I saw my podiatrist this morning. I try to go every two or three months because when I’ve tried to remove the unsightly, dead skin on my feet by myself, I’ve ended up with something even more unsightly, infected and painful, which has meant seeing her anyway. I decided skipping the intermediary steps of that process was in my best interest.

As she inspected, clipped, and buffed, we chatted. She asked me how the school counseling position is going, what kind of weekend plans I have, etc. She told me she’s going on vacation to Mexico next week, and expressed her concerns about the flu. She didn’t say whether or not she and her family had gotten shots, and I didn’t ask, but she said she’s bringing face masks to wear on the plane because she’s worried about H1N1. She admitted people might laugh or make fun of them, but she said she doesn’t trust airplane ventilation systems, and felt it was probable there would be someone on the plane with the virus. She then shared that there have been some cancellations from patients with the flu. I told her I wasn’t aware of any outbreaks at my schools, but that my friend’s son had it recently, and it had been making the rounds in her community.

Back during the summer when the fuss over swine flu was gathering steam, I was fairly worried about my chances of catching it since I planned to return to the school counseling gig. I considered not taking the job, especially when I found out I was going from 11.5 hours a week to 7 hours after the scary nun school didn’t renew their contract. On one hand, it’s not much money, and certainly not enough to risk my health. On the other hand, it’s more money than I’d be making to sit on my sofa and blog, and not taking it because of the risks of hanging out with potentially snotty, coughing, feverish children was a little paranoid, even for me.

News reports were only contributing to my uncertainly and concern about the flu. Once upon a time, news was intended to clarify, but that’s no longer the case. Now it’s intended to amass readers, so more sensationalistic headlines, especially for stories that already have people a little nervous, are the rule. I read a bunch of articles from a variety of sources, and I either figured out they were just trying to scare people, became desensitized to the issue altogether, or some combination thereof because eventually I kind of stopped caring.

I’ve written before about my irrational fear of dying, something with which I’ve really been trying to make peace since it’s going to happen eventually seeing how I’m not immortal as far as I can tell. My fear of death has probably driven my fear of getting the flu, but once I surmised that while the chances of dying from the swine flu might be higher than some other flu strains, they’re still pretty slim.

I also read an article by a doctor posted on Twitter, by JaimieH, I think, back in the summer. I’m drawing from memory so I might have the details a bit wrong, but as I recall, the doctor made some points about how going cuckoo-birds with vaccines and germ-phobia would likely facilitate a stronger mutated strain of the flu, and without any immunity to the current strains, a potentially stronger strain could be significantly more dangerous.

This resonated with me. I’ve never been germ-phobic. I don’t use hand sanitizer. I wash my hands after using the ladies room or if I’m doing something that causes my hands to be obviously dirty – gardening, cleaning, handling a squirming lizard – but I don’t wash them just for the heck of it. I’m careful about using alcohol to clean infusion and sensor sites, but I think that’s justified when you have something inserted under your skin for days at a time. Plus, I had a nasty staph infection at an infusion site a couple of years ago, and I’d like to avoid a recurrence. Besides that, I’m not a neat freak. I’m terrible about housecleaning. I’m not obsessed with bleaching and sanitizing surfaces. I wash my hair maybe three times a week because doing it everyday is bad for my hair. As long as I haven’t been sweating profusely, I don’t shower everyday because it’s better for my skin. If I drop food on the floor, I have a very generous 5-second rule, usually punctuated with an exclamation of, “A little dirt never killed anyone!”.

While I’m not rolling around in the mud like bacon-waiting-to-happen, I think dirt and germs and grime have merit. My evidence? Well, I’m sure favorable genetics have a lot to do with it, but I’ve never had asthma or allergies. I don’t get sick that often. I have days when I don’t feel so awesome, but full-blown infections and viruses with fever and vomiting and feeling like I’m on my death bed don’t happen to me so often *knock on wood*. Jason gets more nuisance upper respiratory infections and colds and the like, and I always tease him about it because he’s supposed to be the healthy one in this operation. I can’t say with absolute certainty that I’m less susceptible to illness, as it’s not based on anything more than my perception and anecdotal evidence, but I do think my appreciation for a few germs has a little something to do with it.

My immune system hasn’t exactly been a total ally considering it offed my beta cells, but as an adult, it’s served me fairly well. Because of that, and also because I don’t completely trust vaccines, I’ve avoided getting a flu shot every year that I’ve known it to be an option, save for one when I worked in a hospital. My coworker was going to get one, and I gave into peer pressure and went with her. I don’t recall having any kind of reaction to it, so it’s not like I swore them off due to a bad experience. I understand getting a vaccine for something like Polio which caused permanent physical problems for people once upon a time, but I honestly don’t put stock into getting vaccines for things like chicken pox, and once I overcame my paranoia about H1N1, I decided I’d likely be just fine skipping the flu vaccine.

So what am I doing to protect myself from swine flu since I’m a person with a supposedly compromised immune system due to chronic illness? Not a darn thing. When I see the endo next, I’m guessing someone will encourage me to get a flu shot, assuming they have them in stock, and I’ll politely decline or fabricate an excuse so they let it go. I think I’m pretty good at following medical recommendations usually, but even if Dr. Joslin came back from the dead, showed up on my doorstep, and advised me to get a flu shot, I still wouldn’t trust it. Maybe I’ll end up regretting it if I get sick, and I’ll definitely be miffed if I die. On the plus side though, at least I’m not ruminating and stressing over it. If I do get it, my immune system still owes me for this little case of type 1 diabetes, so I trust that it’ll take good care of me.

A couple of days ago, Allison sent me an email asking if I’d like to participate on a blogger panel discussion about health care reform. Allison knows this issue is a hot button with me, especially since my COBRA countdown clock only has 4 more months remaining. My biological clock is totally defective, but in its place, I have the ever-deafening din of the COBRA clock, tick-tocking away. Not that I wouldn’t still have the same opinions about health care reform, henceforth known as HRC, otherwise, but my current health insurance predicament has just served to underscore my passion and interest in the topic. As if having a chronic disease that will suck the life and financial security out of me weren’t already enough incentive to back HCR.

I had no other plans, other than a date with Jason on the sofa to watch Game 1 of the World Series, which I was bummed about missing, but I figured this was a pretty unique opportunity that wasn’t as amenable to TiVo as a baseball game. I agreed, procured the details, and got myself onto a train to Manhattan with many of my fellow Phillies fans who were headed to the game yesterday afternoon. I missed the train I meant to take since I have that chronically late problem, but luckily the next train was an express that put me into Penn Station only a few minutes later than the train I intended to catch. A cab ride later, and I was on my way up an elevator to drink Diet Coke (how I love diet soda!), eat cheese (how I love cheese!), and talk about our national healthcare trainwreck with an interesting collection of others with a vested interest in the outcome of HCR.

The event itself was the Green Family Foundation Blogger Roundtable on Access to Healthcare. Kimberly Green, President of GFF, spoke about her philanthropy and advocacy work here in the US and in Haiti, and she shared her own experience as a woman living with stage 4 breast cancer. While fortunate to have the financial resources to pick up where her insurance company has abandoned her, as they so often like to do, she knows all too well that most people don’t have the same financial means, so she’s working to make healthcare more accessible. The discussion was moderated by Eve Gittelson, aka NYCEVE from the Daily Kos who is a prominent healthcare blogger and expert, and also one of the forces behind Public Option Please.

I’m still processing what was discussed, and the organizers will be putting together some video, and sharing the website URLs of the various attendees, so I’ll be posting more about it when those pieces fall into place, but there was one issue in particular that I wanted to highlight now since health care reform legislation is moving forward at a pretty good clip, and because it has everything to do with the prescriptions we take. Maybe Lantus, Humulin, Humalog and Novalog ring a bell with you? Unless you’re taking medical advice from people like Khaki Pants and Red Peacoat, medical professionals, and I use that term oh-so-loosely, who quite frankly, I wouldn’t let manage the diabetes of my friend Allison’s newly diagnosed diabetic cat, then you likely take one or more of those insulins.

You see, today’s insulins are part of a category of medications called biogenics which are produced from living organisms. Our favorite gate keeper to life with diabetes, Big Pharma, has conveniently lobbied to attach a little amendment, the Eshoo/Barton amendment, to HCR legislation that’s currently under consideration that would essentially make it forever, give or take a year, until we saw generic versions of the stinky liquid in the glass bottles that keeps us alive. No generic versions of the medications that we’ll be injecting until we take our last breaths mean their pockets will be generously lined for a very long time. As if poking our fingers upwards of 10 times a day to check our BG’s (on test strips that are a dollar a prick no less) weren’t enough bloodletting, they are determined to make sure we’ll be bleeding from our wallets until the end of days too.

We need to contact our lawmakers, and let them know we are not OK with this amendment. We need to let them know that as people with a very expensive life-long chronic disease, we can’t afford to rely on brand name medications for the rest of our lives. This legislation makes no sense to anyone but Big Pharma and the legislators who are in bed with Big Pharma, to be semi-polite about it. Why the heck should these giant corporations with their overpaid executives get so much protection? If anyone deserves some protection, it’s those of us who are stuck managing diabetes every minute for the rest of our lives. Please, read more about this. You can read Eve Gittelson’s assessment, and she provides plenty of additional links so you know what’s up, and just how ridiculous this little amendment is. Please, blog about it, tell your friends and family about it, ask people to call and email their legislators. Tell them we depend on these medications and we can’t afford to maintain the newer generation of insulins as brand names indefinitely.

Edit: Scott at Scott’s Web Log offers a more thorough discussion of the issue of generic biogenics that should be helpful to anyone who wants to communicate with their legislators any concerns about how to facilitate the availability of generic insulins, preventing Big Pharma from continuing to take advantage of our finances without compromising patient safety.

Yesterday was a busy day with my monthly meeting with my art therapy supervisor, plus a staff meeting for the school counselor program for which I work two mornings a week. I had a couple of hours in between, happened to be passing by a Target on the way home to grab a quick lunch, and still needed to stock up on trick or treat candy, so I figured I ought to pick up some before the choices dwindled to Dots and Whoppers, which are no-go’s in my house.

Target had a plentiful selection. Last year, we got one of those massive variety bags, but there was a disproportionate balance of candies that I like and candies that Jason likes. I browsed the variety bags, and some were so close to meeting our preferences, but just not quite close enough, so after ruling out all the options, I decided to go piecemeal. Of course, I can imagine someone is reading this, thinking, “But the candy isn’t even for YOU! It’s for trick or treaters, so why does it matter what the two of you like??” I beg to differ. It most positively matters, and to suggest otherwise is utter nonsense. Unless we run out of candy, which we never have, we plan to eat the leftovers, so it may as well be candy we like. Furthermore, since we don’t have kiddies, we’ll never have the pleasure of surreptitiously skimming pieces off the top of their stash, and obviously, we’re a little old to go trick or treating ourselves, so this is the only way we get to have our own trick or treat candy.

When You Trick or Treat at the Thills

So I walked up and down the candy aisles, first to assess the choices, and then I went back and carefully selected a variety that would hopefully delight both the trick or treaters and us. 100 Grand, Nestle Crunch, Reese’s Cups, Kit-Kat, Milky Way and Twix for us both, Twizzlers for Jason, and Heath Bars for me. I think I might have overdone it, but I get paranoid every year that I haven’t bought enough goodies, despite, as I already said, that our costumed visitors have never depleted our supply. I’m just an awful judge of that, so I err on the safe side and buy enough bags of candy to sink the Good Ship Lollipop.

Now, based on the plentiful links I’ve seen to articles and posts all over the DOC about how to have a D-friendly Halloween, I’m starting to think my laissez faire, it’s-Halloween-so-enjoy-the-candy attitude is not shared by many, although maybe that’s not an accurate reflection. I think every family has to determine what works best for them by weighing the pros and cons of different approaches. I don’t mean to dismiss or discount more conservative approaches, but personally, it makes me cringe that diabetic kids get singled out or treated differently at Halloween because in this day of BG meters, analog insulins, pumps and CGM systems, I think diabetic kids can indulge in the festivities just like any other kid, albeit with some slight modifications.

Obviously, eating a ton of candy isn’t good for anyone, but if a parent would be OK with letting a non-diabetic kid eat 6 pieces of candy (or whatever limit seems reasonable) on Halloween since it’s not like they do that every day, then why should a diabetic kid be treated any differently? The carb counts for candies are readily available online from a variety of sources, so there’s no need to guess. Candy is food like any other. It’s not good or bad. It’s just food, and when it’s part of a generally healthy, varied diet, there’s no reason to forbid it or make it taboo. In the end, labeling it, either implicitly or explicitly, as a bad food, could completely backfire.

Recently, I was looking though the search terms that people used to arrive here, as I like to keep a list of the more entertaining ones, and I saw something like, “what to do with diabetic kids on Halloween.” Sometimes I wish I could just send emails directly to the sources of search terms, and this was definitely an instance of that. In case the individual comes looking again, here’s what I would like to say:

Dear Diabetic Child’s Parent or Loved One,

You asked what you should do with your child on the candiest of candyful holidays, and I would like to offer my thoughts on this matter, one that is near and dear to my heart since I was once on the receiving end of boxes of raisins, black and orange pencils, judgmental stares, and pitiful looks.

Let your kids go trick or treating. Let your kids enjoy the occasion and have fun. Let your kids be like the other kids. Remember that your kids have had and will continue to have moments every day of their lives when they feel different, when they have to sit during recess because their BG is low, when they have to go to the nurse’s office at school, when they have to check their BG, when they have to take a shot. Maybe they wear a pump, and will forever be fielding questions about what it is and what it does. They’ll be reading nutrition labels before other kids even know the difference between proteins, fats and carbohydrates. Your daughter will have to consider how she’ll wear her pump when she dons a prom dress, your son will have to figure out how to carry all of his D supplies. The reminders are never ending, and most of the time, they are barely blips on the radar. We do our diabetes stuff and manage the intrusions as seamlessly as possible. However, sometimes they add up, and we realize how diabetes makes us and our lives different. We recognize that other people’s concepts of future aren’t littered with fear and uncertainty to the same extent. Even when we have more D friends than we can count online, and we have more resources than we ever imagined, we still feel sad and alone. Hopefully, those times are infrequent, but they happen nonetheless.

So what’s so wrong with sending your kid out the door to trick or treat, with a gentle reminder to check their BG and hang onto any candy wrappers so you can help them figure out the carbs when they return? I can’t really think of a better time to model good real world diabetes care. Why do they need special snacks or sugar-free candy, which is yucky anyway, and not only effects BG’s, but can cause some pretty rotten stomach problems? Let them have the candy they like! Let them trade those icky Whoppers for some awesome Milk Duds with their friends! Foster a healthy attitude about how to enjoy treats in moderation. Validate that special occasions are fun to celebrate, and diabetes shouldn’t be a reason to be excluded or held to different standards. Reserve the raisins to bake oatmeal cookies when it’s closer to the holidays, forget lame pencils, save the judgmental scowls and pitiful frowns, and instead of making the occasion fit the diabetes, make the diabetes fit the occasion because every kid deserves a memorable Halloween with creative costumes, trick or treating tales, and glorious gooey goodies.

Respectfully,
Lee Ann
31 Diabetic Halloweens… and counting

Yesterday I gave you a peek under the dress I wore to the wedding… so to speak, but the diabetes fun didn’t start and stop there. Somewhere on the Pennsylvania Turnpike, I found myself in need of a juicebox because sitting in the car and twittering is apparently a strain. Then when we were within 10 minutes of our destination, I was low again, so I fumbled to pull another juicebox from the plastic shopping bag behind my seat. I turned my basal rate down, knowing we would be there shortly, and we’d be unpacking the car. I had reserved the room under my name, but as we stood at the check-in desk, and I sifted through my wallet looking for the drivers license that I had apparently left at home, I was having some difficulties processing what the clerk or Jason was saying. Hypoglycemia plus multitasking is an inevitable fail. Jason recognized the no-one-is-home expression on my face, and proceeded to get us registered with keycards in hand.

We pulled around to the other side of the hotel, and parked, Jason, anxious to get out of the car and relax after most of the day in the car. I tried to gather a few things because I always feel guilty when my blood sugar is low at such inopportune times. Jason asked repeatedly if I was OK to help. My guilt and stubbornness won out over common sense, and I insisted I was fine as I grabbed as much stuff as I could. I saw a set of stairs inside the glass door, and hoped there was an elevator hiding somewhere. We didn’t see one though, so I concentrated on picking one foot up, then the other, rinse, repeat, while trying to not fall forwards, or worse yet, backwards. Eventually, I made it to the top, and trudged down the hall to the room, and once inside, I sunk onto the bed.

Within about 10 minutes, I was feeling human again, and after hanging some clothes up, and organizing our stuff, I settled onto the bed to relax for a few before we headed back into the rain. The plan, as I told you last week, was to get ice cream sundaes that night to celebrate my D-anniversary. After we ventured out in the pouring rain to do some quick shopping, we set out to get dinner. We had passed a string of chain restaurants on the highway between our hotel and shopping destination, so we decided to go there and see what appealed most to us.

Mexican, Italian, BBQ, pizza and skeeball, or burgers. All no. Japanese, yes. A Friday night at an obviously busy and popular shopping center was going to mean some sort of wait. The waitress asked if we wanted table service or hibachi, and we said either in hopes of getting a table sooner, which ended up working , or so it seemed, as we were escorted to a table, leaving people who’d been waiting when we got there at the entrance to huddle in the cold, damp air that rushed in every time the door was opened.

Jason got filet mignon teriyaki, and I got a bento box with vegetable tempura, sashimi, shrimp teriyaki, and seaweed salad. Not so long before I polished off my dinner, Jason asked about getting sundaes. I had completely forgotten. Ugh. It was creeping up on 9PM, we still needed to get to Target before they closed, and I hadn’t saved room in my tummy so dessert was the last thing I wanted. I like my holidays and occasions and associated traditions and rituals though, so even though Jason assured me we could find time Saturday or Sunday to get ice cream, I was pretty bummed, and annoyed with myself for having forgotten amidst the disruption of traveling.

With ice cream on the back burner, we were off to Target, and then back to the hotel. I checked my BG, and it was 168mg/dL, so not horrible. Accounting for the carbs in the teriyaki sauce and tempura was a pretty wild guess, but it seemed I hadn’t done such an awful job.

Now, I should add, I was wearing my CGM, the very last of my sensors that I had inserted before leaving that morning. I’m still trying to figure out if Horizon Blue Cross/Blue Shield of New Jersey is going to cover another shipment, something I’ve been calling them about at least a couple of times a week for the last two months. Because I hate to run out of sensors, and because I try to make my supply last as long as possible because every time I try to get a new supply, Horizon is [crude expletives] about it, this last sensor was from the supply I had received last January I think. Thus it had expired in June, and thus, it was clearly not working, the monitor having been holding steady at about 140mg/dL for the entire afternoon. So while I was wearing it, it wasn’t giving me accurate information, so I was pretty much stuck with figuring out what direction my BG was headed old school style.

Half an hour later, I checked again. 192mg/dL. I took some insulin even though I had some on board because my BG was not going in the right direction. An hour later, I was 199mg/dL, and I was getting a little annoyed, so the rage bolusing began, and 30 minutes later, I was 138mg/dL. I naively hoped it would settle there, and we went to bed.

About 3AM, I woke up, and I was 46mg/dL, so I drank some juice, and went back to sleep. My BG was just under 200mg/dL when we got up later Saturday morning. The wedding was early in the afternoon, and on the way to the reception, I felt low, so I popped some peppermints. Dinner was served, I bolused, and early in the evening, I checked my BG. 347mg/dL. Argh. I bolused. I checked my BG again, I bolused again. A few times. We left the reception about 8PM, and discussed whether or not to get ice cream. Neither of us were hungry, and my BG was still uncooperative, so we headed back to the hotel room, deciding we’d hang out there for a bit, and see if we wanted ice cream later. Ultimately, the ice cream didn’t happen, but my BG came down. At 10:57, it was 65mg/dL. I treated it. At 11:44, it was 59mg/dL. I drank a juicebox, and ate some Rolos and cookies. At 12:25, it was 62mg/dL. I knew eventually the carbs would do something, so I went to bed.

In the early morning, I awoke to the distinct taste of high blood sugar, so I took a couple of units, and when I got up later to get dressed, and ready to go to breakfast, I was 226mg/dL. I had a very carby breakfast, but bolused conservatively, and about 30 minutes later, as we stood inside the entrance to the Football Hall of Fame, I felt low. I stayed low for a good hour, popping peppermints along the way. We stopped briefly so I could sit and check my sugar.

“I thought of a name for my blog post about the weekend.”
“Oh?”
“Ohilo. I love me a pun.”
“That’s actually very clever.”

And so the post about the weekend had a title before it was even over. Not wanting to sit and rest for long because time was an issue since we still had to drive home, I insisted I could continue despite being 59mg/dL, and crunched on more candies. I think I must have eaten 15-20 candies while we were there.

From the Hall of Fame, we headed home. My BG hovered between 260 and 290mg/dL for the first few hours of the ride home. We stopped for lunch just north of Pittsburgh, with plans to get ice cream after lunch, but again, my BG had other plans. Jason knew my BG had been problematic all weekend, and he also knew getting sundaes was really important, and that I had been disappointed we’d yet to fit them into our trip. He offered to go straight to Friendly’s before we even went home. I knew he was tired form driving, I knew it hadn’t helped that I didn’t have my drivers license with me so he had been stuck with all the driving. I told him we should just go home, but he insisted we get ice cream, emphatically declaring he wanted a sundae, and we were going to get them.

So we did. As we pulled into the Friendly’s parking lot, I could feel my BG was a little low, so the timing was perfect. Finally. He got a strawberry shortcake sundae. I deliberated between a Kit-Kat sundae and a peanut butter banana sundae, finally opting for the latter. We took pictures, and I finally celebrated my 31 years. Diabetes won a lot of the battles last weekend, but I’ll be damned if I’m going to let it win the war.

As I told you on Friday, we went to a wedding over the weekend in Ohio. It took us about 8 hours after getting snarled in traffic in Philly, stopping for lunch, and a couple of other pit stops. If you follow me on Twitter, you likely noticed I entertained myself by tweeting a good portion of the way, which was really nice because my twitter activity has been a little spotty lately. My blog reading has been even more lax, so I tried to read a few blogs, but didn’t make a lot of headway with that because I started feeling a wee queasy.

One of the posts that I caught was Amy’s thoughts on the complications of being a chick and having diabetes. Now, I know there are some things about being a dude and having diabetes that are comparably craptacular. For all of the men who don’t tote a murse of some kind, it amazes me that any guy can keep all of his pre-requisite diabetes supplies in addition to basic necessities like a wallet and keys in nothing more than his pockets. I don’t even like putting my pump in my pocket because I think it looks lumpy, so the idea of cramming my meter, strips, lancing device, candy or glucose tabs, and a pump or pen or insulin bottle with syringe in my pockets is unthinkable. My point though is that I know men have their own set of issues in managing life with diabetes, so it’s not my intention to suggest that’s not the case. I’m not a dude though, so I can only speak about the troubles of being a woman with diabetes with any degree of authority, and as an authority on the matter, Amy’s post elicited lots of nods and that face I make when I agree with an unfortunate and inescapable truth. DiabetesMine is in fact a gold mine of straight talk and encouragement – and accurate accounts of how frustrating life can be with diabetes when you have two X chromosomes.

Pump Garters, Thigh Thing & Leg Thing

When we were about an hour from our destination, it suddenly occurred to me that I had forgotten to bring a critical undergarment to wear under my dress – a pump accessory. I have several different accessories I use when I wear dresses: a couple of different garter pouches, a leg thing, a couple of thigh things, one of which is beat to heck and I keep meaning to replace. They’ve served me well, and while I hate wearing them, I love wearing my pump enough that I tolerate it. While I don’t wear dresses as often as I did once upon a time, partly because wearing a pump with them is a hassle, I’ve had marginal luck with some other solutions, so I’ve stuck with the pump accessories because they generally work.

When I realized I had left this necessary item at home, my mind started spinning, trying to figure out a solution. It’s not like you can just run to Target and pick up a spare pump garter the way I would if I had forgotten to bring extra underwear or something. Pump accessories are made by small companies. Some of the ones I’ve gotten over the last 5 years are clearly handmade. All have been ordered online. I needed something the very next day, so I was going to have to make do without a garment specifically designed for concealing a pump. Quicker than you can say, “Diabetes sucks,” I whipped out my crackberry and fired up Twitter, Amy’s post ringing oh-too-true, but also holding the key to a possible solution. I’m an authority on being a woman with diabetes, but I’m far from the only one. I have countless DOC female friends who are also authorities, and surely one of them would have a suggestion.

So I tweeted, and the responses started to pile up. Several people suggested I stash it in my bra, which I know is a very popular, easy and common solution for pump-wearing ladies who want a discreet place for their plastic pancreas. If only. I am not, um, gifted in that area. I have stood in front of the full length mirror on numerous occasions, as if performing this ritual would somehow be different from the last time I did it. I’ve tried on bras with and without wires, with spaghetti straps, with wide straps, bras with front hooks, bras with back hooks, pullover bras with no hooks at all, and bras with and without padding. I’ve turned my pump up, down, sideways, frontwards and backwards, on my left side, on my right side, and right in the place where the powers that be didn’t give me cleavage. I either have a mutant rectangular lump under my armpit, or I have a mutant rectangular third boob in the middle of my chest. After much experimenting, I can assure you that the bra trick only works if you are of a certain size, and I am not that size. My chest is what it is. It’s mostly proportionate to the rest of me, and it does have its advantages, or so I convince myself since I don’t have $25K to get bigger ones, but it is not, and will never be an insulin pump depository.

Of course, I initially had no intention of wearing a bra at all because one of those aforementioned advantages of being as I am is that I can get away with such a wardrobe omission. As it turned out, I did end up wearing one because I had one that didn’t peek out from under my dress, and I was worried about being freezing so I was looking for extra layers wherever I could get them. Bra or not though, I needed another solution.

There was the suggestion to make one, but that wasn’t a practical solution as (a) I was in a hotel room in (b) an unfamiliar town with (c) limited time, and (d) not enough skill constructing anything with elastic in it to buy the best materials and make something that would serve its purpose without either cutting off the circulation to my foot or being so loose, I’d end up having to hike it up every time I took a step.

A couple of other friends suggested stockings, one specified thigh highs. Now, I have to say that thigh highs are fabulous for keeping a pump under a dress if they’re the stay-up kind with the rubber strips to keep them in place. As long as they have wide bands (I prefer the ones from Victoria’s Secret, personally), put the pump on your leg under the band, and it should pretty much stay put. Once I did that, and I found it slipping down, but I was walking around in Philly, and it was a warm day so I think the movement and the sweat thwarted me. I have also tucked my pump into the top of control top stockings, to the inside of my hip bone, and that’s been an effective solution too. However, the problem was that I was planning to wear open-toed shoes with my dress, and stockings with open-toed shoes looks funny, so that wasn’t going to work either.

Allison suggested a girdle. At first, I wasn’t warming up to the idea. I knew I was going to have to buy something, but I was looking to do it on the cheap, and girdles can be pricey. I also cringed at the idea of something binding like that around me. However, it was the most feasible of suggestion given the circumstances, so I didn’t dismiss it. I also wondered if I might be able to do something with a ace bandage, so that also got on my list of possible solutions.

We checked into the hotel, chilled for a bit, then went to do some other shopping, and grab dinner before we hit Target, where I figured I’d find something to use, even if it was Allison’s first suggestion of duct tape. The women’s underwear section was our first stop. I was glad to have had Twitter to gather ideas from my lady friends in the DOC, and wished I’d had one or two of them with me as I compared various girdle type garments, and stupidly tried to elicit some opinion or response from Jason who looked at me like I had just started speaking Latin. As I expected, even though we were looking at Target where clothing is affordable, the underthings I was inspecting ran a little more than I wanted to spend for something I would rarely, if ever wear again. Some of them definitely had the look and feel of a straightjacket for one’s crotch, so I decided to keep going and hope for something that suited me better.

We then came across the Assets brand of underthings. I don’t know if the brand is exclusively Target’s, but that’s the only place I’ve ever noticed it. I always laugh to myself when I see it because the double entendre is not lost on me, and I’m not ashamed to say that sometimes I have the sense of humor of a 12-year old. I knew they had more than just regular stockings, so we started looking at them. I pulled one thing off the rack that was footless so would work with my shoes. Since there was an open package already, I took enough of it out to examine the waist, and after pulling on it to determine how constricting it felt, I put it back. It seemed like it would dig right into me and cut me clear in half. Jason asked what size I needed, and when I said I didn’t know, he logically suggested we figure that out, find one that was the right size, and then I could more accurately determine if it was going to meet my needs. He couldn’t offer much of an opinion about which product might work, but at least he could look through the racks to find the style and size I wanted.

I finally opted for one that more or less fit like bike shorts, sitting lower on the waist than the first style I’d pulled from the rack, and going down to mid-thigh or so. I wasn’t feeling so confident though having spent too much money on undergarments that ended up being enormous failures in the past, so after grabbing a couple of other things, we stopped to pick up an ace bandage before heading to the cashier. Once back in the hotel room, I took out the article of clothing to inspect all of its unsexy glory, and then give it a trial run. There’s nothing quite as ungraceful, or ironically enough, unladylike as putting on stockings, despite what you may have observed in movies or on TV, but I got it on, fussed to untwist it and get it in place. I slid the pump into the left leg, and walked around the room to see if it felt like it was going to budge, and it seemed completely stable. I sat down to see if it was going to cut into me, and it wasn’t too binding, so I stood up, and declared it the official solution.

Saturday, I wore it without any issues, even when we danced. It was actually easier to get to it than it would have been had I worn one of my pump garters, which is what I had intended to bring with me to wear. Although in the end, hiking up a dress and reaching up between one’s legs to grab a pump always looks pretty questionable. Overall, I was happy with it. I don’t think I’d wear it unless I was without any other options if it were a hot day, which is when I actually prefer to wear dresses, but on a day that’s only slightly warm or even cool, as it was Saturday, it totally worked. Now, if only they’d make test strip bottles a little less bulky so I wouldn’t have to play Tetris to cram my diabetes stuff into my evening bag with my lipstick.

Amy, I’m so on the same page with you. Having diabetes when you’re a girl is awfully complicated.