Spare A Rose, Save A Child.

Remember how I said I'd be asking you for help? This is one of those times.

“Here’s what T1D looks like in Haiti.” (photo of young girl) “This child died.” Heart just exploded. #MedtronicDAF
— Kim / Diabetes (@txtngmypancreas) January 11, 2014

The Spare a Rose, Save a Child campaign is a DOC-driven effort to raise both funding and awareness for Life for a Child, an International Diabetes Federation program aiming to fund the continuous medical care, access to supplies and medication, and diabetes education that children in developing nations need to stay alive.

The cost of one rose is about five dollars - and while that flower will wilt and die, the same five dollars would provide life-saving insulin to a child for one month. There's sort of a beautiful, poetic irony there.

What you're being asked to do is fairly simple: buy one less rose this Valentine's Day, and instead send that money to the Life for a Child program. You can even download a "Certificate of Awesome" to give your loved one in place of that rose.

I've embedded the direct donation code onto my blog (it will remain above my posts), and will leave it until the Spare a Rose campaign concludes on 2/14/14. Please considering donating, if you can.

I hope you'll help us spread the word, too - this one-sheet may help cover the bases on how you can do that, as well as the Spare a Rose, Save a Child website. Our voices are louder when we use them together!

6 Months.

To my littlest Wabbit,

Happy half-birthday! How are you six months old? You've already busted a tooth through your gums and are demolishing vegetables (avocados seem to be a favorite) like a champ. If this pace holds steady I imagine next week will involve driving lessons and the completion of college applications. Please slow down. It's all going so fast.

You accidentally rolled from your back to your tummy a few weeks ago which left your parents quite excited, but we haven't seen you replicate it since. No matter - judging by how strong those sweet, chubby legs of yours are, you'll probably just skip straight to walking. Skipping, maybe. I can tell you have big plans in the works.

You have claimed your father's beard as your property/handle; holding onto it (for dear life) every time he feeds you. You've tried to grab for my beard as well - except that I don't have one, so I guess my bare chin will do. Also, allow me to say here that there is no need to claw and scratch my chin while you're eating. I prefer to keep my skin, please and thank you.

Some verbs most often associated with classic Disney characters seem to fit you - "charming", "enchanting" come to mind. Your grins come so easily, and your laughs - they are the absolute best. Recently you've realized just how hilarious our dog is, and any time Billy wiggles around on the carpet, or releases a tempered bark, or enjoys a spoonful of peanut butter, you erupt in giggles. (Related note: Billy now eats spoonfuls of peanut butter on the regular, always within view of you. Funny coincidence.) Billy has also noticed that you're now in the "dispensing treats" business, and has smartly taken post next to your highchair at meal times. Who knows what treasures might fall to him? You're so generous.

But most of all, your dad and I have loved watching your sweet personality develop in these last few months. I know I'm biased, but I think you're the awesomest little lady I've ever had the pleasure of knowing, and I look forward to all the things we can teach each other in the coming years.

I have to tell you, little Rabbit, that the last half year has been the happiest time I can recall. Everything in life just seems so much better now that you're here. Thank you for that.

I love you,

Mommy

Review: Tandem t:slim Insulin Pump.

I wanted to give myself a few weeks of living with it before I shared my thoughts on the t:slim insulin pump I'm now wearing. I've had time to do several cartridge changes, program boluses of all flavors, experience some alarms and alerts, download my data a few times, and basically just see how this tech fits into my activities (and outfits).

You may not have the patience to read everything I'm going to write about this pump (I get that; do your thing), so here's the GIF short-hand. It's going to be about 90% this:

And the remaining 10% somewhere around this:

My insulin pump experience includes four years with a Cozmo, and four years with an Animas Ping, plus a few weeks of trying out the Asante Snap, so keep that in mind as my frame(s) of reference.

I realize no insulin pump is "perfect" and probably none will possess all of the things I like (and none of the things I don't), but the t:slim gets preeeeeetty close, for me.

Let's get the less favorable qualities out of the way first:

Nothing to see here; everything's normal

• While it's advertised as a pump that can hold 300 units, I don't see a way to actually get to use all 300. When I tried to fill the t:slim's cartridge with a full 300 units (it may have been more like 302), it caused an error that rendered the cartridge - and its insulin - unusable. I called customer service when the error came up, and they said that particular message code appears when the cartridge has been overfilled, and that I wouldn't be able to use that cartridge. Whoops! (Sidenote: some suggested I could draw the insulin back out using the syringe I filled it with, but I hesitated to do so. I'd rather play it safe than use possibly contaminated insulin; that's just me though.) The t:slim still holds more than my Ping did, though, so I can live with it.
• The tubing prime when starting a new cartridge - OH MY does this process seem ridiculous. Having grown used to the < 30 seconds a prime took with the Ping, and the .5 seconds it took to prime tubing with the Snap - this step feels painful. And not only does it take a long time - think minutes, not seconds - I was instructed to sit not only the pump, but the tubing upright during the prime to avoid air bubbles. Considering I use 43" tubing - it's a sight to behold, and a task I've assigned to my kitchen cabinet knobs. (See right.) 
• When my t:slim was shipped to me, they asked what kind of infusion sets I wanted and we decided I'd try some Cleo sets. Unfortunately I had quite a few issues with using these - I've sent back the unopened boxes to swap back for Insets - among them, an airbubble that would get stuck where the "pigtail" meets the luer lock of the tubing. However when I switched back to Insets, I couldn't see that bubble anymore, so this may be a non-issue for me going forward.
• There are what seem to me to be an exorbitant plethora (I like big words as much as I like GIFs, okay) of confirmation screens. I'm aware that this was due to FDA's concerns about a touch screen on a medical device (think about how many people butt-dial on their phones; now imagine butt-bolusing), but it's still a concern from a usability standpoint. It annoys me.
• The "manual bolus" option - that is to say, a way of telling my pump to just administer a certain amount of insulin, not associating it with carbs or a BG - is non-existent on this pump. While there is a workaround that involves programming 1g of carb, and then overriding the units of insulin from there - it seems a silly thing to have omitted.
• The lowest profile clip they offer, which is also the clip that now comes with the pump when you order it (the "t:clip"), is not as low-profile as I'd prefer. Again, I'm used to Animas' clip, which was so nice! And when clipped to the top of my pants, more of the Animas pump would be "below the line", so to speak, than the t:slim and its case.
• And finally, the way it delivers insulin - with this "bladder" that I'm not able to see, within the cartridge - is something new to me. I'm going to need some time and an accumulation of good experiences before I can develop full trust in how reliable and accurate this is. 

There are a few other small things, but they may just be things I need time to get used to, rather than downsides of the pump itself. It's also worth mentioning that during my first few days with the t:slim, my blood sugars were running higher than I expected them to. But, once I switched back to Inset infusion sets from the Cleos, things seemed to even out for me. It could be coincidence and due to some other factor, but it happened, so it's worth noting.

Onward.

Here are my "Oh, HELL Yeah!" items:

• It feels, looks, and behaves like an insulin pump in 2014 should. How I feel about the way I manage my diabetes plays an important role in my psychosocial health, for better or worse, and things like a touchscreen (no more scrolling - huzzah!) and data displayed in color (with graphics!) pleases my sensibilities. The screen is bright; the vibrate setting is noticeable but not too vibratey (technical term); the pump's "feel" is solid and sleek. This matters to me.
• It has a vibrate option, instead of all audible alerts and alarms.
• There's a touch bolus button, which allows me to program a bolus without ever needing to look at my pump screen - I use this often, and realized after trialing the Snap pump that this was a must-have for me.
• The "basics" are all on my home screen, or just one tap away: things like my insulin on board (IOB) and time of my last bolus, current basal rate, battery life, insulin left in cartridge and current I:C ratio are all easy and quick to access. 
• I can plug the pump into the wall, or the USB port on my laptop, or my car,  to charge it. That is so boss.
• "Personal Profiles" include everything you might want to reset for that time of day - not just basal rates, but also I:C, correction factors, target BG, and more can be tailored in each individual profile.
• Speaking of personal profiles, you can name the profiles whatever you want. Again, seems small - but being able to have a profile named "Eff Yeah Wknd" makes me smile.
• I considered listing this as a negative, but I'm actually thinking it should be a plus: the t:slim seems more occlusion-sensitive than other pumps I've worn. This could be good as long as the alarms are actually truthful. 
• It's water-tight. Excellent.
• Delivery noises seem much quieter to me. I'm not talking about confirmation beeps, but the actual noise the piston makes when delivering a bolus or basal. Anyone who has used an Animas Ping and spent any amount of time in a library or super-quiet work environment (hey, that's me!) can attest to the loud noises it makes while delivering insulin, and that always bugged me. Sweet relief!
• I hadn't realized this ahead of time, but the t:slim will alert you if you it thinks a bolus you're creating will cause you to go low. I love a device that can help me out like that.
• The t:connect software (Mac-friendly - yay!) is very visual and easy to use, and I like not having to mess with a special cable/dongle in order to access my information. Downloading my Ping was always such a clunky process that it deterred me from doing it very often - t:slim is very plug-and-play with any micro-USB cord. My doctor hasn't tried to access my data yet (I've heard there's no provider version; that they'll need my password to access it, which doesn't seem right), but so far I like it for my own use.
• I've found Tandem's team to be very responsive - customer service has been good, and my local reps have been very accessible, through emails, texts, calls, or whatever medium I might want to use. And when they issued two different voluntary recalls on cartridges - mine were affected - I was alerted by tweets, phone calls, emails, AND snail mail. 
• Back to those t:clip cases - again, a small thing, but you can totally mix and match colors on these, because the clip is two parts. 
• One last thing - I'm looking forward to hearing more about the partnership Tandem and Dexcom have forged in order to get an integrated system to market. 

I'd also be interested in hearing what other t:slim users do or don't like about pumping with this particular device, so feel free to comment all over this.

As I said, I'm only three weeks in. Time will tell if this pump is a good fit for me over the long haul, but so far? Thumbs most of the way up.

UPDATE SEPTEMBER 2016: To those wondering, two and a half years later, if I'm glad I picked the t:slim... I am. I'm not sure there existed a better option for me at the time I was able to get a new pump (January 2014). That said, I am on my third t:slim as I write this. My original pump, and its refurbished replacement, got to the point that they would not accept a new cartridge installation - which essentially means the pump was rendered useless. Because my pump was still within its four years of warranty, it was replaced at no cost to me. And with my third (current) version, they sent a pump that included updated software.

SO MUCH BETTER.

Here's hoping the updated software continues to solve the "no cartridge for you!" issue my previous t:slim pumps had. After two replacements, it has become more challenging to completely trust this tiny, life-bettering machine on my hip. 

UPDATE TO THE UPDATE, DECEMBER 2016: I'm on a pump break for the first time in 11 years. Details in this post.

In Your Pancreas.

I feel so lost, sometimes

Days pass, and this insulin fills my cart

When I want to exercise

I end up eating carbs

Every time I test, I go

"There must be a better way to know"

My low symptoms; will they return?

New devices I'll have to learn

They make a noise I try to hide

I struggle with how it feels on the inside

But I'm fine

Beta cells might 

Have all died

(But who's complete?)

I'll be fine

I see a closed loop, and a thousand researchers

(Cure in five?)

The resolution in these badass advocates

Okay, not fine

But I see the light and the heat

In these guys

No math, please, while we eat

We want to have the chance

To be complete in our eyes

I don't like to feel so much pain

Test strips, wasted - and this error 4 keeps beeping at me

I get so tired, working so hard for my survival

I wish for a time where I can just be alive

To my eyes

I can't believe

Over twenty five

Years with this... sheet

I see a better answer to Google searches

No disguise!

We share ourselves; all the low-carb lunches

(Or french fries)

We tweet it all, and we see

We're not alone; on the same team

It helps us feel more complete

The same team; the same team

The burden is no longer all mine

Not all mine, not all mine

Not all mine, not all mine

Channeling My Inner DMom.

Some parents who have children with diabetes say they read the blogs of adult PWDs to get a glimpse of what their child's future may be like. They also read to learn how diabetes may fit into an adult's life, and find solutions to what their child may be struggling with.

Well, right back at you guys.

A lot of my carb counting falls into the "carb guessing" category, even when nutritional information is provided on the packing. (I KNOW.) For some reason, when I bought these particular snacks I decided - hey, I should probably count these out from the get-go and put them in marked baggies so I can measure something more accurate than "I ate a handful".

We learn (and sometimes, remember what we should have been doing all along) from you all, too.

Self-tracking and Diabetes.

There's this idea of a "quantified self" - that the better we can track, measure, analyze, and interpet our own personal health data, the better we'll understand ourselves. I heard a whole bunch about it at the first Medicine X conference; it seemed everyone was enamored with the potential of self-tracking tools: blood pressure, sleep patterns, heart rate, you name it. And for people living with diabetes? Whoa-ho! We're the original self-trackers; so open to wearing gadgets both on and underneath our skin, accustomed to the charts and graphs and incessant flow of data. Tiny computer directly on your eyeball? Of course they'd want that!

Except that I don't. The truth about self-tracking is that I hate having to do it, and I hate all of the "add-on"s that come with it.

I can mostly convince myself that all of the self-tracking I have to do is "fun", but I think it's largely because I'm at a point where I have to be okay with it for the sake of my sanity. It's a bit of Stockholm Syndrome, really: the longer I wear an insulin pump, the more I want to buy it accessories; introduce it to friends; to humanize it by naming it. I have to wear these devices that keep track of my blood glucose trends and insulin delivery, and the majority of the time the concept doesn't bother me because I have grown used to it. Having the choice between a zillion apps and devices is a luxury, really, but the act of using them is still work.

And I resent it.

Because while seeing my blood glucose trend up or down in nearly-real time is helpful, the constant flow of data can be an overwhelming experience. I watch as the amount of glucose in my blood waxes and wanes; the tide washing over my brain every five minutes as a new reading emerges. It impacts how I behave; what I eat; how I move; how I feel. It demands my blood. It scolds me. It doesn't apologize when the device, itself, is in the wrong.

The fact that I wear an insulin pump that can tell me all about my insulin delivery is great, but it also means that I am wearing a device that most of the time contains a lethal amount of a drug I'm trusted to administer to (and manage the doses of) myself. It gives me more to worry about - are their air bubbles in the reservoir or the tubing that I can't see? Has the infusion site clogged up, or the cannula bent? Am I sure I only put exactly the maximum amount of insulin in that new cartridge? Do I have enough battery life left to last me the day?

That I can test my own blood at home is a blessing, but I curse the fact that I am stabbing myself with a shard of metal several times a day in order to gain that information. It's a barbaric requirement.

And when it really comes down to it, I resent that self-tracking erodes the invisibility of my disease. An insulin pump and CGM provide me very valuable data, but they also mean that I am never simply me, physically. My tossing and turning at night must be done carefully; my clothing choices must account for how they'll allow me to access or disguise my robot parts; a journey through airport security will never be simple; even the use of a toilet requires intricate and meticulous maneuvers that preserve infusion sites and sensors. These devices are a physical and constant reminder that seem to cruelly whisper to the world, I am different. Something is broken here.

Wearing self-tracking devices means that not only am I working on managing diabetes, but also managing the psychosocial impact they have on who I am and how I feel about myself.

And that impact? Well... it's hard to quantify.

(Update: I participated in a live Google Hangout broadcast on this very topic, hosted by Stanford Med X - find it here.)

CGM: Must-Have.

Reason #3752 that a continuous glucose monitor is in the "must-have" category when it comes to my health:

Fasting numbers don't reveal the whole picture. (Hellooooooo, adjusted basal rates. Would I have even known you needed to be adjusted, if not for these graphs?)

You Can Do This Project: Adding To The Team.

I'm ridiculously pleased to announce two new members to the already incredible You Can Do This Project Advisory Team: Meri and Jacquie!

I welcome the perspective, passion, and general awesomeness these two will add to the work we do. Our group of nine will be working hard to bring that feeling of "me, too" to more of the diabetes community in 2014, and we hope you'll continue to support our efforts to do so.

As you may have guessed, furthering the mission of You Can Do This Project will be among my many Leaps of Doom in 2014. I couldn't imagine better people to take that leap with than all of you.

Steampunk: Diabetes Style.

Someone (@momentsfade) on Twitter tore apart a dead Dexcom transmitter and tweeted photos of each stage of the deconstruction, which lead to the comment:

@momentsfade @SweeterCherise @txtngmypancreas @joltdude It's not steampunk enough for me ;-)
— Kelly / Diabetes (@KellyRawlings) January 14, 2014

One tweet, and my mind goes off the rails:

Medtronic Diabetes Advocate Forum: Leap Of Doom.

You may be aware that I have a history of throwing myself off of proverbial cliffs, hoping that our community will catch me. So far, I'd say that strategy has worked out pretty well.

Keeping that in mind, I have something to ask of you.

Something was ignited at the Diabetes Advocate Forum last week (#MedtronicDAF), and I don't think any of us are willing to let this fire reignited inside of us burn out. Nope, instead we're asking you to add your branches and kindling to the flames and let's get this thing so big and powerful that it amazes even us how far it reaches; so that no corner of our diabetes community goes without feeling its warmth wash over them.

“Here’s what T1D looks like in Haiti.” (photo of young girl) “This child died.” Heart just exploded. #MedtronicDAF
— Kim / Diabetes (@txtngmypancreas) January 11, 2014

Changing diabetes beings with us, and ends with us.

So here's what I'm asking of you: there is work to do, and this community - and me, specifically -  need you to be ready and willing to act. There will be many times this year that I'll be calling upon you for action, in many forms, and I'm asking you to be open to that. I'm asking you to help change the world with me, little bit by little bit.

(Whoooooa, there, big dreamer! It's a pretty big leap of faith to assume you can...)

Oh, hey, I'm glad you said that, because that's exactly what I want to emphasize.

One of the speakers we heard from was David Strasberg - son of Lee Strasberg, the infamous acting coach; he and his son both live with T1D - who coached us on "the art of asking". I'm completely paraphrasing here, but here's one of the things he said that keeps sticking in my brain:

"People call it a 'leap of faith', but that's not what it is at all. 'Faith' assumes that everything works out in the end - that's not real life. When you leap, everything is uncertain and where you'll land is impossible to see. It's more realistic to call it a 'Leap of Doom', and it's one of the hardest things to do."

I'm asking you ("you" is everyone - fellow PWDs, HCPs, advocacy organizations, device manufacturers, pharma, ALL OF YOU) to "leap of doom" with me this year, because doing what feels safe or certain isn't the same stuff that will enact change. I'm asking you to be open to chaos with me; to be bold; to raise your hand at the very moments it feels uncomfortable to do so. Change is scary, but that's exactly the feeling we need to thrust ourselves towards. The things in life that are most worth doing are usually the hardest.

"Imagine a world where industry and patients work together to help #pwd..."- Nancy Katz on taking steps forward, Medtronic #MedtronicDAF
— Medtronic Diabetes (@MDT_Diabetes) January 12, 2014

I'm asking you to use your resources and connections to further the work being done by diabetes advocates like myself. I'm motivated, willing, and over-the-top enthusiastic, but I can't do it alone. If you see value in what we're working towards, show us.

When we don't work together, it's easy to make excuses for why we don't succeed. #MedtronicDAF
— Mike Lawson Diabetes (@MrMikeLawson) January 12, 2014

I'm asking you to be part of "us". Let's Leap of Doom all over the place in 2014.


Disclosure reminder: Medtronic Diabetes and Bayer Health paid for expenses such as travel, lodging, and food during my attendance at their event. I was not paid for or asked to write about the event, and opinions are my own.

Medtronic Diabetes Advocate Forum 2014.

This past weekend marked the third of Medtronic's "Diabetes Advocate Forum" events; the second of which I have attended (disclosure). I love being in a room full of friends - some I'd only just finally met/hugged in person - where our combined passions in the world of diabetes cause the air to tingle with purpose and potential. The room buzzed and pulsed with a sense of urgency, that with our powers combined (and I'm talking our whole community here - not just those physically in the room) we really can enact the change we want to see. We are willing to do the work. We want to motivate action. We want to be a vehicle for another PWD to find and feel the "me, too" of our community.

To paraphrase one of the event's speakers, we're all in the business of "hell yes".

Image courtesy of Medtronic Diabetes' Twitter feed. 

Like at 2012's Forum, I was again struck by the graciousness, openness, and genuine care with which the Medtronic Diabetes team crafted this event and responded to our concerns and feedback.

I expressed this to a member of Medtronic's PR team, and I'll say it again here: I recognize how difficult it must be to orchestrate an event like this one; to invite us into their home. As a group of advocates, we're documenting the whole event live (#MedtronicDAF); quoting sometimes word-for-word the candid responses to our questions (many of which may be very uncomfortable to answer). No matter what speakers, sessions, tours, food or conversations are scheduled, you can't make everyone happy as we all have different priorities and interests. Few to none of us care about making Medtronic look good; what we are interested in is how Medtronic is helping the diabetes community, and if we think they aren't, we're going to express that* to the room, and to the world. (And oh buddy, did we.)

Something felt different to me about this one.

I've attended events like this in the past and there are times where as I'm boarding my flight home, I think, "It was great to see my friends - but what did we really accomplish? What actionable items are we going home to work on? Why did I take vacation days from work (and now, time away from my 5 month-old) for what felt like mostly just a sales pitch?" If you refer to it as an "Advocate Forum", you have to deliver on that
moniker. If you invite people who identify themselves as advocates, you should be doing what is in your power to enable us to do that work.

Some important things to note about how Medronic Diabetes communicates:

• When it comes to using the verbiage "Artificial Pancreas" in their marketing of the 530G system and correcting the places in other media where the AP term was used too liberally, they know they've messed up. "We know, and we're learning." The AP language was used in the FDA's approval of the device, so that's where Medtronic took its cues from. But, as many in the room expressed, there is a difference between "can" and "should". The use of the term is inappropriate and misleading.
• And in order to learn - they listen. What we see is a small percentage of all the wheels turning behind the curtain, and what I saw when that curtain was lifted is reassuring. They may not get everything right, but they try. (One session included their PR team showing us some of their past Facebook and Twitter posts, and asking us what we liked/didn't like about what they did, and what we'd like to see instead.)
• They are listening to not just their own customers, but viewpoints from every direction. Many of us in attendance don't use Medtronic products and many faces were new to the event this time around. Coming into this event with a Dexcom CGM and a Tandem insulin pump could have been weird, but it never felt that way. I actually did a cartridge change while Dr. Fran Kaufman and one of the speakers stood directly in front of my table, a mere two feet away. Instead of feeling uncomfortable, I felt respected.
• They value the feedback they receive, even when it isn't good. Which, btw, can I make a request of y'all here? Instead of saying something like "I HATE YOUR PUMP!", take a step back and think about why. Let's be constructive in our feedback please (did Steve tell you that, perchance?) and tell them why we don't like certain features, and offer what might meet our needs better. For example: "I still can't hear the alarms when I sleep because they aren't loud enough/the pump is under my pillow when I sleep/I've gotten too used to the sounds. A broadened spectrum of alarm sounds and volumes or integration with my phone (because I wake up to my phone's alarms) would help this pump fit into my life better". There's a way to express your discontent without losing your shit or being disrespectful, and I'd encourage us all to strive for that. ::steps off soapbox::

I thought Medtronic did a nice job of making sure we could ask what we wanted to ask of the people who could directly answer our questions, and covering a broad spectrum of concerns. For example, the very first night of the Forum I was introduced to Mike Gill, Vice President of US Sales and Service for Medtronic Diabetes and asked about my experience with Enlite. It's something I appreciated during the 2012 Forum, and again this time.

Foremost in my mind, though, is that Medtronic not only assembled us but scheduled time for us to work on some of our own discussion points: essentially half of our time on Saturday. A session led by Bennet, Scott, and George saw a structured brainstorm of where we want to focus our efforts, how we can engage the diabetes community in evolving ways going forward, etc. And then the last hour of the Forum, which was one of my most favorite parts. It was essentially an "unconference" in which we were brought together, but under no predetermined structure. We were encouraged to interact with our peers about topics of our choosing; this time, on the upcoming Spare A Rose campaign (stay tuned for details) and it was magical. I wish someone had gotten video of it. It was this beautiful conversation of "how can we do this?" and then someone would have an idea but not have the connections to execute it. But then two people would volunteer, "I know someone! I'm emailing them now", and someone else would spin that idea off to something else, and a team would form to take care of that part. "But have we thought of..." and before a sentence could finish, someone else nodded and said, "I'm on it." By the time we were done, a pretty big, multi-level plan was in place.

"Hell yes" indeed.

I enjoy seeing what our community can do when we unite our voices; how a chorus can be heard so much more easily than a solo performance. It doesn't mean that we all need to get behind every intitiative, but it means that where we can, we should. My thanks go to Medtronic Diabetes and Bayer Health for footing the bill to get us all together in a space where that could happen. 

One last takeaway? That I need to map out a quantitative strategy for the advocacy I want to do in 2014, and not shy away from asking for help with it. People can't help you if you don't give them the opportunity and specifics with which to do so.

(Being assertive is a good thing - just ask Mean Scott.)

[Disclosure, as referenced above: Medtronic Diabetes and Bayer Health paid for my hotel, flights, and food while in the Los Angeles area. I was not asked to write about the Forum, and opinions are always my own.]

*Introspective observation: at the last Medtronic Diabetes Advocate Forum, I felt downright intimidated. I wasn't sure why I was there, and felt inadequate in my efforts; the quality of my questions and concerns; my ability to even get a word in among so many vocal advocates. I must be leaving my cocoon, as it were, because my experience at this Forum was full of the self-assurance, ease of speaking my mind, and occasional wearing of sassy pants that had previously only been the stuff of my dreams. Something's changed - age, becoming a mom, having success in some of my advocacy efforts, already having rapport with some Medtronic employees, I don't know - and my goodness, does it feel gooooood.

HONcode Certified.

I'm very proud to say that Texting My Pancreas is now HONcode certified.

Woop woop!

What that means (this is taken from the HONcode website):

The HONcode certification is an ethical standard aimed at offering quality health information. It demonstrates the intent of a website to publish transparent information. The transparency of the website will improve the usefulness and objectivity of the information and the publishment of correct data. 

Sites applying for certification and sites already certified undertake to respect the HONcode and the requirements for certification.

This certification required several edits and elaborations to my disclosure policy, including the addition of a privacy policy. If you're interested in what the ground rules are on TMP from now on, go have a read.

Nothing about what I do here is changing because of this certification, except for the addition of a neat-o badge on the right sidebar and a well-explained re-commitment to being as transparent as possible.

I'd encourage anyone who blogs their own health story to apply for HONcode certification. We can be official together!

(P.S. Thanks to Bennet at YMDV for the nudge - HONcode certification is something I'd always intended to go through the process of applying for, but kept procrastinating. But no more!)

Aaaaand, We're Live.

T:slim training complete; hooked up and ready to party.

Review: Asante's Snap Insulin Pump.

Disclosure: This review was written by me, and was not edited or approved by Asante. I was not monetarily compensated for this review, and opinions are, as always, my own. Also, I must be on a Kristin Wiig kick because I feel a little like Aunt Linda with all of these 'review' posts. "I give it four 'BEEP BOOP BEEP!s!' and an 'Oh, Brother'!")

In my recent search for a new insulin pump, I was able to try out Asante's Snap for a few weeks. (They offer a free trial to those who qualify.) I mentioned this in an earlier blog post, pointing out some "first impressions".

I know the screen looks hard-to-read here - rest assured, this is the
"dim" screen, right before it falls asleep. The screen is much brighter
while you're interacting with it.

Now that I've had a good amount of time to educate myself on how it works, and specifically how it would work for me, I'd like to share a few thoughts.

So, if you don't mind dedicating 14 minutes of your life to watching me talk, here's my review:

(And if you don't want to/can't watch the video, here's the take-away: I really loved wearing it and how the Snap functions, but it's missing a few items on my "Top Ten" of insulin pump features, so in the end I didn't choose to buy it. It's a great pump that I would recommend to others, and who knows - maybe future iterations can include the features I missed.*)

I also did a shorter video showing just how the super easy cartridge change-outs works, since that's one of the main features Asante likes to point out about the Snap. I found it to be as simple as they make it seem.

If you'd like to try out the Snap too, contact Asante and see what's up.

Now for a few days without blogging. Vlasnik OUT!

*Two things: the bit about not having a touch bolus option? I was uninformed! The Snap can do that; I just didn't have my demo pump programmed to do it. And second: the "no software" problem has now been resolved; Snap is compatible with Diasend software. Huzzah!

Post-Pregnancy Resolution.

In what comes as news to exactly no one, pregnancy messes with your body, big time. I've read so many pregnancy advice blogs that I can't even backtrack or credit where I obtained this philosophy, but I noticed that there seems to be a common, resounding theme that "it takes nine months to get that way, so expect it to take at least another nine months to get back".

Ever since my college days, I've struggled with weight - and shortly before becoming pregnant I had actually made some significant strides in a direction that pleased me. Many of the changes I made (like avoiding diet soda and exercising frequently) were well-timed, as I became pregnant shortly after adopting those new practices. But then my belly started to grow inversely to my lung capacity, and by the end of the second trimester I would become out of breath simply from climbing a flight of stairs, so exercise got put on the back burner. And really, aside from carrying that adorable, cooing 16-pound weight around with me, I haven't brought exercise back into the equation yet.

What seems most interesting to me is that pregnancy was maybe the first time in quite a while that I felt good about how I looked. The stretchy clothes probably helped, but to me, my body was finally doing what it was supposed to do and I didn't feel guilty or ashamed of what size I became. My size felt purposeful - perhaps the most significant difference - and pregnancy allowed me to feel a bit of the "normal" I'm not used to enjoying. Weight gain? Awesome! Stretchy clothing? You bet! People often remark on your body when you're pregnant (which, in itself, can be a good or bad thing), and for a change, I could accept those compliments as geniune and true. Why yes, I do look gorgeous today. My belly; I know! Isn't it great?

But once that little fluffy-tailed Rabbit left the premises, that purposefulness left with her. My stomach deflated like a tiger-striped balloon, if you will, and the process of regaining my abdominal strength after a c-section was hard, and continues to be.

I'm now five months post-pregnancy and wondering how in the world I'm going to get back anywhere close to where I was, health and body-wise. (Is it normal to take much longer than nine months to "get back"? Is there really even any "getting back", or just "getting close"?) The surgery left a part of my stomach right above the incision site numb to the touch; advice told me that feeling would come back, but it hasn't fully, and I'm wondering if it ever will. For days, and even weeks, after my surgery even sitting up out of bed was a struggle, as my stomach muscles sloooowly mended themselves - I had to press myself up with my arms to a sitting position, because my stomach couldn't help me do it.  Laying on my stomach feels uncomfortable still in a way that causes me to avoid doing it. Getting up from a sitting position on the floor is something to see (please don't watch, ever). Things just aren't back to where they should be, yet.

Part of me thinks this should be expected, and that I should be patient and forgiving of myself - you made a friggin' person, for crying out loud! But there's another part - the one who watches those around her seem to bounce back so quickly, the one who refuses to buy all new pants, but can't feel good about still having to wear some maternity clothes, the one who wonders, is this just how I'm going to look, now? - that's frustrated and knows that this extra weight and inactivity are contributing in some way to the lackluster results in my diabetes data, too.

I think I'm starting to feel what a few people experience as it relates to the DOC: they come in with a not-the-norm view, and they sometimes find that the sharing social media promotes becomes a negative instead of a positive - a reminder, each time they see a post, of how different they are, instead of hearing that "me too" that we all long for. Instead of feeling happy for my friends and their successes in bouncing back post-baby, I find myself feeling... resentful. It makes no sense, and I don't want to feel that way, but I seem to do so anyway.

And here's the rub: every time I see someone talk about what's working for them in terms of attaining a healthy weight, I feel myself push away. I feel almost angry that this is so hard for me when others seem to find it so easy, yet I don't seem open to new ideas on how to achieve anything there.

I may not yet know how resolution will develop here - getting things done for myself with baby in tow proves a challenge - but I know that it's a place I need to focus on, and soon. I can't afford to let the negativity mope around much longer.