Jane Kokernak teaches in MIT’s Writing Across the Curriculum Program and lives with her family near Boston. In 1992, as an adult, she was diagnosed with Type 1 diabetes; in 2003, she switched from multiple daily injections to an insulin pump and has stayed with it. Her essay on diabetes and sexuality, “Tethered to the Body,” appeared in Bellevue Literary Review’s special issue on disability in 2008 and was republished by ASweetLife in 2010. Other of Jane’s essays have appeared in Equally Shared Parenting and PMS poemmemoirstory and articles on teaching writing in Tomorrow’s Professor. Read full bio

Doing It for Real: A Skater with Type 1 Diabetes Takes Her First Test

I took my figure skating test two days ago, on Sunday, as planned. For me, it was a rite of passage as a skater and a crystallizing learning experience. The outcome was mixed: not a quantifiable triumph, but a personal one.

Because the test would be my first ever as an adult skater, in the days leading up to it I tried to practice as much as I could without burning out, and I sought information from my coach and other skaters as to what the scenario would be like. Both, it turns out, are necessary for facing physical challenges.

On Friday, I had a lesson with my coach, Fred, at which we ran through the test as an approximation. We predicted the test could go either way; in some moves I was strong, in others still tentative. I was nervous. At the end of that lesson he said, “We’ve done what we can do,” in a positive (not resigned) way, and he gave me some last-minute advice on getting ready, which included a good night’s sleep.

On Saturday, I went to the rink hours for my club: the MIT Figure Skating Club (FSC). I continued practicing and tried to keep the urgency out of it. I felt sort of detached, in a useful way. There was no heightened emotion. I was calm.

I went home, washed my skating clothes, thought about what I would eat for breakfast, and went out to dinner with my family. Not nervous, I was still looking ahead to the next morning. I did not overeat at dinner, which might have required a correction bolus with unpredictable results later. I drank only half of my glass of wine, not wanting to experience the paradoxical low blood glucose (BG) sometimes brought on by alcohol consumption.  At bedtime, my BG was close to the ideal 100, so I dialed back on my basal rate by 20%.

Sunday morning, I awoke at 5am, alert. BG was 130 – pretty good. Got ready, double-checked my bag. I ate some whole-wheat crackers and peanut butter and filled a bottle with water. On my hand I wrote: Take off pump! I knew I would want to remove my pump before the test, not wanting the jitters of low BG to coincide with the jitters of test nerves. I arrived at the rink early, and talked to other early-bird skaters who were also registered for tests. A little nervous, not too much.

Went into rink. Judges arrived. Watched the first set of tests, one skater at a time. More nervous. Thirsty.

The 10-minute warm-up for my set of testers was announced. Heart pounding in chest. Knees trembling. Skated and warmed up, thinking too much.

I noticed that my coach, Fred, had arrived, and I was relieved to see him. We stood and watched the two skaters who tested before me and talked in low voices.  He prompted me to say out loud the order of the moves in my test:

  1. perimeter stroking, both directions
  2. forward and backward edges
  3. forward and backward crossovers
  4. waltz 8, twice
  5. spirals

 

Abruptly, without fanfare or announcement – just a nod from the test coordinator — it’s my turn. I fumble at unclipping my pump; I swig from my water bottle and drop the cap. I have practiced a calm skating face, and I put it on. I begin. My knees are shaking. I remind myself to bend into them, harder. I feel awkward. The rink is totally silent; there is no music, and the judges and other skaters do not speak. During my least comfortable moves, I hear my toe picks scrape the ice loud. So loud! They are not supposed to be scraping the ice. I frantically think: Oh no! I can’t stop this sound. I can’t fix this move. I know I am supposed to be skating on the balls of my toes, not on my toes, but I can’t make my feet get back to the balls. Still, I tell myself what Fred has told me: Keep skating. Go through the patterns.

I keep my outward composure, my skating face. I remember the order of all the moves, and I skate them all. My heart is pounding behind my sternum, and my knees shake. My arms, strangely, are steady. My T-stops are firm.

I finish; I skate off; I wait.

The judges’ feedback and scoring sheets are brought over and handed to my coach. Fred holds them, running his finger under certain comments. “Good. Yup, more work on these. We knew that.” He doesn’t say pass or no pass, and I can’t decipher the arrangement of the summary sheet to see if it explicitly says “pass” or “no pass,” but I can tell: no pass.

But, I’m okay. I’m not elated, but I feel lighter and proud of having done it. I feel as though I’ve been initiated and gone from being one kind of skater to another kind, and this is a kind that can’t be measured in technical skill, but in desire and determination.

And I kept skating. I did not back down or lose track of what I had to do.

The main judge, on his way out the door, stopped where I was standing with Fred. He said, “Don’t be discouraged” (I wasn’t), and he gave me some advice and more insight into his score. I thanked him.

The test session ended, and the ice opened up to all skaters. I skated, around and around and around. It was like breathing.

Tomorrow, I have another lesson with Fred. We return to the drawing board with more information. There is a 28-day waiting period to test again, and I will. From the experience, I learned that there are two kinds of preparation for an athletic test or competition: technical and mental. It is one thing to have the skills – and I believe I can skate better, privately, than I did during my test on Sunday – it is another thing to have the mental composure, toughness, and perhaps even bravado to carry me through a public scrutiny of what I can do.

I would never say I am glad I have diabetes, but my many years of living with it has taught me that I can make mistakes – even have a major fail – and I can take the feedback from those mistakes as data and apply them as knowledge to try to improve.

There are no assurances as to outcome. But going back to it, again and again, feels like progress. And on some days, I glide.

 

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Hello, Caution, My Old Friend

I am 47 years old; I am a novice figure skater; and on Sunday February 3rd I will take my first skills test: forward and backward edges, the waltz 8, forward and backward crossovers, and spirals.

Goals like this are clarifying. They simplify life. If my goal is to prepare for the test, other possibilities fall away. I look at the walls of my too-dark dining room and tell myself, “Painting can wait. Skate now.” I think of shoe-shopping and remember, “Skates.” Tired, I want to nap. I look at my GCal, and it says, “Skating, West Roxbury in 10 min.” I go.

I have built my plans for the last several weeks around this goal. I admit I have the luxury of time: there’s plenty of open rinks in the Boston area where I live, and I also can arrange my day, for the most part, to take advantage of their open sessions. I also skate at the rink at MIT, where I work.

Things were developing quite well until last week when I fell hard and hurt my right (writing) hand. I continued skating after one day off and trip to the doc’s for an x-ray, and a week later I feel better, but now on account of this fall my mind is getting in my way. It keeps stopping me in the middle of things I already know how to do.

This uncontrollable stopping — it feels like an arrest. I’m skating into a turn, for example, and something in my brain shuts it down, actually taking my body into its own mental hands. It’s hard to describe the feeling. Maybe you have had it.

Even writing this now, my heart feels palpable to me, like fear is coalescing around it. A buzzing cloud. It spreads up to my neck and I’m clenching my teeth; it spreads out to my elbows — not a pain, but a tension — and I want to wrap my arms around myself to reduce it, or maybe to contain this feeling of being on the verge of flying away or apart. A scream might be a relief.

My natural caution, which leads to vigilance, helps me in life. I prepare for things. I anticipate challenges and develop strategies for meeting them. I monitor my own actions; I reflect on them; and I imagine what I’d do next time.

Diabetes has given me lots and lots of opportunities to practice my gift for premeditation. And, readers, you know that the hallmark of diabetic health is control. Here I am, 20 years with T1D and no complications. My eyes are in beautiful shape, and my feet and kidneys are totally functional. My only medications are vitamins and insulin. I had three diabetic pregnancies, and I have three healthy kids.

And yet my caution, which can be a force for good, is standing in my way right now, and I have no tools to get over it. My inner voice is fluent at saying, “Be careful.” In fact, when my two older kids go out at night, I say to them: “Have fun. Be safe.” Are both possible? I must believe that they are. Or maybe I’m only saying the “Have fun” part to be cool.

YouTube Preview Image

Last summer, Jimmy and the kids and I went to Bethel, Maine. My sister Emily loaned us her house (thanks, sis!), and we went hiking or swimming every day. In Bethel and towns nearby are some swimming holes, scoured out by the mountain rivers, and you can jump from a boulder into churning water below. It seemed so fun in the guidebook, and I have always longed to be the person, like the characters in The Return of the Secaucus Seven (1979), who would do this: be an adult who jumped off a rock into a swimming hole.

Guess what? It’s one thing to fantasize doing it and another thing to let go and do it. In the home video above you can see me studying the water, thinking, studying the water, thinking, and trying to psych myself into doing it. I was holding back (and I did for almost an hour before this video was taken), even though my conscious, deliberate mind was telling my inner self: You can do this. You can swim, and hundreds of people have already done this today.

Still, I held back for the longest time. Jimmy and Eli did it. Eli did it many times. A man standing near me on the rock, sensing my hesitation, remarked, “The mind is a powerful thing. You know you can do it, and yet it is telling you not to do it.”

Eventually I did it (see the end of the video) by suddenly invoking an image of my father, as though he was standing behind me on the rock, yelling, “C’mon, just jump. Jane, jump!” We are inhabited by more than one inner voice; they hinder and help us in unexpected ways.

I made myself do it, filled with both terror and purpose. I knew the hardest part would be taking three steps on the rock and then jumping off into nothingness on the fourth step. After that, the rest would simply unfold, in a way beyond my power. Gravity would get me down into the water. My live body would float up, and my preternatural will to live and breathe would make me kick up.

All those things happened. I was barely aware of the plummet. When my head broke the surface of the water, my sinuses stung. Water must have been forced into them. I swam over to a flat rock and pulled myself up, shaking with triumph and the residue of fear.

Now I have to do again the things in skating that my mind is stopping me from doing.

It’s funny (funny peculiar, not funny ha-ha) because I’m not especially afraid of the pain. I sometimes fall in skating and hurt my bottom or a knee, and these seem to be par for the course. I get up, and my mind does not dwell on them for longer than it takes to skate out the vibration associated with falling hard.

But my hands! These I am so afraid of injuring permanently. What if I couldn’t write? What if I couldn’t manage my own insulin? I feel that underneath a usually sturdy self is my frail self, just waiting for a tiny crack in the shell to come out.

This morning I had a skating lesson. At the end, my teacher Fred said to me, “Your body knows how to do these things. Yet you seem less sure today.” He is very sympathetic about my response to falling and hurting my hand, and he says he is an “over-analyzer” himself and understands my inclination to problem solve, yet I don’t expect him to be a psychologist. He advised me, as I continue to practice on my own, to just work on one thing, not to break down a move into the many micro moves that go into it, which is what my mind is doing, furiously. Just work on one thing. This might be a better mantra.

There is something close to panic that rises when I think of doing this, and a small thing has become a big thing. Maybe there is only so much I am able to do. Maybe I have reached my predetermined limit. Maybe I tried everything, and will try everything, and it will only fall apart. Maybe it’s not only onward-and-upward. Maybe there’s a stop, and not a graceful one.

I realize that whether I pass this test or not does not prevent me from skating for fun or, in the future, taking the test again. I also realize that, in the scope of all possible fears, this is slight, and the stakes are low. However, caution has a hold on me right now, slowing me down and making me self-monitor and doubt every move. Sometimes caution is on my side; this time it’s sticking out its tongue at me.

—–

iPhone video by Jimmy Guterman

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My Holiday Dinner: Good Intentions and Actual Outcome

I hosted Christmas Day dinner at my house this year. Sometimes my mother hosts us all, and sometimes my sister Sally. The last time I did it, I served a traditional menu: glazed spiral ham, scalloped potatoes, a green vegetable.

This year I wanted to do something different, with more variety and less attention to (American) tradition. In my house, we often turn to Mexican-inspired recipes and meals for food that pleases all five of us, so I decided to offer this to my parents, siblings, partners, and nieces on the holiday. Below is the menu, with links to recipes and my modifications.

Chili Verde with Pork (I used only one jalapeño pepper)
Tomato-Braised Chicken (I used only one jalapeño pepper)
Roasted Sweet Potatoes and Black Beans (I only made the filling and didn’t assemble into tacos)
Avocado Salsa
Horseradish Carrots (see page 7 of this Google book for the recipe)
Basmati rice
Tortillas — flour and corn
Shredded cheese
Lime sour cream (add the grated rind of one lime to 16 oz. sour cream)
Chopped cilantro

I served it buffet-style, from the kitchen counter, as I typically do. There are 15 of us and not enough chairs for the dining room table. One thing I like about this kind of meal is that there’s enough variety, protein, and vegetables that each diner can control the amount of carbs he or she eats and still feel well served and filled up. I also like that a lot of the vegetables are incorporated into the main dishes in a flavorful yet substantial way. With a traditional meat-and-potatoes based meal, if you don’t eat the potatoes, you feel as though you missed something, and if you hate green beans, you get no vegetables.

By the way, it was delicious. Everyone agreed. Several went back for seconds.

With the pork, chicken, roasted sweet potato mix, and avocado salsa, I had a dab of rice and no tortillas, saving room for the carbohydrate-intense sangria (made by my sister Emily) and desserts (provided by my mother and my sister Sally). I also loaded up on the Horseradish Carrots, which tasted just like they do at Brasserie Jo in Boston. This is the first time I made the carrots, and the recipe was a real find. I love raw carrots — they are the quintessential “free” food — and I’ll make them again — it would also be a good appetizer or a snack with drinks, perhaps paired with my friend Marcia’s fava beans with pecorino.

How did my blood sugar fare on Christmas Day? Dinner raised it only to 170, then we paused for a couple of hours of conversation and present opening. We ate dessert, and I bolused conservatively. (Too conservatively.) I had a sliver of custard pie and Mexican chocolate cake, and then — unplanned — I nibbled on cookies every time I walked by the platter. They did me in. By 7pm, the end of the celebration, I was at 300. I took a correction bolus, and I was glad that I had done my heavy eating mid-day and would not be turning in for the night until my BG had a chance to go down. Which it did.

Twenty years ago, when I was diagnosed with Type 1, the rules were strict, and my diet was based on the exchange plan. Every day I took a set amount of insulin, short-acting and long-acting, and I followed the same structured diet. If two carbs, three proteins, one fruit, and one vegetable we prescribed for lunch, for example, that didn’t leave a lot of room for dessert, unless it was diet Jello, which I ate a lot of. Dessert was cheating, or at the least it was going off-plan, and there was no way to come down from high BG without intense exercise or an insulin pump, which I did not have then. So I avoided dessert. In some ways those days were easier, more predictable.

Now I’m a carb counter, and I do eat dessert, at Christmas and on other days. I measure out a modest amount. I bolus carefully, with a 1 unit of Humalog to 15 grams of carbohydrate ratio, and try not to overestimate the insulin. Most of the time it comes out right, but not always. More autonomy in my meal plan and more freedom in choosing gives me more food fun, but sometimes less predictability. But you know that.

—–
Instagram photograph of me, at top, by my daughter Lydia Guterman.

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Ready for Hurricane Sandy

Yesterday at home, we discussed a reasonable amount of preparedness for the oncoming Hurricane Sandy, predicted to reach New Jersey later today (Sunday) and affect regions hundreds of miles from its center. My husband and I live in the Boston area with our children, and although the storm still seems like an abstraction, we want to be ready enough with food, batteries, blankets, and card games in case schools are closed and power down.

Jimmy asked me, “How’s your supply of insulin?”

Normally, when a person close to me asks about how things are going with my Type 1 diabetes or implies that I need something I haven’t myself thought of, I can feel defensive. Because I handle about 95% of my diabetes care both independently and invisibly, it irritates me when loved ones want to get involved in the other 5%. I’m not saying this is rational; it’s simply my internal reaction.

In this instance, though, I kept my composure. “Good thinking,” I replied. “I’ll check.”

diabetes and other supplies for Hurricane Sandy

Looking through my stash, I discovered that I did indeed need an insulin refill, and I called in the order to the pharmacy. I also counted insertion sets and reservoirs for my pump and found a package of fresh AAA batteries, checked on test strips, and assessed the juice box situation to treat blood glucose lows.

Check, check, check: I’m ready.

We’re not survivalists, and I don’t fear being trapped in the house by flooding. Still, strong winds, tree damage, and power outages are anticipated. I live only three miles from the world-class Longwood Medical Area, and no doubt could call 911 and get insulin and medical care quickly if needed, even in a weather disaster.

And yet I don’t want to neglect to do for myself what I can do, or ignore the help and suggestions of others when they are offered. That combination of foolhardiness and pride are what can bring people down in an emergency.

If we do experience a loss of power and school closings over the next few days, I want to be safe and even enjoy the forced togetherness. We have already supplied ourselves with food that can be eaten without cooking or refrigeration (hello, peanut butter and tuna fish!) and flashlights. Today, before the rain hits, we have one more task — to pick up a battery-powered lantern we reserved at the local hardware store. We plan to pass the time indoors with some intense, four-handed games of Phase 10, and for that we need some light at the table.

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Cake for Breakfast

“What kind of cake is that?” One of my colleagues pointed with the cake spatula and turned to those of us standing near him in the buffet line.

Another colleague answered, “I don’t know, but it looks awesome.”

“Let’s call it Awesome Cake!” someone proposed. And the mousse-filled, layered, and chocolate-dense cake was called Awesome for the rest of that evening staff meeting, at which food is always served to compensate us for working late and to keep our energy up during long discussions.

Angie was in front of me in the line. As she filled her plate, she asked me, “Are you having Awesome Cake?”

“None for me,” I replied. “I prefer something with nuts.” And I put some egg-salad sandwich triangles and a bite-sized walnut square on my plate. No one else at the table seemed to pass up the Awesome Cake.

Resisting the cake was easy, because I didn’t really want it nor had I planned for it. One thing the discipline of diabetes has forced me to do is think about which foods are good for me, and which foods aren’t but that I nevertheless want. When I indulge, it’s usually a premeditated act. If one can plan ahead for giving in, well, that’s what I do.

This weekend, my daughter Grace, who is 12 years old, browsed through the new issue of Cooking Light with a pack of sticky notes in her hand. She marked the pages of recipes she wanted to try, and she announced she would be cooking and baking in the days ahead. On Saturday afternoon, she made this cake with fluffy frosting.

A slice of cake, baked by Grace

It was cooled by 8:30pm, and Grace frosted it (using half of the frosting and discarding the excess). We wrapped it up and put it away without eating any, because of the late hour. On Sunday morning, we sat down to cake for breakfast. That’s my slice, pictured in the photograph above, in the moment before I ate the first bite. We each had a glass of milk, too.

What does this post, which includes a link to a recipe for chocolate cake, have to do with diabetes? A lot. When I was first diagnosed with Type 1 diabetes in 1992, for months I followed the prescribed diet to the letter. I ate about 1800 calories a day, split across 3 meals and 3 small snacks. I took four injections a day, two with a mix of short- and long-acting insulin (Regular and NPH — remember those?) and two with short-acting only. My A1C was midway between 6.0 and 7.0, and my doctor was pleased with how all the pieces fit together and the seriousness and rigor with which I maintained control. It was wearying.

I recall the day I asked him for permission to have some dessert and a little variance from my structured menu (lunch: 2 carbs, 3 proteins, 1 fruit, 1 veg, and 1 milk). “Dr. A., would it be okay if I had some cake at the Passover Seder this week?” We were heading to New Jersey to celebrate with my in-laws.

“Of course!” Dr. A. said this enthusiastically, without hesitation. “You have diabetes, but you must also enjoy life. Within reason.” We spent a few minutes discussing an insulin strategy, and I had a piece of the flour-less, unleavened chocolate cake at the first Seder. After a long time without sweets, a sliver satisfied me.

I do eat cake occasionally, if it’s homemade and a flavor I like. I’ll take a good oatmeal cookie when I can get one. If my mother has baked a fruit pie (she reduces the sugar), ah, that’s heaven.

I try hard to indulge in a diabetically responsible way. I analyze the carbohydrates per slice, I calculate an insulin dose based on my personal ratio (1 unit: 15 g carbs), and I eat during the day, when I’m up and moving around and exercise can help by increasing insulin sensitivity.

On Sunday, I bolused 3.4 units of Humalog for the 52 grams of carbohydrates indicated in Cooking Light’s nutrition facts for the cake. I ate slowly, and when the cake was gone I pressed my fork tines into the crumbs and ate those too. Two hours later, my BG was where it should be, at 118.

Today: no cake. After Sunday’s breakfast, I sliced up the rest and put it away in the freezer. It really is enough to have a treat every once in a while. The satisfaction lingers.

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Swimming with the Manatees, and Diabetes

My two daughters, who are 16 and 12 years old, had the same teacher when they were each in kindergarten. A feature of the teacher’s curriculum was an in-depth study of manatees from every educational angle: social studies, arts and crafts, and environmental science. Lydia and Grace both loved the teacher and the exposure to manatees. It was a dream of theirs to swim with these endangered creatures, which is possible through an eco-tour in Florida, their habitat.

on a boat (l to r): Grace, Lydia, and Jane

This weekend, we did it: we swam with the manatees! I had a conference in Florida and, realizing it was as close as we might ever get to the manatees habitat as a family, I took Lydia and Grace along with me. On Sunday, through a River Ventures tour in Crystal River, Florida, we went out into a boat, donned wet suits and snorkel masks, learned the proper floating technique from Captain Glenn Wilsey (aka Gatorman) and, along with eight other people in our boat, we met the manatees.

the proper floating technique

It was thrilling to fulfill a long-held wish and awesome, in the truest sense of the word, to hover around such huge and gentle creatures. We also loved doing something that for us was really different. We drove 98 miles from Orlando, where we were staying, to the Gulf Coast and saw a part of the country we’d never seen before. Unexpected observation: there are lots of farms and cows in that region.

manatee, aka the sea cow

And, a first for me, I had to figure out what to do with my insulin pump while wearing a wet suit. (Alas, my Minimed Paradigm is not water resistant.) Before I wiggled into the wet suit, I whispered to my daughter Lydia, “Do you think it’s waterproof, and I can wear my pump under it?” She answered dryly, “Mom, why do you think they call it a wet suit?” So I checked my blood sugar before zipping up (BG was 112), disconnected the pump, and stowed it in my bag with our dry clothes and other supplies.

suit on, pump off

Periodically, I would get out of the water, reconnect, take a miniscule bolus, and disconnect again. We were out on the bay for four hours, so I couldn’t just ignore my pump or diabetes the whole time. (I’m comfortable disconnecting for an hour, but that’s about my limit.) I didn’t feel inconvenienced, because we floated pretty close to the boat anyway, and a few times the captain called us back in so that he could motor us over to another site. Everyone was in and out of the boat. That I had to fiddle with my pump and bolus went unnoticed by our fellow travelers.

Still, I thought about this extra layer of preparation to all of life’s adventures when one has type 1 diabetes and relies on an insulin pump. I don’t want diabetes to interfere with these moments. Paradoxically, though, I have to attend to my diabetes carefully so that it won’t interfere in an urgent way. I didn’t want our long-planned encounter with the manatees to be disrupted by a malfunctioning pump, high blood sugar, or personal drama.

As the tour wrapped up, we asked Captain Glenn how far we were from the shores of the Gulf of Mexico. We had never been there, and we simply wanted to stand at the water’s edge and have that feeling of being there. I was willing to drive even more than I already had, but I was relieved when he answered that it was only about 10 miles. Even though I needed to get back to Orlando and prepare for the conference that started the next day, the girls and I decided to extend our journey a bit more. After a late lunch at a local hangout called Crackers, we drove out to Fort Island Gulf Beach and did more than stand on the shore. We had another swim, absorbed the southern sun that’s as hot as an iron, and felt as though we made time stand still for an afternoon.

where earth, sky, sea, and a red kite meet

I had no worries. It was a perfect day.

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Glucose Meter Knows Me (and My Blood Sugar) Better

Last night my blood sugar at bedtime was 64, so I ate a bowl of cereal and milk. It’s a decent bedtime snack for me, and it typically results in a morning blood sugar in the low 100s, which is where I want to be.

But I woke up at 6:30am with a head that felt full of cotton balls, and my blood sugar was 315. Wow! I took a correction bolus, drank coffee, and got ready for work.

Several hours later, the stuffed-head feeling still had a hold on me. I thought of taking another few units of insulin, convinced that I was loaded with glucose resistant to coming down. But I wanted to eat something, too, so I checked my blood sugar. Ha! The magic 100. (Wasn’t there last year some sort of effort by the diabetes crowd to collect and post pics of “the perfect score”? Finally, I have one.)

I bolused enough for some food, which I ate. The headache took a while longer to subside, even thought my numbers had settled down and stayed that way all afternoon.

Those 100s seem to come totally by accident, when they do, and the achievement of today is not really that number. I’m glad I didn’t rely on my intuition today to tell me what my blood sugar was. Sometimes I believe my brain and senses comprise an on-board glucose meter, which is a ruse.

Glucose meters lack accuracy, but their plus or minus 20 percent monitoring beats the error in my estimate based on body awareness or a “felt sense” today. I was convinced I was hovering around 300 and found out I was 100. Imagine if I had taken a correction bolus without testing, without eating? That would have ended up in a blood sugar nosedive.

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Artist Finds Humility in Lasting Injury

When he was in his early 20s and struggling to get started as a songwriter, Peter Selgin was attacked by a black Labrador retriever owned by the woman for whom he was apartment sitting in New York. The dog chomped into Selgin’s left wrist. He underwent microsurgery to address significant scarring around the ulnar nerve that affected feeling in and mobility of the hand. Results were minimal.

This event is described in his essay, “Confessions of a Left-Handed Man,” which is the centerpiece of a new book of essays by the same name. I first read this essay in Best American Essays 2006.

Always a left-handed artist and writer, Peter Selgin knew at age 25 that the full manual dexterity of his dominant hand would not return after the attack and surgery. In the essay he recounts his attempt to train his right hand, which felt like “trying to sing with [his] fingers holding [his] tongue,” to do what his left hand had always done for him. Around this time he also broke his leg. One night he walked on crutches to the East River with thoughts of killing himself. He had always been the left-handed boy — had identified himself as that — and the mirror opposite of his twin brother George, a right-handed boy who became an economist. At the river that night he had a “good bawl” and “hobbled back” to his room.

Twenty years later, he wrote the essay from a point in time he no longer felt that his left-handedness had any special meaning. It simply was. Furthermore, he continued to write and make art with his compromised left hand. The work he made before and after the injury, though, have “nothing in common” with each other. He calls his style “naive, even primitive,” and he asserts that his “lack of dexterity has freed [him] from glibness, which in turn has delivered [him] from the temptation” to show off.

Even though Selgin’s theme for his essay is humility — he says that, for an artist, “to master humility” is as important as mastering the techniques of his medium — for me, the lesson is about limits that we cannot overcome, that we must work within. There is nobility in this, and necessity, once the sorrow passes.

His limitation is physical. I do not think that my having Type 1 diabetes and surviving on insulin has disabled me in a noticeable way, although it is a project managing it. And yet there are realities of my life that recognizably limit what I imagine or dream of doing.

– My age limits what I will ever accomplish as a skater.
— My parenthood limits my free time and therefore what I may accomplish as a writer.
— My teaching, although I love it, also limits my free, avocational time and my free mind, and may affect the creative or even scholarly work I may do.

It is tempting to feel sorry for one’s self, to stand along the East River at night and have a good bawl about what is over and past: vitality, dexterity, leisure. These qualities, when lacking, seem to be the very ones we need in order to get or do what we desire. The longing for them may be acute.

Painting by Peter Selgin

What Peter Selgin’s essay helped me see, though, is that I did not need to bemoan or even romanticize the limits of my life; they simply are its conditions. These conditions do not stop what I want to do, although they do change life, sport, and art.

If I said, however, that I had permanently adopted peace of mind about this I would be exaggerating. I must remind myself of Selgin’s humility, and the imperative to accept what cannot be fought or restored, again and again.

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Photograph of watercolor painting, Barca di Frutti (2012), by Peter Selgin on Flickr.

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This was originally posted at leaf – stitch – word, the author’s personal blog.

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Bride Wears Insulin Pump in Pocket

While I am not much of a romantic, I love reading the Vows column in the Style section of the Sunday New York Times. Every week, the story of a couple — from their initial meeting, through their courtship, to the wedding — is described in a feature among all the other engagement and wedding announcements. I like the Vows column because it shows the diversity of adult love: some stories are admittedly like fairy tales, and yet many incorporate more realism in the setbacks the individuals or couples have encountered.

I know, I know: whether a fairy tale or heroic journey, these stories still reach the same conclusion, with a wedding as a kind of achievement. In these ways, the Vows column is not unlike a 19th-century novel. But I like Jane Austen and the Brontes, and I like the plots of these wedding tales too.

Today’s story, about the friendship, courtship, and union of Bridget Kelly and Eric Strauss, especially touched me. Bridget, now age 34 and a reading specialist in a Brooklyn public school, was attacked, raped, and shot by a stranger when she was 22 and a new teacher in Killeen, Texas. After her recovery from surgery, she made an unusual decision to go public with her story:

[S]he wanted the rape to be reported in the articles with her name as the victim. At the request of the Texas Association Against Sexual Assault, she returned to the field where she was attacked and made a video that was shown statewide as part of a public awareness campaign. Her message — that she had done nothing wrong and bore no stigma or shame — resonated with many.

A couple of years later, she met Eric Strauss, who is now 39, when she was interviewed by Charles Gibson for ABC’s Primetime. Strauss was then an ABC producer who was in charge of the interview site. Bridget and Eric became friends, corresponded by email for as long as she continued to live in Texas and he in Manhattan, and became better friends, and eventually a couple, after she moved to New York.

The story of Bridget and Eric’s wedding was written by the bride’s father, journalist Michael Kelly. About two-thirds of the way through, he describes the part — the diabetes part — of Bridget’s life that really grabbed me:

Two months after Bridget’s 2002 attack, her pancreas stopped producing insulin and her blood-sugar readings went very high. At 25, through no fault of her own, she had Type 1 diabetes, formerly called juvenile diabetes. It was another life-changing event. Like the three million or so other Americans with the disease, she must prick her finger several times a day and regulate her food intake and insulin injections. It is an imposing and constant balancing act for her.

Later in the piece, describing the wedding itself, Michael Kelly adds: “Bridget, wearing a Ramona Ponce gown specially designed with an insulin pump pocket, smiled during the reception as her young nieces and nephews danced about her.”

Why does this particular story move me, besides the fact that the bride has Type 1 diabetes and wears an insulin pump, as so many of us do?

Bridget’s story reminds me that diabetes, which on some days feels like The Big Story to me, may be secondary in many lives, which have been complicated by bigger challenges, events, traumas, and eventual happiness.

The theme of today’s wedding story, no matter how I read it or what part I emphasize, is more about resilience than romance. This my pragmatic heart loves.

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Photograph “Bridal Bouquet” by whatsthatpicture on Flickr and published here via a Creative Commons license.

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The Detritus of the Day

It’s the end of the weekend, and Sunday night is spent as usual: folding laundry, tidying the kitchen, and organizing my work stuff for the next day. I just emptied out the pack I carried on a long coastal walk with my family today, and I found a handful of test strips at the bottom. In a two-hour period — the whole time of the walk — I tested my blood sugar 8 times. When I started the walk, I was at 105 and ate a banana, and yet my glucose went down from there: to 75, to 69, to 59. I had turned down the basal rate on my pump to 40% of the usual rate, but clearly that modification and the banana were not enough to prevent hypoglycemia, so I disconnected. For a while, I sipped at juice boxes. A few times my husband and I sat down on a bench and let the others go ahead. When I walked, I shuffled slowly, believing myself to be conserving energy but not actually sure.

After 59, the numbers started to rise again: to 77, to 101. At the halfway point of our walk, on Boston’s Castle Island, we all stopped at Sullivan’s for a snack. Everyone had ice cream but for me. I chose the French fries for their high glycemic index. Soon I was at 125 again, which is where I remained for the remaining 3 miles of our walk.

Low numbers are desirable until they’re not. You really can’t get too far very fast when your blood sugar is 75 and falling. Today I really felt myself to be disabled, when most of the other walkers in my party — the ones without diabetes — walked, skipped, and ran ahead blithely in the sun.

It was a beautiful day, and I enjoyed it. Still, it was a task to manage that enjoyment.

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