Wordless Wednesday: In That Moment, It's Aptly Named.

Looks Like...

...a cowgirl who has spent too much time in the tanning booth.

It's that glamorous and elegant time of year where I have to collect all of my pee for 24 hours into a plastic jug, and then try to discreetly transport it in a tote bag to the hospital lab while hoping no one notices the slooshing sound as I briskly walk the hallways.

Man oh man, the adventures those people without diabetes miss out on.

C'mon, kidneys! Don't let me down now!

Week Thirteen.

Second trimester say whaaaaaaaa?

I'm still feeling good - so good in fact that I often feel badly when I'm asked, "so, how are you feeling?" (often delivered with that concerned and empathetic eyebrow-squishing move - you know the one, right?), because I feel as though I should meet their concern with reason for it - and there is none. No nausea. Little to no food aversion (though Aaron's chinese food the other night did leave me thinking that I'd never eat sesame chicken again, if given the choice), and no weird food cravings. It's just been more of the same - a tendency to run low if anything, a pleasing ability to bolus right as I begin eating (as opposed to pre-bolusing 15 minutes ahead, which is my norm), and a general case of sleepyheadedness.

And we can now add "epic pregnancy-induced clumsiness" to the list.

Clockwise, from top left: beginnings of baby bump; a "good" day; a "what the hell happened" day; my broken heart.

Yesterday, somehow, I managed to drop my phone iBGStar-first into the dog's food dish. As a friend put it, it seemed to have landed on its self-destruct button, because it busted into a bunch of unrecognizable and unsalvageable pieces. (Actually, I just think it's the weight of the phone - and landing in a ceramic dish - that did it, but I like the other imagery better.) I've been finding the iBGStar app data and charts immensely useful during pregnancy, so I was disheartened to lose it. I'm using my Verio IQ in the meantime (a fine meter itself), and I found out this morning that Sanofi will send me a replacement iBGStar, so my data withdrawal symptoms should only last for another 24 hours or so. Woo!

I'm also noticing some old wives tales rearing their heads - if you can believe those sorts of things - which has Aaron and I (and all of our families) guessing the gender. We will be able to find out at my OB appointment next month, and I don't know how I'm going to be able to wait that long.

In the meantime, I'll be eating fruit by the foot (as in amount, not the candy, because gross) and restraining myself from buying any more gender-neutral footed onsies.

Ginger.io.

(Alternate titles to this post: "Following Your Every Move [But Not In A Creepy Way]", "Stalking Has Never Been So Healthy", "Maybe I Should Just Get On With The Post Already")

I remember seeing the name "Ginger.io" at the Stanford Medicine X conference last September, but never really got a chance to find out what (or who?) it was. I made a mental note to Google it later, but never did... which meant I was really glad to see an email from them a couple of weeks back, explaining what they're all about. I think what they're working on is a really cool concept and could help a lot of people (and requires minimal effort from the user to gain the benefits), so I wanted to help spread the word.

[Kim]: Can you tell us a little about what Ginger.io is, and how it got started?

[Peter of Ginger.io]: Sure, Ginger.io is a small startup on a big mission to change how people living with chronic conditions connect through health information — using just an iPhone or Android phone. Our application uses the sensors in your smartphone to map the relationship between your behavior and your health — and turn it into insights.

Ginger.io is based on research that came out of MIT’s Media Lab, where Anmol, our co-founder, was pursuing a PhD in computer science with a focus in modeling human behavior patterns. While at MIT Anmol met Karan, our other co-founder and an MBA with a deep knowledge of the health care system, and together they set out to build a check engine light for human health.

How does the whole thing work, and how much information do you have to share with the Ginger.io app?

For the first month or two, we’ll focus on collecting data and learning how your condition affects your behavior. Once we have your behavior baseline, we’ll start delivering personalized health insights, provide insights into how the study community is doing, and allow you to better connect with your care team by alerting them when something seems out of place.

So what type of data do we collect? The first type is active data - this data is short surveys that our application will ask you to answer periodically. They are easy to fill out and ask general questions around your mood, exercise behavior, etc. The second type of data we collect is passive data through sensors in your smartphone. Passive data is general patterns around your calling, texting, and movement behavior. Our system does not collect any specifics (i.e. who you are talking to, what you said, where you went). All we gather is general patterns like “how many calls did you make yesterday” and “how far did you travel”. All of your data is fully HIPAA compliant and treated just like a medical record at the doctor’s office.

Sounds legit. So why do you think this will be helpful for people living with diabetes? What value will patients get out of using the app?

Many people living with diabetes often feel overwhelmed at the sheer amount of things they need to keep track of. Ginger.io tries to track behavior with minimal effort on the participants side and help them get the support they need when they need it. Participants will receive:

• Personal insights into their health patterns — right away
• Improved connection to their care team (after the first couple of months you can set up alerts to be delivered to your care team when something seems out of place)
• Satisfaction that they’re contributing to science to benefit the diabetes community

Is this for people with all types of diabetes?

Our current study is targeting those with type 2 diabetes but we plan to release a version of the application for pre-diabetes and type 1 diabetes in the future. As such, we encourage anyone living with diabetes to sign up for the program and we’ll get them on the app whenever possible. [Editor's note: I downloaded the app a couple of weeks ago and while it's intended for people living with type 2 at this time, it has pointed out how far I'm traveling each day which is kind of nerdy cool and interesting.]

How can people find out more about you guys, and find the app?

Those interested can learn more and/or sign up at http://ginger.io/join/ddd/. For more general information on Ginger.io they can visit http://ginger.io/contribute-to-science/.

Spare A Rose, Save A Child.

What if the cost of one less rose for your schnookums (hey, I'm not judging your pet names) this Valentine's Day could help save a child's life?

It can!

A small group of diabetes advocates – Kelly Close, Manny Hernandez, Bennet Dunlap, Adam Brown, Kerri Sparling, and Jeff Hitchcock – with the support of some friends at Johnson & Johnson, got together recently to see how the diabetes community could use social media for social good, and here's the great idea that came out of that meeting:

This Valentine's Day, the diabetes community can help the Life for a Child program, sponsored by the International Diabetes Federation, which aims to take “contributions from donors [to] go to established diabetes centers enabling them to provide the ongoing clinical care and diabetes education these children need to stay alive.” The idea is to take the typical “dozen roses,” so popular on Valentine’s Day, and save just one rose to spare the life of a child. “Spare a Rose, Save a Child” is simple: buy one less rose this Valentine’s Day and share the value of that flower with a child with diabetes in the developing world. Your loved one at home still gets flowers, and you both show some love to someone who needs it.

Want to help spread the word? Here's what you can do:

• This week, February 10 - 16, spread the word through your blog, Facebook, Twitter (use the hashtag #sparearose), Google+, Tumblr, or your menagerie of carrier pigeons about the "Spare a Rose, Save a Child" idea, which will also help raise awareness of the Life for a Child program. (And if you do post about this effort, please leave a comment on Kerri's blog post so that everything can be kept track of.)
• If you're so inclined, download one of these images to use in your post, on your site, as your social media avatar, whatevs, during this week: Banner 1, Banner 2, Banner 3. 
• Please use the URL: http://bit.ly/SpareRoseSaveChild to link to the IDF site. (This is a short URL created to see how much impact our social media campaign has generated.) For more information on the Life for a Child program, please check out that link.

Let's help spread the love offline to those in our diabetes community that most need it.

Pregnancy Observations.

Why do most maternity pants not have functional pockets? I've never felt so let down by a garment of clothing. Do designers believe that pregnant women have no further need to carry small items around with them? Do they expect us to just shove everything in the stretchy tummy fabric and look as though we're growing a robot of some sort in our bellies? My insulin pump most comfortably resides in my pants pocket, sirs. Please fix this.

Is being pregnant like being cured? I'm beginning to think so, because the amount of carbs I'm eating might make even Adam Richman raise an eyebrow. Hungry Hungry Hippos don't even snack this often.

I miss (caffeinated) coffee. I miss coffee like Champ misses Ron. I've been crashing around 9:30 pm most nights (!) and taking naps left and right. I miss your musk, Ron.

Never has an embellished CGM beep been so annoying. "You're under 55! Wake up!" (I do; I test; 75 mg/dL.) "You... are a jerk. And wrong. Please stop, and let me sleep." And so on. Every night, nearly. It's hard to maintain a fasting bg of between 65 and 95 when your CGM threshold is 60 and it seems prone to overreacting.

Have I mentioned that I miss coffee?

It's one item on a long list of "things to avoid that I rather enjoy": smoked or cured meats (meaning: bacon, some ham, breakfast sausage, the salmon in some cooked sushi... pretty much all of the good stuff), cold cut sandwiches, anything with raw-ish eggs (most Caesar dressings, hollandaise sauce), and the obvious: alcohol. Pretty sure that once August comes and goes, I will be washing a bacon Eggs Benedict down with some wine.

It's all worth it, mind you, but it's an adjustment I haven't been looking forward to making. And now it's here, and now I need a nap.

A Case For Everything, and Everything In Its Case.

Now that I'm in the process of turning food into a tiny human, I've been told by my endo that I need to start entering all of my blood test results into my insulin pump. At first I was miffed about having to do an additional step (several times a day) on top of all the other steps I'm already doing, but when we had to print off separate charts for my Ping stuff, my iBGStar readings, and my Dexcom graphs and charts, I realized what a pain in the ass I was being if I didn't help her out just a little.

Besides, it's not like she's making me use the Ping remote meter for testing again - while I like my insulin pump, I can do without that chunky, clunky, fat snail of a meter. The iBGStar app provides a lot of meaningful information for me, and going back to life without it... well, I don't want to.

But what this does mean is that I now have one more thing to carry around everywhere; one more accessory sitting on my desk during my workday. They all have cases (because, hi, that's what I do), and while they don't match, it makes me feel slightly better about needing to have so many carry-on items.

Clockwise from top left: a Vera Bradley wallet (modified like so); Fossil cosmetic case that houses all of my
meter crap, an extra pump site, a Humalog pen and needles; Tallygear case for the Dexcom G4
(disclosure: I was sent one free to try out); the bottom of my iBGStar phone case.

Watching Over Gotham.

"What am I doing?", my endocrinologist said to herself, out loud. "This goes against all of my training! But, it's what your numbers are telling me..."

Sounds right.

It seems like my insulin needs have never quite matched up with what's considered "standard", whether it's the ratio of daily bolus to basal insulin, the increase in basal rates while I'm sleeping (my body won't even look at insulin while I'm dreaming; it's that resistant), or the number of basal rates I'm running throughout the day (they once totaled 12 rates in one day, and it worked really well at the time).

It doesn't surprise me that my endo (whom I adore - I've only had two appointments with her and I'd already like to send her a basket of puppies and chocolate, though not in the same basket because then I'm sending her a basket of dead puppies, and what the hell kind of tangent is this) is needing to do things a bit differently to keep me in range - and you know what? So far, it's working pretty well.

But while basal rate changes help, they don't do all of the work for me. I still see myself trending down several times a day, but it sort of works out for now since pregnancy has brought me a bottomless pit for a stomach. "Oh! Cool! I can eat again." But things change sporadically, randomly, and often - much like Batman watching over his beloved Gotham, I too must remain vigilantly attentive to what's going on around (and in) me.

I'm back in super-obsessive mode, which means I'm clicking the Dexcom button every few minutes (even though I know it only updates every five) and doing a finger stick about every hour and a half - but sometimes I'll get crazy and wait TWO HOURS YOU GUYS! I haven't gone through this many lancets in... ever? My fingers are losing their patience with me swiftly.

What would be reeeeeally wonderful right about now is this:

That's the Artificial Pancreas system that Tom Brobson, JDRF National Director of Research Investment Opportunities (and star of this YouTube video detailing his experience using this thing in a real-world setting) brought along with him to a JDRF breakfast here locally on Wednesday, that I felt very lucky to be able to attend. It's not perfect - no technology is - but having a system that would look out for me and minimize the highs and lows? I'd take it in a heartbeat.

Until then, I will do my throw my Bat-darts at this ever-moving target called diabetes, in the hopes that I can hit something more often than not.

Week Eleven.

"Week Eleven"? What does that even mean?

Well, let me explain...

We're having a baby! (Which is a weirdly wonderful thing to be able to say, let me tell you.)

You may have seen a post a couple of years ago in which I accurately predicted that "life doesn't always follow the nice neat path you have for it". What I also believe is that things happen when they are supposed to happen, and someone's decided that 2013 is when Baby V is ready to join our crew.

And because we had been hopeful for two years, I had sort of lost a bit of the optimism and on-pointness I began with. It was no longer top-of-mind that I could be pregnant, so a slightly puffy-feeling tummy didn't tip me off right away. I have yet to experience any of the nausea or sickness so often coupled with early pregnancy (and I am SO THANKFUL for that luck), so no clues there. Trips to the bathroom became more frequent, but I was also making an unrelated effort to drink more water, so that seemed like NBD.

What finally tipped me off was diabetes. (One thing to be thankful for, in this whole pancreatic mess?) I am running low all the time, and am hungry all the time. The relentless lows, which also have involved many middle of the night excursions, are to thank for finally igniting my brain lightbulb so that I could say, "Oh, maybe I should pee on a stick". And so I did, late at night, and promptly lost my mind for a few minutes.

After a flurry of phone calls the next morning, I had an appointment set with my OB-GYN for a few days later (this happened over MLK Jr. weekend, which means I didn't know I was pregnant when I declared that blog break, but again... happens for a reason). I had no idea how far along I was, so imagine my shock when the ultrasound tech told me that "Yep, looks like you're 10 weeks!" Exsqueeze me, what? Ten? Like, almost done with the first trimester, ten? We also were able to hear a heartbeat so strong and loud that it momentarily paused my own, and we're told that everything looks normal so far; a label for which I've never been so thankful in my entire life.

I'll be spending the next 29-ish weeks (gosh, is that IT?) frequenting doctor's offices, eating more fruits and veggies and whole grains and lean proteins and OMG can't we fit a cheeseburger in here somewhere, and clearing out the office nursery to make way for a wee one. I already miss many things, the most of which is my beloved caffienated coffee, to whom I've considered writing love letters of longing on more than one occasion. Lots of work ahead, you guys. Lots of work.

But also, a lot of happy. More happy than I can fathom right now, I think.

Break.

If you've ever spent a decent amount of time around a Corgi (or the flooring in my house), you'll notice that every so often they get this giant burst of energy. Suddenly, they are compelled to run like a joyful maniac all over the house at top speed, for maybe 30 - 45 seconds. They just kind of lose their minds for a brief time - it's nuts, and I can't stop giggling every time Billy does it. It has a name - it's called "frapping", and Corgis are notorious for it.

And then, as swiftly as it started, it ends. They lay down, exhausted from the sprinting, and recooperate a bit.

I feel like I've been frapping, myself, for a while now. I've been running and running, except that instead of torn-up carpeting, I've left unfinished projects, date nights with my husband, sleep, and the ability to remember what I did even last week in my wake. While I am proud of everything I was able to do "here" this past year, I'm looking forward in 2013 to finding out what I can do everywhere else in my life. Can I merge what I love doing and what I can make a living doing? Maybe. Can I find a better balance between my laptop and my life? I hope so. Can I see some of my "real life" friends more than twice a year? Goodness, I hope so.

And so, I'm going to take Billy's lead and just lay down for a while, bloggily speaking. In order to do that, I'll be putting this blog into a medically-induced coma hiatus for a little while. I'm not done, but I do want a breather. Will it be a few weeks? A few months? Will I go four days and then have something I want to post again? I don't know, but I'm going to take the opportunity to find out.

(For those trying to read between the lines, nothing is "wrong", but thank you for being concerned. And yeah, I built all of that momentum with #GiveAllTheThings last month, and now it will lay down for a nice nap. That's just how I roll.)

My wish is that your new year is off to a wonderful start, and that you, too, will take the steps you need to in order to be as healthy and happy as you can be. We all deserve the chance at better balance.