LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Thursday, January 19, 2006

The Art of Control

Yes, that is a direct and intentional plagiarization the Art of War by Sun Tzu. But he's long, long, long it's OK. But I chose to knock off the title for a specific reason. BG control is a war of sorts. A war that needs to be won with an artful approach, rather than a purely scientific one.

We now have a very important new weapon in the war to control our BG. One that requires new strategies and tactics, and a new mind set to use it to its fullest potential. So without further ado, Wil Print Tzu brings you: The Art of Control.

The first principal: Watch the flow of the water, not the stones in the stream. Don’t think about BG numbers; think rather about the motion of BG. Direction. Speed. Duration.

The second principal: Know that your house is built on sand. There is no true BG. It cannot really be measured and doesn’t need to be. BG does not matter. Only changes in BG matter.

The third principal: Use the crystal ball. Be proactive in your thinking. You can watch the flow. Now, you can think ahead. Plan ahead. Be ahead. Avoid surprises.

The fourth principal: Be a red state. In this case, it really is better red than dead. Use conservative alert thresholds. An alert means to listen. It does not mean you have to act. This means a high low and a low high. You’ll need to read that twice to get it, but you will.

The fifth principal: Calibrate in safe harbor so your readings are accurate in rough seas. Don’t calibrate your monitor when you are way out of your normal range or when your BG is shifting rapidly. For one thing, your test strips aren’t as good here, and for another the delays between you finger stick, your entry, and the calibration process all add up.

The sixth principal: Think deeply sometimes, think shallowly always. You should always be alert to your BG, but do not obsess 24/7. In your daily life stay aware but don’t micro manage. By the same token, set aside a hour or two per week to sit down and really study all the information that is available to you. Think about it deeply. Learn from it.

The seventh principal: Celebrate defeat. Even with the best technology has to offer, bad days will happen. We count carbs wrong. The infusion tubing tangles. The wind is from the west and the moon is in Leo and your BG does a mystery dance. Don’t be angry, sad, or frustrated. Take joy in being human with all our frailties and uncertainties. This is a game of averages, a bad day that doesn’t end in a coma is not the end of the world, and it won’t even screw with your A1C. Be right most of the time and you get to keep your toes and eyes.

The eighth principal: In this modern warfare we need fewer soldiers. In the new world order there are only three uses for test strips: Test strips are for insulin. Test strips are for emergency sugar. Test strips are for calibration. Other than these three times, they have no further use and are otherwise obsolete.

The ninth principal: Walk the field of battle after the fighting ends. Be the Monday Morning Quarterback. If you keep good records you have a great opportunity to learn from both your victories and your mistakes. Review battles lost and won. Read the map. Look at your traces. Search for patterns and connections. Use that information to plan for the battles ahead, for this is a never ending war.

The final principal: Be the lion tamer, not the lion. Control your D. Don’t let D control you. We’ve been managing our condition in a knee jerk fashion. We are reactive. Now we have the opportunity to take the reigns. To be proactive. To see what is coming, to plan, to manage. The Guardian is more than a Watcher. It is a Seerer. It can let you put two and two together. You eat the Egg McMuffin. You take the insulin. You watch the BG, first slowly snaking upwards, then suddenly shooting towards the sky like a rocket to the moon, now leveling off, begging for more insulin....With continuous, real time feedback you can see what is happening as it happens, take action with the flow of information, and stay on top.

A final note. This new technology, this new way of thinking about BG, this new way of treating ourselves: it will be a revolution. We stand at a moment in time where everything is about to change. And change for the better. I believe that in twenty five years most diabetics will carry some sort of advanced descendant of the Guardian, just as most of us carry our little BG meters today. The technology is good now and will only get better; and it carries a promise of a whole new approach to managing diabetes. Not just to treat, but to truly manage and control it. Short of a cure, what more could we want?


Blogger Allison said...

Wil, I hate you for leaving. But I love you for Everything you have given us. Thank you so much.

12:11 AM  
Anonymous Anonymous said...

Your blog has truly been very informative. You have obviously put in an enormous amount of thought, time, and effort. I have no doubt you will continue to succeed in your battle against such a stubborn foe.

Good luck with all of your future endeavors and here is wishing that in 25 years the guardian will merely be a display in a museum of how a no longer existent disease used to be monitored and treated.

7:09 AM  
Blogger Scott K. Johnson said...

Best post yet. I love it! Diabetes management is most surely an art and requires many shifts in perspectives to make good use of it.

You have artfully broken down some very valuable insights Grand Master Wil Print Tzu! This is truly a masterful post.

8:59 AM  
Blogger Ellen said...

So very eloquently stated Wil and you put gave us a beautiful perspective of something that can so often feel out of control.

Have you considered organizing/creating a New Mexico diabetes fest/conference - around balloon festival time in Albuquerque? We can all toss a spare meter into a hot air balloon basket, watch it launch, and give an entirely new meaning to "soaring blood sugars" :-).

You're a treasure and I thank you for your wisdom. I hope our paths will cross one day.

7:20 PM  
Anonymous JasonJayahwk said...

Sun Tzu's lawyers will be contacting you. ;-)
Good lessons, Wil. You could always post on a less frequent occassion. We wouldn't mind. I know your fingers can't resist.

8:27 PM  
Blogger Kerri. said...

You will be achingly missed.

And that email is coming, mark my words.

8:41 AM  
Blogger Kassie said...

Talk about going out on a high note! I am making a poster out of this last one, maybe even complete with inspirational photos of golf courses or something (hmmm, kidding, but I'd buy a print from you that had any one of these tidbits.)

I'm worried about preserving this info! Would you consider changing your blog settings to show 999 posts - that way it could be saved as a whole by interested readers, maybe archived at the OC or somewhere else. Just a thought.

9:18 AM  
Anonymous Doug Sur said...

I heard about your blog at a recent pump meeting. I can't wait to read the rest! Are there other blogs by other pumpers?

10:29 AM  
Anonymous Deb, mom to Anthony (age 4 & D) said...

Boo hoo:( I am sad you are ending your blog.

Thank you for keeping us informed along the way during your adventure with the Guardian. It was an excellent experience for all of us and I can't wait to get my hands on a CGMS system, whether it is the Guardian or the Navigator. I definetly will have better insight using it on my son thanks to you.

I have to echo anonymous' sentiments...lets hope in 25 years the Guardian is on display at one of the Smithsonian museums, with all the other trinkets we used to use when our kids (and some of us) had diabetes.

Health and happiness:)

6:11 AM  
Blogger Elizabeth Snouffer said...

Let us know how things go for you -especially when you complete your novel.
Yes, indeed, your blog was ginourmous - my 5 year old's fav expression.

Good luck.

9:14 AM  
Blogger FeatherIron said...

Excellent! Thank you. I look forward to getting a gardian for E.

7:08 PM  
Anonymous Anonymous said...

I'm a little mad. Medtronic, in order to keep up with prices from Dexcom, has lowered the price of their sensors from $40 to $35/each, and the ~$2,900 unit has been lowered to ~$999. This is to keep up with pricing from Dexcom and from their Minimed 522/722 pumps.

It is a painful reminder of how early adopters pay dearly. :-(

9:56 PM  
Anonymous Anonymous said...

Thank you for the blog. I found it late and am sad you are done. I will keep a printout of the final principles probably for decades. How about that for posterity?! Really, thank you, and the best to you.

7:10 PM  
Anonymous AmyT said...

Wow. I missed this post the first time. It has touched me.

10:25 PM  

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