Archive for the ‘FOR WOMEN’ Category

Onward and Upward With Diabetes

Saturday, October 25th, 2008

Swaying in rhythm like drunk fans singing their team fight song, we campers bellowed our camp theme, clapping and banging on dining tables: “Shock, shock for Camp Firefly! We take the insulin - try not to cry!”

Camp Firefly for Juvenile Diabetics, located in Springmount, Pennsylvania, was our summer haven. Free from our overprotective parents, we played in the river, pulled pranks on staff, and shared our fears and funny stories of living with diabetes.

We were free as birds until it was time for our diabetes education classes, thick with deadening medical jargon. Listening to campers’ horrific testimonies, I became imprisoned by silence. I remember one girl telling us about being placed in foster care because her parents neglected her health. I remained friends with my fellow campers long after camp ended, returning with them every summer until we were old enough to become counselors.

Today, August 2, 2007, at 7:02 a.m., is the thirty-fifth anniversary of my diagnosis with type 1 diabetes at the old Children’s Hospital of Philadelphia. I remember that foggy Monday morning so clearly, exactly what I wore and everything that was said. When I returned to the examining room after having left nearly a gallon of urine in the bathroom container, the doctor asked my mother, “Mrs. Gordon, have beverages been mysteriously disappearing from your refrigerator?” The list began: gallons daily of water, orange juice, milk, lemonade; even two entire cases of soda meant for the school fair.

Blurting that I had diabetes, the doctor summoned the nurse and told my mother to hold my arm as he drew blood. I was sure that my condition was only temporary. My favorite television show was Dr. Welby, and I credulously believed that doctors could cure anything. When the endocrinologist entered my hospital room, I faced the wall and refused to acknowledge him, hiccupping, sobbing, and wiping snot from my nose.

“Stop crying,” he told me sternly. “You’re acting like a child!” “But I am a child,” I sobbed. “And you’ve been taking blood since I arrived.” He apologized and tried to console me, but I heard only every other word: “There’s no cure, blah, blah, blah. I know you’re scared, but blah blah, blah.”

On the fourth day, the nurse demonstrated withdrawing insulin from two vials, stressing the importance of not contaminating one with the other. “What the hell!” I thought. “Why am I practicing injecting a navel orange when I could be eating it? I don’t know what to do, and I don’t care,” I was given a book about diabetes, edited for children. It was full of kids frolicking in the grass after learning that they had diabetes, and following protocol perfectly.

Walking the corridors as if I were a hotel concierge, I poked my nose into every new admission’s room. “What’s your name, and what brings you here?” Linda, age ten, had five older brothers with type 1 diabetes. While experimenting with their urine testing supplies, she had learned that she had diabetes too. As she told the story I panicked, returning to my room in tears. Linda and her brothers proved that diabetes was incurable. Even Dr. Welby verified it was incurable in an episode that aired during my second week in the hospital, featuring a child with symptoms like Linda’s and mine. During my remaining stay I refused to talk to anyone. I cried during arts & crafts, the magic act, and story time.

After I was released, a visiting nurse came every day for one week to monitor my health, diet, and mental state. That was during the “good old days,” when insurance gave you what you needed and did not rob you blind. As she and my mother talked, I hid behind the refrigerator, crying.

A diabetic guide traveled to school with me that September, along with a cigar box containing a syringe (without the needle, of course), a cotton ball, two empty vials of insulin, and other diabetic apparatus taped and arranged in order of importance. During my first class, my teacher asked, “And how did you spend your summer, Little Miss Gordon?” Showing him the box, I whispered in his ear. After he prepared the students for my presentation, I talked about being diagnosed with diabetes and how they could help me adjust.

The children were given literature, and a poster with illustrations of insulin reactions and high blood sugar symptoms was tacked to the door. The girls were happy because they hoped that they would be chosen to escort me to Nurse Chin’s office. When I visited her, she always seemed confused and asked me why I was there. A temperature was her only gauge for measuring illness.

After a year, I became lackadaisical. I still took my insulin, but neglected to test urine sugars and abandoned my diabetes paraphernalia. The night before every quarterly doctor’s visit, I stayed awake until three in the morning, creating three months’ worth of urine sugars. To make sure they were realistic, I logged a few 3 and 4+’s. I had to balance the ketoacidosis tests as well: mostly negatives and a few moderates. To top it off, I performed calisthenics, doing jumping jacks, jumping rope, and jogging in place in an attempt to lower my blood sugar before my check-up.

I appeared so zombie-like during my doctor visits that Dr. Baker asked my mother if I was getting ample rest. To my chagrin, he also told my mother that he believed I was creating fictitious urine and ketone tests. My behavior was not uncommon, he said, especially among female patients; male patients were apparently more honest when they failed to adhere. Dr. Baker told me that if I did not stop these shenanigans, I would be banned. He added that I was wasting my parents’ money and digging myself an early grave.

What harsh words for an eleven-year-old, I thought. But it was not out of character for Dr. Baker, who often took young diabetic patients on a hospital tour to impress upon them the consequences of neglected diabetes. He even coined a term, Frequent Flyers, to describe patients hospitalized two or more times per year due to personal negligence. Dr. Baker never dismissed me as a patient, though, and he didn’t put me into foster care either. And once I turned fourteen I began to understand the importance of managing diabetes.

This was the regimen: piss in a paper cup, measure five drops of urine and ten drops of water into a test tube, and then drop in a speckled blue pill that fizzed like Alka-Seltzer once it hit the concoction. Don’t dare touch the bottom of the tube; you might get burnt! Performing these test made me feel like a wizard in a lab, creating magic. Adding to the appeal was Dr. Baker’s handsome twenty-four-year-old assistant, Joe. Joe had type 1 diabetes as well, and he taught me the tricks of the trade. Once he arrived, Dr. Baker’s office became my after-school hang out. Having diabetes never felt so good, until Joe left for graduate school.

During the wee hours I would contact the glucose strip hotline to troubleshoot. Once my problems were solved, the operator and I would shoot the breeze for hours. Our topics ranged from being diagnosed, to relatives who had diabetes, to my quest to win free gifts. Each vial tab was worth points that you could trade in for prizes. “Okay, Monique, for twelve points you can get cotton balls, lancets, a diabetic fiction or nonfiction book, a cook book, or diabetic vitamins.” Stalling as if I were on “Let’s Make A Deal,” I would ask, “Can you repeat that?” “C’mon Monique, it’s 1:00 a.m. Shouldn’t you be in bed? Don’t you have school?” “Okay, okay, I’ll take the all-natural vitamins for nine points.” Two years later the point system was discontinued. My mother claimed that I called so often that I depleted the gift selection.

As technology progressed, injections became less painful. Home blood glucose monitor testing kits replaced urine tests, spelling the end, to my everlasting delight, of eye droppers and test tubes. Hemoglobin A1c tests appeared, and one insulin injection increased to multiple injections. Later, my multiple injections were replaced by the insulin pump. Sometimes I clip my pump to my attire’s waistband, or a thigh band if I want to conceal it under a skirt or dress. “Calling Agent 99!” my friends would jokingly say whenever I wore the leg band and operated the pump with my remote.

“Ms. G’s bugging the room! Everyone quiet! She has us under surveillance!” a student shouted as my pump tubing dangled while I reached to write an equation on the board. “She has a bomb - everybody duck!” another yelled. Amidst the laughter, I stopped to teach the students about insulin pumps, relating its functions to math, science, and nutrition. Students begin sharing tales about family members who had died or suffered from diabetic complications. “Don’t you hate carrying all that stuff?” one student questioned. “I would just have to die!” another shouted. Telling stories and sharing times when I felt like quitting brought my students to realize that some conditions make one stronger.

When I travel, I carry a black insulated medical case, 7″x 9″ x 2″, in my backpack. It holds glucose tablets, glucose gel, two syringes, alcohol swabs, one vial of insulin and an icepack, batteries, a glucose meter, strips, a log book, and pump supplies, not to mention the Medic Alert ID bracelet I wear in case I become ill and cannot communicate. Carrying the case invites the following responses: “Monique what the hell is in your backpack?” “Girrrrrl, your diabetes must be bad if you have to carry meds around.” “Do you always have to carry it? And so much? When do you carry a regular purse?” “Think about it,” I have to explain. A thief is more likely to steal a handbag than a backpack, so I save purses for special occasions. Being adherent means having control and knowing my blood sugar levels during the course of the day. If I didn’t carry this “stuff,” as people call it, and use it properly, I would be of no use to myself or anyone.

There was a period when I concealed my condition from dates, fearing they would run like the devil. But the number one “do” in the diabetic manual is “avoid unnecessary stress.” Now I refuse to make compromises just to make someone else feel comfortable. Usually, I have been the one to break the relationship because of my partner’s unhealthy lifestyle. One resumed smoking after my first insulin reaction, blaming his smoking addiction on that one episode. Another couldn’t understand why I didn’t prepare meals like his momma: full of fat, sugar, salt, and that poison red punch KoolAid. “Put your life insurance policy in my name and I’ll prepare any meal you desire,” I responded sarcastically.

“Oh, Monique, I don’t want you to die!” another one said. “Die!” I yelled into the phone, “With your lifestyle, I can have your grave prepared tomorrow!” After that comment, I was labeled insensitive.

I developed a sense of humor from having diabetes. Every day is an adventure. Although diabetes can be a nuisance, you can lead a somewhat normal life. My most comforting adventure was rescuing a two-year-old Chihuahua Rat Terrier. Endo Jesus Divo and I have a lot in common: a Napoleonic demeanor, a sense of humor, lots of energy, and many admirers. I prepare him home-cooked organic meals and bathe his paws after every walk, making me feel like Mary Magdalene. In return, he alerts me when I’m about to have an insulin reaction and wakens me at 3:00 am as a reminder to test my blood sugar:

I often meet newly diagnosed people and those who have struggled to manage their diabetes. Once I tried to advise a parent on the do’s and don’ts of soft drinks for her newly diagnosed daughter. As a result the mother arranged for us to meet. While I was discussing the ups and downs of diabetes, they both freaked and I was banned from ever communicating with the daughter again. Now, ten years later, the daughter and I are colleagues in the school system. After complimenting me on my appearance, she discussed her battle with diabetes and accused me of ignoring her plight because of what her mother did. “I’m afraid that I might scare you now, even though you’re thirty-four,” I responded. “I’d hate to have your mother threatening me again.”

I used to rate my health as “poor,” but my physician rates it as “excellent.” Having an illness does not mean you’re in poor health, I have learned. Examinations, mental state, and medical history are what count. People are free to do what they want, when they want. I choose to live.

“Shock, shock for Camp Firefly!
We take the insulin - try not to cry!
Take us campers for a swim
And don’t let a shocky camper in!
We never stumble! We never fall!
We sober up on orange juice all!
All us campers want to fight
Diabetes with all our might!
Fight! Fight! Fight! Fight!

Monique Gordon (Binky), a Philadelphia native, is a gifted poet, playwright, and performance artist.

Story from: Diabetes Health

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Making Lemonade

Wednesday, October 22nd, 2008

I am a survivor and proud of it. Not only have I lived with diabetes for 52 years, since the age of five, but I am also a breast cancer survivor for over fifteen years.

Living with diabetes was not easy as a child in the mid-fifties. It was a real hassle having to test my urine, and no one ever told me to empty my bladder first or how to count carbs. Who knows how I survived this long? I really believe that walking to school each day benefited me.

Diabetes is definitely genetic in my family. Both my grandfathers had diabetes, as did my father and two of his siblings. A couple of years after I became diabetic, my sister also got it. One of my brothers got type 2 in his fifties. So far, only my mother and youngest brother do not have diabetes.

I was thrilled that neither of my two sons got diabetes, and then my younger son got diabetes just before his twenty-fifth birthday. My older son is still okay, but the worst day of my life was when his three-year-old daughter got diabetes. I knew it was not my fault, but I was just devastated to think that our darling granddaughter would have to take four shots a day. She is doing well and has no fear of needles. When I was a little girl, the shots hurt so much that to this day I am afraid of needles.

I am proud of the fact that I have coped with diabetes without any complications. I have worked hard at trying to maintain good blood sugars. Since beginning on the pump about fourteen years ago, I have maintained my A1c at around 6%. I do exercise every day, even when I don’t want to. It certainly has helped me maintain good health. When you feel good, you look good, and when you look good, you feel even better.

I never kept my diabetes a secret, just in case I did get low blood sugar. I am prone to more lows than highs, even though I take a total of only about 15 units of Novolog a day.

I always believed that something good comes out of something bad. I thought for sure that my life was over when I was diagnosed with breast cancer at the age of 42 and had to undergo chemo and radiation. It was not a comfortable situation, but I am a survivor. I made lemonade out of lemons by not letting diabetes or cancer drag me down.

It was after going through all those chemo injections in addition to insulin shots that I went on the pump, and I’ve never regretted it. Taking one needle every three days to insert the pump is so much better than three or more shots a day. I just hate needles.

Before my sons moved out of the house, I was the only person with diabetes in the household. I had to learn to cook so that I could eat correctly, and they all were happy with what I made. I love to cook and bake, and my favorite food is cookies. I learned to prepare foods the healthy way, and I continue to prepare dessert almost every night.

My men, family, and friends were all satisfied with what I prepared, and they loved my cookies, cakes, pies, and other tasty desserts made without artificial sweeteners. People with diabetes can incorporate sugar into their meals but must watch the carbs. My Craving Chocolate Cheesecake is the ultimate dessert that I can eat and not have to worry about blood sugar swings.

At my oldest son’s suggestion, I wrote my first cookbook. It sold very well, so I started teaching cooking classes and lecturing on healthy cooking. I never attended a culinary school nor went to college, but have done very well in helping others learn how to prepare foods the easy yet healthy way.

Even though my sons have their own families, I still cook and bake for my husband and guests and enjoy preparing foods that fit into my meal plan and satisfy everyone else. I have learned to prepare recipes using a minimum of fat, salt, and sugar while retaining flavor and texture. My latest cookbook contains over 300 recipes that even the novice cook can prepare. I am fortunate to have a very supporting husband who loves to taste-test whatever I make.

If I can survive diabetes for 52 years and breast cancer for over fifteen, so can you. A positive attitude is important since you never get a break from living with diabetes. It is your life, and if you want a satisfying life, you must work on it yourself.

Eating correctly and taking the correct medication are only part of good diabetes care. I believe that daily exercise is a major component to healthy living. I personally hate to exercise, but it is definitely worth the effort. My blood sugars are usually within the required range, and my weight is just fine. Exercise and drinking water throughout the day also help your skin.

Please join me in learning to accept life with diabetes and make the best of it. Turn those lemons in lemonade and enjoy life.

Kathy Kochan’s website can be found at www.healthyeatingcookbooks.com. Her email address is k.kochan@att.net.

Story from: Diabetes Health

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Embracing My Second Chance at Life

Tuesday, October 21st, 2008

Michigan-based Leeanne Marie Stephenson’s Web site can be reached at http://www.lmstephenson.com

My introduction into the world of diabetes occurred long ago, when I was diagnosed with brittle diabetes at the age of six. I spent the majority of my childhood in the hospital. There, my doctors, nurses, and nutritionists taught me how to balance my food intake and insulin injections so that I could lead a somewhat normal life.

I was so impressed by their patience, sensitivity, and positive can-do attitude that I wanted to become part of their care-giving community, and I became a registered nurse. After graduating with honors from Mercy Central School of Nursing in Grand Rapids, Michigan, I secured a position as a registered nurse at Blodgett Hospital.

Over the next 10 years, I married my high school sweetheart and started a family. Periodically I changed jobs to meet the demands of parenthood and family life. Then my life took a dramatic turn as I was diagnosed with kidney failure due to my diabetes. The prognosis was less than promising. As my physical condition deteriorated, I was forced to give up my career as a nurse. Fatigue and weakness became my entire world as I underwent dialysis treatments.

Once again, I was on the receiving end of medical care. Desperate and determined to remain connected to this wonderful profession, I started writing a romance novel based on the experiences I had encountered as a nurse. When the days that lay ahead of me seemed impossible to face, I did not allow my tears to compromise my strength.

Instead of giving up during the darkest time in my life, I drew on the love that surrounded me from my wonderful husband and family. When I wrote, I was released from my physical problems and taken back into the world of nursing, which I love so much. Romantic stories can always release us from the problems of real life. They send us into a fantasy world where our imaginations can soar. I strove to take my readers and myself into that world. Thus was born my book, “A Prescription for Love. ”

This book is very special because it represents the strong love that surrounded me and motivated me throughout my lowest point. The one driving force in my life was to be there for my family, especially my precious children. By example, I demonstrated to them that when adversity is overwhelming, you still have to endure. I reached deep inside myself and drew upon my core values of perseverance and unfaltering resolve to overcome the obstacles in my life and achieve one of my dreams!

After a year on dialysis, I was told I could have a kidney transplant. My wonderful brother stepped forward and gave me the gift of life. From that moment on, my whole world changed for the better, and I eagerly embraced this second chance at life. When I felt well enough, I set about getting my romance story published so that I could be an inspirational example of what can be accomplished when life seems overwhelmingly hopeless.

Story from: Diabetes Health

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Gertrude ‘Blondie’ Fram, Age 93: Living With Type 2 Diabetes For More Than Forty Years

Saturday, October 18th, 2008

From the book “50 Secrets of the Longest Living People With Diabetes”© 2007, by Sheri R. Colberg and Steven V. Edelman. Published in November 2007. Appears by permission of the publisher, Perseus Books, an imprint of Da Capo Press. Contact Dr. Colberg at www.shericolberg.com and Dr. Edelman at www.tcoyd.org.

Blondie Fram has been living well with type 2 diabetes for at least four decades, and probably many more before she was diagnosed. She attributes her long life with diabetes first and foremost to solid family ties. “I have had wonderful support from my children and their spouses,” she says.

Her success also comes in large part from the great medical support that she has received from her son-in-law, Dr. Aaron I. Vinik. Dr. Vinik is a world-renowned diabetologist and neuropathy specialist at the Strelitz Diabetes Institutes in Norfolk, Virginia. “My son-in-law has looked after me carefully,” she says. “I know I could phone him in the middle of the night with any problem, but I try not to take advantage.” After she had controlled her diabetes for many years with diet and exercise alone, Dr. Vinik was instrumental in getting her on insulin, which she now takes four times a day.

Ever since she was widowed in her late fifties, Blondie has lived with one of her children and his or her family. When the entire clan emigrated from South Africa to the United States, they brought her along with them. She currently spends six months of every year with one daughter’s family in Nashville, Tennessee, and the remainder of the year with her other daughter in Norfolk. She has enjoyed being in the heart of her family all that time, especially because she has been able to help raise her grandchildren. “I think I’ve been really lucky to be surrounded by younger people all these years,” she says.

Blondie has always been a very active person, and even now she refuses to let life slow her down too much. She was a musician in her younger years, and she still tries to get out to concerts. In South Africa, she played golf and tennis for years (even though ignorant practitioners there told her that that exercise isn’t good for people with diabetes). Until a fall that resulted in a bad fracture, she walked in a local mall two to three miles a day. She still tries to walk as much as possible because she knows how important being active is to living well - with or without diabetes.

Blondie’s active lifestyle extends to mental exercise as well. Always a reader, she belongs to a book club to this day. She never goes to bed without doing a crossword puzzle, and she also enjoys the Sudoku number puzzles. “You have to try to keep your mind going,” she says. It’s apparent that this strategy has worked remarkably well for her.

Finally, Blondie attributes her success in living well with diabetes to her positive outlook. “I always have something to look forward to. Right now I’m looking forward to seeing what colleges my great-grandkids get into!” She doesn’t let her health problems bother her (she has been treated twice for breast cancer), and she is extremely careful about what she eats (a balanced diet with no added sugar and small quantities of food). “I have just learned to live with what I have to live with,” she remarks. The fact that she can’t move around as fast anymore bothers her, but at 93 years old, she is still moving pretty fast.

Story from: Diabetes Health

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The Two Faces of Diabetes

Friday, October 17th, 2008

Article Quote: “Anyone who says you can have diabetes and lead a normal life is letting everybody off the hook and robbing [my son] Joey of a future,” says Joey’s mother, Sandra Silvestri of Calif.

The table was set for Thanksgiving and all the family was there. Joey, the baby, was the center of attention. This would be the second Thanksgiving he had witnessed in his relatively short life. Somebody remarked that he looked thin, but Sandra, Joey’s mother, thought that it was just a sign of growth. As the turkey and mashed potatoes were served, the family turned its attention away from the cooing baby to ladling piles of food onto plates. Joey didn’t eat much that night, but kept asking for more to drink.

Joey’s health got worse over the following days-he was vomiting and looked pale. On the following Monday he slept in late. Sandra didn’t want to wake him. When she entered Joey’s room late in the morning, she found her son in a state of shock. He was almost blue, his lips drawn back in a grimace, his breath shallow. She rushed him to the hospital where it took about half an hour for the nurses to figure out that Joey had diabetes and was suffering from hyperglycemia. Joey was lucky enough to recover, but not before his and his parents’ lives were changed forever.

“It was like a new baby was born,” Sandra Silvestri says. “I had a new baby, a baby with diabetes.

The Silvestri’s story is not unusual. Sandra did what every other terrified mother of a child with diabetes does-she panicked and tried to consume every piece of information available about diabetes. Unfortunately, the more she read, the more terrified she became. She found all the information overwhelming. “I put my head down and tried to survive,” she says. With every new complication discovered, she became angrier, until she was mad at the entire diabetes community, resentful of anything related to diabetes.

Silvestri’s anger lasted until she learned to channel it into something productive. She is now using her knowledge to produce a television documentary about diabetes called “Time Bomb.” The documentary focuses on the sobering complications of diabetes and the need for a cure.

When she speaks about the documentary, a hint of anger swells in her voice. She thinks the media spends too much effort attempting to make people with diabetes appear “normal.” According to Silvestri, the only way the public will take the disease seriously is by showing its debilitating complications.

“Anyone who says you can have diabetes and lead a normal life is letting everybody off the hook and robbing Joey of a future. The technology we have now is not good enough. I don’t want Joey to live a life with diabetes; I want to find a cure. Diabetes only takes from people’s lives and I hate it,” Silvestri says.

To show how serious diabetes can be, Silvestri joined Pam Fernandes to speak in front of members of congress at a Diabetes Summit in May of ‘96. The Summit drew members from all walks of the diabetes community to speak in front of congressmen and women, legislative aides, community leaders and the media. Fernandes was diagnosed with diabetes when she was four years old. She was declared legally blind at 21. She has now had 30 operations, with a kidney transplant in 1987. She was chosen to represent the 16 million people with diabetes to show the physical toll diabetes can inflict on a body.

Fernandes told the audience that unlike other people with disabilities, she was born healthy and in a matter of 20 years, diabetes changed her life. She says it’s difficult to have to continue making adjustments to her life-to lose her sight, to become infertile. Losing these capabilities has made Fernandes question what she still can do, and the answers she has received from the public have fueled her advocacy campaign.

“People tell me I shouldn’t have to work, that I should stay home and rest. They want to cut my steak for me. The public has low expectations for people with any kind of disability. We all must raise our expectations of what can be done and we have to stretch to reach those expectations,” says Fernandes.

Misdirected Solutions

Many patient advocates for diabetes believe that diabetes has become a disease too profitable to cure. Diabetes maintenance has created an industry predicted to surpass $5 billion by the year 2001. David Groves, who leads the chatline Diabetes Forum through CompuServe, and has had type I diabetes for 43 years, believes that the business community intentionally focuses on the maintenance rather than a cure for diabetes.

“Diabetes Forecast comes out and says, ‘Little Johnny has diabetes, but don’t worry, he’s going to be all right.’ It’s just not true. Little Johnny is going to die of diabetes,” says Groves.

Diabetes Health board member Joan Hoover shares Grove’s cynicism, though her anger over time has mellowed. When her daughter was diagnosed with diabetes 30 years ago, Hoover began a fund-raising campaign to find a cure. She found her greatest success when she went to Las Vegas and convinced Wayne Newton to donate the proceeds from five of his shows towards diabetes research. The benefits raised $500,000.

But after years of fund-raising, Hoover has become frustrated. Every year scientists would say that a cure for diabetes could be found with more money. But Hoover never knew where the money went after she handed it over. A cure has yet to be found, and Hoover doesn’t know if scientists are any closer to finding a cure than they were when she began. Yet articles about people with diabetes continue to emphasize the success stories without showing the darker complications of the disease.

“People always complain to me that they can’t possibly match the lives of those shown in Diabetes Forecast,” says Hoover. “The reality is that many people’s lives are much tougher, and those people aren’t highlighted by the media.”

In the past the ADA and Forecast have been somewhat hesitant to portray the darker side of diabetes, concedes Jerry Franz, vice president of communications for the ADA. But that has changed, Franz says, and the ADA’s policy has shifted to one of exposing the seriousness of the disease.

But there are other problems. Hoover and Groves point to the historic DCCT study as a prime example of how funding for diabetes research has been misappropriated. The study was the largest in diabetes history, taking ten years and using $250 to $300 million. Instead of finding a cure, “tight control of blood sugars” was the DCCT’s answer to diabetes. Groves calls the study a deliberate exercise to avoid spending money on research for a cure.

Yachmiel Altman, a software designer for Information Builders in New York, says that when the DCCT results came out, he and the people he knew with diabetes considered it a joke. “We thought it was hysterical. They spent $250 million to say that people had to control their blood sugars? I had been doing that since I was six years old,” says Altman.

How Do I Present Myself to the Watching World?

Gary Kleiman, executive director of medical development for the Diabetes Research Institute at the University of Miami, divides the ways people cope with diabetes into two categories: those who look at their lives positively, but shield themselves from the grim implications of diabetes, and those who view their lives negatively, but perhaps more honestly.

“I think most people would rather keep their heads in the sand,” says Kleiman, who has lived with diabetes for 36 years. “Who wouldn’t? What person, with or without diabetes, is ready to contemplate their own death? It’s too heavy. People would rather look at the bright side and work to make their lives as productive as they can.”

Kleiman says that once people have learned to accept the fact that they have diabetes, the natural reaction is to resign themselves and make the best of it. They don’t want to deal with feeling different. People with diabetes often overcompensate to make sure that they are just as good as anybody else.

“A person with diabetes, like anybody else, wants to promote his or her positive qualities. If diabetes is considered a defect then a person with diabetes will naturally downplay that defect,” says Kleiman.

Unfortunately, until a cure is found, diabetes will remain a part of a person’s life. Whether people choose to wallow in their own misery or ignore the problem entirely, diabetes does not go away. Diabetes Health board member William Polonsky, PhD, CDE, makes the point that a person can complain all his life about diabetes without making the disease any easier to live with.

“Diabetes is like an unwanted guest who won’t move out. You can complain to every person you know about what a crummy roommate you have, or you can do something about it,” says Polonsky. “You can get perspective, you can find humor, and you can find an adequate way of compromising.”

Groves looks at this “make the best of it” approach as a waste of time. He says that anyone who makes any claims that diabetes changed his life for the better, or even anyone who claims to have led a normal life with diabetes, is fooling himself.

“I’ve climbed the Great Wall of China. I’ve seen priceless Faberg_ eggs in Russia. I’ve done a lot of things in my life no one even dreams about, but I could have done them a hell of a lot better without diabetes,” says Groves.

Exemplar or Victim?

Fundraising groups must walk a fine line when presenting the diabetes community to the public. As Hoover says, she can go to a company such as General Motors and describe diabetes as a terrible disease with ghastly complications, and ask for money to find a cure. Then she may go back the next day to General Motors and present the person with diabetes as dependable as well as productive, and ask General Motors to give the person with diabetes a job.

According to Hoover, the only mistake a person can make is to attempt a common voice for the diabetes community. No single image of the diabetic exists. The only way to view the community is person by person.

“Diabetes is a democratic disease. For every one of the 16 million, you’ll find another image, another story,” says Hoover.
Tell Me a Happy Story

Silvestri and Hoover sit together in the pressroom, taking a break from a long morning at the 56th Annual Scientific Sessions in San Francisco. The lights are bright, the ceiling high, suggesting endless possibility. While the convention roars on outside the door with all the razz and glitter of a carnival, the women speak to each other quietly.

“Can you imagine what would happen to all those people out there if somebody suddenly found a cure for diabetes?” Hoover asks with a sly smile. “They would all be out of business.”

The women have something in common. Both are fighting for their children against a disease they don’t have. Silvestri has been at it for four years now while Hoover has been campaigning for 30. Silvestri’s son, Joey, is now six-years-old, a healthy kid in every way except that he has diabetes. Silvestri is not fighting to end Joey’s six shots of insulin a day. She is fighting against the ghost of “what could be”: the blindness, the amputations, and the kidney disease her son might have to face.

“This is not my disease,” says Silvestri. “These are not my issues. But somebody has to be brave.”

When Hoover talks about her daughter’s case, she does not refer to “what could be.” She acknowledges what she has seen-the complications touching her own life. When she recites the list of her daughter’s complications, the 20 surgeries, the two kidney transplants and the blindness, the angry blood subsides from Silvestri’s face. The edge in her voice catches and quiets to a whisper, until all that is left are tears.

Hoover holds Silvestri’s hand. She wonders, as she’s wondered before, if she has spoken too freely about her daughter. Her daughter’s story, with its long list of complications, does not happen to everyone. Though she wants to speak honestly about diabetes, she worries about presenting a laundry list of possible things which may go wrong.

Hoover now has a granddaughter who has had diabetes for three years and a daughter who has had it for 30. Hoover has begun the cycle for the second time. She says that people think because she has raised a daughter with diabetes, she can tell them how to make life easier.

“They want to hear a success story,” she says, “but it’s a story I’m not sure how to tell.”

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