Caught Blue Handed! She Sugar

Jewels Doskicz caught my eye on Twitter one day. I was intrigued with the great information that she was posting on type 1 diabetes and celiac disease at SheSugar.com. When I found out she was a nurse with type 1 diabetes, I knew I wanted to meet her. I was interested in learning her take on the diabetes online community from two different perspectives, as a health care provider and as someone with diabetes. I reached out to her and she agreed to be interviewed for Caught Blue Handed! Caught Blue Handed! is a way for me to highlight individuals, organizations, and advocacy campaigns that promote diabetes awareness.

1. Tell me a little about yourself.

I’ve been a Registered Nurse since 1995, and also have a BA in psychology. I have been living personally with type 1 diabetes since 1984, diagnosed at age 13. My youngest daughter was diagnosed at age 5 with type 1 diabetes & celiac disease in 2007. One thing that I haven’t written heavily about yet is exercise. I am an avid exerciser- I have run marathons, I road bike distances (hoping to a century ride for JDRF in Tucson this November), yoga, skiing, hiking. I try my best to do something active every day that I enjoy. Some days this puts me at the health club unfortunately, but I get it in. I am a true believer that diabetes cannot be controlled nearly as well without it.

2. Why are you so passionate about diabetes? And helping others with diabetes?

My passion about diabetes has always been present. Diagnosed at age 13 had its difficulties but I remember wrapping them up quite succinctly. At that young age I realized that I could live a healthful live with diabetes. I knew it wasn’t going to go away anytime soon, so why not embrace it?

Back then (1984) there weren’t glucometers, insulin pumps or fast acting insulins. I would check my blood sugar by applying blood to a strip, wiping it with a cotton ball and comparing it to a range of colors on the bottle. I would also test my urine for sugar and ketones daily. My insulin was Regular and NPH, given via syringe twice a day. The first glucometer I had was gigantic compared to what we have today. Believe it or not, my control was really great. My parents ate very well and taught me how to care for myself and my diabetes the right way. Even with limited tools, it was possible. Twenty eight years later, I have no complications from type 1 diabetes and I start every day with a smile on my face. Life has been very good to me and diabetes has made me into a very health oriented person. Diabetes has its gifts too.

3. Tell me about your blog, shesugar.com. What do you hope to accomplish?

When my daughter Emma was diagnosed it really lit a fire inside me to make a difference in the diabetes world. I have often been told by others what a wonderful resource I am for people with diabetes and their families. People frequently tell me I need to write a book (perhaps my writing with She Sugar will take me there…). My knowledge base quickly expanded with Emma’s diagnosis, as well as phone calls from others for advice. I quickly realized the needs of the general public in regards to managing their children’s diabetes and celiac disease as well.

I see She Sugar as a great outlet for me to express myself and share my growing knowledge with others. Knowing about diabetes and living with diabetes are two totally different things. People look to others who have it or parent to it for compassion and understanding. Parents want to know if they are doing things right or how they can make things better. A doctor’s office is a wonderful place to start this process, but it never ends there. Practical knowledge isn’t found in an office, it is found through others living lives parallel to yours.

When I meet another family there is an instant bonding that happens. We can look each other in the eye and know in that moment we understand what is happening in each other’s lives. It can be very personal and raw for people; they may be feeling alone and failing in their struggle with diabetes. It is difficult for me to express the constant vigilance that goes into managing diabetes in a young child. It doesn’t stop for a day, it is always there. We worry, we check, we get up at night, we call, our children call, you can’t turn it off.

Diabetes is a special disease because it requires maintenance minute to minute, hour to hour, day to day. No two days are the same, no person is the same. Everyone’s experience is unique, there is a general mold to follow for management but it is merely a guide. I often say type 1 diabetes is a giant science experiment, sometimes you just don’t know what you are going to get. The stakes are high and management is so important.

Children in general are much more difficult to manage in my personal experience. Adults know how they feel, plan their food, exercise, and other variables. Kids start to eat and then only take two bites making insulin management crazy! They have bursts of activity, growth hormone, more colds than adults and are learning their bodies and its cues. They are just a bundle of surprises as are all children.

It was challenging for me when my daughter was diagnosed as I already had diabetes for 23 years. I knew all about diabetes, which made it easier, but also more difficult in the same breath. I never thought in a million years my children would too, I just didn’t.

4. How do you use your background as a RN to inform your blog and tweets?

I realized the small list of resources for women with type 1 when I was pregnant with my oldest daughter. I couldn’t find much online and started to work on my own website. Twelve years ago I called it Shesugar.com, but I never completed my project. The idea of She Sugar of course continued to pulse through my brain over a number of busy years. Last year my husband and I were talking about getting a website rolling again. I searched and realized Shesugar.com was still available and bought the domain name on the spot. That was the beginnings of Shesugar.com, which went live at the end of Dec. 2011.

I have a large base of knowledge from my education and my years of experience as a nurse, a mom and a person with diabetes. When it comes to medicine, I really understand the way the body works which is an important piece in writing about diabetes or any health condition. Being a nurse gives me a leg up on understanding medical jargon, articles and politics in the medical community. I try my best to write in an easily understandable and digestible fashion. Diabetes and celiac disease are both my specialties and my passion. I’m an educator, advocate, and volunteer. I do this all while managing my own diabetes and parenting to my daughter’s diabetes.

5. As a health care provider, and someone with diabetes, how do you feel about the diabetes online community?

The online community is truly a wonderful way for people to connect from all over the globe. I have met some fantastic people through social media that I never would have otherwise. I am very careful not to give medical advice to people online. Those waters need to be treaded very carefully. I had already been primed about this, as I volunteer for the JDRF Online Diabetes Support Team (ODST) answering questions from people about type 1 diabetes.

Through my voice on Shesugar, I hope to inspire health, happiness and well being with type 1 diabetes. Information and education are very powerful tools. If individuals and families have knowledge, they will feel better equipped to face the daily challenges of life with type 1 diabetes.

I think there is definitely room for growth and expansion of services online. I appreciate my online interactions with others and make my career even more fulfilling through volunteerism. I volunteer in many capacities with JDRF, our community, summer camps, and through my website.

6. Finally, what are your social media links so people can follow you?

Facebook: http://www.facebook.com/shesugarjewels

Twitter: @She_Sugar

Website: www.shesugar.com

Pinterest: pinterest.com/shesugar

Linked In: http://www.linkedin.com/company/she-sugar

Thank you Jewels and She Sugar, you have officially been

Caught Blue Handed!

Caught Blue Handed! Blogging Diabetes

If you want to chat, blog, or tweet diabetes, Tony Rose is someone to know. I have followed Tony on both Facebook and Twitter for quite sometime, and just recently discovered his awesome podcast. Tony agreed to tell us more about his work on “Caught Blue Handed!”. Caught Blue Handed! is a way for me to highlight individuals, organizations, and advocacy campaigns that promote diabetes awareness.

1. Tell me a little about yourself. What do you like to do?

Most importantly, I’m a husband to my wife of almost 12 years and father to my two young girls ages 6 and 3 with a baby due in June (girl).  I’mlucky enough to work remotely for my full time job as a Compensation Manager where I design incentive plans for sales people to drive behaviors.  I’ve got a background in finance with an under graduate degree in business/finance and more recently an MBA in Management. When I’m not playing around our house with my girls or working, I like to golf, bike, exercise and am a big fan of mixed martial arts (UFC), though I don’t practice it.  I also like to end each day with a little reading to help take my mind of the days stressors, next day’s work or everything in between. It’s usually a mix between business, diabetes and fiction books with multiple books sometimes active at once on my Kindle.

2. Why are you so passionate about diabetes? And helping others with diabetes?

I’ve lived with type 1 diabetes for 14 years now after being diagnosed before my senior year of college.  For about 7 years I lived with diabetes and managed it pretty well, but never having a laser like focus on it. After my oldest daughter was born, I got more involved and wanted to take as good care of myself as possible. Honestly, I’m a high-achiever and repeatedly hearing that I was doing “good” from my doctor wasn’t good enough for me. I started Blogging Diabetes in 2008 with two main goals. First to give others with diabetes a resource to learn about someone else who may be experiencing the same issues. Secondly, my co-goal was to help me take my diabetes care to the next level and get excellent control. Helping others has been the most rewarding. Whenever I get a message from someone who thanks me or just says hi, it truly makes my day and makes all the work very rewarding.

 3. Tell me about your blog and podcast? How do these promote diabetes awareness/advocacy?

Since 2008, I’ve been mainly writing articles on Blogging Diabetes and connecting with friends on Twitter and Facebook. Most of my articlesfocus on a tip or something to help others learn something. Back in June of 2011, I started the weekly Blogging Diabetes Podcast that took sharing information with others to a whole new level. I interview, doctors, chefs, professionals and fellow friends with diabetes to help me and others learn more about diabetes and connecting with another person that has diabetes. I love sharing information, telling stories and taking my friends and listeners through events as I experience them.

 4. What do you hope to accomplish?

My goal is to gain better control and continue to deliver valuable insights and information to those around me on the blog and podcast. As with many diabetics, my goal is to be consistently under 7.0 for my A1c with tight variation. I’ve usually been in the mid to lower 7s and have only once been under 7 at 6.9%. On the podcast, my goal is to bring better and more information to those that listen by interviewing doctors, professionals, companies, other friends with diabetes and anyone that has something to share with my community that adds value.

 5. How can people get involved?

There are many ways people can get involved with diabetes.  Financially, they can support foundations that help make living with diabetes better or researching for a cure. Also, many areas have local JDRF chapters, events, walks, etc. where people can interact and support those with diabetes. More available is the online platform where people can listen to my podcast on the site or itunes, interact on the blog, or find me and many other people with diabetes on twitter and facebook. The twitter #DSMA chats on Wednesday nights at 9PM EST are a great way to get a glimpse of what it’s really like to live with diabetes.

Me specifically, I am available to email with questions or just to say hi at tony@bloggingdiabetes.com . I also have a voicemail box setup for the podcast where people can send in questions or comments and also text me at 410-774-6079.

Thank you Tony and Blogging Diabetes, you have been officially

Caught Blue Handed!

HCP Fakeabetes Challenge

Last week I came across a great blog post by Lawren Romero in which she described her fakeabetes diagnosis. Lawren doesn’t have diabetes, but she wanted to better understand what it was like to have diabetes. She underwent a fakeabetes diagnosis, saw an endocrinologist and certified diabetes educator, began testing her blood sugar, and started taking fake insulin (saline). She had fakeabetes for 18 days, during this she experienced one week of shots, three pumps, a continuous glucose monitor (CGM), many glucose tests, and a lengthy hunt for fake insulin.

After reading this, I was reminded of research being conducted by Marilyn Guggliucci at the University of New England College of Osteopathic Medicine. Focused on aging, Dr. Guggliucci developed a program in which medical students live in nursing homes so they better understand what it is like to be an elderly nursing home resident. These students are given a medical diagnosis (or multiple diagnoses) and have to live their nursing home life accordingly. Some students have to use assistive devices such as a walker or wheelchair to get around. Some have a diagnosis of stroke, and will have their food thickened to allow for better swallowing. Others will require help showering and dressing due to physical limitations. This ongoing research has opened the eyes to many of the incoming health workforce.

What about diabetes? Do existing and new healthcare providers fully understand what it is like to have diabetes? When I underwent a similar experience as Lawren in 2007, I realized things you cannot fully understand until you have experienced them. I’m grateful I did this early in my diabetes specialty career, I feel like it has helped me become a better healthcare provider. I challenge any healthcare provider/student that cares for or will care individuals with diabetes to undergo a fakeabetes diagnosis. See what its like. I dare you!

Caught Blue Handed! You Can Do This Project

Kim Vlasnik is inspirational, full of enthusiasm, and an amazing diabetes advocate! I got to know her initially through the cartoons she drew for Diabetes Mine, but grew to realize the amazing work she has been doing with the You Can Do This Project. Kim agreed to share the vision behind the You Can Do This Project and her work as a cartoonist with “Caught Blue Handed”. “Caught Blue Handed” is a way for me to highlight individuals, organizations, and advocacy campaigns that promote diabetes awareness.

Tell me a little about yourself. What do you like to do?

Kim Vlasnik

I’m a 32 year-old who lives in Nebraska with her husband and dog, and I’ve had type 1 diabetes for 25 years. I work a full-time gig as well as spending time as a diabetes advocate, blogger and cartoonist. I’m currently rediscovering my love for early 90′s dance steps as I work my way through Dance Central 2 on XBox Kinect (Montell Jordan, anyone?).

Why do you use social media to talk about diabetes?

Until recently, I didn’t know anyone else with type 1 who lived near me. Social media helps you find what you need, when you need it – it’s there any time of day or night, and you can always find someone who is in the same situation you are. Talking about diabetes online,

Kim with other people who have diabetes at a Kansas City meet-up

and in real time, can help relieve that feeling of isolation that living with diabetes can sometimes bring. You get to talk with people who really “get it”.

What is the You Can Do This Project?

The You Can Do This Project is a community of user-created videos where people with diabetes share their stories. It’s centered around the idea that living with diabetes can be really hard and challenging, and a lot can “come along for the ride” – depression, diabulimia, high A1Cs, complications – but that we can find strength in knowing that we aren’t alone in traveling those roads. We can support each other’s emotional and psychosocial health by saying “Yeah, this is hard for me too – and I’m right here, living it alongside you”. There have also been great videos from people who have accomplished some pretty miraculous things – Ironman triathlons and Olympic cross-country skiing, for example – and they’re showing others that diabetes doesn’t have to stop you from pursing what you want out of life.

What do you hope to accomplish?

Comment from the community about the You Can Do This Project

The ultimate goal is that people with diabetes get connected with each other and have conversations about the parts of diabetes that generally don’t get talked about. Peer-to-peer encouragement can help everyone with diabetes feel just a bit less alone. Every time one of the You Can Do This videos does that for someone, our diabetes community grows a little stronger.

How can people get involved?

The process is relatively simple – record a video, upload it somewhere it can be publicly viewed, and let me know about it. People can find out more about the project and see some of the contributions already made at www.youcandothisproject.com, and can find people familiar with the project on Twitter by using hashtags like #YouCanDoThis and #YouCanDoThisProject.

You are a frequent guest cartoonist for the Diabetes Mine Sunday Funnies. Tell me a little bit about that.

I’ve been contributing diabetes-themed cartoons once a month to Diabetes Mine since last fall. I had been drawing (longer, more elaborate) cartoons for my own site for a few months, and it happened that DMine had been looking for guest cartoonists. Humor has been a great way for me personally to deal with my own diabetes ups and downs, and I love sharing that. I mean, really. What good in an incurable disease if you can’t laugh about it?

Thank you Kim Vlasnik and the You Can Do This Project, you have officially been

Caught Blue Handed!

Using Social Media (and the DOC) to Gain Clinical Insight

I was invited by Harriot Hopf, anesthesiologist at the University of Utah to speak about how I use social media as a clinician. This presentation was given at the University of Utah “Social Media and Your Career” Mentoring for U workshop on 03/06/12. The featured guest at this workshop was Lee Aase, social media expert from the Mayo Clinic. A copy of the presentation can be accessed here (my first Prezi!), below is an overview of what I had to say.

Social media can be complex and cumbersome. However, if used effectively, healthcare providers can become more educated, and perhaps more compassionate clinicians.  There are two ways in which I have been able to use Medicine 2.0 applications to gain clinical insight: tracking research and information generated by other health care professionals, and reading about the healthcare experience from the patient perspective.

There are lots of great social media sites to access the knowledge base of other health professionals. From a research perspective, Mendeley and ResearchGate provide me with the ability to access original research and connect with other researchers on topics that interest me. Mendeley is a free, open source reference manager and academic social network that can helps to organize research articles. Others can access the PDF or link to the articles you like, and collaborate with you should they feel there is common ground. ResearchGate is a free social networking site for researchers. This site is a great way to generate discussions with others who are interested in similar research topics. You are notified if there are any new articles posted in the interest areas you select, allowing you to be up to date on the latest research.

Clinically speaking, there are numerous Medicine 2.0 applications that can be helpful to clinicians. As a diabetes specialist, I focus my efforts on areas that will help me be a better healthcare provider. From a general healthcare perspective, there are useful blogs that I access (KevinMD, ScienceRoll, while I’m not focused on pediatrics Seattle Mama Doc is good example). On Twitter I access information from professional organizations, major healthcare centers, other professionals involved with diabetes care, and individuals who actually have diabetes to stay up to date on the latest in diabetes care. While not always actively participating, I learn invaluable nuggets of information, just by reading what others have to say.

Following individuals who have diabetes provides me with perspective that cannot be obtained through other means. Sure I know how to carbohydrate count, test a blood sugar on various devices, inject insulin using a pen or syringe, and have worn all of the insulin pump and sensors. However, I have never personally experienced diabetes, I don’t have it. Sure I have friends and family who have/had diabetes, but I don’t see those individuals every day. Through individuals personally connected to diabetes who share tweets, blogs, vlogs, and discussion board postings, I better learn the day-to-day nuances, frustrations , and victories related to having diabetes. This is a side of diabetes I never saw in the clinical setting. Having this knowledge, provided me with a different level of compassion and understanding for what it is like to live with diabetes every day. Additionally, it helped me become more effective in my visits with patients in the clinic. Finally, it’s become a place where I can ask questions. What are the most useful diabetes mobile applications? What have been some frustrations with being diagnosed (or misdiagnosed) with LADA? While there are a number of individuals I credit to unknowingly teaching me about life with diabetes, here are a few that I have been following since the beginning:

• Amy Tenderich (@AmyDBMine)
• Cherise Shockely (@Diabetic_Iz_Me)
• Ginger Vieira (@GingerVieira)
• Kim Vlasnik (@txtingmypancreas)
• Manny Hernandez (@askmanny)
• Mike Lawson (@MrMikeLawson)
• Riva Greenberg (@diabetesmyths)
• Tony Rose (@bloggingdiabetes)

I was able to share with the audience information about Tony Rose who tweeted about his experience with getting a new continuous glucose monitoring system, how Mike Lawson’s Diabetes Police video has informed the way I practice and talk to patients about those who police their diabetes, and the rich information that can be learned from Diabetes Mine, including Kim Vlasnik’s contribution to the Sunday Funnies. Finally, I was able to share the diabetes related hashtags (#diabetes, #dsma, #bgnow, #CGM to name a few) I follow. These hashtags provide me additional insight about what is going on in diabetes care. I especially find the #dsma tweetchats rewarding and invaluable.

Through social media, I am able to gain clinical insight from many perspectives of healthcare. Particularly valuable is the insight I have gained from learning from patients. I strongly feel that I am a better healthcare provider for it. I encourage other healthcare providers to seek out social media applications to see if they feel they are benefiting as much as I do!

Test Strips and Insurance Benefits

After reading a post on the DOC about frustrations related to the cost of test strips and insurance coverage, I asked my friend Susan Elms to provide a guest blog about this topic. Susan works at Diabetes Specialty Center and has lots of experience working with insurance benefits and test strips. While this won’t solve all frustrations related to the cost of test strips, we hope this will provide tips on working with your insurance carrier, pharmacy, and durable medical equipment provider to obtain the most reasonably priced strips possible.

Navigating insurance benefits can be daunting to say the least. Here are a few things that might be helpful to know. Most people with insurance have a pharmacy benefit and a medical benefit. It is important to check the pharmacy and medical benefits so that the plan can be utilized appropriately for each person. Not all places process the medical benefit along with the pharmacy benefit. However, it could be worthwhile to find a place that does process both to see what is available to you. Sometimes going through one benefit over the other can save considerable amounts of money over the course of the month and year. When it comes to diabetes test strips and supplies, they can often be covered under either benefit, but people do not always realize this is an option. Also, going through the medical benefit can sometimes assist in keeping those with Medicare out of the doughnut hole. Checking both benefits, to see what is available, empowers you to make an informed decision.

Costs of testing supplies can vary due to the insurance coverage, and where you are getting your supplies. Companies negotiate with insurance plans on their contracts and what is covered. Through some companies you might not have a co-payment on testing supplies, while with others you will. This is due to the contracts each company has negotiated.

Insurance companies usually have a preferred meter. If the meter you are using is not the preferred meter of the insurance company, test strip costs are higher. Through some insurance plans going through the medical benefit allows flexibility in which meter is used. It does this by taking the preferred meter status out of the question since that applies on the pharmacy benefit side. This is not always an option, but it does not hurt to check.

Being proactive about the benefits you have available is your right. Also, it does not hurt to shop around to see options of services and costs that are available with different companies. A gentleman we work with had tertiary (triple) insurance coverage, and was still paying a twenty dollar co-payment for supplies each month. After doing a benefit analysis, he was thrilled to find out he would no longer have a co-payment for supplies. Ask your pharmacist, mail-order company, or diabetes supplier for a benefit analysis on your medical and pharmacy benefits. Checking this each year can be beneficial as contracts can, and do, change for supplies.

Betty White: Changing the Way We View Older Adults

I have enjoyed the work of Betty White for quite sometime; from the Mary Tyler Moore Show to Boston Legal, I have been a fan. Flipping through the channels recently, I came across Betty White’s 90th birthday special on NBC. I was amazed as her work over several decades was highlighted. The icing on the cake was the show that came on afterwards, Off Their Rockers (my favorite clip is at 7:16 minutes through). This show is about older adults pranking unsuspecting young people about stereotypes that are common among senior citizens. Not only is it hilarious, it shows a side of older adults that isn’t often depicted in national television programming.

In healthcare, we are sometimes too quick to make assumptions about people, especially the elderly. Sometimes we talk louder or slower, expecting the person to be hard of hearing. With regards to diabetes, one might avoid talking to an older adult about new technology or medications, assuming it may be over their head or to hard to master. Or one might not encourage healthy eating or exercise, assuming the person is too set in their ways.

It’s important to tailor health treatments to the individual person, not their chronological age. I have seen “old” 40 year olds and “young” 80 year olds. There isn’t a diabetes recipe for blood sugar and A1C targets based on how old someone is without considering other factors. We should be working with patients to develop reasonable goals, based on individual healthcare needs. Betty White once said, “I’m a teenage trapped in an old body”. Do your patients relate?