – a neurosurgeon, a GP and an immunologist; healthcare professionals that people trust with medical advice.

And – showing some bias here – perhaps it would have been easier to dismiss and discredit the whole show if it was broadcast on a more traditional tabloid program such as A Current Affair. An SBS show, with three Australian practising HCPs? People will think this is legitimate.

The way Medicine or Myth whitewashed type 2 diabetes was a disgrace. And as diabetes advocates, we should be calling out this sort of garbage, the same way we would ludicrous claims about type 1 diabetes treatments.

Totally unrelated, but I live in the most hipster street in the most hipster suburb of Melbourne and there is a place on my street that brews and sells seventeen different types of kombucha.

Step away from the hemp kombucha

July 4, 2019 in Diabetes, Food | 7 comments

I love working out of the same office as Jane Speight. It means that I have a friend just down the corridor, plus I have this idea that being around her and the ACBRD team makes me smarter. (Admittedly, I am the only one who thinks that.)

Jane may not be quite as excited by the working arrangements, especially on the not rare occasions where I appear at her door and go on some rant that she didn’t ask for. (‘Jane! Have you seen <insert latest thing that is pissing me off>? Let me tell you all my thoughts about it right now.’)

So, the other day, when Jane appeared at my door wanting to talk (rant) about hemp kombucha, I was more than ready to sit back and listen. For a change.

Yes…

Hemp kombucha.

There is a television show on SBS in Australia called Medicine or Myth. I’d never seen it, however I did know that Dr Charlie Teo is one of the hosts. Charlie is a well-known and controversial neurosurgeon. He is joined by GP, Dr Ginni Mansberg and associate professor in immunology, Dr Ashraful Haque. They are the trio directing the show, which sees Aussie pitching home-grown treatments for treating all that ails them.

I had not ever come across the other two hosts before, but a Twitter search showed that Ashraful is interested in host-parasite interactions (and guitars). The first bit made no sense, but I like guitars. Ginni also hosts (the horribly named) Embarrassing Bodies Down Under, and is a ‘passionate anti-aging skincare geek’. I don’t know about you, but I generally don’t go to my GP for advice on how to reduce fine lines and wrinkles, but maybe I’m being narrow-minded.

The episode that screened this week featured John Leith who was diagnosed with type 2 diabetes a couple of years ago. And that brings us to hemp kombucha.

Within about thirty seconds of watching the segment I had already dismissed it as complete and utter rubbish. In fact, the second that John referred to hemp as a ‘superfood’ I rolled my eyes so far back into my head that I almost blacked out.

I then grabbed a piece of paper and started making notes of all the misconceptions about diabetes that were being thrown around. I’m not going to list them all here, because I have more important coffee to drink, but if Ginni Mansberg is your GP, find another one now. Her statement that ‘Poorly controlled diabetes will [….] destroy your feet’ followed by saying that an A1c of under 10% is what ‘diabetics should aim for’ was enough to set me off yelling at the computer screen.

But back to John and his magical mystery kombucha. Apparently, it cured his diabetes. That’s right, after five or six weeks of drinking this glucose busting elixir, his glucose levels were back in range. The three experts – and I am now using this term loosely – were astounded, and to make sure we knew that, made acceptable TV astounded noises. In fact, they were so caught up also making acceptable TV astounded faces that not one of them asked if the corresponding reduction of food portions, increased fresh food or boosted exercise plan could have contributed (i.e. caused) the improved glucose numbers John was seeing.

In fact, John’s claims were enough for this merry band of HCPs to send the hemp kombucha off to trial – another term I am now using very loosely. According to the voice-over person narrating the program in a serious voice, trials are run by an independent scientific team experienced in clinical research who recruit carefully selected participants.

According to the next segment, those carefully selected participants included three people: two with type 2 diabetes and one with ‘pre-diabetes’. They all drank 100ml of hemp kombucha a day and then recorded their BGL on day 1, 3 and 7 of the week-long trial.

I know. Robust.

The results were astonishing. Apparently, blood glucose results came down on average 0.8mmol/l, with 75% of participants (out of a total of 3?) reporting improvement in glucose results.

I have so.many.questions.

We were not told if the participants were doing any else to manage their diabetes. Were they taking medication? Were they on a specific eating plan? Were they exercising? Had any of them lost any weight during that week? Why did the trial (really? trial??) only run a week? Is it reasonable to suggest that three data points is really enough to confirm that a treatment is successful?

I can’t answer any of these because none of this was revealed in the program.

However, it was enough for the hosts to claim that they were excited about this as a treatment for type 2 diabetes.

Let’s just think about that for a moment. This ridiculously shambolic and hopeless experiment was enough for three healthcare professionals to suggest that hemp kombucha is something people with diabetes should consider…and that the scientific community should sit up and pay attention. All this without a glance to the fact that John and his n=1 claims are also associated with a hemp kombucha business, and the least vigorous trial I have ever heard.

You know, this really could work for some people. Complementary therapies do have a place in modern medicine. Many have been studied extensively to see how they can augment science-based treatments. However, before any HCP even thinks about mentioning them, they need to be able to point to some evidence. Three people and three blood glucose checks is not evidence. It’s a twenty-minute segment in a sensationalist crappy television program.

Look, I don’t really want to link to this train wreck of a story, but I think that you need to watch it yourself to appreciate just how ridiculous it is. So here you go. (I’m sorry.)

Language of new diabetes treatments

July 2, 2019 in Diabetes, Language | 3 comments

Belle Gibson has been pretty much universally shamed for her claims that she was able to cure her cancer by ignoring medical treatments, instead using diet and alternative therapies.

We question (as we should) the validity of curing conditions such as autism with specific diets; epilepsy with light therapy, and asthma with reiki.

Anti-vaxxers are called out (although not enough) for their claims that pixie dust and sun-charged crystals will protect their darling, perfect offspring, and that injecting toxic toxins of toxicity is a waste of time that only serves to line the pockets of BigPharma. And Governments, who are in the pockets of BigPharma. (It must be really crowded in those BigPharma pockets…)

(Soon to be former) US Democrat presidential-nominee Marianne Williamson added her voice to the throng of lunatics back in 2009 when she claimed that vaccine-prevented diseases are insignificant, and that god will protect us as long as we pour his love over our immune systems. I’m still trying to work out: 1. Where to get my dose of god’s love (my pharmacy doesn’t seem to have it listed on their website) and 2. How the fuck I’m meant to administer it to my already over-sensitive immune system. It’s likely to self-combust.

Main stream press unfortunately does give voice to these fools, but thankfully, the voices of science – you know, those that actually understand and believe in real science-based evidence – are loud and clear in their condemnation of charlatan claims.

Of course, diabetes isn’t immune (autoimmune?) from these sorts of claims. I still regularly show this ridiculous Khloe Khardashian claim klaim that kumcumbers kure diabetes when explaining how so-called wellness gurus (or reality television stars) infiltrate – and influence – what we know actually works as a treatment for diabetes.

And the delightful cinnamon cure-all gets rolled out at every possible moment.

Marrakech 2013: holding the cure in my hands.

But what happens when there is evidence showing something that challenges what we have long-held to be true means we do need to sit up and listen…but it is being communicated in a way that could potentially be more damaging than beneficial?

We are hearing more and more that there is evidence to support that type 2 diabetes can be ‘cured’ and put into ‘remission’. I am not looking at the science here; I do understand that there is a growing body of evidence to show that for some people, a very strict low-calorie eating plan can mean that people see in range glucose levels.

This is being hailed as positive, but where I start to feel uncomfortable is when this is reported in the mainstream media as a cure, which is often how it is touted. Other words that seem to be bandied about are ‘remission’ and ‘reversal’

But is it a cure? Is type 2 diabetes able to be truly reversed or put into remission? Because that is how I am seeing this presented with very little question.

As ever, language matters. Using the word ‘cure’ suggests that a health condition is fixed, forever gone away. That is not what is happening here.

Remission, when used in the context of cancer, is not an absolute. There are stages to remission. Partial remission suggests that treatment may be ceased as long as the cancer doesn’t grow again. No evidence of cancer in scans and other examinations is referred to as complete remission.

In diabetes, remission and cure are used to suggest that glucose levels return to ‘normal’ levels, (i.e. those seen in people not living with diabetes), usually because something has happened – the person lost weight, changed the way they are eating, increased their exercise etc. And this happens because people followed a treatment plan. What happens if they stop that treatment? And how long will this treatment continue to work this way? Does it mean that they no longer have any of the concerns that occupy the hearts and minds of people with diabetes?

Just as in cancer – and in other conditions – some people respond to treatments better than others do. When the media says type 2 diabetes can be cured or put into remission with these treatments, there is never any nuance to that statement, explaining what that means. No one talks about the non-modifiable risk factors that play a huge part in type 2 diabetes.

The last thing we want to do is for those who don’t see the results promised – cure! remission! – is for them to feel that they have failed. There is already too much of that in diabetes…especially in type 2 diabetes. (This never happens in cancer. If a treatment doesn’t work, the person is not told they have failed.)

The words we use do matter. How we are communicating these new treatments for people with type 2 diabetes is important. We need to remember that these treatments will not work for everyone and it is never okay to make people with type 2 diabetes feel responsible if they don’t work for them, or that they haven’t tried hard enough. Or that they haven’t wanted it hard enough.

My passive aggressive health condition

July 1, 2019 in Diabetes, Real life | 2 comments

If there is one trait that drives me absolutely batty, it’s passive aggressiveness. I suspect part of that is to do with my directness – I am very good at being clear about how I am feeling and what I need. Skirting around an issue or saying things indirectly and being obtuse in the hope that others will understand what is going on just annoys me. Why make people guess when I can just tell them?

And of course, social media provides the most perfect platform to excel at passive aggressive behaviours: ‘vague booking’ and ‘sub-tweeting’ are the habits de jour of those who employ passive aggressive behaviours. I just swear too much and pointedly say pretty much everything that is going on in my head. Without a filter. Have I mentioned recently that I’m a delight?

So, naturally, I have the most passive aggressive of all health conditions possible; the health condition that appears one way, when really there is so much more going on. This is the health condition that likes to leave pathetic little hints as to what is going on, but rarely decides to be direct about anything.

Let me introduce you to diabetes where the passive aggressive comes in different forms.

We see this at diagnosis. Sometimes, there’s shitloads of stuff going on behind the scenes, but nothing outward (hello all the people walking around with undiagnosed type 2 diabetes), or it does give little suggestions, but those symptoms could also be another million other things (hello to all the people who were told their type 1 diabetes was just a cold/UTI/tummy virus etc etc.).

There are rarely super, super visible, really obvious and unmistakeable signs that scream loudly ‘THIS IS DIABETES’, which would be really useful because we know that early diagnosis and treatment means better outcomes.

Also, there’s impaired hypo awareness. For those of us living with this particularly fun type of hypoglycaemia, we have our lows, but diabetes has found a way to hide the symptoms away. That’s right, don’t actually let us know that we’re low (even though previously there were lots of symptoms), just go about letting us believe that everything is okay.

Or those times when we are convinced that we are low and are exhibiting all the classic signs, only to realise that actually, no, right now I am either sitting right in that sweet spot; or high as a freaking kite and downing that juice would really not have been a great idea. At all.

Diabetes complications can give the silent treatment for years, and conversely, there are weird symptoms that mimic the onset of a complications, setting us up for sleepless nights of worry, only to find out that actually, there is nothing sinister there.

But perhaps the most frustrating and maddening way that diabetes exhibits is passive aggressiveness is the way it makes us appear to others. Mostly, we look perfectly fine and good and that all is well I the world, when really, it is doing all it can in the background to make it so that we are not.

Living with a health condition that doesn’t communicate effectively (and deliberately in a wishy-washy manner at times) really is one of the things I like least about it. It’s no wonder that often we don’t realise that there is something wrong, because everything seems okay, or the message we’re getting is that nothing has changed. Being blamed for this is unfair, and yet that’s the way the cards fall.

I don’t really know how to overcome this particular trait of diabetes, but I have been known to silently scream ‘Tell me what you mean’when it seems to be deliberately confusing and not responding the way I would expect. Really, that’s all I’m asking for: clarity, no ambiguity, directness. And a health condition that isn’t trying to drive me to despair by not just telling me what I need to do and responding accordingly. It’s not too much to ask.

Passive aggressiveness is never the answer. However, I do love this cartoon. Because Poe puns are hilarious! (Click for artist details.)

Sum total

June 28, 2019 in Complications, Diabetes, Health, Real life | 2 comments

My favourite answer to give when someone asks me how I went at any diabetes-related medical appointment is ‘Nothing to report.’ I love being able to say that things are boring. If there is ever a time in my life that I want to be unexceptional and routine, it is when I am hearing or sharing news about my diabetes.

For as long as I live with diabetes, I want to forever be told ‘It’s nothing,’ or ‘There’s nothing.’ I want there to be nothing there when my eyes are screened; nothing to report when I have my kidney function checked; nothing new, nothing scary, nothing to worry about.

The thing is: to get to nothing, we put in a lot of effort. We push ourselves and do things over and over and over and over. Because we’re told if we do all the things, all the time, nothing will happen.

But sometimes, despite all that effort, it’s not nothing; it’s something.

We have done everything possible – everything we possibly can – and we walk in and expect to hear another nothing. But instead, this time we’re told there’s something and we can’t help but wonder why we didn’t do more.

That’s just how diabetes works. There is no rhyme or reason. There is nothing fair about it. But we keep doing it – whatever we can manage at that particular moment.

And we ask and hope for nothing – absolutely nothing – in return. Except our health.

Which, as it turns out, is absolutely everything.

Hoping for nothing.

Breaking rules in Florence

June 27, 2019 in Diabetes, Food, Real life | 1 comment

Ten years ago, we stumbled across a little out of the way restaurant in a small backstreet of Florence. It was run by a couple and the food was sublime – beautiful Italian dishes served without fanfare, just simple flavours that let the freshness of the food shine through.

So, last month, returning to Florence for meetings, I made sure that one night was spent there and was pleased to find that the food was once again perfect. Mains done and plates cleared away, the waiter came to take our dessert orders and followed up asking if anyone wanted coffee.

All had been going so well. Until this…

‘I’ll have a latte please,’ said someone at the table. It was an innocent enough request, but I knew where this was going.

The waiter looked horrified. ‘No!’ he said indignantly. I’d ordered an espresso, knowing there would be no response other than a nod. But the idea of a caffè latte at this time of night, after a meal, was not getting past him.

Clearly, our waiter felt that it was part of his job to enforce the Italian gastronomic rule of no milky coffees after 10.30am. This was an abomination, as far as he was concerned, and he was having none of this flouting the rules business in his restaurant. I suspect that if someone had asked for a sprinkle of Parmigiano-Reggiano over their spaghetti con vongole his response would have been the same.

Perhaps his response would usually have had the customer slinking back in their chair and ordering an accepted coffee-based post-dinner drink. But this was a table of people with diabetes and telling us that we can’t break the rules never goes down well. Because breaking rules is how we survive. And jeez, we get defiant when people tell us that we can’t. Rule books states that injections should never been given through clothes? Watch how easily this needle goes right through my jeans. Rule books claims the only place that CGM sensors must be worn is on the stomach? I’ll just roll up my sleeve and put it there, thanks. Rule book instructs single use of all diabetes consumables? Let’s see just how many times this insulin pump cartridge can be refilled before getting stuck.

We learn the rules and then turn them upside down and inside out to work for us to help our endless search to make diabetes that tiny bit more manageable and forget expecting us to say sorry for doing it our own way. We make no apologies for taking what some may consider short cuts, instead sharing them with our diabetes peers because everyone deserves a break with this condition if there is a way! And sometimes we just do things in a different way because we like it better.

The waiter in our restaurant looked to me to back him up. I think he assumed that my decent Italian accent that he’d heard when I ordered meant that I was across Italian food rules and that he had an ally. I wasn’t surprised at his response – I do know the food rules – but I treat them in equal measure with respect and contempt, just as I do diabetes rules. I understand why they are there, and sometimes I’ll abide by them. But if I want a milky coffee after my meal because that’s what I feel like, you bet I’m going to order it.

I shrugged my shoulders at the waiter, I’m sure disappointing him that I wasn’t going to back him up. ‘Un latte?’ he asked disbelievingly. ‘Si,’ I confirmed, and then clarified. ‘Con caffè.’ The last thing I wanted was the delivery of nothing more than a glass of warm milk to the table and all that was going to ensue following that.

All our lives we are told there are rules and some of them are just stupid: blue and green should never be seen, unless there’s a colour in between. Never wear pink and red together. Others don’t allow for personal choice: don’t order a steak well done… (or a milky coffee after dinner). And some forget that those rules are connected with something that is boring, tedious, unpleasant, frightening and sometimes downright horrible: every single diabetes rule.

Sure, sometimes rules are there for safety, and we all want to be safe. Living with diabetes doesn’t suddenly make us reckless and not interested in being healthy and safe.

There are some rules that we know are just non-negotiable and we will begrudgingly follow those. But the ones that we think are ridiculous, or we have found a work around to? Those are the ones we’ll do whatever we can to shake up or lose.

Our tiramisu desserts were delivered to us, and so were our coffees, including the caffè latte, which the waiter placed down while shaking his head and making ‘tsk tsk’ sounds. Thirty seconds later, he reappeared and placed down a shot of grappa, making some comment about this being needed to cancel out the coffee.

I smiled up at him, because that’s how Italians do it. (I know – I’ve spent 45 years doing things the opposite to how my Italian father thinks I should do them!) They’ll let you know they’re not happy with you, and absolutely don’t approve of your obviously wrong decision making. And they’ll remind you at every chance that they have.

And then? Then they’ll somehow offer a final fuck-you-and-fuck-your-bad-choices. And, really, there is nothing better than some oesophagus-destroying hard liquor to get that point across!

Viva Italia!

Perfect tiramisu.

DISLCOSURE

I was in Florence for DOCLab Advisory meetings. My flight to Florence from Amsterdam and two nights’ accommodation were covered by Lilly. The attitude during this meal was all courtesy of the rather cheeky waiter.

Diabetes in neon

June 26, 2019 in Diabetes, Real life | 1 comment

Wandering the streets of SoHo, there is a shop with windows covered in neon signs.

And look! One that is a perfect mantra for diabetes.

Diabetes is all about the unexpected. And the moment we think we have it all worked out, and know just what to expect, something completely, utterly, totally unexpected happens.

That’s one thing we can expect.

Don’t be a dick

June 24, 2019 in Community, Diabetes, DOC, Social media | 1 comment

One thing that is somewhat of a consolation while dealing with jet lag, is that while I’m not sleeping in the middle of the night, Twitter is right there keeping me company! There is always someone from the DOC up and ready for a chat. And if I don’t feel like chatting (because honestly, at 3am when I’ve not had enough sleep, stringing words together is a challenge), there are always things to read.

And that is great.

Also great is when people jump on board to support each other, or cheer when others are involved in an exciting initiative. (Seeing people in the DOC welcome and embrace the amazing young advocates from the Philippines as they have launched their online activities is one such example.) There is comfort in the reliability of the way people respond in those situations.

But then there is frustration in the reliability of how people react and complain about being left out when it seems some folks in the DOC are doing something. It may be an event, a conference, or people just doing stuff like starting peer support campaigns. It could be people giving talks, writing pieces or coming together on advisory committees.

I wrote a whole thing about this at 3am. Words were strung together, and I started getting strung out, so I deleted it after wise counsel from a Twitter friend who reminded me that sometimes just writing stuff down is therapy enough. (Thank you to that wise person.)

She is right.

What is also right is that there is an Effin’ Birds moment for everything in life. Even when you don’t think there is and you put a call out, the nice folk at Effin’ Birds direct you and then deliver. And it’s perfect.