Talent and Dreams Fulfilled! (Despite My IDDM of 46 Years)

October 16th, 2008

Forty-six years of coping with IDDM hasn’t stopped me!  I’m a published, award-winning poet, an actress and, in my “retirement,” a vocalist.  All this from a girl from a far off place known as The Bronx – and a policeman’s daughter, no less!

I retired several years ago and will be 65 in June. In my retirement, despite my diabetes, I’m nurturing talents and realizing life-long dreams by pursuing a successful new vocation: entertaining.

The two acts that I’ve developed are flourishing. The first, Merilee’s Melodies, includes me as the vocalist, accompanied by a talented jazz pianist. We travel to libraries, senior residences, women’s groups, temples and assisted living centers around Long Island (where we both live,) presenting one-hour musicals.

For our elderly audiences, we bring music of their time – Tin Pan Alley and swing, including the Gershwins, Rodgers and Hart, Billie Holiday, Rosemary Clooney and other greats. We invite audience participation, and once the interaction gets going, everybody has a fine time.

After I retired, I discovered that I had a knack for writing. That’s when I teamed with my colleague and friend Jerome Coopersmith, a Tony-nominated dramatist (who was also a writer for the Hawaii 5-0 series, among other TV productions), to create my second act, “Your Neighbors, The Writers.” We create and present themed programs of original works at such venues as VA hospitals, and for such organizations as the Social Security Administration.

Who does the booking for all these gigs?  I do! Before I retired, I worked as a press agent and picked up such skills as researching venues and booking clients into them. So, naturally, booking falls to me. Ingredients needed: creativity, energy, intelligence, diligence and drive. My good health, happily, has allowed me to apply all these things.

Gigs Galore

After my mom died five years ago, a friend who was a recreation director at a senior residence suggested that, to help me through my loss, I volunteer.  From that came my weekly singing appearance in front of Nassau County’s RSVP group  of retired seniors volunteers.

With my temple’s Sisterhood, I’ve served for years on the committee for our annual membership dinner and fashion show. For me this means running around town soliciting raffle prizes. Due to my hypoglycemic unawareness (of 20 years duration), I don’t drive.  So, every year my darling husband chauffeurs me around to local vendors, who take one look and say, “Merilee’s here for the temple show. Get out the gift certificate book!”

Through the years, I’ve maintained my figure, so I’m also able to lend these events my modeling, as well as stage, talents. A vital part of that has been staying fit. Fitness is necessary for health, as well as vocational success.  That’s why I work out three times a week at the gym.

It Wasn’t Always Like This

Years ago, when I was less accepting of my diabetes, and, therefore, less diligent about my control and unsure of my BG at any time, I feared tackling projects.  When I resumed performing four years ago, I was uncertain at first. I worried whether my brain would have enough glucose while I performed. Now, despite my hypoglycemic unawareness, close self-monitoring permits me to know blood sugars pretty well. This allows me to perform, or treat a high or low BG, and get on with things.  welve to 15 tests daily do the job.

Still, despite my best efforts, things don’t always go smoothly. Years ago I’d get angry with myself, treat a high BG with insulin, then comfort myself with high-glucose foods – totally inappropriate.  These days, when I get a high BG, I am now wiser, and more knowledgeable and experienced. Despite my disappointment, I treat with insulin then don my Sherlock Holmes cap and go searching for the cause.  With so much to do and look forward to, I just don’t permit myself to dwell on setbacks.  I take the necessary insulin and get on with my daily activities.  When necessary, I transmit my BG numbers to my endocrinologist and ask for his input.

I’m fortunate to live in this time of advancements in technology, science and medicine.  Recently, I switched my basal Lantus, from one dose to a split dose.  With three alarms, my trusty digital wristwatch announces the time for my a.m. dose and another for my evening dose. I set the third for my two-hour post prandial BG test.

I chose not to have children. But my husband of 35 years, Herb – creative, sharp, talented and caring – has supported me all along the way.  Together, we’ve “learned diabetes” – invaluable to coping.

Some Advice for the Newly Diagnosed

Attitude is vital to one’s success, I believe.  If you’ve got to have a disability, being blessed with the smarts to take care of it, talent, drive and super support foster fulfillment.

To any newly diagnosed diabetic I’d recommend first, accept the condition, get educated and join support groups, and then get on with your life.  Find the things you enjoy and go for them.  Remember, diabetes is a chronic condition over which we are the masters.

Do I have any spare time, you ask?  Well, my schedule is usually packed, but with my hubby or friends I make enough time to enjoy such pleasures as jazz shows, theater, films and get-togethers.

With my music and writing/acting careers flourishing , thanks to Merilee’s Melodies and “Your Neighbors, The Writers,” as well as good health and the support of a loving mate, I couldn’t be happier!

Story from: Diabetes Health

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Still Healthy After 54 Years Living With Type 1

October 15th, 2008

I was diagnosed with type I insulin-dependent diabetes 54 years ago at the age of 22 months. A dear family friend suggested my parents take me to our family doctor and have me checked for diabetes after I showed some of the more common symptoms. I was unusually cranky and always hungry, but had a stomach that was hard to the touch as though food was not digesting properly. I was also always thirsty, drinking a lot and urinating frequently. Our doctor tested my blood sugar, and the result was high enough to indicate diabetes. He put me on 60 units of insulin per day and told my parents to take me to the hospital 30 miles from the little Western Kansas town where we lived to get a shot of insulin once a day.

Because I was such a small child, I had one insulin reaction after another on that dosage. My parents were forced to seek other medical advice when this doctor would not listen to what they were telling him or consider making changes in my treatment.

My loving parents then took me to another doctor, Dr. William Brenner, for whom they had a huge amount of respect. Dr. Brenner had grown up in my father’s hometown, so my parents knew him well. He was a man of great character, compassion and integrity, who had survived the infamous Bataan Death March in the Philippines in World War II. His practice was in Larned, Kansas, a town 60 miles away. Dr. Brenner agreed to treat me as his patient, but only if my parents first took me to a diabetes specialist who practiced in Wichita, Kansas.

My parents, who were willing to do anything it took to aid my survival, did so. The diabetes specialist told them it was a wonder I had survived being on 60 daily units of insulin. He sent me home on two units of insulin a day. Both he and Dr. Brenner told my parents they had a choice: They could raise me as a “normal” child or they could raise me as a child with a crippling disability. To their credit and my joy, my parents chose to raise me as close to normal as it’s possible for a diabetic to be. My life, to this day, has surpassed most expectations.

Very Different from Today

When I was first diagnosed, glass syringes, which had to be boiled for sterilization purposes, were used to administer shots, and blood had to be drawn at a hospital lab to determine exact blood sugar count. At home, blood sugar ranges were imprecisely measured by urinating on special strips. Fortunately, diabetes care has improved a great deal. One of the most important aspects of care is still the same: A person with a chronic condition needs to be her own case manager and to be very much in tune with her own body. During my life, I have had both wonderful doctors and those who treated all diabetics the same and were not interested in listening to me. As my own best advocate, I have changed doctors if needed. I consider it essential to be able to talk with and to my health care providers.

Having much to learn, there was any number of ups and downs as I grew. When I was young and had the flu, I’d end up in the hospital for a week or so. Now if I get the flu, I stay at home and take care of myself. I spent six weeks in the hospital as a sixth grader while our doctor worked at stabilizing my blood sugars. I was previously described as a brittle diabetic, and the blood sugar swings that go with that diagnosis are with me to this day.

Adolescence was a major challenge, and a time when I put on a lot of additional weight. My body had quit growing, but I continued to feed it as though I still were. College was my first time of being away from home for any length of time, and it necessitated a lot of quick learning. The importance of sharing my condition with those around me was reinforced. For example, when I didn’t show up for class one day, my instructor called the “dorm mother,” who checked on me and helped me get treatment for a serious reaction. If I had not shared information about my disease, I might have suffered severe damage from lack of treatment.

Except for one year of living with my sister after she graduated from college, I lived on my own from the time I graduated from college at 20 until I got married at age 47 to a man with custody of his four birth children. In those years of living alone, I learned how to handle both my food and my insulin needs. Some of that learning included times when I voiced resentment about being diabetic and chose to eat what I wanted, when I wanted it, while attempting to adjust my insulin dosages to my desires for food.

Workshop Made a Great Difference

Over the years I’ve had some seriously frightening insulin reactions where I was unconscious and convulsing, but not many and they have always occurred around members of my birth family, who have learned a lot over the years about how to help me when I was in no condition to take care of myself. These reactions led me to attend a weeklong diabetes workshop offered by Dr. Richard Guthrie in Wichita, Kansas, nearly 25 years ago. Much that I heard I’d already learned from living with the disease so long, but the information and the treatment plan that were new to me later made a huge difference in the way I have since lived my life and cared for my physical needs.

November 2007 marked 56 years of living with a chronic condition that is often crippling or fatal. Because it was true for that period of time, the doctors told my parents that I probably would lose my vision and would be lucky to live to the age of 18. From the time I was old enough to understand, medical personnel have preached to me about the importance of taking good care of myself and the possibility of complications arising from poorly controlled diabetes.

I was not always a willing listener. But over the years I have learned to be more self-disciplined largely due to my spiritual growth and a desire to avoid complications of diabetes as long as possible. I’ve also managed two trips to Europe and two trips to Hawaii without incident, and I’ve taught special education for 34 years–demanding but rewarding work.

My control of my diabetes has never been perfect, and I doubt if it ever will be. The only major complication I’ve dealt with so far is a microscopic heart attack, followed three years later by quadruple bypass open-heart surgery. A minor complication is having been diagnosed with cataracts on both eyes, which were removed more than 10 years ago, followed by laser surgery on each eye. Another blessing I thoroughly enjoy is that I currently have 20/15 vision while wearing prescription lenses.

So Many Good Reasons for Living

I consider the present length of my life and my general state of health to be gifts from God. But He also makes me aware that my attitudes about self-discipline (very important for many reasons) and giving my best effort without berating myself when what I try doesn’t work are also important factors in my good health.

Give yourself reasons to live a long, healthy life – mine center on my relationships with God, husband, children, sister, dad, other family members and friends – and choose to avoid complications by (1) eating in ways that aid blood sugar control, (2) exercising mind and body, and (3) taking your medicines as directed. Don’t live in fear. Diabetes requires serious respect and serious effort, but it doesn’t have to be a quick death sentence. Don’t give up on yourself – enjoy life to the best of your ability. I am saddened and horrified that I hear of so few diabetics who have lived as long and healthy a life as I have, and I want to say to all who read my letter that life with diabetes can be good. Mine is!

LuAnn’s Secrets to Living Well With Diabetes

1. Focus on your relationships with God, family and friends to give yourself reasons to live.
2. Control your blood sugar by what you eat, get mental and physical exercise, and take your medicines.
3. Do not live in fear

Story from: Diabetic Health

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Diabetes Is Woven Into the Fabric of My Family

October 14th, 2008

Let me start with my maternal grandmother, Helen. Helen had diabetes and lived to the age of 73. We all assumed that she didn’t do a good job with it, as we would often find candy wrappers under her bed. When it came to taking care of herself, Helen was my mother’s role model.

She was not a good model. That’s why I vividly remember my mother toward the end of her life as she lay in a hospital bed, suffering from the many complications brought on by her diabetes: blindness, neuropathy, bad circulation, chafi ng skin and multiple strokes.

While she was still able to talk (before another stroke took that away), my mother told me she regretted how diabetes had taken its toll on her. I thought I would live as long as my mother,” she said. “If I could do it all over again, I would have taken better care of myself.”

Our big family was all there, holding her hand and wishing for the best. She later slipped into a coma and, with a hospice’s help, she passed away peacefully at my home. She had been diagnosed with diabetes at the age of 50, and her complications started at age 62. She was 65 when we buried her.

My paternal grandmother lived in Baghdad and died in 1978 from diabetes complications as well. Back in the 70’s her diabetes education had been quite simple: Use saccharine with your chai instead of sugar. She didn’t have an opportunity to learn about the glycemic diet and how it could impact her blood sugars. Although nothing outside of the Middle East rivals great Iraqi cooking, it was still a diet heavy with rice and homemade breads – not exactly the best ingredients for keeping blood sugars down.

And now my generation has diabetes calling. Can we make a difference? Read on and see.

My Brother: Like Mother, Like Grandmothers

My brother Jamal recently came to visit from Australia. He was diagnosed with diabetes in 1997. The last time he had been in the United States was for my mother’s funeral.

For the last five years my brother had felt terrible. His vision was foggy and he had not slept through the night for at least three years because of his high blood sugars and frequent trips to the bathroom. Sleep deprivation, exhaustion and struggling to make it through the day were commonplace conditions for him.

I couldn’t wait to ask him about his diagnosis and the treatment he had been following. When he arrived, my sister Mimi picked him up at the airport and took him out to eat at his favorite Bay Area places. She treated him to Chinese food with fried rice and noodles, followed by ice cream for dessert.

Later, when I called my sister to check in, she talked with me about her evening with Jamal. I asked her about his blood sugars after dinner. She told me, “The meter says ‘hi.’” I was confused. “The meter said ‘hi?’” “No,” she said, “‘high,’ like in ‘up there.’”

I was upset. I remembered my days at our company, Sugar Happy Diabetes Supplies, where I taught people how to use meters. When a meter said “high,” that meant the reading was so high it was off the charts. On Jamal’s meter, “high” meant over 550 mg/dl!

My first reaction was that my sister was responsible for this. I blamed her for feeding Jamal the wrong food and helping his blood sugars skyrocket. I was just plain scared for him – so scared, I blurted out, “Mimi, you might as well drive Jamal to the Golden Gate Bridge and have him jump off!”

Later, my business partner Scott reminded me that my sister was not responsible for Jamal’s blood sugars. I knew he was right, but I had been there with my grandmother and mother when they had faced the devastating complications of diabetes. I don’t want my brother to go through the same thing. And I don’t want to hear him utter from a
hospital bed, “I wish I had known better.”

Once I caught up with my brother, I asked him about his average blood sugar. He told me it hovered around 450-500. I asked him what type of treatment his doctor was prescribing. He said that he had been put on metformin and that his dose recently had been doubled.

Our Family Intervenes

It clearly was time for family intervention. I called one of our family doctors and asked him to put my brother on an aggressive treatment to bring down his blood sugars. Scott and I took Jamal aside and gave him a mini-course about diet and which foods raise BG’s. Our doctor started him on NovoLog fast-acting insulin. He started taking 5 units every two hours until his BGs came down. And, boy, did he start feeling better!

Armed with a new meter, insulin and a carb counting book, Jamal was able to bring his average from 450 to around 160 in the month he was with us. On his last day in the United States he took his blood sugar at the airport and had a reading of 140.

A Different Man

I was so happy that he came here when he did. He left feeling the best he had felt in years. He went back to Australia armed with his new knowledge and food, his blood sugar and injection logbook, and a determination to show his doctor his newfound energy and clarity.

His Australian doctor is providing him with aggressive treatment for his high blood sugar, including insulin. In the meantime, Jamal now understands the importance of testing, making better glycemic food choices and lowering his blood sugars with insulin.

He would not be at this stage if his family had not been there to firmly, but lovingly, show him what he had to do. In a way, the suffering of his mother and grandmothers, which made an indelible impression on all of us, was vindicated. We remember their suffering, and we feared we were seeing Jamal heading down the same path. That gave us the courage to intervene. I really hope he and I can reach a ripe old age together.

Let’s all work together to make a difference.

Story from: Diabetic Health

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When Being High in the “Mile-High” City Isn’t a Good Thing

October 13th, 2008

Denver Broncos quarterback Jay Cutler plays in the “Mile-High City.” But he was higher than usual last season.

How high? A normally functioning body’s glucose level is generally between 70 and 150 mg. But Cutler says that as he lay gasping in his apartment, trying to recapture some modicum of energy after his morning workouts in January and February, his glucose levels were probably “in the 500s and 600s.” He would sleep from 2 to 6 p.m., eat dinner, and then go back to sleep for the night.

Cutler had all the classic signs of diabetes. In addition to the weight loss and lack of energy, he experienced frequent urination and constant thirst.

When he was diagnosed with type 1 diabetes in mid-April, it was a relief. “I was just glad for a diagnosis,” Cutler says. “Not knowing what was wrong was much scarier.”

The 6-foot-3 Cutler, who will soon be outfitted with an insulin pump, began dropping weight in October. He ultimately lost 32 pounds, down to 202 by the time he was diagnosed. Routine blood tests required of players in the National Football League revealed that his glucose levels were about five times higher than normal.

Cutler is far from the first football player to get diabetes. Former Broncos defensive end Mike Sinclair, former Vikings and Cowboys quarterback Wade Wilson, and former Titans defensive backs Tony George and Mike Echols all continued to play in the NFL after being diagnosed with diabetes. The list of professional athletes with diabetes includes tennis great Billy Jean King, former heavyweight champion Joe Frazier, Olympic swimmer Gary Hall Jr., golfers Kelli Kuehne and Michelle McGann, and basketball player Adam Morrison of the Charlotte Bobcats.

Cutler, 25, told Diabetes Health he feels a crisis was narrowly averted. “I’ve talked to a lot of people and read stories, and the way many of them find out is they go into a coma for two, three days,” said Cutler, who has regained 18 pounds since his diagnosis. “I’m fortunate nothing critical happened.”

Cutler says he’s radically altered his diet from the days when he ate “anything and everything.”

“It’s a big adjustment,” he said. “You’re 25 years old, you’re used to eating whatever you want, doing whatever you want. If you want to go out to lunch, go ahead and go. Now, you’re counting carbs and eating healthier and injecting insulin at the table. You’ve got to have your insulin, your needles, your glucose meter…yeah, it’s a big change. But it’s something you have to deal with.”

Now he’s working with doctors to make sure he can play to his potential on game days without putting himself at risk. He’ll wear an insulin pump in practices and warm-ups to keep his glucose levels normal. Then he’ll take the device off for the games, closely monitoring his glucose levels and drinking Gatorade if his BGs start dropping.

“The more knowledge I get, the more I will be able to manage [my diabetes],” Cutler told ABC News.

Cutler does admit to being a little overwhelmed with all of the information he’s had to take in about diabetes and its ramifications if left uncontrolled.

“It’s a lot to get that news and realize I’m going to have to completely change my life,” Cutler says. “It’s not something that’s going to go away. It’s something I’m going to have to deal with my entire life, and I’ve got to come to grips with that.”

He says he initially feared his career would be over, but doctors put that fear to rest quickly.

“The first thing they said to me [was], ‘It’s going to affect your lifestyle a little bit, but you’ll be able to continue to play football,’” Cutler says.

Cutler, the eleventh pick in the 2006 draft, threw for nearly 3,500 yards and 20 touchdowns last season, but the Broncos missed the playoffs for a second straight year. It was obvious as the season wore on that his arm strength was not what it used to be.

“I’m not going to blame it on diabetes, but thinking back, there were some throws that didn’t have a lot on them,” Cutler says. “I was able to go out and perform, but I just wasn’t that energetic. I was tired. After the games, I was completely wiped out. Some games I didn’t do a whole lot. There was something wrong.”

Today, the third-year quarterback says he feels terrific, and he’s eager to get into practices to see how his body reacts. He wants fans to know he’s going to be fine.

“I’m feeling a hundred times better,” Cutler says. “It’s hard to explain what it feels like when your levels are at 400, 500. You don’t have energy, you don’t really want to do anything, you sleep a lot. It’s tough to deal with.”

Now Cutler is taking up the diabetes cause. He’s appeared on the Today Show, chatting with Al Roker before the weather forecast, and he let cameras trail him for a segment about diabetes on the NFL Network. He’s also planning a golf tournament in Parker, Colorado, to raise money for juvenile diabetes, among several causes.

“I’m blessed to have a [public] profile where I can actually do something to promote awareness about the disease that I have,” Cutler says. “Not many people are in that position.”

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Flying on Insulin

October 12th, 2008

Every pilot’s nightmare is the thought of losing his medical certification and being stopped from flying. That happened to me in May of 1986, when I was diagnosed with type 1. In accordance with the International Civil Aviation Organization (ICAO) Standards and Recommended Practices, Canada, along with every other country in the world, would not allow insulin-dependent pilots to hold any type of pilot’s license. My short eight-year career with Air Canada came to an abrupt end, and I was told in no uncertain terms that I would never be allowed to fly an aircraft again.

The ICAO worried that a type 1 pilot might not always be able to maintain the delicate balance of food intake, timing of meals, insulin, exercise and fatigue that all type 1’s struggle with. If a pilot suffered a low blood glucose during flight, he could lose consciousness, with obvious disastrous consequences. For these safety reasons, the ICAO prohibited all persons with type 1 from acting as a crewmember. In 1986, no consideration was given to how well an individual could control his diabetes.

Because I was only 30 years old at the time, I decided to start a new career. What followed was a five-year commitment to obtain my law degree and three years of private practice as a general practice lawyer. Although I did not specifically pick my new job as a lawyer with the intent of attempting to regain my pilot’s license, it turned out that this became a fortuitous benefit of my newly chosen career. Special thanks must go to Air Canada because they were very supportive during this transition period. I was hired as a simulator instructor and spent eight years as both a full-time and, during law school, a part-time simulator instructor on the DC-9, teaching other pilots how to fly this aircraft.

In 1982, Transport Canada’s Civil Aviation Medicine Branch decided to reexamine its policies on diabetes mellitus. However, this proved to be a very drawn out affair. In 1986, Transport Canada started to look at re-licensing pilots who had non-insulin dependent diabetes and who were taking oral agents to control their diabetes. Unfortunately for me, Transport Canada was still shying away from looking at insulin-treated diabetes. Things turned the corner in April 1992, when a panel of expert doctors met to review diabetes in the context of the modern aviation environment. Thanks to the work of the late Dr. Gerald S. Wong, Dr. James Wallace, Dr. Robert Depuis, and Dr. G.Y. Takahashi, a new process for pilots with type 1 was born.
During this ten-year process, the Canadian Diabetes Association decided to take the issue to court in an attempt to speed things up. The Canadian Charter of Rights and Freedoms was used to attempt to force Transport Canada to develop guidelines to reinstate pilots with type 1. In Her Majesty the Queen as represented by the Minister of Transport (Appellant) (Defendant) v. Eileen Grace Bahlsen (Respondent) (Plaintiff) (1996), the Federal Court of Appeal ruled that refusing a medical certificate to an applicant for a pilot’s license because of a blanket prohibition against diabetes was justified under Canadian law. Even though the practice discriminated against the applicant, the court held that as there was no other state licensing type 1 pilots for solo (single pilot) flight, and as there was no consensus of medical opinion on the safety of solo flight by insulin-dependent pilots, Transport Canada was justified in prohibiting pilots with type 1 from flying. The case did, however, help spur Transport Canada into looking at re-licensing pilots with diabetes for multi-crewed aircraft.

The very first pilot in the world with type 1 to get his medical certification and, therefore, his pilot’s license reinstated was a Canadian military pilot, Capt. Chuck Grenkow. Chuck became a diabetic in 1987. After two years of monitoring and individual assessments of his ability to control his diabetes, a very forward thinking Dr. Gary Gray, with the help of Chuck’s endocrinologist, Dr. John Dupre, authorized Chuck to return to flying duties. In August of 1989, Chuck moved to Summerside PEI and returned to active flying status at 413 Sqn. Chuck is presently working as a Major in Esquimalt, BC, where he is still licensed to fly. He will be retiring from the Canadian Forces in July of 2010.

On the civilian side of things, it took much longer.

John McDermott was the first civilian pilot to receive his medical certification with type 1. John had been a Boeing 727 Captain with Air Canada before developing diabetes in 1981. John’s medical certificate was returned to him in September of 1999, and he returned to Air Canada on a Boeing 767 course. Unfortunately, John ran into a number of circumstances totally outside of flying that precluded him from completing his return to work. John was the pioneer in the return-to-work protocol, and it is quite likely that without his efforts, none of the rest of us would have been able to return to flying. He is owed a great debt for paving the way for others.

Brett Walker was next. Brett was diagnosed with diabetes in December of 1998, but he was able to stay off insulin for awhile and continue flying the Boeing 737 and later the Airbus A320. He had to start taking insulin in December 2000 and had his medical certification revoked at that time, but it was returned to him in June of 2001. Brett returned to flying as a First Officer (Co-Pilot) on the Airbus A320 based in Toronto. Brett was the very first civilian pilot with type 1 to return to operational line flying anywhere in the world.

Next came myself and another Air Canada First Officer whom we will call “Tom.” We both received our medical recertification in December of 2001. Tom returned to flying on the Airbus A320 in January of 2002. He is now an Embraer Captain based in Toronto.

I took a little longer because I was living in Hong Kong at the time. I gave up the practice of law in 1994 and moved to Hong Kong to work as a simulator instructor on the Airbus A340 with Cathay Pacific Airways. Following our family’s return from Hong Kong, I returned to Air Canada in November of 2002 as a Captain on the Airbus A320. The return-to-work protocol required me to fly as a First Officer for the first six months to make sure everything went well, but I was able to transition into the left seat (Captain) in October 2003. This made me the first person in the world to fly as the Captain of a commercial airliner while taking insulin. In June 2006, I transitioned to the Boeing 767, which I am still happily flying on international routes around the globe.

Ron Swaisland was the latest of the current crop of airline pilots with diabetes. Ron was first diagnosed with type 2 diabetes in August of 1996. He maintained his active flight status by controlling his blood glucose levels with diet and exercise until July of 2004, when he had to transition to oral medications. Unfortunately for Ron, the oral medications proved unsuccessful and he was placed on insulin therapy in October 2004. Ron returned to active flying status in June 2006 as an Airbus A340 Captain. He retired from Air Canada on June 1, 2007.

Canada is the only country in the world allowing commercial pilots with type 1 to fly, and we are subject to a very strict in-flight protocol to ensure the safety of our flights. We must complete a fingertip blood test within 30 minutes prior to flight departure and at least every 60 minutes thereafter for the duration of the flight. In cases when the blood glucose readings are in the lower range of acceptable readings, that time period is reduced to 30 minutes between blood tests. All of these readings must be forwarded to Transport Canada with each medical renewal, and these readings are the deciding factor in whether our medical certificates are re-issued each medical cycle. We are by far the most medically scrutinized pilots in the world. Our licenses are never renewed: they are revoked at the end of each medical period and then re-issued if we continue to comply with the requirements set forth by Transport Canada.

Today in Canada there are 15 Airline Transport or Commercial pilots with type 1. Three of us continue fly for Air Canada. There are also two air traffic controllers working with type 1.

Canadian pilots are still the only pilots in the world flying with type 1 in a commercial environment. We hope that through our experiences in Canada, type 1 pilots in other countries will eventually gain the medical re-certification that Transport Canada has provided to us.

For each one of the pilots named in this article, a very special thank you must go to the doctors who saw fit to give us the opportunity to return to work. To Drs. Gary Gray at the DRDC, Jim Wallace and Edward Brook at Transport Canada, Ed Bekeris, Craig Winsor and Peter Hopkins at Air Canada, along with some very special endocrinologists, Dr. John Dupre and Dr. Irv Gottesman, we give our personal thanks. A very special thank you is also owed to Capt. Dave Noble of the Air Canada Pilots Association and to Air Canada Flight Operations Management for their help in the return-to-work process. Without the help of these individuals, none of this would have been possible.

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