I’ve thought about posting my master’s thesis here before, but had set the idea aside for various reasons. If you aren’t entirely clear on what a masters thesis is, it’s a ginormous research paper, and for the art therapy graduate program I attended, it was a graduation requirement. Last week, someone posted a link on Twitter to a master’s thesis written by a student who was in the same graduate program I attended, and that inspired me to think about my idea of posting it again. I twittered about it to get some feedback, and a few people said they’d be interested in reading it, but I thought I’d toss out the idea here and see if anyone has an opinion either way.

Yes, No Bins, Denise Hawrysio, 2007, Etching + Silk screen, 820 x 1024cm

My thought was to have ‘Thesis Thursday’, so I’d post a section every Thursday. The obvious advantage for anyone who’s interested in reading it is that it’s broken into manageable chunks. The disadvantage is that there would only be one chunk a week, so if you don’t remember what you read the previous week(s), it won’t necessarily flow well. Of course, if it’s subject matter in which you aren’t even interested, that’s one day a week you won’t want to read which I suppose could be good or bad, depending on your point of view.

Now, it’s long. The body of the text comes in at 117 pages. For the sake of giving you an idea of how long that is, it would be equal to about 24 posts based on comparing the word count of it and the word count of an average post of mine. I wouldn’t divide it solely based on word count to post it though. I’d try to find logical places to chop it up, so there could be some variation in length from week to week. So you have an idea of what it’s about, here’s the table of contents and the abstract:

TABLE OF CONTENTS
Chapter 1: Introduction ……………………………………….. 1
Chapter 2: Review of Related Literature ……………… 5
Health Psychology ………………………………………………… 6
Adolescence …………………………………………………………. 8
Diabetes ………………………………………………………………. 23
Psychosocial Implications of Diabetes ………………… 36
Art Therapy …………………………………………………………… 61
Medical Art Therapy ……………………………………………… 66
Chapter 3: Methodology ………………………………………. 74
Chapter 4: Results ……………………………………………….. 81
Chapter 5: Discussion ………………………………………….. 93
Chapter 6: Summary and Conclusion …………………… 116

ABSTRACT
The thesis of this literature based study is that art therapy can be used with type 1 diabetic adolescents who do not adhere to their prescribed self-management regimen, and to propose art therapy treatment strategies which would address this issue. It is suggested that art therapy with this group would provide a means of self-expression and self-exploration, allowing them to address conflictual feelings about their medical condition. The resolution or partial resolution of these issues is thought to lead to improved adherence to self-management tasks by improving self-esteem, increasing problem-solving capabilities, and providing a means of healthy self-expression of negative feelings rather than acting out through non-adherent behaviors. Improved adherence has been positively linked to improved medical outcomes.

While a search of the relevant literature did not provide any sources specifically on art therapy with diabetic patients, a review and synthesis of the available literature on related topics indicates the potential validity of the treatment modality. There has been much written on the psychosocial aspects of living with diabetes, the reasons for non-adherence in type 1 diabetic adolescents, and the long-term effects of such non-adherence. There is also a limited, but growing body of research on treatment methods other than art therapy, designed to address the same issues. In response to this research, reasons why art therapy could be equally, if not more effective, were introduced.

The literature collected, categorized and analyzed addresses relevant topics related to the diabetes disease process, medical treatment regimens, and developmental issues of adolescence, resulting in a proposal of art therapy treatment strategies indicated for adolescents with type 1 diabetes who are non-adherent to self-management regimens.

Having given you a general idea of what this would entail and a description of what it’s about, I’d like to get your frank opinions about this. I blog in hopes of sharing information and entertaining you, so if posting this doesn’t really do anything for you, then I won’t do it – that’s why I’m asking what you think. Feel free to tell me if you think it would be boring or lame and how you’d rather I post vlogs of feeding cat food to Smeagol – or if you’re into the idea, let me know that too! If you’re interested, I can still post vlogs of Smeagol – this isn’t an either/or kind of thing

“Art Therapy with Type 1 Diabetic Adolescents, Non-Adherent to Treatment: A Literature Based Study” copyright 2004 Lee Ann Thill (nee Pitts)

Winter brings out the love of layers in me because I’m perpetually cold, but summer brings out the opposite in me – the desire to wear as few clothes as I can decently get away with. In the years leading up to getting my pump, I had fallen in love with sundresses, which represent the epitome of wardrobe minimalism to me. When I got my pump, I all but retired my sundresses because wearing them lost their magic once I had to start finding a place to stash my pump. The leg garters and spandex pockets worked from a functional standpoint, but having something strapped to my leg seemed to negate what I love most about wearing sundresses – feeling cool and unconfined.

Since I don’t wear my sundresses so much anymore, I mostly wear shorts and tank-tops in the summer. This has worked well for me because I could clip my diabetic gadgets to my waistband. However, recently the lengths of my shirts have become an increasing issue. Fashion is cyclical, so once people got tired of baby-doll style shirts, which were all the rage a few years ago, the hems of shirts fell – drastically. So many of the shirts I’ve purchased over the last couple of years are longer, meant to be pulled down over the hips. I’m a 30-something year old woman, not a 15-year old girl, so despite being fairly slim, I happen to have hips and a butt, relative to someone half my age anyway. Because of that, if one of these longer shirts is even a little clingy, this tends to be an unbecoming look on me. Regardless of what I have to work with physically and what may or may not be especially flattering on me, I also have a pump and a CGM to consider, which has made these lower shirt hems even more annoying.

Saturday, when the temperature was supposed to soar toward 90 degrees, I put on this snazzy red racer-back tank-top. Unfortunately, it’s got one of these long hems which I’ve come to loathe since I wear my cyborg parts on my hip. I like this shirt, and every time I’ve worn it, I end up fussing in front of the full-length mirror trying to make it work. I can leave the hem all bunched up around my waist, which looks dumb because I look unkempt or like I haven’t quite finished getting dressed. I can tuck it in, but I hate tucking in shirts, and there are some things that just look plain silly tucked in anyway, or I can pull the shirt down over my cyborg parts, but that also looks dumb because it looks like I’m trying to conceal these conspicuous rectangular lumps. It’s akin to being big-busted, wearing a clingy top, and expecting people to not notice your boobs – or at least that’s how I imagine it would be if I were more top-heavy. Although I adjust and readjust the top in an effort to make it look OK, with this particular shirt, and actually with most if not all of these longer shirts, I end up leaving the hem pushed higher than it’s supposed to be worn in order to accommodate my pump and CGM, and I look frumpy. I wish I could just take the stinking pump off long enough to wear the shirt the way I think it’s supposed to be worn.

I know a young woman with a pump who used to talk about switching back and forth between the pump and syringes. I don’t know if she still does this, but I know she had been doing it a couple of years ago. From what I understood, her management was pretty good overall, but it seemed that alternating did create more BG excursions than she might have had otherwise, which is to be expected I think. She really didn’t like wearing a pump, but she conceded using it did make it easier to control her BG’s, so as much as I think she might have preferred the idea of only using syringes, she tried to wear it as often as she could tolerate. She went old-school with syringes as often as she thought she could for the sake of style and convenience though. I could never really figure out how anyone could easily go back and forth between the two regimens, but at that time, it wasn’t an option in which I was interested. I was happy wearing my pump, and other than the sundress issue, didn’t find that its physical presence was an issue.

When Jason and I had been to Aruba for our honeymoon back in 2004, I had religiously worn my pump, clipping it onto my swim bottoms even when I was in the pool or the ocean. I was still marveling at the device, wishing I hadn’t been so resistant for so many years to try one, and proud to show it off because I had only been pumping for six months at that point. I was still adjusting, learning how to fine tune things, so I wasn’t really in a position to go messing with things by removing my plastic pancreas, and I was OK with that.

Only once have I tried to take a “pump vacation”, when we were on vacation in Jamaica in December 2007. After we’d been there a day and a half or so, I wanted to be free of the device that was difficult to hide when wearing a bikini – and by difficult, I mean simply not possible. Although I had been fine with it in Aruba three years earlier, I didn’t feel like dealing with it on the beach in Jamaica. I had planned to give it a try, and in preparation had gotten a supply of 0.5 unit increment syringes, as opposed to the 1 unit syringes I’d always used before. The pump vacation was short-lived though. I didn’t go more than two full days before I was like, ‘screw this’, and reattached myself to it because my BG’s had been all over the place.

Peach Margarita

It would be hard enough to keep BG’s managed if I had tried it at home where my eating habits and general routine wouldn’t change, but on vacation, the amount of activity I was getting changed, I was eating foods I don’t typically eat, and what really killed me was drinking fruity tropical alcoholic beverages, something I almost never do ordinarily. The resort we like in Jamaica is all-inclusive though, which honestly, if you haven’t tried it, makes for the most fabulous worry-free vacation imaginable. I like fruity boozey drinks, they were included in the price of the vacation, and the words “I can’t, I’m diabetic” don’t spill out of my mouth often or easily. That’s an approach to life with diabetes that I can’t get behind. So, I drank pink flamingoes, pina coladas and hummingbirds, but I found that I needed to wear my pump to keep my diabetes semi-managed. Thus my experiment with a pump vacation didn’t work out as I had hoped.

I had really wanted to frolic without the machinery though. I was already self-conscious about the constellation of infusion set and sensor scars on my midriff, lower back, and upper thighs, making me look like I was contagious with something. After my trial pump vacation seemed to fail miserably, I tried just hooking myself up periodically to give a unit or two for basal as needed while we were on the beach, but that resulted in pretty wonky numbers too.

Don’t get me wrong – I love my pump, and I love that my BG’s are so much easier to manage with it than without it. Obviously, not wearing the pump at all for stretches of time defeats its very purpose, and seriously, heaven help the person that tries to take my pump from me because it has made such a fabulous difference in my overall quality of life. Now that the weather is getting warmer though, and I’m dressing accordingly, I miss the days of slipping on a sundress and sandals, and not having to strap equipment to my leg. I’d like to wear my too-long tank-top without fussing with how it looks with my pump, and I’d like to wear a swimsuit the way everyone else gets to wear one, without electronics clipped precariously to it. After cleaning my purse for all to see the massive heap of diabetes trash, most of which was pump litter, I miss having a meter case with a bottle of insulin and a syringe tucked neatly inside, and nothing more. I didn’t used to feel this way, but more and more, I want to be free of the devices without sacrificing the BG control I have. Is that even possible?

Today I decided to jump into the vlogging arena. I’ve been needing to clean out my purse because the collection of diabetes accessories and trash has become unwieldy to the point of being dangerous. So I settled onto the sofa with my bag to sort through it. I felt like my bag was a metaphor for my life. It looks normal on the outside for the most part, and certainly contains many normal things (i.e. loose change, wallet, keys, etc.), but when you dive in and examine the contents, it’s littered with all things diabetes.

Much thanks to Jason who helped me edit it. I forgot that YouTube will only allow videos that are less than 10 minutes long, and mine originally clocked in at just over 13 minutes. We trimmed little bits throughout to get it down to 9:58, so if it seems a wee bit choppy at times, that’s why. I can’t see myself making a habit of this vlogging thing, but if I happen to get any more ideas for it, I think it will be easier next time – especially if I keep it shorter than 10 minutes.

Today, I just have some tidbits and updates.

First, I got a message from my endo about the thyroid ultrasound. There’s nothing of concern, as everyone told me would likely be the case. I’m so grateful for all the comments and private messages I received regarding this because I was pretty freaked when he told me that he felt a lump. After all that reassurance, I felt more confident that it would be nothing serious, which is exactly what it is. I have some small cysts that have taken residence on my thyroid apparently. I haven’t had a chance to look up anything about what might cause this, but I was wondering if had anything to do with getting old? I’ve arrived at the obvious and rather unfortunate conclusion that I must be old now because the oldies radio station in Philly has been playing 80’s music much to my horror. Anyway, the doctor said that he’ll order more images in 6-8 months to see if there are any changes, and for now, I won’t worry about it, other than to be grossed out when I think about weird things growing in my neck.

In a post I wrote a couple of weeks ago about the pro-eatind disorder phenomenon, I mentioned a blog that had used a picture of me that was taken by an Associated Press photographer for an article for which I was interviewed a couple of years ago. The blog post in question focused on diabulimia and mocked people with eating disorders, specifically people who are pro-eating disorder. The sarcasm was pretty harsh, although I understand that it’s almost inconceivable that a pro-eating disorder phenomenon even exists. I probably wouldn’t mind if a photo of me was used in association with something positive, although ideally, I’d like to give my personal thumbs-up, but a photo of me used for something negative, even if it’s meant in jest wasn’t too cool. So I had emailed them, and asked them to remove the photo

I finally heard from them last week, and it was actually a very nice email. The girl said they had removed the picture, and she apologized for it having been an issue. My emails had apparently gone into their spam folder, which happens to me all the time (probably more than I realize, even though I try to check regularly). Seeing that I had linked to them, they found the emails, understood my concern, and removed the photo. They also added an addendum to the post, explaining that the message behind the post was really that being slim is fine as long as you do it in a healthy way because what’s the point of trying to improve your appearance if you’re too sick to enjoy whatever benefits might follow. While I took issue with the initial delivery, I can totally get behind that underlying message – if you want to lose weight, do it without compromising your well-being. Heaven knows I’m happier and healthier now that I’m taking care of my diabetes.

Much thanks to Serhorn for amending their post.

In case anyone missed the resolution to my BlogHer roomie drama, it has been resolved. The silliness started when a couple of girls invited me to room with them, and after one of them miscommunicated about the arrangement, they decided that they didn’t want me rooming with them. It was painfully reminiscent of junior high as several people observed in comments to that post (yes, my feelings were hurt, and I did cry because I’m just sensitive like that). Shortly after that post, I received messages from two different women looking for roommates, one of whom had a friend already included in her rooming arrangement. Now both the women who messaged me and the one woman’s friend will be sharing a room, so that part of the cost of the trip is going to be as minimal as possible since there are four of us, much to my delight. They seem super nice, and best of all, not flaky and drama-prone. I was excited about BlogHer when I registered, but now I’m looking forward to it even more.

We’re a nice eclectic bunch, which I totally dig, and I’m looking forward to meeting them in person and blogging about our BlogHer Conference adventures!
Verria from Good Health Coach
Heather from The Mother Tongue
busweet from My Kingdom for a Book

Lunch at Whole Foods with k2

I had the pleasure of meeting Kelly from diabetesaliciousness for lunch on Wednesday. We met at Whole Foods in Philly because they have such a fabulous prepared foods/salad bar area. As many of you out there who’ve had the marvelous opportunity to attend D meet-ups know, spending time with other diabetics is like no other experience. It comforts the soul, heals the spirit, and recharges the proverbial battery – and my battery has been drained so Kelly’s invitation was welcome.

I got an eclectic assortment of dishes from the hot foods bar – some kind of Indian chicken, Ethiopian veggies, a small serving of some kind of crazy rice with raisins in it. I also got a cup of triple squash soup, but I didn’t have room in my tummy for that, so I brought it home and ate it for lunch yesterday – it was heavenly. Kelly got a salad and an oatmeal cookie. We were there for over two hours talking about pump companies, jobs we have, jobs we’d like to have (working with diabetics of course!), health insurance, and all kinds of stuff. Kelly is great because even when she has too much on her plate, she’s willing to make time for lunch with a friend, and she exudes positive energy, which is especially good for me right now since the employment situation has had me discouraged.

Eventually, she had to be on her way for an appointment, so we snapped some pictures, hugged and she left. I, of course, ran back through the store to grab a few things, including some of my favorite cheese. Usually cheese is my primary motive for going to Whole Foods, but that day, much to my delight, it was the secondary motive – thanks to k2!

I hope everyone has a super weekend. It’s going to be in the mid-high 80’s and sunny here, so I see gardening and a walk to The Water Ice Factory in my immediate future. Should be awesome

Bling Bling

Our anniversary was great, and thanks to everyone for the good wishes! Allison had asked me to post about my impromptu wedding several months ago – long enough ago that she probably doesn’t remember asking – but I’d been saving the story because I knew yesterday would be the most fitting day to share it.

Jason actually came through with the traditional gift of wood (It wasn’t until I went back to proofread that I saw the multiple interpretations there. I didn’t it mean it like that, but it made me laugh so I left it as is). That is if you let it decompose into carbon, and then let geologic forces have their way with it for a million years or so. He got me diamond earrings! I‘m not much of a jewelry person for the most part. Usually, I wear my wedding set, and my Medic-Alert bracelet (bling bling, right!). I do have some costume jewelry that I love, but I don’t wear it unless I have a reason to get dressed up, which isn’t very often.

All that said, I like having a few simple, really nice pieces of jewelry. The earrings are small, but for something I can wear for any occasion or no occasion at all, they’re perfect. I love them, and I love that he’d apparently had this gift in mind for a few years, and was just waiting for the right occasion to surprise me. Jason actually doesn’t care either way about these sentimental occasions (anniversaries, birthdays, Valentine’s Day), but he knows I like them, and he always makes it awesome.

It's the Thought that Counts

He also got me a little LCD flashlight keychain, which might sound really lame, unless you’ve been diabetic forever and know how our ability to see, transitioning from light to dark and vice versa can be brutal. When we dine at restaurants, I’m always holding the menu to any light I can find. I’ve had to leave my seat to find light so I could read menus. I’ve almost set menus on fire, holding them up to candles. I can’t see the buttons on the car key at night so if I’m driving Jason’s car, which I don’t do often enough to remember how the buttons are situated, I’m popping the trunk when I mean to be locking it, I’m locking it when I mean to be unlocking it. So a flashlight keychain might not sound like much, but it is.

Now, my gift to him was kind of goofy, but I was really excited to give it to him. He told me not to get him anything since it’s not a big deal to him so initially I wasn’t, but a couple of weeks ago, my friend asked me to go to one of those pottery-painting places where you pick your bisqueware, apply the glaze, they fire it, and you pick it up like a week later. My bachelor’s degree is in ceramics, so this was kind of basic for me, but I accepted the invite. I figured I could make some kind of gift for Jason, and even though glazing isn’t one of my strengths – it’s working with clay that I love – I knew this would be therapeutic and fun.

Nothing Says 5 Year Anniversary Like a Robot

I saw the frame, and figured I could do something anniversary-ish with that, and then I saw the robot coin bank and fell in love with it, partly because it reminded me the robot from “Lost in Space”, and partly because it’s just super cool. The frame turned out OK, and nicely captures the idea of it being the thought that counts. The robot took forever to glaze because I wanted to get all the details and you have to do three coats of each color in order to get the brightest effect. It didn’t help that I didn’t have brushes that I like, but it never occurred to me to bring my own. Yes, it’s true that I’m a pretentious art snob who’s very particular about having just the right supplies and materials – but not so pretentious that I can’t get excited about slipcast robot piggy banks. I actually didn’t put quite enough glaze on it, but overall, I was happy with the final product. I should have just stuck with one project, but at the time, limiting myself to just two projects was difficult enough. My friend and I ended up being there for like 5 hours, and I could have stayed another two hours perfecting my projects, but both of us needed to get home. I thought the robot was a perfect gift because Jason is a geek and likes sci-fi, and it was just kind of quirky and weird and partially homemade. He seemed to like it, and really, I don’t know how anyone can not like a homemade gift. The robot and the picture frame were nothing fancy, but definitely gifts straight from my heart.

We went out for a late dinner at a place called Swanky Bubbles, the cuisine of which is strongly Asian influenced. We started off with dumplings stuffed with curry chicken, tofu and sprouts, served with a cucumber salad and sweet soy sauce. For an entrée, Jason had filet mignon served with wasabi mashed potatoes, greens and teriyaki sauce. I had Polynesian crab cakes presented with spicy Chinese mustard and a bittergreen salad. We don’t typically order dessert, but we splurged this time on cheesecake for me and vanilla ice cream for him. I also had one bellini which was champagne with peach Schnapps. It’s embarrassing what a lightweight I am because that one drink made me feel a little tipsy. The food was good, we had a nice time, and it made me happy to get dressed up and go out with my hubby to celebrate our 5th anniversary.

5 Years of Marriage